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S1613, Trastuzumab og Pertuzumab eller Cetuximab og Irinotecan Hydrochlorid til behandling af patienter med lokalt avanceret eller metastatisk HER2/Neu amplificeret kolorektal cancer, der ikke kan fjernes ved kirurgi

21. januar 2026 opdateret af: SWOG Cancer Research Network

S1613, et randomiseret fase II studie af Trastuzumab og Pertuzumab (TP) sammenlignet med Cetuximab og Irinotecan (CETIRI) i avanceret/metastatisk kolorektal cancer (mCRC) med HER-2 amplifikation

Dette randomiserede fase II-forsøg undersøger, hvor godt trastuzumab og pertuzumab virker sammenlignet med cetuximab og irinotecanhydrochlorid til behandling af patienter med HER2/neu forstærket kolorektal cancer, der har spredt sig fra hvor den startede til andre steder i kroppen og ikke kan fjernes ved kirurgi. Monoklonale antistoffer, såsom trastuzumab og pertuzumab, kan interferere med tumorcellers evne til at vokse og sprede sig. Lægemidler, der bruges i kemoterapi, såsom cetuximab og irinotecanhydrochlorid, virker på forskellige måder for at stoppe væksten af tumorceller, enten ved at dræbe cellerne, ved at stoppe dem i at dele sig eller ved at stoppe dem i at sprede sig. At give trastuzumab og pertuzumab kan fungere bedre sammenlignet med cetuximab og irinotecanhydrochlorid til behandling af patienter med kolorektal cancer.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

PRIMÆRE MÅL:

I. At evaluere effektiviteten af trastuzumab og pertuzumab (TP) (arm 1) i HER-2 amplificeret metastatisk kolorektal cancer (mCRC) ved at sammenligne progressionsfri overlevelse (PFS) på TP sammenlignet med kontrolarm (arm 2) af cetuximab og irinotecanhydrochlorid (irinotecan) (CETIRI).

SEKUNDÆRE MÅL:

I. At evaluere den overordnede responsrate (ORR), inklusive bekræftet fuldstændig og delvis respons pr. responsevalueringskriterier i solide tumorer (RECIST) 1.1, i behandlingsarm 1 og 2.

II. At evaluere den samlede overlevelse (OS) i behandlingsarm 1 og 2. III. For at evaluere sikkerheden og toksiciteten af TP sammenlignet med CETIRI.

TERTIÆRE MÅL:

I. At estimere frekvensen af PFS, OS og ORR hos patienter, der går over til TP (arm 3) efter sygdomsprogression på CETIRI.

II. Til bankbilleder til fremtidig retrospektiv analyse. III. For at evaluere, om HER-2/centromer probe (CEP17) signalforhold og HER-2-genkopinummer (GCN) er forudsigelige for klinisk effekt for patienter, der modtager TP versus CETIRI.

IV. At banke vævs- og blodprøver til andre fremtidige korrelative undersøgelser fra patienter, der er tilmeldt undersøgelsen.

OVERSIGT: Patienter med HER2-genamplifikation randomiseres til 1 ud af 2 arme.

ARM I: Patienterne får pertuzumab intravenøst (IV) over 30-60 minutter og trastuzumab IV over 30-120 minutter på dag 1. Kurser gentages hver 21. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.

ARM II: Patienterne får cetuximab IV over 60-120 minutter og irinotecanhydrochlorid IV over 90 minutter på dag 1. Kurser gentages hver 14. dag i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienter med dokumenteret sygdomsprogression kan eventuelt gå over til Arm I.

Efter afsluttet undersøgelsesbehandling følges patienterne op i 3 år.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

240

Fase

Fase 2

Kontakter og lokationer

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

Studiesteder

Forenede Stater
- Alaska
  - Anchorage, Alaska, Forenede Stater, 98508
    - Anchorage Associates in Radiation Medicine
  - Anchorage, Alaska, Forenede Stater, 99508
    - Alaska Breast Care and Surgery LLC
  - Anchorage, Alaska, Forenede Stater, 99508
    - Alaska Oncology and Hematology LLC
  - Anchorage, Alaska, Forenede Stater, 99508
    - Alaska Women's Cancer Care
  - Anchorage, Alaska, Forenede Stater, 99508
    - Anchorage Oncology Centre
  - Anchorage, Alaska, Forenede Stater, 99508
    - Katmai Oncology Group
  - Anchorage, Alaska, Forenede Stater, 99508
    - Providence Alaska Medical Center
  - Anchorage, Alaska, Forenede Stater, 99504
    - Anchorage Radiation Therapy Center
  - Fairbanks, Alaska, Forenede Stater, 99701
    - Fairbanks Memorial Hospital
- Arizona
  - Goodyear, Arizona, Forenede Stater, 85338
    - CTCA at Western Regional Medical Center
  - Kingman, Arizona, Forenede Stater, 86401
    - Kingman Regional Medical Center
- Arkansas
  - Fort Smith, Arkansas, Forenede Stater, 72903
    - Mercy Hospital Fort Smith
  - Hot Springs, Arkansas, Forenede Stater, 71913
    - CHI Saint Vincent Cancer Center Hot Springs
  - Jonesboro, Arkansas, Forenede Stater, 72401
    - Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
- California
  - Anaheim, California, Forenede Stater, 92806
    - Kaiser Permanente-Anaheim
  - 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
  - Baldwin Park, California, Forenede Stater, 91706
    - Kaiser Permanente-Baldwin Park
  - Bellflower, California, Forenede Stater, 90706
    - Kaiser Permanente-Bellflower
  - Berkeley, California, Forenede Stater, 94704
    - Alta Bates Summit Medical Center-Herrick Campus
  - Burbank, California, Forenede Stater, 91505
    - Providence Saint Joseph Medical Center/Disney Family Cancer Center
  - Burlingame, California, Forenede Stater, 94010
    - Mills-Peninsula 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
  - Corona, California, Forenede Stater, 92879
    - City of Hope Corona
  - Costa Mesa, California, Forenede Stater, 92627
    - UC Irvine Health Cancer Center-Newport
  - Davis, California, Forenede Stater, 95616
    - Sutter Davis Hospital
  - Duarte, California, Forenede Stater, 91010
    - City of Hope Comprehensive Cancer Center
  - Dublin, California, Forenede Stater, 94568
    - Epic Care-Dublin
  - Emeryville, California, Forenede Stater, 94608
    - Bay Area Breast Surgeons Inc
  - Emeryville, California, Forenede Stater, 94608
    - Epic Care Partners in Cancer Care
  - Fontana, California, Forenede Stater, 92335
    - Kaiser Permanente-Fontana
  - Fremont, California, Forenede Stater, 94538
    - Palo Alto Medical Foundation-Fremont
  - Harbor City, California, Forenede Stater, 90710
    - Kaiser Permanente - Harbor City
  - Irvine, California, Forenede Stater, 92618
    - Kaiser Permanente-Irvine
  - Lancaster, California, Forenede Stater, 93534
    - City of Hope Antelope Valley
  - Loma Linda, California, Forenede Stater, 92354
    - Loma Linda University Medical Center
  - Los Angeles, California, Forenede Stater, 90033
    - USC / Norris Comprehensive Cancer Center
  - Los Angeles, California, Forenede Stater, 90033
    - Los Angeles County-USC Medical Center
  - Los Angeles, California, Forenede Stater, 90027
    - Kaiser Permanente Los Angeles Medical Center
  - Los Angeles, California, Forenede Stater, 90034
    - Kaiser Permanente West Los Angeles
  - Martinez, California, Forenede Stater, 94553-3156
    - Contra Costa Regional Medical Center
  - Marysville, California, Forenede Stater, 95901
    - Fremont - Rideout Cancer Center
  - Mission Hills, California, Forenede Stater, 91345
    - City of Hope Mission Hills
  - Modesto, California, Forenede Stater, 95355
    - Memorial Medical Center
  - Mountain View, California, Forenede Stater, 94040
    - Palo Alto Medical Foundation-Camino Division
  - Mountain View, California, Forenede Stater, 94040
    - Palo Alto Medical Foundation-Gynecologic Oncology
  - Novato, California, Forenede Stater, 94945
    - Sutter Cancer Research Consortium
  - Oakland, California, Forenede Stater, 94609
    - Alta Bates Summit Medical Center - Summit Campus
  - Oakland, California, Forenede Stater, 94609
    - Bay Area Tumor Institute
  - Ontario, California, Forenede Stater, 91761
    - Kaiser Permanente-Ontario
  - Orange, California, Forenede Stater, 92868
    - UC Irvine Health/Chao Family Comprehensive Cancer Center
  - Palo Alto, California, Forenede Stater, 94301
    - Palo Alto Medical Foundation Health Care
  - Panorama City, California, Forenede Stater, 91402
    - Kaiser Permanente - Panorama City
  - Riverside, California, Forenede Stater, 92505
    - Kaiser Permanente-Riverside
  - 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, 95817
    - University of California Davis Comprehensive Cancer Center
  - San Diego, California, Forenede Stater, 92120
    - Kaiser Permanente-San Diego Zion
  - San Diego, California, Forenede Stater, 92108
    - Kaiser Permanente-San Diego Mission
  - San Francisco, California, Forenede Stater, 94115
    - California Pacific Medical Center-Pacific Campus
  - San Luis Obispo, California, Forenede Stater, 93401
    - Pacific Central Coast Health Center-San Luis Obispo
  - San Marcos, California, Forenede Stater, 92078
    - Kaiser Permanente-San Marcos
  - San Mateo, California, Forenede Stater, 94401
    - Mills Health Center
  - Santa Clarita, California, Forenede Stater, 91355
    - City of Hope - Santa Clarita
  - 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
    - Sutter Pacific Medical Foundation
  - South Pasadena, California, Forenede Stater, 91030
    - City of Hope South Pasadena
  - Sunnyvale, California, Forenede Stater, 94086
    - Palo Alto Medical Foundation-Sunnyvale
  - Upland, California, Forenede Stater, 91786
    - City of Hope Upland
  - Vacaville, California, Forenede Stater, 95687
    - Sutter Cancer Centers Radiation Oncology Services-Vacaville
  - Vallejo, California, Forenede Stater, 94589
    - Sutter Solano Medical Center/Cancer Center
  - Walnut Creek, California, Forenede Stater, 94597
    - Epic Care Cyberknife Center
  - West Covina, California, Forenede Stater, 91790
    - City of Hope West Covina
  - Woodland Hills, California, Forenede Stater, 91367
    - Kaiser Permanente-Woodland Hills
- Colorado
  - Aurora, Colorado, Forenede Stater, 80045
    - Children's Hospital Colorado
  - Aurora, Colorado, Forenede Stater, 80045
    - University of Colorado Hospital
  - Aurora, Colorado, Forenede Stater, 80012
    - Rocky Mountain Cancer Centers-Aurora
  - Aurora, Colorado, Forenede Stater, 80012
    - The Medical Center of Aurora
  - Boulder, Colorado, Forenede Stater, 80301
    - Boulder Community Hospital
  - Boulder, Colorado, Forenede Stater, 80303
    - Boulder Community Foothills Hospital
  - Boulder, Colorado, Forenede Stater, 80304
    - Rocky Mountain Cancer Centers-Boulder
  - Centennial, Colorado, Forenede Stater, 80112
    - Rocky Mountain Cancer Centers - Centennial
  - Colorado Springs, Colorado, Forenede Stater, 80907
    - Penrose-Saint Francis Healthcare
  - Colorado Springs, Colorado, Forenede Stater, 80909
    - UCHealth Memorial Hospital Central
  - Colorado Springs, Colorado, Forenede Stater, 80907
    - Rocky Mountain Cancer Centers-Penrose
  - Colorado Springs, Colorado, Forenede Stater, 80920
    - Memorial Hospital North
  - Denver, Colorado, Forenede Stater, 80210
    - Porter Adventist Hospital
  - Denver, Colorado, Forenede Stater, 80218
    - Presbyterian - Saint Lukes Medical Center - Health One
  - Denver, Colorado, Forenede Stater, 80218
    - SCL Health Saint Joseph Hospital
  - Denver, Colorado, Forenede Stater, 80220
    - Rose Medical Center
  - Denver, Colorado, Forenede Stater, 80218
    - Rocky Mountain Cancer Centers-Midtown
  - Denver, Colorado, Forenede Stater, 80220
    - Rocky Mountain Cancer Centers-Rose
  - Denver, Colorado, Forenede Stater, 80204
    - Denver Health Medical Center
  - Denver, Colorado, Forenede Stater, 80218
    - Colorado Blood Cancer Institute
  - Denver, Colorado, Forenede Stater, 80204
    - Cancer Center of Colorado at Sloan's Lake
  - Denver, Colorado, Forenede Stater, 80209
    - The Women's Imaging Center
  - Denver, Colorado, Forenede Stater, 80206
    - National Jewish Health-Main Campus
  - Durango, Colorado, Forenede Stater, 81301
    - Mercy Medical Center
  - Durango, Colorado, Forenede Stater, 81301
    - Southwest Oncology PC
  - Englewood, Colorado, Forenede Stater, 80113
    - Mountain Blue Cancer Care Center - Swedish
  - Englewood, Colorado, Forenede Stater, 80113
    - Swedish Medical Center
  - Englewood, Colorado, Forenede Stater, 80113
    - Rocky Mountain Cancer Centers - Swedish
  - Englewood, Colorado, Forenede Stater, 80113
    - The Melanoma and Skin Cancer Institute
  - Fort Collins, Colorado, Forenede Stater, 80524
    - Poudre Valley Hospital
  - Fort Collins, Colorado, Forenede Stater, 80528
    - Cancer Care and Hematology-Fort Collins
  - Golden, Colorado, Forenede Stater, 80401
    - Mountain Blue Cancer Care Center
  - Golden, Colorado, Forenede Stater, 80401
    - National Jewish Health-Western Hematology Oncology
  - Grand Junction, Colorado, Forenede Stater, 81501
    - Saint Mary's Hospital and Regional Medical Center
  - Grand Junction, Colorado, Forenede Stater, 81505
    - Grand Valley Oncology
  - Greeley, Colorado, Forenede Stater, 80631
    - North Colorado Medical Center
  - Greeley, Colorado, Forenede Stater, 80631
    - UCHealth Greeley Hospital
  - Highlands Ranch, Colorado, Forenede Stater, 80129
    - UCHealth Highlands Ranch Hospital
  - Lafayette, Colorado, Forenede Stater, 80026
    - Good Samaritan Medical Center
  - Lakewood, Colorado, Forenede Stater, 80228
    - Saint Anthony Hospital
  - Lakewood, Colorado, Forenede Stater, 80228
    - Rocky Mountain Cancer Centers-Lakewood
  - Littleton, Colorado, Forenede Stater, 80120
    - Rocky Mountain Cancer Centers-Littleton
  - Littleton, Colorado, Forenede Stater, 80122
    - Littleton Adventist Hospital
  - Lone Tree, Colorado, Forenede Stater, 80124
    - Sky Ridge Medical Center
  - Lone Tree, Colorado, Forenede Stater, 80124
    - Rocky Mountain Cancer Centers-Sky Ridge
  - Longmont, Colorado, Forenede Stater, 80501
    - Longmont United Hospital
  - Longmont, Colorado, Forenede Stater, 80501
    - Rocky Mountain Cancer Centers-Longmont
  - Loveland, Colorado, Forenede Stater, 80539
    - McKee Medical Center
  - Loveland, Colorado, Forenede Stater, 80538
    - Medical Center of the Rockies
  - 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
  - Thornton, Colorado, Forenede Stater, 80260
    - National Jewish Health-Northern Hematology Oncology
  - Wheat Ridge, Colorado, Forenede Stater, 80033
    - SCL Health Lutheran Medical Center
- Connecticut
  - Derby, Connecticut, Forenede Stater, 06418
    - Smilow Cancer Hospital-Derby Care Center
  - Fairfield, Connecticut, Forenede Stater, 06824
    - Smilow Cancer Hospital Care Center-Fairfield
  - Glastonbury, Connecticut, Forenede Stater, 06033
    - Smilow Cancer Hospital Care Center at Glastonbury
  - Guilford, Connecticut, Forenede Stater, 06437
    - Smilow Cancer Hospital Care Center - Guiford
  - Hartford, Connecticut, Forenede Stater, 06105
    - Smilow Cancer Hospital Care Center at Saint Francis
  - Middletown, Connecticut, Forenede Stater, 06457
    - Middlesex Hospital
  - New Haven, Connecticut, Forenede Stater, 06520
    - Yale University
  - New Haven, Connecticut, Forenede Stater, 06510
    - Smilow Cancer Center/Yale-New Haven Hospital
  - North Haven, Connecticut, Forenede Stater, 06473
    - Yale-New Haven Hospital North Haven Medical Center
  - Orange, Connecticut, Forenede Stater, 06477
    - Smilow Cancer Hospital-Orange Care Center
  - Torrington, Connecticut, Forenede Stater, 06790
    - Smilow Cancer Hospital-Torrington Care Center
  - Trumbull, Connecticut, Forenede Stater, 06611
    - Smilow Cancer Hospital Care Center-Trumbull
  - Waterbury, Connecticut, Forenede Stater, 06708
    - Smilow Cancer Hospital-Waterbury Care Center
  - Waterford, Connecticut, Forenede Stater, 06385
    - Smilow Cancer Hospital Care Center - Waterford
- Florida
  - Aventura, Florida, Forenede Stater, 33180
    - Mount Sinai Comprehensive Cancer Center at Aventura
  - Fort Lauderdale, Florida, Forenede Stater, 33308
    - Holy Cross Hospital
  - Fort Myers, Florida, Forenede Stater, 33905
    - Regional Cancer Center-Lee Memorial Health System
  - Fort Myers, Florida, Forenede Stater, 33901
    - Lee Memorial Health System
  - Hollywood, Florida, Forenede Stater, 33021
    - Memorial Regional Hospital/Joe DiMaggio Children's Hospital
  - Miami Beach, Florida, Forenede Stater, 33140
    - Mount Sinai Medical Center
  - Pembroke Pines, Florida, Forenede Stater, 33028
    - Memorial Hospital West
- Georgia
  - Savannah, Georgia, Forenede Stater, 31405
    - Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
  - Savannah, Georgia, Forenede Stater, 31405
    - Summit Cancer Care-Candler
  - Savannah, Georgia, Forenede Stater, 31404
    - Low Country Cancer Care
- Hawaii
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Queen's Medical Center
  - Honolulu, Hawaii, Forenede Stater, 96817
    - The Cancer Center of Hawaii-Liliha
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Hawaii Cancer Care Inc - Waterfront Plaza
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Queen's Cancer Cenrer - POB I
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Straub Clinic and Hospital
  - Honolulu, Hawaii, Forenede Stater, 96813
    - University of Hawaii Cancer Center
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Hawaii Cancer Care Inc-Liliha
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Kuakini Medical Center
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Queen's Cancer Center - Kuakini
  - Honolulu, Hawaii, Forenede Stater, 96826
    - Kapiolani Medical Center for Women and Children
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Island Urology
  - Lihue, Hawaii, Forenede Stater, 96766
    - Wilcox Memorial Hospital and Kauai Medical Clinic
  - ‘Aiea, Hawaii, Forenede Stater, 96701
    - Pali Momi Medical Center
  - ‘Aiea, Hawaii, Forenede Stater, 96701
    - Queen's Cancer Center - Pearlridge
  - ‘Aiea, Hawaii, Forenede Stater, 96701
    - The Cancer Center of Hawaii-Pali Momi
  - ‘Aiea, Hawaii, Forenede Stater, 96701
    - Hawaii Cancer Care - Savio
- Idaho
  - Boise, Idaho, Forenede Stater, 83706
    - Saint Alphonsus Cancer Care Center-Boise
  - Boise, Idaho, Forenede Stater, 83712
    - Saint Luke's Cancer Institute - Boise
  - Caldwell, Idaho, Forenede Stater, 83605
    - Saint Alphonsus Cancer Care Center-Caldwell
  - Coeur d'Alene, Idaho, Forenede Stater, 83814
    - Kootenai Health - Coeur d'Alene
  - Emmett, Idaho, Forenede Stater, 83617
    - Walter Knox Memorial Hospital
  - Fruitland, Idaho, Forenede Stater, 83619
    - Saint Luke's Cancer Institute - Fruitland
  - Meridian, Idaho, Forenede Stater, 83642
    - Idaho Urologic Institute-Meridian
  - Meridian, Idaho, Forenede Stater, 83642
    - Saint Luke's Cancer Institute - Meridian
  - Nampa, Idaho, Forenede Stater, 83686
    - Saint Alphonsus Medical Center-Nampa
  - Nampa, Idaho, Forenede Stater, 83686
    - Saint Luke's Cancer Institute - Nampa
  - Post Falls, Idaho, Forenede Stater, 83854
    - Kootenai Clinic Cancer Services - Post Falls
  - Sandpoint, Idaho, Forenede Stater, 83864
    - Kootenai Cancer Clinic
  - Twin Falls, Idaho, Forenede Stater, 83301
    - Saint Luke's Cancer Institute - Twin Falls
- Illinois
  - Alton, Illinois, Forenede Stater, 62002
    - Saint Anthony's Health
  - Aurora, Illinois, Forenede Stater, 60504
    - Rush - Copley Medical Center
  - Bloomington, Illinois, Forenede Stater, 61704
    - Illinois CancerCare-Bloomington
  - 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
  - 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
  - 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
    - 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
  - 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
  - Washington, Illinois, Forenede Stater, 61571
    - Illinois CancerCare - Washington
  - Yorkville, Illinois, Forenede Stater, 60560
    - Rush-Copley Healthcare Center
- Indiana
  - Indianapolis, Indiana, Forenede Stater, 46237
    - Franciscan Health Indianapolis
  - Indianapolis, Indiana, Forenede Stater, 46219
    - Community Cancer Center East
  - Indianapolis, Indiana, Forenede Stater, 46227
    - Community Cancer Center South
  - Indianapolis, Indiana, Forenede Stater, 46256
    - Community Cancer Center North
  - Kokomo, Indiana, Forenede Stater, 46904
    - Community Howard Regional Health
  - Lafayette, Indiana, Forenede Stater, 47905
    - Franciscan Saint Elizabeth Health - Lafayette East
  - 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
  - New Albany, Indiana, Forenede Stater, 47150
    - Baptist Health Floyd
  - Richmond, Indiana, Forenede Stater, 47374
    - Reid Health
  - South Bend, Indiana, Forenede Stater, 46601
    - Memorial Hospital of South Bend
  - Terre Haute, Indiana, Forenede Stater, 47804
    - Union Hospital
- Iowa
  - Carroll, Iowa, Forenede Stater, 51401
    - Saint Anthony Regional Hospital
  - 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
  - Council Bluffs, Iowa, Forenede Stater, 51502
    - Jennie Edmundson Memorial Hospital
  - Council Bluffs, Iowa, Forenede Stater, 51503
    - Heartland Oncology and Hematology LLP
  - Creston, Iowa, Forenede Stater, 50801
    - Greater Regional Medical Center
  - Des Moines, Iowa, Forenede Stater, 50309
    - Iowa Methodist Medical Center
  - Des Moines, Iowa, Forenede Stater, 50314
    - Mercy Medical Center - Des Moines
  - Des Moines, Iowa, Forenede Stater, 50309
    - Medical Oncology and Hematology Associates-Des Moines
  - Des Moines, Iowa, Forenede Stater, 50314
    - Broadlawns Medical Center
  - Des Moines, Iowa, Forenede Stater, 50316
    - Iowa Lutheran Hospital
  - Des Moines, Iowa, Forenede Stater, 50314
    - Medical Oncology and Hematology Associates-Laurel
  - Fort Dodge, Iowa, Forenede Stater, 50501
    - Trinity Regional Medical Center
  - West Des Moines, Iowa, Forenede Stater, 50266-7700
    - Methodist West Hospital
  - West Des Moines, Iowa, Forenede Stater, 50266
    - Mercy Medical Center-West Lakes
- Kansas
  - Coffeyville, Kansas, Forenede Stater, 67337
    - Coffeyville Regional Medical Center
  - Fairway, Kansas, Forenede Stater, 66205
    - University of Kansas Clinical Research Center
  - 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
  - Kansas City, Kansas, Forenede Stater, 66160
    - University of Kansas Cancer Center
  - Kansas City, Kansas, Forenede Stater, 66112
    - University of Kansas Cancer Center-West
  - 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
  - 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
  - Pittsburg, Kansas, Forenede Stater, 66762
    - Ascension Via Christi - Pittsburg
  - Salina, Kansas, Forenede Stater, 67401
    - Salina Regional Health Center
  - Topeka, Kansas, Forenede Stater, 66606
    - University of Kansas Health System Saint Francis Campus
  - Westwood, Kansas, Forenede Stater, 66205
    - University of Kansas Hospital-Westwood Cancer Center
  - Wichita, Kansas, Forenede Stater, 67208
    - Cancer Center of Kansas-Wichita Medical Arts Tower
  - Wichita, Kansas, Forenede Stater, 67214
    - Cancer Center of Kansas - Wichita
- Kentucky
  - Bardstown, Kentucky, Forenede Stater, 40004
    - Flaget Memorial Hospital
  - Corbin, Kentucky, Forenede Stater, 40701
    - Baptist Health Corbin
  - Corbin, Kentucky, Forenede Stater, 40701
    - Commonwealth Cancer Center-Corbin
  - Lexington, Kentucky, Forenede Stater, 40536
    - University of Kentucky/Markey Cancer Center
  - Lexington, Kentucky, Forenede Stater, 40504
    - Saint Joseph Radiation Oncology Resource Center
  - Lexington, Kentucky, Forenede Stater, 40509
    - Saint Joseph Hospital East
  - Lexington, Kentucky, Forenede Stater, 40503
    - Baptist Health Lexington
  - London, Kentucky, Forenede Stater, 40741
    - Saint Joseph London
  - Louisville, Kentucky, Forenede Stater, 40202
    - Jewish Hospital
  - Louisville, Kentucky, Forenede Stater, 40207
    - Baptist Health Louisville
  - Louisville, Kentucky, Forenede Stater, 40215
    - Saints Mary and Elizabeth Hospital
  - Louisville, Kentucky, Forenede Stater, 40245
    - Jewish Hospital Medical Center Northeast
  - Madisonville, Kentucky, Forenede Stater, 42431
    - Baptist Health Madisonville/Merle Mahr Cancer Center
  - Paducah, Kentucky, Forenede Stater, 42003
    - Baptist Health Paducah
  - Shepherdsville, Kentucky, Forenede Stater, 40165
    - Jewish Hospital Medical Center South
- Louisiana
  - Baton Rouge, Louisiana, Forenede Stater, 70809
    - Ochsner Health Center-Summa
  - Baton Rouge, Louisiana, Forenede Stater, 70816
    - Medical Center of Baton Rouge
  - Baton Rouge, Louisiana, Forenede Stater, 70836
    - Ochsner High Grove
  - New Orleans, Louisiana, Forenede Stater, 70121
    - Ochsner Medical Center Jefferson
- Maryland
  - Baltimore, Maryland, Forenede Stater, 21201
    - University of Maryland/Greenebaum Cancer Center
- Massachusetts
  - Beverly, Massachusetts, Forenede Stater, 01915
    - Beverly Hospital
  - Burlington, Massachusetts, Forenede Stater, 01805
    - Lahey Hospital and Medical Center
  - Gloucester, Massachusetts, Forenede Stater, 01930
    - Addison Gilbert Hospital
  - Peabody, Massachusetts, Forenede Stater, 01960
    - Lahey Medical Center-Peabody
  - Springfield, Massachusetts, Forenede Stater, 01104
    - Mercy Medical Center
  - Winchester, Massachusetts, Forenede Stater, 01890
    - Winchester Hospital
- 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
  - Bloomfield, Michigan, Forenede Stater, 48302
    - McLaren Cancer Institute-Bloomfield
  - Brighton, Michigan, Forenede Stater, 48114
    - Saint Joseph Mercy Brighton
  - Brighton, Michigan, Forenede Stater, 48114
    - IHA Hematology Oncology Consultants-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
    - IHA Hematology Oncology Consultants-Canton
  - Caro, Michigan, Forenede Stater, 48723
    - Caro Cancer Center
  - Chelsea, Michigan, Forenede Stater, 48118
    - Saint Joseph Mercy Chelsea
  - Chelsea, Michigan, Forenede Stater, 48118
    - IHA Hematology Oncology Consultants-Chelsea
  - Clarkston, Michigan, Forenede Stater, 48346
    - McLaren Cancer Institute-Clarkston
  - 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, 48124
    - Beaumont Hospital - Dearborn
  - 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 Township, 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, 48532
    - Singh and Arora Hematology Oncology PC
  - 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
    - Mercy Health Saint Mary's
  - 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
  - Lansing, Michigan, Forenede Stater, 48910
    - McLaren-Greater Lansing
  - Lansing, Michigan, Forenede Stater, 48912
    - Mid-Michigan Physicians-Lansing
  - Livonia, Michigan, Forenede Stater, 48154
    - Saint Mary Mercy 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
    - Toledo Clinic Cancer Centers-Monroe
  - Mount Clemens, Michigan, Forenede Stater, 48043
    - McLaren Cancer Institute-Macomb
  - Mount Pleasant, Michigan, Forenede Stater, 48858
    - McLaren Cancer Institute-Central Michigan
  - Muskegon, Michigan, Forenede Stater, 49444
    - Mercy Health Mercy Campus
  - Niles, Michigan, Forenede Stater, 49120
    - Lakeland 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
  - 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
  - Pontiac, Michigan, Forenede Stater, 48341
    - Hope Cancer Center
  - Pontiac, Michigan, Forenede Stater, 48341
    - Newland Medical Associates-Pontiac
  - Port Huron, Michigan, Forenede Stater, 48060
    - McLaren-Port Huron
  - 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, 48106
    - Huron Gastroenterology PC
  - Ypsilanti, Michigan, Forenede Stater, 48197
    - IHA Hematology Oncology Consultants-Ann Arbor
- Minnesota
  - Aitkin, Minnesota, Forenede Stater, 56431
    - Riverwood Healthcare Center
  - Brainerd, Minnesota, Forenede Stater, 56401
    - Essentia Health Saint Joseph's Medical 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
  - 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
    - 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
  - New Ulm, Minnesota, Forenede Stater, 56073
    - New Ulm Medical Center
  - Park Rapids, Minnesota, Forenede Stater, 56470
    - Essentia Health - Park Rapids
  - Princeton, Minnesota, Forenede Stater, 55371
    - Fairview Northland Medical Center
  - Robbinsdale, Minnesota, Forenede Stater, 55422
    - North Memorial Medical Health Center
  - 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
  - Wyoming, Minnesota, Forenede Stater, 55092
    - Fairview Lakes Medical Center
- Mississippi
  - Pascagoula, Mississippi, Forenede Stater, 39581
    - Singing River Hospital
- 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, 64128
    - Kansas City Veterans Affairs Medical Center
  - 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
  - Billings, Montana, Forenede Stater, 59102
    - Saint Vincent Frontier Cancer Center
  - 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, 68114
    - Nebraska Methodist Hospital
  - 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
    - 21st Century Oncology-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, 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
    - HealthCare Partners Medical Group Oncology/Hematology-Tenaya
  - Las Vegas, Nevada, Forenede Stater, 89148-2405
    - Las Vegas Cancer Center-Medical Center
  - Las Vegas, Nevada, Forenede Stater, 89149
    - HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
  - Las Vegas, Nevada, Forenede Stater, 89109
    - 21st Century Oncology
  - Las Vegas, Nevada, Forenede Stater, 89128
    - 21st Century Oncology-Vegas Tenaya
  - Las Vegas, Nevada, Forenede Stater, 89148
    - 21st Century Oncology-Fort Apache
  - 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, 89148
    - Urology Specialists of Nevada - Southwest
  - Las Vegas, Nevada, Forenede Stater, 89169
    - University Cancer Center
  - 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
  - Manchester, New Hampshire, Forenede Stater, 03102
    - Norris Cotton Cancer Center-Manchester
  - Nashua, New Hampshire, Forenede Stater, 03063
    - Norris Cotton Cancer Center-Nashua
- New Jersey
  - Cape May Court House, New Jersey, Forenede Stater, 08210
    - AtlantiCare Health Park-Cape May Court House
  - Egg Harbor, New Jersey, Forenede Stater, 08234
    - AtlantiCare Surgery Center
  - Mullica Hill, New Jersey, Forenede Stater, 08062
    - Inspira Medical Center Mullica Hill
  - New Brunswick, New Jersey, Forenede Stater, 08903
    - Rutgers Cancer Institute of New Jersey
  - Newark, New Jersey, Forenede Stater, 07112
    - Newark Beth Israel Medical Center
  - Vineland, New Jersey, Forenede Stater, 08360
    - Inspira Medical Center Vineland
- New Mexico
  - Albuquerque, New Mexico, Forenede Stater, 87102
    - University of New Mexico Cancer Center
  - Albuquerque, New Mexico, Forenede Stater, 87102
    - Lovelace Medical Center-Saint Joseph Square
  - Albuquerque, New Mexico, Forenede Stater, 87109
    - New Mexico Oncology Hematology Consultants
  - Albuquerque, New Mexico, Forenede Stater, 87106
    - New Mexico Cancer Care Alliance
  - Albuquerque, New Mexico, Forenede Stater, 87110
    - Presbyterian Kaseman Hospital
  - Las Cruces, New Mexico, Forenede Stater, 88011
    - Memorial Medical Center - Las Cruces
  - Rio Rancho, New Mexico, Forenede Stater, 87124
    - Presbyterian Rust Medical Center/Jorgensen Cancer Center
- North Carolina
  - Albemarle, North Carolina, Forenede Stater, 28002
    - Atrium Health Stanly/LCI-Albemarle
  - Asheville, North Carolina, Forenede Stater, 28803
    - AdventHealth Infusion Center Asheville
  - Charlotte, North Carolina, Forenede Stater, 28203
    - Carolinas Medical Center/Levine Cancer Institute
  - Charlotte, North Carolina, Forenede Stater, 28210
    - Atrium Health Pineville/LCI-Pineville
  - Charlotte, North Carolina, Forenede Stater, 28262
    - Atrium Health University City/LCI-University
  - Charlotte, North Carolina, Forenede Stater, 28211
    - Levine Cancer Institute-SouthPark
  - Charlotte, North Carolina, Forenede Stater, 28277
    - Levine Cancer Institute-Ballantyne
  - Clinton, North Carolina, Forenede Stater, 28328
    - Southeastern Medical Oncology Center-Clinton
  - Clyde, North Carolina, Forenede Stater, 28721
    - AdventHealth Infusion Center Haywood
  - Concord, North Carolina, Forenede Stater, 28025
    - Atrium Health Cabarrus/LCI-Concord
  - Forest City, North Carolina, Forenede Stater, 28043
    - Levine Cancer Institute - Rutherford
  - Gastonia, North Carolina, Forenede Stater, 28054
    - CaroMont Regional Medical Center
  - Gastonia, North Carolina, Forenede Stater, 28054
    - Levine Cancer Institute-Gaston
  - 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
  - Kenansville, North Carolina, Forenede Stater, 28349
    - Vidant Oncology-Kenansville
  - Kinston, North Carolina, Forenede Stater, 28501
    - Vidant Oncology-Kinston
  - Lincolnton, North Carolina, Forenede Stater, 28092
    - Atrium Health Lincoln/LCI-Lincolnton
  - Monroe, North Carolina, Forenede Stater, 28112
    - Atrium Health Union/LCI-Union
  - Richlands, North Carolina, Forenede Stater, 28574
    - Vidant Oncology-Richlands
  - Shelby, North Carolina, Forenede Stater, 28150
    - Atrium Health Cleveland/LCI-Cleveland
  - Smithfield, North Carolina, Forenede Stater, 27577
    - Johnston Memorial Hospital
  - Weaverville, North Carolina, Forenede Stater, 28787
    - AdventHealth Infusion Center Weaverville
- North Dakota
  - Fargo, North Dakota, Forenede Stater, 58103
    - Essentia Health Cancer Center-South University Clinic
  - Grand Forks, North Dakota, Forenede Stater, 58201
    - Altru Cancer Center
  - Jamestown, North Dakota, Forenede Stater, 58401
    - Essentia Health - Jamestown Clinic
- Ohio
  - Akron, Ohio, Forenede Stater, 44307
    - Cleveland Clinic Akron General
  - Beavercreek, Ohio, Forenede Stater, 45431
    - Indu and Raj Soin Medical Center
  - Belpre, Ohio, Forenede Stater, 45714
    - Strecker Cancer Center-Belpre
  - Boardman, Ohio, Forenede Stater, 44512
    - Saint Elizabeth Boardman Hospital
  - Centerville, Ohio, Forenede Stater, 45459
    - Miami Valley Hospital South
  - Centerville, Ohio, Forenede Stater, 45459
    - Dayton Physicians LLC-Miami Valley South
  - Chillicothe, Ohio, Forenede Stater, 45601
    - Adena Regional Medical Center
  - Cincinnati, Ohio, Forenede Stater, 45220
    - Good Samaritan Hospital - Cincinnati
  - Cincinnati, Ohio, Forenede Stater, 45242
    - Bethesda North Hospital
  - Cincinnati, Ohio, Forenede Stater, 45236
    - Oncology Hematology Care Inc-Kenwood
  - Cincinnati, Ohio, Forenede Stater, 45247
    - TriHealth Cancer Institute-Westside
  - Cincinnati, Ohio, Forenede Stater, 45255
    - TriHealth Cancer Institute-Anderson
  - Columbus, Ohio, Forenede Stater, 43214
    - Riverside Methodist Hospital
  - Columbus, Ohio, Forenede Stater, 43210
    - Ohio State University Comprehensive Cancer Center
  - Columbus, Ohio, Forenede Stater, 43219
    - The Mark H Zangmeister Center
  - Columbus, Ohio, Forenede Stater, 43214
    - Columbus Oncology and Hematology Associates Inc
  - Columbus, Ohio, Forenede Stater, 43228
    - Doctors Hospital
  - Columbus, Ohio, Forenede Stater, 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
  - 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
  - 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
  - Lima, Ohio, Forenede Stater, 45801
    - Saint Rita's 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
  - Maumee, Ohio, Forenede Stater, 43537
    - Toledo Clinic Cancer Centers-Maumee
  - Maumee, Ohio, Forenede Stater, 43537
    - Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
  - Mount Vernon, Ohio, Forenede Stater, 43050
    - Knox Community Hospital
  - Newark, Ohio, Forenede Stater, 43055
    - Licking Memorial Hospital
  - Newark, Ohio, Forenede Stater, 43055
    - Newark Radiation Oncology
  - Perrysburg, Ohio, Forenede Stater, 43551
    - Mercy Health Perrysburg Cancer Center
  - Portsmouth, Ohio, Forenede Stater, 45662
    - Southern Ohio Medical Center
  - Springfield, Ohio, Forenede Stater, 45505
    - Springfield Regional Medical Center
  - Springfield, Ohio, Forenede Stater, 45504
    - Springfield Regional Cancer Center
  - Toledo, Ohio, Forenede Stater, 43608
    - Saint Vincent Mercy Medical Center
  - Toledo, Ohio, Forenede Stater, 43623
    - Mercy Health - Saint Anne Hospital
  - Toledo, Ohio, Forenede Stater, 43623
    - Toledo Clinic Cancer Centers-Toledo
  - Troy, Ohio, Forenede Stater, 45373
    - Upper Valley Medical Center
  - Troy, Ohio, Forenede Stater, 45373
    - Dayton Physicians LLC-Upper Valley
  - Warren, Ohio, Forenede Stater, 44484
    - Saint Joseph Warren Hospital
  - Westerville, Ohio, Forenede Stater, 43081
    - Saint Ann's Hospital
  - Youngstown, Ohio, Forenede Stater, 44501
    - Saint Elizabeth Youngstown Hospital
  - Zanesville, Ohio, Forenede Stater, 43701
    - Genesis Healthcare System Cancer Care Center
- Oklahoma
  - Lawton, Oklahoma, Forenede Stater, 73505
    - Cancer Centers of Southwest Oklahoma Research
  - Oklahoma City, Oklahoma, Forenede Stater, 73104
    - University of Oklahoma Health Sciences Center
  - Oklahoma City, Oklahoma, Forenede Stater, 73120
    - Mercy Hospital Oklahoma City
  - Oklahoma City, Oklahoma, Forenede Stater, 73109
    - Integris Southwest Medical Center
  - Oklahoma City, Oklahoma, Forenede Stater, 73142
    - Integris Cancer Institute of Oklahoma
  - Tulsa, Oklahoma, Forenede Stater, 74146
    - Oklahoma Cancer Specialists and Research Institute-Tulsa
- Oregon
  - Baker City, Oregon, Forenede Stater, 97814
    - Saint Alphonsus Medical Center-Baker City
  - Bend, Oregon, Forenede Stater, 97701
    - Saint Charles Health System
  - Clackamas, Oregon, Forenede Stater, 97015
    - Clackamas Radiation Oncology Center
  - Clackamas, Oregon, Forenede Stater, 97015
    - Providence Cancer Institute Clackamas Clinic
  - Coos Bay, Oregon, Forenede Stater, 97420
    - Bay Area Hospital
  - Newberg, Oregon, Forenede Stater, 97132
    - Providence Newberg Medical Center
  - Ontario, Oregon, Forenede Stater, 97914
    - Saint Alphonsus Medical Center-Ontario
  - Portland, Oregon, Forenede Stater, 97213
    - Providence Portland Medical Center
  - Portland, Oregon, Forenede Stater, 97225
    - Providence Saint Vincent Medical Center
  - Redmond, Oregon, Forenede Stater, 97756
    - Saint Charles Health System-Redmond
- Pennsylvania
  - Allentown, Pennsylvania, Forenede Stater, 18103
    - Lehigh Valley Hospital-Cedar Crest
  - Bethlehem, Pennsylvania, Forenede Stater, 18017
    - Lehigh Valley Hospital - Muhlenberg
  - Bryn Mawr, Pennsylvania, Forenede Stater, 19010
    - Bryn Mawr Hospital
  - Collegeville, Pennsylvania, Forenede Stater, 19426
    - Main Line Health Center-Collegeville
  - Danville, Pennsylvania, Forenede Stater, 17822
    - Geisinger Medical Center
  - East Stroudsburg, Pennsylvania, Forenede Stater, 18301
    - Pocono Medical Center
  - Exton, Pennsylvania, Forenede Stater, 19341
    - Main Line Health Center-Exton
  - Hazleton, Pennsylvania, Forenede Stater, 18201
    - Geisinger Medical Center-Cancer Center Hazleton
  - Hazleton, Pennsylvania, Forenede Stater, 18201
    - Lehigh Valley Hospital-Hazleton
  - Lewisburg, Pennsylvania, Forenede Stater, 17837
    - Geisinger Medical Oncology-Lewisburg
  - Lewistown, Pennsylvania, Forenede Stater, 17044
    - Lewistown Hospital
  - Media, Pennsylvania, Forenede Stater, 19063
    - Riddle Memorial Hospital
  - Newtown Square, Pennsylvania, Forenede Stater, 19073
    - Bryn Mawr Health Center
  - Paoli, Pennsylvania, Forenede Stater, 19301
    - Paoli Memorial Hospital
  - Philadelphia, Pennsylvania, Forenede Stater, 19111
    - Fox Chase Cancer Center
  - Philadelphia, Pennsylvania, Forenede Stater, 19140
    - Temple University Hospital
  - Pottstown, Pennsylvania, Forenede Stater, 19464
    - Pottstown Hospital
  - 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
  - State College, Pennsylvania, Forenede Stater, 16801
    - Geisinger Medical Group
  - West Reading, Pennsylvania, Forenede Stater, 19611
    - Reading Hospital
  - Wilkes-Barre, Pennsylvania, Forenede Stater, 18711
    - Geisinger Wyoming Valley/Henry Cancer Center
  - Wynnewood, Pennsylvania, Forenede Stater, 19096
    - Lankenau Medical Center
- Rhode Island
  - Warwick, Rhode Island, Forenede Stater, 02886
    - Kent Hospital
- South Carolina
  - Bluffton, South Carolina, Forenede Stater, 29910
    - Saint Joseph's/Candler - Bluffton Campus
  - Hilton Head Island, South Carolina, Forenede Stater, 29926-3827
    - South Carolina Cancer Specialists PC
  - Rock Hill, South Carolina, Forenede Stater, 29732
    - Levine Cancer Institute-Rock Hill
- 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
  - Baytown, Texas, Forenede Stater, 77521
    - Houston Methodist San Jacinto Hospital
  - 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
    - M D Anderson Cancer Center
  - 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
  - Round Rock, Texas, Forenede Stater, 78665
    - Scott and White Healthcare Round Rock
  - Sugar Land, Texas, Forenede Stater, 77479
    - Houston Methodist Sugar Land Hospital
  - Temple, Texas, Forenede Stater, 76508
    - Scott and White Memorial Hospital
- Utah
  - American Fork, Utah, Forenede Stater, 84003
    - American Fork Hospital / Huntsman Intermountain Cancer Center
  - Cedar City, Utah, Forenede Stater, 84720
    - Sandra L Maxwell Cancer Center
  - Farmington, Utah, Forenede Stater, 84025
    - Farmington Health Center
  - Logan, Utah, Forenede Stater, 84321
    - Logan Regional Hospital
  - Murray, Utah, Forenede Stater, 84107
    - Intermountain Medical Center
  - Ogden, Utah, Forenede Stater, 84403
    - McKay-Dee Hospital Center
  - Provo, Utah, Forenede Stater, 84604
    - Utah Valley Regional Medical Center
  - Riverton, Utah, Forenede Stater, 84065
    - Riverton Hospital
  - Salt Lake City, Utah, Forenede Stater, 84112
    - Huntsman Cancer Institute/University of Utah
  - Salt Lake City, Utah, Forenede Stater, 84106
    - Utah Cancer Specialists-Salt Lake City
  - Salt Lake City, Utah, Forenede Stater, 84143
    - LDS Hospital
  - South Jordan, Utah, Forenede Stater, 84009
    - South Jordan Health Center
  - St. George, Utah, Forenede Stater, 84770
    - Dixie Medical Center Regional Cancer Center
- Vermont
  - Saint Johnsbury, Vermont, Forenede Stater, 05819
    - Norris Cotton Cancer Center-North
- Washington
  - Aberdeen, Washington, Forenede Stater, 98520
    - Providence Regional Cancer System-Aberdeen
  - Auburn, Washington, Forenede Stater, 98001
    - MultiCare Auburn Medical Center
  - Bellevue, Washington, Forenede Stater, 98004
    - Overlake Medical Center
  - Bellingham, Washington, Forenede Stater, 98225
    - PeaceHealth Saint Joseph Medical Center
  - Bremerton, Washington, Forenede Stater, 98310
    - Harrison HealthPartners Hematology and Oncology-Bremerton
  - Bremerton, Washington, Forenede Stater, 98310
    - Harrison Medical Center
  - Burien, Washington, Forenede Stater, 98166
    - Highline Medical Center-Main Campus
  - Centralia, Washington, Forenede Stater, 98531
    - Providence Regional Cancer System-Centralia
  - Edmonds, Washington, Forenede Stater, 98026
    - Swedish Cancer Institute-Edmonds
  - Enumclaw, Washington, Forenede Stater, 98022
    - Saint Elizabeth Hospital
  - Everett, Washington, Forenede Stater, 98201
    - Providence Regional Cancer Partnership
  - Federal Way, Washington, Forenede Stater, 98003
    - Saint Francis Hospital
  - Gig Harbor, Washington, Forenede Stater, 98335
    - MultiCare Gig Harbor Medical Park
  - Issaquah, Washington, Forenede Stater, 98029
    - Swedish Cancer Institute-Issaquah
  - Kennewick, Washington, Forenede Stater, 99336
    - Kadlec Clinic Hematology and Oncology
  - Lacey, Washington, Forenede Stater, 98503
    - Providence Regional Cancer System-Lacey
  - Lakewood, Washington, Forenede Stater, 98499
    - Saint Clare Hospital
  - Longview, Washington, Forenede Stater, 98632
    - PeaceHealth Saint John Medical Center
  - Port Townsend, Washington, Forenede Stater, 98368
    - Jefferson Healthcare
  - Poulsbo, Washington, Forenede Stater, 98370
    - Harrison HealthPartners Hematology and Oncology-Poulsbo
  - Puyallup, Washington, Forenede Stater, 98372
    - MultiCare Good Samaritan Hospital
  - Renton, Washington, Forenede Stater, 98055
    - Valley Medical Center
  - Seattle, Washington, Forenede Stater, 98107
    - Swedish Medical Center-Ballard Campus
  - Seattle, Washington, Forenede Stater, 98112
    - Kaiser Permanente Washington
  - Seattle, Washington, Forenede Stater, 98104
    - Pacific Gynecology Specialists
  - Seattle, Washington, Forenede Stater, 98122-4307
    - Swedish Medical Center-First Hill
  - Seattle, Washington, Forenede Stater, 98122-5711
    - Swedish Medical Center-Cherry Hill
  - Sedro-Woolley, Washington, Forenede Stater, 98284
    - PeaceHealth United General Medical Center
  - Shelton, Washington, Forenede Stater, 98584
    - Providence Regional Cancer System-Shelton
  - Spokane, Washington, Forenede Stater, 99204
    - MultiCare Deaconess Cancer and Blood Specialty Center - Downtown
  - Spokane, Washington, Forenede Stater, 99218
    - MultiCare Deaconess Cancer and Blood Specialty Center - North
  - Spokane Valley, Washington, Forenede Stater, 99216
    - MultiCare Deaconess Cancer and Blood Specialty Center - Valley
  - Tacoma, Washington, Forenede Stater, 98405
    - Mary Bridge Children's Hospital and Health Center
  - Tacoma, Washington, Forenede Stater, 98405
    - Northwest Medical Specialties PLLC
  - Tacoma, Washington, Forenede Stater, 98405
    - MultiCare Tacoma General Hospital
  - Tacoma, Washington, Forenede Stater, 98405
    - Franciscan Research Center-Northwest Medical Plaza
  - Vancouver, Washington, Forenede Stater, 98664
    - PeaceHealth Southwest Medical Center
  - Walla Walla, Washington, Forenede Stater, 99362
    - Providence Saint Mary Regional Cancer Center
  - Yakima, Washington, Forenede Stater, 98902
    - North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
  - Yelm, Washington, Forenede Stater, 98597
    - Providence Regional Cancer System-Yelm
- West Virginia
  - Bridgeport, West Virginia, Forenede Stater, 26330
    - United Hospital Center
  - Huntington, West Virginia, Forenede Stater, 25701
    - Edwards Comprehensive Cancer Center
  - Martinsburg, West Virginia, Forenede Stater, 25401
    - WVUH-Berkely Medical Center
  - Morgantown, West Virginia, Forenede Stater, 26506
    - West Virginia University Healthcare
  - Parkersburg, West Virginia, Forenede Stater, 26101
    - Camden Clark Medical Center
- Wisconsin
  - Ashland, Wisconsin, Forenede Stater, 54806
    - Duluth Clinic Ashland
  - Ashland, Wisconsin, Forenede Stater, 54806
    - Northwest Wisconsin Cancer Center
  - Chippewa Falls, Wisconsin, Forenede Stater, 54729
    - Marshfield Clinic-Chippewa Center
  - Eau Claire, Wisconsin, Forenede Stater, 54701
    - Marshfield Medical Center-EC Cancer Center
  - Janesville, Wisconsin, Forenede Stater, 53548
    - Mercyhealth Hospital and Cancer Center - Janesville
  - La Crosse, Wisconsin, Forenede Stater, 54601
    - Gundersen Lutheran Medical Center
  - Ladysmith, Wisconsin, Forenede Stater, 54848
    - Marshfield Clinic - Ladysmith Center
  - Marshfield, Wisconsin, Forenede Stater, 54449
    - Marshfield Medical Center-Marshfield
  - Minocqua, Wisconsin, Forenede Stater, 54548
    - Marshfield Clinic-Minocqua Center
  - New Richmond, Wisconsin, Forenede Stater, 54017
    - Cancer Center of Western Wisconsin
  - Rice Lake, Wisconsin, Forenede Stater, 54868
    - Marshfield Medical Center-Rice Lake
  - Stevens Point, Wisconsin, Forenede Stater, 54482
    - Marshfield Clinic Stevens Point Center
  - Wausau, Wisconsin, Forenede Stater, 54401
    - Marshfield Clinic-Wausau Center
  - Weston, Wisconsin, Forenede Stater, 54476
    - Marshfield Medical Center - Weston
  - Wisconsin Rapids, Wisconsin, Forenede Stater, 54494
    - Marshfield Clinic - Wisconsin Rapids Center
- Wyoming
  - Cheyenne, Wyoming, Forenede Stater, 82001
    - Cheyenne Regional Medical Center-West
  - Cody, Wyoming, Forenede Stater, 82414
    - Billings Clinic-Cody
  - Sheridan, Wyoming, Forenede Stater, 82801
    - Welch Cancer Center
Puerto Rico
- - Aguadilla, Puerto Rico, 00603
    - Advance Oncology Center
  - Arecibo, Puerto Rico, 00614
    - Doctor's Cancer Center-Arecibo
  - Bayamón, Puerto Rico, 00959-5060
    - Cancer Center-Metro Medical Center Bayamon
  - Bayamón, Puerto Rico, 00961
    - Hematologia Oncologia San Pablo
  - Caguas, Puerto Rico, 00726
    - HIMA San Pablo Oncologic Hospital
  - Manatí, Puerto Rico, 00674
    - Doctors Cancer Center
  - Ponce, Puerto Rico, 00716
    - Instituto Oncologia Moderna Ponce
  - 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
  - San Juan, Puerto Rico, 00920
    - Primary Care Physician Group
  - Santa Isabel, Puerto Rico, 00757
    - Centro de Hematologia y Oncologia del Sur

Deltagelseskriterier

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

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Beskrivelse

Inklusionskriterier:

TRIN 1 FØRSTE REGISTRERING: HER2 TEST
Patienter skal have histologisk eller cytologisk dokumenteret adenocarcinom i tyktarmen eller endetarmen, som er metastatisk eller lokalt fremskreden og uoperabel
Mutationsresultater:
- Alle patienter skal have udført molekylær testning i et Clinical Laboratory Improvement Act (CLIA) certificeret laboratorium, som inkluderer KRAS- og NRAS-genet og exon 15 af BRAF-genet (BRAF V600E-mutation); patienter med en hvilken som helst kendt aktiverende mutation i exon 2 [kodon 12 og 13], exon 3 [kodon 59 og 61] og exon 4 [kodon 117 og 146]) af KRAS/NRAS gener og i exon 15 (BRAFV600E mutation) af BRAF genet er ikke berettigede
Patienter må ikke være blevet behandlet med nogen af følgende forud for trin 1 indledende registrering:
- Cetuximab, panitumumab eller ethvert andet monoklonalt antistof mod EGFR eller inhibitor af EGFR
- HER-2-målretning til behandling af kolorektal cancer; patienter, der tidligere har modtaget trastuzumab eller pertuzumab for andre indikationer, såsom tidligere adjuverende eller neoadjuverende brystkræftbehandling forud for udviklingen af fremskreden kolorektal cancer, er kvalificerede
Patienter må ikke have haft alvorlig toksicitet og intolerance over for eller overfølsomhed over for irinotecan eller andre undersøgelseslægemidler. patienter må ikke have haft en alvorlig infusionsrelateret reaktion under nogen tidligere behandling med pertuzumab eller trastuzumab
Patienter skal have tumorglas til rådighed til indsendelse til HER-2-testning; HER-2-testning skal udføres af det centrale laboratorium før randomisering i trin 2
Patienterne skal informeres om undersøgelsens karakter af denne undersøgelse og skal underskrive og give informeret samtykke i overensstemmelse med institutionelle og føderale retningslinjer; for trin 1 indledende registrering er den relevante samtykkeformular trin 1 samtykkeformularen
Som en del af OPEN-registreringsprocessen oplyses den behandlende institutions identitet for at sikre, at den aktuelle (inden for 365 dage) dato for institutionsbedømmelsesudvalgets godkendelse af denne undersøgelse er blevet indtastet i systemet
TRIN 2 RANDOMISERING
Patienter skal have HER-2-amplifikation som bestemt ved central test (3+ eller 2+ ved immunhistokemi og HER-2-genamplifikation ved in situ hybridisering med et forhold mellem HER-2-gensignaler og centromere 17-signaler >= 2,0)
Patienter skal have målbar sygdom, som er metastatisk eller lokalt fremskreden og ikke-opererbar; billeddannelse, der anvendes til at vurdere al sygdom pr. RECIST 1.1, skal være afsluttet inden for 28 dage før randomisering i trin 2; al sygdom skal vurderes og dokumenteres på Baseline Tumor Assessment Form
Patienter skal have haft mindst ét tidligere regime med systemisk kemoterapi for metastatisk eller lokalt fremskreden, ikke-operabel sygdom; patienter skal have udviklet sig efter den seneste behandling; forudgående behandling med irinotecan er tilladt; for patienter, der modtog adjuverende kemoterapi: forudgående behandling for metastatisk sygdom er ikke påkrævet for patienter, der oplevede sygdomsgentagelse under eller inden for 6 måneder efter afslutning af adjuverende kemoterapi; hvis patienten modtog én linje af adjuverende behandling og havde sygdomsrecidiv efter 6 måneders afslutning af kemoterapi, vil patienterne kun være berettigede efter at have svigtet en yderligere linje af kemoterapi, der bruges til at behandle den metastatiske eller lokalt fremskredne, ikke-operable sygdom; patienter, der har modtaget >= 3 linjer med systemisk kemoterapi for metastatisk eller lokalt fremskreden, ikke-operabel sygdom, er ikke kvalificerede
Patienter skal have gennemført forudgående kemoterapi, immunterapi eller strålebehandling mindst 14 dage før randomisering i trin 2, og al toksicitet skal være løst til Common Terminology Criteria for Adverse Events (CTCAE) version (v)4.0 grad 1 (med undtagelse af CTCAE) v4.0 grad 2 neuropati) før trin 2 randomisering
Hjernemetastaser er tilladt, hvis de er blevet tilstrækkeligt behandlet med strålebehandling eller kirurgi og er stabile i mindst 30 dage før trin 2 randomisering; kvalificerede patienter skal være neurologisk asymptomatiske og uden kortikosteroidbehandling i mindst 7 dage før trin 2 randomisering
Patienter skal have en Zubrod præstationsstatus på 0 eller 1
Patienter skal have en fuldstændig fysisk undersøgelse og sygehistorie inden for 28 dage før trin 2 randomisering
Absolut neutrofiltal (ANC) >= 1.500/mcL
Blodplader >= 75.000/mcL
Hæmoglobin >= 9 g/dL
Aspartataminotransferase (AST) og alaninaminotransferase (ALT) begge =< 5 x institutionel øvre normalgrænse (IULN)
Bilirubin =< 1,5 mg/dL
Beregnet kreatininclearance > 30 ml/min inden for 14 dage før trin 2 randomisering
Patienter, der har fået foretaget et ekkokardiogram inden for 6 måneder forud for trin 2 randomisering, skal have ventrikulær ejektionsfraktion (venstre ventrikel ejektionsfraktion [LVEF]) >= 50 % eller >= inden for institutionens normale grænser
Patienter må ikke have en ukontrolleret interkurrent sygdom, herunder, men ikke begrænset til diabetes, hypertension, alvorlig infektion, alvorlig underernæring, ustabil angina, klasse III-IV New York Heart Association (NYHA) kongestiv hjertesvigt, ventrikulære arytmier, aktiv iskæmisk hjertesygdom, eller myokardieinfarkt inden for 6 måneder før trin 2 randomisering
Patienter må ikke have nogen kendt tidligere eller samtidig tilstand, der tyder på modtagelighed for overfølsomhed eller allergiske reaktioner, herunder, men ikke begrænset til: kendt overfølsomhed over for nogen af undersøgelsesbehandlingerne eller over for hjælpestoffer af rekombinante humane eller humaniserede antistoffer; patienter med mild eller sæsonbestemt allergi kan inddrages efter drøftelse med studielederne
Patienter må ikke planlægge behandling med andre systemiske anticancermidler (f.eks. kemoterapi, hormonbehandling, immunterapi) eller andre behandlinger, der ikke er en del af protokolspecificeret anticancerterapi, herunder samtidige undersøgelsesmidler af enhver type
Ingen tidligere malignitet er tilladt undtagen for tilstrækkeligt behandlet basalcelle- eller pladecellehudkræft, in situ livmoderhalskræft, duktalt karcinom in situ, andre lavgradige læsioner såsom tilfældig blindtarmscarcinoid eller enhver anden cancer, hvorfra patienten har været sygdom og behandlet gratis i to år; prostatakræftpatienter på aktiv overvågning er berettiget
Patienter må ikke være gravide eller ammende; kvinder i den fødedygtige alder skal have en negativ serumgraviditetstest inden for 7 dage før registrering; kvinder/mænd med reproduktionspotentiale skal have accepteret at bruge en effektiv præventionsmetode under undersøgelsen og i mindst 7 måneder efter den sidste dosis af undersøgelsesbehandlingen; en kvinde anses for at have "reproduktionspotentiale", hvis hun har haft menstruation på noget tidspunkt i de foregående 12 på hinanden følgende måneder; ud over rutinepræventionsmetoder omfatter "effektiv prævention" også heteroseksuel cølibat og kirurgi beregnet til at forhindre graviditet (eller med en bivirkning af graviditetsforebyggelse) defineret som en hysterektomi, bilateral oophorektomi eller bilateral tubal ligering; men hvis en tidligere cølibatpatient på noget tidspunkt vælger at blive heteroseksuelt aktiv i løbet af tidsperioden for brug af præventionsforanstaltninger, der er beskrevet i protokollen, er han/hun ansvarlig for at påbegynde præventionsforanstaltninger
Patienter skal have mulighed for at give samtykke til valgfri indsendelse af væv til fremtidig forskning
Patienter skal informeres om undersøgelsens karakter af denne undersøgelse og skal underskrive og give skriftligt informeret samtykke i overensstemmelse med institutionelle og føderale retningslinjer; den passende samtykkeformular til denne registrering er samtykkeformularen i trin 2
TRIN 2 RANDOMISERING: Som en del af registreringsprocessen for Oncology Patient Enrollment Network (OPEN) oplyses den behandlende institutions identitet for at sikre, at den aktuelle (inden for 365 dage) dato for institutionelle revisionsnævns godkendelse af denne undersøgelse er blevet indtastet i system
TRIN 3 CROSSOVER REGISTRERING (VALGFRI): Patienter skal have dokumenteret sygdomsprogression, mens de er på CETIRI (arm 2) på denne protokol; Formularen til opfølgning af tumorvurdering, der dokumenterer sygdomsprogression, skal indsendes til Southwest Oncology Group (SWOG) før trin 3 crossover-registrering; registrering til trin 3 crossover skal ske inden for 28 dage efter seponering af CETIRI-protokolbehandling; patienter, der afgår i behandlingen af andre årsager, er ikke berettigede
TRIN 3 CROSSOVER REGISTRERING (VALGFRI): Patienter skal have en Zubrod præstationsstatus på 0 eller 1
TRIN 3 CROSSOVER REGISTRERING (VALGFRI): ANC >= 1.500/mcL
TRIN 3 CROSSOVER REGISTRERING (VALGFRI): Blodplader >= 75.000/mcL
TRIN 3 CROSSOVER REGISTRERING (VALGFRI): Hæmoglobin >= 9 g/dL
TRIN 3 CROSSOVER REGISTRERING (VALGFRI): AST og ALT begge =< 5 x institutionel øvre normalgrænse (IULN)
TRIN 3 CROSSOVER REGISTRERING (VALGFRI): Bilirubin =< 1,5 mg/dL
TRIN 3 CROSSOVER REGISTRERING (VALGFRI): Beregnet kreatininclearance > 30 ml/min inden for 14 dage før trin 3 crossover registrering
TRIN 3 CROSSOVER REGISTRERING (VALGFRI): Patienter skal have venstre ventrikulær ejektionsfraktion (LVEF) >= 50 % eller >= nedre normalgrænse for institutionen ved ekkokardiogram inden for 14 dage før trin 3 crossover-registrering
TRIN 3 CROSSOVER REGISTRERING (VALGFRI): Patienter skal have en magnesium, kalium, calcium, natrium, bicarbonat og chlorid udført inden for 14 dage før trin 3 crossover registrering
TRIN 3 CROSSOVER REGISTRERING (VALGFRI): Patienter skal informeres om undersøgelsens karakter af denne undersøgelse og skal underskrive og give skriftligt informeret samtykke i overensstemmelse med institutionelle og føderale retningslinjer; den passende samtykkeformular til denne registrering er samtykkeformularen i trin 2
TRIN 3 CROSSOVER REGISTRERING (VALGFRI): Som en del af OPEN registreringsprocessen oplyses den behandlende institutions identitet for at sikre, at den aktuelle (inden for 365 dage) dato for institutionelle revisionsnævns godkendelse af denne undersøgelse er blevet indtastet i systemet

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

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

Antal våben

Våben og indgreb

Deltagergruppe / Arm	Intervention / Behandling
Eksperimentel: Arm I (pertuzumab, trastuzumab) Patienterne får pertuzumab IV over 30-60 minutter og trastuzumab IV over 30-120 minutter på dag 1. Kurser gentages hver 21. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.	Andet: Laboratoriebiomarkøranalyse Korrelative undersøgelser Biologisk: Trastuzumab Givet IV Andre navne: Herceptin ABP 980 Anti-c-ERB-2 Anti-c-erbB2 monoklonalt antistof Anti-ERB-2 Anti-erbB-2 Anti-erbB2 monoklonalt antistof Anti-HER2/c-erbB2 monoklonalt antistof Anti-p185-HER2 c-erb-2 monoklonalt antistof HER2 monoklonalt antistof Herceptin Biosimilar PF-05280014 Herceptin Trastuzumab Biosimilar PF-05280014 MoAb HER2 Monoklonalt antistof c-erb-2 Monoklonalt antistof HER2 PF-05280014 rhuMAb HER2 RO0452317 Trastuzumab Biosimilar ABP 980 Trastuzumab Biosimilar PF-05280014 Biologisk: Pertuzumab Givet IV Andre navne: Perjeta 2C4 2C4 antistof MoAb 2C4 Monoklonalt antistof 2C4 rhuMAb2C4 RO4368451 Enhed: HER-2 test Central test af HER-2 for berettigelse
Eksperimentel: Arm II (cetuximab, irinotecan hydrochlorid) Patienterne får cetuximab IV over 60-120 minutter og irinotecanhydrochlorid IV over 90 minutter på dag 1. Kurser gentages hver 14. dag i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienter med dokumenteret sygdomsprogression kan eventuelt gå over til Arm I.	Andet: Laboratoriebiomarkøranalyse Korrelative undersøgelser Biologisk: Cetuximab Givet IV Andre navne: Erbitux IMC-C225 Kimærisk anti-EGFR monoklonalt antistof Kimærisk MoAb C225 Kimært monoklonalt antistof C225 Medicin: Irinotecan hydrochlorid Givet IV Andre navne: Campto Camptosar U-101440E CPT-11 Camptothecin 11 Camptothecin-11 CPT 11 Irinomedac Enhed: HER-2 test Central test af HER-2 for berettigelse

Deltagergruppe / Arm

Intervention / Behandling

Eksperimentel: Arm I (pertuzumab, trastuzumab)

Patienterne får pertuzumab IV over 30-60 minutter og trastuzumab IV over 30-120 minutter på dag 1. Kurser gentages hver 21. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.

Andet: Laboratoriebiomarkøranalyse

Korrelative undersøgelser

Biologisk: Trastuzumab

Givet IV

Andre navne:

Herceptin
ABP 980
Anti-c-ERB-2
Anti-c-erbB2 monoklonalt antistof
Anti-ERB-2
Anti-erbB-2
Anti-erbB2 monoklonalt antistof
Anti-HER2/c-erbB2 monoklonalt antistof
Anti-p185-HER2
c-erb-2 monoklonalt antistof
HER2 monoklonalt antistof
Herceptin Biosimilar PF-05280014
Herceptin Trastuzumab Biosimilar PF-05280014
MoAb HER2
Monoklonalt antistof c-erb-2
Monoklonalt antistof HER2
PF-05280014
rhuMAb HER2
RO0452317
Trastuzumab Biosimilar ABP 980
Trastuzumab Biosimilar PF-05280014

Biologisk: Pertuzumab

Givet IV

Andre navne:

Perjeta
2C4
2C4 antistof
MoAb 2C4
Monoklonalt antistof 2C4
rhuMAb2C4
RO4368451

Enhed: HER-2 test

Central test af HER-2 for berettigelse

Eksperimentel: Arm II (cetuximab, irinotecan hydrochlorid)

Patienterne får cetuximab IV over 60-120 minutter og irinotecanhydrochlorid IV over 90 minutter på dag 1. Kurser gentages hver 14. dag i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienter med dokumenteret sygdomsprogression kan eventuelt gå over til Arm I.

Andet: Laboratoriebiomarkøranalyse

Korrelative undersøgelser

Biologisk: Cetuximab

Givet IV

Andre navne:

Erbitux
IMC-C225
Kimærisk anti-EGFR monoklonalt antistof
Kimærisk MoAb C225
Kimært monoklonalt antistof C225

Medicin: Irinotecan hydrochlorid

Givet IV

Andre navne:

Campto
Camptosar
U-101440E
CPT-11
Camptothecin 11
Camptothecin-11
CPT 11
Irinomedac

Enhed: HER-2 test

Central test af HER-2 for berettigelse

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Progressionsfri overlevelse (PFS) Tidsramme: Op til 3 år efter randomisering	At evaluere effektiviteten af trastuzumab og pertuzumab (TP) i HER-2 amplificeret metastatisk kolorektal cancer (mCRC) ved at sammenligne progressionsfri overlevelse (PFS) på TP sammenlignet med kontrolarmen af cetuximab og irinotecan (CETIRI). Progressionsfri overlevelse er defineret som tiden fra datoen for randomisering til datoen for første dokumentation for progression. Ved at bruge RECIST 1.1 defineres progression som en stigning på 20 % i summen af passende diametre af målbare læsioner i forhold til den mindste observerede sum og en absolut stigning på mindst 0,5 cm, utvetydig progression af ikke-målbar sygdom efter den behandlende læges vurdering , fremkomst af enhver ny læsion/sted, død på grund af sygdom uden forudgående dokumentation for progression og uden symptomatisk forværring (defineret som global forringelse af helbredstilstand, der kræver seponering af behandlingen uden objektive beviser for progression), eller død på grund af en hvilken som helst årsag.	Op til 3 år efter randomisering

Sekundære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Samlet responsrate (ORR) for TP- og CETIRI-behandlingsarme Tidsramme: Fra baseline, gennem behandlingens varighed (én gang pr. cyklus under behandling) og hver 8. uge efter behandlingen indtil progression, op til 3 år efter sidste tilløb til registreringstrin 2	At evaluere den overordnede responsrate (ORR), inklusive bekræftet fuldstændig og delvis respons pr. RECIST 1.1, i TP- og CETIRI-behandlingsarmene. Samlet svarprocent inkluderer komplet respons (CR) og delvis respons (PR). Komplet respons defineres som fuldstændig forsvinden af alle mål- og ikke-mållæsioner og ingen relaterede symptomer. Delvis respons er defineret som et fald på mere end eller lig med 30 % under baseline af summen af passende diametre af alle målbare læsioner for patienter med mindst én målelig læsion.	Fra baseline, gennem behandlingens varighed (én gang pr. cyklus under behandling) og hver 8. uge efter behandlingen indtil progression, op til 3 år efter sidste tilløb til registreringstrin 2
2 års samlet overlevelse (OS) for TP- og CETIRI-behandlingsarme Tidsramme: fra datoen for sidste optjening til registreringstrin 2 til datoen for dødsfald på grund af enhver årsag, op til 2 år	Procentdel af deltagere, der stadig er i live 2 år efter sidste optjening til registreringstrin 2. Samlet overlevelse er defineret som tiden fra registreringsdatoen til datoen for dødsfald på grund af en hvilken som helst årsag. Patienter, der sidst vides at være i live, censureres på deres sidste kontaktdato.	fra datoen for sidste optjening til registreringstrin 2 til datoen for dødsfald på grund af enhver årsag, op til 2 år
Antal deltagere med gr 3 til 5 uønskede hændelser, der er relateret til undersøgelsesstoffer. Tidsramme: Behandlingsvarighed og opfølgning indtil død eller 3 år efter Trin 2 Randomisering.	Rutinemæssige toksiciteter blev evalueret i henhold til National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0, og SAE'er blev evalueret i henhold til CTCAE version 5.0. Kun uønskede hændelser, der er muligvis, sandsynligvis eller definitivt relateret til undersøgelseslægemidlet, er rapporteret.	Behandlingsvarighed og opfølgning indtil død eller 3 år efter Trin 2 Randomisering.

Andre resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Forbindelse mellem HER-2-genkopinummer (GCN) og PFS Tidsramme: Op til 3 år	Forbindelserne mellem GCN og PFS vil blive udforsket via Kaplan-Meier-kurver og Cox-regression.	Op til 3 år
Sammenhæng mellem HER-2-genkopinummer (GCN) og respons Tidsramme: Op til 3 år	Forbindelserne mellem GCN og respons vil blive udforsket via logistisk regression.	Op til 3 år
Sammenhæng mellem HER-2/CEP17 signalforhold og PFS Tidsramme: Op til 3 år	Forbindelserne mellem HER-2/CEP17-signalforhold og PFS vil blive udforsket via Kaplan-Meier-kurver og Cox-regression.	Op til 3 år
Sammenhæng mellem HER-2/CEP17 signalforhold og respons Tidsramme: Op til 3 år	Forbindelserne mellem HER-2/CEP17 signalforhold og respons vil blive udforsket via logistisk regression.	Op til 3 år

Samarbejdspartnere og efterforskere

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

Sponsor

SWOG Cancer Research Network

Samarbejdspartnere

National Cancer Institute (NCI)

Efterforskere

Ledende efterforsker: Kanwal Raghav, SWOG Cancer Research Network

Publikationer og nyttige links

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

Generelle publikationer

Raghav KPS, Guthrie KA, Tan B Jr, Denlinger CS, Fakih M, Overman MJ, Dasari NA, Corum LR, Hicks LG, Patel MS, Esparaz BT, Kazmi SM, Alluri N, Colby S, Gholami S, Gold PJ, Chiorean EG, Kopetz S, Hochster HS, Philip PA. Trastuzumab Plus Pertuzumab Versus Cetuximab Plus Irinotecan in Patients With RAS/BRAF Wild-Type, HER2-Positive, Metastatic Colorectal Cancer (S1613): A Randomized Phase II Trial. J Clin Oncol. 2025 Apr 10;43(11):1348-1357. doi: 10.1200/JCO-24-01710. Epub 2025 Jan 6.

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)

27. november 2017

Primær færdiggørelse (Faktiske)

1. november 2022

Studieafslutning (Faktiske)

1. juli 2025

Datoer for studieregistrering

Først indsendt

2. oktober 2017

Først indsendt, der opfyldte QC-kriterier

1. december 2017

Først opslået (Faktiske)

7. december 2017

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

10. februar 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

21. januar 2026

Sidst verificeret

1. januar 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

S1613 (Anden identifikator: CTEP)
U10CA180888 (U.S. NIH-bevilling/kontrakt)
NCI-2016-01422 (Registry Identifier: CTRP (Clinical Trial Reporting Program))

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Studerer et amerikansk FDA-reguleret enhedsprodukt

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

Kliniske forsøg med Tilbagevendende tyktarmscarcinom

Ohio State University
Merck Sharp & Dohme LLC

Ikke rekrutterer endnu

Effektiviteten af en boosterinjektion med Gardasil-9-vaccinen på intersurgicalt interval* hos voksne med recidiverende respiratorisk papillomatose* (*ISI *RRP)

Recurrent Respiratory Papillomatosis (RRP)

Forenede Stater
National Cancer Institute (NCI)

Ikke rekrutterer endnu

Sacituzumab Govitecan med Bevacizumab sammenlignet med sædvanlig kemoterapi (Carboplatin, pegyleret liposomal Doxorubicin og Bevacizumab) til behandling af tilbagevendende platinfølsom æggestokkræft efter PARP-hæmmer vedligeholdelsesterapi

Recidiverende platinfølsomt tuba fallopii højgradigt serøst adenokarcinom | Recidiverende Platinfølsom Ovarie Højgradigt Serøs Adenokarcinom | Recurrent Platinum-Sensitive Primary Peritoneal High Grade Serous Adenocarcinoma | Recurrent Platinum-Sensitive Endometrioid Adenokarcinom i Æggelederen og andre forhold
Xiangya Hospital of Central South University

Ikke rekrutterer endnu

Effekt og sikkerhed af Camrelizumab plus Rivoceranib og lokal terapi for hepatocellulært karcinom med lunge metastaser (CAPLocal): En multicentrisk, enkelt-armet, prospektiv kohortestudie

Hepatecellular carcinoma
Alliance for Clinical Trials in Oncology
National Cancer Institute (NCI)

Rekruttering

Undersøgelse af PAGODA-algoritmen til ændringer af kemoterapidosis for at forebygge uplanlagte behandlingsforsinkelser

Gastrisk karcinom | Colon karcinom | Esophageal carcinom | Rektalt karcinom | Malignt fordøjelsessystem neoplasma | Gastroøsofageal Junction Carcinom | Tillæg Carcinom | Tyndtarmscarcinom | Ampulla af Vater Carcinoma | Carcinoma af ukendt primær med gastrointestinal profil

Forenede Stater, Puerto Rico
National Cancer Institute (NCI)

Afsluttet

Cisplatin og gemcitabinhydrochlorid med eller uden berzosertib til behandling af patienter med metastatisk urothelial cancer

Metastatisk blæreurothelial karcinom | Metastatisk Ureter Urothelial Carcinoma | Stadie IV Blære Urothelial Carcinoma AJCC v7 | Metastatisk nyrebækken og Ureter Urothelial Carcinoma

Forenede Stater
Tyra Biosciences, Inc

Rekruttering

Fase 2A/B Effektivitet og Sikkerhed af Dabogratinib hos Deltagere med Lavgrads Øvre Urinvejskarcinom (SURF303)

Low Grade Upper Tract Urothelial Carcinoma

Forenede Stater
Alliance for Clinical Trials in Oncology
National Cancer Institute (NCI)

Aktiv, ikke rekrutterende

Forsøger at finde den korrekte behandlingslængde med immunkontrolpunktterapi (IMAGINE)

Metastatisk blæreurothelial karcinom | Metastatisk nyrebækken Urothelial Carcinom | Metastatisk Ureter Urothelial Carcinoma | Metastatisk Urethral Urothelial Carcinoma | Metastatisk Urothelial Carcinom | Lokalt avanceret blæreurothelial karcinom | Lokalt avanceret nyrebækken Urothelial Carcinoma | Lokalt... og andre forhold

Forenede Stater
Roswell Park Cancer Institute
Iovance Biotherapeutics, Inc.

Trukket tilbage

Adoptiv celleterapi med (LN-145) i kombination med Pembrolizumab til behandling af patienter med inoperabel eller metastatisk overgangscellekræft, som har fejlet Cisplatin-baseret kemoterapi

Metastatisk blæreurothelial karcinom | Metastatisk nyrebækken Urothelial Carcinom | Metastatisk Ureter Urothelial Carcinoma | Metastatisk Urethral Urothelial Carcinoma | Uoperabelt nyrebækken Urothelial Carcinom | Uoperabelt Ureter Urothelial Carcinoma

Forenede Stater
All India Institute of Medical Sciences, New Delhi

Ukendt

Evaluering af 3DCRT versus IGRT og analyse af tidlig respons ved hoved- og halskræft.

HOVED- OG NAKKEKRÆFT | CARCINOMA OROPHARYNX | CARCINOMA PYRIFORM SINUS | CARCINOMA LARYNX

Indien
Changhai Hospital

Aktiv, ikke rekrutterende

Neoadjuvant kemoterapi før kirurgi kontra kun kirurgi for UTUC: Et randomiseret forsøg

Neoadjuverende terapi | Urothelial Carcinoma Ureter | Øvre urinvejsurothelial karcinom

Kina

Kliniske forsøg med Laboratoriebiomarkøranalyse

Centre Médico-Chirurgical de Réadaptation des Massues...

Rekruttering

Karakterisering af synsopfattelsesforstyrrelser hos patienter med idiopatisk skoliose (EYAIS)

Idiopatisk skoliose

Frankrig
Liao Jian An

Rekruttering

Meridianenergiændringer hos patienter med hoved- og nakkekræft efter kemoterapi eller strålebehandling

Hoved- og halskræft

Taiwan
Progenity, Inc.

Afsluttet

Udvidet ikke-invasiv genomisk medicinsk vurdering: Enigma-undersøgelsen

Downs syndrom | Aneuploidi | DiGeorges syndrom | Turners syndrom | Klinefelters syndrom | Kromosom sletning | Edwards syndrom | Patau syndrom

Forenede Stater
Nantes University Hospital

Ikke rekrutterer endnu

Reproducerbarhed af dental bidmærkeoverlayanalyse ved hjælp af digitale 3D-modeller hos voksne deltagere (OVERLAY-REPRO)

Rettsmedicinsk Tandlægevidenskab | Bidanalyse
Fondation Lenval

Trukket tilbage

Indflydelse af træthed på gangmønsteret hos patienter med cerebral parese.

Cerebral Parese

Frankrig
IRCCS Eugenio Medea

Rekruttering

Bekræft præstationen i klinisk praksis af den fordybende Virtual Reality Platform GRAIL (Gait Real-time Analysis Interactive Lab)

Cerebral Parese | Erhvervet hjerneskade

Italien
IRCCS Eugenio Medea

Afsluttet

Biomarkørers baner for tidlig intervention hos søskende til børn med autismespektrumforstyrrelse

Autismespektrumforstyrrelse | Tidlig indsats

Italien
Oregon Health and Science University
4DMedical

Tilmelding efter invitation

Ventilationsubalancer ved let til moderat kronisk obstruktiv lungesygdom (VAPOR)

Lungesygdomme | KOL | Luftvejssygdom | Dyspnø

Forenede Stater
Healthy.io Ltd.

Afsluttet

[Prøvning af enhed, der ikke er godkendt eller godkendt af U.S. FDA]

Albuminuri

Forenede Stater
Modarres Hospital

Afsluttet

Renal parenkymal kernenålbiopsi

Komplikationer | Billedstyret biopsi | Nyre Glomerulus

Iran, Islamisk Republik

S1613, Trastuzumab og Pertuzumab eller Cetuximab og Irinotecan Hydrochlorid til behandling af patienter med lokalt avanceret eller metastatisk HER2/Neu amplificeret kolorektal cancer, der ikke kan fjernes ved kirurgi

S1613, et randomiseret fase II studie af Trastuzumab og Pertuzumab (TP) sammenlignet med Cetuximab og Irinotecan (CETIRI) i avanceret/metastatisk kolorektal cancer (mCRC) med HER-2 amplifikation

Studieoversigt

Status

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Undersøgelsestype

Tilmelding (Faktiske)

Fase

Kontakter og lokationer

Studiesteder

Deltagelseskriterier

Berettigelseskriterier

Aldre berettiget til at studere

Tager imod sunde frivillige

Beskrivelse

Studieplan

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Antal våben

Våben og indgreb

Deltagergruppe / Arm

Intervention / Behandling

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Sekundære resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Andre resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Samarbejdspartnere og efterforskere

Sponsor

Samarbejdspartnere

Efterforskere

Publikationer og nyttige links

Generelle publikationer

Datoer for undersøgelser

Studer store datoer

Studiestart (Faktiske)

Primær færdiggørelse (Faktiske)

Studieafslutning (Faktiske)

Datoer for studieregistrering

Først indsendt

Først indsendt, der opfyldte QC-kriterier

Først opslået (Faktiske)

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

Sidst verificeret

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Studerer et amerikansk FDA-reguleret enhedsprodukt

Kliniske forsøg med Tilbagevendende tyktarmscarcinom

Kliniske forsøg med Laboratoriebiomarkøranalyse

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Portugal

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

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