- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT02921256
Veliparib, Pembrolizumab og kombinationskemoterapi til behandling af patient med lokalt avanceret rektalcancer
En klinisk fase II-forsøgsplatform for sensibilisering ved anvendelse af total neoadjuverende terapi (TNT) ved rektalcancer
Studieoversigt
Status
Detaljeret beskrivelse
PRIMÆR MÅL:
I. At demonstrere en absolut forbedring i neoadjuvant rektal cancer (NAR) score for det eksperimentelle regime sammenlignet med samtidig randomiserede kontrolpatienter.
SEKUNDÆRE MÅL:
I. At sammenligne overordnet overlevelse (OS). II. At sammenligne sygdomsfri overlevelse (DFS). III. At sammenligne hastigheden af patologisk komplet respons (pCR) (knuder og tumor).
IV. For at sammenligne hastigheden af sphincter bevaring.
TERTIÆRE MÅL:
I. At sammenligne andelen af patienter, der har en tumorresektion samlet set, betinget af påbegyndelse af induktionskemoterapi og betinget af påbegyndelse af kemoradioterapi.
II. At sammenligne tiden fra påbegyndelse af kemoradioterapi til operation i undergruppen af patienter med tumorresektion.
UNDERSØGENDE MÅL:
I. At estimere hastigheden af sygdomsprogression under kemoterapi (før kemoradiation).
II. At sammenligne frekvensen af klinisk fuldstændig responsrate (cCR). III. For at sammenligne hastigheden af negativ perifer margin. IV. At sammenligne fuldførelseshastigheden for alle cyklusser af neoadjuverende kemoterapi.
V. At sammenligne hastigheden for fuldførelse af fuld kemoradiationsforløb. VI. At sammenligne toksiciteten og sikkerheden mellem indgreb. VII. At udforske de korrelative molekylære forudsigere for respons og fjernt svigt.
VIII. At udforske forholdet mellem radiografiske fund og patologiske resultater.
OVERSIGT: Patienterne randomiseres til 1 ud af 3 behandlingsarme.
ARM I: Patienter får mFOLFOX6-regimen bestående af oxaliplatin intravenøst (IV) over 2 timer, leucovorin calcium IV over 2 timer på dag 1 og fluorouracil IV kontinuerligt over 46-48 timer på dag 1-2. Behandlingen gentages hver anden uge i 8 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. 3-4 uger efter sidste dosis af mFOLFOX6 gennemgår patienten strålebehandling (RT) og får capecitabin oralt (PO) to gange dagligt (BID) mandag-fredag i 5 uger i fravær af sygdomsprogression eller uacceptabel toksicitet.
ARM II: Patienterne får mFOLFOX6-regimen bestående af oxaliplatin IV over 2 timer, leucovorin calcium IV over 2 timer på dag 1 og fluorouracil IV kontinuerligt over 46-48 timer på dag 1-2. Behandlingen gentages hver anden uge i 8 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. 3-4 uger efter sidste dosis af mFOLFOX6 patienten gennemgår RT og modtager capecitabin PO BID og veliparib PO BID mandag-fredag i 5 uger i fravær af sygdomsprogression eller uacceptabel toksicitet.
ARM III: Patienterne får mFOLFOX6-regimen bestående af oxaliplatin IV over 2 timer, leucovorin calcium IV over 2 timer på dag 1 og fluorouracil IV kontinuerligt over 46-48 timer på dag 1-2. Behandlingen gentages hver anden uge i 8 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. 3-4 uger efter sidste dosis af mFOLFOX6 skal patienten gennemgå RT og modtage capecitabin PO BID mandag-fredag i 5 uger. De modtager også pembrolizumab IV over 30 minutter hver 3. uge begyndende på dag 1 af RT i op til 6 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet.
Efter afslutning af undersøgelsesbehandlingen følges patienterne op efter 30 dage og hver 6. måned i op til 3 år.
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Fase 2
Kontakter og lokationer
Studiesteder
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Alabama
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Birmingham, Alabama, Forenede Stater, 35233
- University of Alabama at Birmingham Cancer Center
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Mobile, Alabama, Forenede Stater, 36688
- University of South Alabama Mitchell Cancer Institute
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Mobile, Alabama, Forenede Stater, 36607
- Southern Cancer Center PC-Mobile
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Mobile, Alabama, Forenede Stater, 36608
- Southern Cancer Center PC-Providence
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Mobile, Alabama, Forenede Stater, 36608
- Southern Cancer Center PC-Springhill
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Alaska
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Fairbanks, Alaska, Forenede Stater, 99701
- Fairbanks Memorial Hospital
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Arizona
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Gilbert, Arizona, Forenede Stater, 85234
- Banner MD Anderson Cancer Center
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Scottsdale, Arizona, Forenede Stater, 85259
- Mayo Clinic in Arizona
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Tucson, Arizona, Forenede Stater, 85704
- University of Arizona Cancer Center-Orange Grove Campus
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Tucson, Arizona, Forenede Stater, 85719
- Banner University Medical Center - Tucson
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Tucson, Arizona, Forenede Stater, 85719
- University of Arizona Cancer Center-North Campus
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Arkansas
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Fort Smith, Arkansas, Forenede Stater, 72903
- Mercy Hospital Fort Smith
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Hot Springs, Arkansas, Forenede Stater, 71913
- CHI Saint Vincent Cancer Center Hot Springs
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Jonesboro, Arkansas, Forenede Stater, 72401
- NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
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Little Rock, Arkansas, Forenede Stater, 72205
- University of Arkansas for Medical Sciences
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California
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Anaheim, California, Forenede Stater, 92806
- Kaiser Permanente-Anaheim
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Antioch, California, Forenede Stater, 94531
- Kaiser Permanente-Deer Valley Medical Center
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Arroyo Grande, California, Forenede Stater, 93420
- PCR Oncology
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Auburn, California, Forenede Stater, 95603
- Sutter Cancer Centers Radiation Oncology Services-Auburn
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Bakersfield, California, Forenede Stater, 93301
- AIS Cancer Center at San Joaquin Community Hospital
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Berkeley, California, Forenede Stater, 94704
- Alta Bates Summit Medical Center-Herrick Campus
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Burlingame, California, Forenede Stater, 94010
- Mills-Peninsula Medical Center
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Cameron Park, California, Forenede Stater, 95682
- Sutter Cancer Centers Radiation Oncology Services-Cameron Park
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Castro Valley, California, Forenede Stater, 94546
- Eden Hospital Medical Center
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Chico, California, Forenede Stater, 95926
- Enloe Medical Center
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Corona, California, Forenede Stater, 92879
- City of Hope Corona
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Duarte, California, Forenede Stater, 91010
- City of Hope Comprehensive Cancer Center
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Dublin, California, Forenede Stater, 94568
- Kaiser Permanente Dublin
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Fremont, California, Forenede Stater, 94538
- Kaiser Permanente-Fremont
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Fresno, California, Forenede Stater, 93720
- Kaiser Permanente-Fresno
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Fresno, California, Forenede Stater, 93720
- Fresno Cancer Center
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La Jolla, California, Forenede Stater, 92093
- UC San Diego Moores Cancer Center
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Lancaster, California, Forenede Stater, 93534
- City of Hope Antelope Valley
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Los Angeles, California, Forenede Stater, 90033
- USC / Norris Comprehensive Cancer Center
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Los Angeles, California, Forenede Stater, 90033
- Los Angeles County-USC Medical Center
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Los Angeles, California, Forenede Stater, 90027
- Kaiser Permanente Los Angeles Medical Center
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Los Angeles, California, Forenede Stater, 90048
- Cedars Sinai Medical Center
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Marysville, California, Forenede Stater, 95901
- Fremont - Rideout Cancer Center
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Modesto, California, Forenede Stater, 95355
- Memorial Medical Center
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Modesto, California, Forenede Stater, 95356
- Kaiser Permanente-Modesto
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Mountain View, California, Forenede Stater, 94040
- Palo Alto Medical Foundation-Camino Division
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Novato, California, Forenede Stater, 94945
- Sutter Cancer Research Consortium
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Oakland, California, Forenede Stater, 94611
- Kaiser Permanente-Oakland
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Oakland, California, Forenede Stater, 94611
- Kaiser Permanente Oakland-Broadway
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Orange, California, Forenede Stater, 92868
- UC Irvine Health/Chao Family Comprehensive Cancer Center
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Palo Alto, California, Forenede Stater, 94301
- Palo Alto Medical Foundation Health Care
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Rancho Cordova, California, Forenede Stater, 95670
- Kaiser Permanente-Rancho Cordova Cancer Center
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Redwood City, California, Forenede Stater, 94063
- Kaiser Permanente-Redwood City
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Richmond, California, Forenede Stater, 94801
- Kaiser Permanente-Richmond
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Riverside, California, Forenede Stater, 92505
- Kaiser Permanente-Riverside
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Rohnert Park, California, Forenede Stater, 94928
- Rohnert Park Cancer Center
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Roseville, California, Forenede Stater, 95678
- The Permanente Medical Group-Roseville Radiation Oncology
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Roseville, California, Forenede Stater, 95661
- Kaiser Permanente-Roseville
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Roseville, California, Forenede Stater, 95661
- Sutter Cancer Centers Radiation Oncology Services-Roseville
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Roseville, California, Forenede Stater, 95661
- Sutter Roseville Medical Center
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Sacramento, California, Forenede Stater, 95816
- Sutter Medical Center Sacramento
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Sacramento, California, Forenede Stater, 95817
- University of California Davis Comprehensive Cancer Center
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Sacramento, California, Forenede Stater, 95814
- Kaiser Permanente Downtown Commons
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Sacramento, California, Forenede Stater, 95823
- Kaiser Permanente-South Sacramento
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Sacramento, California, Forenede Stater, 95823
- South Sacramento Cancer Center
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Sacramento, California, Forenede Stater, 95825
- Kaiser Permanente - Sacramento
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San Diego, California, Forenede Stater, 92120
- Kaiser Permanente-San Diego Zion
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San Francisco, California, Forenede Stater, 94115
- Kaiser Permanente-San Francisco
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San Francisco, California, Forenede Stater, 94115
- California Pacific Medical Center-Pacific Campus
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San Jose, California, Forenede Stater, 95119
- Kaiser Permanente-Santa Teresa-San Jose
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San Leandro, California, Forenede Stater, 94577
- Kaiser Permanente San Leandro
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San Marcos, California, Forenede Stater, 92078
- Kaiser Permanente-San Marcos
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San Rafael, California, Forenede Stater, 94903
- Kaiser San Rafael-Gallinas
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San Rafael, California, Forenede Stater, 94903
- Kaiser Permanente-San Rafael
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Santa Clara, California, Forenede Stater, 95051
- Kaiser Permanente Medical Center - Santa Clara
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Santa Rosa, California, Forenede Stater, 95403
- Kaiser Permanente-Santa Rosa
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South Pasadena, California, Forenede Stater, 91030
- City of Hope South Pasadena
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South San Francisco, California, Forenede Stater, 94080
- Kaiser Permanente Cancer Treatment Center
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South San Francisco, California, Forenede Stater, 94080
- Kaiser Permanente-South San Francisco
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Stockton, California, Forenede Stater, 95210
- Kaiser Permanente-Stockton
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Sunnyvale, California, Forenede Stater, 94086
- Palo Alto Medical Foundation-Sunnyvale
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Truckee, California, Forenede Stater, 96161
- Gene Upshaw Memorial Tahoe Forest Cancer Center
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Upland, California, Forenede Stater, 91786
- City of Hope Upland
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Vacaville, California, Forenede Stater, 95688
- Kaiser Permanente Medical Center-Vacaville
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Vacaville, California, Forenede Stater, 95687
- Sutter Cancer Centers Radiation Oncology Services-Vacaville
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Vallejo, California, Forenede Stater, 94589
- Kaiser Permanente-Vallejo
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Vallejo, California, Forenede Stater, 94589
- Sutter Solano Medical Center/Cancer Center
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Walnut Creek, California, Forenede Stater, 94596
- Kaiser Permanente-Walnut Creek
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Whittier, California, Forenede Stater, 90602
- Presbyterian Intercommunity Hospital
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Colorado
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Aurora, Colorado, Forenede Stater, 80012
- Rocky Mountain Cancer Centers-Aurora
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Aurora, Colorado, Forenede Stater, 80045
- UCHealth University of Colorado Hospital
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Boulder, Colorado, Forenede Stater, 80301
- Boulder Community Hospital
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Boulder, Colorado, Forenede Stater, 80304
- Rocky Mountain Cancer Centers-Boulder
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Colorado Springs, Colorado, Forenede Stater, 80907
- Penrose-Saint Francis Healthcare
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Colorado Springs, Colorado, Forenede Stater, 80909
- UCHealth Memorial Hospital Central
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Colorado Springs, Colorado, Forenede Stater, 80907
- Rocky Mountain Cancer Centers-Penrose
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Denver, Colorado, Forenede Stater, 80210
- Porter Adventist Hospital
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Denver, Colorado, Forenede Stater, 80218
- Presbyterian - Saint Lukes Medical Center - Health One
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Denver, Colorado, Forenede Stater, 80218
- SCL Health Saint Joseph Hospital
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Englewood, Colorado, Forenede Stater, 80113
- Swedish Medical Center
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Fort Collins, Colorado, Forenede Stater, 80524
- Poudre Valley Hospital
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Grand Junction, Colorado, Forenede Stater, 81501
- Saint Mary's Hospital and Regional Medical Center
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Greeley, Colorado, Forenede Stater, 80631
- North Colorado Medical Center
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Lakewood, Colorado, Forenede Stater, 80228
- Saint Anthony Hospital
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Littleton, Colorado, Forenede Stater, 80120
- Rocky Mountain Cancer Centers-Littleton
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Littleton, Colorado, Forenede Stater, 80122
- Littleton Adventist Hospital
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Longmont, Colorado, Forenede Stater, 80501
- Longmont United Hospital
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Loveland, Colorado, Forenede Stater, 80539
- McKee Medical Center
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Pueblo, Colorado, Forenede Stater, 81004
- Saint Mary Corwin Medical Center
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Thornton, Colorado, Forenede Stater, 80260
- Rocky Mountain Cancer Centers-Thornton
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Wheat Ridge, Colorado, Forenede Stater, 80033
- SCL Health Lutheran Medical Center
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Connecticut
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Guilford, Connecticut, Forenede Stater, 06437
- Smilow Cancer Hospital Care Center - Guilford
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Hartford, Connecticut, Forenede Stater, 06102
- Hartford Hospital
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Meriden, Connecticut, Forenede Stater, 06451
- Midstate Medical Center
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New Britain, Connecticut, Forenede Stater, 06050
- The Hospital of Central Connecticut
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New Haven, Connecticut, Forenede Stater, 06520
- Yale University
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New Haven, Connecticut, Forenede Stater, 06510
- Smilow Cancer Center/Yale-New Haven Hospital
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North Haven, Connecticut, Forenede Stater, 06473
- Yale-New Haven Hospital North Haven Medical Center
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Norwich, Connecticut, Forenede Stater, 06360
- William Backus Hospital
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Trumbull, Connecticut, Forenede Stater, 06611
- Smilow Cancer Hospital Care Center-Trumbull
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Waterford, Connecticut, Forenede Stater, 06385
- Smilow Cancer Hospital Care Center - Waterford
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Delaware
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Lewes, Delaware, Forenede Stater, 19958
- Beebe Medical Center
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Newark, Delaware, Forenede Stater, 19713
- Helen F Graham Cancer Center
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Newark, Delaware, Forenede Stater, 19713
- Delaware Clinical and Laboratory Physicians PA
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Newark, Delaware, Forenede Stater, 19713
- Medical Oncology Hematology Consultants PA
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Newark, Delaware, Forenede Stater, 19718
- Christiana Care Health System-Christiana Hospital
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Rehoboth Beach, Delaware, Forenede Stater, 19971
- Beebe Health Campus
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Seaford, Delaware, Forenede Stater, 19973
- TidalHealth Nanticoke / Allen Cancer Center
-
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Florida
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Gainesville, Florida, Forenede Stater, 32610
- University of Florida Health Science Center - Gainesville
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Jacksonville, Florida, Forenede Stater, 32224-9980
- Mayo Clinic in Florida
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Orlando, Florida, Forenede Stater, 32806
- Orlando Health Cancer Institute
-
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Georgia
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Atlanta, Georgia, Forenede Stater, 30308
- Emory University Hospital Midtown
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Atlanta, Georgia, Forenede Stater, 30322
- Emory University Hospital/Winship Cancer Institute
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Atlanta, Georgia, Forenede Stater, 30342
- Emory Saint Joseph's Hospital
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Gainesville, Georgia, Forenede Stater, 30501
- Northeast Georgia Medical Center-Gainesville
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Savannah, Georgia, Forenede Stater, 31405
- Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
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Savannah, Georgia, Forenede Stater, 31404
- Memorial Health University Medical Center
-
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Hawaii
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Honolulu, Hawaii, Forenede Stater, 96813
- Queen's Medical Center
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Honolulu, Hawaii, Forenede Stater, 96817
- The Cancer Center of Hawaii-Liliha
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Honolulu, Hawaii, Forenede Stater, 96813
- Hawaii Cancer Care Inc - Waterfront Plaza
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Honolulu, Hawaii, Forenede Stater, 96813
- Straub Clinic and Hospital
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Honolulu, Hawaii, Forenede Stater, 96813
- University of Hawaii Cancer Center
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Honolulu, Hawaii, Forenede Stater, 96817
- Hawaii Cancer Care Inc-Liliha
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Honolulu, Hawaii, Forenede Stater, 96817
- Kuakini Medical Center
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Honolulu, Hawaii, Forenede Stater, 96817
- Queen's Cancer Center - Kuakini
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Honolulu, Hawaii, Forenede Stater, 96826
- Kapiolani Medical Center for Women and Children
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Honolulu, Hawaii, Forenede Stater, 96813
- Island Urology
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Honolulu, Hawaii, Forenede Stater, 96819
- Kaiser Permanente Moanalua Medical Center
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Lihue, Hawaii, Forenede Stater, 96766
- Wilcox Memorial Hospital and Kauai Medical Clinic
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‘Aiea, Hawaii, Forenede Stater, 96701
- Pali Momi Medical Center
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‘Aiea, Hawaii, Forenede Stater, 96701
- Queen's Cancer Center - Pearlridge
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‘Aiea, Hawaii, Forenede Stater, 96701
- The Cancer Center of Hawaii-Pali Momi
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Idaho
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Boise, Idaho, Forenede Stater, 83706
- Saint Alphonsus Cancer Care Center-Boise
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Caldwell, Idaho, Forenede Stater, 83605
- Saint Alphonsus Cancer Care Center-Caldwell
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Meridian, Idaho, Forenede Stater, 83642
- Idaho Urologic Institute-Meridian
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Post Falls, Idaho, Forenede Stater, 83854
- Kootenai Clinic Cancer Services - Post Falls
-
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Illinois
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Arlington Heights, Illinois, Forenede Stater, 60005
- Northwest Community Hospital
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Aurora, Illinois, Forenede Stater, 60504
- Rush - Copley Medical Center
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Bloomington, Illinois, Forenede Stater, 61704
- Illinois CancerCare-Bloomington
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Carbondale, Illinois, Forenede Stater, 62902
- Memorial Hospital of Carbondale
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Carterville, Illinois, Forenede Stater, 62918
- SIH Cancer Institute
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Centralia, Illinois, Forenede Stater, 62801
- Centralia Oncology Clinic
-
Chicago, Illinois, Forenede Stater, 60611
- Northwestern University
-
Chicago, Illinois, Forenede Stater, 60637
- University of Chicago Comprehensive Cancer Center
-
Chicago, Illinois, Forenede Stater, 60657
- Advocate Illinois Masonic Medical Center
-
Danville, Illinois, Forenede Stater, 61832
- Carle at The Riverfront
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Decatur, Illinois, Forenede Stater, 62526
- Decatur Memorial Hospital
-
Decatur, Illinois, Forenede Stater, 62526
- Cancer Care Specialists of Illinois - Decatur
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Effingham, Illinois, Forenede Stater, 62401
- Crossroads Cancer Center
-
Effingham, Illinois, Forenede Stater, 62401
- Carle Physician Group-Effingham
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Galesburg, Illinois, Forenede Stater, 61401
- Western Illinois Cancer Treatment Center
-
Geneva, Illinois, Forenede Stater, 60134
- Northwestern Medicine Cancer Center Delnor
-
Harvey, Illinois, Forenede Stater, 60426
- Ingalls Memorial Hospital
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Lake Forest, Illinois, Forenede Stater, 60045
- Northwestern Medicine Lake Forest Hospital
-
Mattoon, Illinois, Forenede Stater, 61938
- Carle Physician Group-Mattoon/Charleston
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Maywood, Illinois, Forenede Stater, 60153
- Loyola University Medical Center
-
Mount Vernon, Illinois, Forenede Stater, 62864
- Good Samaritan Regional Health Center
-
New Lenox, Illinois, Forenede Stater, 60451
- UC Comprehensive Cancer Center at Silver Cross
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O'Fallon, Illinois, Forenede Stater, 62269
- Cancer Care Center of O'Fallon
-
Ottawa, Illinois, Forenede Stater, 61350
- Illinois CancerCare-Ottawa Clinic
-
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
-
Rockford, Illinois, Forenede Stater, 61114
- SwedishAmerican Regional Cancer Center/ACT
-
Silvis, Illinois, Forenede Stater, 61282
- Genesis Cancer Center - Silvis
-
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
-
Warrenville, Illinois, Forenede Stater, 60555
- Northwestern Medicine Cancer Center Warrenville
-
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Indiana
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Evansville, Indiana, Forenede Stater, 47713
- Deaconess Clinic Downtown
-
Fort Wayne, Indiana, Forenede Stater, 46805
- Parkview Hospital Randallia
-
Fort Wayne, Indiana, Forenede Stater, 46845
- Parkview Regional Medical Center
-
Goshen, Indiana, Forenede Stater, 46526
- Goshen Center for Cancer Care
-
Indianapolis, Indiana, Forenede Stater, 46237
- Franciscan Health Indianapolis
-
Michigan City, Indiana, Forenede Stater, 46360
- Woodland Cancer Care Center
-
Mishawaka, Indiana, Forenede Stater, 46545
- Memorial Regional Cancer Center Day Road
-
Mooresville, Indiana, Forenede Stater, 46158
- Franciscan Health Mooresville
-
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
-
Cedar Rapids, Iowa, Forenede Stater, 52403
- Mercy Hospital
-
Cedar Rapids, Iowa, Forenede Stater, 52403
- Oncology Associates at Mercy Medical Center
-
Clive, Iowa, Forenede Stater, 50325
- Mercy Cancer Center-West Lakes
-
Clive, Iowa, Forenede Stater, 50325
- Medical Oncology and Hematology Associates-West Des Moines
-
Davenport, Iowa, Forenede Stater, 52803
- Genesis Medical Center - East Campus
-
Davenport, Iowa, Forenede Stater, 52804
- Genesis Cancer Care Institute
-
Davenport, Iowa, Forenede Stater, 52807
- Iowa Cancer Specialists
-
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, 50309
- Medical Oncology and Hematology Associates-Des Moines
-
Des Moines, Iowa, Forenede Stater, 50314
- Broadlawns Medical Center
-
Des Moines, Iowa, Forenede Stater, 50314
- Mission Cancer and Blood - Laurel
-
Des Moines, Iowa, Forenede Stater, 50316
- Iowa Lutheran Hospital
-
Iowa City, Iowa, Forenede Stater, 52242
- University of Iowa/Holden Comprehensive 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
-
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Kansas
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Dodge City, Kansas, Forenede Stater, 67801
- Cancer Center of Kansas - Dodge City
-
El Dorado, Kansas, Forenede Stater, 67042
- Cancer Center of Kansas - El Dorado
-
Garden City, Kansas, Forenede Stater, 67846
- Central Care Cancer Center - Garden City
-
Great Bend, Kansas, Forenede Stater, 67530
- Central Care Cancer Center - Great Bend
-
Kansas City, Kansas, Forenede Stater, 66160
- University of Kansas Cancer Center
-
Lawrence, Kansas, Forenede Stater, 66044
- Lawrence Memorial Hospital
-
Olathe, Kansas, Forenede Stater, 66061
- Olathe Health Cancer Center
-
Overland Park, Kansas, Forenede Stater, 66210
- University of Kansas Cancer Center-Overland Park
-
Pittsburg, Kansas, Forenede Stater, 66762
- Ascension Via Christi - Pittsburg
-
Salina, Kansas, Forenede Stater, 67401
- Salina Regional Health Center
-
Salina, Kansas, Forenede Stater, 67401
- Cancer Center of Kansas - Salina
-
Topeka, Kansas, Forenede Stater, 66606
- University of Kansas Health System Saint Francis Campus
-
Topeka, Kansas, Forenede Stater, 66606
- Cotton O'Neil Cancer Center / Stormont Vail Health
-
Wellington, Kansas, Forenede Stater, 67152
- Cancer Center of Kansas - Wellington
-
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
-
Wichita, Kansas, Forenede Stater, 67214
- Wesley Medical Center
-
Winfield, Kansas, Forenede Stater, 67156
- Cancer Center of Kansas - Winfield
-
-
Kentucky
-
Lexington, Kentucky, Forenede Stater, 40504
- Saint Joseph Radiation Oncology Resource Center
-
Lexington, Kentucky, Forenede Stater, 40509
- Saint Joseph Hospital East
-
Louisville, Kentucky, Forenede Stater, 40202
- Jewish Hospital
-
Louisville, Kentucky, Forenede Stater, 40245
- UofL Health Medical Center Northeast
-
-
Louisiana
-
Baton Rouge, Louisiana, Forenede Stater, 70805
- LSU Health Baton Rouge-North Clinic
-
Baton Rouge, Louisiana, Forenede Stater, 70809
- Louisiana Hematology Oncology Associates LLC
-
Baton Rouge, Louisiana, Forenede Stater, 70809
- Mary Bird Perkins Cancer Center
-
Baton Rouge, Louisiana, Forenede Stater, 70809
- Our Lady of the Lake Physicians Group - Medical Oncology
-
Covington, Louisiana, Forenede Stater, 70433
- Mary Bird Perkins Cancer Center - Covington
-
Covington, Louisiana, Forenede Stater, 70433
- Northshore Oncology Associates-Covington
-
Houma, Louisiana, Forenede Stater, 70360
- Mary Bird Perkins Cancer Center - Houma
-
Houma, Louisiana, Forenede Stater, 70360
- Oncology Center of The South Incorporated
-
New Orleans, Louisiana, Forenede Stater, 70121
- Ochsner Medical Center Jefferson
-
-
Maine
-
Bangor, Maine, Forenede Stater, 04401
- Eastern Maine Medical Center
-
Brewer, Maine, Forenede Stater, 04412
- Lafayette Family Cancer Center-EMMC
-
-
Maryland
-
Baltimore, Maryland, Forenede Stater, 21204
- Greater Baltimore Medical Center
-
Salisbury, Maryland, Forenede Stater, 21801
- TidalHealth Peninsula Regional
-
-
Massachusetts
-
Boston, Massachusetts, Forenede Stater, 02215
- Beth Israel Deaconess Medical Center
-
Boston, Massachusetts, Forenede Stater, 02215
- Dana-Farber Cancer Institute
-
Boston, Massachusetts, Forenede Stater, 02115
- Brigham and Women's Hospital
-
Boston, Massachusetts, Forenede Stater, 02114
- Massachusetts General Hospital Cancer Center
-
Pittsfield, Massachusetts, Forenede Stater, 01201
- Berkshire Medical Center - Cancer Center
-
-
Michigan
-
Adrian, Michigan, Forenede Stater, 49221
- Hickman Cancer Center
-
Ann Arbor, Michigan, Forenede Stater, 48109
- University Of Michigan Comprehensive Cancer Center
-
Ann Arbor, Michigan, Forenede Stater, 48106
- Saint Joseph Mercy Hospital
-
Battle Creek, Michigan, Forenede Stater, 49017
- Bronson Battle Creek
-
Bay City, Michigan, Forenede Stater, 48706
- McLaren Cancer Institute-Bay City
-
Brownstown, Michigan, Forenede Stater, 48183
- Henry Ford Cancer Institute-Downriver
-
Clarkston, Michigan, Forenede Stater, 48346
- McLaren Cancer Institute-Clarkston
-
Clinton Township, Michigan, Forenede Stater, 48038
- Henry Ford Macomb Hospital-Clinton Township
-
Dearborn, Michigan, Forenede Stater, 48124
- Beaumont Hospital - Dearborn
-
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
-
Farmington Hills, Michigan, Forenede Stater, 48334
- Weisberg Cancer Treatment Center
-
Farmington Hills, Michigan, Forenede Stater, 48336
- Beaumont Hospital - Farmington Hills
-
Flint, Michigan, Forenede Stater, 48532
- McLaren Cancer Institute-Flint
-
Flint, Michigan, Forenede Stater, 48532
- Singh and Arora Hematology Oncology PC
-
Flint, Michigan, Forenede Stater, 48503
- Hurley Medical Center
-
Flint, Michigan, Forenede Stater, 48503
- Genesys Hurley Cancer Institute
-
Grand Rapids, Michigan, Forenede Stater, 49503
- Spectrum Health at Butterworth Campus
-
Grand Rapids, Michigan, Forenede Stater, 49503
- Helen DeVos Children's Hospital at Spectrum Health
-
Grand Rapids, Michigan, Forenede Stater, 49503
- Trinity Health Grand Rapids Hospital
-
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
-
Lansing, Michigan, Forenede Stater, 48910
- Karmanos Cancer Institute at McLaren Greater Lansing
-
Lapeer, Michigan, Forenede Stater, 48446
- McLaren Cancer Institute-Lapeer Region
-
Livonia, Michigan, Forenede Stater, 48154
- Trinity Health Saint Mary Mercy Livonia Hospital
-
Mount Clemens, Michigan, Forenede Stater, 48043
- McLaren Cancer Institute-Macomb
-
Mount Pleasant, Michigan, Forenede Stater, 48858
- McLaren Cancer Institute-Central Michigan
-
Muskegon, Michigan, Forenede Stater, 49444
- Trinity Health Muskegon Hospital
-
Niles, Michigan, Forenede Stater, 49120
- Lakeland Hospital Niles
-
Novi, Michigan, Forenede Stater, 48374
- Ascension Providence Hospitals - Novi
-
Owosso, Michigan, Forenede Stater, 48867
- McLaren Cancer Institute-Owosso
-
Petoskey, Michigan, Forenede Stater, 49770
- McLaren Cancer Institute-Northern Michigan
-
Pontiac, Michigan, Forenede Stater, 48341
- Saint Joseph Mercy Oakland
-
Pontiac, Michigan, Forenede Stater, 48341
- 21st Century Oncology-Pontiac
-
Port Huron, Michigan, Forenede Stater, 48060
- McLaren-Port Huron
-
Reed City, Michigan, Forenede Stater, 49677
- Spectrum Health Reed City Hospital
-
Royal Oak, Michigan, Forenede Stater, 48073
- William Beaumont Hospital-Royal Oak
-
Saginaw, Michigan, Forenede Stater, 48601
- Ascension Saint Mary's Hospital
-
Saint Joseph, Michigan, Forenede Stater, 49085
- Lakeland Medical Center Saint Joseph
-
Saint Joseph, Michigan, Forenede Stater, 49085
- Marie Yeager Cancer Center
-
Southfield, Michigan, Forenede Stater, 48075
- Ascension Providence Hospitals - Southfield
-
Traverse City, Michigan, Forenede Stater, 49684
- Munson Medical Center
-
Troy, Michigan, Forenede Stater, 48085
- William Beaumont Hospital - Troy
-
Warren, Michigan, Forenede Stater, 48093
- Saint John Macomb-Oakland Hospital
-
West Bloomfield, Michigan, Forenede Stater, 48322
- Henry Ford West Bloomfield Hospital
-
Wyoming, Michigan, Forenede Stater, 49519
- University of Michigan Health - West
-
-
Minnesota
-
Bemidji, Minnesota, Forenede Stater, 56601
- Sanford Joe Lueken Cancer Center
-
Brainerd, Minnesota, Forenede Stater, 56401
- Essentia Health Saint Joseph's Medical Center
-
Burnsville, Minnesota, Forenede Stater, 55337
- Fairview Ridges Hospital
-
Coon Rapids, Minnesota, Forenede Stater, 55433
- Mercy Hospital
-
Deer River, Minnesota, Forenede Stater, 56636
- Essentia Health - Deer River Clinic
-
Detroit Lakes, Minnesota, Forenede Stater, 56501
- Essentia Health Saint Mary's - Detroit Lakes Clinic
-
Duluth, Minnesota, Forenede Stater, 55805
- Saint Luke's Hospital of Duluth
-
Duluth, Minnesota, Forenede Stater, 55805
- Essentia Health Cancer Center
-
Duluth, Minnesota, Forenede Stater, 55805
- Essentia Health Saint Mary's Medical Center
-
Duluth, Minnesota, Forenede Stater, 55805
- Miller-Dwan Hospital
-
Edina, Minnesota, Forenede Stater, 55435
- Fairview Southdale Hospital
-
Fergus Falls, Minnesota, Forenede Stater, 56537
- Lake Region Healthcare Corporation-Cancer Care
-
Fosston, Minnesota, Forenede Stater, 56542
- Essentia Health - Fosston
-
Fridley, Minnesota, Forenede Stater, 55432
- Unity Hospital
-
Hibbing, Minnesota, Forenede Stater, 55746
- Essentia Health Hibbing Clinic
-
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
-
Park Rapids, Minnesota, Forenede Stater, 56470
- Essentia Health - Park Rapids
-
Robbinsdale, Minnesota, Forenede Stater, 55422
- North Memorial Medical Health Center
-
Rochester, Minnesota, Forenede Stater, 55905
- Mayo Clinic in Rochester
-
Saint Cloud, Minnesota, Forenede Stater, 56303
- Coborn Cancer Center at Saint Cloud Hospital
-
Saint 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
-
Sandstone, Minnesota, Forenede Stater, 55072
- Essentia Health Sandstone
-
Shakopee, Minnesota, Forenede Stater, 55379
- Saint Francis Regional Medical Center
-
Stillwater, Minnesota, Forenede Stater, 55082
- Lakeview Hospital
-
Virginia, Minnesota, Forenede Stater, 55792
- Essentia Health Virginia Clinic
-
Waconia, Minnesota, Forenede Stater, 55387
- Ridgeview Medical Center
-
Willmar, Minnesota, Forenede Stater, 56201
- Rice Memorial Hospital
-
Woodbury, Minnesota, Forenede Stater, 55125
- Minnesota Oncology Hematology PA-Woodbury
-
-
Mississippi
-
Grenada, Mississippi, Forenede Stater, 38901
- Baptist Cancer Center-Grenada
-
New Albany, Mississippi, Forenede Stater, 38652
- Baptist Memorial Hospital and Cancer Center-Union County
-
Oxford, Mississippi, Forenede Stater, 38655
- Baptist Memorial Hospital and Cancer Center-Oxford
-
Southhaven, Mississippi, Forenede Stater, 38671
- Baptist Memorial Hospital and Cancer Center-Desoto
-
-
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
-
Cape Girardeau, Missouri, Forenede Stater, 63703
- Saint Francis Medical Center
-
Cape Girardeau, Missouri, Forenede Stater, 63703
- Southeast Cancer Center
-
Jefferson City, Missouri, Forenede Stater, 65109
- Capital Region Southwest Campus
-
Joplin, Missouri, Forenede Stater, 64804
- Freeman Health System
-
Kansas City, Missouri, Forenede Stater, 64154
- University of Kansas Cancer Center - North
-
Kansas City, Missouri, Forenede Stater, 64132
- Research Medical Center
-
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, 63131
- Missouri Baptist Medical Center
-
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
- Missouri Baptist Outpatient Center-Sunset Hills
-
-
Montana
-
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
-
Kalispell, Montana, Forenede Stater, 59901
- Kalispell Regional Medical Center
-
Missoula, Montana, Forenede Stater, 59804
- Community Medical Hospital
-
-
Nebraska
-
Grand Island, Nebraska, Forenede Stater, 68803
- CHI Health Saint Francis
-
Kearney, Nebraska, Forenede Stater, 68847
- CHI Health Good Samaritan
-
Lincoln, Nebraska, Forenede Stater, 68506
- Nebraska Hematology and Oncology
-
Lincoln, Nebraska, Forenede Stater, 68510
- Nebraska Cancer Research Center
-
Lincoln, Nebraska, Forenede Stater, 68516
- Southeast Nebraska Cancer Center - 68th Street Place
-
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, 68124
- Nebraska Cancer Specialists - Omaha
-
Scottsbluff, Nebraska, Forenede Stater, 69361
- Regional West Medical Center Cancer Center
-
-
Nevada
-
Henderson, Nevada, Forenede Stater, 89052
- OptumCare Cancer Care at Seven Hills
-
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, 89128
- OptumCare Cancer Care at MountainView
-
Las Vegas, Nevada, Forenede Stater, 89148
- Comprehensive Cancer Centers of Nevada
-
Las Vegas, Nevada, Forenede Stater, 89148
- OptumCare Cancer Care at Fort Apache
-
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
-
Englewood, New Jersey, Forenede Stater, 07631
- Englewood Hospital and Medical Center
-
Moorestown, New Jersey, Forenede Stater, 08057
- Virtua Samson Cancer Center
-
Mount Holly, New Jersey, Forenede Stater, 08060
- Virtua Memorial
-
New Brunswick, New Jersey, Forenede Stater, 08903
- Rutgers Cancer Institute of New Jersey
-
Somerville, New Jersey, Forenede Stater, 08876
- Robert Wood Johnson University Hospital Somerset
-
Teaneck, New Jersey, Forenede Stater, 07666
- Holy Name Hospital
-
Voorhees Township, New Jersey, Forenede Stater, 08043
- Virtua Voorhees
-
-
New Mexico
-
Albuquerque, New Mexico, Forenede Stater, 87102
- University of New Mexico Cancer Center
-
Albuquerque, New Mexico, Forenede Stater, 87109
- New Mexico Oncology Hematology Consultants
-
Santa Fe, New Mexico, Forenede Stater, 87505
- Christus Saint Vincent Regional Cancer Center
-
-
New York
-
Bay Shore, New York, Forenede Stater, 11706
- Northwell Health Imbert Cancer Center
-
Glens Falls, New York, Forenede Stater, 12801
- Glens Falls Hospital
-
Lake Success, New York, Forenede Stater, 11042
- Northwell Health/Center for Advanced Medicine
-
Manhasset, New York, Forenede Stater, 11030
- North Shore University Hospital
-
Middletown, New York, Forenede Stater, 10940
- Garnet Health Medical Center
-
New Hyde Park, New York, Forenede Stater, 11040
- Long Island Jewish Medical Center
-
New York, New York, Forenede Stater, 10016
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
-
Rochester, New York, Forenede Stater, 14642
- University of Rochester
-
Staten Island, New York, Forenede Stater, 10305
- Staten Island University Hospital
-
Syracuse, New York, Forenede Stater, 13210
- State University of New York Upstate Medical University
-
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
-
Albemarle, North Carolina, Forenede Stater, 28002
- Atrium Health Stanly/LCI-Albemarle
-
Asheville, North Carolina, Forenede Stater, 28801
- Mission Hospital
-
Charlotte, North Carolina, Forenede Stater, 28203
- Carolinas Medical Center/Levine Cancer Institute
-
Charlotte, North Carolina, Forenede Stater, 28204
- Novant Health Presbyterian Medical Center
-
Charlotte, North Carolina, Forenede Stater, 28210
- Atrium Health Pineville/LCI-Pineville
-
Charlotte, North Carolina, Forenede Stater, 28262
- Atrium Health University City/LCI-University
-
Concord, North Carolina, Forenede Stater, 28025
- Atrium Health Cabarrus/LCI-Concord
-
Huntersville, North Carolina, Forenede Stater, 28078
- Novant Health Presbyterian Medical Center Huntersville
-
Matthews, North Carolina, Forenede Stater, 28105
- Matthews Radiation Oncology Center
-
Monroe, North Carolina, Forenede Stater, 28112
- Atrium Health Union/LCI-Union
-
Raleigh, North Carolina, Forenede Stater, 27607
- UNC Rex Healthcare
-
Shelby, North Carolina, Forenede Stater, 28150
- Atrium Health Cleveland/LCI-Cleveland
-
Winston-Salem, North Carolina, Forenede Stater, 27157
- Wake Forest University Health Sciences
-
-
North Dakota
-
Bismarck, North Dakota, Forenede Stater, 58501
- Sanford Bismarck Medical Center
-
Fargo, North Dakota, Forenede Stater, 58122
- Sanford Roger Maris Cancer Center
-
Fargo, North Dakota, Forenede Stater, 58103
- Essentia Health Cancer Center-South University Clinic
-
Fargo, North Dakota, Forenede Stater, 58122
- Sanford Broadway Medical Center
-
Jamestown, North Dakota, Forenede Stater, 58401
- Essentia Health - Jamestown Clinic
-
-
Ohio
-
Akron, Ohio, Forenede Stater, 44307
- Cleveland Clinic Akron General
-
Beachwood, Ohio, Forenede Stater, 44122
- UHHS-Chagrin Highlands Medical Center
-
Beavercreek, Ohio, Forenede Stater, 45431
- Indu and Raj Soin Medical Center
-
Canton, Ohio, Forenede Stater, 44708
- Cleveland Clinic Mercy 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
-
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, 45236
- Oncology Hematology Care Inc-Kenwood
-
Cleveland, Ohio, Forenede Stater, 44106
- Case Western Reserve University
-
Columbus, Ohio, Forenede Stater, 43210
- Ohio State University Comprehensive Cancer Center
-
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
-
Elyria, Ohio, Forenede Stater, 44035
- Mercy Cancer Center-Elyria
-
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
-
Maumee, Ohio, Forenede Stater, 43537
- Toledo Clinic Cancer Centers-Maumee
-
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
-
Parma, Ohio, Forenede Stater, 44129
- University Hospitals Parma Medical Center
-
Ravenna, Ohio, Forenede Stater, 44266
- University Hospitals Portage Medical Center
-
Sandusky, Ohio, Forenede Stater, 44870
- UH Seidman Cancer Center at Firelands Regional Medical Center
-
Springfield, Ohio, Forenede Stater, 45505
- Springfield Regional Medical Center
-
Springfield, Ohio, Forenede Stater, 45504
- Springfield Regional Cancer Center
-
Sylvania, Ohio, Forenede Stater, 43560
- ProMedica Flower Hospital
-
Toledo, Ohio, Forenede Stater, 43606
- ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
-
Toledo, Ohio, Forenede Stater, 43623
- Mercy Health - Saint Anne Hospital
-
Toledo, Ohio, Forenede Stater, 43623
- Toledo Clinic Cancer Centers-Toledo
-
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
-
West Chester, Ohio, Forenede Stater, 45069
- University of Cincinnati Cancer Center-West Chester
-
Westlake, Ohio, Forenede Stater, 44145
- UH Seidman Cancer Center at Saint John Medical Center
-
Westlake, Ohio, Forenede Stater, 44145
- UHHS-Westlake Medical 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
-
-
Oregon
-
Gresham, Oregon, Forenede Stater, 97030
- Legacy Mount Hood Medical Center
-
Portland, Oregon, Forenede Stater, 97210
- Legacy Good Samaritan Hospital and Medical Center
-
Portland, Oregon, Forenede Stater, 97227
- Kaiser Permanente Northwest
-
-
Pennsylvania
-
Abington, Pennsylvania, Forenede Stater, 19001
- Jefferson Abington Hospital
-
Allentown, Pennsylvania, Forenede Stater, 18103
- Lehigh Valley Hospital-Cedar Crest
-
Bethlehem, Pennsylvania, Forenede Stater, 18017
- Lehigh Valley Hospital - Muhlenberg
-
Broomall, Pennsylvania, Forenede Stater, 19008
- Crozer-Keystone Regional Cancer Center at Broomall
-
Chadds Ford, Pennsylvania, Forenede Stater, 19317
- Christiana Care Health System-Concord Health Center
-
Danville, Pennsylvania, Forenede Stater, 17822
- Geisinger Medical Center
-
Dunmore, Pennsylvania, Forenede Stater, 18512
- Northeast Radiation Oncology Center
-
East Stroudsburg, Pennsylvania, Forenede Stater, 18301
- Pocono Medical Center
-
Erie, Pennsylvania, Forenede Stater, 16544
- Saint Vincent Hospital
-
Glen Mills, Pennsylvania, Forenede Stater, 19342
- Crozer Regional Cancer Center at Brinton Lake
-
Jefferson Hills, Pennsylvania, Forenede Stater, 15025
- Jefferson Hospital
-
Lewisburg, Pennsylvania, Forenede Stater, 17837
- Geisinger Medical Oncology-Lewisburg
-
Lewistown, Pennsylvania, Forenede Stater, 17044
- Lewistown Hospital
-
Monroeville, Pennsylvania, Forenede Stater, 15146
- Forbes Hospital
-
Philadelphia, Pennsylvania, Forenede Stater, 19111
- Fox Chase Cancer Center
-
Philadelphia, Pennsylvania, Forenede Stater, 19107
- Thomas Jefferson University Hospital
-
Philadelphia, Pennsylvania, Forenede Stater, 19140
- Temple University Hospital
-
Pittsburgh, Pennsylvania, Forenede Stater, 15212
- Allegheny General Hospital
-
Selinsgrove, Pennsylvania, Forenede Stater, 17870
- Geisinger Medical Oncology-Selinsgrove
-
Sellersville, Pennsylvania, Forenede Stater, 18960
- Grand View Hospital
-
West Reading, Pennsylvania, Forenede Stater, 19611
- Reading Hospital
-
Wilkes-Barre, Pennsylvania, Forenede Stater, 18711
- Geisinger Wyoming Valley/Henry Cancer Center
-
Willow Grove, Pennsylvania, Forenede Stater, 19090
- Asplundh Cancer Pavilion
-
Wynnewood, Pennsylvania, Forenede Stater, 19096
- Lankenau Medical 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
-
Gaffney, South Carolina, Forenede Stater, 29341
- Gibbs Cancer Center-Gaffney
-
Greenville, South Carolina, Forenede Stater, 29605
- Prisma Health Cancer Institute - Faris
-
Greenville, South Carolina, Forenede Stater, 29615
- Prisma Health Cancer Institute - Eastside
-
Greer, South Carolina, Forenede Stater, 29650
- Prisma Health Cancer Institute - Greer
-
Greer, South Carolina, Forenede Stater, 29651
- Gibbs Cancer Center-Pelham
-
Rock Hill, South Carolina, Forenede Stater, 29732
- Levine Cancer Institute-Rock Hill
-
Rock Hill, South Carolina, Forenede Stater, 29730
- Rock Hill Radiation Therapy Center
-
Seneca, South Carolina, Forenede Stater, 29672
- Prisma Health Cancer Institute - Seneca
-
Spartanburg, South Carolina, Forenede Stater, 29303
- Spartanburg Medical Center
-
Union, South Carolina, Forenede Stater, 29379
- MGC Hematology Oncology-Union
-
-
South Dakota
-
Aberdeen, South Dakota, Forenede Stater, 57401
- Avera Cancer Institute-Aberdeen
-
Sioux Falls, South Dakota, Forenede Stater, 57105
- Avera Cancer Institute
-
Sioux Falls, South Dakota, Forenede Stater, 57117-5134
- Sanford USD Medical Center - Sioux Falls
-
Sioux Falls, South Dakota, Forenede Stater, 57104
- Sanford Cancer Center Oncology Clinic
-
-
Tennessee
-
Chattanooga, Tennessee, Forenede Stater, 37404
- Memorial Hospital
-
Collierville, Tennessee, Forenede Stater, 38017
- Baptist Memorial Hospital and Cancer Center-Collierville
-
Germantown, Tennessee, Forenede Stater, 38138
- The West Clinic - Wolf River
-
Memphis, Tennessee, Forenede Stater, 38120
- Baptist Memorial Hospital and Cancer Center-Memphis
-
Memphis, Tennessee, Forenede Stater, 38163
- University of Tennessee Health Science Center
-
Memphis, Tennessee, Forenede Stater, 38104
- The West Clinic - Mid-Town
-
Nashville, Tennessee, Forenede Stater, 37232
- Vanderbilt University/Ingram Cancer Center
-
Nashville, Tennessee, Forenede Stater, 37204
- Vanderbilt Breast Center at One Hundred Oaks
-
-
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
-
Dallas, Texas, Forenede Stater, 75246
- Baylor University Medical Center
-
Galveston, Texas, Forenede Stater, 77555-0565
- University of Texas Medical Branch
-
Houston, Texas, Forenede Stater, 77030
- M D Anderson Cancer Center
-
Houston, Texas, Forenede Stater, 77030
- Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
-
Houston, Texas, Forenede Stater, 77030
- Ben Taub General Hospital
-
League City, Texas, Forenede Stater, 77573
- UTMB Cancer Center at Victory Lakes
-
Lubbock, Texas, Forenede Stater, 79410
- Covenant Medical Center-Lakeside
-
Temple, Texas, Forenede Stater, 76508
- Scott and White Memorial Hospital
-
-
Utah
-
Cedar City, Utah, Forenede Stater, 84720
- Sandra L Maxwell Cancer 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, 84106
- Utah Cancer Specialists-Salt Lake City
-
Salt Lake City, Utah, Forenede Stater, 84143
- LDS Hospital
-
St. George, Utah, Forenede Stater, 84770
- Saint George Regional Medical Center
-
-
Vermont
-
Berlin Corners, Vermont, Forenede Stater, 05602
- Central Vermont Medical Center/National Life Cancer Treatment
-
Burlington, Vermont, Forenede Stater, 05401
- University of Vermont Medical Center
-
Burlington, Vermont, Forenede Stater, 05405
- University of Vermont and State Agricultural College
-
Saint Johnsbury, Vermont, Forenede Stater, 05819
- Norris Cotton Cancer Center-North
-
-
Virginia
-
Hampton, Virginia, Forenede Stater, 23666
- Sentara Cancer Institute at Sentara CarePlex Hospital
-
Norfolk, Virginia, Forenede Stater, 23507
- Sentara Norfolk General Hospital
-
Norfolk, Virginia, Forenede Stater, 23502
- Sentara Leigh Hospital
-
Richmond, Virginia, Forenede Stater, 23298
- Virginia Commonwealth University/Massey Cancer Center
-
-
Washington
-
Auburn, Washington, Forenede Stater, 98001
- MultiCare Auburn Medical Center
-
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
-
Federal Way, Washington, Forenede Stater, 98002
- Virginia Mason Federal Way Medical Center
-
Gig Harbor, Washington, Forenede Stater, 98332
- Tacoma/Valley Radiation Oncology Centers-Gig Harbor
-
Gig Harbor, Washington, Forenede Stater, 98335
- MultiCare Gig Harbor Medical Park
-
Kennewick, Washington, Forenede Stater, 99336
- Tri-Cities Cancer Center
-
Kirkland, Washington, Forenede Stater, 98034
- Seattle Cancer Care Alliance at EvergreenHealth
-
Mount Vernon, Washington, Forenede Stater, 98274
- Skagit Valley Hospital
-
Mount Vernon, Washington, Forenede Stater, 98274
- Skagit Regional Health Cancer Care 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, 98109
- Fred Hutchinson Cancer Research Center
-
Seattle, Washington, Forenede Stater, 98101
- Virginia Mason Medical Center
-
Seattle, Washington, Forenede Stater, 98195
- University of Washington Medical Center - Montlake
-
Seattle, Washington, Forenede Stater, 98109
- FHCC South Lake Union
-
Seattle, Washington, Forenede Stater, 98133
- FHCC at Northwest Hospital
-
Spokane, Washington, Forenede Stater, 99208
- Spokane Valley Cancer Center-Mayfair
-
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
-
Vancouver, Washington, Forenede Stater, 98686
- Legacy Salmon Creek Hospital
-
Wenatchee, Washington, Forenede Stater, 98801
- Wenatchee Valley Hospital and Clinics
-
Yakima, Washington, Forenede Stater, 98902
- North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
-
-
West Virginia
-
Bridgeport, West Virginia, Forenede Stater, 26330
- United Hospital Center
-
Charleston, West Virginia, Forenede Stater, 25304
- West Virginia University Charleston Division
-
Morgantown, West Virginia, Forenede Stater, 26506
- West Virginia University Healthcare
-
Parkersburg, West Virginia, Forenede Stater, 26101
- Camden Clark Medical Center
-
Wheeling, West Virginia, Forenede Stater, 26003
- Wheeling Hospital/Schiffler Cancer Center
-
-
Wisconsin
-
Ashland, Wisconsin, Forenede Stater, 54806
- Duluth Clinic Ashland
-
Ashland, Wisconsin, Forenede Stater, 54806
- Northwest Wisconsin Cancer Center
-
Burlington, Wisconsin, Forenede Stater, 53105
- Aurora Cancer Care-Southern Lakes VLCC
-
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
-
Madison, Wisconsin, Forenede Stater, 53792
- University of Wisconsin Carbone Cancer Center
-
Marinette, Wisconsin, Forenede Stater, 54143
- Aurora Bay Area Medical Group-Marinette
-
Marshfield, Wisconsin, Forenede Stater, 54449
- Marshfield Medical Center-Marshfield
-
Menomonee Falls, Wisconsin, Forenede Stater, 53051
- Froedtert Menomonee Falls Hospital
-
Milwaukee, Wisconsin, Forenede Stater, 53226
- Medical College of Wisconsin
-
Milwaukee, Wisconsin, Forenede Stater, 53209
- Aurora Cancer Care-Milwaukee
-
Milwaukee, Wisconsin, Forenede Stater, 53215
- Aurora Saint Luke's Medical Center
-
Milwaukee, Wisconsin, Forenede Stater, 53233
- Aurora Sinai Medical Center
-
Minocqua, Wisconsin, Forenede Stater, 54548
- Marshfield Clinic-Minocqua Center
-
Mukwonago, Wisconsin, Forenede Stater, 53149
- ProHealth D N Greenwald Center
-
New Richmond, Wisconsin, Forenede Stater, 54017
- Cancer Center of Western Wisconsin
-
Oconomowoc, Wisconsin, Forenede Stater, 53066
- ProHealth Oconomowoc Memorial Hospital
-
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, 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
- UW Cancer Center at ProHealth Care
-
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
-
West Bend, Wisconsin, Forenede Stater, 53095
- Froedtert West Bend Hospital/Kraemer Cancer Center
-
Weston, Wisconsin, Forenede Stater, 54476
- Marshfield Medical Center - Weston
-
Weston, Wisconsin, Forenede Stater, 54476
- Diagnostic and Treatment Center
-
-
-
-
-
Bayamón, Puerto Rico, 00959-5060
- Cancer Center-Metro Medical Center Bayamon
-
Manatí, Puerto Rico, 00674
- Doctors Cancer Center
-
San Juan, Puerto Rico, 00917
- San Juan Community Oncology Group
-
San Juan, Puerto Rico, 00927
- Centro Comprensivo de Cancer de UPR
-
San Juan, Puerto Rico, 00936
- San Juan City Hospital
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Beskrivelse
Inklusionskriterier:
- Patienten skal have underskrevet og dateret en Institutional Review Board (IRB)-godkendt samtykkeformular, der er i overensstemmelse med føderale og institutionelle retningslinjer
- Eastern Cooperative Oncology Group (ECOG) præstationsstatus på 0, 1 eller 2
Diagnose af adenocarcinom i endetarmen med den største del af tumoren intakt; Bemærk: Inden randomisering skal investigator specificere og dokumentere hvert af følgende:
- Afstanden mellem den laveste tumormargin fra analkanten; og
- Hensigt til lukkemuskelbesparende eller ikke-sfinkterbesparende kirurgisk resektion ifølge den primære kirurg; og
- Størstedelen af den ubehandlede tumor skal være < 12 cm fra analkanten eller under den peritoneale refleksion som bestemt af den behandlende kirurg
Tumoren skal være klinisk bestemt til at være lokalt fremskreden stadium II eller stadium III rektal cancer, og skal også opfylde et hvilket som helst af følgende kriterier:
- Distal lokation (som defineret ved måling på magnetisk resonansbilleddannelse [MRI], transrektal ultralyd [ERUS]/bækkencomputertomografi [CT] [med IV kontrast] scanning eller palpabel ved digital rektalundersøgelse [DRE]): cT3-4 =< 5 cm fra analkanten, enhver N
- Voluminøs: enhver cT4 eller bevis for, at tumoren støder op til (defineret som inden for 3 mm fra) den mesorektale fascia på MR- eller ERUS/bækken-CT (med IV kontrast) scanning
- Høj risiko for metastatisk sygdom med 4 eller flere regionale lymfeknuder (cN2); klinisk nodal- eller "cN"-status for berettigelse inkluderer det samlede antal noder (N2 = 4 eller mere) i de mesorektale og superior rektale stationer, der måler >= 1,0 cm i enhver akse ved tværsnits- eller endoskopisk billeddannelse; Bemærk: knudepunkter skal være 1,0 cm eller mere for at blive betragtet som positive for dette berettigelseskrav
Ikke en kandidat til lukkemuskelbesparende kirurgisk resektion forud for neoadjuverende terapi (som planlagt af den primære kirurg)
- Bemærk: det kliniske stadie af den primære tumor og noder kan bestemmes lokalt ved rektal endoskopisk ultralyd eller bækken-MR (bækken-MR er stærkt foretrukket); CT-scanning med IV-kontrast er acceptabel, forudsat at der er tegn på T4- og/eller N2-sygdom
- Patienter skal have evnen til at sluge og beholde oral medicin
- Absolut neutrofiltal (ANC) skal være >= 1200/mm^3 (inden for 28 dage før randomisering)
- Blodpladeantal skal være >= 100.000/mm^3 (inden for 28 dage før randomisering)
- Hæmoglobin skal være >= 10 g/dL (inden for 28 dage før randomisering)
- Total bilirubin skal være =< ULN (øvre grænse for normal) for laboratoriet, medmindre patienten har en bilirubinforhøjelse > ULN til 1,5 x ULN på grund af Gilberts sygdom eller lignende syndrom, der involverer langsom konjugering af bilirubin (inden for 28 dage før randomisering)
- Alkalisk fosfatase skal være =< 3 x ULN for laboratoriet (inden for 28 dage før randomisering)
Aspartataminotransferase (AST) skal være =< 3 x ULN for laboratoriet (inden for 28 dage før randomisering);
- Bemærk: hvis alaninaminotransferase (ALT) udføres i stedet for AST (pr. institutions standardpraksis), skal ALT-værdien være =< 3 x ULN; hvis begge blev udført, skal AST også være =< 3 x ULN; hvis ASAT og/eller ALAT er >= ULN men =< 3 x ULN, skal der udføres serologisk test for hepatitis B og C, og resultaterne for virusinfektion skal være negative
- Serumkreatinin =< ULN for laboratoriet og målt eller beregnet kreatininclearance > 60 ml/min (inden for 28 dage før randomisering)
- Serum-kalium-, magnesium- og calciumniveauer inden for 28 dage før randomisering skal være inden for normale grænser (WNL) for laboratoriet
- Internationalt normaliseret forhold mellem protrombintid (INR) inden for 28 dage før randomisering skal være =< ULN for laboratoriet; patienter, der er terapeutisk behandlet med et middel såsom warfarin, kan deltage, hvis de er på en stabil dosis, og der ikke findes nogen underliggende abnormitet i koagulationsparametre pr.
Patienter med erhvervet immundefektsyndrom (AIDS-relaterede sygdomme) eller kendt human immundefektvirus (HIV) sygdom skal:
- Har en klynge af differentiering (CD)4-tal >= 200 celler/uL inden for 30 dage før påbegyndelse af studieterapi
- Afstå fra al antiretroviral behandling (profylakse/behandling) mere end 60 dage før påbegyndelse af studiebehandling, og
- Har ingen tegn på opportunistiske infektioner
- Graviditetstest (urin eller serum beta-humant choriongonadotropin [HCG]) udført inden for 72 timer før randomisering skal være negativ (kun for kvinder i den fødedygtige alder); hvis uringraviditetsresultater er positive eller ikke kan bekræftes som negative, vil en serumgraviditetstest være påkrævet
Ekskluderingskriterier:
- Endetarmskræft histologi, bortset fra adenocarcinom (dvs. sarkom, lymfom, pladecellecarcinom, slimhinde melanom osv.)
definitive kliniske eller radiologiske tegn på metastatisk sygdom; påkrævede billeddiagnostiske undersøgelser skal være udført inden for 28 dage før randomisering; Bemærk: Fjern klinisk stadieinddeling for at udelukke patienter med åbenlys metastatisk sygdom bestemmes af:
- Bryst: CT-scanning (foretrukket); røntgen af thorax posterioranterior (PA) og lateral (acceptabel); eller positron emission tomografi (PET) scanning (acceptabel)
- Abdomen: CT-scanning med IV-kontrast (foretrukket); eller MR (acceptabelt)
Bækken: MR (foretrukket) eller CT-scanning med IV-kontrast (acceptabelt)
- (Det anbefales, at de samme billeddiagnostiske tests, som udføres før randomisering, anvendes ved opfølgningstidspunkter; Bemærk: CT-scanninger af mave og bækken skal udføres med IV-kontrast)
- Anamnese med tidligere invasiv rektal malignitet, uanset sygdomsfrit interval
Hjertesygdom, der ville udelukke brugen af nogen af de lægemidler, der er inkluderet i GI002-behandlingsregimet; dette omfatter, men er ikke begrænset til:
- Klinisk ustabil hjertesygdom, herunder ustabil atrieflimren, symptomatisk bradykardi, ustabil kongestiv hjerteinsufficiens, aktiv myokardieiskæmi eller fastboende midlertidig pacemaker
- Ventrikulær takykardi eller supraventrikulær takykardi, der kræver behandling med klasse Ia antiarytmiske lægemidler (f.eks. quinidin, procainamid, disopyramid) eller klasse III antiarytmiske lægemidler (f.eks. sotalol, amiodaron, dofetilid); brug af andre antiarytmika er tilladt
- Anden eller tredje grads atrioventrikulær (AV) blokering, medmindre den behandles med en permanent pacemaker
- Komplet venstre grenblok (LBBB)
- Anamnese med langt QT-syndrom
- Korrigeret QT (QTc) >= 450 ms
- Sensorisk eller motorisk neuropati >= grad 2
- Anamnese med eller tegn på aktiv, ikke-infektiøs pneumonitis
- Aktiv inflammatorisk tarmsygdom (dvs. patienter, der kræver aktuelle medicinske indgreb, eller som er symptomatiske) eller har en historie med abdominal kirurgi eller anden medicinsk tilstand, der efter den behandlende læges mening kan forstyrre gastrointestinal motilitet eller absorption
- Aktiv autoimmun sygdom, der har krævet systemisk behandling inden for de seneste 2 år (dvs. med brug af modificerende midler, kortikosteroider eller immunsuppressive lægemidler); erstatningsterapi (f.eks. thyroxin, insulin eller fysiologisk kortikosteroiderstatningsterapi for binyre- eller hypofyseinsufficiens osv.) betragtes ikke som en form for systemisk behandling
- Anamnese med aktiv TB (Bacillus tuberculosis)
- Aktiv eller kronisk infektion, der kræver systemisk terapi
- Diagnose af immundefekt eller modtagelse af systemisk steroidbehandling eller enhver anden form for immunsuppressiv terapi inden for 7 dage før den første dosis af undersøgelsesterapi; brugen af fysiologiske doser af kortikosteroider kan godkendes efter samråd med undersøgelsens hovedinvestigator (PI)
- Aktiv anfaldsforstyrrelse ukontrolleret af medicin
- Enhver antineoplastisk terapi for denne cancer før randomisering
- Synkron tyktarmskræft
- Anden invasiv cancer inden for 5 år før randomisering; undtagelser er tyktarmspolypper, ikke-melanom hudkræft eller carcinom-in-situ i livmoderhalsen
- Antineoplastisk behandling (f.eks. kemoterapi eller målrettet terapi) for anden invasiv cancer inden for 5 år før randomisering; (i forbindelse med denne undersøgelse betragtes hormonbehandling ikke som kemoterapi)
- Forudgående behandling med en undersøgelsesforbindelse, der testes i denne undersøgelse (f.eks. poly ADP-ribosepolymerase [PARP]-hæmmer, anti-PD-1, anti-PD-L1 eller anti-PD-L2)
- Modtagelse af levende vaccination inden for 28 dage før randomisering; sæsonbestemte influenzavacciner, der ikke indeholder levende virus, er tilladt
- Større operation inden for 4 uger før randomisering
- Enhver terapeutisk bækkenstråling
- Kendt homozygot DPD (dihydro pyrimidin dehydrogenase) mangel
Enhver af følgende, fordi denne undersøgelse involverer midler, der har kendte eller potentielle genotoksiske eller mutagene og teratogene virkninger:
- Gravid kvinde
- Sygeplejerske kvinder, der ikke er villige til at afbryde sygeplejen
- Mænd eller kvinder i den fødedygtige alder, som ikke er villige til at anvende passende prævention (f.eks. hormonel prævention eller barrieremetode til prævention, afholdenhed) under undersøgelsesbehandlingens varighed og i 4 måneder efter den sidste dosis af undersøgelsesterapien
- Komorbide sygdomme eller anden samtidig sygdom, der efter klinikerens vurdering, der opnår informeret samtykke, ville gøre patienten uegnet til at deltage i denne undersøgelse eller væsentligt forstyrre den korrekte vurdering af sikkerhed og toksicitet af de ordinerede regimer eller forhindre påkrævet opfølgning. op
Studieplan
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 II (mFOLFOX6, RT, capecitabin, veliparib)
Patienterne får mFOLFOX6-regimen bestående af oxaliplatin IV over 2 timer på dag 1, leucovorin calcium IV over 2 timer på dag 1 og fluorouracil IV kontinuerligt over 46-48 timer på dag 1-2.
Behandlingen gentages hver anden uge i op til 8 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet.
3-4 uger efter sidste dosis af mFOLFOX6 patienten gennemgår RT og modtager capecitabin PO BID og veliparib PO BID mandag-fredag i 5 uger i fravær af sygdomsprogression eller uacceptabel toksicitet.
|
Givet IV
Andre navne:
Givet IV
Andre navne:
Givet IV
Andre navne:
Givet PO
Andre navne:
Givet PO
Andre navne:
Gennemgå intensitetsmoduleret strålebehandling
Andre navne:
|
|
Eksperimentel: Arm III (mFOLFOX6, RT, capecitabin, pembrolizumab)
ARM III: Patienterne får mFOLFOX6-regimen bestående af oxaliplatin IV over 2 timer, leucovorin calcium IV over 2 timer på dag 1 og fluorouracil IV kontinuerligt over 46-48 timer på dag 1-2.
Behandlingen gentages hver anden uge i 8 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet.
3-4 uger efter sidste dosis af mFOLFOX6 skal patienten gennemgå RT og modtage capecitabin PO BID mandag-fredag i 5 uger.
De modtager også pembrolizumab IV over 30 minutter hver 3. uge begyndende på dag 1 af RT i op til 6 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet.
|
Givet IV
Andre navne:
Givet IV
Andre navne:
Givet IV
Andre navne:
Givet IV
Andre navne:
Givet PO
Andre navne:
Gennemgå intensitetsmoduleret strålebehandling
Andre navne:
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Aktiv komparator: Arm I (mFOLFOX6, RT, capecitabin)
Patienterne får mFOLFOX6-regimen bestående af oxaliplatin IV over 2 timer på dag 1, leucovorin calcium IV over 2 timer på dag 1 og fluorouracil IV kontinuerligt over 46-48 timer på dag 1-2.
Behandlingen gentages hver anden uge i 8 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet.
3-4 uger efter sidste dosis af mFOLFOX6 patienten gennemgår RT og modtager capecitabin PO BID mandag-fredag i 5 uger i fravær af sygdomsprogression eller uacceptabel toksicitet.
Deltagere tildelt til arm I samtidig med arm II eller med arm III.
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Givet IV
Andre navne:
Givet IV
Andre navne:
Givet IV
Andre navne:
Givet PO
Andre navne:
Gennemgå intensitetsmoduleret strålebehandling
Andre navne:
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Score for neoadjuverende rektalcancer (NAR).
Tidsramme: Baseline til op til 3 år
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En lineær regressionsmodel, der kontrollerer for stratifikationsfaktorerne (cT-stadiet og cN-stadiet), vil blive brugt.
Gennemsnitlige NAR-scores sammen med standardfejl og konfidensintervaller vil blive rapporteret efter behandling.
NAR-scoren varierer fra nul til 100 med lavere værdier svarende til bedre prognose.
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Baseline til op til 3 år
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Frekvens for patologisk fuldstændig respons (knuder og tumor) ypT0 og ypN0
Tidsramme: Op til 3 år
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Patologisk komplet respons betyder, at der ikke er nogen tilbageværende kræft, der kan påvises i patologiprøven.
Analyseret af en logistisk regressionsmodel, der kontrollerer for stratifikationsfaktorerne (cT-stadiet og cN-stadiet).
Observerede proportioner sammen med konfidensintervaller vil blive præsenteret ved behandling.
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Op til 3 år
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Bevarelse af sphincter
Tidsramme: Op til 3 år
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Bevarelse af sphincter betyder, at den kirurgiske procedure, der blev brugt til at fjerne tumoren, ikke forstyrrede lukkemusklen.
Analyseret af en logistisk regressionsmodel, der kontrollerer for stratifikationsfaktorerne (cT-stadiet og cN-stadiet).
Observerede proportioner sammen med konfidensintervaller vil blive præsenteret ved behandling.
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Op til 3 år
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Overlevelse
Tidsramme: Tid fra randomisering, vurderet op til 3 år
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Analyseret ved hjælp af den stratificerede log rank-test med strata cT-stadie og cN-stadie.
Kaplan-Meier-plots vil illustrere fordelingen af disse slutpunkter efter behandling.
Cox-regressionsmodeller vil blive brugt til at estimere hazardforhold og tilhørende konfidensintervaller.
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Tid fra randomisering, vurderet op til 3 år
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Sygningsfri overlevelse
Tidsramme: Tid fra randomisering, vurderet op til 3 år
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Analyseret ved hjælp af den stratificerede log-rank test med stratifikation efter cT-stadie og cN-stadie.
Kaplan-Meier-plot vil illustrere fordelingen af disse endepunkter efter behandling.
Cox-regressionsmodeller vil blive brugt til at estimere hazard ratioer og tilhørende konfidensintervaller.
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Tid fra randomisering, vurderet op til 3 år
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Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Andel af patienter, der har en tumorresektion samlet (og betinget af påbegyndelse af induktionskemoterapi og betinget af påbegyndelse af kemoradioterapi)
Tidsramme: Op til 3 år
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Analyseret af en logistisk regressionsmodel, der kontrollerer for stratifikationsfaktorerne (cT-stadiet og cN-stadiet).
Observerede proportioner sammen med konfidensintervaller vil blive præsenteret ved behandling.
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Op til 3 år
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Tid fra påbegyndelse af kemoradioterapi til kirurgi i undergruppen af patienter med tumorresektion
Tidsramme: Op til 3 år
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Analyseret ved hjælp af den stratificerede log rank test med strata cT-stadium og cN-stadium.
Kaplan-Meier plots vil illustrere fordelingen af tid til operation (TTS) efter behandling.
Cox-regressionsmodeller vil blive brugt til at estimere fareforhold og tilhørende konfidensintervaller.
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Op til 3 år
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Hyppighed af sygdomsprogression under kemoterapi (før kemoterapi)
Tidsramme: Op til 3 år
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Analyseret af en logistisk regressionsmodel, der kontrollerer for stratifikationsfaktorerne (cT-stadiet og cN-stadiet).
Observerede proportioner sammen med konfidensintervaller vil blive præsenteret ved behandling.
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Op til 3 år
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Rate of Clinical Complete Response Rate, ycT0
Tidsramme: Op til 3 år
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Analyseret af en logistisk regressionsmodel, der kontrollerer for stratifikationsfaktorerne (cT-stadiet og cN-stadiet).
Observerede proportioner sammen med konfidensintervaller vil blive præsenteret ved behandling.
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Op til 3 år
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Rate for negativ periferisk margin
Tidsramme: Op til 3 år
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Analyseret af en logistisk regressionsmodel, der kontrollerer for stratifikationsfaktorerne (cT-stadiet og cN-stadiet).
Observerede proportioner sammen med konfidensintervaller vil blive præsenteret ved behandling.
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Op til 3 år
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Gennemførelseshastigheden af alle cyklusser af neoadjuverende kemoterapi
Tidsramme: Op til 3 år
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Analyseret af en logistisk regressionsmodel, der kontrollerer for stratifikationsfaktorerne (cT-stadiet og cN-stadiet).
Observerede proportioner sammen med konfidensintervaller vil blive præsenteret ved behandling.
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Op til 3 år
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Fuldførelsesgrad for fuld kemoradiation
Tidsramme: Op til 3 år
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Analyseret af en logistisk regressionsmodel, der kontrollerer for stratifikationsfaktorerne (cT-stadiet og cN-stadiet).
Observerede proportioner sammen med konfidensintervaller vil blive præsenteret ved behandling.
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Op til 3 år
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Forekomst af toksicitet, herunder patientrapporterede toksiciteter
Tidsramme: 30 dage efter sidste undersøgelsesbehandling
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Vil blive vurderet ved hjælp af Common Terminology for Adverse Events (CTCAE) version 4.0 (CTCAE version 5.0 fra den 1. april 2018).
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30 dage efter sidste undersøgelsesbehandling
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Korrelative molekylære prædiktorer for respons og fjernt svigt
Tidsramme: Op til 3 år
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Cox regressionsmodeller vil blive brugt til at evaluere markører for tid-til-hændelse variabler.
Logistiske regressionsmodeller vil blive brugt til binære variable.
Modeller vil kontrollere for stratifikationsfaktorer og muligvis andre prognostiske variabler (f.
køn eller behandling).
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Op til 3 år
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Forholdet mellem radiografiske fund og patologiske resultater
Tidsramme: Op til 3 år
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Vil undersøge sammenhængen mellem radiografiske fund og patologiske resultater.
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Op til 3 år
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Samarbejdspartnere og efterforskere
Sponsor
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: Thomas J George, NRG Oncology
Publikationer og nyttige links
Generelle publikationer
- Hall WA, Li J, You YN, Gollub MJ, Grajo JR, Rosen M, dePrisco G, Yothers G, Dorth JA, Rahma OE, Russell MM, Gross HM, Jacobs SA, Faller BA, George S, Al Baghdadi T, Haddock MG, Valicenti R, Hong TS, George TJ. Prospective Correlation of Magnetic Resonance Tumor Regression Grade With Pathologic Outcomes in Total Neoadjuvant Therapy for Rectal Adenocarcinoma. J Clin Oncol. 2023 Oct 10;41(29):4643-4651. doi: 10.1200/JCO.22.02525. Epub 2023 Jul 21.
- Rahma OE, Yothers G, Hong TS, Russell MM, You YN, Parker W, Jacobs SA, Colangelo LH, Lucas PC, Gollub MJ, Hall WA, Kachnic LA, Vijayvergia N, O'Rourke MA, Faller BA, Valicenti RK, Schefter TE, George S, Kainthla R, Stella PJ, Sigurdson E, Wolmark N, George TJ. Use of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer: Initial Results From the Pembrolizumab Arm of a Phase 2 Randomized Clinical Trial. JAMA Oncol. 2021 Aug 1;7(8):1225-1230. doi: 10.1001/jamaoncol.2021.1683.
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Anslået)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Anslået)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Neoplasmer efter sted
- Neoplasmer
- Tarmsygdomme
- Gastrointestinale neoplasmer
- Neoplasmer i fordøjelsessystemet
- Sygdomme i fordøjelsessystemet
- Gastrointestinale sygdomme
- Kolorektale neoplasmer
- Intestinale neoplasmer
- Endetarmssygdomme
- Rektale neoplasmer
- Organiske kemikalier
- Heterocykliske forbindelser, 1-ring
- Heterocykliske forbindelser
- Heterocykliske forbindelser, 2-ring
- Heterocykliske forbindelser, smeltet ring
- Terapeutik
- Nukleinsyrer, nukleotider og nukleosider
- Enzymer og coenzymer
- Koordinationskomplekser
- Deoxycytidin
- Cytidin
- Pyrimidin -nukleosider
- Pyrimidiner
- Nukleosider
- Formyltetrahydrofolater
- Tetrahydrofolater
- Folinsyre
- Pterins
- Pteridiner
- Uracil
- Pyrimidinoner
- Coenzymer
- Strålebehandling
- Deoxyribonucleosider
- Strålebehandling, konform
- Strålebehandling, computerassisteret
- Capecitabin
- Oxaliplatin
- Fluorouracil
- Leucovorin
- pembrolizumab
- Strålebehandling, intensitetsmoduleret
- Veliparib
- Dehydroftorafur
Andre undersøgelses-id-numre
- NCI-2016-00222 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
- U10CA180868 (U.S. NIH-bevilling/kontrakt)
- NRG-GI002 (Anden identifikator: CTEP)
- s17-00197
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 .