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Afprøvning af tilføjelsen af ​​et nyt lægemiddel mod kræft, Venetoclax, til den sædvanlige behandling (Ibrutinib og Obinutuzumab) hos ubehandlede, ældre patienter med kronisk lymfatisk leukæmi

12. juni 2026 opdateret af: National Cancer Institute (NCI)

Et randomiseret fase III-studie af Ibrutinib Plus Obinutuzumab versus Ibrutinib Plus Venetoclax og Obinutuzumab hos ubehandlede ældre patienter (>/= 65 år) med kronisk lymfatisk leukæmi (CLL)

Dette fase III-forsøg sammenligner tilføjelse af et nyt anticancerlægemiddel (venetoclax) til den sædvanlige behandling (ibrutinib plus obinutuzumab) hos ældre patienter med kronisk lymfatisk leukæmi, som ikke har modtaget tidligere behandling. Tilføjelse af venetoclax til den sædvanlige behandling kan forhindre kronisk lymfatisk leukæmi i at vende tilbage. Dette forsøg vil også undersøge, om patienter, der får ibrutinib plus obinutuzumab plus venetoclax og ikke har nogen påviselig kronisk lymfatisk leukæmi efter 1 års behandling, kan stoppe med at tage ibrutinib. Ibrutinib kan stoppe væksten af ​​kræftceller ved at blokere nogle af de enzymer, der er nødvendige for cellevækst. Immunterapi med obinutuzumab kan inducere ændringer i kroppens immunsystem og kan interferere med kræftcellernes evne til at vokse og sprede sig. Venetoclax er i en klasse af medicin kaldet B-celle lymfom-2 (BCL-2) hæmmere. Det kan stoppe væksten af ​​kræftceller ved at blokere Bcl-2, et protein, der er nødvendigt for kræftcellernes overlevelse. At give ibrutinib og obinutuzumab sammen med venetoclax kan virke bedre til behandling af kronisk lymfatisk leukæmi sammenlignet med ibrutinib og obinutuzumab.

Studieoversigt

Status

Aktiv, ikke rekrutterende

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

PRIMÆR MÅL:

I. At sammenligne den progressionsfrie overlevelse (PFS) mellem kontrolbehandling og eksperimentelle behandlingsstrategier: ibrutinib/obinutuzumab (IO) med ibrutinib vedligeholdelse (IM) versus ibrutinib/venetoclax/obinutuzumab (IVO) uanset IM eller observation.

SEKUNDÆRE MÅL:

I. At sammenligne knoglemarv (BM) minimale restsygdomme (MRD) - fuldstændig respons (CR) rater, MRD- rater og dybde af respons ved cyklus 15 dag 1 mellem patienter behandlet med IO versus IVO.

II. For at sammenligne overordnet overlevelse (OS) mellem kontrol- og eksperimentelle behandlingsstrategier: IO med IM versus IVO uanset IM eller observation.

III. At sammenligne 5-års PFS og samlet overlevelse (OS) for kontrol- og eksperimentelle behandlingsstrategier: IO med IM versus IVO uanset IM eller observation.

IV. At beskrive toksicitetsprofilen for hver af behandlingsstrategierne og ved hvert behandlingsforløb.

KORRELATIVER SCIENCE MÅL:

I. At sammenligne MRD-status mellem blod og knoglemarv ved afslutningen af ​​induktionsbehandling/cyklus 15 dag 1 for at bestemme, om blod-MRD kan bruges som surrogat til knoglemarvs-MRD med disse behandlingsregimer.

II. At sammenligne MRD-status i perifert blod ved standard central flowcytometri med næste generations sekventering (NGS) ved hjælp af ClonoSeq-teknik for at bestemme overensstemmelsen i MRD-negativitet mellem de to teknikker.

OVERSIGT: Patienterne randomiseres til 1 af 2 arme.

ARM I: Patienterne får ibrutinib oralt (PO) én gang dagligt (QD) på dag 1-28. Patienter får også obinutuzumab intravenøst ​​(IV) på dag 1, 2, 8 og 15 i cyklus 1 og på dag 1 i cyklus 2-6. Behandlingen gentages hver 28. dag i op til 14 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Fra cyklus 15 modtager patienter ibrutinib PO QD hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.

ARM II: Patienter får ibrutinib PO QD på dag 1-28. Patienterne får også obinutuzumab IV på dag 1, 2, 8 og 15 i cyklus 1 og på dag 1 i cyklus 2-6. Begyndende cyklus 3 får patienterne også venetoclax PO QD på dag 1-28. Behandlingen gentages hver 28. dag i 14 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Alle patienter vil derefter modtage en 15. cyklus af ibrutinib. Begyndende cyklus 16, patienter, som ikke opnår en BM MRD negativ CR, modtager ibrutinib PO QD hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienter, som opnår en BM MRD negativ CR, gennemgår observation hver 3. cyklus i 6 år, derefter hver 6. cyklus derefter.

Efter afsluttet undersøgelsesbehandling følges patienterne hver 6. måned indtil 10 år fra registreringen.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

465

Fase

  • Fase 3

Kontakter og lokationer

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

Studiesteder

  • Forenede Stater
    • Alabama
      • Birmingham, Alabama, Forenede Stater, 35233
        • University of Alabama at Birmingham Cancer Center
    • Alaska
      • Anchorage, Alaska, Forenede Stater, 98508
        • Anchorage Associates in Radiation Medicine
      • Anchorage, Alaska, Forenede Stater, 99508
        • Alaska Breast Care and Surgery LLC
      • Anchorage, Alaska, Forenede Stater, 99508
        • Alaska Oncology and Hematology LLC
      • Anchorage, Alaska, Forenede Stater, 99508
        • Alaska Women's Cancer Care
      • Anchorage, Alaska, Forenede Stater, 99508
        • Anchorage Oncology Centre
      • Anchorage, Alaska, Forenede Stater, 99508
        • Katmai Oncology Group
      • Anchorage, Alaska, Forenede Stater, 99508
        • Providence Alaska Medical Center
      • Anchorage, Alaska, Forenede Stater, 99504
        • Anchorage Radiation Therapy Center
      • Fairbanks, Alaska, Forenede Stater, 99701
        • Fairbanks Memorial Hospital
    • Arizona
      • Kingman, Arizona, Forenede Stater, 86401
        • Kingman Regional Medical Center
      • Phoenix, Arizona, Forenede Stater, 85054
        • Mayo Clinic Hospital in Arizona
      • Phoenix, Arizona, Forenede Stater, 85004
        • Cancer Center at Saint Joseph's
      • Scottsdale, Arizona, Forenede Stater, 85259
        • Mayo Clinic in Arizona
      • Tucson, Arizona, Forenede Stater, 85704
        • University of Arizona Cancer Center-Orange Grove Campus
      • Tucson, Arizona, Forenede Stater, 85719
        • Banner University Medical Center - Tucson
      • Tucson, Arizona, Forenede Stater, 85719
        • University of Arizona Cancer Center-North Campus
    • Arkansas
      • Fort Smith, Arkansas, Forenede Stater, 72903
        • Mercy Hospital Fort Smith
      • Hot Springs, Arkansas, Forenede Stater, 71913
        • CHI Saint Vincent Cancer Center Hot Springs
      • Little Rock, Arkansas, Forenede Stater, 72205
        • John L McClellan Memorial Veterans Hospital
    • 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
      • Baldwin Park, California, Forenede Stater, 91706
        • Kaiser Permanente-Baldwin Park
      • Bellflower, California, Forenede Stater, 90706
        • Kaiser Permanente-Bellflower
      • Burbank, California, Forenede Stater, 91505
        • Providence Saint Joseph Medical Center/Disney Family Cancer Center
      • Clovis, California, Forenede Stater, 93611
        • Community Cancer Institute
      • Clovis, California, Forenede Stater, 93611
        • University Oncology Associates
      • Costa Mesa, California, Forenede Stater, 92627
        • UC Irvine Health Cancer Center-Newport
      • Duarte, California, Forenede Stater, 91010
        • City of Hope Comprehensive Cancer Center
      • Fontana, California, Forenede Stater, 92335
        • Kaiser Permanente-Fontana
      • Harbor City, California, Forenede Stater, 90710
        • Kaiser Permanente South Bay
      • Irvine, California, Forenede Stater, 92618
        • Kaiser Permanente-Irvine
      • Long Beach, California, Forenede Stater, 90822
        • Tibor Rubin VA 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
      • Ontario, California, Forenede Stater, 91761
        • Kaiser Permanente-Ontario
      • Orange, California, Forenede Stater, 92868
        • UC Irvine Health/Chao Family Comprehensive Cancer Center
      • Palm Springs, California, Forenede Stater, 92262
        • Desert Regional Medical Center
      • Palo Alto, California, Forenede Stater, 94304
        • Stanford Cancer Institute Palo Alto
      • Panorama City, California, Forenede Stater, 91402
        • Kaiser Permanente - Panorama City
      • Riverside, California, Forenede Stater, 92505
        • Kaiser Permanente-Riverside
      • San Diego, California, Forenede Stater, 92120
        • Kaiser Permanente-San Diego Zion
      • San Diego, California, Forenede Stater, 92108
        • Kaiser Permanente-San Diego Mission
      • 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
      • Santa Maria, California, Forenede Stater, 93444
        • Mission Hope Medical Oncology - Santa Maria
      • Woodland Hills, California, Forenede Stater, 91367
        • Kaiser Permanente-Woodland Hills
    • Colorado
      • Aurora, Colorado, Forenede Stater, 80012
        • Rocky Mountain Cancer Centers-Aurora
      • Aurora, Colorado, Forenede Stater, 80012
        • The Medical Center of Aurora
      • Aurora, Colorado, Forenede Stater, 80045
        • Rocky Mountain Regional VA Medical Center
      • 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, 80907
        • Rocky Mountain Cancer Centers-Penrose
      • Denver, Colorado, Forenede Stater, 80205
        • Kaiser Permanente-Franklin
      • Denver, Colorado, Forenede Stater, 80218
        • Presbyterian - Saint Lukes Medical Center - Health One
      • Denver, Colorado, Forenede Stater, 80220
        • Rose Medical Center
      • Denver, Colorado, Forenede Stater, 80218
        • Rocky Mountain Cancer Centers-Midtown
      • Denver, Colorado, Forenede Stater, 80220
        • Rocky Mountain Cancer Centers-Rose
      • Denver, Colorado, Forenede Stater, 80204
        • Denver Health Medical Center
      • Denver, Colorado, Forenede Stater, 80218
        • Colorado Blood Cancer Institute
      • Denver, Colorado, Forenede Stater, 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
      • Denver, Colorado, Forenede Stater, 80220
        • Western Surgical Care
      • Denver, Colorado, Forenede Stater, 80218
        • Saint Joseph Hospital - Cancer Centers of Colorado
      • Denver, Colorado, Forenede Stater, 80210
        • AdventHealth Porter
      • Durango, Colorado, Forenede Stater, 81301
        • Mercy Medical Center
      • Durango, Colorado, Forenede Stater, 81301
        • CommonSpirit Cancer Center Mercy
      • Englewood, Colorado, Forenede Stater, 80113
        • Mountain Blue Cancer Care Center - Swedish
      • Englewood, Colorado, Forenede Stater, 80113
        • Swedish Medical Center
      • Englewood, Colorado, Forenede Stater, 80113
        • Rocky Mountain Cancer Centers - Swedish
      • Englewood, Colorado, Forenede Stater, 80113
        • The Melanoma and Skin Cancer Institute
      • Golden, Colorado, Forenede Stater, 80401
        • Mountain Blue Cancer Care Center
      • Golden, Colorado, Forenede Stater, 80401
        • National Jewish Health-Western Hematology Oncology
      • Grand Junction, Colorado, Forenede Stater, 81501
        • Saint Mary's Hospital and Regional Medical Center
      • Grand Junction, Colorado, Forenede Stater, 81505
        • Grand Valley Oncology
      • Greeley, Colorado, Forenede Stater, 80631
        • Banner North Colorado Medical Center
      • Lafayette, Colorado, Forenede Stater, 80026
        • Kaiser Permanente-Rock Creek
      • Lafayette, Colorado, Forenede Stater, 80026
        • Good Samaritan Hospital - Cancer Centers of Colorado
      • Lakewood, Colorado, Forenede Stater, 80228
        • Rocky Mountain Cancer Centers-Lakewood
      • Lakewood, Colorado, Forenede Stater, 80228
        • CommonSpirit Saint Anthony Hospital Cancer Center
      • Littleton, Colorado, Forenede Stater, 80120
        • Rocky Mountain Cancer Centers-Littleton
      • Littleton, Colorado, Forenede Stater, 80122
        • AdventHealth Littleton
      • Lone Tree, Colorado, Forenede Stater, 80124
        • Kaiser Permanente-Lone Tree
      • Lone Tree, Colorado, Forenede Stater, 80124
        • Sky Ridge Medical Center
      • Lone Tree, Colorado, Forenede Stater, 80124
        • Rocky Mountain Cancer Centers-Sky Ridge
      • Longmont, Colorado, Forenede Stater, 80501
        • Longmont United Hospital
      • Longmont, Colorado, Forenede Stater, 80501
        • Rocky Mountain Cancer Centers-Longmont
      • Loveland, Colorado, Forenede Stater, 80539
        • Banner North Colorado Medical Center - Loveland Campus
      • Parker, Colorado, Forenede Stater, 80138
        • Rocky Mountain Cancer Centers-Parker
      • Parker, Colorado, Forenede Stater, 80138
        • AdventHealth Parker
      • Pueblo, Colorado, Forenede Stater, 81004
        • Saint Mary Corwin Medical Center
      • Pueblo, Colorado, Forenede Stater, 81008
        • Rocky Mountain Cancer Centers - Pueblo
      • Thornton, Colorado, Forenede Stater, 80260
        • Rocky Mountain Cancer Centers-Thornton
      • Thornton, Colorado, Forenede Stater, 80260
        • National Jewish Health-Northern Hematology Oncology
      • Wheat Ridge, Colorado, Forenede Stater, 80401
        • Intermountain Health Lutheran Hospital
    • 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 - Guilford
      • Hartford, Connecticut, Forenede Stater, 06105
        • Smilow Cancer Hospital Care Center at Saint Francis
      • 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
      • 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
      • West Haven, Connecticut, Forenede Stater, 06516
        • Veterans Affairs Connecticut Healthcare System-West Haven Campus
    • Delaware
      • Lewes, Delaware, Forenede Stater, 19958
        • Beebe Medical Center
      • Millville, Delaware, Forenede Stater, 19967
        • Beebe South Coastal Health Campus
      • Newark, Delaware, Forenede Stater, 19713
        • Helen F Graham Cancer Center
      • Newark, Delaware, Forenede Stater, 19713
        • Delaware Clinical and Laboratory Physicians PA
      • Newark, Delaware, Forenede Stater, 19713
        • Medical Oncology Hematology Consultants PA
      • Newark, Delaware, Forenede Stater, 19718
        • Christiana Care Health System-Christiana Hospital
      • Rehoboth Beach, Delaware, Forenede Stater, 19971
        • Beebe Health Campus
      • Seaford, Delaware, Forenede Stater, 19973
        • TidalHealth Nanticoke / Allen Cancer Center
      • Wilmington, Delaware, Forenede Stater, 19801
        • Christiana Care Health System-Wilmington Hospital
    • Florida
      • Coral Gables, Florida, Forenede Stater, 33146
        • UM Sylvester Comprehensive Cancer Center at Coral Gables
      • Deerfield Beach, Florida, Forenede Stater, 33442
        • UM Sylvester Comprehensive Cancer Center at Deerfield Beach
      • Deerfield Beach, Florida, Forenede Stater, 33064
        • Broward Health North
      • Fort Lauderdale, Florida, Forenede Stater, 33316
        • Broward Health Medical Center
      • Fort Lauderdale, Florida, Forenede Stater, 33308
        • Holy Cross Hospital
      • Hollywood, Florida, Forenede Stater, 33021
        • UM Sylvester Comprehensive Cancer Center at Hollywood
      • Miami, Florida, Forenede Stater, 33136
        • University of Miami Miller School of Medicine-Sylvester Cancer Center
      • Plantation, Florida, Forenede Stater, 33324
        • UM Sylvester Comprehensive Cancer Center at Plantation
      • Weston, Florida, Forenede Stater, 33331
        • Cleveland Clinic-Weston
    • Georgia
      • Athens, Georgia, Forenede Stater, 30607
        • University Cancer and Blood Center LLC
      • Augusta, Georgia, Forenede Stater, 30912
        • Augusta University Medical Center
      • Augusta, Georgia, Forenede Stater, 30901
        • Augusta Oncology Associates PC-D'Antignac
      • Augusta, Georgia, Forenede Stater, 30909
        • Augusta Oncology Associates PC-Wheeler
      • Decatur, Georgia, Forenede Stater, 30033
        • Atlanta VA Medical Center
      • Savannah, Georgia, Forenede Stater, 31405
        • Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
    • Hawaii
      • Hilo, Hawaii, Forenede Stater, 96720
        • Island Urology-Hilo
      • 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
        • Hawaii Cancer Care - Westridge
      • ‘Aiea, Hawaii, Forenede Stater, 96701
        • Pali Momi Medical Center
      • ‘Aiea, Hawaii, Forenede Stater, 96701
        • Queen's Cancer Center - Pearlridge
      • ‘Aiea, Hawaii, Forenede Stater, 96701
        • The Cancer Center of Hawaii-Pali Momi
    • Idaho
      • Boise, Idaho, Forenede Stater, 83706
        • Saint Alphonsus Cancer Care Center-Boise
      • Boise, Idaho, Forenede Stater, 83712
        • Saint Luke's Cancer Institute - Boise
      • Caldwell, Idaho, Forenede Stater, 83605
        • Saint Alphonsus Cancer Care Center-Caldwell
      • Coeur d'Alene, Idaho, Forenede Stater, 83814
        • Kootenai Health - Coeur d'Alene
      • Emmett, Idaho, Forenede Stater, 83617
        • Walter Knox Memorial Hospital
      • Fruitland, Idaho, Forenede Stater, 83619
        • Saint Luke's Cancer Institute - Fruitland
      • Meridian, Idaho, Forenede Stater, 83642
        • Idaho Urologic Institute-Meridian
      • Meridian, Idaho, Forenede Stater, 83642
        • Saint Luke's Cancer Institute - Meridian
      • Nampa, Idaho, Forenede Stater, 83687
        • Saint Alphonsus Cancer Care Center-Nampa
      • Nampa, Idaho, Forenede Stater, 83687
        • Saint Luke's Cancer Institute - Nampa
      • Post Falls, Idaho, Forenede Stater, 83854
        • Kootenai Clinic Cancer Services - Post Falls
      • Sandpoint, Idaho, Forenede Stater, 83864
        • Kootenai Clinic Cancer Services - Sandpoint
      • Twin Falls, Idaho, Forenede Stater, 83301
        • Saint Luke's Cancer Institute - Twin Falls
    • Illinois
      • Alton, Illinois, Forenede Stater, 62002
        • OSF Saint Anthony's Health Center
      • 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
      • Chicago, Illinois, Forenede Stater, 60637
        • University of Chicago Comprehensive Cancer Center
      • Chicago, Illinois, Forenede Stater, 60612
        • University of Illinois
      • Chicago, Illinois, Forenede Stater, 60612
        • Rush MD Anderson Cancer Center
      • Danville, Illinois, Forenede Stater, 61832
        • Carle at The Riverfront
      • 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
      • Evanston, Illinois, Forenede Stater, 60201
        • NorthShore University HealthSystem-Evanston Hospital
      • Galesburg, Illinois, Forenede Stater, 61401
        • Western Illinois Cancer Treatment Center
      • Galesburg, Illinois, Forenede Stater, 61401
        • Illinois CancerCare-Galesburg
      • Geneva, Illinois, Forenede Stater, 60134
        • Northwestern Medicine Cancer Center Delnor
      • Glenview, Illinois, Forenede Stater, 60026
        • NorthShore University HealthSystem-Glenbrook Hospital
      • Harvey, Illinois, Forenede Stater, 60426
        • Ingalls Memorial Hospital
      • Highland Park, Illinois, Forenede Stater, 60035
        • NorthShore University HealthSystem-Highland Park Hospital
      • 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
        • SSM Health Good Samaritan
      • New Lenox, Illinois, Forenede Stater, 60451
        • UC Comprehensive Cancer Center at Silver Cross
      • O'Fallon, Illinois, Forenede Stater, 62269
        • Cancer Care Center of O'Fallon
      • Orland Park, Illinois, Forenede Stater, 60462
        • University of Chicago Medicine-Orland Park
      • Ottawa, Illinois, Forenede Stater, 61350
        • Illinois CancerCare-Ottawa Clinic
      • Pekin, Illinois, Forenede Stater, 61554
        • Illinois CancerCare-Pekin
      • Pekin, Illinois, Forenede Stater, 61554
        • OSF Saint Francis Radiation Oncology at Pekin
      • Peoria, Illinois, Forenede Stater, 61636
        • Methodist Medical Center of Illinois
      • Peoria, Illinois, Forenede Stater, 61637
        • OSF Saint Francis Medical Center
      • Peoria, Illinois, Forenede Stater, 61615
        • Illinois CancerCare-Peoria
      • Peoria, Illinois, Forenede Stater, 61615
        • OSF Saint Francis Radiation Oncology at Peoria Cancer Center
      • Peru, Illinois, Forenede Stater, 61354
        • Illinois CancerCare-Peru
      • Peru, Illinois, Forenede Stater, 61354
        • Valley Radiation Oncology
      • Princeton, Illinois, Forenede Stater, 61356
        • Illinois CancerCare-Princeton
      • Rockford, Illinois, Forenede Stater, 61114
        • UW Health Carbone Cancer Center Rockford
      • Skokie, Illinois, Forenede Stater, 60076
        • North Shore Medical Center
      • Springfield, Illinois, Forenede Stater, 62702
        • Southern Illinois University School of Medicine
      • Springfield, Illinois, Forenede Stater, 62702
        • Springfield Clinic
      • Springfield, Illinois, Forenede Stater, 62781
        • Springfield Memorial Hospital
      • Swansea, Illinois, Forenede Stater, 62226
        • Southwest Illinois Health Services LLP
      • Urbana, Illinois, Forenede Stater, 61801
        • Carle Cancer Center
      • Urbana, Illinois, Forenede Stater, 61801
        • The Carle Foundation Hospital
      • Warrenville, Illinois, Forenede Stater, 60555
        • Northwestern Medicine Cancer Center Warrenville
      • 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
      • Mooresville, Indiana, Forenede Stater, 46158
        • Franciscan Health Mooresville
      • Richmond, Indiana, Forenede Stater, 47374
        • Reid Health
    • Iowa
      • Ames, Iowa, Forenede Stater, 50010
        • Mary Greeley Medical Center
      • Ames, Iowa, Forenede Stater, 50010
        • McFarland Clinic - Ames
      • Bettendorf, Iowa, Forenede Stater, 52722
        • University of Iowa Healthcare Cancer Services Quad Cities
      • Boone, Iowa, Forenede Stater, 50036
        • McFarland Clinic - Boone
      • Cedar Rapids, Iowa, Forenede Stater, 52402
        • Physicians' Clinic of Iowa PC
      • Clive, Iowa, Forenede Stater, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Forenede Stater, 50325
        • UI Health Care Mission Cancer and Blood - West Des Moines Clinic
      • Council Bluffs, Iowa, Forenede Stater, 51503
        • Alegent Health Mercy Hospital
      • Creston, Iowa, Forenede Stater, 50801
        • Greater Regional Medical Center
      • Des Moines, Iowa, Forenede Stater, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Forenede Stater, 50314
        • UI Health Care Mission Cancer and Blood - Laurel Clinic
      • Fort Dodge, Iowa, Forenede Stater, 50501
        • McFarland Clinic - Trinity Cancer Center
      • Iowa City, Iowa, Forenede Stater, 52242
        • University of Iowa/Holden Comprehensive Cancer Center
      • Jefferson, Iowa, Forenede Stater, 50129
        • McFarland Clinic - Jefferson
      • Marshalltown, Iowa, Forenede Stater, 50158
        • McFarland Clinic - Marshalltown
      • Sioux City, Iowa, Forenede Stater, 51101
        • Siouxland Regional Cancer Center
      • Waterloo, Iowa, Forenede Stater, 50702
        • MercyOne Waterloo Cancer Center
      • West Des Moines, Iowa, Forenede Stater, 50266
        • Mercy Medical Center-West Lakes
    • Kansas
      • Coffeyville, Kansas, Forenede Stater, 67337
        • Coffeyville Regional Medical 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
      • Independence, Kansas, Forenede Stater, 67301
        • Cancer Center of Kansas-Independence
      • Kansas City, Kansas, Forenede Stater, 66160
        • University of Kansas Cancer Center
      • Kansas City, Kansas, Forenede Stater, 66112
        • University of Kansas Cancer Center-West
      • 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
        • The University of Kansas Cancer Center - Olathe
      • Overland Park, Kansas, Forenede Stater, 66210
        • University of Kansas Cancer Center-Overland Park
      • Overland Park, Kansas, Forenede Stater, 66209
        • Menorah Medical Center
      • Pittsburg, Kansas, Forenede Stater, 66762
        • Mercy Hospital 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, 67214
        • Ascension Via Christi Hospitals Wichita
      • Wichita, Kansas, Forenede Stater, 67208
        • Cancer Center of Kansas-Wichita Medical Arts Tower
      • Wichita, Kansas, Forenede Stater, 67214
        • Cancer Center of Kansas - Wichita
      • Wichita, Kansas, Forenede Stater, 67214
        • Wesley Medical Center
    • Kentucky
      • Bardstown, Kentucky, Forenede Stater, 40004
        • Flaget Memorial Hospital
      • Corbin, Kentucky, Forenede Stater, 40701
        • Commonwealth Cancer Center-Corbin
      • Lexington, Kentucky, Forenede Stater, 40504
        • Saint Joseph Radiation Oncology Resource Center
      • Lexington, Kentucky, Forenede Stater, 40509
        • Saint Joseph Hospital East
      • London, Kentucky, Forenede Stater, 40741
        • Saint Joseph London
      • Louisville, Kentucky, Forenede Stater, 40202
        • Jewish Hospital
      • Louisville, Kentucky, Forenede Stater, 40245
        • UofL Health Medical Center Northeast
      • Louisville, Kentucky, Forenede Stater, 40215
        • Saints Mary and Elizabeth Hospital
      • Shepherdsville, Kentucky, Forenede Stater, 40165
        • Jewish Hospital Medical Center South
    • Louisiana
      • Alexandria, Louisiana, Forenede Stater, 71301
        • Christus Saint Frances Cabrini Hospital
      • 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, 21201
        • University of Maryland/Greenebaum Cancer Center
      • Baltimore, Maryland, Forenede Stater, 21229
        • Saint Agnes Hospital
      • Cumberland, Maryland, Forenede Stater, 21502
        • UPMC Western Maryland
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02111
        • Tufts Medical Center
      • Burlington, Massachusetts, Forenede Stater, 01805
        • Lahey Hospital and Medical Center
      • Lowell, Massachusetts, Forenede Stater, 01854
        • Lowell General Hospital
      • Springfield, Massachusetts, Forenede Stater, 01199
        • Baystate Medical Center
      • Springfield, Massachusetts, Forenede Stater, 01104
        • Mercy Medical Center
    • Michigan
      • Ann Arbor, Michigan, Forenede Stater, 48106
        • Trinity Health Saint Joseph Mercy Hospital Ann Arbor
      • Battle Creek, Michigan, Forenede Stater, 49017
        • Bronson Battle Creek
      • Brighton, Michigan, Forenede Stater, 48114
        • Trinity Health IHA Medical Group Hematology Oncology - Brighton
      • Brighton, Michigan, Forenede Stater, 48114
        • Trinity Health Medical Center - Brighton
      • Brownstown, Michigan, Forenede Stater, 48183
        • Henry Ford Cancer Institute-Downriver
      • Canton, Michigan, Forenede Stater, 48188
        • Trinity Health IHA Medical Group Hematology Oncology - Canton
      • Canton, Michigan, Forenede Stater, 48188
        • Trinity Health Medical Center - Canton
      • Caro, Michigan, Forenede Stater, 48723
        • Caro Cancer Center
      • Chelsea, Michigan, Forenede Stater, 48118
        • Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
      • Chelsea, Michigan, Forenede Stater, 48118
        • Chelsea Hospital
      • Clarkston, Michigan, Forenede Stater, 48346
        • Hematology Oncology Consultants-Clarkston
      • Clarkston, Michigan, Forenede Stater, 48346
        • Newland Medical Associates-Clarkston
      • Clinton Township, Michigan, Forenede Stater, 48038
        • Henry Ford Macomb Hospital-Clinton Township
      • Dearborn, Michigan, Forenede Stater, 48126
        • Henry Ford Medical Center-Fairlane
      • Dearborn, Michigan, Forenede Stater, 48124
        • Corewell Health Dearborn Hospital
      • Detroit, Michigan, Forenede Stater, 48202
        • Henry Ford Hospital
      • Detroit, Michigan, Forenede Stater, 48201
        • Wayne State University/Karmanos Cancer Institute
      • Detroit, Michigan, Forenede Stater, 48236
        • Henry Ford Health Saint John Hospital
      • East China Township, Michigan, Forenede Stater, 48054
        • Henry Ford River District Hospital
      • Escanaba, Michigan, Forenede Stater, 49829
        • OSF Saint Francis Hospital and Medical Group
      • Farmington Hills, Michigan, Forenede Stater, 48334
        • Weisberg Cancer Treatment Center
      • Farmington Hills, Michigan, Forenede Stater, 48336
        • Corewell Health Farmington Hills Hospital
      • Flint, Michigan, Forenede Stater, 48503
        • Hurley Medical Center
      • Flint, Michigan, Forenede Stater, 48503
        • Genesee Hematology Oncology PC
      • Flint, Michigan, Forenede Stater, 48503
        • Genesys Hurley Cancer Institute
      • Flint, Michigan, Forenede Stater, 48503
        • Cancer Hematology Centers - Flint
      • Grand Rapids, Michigan, Forenede Stater, 49503
        • Trinity Health Grand Rapids Hospital
      • Grand Rapids, Michigan, Forenede Stater, 49503
        • Corewell Health Grand Rapids Hospitals - Butterworth Hospital
      • Grand Rapids, Michigan, Forenede Stater, 49503
        • Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
      • Grosse Pointe, Michigan, Forenede Stater, 48230
        • William Beaumont Hospital-Grosse Pointe
      • Grosse Pointe Woods, Michigan, Forenede Stater, 48236
        • Henry Ford Saint John Hospital - Academic
      • Grosse Pointe Woods, Michigan, Forenede Stater, 48236
        • Henry Ford Saint John Hospital - Breast
      • Grosse Pointe Woods, Michigan, Forenede Stater, 48236
        • Henry Ford Saint John Hospital - Van Elslander
      • 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, 49009
        • Beacon Kalamazoo Cancer Center
      • Kalamazoo, Michigan, Forenede Stater, 49048
        • Beacon Kalamazoo
      • Lansing, Michigan, Forenede Stater, 48912
        • University of Michigan Health - Sparrow Lansing
      • Livonia, Michigan, Forenede Stater, 48154
        • Trinity Health Saint Mary Mercy Livonia Hospital
      • Livonia, Michigan, Forenede Stater, 48154
        • Hope Cancer Clinic
      • Macomb, Michigan, Forenede Stater, 48044
        • Henry Ford Warren Hospital - Breast Macomb
      • Macomb, Michigan, Forenede Stater, 48044
        • Henry Ford Saint John Hospital - Macomb Medical
      • Marlette, Michigan, Forenede Stater, 48453
        • Saint Mary's Oncology/Hematology Associates of Marlette
      • Muskegon, Michigan, Forenede Stater, 49444
        • Trinity Health Muskegon Hospital
      • Niles, Michigan, Forenede Stater, 49120
        • Corewell Health Lakeland Hospitals - Niles Hospital
      • Norton Shores, Michigan, Forenede Stater, 49444
        • Cancer and Hematology Centers of Western Michigan - Norton Shores
      • Novi, Michigan, Forenede Stater, 48377
        • Henry Ford Medical Center-Columbus
      • Pontiac, Michigan, Forenede Stater, 48341
        • Hope Cancer Center
      • Pontiac, Michigan, Forenede Stater, 48341
        • Newland Medical Associates-Pontiac
      • Pontiac, Michigan, Forenede Stater, 48341
        • Trinity Health Saint Joseph Mercy Oakland Hospital
      • Pontiac, Michigan, Forenede Stater, 48341
        • Michigan Healthcare Professionals Pontiac
      • Reed City, Michigan, Forenede Stater, 49677
        • Corewell Health Reed City Hospital
      • Rochester Hills, Michigan, Forenede Stater, 48309
        • Henry Ford Rochester Hospital
      • Roseville, Michigan, Forenede Stater, 48066
        • Michigan Cancer Specialists
      • Royal Oak, Michigan, Forenede Stater, 48073
        • Cancer Care Associates PC
      • Royal Oak, Michigan, Forenede Stater, 48073
        • Comprehensive Medical Center PLLC
      • Royal Oak, Michigan, Forenede Stater, 48073
        • Oakland Medical Group
      • Royal Oak, Michigan, Forenede Stater, 48067
        • Oakland Colon Rectal Associates
      • Royal Oak, Michigan, Forenede Stater, 48073
        • Hematology Oncology Consultants PC-Royal Oak
      • Royal Oak, Michigan, Forenede Stater, 48073
        • Corewell Health William Beaumont University Hospital
      • Saginaw, Michigan, Forenede Stater, 48604
        • Oncology Hematology Associates of Saginaw Valley PC
      • Saginaw, Michigan, Forenede Stater, 48601
        • MyMichigan Medical Center Saginaw
      • Saint Joseph, Michigan, Forenede Stater, 49085
        • Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
      • Saint Joseph, Michigan, Forenede Stater, 49085
        • Corewell Health Lakeland Hospitals - Saint Joseph Hospital
      • Shelby, Michigan, Forenede Stater, 48315
        • Henry Ford Macomb Health Center - Shelby Township
      • Sterling Heights, Michigan, Forenede Stater, 48312
        • Bhadresh Nayak MD PC-Sterling Heights
      • Sterling Heights, Michigan, Forenede Stater, 48312
        • Premier Hematology Oncology Care
      • Tawas City, Michigan, Forenede Stater, 48764
        • MyMichigan Medical Center Tawas
      • Traverse City, Michigan, Forenede Stater, 49684
        • Munson Medical Center
      • Troy, Michigan, Forenede Stater, 48084
        • Michigan Institute of Urology-Town Center
      • Troy, Michigan, Forenede Stater, 48098
        • Hematology Oncology Consultants PC-Troy
      • Troy, Michigan, Forenede Stater, 48085
        • Corewell Health Beaumont Troy Hospital
      • Warren, Michigan, Forenede Stater, 48088
        • Advanced Breast Care Center PLLC
      • Warren, Michigan, Forenede Stater, 48093
        • Macomb Hematology Oncology PC
      • Warren, Michigan, Forenede Stater, 48093
        • Henry Ford Madison Heights Hospital - Breast
      • Warren, Michigan, Forenede Stater, 48093
        • Henry Ford Health Warren Hospital
      • Warren, Michigan, Forenede Stater, 48093
        • Henry Ford Warren Hospital - GLCMS
      • 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
        • University of Michigan Health - West
      • Ypsilanti, Michigan, Forenede Stater, 48197
        • Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
      • Ypsilanti, Michigan, Forenede Stater, 48106
        • Huron Gastroenterology PC
    • 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
      • 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
      • Mankato, Minnesota, Forenede Stater, 56001
        • Mayo Clinic Health Systems-Mankato
      • 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
      • Minneapolis, Minnesota, Forenede Stater, 55417
        • Minneapolis VA Medical Center
      • 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
      • Rochester, Minnesota, Forenede Stater, 55905
        • Mayo Clinic in Rochester
      • Saint Cloud, Minnesota, Forenede Stater, 56303
        • Coborn Cancer Center at Saint Cloud Hospital
      • Saint Louis Park, Minnesota, Forenede Stater, 55416
        • Park Nicollet Clinic - Saint Louis Park
      • Saint Paul, Minnesota, Forenede Stater, 55101
        • Regions Hospital
      • Saint Paul, Minnesota, Forenede Stater, 55102
        • United Hospital
      • Sandstone, Minnesota, Forenede Stater, 55072
        • Essentia Health Sandstone
      • Shakopee, Minnesota, Forenede Stater, 55379
        • Saint Francis Regional Medical Center
      • Stillwater, Minnesota, Forenede Stater, 55082
        • Lakeview Hospital
      • 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
        • Mercy Oncology and Hematology - Clayton-Clarkson
      • Bolivar, Missouri, Forenede Stater, 65613
        • Central Care Cancer Center - Bolivar
      • Bonne Terre, Missouri, Forenede Stater, 63628
        • Parkland Health Center-Bonne Terre
      • Branson, Missouri, Forenede Stater, 65616
        • Cox Cancer Center Branson
      • Cape Girardeau, Missouri, Forenede Stater, 63703
        • Saint Francis Medical Center
      • Cape Girardeau, Missouri, Forenede Stater, 63703
        • Mercy Cancer Center - Cape Girardeau
      • 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
        • MU Health Care Goldschmidt Cancer Center
      • Joplin, Missouri, Forenede Stater, 64804
        • Freeman Health System
      • Joplin, Missouri, Forenede Stater, 64804
        • Mercy Hospital Joplin
      • Kansas City, Missouri, Forenede Stater, 64154
        • University of Kansas Cancer Center - North
      • Kansas City, Missouri, Forenede Stater, 64132
        • Research Medical Center
      • Kansas City, Missouri, Forenede Stater, 64108
        • University Health Truman Medical Center
      • Lee's Summit, Missouri, Forenede Stater, 64064
        • University of Kansas Cancer Center - Lee's Summit
      • North Kansas City, Missouri, Forenede Stater, 64116
        • University of Kansas Cancer Center at North Kansas City Hospital
      • Rolla, Missouri, Forenede Stater, 65401
        • Mercy Clinic-Rolla-Cancer and Hematology
      • Rolla, Missouri, Forenede Stater, 65401
        • Phelps Health Delbert Day Cancer Institute
      • Saint Joseph, Missouri, Forenede Stater, 64506
        • Heartland Regional Medical Center
      • Sainte Genevieve, Missouri, Forenede Stater, 63670
        • Sainte Genevieve County Memorial Hospital
      • Springfield, Missouri, Forenede Stater, 65807
        • CoxHealth South Hospital
      • Springfield, Missouri, Forenede Stater, 65804
        • Mercy Hospital Springfield
      • St Louis, Missouri, Forenede Stater, 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, 63109
        • Mercy Infusion Center - Chippewa
      • St Louis, Missouri, Forenede Stater, 63141
        • Mercy Hospital Saint Louis
      • St Louis, Missouri, Forenede Stater, 63128
        • Mercy Hospital South
      • Sullivan, Missouri, Forenede Stater, 63080
        • Missouri Baptist Sullivan Hospital
      • Sunset Hills, Missouri, Forenede Stater, 63127
        • BJC Outpatient Center at Sunset Hills
      • 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 Health Deaconess Hospital
      • Butte, Montana, Forenede Stater, 59701
        • Saint James Community Hospital and Cancer Treatment Center
      • Great Falls, Montana, Forenede Stater, 59405
        • Great Falls Clinic
      • Great Falls, Montana, Forenede Stater, 59405
        • Benefis Sletten Cancer Institute
      • Helena, Montana, Forenede Stater, 59601
        • Saint Peter's Community Hospital
      • Kalispell, Montana, Forenede Stater, 59901
        • Logan Health Medical Center
      • Missoula, Montana, Forenede Stater, 59802
        • Saint Patrick Hospital - Community Hospital
      • Missoula, Montana, Forenede Stater, 59804
        • Community Medical Center
    • Nebraska
      • Bellevue, Nebraska, Forenede Stater, 68123
        • Nebraska Medicine-Bellevue
      • Grand Island, Nebraska, Forenede Stater, 68803
        • Nebraska Cancer Specialists/Oncology Hematology West PC
      • Kearney, Nebraska, Forenede Stater, 68847
        • CHI Health Good Samaritan
      • Kearney, Nebraska, Forenede Stater, 68845
        • Fred and Pamela Buffett Cancer Center - Kearney
      • Lincoln, Nebraska, Forenede Stater, 68510
        • Saint Elizabeth Regional Medical Center
      • Omaha, Nebraska, Forenede Stater, 68114
        • Nebraska Methodist Hospital
      • Omaha, Nebraska, Forenede Stater, 68198
        • University of Nebraska Medical Center
      • Omaha, Nebraska, Forenede Stater, 68124
        • Alegent Health Bergan Mercy Medical Center
      • Omaha, Nebraska, Forenede Stater, 68118
        • Nebraska Medicine-Village Pointe
      • Omaha, Nebraska, Forenede Stater, 68122
        • Alegent Health Immanuel Medical Center
      • Omaha, Nebraska, Forenede Stater, 68130
        • Alegent Health Lakeside Hospital
      • Omaha, Nebraska, Forenede Stater, 68122
        • Hematology and Oncology Consultants PC
      • Papillion, Nebraska, Forenede Stater, 68046
        • Midlands Community Hospital
    • Nevada
      • Carson City, Nevada, Forenede Stater, 89703
        • Carson Tahoe Regional Medical Center
      • Henderson, Nevada, Forenede Stater, 89052
        • Comprehensive Cancer Centers of Nevada - Henderson
      • Henderson, Nevada, Forenede Stater, 89052
        • Cancer and Blood Specialists-Henderson
      • Henderson, Nevada, Forenede Stater, 89052
        • Las Vegas Cancer Center-Henderson
      • Henderson, Nevada, Forenede Stater, 89074
        • Comprehensive Cancer Centers of Nevada-Southeast Henderson
      • Henderson, Nevada, Forenede Stater, 89052
        • Comprehensive Cancer Centers of Nevada-Horizon Ridge
      • Henderson, Nevada, Forenede Stater, 89074
        • 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
      • Henderson, Nevada, Forenede Stater, 89074
        • Oncology Las Vegas - Henderson
      • Las Vegas, Nevada, Forenede Stater, 89144
        • Summerlin Hospital Medical Center
      • Las Vegas, Nevada, Forenede Stater, 89109
        • Sunrise Hospital and Medical Center
      • Las Vegas, Nevada, Forenede Stater, 89102
        • OptumCare Cancer Care at Charleston
      • Las Vegas, Nevada, Forenede Stater, 89106
        • Radiation Oncology Centers of Nevada Central
      • Las Vegas, Nevada, Forenede Stater, 89119
        • Radiation Oncology Centers of Nevada Southeast
      • Las Vegas, Nevada, Forenede Stater, 89128
        • Comprehensive Cancer Centers of Nevada - Northwest
      • Las Vegas, Nevada, Forenede Stater, 89128
        • OptumCare Cancer Care at MountainView
      • Las Vegas, Nevada, Forenede Stater, 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, 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, 89128
        • Ann M Wierman MD LTD
      • Las Vegas, Nevada, Forenede Stater, 89074
        • Las Vegas Urology - Pecos
      • Las Vegas, Nevada, Forenede Stater, 89102
        • Desert West Surgery
      • Las Vegas, Nevada, Forenede Stater, 89103
        • Hope Cancer Care of Nevada
      • Las Vegas, Nevada, Forenede Stater, 89106
        • Urology Specialists of Nevada - Central
      • Las Vegas, Nevada, Forenede Stater, 89113
        • Las Vegas Prostate Cancer Center
      • Las Vegas, Nevada, Forenede Stater, 89113
        • Las Vegas Urology - Sunset
      • Las Vegas, Nevada, Forenede Stater, 89128
        • Las Vegas Urology - Cathedral Rock
      • Las Vegas, Nevada, Forenede Stater, 89128
        • Las Vegas Urology - Smoke Ranch
      • Las Vegas, Nevada, Forenede Stater, 89128
        • Urology Specialists of Nevada - Northwest
      • Las Vegas, Nevada, Forenede Stater, 89169
        • University Cancer Center
      • Las Vegas, Nevada, Forenede Stater, 89113
        • Urology Specialists of Nevada - Southwest
      • Las Vegas, Nevada, Forenede Stater, 89128
        • Oncology Las Vegas - Tenaya
      • Las Vegas, Nevada, Forenede Stater, 89183
        • OptumCare Cancer Care at Fort Apache
      • Pahrump, Nevada, Forenede Stater, 89048
        • Hope Cancer Care of Nevada-Pahrump
      • Reno, Nevada, Forenede Stater, 89502
        • Renown Regional Medical Center
      • Reno, Nevada, Forenede Stater, 89503
        • Saint Mary's Regional Medical Center
      • Reno, Nevada, Forenede Stater, 89509
        • Radiation Oncology Associates
    • New Hampshire
      • Concord, New Hampshire, Forenede Stater, 03301
        • New Hampshire Oncology Hematology PA-Concord
      • Manchester, New Hampshire, Forenede Stater, 03103
        • Solinsky Center for Cancer Care
    • New Jersey
      • Lakewood, New Jersey, Forenede Stater, 08701
        • Monmouth Medical Center Southern Campus
      • Long Branch, New Jersey, Forenede Stater, 07740
        • Monmouth Medical Center
      • Morristown, New Jersey, Forenede Stater, 07960
        • Morristown Medical Center
      • New Brunswick, New Jersey, Forenede Stater, 08903
        • Rutgers Cancer Institute of New Jersey
      • Paramus, New Jersey, Forenede Stater, 07652
        • The Valley Hospital - Luckow Pavilion
      • Ridgewood, New Jersey, Forenede Stater, 07450
        • Neurosurgeons of New Jersey-Ridgewood
      • Ridgewood, New Jersey, Forenede Stater, 07450
        • Valley Health System Ridgewood Campus
      • Summit, New Jersey, Forenede Stater, 07902
        • Overlook Hospital
      • Westwood, New Jersey, Forenede Stater, 07675
        • Valley Health System-Hematology/Oncology
    • New Mexico
      • Albuquerque, New Mexico, Forenede Stater, 87106
        • University of New Mexico Cancer Center
      • Las Cruces, New Mexico, Forenede Stater, 88011
        • Memorial Medical Center-Las Cruces
    • New York
      • Auburn, New York, Forenede Stater, 13021
        • Hematology Oncology Associates of Central New York-Auburn
      • Buffalo, New York, Forenede Stater, 14263
        • Roswell Park Cancer Institute
      • Camillus, New York, Forenede Stater, 13031
        • Hematology Oncology Associates of CNY at Camillus
      • East Hills, New York, Forenede Stater, 11548
        • The Cancer Institute at Saint Francis Hospital
      • 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
      • Lake Success, New York, Forenede Stater, 11042
        • Northwell Health/Center for Advanced Medicine
      • Manhasset, New York, Forenede Stater, 11030
        • North Shore University Hospital
      • New Hyde Park, New York, Forenede Stater, 11040
        • Long Island Jewish Medical Center
      • New York, New York, Forenede Stater, 10065
        • NYP/Weill Cornell Medical Center
      • Rochester, New York, Forenede Stater, 14642
        • University of Rochester
      • Syracuse, New York, Forenede Stater, 13210
        • State University of New York Upstate Medical University
      • Verona, New York, Forenede Stater, 13478
        • Upstate Cancer Center at Verona
      • West Islip, New York, Forenede Stater, 11795
        • Good Samaritan University Hospital
    • North Carolina
      • Asheville, North Carolina, Forenede Stater, 28801
        • Mission Hospital
      • Asheville, North Carolina, Forenede Stater, 28806
        • Messino Cancer Centers
      • Cary, North Carolina, Forenede Stater, 27518
        • Waverly Hematology Oncology
      • Chapel Hill, North Carolina, Forenede Stater, 27599
        • UNC Lineberger Comprehensive Cancer Center
      • Clemmons, North Carolina, Forenede Stater, 27012
        • Wake Forest University at Clemmons
      • 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
      • Greenville, North Carolina, Forenede Stater, 27834
        • East Carolina University
      • Hendersonville, North Carolina, Forenede Stater, 28791
        • Margaret R Pardee Memorial Hospital
      • Jacksonville, North Carolina, Forenede Stater, 28546
        • Southeastern Medical Oncology Center-Jacksonville
      • Jacksonville, North Carolina, Forenede Stater, 28546
        • Onslow Memorial Hospital
      • Kenansville, North Carolina, Forenede Stater, 28349
        • ECU Health Oncology Kenansville
      • Kernersville, North Carolina, Forenede Stater, 27284
        • Novant Health Cancer Institute - Kernersville
      • Kinston, North Carolina, Forenede Stater, 28501
        • ECU Health Oncology Kinston
      • Mount Airy, North Carolina, Forenede Stater, 27030
        • Novant Health Cancer Institute - Mount Airy
      • North Wilkesboro, North Carolina, Forenede Stater, 28659
        • Novant Health Cancer Institute - Wilkesboro
      • Pinehurst, North Carolina, Forenede Stater, 28374
        • FirstHealth of the Carolinas-Moore Regional Hospital
      • Richlands, North Carolina, Forenede Stater, 28574
        • ECU Health Oncology Richlands
      • Statesville, North Carolina, Forenede Stater, 28625
        • Novant Health Cancer Institute - Statesville
      • Thomasville, North Carolina, Forenede Stater, 27360
        • Novant Health Cancer Institute - Thomasville
      • Wilkesboro, North Carolina, Forenede Stater, 28659
        • Wake Forest Baptist Health - Wilkes Medical Center
      • Winston-Salem, North Carolina, Forenede Stater, 27157
        • Wake Forest University Health Sciences
      • Winston-Salem, North Carolina, Forenede Stater, 27103
        • Novant Health Forsyth Medical Center
    • 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
      • Jamestown, North Dakota, Forenede Stater, 58401
        • Essentia Health - Jamestown Clinic
    • Ohio
      • Beavercreek, Ohio, Forenede Stater, 45431
        • Indu and Raj Soin Medical Center
      • Belpre, Ohio, Forenede Stater, 45714
        • Strecker Cancer Center-Belpre
      • Boardman, Ohio, Forenede Stater, 44512
        • Saint Elizabeth Boardman Hospital
      • Centerville, Ohio, Forenede Stater, 45459
        • Miami Valley Hospital South
      • Centerville, Ohio, Forenede Stater, 45459
        • Dayton Physicians LLC-Miami Valley South
      • Chardon, Ohio, Forenede Stater, 44024
        • Geauga Hospital
      • 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
      • Cleveland, Ohio, Forenede Stater, 44106
        • Case Western Reserve University
      • Cleveland, Ohio, Forenede Stater, 44195
        • Cleveland Clinic Foundation
      • Cleveland, Ohio, Forenede Stater, 44111
        • Cleveland Clinic Cancer Center/Fairview Hospital
      • Columbus, Ohio, Forenede Stater, 43214
        • Riverside Methodist Hospital
      • Columbus, Ohio, Forenede Stater, 43210
        • Ohio State University Comprehensive Cancer Center
      • Columbus, Ohio, Forenede Stater, 43219
        • The Mark H Zangmeister Center
      • Columbus, Ohio, Forenede Stater, 43214
        • Columbus Oncology and Hematology Associates Inc
      • Columbus, Ohio, Forenede Stater, 43228
        • Doctors Hospital
      • Columbus, Ohio, Forenede Stater, 43213
        • Mount Carmel East Hospital
      • Columbus, Ohio, Forenede Stater, 43215
        • Grant Medical Center
      • Columbus, Ohio, Forenede Stater, 43222
        • Mount Carmel Health Center West
      • Dayton, Ohio, Forenede Stater, 45406
        • Good Samaritan Hospital - Dayton
      • Dayton, Ohio, Forenede Stater, 45409
        • Miami Valley Hospital
      • Dayton, Ohio, Forenede Stater, 45415
        • Miami Valley Hospital North
      • Dayton, Ohio, Forenede Stater, 45428
        • Dayton Veterans Affairs Medical Center
      • Dayton, Ohio, Forenede Stater, 45415
        • Dayton Physician LLC - Englewood
      • Delaware, Ohio, Forenede Stater, 43015
        • Delaware Health Center-Grady Cancer Center
      • Delaware, Ohio, Forenede Stater, 43015
        • 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
      • Gahanna, Ohio, Forenede Stater, 43230
        • Central Ohio Breast and Endocrine Surgery
      • 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, 44906
        • Cleveland Clinic Cancer Center Mansfield
      • Mansfield, Ohio, Forenede Stater, 44903
        • OhioHealth Mansfield Hospital
      • Marietta, Ohio, Forenede Stater, 45750
        • Marietta Memorial Hospital
      • Marion, Ohio, Forenede Stater, 43302
        • OhioHealth Marion General Hospital
      • Mayfield Heights, Ohio, Forenede Stater, 44124
        • Hillcrest Hospital Cancer Center
      • Mentor, Ohio, Forenede Stater, 44060
        • UH Seidman Cancer Center at Lake Health Mentor Campus
      • Middleburg Heights, Ohio, Forenede Stater, 44130
        • UH Seidman Cancer Center at Southwest General Hospital
      • Mount Vernon, Ohio, Forenede Stater, 43050
        • Knox Community Hospital
      • Newark, Ohio, Forenede Stater, 43055
        • Licking Memorial Hospital
      • Newark, Ohio, Forenede Stater, 43055
        • Newark Radiation Oncology
      • Parma, Ohio, Forenede Stater, 44129
        • University Hospitals Parma Medical Center
      • Perrysburg, Ohio, Forenede Stater, 43551
        • Mercy Health - Perrysburg Hospital
      • Portsmouth, Ohio, Forenede Stater, 45662
        • Southern Ohio Medical Center
      • Ravenna, Ohio, Forenede Stater, 44266
        • University Hospitals Portage Medical Center
      • Sandusky, Ohio, Forenede Stater, 44870
        • North Coast Cancer Care
      • Sandusky, Ohio, Forenede Stater, 44870
        • UH Seidman Cancer Center at Firelands Regional Medical Center
      • Springfield, Ohio, Forenede Stater, 45504
        • Springfield Regional Cancer Center
      • Springfield, Ohio, Forenede Stater, 45504
        • Springfield Regional Medical Center
      • Strongsville, Ohio, Forenede Stater, 44136
        • Cleveland Clinic Cancer Center Strongsville
      • Toledo, Ohio, Forenede Stater, 43623
        • Mercy Health - Saint Anne Hospital
      • Toledo, Ohio, Forenede Stater, 43608
        • Mercy Health - Saint Vincent Hospital
      • Troy, Ohio, Forenede Stater, 45373
        • Upper Valley Medical Center
      • Troy, Ohio, Forenede Stater, 45373
        • Dayton Physicians LLC - Troy
      • Wadsworth, Ohio, Forenede Stater, 44281
        • University Hospitals Sharon Health Center
      • Warren, Ohio, Forenede Stater, 44484
        • Saint Joseph Warren Hospital
      • Warrensville Heights, Ohio, Forenede Stater, 44122
        • South Pointe Hospital
      • Westerville, Ohio, Forenede Stater, 43081
        • Saint Ann's Hospital
      • Westlake, Ohio, Forenede Stater, 44145
        • UH Seidman Cancer Center at Saint John Medical Center
      • Wooster, Ohio, Forenede Stater, 44691
        • Cleveland Clinic Wooster Family Health and Surgery Center
      • Wright-Patterson Air Force Base, Ohio, Forenede Stater, 45433
        • Wright-Patterson Medical Center
      • Youngstown, Ohio, Forenede Stater, 44501
        • Saint Elizabeth Youngstown Hospital
      • Zanesville, Ohio, Forenede Stater, 43701
        • Genesis Healthcare System Cancer Care Center
    • Oklahoma
      • Lawton, Oklahoma, Forenede Stater, 73505
        • Cancer Centers of Southwest Oklahoma Research
      • Oklahoma City, Oklahoma, Forenede Stater, 73104
        • University of Oklahoma Health Sciences Center
      • Oklahoma City, Oklahoma, Forenede Stater, 73120
        • Mercy Hospital Oklahoma City
      • Tulsa, Oklahoma, Forenede Stater, 74146
        • Oklahoma Cancer Specialists and Research Institute-Tulsa
    • Oregon
      • Baker City, Oregon, Forenede Stater, 97814
        • Saint Alphonsus Cancer Care Center-Baker City
      • Bend, Oregon, Forenede Stater, 97701
        • Saint Charles Health System
      • Clackamas, Oregon, Forenede Stater, 97015
        • Clackamas Radiation Oncology Center
      • Clackamas, Oregon, Forenede Stater, 97015
        • Providence Cancer Institute Clackamas Clinic
      • Coos Bay, Oregon, Forenede Stater, 97420
        • Bay Area Hospital
      • Newberg, Oregon, Forenede Stater, 97132
        • Providence Newberg Medical Center
      • Ontario, Oregon, Forenede Stater, 97914
        • Saint Alphonsus Cancer Care Center-Ontario
      • Portland, Oregon, Forenede Stater, 97239
        • Oregon Health and Science University
      • 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
      • Chambersburg, Pennsylvania, Forenede Stater, 17201
        • Chambersburg Hospital
      • 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
        • WellSpan Medical Oncology and Hematology
      • 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
      • Lewistown, Pennsylvania, Forenede Stater, 17044
        • Lewistown 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
      • Wilkes-Barre, Pennsylvania, Forenede Stater, 18711
        • Geisinger Wyoming Valley/Henry Cancer Center
      • York, Pennsylvania, Forenede Stater, 17403
        • WellSpan Health-York Cancer Center
      • York, Pennsylvania, Forenede Stater, 17403
        • WellSpan Health-York Hospital
    • Rhode Island
      • Westerly, Rhode Island, Forenede Stater, 02891
        • Smilow Cancer Hospital Care Center - Westerly
    • South Carolina
      • Bluffton, South Carolina, Forenede Stater, 29910
        • Saint Joseph's/Candler - Bluffton Campus
      • Boiling Springs, South Carolina, Forenede Stater, 29316
        • Prisma Health Cancer Institute - Spartanburg
      • Charleston, South Carolina, Forenede Stater, 29425
        • Medical University of South Carolina
      • Clinton, South Carolina, Forenede Stater, 29325
        • Prisma Health Cancer Institute - Laurens
      • Easley, South Carolina, Forenede Stater, 29640
        • Prisma Health Cancer Institute - Easley
      • Gaffney, South Carolina, Forenede Stater, 29341
        • Gibbs Cancer Center-Gaffney
      • Greenville, South Carolina, Forenede Stater, 29605
        • Prisma Health Cancer Institute - Faris
      • Greenville, South Carolina, Forenede Stater, 29607
        • Saint Francis Cancer Center
      • Greenville, South Carolina, Forenede Stater, 29615
        • Prisma Health Cancer Institute - Eastside
      • Greenville, South Carolina, Forenede Stater, 29605
        • Prisma Health Cancer Institute - Butternut
      • Greenville, South Carolina, Forenede Stater, 29601
        • Saint Francis Hospital
      • Greenville, South Carolina, Forenede Stater, 29605
        • BI-LO Charities Children's Cancer Center
      • Greenville, South Carolina, Forenede Stater, 29605
        • Prisma Health Greenville Memorial Hospital
      • Greer, South Carolina, Forenede Stater, 29650
        • Prisma Health Cancer Institute - Greer
      • Greer, South Carolina, Forenede Stater, 29651
        • Gibbs Cancer Center-Pelham
      • Hilton Head Island, South Carolina, Forenede Stater, 29926-3827
        • South Carolina Cancer Specialists PC
      • Seneca, South Carolina, Forenede Stater, 29672
        • Prisma Health Cancer Institute - Seneca
      • Spartanburg, South Carolina, Forenede Stater, 29303
        • Spartanburg Medical Center
      • Union, South Carolina, Forenede Stater, 29379
        • SMC Center for Hematology Oncology Union
    • South Dakota
      • Aberdeen, South Dakota, Forenede Stater, 57401
        • Avera Cancer Institute-Aberdeen
      • Pierre, South Dakota, Forenede Stater, 57501
        • Avera Cancer Institute at Pierre
      • Sioux Falls, South Dakota, Forenede Stater, 57105
        • Avera Cancer Institute
      • Sioux Falls, South Dakota, Forenede Stater, 57117-5134
        • Sanford USD Medical Center - Sioux Falls
      • Sioux Falls, South Dakota, Forenede Stater, 57104
        • Sanford Cancer Center Oncology Clinic
    • Tennessee
      • Chattanooga, Tennessee, Forenede Stater, 37404
        • Memorial Hospital
      • Cookeville, Tennessee, Forenede Stater, 38501
        • Cookeville Regional Medical Center
      • Hixson, Tennessee, Forenede Stater, 37343
        • Pulmonary Medicine Center of Chattanooga-Hixson
      • Ooltewah, Tennessee, Forenede Stater, 37363
        • Memorial GYN Plus
    • Texas
      • Amarillo, Texas, Forenede Stater, 79106
        • The Don and Sybil Harrington Cancer Center
      • Bryan, Texas, Forenede Stater, 77802
        • Saint Joseph Regional Cancer Center
      • Dallas, Texas, Forenede Stater, 75390
        • UT Southwestern/Simmons Cancer Center-Dallas
      • Edinburg, Texas, Forenede Stater, 78539
        • STCC at DHR Health Institute for Research and Development
      • Fort Worth, Texas, Forenede Stater, 76104
        • UT Southwestern/Simmons Cancer Center-Fort Worth
      • Richardson, Texas, Forenede Stater, 75080
        • UT Southwestern Clinical Center at Richardson/Plano
    • 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
      • 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
      • St. George, Utah, Forenede Stater, 84770
        • Saint George Regional Medical Center
    • Virginia
      • Charlottesville, Virginia, Forenede Stater, 22908
        • University of Virginia Cancer Center
      • Lynchburg, Virginia, Forenede Stater, 24501
        • Centra Alan B Pearson Regional Cancer Center
      • Richmond, Virginia, Forenede Stater, 23229
        • Virginia Cancer Institute
      • Richmond, Virginia, Forenede Stater, 23298
        • VCU Massey Comprehensive Cancer Center
      • South Hill, Virginia, Forenede Stater, 23970
        • VCU Community Memorial Health Center
    • Washington
      • Aberdeen, Washington, Forenede Stater, 98520
        • Providence Regional Cancer System-Aberdeen
      • Auburn, Washington, Forenede Stater, 98001
        • MultiCare Auburn Medical Center
      • Bainbridge Island, Washington, Forenede Stater, 98110
        • Virginia Mason Bainbridge Island Medical Center
      • Bellevue, Washington, Forenede Stater, 98004
        • Overlake Medical Center
      • Bellingham, Washington, Forenede Stater, 98225
        • PeaceHealth Saint Joseph Medical Center
      • Burien, Washington, Forenede Stater, 98166
        • Highline Medical Center-Main Campus
      • Centralia, Washington, Forenede Stater, 98531
        • Providence Regional Cancer System-Centralia
      • Edmonds, Washington, Forenede Stater, 98026
        • Swedish Cancer Institute-Edmonds
      • Enumclaw, Washington, Forenede Stater, 98022
        • Saint Elizabeth Hospital
      • Everett, Washington, Forenede Stater, 98201
        • Providence Regional Cancer Partnership
      • Federal Way, Washington, Forenede Stater, 98002
        • Virginia Mason Federal Way Medical Center
      • Federal Way, Washington, Forenede Stater, 98003
        • Saint Francis Hospital
      • Gig Harbor, Washington, Forenede Stater, 98332
        • Tacoma/Valley Radiation Oncology Centers-Gig Harbor
      • Gig Harbor, Washington, Forenede Stater, 98335
        • MultiCare Gig Harbor Medical Park
      • Issaquah, Washington, Forenede Stater, 98029
        • Swedish Cancer Institute-Issaquah
      • Kennewick, Washington, Forenede Stater, 99336
        • Kadlec Clinic Hematology and Oncology
      • Kennewick, Washington, Forenede Stater, 99336
        • Northwest Cancer Clinic
      • Lacey, Washington, Forenede Stater, 98503
        • Providence Regional Cancer System-Lacey
      • Lakewood, Washington, Forenede Stater, 98499
        • Saint Clare Hospital
      • Longview, Washington, Forenede Stater, 98632
        • PeaceHealth Saint John Medical Center
      • Lynnwood, Washington, Forenede Stater, 98036
        • Virginia Mason Lynnwood Medical Center
      • Port Townsend, Washington, Forenede Stater, 98368
        • Jefferson Healthcare
      • Poulsbo, Washington, Forenede Stater, 98370
        • Harrison HealthPartners Hematology and Oncology-Poulsbo
      • Puyallup, Washington, Forenede Stater, 98372
        • MultiCare Good Samaritan Hospital
      • Puyallup, Washington, Forenede Stater, 98372
        • Tacoma/Valley Radiation Oncology Centers-Puyallup
      • Renton, Washington, Forenede Stater, 98055
        • Valley Medical Center
      • Seattle, Washington, Forenede Stater, 98101
        • Virginia Mason Medical Center
      • Seattle, Washington, Forenede Stater, 98107
        • Swedish Medical Center-Ballard Campus
      • Seattle, Washington, Forenede Stater, 98122
        • Swedish Medical Center-First Hill
      • Seattle, Washington, Forenede Stater, 98112
        • Kaiser Permanente Washington
      • Seattle, Washington, Forenede Stater, 98104
        • Pacific Gynecology Specialists
      • 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
      • Silverdale, Washington, Forenede Stater, 98383
        • Saint Joseph Medical Center Hematology and Oncology - Silverdale
      • Spokane, Washington, Forenede Stater, 99204
        • MultiCare Deaconess Cancer and Blood Specialty Center - Downtown
      • Spokane, Washington, Forenede Stater, 99218
        • MultiCare Deaconess Cancer and Blood Specialty Center - North
      • Spokane Valley, Washington, Forenede Stater, 99216
        • MultiCare Deaconess Cancer and Blood Specialty Center - Valley
      • Tacoma, Washington, Forenede Stater, 98405
        • 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
        • Tacoma/Valley Radiation Oncology Centers-Saint Joe's
      • Tacoma, Washington, Forenede Stater, 97405
        • Tacoma/Valley Radiation Oncology Centers-Jackson Hall
      • Tacoma, Washington, Forenede Stater, 98405
        • Franciscan Research Center-Northwest Medical Plaza
      • Vancouver, Washington, Forenede Stater, 98664
        • PeaceHealth Southwest Medical Center
      • Walla Walla, Washington, Forenede Stater, 99362
        • Providence Saint Mary Regional Cancer Center
      • Yakima, Washington, Forenede Stater, 98902
        • North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
      • Yelm, Washington, Forenede Stater, 98597
        • Providence Regional Cancer System-Yelm
    • Wisconsin
      • Antigo, Wisconsin, Forenede Stater, 54409
        • Langlade Hospital and Cancer Center
      • Appleton, Wisconsin, Forenede Stater, 54911
        • ThedaCare Regional Cancer Center
      • Appleton, Wisconsin, Forenede Stater, 54915
        • Ascension Saint Elizabeth Hospital
      • Ashland, Wisconsin, Forenede Stater, 54806
        • Duluth Clinic Ashland
      • Ashland, Wisconsin, Forenede Stater, 54806
        • Northwest Wisconsin Cancer Center
      • Brookfield, Wisconsin, Forenede Stater, 53045
        • Ascension Southeast Wisconsin Hospital - Elmbrook Campus
      • Burlington, Wisconsin, Forenede Stater, 53105
        • Aurora Cancer Care-Southern Lakes VLCC
      • Chilton, Wisconsin, Forenede Stater, 53014
        • Ascension Calumet Hospital
      • Eau Claire, Wisconsin, Forenede Stater, 54701
        • Marshfield Medical Center-EC Cancer Center
      • Eau Claire, Wisconsin, Forenede Stater, 54701
        • HSHS Sacred Heart Hospital
      • Fond du Lac, Wisconsin, Forenede Stater, 54937
        • Aurora Health Center-Fond du Lac
      • Franklin, Wisconsin, Forenede Stater, 53132
        • Ascension Saint Francis - Reiman Cancer Center
      • Franklin, Wisconsin, Forenede Stater, 53132
        • Ascension Southeast Wisconsin Hospital - Franklin
      • Germantown, Wisconsin, Forenede Stater, 53022
        • Aurora Health Care Germantown Health Center
      • Grafton, Wisconsin, Forenede Stater, 53024
        • Aurora Cancer Care-Grafton
      • Green Bay, Wisconsin, Forenede Stater, 54311
        • Aurora BayCare Medical Center
      • Green Bay, Wisconsin, Forenede Stater, 54301
        • Saint Vincent Hospital Cancer Center Green Bay
      • Green Bay, Wisconsin, Forenede Stater, 54303
        • Saint Vincent Hospital Cancer Center at Saint Mary's
      • Kenosha, Wisconsin, Forenede Stater, 53142
        • Aurora Cancer Care-Kenosha South
      • La Crosse, Wisconsin, Forenede Stater, 54601
        • Gundersen Lutheran Medical Center
      • La Crosse, Wisconsin, Forenede Stater, 54601
        • Mayo Clinic Health System-Franciscan Healthcare
      • Madison, Wisconsin, Forenede Stater, 53705
        • William S Middleton VA Medical Center
      • Madison, Wisconsin, Forenede Stater, 53792
        • University of Wisconsin Carbone Cancer Center - University Hospital
      • Madison, Wisconsin, Forenede Stater, 53715
        • SSM Health Dean Medical Group - South Madison Campus
      • Manitowoc, Wisconsin, Forenede Stater, 54221
        • Holy Family Memorial Hospital
      • Marinette, Wisconsin, Forenede Stater, 54143
        • Aurora Bay Area Medical Group-Marinette
      • Marshfield, Wisconsin, Forenede Stater, 54449
        • Marshfield Medical Center-Marshfield
      • Medford, Wisconsin, Forenede Stater, 54451
        • Aspirus Medford Hospital
      • Mequon, Wisconsin, Forenede Stater, 53097
        • Ascension Columbia Saint Mary's Hospital Ozaukee
      • Milwaukee, Wisconsin, Forenede Stater, 53226
        • Medical College of Wisconsin
      • Milwaukee, Wisconsin, Forenede Stater, 53209
        • Aurora Cancer Care-Milwaukee
      • Milwaukee, Wisconsin, Forenede Stater, 53215
        • Aurora Saint Luke's Medical Center
      • Milwaukee, Wisconsin, Forenede Stater, 53233
        • Aurora Sinai Medical Center
      • Milwaukee, Wisconsin, Forenede Stater, 53210
        • Ascension Southeast Wisconsin Hospital - Saint Joseph Campus
      • Milwaukee, Wisconsin, Forenede Stater, 53211
        • Ascension Columbia Saint Mary's Hospital - Milwaukee
      • Milwaukee, Wisconsin, Forenede Stater, 53215
        • Ascension Saint Francis Hospital
      • Minocqua, Wisconsin, Forenede Stater, 54548
        • Marshfield Medical Center - Minocqua
      • Mukwonago, Wisconsin, Forenede Stater, 53149
        • ProHealth D N Greenwald Center
      • New Berlin, Wisconsin, Forenede Stater, 53151
        • Froedtert and MCW Moorland Reserve Health Center
      • New Richmond, Wisconsin, Forenede Stater, 54017
        • Cancer Center of Western Wisconsin
      • Oconomowoc, Wisconsin, Forenede Stater, 53066
        • ProHealth Oconomowoc Memorial Hospital
      • Oconto Falls, Wisconsin, Forenede Stater, 54154
        • Saint Vincent Hospital Cancer Center at Oconto Falls
      • Oshkosh, Wisconsin, Forenede Stater, 54904
        • Ascension Mercy Hospital
      • Oshkosh, Wisconsin, Forenede Stater, 54904
        • Vince Lombardi Cancer Clinic - Oshkosh
      • Racine, Wisconsin, Forenede Stater, 53406
        • Aurora Cancer Care-Racine
      • Racine, Wisconsin, Forenede Stater, 53405
        • Ascension All Saints Hospital
      • Rhinelander, Wisconsin, Forenede Stater, 54501
        • Aspirus Cancer Care - James Beck Cancer Center
      • Rice Lake, Wisconsin, Forenede Stater, 54868
        • Marshfield Medical Center-Rice Lake
      • Sheboygan, Wisconsin, Forenede Stater, 53081
        • Vince Lombardi Cancer Clinic-Sheboygan
      • Sheboygan, Wisconsin, Forenede Stater, 53081
        • HSHS Saint Nicholas Hospital
      • Stevens Point, Wisconsin, Forenede Stater, 54482
        • Marshfield Medical Center-River Region at Stevens Point
      • Stevens Point, Wisconsin, Forenede Stater, 54481
        • Aspirus Cancer Care - Stevens Point
      • Sturgeon Bay, Wisconsin, Forenede Stater, 54235-1495
        • Saint Vincent Hospital Cancer Center at Sturgeon Bay
      • Summit, Wisconsin, Forenede Stater, 53066
        • Aurora Medical Center in Summit
      • Two Rivers, Wisconsin, Forenede Stater, 54241
        • Vince Lombardi Cancer Clinic-Two Rivers
      • Waukesha, Wisconsin, Forenede Stater, 53188
        • UW Cancer Center at ProHealth Care
      • Waukesha, Wisconsin, Forenede Stater, 53188
        • ProHealth Waukesha Memorial Hospital
      • Waupaca, Wisconsin, Forenede Stater, 54981
        • ThedaCare Cancer Care - Waupaca
      • Wausau, Wisconsin, Forenede Stater, 54401
        • Aspirus Regional Cancer Center
      • Wauwatosa, Wisconsin, Forenede Stater, 53226
        • Aurora Cancer Care-Milwaukee West
      • Wauwatosa, Wisconsin, Forenede Stater, 53226
        • Ascension Medical Group Southeast Wisconsin - Mayfair Road
      • West Allis, Wisconsin, Forenede Stater, 53227
        • Aurora West Allis Medical Center
      • Weston, Wisconsin, Forenede Stater, 54476
        • Marshfield Medical Center - Weston
      • Wisconsin Rapids, Wisconsin, Forenede Stater, 54494
        • Aspirus Cancer Care - Wisconsin Rapids
      • 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

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

61 år og ældre (Ældre voksen)

Tager imod sunde frivillige

Ingen

Beskrivelse

Inklusionskriterier:

  • KRITERIER FOR KVALIFIKATION AF FORREGISTRERING (TRIN 0)
  • Patienter skal have været diagnosticeret med kronisk lymfatisk leukæmi (CLL) (> 5000 B-celler pr. uL perifert blod på et hvilket som helst tidspunkt i løbet af deres sygdom) eller lille lymfatisk lymfom (SLL) med < 5000 B-celler pr. uL blod men med sygdomsassocieret lymfadenopati
  • Denne blodindsendelse er obligatorisk før registrering/randomisering for at udføre fluorescens in situ hybridisering (FISH) centralt, som vil blive brugt til stratificering. Den skal indhentes hurtigst muligt efter forhåndstilmelding
  • KRITERIER FOR BERETNING TIL REGISTRERING (TRIN 1)

  • Patienter skal diagnosticeres med CLL eller SLL i overensstemmelse med 2018 International Workshop on Chronic Lymfocytic Leukæmi (IWCLL), som omfatter alle følgende:

    • >= 5 x10^9 B-lymfocytter (5000/uL) i det perifere blod målt ved flowcytometri på et hvilket som helst tidspunkt i sygdomsforløbet eller mindre involvering af perifert blod, men sygdomsassocieret lymfadenopati
    • Ved lokal morfologisk gennemgang skal leukæmicellerne være små modne lymfocytter, og prolymfocytter må ikke overstige 55 % af blodlymfocytterne
    • Neoplastiske celler på immunfænotype (udført lokalt) skal afsløre en klonal B-cellepopulation, som udtrykker B-celleoverflademarkørerne for CD19 og CD20, samt T-celleantigenet CD5. Patienter med lys overflade-immunoglobulinekspression eller mangel på CD23-ekspression i >10 % af cellerne skal mangle t(11;14) translokation ved interfase cytogenetik

  • Patienter skal være mellem- eller højrisiko Rai-stadium CLL eller SLL

    • Mellemrisiko (tidligere stadium I/II) er defineret ved lymfadenopati og/eller hepatomegali eller splenomegali uden anæmi eller trombocytopeni
    • Høj risiko (tidligere stadium III/IV) er defineret ved splenomegali og/eller anæmi (hæmoglobin < 11g/dL), der ikke kan tilskrives autoimmun hæmolytisk anæmi og/eller trombocytopeni (blodplader [plt] < 100 x10^9/L), som ikke kan tilskrives autoimmun trombocytopeni

  • Patienter skal opfylde kriterier for behandling som defineret af 2018 IWCLL-retningslinjer, som omfatter mindst et af følgende kriterier:

    • Tegn på marvsvigt som manifesteret ved udvikling eller forværring af anæmi eller trombocytopeni (ikke tilskrives autoimmun hæmolytisk anæmi eller trombocytopeni)
    • Massiv (>= 6 cm under costal margin), progressiv eller symptomatisk splenomegali
    • Massive noder (>= 10 cm) eller progressiv eller symptomatisk lymfadenopati
    • Progressiv lymfocytose med en lymfocytfordoblingstid < 6 måneder eller en stigning på >= 50 % over en 2 måneders periode
    • Autoimmun anæmi og/eller trombocytopeni, der reagerer dårligt på standardbehandling
    • Symptomatisk eller funktionel ekstranodal involvering (f. hud, nyre, lunge, rygsøjle)

    • Konstitutionelle symptomer, som omfatter et af følgende:

      • Utilsigtet vægttab på 10 % eller mere inden for 6 måneder
      • Betydelig træthed
      • Feber > 100,5 grader Fahrenheit (F) i 2 uger eller mere uden tegn på infektion
      • Nattesved >= 1 måned uden tegn på infektion
  • Behandling med rituximab og/eller højdosis kortikosteroider for autoimmune komplikationer af CLL/SLL skal være afsluttet mindst 4 uger før indskrivning. Palliative steroider skal have en dosis på ikke højere end 20 mg/dag af prednison eller tilsvarende kortikosteroid på registreringstidspunktet
  • Alder >= 65 år
  • Eastern Cooperative Oncology Group (ECOG) præstationsstatus 0-2
  • Absolut neutrofiltal (ANC) >= 1.000/mm^3 undtagen hvis det skyldes knoglemarvspåvirkning
  • Blodpladetal (ikke-transfunderet) >= 30.000/mm^3 undtagen hvis det skyldes knoglemarvspåvirkning
  • Beregnet (beregnet) kreatininclearance >= 40 ml/min (af Cockcroft-Gault)
  • Bilirubin =< 1,5 x øvre normalgrænse (ULN), undtagen hvis det skyldes leverpåvirkning, hæmolyse eller Gilberts sygdom
  • Aspartataminotransferase (AST)/alaninaminotransferase (ALT) =< 2,5 x øvre normalgrænse (ULN), undtagen hvis det skyldes leverpåvirkning
  • Hvis tegn på kronisk hepatitis B virus (HBV) infektion, skal HBV viral belastning være upåviselig ved suppressiv behandling, hvis indiceret
  • Bemærk venligst: Intravenøs immunoglobulinbehandling (IVIG) kan forårsage en falsk positiv hepatitis B-serologi. Hvis patienter, der modtager rutine IVIG, har kerneantistof- eller overfladeantigenpositivitet uden tegn på aktiv viræmi (negativ hepatitis B-deoxyribonukleinsyre [DNA]), kan de stadig deltage i undersøgelsen, skal hepatitis-serologier og hepatitis B-DNA overvåges periodisk af den behandlende læge
  • Hvis en historie med hepatitis C-virus (HCV)-infektion, skal behandles med upåviselig HCV-virusbelastning
  • Humant immundefektvirus (HIV)-inficerede patienter i effektiv antiretroviral behandling med upåviselig viral belastning inden for 6 måneder er kvalificerede til dette forsøg
  • Central fluorescerende in situ hybridisering (FISH) blodresultater er obligatoriske før registrering/randomisering, da det vil blive brugt til stratificering
  • Patienter skal være i stand til at sluge kapsler og ikke have følgende tilstande: sygdom, der signifikant påvirker gastrointestinal absorption, resektion af mave eller tyndtarm, delvis eller fuldstændig tarmobstruktion
  • Patienter skal være i stand til at modtage enten en xanthinoxidasehæmmer eller rasburikase til profylakse/behandling af tumorlysissyndrom (TLS)
  • KRITERIER FOR OMREGISTRERING BERETNING (TRIN 2)
  • Afslutning af behandling gennem cyklus 14 dag 28, og forbliv på ibrutinib-behandling
  • Modtagelse af centrale BM MRD resultater
  • Responsvurdering afsluttet med CR-bestemmelse

Ekskluderingskriterier:

  • Patienter må ikke have haft tidligere behandling for CLL/SLL (undtagen palliative steroider eller behandling af autoimmune komplikationer af CLL med rituximab eller steroider)
  • Patienter må ikke have nogen historie med Richters transformation eller prolymfocytisk leukæmi (prolymfocytter i blod > 55 %)
  • Patienter med klasse III eller klasse IV hjertesvigt af New York Heart Association, dem med ustabil angina og dem med ukontrolleret arytmi er ikke kvalificerede
  • Patienter, der har haft et myokardieinfarkt, intrakraniel blødning eller slagtilfælde inden for de seneste 6 måneder, er ikke kvalificerede
  • Patienter må ikke modtage aktiv systemisk antikoagulering med heparin eller warfarin. Patienter på warfarin skal seponere lægemidlet i mindst 10 dage før registrering i undersøgelsen
  • Kronisk samtidig behandling med stærke hæmmere af CYP3A4/5 er ikke tilladt i denne undersøgelse. Patienter på stærke CYP3A-hæmmere skal seponere lægemidlet i 14 dage før registrering i undersøgelsen
  • Kronisk samtidig behandling med stærke CYP3A4/5-inducere er ikke tilladt. Patienter skal seponere lægemidlet 14 dage før registrering i undersøgelsen
  • Patienter må ikke kræve mere end 20 mg prednison eller tilsvarende kortikosteroid dagligt
  • Patienter må ikke have ukontrolleret aktiv systemisk infektion, der kræver intravenøs antibiotika
  • Patienter må ikke have en kendt allergi over for mannitol
  • Patienter må ikke tidligere have signifikant overfølsomhed over for rituximab (ikke inklusive infusionsreaktioner)
  • Patienter må ikke have gennemgået en større operation inden for 10 dage før registrering, eller mindre operation inden for 7 dage før registrering. Eksempler på mindre operationer omfatter tandkirurgi, indsættelse af en venøs adgangsanordning, hudbiopsi eller aspiration til et led. Beslutningen om, hvorvidt en operation er større eller mindre, kan træffes efter den behandlende læges skøn

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

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

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Arm I (ibrutinib, obinutuzumab)
Patienterne får ibrutinib PO QD på dag 1-28. Patienterne får også obinutuzumab IV på dag 1, 2, 8 og 15 i cyklus 1 og på dag 1 i cyklus 2-6. Behandlingen gentages hver 28. dag i op til 14 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Fra cyklus 15 modtager patienter ibrutinib PO QD hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.
Medicin: Ibrutinib
Givet PO
Andre navne:
  • PCI-32765
  • Imbruvica
  • BTK-hæmmer PCI-32765
  • CRA-032765
  • PCI32765
  • CRA 032765
  • CRA032765
  • PCI 32765
Biologisk: Obinutuzumab
Givet IV
Andre navne:
  • Gazyva
  • RO5072759
  • GA101
  • Anti-CD20 monoklonalt antistof R7159
  • GA-101
  • huMAB(CD20)
  • 7159 kr
  • RO 5072759
  • RO-5072759
  • GA 101
  • R-7159
Eksperimentel: Arm II (ibrutinib, obinutuzumab, venetoclax)
Patienterne får ibrutinib PO QD på dag 1-28. Patienterne får også obinutuzumab IV på dag 1, 2, 8 og 15 i cyklus 1 og på dag 1 i cyklus 2-6. Begyndende cyklus 3 får patienterne også venetoclax PO QD på dag 1-28. Behandlingen gentages hver 28. dag i 14 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Alle patienter vil derefter modtage en 15. cyklus af ibrutinib. Begyndende cyklus 16, patienter, som ikke opnår en BM MRD negativ CR, modtager ibrutinib PO QD hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienter, som opnår en BM MRD negativ CR, gennemgår observation hver 3. cyklus i 6 år, derefter hver 6. cyklus derefter.
Medicin: Venetoclax
Givet PO
Andre navne:
  • Venclexta
  • ABT-0199
  • ABT-199
  • ABT199
  • GDC-0199
  • RG7601
  • Venclyxto
  • ABT 199
  • GDC 0199
  • GDC0199
Medicin: Ibrutinib
Givet PO
Andre navne:
  • PCI-32765
  • Imbruvica
  • BTK-hæmmer PCI-32765
  • CRA-032765
  • PCI32765
  • CRA 032765
  • CRA032765
  • PCI 32765
Biologisk: Obinutuzumab
Givet IV
Andre navne:
  • Gazyva
  • RO5072759
  • GA101
  • Anti-CD20 monoklonalt antistof R7159
  • GA-101
  • huMAB(CD20)
  • 7159 kr
  • RO 5072759
  • RO-5072759
  • GA 101
  • R-7159
Andet: Observationsaktivitet
Gennemgå observation
Andre navne:
  • Observation

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Progressionfri overlevelse (PFS)
Tidsramme: 5 år
PFS vil blive sammenlignet mellem de eksperimentelle og kontrollerede behandlingsstrategigrupper ved brug af en stratificeret log-rank test (stratificeret på Rai-stadie, mellemliggende versus [vs.] højt, og del(17p13.1) ved fluorescens in situ hybridisering [FISH], til stede vs. fraværende). Kaplan-Meier-metoden vil blive anvendt til at estimere PFS-fordelinger. Femårige PFS-estimater og tilsvarende hazard ratios vil blive angivet med 95% konfidensintervaller for hver behandlingsstrategi.
5 år

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Knoglemarv (BM) Minimal Resterende Sygdom (MRD) - Komplet respons (CR)-rate
Tidsramme: Op til 10 år
BM MRD- CR-frekvensen vil blive beregnet og estimeret ved at bruge antallet af patienter, der opfylder BM MRD- CR-kriterierne, divideret med det samlede antal patienter, der er randomiseret til hver af behandlingsgrupperne. Den stratificerede Cochran-Mantel-Haenszel-test vil blive anvendt til at sammenligne BM MRD- CR-frekvenserne mellem behandlingsgrupperne (stratificeret på Rai-stadie, mellem vs. høj, og del(17p13.1) ved FISH, til stede vs. fraværende).
Op til 10 år
Overlevelse (OS)
Tidsramme: Fra randomiseringsdato indtil død af enhver årsag, vurderet op til 10 år
Kaplan-Meier-metoden vil blive brugt til at estimere OS-fordelingen for hver behandlingsstrategi. Estimatet ved 5 år vil blive beregnet med tilsvarende 95% konfidensintervaller, og forskelle i disse estimater mellem behandlingsstrategierne vil blive testet ved hjælp af en stratificeret chi-i-anden-test baseret på den komplementære log-log-transformation af Kaplan-Meier-estimaterne. Sammenligninger i OS-kurver mellem eksperimentelle og kontrolbehandlingsstrategier vil bruge en stratificeret log-rank-test (stratificeret på Rai-stadie, intermediært vs. højt, og del(17p13.1) ved FISH, til stede vs. fraværende). Hazard ratioer med 95% konfidensintervaller vil blive estimeret fra den tilsvarende, stratificerede proportional hazards-model.
Fra randomiseringsdato indtil død af enhver årsag, vurderet op til 10 år
Forekomst af bivirkninger
Tidsramme: Op til 10 år
Vil blive defineret som bivirkninger, der er klassificeret som enten muligvis, sandsynligvis eller definitivt relateret til undersøgelsesbehandlingen, graderet efter National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0.
Hyppighed og sværhedsgrad af bivirkninger samt tolerabiliteten for hver behandlingsstrategigruppe vil blive opsummeret ved hjælp af beskrivende statistik.
Den maksimale grad for hver type toksicitet vil blive registreret for hver patient, og frekvenstabeller vil blive gennemgået for at fastslå toksicitetsmønstre.
Forekomsten af svære (grad 3+) bivirkninger eller toksiciteter vil blive beskrevet.
Op til 10 år

Samarbejdspartnere og efterforskere

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

Sponsor

National Cancer Institute (NCI)

Efterforskere

  • Ledende efterforsker: Jennifer A Woyach, Alliance for Clinical Trials in Oncology

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)

31. januar 2019

Primær færdiggørelse (Faktiske)

17. januar 2025

Studieafslutning (Anslået)

29. december 2026

Datoer for studieregistrering

Først indsendt

9. november 2018

Først indsendt, der opfyldte QC-kriterier

9. november 2018

Først opslået (Faktiske)

13. november 2018

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

15. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

12. juni 2026

Sidst verificeret

1. januar 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • NCI-2018-02485 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
  • U10CA180821 (U.S. NIH-bevilling/kontrakt)
  • A041702 (Anden identifikator: CTEP)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

NCI er forpligtet til at dele data i overensstemmelse med NIHs politik. For flere detaljer om, hvordan kliniske forsøgsdata deles, skal du gå til linket til NIH-siden for datadelingspolitik

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

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

Kliniske forsøg med Kronisk lymfatisk leukæmi

Kliniske forsøg med Venetoclax

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Poland

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

Abonner