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Rituximab og Bendamustine Hydrochloride, Rituximab og Ibrutinib eller Ibrutinib alene til behandling af ældre patienter med tidligere ubehandlet kronisk lymfatisk leukæmi

21. oktober 2026 opdateret af: National Cancer Institute (NCI)

Et randomiseret fase III-studie af Bendamustine Plus Rituximab versus Ibrutinib Plus Rituximab Versus Ibrutinib alene hos ubehandlede ældre patienter (>/= 65 år) med kronisk lymfatisk leukæmi (CLL)

This randomized phase III trial studies rituximab with bendamustine hydrochloride or ibrutinib to see how well they work compared to ibrutinib alone in treating older patients with previously untreated chronic lymphocytic leukemia. Rituximab is a monoclonal antibody that may interfere with the ability of cancer cells to grow and spread. A monoclonal antibody is a type of protein that can bind to certain targets in the body, such as molecules that cause the body to make an immune response (antigens). Chemotherapy drugs, such as bendamustine hydrochloride, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Ibrutinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. It is not yet known whether rituximab with bendamustine hydrochloride may work better than rituximab and ibrutinib or ibrutinib alone in treating chronic lymphocytic leukemia.

Studieoversigt

Status

Aktiv, ikke rekrutterende

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

PRIMARY OBJECTIVE:

I. To determine whether progression free survival (PFS) is superior after therapy with bendamustine hydrochloride (bendamustine) in combination with rituximab, ibrutinib alone, or ibrutinib in combination with rituximab in patients age 65 or older with previously untreated chronic lymphocytic leukemia (CLL).

SECONDARY OBJECTIVES:

I. To determine 2-year PFS in each of the three treatment arms. II. To determine which treatment arm produces superior overall survival (OS). III. To determine the complete response (CR) rate, complete and nodular partial response (CR/nPR) rate, and overall response (PR+nPR+CR) rate (ORR) among the three treatment arms and compare these arms.

IV. To determine the impact of minimal residual disease (MRD)-negative disease at time of CR documentation and at 2 years on PFS and OS in each of the treatment arms.

V. To determine duration of response after each of the three treatments and compare these treatment arms.

VI. To determine toxicity and tolerability of the three treatment regimens. VII. To determine response and PFS of patients initially on the bendamustine in combination with rituximab arm who cross over to ibrutinib.

OTHER PRE-SPECIFIED OBJECTIVES:

I. To determine whether baseline cytogenetic markers, Zap-70 methylation, IgVH mutational status, or select deoxyribonucleic acid (DNA) mutations predict outcomes or time to response in these three arms.

II. To determine whether local fluorescence in situ hybridization (FISH) results for del(11q22.3) and del(17p13.1) are consistent with central analysis.

III. To determine whether baseline micro ribonucleic acid (RNA) and gene expression markers are correlated with clinical outcomes of interest (e.g. progression-free and alive at 2 years versus not), as well as to explore changes in microRNA expression from baseline to post-treatment time points, with a focus on those with persistent lymphocytosis and relapse.

IV. To determine whether eradication of MRD predicts longer duration of response with standard therapy and ibrutinib-based regimens.

V. To describe the baseline functional status, comorbid medical conditions, and number of medications of older CLL patients who meet criteria for therapy.

VI. To determine how functional status changes with therapy using baseline to 3-month evaluation and end-of-study/2-year evaluation; to determine whether this change is different among the treatment groups.

VII. To determine whether geriatric assessment variables known to be associated with chemotherapy toxicity in other disease groups can also predict therapy-associated toxicity in the CLL population.

VIII. To assess whether the FCGR3A polymorphism (rs396991) is correlated with depth of response (MRD status) to ibrutinib plus rituximab after 6 cycles, with secondary endpoints CR rate, rapidity of response, and progression-free survival (PFS).

IX. To assess whether C1QA polymorphism (rs172378) is correlated with MRD status, CR rate, rapidity of response, and PFS.

OUTLINE: Patients are randomized to 1 of 3 treatment arms.

ARM I: Patients receive rituximab intravenously (IV) on day 1 (day 0 course 1) and bendamustine hydrochloride IV over 30 minutes on days 1-2. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover to Arm II.

ARM II: Patients receive ibrutinib orally (PO) daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

ARM III: Patients receive ibrutinib as in Arm II. Patients receive rituximab IV on days 1, 8, 15, and 22 of course 2 and on day 1 of courses 3-6. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and computed tomography (CT) throughout the study.

After completion of study treatment, patients are followed up every 6 months for up to 10 years.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

547

Fase

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 5G2
    - Arthur J E Child Comprehensive Cancer Centre
- New Brunswick
  - Moncton, New Brunswick, Canada, E1C 6Z8
    - The Moncton Hospital
- Nova Scotia
  - Halifax, Nova Scotia, Canada, B3H 2Y9
    - QEII Health Sciences Centre/Nova Scotia Health Authority
- Ontario
  - Greater Sudbury, Ontario, Canada, P3E 5J1
    - Health Sciences North
  - Hamilton, Ontario, Canada, L8V 5C2
    - Juravinski Cancer Centre at Hamilton Health Sciences
  - Kingston, Ontario, Canada, K7L 2V7
    - Kingston Health Sciences Centre
  - London, Ontario, Canada, N6A 4L6
    - London Regional Cancer Program
  - Newmarket, Ontario, Canada, L3Y 2P9
    - Stronach Regional Health Centre at Southlake
  - Oshawa, Ontario, Canada, L1G 2B9
    - Lakeridge Health Oshawa
  - Ottawa, Ontario, Canada, K1H 8L6
    - Ottawa Hospital and Cancer Center-General Campus
  - Toronto, Ontario, Canada, M4C 3E7
    - Michael Garron Hospital
  - Toronto, Ontario, Canada, M5G 2M9
    - University Health Network-Princess Margaret Hospital
  - Toronto, Ontario, Canada, M4N 3M5
    - Odette Cancer Centre- Sunnybrook Health Sciences Centre
  - Toronto, Ontario, Canada, M3M 0B2
    - Humber River Hospital
- Quebec
  - Greenfield Park, Quebec, Canada, J4V 2H1
    - CSSS Champlain-Charles Le Moyne
  - Montreal, Quebec, Canada, H3T 1E2
    - Jewish General Hospital
  - Montreal, Quebec, Canada, H2W 1S6
    - McGill University Department of Oncology
  - Montreal, Quebec, Canada, H2X 3E4
    - CHUM - Centre Hospitalier de l'Universite de Montreal
- 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
- Alaska
  - 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
- Arizona
  - Phoenix, Arizona, Forenede Stater, 85054
    - Mayo Clinic Hospital in Arizona
  - Scottsdale, Arizona, Forenede Stater, 85259
    - Mayo Clinic in Arizona
  - Tucson, Arizona, Forenede Stater, 85719
    - Banner University Medical Center - Tucson
  - Tucson, Arizona, Forenede Stater, 85719
    - University of Arizona Cancer Center-North Campus
  - Yuma, Arizona, Forenede Stater, 85364
    - Onvida Health Yuma Medical Center
- Arkansas
  - Hot Springs, Arkansas, Forenede Stater, 71913
    - CHI Saint Vincent Cancer Center Hot Springs
  - Jonesboro, Arkansas, Forenede Stater, 72401
    - NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
- 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
  - Concord, California, Forenede Stater, 94520
    - John Muir Medical Center-Concord
  - Davis, California, Forenede Stater, 95616
    - Sutter Davis Hospital
  - Duarte, California, Forenede Stater, 91010
    - City of Hope Comprehensive Cancer Center
  - Fontana, California, Forenede Stater, 92335
    - Kaiser Permanente-Fontana
  - Fremont, California, Forenede Stater, 94538
    - Kaiser Permanente-Fremont
  - Fresno, California, Forenede Stater, 93720
    - Kaiser Permanente-Fresno
  - Greenbrae, California, Forenede Stater, 94904
    - Marin Cancer Care Inc
  - Greenbrae, California, Forenede Stater, 94904
    - Marin General Hospital
  - Harbor City, California, Forenede Stater, 90710
    - Kaiser Permanente South Bay
  - Irvine, California, Forenede Stater, 92618
    - Kaiser Permanente-Irvine
  - Los Angeles, California, Forenede Stater, 90048
    - Cedars-Sinai Medical Center
  - Los Angeles, California, Forenede Stater, 90027
    - Kaiser Permanente Los Angeles Medical Center
  - Los Angeles, California, Forenede Stater, 90034
    - Kaiser Permanente West Los Angeles
  - Modesto, California, Forenede Stater, 95355
    - Memorial Medical Center
  - Modesto, California, Forenede Stater, 95356
    - Kaiser Permanente-Modesto
  - Mountain View, California, Forenede Stater, 94040
    - Palo Alto Medical Foundation-Camino Division
  - Mountain View, California, Forenede Stater, 94040
    - Palo Alto Medical Foundation-Gynecologic Oncology
  - Novato, California, Forenede Stater, 94945
    - Sutter Cancer Research Consortium
  - Oakland, California, Forenede Stater, 94611
    - Kaiser Permanente-Oakland
  - Palo Alto, California, Forenede Stater, 94304
    - Stanford Cancer Institute Palo Alto
  - Palo Alto, California, Forenede Stater, 94301
    - Palo Alto Medical Foundation Health Care
  - Panorama City, California, Forenede Stater, 91402
    - Kaiser Permanente - Panorama City
  - 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, 95823
    - Kaiser Permanente-South Sacramento
  - Sacramento, California, Forenede Stater, 95825
    - Kaiser Permanente Sacramento Medical Center
  - San Diego, California, Forenede Stater, 92120
    - Kaiser Permanente-San Diego Zion
  - San Diego, California, Forenede Stater, 92134
    - Naval Medical Center -San Diego
  - San Francisco, California, Forenede Stater, 94115
    - Kaiser Permanente-San Francisco
  - San Francisco, California, Forenede Stater, 94115
    - California Pacific Medical Center-Pacific Campus
  - San Jose, California, Forenede Stater, 95119
    - Kaiser Permanente-Santa Teresa-San Jose
  - San Jose, California, Forenede Stater, 95124
    - Stanford Cancer Center South Bay
  - San Leandro, California, Forenede Stater, 94577
    - Kaiser Permanente San Leandro
  - San Marcos, California, Forenede Stater, 92078
    - Kaiser Permanente-San Marcos
  - 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
  - St. Helena, California, Forenede Stater, 94574
    - Saint Helena Hospital
  - 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
  - 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
  - Whittier, California, Forenede Stater, 90602
    - Presbyterian Intercommunity Hospital
  - Woodland Hills, California, Forenede Stater, 91367
    - Kaiser Permanente-Woodland Hills
- 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, 80303
    - Boulder Community Foothills 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, 80205
    - Kaiser Permanente-Franklin
  - Denver, Colorado, Forenede Stater, 80218
    - Presbyterian - Saint Lukes Medical Center - Health One
  - 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, 80222
    - Western States Cancer Research NCORP
  - Denver, Colorado, Forenede Stater, 80218
    - Saint Joseph Hospital - Cancer Centers of Colorado
  - Denver, Colorado, Forenede Stater, 80210
    - AdventHealth Porter
  - Durango, Colorado, Forenede Stater, 81301
    - Mercy Medical Center
  - Durango, Colorado, Forenede Stater, 81301
    - CommonSpirit Cancer Center Mercy
  - Englewood, Colorado, Forenede Stater, 80113
    - Mountain Blue Cancer Care Center - Swedish
  - Englewood, Colorado, Forenede Stater, 80113
    - Swedish Medical Center
  - 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
  - Greeley, Colorado, Forenede Stater, 80631
    - Banner North Colorado Medical Center
  - Greenwood Village, Colorado, Forenede Stater, 80111
    - Rocky Mountain Cancer Centers-Greenwood Village
  - Lafayette, Colorado, Forenede Stater, 80026
    - Kaiser Permanente-Rock Creek
  - Lakewood, Colorado, Forenede Stater, 80228
    - Rocky Mountain Cancer Centers-Lakewood
  - Lakewood, Colorado, Forenede Stater, 80228
    - CommonSpirit Saint Anthony Hospital Cancer Center
  - Littleton, Colorado, Forenede Stater, 80120
    - Rocky Mountain Cancer Centers-Littleton
  - Littleton, Colorado, Forenede Stater, 80122
    - AdventHealth Littleton
  - Lone Tree, Colorado, Forenede Stater, 80124
    - Kaiser Permanente-Lone Tree
  - 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
    - Banner North Colorado Medical Center - Loveland Campus
  - Parker, Colorado, Forenede Stater, 80138
    - Rocky Mountain Cancer Centers-Parker
  - Parker, Colorado, Forenede Stater, 80138
    - AdventHealth 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, 80401
    - Intermountain Health Lutheran Hospital
- Connecticut
  - Danbury, Connecticut, Forenede Stater, 06810
    - Danbury Hospital
  - Derby, Connecticut, Forenede Stater, 06418
    - Smilow Cancer Hospital-Derby Care Center
  - Fairfield, Connecticut, Forenede Stater, 06824
    - Smilow Cancer Hospital Care Center-Fairfield
  - Guilford, Connecticut, Forenede Stater, 06437
    - Smilow Cancer Hospital Care Center - Guilford
  - Hartford, Connecticut, Forenede Stater, 06105
    - Smilow Cancer Hospital Care Center at Saint Francis
  - Middletown, Connecticut, Forenede Stater, 06457
    - Middlesex Hospital
  - New Britain, Connecticut, Forenede Stater, 06050
    - The Hospital of Central Connecticut
  - New Haven, Connecticut, Forenede Stater, 06520
    - Yale University
  - North Haven, Connecticut, Forenede Stater, 06473
    - Yale-New Haven Hospital North Haven Medical Center
  - Norwalk, Connecticut, Forenede Stater, 06856
    - Norwalk Hospital
  - Orange, Connecticut, Forenede Stater, 06477
    - Smilow Cancer Hospital-Orange Care Center
  - Torrington, Connecticut, Forenede Stater, 06790
    - Smilow Cancer Hospital-Torrington Care Center
  - Trumbull, Connecticut, Forenede Stater, 06611
    - Smilow Cancer Hospital Care Center-Trumbull
  - Waterbury, Connecticut, Forenede Stater, 06708
    - Smilow Cancer Hospital-Waterbury Care Center
  - Waterford, Connecticut, Forenede Stater, 06385
    - Smilow Cancer Hospital Care Center - Waterford
  - West Haven, Connecticut, Forenede Stater, 06516
    - Veterans Affairs Connecticut Healthcare System-West Haven Campus
- 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
  - 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 D.C., District of Columbia, Forenede Stater, 20010
    - MedStar Washington Hospital Center
  - Washington D.C., District of Columbia, Forenede Stater, 20007
    - MedStar Georgetown University Hospital
- Florida
  - Altamonte Springs, Florida, Forenede Stater, 32701
    - AdventHealth Altamonte
  - Deerfield Beach, Florida, Forenede Stater, 33442
    - UM Sylvester Comprehensive Cancer Center at Deerfield Beach
  - Fort Lauderdale, Florida, Forenede Stater, 33308
    - Holy Cross Hospital
  - Jacksonville, Florida, Forenede Stater, 32207
    - Baptist MD Anderson Cancer Center
  - Jupiter, Florida, Forenede Stater, 33458
    - Jupiter Medical Center
  - Kissimmee, Florida, Forenede Stater, 34744
    - AdventHealth Kissimmee
  - 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
  - Orlando, Florida, Forenede Stater, 32806
    - Orlando Health Cancer Institute
  - Orlando, Florida, Forenede Stater, 32803
    - AdventHealth Orlando
  - Orlando, Florida, Forenede Stater, 32803
    - AdventHealth Medical Group Urology at Orlando
  - Orlando, Florida, Forenede Stater, 32822
    - AdventHealth East Orlando
  - Pensacola, Florida, Forenede Stater, 32504
    - Sacred Heart Hospital
  - Plantation, Florida, Forenede Stater, 33324
    - UM Sylvester Comprehensive Cancer Center at Plantation
  - Weston, Florida, Forenede Stater, 33331
    - Cleveland Clinic-Weston
  - Winter Park, Florida, Forenede Stater, 32792
    - AdventHealth Winter Park
- Georgia
  - Atlanta, Georgia, Forenede Stater, 30322
    - Emory University Hospital/Winship Cancer Institute
  - Atlanta, Georgia, Forenede Stater, 30342
    - Northside Hospital
  - Columbus, Georgia, Forenede Stater, 31904
    - John B Amos Cancer Center
  - Cumming, Georgia, Forenede Stater, 30041
    - Northside Hospital-Forsyth
- Hawaii
  - 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
    - 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
    - Kuakini Medical Center
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Queen's Cancer Center - Kuakini
  - Honolulu, Hawaii, Forenede Stater, 96826
    - Kapiolani Medical Center for Women and Children
  - Honolulu, Hawaii, Forenede Stater, 96819
    - Kaiser Permanente Moanalua Medical Center
  - Lihue, Hawaii, Forenede Stater, 96766
    - Wilcox Memorial Hospital and Kauai Medical Clinic
  - ‘Aiea, Hawaii, Forenede Stater, 96701
    - Pali Momi Medical Center
  - ‘Aiea, Hawaii, Forenede Stater, 96701
    - Queen's Cancer Center - Pearlridge
  - ‘Aiea, Hawaii, Forenede Stater, 96701
    - The Cancer Center of Hawaii-Pali Momi
- Idaho
  - Boise, Idaho, Forenede Stater, 83706
    - Saint Alphonsus Cancer Care Center-Boise
  - Boise, Idaho, Forenede Stater, 83712
    - Saint Luke's Cancer Institute - Boise
  - Coeur d'Alene, Idaho, Forenede Stater, 83814
    - Kootenai Health - Coeur d'Alene
  - Fruitland, Idaho, Forenede Stater, 83619
    - Saint Luke's Cancer Institute - Fruitland
  - Meridian, Idaho, Forenede Stater, 83642
    - Saint Luke's Cancer Institute - Meridian
  - Nampa, Idaho, Forenede Stater, 83687
    - Saint Luke's Cancer Institute - Nampa
  - Post Falls, Idaho, Forenede Stater, 83854
    - Kootenai Clinic Cancer Services - Post Falls
  - Sandpoint, Idaho, Forenede Stater, 83864
    - Kootenai Clinic Cancer Services - Sandpoint
  - Twin Falls, Idaho, Forenede Stater, 83301
    - Saint Luke's Cancer 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
    - OSF 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, 60611
    - Northwestern University
  - Chicago, Illinois, Forenede Stater, 60637
    - University of Chicago Comprehensive Cancer Center
  - Chicago, Illinois, Forenede Stater, 60612
    - University of Illinois
  - Danville, Illinois, Forenede Stater, 61832
    - Carle at The Riverfront
  - 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
  - Elk Grove Village, Illinois, Forenede Stater, 60007
    - Ascension Alexian Brothers - Elk Grove Village
  - 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
  - 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
  - Hinsdale, Illinois, Forenede Stater, 60521
    - Hinsdale Hematology Oncology Associates Incorporated
  - Joliet, Illinois, Forenede Stater, 60435
    - Duly Health and Care Joliet
  - Kankakee, Illinois, Forenede Stater, 60901
    - Presence Saint Mary's Hospital
  - Kewanee, Illinois, Forenede Stater, 61443
    - Illinois CancerCare-Kewanee Clinic
  - Libertyville, Illinois, Forenede Stater, 60048
    - AMG Libertyville - Oncology
  - 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
  - Monmouth, Illinois, Forenede Stater, 61462
    - Illinois CancerCare-Monmouth
  - Mount Vernon, Illinois, Forenede Stater, 62864
    - SSM Health Good Samaritan
  - New Lenox, Illinois, Forenede Stater, 60451
    - UC Comprehensive Cancer Center at Silver Cross
  - Normal, Illinois, Forenede Stater, 61761
    - Carle Cancer Institute Normal
  - O'Fallon, Illinois, Forenede Stater, 62269
    - Cancer Care Center of O'Fallon
  - 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
  - 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
  - Quincy, Illinois, Forenede Stater, 62301
    - Quincy Medical Group-Clinic
  - Rockford, Illinois, Forenede Stater, 61114
    - UW Health Carbone Cancer Center Rockford
  - Skokie, Illinois, Forenede Stater, 60076
    - North Shore 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
  - Springfield, Illinois, Forenede Stater, 62781
    - Springfield Memorial Hospital
  - 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
  - Crown Point, Indiana, Forenede Stater, 46307
    - Michiana Hematology Oncology PC-Crown Point
  - 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, 46628
    - Northern Indiana Cancer Research Consortium
  - Westville, Indiana, Forenede Stater, 46391
    - Michiana Hematology Oncology PC-Westville
- Iowa
  - Ames, Iowa, Forenede Stater, 50010
    - Mary Greeley Medical Center
  - Ames, Iowa, Forenede Stater, 50010
    - McFarland Clinic - Ames
  - Boone, Iowa, Forenede Stater, 50036
    - McFarland Clinic - Boone
  - Cedar Rapids, Iowa, Forenede Stater, 52403
    - Mercy Hospital
  - Cedar Rapids, Iowa, Forenede Stater, 52403
    - Oncology Associates at Mercy Medical Center
  - Cedar Rapids, Iowa, Forenede Stater, 52402
    - Physicians' Clinic of Iowa PC
  - Clive, Iowa, Forenede Stater, 50325
    - Mercy Cancer Center-West Lakes
  - Clive, Iowa, Forenede Stater, 50325
    - UI Health Care Mission Cancer and Blood - West Des Moines Clinic
  - Council Bluffs, Iowa, Forenede Stater, 51503
    - Alegent Health Mercy Hospital
  - Creston, Iowa, Forenede Stater, 50801
    - Greater Regional Medical Center
  - Des Moines, Iowa, Forenede Stater, 50314
    - Mercy Medical Center - Des Moines
  - Des Moines, Iowa, Forenede Stater, 50309
    - Iowa-Wide Oncology Research Coalition NCORP
  - Des Moines, Iowa, Forenede Stater, 50314
    - UI Health Care Mission Cancer and Blood - Laurel Clinic
  - Fort Dodge, Iowa, Forenede Stater, 50501
    - McFarland Clinic - Trinity Cancer Center
  - Iowa City, Iowa, Forenede Stater, 52242
    - University of Iowa/Holden Comprehensive Cancer Center
  - Iowa City, Iowa, Forenede Stater, 52246
    - Iowa City VA Healthcare System
  - Jefferson, Iowa, Forenede Stater, 50129
    - McFarland Clinic - Jefferson
  - Marshalltown, Iowa, Forenede Stater, 50158
    - McFarland Clinic - Marshalltown
  - Mason City, Iowa, Forenede Stater, 50401
    - Mercy Medical Center - North Iowa
  - 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
  - Spencer, Iowa, Forenede Stater, 51301
    - Abben Cancer Center
  - Waterloo, Iowa, Forenede Stater, 50702
    - MercyOne Waterloo Cancer Center
  - 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
  - Emporia, Kansas, Forenede Stater, 66801
    - Newman Regional Health
  - Fort Scott, Kansas, Forenede Stater, 66701
    - Cancer Center of Kansas - Fort Scott
  - Garden City, Kansas, Forenede Stater, 67846
    - Saint Catherine Hospital
  - Great Bend, Kansas, Forenede Stater, 67530
    - Saint Rose Ambulatory and Surgery Center
  - Hays, Kansas, Forenede Stater, 67601
    - HaysMed
  - Independence, Kansas, Forenede Stater, 67301
    - Cancer Center of Kansas-Independence
  - Kansas City, Kansas, Forenede Stater, 66160
    - University of Kansas Cancer Center
  - Kansas City, Kansas, Forenede Stater, 66112
    - University of Kansas Cancer Center-West
  - 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
  - Newton, Kansas, Forenede Stater, 67114
    - Cancer Center of Kansas - Newton
  - Olathe, Kansas, Forenede Stater, 66061
    - The University of Kansas Cancer Center - Olathe
  - 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
    - Mercy Hospital Pittsburg
  - Prairie Village, Kansas, Forenede Stater, 66208
    - Kansas City NCI Community Oncology Research Program
  - 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
    - University of Kansas Health System Saint Francis Campus
  - Topeka, Kansas, Forenede Stater, 66606
    - Cotton O'Neil Cancer Center / Stormont Vail Health
  - 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
  - Winfield, Kansas, Forenede Stater, 67156
    - Cancer Center of Kansas - Winfield
- Kentucky
  - Bardstown, Kentucky, Forenede Stater, 40004
    - CommonSpirit Saint Joseph Hospital - Bardstown
  - Corbin, Kentucky, Forenede Stater, 40701
    - Commonwealth Cancer Center-Corbin
  - Crestview Hills, Kentucky, Forenede Stater, 41017
    - Oncology Hematology Care Inc-Crestview
  - Lexington, Kentucky, Forenede Stater, 40504
    - Saint Joseph Radiation Oncology Resource Center
  - Lexington, Kentucky, Forenede Stater, 40509
    - CommonSpirit Saint Joseph Medical Center - East Lexington
  - Louisville, Kentucky, Forenede Stater, 40202
    - Jewish Hospital
  - Louisville, Kentucky, Forenede Stater, 40245
    - UofL Health Medical Center Northeast
  - Louisville, Kentucky, Forenede Stater, 40215
    - Saints Mary and Elizabeth Hospital
  - 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
    - Ochsner Health Center-Summa
  - Baton Rouge, Louisiana, Forenede Stater, 70808
    - Our Lady of the Lake Physician Group
  - Covington, Louisiana, Forenede Stater, 70433
    - Mary Bird Perkins Cancer Center - Covington
  - Houma, Louisiana, Forenede Stater, 70360
    - Mary Bird Perkins Cancer Center - Houma
  - Kenner, Louisiana, Forenede Stater, 70065
    - Ochsner Medical Center Kenner
  - 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
  - Brewer, Maine, Forenede Stater, 04412
    - Lafayette Family Cancer Center-EMMC
  - Rockport, Maine, Forenede Stater, 04856
    - Penobscot Bay Medical Center
  - York Village, Maine, Forenede Stater, 03909
    - York Hospital
- Maryland
  - Baltimore, Maryland, Forenede Stater, 21237
    - MedStar Franklin Square Medical Center/Weinberg Cancer Institute
  - Baltimore, Maryland, Forenede Stater, 21215
    - Sinai Hospital of Baltimore
  - Baltimore, Maryland, Forenede Stater, 21204
    - Greater Baltimore Medical Center
  - Baltimore, Maryland, Forenede Stater, 21229
    - Saint Agnes Hospital
  - Cumberland, Maryland, Forenede Stater, 21502
    - UPMC Western Maryland
  - Frederick, Maryland, Forenede Stater, 21701
    - Frederick Memorial Hospital
  - Randallstown, Maryland, Forenede Stater, 21133
    - Northwest Hospital Center
  - Salisbury, Maryland, Forenede Stater, 21801
    - TidalHealth Peninsula Regional
- Massachusetts
  - Beverly, Massachusetts, Forenede Stater, 01915
    - Beverly Hospital
  - Boston, Massachusetts, Forenede Stater, 02215
    - Dana-Farber Cancer Institute
  - Boston, Massachusetts, Forenede Stater, 02115
    - Brigham and Women's Hospital
  - Boston, Massachusetts, Forenede Stater, 02111
    - Tufts Medical Center
  - Boston, Massachusetts, Forenede Stater, 02118
    - Boston Medical Center
  - Boston, Massachusetts, Forenede Stater, 02114
    - Massachusetts General Hospital Cancer Center
  - Burlington, Massachusetts, Forenede Stater, 01805
    - Lahey Clinic
  - Fitchburg, Massachusetts, Forenede Stater, 01420
    - Simonds-Sinon Regional Cancer Center
  - Gloucester, Massachusetts, Forenede Stater, 01930
    - Addison Gilbert Hospital
  - Newton, Massachusetts, Forenede Stater, 02462
    - Newton-Wellesley Hospital
  - Springfield, Massachusetts, Forenede Stater, 01199
    - Baystate Medical Center
  - Springfield, Massachusetts, Forenede Stater, 01107
    - D'Amour Center for Cancer Care
  - Winchester, Massachusetts, Forenede Stater, 01890
    - Beth Israel Deaconess Medical Center/Winchester Center for Cancer Care
  - Worcester, Massachusetts, Forenede Stater, 01655
    - UMass Memorial Medical Center - University Campus
- Michigan
  - Adrian, Michigan, Forenede Stater, 49221
    - Bixby Medical Center
  - Adrian, Michigan, Forenede Stater, 49221
    - Hickman Cancer Center
  - Ann Arbor, Michigan, Forenede Stater, 48106
    - Michigan Cancer Research Consortium NCORP
  - Ann Arbor, Michigan, Forenede Stater, 48106
    - Trinity Health Saint Joseph Mercy Hospital Ann Arbor
  - Battle Creek, Michigan, Forenede Stater, 49017
    - Bronson Battle Creek
  - Bay City, Michigan, Forenede Stater, 48706
    - McLaren Cancer Institute-Bay City
  - Brownstown, Michigan, Forenede Stater, 48183
    - Henry Ford Cancer Institute-Downriver
  - Clarkston, Michigan, Forenede Stater, 48346
    - McLaren Cancer Institute-Clarkston
  - Clinton Township, Michigan, Forenede Stater, 48038
    - Henry Ford Macomb Hospital-Clinton Township
  - Commerce, Michigan, Forenede Stater, 48382
    - Huron Valley-Sinai Hospital
  - Dearborn, Michigan, Forenede Stater, 48126
    - Henry Ford Medical Center-Fairlane
  - Dearborn, Michigan, Forenede Stater, 48124
    - Corewell Health Dearborn Hospital
  - Detroit, Michigan, Forenede Stater, 48202
    - Henry Ford Hospital
  - Detroit, Michigan, Forenede Stater, 48201
    - Wayne State University/Karmanos Cancer Institute
  - Detroit, Michigan, Forenede Stater, 48236
    - Henry Ford Health Saint John Hospital
  - Escanaba, Michigan, Forenede Stater, 49829
    - OSF Saint Francis Hospital and Medical Group
  - Farmington Hills, Michigan, Forenede Stater, 48334
    - Weisberg Cancer Treatment Center
  - Farmington Hills, Michigan, Forenede Stater, 48336
    - Corewell Health Farmington Hills Hospital
  - Flint, Michigan, Forenede Stater, 48532
    - Singh and Arora Hematology Oncology PC
  - Flint, Michigan, Forenede Stater, 48503
    - Hurley Medical Center
  - Flint, Michigan, Forenede Stater, 48503
    - Genesys Hurley Cancer Institute
  - Grand Rapids, Michigan, Forenede Stater, 49503
    - Cancer Research Consortium of West Michigan NCORP
  - Grand Rapids, Michigan, Forenede Stater, 49503
    - Trinity Health Grand Rapids Hospital
  - Grand Rapids, Michigan, Forenede Stater, 49503
    - Corewell Health Grand Rapids Hospitals - Butterworth Hospital
  - Grosse Pointe, Michigan, Forenede Stater, 48230
    - William Beaumont Hospital-Grosse Pointe
  - Jackson, Michigan, Forenede Stater, 49201
    - Allegiance Health
  - Kalamazoo, Michigan, Forenede Stater, 49007
    - West Michigan Cancer Center
  - Lansing, Michigan, Forenede Stater, 48910
    - Karmanos Cancer Institute at McLaren Greater Lansing
  - Lansing, Michigan, Forenede Stater, 48912
    - University of Michigan Health - Sparrow Lansing
  - Lapeer, Michigan, Forenede Stater, 48446
    - McLaren Cancer Institute-Lapeer Region
  - Livonia, Michigan, Forenede Stater, 48154
    - Trinity Health Saint Mary Mercy Livonia Hospital
  - Monroe, Michigan, Forenede Stater, 48162
    - Mercy Memorial Hospital
  - Monroe, Michigan, Forenede Stater, 48162
    - Toledo Clinic Cancer Centers-Monroe
  - Mount Clemens, Michigan, Forenede Stater, 48043
    - McLaren Cancer Institute-Macomb
  - Mount Pleasant, Michigan, Forenede Stater, 48858
    - McLaren Cancer Institute-Central Michigan
  - Muskegon, Michigan, Forenede Stater, 49444
    - Trinity Health Muskegon Hospital
  - Novi, Michigan, Forenede Stater, 48377
    - Henry Ford Medical Center-Columbus
  - Novi, Michigan, Forenede Stater, 48374
    - Henry Ford Health Providence Novi Hospital
  - Petoskey, Michigan, Forenede Stater, 49770
    - McLaren Cancer Institute-Northern Michigan
  - Pontiac, Michigan, Forenede Stater, 48341
    - Trinity Health Saint Joseph Mercy Oakland Hospital
  - Port Huron, Michigan, Forenede Stater, 48060
    - Lake Huron Medical Center
  - Reed City, Michigan, Forenede Stater, 49677
    - Corewell Health Reed City Hospital
  - Roseville, Michigan, Forenede Stater, 48066
    - Michigan Cancer Specialists
  - 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
    - Oakland Medical Group
  - Royal Oak, Michigan, Forenede Stater, 48067
    - Oakland Colon Rectal Associates
  - Royal Oak, Michigan, Forenede Stater, 48073
    - Hematology Oncology Consultants PC-Royal Oak
  - Royal Oak, Michigan, Forenede Stater, 48073
    - Corewell Health William Beaumont University Hospital
  - Saginaw, Michigan, Forenede Stater, 48601
    - MyMichigan Medical Center Saginaw
  - Southfield, Michigan, Forenede Stater, 48075
    - Henry Ford Health Providence Southfield Hospital
  - Sterling Heights, Michigan, Forenede Stater, 48312
    - Premier Hematology Oncology Care
  - Sterling Heights, Michigan, Forenede Stater, 48314
    - Mitchell Folbe MD PC
  - Traverse City, Michigan, Forenede Stater, 49684
    - Munson Medical Center
  - 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
  - Troy, Michigan, Forenede Stater, 48085
    - Corewell Health Beaumont Troy Hospital
  - Warren, Michigan, Forenede Stater, 48093
    - Henry Ford Health Warren Hospital
  - West Bloomfield, Michigan, Forenede Stater, 48322
    - Henry Ford West Bloomfield Hospital
- Minnesota
  - Bemidji, Minnesota, Forenede Stater, 56601
    - Sanford Joe Lueken Cancer Center
  - Brainerd, Minnesota, Forenede Stater, 56401
    - Essentia Health Saint Joseph's Medical Center
  - Burnsville, Minnesota, Forenede Stater, 55337
    - Fairview Ridges Hospital
  - Coon Rapids, Minnesota, Forenede Stater, 55433
    - Mercy Hospital
  - Duluth, Minnesota, Forenede Stater, 55805
    - Saint Luke's Hospital of Duluth
  - Duluth, Minnesota, Forenede Stater, 55805
    - Essentia Health Cancer Center
  - Duluth, Minnesota, Forenede Stater, 55805
    - Essentia Health Saint Mary's Medical Center
  - Duluth, Minnesota, Forenede Stater, 55805
    - Miller-Dwan Hospital
  - Edina, Minnesota, Forenede Stater, 55435
    - Fairview Southdale Hospital
  - Fergus Falls, Minnesota, Forenede Stater, 56537
    - Lake Region Healthcare Corporation-Cancer Care
  - 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
- Mississippi
  - Jackson, Mississippi, Forenede Stater, 39216
    - University of Mississippi Medical Center
- 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
    - Mercy Cancer Center - Cape Girardeau
  - Chesterfield, Missouri, Forenede Stater, 63017
    - Saint Luke's Hospital
  - City of Saint Peters, Missouri, Forenede Stater, 63376
    - Siteman Cancer Center at Saint Peters Hospital
  - Columbia, Missouri, Forenede Stater, 65212
    - MU Health - University Hospital/Ellis Fischel Cancer Center
  - 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
    - MU Health Care Goldschmidt Cancer Center
  - Joplin, Missouri, Forenede Stater, 64804
    - Freeman Health System
  - Joplin, Missouri, Forenede Stater, 64804
    - Mercy Hospital Joplin
  - Kansas City, Missouri, Forenede Stater, 64154
    - University of Kansas Cancer Center - North
  - Kansas City, Missouri, Forenede Stater, 64116
    - North Kansas City Hospital
  - 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, 64108
    - University Health Truman Medical Center
  - Lee's Summit, Missouri, Forenede Stater, 64064
    - University of Kansas Cancer Center - Lee's Summit
  - Lee's Summit, Missouri, Forenede Stater, 64086
    - Saint Luke's East - Lee's Summit
  - Liberty, Missouri, Forenede Stater, 64068
    - Liberty Hospital
  - Rolla, Missouri, Forenede Stater, 65401
    - Mercy Clinic-Rolla-Cancer and Hematology
  - Rolla, Missouri, Forenede Stater, 65401
    - Phelps Health Delbert Day Cancer Institute
  - Saint Joseph, Missouri, Forenede Stater, 64506
    - Heartland Regional Medical Center
  - 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
  - St Louis, Missouri, Forenede Stater, 63110
    - Washington University School of Medicine
  - St Louis, Missouri, Forenede Stater, 63129
    - Siteman Cancer Center-South County
  - St Louis, Missouri, Forenede Stater, 63131
    - Missouri Baptist Medical Center
  - St Louis, Missouri, Forenede Stater, 63109
    - Mercy Infusion Center - Chippewa
  - St Louis, Missouri, Forenede Stater, 63141
    - Mercy Hospital Saint Louis
  - Sullivan, Missouri, Forenede Stater, 63080
    - Missouri Baptist Sullivan Hospital
- 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 Health Deaconess Hospital
  - Butte, Montana, Forenede Stater, 59701
    - Saint James Community Hospital and Cancer Treatment Center
  - Great Falls, Montana, Forenede Stater, 59405
    - Benefis Sletten Cancer Institute
  - Helena, Montana, Forenede Stater, 59601
    - Saint Peter's Community Hospital
  - Kalispell, Montana, Forenede Stater, 59901
    - Logan Health Medical Center
  - Missoula, Montana, Forenede Stater, 59802
    - Saint Patrick Hospital - Community Hospital
  - Missoula, Montana, Forenede Stater, 59804
    - Community Medical Center
- Nebraska
  - Grand Island, Nebraska, Forenede Stater, 68803
    - Nebraska Cancer Specialists/Oncology Hematology West PC
  - Kearney, Nebraska, Forenede Stater, 68847
    - CHI Health Good Samaritan
  - Kearney, Nebraska, Forenede Stater, 68845
    - Fred and Pamela Buffett Cancer Center - Kearney
  - 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, 68122
    - Alegent Health Immanuel Medical Center
  - Omaha, Nebraska, Forenede Stater, 68130
    - Alegent Health Lakeside Hospital
  - Omaha, Nebraska, Forenede Stater, 68122
    - Hematology and Oncology Consultants PC
  - Papillion, Nebraska, Forenede Stater, 68046
    - Midlands Community Hospital
- 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
    - Oncology Las Vegas - Henderson
  - 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, 89135
    - Alliance for Childhood Diseases/Cure 4 the Kids Foundation
  - 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, 89169
    - Comprehensive Cancer Centers of Nevada - Central Valley
  - 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, 89120
    - Nevada Cancer Research Foundation NCORP
  - Las Vegas, Nevada, Forenede Stater, 89128
    - Oncology Las Vegas - Tenaya
  - Las Vegas, Nevada, Forenede Stater, 89183
    - OptumCare Cancer Care at Fort Apache
  - Reno, Nevada, Forenede Stater, 89503
    - Saint Mary's Regional Medical Center
- New Hampshire
  - Concord, New Hampshire, Forenede Stater, 03301
    - New Hampshire Oncology Hematology PA-Concord
  - Derry, New Hampshire, Forenede Stater, 03038
    - Parkland Medical Center
  - Dover, New Hampshire, Forenede Stater, 03820
    - Wentworth-Douglass Hospital
  - Laconia, New Hampshire, Forenede Stater, 03246
    - LRGHealthcare-Lakes Region General Hospital
  - Lebanon, New Hampshire, Forenede Stater, 03756
    - Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
  - Manchester, New Hampshire, Forenede Stater, 03103
    - Solinsky Center for Cancer Care
  - Manchester, New Hampshire, Forenede Stater, 03104
    - Dartmouth Cancer Center - Manchester/ DCC Manchester
  - Nashua, New Hampshire, Forenede Stater, 03063
    - Dartmouth Cancer Center - Nashua
  - Portsmouth, New Hampshire, Forenede Stater, 03802
    - Portsmouth Regional Hospital
- New Jersey
  - East Orange, New Jersey, Forenede Stater, 07018-1095
    - Veterans Adminstration New Jersey Health Care System
  - Englewood, New Jersey, Forenede Stater, 07631
    - Englewood Hospital and Medical Center
  - New Brunswick, New Jersey, Forenede Stater, 08903
    - Rutgers Cancer Institute of New Jersey
  - Newark, New Jersey, Forenede Stater, 07112
    - Newark Beth Israel Medical Center
  - Paramus, New Jersey, Forenede Stater, 07652
    - The Valley Hospital - Luckow Pavilion
  - Plainsboro, New Jersey, Forenede Stater, 08536
    - Penn Medicine Princeton Health
  - Ridgewood, New Jersey, Forenede Stater, 07450
    - Valley Health System Ridgewood Campus
  - Summit, New Jersey, Forenede Stater, 07902
    - Overlook Hospital
  - Westwood, New Jersey, Forenede Stater, 07675
    - Valley Health System-Hematology/Oncology
- New Mexico
  - Albuquerque, New Mexico, Forenede Stater, 87106
    - University of New Mexico Cancer Center
  - Albuquerque, New Mexico, Forenede Stater, 87110
    - Presbyterian Kaseman Hospital
  - Las Cruces, New Mexico, Forenede Stater, 88011
    - Memorial Medical Center-Las Cruces
- New York
  - Auburn, New York, Forenede Stater, 13021
    - Hematology Oncology Associates of Central New York-Auburn
  - Brooklyn, New York, Forenede Stater, 11219
    - Maimonides Medical Center
  - Buffalo, New York, Forenede Stater, 14263
    - Roswell Park Cancer Institute
  - Camillus, New York, Forenede Stater, 13031
    - Hematology Oncology Associates of CNY at Camillus
  - 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
  - Manhasset, New York, Forenede Stater, 11030
    - North Shore University Hospital
  - Middletown, New York, Forenede Stater, 10940
    - Garnet Health Medical Center
  - New York, New York, Forenede Stater, 10032
    - NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
  - Plattsburgh, New York, Forenede Stater, 12901
    - Champlain Valley Physicians Hospital Medical Center
  - Rochester, New York, Forenede Stater, 14642
    - University of Rochester
  - Rome, New York, Forenede Stater, 13440
    - Hematology Oncology Associates of Central New York-Rome
  - Stony Brook, New York, Forenede Stater, 11794
    - Stony Brook University Medical Center
  - Syracuse, New York, Forenede Stater, 13210
    - State University of New York Upstate Medical University
  - Utica, New York, Forenede Stater, 13502
    - Faxton-Saint Luke's Healthcare
- North Carolina
  - Asheville, North Carolina, Forenede Stater, 28801
    - Mission Hospital
  - Asheville, North Carolina, Forenede Stater, 28816
    - Hope Women's Cancer Centers-Asheville
  - Asheville, North Carolina, Forenede Stater, 28806
    - Messino Cancer Centers
  - Asheville, North Carolina, Forenede Stater, 28801
    - Mountain Radiation Oncology PA
  - Asheville, North Carolina, Forenede Stater, 28803
    - AdventHealth Infusion Center Asheville
  - Brevard, North Carolina, Forenede Stater, 28712
    - Transylvania Regional Hospital
  - Chapel Hill, North Carolina, Forenede Stater, 27599
    - UNC Lineberger Comprehensive Cancer Center
  - Clinton, North Carolina, Forenede Stater, 28328
    - Southeastern Medical Oncology Center-Clinton
  - Clinton, North Carolina, Forenede Stater, 28328
    - Sampson Radiation Oncology
  - Durham, North Carolina, Forenede Stater, 27710
    - Duke University Medical Center
  - Franklin, North Carolina, Forenede Stater, 28734
    - Angel Medical Center
  - 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, 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
  - Jacksonville, North Carolina, Forenede Stater, 28546
    - Onslow Memorial Hospital
  - Kinston, North Carolina, Forenede Stater, 28501
    - ECU Health Oncology Kinston
  - Marion, North Carolina, Forenede Stater, 28752
    - Mission Hospital McDowell
  - Pinehurst, North Carolina, Forenede Stater, 28374
    - FirstHealth of the Carolinas-Moore Regional Hospital
  - Spruce Pine, North Carolina, Forenede Stater, 28777
    - Blue Ridge 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, 58103
    - Essentia Health Cancer Center-South University Clinic
  - Fargo, North Dakota, Forenede Stater, 58122
    - Sanford Broadway Medical Center
  - Grand Forks, North Dakota, Forenede Stater, 58201
    - Altru Cancer Center
  - Minot, North Dakota, Forenede Stater, 58701
    - Trinity Cancer Care Center
- Ohio
  - Akron, Ohio, Forenede Stater, 44307
    - Cleveland Clinic Akron General
  - Beachwood, Ohio, Forenede Stater, 44122
    - UHHS-Chagrin Highlands Medical Center
  - Beachwood, Ohio, Forenede Stater, 44122
    - Cleveland Clinic Cancer Center Beachwood
  - Belpre, Ohio, Forenede Stater, 45714
    - Strecker Cancer Center-Belpre
  - Bowling Green, Ohio, Forenede Stater, 43402
    - Toledo Clinic Cancer Centers-Bowling Green
  - Centerville, Ohio, Forenede Stater, 45459
    - Miami Valley Hospital South
  - Chardon, Ohio, Forenede Stater, 44024
    - Geauga Hospital
  - Chillicothe, Ohio, Forenede Stater, 45601
    - Adena Regional Medical Center
  - Cincinnati, Ohio, Forenede Stater, 45219
    - University of Cincinnati Cancer Center-UC 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, 45230
    - Oncology Hematology Care Inc-Anderson
  - Cincinnati, Ohio, Forenede Stater, 45236
    - Oncology Hematology Care Inc-Kenwood
  - 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
  - Cleveland, Ohio, Forenede Stater, 44195
    - Cleveland Clinic Foundation
  - Cleveland, Ohio, Forenede Stater, 44111
    - Cleveland Clinic Cancer Center/Fairview Hospital
  - 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
  - Elyria, Ohio, Forenede Stater, 44035
    - Mercy Cancer Center-Elyria
  - 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
  - Independence, Ohio, Forenede Stater, 44131
    - Cleveland Clinic Cancer Center Independence
  - 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
  - Mansfield, Ohio, Forenede Stater, 44906
    - Cleveland Clinic Cancer Center Mansfield
  - 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
  - Mayfield Heights, Ohio, Forenede Stater, 44124
    - Hillcrest Hospital Cancer Center
  - Mayfield Heights, Ohio, Forenede Stater, 44124
    - UH Seidman Cancer Center at Landerbrook Health Center
  - Mentor, Ohio, Forenede Stater, 44060
    - UH Seidman Cancer Center at Lake Health Mentor Campus
  - Middleburg Heights, Ohio, Forenede Stater, 44130
    - UH Seidman Cancer Center at Southwest General Hospital
  - 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
  - Sandusky, Ohio, Forenede Stater, 44870
    - North Coast Cancer Care
  - Springfield, Ohio, Forenede Stater, 45504
    - Springfield Regional Cancer Center
  - Springfield, Ohio, Forenede Stater, 45504
    - Springfield Regional Medical Center
  - Strongsville, Ohio, Forenede Stater, 44136
    - Cleveland Clinic Cancer Center Strongsville
  - 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, 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
  - Toledo, Ohio, Forenede Stater, 43608
    - Mercy Health - Saint Vincent Hospital
  - Troy, Ohio, Forenede Stater, 45373
    - Upper Valley Medical Center
  - Warrensville Heights, Ohio, Forenede Stater, 44122
    - South Pointe Hospital
  - Wauseon, Ohio, Forenede Stater, 43567
    - Fulton County Health Center
  - West Chester, Ohio, Forenede Stater, 45069
    - University of Cincinnati Cancer Center-West Chester
  - Westerville, Ohio, Forenede Stater, 43081
    - Saint Ann's Hospital
  - Westlake, Ohio, Forenede Stater, 44145
    - UH Seidman Cancer Center at Saint John Medical Center
  - Wooster, Ohio, Forenede Stater, 44691
    - Cleveland Clinic Wooster Family Health and Surgery Center
  - Wright-Patterson Air Force Base, Ohio, Forenede Stater, 45433
    - Wright-Patterson Medical Center
  - 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, 74146
    - Warren Clinic Oncology-Tulsa
  - Tulsa, Oklahoma, Forenede Stater, 74136
    - Saint Francis Children's Hospital
- Oregon
  - Bend, Oregon, Forenede Stater, 97701
    - Saint Charles Health System
  - Clackamas, Oregon, Forenede Stater, 97015
    - Clackamas Radiation Oncology Center
  - Clackamas, Oregon, Forenede Stater, 97015
    - Providence Cancer Institute Clackamas Clinic
  - 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
  - Oregon City, Oregon, Forenede Stater, 97045
    - Providence Willamette Falls Medical Center
  - Portland, Oregon, Forenede Stater, 97239
    - Oregon Health and Science University
  - 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
- Pennsylvania
  - 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
  - Bryn Mawr, Pennsylvania, Forenede Stater, 19010
    - Bryn Mawr Hospital
  - Chadds Ford, Pennsylvania, Forenede Stater, 19317
    - Christiana Care Health System-Concord Health Center
  - Danville, Pennsylvania, Forenede Stater, 17822
    - Geisinger Medical Center
  - Drexel Hill, Pennsylvania, Forenede Stater, 19026
    - Delaware County Memorial Hospital
  - East Stroudsburg, Pennsylvania, Forenede Stater, 18301
    - Pocono Medical Center
  - Ephrata, Pennsylvania, Forenede Stater, 17522
    - Ephrata Cancer Center
  - Ephrata, Pennsylvania, Forenede Stater, 17522
    - Ephrata Community Hospital
  - Gettysburg, Pennsylvania, Forenede Stater, 17325
    - Adams Cancer Center
  - Greensburg, Pennsylvania, Forenede Stater, 15601
    - UPMC Cancer Centers - Arnold Palmer Pavilion
  - Hanover, Pennsylvania, Forenede Stater, 17331
    - WellSpan Medical Oncology and Hematology
  - Hazleton, Pennsylvania, Forenede Stater, 18201
    - Geisinger Medical Center-Cancer Center Hazleton
  - Hershey, Pennsylvania, Forenede Stater, 17033-0850
    - Penn State Milton S Hershey Medical Center
  - Johnstown, Pennsylvania, Forenede Stater, 15901
    - UPMC-Johnstown/John P. Murtha Regional Cancer Center
  - McKeesport, Pennsylvania, Forenede Stater, 15132
    - UPMC Cancer Center at UPMC McKeesport
  - Media, Pennsylvania, Forenede Stater, 19063
    - Riddle Memorial Hospital
  - Moon Township, Pennsylvania, Forenede Stater, 15108
    - UPMC Hillman Cancer Center in Coraopolis
  - Paoli, Pennsylvania, Forenede Stater, 19301
    - Paoli Memorial Hospital
  - Philadelphia, Pennsylvania, Forenede Stater, 19111
    - Fox Chase Cancer Center
  - Philadelphia, Pennsylvania, Forenede Stater, 19107
    - Thomas Jefferson University Hospital
  - Philadelphia, Pennsylvania, Forenede Stater, 19114
    - Jefferson Torresdale Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15232
    - UPMC Hillman Cancer Center
  - Pittsburgh, Pennsylvania, Forenede Stater, 15213
    - UPMC-Magee Womens Hospital
  - 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
  - Pottsville, Pennsylvania, Forenede Stater, 17901
    - Geisinger Cancer Services-Pottsville
  - Scranton, Pennsylvania, Forenede Stater, 18508
    - Hematology and Oncology Associates of North East Pennsylvania
  - Seneca, Pennsylvania, Forenede Stater, 16346
    - UPMC Cancer Center at UPMC Northwest
  - State College, Pennsylvania, Forenede Stater, 16801
    - Geisinger Medical Group
  - Uniontown, Pennsylvania, Forenede Stater, 15401
    - UPMC Uniontown Hospital Radiation Oncology
  - Upland, Pennsylvania, Forenede Stater, 19013
    - Associates In Hematology Oncology PC-Upland
  - Washington, Pennsylvania, Forenede Stater, 15301
    - UPMC Washington Hospital Radiation Oncology
  - West Chester, Pennsylvania, Forenede Stater, 19380
    - Chester County Hospital
  - West Reading, Pennsylvania, Forenede Stater, 19611
    - Reading Hospital
  - Wilkes-Barre, Pennsylvania, Forenede Stater, 18711
    - Geisinger Wyoming Valley/Henry Cancer Center
  - Williamsport, Pennsylvania, Forenede Stater, 17701
    - UPMC Susquehanna
  - Wynnewood, Pennsylvania, Forenede Stater, 19096
    - Lankenau Medical Center
  - York, Pennsylvania, Forenede Stater, 17403
    - WellSpan Health-York Cancer Center
  - York, Pennsylvania, Forenede Stater, 17403
    - WellSpan Health-York Hospital
- Rhode Island
  - Pawtucket, Rhode Island, Forenede Stater, 02860
    - Memorial Hospital of Rhode Island
  - Providence, Rhode Island, Forenede Stater, 02903
    - Rhode Island Hospital
  - Providence, Rhode Island, Forenede Stater, 02906
    - Miriam Hospital
- 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
  - Charleston, South Carolina, Forenede Stater, 29401
    - Roper Hospital
  - Charleston, South Carolina, Forenede Stater, 29406
    - Lowcountry Hematology Oncology PA-North Charleston
  - Charleston, South Carolina, Forenede Stater, 29414
    - Bon Secours Saint Francis Hospital
  - Charleston, South Carolina, Forenede Stater, 29403
    - Charleston Oncology - Roper
  - Charleston, South Carolina, Forenede Stater, 29414
    - Charleston Oncology - Saint Francis
  - Charleston, South Carolina, Forenede Stater, 29414
    - Lowcountry Oncology Associates - West Ashley
  - Easley, South Carolina, Forenede Stater, 29640
    - Prisma Health Cancer Institute - Easley
  - Florence, South Carolina, Forenede Stater, 29506
    - McLeod Regional Medical Center
  - Gaffney, South Carolina, Forenede Stater, 29341
    - Gibbs Cancer Center-Gaffney
  - Greenville, South Carolina, Forenede Stater, 29605
    - Prisma Health Cancer Institute - Faris
  - Greenville, South Carolina, Forenede Stater, 29607
    - Saint Francis Cancer Center
  - 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
  - Lancaster, South Carolina, Forenede Stater, 29720
    - Carolina Blood and Cancer Care Associates PA-Lancaster
  - Mt. Pleasant, South Carolina, Forenede Stater, 29464
    - Lowcountry Oncology Associates - Mount Pleasant
  - Rock Hill, South Carolina, Forenede Stater, 29732
    - Carolina Blood and Cancer Care Associates PA
  - Seneca, South Carolina, Forenede Stater, 29672
    - Prisma Health Cancer Institute - Seneca
  - Spartanburg, South Carolina, Forenede Stater, 29303
    - Spartanburg Medical Center
  - Union, South Carolina, Forenede Stater, 29379
    - SMC Center for Hematology Oncology Union
  - West Columbia, South Carolina, Forenede Stater, 29169
    - Lexington Health
- 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
    - Bristol Regional Medical Center
  - Chattanooga, Tennessee, Forenede Stater, 37404
    - Memorial Hospital
  - Chattanooga, Tennessee, Forenede Stater, 37403
    - Erlanger Medical Center
  - Hixson, Tennessee, Forenede Stater, 37343
    - Pulmonary Medicine Center of Chattanooga-Hixson
  - Kingsport, Tennessee, Forenede Stater, 37660
    - Ballad Health Cancer Care - Kingsport
  - Kingsport, Tennessee, Forenede Stater, 37660
    - Wellmont Holston Valley Hospital and Medical Center
  - Ooltewah, Tennessee, Forenede Stater, 37363
    - Memorial GYN Plus
- Texas
  - Amarillo, Texas, Forenede Stater, 79106
    - The Don and Sybil Harrington Cancer Center
  - Dallas, Texas, Forenede Stater, 75235
    - Parkland Memorial Hospital
  - Dallas, Texas, Forenede Stater, 75390
    - UT Southwestern/Simmons Cancer Center-Dallas
  - San Antonio, Texas, Forenede Stater, 78229
    - University Hospital
  - San Antonio, Texas, Forenede Stater, 78229
    - University of Texas Health Science Center at San Antonio
- Vermont
  - Bennington, Vermont, Forenede Stater, 05201
    - Southwestern Vermont Medical Center
  - Berlin Corners, Vermont, Forenede Stater, 05602
    - Central Vermont Medical Center/National Life Cancer Treatment
  - Burlington, Vermont, Forenede Stater, 05405
    - University of Vermont and State Agricultural College
  - White River Junction, Vermont, Forenede Stater, 05009
    - White River Junction Veteran Administration Medical Center
- Virginia
  - Charlottesville, Virginia, Forenede Stater, 22908
    - University of Virginia Cancer Center
  - Fredericksburg, Virginia, Forenede Stater, 22401
    - Fredericksburg Oncology Inc
  - Fredericksburg, Virginia, Forenede Stater, 22408
    - Hematology Oncology Associates of Fredericksburg Inc
  - Hampton, Virginia, Forenede Stater, 23666
    - Virginia Oncology Associates-Hampton
  - Lynchburg, Virginia, Forenede Stater, 24501
    - Centra Alan B Pearson Regional Cancer Center
  - Norton, Virginia, Forenede Stater, 24273
    - Ballad Health Cancer Care - Norton
  - Richmond, Virginia, Forenede Stater, 23229
    - Virginia Cancer Institute
  - Richmond, Virginia, Forenede Stater, 23298
    - VCU Massey Comprehensive Cancer Center
  - 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
  - Bellevue, Washington, Forenede Stater, 98005
    - Swedish Cancer Institute-Eastside Oncology Hematology
  - Bellingham, Washington, Forenede Stater, 98225
    - PeaceHealth Saint Joseph Medical Center
  - Burien, Washington, Forenede Stater, 98166
    - Saint Anne Hospital
  - Centralia, Washington, Forenede Stater, 98531
    - Providence Regional Cancer System-Centralia
  - Edmonds, Washington, Forenede Stater, 98026
    - Swedish Cancer Institute-Edmonds
  - Enumclaw, Washington, Forenede Stater, 98022
    - Saint Elizabeth Hospital
  - Everett, Washington, Forenede Stater, 98201
    - Providence Regional Cancer Partnership
  - Federal Way, Washington, Forenede Stater, 98003
    - Saint Francis Hospital
  - Issaquah, Washington, Forenede Stater, 98029
    - Swedish Cancer Institute-Issaquah
  - 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
  - Poulsbo, Washington, Forenede Stater, 98370
    - Harrison HealthPartners Hematology and Oncology-Poulsbo
  - Seattle, Washington, Forenede Stater, 98107
    - Swedish Medical Center-Ballard Campus
  - Seattle, Washington, Forenede Stater, 98122
    - Swedish Medical Center-First Hill
  - 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
  - Shelton, Washington, Forenede Stater, 98584
    - Providence Regional Cancer System-Shelton
  - Silverdale, Washington, Forenede Stater, 98383
    - Saint Joseph Medical Center Hematology and Oncology - Silverdale
  - Spokane, Washington, Forenede Stater, 99218
    - Evergreen Hematology and Oncology PS
  - Spokane, Washington, Forenede Stater, 99204
    - MultiCare Deaconess Cancer and Blood Specialty Center - Downtown
  - Spokane Valley, Washington, Forenede Stater, 99216
    - MultiCare Deaconess Cancer and Blood Specialty Center - Valley
  - Tacoma, Washington, Forenede Stater, 98405
    - Northwest Medical Specialties PLLC
  - Tacoma, Washington, Forenede Stater, 98405
    - Franciscan Research Center-Northwest Medical Plaza
  - Vancouver, Washington, Forenede Stater, 98664
    - PeaceHealth Southwest Medical Center
  - Walla Walla, Washington, Forenede Stater, 99362
    - Providence Saint Mary Regional Cancer Center
  - 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
  - Charleston, West Virginia, Forenede Stater, 25304
    - Vandalia Health/CAMC Institute for Academic Medicine
  - Huntington, West Virginia, Forenede Stater, 25701
    - Edwards Comprehensive Cancer Center
  - Huntington, West Virginia, Forenede Stater, 25702
    - Saint Mary's Medical 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
    - Aspirus Cancer Care-Antigo-Volm 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
    - Marshfield Clinic Cancer Center at Sacred Heart
  - 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
  - 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, 54301
    - Bellin Memorial Hospital
  - Green Bay, Wisconsin, Forenede Stater, 54301-3526
    - Green Bay Oncology at Saint Vincent Hospital
  - Kenosha, Wisconsin, Forenede Stater, 53142
    - Aurora Cancer Care-Kenosha South
  - La Crosse, Wisconsin, Forenede Stater, 54601
    - Gundersen Lutheran Medical Center
  - Ladysmith, Wisconsin, Forenede Stater, 54848
    - Marshfield Medical Center - Ladysmith
  - Manitowoc, Wisconsin, Forenede Stater, 54221
    - Holy Family Memorial Hospital
  - 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
    - 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 Medical Center - Minocqua
  - 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
  - Oshkosh, Wisconsin, Forenede Stater, 54904
    - Vince Lombardi Cancer Clinic - Oshkosh
  - Racine, Wisconsin, Forenede Stater, 53406
    - Aurora Cancer Care-Racine
  - Rhinelander, Wisconsin, Forenede Stater, 54501
    - Saint Mary's Hospital
  - Rhinelander, Wisconsin, Forenede Stater, 54501
    - Aspirus Cancer Care-Rhinelander-James Beck Cancer Center
  - Rice Lake, Wisconsin, Forenede Stater, 54868
    - Marshfield Medical Center-Rice Lake
  - Sheboygan, Wisconsin, Forenede Stater, 53081
    - Vince Lombardi Cancer Clinic-Sheboygan
  - Sheboygan, Wisconsin, Forenede Stater, 53081
    - HSHS Saint Nicholas Hospital
  - Stevens Point, Wisconsin, Forenede Stater, 54481
    - Aspirus Cancer Care - Stevens Point
  - 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
    - UW Cancer Center at ProHealth Care
  - Waukesha, Wisconsin, Forenede Stater, 53188
    - ProHealth Waukesha Memorial Hospital
  - Waukesha, Wisconsin, Forenede Stater, 53188
    - Aurora Cancer Care-Waukesha
  - Wausau, Wisconsin, Forenede Stater, 54401
    - Marshfield Clinic-Wausau Center
  - Wausau, Wisconsin, Forenede Stater, 54401
    - Aspirus Cancer Care-Wausau
  - 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
    - Marshfield Medical Center - Weston
  - Wisconsin Rapids, Wisconsin, Forenede Stater, 54494
    - Aspirus Cancer Care - Wisconsin Rapids
  - 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

65 år og ældre (Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

PRE-REGISTRATION (STEP 0)
All patients are REQUIRED to be pre-registered to A041202 in order to submit peripheral blood to the Alliance Hematologic Malignancy Biorepository (HEME) for central Zap-70 methylation. This specimen submission is mandatory prior to registration as results will be used for stratification
REGISTRATION (STEP 1)
Patients must be diagnosed with CLL in accordance with International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2008 criteria that includes all of the following:
- >= 5 x 10^9 B lymphocytes (5000/uL) in the peripheral blood
- On morphologic review, the leukemic cells must be small mature lymphocytes, and prolymphocytes must not exceed 55% of the blood lymphocytes
- CLL cells on immunophenotype (performed locally) must reveal a clonal B-cell population, which express the B cell surface markers of CD19 and CD20, as well as the T-cell antigen CD5; patients with bright surface immunoglobulin expression or lack of CD23 expression in > 10% of cells must lack t(11;14) translocation by interphase cytogenetics
Patients must be intermediate or high-risk Rai stage CLL
- Intermediate risk (formerly Rai stage I/II) is defined by lymphocytosis plus enlarged lymph nodes at any site, with or without hepatomegaly or splenomegaly
- High risk (formerly Rai stage III/IV) is defined by lymphocytosis with or without enlarged nodes and spleen plus disease-related anemia (hemoglobin < 11 g/dL) or thrombocytopenia (platelet count < 100 x 10^9/L) that is not attributable to autoimmune hemolytic anemia or thrombocytopenia
Patients must meet criteria for treatment as defined by IWCLL 2008 guidelines which includes at least one of the following criteria:
- Evidence of marrow failure as manifested by the development or worsening of anemia or thrombocytopenia (not attributable to autoimmune hemolytic anemia or thrombocytopenia)
- Massive (>= 6 cm below the costal margin), progressive or symptomatic splenomegaly
- Massive nodes (>= 10 cm) or progressive or symptomatic lymphadenopathy
- Autoimmune anemia and/or thrombocytopenia that is poorly responsive to standard therapy
- Constitutional symptoms, which include any of the following:
  - Unintentional weight loss of 10% or more within 6 months
  - Significant fatigue
  - Fevers > 100.5 degrees F for 2 weeks or more without evidence of infection
  - Night sweats > 1 month without evidence of infection
Prior treatment
- Patients must not have had prior therapy for CLL (except palliative steroids or treatment of autoimmune complications of CLL with rituximab or steroids)
- Treatment with rituximab and/or high dose corticosteroids for autoimmune complications of CLL must be complete at least 4 weeks prior to enrollment; palliative steroids must be at a dose not higher than 20 mg/day of prednisone or equivalent corticosteroid at the time of registration
Age >= 65 years
Eastern Cooperative Oncology Group (ECOG) performance status 0-2
Patients with active hepatitis B defined by hepatitis B surface antigen positivity or core antibody positivity in the presence of hepatitis B DNA are not eligible for this study; patients with a positive hepatitis B core antibody but with negative hepatitis B DNA may participate, but must have hepatitis serologies and hepatitis B DNA monitored periodically by the treating physician
- Intravenous immunoglobulin (IVIG) can cause a false positive hepatitis B serology; if patients receiving routine IVIG have core antibody or surface antigen positivity without evidence of active viremia (negative hepatitis B DNA) they may still participate in the study, but should have hepatitis serologies and hepatitis B DNA monitored periodically by the treating physician
Patients must not be receiving active systemic anticoagulation with heparin or warfarin; patients must be off warfarin therapy for at least 30 days prior to enrollment
Patients with class III or class IV heart failure by New York Heart Association, those with unstable angina, and those with uncontrolled arrhythmia are not eligible
Patients who have had a myocardial infarction, intracranial bleed, or stroke within the past 6 months are not eligible
Patients with known human immunodeficiency virus (HIV) are eligible if their CD4 count is >= 350 cells/mm^3 and if they are not taking prohibited CYP-interacting medications
Patients must not have any history of Richter's transformation or prolymphocytic leukemia (prolymphocytes in blood > 55%)
Patients must not require more than 20 mg prednisone or equivalent corticosteroid daily
Patients must not have uncontrolled active systemic infection requiring intravenous antibiotics
Patients must not have continued requirement for therapy with a strong cytochrome P450 3A4/5 (CYP3A4/5) inhibitor or inducer
Patients must not have a known allergy to mannitol
Patients must not have prior significant hypersensitivity to rituximab (not including infusion reactions)
Patients may not have had major surgery within 10 days of enrollment, or minor surgery within 7 days of enrollment; examples of minor surgery include dental surgery, insertion of a venous access device, skin biopsy, or aspiration of a joint; the decision about whether a surgery is major or minor can be made at the discretion of the treating physician
Absolute neutrophil count (ANC) >= 1,000/uL unless due to bone marrow involvement
Aspartate aminotransferase (AST) or alanine aminotransferase (AST) =< 2.5 x upper limits of normal except if due to disease infiltration of the liver
Bilirubin =< 1.5 x upper limits of normal (unless due to liver involvement, hemolysis, or Gilbert's disease)
Creatinine clearance >= 40 mL/min
- To be calculated by modified Cockcroft-Gault formula
Platelet count (untransfused) >= 30,000/uL

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: Crossover opgave
Maskning: Ingen (Åben etiket)

Antal våben

Våben og indgreb

Deltagergruppe / Arm	Intervention / Behandling
Aktiv komparator: Arm I (rituximab, bendamustine hydrochloride) Patients receive rituximab IV on day 1 (day 0 course 1) and bendamustine hydrochloride IV over 30 minutes on days 1-2. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover to Arm II. Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and CT throughout the study.	Andet: Laboratory Biomarker Analysis Correlative studies Andet: Quality-of-Life Assessment Ancillary studies Andre navne: Livskvalitetsvurdering Procedure: Biospecimen Collection Undergo blood sample collection Andre navne: Biologisk prøvesamling Bioprøve indsamlet Prøvesamling Prøvekollektion Biologisk: Rituximab Given IV Andre navne: Rituxan MabThera ABP 798 BI 695500 C2B8 monoklonalt antistof Kimærisk anti-CD20 antistof CT-P10 IDEC-102 IDEC-C2B8 IDEC-C2B8 monoklonalt antistof Monoklonalt antistof IDEC-C2B8 PF-05280586 Riabni Rituximab ABBS Rituximab ARRX Rituximab Biosimilar ABP 798 Rituximab Biosimilar BI 695500 Rituximab Biosimilar CT-P10 Rituximab Biosimilar GB241 Rituximab Biosimilar IBI301 Rituximab Biosimilar JHL1101 Rituximab Biosimilar PF-05280586 Rituximab Biosimilar RTXM83 Rituximab Biosimilar SAIT101 Rituximab Biosimilar SIBP-02 rituximab biosimilær TQB2303 Rituximab PVVR Rituximab-arrx Rituximab-pvvr RTXM83 Ruxience Truxima Rixathon Ikgdar Mabtas Rituximab-abbs BI-695500 BI695500 Blitzima IDEC 102 IDEC102 PF 05280586 PF05280586 Ritemvia Rituximab-blit Rituximab-rite Rituximab-rixa Rituximab-rixi Riximyo RTXM 83 RTXM-83 ABP-798 ABP798 CT P10 CTP10 GP 2013 GP-2013 GP2013 Rituximab Biosimilar GP2013 Procedure: Computed Tomography Undergo CT Andre navne: CT KAT CAT-scanning Beregnet aksial tomografi Computerstyret aksial tomografi Computerstyret tomografi CT-scanning tomografi Computerstyret aksial tomografi (procedure) Computerstyret tomografi (CT) scanning Diagnostisk CAT -scanning Diagnostic CAT Scan Service Type Medicin: Bendamustine Hydrochloride Given IV Andre navne: Treanda Bendeka CEP-18083 Bendamustin hydrochlorid Cytostasan hydrochlorid Levact Ribomustin SyB L-0501 Treakisym Belrapzo CEP 18083 CEP18083 VIVIMUSTA Procedure: Bone Marrow Aspiration Undergo bone marrow aspiration and biopsy Procedure: Bone Marrow Biopsy Undergo bone marrow aspiration and biopsy Andre navne: Biopsi af knoglemarv Biopsi, knoglemarv
Eksperimentel: Arm II (ibrutinib) Patients receive ibrutinib PO daily. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and CT throughout the study.	Andet: Laboratory Biomarker Analysis Correlative studies Andet: Quality-of-Life Assessment Ancillary studies Andre navne: Livskvalitetsvurdering Procedure: Biospecimen Collection Undergo blood sample collection Andre navne: Biologisk prøvesamling Bioprøve indsamlet Prøvesamling Prøvekollektion Procedure: Computed Tomography Undergo CT Andre navne: CT KAT CAT-scanning Beregnet aksial tomografi Computerstyret aksial tomografi Computerstyret tomografi CT-scanning tomografi Computerstyret aksial tomografi (procedure) Computerstyret tomografi (CT) scanning Diagnostisk CAT -scanning Diagnostic CAT Scan Service Type Procedure: Bone Marrow Aspiration Undergo bone marrow aspiration and biopsy Procedure: Bone Marrow Biopsy Undergo bone marrow aspiration and biopsy Andre navne: Biopsi af knoglemarv Biopsi, knoglemarv Medicin: Ibrutinib Given PO Andre navne: PCI-32765 Imbruvica BTK-hæmmer PCI-32765 CRA-032765 PCI32765 CRA 032765 CRA032765 PCI 32765
Eksperimentel: Arm III (ibrutinib, rituximab) Patients receive ibrutinib as in Arm II. Patients receive rituximab IV on days 1, 8, 15, and 22 of course 2 and on day 1 of courses 3-6. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and CT throughout the study.	Andet: Laboratory Biomarker Analysis Correlative studies Andet: Quality-of-Life Assessment Ancillary studies Andre navne: Livskvalitetsvurdering Procedure: Biospecimen Collection Undergo blood sample collection Andre navne: Biologisk prøvesamling Bioprøve indsamlet Prøvesamling Prøvekollektion Biologisk: Rituximab Given IV Andre navne: Rituxan MabThera ABP 798 BI 695500 C2B8 monoklonalt antistof Kimærisk anti-CD20 antistof CT-P10 IDEC-102 IDEC-C2B8 IDEC-C2B8 monoklonalt antistof Monoklonalt antistof IDEC-C2B8 PF-05280586 Riabni Rituximab ABBS Rituximab ARRX Rituximab Biosimilar ABP 798 Rituximab Biosimilar BI 695500 Rituximab Biosimilar CT-P10 Rituximab Biosimilar GB241 Rituximab Biosimilar IBI301 Rituximab Biosimilar JHL1101 Rituximab Biosimilar PF-05280586 Rituximab Biosimilar RTXM83 Rituximab Biosimilar SAIT101 Rituximab Biosimilar SIBP-02 rituximab biosimilær TQB2303 Rituximab PVVR Rituximab-arrx Rituximab-pvvr RTXM83 Ruxience Truxima Rixathon Ikgdar Mabtas Rituximab-abbs BI-695500 BI695500 Blitzima IDEC 102 IDEC102 PF 05280586 PF05280586 Ritemvia Rituximab-blit Rituximab-rite Rituximab-rixa Rituximab-rixi Riximyo RTXM 83 RTXM-83 ABP-798 ABP798 CT P10 CTP10 GP 2013 GP-2013 GP2013 Rituximab Biosimilar GP2013 Procedure: Computed Tomography Undergo CT Andre navne: CT KAT CAT-scanning Beregnet aksial tomografi Computerstyret aksial tomografi Computerstyret tomografi CT-scanning tomografi Computerstyret aksial tomografi (procedure) Computerstyret tomografi (CT) scanning Diagnostisk CAT -scanning Diagnostic CAT Scan Service Type Procedure: Bone Marrow Aspiration Undergo bone marrow aspiration and biopsy Procedure: Bone Marrow Biopsy Undergo bone marrow aspiration and biopsy Andre navne: Biopsi af knoglemarv Biopsi, knoglemarv Medicin: Ibrutinib Given PO Andre navne: PCI-32765 Imbruvica BTK-hæmmer PCI-32765 CRA-032765 PCI32765 CRA 032765 CRA032765 PCI 32765

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Progression Free Survival (PFS) Tidsramme: Time from study entry to the time of documented disease progression or death. The analysis was event driven, performed at 2.5 years after the last patient enrolled;up to 4 years.	The Kaplan-Meier method will be used to estimate the progression free survival distributions for each arm, with median estimates provided. Progression is defined as any one of the following: an increase in number of blood lymphocytes by >= 50% with >= 5000 B lymphocytes/mL in patients on Arm A or those on Arms 2 or 3 no longer receiving ibrutinib, >= 50% increase in the products of at least 2 lymph nodes on 2 consecutive determination 2 weeks apart, >= 50% increase in the size of the liver/spleen, transformation to a more aggressive histology, progression of any cytopenia (i.e. decrease of Hb levels > 2g/dL). Progression free survival time will be the time to either progression or death whichever occurs first.	Time from study entry to the time of documented disease progression or death. The analysis was event driven, performed at 2.5 years after the last patient enrolled;up to 4 years.

Sekundære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Progression Free Survival (PFS) Rate at 2 Years Tidsramme: Time from study entry to the time of documented disease progression or death, assessed up to 2 years	The Kaplan-Meier method will be used to estimate the rate of progression free survival at 2 years in each treatment arm. Progression is defined as any one of the following: an increase in number of blood lymphocytes by >= 50%, >= 50% increase in the products of at least 2 lymph nodes on 2 consecutive determination 2 weeks apart, >= 50% increase in the size of the liver/spleen, transformation to a more aggressive histology, progression of any cytopenia (i.e. decrease of Hb levels > 2g/dL). Progression free survival time will be the time to either progression or death whichever occurs first.	Time from study entry to the time of documented disease progression or death, assessed up to 2 years
Overall Survival (OS) at 2 Years Tidsramme: From the date of registration to the date of death, assessed up to 2 years	The Kaplan-Meier method will be used to estimate the rate of overall survival at 2 years in each treatment arm. OS will be measured from the date of registration to the date of the event (i.e., death) or the date of last follow-up to evaluate that event. Patients who are event-free at their last follow-up evaluation will be censored at that time point.	From the date of registration to the date of death, assessed up to 2 years
Duration of Response (DOR) (Complete Response [CR], CCR, Nodular Partial Response [nPR], Partial Response [PR], and PRL) Tidsramme: From the date of first response until progression or death, performed at 2.5 years after the last patient enrolled; up to 4 years.	The Kaplan-Meier method will be used to estimate median DOR. DOR is the time from first objective status to progression or death. CR requires all of the following: absence of lymphadenopathy > 1.5 cm on physical exam/CT scan, no hepatomegaly/splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate & biopsy must be normocellular for age. PR requires >= 50% decrease in peripheral lymphocyte count from pre-treatment value, >= 50% reduction in lymphadenopathy, and/or ≥ 50% reduction in splenomegaly/hepatomegaly. CR with exception of having bone marrow lymphoid CLL nodules will be considered a nodular PR (nPR). CR with exception of not having a bone marrow biopsy performed will be considered a clinical CR (CCR). PR with the exception of having less than a 50% reduction in peripheral lymphocyte count will be considered a PR except persistent lymphocytosis (PRL).	From the date of first response until progression or death, performed at 2.5 years after the last patient enrolled; up to 4 years.
Percentage of Patients Achieving Any Response to Treatment (Overall Response Rate [ORR] [Complete Response [CR], CCR, Nodular Partial Response [nPR], Partial Response [PR], and PRL]) Tidsramme: Performed at 2.5 years after the last patient enrolled;up to 4 years.	Complete response (CR) requires all of the following: absence of lymphadenopathy >1.5 cm on physical exam/CT scan, no hepatomegaly/splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate & biopsy must be normocellular for age. Partial response (PR) requires >= 50% decrease in peripheral lymphocyte count from pre-treatment value, >= 50% reduction in lymphadenopathy, and/or ≥ 50% reduction in splenomegaly/hepatomegaly. CR with exception of having bone marrow lymphoid CLL nodules will be considered a nodular PR (nPR). CR with exception of not having a bone marrow biopsy performed will be considered a clinical CR (CCR). PR with the exception of having less than a 50% reduction in peripheral lymphocyte count will be considered a PR except persistent lymphocytosis (PRL).Overall response rate and corresponding exact binomial 95% CI provided.	Performed at 2.5 years after the last patient enrolled;up to 4 years.
Percentage of Patients Achieving a Biopsy-proven Complete Response (CR) Tidsramme: Performed at 2.5 years after the last patient enrolled; up to 4 years.	Complete response (CR) requires all of the following: absence of lymphadenopathy > 1.5 cm on physical exam/CT scan, no hepatomegaly or splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate and biopsy must be normocellular for age. Complete response rate and corresponding exact binomial 95% confidence intervals provided.	Performed at 2.5 years after the last patient enrolled; up to 4 years.
Percentage of Patients Achieving Complete (CR and CCR) or Nodular Partial Response (nPR) Tidsramme: Performed at 2.5 years after the last patient enrolled; up to 4 years.	Complete response (CR) requires all of the following: absence of lymphadenopathy > 1.5 cm on physical exam/CT scan, no hepatomegaly or splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate and biopsy must be normocellular for age. CR with exception of having bone marrow lymphoid CLL nodules will be considered a nodular PR (nPR). CR with exception of not having a bone marrow biopsy performed will be considered a clinical CR (CCR). Response rate and corresponding exact binomial 95% confidence intervals provided.	Performed at 2.5 years after the last patient enrolled; up to 4 years.
Percentage of Patients Who Attain Minimal Residual Disease (MRD) Negative Status Tidsramme: Cycle 9 Day 1 Evaluation	Estimated using the number of patients who achieve minimal residual disease divided by the total number randomized to that treatment arm. Corresponding exact binomial 95% confidence intervals for MRD rates will be calculated.	Cycle 9 Day 1 Evaluation
The Rate of Grade 3, 4, or 5 Treatment-related Non-hematologic Adverse Events (Toxicities) Tidsramme: Performed at 2.5 years after the last patient enrolled; up to 4 years.	The rate of grade 3, 4, or 5 treatment-related non-hematologic adverse events (toxicities) by arm; excludes adverse events occurring post-crossover for patients in Arm A	Performed at 2.5 years after the last patient enrolled; up to 4 years.

Andre resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Geriatric Functional Status (Optional) Tidsramme: Performed at 2.5 years after the last patient enrolled	Assessed using the Older Americans' Resources and Services Multidimensional Functional Assessment Questionnaire, Activities of Daily Living, Medical Outcomes Study physical functioning, Karnofsky performance status rated by a health care professional, Karnofsky performance status rated by the patient, timed "Up and Go", and number of falls in the last six months.	Performed at 2.5 years after the last patient enrolled

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: Jennifer A Woyach, 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

Hjælpsomme links

<p>Data Available: Select individual patient-level data from this trial can be requested from the NCTN/NCORP Data Archive.</p>

Datoer for undersøgelser

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

Studer store datoer

Studiestart (Faktiske)

15. januar 2014

Primær færdiggørelse (Faktiske)

7. august 2018

Studieafslutning (Anslået)

24. juni 2027

Datoer for studieregistrering

Først indsendt

24. juni 2013

Først indsendt, der opfyldte QC-kriterier

24. juni 2013

Først opslået (Anslået)

26. juni 2013

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

22. oktober 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

21. oktober 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

NCI-2013-01220
U10CA180821 (U.S. NIH-bevilling/kontrakt)
U10CA031946 (U.S. NIH-bevilling/kontrakt)
NCI-2013-01220 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
ALLIANCE A041202
A041202 (Anden identifikator: CTEP)
K23CA178183 (U.S. NIH-bevilling/kontrakt)
R01CA183444 (U.S. NIH-bevilling/kontrakt)
A041202 (Anden identifikator: Alliance for Clinical Trials in Oncology)

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 .

Rituximab og Bendamustine Hydrochloride, Rituximab og Ibrutinib eller Ibrutinib alene til behandling af ældre patienter med tidligere ubehandlet kronisk lymfatisk leukæmi

Et randomiseret fase III-studie af Bendamustine Plus Rituximab versus Ibrutinib Plus Rituximab Versus Ibrutinib alene hos ubehandlede ældre patienter (>/= 65 år) med kronisk lymfatisk leukæmi (CLL)

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

Køn, der er berettiget til at studere

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

Andre resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Samarbejdspartnere og efterforskere

Sponsor

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 (Faktiske)

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

Sidst verificeret

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre