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Dabrafenib og Trametinib til behandling af patienter med trin III-IV BRAF mutant melanom, der ikke kan fjernes ved kirurgi

28. maj 2026 opdateret af: National Cancer Institute (NCI)

Et randomiseret fase II forsøg med intermitterende versus kontinuerlig dosering af Dabrafenib (NSC-763760) og Trametinib (NSC-763093) i BRAF V600E/K mutant melanom

Dette fase II-studie undersøger, hvor godt dabrafenib og trametinib virker ved behandling af patienter med stadium III-IV melanom, som ikke kan fjernes ved kirurgi og indeholder en B-Raf proto-onkogen, serin/threoninkinase (BRAF) mutation. Dabrafenib og trametinib kan stoppe væksten af tumorceller ved at blokere nogle af de enzymer, der er nødvendige for cellevækst.

Studieoversigt

Status

Aktiv, ikke rekrutterende

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

PRIMÆR MÅL:

I. At sammenligne progressionsfri overlevelse med intermitterende dosering og kontinuerlig dosering af dabrafenib og trametinib blandt patienter med metastatisk BRAF V600E/K mutant melanom.

SEKUNDÆRE MÅL:

I. At estimere hyppigheden og sværhedsgraden af toksiciteter for de to doseringsskemaer.

II. For at sammenligne hyppigheden og sværhedsgraden af feber >= grad 1 i henhold til Common Terminology Criteria for Adverse Events (CTCAE) 4.0 af de to doseringsskemaer.

III. For at sammenligne responsraten (komplet og delvist svar, bekræftet og ubekræftet), samlet overlevelse og overlevelse efter progression mellem de to doseringsskemaer på trin 2.

MÅL FOR TRANSLATIONEL MEDICIN:

I. At evaluere, om erhvervede molekylære hændelser, der fører til reaktivering af MAPK-vejen, er mere almindelige blandt patienter på den kontinuerlige doseringsarm end på den intermitterende doseringsarm, der anvender cirkulerende tumor-deoxyribonukleinsyre (DNA) (ctDNA).

II. At vurdere den prognostiske sammenhæng mellem baseline biomarkører og tidlige molekylære hændelser med progressionsfri overlevelse (PFS).

III. At udforske den potentielle interaktion mellem behandlingsarm og baseline biomarkører/tidlige molekylære hændelser med PFS.

IV. At banke væv og fuldblod i forventning om fremtidige undersøgelser for at evaluere molekylære hændelser forbundet med klinisk fordel og sygdomsprogression hos patienter behandlet med kontinuerlig versus intermitterende dabrafenib og trametinib.

OVERSIGT: Patienterne randomiseres til 1 ud af 2 behandlingsarme.

ARM I (KONTINUERLIG DOSERING): Patienterne får dabrafenib oralt (PO) to gange dagligt (BID) og trametinib PO én gang dagligt (QD) på dag 1-56 i hver cyklus. Cykler gentages hver 56. dag i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienterne gennemgår også PET/CT- eller CT-scanninger i uge 1 af cyklus 2 og efter opfølgning uden behandling før progression.

ARM II (INTERMITTERENDE DOSERING): Patienterne får dabrafenib PO BID og trametinib PO QD på dag 1-7 og 29-56 i hver cyklus. Cykler gentages hver 56. dag i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienterne gennemgår også PET/CT- eller CT-scanninger i uge 1 af cyklus 2 og efter opfølgning uden behandling før progression.

Efter afsluttet undersøgelsesbehandling følges patienterne hver 6. måned i 3 år og derefter årligt i 2 år.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

280

Fase

Fase 2

Kontakter og lokationer

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

Studiesteder

Forenede Stater
- Alabama
  - Birmingham, Alabama, Forenede Stater, 35233
    - University of Alabama at Birmingham Cancer Center
- Alaska
  - Anchorage, Alaska, Forenede Stater, 98508
    - Anchorage Associates in Radiation Medicine
  - 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, 85719
    - Banner University Medical Center - Tucson
  - Tucson, Arizona, Forenede Stater, 85719
    - University of Arizona Cancer Center-North Campus
  - Yuma, Arizona, Forenede Stater, 85364
    - Onvida Health Yuma Medical Center
- Arkansas
  - Fort Smith, Arkansas, Forenede Stater, 72903
    - Mercy Hospital Fort Smith
  - Hot Springs, Arkansas, Forenede Stater, 71913
    - CHI Saint Vincent Cancer Center Hot Springs
  - Jonesboro, Arkansas, Forenede Stater, 72401
    - NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
  - Little Rock, Arkansas, Forenede Stater, 72205
    - University of Arkansas for Medical Sciences
  - Little Rock, Arkansas, Forenede Stater, 72205
    - John L McClellan Memorial Veterans Hospital
  - Rogers, Arkansas, Forenede Stater, 72758
    - Highlands Oncology Group - Rogers
- California
  - Anaheim, California, Forenede Stater, 92806
    - Kaiser Permanente-Anaheim
  - Antioch, California, Forenede Stater, 94531
    - Kaiser Permanente-Deer Valley Medical Center
  - Arroyo Grande, California, Forenede Stater, 93420
    - PCR Oncology
  - Baldwin Park, California, Forenede Stater, 91706
    - Kaiser Permanente-Baldwin Park
  - Bellflower, California, Forenede Stater, 90706
    - Kaiser Permanente-Bellflower
  - Burbank, California, Forenede Stater, 91505
    - Providence Saint Joseph Medical Center/Disney Family 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-Fontana
  - Fremont, California, Forenede Stater, 94538
    - Kaiser Permanente-Fremont
  - Fresno, California, Forenede Stater, 93720
    - Kaiser Permanente-Fresno
  - Harbor City, California, Forenede Stater, 90710
    - Kaiser Permanente South Bay
  - Irvine, California, Forenede Stater, 92618
    - Kaiser Permanente-Irvine
  - Loma Linda, California, Forenede Stater, 92354
    - Loma Linda University Medical Center
  - Los Angeles, California, Forenede Stater, 90095
    - UCLA / Jonsson Comprehensive Cancer Center
  - Los Angeles, California, Forenede Stater, 90027
    - Kaiser Permanente Los Angeles Medical Center
  - Los Angeles, California, Forenede Stater, 90034
    - Kaiser Permanente West Los Angeles
  - Martinez, California, Forenede Stater, 94553-3156
    - Contra Costa Regional Medical Center
  - Modesto, California, Forenede Stater, 95356
    - Kaiser Permanente-Modesto
  - 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
  - Panorama City, California, Forenede Stater, 91402
    - Kaiser Permanente - Panorama City
  - Rancho Cordova, California, Forenede Stater, 95670
    - Kaiser Permanente-Rancho Cordova Cancer Center
  - Rancho Mirage, California, Forenede Stater, 92270
    - Eisenhower Medical 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
  - Sacramento, California, Forenede Stater, 95814
    - Kaiser Permanente Downtown Commons
  - 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 Medical Center
  - San Diego, California, Forenede Stater, 92120
    - Kaiser Permanente-San Diego Zion
  - San Diego, California, Forenede Stater, 92108
    - Kaiser Permanente-San Diego Mission
  - San Francisco, California, Forenede Stater, 94115
    - Kaiser Permanente-San Francisco
  - San Francisco, California, Forenede Stater, 94115
    - 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, 92078
    - Kaiser Permanente-San Marcos
  - San Rafael, California, Forenede Stater, 94903
    - Kaiser San Rafael-Gallinas
  - San Rafael, California, Forenede Stater, 94903
    - Kaiser Permanente-San Rafael
  - Santa Clara, California, Forenede Stater, 95051
    - Kaiser Permanente Medical Center - Santa Clara
  - Santa Rosa, California, Forenede Stater, 95403
    - Kaiser Permanente-Santa Rosa
  - 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
  - Vacaville, California, Forenede Stater, 95688
    - Kaiser Permanente Medical Center-Vacaville
  - Vallejo, California, Forenede Stater, 94589
    - Kaiser Permanente-Vallejo
  - Walnut Creek, California, Forenede Stater, 94596
    - Kaiser Permanente-Walnut Creek
  - Walnut Creek, California, Forenede Stater, 94597
    - Epic Care Cyberknife Center
  - Woodland Hills, California, Forenede Stater, 91367
    - Kaiser Permanente-Woodland Hills
- Colorado
  - Aurora, Colorado, Forenede Stater, 80012
    - Rocky Mountain Cancer Centers-Aurora
  - Aurora, Colorado, Forenede Stater, 80012
    - The Medical Center of Aurora
  - Aurora, Colorado, Forenede Stater, 80045
    - UCHealth University of Colorado Hospital
  - Boulder, Colorado, Forenede Stater, 80303
    - Boulder Community Foothills Hospital
  - Boulder, Colorado, Forenede Stater, 80304
    - Rocky Mountain Cancer Centers-Boulder
  - Colorado Springs, Colorado, Forenede Stater, 80907
    - Penrose-Saint Francis Healthcare
  - Colorado Springs, Colorado, Forenede Stater, 80907
    - Rocky Mountain Cancer Centers-Penrose
  - Denver, Colorado, Forenede Stater, 80205
    - Kaiser Permanente-Franklin
  - Denver, Colorado, Forenede Stater, 80218
    - Presbyterian - Saint Lukes Medical Center - Health One
  - Denver, Colorado, Forenede Stater, 80220
    - Rose Medical Center
  - Denver, Colorado, Forenede Stater, 80218
    - Rocky Mountain Cancer Centers-Midtown
  - Denver, Colorado, Forenede Stater, 80220
    - Rocky Mountain Cancer Centers-Rose
  - Denver, Colorado, Forenede Stater, 80204
    - Denver Health Medical Center
  - Denver, Colorado, Forenede Stater, 80218
    - Colorado Blood Cancer Institute
  - Denver, Colorado, Forenede Stater, 80209
    - The Women's Imaging Center
  - Denver, Colorado, Forenede Stater, 80218
    - Saint Joseph Hospital - Cancer Centers of Colorado
  - Denver, Colorado, Forenede Stater, 80210
    - AdventHealth Porter
  - Durango, Colorado, Forenede Stater, 81301
    - Mercy Medical Center
  - Durango, Colorado, Forenede Stater, 81301
    - CommonSpirit Cancer Center Mercy
  - Englewood, Colorado, Forenede Stater, 80113
    - Mountain Blue Cancer Care Center - Swedish
  - Englewood, Colorado, Forenede Stater, 80113
    - Swedish Medical Center
  - Fort Collins, Colorado, Forenede Stater, 80524
    - Poudre Valley Hospital
  - Golden, Colorado, Forenede Stater, 80401
    - Mountain Blue Cancer Care Center
  - Golden, Colorado, Forenede Stater, 80401
    - National Jewish Health-Western Hematology Oncology
  - Grand Junction, Colorado, Forenede Stater, 81501
    - Saint Mary's Hospital and Regional Medical Center
  - Grand Junction, Colorado, Forenede Stater, 81505
    - Grand Valley Oncology
  - Greeley, Colorado, Forenede Stater, 80631
    - Banner North Colorado Medical Center
  - Greenwood Village, Colorado, Forenede Stater, 80111
    - Rocky Mountain Cancer Centers-Greenwood Village
  - Lafayette, Colorado, Forenede Stater, 80026
    - Kaiser Permanente-Rock Creek
  - Lafayette, Colorado, Forenede Stater, 80026
    - Good Samaritan Hospital - Cancer Centers of Colorado
  - Lakewood, Colorado, Forenede Stater, 80228
    - Rocky Mountain Cancer Centers-Lakewood
  - Lakewood, Colorado, Forenede Stater, 80228
    - CommonSpirit Saint Anthony Hospital Cancer Center
  - Littleton, Colorado, Forenede Stater, 80120
    - Rocky Mountain Cancer Centers-Littleton
  - Littleton, Colorado, Forenede Stater, 80122
    - AdventHealth Littleton
  - Lone Tree, Colorado, Forenede Stater, 80124
    - Kaiser Permanente-Lone Tree
  - Lone Tree, Colorado, Forenede Stater, 80124
    - Sky Ridge Medical Center
  - Lone Tree, Colorado, Forenede Stater, 80124
    - Rocky Mountain Cancer Centers-Sky Ridge
  - Longmont, Colorado, Forenede Stater, 80501
    - Longmont United Hospital
  - Longmont, Colorado, Forenede Stater, 80501
    - Rocky Mountain Cancer Centers-Longmont
  - Loveland, Colorado, Forenede Stater, 80539
    - Banner North Colorado Medical Center - Loveland Campus
  - Parker, Colorado, Forenede Stater, 80138
    - Rocky Mountain Cancer Centers-Parker
  - Parker, Colorado, Forenede Stater, 80138
    - AdventHealth Parker
  - Pueblo, Colorado, Forenede Stater, 81004
    - Saint Mary Corwin Medical Center
  - Pueblo, Colorado, Forenede Stater, 81008
    - Rocky Mountain Cancer Centers - Pueblo
  - Thornton, Colorado, Forenede Stater, 80260
    - Rocky Mountain Cancer Centers-Thornton
  - Thornton, Colorado, Forenede Stater, 80260
    - National Jewish Health-Northern Hematology Oncology
  - Wheat Ridge, Colorado, Forenede Stater, 80401
    - Intermountain Health Lutheran Hospital
- Delaware
  - Lewes, Delaware, Forenede Stater, 19958
    - Beebe Medical Center
  - Newark, Delaware, Forenede Stater, 19713
    - Helen F Graham Cancer Center
  - Newark, Delaware, Forenede Stater, 19713
    - Delaware Clinical and Laboratory Physicians PA
  - Newark, Delaware, Forenede Stater, 19713
    - Medical Oncology Hematology Consultants PA
  - Newark, Delaware, Forenede Stater, 19718
    - Christiana Care Health System-Christiana Hospital
  - Rehoboth Beach, Delaware, Forenede Stater, 19971
    - Beebe Health Campus
  - Seaford, Delaware, Forenede Stater, 19973
    - TidalHealth Nanticoke / Allen Cancer Center
  - Wilmington, Delaware, Forenede Stater, 19801
    - Christiana Care Health System-Wilmington Hospital
- Florida
  - Altamonte Springs, Florida, Forenede Stater, 32701
    - AdventHealth Altamonte
  - Aventura, Florida, Forenede Stater, 33180
    - Mount Sinai Comprehensive Cancer Center at Aventura
  - Fort Lauderdale, Florida, Forenede Stater, 33308
    - Holy Cross Hospital
  - Gainesville, Florida, Forenede Stater, 32610
    - UF Health Cancer Institute - Gainesville
  - Kissimmee, Florida, Forenede Stater, 34744
    - AdventHealth Kissimmee
  - Miami Beach, Florida, Forenede Stater, 33140
    - Mount Sinai Medical Center
  - Orlando, Florida, Forenede Stater, 32806
    - Orlando Health Cancer Institute
  - Orlando, Florida, Forenede Stater, 32803
    - AdventHealth Orlando
  - Orlando, Florida, Forenede Stater, 32803
    - AdventHealth Medical Group Urology at Orlando
  - Orlando, Florida, Forenede Stater, 32822
    - AdventHealth East Orlando
  - Winter Park, Florida, Forenede Stater, 32792
    - AdventHealth Winter Park
- Georgia
  - Atlanta, Georgia, Forenede Stater, 30322
    - Emory University Hospital/Winship Cancer Institute
  - Savannah, Georgia, Forenede Stater, 31405
    - Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
  - Savannah, Georgia, Forenede Stater, 31404
    - Memorial Health University Medical Center
  - Savannah, Georgia, Forenede Stater, 31404
    - Summit Cancer Care-Memorial
  - Savannah, Georgia, Forenede Stater, 31405
    - Summit Cancer Care-Candler
  - Savannah, Georgia, Forenede Stater, 31404
    - Low Country Cancer Care
- Hawaii
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Queen's Medical Center
  - Honolulu, Hawaii, Forenede Stater, 96817
    - The Cancer Center of Hawaii-Liliha
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Hawaii Cancer Care Inc - Waterfront Plaza
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Queen's Cancer Cenrer - POB I
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Straub Clinic and Hospital
  - Honolulu, Hawaii, Forenede Stater, 96813
    - University of Hawaii Cancer Center
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Hawaii Cancer Care Inc-Liliha
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Kuakini Medical Center
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Queen's Cancer Center - Kuakini
  - Honolulu, Hawaii, Forenede Stater, 96826
    - Kapiolani Medical Center for Women and Children
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Island Urology
  - Honolulu, Hawaii, Forenede Stater, 96819
    - Kaiser Permanente Moanalua Medical Center
  - Honolulu, Hawaii, Forenede Stater, 96859
    - Tripler Army Medical Center
  - Lihue, Hawaii, Forenede Stater, 96766
    - Wilcox Memorial Hospital and Kauai Medical Clinic
  - ‘Aiea, Hawaii, Forenede Stater, 96701
    - Hawaii Cancer Care - Westridge
  - ‘Aiea, Hawaii, Forenede Stater, 96701
    - Pali Momi Medical Center
  - ‘Aiea, Hawaii, Forenede Stater, 96701
    - Queen's Cancer Center - Pearlridge
  - ‘Aiea, Hawaii, Forenede Stater, 96701
    - The Cancer Center of Hawaii-Pali Momi
- Idaho
  - Boise, Idaho, Forenede Stater, 83706
    - Saint Alphonsus Cancer Care Center-Boise
  - Boise, Idaho, Forenede Stater, 83712
    - Saint Luke's Cancer Institute - Boise
  - Caldwell, Idaho, Forenede Stater, 83605
    - Saint Alphonsus Cancer Care Center-Caldwell
  - Coeur d'Alene, Idaho, Forenede Stater, 83814
    - Kootenai Health - Coeur d'Alene
  - Emmett, Idaho, Forenede Stater, 83617
    - Walter Knox Memorial Hospital
  - Fruitland, Idaho, Forenede Stater, 83619
    - Saint Luke's Cancer Institute - Fruitland
  - Meridian, Idaho, Forenede Stater, 83642
    - Idaho Urologic Institute-Meridian
  - Meridian, Idaho, Forenede Stater, 83642
    - Saint Luke's Cancer Institute - Meridian
  - Nampa, Idaho, Forenede Stater, 83687
    - Saint Alphonsus Cancer Care Center-Nampa
  - Nampa, Idaho, Forenede Stater, 83687
    - Saint Luke's Cancer Institute - Nampa
  - Post Falls, Idaho, Forenede Stater, 83854
    - Kootenai Clinic Cancer Services - Post Falls
  - Sandpoint, Idaho, Forenede Stater, 83864
    - Kootenai Clinic Cancer Services - Sandpoint
  - Twin Falls, Idaho, Forenede Stater, 83301
    - Saint Luke's Cancer Institute - Twin Falls
- Illinois
  - Aurora, Illinois, Forenede Stater, 60504
    - Rush-Copley Medical Center
  - Bloomington, Illinois, Forenede Stater, 61704
    - Illinois CancerCare-Bloomington
  - Bloomington, Illinois, Forenede Stater, 61701
    - OSF Saint Joseph Medical Center
  - Canton, Illinois, Forenede Stater, 61520
    - Illinois CancerCare-Canton
  - Carbondale, Illinois, Forenede Stater, 62902
    - Memorial Hospital of Carbondale
  - Carterville, Illinois, Forenede Stater, 62918
    - SIH Cancer Institute
  - Carthage, Illinois, Forenede Stater, 62321
    - Illinois CancerCare-Carthage
  - Centralia, Illinois, Forenede Stater, 62801
    - Centralia Oncology Clinic
  - Danville, Illinois, Forenede Stater, 61832
    - Carle at The Riverfront
  - Decatur, Illinois, Forenede Stater, 62526
    - Decatur Memorial Hospital
  - Decatur, Illinois, Forenede Stater, 62526
    - Cancer Care Specialists of Illinois - Decatur
  - Effingham, Illinois, Forenede Stater, 62401
    - Crossroads Cancer Center
  - Effingham, Illinois, Forenede Stater, 62401
    - Carle Physician Group-Effingham
  - Eureka, Illinois, Forenede Stater, 61530
    - Illinois CancerCare-Eureka
  - Evanston, Illinois, Forenede Stater, 60201
    - NorthShore University HealthSystem-Evanston Hospital
  - Galesburg, Illinois, Forenede Stater, 61401
    - Western Illinois Cancer Treatment Center
  - Galesburg, Illinois, Forenede Stater, 61401
    - Illinois CancerCare-Galesburg
  - Geneva, Illinois, Forenede Stater, 60134
    - Northwestern Medicine Cancer Center Delnor
  - Glenview, Illinois, Forenede Stater, 60026
    - NorthShore University HealthSystem-Glenbrook Hospital
  - Highland Park, Illinois, Forenede Stater, 60035
    - NorthShore University HealthSystem-Highland Park Hospital
  - 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
    - SSM Health Good Samaritan
  - O'Fallon, Illinois, Forenede Stater, 62269
    - Cancer Care Center of O'Fallon
  - Ottawa, Illinois, Forenede Stater, 61350
    - Illinois CancerCare-Ottawa Clinic
  - Ottawa, Illinois, Forenede Stater, 61350
    - Radiation Oncology of Northern Illinois
  - Pekin, Illinois, Forenede Stater, 61554
    - Illinois CancerCare-Pekin
  - Pekin, Illinois, Forenede Stater, 61554
    - OSF Saint Francis Radiation Oncology at Pekin
  - Peoria, Illinois, Forenede Stater, 61636
    - Methodist Medical Center of Illinois
  - Peoria, Illinois, Forenede Stater, 61637
    - OSF Saint Francis Medical Center
  - Peoria, Illinois, Forenede Stater, 61615
    - Illinois CancerCare-Peoria
  - Peoria, Illinois, Forenede Stater, 61615
    - OSF Saint Francis Radiation Oncology at Peoria Cancer Center
  - Peru, Illinois, Forenede Stater, 61354
    - Illinois CancerCare-Peru
  - Peru, Illinois, Forenede Stater, 61354
    - Valley Radiation Oncology
  - Princeton, Illinois, Forenede Stater, 61356
    - Illinois CancerCare-Princeton
  - Rockford, Illinois, Forenede Stater, 61114
    - UW Health Carbone Cancer Center Rockford
  - Silvis, Illinois, Forenede Stater, 61282
    - MercyOne Genesis Silvis Cancer Center
  - Skokie, Illinois, Forenede Stater, 60076
    - North Shore Medical Center
  - Springfield, Illinois, Forenede Stater, 62702
    - Southern Illinois University School of Medicine
  - Springfield, Illinois, Forenede Stater, 62702
    - Springfield Clinic
  - Springfield, Illinois, Forenede Stater, 62702
    - Central Illinois Hematology Oncology Center
  - Springfield, Illinois, Forenede Stater, 62781
    - Springfield Memorial Hospital
  - Swansea, Illinois, Forenede Stater, 62226
    - Southwest Illinois Health Services LLP
  - Urbana, Illinois, Forenede Stater, 61801
    - Carle Cancer Center
  - Urbana, Illinois, Forenede Stater, 61801
    - The Carle Foundation Hospital
  - Warrenville, Illinois, Forenede Stater, 60555
    - Northwestern Medicine Cancer Center Warrenville
  - Yorkville, Illinois, Forenede Stater, 60560
    - Rush-Copley Healthcare Center
- Indiana
  - Evansville, Indiana, Forenede Stater, 47713
    - Deaconess Clinic Downtown
  - Michigan City, Indiana, Forenede Stater, 46360
    - Franciscan Saint Anthony Health-Michigan City
  - Michigan City, Indiana, Forenede Stater, 46360
    - Woodland Cancer Care Center
  - Mishawaka, Indiana, Forenede Stater, 46545
    - Memorial Regional Cancer Center Day Road
  - Newburgh, Indiana, Forenede Stater, 47630
    - Chancellor Center for Oncology
  - Richmond, Indiana, Forenede Stater, 47374
    - Reid Health
  - South Bend, Indiana, Forenede Stater, 46601
    - Memorial Hospital of South Bend
- Iowa
  - Ames, Iowa, Forenede Stater, 50010
    - Mary Greeley Medical Center
  - Ames, Iowa, Forenede Stater, 50010
    - McFarland Clinic - Ames
  - Bettendorf, Iowa, Forenede Stater, 52722
    - University of Iowa Healthcare Cancer Services Quad Cities
  - Boone, Iowa, Forenede Stater, 50036
    - McFarland Clinic - Boone
  - Clive, Iowa, Forenede Stater, 50325
    - Mercy Cancer Center-West Lakes
  - Clive, Iowa, Forenede Stater, 50325
    - UI Health Care Mission Cancer and Blood - West Des Moines Clinic
  - Council Bluffs, Iowa, Forenede Stater, 51503
    - Alegent Health Mercy Hospital
  - Creston, Iowa, Forenede Stater, 50801
    - Greater Regional Medical Center
  - Davenport, Iowa, Forenede Stater, 52807
    - Iowa Cancer Specialists
  - Davenport, Iowa, Forenede Stater, 52804
    - MercyOne Genesis Davenport Cancer Center
  - Davenport, Iowa, Forenede Stater, 52803
    - MercyOne Genesis Davenport Medical Center
  - Des Moines, Iowa, Forenede Stater, 50309
    - Iowa Methodist Medical Center
  - Des Moines, Iowa, Forenede Stater, 50314
    - Mercy Medical Center - Des Moines
  - Des Moines, Iowa, Forenede Stater, 50314
    - Broadlawns Medical Center
  - Des Moines, Iowa, Forenede Stater, 50316
    - Iowa Lutheran Hospital
  - Des Moines, Iowa, Forenede Stater, 50309
    - UI Health Care Mission Cancer and Blood - Des Moines Clinic
  - Des Moines, Iowa, Forenede Stater, 50314
    - UI Health Care Mission Cancer and Blood - Laurel Clinic
  - Fort Dodge, Iowa, Forenede Stater, 50501
    - McFarland Clinic - Trinity Cancer Center
  - Fort Dodge, Iowa, Forenede Stater, 50501
    - UI Healthcare Mission Cancer and Blood - Fort Dodge
  - Jefferson, Iowa, Forenede Stater, 50129
    - McFarland Clinic - Jefferson
  - Marshalltown, Iowa, Forenede Stater, 50158
    - McFarland Clinic - Marshalltown
  - Sioux City, Iowa, Forenede Stater, 51101
    - Siouxland Regional Cancer Center
  - West Des Moines, Iowa, Forenede Stater, 50266-7700
    - Methodist West Hospital
  - West Des Moines, Iowa, Forenede Stater, 50266
    - Mercy Medical Center-West Lakes
- Kansas
  - Chanute, Kansas, Forenede Stater, 66720
    - Cancer Center of Kansas - Chanute
  - Coffeyville, Kansas, Forenede Stater, 67337
    - Coffeyville Regional Medical Center
  - 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
    - Central Care Cancer Center - Garden City
  - Garden City, Kansas, Forenede Stater, 67846
    - Saint Catherine Hospital
  - Great Bend, Kansas, Forenede Stater, 67530
    - Central Care Cancer Center - Great Bend
  - Great Bend, Kansas, Forenede Stater, 67530
    - Saint Rose Ambulatory and Surgery Center
  - Hays, Kansas, Forenede Stater, 67601
    - HaysMed
  - Independence, Kansas, Forenede Stater, 67301
    - Cancer Center of Kansas-Independence
  - Kansas City, Kansas, Forenede Stater, 66160
    - University of Kansas Cancer Center
  - Kansas City, Kansas, Forenede Stater, 66112
    - University of Kansas Cancer Center-West
  - Kingman, Kansas, Forenede Stater, 67068
    - Cancer Center of Kansas-Kingman
  - Lawrence, Kansas, Forenede Stater, 66044
    - Lawrence Memorial Hospital
  - Lenexa, Kansas, Forenede Stater, 66219
    - Kansas Institute of Medicine Cancer and Blood Center
  - Lenexa, Kansas, Forenede Stater, 66219
    - Minimally Invasive Surgery Hospital
  - Liberal, Kansas, Forenede Stater, 67905
    - Cancer Center of Kansas-Liberal
  - Manhattan, Kansas, Forenede Stater, 66502
    - Cancer Center of Kansas-Manhattan
  - McPherson, Kansas, Forenede Stater, 67460
    - Cancer Center of Kansas - McPherson
  - Newton, Kansas, Forenede Stater, 67114
    - Cancer Center of Kansas - Newton
  - Olathe, Kansas, Forenede Stater, 66061
    - The University of Kansas Cancer Center - Olathe
  - Overland Park, Kansas, Forenede Stater, 66210
    - University of Kansas Cancer Center-Overland Park
  - Overland Park, Kansas, Forenede Stater, 66209
    - Menorah Medical Center
  - Overland Park, Kansas, Forenede Stater, 66213
    - Saint Luke's South Hospital
  - Parsons, Kansas, Forenede Stater, 67357
    - Cancer Center of Kansas - Parsons
  - Pittsburg, Kansas, Forenede Stater, 66762
    - Mercy Hospital Pittsburg
  - Pratt, Kansas, Forenede Stater, 67124
    - Cancer Center of Kansas - Pratt
  - Salina, Kansas, Forenede Stater, 67401
    - Salina Regional Health Center
  - Salina, Kansas, Forenede Stater, 67401
    - Cancer Center of Kansas - Salina
  - Topeka, Kansas, Forenede Stater, 66606
    - University of Kansas Health System Saint Francis Campus
  - Wellington, Kansas, Forenede Stater, 67152
    - Cancer Center of Kansas - Wellington
  - Westwood, Kansas, Forenede Stater, 66205
    - University of Kansas Hospital-Westwood Cancer Center
  - Wichita, Kansas, Forenede Stater, 67214
    - Ascension Via Christi Hospitals Wichita
  - Wichita, Kansas, Forenede Stater, 67208
    - Cancer Center of Kansas-Wichita Medical Arts Tower
  - Wichita, Kansas, Forenede Stater, 67214
    - Cancer Center of Kansas - Wichita
  - Wichita, Kansas, Forenede Stater, 67208
    - Associates In Womens Health
  - Winfield, Kansas, Forenede Stater, 67156
    - Cancer Center of Kansas - Winfield
- Kentucky
  - Bardstown, Kentucky, Forenede Stater, 40004
    - Flaget Memorial Hospital
  - Corbin, Kentucky, Forenede Stater, 40701
    - Baptist Health Corbin
  - Corbin, Kentucky, Forenede Stater, 40701
    - Commonwealth Cancer Center-Corbin
  - Crestview Hills, Kentucky, Forenede Stater, 41017
    - Oncology Hematology Care Inc-Crestview
  - Elizabethtown, Kentucky, Forenede Stater, 42701
    - Baptist Health Hardin
  - Lexington, Kentucky, Forenede Stater, 40504
    - Saint Joseph Radiation Oncology Resource Center
  - Lexington, Kentucky, Forenede Stater, 40509
    - Saint Joseph Hospital East
  - Lexington, Kentucky, Forenede Stater, 40503
    - Baptist Health Lexington
  - London, Kentucky, Forenede Stater, 40741
    - Saint Joseph London
  - Louisville, Kentucky, Forenede Stater, 40202
    - The James Graham Brown Cancer Center at University of Louisville
  - Louisville, Kentucky, Forenede Stater, 40202
    - Jewish Hospital
  - Louisville, Kentucky, Forenede Stater, 40245
    - UofL Health Medical Center Northeast
  - Louisville, Kentucky, Forenede Stater, 40207
    - Baptist Health Louisville
  - Louisville, Kentucky, Forenede Stater, 40215
    - Saints Mary and Elizabeth Hospital
  - Madisonville, Kentucky, Forenede Stater, 42431
    - Baptist Health Madisonville/Merle Mahr Cancer Center
  - Paducah, Kentucky, Forenede Stater, 42003
    - Baptist Health Paducah
  - Shepherdsville, Kentucky, Forenede Stater, 40165
    - Jewish Hospital Medical Center South
- Maine
  - Augusta, Maine, Forenede Stater, 04330
    - Harold Alfond Center for Cancer Care
  - Bangor, Maine, Forenede Stater, 04401
    - Eastern Maine Medical Center
  - Belfast, Maine, Forenede Stater, 04915
    - MaineHealth Waldo Hospital
  - Biddeford, Maine, Forenede Stater, 04005
    - MaineHealth Maine Medical Center - Biddeford
  - Brewer, Maine, Forenede Stater, 04412
    - Lafayette Family Cancer Center-EMMC
  - Norway, Maine, Forenede Stater, 04268
    - MaineHealth Stephens Hospital
  - Rockport, Maine, Forenede Stater, 04856
    - Penobscot Bay Medical Center
  - Sanford, Maine, Forenede Stater, 04073
    - MaineHealth Cancer Care and IV Therapy - Sanford
  - South Portland, Maine, Forenede Stater, 04106
    - MaineHealth Cancer Care and IV Therapy - South Portland
- Maryland
  - Baltimore, Maryland, Forenede Stater, 21204
    - Greater Baltimore Medical Center
  - Bethesda, Maryland, Forenede Stater, 20889-5600
    - Walter Reed National Military Medical Center
- Massachusetts
  - Boston, Massachusetts, Forenede Stater, 02118
    - Boston Medical Center
  - Burlington, Massachusetts, Forenede Stater, 01805
    - Lahey Hospital and Medical Center
  - Winchester, Massachusetts, Forenede Stater, 01890
    - Beth Israel Deaconess Medical Center/Winchester Center for Cancer Care
- Michigan
  - Adrian, Michigan, Forenede Stater, 49221
    - Hickman Cancer Center
  - Ann Arbor, Michigan, Forenede Stater, 48109
    - University of Michigan Rogel Cancer Center
  - Battle Creek, Michigan, Forenede Stater, 49017
    - Bronson Battle Creek
  - Dearborn, Michigan, Forenede Stater, 48124
    - Corewell Health Dearborn Hospital
  - Detroit, Michigan, Forenede Stater, 48201
    - Wayne State University/Karmanos Cancer Institute
  - Farmington Hills, Michigan, Forenede Stater, 48334
    - Weisberg Cancer Treatment Center
  - Farmington Hills, Michigan, Forenede Stater, 48336
    - Corewell Health Farmington Hills Hospital
  - Grand Rapids, Michigan, Forenede Stater, 49503
    - Trinity Health Grand Rapids Hospital
  - Grand Rapids, Michigan, Forenede Stater, 49503
    - Corewell Health Grand Rapids Hospitals - Butterworth Hospital
  - Grand Rapids, Michigan, Forenede Stater, 49503
    - Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
  - Grosse Pointe, Michigan, Forenede Stater, 48230
    - William Beaumont Hospital-Grosse Pointe
  - Kalamazoo, Michigan, Forenede Stater, 49007
    - West Michigan Cancer Center
  - Kalamazoo, Michigan, Forenede Stater, 49007
    - Bronson Methodist Hospital
  - Kalamazoo, Michigan, Forenede Stater, 49048
    - Beacon Kalamazoo
  - Monroe, Michigan, Forenede Stater, 48162
    - Toledo Clinic Cancer Centers-Monroe
  - Muskegon, Michigan, Forenede Stater, 49444
    - Trinity Health Muskegon Hospital
  - Niles, Michigan, Forenede Stater, 49120
    - Corewell Health Lakeland Hospitals - Niles Hospital
  - Port Huron, Michigan, Forenede Stater, 48060
    - Lake Huron Medical Center
  - Port Huron, Michigan, Forenede Stater, 48060
    - Huron Medical Center PC
  - Reed City, Michigan, Forenede Stater, 49677
    - Corewell Health Reed City Hospital
  - Roseville, Michigan, Forenede Stater, 48066
    - Michigan Cancer Specialists
  - Royal Oak, Michigan, Forenede Stater, 48073
    - Comprehensive Medical Center PLLC
  - Royal Oak, Michigan, Forenede Stater, 48073
    - Oakland Medical Group
  - Royal Oak, Michigan, Forenede Stater, 48067
    - Oakland Colon Rectal Associates
  - Royal Oak, Michigan, Forenede Stater, 48073
    - Hematology Oncology Consultants PC-Royal Oak
  - Royal Oak, Michigan, Forenede Stater, 48073
    - Corewell Health William Beaumont University Hospital
  - Saint Joseph, Michigan, Forenede Stater, 49085
    - Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
  - Saint Joseph, Michigan, Forenede Stater, 49085
    - Corewell Health Lakeland Hospitals - Saint Joseph Hospital
  - Sterling Heights, Michigan, Forenede Stater, 48312
    - Premier Hematology Oncology Care
  - Sterling Heights, Michigan, Forenede Stater, 48314
    - Mitchell Folbe MD PC
  - Traverse City, Michigan, Forenede Stater, 49684
    - Munson Medical Center
  - Troy, Michigan, Forenede Stater, 48084
    - Michigan Institute of Urology-Town Center
  - Troy, Michigan, Forenede Stater, 48085
    - Claudia BR Herke MD PC
  - Troy, Michigan, Forenede Stater, 48098
    - Hematology Oncology Consultants PC-Troy
  - Troy, Michigan, Forenede Stater, 48085
    - Corewell Health Beaumont Troy Hospital
  - Wyoming, Michigan, Forenede Stater, 49519
    - University of Michigan Health - West
- Minnesota
  - Brainerd, Minnesota, Forenede Stater, 56401
    - Essentia Health Saint Joseph's Medical Center
  - Burnsville, Minnesota, Forenede Stater, 55337
    - Fairview Ridges Hospital
  - Coon Rapids, Minnesota, Forenede Stater, 55433
    - Mercy Hospital
  - Duluth, Minnesota, Forenede Stater, 55805
    - Essentia Health Cancer Center
  - Duluth, Minnesota, Forenede Stater, 55805
    - Essentia Health Saint Mary's Medical Center
  - Duluth, Minnesota, Forenede Stater, 55805
    - Miller-Dwan Hospital
  - Edina, Minnesota, Forenede Stater, 55435
    - Fairview Southdale Hospital
  - Fergus Falls, Minnesota, Forenede Stater, 56537
    - Lake Region Healthcare Corporation-Cancer Care
  - Fridley, Minnesota, Forenede Stater, 55432
    - Unity Hospital
  - Hutchinson, Minnesota, Forenede Stater, 55350
    - Hutchinson Area Health Care
  - Maple Grove, Minnesota, Forenede Stater, 55369
    - Fairview Clinics and Surgery Center Maple Grove
  - 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
  - Monticello, Minnesota, Forenede Stater, 55362
    - Monticello Cancer Center
  - New Ulm, Minnesota, Forenede Stater, 56073
    - New Ulm Medical Center
  - Robbinsdale, Minnesota, Forenede Stater, 55422
    - North Memorial Medical Health Center
  - Saint Louis Park, Minnesota, Forenede Stater, 55416
    - Park Nicollet Clinic - Saint Louis Park
  - Saint 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
  - Wyoming, Minnesota, Forenede Stater, 55092
    - Fairview Lakes Medical Center
- Mississippi
  - 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 - Bolivar
  - Bonne Terre, Missouri, Forenede Stater, 63628
    - Parkland Health Center-Bonne Terre
  - Branson, Missouri, Forenede Stater, 65616
    - Cox Cancer Center Branson
  - Cape Girardeau, Missouri, Forenede Stater, 63703
    - Saint Francis Medical Center
  - Cape Girardeau, Missouri, Forenede Stater, 63703
    - Mercy Cancer Center - Cape Girardeau
  - Columbia, Missouri, Forenede Stater, 65212
    - MU Health - University Hospital/Ellis Fischel Cancer Center
  - Independence, Missouri, Forenede Stater, 64057
    - Centerpoint Medical Center LLC
  - Jefferson City, Missouri, Forenede Stater, 65109
    - MU Health Care Goldschmidt Cancer Center
  - Joplin, Missouri, Forenede Stater, 64804
    - Freeman Health System
  - Joplin, Missouri, Forenede Stater, 64804
    - Mercy Hospital Joplin
  - Kansas City, Missouri, Forenede Stater, 64154
    - University of Kansas Cancer Center - North
  - Kansas City, Missouri, Forenede Stater, 64131
    - The University of Kansas Cancer Center-South
  - Kansas City, Missouri, Forenede Stater, 64111
    - Saint Luke's Hospital of Kansas City
  - Kansas City, Missouri, Forenede Stater, 64132
    - Research Medical Center
  - Kansas City, Missouri, Forenede Stater, 64118
    - Heartland Hematology and Oncology Associates Incorporated
  - Kansas City, Missouri, Forenede Stater, 64108
    - University Health Truman Medical Center
  - Lee's Summit, Missouri, Forenede Stater, 64064
    - University of Kansas Cancer Center - Lee's Summit
  - Lee's Summit, Missouri, Forenede Stater, 64086
    - Saint Luke's East - Lee's Summit
  - Liberty, Missouri, Forenede Stater, 64068
    - Liberty Hospital
  - Rolla, Missouri, Forenede Stater, 65401
    - Mercy Clinic-Rolla-Cancer and Hematology
  - Rolla, Missouri, Forenede Stater, 65401
    - Phelps Health Delbert Day Cancer Institute
  - Saint Joseph, Missouri, Forenede Stater, 64506
    - Heartland Regional Medical Center
  - Sainte Genevieve, Missouri, Forenede Stater, 63670
    - Sainte Genevieve County Memorial Hospital
  - Springfield, Missouri, Forenede Stater, 65807
    - CoxHealth South Hospital
  - Springfield, Missouri, Forenede Stater, 65804
    - Mercy Hospital Springfield
  - St Louis, Missouri, Forenede Stater, 63131
    - Missouri Baptist Medical Center
  - St Louis, Missouri, Forenede Stater, 63109
    - Mercy Infusion Center - Chippewa
  - St Louis, Missouri, Forenede Stater, 63141
    - Mercy Hospital Saint Louis
  - St Louis, Missouri, Forenede Stater, 63128
    - Mercy Hospital South
  - Sullivan, Missouri, Forenede Stater, 63080
    - Missouri Baptist Sullivan Hospital
  - Sunset Hills, Missouri, Forenede Stater, 63127
    - BJC Outpatient Center at Sunset Hills
- Montana
  - Anaconda, Montana, Forenede Stater, 59711
    - Community Hospital of Anaconda
  - Billings, Montana, Forenede Stater, 59101
    - Billings Clinic Cancer Center
  - Billings, Montana, Forenede Stater, 59101
    - Saint Vincent Healthcare
  - Billings, Montana, Forenede Stater, 59102
    - Saint Vincent Frontier Cancer Center
  - Bozeman, Montana, Forenede Stater, 59715
    - Bozeman Health Deaconess Hospital
  - Butte, Montana, Forenede Stater, 59701
    - Saint James Community Hospital and Cancer Treatment Center
  - Great Falls, Montana, Forenede Stater, 59405
    - Great Falls Clinic
  - Great Falls, Montana, Forenede Stater, 59405
    - Benefis Sletten Cancer Institute
  - Helena, Montana, Forenede Stater, 59601
    - Saint Peter's Community Hospital
  - Kalispell, Montana, Forenede Stater, 59901
    - Logan Health Medical Center
  - Missoula, Montana, Forenede Stater, 59802
    - Saint Patrick Hospital - Community Hospital
  - Missoula, Montana, Forenede Stater, 59804
    - Community Medical Center
- Nebraska
  - Grand Island, Nebraska, Forenede Stater, 68803
    - Nebraska Cancer Specialists/Oncology Hematology West PC
  - Kearney, Nebraska, Forenede Stater, 68847
    - CHI Health Good Samaritan
  - Kearney, Nebraska, Forenede Stater, 68845
    - Fred and Pamela Buffett Cancer Center - Kearney
  - Lincoln, Nebraska, Forenede Stater, 68510
    - Saint Elizabeth Regional Medical Center
  - Omaha, Nebraska, Forenede Stater, 68198
    - University of Nebraska Medical Center
  - Omaha, Nebraska, Forenede Stater, 68124
    - Alegent Health Bergan Mercy Medical Center
  - Omaha, Nebraska, Forenede Stater, 68122
    - Alegent Health Immanuel Medical Center
  - Omaha, Nebraska, Forenede Stater, 68130
    - Alegent Health Lakeside Hospital
  - Omaha, Nebraska, Forenede Stater, 68131
    - Creighton University Medical Center
  - Omaha, Nebraska, Forenede Stater, 68122
    - Hematology and Oncology Consultants PC
  - Papillion, Nebraska, Forenede Stater, 68046
    - Midlands Community Hospital
- Nevada
  - Carson City, Nevada, Forenede Stater, 89703
    - Carson Tahoe Regional Medical Center
  - 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, 89052
    - Comprehensive Cancer Centers of Nevada-Horizon Ridge
  - Henderson, Nevada, Forenede Stater, 89074
    - Oncology Las Vegas - Henderson
  - Las Vegas, Nevada, Forenede Stater, 89144
    - Summerlin Hospital Medical Center
  - Las Vegas, Nevada, Forenede Stater, 89109
    - Sunrise Hospital and Medical Center
  - Las Vegas, Nevada, Forenede Stater, 89102
    - OptumCare Cancer Care at Charleston
  - 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, 89128
    - OptumCare Cancer Care at MountainView
  - Las Vegas, Nevada, Forenede Stater, 89144
    - Comprehensive Cancer Centers of Nevada - Town Center
  - 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, 89102
    - University Medical Center of Southern Nevada
  - Las Vegas, Nevada, Forenede Stater, 89106
    - Cancer and Blood Specialists-Shadow
  - Las Vegas, Nevada, Forenede Stater, 89109
    - HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
  - Las Vegas, Nevada, Forenede Stater, 89113
    - HealthCare Partners Medical Group Oncology/Hematology-San Martin
  - Las Vegas, Nevada, Forenede Stater, 89121
    - Cancer Therapy and Integrative Medicine
  - Las Vegas, Nevada, Forenede Stater, 89128
    - Cancer and Blood Specialists-Tenaya
  - Las Vegas, Nevada, Forenede Stater, 89128
    - HealthCare Partners Medical Group Oncology/Hematology-Tenaya
  - Las Vegas, Nevada, Forenede Stater, 89148-2405
    - Las Vegas Cancer Center-Medical Center
  - Las Vegas, Nevada, Forenede Stater, 89149
    - HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
  - Las Vegas, Nevada, Forenede Stater, 89128
    - Ann M Wierman MD LTD
  - Las Vegas, Nevada, Forenede Stater, 89102
    - Desert West Surgery
  - Las Vegas, Nevada, Forenede Stater, 89103
    - Hope Cancer Care of Nevada
  - Las Vegas, Nevada, Forenede Stater, 89169
    - University Cancer Center
  - Las Vegas, Nevada, Forenede Stater, 89128
    - Oncology Las Vegas - Tenaya
  - Las Vegas, Nevada, Forenede Stater, 89183
    - OptumCare Cancer Care at Fort Apache
  - Pahrump, Nevada, Forenede Stater, 89048
    - Hope Cancer Care of Nevada-Pahrump
  - Reno, Nevada, Forenede Stater, 89502
    - Renown Regional Medical Center
  - Reno, Nevada, Forenede Stater, 89503
    - Saint Mary's Regional Medical Center
  - Reno, Nevada, Forenede Stater, 89509
    - Radiation Oncology Associates
- New Jersey
  - Brick, New Jersey, Forenede Stater, 08724
    - Ocean University Medical Center
  - Hackensack, New Jersey, Forenede Stater, 07601
    - Hackensack University Medical Center
  - Holmdel, New Jersey, Forenede Stater, 07733
    - Bayshore Community Hospital
  - Manahawkin, New Jersey, Forenede Stater, 08050
    - Southern Ocean County Medical Center
  - Morristown, New Jersey, Forenede Stater, 07960
    - Morristown Medical Center
  - Neptune City, New Jersey, Forenede Stater, 07753
    - Jersey Shore Medical Center
  - Red Bank, New Jersey, Forenede Stater, 07701
    - Riverview Medical Center/Booker Cancer Center
  - Summit, New Jersey, Forenede Stater, 07902
    - Overlook Hospital
- New York
  - Lake Success, New York, Forenede Stater, 11042
    - Northwell Health/Center for Advanced Medicine
  - Middletown, New York, Forenede Stater, 10940
    - Garnet Health Medical Center
  - New York, New York, Forenede Stater, 10032
    - NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
  - Rochester, New York, Forenede Stater, 14642
    - University of Rochester
- North Carolina
  - Asheville, North Carolina, Forenede Stater, 28801
    - Mission Hospital
  - Asheville, North Carolina, Forenede Stater, 28806
    - Messino Cancer Centers
  - Asheville, North Carolina, Forenede Stater, 28803
    - AdventHealth Infusion Center Asheville
  - Charlotte, North Carolina, Forenede Stater, 28204
    - Novant Health Presbyterian Medical Center
  - Charlotte, North Carolina, Forenede Stater, 28207
    - Oncology Specialists of Charlotte
  - Charlotte, North Carolina, Forenede Stater, 28262
    - Southern Oncology Specialists-Charlotte
  - Charlotte, North Carolina, Forenede Stater, 28207
    - Novant Health Carolina Surgical - Randolph
  - Clinton, North Carolina, Forenede Stater, 28328
    - Southeastern Medical Oncology Center-Clinton
  - Clinton, North Carolina, Forenede Stater, 28328
    - Sampson Radiation Oncology
  - Clyde, North Carolina, Forenede Stater, 28721
    - AdventHealth Infusion Center Haywood
  - 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
  - Hendersonville, North Carolina, Forenede Stater, 28791
    - Margaret R Pardee Memorial Hospital
  - Hendersonville, North Carolina, Forenede Stater, 28792
    - AdventHealth Hendersonville
  - Huntersville, North Carolina, Forenede Stater, 28078
    - Novant Health Cancer Institute - Huntersville
  - Huntersville, North Carolina, Forenede Stater, 28078
    - Southern Oncology Specialists-Huntersville
  - Jacksonville, North Carolina, Forenede Stater, 28546
    - Southeastern Medical Oncology Center-Jacksonville
  - Jacksonville, North Carolina, Forenede Stater, 28546
    - Onslow Memorial Hospital
  - Kenansville, North Carolina, Forenede Stater, 28349
    - ECU Health Oncology Kenansville
  - Kinston, North Carolina, Forenede Stater, 28501
    - ECU Health Oncology Kinston
  - Matthews, North Carolina, Forenede Stater, 28105
    - Matthews Radiation Oncology Center
  - Matthews, North Carolina, Forenede Stater, 28105
    - Novant Health Cancer Institute - Matthews
  - Mooresville, North Carolina, Forenede Stater, 28117
    - Novant Health Cancer Institute - Mooresville
  - Richlands, North Carolina, Forenede Stater, 28574
    - ECU Health Oncology Richlands
- North Dakota
  - Fargo, North Dakota, Forenede Stater, 58103
    - Essentia Health Cancer Center-South University Clinic
- Ohio
  - Beavercreek, Ohio, Forenede Stater, 45431
    - Indu and Raj Soin Medical Center
  - Belpre, Ohio, Forenede Stater, 45714
    - Strecker Cancer Center-Belpre
  - Boardman, Ohio, Forenede Stater, 44512
    - Saint Elizabeth Boardman Hospital
  - Centerville, Ohio, Forenede Stater, 45459
    - Miami Valley Hospital South
  - Centerville, Ohio, Forenede Stater, 45459
    - Dayton Physicians LLC-Miami Valley South
  - Chillicothe, Ohio, Forenede Stater, 45601
    - Adena Regional Medical Center
  - Cincinnati, Ohio, Forenede Stater, 45219
    - University of Cincinnati Cancer Center-UC Medical Center
  - Cincinnati, Ohio, Forenede Stater, 45220
    - Good Samaritan Hospital - Cincinnati
  - Cincinnati, Ohio, Forenede Stater, 45242
    - Bethesda North Hospital
  - Cincinnati, Ohio, Forenede Stater, 45242
    - Oncology Hematology Care Inc-Blue Ash
  - Cincinnati, Ohio, Forenede Stater, 45202
    - Oncology Hematology Care Inc-Eden Park
  - Cincinnati, Ohio, Forenede Stater, 45211
    - Oncology Hematology Care Inc-Mercy West
  - Cincinnati, Ohio, Forenede Stater, 45230
    - Oncology Hematology Care Inc-Anderson
  - Cincinnati, Ohio, Forenede Stater, 45236
    - Oncology Hematology Care Inc-Kenwood
  - Cincinnati, Ohio, Forenede Stater, 45247
    - TriHealth Cancer Institute-Westside
  - Cincinnati, Ohio, Forenede Stater, 45255
    - TriHealth Cancer Institute-Anderson
  - Columbus, Ohio, Forenede Stater, 43214
    - Riverside Methodist Hospital
  - Columbus, Ohio, Forenede Stater, 43210
    - Ohio State University Comprehensive Cancer Center
  - Columbus, Ohio, Forenede Stater, 43219
    - The Mark H Zangmeister Center
  - Columbus, Ohio, Forenede Stater, 43214
    - Columbus Oncology and Hematology Associates Inc
  - Columbus, Ohio, Forenede Stater, 43228
    - Doctors Hospital
  - Columbus, Ohio, Forenede Stater, 43215
    - Grant Medical Center
  - Columbus, Ohio, Forenede Stater, 43222
    - Mount Carmel Health Center West
  - Dayton, Ohio, Forenede Stater, 45406
    - Good Samaritan Hospital - Dayton
  - Dayton, Ohio, Forenede Stater, 45409
    - Miami Valley Hospital
  - Dayton, Ohio, Forenede Stater, 45415
    - Miami Valley Hospital North
  - Dayton, Ohio, Forenede Stater, 45415
    - Dayton Physician LLC - Englewood
  - Delaware, Ohio, Forenede Stater, 43015
    - Delaware Health Center-Grady Cancer Center
  - Delaware, Ohio, Forenede Stater, 43015
    - Delaware Radiation Oncology
  - Delaware, Ohio, Forenede Stater, 43015
    - Grady Memorial Hospital
  - Fairfield, Ohio, Forenede Stater, 45014
    - Oncology Hematology Care Inc-Healthplex
  - Findlay, Ohio, Forenede Stater, 45840
    - Blanchard Valley Hospital
  - Findlay, Ohio, Forenede Stater, 45840
    - Armes Family Cancer Center
  - Findlay, Ohio, Forenede Stater, 45840
    - Orion Cancer Care
  - Franklin, Ohio, Forenede Stater, 45005-1066
    - Atrium Medical Center-Middletown Regional Hospital
  - Franklin, Ohio, Forenede Stater, 45005
    - Dayton Physicians LLC-Atrium
  - Greenville, Ohio, Forenede Stater, 45331
    - Wayne Hospital
  - Greenville, Ohio, Forenede Stater, 45331
    - Dayton Physicians LLC-Wayne
  - Kettering, Ohio, Forenede Stater, 45429
    - Kettering Medical Center
  - Kettering, Ohio, Forenede Stater, 45409
    - Greater Dayton Cancer Center
  - Kettering, Ohio, Forenede Stater, 45420
    - First Dayton Cancer Care
  - Lancaster, Ohio, Forenede Stater, 43130
    - Fairfield Medical Center
  - Marietta, Ohio, Forenede Stater, 45750
    - Marietta Memorial Hospital
  - Maumee, Ohio, Forenede Stater, 43537
    - Toledo Clinic Cancer Centers-Maumee
  - Maumee, Ohio, Forenede Stater, 43537
    - Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
  - Mount Vernon, Ohio, Forenede Stater, 43050
    - Knox Community Hospital
  - Newark, Ohio, Forenede Stater, 43055
    - Licking Memorial Hospital
  - Newark, Ohio, Forenede Stater, 43055
    - Newark Radiation Oncology
  - Oregon, Ohio, Forenede Stater, 43616
    - Saint Charles Hospital
  - Perrysburg, Ohio, Forenede Stater, 43551
    - Mercy Health - Perrysburg Hospital
  - Portsmouth, Ohio, Forenede Stater, 45662
    - Southern Ohio Medical Center
  - Sidney, Ohio, Forenede Stater, 45365
    - Dayton Physicians LLC-Wilson
  - Springfield, Ohio, Forenede Stater, 45504
    - Springfield Regional Cancer Center
  - Springfield, Ohio, Forenede Stater, 45504
    - Springfield Regional Medical Center
  - Toledo, Ohio, Forenede Stater, 43623
    - Mercy Health - Saint Anne Hospital
  - Toledo, Ohio, Forenede Stater, 43623
    - Toledo Clinic Cancer Centers-Toledo
  - Troy, Ohio, Forenede Stater, 45373
    - Upper Valley Medical Center
  - Troy, Ohio, Forenede Stater, 45373
    - Dayton Physicians LLC - Troy
  - Warren, Ohio, Forenede Stater, 44484
    - Saint Joseph Warren Hospital
  - West Chester, Ohio, Forenede Stater, 45069
    - University of Cincinnati Cancer Center-West Chester
  - Westerville, Ohio, Forenede Stater, 43081
    - Saint Ann's Hospital
  - Wright-Patterson Air Force Base, Ohio, Forenede Stater, 45433
    - Wright-Patterson Medical Center
  - Youngstown, Ohio, Forenede Stater, 44501
    - Saint Elizabeth Youngstown Hospital
  - Zanesville, Ohio, Forenede Stater, 43701
    - Genesis Healthcare System Cancer Care Center
- Oklahoma
  - Lawton, Oklahoma, Forenede Stater, 73505
    - Cancer Centers of Southwest Oklahoma Research
  - Oklahoma City, Oklahoma, Forenede Stater, 73104
    - University of Oklahoma Health Sciences Center
  - Oklahoma City, Oklahoma, Forenede Stater, 73120
    - Mercy Hospital Oklahoma City
  - Oklahoma City, Oklahoma, Forenede Stater, 73109
    - Integris Southwest Medical Center
  - Oklahoma City, Oklahoma, Forenede Stater, 73142
    - Integris Cancer Institute of Oklahoma
  - Tulsa, Oklahoma, Forenede Stater, 74146
    - Oklahoma Cancer Specialists and Research Institute-Tulsa
- Oregon
  - Baker City, Oregon, Forenede Stater, 97814
    - Saint Alphonsus Cancer Care Center-Baker City
  - Bend, Oregon, Forenede Stater, 97701
    - Saint Charles Health System
  - Clackamas, Oregon, Forenede Stater, 97015
    - Clackamas Radiation Oncology Center
  - Clackamas, Oregon, Forenede Stater, 97015
    - Providence Cancer Institute Clackamas Clinic
  - Coos Bay, Oregon, Forenede Stater, 97420
    - Bay Area Hospital
  - Newberg, Oregon, Forenede Stater, 97132
    - Providence Newberg Medical Center
  - Ontario, Oregon, Forenede Stater, 97914
    - Saint Alphonsus Cancer Care Center-Ontario
  - 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
  - Redmond, Oregon, Forenede Stater, 97756
    - Saint Charles Health System-Redmond
- Pennsylvania
  - Abington, Pennsylvania, Forenede Stater, 19001
    - Jefferson Abington Hospital
  - Beaver, Pennsylvania, Forenede Stater, 15009
    - UPMC-Heritage Valley Health System Beaver
  - Chadds Ford, Pennsylvania, Forenede Stater, 19317
    - Christiana Care Health System-Concord Health Center
  - Danville, Pennsylvania, Forenede Stater, 17822
    - Geisinger Medical Center
  - Greensburg, Pennsylvania, Forenede Stater, 15601
    - UPMC Cancer Centers - Arnold Palmer Pavilion
  - Hazleton, Pennsylvania, Forenede Stater, 18201
    - Geisinger Medical Center-Cancer Center Hazleton
  - Johnstown, Pennsylvania, Forenede Stater, 15901
    - UPMC-Johnstown/John P. Murtha Regional Cancer Center
  - Lewisburg, Pennsylvania, Forenede Stater, 17837
    - Geisinger Medical Oncology-Lewisburg
  - Lewistown, Pennsylvania, Forenede Stater, 17044
    - Lewistown Hospital
  - McKeesport, Pennsylvania, Forenede Stater, 15132
    - UPMC Cancer Center at UPMC McKeesport
  - Moon Township, Pennsylvania, Forenede Stater, 15108
    - UPMC Hillman Cancer Center in Coraopolis
  - Pittsburgh, Pennsylvania, Forenede Stater, 15213
    - UPMC-Magee Womens Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15232
    - University of Pittsburgh Cancer Institute (UPCI)
  - Pittsburgh, Pennsylvania, Forenede Stater, 15232
    - UPMC-Shadyside Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15213
    - UPMC-Presbyterian Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15215
    - UPMC-Saint Margaret
  - Pittsburgh, Pennsylvania, Forenede Stater, 15237
    - UPMC-Passavant Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15243
    - UPMC-Saint Clair Hospital Cancer Center
  - Pottsville, Pennsylvania, Forenede Stater, 17901
    - Geisinger Cancer Services-Pottsville
  - Scranton, Pennsylvania, Forenede Stater, 18510
    - Community Medical Center
  - Selinsgrove, Pennsylvania, Forenede Stater, 17870
    - Geisinger Medical Oncology-Selinsgrove
  - Seneca, Pennsylvania, Forenede Stater, 16346
    - UPMC Cancer Center at UPMC Northwest
  - State College, Pennsylvania, Forenede Stater, 16801
    - Geisinger Medical Group
  - Uniontown, Pennsylvania, Forenede Stater, 15401
    - UPMC Uniontown Hospital Radiation Oncology
  - Washington, Pennsylvania, Forenede Stater, 15301
    - UPMC Washington Hospital Radiation Oncology
  - West Reading, Pennsylvania, Forenede Stater, 19611
    - Reading Hospital
  - Wilkes-Barre, Pennsylvania, Forenede Stater, 18711
    - Geisinger Wyoming Valley/Henry Cancer Center
  - Williamsport, Pennsylvania, Forenede Stater, 17701
    - UPMC Susquehanna
- South Carolina
  - Anderson, South Carolina, Forenede Stater, 29621
    - AnMed Health Cancer Center
  - Charleston, South Carolina, Forenede Stater, 29401
    - Roper Hospital
  - Charleston, South Carolina, Forenede Stater, 29406
    - Lowcountry Hematology Oncology PA-North Charleston
  - Charleston, South Carolina, Forenede Stater, 29414
    - Bon Secours Saint Francis Hospital
  - Charleston, South Carolina, Forenede Stater, 29403
    - Charleston Oncology - Roper
  - Charleston, South Carolina, Forenede Stater, 29414
    - Charleston Oncology - Saint Francis
  - Charleston, South Carolina, Forenede Stater, 29414
    - Lowcountry Oncology Associates - West Ashley
  - Gaffney, South Carolina, Forenede Stater, 29341
    - Gibbs Cancer Center-Gaffney
  - Greenville, South Carolina, Forenede Stater, 29607
    - Saint Francis Cancer Center
  - Greenville, South Carolina, Forenede Stater, 29601
    - Saint Francis Hospital
  - Greer, South Carolina, Forenede Stater, 29651
    - Gibbs Cancer Center-Pelham
  - Mt. Pleasant, South Carolina, Forenede Stater, 29464
    - Lowcountry Oncology Associates - Mount Pleasant
  - Spartanburg, South Carolina, Forenede Stater, 29303
    - Spartanburg Medical Center
  - Union, South Carolina, Forenede Stater, 29379
    - SMC Center for Hematology Oncology Union
- South Dakota
  - Rapid City, South Dakota, Forenede Stater, 57701
    - Rapid City Regional Hospital
- Tennessee
  - Bristol, Tennessee, Forenede Stater, 37620
    - Wellmont Medical Associates Oncology and Hematology-Bristol
  - Bristol, Tennessee, Forenede Stater, 37620
    - Bristol Regional Medical Center
  - Chattanooga, Tennessee, Forenede Stater, 37404
    - Memorial Hospital
  - Hixson, Tennessee, Forenede Stater, 37343
    - Pulmonary Medicine Center of Chattanooga-Hixson
  - Johnson City, Tennessee, Forenede Stater, 37604
    - Wellmont Medical Associates Oncology and Hematology-Johnson City
  - Kingsport, Tennessee, Forenede Stater, 37660
    - Ballad Health Cancer Care - Kingsport
  - Kingsport, Tennessee, Forenede Stater, 37660
    - Wellmont Holston Valley Hospital and Medical Center
  - Ooltewah, Tennessee, Forenede Stater, 37363
    - Memorial GYN Plus
- Texas
  - Bryan, Texas, Forenede Stater, 77802
    - Saint Joseph Regional Cancer Center
- Utah
  - American Fork, Utah, Forenede Stater, 84003
    - American Fork Hospital / Huntsman Intermountain Cancer Center
  - Cedar City, Utah, Forenede Stater, 84720
    - Sandra L Maxwell Cancer Center
  - Farmington, Utah, Forenede Stater, 84025
    - Farmington Health Center
  - Logan, Utah, Forenede Stater, 84321
    - Logan Regional Hospital
  - Murray, Utah, Forenede Stater, 84107
    - Intermountain Medical Center
  - Ogden, Utah, Forenede Stater, 84403
    - McKay-Dee Hospital Center
  - Provo, Utah, Forenede Stater, 84604
    - Utah Valley Regional Medical Center
  - Riverton, Utah, Forenede Stater, 84065
    - Riverton Hospital
  - Salt Lake City, Utah, Forenede Stater, 84112
    - Huntsman Cancer Institute/University of Utah
  - Salt Lake City, Utah, Forenede Stater, 84106
    - Utah Cancer Specialists-Salt Lake City
  - Salt Lake City, Utah, Forenede Stater, 84143
    - LDS Hospital
  - South Jordan, Utah, Forenede Stater, 84009
    - South Jordan Health Center
  - St. George, Utah, Forenede Stater, 84770
    - Saint George Regional Medical Center
- Virginia
  - Bristol, Virginia, Forenede Stater, 24201
    - Ballad Health Cancer Care - Bristol
  - Norton, Virginia, Forenede Stater, 24273
    - Ballad Health Cancer Care - Norton
- 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, 98004
    - Overlake Medical Center
  - Bellevue, Washington, Forenede Stater, 98005
    - Swedish Cancer Institute-Eastside Oncology Hematology
  - Bellingham, Washington, Forenede Stater, 98225
    - PeaceHealth Saint Joseph Medical Center
  - Burien, Washington, Forenede Stater, 98166
    - Highline Medical Center-Main Campus
  - Centralia, Washington, Forenede Stater, 98531
    - Providence Regional Cancer System-Centralia
  - Edmonds, Washington, Forenede Stater, 98026
    - Swedish Cancer Institute-Edmonds
  - Enumclaw, Washington, Forenede Stater, 98022
    - Saint Elizabeth Hospital
  - Everett, Washington, Forenede Stater, 98201
    - Providence Regional Cancer Partnership
  - Federal Way, Washington, Forenede Stater, 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
    - Northwest Cancer Clinic
  - 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
  - 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
  - Renton, Washington, Forenede Stater, 98055
    - Valley 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, 98122
    - Swedish Medical Center-First Hill
  - Seattle, Washington, Forenede Stater, 98112
    - Kaiser Permanente Washington
  - Seattle, Washington, Forenede Stater, 98104
    - Minor and James Medical PLLC
  - Seattle, Washington, Forenede Stater, 98104
    - Pacific Gynecology Specialists
  - Sedro-Woolley, Washington, Forenede Stater, 98284
    - PeaceHealth United General Medical Center
  - Shelton, Washington, Forenede Stater, 98584
    - Providence Regional Cancer System-Shelton
  - Silverdale, Washington, Forenede Stater, 98383
    - Saint Joseph Medical Center Hematology and Oncology - Silverdale
  - Spokane, Washington, Forenede Stater, 99204
    - MultiCare Deaconess Cancer and Blood Specialty Center - Downtown
  - Spokane, Washington, Forenede Stater, 99218
    - MultiCare Deaconess Cancer and Blood Specialty Center - North
  - Spokane Valley, Washington, Forenede Stater, 99216
    - MultiCare Deaconess Cancer and Blood Specialty Center - Valley
  - Tacoma, Washington, Forenede Stater, 98405
    - Northwest Medical Specialties PLLC
  - Tacoma, Washington, Forenede Stater, 98405
    - 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
  - Vancouver, Washington, Forenede Stater, 98664
    - PeaceHealth Southwest Medical Center
  - Walla Walla, Washington, Forenede Stater, 99362
    - Providence Saint Mary Regional Cancer Center
  - Yakima, Washington, Forenede Stater, 98902
    - North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
  - Yelm, Washington, Forenede Stater, 98597
    - Providence Regional Cancer System-Yelm
- Wisconsin
  - Burlington, Wisconsin, Forenede Stater, 53105
    - Aurora Cancer Care-Southern Lakes VLCC
  - Fond du Lac, Wisconsin, Forenede Stater, 54937
    - Aurora Health Center-Fond du Lac
  - Germantown, Wisconsin, Forenede Stater, 53022
    - Aurora Health Care Germantown Health Center
  - Grafton, Wisconsin, Forenede Stater, 53024
    - Aurora Cancer Care-Grafton
  - Green Bay, Wisconsin, Forenede Stater, 54311
    - Aurora BayCare Medical Center
  - Johnson Creek, Wisconsin, Forenede Stater, 53038
    - University of Wisconsin Carbone Cancer Center - Johnson Creek
  - Kenosha, Wisconsin, Forenede Stater, 53142
    - Aurora Cancer Care-Kenosha South
  - La Crosse, Wisconsin, Forenede Stater, 54601
    - Gundersen Lutheran Medical Center
  - Madison, Wisconsin, Forenede Stater, 53792
    - University of Wisconsin Carbone Cancer Center - University Hospital
  - Marinette, Wisconsin, Forenede Stater, 54143
    - Aurora Bay Area Medical Group-Marinette
  - Marinette, Wisconsin, Forenede Stater, 54143
    - Bay Area Medical Center
  - Milwaukee, Wisconsin, Forenede Stater, 53226
    - Medical College of Wisconsin
  - Milwaukee, Wisconsin, Forenede Stater, 53209
    - Aurora Cancer Care-Milwaukee
  - Milwaukee, Wisconsin, Forenede Stater, 53215
    - Aurora Saint Luke's Medical Center
  - Milwaukee, Wisconsin, Forenede Stater, 53233
    - Aurora Sinai Medical Center
  - 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
  - Oshkosh, Wisconsin, Forenede Stater, 54904
    - Vince Lombardi Cancer Clinic - Oshkosh
  - Racine, Wisconsin, Forenede Stater, 53406
    - Aurora Cancer Care-Racine
  - Sheboygan, Wisconsin, Forenede Stater, 53081
    - Vince Lombardi Cancer Clinic-Sheboygan
  - Summit, Wisconsin, Forenede Stater, 53066
    - Aurora Medical Center in Summit
  - Two Rivers, Wisconsin, Forenede Stater, 54241
    - Vince Lombardi Cancer Clinic-Two Rivers
  - Waukesha, Wisconsin, Forenede Stater, 53188
    - UW Cancer Center at ProHealth Care
  - Waukesha, Wisconsin, Forenede Stater, 53188
    - ProHealth Waukesha Memorial Hospital
  - Wauwatosa, Wisconsin, Forenede Stater, 53226
    - Aurora Cancer Care-Milwaukee West
  - West Allis, Wisconsin, Forenede Stater, 53227
    - Aurora West Allis Medical Center
- Wyoming
  - Cheyenne, Wyoming, Forenede Stater, 82001
    - Cheyenne Regional Medical Center-West
  - Cody, Wyoming, Forenede Stater, 82414
    - Big Horn Basin Cancer Center
  - Cody, Wyoming, Forenede Stater, 82414
    - Billings Clinic-Cody
  - Sheridan, Wyoming, Forenede Stater, 82801
    - Welch Cancer Center

Deltagelseskriterier

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

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Beskrivelse

Inklusionskriterier:

TRIN 1: REGISTRERING
Patienter skal have histologisk eller cytologisk bekræftet stadium IV eller ikke-operabelt stadium III BRAF V600E eller BRAF V600K mutant melanom
Patienter skal have BRAF V600E eller BRAF V600K mutation identificeret af et Clinical Laboratory Improvement Amendments (CLIA)-certificeret laboratorium; acceptable analytiske teknikker omfatter, men er ikke begrænset til, DNA-sekventering, pyrosequencing, polymerasekædereaktion (PCR), smeltepunktsassays og immunhistokemi
Kontrastforstærket computertomografi (CT)-scanninger af nakke, bryst, mave og bækken er påkrævet; en helkropspositronemissionstomografi (PET)/CT-scanning med diagnostiske kvalitetsbilleder og intravenøs iodholdig kontrast kan anvendes i stedet for en kontrastforstærket CT af nakke, bryst, mave og bækken; kontrast kan udelades, hvis den behandlende investigator mener, at eksponering for kontrast udgør en overdreven risiko for patienten; patienter skal have målbar sygdom i henhold til responsevalueringskriterier i solide tumorer (RECIST) 1.1; alle målbare læsioner skal vurderes inden for 28 dage før registrering; test til vurdering af ikke-målbar sygdom skal udføres inden for 42 dage før registrering; al sygdom skal vurderes og dokumenteres på Baseline Tumor Assessment Form (RECIST 1.1)
Patienter med en anamnese med hjernemetastaser er kvalificerede, hvis patienten er asymptomatisk uden resterende neurologisk dysfunktion og ikke har modtaget enzymreducerende antiepileptika eller kortikosteroider i mindst 7 dage før registrering
Patienterne skal være >= 18 år
Absolut neutrofiltal (ANC) >= 1.200/ul (opnået inden for 28 dage før registrering)
Blodplader >= 100.000/ul (opnået inden for 28 dage før registrering)
Hæmoglobin >= 9 g/dL (opnået inden for 28 dage før registrering)
Total bilirubin =< 1,5 x institutionel øvre normalgrænse (IULN) (eller =< 2,5 x øvre grænse for normal [ULN] med Gilberts syndrom) (opnået inden for 28 dage før registrering)
Aspartataminotransferase (AST) og alaninaminotransferase (ALT) =< 2,5 x IULN (eller < 5 x IULN for patienter med kendte levermetastaser) (opnået inden for 28 dage før registrering)
Serumalbumin >= 2,5 g/dL (opnået inden for 28 dage før registrering)
Serumkreatinin =< 1,5 mg/dL ELLER målt eller beregnet kreatininclearance >= 50 ml/min; kreatininmålinger skal indhentes inden for 28 dage før registrering
Patienter skal have laktatdehydrogenase (LDH) opnået inden for 28 dage før registrering for at få oplysninger om basislinjestratifikation
Patienter skal have en venstre ventrikulær ejektionsfraktion (LVEF) >= institutionel nedre normalgrænse (ILLN) ved ekkokardiogram (ECHO) eller multi gated acquisition scan (MUGA) inden for 28 dage før registrering
Patienterne skal have korrigeret QT (QTc) =< 480 msek ved elektrokardiogram (EKG) (korrigeret ved hjælp af Bazetts formel) inden for 28 dage før registrering
Patienter skal kunne tage oral medicin; patienter må ikke have nogen svækkelse af mave-tarm-funktionen eller mave-tarm-sygdom, som væsentligt kan ændre absorptionen af protokolbehandling (f. ulcerosa, ukontrolleret kvalme, opkastning, diarré, malabsorptionssyndrom eller tyndtarmsresektion)
Patienter, der modtager antikoagulationsbehandling, får lov til at deltage med international normaliseret ratio (INR) etableret inden for det terapeutiske område
Patienter med kendt human immundefektvirus (HIV) kan være berettigede, forudsat at de opfylder følgende yderligere kriterier:
- Cluster of differentiation (CD)4-celler >= 500/uL
- Serum HIV viral belastning på < 25.000 IE/ml
- Ingen nuværende antiretroviral behandling
  - Prøver skal indhentes inden for 28 dage før registrering; patienter, der er HIV-positive (+) og ikke opfylder alle disse kriterier, er ikke kvalificerede til denne undersøgelse (HIV/hepatitis-test er ikke påkrævet for patienter uden kendt infektion)
Forstudiehistorie og fysisk skal indhentes 28 dage før tilmelding
Patienter skal have en dermatologisk undersøgelse foretaget inden for 28 dage før registrering for at opnå baseline-måling; undersøgelse, der skal udføres af behandlende læge eller udpeget hudlæge
Patienter skal have Zubrod præstationsstatus på 0, 1 eller 2
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; undtagelse: patienter med kendt historie af tyktarmskræft, kræft i bugspytkirtlen eller enhver kræft, der vides at rumme en aktiverende RAS-mutation, er ikke kvalificerede uanset stadie eller tidspunkt siden diagnosen
Patienter skal tilbydes mulighed for at deltage i prøvebank
Patienter med kutane eller overfladiske læsioner, der ikke kræver billeddiagnostisk vejledning til biopsi, skal være villige til at gennemgå biopsier til vævsindsendelse og blodprøvetagning til translationel medicin
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
Som en del af registreringsprocessen for Oncology Patient Enrollment Network (OPEN) 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 2: RANDOMISERING
Efter at have afsluttet en behandlingscyklus vil patienter blive registreret til randomisering mellem intermitterende og kontinuerlig dosering, forudsat at de var berettiget til den indledende trin 1-registrering og opfylder følgende kriterier
Patienter skal registreres til trin 2: randomisering inden for +/- 5 dage efter start af cyklus 2; patienter MÅ IKKE registreres før dag 56 sygdomsvurdering

Ekskluderingskriterier:

Patienter må ikke have modtaget en tidligere BRAF eller mitogen-aktiveret proteinkinase kinase (MEK) hæmmer
Patienter må ikke have modtaget noget anticancerlægemiddel inden for 28 dage før registrering og må ikke have modtaget nogen nitrosoureas eller mitomycin C inden for 42 dage før registrering
Patienter må ikke have modtaget nogen større operation eller immunterapi inden for 28 dage før registrering
Patienter må ikke have nogen uafklaret toksicitet, der er større end National Cancer Institute (NCI)-CTCAE version (v) 4.0 grad 1 fra tidligere anti-cancerbehandling, undtagen alopeci inden for 7 dage før registrering
Patienter med kendt historie eller aktuelle tegn på retinal veneokklusion (RVO) eller central serøs retinopati (CSR) er ikke kvalificerede:
- Anamnese med RVO eller CSR, eller prædisponerende faktorer for RVO eller CSR (f.eks. ukontrolleret glaukom eller okulær hypertension, ukontrolleret systemisk sygdom, såsom hypertension, diabetes mellitus, eller historie med hyperviskositet eller hyperkoagulabilitetssyndrom)
- Synlig retinal patologi vurderet ved oftalmisk undersøgelse, der betragtes som en risikofaktor for RVO eller CSR såsom:
  - Bevis på ny optisk skive-cupping
  - Bevis på nye synsfeltdefekter
  - Intraokulært tryk > 21 mmHg
- BEMÆRK: oftalmisk undersøgelse er påkrævet for alle patienter; eksamen skal være opnået inden for 28 dage før tilmelding
Patienter må ikke have en historie med pneumonitis eller interstitiel lungesygdom
Patienter må ikke have nogen grad II/III/IV hjertesygdom som defineret af New York Heart Associations kriterier (dvs. patienter med hjertesygdom, der resulterer i markant begrænsning af fysisk aktivitet eller resulterer i manglende evne til at udføre fysisk aktivitet uden ubehag). ustabil angina pectoris, myokardieinfarkt inden for 6 måneder eller alvorlig ukontrolleret hjertearytmi; abnorm hjerteklapmorfologi (>= grad 2) dokumenteret ved ekkokardiogram (personer med grad 1 abnormiteter [dvs. mild regurgitation/stenose]) kan indgå i undersøgelsen; patienter med en anamnese med atrieflimren skal have kontrolleret atrieflimren i mindst 30 dage før registrering
Patienter med kendt hepatitis B eller hepatitis C er ikke berettigede, uanset samtidig antiretroviral behandling eller nuværende viral belastning
Patienter må ikke være gravide eller ammende på grund af risikoen for fosterskader; kvinder/mænd med reproduktionspotentiale skal have accepteret at bruge en effektiv præventionsmetode; 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 oophorektomi eller bilateral tubal ligering; men hvis en tidligere cølibatpatient på noget tidspunkt vælger at blive heteroseksuelt aktiv i løbet af tidsperioden for brug af præventionsforanstaltninger, der er beskrevet i protokollen, er han/hun ansvarlig for at påbegynde præventionsforanstaltninger; hormonel prævention er ikke tilladt på grund af lægemiddelinteraktioner, som kan gøre hormonelle præventionsmidler ineffektive
Patienter må ikke have en utvetydig sygdomsprogression (af RECIST v1.1) under den første cyklus; patienter skal have sygdomsbedømt ved hjælp af samme metode som baseline inden for +/- 5 dage fra dag 56 planlagt vurdering (mellem dag 51-55 i cyklus 1 eller dag 1-5 i cyklus 2); al sygdom skal vurderes og dokumenteres på opfølgende tumorvurderingsskema (RECIST 1.1)

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

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

Antal våben

Våben og indgreb

Deltagergruppe / Arm	Intervention / Behandling
Eksperimentel: Arm I (kontinuerlig dosering) Patienterne får dabrafenib PO BID og trametinib PO QD på dag 1-56 i hver cyklus. Cykler gentages hver 56. dag i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienterne gennemgår også PET/CT- eller CT-scanninger i uge 1 af cyklus 2 og efter opfølgning uden behandling før progression. Derudover gennemgår patienter blodprøvetagning, ECHO eller MUGA på undersøgelse.	Medicin: Dabrafenibmesylat Givet PO Andre navne: Dabrafenib Methansulfonat GSK2118436 Methansulfonatsalt GSK2118436B Tafinlar Medicin: Trametinib Dimethyl Sulfoxide Givet PO Andre navne: Mekinist Meqsel Spexotras Procedure: Bioprøvesamling Gennemgå blodprøvetagning Andre navne: Biologisk prøvesamling Bioprøve indsamlet Prøvesamling Prøvekollektion Procedure: Multigated Acquisition Scan Gennemgå MUGA Andre navne: Blood Pool Scan Ligevægtsradionuklidangiografi Gated Blood Pool Imaging MUGA Radionuklid ventrikulografi RNVG SYMA-scanning Synkroniseret Multigated Acquisition Scanning MUGA Scan Multi-Gated Acquisition Scan Radionuklid Ventrikulogram Scan Gated Heart Pool Scan RNV Scan Procedure: Positron emissionstomografi Gennemgå PET/CT Andre navne: Medicinsk billeddannelse, Positron Emission Tomografi KÆLEDYR PET-scanning Positron Emission Tomografi Scan Positron-emissionstomografi PT Positron emissionstomografi (procedure) Procedure: Computertomografi Gennemgå CT eller PET/CT Andre navne: CT KAT CAT-scanning Beregnet aksial tomografi Computerstyret aksial tomografi Computerstyret tomografi CT-scanning tomografi Computerstyret aksial tomografi (procedure) Computerstyret tomografi (CT) scanning Diagnostisk CAT -scanning Diagnostic CAT Scan Service Type Procedure: Ekkokardiografitest Gennemgå Echo Andre navne: Ekkokardiografi EC
Eksperimentel: Arm II (intermitterende dosering) Patienterne modtager dabrafenib PO BID og trametinib PO QD på dag 1-7 og 29-56 i hver cyklus. Cykler gentages hver 56. dag i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienterne gennemgår også PET/CT- eller CT-scanninger i uge 1 af cyklus 2 og efter opfølgning uden behandling før progression. Derudover gennemgår patienter blodprøvetagning, ECHO eller MUGA på undersøgelse.	Medicin: Dabrafenibmesylat Givet PO Andre navne: Dabrafenib Methansulfonat GSK2118436 Methansulfonatsalt GSK2118436B Tafinlar Medicin: Trametinib Dimethyl Sulfoxide Givet PO Andre navne: Mekinist Meqsel Spexotras Procedure: Bioprøvesamling Gennemgå blodprøvetagning Andre navne: Biologisk prøvesamling Bioprøve indsamlet Prøvesamling Prøvekollektion Procedure: Multigated Acquisition Scan Gennemgå MUGA Andre navne: Blood Pool Scan Ligevægtsradionuklidangiografi Gated Blood Pool Imaging MUGA Radionuklid ventrikulografi RNVG SYMA-scanning Synkroniseret Multigated Acquisition Scanning MUGA Scan Multi-Gated Acquisition Scan Radionuklid Ventrikulogram Scan Gated Heart Pool Scan RNV Scan Procedure: Positron emissionstomografi Gennemgå PET/CT Andre navne: Medicinsk billeddannelse, Positron Emission Tomografi KÆLEDYR PET-scanning Positron Emission Tomografi Scan Positron-emissionstomografi PT Positron emissionstomografi (procedure) Procedure: Computertomografi Gennemgå CT eller PET/CT Andre navne: CT KAT CAT-scanning Beregnet aksial tomografi Computerstyret aksial tomografi Computerstyret tomografi CT-scanning tomografi Computerstyret aksial tomografi (procedure) Computerstyret tomografi (CT) scanning Diagnostisk CAT -scanning Diagnostic CAT Scan Service Type Procedure: Ekkokardiografitest Gennemgå Echo Andre navne: Ekkokardiografi EC

Deltagergruppe / Arm

Intervention / Behandling

Eksperimentel: Arm I (kontinuerlig dosering)

Patienterne får dabrafenib PO BID og trametinib PO QD på dag 1-56 i hver cyklus. Cykler gentages hver 56. dag i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienterne gennemgår også PET/CT- eller CT-scanninger i uge 1 af cyklus 2 og efter opfølgning uden behandling før progression. Derudover gennemgår patienter blodprøvetagning, ECHO eller MUGA på undersøgelse.

Medicin: Dabrafenibmesylat

Givet PO

Andre navne:

Dabrafenib Methansulfonat
GSK2118436 Methansulfonatsalt
GSK2118436B
Tafinlar

Medicin: Trametinib Dimethyl Sulfoxide

Givet PO

Andre navne:

Mekinist
Meqsel
Spexotras

Procedure: Bioprøvesamling

Gennemgå blodprøvetagning

Andre navne:

Biologisk prøvesamling
Bioprøve indsamlet
Prøvesamling
Prøvekollektion

Procedure: Multigated Acquisition Scan

Gennemgå MUGA

Andre navne:

Blood Pool Scan
Ligevægtsradionuklidangiografi
Gated Blood Pool Imaging
MUGA
Radionuklid ventrikulografi
RNVG
SYMA-scanning
Synkroniseret Multigated Acquisition Scanning
MUGA Scan
Multi-Gated Acquisition Scan
Radionuklid Ventrikulogram Scan
Gated Heart Pool Scan
RNV Scan

Procedure: Positron emissionstomografi

Gennemgå PET/CT

Andre navne:

Medicinsk billeddannelse, Positron Emission Tomografi
KÆLEDYR
PET-scanning
Positron Emission Tomografi Scan
Positron-emissionstomografi
PT
Positron emissionstomografi (procedure)

Procedure: Computertomografi

Gennemgå CT eller PET/CT

Andre navne:

CT
KAT
CAT-scanning
Beregnet aksial tomografi
Computerstyret aksial tomografi
Computerstyret tomografi
CT-scanning
tomografi
Computerstyret aksial tomografi (procedure)
Computerstyret tomografi (CT) scanning
Diagnostisk CAT -scanning
Diagnostic CAT Scan Service Type

Procedure: Ekkokardiografitest

Gennemgå Echo

Andre navne:

Ekkokardiografi
EC

Eksperimentel: Arm II (intermitterende dosering)

Patienterne modtager dabrafenib PO BID og trametinib PO QD på dag 1-7 og 29-56 i hver cyklus. Cykler gentages hver 56. dag i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienterne gennemgår også PET/CT- eller CT-scanninger i uge 1 af cyklus 2 og efter opfølgning uden behandling før progression. Derudover gennemgår patienter blodprøvetagning, ECHO eller MUGA på undersøgelse.

Medicin: Dabrafenibmesylat

Givet PO

Andre navne:

Dabrafenib Methansulfonat
GSK2118436 Methansulfonatsalt
GSK2118436B
Tafinlar

Medicin: Trametinib Dimethyl Sulfoxide

Givet PO

Andre navne:

Mekinist
Meqsel
Spexotras

Procedure: Bioprøvesamling

Gennemgå blodprøvetagning

Andre navne:

Biologisk prøvesamling
Bioprøve indsamlet
Prøvesamling
Prøvekollektion

Procedure: Multigated Acquisition Scan

Gennemgå MUGA

Andre navne:

Blood Pool Scan
Ligevægtsradionuklidangiografi
Gated Blood Pool Imaging
MUGA
Radionuklid ventrikulografi
RNVG
SYMA-scanning
Synkroniseret Multigated Acquisition Scanning
MUGA Scan
Multi-Gated Acquisition Scan
Radionuklid Ventrikulogram Scan
Gated Heart Pool Scan
RNV Scan

Procedure: Positron emissionstomografi

Gennemgå PET/CT

Andre navne:

Medicinsk billeddannelse, Positron Emission Tomografi
KÆLEDYR
PET-scanning
Positron Emission Tomografi Scan
Positron-emissionstomografi
PT
Positron emissionstomografi (procedure)

Procedure: Computertomografi

Gennemgå CT eller PET/CT

Andre navne:

CT
KAT
CAT-scanning
Beregnet aksial tomografi
Computerstyret aksial tomografi
Computerstyret tomografi
CT-scanning
tomografi
Computerstyret aksial tomografi (procedure)
Computerstyret tomografi (CT) scanning
Diagnostisk CAT -scanning
Diagnostic CAT Scan Service Type

Procedure: Ekkokardiografitest

Gennemgå Echo

Andre navne:

Ekkokardiografi
EC

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Progressionsfri overlevelse (PFS) Tidsramme: Målt fra dato for randomisering, vurderet op til 5 år	Test af overlegenheden af intermitterende dosering af dabrafenib og trametinib sammenlignet med kontinuerlig dosering med disse to samme midler vil være baseret på progressionsfri overlevelse. Stratificerede Cox-regressionsmodeller stratificeret efter stratifikationsfaktorer vil blive brugt til alle analyser.	Målt fra dato for randomisering, vurderet op til 5 år

Sekundære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Samlet overlevelse Tidsramme: Op til 5 år	Samlet overlevelse mellem patienter på hver arm og overlevelse efter progression vil blive sammenlignet ved hjælp af Cox-regressionsmodeller.	Op til 5 år
Svarprocenter Tidsramme: Op til 5 år	Responsrater mellem arme vil blive sammenlignet ved hjælp af Fishers eksakte test.	Op til 5 år
Hyppigheder af feber Tidsramme: Op til 5 år	Defineret som >= grad 3 pr. Common Terminology Criteria for Adverse Events (CTCAE) version (v)4.0 med tilskrivning muligvis, sandsynligvis eller bestemt relateret til behandling; eller enhver >= grad 1 pr. CTCAE v4.0 med tilskrivning muligvis, sandsynligvis eller helt sikkert relateret til behandling med kulderystelser, dehydrering, hypotension, svimmelhed eller muskelsvaghed pr. CTCAE v4.0 med tilskrivning muligvis, sandsynligvis eller helt sikkert relateret til behandling rapporteret under samme forløb. Hyppigheden af feber mellem armene vil også blive sammenlignet ved hjælp af Fishers eksakte test.	Op til 5 år

Andre resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Molekylære hændelser, der fører til reaktivering af MAPK-vejen Tidsramme: Op til 5 år	Sammenlignet mellem patienter i de to behandlingsgrupper.	Op til 5 år
Ændring i biomarkører forbundet med PFS af arkiveret væv Tidsramme: Baseline op til 5 år	Cox regressionsanalyser vil blive brugt til at evaluere biomarkørers sammenhænge med PFS.	Baseline op til 5 år
Interaktion mellem baseline biomarkører og behandlingsarm Tidsramme: Baseline op til 5 år	Cox regressionsanalyser vil blive brugt til at evaluere biomarkørers sammenhænge med PFS.	Baseline op til 5 år

Samarbejdspartnere og efterforskere

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

Sponsor

National Cancer Institute (NCI)

Efterforskere

Ledende efterforsker: Alain P Algazi, SWOG Cancer Research Network

Publikationer og nyttige links

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

Generelle publikationer

Datoer for undersøgelser

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

Studer store datoer

Studiestart (Faktiske)

19. september 2014

Primær færdiggørelse (Anslået)

15. marts 2027

Studieafslutning (Anslået)

15. marts 2027

Datoer for studieregistrering

Først indsendt

18. juli 2014

Først indsendt, der opfyldte QC-kriterier

18. juli 2014

Først opslået (Anslået)

21. juli 2014

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

29. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

28. maj 2026

Sidst verificeret

1. marts 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

NCI-2014-01470 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
U10CA032102 (U.S. NIH-bevilling/kontrakt)
U10CA180888 (U.S. NIH-bevilling/kontrakt)
S1320 (Anden identifikator: CTEP)

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

Kliniske forsøg med Fase III kutan melanom AJCC v7

National Cancer Institute (NCI)
Exelisis

Afsluttet

Cabozantinib-S-Malate sammenlignet med temozolomid eller dacarbazin til behandling af patienter med metastatisk melanom i øjet, der ikke kan fjernes ved kirurgi

Stage IV Uveal Melanoma AJCC v7 | Tilbagevendende uveal melanom | Stage III Uveal Melanoma AJCC v7 | Stage IIIA Uveal Melanoma AJCC v7 | Stadie IIIB Uveal Melanoma AJCC v7 | Stage IIIC Uveal Melanoma AJCC v7

Forenede Stater, Canada
M.D. Anderson Cancer Center
National Cancer Institute (NCI)

Afsluttet

Neoadjuvant og Adjuvant Checkpoint Blockade

Fase IV kutan melanom AJCC v6 og v7 | Okulært melanom | Fase IIIC kutan melanom AJCC v7 | Kutant melanom | Slimhinde melanom | Fase IIIB kutan melanom AJCC v7 | Stage IV Uveal Melanoma AJCC v7 | Stadie IIIB Uveal Melanoma AJCC v7 | Stage IIIC Uveal Melanoma AJCC v7 | Stadie III Akral Lentiginøst Melanom AJCC... og andre forhold

Forenede Stater
National Cancer Institute (NCI)

Trukket tilbage

Glembatumumab Vedotin, Nivolumab og Ipilimumab til behandling af patienter med avancerede metastatiske solide tumorer, der ikke kan fjernes ved kirurgi

Metastatisk melanom | Fase III kutan melanom AJCC v7 | Fase IV kutan melanom AJCC v6 og v7 | Avanceret malignt fast neoplasma | Metastatisk malignt fast neoplasma | Fase IIIC kutan melanom AJCC v7 | Østrogenreceptor negativ | HER2/Neu negativ | Progesteronreceptor negativ | Triple-negativt brystkarcinom | Uoprettelig... og andre forhold
Sidney Kimmel Comprehensive Cancer Center at Thomas...
Pfizer

Aktiv, ikke rekrutterende

Sunitinib-malat eller valproinsyre til forebyggelse af metastaser hos patienter med højrisiko uveal melanom

Ciliær krop og choroid melanom, medium/stor størrelse | Ciliær krop og choroidea melanom, lille størrelse | Iris melanom | Stadium IIIA Intraokulært melanom | Stadium IIIB Intraokulært melanom | Stadie IIIC Intraokulært melanom | Stadie I Intraokulært melanom | Stadie IIA Intraokulært melanom | Stadie IIB... og andre forhold

Forenede Stater

Kliniske forsøg med Dabrafenibmesylat

Oslo University Hospital
University Hospital of North Norway; Helse Stavanger HF; Haukeland University... og andre samarbejdspartnere

Rekruttering

Præcisionskræftbehandling ved sjældne kræftformer (MATRIX-Rare)

Sjælden malign neoplasma

Norge
Cancer Research UK
University of Manchester; University of Birmingham; Novartis Pharmaceuticals... og andre samarbejdspartnere

Ikke rekrutterer endnu

DETERMINE Trial Behandlingsarm 07: Dabrafenib i kombination med Trametinib hos voksne, børn og teenagere/unge voksne patienter med BRAF V600-mutationspositive kræftformer. (DETERMINE)

Gliom | Neoplasmer efter histologisk type | Lymfoproliferative lidelser | Neoplasmer efter sted | Kræft | Myelomatose | Kolorektale neoplasmer | Ovariale neoplasmer | Gastrointestinal kræft | Ondartet neoplasma | Skjoldbruskkirtelcarcinom, Anaplastisk | Laryngeale neoplasmer | Erdheim-Chesters sygdom | Solid tumor | Hæmatologisk... og andre forhold

Det Forenede Kongerige
University of California, San Francisco
Rising Tide Foundation

Rekruttering

Dabrafenib og trametinib til braf v600 mutant lavkvalitets gliomas (PNOC037)

Gliom af lav kvalitet | BRAF V600 Mutation | Lav grad af hjernegliom | Tilbagevendende glioma med lav kvalitet

Forenede Stater
Novartis Pharmaceuticals

Ikke længere tilgængelig

Compassionate Use Program for at få adgang til Trametinib og Dabrafenib til patienter med BRAF-mutationspositivt metastatisk melanom

Melanom
IlDong Pharmaceutical Co Ltd

Afsluttet

En fase I-undersøgelse af IDP-73152 mesylat i sundhed mandlig frivillig (PDF inhibitor)

Sund og rask

Korea, Republikken
Novartis Pharmaceuticals

Aktiv, ikke rekrutterende

Undersøgelse af effektivitet og sikkerhed af Dabrafenib Plus Trametinib hos tidligere behandlede patienter med lokalt avanceret eller metastatisk, radioaktivt jod refraktær BRAFV600E Mutationspositiv differentieret skjoldbruskkirtelkræft

Differentieret skjoldbruskkirtelkræft (DTC)

Forenede Stater, Kina, Canada, Taiwan, Malaysia, Vietnam, Brasilien, Indien, Sydkorea, Tyrkiet (Türkiye), Argentina
Chengdu Zenitar Biomedical Technology Co., Ltd

Afsluttet

Undersøgelse af Prilinostatmesylat til injektion til behandling af recidiverende eller refraktær B-celle-relateret tumor-dominerende

Diffust storcellet B-celle lymfom, DLBCL

Kina
Leiden University Medical Center
Novartis

Rekruttering

NEO- og adjuverende målrettet terapi i Braf-muteret anaplastisk kræft i skjoldbruskkirtlen (NEO-ATACT-undersøgelse) (NEO-ATACT)

Anaplastisk kræft i skjoldbruskkirtlen

Holland
JS InnoPharm, LLC

Suspenderet

JSI-1187-01 Monoterapi og i kombination med Dabrafenib til avancerede solide tumorer med MAPK Pathway-mutationer

Faste tumorer

Forenede Stater
Fondazione Melanoma Onlus

Trukket tilbage

"Dabrafenib og Trametinib i cirkulerende frit DNA BRAFV600 muterede metastatiske melanompatienter: et prospektivt fase II, åbent mærke, multicenterstudie - (Bioliquid TAILOR Study - BIOTAILOR)"

Melanom

Italien

Dabrafenib og Trametinib til behandling af patienter med trin III-IV BRAF mutant melanom, der ikke kan fjernes ved kirurgi

Et randomiseret fase II forsøg med intermitterende versus kontinuerlig dosering af Dabrafenib (NSC-763760) og Trametinib (NSC-763093) i BRAF V600E/K mutant melanom

Studieoversigt

Status

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Undersøgelsestype

Tilmelding (Anslået)

Fase

Kontakter og lokationer

Studiesteder

Deltagelseskriterier

Berettigelseskriterier

Aldre berettiget til at studere

Tager imod sunde frivillige

Beskrivelse

Studieplan

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Antal våben

Våben og indgreb

Deltagergruppe / Arm

Intervention / Behandling

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Sekundære resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Andre resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Samarbejdspartnere og efterforskere

Sponsor

Efterforskere

Publikationer og nyttige links

Generelle publikationer

Datoer for undersøgelser

Studer store datoer

Studiestart (Faktiske)

Primær færdiggørelse (Anslået)

Studieafslutning (Anslået)

Datoer for studieregistrering

Først indsendt

Først indsendt, der opfyldte QC-kriterier

Først opslået (Anslået)

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

Sidst verificeret

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

Kliniske forsøg med Fase III kutan melanom AJCC v7

Kliniske forsøg med Dabrafenibmesylat

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Bangladesh

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer