Testen von Docetaxel-Cetuximab oder der Zusatz eines Immuntherapeutikums, Atezolizumab, zur üblichen Chemotherapie und Strahlentherapie bei Kopf- und Halskrebs mit hohem Risiko
Randomisierte Phase-II/III-Studie zur adjuvanten Strahlentherapie mit Cisplatin, Docetaxel-Cetuximab oder Cisplatin-Atezolizumab bei pathologischem Plattenepithelkarzinom mit hohem Risiko im Kopf-Hals-Bereich
This phase II/III trial studies how well radiation therapy works when given together with cisplatin, docetaxel, cetuximab, and/or atezolizumab after surgery in treating patients with high-risk stage III-IV head and neck cancer the begins in the thin, flat cells (squamous cell). Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. Drugs used in chemotherapy, such as cisplatin and docetaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Cetuximab is a monoclonal antibody that may interfere with the ability of tumor cells to grow and spread. Immunotherapy with monoclonal antibodies, such as atezolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. The purpose of this study is to compare the usual treatment (radiation therapy with cisplatin chemotherapy) to using radiation therapy with docetaxel and cetuximab chemotherapy, and using the usual treatment plus an immunotherapy drug, atezolizumab.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
- Hypopharynx-Plattenepithelkarzinom im Stadium IV AJCC v7
- Larynx-Plattenepithelkarzinom im Stadium IV AJCC v7
- Plattenepithelkarzinom der Mundhöhle im Stadium IV AJCC v6 und v7
- Stadium IV Plattenepithelkarzinom des Oropharynx AJCC v7
- Oropharyngeales p16INK4a-Negatives Plattenepithelkarzinom
- Stadium III Plattenepithelkarzinom des Hypopharynx AJCC v7
- Larynx-Plattenepithelkarzinom im Stadium III AJCC v6 und v7
- Plattenepithelkarzinom der Mundhöhle im Stadium III AJCC v6 und v7
- Stadium III Plattenepithelkarzinom des Oropharynx AJCC v7
Intervention / Behandlung
Intervention / Behandlung
- Arzneimittel: Cisplatin
- Arzneimittel: Docetaxel
- Verfahren: Computed Tomography
- Verfahren: Magnetic Resonance Imaging
- Verfahren: Biopsy Procedure
- Verfahren: Biospecimen Collection
- Arzneimittel: Atezolizumab
- Strahlung: Intensity-Modulated Radiation Therapy
- Biologisch: Cetuximab
- Sonstiges: Survey Administration
Detaillierte Beschreibung
PRIMARY OBJECTIVES:
I. To select the better docetaxel-based experimental arm to improve disease-free survival (DFS) over the control arm of radiation and cisplatin. (Phase II) (COMPLETE AS OF 20-MAR-2020) II. To determine if the combination of docetaxel-cetuximab and intensity-modulated radiation therapy (IMRT) is superior in terms of overall survival (OS) compared to standard cisplatin and IMRT in the adjuvant treatment of pathologic high risk, human papillomavirus (HPV)-negative head and neck squamous cell carcinoma (HNSCC). (Phase III) III. To determine if the combination of atezolizumab, cisplatin, and IMRT is superior in terms of OS compared to standard cisplatin and IMRT in the adjuvant treatment of pathologic high risk, HPV-negative HNSCC. (Phase III)
SECONDARY OBJECTIVES:
I. To compare disease-free survival (DFS) between each experimental arm and the control arm. (Phase III) II. To determine whether each experimental arm improves local-regional disease control and the rate of distant metastasis. (Phase III) III. To compare acute toxicity profiles between each experimental arm and the control arm. (Phase III) IV. To compare late toxicity profiles at 1, 3, and 5 years after treatment. (Phase III) V. To assess long term DFS and OS between each experimental arm and the control arm. (Phase III) VI. To compare symptom burden, as measured by the MD Anderson Symptom Inventory - Head and Neck (MDASI-HN) (primary patient reported outcome [PRO]), and quality of life, as measured by the Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) (secondary PRO), between each experimental arm and the control arm. (Phase III)
EXPLORATORY OBJECTIVE:
I. To collect blood and tissue specimens for future translational research. (Phase III)
OUTLINE: Patients are randomized to 1 of 3 arms - Phase II (Arms 1, 2 or 3) and for Phase III (Arms 1, 3 or 4).
ARM 1: Patients undergo intensity modulated radiation therapy (IMRT) once daily (QD) five days a week for 6 weeks and receive concurrent cisplatin intravenously (IV) over 1-2 hours once weekly for 6 weeks in the absence of disease progression or unacceptable toxicity.
ARM 2: Patients undergo IMRT as in Arm I and receive concurrent docetaxel IV over 60 minutes once weekly for 6 weeks in the absence of disease progression or unacceptable toxicity. (CLOSED AS OF 20-MAR-2020)
ARM 3: Patients receive cetuximab IV over 120 minutes on week 1 and over 60 minutes once weekly on weeks 2-7. Patients undergo IMRT as in Arm I and concurrently receive docetaxel once weekly for 6 weeks in the absence of disease progression or unacceptable toxicity.
ARM 4: Patients undergo IMRT QD five days a week for 6 weeks and receive concurrent cisplatin IV over 1-2 hours once weekly for 6 weeks. Starting 1 week before IMRT, patients also receive atezolizumab IV over 30-60 minutes every 3 weeks for up to 8 doses (weeks -1, 3, 6, 9, 12, 15, 18, and 21) in the absence of disease progression and unacceptable toxicity.
All patients undergo collection of blood samples during screening and throughout the study and may undergo computed tomography (CT) scans and/or magnetic resonance imaging (MRI) and biopsy as clinically indicated on study.
After completion of study treatment, patients are followed up at 1 and 3 months, every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Phase 2
- Phase 3
Kontakte und Standorte
Studienorte
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Shatin, Hongkong
- Chinese University of Hong Kong-Prince of Wales Hospital
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Alberta
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Edmonton, Alberta, Kanada, T6G 1Z2
- Cross Cancer Institute
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Saskatchewan
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Regina, Saskatchewan, Kanada, S4T 7T1
- Allan Blair Cancer Centre
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Saskatoon, Saskatchewan, Kanada, S7N 4H4
- Saskatoon Cancer Centre
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Alabama
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Birmingham, Alabama, Vereinigte Staaten, 35233
- University of Alabama at Birmingham Cancer Center
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Birmingham, Alabama, Vereinigte Staaten, 35243
- The Kirklin Clinic at Acton Road
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Arizona
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Tucson, Arizona, Vereinigte Staaten, 85719
- Banner University Medical Center - Tucson
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Tucson, Arizona, Vereinigte Staaten, 85719
- University of Arizona Cancer Center-North Campus
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Arkansas
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Little Rock, Arkansas, Vereinigte Staaten, 72205
- University of Arkansas for Medical Sciences
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California
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Auburn, California, Vereinigte Staaten, 95603
- Sutter Cancer Centers Radiation Oncology Services-Auburn
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Burbank, California, Vereinigte Staaten, 91505
- Providence Saint Joseph Medical Center/Disney Family Cancer Center
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Cameron Park, California, Vereinigte Staaten, 95682
- Sutter Cancer Centers Radiation Oncology Services-Cameron Park
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Carmichael, California, Vereinigte Staaten, 95608
- Mercy San Juan Medical Center
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Encinitas, California, Vereinigte Staaten, 92024
- UC San Diego Health System - Encinitas
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La Jolla, California, Vereinigte Staaten, 92093
- UC San Diego Moores Cancer Center
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Los Angeles, California, Vereinigte Staaten, 90048
- Cedars-Sinai Medical Center
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Modesto, California, Vereinigte Staaten, 95355
- Memorial Medical Center
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Orange, California, Vereinigte Staaten, 92868
- UC Irvine Health/Chao Family Comprehensive Cancer Center
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Palo Alto, California, Vereinigte Staaten, 94304
- Stanford Cancer Institute Palo Alto
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Roseville, California, Vereinigte Staaten, 95661
- Sutter Cancer Centers Radiation Oncology Services-Roseville
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Sacramento, California, Vereinigte Staaten, 95816
- Sutter Medical Center Sacramento
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Sacramento, California, Vereinigte Staaten, 95817
- University of California Davis Comprehensive Cancer Center
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San Francisco, California, Vereinigte Staaten, 94158
- UCSF Medical Center-Mission Bay
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San Francisco, California, Vereinigte Staaten, 94115
- UCSF Medical Center-Mount Zion
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San Mateo, California, Vereinigte Staaten, 94401
- Mills Health Center
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St. Helena, California, Vereinigte Staaten, 94574
- Saint Helena Hospital
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Colorado
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Aurora, Colorado, Vereinigte Staaten, 80045
- UCHealth University of Colorado Hospital
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Boulder, Colorado, Vereinigte Staaten, 80304
- Rocky Mountain Cancer Centers-Boulder
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Colorado Springs, Colorado, Vereinigte Staaten, 80907
- Penrose-Saint Francis Healthcare
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Denver, Colorado, Vereinigte Staaten, 80210
- AdventHealth Porter
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Edwards, Colorado, Vereinigte Staaten, 81632
- Shaw Cancer Center
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Greeley, Colorado, Vereinigte Staaten, 80631
- Banner North Colorado Medical Center
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Littleton, Colorado, Vereinigte Staaten, 80120
- Rocky Mountain Cancer Centers-Littleton
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Longmont, Colorado, Vereinigte Staaten, 80501
- Longmont United Hospital
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Loveland, Colorado, Vereinigte Staaten, 80539
- Banner North Colorado Medical Center - Loveland Campus
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Parker, Colorado, Vereinigte Staaten, 80138
- AdventHealth Parker
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Connecticut
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Farmington, Connecticut, Vereinigte Staaten, 06030
- University of Connecticut
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New Haven, Connecticut, Vereinigte Staaten, 06520
- Yale University
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Waterford, Connecticut, Vereinigte Staaten, 06385
- Smilow Cancer Hospital Care Center - Waterford
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Delaware
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Newark, Delaware, Vereinigte Staaten, 19713
- Helen F Graham Cancer Center
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Newark, Delaware, Vereinigte Staaten, 19718
- Christiana Care Health System-Christiana Hospital
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District of Columbia
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Washington D.C., District of Columbia, Vereinigte Staaten, 20037
- George Washington University Medical Center
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Florida
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Deerfield Beach, Florida, Vereinigte Staaten, 33442
- UM Sylvester Comprehensive Cancer Center at Deerfield Beach
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Fort Lauderdale, Florida, Vereinigte Staaten, 33308
- Holy Cross Hospital
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Miami, Florida, Vereinigte Staaten, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
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Orlando, Florida, Vereinigte Staaten, 32806
- Orlando Health Cancer Institute
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Orlando, Florida, Vereinigte Staaten, 32803
- AdventHealth Orlando
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Ruskin, Florida, Vereinigte Staaten, 33570
- Moffitt Cancer Center at SouthShore
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Tampa, Florida, Vereinigte Staaten, 33612
- Moffitt Cancer Center
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Tampa, Florida, Vereinigte Staaten, 33607
- Moffitt Cancer Center-International Plaza
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Georgia
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Atlanta, Georgia, Vereinigte Staaten, 30308
- Emory University Hospital Midtown
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Atlanta, Georgia, Vereinigte Staaten, 30322
- Emory University Hospital/Winship Cancer Institute
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Augusta, Georgia, Vereinigte Staaten, 30912
- Augusta University Medical Center
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Savannah, Georgia, Vereinigte Staaten, 31405
- Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
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Savannah, Georgia, Vereinigte Staaten, 31404
- Memorial Health University Medical Center
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Hawaii
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Honolulu, Hawaii, Vereinigte Staaten, 96813
- Queen's Medical Center
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Honolulu, Hawaii, Vereinigte Staaten, 96817
- The Cancer Center of Hawaii-Liliha
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Idaho
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Nampa, Idaho, Vereinigte Staaten, 83687
- Saint Alphonsus Cancer Care Center-Nampa
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Illinois
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Chicago, Illinois, Vereinigte Staaten, 60611
- Northwestern University
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Chicago, Illinois, Vereinigte Staaten, 60612
- University of Illinois
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Chicago, Illinois, Vereinigte Staaten, 60612
- John H Stroger Jr Hospital of Cook County
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Chicago, Illinois, Vereinigte Staaten, 60612
- Rush MD Anderson Cancer Center
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Decatur, Illinois, Vereinigte Staaten, 62526
- Decatur Memorial Hospital
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Effingham, Illinois, Vereinigte Staaten, 62401
- Crossroads Cancer Center
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Evanston, Illinois, Vereinigte Staaten, 60201
- NorthShore University HealthSystem-Evanston Hospital
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Glenview, Illinois, Vereinigte Staaten, 60026
- NorthShore University HealthSystem-Glenbrook Hospital
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Highland Park, Illinois, Vereinigte Staaten, 60035
- NorthShore University HealthSystem-Highland Park Hospital
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O'Fallon, Illinois, Vereinigte Staaten, 62269
- HSHS Saint Elizabeth's Hospital
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Oak Lawn, Illinois, Vereinigte Staaten, 60453-2699
- Advocate Christ Medical Center
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Peoria, Illinois, Vereinigte Staaten, 61637
- OSF Saint Francis Medical Center
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Peoria, Illinois, Vereinigte Staaten, 61615
- OSF Saint Francis Radiation Oncology at Peoria Cancer Center
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Rockford, Illinois, Vereinigte Staaten, 61114
- UW Health Carbone Cancer Center Rockford
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Springfield, Illinois, Vereinigte Staaten, 62781
- Springfield Memorial Hospital
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Urbana, Illinois, Vereinigte Staaten, 61801
- Carle Cancer Center
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Indiana
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Anderson, Indiana, Vereinigte Staaten, 46016
- Ascension Saint Vincent Anderson
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Elkhart, Indiana, Vereinigte Staaten, 46515
- Elkhart General Hospital
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Fort Wayne, Indiana, Vereinigte Staaten, 46805
- Parkview Hospital Randallia
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Fort Wayne, Indiana, Vereinigte Staaten, 46845
- Parkview Regional Medical Center
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Fort Wayne, Indiana, Vereinigte Staaten, 46804
- Radiation Oncology Associates PC
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Goshen, Indiana, Vereinigte Staaten, 46526
- Goshen Center for Cancer Care
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Indianapolis, Indiana, Vereinigte Staaten, 46202
- Indiana University/Melvin and Bren Simon Cancer Center
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Indianapolis, Indiana, Vereinigte Staaten, 46219
- IU Health Central Indiana Cancer Centers-East
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Indianapolis, Indiana, Vereinigte Staaten, 46202
- IU Health Methodist Hospital
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Mishawaka, Indiana, Vereinigte Staaten, 46545
- Michiana Hematology Oncology PC-Mishawaka
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South Bend, Indiana, Vereinigte Staaten, 46601
- Memorial Hospital of South Bend
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Iowa
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Ames, Iowa, Vereinigte Staaten, 50010
- McFarland Clinic - Ames
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Des Moines, Iowa, Vereinigte Staaten, 50309
- Iowa Methodist Medical Center
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Kansas
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Kansas City, Kansas, Vereinigte Staaten, 66160
- University of Kansas Cancer Center
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Lawrence, Kansas, Vereinigte Staaten, 66044
- Lawrence Memorial Hospital
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Olathe, Kansas, Vereinigte Staaten, 66061
- The University of Kansas Cancer Center - Olathe
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Overland Park, Kansas, Vereinigte Staaten, 66210
- University of Kansas Cancer Center-Overland Park
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Salina, Kansas, Vereinigte Staaten, 67401
- Salina Regional Health Center
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Kentucky
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Lexington, Kentucky, Vereinigte Staaten, 40536
- University of Kentucky/Markey Cancer Center
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Louisville, Kentucky, Vereinigte Staaten, 40202
- The James Graham Brown Cancer Center at University of Louisville
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Louisville, Kentucky, Vereinigte Staaten, 40245
- UofL Health Medical Center Northeast
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Louisiana
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Baton Rouge, Louisiana, Vereinigte Staaten, 70805
- LSU Health Baton Rouge-North Clinic
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Baton Rouge, Louisiana, Vereinigte Staaten, 70808
- Our Lady of The Lake
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Baton Rouge, Louisiana, Vereinigte Staaten, 70808
- Our Lady of the Lake Physician Group
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New Orleans, Louisiana, Vereinigte Staaten, 70112
- Tulane University School of Medicine
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New Orleans, Louisiana, Vereinigte Staaten, 70121
- Ochsner Medical Center Jefferson
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New Orleans, Louisiana, Vereinigte Staaten, 70112
- University Medical Center New Orleans
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New Orleans, Louisiana, Vereinigte Staaten, 70115
- Touro Infirmary
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Maryland
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Baltimore, Maryland, Vereinigte Staaten, 21287
- Johns Hopkins University/Sidney Kimmel Cancer Center
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Baltimore, Maryland, Vereinigte Staaten, 21204
- Greater Baltimore Medical Center
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Baltimore, Maryland, Vereinigte Staaten, 21201
- University of Maryland/Greenebaum Cancer Center
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Bel Air, Maryland, Vereinigte Staaten, 21014
- UM Upper Chesapeake Medical Center
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Columbia, Maryland, Vereinigte Staaten, 21044
- Central Maryland Radiation Oncology in Howard County
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Glen Burnie, Maryland, Vereinigte Staaten, 21061
- UM Baltimore Washington Medical Center/Tate Cancer Center
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Silver Spring, Maryland, Vereinigte Staaten, 20910
- Holy Cross Hospital
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Massachusetts
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Boston, Massachusetts, Vereinigte Staaten, 02118
- Boston Medical Center
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Michigan
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Ann Arbor, Michigan, Vereinigte Staaten, 48109
- University of Michigan Rogel Cancer Center
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Ann Arbor, Michigan, Vereinigte Staaten, 48106
- Trinity Health Saint Joseph Mercy Hospital Ann Arbor
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Brighton, Michigan, Vereinigte Staaten, 48116
- University of Michigan - Brighton Center for Specialty Care
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Brighton, Michigan, Vereinigte Staaten, 48114
- Trinity Health Medical Center - Brighton
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Brownstown, Michigan, Vereinigte Staaten, 48183
- Henry Ford Cancer Institute-Downriver
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Clinton Township, Michigan, Vereinigte Staaten, 48038
- Henry Ford Macomb Hospital-Clinton Township
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Dearborn, Michigan, Vereinigte Staaten, 48126
- Henry Ford Medical Center-Fairlane
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Detroit, Michigan, Vereinigte Staaten, 48202
- Henry Ford Hospital
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Grand Rapids, Michigan, Vereinigte Staaten, 49503
- Corewell Health Grand Rapids Hospitals - Butterworth Hospital
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Jackson, Michigan, Vereinigte Staaten, 49201
- Allegiance Health
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Kalamazoo, Michigan, Vereinigte Staaten, 49007
- West Michigan Cancer Center
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Lansing, Michigan, Vereinigte Staaten, 48912
- University of Michigan Health - Sparrow Lansing
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Livonia, Michigan, Vereinigte Staaten, 48154
- Trinity Health Saint Mary Mercy Livonia Hospital
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Novi, Michigan, Vereinigte Staaten, 48377
- Henry Ford Medical Center-Columbus
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Royal Oak, Michigan, Vereinigte Staaten, 48073
- Corewell Health William Beaumont University Hospital
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Saginaw, Michigan, Vereinigte Staaten, 48601
- MyMichigan Medical Center Saginaw
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Troy, Michigan, Vereinigte Staaten, 48085
- Corewell Health Beaumont Troy Hospital
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West Bloomfield, Michigan, Vereinigte Staaten, 48322
- Henry Ford West Bloomfield Hospital
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Wyandotte, Michigan, Vereinigte Staaten, 48192
- Henry Ford Wyandotte Hospital
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Wyoming, Michigan, Vereinigte Staaten, 49519
- University of Michigan Health - West
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Minnesota
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Bemidji, Minnesota, Vereinigte Staaten, 56601
- Sanford Joe Lueken Cancer Center
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Burnsville, Minnesota, Vereinigte Staaten, 55337
- Minnesota Oncology - Burnsville
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Duluth, Minnesota, Vereinigte Staaten, 55805
- Miller-Dwan Hospital
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Minneapolis, Minnesota, Vereinigte Staaten, 55415
- Hennepin County Medical Center
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Robbinsdale, Minnesota, Vereinigte Staaten, 55422
- North Memorial Medical Health Center
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Rochester, Minnesota, Vereinigte Staaten, 55905
- Mayo Clinic in Rochester
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Saint Cloud, Minnesota, Vereinigte Staaten, 56303
- Coborn Cancer Center at Saint Cloud Hospital
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Mississippi
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Jackson, Mississippi, Vereinigte Staaten, 39216
- University of Mississippi Medical Center
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Missouri
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Cape Girardeau, Missouri, Vereinigte Staaten, 63703
- Saint Francis Medical Center
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City of Saint Peters, Missouri, Vereinigte Staaten, 63376
- Siteman Cancer Center at Saint Peters Hospital
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Columbia, Missouri, Vereinigte Staaten, 65212
- MU Health - University Hospital/Ellis Fischel Cancer Center
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Creve Coeur, Missouri, Vereinigte Staaten, 63141
- Siteman Cancer Center at West County Hospital
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Kansas City, Missouri, Vereinigte Staaten, 64154
- University of Kansas Cancer Center - North
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Kansas City, Missouri, Vereinigte Staaten, 64116
- North Kansas City Hospital
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Kansas City, Missouri, Vereinigte Staaten, 64131
- The University of Kansas Cancer Center-South
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Lee's Summit, Missouri, Vereinigte Staaten, 64064
- University of Kansas Cancer Center - Lee's Summit
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Rolla, Missouri, Vereinigte Staaten, 65401
- Phelps Health Delbert Day Cancer Institute
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Springfield, Missouri, Vereinigte Staaten, 65807
- CoxHealth South Hospital
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Springfield, Missouri, Vereinigte Staaten, 65804
- Mercy Hospital Springfield
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St Louis, Missouri, Vereinigte Staaten, 63110
- Washington University School of Medicine
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St Louis, Missouri, Vereinigte Staaten, 63129
- Siteman Cancer Center-South County
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St Louis, Missouri, Vereinigte Staaten, 63131
- Missouri Baptist Medical Center
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St Louis, Missouri, Vereinigte Staaten, 63141
- Mercy Hospital Saint Louis
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Nebraska
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Kearney, Nebraska, Vereinigte Staaten, 68847
- CHI Health Good Samaritan
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Omaha, Nebraska, Vereinigte Staaten, 68114
- Nebraska Methodist Hospital
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Omaha, Nebraska, Vereinigte Staaten, 68124
- Alegent Health Bergan Mercy Medical Center
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New Hampshire
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Lebanon, New Hampshire, Vereinigte Staaten, 03756
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
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New Jersey
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Basking Ridge, New Jersey, Vereinigte Staaten, 07920
- Memorial Sloan Kettering Basking Ridge
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Hamilton, New Jersey, Vereinigte Staaten, 08690
- The Cancer Institute of New Jersey Hamilton
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Livingston, New Jersey, Vereinigte Staaten, 07039
- Cooperman Barnabas Medical Center
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Long Branch, New Jersey, Vereinigte Staaten, 07740
- Monmouth Medical Center
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Middletown, New Jersey, Vereinigte Staaten, 07748
- Memorial Sloan Kettering Monmouth
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Montvale, New Jersey, Vereinigte Staaten, 07645
- Memorial Sloan Kettering Bergen
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Mount Holly, New Jersey, Vereinigte Staaten, 08060
- Virtua Memorial
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New Brunswick, New Jersey, Vereinigte Staaten, 08903
- Rutgers Cancer Institute of New Jersey
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Newark, New Jersey, Vereinigte Staaten, 07101
- Rutgers New Jersey Medical School
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Somerville, New Jersey, Vereinigte Staaten, 08876
- Robert Wood Johnson University Hospital Somerset
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Sparta, New Jersey, Vereinigte Staaten, 07871
- Sparta Cancer Treatment Center
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Toms River, New Jersey, Vereinigte Staaten, 08755
- Community Medical Center
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Voorhees Township, New Jersey, Vereinigte Staaten, 08043
- Virtua Voorhees
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New Mexico
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Albuquerque, New Mexico, Vereinigte Staaten, 87109
- New Mexico Oncology Hematology Consultants
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Albuquerque, New Mexico, Vereinigte Staaten, 87106
- University of New Mexico Cancer Center
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New York
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Bay Shore, New York, Vereinigte Staaten, 11706
- South Shore University Hospital
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Brooklyn, New York, Vereinigte Staaten, 11215
- New York-Presbyterian/Brooklyn Methodist Hospital
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Brooklyn, New York, Vereinigte Staaten, 11220
- NYU Langone Hospital - Brooklyn
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Buffalo, New York, Vereinigte Staaten, 14263
- Roswell Park Cancer Institute
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Canandaigua, New York, Vereinigte Staaten, 14424
- Sands Cancer Center
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Commack, New York, Vereinigte Staaten, 11725
- Memorial Sloan Kettering Commack
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Elmira, New York, Vereinigte Staaten, 14905
- Arnot Ogden Medical Center/Falck Cancer Center
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Harrison, New York, Vereinigte Staaten, 10604
- Memorial Sloan Kettering Westchester
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Lake Success, New York, Vereinigte Staaten, 11042
- Northwell Health/Center for Advanced Medicine
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Mineola, New York, Vereinigte Staaten, 11501
- NYU Langone Hospital - Long Island
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New York, New York, Vereinigte Staaten, 10065
- Memorial Sloan Kettering Cancer Center
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New York, New York, Vereinigte Staaten, 10032
- NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
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New York, New York, Vereinigte Staaten, 10016
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
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New York, New York, Vereinigte Staaten, 10003
- Mount Sinai Union Square
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Rochester, New York, Vereinigte Staaten, 14642
- University of Rochester
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Rochester, New York, Vereinigte Staaten, 14620
- Highland Hospital
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Rochester, New York, Vereinigte Staaten, 14606
- Wilmot Cancer Institute Radiation Oncology at Greece
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Sleepy Hollow, New York, Vereinigte Staaten, 10591
- Memorial Sloan Kettering Sleepy Hollow
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Syracuse, New York, Vereinigte Staaten, 13210
- State University of New York Upstate Medical University
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The Bronx, New York, Vereinigte Staaten, 10461
- Montefiore Medical Center-Einstein Campus
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The Bronx, New York, Vereinigte Staaten, 10467
- Montefiore Medical Center - Moses Campus
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Uniondale, New York, Vereinigte Staaten, 11553
- Memorial Sloan Kettering Nassau
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North Carolina
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Albemarle, North Carolina, Vereinigte Staaten, 28002
- Atrium Health Stanly/LCI-Albemarle
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Chapel Hill, North Carolina, Vereinigte Staaten, 27599
- UNC Lineberger Comprehensive Cancer Center
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Charlotte, North Carolina, Vereinigte Staaten, 28203
- Carolinas Medical Center/Levine Cancer Institute
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Charlotte, North Carolina, Vereinigte Staaten, 28210
- Atrium Health Pineville/LCI-Pineville
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Charlotte, North Carolina, Vereinigte Staaten, 28262
- Atrium Health University City/LCI-University
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Concord, North Carolina, Vereinigte Staaten, 28025
- Atrium Health Cabarrus/LCI-Concord
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Greenville, North Carolina, Vereinigte Staaten, 27834
- East Carolina University
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Kinston, North Carolina, Vereinigte Staaten, 28501
- ECU Health Oncology Kinston
-
Monroe, North Carolina, Vereinigte Staaten, 28112
- Atrium Health Union/LCI-Union
-
Winston-Salem, North Carolina, Vereinigte Staaten, 27157
- Wake Forest University Health Sciences
-
-
North Dakota
-
Bismarck, North Dakota, Vereinigte Staaten, 58501
- Sanford Bismarck Medical Center
-
Fargo, North Dakota, Vereinigte Staaten, 58122
- Sanford Roger Maris Cancer Center
-
-
Ohio
-
Akron, Ohio, Vereinigte Staaten, 44307
- Cleveland Clinic Akron General
-
Akron, Ohio, Vereinigte Staaten, 44304
- Summa Health System - Akron Campus
-
Avon, Ohio, Vereinigte Staaten, 44011
- UH Seidman Cancer Center at UH Avon Health Center
-
Barberton, Ohio, Vereinigte Staaten, 44203
- Summa Health System - Barberton Campus
-
Beachwood, Ohio, Vereinigte Staaten, 44122
- UHHS-Chagrin Highlands Medical Center
-
Chardon, Ohio, Vereinigte Staaten, 44024
- Geauga Hospital
-
Chillicothe, Ohio, Vereinigte Staaten, 45601
- Adena Regional Medical Center
-
Cincinnati, Ohio, Vereinigte Staaten, 45219
- University of Cincinnati Cancer Center-UC Medical Center
-
Cleveland, Ohio, Vereinigte Staaten, 44106
- Case Western Reserve University
-
Cleveland, Ohio, Vereinigte Staaten, 44109
- MetroHealth Medical Center
-
Cleveland, Ohio, Vereinigte Staaten, 44195
- Cleveland Clinic Foundation
-
Cleveland, Ohio, Vereinigte Staaten, 44111
- Cleveland Clinic Cancer Center/Fairview Hospital
-
Columbus, Ohio, Vereinigte Staaten, 43210
- Ohio State University Comprehensive Cancer Center
-
Elyria, Ohio, Vereinigte Staaten, 44035
- Mercy Cancer Center-Elyria
-
Independence, Ohio, Vereinigte Staaten, 44131
- Cleveland Clinic Cancer Center Independence
-
Mansfield, Ohio, Vereinigte Staaten, 44903
- OhioHealth Mansfield Hospital
-
Mayfield Heights, Ohio, Vereinigte Staaten, 44124
- Hillcrest Hospital Cancer Center
-
Medina, Ohio, Vereinigte Staaten, 44256
- Summa Health Medina Medical Center
-
Mentor, Ohio, Vereinigte Staaten, 44060
- UH Seidman Cancer Center at Lake Health Mentor Campus
-
Middleburg Heights, Ohio, Vereinigte Staaten, 44130
- UH Seidman Cancer Center at Southwest General Hospital
-
Parma, Ohio, Vereinigte Staaten, 44129
- University Hospitals Parma Medical Center
-
Portsmouth, Ohio, Vereinigte Staaten, 45662
- Southern Ohio Medical Center
-
Ravenna, Ohio, Vereinigte Staaten, 44266
- University Hospitals Portage Medical Center
-
Sandusky, Ohio, Vereinigte Staaten, 44870
- North Coast Cancer Care
-
Sandusky, Ohio, Vereinigte Staaten, 44870
- UH Seidman Cancer Center at Firelands Regional Medical Center
-
Strongsville, Ohio, Vereinigte Staaten, 44136
- Cleveland Clinic Cancer Center Strongsville
-
West Chester, Ohio, Vereinigte Staaten, 45069
- University of Cincinnati Cancer Center-West Chester
-
Westlake, Ohio, Vereinigte Staaten, 44145
- UHHS-Westlake Medical Center
-
Wooster, Ohio, Vereinigte Staaten, 44691
- Cleveland Clinic Wooster Family Health and Surgery Center
-
-
Oklahoma
-
Oklahoma City, Oklahoma, Vereinigte Staaten, 73104
- University of Oklahoma Health Sciences Center
-
-
Oregon
-
Clackamas, Oregon, Vereinigte Staaten, 97015
- Clackamas Radiation Oncology Center
-
Portland, Oregon, Vereinigte Staaten, 97213
- Providence Portland Medical Center
-
Portland, Oregon, Vereinigte Staaten, 97225
- Providence Saint Vincent Medical Center
-
-
Pennsylvania
-
Allentown, Pennsylvania, Vereinigte Staaten, 18103
- Lehigh Valley Hospital-Cedar Crest
-
Allentown, Pennsylvania, Vereinigte Staaten, 18104
- Saint Luke's Cancer Center - Allentown
-
Altoona, Pennsylvania, Vereinigte Staaten, 16601
- UPMC Altoona
-
Beaver, Pennsylvania, Vereinigte Staaten, 15009
- UPMC-Heritage Valley Health System Beaver
-
Bethlehem, Pennsylvania, Vereinigte Staaten, 18017
- Lehigh Valley Hospital - Muhlenberg
-
Carlisle, Pennsylvania, Vereinigte Staaten, 17015
- Carlisle Regional Cancer Center
-
East Stroudsburg, Pennsylvania, Vereinigte Staaten, 18301
- Pocono Medical Center
-
Easton, Pennsylvania, Vereinigte Staaten, 18045
- Saint Luke's Hospital-Anderson Campus
-
Erie, Pennsylvania, Vereinigte Staaten, 16505
- UPMC Hillman Cancer Center Erie
-
Farrell, Pennsylvania, Vereinigte Staaten, 16121
- UPMC Cancer Center at UPMC Horizon
-
Greensburg, Pennsylvania, Vereinigte Staaten, 15601
- UPMC Cancer Centers - Arnold Palmer Pavilion
-
Harrisburg, Pennsylvania, Vereinigte Staaten, 17109
- UPMC Pinnacle Cancer Center/Community Osteopathic Campus
-
Hershey, Pennsylvania, Vereinigte Staaten, 17033-0850
- Penn State Milton S Hershey Medical Center
-
Indiana, Pennsylvania, Vereinigte Staaten, 15701
- IRMC Cancer Center
-
Johnstown, Pennsylvania, Vereinigte Staaten, 15901
- UPMC-Johnstown/John P. Murtha Regional Cancer Center
-
McKeesport, Pennsylvania, Vereinigte Staaten, 15132
- UPMC Cancer Center at UPMC McKeesport
-
Mechanicsburg, Pennsylvania, Vereinigte Staaten, 17050
- UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion
-
Monroeville, Pennsylvania, Vereinigte Staaten, 15146
- UPMC Cancer Center - Monroeville
-
Moon Township, Pennsylvania, Vereinigte Staaten, 15108
- UPMC Hillman Cancer Center in Coraopolis
-
Natrona Heights, Pennsylvania, Vereinigte Staaten, 15065
- UPMC Cancer Center-Natrona Heights
-
New Castle, Pennsylvania, Vereinigte Staaten, 16105
- UPMC Jameson
-
Philadelphia, Pennsylvania, Vereinigte Staaten, 19111
- Fox Chase Cancer Center
-
Philadelphia, Pennsylvania, Vereinigte Staaten, 19107
- Thomas Jefferson University Hospital
-
Philadelphia, Pennsylvania, Vereinigte Staaten, 19140
- Temple University Hospital
-
Pittsburgh, Pennsylvania, Vereinigte Staaten, 15212
- Allegheny General Hospital
-
Pittsburgh, Pennsylvania, Vereinigte Staaten, 15213
- UPMC-Magee Womens Hospital
-
Pittsburgh, Pennsylvania, Vereinigte Staaten, 15232
- UPMC-Shadyside Hospital
-
Pittsburgh, Pennsylvania, Vereinigte Staaten, 15215
- UPMC-Saint Margaret
-
Pittsburgh, Pennsylvania, Vereinigte Staaten, 15236
- UPMC Jefferson Regional Radiation Oncology
-
Pittsburgh, Pennsylvania, Vereinigte Staaten, 15237
- UPMC-Passavant Hospital
-
Pittsburgh, Pennsylvania, Vereinigte Staaten, 15243
- UPMC-Saint Clair Hospital Cancer Center
-
Quakertown, Pennsylvania, Vereinigte Staaten, 18951
- Saint Luke's Hospital - Upper Bucks Campus
-
Seneca, Pennsylvania, Vereinigte Staaten, 16346
- UPMC Cancer Center at UPMC Northwest
-
Stroudsburg, Pennsylvania, Vereinigte Staaten, 18360
- Saint Luke's Hospital - Monroe Campus
-
Uniontown, Pennsylvania, Vereinigte Staaten, 15401
- UPMC Uniontown Hospital Radiation Oncology
-
Washington, Pennsylvania, Vereinigte Staaten, 15301
- UPMC Washington Hospital Radiation Oncology
-
West Reading, Pennsylvania, Vereinigte Staaten, 19611
- Reading Hospital
-
Wexford, Pennsylvania, Vereinigte Staaten, 15090
- Wexford Health and Wellness Pavilion
-
-
South Carolina
-
Anderson, South Carolina, Vereinigte Staaten, 29621
- AnMed Health Cancer Center
-
Bluffton, South Carolina, Vereinigte Staaten, 29910
- Saint Joseph's/Candler - Bluffton Campus
-
Boiling Springs, South Carolina, Vereinigte Staaten, 29316
- Prisma Health Cancer Institute - Spartanburg
-
Charleston, South Carolina, Vereinigte Staaten, 29425
- Medical University of South Carolina
-
Greenville, South Carolina, Vereinigte Staaten, 29605
- Prisma Health Cancer Institute - Faris
-
Greenville, South Carolina, Vereinigte Staaten, 29615
- Prisma Health Cancer Institute - Eastside
-
Greer, South Carolina, Vereinigte Staaten, 29650
- Prisma Health Cancer Institute - Greer
-
Greer, South Carolina, Vereinigte Staaten, 29651
- Gibbs Cancer Center-Pelham
-
Rock Hill, South Carolina, Vereinigte Staaten, 29730
- Rock Hill Radiation Therapy Center
-
Seneca, South Carolina, Vereinigte Staaten, 29672
- Prisma Health Cancer Institute - Seneca
-
Spartanburg, South Carolina, Vereinigte Staaten, 29303
- Spartanburg Medical Center
-
-
South Dakota
-
Rapid City, South Dakota, Vereinigte Staaten, 57701
- Rapid City Regional Hospital
-
Sioux Falls, South Dakota, Vereinigte Staaten, 57117-5134
- Sanford USD Medical Center - Sioux Falls
-
-
Tennessee
-
Nashville, Tennessee, Vereinigte Staaten, 37232
- Vanderbilt University/Ingram Cancer Center
-
-
Texas
-
Conroe, Texas, Vereinigte Staaten, 77384
- UT MD Anderson - The Woodlands
-
Dallas, Texas, Vereinigte Staaten, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Galveston, Texas, Vereinigte Staaten, 77555-0565
- University of Texas Medical Branch
-
Houston, Texas, Vereinigte Staaten, 77030
- UT MD Anderson Cancer Center
-
Houston, Texas, Vereinigte Staaten, 77079
- UT MD Anderson - West Houston
-
League City, Texas, Vereinigte Staaten, 77573
- UTMB Cancer Center at Victory Lakes
-
League City, Texas, Vereinigte Staaten, 77573
- UT MD Anderson - League City
-
Lubbock, Texas, Vereinigte Staaten, 79410
- Covenant Medical Center-Lakeside
-
Sugar Land, Texas, Vereinigte Staaten, 77478
- UT MD Anderson - Sugar Land
-
-
Utah
-
Murray, Utah, Vereinigte Staaten, 84107
- Intermountain Medical Center
-
Salt Lake City, Utah, Vereinigte Staaten, 84112
- Huntsman Cancer Institute/University of Utah
-
Salt Lake City, Utah, Vereinigte Staaten, 84106
- Utah Cancer Specialists-Salt Lake City
-
St. George, Utah, Vereinigte Staaten, 84770
- Saint George Regional Medical Center
-
-
Vermont
-
Saint Johnsbury, Vermont, Vereinigte Staaten, 05819
- Dartmouth Cancer Center - North
-
-
Virginia
-
Falls Church, Virginia, Vereinigte Staaten, 22042
- Inova Fairfax Hospital
-
Hampton, Virginia, Vereinigte Staaten, 23666
- Sentara Cancer Institute at Sentara CarePlex Hospital
-
Norfolk, Virginia, Vereinigte Staaten, 23507
- Sentara Norfolk General Hospital
-
Richmond, Virginia, Vereinigte Staaten, 23298
- VCU Massey Comprehensive Cancer Center
-
Virginia Beach, Virginia, Vereinigte Staaten, 23454
- Sentara Virginia Beach General Hospital
-
-
Washington
-
Federal Way, Washington, Vereinigte Staaten, 98003
- Saint Francis Hospital
-
Kennewick, Washington, Vereinigte Staaten, 99336
- Tri-Cities Cancer Center
-
Longview, Washington, Vereinigte Staaten, 98632
- PeaceHealth Saint John Medical Center
-
Mount Vernon, Washington, Vereinigte Staaten, 98274
- Skagit Regional Health Cancer Care Center
-
Seattle, Washington, Vereinigte Staaten, 98195
- University of Washington Medical Center - Montlake
-
Spokane, Washington, Vereinigte Staaten, 99208
- Spokane Valley Cancer Center-Mayfair
-
Spokane, Washington, Vereinigte Staaten, 99216
- Spokane Valley Cancer Center-Mission
-
Wenatchee, Washington, Vereinigte Staaten, 98801
- Wenatchee Valley Hospital and Clinics
-
-
West Virginia
-
Morgantown, West Virginia, Vereinigte Staaten, 26506
- West Virginia University Healthcare
-
Parkersburg, West Virginia, Vereinigte Staaten, 26101
- Camden Clark Medical Center
-
Wheeling, West Virginia, Vereinigte Staaten, 26003
- Wheeling Hospital/Schiffler Cancer Center
-
-
Wisconsin
-
Antigo, Wisconsin, Vereinigte Staaten, 54409
- Aspirus Cancer Care-Antigo-Volm Cancer Center
-
Green Bay, Wisconsin, Vereinigte Staaten, 54301
- Saint Vincent Hospital Cancer Center Green Bay
-
Green Bay, Wisconsin, Vereinigte Staaten, 54303
- Saint Vincent Hospital Cancer Center at Saint Mary's
-
Johnson Creek, Wisconsin, Vereinigte Staaten, 53038
- University of Wisconsin Carbone Cancer Center - Johnson Creek
-
La Crosse, Wisconsin, Vereinigte Staaten, 54601
- Gundersen Lutheran Medical Center
-
La Crosse, Wisconsin, Vereinigte Staaten, 54601
- Mayo Clinic Health System-Franciscan Healthcare
-
Madison, Wisconsin, Vereinigte Staaten, 53792
- University of Wisconsin Carbone Cancer Center - University Hospital
-
Madison, Wisconsin, Vereinigte Staaten, 53718
- University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
-
Marinette, Wisconsin, Vereinigte Staaten, 54143
- Bay Area Medical Center
-
Marshfield, Wisconsin, Vereinigte Staaten, 54449
- Marshfield Medical Center
-
Menomonee Falls, Wisconsin, Vereinigte Staaten, 53051
- Froedtert Menomonee Falls Hospital
-
Milwaukee, Wisconsin, Vereinigte Staaten, 53226
- Medical College of Wisconsin
-
Minocqua, Wisconsin, Vereinigte Staaten, 54548
- Marshfield Medical Center - Minocqua
-
New Richmond, Wisconsin, Vereinigte Staaten, 54017
- Cancer Center of Western Wisconsin
-
Oak Creek, Wisconsin, Vereinigte Staaten, 53154
- Drexel Town Square Health Center
-
Rhinelander, Wisconsin, Vereinigte Staaten, 54501
- Aspirus Cancer Care-Rhinelander-James Beck Cancer Center
-
Stevens Point, Wisconsin, Vereinigte Staaten, 54481
- Aspirus Cancer Care - Stevens Point
-
Sturgeon Bay, Wisconsin, Vereinigte Staaten, 54235-1495
- Saint Vincent Hospital Cancer Center at Sturgeon Bay
-
Wausau, Wisconsin, Vereinigte Staaten, 54401
- Aspirus Cancer Care-Wausau
-
West Bend, Wisconsin, Vereinigte Staaten, 53095
- Froedtert West Bend Hospital/Kraemer Cancer Center
-
Wisconsin Rapids, Wisconsin, Vereinigte Staaten, 54494
- Aspirus Cancer Care - Wisconsin Rapids
-
-
Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
-
PHASE II INCLUSION CRITERIA (COMPLETE AS OF 20-MAR-2020)
-
Pathologically (histologically or cytologically) proven diagnosis of head and neck squamous cell carcinoma (HNSCC) involving the oral cavity (excluding lips), oropharynx (p16 negative), larynx, or hypopharynx
-
Patients must have undergone gross total surgical resection of high-risk oral cavity, oropharynx (p16 negative), larynx, or hypopharynx within 63 days prior to registration; Note: patients may have biopsy under general anesthesia in an operating room followed by definitive ablative cancer surgery representing gross total resection; the gross total resection has to be done within 63 days prior to registration; if, however, patients have ablative resection but shortly recur or are determined to have persisting disease requiring re-resection to achieve gross total resection, then the patient is not eligible
-
Patients must have at least 1 of the following high-risk pathologic features: extracapsular nodal extension or invasive cancer at the primary tumor resection margin (tumor on ink)
-
Pathologic stage III or IV HNSCC, including no distant metastases, based upon the following minimum diagnostic workup:
- General history and physical examination by a radiation oncologist and/or medical oncologist within 84 days prior to registration;
- Examination by an ear nose throat (ENT) or head & neck surgeon prior to surgery; a laryngopharyngoscopy (mirror and/or fiber optic and/or direct procedure), if appropriate, is recommended but not required; intra-operative examination is acceptable documentation
- Pre-operative (op) Imaging of the head and neck: A neck computed tomography (CT) (with contrast) or CT/positron emission tomography (PET) (with contrast) and/or an magnetic resonance imaging (MRI) of the neck (T1 with gadolinium and T2) within 84 days prior to surgery; Note: this imaging data (diagnostic pre-operative scan showing gross disease) is to be submitted in Digital Imaging and Communications in Medicine (DICOM) format via TRIAD; the report is to be uploaded into Rave
- Chest CT scan (with or without contrast) or CT/PET that includes the chest (with or without contrast) either within 84 days prior to surgery or within 120 days prior to registration; Note: if the CT/PET with or without contrast is done within 84 days prior to surgery, it fulfills the chest imaging requirement
-
Zubrod performance status of 0-1 within 14 days prior to registration
-
Age >= 18
-
Absolute granulocyte count (AGC) >= 1,500 cells/mm^3 (obtained within 14 days prior to registration on study)
-
Platelets >= 100,000 cells/mm^3 (obtained within 14 days prior to registration on study)
-
Hemoglobin >= 8.0 g/dl (Note: the use of transfusion or other intervention to achieve hemoglobin [Hgb] >= 8.0 g/dl is acceptable)
-
Total bilirubin < 2 x institutional upper limit of normal (ULN) within 14 days prior to registration
-
Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) < 3 x institutional ULN within 14 days prior to registration
-
Serum creatinine institutional ULN within 14 days prior to registration or; creatinine clearance (CC) >= 50 ml/min within 14 days prior to registration determined by 24-hour collection or estimated by Cockcroft-Gault formula
-
Negative urine or serum pregnancy test within 14 days prior to registration for women of childbearing potential
-
The following assessments are required within 14 days prior to registration: sodium (Na), potassium (K), chloride (Cl), glucose, calcium (Ca), magnesium (Mg), and albumin; Note: patients with an initial magnesium < 0.5 mmol/L (1.2 mg/dl) may receive corrective magnesium supplementation but should continue to receive either prophylactic weekly infusion of magnesium and/or oral magnesium supplementation (e.g., magnesium oxide) at the investigator's discretion
-
Patients with feeding tubes are eligible for the study
-
Women of childbearing potential and male participants who are sexually active must agree to use a medically effective means of birth control
-
Patient must provide study specific informed consent prior to study entry, including consent for mandatory tissue submission for epidermal growth factor receptor (EGFR) analysis and for oropharyngeal cancer patients, human papilloma virus (HPV) analysis
-
PHASE III: Pathologically (histologically or cytologically) proven diagnosis of head and neck squamous cell carcinoma (HNSCC) involving the oral cavity (excluding lips), oropharynx (p16 negative), larynx, or hypopharynx
-
PHASE III: Patients with oropharyngeal cancer must have p16-negative based on central review prior to Step 2 registration. All patients with oropharyngeal primary must consent for mandatory tissue submission for central p16 confirmation
-
PHASE III: Patients must have undergone gross total surgical resection of high-risk oral cavity, oropharynx (p16 negative), larynx, or hypopharynx within 63 days prior to registration
- Note: Patients may have biopsy under general anesthesia in an operating room followed by definitive ablative cancer surgery representing gross total resection. The gross total resection has to be done within 63 days prior to registration. If, however, patients have ablative resection but shortly recur or are determined to have persisting disease requiring re-resection to achieve gross total resection, then the patient is not eligible
-
PHASE III: Patients must have at least 1 of the following high-risk pathologic features: extracapsular nodal extension or invasive cancer at the primary tumor resection margin (tumor on ink or tumor in a final separately submitted margin)
-
PHASE III: Pathologic stage III or IV HNSCC (American Joint Committee on Cancer [AJCC] 7th edition), including no distant metastases, based upon the following minimum diagnostic workup:
- General history and physical examination by a radiation oncologist or medical oncologist within 84 days prior to registration;
- Examination by an ENT or head & neck surgeon prior to surgery; a laryngopharyngoscopy (mirror or fiberoptic or direct procedure), if appropriate, is recommended but not required. Intra-operative examination is acceptable documentation.
- Pre-op Imaging of the head and neck: A neck CT (with contrast and of diagnostic quality) or PET/CT (with contrast and of diagnostic quality) and/or an MRI of the neck of diagnostic quality (T1 with gadolinium and T2) within 84 days prior to surgery; Note: this imaging data (diagnostic pre-operative scan showing gross disease) is to be submitted in DICOM format via TRIAD. The report is to be uploaded into Rave.
- Chest CT scan (with or without contrast) or PET/CT that includes the chest (with or without contrast) either within 84 days prior to surgery or within 120 days prior to registration; Note: If the PET/CT with or without contrast is done within 84 days prior to surgery, it fulfills the chest imaging requirement
-
PHASE III: Zubrod performance status of 0-1 within 14 days prior to registration
-
PHASE III: Age >= 18
-
PHASE III: Leukocytes >= 2,500 cells/mm^3 (obtained within 14 days prior to registration on study)
-
PHASE III: Absolute neutrophil count (ANC) >= 1,500 cells/mm^3 (obtained within 14 days prior to registration on study)
-
PHASE III: Platelets >= 100,000 cells/mm^3 (obtained within 14 days prior to registration on study)
-
PHASE III: Hemoglobin >= 8.0 g/dL (Note: The use of transfusion or other intervention to achieve Hgb >= 8.0 g/dL is acceptable) (obtained within 14 days prior to registration on study)
-
PHASE III: Total bilirubin =< 1.5 x institutional upper limit of normal (ULN) (however, patients with known Gilbert disease who have serum bilirubin level =< 3 x institutional ULN may be enrolled) (within 14 days prior to registration)
-
PHASE III: AST or ALT =< 3 x institutional ULN (within 14 days prior to registration)
-
PHASE III: Alkaline phosphatase =< 2.5 x institutional ULN (within 14 days prior to registration)
-
PHASE III: Creatinine clearance (CrCl) >= 50 mL/min within 14 days prior to registration determined by 24-hour collection or estimated by Cockcroft-Gault formula
-
PHASE III: Patients with feeding tubes are eligible for the study
-
PHASE III: Negative urine or serum pregnancy test within 14 days prior to registration for women of childbearing potential
-
PHASE III: All patients must provide study specific informed consent prior to study entry
-
PHASE III: Patients positive for human immunodeficiency virus (HIV) are allowed on study, but HIV-positive patients must have:
- A stable regimen of highly active anti-retroviral therapy (HAART);
- No requirement for concurrent antibiotics or antifungal agents for the prevention of opportunistic infections;
- A CD4 count above 250 cells/mcL and an undetectable HIV viral load on standard polymerase chain reaction (PCR)-based tests
Exclusion Criteria:
-
PHASE II EXCLUSION CRITERIA (COMPLETE AS OF 20-MAR-2020)
-
Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 1095 days (3 years); noninvasive cancers (for example, carcinoma in situ of the breast, oral cavity, or cervix are all permissible) are permitted even if diagnosed and treated < 3 years ago
-
Patients with simultaneous primaries or bilateral tumors are excluded, with the exception of patients with bilateral tonsil cancers or patients with T1-2, N0, M0 resected differentiated thyroid carcinoma, who are eligible
-
Prior systemic chemotherapy or anti-epidermal growth factor (EGF) therapy for the study cancer; note that prior chemotherapy for a different cancer is allowable
-
Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields
-
Severe, active co-morbidity, defined as follows:
-
Unstable angina and/or congestive heart failure requiring hospitalization within 6 months prior to registration
-
Transmural myocardial infarction within 6 months prior to registration
-
Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration
-
Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration
- Idiopathic pulmonary fibrosis or other severe interstitial lung disease that requires oxygen therapy or is thought to require oxygen therapy within 1 year prior to registration
-
Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects; note, however, that laboratory tests for coagulation parameters are not required for entry into this protocol
- Acquired immune deficiency syndrome (AIDS) based upon current Centers for Disease and Control and Prevention (CDC) definition; note: human immunodeficiency virus (HIV) testing is not required for entry into this protocol; the need to exclude patients with AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive; protocol-specific requirements may also exclude immuno-compromised patients.
-
-
Grade 3-4 electrolyte abnormalities (Common Terminology Criteria for Adverse Events [CTCAE], version [v.] 4):
-
Serum calcium (ionized or adjusted for albumin) < 7 mg/dl (1.75 mmol/L) or > 12.5 mg/dl (> 3.1 mmol/L) despite intervention to normalize levels
-
Glucose < 40 mg/dl (< 2.2 mmol/L) or > 250 mg/dl (> 14 mmol/L)
-
Magnesium < 0.9 mg/dl (< 0.4 mmol/L) or > 3 mg/dl (> 1.23 mmol/L) despite intervention to normalize levels
-
Potassium < 3.0 mmol/L or > 6 mmol/L despite intervention to normalize levels
-
Sodium < 130 mmol/L or > 155 mmol/L despite intervention to normalize levels
-
Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception; this exclusion is necessary because the treatment involved in this study may be significantly teratogenic
-
Prior allergic reaction to cetuximab
-
PHASE III: Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 1095 days (3 years) with the following exceptions: T1-2, N0, M0 resected differentiated thyroid carcinoma; Note that noninvasive cancers (For example, carcinoma in situ of the breast, oral cavity, or cervix) are permitted even if diagnosed and treated < 3 years ago
-
PHASE III: Patients with simultaneous primaries or bilateral tumors are excluded, with the exception of patients with bilateral tonsil cancers or patients with T1-2, N0, M0 resected differentiated thyroid carcinoma, who are eligible
-
PHASE III: Prior systemic therapy, including cytotoxic chemotherapy, biologic/targeted therapy (such as anti-EGF therapy), or immune therapy for the study cancer; note that prior chemotherapy for a different cancer is allowable, however, a prior anti-PD-1, anti-PD-L1, or anti-PD-L2 agent is not permitted
-
PHASE III: Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields
-
PHASE III: Severe, active co-morbidity, defined as follows:
-
Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification; to be eligible for this trial, patients should be class 2B or better within 6 months prior to registration
-
Transmural myocardial infarction within 6 months prior to registration;
-
Severe infections within 4 weeks prior to registration including, but not limited to, hospitalization for complications of infection, bacteremia, or severe pneumonia;
-
Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration; Note: Patients receiving prophylactic antibiotics (e.g., for prevention of a urinary tract infection or chronic obstructive pulmonary disease exacerbation) are eligible.
-
Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration;
-
History of idiopathic pulmonary fibrosis, pneumonitis (including drug induced), organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia, etc.), or evidence of active pneumonitis on screening chest computed tomography (CT) scan. History of radiation pneumonitis in a prior radiation field (fibrosis) is permitted, provided that field does not overlap with the planned radiation field for the study cancer;
-
Patients with active tuberculosis (TB) are excluded;
-
Known clinically significant liver disease, including active viral, alcoholic, or other hepatitis; cirrhosis; fatty liver; and inherited liver disease;
- Patients with past or resolved hepatitis B infection (defined as having a negative hepatitis B surface antigen [HBsAg] test and a positive anti-HBc [antibody to hepatitis B core antigen] antibody test) are eligible.
- Patients positive for hepatitis C virus (HCV) antibody are eligible only if polymerase chain reaction (PCR) is negative for HCV RNA.
-
History of allogeneic bone marrow transplantation or solid organ transplantation.
-
A diagnosis of immunodeficiency:
- Acquired immune deficiency syndrome (AIDS) based upon current CDC definition; note: HIV testing is not required for entry into this protocol; the need to exclude patients with AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive.
-
Is receiving treatment with systemic immunosuppressive medications (including, but not limited to, prednisone, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor [anti-TNF] agents) within 2 weeks prior to registration.
- Note: Patients who have received acute, low dose, systemic immunosuppressant medications (e.g., a one-time dose of dexamethasone for nausea) may be enrolled.
- Note: The use of inhaled corticosteroids and mineralocorticoids (e.g., fludrocortisone) for patients with orthostatic hypotension or adrenocortical insufficiency is allowed.
-
History or risk of autoimmune disease, including, but not limited to, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with antiphospholipid syndrome, Wegener's granulomatosis, Sjogren's syndrome, Guillain-Barré syndrome, multiple sclerosis, vasculitis, or glomerulonephritis.
- Patients with a history of autoimmune hypothyroidism who are asymptomatic and/or are on a stable dose of thyroid replacement hormone are eligible.
- Patients with controlled Type 1 diabetes mellitus on a stable insulin regimen are eligible.
- Patients with eczema, psoriasis, lichen simplex chronicus, or vitiligo with dermatologic manifestations only (e.g., patients with psoriatic arthritis would be excluded) are permitted provided that they meet the following conditions:
- Patients with psoriasis must have a baseline ophthalmologic exam to rule out ocular manifestations
- Rash must cover less than 10% of body surface area (BSA)
- Disease is well controlled at baseline and only requiring low potency topical steroids (e.g., hydrocortisone 2.5%, hydrocortisone butyrate 0.1%, flucinolone 0.01%, desonide 0.05%, aclometasone dipropionate 0.05%)
- No acute exacerbations of underlying condition within the last 12 months (not requiring psoralen plus ultraviolet A radiation [PUVA], methotrexate, retinoids, biologic agents, oral calcineurin inhibitors; high potency or oral steroids)
-
-
PHASE III: Grade 3-4 electrolyte abnormalities (CTCAE, v. 4) within 14 days prior to registration:
- Serum calcium (ionized or adjusted for albumin) < 7 mg/dL (1.75 mmol/L) or > 12.5 mg/dL (> 3.1 mmol/L) despite intervention to normalize levels;
- Glucose < 40 mg/dL (< 2.2 mmol/L) or > 250 mg/dL (> 14 mmol/L);
- Magnesium < 0.9 mg/dL (< 0.4 mmol/L) or > 3 mg/dL (> 1.23 mmol/L) despite intervention to normalize levels;
- Potassium < 3.0 mmol/L or > 6 mmol/L despite intervention to normalize levels;
- Sodium < 130 mmol/L or > 155 mmol/L despite intervention to normalize levels.
-
PHASE III: Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception for up to 5 months from last study treatment; this exclusion is necessary because the treatment involved in this study may be significantly teratogenic. Women who are breastfeeding and unwilling to discontinue are also excluded
-
PHASE III: History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins
-
PHASE III: Patients taking bisphosphonate therapy for symptomatic hypercalcemia. Use of bisphosphonate therapy for other non-oncologic reasons (e.g., osteoporosis) is allowed
-
PHASE III: Patients requiring treatment with a RANKL inhibitor (e.g. denosumab) for non-oncologic reasons who cannot discontinue it before registration
-
PHASE III: Patients with known distant metastatic disease are excluded
-
PHASE III: Known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies
-
PHASE III: Major surgical procedure within 28 days prior to registration or anticipation of need for a major surgical procedure during the course of the study
-
PHASE III: Administration of a live, attenuated vaccine within 4 weeks prior to registration or anticipation that such a live, attenuated vaccine will be required during the study and for patients receiving atezolizumab, up to 5 months after the last dose of atezolizumab.
- Influenza vaccination should be given during influenza season only (approximately October to
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
|
Experimental: Arm 1 (IMRT, cisplatin)
Patients undergo IMRT QD five days a week for 6 weeks and receive concurrent cisplatin IV over 1-2 hours once weekly for 6 weeks in the absence of disease progression or unacceptable toxicity. Patients undergo collection of blood samples during screening and throughout the study and may undergo CT scans and/or MRI and biopsy as clinically indicated on study. |
Given IV
Andere Namen:
Undergo CT
Andere Namen:
Undergo MRI
Andere Namen:
Undergo biopsy
Andere Namen:
Undergo collection of blood
Andere Namen:
Undergo IMRT
Andere Namen:
Ancillary studies |
|
Experimental: Arm 2 (IMRT, docetaxel)
Patients undergo IMRT as in Arm I and receive concurrent docetaxel IV over 60 minutes once weekly for 6 weeks in the absence of disease progression or unacceptable toxicity. Patients undergo CT scans and/or MRI, and collection of blood during follow-up. (CLOSED AS OF 20-MAR-2020) |
Given IV
Andere Namen:
Undergo CT
Andere Namen:
Undergo MRI
Andere Namen:
Undergo collection of blood
Andere Namen:
Undergo IMRT
Andere Namen:
Ancillary studies |
|
Experimental: Arm 3 (IMRT, docetaxel, cetuximab)
Patients receive cetuximab IV over 120 minutes on week 1 and over 60 minutes once weekly on weeks 2-7. Patients undergo IMRT as in Arm I and receive concurrent docetaxel once weekly for 6 weeks in the absence of disease progression or unacceptable toxicity. Patients undergo collection of blood samples during screening and throughout the study and may undergo CT scans and/or MRI and biopsy as clinically indicated on study. |
Given IV
Andere Namen:
Undergo CT
Andere Namen:
Undergo MRI
Andere Namen:
Undergo biopsy
Andere Namen:
Undergo collection of blood
Andere Namen:
Undergo IMRT
Andere Namen:
Given IV
Andere Namen:
Ancillary studies |
|
Experimental: Arm 4 (IMRT, cisplatin, atezolizumab)
Patients undergo IMRT QD five days a week for 6 weeks and receive concurrent cisplatin IV over 1-2 hours once weekly for 6 weeks. Starting 1 week before IMRT, patients also receive atezolizumab IV over 30-60 minutes every 3 weeks for up to 8 doses (weeks -1, 3, 6, 9, 12, 15, 18, and 21) in the absence of disease progression and unacceptable toxicity. Patients undergo collection of blood samples during screening and throughout the study and may undergo CT scans and/or MRI and biopsy as clinically indicated on study. |
Given IV
Andere Namen:
Undergo CT
Andere Namen:
Undergo MRI
Andere Namen:
Undergo biopsy
Andere Namen:
Undergo collection of blood
Andere Namen:
Given IV
Andere Namen:
Undergo IMRT
Andere Namen:
Ancillary studies |
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Disease-free survival (Phase II)
Zeitfenster: From date of randomization until date of local-regional recurrence, distant metastasis or death due to any cause, assessed up to 7 years
|
Estimated using the Kaplan-Meier method for each arm. Their distributions will be compared between treatment arms with a one-sided log rank test. |
From date of randomization until date of local-regional recurrence, distant metastasis or death due to any cause, assessed up to 7 years
|
|
Overall survival (Phase III)
Zeitfenster: From date of randomization to death due to any cause, assessed up to 7 years
|
Estimated using the Kaplan-Meier method for each arm. Their distributions will be compared between treatment arms with a one-sided log rank test. Multivariate analysis will be performed using the Cox proportional hazards model. |
From date of randomization to death due to any cause, assessed up to 7 years
|
Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Local-regional failure
Zeitfenster: From date of randomization until date of local-regional recurrence, assessed up to 7 years
|
The cumulative incidence method will be used to estimate rates, and the failure rates for the experimental arms will be compared against the control using a failure-specific log rank test. |
From date of randomization until date of local-regional recurrence, assessed up to 7 years
|
|
Distant metastasis
Zeitfenster: From date of randomization to date of distant metastasis, assessed up to 7 years
|
The cumulative incidence method will be used to estimate rates, and the failure rates for the experimental arms will be compared against the control using a failure-specific log rank test. |
From date of randomization to date of distant metastasis, assessed up to 7 years
|
|
Toxicity
Zeitfenster: From start of treatment to death or last follow-up
|
Adverse events will be graded using Common Terminology Criteria for Adverse Events version 4.0. Rates of grade 3+ adverse events overall will be compared between arms by Chi-square test, or Fisher's exact test. |
From start of treatment to death or last follow-up
|
|
Patient-reported outcome, symptom burden
Zeitfenster: Time from randomization to a first recovery within at least one MID unit of total symptom severity compared to the baseline (reference) score
|
Time to recovery of baseline total symptom severity from the MD Anderson Symptom Inventory - Head and Neck. The cumulative incidence method will be used to estimate the event rates, and the event rates between arms will be compared using a cause-specific log rank test. The Fine-Gray subdistribution hazards model may be applied to further explore outcomes by treatment arm and other covariates. |
Time from randomization to a first recovery within at least one MID unit of total symptom severity compared to the baseline (reference) score
|
|
Quality of life
Zeitfenster: Baseline and 1 year post radiation therapy
|
Quality of life change from baseline at 1-year post RT, as measured by the Functional Assessment of Cancer Therapy - Head and Neck (FACT) Trial Outcome Index (TOI). FACT TOI is a validated efficient summary index of physical/functional outcomes, and disease site-specific items, which is highly reliable and sensitive to change in performance status rating. A constrained longitudinal data analysis model will be fitted with all the time points (discrete), the treatment factor and its interaction. The secondary non-inferiority patient-reported outcome hypothesis will be tested using a confidence interval approach. |
Baseline and 1 year post radiation therapy
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Hauptermittler: Paul M Harari, NRG Oncology
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Geschätzt)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
- Neubildungen nach Standort
- Neubildungen
- Neubildungen nach histologischem Typ
- Kopf-Hals-Neubildungen
- Neubildungen, Drüsen und Epithelien
- Karzinom
- Karzinom, Plattenepithel
- Plattenepithelkarzinom von Kopf und Hals
- Aminosäuren, Peptide und Proteine
- Proteine
- Organische Chemikalien
- Untersuchungstechniken
- Therapeutika
- Klinische Labortechniken
- Diagnosetechniken und Verfahren
- Diagnose
- Chirurgische Eingriffe, operativ
- Zytologische Techniken
- Zytodiagnose
- Kohlenwasserstoffe
- Cycloparaffine
- Kohlenwasserstoffe, alicyclisch
- Kohlenwasserstoffe, zyklisch
- Terpene
- Antikörper, monoklonal, humanisiert
- Antikörper, monoklonal
- Antikörper
- Immunglobuline
- Immunoproteine
- Blutproteine
- Serumglobuline
- Globuline
- Anorganische Chemikalien
- Chlorverbindungen
- Stickstoffverbindungen
- Taxoid
- Cyclodececane
- Diterpene
- Elemente
- Metalle
- Diagnosetechniken, chirurgisch
- Chemie -Techniken, analytisch
- Spektrumanalyse
- Metalle, schwer
- Platinverbindungen
- Strahlentherapie
- Übergangselemente
- Strahlentherapie, konform
- Strahlentherapie, computergestützt
- Docetaxel
- Cetuximab
- Cisplatin
- 1,2-Diaminocyclohexanplatin-II-Citrat
- Biopsie
- Handhabung von Proben
- Magnetresonanzspektroskopie
- Platin
- Atezolizumab
- Strahlentherapie, intensität moduliert
- (225) AC-DOTA-C (RGDYK)
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- NCI-2013-00500
- U10CA180868 (US NIH Stipendium/Vertrag)
- U10CA021661 (US NIH Stipendium/Vertrag)
- NCI-2013-00500 (Registrierungskennung: CTRP (Clinical Trial Reporting Program))
- RTOG-1216 (Andere Kennung: CTEP)
- RTOG-1216 (Andere Kennung: NRG Oncology)
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