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Palbociclib og Letrozol eller Fulvestrant til behandling af patienter med østrogenreceptorpositiv, HER2-negativ metastatisk brystkræft

9. april 2026 opdateret af: Alliance for Clinical Trials in Oncology

Et fase II-forsøg, der vurderer tolerabiliteten af ​​Palbociclib i kombination med Letrozol eller Fulvestrant hos patienter i alderen 70 og ældre med østrogenreceptorpositiv, HER2-negativ metastatisk brystkræft

Dette fase II-forsøg undersøger bivirkningerne og hvor godt palbociclib og letrozol eller fulvestrant virker ved behandling af patienter i alderen 70 år og ældre med østrogenreceptorpositiv, HER2-negativ brystkræft, der har spredt sig til andre steder i kroppen. Palbociclib kan stoppe væksten af ​​tumorceller ved at blokere nogle af de enzymer, der er nødvendige for cellevækst. Lægemidler, der bruges i kemoterapi, såsom letrozol eller fulvestrant, 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 palbociclib og letrozol eller fulvestrant kan virke bedre til behandling af patienter med brystkræft. Forsøget vil undersøge andre faktorer end kronologisk alder, der kan påvirke toksicitetsrater som identificeret ved hjælp af en cancerspecifik geriatrisk vurdering.

Studieoversigt

Detaljeret beskrivelse

PRIMÆRE MÅL:

I. At estimere sikkerheden og tolerabiliteten (rate for bivirkninger) af kombinationen af ​​palbociclib og letrozol eller fulvestrant hos voksne på 70 år eller ældre med østrogenreceptorpositiv, HER2-negativ metastatisk brystkræft.

SEKUNDÆRE MÅL:

I. At beskrive den fulde toksicitetsprofil inklusive alle uønskede hændelser af grad 2 og højere (i henhold til National Cancer Institute [NCI] Common Terminology Criteria for Adverse Events [CTCAE] version [v.] 5.0), specifikt estimering af graden af ​​grad 2 og højere myelosuppression (neutropeni, leukopeni, trombocytopeni og anæmi), neutropen feber, gastrointestinale (GI) bivirkninger (kvalme, diarré, nedsat appetit, opkastning, mucositis-oral), træthed, neuropati og tromboemboli.

II. Til at beskrive hastigheder for dosisreduktioner, dosishold og indlæggelser. III. At estimere mediantid til behandlingssvigt, inklusive progressionsfri overlevelse og samlet overlevelse.

IV. For at vurdere graden af ​​adhærens til palbociclib, letrozol og fulvestrant.

V. At udforske andre faktorer end kronologisk alder, der kan påvirke toksicitetsrater som identificeret ved hjælp af en cancerspecifik geriatrisk vurdering.

VI. At beskrive resultaterne af Overall Treatment Utility (OTU). VII. At bestemme graden af ​​overensstemmelse mellem patientrapporterede bivirkninger (AE'er) ved hjælp af Patient Reported Outcomes (PRO)-CTCAE-mål og dem, der rapporteres ved hjælp af traditionelle samlinger for AE'er.

VIII. At undersøge sammenhængen mellem sarkopeni og udviklingen af ​​toksicitet og uønskede hændelser.

OMRIDS:

Patienter får palbociclib oralt (PO) én gang dagligt (QD) på dag 1-21. Patienter modtager også letrozol PO QD på dag 1-28 eller fulvestrant intramuskulært (IM) på dag 1 og 15 i kursus 1 og på dag 1 i efterfølgende forløb efter lægens skøn (MD). Kurser gentages hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.

Efter afsluttet studiebehandling følges patienterne op i op til 5 år.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

93

Fase

  • Fase 2

Kontakter og lokationer

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

Studiesteder

    • 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
    • Arizona
      • Kingman, Arizona, Forenede Stater, 86401
        • Kingman Regional Medical Center
    • California
      • Arroyo Grande, California, Forenede Stater, 93420
        • PCR Oncology
      • Burbank, California, Forenede Stater, 91505
        • Providence Saint Joseph Medical Center/Disney Family Cancer Center
      • Corona, California, Forenede Stater, 92879
        • City of Hope Corona
      • Duarte, California, Forenede Stater, 91010
        • City of Hope Comprehensive Cancer Center
      • Lancaster, California, Forenede Stater, 93534
        • City of Hope Antelope Valley
      • Mission Hills, California, Forenede Stater, 91345
        • City of Hope Mission Hills
      • Orange, California, Forenede Stater, 92868
        • Saint Joseph Hospital - Orange
      • Sacramento, California, Forenede Stater, 95817
        • University of California Davis Comprehensive Cancer Center
      • Santa Clarita, California, Forenede Stater, 91355
        • City of Hope - Santa Clarita
      • South Pasadena, California, Forenede Stater, 91030
        • City of Hope South Pasadena
      • Upland, California, Forenede Stater, 91786
        • City of Hope Upland
      • West Covina, California, Forenede Stater, 91790
        • City of Hope West Covina
    • Colorado
      • Denver, Colorado, Forenede Stater, 80218
        • SCL Health Saint Joseph Hospital
      • Denver, Colorado, Forenede Stater, 80204
        • Cancer Center of Colorado at Sloan's Lake
      • Lafayette, Colorado, Forenede Stater, 80026
        • Good Samaritan Medical Center
      • Wheat Ridge, Colorado, Forenede Stater, 80033
        • SCL Health Lutheran Medical Center
    • Delaware
      • Lewes, Delaware, Forenede Stater, 19958
        • Beebe Medical Center
      • Newark, Delaware, Forenede Stater, 19713
        • Helen F Graham Cancer Center
      • Newark, Delaware, Forenede Stater, 19713
        • Delaware Clinical and Laboratory Physicians PA
      • Newark, Delaware, Forenede Stater, 19713
        • Medical Oncology Hematology Consultants PA
      • Newark, Delaware, Forenede Stater, 19718
        • Christiana Care Health System-Christiana Hospital
      • Rehoboth Beach, Delaware, Forenede Stater, 19971
        • Beebe Health Campus
      • Seaford, Delaware, Forenede Stater, 19973
        • Nanticoke Memorial Hospital
      • Wilmington, Delaware, Forenede Stater, 19801
        • Christiana Care Health System-Wilmington Hospital
    • District of Columbia
      • Washington D.C., District of Columbia, Forenede Stater, 20016
        • Sibley Memorial Hospital
    • Florida
      • Lakeland, Florida, Forenede Stater, 33805
        • The Watson Clinic
    • 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
        • Straub Clinic and Hospital
      • Honolulu, Hawaii, Forenede Stater, 96813
        • University of Hawaii Cancer Center
      • Honolulu, Hawaii, Forenede Stater, 96817
        • Hawaii Cancer Care Inc-Liliha
      • Honolulu, Hawaii, Forenede Stater, 96817
        • Kuakini Medical Center
      • Honolulu, Hawaii, Forenede Stater, 96826
        • Kapiolani Medical Center for Women and Children
      • Honolulu, Hawaii, Forenede Stater, 96813
        • Island Urology
      • Honolulu, Hawaii, Forenede Stater, 96813
        • Hawaii Cancer Care Inc-POB II
      • Honolulu, Hawaii, Forenede Stater, 96813
        • Hawaii Oncology Inc-POB I
      • Honolulu, Hawaii, Forenede Stater, 96817
        • Hawaii Oncology Inc-Kuakini
      • 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
        • The Cancer Center of Hawaii-Pali Momi
      • ‘Aiea, Hawaii, Forenede Stater, 96701
        • Hawaii Cancer Care - Savio
      • ‘Aiea, Hawaii, Forenede Stater, 96701
        • Hawaii Oncology Inc-Pali Momi
    • Idaho
      • Boise, Idaho, Forenede Stater, 83706
        • Saint Alphonsus Cancer Care Center-Boise
      • Boise, Idaho, Forenede Stater, 83712
        • Saint Luke's Mountain States Tumor Institute
      • Caldwell, Idaho, Forenede Stater, 83605
        • Saint Alphonsus Cancer Care Center-Caldwell
      • Coeur d'Alene, Idaho, Forenede Stater, 83814
        • Kootenai Medical Center
      • Emmett, Idaho, Forenede Stater, 83617
        • Walter Knox Memorial Hospital
      • Fruitland, Idaho, Forenede Stater, 83619
        • Saint Luke's Mountain States Tumor Institute - Fruitland
      • Meridian, Idaho, Forenede Stater, 83642
        • Idaho Urologic Institute-Meridian
      • Meridian, Idaho, Forenede Stater, 83642
        • Saint Luke's Mountain States Tumor Institute - Meridian
      • Nampa, Idaho, Forenede Stater, 83686
        • Saint Alphonsus Medical Center-Nampa
      • Nampa, Idaho, Forenede Stater, 83686
        • Saint Luke's Mountain States Tumor Institute - Nampa
      • Post Falls, Idaho, Forenede Stater, 83854
        • Kootenai Cancer Center
      • Sandpoint, Idaho, Forenede Stater, 83864
        • Kootenai Cancer Clinic
      • Twin Falls, Idaho, Forenede Stater, 83301
        • Saint Luke's Mountain States Tumor Institute-Twin Falls
    • Illinois
      • Aurora, Illinois, Forenede Stater, 60504
        • Rush - Copley Medical Center
      • Bloomington, Illinois, Forenede Stater, 61704
        • Illinois CancerCare-Bloomington
      • Canton, Illinois, Forenede Stater, 61520
        • Illinois CancerCare-Canton
      • Carthage, Illinois, Forenede Stater, 62321
        • Illinois CancerCare-Carthage
      • Centralia, Illinois, Forenede Stater, 62801
        • Centralia Oncology Clinic
      • Chicago, Illinois, Forenede Stater, 60611
        • Northwestern University
      • Chicago, Illinois, Forenede Stater, 60637
        • University of Chicago Comprehensive Cancer Center
      • Danville, Illinois, Forenede Stater, 61832
        • Carle on Vermilion
      • 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
      • Joliet, Illinois, Forenede Stater, 60435
        • Joliet Oncology-Hematology Associates Limited
      • Kewanee, Illinois, Forenede Stater, 61443
        • Illinois CancerCare-Kewanee Clinic
      • Macomb, Illinois, Forenede Stater, 61455
        • Illinois CancerCare-Macomb
      • Mattoon, Illinois, Forenede Stater, 61938
        • Carle Physician Group-Mattoon/Charleston
      • Mount Vernon, Illinois, Forenede Stater, 62864
        • Good Samaritan Regional Health Center
      • New Lenox, Illinois, Forenede Stater, 60451
        • UC Comprehensive Cancer Center at Silver Cross
      • Orland Park, Illinois, Forenede Stater, 60462
        • University of Chicago Medicine-Orland Park
      • Ottawa, Illinois, Forenede Stater, 61350
        • Illinois CancerCare-Ottawa Clinic
      • Pekin, Illinois, Forenede Stater, 61554
        • Illinois CancerCare-Pekin
      • Peoria, Illinois, Forenede Stater, 61636
        • Methodist Medical Center of Illinois
      • Peoria, Illinois, Forenede Stater, 61615
        • Illinois CancerCare-Peoria
      • 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
        • Cancer Care Specialists of Illinois-Swansea
      • Urbana, Illinois, Forenede Stater, 61801
        • Carle Cancer Center
      • Urbana, Illinois, Forenede Stater, 61801
        • The Carle Foundation Hospital
      • Yorkville, Illinois, Forenede Stater, 60560
        • Rush-Copley Healthcare Center
    • Indiana
      • South Bend, Indiana, Forenede Stater, 46601
        • Memorial Hospital of South Bend
    • Iowa
      • Ames, Iowa, Forenede Stater, 50010
        • McFarland Clinic PC - Ames
      • Ames, Iowa, Forenede Stater, 50010
        • Mary Greeley Medical Center
      • Boone, Iowa, Forenede Stater, 50036
        • McFarland Clinic PC-Boone
      • Cedar Rapids, Iowa, Forenede Stater, 52403
        • Mercy Hospital
      • Cedar Rapids, Iowa, Forenede Stater, 52403
        • Oncology Associates at Mercy Medical Center
      • Cedar Rapids, Iowa, Forenede Stater, 52402
        • Physicians' Clinic of Iowa PC
      • Des Moines, Iowa, Forenede Stater, 50309
        • Iowa Methodist Medical Center
      • 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
      • Fort Dodge, Iowa, Forenede Stater, 50501
        • McFarland Clinic PC-Trinity Cancer Center
      • Fort Dodge, Iowa, Forenede Stater, 50501
        • Trinity Regional Medical Center
      • Jefferson, Iowa, Forenede Stater, 50129
        • McFarland Clinic PC-Jefferson
      • Marshalltown, Iowa, Forenede Stater, 50158
        • McFarland Clinic PC-Marshalltown
      • Sioux City, Iowa, Forenede Stater, 51101
        • Siouxland Regional Cancer Center
      • West Des Moines, Iowa, Forenede Stater, 50266-7700
        • Methodist West Hospital
    • Kansas
      • Lawrence, Kansas, Forenede Stater, 66044
        • Lawrence Memorial Hospital
      • Wichita, Kansas, Forenede Stater, 67208
        • Cancer Center of Kansas-Wichita Medical Arts Tower
      • Wichita, Kansas, Forenede Stater, 67214
        • Cancer Center of Kansas - Wichita
    • Louisiana
      • New Orleans, Louisiana, Forenede Stater, 70121
        • Ochsner Medical Center Jefferson
    • Maine
      • Bangor, Maine, Forenede Stater, 04401
        • Eastern Maine Medical Center
      • Brewer, Maine, Forenede Stater, 04412
        • Lafayette Family Cancer Center-EMMC
    • Maryland
      • Baltimore, Maryland, Forenede Stater, 21287
        • Johns Hopkins University/Sidney Kimmel Cancer Center
      • Bethesda, Maryland, Forenede Stater, 20889-5600
        • Walter Reed National Military Medical Center
      • Towson, Maryland, Forenede Stater, 21204
        • UM Saint Joseph Medical Center
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02215
        • Dana-Farber Cancer Institute
      • Boston, Massachusetts, Forenede Stater, 02115
        • Brigham and Women's Hospital
      • Boston, Massachusetts, Forenede Stater, 02111
        • Tufts Medical Center
      • Brighton, Massachusetts, Forenede Stater, 02135
        • Steward Saint Elizabeth's Medical Center
      • Milford, Massachusetts, Forenede Stater, 01757
        • Dana-Farber/Brigham and Women's Cancer Center at Milford Regional
      • South Weymouth, Massachusetts, Forenede Stater, 02190
        • Dana-Farber/Brigham and Women's Cancer Center at South Shore
    • Michigan
      • Adrian, Michigan, Forenede Stater, 49221
        • Hickman 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
      • Brighton, Michigan, Forenede Stater, 48114
        • Saint Joseph Mercy Brighton
      • Brighton, Michigan, Forenede Stater, 48114
        • IHA Hematology Oncology Consultants-Brighton
      • 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
      • 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
        • McLaren Cancer Institute-Flint
      • Flint, Michigan, Forenede Stater, 48532
        • Singh and Arora Hematology Oncology PC
      • Flint, Michigan, Forenede Stater, 48503
        • Hurley Medical Center
      • Flint, Michigan, Forenede Stater, 48503
        • 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
      • 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
      • 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
      • Lapeer, Michigan, Forenede Stater, 48446
        • McLaren Cancer Institute-Lapeer Region
      • 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
      • 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
      • 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
      • Sterling Heights, Michigan, Forenede Stater, 48312
        • Bhadresh Nayak MD PC-Sterling Heights
      • Tawas City, Michigan, Forenede Stater, 48764
        • Ascension Saint Joseph Hospital
      • 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 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
      • Bemidji, Minnesota, Forenede Stater, 56601
        • Sanford Joe Lueken Cancer Center
      • Brainerd, Minnesota, Forenede Stater, 56401
        • Essentia Health Saint Joseph's Medical Center
      • Burnsville, Minnesota, Forenede Stater, 55337
        • Fairview Ridges Hospital
      • 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 Maple Grove Medical Center
      • 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
      • Thief River Falls, Minnesota, Forenede Stater, 56701
        • Sanford Thief River Falls Medical Center
      • 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
      • Worthington, Minnesota, Forenede Stater, 56187
        • Sanford Cancer Center Worthington
      • Wyoming, Minnesota, Forenede Stater, 55092
        • Fairview Lakes Medical Center
    • Missouri
      • Ballwin, Missouri, Forenede Stater, 63011
        • Saint Louis Cancer and Breast Institute-Ballwin
      • Bonne Terre, Missouri, Forenede Stater, 63628
        • Parkland Health Center-Bonne Terre
      • Cape Girardeau, Missouri, Forenede Stater, 63703
        • Saint Francis Medical Center
      • Cape Girardeau, Missouri, Forenede Stater, 63703
        • Southeast Cancer Center
      • Chesterfield, Missouri, Forenede Stater, 63017
        • Saint Luke's Hospital
      • City of Saint Peters, Missouri, Forenede Stater, 63376
        • Siteman Cancer Center at Saint Peters Hospital
      • Columbia, Missouri, Forenede Stater, 65212
        • University of Missouri - Ellis Fischel
      • Creve Coeur, Missouri, Forenede Stater, 63141
        • Siteman Cancer Center at West County Hospital
      • Farmington, Missouri, Forenede Stater, 63640
        • Parkland Health Center - Farmington
      • Jefferson City, Missouri, Forenede Stater, 65109
        • Capital Region Southwest Campus
      • Sainte Genevieve, Missouri, Forenede Stater, 63670
        • Sainte Genevieve County Memorial 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
      • Bozeman, Montana, Forenede Stater, 59715
        • Bozeman Deaconess Hospital
      • Great Falls, Montana, Forenede Stater, 59405
        • Benefis Healthcare- Sletten Cancer Institute
      • Kalispell, Montana, Forenede Stater, 59901
        • Kalispell Regional Medical Center
      • Missoula, Montana, Forenede Stater, 59804
        • Community Medical Hospital
      • Missoula, Montana, Forenede Stater, 59802
        • Saint Patrick Hospital - Community Hospital
    • Nebraska
      • Omaha, Nebraska, Forenede Stater, 68114
        • Nebraska Methodist Hospital
    • Nevada
      • 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
        • Las Vegas Cancer Center-Henderson
      • Henderson, Nevada, Forenede Stater, 89074
        • Comprehensive Cancer Centers of Nevada-Southeast Henderson
      • Henderson, Nevada, Forenede Stater, 89052
        • Comprehensive Cancer Centers of Nevada-Horizon Ridge
      • Las Vegas, Nevada, Forenede Stater, 89106
        • Radiation Oncology Centers of Nevada Central
      • Las Vegas, Nevada, Forenede Stater, 89119
        • Radiation Oncology Centers of Nevada Southeast
      • Las Vegas, Nevada, Forenede Stater, 89128
        • Comprehensive Cancer Centers of Nevada - Northwest
      • Las Vegas, Nevada, Forenede Stater, 89128
        • OptumCare Cancer Care at MountainView
      • Las Vegas, Nevada, Forenede Stater, 89144
        • Comprehensive Cancer Centers of Nevada - Town Center
      • Las Vegas, Nevada, Forenede Stater, 89144
        • Comprehensive Cancer Centers of Nevada-Summerlin
      • Las Vegas, Nevada, Forenede Stater, 89148
        • Comprehensive Cancer Centers of Nevada
      • Las Vegas, Nevada, Forenede Stater, 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, 89148-2405
        • Las Vegas Cancer Center-Medical Center
      • Las Vegas, Nevada, Forenede Stater, 89102
        • Desert West Surgery
      • Las Vegas, Nevada, Forenede Stater, 89102
        • OptumCare Cancer Care at Oakey
      • Las Vegas, Nevada, Forenede Stater, 89103
        • Hope Cancer Care of Nevada
      • Pahrump, Nevada, Forenede Stater, 89048
        • Hope Cancer Care of Nevada-Pahrump
      • Reno, Nevada, Forenede Stater, 89502
        • Renown Regional Medical Center
      • Reno, Nevada, Forenede Stater, 89509
        • Radiation Oncology Associates
    • New Hampshire
      • Concord, New Hampshire, Forenede Stater, 03301
        • New Hampshire Oncology Hematology PA-Concord
      • Hooksett, New Hampshire, Forenede Stater, 03106
        • New Hampshire Oncology Hematology PA-Hooksett
      • Londonderry, New Hampshire, Forenede Stater, 03053
        • The Dana-Farber Cancer Institute at Londonderry
    • 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
    • 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, 87110
        • Presbyterian Kaseman Hospital
      • Rio Rancho, New Mexico, Forenede Stater, 87124
        • Presbyterian Rust Medical Center/Jorgensen Cancer Center
      • Santa Fe, New Mexico, Forenede Stater, 87505
        • Christus Saint Vincent Regional Cancer Center
    • New York
      • Auburn, New York, Forenede Stater, 13021
        • Hematology Oncology Associates of Central New York-Auburn
      • Bay Shore, New York, Forenede Stater, 11706
        • Northwell Health Imbert Cancer Center
      • Buffalo, New York, Forenede Stater, 14263
        • Roswell Park Cancer Institute
      • East Syracuse, New York, Forenede Stater, 13057
        • Hematology Oncology Associates of Central New York-East Syracuse
      • Glens Falls, New York, Forenede Stater, 12801
        • Glens Falls Hospital
      • Greenlawn, New York, Forenede Stater, 11740
        • Northwell Health Cancer Institute at Huntington
      • Lake Success, New York, Forenede Stater, 11042
        • Northwell Health/Center for Advanced Medicine
      • Stony Brook, New York, Forenede Stater, 11794
        • Stony Brook University Medical Center
      • Syracuse, New York, Forenede Stater, 13215
        • Hematology Oncology Associates of Central New York-Onondaga Hill
      • The Bronx, New York, Forenede Stater, 10461
        • Montefiore Medical Center-Einstein Campus
      • The Bronx, New York, Forenede Stater, 10467
        • Montefiore Medical Center - Moses Campus
      • The Bronx, New York, Forenede Stater, 10461
        • Montefiore Medical Center-Weiler Hospital
    • North Carolina
      • Chapel Hill, North Carolina, Forenede Stater, 27599
        • UNC Lineberger Comprehensive Cancer Center
      • Clinton, North Carolina, Forenede Stater, 28328
        • Southeastern Medical Oncology Center-Clinton
      • Durham, North Carolina, Forenede Stater, 27710
        • Duke University Medical Center
      • Goldsboro, North Carolina, Forenede Stater, 27534
        • Southeastern Medical Oncology Center-Goldsboro
      • Goldsboro, North Carolina, Forenede Stater, 27534
        • Wayne Memorial Hospital
      • Jacksonville, North Carolina, Forenede Stater, 28546
        • Southeastern Medical Oncology Center-Jacksonville
      • Kernersville, North Carolina, Forenede Stater, 27284
        • Novant Health Oncology Specialists-Kernersville
      • Mount Airy, North Carolina, Forenede Stater, 27030
        • Novant Health Oncology Specialists-Mount Airy
      • New Bern, North Carolina, Forenede Stater, 28561
        • CarolinaEast Medical Center
      • New Bern, North Carolina, Forenede Stater, 28562
        • CarolinaEast Oncology and Hematology Associates
      • Statesville, North Carolina, Forenede Stater, 28625
        • Novant Health Oncology Specialists-Statesville
      • Thomasville, North Carolina, Forenede Stater, 27360
        • Novant Health Oncology Specialists-Davidson County
      • Wilkesboro, North Carolina, Forenede Stater, 28659
        • Novant Health Oncology Specialists-Wilkesboro
      • Winston-Salem, North Carolina, Forenede Stater, 27157
        • Wake Forest University Health Sciences
      • Winston-Salem, North Carolina, Forenede Stater, 27103
        • Novant Health Forsyth Medical Center
      • Winston-Salem, North Carolina, Forenede Stater, 27103
        • Novant Health Oncology Specialists
    • North Dakota
      • Bismarck, North Dakota, Forenede Stater, 58501
        • Sanford Bismarck Medical Center
      • Fargo, North Dakota, Forenede Stater, 58122
        • Sanford Roger Maris Cancer Center
      • Fargo, North Dakota, Forenede Stater, 58103
        • Essentia Health Cancer Center-South University Clinic
      • Fargo, North Dakota, Forenede Stater, 58122
        • Sanford Broadway Medical Center
      • Fargo, North Dakota, Forenede Stater, 58103
        • Sanford South University Medical Center
      • Fargo, North Dakota, Forenede Stater, 58104
        • Sanford Medical Center Fargo
      • Grand Forks, North Dakota, Forenede Stater, 58201
        • Altru Cancer Center
      • Jamestown, North Dakota, Forenede Stater, 58401
        • Essentia Health - Jamestown Clinic
    • Ohio
      • Belpre, Ohio, Forenede Stater, 45714
        • Strecker Cancer Center-Belpre
      • Canton, Ohio, Forenede Stater, 44708
        • Mercy Medical Center
      • Columbus, Ohio, Forenede Stater, 43219
        • The Mark H Zangmeister Center
      • 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
      • Delaware, Ohio, Forenede Stater, 43015
        • Delaware Health Center-Grady Cancer Center
      • Delaware, Ohio, Forenede Stater, 43015
        • Grady Memorial Hospital
      • Grove City, Ohio, Forenede Stater, 43123
        • Mount Carmel Grove City Hospital
      • Marietta, Ohio, Forenede Stater, 45750
        • Marietta Memorial Hospital
      • Perrysburg, Ohio, Forenede Stater, 43551
        • Mercy Health Perrysburg Cancer Center
      • Toledo, Ohio, Forenede Stater, 43623
        • Toledo Clinic Cancer Centers-Toledo
      • Toledo, Ohio, Forenede Stater, 43623
        • Mercy Saint Anne Hospital
      • Westerville, Ohio, Forenede Stater, 43081
        • Saint Ann's Hospital
    • Oklahoma
      • Oklahoma City, Oklahoma, Forenede Stater, 73120
        • Mercy Hospital Oklahoma City
    • 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
      • Chadds Ford, Pennsylvania, Forenede Stater, 19317
        • Christiana Care Health System-Concord Health Center
      • Danville, Pennsylvania, Forenede Stater, 17822
        • Geisinger Medical Center
      • East Stroudsburg, Pennsylvania, Forenede Stater, 18301
        • Pocono Medical Center
      • Ephrata, Pennsylvania, Forenede Stater, 17522
        • Ephrata Cancer Center
      • Ephrata, Pennsylvania, Forenede Stater, 17522
        • Ephrata Community Hospital
      • Gettysburg, Pennsylvania, Forenede Stater, 17325
        • Adams Cancer Center
      • Hanover, Pennsylvania, Forenede Stater, 17331
        • Cherry Tree Cancer Center
      • Harrisburg, Pennsylvania, Forenede Stater, 17109
        • UPMC Pinnacle Cancer Center/Community Osteopathic Campus
      • Harrisburg, Pennsylvania, Forenede Stater, 17101
        • UPMC Pinnacle Harrisburg
      • Hazleton, Pennsylvania, Forenede Stater, 18201
        • Geisinger Medical Center-Cancer Center Hazleton
      • Hazleton, Pennsylvania, Forenede Stater, 18201
        • Lehigh Valley Hospital-Hazleton
      • Lebanon, Pennsylvania, Forenede Stater, 17042
        • Sechler Family Cancer Center
      • Lewisburg, Pennsylvania, Forenede Stater, 17837
        • Geisinger Medical Oncology-Lewisburg
      • Pittsburgh, Pennsylvania, Forenede Stater, 15232
        • University of Pittsburgh Cancer Institute (UPCI)
      • Pottsville, Pennsylvania, Forenede Stater, 17901
        • Geisinger Cancer Services-Pottsville
      • Sayre, Pennsylvania, Forenede Stater, 18840
        • Guthrie Medical Group PC-Robert Packer Hospital
      • 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
      • Williamsport, Pennsylvania, Forenede Stater, 17701
        • UPMC Susquehanna
      • York, Pennsylvania, Forenede Stater, 17403
        • WellSpan Health-York Cancer Center
      • York, Pennsylvania, Forenede Stater, 17403
        • WellSpan Health-York Hospital
    • South Carolina
      • Charleston, South Carolina, Forenede Stater, 29425
        • Medical University of South Carolina
      • West Columbia, South Carolina, Forenede Stater, 29169
        • Lexington Medical Center
    • South Dakota
      • Rapid City, South Dakota, Forenede Stater, 57701
        • Rapid City Regional Hospital
      • Sioux Falls, South Dakota, Forenede Stater, 57117-5134
        • Sanford USD Medical Center - Sioux Falls
      • Sioux Falls, South Dakota, Forenede Stater, 57104
        • Sanford Cancer Center Oncology Clinic
    • Utah
      • Farmington, Utah, Forenede Stater, 84025
        • Farmington Health Center
      • Salt Lake City, Utah, Forenede Stater, 84112
        • Huntsman Cancer Institute/University of Utah
      • South Jordan, Utah, Forenede Stater, 84009
        • South Jordan Health Center
    • Vermont
      • Berlin Corners, Vermont, Forenede Stater, 05602
        • Central Vermont Medical Center/National Life Cancer Treatment
      • Burlington, Vermont, Forenede Stater, 05401
        • University of Vermont Medical Center
      • Burlington, Vermont, Forenede Stater, 05405
        • University of Vermont and State Agricultural College
    • Virginia
      • Lynchburg, Virginia, Forenede Stater, 24501
        • Centra Lynchburg Hematology-Oncology Clinic Inc
      • Martinsville, Virginia, Forenede Stater, 24115
        • Sovah Health Martinsville
      • Mechanicsville, Virginia, Forenede Stater, 23116
        • Bon Secours Memorial Regional Medical Center
      • Midlothian, Virginia, Forenede Stater, 23114
        • Bon Secours Saint Francis Medical Center
      • Norfolk, Virginia, Forenede Stater, 23505
        • Bon Secours DePaul Medical Center
      • Richmond, Virginia, Forenede Stater, 23235
        • VCU Massey Cancer Center at Stony Point
      • Richmond, Virginia, Forenede Stater, 23298
        • Virginia Commonwealth University/Massey Cancer Center
      • Richmond, Virginia, Forenede Stater, 23230
        • Virginia Cancer Institute
      • Richmond, Virginia, Forenede Stater, 23226
        • Bon Secours Saint Mary's Hospital
      • Richmond, Virginia, Forenede Stater, 23230
        • Bon Secours Cancer Institute at Reynolds Crossing
      • South Hill, Virginia, Forenede Stater, 23970
        • VCU Community Memorial Health Center
      • Suffolk, Virginia, Forenede Stater, 23435
        • Bon Secours Health Center at Harbour View
      • Winchester, Virginia, Forenede Stater, 22601
        • Shenandoah Oncology PC
    • Washington
      • Aberdeen, Washington, Forenede Stater, 98520
        • Providence Regional Cancer System-Aberdeen
      • Bellingham, Washington, Forenede Stater, 98225
        • PeaceHealth Saint Joseph Medical Center
      • Centralia, Washington, Forenede Stater, 98531
        • Providence Regional Cancer System-Centralia
      • Edmonds, Washington, Forenede Stater, 98026
        • Swedish Cancer Institute-Edmonds
      • Everett, Washington, Forenede Stater, 98201
        • Providence Regional Cancer Partnership
      • 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
      • Longview, Washington, Forenede Stater, 98632
        • PeaceHealth Saint John Medical Center
      • 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
      • Vancouver, Washington, Forenede Stater, 98664
        • PeaceHealth Southwest Medical Center
      • Walla Walla, Washington, Forenede Stater, 99362
        • Providence Saint Mary Regional Cancer Center
      • Yelm, Washington, Forenede Stater, 98597
        • Providence Regional Cancer System-Yelm
    • 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
      • 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 Clinic - Weston Center
      • Wisconsin Rapids, Wisconsin, Forenede Stater, 54494
        • Marshfield Clinic - Wisconsin Rapids Center

Deltagelseskriterier

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

Berettigelseskriterier

Aldre berettiget til at studere

70 år og ældre (Ældre voksen)

Tager imod sunde frivillige

Ingen

Beskrivelse

Inklusionskriterier:

  • Dokumentation af sygdom: østrogenreceptor positiv og/eller progesteronreceptor (PR) positiv, HER2 negativ metastatisk brystkræft; histologisk bekræftelse er påkrævet
  • Målbar sygdom eller ikke-målbar sygdom
  • Planlægger at begynde palbociclib for metastatisk sygdom; en tidligere linje med endokrin terapi og/eller kemoterapi for metastatisk sygdom er tilladt; patienter kan påbegynde eller allerede have påbegyndt endokrin behandling, før de starter behandling med palbociclib, men ikke mere end to uger før registrering
  • Ingen tidligere behandling med en CDK-hæmmer
  • Resolution af alle akutte toksiske virkninger af tidligere terapi eller kirurgiske procedurer til CTCAE-grad =< 1 (undtagen alopeci) eller til baseline toksicitet før tidligere behandling eller kirurgiske procedurer, før registrering
  • Ingen ubehandlede hjernemetastaser; patienter med behandlede hjernemetastaser skal have afsluttet behandling med steroider for at være berettiget
  • Ingen kendt interstitiel lungesygdom
  • Ingen anden malignitet udover ikke-melanom hudcancer eller cervikal carcinom in situ; dog anses patienter ikke for at have en "aktuelt aktiv" malignitet, hvis de har afsluttet behandlingen og er fri for sygdom i >= 3 år
  • Ingen aktiv infektion, der kræver behandling med antibiotika
  • Patienter skal kunne sluge og beholde oral medicin
  • Eastern Cooperative Oncology Group (ECOG) præstationsstatus 0, 1 eller 2
  • Patienterne skal kunne læse og forstå engelsk eller spansk
  • Absolut neutrofiltal (ANC) >= 1500/mm^3 (1,5 x 10^9/L)
  • Blodpladeantal >= 100.000/mm^3 (100 x 10^9/L)
  • Kreatininclearance >= 30 ml/min. beregnet ved hjælp af Cockcroft-Gault-formlen
  • Total serumbilirubin =< 1,5 øvre normalgrænse (ULN) (< 3 ULN hvis Gilberts sygdom)
  • Aspartataminotransferase (AST) og/eller alaninaminotransferase (ALT) =< 3 x ULN (=< 5,0 x ULN, hvis levermetastaser er til stede)
  • Alkalisk fosfatase =< 2,5 x ULN (=< 5 x ULN, hvis knogle- eller levermetastaser er til stede)

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: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Behandling (palbociclib, letrozol eller fulvestrant)
Patienter får palbociclib PO QD på dag 1-21. Patienter får også letrozol PO QD på dag 1-28 eller fulvestrant IM på dag 1 og 15 i kursus 1 og på dag 1 i efterfølgende kurser efter lægens skøn. Kurser gentages hver 28. dag i mangel af sygdomsprogression eller uacceptabel toksicitet.
Hjælpestudier
Hjælpestudier
Givet PO
Givet PO
Givet IM

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Forekomst af uønskede hændelser
Tidsramme: 6 måneder
Defineret som andelen af ​​patienter med dokumentation for grad 3 - 5 toksicitet (uanset tilskrivning ved brug af National Cancer Institute [NCI] Common Terminology Criteria for Adverse Events [CTCAE] version [v.] 5.0 kriterier). Et 95 % binomialt konfidensinterval for enkelte proportioner vil blive konstrueret for den alvorlige toksicitetsrate under behandlingen. Univariate sammenhænge mellem det primære endepunkt og forskellige patientkarakteristika før behandling såsom anæmi, selvvurderet funktionsstatus eller social støtte vil blive beskrevet via krydstabulering og Fishers eksakte test. Eksplorativ logistisk regressionsmodellering, med begrænset generaliserbarhed på grund af den beskedne stikprøvestørrelse, vil blive brugt til at vurdere de relative bidrag fra disse variabler påvirker sandsynligheden for at udvikle en alvorlig toksicitet under behandlingen. Styrken af ​​denne association vil blive udtrykt i form af et oddsforhold og dets tilhørende 95 % konfidensinterval.
6 måneder

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Tid til behandlingsfejl (og årsag til, at undersøgelsen stopper - toksicitet, patientpræference, progression)
Tidsramme: Op til 5 år
Distributionstiden til behandlingssvigt vil blive estimeret ved hjælp af Kaplan-Meier-metoden. Behandlingssvigt defineres som en alvorlig bivirkning, sygdomsprogression eller patientens afvisning af at fortsætte den tildelte behandling. Enhver grund til, at behandlingen afbrydes til tid til behandlingssvigt og ikke censurerer patienter, vil blive inkluderet. Årsagen til seponering af behandlingen vil blive registreret.
Op til 5 år
Palbociclib Overholdelsesrate
Tidsramme: Op til 12 uger
Patienter, der skal inkluderes i analysekohorten, vil være de patienter, der har taget en eller flere doser af undersøgelsesbehandlingen. Disse patienter vil blive betragtet som tilhængere af studiebehandling. For hver af de første 3 cyklusser vil et estimat af andelen af ​​patienter, der opfylder kriterierne for adhærens, og dets tilsvarende 95 % konfidensinterval blive bestemt.
Op til 12 uger
Responsrate som bestemt af responsevalueringskriterier i solide tumorer (RECIST)
Tidsramme: Op til 1 år
Responsraten er defineret som andelen af ​​patienter, hvis sygdomsstatus opfyldte kriterierne for responsevaluering i solide tumorer (RECIST) for komplet respons (CR) eller delvis respons (PR) på 2 på hinanden følgende evalueringer med mindst 8 ugers mellemrum. Et 95 % binomialt konfidensinterval for svarprocenten vil blive konstrueret.
Op til 1 år
Overordnede resultater for behandlingsværktøj (OTU).
Tidsramme: Op til 1 år
OTU er et nyt sammensat endepunkt udviklet af efterforskere af FOCUS2-studiet for at vurdere resultatet af palliativ kemoterapi. Patienten vil blive givet enten en samlet score på "god", "mellemliggende" eller "dårlig". Et 95 % binomialt konfidensinterval vil blive konstrueret for procentdelen af ​​patienter, der scorede "godt" på OTU.
Op til 1 år
Sarkopeni Analyse
Tidsramme: Op til 1 år
Vil undersøge variabler forbundet med tab af skeletmuskel under behandling og om tab af skeletmuskel under behandling er forbundet med tilstedeværelsen af ​​grad 3-5 toksicitet og uønskede hændelser. Sarkopeni vil blive behandlet som en binær variabel ved brug af skeletmuskelindekset (SMI) (SMI < 41 cm^2/m^2 vs. SMI > 41 cm^2/m^2), og forskelle i graderne kemoterapitoksicitet og bivirkninger vil analyseres ved hjælp af to gruppe t-tests og fisher's exact test. Antallet af patienter med og uden sarkopeni grupperet efter patienter med eller uden grad 3+ bivirkninger (AE'er) vil også blive rapporteret.
Op til 1 år
Hyppighed af grad 3+ lægemiddeltoksiciteter
Tidsramme: 1 år
Målt ved National Cancer Institute [NCI] Common Terminology Criteria for Adverse Events [CTCAE] v. 5.0.
Rapporteret i dette afsnit er procentdelen af patienter, der oplevede en grad 3 eller højere toksicitet.
1 år
Dosisnedsættelse, dosispause og indlæggelsesårsager
Tidsramme: Op til 1 år

Afbrydelse af dosis og/eller dosereduktion anbefales baseret på individuel sikkerhed og tolerabilitet.

Palbociclib-cykluslængden forbliver 28 dage (± 2 dage) (på trods af forsinkelse i påbegyndelse af en ny cyklus af palbociclib); endokrin behandling kan fortsat administreres efter den planlagte tidsplan.

  • Dosispause/reduktion af letrozol eller fulvestrant vil ske i henhold til produktresuméet samt efter den behandlende investigators skøn.
  • Dosisoptrapning vil ikke være tilladt i denne undersøgelse.
  • Mistede palbociclib-doser på grund af toksicitet vil ikke blive indhentes.
  • Start af en ny cyklus kan udsættes i op til 7 dage.
Op til 1 år
Progressionsfri overlevelse (PFS)
Tidsramme: op til 5 år
Fordeling af progressionsfri overlevelse (PFS) tider vil blive estimeret ved hjælp af Kaplan-Meier-metoden.
PFS-tiden beregnes som tiden mellem en patients påbegyndelse af behandling og sygdomsprogression eller død.
op til 5 år
Samlet overlevelse (OS)
Tidsramme: Op til 5 år
Fordelingerne af de overordnede overlevelsestider (OS) vil blive estimeret ved hjælp af Kaplan-Meier-metodologi. OS-tiden beregnes som tiden mellem datoen, hvor en patient påbegyndte behandling, og deres død.
Op til 5 år
Livskvalitet målt ved European Quality of Life Five Dimension Three Level Questionnaire (EQ-5D-3L)
Tidsramme: Op til 1 år
Det europæiske livskvalitetsspørgeskema med fem dimensioner på tre niveauer (EQ-5D-3L) består af 5 dimensioner. Mobilitet, egenomsorg, sædvanlige aktiviteter, smerter/ubehag og angst/depression. Hver dimension har 3 niveauer: ingen problemer, nogle problemer, ekstreme problemer. EQ-5D-3L kan omregnes til en enkelt opsummeringsindeks, 0-1, hvor højere score betyder bedre helbred. Medianen og intervallet for denne samlede score vil blive rapporteret.
Op til 1 år

Samarbejdspartnere og efterforskere

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

Samarbejdspartnere

Efterforskere

  • Studiestol: Mina Sedrak, MD, MS, City of Hope Comprehensive Cancer Center

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.

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)

15. august 2018

Primær færdiggørelse (Faktiske)

8. september 2020

Studieafslutning (Faktiske)

27. februar 2026

Datoer for studieregistrering

Først indsendt

7. august 2018

Først indsendt, der opfyldte QC-kriterier

15. august 2018

Først opslået (Faktiske)

16. august 2018

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

29. april 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

9. april 2026

Sidst verificeret

1. april 2026

Mere information

Begreber relateret til denne undersøgelse

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

UBESLUTET

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

produkt fremstillet i og eksporteret fra U.S.A.

Ja

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 HER2/Neu negativ

Kliniske forsøg med Livskvalitetsvurdering

Abonner