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Cisplatin, Carboplatin og Etoposid eller Temozolomide og Capecitabin til behandling af patienter med neuroendokrint karcinom i mave-tarmkanalen eller bugspytkirtlen, der er metastatisk eller ikke kan fjernes ved kirurgi

29. april 2026 opdateret af: ECOG-ACRIN Cancer Research Group

Randomiseret fase II undersøgelse af cisplatin og etoposid versus temozolomid og capecitabin hos patienter med avanceret G3 ikke-småcellet gastroenteropancreatisk neuroendokrine karcinomer

Dette randomiserede fase II-studie undersøger, hvor godt temozolomid og capecitabin virker sammenlignet med standardbehandling med cisplatin eller carboplatin og etoposid til behandling af patienter med neuroendokrint karcinom i mave-tarmkanalen eller bugspytkirtlen, som har spredt sig til andre dele af kroppen (metastatisk) eller ikke kan fjernes. ved operation. Lægemidler, der bruges i kemoterapi, såsom temozolomid, capecitabin, cisplatin, carboplatin og etoposid, virker på forskellige måder for at stoppe væksten af ​​tumorceller, enten ved at dræbe cellerne, ved at stoppe dem i at dele sig eller ved at stoppe dem i at sprede sig. Visse typer af neuroendokrine karcinomer kan reagere bedre på andre behandlinger end den nuværende standardbehandling af cisplatin og etoposid. Det vides endnu ikke, om temozolomid og capecitabin kan virke bedre end cisplatin eller carboplatin og etoposid ved behandling af patienter med denne type neuroendokrine karcinomer, kaldet ikke-småcellet neuroendokrin karcinom.

Studieoversigt

Detaljeret beskrivelse

PRIMÆRE MÅL:

I. At vurdere progressionsfri overlevelse (PFS) af platin (cisplatin eller carboplatin) og etoposid versus PFS af temozolomid og capecitabin hos patienter med fremskredne G3 ikke-småcellede gastroenteropancreatiske neuroendokrine karcinomer.

SEKUNDÆRE MÅL:

I. At vurdere responsraten (RR) af platin (cisplatin eller carboplatin) og etoposid versus RR for temozolomid og capecitabin hos patienter med fremskredne G3 ikke-småcellede gastroenteropancreatiske neuroendokrine karcinomer.

II. At vurdere den samlede overlevelse (OS) af platin (cisplatin eller carboplatin) og etoposid versus OS af temozolomid og capecitabin hos patienter med fremskredne G3 ikke-småcellede gastroenteropancreatiske neuroendokrine karcinomer.

III. At evaluere toksiciteten forbundet med kombinationen af ​​temozolomid og capecitabin og kombinationen af ​​henholdsvis platin (cisplatin eller carboplatin) og etoposid hos patienter med fremskredne G3 ikke-småcellede gastroenteropancreatiske neuroendokrine karcinomer.

TERTIÆRE MÅL:

I. At vurdere virkningen af ​​hvert behandlingsregime på PFS, RR og OS baseret på markør for proliferation Ki-67 indeks hos patienter med fremskredne G3 ikke-småcellede gastroenteropancreatiske neuroendokrine karcinomer. (Laboratorie) II. At vurdere den prognostiske betydning af veldifferentierede versus dårligt differentierede ikke-småcellede gastroenteropancreatiske neuroendokrine tumorer i forhold til overlevelse og respons på behandling. (Laboratorie) III. At vurdere overensstemmelsen i Ki-67-status mellem den, der er rapporteret af institutionel patolog og den, der er rapporteret af central patologigennemgang. (Laboratorium)

OVERSIGT: Patienterne randomiseres til 1 ud af 2 behandlingsarme.

ARM A: Patienterne modtager capecitabin oralt (PO) to gange dagligt (BID) på dag 1-14 og temozolomid PO én gang dagligt (QD) på dag 10-14. Kurser gentages hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.

ARM B: Patienter får cisplatin intravenøst ​​(IV) på dag 1-3 eller carboplatin IV på dag 1. Patienterne får også etoposid IV på dag 1-3. Kurser gentages hver 21. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.

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

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

67

Fase

  • Fase 2

Kontakter og lokationer

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

Studiesteder

    • Arizona
      • Kingman, Arizona, Forenede Stater, 86401
        • Kingman Regional Medical Center
      • Phoenix, Arizona, Forenede Stater, 85004
        • Cancer Center at Saint Joseph's
    • Arkansas
      • Fort Smith, Arkansas, Forenede Stater, 72903
        • Mercy Hospital Fort Smith
      • Hot Springs, Arkansas, Forenede Stater, 71913
        • CHI Saint Vincent Cancer Center Hot Springs
    • California
      • Antioch, California, Forenede Stater, 94531
        • Kaiser Permanente-Deer Valley Medical Center
      • Arroyo Grande, California, Forenede Stater, 93420
        • PCR Oncology
      • Arroyo Grande, California, Forenede Stater, 93420
        • Mission Hope Medical Oncology - Arroyo Grande
      • Auburn, California, Forenede Stater, 95602
        • Sutter Auburn Faith Hospital
      • Auburn, California, Forenede Stater, 95603
        • Sutter Cancer Centers Radiation Oncology Services-Auburn
      • Berkeley, California, Forenede Stater, 94704
        • Alta Bates Summit Medical Center-Herrick Campus
      • Burlingame, California, Forenede Stater, 94010
        • Mills-Peninsula Medical Center
      • Cameron Park, California, Forenede Stater, 95682
        • Sutter Cancer Centers Radiation Oncology Services-Cameron Park
      • Castro Valley, California, Forenede Stater, 94546
        • Eden Hospital Medical Center
      • Davis, California, Forenede Stater, 95616
        • Sutter Davis Hospital
      • Dublin, California, Forenede Stater, 94568
        • Kaiser Permanente Dublin
      • Fremont, California, Forenede Stater, 94538
        • Kaiser Permanente-Fremont
      • Fremont, California, Forenede Stater, 94538
        • Palo Alto Medical Foundation-Fremont
      • Fresno, California, Forenede Stater, 93720
        • Kaiser Permanente-Fresno
      • Los Angeles, California, Forenede Stater, 90033
        • USC / Norris Comprehensive Cancer Center
      • Los Angeles, California, Forenede Stater, 90033
        • Los Angeles County-USC Medical Center
      • Los Angeles, California, Forenede Stater, 90048
        • Cedars Sinai Medical Center
      • Modesto, California, Forenede Stater, 95355
        • Memorial Medical Center
      • Modesto, California, Forenede Stater, 95356
        • Kaiser Permanente-Modesto
      • Mountain View, California, Forenede Stater, 94040
        • Palo Alto Medical Foundation-Camino Division
      • Mountain View, California, Forenede Stater, 94040
        • Palo Alto Medical Foundation-Gynecologic Oncology
      • Newport Beach, California, Forenede Stater, 92663
        • USC Norris Oncology/Hematology-Newport Beach
      • Novato, California, Forenede Stater, 94945
        • Sutter Cancer Research Consortium
      • Oakland, California, Forenede Stater, 94611
        • Kaiser Permanente-Oakland
      • Palo Alto, California, Forenede Stater, 94304
        • Stanford Cancer Institute Palo Alto
      • Palo Alto, California, Forenede Stater, 94301
        • Palo Alto Medical Foundation Health Care
      • Pasadena, California, Forenede Stater, 91105
        • Keck Medical Center of USC Pasadena
      • 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
      • Roseville, California, Forenede Stater, 95661
        • Kaiser Permanente-Roseville
      • Roseville, California, Forenede Stater, 95661
        • Sutter Cancer Centers Radiation Oncology Services-Roseville
      • Roseville, California, Forenede Stater, 95661
        • Sutter Roseville Medical Center
      • Sacramento, California, Forenede Stater, 95816
        • Sutter Medical Center Sacramento
      • Sacramento, California, Forenede Stater, 95814
        • Kaiser Permanente Downtown Commons
      • Sacramento, California, Forenede Stater, 95823
        • Kaiser Permanente-South Sacramento
      • Sacramento, California, Forenede Stater, 95825
        • Kaiser Permanente - Sacramento
      • San Francisco, California, Forenede Stater, 94115
        • Kaiser Permanente-San Francisco
      • San Francisco, California, Forenede Stater, 94158
        • UCSF Medical Center-Mission Bay
      • San Francisco, California, Forenede Stater, 94115
        • California Pacific Medical Center-Pacific Campus
      • San Jose, California, Forenede Stater, 95119
        • Kaiser Permanente-Santa Teresa-San Jose
      • San Leandro, California, Forenede Stater, 94577
        • Kaiser Permanente San Leandro
      • San Luis Obispo, California, Forenede Stater, 93401
        • Pacific Central Coast Health Center-San Luis Obispo
      • 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 Cruz, California, Forenede Stater, 95065
        • Palo Alto Medical Foundation-Santa Cruz
      • Santa Maria, California, Forenede Stater, 93444
        • Mission Hope Medical Oncology - Santa Maria
      • Santa Rosa, California, Forenede Stater, 95403
        • Kaiser Permanente-Santa Rosa
      • Santa Rosa, California, Forenede Stater, 95403
        • Sutter Pacific Medical Foundation
      • South San Francisco, California, Forenede Stater, 94080
        • Kaiser Permanente-South San Francisco
      • Stockton, California, Forenede Stater, 95210
        • Kaiser Permanente-Stockton
      • Sunnyvale, California, Forenede Stater, 94086
        • Palo Alto Medical Foundation-Sunnyvale
      • Vacaville, California, Forenede Stater, 95688
        • Kaiser Permanente Medical Center-Vacaville
      • Vacaville, California, Forenede Stater, 95687
        • Sutter Cancer Centers Radiation Oncology Services-Vacaville
      • Vallejo, California, Forenede Stater, 94589
        • Kaiser Permanente-Vallejo
      • Vallejo, California, Forenede Stater, 94589
        • Sutter Solano Medical Center/Cancer Center
      • Walnut Creek, California, Forenede Stater, 94596
        • Kaiser Permanente-Walnut Creek
    • Colorado
      • Aurora, Colorado, Forenede Stater, 80045
        • University of Colorado Hospital
      • Colorado Springs, Colorado, Forenede Stater, 80907
        • Penrose-Saint Francis Healthcare
      • Colorado Springs, Colorado, Forenede Stater, 80907
        • Rocky Mountain Cancer Centers-Penrose
      • Denver, Colorado, Forenede Stater, 80210
        • Porter Adventist Hospital
      • Durango, Colorado, Forenede Stater, 81301
        • Mercy Medical Center
      • Durango, Colorado, Forenede Stater, 81301
        • Southwest Oncology PC
      • Golden, Colorado, Forenede Stater, 80401
        • Mountain Blue Cancer Care Center
      • Lakewood, Colorado, Forenede Stater, 80228
        • Saint Anthony Hospital
      • Lakewood, Colorado, Forenede Stater, 80228
        • Rocky Mountain Cancer Centers-Lakewood
      • Littleton, Colorado, Forenede Stater, 80122
        • Littleton Adventist Hospital
      • Longmont, Colorado, Forenede Stater, 80501
        • Longmont United Hospital
      • Longmont, Colorado, Forenede Stater, 80501
        • Rocky Mountain Cancer Centers-Longmont
      • Parker, Colorado, Forenede Stater, 80138
        • Parker Adventist Hospital
      • Parker, Colorado, Forenede Stater, 80138
        • Rocky Mountain Cancer Centers-Parker
      • Pueblo, Colorado, Forenede Stater, 81004
        • Saint Mary Corwin Medical Center
      • Pueblo, Colorado, Forenede Stater, 81008
        • Rocky Mountain Cancer Centers - Pueblo
      • Thornton, Colorado, Forenede Stater, 80260
        • Rocky Mountain Cancer Centers-Thornton
    • Delaware
      • Frankford, Delaware, Forenede Stater, 19945
        • Beebe South Coastal Health Campus
      • Lewes, Delaware, Forenede Stater, 19958
        • Beebe Medical Center
      • Newark, Delaware, Forenede Stater, 19713
        • Helen F Graham Cancer Center
      • Newark, Delaware, Forenede Stater, 19713
        • Delaware Clinical and Laboratory Physicians PA
      • Newark, Delaware, Forenede Stater, 19713
        • Medical Oncology Hematology Consultants PA
      • Newark, Delaware, Forenede Stater, 19718
        • Christiana Care Health System-Christiana Hospital
      • Newark, Delaware, Forenede Stater, 19713
        • Christiana Gynecologic Oncology LLC
      • Rehoboth Beach, Delaware, Forenede Stater, 19971
        • Beebe Health Campus
      • Seaford, Delaware, Forenede Stater, 19973
        • TidalHealth Nanticoke / Allen Cancer Center
      • Wilmington, Delaware, Forenede Stater, 19801
        • Christiana Care Health System-Wilmington Hospital
    • District of Columbia
      • Washington D.C., District of Columbia, Forenede Stater, 20010
        • Medstar Washington Hospital Center
      • Washington D.C., District of Columbia, Forenede Stater, 20016
        • Sibley Memorial Hospital
    • Florida
      • Fort Lauderdale, Florida, Forenede Stater, 33308
        • Holy Cross Hospital
    • Georgia
      • Atlanta, Georgia, Forenede Stater, 30308
        • Emory University Hospital Midtown
      • Atlanta, Georgia, Forenede Stater, 30322
        • Emory University Hospital/Winship Cancer Institute
      • Atlanta, Georgia, Forenede Stater, 30342
        • Emory Saint Joseph's Hospital
      • Atlanta, Georgia, Forenede Stater, 30303
        • Grady Health System
      • Johns Creek, Georgia, Forenede Stater, 30097
        • Emory Johns Creek Hospital
      • Macon, Georgia, Forenede Stater, 31201
        • Medical Center of Central Georgia
    • Hawaii
      • Honolulu, Hawaii, Forenede Stater, 96819
        • Kaiser Permanente Moanalua Medical Center
    • Idaho
      • Boise, Idaho, Forenede Stater, 83706
        • Saint Alphonsus Cancer Care Center-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
      • Meridian, Idaho, Forenede Stater, 83642
        • Idaho Urologic Institute-Meridian
      • Nampa, Idaho, Forenede Stater, 83687
        • Saint Alphonsus Cancer Care Center-Nampa
      • Post Falls, Idaho, Forenede Stater, 83854
        • Kootenai Clinic Cancer Services - Post Falls
      • Sandpoint, Idaho, Forenede Stater, 83864
        • Kootenai Cancer Clinic
    • Illinois
      • Aurora, Illinois, Forenede Stater, 60504
        • Rush - Copley Medical Center
      • Bloomington, Illinois, Forenede Stater, 61704
        • Illinois CancerCare-Bloomington
      • Bloomington, Illinois, Forenede Stater, 61701
        • Saint Joseph Medical Center
      • Burr Ridge, Illinois, Forenede Stater, 60527
        • Loyola Center for Health at Burr Ridge
      • 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
      • Chicago, Illinois, Forenede Stater, 60611
        • Northwestern University
      • Chicago, Illinois, Forenede Stater, 60612
        • Rush University Medical Center
      • Chicago, Illinois, Forenede Stater, 60637
        • University of Chicago Comprehensive Cancer Center
      • Danville, Illinois, Forenede Stater, 61832
        • Carle on Vermilion
      • DeKalb, Illinois, Forenede Stater, 60115
        • Northwestern Medicine Cancer Center Kishwaukee
      • Decatur, Illinois, Forenede Stater, 62526
        • Decatur Memorial Hospital
      • Decatur, Illinois, Forenede Stater, 62526
        • Cancer Care Specialists of Illinois - Decatur
      • Dixon, Illinois, Forenede Stater, 61021
        • Illinois CancerCare-Dixon
      • 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
      • 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
      • Homer Glen, Illinois, Forenede Stater, 60491
        • Loyola Medicine Homer Glen
      • Kewanee, Illinois, Forenede Stater, 61443
        • Illinois CancerCare-Kewanee Clinic
      • Lake Forest, Illinois, Forenede Stater, 60045
        • Northwestern Medicine Lake Forest Hospital
      • 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
      • Melrose Park, Illinois, Forenede Stater, 60160
        • Marjorie Weinberg Cancer Center at Loyola-Gottlieb
      • Mount Vernon, Illinois, Forenede Stater, 62864
        • Good Samaritan Regional Health Center
      • New Lenox, Illinois, Forenede Stater, 60451
        • UC Comprehensive Cancer Center at Silver Cross
      • O'Fallon, Illinois, Forenede Stater, 62269
        • Cancer Care Center of O'Fallon
      • Orland Park, Illinois, Forenede Stater, 60462
        • University of Chicago Medicine-Orland Park
      • Ottawa, Illinois, Forenede Stater, 61350
        • Illinois CancerCare-Ottawa Clinic
      • Ottawa, Illinois, Forenede Stater, 61350
        • Radiation Oncology of Northern Illinois
      • Pekin, Illinois, Forenede Stater, 61554
        • Illinois CancerCare-Pekin
      • Pekin, Illinois, Forenede Stater, 61554
        • OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
      • Peoria, Illinois, Forenede Stater, 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
      • Springfield, Illinois, Forenede Stater, 62781
        • Memorial Medical Center
      • Springfield, Illinois, Forenede Stater, 62702
        • Southern Illinois University School of Medicine
      • Springfield, Illinois, Forenede Stater, 62702
        • Springfield Clinic
      • Springfield, Illinois, Forenede Stater, 62702
        • Central Illinois Hematology Oncology Center
      • Swansea, Illinois, Forenede Stater, 62226
        • 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
      • Newburgh, Indiana, Forenede Stater, 47630
        • Chancellor Center for Oncology
      • Richmond, Indiana, Forenede Stater, 47374
        • Reid Health
    • Iowa
      • Ames, Iowa, Forenede Stater, 50010
        • McFarland Clinic PC - Ames
      • Ames, Iowa, Forenede Stater, 50010
        • Mary Greeley Medical Center
      • Boone, Iowa, Forenede Stater, 50036
        • McFarland Clinic PC-Boone
      • Clive, Iowa, Forenede Stater, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Forenede Stater, 50325
        • Medical Oncology and Hematology Associates-West Des Moines
      • Council Bluffs, Iowa, Forenede Stater, 51503
        • Alegent Health Mercy Hospital
      • Creston, Iowa, Forenede Stater, 50801
        • Greater Regional Medical Center
      • Des Moines, Iowa, Forenede Stater, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Forenede Stater, 50314
        • Mission Cancer and Blood - Laurel
      • Fort Dodge, Iowa, Forenede Stater, 50501
        • McFarland Clinic PC-Trinity Cancer Center
      • Jefferson, Iowa, Forenede Stater, 50129
        • McFarland Clinic PC-Jefferson
      • Marshalltown, Iowa, Forenede Stater, 50158
        • McFarland Clinic PC-Marshalltown
      • Sioux City, Iowa, Forenede Stater, 51101
        • Siouxland Regional Cancer Center
      • West Des Moines, Iowa, Forenede Stater, 50266
        • Mercy Medical Center-West Lakes
    • Kansas
      • Chanute, Kansas, Forenede Stater, 66720
        • Cancer Center of Kansas - Chanute
      • 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
      • Fort Scott, Kansas, Forenede Stater, 66701
        • Cancer Center of Kansas - Fort Scott
      • Garden City, Kansas, Forenede Stater, 67846
        • Central Care Cancer Center - Garden City
      • Great Bend, Kansas, Forenede Stater, 67530
        • Central Care Cancer Center - Great Bend
      • Hays, Kansas, Forenede Stater, 67601
        • HaysMed University of Kansas Health System
      • Independence, Kansas, Forenede Stater, 67301
        • Cancer Center of Kansas-Independence
      • Kansas City, Kansas, Forenede Stater, 66160
        • University of Kansas Cancer Center
      • 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
        • Olathe Health Cancer Center
      • Overland Park, Kansas, Forenede Stater, 66210
        • University of Kansas Cancer Center-Overland Park
      • Overland Park, Kansas, Forenede Stater, 66209
        • Menorah Medical Center
      • Parsons, Kansas, Forenede Stater, 67357
        • Cancer Center of Kansas - Parsons
      • Pittsburg, Kansas, Forenede Stater, 66762
        • Ascension Via Christi - 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
        • Commonwealth Cancer Center-Corbin
      • Crestview Hills, Kentucky, Forenede Stater, 41017
        • Oncology Hematology Care Inc-Crestview
      • Lexington, Kentucky, Forenede Stater, 40536
        • University of Kentucky/Markey Cancer Center
      • Lexington, Kentucky, Forenede Stater, 40504
        • Saint Joseph Radiation Oncology Resource Center
      • Lexington, Kentucky, Forenede Stater, 40509
        • Saint Joseph Hospital East
      • London, Kentucky, Forenede Stater, 40741
        • Saint Joseph London
      • Louisville, Kentucky, Forenede Stater, 40202
        • Jewish Hospital
      • Louisville, Kentucky, Forenede Stater, 40245
        • UofL Health Medical Center Northeast
      • Louisville, Kentucky, Forenede Stater, 40215
        • Saints Mary and Elizabeth Hospital
      • Shepherdsville, Kentucky, Forenede Stater, 40165
        • Jewish Hospital Medical Center South
    • Louisiana
      • Alexandria, Louisiana, Forenede Stater, 71301
        • Christus Saint Frances Cabrini Hospital
      • Baton Rouge, Louisiana, Forenede Stater, 70809
        • Ochsner Health Center-Summa
      • Baton Rouge, Louisiana, Forenede Stater, 70816
        • Medical Center of Baton Rouge
      • Baton Rouge, Louisiana, Forenede Stater, 70836
        • Ochsner High Grove
      • Kenner, Louisiana, Forenede Stater, 70065
        • Ochsner Medical Center Kenner
      • Lake Charles, Louisiana, Forenede Stater, 70605
        • CHRISTUS Lake Charles Medical Center
      • Monroe, Louisiana, Forenede Stater, 71202
        • Ochsner LSU Health Monroe Medical Center
      • New Orleans, Louisiana, Forenede Stater, 70121
        • Ochsner Medical Center Jefferson
      • Shreveport, Louisiana, Forenede Stater, 71103
        • LSU Health Sciences Center at Shreveport
    • Maryland
      • Baltimore, Maryland, Forenede Stater, 21287
        • Johns Hopkins University/Sidney Kimmel Cancer Center
      • Baltimore, Maryland, Forenede Stater, 21215
        • Sinai Hospital of Baltimore
      • Randallstown, Maryland, Forenede Stater, 21133
        • Northwest Hospital Center
      • Westminster, Maryland, Forenede Stater, 21157
        • William E Kahlert Regional Cancer Center/Sinai Hospital
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02215
        • Beth Israel Deaconess Medical Center
      • Boston, Massachusetts, Forenede Stater, 02215
        • Dana-Farber Cancer Institute
      • Boston, Massachusetts, Forenede Stater, 02114
        • Massachusetts General Hospital Cancer Center
      • Springfield, Massachusetts, Forenede Stater, 01104
        • Mercy Medical Center
    • Michigan
      • Ann Arbor, Michigan, Forenede Stater, 48109
        • University of Michigan Comprehensive Cancer Center
      • Ann Arbor, Michigan, Forenede Stater, 48106
        • Saint Joseph Mercy Hospital
      • Battle Creek, Michigan, Forenede Stater, 49017
        • Bronson Battle Creek
      • Brighton, Michigan, Forenede Stater, 48114
        • Saint Joseph Mercy Brighton
      • Brighton, Michigan, Forenede Stater, 48114
        • Trinity Health IHA Medical Group Hematology Oncology - Brighton
      • Brownstown, Michigan, Forenede Stater, 48183
        • Henry Ford Cancer Institute-Downriver
      • Canton, Michigan, Forenede Stater, 48188
        • Saint Joseph Mercy Canton
      • Canton, Michigan, Forenede Stater, 48188
        • Trinity Health IHA Medical Group Hematology Oncology - Canton
      • Caro, Michigan, Forenede Stater, 48723
        • Caro Cancer Center
      • Chelsea, Michigan, Forenede Stater, 48118
        • Saint Joseph Mercy Chelsea
      • Chelsea, Michigan, Forenede Stater, 48118
        • Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
      • Clarkston, Michigan, Forenede Stater, 48346
        • Hematology Oncology Consultants-Clarkston
      • Clarkston, Michigan, Forenede Stater, 48346
        • Newland Medical Associates-Clarkston
      • Clinton Township, Michigan, Forenede Stater, 48038
        • Henry Ford Macomb Hospital-Clinton Township
      • Dearborn, Michigan, Forenede Stater, 48126
        • Henry Ford Medical Center-Fairlane
      • Detroit, Michigan, Forenede Stater, 48202
        • Henry Ford Hospital
      • Detroit, Michigan, Forenede Stater, 48201
        • Wayne State University/Karmanos Cancer Institute
      • Detroit, Michigan, Forenede Stater, 48236
        • Ascension Saint John Hospital
      • East China, Michigan, Forenede Stater, 48054
        • Great Lakes Cancer Management Specialists-Doctors Park
      • Farmington Hills, Michigan, Forenede Stater, 48334
        • Weisberg Cancer Treatment Center
      • Flint, Michigan, Forenede Stater, 48503
        • Hurley Medical Center
      • Flint, Michigan, Forenede Stater, 48503
        • Genesee Cancer and Blood Disease Treatment Center
      • Flint, Michigan, Forenede Stater, 48503
        • Genesee Hematology Oncology PC
      • Flint, Michigan, Forenede Stater, 48503
        • Genesys Hurley Cancer Institute
      • Grand Rapids, Michigan, Forenede Stater, 49503
        • Spectrum Health at Butterworth Campus
      • Grand Rapids, Michigan, Forenede Stater, 49503
        • Helen DeVos Children's Hospital at Spectrum Health
      • Grand Rapids, Michigan, Forenede Stater, 49503
        • Trinity Health Grand Rapids Hospital
      • Grosse Pointe Woods, Michigan, Forenede Stater, 48236
        • Academic Hematology Oncology Specialists
      • Grosse Pointe Woods, Michigan, Forenede Stater, 48236
        • Great Lakes Cancer Management Specialists-Van Elslander Cancer Center
      • Grosse Pointe Woods, Michigan, Forenede Stater, 48236
        • Michigan Breast Specialists-Grosse Pointe Woods
      • Jackson, Michigan, Forenede Stater, 49201
        • Allegiance Health
      • Kalamazoo, Michigan, Forenede Stater, 49007
        • West Michigan Cancer Center
      • Kalamazoo, Michigan, Forenede Stater, 49007
        • Bronson Methodist Hospital
      • Kalamazoo, Michigan, Forenede Stater, 49048
        • Borgess Medical Center
      • Lansing, Michigan, Forenede Stater, 48912
        • Sparrow Hospital
      • Livonia, Michigan, Forenede Stater, 48154
        • Trinity Health Saint Mary Mercy Livonia Hospital
      • Livonia, Michigan, Forenede Stater, 48154
        • Hope Cancer Clinic
      • Macomb, Michigan, Forenede Stater, 48044
        • Great Lakes Cancer Management Specialists-Macomb Medical Campus
      • Macomb, Michigan, Forenede Stater, 48044
        • Michigan Breast Specialists-Macomb Township
      • Marlette, Michigan, Forenede Stater, 48453
        • Saint Mary's Oncology/Hematology Associates of Marlette
      • Monroe, Michigan, Forenede Stater, 48162
        • Monroe Cancer Center
      • Muskegon, Michigan, Forenede Stater, 49444
        • Trinity Health Muskegon Hospital
      • Niles, Michigan, Forenede Stater, 49120
        • Lakeland Hospital Niles
      • Norton Shores, Michigan, Forenede Stater, 49444
        • Cancer and Hematology Centers of Western Michigan - Norton Shores
      • Novi, Michigan, Forenede Stater, 48377
        • Henry Ford Medical Center-Columbus
      • Pontiac, Michigan, Forenede Stater, 48341
        • Saint Joseph Mercy Oakland
      • Pontiac, Michigan, Forenede Stater, 48341
        • 21st Century Oncology-Pontiac
      • Pontiac, Michigan, Forenede Stater, 48341
        • Hope Cancer Center
      • Pontiac, Michigan, Forenede Stater, 48341
        • Newland Medical Associates-Pontiac
      • 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
        • Spectrum Health Reed City Hospital
      • Rochester Hills, Michigan, Forenede Stater, 48309
        • Great Lakes Cancer Management Specialists-Rochester Hills
      • Saginaw, Michigan, Forenede Stater, 48601
        • Ascension Saint Mary's Hospital
      • Saginaw, Michigan, Forenede Stater, 48604
        • Oncology Hematology Associates of Saginaw Valley PC
      • Saint Joseph, Michigan, Forenede Stater, 49085
        • Lakeland Medical Center Saint Joseph
      • Saint Joseph, Michigan, Forenede Stater, 49085
        • Marie Yeager Cancer Center
      • Shelby, Michigan, Forenede Stater, 48315
        • Henry Ford Macomb Health Center - Shelby Township
      • Sterling Heights, Michigan, Forenede Stater, 48312
        • Bhadresh Nayak MD PC-Sterling Heights
      • Tawas City, Michigan, Forenede Stater, 48764
        • Ascension Saint Joseph Hospital
      • Traverse City, Michigan, Forenede Stater, 49684
        • Munson Medical Center
      • Warren, Michigan, Forenede Stater, 48093
        • Saint John Macomb-Oakland Hospital
      • Warren, Michigan, Forenede Stater, 48088
        • Advanced Breast Care Center PLLC
      • Warren, Michigan, Forenede Stater, 48093
        • Great Lakes Cancer Management Specialists-Macomb Professional Building
      • Warren, Michigan, Forenede Stater, 48093
        • Macomb Hematology Oncology PC
      • Warren, Michigan, Forenede Stater, 48093
        • Michigan Breast Specialists-Warren
      • West Bloomfield, Michigan, Forenede Stater, 48322
        • Henry Ford West Bloomfield Hospital
      • West Branch, Michigan, Forenede Stater, 48661
        • Saint Mary's Oncology/Hematology Associates of West Branch
      • Wyoming, Michigan, Forenede Stater, 49519
        • Metro Health Hospital
      • Ypsilanti, Michigan, Forenede Stater, 48197
        • Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
      • Ypsilanti, Michigan, Forenede Stater, 48106
        • Huron Gastroenterology PC
    • Minnesota
      • Bemidji, Minnesota, Forenede Stater, 56601
        • Sanford Joe Lueken Cancer Center
      • Burnsville, Minnesota, Forenede Stater, 55337
        • Fairview Ridges Hospital
      • Burnsville, Minnesota, Forenede Stater, 55337
        • Minnesota Oncology - Burnsville
      • Cambridge, Minnesota, Forenede Stater, 55008
        • Cambridge Medical Center
      • Coon Rapids, Minnesota, Forenede Stater, 55433
        • Mercy Hospital
      • Edina, Minnesota, Forenede Stater, 55435
        • Fairview Southdale Hospital
      • Fridley, Minnesota, Forenede Stater, 55432
        • Unity Hospital
      • 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
      • Princeton, Minnesota, Forenede Stater, 55371
        • Fairview Northland Medical Center
      • Robbinsdale, Minnesota, Forenede Stater, 55422
        • North Memorial Medical Health Center
      • Rochester, Minnesota, Forenede Stater, 55905
        • Mayo Clinic in Rochester
      • 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
      • Thief River Falls, Minnesota, Forenede Stater, 56701
        • Sanford Thief River Falls Medical Center
      • 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
      • Worthington, Minnesota, Forenede Stater, 56187
        • Sanford Cancer Center Worthington
      • Wyoming, Minnesota, Forenede Stater, 55092
        • Fairview Lakes Medical Center
    • Missouri
      • Ballwin, Missouri, Forenede Stater, 63011
        • Saint Louis Cancer and Breast Institute-Ballwin
      • Bolivar, Missouri, Forenede Stater, 65613
        • Central Care Cancer Center - Bolivar
      • Bonne Terre, Missouri, Forenede Stater, 63628
        • Parkland Health Center-Bonne Terre
      • Branson, Missouri, Forenede Stater, 65616
        • Cox Cancer Center Branson
      • Cape Girardeau, Missouri, Forenede Stater, 63703
        • Saint Francis Medical Center
      • Cape Girardeau, Missouri, Forenede Stater, 63703
        • Southeast Cancer Center
      • City of Saint Peters, Missouri, Forenede Stater, 63376
        • Siteman Cancer Center at Saint Peters Hospital
      • Creve Coeur, Missouri, Forenede Stater, 63141
        • Siteman Cancer Center at West County Hospital
      • Farmington, Missouri, Forenede Stater, 63640
        • Parkland Health Center - Farmington
      • Independence, Missouri, Forenede Stater, 64057
        • Centerpoint Medical Center LLC
      • Jefferson City, Missouri, Forenede Stater, 65109
        • Capital Region Southwest Campus
      • Joplin, Missouri, Forenede Stater, 64804
        • Freeman Health System
      • Joplin, Missouri, Forenede Stater, 64804
        • Mercy Hospital Joplin
      • Kansas City, Missouri, Forenede Stater, 64154
        • University of Kansas Cancer Center - North
      • Kansas City, Missouri, Forenede Stater, 64132
        • Research Medical Center
      • Kansas City, Missouri, Forenede Stater, 64108
        • Truman Medical Centers
      • Lee's Summit, Missouri, Forenede Stater, 64064
        • University of Kansas Cancer Center - Lee's Summit
      • Rolla, Missouri, Forenede Stater, 65401
        • Delbert Day Cancer Institute at PCRMC
      • Rolla, Missouri, Forenede Stater, 65401
        • Mercy Clinic-Rolla-Cancer and Hematology
      • Saint Joseph, Missouri, Forenede Stater, 64506
        • Heartland Regional Medical Center
      • Sainte Genevieve, Missouri, Forenede Stater, 63670
        • Sainte Genevieve County Memorial Hospital
      • Springfield, Missouri, Forenede Stater, 65807
        • CoxHealth South Hospital
      • Springfield, Missouri, Forenede Stater, 65804
        • Mercy Hospital Springfield
      • St Louis, Missouri, Forenede Stater, 63110
        • Washington University School of Medicine
      • St Louis, Missouri, Forenede Stater, 63129
        • Siteman Cancer Center-South County
      • St Louis, Missouri, Forenede Stater, 63136
        • Siteman Cancer Center at Christian Hospital
      • St Louis, Missouri, Forenede Stater, 63131
        • Missouri Baptist Medical Center
      • St Louis, Missouri, Forenede Stater, 63141
        • Mercy Hospital Saint Louis
      • St Louis, Missouri, Forenede Stater, 63128
        • Mercy Hospital South
      • St Louis, Missouri, Forenede Stater, 63109
        • Saint Louis Cancer and Breast Institute-South City
      • Sullivan, Missouri, Forenede Stater, 63080
        • Missouri Baptist Sullivan Hospital
      • Sunset Hills, Missouri, Forenede Stater, 63127
        • Missouri Baptist Outpatient Center-Sunset Hills
      • Washington, Missouri, Forenede Stater, 63090
        • Mercy Hospital Washington
    • 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
      • Bozeman, Montana, Forenede Stater, 59715
        • Bozeman Deaconess Hospital
      • Butte, Montana, Forenede Stater, 59701
        • Saint James Community Hospital and Cancer Treatment Center
      • Great Falls, Montana, Forenede Stater, 59405
        • Great Falls Clinic
      • Great Falls, Montana, Forenede Stater, 59405
        • Benefis Healthcare- Sletten Cancer Institute
      • Helena, Montana, Forenede Stater, 59601
        • Saint Peter's Community Hospital
      • Kalispell, Montana, Forenede Stater, 59901
        • Kalispell Regional Medical Center
      • Missoula, Montana, Forenede Stater, 59804
        • Community Medical Hospital
      • Missoula, Montana, Forenede Stater, 59802
        • Saint Patrick Hospital - Community Hospital
    • Nebraska
      • Grand Island, Nebraska, Forenede Stater, 68803
        • CHI Health Saint Francis
      • Kearney, Nebraska, Forenede Stater, 68847
        • CHI Health Good Samaritan
      • Kearney, Nebraska, Forenede Stater, 68845
        • Heartland Hematology and Oncology
      • Lincoln, Nebraska, Forenede Stater, 68510
        • Saint Elizabeth Regional Medical Center
      • Omaha, Nebraska, Forenede Stater, 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
        • OptumCare Cancer Care at Seven Hills
      • Henderson, Nevada, Forenede Stater, 89052
        • Cancer and Blood Specialists-Henderson
      • Henderson, Nevada, Forenede Stater, 89052
        • Las Vegas Cancer Center-Henderson
      • Henderson, Nevada, Forenede Stater, 89074
        • Comprehensive Cancer Centers of Nevada-Southeast Henderson
      • Henderson, Nevada, Forenede Stater, 89074
        • GenesisCare USA - Henderson
      • Henderson, Nevada, Forenede Stater, 89052
        • Comprehensive Cancer Centers of Nevada-Horizon Ridge
      • Henderson, Nevada, Forenede Stater, 89074
        • Las Vegas Urology - Green Valley
      • Henderson, Nevada, Forenede Stater, 89074
        • Las Vegas Urology - Pebble
      • Henderson, Nevada, Forenede Stater, 89074
        • Urology Specialists of Nevada - Green Valley
      • 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, 89109
        • GenesisCare USA - Las Vegas
      • Las Vegas, Nevada, Forenede Stater, 89119
        • Radiation Oncology Centers of Nevada Southeast
      • Las Vegas, Nevada, Forenede Stater, 89128
        • Comprehensive Cancer Centers of Nevada - Northwest
      • Las Vegas, Nevada, Forenede Stater, 89128
        • OptumCare Cancer Care at MountainView
      • Las Vegas, Nevada, Forenede Stater, 89135
        • Alliance for Childhood Diseases/Cure 4 the Kids Foundation
      • Las Vegas, Nevada, Forenede Stater, 89144
        • Comprehensive Cancer Centers of Nevada - 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, 89148
        • OptumCare Cancer Care at Fort Apache
      • Las Vegas, Nevada, Forenede Stater, 89169
        • Comprehensive Cancer Centers of Nevada - Central Valley
      • Las Vegas, Nevada, Forenede Stater, 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
        • GenesisCare USA - Vegas Tenaya
      • Las Vegas, Nevada, Forenede Stater, 89128
        • HealthCare Partners Medical Group Oncology/Hematology-Tenaya
      • Las Vegas, Nevada, Forenede Stater, 89148-2405
        • Las Vegas Cancer Center-Medical Center
      • Las Vegas, Nevada, Forenede Stater, 89148
        • GenesisCare USA - Fort Apache
      • Las Vegas, Nevada, Forenede Stater, 89149
        • HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
      • Las Vegas, Nevada, Forenede Stater, 89128
        • Ann M Wierman MD LTD
      • Las Vegas, Nevada, Forenede Stater, 89074
        • Las Vegas Urology - Pecos
      • 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, 89106
        • Urology Specialists of Nevada - Central
      • Las Vegas, Nevada, Forenede Stater, 89113
        • Las Vegas Prostate Cancer Center
      • Las Vegas, Nevada, Forenede Stater, 89113
        • Las Vegas Urology - Sunset
      • Las Vegas, Nevada, Forenede Stater, 89128
        • Las Vegas Urology - Cathedral Rock
      • Las Vegas, Nevada, Forenede Stater, 89128
        • Las Vegas Urology - Smoke Ranch
      • Las Vegas, Nevada, Forenede Stater, 89128
        • Urology Specialists of Nevada - Northwest
      • Las Vegas, Nevada, Forenede Stater, 89169
        • University Cancer Center
      • Las Vegas, Nevada, Forenede Stater, 89113
        • Urology Specialists of Nevada - Southwest
      • 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 Hampshire
      • Lebanon, New Hampshire, Forenede Stater, 03756
        • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
    • New Jersey
      • Mullica Hill, New Jersey, Forenede Stater, 08062
        • Inspira Medical Center Mullica Hill
      • Vineland, New Jersey, Forenede Stater, 08360
        • Inspira Medical Center Vineland
    • New Mexico
      • Albuquerque, New Mexico, Forenede Stater, 87102
        • University of New Mexico Cancer Center
    • New York
      • New York, New York, Forenede Stater, 10032
        • NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
      • The Bronx, New York, Forenede Stater, 10461
        • Montefiore Medical Center-Einstein Campus
      • The Bronx, New York, Forenede Stater, 10467
        • Montefiore Medical Center - Moses Campus
      • The Bronx, New York, Forenede Stater, 10461
        • Montefiore Medical Center-Weiler Hospital
    • North Carolina
      • Asheville, North Carolina, Forenede Stater, 28803
        • AdventHealth Infusion Center Asheville
      • Cary, North Carolina, Forenede Stater, 27518
        • Duke Cancer Institute Cary
      • Clinton, North Carolina, Forenede Stater, 28328
        • Southeastern Medical Oncology Center-Clinton
      • Clyde, North Carolina, Forenede Stater, 28721
        • AdventHealth Infusion Center Haywood
      • Durham, North Carolina, Forenede Stater, 27710
        • Duke University Medical Center
      • Goldsboro, North Carolina, Forenede Stater, 27534
        • Southeastern Medical Oncology Center-Goldsboro
      • Goldsboro, North Carolina, Forenede Stater, 27534
        • Wayne Memorial Hospital
      • Hendersonville, North Carolina, Forenede Stater, 28792
        • AdventHealth Hendersonville
      • Jacksonville, North Carolina, Forenede Stater, 28546
        • Southeastern Medical Oncology Center-Jacksonville
      • Jacksonville, North Carolina, Forenede Stater, 28546
        • Onslow Memorial Hospital
      • Raleigh, North Carolina, Forenede Stater, 27609
        • Duke Raleigh Hospital
      • Washington, North Carolina, Forenede Stater, 27889
        • Marion L Shepard Cancer Center at Vidant Beaufort Hospital
    • North Dakota
      • Bismarck, North Dakota, Forenede Stater, 58501
        • Sanford Bismarck Medical Center
      • Fargo, North Dakota, Forenede Stater, 58122
        • Sanford Roger Maris Cancer Center
      • Fargo, North Dakota, Forenede Stater, 58122
        • Sanford Broadway Medical Center
      • Fargo, North Dakota, Forenede Stater, 58122
        • Sanford Clinic North-Fargo
      • Fargo, North Dakota, Forenede Stater, 58103
        • Sanford South University Medical Center
    • Ohio
      • Beachwood, Ohio, Forenede Stater, 44122
        • UHHS-Chagrin Highlands Medical Center
      • 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
      • Chardon, Ohio, Forenede Stater, 44024
        • Geauga Hospital
      • Chillicothe, Ohio, Forenede Stater, 45601
        • Adena Regional Medical Center
      • Cincinnati, Ohio, Forenede Stater, 45219
        • University of Cincinnati Cancer Center-UC Medical Center
      • Cincinnati, Ohio, Forenede Stater, 45220
        • Good Samaritan Hospital - Cincinnati
      • Cincinnati, Ohio, Forenede Stater, 45242
        • Bethesda North Hospital
      • Cincinnati, Ohio, Forenede Stater, 45242
        • Oncology Hematology Care Inc-Blue Ash
      • Cincinnati, Ohio, Forenede Stater, 45202
        • Oncology Hematology Care Inc-Eden Park
      • Cincinnati, Ohio, Forenede Stater, 45211
        • Oncology Hematology Care Inc-Mercy West
      • Cincinnati, Ohio, Forenede Stater, 45230
        • Oncology Hematology Care Inc-Anderson
      • Cincinnati, Ohio, Forenede Stater, 45236
        • Oncology Hematology Care Inc-Kenwood
      • Cincinnati, Ohio, Forenede Stater, 45247
        • TriHealth Cancer Institute-Westside
      • Cincinnati, Ohio, Forenede Stater, 45255
        • TriHealth Cancer Institute-Anderson
      • Cleveland, Ohio, Forenede Stater, 44106
        • Case Western Reserve University
      • Cleveland, Ohio, Forenede Stater, 44109
        • MetroHealth Medical Center
      • Cleveland, Ohio, Forenede Stater, 44195
        • Cleveland Clinic Foundation
      • Cleveland, Ohio, Forenede Stater, 44111
        • Cleveland Clinic Cancer Center/Fairview Hospital
      • Columbus, Ohio, Forenede Stater, 43214
        • Riverside Methodist Hospital
      • Columbus, Ohio, Forenede Stater, 43210
        • Ohio State University Comprehensive Cancer Center
      • Columbus, Ohio, Forenede Stater, 43219
        • The Mark H Zangmeister Center
      • Columbus, Ohio, Forenede Stater, 43214
        • Columbus Oncology and Hematology Associates Inc
      • Columbus, Ohio, Forenede Stater, 43228
        • Doctors Hospital
      • Columbus, Ohio, Forenede Stater, 43213
        • Mount Carmel East Hospital
      • Columbus, Ohio, Forenede Stater, 43215
        • Grant Medical Center
      • Columbus, Ohio, Forenede Stater, 43222
        • Mount Carmel Health Center West
      • Dayton, Ohio, Forenede Stater, 45406
        • Good Samaritan Hospital - Dayton
      • Dayton, Ohio, Forenede Stater, 45409
        • Miami Valley Hospital
      • Dayton, Ohio, Forenede Stater, 45415
        • Dayton Physician LLC-Miami Valley Hospital North
      • Dayton, Ohio, Forenede Stater, 45415
        • Miami Valley Hospital North
      • 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
      • Dublin, Ohio, Forenede Stater, 43016
        • Dublin Methodist Hospital
      • Elyria, Ohio, Forenede Stater, 44035
        • Mercy Cancer Center-Elyria
      • Fairfield, Ohio, Forenede Stater, 45014
        • Oncology Hematology Care Inc-Healthplex
      • Findlay, Ohio, Forenede Stater, 45840
        • Blanchard Valley Hospital
      • Findlay, Ohio, Forenede Stater, 45840
        • Armes Family Cancer Center
      • Findlay, Ohio, Forenede Stater, 45840
        • Orion Cancer Care
      • Franklin, Ohio, Forenede Stater, 45005-1066
        • Atrium Medical Center-Middletown Regional Hospital
      • Franklin, Ohio, Forenede Stater, 45005
        • Dayton Physicians LLC-Atrium
      • Greenville, Ohio, Forenede Stater, 45331
        • Wayne Hospital
      • Greenville, Ohio, Forenede Stater, 45331
        • Dayton Physicians LLC-Wayne
      • Grove City, Ohio, Forenede Stater, 43123
        • Mount Carmel Grove City Hospital
      • Independence, Ohio, Forenede Stater, 44131
        • Cleveland Clinic Cancer Center Independence
      • Kettering, Ohio, Forenede Stater, 45429
        • Kettering Medical Center
      • Kettering, Ohio, Forenede Stater, 45409
        • Greater Dayton Cancer Center
      • Kettering, Ohio, Forenede Stater, 45420
        • First Dayton Cancer Care
      • Lancaster, Ohio, Forenede Stater, 43130
        • Fairfield Medical Center
      • Mansfield, Ohio, Forenede Stater, 44903
        • OhioHealth Mansfield Hospital
      • Marietta, Ohio, Forenede Stater, 45750
        • Marietta Memorial Hospital
      • Marion, Ohio, Forenede Stater, 43302
        • OhioHealth Marion General Hospital
      • Mayfield Heights, Ohio, Forenede Stater, 44124
        • Hillcrest Hospital Cancer Center
      • Mayfield Heights, Ohio, Forenede Stater, 44124
        • UH Seidman Cancer Center at Landerbrook Health Center
      • Mentor, Ohio, Forenede Stater, 44060
        • UH Seidman Cancer Center at Lake Health Mentor Campus
      • Middleburg Heights, Ohio, Forenede Stater, 44130
        • UH Seidman Cancer Center at Southwest General Hospital
      • Middletown, Ohio, Forenede Stater, 45042
        • Dayton Physicians LLC-Signal Point
      • Mount Vernon, Ohio, Forenede Stater, 43050
        • Knox Community Hospital
      • Newark, Ohio, Forenede Stater, 43055
        • Licking Memorial Hospital
      • Newark, Ohio, Forenede Stater, 43055
        • Newark Radiation Oncology
      • Parma, Ohio, Forenede Stater, 44129
        • University Hospitals Parma Medical Center
      • Portsmouth, Ohio, Forenede Stater, 45662
        • Southern Ohio Medical Center
      • Sandusky, Ohio, Forenede Stater, 44870
        • North Coast Cancer Care
      • Sandusky, Ohio, Forenede Stater, 44870
        • UH Seidman Cancer Center at Firelands Regional Medical Center
      • Sidney, Ohio, Forenede Stater, 45365
        • Dayton Physicians LLC-Wilson
      • Springfield, Ohio, Forenede Stater, 45505
        • Springfield Regional Medical Center
      • Springfield, Ohio, Forenede Stater, 45504
        • Springfield Regional Cancer Center
      • Strongsville, Ohio, Forenede Stater, 44136
        • Cleveland Clinic Cancer Center Strongsville
      • Sylvania, Ohio, Forenede Stater, 43560
        • ProMedica Flower Hospital
      • Toledo, Ohio, Forenede Stater, 43606
        • ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
      • Troy, Ohio, Forenede Stater, 45373
        • Upper Valley Medical Center
      • Troy, Ohio, Forenede Stater, 45373
        • Dayton Physicians LLC - Troy
      • Wadsworth, Ohio, Forenede Stater, 44281
        • University Hospitals Sharon Health Center
      • Warren, Ohio, Forenede Stater, 44484
        • Saint Joseph Warren Hospital
      • Warrensville Heights, Ohio, Forenede Stater, 44122
        • South Pointe Hospital
      • West Chester, Ohio, Forenede Stater, 45069
        • University of Cincinnati Cancer Center-West Chester
      • Westerville, Ohio, Forenede Stater, 43081
        • Saint Ann's Hospital
      • Westlake, Ohio, Forenede Stater, 44145
        • UH Seidman Cancer Center at Saint John Medical Center
      • Westlake, Ohio, Forenede Stater, 44145
        • UHHS-Westlake Medical Center
      • Wooster, Ohio, Forenede Stater, 44691
        • Cleveland Clinic Wooster Family Health and Surgery 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
    • Oregon
      • Baker City, Oregon, Forenede Stater, 97814
        • Saint Alphonsus Medical Center-Baker City
      • Ontario, Oregon, Forenede Stater, 97914
        • Saint Alphonsus Medical Center-Ontario
    • Pennsylvania
      • Allentown, Pennsylvania, Forenede Stater, 18103
        • Lehigh Valley Hospital-Cedar Crest
      • Beaver, Pennsylvania, Forenede Stater, 15009
        • UPMC-Heritage Valley Health System Beaver
      • Bethlehem, Pennsylvania, Forenede Stater, 18017
        • Lehigh Valley Hospital - Muhlenberg
      • Chadds Ford, Pennsylvania, Forenede Stater, 19317
        • Christiana Care Health System-Concord Health Center
      • Danville, Pennsylvania, Forenede Stater, 17822
        • Geisinger Medical Center
      • East Stroudsburg, Pennsylvania, Forenede Stater, 18301
        • Pocono Medical Center
      • Greensburg, Pennsylvania, Forenede Stater, 15601
        • UPMC Cancer Centers - Arnold Palmer Pavilion
      • Hazleton, Pennsylvania, Forenede Stater, 18201
        • Geisinger Medical Center-Cancer Center Hazleton
      • Hazleton, Pennsylvania, Forenede Stater, 18201
        • Lehigh Valley Hospital-Hazleton
      • Hershey, Pennsylvania, Forenede Stater, 17033-0850
        • Penn State Milton S Hershey Medical Center
      • Johnstown, Pennsylvania, Forenede Stater, 15901
        • UPMC-Johnstown/John P. Murtha Regional Cancer Center
      • 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
      • Philadelphia, Pennsylvania, Forenede Stater, 19111
        • Fox Chase Cancer Center
      • Philadelphia, Pennsylvania, Forenede Stater, 19104
        • University of Pennsylvania/Abramson Cancer Center
      • Pittsburgh, Pennsylvania, Forenede Stater, 15213
        • UPMC-Magee Womens Hospital
      • Pittsburgh, Pennsylvania, Forenede Stater, 15232
        • University of Pittsburgh Cancer Institute (UPCI)
      • Pittsburgh, Pennsylvania, Forenede Stater, 15232
        • UPMC-Shadyside Hospital
      • Pittsburgh, Pennsylvania, Forenede Stater, 15213
        • UPMC-Presbyterian Hospital
      • Pittsburgh, Pennsylvania, Forenede Stater, 15215
        • UPMC-Saint Margaret
      • Pittsburgh, Pennsylvania, Forenede Stater, 15236
        • UPMC Jefferson Regional Radiation Oncology
      • Pittsburgh, Pennsylvania, Forenede Stater, 15237
        • UPMC-Passavant Hospital
      • Pittsburgh, Pennsylvania, Forenede Stater, 15243
        • UPMC-Saint Clair Hospital Cancer Center
      • Pottsville, Pennsylvania, Forenede Stater, 17901
        • Geisinger Cancer Services-Pottsville
      • Scranton, Pennsylvania, Forenede Stater, 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
      • Wilkes-Barre, Pennsylvania, Forenede Stater, 18711
        • Geisinger Wyoming Valley/Henry Cancer Center
    • South Carolina
      • Anderson, South Carolina, Forenede Stater, 29621
        • AnMed Health Cancer Center
      • Boiling Springs, South Carolina, Forenede Stater, 29316
        • Prisma Health Cancer Institute - Spartanburg
      • Charleston, South Carolina, Forenede Stater, 29425
        • Medical University of South Carolina
      • Easley, South Carolina, Forenede Stater, 29640
        • Prisma Health Cancer Institute - Easley
      • Greenville, South Carolina, Forenede Stater, 29605
        • Prisma Health Cancer Institute - Faris
      • Greenville, South Carolina, Forenede Stater, 29615
        • Prisma Health Cancer Institute - Eastside
      • Greenville, South Carolina, Forenede Stater, 29605
        • Prisma Health Cancer Institute - Butternut
      • Greenville, South Carolina, Forenede Stater, 29605
        • Prisma Health Greenville Memorial Hospital
      • Greer, South Carolina, Forenede Stater, 29650
        • Prisma Health Cancer Institute - Greer
      • Seneca, South Carolina, Forenede Stater, 29672
        • Prisma Health Cancer Institute - Seneca
    • South Dakota
      • Sioux Falls, South Dakota, Forenede Stater, 57117-5134
        • Sanford USD Medical Center - Sioux Falls
      • Sioux Falls, South Dakota, Forenede Stater, 57104
        • Sanford Cancer Center Oncology Clinic
    • Tennessee
      • Chattanooga, Tennessee, Forenede Stater, 37404
        • Memorial Hospital
      • Hixson, Tennessee, Forenede Stater, 37343
        • Pulmonary Medicine Center of Chattanooga-Hixson
      • Ooltewah, Tennessee, Forenede Stater, 37363
        • Memorial GYN Plus
    • Texas
      • Bryan, Texas, Forenede Stater, 77802
        • Saint Joseph Regional Cancer Center
      • Dallas, Texas, Forenede Stater, 75235
        • Parkland Memorial Hospital
      • Dallas, Texas, Forenede Stater, 75390
        • UT Southwestern/Simmons Cancer Center-Dallas
      • Fort Worth, Texas, Forenede Stater, 76104
        • UT Southwestern/Simmons Cancer Center-Fort Worth
      • Houston, Texas, Forenede Stater, 77030
        • Houston Methodist Hospital
      • Houston, Texas, Forenede Stater, 77070
        • Methodist Willowbrook Hospital
      • Richardson, Texas, Forenede Stater, 75080
        • UT Southwestern Clinical Center at Richardson/Plano
      • San Antonio, Texas, Forenede Stater, 78229
        • University of Texas Health Science Center at San Antonio
      • Sugar Land, Texas, Forenede Stater, 77479
        • Houston Methodist Sugar Land Hospital
    • Utah
      • Farmington, Utah, Forenede Stater, 84025
        • Farmington Health Center
      • Salt Lake City, Utah, Forenede Stater, 84112
        • Huntsman Cancer Institute/University of Utah
      • Salt Lake City, Utah, Forenede Stater, 84106
        • University of Utah Sugarhouse Health Center
    • Washington
      • Bellevue, Washington, Forenede Stater, 98004
        • Overlake Medical Center
      • Bremerton, Washington, Forenede Stater, 98310
        • Harrison HealthPartners Hematology and Oncology-Bremerton
      • Bremerton, Washington, Forenede Stater, 98310
        • Harrison Medical Center
      • Burien, Washington, Forenede Stater, 98166
        • Highline Medical Center-Main Campus
      • Enumclaw, Washington, Forenede Stater, 98022
        • Saint Elizabeth Hospital
      • Federal Way, Washington, Forenede Stater, 98003
        • Saint Francis Hospital
      • Lakewood, Washington, Forenede Stater, 98499
        • Saint Clare Hospital
      • Poulsbo, Washington, Forenede Stater, 98370
        • Harrison HealthPartners Hematology and Oncology-Poulsbo
      • Renton, Washington, Forenede Stater, 98055
        • Valley Medical Center
      • Tacoma, Washington, Forenede Stater, 98405
        • Northwest Medical Specialties PLLC
      • Tacoma, Washington, Forenede Stater, 98405
        • Franciscan Research Center-Northwest Medical Plaza
    • Wisconsin
      • Burlington, Wisconsin, Forenede Stater, 53105
        • Aurora Cancer Care-Southern Lakes VLCC
      • Chippewa Falls, Wisconsin, Forenede Stater, 54729
        • Marshfield Clinic-Chippewa Center
      • Eau Claire, Wisconsin, Forenede Stater, 54701
        • Marshfield Medical Center-EC Cancer Center
      • Eau Claire, Wisconsin, Forenede Stater, 54701
        • Marshfield Clinic Cancer Center at Sacred Heart
      • Fond du Lac, Wisconsin, Forenede Stater, 54937
        • Aurora Health Center-Fond du Lac
      • Germantown, Wisconsin, Forenede Stater, 53022
        • Aurora Health Care Germantown Health Center
      • Grafton, Wisconsin, Forenede Stater, 53024
        • Aurora Cancer Care-Grafton
      • Green Bay, Wisconsin, Forenede Stater, 54311
        • Aurora BayCare Medical Center
      • Johnson Creek, Wisconsin, Forenede Stater, 53038
        • UW Cancer Center Johnson Creek
      • Kenosha, Wisconsin, Forenede Stater, 53142
        • Aurora Cancer Care-Kenosha South
      • Ladysmith, Wisconsin, Forenede Stater, 54848
        • Marshfield Clinic - Ladysmith Center
      • Madison, Wisconsin, Forenede Stater, 53792
        • University of Wisconsin Carbone Cancer Center
      • Marinette, Wisconsin, Forenede Stater, 54143
        • Aurora Bay Area Medical Group-Marinette
      • Marinette, Wisconsin, Forenede Stater, 54143
        • Bay Area Medical Center
      • Marshfield, Wisconsin, Forenede Stater, 54449
        • Marshfield Medical Center-Marshfield
      • Milwaukee, Wisconsin, Forenede Stater, 53226
        • Medical College of Wisconsin
      • Milwaukee, Wisconsin, Forenede Stater, 53209
        • Aurora Cancer Care-Milwaukee
      • Milwaukee, Wisconsin, Forenede Stater, 53215
        • Aurora Saint Luke's Medical Center
      • Milwaukee, Wisconsin, Forenede Stater, 53233
        • Aurora Sinai Medical Center
      • Minocqua, Wisconsin, Forenede Stater, 54548
        • Marshfield Clinic-Minocqua Center
      • New Richmond, Wisconsin, Forenede Stater, 54017
        • Cancer Center of Western Wisconsin
      • Oshkosh, Wisconsin, Forenede Stater, 54904
        • Vince Lombardi Cancer Clinic - Oshkosh
      • Racine, Wisconsin, Forenede Stater, 53406
        • Aurora Cancer Care-Racine
      • Rice Lake, Wisconsin, Forenede Stater, 54868
        • Marshfield Medical Center-Rice Lake
      • Sheboygan, Wisconsin, Forenede Stater, 53081
        • Vince Lombardi Cancer Clinic-Sheboygan
      • Stevens Point, Wisconsin, Forenede Stater, 54481
        • Ascension Saint Michael's Hospital
      • Stevens Point, Wisconsin, Forenede Stater, 54482
        • Marshfield Medical Center-River Region at Stevens Point
      • Summit, Wisconsin, Forenede Stater, 53066
        • Aurora Medical Center in Summit
      • Two Rivers, Wisconsin, Forenede Stater, 54241
        • Vince Lombardi Cancer Clinic-Two Rivers
      • Waukesha, Wisconsin, Forenede Stater, 53188
        • Aurora Cancer Care-Waukesha
      • Wausau, Wisconsin, Forenede Stater, 54401
        • Marshfield Clinic-Wausau Center
      • Wauwatosa, Wisconsin, Forenede Stater, 53226
        • Aurora Cancer Care-Milwaukee West
      • West Allis, Wisconsin, Forenede Stater, 53227
        • Aurora West Allis Medical Center
      • Weston, Wisconsin, Forenede Stater, 54476
        • Marshfield Medical Center - Weston
      • Wisconsin Rapids, Wisconsin, Forenede Stater, 54494
        • Marshfield Clinic - Wisconsin Rapids Center
    • Wyoming
      • 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:

  • Patienter skal have et lokalt fremskredent og inoperabelt eller metastatisk gastroenteropancreatisk neuroendokrint karcinom, der enten er kendt eller formodet at være af gastrointestinal (GI) oprindelse; primære tumorer, der stammer fra lunger, gynækologiske organer eller prostata, er ikke tilladt
  • Patienter skal have patologisk/histologisk bekræftet tumor af ikke-småcellet histologi
  • Patienter skal have et Ki-67 proliferativt indeks på 20-100 % ELLER mindst 10 mitotiske tal pr. 10 kraftige felter
  • Patienter skal have målbar sygdom ved responsevalueringskriterier i solide tumorer (RECIST) 1.1 kriterier; baseline målinger og evalueringer af alle sygdomssteder skal opnås inden for 4 uger før randomisering og skal erhverves ved multifasisk computertomografi (CT) eller kontrastmagnetisk resonansbilleddannelse (MRI)

    • BEMÆRK: positronemissionstomografi (PET)-CT-scanninger er tilladt, forudsat at CT-delen af ​​undersøgelsen svarer til en diagnostisk CT-scanning og inkluderer både oral og IV kontrast
  • Patienter har muligvis ikke haft nogen tidligere systemisk behandling for denne malignitet (f.eks. kemoterapi eller somatostatinanaloger); forudgående palliativ stråling er tilladt, men udstrålede læsioner må ikke anvendes til måling
  • Patienter har muligvis ikke modtaget nogen af ​​protokolmidlerne inden for 5 år før randomisering
  • Eventuelle tidligere operationer skal være gennemført mindst 4 uger før randomisering
  • Patienter skal have en Eastern Cooperative Oncology Group (ECOG) præstationsstatus på 0-2
  • Patienter får muligvis ikke andre forsøgsmidler, mens de er i undersøgelsesbehandling
  • Patienter får muligvis ikke Coumadin, mens de er i behandling; andre antikoagulantia er tilladt
  • Leukocytter >= 3.000/mm^3
  • Absolut neutrofiltal >= 1.500/mm^3
  • Hæmoglobin >= 9 g/dL
  • Blodplader >= 100.000/mm^3
  • Total bilirubin =< institutionel øvre normalgrænse (ULN) eller =< 1,5 X institutionel ULN (hvis patienten har levermetastaser)
  • Aspartataminotransferase (AST) (serumglutamin-oxaloeddikesyretransaminase [SGOT])/alaninaminotransferase (ALT) (serumglutamatpyruvattransaminase [SGPT]) =< 2,5 X institutionel ULN eller (=< 5 X institutionel ULN, hvis patienten har levermetastaser)
  • Serumkreatinin =< 1,5 X institutionel ULN og kreatininclearance >= 60 ml/min.

    • BEMÆRK: Kreatininclearance skal beregnes ved hjælp af Cockcroft-Gault-ligningen
  • Patienter skal have en forventet levetid på >= 12 uger som bestemt klinisk af den behandlende læge
  • Patienter med hjernemetastaser (enten fjerntliggende eller aktuelle) eller tilstedeværelse af karcinomatøs meningitis er ikke kvalificerede
  • Patienter med kendt dihydropyrimidin dehydrogenase (DPD) mangel vil blive udelukket
  • Patienter må IKKE have aktiv eller ukontrolleret infektion, symptomatisk hjertesvigt, ustabil angina pectoris, hjertearytmi eller en alvorlig psykiatrisk sygdom/social situation, der ville begrænse overholdelse af undersøgelseskrav
  • Patienter med nedsat beslutningsevne kan deltage i undersøgelsen, hvis en juridisk autoriseret repræsentant er tilgængelig for samtykke
  • Patienter må IKKE have en historie med allergiske reaktioner, der tilskrives forbindelser af lignende kemisk eller biokemisk sammensætning som cisplatin, carboplatin, etoposid, temozolomid eller capecitabin
  • Patienter må IKKE have absorptionsproblemer, der ville begrænse evnen til at absorbere undersøgelsesmidler
  • Patienter med en anamnese på følgende inden for =< 12 måneder efter studiestart er ikke kvalificerede:

    • Arterielle tromboemboliske hændelser
    • Ustabil angina
    • Myokardieinfarkt
  • Patienter med symptomatisk perifer vaskulær sygdom er ikke kvalificerede
  • Patienter må IKKE have tidligere eller samtidig malignitet; der gøres undtagelser for patienter, der opfylder en af ​​følgende betingelser:

    • Ikke-melanom hudkræft, in situ livmoderhalskræft, overfladisk blærekræft eller brystkræft in situ ELLER
    • Tidligere malignitet er fuldstændigt udskåret eller fjernet, og patienten har været uafbrudt sygdomsfri i > 5 år ELLER
    • Tidligere malignitet helbredt af ikke-kirurgiske modaliteter, og patienten har været konstant sygdomsfri i > 5 år
  • Kvinder må ikke være gravide eller ammende

    • Alle kvinder i den fødedygtige alder skal have en blodprøve eller urinundersøgelse inden for 2 uger før randomisering for at udelukke graviditet
    • En kvinde i den fødedygtige alder er enhver kvinde, uanset seksuel orientering eller om de har gennemgået tubal ligering, som opfylder følgende kriterier: 1) ikke har gennemgået en hysterektomi eller bilateral ooforektomi; eller 2) ikke har været naturligt postmenopausal i mindst 24 på hinanden følgende måneder (dvs. har haft menstruation på noget tidspunkt i de foregående 24 på hinanden følgende måneder)
  • Kvinder i den fødedygtige alder og seksuelt aktive mænd skal kraftigt rådes til at bruge en accepteret og effektiv præventionsmetode eller at afholde sig fra samleje i hele deres deltagelse i undersøgelsen
  • Patienter skal kunne sluge piller
  • Patienter skal være i stand til at tolerere CT- eller magnetisk resonans (MR)-billeddannelse inklusive kontrastmidler efter behov for behandlingen og protokollen
  • Patienter, der vides at have humant immundefektvirus (HIV) eller er i antiretroviral kombinationsbehandling, er ikke kvalificerede

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

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

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Arm A (capecitabin, temozolomid)
Patienterne modtager capecitabin PO BID på dag 1-14 og temozolomid PO QD på dag 10-14. Kurser gentages hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.
Korrelative undersøgelser
Andre navne:
  • VePesid®
Givet PO
Andre navne:
  • Toposar®
Givet PO
Andre navne:
  • Xeloda
  • ACH-Capecitabin
  • Mint-Capecitabin
  • SANDOZ Capecitabine
  • TARO-Capecitabin
  • EVA-Capecitabin
Aktiv komparator: Arm B (cisplatin, carboplatin, etoposid)
Patienterne får cisplatin IV på dag 1-3 eller carboplatin IV på dag 1. Patienterne får også etoposid IV på dag 1-3. Kurser gentages hver 21. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.
Korrelative undersøgelser
Andre navne:
  • VePesid®
Givet IV
Andre navne:
  • Paraplatin
Givet IV
Andre navne:
  • VP-16 eller VP-16-213
Givet IV
Andre navne:
  • Platinol-AQ

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Progressionfri Overlevelse (PFS)
Tidsramme: vurderet ved baseline, hver 8. uge indtil behandlingen er afsluttet, derefter hver 3. måned inden for 2 år og hver 6. måned inden for 3-5 år fra randomisering indtil sygdomsprogression, op til 5 år fra studieindmeldelse
PFS defineres som tiden fra randomisering til dokumenteret progression eller død uden progression. PFS censureres på datoen for sidste sygdomsvurdering. Studiet blev lukket på grund af futilitet i 2021 efter DSMC-mødet i foråret 2021, hvor det blev konstateret, at grænsen for futilitet var opfyldt (dvs. temozolomid og capecitabin syntes ikke at være overlegne i forhold til kemoterapi med platin og etoposid). Da den midlertidige analyse førte til studiekonklusionen, blev der ikke udført nogen PFS-stratificeret logrank-test med de data, der blev uddraget den 23. april 2025 til den endelige analyse, som blev præsenteret her.
vurderet ved baseline, hver 8. uge indtil behandlingen er afsluttet, derefter hver 3. måned inden for 2 år og hver 6. måned inden for 3-5 år fra randomisering indtil sygdomsprogression, op til 5 år fra studieindmeldelse

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Overall overlevelse (OS)
Tidsramme: vurderet ved baseline, derefter hver 3. måned inden for 2 år fra randomisering, og hver 6. måned hvis patienten er 3-5 år fra randomisering, op til 5 år fra randomisering
OS defineres som tiden fra randomisering til død af enhver årsag. OS censureres på datoen for sidste kontakt. Median OS estimeres ved hjælp af Kaplan-Meier-metoden.
vurderet ved baseline, derefter hver 3. måned inden for 2 år fra randomisering, og hver 6. måned hvis patienten er 3-5 år fra randomisering, op til 5 år fra randomisering
Objektiv responsrate (ORR)
Tidsramme: vurderet ved baseline, hver 8. uge indtil behandlingsafslutning, derefter hver 3. måned inden for 2 år og hver 6. måned inden for 3-5 år, op til 5 år fra registrering; det bedste respons blandt alle vurderinger blev betragtet som objektiv respons
ORR defineres som andelen af patienter med komplet respons (CR) eller delvis respons (PR). Respons evalueres ved hjælp af RECIST 1.1-kriterierne. CR defineres som forsvinden af alle læsioner. Alle patologiske lymfeknuder (uanset om de er mål eller ikke-mål) skal have en reduktion i kort akse til < 10 mm. PR defineres som mindst en 30 % reduktion i summen af diametrene af mållæsioner, med udgangspunkt i baseline summen af diametrene.
vurderet ved baseline, hver 8. uge indtil behandlingsafslutning, derefter hver 3. måned inden for 2 år og hver 6. måned inden for 3-5 år, op til 5 år fra registrering; det bedste respons blandt alle vurderinger blev betragtet som objektiv respons

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
At vurdere den objektive responsrate baseret på proliferationsmarkør Ki-67-indeks
Tidsramme: vurderet ved baseline, hver 8. uge indtil behandlingsafslutning, derefter hver 3. måned inden for 2 år og hver 6. måned inden for 3-5 år, op til 5 år fra registrering; den bedste respons blandt alle vurderinger blev betragtet som objektiv respons
Effekten af hver behandlingsregime på objektiv responsrate (ORR, defineret som ovenfor i det sekundære mål) vurderes ved Ki-67-indeksniveau som en eksplorativ analyse. Ved brug af Youdens indeks, som betragter specificitet og sensitivitet som lige vigtige, er det optimale cutoff-punkt for Ki-67-indeks til bedst at forudsige respons 50,5. Ved at bruge den optimale Ki-67 cutoff-værdi på 50,5 fra ROC-analysen blev patienterne opdelt i Ki-67 lav (Ki-67 < 50,5) og høj (Ki-67 ≥ 50,5) grupper. Effekten af hver behandlingsregime på ORR blev undersøgt i Ki-67 lav og Ki-67 høj separat.
vurderet ved baseline, hver 8. uge indtil behandlingsafslutning, derefter hver 3. måned inden for 2 år og hver 6. måned inden for 3-5 år, op til 5 år fra registrering; den bedste respons blandt alle vurderinger blev betragtet som objektiv respons
At vurdere behandlingseffekten baseret på markør for proliferation Ki-67-indeks
Tidsramme: vurderet ved baseline, hver 8. uge indtil behandlingsafslutning, derefter hver 3. måned inden for 2 år og hver 6. måned inden for 3-5 år fra randomisering indtil sygdomsprogression, op til 5 år fra studiestart
Virkningen af hver behandlingsregime på PFS og OS (defineret som ovenfor i de primære og sekundære mål) vurderes ved Ki-67-indeksniveau som en udforskende analyse. Ved hjælp af Youdens indeks, som betragter specificitet og følsomhed som lige vigtige, er det optimale afskæringspunkt for Ki-67-indeks til bedst at forudsige respons 50,5. Ved hjælp af den optimale Ki-67-afskæringsværdi på 50,5 fra ROC-analysen blev patienterne inddelt i Ki-67 lav (Ki-67 < 50,5) og høj (Ki-67 ≥ 50,5) grupper. Virkningen af hver behandlingsregime på PFS og OS blev undersøgt i Ki-67 lav og Ki-67 høj hver for sig.
vurderet ved baseline, hver 8. uge indtil behandlingsafslutning, derefter hver 3. måned inden for 2 år og hver 6. måned inden for 3-5 år fra randomisering indtil sygdomsprogression, op til 5 år fra studiestart
Sammenhæng mellem tumordifferentiering og behandlingseffekt
Tidsramme: vurderet ved baseline, hver 8. uge indtil behandlingsafslutning, derefter hver 3. måned inden for 2 år og hver 6. måned inden for 3-5 år fra randomisering indtil sygdomsprogression, op til 5 år fra studieregistrering
Sammenhængen mellem tumordifferentiering (veldifferentieret kontra dårligt differentieret) med PFS, ORR og OS (defineret som i de primære og sekundære mål) blev evalueret.
vurderet ved baseline, hver 8. uge indtil behandlingsafslutning, derefter hver 3. måned inden for 2 år og hver 6. måned inden for 3-5 år fra randomisering indtil sygdomsprogression, op til 5 år fra studieregistrering

Samarbejdspartnere og efterforskere

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

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Jennifer Eads, ECOG-ACRIN Cancer Research Group

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)

6. november 2015

Primær færdiggørelse (Faktiske)

23. april 2025

Studieafslutning (Anslået)

1. januar 2029

Datoer for studieregistrering

Først indsendt

2. november 2015

Først indsendt, der opfyldte QC-kriterier

2. november 2015

Først opslået (Anslået)

3. november 2015

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

1. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

29. april 2026

Sidst verificeret

1. april 2026

Mere information

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Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

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

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