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Docetaxel, Carboplatin, Trastuzumab og Pertuzumab med eller uden østrogenmangel til behandling af patienter med hormonreceptorpositiv, HER2-positiv operabel eller lokalt fremskreden brystkræft

25. juli 2025 opdateret af: National Cancer Institute (NCI)

Et randomiseret fase III-forsøg, der evaluerer patologiske fuldstændige responsrater hos patienter med hormonreceptorpositiv, HER2-positiv, stor operabel og lokalt avanceret brystkræft behandlet med neoadjuverende terapi af Docetaxel, Carboplatin, Trastuzumab og Pertuzumab (TCHP) med deprivation (TCHP)

Dette randomiserede fase III-forsøg undersøger docetaxel, carboplatin, trastuzumab og pertuzumab med østrogenmangel for at se, hvordan de virker sammenlignet med docetaxel, carboplatin, trastuzumab og pertuzumab uden østrogendeprivation ved behandling af patienter med hormonreceptorpositiv, human epidermal vækstfaktorreceptor2 (HER2)-positiv brystkræft, der kan opereres eller har spredt sig fra det sted, hvor den startede, til nærliggende væv eller lymfeknuder (lokalt fremskreden). Lægemidler brugt i kemoterapi, såsom docetaxel, carboplatin, trastuzumab og pertuzumab, virker på forskellige måder for at stoppe væksten af ​​tumorceller, enten ved at dræbe cellerne, ved at stoppe dem i at dele sig eller ved at stoppe dem i at sprede sig. At give mere end ét lægemiddel (kombinationskemoterapi) kan dræbe flere tumorceller. Østrogen kan forårsage vækst af brystkræftceller. Hormonbehandling med goserelinacetat og aromatasehæmmende behandling kan bekæmpe brystkræft ved at blokere for brugen af ​​østrogen i tumorcellerne. Strålebehandling bruger højenergi røntgenstråler til at dræbe tumorceller. At give kombinationskemoterapi og strålebehandling med eller uden hormonbehandling kan være en effektiv behandling af hormonreceptorpositiv, HER2-positiv, operabel eller lokalt fremskreden brystkræft.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

PRIMÆRE MÅL:

I. For at bestemme, om tilføjelsen af ​​østrogendeprivation til neoadjuverende terapi bestående af terapi med docetaxel, carboplatin, trastuzumab og pertuzumab (TCHP) giver en højere grad af patologisk fuldstændig respons (pCR) (bryst og noder) end TCHP alene, når det administreres til kvinder med operabel, hormonreceptor-positiv, HER2-positiv brystkræft.

SEKUNDÆRE MÅL:

I. At bestemme, om tilføjelsen af ​​østrogendeprivation til neoadjuverende terapi bestående af TCHP vil øge pCR-hastigheden i brystet sammenlignet med TCHP alene, når det administreres til kvinder med operabel, hormonreceptor-positiv, HER2-positiv brystcancer.

II. For at bestemme, om tilføjelsen af ​​østrogendeprivation til neoadjuverende terapi bestående af TCHP forbedrer recidivfrit interval (RFI) hos kvinder med operabel, hormonreceptorpositiv, HER2-positiv brystkræft.

III. For at bestemme, om tilføjelsen af ​​østrogendeprivation til neoadjuverende terapi bestående af TCHP forbedrer den samlede overlevelse (OS) hos kvinder med operationsdygtig, hormonreceptor-positiv, HER2-positiv brystkræft.

IV. At sammenligne frekvensen af ​​anden primær invasiv cancer efter behandlingsarm. V. Vurdering af mønstre for pCR, RFI og OS efter overgangsalderens status. VI. At evaluere hjertetoksiciteten forbundet med hver af regimerne. VII. At sammenligne effekten af ​​at tilføje østrogendeprivation til neoadjuverende terapi på endokrine relaterede symptomer hos alle patienter efter behandlingsarm.

VIII. At sammenligne effekten af ​​at tilføje østrogenmangel til neoadjuverende terapi på vasomotoriske symptomer, muskuloskeletale og vaginale lidelser samt livskvalitet.

IX. At bestemme et forhold mellem pCR og en potentiel mekanisme for resistens/følsomhed i hormonreceptor-positive, HER2-positive tumorer.

X. At evaluere tumorinfiltrerende lymfocytter (TIL'er) og immunbiomarkører som prædiktorer for pCR.

XI. At studere tidlige ændringer i TIL'er og andre immune biomarkører som reaktion på TCHP.

OVERSIGT: Patienterne randomiseres til 1 af 2 behandlingsarme.

NEOADJUVANT:

ARM I: Patienter får docetaxel intravenøst ​​(IV) over 60 minutter, carboplatin IV over 30-60 minutter, trastuzumab IV over 30-90 minutter og pertuzumab IV over 30-60 på dag 1. Behandlingen gentages hver 21. dag i op til 6 kure i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienter, der er indskrevet efter ændringsforslag #4, gennemgår 2 kernebiopsier før behandlingsforløb 3.

ARM II: Alle patienter får docetaxel, carboplatin, trastuzumab og pertuzumab som i arm I. Præmenopausale patienter får også goserelinacetat subkutant (SC) hver 28. dag indtil operation og aromatasehæmmende behandling efter investigators skøn dagligt indtil 1 dag før operationen. Postmenopausale patienter modtager aromatasehæmmende behandling efter investigatorens skøn dagligt indtil 1 dag før operationen. Patienter, der er indskrevet efter ændringsforslag #4, gennemgår 2 kernebiopsier før behandlingsforløb 3.

KIRURGI: Patienter gennemgår lumpektomi eller mastektomi.

STRÅLING: Patienter gennemgår helbrystbestråling inden for 8 uger efter operationen.

ADJUVANT: Patienter får trastuzumab IV over 30-60 minutter hver 21. dag i op til 1 år.

Efter afslutning af undersøgelsesbehandlingen følges patienterne op hver 6., 9., 12. og 18. måned i 5 år.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

315

Fase

  • Fase 3

Kontakter og lokationer

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

Studiesteder

  • Forenede Stater
    • Alaska
      • Fairbanks, Alaska, Forenede Stater, 99701
        • Fairbanks Memorial Hospital
    • Arkansas
      • Hot Springs, Arkansas, Forenede Stater, 71913
        • CHI Saint Vincent Cancer Center Hot Springs
    • 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
      • Burlingame, California, Forenede Stater, 94010
        • Mills-Peninsula Medical Center
      • Cameron Park, California, Forenede Stater, 95682
        • Sutter Cancer Centers Radiation Oncology Services-Cameron Park
      • Castro Valley, California, Forenede Stater, 94546
        • Eden Hospital Medical Center
      • Castro Valley, California, Forenede Stater, 94546
        • East Bay Radiation Oncology Center
      • Davis, California, Forenede Stater, 95616
        • Sutter Davis Hospital
      • Dublin, California, Forenede Stater, 94568
        • Epic Care-Dublin
      • Emeryville, California, Forenede Stater, 94608
        • Bay Area Breast Surgeons Inc
      • Emeryville, California, Forenede Stater, 94608
        • Epic Care Partners in Cancer Care
      • Fontana, California, Forenede Stater, 92335
        • Kaiser Permanente-Fontana
      • Fremont, California, Forenede Stater, 94538
        • Kaiser Permanente-Fremont
      • Fresno, California, Forenede Stater, 93720
        • Kaiser Permanente-Fresno
      • Harbor City, California, Forenede Stater, 90710
        • Kaiser Permanente South Bay
      • Irvine, California, Forenede Stater, 92618
        • Kaiser Permanente-Irvine
      • Loma Linda, California, Forenede Stater, 92354
        • Loma Linda University Medical Center
      • 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
      • Martinez, California, Forenede Stater, 94553-3156
        • Contra Costa Regional Medical Center
      • Modesto, California, Forenede Stater, 95355
        • Memorial Medical Center
      • Modesto, California, Forenede Stater, 95356
        • Kaiser Permanente-Modesto
      • Mountain View, California, Forenede Stater, 94040
        • El Camino Hospital
      • Mountain View, California, Forenede Stater, 94040
        • Palo Alto Medical Foundation-Camino Division
      • Mountain View, California, Forenede Stater, 94040
        • Palo Alto Medical Foundation-Gynecologic Oncology
      • Novato, California, Forenede Stater, 94945
        • Sutter Cancer Research Consortium
      • Oakland, California, Forenede Stater, 94611
        • Kaiser Permanente-Oakland
      • Oakland, California, Forenede Stater, 94609
        • Alta Bates Summit Medical Center - Summit Campus
      • Oakland, California, Forenede Stater, 94609
        • Hematology and Oncology Associates-Oakland
      • Oakland, California, Forenede Stater, 94609
        • Bay Area Tumor Institute
      • Oakland, California, Forenede Stater, 94602
        • Wilma Chan Highland Hospital
      • Orange, California, Forenede Stater, 92868
        • Saint Joseph Hospital - Orange
      • Palo Alto, California, Forenede Stater, 94304
        • Stanford Cancer Institute Palo Alto
      • Palo Alto, California, Forenede Stater, 94301
        • Palo Alto Medical Foundation Health Care
      • Panorama City, California, Forenede Stater, 91402
        • Kaiser Permanente - Panorama City
      • Pleasanton, California, Forenede Stater, 94588
        • Valley Medical Oncology Consultants
      • Redwood City, California, Forenede Stater, 94063
        • Kaiser Permanente-Redwood City
      • Richmond, California, Forenede Stater, 94801
        • Kaiser Permanente-Richmond
      • Riverside, California, Forenede Stater, 92505
        • Kaiser Permanente-Riverside
      • Roseville, California, Forenede Stater, 95661
        • Kaiser Permanente-Roseville
      • Roseville, California, Forenede Stater, 95661
        • Sutter Cancer Centers Radiation Oncology Services-Roseville
      • Roseville, California, Forenede Stater, 95661
        • Sutter Roseville Medical Center
      • Sacramento, California, Forenede Stater, 95816
        • Sutter Medical Center Sacramento
      • Sacramento, California, Forenede Stater, 95823
        • Kaiser Permanente-South Sacramento
      • Sacramento, California, Forenede Stater, 95825
        • Kaiser Permanente Sacramento Medical Center
      • San Diego, California, Forenede Stater, 92120
        • Kaiser Permanente-San Diego Zion
      • San Diego, California, Forenede Stater, 92108
        • Kaiser Permanente-San Diego Mission
      • San Francisco, California, Forenede Stater, 94115
        • Kaiser Permanente-San Francisco
      • San Francisco, California, Forenede Stater, 94115
        • California Pacific Medical Center-Pacific Campus
      • San Jose, California, Forenede Stater, 95119
        • Kaiser Permanente-Santa Teresa-San Jose
      • San Leandro, California, Forenede Stater, 94577
        • Kaiser Permanente San Leandro
      • San Marcos, California, Forenede Stater, 92078
        • Kaiser Permanente-San Marcos
      • San Pablo, California, Forenede Stater, 94806
        • Doctors Medical Center- JC Robinson Regional Cancer Center
      • San Rafael, California, Forenede Stater, 94903
        • Kaiser Permanente-San Rafael
      • Santa Clara, California, Forenede Stater, 95051
        • Kaiser Permanente Medical Center - Santa Clara
      • Santa 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
      • Vallejo, California, Forenede Stater, 94589
        • Kaiser Permanente-Vallejo
      • Vallejo, California, Forenede Stater, 94589
        • Sutter Solano Medical Center/Cancer Center
      • Walnut Creek, California, Forenede Stater, 94596
        • Kaiser Permanente-Walnut Creek
      • Woodland Hills, California, Forenede Stater, 91367
        • Kaiser Permanente-Woodland Hills
    • Colorado
      • Aurora, Colorado, Forenede Stater, 80012
        • Rocky Mountain Cancer Centers-Aurora
      • Aurora, Colorado, Forenede Stater, 80012
        • The Medical Center of Aurora
      • Aurora, Colorado, Forenede Stater, 80045
        • UCHealth University of Colorado Hospital
      • Boulder, Colorado, Forenede Stater, 80303
        • Boulder Community Foothills Hospital
      • Boulder, Colorado, Forenede Stater, 80304
        • Rocky Mountain Cancer Centers-Boulder
      • Colorado Springs, Colorado, Forenede Stater, 80907
        • Penrose-Saint Francis Healthcare
      • Colorado Springs, Colorado, Forenede Stater, 80909
        • UCHealth Memorial Hospital Central
      • Colorado Springs, Colorado, Forenede Stater, 80907
        • Rocky Mountain Cancer Centers-Penrose
      • Denver, Colorado, Forenede Stater, 80218
        • Presbyterian - Saint Lukes Medical Center - Health One
      • Denver, Colorado, Forenede Stater, 80220
        • Rose Medical Center
      • Denver, Colorado, Forenede Stater, 80218
        • Rocky Mountain Cancer Centers-Midtown
      • Denver, Colorado, Forenede Stater, 80220
        • Rocky Mountain Cancer Centers-Rose
      • Denver, Colorado, Forenede Stater, 80218
        • Colorado Blood Cancer Institute
      • Denver, Colorado, Forenede Stater, 80222
        • Western States Cancer Research NCORP
      • Denver, Colorado, Forenede Stater, 80218
        • Saint Joseph Hospital - Cancer Centers of Colorado
      • Denver, Colorado, Forenede Stater, 80210
        • AdventHealth Porter
      • Durango, Colorado, Forenede Stater, 81301
        • Mercy Medical Center
      • Durango, Colorado, Forenede Stater, 81301
        • 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
      • Greeley, Colorado, Forenede Stater, 80631
        • Banner North Colorado Medical Center
      • Greenwood Village, Colorado, Forenede Stater, 80111
        • Rocky Mountain Cancer Centers-Greenwood Village
      • Lakewood, Colorado, Forenede Stater, 80228
        • Saint Anthony Hospital
      • Lakewood, Colorado, Forenede Stater, 80228
        • Rocky Mountain Cancer Centers-Lakewood
      • Littleton, Colorado, Forenede Stater, 80120
        • Rocky Mountain Cancer Centers-Littleton
      • Littleton, Colorado, Forenede Stater, 80122
        • AdventHealth Littleton
      • Lone Tree, Colorado, Forenede Stater, 80124
        • Sky Ridge Medical Center
      • Lone Tree, Colorado, Forenede Stater, 80124
        • Rocky Mountain Cancer Centers-Sky Ridge
      • Longmont, Colorado, Forenede Stater, 80501
        • Longmont United Hospital
      • Longmont, Colorado, Forenede Stater, 80501
        • Rocky Mountain Cancer Centers-Longmont
      • Loveland, Colorado, Forenede Stater, 80539
        • Banner McKee Medical Center
      • Parker, Colorado, Forenede Stater, 80138
        • Rocky Mountain Cancer Centers-Parker
      • Parker, Colorado, Forenede Stater, 80138
        • AdventHealth Parker
      • Pueblo, Colorado, Forenede Stater, 81004
        • Saint Mary Corwin Medical Center
      • Pueblo, Colorado, Forenede Stater, 81008
        • Rocky Mountain Cancer Centers - Pueblo
      • Thornton, Colorado, Forenede Stater, 80260
        • Rocky Mountain Cancer Centers-Thornton
      • Wheat Ridge, Colorado, Forenede Stater, 80401
        • Intermountain Health Lutheran Hospital
    • Connecticut
      • Hartford, Connecticut, Forenede Stater, 06105
        • Smilow Cancer Hospital Care Center at Saint Francis
      • Hartford, Connecticut, Forenede Stater, 06102
        • Hartford Hospital
    • Delaware
      • Lewes, Delaware, Forenede Stater, 19958
        • Beebe Medical Center
      • Newark, Delaware, Forenede Stater, 19713
        • Helen F Graham Cancer Center
      • Newark, Delaware, Forenede Stater, 19713
        • Delaware Clinical and Laboratory Physicians PA
      • Newark, Delaware, Forenede Stater, 19713
        • Medical Oncology Hematology Consultants PA
      • Newark, Delaware, Forenede Stater, 19718
        • Christiana Care Health System-Christiana Hospital
      • 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
      • Deerfield Beach, Florida, Forenede Stater, 33442
        • UM Sylvester Comprehensive Cancer Center at Deerfield Beach
      • Gainesville, Florida, Forenede Stater, 32610
        • University of Florida Health Science Center - Gainesville
      • Miami, Florida, Forenede Stater, 33136
        • University of Miami Miller School of Medicine-Sylvester Cancer Center
      • Orlando, Florida, Forenede Stater, 32806
        • Orlando Health Cancer Institute
      • Orlando, Florida, Forenede Stater, 32803
        • AdventHealth Orlando
    • Georgia
      • Athens, Georgia, Forenede Stater, 30607
        • University Cancer and Blood Center LLC
      • Atlanta, Georgia, Forenede Stater, 30342
        • Northside Hospital
      • Augusta, Georgia, Forenede Stater, 30912
        • Augusta University Medical Center
      • Cumming, Georgia, Forenede Stater, 30041
        • Northside Hospital-Forsyth
      • Decatur, Georgia, Forenede Stater, 30033
        • Emory Decatur Hospital
      • Gainesville, Georgia, Forenede Stater, 30501
        • Northeast Georgia Medical Center-Gainesville
      • Savannah, Georgia, Forenede Stater, 31405
        • Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
      • Savannah, Georgia, Forenede Stater, 31404
        • Memorial Health University Medical Center
      • Savannah, Georgia, Forenede Stater, 31404
        • Summit Cancer Care-Memorial
      • Savannah, Georgia, Forenede Stater, 31404
        • Low Country Cancer Care
    • 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, 96819
        • Kaiser Permanente Moanalua Medical Center
      • Kailua, Hawaii, Forenede Stater, 96734
        • Castle Medical Center
      • Lihue, Hawaii, Forenede Stater, 96766
        • Wilcox Memorial Hospital and Kauai Medical Clinic
    • Idaho
      • Boise, Idaho, Forenede Stater, 83706
        • Saint Alphonsus Cancer Care Center-Boise
      • Coeur d'Alene, Idaho, Forenede Stater, 83814
        • Kootenai Health - Coeur d'Alene
      • Lewiston, Idaho, Forenede Stater, 83501
        • Saint Joseph Regional Medical Center
      • Post Falls, Idaho, Forenede Stater, 83854
        • Kootenai Clinic Cancer Services - Post Falls
      • Sandpoint, Idaho, Forenede Stater, 83864
        • Kootenai Clinic Cancer Services - Sandpoint
    • Illinois
      • Aurora, Illinois, Forenede Stater, 60504
        • Rush-Copley Medical Center
      • Bloomington, Illinois, Forenede Stater, 61704
        • Illinois CancerCare-Bloomington
      • Bloomington, Illinois, Forenede Stater, 61701
        • OSF Saint Joseph Medical Center
      • Canton, Illinois, Forenede Stater, 61520
        • Illinois CancerCare-Canton
      • Carbondale, Illinois, Forenede Stater, 62902
        • Memorial Hospital of Carbondale
      • Carthage, Illinois, Forenede Stater, 62321
        • Illinois CancerCare-Carthage
      • Centralia, Illinois, Forenede Stater, 62801
        • Centralia Oncology Clinic
      • Chicago, Illinois, Forenede Stater, 60612
        • University of Illinois
      • Chicago, Illinois, Forenede Stater, 60612
        • John H Stroger Jr Hospital of Cook County
      • Chicago, Illinois, Forenede Stater, 60608
        • Mount Sinai Hospital Medical Center
      • Chicago, Illinois, Forenede Stater, 60625
        • Swedish Covenant Hospital
      • Chicago, Illinois, Forenede Stater, 60631
        • Presence Resurrection Medical Center
      • 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
      • 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, 60202
        • Saint Francis 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
      • Harvey, Illinois, Forenede Stater, 60426
        • Ingalls Memorial Hospital
      • Kankakee, Illinois, Forenede Stater, 60901
        • Presence Saint Mary's Hospital
      • Kewanee, Illinois, Forenede Stater, 61443
        • Illinois CancerCare-Kewanee Clinic
      • Macomb, Illinois, Forenede Stater, 61455
        • Illinois CancerCare-Macomb
      • Mattoon, Illinois, Forenede Stater, 61938
        • Carle Physician Group-Mattoon/Charleston
      • Mount Vernon, Illinois, Forenede Stater, 62864
        • SSM Health Good Samaritan
      • Naperville, Illinois, Forenede Stater, 60540
        • Edward Hospital/Cancer Center
      • 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
      • Pekin, Illinois, Forenede Stater, 61554
        • Illinois CancerCare-Pekin
      • Pekin, Illinois, Forenede Stater, 61554
        • OSF Saint Francis Radiation Oncology at Pekin
      • Peoria, Illinois, Forenede Stater, 61636
        • Methodist Medical Center of Illinois
      • Peoria, Illinois, Forenede Stater, 61637
        • OSF Saint Francis Medical Center
      • Peoria, Illinois, Forenede Stater, 61615
        • Illinois CancerCare-Peoria
      • Peoria, Illinois, Forenede Stater, 61615
        • OSF Saint Francis Radiation Oncology at Peoria Cancer Center
      • Peru, Illinois, Forenede Stater, 61354
        • Illinois CancerCare-Peru
      • Peru, Illinois, Forenede Stater, 61354
        • Valley Radiation Oncology
      • Plainfield, Illinois, Forenede Stater, 60585
        • Edward Hospital/Cancer Center?Plainfield
      • Princeton, Illinois, Forenede Stater, 61356
        • Illinois CancerCare-Princeton
      • Rockford, Illinois, Forenede Stater, 61108
        • OSF Saint Anthony Medical Center
      • Rockford, Illinois, Forenede Stater, 61114
        • UW Health Carbone Cancer Center Rockford
      • Springfield, Illinois, Forenede Stater, 62702
        • Southern Illinois University School of Medicine
      • Springfield, Illinois, Forenede Stater, 62702
        • Springfield Clinic
      • Springfield, Illinois, Forenede Stater, 62702
        • Central Illinois Hematology Oncology Center
      • Springfield, Illinois, Forenede Stater, 62781
        • Springfield Memorial Hospital
      • Urbana, Illinois, Forenede Stater, 61801
        • Carle Cancer Center
      • Urbana, Illinois, Forenede Stater, 61801
        • The Carle Foundation Hospital
      • Warrenville, Illinois, Forenede Stater, 60555
        • Northwestern Medicine Cancer Center Warrenville
      • Yorkville, Illinois, Forenede Stater, 60560
        • Rush-Copley Healthcare Center
    • Indiana
      • Crown Point, Indiana, Forenede Stater, 46307
        • Michiana Hematology Oncology PC-Crown Point
      • Elkhart, Indiana, Forenede Stater, 46515
        • Elkhart General Hospital
      • Elkhart, Indiana, Forenede Stater, 46514
        • Michiana Hematology Oncology PC-Elkhart
      • Elkhart, Indiana, Forenede Stater, 46514-2098
        • Elkhart Clinic
      • Indianapolis, Indiana, Forenede Stater, 46237
        • Franciscan Health Indianapolis
      • Kokomo, Indiana, Forenede Stater, 46904
        • Community Howard Regional Health
      • La Porte, Indiana, Forenede Stater, 46350
        • IU Health La Porte Hospital
      • 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
        • Michiana Hematology Oncology PC-Mishawaka
      • Mishawaka, Indiana, Forenede Stater, 46545
        • Saint Joseph Regional Medical Center-Mishawaka
      • Munster, Indiana, Forenede Stater, 46321
        • The Community Hospital
      • Plymouth, Indiana, Forenede Stater, 46563
        • Michiana Hematology Oncology PC-Plymouth
      • Richmond, Indiana, Forenede Stater, 47374
        • Reid Health
      • South Bend, Indiana, Forenede Stater, 46628
        • Northern Indiana Cancer Research Consortium
      • Terre Haute, Indiana, Forenede Stater, 47804
        • Union Hospital
      • 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
      • Clive, Iowa, Forenede Stater, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Forenede Stater, 50325
        • UI Health Care Mission Cancer and Blood - West Des Moines Clinic
      • Council Bluffs, Iowa, Forenede Stater, 51503
        • Alegent Health Mercy Hospital
      • Creston, Iowa, Forenede Stater, 50801
        • Greater Regional Medical Center
      • Des Moines, Iowa, Forenede Stater, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Forenede Stater, 50314
        • UI Health Care Mission Cancer and Blood - Laurel Clinic
      • Fort Dodge, Iowa, Forenede Stater, 50501
        • McFarland Clinic - Trinity Cancer Center
      • Iowa City, Iowa, Forenede Stater, 52242
        • University of Iowa/Holden Comprehensive Cancer Center
      • Jefferson, Iowa, Forenede Stater, 50129
        • McFarland Clinic - Jefferson
      • Marshalltown, Iowa, Forenede Stater, 50158
        • McFarland Clinic - Marshalltown
      • West Des Moines, Iowa, Forenede Stater, 50266
        • Mercy Medical Center-West Lakes
    • Kansas
      • Chanute, Kansas, Forenede Stater, 66720
        • Cancer Center of Kansas - Chanute
      • Dodge City, Kansas, Forenede Stater, 67801
        • Cancer Center of Kansas - Dodge City
      • El Dorado, Kansas, Forenede Stater, 67042
        • Cancer Center of Kansas - El Dorado
      • Fort Scott, Kansas, Forenede Stater, 66701
        • Cancer Center of Kansas - Fort Scott
      • Independence, Kansas, Forenede Stater, 67301
        • Cancer Center of Kansas-Independence
      • Kingman, Kansas, Forenede Stater, 67068
        • Cancer Center of Kansas-Kingman
      • Lawrence, Kansas, Forenede Stater, 66044
        • Lawrence Memorial Hospital
      • Liberal, Kansas, Forenede Stater, 67905
        • Cancer Center of Kansas-Liberal
      • Manhattan, Kansas, Forenede Stater, 66502
        • Cancer Center of Kansas-Manhattan
      • McPherson, Kansas, Forenede Stater, 67460
        • Cancer Center of Kansas - McPherson
      • Newton, Kansas, Forenede Stater, 67114
        • Cancer Center of Kansas - Newton
      • Parsons, Kansas, Forenede Stater, 67357
        • Cancer Center of Kansas - Parsons
      • Pratt, Kansas, Forenede Stater, 67124
        • Cancer Center of Kansas - Pratt
      • Salina, Kansas, Forenede Stater, 67401
        • Cancer Center of Kansas - Salina
      • 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
      • Wichita, Kansas, Forenede Stater, 67214
        • Wichita NCI Community Oncology Research Program
      • Winfield, Kansas, Forenede Stater, 67156
        • Cancer Center of Kansas - Winfield
    • Kentucky
      • Bardstown, Kentucky, Forenede Stater, 40004
        • Flaget Memorial Hospital
      • Corbin, Kentucky, Forenede Stater, 40701
        • Baptist Health Corbin
      • Corbin, Kentucky, Forenede Stater, 40701
        • Commonwealth Cancer Center-Corbin
      • Crestview Hills, Kentucky, Forenede Stater, 41017
        • Oncology Hematology Care Inc-Crestview
      • Elizabethtown, Kentucky, Forenede Stater, 42701
        • Baptist Health Hardin
      • Lexington, Kentucky, Forenede Stater, 40536
        • University of Kentucky/Markey Cancer Center
      • Lexington, Kentucky, Forenede Stater, 40504
        • Saint Joseph Radiation Oncology Resource Center
      • Lexington, Kentucky, Forenede Stater, 40509
        • Saint Joseph Hospital East
      • Lexington, Kentucky, Forenede Stater, 40503
        • Baptist Health Lexington
      • Louisville, Kentucky, Forenede Stater, 40202
        • The James Graham Brown Cancer Center at University of Louisville
      • Louisville, Kentucky, Forenede Stater, 40202
        • Jewish Hospital
      • Louisville, Kentucky, Forenede Stater, 40245
        • UofL Health Medical Center Northeast
      • Louisville, Kentucky, Forenede Stater, 40207
        • Baptist Health Louisville
      • Louisville, Kentucky, Forenede Stater, 40215
        • Saints Mary and Elizabeth Hospital
      • Madisonville, Kentucky, Forenede Stater, 42431
        • Baptist Health Madisonville/Merle Mahr Cancer Center
      • Paducah, Kentucky, Forenede Stater, 42003
        • Baptist Health Paducah
      • Shepherdsville, Kentucky, Forenede Stater, 40165
        • Jewish Hospital Medical Center South
    • Louisiana
      • Baton Rouge, Louisiana, Forenede Stater, 70809
        • Ochsner Health Center-Summa
      • Kenner, Louisiana, Forenede Stater, 70065
        • Ochsner Medical Center Kenner
      • New Orleans, Louisiana, Forenede Stater, 70121
        • Ochsner Medical Center Jefferson
    • Maine
      • Bangor, Maine, Forenede Stater, 04401
        • Eastern Maine Medical Center
      • Brewer, Maine, Forenede Stater, 04412
        • Lafayette Family Cancer Center-EMMC
    • Maryland
      • Baltimore, Maryland, Forenede Stater, 21237
        • MedStar Franklin Square Medical Center/Weinberg Cancer Institute
      • Baltimore, Maryland, Forenede Stater, 21204
        • Greater Baltimore Medical Center
      • Elkton, Maryland, Forenede Stater, 21921
        • Christiana Care - Union Hospital
      • Frederick, Maryland, Forenede Stater, 21701
        • Frederick Memorial Hospital
    • Massachusetts
      • Fall River, Massachusetts, Forenede Stater, 02721
        • Saint Anne's Hospital
      • Pittsfield, Massachusetts, Forenede Stater, 01201
        • Berkshire Medical Center - Cancer Center
    • Michigan
      • Adrian, Michigan, Forenede Stater, 49221
        • Bixby Medical Center
      • Adrian, Michigan, Forenede Stater, 49221
        • Hickman Cancer Center
      • Ann Arbor, Michigan, Forenede Stater, 48109
        • University of Michigan Comprehensive Cancer Center
      • Ann Arbor, Michigan, Forenede Stater, 48106
        • Michigan Cancer Research Consortium NCORP
      • Ann Arbor, Michigan, Forenede Stater, 48106
        • Trinity Health Saint Joseph Mercy Hospital Ann Arbor
      • Dearborn, Michigan, Forenede Stater, 48124
        • Corewell Health Dearborn Hospital
      • Detroit, Michigan, Forenede Stater, 48202
        • Henry Ford Hospital
      • Detroit, Michigan, Forenede Stater, 48201
        • Wayne State University/Karmanos Cancer Institute
      • Detroit, Michigan, Forenede Stater, 48236
        • Henry Ford Health Saint John Hospital
      • Farmington Hills, Michigan, Forenede Stater, 48334
        • Weisberg Cancer Treatment Center
      • Farmington Hills, Michigan, Forenede Stater, 48336
        • Corewell Health Farmington Hills Hospital
      • Flint, Michigan, Forenede Stater, 48503
        • Hurley Medical Center
      • Flint, Michigan, Forenede Stater, 48503
        • Genesys Hurley Cancer Institute
      • Grosse Pointe, Michigan, Forenede Stater, 48230
        • William Beaumont Hospital-Grosse Pointe
      • Jackson, Michigan, Forenede Stater, 49201
        • Allegiance Health
      • Kalamazoo, Michigan, Forenede Stater, 49007
        • West Michigan Cancer Center
      • Lansing, Michigan, Forenede Stater, 48912
        • University of Michigan Health - Sparrow Lansing
      • Livonia, Michigan, Forenede Stater, 48154
        • Trinity Health Saint Mary Mercy Livonia Hospital
      • Midland, Michigan, Forenede Stater, 48670
        • MyMichigan Medical Center Midland
      • Monroe, Michigan, Forenede Stater, 48162
        • Mercy Memorial Hospital
      • Monroe, Michigan, Forenede Stater, 48162
        • Toledo Clinic Cancer Centers-Monroe
      • Pontiac, Michigan, Forenede Stater, 48341
        • Trinity Health Saint Joseph Mercy Oakland Hospital
      • Port Huron, Michigan, Forenede Stater, 48060
        • Lake Huron Medical Center
      • Roseville, Michigan, Forenede Stater, 48066
        • Michigan Cancer Specialists
      • Royal Oak, Michigan, Forenede Stater, 48073
        • Cancer Care Associates PC
      • Royal Oak, Michigan, Forenede Stater, 48073
        • Comprehensive Medical Center PLLC
      • Royal Oak, Michigan, Forenede Stater, 48073
        • Oakland Medical Group
      • Royal Oak, Michigan, Forenede Stater, 48067
        • Oakland Colon Rectal Associates
      • Royal Oak, Michigan, Forenede Stater, 48073
        • Hematology Oncology Consultants PC-Royal Oak
      • Royal Oak, Michigan, Forenede Stater, 48073
        • Corewell Health William Beaumont University Hospital
      • Saginaw, Michigan, Forenede Stater, 48601
        • MyMichigan Medical Center Saginaw
      • Sterling Heights, Michigan, Forenede Stater, 48312
        • Premier Hematology Oncology Care
      • Sterling Heights, Michigan, Forenede Stater, 48314
        • Mitchell Folbe MD PC
      • Troy, Michigan, Forenede Stater, 48084
        • Michigan Institute of Urology-Town Center
      • Troy, Michigan, Forenede Stater, 48085
        • Claudia BR Herke MD PC
      • Troy, Michigan, Forenede Stater, 48098
        • Hematology Oncology Consultants PC-Troy
      • Troy, Michigan, Forenede Stater, 48085
        • Corewell Health Beaumont Troy Hospital
      • Warren, Michigan, Forenede Stater, 48093
        • Henry Ford Health Warren Hospital
    • 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
        • 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
      • New Ulm, Minnesota, Forenede Stater, 56073
        • New Ulm Medical Center
      • Robbinsdale, Minnesota, Forenede Stater, 55422
        • North Memorial Medical Health Center
      • Saint Louis Park, Minnesota, Forenede Stater, 55416
        • Park Nicollet Clinic - Saint Louis Park
      • Saint Louis Park, Minnesota, Forenede Stater, 55416
        • Metro Minnesota Community Oncology Research Consortium
      • Saint Paul, Minnesota, Forenede Stater, 55101
        • Regions Hospital
      • Saint Paul, Minnesota, Forenede Stater, 55102
        • United Hospital
      • Shakopee, Minnesota, Forenede Stater, 55379
        • Saint Francis Regional Medical Center
      • Stillwater, Minnesota, Forenede Stater, 55082
        • Lakeview Hospital
      • Waconia, Minnesota, Forenede Stater, 55387
        • Ridgeview Medical Center
      • Willmar, Minnesota, Forenede Stater, 56201
        • Rice Memorial Hospital
      • Woodbury, Minnesota, Forenede Stater, 55125
        • Minnesota Oncology Hematology PA-Woodbury
    • Missouri
      • Ballwin, Missouri, Forenede Stater, 63011
        • Mercy Oncology and Hematology - Clayton-Clarkson
      • Bolivar, Missouri, Forenede Stater, 65613
        • Central Care Cancer Center - Bolivar
      • Bonne Terre, Missouri, Forenede Stater, 63628
        • Parkland Health Center-Bonne Terre
      • Branson, Missouri, Forenede Stater, 65616
        • Cox Cancer Center Branson
      • Cape Girardeau, Missouri, Forenede Stater, 63703
        • Saint Francis Medical Center
      • Cape Girardeau, Missouri, Forenede Stater, 63703
        • Mercy Cancer Center - Cape Girardeau
      • Columbia, Missouri, Forenede Stater, 65212
        • MU Health - University Hospital/Ellis Fischel Cancer Center
      • Jefferson City, Missouri, Forenede Stater, 65109
        • MU Health Care Goldschmidt Cancer Center
      • Joplin, Missouri, Forenede Stater, 64804
        • Freeman Health System
      • Joplin, Missouri, Forenede Stater, 64804
        • Mercy Hospital Joplin
      • Rolla, Missouri, Forenede Stater, 65401
        • Mercy Clinic-Rolla-Cancer and Hematology
      • Rolla, Missouri, Forenede Stater, 65401
        • Phelps Health Delbert Day Cancer Institute
      • Saint Louis, Missouri, Forenede Stater, 63131
        • Missouri Baptist Medical Center
      • Saint Louis, Missouri, Forenede Stater, 63141
        • Mercy Hospital Saint Louis
      • Saint Louis, Missouri, Forenede Stater, 63109
        • Mercy Infusion Center - Chippewa
      • 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
      • Anaconda, Montana, Forenede Stater, 59711
        • Community Hospital of Anaconda
      • Billings, Montana, Forenede Stater, 59101
        • Billings Clinic Cancer Center
      • Billings, Montana, Forenede Stater, 59101
        • Saint Vincent Healthcare
      • Billings, Montana, Forenede Stater, 59102
        • Montana Cancer Consortium NCORP
      • Bozeman, Montana, Forenede Stater, 59715
        • Bozeman Health Deaconess Hospital
      • Butte, Montana, Forenede Stater, 59701
        • Saint James Community Hospital and Cancer Treatment Center
      • Great Falls, Montana, Forenede Stater, 59405
        • Benefis Sletten Cancer Institute
      • Helena, Montana, Forenede Stater, 59601
        • Saint Peter's Community Hospital
      • Kalispell, Montana, Forenede Stater, 59901
        • Logan Health Medical Center
      • Missoula, Montana, Forenede Stater, 59802
        • Saint Patrick Hospital - Community Hospital
      • Missoula, Montana, Forenede Stater, 59804
        • Community Medical Center
    • Nebraska
      • Grand Island, Nebraska, Forenede Stater, 68803
        • Nebraska Cancer Specialists/Oncology Hematology West PC
      • Kearney, Nebraska, Forenede Stater, 68847
        • CHI Health Good Samaritan
      • Kearney, Nebraska, Forenede Stater, 68845
        • Fred and Pamela Buffett Cancer Center - Kearney
      • Lincoln, Nebraska, Forenede Stater, 68510
        • Saint Elizabeth Regional Medical Center
      • Omaha, Nebraska, Forenede Stater, 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, 89120
        • Nevada Cancer Research Foundation NCORP
      • Reno, Nevada, Forenede Stater, 89502
        • Renown Regional Medical Center
      • Reno, Nevada, Forenede Stater, 89503
        • Saint Mary's Regional Medical Center
    • New Hampshire
      • Lebanon, New Hampshire, Forenede Stater, 03756
        • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
    • New Jersey
      • Elizabeth, New Jersey, Forenede Stater, 07207
        • Trinitas Hospital and Comprehensive Cancer Center - Williamson Street Campus
      • Englewood, New Jersey, Forenede Stater, 07631
        • Englewood Hospital and Medical Center
      • Flemington, New Jersey, Forenede Stater, 08822
        • Hunterdon Medical Center
      • Mullica Hill, New Jersey, Forenede Stater, 08062
        • Inspira Medical Center Mullica Hill
      • Newark, New Jersey, Forenede Stater, 07112
        • Newark Beth Israel Medical Center
      • Newton, New Jersey, Forenede Stater, 07860
        • Newton Medical Center
      • Pompton, New Jersey, Forenede Stater, 07444
        • Chilton Medical Center
      • Summit, New Jersey, Forenede Stater, 07902
        • Overlook Hospital
      • Vineland, New Jersey, Forenede Stater, 08360
        • Inspira Medical Center Vineland
    • New Mexico
      • Albuquerque, New Mexico, Forenede Stater, 87106
        • University of New Mexico Cancer Center
      • Albuquerque, New Mexico, Forenede Stater, 87106
        • Hematology Oncology Associates
      • Las Cruces, New Mexico, Forenede Stater, 88011
        • Memorial Medical Center-Las Cruces
      • Santa Fe, New Mexico, Forenede Stater, 87505
        • Christus Saint Vincent Regional Cancer Center
    • New York
      • Buffalo, New York, Forenede Stater, 14263
        • Roswell Park Cancer Institute
      • Glens Falls, New York, Forenede Stater, 12801
        • Glens Falls 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
    • North Carolina
      • Asheboro, North Carolina, Forenede Stater, 27203
        • Randolph Hospital
      • Asheville, North Carolina, Forenede Stater, 28803
        • AdventHealth Infusion Center Asheville
      • Burlington, North Carolina, Forenede Stater, 27215
        • Cone Health Cancer Center at Alamance Regional
      • Chapel Hill, North Carolina, Forenede Stater, 27599
        • UNC Lineberger Comprehensive Cancer Center
      • Clinton, North Carolina, Forenede Stater, 28328
        • Southeastern Medical Oncology Center-Clinton
      • Goldsboro, North Carolina, Forenede Stater, 27534
        • Southeastern Medical Oncology Center-Goldsboro
      • Goldsboro, North Carolina, Forenede Stater, 27534
        • Wayne Memorial Hospital
      • Greensboro, North Carolina, Forenede Stater, 27403
        • Cone Health Cancer Center
      • Hendersonville, North Carolina, Forenede Stater, 28792
        • AdventHealth Hendersonville
      • Jacksonville, North Carolina, Forenede Stater, 28546
        • Southeastern Medical Oncology Center-Jacksonville
      • Kernersville, North Carolina, Forenede Stater, 27284
        • Novant Health Cancer Institute - Kernersville
      • Kinston, North Carolina, Forenede Stater, 28501
        • ECU Health Oncology Kinston
      • Mebane, North Carolina, Forenede Stater, 27302
        • Cone Heath Cancer Center at Mebane
      • Mount Airy, North Carolina, Forenede Stater, 27030
        • Novant Health Cancer Institute - Mount Airy
      • North Wilkesboro, North Carolina, Forenede Stater, 28659
        • Novant Health Cancer Institute - Wilkesboro
      • Pinehurst, North Carolina, Forenede Stater, 28374
        • FirstHealth of the Carolinas-Moore Regional Hospital
      • Reidsville, North Carolina, Forenede Stater, 27320
        • Annie Penn Memorial Hospital
      • Salisbury, North Carolina, Forenede Stater, 28144
        • Novant Health Cancer Institute - Rowan
      • Statesville, North Carolina, Forenede Stater, 28625
        • Novant Health Cancer Institute - Statesville
      • Statesville, North Carolina, Forenede Stater, 28677
        • Iredell Memorial Hospital
      • Thomasville, North Carolina, Forenede Stater, 27360
        • Novant Health Cancer Institute - Thomasville
      • Winston-Salem, North Carolina, Forenede Stater, 27157
        • Wake Forest University Health Sciences
      • Winston-Salem, North Carolina, Forenede Stater, 27103
        • Novant Health Forsyth Medical Center
      • Winston-Salem, North Carolina, Forenede Stater, 27103
        • Novant Health Oncology Specialists
      • Winston-Salem, North Carolina, Forenede Stater, 27103
        • Winston-Salem Health Care
      • Winston-Salem, North Carolina, Forenede Stater, 27104
        • Southeast Clinical Oncology Research Consortium NCORP
    • North Dakota
      • Bismarck, North Dakota, Forenede Stater, 58501
        • Sanford Bismarck Medical Center
      • Fargo, North Dakota, Forenede Stater, 58122
        • Sanford Roger Maris Cancer Center
      • Fargo, North Dakota, Forenede Stater, 58103
        • Essentia Health Cancer Center-South University Clinic
      • Fargo, North Dakota, Forenede Stater, 58122
        • Sanford Broadway Medical Center
      • Grand Forks, North Dakota, Forenede Stater, 58201
        • Altru Cancer Center
      • Minot, North Dakota, Forenede Stater, 58701
        • Trinity Cancer Care Center
    • Ohio
      • Akron, Ohio, Forenede Stater, 44307
        • Cleveland Clinic Akron General
      • Akron, Ohio, Forenede Stater, 44304
        • Summa Health System - Akron Campus
      • Barberton, Ohio, Forenede Stater, 44203
        • Summa Health System - Barberton Campus
      • Belpre, Ohio, Forenede Stater, 45714
        • Strecker Cancer Center-Belpre
      • Bowling Green, Ohio, Forenede Stater, 43402
        • Toledo Clinic Cancer Centers-Bowling Green
      • Canton, Ohio, Forenede Stater, 44710
        • Aultman Health Foundation
      • Centerville, Ohio, Forenede Stater, 45459
        • Miami Valley Hospital South
      • Centerville, Ohio, Forenede Stater, 45459
        • Dayton Physicians LLC-Miami Valley South
      • Chillicothe, Ohio, Forenede Stater, 45601
        • Adena Regional Medical Center
      • Cincinnati, Ohio, Forenede Stater, 45219
        • The Christ Hospital
      • 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
      • Columbus, Ohio, Forenede Stater, 43214
        • Riverside Methodist Hospital
      • 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
      • Dayton, Ohio, Forenede Stater, 45415
        • Dayton Physician LLC - Englewood
      • Delaware, Ohio, Forenede Stater, 43015
        • Delaware Health Center-Grady Cancer Center
      • Delaware, Ohio, Forenede Stater, 43015
        • Delaware Radiation Oncology
      • Delaware, Ohio, Forenede Stater, 43015
        • Grady Memorial Hospital
      • Fairfield, Ohio, Forenede Stater, 45014
        • Oncology Hematology Care Inc-Healthplex
      • Findlay, Ohio, Forenede Stater, 45840
        • Blanchard Valley Hospital
      • Findlay, Ohio, Forenede Stater, 45840
        • Armes Family Cancer Center
      • Findlay, Ohio, Forenede Stater, 45840
        • Orion Cancer Care
      • Franklin, Ohio, Forenede Stater, 45005-1066
        • Atrium Medical Center-Middletown Regional Hospital
      • Franklin, Ohio, Forenede Stater, 45005
        • Dayton Physicians LLC-Atrium
      • Greenville, Ohio, Forenede Stater, 45331
        • Wayne Hospital
      • Greenville, Ohio, Forenede Stater, 45331
        • Dayton Physicians LLC-Wayne
      • Kettering, Ohio, Forenede Stater, 45429
        • Kettering Medical Center
      • Kettering, Ohio, Forenede Stater, 45409
        • Greater Dayton Cancer Center
      • Lancaster, Ohio, Forenede Stater, 43130
        • Fairfield Medical Center
      • Lancaster, Ohio, Forenede Stater, 43130
        • Lancaster Radiation Oncology
      • Lima, Ohio, Forenede Stater, 45804
        • Lima Memorial Hospital
      • Marietta, Ohio, Forenede Stater, 45750
        • Marietta Memorial Hospital
      • Maumee, Ohio, Forenede Stater, 43537
        • Toledo Clinic Cancer Centers-Maumee
      • Maumee, Ohio, Forenede Stater, 43537
        • Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
      • Medina, Ohio, Forenede Stater, 44256
        • Summa Health Medina Medical Center
      • Middletown, Ohio, Forenede Stater, 45042
        • Dayton Physicians LLC-Signal Point
      • Mount Vernon, Ohio, Forenede Stater, 43050
        • Knox Community Hospital
      • Newark, Ohio, Forenede Stater, 43055
        • Licking Memorial Hospital
      • Newark, Ohio, Forenede Stater, 43055
        • Newark Radiation Oncology
      • 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
      • Sidney, Ohio, Forenede Stater, 45365
        • Dayton Physicians LLC-Wilson
      • Springfield, Ohio, Forenede Stater, 45504
        • Springfield Regional Cancer Center
      • Springfield, Ohio, Forenede Stater, 45504
        • Springfield Regional Medical Center
      • Sylvania, Ohio, Forenede Stater, 43560
        • ProMedica Flower Hospital
      • Tiffin, Ohio, Forenede Stater, 44883
        • Mercy Hospital of Tiffin
      • Toledo, Ohio, Forenede Stater, 43606
        • ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
      • Toledo, Ohio, Forenede Stater, 43623
        • Mercy Health - Saint Anne Hospital
      • Toledo, Ohio, Forenede Stater, 43623
        • Toledo Clinic Cancer Centers-Toledo
      • Toledo, Ohio, Forenede Stater, 43614
        • University of Toledo
      • Toledo, Ohio, Forenede Stater, 43617
        • Toledo Community Hospital Oncology Program CCOP
      • Toledo, Ohio, Forenede Stater, 43608
        • Mercy Health - Saint Vincent Hospital
      • Troy, Ohio, Forenede Stater, 45373
        • Upper Valley Medical Center
      • Troy, Ohio, Forenede Stater, 45373
        • Dayton Physicians LLC - Troy
      • 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
      • 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
      • Tulsa, Oklahoma, Forenede Stater, 74136
        • Natalie Warren Bryant Cancer Center at Saint Francis
      • Tulsa, Oklahoma, Forenede Stater, 74136
        • Surgical Associates Inc
      • Tulsa, Oklahoma, Forenede Stater, 74146
        • Warren Clinic Oncology-Tulsa
    • Oregon
      • Portland, Oregon, Forenede Stater, 97227
        • Kaiser Permanente Northwest
    • Pennsylvania
      • Beaver, Pennsylvania, Forenede Stater, 15009
        • UPMC-Heritage Valley Health System Beaver
      • Chadds Ford, Pennsylvania, Forenede Stater, 19317
        • Christiana Care Health System-Concord Health Center
      • Danville, Pennsylvania, Forenede Stater, 17822
        • Geisinger Medical Center
      • Easton, Pennsylvania, Forenede Stater, 18042
        • Easton Hospital
      • Greensburg, Pennsylvania, Forenede Stater, 15601
        • UPMC Cancer Centers - Arnold Palmer Pavilion
      • Harrisburg, Pennsylvania, Forenede Stater, 17109
        • UPMC Pinnacle Cancer Center/Community Osteopathic Campus
      • Hazleton, Pennsylvania, Forenede Stater, 18201
        • Geisinger Medical Center-Cancer Center Hazleton
      • Hershey, Pennsylvania, Forenede Stater, 17033-0850
        • Penn State Milton S Hershey Medical Center
      • Jefferson Hills, Pennsylvania, Forenede Stater, 15025
        • Jefferson Hospital
      • Johnstown, Pennsylvania, Forenede Stater, 15901
        • UPMC-Johnstown/John P. Murtha Regional Cancer Center
      • Lewisburg, Pennsylvania, Forenede Stater, 17837
        • Geisinger Medical Oncology-Lewisburg
      • Lewistown, Pennsylvania, Forenede Stater, 17044
        • Lewistown Hospital
      • McKeesport, Pennsylvania, Forenede Stater, 15132
        • UPMC Cancer Center at UPMC McKeesport
      • Monroeville, Pennsylvania, Forenede Stater, 15146
        • Forbes Hospital
      • Moon, Pennsylvania, Forenede Stater, 15108
        • UPMC Hillman Cancer Center in Coraopolis
      • Philadelphia, Pennsylvania, Forenede Stater, 19107
        • Thomas Jefferson University Hospital
      • Philadelphia, Pennsylvania, Forenede Stater, 19114
        • Jefferson Torresdale Hospital
      • Phoenixville, Pennsylvania, Forenede Stater, 19460
        • Reading Hospital McGlinn Cancer Institute at Phoenixville
      • Pittsburgh, Pennsylvania, Forenede Stater, 15212
        • Allegheny General Hospital
      • Pittsburgh, Pennsylvania, Forenede Stater, 15224
        • West Penn 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
      • Washington, Pennsylvania, Forenede Stater, 15301
        • UPMC Washington Hospital Radiation Oncology
      • West Chester, Pennsylvania, Forenede Stater, 19380
        • Chester County Hospital
      • West Grove, Pennsylvania, Forenede Stater, 19390
        • Jennersville Regional 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
    • Rhode Island
      • Providence, Rhode Island, Forenede Stater, 02905
        • Women and Infants Hospital
      • Warwick, Rhode Island, Forenede Stater, 02886
        • Kent 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
      • Easley, South Carolina, Forenede Stater, 29640
        • Prisma Health Cancer Institute - Easley
      • Georgetown, South Carolina, Forenede Stater, 29440
        • Tidelands Georgetown Memorial Hospital
      • 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
      • Rock Hill, South Carolina, Forenede Stater, 29732
        • Carolina Blood and Cancer Care Associates PA
      • Seneca, South Carolina, Forenede Stater, 29672
        • Prisma Health Cancer Institute - Seneca
      • Spartanburg, South Carolina, Forenede Stater, 29303
        • Spartanburg Medical Center
      • Union, South Carolina, Forenede Stater, 29379
        • SMC Center for Hematology Oncology Union
    • South Dakota
      • 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
      • Chattanooga, Tennessee, Forenede Stater, 37404
        • Memorial Hospital
      • Hixson, Tennessee, Forenede Stater, 37343
        • Pulmonary Medicine Center of Chattanooga-Hixson
      • Jackson, Tennessee, Forenede Stater, 38301
        • Jackson-Madison County General Hospital
      • Nashville, Tennessee, Forenede Stater, 37208
        • Meharry Medical College
      • Ooltewah, Tennessee, Forenede Stater, 37363
        • Memorial GYN Plus
    • Texas
      • Abilene, Texas, Forenede Stater, 79601
        • Hendrick Medical Center
      • Houston, Texas, Forenede Stater, 77026-1967
        • Lyndon Baines Johnson General Hospital
      • Houston, Texas, Forenede Stater, 77030
        • Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
      • Houston, Texas, Forenede Stater, 77030
        • Ben Taub General Hospital
      • Laredo, Texas, Forenede Stater, 78041
        • Doctor's Hospital of Laredo
      • 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
    • Utah
      • Salt Lake City, Utah, Forenede Stater, 84112
        • Huntsman Cancer Institute/University of Utah
    • Vermont
      • Berlin, Vermont, Forenede Stater, 05602
        • Central Vermont Medical Center/National Life Cancer Treatment
      • Burlington, Vermont, Forenede Stater, 05401
        • University of Vermont Medical Center
      • Burlington, Vermont, Forenede Stater, 05405
        • University of Vermont and State Agricultural College
    • Virginia
      • Fredericksburg, Virginia, Forenede Stater, 22401
        • Fredericksburg Oncology Inc
      • Fredericksburg, Virginia, Forenede Stater, 22408
        • Hematology Oncology Associates of Fredericksburg Inc
      • Mechanicsville, Virginia, Forenede Stater, 23116
        • Bon Secours Memorial Regional Medical Center
      • Midlothian, Virginia, Forenede Stater, 23114
        • Bon Secours Saint Francis Medical Center
      • Richmond, Virginia, Forenede Stater, 23226
        • Bon Secours Saint Mary's Hospital
      • Richmond, Virginia, Forenede Stater, 23298
        • VCU Massey Comprehensive Cancer Center
      • South Hill, Virginia, Forenede Stater, 23970
        • VCU Community Memorial Health Center
      • Winchester, Virginia, Forenede Stater, 22601
        • Shenandoah Oncology PC
    • Washington
      • Auburn, Washington, Forenede Stater, 98001
        • MultiCare Auburn Medical Center
      • Bainbridge Island, Washington, Forenede Stater, 98110
        • Virginia Mason Bainbridge Island Medical Center
      • Bellevue, Washington, Forenede Stater, 98004
        • Overlake Medical Center
      • Burien, Washington, Forenede Stater, 98166
        • Highline Medical Center-Main Campus
      • Centralia, Washington, Forenede Stater, 98531
        • Providence Regional Cancer System-Centralia
      • Enumclaw, Washington, Forenede Stater, 98022
        • Saint Elizabeth Hospital
      • Everett, Washington, Forenede Stater, 98201
        • Providence Regional Cancer Partnership
      • Federal Way, Washington, Forenede Stater, 98002
        • Virginia Mason Federal Way Medical Center
      • Federal Way, Washington, Forenede Stater, 98003
        • Saint Francis Hospital
      • Gig Harbor, Washington, Forenede Stater, 98332
        • Tacoma/Valley Radiation Oncology Centers-Gig Harbor
      • Gig Harbor, Washington, Forenede Stater, 98335
        • MultiCare Gig Harbor Medical Park
      • Kennewick, Washington, Forenede Stater, 99336
        • Northwest Cancer Clinic
      • Lacey, Washington, Forenede Stater, 98503
        • Providence Regional Cancer System-Lacey
      • Lakewood, Washington, Forenede Stater, 98499
        • Saint Clare Hospital
      • Lynnwood, Washington, Forenede Stater, 98036
        • Virginia Mason Lynnwood Medical Center
      • Olympia, Washington, Forenede Stater, 98506-5166
        • Providence - Saint Peter Hospital
      • Olympia, Washington, Forenede Stater, 98507
        • Capital Medical Center
      • Port Townsend, Washington, Forenede Stater, 98368
        • Jefferson Healthcare
      • Poulsbo, Washington, Forenede Stater, 98370
        • Harrison HealthPartners Hematology and Oncology-Poulsbo
      • Poulsbo, Washington, Forenede Stater, 98370
        • Peninsula Cancer Center
      • Puyallup, Washington, Forenede Stater, 98372
        • MultiCare Good Samaritan Hospital
      • Puyallup, Washington, Forenede Stater, 98372
        • Tacoma/Valley Radiation Oncology Centers-Puyallup
      • Seattle, Washington, Forenede Stater, 98101
        • Virginia Mason Medical Center
      • Silverdale, Washington, Forenede Stater, 98383
        • Saint Michael Cancer Center
      • Tacoma, Washington, Forenede Stater, 98405
        • Northwest Medical Specialties PLLC
      • Tacoma, Washington, Forenede Stater, 98405
        • MultiCare Tacoma General Hospital
      • Tacoma, Washington, Forenede Stater, 98405
        • Tacoma/Valley Radiation Oncology Centers-Saint Joe's
      • Tacoma, Washington, Forenede Stater, 97405
        • Tacoma/Valley Radiation Oncology Centers-Jackson Hall
      • Tacoma, Washington, Forenede Stater, 98405
        • Franciscan Research Center-Northwest Medical Plaza
      • Tacoma, Washington, Forenede Stater, 98405
        • MultiCare Allenmore Hospital
      • Tacoma, Washington, Forenede Stater, 98405
        • Northwest NCI Community Oncology Research Program
      • Tacoma, Washington, Forenede Stater, 98405
        • Saint Joseph Medical Center
    • 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
      • Martinsburg, West Virginia, Forenede Stater, 25401
        • WVUH-Berkely Medical Center
      • Morgantown, West Virginia, Forenede Stater, 26506
        • West Virginia University Healthcare
      • Morgantown, West Virginia, Forenede Stater, 26505
        • Monongalia Hospital
      • Parkersburg, West Virginia, Forenede Stater, 26101
        • Camden Clark Medical Center
    • Wisconsin
      • 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
        • Bellin Memorial Hospital
      • Janesville, Wisconsin, Forenede Stater, 53548
        • Mercyhealth Hospital and Cancer Center - Janesville
      • Kenosha, Wisconsin, Forenede Stater, 53142
        • Aurora Cancer Care-Kenosha South
      • Ladysmith, Wisconsin, Forenede Stater, 54848
        • Marshfield Medical Center - Ladysmith
      • Marinette, Wisconsin, Forenede Stater, 54143
        • Aurora Bay Area Medical Group-Marinette
      • Marshfield, Wisconsin, Forenede Stater, 54449
        • Marshfield Medical Center-Marshfield
      • Marshfield, Wisconsin, Forenede Stater, 54449
        • Marshfield Medical Center
      • Milwaukee, Wisconsin, Forenede Stater, 53226
        • Medical College of Wisconsin
      • Milwaukee, Wisconsin, Forenede Stater, 53209
        • Aurora Cancer Care-Milwaukee
      • Milwaukee, Wisconsin, Forenede Stater, 53215
        • Aurora Saint Luke's Medical Center
      • Milwaukee, Wisconsin, Forenede Stater, 53233
        • Aurora Sinai Medical Center
      • Minocqua, Wisconsin, Forenede Stater, 54548
        • Marshfield Medical Center - Minocqua
      • New Richmond, Wisconsin, Forenede Stater, 54017
        • Cancer Center of Western Wisconsin
      • Oshkosh, Wisconsin, Forenede Stater, 54904
        • Vince Lombardi Cancer Clinic - Oshkosh
      • Racine, Wisconsin, Forenede Stater, 53406
        • Aurora Cancer Care-Racine
      • Rhinelander, Wisconsin, Forenede Stater, 54501
        • Saint Mary's Hospital
      • Rhinelander, Wisconsin, Forenede Stater, 54501
        • Aspirus Cancer Care - James Beck Cancer Center
      • Rice Lake, Wisconsin, Forenede Stater, 54868
        • Marshfield Medical Center-Rice Lake
      • Sheboygan, Wisconsin, Forenede Stater, 53081
        • Vince Lombardi Cancer Clinic-Sheboygan
      • Stevens Point, Wisconsin, Forenede Stater, 54481
        • Aspirus Cancer Care - Stevens Point
      • Summit, Wisconsin, Forenede Stater, 53066
        • Aurora Medical Center in Summit
      • Two Rivers, Wisconsin, Forenede Stater, 54241
        • Vince Lombardi Cancer Clinic-Two Rivers
      • Waukesha, Wisconsin, Forenede Stater, 53188
        • Aurora Cancer Care-Waukesha
      • 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
        • 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
  • Puerto Rico
      • San Juan, Puerto Rico, 00936
        • San Juan City Hospital

Deltagelseskriterier

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

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Beskrivelse

Inklusionskriterier:

  • Patienter bør have en forventet levetid på mindst 10 år, eksklusive deres diagnose af brystkræft; (komorbide tilstande bør tages i betragtning, men ikke diagnosen brystkræft)
  • Kvinder med reproduktionspotentiale skal acceptere at bruge en effektiv ikke-hormonel præventionsmetode under studieterapi (kemoterapi, trastuzumab, pertuzumab og østrogendeprivationsterapi) og i mindst 7 måneder efter den sidste dosis af undersøgelsesterapien
  • Indsendelse af tumorprøver er påkrævet for alle patienter; den lokale patologiafdelings politik vedrørende frigivelse af tumorprøver skal overvejes i screeningsprocessen; Patienter, hvis tumorprøver er placeret på en patologisk afdeling, som ifølge politik ikke vil indsende prøver til forskningsformål, bør ikke kontaktes for deltagelse i B-52-forsøget
  • Patienten skal have underskrevet og dateret en Institutional Review Board (IRB)-godkendt samtykkeformular, der er i overensstemmelse med føderale og institutionelle retningslinjer
  • Patienten skal have en Eastern Cooperative Oncology Group (ECOG) præstationsstatus på 0 eller 1
  • Klinisk stadieinddeling for den primære tumor kan være cT1c (skal være 2,0 cm) eller T2-T4, hvis den er klinisk node negativ; hvis de regionale lymfeknuder er cN1 og cytologisk eller histologisk positive eller hvis cN2-N3 med eller uden en biopsi, kan den primære brysttumor være cT0-T4
  • Diagnosen invasivt adenokarcinom i brystet skal være stillet ved kernenålebiopsi

  • Ipsilaterale aksillære lymfeknuder skal evalueres ved billeddannelse (mammogram, ultralyd og/eller magnetisk resonansbilleddannelse [MRI]) inden for 6 uger før randomisering; hvis det er mistænkeligt eller unormalt, anbefales finnålsaspirat (FNA) eller kernebiopsi, også inden for 6 uger før randomisering; resultaterne af disse evalueringer vil blive brugt til at bestemme nodalstatus før randomisering:

    • Nodalstatus - negativ

      • Billeddannelse af aksillen er negativ
      • Billeddannelse er mistænkelig eller unormal, men FNA eller kernebiopsi af den eller de tvivlsomme knudepunkter på billeddannelse er negativ

    • Nodalstatus - positiv

      • FNA eller kernebiopsi af knudepunkterne er cytologisk eller histologisk mistænkelig eller positiv
      • Billeddannelse er mistænkelig eller unormal, men FNA eller kernebiopsi blev ikke udført

  • Patienter kan være præmenopausale eller postmenopausale på tidspunktet for randomisering; til undersøgelsesformål defineres postmenopausal som:

    • Alder 56 eller ældre uden spontan menstruation i mindst 12 måneder før studiestart; eller
    • Alder 55 eller yngre uden spontan menstruation i mindst 12 måneder før studiestart (f.eks. spontan eller sekundær til hysterektomi) og med et dokumenteret østradiolniveau i det postmenopausale område i henhold til lokal institutionel/laboratoriestandard; eller
    • Dokumenteret bilateral oophorektomi

  • Tumoren skal være blevet bestemt til at være HER2-postiv som følger:

    • Immunhistokemi (IHC) 3+ eller
    • In situ hybridisering (ISH)-positiv (defineret ved forholdet mellem HER2 og cirkulerende endotelprogenitorer [CEP]17 >= 2,0 eller HER2-genkopital >= 6 pr. kerne)
  • Tumoren skal være blevet bestemt til at være østrogenreceptor (ER) og/eller progesteron (PgR) positiv vurderet af de nuværende retningslinjer fra American Society of Clinical Oncology (ASCO)/College of American Pathologist (CAP) for hormonreceptortestning; patienter med >= 1 % ER- eller PgR-farvning med IHC betragtes som positive
  • Absolut neutrofiltal (ANC) skal være >= 1200/mm^3
  • Blodpladeantal skal være >= 100.000/mm^3
  • Hæmoglobin skal være >= 10 g/dL
  • Total bilirubin skal være =< øvre normalgrænse (ULN) for laboratoriet, medmindre patienten har en bilirubinforhøjelse > ULN til 1,5 x ULN på grund af Gilberts sygdom eller lignende syndrom, der involverer langsom konjugering af bilirubin
  • Alkalisk fosfatase skal være =< 2,5 x ULN for laboratoriet
  • Aspartataminotransferase (AST) skal være =< 1,5 x ULN for laboratoriet
  • Alkalisk fosfatase og ASAT er muligvis ikke begge > ULN; for eksempel, hvis den alkaliske fosfatase er > ULN, men =< 2,5 x ULN, skal AST være =< ULN; hvis AST er > ULN, men =< 1,5 x ULN, skal den alkaliske fosfatase være =< ULN; Bemærk: Hvis alaninaminotransferase (ALT) udføres i stedet for AST (pr. institutions standardpraksis), skal ALT-værdien være =< 1,5 x ULN; hvis begge blev udført, skal AST være =< 1,5 x ULN
  • Patienter med ASAT eller alkalisk fosfatase > ULN er berettiget til at blive inkluderet i undersøgelsen, hvis leverbilleddannelse (computertomografi [CT], MR, positronemissionstomografi [PET]-CT eller PET-scanning) udført inden for 6 uger før randomisering ikke viser. metastatisk sygdom og kravene er opfyldt
  • Patienter med alkalisk fosfatase, som er > ULN, men =< 2,5 x ULN eller uforklarlige knoglesmerter er berettigede til at blive inkluderet i undersøgelsen, hvis en knoglescanning, PET-CT-scanning eller PET-scanning udført inden for 6 uger før randomisering ikke viser metastatisk sygdom
  • Inden for 6 uger før randomisering skal det seneste serumkreatinin være =< ULN eller målt eller beregnet kreatininclearance skal være > 60 ml/min.
  • Vurdering af venstre ventrikulær ejektionsfraktion (LVEF) skal udføres inden for 90 dage før randomisering; (LVEF-vurdering udført ved 2-dimensionelt [2-D] ekkokardiogram foretrækkes; multi-gated acquisition scan [MUGA] scanning kan dog erstattes baseret på institutionelle præferencer); LVEF skal være >= 50 % uanset hjertebilledbehandlingsfacilitetens nedre normalgrænse; bemærk: da præ-entry LVEF tjener som udgangspunkt for sammenligning af efterfølgende LVEF vurderinger, er det afgørende, at denne baseline undersøgelse er en nøjagtig vurdering; hvis baseline LVEF er > 65 %, opfordres investigator til at få bekræftet nøjagtigheden af ​​det oprindelige LVEF resultat og gentage testen, hvis nøjagtigheden er usikker

Ekskluderingskriterier:

  • FNA alene til at diagnosticere brystkræft
  • Excisionsbiopsi eller lumpektomi udført før randomisering
  • Kirurgisk aksillær stadieinddelingsprocedure før randomisering; pre-neoadjuverende terapi sentinel node biopsi er ikke tilladt
  • definitive kliniske eller radiologiske tegn på metastatisk sygdom; (brystbilleddannelse [obligatorisk for alle patienter] og anden billeddannelse [hvis påkrævet] skal være udført inden for 90 dage før randomisering)
  • Synkron bilateral invasiv brystkræft
  • Synkron eller tidligere kontralateral invasiv brystkræft; (patienter med synkront og/eller tidligere kontralateralt duktalt karcinom in situ [DCIS] eller lobulært karcinom in situ [LCIS] er kvalificerede)
  • Enhver tidligere historie med ipsilateral invasiv brystkræft eller ipsilateral DCIS; (patienter med synkron eller tidligere ipsilateral LCIS er kvalificerede)
  • Behandling inklusive strålebehandling (RT), kemoterapi, målrettet terapi eller endokrin terapi for den aktuelt diagnosticerede brystkræft før randomisering
  • Tidligere endokrin behandling såsom raloxifen eller tamoxifen (eller anden selektiv østrogenreceptormodulator [SERM]) eller en aromatasehæmmer for enhver malignitet
  • Tidligere behandling med antracyklin, taxaner, carboplatin, trastuzumab eller andre HER2-målrettede behandlinger for enhver malignitet
  • Enhver kønshormonbehandling, f.eks. p-piller, ovariehormonerstatningsterapi osv. (disse patienter er berettigede, hvis denne terapi afbrydes før randomisering)
  • Anamnese med ikke-brystmaligniteter (bortset fra in situ-kræft, der kun er behandlet med lokal excision og basalcelle- og pladecellekarcinomer i huden) inden for 5 år før randomisering

  • Hjertesygdom (historie af og/eller aktiv sygdom), der ville udelukke brugen af ​​de lægemidler, der er inkluderet i behandlingsregimerne; dette omfatter, men er ikke begrænset til:

    • Aktiv hjertesygdom:

      • Angina pectoris, der kræver brug af anti-anginal medicin;
      • Ventrikulære arytmier med undtagelse af benigne præmature ventrikulære kontraktioner;
      • Supraventrikulære og nodale arytmier, der kræver en pacemaker eller ikke kontrolleres med medicin;
      • Ledningsabnormitet, der kræver en pacemaker;
      • Valvulær sygdom med dokumenteret kompromittering af hjertefunktion; og
      • Symptomatisk perikarditis

    • Anamnese med hjertesygdom:

      • Myokardieinfarkt dokumenteret af forhøjede hjerteenzymer eller vedvarende regionale vægabnormiteter ved vurdering af venstre ventrikelfunktion (LV);
      • Anamnese med dokumenteret kongestiv hjerteinsufficiens (CHF); og
      • Dokumenteret kardiomyopati
  • Ukontrolleret hypertension defineret som vedvarende systolisk blodtryk (BP) > 150 mmHg eller diastolisk BP > 90 mmHg; (patienter med initiale BP-forhøjelser er berettigede, hvis initiering eller justering af BP-medicin sænker trykket for at opfylde adgangskriterierne)
  • Aktiv hepatitis B eller hepatitis C med unormale leverfunktionstests
  • Iboende lungesygdom, der resulterer i dyspnø
  • Dårligt kontrolleret diabetes mellitus
  • Aktiv infektion eller kronisk infektion, der kræver kronisk undertrykkende antibiotika
  • Patienter, der vides at være humane immundefektvirus (HIV)-positive med et baseline-cluster of differentiation (CD)4-tal på < 250 celler/mm^3 eller har en historie med erhvervet immundefektsyndrom (AIDS) indikatortilstande; patienter, der tager antiretroviral behandling, der kan have en potentiel overlappende toksicitet med undersøgelsesterapien, er ikke kvalificerede
  • Forstyrrelse i nervesystemet (paræstesi, perifer motorisk neuropati eller perifer sensorisk neuropati) >= grad 2, i henhold til Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v4.0)
  • Malabsorptionssyndrom, colitis ulcerosa, resektion af mave eller tyndtarm eller anden sygdom, der signifikant påvirker mave-tarmfunktionen
  • Anden ikke-malign systemisk sygdom, der ville udelukke behandling med nogen af ​​behandlingsregimerne eller ville forhindre nødvendig opfølgning
  • Forhold, der ville forbyde administration af kortikosteroider
  • Kronisk daglig behandling med kortikosteroider med en dosis på >= 10 mg/dag methylprednisolonækvivalent (eksklusive inhalerede steroider)
  • Kendt overfølsomhed over for et hvilket som helst af undersøgelseslægemidlerne eller nogen af ​​ingredienserne eller hjælpestofferne i disse lægemidler (f.eks. polysorbat 80), herunder følsomhed over for benzylalkohol
  • Graviditet eller amning på tidspunktet for studiestart; (bemærk: graviditetstest skal udføres inden for 2 uger før randomisering i henhold til institutionelle standarder for kvinder i den fødedygtige alder)
  • Psykiatriske eller vanedannende lidelser eller andre tilstande, der efter investigatorens opfattelse vil forhindre patienten i at opfylde undersøgelseskravene
  • Brug af ethvert forsøgsprodukt inden for 30 dage før randomisering

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Arm I (kombination kemoterapi, kirurgi, stråling)

NEOADJUVANT: Patienter får docetaxel IV over 60 minutter, carboplatin IV over 30-60 minutter, trastuzumab IV over 30-90 minutter og pertuzumab IV over 30-60 på dag 1. Behandlingen gentages hver 21. dag i op til 6 kure i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienter, der er indskrevet efter ændringsforslag #4, gennemgår 2 kernebiopsier før behandlingsforløb 3.

KIRURGI: Patienter gennemgår lumpektomi eller mastektomi.

STRÅLING: Patienter gennemgår helbrystbestråling inden for 8 uger efter operationen.

ADJUVANT: Patienter får trastuzumab IV over 30-60 minutter hver 21. dag i op til 1 år.
Andet: Laboratoriebiomarkøranalyse
Korrelative undersøgelser
Medicin: Carboplatin
Givet IV
Andre navne:
  • Blastocarb
  • Carboplat
  • Carboplatin Hexal
  • Carboplatino
  • Carboplatin
  • Carbosin
  • Carbosol
  • Carbotec
  • CBDCA
  • Displata
  • Ercar
  • JM-8
  • Nealorin
  • Novoplatin
  • Paraplatin
  • Paraplatin AQ
  • Platinwas
  • Ribocarbo
  • JM8
Andet: Livskvalitetsvurdering
Hjælpestudier
Andre navne:
  • Livskvalitetsvurdering
Biologisk: Trastuzumab
Givet IV
Andre navne:
  • Herceptin
  • ABP 980
  • ALT02
  • Herceptin Biosimilar PF-05280014
  • Herceptin Trastuzumab Biosimilar PF-05280014
  • Herzuma
  • Ogivri
  • Ontruzant
  • PF-05280014
  • rhuMAb HER2
  • RO0452317
  • SB3
  • Trastuzumab Biosimilar ABP 980
  • Trastuzumab Biosimilar ALT02
  • trastuzumab biosimilar EG12014
  • Trastuzumab Biosimilar HLX02
  • Trastuzumab Biosimilar PF-05280014
  • Trastuzumab Biosimilar SB3
  • Trastuzumab-dkst
  • Trastuzumab-dttb
  • Trastuzumab-pkrb
  • Trazimera
  • Kanjinti
  • Trastuzumab Biosimilar SIBP-01
  • Trastuzumab-anns
  • Trastuzumab-qyyp
  • Herclon
  • Zercepac
  • QL 1701
  • QL-1701
  • QL1701
  • Trastuzumab Biosimilar QL1701
  • CT-P06
  • CT-P6
  • Trastuzumab Biosimilar CT-P6
  • Biceltis
  • CANMab
  • Hertraz
  • Hercessi
  • Trastuzumab-strf
  • Herwenda
  • Trastuzumab-herw
  • Trastuzumab-zerc
  • HLX 02
  • HLX-02
  • HLX02
  • PF 05280014
  • PF05280014
Medicin: Docetaxel
Givet IV
Andre navne:
  • Taxotere
  • Docecad
  • RP56976
  • Taxotere injektionskoncentrat
  • RP 56976
  • RP-56976
Biologisk: Pertuzumab
Givet IV
Andre navne:
  • Perjeta
  • 2C4
  • 2C4 antistof
  • EG1206A
  • HLX11
  • HS627
  • MoAb 2C4
  • Monoklonalt antistof 2C4
  • Omnitarg
  • Pertuzumab Biosimilar EG1206A
  • Pertuzumab Biosimilar HLX11
  • Pertuzumab Biosimilar HS627
  • rhuMAb2C4
  • RO4368451
  • BCD-178
  • Pertuzumab Biosimilar BCD-178
  • Rhumab 2C4
  • Pertuzumab Biosimilar TQB2440
  • TQB 2440
  • TQB-2440
  • TQB2440
Stråling: Helbrystbestråling
Gennemgå helbrystbestråling
Andet: Cytologisk prøvetagningsprocedure
Gennemgå 2 kernebiopsier
Andre navne:
  • Cytologisk prøveudtagning
Procedure: Terapeutisk konventionel kirurgi
Gennemgå lumpektomi eller mastektomi
Eksperimentel: Arm II (kemo, østrogenmangel, kirurgi, stråling)

NEOADJUVANT: Alle patienter får docetaxel, carboplatin, trastuzumab og pertuzumab som i arm I. Præmenopausale patienter får også goserelinacetat SC hver 28. dag indtil operation og aromatasehæmmende behandling efter investigators skøn dagligt indtil 1 dag før operationen. Postmenopausale patienter modtager aromatasehæmmende behandling efter investigatorens skøn dagligt indtil 1 dag før operationen. Patienter, der er indskrevet efter ændringsforslag #4, gennemgår 2 kernebiopsier før behandlingsforløb 3.

KIRURGI: Patienter gennemgår lumpektomi eller mastektomi.

STRÅLING: Patienter gennemgår helbrystbestråling inden for 8 uger efter operationen.

ADJUVANT: Patienter får trastuzumab IV over 30-60 minutter hver 21. dag i op til 1 år.
Andet: Laboratoriebiomarkøranalyse
Korrelative undersøgelser
Medicin: Carboplatin
Givet IV
Andre navne:
  • Blastocarb
  • Carboplat
  • Carboplatin Hexal
  • Carboplatino
  • Carboplatin
  • Carbosin
  • Carbosol
  • Carbotec
  • CBDCA
  • Displata
  • Ercar
  • JM-8
  • Nealorin
  • Novoplatin
  • Paraplatin
  • Paraplatin AQ
  • Platinwas
  • Ribocarbo
  • JM8
Andet: Livskvalitetsvurdering
Hjælpestudier
Andre navne:
  • Livskvalitetsvurdering
Biologisk: Trastuzumab
Givet IV
Andre navne:
  • Herceptin
  • ABP 980
  • ALT02
  • Herceptin Biosimilar PF-05280014
  • Herceptin Trastuzumab Biosimilar PF-05280014
  • Herzuma
  • Ogivri
  • Ontruzant
  • PF-05280014
  • rhuMAb HER2
  • RO0452317
  • SB3
  • Trastuzumab Biosimilar ABP 980
  • Trastuzumab Biosimilar ALT02
  • trastuzumab biosimilar EG12014
  • Trastuzumab Biosimilar HLX02
  • Trastuzumab Biosimilar PF-05280014
  • Trastuzumab Biosimilar SB3
  • Trastuzumab-dkst
  • Trastuzumab-dttb
  • Trastuzumab-pkrb
  • Trazimera
  • Kanjinti
  • Trastuzumab Biosimilar SIBP-01
  • Trastuzumab-anns
  • Trastuzumab-qyyp
  • Herclon
  • Zercepac
  • QL 1701
  • QL-1701
  • QL1701
  • Trastuzumab Biosimilar QL1701
  • CT-P06
  • CT-P6
  • Trastuzumab Biosimilar CT-P6
  • Biceltis
  • CANMab
  • Hertraz
  • Hercessi
  • Trastuzumab-strf
  • Herwenda
  • Trastuzumab-herw
  • Trastuzumab-zerc
  • HLX 02
  • HLX-02
  • HLX02
  • PF 05280014
  • PF05280014
Medicin: Docetaxel
Givet IV
Andre navne:
  • Taxotere
  • Docecad
  • RP56976
  • Taxotere injektionskoncentrat
  • RP 56976
  • RP-56976
Biologisk: Pertuzumab
Givet IV
Andre navne:
  • Perjeta
  • 2C4
  • 2C4 antistof
  • EG1206A
  • HLX11
  • HS627
  • MoAb 2C4
  • Monoklonalt antistof 2C4
  • Omnitarg
  • Pertuzumab Biosimilar EG1206A
  • Pertuzumab Biosimilar HLX11
  • Pertuzumab Biosimilar HS627
  • rhuMAb2C4
  • RO4368451
  • BCD-178
  • Pertuzumab Biosimilar BCD-178
  • Rhumab 2C4
  • Pertuzumab Biosimilar TQB2440
  • TQB 2440
  • TQB-2440
  • TQB2440
Stråling: Helbrystbestråling
Gennemgå helbrystbestråling
Medicin: Goserelinacetat
Givet SC
Andre navne:
  • ZDX
  • Zoladex
Andet: Cytologisk prøvetagningsprocedure
Gennemgå 2 kernebiopsier
Andre navne:
  • Cytologisk prøveudtagning
Procedure: Terapeutisk konventionel kirurgi
Gennemgå lumpektomi eller mastektomi
Medicin: Aromatasehæmmende terapi
Givet efter efterforskerens skøn
Andre navne:
  • Aromatasehæmning

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Procent af patienter med patologisk fuldstændig respons (pCR) i bryst- og lymfeknuder efter terapi
Tidsramme: Op til 2,8 år (når alle patienter gennemførte primær brystoperation)
Andel af patienter med pCR evalueret histologisk og defineret som fraværet af nogen invasiv komponent i den resekerede brystprøve og alle resekerede lymfeknuder efter afslutning af neoadjuverende terapi.
Op til 2,8 år (når alle patienter gennemførte primær brystoperation)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Procentdel af patienter med patologisk komplet respons (pCR) i brystet
Tidsramme: Op til 2,8 år (når alle patienter gennemførte primær brystoperation)
Andel af patienter med pCR i brystet, defineret som fraværet af nogen invasiv komponent i den resekerede brystprøve.
Op til 2,8 år (når alle patienter gennemførte primær brystoperation)
Gentagelsesfrit interval (RFI)
Tidsramme: Tid fra operation til invasiv lokalt, regionalt eller fjernt tilbagefald eller død af brystkræft for patienter med operabel sygdom og for patienter med inoperabel progressiv sygdom, vurderet op til 8,4 år
Kaplan-Meier estimerer procentdelen af ​​patienter fri for tilbagefald.
Tid fra operation til invasiv lokalt, regionalt eller fjernt tilbagefald eller død af brystkræft for patienter med operabel sygdom og for patienter med inoperabel progressiv sygdom, vurderet op til 8,4 år
Samlet overlevelse (OS)
Tidsramme: Tid fra randomisering til død uanset årsag, vurderet op til 8,4 år
Kaplan-Meier skøn over procentdelen af ​​patienter, der overlever.
Tid fra randomisering til død uanset årsag, vurderet op til 8,4 år
Hyppighed af anden primær invasiv kræft af enhver type
Tidsramme: Tid fra randomisering til udvikling af en anden primær invasiv cancer på et hvilket som helst sted, undtagen plade- og basalcellekarcinom i huden, vurderet op til 8,4 år
De kumulative forekomster af anden primær cancer for de to behandlingsgrupper.
Tid fra randomisering til udvikling af en anden primær invasiv cancer på et hvilket som helst sted, undtagen plade- og basalcellekarcinom i huden, vurderet op til 8,4 år
Procentdel af patienter med patologisk fuldstændig respons (pCR) i bryst- og lymfeknuder efter behandling efter overgangsalderen
Tidsramme: Op til 2,8 år (når alle patienter gennemførte primær brystoperation)
Andel af patienter med pCR evalueret histologisk og defineret som fraværet af enhver invasiv komponent i den resekerede brystprøve og alle resekerede lymfeknuder efter afslutning af neoadjuverende terapi beregnet separat for præmenopausale og postmenopausale kvinder.
Op til 2,8 år (når alle patienter gennemførte primær brystoperation)
Mønstre for gentagelsesfrit interval (RFI) efter overgangsalderens status
Tidsramme: Op til 5 år
Kaplan-Meier skøn over procentdelen af ​​patienter, der er fri for recidiv efter menopausal status.
Op til 5 år
Mønstre for samlet overlevelse (OS) efter overgangsalderens status
Tidsramme: Op til 5 år
Kaplan-Meier skøn over procentdelen af ​​patienter, der overlever efter overgangsalderen.
Op til 5 år
Procentdel af deltagere med hjertetoksicitet kategoriseret i henhold til National Cancer Institute CTCAE Version 4.0
Tidsramme: Op til 6 uger efter operationen
Procentdel af patienter med grad 1 eller højere toksicitet fra systemorganklassen for hjertesygdomme.
Op til 6 uger efter operationen
Median procentdel af tumorinfiltrerende lymfocytter (sTILS)
Tidsramme: 2,8 år
Procentdel af tumorinfiltrerende lymfocytter til stede i stroma i vævsprøver.
2,8 år
Ændring i endokrine relaterede symptomer ved brug af forsøg med brystkræftforebyggelse (BCPT) Symptomcheckliste
Tidsramme: Baseline til op til 4 uger efter den sidste dosis kemoterapi
Gennemsnitlig totalscore fra BCPT-symptomchecklisten beregnet som den gennemsnitlige sværhedsgrad på tværs af alle emner på hvert tidspunkt.
Baseline til op til 4 uger efter den sidste dosis kemoterapi

Samarbejdspartnere og efterforskere

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

Sponsor

National Cancer Institute (NCI)

Samarbejdspartnere

NRG Oncology

Efterforskere

  • Ledende efterforsker: Mothaffar F Rimawi, NRG Oncology

Datoer for undersøgelser

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

Studer store datoer

Studiestart (Faktiske)

18. februar 2014

Primær færdiggørelse (Faktiske)

31. oktober 2016

Studieafslutning (Faktiske)

30. juni 2025

Datoer for studieregistrering

Først indsendt

2. december 2013

Først indsendt, der opfyldte QC-kriterier

2. december 2013

Først opslået (Anslået)

6. december 2013

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

8. august 2025

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. juli 2025

Sidst verificeret

1. juli 2025

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • NCI-2013-02228 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
  • U10CA180868 (U.S. NIH-bevilling/kontrakt)
  • U10CA012027 (U.S. NIH-bevilling/kontrakt)
  • NSABP-B-52 (Anden identifikator: CTEP)

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

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