Studie zur Chemotherapie mit oder ohne Binimetinib bei fortgeschrittenem Krebs der Gallenwege in der Zweitlinieneinstellung (eine ComboMATCH-Behandlungsstudie)
Eine ComboMATCH-Behandlungsstudie: FOLFOX in Kombination mit Binimetinib als Zweitlinientherapie für Patienten mit fortgeschrittenem Gallengangskrebs mit Veränderungen des MAPK-Signalwegs
This phase II ComboMATCH treatment trial compares the usual treatment of modified leucovorin, fluorouracil and oxaliplatin (mFOLFOX6) chemotherapy to using binimetinib plus mFOLFOX6 chemotherapy to shrink tumors in patients with biliary tract cancers that have spread to other places in the body (advanced) and had progression of cancer after previous treatments (2nd line setting). Fluorouracil is in a class of medications called antimetabolites. It works by slowing or stopping the growth of cancer cells in the body. Oxaliplatin is in a class of medications called platinum-containing antineoplastic agents. It works by killing tumor cells. Leucovorin may help the other drugs in the mFOLFOX6 chemotherapy regimen work better by making tumor cells more sensitive to the drugs. Binimetinib is in a class of medications called kinase inhibitors. It works by blocking the action of the abnormal protein that signals tumor cells to multiply. This helps to stop or slow the spread of tumor cells. Giving binimetinib in combination with mFOLFOX6 chemotherapy may be effective in shrinking or stabilizing advanced biliary tract cancers in the 2nd line setting.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
- Stadium III Intrahepatisches Cholangiokarzinom AJCC v8
- Stadium III Gallenblasenkrebs AJCC v8
- Rezidivierendes Gallenblasenkarzinom
- Inoperables Gallenblasenkarzinom
- Stadium III Hilar Cholangiokarzinom AJCC v8
- Stadium IV Gallenblasenkrebs AJCC v8
- Stadium IV Hilar Cholangiokarzinom AJCC v8
- Stadium IV Intrahepatisches Cholangiokarzinom AJCC v8
- Distaler Gallengangskrebs im Stadium IV AJCC v8
- Nicht resezierbares intrahepatisches Cholangiokarzinom
- Fortgeschrittenes Gallengangskarzinom
- Fortgeschrittenes intrahepatisches Cholangiokarzinom
- Rezidivierendes intrahepatisches Cholangiokarzinom
- Distaler Gallengangskrebs im Stadium III AJCC v8
- Fortgeschrittenes Gallenblasenkarzinom
- Rezidivierendes Karzinom der Gallenwege
- Nicht resezierbares Karzinom der Gallenwege
Intervention / Behandlung
Intervention / Behandlung
- Arzneimittel: Fluorouracil
- Verfahren: Computed Tomography
- Verfahren: Magnetic Resonance Imaging
- Verfahren: Echocardiography Test
- Verfahren: Multigated Acquisition Scan
- Verfahren: Biopsy Procedure
- Verfahren: Biospecimen Collection
- Arzneimittel: Binimetinib
- Arzneimittel: Leucovorin Calcium
- Arzneimittel: Oxaliplatin
- Verfahren: Bone Scan
Detaillierte Beschreibung
PRIMARY OBJECTIVE:
I. To determine whether binimetinib and mFOLFOX6 combination therapy improves overall survival (OS) compared to mFOLFOX6 alone in patients with advanced/recurrent biliary tract cancer (BTC) and with alterations in RAS/RAF/MEK/ERK pathway, who have progressed on one prior line of therapy.
SECONDARY OBJECTIVES:
I. To determine whether binimetinib and mFOLFOX6 combination therapy improves objective response rate (ORR) compared to FOLFOX alone.
II. To determine if clinical outcomes including progression free survival (PFS), duration of response (DOR), and disease control rate (DCR) are improved with combination treatment of binimetinib and mFOLFOX6 compared to FOLFOX alone in patients with advanced/recurrent BTC and with alterations in RAS/RAF/MEK/ERK pathway who have progression on one prior line of therapy.
III. Toxicity and tolerability will be evaluated within and between the two treatment arms, where frequency, type, and severity of adverse events will be assessed per the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version (v)5.0.
IV. Collect tissue and provide it to the ComboMATCH Registration Protocol to assess concordance between the diagnostic tumor mutation profile generated by the Designated Laboratories, the pre-treatment biopsy mutation profile, and the pre-treatment circulating tumor deoxyribonucleic acid (ctDNA) mutation profile from plasma, as described in ComboMATCH Registration Protocol.
EXPLORATORY OBJECTIVES:
I. Generate a prognostic model of MAPK mutations for this patient population using clinical, laboratory and molecular features of their disease and clinical outcome to validate on future samples.
II. Correlation of outcome with albumin. III. Assess the correlation between the presence of MAPK pathway mutations and activity of addition of binimetinib therapy to standard 2nd line chemotherapy.
IV. Conduct whole-exome sequencing and ribonucleic acid (RNA)-sequencing at baseline, and on optional biopsy upon progression to assess determinants of response and resistance.
V. Explore changes in plasma MAPK mutations allelic burden and other molecular findings at baseline and upon progression using ctDNA and correlate changes with clinical activity, disease course as well as response/resistance to therapy.
VI. Evaluate if our machine learning algorithm for RAS/RAF/MEK/ERK pathway mutations correlates with detection of mutations as well as prediction of outcomes from samples obtained in this study.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM 1: Patients receive leucovorin intravenously (IV) over 2 hours and oxaliplatin IV over 2 hours on day 1, and fluorouracil IV over 46-48 hours on days 1-2. Cycles repeat every 14 days in the absence of disease progression or unacceptable toxicity. Patients undergo collection of blood during screening and on study, and undergo computed tomography (CT) with contrast, magnetic resonance imaging (MRI), or fludeoxyglucose F-18 positron emission tomography (FDG-PET) throughout the trial as clinically indicated. Patients may also undergo bone scans on study and may undergo biopsies throughout the study as clinically indicated.
ARM 2: Patients receive binimetinib orally (PO) on days 1-14, and leucovorin IV, oxaliplatin IV, and fluorouracil IV as in Arm 1. Cycles repeat every 14 days in the absence of disease progression or unacceptable toxicity. Patients undergo echocardiogram (ECHO) or multigated acquisition scan (MUGA) and collection of blood during screening and on study, and undergo CT with contrast, MRI, or FDG-PET throughout the trial as clinically indicated. Patients may also undergo bone scans on study and may undergo biopsies throughout the study as clinically indicated.
After completion of study treatment, patients are followed up every 8 weeks until disease progression, thereafter patients are followed for survival every 4 months for up to 5 years following registration.
Studientyp
Studientyp
Einschreibung (Tatsächlich)
Einschreibung
Phase
Phase
- Phase 2
Kontakte und Standorte
Studienorte
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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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Mobile, Alabama, Vereinigte Staaten, 36688
- University of South Alabama Mitchell Cancer Institute
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Arizona
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Phoenix, Arizona, Vereinigte Staaten, 85054
- Mayo Clinic Hospital in Arizona
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Arkansas
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Jonesboro, Arkansas, Vereinigte Staaten, 72401
- NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
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California
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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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Whittier, California, Vereinigte Staaten, 90602
- Presbyterian Intercommunity Hospital
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Florida
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Aventura, Florida, Vereinigte Staaten, 33180
- UM Sylvester Comprehensive Cancer Center at Aventura
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Coral Gables, Florida, Vereinigte Staaten, 33146
- UM Sylvester Comprehensive Cancer Center at Coral Gables
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Deerfield Beach, Florida, Vereinigte Staaten, 33442
- UM Sylvester Comprehensive Cancer Center at Deerfield Beach
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Gainesville, Florida, Vereinigte Staaten, 32610
- UF Health Cancer Institute - Gainesville
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Jacksonville, Florida, Vereinigte Staaten, 32224-9980
- Mayo Clinic in Florida
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Miami, Florida, Vereinigte Staaten, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
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Miami, Florida, Vereinigte Staaten, 33176
- UM Sylvester Comprehensive Cancer Center at Kendall
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Plantation, Florida, Vereinigte Staaten, 33324
- UM Sylvester Comprehensive Cancer Center at Plantation
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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, 96813
- Hawaii Cancer Care Inc - Waterfront Plaza
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Honolulu, Hawaii, Vereinigte Staaten, 96813
- Queen's Cancer Cenrer - POB I
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Honolulu, Hawaii, Vereinigte Staaten, 96817
- Queen's Cancer Center - Kuakini
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‘Aiea, Hawaii, Vereinigte Staaten, 96701
- Hawaii Cancer Care - Westridge
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‘Ewa Beach, Hawaii, Vereinigte Staaten, 96706
- The Queen's Medical Center - West Oahu
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Idaho
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Boise, Idaho, Vereinigte Staaten, 83706
- Saint Alphonsus Cancer Care Center-Boise
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Boise, Idaho, Vereinigte Staaten, 83712
- Saint Luke's Cancer Institute - Boise
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Caldwell, Idaho, Vereinigte Staaten, 83605
- Saint Alphonsus Cancer Care Center-Caldwell
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Coeur d'Alene, Idaho, Vereinigte Staaten, 83814
- Kootenai Health - Coeur d'Alene
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Fruitland, Idaho, Vereinigte Staaten, 83619
- Saint Luke's Cancer Institute - Fruitland
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Meridian, Idaho, Vereinigte Staaten, 83642
- Saint Luke's Cancer Institute - Meridian
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Nampa, Idaho, Vereinigte Staaten, 83687
- Saint Alphonsus Cancer Care Center-Nampa
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Nampa, Idaho, Vereinigte Staaten, 83687
- Saint Luke's Cancer Institute - Nampa
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Post Falls, Idaho, Vereinigte Staaten, 83854
- Kootenai Clinic Cancer Services - Post Falls
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Sandpoint, Idaho, Vereinigte Staaten, 83864
- Kootenai Clinic Cancer Services - Sandpoint
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Illinois
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Barrington, Illinois, Vereinigte Staaten, 60010
- Advocate Good Shepherd Hospital
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Chicago, Illinois, Vereinigte Staaten, 60611
- Northwestern University
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Chicago, Illinois, Vereinigte Staaten, 60637
- University of Chicago Comprehensive Cancer Center
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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, 60657
- Advocate Illinois Masonic Medical Center
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Crystal Lake, Illinois, Vereinigte Staaten, 60014
- AMG Crystal Lake - Oncology
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Danville, Illinois, Vereinigte Staaten, 61832
- Carle at The Riverfront
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DeKalb, Illinois, Vereinigte Staaten, 60115
- Northwestern Medicine Cancer Center Kishwaukee
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Decatur, Illinois, Vereinigte Staaten, 62526
- Decatur Memorial Hospital
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Decatur, Illinois, Vereinigte Staaten, 62526
- Cancer Care Specialists of Illinois - Decatur
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Downers Grove, Illinois, Vereinigte Staaten, 60515
- Advocate Good Samaritan Hospital
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Effingham, Illinois, Vereinigte Staaten, 62401
- Crossroads Cancer Center
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Effingham, Illinois, Vereinigte Staaten, 62401
- Carle Physician Group-Effingham
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Elgin, Illinois, Vereinigte Staaten, 60123
- Advocate Sherman Hospital
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Geneva, Illinois, Vereinigte Staaten, 60134
- Northwestern Medicine Cancer Center Delnor
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Glenview, Illinois, Vereinigte Staaten, 60026
- Northwestern Medicine Glenview Outpatient Center
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Grayslake, Illinois, Vereinigte Staaten, 60030
- Northwestern Medicine Grayslake Outpatient Center
-
Hazel Crest, Illinois, Vereinigte Staaten, 60429
- Advocate South Suburban Hospital
-
Lake Forest, Illinois, Vereinigte Staaten, 60045
- Northwestern Medicine Lake Forest Hospital
-
Libertyville, Illinois, Vereinigte Staaten, 60048
- Condell Memorial Hospital
-
Libertyville, Illinois, Vereinigte Staaten, 60048
- AMG Libertyville - Oncology
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Mattoon, Illinois, Vereinigte Staaten, 61938
- Carle Physician Group-Mattoon/Charleston
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New Lenox, Illinois, Vereinigte Staaten, 60451
- UC Comprehensive Cancer Center at Silver Cross
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O'Fallon, Illinois, Vereinigte Staaten, 62269
- Cancer Care Center of O'Fallon
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Oak Lawn, Illinois, Vereinigte Staaten, 60453-2699
- Advocate Christ Medical Center
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Orland Park, Illinois, Vereinigte Staaten, 60462
- University of Chicago Medicine-Orland Park
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Orland Park, Illinois, Vereinigte Staaten, 60462
- Northwestern Medicine Orland Park
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Park Ridge, Illinois, Vereinigte Staaten, 60068
- Advocate Lutheran General Hospital
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Shiloh, Illinois, Vereinigte Staaten, 62269
- Memorial Hospital East
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Springfield, Illinois, Vereinigte Staaten, 62702
- Southern Illinois University School of Medicine
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Springfield, Illinois, Vereinigte Staaten, 62702
- Springfield Clinic
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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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Warrenville, Illinois, Vereinigte Staaten, 60555
- Northwestern Medicine Cancer Center Warrenville
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Iowa
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Ankeny, Iowa, Vereinigte Staaten, 50023
- UI Health Care Mission Cancer and Blood - Ankeny Clinic
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Des Moines, Iowa, Vereinigte Staaten, 50309
- UI Health Care Mission Cancer and Blood - Des Moines Clinic
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Waukee, Iowa, Vereinigte Staaten, 50263
- UI Health Care Mission Cancer and Blood - Waukee Clinic
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Kentucky
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Lexington, Kentucky, Vereinigte Staaten, 40536
- University of Kentucky/Markey Cancer Center
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Maine
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Brewer, Maine, Vereinigte Staaten, 04412
- Lafayette Family Cancer Center-EMMC
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Maryland
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Baltimore, Maryland, Vereinigte Staaten, 21201
- University of Maryland/Greenebaum Cancer Center
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Bethesda, Maryland, Vereinigte Staaten, 20892
- National Institutes of Health Clinical Center
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Bethesda, Maryland, Vereinigte Staaten, 20889-5600
- Walter Reed National Military Medical Center
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Cumberland, Maryland, Vereinigte Staaten, 21502
- UPMC Western Maryland
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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, 48114
- Trinity Health IHA Medical Group Hematology Oncology - Brighton
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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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Canton, Michigan, Vereinigte Staaten, 48188
- Trinity Health IHA Medical Group Hematology Oncology - Canton
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Canton, Michigan, Vereinigte Staaten, 48188
- Trinity Health Medical Center - Canton
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Chelsea, Michigan, Vereinigte Staaten, 48118
- Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
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Chelsea, Michigan, Vereinigte Staaten, 48118
- Chelsea Hospital
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Dearborn, Michigan, Vereinigte Staaten, 48124
- Corewell Health Dearborn Hospital
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Farmington Hills, Michigan, Vereinigte Staaten, 48336
- Corewell Health Farmington Hills Hospital
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Flint, Michigan, Vereinigte Staaten, 48503
- Hurley Medical Center
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Flint, Michigan, Vereinigte Staaten, 48503
- Genesee Hematology Oncology PC
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Flint, Michigan, Vereinigte Staaten, 48503
- Genesys Hurley Cancer Institute
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Flint, Michigan, Vereinigte Staaten, 48503
- Cancer Hematology Centers - Flint
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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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Macomb, Michigan, Vereinigte Staaten, 48044
- Henry Ford Saint John Hospital - Macomb Medical
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Pontiac, Michigan, Vereinigte Staaten, 48341
- Trinity Health Saint Joseph Mercy Oakland Hospital
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Royal Oak, Michigan, Vereinigte Staaten, 48073
- Corewell Health William Beaumont University Hospital
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Troy, Michigan, Vereinigte Staaten, 48085
- Corewell Health Beaumont Troy Hospital
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Ypsilanti, Michigan, Vereinigte Staaten, 48197
- Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
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Ypsilanti, Michigan, Vereinigte Staaten, 48106
- Huron Gastroenterology PC
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Minnesota
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Bemidji, Minnesota, Vereinigte Staaten, 56601
- Sanford Joe Lueken Cancer Center
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Coon Rapids, Minnesota, Vereinigte Staaten, 55433
- Mercy Hospital
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Deer River, Minnesota, Vereinigte Staaten, 56636
- Essentia Health - Deer River Clinic
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Duluth, Minnesota, Vereinigte Staaten, 55805
- Essentia Health Cancer Center
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Edina, Minnesota, Vereinigte Staaten, 55435
- Fairview Southdale Hospital
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Hibbing, Minnesota, Vereinigte Staaten, 55746
- Essentia Health Hibbing Clinic
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Maplewood, Minnesota, Vereinigte Staaten, 55109
- Saint John's Hospital - Healtheast
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Minneapolis, Minnesota, Vereinigte Staaten, 55407
- Abbott-Northwestern Hospital
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Rochester, Minnesota, Vereinigte Staaten, 55905
- Mayo Clinic in Rochester
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Saint Louis Park, Minnesota, Vereinigte Staaten, 55416
- Park Nicollet Clinic - Saint Louis Park
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Saint Paul, Minnesota, Vereinigte Staaten, 55101
- Regions Hospital
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Saint Paul, Minnesota, Vereinigte Staaten, 55102
- United Hospital
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Sandstone, Minnesota, Vereinigte Staaten, 55072
- Essentia Health Sandstone
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Virginia, Minnesota, Vereinigte Staaten, 55792
- Essentia Health Virginia Clinic
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Mississippi
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Columbus, Mississippi, Vereinigte Staaten, 39705
- Baptist Memorial Hospital and Cancer Center-Golden Triangle
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Grenada, Mississippi, Vereinigte Staaten, 38901
- Baptist Cancer Center-Grenada
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New Albany, Mississippi, Vereinigte Staaten, 38652
- Baptist Memorial Hospital and Cancer Center-Union County
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Oxford, Mississippi, Vereinigte Staaten, 38655
- Baptist Memorial Hospital and Cancer Center-Oxford
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Southhaven, Mississippi, Vereinigte Staaten, 38671
- Baptist Memorial Hospital and Cancer Center-Desoto
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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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Creve Coeur, Missouri, Vereinigte Staaten, 63141
- Siteman Cancer Center at West County Hospital
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Farmington, Missouri, Vereinigte Staaten, 63640
- Parkland Health Center - Farmington
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Sainte Genevieve, Missouri, Vereinigte Staaten, 63670
- Sainte Genevieve County Memorial Hospital
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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, 63136
- Siteman Cancer Center at Christian Hospital
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St Louis, Missouri, Vereinigte Staaten, 63131
- Missouri Baptist Medical Center
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Sullivan, Missouri, Vereinigte Staaten, 63080
- Missouri Baptist Sullivan Hospital
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Montana
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Anaconda, Montana, Vereinigte Staaten, 59711
- Community Hospital of Anaconda
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Billings, Montana, Vereinigte Staaten, 59101
- Billings Clinic Cancer Center
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Bozeman, Montana, Vereinigte Staaten, 59715
- Bozeman Health Deaconess Hospital
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Great Falls, Montana, Vereinigte Staaten, 59405
- Benefis Sletten Cancer Institute
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Kalispell, Montana, Vereinigte Staaten, 59901
- Logan Health Medical Center
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Missoula, Montana, Vereinigte Staaten, 59804
- Community Medical Center
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Nebraska
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Bellevue, Nebraska, Vereinigte Staaten, 68123
- Nebraska Medicine-Bellevue
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Omaha, Nebraska, Vereinigte Staaten, 68198
- University of Nebraska Medical Center
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Omaha, Nebraska, Vereinigte Staaten, 68118
- Nebraska Medicine-Village Pointe
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Nevada
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Las Vegas, Nevada, Vereinigte Staaten, 89102
- OptumCare Cancer Care at Charleston
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Las Vegas, Nevada, Vereinigte Staaten, 89183
- OptumCare Cancer Care at Fort Apache
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Reno, Nevada, Vereinigte Staaten, 89502
- Renown Regional Medical Center
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New Mexico
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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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Buffalo, New York, Vereinigte Staaten, 14263
- Roswell Park Cancer Institute
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North Dakota
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Bismarck, North Dakota, Vereinigte Staaten, 58501
- Sanford Bismarck Medical Center
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Fargo, North Dakota, Vereinigte Staaten, 58122
- Sanford Roger Maris Cancer Center
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Fargo, North Dakota, Vereinigte Staaten, 58122
- Sanford Broadway Medical Center
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Ohio
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Centerville, Ohio, Vereinigte Staaten, 45459
- Miami Valley Hospital South
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Dayton, Ohio, Vereinigte Staaten, 45409
- Miami Valley Hospital
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Dayton, Ohio, Vereinigte Staaten, 45415
- Miami Valley Hospital North
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Dayton, Ohio, Vereinigte Staaten, 45415
- Dayton Physician LLC - Englewood
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Dayton, Ohio, Vereinigte Staaten, 45409
- Premier Blood and Cancer Center
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Franklin, Ohio, Vereinigte Staaten, 45005-1066
- Atrium Medical Center-Middletown Regional Hospital
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Greenville, Ohio, Vereinigte Staaten, 45331
- Miami Valley Cancer Care and Infusion
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Kettering, Ohio, Vereinigte Staaten, 45429
- Kettering Medical Center
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Troy, Ohio, Vereinigte Staaten, 45373
- Upper Valley Medical Center
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Oklahoma
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Oklahoma City, Oklahoma, Vereinigte Staaten, 73104
- University of Oklahoma Health Sciences Center
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Oregon
-
Ontario, Oregon, Vereinigte Staaten, 97914
- Saint Alphonsus Cancer Care Center-Ontario
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Pennsylvania
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Allentown, Pennsylvania, Vereinigte Staaten, 18103
- Lehigh Valley Hospital-Cedar Crest
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Altoona, Pennsylvania, Vereinigte Staaten, 16601
- UPMC Altoona
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Bethlehem, Pennsylvania, Vereinigte Staaten, 18017
- Lehigh Valley Hospital - Muhlenberg
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East Stroudsburg, Pennsylvania, Vereinigte Staaten, 18301
- Pocono Medical Center
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Erie, Pennsylvania, Vereinigte Staaten, 16505
- UPMC Hillman Cancer Center Erie
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Greensburg, Pennsylvania, Vereinigte Staaten, 15601
- UPMC Cancer Centers - Arnold Palmer Pavilion
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Hazleton, Pennsylvania, Vereinigte Staaten, 18201
- Lehigh Valley Hospital-Hazleton
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Mechanicsburg, Pennsylvania, Vereinigte Staaten, 17050
- UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion
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Monroeville, Pennsylvania, Vereinigte Staaten, 15146
- UPMC Hillman Cancer Center - Monroeville
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Pittsburgh, Pennsylvania, Vereinigte Staaten, 15232
- UPMC Hillman Cancer Center
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Pittsburgh, Pennsylvania, Vereinigte Staaten, 15237
- UPMC-Passavant Hospital
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South Dakota
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Sioux Falls, South Dakota, Vereinigte Staaten, 57117-5134
- Sanford USD Medical Center - Sioux Falls
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Sioux Falls, South Dakota, Vereinigte Staaten, 57104
- Sanford Cancer Center Oncology Clinic
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Tennessee
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Collierville, Tennessee, Vereinigte Staaten, 38017
- Baptist Memorial Hospital and Cancer Center-Collierville
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Memphis, Tennessee, Vereinigte Staaten, 38120
- Baptist Memorial Hospital and Cancer Center-Memphis
-
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Texas
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Conroe, Texas, Vereinigte Staaten, 77384
- UT MD Anderson - The Woodlands
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Houston, Texas, Vereinigte Staaten, 77030
- UT MD Anderson Cancer Center
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Houston, Texas, Vereinigte Staaten, 77079
- UT MD Anderson - West Houston
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League City, Texas, Vereinigte Staaten, 77573
- UT MD Anderson - League City
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Sugar Land, Texas, Vereinigte Staaten, 77478
- UT MD Anderson - Sugar Land
-
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Virginia
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Charlottesville, Virginia, Vereinigte Staaten, 22908
- University of Virginia Cancer Center
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Fairfax, Virginia, Vereinigte Staaten, 22031
- Inova Schar Cancer Institute
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Falls Church, Virginia, Vereinigte Staaten, 22042
- Inova Fairfax Hospital
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Richmond, Virginia, Vereinigte Staaten, 23235
- VCU Massey Cancer Center at Stony Point
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Richmond, Virginia, Vereinigte Staaten, 23229
- Virginia Cancer Institute
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Richmond, Virginia, Vereinigte Staaten, 23298
- VCU Massey Comprehensive Cancer Center
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South Hill, Virginia, Vereinigte Staaten, 23970
- VCU Community Memorial Health Center
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Washington
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Edmonds, Washington, Vereinigte Staaten, 98026
- Swedish Cancer Institute-Edmonds
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Issaquah, Washington, Vereinigte Staaten, 98029
- Swedish Cancer Institute-Issaquah
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Renton, Washington, Vereinigte Staaten, 98055
- Valley Medical Center
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Seattle, Washington, Vereinigte Staaten, 98122
- Swedish Medical Center-First Hill
-
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West Virginia
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Morgantown, West Virginia, Vereinigte Staaten, 26506
- West Virginia University Healthcare
-
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Wisconsin
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Appleton, Wisconsin, Vereinigte Staaten, 54911
- ThedaCare Regional Cancer Center
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Ashland, Wisconsin, Vereinigte Staaten, 54806
- Duluth Clinic Ashland
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Berlin, Wisconsin, Vereinigte Staaten, 54923
- ThedaCare Cancer Care - Berlin
-
Burlington, Wisconsin, Vereinigte Staaten, 53105
- Aurora Cancer Care-Southern Lakes VLCC
-
Cudahy, Wisconsin, Vereinigte Staaten, 53110
- Aurora Saint Luke's South Shore
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Germantown, Wisconsin, Vereinigte Staaten, 53022
- Aurora Health Care Germantown Health Center
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Grafton, Wisconsin, Vereinigte Staaten, 53024
- Aurora Cancer Care-Grafton
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Green Bay, Wisconsin, Vereinigte Staaten, 54311
- Aurora BayCare Medical Center
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Kenosha, Wisconsin, Vereinigte Staaten, 53142
- Aurora Cancer Care-Kenosha South
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Marinette, Wisconsin, Vereinigte Staaten, 54143
- Aurora Bay Area Medical Group-Marinette
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Milwaukee, Wisconsin, Vereinigte Staaten, 53209
- Aurora Cancer Care-Milwaukee
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Milwaukee, Wisconsin, Vereinigte Staaten, 53215
- Aurora Saint Luke's Medical Center
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Milwaukee, Wisconsin, Vereinigte Staaten, 53233
- Aurora Sinai Medical Center
-
Neenah, Wisconsin, Vereinigte Staaten, 54956
- ThedaCare Regional Medical Center - Neenah
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Oshkosh, Wisconsin, Vereinigte Staaten, 54904
- Vince Lombardi Cancer Clinic - Oshkosh
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Racine, Wisconsin, Vereinigte Staaten, 53406
- Aurora Cancer Care-Racine
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Sheboygan, Wisconsin, Vereinigte Staaten, 53081
- Vince Lombardi Cancer Clinic-Sheboygan
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Summit, Wisconsin, Vereinigte Staaten, 53066
- Aurora Medical Center in Summit
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Two Rivers, Wisconsin, Vereinigte Staaten, 54241
- Vince Lombardi Cancer Clinic-Two Rivers
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Wauwatosa, Wisconsin, Vereinigte Staaten, 53226
- Aurora Cancer Care-Milwaukee West
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West Allis, Wisconsin, Vereinigte Staaten, 53227
- Aurora West Allis Medical Center
-
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
-
Patient must have enrolled onto EAY191 and must have been given a treatment assignment to ComboMATCH to EAY191-A6 based on the presence of an actionable mutation as defined in EAY191
-
GENERAL COMBOMATCH EAY191:
-
Patients must be registered to the ComboMATCH Registration Protocol (EAY191)
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Patients must have RAS/RAF/MEK/ERK mutations as determined by the ComboMATCH screening assessment
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Patients must not have BRAF V600E as determined by the ComboMATCH screening assessment
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Patients must have disease that can be safely biopsied and agree to a pre-treatment biopsy or have archival tissue available from within 12 months prior to registration on the ComboMATCH Registration Trial (EAY191).
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Please note the current actionable marker of interest (aMOI)/actionable alteration list for this treatment trial can be found on the Cancer Trials Support Unit (CTSU) website
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Please note novel/Dynamic aMOI can be submitted for review per the process described in the ComboMATCH Registration Protocol
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EAY191-A6 REGISTRATION:
-
Participants must have histologically confirmed BTC (intrahepatic cholangiocarcinoma [IHC], extrahepatic cholangiocarcinoma [EHC] or gallbladder cancer [GBC]) that is unresectable or recurrent with a confirmed RAS/RAF/MEK/ERK pathway mutation via any Clinical Laboratory Improvement Act (CLIA)-certified method. BRAFV600E mutations are not eligible due to other ongoing/upcoming studies in this disease cohort
-
Tumor tissue must be available:
-
Adequate archival tumor specimen (obtained within 12 months of EAY191 registration which has not had a Response Evaluation Criteria in Solid Tumors (RECIST) response, complete response (CR) or partial response (PR), to any intervening therapy after collection of the tissue) must be available with formalin-fixed paraffin-embedded tumor tissue (blocks or slides) OR
-
Consent to a new tumor tissue biopsy which is not a representative target lesion. This lesion must be amenable to a minimal risk image-guided or direct vision biopsy
- A new biopsy is preferred but is not required for enrollment in EAY191-A6 if sufficient archival tissue is available as described above.
-
-
Measurable disease per RECIST 1.1 Of note, in the case when a baseline biopsy is done after scans are obtained, a lesion separate from one that is biopsied needs to be measurable per RECIST 1.1. All radiologic studies must be performed within 28 days prior to registration
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Progression of disease on gemcitabine based first-line regimen (i.e. only one prior line of therapy is permitted)
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No systemic anti-cancer therapy within 4 weeks of registration to EAY191-A6
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No prior MEK inhibitor therapy
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No prior history of treatment with a direct and specific inhibitor of KRAS
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Patients who only received radio-sensitizing chemotherapy with fluorouracil (5-FU) or capecitabine are eligible, but need to have received and failed first-line systemic chemotherapy upon recurrence. Peri-operative systemic 5-FU/capecitabine and/or oxaliplatin, is allowed if it's been more than 12 months of registration to EAY191-A6
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No major surgery within 4 weeks (excluding placement of vascular access) of registration to EAY191-A6
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No minor surgery within 2 weeks of registration to EAY191-A6
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No palliative radiotherapy within 1 week of registration to EAY191-A6
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Not pregnant and not nursing, because this study involves an investigational agent whose genotoxic, mutagenic and teratogenic effects on the developing fetus and newborn are unknown
- Therefore, for women of childbearing potential only, a negative pregnancy test done =< 14 days prior to registration is required
- Adequate contraception is needed for at least 30 days after the last dose of binimetinib and breastfeeding should be discontinued for at least 3 days after the last dose of binimetinib. For FOLFOX regimen, 9 months is recommended for contraception after last dose of oxaliplatin for females of childbearing potential and 6 months for males
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Age >= 18 years
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Eastern Cooperative Oncology Group (ECOG) performance status =< 2 (Karnofsky >= 60%)
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Absolute neutrophil count (ANC) >= 1,000/mm^3, no growth factor within 14 days of 1st dose
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Platelet count >= 75,000/mm^3
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Creatinine < 1.6 x upper limit of normal (ULN) OR
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Calculated (Calc.) creatinine clearance >= 50 mL/min, as calculated by the Cockcroft-Gault formula
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Total bilirubin =< 2.0 x upper limit of normal (ULN); Patients with Gilbert syndrome may enroll if < 3.0 x ULN
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Aspartate aminotransferase (AST) /alanine aminotransferase (ALT) =< 5.0 x upper limit of normal (ULN)
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Hemoglobin >= 8 g/dL, no transfusion within 7 days of 1st dose
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Creatine phosphokinase =< 2.5 x ULN
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High blood pressure more than 160/90 despite treatment are ineligible
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No history of interstitial lung disease. No history of idiopathic pulmonary fibrosis, organizing pneumonia (e.g., bronchiolitis obliterans), drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography (CT) scan
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Patients should not have history of bowel perforation or intestinal fistulas in the last 6 months
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Patients with the inability to swallow oral medications or impaired gastrointestinal absorption due to gastrectomy or active inflammatory bowel disease are ineligible
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Must have adequate cardiac function with left ventricular ejection fraction >= 50% by echocardiography (ECHO) or multiple-gated acquisition (MUGA) scan. Patients with congenital long QT syndrome are not permitted
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No history of prolonged QTc or at risk for prolonged QTc due to any reason (for example, concomitant medications during or before chemotherapy that may increase the risk of prolonged QTc), uncontrolled congestive heart failure, prior history of class III/ IV cardiac disease (New York Heart Association [NYHA]), myocardial infarction within the last 6 months, unstable arrhythmias, unstable angina or severe obstructive pulmonary disease
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No active skin disorder that has required systemic therapy within the past 1 year
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No history of rhabdomyolysis
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No concurrent ocular disorders, including:
- Patients with history of glaucoma, history of retinal vein occlusion (RVO), predisposing factors for RVO, including but not limited to uncontrolled hypertension, uncontrolled diabetes
- Patients with history of retinal pathology or evidence of visible retinal pathology that is considered a risk factor for RVO, intraocular pressure > 21 mm Hg as measured by tonometry, or other significant ocular pathology, such as anatomical abnormalities that increase the risk for RVO
- Patients with a history of corneal erosion (instability of corneal epithelium), corneal degeneration, active or recurrent keratitis, and other forms of serious ocular surface inflammatory conditions
- Patients with known or at risk for retinopathies, uveitis or retinal vein occlusion
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No patients with a history of hypersensitivity to any of the inactive ingredients in binimetinib, nor known severe allergic reactions or hypersensitivity of 5-FU, leucovorin (LV) or oxaliplatin will be allowed to participate in this study for safety concerns
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No other medical condition (e.g. cardiac, gastrointestinal, pulmonary, psychiatric, neurological, genetic, etc.) that in the opinion of the investigator would places the subject at unacceptably high risk for toxicity
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No prior allogeneic stem cell or solid organ transplantation
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Central nervous system (CNS) metastases must have been treated with local therapy (surgery, radiation, ablation) with systemic steroids tapered to a physiologic dose (10 mg or prednisone equivalent or less)
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Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial
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For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated
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Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load
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Patients must not have grade 2 neuropathy or greater, within 14 days prior to registration
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 |
|---|---|
|
Aktiver Komparator: Arm 1 (mFOLFOX6)
Patients receive leucovorin IV over 2 hours and oxaliplatin IV over 2 hours on day 1, and fluorouracil IV over 46-48 hours on days 1-2. Cycles repeat every 14 days in the absence of disease progression or unacceptable toxicity. Patients undergo collection of blood during screening and on study, and undergo CT with contrast, MRI, or FDG-PET throughout the trial as clinically indicated. Patients may also undergo bone scans on study and may undergo biopsies throughout the study as clinically indicated. |
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:
Given IV
Andere Namen:
Undergo bone scan
Andere Namen:
|
|
Experimental: Arm 2 (binimetinib, mFOLFOX6)
Patients receive binimetinib PO on days 1-14, and leucovorin IV, oxaliplatin IV, and fluorouracil IV as in Arm 1. Cycles repeat every 14 days in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO or MUGA and collection of blood during screening and on study, and undergo CT with contrast, MRI, or FDG-PET throughout the trial as clinically indicated. Patients may also undergo bone scans on study and may undergo biopsies throughout the study as clinically indicated. |
Given IV
Andere Namen:
Undergo CT
Andere Namen:
Undergo MRI
Andere Namen:
Undergo ECHO
Andere Namen:
Undergo MUGA
Andere Namen:
Undergo biopsy
Andere Namen:
Undergo collection of blood
Andere Namen:
Given PO
Andere Namen:
Given IV
Andere Namen:
Given IV
Andere Namen:
Undergo bone scan
Andere Namen:
|
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Overall survival (OS)
Zeitfenster: From randomization to the time of death due to any cause, assessed up to 30 months
|
The primary efficacy analysis will be to compare the OS distributions between those treated with modified leucovorin, fluorouracil and oxaliplatin (mFOLFOX6) and binimetinib versus (vs.) mFOLFOX6. Despite being a randomized phase II trial, we will utilize an intent to treat approach such that patients will be analyzed based on the treatment arm to which they were randomized. As defined above, OS will be compared between the two treatment arms using Kaplan-Meier methods. The hazard ratio, median OS, and estimated OS rates at 6, 12, 18, 24, and 30 months will be estimated along with corresponding 95% confidence intervals. Anticipating that the treatment arms will be balanced in terms of the potential confounders reflect in the stratification factors, a log-rank test will be used to compare the OS distributions between the two treatment arms in this cohort. |
From randomization to the time of death due to any cause, assessed up to 30 months
|
Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Objective response
Zeitfenster: Up to 5 years
|
Objective response by Response Evaluation Criteria in Solid Tumors (RECIST) version (v)1.1 criteria will be estimated using objective response rate (ORR) where ORR is defined as the number of evaluable patients achieving a response (partial response [PR] or complete response [CR] per RECIST v1.1) during treatment with study therapy divided by the total number of evaluable patients. Rates of response will be compared across arms using a Chi-Square Test for Proportion. Point estimates will be generated for objective response rates within each arm along with 95% confidence intervals using the Clopper-Pearson method. |
Up to 5 years
|
|
Progression free survival (PFS)
Zeitfenster: From study entry to the first of either disease progression or death from any cause, assessed up to 5 years
|
Disease progression will be determined based on RECIST 1.1 criteria. PFS will be estimated using the Kaplan-Meier method. The median PFS and 95% confidence interval will be reported. Patients will be censored at the last disease assessment date. |
From study entry to the first of either disease progression or death from any cause, assessed up to 5 years
|
|
Duration of response (DoR)
Zeitfenster: Up to 5 years
|
Defined for all evaluable patients who have achieved an objective response as the date at which the patient's earliest best objective status is first noted to be either a CR or PR to the earliest date progression is documented, or death if no prior evidence of disease progression. The distribution of DoR will be estimated using the method of Kaplan-Meier. |
Up to 5 years
|
|
Clinical benefit
Zeitfenster: Up to 5 years
|
Defined as achieving CR, PR, or stable disease (SD) for at least 4 months while on treatment. Disease status will be assessed using RECIST v. 1.1 criteria. Clinical benefit rate (CBR) will be calculated as the proportion of evaluable patients who achieve clinical benefit. The final CBR point estimate and corresponding 95% confidence interval calculated using Clopper-Pearson method. |
Up to 5 years
|
|
Incidence of adverse events
Zeitfenster: Up to 5 years
|
Patients will be evaluated for adverse events using the National Cancer Institute (NCI) Common Toxicity Criteria for Adverse Events version 5.0. Summary statistics (e.g., mean, median, standard deviation) and frequency tables will be used to describe the distributions of adverse events. Rates of adverse events occurring in the treatment arm will be compared to the control arm with chi-squared tests (or suitable alternative) used for comparisons where applicable. Tolerability will also be evaluated, summarizing rates of dose delays or modifications, reasons patients end treatment, and time to end of active treatment. |
Up to 5 years
|
Andere Ergebnismessungen
Andere Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Prognostic model/scoring system
Zeitfenster: Up to 5 years
|
Defined as presence of peritoneal disease/locally advanced disease/metastatic disease, Eastern Cooperative Oncology Group (ECOG) performance status, CA19.9 level. Will fit multivariate Cox regression models including MAPK mutation status, presence of peritoneal disease/locally advance disease/metastatic disease, ECOG performance status, and CA19-9 level, stratified by treatment arm. We will calculate C-statistics with 5-fold cross-validation |
Up to 5 years
|
|
Albumin
Zeitfenster: Up to 5 years
|
Will correlate outcome with albumin. |
Up to 5 years
|
|
Presence of MAPK pathway mutations
Zeitfenster: Up to 5 years
|
Will correlate with activity of addition of binimetinib therapy to standard 2nd line chemotherapy. |
Up to 5 years
|
|
Activity of addition of binimetinib therapy to standard 2nd line chemotherapy
Zeitfenster: Up to 5 years
|
Will correlate with presence of MAPK pathway mutations. |
Up to 5 years
|
|
Whole-exome sequencing and ribonucleic acid (RNA)-sequencing
Zeitfenster: Up to 5 years
|
Will be used to assess determinants of response and resistance. Concordance of diagnostic tumor mutation profile generated by the Designated Laboratory, the pre-treatment biopsy mutation profile, and the pre-treatment circulating tumor deoxyribonucleic acid (ctDNA) mutation profile will be assessed. Details are provided in the statistical plan of the ComboMATCH Registration Protocol. |
Up to 5 years
|
|
Changes in plasma MAPK mutations allelic burden and other molecular findings
Zeitfenster: Up to 5 years
|
Will correlate changes with clinical activity, disease course as well as response/resistance to therapy. |
Up to 5 years
|
|
Detection of mutations as well as prediction of outcomes
Zeitfenster: Up to 5 years
|
Will evaluate if our machine learning algorithm for RAS/RAF/MEK/ERK pathway mutations correlates with detection of mutations as well as prediction of outcomes from samples obtained in this study. |
Up to 5 years
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Hauptermittler: Ardaman Shergill, Alliance for Clinical Trials in Oncology
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Tatsächlich)
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 (Tatsächlich)
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
- Neoplasmen des Verdauungssystems
- Erkrankungen des Verdauungssystems
- Erkrankungen der Gallenwege
- Neubildungen, Drüsen und Epithelien
- Adenokarzinom
- Karzinom
- Erkrankungen der Gallenblase
- Neoplasien der Gallenwege
- Cholangiokarzinom
- Klatskin-Tumor
- Neoplasien der Gallenblase
- Organische Chemikalien
- Heterocyclische Verbindungen, 1-Ring
- Heterocyclische Verbindungen
- Heterocyclische Verbindungen, 2-Ring
- Heterocyclische Verbindungen, Fusionsring
- Untersuchungstechniken
- Klinische Labortechniken
- Diagnosetechniken und Verfahren
- Diagnose
- Chirurgische Eingriffe, operativ
- Zytologische Techniken
- Zytodiagnose
- Enzyme und Coenzyme
- Koordinationskomplexe
- Pyrimidine
- Diagnosetechniken, chirurgisch
- Chemie -Techniken, analytisch
- Spektrumanalyse
- Formyltetrahydrofolate
- Tetrahydrofolate
- Folsäure
- Pterins
- Pteridine
- Uracil
- Pyrimidinone
- Coenzyme
- Oxaliplatin
- Fluoruracil
- Leucovorin
- Biopsie
- Handhabung von Proben
- Magnetresonanzspektroskopie
- Binimetinib
- Dehydroftorafur
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- NCI-2022-07833
- U10CA180821 (US NIH Stipendium/Vertrag)
- NCI-2022-07833 (Registrierungskennung: CTRP (Clinical Trial Reporting Program))
- EAY191-A6 (Andere Kennung: CTEP)
- EAY191-A6 (Andere Kennung: Alliance for Clinical Trials in Oncology)
Plan für individuelle Teilnehmerdaten (IPD)
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Beschreibung des IPD-Plans
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