Denne side blev automatisk oversat, og nøjagtigheden af oversættelsen er ikke garanteret. Der henvises til engelsk version for en kildetekst.

S1406 fase II undersøgelse af irinotecan og cetuximab med eller uden Vemurafenib i BRAF mutant metastatisk kolorektal cancer

7. december 2020 opdateret af: Southwest Oncology Group

Randomiseret fase II undersøgelse af Irinotecan og Cetuximab med eller uden Vemurafenib i BRAF mutant metastatisk kolorektal cancer

Dette randomiserede fase II-forsøg undersøger, hvor godt irinotecanhydrochlorid og cetuximab med eller uden vemurafenib virker i behandlingen af patienter med kolorektal cancer, der har spredt sig til nærliggende væv eller lymfeknuder, som har spredt sig til andre steder i kroppen eller ikke kan fjernes ved kirurgi. Irinotecanhydrochlorid og vemurafenib kan stoppe væksten af tumorceller ved at blokere nogle af de enzymer, der er nødvendige for cellevækst. Monoklonale antistoffer, såsom cetuximab, kan blokere tumorcellernes evne til at vokse og sprede sig. Det vides endnu ikke, om irinotecanhydrochlorid og cetuximab er mere effektive med eller uden vemurafenib til behandling af kolorektal cancer.

Studieoversigt

Status

Afsluttet

Betingelser

Kolorektal cancer

Intervention / Behandling

Detaljeret beskrivelse

PRIMÆRE MÅL:

I. At evaluere den progressionsfrie overlevelse (PFS) af v-raf murine sarkom viral onkogen homolog B (BRAF) mutant metastatisk kolorektal cancerpatienter behandlet med irinotecan (irinotecan hydrochlorid), cetuximab og vemurafenib sammenlignet med en kontrolarm af irinotecan og cetuximab.

SEKUNDÆRE MÅL:

I. At evaluere hyppigheden og sværhedsgraden af toksicitet forbundet med hver af behandlingsarmene i denne patientpopulation.

TERTIÆRE MÅL:

I. At evaluere samlet overlevelse (OS) i behandlingsarm 1 og 2. II. At evaluere den samlede responsrate (ORR), inklusive bekræftet og ubekræftet, fuldstændig og delvis respons, i behandlingsarm 1 og 2 i undergruppen af patienter med målbar sygdom.

III. At estimere frekvensen af OS, ORR og PFS hos patienter, der registrerer sig til arm 3 efter sygdomsprogression på arm 1.

IV. At evaluere lavfrekvente Kirsten rottesarkom viral onkogen homolog (KRAS) eller neuroblastom RAS viral (v-ras) onkogen homolog (NRAS) mutationer som påvist ved højdybdesekventering som prædiktive biomarkører for effektivitet.

V. At evaluere phosphatidylinositol-4,5-bisphosphat 3-kinase, aktivering af katalytisk subunit alpha (PIK3CA) pathway gennem PIK3CA mutationer eller phosphatase og tensin homolog (PTEN) proteintab som en forudsigelig biomarkør for medfødt resistens over for dette regime.

VI. At evaluere genekspressionssignaturer fra screenede patienter med v-raf murine sarkom viral onkogen homolog B vildtype (BRAFWT) og BRAFV600E tumorer.

VII. At levere validering af BRAF-immunhistokemi (IHC) ved hjælp af komplementær sekventeringsmetodologi fra screenede patienter med BRAFWT- og BRAFV600E-tumorer.

VIII. For at bekræfte den estimerede følsomhed af påviselig BRAF V600E cirkulerende cellefri deoxyribonukleinsyre (DNA) som en ikke-invasiv biomarkør for BRAF V600E mutation som påvist af IHC i den primære tumor.

IX. At korrelere radiografisk tumorrespons med ændring i kvantificering af BRAFV600E-alleler i cirkulerende cellefrit DNA.

X. At overvåge for kendt mekanisme for erhvervet resistens mod epidermal vækstfaktorreceptor (EGFR) hæmning i cirkulerende cellefrit DNA (KRAS, NRAS mutationer).

OVERSIGT: Patienterne randomiseres til 1 ud af 2 behandlingsarme.

ARM I: Patienter får cetuximab intravenøst (IV) og irinotecanhydrochlorid IV på dag 1 og 14. Kurser gentages hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienter med sygdomsprogression kan gå over til arm II.

ARM II: Patienterne får cetuximab og irinotecanhydrochlorid som i arm I og vemurafenib oralt (PO) to gange dagligt (BID) på dag 1-28. Kurser gentages hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.

Efter afsluttet undersøgelsesbehandling følges patienterne hver 2.-6. måned i 3 år.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

106

Fase

Fase 2

Kontakter og lokationer

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

Studiesteder

Forenede Stater
- Alaska
  - Anchorage, Alaska, Forenede Stater, 99508
    - Alaska Breast Care and Surgery LLC
  - Anchorage, Alaska, Forenede Stater, 99508
    - Alaska Oncology and Hematology LLC
  - Anchorage, Alaska, Forenede Stater, 99508
    - Alaska Women's Cancer Care
  - Anchorage, Alaska, Forenede Stater, 99508
    - Anchorage Oncology Centre
  - Anchorage, Alaska, Forenede Stater, 99508
    - Katmai Oncology Group
  - Anchorage, Alaska, Forenede Stater, 99508
    - Providence Alaska Medical Center
  - Anchorage, Alaska, Forenede Stater, 99504
    - Anchorage Radiation Therapy Center
  - Anchorage, Alaska, Forenede Stater, 99508
    - Alaska Regional Hospital
  - Fairbanks, Alaska, Forenede Stater, 99701
    - Fairbanks Memorial Hospital
- Arizona
  - Tucson, Arizona, Forenede Stater, 85704
    - University of Arizona Cancer Center-Orange Grove Campus
  - Tucson, Arizona, Forenede Stater, 85719
    - University of Arizona Cancer Center-North Campus
  - Tucson, Arizona, Forenede Stater, 85724
    - The University of Arizona Medical Center-University Campus
- Arkansas
  - Hot Springs, Arkansas, Forenede Stater, 71913
    - Mercy Cancer Center-Hot Springs
  - Jonesboro, Arkansas, Forenede Stater, 72401
    - Fowler Family Center for Cancer Care
  - Little Rock, Arkansas, Forenede Stater, 72205
    - University of Arkansas for Medical Sciences
  - Little Rock, Arkansas, Forenede Stater, 72205
    - Veteran's Administration Medical Center
- California
  - Anaheim, California, Forenede Stater, 92807
    - Kaiser Permanente-Anaheim
  - Antioch, California, Forenede Stater, 94531
    - Kaiser Permanente-Deer Valley Medical Center
  - Auburn, California, Forenede Stater, 95602
    - Sutter Auburn Faith Hospital
  - Auburn, California, Forenede Stater, 95603
    - Sutter Cancer Centers Radiation Oncology Services-Auburn
  - Baldwin Park, California, Forenede Stater, 91706
    - Kaiser Permanente-Baldwin Park
  - Bellflower, California, Forenede Stater, 90706
    - Kaiser Permanente-Bellflower
  - Berkeley, California, Forenede Stater, 94704
    - Alta Bates Summit Medical Center-Herrick Campus
  - Burbank, California, Forenede Stater, 91505
    - Providence Saint Joseph Medical Center/Disney Family Cancer Center
  - Burlingame, California, Forenede Stater, 94010
    - Mills - Peninsula Hospitals
  - Cameron Park, California, Forenede Stater, 95682
    - Sutter Cancer Centers Radiation Oncology Services-Cameron Park
  - Castro Valley, California, Forenede Stater, 94546
    - Eden Hospital Medical Center
  - Davis, California, Forenede Stater, 95616
    - Sutter Davis Hospital
  - Duarte, California, Forenede Stater, 91010
    - City of Hope Comprehensive Cancer Center
  - 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 Hospital
  - Fremont, California, Forenede Stater, 94538
    - Kaiser Permanente-Fremont
  - Fresno, California, Forenede Stater, 93720
    - Kaiser Permanente
  - Greenbrae, California, Forenede Stater, 94904
    - Marin Cancer Care Inc
  - Greenbrae, California, Forenede Stater, 94904
    - Marin General Hospital
  - Harbor City, California, Forenede Stater, 90710
    - Kaiser Permanente - Harbor City
  - Irvine, California, Forenede Stater, 92618
    - Kaiser Permanente-Irvine
  - Los Angeles, California, Forenede Stater, 90033
    - USC / Norris Comprehensive Cancer Center
  - Los Angeles, California, Forenede Stater, 90033
    - Los Angeles County-USC Medical Center
  - Los Angeles, California, Forenede Stater, 90027
    - Kaiser Permanente Los Angeles Medical Center
  - Los Angeles, California, Forenede Stater, 90034
    - Kaiser Permanente-Cadillac
  - Martinez, California, Forenede Stater, 94553-3156
    - Contra Costa Regional Medical Center
  - Marysville, California, Forenede Stater, 95901
    - Fremont - Rideout Cancer Center
  - Modesto, California, Forenede Stater, 95355
    - Memorial Medical Center
  - Modesto, California, Forenede Stater, 95356
    - Kaiser Permanente-Modesto
  - Mountain View, California, Forenede Stater, 94040
    - Palo Alto Medical Foundation-Camino Division
  - Mountain View, California, Forenede Stater, 94040
    - Palo Alto Medical Foundation-Gynecologic Oncology
  - Novato, California, Forenede Stater, 94945
    - Sutter Cancer Research Consortium
  - Oakland, California, Forenede Stater, 94611
    - Kaiser Permanente-Oakland
  - Oakland, California, Forenede Stater, 94611
    - Kaiser Permanente Oakland-Broadway
  - 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
  - Orange, California, Forenede Stater, 92868
    - UC Irvine Health/Chao Family Comprehensive Cancer Center
  - Palo Alto, California, Forenede Stater, 94301
    - Palo Alto Medical Foundation Health Care
  - Panorama City, California, Forenede Stater, 91402
    - Kaiser Permanente - Panorama City
  - Pasadena, California, Forenede Stater, 91105
    - Keck Medical Center of USC Pasadena
  - Pismo Beach, California, Forenede Stater, 93449
    - PCR Oncology
  - Rancho Cordova, California, Forenede Stater, 95670
    - Kaiser Permanente-Rancho Cordova Cancer Center
  - 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
  - Rohnert Park, California, Forenede Stater, 94928
    - Rohnert Park Cancer Center
  - Roseville, California, Forenede Stater, 95678
    - The Permanente Medical Group-Roseville Radiation Oncology
  - 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, 95817
    - University of California Davis Comprehensive Cancer Center
  - Sacramento, California, Forenede Stater, 95823
    - Kaiser Permanente-South Sacramento
  - Sacramento, California, Forenede Stater, 95823
    - South Sacramento Cancer Center
  - Sacramento, California, Forenede Stater, 95825
    - Kaiser Permanente - Sacramento
  - Sacramento, California, Forenede Stater, 95816
    - Sutter General Hospital
  - Salinas, California, Forenede Stater, 93901
    - Salinas Valley Memorial
  - 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, 94158
    - UCSF Medical Center-Mission Bay
  - San Francisco, California, Forenede Stater, 94115
    - California Pacific Medical Center-Pacific Campus
  - San Francisco, California, Forenede Stater, 94115
    - UCSF Medical Center-Mount Zion
  - San Jose, California, Forenede Stater, 95119
    - Kaiser Permanente-Santa Teresa-San Jose
  - San Leandro, California, Forenede Stater, 94577
    - Kaiser Permanente San Leandro
  - San Marcos, California, Forenede Stater, 92069
    - Kaiser Permanente-San Marcos
  - San Rafael, California, Forenede Stater, 94903
    - Kaiser Permanente-San Rafael
  - Santa Clara, California, Forenede Stater, 95051
    - Kaiser Permanente Medical Center - Santa Clara
  - Santa Cruz, California, Forenede Stater, 95065
    - Palo Alto Medical Foundation-Santa Cruz
  - Santa Rosa, California, Forenede Stater, 95403
    - Kaiser Permanente-Santa Rosa
  - Santa Rosa, California, Forenede Stater, 95403
    - Sutter Pacific Medical Foundation
  - South San Francisco, California, Forenede Stater, 94080
    - Kaiser Permanente Cancer Treatment Center
  - 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
  - Truckee, California, Forenede Stater, 96161
    - Gene Upshaw Memorial Tahoe Forest Cancer Center
  - Vacaville, California, Forenede Stater, 95688
    - Kaiser Permanente Medical Center-Vacaville
  - Vacaville, California, Forenede Stater, 95687
    - Sutter Cancer Centers Radiation Oncology Services-Vacaville
  - Vallejo, California, Forenede Stater, 94589
    - Kaiser Permanente-Vallejo
  - Vallejo, California, Forenede Stater, 94589
    - Sutter Solano Medical Center/Cancer Center
  - Walnut Creek, California, Forenede Stater, 94596
    - Kaiser Permanente-Walnut Creek
  - Woodland Hills, California, Forenede Stater, 91367
    - Kaiser Permanente
- Colorado
  - Aurora, Colorado, Forenede Stater, 80045
    - University of Colorado Cancer Center - Anschutz Cancer Pavilion
  - Aurora, Colorado, Forenede Stater, 80012
    - Rocky Mountain Cancer Centers-Aurora
  - Aurora, Colorado, Forenede Stater, 80012
    - The Medical Center of Aurora
  - Boulder, Colorado, Forenede Stater, 80301
    - Boulder Community Hospital
  - Boulder, Colorado, Forenede Stater, 80304
    - Rocky Mountain Cancer Centers-Boulder
  - Colorado Springs, Colorado, Forenede Stater, 80907
    - Penrose-Saint Francis Healthcare
  - Colorado Springs, Colorado, Forenede Stater, 80907
    - Rocky Mountain Cancer Centers-Penrose
  - Colorado Springs, Colorado, Forenede Stater, 80909
    - Memorial Hospital Colorado Springs
  - Denver, Colorado, Forenede Stater, 80210
    - Porter Adventist Hospital
  - Denver, Colorado, Forenede Stater, 80218
    - Presbyterian - Saint Lukes Medical Center - Health One
  - Denver, Colorado, Forenede Stater, 80218
    - SCL Health Saint Joseph Hospital
  - Denver, Colorado, Forenede Stater, 80220
    - Rose Medical Center
  - Denver, Colorado, Forenede Stater, 80218
    - Rocky Mountain Cancer Centers-Midtown
  - Denver, Colorado, Forenede Stater, 80220
    - Rocky Mountain Cancer Centers-Rose
  - Denver, Colorado, Forenede Stater, 80204
    - Denver Health Medical Center
  - Denver, Colorado, Forenede Stater, 80218
    - Colorado Blood Cancer Institute
  - Denver, Colorado, Forenede Stater, 80222
    - Colorado Cancer Research Program NCORP
  - Durango, Colorado, Forenede Stater, 81301
    - Mercy Medical Center
  - Durango, Colorado, Forenede Stater, 81301
    - Southwest Oncology PC
  - Englewood, Colorado, Forenede Stater, 80113
    - Swedish Medical Center
  - Englewood, Colorado, Forenede Stater, 80113
    - Comprehensive Cancer Care and Research Institute of Colorado LLC
  - Fort Collins, Colorado, Forenede Stater, 80524
    - Poudre Valley Hospital
  - Golden, Colorado, Forenede Stater, 80401
    - Mountain Blue Cancer Care Center
  - Golden, Colorado, Forenede Stater, 80401
    - National Jewish Health-Western Hematology Oncology
  - Greeley, Colorado, Forenede Stater, 80631
    - North Colorado Medical Center
  - Greenwood Village, Colorado, Forenede Stater, 80111
    - Rocky Mountain Cancer Centers-Greenwood Village
  - Lakewood, Colorado, Forenede Stater, 80228
    - Saint Anthony Hospital
  - Lakewood, Colorado, Forenede Stater, 80228
    - Rocky Mountain Cancer Centers-Lakewood
  - Littleton, Colorado, Forenede Stater, 80120
    - Rocky Mountain Cancer Centers-Littleton
  - Littleton, Colorado, Forenede Stater, 80122
    - Littleton Adventist Hospital
  - Lone Tree, Colorado, Forenede Stater, 80124
    - Sky Ridge Medical Center
  - Lone Tree, Colorado, Forenede Stater, 80124
    - Rocky Mountain Cancer Centers-Sky Ridge
  - Longmont, Colorado, Forenede Stater, 80501
    - Longmont United Hospital
  - Longmont, Colorado, Forenede Stater, 80501
    - Rocky Mountain Cancer Centers-Longmont
  - Loveland, Colorado, Forenede Stater, 80539
    - McKee Medical Center
  - Parker, Colorado, Forenede Stater, 80138
    - Parker Adventist Hospital
  - Parker, Colorado, Forenede Stater, 80138
    - Rocky Mountain Cancer Centers-Parker
  - Pueblo, Colorado, Forenede Stater, 81004
    - Saint Mary Corwin Medical Center
  - Pueblo, Colorado, Forenede Stater, 81008
    - Rocky Mountain Cancer Centers - Pueblo
  - Thornton, Colorado, Forenede Stater, 80260
    - Rocky Mountain Cancer Centers-Thornton
  - Wheat Ridge, Colorado, Forenede Stater, 80033
    - SCL Health Lutheran Medical Center
- Connecticut
  - Derby, Connecticut, Forenede Stater, 06418
    - Smilow Cancer Hospital-Derby Care Center
  - Fairfield, Connecticut, Forenede Stater, 06824
    - Smilow Cancer Hospital Care Center-Fairfield
  - Greenwich, Connecticut, Forenede Stater, 06830
    - Greenwich Hospital
  - Guilford, Connecticut, Forenede Stater, 06437
    - Medical Oncology and Hematology Group PC-Guilford
  - Hartford, Connecticut, Forenede Stater, 06105
    - Smilow Cancer Hospital Care Center at Saint Francis
  - Middletown, Connecticut, Forenede Stater, 06457
    - Middlesex Hospital
  - New Haven, Connecticut, Forenede Stater, 06520
    - Yale University
  - North Haven, Connecticut, Forenede Stater, 06473
    - Yale-New Haven Hospital North Haven Medical Center
  - Norwich, Connecticut, Forenede Stater, 06360
    - Eastern Connecticut Hematology and Oncology Associates
  - Orange, Connecticut, Forenede Stater, 06477
    - Smilow Cancer Hospital-Orange Care Center
  - Torrington, Connecticut, Forenede Stater, 06790
    - Charlotte Hungerford Hospital Center for Cancer Care
  - Trumbull, Connecticut, Forenede Stater, 06611
    - Smilow Cancer Hospital Care Center-Trumbull
  - Waterbury, Connecticut, Forenede Stater, 06708
    - Smilow Cancer Hospital-Waterbury Care Center
- Delaware
  - Lewes, Delaware, Forenede Stater, 19958
    - Beebe Medical Center
  - Newark, Delaware, Forenede Stater, 19713
    - Helen F Graham Cancer Center
  - Newark, Delaware, Forenede Stater, 19713
    - Delaware Clinical and Laboratory Physicians PA
  - Newark, Delaware, Forenede Stater, 19713
    - Medical Oncology Hematology Consultants PA
  - Newark, Delaware, Forenede Stater, 19718
    - Christiana Care Health System-Christiana Hospital
  - Newark, Delaware, Forenede Stater, 19713
    - Christiana Gynecologic Oncology LLC
  - Newark, Delaware, Forenede Stater, 19713
    - Regional Hematology and Oncology PA
  - Rehoboth Beach, Delaware, Forenede Stater, 19971
    - Beebe Health Campus
  - Seaford, Delaware, Forenede Stater, 19973
    - Nanticoke Memorial Hospital
  - Wilmington, Delaware, Forenede Stater, 19801
    - Christiana Care Health System-Wilmington Hospital
- Florida
  - Altamonte Springs, Florida, Forenede Stater, 32701
    - Florida Hospital Cancer Institute Altamonte
  - Gainesville, Florida, Forenede Stater, 32610
    - University of Florida
  - Kissimmee, Florida, Forenede Stater, 34744
    - Florida Hospital Kissimmee
  - Miami Beach, Florida, Forenede Stater, 33140
    - Mount Sinai Medical Center
  - Orlando, Florida, Forenede Stater, 32803
    - Florida Hospital Orlando
  - Orlando, Florida, Forenede Stater, 32806
    - UF Cancer Center at Orlando Health
  - Orlando, Florida, Forenede Stater, 32803
    - Florida Urology Associates-Orlando
  - Orlando, Florida, Forenede Stater, 32822
    - Florida Hospital East Orlando
  - Winter Park, Florida, Forenede Stater, 32792
    - Florida Hospital Cancer Institute Winter Park
- Georgia
  - Atlanta, Georgia, Forenede Stater, 30342
    - Northside Hospital
  - Columbus, Georgia, Forenede Stater, 31904
    - John B Amos Cancer Center
  - Savannah, Georgia, Forenede Stater, 31405
    - Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
  - Savannah, Georgia, Forenede Stater, 31404
    - Memorial University Medical Center
  - Savannah, Georgia, Forenede Stater, 31404
    - Summit Cancer Care-Memorial
  - Savannah, Georgia, Forenede Stater, 31405
    - Low Country Cancer Care Associates PC
- Hawaii
  - 'Aiea, Hawaii, Forenede Stater, 96701
    - Pali Momi Medical Center
  - 'Aiea, Hawaii, Forenede Stater, 96701
    - Hawaii Oncology Inc-Pali Momi
  - 'Ewa Beach, Hawaii, Forenede Stater, 96706
    - The Cancer Center of Hawaii-Leeward
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Queen's Medical Center
  - Honolulu, Hawaii, Forenede Stater, 96817
    - The Cancer Center of Hawaii-Liliha
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Straub Clinic and Hospital
  - Honolulu, Hawaii, Forenede Stater, 96813
    - University of Hawaii Cancer Center
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Hawaii Cancer Care Inc-Liliha
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Kuakini Medical Center
  - Honolulu, Hawaii, Forenede Stater, 96826
    - Kapiolani Medical Center for Women and Children
  - Honolulu, Hawaii, Forenede Stater, 96819
    - Kaiser Permanente Moanalua Medical Center
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Hawaii Cancer Care Inc-POB II
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Hawaii Oncology Inc-Kuakini
  - Lihue, Hawaii, Forenede Stater, 96766
    - Wilcox Memorial Hospital and Kauai Medical Clinic
- Idaho
  - Boise, Idaho, Forenede Stater, 83706
    - Saint Alphonsus Cancer Care Center-Boise
  - Boise, Idaho, Forenede Stater, 83712
    - Saint Luke's Mountain States Tumor Institute
  - Fruitland, Idaho, Forenede Stater, 83619
    - Saint Luke's Mountain States Tumor Institute - Fruitland
  - Meridian, Idaho, Forenede Stater, 83642
    - Saint Luke's Mountain States Tumor Institute - Meridian
  - Nampa, Idaho, Forenede Stater, 83686
    - Saint Luke's Mountain States Tumor Institute - Nampa
  - Twin Falls, Idaho, Forenede Stater, 83301
    - Saint Luke's Mountain States Tumor Institute-Twin Falls
- Illinois
  - Aurora, Illinois, Forenede Stater, 60504
    - Rush - Copley Medical Center
  - Bloomington, Illinois, Forenede Stater, 61704
    - Illinois CancerCare-Bloomington
  - Bloomington, Illinois, Forenede Stater, 61701
    - Saint Joseph Medical Center
  - Canton, Illinois, Forenede Stater, 61520
    - Illinois CancerCare-Canton
  - Carbondale, Illinois, Forenede Stater, 62902
    - Memorial Hospital of Carbondale
  - Carthage, Illinois, Forenede Stater, 62321
    - Illinois CancerCare-Carthage
  - Centralia, Illinois, Forenede Stater, 62801
    - Centralia Oncology Clinic
  - Chicago, Illinois, Forenede Stater, 60611
    - Northwestern University
  - Chicago, Illinois, Forenede Stater, 60637
    - University of Chicago Comprehensive Cancer Center
  - Chicago, Illinois, Forenede Stater, 60612
    - John H Stroger Jr Hospital of Cook County
  - Danville, Illinois, Forenede Stater, 61832
    - Carle on Vermilion
  - Decatur, Illinois, Forenede Stater, 62526
    - Decatur Memorial Hospital
  - Decatur, Illinois, Forenede Stater, 62526
    - Cancer Care Center of Decatur
  - Effingham, Illinois, Forenede Stater, 62401
    - Crossroads Cancer Center
  - Effingham, Illinois, Forenede Stater, 62401
    - Carle Physician Group-Effingham
  - Eureka, Illinois, Forenede Stater, 61530
    - Illinois CancerCare-Eureka
  - Evanston, Illinois, Forenede Stater, 60201
    - NorthShore University HealthSystem-Evanston Hospital
  - Galesburg, Illinois, Forenede Stater, 61401
    - Western Illinois Cancer Treatment Center
  - Galesburg, Illinois, Forenede Stater, 61401
    - Illinois CancerCare-Galesburg
  - Glenview, Illinois, Forenede Stater, 60026
    - NorthShore University HealthSystem-Glenbrook Hospital
  - Highland Park, Illinois, Forenede Stater, 60035
    - NorthShore University HealthSystem-Highland Park Hospital
  - Joliet, Illinois, Forenede Stater, 60435
    - Joliet Oncology-Hematology Associates Limited
  - 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
  - Maywood, Illinois, Forenede Stater, 60153
    - Loyola University Medical Center
  - Mount Vernon, Illinois, Forenede Stater, 62864
    - Good Samaritan Regional Health Center
  - Naperville, Illinois, Forenede Stater, 60540
    - Edward Hospital/Cancer Center
  - New Lenox, Illinois, Forenede Stater, 60451
    - UC Comprehensive Cancer Center at Silver Cross
  - 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 Cancer Treatment Center
  - Peoria, Illinois, Forenede Stater, 61637
    - OSF Saint Francis Medical Center
  - Peoria, Illinois, Forenede Stater, 61615
    - Illinois CancerCare-Peoria
  - Peoria, Illinois, Forenede Stater, 61615
    - OSF Saint Francis Radiation Oncology at Peoria Cancer Center
  - Peoria, Illinois, Forenede Stater, 61603
    - Methodist Medical Center of Illinois
  - 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
  - Skokie, Illinois, Forenede Stater, 60076
    - North Shore Medical Center
  - Springfield, Illinois, Forenede Stater, 62781
    - Memorial Medical Center
  - Springfield, Illinois, Forenede Stater, 62702
    - Southern Illinois University School of Medicine
  - Springfield, Illinois, Forenede Stater, 62702
    - Springfield Clinic
  - Springfield, Illinois, Forenede Stater, 62702
    - Central Illinois Hematology Oncology Center
  - Swansea, Illinois, Forenede Stater, 62226
    - Cancer Care Specialists of Illinois-Swansea
  - Urbana, Illinois, Forenede Stater, 61801
    - Carle Cancer Center
  - Urbana, Illinois, Forenede Stater, 61801
    - The Carle Foundation Hospital
  - Yorkville, Illinois, Forenede Stater, 60560
    - Rush-Copley Healthcare Center
- Indiana
  - 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, 46544
    - Memorial Regional Cancer Center Day Road
  - Richmond, Indiana, Forenede Stater, 47374
    - Reid Health
  - South Bend, Indiana, Forenede Stater, 46601
    - Memorial Hospital of South Bend
  - South Bend, Indiana, Forenede Stater, 46628
    - Northern Indiana Cancer Research Consortium
  - Valparaiso, Indiana, Forenede Stater, 46383
    - Porter Memorial Hospital
- Iowa
  - Ames, Iowa, Forenede Stater, 50010
    - Mary Greeley Medical Center
  - Ames, Iowa, Forenede Stater, 50010
    - McFarland Clinic PC-William R Bliss Cancer Center
  - Boone, Iowa, Forenede Stater, 50036
    - McFarland Clinic PC-Boone
  - Clive, Iowa, Forenede Stater, 50325
    - Mercy Cancer Center-West Lakes
  - Clive, Iowa, Forenede Stater, 50325
    - Medical Oncology and Hematology Associates-West Des Moines
  - Council Bluffs, Iowa, Forenede Stater, 51503
    - Alegent Health Mercy Hospital
  - Creston, Iowa, Forenede Stater, 50801
    - Greater Regional Medical Center
  - Des Moines, Iowa, Forenede Stater, 50314
    - Mercy Medical Center - Des Moines
  - Des Moines, Iowa, Forenede Stater, 50314
    - Medical Oncology and Hematology Associates-Laurel
  - Fort Dodge, Iowa, Forenede Stater, 50501
    - McFarland Clinic PC-Trinity Cancer Center
  - Jefferson, Iowa, Forenede Stater, 50129
    - McFarland Clinic PC-Jefferson
  - Marshalltown, Iowa, Forenede Stater, 50158
    - McFarland Clinic PC-Marshalltown
  - Mason City, Iowa, Forenede Stater, 50401
    - Mercy Medical Center - North Iowa
  - Nevada, Iowa, Forenede Stater, 50201
    - Story County Medical Center-South Campus
  - Sioux City, Iowa, Forenede Stater, 51101
    - Siouxland Regional Cancer Center
  - West Des Moines, Iowa, Forenede Stater, 50266
    - Mercy Medical Center-West Lakes
- Kansas
  - Chanute, Kansas, Forenede Stater, 66720
    - Cancer Center of Kansas - Chanute
  - Dodge City, Kansas, Forenede Stater, 67801
    - Cancer Center of Kansas - Dodge City
  - El Dorado, Kansas, Forenede Stater, 67042
    - Cancer Center of Kansas - El Dorado
  - Emporia, Kansas, Forenede Stater, 66801
    - Newman Regional Health
  - Fort Scott, Kansas, Forenede Stater, 66701
    - Cancer Center of Kansas - Fort Scott
  - Garden City, Kansas, Forenede Stater, 67846
    - Saint Catherine Hospital
  - Great Bend, Kansas, Forenede Stater, 67530
    - Saint Rose Ambulatory and Surgery Center
  - Hays, Kansas, Forenede Stater, 67601
    - Hays Medical Center
  - Independence, Kansas, Forenede Stater, 67301
    - Cancer Center of Kansas-Independence
  - Kansas City, Kansas, Forenede Stater, 66160
    - University of Kansas Cancer Center
  - Kansas City, Kansas, Forenede Stater, 66112
    - University of Kansas Cancer Center-West
  - Kingman, Kansas, Forenede Stater, 67068
    - Cancer Center of Kansas-Kingman
  - Lawrence, Kansas, Forenede Stater, 66044
    - Lawrence Memorial Hospital
  - Liberal, Kansas, Forenede Stater, 67905
    - Cancer Center of Kansas-Liberal
  - Newton, Kansas, Forenede Stater, 67114
    - Cancer Center of Kansas - Newton
  - Olathe, Kansas, Forenede Stater, 66061
    - Olathe Medical Center
  - Overland Park, Kansas, Forenede Stater, 66210
    - University of Kansas Cancer Center-Overland Park
  - Parsons, Kansas, Forenede Stater, 67357
    - Cancer Center of Kansas - Parsons
  - Pittsburg, Kansas, Forenede Stater, 66762
    - Via Christi Hospital-Pittsburg
  - Pratt, Kansas, Forenede Stater, 67124
    - Cancer Center of Kansas - Pratt
  - Salina, Kansas, Forenede Stater, 67401
    - Salina Regional Health Center
  - Salina, Kansas, Forenede Stater, 67401
    - Cancer Center of Kansas - Salina
  - Topeka, Kansas, Forenede Stater, 66606
    - Saint Francis Hospital and Medical Center - Topeka
  - Wellington, Kansas, Forenede Stater, 67152
    - Cancer Center of Kansas - Wellington
  - 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
  - Wichita, Kansas, Forenede Stater, 67214
    - Via Christi Regional Medical Center
  - Winfield, Kansas, Forenede Stater, 67156
    - Cancer Center of Kansas - Winfield
- Kentucky
  - Bardstown, Kentucky, Forenede Stater, 40004
    - Flaget Memorial Hospital
  - Corbin, Kentucky, Forenede Stater, 40701
    - Commonwealth Cancer Center-Corbin
  - Crestview Hills, Kentucky, Forenede Stater, 41017
    - Oncology Hematology Care Inc-Crestview
  - Lexington, Kentucky, Forenede Stater, 40504
    - Saint Joseph Radiation Oncology Resource Center
  - Lexington, Kentucky, Forenede Stater, 40509
    - Saint Joseph Hospital East
  - Louisville, Kentucky, Forenede Stater, 40202
    - Jewish Hospital
  - Louisville, Kentucky, Forenede Stater, 40215
    - Saints Mary and Elizabeth Hospital
  - Louisville, Kentucky, Forenede Stater, 40245
    - Jewish Hospital Medical Center Northeast
  - Shepherdsville, Kentucky, Forenede Stater, 40165
    - Jewish Hospital Medical Center South
- Louisiana
  - Alexandria, Louisiana, Forenede Stater, 71301
    - Christus Saint Frances Cabrini Hospital
  - Baton Rouge, Louisiana, Forenede Stater, 70805
    - LSU Health Baton Rouge-North Clinic
  - Baton Rouge, Louisiana, Forenede Stater, 70809
    - Louisiana Hematology Oncology Associates LLC
  - Baton Rouge, Louisiana, Forenede Stater, 70809
    - Medical Oncology LLC
  - Covington, Louisiana, Forenede Stater, 70433
    - Mary Bird Cancer Center/Saint Tammany Parish
  - Houma, Louisiana, Forenede Stater, 70360
    - Mary Bird Perkins Cancer Center/Terrebonne General Medical Center
  - New Orleans, Louisiana, Forenede Stater, 70121
    - Ochsner Medical Center Jefferson
- Maine
  - Augusta, Maine, Forenede Stater, 04330
    - Harold Alfond Center for Cancer Care
  - Bangor, Maine, Forenede Stater, 04401
    - Eastern Maine Medical Center
  - Brewer, Maine, Forenede Stater, 04412
    - Lafayette Family Cancer Center-EMMC
- Maryland
  - Baltimore, Maryland, Forenede Stater, 21287
    - Johns Hopkins University/Sidney Kimmel Cancer Center
  - Baltimore, Maryland, Forenede Stater, 21215
    - Sinai Hospital of Baltimore
  - Elkton, Maryland, Forenede Stater, 21921
    - Union Hospital of Cecil County
  - Randallstown, Maryland, Forenede Stater, 21133
    - Northwest Hospital Center
  - Salisbury, Maryland, Forenede Stater, 21801
    - Peninsula Regional Medical Center
- Massachusetts
  - Beverly, Massachusetts, Forenede Stater, 01915
    - Beverly Hospital
  - Burlington, Massachusetts, Forenede Stater, 01805
    - Lahey Hospital and Medical Center
  - Gloucester, Massachusetts, Forenede Stater, 01930
    - Addison Gilbert Hospital
  - Springfield, Massachusetts, Forenede Stater, 01199
    - Baystate Medical Center
- Michigan
  - Adrian, Michigan, Forenede Stater, 49221
    - Hickman Cancer Center
  - Ann Arbor, Michigan, Forenede Stater, 48106-0995
    - Saint Joseph Mercy Hospital
  - Ann Arbor, Michigan, Forenede Stater, 48109
    - University of Michigan Comprehensive Cancer Center
  - Battle Creek, Michigan, Forenede Stater, 49017
    - Bronson Battle Creek
  - Bay City, Michigan, Forenede Stater, 48706
    - McLaren-Bay Region
  - Brownstown, Michigan, Forenede Stater, 48183
    - Henry Ford Cancer Institute¿Downriver
  - Clarkston, Michigan, Forenede Stater, 48346
    - Great Lakes Cancer Institute
  - Clinton Township, Michigan, Forenede Stater, 48038
    - Henry Ford Macomb Hospital-Clinton Township
  - Dearborn, Michigan, Forenede Stater, 48126
    - Henry Ford Medical Center-Fairlane
  - Dearborn, Michigan, Forenede Stater, 48124
    - Beaumont Hospital-Dearborn
  - Detroit, Michigan, Forenede Stater, 48202
    - Henry Ford Hospital
  - Detroit, Michigan, Forenede Stater, 48236
    - Saint John Hospital and Medical Center
  - Detroit, Michigan, Forenede Stater, 48201
    - Wayne State University/Karmanos Cancer Institute
  - Escanaba, Michigan, Forenede Stater, 49829
    - Green Bay Oncology - Escanaba
  - Farmington Hills, Michigan, Forenede Stater, 48334
    - Weisberg Cancer Treatment Center
  - Flint, Michigan, Forenede Stater, 48502
    - Hurley Medical Center
  - Flint, Michigan, Forenede Stater, 48532
    - Singh and Arora Hematology Oncology PC
  - Flint, Michigan, Forenede Stater, 48503
    - Genesys Hurley Cancer Institute
  - Grand Rapids, Michigan, Forenede Stater, 49503
    - Spectrum Health at Butterworth Campus
  - Grand Rapids, Michigan, Forenede Stater, 49503
    - Mercy Health Saint Mary's
  - Jackson, Michigan, Forenede Stater, 49201
    - Allegiance Health
  - Kalamazoo, Michigan, Forenede Stater, 49007
    - West Michigan Cancer Center
  - Kalamazoo, Michigan, Forenede Stater, 49007
    - Bronson Methodist Hospital
  - Kalamazoo, Michigan, Forenede Stater, 49001
    - Borgess Medical Center
  - Lansing, Michigan, Forenede Stater, 48912
    - Sparrow Hospital
  - Lansing, Michigan, Forenede Stater, 48910
    - McLaren-Greater Lansing
  - Lapeer, Michigan, Forenede Stater, 48446
    - McLaren Cancer Institute-Lapeer Region
  - Livonia, Michigan, Forenede Stater, 48154
    - Saint Mary Mercy Hospital
  - Monroe, Michigan, Forenede Stater, 48162
    - Toledo Clinic Cancer Centers-Monroe
  - Monroe, Michigan, Forenede Stater, 48162
    - Monroe Cancer Center
  - Mount Clemens, Michigan, Forenede Stater, 48043
    - McLaren Cancer Institute-Macomb
  - Mount Pleasant, Michigan, Forenede Stater, 48858
    - McLaren Cancer Institute-Central Michigan
  - Muskegon, Michigan, Forenede Stater, 49444
    - Mercy Health Mercy Campus
  - Niles, Michigan, Forenede Stater, 49120
    - Lakeland Community Hospital
  - Novi, Michigan, Forenede Stater, 48377
    - Henry Ford Medical Center-Columbus
  - Novi, Michigan, Forenede Stater, 48374-1236
    - Assarian Cancer Center
  - Petoskey, Michigan, Forenede Stater, 49770
    - McLaren Cancer Institute-Northern Michigan
  - Pontiac, Michigan, Forenede Stater, 48341
    - Saint Joseph Mercy Oakland
  - Port Huron, Michigan, Forenede Stater, 48060
    - Lake Huron Medical Center
  - Reed City, Michigan, Forenede Stater, 49677
    - Spectrum Health Reed City Hospital
  - Saginaw, Michigan, Forenede Stater, 48601
    - Saint Mary's of Michigan
  - Saint Joseph, Michigan, Forenede Stater, 49085
    - Marie Yeager Cancer Center
  - Saint Joseph, Michigan, Forenede Stater, 49085
    - Lakeland Hospital
  - Southfield, Michigan, Forenede Stater, 48075
    - Providence Hospital-Southfield Cancer Center
  - Traverse City, Michigan, Forenede Stater, 49684
    - Munson Medical Center
  - Warren, Michigan, Forenede Stater, 48093
    - Saint John Macomb-Oakland Hospital
  - West Bloomfield, Michigan, Forenede Stater, 48322
    - Henry Ford West Bloomfield Hospital
- Minnesota
  - Bemidji, Minnesota, Forenede Stater, 56601
    - Sanford Clinic North-Bemidgi
  - Brainerd, Minnesota, Forenede Stater, 56401
    - Essentia Health Saint Joseph's Medical Center
  - Burnsville, Minnesota, Forenede Stater, 55337
    - Fairview Ridges Hospital
  - Coon Rapids, Minnesota, Forenede Stater, 55433
    - Mercy Hospital
  - Duluth, Minnesota, Forenede Stater, 55805
    - Saint Luke's Hospital of Duluth
  - Duluth, Minnesota, Forenede Stater, 55805
    - Essentia Health Cancer Center
  - Duluth, Minnesota, Forenede Stater, 55805
    - Essentia Health Saint Mary's Medical Center
  - Duluth, Minnesota, Forenede Stater, 55805
    - Miller-Dwan Hospital
  - Edina, Minnesota, Forenede Stater, 55435
    - Fairview-Southdale Hospital
  - Fergus Falls, Minnesota, Forenede Stater, 56537
    - Lake Region Healthcare Corporation-Cancer Care
  - Fridley, Minnesota, Forenede Stater, 55432
    - Unity Hospital
  - Hutchinson, Minnesota, Forenede Stater, 55350
    - Hutchinson Area Health Care
  - Maplewood, Minnesota, Forenede Stater, 55109
    - Saint John's Hospital - Healtheast
  - Maplewood, Minnesota, Forenede Stater, 55109
    - Minnesota Oncology Hematology PA-Maplewood
  - Minneapolis, Minnesota, Forenede Stater, 55415
    - Hennepin County Medical Center
  - Minneapolis, Minnesota, Forenede Stater, 55407
    - Abbott-Northwestern Hospital
  - Minneapolis, Minnesota, Forenede Stater, 55454
    - Health Partners Inc
  - New Ulm, Minnesota, Forenede Stater, 56073
    - New Ulm Medical Center
  - Robbinsdale, Minnesota, Forenede Stater, 55422
    - North Memorial Medical Health Center
  - Rochester, Minnesota, Forenede Stater, 55905
    - Mayo Clinic
  - Saint Cloud, Minnesota, Forenede Stater, 56303
    - Coborn Cancer Center at Saint Cloud Hospital
  - Saint Louis Park, Minnesota, Forenede Stater, 55416
    - Park Nicollet Clinic - Saint Louis Park
  - Saint Paul, Minnesota, Forenede Stater, 55101
    - Regions Hospital
  - Saint Paul, Minnesota, Forenede Stater, 55102
    - United Hospital
  - Shakopee, Minnesota, Forenede Stater, 55379
    - Saint Francis Regional Medical Center
  - Stillwater, Minnesota, Forenede Stater, 55082
    - Lakeview Hospital
  - Waconia, Minnesota, Forenede Stater, 55387
    - Ridgeview Medical Center
  - Willmar, Minnesota, Forenede Stater, 56201
    - Rice Memorial Hospital
  - Woodbury, Minnesota, Forenede Stater, 55125
    - Minnesota Oncology Hematology PA-Woodbury
- Mississippi
  - Hattiesburg, Mississippi, Forenede Stater, 39401
    - Hattiesburg Clinic - Hematology/Oncology Clinic
  - Hattiesburg, Mississippi, Forenede Stater, 39404
    - Forrest General Hospital / Cancer Center
  - Jackson, Mississippi, Forenede Stater, 39216
    - University of Mississippi Medical Center
  - Pascagoula, Mississippi, Forenede Stater, 39581
    - Singing River Hospital
- Missouri
  - Bolivar, Missouri, Forenede Stater, 65613
    - Central Care Cancer Center-Carrie J Babb Cancer Center
  - Bonne Terre, Missouri, Forenede Stater, 63628
    - Parkland Health Center-Bonne Terre
  - Branson, Missouri, Forenede Stater, 65616
    - CoxHealth Cancer Center
  - Cape Girardeau, Missouri, Forenede Stater, 63703
    - Saint Francis Medical Center
  - Cape Girardeau, Missouri, Forenede Stater, 63703
    - Southeast Cancer Center
  - Chesterfield, Missouri, Forenede Stater, 63017
    - Saint Luke's Hospital
  - Creve Coeur, Missouri, Forenede Stater, 63141
    - Barnes-Jewish West County Hospital
  - Jefferson City, Missouri, Forenede Stater, 65109
    - Capital Region Medical Center-Goldschmidt Cancer Center
  - Joplin, Missouri, Forenede Stater, 64804
    - Freeman Health System
  - Joplin, Missouri, Forenede Stater, 64804
    - Mercy Hospital-Joplin
  - Kansas City, Missouri, Forenede Stater, 64131
    - The University of Kansas Cancer Center-South
  - Kansas City, Missouri, Forenede Stater, 64108
    - Truman Medical Center
  - Kansas City, Missouri, Forenede Stater, 64154
    - The University of Kansas Cancer Center-North
  - Lee's Summit, Missouri, Forenede Stater, 64064
    - The University of Kansas Cancer Center-Lee's Summit
  - Rolla, Missouri, Forenede Stater, 65401
    - Delbert Day Cancer Institute at PCRMC
  - Rolla, Missouri, Forenede Stater, 65401
    - Saint John's Clinic-Rolla-Cancer and Hematology
  - Saint Louis, Missouri, Forenede Stater, 63110
    - Washington University School of Medicine
  - Saint Louis, Missouri, Forenede Stater, 63131
    - Missouri Baptist Medical Center
  - Saint Louis, Missouri, Forenede Stater, 63141
    - Mercy Hospital Saint Louis
  - Saint Louis, Missouri, Forenede Stater, 63109
    - Saint Louis Cancer and Breast Institute-South City
  - Saint Peters, Missouri, Forenede Stater, 63376
    - Siteman Cancer Center - Saint Peters
  - Sainte Genevieve, Missouri, Forenede Stater, 63670
    - Sainte Genevieve County Memorial Hospital
  - Springfield, Missouri, Forenede Stater, 65807
    - CoxHealth South Hospital
  - Springfield, Missouri, Forenede Stater, 65804
    - Mercy Hospital Springfield
  - Sullivan, Missouri, Forenede Stater, 63080
    - Missouri Baptist Sullivan Hospital
  - Sunset Hills, Missouri, Forenede Stater, 63127
    - Missouri Baptist Outpatient Center-Sunset Hills
- Nebraska
  - Grand Island, Nebraska, Forenede Stater, 68803
    - CHI Health Saint Francis
  - Kearney, Nebraska, Forenede Stater, 68847
    - CHI Health Good Samaritan
  - Kearney, Nebraska, Forenede Stater, 68845
    - Heartland Hematology and Oncology
  - Lincoln, Nebraska, Forenede Stater, 68506
    - Nebraska Hematology and Oncology
  - Lincoln, Nebraska, Forenede Stater, 68510
    - Nebraska Cancer Research Center
  - Lincoln, Nebraska, Forenede Stater, 68510
    - Saint Elizabeth Regional Medical Center
  - Lincoln, Nebraska, Forenede Stater, 68510
    - Southeast Nebraska Cancer Center
  - Norfolk, Nebraska, Forenede Stater, 68701
    - Faith Regional Medical Offices West
  - North Platte, Nebraska, Forenede Stater, 69103
    - Great Plains 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, 68106
    - Missouri Valley Cancer Consortium
  - Omaha, Nebraska, Forenede Stater, 68130
    - Oncology Hematology West PC
  - Omaha, Nebraska, Forenede Stater, 68122
    - Hemotology and Oncology Consultants PC
  - Omaha, Nebraska, Forenede Stater, 68124
    - Oncology Hematology West
  - Papillion, Nebraska, Forenede Stater, 68046
    - Midlands Community Hospital
  - Scottsbluff, Nebraska, Forenede Stater, 69361
    - Regional West Medical Center
- Nevada
  - Henderson, Nevada, Forenede Stater, 89052
    - Comprehensive Cancer Centers of Nevada - Henderson
  - Henderson, Nevada, Forenede Stater, 89052
    - Cancer and Blood Specialists-Henderson
  - Henderson, Nevada, Forenede Stater, 89052
    - Las Vegas Cancer Center-Henderson
  - Henderson, Nevada, Forenede Stater, 89074
    - Comprehensive Cancer Centers of Nevada-Southeast Henderson
  - Henderson, Nevada, Forenede Stater, 89074
    - 21st Century Oncology - Henderson
  - Las Vegas, Nevada, Forenede Stater, 89144
    - Summerlin Hospital Medical Center
  - Las Vegas, Nevada, Forenede Stater, 89106
    - Radiation Oncology Centers of Nevada Central
  - Las Vegas, Nevada, Forenede Stater, 89119
    - Radiation Oncology Centers of Nevada Southeast
  - Las Vegas, Nevada, Forenede Stater, 89128
    - Comprehensive Cancer Centers of Nevada - Northwest
  - Las Vegas, Nevada, Forenede Stater, 89144
    - Comprehensive Cancer Centers of Nevada-Summerlin
  - Las Vegas, Nevada, Forenede Stater, 89148
    - Comprehensive Cancer Centers of Nevada
  - Las Vegas, Nevada, Forenede Stater, 89169
    - Comprehensive Cancer Centers of Nevada - Central Valley
  - Las Vegas, Nevada, Forenede Stater, 89106
    - Cancer and Blood Specialists-Shadow
  - Las Vegas, Nevada, Forenede Stater, 89109
    - HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
  - Las Vegas, Nevada, Forenede Stater, 89113
    - HealthCare Partners Medical Group Oncology/Hematology-San Martin
  - Las Vegas, Nevada, Forenede Stater, 89121
    - Cancer Therapy and Integrative Medicine
  - Las Vegas, Nevada, Forenede Stater, 89128
    - Cancer and Blood Specialists-Tenaya
  - Las Vegas, Nevada, Forenede Stater, 89128
    - HealthCare Partners Medical Group Oncology/Hematology-Tenaya
  - Las Vegas, Nevada, Forenede Stater, 89148-2405
    - Las Vegas Cancer Center-Medical Center
  - Las Vegas, Nevada, Forenede Stater, 89149
    - HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
  - Las Vegas, Nevada, Forenede Stater, 89109
    - 21st Century Oncology
  - Las Vegas, Nevada, Forenede Stater, 89148
    - Cancer and Blood Specialists-Fort Apache
  - Las Vegas, Nevada, Forenede Stater, 89148
    - 21st Century Oncology - Fort Apache
  - Las Vegas, Nevada, Forenede Stater, 89182
    - 21st Century Oncology - Vegas Tenaya
  - Reno, Nevada, Forenede Stater, 89503
    - Saint Mary's Regional Medical Center
- New Hampshire
  - Lebanon, New Hampshire, Forenede Stater, 03756
    - Dartmouth Hitchcock Medical Center
  - Manchester, New Hampshire, Forenede Stater, 03102
    - Norris Cotton Cancer Center-Manchester
  - Nashua, New Hampshire, Forenede Stater, 03063
    - Norris Cotton Cancer Center-Nashua
- New Jersey
  - Englewood, New Jersey, Forenede Stater, 07631
    - Englewood Hospital and Medical Center
  - Mount Holly, New Jersey, Forenede Stater, 08060
    - Virtua Memorial
  - Newark, New Jersey, Forenede Stater, 07112
    - Newark Beth Israel Medical Center
  - Paramus, New Jersey, Forenede Stater, 07652
    - The Valley Hospital-Luckow Pavilion
  - Ridgewood, New Jersey, Forenede Stater, 07450
    - Valley Hospital
  - Sparta, New Jersey, Forenede Stater, 07871
    - Sparta Cancer Treatment Center
  - Vineland, New Jersey, Forenede Stater, 08360
    - Inspira Medical Center Vineland
  - Voorhees, New Jersey, Forenede Stater, 08043
    - Virtua Voorhees
  - Westwood, New Jersey, Forenede Stater, 07675
    - Valley Health System-Hematology/Oncology
  - Woodbury, New Jersey, Forenede Stater, 08096
    - Inspira Medical Center Woodbury
- New Mexico
  - Albuquerque, New Mexico, Forenede Stater, 87102
    - University of New Mexico Cancer Center
  - Las Cruces, New Mexico, Forenede Stater, 88011
    - Memorial Medical Center - Las Cruces
- New York
  - Bronx, New York, Forenede Stater, 10461
    - Montefiore Medical Center-Einstein Campus
  - Bronx, New York, Forenede Stater, 10461
    - Montefiore Medical Center-Weiler Hospital
  - Bronx, New York, Forenede Stater, 10467-2490
    - Montefiore Medical Center - Moses Campus
  - Elmira, New York, Forenede Stater, 14905
    - Arnot Ogden Medical Center/Falck Cancer Center
  - Glens Falls, New York, Forenede Stater, 12801
    - Glens Falls Hospital
  - New York, New York, Forenede Stater, 10065
    - Weill Medical College of Cornell University
  - Syracuse, New York, Forenede Stater, 13210
    - State University of New York Upstate Medical University
  - Utica, New York, Forenede Stater, 13502
    - Faxton-Saint Luke's Healthcare
- North Carolina
  - Asheboro, North Carolina, Forenede Stater, 27203
    - Randolph Hospital
  - Asheville, North Carolina, Forenede Stater, 28803
    - Asheville Hematology-Oncology Associates
  - Burlington, North Carolina, Forenede Stater, 27215
    - Cone Health Cancer Center at Alamance Regional
  - Clinton, North Carolina, Forenede Stater, 28328
    - Southeastern Medical Oncology Center-Clinton
  - Clinton, North Carolina, Forenede Stater, 28328
    - Sampson Radiation Oncology
  - Durham, North Carolina, Forenede Stater, 27710
    - Duke University Medical Center
  - Goldsboro, North Carolina, Forenede Stater, 27534
    - Southeastern Medical Oncology Center-Goldsboro
  - Goldsboro, North Carolina, Forenede Stater, 27534
    - Wayne Memorial Hospital
  - Goldsboro, North Carolina, Forenede Stater, 27534
    - Wayne Radiation Oncology
  - Greensboro, North Carolina, Forenede Stater, 27403
    - Cone Health Cancer Center
  - Henderson, North Carolina, Forenede Stater, 27536
    - Maria Parham Hospital
  - Hendersonville, North Carolina, Forenede Stater, 28791
    - Hendersonville Hematology and Oncology at Pardee
  - Hendersonville, North Carolina, Forenede Stater, 28791
    - Margaret R Pardee Memorial Hospital
  - Hendersonville, North Carolina, Forenede Stater, 28792
    - Park Ridge Hospital Breast Health Center
  - Jacksonville, North Carolina, Forenede Stater, 28546
    - Southeastern Medical Oncology Center-Jacksonville
  - Jacksonville, North Carolina, Forenede Stater, 28546
    - Onslow Memorial Hospital
  - Kinston, North Carolina, Forenede Stater, 28501
    - Kinston Medical Specialists PA
  - Laurinburg, North Carolina, Forenede Stater, 28352
    - Scotland Memorial Hospital-Laurinburg Cancer Center
  - Mebane, North Carolina, Forenede Stater, 27302
    - Cone Heath Cancer Center at Mebane
  - Reidsville, North Carolina, Forenede Stater, 27320
    - Annie Penn Memorial Hospital
  - Smithfield, North Carolina, Forenede Stater, 27577
    - Johnston Memorial Hospital
  - Wilson, North Carolina, Forenede Stater, 27893
    - Southeastern Medical Oncology Center-Wilson
- North Dakota
  - Bismarck, North Dakota, Forenede Stater, 58501
    - Sanford Bismarck Medical Center
  - Fargo, North Dakota, Forenede Stater, 58103
    - Essentia Health Cancer Center-South University Clinic
  - Fargo, North Dakota, Forenede Stater, 58122
    - Sanford Clinic North-Fargo
  - Fargo, North Dakota, Forenede Stater, 58122
    - Sanford Medical Center-Fargo
  - Fargo, North Dakota, Forenede Stater, 58122
    - Roger Maris Cancer Center
- Ohio
  - Akron, Ohio, Forenede Stater, 44307
    - Akron General Medical Center
  - Belpre, Ohio, Forenede Stater, 45714
    - Strecker Cancer Center-Belpre
  - Canton, Ohio, Forenede Stater, 44708
    - Mercy Medical Center
  - Centerville, Ohio, Forenede Stater, 45459
    - Miami Valley Hospital South
  - Centerville, Ohio, Forenede Stater, 45459
    - Dayton Physicians LLC-Miami Valley South
  - Chardon, Ohio, Forenede Stater, 44024
    - Geaugra Hospital
  - Chillicothe, Ohio, Forenede Stater, 45601
    - Adena Regional Medical Center
  - Cincinnati, Ohio, Forenede Stater, 45220
    - Good Samaritan Hospital - Cincinnati
  - Cincinnati, Ohio, Forenede Stater, 45242
    - Bethesda North Hospital
  - Cincinnati, Ohio, Forenede Stater, 45242
    - Oncology Hematology Care Inc-Blue Ash
  - Cincinnati, Ohio, Forenede Stater, 45202
    - Oncology Hematology Care Inc-Eden Park
  - Cincinnati, Ohio, Forenede Stater, 45211
    - Oncology Hematology Care Inc-Mercy West
  - Cincinnati, Ohio, Forenede Stater, 45236
    - Oncology Hematology Care Inc-Kenwood
  - Cincinnati, Ohio, Forenede Stater, 45219
    - University of Cincinnati/Barrett Cancer Center
  - Cincinnati, Ohio, Forenede Stater, 45230
    - Oncology Hematology Care Inc - Anderson
  - Cincinnati, Ohio, Forenede Stater, 45247
    - TriHealth Cancer Institute-Westside
  - Cincinnati, Ohio, Forenede Stater, 45255
    - TriHealth Cancer Institute-Anderson
  - Cleveland, Ohio, Forenede Stater, 44106
    - Case Western Reserve University
  - Cleveland, Ohio, Forenede Stater, 44109
    - MetroHealth Medical Center
  - Cleveland, Ohio, Forenede Stater, 44195
    - Cleveland Clinic Foundation
  - Cleveland, Ohio, Forenede Stater, 44111
    - Cleveland Clinic Cancer Center/Fairview Hospital
  - Columbus, Ohio, Forenede Stater, 43214
    - Riverside Methodist Hospital
  - Columbus, Ohio, Forenede Stater, 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
  - Dayton, Ohio, Forenede Stater, 45406
    - Good Samaritan Hospital - Dayton
  - Dayton, Ohio, Forenede Stater, 45409
    - Miami Valley Hospital
  - Dayton, Ohio, Forenede Stater, 45415
    - Dayton Physicians LLC-Samaritan North
  - Dayton, Ohio, Forenede Stater, 45415
    - Samaritan North Health Center
  - Delaware, Ohio, Forenede Stater, 43015
    - Delaware Health Center-Grady Cancer Center
  - Delaware, Ohio, Forenede Stater, 43015
    - Delaware Radiation Oncology
  - Delaware, Ohio, Forenede Stater, 43015
    - Grady Memorial Hospital
  - Elyria, Ohio, Forenede Stater, 44035
    - Mercy Cancer Center-Elyria
  - Fairfield, Ohio, Forenede Stater, 45014
    - Oncology Hematology Care Inc-Healthplex
  - Findlay, Ohio, Forenede Stater, 45840
    - Blanchard Valley Hospital
  - 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
  - Independence, Ohio, Forenede Stater, 44131
    - Cleveland Clinic Cancer Center Independence
  - 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
  - Lima, Ohio, Forenede Stater, 45801
    - Saint Rita's Medical Center
  - Mansfield, Ohio, Forenede Stater, 44906
    - Cleveland Clinic Cancer Center Mansfield
  - Marietta, Ohio, Forenede Stater, 45750
    - Marietta Memorial Hospital
  - Maumee, Ohio, Forenede Stater, 43537
    - Toledo Clinic Cancer Centers-Maumee
  - Maumee, Ohio, Forenede Stater, 43537
    - Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
  - Mayfield Heights, Ohio, Forenede Stater, 44124
    - Hillcrest Hospital Cancer Center
  - Mentor, Ohio, Forenede Stater, 44060
    - Lake University Ireland Cancer Center
  - Middleburg Heights, Ohio, Forenede Stater, 44130
    - Southwest General Health Center Ireland Cancer 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
  - Parma, Ohio, Forenede Stater, 44129
    - University Hospitals Parma Medical Center
  - Portsmouth, Ohio, Forenede Stater, 45662
    - Southern Ohio Medical Center
  - Sandusky, Ohio, Forenede Stater, 44870
    - North Coast Cancer Care
  - Sandusky, Ohio, Forenede Stater, 44870
    - Ireland Cancer Center at Firelands Regional Medical Center
  - Sidney, Ohio, Forenede Stater, 45365
    - Dayton Physicians LLC-Wilson
  - Springfield, Ohio, Forenede Stater, 45505
    - Springfield Regional Medical Center
  - Springfield, Ohio, Forenede Stater, 45504
    - Springfield Regional Cancer Center
  - Strongsville, Ohio, Forenede Stater, 44136
    - Cleveland Clinic Cancer Center Strongsville
  - Sylvania, Ohio, Forenede Stater, 43560
    - Flower Hospital
  - Toledo, Ohio, Forenede Stater, 43623
    - Toledo Clinic Cancer Centers-Toledo
  - Toledo, Ohio, Forenede Stater, 43623
    - Mercy Saint Anne Hospital
  - Troy, Ohio, Forenede Stater, 45373
    - Upper Valley Medical Center
  - Troy, Ohio, Forenede Stater, 45373
    - Dayton Physicians LLC-Upper Valley
  - Wadsworth, Ohio, Forenede Stater, 44281
    - University Hospitals Sharon Health Center
  - Warrensville Heights, Ohio, Forenede Stater, 44122
    - South Pointe Hospital
  - West Chester, Ohio, Forenede Stater, 45069
    - University Pointe
  - Westerville, Ohio, Forenede Stater, 43081
    - Saint Ann's Hospital
  - Westlake, Ohio, Forenede Stater, 44145
    - UH-Seidman Cancer Center at Saint John Medical Center
  - Wooster, Ohio, Forenede Stater, 44691
    - Cleveland Clinic Wooster Family Health and Surgery Center
  - Wright-Patterson Air Force Base, Ohio, Forenede Stater, 45433-5529
    - 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
- Oregon
  - Bend, Oregon, Forenede Stater, 97701
    - Saint Charles Health System
  - Clackamas, Oregon, Forenede Stater, 97015
    - Clackamas Radiation Oncology Center
  - Clackamas, Oregon, Forenede Stater, 97015
    - Providence Oncology and Hematology Care Southeast
  - Coos Bay, Oregon, Forenede Stater, 97420
    - Bay Area Hospital
  - Newberg, Oregon, Forenede Stater, 97132
    - Providence Newberg Medical Center
  - Oregon City, Oregon, Forenede Stater, 97045
    - Providence Willamette Falls Medical Center
  - Portland, Oregon, Forenede Stater, 97213
    - Providence Portland Medical Center
  - Portland, Oregon, Forenede Stater, 97225
    - Providence Saint Vincent Medical Center
  - Portland, Oregon, Forenede Stater, 97227
    - Kaiser Permanente Northwest
- Pennsylvania
  - Chadds Ford, Pennsylvania, Forenede Stater, 19317
    - Christiana Care Health System-Concord Health Center
  - Danville, Pennsylvania, Forenede Stater, 17822
    - Geisinger Medical Center
  - Doylestown, Pennsylvania, Forenede Stater, 18901
    - Doylestown Hospital
  - Harrisburg, Pennsylvania, Forenede Stater, 17109
    - PinnacleHealth Cancer Center-Community 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
  - Lewisburg, Pennsylvania, Forenede Stater, 17837
    - Geisinger Medical Oncology-Lewisburg
  - Lewistown, Pennsylvania, Forenede Stater, 17044
    - Lewistown Hospital
  - Philadelphia, Pennsylvania, Forenede Stater, 19107
    - Thomas Jefferson University Hospital
  - Philadelphia, Pennsylvania, Forenede Stater, 19104
    - University of Pennsylvania/Abramson Cancer Center
  - Phoenixville, Pennsylvania, Forenede Stater, 19460
    - Phoenixville Hospital
  - Pottsville, Pennsylvania, Forenede Stater, 17901
    - Geisinger Medical Oncology-Pottsville
  - Sayre, Pennsylvania, Forenede Stater, 18840
    - Guthrie Medical Group PC-Robert Packer Hospital
  - Scranton, Pennsylvania, Forenede Stater, 18508
    - Hematology and Oncology Associates of North East Pennsylvania
  - State College, Pennsylvania, Forenede Stater, 16801
    - Geisinger Medical Group
  - 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
    - Susquehanna Cancer Center
- South Carolina
  - Charleston, South Carolina, Forenede Stater, 29401
    - Roper Hospital
  - Charleston, South Carolina, Forenede Stater, 29403
    - Charleston Hematology Oncology Associates-Roper
  - Charleston, South Carolina, Forenede Stater, 29406
    - Lowcountry Hematology Oncology PA-North Charleston
  - Charleston, South Carolina, Forenede Stater, 29414
    - Bon Secours Saint Francis Hospital
  - Charleston, South Carolina, Forenede Stater, 29414
    - Charleston Hematology Oncology Associates PA-St. Francis
  - Charleston, South Carolina, Forenede Stater, 29414
    - Lowcountry Hematology Oncology PA-West Ashley
  - Easley, South Carolina, Forenede Stater, 29640
    - Greenville Health System Cancer Institute-Easley
  - Greenville, South Carolina, Forenede Stater, 29607
    - Saint Francis Cancer Center
  - Greenville, South Carolina, Forenede Stater, 29601
    - Saint Francis Hospital
  - Greenville, South Carolina, Forenede Stater, 29605
    - Greenville Health System Cancer Institute-Andrews
  - Greenville, South Carolina, Forenede Stater, 29605
    - Greenville Health System Cancer Institute-Faris
  - Greenville, South Carolina, Forenede Stater, 29605
    - Greenville Memorial Hospital
  - Greenville, South Carolina, Forenede Stater, 29615
    - Greenville Health System Cancer Institute-Eastside
  - Greenville, South Carolina, Forenede Stater, 29605
    - Greenville Health System Cancer Institute-Butternut
  - Greer, South Carolina, Forenede Stater, 29650
    - Greenville Health System Cancer Institute-Greer
  - Mount Pleasant, South Carolina, Forenede Stater, 29464
    - Lowcountry Hematology Oncology PA-Mount Pleasant
  - Seneca, South Carolina, Forenede Stater, 29672
    - Greenville Health System Cancer Institute-Seneca
  - Spartanburg, South Carolina, Forenede Stater, 29307
    - Greenville Health System Cancer Institute-Spartanburg
- South Dakota
  - Sioux Falls, South Dakota, Forenede Stater, 57105
    - Avera Cancer Institute
  - 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
  - Knoxville, Tennessee, Forenede Stater, 37916
    - Thompson Cancer Survival Center
  - Nashville, Tennessee, Forenede Stater, 37208
    - Meharry Medical College
  - Ooltewah, Tennessee, Forenede Stater, 37363
    - Memorial GYN Plus
- Texas
  - Houston, Texas, Forenede Stater, 77030
    - M D Anderson Cancer Center
  - Round Rock, Texas, Forenede Stater, 78665
    - Scott and White Healthcare Round Rock
  - San Antonio, Texas, Forenede Stater, 78229
    - University of Texas Health Science Center at San Antonio
  - Temple, Texas, Forenede Stater, 76508
    - Scott and White Memorial Hospital
- Vermont
  - Berlin, Vermont, Forenede Stater, 05602
    - Central Vermont Medical Center/National Life Cancer Treatment
  - Burlington, Vermont, Forenede Stater, 05401
    - University of Vermont Medical Center
  - Burlington, Vermont, Forenede Stater, 05405
    - University of Vermont College of Medicine
- Washington
  - Aberdeen, Washington, Forenede Stater, 98520
    - Providence Regional Cancer System-Aberdeen
  - Anacortes, Washington, Forenede Stater, 98221
    - Cancer Care Center at Island Hospital
  - Auburn, Washington, Forenede Stater, 98001
    - MultiCare Auburn Medical Center
  - Bainbridge Island, Washington, Forenede Stater, 98110
    - Virginia Mason Bainbridge Island Medical Center
  - Bellevue, Washington, Forenede Stater, 98005
    - Swedish Cancer Institute-Eastside Oncology Hematology
  - Bellevue, Washington, Forenede Stater, 98004
    - Overlake Hospital Medical Center
  - Bellingham, Washington, Forenede Stater, 98225
    - PeaceHealth Saint Joseph Medical Center
  - Bremerton, Washington, Forenede Stater, 98310
    - Harrison HealthPartners Hematology and Oncology-Bremerton
  - Bremerton, Washington, Forenede Stater, 98310
    - Harrison Medical Center
  - Burien, Washington, Forenede Stater, 98166
    - Highline Medical Center-Main Campus
  - Centralia, Washington, Forenede Stater, 98531
    - Providence Regional Cancer System-Centralia
  - Edmonds, Washington, Forenede Stater, 98026
    - Swedish Medical Center-Edmonds
  - Enumclaw, Washington, Forenede Stater, 98022
    - Saint Elizabeth Hospital
  - Everett, Washington, Forenede Stater, 98201
    - Providence Regional Cancer Partnership
  - Federal Way, Washington, Forenede Stater, 98002
    - Virginia Mason Federal Way Medical Center
  - Federal Way, Washington, Forenede Stater, 98003
    - Saint Francis Hospital
  - Gig Harbor, Washington, Forenede Stater, 98332
    - Tacoma/Valley Radiation Oncology Centers-Gig Harbor
  - Gig Harbor, Washington, Forenede Stater, 98335
    - MultiCare Gig Harbor Medical Park
  - Issaquah, Washington, Forenede Stater, 98029
    - Swedish Cancer Institute-Issaquah
  - Kennewick, Washington, Forenede Stater, 99336
    - Kadlec Clinic Hematology and Oncology
  - Kennewick, Washington, Forenede Stater, 99336
    - Northwest Cancer Clinic
  - Kirkland, Washington, Forenede Stater, 98034
    - Seattle Cancer Care Alliance at EvergreenHealth
  - Lacey, Washington, Forenede Stater, 98503
    - Providence Regional Cancer System-Lacey
  - Lakewood, Washington, Forenede Stater, 98499
    - Saint Clare Hospital
  - Longview, Washington, Forenede Stater, 98632
    - PeaceHealth Saint John Medical Center
  - Lynnwood, Washington, Forenede Stater, 98036
    - Virginia Mason Lynnwood Medical Center
  - Mount Vernon, Washington, Forenede Stater, 98273
    - Skagit Valley Hospital Regional Cancer Care Center
  - Mount Vernon, Washington, Forenede Stater, 98274
    - Skagit Valley Hospital
  - Port Angeles, Washington, Forenede Stater, 98362
    - Olympic 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, 98109
    - Fred Hutchinson Cancer Research Center
  - Seattle, Washington, Forenede Stater, 98109
    - Seattle Cancer Care Alliance
  - Seattle, Washington, Forenede Stater, 98195
    - University of Washington Medical Center
  - Seattle, Washington, Forenede Stater, 98101
    - Virginia Mason Medical Center
  - Seattle, Washington, Forenede Stater, 98107
    - Swedish Medical Center-Ballard Campus
  - Seattle, Washington, Forenede Stater, 98104
    - Minor and James Medical PLLC
  - Seattle, Washington, Forenede Stater, 98104
    - Pacific Gynecology Specialists
  - Seattle, Washington, Forenede Stater, 98112
    - Group Health Cooperative-Seattle
  - Seattle, Washington, Forenede Stater, 98122-4307
    - Swedish Medical Center-First Hill
  - Sequim, Washington, Forenede Stater, 98384
    - Olympic Medical Cancer Care Center
  - Shelton, Washington, Forenede Stater, 98584
    - Providence Regional Cancer System-Shelton
  - Spokane, Washington, Forenede Stater, 99204
    - Rockwood Cancer Treatment Center-DHEC-Downtown
  - Spokane, Washington, Forenede Stater, 99202
    - Cancer Care Northwest - Spokane South
  - Spokane, Washington, Forenede Stater, 99208
    - Spokane Valley Cancer Center-Mayfair
  - Spokane, Washington, Forenede Stater, 99216
    - Cancer Care Northwest-Valley
  - Spokane, Washington, Forenede Stater, 99218
    - Cancer Care Northwest-North Spokane
  - Spokane Valley, Washington, Forenede Stater, 99216
    - Rockwood Clinic Cancer Treatment Center-Valley
  - Tacoma, Washington, Forenede Stater, 98405
    - Northwest Medical Specialties PLLC
  - Tacoma, Washington, Forenede Stater, 98405
    - MultiCare Tacoma General Hospital
  - Tacoma, Washington, Forenede Stater, 98405
    - Tacoma/Valley Radiation Oncology Centers-Saint Joe's
  - Tacoma, Washington, Forenede Stater, 97405
    - Tacoma/Valley Radiation Oncology Centers-Jackson Hall
  - Tacoma, Washington, Forenede Stater, 98405
    - Franciscan Research Center-Northwest Medical Plaza
  - Tacoma, Washington, Forenede Stater, 98405
    - Northwest NCI Community Oncology Research Program
  - Vancouver, Washington, Forenede Stater, 98664
    - PeaceHealth Southwest Medical Center
  - Walla Walla, Washington, Forenede Stater, 99362
    - Providence Saint Mary Regional Cancer Center
  - Wenatchee, Washington, Forenede Stater, 98801
    - Wenatchee Valley Hospital and Clinics
  - Yakima, Washington, Forenede Stater, 98902
    - North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
  - Yelm, Washington, Forenede Stater, 98597
    - Providence Regional Cancer System-Yelm
- West Virginia
  - Charleston, West Virginia, Forenede Stater, 25304
    - West Virginia University Charleston
- Wisconsin
  - Antigo, Wisconsin, Forenede Stater, 54409
    - Langlade Hospital and Cancer Center
  - Chippewa Falls, Wisconsin, Forenede Stater, 54729
    - Marshfield Clinic-Chippewa Center
  - Eau Claire, Wisconsin, Forenede Stater, 54701
    - Marshfield Clinic Cancer Center at Sacred Heart
  - Green Bay, Wisconsin, Forenede Stater, 54301
    - Saint Vincent Hospital Cancer Center Green Bay
  - Green Bay, Wisconsin, Forenede Stater, 54303
    - Saint Vincent Hospital Cancer Center at Saint Mary's
  - Green Bay, Wisconsin, Forenede Stater, 54303
    - Green Bay Oncology Limited at Saint Mary's Hospital
  - Green Bay, Wisconsin, Forenede Stater, 54301-3526
    - Green Bay Oncology at Saint Vincent Hospital
  - La Crosse, Wisconsin, Forenede Stater, 54601
    - Gundersen Lutheran Medical Center
  - Manitowoc, Wisconsin, Forenede Stater, 54221
    - Holy Family Memorial Hospital
  - Marshfield, Wisconsin, Forenede Stater, 54449
    - Marshfield Clinic
  - Milwaukee, Wisconsin, Forenede Stater, 53210
    - Wheaton Franciscan Healthcare - Saint Joseph
  - Minocqua, Wisconsin, Forenede Stater, 54548
    - Marshfield Clinic-Minocqua Center
  - Mukwonago, Wisconsin, Forenede Stater, 53149
    - ProHealth D N Greenwald Center
  - New Richmond, Wisconsin, Forenede Stater, 54017
    - Cancer Center of Western Wisconsin
  - Oconomowoc, Wisconsin, Forenede Stater, 53066
    - ProHealth Oconomowoc Memorial Hospital
  - Oconto Falls, Wisconsin, Forenede Stater, 54154
    - Green Bay Oncology - Oconto Falls
  - Rice Lake, Wisconsin, Forenede Stater, 54868
    - Marshfield Clinic-Rice Lake Center
  - Sheboygan, Wisconsin, Forenede Stater, 53081
    - HSHS Saint Nicholas Hospital
  - Stevens Point, Wisconsin, Forenede Stater, 54481
    - Marshfield Clinic Cancer Care at Saint Michael's Hospital
  - Sturgeon Bay, Wisconsin, Forenede Stater, 54235
    - Green Bay Oncology - Sturgeon Bay
  - Waukesha, Wisconsin, Forenede Stater, 53188
    - UW Cancer Center at ProHealth Care
  - Waukesha, Wisconsin, Forenede Stater, 53188
    - ProHealth Waukesha Memorial Hospital
  - Wausau, Wisconsin, Forenede Stater, 54401
    - Aspirus Regional Cancer Center
  - Wausau, Wisconsin, Forenede Stater, 54401
    - Marshfield Clinic-Wausau Center
  - Weston, Wisconsin, Forenede Stater, 54476
    - Marshfield Clinic - Weston Center
  - Wisconsin Rapids, Wisconsin, Forenede Stater, 54494
    - Marshfield Clinic - Wisconsin Rapids Center
  - Wisconsin Rapids, Wisconsin, Forenede Stater, 54494
    - Aspirus UW Cancer Center
- Wyoming
  - Cheyenne, Wyoming, Forenede Stater, 82001
    - Cheyenne Regional Medical Center-West

Deltagelseskriterier

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

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

TRIN I INDLEDENDE REGISTRERING: BRAFV600E TEST:
Patienter skal have histologisk eller cytologisk dokumenteret adenokarcinom i tyktarmen eller endetarmen, som enten er metastatisk eller lokalt fremskreden og ikke-operable
Patienter skal have BRAFV600E mutantstatus dokumenteret af et Clinical Laboratory Improvements Amendments (CLIA) certificeret laboratorium på en patologirapport før trin 2 registrering; brug af en Food and Drug Administration (FDA)-godkendt test foretrækkes, selvom andre BRAF-tests på et CLIA-certificeret laboratorium også kan accepteres; hvis en BRAFV600E-mutation er kendt, skal patienten registreres til trin 2 randomisering umiddelbart efter trin 1 indledende registrering; hvis testning ikke er blevet udført lokalt, skal BRAFV600E-testning udføres af det centrale laboratorium før trin 2 randomisering; hvis prøven ikke har en BRAFV600E-mutation, er patienten ikke berettiget til trin 2 randomisering
Hjernemetastaser er tilladt, hvis de er blevet tilstrækkeligt behandlet med strålebehandling eller kirurgi og er stabile i mindst 90 dage før trin 1 indledende registrering; kvalificerede patienter skal være neurologisk asymptomatiske og uden kortikosteroidbehandling i mindst 7 dage før trin 1 indledende registrering
Patienter skal have haft et eller to tidligere regimer med systemisk kemoterapi for metastatisk sygdom; forudgående behandling med irinotecan er tilladt; et vedligeholdelsesregime med 5-fluorouracil eller capecitabin, med eller uden bevacizumab, bør ikke tælles som en separat behandlingslinje; forudgående behandling for metastatisk sygdom er ikke påkrævet for patienter, der oplevede sygdomsgentagelse under eller inden for 6 måneder efter afslutning af adjuverende kemoterapi
Patienter må ikke have været behandlet med noget af følgende før trin 2 randomisering:
- Cetuximab, panitumumab eller ethvert andet monoklonalt antistof mod EGFR eller inhibitor af EGFR
- BRAF-hæmmer inklusive, men ikke begrænset til vemurafenib eller dabrafenib; regorafenib betragtes ikke som en BRAF-hæmmer med henblik på at afgøre, om forsøget er berettiget
- Mitogen-aktiveret protein/ekstracellulær signal-reguleret kinase (MEK) hæmmer inklusive, men ikke begrænset til, trametinib eller selumetinib
Tidligere kemoterapi, immunterapi eller strålebehandling skal være afsluttet mindst 14 dage før trin 1 indledende registrering, og al toksicitet skal være løst til Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v4.0) grad 1 (med undtagelse af CTCAE v4.0 grad 2 neuropati) før trin 1 indledende registrering
Patienter må ikke have en tumor med en mutation påvist i kodon 12 eller 13 i KRAS; patienter må ikke have en tumor med en kendt mutation påvist i kodon 61, 117 eller 146 af KRAS eller NRAS
PRØVEINDSENDELSESKRITERIER:
Patienter skal have tumor (slides eller blok) tilgængelig for indsendelse til V600E BRAF-test
Patienter skal have yderligere tumor til rådighed og være villige til at indsende vævs- og blodprøver
PRØVEINDSENDELSESKRITERIER REGULERINGSKRITERIER:
Patienter eller deres juridisk autoriserede repræsentant skal informeres om undersøgelsens karakter af denne undersøgelse og skal underskrive og give skriftligt informeret samtykke i overensstemmelse med institutionelle og føderale retningslinjer; for trin 1 indledende registrering af patienter, der endnu ikke har indsendt prøver til den centrale BRAFV600E-test, er den relevante samtykkeformular trin 1 samtykkeformularen; for både trin 1 indledende registrering og trin 2 randomisering af patienter, hvis BRAF-mutationsstatus allerede er kendt, er den passende samtykkeformular trin 2 samtykkeformularen
TRIN 2 RANDOMISERING:
Patienter skal have BRAFV600E-mutation
Patienter skal have målbar eller ikke-målbar metastatisk sygdom; computertomografi (CT)-scanninger eller magnetisk resonansbilleddannelse (MRI), der bruges til at vurdere al sygdom, skal være afsluttet inden for 28 dage før trin 2 randomisering; CT-scanninger eller MR'er skal vurderes og dokumenteres på baseline tumorvurderingsskemaet (responsevalueringskriterier i solide tumorer [RECIST] 1.1)
Patienter skal have en Zubrod præstationsstatus på 0-1
Absolut neutrofiltal (ANC) >= 1.500/mcL
Blodplader >= 100,00/mcL
Hæmoglobin >= 9 g/dL
Aspartataminotransferase (AST) og alaninaminotransferase (ALT) =< 2,5 x institutionel øvre normalgrænse (IULN) eller =< 5 x IULN, hvis levermetastaser er til stede
Total bilirubin =< 1,5 x IULN
Serumkreatinin =< 1,5 x IULN inden for 14 dage før trin 2 randomisering ELLER
Beregnet kreatininclearance > 60 ml/min; serumkreatininværdien anvendt i beregningen skal være opnået inden for 14 dage før trin 2 randomisering
Patienter skal have et elektrokardiogram (EKG) inden for 14 dage før trin 2 randomisering
Patienterne skal have korrigeret QT (QTc) =< 500 msek
Patienter må ikke have en kendt anamnese med Gilberts syndrom eller kendt homozygositet for UDP glucuronosyltransferase 1-familien, polypeptid A1 (UGT1A1)*28-allelen
Patienter må ikke have interstitiel lungebetændelse eller omfattende symptomatisk interstitiel fibrose i lungen
Patienter må ikke have en ukontrolleret interkurrent sygdom, herunder, men ikke begrænset til, aktiv blødningsdiatese, ukontrolleret infektion/lidelser, ikke-maligne medicinske sygdomme, der er ukontrollerede, eller hvis kontrol kan blive sat i fare af behandlingen med undersøgelsesterapien, eller psykiatrisk sygdom/sociale situationer hvilket ville begrænse overholdelse af studiekrav
Patienter skal være i stand til at sluge pille/tablet og ikke have refraktær kvalme, opkastning, malabsorption, ekstern galde-shunt eller væsentlig tyndtarmsresektion, der ville udelukke tilstrækkelig absorption
Patienter må ikke være gravide eller ammende; kvinder/mænd med reproduktionspotentiale skal have accepteret at bruge en effektiv præventionsmetode under undersøgelsen og i 30 dage efter undersøgelsesbehandlingen; en kvinde anses for at have "reproduktionspotentiale", hvis hun har haft menstruation på noget tidspunkt i de foregående 12 på hinanden følgende måneder; ud over rutinepræventionsmetoder omfatter "effektiv prævention" også heteroseksuel cølibat og kirurgi beregnet til at forhindre graviditet (eller med en bivirkning af graviditetsforebyggelse) defineret som en hysterektomi, bilateral ooforektomi eller bilateral tubal ligering; men hvis en tidligere cølibatpatient på noget tidspunkt vælger at blive heteroseksuelt aktiv i løbet af tidsperioden for brug af præventionsmidler, er han/hun ansvarlig for at påbegynde præventionsforanstaltninger
Ingen anden tidligere malignitet er tilladt bortset fra følgende: tilstrækkeligt behandlet basalcelle- eller pladecellehudkræft, in situ livmoderhalskræft, tilstrækkeligt behandlet stadium I- eller II-kræft, hvorfra patienten i øjeblikket er i fuldstændig remission, eller enhver anden kræftsygdom, hvorfra patienten har været sygdomsfri i tre år
TRIN 2 REGULERINGSKRITERIER FOR RANDOMISERING:
Patienter eller deres juridisk autoriserede repræsentant skal informeres om undersøgelsens karakter af denne undersøgelse og skal underskrive og give skriftligt informeret samtykke i overensstemmelse med institutionelle og føderale retningslinjer; for alle patienter er den passende samtykkeformular til denne registrering trin 2 samtykkeformularen
Som en del af OPEN-registreringsprocessen oplyses den behandlende institutions identitet for at sikre, at den aktuelle (inden for 365 dage) dato for institutionsbedømmelsesudvalgets godkendelse af denne undersøgelse er blevet indtastet i systemet
TRIN 3 CROSSOVER REGISTRERING:
Patienter skal have dokumenteret sygdomsprogression, mens de er på arm 1 i denne protokol; det opfølgende tumorvurderingsskema, der dokumenterer sygdomsprogression, skal indsendes til Southwestern Oncology Group (SWOG) før trin 3
Tilmelding til Trin 3 Crossover skal ske inden for 28 dage efter afbrydelse af Arm 1-protokolbehandling; patienter, der afgår i behandlingen af andre årsager, er ikke berettigede
ANC >= 1.500/mcL inden for 14 dage før trin 3-registrering
Blodplader >= 100,00/mcL inden for 14 dage før trin 3 registrering
Hæmoglobin >= 9 g/dL inden for 14 dage før trin 3 registrering
ASAT og ALAT =< 2,5 x institutionel øvre normalgrænse (IULN) eller =< 5 x IULN, hvis levermetastaser er til stede inden for 14 dage før trin 3 registrering
Total bilirubin =< 1,5 x IULN inden for 14 dage før trin 3 registrering
Serumkreatinin =< 1,5 x IULN inden for 14 dage før trin 3 registrering ELLER
Beregnet kreatininclearance > 60 ml/min; serumkreatininværdien anvendt i beregningen skal være opnået inden for 14 dage før trin 3 registrering

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Primært formål: Behandling
Tildeling: Randomiseret
Interventionel model: Crossover opgave
Maskning: Ingen (Åben etiket)

Antal våben

Våben og indgreb

Deltagergruppe / Arm	Intervention / Behandling
Aktiv komparator: Arm I (cetuximab, irinotecan hydrochlorid) Patienterne får cetuximab IV og irinotecanhydrochlorid IV på dag 1 og 14. Kurser gentages hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienter med sygdomsprogression kan gå over til arm II.	Biologisk: cetuximab Givet IV Andre navne: C225 Erbitux IMC-C225 C225 monoklonalt antistof MOAB C225 monoklonalt antistof C225 Kimærisk anti-EGFR monoklonalt antistof Kimærisk MoAb C225 Kimært monoklonalt antistof C225 Immunoglobulin G1 Anti-EGFR monoklonalt antistof 11460 205923-56-4 3610 714692 Anti-epidermal vækstfaktor receptor monoklonalt antistof anti-(human epidermal vækstfaktor receptor) (human-mus monoklonal C225 gamma1-kæde) disulfid med human-mus monoklonal C225 kappa-kæde dimer Medicin: irinotecan hydrochlorid Givet IV Andre navne: irinotecan Campto Camptosar U-101440E CPT-11 camptothecin-11 irinotecan HCl
Eksperimentel: Arm II (cetuximab, irinotecanhydrochlorid, vemurafenib) Patienterne får cetuximab og irinotecanhydrochlorid som i arm I og vemurafenib PO BID på dag 1-28. Kurser gentages hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.	Biologisk: cetuximab Givet IV Andre navne: C225 Erbitux IMC-C225 C225 monoklonalt antistof MOAB C225 monoklonalt antistof C225 Kimærisk anti-EGFR monoklonalt antistof Kimærisk MoAb C225 Kimært monoklonalt antistof C225 Immunoglobulin G1 Anti-EGFR monoklonalt antistof 11460 205923-56-4 3610 714692 Anti-epidermal vækstfaktor receptor monoklonalt antistof anti-(human epidermal vækstfaktor receptor) (human-mus monoklonal C225 gamma1-kæde) disulfid med human-mus monoklonal C225 kappa-kæde dimer Medicin: irinotecan hydrochlorid Givet IV Andre navne: irinotecan Campto Camptosar U-101440E CPT-11 camptothecin-11 irinotecan HCl Medicin: vemurafenib Givet PO Andre navne: PLX4032 RG7204 Zelboraf RO5185426 BRAF(V600E) kinaseinhibitor RO5185426

Deltagergruppe / Arm

Intervention / Behandling

Aktiv komparator: Arm I (cetuximab, irinotecan hydrochlorid)

Patienterne får cetuximab IV og irinotecanhydrochlorid IV på dag 1 og 14. Kurser gentages hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienter med sygdomsprogression kan gå over til arm II.

Biologisk: cetuximab

Givet IV

Andre navne:

C225
Erbitux
IMC-C225
C225 monoklonalt antistof
MOAB C225
monoklonalt antistof C225
Kimærisk anti-EGFR monoklonalt antistof
Kimærisk MoAb C225
Kimært monoklonalt antistof C225
Immunoglobulin G1
Anti-EGFR monoklonalt antistof
11460
205923-56-4
3610
714692
Anti-epidermal vækstfaktor receptor monoklonalt antistof
anti-(human epidermal vækstfaktor receptor) (human-mus monoklonal C225 gamma1-kæde)
disulfid med human-mus monoklonal C225 kappa-kæde
dimer

Medicin: irinotecan hydrochlorid

Givet IV

Andre navne:

irinotecan
Campto
Camptosar
U-101440E
CPT-11
camptothecin-11
irinotecan HCl

Eksperimentel: Arm II (cetuximab, irinotecanhydrochlorid, vemurafenib)

Patienterne får cetuximab og irinotecanhydrochlorid som i arm I og vemurafenib PO BID på dag 1-28. Kurser gentages hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.

Biologisk: cetuximab

Givet IV

Andre navne:

C225
Erbitux
IMC-C225
C225 monoklonalt antistof
MOAB C225
monoklonalt antistof C225
Kimærisk anti-EGFR monoklonalt antistof
Kimærisk MoAb C225
Kimært monoklonalt antistof C225
Immunoglobulin G1
Anti-EGFR monoklonalt antistof
11460
205923-56-4
3610
714692
Anti-epidermal vækstfaktor receptor monoklonalt antistof
anti-(human epidermal vækstfaktor receptor) (human-mus monoklonal C225 gamma1-kæde)
disulfid med human-mus monoklonal C225 kappa-kæde
dimer

Medicin: irinotecan hydrochlorid

Givet IV

Andre navne:

irinotecan
Campto
Camptosar
U-101440E
CPT-11
camptothecin-11
irinotecan HCl

Medicin: vemurafenib

Givet PO

Andre navne:

PLX4032
RG7204
Zelboraf
RO5185426
BRAF(V600E) kinaseinhibitor RO5185426

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Progressionsfri overlevelse Tidsramme: Op til 3 år fra randomisering	Fra dato for randomisering til dato for første dokumentation for progression eller symptomatisk forværring, eller død på grund af en hvilken som helst årsag. Patienter, der sidst er kendt for at være i live og progressionsfri, censureres på datoen for sidste kontakt. Progression defineres som en eller flere af følgende: 20 % stigning i summen af passende diametre af målbare læsioner i forhold til den mindste observerede sum (over baseline, hvis intet fald under behandlingen) ved brug af de samme teknikker som baseline, samt en absolut stigning på mindst 0,5 cm; utvetydig progression af ikke-målbar sygdom efter den behandlende læges mening; udseende af enhver ny læsion/sted; og/eller død som følge af sygdom uden forudgående dokumentation for progression og uden symptomatisk forværring.	Op til 3 år fra randomisering

Sekundære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Antal patienter med grad 3 til 5 bivirkninger, der er relateret til undersøgelsesmedicin Tidsramme: Op til 3 år	Kun uønskede hændelser, der muligvis, sandsynligvis eller helt sikkert er relateret til undersøgelseslægemidlet, er rapporteret.	Op til 3 år

Andre resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Samlet overlevelse Tidsramme: Op til 3 år fra randomisering	Fra dato for randomisering til dato for død på grund af enhver årsag. Patienter, der sidst vides at være i live, censureres på datoen for sidste kontakt.	Op til 3 år fra randomisering
Samlet svarprocent Tidsramme: Op til 3 år fra randomisering	Bekræftet respons (CR) er to eller flere objektive statusser af CR med mindst fire ugers mellemrum dokumenteret før progression eller symptomatisk forværring. Delvis respons (PR) er to eller flere objektive statusser af PR eller bedre med minimum fire ugers mellemrum dokumenteret før progression eller symptomatisk forværring. Ubekræftet CR er en objektiv status for CR dokumenteret før progression eller symptomatisk forværring, men ikke kvalificeret som CR eller PR. Ubekræftet PR er en objektiv status for PR dokumenteret før progression eller symptomatisk forværring, men ikke kvalificeret som CR, PR eller ubekræftet CR.	Op til 3 år fra randomisering
Progressionsfri overlevelse hos patienter, der registrerer sig til arm 3 (overkrydsning) efter sygdomsprogression på arm 1 Tidsramme: Op til 3 år fra randomisering	Fra datoen for trin 3 Crossover-registrering til datoen for første dokumentation for progression eller symptomatisk forværring eller død på grund af en hvilken som helst årsag. Patienter, der sidst vides at være i live uden rapport om progression, censureres på datoen for sidste kontakt. Progression defineres som en eller flere af følgende: 20 % stigning i summen af passende diametre af målbare læsioner i forhold til den mindste observerede sum (over baseline, hvis intet fald under behandlingen) ved brug af de samme teknikker som baseline, samt en absolut stigning på mindst 0,5 cm; utvetydig progression af ikke-målbar sygdom efter den behandlende læges mening; udseende af enhver ny læsion/sted; og/eller død som følge af sygdom uden forudgående dokumentation for progression og uden symptomatisk forværring.	Op til 3 år fra randomisering
Samlet overlevelse hos patienter, der registrerer sig til arm 3 (crossover) efter sygdomsprogression på arm 1 Tidsramme: Op til 3 år fra randomisering	Fra dato for randomisering til dato for død på grund af enhver årsag. Patienter, der sidst vides at være i live, censureres på datoen for sidste kontakt.	Op til 3 år fra randomisering
Samlet responsrate hos patienter, der registrerer sig til arm 3 (crossover) efter sygdomsprogression på arm 1 Tidsramme: Op til 3 år fra randomisering	Bekræftet respons (CR) er to eller flere objektive statusser af CR med mindst fire ugers mellemrum dokumenteret før progression eller symptomatisk forværring. Delvis respons (PR) er to eller flere objektive statusser af PR eller bedre med minimum fire ugers mellemrum dokumenteret før progression eller symptomatisk forværring. Ubekræftet CR er en objektiv status for CR dokumenteret før progression eller symptomatisk forværring, men ikke kvalificeret som CR eller PR. Ubekræftet PR er en objektiv status for PR dokumenteret før progression eller symptomatisk forværring, men ikke kvalificeret som CR, PR eller ubekræftet CR.	Op til 3 år fra randomisering

Samarbejdspartnere og efterforskere

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

Sponsor

Southwest Oncology Group

Samarbejdspartnere

National Cancer Institute (NCI)

Roche-Genentech

Efterforskere

Ledende efterforsker: Edmund S Kopetz, M.D., M.D. Anderson

Publikationer og nyttige links

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

Generelle publikationer

Kopetz S, Guthrie KA, Morris VK, Lenz HJ, Magliocco AM, Maru D, Yan Y, Lanman R, Manyam G, Hong DS, Sorokin A, Atreya CE, Diaz LA, Allegra C, Raghav KP, Wang SE, Lieu CH, McDonough SL, Philip PA, Hochster HS. Randomized Trial of Irinotecan and Cetuximab With or Without Vemurafenib in BRAF-Mutant Metastatic Colorectal Cancer (SWOG S1406). J Clin Oncol. 2021 Feb 1;39(4):285-294. doi: 10.1200/JCO.20.01994. Epub 2020 Dec 23.

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

1. november 2014

Primær færdiggørelse (Faktiske)

13. november 2017

Studieafslutning (Faktiske)

19. november 2020

Datoer for studieregistrering

Først indsendt

13. juni 2014

Først indsendt, der opfyldte QC-kriterier

13. juni 2014

Først opslået (Skøn)

17. juni 2014

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

30. december 2020

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

7. december 2020

Sidst verificeret

1. december 2020

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

S1406 (Anden identifikator: SWOG)
U10CA180888 (U.S. NIH-bevilling/kontrakt)
NCI-2014-00814 (Anden identifikator: NCI)

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

Kliniske forsøg med Kolorektal cancer

University of Arkansas

Aktiv, ikke rekrutterende

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

Colorectal cancer og inflammatorisk tarmsygdom

Forenede Stater
University Health Network, Toronto
AstraZeneca

Aktiv, ikke rekrutterende

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

Adenocarcinom i bugspytkirtlen | Leiomyosarkom | Mismatch Reparation Proficient Colorectal Cancer

Canada
Tianjin Medical University Cancer Institute and...

Rekruttering

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

MSI-H Advanced Colorectal Cancer

Kina
Bristol-Myers Squibb

Aktiv, ikke rekrutterende

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

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

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

Afsluttet

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

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

Forenede Stater

Kliniske forsøg med cetuximab

University Medical Center Groningen
UMC Utrecht; Erasmus Medical Center

Rekruttering

Billedstyret kirurgi til marginvurdering af hoved- og nakkekræft ved hjælp af Cetuximab-IRDye800CW conjugate (ICON)

Planocellulært karcinom i hoved og hals | Marginvurdering

Holland
Amsterdam UMC, location VUmc
Radboud University Medical Center; University Medical Center Groningen

Afsluttet

Billedstyret behandlingsoptimering med Cetuximab til patienter med metastatisk tyktarmskræft (IMPACT-CRC)

Metastatisk tyktarmskræft

Holland
West China Hospital
First Affiliated Hospital of Chongqing Medical University

Rekruttering

Førstelinje mCapOX+Cetuximab vs. mFOLFOX6+Cetuximab til metastatisk venstresidet CRC med vildtype RAS/BRAF-gener (CAPCET)

Colo-rektal cancer | Capecitabin | Cetuximab

Kina
Eben Rosenthal
National Cancer Institute (NCI)

Afsluttet

Cetuximab-IRDye 800CW og intraoperativ billeddannelse til at finde kræft i bugspytkirtlen hos patienter, der gennemgår kirurgi

Adenocarcinom i bugspytkirtlen

Forenede Stater
HiberCell, Inc.

Afsluttet

Undersøgelse af Imprime PGG® i kombination med Cetuximab hos forsøgspersoner med tilbagevendende eller progressiv KRAS vildtype kolorektal cancer (PRIMUS)

Kolorektal cancer

Forenede Stater, Puerto Rico, Tyskland, Frankrig
Merck KGaA, Darmstadt, Germany

Afsluttet

Undersøgelse for at evaluere effektiviteten og sikkerheden af FOLFOX-4 Plus Cetuximab versus UFOX Plus Cetuximab. (FUTURE)

Tidligere ubehandlet metastatisk tyktarmskræft

Frankrig, Italien, Polen, Tyskland, Hong Kong, Østrig, Brasilien, Israel, Grækenland, Argentina, Thailand, Belgien, Australien, Mexico
Universitaire Ziekenhuizen KU Leuven
Merck KGaA, Darmstadt, Germany

Afsluttet

Cetuximab standard eller dosiseskalering ved første linje kolorektal cancer (Everest2)

Kolorektal cancer

Spanien, Frankrig, Belgien, Ungarn, Østrig
Gruppo Oncologico del Nord-Ovest

Afsluttet

Induktionskemoterapi med Folfoxiri Plus Cetuxumab hos uoperabel kolorektal cancerpatient (MACBETH)

Metastatisk tyktarmskræft

Italien
Cancer Institute and Hospital, Chinese Academy...

Rekruttering

Effektiviteten og sikkerheden af modificeret XELOX(mXELOX) Plus Cetuximab vs FOLFOX Plus Cetuximab i RAS og BRAF WT mCRC Pts

Colo-rektal cancer

Kina
Poitiers University Hospital

Afsluttet

Undersøgelse af hudtoksicitet af Cetuximab: Find en forbindelse mellem hudbetændelse og tumorrespons

Metastatisk tyktarmskræft

Frankrig

S1406 fase II undersøgelse af irinotecan og cetuximab med eller uden Vemurafenib i BRAF mutant metastatisk kolorektal cancer

Randomiseret fase II undersøgelse af Irinotecan og Cetuximab med eller uden Vemurafenib i BRAF mutant metastatisk kolorektal cancer

Studieoversigt

Status

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Undersøgelsestype

Tilmelding (Faktiske)

Fase

Kontakter og lokationer

Studiesteder

Deltagelseskriterier

Berettigelseskriterier

Aldre berettiget til at studere

Tager imod sunde frivillige

Køn, der er berettiget til at studere

Beskrivelse

Studieplan

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Antal våben

Våben og indgreb

Deltagergruppe / Arm

Intervention / Behandling

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Sekundære resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Andre resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Samarbejdspartnere og efterforskere

Sponsor

Samarbejdspartnere

Efterforskere

Publikationer og nyttige links

Generelle publikationer

Datoer for undersøgelser

Studer store datoer

Studiestart

Primær færdiggørelse (Faktiske)

Studieafslutning (Faktiske)

Datoer for studieregistrering

Først indsendt

Først indsendt, der opfyldte QC-kriterier

Først opslået (Skøn)

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

Sidst verificeret

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

Kliniske forsøg med Kolorektal cancer

Kliniske forsøg med cetuximab

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Serbia

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer