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Immunterapi (Nivolumab eller Brentuximab Vedotin) plus kombinationskemoterapi til behandling af patienter med nydiagnosticeret trin III-IV klassisk Hodgkin-lymfom

17. april 2024 opdateret af: National Cancer Institute (NCI)

En fase III, randomiseret undersøgelse af Nivolumab (Opdivo) Plus AVD eller Brentuximab Vedotin (Adcetris) Plus AVD hos patienter (alder >/= 12 år) med nyligt diagnosticeret klassisk Hodgkin-lymfom i avanceret stadium

Dette fase III-forsøg sammenligner immunterapilægemidler (nivolumab eller brentuximab vedotin), når det gives med kombinationskemoterapi til behandling af patienter med nyligt diagnosticeret stadium III eller IV klassisk Hodgkin-lymfom. Immunterapi med monoklonale antistoffer, såsom nivolumab, kan hjælpe kroppens immunsystem med at angribe kræften og kan forstyrre tumorcellernes evne til at vokse og sprede sig. Brentuximab vedotin er et monoklonalt antistof, brentuximab, forbundet med et giftigt middel kaldet vedotin. Brentuximab binder sig til kræftceller på en målrettet måde og leverer vedotin for at dræbe dem. Kemoterapimedicin, såsom doxorubicin, vinblastin og dacarbazin, virker på forskellige måder for at stoppe væksten af ​​kræftceller, enten ved at dræbe cellerne, ved at stoppe dem i at dele sig eller ved at stoppe dem i at sprede sig. Tilføjelse af nivolumab eller brentuximab vedotin til kombinationskemoterapi kan formindske kræften eller forlænge tiden, uden at sygdomssymptomer kommer tilbage.

Studieoversigt

Status

Aktiv, ikke rekrutterende

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

PRIMÆR MÅL:

I. At sammenligne den progressionsfrie overlevelse (PFS) hos patienter med nyligt diagnosticeret fremskredent stadium klassisk Hodgkin lymfom randomiseret til N-AVD (nivolumab, doxorubicin hydrochlorid [doxorubicin], vinblastinsulfat [vinblastin], dacarbazin) versus det opnået med BV- AVD (brentuximab vedotin, doxorubicin, vinblastin, dacarbazin).

SEKUNDÆRE MÅL:

I. At sammenligne overordnet overlevelse (OS) hos patienter randomiseret til N-AVD versus BV-AVD.

II. At sammenligne hændelsesfri overlevelse (EFS) hos patienter randomiseret til N-AVD versus BV-AVD.

III. At sammenligne den metaboliske fuldstændige respons (CR) rate ved slutningen af ​​behandlingen hos patienter randomiseret til N-AVD versus BV-AVD.

IV. At sammenligne de lægerapporterede behandlingsrelaterede bivirkninger mellem arme stratificeret efter aldersgrupper.

V. At sammenligne patientrapporterede symptomer ved hjælp af udvalgte Patient Reported Outcome Common Toxicity Criteria for Adverse Events (PRO-CTCAE) elementer mellem arme stratificeret efter aldersgrupper.

VI. At sammenligne sikkerheden og tolerabiliteten af ​​N-AVD versus BV-AVD.

LIVSKVALITET MÅL:

I. At sammenligne mellem patientrapporteret træthed i armene, neuropati og sundhedsrelateret livskvalitet over tid (baseline, begyndelsen af ​​cyklus 3, 4-8 uger efter den sidste dosis af protokolbehandling [efter sidste dosis af studielægemidlet eller strålebehandling] , alt efter hvad der er senere], og 1 og 3 år efter randomisering) ved hjælp af Patient Reported Outcomes Measurement Information System (PROMIS)-træthed, den funktionelle vurdering af kræftterapi/gynækologisk onkologi gruppe-neurotoksicitet (FACT/GOG-Ntx) og PROMIS Global, hhv.

BANKENS MÅL:

I. Til bankprøver til fremtidige korrelative undersøgelser. II. At banke positron emission tomografi (PET)-computertomografi (CT) billeder til fremtidige korrelative undersøgelser.

OVERSIGT: Patienterne randomiseres til 1 af 2 arme.

ARM I: Patienter får doxorubicinhydrochlorid intravenøst ​​(IV), vinblastinsulfat IV, dacarbazin IV og nivolumab IV over 30 minutter på dag 1 og 15. Patienter kan få pegfilgrastim subkutant (SC) på dag 2 og 16, eller filgrastim SC eller IV på dag 6-10 og 21-25. Behandlingen gentages hver 28. dag i 6 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Efter afslutning af cyklus 6 kan patienter modtage strålebehandling 5 dage om ugen i ca. 4 uger efter den behandlende læges skøn.

ARM II: Patienter får doxorubicinhydrochlorid IV, vinblastinsulfat IV, dacarbazin IV og brentuximab vedotin IV over 30 minutter på dag 1 og 15. Patienter kan få pegfilgrastim SC på dag 2 og 16, eller filgrastim SC eller IV på dag 6-10 og 21-25. Behandlingen gentages hver 28. dag i 6 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Efter afslutning af cyklus 6 kan patienter modtage strålebehandling 5 dage om ugen i ca. 4 uger efter den behandlende læges skøn.

Efter afslutning af undersøgelsesbehandling og forud for sygdomsprogression følges patienterne hver 3. måned det første år, hver 6. måned i år 2 og 3, derefter årligt indtil 10 år efter registrering. Patienterne følges op på progressionstidspunktet og derefter årligt indtil 10 år efter registreringen. Patienter, der får strålebehandling, følges op 8-12 uger efter afsluttet strålebehandling.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

995

Fase

  • Fase 3

Kontakter og lokationer

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

Studiesteder

  • Canada
      • Quebec, Canada, G1V 4G2
        • CHU de Quebec-Centre Hospitalier de l'Universite Laval (CHUL)
    • British Columbia
      • Vancouver, British Columbia, Canada, V5Z 4E6
        • BCCA-Vancouver Cancer Centre
      • Victoria, British Columbia, Canada, V8R 6V5
        • BCCA-Vancouver Island Cancer Centre
    • New Brunswick
      • Saint John, New Brunswick, Canada, E2L 4L2
        • Atlantic Health Sciences Corporation-Saint John Regional Hospital
    • Nova Scotia
      • Halifax, Nova Scotia, Canada, B3H 2Y9
        • QEII Health Sciences Centre/Nova Scotia Health Authority
    • Ontario
      • Brampton, Ontario, Canada, L6R 3J7
        • William Osler Health System-Brampton Civic Hospital
      • Kingston, Ontario, Canada, K7L 2V7
        • Kingston Health Sciences Centre
      • Ottawa, Ontario, Canada, K1H 8L6
        • Ottawa Hospital and Cancer Center-General Campus
      • Toronto, Ontario, Canada, M5G 1X8
        • Hospital for Sick Children
      • Toronto, Ontario, Canada, M5G 2M9
        • University Health Network-Princess Margaret Hospital
    • Quebec
      • Montreal, Quebec, Canada, H3H 1P3
        • The Montreal Children's Hospital of the MUHC
      • Montreal, Quebec, Canada, H3H 2R9
        • The Research Institute of the McGill University Health Centre (MUHC)
      • Montreal, Quebec, Canada, H3T 1C5
        • Centre Hospitalier Universitaire Sainte-Justine
      • Quebec City, Quebec, Canada, G1J 1Z4
        • CHA Hopital L'Enfant-Jesus
    • Saskatchewan
      • Regina, Saskatchewan, Canada, S4T 7T1
        • Allan Blair Cancer Centre
  • Forenede Stater
    • Alabama
      • Birmingham, Alabama, Forenede Stater, 35233
        • University of Alabama at Birmingham Cancer Center
      • Birmingham, Alabama, Forenede Stater, 35233
        • Children's Hospital of Alabama
      • Mobile, Alabama, Forenede Stater, 36604
        • USA Health Strada Patient Care Center
      • Mobile, Alabama, Forenede Stater, 36688
        • University of South Alabama Mitchell Cancer Institute
    • 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
      • Fairbanks, Alaska, Forenede Stater, 99701
        • Fairbanks Memorial Hospital
    • Arizona
      • Goodyear, Arizona, Forenede Stater, 85338
        • CTCA at Western Regional Medical Center
      • Phoenix, Arizona, Forenede Stater, 85004
        • Cancer Center at Saint Joseph's
      • Phoenix, Arizona, Forenede Stater, 85016
        • Phoenix Childrens Hospital
      • 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
      • Jonesboro, Arkansas, Forenede Stater, 72401
        • NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
      • Little Rock, Arkansas, Forenede Stater, 72205
        • University of Arkansas for Medical Sciences
      • Little Rock, Arkansas, Forenede Stater, 72202-3591
        • Arkansas Children's Hospital
    • California
      • Anaheim, California, Forenede Stater, 92806
        • Kaiser Permanente-Anaheim
      • Antioch, California, Forenede Stater, 94531
        • Kaiser Permanente-Deer Valley Medical Center
      • Arroyo Grande, California, Forenede Stater, 93420
        • PCR Oncology
      • Baldwin Park, California, Forenede Stater, 91706
        • Kaiser Permanente-Baldwin Park
      • Bellflower, California, Forenede Stater, 90706
        • Kaiser Permanente-Bellflower
      • Beverly Hills, California, Forenede Stater, 90211
        • Tower Cancer Research Foundation
      • Burbank, California, Forenede Stater, 91505
        • Providence Saint Joseph Medical Center/Disney Family Cancer Center
      • Duarte, California, Forenede Stater, 91010
        • City of Hope Comprehensive Cancer Center
      • Dublin, California, Forenede Stater, 94568
        • Kaiser Permanente Dublin
      • Fontana, California, Forenede Stater, 92335
        • Kaiser Permanente-Fontana
      • Fremont, California, Forenede Stater, 94538
        • Kaiser Permanente-Fremont
      • Fresno, California, Forenede Stater, 93720
        • Kaiser Permanente-Fresno
      • Harbor City, California, Forenede Stater, 90710
        • Kaiser Permanente - Harbor City
      • Irvine, California, Forenede Stater, 92618
        • Kaiser Permanente-Irvine
      • La Jolla, California, Forenede Stater, 92093
        • UC San Diego Moores Cancer Center
      • Loma Linda, California, Forenede Stater, 92354
        • Loma Linda University Medical Center
      • Los Angeles, California, Forenede Stater, 90027
        • Children's Hospital Los Angeles
      • Los Angeles, California, Forenede Stater, 90027
        • Kaiser Permanente Los Angeles Medical Center
      • Los Angeles, California, Forenede Stater, 90048
        • Cedars Sinai Medical Center
      • Los Angeles, California, Forenede Stater, 90034
        • Kaiser Permanente West Los Angeles
      • Madera, California, Forenede Stater, 93636
        • Valley Children's Hospital
      • Marysville, California, Forenede Stater, 95901
        • Fremont - Rideout Cancer Center
      • Modesto, California, Forenede Stater, 95356
        • Kaiser Permanente-Modesto
      • Oakland, California, Forenede Stater, 94611
        • Kaiser Permanente-Oakland
      • Ontario, California, Forenede Stater, 91761
        • Kaiser Permanente-Ontario
      • Orange, California, Forenede Stater, 92868
        • UC Irvine Health/Chao Family Comprehensive Cancer Center
      • Orange, California, Forenede Stater, 92868
        • Children's Hospital of Orange County
      • 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
      • Richmond, California, Forenede Stater, 94801
        • Kaiser Permanente-Richmond
      • Riverside, California, Forenede Stater, 92505
        • Kaiser Permanente-Riverside
      • Sacramento, California, Forenede Stater, 95816
        • Sutter Medical Center Sacramento
      • Sacramento, California, Forenede Stater, 95817
        • University of California Davis Comprehensive Cancer Center
      • Sacramento, California, Forenede Stater, 95814
        • Kaiser Permanente Downtown Commons
      • Sacramento, California, Forenede Stater, 95823
        • Kaiser Permanente-South Sacramento
      • San Diego, California, Forenede Stater, 92123
        • Rady Children's Hospital - San Diego
      • San Diego, California, Forenede Stater, 92120
        • Kaiser Permanente-San Diego Zion
      • San Diego, California, Forenede Stater, 92134
        • Naval Medical Center -San Diego
      • San Francisco, California, Forenede Stater, 94115
        • Kaiser Permanente-San Francisco
      • San Francisco, California, Forenede Stater, 94158
        • UCSF Medical Center-Mission Bay
      • San Jose, California, Forenede Stater, 95119
        • Kaiser Permanente-Santa Teresa-San Jose
      • San Leandro, California, Forenede Stater, 94577
        • Kaiser Permanente San Leandro
      • San Luis Obispo, California, Forenede Stater, 93401
        • Pacific Central Coast Health Center-San Luis Obispo
      • San Marcos, California, Forenede Stater, 92078
        • Kaiser Permanente-San Marcos
      • San Rafael, California, Forenede Stater, 94903
        • Kaiser San Rafael-Gallinas
      • Santa Maria, California, Forenede Stater, 93444
        • Mission Hope Medical Oncology - Santa Maria
      • Santa Rosa, California, Forenede Stater, 95403
        • Kaiser Permanente-Santa Rosa
      • South San Francisco, California, Forenede Stater, 94080
        • Kaiser Permanente-South San Francisco
      • Stockton, California, Forenede Stater, 95210
        • Kaiser Permanente-Stockton
      • Torrance, California, Forenede Stater, 90502
        • Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
      • Vacaville, California, Forenede Stater, 95688
        • Kaiser Permanente Medical Center-Vacaville
      • Vallejo, California, Forenede Stater, 94589
        • Kaiser Permanente-Vallejo
      • Walnut Creek, California, Forenede Stater, 94596
        • Kaiser Permanente-Walnut Creek
      • Whittier, California, Forenede Stater, 90602
        • Presbyterian Intercommunity Hospital
      • Woodland Hills, California, Forenede Stater, 91367
        • Kaiser Permanente-Woodland Hills
    • Colorado
      • Aurora, Colorado, Forenede Stater, 80045
        • Children's Hospital 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
        • UCHealth University of Colorado Hospital
      • Boulder, Colorado, Forenede Stater, 80301
        • Boulder Community Hospital
      • Boulder, Colorado, Forenede Stater, 80303
        • Boulder Community Foothills Hospital
      • Boulder, Colorado, Forenede Stater, 80304
        • Rocky Mountain Cancer Centers-Boulder
      • Colorado Springs, Colorado, Forenede Stater, 80907
        • Penrose-Saint Francis Healthcare
      • Colorado Springs, Colorado, Forenede Stater, 80907
        • Rocky Mountain Cancer Centers-Penrose
      • Denver, Colorado, Forenede Stater, 80210
        • Porter Adventist Hospital
      • Denver, Colorado, Forenede Stater, 80205
        • Kaiser Permanente-Franklin
      • Denver, Colorado, Forenede Stater, 80218
        • Presbyterian - Saint Lukes Medical Center - Health One
      • Denver, Colorado, Forenede Stater, 80218
        • Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center
      • Denver, Colorado, Forenede Stater, 80218
        • SCL Health Saint Joseph Hospital
      • Englewood, Colorado, Forenede Stater, 80113
        • Mountain Blue Cancer Care Center - Swedish
      • Englewood, Colorado, Forenede Stater, 80113
        • Swedish Medical Center
      • Grand Junction, Colorado, Forenede Stater, 81501
        • Saint Mary's Hospital and Regional Medical Center
      • Greeley, Colorado, Forenede Stater, 80631
        • North Colorado Medical Center
      • Lafayette, Colorado, Forenede Stater, 80026
        • Kaiser Permanente-Rock Creek
      • Lakewood, Colorado, Forenede Stater, 80228
        • Saint Anthony Hospital
      • Littleton, Colorado, Forenede Stater, 80120
        • Rocky Mountain Cancer Centers-Littleton
      • Littleton, Colorado, Forenede Stater, 80122
        • Littleton Adventist Hospital
      • Lone Tree, Colorado, Forenede Stater, 80124
        • Kaiser Permanente-Lone Tree
      • Lone Tree, Colorado, Forenede Stater, 80124
        • Sky Ridge Medical Center
      • Longmont, Colorado, Forenede Stater, 80501
        • Longmont United Hospital
      • Loveland, Colorado, Forenede Stater, 80539
        • McKee Medical Center
      • Parker, Colorado, Forenede Stater, 80138
        • Parker Adventist Hospital
      • Pueblo, Colorado, Forenede Stater, 81004
        • Saint Mary Corwin Medical Center
      • Thornton, Colorado, Forenede Stater, 80260
        • Rocky Mountain Cancer Centers-Thornton
      • Wheat Ridge, Colorado, Forenede Stater, 80033
        • SCL Health Lutheran Medical Center
    • Connecticut
      • Derby, Connecticut, Forenede Stater, 06418
        • Smilow Cancer Hospital-Derby Care Center
      • Hartford, Connecticut, Forenede Stater, 06106
        • Connecticut Children's Medical Center
      • New Haven, Connecticut, Forenede Stater, 06520
        • Yale University
      • New Haven, Connecticut, Forenede Stater, 06510
        • Smilow Cancer Center/Yale-New Haven Hospital
      • Orange, Connecticut, Forenede Stater, 06477
        • Smilow Cancer Hospital-Orange Care Center
      • Trumbull, Connecticut, Forenede Stater, 06611
        • Smilow Cancer Hospital Care Center-Trumbull
      • Waterford, Connecticut, Forenede Stater, 06385
        • Smilow Cancer Hospital Care Center - Waterford
    • Delaware
      • Frankford, Delaware, Forenede Stater, 19945
        • Beebe South Coastal Health Campus
      • Lewes, Delaware, Forenede Stater, 19958
        • Beebe Medical Center
      • Newark, Delaware, Forenede Stater, 19713
        • Helen F Graham Cancer Center
      • Newark, Delaware, Forenede Stater, 19713
        • Delaware Clinical and Laboratory Physicians PA
      • Newark, Delaware, Forenede Stater, 19713
        • Medical Oncology Hematology Consultants PA
      • Newark, Delaware, Forenede Stater, 19718
        • Christiana Care Health System-Christiana Hospital
      • Rehoboth Beach, Delaware, Forenede Stater, 19971
        • Beebe Health Campus
      • Seaford, Delaware, Forenede Stater, 19973
        • TidalHealth Nanticoke / Allen Cancer Center
      • Wilmington, Delaware, Forenede Stater, 19803
        • Alfred I duPont Hospital for Children
    • District of Columbia
      • Washington, District of Columbia, Forenede Stater, 20010
        • Children's National Medical Center
      • Washington, District of Columbia, Forenede Stater, 20007
        • MedStar Georgetown University Hospital
    • Florida
      • Coral Gables, Florida, Forenede Stater, 33146
        • UM Sylvester Comprehensive Cancer Center at Coral Gables
      • Fort Lauderdale, Florida, Forenede Stater, 33316
        • Broward Health Medical Center
      • Fort Myers, Florida, Forenede Stater, 33905
        • Regional Cancer Center-Lee Memorial Health System
      • Fort Myers, Florida, Forenede Stater, 33908
        • Golisano Children's Hospital of Southwest Florida
      • Gainesville, Florida, Forenede Stater, 32610
        • University of Florida Health Science Center - Gainesville
      • Hollywood, Florida, Forenede Stater, 33021
        • Memorial Regional Hospital/Joe DiMaggio Children's Hospital
      • Hollywood, Florida, Forenede Stater, 33021
        • UM Sylvester Comprehensive Cancer Center at Hollywood
      • Jacksonville, Florida, Forenede Stater, 32207
        • Nemours Children's Clinic-Jacksonville
      • Loxahatchee Groves, Florida, Forenede Stater, 33470
        • Palms West Radiation Therapy
      • Miami, Florida, Forenede Stater, 33155
        • Nicklaus Children's Hospital
      • Miami, Florida, Forenede Stater, 33136
        • University of Miami Miller School of Medicine-Sylvester Cancer Center
      • Miami, Florida, Forenede Stater, 33176
        • Miami Cancer Institute
      • Miami Beach, Florida, Forenede Stater, 33140
        • Mount Sinai Medical Center
      • Orlando, Florida, Forenede Stater, 32806
        • Orlando Health Cancer Institute
      • Orlando, Florida, Forenede Stater, 32827
        • Nemours Children's Hospital
      • Pensacola, Florida, Forenede Stater, 32504
        • Sacred Heart Hospital
      • Saint Petersburg, Florida, Forenede Stater, 33701
        • Johns Hopkins All Children's Hospital
      • Tampa, Florida, Forenede Stater, 33612
        • Moffitt Cancer Center
      • Tampa, Florida, Forenede Stater, 33607
        • Moffitt Cancer Center-International Plaza
      • Tampa, Florida, Forenede Stater, 33607
        • Saint Joseph's Hospital/Children's Hospital-Tampa
      • Tampa, Florida, Forenede Stater, 33612
        • Moffitt Cancer Center - McKinley Campus
      • West Palm Beach, Florida, Forenede Stater, 33407
        • Saint Mary's Hospital
    • Georgia
      • Atlanta, Georgia, Forenede Stater, 30322
        • Emory University Hospital/Winship Cancer Institute
      • Atlanta, Georgia, Forenede Stater, 30342
        • Emory Saint Joseph's Hospital
      • Atlanta, Georgia, Forenede Stater, 30322
        • Children's Healthcare of Atlanta - Egleston
      • Augusta, Georgia, Forenede Stater, 30912
        • Augusta University Medical Center
      • Savannah, Georgia, Forenede Stater, 31404
        • Memorial Health University Medical Center
    • Hawaii
      • 'Aiea, Hawaii, Forenede Stater, 96701
        • Pali Momi Medical Center
      • 'Aiea, Hawaii, Forenede Stater, 96701
        • Queen's Cancer Center - Pearlridge
      • 'Aiea, Hawaii, Forenede Stater, 96701
        • The Cancer Center of Hawaii-Pali Momi
      • 'Aiea, Hawaii, Forenede Stater, 96701
        • Hawaii Cancer Care - Westridge
      • 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
      • Lihue, Hawaii, Forenede Stater, 96766
        • Wilcox Memorial Hospital and Kauai Medical Clinic
    • 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
      • Fruitland, Idaho, Forenede Stater, 83619
        • Saint Luke's Cancer Institute - Fruitland
      • Meridian, Idaho, Forenede Stater, 83642
        • Idaho Urologic Institute-Meridian
      • Meridian, Idaho, Forenede Stater, 83642
        • Saint Luke's Cancer Institute - Meridian
      • Nampa, Idaho, Forenede Stater, 83686
        • Saint Luke's Cancer Institute - Nampa
      • Nampa, Idaho, Forenede Stater, 83687
        • Saint Alphonsus Cancer Care Center-Nampa
      • Post Falls, Idaho, Forenede Stater, 83854
        • Kootenai Clinic Cancer Services - Post Falls
      • Twin Falls, Idaho, Forenede Stater, 83301
        • Saint Luke's Cancer Institute - Twin Falls
    • Illinois
      • Aurora, Illinois, Forenede Stater, 60504
        • Rush - Copley Medical Center
      • Bloomington, Illinois, Forenede Stater, 61704
        • Illinois CancerCare-Bloomington
      • Canton, Illinois, Forenede Stater, 61520
        • Illinois CancerCare-Canton
      • Carbondale, Illinois, Forenede Stater, 62902
        • Memorial Hospital of Carbondale
      • Carterville, Illinois, Forenede Stater, 62918
        • SIH Cancer Institute
      • Carthage, Illinois, Forenede Stater, 62321
        • Illinois CancerCare-Carthage
      • Centralia, Illinois, Forenede Stater, 62801
        • Centralia Oncology Clinic
      • Chicago, Illinois, Forenede Stater, 60611
        • Northwestern University
      • Chicago, Illinois, Forenede Stater, 60612
        • Rush University Medical Center
      • Chicago, Illinois, Forenede Stater, 60637
        • University of Chicago Comprehensive Cancer Center
      • Chicago, Illinois, Forenede Stater, 60612
        • University of Illinois
      • 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
      • Hinsdale, Illinois, Forenede Stater, 60521
        • AMITA Health Cancer Institute and Outpatient Center
      • Joliet, Illinois, Forenede Stater, 60435
        • Duly Health and Care Joliet
      • 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
      • Mount Vernon, Illinois, Forenede Stater, 62864
        • Good Samaritan Regional Health Center
      • New Lenox, Illinois, Forenede Stater, 60451
        • UC Comprehensive Cancer Center at Silver Cross
      • O'Fallon, Illinois, Forenede Stater, 62269
        • Cancer Care Center of O'Fallon
      • Oak Lawn, Illinois, Forenede Stater, 60453
        • Advocate Children's Hospital-Oak Lawn
      • Orland Park, Illinois, Forenede Stater, 60462
        • University of Chicago Medicine-Orland Park
      • Ottawa, Illinois, Forenede Stater, 61350
        • Illinois CancerCare-Ottawa Clinic
      • Park Ridge, Illinois, Forenede Stater, 60068
        • Advocate Children's Hospital-Park Ridge
      • Pekin, Illinois, Forenede Stater, 61554
        • Illinois CancerCare-Pekin
      • Pekin, Illinois, Forenede Stater, 61554
        • OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
      • Peoria, Illinois, Forenede Stater, 61636
        • Methodist Medical Center of Illinois
      • Peoria, Illinois, Forenede Stater, 61637
        • OSF Saint Francis Medical Center
      • Peoria, Illinois, Forenede Stater, 61615
        • Illinois CancerCare-Peoria
      • Peoria, Illinois, Forenede Stater, 61615
        • OSF Saint Francis Radiation Oncology at Peoria Cancer Center
      • Peru, Illinois, Forenede Stater, 61354
        • Illinois CancerCare-Peru
      • Peru, Illinois, Forenede Stater, 61354
        • Valley Radiation Oncology
      • Princeton, Illinois, Forenede Stater, 61356
        • Illinois CancerCare-Princeton
      • Springfield, Illinois, Forenede Stater, 62781
        • Memorial Medical Center
      • Springfield, Illinois, Forenede Stater, 62702
        • Southern Illinois University School of Medicine
      • Springfield, Illinois, Forenede Stater, 62702
        • Springfield Clinic
      • Swansea, Illinois, Forenede Stater, 62226
        • Southwest Illinois Health Services LLP
      • Urbana, Illinois, Forenede Stater, 61801
        • Carle Cancer Center
      • Urbana, Illinois, Forenede Stater, 61801
        • The Carle Foundation Hospital
      • Warrenville, Illinois, Forenede Stater, 60555
        • Northwestern Medicine Cancer Center Warrenville
      • Washington, Illinois, Forenede Stater, 61571
        • Illinois CancerCare - Washington
    • Indiana
      • Fort Wayne, Indiana, Forenede Stater, 46845
        • Parkview Regional Medical Center
      • Indianapolis, Indiana, Forenede Stater, 46202
        • Indiana University/Melvin and Bren Simon Cancer Center
      • Indianapolis, Indiana, Forenede Stater, 46202
        • Riley Hospital for Children
      • Indianapolis, Indiana, Forenede Stater, 46260
        • Ascension Saint Vincent Indianapolis Hospital
    • Iowa
      • Ames, Iowa, Forenede Stater, 50010
        • McFarland Clinic - Ames
      • Carroll, Iowa, Forenede Stater, 51401
        • Saint Anthony Regional Hospital
      • Cedar Rapids, Iowa, Forenede Stater, 52403
        • Mercy Hospital
      • Cedar Rapids, Iowa, Forenede Stater, 52403
        • Oncology Associates at Mercy Medical Center
      • Clive, Iowa, Forenede Stater, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Forenede Stater, 50325
        • Medical Oncology and Hematology Associates-West Des Moines
      • Creston, Iowa, Forenede Stater, 50801
        • Greater Regional Medical Center
      • Des Moines, Iowa, Forenede Stater, 50309
        • Iowa Methodist Medical Center
      • Des Moines, Iowa, Forenede Stater, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Forenede Stater, 50309
        • Blank Children's Hospital
      • Des Moines, Iowa, Forenede Stater, 50309
        • Medical Oncology and Hematology Associates-Des Moines
      • Des Moines, Iowa, Forenede Stater, 50314
        • Broadlawns Medical Center
      • Des Moines, Iowa, Forenede Stater, 50314
        • Mission Cancer and Blood - Laurel
      • Des Moines, Iowa, Forenede Stater, 50316
        • Iowa Lutheran Hospital
      • Iowa City, Iowa, Forenede Stater, 52242
        • University of Iowa/Holden Comprehensive Cancer Center
      • West Des Moines, Iowa, Forenede Stater, 50266-7700
        • Methodist West Hospital
      • West Des Moines, Iowa, Forenede Stater, 50266
        • Mercy Medical Center-West Lakes
    • Kansas
      • Garden City, Kansas, Forenede Stater, 67846
        • Central Care Cancer Center - Garden City
      • Great Bend, Kansas, Forenede Stater, 67530
        • Central Care Cancer Center - Great Bend
      • Kansas City, Kansas, Forenede Stater, 66160
        • University of Kansas Cancer Center
      • Kansas City, Kansas, Forenede Stater, 66112
        • University of Kansas Cancer Center-West
      • Overland Park, Kansas, Forenede Stater, 66210
        • University of Kansas Cancer Center-Overland Park
      • Westwood, Kansas, Forenede Stater, 66205
        • University of Kansas Hospital-Westwood Cancer Center
    • Kentucky
      • Lexington, Kentucky, Forenede Stater, 40536
        • University of Kentucky/Markey Cancer Center
      • Lexington, Kentucky, Forenede Stater, 40504
        • Saint Joseph Radiation Oncology Resource Center
      • Lexington, Kentucky, Forenede Stater, 40509
        • Saint Joseph Hospital East
      • Louisville, Kentucky, Forenede Stater, 40202
        • Jewish Hospital
      • Louisville, Kentucky, Forenede Stater, 40202
        • Norton Children's Hospital
      • Louisville, Kentucky, Forenede Stater, 40207
        • Norton Suburban Hospital and Medical Campus
      • Louisville, Kentucky, Forenede Stater, 40245
        • UofL Health Medical Center Northeast
    • Louisiana
      • Kenner, Louisiana, Forenede Stater, 70065
        • Ochsner Medical Center Kenner
      • New Orleans, Louisiana, Forenede Stater, 70121
        • Ochsner Medical Center Jefferson
      • New Orleans, Louisiana, Forenede Stater, 70118
        • Children's Hospital New Orleans
      • Shreveport, Louisiana, Forenede Stater, 71103
        • LSU Health Sciences Center at Shreveport
    • Maine
      • Augusta, Maine, Forenede Stater, 04330
        • Harold Alfond Center for Cancer Care
      • Bangor, Maine, Forenede Stater, 04401
        • Eastern Maine Medical Center
      • Bath, Maine, Forenede Stater, 04530
        • MaineHealth Coastal Cancer Treatment Center
      • Belfast, Maine, Forenede Stater, 04915
        • Waldo County General Hospital
      • Biddeford, Maine, Forenede Stater, 04005
        • MaineHealth/SMHC Cancer Care and Blood Disorders-Biddeford
      • Portland, Maine, Forenede Stater, 04102
        • Maine Medical Center-Bramhall Campus
      • Rockport, Maine, Forenede Stater, 04856
        • Penobscot Bay Medical Center
      • Sanford, Maine, Forenede Stater, 04073
        • MaineHealth Cancer Care Center of York County
      • Sanford, Maine, Forenede Stater, 04073
        • MaineHealth/SMHC Cancer Care and Blood Disorders-Sanford
      • Scarborough, Maine, Forenede Stater, 04074
        • Maine Medical Center- Scarborough Campus
      • South Portland, Maine, Forenede Stater, 04106
        • Maine Medical Partners - South Portland
    • Maryland
      • Baltimore, Maryland, Forenede Stater, 21287
        • Johns Hopkins University/Sidney Kimmel Cancer Center
      • Baltimore, Maryland, Forenede Stater, 21215
        • Sinai Hospital of Baltimore
      • Baltimore, Maryland, Forenede Stater, 21201
        • University of Maryland/Greenebaum Cancer Center
      • Bel Air, Maryland, Forenede Stater, 21014
        • UM Upper Chesapeake Medical Center
      • Bethesda, Maryland, Forenede Stater, 20889-5600
        • Walter Reed National Military Medical Center
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02215
        • Dana-Farber Cancer Institute
      • Boston, Massachusetts, Forenede Stater, 02115
        • Brigham and Women's Hospital
      • Boston, Massachusetts, Forenede Stater, 02111
        • Tufts Medical Center
      • Boston, Massachusetts, Forenede Stater, 02118
        • Boston Medical Center
      • Boston, Massachusetts, Forenede Stater, 02114
        • Massachusetts General Hospital Cancer Center
      • Boston, Massachusetts, Forenede Stater, 02111
        • Tufts Children's Hospital
      • Springfield, Massachusetts, Forenede Stater, 01199
        • Baystate Medical Center
    • Michigan
      • Ann Arbor, Michigan, Forenede Stater, 48106
        • Saint Joseph Mercy Hospital
      • Ann Arbor, Michigan, Forenede Stater, 48109
        • C S Mott Children's Hospital
      • Battle Creek, Michigan, Forenede Stater, 49017
        • Bronson Battle Creek
      • Brighton, Michigan, Forenede Stater, 48114
        • Saint Joseph Mercy Brighton
      • Brighton, Michigan, Forenede Stater, 48114
        • Trinity Health IHA Medical Group Hematology Oncology - Brighton
      • Brownstown, Michigan, Forenede Stater, 48183
        • Henry Ford Cancer Institute-Downriver
      • Canton, Michigan, Forenede Stater, 48188
        • Saint Joseph Mercy Canton
      • Canton, Michigan, Forenede Stater, 48188
        • Trinity Health IHA Medical Group Hematology Oncology - Canton
      • Chelsea, Michigan, Forenede Stater, 48118
        • Saint Joseph Mercy Chelsea
      • Chelsea, Michigan, Forenede Stater, 48118
        • Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
      • Clinton Township, Michigan, Forenede Stater, 48038
        • Henry Ford Macomb Hospital-Clinton Township
      • Dearborn, Michigan, Forenede Stater, 48124
        • Beaumont Hospital - Dearborn
      • Dearborn, Michigan, Forenede Stater, 48126
        • Henry Ford Medical Center-Fairlane
      • Detroit, Michigan, Forenede Stater, 48202
        • Henry Ford Hospital
      • Detroit, Michigan, Forenede Stater, 48201
        • Wayne State University/Karmanos Cancer Institute
      • Detroit, Michigan, Forenede Stater, 48236
        • Ascension Saint John Hospital
      • Farmington Hills, Michigan, Forenede Stater, 48334
        • Weisberg Cancer Treatment Center
      • Grand Rapids, Michigan, Forenede Stater, 49503
        • Spectrum Health at Butterworth Campus
      • Grand Rapids, Michigan, Forenede Stater, 49503
        • Helen DeVos Children's Hospital at Spectrum Health
      • Grand Rapids, Michigan, Forenede Stater, 49503
        • Trinity Health Grand Rapids Hospital
      • Jackson, Michigan, Forenede Stater, 49201
        • Allegiance Health
      • Kalamazoo, Michigan, Forenede Stater, 49007
        • West Michigan Cancer Center
      • Kalamazoo, Michigan, Forenede Stater, 49007
        • Bronson Methodist Hospital
      • Kalamazoo, Michigan, Forenede Stater, 49048
        • Borgess Medical Center
      • Livonia, Michigan, Forenede Stater, 48154
        • Trinity Health Saint Mary Mercy Livonia Hospital
      • 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, 48374
        • Ascension Providence Hospitals - Novi
      • Novi, Michigan, Forenede Stater, 48377
        • Henry Ford Medical Center-Columbus
      • Reed City, Michigan, Forenede Stater, 49677
        • Corewell Health Reed City Hospital
      • Royal Oak, Michigan, Forenede Stater, 48073
        • William Beaumont Hospital-Royal Oak
      • Royal Oak, Michigan, Forenede Stater, 48073
        • Beaumont Children's Hospital-Royal Oak
      • Saint Joseph, Michigan, Forenede Stater, 49085
        • Lakeland Medical Center Saint Joseph
      • Saint Joseph, Michigan, Forenede Stater, 49085
        • Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
      • Shelby, Michigan, Forenede Stater, 48315
        • Henry Ford Macomb Health Center - Shelby Township
      • Southfield, Michigan, Forenede Stater, 48075
        • Ascension Providence Hospitals - Southfield
      • Traverse City, Michigan, Forenede Stater, 49684
        • Munson Medical Center
      • Troy, Michigan, Forenede Stater, 48085
        • William Beaumont Hospital - Troy
      • West Bloomfield, Michigan, Forenede Stater, 48322
        • Henry Ford West Bloomfield Hospital
      • 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
    • Minnesota
      • Bemidji, Minnesota, Forenede Stater, 56601
        • Sanford Joe Lueken Cancer Center
      • Brainerd, Minnesota, Forenede Stater, 56401
        • Essentia Health Saint Joseph's Medical Center
      • Burnsville, Minnesota, Forenede Stater, 55337
        • Fairview Ridges Hospital
      • Burnsville, Minnesota, Forenede Stater, 55337
        • Minnesota Oncology - Burnsville
      • Coon Rapids, Minnesota, Forenede Stater, 55433
        • Mercy Hospital
      • Deer River, Minnesota, Forenede Stater, 56636
        • Essentia Health - Deer River Clinic
      • Detroit Lakes, Minnesota, Forenede Stater, 56501
        • Essentia Health Saint Mary's - Detroit Lakes Clinic
      • Duluth, Minnesota, Forenede Stater, 55805
        • Essentia Health Cancer Center
      • Duluth, Minnesota, Forenede Stater, 55805
        • Essentia Health Saint Mary's Medical Center
      • Duluth, Minnesota, Forenede Stater, 55805
        • Miller-Dwan Hospital
      • Edina, Minnesota, Forenede Stater, 55435
        • Fairview Southdale Hospital
      • Fergus Falls, Minnesota, Forenede Stater, 56537
        • Lake Region Healthcare Corporation-Cancer Care
      • Fosston, Minnesota, Forenede Stater, 56542
        • Essentia Health - Fosston
      • Fridley, Minnesota, Forenede Stater, 55432
        • Unity Hospital
      • Hibbing, Minnesota, Forenede Stater, 55746
        • Essentia Health Hibbing Clinic
      • Maple Grove, Minnesota, Forenede Stater, 55369
        • Fairview Clinics and Surgery Center Maple Grove
      • Maplewood, Minnesota, Forenede Stater, 55109
        • Saint John's Hospital - Healtheast
      • Maplewood, Minnesota, Forenede Stater, 55109
        • Minnesota Oncology Hematology PA-Maplewood
      • Minneapolis, Minnesota, Forenede Stater, 55415
        • Hennepin County Medical Center
      • Minneapolis, Minnesota, Forenede Stater, 55404
        • Children's Hospitals and Clinics of Minnesota - Minneapolis
      • Minneapolis, Minnesota, Forenede Stater, 55407
        • Abbott-Northwestern Hospital
      • Minneapolis, Minnesota, Forenede Stater, 55454
        • Health Partners Inc
      • Minneapolis, Minnesota, Forenede Stater, 55455
        • University of Minnesota/Masonic Cancer Center
      • Monticello, Minnesota, Forenede Stater, 55362
        • Monticello Cancer Center
      • Park Rapids, Minnesota, Forenede Stater, 56470
        • Essentia Health - Park Rapids
      • Robbinsdale, Minnesota, Forenede Stater, 55422
        • North Memorial Medical Health Center
      • Rochester, Minnesota, Forenede Stater, 55905
        • Mayo Clinic in Rochester
      • Saint Louis Park, Minnesota, Forenede Stater, 55416
        • Park Nicollet Clinic - Saint Louis Park
      • Saint Paul, Minnesota, Forenede Stater, 55101
        • Regions Hospital
      • Saint Paul, Minnesota, Forenede Stater, 55102
        • United Hospital
      • Sandstone, Minnesota, Forenede Stater, 55072
        • Essentia Health Sandstone
      • Shakopee, Minnesota, Forenede Stater, 55379
        • Saint Francis Regional Medical Center
      • Stillwater, Minnesota, Forenede Stater, 55082
        • Lakeview Hospital
      • Virginia, Minnesota, Forenede Stater, 55792
        • Essentia Health Virginia Clinic
      • Waconia, Minnesota, Forenede Stater, 55387
        • Ridgeview Medical Center
      • Willmar, Minnesota, Forenede Stater, 56201
        • Rice Memorial Hospital
      • Woodbury, Minnesota, Forenede Stater, 55125
        • Minnesota Oncology Hematology PA-Woodbury
    • Mississippi
      • Columbus, Mississippi, Forenede Stater, 39705
        • Baptist Memorial Hospital and Cancer Center-Golden Triangle
      • Grenada, Mississippi, Forenede Stater, 38901
        • Baptist Cancer Center-Grenada
      • Jackson, Mississippi, Forenede Stater, 39216
        • University of Mississippi Medical Center
      • New Albany, Mississippi, Forenede Stater, 38652
        • Baptist Memorial Hospital and Cancer Center-Union County
      • Oxford, Mississippi, Forenede Stater, 38655
        • Baptist Memorial Hospital and Cancer Center-Oxford
      • Southhaven, Mississippi, Forenede Stater, 38671
        • Baptist Memorial Hospital and Cancer Center-Desoto
    • Missouri
      • Ballwin, Missouri, Forenede Stater, 63011
        • Saint Louis Cancer and Breast Institute-Ballwin
      • Bolivar, Missouri, Forenede Stater, 65613
        • Central Care Cancer Center - Bolivar
      • Bonne Terre, Missouri, Forenede Stater, 63628
        • Parkland Health Center-Bonne Terre
      • Cape Girardeau, Missouri, Forenede Stater, 63703
        • Saint Francis Medical Center
      • Cape Girardeau, Missouri, Forenede Stater, 63703
        • Southeast Cancer Center
      • Creve Coeur, Missouri, Forenede Stater, 63141
        • Siteman Cancer Center at West County Hospital
      • Farmington, Missouri, Forenede Stater, 63640
        • Parkland Health Center - Farmington
      • Jefferson City, Missouri, Forenede Stater, 65109
        • Capital Region Southwest Campus
      • Joplin, Missouri, Forenede Stater, 64804
        • Freeman Health System
      • Joplin, Missouri, Forenede Stater, 64804
        • Mercy Hospital Joplin
      • Kansas City, Missouri, Forenede Stater, 64108
        • Children's Mercy Hospitals and Clinics
      • Kansas City, Missouri, Forenede Stater, 64154
        • University of Kansas Cancer Center - North
      • 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
        • Delbert Day Cancer Institute at PCRMC
      • Rolla, Missouri, Forenede Stater, 65401
        • Mercy Clinic-Rolla-Cancer and Hematology
      • Saint Joseph, Missouri, Forenede Stater, 64506
        • Heartland Regional Medical Center
      • Saint Louis, Missouri, Forenede Stater, 63110
        • Washington University School of Medicine
      • Saint Louis, Missouri, Forenede Stater, 63131
        • Missouri Baptist Medical Center
      • Saint Louis, Missouri, Forenede Stater, 63141
        • Mercy Hospital Saint Louis
      • Saint Louis, Missouri, Forenede Stater, 63104
        • Cardinal Glennon Children's Medical Center
      • Saint Louis, Missouri, Forenede Stater, 63128
        • Mercy Hospital South
      • Saint Louis, Missouri, Forenede Stater, 63129
        • Siteman Cancer Center-South County
      • Saint Louis, Missouri, Forenede Stater, 63136
        • Siteman Cancer Center at Christian Hospital
      • Saint Peters, Missouri, Forenede Stater, 63376
        • Siteman Cancer Center at Saint Peters Hospital
      • 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
      • Sullivan, Missouri, Forenede Stater, 63080
        • Missouri Baptist Sullivan Hospital
      • Sunset Hills, Missouri, Forenede Stater, 63127
        • BJC Outpatient Center at Sunset Hills
    • Montana
      • Billings, Montana, Forenede Stater, 59101
        • Billings Clinic Cancer Center
      • Billings, Montana, Forenede Stater, 59101
        • Saint Vincent Healthcare
      • Bozeman, Montana, Forenede Stater, 59715
        • Bozeman Deaconess Hospital
      • Butte, Montana, Forenede Stater, 59701
        • Saint James Community Hospital and Cancer Treatment Center
      • Great Falls, Montana, Forenede Stater, 59405
        • Great Falls Clinic
      • Great Falls, Montana, Forenede Stater, 59405
        • Benefis Healthcare- Sletten Cancer Institute
      • Kalispell, Montana, Forenede Stater, 59901
        • Kalispell Regional Medical Center
      • Missoula, Montana, Forenede Stater, 59804
        • Community Medical Hospital
    • Nebraska
      • Bellevue, Nebraska, Forenede Stater, 68123
        • Nebraska Medicine-Bellevue
      • Grand Island, Nebraska, Forenede Stater, 68803
        • CHI Health Saint Francis
      • Kearney, Nebraska, Forenede Stater, 68847
        • CHI Health Good Samaritan
      • 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, 68131
        • Creighton University Medical Center
    • Nevada
      • Henderson, Nevada, Forenede Stater, 89052
        • Comprehensive Cancer Centers of Nevada - Henderson
      • Henderson, Nevada, Forenede Stater, 89052
        • OptumCare Cancer Care at Seven Hills
      • Las Vegas, Nevada, Forenede Stater, 89102
        • OptumCare Cancer Care at Charleston
      • Las Vegas, Nevada, Forenede Stater, 89106
        • Radiation Oncology Centers of Nevada Central
      • Las Vegas, Nevada, Forenede Stater, 89109
        • GenesisCare USA - Las Vegas
      • Las Vegas, Nevada, Forenede Stater, 89119
        • Radiation Oncology Centers of Nevada Southeast
      • Las Vegas, Nevada, Forenede Stater, 89128
        • Comprehensive Cancer Centers of Nevada - Northwest
      • Las Vegas, Nevada, Forenede Stater, 89128
        • OptumCare Cancer Care at MountainView
      • Las Vegas, Nevada, Forenede Stater, 89135
        • Alliance for Childhood Diseases/Cure 4 the Kids Foundation
      • Las Vegas, Nevada, Forenede Stater, 89144
        • Comprehensive Cancer Centers of Nevada - Town Center
      • Las Vegas, Nevada, Forenede Stater, 89144
        • Comprehensive Cancer Centers of Nevada-Summerlin
      • Las Vegas, Nevada, Forenede Stater, 89148
        • Comprehensive Cancer Centers of Nevada
      • Las Vegas, Nevada, Forenede Stater, 89148
        • OptumCare Cancer Care at Fort Apache
      • Las Vegas, Nevada, Forenede Stater, 89169
        • Comprehensive Cancer Centers of Nevada - Central Valley
      • 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
      • Reno, Nevada, Forenede Stater, 89511
        • Cancer Care Specialists - Reno
    • New Hampshire
      • Lebanon, New Hampshire, Forenede Stater, 03756
        • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
      • Nashua, New Hampshire, Forenede Stater, 03063
        • Dartmouth Cancer Center - Nashua
    • New Jersey
      • Camden, New Jersey, Forenede Stater, 08103
        • Cooper Hospital University Medical Center
      • Hackensack, New Jersey, Forenede Stater, 07601
        • Hackensack University Medical Center
      • Livingston, New Jersey, Forenede Stater, 07039
        • Saint Barnabas Medical Center
      • Morristown, New Jersey, Forenede Stater, 07960
        • Morristown Medical Center
      • New Brunswick, New Jersey, Forenede Stater, 08903
        • Rutgers Cancer Institute of New Jersey
      • New Brunswick, New Jersey, Forenede Stater, 08901
        • Saint Peter's University Hospital
      • New Brunswick, New Jersey, Forenede Stater, 08903
        • Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
      • Newark, New Jersey, Forenede Stater, 07101
        • Rutgers New Jersey Medical School
      • Newark, New Jersey, Forenede Stater, 07112
        • Newark Beth Israel Medical Center
      • Paramus, New Jersey, Forenede Stater, 07652
        • The Valley Hospital-Luckow Pavilion
      • Paterson, New Jersey, Forenede Stater, 07503
        • Saint Joseph's Regional Medical Center
      • Ridgewood, New Jersey, Forenede Stater, 07450
        • Valley Hospital
      • Summit, New Jersey, Forenede Stater, 07902
        • Overlook Hospital
      • Voorhees, New Jersey, Forenede Stater, 08043
        • MD Anderson Cancer Center at Cooper-Voorhees
      • Westwood, New Jersey, Forenede Stater, 07675
        • Valley Health System-Hematology/Oncology
    • New Mexico
      • Albuquerque, New Mexico, Forenede Stater, 87102
        • University of New Mexico Cancer Center
      • Albuquerque, New Mexico, Forenede Stater, 87106
        • Presbyterian Hospital
    • New York
      • Albany, New York, Forenede Stater, 12208
        • Albany Medical Center
      • Bronx, New York, Forenede Stater, 10467
        • Montefiore Medical Center - Moses Campus
      • Brooklyn, New York, Forenede Stater, 11215
        • New York-Presbyterian/Brooklyn Methodist Hospital
      • Buffalo, New York, Forenede Stater, 14263
        • Roswell Park Cancer Institute
      • East Syracuse, New York, Forenede Stater, 13057
        • Hematology Oncology Associates of Central New York-East Syracuse
      • Glens Falls, New York, Forenede Stater, 12801
        • Glens Falls Hospital
      • Mineola, New York, Forenede Stater, 11501
        • NYU Winthrop Hospital
      • New York, New York, Forenede Stater, 10065
        • Memorial Sloan Kettering Cancer Center
      • New York, New York, Forenede Stater, 10032
        • NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
      • New York, New York, Forenede Stater, 10065
        • NYP/Weill Cornell Medical Center
      • Rochester, New York, Forenede Stater, 14642
        • University of Rochester
      • Stony Brook, New York, Forenede Stater, 11794
        • Stony Brook University Medical Center
      • Syracuse, New York, Forenede Stater, 13210
        • State University of New York Upstate Medical University
      • Syracuse, New York, Forenede Stater, 13215
        • Hematology Oncology Associates of Central New York-Onondaga Hill
    • North Carolina
      • Albemarle, North Carolina, Forenede Stater, 28002
        • Atrium Health Stanly/LCI-Albemarle
      • Chapel Hill, North Carolina, Forenede Stater, 27599
        • UNC Lineberger Comprehensive Cancer Center
      • Charlotte, North Carolina, Forenede Stater, 28203
        • Carolinas Medical Center/Levine Cancer Institute
      • Charlotte, North Carolina, Forenede Stater, 28204
        • Novant Health Presbyterian Medical Center
      • Charlotte, North Carolina, Forenede Stater, 28210
        • Atrium Health Pineville/LCI-Pineville
      • Charlotte, North Carolina, Forenede Stater, 28262
        • Atrium Health University City/LCI-University
      • Clemmons, North Carolina, Forenede Stater, 27012
        • Wake Forest University at Clemmons
      • Concord, North Carolina, Forenede Stater, 28025
        • Atrium Health Cabarrus/LCI-Concord
      • Durham, North Carolina, Forenede Stater, 27710
        • Duke University Medical Center
      • Greenville, North Carolina, Forenede Stater, 27834
        • East Carolina University
      • Kenansville, North Carolina, Forenede Stater, 28349
        • Vidant Oncology-Kenansville
      • Kernersville, North Carolina, Forenede Stater, 27284
        • Novant Health Cancer Institute - Kernersville
      • Kinston, North Carolina, Forenede Stater, 28501
        • Vidant Oncology-Kinston
      • Lincolnton, North Carolina, Forenede Stater, 28092
        • Atrium Health Lincoln/LCI-Lincolnton
      • Mount Airy, North Carolina, Forenede Stater, 27030
        • Novant Health Cancer Institute - Mount Airy
      • Pinehurst, North Carolina, Forenede Stater, 28374
        • FirstHealth of the Carolinas-Moore Regional Hospital
      • Richlands, North Carolina, Forenede Stater, 28574
        • Vidant 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
        • Novant Health Cancer Institute - Wilkesboro
      • 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
      • Jamestown, North Dakota, Forenede Stater, 58401
        • Essentia Health - Jamestown Clinic
    • Ohio
      • Akron, Ohio, Forenede Stater, 44308
        • Children's Hospital Medical Center of Akron
      • Canton, Ohio, Forenede Stater, 44708
        • Cleveland Clinic Mercy Hospital
      • Chillicothe, Ohio, Forenede Stater, 45601
        • Adena Regional Medical Center
      • Cincinnati, Ohio, Forenede Stater, 45229
        • Cincinnati Children's Hospital Medical Center
      • Cincinnati, Ohio, Forenede Stater, 45219
        • University of Cincinnati Cancer Center-UC Medical Center
      • Cincinnati, Ohio, Forenede Stater, 45220
        • Good Samaritan Hospital - Cincinnati
      • Cincinnati, Ohio, Forenede Stater, 45242
        • Bethesda North Hospital
      • Cleveland, Ohio, Forenede Stater, 44106
        • Case Western Reserve University
      • Cleveland, Ohio, Forenede Stater, 44109
        • MetroHealth Medical Center
      • Cleveland, Ohio, Forenede Stater, 44195
        • Cleveland Clinic Foundation
      • Cleveland, Ohio, Forenede Stater, 44106
        • Rainbow Babies and Childrens 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, 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
      • Delaware, Ohio, Forenede Stater, 43015
        • Delaware Health Center-Grady Cancer Center
      • Dublin, Ohio, Forenede Stater, 43016
        • Dublin Methodist Hospital
      • Lima, Ohio, Forenede Stater, 45801
        • Saint Rita's Medical Center
      • Mansfield, Ohio, Forenede Stater, 44903
        • OhioHealth Mansfield Hospital
      • Marietta, Ohio, Forenede Stater, 45750
        • Marietta Memorial Hospital
      • Newark, Ohio, Forenede Stater, 43055
        • Licking Memorial Hospital
      • Newark, Ohio, Forenede Stater, 43055
        • Newark Radiation Oncology
      • Portsmouth, Ohio, Forenede Stater, 45662
        • Southern Ohio Medical Center
      • Sylvania, Ohio, Forenede Stater, 43560
        • ProMedica Flower Hospital
      • Toledo, Ohio, Forenede Stater, 43606
        • ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
      • Toledo, Ohio, Forenede Stater, 43608
        • Saint Vincent Mercy Medical Center
      • Toledo, Ohio, Forenede Stater, 43623
        • Mercy Health - Saint Anne Hospital
      • Toledo, Ohio, Forenede Stater, 43623
        • Toledo Clinic Cancer Centers-Toledo
      • West Chester, Ohio, Forenede Stater, 45069
        • University of Cincinnati Cancer Center-West Chester
      • Westerville, Ohio, Forenede Stater, 43081
        • Saint Ann's Hospital
      • Westlake, Ohio, Forenede Stater, 44145
        • UH Seidman Cancer Center at Saint John Medical Center
      • Zanesville, Ohio, Forenede Stater, 43701
        • Genesis Healthcare System Cancer Care Center
    • Oklahoma
      • Lawton, Oklahoma, Forenede Stater, 73505
        • Cancer Centers of Southwest Oklahoma Research
      • Oklahoma City, Oklahoma, Forenede Stater, 73104
        • University of Oklahoma Health Sciences Center
      • Oklahoma City, Oklahoma, Forenede Stater, 73120
        • Mercy Hospital Oklahoma City
    • Oregon
      • 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
      • 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
      • Portland, Oregon, Forenede Stater, 97227
        • Kaiser Permanente Northwest
      • Portland, Oregon, Forenede Stater, 97227
        • Legacy Emanuel Children's Hospital
    • Pennsylvania
      • Allentown, Pennsylvania, Forenede Stater, 18103
        • Lehigh Valley Hospital-Cedar Crest
      • Bethlehem, Pennsylvania, Forenede Stater, 18017
        • Lehigh Valley Hospital - Muhlenberg
      • Chadds Ford, Pennsylvania, Forenede Stater, 19317
        • Christiana Care Health System-Concord Health Center
      • Danville, Pennsylvania, Forenede Stater, 17822
        • Geisinger Medical Center
      • Hazleton, Pennsylvania, Forenede Stater, 18201
        • Geisinger Medical Center-Cancer Center Hazleton
      • Lewisburg, Pennsylvania, Forenede Stater, 17837
        • Geisinger Medical Oncology-Lewisburg
      • Lewistown, Pennsylvania, Forenede Stater, 17044
        • Lewistown Hospital
      • Philadelphia, Pennsylvania, Forenede Stater, 19111
        • Fox Chase Cancer Center
      • Philadelphia, Pennsylvania, Forenede Stater, 19104
        • Children's Hospital of Philadelphia
      • Philadelphia, Pennsylvania, Forenede Stater, 19104
        • University of Pennsylvania/Abramson Cancer Center
      • Philadelphia, Pennsylvania, Forenede Stater, 19134
        • Saint Christopher's Hospital for Children
      • Pittsburgh, Pennsylvania, Forenede Stater, 15224
        • Children's Hospital of Pittsburgh of UPMC
      • 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
      • West Reading, Pennsylvania, Forenede Stater, 19611
        • Reading Hospital
      • Wilkes-Barre, Pennsylvania, Forenede Stater, 18711
        • Geisinger Wyoming Valley/Henry Cancer Center
    • Rhode Island
      • Providence, Rhode Island, Forenede Stater, 02903
        • Rhode Island Hospital
    • South Carolina
      • Charleston, South Carolina, Forenede Stater, 29425
        • Medical University of South Carolina
      • Columbia, South Carolina, Forenede Stater, 29203
        • Prisma Health Richland Hospital
      • 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, 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
      • Seneca, South Carolina, Forenede Stater, 29672
        • Prisma Health Cancer Institute - Seneca
      • Spartanburg, South Carolina, Forenede Stater, 29303
        • Spartanburg Medical Center
      • Union, South Carolina, Forenede Stater, 29379
        • MGC Hematology Oncology-Union
    • South Dakota
      • 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, 37403
        • T C Thompson Children's Hospital
      • Collierville, Tennessee, Forenede Stater, 38017
        • Baptist Memorial Hospital and Cancer Center-Collierville
      • Knoxville, Tennessee, Forenede Stater, 37916
        • East Tennessee Childrens Hospital
      • Memphis, Tennessee, Forenede Stater, 38120
        • Baptist Memorial Hospital and Cancer Center-Memphis
      • Nashville, Tennessee, Forenede Stater, 37232
        • Vanderbilt University/Ingram Cancer Center
      • Nashville, Tennessee, Forenede Stater, 37203
        • The Children's Hospital at TriStar Centennial
    • Texas
      • Austin, Texas, Forenede Stater, 78723
        • Dell Children's Medical Center of Central Texas
      • Bryan, Texas, Forenede Stater, 77802
        • Saint Joseph Regional Cancer Center
      • Corpus Christi, Texas, Forenede Stater, 78411
        • Driscoll Children's Hospital
      • Dallas, Texas, Forenede Stater, 75230
        • Medical City Dallas Hospital
      • Edinburg, Texas, Forenede Stater, 78539
        • STCC at DHR Health Institute for Research and Development
      • El Paso, Texas, Forenede Stater, 79905
        • El Paso Children's Hospital
      • Houston, Texas, Forenede Stater, 77030
        • M D Anderson Cancer Center
      • Houston, Texas, Forenede Stater, 77030
        • Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
      • Lubbock, Texas, Forenede Stater, 79410
        • Covenant Children's Hospital
      • Lubbock, Texas, Forenede Stater, 79415
        • UMC Cancer Center / UMC Health System
      • San Antonio, Texas, Forenede Stater, 78229
        • University of Texas Health Science Center at San Antonio
      • San Antonio, Texas, Forenede Stater, 78207
        • Children's Hospital of San Antonio
      • San Antonio, Texas, Forenede Stater, 78229
        • Methodist Children's Hospital of South Texas
    • Utah
      • Cedar City, Utah, Forenede Stater, 84720
        • Sandra L Maxwell Cancer Center
      • Logan, Utah, Forenede Stater, 84321
        • Logan Regional Hospital
      • Murray, Utah, Forenede Stater, 84107
        • Intermountain Medical Center
      • Ogden, Utah, Forenede Stater, 84403
        • McKay-Dee Hospital Center
      • Provo, Utah, Forenede Stater, 84604
        • Utah Valley Regional Medical Center
      • Riverton, Utah, Forenede Stater, 84065
        • Riverton Hospital
      • Saint George, Utah, Forenede Stater, 84770
        • Saint George Regional Medical Center
      • 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, 84113
        • Primary Children's Hospital
      • Salt Lake City, Utah, Forenede Stater, 84143
        • LDS Hospital
    • Vermont
      • Burlington, Vermont, Forenede Stater, 05405
        • University of Vermont and State Agricultural College
      • Saint Johnsbury, Vermont, Forenede Stater, 05819
        • Norris Cotton Cancer Center-North
    • Virginia
      • Falls Church, Virginia, Forenede Stater, 22042
        • Inova Fairfax Hospital
      • Gloucester, Virginia, Forenede Stater, 23061
        • Peninsula Cancer Institute-Gloucester
      • Lynchburg, Virginia, Forenede Stater, 24501
        • Centra Lynchburg Hematology-Oncology Clinic Inc
      • Newport News, Virginia, Forenede Stater, 23601
        • Peninsula Cancer Institute-Newport News
      • Norfolk, Virginia, Forenede Stater, 23507
        • Children's Hospital of The King's Daughters
      • Portsmouth, Virginia, Forenede Stater, 23708-2197
        • Naval Medical Center - Portsmouth
      • Richmond, Virginia, Forenede Stater, 23298
        • Virginia Commonwealth University/Massey Cancer Center
      • Richmond, Virginia, Forenede Stater, 23229
        • Virginia Cancer Institute
      • Williamsburg, Virginia, Forenede Stater, 23185
        • Peninsula Cancer Institute-Williamsburg
    • Washington
      • Aberdeen, Washington, Forenede Stater, 98520
        • Providence Regional Cancer System-Aberdeen
      • Bellevue, Washington, Forenede Stater, 98004
        • Overlake Medical Center
      • Bellingham, Washington, Forenede Stater, 98225
        • PeaceHealth Saint Joseph Medical Center
      • Bremerton, Washington, Forenede Stater, 98310
        • Harrison HealthPartners Hematology and Oncology-Bremerton
      • Bremerton, Washington, Forenede Stater, 98310
        • Harrison Medical Center
      • Burien, Washington, Forenede Stater, 98166
        • Highline Medical Center-Main Campus
      • Centralia, Washington, Forenede Stater, 98531
        • Providence Regional Cancer System-Centralia
      • Edmonds, Washington, Forenede Stater, 98026
        • Swedish Cancer Institute-Edmonds
      • Everett, Washington, Forenede Stater, 98201
        • Providence Regional Cancer Partnership
      • Issaquah, Washington, Forenede Stater, 98029
        • Swedish Cancer Institute-Issaquah
      • Kennewick, Washington, Forenede Stater, 99336
        • Kadlec Clinic Hematology and Oncology
      • Lacey, Washington, Forenede Stater, 98503
        • Providence Regional Cancer System-Lacey
      • Longview, Washington, Forenede Stater, 98632
        • PeaceHealth Saint John Medical Center
      • Renton, Washington, Forenede Stater, 98055
        • Valley Medical Center
      • Seattle, Washington, Forenede Stater, 98109
        • Fred Hutchinson Cancer Research Center
      • Seattle, Washington, Forenede Stater, 98105
        • Seattle Children's Hospital
      • Seattle, Washington, Forenede Stater, 98107
        • Swedish Medical Center-Ballard Campus
      • Seattle, Washington, Forenede Stater, 98122
        • Swedish Medical Center-First Hill
      • Seattle, Washington, Forenede Stater, 98195
        • University of Washington Medical Center - Montlake
      • Sedro-Woolley, Washington, Forenede Stater, 98284
        • PeaceHealth United General Medical Center
      • Spokane, Washington, Forenede Stater, 99204
        • Providence Sacred Heart Medical Center and Children's Hospital
      • 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, 98431
        • Madigan Army Medical Center
      • 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
    • West Virginia
      • Charleston, West Virginia, Forenede Stater, 25304
        • West Virginia University Charleston Division
    • Wisconsin
      • 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
      • Eau Claire, Wisconsin, Forenede Stater, 54701
        • Mayo Clinic Health System-Eau Claire Clinic
      • Eau Claire, Wisconsin, Forenede Stater, 54703
        • Mayo Clinic Health System Eau Claire Hospital-Luther Campus
      • 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
      • Madison, Wisconsin, Forenede Stater, 53717
        • Dean Hematology and Oncology Clinic
      • Madison, Wisconsin, Forenede Stater, 53792
        • University of Wisconsin Carbone Cancer Center
      • Marinette, Wisconsin, Forenede Stater, 54143
        • Aurora Bay Area Medical Group-Marinette
      • Marshfield, Wisconsin, Forenede Stater, 54449
        • Marshfield Medical Center-Marshfield
      • 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 Clinic-Minocqua Center
      • 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
        • Ascension Saint Mary's Hospital
      • Rice Lake, Wisconsin, Forenede Stater, 54868
        • Marshfield Medical Center-Rice Lake
      • Sheboygan, Wisconsin, Forenede Stater, 53081
        • Vince Lombardi Cancer Clinic-Sheboygan
      • Stevens Point, Wisconsin, Forenede Stater, 54481
        • Ascension Saint Michael's Hospital
      • Stevens Point, Wisconsin, Forenede Stater, 54482
        • Marshfield Medical Center-River Region at Stevens Point
      • 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
      • 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
      • Weston, Wisconsin, Forenede Stater, 54476
        • Diagnostic and Treatment Center
      • Wisconsin Rapids, Wisconsin, Forenede Stater, 54494
        • Marshfield Clinic - Wisconsin Rapids Center
    • Wyoming
      • Sheridan, Wyoming, Forenede Stater, 82801
        • Welch Cancer Center
  • Puerto Rico
      • Caguas, Puerto Rico, 00726
        • HIMA San Pablo Oncologic Hospital
      • San Juan, Puerto Rico, 00926
        • University Pediatric Hospital

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

12 år og ældre (Barn, Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Beskrivelse

Inklusionskriterier:

  • Alle patienter skal have histologisk bekræftet nyligt diagnosticeret, tidligere ubehandlet stadium III eller IV klassisk Hodgkin-lymfom (nodulær sklerosering, blandet cellularitet, lymfocyt-rig eller lymfocyt-depleteret eller ikke på anden måde specificeret [NOS]). Nodulært lymfocytdominerende Hodgkin-lymfom er ikke kvalificeret.
  • Patienter skal have bidimensionelt målbar sygdom (mindst én læsion med længste diameter >= 1,5 cm) dokumenteret på Lymphoma Baseline Tumor Assessment Form i Rave.
  • Patienter skal have foretaget en helkrops- eller begrænset helkrops-PET-CT-scanning inden for 42 dage før registrering. (En kontrastforstærket [diagnostisk] CT, MR eller MR-PET er acceptabel i tilfælde af, at PET-CT er kontraindiceret, men hvis det senere er muligt at administrere en PET-CT, er PET-CT stærkt foretrukket til midlertidig scanning (efter cyklus 2) (hvis udført) og EOT-vurderingen. Ellers, hvis PET-CT ikke efterfølgende er mulig, skal den samme modalitet som baseline anvendes under hele forsøget.) BEMÆRK: Alle billeder fra PET-CT-, CT-, MR- eller MR-PET-scanninger udført som standardbehandling for at vurdere sygdom (inden for 42 dage før registrering) skal indsendes, og tilhørende radiologirapporter skal indsendes.
  • Patienter må ikke have modtaget nogen tidligere kemoterapi, stråling eller antistofbaseret behandling for klassisk Hodgkin-lymfom. Steroidforbehandling er tilladt.
  • Patienter må ikke have haft tidligere solid organtransplantation.
  • Patienter må ikke have haft tidligere allogen stamcelletransplantation.
  • Patienter må ikke have modtaget en levende vaccine inden for 30 dage før planlagt dag 1 af protokolbehandling (f. mæslinger, fåresyge, røde hunde, skoldkopper, gul feber, rabies, Bacillus Calmette-Guerin [BCG], oral poliovaccine og oral tyfus).

  • Ved registreringen skal investigator erklære intention-to-treat med resterende PET-strålebehandling (rest-PET RT-RPRT), der skal administreres, efter at patienten har gennemført 6 behandlingscyklusser, hvis patienten efter endt behandling opfylder de kriterier, der er specificeret for at modtage RT). Patienter vil blive stratificeret efter investigators intention-to-treat med resterende PET RT.

    • Alle pædiatriske patienter (< 18 år) vil blive betragtet som intention-to-treat med Residual PET RT på registreringstidspunktet.
  • Patienter skal have en præstationsstatus svarende til Zubrod-score på 0, 1 eller 2. Brug Lansky til patienter =< 17 år. *Konverteringen af ​​Lansky til Eastern Cooperative Oncology Group (ECOG) skalaer er kun beregnet til National Cancer Institute (NCI) rapporteringsformål.
  • Voksne (18 år eller ældre): Kreatininclearance >= 30 ml/min, som estimeret af Cockcroft og Gault-formlen. Kreatininværdien anvendt i beregningen skal være opnået inden for 28 dage før registrering. Estimeret kreatininclearance er baseret på den faktiske kropsvægt.

Pædiatriske patienter (12-17 år), følgende skal være opnået inden for 14 dage før registrering:

  • Målt eller beregnet kreatininclearance eller radioisotop glomerulær filtrationshastighed (GFR) >= 70 ml/min/1,73 m^2, eller

  • Serumkreatinin =< 1,5 x institutionel øvre normalgrænse (IULN), eller et serumkreatinin (SCr) baseret på alder/køn som følger:

    • Alder < 13 maksimal serumkreatinin: Mand 1,2 mg/dL; Kvinde 1,2 mg/dL
    • Alder 13 til < 16 maksimal serumkreatinin: Mand 1,5 mg/dL; Kvinde 1,4 mg/dL

    • Alder 16-17 maksimal serumkreatinin: Mand 1,7 mg/dL; Kvinde 1,4 mg/dL

      • Total bilirubin =< 2 x IULN (skal dokumenteres inden for 28 dage før registrering for voksne [18 år eller ældre]; skal dokumenteres inden for 14 dage før registrering for pædiatriske patienter [alder 12-17]).

  • Medmindre det skyldes Gilberts sygdom, lymfomatøs involvering af lever eller forsvindende galdegangsyndrom

    • Aspartataminotransferase (AST) og alaninaminotransferase (ALAT) =< 3 x IULN (skal dokumenteres inden for 28 dage før registrering for voksne [18 år eller ældre]; skal dokumenteres inden for 14 dage før registrering for pædiatriske patienter [12 år) -17]).

  • Medmindre det skyldes Gilberts sygdom, lymfomatøs involvering af lever eller forsvindende galdegangsyndrom

    • Patienterne skal have et ekkokardiogram (ECHO), multigated acquisition (MUGA) eller funktionel hjertebilledscanning med en venstre ventrikulær ejektionsfraktion (LVEF) >= 50 % eller en afkortningsfraktion på >= 27 %. For alle patienter skal ECHO-, MUGA- eller funktionel hjertebilledscanning udføres inden for 42 dage før registrering.
    • Patienter med kendt human immundefektvirus (HIV)-infektion skal modtage antiretroviral behandling og have en upåviselig eller ikke-kvantificerbar viral belastning ved deres seneste virusbelastningstest inden for 6 måneder før registrering.
    • Patienter må ikke have kendt aktiv hepatitis B (HBV) eller hepatitis C-virus (HCV) på registreringsdatoen. Patienter med tidligere behandlet HBV eller HCV, som har en upåviselig viral belastning inden for 6 måneder før registrering og ingen resterende leverinsufficiens er kvalificerede.
    • Patienter må ikke have nogen kendt lymfom i centralnervesystemet.
    • Patienter må ikke have en historie med eller aktiv interstitiel pneumonitis eller interstitiel lungesygdom.
    • Patienter må ikke have haft diagnosen arvelig eller erhvervet immundefekt.
    • Patienter må ikke have nogen kendt ukontrolleret interkurrent sygdom, herunder, men ikke begrænset til, symptomatisk kongestiv hjerteinsufficiens, ustabil angina pectoris, hæmodynamisk ustabil hjertearytmi eller psykiatrisk sygdom/sociale situationer, der ville begrænse overholdelse af undersøgelseskravene.
    • Patienter må ikke have en tilstand, der kræver systemisk behandling med enten kortikosteroider (> 10 mg dagligt prednisonækvivalenter) eller anden immunsuppressiv medicin inden for 14 dage før registrering. Inhalerede eller topiske steroider og binyresubstitutionsdoser > 10 mg daglige prednisonækvivalenter er tilladt i fravær af aktiv autoimmun sygdom. Steroidbrug til kontrol af Hodgkin-lymfomsymptomer er tilladt, men skal seponeres før cyklus 1, dag 1.
    • Patienter med perifer neuropati skal have < grad 2 på registreringsdatoen.
    • Patienter må ikke have aktiv autoimmun sygdom, der har krævet systemisk behandling i de sidste 2 år (dvs. med brug af sygdomsmodificerende midler, immunsuppressive lægemidler eller kortikosteroider med doser højere end prednison 10 mg eller tilsvarende). Autoimmune sygdomme indbefatter, men er ikke begrænset til, autoimmun hepatitis, inflammatorisk tarmsygdom (herunder colitis ulcerosa og Crohns sygdom), såvel som symptomatisk sygdom (f.eks.: reumatoid arthritis, systemisk progressiv sklerose [sklerodermi], systemisk lupus erythematosus, [autoimmun vaskulitis, autoimmun. Wegeners granulomatose]); centralnervesystemet (CNS) eller motorisk neuropati, der anses for at være af autoimmun oprindelse (f.eks. Guillain-Barre syndrom og myasthenia gravis, multipel sklerose eller glomerulonefritis). Vitiligo, alopeci, hypothyroidisme på stabile doser af thyreoideasubstitutionsterapi, psoriasis, der ikke kræver systemisk behandling inden for de seneste 2 år, er tilladt.
    • Ingen anden tidligere malignitet er tilladt undtagen for tilstrækkeligt behandlet basal (eller pladecelle-) hudkræft, enhver in situ-kræft eller anden cancer, som patienten har været sygdomsfri for i to år.
    • Kvinder i den fødedygtige alder må ikke være gravide eller ammende og have en negativ graviditetstest inden for 28 dage før registrering. Kvinder/mænd med reproduktionspotentiale skal have accepteret at bruge en effektiv præventionsmetode, mens de får forsøgslægemidlet og for kvinder indtil 6 måneder efter at have modtaget den sidste dosis af undersøgelseslægemidlet eller, for mænd, indtil 7 måneder efter at have modtaget den sidste dosis af undersøgelseslægemidlet. En kvinde anses for at have "reproduktionspotentiale", hvis hun har haft menstruation på noget tidspunkt i de foregående 12 på hinanden følgende måneder. Ud over rutinepræventionsmetoder omfatter "effektiv prævention" også heteroseksuel cølibat og kirurgi beregnet til at forhindre graviditet (eller med en bivirkning af graviditetsforebyggelse) defineret som en hysterektomi, bilateral oophorektomi eller bilateral tubal ligering. Men hvis en tidligere cølibatpatient på noget tidspunkt vælger at blive heteroseksuelt aktiv i løbet af tidsperioden for brug af svangerskabsforebyggende foranstaltninger, der er beskrevet i protokollen, er han/hun ansvarlig for at påbegynde svangerskabsforebyggende foranstaltninger.
    • Patienter skal have én formalinfikseret paraffinindlejret (FFPE) diagnostisk tumorblok eller mindst 1 diagnostisk, 4-5 mikron, hæmatoxylin og eosin (H&E) objektglas indsamlet før registrering og tilgængelig til indsendelse.
    • Patienter skal tilbydes deltagelse i bankvirksomhed for planlagt translationel medicin og fremtidig forskning. Med patientens samtykke vil eventuelle rester fra den obligatoriske vævsindsendelse også blive deponeret til fremtidig forskning.
    • Patienter, der kan udfylde Patient-Reported Outcome-instrumenter på engelsk, spansk eller fransk, skal udfylde PROMIS Fatigue, FACT/GOG-Ntx og PROMIS Global før registrering.
    • Patienter, der kan udfylde instrumenter til patientrapporteret resultat på engelsk, spansk eller fransk, skal også acceptere at gennemføre PROMIS Fatigue, FACT/GOG-Ntx, PROMIS Global og PRO-CTCAE (eller Ped PRO-CTCAE) på planlagte undersøgelsestidspunkter for vurdering.
    • Patienterne skal informeres om undersøgelsens karakter af denne undersøgelse, og alle patienter og/eller deres forældre eller værger (for patienter < 18 år) skal underskrive og give informeret samtykke og samtykke (hvor det er relevant) i overensstemmelse med institutionelle og føderale retningslinjer . For deltagere med svækkede beslutningsevner kan lovligt autoriserede repræsentanter underskrive og give informeret samtykke på vegne af undersøgelsesdeltagere i overensstemmelse med gældende føderale, lokale og Central Institutional Review Board Initiative (CIRB) bestemmelser.
  • Bemærk: Som en del af registreringsprocessen for Oncology Patient Enrollment Network (OPEN) oplyses den behandlende institutions identitet for at sikre, at den aktuelle (inden for 365 dage) dato for institutionelle revisionsnævns godkendelse af denne undersøgelse er blevet indtastet i systemet.

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

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

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Arm I (kemoterapi, nivolumab, stråling)
Patienterne får doxorubicinhydrochlorid IV, vinblastinsulfat IV, dacarbazin IV og nivolumab IV over 30 minutter på dag 1 og 15. Patienter kan få pegfilgrastim SC på dag 2 og 16, eller filgrastim SC eller IV på dag 6-10 og 21-25. Behandlingen gentages hver 28. dag i 6 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Efter afslutning af cyklus 6 kan patienter modtage strålebehandling 5 dage om ugen i ca. 4 uger efter den behandlende læges skøn. Patienterne gennemgår også perifer blodprøvetagning og CT, PET/CT og MRI på undersøgelse.
Biologisk: Nivolumab
Givet IV
Andre navne:
  • BMS-936558
  • MDX-1106
  • NIVO
  • ONO-4538
  • Opdivo
  • CMAB819
  • Nivolumab Biosimilar CMAB819
  • ABP 206
  • Nivolumab Biosimilar ABP 206
  • BCD-263
  • Nivolumab Biosimilar BCD-263
Andet: Livskvalitetsvurdering
Hjælpestudier
Andre navne:
  • Livskvalitetsvurdering
Andet: Spørgeskemaadministration
Hjælpestudier
Procedure: MR scanning
Gennemgå MR
Andre navne:
  • MR
  • Magnetisk resonans
  • Magnetisk resonansbilledscanning
  • Medicinsk billeddannelse, magnetisk resonans / kernemagnetisk resonans
  • HR
  • MR billeddannelse
  • MR-scanning
  • NMR billeddannelse
  • NMRI
  • Kernemagnetisk resonansbilleddannelse
  • Magnetisk resonansbilleddannelse (MRI)
  • sMRI
  • Magnetisk resonansbilleddannelse (procedure)
  • MRI'er
  • Strukturel MR
Procedure: Positron emissionstomografi
Gennemgå PET/CT-scanning
Andre navne:
  • Medicinsk billeddannelse, Positron Emission Tomografi
  • KÆLEDYR
  • PET-scanning
  • Positron Emission Tomografi Scan
  • Positron-emissionstomografi
  • proton magnetisk resonans spektroskopisk billeddannelse
  • PT
  • Positron emissionstomografi (procedure)
Medicin: Dacarbazin
Givet IV
Andre navne:
  • 4-(dimethyltriazeno)imidazol-5-carboxamid
  • 5-(dimethyltriazeno)imidazol-4-carboxamid
  • Asercit
  • Biocarbazin
  • Dacarbazina
  • Dacarbazina Almirall
  • Dacarbazin - DTIC
  • Dakatisk
  • Dakarbazin
  • Deticene
  • Detimedac
  • DIC
  • Dimethyl (triazeno) imidazolcarboxamid
  • Dimethyl Triazeno Imidazol Carboxamide
  • dimethyl-triazeno-imidazolcarboxamid
  • Dimethyl-triazeno-imidazol-carboximid
  • DTIC
  • DTIC-Dome
  • Falsk
  • Imidazol Carboxamid
  • Imidazol Carboxamid Dimethyltriazeno
  • WR-139007
Medicin: Doxorubicin Hydrochlorid
Givet IV
Andre navne:
  • Adriamycin
  • 5,12-naphthacendion, 10-[(3-amino-2,3,6-trideoxy-alfa-L-lyxo-hexopyranosyl)oxy]-7,8, 9,10-tetrahydro-6,8,11-trihydroxy -8-(hydroxyacetyl)-1-methoxy-, hydrochlorid, (8S-cis)- (9Cl)
  • ADM
  • Adriacin
  • Adriamycin hydrochlorid
  • Adriamycin PFS
  • Adriamycin RDF
  • ADRIAMYCIN, HYDROCHLORID
  • Adriblastina
  • Adriblastin
  • Adrimedac
  • Chloridrato de Doxorrubicina
  • DOX
  • DOXO-CELL
  • Doxolem
  • Doxorubicin HCl
  • Doxorubicin.HCl
  • Doxorubin
  • Farmiblastina
  • FI 106
  • FI-106
  • hydroxydaunorubicin
  • Rubex
Biologisk: Filgrastim
Givet SC eller IV
Andre navne:
  • G-CSF
  • r-metHuG-CSF
  • Neupogen
  • Filgrastim-aafi
  • Nivestym
  • Rekombinant methionyl human granulocytkolonistimulerende faktor
  • rG-CSF
  • Tevagrastim
  • Filgrastim Biosimilar Filgrastim-sndz
  • Zarxio
  • Filgrastim XM02
  • Tbo-filgrastim
  • Granix
  • XM02
  • Filgrastim-sndz
  • Filgrastim Biosimilar Tbo-filgrastim
  • Filgrastim-ayow
  • Releuko
  • Neutroval
Biologisk: Pegfilgrastim
Givet SC
Andre navne:
  • Filgrastim SD-01
  • filgrastim-SD/01
  • Fulphila
  • HSP-130
  • Jinyouli
  • Neulasta
  • Neulastim
  • Nyvepria
  • PEG-filgrastim
  • Pegcyte
  • Pegfilgrastim Biosimilar HSP-130
  • Pegfilgrastim Biosimilar Nyvepria
  • Pegfilgrastim Biosimilar Pegcyte
  • Pegfilgrastim Biosimilar PF-06881894
  • Pegfilgrastim Biosimilar Udenyca
  • Pegfilgrastim Biosimilar Ziextenzo
  • Pegfilgrastim-jmdb
  • PF-06881894
  • SD-01
  • SD-01 vedvarende varighed G-CSF
  • Udenyca
  • Ziextenzo
  • Neupopeg
  • Pegyleret G-CSF
  • Pegyleret GCSF
  • Pegyleret granulocytkolonistimulerende faktor
  • Pegfilgrastim-apgf
  • Pegfilgrastim-bmez
  • Pegfilgrastim-cbqv
  • Dulastin
  • Tripegfilgrastim
Stråling: Stråleterapi
Modtag strålebehandling
Andre navne:
  • Kræftstrålebehandling
  • ENERGY_TYPE
  • Bestråle
  • Bestrålet
  • Bestråling
  • Stråling
  • Stråleterapi, NOS
  • Radioterapeutika
  • Strålebehandling
  • RT
  • Terapi, Stråling
  • Energitype
Medicin: Vinblastinsulfat
Givet IV
Andre navne:
  • 29060 LE
  • 29060-LE
  • Exal
  • Velban
  • Velbe
  • Velsar
  • VINCALEUKOBLASTINE
Procedure: Bioprøvesamling
Gennemgå perifer blodopsamling
Andre navne:
  • Biologisk prøvesamling
  • Bioprøve indsamlet
  • Prøvesamling
Procedure: Computertomografi
Gennemgå PET/CT eller CT-scanning
Andre navne:
  • CT
  • KAT
  • CAT-scanning
  • Beregnet aksial tomografi
  • Computerstyret aksial tomografi
  • Computerstyret tomografi
  • CT-scanning
  • tomografi
  • Computerstyret aksial tomografi (procedure)
  • Computerstyret tomografi (CT) scanning
Eksperimentel: Arm II (kemoterapi, brentuximab vedotin, stråling)
Patienterne får doxorubicinhydrochlorid IV, vinblastinsulfat IV, dacarbazin IV og brentuximab vedotin IV over 30 minutter på dag 1 og 15. Patienter kan få pegfilgrastim SC på dag 2 og 16, eller filgrastim SC eller IV på dag 6-10 og 21-25. Behandlingen gentages hver 28. dag i 6 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Efter afslutning af cyklus 6 kan patienter modtage strålebehandling 5 dage om ugen i ca. 4 uger efter den behandlende læges skøn. Patienterne gennemgår også perifer blodprøvetagning og CT, PET/CT og MRI på undersøgelse.
Andet: Livskvalitetsvurdering
Hjælpestudier
Andre navne:
  • Livskvalitetsvurdering
Andet: Spørgeskemaadministration
Hjælpestudier
Procedure: MR scanning
Gennemgå MR
Andre navne:
  • MR
  • Magnetisk resonans
  • Magnetisk resonansbilledscanning
  • Medicinsk billeddannelse, magnetisk resonans / kernemagnetisk resonans
  • HR
  • MR billeddannelse
  • MR-scanning
  • NMR billeddannelse
  • NMRI
  • Kernemagnetisk resonansbilleddannelse
  • Magnetisk resonansbilleddannelse (MRI)
  • sMRI
  • Magnetisk resonansbilleddannelse (procedure)
  • MRI'er
  • Strukturel MR
Procedure: Positron emissionstomografi
Gennemgå PET/CT-scanning
Andre navne:
  • Medicinsk billeddannelse, Positron Emission Tomografi
  • KÆLEDYR
  • PET-scanning
  • Positron Emission Tomografi Scan
  • Positron-emissionstomografi
  • proton magnetisk resonans spektroskopisk billeddannelse
  • PT
  • Positron emissionstomografi (procedure)
Medicin: Dacarbazin
Givet IV
Andre navne:
  • 4-(dimethyltriazeno)imidazol-5-carboxamid
  • 5-(dimethyltriazeno)imidazol-4-carboxamid
  • Asercit
  • Biocarbazin
  • Dacarbazina
  • Dacarbazina Almirall
  • Dacarbazin - DTIC
  • Dakatisk
  • Dakarbazin
  • Deticene
  • Detimedac
  • DIC
  • Dimethyl (triazeno) imidazolcarboxamid
  • Dimethyl Triazeno Imidazol Carboxamide
  • dimethyl-triazeno-imidazolcarboxamid
  • Dimethyl-triazeno-imidazol-carboximid
  • DTIC
  • DTIC-Dome
  • Falsk
  • Imidazol Carboxamid
  • Imidazol Carboxamid Dimethyltriazeno
  • WR-139007
Medicin: Doxorubicin Hydrochlorid
Givet IV
Andre navne:
  • Adriamycin
  • 5,12-naphthacendion, 10-[(3-amino-2,3,6-trideoxy-alfa-L-lyxo-hexopyranosyl)oxy]-7,8, 9,10-tetrahydro-6,8,11-trihydroxy -8-(hydroxyacetyl)-1-methoxy-, hydrochlorid, (8S-cis)- (9Cl)
  • ADM
  • Adriacin
  • Adriamycin hydrochlorid
  • Adriamycin PFS
  • Adriamycin RDF
  • ADRIAMYCIN, HYDROCHLORID
  • Adriblastina
  • Adriblastin
  • Adrimedac
  • Chloridrato de Doxorrubicina
  • DOX
  • DOXO-CELL
  • Doxolem
  • Doxorubicin HCl
  • Doxorubicin.HCl
  • Doxorubin
  • Farmiblastina
  • FI 106
  • FI-106
  • hydroxydaunorubicin
  • Rubex
Biologisk: Filgrastim
Givet SC eller IV
Andre navne:
  • G-CSF
  • r-metHuG-CSF
  • Neupogen
  • Filgrastim-aafi
  • Nivestym
  • Rekombinant methionyl human granulocytkolonistimulerende faktor
  • rG-CSF
  • Tevagrastim
  • Filgrastim Biosimilar Filgrastim-sndz
  • Zarxio
  • Filgrastim XM02
  • Tbo-filgrastim
  • Granix
  • XM02
  • Filgrastim-sndz
  • Filgrastim Biosimilar Tbo-filgrastim
  • Filgrastim-ayow
  • Releuko
  • Neutroval
Biologisk: Pegfilgrastim
Givet SC
Andre navne:
  • Filgrastim SD-01
  • filgrastim-SD/01
  • Fulphila
  • HSP-130
  • Jinyouli
  • Neulasta
  • Neulastim
  • Nyvepria
  • PEG-filgrastim
  • Pegcyte
  • Pegfilgrastim Biosimilar HSP-130
  • Pegfilgrastim Biosimilar Nyvepria
  • Pegfilgrastim Biosimilar Pegcyte
  • Pegfilgrastim Biosimilar PF-06881894
  • Pegfilgrastim Biosimilar Udenyca
  • Pegfilgrastim Biosimilar Ziextenzo
  • Pegfilgrastim-jmdb
  • PF-06881894
  • SD-01
  • SD-01 vedvarende varighed G-CSF
  • Udenyca
  • Ziextenzo
  • Neupopeg
  • Pegyleret G-CSF
  • Pegyleret GCSF
  • Pegyleret granulocytkolonistimulerende faktor
  • Pegfilgrastim-apgf
  • Pegfilgrastim-bmez
  • Pegfilgrastim-cbqv
  • Dulastin
  • Tripegfilgrastim
Stråling: Stråleterapi
Modtag strålebehandling
Andre navne:
  • Kræftstrålebehandling
  • ENERGY_TYPE
  • Bestråle
  • Bestrålet
  • Bestråling
  • Stråling
  • Stråleterapi, NOS
  • Radioterapeutika
  • Strålebehandling
  • RT
  • Terapi, Stråling
  • Energitype
Medicin: Vinblastinsulfat
Givet IV
Andre navne:
  • 29060 LE
  • 29060-LE
  • Exal
  • Velban
  • Velbe
  • Velsar
  • VINCALEUKOBLASTINE
Medicin: Brentuximab Vedotin
Givet IV
Andre navne:
  • Adcetris
  • SGN-35
  • cAC10-vcMMAE
  • ADC SGN-35
  • Anti-CD30 antistof-lægemiddelkonjugat SGN-35
  • Anti-CD30 monoklonalt antistof-MMAE SGN-35
  • Anti-CD30 Monoklonalt Antistof-Monomethylauristatin E SGN-35
Procedure: Bioprøvesamling
Gennemgå perifer blodopsamling
Andre navne:
  • Biologisk prøvesamling
  • Bioprøve indsamlet
  • Prøvesamling
Procedure: Computertomografi
Gennemgå PET/CT eller CT-scanning
Andre navne:
  • CT
  • KAT
  • CAT-scanning
  • Beregnet aksial tomografi
  • Computerstyret aksial tomografi
  • Computerstyret tomografi
  • CT-scanning
  • tomografi
  • Computerstyret aksial tomografi (procedure)
  • Computerstyret tomografi (CT) scanning

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Progressionsfri overlevelse (PFS)
Tidsramme: Fra registreringsdatoen til datoen for første observation af progressiv sygdom i henhold til Lugano-klassifikationen 2014, eller død på grund af en hvilken som helst årsag, vurderet til 2 år
Vil teste nulhypotesen (HR=1) for PFS ved hjælp af stratificeret log-rank test med en ensidig alfa på 0,021. Analysen vil være baseret på modificeret intention-to-treat og vil omfatte alle kvalificerede patienter som randomiserede uanset modtaget behandling. Den ensidede alfa af .021 vil kontrollere den overordnede type 1-fejl i undersøgelsen (inklusive de 2 foreløbige overlegenhedsanalyser) til at være mindre end 0,025.
Fra registreringsdatoen til datoen for første observation af progressiv sygdom i henhold til Lugano-klassifikationen 2014, eller død på grund af en hvilken som helst årsag, vurderet til 2 år

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Samlet overlevelse
Tidsramme: 2 år
2 år
Begivenhedsfri overlevelse (EFS)
Tidsramme: Fra registreringsdatoen til datoen for den første forekomst af EFS-hændelse, vurderet til 2 år
Vil blive estimeret ved hjælp af Kaplan-Meier metode og sammenlignet mellem behandlingsarme ved hjælp af cox regressionsmodel.
Fra registreringsdatoen til datoen for den første forekomst af EFS-hændelse, vurderet til 2 år
Metabolisk fuldstændig responsrate
Tidsramme: Op til 10 år
Defineret ved hjælp af 2014 Lugano-klassifikation.
Op til 10 år
Forekomst af uønskede hændelser
Tidsramme: Op til 10 år
Toksicitet vil blive evalueret ved hjælp af Common Terminology Criteria of Adverse Events (CTCAE) version 5 elementer. Behandlingsrelaterede toksiciteter mellem arme vil blive sammenlignet ved hjælp af Fishers eksakte test stratificeret efter aldersgrupper. Målrettede patientrapporterede toksiciteter vil også blive indsamlet på hvert tidspunkt ved hjælp af Patient Reported Outcome (PRO)-CTCAE for patienter 18 år og ældre og fra unge 12-17 år, ved hjælp af Pædiatrisk PRO-CTCAE.
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: Alex F Herrera, SWOG Cancer Research Network

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)

29. august 2019

Primær færdiggørelse (Faktiske)

31. marts 2024

Studieafslutning (Anslået)

1. april 2025

Datoer for studieregistrering

Først indsendt

8. april 2019

Først indsendt, der opfyldte QC-kriterier

8. april 2019

Først opslået (Faktiske)

9. april 2019

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

18. april 2024

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

17. april 2024

Sidst verificeret

1. april 2024

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • NCI-2019-01960 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
  • S1826 (Anden identifikator: CTEP)
  • U10CA180888 (U.S. NIH-bevilling/kontrakt)

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

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

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 Ann Arbor Stadium III Hodgkin lymfom

Kliniske forsøg med Nivolumab

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Zimbabwe

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

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