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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

3. april 2024 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)

Dette randomiserede fase III-studie undersøger rituximab med bendamustinhydrochlorid eller ibrutinib for at se, hvor godt de virker sammenlignet med ibrutinib alene til behandling af ældre patienter med tidligere ubehandlet kronisk lymfatisk leukæmi. Monoklonale antistoffer, såsom rituximab, kan blokere kræftvækst på forskellige måder ved at målrette mod bestemte celler. Lægemidler, der bruges i kemoterapi, såsom bendamustinhydrochlorid, virker på forskellige måder for at stoppe væksten af kræftceller, enten ved at dræbe cellerne, ved at stoppe dem i at dele sig eller ved at stoppe dem i at sprede sig. Ibrutinib kan stoppe væksten af kræftceller ved at blokere nogle af de enzymer, der er nødvendige for cellevækst. Det vides endnu ikke, om rituximab med bendamustinhydrochlorid kan virke bedre end rituximab og ibrutinib eller ibrutinib alene til behandling af kronisk lymfatisk leukæmi.

Studieoversigt

Status

Aktiv, ikke rekrutterende

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

PRIMÆR MÅL:

I. For at bestemme, om progressionsfri overlevelse (PFS) er overlegen efter behandling med bendamustinhydrochlorid (bendamustin) i kombination med rituximab, ibrutinib alene eller ibrutinib i kombination med rituximab hos patienter på 65 år eller ældre med tidligere ubehandlet kronisk lymfatisk leukæmi (CLL) .

SEKUNDÆRE MÅL:

I. At bestemme 2-årig PFS i hver af de tre behandlingsarme. II. For at bestemme, hvilken behandlingsarm der producerer overlegen total overlevelse (OS). III. For at bestemme den fuldstændige respons (CR) rate, fuldstændig og nodulær partiel respons (CR/nPR) rate og overordnet respons (PR+nPR+CR) rate (ORR) blandt de tre behandlingsarme og sammenligne disse arme.

IV. At bestemme virkningen af minimal residual disease (MRD)-negativ sygdom på tidspunktet for CR-dokumentation og efter 2 år på PFS og OS i hver af behandlingsarmene.

V. At bestemme varigheden af respons efter hver af de tre behandlinger og sammenligne disse behandlingsarme.

VI. For at bestemme toksicitet og tolerabilitet af de tre behandlingsregimer. VII. For at bestemme respons og PFS hos patienter, der initialt tager bendamustin i kombination med rituximab-armen, som går over til ibrutinib.

ANDRE FORUDSPECIFICEREDE MÅL:

I. For at bestemme om baseline cytogenetiske markører, Zap-70 methylering, IgVH mutationsstatus eller selekterede deoxyribonukleinsyre (DNA) mutationer forudsiger resultater eller tid til respons i disse tre arme.

II. For at bestemme, om lokal fluorescens in situ hybridisering (FISH) resulterer for del(11q22.3) og del(17p13.1) er i overensstemmelse med central analyse.

III. For at bestemme, om baseline mikroribonukleinsyre (RNA) og genekspressionsmarkører er korreleret med kliniske resultater af interesse (f.eks. progressionsfri og i live efter 2 år versus ikke), samt at udforske ændringer i mikroRNA-ekspression fra baseline til tidspunkter efter behandling med fokus på dem med vedvarende lymfocytose og tilbagefald.

IV. For at bestemme, om udryddelse af MRD forudsiger længere varighed af respons med standardterapi og ibrutinib-baserede regimer.

V. At beskrive den grundlæggende funktionelle status, komorbide medicinske tilstande og antallet af medicin af ældre CLL-patienter, der opfylder kriterierne for terapi.

VI. For at bestemme, hvordan funktionel status ændrer sig med terapi ved hjælp af baseline til 3-måneders evaluering og end-of-studie/2-års evaluering; for at afgøre, om denne ændring er forskellig blandt behandlingsgrupperne.

VII. For at bestemme, om geriatriske vurderingsvariable, der vides at være forbundet med kemoterapitoksicitet i andre sygdomsgrupper, også kan forudsige terapiassocieret toksicitet i CLL-populationen.

VIII. For at vurdere, om FCGR3A-polymorfi (rs396991) er korreleret med dybde af respons (MRD-status) på ibrutinib plus rituximab efter 6 cyklusser, med sekundære endepunkter CR-rate, hurtighed af respons og progressionsfri overlevelse (PFS).

IX. For at vurdere om C1QA-polymorfi (rs172378) er korreleret med MRD-status, CR-rate, responshastighed og PFS.

OVERSIGT: Patienterne randomiseres til 1 ud af 3 behandlingsarme.

ARM I: Patienterne får rituximab intravenøst (IV) på dag 1 (dag 0 kursus 1) og bendamustinhydrochlorid IV over 30 minutter på dag 1-2. Behandlingen gentages hver 28. dag i 6 forløb i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienter, der oplever sygdomsprogression, kan gå over til arm II.

ARM II: Patienterne får ibrutinib oralt (PO) dagligt på dag 1-28. Kurser gentages hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.

ARM III: Patienter får ibrutinib som i arm II. Patienterne får rituximab IV på dag 1, 8, 15 og 22 i kursus 2 og på dag 1 i kursus 3-6. Kurser gentages hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.

Efter afsluttet undersøgelsesbehandling følges patienterne hver 6. måned i op til 10 år.

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 4N2
    - Tom Baker 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
  - 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
  - Sudbury, Ontario, Canada, P3E 5J1
    - Health Sciences North
  - 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
  - Toronto, Ontario, Canada, M4C 3E7
    - Michael Garron Hospital
- Quebec
  - Greenfield Park, Quebec, Canada, J4V 2H1
    - CSSS Champlain-Charles Le Moyne
  - Montreal, Quebec, Canada, H3T 1E2
    - Jewish General Hospital
  - Montreal, Quebec, Canada, H2L 4M1
    - CHUM - Hopital Notre-Dame
  - 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
    - Yuma Regional 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 Campus
  - 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 - Harbor City
  - Irvine, California, Forenede Stater, 92618
    - Kaiser Permanente-Irvine
  - Los Angeles, California, Forenede Stater, 90027
    - Kaiser Permanente Los Angeles Medical Center
  - Los Angeles, California, Forenede Stater, 90048
    - Cedars Sinai 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
  - Saint Helena, California, Forenede Stater, 94574
    - Saint Helena Hospital
  - San Diego, California, Forenede Stater, 92120
    - Kaiser Permanente-San Diego Zion
  - San Diego, California, Forenede Stater, 92134
    - Naval Medical Center -San Diego
  - San 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
  - Stockton, California, Forenede Stater, 95210
    - Kaiser Permanente-Stockton
  - Sunnyvale, California, Forenede Stater, 94086
    - Palo Alto Medical Foundation-Sunnyvale
  - Vacaville, California, Forenede Stater, 95688
    - Kaiser Permanente Medical Center-Vacaville
  - Vacaville, California, Forenede Stater, 95687
    - Northbay Cancer Center
  - Vacaville, California, Forenede Stater, 95687
    - Sutter Cancer Centers Radiation Oncology Services-Vacaville
  - Vallejo, California, Forenede Stater, 94589
    - Kaiser Permanente-Vallejo
  - Vallejo, California, Forenede Stater, 94589
    - Sutter Solano Medical Center/Cancer Center
  - Walnut Creek, California, Forenede Stater, 94596
    - Kaiser Permanente-Walnut Creek
  - Walnut Creek, California, Forenede Stater, 94598
    - John Muir Medical Center-Walnut Creek
  - 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, 80301
    - Boulder Community Hospital
  - Boulder, Colorado, Forenede Stater, 80304
    - Rocky Mountain Cancer Centers-Boulder
  - Colorado Springs, Colorado, Forenede Stater, 80907
    - Penrose-Saint Francis Healthcare
  - Colorado Springs, Colorado, Forenede Stater, 80907
    - Rocky Mountain Cancer Centers-Penrose
  - Denver, Colorado, Forenede Stater, 80210
    - Porter Adventist Hospital
  - Denver, Colorado, Forenede Stater, 80205
    - Kaiser Permanente-Franklin
  - Denver, Colorado, Forenede Stater, 80218
    - Presbyterian - Saint Lukes Medical Center - Health One
  - Denver, Colorado, Forenede Stater, 80218
    - SCL Health Saint Joseph Hospital
  - Denver, Colorado, Forenede Stater, 80220
    - Rose Medical Center
  - Denver, Colorado, Forenede Stater, 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
  - Durango, Colorado, Forenede Stater, 81301
    - Mercy Medical Center
  - Durango, Colorado, Forenede Stater, 81301
    - Southwest Oncology PC
  - 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
    - 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
    - Saint Anthony Hospital
  - Lakewood, Colorado, Forenede Stater, 80228
    - Rocky Mountain Cancer Centers-Lakewood
  - Littleton, Colorado, Forenede Stater, 80120
    - Rocky Mountain Cancer Centers-Littleton
  - Littleton, Colorado, Forenede Stater, 80122
    - Littleton Adventist Hospital
  - Lone Tree, Colorado, Forenede Stater, 80124
    - 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
    - McKee Medical Center
  - Parker, Colorado, Forenede Stater, 80138
    - Parker Adventist Hospital
  - Parker, Colorado, Forenede Stater, 80138
    - Rocky Mountain Cancer Centers-Parker
  - Pueblo, Colorado, Forenede Stater, 81004
    - Saint Mary Corwin Medical Center
  - Pueblo, Colorado, Forenede Stater, 81008
    - Rocky Mountain Cancer Centers - Pueblo
  - Thornton, Colorado, Forenede Stater, 80260
    - Rocky Mountain Cancer Centers-Thornton
  - Wheat Ridge, Colorado, Forenede Stater, 80033
    - SCL Health Lutheran Medical Center
- Connecticut
  - 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
  - Newark, Delaware, Forenede Stater, 19713
    - Christiana Gynecologic Oncology LLC
  - Rehoboth Beach, Delaware, Forenede Stater, 19971
    - Beebe Health Campus
  - Seaford, Delaware, Forenede Stater, 19973
    - TidalHealth Nanticoke / Allen Cancer Center
  - Wilmington, Delaware, Forenede Stater, 19801
    - Christiana Care Health System-Wilmington Hospital
- District of Columbia
  - Washington, District of Columbia, Forenede Stater, 20010
    - MedStar Washington Hospital Center
  - Washington, District of Columbia, Forenede Stater, 20007
    - MedStar Georgetown University Hospital
- Florida
  - 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
  - '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
  - 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
- 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, 83686
    - Saint Luke's Cancer Institute - Nampa
  - Post Falls, Idaho, Forenede Stater, 83854
    - Kootenai Clinic Cancer Services - Post Falls
  - Sandpoint, Idaho, Forenede Stater, 83864
    - Kootenai Cancer Clinic
  - 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
    - 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
    - Good Samaritan Regional Health Center
  - 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 Cancer Treatment Center
  - Peoria, Illinois, Forenede Stater, 61636
    - Methodist Medical Center of Illinois
  - Peoria, Illinois, Forenede Stater, 61637
    - OSF Saint Francis Medical Center
  - Peoria, Illinois, Forenede Stater, 61615
    - Illinois CancerCare-Peoria
  - Peoria, Illinois, Forenede Stater, 61615
    - OSF Saint Francis Radiation Oncology at Peoria Cancer Center
  - Peoria, Illinois, Forenede Stater, 61614
    - Proctor Hospital
  - Peru, Illinois, Forenede Stater, 61354
    - Illinois CancerCare-Peru
  - Peru, Illinois, Forenede Stater, 61354
    - Valley Radiation Oncology
  - Princeton, Illinois, Forenede Stater, 61356
    - Illinois CancerCare-Princeton
  - Quincy, Illinois, Forenede Stater, 62301
    - Quincy Medical Group-Clinic
  - Rockford, Illinois, Forenede Stater, 61114
    - SwedishAmerican Regional Cancer Center/ACT
  - Skokie, Illinois, Forenede Stater, 60076
    - North Shore Medical Center
  - Springfield, Illinois, Forenede Stater, 62781
    - Memorial Medical Center
  - Springfield, Illinois, Forenede Stater, 62702
    - Southern Illinois University School of Medicine
  - Springfield, Illinois, Forenede Stater, 62702
    - Springfield Clinic
  - Springfield, Illinois, Forenede Stater, 62702
    - Central Illinois Hematology Oncology Center
  - 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, 46601
    - Michiana Hematology Oncology PC-South Bend
  - South Bend, Indiana, Forenede Stater, 46628
    - Northern Indiana Cancer Research Consortium
  - Westville, Indiana, Forenede Stater, 46391
    - Michiana Hematology Oncology PC-Westville
- Iowa
  - Ames, Iowa, Forenede Stater, 50010
    - 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
    - Medical Oncology and Hematology Associates-West Des Moines
  - Council Bluffs, Iowa, Forenede Stater, 51503
    - Alegent Health Mercy Hospital
  - Creston, Iowa, Forenede Stater, 50801
    - Greater Regional Medical Center
  - Des Moines, Iowa, Forenede Stater, 50314
    - Mercy Medical Center - Des Moines
  - Des Moines, Iowa, Forenede Stater, 50314
    - Mission Cancer and Blood - Laurel
  - Des Moines, Iowa, Forenede Stater, 50309
    - Iowa-Wide Oncology Research Coalition NCORP
  - 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 University of Kansas Health System
  - 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
    - Olathe Health Cancer Center
  - Overland Park, Kansas, Forenede Stater, 66210
    - University of Kansas Cancer Center-Overland Park
  - Overland Park, Kansas, Forenede Stater, 66209
    - Menorah Medical Center
  - Overland Park, Kansas, Forenede Stater, 66213
    - Saint Luke's South Hospital
  - Parsons, Kansas, Forenede Stater, 67357
    - Cancer Center of Kansas - Parsons
  - Pittsburg, Kansas, Forenede Stater, 66762
    - Ascension Via Christi - 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
    - Flaget Memorial Hospital
  - 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
    - Saint Joseph Hospital East
  - 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
    - Our Lady of the Lake Physicians Group - Medical Oncology
  - Baton Rouge, Louisiana, Forenede Stater, 70809
    - Ochsner Health Center-Summa
  - 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, 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 Hospital and Medical Center
  - 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
    - Winchester Hospital
  - 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
    - Saint Joseph Mercy Hospital
  - Ann Arbor, Michigan, Forenede Stater, 48106
    - Michigan Cancer Research Consortium NCORP
  - 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, 48124
    - Beaumont Hospital - Dearborn
  - Dearborn, Michigan, Forenede Stater, 48126
    - Henry Ford Medical Center-Fairlane
  - Detroit, Michigan, Forenede Stater, 48202
    - Henry Ford Hospital
  - Detroit, Michigan, Forenede Stater, 48201
    - Wayne State University/Karmanos Cancer Institute
  - Detroit, Michigan, Forenede Stater, 48236
    - Ascension Saint John Hospital
  - Escanaba, Michigan, Forenede Stater, 49829
    - Green Bay Oncology - Escanaba
  - Farmington Hills, Michigan, Forenede Stater, 48334
    - Weisberg Cancer Treatment Center
  - Farmington Hills, Michigan, Forenede Stater, 48336
    - Beaumont Hospital - Farmington Hills
  - 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
    - Spectrum Health at Butterworth Campus
  - Grand Rapids, Michigan, Forenede Stater, 49503
    - Cancer Research Consortium of West Michigan NCORP
  - Grand Rapids, Michigan, Forenede Stater, 49503
    - Trinity Health Grand Rapids Hospital
  - Grosse Pointe, Michigan, Forenede Stater, 48230
    - William Beaumont Hospital-Grosse Pointe
  - Iron Mountain, Michigan, Forenede Stater, 49801
    - Green Bay Oncology - Iron Mountain
  - Jackson, Michigan, Forenede Stater, 49201
    - Allegiance Health
  - Kalamazoo, Michigan, Forenede Stater, 49007
    - West Michigan Cancer Center
  - 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, 48374
    - Ascension Providence Hospitals - Novi
  - Novi, Michigan, Forenede Stater, 48377
    - Henry Ford Medical Center-Columbus
  - Petoskey, Michigan, Forenede Stater, 49770
    - McLaren Cancer Institute-Northern Michigan
  - Pontiac, Michigan, Forenede Stater, 48341
    - Saint Joseph Mercy Oakland
  - 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
    - William Beaumont Hospital-Royal Oak
  - Royal Oak, Michigan, Forenede Stater, 48073
    - Cancer Care Associates PC
  - Royal Oak, Michigan, Forenede Stater, 48073
    - Comprehensive Medical Center PLLC
  - Royal Oak, Michigan, Forenede Stater, 48073
    - Hematology Oncology Consultants PC
  - Royal Oak, Michigan, Forenede Stater, 48073
    - Oakland Medical Group
  - Royal Oak, Michigan, Forenede Stater, 48067
    - Oakland Colon Rectal Associates
  - Saginaw, Michigan, Forenede Stater, 48601
    - Ascension Saint Mary's Hospital
  - Southfield, Michigan, Forenede Stater, 48075
    - Ascension Providence Hospitals - Southfield
  - 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, 48085
    - William Beaumont Hospital - Troy
  - Troy, Michigan, Forenede Stater, 48084
    - Michigan Institute of Urology-Town Center
  - Troy, Michigan, Forenede Stater, 48085
    - Claudia BR Herke MD PC
  - Troy, Michigan, Forenede Stater, 48098
    - Hematology Oncology Consultants PC-Troy
  - Warren, Michigan, Forenede Stater, 48093
    - Saint John Macomb-Oakland Hospital
  - 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
    - Southeast Cancer Center
  - Chesterfield, Missouri, Forenede Stater, 63017
    - Saint Luke's 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
    - Capital Region Southwest Campus
  - Joplin, Missouri, Forenede Stater, 64804
    - Freeman Health System
  - Joplin, Missouri, Forenede Stater, 64804
    - Mercy Hospital Joplin
  - Kansas City, Missouri, Forenede Stater, 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, 64108
    - Truman Medical Centers
  - Kansas City, Missouri, Forenede Stater, 64118
    - Heartland Hematology and Oncology Associates Incorporated
  - 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 Radiation Oncology Center
  - Rolla, Missouri, Forenede Stater, 65401
    - Delbert Day Cancer Institute at PCRMC
  - Rolla, Missouri, Forenede Stater, 65401
    - Mercy Clinic-Rolla-Cancer and Hematology
  - Saint Joseph, Missouri, Forenede Stater, 64506
    - Heartland Regional Medical Center
  - Saint Louis, Missouri, Forenede Stater, 63110
    - Washington University School of Medicine
  - Saint Louis, Missouri, Forenede Stater, 63131
    - Missouri Baptist Medical Center
  - Saint Louis, Missouri, Forenede Stater, 63141
    - Mercy Hospital Saint Louis
  - Saint Louis, Missouri, Forenede Stater, 63129
    - Siteman Cancer Center-South County
  - Saint Louis, Missouri, Forenede Stater, 63109
    - Saint Louis Cancer and Breast Institute-South City
  - Saint Peters, Missouri, Forenede Stater, 63376
    - Siteman Cancer Center at Saint Peters Hospital
  - Sainte Genevieve, Missouri, Forenede Stater, 63670
    - Sainte Genevieve County Memorial Hospital
  - Springfield, Missouri, Forenede Stater, 65807
    - CoxHealth South Hospital
  - Springfield, Missouri, Forenede Stater, 65804
    - Mercy Hospital Springfield
  - Sullivan, Missouri, Forenede Stater, 63080
    - Missouri Baptist Sullivan Hospital
  - Sunset Hills, Missouri, Forenede Stater, 63127
    - BJC Outpatient Center at Sunset Hills
- Montana
  - Billings, Montana, Forenede Stater, 59101
    - Billings Clinic Cancer Center
  - Billings, Montana, Forenede Stater, 59101
    - Saint Vincent Healthcare
  - Billings, Montana, Forenede Stater, 59102
    - Montana Cancer Consortium NCORP
  - Bozeman, Montana, Forenede Stater, 59715
    - Bozeman Deaconess Hospital
  - Butte, Montana, Forenede Stater, 59701
    - Saint James Community Hospital and Cancer Treatment Center
  - Great Falls, Montana, Forenede Stater, 59405
    - Benefis Healthcare- Sletten Cancer Institute
  - Helena, Montana, Forenede Stater, 59601
    - Saint Peter's Community Hospital
  - Kalispell, Montana, Forenede Stater, 59901
    - Kalispell Regional Medical Center
  - Missoula, Montana, Forenede Stater, 59804
    - Community Medical Hospital
  - Missoula, Montana, Forenede Stater, 59802
    - Saint Patrick Hospital - Community Hospital
- Nebraska
  - Grand Island, Nebraska, Forenede Stater, 68803
    - CHI Health Saint Francis
  - Kearney, Nebraska, Forenede Stater, 68847
    - CHI Health Good Samaritan
  - Kearney, Nebraska, Forenede Stater, 68845
    - Heartland Hematology and Oncology
  - Lincoln, Nebraska, Forenede Stater, 68510
    - Saint Elizabeth Regional Medical Center
  - Omaha, Nebraska, Forenede Stater, 68198
    - University of Nebraska Medical Center
  - Omaha, Nebraska, Forenede Stater, 68124
    - Alegent Health Bergan Mercy Medical Center
  - Omaha, Nebraska, Forenede Stater, 68122
    - Alegent Health Immanuel Medical Center
  - Omaha, Nebraska, Forenede Stater, 68130
    - Alegent Health Lakeside Hospital
  - Omaha, Nebraska, Forenede Stater, 68131
    - Creighton University Medical Center
  - Omaha, Nebraska, Forenede Stater, 68122
    - Hematology and Oncology Consultants PC
  - Papillion, Nebraska, Forenede Stater, 68046
    - Midlands Community Hospital
- Nevada
  - 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
    - GenesisCare USA - 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, 89109
    - GenesisCare USA - Las Vegas
  - 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, 89148
    - OptumCare Cancer Care at Fort Apache
  - Las Vegas, Nevada, Forenede Stater, 89169
    - Comprehensive Cancer Centers of Nevada - Central Valley
  - Las Vegas, Nevada, Forenede Stater, 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
    - GenesisCare USA - Vegas 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, 89148
    - GenesisCare USA - Fort Apache
  - Las Vegas, Nevada, Forenede Stater, 89149
    - HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
  - Las Vegas, Nevada, Forenede Stater, 89169
    - Nevada Cancer Research Foundation NCORP
  - 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, 03102
    - Norris Cotton Cancer Center-Manchester
  - Manchester, New Hampshire, Forenede Stater, 03103
    - Solinsky Center for Cancer Care
  - 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 Hospital
  - 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, 87102
    - 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
  - 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
  - Syracuse, New York, Forenede Stater, 13215
    - Hematology Oncology Associates of Central New York-Onondaga Hill
  - 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
    - Hendersonville Hematology and Oncology at Pardee
  - Hendersonville, North Carolina, Forenede Stater, 28791
    - Margaret R Pardee Memorial Hospital
  - Hendersonville, North Carolina, Forenede Stater, 28792
    - AdventHealth Hendersonville
  - Jacksonville, North Carolina, Forenede Stater, 28546
    - Southeastern Medical Oncology Center-Jacksonville
  - Jacksonville, North Carolina, Forenede Stater, 28546
    - Onslow Memorial Hospital
  - Kinston, North Carolina, Forenede Stater, 28501
    - Vidant 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
  - Fargo, North Dakota, Forenede Stater, 58122
    - Sanford Clinic North-Fargo
  - 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, 45505
    - Springfield Regional Medical Center
  - Springfield, Ohio, Forenede Stater, 45504
    - Springfield Regional Cancer 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, 43608
    - Saint Vincent Mercy Medical Center
  - Toledo, Ohio, Forenede Stater, 43623
    - Mercy Health - Saint Anne Hospital
  - Toledo, Ohio, Forenede Stater, 43623
    - Toledo Clinic Cancer Centers-Toledo
  - Toledo, Ohio, Forenede Stater, 43614
    - University of Toledo
  - Toledo, Ohio, Forenede Stater, 43617
    - Toledo Community Hospital Oncology Program CCOP
  - Troy, Ohio, Forenede Stater, 45373
    - Upper Valley Medical Center
  - 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, 74136
    - Natalie Warren Bryant Cancer Center at Saint Francis
  - Tulsa, Oklahoma, Forenede Stater, 74146
    - Warren Clinic Oncology-Tulsa
- 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
    - Cherry Tree Cancer Center
  - Hazleton, Pennsylvania, Forenede Stater, 18201
    - Geisinger Medical Center-Cancer Center Hazleton
  - Hershey, Pennsylvania, Forenede Stater, 17033-0850
    - Penn State Milton S Hershey Medical Center
  - 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, 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, 15213
    - UPMC-Magee Womens Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15232
    - University of Pittsburgh Cancer Institute (UPCI)
  - Pittsburgh, Pennsylvania, Forenede Stater, 15232
    - UPMC-Shadyside Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15213
    - UPMC-Presbyterian Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15215
    - UPMC-Saint Margaret
  - Pittsburgh, Pennsylvania, Forenede Stater, 15236
    - UPMC Jefferson Regional Radiation Oncology
  - Pittsburgh, Pennsylvania, Forenede Stater, 15237
    - UPMC-Passavant Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15243
    - UPMC-Saint Clair Hospital Cancer Center
  - 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, 29414
    - Lowcountry Hematology Oncology PA-West Ashley
  - Charleston, South Carolina, Forenede Stater, 29403
    - Charleston Oncology - Roper
  - Charleston, South Carolina, Forenede Stater, 29414
    - Charleston Oncology - Saint Francis
  - 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
  - Mount Pleasant, South Carolina, Forenede Stater, 29464
    - Lowcountry Hematology Oncology PA-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
    - MGC Hematology Oncology-Union
  - West Columbia, South Carolina, Forenede Stater, 29169
    - Lexington Medical Center
- South Dakota
  - Rapid City, South Dakota, Forenede Stater, 57701
    - Rapid City Regional Hospital
  - Sioux Falls, South Dakota, Forenede Stater, 57105
    - Avera Cancer Institute
  - Sioux Falls, South Dakota, Forenede Stater, 57117-5134
    - Sanford USD Medical Center - Sioux Falls
  - Sioux Falls, South Dakota, Forenede Stater, 57104
    - Sanford Cancer Center Oncology Clinic
- Tennessee
  - Bristol, Tennessee, Forenede Stater, 37620
    - Wellmont Medical Associates Oncology and Hematology-Bristol
  - Bristol, Tennessee, Forenede Stater, 37620
    - 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
  - San Antonio, Texas, Forenede Stater, 78229
    - Cancer Therapy and Research Center at The UT Health Science Center at San Antonio
- Vermont
  - Bennington, Vermont, Forenede Stater, 05201
    - Southwestern Vermont Medical Center
  - Berlin, 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 Lynchburg Hematology-Oncology Clinic Inc
  - Norton, Virginia, Forenede Stater, 24273
    - Southwest VA Regional Cancer Center
  - Richmond, Virginia, Forenede Stater, 23298
    - Virginia Commonwealth University/Massey Cancer Center
  - Richmond, Virginia, Forenede Stater, 23229
    - Virginia Cancer Institute
  - 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
  - Bremerton, Washington, Forenede Stater, 98310
    - Harrison HealthPartners Hematology and Oncology-Bremerton
  - Bremerton, Washington, Forenede Stater, 98310
    - Harrison Medical Center
  - Burien, Washington, Forenede Stater, 98166
    - Highline Medical Center-Main Campus
  - Centralia, Washington, Forenede Stater, 98531
    - Providence Regional Cancer System-Centralia
  - Edmonds, Washington, Forenede Stater, 98026
    - Swedish 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
  - 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
    - West Virginia University Charleston Division
  - 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
    - Langlade Hospital and Cancer Center
  - Burlington, Wisconsin, Forenede Stater, 53105
    - Aurora Cancer Care-Southern Lakes VLCC
  - Chippewa Falls, Wisconsin, Forenede Stater, 54729
    - Marshfield Clinic-Chippewa Center
  - Eau Claire, Wisconsin, Forenede Stater, 54701
    - HSHS Sacred Heart Hospital
  - Eau Claire, Wisconsin, Forenede Stater, 54701
    - 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, 54303
    - Green Bay Oncology Limited at Saint Mary's Hospital
  - Green Bay, Wisconsin, Forenede Stater, 54301-3526
    - Green Bay Oncology at Saint Vincent Hospital
  - Kenosha, Wisconsin, Forenede Stater, 53142
    - Aurora Cancer Care-Kenosha South
  - La Crosse, Wisconsin, Forenede Stater, 54601
    - Gundersen Lutheran Medical Center
  - Ladysmith, Wisconsin, Forenede Stater, 54848
    - Marshfield Clinic - Ladysmith Center
  - 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 Clinic-Minocqua Center
  - Mukwonago, Wisconsin, Forenede Stater, 53149
    - ProHealth D N Greenwald Center
  - New Richmond, Wisconsin, Forenede Stater, 54017
    - Cancer Center of Western Wisconsin
  - Oconomowoc, Wisconsin, Forenede Stater, 53066
    - ProHealth Oconomowoc Memorial Hospital
  - Oconto Falls, Wisconsin, Forenede Stater, 54154
    - Saint Vincent Hospital Cancer Center at Oconto Falls
  - Oshkosh, Wisconsin, Forenede Stater, 54904
    - Vince Lombardi Cancer Clinic - Oshkosh
  - Racine, Wisconsin, Forenede Stater, 53406
    - Aurora Cancer Care-Racine
  - Rhinelander, Wisconsin, Forenede Stater, 54501
    - Ascension Saint Mary's Hospital
  - Rhinelander, Wisconsin, Forenede Stater, 54501
    - Saint Mary's Hospital
  - Rice Lake, Wisconsin, Forenede Stater, 54868
    - Marshfield Medical Center-Rice Lake
  - Sheboygan, Wisconsin, Forenede Stater, 53081
    - Vince Lombardi Cancer Clinic-Sheboygan
  - Sheboygan, Wisconsin, Forenede Stater, 53081
    - HSHS Saint Nicholas Hospital
  - Stevens Point, Wisconsin, Forenede Stater, 54481
    - Ascension Saint Michael's Hospital
  - Sturgeon Bay, Wisconsin, Forenede Stater, 54235
    - Green Bay Oncology - Sturgeon Bay
  - 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
    - Aspirus Regional Cancer Center
  - Wausau, Wisconsin, Forenede Stater, 54401
    - Marshfield Clinic-Wausau Center
  - Wauwatosa, Wisconsin, Forenede Stater, 53226
    - Aurora Cancer Care-Milwaukee West
  - West Allis, Wisconsin, Forenede Stater, 53227
    - Aurora West Allis Medical Center
  - Weston, Wisconsin, Forenede Stater, 54476
    - Marshfield Medical Center - Weston
  - Weston, Wisconsin, Forenede Stater, 54476
    - Diagnostic and Treatment Center
  - Weston, Wisconsin, Forenede Stater, 54476
    - Ascension Saint Clare's Hospital
  - 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

Beskrivelse

Inklusionskriterier:

FORUDREGISTRERING (TRIN 0)
Alle patienter SKAL være præregistreret til A041202 for at indsende perifert blod til Alliance Hematologic Malignancy Biorepository (HEME) til central Zap-70-methylering. Denne prøveindsendelse er obligatorisk før registrering, da resultaterne vil blive brugt til stratificering
REGISTRERING (TRIN 1)
Patienter skal diagnosticeres med CLL i overensstemmelse med International Workshop on Chronic Lymphocytic Leukæmi (IWCLL) 2008-kriterier, der omfatter alle følgende:
- >= 5 x 10^9 B-lymfocytter (5000/uL) i det perifere blod
- Ved morfologisk gennemgang skal leukæmicellerne være små modne lymfocytter, og prolymfocytter må ikke overstige 55 % af blodlymfocytterne
- CLL-celler på immunfænotype (udført lokalt) skal afsløre en klonal B-cellepopulation, som udtrykker B-celleoverflademarkørerne for CD19 og CD20, såvel som T-celleantigenet CD5; patienter med lys overflade-immunoglobulinekspression eller mangel på CD23-ekspression i > 10 % af cellerne skal mangle t(11;14) translokation ved interfase cytogenetik
Patienter skal være i mellem- eller højrisiko Rai-stadie CLL
- Mellemrisiko (tidligere Rai stadium I/II) er defineret ved lymfocytose plus forstørrede lymfeknuder på ethvert sted, med eller uden hepatomegali eller splenomegali
- Høj risiko (tidligere Rai stadium III/IV) er defineret ved lymfocytose med eller uden forstørrede noder og milt plus sygdomsrelateret anæmi (hæmoglobin < 11 g/dL) eller trombocytopeni (trombocyttal < 100 x 10^9/L), dvs. ikke kan tilskrives autoimmun hæmolytisk anæmi eller trombocytopeni
Patienter skal opfylde kriterier for behandling som defineret af IWCLL 2008 retningslinjer, som omfatter mindst et af følgende kriterier:
- Tegn på marvsvigt som manifesteret ved udvikling eller forværring af anæmi eller trombocytopeni (ikke tilskrives autoimmun hæmolytisk anæmi eller trombocytopeni)
- Massiv (>= 6 cm under costal margin), progressiv eller symptomatisk splenomegali
- Massive noder (>= 10 cm) eller progressiv eller symptomatisk lymfadenopati
- Autoimmun anæmi og/eller trombocytopeni, der reagerer dårligt på standardbehandling
- Konstitutionelle symptomer, som omfatter et af følgende:
  - Utilsigtet vægttab på 10 % eller mere inden for 6 måneder
  - Betydelig træthed
  - Feber > 100,5 grader F i 2 uger eller mere uden tegn på infektion
  - Nattesved > 1 måned uden tegn på infektion
Alder >= 65 år
Eastern Cooperative Oncology Group (ECOG) præstationsstatus 0-2
Patienter med aktiv hepatitis B defineret ved hepatitis B overfladeantigenpositivitet eller kerneantistofpositivitet i nærvær af hepatitis B DNA er ikke kvalificerede til denne undersøgelse; patienter med et positivt hepatitis B-kerneantistof, men med negativt hepatitis B-DNA, kan deltage, men skal have hepatitis-serologier og hepatitis B-DNA overvåget periodisk af den behandlende læge
- Intravenøst immunglobulin (IVIG) kan forårsage en falsk positiv hepatitis B-serologi; hvis patienter, der modtager rutine IVIG har kerne-antistof- eller overfladeantigenpositivitet uden tegn på aktiv viræmi (negativ hepatitis B-DNA), kan de stadig deltage i undersøgelsen, men bør have hepatitis-serologier og hepatitis B-DNA overvåget periodisk af den behandlende læge
Patienter med klasse III eller klasse IV hjertesvigt af New York Heart Association, dem med ustabil angina og dem med ukontrolleret arytmi er ikke kvalificerede
Patienter, der har haft et myokardieinfarkt, intrakraniel blødning eller slagtilfælde inden for de seneste 6 måneder, er ikke kvalificerede
Patienter med kendt human immundefektvirus (HIV) er kvalificerede, hvis deres CD4-tal er >= 350 celler/mm^3, og hvis de ikke tager forbudte CYP-interagerende medicin
Patienter har muligvis ikke fået foretaget en større operation inden for 10 dage efter tilmelding, eller mindre operation inden for 7 dage efter tilmelding; eksempler på mindre operationer omfatter tandkirurgi, indsættelse af en venøs adgangsanordning, hudbiopsi eller aspiration af et led; beslutningen om, hvorvidt en operation er større eller mindre, kan træffes efter den behandlende læges skøn
Absolut neutrofiltal (ANC) >= 1.000/uL, medmindre det skyldes knoglemarvspåvirkning
Aspartataminotransferase (AST) eller alaninaminotransferase (AST) =< 2,5 x øvre normalgrænser undtagen hvis det skyldes sygdomsinfiltration i leveren
Bilirubin =< 1,5 x øvre normalgrænse (medmindre det skyldes leverpåvirkning, hæmolyse eller Gilberts sygdom)
Kreatininclearance >= 40 ml/min
- Skal beregnes med modificeret Cockcroft-Gault formel
Blodpladeantal (ikke-transfunderet) >= 30.000/uL

Ekskluderingskriterier:

Forudgående behandling
- Patienter må ikke have haft tidligere behandling for CLL (undtagen palliative steroider eller behandling af autoimmune komplikationer af CLL med rituximab eller steroider)
- Behandling med rituximab og/eller højdosis kortikosteroider til autoimmune komplikationer af CLL skal være afsluttet mindst 4 uger før indskrivning; palliative steroider skal have en dosis på ikke højere end 20 mg/dag af prednison eller tilsvarende kortikosteroid på registreringstidspunktet
Patienter må ikke modtage aktiv systemisk antikoagulering med heparin eller warfarin; patienter skal have fri for warfarinbehandling i mindst 30 dage før indskrivning
Patienter må ikke have nogen historie med Richters transformation eller prolymfocytisk leukæmi (prolymfocytter i blod > 55 %)
Patienter må ikke kræve mere end 20 mg prednison eller tilsvarende kortikosteroid dagligt
Patienter må ikke have ukontrolleret aktiv systemisk infektion, der kræver intravenøs antibiotika
Patienter må ikke have fortsat behov for behandling med en stærk cytokrom P450 3A4/5 (CYP3A4/5) hæmmer eller inducer
Patienter må ikke have en kendt allergi over for mannitol
Patienter må ikke tidligere have signifikant overfølsomhed over for rituximab (ikke inklusive infusionsreaktioner)

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, bendamustinhydrochlorid) Patienterne får rituximab IV på dag 1 (dag 0 kursus 1) og bendamustinhydrochlorid IV over 30 minutter på dag 1-2. Behandlingen gentages hver 28. dag i 6 forløb i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienter, der oplever sygdomsprogression, kan gå over til arm II.	Andet: Laboratoriebiomarkøranalyse Korrelative undersøgelser Andet: Livskvalitetsvurdering Hjælpestudier Andre navne: Livskvalitetsvurdering Biologisk: Rituximab Givet 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 Ikgdar Mabtas Rituximab-abbs Medicin: Bendamustine hydrochlorid Givet IV Andre navne: Treanda Bendeka CEP-18083 Bendamustin hydrochlorid Cytostasan hydrochlorid Levact Ribomustin SyB L-0501 Treakisym Belrapzo
Eksperimentel: Arm II (ibrutinib) Patienter får ibrutinib PO dagligt. Kurser gentages hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.	Andet: Laboratoriebiomarkøranalyse Korrelative undersøgelser Andet: Livskvalitetsvurdering Hjælpestudier Andre navne: Livskvalitetsvurdering Medicin: Ibrutinib Givet PO Andre navne: PCI-32765 Imbruvica BTK-hæmmer PCI-32765 CRA-032765
Eksperimentel: Arm III (ibrutinib, rituximab) Patienterne får ibrutinib som i arm II. Patienterne får rituximab IV på dag 1, 8, 15 og 22 i kursus 2 og på dag 1 i kursus 3-6. Kurser gentages hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.	Andet: Laboratoriebiomarkøranalyse Korrelative undersøgelser Andet: Livskvalitetsvurdering Hjælpestudier Andre navne: Livskvalitetsvurdering Biologisk: Rituximab Givet 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 Ikgdar Mabtas Rituximab-abbs Medicin: Ibrutinib Givet PO Andre navne: PCI-32765 Imbruvica BTK-hæmmer PCI-32765 CRA-032765

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Progressionsfri overlevelse (PFS) Tidsramme: Tid fra studiestart til tidspunktet for dokumenteret sygdomsprogression eller død. Analysen var hændelsesdrevet, udført 2,5 år efter den sidste patient blev indskrevet; op til 4 år.	Kaplan-Meier metoden vil blive brugt til at estimere de progressionsfrie overlevelsesfordelinger for hver arm, med median estimater. Progression er defineret som en af følgende: en stigning i antallet af blodlymfocytter med >= 50 % med >= 5000 B-lymfocytter/ml hos patienter på arm A eller dem på arm 2 eller 3, der ikke længere får ibrutinib, >= 50 % stigning i produkterne fra mindst 2 lymfeknuder ved 2 på hinanden følgende bestemmelse med 2 ugers mellemrum, >= 50 % stigning i størrelsen af leveren/milten, transformation til en mere aggressiv histologi, progression af enhver cytopeni (dvs. fald i Hb-niveauer > 2g/dL). Progressionsfri overlevelsestid vil være tiden til enten progression eller død, alt efter hvad der indtræffer først.	Tid fra studiestart til tidspunktet for dokumenteret sygdomsprogression eller død. Analysen var hændelsesdrevet, udført 2,5 år efter den sidste patient blev indskrevet; op til 4 år.

Sekundære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Progressionsfri overlevelse (PFS) rate ved 2 år Tidsramme: Tid fra studiestart til tidspunktet for dokumenteret sygdomsprogression eller død, vurderet op til 2 år	Kaplan-Meier metoden vil blive brugt til at estimere graden af progressionsfri overlevelse efter 2 år i hver behandlingsarm. Progression er defineret som en af følgende: en stigning i antallet af blodlymfocytter med >= 50 %, >= 50 % stigning i produkterne fra mindst 2 lymfeknuder ved 2 på hinanden følgende bestemmelse med 2 ugers mellemrum, >= 50 % stigning i størrelsen af leveren/milten, transformation til en mere aggressiv histologi, progression af enhver cytopeni (dvs. fald i Hb-niveauer > 2g/dL). Progressionsfri overlevelsestid vil være tiden til enten progression eller død, alt efter hvad der indtræffer først.	Tid fra studiestart til tidspunktet for dokumenteret sygdomsprogression eller død, vurderet op til 2 år
Samlet overlevelse (OS) efter 2 år Tidsramme: Fra registreringsdatoen til dødsdatoen, vurderet op til 2 år	Kaplan-Meier metoden vil blive brugt til at estimere graden af samlet overlevelse efter 2 år i hver behandlingsarm. OS vil blive målt fra registreringsdatoen til datoen for hændelsen (dvs. dødsfald) eller datoen for sidste opfølgning for at evaluere denne hændelse. Patienter, der er hændelsesfri ved deres sidste opfølgende evaluering, vil blive censureret på det tidspunkt.	Fra registreringsdatoen til dødsdatoen, vurderet op til 2 år
Varighed af respons (DOR) (komplet respons [CR], CCR, nodulær partiel respons [nPR], delvis respons [PR] og PRL) Tidsramme: Fra datoen for første respons indtil progression eller død, udført 2,5 år efter den sidste patient blev indskrevet; op til 4 år.	Kaplan-Meier metoden vil blive brugt til at estimere median DOR. DOR er tiden fra første objektiv status til progression eller død. CR kræver alt af følgende: fravær af lymfadenopati > 1,5 cm ved fysisk undersøgelse/CT-scanning, ingen hepatomegali/splenomegali ved fysisk undersøgelse, ingen klonale B-celler i blodet, Normal CBC, knoglemarvsaspirat & biopsi skal være normocellulær for alder . PR kræver >= 50 % reduktion i perifert lymfocyttal fra før-behandlingsværdi, >= 50 % reduktion i lymfadenopati og/eller ≥ 50 % reduktion i splenomegali/hepatomegali. CR med undtagelse af at have knoglemarvslymfoide CLL-knuder vil blive betragtet som en nodulær PR (nPR). CR med undtagelse af ikke at få udført en knoglemarvsbiopsi vil blive betragtet som en klinisk CR (CCR). PR med undtagelse af at have mindre end 50 % reduktion i perifert lymfocyttal vil blive betragtet som en PR undtagen persistent lymfocytose (PRL).	Fra datoen for første respons indtil progression eller død, udført 2,5 år efter den sidste patient blev indskrevet; op til 4 år.
Procentdel af patienter, der opnår en hvilken som helst respons på behandling (samlet responsrate [ORR] [komplet respons [CR], CCR, nodulær partiel respons [nPR], delvis respons [PR] og PRL]) Tidsramme: Udført 2,5 år efter den sidste patient tilmeldte; op til 4 år.	Komplet respons (CR) kræver alt af følgende: fravær af lymfadenopati >1,5 cm ved fysisk undersøgelse/CT-scanning, ingen hepatomegali/splenomegali ved fysisk undersøgelse, ingen klonale B-celler i blodet, normal CBC, knoglemarvsaspirat & biopsi skal være normocellulær for alderen. Delvis respons (PR) kræver >= 50 % reduktion i perifert lymfocyttal fra før-behandlingsværdi, >= 50 % reduktion i lymfadenopati og/eller ≥ 50 % reduktion i splenomegali/hepatomegali. CR med undtagelse af at have knoglemarvslymfoide CLL-knuder vil blive betragtet som en nodulær PR (nPR). CR med undtagelse af ikke at få udført en knoglemarvsbiopsi vil blive betragtet som en klinisk CR (CCR). PR med undtagelse af at have mindre end 50 % reduktion i perifert lymfocyttal vil blive betragtet som PR undtagen persistent lymfocytose (PRL). Samlet responsrate og tilsvarende nøjagtig binomial 95 % CI angivet.	Udført 2,5 år efter den sidste patient tilmeldte; op til 4 år.
Procentdel af patienter, der opnår en biopsi-bevist komplet respons (CR) Tidsramme: Udført 2,5 år efter den sidste patient tilmeldte; op til 4 år.	Komplet respons (CR) kræver alt af følgende: fravær af lymfadenopati > 1,5 cm ved fysisk undersøgelse/CT-scanning, ingen hepatomegali eller splenomegali ved fysisk undersøgelse, ingen klonale B-celler i blodet, normal CBC, knoglemarvsaspirat og biopsi skal være normocellulær for alder. Fuldstændig svarprocent og tilsvarende nøjagtige binomiale 95 % konfidensintervaller angivet.	Udført 2,5 år efter den sidste patient tilmeldte; op til 4 år.
Procentdel af patienter, der opnår fuldstændig (CR og CCR) eller nodulær partiel respons (nPR) Tidsramme: Udført 2,5 år efter den sidste patient tilmeldte; op til 4 år.	Komplet respons (CR) kræver alt af følgende: fravær af lymfadenopati > 1,5 cm ved fysisk undersøgelse/CT-scanning, ingen hepatomegali eller splenomegali ved fysisk undersøgelse, ingen klonale B-celler i blodet, normal CBC, knoglemarvsaspirat og biopsi skal være normocellulær for alder. CR med undtagelse af at have knoglemarvslymfoide CLL-knuder vil blive betragtet som en nodulær PR (nPR). CR med undtagelse af ikke at få udført en knoglemarvsbiopsi vil blive betragtet som en klinisk CR (CCR). Svarprocent og tilsvarende nøjagtige binomiale 95 % konfidensintervaller angivet.	Udført 2,5 år efter den sidste patient tilmeldte; op til 4 år.
Procentdel af patienter, der opnår minimal restsygdom (MRD) negativ status Tidsramme: Cyklus 9 Dag 1 Evaluering	Estimeret ved hjælp af antallet af patienter, der opnår minimal resterende sygdom divideret med det samlede antal randomiseret til den pågældende behandlingsarm. Tilsvarende nøjagtige binomiale 95 % konfidensintervaller for MRD-rater vil blive beregnet.	Cyklus 9 Dag 1 Evaluering
Hyppigheden af grad 3, 4 eller 5 behandlingsrelaterede ikke-hæmatologiske bivirkninger (toksiciteter) Tidsramme: Udført 2,5 år efter den sidste patient tilmeldte; op til 4 år.	Hyppigheden af grad 3, 4 eller 5 behandlingsrelaterede ikke-hæmatologiske bivirkninger (toksicitet) efter arm; udelukker bivirkninger, der opstår efter crossover for patienter i arm A	Udført 2,5 år efter den sidste patient tilmeldte; op til 4 år.

Andre resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Geriatrisk funktionel status (valgfrit) Tidsramme: Udført 2,5 år efter sidste patientindskrivning	Vurderet ved hjælp af ældre amerikaneres ressourcer og tjenester Multidimensional funktionel vurderingsspørgeskema, dagligdags aktiviteter, medicinske resultater Undersøg fysisk funktion, Karnofsky præstationsstatus vurderet af en sundhedspersonale, Karnofsky præstationsstatus vurderet af patienten, timet "Up and Go", og antal fald i de sidste seks måneder.	Udført 2,5 år efter sidste patientindskrivning

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

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

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)

9. december 2013

Primær færdiggørelse (Faktiske)

7. august 2018

Studieafslutning (Anslået)

30. januar 2025

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)

4. april 2024

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

3. april 2024

Sidst verificeret

1. januar 2024

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

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

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

Kliniske forsøg med Laboratoriebiomarkøranalyse

Liao Jian An

Rekruttering

Meridianenergiændringer hos patienter med hoved- og nakkekræft efter kemoterapi eller strålebehandling

Hoved- og halskræft

Taiwan
Progenity, Inc.

Afsluttet

Udvidet ikke-invasiv genomisk medicinsk vurdering: Enigma-undersøgelsen

Downs syndrom | Aneuploidi | DiGeorges syndrom | Turners syndrom | Klinefelters syndrom | Kromosom sletning | Edwards syndrom | Patau syndrom

Forenede Stater
Fondation Lenval

Trukket tilbage

Indflydelse af træthed på gangmønsteret hos patienter med cerebral parese.

Cerebral Parese

Frankrig
IRCCS Eugenio Medea

Rekruttering

Biomarkørers baner for tidlig intervention hos søskende til børn med autismespektrumforstyrrelse

Autismespektrumforstyrrelse | Tidlig indsats

Italien
Oregon Health and Science University
4DMedical

Tilmelding efter invitation

Ventilationsubalancer ved let til moderat kronisk obstruktiv lungesygdom (VAPOR)

Lungesygdomme | KOL | Luftvejssygdom | Dyspnø

Forenede Stater
IRCCS Eugenio Medea

Rekruttering

Bekræft præstationen i klinisk praksis af den fordybende Virtual Reality Platform GRAIL (Gait Real-time Analysis Interactive Lab)

Cerebral Parese | Erhvervet hjerneskade

Italien
Modarres Hospital

Afsluttet

Renal parenkymal kernenålbiopsi

Komplikationer | Billedstyret biopsi | Nyre Glomerulus

Iran, Islamisk Republik
Healthy.io Ltd.

Afsluttet

[Prøvning af enhed, der ikke er godkendt eller godkendt af U.S. FDA]

Albuminuri

Forenede Stater
Medwave Estudios Limitada
Asociación Chilena de Seguridad

Ukendt

Diagnostisk værdi af arbejdsbelastningsanalyseinstrument til at påvise erhvervsmæssige risici ved muskel- og skelettilstande i øvre lemmer (ACT-ACHS)

Erhvervsmæssig eksponering | Muskuloskeletal sygdom

Chile
Alcon Research

Afsluttet

Clareon IOL retrospektiv dataindsamling

Astigmatisme | Aphakia

Forenede Stater

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

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

Kliniske forsøg med Laboratoriebiomarkøranalyse

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Poland

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer