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Rituximab y clorhidrato de bendamustina, rituximab e ibrutinib, o ibrutinib solo en el tratamiento de pacientes mayores con leucemia linfocítica crónica sin tratamiento previo

21 de octubre de 2026 actualizado por: National Cancer Institute (NCI)

Un estudio aleatorizado de fase III de bendamustina más rituximab versus ibrutinib más rituximab versus ibrutinib solo en pacientes mayores no tratados (>/= 65 años de edad) con leucemia linfocítica crónica (LLC)

This randomized phase III trial studies rituximab with bendamustine hydrochloride or ibrutinib to see how well they work compared to ibrutinib alone in treating older patients with previously untreated chronic lymphocytic leukemia. Rituximab is a monoclonal antibody that may interfere with the ability of cancer cells to grow and spread. A monoclonal antibody is a type of protein that can bind to certain targets in the body, such as molecules that cause the body to make an immune response (antigens). Chemotherapy drugs, such as bendamustine hydrochloride, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Ibrutinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. It is not yet known whether rituximab with bendamustine hydrochloride may work better than rituximab and ibrutinib or ibrutinib alone in treating chronic lymphocytic leukemia.

Descripción general del estudio

Estado

Activo, no reclutando

Condiciones

Intervención / Tratamiento

Descripción detallada

PRIMARY OBJECTIVE:

I. To determine whether progression free survival (PFS) is superior after therapy with bendamustine hydrochloride (bendamustine) in combination with rituximab, ibrutinib alone, or ibrutinib in combination with rituximab in patients age 65 or older with previously untreated chronic lymphocytic leukemia (CLL).

SECONDARY OBJECTIVES:

I. To determine 2-year PFS in each of the three treatment arms. II. To determine which treatment arm produces superior overall survival (OS). III. To determine the complete response (CR) rate, complete and nodular partial response (CR/nPR) rate, and overall response (PR+nPR+CR) rate (ORR) among the three treatment arms and compare these arms.

IV. To determine the impact of minimal residual disease (MRD)-negative disease at time of CR documentation and at 2 years on PFS and OS in each of the treatment arms.

V. To determine duration of response after each of the three treatments and compare these treatment arms.

VI. To determine toxicity and tolerability of the three treatment regimens. VII. To determine response and PFS of patients initially on the bendamustine in combination with rituximab arm who cross over to ibrutinib.

OTHER PRE-SPECIFIED OBJECTIVES:

I. To determine whether baseline cytogenetic markers, Zap-70 methylation, IgVH mutational status, or select deoxyribonucleic acid (DNA) mutations predict outcomes or time to response in these three arms.

II. To determine whether local fluorescence in situ hybridization (FISH) results for del(11q22.3) and del(17p13.1) are consistent with central analysis.

III. To determine whether baseline micro ribonucleic acid (RNA) and gene expression markers are correlated with clinical outcomes of interest (e.g. progression-free and alive at 2 years versus not), as well as to explore changes in microRNA expression from baseline to post-treatment time points, with a focus on those with persistent lymphocytosis and relapse.

IV. To determine whether eradication of MRD predicts longer duration of response with standard therapy and ibrutinib-based regimens.

V. To describe the baseline functional status, comorbid medical conditions, and number of medications of older CLL patients who meet criteria for therapy.

VI. To determine how functional status changes with therapy using baseline to 3-month evaluation and end-of-study/2-year evaluation; to determine whether this change is different among the treatment groups.

VII. To determine whether geriatric assessment variables known to be associated with chemotherapy toxicity in other disease groups can also predict therapy-associated toxicity in the CLL population.

VIII. To assess whether the FCGR3A polymorphism (rs396991) is correlated with depth of response (MRD status) to ibrutinib plus rituximab after 6 cycles, with secondary endpoints CR rate, rapidity of response, and progression-free survival (PFS).

IX. To assess whether C1QA polymorphism (rs172378) is correlated with MRD status, CR rate, rapidity of response, and PFS.

OUTLINE: Patients are randomized to 1 of 3 treatment arms.

ARM I: Patients receive rituximab intravenously (IV) on day 1 (day 0 course 1) and bendamustine hydrochloride IV over 30 minutes on days 1-2. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover to Arm II.

ARM II: Patients receive ibrutinib orally (PO) daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

ARM III: Patients receive ibrutinib as in Arm II. Patients receive rituximab IV on days 1, 8, 15, and 22 of course 2 and on day 1 of courses 3-6. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and computed tomography (CT) throughout the study.

After completion of study treatment, patients are followed up every 6 months for up to 10 years.

Tipo de estudio

Intervencionista

Inscripción (Actual)

547

Fase

Fase 3

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

Canadá
- Alberta
  - Calgary, Alberta, Canadá, T2N 5G2
    - Arthur J E Child Comprehensive Cancer Centre
- New Brunswick
  - Moncton, New Brunswick, Canadá, E1C 6Z8
    - The Moncton Hospital
- Nova Scotia
  - Halifax, Nova Scotia, Canadá, B3H 2Y9
    - QEII Health Sciences Centre/Nova Scotia Health Authority
- Ontario
  - Greater Sudbury, Ontario, Canadá, P3E 5J1
    - Health Sciences North
  - Hamilton, Ontario, Canadá, L8V 5C2
    - Juravinski Cancer Centre at Hamilton Health Sciences
  - Kingston, Ontario, Canadá, K7L 2V7
    - Kingston Health Sciences Centre
  - London, Ontario, Canadá, N6A 4L6
    - London Regional Cancer Program
  - Newmarket, Ontario, Canadá, L3Y 2P9
    - Stronach Regional Health Centre at Southlake
  - Oshawa, Ontario, Canadá, L1G 2B9
    - Lakeridge Health Oshawa
  - Ottawa, Ontario, Canadá, K1H 8L6
    - Ottawa Hospital and Cancer Center-General Campus
  - Toronto, Ontario, Canadá, M4C 3E7
    - Michael Garron Hospital
  - Toronto, Ontario, Canadá, M5G 2M9
    - University Health Network-Princess Margaret Hospital
  - Toronto, Ontario, Canadá, M4N 3M5
    - Odette Cancer Centre- Sunnybrook Health Sciences Centre
  - Toronto, Ontario, Canadá, M3M 0B2
    - Humber River Hospital
- Quebec
  - Greenfield Park, Quebec, Canadá, J4V 2H1
    - CSSS Champlain-Charles Le Moyne
  - Montreal, Quebec, Canadá, H3T 1E2
    - Jewish General Hospital
  - Montreal, Quebec, Canadá, H2W 1S6
    - McGill University Department of Oncology
  - Montreal, Quebec, Canadá, H2X 3E4
    - CHUM - Centre Hospitalier de l'Universite de Montreal
- Saskatchewan
  - Regina, Saskatchewan, Canadá, S4T 7T1
    - Allan Blair Cancer Centre
  - Saskatoon, Saskatchewan, Canadá, S7N 4H4
    - Saskatoon Cancer Centre
Estados Unidos
- Alabama
  - Birmingham, Alabama, Estados Unidos, 35233
    - University of Alabama at Birmingham Cancer Center
- Alaska
  - Anchorage, Alaska, Estados Unidos, 99508
    - Alaska Breast Care and Surgery LLC
  - Anchorage, Alaska, Estados Unidos, 99508
    - Alaska Oncology and Hematology LLC
  - Anchorage, Alaska, Estados Unidos, 99508
    - Alaska Women's Cancer Care
  - Anchorage, Alaska, Estados Unidos, 99508
    - Anchorage Oncology Centre
  - Anchorage, Alaska, Estados Unidos, 99508
    - Katmai Oncology Group
  - Anchorage, Alaska, Estados Unidos, 99508
    - Providence Alaska Medical Center
  - Anchorage, Alaska, Estados Unidos, 99504
    - Anchorage Radiation Therapy Center
  - Anchorage, Alaska, Estados Unidos, 99508
    - Alaska Regional Hospital
- Arizona
  - Phoenix, Arizona, Estados Unidos, 85054
    - Mayo Clinic Hospital in Arizona
  - Scottsdale, Arizona, Estados Unidos, 85259
    - Mayo Clinic in Arizona
  - Tucson, Arizona, Estados Unidos, 85719
    - Banner University Medical Center - Tucson
  - Tucson, Arizona, Estados Unidos, 85719
    - University of Arizona Cancer Center-North Campus
  - Yuma, Arizona, Estados Unidos, 85364
    - Onvida Health Yuma Medical Center
- Arkansas
  - Hot Springs, Arkansas, Estados Unidos, 71913
    - CHI Saint Vincent Cancer Center Hot Springs
  - Jonesboro, Arkansas, Estados Unidos, 72401
    - NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
- California
  - Anaheim, California, Estados Unidos, 92806
    - Kaiser Permanente-Anaheim
  - Antioch, California, Estados Unidos, 94531
    - Kaiser Permanente-Deer Valley Medical Center
  - Arroyo Grande, California, Estados Unidos, 93420
    - PCR Oncology
  - Auburn, California, Estados Unidos, 95602
    - Sutter Auburn Faith Hospital
  - Auburn, California, Estados Unidos, 95603
    - Sutter Cancer Centers Radiation Oncology Services-Auburn
  - Baldwin Park, California, Estados Unidos, 91706
    - Kaiser Permanente-Baldwin Park
  - Bellflower, California, Estados Unidos, 90706
    - Kaiser Permanente-Bellflower
  - Berkeley, California, Estados Unidos, 94704
    - Alta Bates Summit Medical Center-Herrick Campus
  - Burbank, California, Estados Unidos, 91505
    - Providence Saint Joseph Medical Center/Disney Family Cancer Center
  - Burlingame, California, Estados Unidos, 94010
    - Mills-Peninsula Medical Center
  - Cameron Park, California, Estados Unidos, 95682
    - Sutter Cancer Centers Radiation Oncology Services-Cameron Park
  - Concord, California, Estados Unidos, 94520
    - John Muir Medical Center-Concord
  - Davis, California, Estados Unidos, 95616
    - Sutter Davis Hospital
  - Duarte, California, Estados Unidos, 91010
    - City of Hope Comprehensive Cancer Center
  - Fontana, California, Estados Unidos, 92335
    - Kaiser Permanente-Fontana
  - Fremont, California, Estados Unidos, 94538
    - Kaiser Permanente-Fremont
  - Fresno, California, Estados Unidos, 93720
    - Kaiser Permanente-Fresno
  - Greenbrae, California, Estados Unidos, 94904
    - Marin Cancer Care Inc
  - Greenbrae, California, Estados Unidos, 94904
    - Marin General Hospital
  - Harbor City, California, Estados Unidos, 90710
    - Kaiser Permanente South Bay
  - Irvine, California, Estados Unidos, 92618
    - Kaiser Permanente-Irvine
  - Los Angeles, California, Estados Unidos, 90048
    - Cedars-Sinai Medical Center
  - Los Angeles, California, Estados Unidos, 90027
    - Kaiser Permanente Los Angeles Medical Center
  - Los Angeles, California, Estados Unidos, 90034
    - Kaiser Permanente West Los Angeles
  - Modesto, California, Estados Unidos, 95355
    - Memorial Medical Center
  - Modesto, California, Estados Unidos, 95356
    - Kaiser Permanente-Modesto
  - Mountain View, California, Estados Unidos, 94040
    - Palo Alto Medical Foundation-Camino Division
  - Mountain View, California, Estados Unidos, 94040
    - Palo Alto Medical Foundation-Gynecologic Oncology
  - Novato, California, Estados Unidos, 94945
    - Sutter Cancer Research Consortium
  - Oakland, California, Estados Unidos, 94611
    - Kaiser Permanente-Oakland
  - Palo Alto, California, Estados Unidos, 94304
    - Stanford Cancer Institute Palo Alto
  - Palo Alto, California, Estados Unidos, 94301
    - Palo Alto Medical Foundation Health Care
  - Panorama City, California, Estados Unidos, 91402
    - Kaiser Permanente - Panorama City
  - Redwood City, California, Estados Unidos, 94063
    - Kaiser Permanente-Redwood City
  - Richmond, California, Estados Unidos, 94801
    - Kaiser Permanente-Richmond
  - Riverside, California, Estados Unidos, 92505
    - Kaiser Permanente-Riverside
  - Roseville, California, Estados Unidos, 95661
    - Kaiser Permanente-Roseville
  - Roseville, California, Estados Unidos, 95661
    - Sutter Cancer Centers Radiation Oncology Services-Roseville
  - Roseville, California, Estados Unidos, 95661
    - Sutter Roseville Medical Center
  - Sacramento, California, Estados Unidos, 95816
    - Sutter Medical Center Sacramento
  - Sacramento, California, Estados Unidos, 95823
    - Kaiser Permanente-South Sacramento
  - Sacramento, California, Estados Unidos, 95825
    - Kaiser Permanente Sacramento Medical Center
  - San Diego, California, Estados Unidos, 92120
    - Kaiser Permanente-San Diego Zion
  - San Diego, California, Estados Unidos, 92134
    - Naval Medical Center -San Diego
  - San Francisco, California, Estados Unidos, 94115
    - Kaiser Permanente-San Francisco
  - San Francisco, California, Estados Unidos, 94115
    - California Pacific Medical Center-Pacific Campus
  - San Jose, California, Estados Unidos, 95119
    - Kaiser Permanente-Santa Teresa-San Jose
  - San Jose, California, Estados Unidos, 95124
    - Stanford Cancer Center South Bay
  - San Leandro, California, Estados Unidos, 94577
    - Kaiser Permanente San Leandro
  - San Marcos, California, Estados Unidos, 92078
    - Kaiser Permanente-San Marcos
  - San Rafael, California, Estados Unidos, 94903
    - Kaiser Permanente-San Rafael
  - Santa Clara, California, Estados Unidos, 95051
    - Kaiser Permanente Medical Center - Santa Clara
  - Santa Cruz, California, Estados Unidos, 95065
    - Palo Alto Medical Foundation-Santa Cruz
  - Santa Rosa, California, Estados Unidos, 95403
    - Kaiser Permanente-Santa Rosa
  - Santa Rosa, California, Estados Unidos, 95403
    - Sutter Pacific Medical Foundation
  - South San Francisco, California, Estados Unidos, 94080
    - Kaiser Permanente-South San Francisco
  - St. Helena, California, Estados Unidos, 94574
    - Saint Helena Hospital
  - Stockton, California, Estados Unidos, 95210
    - Kaiser Permanente-Stockton
  - Sunnyvale, California, Estados Unidos, 94086
    - Palo Alto Medical Foundation-Sunnyvale
  - Vacaville, California, Estados Unidos, 95688
    - Kaiser Permanente Medical Center-Vacaville
  - Vacaville, California, Estados Unidos, 95687
    - Northbay Cancer Center
  - Vallejo, California, Estados Unidos, 94589
    - Kaiser Permanente-Vallejo
  - Vallejo, California, Estados Unidos, 94589
    - Sutter Solano Medical Center/Cancer Center
  - Walnut Creek, California, Estados Unidos, 94596
    - Kaiser Permanente-Walnut Creek
  - Walnut Creek, California, Estados Unidos, 94598
    - John Muir Medical Center-Walnut Creek
  - Whittier, California, Estados Unidos, 90602
    - Presbyterian Intercommunity Hospital
  - Woodland Hills, California, Estados Unidos, 91367
    - Kaiser Permanente-Woodland Hills
- Colorado
  - Aurora, Colorado, Estados Unidos, 80012
    - Rocky Mountain Cancer Centers-Aurora
  - Aurora, Colorado, Estados Unidos, 80012
    - The Medical Center of Aurora
  - Boulder, Colorado, Estados Unidos, 80303
    - Boulder Community Foothills Hospital
  - Boulder, Colorado, Estados Unidos, 80304
    - Rocky Mountain Cancer Centers-Boulder
  - Colorado Springs, Colorado, Estados Unidos, 80907
    - Penrose-Saint Francis Healthcare
  - Colorado Springs, Colorado, Estados Unidos, 80907
    - Rocky Mountain Cancer Centers-Penrose
  - Denver, Colorado, Estados Unidos, 80205
    - Kaiser Permanente-Franklin
  - Denver, Colorado, Estados Unidos, 80218
    - Presbyterian - Saint Lukes Medical Center - Health One
  - Denver, Colorado, Estados Unidos, 80220
    - Rose Medical Center
  - Denver, Colorado, Estados Unidos, 80218
    - Rocky Mountain Cancer Centers-Midtown
  - Denver, Colorado, Estados Unidos, 80220
    - Rocky Mountain Cancer Centers-Rose
  - Denver, Colorado, Estados Unidos, 80204
    - Denver Health Medical Center
  - Denver, Colorado, Estados Unidos, 80218
    - Colorado Blood Cancer Institute
  - Denver, Colorado, Estados Unidos, 80222
    - Western States Cancer Research NCORP
  - Denver, Colorado, Estados Unidos, 80218
    - Saint Joseph Hospital - Cancer Centers of Colorado
  - Denver, Colorado, Estados Unidos, 80210
    - AdventHealth Porter
  - Durango, Colorado, Estados Unidos, 81301
    - Mercy Medical Center
  - Durango, Colorado, Estados Unidos, 81301
    - CommonSpirit Cancer Center Mercy
  - Englewood, Colorado, Estados Unidos, 80113
    - Mountain Blue Cancer Care Center - Swedish
  - Englewood, Colorado, Estados Unidos, 80113
    - Swedish Medical Center
  - Fort Collins, Colorado, Estados Unidos, 80524
    - Poudre Valley Hospital
  - Golden, Colorado, Estados Unidos, 80401
    - Mountain Blue Cancer Care Center
  - Golden, Colorado, Estados Unidos, 80401
    - National Jewish Health-Western Hematology Oncology
  - Greeley, Colorado, Estados Unidos, 80631
    - Banner North Colorado Medical Center
  - Greenwood Village, Colorado, Estados Unidos, 80111
    - Rocky Mountain Cancer Centers-Greenwood Village
  - Lafayette, Colorado, Estados Unidos, 80026
    - Kaiser Permanente-Rock Creek
  - Lakewood, Colorado, Estados Unidos, 80228
    - Rocky Mountain Cancer Centers-Lakewood
  - Lakewood, Colorado, Estados Unidos, 80228
    - CommonSpirit Saint Anthony Hospital Cancer Center
  - Littleton, Colorado, Estados Unidos, 80120
    - Rocky Mountain Cancer Centers-Littleton
  - Littleton, Colorado, Estados Unidos, 80122
    - AdventHealth Littleton
  - Lone Tree, Colorado, Estados Unidos, 80124
    - Kaiser Permanente-Lone Tree
  - Lone Tree, Colorado, Estados Unidos, 80124
    - Sky Ridge Medical Center
  - Lone Tree, Colorado, Estados Unidos, 80124
    - Rocky Mountain Cancer Centers-Sky Ridge
  - Longmont, Colorado, Estados Unidos, 80501
    - Longmont United Hospital
  - Longmont, Colorado, Estados Unidos, 80501
    - Rocky Mountain Cancer Centers-Longmont
  - Loveland, Colorado, Estados Unidos, 80539
    - Banner North Colorado Medical Center - Loveland Campus
  - Parker, Colorado, Estados Unidos, 80138
    - Rocky Mountain Cancer Centers-Parker
  - Parker, Colorado, Estados Unidos, 80138
    - AdventHealth Parker
  - Pueblo, Colorado, Estados Unidos, 81004
    - Saint Mary Corwin Medical Center
  - Pueblo, Colorado, Estados Unidos, 81008
    - Rocky Mountain Cancer Centers - Pueblo
  - Thornton, Colorado, Estados Unidos, 80260
    - Rocky Mountain Cancer Centers-Thornton
  - Wheat Ridge, Colorado, Estados Unidos, 80401
    - Intermountain Health Lutheran Hospital
- Connecticut
  - Danbury, Connecticut, Estados Unidos, 06810
    - Danbury Hospital
  - Derby, Connecticut, Estados Unidos, 06418
    - Smilow Cancer Hospital-Derby Care Center
  - Fairfield, Connecticut, Estados Unidos, 06824
    - Smilow Cancer Hospital Care Center-Fairfield
  - Guilford, Connecticut, Estados Unidos, 06437
    - Smilow Cancer Hospital Care Center - Guilford
  - Hartford, Connecticut, Estados Unidos, 06105
    - Smilow Cancer Hospital Care Center at Saint Francis
  - Middletown, Connecticut, Estados Unidos, 06457
    - Middlesex Hospital
  - New Britain, Connecticut, Estados Unidos, 06050
    - The Hospital of Central Connecticut
  - New Haven, Connecticut, Estados Unidos, 06520
    - Yale University
  - North Haven, Connecticut, Estados Unidos, 06473
    - Yale-New Haven Hospital North Haven Medical Center
  - Norwalk, Connecticut, Estados Unidos, 06856
    - Norwalk Hospital
  - Orange, Connecticut, Estados Unidos, 06477
    - Smilow Cancer Hospital-Orange Care Center
  - Torrington, Connecticut, Estados Unidos, 06790
    - Smilow Cancer Hospital-Torrington Care Center
  - Trumbull, Connecticut, Estados Unidos, 06611
    - Smilow Cancer Hospital Care Center-Trumbull
  - Waterbury, Connecticut, Estados Unidos, 06708
    - Smilow Cancer Hospital-Waterbury Care Center
  - Waterford, Connecticut, Estados Unidos, 06385
    - Smilow Cancer Hospital Care Center - Waterford
  - West Haven, Connecticut, Estados Unidos, 06516
    - Veterans Affairs Connecticut Healthcare System-West Haven Campus
- Delaware
  - Lewes, Delaware, Estados Unidos, 19958
    - Beebe Medical Center
  - Newark, Delaware, Estados Unidos, 19713
    - Helen F Graham Cancer Center
  - Newark, Delaware, Estados Unidos, 19713
    - Delaware Clinical and Laboratory Physicians PA
  - Newark, Delaware, Estados Unidos, 19713
    - Medical Oncology Hematology Consultants PA
  - Newark, Delaware, Estados Unidos, 19718
    - Christiana Care Health System-Christiana Hospital
  - Rehoboth Beach, Delaware, Estados Unidos, 19971
    - Beebe Health Campus
  - Seaford, Delaware, Estados Unidos, 19973
    - TidalHealth Nanticoke / Allen Cancer Center
  - Wilmington, Delaware, Estados Unidos, 19801
    - Christiana Care Health System-Wilmington Hospital
- District of Columbia
  - Washington D.C., District of Columbia, Estados Unidos, 20010
    - MedStar Washington Hospital Center
  - Washington D.C., District of Columbia, Estados Unidos, 20007
    - MedStar Georgetown University Hospital
- Florida
  - Altamonte Springs, Florida, Estados Unidos, 32701
    - AdventHealth Altamonte
  - Deerfield Beach, Florida, Estados Unidos, 33442
    - UM Sylvester Comprehensive Cancer Center at Deerfield Beach
  - Fort Lauderdale, Florida, Estados Unidos, 33308
    - Holy Cross Hospital
  - Jacksonville, Florida, Estados Unidos, 32207
    - Baptist MD Anderson Cancer Center
  - Jupiter, Florida, Estados Unidos, 33458
    - Jupiter Medical Center
  - Kissimmee, Florida, Estados Unidos, 34744
    - AdventHealth Kissimmee
  - Miami, Florida, Estados Unidos, 33136
    - University of Miami Miller School of Medicine-Sylvester Cancer Center
  - Miami Beach, Florida, Estados Unidos, 33140
    - Mount Sinai Medical Center
  - Orlando, Florida, Estados Unidos, 32806
    - Orlando Health Cancer Institute
  - Orlando, Florida, Estados Unidos, 32803
    - AdventHealth Orlando
  - Orlando, Florida, Estados Unidos, 32803
    - AdventHealth Medical Group Urology at Orlando
  - Orlando, Florida, Estados Unidos, 32822
    - AdventHealth East Orlando
  - Pensacola, Florida, Estados Unidos, 32504
    - Sacred Heart Hospital
  - Plantation, Florida, Estados Unidos, 33324
    - UM Sylvester Comprehensive Cancer Center at Plantation
  - Weston, Florida, Estados Unidos, 33331
    - Cleveland Clinic-Weston
  - Winter Park, Florida, Estados Unidos, 32792
    - AdventHealth Winter Park
- Georgia
  - Atlanta, Georgia, Estados Unidos, 30322
    - Emory University Hospital/Winship Cancer Institute
  - Atlanta, Georgia, Estados Unidos, 30342
    - Northside Hospital
  - Columbus, Georgia, Estados Unidos, 31904
    - John B Amos Cancer Center
  - Cumming, Georgia, Estados Unidos, 30041
    - Northside Hospital-Forsyth
- Hawaii
  - Honolulu, Hawaii, Estados Unidos, 96813
    - Queen's Medical Center
  - Honolulu, Hawaii, Estados Unidos, 96817
    - The Cancer Center of Hawaii-Liliha
  - Honolulu, Hawaii, Estados Unidos, 96813
    - Hawaii Cancer Care Inc - Waterfront Plaza
  - Honolulu, Hawaii, Estados Unidos, 96813
    - Straub Clinic and Hospital
  - Honolulu, Hawaii, Estados Unidos, 96813
    - University of Hawaii Cancer Center
  - Honolulu, Hawaii, Estados Unidos, 96817
    - Hawaii Cancer Care Inc-Liliha
  - Honolulu, Hawaii, Estados Unidos, 96817
    - Kuakini Medical Center
  - Honolulu, Hawaii, Estados Unidos, 96817
    - Queen's Cancer Center - Kuakini
  - Honolulu, Hawaii, Estados Unidos, 96826
    - Kapiolani Medical Center for Women and Children
  - Honolulu, Hawaii, Estados Unidos, 96819
    - Kaiser Permanente Moanalua Medical Center
  - Lihue, Hawaii, Estados Unidos, 96766
    - Wilcox Memorial Hospital and Kauai Medical Clinic
  - ‘Aiea, Hawaii, Estados Unidos, 96701
    - Pali Momi Medical Center
  - ‘Aiea, Hawaii, Estados Unidos, 96701
    - Queen's Cancer Center - Pearlridge
  - ‘Aiea, Hawaii, Estados Unidos, 96701
    - The Cancer Center of Hawaii-Pali Momi
- Idaho
  - Boise, Idaho, Estados Unidos, 83706
    - Saint Alphonsus Cancer Care Center-Boise
  - Boise, Idaho, Estados Unidos, 83712
    - Saint Luke's Cancer Institute - Boise
  - Coeur d'Alene, Idaho, Estados Unidos, 83814
    - Kootenai Health - Coeur d'Alene
  - Fruitland, Idaho, Estados Unidos, 83619
    - Saint Luke's Cancer Institute - Fruitland
  - Meridian, Idaho, Estados Unidos, 83642
    - Saint Luke's Cancer Institute - Meridian
  - Nampa, Idaho, Estados Unidos, 83687
    - Saint Luke's Cancer Institute - Nampa
  - Post Falls, Idaho, Estados Unidos, 83854
    - Kootenai Clinic Cancer Services - Post Falls
  - Sandpoint, Idaho, Estados Unidos, 83864
    - Kootenai Clinic Cancer Services - Sandpoint
  - Twin Falls, Idaho, Estados Unidos, 83301
    - Saint Luke's Cancer Institute - Twin Falls
- Illinois
  - Aurora, Illinois, Estados Unidos, 60504
    - Rush-Copley Medical Center
  - Bloomington, Illinois, Estados Unidos, 61704
    - Illinois CancerCare-Bloomington
  - Bloomington, Illinois, Estados Unidos, 61701
    - OSF Saint Joseph Medical Center
  - Canton, Illinois, Estados Unidos, 61520
    - Illinois CancerCare-Canton
  - Carbondale, Illinois, Estados Unidos, 62902
    - Memorial Hospital of Carbondale
  - Carthage, Illinois, Estados Unidos, 62321
    - Illinois CancerCare-Carthage
  - Centralia, Illinois, Estados Unidos, 62801
    - Centralia Oncology Clinic
  - Chicago, Illinois, Estados Unidos, 60611
    - Northwestern University
  - Chicago, Illinois, Estados Unidos, 60637
    - University of Chicago Comprehensive Cancer Center
  - Chicago, Illinois, Estados Unidos, 60612
    - University of Illinois
  - Danville, Illinois, Estados Unidos, 61832
    - Carle at The Riverfront
  - Decatur, Illinois, Estados Unidos, 62526
    - Decatur Memorial Hospital
  - Decatur, Illinois, Estados Unidos, 62526
    - Cancer Care Specialists of Illinois - Decatur
  - Decatur, Illinois, Estados Unidos, 62526
    - Heartland Cancer Research NCORP
  - Effingham, Illinois, Estados Unidos, 62401
    - Crossroads Cancer Center
  - Effingham, Illinois, Estados Unidos, 62401
    - Carle Physician Group-Effingham
  - Elk Grove Village, Illinois, Estados Unidos, 60007
    - Ascension Alexian Brothers - Elk Grove Village
  - Eureka, Illinois, Estados Unidos, 61530
    - Illinois CancerCare-Eureka
  - Evanston, Illinois, Estados Unidos, 60201
    - NorthShore University HealthSystem-Evanston Hospital
  - Galesburg, Illinois, Estados Unidos, 61401
    - Western Illinois Cancer Treatment Center
  - Galesburg, Illinois, Estados Unidos, 61401
    - Illinois CancerCare-Galesburg
  - Geneva, Illinois, Estados Unidos, 60134
    - Northwestern Medicine Cancer Center Delnor
  - Glenview, Illinois, Estados Unidos, 60026
    - NorthShore University HealthSystem-Glenbrook Hospital
  - Highland Park, Illinois, Estados Unidos, 60035
    - NorthShore University HealthSystem-Highland Park Hospital
  - Highland Park, Illinois, Estados Unidos, 60035
    - Hematology Oncology Associates of Illinois-Highland Park
  - Hinsdale, Illinois, Estados Unidos, 60521
    - Hinsdale Hematology Oncology Associates Incorporated
  - Joliet, Illinois, Estados Unidos, 60435
    - Duly Health and Care Joliet
  - Kankakee, Illinois, Estados Unidos, 60901
    - Presence Saint Mary's Hospital
  - Kewanee, Illinois, Estados Unidos, 61443
    - Illinois CancerCare-Kewanee Clinic
  - Libertyville, Illinois, Estados Unidos, 60048
    - AMG Libertyville - Oncology
  - Macomb, Illinois, Estados Unidos, 61455
    - Illinois CancerCare-Macomb
  - Mattoon, Illinois, Estados Unidos, 61938
    - Carle Physician Group-Mattoon/Charleston
  - Maywood, Illinois, Estados Unidos, 60153
    - Loyola University Medical Center
  - Monmouth, Illinois, Estados Unidos, 61462
    - Illinois CancerCare-Monmouth
  - Mount Vernon, Illinois, Estados Unidos, 62864
    - SSM Health Good Samaritan
  - New Lenox, Illinois, Estados Unidos, 60451
    - UC Comprehensive Cancer Center at Silver Cross
  - Normal, Illinois, Estados Unidos, 61761
    - Carle Cancer Institute Normal
  - O'Fallon, Illinois, Estados Unidos, 62269
    - Cancer Care Center of O'Fallon
  - Ottawa, Illinois, Estados Unidos, 61350
    - Illinois CancerCare-Ottawa Clinic
  - Ottawa, Illinois, Estados Unidos, 61350
    - Radiation Oncology of Northern Illinois
  - Ottawa, Illinois, Estados Unidos, 61350
    - Ottawa Regional Hospital and Healthcare Center
  - Pekin, Illinois, Estados Unidos, 61554
    - Illinois CancerCare-Pekin
  - Pekin, Illinois, Estados Unidos, 61554
    - OSF Saint Francis Radiation Oncology at Pekin
  - Peoria, Illinois, Estados Unidos, 61636
    - Methodist Medical Center of Illinois
  - Peoria, Illinois, Estados Unidos, 61637
    - OSF Saint Francis Medical Center
  - Peoria, Illinois, Estados Unidos, 61615
    - Illinois CancerCare-Peoria
  - Peoria, Illinois, Estados Unidos, 61615
    - OSF Saint Francis Radiation Oncology at Peoria Cancer Center
  - Peoria, Illinois, Estados Unidos, 61614
    - Proctor Hospital
  - Peru, Illinois, Estados Unidos, 61354
    - Illinois CancerCare-Peru
  - Peru, Illinois, Estados Unidos, 61354
    - Valley Radiation Oncology
  - Princeton, Illinois, Estados Unidos, 61356
    - Illinois CancerCare-Princeton
  - Quincy, Illinois, Estados Unidos, 62301
    - Quincy Medical Group-Clinic
  - Rockford, Illinois, Estados Unidos, 61114
    - UW Health Carbone Cancer Center Rockford
  - Skokie, Illinois, Estados Unidos, 60076
    - North Shore Medical Center
  - Springfield, Illinois, Estados Unidos, 62702
    - Southern Illinois University School of Medicine
  - Springfield, Illinois, Estados Unidos, 62702
    - Springfield Clinic
  - Springfield, Illinois, Estados Unidos, 62702
    - Central Illinois Hematology Oncology Center
  - Springfield, Illinois, Estados Unidos, 62781
    - Springfield Memorial Hospital
  - Urbana, Illinois, Estados Unidos, 61801
    - Carle Cancer Center
  - Urbana, Illinois, Estados Unidos, 61801
    - The Carle Foundation Hospital
  - Warrenville, Illinois, Estados Unidos, 60555
    - Northwestern Medicine Cancer Center Warrenville
  - Yorkville, Illinois, Estados Unidos, 60560
    - Rush-Copley Healthcare Center
- Indiana
  - Crown Point, Indiana, Estados Unidos, 46307
    - Michiana Hematology Oncology PC-Crown Point
  - Elkhart, Indiana, Estados Unidos, 46515
    - Elkhart General Hospital
  - Elkhart, Indiana, Estados Unidos, 46514
    - Michiana Hematology Oncology PC-Elkhart
  - Elkhart, Indiana, Estados Unidos, 46514-2098
    - Elkhart Clinic
  - Fort Wayne, Indiana, Estados Unidos, 46845
    - Fort Wayne Medical Oncology and Hematology Inc-Parkview
  - Kokomo, Indiana, Estados Unidos, 46904
    - Community Howard Regional Health
  - La Porte, Indiana, Estados Unidos, 46350
    - IU Health La Porte Hospital
  - Michigan City, Indiana, Estados Unidos, 46360
    - Franciscan Saint Anthony Health-Michigan City
  - Michigan City, Indiana, Estados Unidos, 46360
    - Woodland Cancer Care Center
  - Mishawaka, Indiana, Estados Unidos, 46545
    - Memorial Regional Cancer Center Day Road
  - Mishawaka, Indiana, Estados Unidos, 46545
    - Michiana Hematology Oncology PC-Mishawaka
  - Mishawaka, Indiana, Estados Unidos, 46545
    - Saint Joseph Regional Medical Center-Mishawaka
  - Plymouth, Indiana, Estados Unidos, 46563
    - Michiana Hematology Oncology PC-Plymouth
  - Richmond, Indiana, Estados Unidos, 47374
    - Reid Health
  - South Bend, Indiana, Estados Unidos, 46601
    - Memorial Hospital of South Bend
  - South Bend, Indiana, Estados Unidos, 46628
    - Northern Indiana Cancer Research Consortium
  - Westville, Indiana, Estados Unidos, 46391
    - Michiana Hematology Oncology PC-Westville
- Iowa
  - Ames, Iowa, Estados Unidos, 50010
    - Mary Greeley Medical Center
  - Ames, Iowa, Estados Unidos, 50010
    - McFarland Clinic - Ames
  - Boone, Iowa, Estados Unidos, 50036
    - McFarland Clinic - Boone
  - Cedar Rapids, Iowa, Estados Unidos, 52403
    - Mercy Hospital
  - Cedar Rapids, Iowa, Estados Unidos, 52403
    - Oncology Associates at Mercy Medical Center
  - Cedar Rapids, Iowa, Estados Unidos, 52402
    - Physicians' Clinic of Iowa PC
  - Clive, Iowa, Estados Unidos, 50325
    - Mercy Cancer Center-West Lakes
  - Clive, Iowa, Estados Unidos, 50325
    - UI Health Care Mission Cancer and Blood - West Des Moines Clinic
  - Council Bluffs, Iowa, Estados Unidos, 51503
    - Alegent Health Mercy Hospital
  - Creston, Iowa, Estados Unidos, 50801
    - Greater Regional Medical Center
  - Des Moines, Iowa, Estados Unidos, 50314
    - Mercy Medical Center - Des Moines
  - Des Moines, Iowa, Estados Unidos, 50309
    - Iowa-Wide Oncology Research Coalition NCORP
  - Des Moines, Iowa, Estados Unidos, 50314
    - UI Health Care Mission Cancer and Blood - Laurel Clinic
  - Fort Dodge, Iowa, Estados Unidos, 50501
    - McFarland Clinic - Trinity Cancer Center
  - Iowa City, Iowa, Estados Unidos, 52242
    - University of Iowa/Holden Comprehensive Cancer Center
  - Iowa City, Iowa, Estados Unidos, 52246
    - Iowa City VA Healthcare System
  - Jefferson, Iowa, Estados Unidos, 50129
    - McFarland Clinic - Jefferson
  - Marshalltown, Iowa, Estados Unidos, 50158
    - McFarland Clinic - Marshalltown
  - Mason City, Iowa, Estados Unidos, 50401
    - Mercy Medical Center - North Iowa
  - Sioux City, Iowa, Estados Unidos, 51101
    - Siouxland Regional Cancer Center
  - Sioux City, Iowa, Estados Unidos, 51102
    - Mercy Medical Center-Sioux City
  - Sioux City, Iowa, Estados Unidos, 51104
    - Saint Luke's Regional Medical Center
  - Spencer, Iowa, Estados Unidos, 51301
    - Abben Cancer Center
  - Waterloo, Iowa, Estados Unidos, 50702
    - MercyOne Waterloo Cancer Center
  - West Des Moines, Iowa, Estados Unidos, 50266
    - Mercy Medical Center-West Lakes
- Kansas
  - Chanute, Kansas, Estados Unidos, 66720
    - Cancer Center of Kansas - Chanute
  - Dodge City, Kansas, Estados Unidos, 67801
    - Cancer Center of Kansas - Dodge City
  - El Dorado, Kansas, Estados Unidos, 67042
    - Cancer Center of Kansas - El Dorado
  - Emporia, Kansas, Estados Unidos, 66801
    - Newman Regional Health
  - Fort Scott, Kansas, Estados Unidos, 66701
    - Cancer Center of Kansas - Fort Scott
  - Garden City, Kansas, Estados Unidos, 67846
    - Saint Catherine Hospital
  - Great Bend, Kansas, Estados Unidos, 67530
    - Saint Rose Ambulatory and Surgery Center
  - Hays, Kansas, Estados Unidos, 67601
    - HaysMed
  - Independence, Kansas, Estados Unidos, 67301
    - Cancer Center of Kansas-Independence
  - Kansas City, Kansas, Estados Unidos, 66160
    - University of Kansas Cancer Center
  - Kansas City, Kansas, Estados Unidos, 66112
    - University of Kansas Cancer Center-West
  - Kingman, Kansas, Estados Unidos, 67068
    - Cancer Center of Kansas-Kingman
  - Lawrence, Kansas, Estados Unidos, 66044
    - Lawrence Memorial Hospital
  - Liberal, Kansas, Estados Unidos, 67905
    - Cancer Center of Kansas-Liberal
  - Newton, Kansas, Estados Unidos, 67114
    - Cancer Center of Kansas - Newton
  - Olathe, Kansas, Estados Unidos, 66061
    - The University of Kansas Cancer Center - Olathe
  - Overland Park, Kansas, Estados Unidos, 66210
    - University of Kansas Cancer Center-Overland Park
  - Overland Park, Kansas, Estados Unidos, 66209
    - Menorah Medical Center
  - Overland Park, Kansas, Estados Unidos, 66213
    - Saint Luke's South Hospital
  - Parsons, Kansas, Estados Unidos, 67357
    - Cancer Center of Kansas - Parsons
  - Pittsburg, Kansas, Estados Unidos, 66762
    - Mercy Hospital Pittsburg
  - Prairie Village, Kansas, Estados Unidos, 66208
    - Kansas City NCI Community Oncology Research Program
  - Pratt, Kansas, Estados Unidos, 67124
    - Cancer Center of Kansas - Pratt
  - Salina, Kansas, Estados Unidos, 67401
    - Salina Regional Health Center
  - Salina, Kansas, Estados Unidos, 67401
    - Cancer Center of Kansas - Salina
  - Topeka, Kansas, Estados Unidos, 66606
    - University of Kansas Health System Saint Francis Campus
  - Topeka, Kansas, Estados Unidos, 66606
    - Cotton O'Neil Cancer Center / Stormont Vail Health
  - Wellington, Kansas, Estados Unidos, 67152
    - Cancer Center of Kansas - Wellington
  - Wichita, Kansas, Estados Unidos, 67214
    - Ascension Via Christi Hospitals Wichita
  - Wichita, Kansas, Estados Unidos, 67208
    - Cancer Center of Kansas-Wichita Medical Arts Tower
  - Wichita, Kansas, Estados Unidos, 67214
    - Cancer Center of Kansas - Wichita
  - Wichita, Kansas, Estados Unidos, 67208
    - Associates In Womens Health
  - Winfield, Kansas, Estados Unidos, 67156
    - Cancer Center of Kansas - Winfield
- Kentucky
  - Bardstown, Kentucky, Estados Unidos, 40004
    - CommonSpirit Saint Joseph Hospital - Bardstown
  - Corbin, Kentucky, Estados Unidos, 40701
    - Commonwealth Cancer Center-Corbin
  - Crestview Hills, Kentucky, Estados Unidos, 41017
    - Oncology Hematology Care Inc-Crestview
  - Lexington, Kentucky, Estados Unidos, 40504
    - Saint Joseph Radiation Oncology Resource Center
  - Lexington, Kentucky, Estados Unidos, 40509
    - CommonSpirit Saint Joseph Medical Center - East Lexington
  - Louisville, Kentucky, Estados Unidos, 40202
    - Jewish Hospital
  - Louisville, Kentucky, Estados Unidos, 40245
    - UofL Health Medical Center Northeast
  - Louisville, Kentucky, Estados Unidos, 40215
    - Saints Mary and Elizabeth Hospital
  - Shepherdsville, Kentucky, Estados Unidos, 40165
    - Jewish Hospital Medical Center South
- Louisiana
  - Baton Rouge, Louisiana, Estados Unidos, 70805
    - LSU Health Baton Rouge-North Clinic
  - Baton Rouge, Louisiana, Estados Unidos, 70809
    - Louisiana Hematology Oncology Associates LLC
  - Baton Rouge, Louisiana, Estados Unidos, 70809
    - Mary Bird Perkins Cancer Center
  - Baton Rouge, Louisiana, Estados Unidos, 70809
    - Ochsner Health Center-Summa
  - Baton Rouge, Louisiana, Estados Unidos, 70808
    - Our Lady of the Lake Physician Group
  - Covington, Louisiana, Estados Unidos, 70433
    - Mary Bird Perkins Cancer Center - Covington
  - Houma, Louisiana, Estados Unidos, 70360
    - Mary Bird Perkins Cancer Center - Houma
  - Kenner, Louisiana, Estados Unidos, 70065
    - Ochsner Medical Center Kenner
  - New Orleans, Louisiana, Estados Unidos, 70121
    - Ochsner Medical Center Jefferson
- Maine
  - Augusta, Maine, Estados Unidos, 04330
    - Harold Alfond Center for Cancer Care
  - Bangor, Maine, Estados Unidos, 04401
    - Eastern Maine Medical Center
  - Brewer, Maine, Estados Unidos, 04412
    - Lafayette Family Cancer Center-EMMC
  - Rockport, Maine, Estados Unidos, 04856
    - Penobscot Bay Medical Center
  - York Village, Maine, Estados Unidos, 03909
    - York Hospital
- Maryland
  - Baltimore, Maryland, Estados Unidos, 21237
    - MedStar Franklin Square Medical Center/Weinberg Cancer Institute
  - Baltimore, Maryland, Estados Unidos, 21215
    - Sinai Hospital of Baltimore
  - Baltimore, Maryland, Estados Unidos, 21204
    - Greater Baltimore Medical Center
  - Baltimore, Maryland, Estados Unidos, 21229
    - Saint Agnes Hospital
  - Cumberland, Maryland, Estados Unidos, 21502
    - UPMC Western Maryland
  - Frederick, Maryland, Estados Unidos, 21701
    - Frederick Memorial Hospital
  - Randallstown, Maryland, Estados Unidos, 21133
    - Northwest Hospital Center
  - Salisbury, Maryland, Estados Unidos, 21801
    - TidalHealth Peninsula Regional
- Massachusetts
  - Beverly, Massachusetts, Estados Unidos, 01915
    - Beverly Hospital
  - Boston, Massachusetts, Estados Unidos, 02215
    - Dana-Farber Cancer Institute
  - Boston, Massachusetts, Estados Unidos, 02115
    - Brigham and Women's Hospital
  - Boston, Massachusetts, Estados Unidos, 02111
    - Tufts Medical Center
  - Boston, Massachusetts, Estados Unidos, 02118
    - Boston Medical Center
  - Boston, Massachusetts, Estados Unidos, 02114
    - Massachusetts General Hospital Cancer Center
  - Burlington, Massachusetts, Estados Unidos, 01805
    - Lahey Clinic
  - Fitchburg, Massachusetts, Estados Unidos, 01420
    - Simonds-Sinon Regional Cancer Center
  - Gloucester, Massachusetts, Estados Unidos, 01930
    - Addison Gilbert Hospital
  - Newton, Massachusetts, Estados Unidos, 02462
    - Newton-Wellesley Hospital
  - Springfield, Massachusetts, Estados Unidos, 01199
    - Baystate Medical Center
  - Springfield, Massachusetts, Estados Unidos, 01107
    - D'Amour Center for Cancer Care
  - Winchester, Massachusetts, Estados Unidos, 01890
    - Beth Israel Deaconess Medical Center/Winchester Center for Cancer Care
  - Worcester, Massachusetts, Estados Unidos, 01655
    - UMass Memorial Medical Center - University Campus
- Michigan
  - Adrian, Michigan, Estados Unidos, 49221
    - Bixby Medical Center
  - Adrian, Michigan, Estados Unidos, 49221
    - Hickman Cancer Center
  - Ann Arbor, Michigan, Estados Unidos, 48106
    - Michigan Cancer Research Consortium NCORP
  - Ann Arbor, Michigan, Estados Unidos, 48106
    - Trinity Health Saint Joseph Mercy Hospital Ann Arbor
  - Battle Creek, Michigan, Estados Unidos, 49017
    - Bronson Battle Creek
  - Bay City, Michigan, Estados Unidos, 48706
    - McLaren Cancer Institute-Bay City
  - Brownstown, Michigan, Estados Unidos, 48183
    - Henry Ford Cancer Institute-Downriver
  - Clarkston, Michigan, Estados Unidos, 48346
    - McLaren Cancer Institute-Clarkston
  - Clinton Township, Michigan, Estados Unidos, 48038
    - Henry Ford Macomb Hospital-Clinton Township
  - Commerce, Michigan, Estados Unidos, 48382
    - Huron Valley-Sinai Hospital
  - Dearborn, Michigan, Estados Unidos, 48126
    - Henry Ford Medical Center-Fairlane
  - Dearborn, Michigan, Estados Unidos, 48124
    - Corewell Health Dearborn Hospital
  - Detroit, Michigan, Estados Unidos, 48202
    - Henry Ford Hospital
  - Detroit, Michigan, Estados Unidos, 48201
    - Wayne State University/Karmanos Cancer Institute
  - Detroit, Michigan, Estados Unidos, 48236
    - Henry Ford Health Saint John Hospital
  - Escanaba, Michigan, Estados Unidos, 49829
    - OSF Saint Francis Hospital and Medical Group
  - Farmington Hills, Michigan, Estados Unidos, 48334
    - Weisberg Cancer Treatment Center
  - Farmington Hills, Michigan, Estados Unidos, 48336
    - Corewell Health Farmington Hills Hospital
  - Flint, Michigan, Estados Unidos, 48532
    - Singh and Arora Hematology Oncology PC
  - Flint, Michigan, Estados Unidos, 48503
    - Hurley Medical Center
  - Flint, Michigan, Estados Unidos, 48503
    - Genesys Hurley Cancer Institute
  - Grand Rapids, Michigan, Estados Unidos, 49503
    - Cancer Research Consortium of West Michigan NCORP
  - Grand Rapids, Michigan, Estados Unidos, 49503
    - Trinity Health Grand Rapids Hospital
  - Grand Rapids, Michigan, Estados Unidos, 49503
    - Corewell Health Grand Rapids Hospitals - Butterworth Hospital
  - Grosse Pointe, Michigan, Estados Unidos, 48230
    - William Beaumont Hospital-Grosse Pointe
  - Jackson, Michigan, Estados Unidos, 49201
    - Allegiance Health
  - Kalamazoo, Michigan, Estados Unidos, 49007
    - West Michigan Cancer Center
  - Lansing, Michigan, Estados Unidos, 48910
    - Karmanos Cancer Institute at McLaren Greater Lansing
  - Lansing, Michigan, Estados Unidos, 48912
    - University of Michigan Health - Sparrow Lansing
  - Lapeer, Michigan, Estados Unidos, 48446
    - McLaren Cancer Institute-Lapeer Region
  - Livonia, Michigan, Estados Unidos, 48154
    - Trinity Health Saint Mary Mercy Livonia Hospital
  - Monroe, Michigan, Estados Unidos, 48162
    - Mercy Memorial Hospital
  - Monroe, Michigan, Estados Unidos, 48162
    - Toledo Clinic Cancer Centers-Monroe
  - Mount Clemens, Michigan, Estados Unidos, 48043
    - McLaren Cancer Institute-Macomb
  - Mount Pleasant, Michigan, Estados Unidos, 48858
    - McLaren Cancer Institute-Central Michigan
  - Muskegon, Michigan, Estados Unidos, 49444
    - Trinity Health Muskegon Hospital
  - Novi, Michigan, Estados Unidos, 48377
    - Henry Ford Medical Center-Columbus
  - Novi, Michigan, Estados Unidos, 48374
    - Henry Ford Health Providence Novi Hospital
  - Petoskey, Michigan, Estados Unidos, 49770
    - McLaren Cancer Institute-Northern Michigan
  - Pontiac, Michigan, Estados Unidos, 48341
    - Trinity Health Saint Joseph Mercy Oakland Hospital
  - Port Huron, Michigan, Estados Unidos, 48060
    - Lake Huron Medical Center
  - Reed City, Michigan, Estados Unidos, 49677
    - Corewell Health Reed City Hospital
  - Roseville, Michigan, Estados Unidos, 48066
    - Michigan Cancer Specialists
  - Royal Oak, Michigan, Estados Unidos, 48073
    - Cancer Care Associates PC
  - Royal Oak, Michigan, Estados Unidos, 48073
    - Comprehensive Medical Center PLLC
  - Royal Oak, Michigan, Estados Unidos, 48073
    - Oakland Medical Group
  - Royal Oak, Michigan, Estados Unidos, 48067
    - Oakland Colon Rectal Associates
  - Royal Oak, Michigan, Estados Unidos, 48073
    - Hematology Oncology Consultants PC-Royal Oak
  - Royal Oak, Michigan, Estados Unidos, 48073
    - Corewell Health William Beaumont University Hospital
  - Saginaw, Michigan, Estados Unidos, 48601
    - MyMichigan Medical Center Saginaw
  - Southfield, Michigan, Estados Unidos, 48075
    - Henry Ford Health Providence Southfield Hospital
  - Sterling Heights, Michigan, Estados Unidos, 48312
    - Premier Hematology Oncology Care
  - Sterling Heights, Michigan, Estados Unidos, 48314
    - Mitchell Folbe MD PC
  - Traverse City, Michigan, Estados Unidos, 49684
    - Munson Medical Center
  - Troy, Michigan, Estados Unidos, 48084
    - Michigan Institute of Urology-Town Center
  - Troy, Michigan, Estados Unidos, 48085
    - Claudia BR Herke MD PC
  - Troy, Michigan, Estados Unidos, 48098
    - Hematology Oncology Consultants PC-Troy
  - Troy, Michigan, Estados Unidos, 48085
    - Corewell Health Beaumont Troy Hospital
  - Warren, Michigan, Estados Unidos, 48093
    - Henry Ford Health Warren Hospital
  - West Bloomfield, Michigan, Estados Unidos, 48322
    - Henry Ford West Bloomfield Hospital
- Minnesota
  - Bemidji, Minnesota, Estados Unidos, 56601
    - Sanford Joe Lueken Cancer Center
  - Brainerd, Minnesota, Estados Unidos, 56401
    - Essentia Health Saint Joseph's Medical Center
  - Burnsville, Minnesota, Estados Unidos, 55337
    - Fairview Ridges Hospital
  - Coon Rapids, Minnesota, Estados Unidos, 55433
    - Mercy Hospital
  - Duluth, Minnesota, Estados Unidos, 55805
    - Saint Luke's Hospital of Duluth
  - Duluth, Minnesota, Estados Unidos, 55805
    - Essentia Health Cancer Center
  - Duluth, Minnesota, Estados Unidos, 55805
    - Essentia Health Saint Mary's Medical Center
  - Duluth, Minnesota, Estados Unidos, 55805
    - Miller-Dwan Hospital
  - Edina, Minnesota, Estados Unidos, 55435
    - Fairview Southdale Hospital
  - Fergus Falls, Minnesota, Estados Unidos, 56537
    - Lake Region Healthcare Corporation-Cancer Care
  - Fridley, Minnesota, Estados Unidos, 55432
    - Unity Hospital
  - Hutchinson, Minnesota, Estados Unidos, 55350
    - Hutchinson Area Health Care
  - Maplewood, Minnesota, Estados Unidos, 55109
    - Saint John's Hospital - Healtheast
  - Maplewood, Minnesota, Estados Unidos, 55109
    - Minnesota Oncology Hematology PA-Maplewood
  - Minneapolis, Minnesota, Estados Unidos, 55415
    - Hennepin County Medical Center
  - Minneapolis, Minnesota, Estados Unidos, 55407
    - Abbott-Northwestern Hospital
  - Minneapolis, Minnesota, Estados Unidos, 55454
    - Health Partners Inc
  - Minneapolis, Minnesota, Estados Unidos, 55417
    - Minneapolis VA Medical Center
  - New Ulm, Minnesota, Estados Unidos, 56073
    - New Ulm Medical Center
  - Robbinsdale, Minnesota, Estados Unidos, 55422
    - North Memorial Medical Health Center
  - Rochester, Minnesota, Estados Unidos, 55905
    - Mayo Clinic in Rochester
  - Saint Cloud, Minnesota, Estados Unidos, 56303
    - Coborn Cancer Center at Saint Cloud Hospital
  - Saint Cloud, Minnesota, Estados Unidos, 56303
    - Saint Cloud Hospital
  - Saint Louis Park, Minnesota, Estados Unidos, 55416
    - Park Nicollet Clinic - Saint Louis Park
  - Saint Louis Park, Minnesota, Estados Unidos, 55416
    - Metro Minnesota Community Oncology Research Consortium
  - Saint Paul, Minnesota, Estados Unidos, 55101
    - Regions Hospital
  - Saint Paul, Minnesota, Estados Unidos, 55102
    - United Hospital
  - Shakopee, Minnesota, Estados Unidos, 55379
    - Saint Francis Regional Medical Center
  - Stillwater, Minnesota, Estados Unidos, 55082
    - Lakeview Hospital
  - Waconia, Minnesota, Estados Unidos, 55387
    - Ridgeview Medical Center
  - Willmar, Minnesota, Estados Unidos, 56201
    - Rice Memorial Hospital
  - Woodbury, Minnesota, Estados Unidos, 55125
    - Minnesota Oncology Hematology PA-Woodbury
- Mississippi
  - Jackson, Mississippi, Estados Unidos, 39216
    - University of Mississippi Medical Center
- Missouri
  - Bolivar, Missouri, Estados Unidos, 65613
    - Central Care Cancer Center - Bolivar
  - Bonne Terre, Missouri, Estados Unidos, 63628
    - Parkland Health Center-Bonne Terre
  - Branson, Missouri, Estados Unidos, 65616
    - Cox Cancer Center Branson
  - Cape Girardeau, Missouri, Estados Unidos, 63703
    - Saint Francis Medical Center
  - Cape Girardeau, Missouri, Estados Unidos, 63703
    - Mercy Cancer Center - Cape Girardeau
  - Chesterfield, Missouri, Estados Unidos, 63017
    - Saint Luke's Hospital
  - City of Saint Peters, Missouri, Estados Unidos, 63376
    - Siteman Cancer Center at Saint Peters Hospital
  - Columbia, Missouri, Estados Unidos, 65212
    - MU Health - University Hospital/Ellis Fischel Cancer Center
  - Creve Coeur, Missouri, Estados Unidos, 63141
    - Siteman Cancer Center at West County Hospital
  - Independence, Missouri, Estados Unidos, 64057
    - Centerpoint Medical Center LLC
  - Jefferson City, Missouri, Estados Unidos, 65109
    - MU Health Care Goldschmidt Cancer Center
  - Joplin, Missouri, Estados Unidos, 64804
    - Freeman Health System
  - Joplin, Missouri, Estados Unidos, 64804
    - Mercy Hospital Joplin
  - Kansas City, Missouri, Estados Unidos, 64154
    - University of Kansas Cancer Center - North
  - Kansas City, Missouri, Estados Unidos, 64116
    - North Kansas City Hospital
  - Kansas City, Missouri, Estados Unidos, 64131
    - The University of Kansas Cancer Center-South
  - Kansas City, Missouri, Estados Unidos, 64111
    - Saint Luke's Hospital of Kansas City
  - Kansas City, Missouri, Estados Unidos, 64132
    - Research Medical Center
  - Kansas City, Missouri, Estados Unidos, 64118
    - Heartland Hematology and Oncology Associates Incorporated
  - Kansas City, Missouri, Estados Unidos, 64108
    - University Health Truman Medical Center
  - Lee's Summit, Missouri, Estados Unidos, 64064
    - University of Kansas Cancer Center - Lee's Summit
  - Lee's Summit, Missouri, Estados Unidos, 64086
    - Saint Luke's East - Lee's Summit
  - Liberty, Missouri, Estados Unidos, 64068
    - Liberty Hospital
  - Rolla, Missouri, Estados Unidos, 65401
    - Mercy Clinic-Rolla-Cancer and Hematology
  - Rolla, Missouri, Estados Unidos, 65401
    - Phelps Health Delbert Day Cancer Institute
  - Saint Joseph, Missouri, Estados Unidos, 64506
    - Heartland Regional Medical Center
  - Sainte Genevieve, Missouri, Estados Unidos, 63670
    - Sainte Genevieve County Memorial Hospital
  - Springfield, Missouri, Estados Unidos, 65807
    - CoxHealth South Hospital
  - Springfield, Missouri, Estados Unidos, 65804
    - Mercy Hospital Springfield
  - St Louis, Missouri, Estados Unidos, 63110
    - Washington University School of Medicine
  - St Louis, Missouri, Estados Unidos, 63129
    - Siteman Cancer Center-South County
  - St Louis, Missouri, Estados Unidos, 63131
    - Missouri Baptist Medical Center
  - St Louis, Missouri, Estados Unidos, 63109
    - Mercy Infusion Center - Chippewa
  - St Louis, Missouri, Estados Unidos, 63141
    - Mercy Hospital Saint Louis
  - Sullivan, Missouri, Estados Unidos, 63080
    - Missouri Baptist Sullivan Hospital
- Montana
  - Billings, Montana, Estados Unidos, 59101
    - Billings Clinic Cancer Center
  - Billings, Montana, Estados Unidos, 59101
    - Saint Vincent Healthcare
  - Billings, Montana, Estados Unidos, 59102
    - Montana Cancer Consortium NCORP
  - Bozeman, Montana, Estados Unidos, 59715
    - Bozeman Health Deaconess Hospital
  - Butte, Montana, Estados Unidos, 59701
    - Saint James Community Hospital and Cancer Treatment Center
  - Great Falls, Montana, Estados Unidos, 59405
    - Benefis Sletten Cancer Institute
  - Helena, Montana, Estados Unidos, 59601
    - Saint Peter's Community Hospital
  - Kalispell, Montana, Estados Unidos, 59901
    - Logan Health Medical Center
  - Missoula, Montana, Estados Unidos, 59802
    - Saint Patrick Hospital - Community Hospital
  - Missoula, Montana, Estados Unidos, 59804
    - Community Medical Center
- Nebraska
  - Grand Island, Nebraska, Estados Unidos, 68803
    - Nebraska Cancer Specialists/Oncology Hematology West PC
  - Kearney, Nebraska, Estados Unidos, 68847
    - CHI Health Good Samaritan
  - Kearney, Nebraska, Estados Unidos, 68845
    - Fred and Pamela Buffett Cancer Center - Kearney
  - Lincoln, Nebraska, Estados Unidos, 68510
    - Saint Elizabeth Regional Medical Center
  - Omaha, Nebraska, Estados Unidos, 68198
    - University of Nebraska Medical Center
  - Omaha, Nebraska, Estados Unidos, 68124
    - Alegent Health Bergan Mercy Medical Center
  - Omaha, Nebraska, Estados Unidos, 68122
    - Alegent Health Immanuel Medical Center
  - Omaha, Nebraska, Estados Unidos, 68130
    - Alegent Health Lakeside Hospital
  - Omaha, Nebraska, Estados Unidos, 68122
    - Hematology and Oncology Consultants PC
  - Papillion, Nebraska, Estados Unidos, 68046
    - Midlands Community Hospital
- Nevada
  - Henderson, Nevada, Estados Unidos, 89052
    - Comprehensive Cancer Centers of Nevada - Henderson
  - Henderson, Nevada, Estados Unidos, 89052
    - Cancer and Blood Specialists-Henderson
  - Henderson, Nevada, Estados Unidos, 89052
    - Las Vegas Cancer Center-Henderson
  - Henderson, Nevada, Estados Unidos, 89074
    - Comprehensive Cancer Centers of Nevada-Southeast Henderson
  - Henderson, Nevada, Estados Unidos, 89074
    - Oncology Las Vegas - Henderson
  - Las Vegas, Nevada, Estados Unidos, 89144
    - Summerlin Hospital Medical Center
  - Las Vegas, Nevada, Estados Unidos, 89106
    - Radiation Oncology Centers of Nevada Central
  - Las Vegas, Nevada, Estados Unidos, 89119
    - Radiation Oncology Centers of Nevada Southeast
  - Las Vegas, Nevada, Estados Unidos, 89128
    - Comprehensive Cancer Centers of Nevada - Northwest
  - Las Vegas, Nevada, Estados Unidos, 89135
    - Alliance for Childhood Diseases/Cure 4 the Kids Foundation
  - Las Vegas, Nevada, Estados Unidos, 89144
    - Comprehensive Cancer Centers of Nevada-Summerlin
  - Las Vegas, Nevada, Estados Unidos, 89148
    - Comprehensive Cancer Centers of Nevada
  - Las Vegas, Nevada, Estados Unidos, 89169
    - Comprehensive Cancer Centers of Nevada - Central Valley
  - Las Vegas, Nevada, Estados Unidos, 89106
    - Cancer and Blood Specialists-Shadow
  - Las Vegas, Nevada, Estados Unidos, 89109
    - HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
  - Las Vegas, Nevada, Estados Unidos, 89113
    - HealthCare Partners Medical Group Oncology/Hematology-San Martin
  - Las Vegas, Nevada, Estados Unidos, 89121
    - Cancer Therapy and Integrative Medicine
  - Las Vegas, Nevada, Estados Unidos, 89128
    - Cancer and Blood Specialists-Tenaya
  - Las Vegas, Nevada, Estados Unidos, 89128
    - HealthCare Partners Medical Group Oncology/Hematology-Tenaya
  - Las Vegas, Nevada, Estados Unidos, 89148-2405
    - Las Vegas Cancer Center-Medical Center
  - Las Vegas, Nevada, Estados Unidos, 89149
    - HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
  - Las Vegas, Nevada, Estados Unidos, 89120
    - Nevada Cancer Research Foundation NCORP
  - Las Vegas, Nevada, Estados Unidos, 89128
    - Oncology Las Vegas - Tenaya
  - Las Vegas, Nevada, Estados Unidos, 89183
    - OptumCare Cancer Care at Fort Apache
  - Reno, Nevada, Estados Unidos, 89503
    - Saint Mary's Regional Medical Center
- New Hampshire
  - Concord, New Hampshire, Estados Unidos, 03301
    - New Hampshire Oncology Hematology PA-Concord
  - Derry, New Hampshire, Estados Unidos, 03038
    - Parkland Medical Center
  - Dover, New Hampshire, Estados Unidos, 03820
    - Wentworth-Douglass Hospital
  - Laconia, New Hampshire, Estados Unidos, 03246
    - LRGHealthcare-Lakes Region General Hospital
  - Lebanon, New Hampshire, Estados Unidos, 03756
    - Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
  - Manchester, New Hampshire, Estados Unidos, 03103
    - Solinsky Center for Cancer Care
  - Manchester, New Hampshire, Estados Unidos, 03104
    - Dartmouth Cancer Center - Manchester/ DCC Manchester
  - Nashua, New Hampshire, Estados Unidos, 03063
    - Dartmouth Cancer Center - Nashua
  - Portsmouth, New Hampshire, Estados Unidos, 03802
    - Portsmouth Regional Hospital
- New Jersey
  - East Orange, New Jersey, Estados Unidos, 07018-1095
    - Veterans Adminstration New Jersey Health Care System
  - Englewood, New Jersey, Estados Unidos, 07631
    - Englewood Hospital and Medical Center
  - New Brunswick, New Jersey, Estados Unidos, 08903
    - Rutgers Cancer Institute of New Jersey
  - Newark, New Jersey, Estados Unidos, 07112
    - Newark Beth Israel Medical Center
  - Paramus, New Jersey, Estados Unidos, 07652
    - The Valley Hospital - Luckow Pavilion
  - Plainsboro, New Jersey, Estados Unidos, 08536
    - Penn Medicine Princeton Health
  - Ridgewood, New Jersey, Estados Unidos, 07450
    - Valley Health System Ridgewood Campus
  - Summit, New Jersey, Estados Unidos, 07902
    - Overlook Hospital
  - Westwood, New Jersey, Estados Unidos, 07675
    - Valley Health System-Hematology/Oncology
- New Mexico
  - Albuquerque, New Mexico, Estados Unidos, 87106
    - University of New Mexico Cancer Center
  - Albuquerque, New Mexico, Estados Unidos, 87110
    - Presbyterian Kaseman Hospital
  - Las Cruces, New Mexico, Estados Unidos, 88011
    - Memorial Medical Center-Las Cruces
- New York
  - Auburn, New York, Estados Unidos, 13021
    - Hematology Oncology Associates of Central New York-Auburn
  - Brooklyn, New York, Estados Unidos, 11219
    - Maimonides Medical Center
  - Buffalo, New York, Estados Unidos, 14263
    - Roswell Park Cancer Institute
  - Camillus, New York, Estados Unidos, 13031
    - Hematology Oncology Associates of CNY at Camillus
  - East Syracuse, New York, Estados Unidos, 13057
    - Hematology Oncology Associates of Central New York-East Syracuse
  - Glens Falls, New York, Estados Unidos, 12801
    - Glens Falls Hospital
  - Lake Success, New York, Estados Unidos, 11042
    - Northwell Health/Center for Advanced Medicine
  - Manhasset, New York, Estados Unidos, 11030
    - North Shore University Hospital
  - Middletown, New York, Estados Unidos, 10940
    - Garnet Health Medical Center
  - New York, New York, Estados Unidos, 10032
    - NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
  - Plattsburgh, New York, Estados Unidos, 12901
    - Champlain Valley Physicians Hospital Medical Center
  - Rochester, New York, Estados Unidos, 14642
    - University of Rochester
  - Rome, New York, Estados Unidos, 13440
    - Hematology Oncology Associates of Central New York-Rome
  - Stony Brook, New York, Estados Unidos, 11794
    - Stony Brook University Medical Center
  - Syracuse, New York, Estados Unidos, 13210
    - State University of New York Upstate Medical University
  - Utica, New York, Estados Unidos, 13502
    - Faxton-Saint Luke's Healthcare
- North Carolina
  - Asheville, North Carolina, Estados Unidos, 28801
    - Mission Hospital
  - Asheville, North Carolina, Estados Unidos, 28816
    - Hope Women's Cancer Centers-Asheville
  - Asheville, North Carolina, Estados Unidos, 28806
    - Messino Cancer Centers
  - Asheville, North Carolina, Estados Unidos, 28801
    - Mountain Radiation Oncology PA
  - Asheville, North Carolina, Estados Unidos, 28803
    - AdventHealth Infusion Center Asheville
  - Brevard, North Carolina, Estados Unidos, 28712
    - Transylvania Regional Hospital
  - Chapel Hill, North Carolina, Estados Unidos, 27599
    - UNC Lineberger Comprehensive Cancer Center
  - Clinton, North Carolina, Estados Unidos, 28328
    - Southeastern Medical Oncology Center-Clinton
  - Clinton, North Carolina, Estados Unidos, 28328
    - Sampson Radiation Oncology
  - Durham, North Carolina, Estados Unidos, 27710
    - Duke University Medical Center
  - Franklin, North Carolina, Estados Unidos, 28734
    - Angel Medical Center
  - Goldsboro, North Carolina, Estados Unidos, 27534
    - Southeastern Medical Oncology Center-Goldsboro
  - Goldsboro, North Carolina, Estados Unidos, 27534
    - Wayne Memorial Hospital
  - Goldsboro, North Carolina, Estados Unidos, 27534
    - Wayne Radiation Oncology
  - Greenville, North Carolina, Estados Unidos, 27834
    - East Carolina University
  - Hendersonville, North Carolina, Estados Unidos, 28791
    - Margaret R Pardee Memorial Hospital
  - Hendersonville, North Carolina, Estados Unidos, 28792
    - AdventHealth Hendersonville
  - Jacksonville, North Carolina, Estados Unidos, 28546
    - Southeastern Medical Oncology Center-Jacksonville
  - Jacksonville, North Carolina, Estados Unidos, 28546
    - Onslow Memorial Hospital
  - Kinston, North Carolina, Estados Unidos, 28501
    - ECU Health Oncology Kinston
  - Marion, North Carolina, Estados Unidos, 28752
    - Mission Hospital McDowell
  - Pinehurst, North Carolina, Estados Unidos, 28374
    - FirstHealth of the Carolinas-Moore Regional Hospital
  - Spruce Pine, North Carolina, Estados Unidos, 28777
    - Blue Ridge Regional Hospital
  - Statesville, North Carolina, Estados Unidos, 28677
    - Iredell Memorial Hospital
  - Winston-Salem, North Carolina, Estados Unidos, 27157
    - Wake Forest University Health Sciences
  - Winston-Salem, North Carolina, Estados Unidos, 27104
    - Southeast Clinical Oncology Research Consortium NCORP
- North Dakota
  - Bismarck, North Dakota, Estados Unidos, 58501
    - Sanford Bismarck Medical Center
  - Fargo, North Dakota, Estados Unidos, 58122
    - Sanford Roger Maris Cancer Center
  - Fargo, North Dakota, Estados Unidos, 58103
    - Essentia Health Cancer Center-South University Clinic
  - Fargo, North Dakota, Estados Unidos, 58122
    - Sanford Broadway Medical Center
  - Grand Forks, North Dakota, Estados Unidos, 58201
    - Altru Cancer Center
  - Minot, North Dakota, Estados Unidos, 58701
    - Trinity Cancer Care Center
- Ohio
  - Akron, Ohio, Estados Unidos, 44307
    - Cleveland Clinic Akron General
  - Beachwood, Ohio, Estados Unidos, 44122
    - UHHS-Chagrin Highlands Medical Center
  - Beachwood, Ohio, Estados Unidos, 44122
    - Cleveland Clinic Cancer Center Beachwood
  - Belpre, Ohio, Estados Unidos, 45714
    - Strecker Cancer Center-Belpre
  - Bowling Green, Ohio, Estados Unidos, 43402
    - Toledo Clinic Cancer Centers-Bowling Green
  - Centerville, Ohio, Estados Unidos, 45459
    - Miami Valley Hospital South
  - Chardon, Ohio, Estados Unidos, 44024
    - Geauga Hospital
  - Chillicothe, Ohio, Estados Unidos, 45601
    - Adena Regional Medical Center
  - Cincinnati, Ohio, Estados Unidos, 45219
    - University of Cincinnati Cancer Center-UC Medical Center
  - Cincinnati, Ohio, Estados Unidos, 45220
    - Good Samaritan Hospital - Cincinnati
  - Cincinnati, Ohio, Estados Unidos, 45242
    - Bethesda North Hospital
  - Cincinnati, Ohio, Estados Unidos, 45242
    - Oncology Hematology Care Inc-Blue Ash
  - Cincinnati, Ohio, Estados Unidos, 45202
    - Oncology Hematology Care Inc-Eden Park
  - Cincinnati, Ohio, Estados Unidos, 45211
    - Oncology Hematology Care Inc-Mercy West
  - Cincinnati, Ohio, Estados Unidos, 45230
    - Oncology Hematology Care Inc-Anderson
  - Cincinnati, Ohio, Estados Unidos, 45236
    - Oncology Hematology Care Inc-Kenwood
  - Cincinnati, Ohio, Estados Unidos, 45247
    - TriHealth Cancer Institute-Westside
  - Cincinnati, Ohio, Estados Unidos, 45255
    - TriHealth Cancer Institute-Anderson
  - Cleveland, Ohio, Estados Unidos, 44106
    - Case Western Reserve University
  - Cleveland, Ohio, Estados Unidos, 44109
    - MetroHealth Medical Center
  - Cleveland, Ohio, Estados Unidos, 44195
    - Cleveland Clinic Foundation
  - Cleveland, Ohio, Estados Unidos, 44111
    - Cleveland Clinic Cancer Center/Fairview Hospital
  - Columbus, Ohio, Estados Unidos, 43214
    - Riverside Methodist Hospital
  - Columbus, Ohio, Estados Unidos, 43210
    - Ohio State University Comprehensive Cancer Center
  - Columbus, Ohio, Estados Unidos, 43219
    - The Mark H Zangmeister Center
  - Columbus, Ohio, Estados Unidos, 43214
    - Columbus Oncology and Hematology Associates Inc
  - Columbus, Ohio, Estados Unidos, 43228
    - Doctors Hospital
  - Columbus, Ohio, Estados Unidos, 43215
    - Grant Medical Center
  - Columbus, Ohio, Estados Unidos, 43222
    - Mount Carmel Health Center West
  - Columbus, Ohio, Estados Unidos, 43215
    - Columbus NCI Community Oncology Research Program
  - Dayton, Ohio, Estados Unidos, 45406
    - Good Samaritan Hospital - Dayton
  - Dayton, Ohio, Estados Unidos, 45409
    - Miami Valley Hospital
  - Dayton, Ohio, Estados Unidos, 45415
    - Miami Valley Hospital North
  - Dayton, Ohio, Estados Unidos, 45459
    - Dayton NCI Community Oncology Research Program
  - Delaware, Ohio, Estados Unidos, 43015
    - Delaware Health Center-Grady Cancer Center
  - Delaware, Ohio, Estados Unidos, 43015
    - Delaware Radiation Oncology
  - Delaware, Ohio, Estados Unidos, 43015
    - Grady Memorial Hospital
  - Elyria, Ohio, Estados Unidos, 44035
    - Mercy Cancer Center-Elyria
  - Fairfield, Ohio, Estados Unidos, 45014
    - Oncology Hematology Care Inc-Healthplex
  - Findlay, Ohio, Estados Unidos, 45840
    - Blanchard Valley Hospital
  - Franklin, Ohio, Estados Unidos, 45005-1066
    - Atrium Medical Center-Middletown Regional Hospital
  - Greenville, Ohio, Estados Unidos, 45331
    - Wayne Hospital
  - Independence, Ohio, Estados Unidos, 44131
    - Cleveland Clinic Cancer Center Independence
  - Kettering, Ohio, Estados Unidos, 45429
    - Kettering Medical Center
  - Lancaster, Ohio, Estados Unidos, 43130
    - Fairfield Medical Center
  - Lancaster, Ohio, Estados Unidos, 43130
    - Lancaster Radiation Oncology
  - Lima, Ohio, Estados Unidos, 45804
    - Lima Memorial Hospital
  - Mansfield, Ohio, Estados Unidos, 44906
    - Cleveland Clinic Cancer Center Mansfield
  - Marietta, Ohio, Estados Unidos, 45750
    - Marietta Memorial Hospital
  - Maumee, Ohio, Estados Unidos, 43537
    - Toledo Clinic Cancer Centers-Maumee
  - Maumee, Ohio, Estados Unidos, 43537
    - Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
  - Mayfield Heights, Ohio, Estados Unidos, 44124
    - Hillcrest Hospital Cancer Center
  - Mayfield Heights, Ohio, Estados Unidos, 44124
    - UH Seidman Cancer Center at Landerbrook Health Center
  - Mentor, Ohio, Estados Unidos, 44060
    - UH Seidman Cancer Center at Lake Health Mentor Campus
  - Middleburg Heights, Ohio, Estados Unidos, 44130
    - UH Seidman Cancer Center at Southwest General Hospital
  - Mount Vernon, Ohio, Estados Unidos, 43050
    - Knox Community Hospital
  - Newark, Ohio, Estados Unidos, 43055
    - Licking Memorial Hospital
  - Newark, Ohio, Estados Unidos, 43055
    - Newark Radiation Oncology
  - Oregon, Ohio, Estados Unidos, 43616
    - Saint Charles Hospital
  - Oregon, Ohio, Estados Unidos, 43616
    - Toledo Clinic Cancer Centers-Oregon
  - Portsmouth, Ohio, Estados Unidos, 45662
    - Southern Ohio Medical Center
  - Sandusky, Ohio, Estados Unidos, 44870
    - North Coast Cancer Care
  - Springfield, Ohio, Estados Unidos, 45504
    - Springfield Regional Cancer Center
  - Springfield, Ohio, Estados Unidos, 45504
    - Springfield Regional Medical Center
  - Strongsville, Ohio, Estados Unidos, 44136
    - Cleveland Clinic Cancer Center Strongsville
  - Sylvania, Ohio, Estados Unidos, 43560
    - ProMedica Flower Hospital
  - Tiffin, Ohio, Estados Unidos, 44883
    - Mercy Hospital of Tiffin
  - Toledo, Ohio, Estados Unidos, 43606
    - ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
  - Toledo, Ohio, Estados Unidos, 43623
    - Mercy Health - Saint Anne Hospital
  - Toledo, Ohio, Estados Unidos, 43623
    - Toledo Clinic Cancer Centers-Toledo
  - Toledo, Ohio, Estados Unidos, 43614
    - University of Toledo
  - Toledo, Ohio, Estados Unidos, 43617
    - Toledo Community Hospital Oncology Program CCOP
  - Toledo, Ohio, Estados Unidos, 43608
    - Mercy Health - Saint Vincent Hospital
  - Troy, Ohio, Estados Unidos, 45373
    - Upper Valley Medical Center
  - Warrensville Heights, Ohio, Estados Unidos, 44122
    - South Pointe Hospital
  - Wauseon, Ohio, Estados Unidos, 43567
    - Fulton County Health Center
  - West Chester, Ohio, Estados Unidos, 45069
    - University of Cincinnati Cancer Center-West Chester
  - Westerville, Ohio, Estados Unidos, 43081
    - Saint Ann's Hospital
  - Westlake, Ohio, Estados Unidos, 44145
    - UH Seidman Cancer Center at Saint John Medical Center
  - Wooster, Ohio, Estados Unidos, 44691
    - Cleveland Clinic Wooster Family Health and Surgery Center
  - Wright-Patterson Air Force Base, Ohio, Estados Unidos, 45433
    - Wright-Patterson Medical Center
  - Zanesville, Ohio, Estados Unidos, 43701
    - Genesis Healthcare System Cancer Care Center
- Oklahoma
  - Lawton, Oklahoma, Estados Unidos, 73505
    - Cancer Centers of Southwest Oklahoma Research
  - Oklahoma City, Oklahoma, Estados Unidos, 73104
    - University of Oklahoma Health Sciences Center
  - Oklahoma City, Oklahoma, Estados Unidos, 73120
    - Mercy Hospital Oklahoma City
  - Tulsa, Oklahoma, Estados Unidos, 74146
    - Oklahoma Cancer Specialists and Research Institute-Tulsa
  - Tulsa, Oklahoma, Estados Unidos, 74146
    - Warren Clinic Oncology-Tulsa
  - Tulsa, Oklahoma, Estados Unidos, 74136
    - Saint Francis Children's Hospital
- Oregon
  - Bend, Oregon, Estados Unidos, 97701
    - Saint Charles Health System
  - Clackamas, Oregon, Estados Unidos, 97015
    - Clackamas Radiation Oncology Center
  - Clackamas, Oregon, Estados Unidos, 97015
    - Providence Cancer Institute Clackamas Clinic
  - Coos Bay, Oregon, Estados Unidos, 97420
    - Bay Area Hospital
  - Milwaukie, Oregon, Estados Unidos, 97222
    - Providence Milwaukie Hospital
  - Newberg, Oregon, Estados Unidos, 97132
    - Providence Newberg Medical Center
  - Oregon City, Oregon, Estados Unidos, 97045
    - Providence Willamette Falls Medical Center
  - Portland, Oregon, Estados Unidos, 97239
    - Oregon Health and Science University
  - Portland, Oregon, Estados Unidos, 97213
    - Providence Portland Medical Center
  - Portland, Oregon, Estados Unidos, 97225
    - Providence Saint Vincent Medical Center
  - Portland, Oregon, Estados Unidos, 97227
    - Kaiser Permanente Northwest
- Pennsylvania
  - Allentown, Pennsylvania, Estados Unidos, 18103
    - Lehigh Valley Hospital-Cedar Crest
  - Beaver, Pennsylvania, Estados Unidos, 15009
    - UPMC-Heritage Valley Health System Beaver
  - Bethlehem, Pennsylvania, Estados Unidos, 18017
    - Lehigh Valley Hospital - Muhlenberg
  - Bryn Mawr, Pennsylvania, Estados Unidos, 19010
    - Bryn Mawr Hospital
  - Chadds Ford, Pennsylvania, Estados Unidos, 19317
    - Christiana Care Health System-Concord Health Center
  - Danville, Pennsylvania, Estados Unidos, 17822
    - Geisinger Medical Center
  - Drexel Hill, Pennsylvania, Estados Unidos, 19026
    - Delaware County Memorial Hospital
  - East Stroudsburg, Pennsylvania, Estados Unidos, 18301
    - Pocono Medical Center
  - Ephrata, Pennsylvania, Estados Unidos, 17522
    - Ephrata Cancer Center
  - Ephrata, Pennsylvania, Estados Unidos, 17522
    - Ephrata Community Hospital
  - Gettysburg, Pennsylvania, Estados Unidos, 17325
    - Adams Cancer Center
  - Greensburg, Pennsylvania, Estados Unidos, 15601
    - UPMC Cancer Centers - Arnold Palmer Pavilion
  - Hanover, Pennsylvania, Estados Unidos, 17331
    - WellSpan Medical Oncology and Hematology
  - Hazleton, Pennsylvania, Estados Unidos, 18201
    - Geisinger Medical Center-Cancer Center Hazleton
  - Hershey, Pennsylvania, Estados Unidos, 17033-0850
    - Penn State Milton S Hershey Medical Center
  - Johnstown, Pennsylvania, Estados Unidos, 15901
    - UPMC-Johnstown/John P. Murtha Regional Cancer Center
  - McKeesport, Pennsylvania, Estados Unidos, 15132
    - UPMC Cancer Center at UPMC McKeesport
  - Media, Pennsylvania, Estados Unidos, 19063
    - Riddle Memorial Hospital
  - Moon Township, Pennsylvania, Estados Unidos, 15108
    - UPMC Hillman Cancer Center in Coraopolis
  - Paoli, Pennsylvania, Estados Unidos, 19301
    - Paoli Memorial Hospital
  - Philadelphia, Pennsylvania, Estados Unidos, 19111
    - Fox Chase Cancer Center
  - Philadelphia, Pennsylvania, Estados Unidos, 19107
    - Thomas Jefferson University Hospital
  - Philadelphia, Pennsylvania, Estados Unidos, 19114
    - Jefferson Torresdale Hospital
  - Pittsburgh, Pennsylvania, Estados Unidos, 15232
    - UPMC Hillman Cancer Center
  - Pittsburgh, Pennsylvania, Estados Unidos, 15213
    - UPMC-Magee Womens Hospital
  - Pittsburgh, Pennsylvania, Estados Unidos, 15232
    - UPMC-Shadyside Hospital
  - Pittsburgh, Pennsylvania, Estados Unidos, 15213
    - UPMC-Presbyterian Hospital
  - Pittsburgh, Pennsylvania, Estados Unidos, 15215
    - UPMC-Saint Margaret
  - Pittsburgh, Pennsylvania, Estados Unidos, 15236
    - UPMC Jefferson Regional Radiation Oncology
  - Pittsburgh, Pennsylvania, Estados Unidos, 15237
    - UPMC-Passavant Hospital
  - Pittsburgh, Pennsylvania, Estados Unidos, 15243
    - UPMC-Saint Clair Hospital Cancer Center
  - Pottsville, Pennsylvania, Estados Unidos, 17901
    - Geisinger Cancer Services-Pottsville
  - Scranton, Pennsylvania, Estados Unidos, 18508
    - Hematology and Oncology Associates of North East Pennsylvania
  - Seneca, Pennsylvania, Estados Unidos, 16346
    - UPMC Cancer Center at UPMC Northwest
  - State College, Pennsylvania, Estados Unidos, 16801
    - Geisinger Medical Group
  - Uniontown, Pennsylvania, Estados Unidos, 15401
    - UPMC Uniontown Hospital Radiation Oncology
  - Upland, Pennsylvania, Estados Unidos, 19013
    - Associates In Hematology Oncology PC-Upland
  - Washington, Pennsylvania, Estados Unidos, 15301
    - UPMC Washington Hospital Radiation Oncology
  - West Chester, Pennsylvania, Estados Unidos, 19380
    - Chester County Hospital
  - West Reading, Pennsylvania, Estados Unidos, 19611
    - Reading Hospital
  - Wilkes-Barre, Pennsylvania, Estados Unidos, 18711
    - Geisinger Wyoming Valley/Henry Cancer Center
  - Williamsport, Pennsylvania, Estados Unidos, 17701
    - UPMC Susquehanna
  - Wynnewood, Pennsylvania, Estados Unidos, 19096
    - Lankenau Medical Center
  - York, Pennsylvania, Estados Unidos, 17403
    - WellSpan Health-York Cancer Center
  - York, Pennsylvania, Estados Unidos, 17403
    - WellSpan Health-York Hospital
- Rhode Island
  - Pawtucket, Rhode Island, Estados Unidos, 02860
    - Memorial Hospital of Rhode Island
  - Providence, Rhode Island, Estados Unidos, 02903
    - Rhode Island Hospital
  - Providence, Rhode Island, Estados Unidos, 02906
    - Miriam Hospital
- South Carolina
  - Anderson, South Carolina, Estados Unidos, 29621
    - AnMed Health Cancer Center
  - Boiling Springs, South Carolina, Estados Unidos, 29316
    - Prisma Health Cancer Institute - Spartanburg
  - Charleston, South Carolina, Estados Unidos, 29425
    - Medical University of South Carolina
  - Charleston, South Carolina, Estados Unidos, 29401
    - Roper Hospital
  - Charleston, South Carolina, Estados Unidos, 29406
    - Lowcountry Hematology Oncology PA-North Charleston
  - Charleston, South Carolina, Estados Unidos, 29414
    - Bon Secours Saint Francis Hospital
  - Charleston, South Carolina, Estados Unidos, 29403
    - Charleston Oncology - Roper
  - Charleston, South Carolina, Estados Unidos, 29414
    - Charleston Oncology - Saint Francis
  - Charleston, South Carolina, Estados Unidos, 29414
    - Lowcountry Oncology Associates - West Ashley
  - Easley, South Carolina, Estados Unidos, 29640
    - Prisma Health Cancer Institute - Easley
  - Florence, South Carolina, Estados Unidos, 29506
    - McLeod Regional Medical Center
  - Gaffney, South Carolina, Estados Unidos, 29341
    - Gibbs Cancer Center-Gaffney
  - Greenville, South Carolina, Estados Unidos, 29605
    - Prisma Health Cancer Institute - Faris
  - Greenville, South Carolina, Estados Unidos, 29607
    - Saint Francis Cancer Center
  - Greenville, South Carolina, Estados Unidos, 29615
    - Prisma Health Cancer Institute - Eastside
  - Greenville, South Carolina, Estados Unidos, 29605
    - Prisma Health Cancer Institute - Butternut
  - Greenville, South Carolina, Estados Unidos, 29601
    - Saint Francis Hospital
  - Greenville, South Carolina, Estados Unidos, 29605
    - Prisma Health Greenville Memorial Hospital
  - Greenville, South Carolina, Estados Unidos, 29601
    - Greenville Health System Cancer Institute-Andrews
  - Greer, South Carolina, Estados Unidos, 29650
    - Prisma Health Cancer Institute - Greer
  - Greer, South Carolina, Estados Unidos, 29651
    - Gibbs Cancer Center-Pelham
  - Lancaster, South Carolina, Estados Unidos, 29720
    - Carolina Blood and Cancer Care Associates PA-Lancaster
  - Mt. Pleasant, South Carolina, Estados Unidos, 29464
    - Lowcountry Oncology Associates - Mount Pleasant
  - Rock Hill, South Carolina, Estados Unidos, 29732
    - Carolina Blood and Cancer Care Associates PA
  - Seneca, South Carolina, Estados Unidos, 29672
    - Prisma Health Cancer Institute - Seneca
  - Spartanburg, South Carolina, Estados Unidos, 29303
    - Spartanburg Medical Center
  - Union, South Carolina, Estados Unidos, 29379
    - SMC Center for Hematology Oncology Union
  - West Columbia, South Carolina, Estados Unidos, 29169
    - Lexington Health
- South Dakota
  - Rapid City, South Dakota, Estados Unidos, 57701
    - Rapid City Regional Hospital
  - Sioux Falls, South Dakota, Estados Unidos, 57105
    - Avera Cancer Institute
  - Sioux Falls, South Dakota, Estados Unidos, 57117-5134
    - Sanford USD Medical Center - Sioux Falls
  - Sioux Falls, South Dakota, Estados Unidos, 57104
    - Sanford Cancer Center Oncology Clinic
- Tennessee
  - Bristol, Tennessee, Estados Unidos, 37620
    - Wellmont Medical Associates Oncology and Hematology-Bristol
  - Bristol, Tennessee, Estados Unidos, 37620
    - Bristol Regional Medical Center
  - Chattanooga, Tennessee, Estados Unidos, 37404
    - Memorial Hospital
  - Chattanooga, Tennessee, Estados Unidos, 37403
    - Erlanger Medical Center
  - Hixson, Tennessee, Estados Unidos, 37343
    - Pulmonary Medicine Center of Chattanooga-Hixson
  - Kingsport, Tennessee, Estados Unidos, 37660
    - Ballad Health Cancer Care - Kingsport
  - Kingsport, Tennessee, Estados Unidos, 37660
    - Wellmont Holston Valley Hospital and Medical Center
  - Ooltewah, Tennessee, Estados Unidos, 37363
    - Memorial GYN Plus
- Texas
  - Amarillo, Texas, Estados Unidos, 79106
    - The Don and Sybil Harrington Cancer Center
  - Dallas, Texas, Estados Unidos, 75235
    - Parkland Memorial Hospital
  - Dallas, Texas, Estados Unidos, 75390
    - UT Southwestern/Simmons Cancer Center-Dallas
  - San Antonio, Texas, Estados Unidos, 78229
    - University Hospital
  - San Antonio, Texas, Estados Unidos, 78229
    - University of Texas Health Science Center at San Antonio
- Vermont
  - Bennington, Vermont, Estados Unidos, 05201
    - Southwestern Vermont Medical Center
  - Berlin Corners, Vermont, Estados Unidos, 05602
    - Central Vermont Medical Center/National Life Cancer Treatment
  - Burlington, Vermont, Estados Unidos, 05405
    - University of Vermont and State Agricultural College
  - White River Junction, Vermont, Estados Unidos, 05009
    - White River Junction Veteran Administration Medical Center
- Virginia
  - Charlottesville, Virginia, Estados Unidos, 22908
    - University of Virginia Cancer Center
  - Fredericksburg, Virginia, Estados Unidos, 22401
    - Fredericksburg Oncology Inc
  - Fredericksburg, Virginia, Estados Unidos, 22408
    - Hematology Oncology Associates of Fredericksburg Inc
  - Hampton, Virginia, Estados Unidos, 23666
    - Virginia Oncology Associates-Hampton
  - Lynchburg, Virginia, Estados Unidos, 24501
    - Centra Alan B Pearson Regional Cancer Center
  - Norton, Virginia, Estados Unidos, 24273
    - Ballad Health Cancer Care - Norton
  - Richmond, Virginia, Estados Unidos, 23229
    - Virginia Cancer Institute
  - Richmond, Virginia, Estados Unidos, 23298
    - VCU Massey Comprehensive Cancer Center
  - South Hill, Virginia, Estados Unidos, 23970
    - VCU Community Memorial Health Center
  - Winchester, Virginia, Estados Unidos, 22601
    - Shenandoah Oncology PC
- Washington
  - Aberdeen, Washington, Estados Unidos, 98520
    - Providence Regional Cancer System-Aberdeen
  - Anacortes, Washington, Estados Unidos, 98221
    - Cancer Care Center at Island Hospital
  - Bellevue, Washington, Estados Unidos, 98005
    - Swedish Cancer Institute-Eastside Oncology Hematology
  - Bellingham, Washington, Estados Unidos, 98225
    - PeaceHealth Saint Joseph Medical Center
  - Burien, Washington, Estados Unidos, 98166
    - Saint Anne Hospital
  - Centralia, Washington, Estados Unidos, 98531
    - Providence Regional Cancer System-Centralia
  - Edmonds, Washington, Estados Unidos, 98026
    - Swedish Cancer Institute-Edmonds
  - Enumclaw, Washington, Estados Unidos, 98022
    - Saint Elizabeth Hospital
  - Everett, Washington, Estados Unidos, 98201
    - Providence Regional Cancer Partnership
  - Federal Way, Washington, Estados Unidos, 98003
    - Saint Francis Hospital
  - Issaquah, Washington, Estados Unidos, 98029
    - Swedish Cancer Institute-Issaquah
  - Lacey, Washington, Estados Unidos, 98503
    - Providence Regional Cancer System-Lacey
  - Lakewood, Washington, Estados Unidos, 98499
    - Saint Clare Hospital
  - Longview, Washington, Estados Unidos, 98632
    - PeaceHealth Saint John Medical Center
  - Poulsbo, Washington, Estados Unidos, 98370
    - Harrison HealthPartners Hematology and Oncology-Poulsbo
  - Seattle, Washington, Estados Unidos, 98107
    - Swedish Medical Center-Ballard Campus
  - Seattle, Washington, Estados Unidos, 98122
    - Swedish Medical Center-First Hill
  - Seattle, Washington, Estados Unidos, 98112
    - Kaiser Permanente Washington
  - Seattle, Washington, Estados Unidos, 98104
    - Minor and James Medical PLLC
  - Seattle, Washington, Estados Unidos, 98104
    - Pacific Gynecology Specialists
  - Shelton, Washington, Estados Unidos, 98584
    - Providence Regional Cancer System-Shelton
  - Silverdale, Washington, Estados Unidos, 98383
    - Saint Joseph Medical Center Hematology and Oncology - Silverdale
  - Spokane, Washington, Estados Unidos, 99218
    - Evergreen Hematology and Oncology PS
  - Spokane, Washington, Estados Unidos, 99204
    - MultiCare Deaconess Cancer and Blood Specialty Center - Downtown
  - Spokane Valley, Washington, Estados Unidos, 99216
    - MultiCare Deaconess Cancer and Blood Specialty Center - Valley
  - Tacoma, Washington, Estados Unidos, 98405
    - Northwest Medical Specialties PLLC
  - Tacoma, Washington, Estados Unidos, 98405
    - Franciscan Research Center-Northwest Medical Plaza
  - Vancouver, Washington, Estados Unidos, 98664
    - PeaceHealth Southwest Medical Center
  - Walla Walla, Washington, Estados Unidos, 99362
    - Providence Saint Mary Regional Cancer Center
  - Yakima, Washington, Estados Unidos, 98902
    - North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
  - Yelm, Washington, Estados Unidos, 98597
    - Providence Regional Cancer System-Yelm
- West Virginia
  - Bridgeport, West Virginia, Estados Unidos, 26330
    - United Hospital Center
  - Charleston, West Virginia, Estados Unidos, 25304
    - Vandalia Health/CAMC Institute for Academic Medicine
  - Huntington, West Virginia, Estados Unidos, 25701
    - Edwards Comprehensive Cancer Center
  - Huntington, West Virginia, Estados Unidos, 25702
    - Saint Mary's Medical Center
  - Martinsburg, West Virginia, Estados Unidos, 25401
    - WVUH-Berkely Medical Center
  - Morgantown, West Virginia, Estados Unidos, 26506
    - West Virginia University Healthcare
  - Parkersburg, West Virginia, Estados Unidos, 26101
    - Camden Clark Medical Center
- Wisconsin
  - Antigo, Wisconsin, Estados Unidos, 54409
    - Aspirus Cancer Care-Antigo-Volm Cancer Center
  - Burlington, Wisconsin, Estados Unidos, 53105
    - Aurora Cancer Care-Southern Lakes VLCC
  - Chippewa Falls, Wisconsin, Estados Unidos, 54729
    - Marshfield Clinic-Chippewa Center
  - Eau Claire, Wisconsin, Estados Unidos, 54701
    - HSHS Sacred Heart Hospital
  - Eau Claire, Wisconsin, Estados Unidos, 54701
    - Marshfield Clinic Cancer Center at Sacred Heart
  - Fond du Lac, Wisconsin, Estados Unidos, 54937
    - Aurora Health Center-Fond du Lac
  - Germantown, Wisconsin, Estados Unidos, 53022
    - Aurora Health Care Germantown Health Center
  - Grafton, Wisconsin, Estados Unidos, 53024
    - Aurora Cancer Care-Grafton
  - Green Bay, Wisconsin, Estados Unidos, 54311
    - Aurora BayCare Medical Center
  - Green Bay, Wisconsin, Estados Unidos, 54301
    - Saint Vincent Hospital Cancer Center Green Bay
  - Green Bay, Wisconsin, Estados Unidos, 54303
    - Saint Vincent Hospital Cancer Center at Saint Mary's
  - Green Bay, Wisconsin, Estados Unidos, 54301
    - Bellin Memorial Hospital
  - Green Bay, Wisconsin, Estados Unidos, 54301-3526
    - Green Bay Oncology at Saint Vincent Hospital
  - Kenosha, Wisconsin, Estados Unidos, 53142
    - Aurora Cancer Care-Kenosha South
  - La Crosse, Wisconsin, Estados Unidos, 54601
    - Gundersen Lutheran Medical Center
  - Ladysmith, Wisconsin, Estados Unidos, 54848
    - Marshfield Medical Center - Ladysmith
  - Manitowoc, Wisconsin, Estados Unidos, 54221
    - Holy Family Memorial Hospital
  - Marinette, Wisconsin, Estados Unidos, 54143
    - Aurora Bay Area Medical Group-Marinette
  - Marinette, Wisconsin, Estados Unidos, 54143
    - Bay Area Medical Center
  - Marshfield, Wisconsin, Estados Unidos, 54449
    - Marshfield Medical Center-Marshfield
  - Marshfield, Wisconsin, Estados Unidos, 54449
    - Marshfield Medical Center
  - Milwaukee, Wisconsin, Estados Unidos, 53226
    - Medical College of Wisconsin
  - Milwaukee, Wisconsin, Estados Unidos, 53209
    - Aurora Cancer Care-Milwaukee
  - Milwaukee, Wisconsin, Estados Unidos, 53215
    - Aurora Saint Luke's Medical Center
  - Milwaukee, Wisconsin, Estados Unidos, 53233
    - Aurora Sinai Medical Center
  - Minocqua, Wisconsin, Estados Unidos, 54548
    - Marshfield Medical Center - Minocqua
  - Mukwonago, Wisconsin, Estados Unidos, 53149
    - ProHealth D N Greenwald Center
  - New Richmond, Wisconsin, Estados Unidos, 54017
    - Cancer Center of Western Wisconsin
  - Oconomowoc, Wisconsin, Estados Unidos, 53066
    - ProHealth Oconomowoc Memorial Hospital
  - Oconto Falls, Wisconsin, Estados Unidos, 54154
    - Saint Vincent Hospital Cancer Center at Oconto Falls
  - Oshkosh, Wisconsin, Estados Unidos, 54904
    - Vince Lombardi Cancer Clinic - Oshkosh
  - Racine, Wisconsin, Estados Unidos, 53406
    - Aurora Cancer Care-Racine
  - Rhinelander, Wisconsin, Estados Unidos, 54501
    - Saint Mary's Hospital
  - Rhinelander, Wisconsin, Estados Unidos, 54501
    - Aspirus Cancer Care-Rhinelander-James Beck Cancer Center
  - Rice Lake, Wisconsin, Estados Unidos, 54868
    - Marshfield Medical Center-Rice Lake
  - Sheboygan, Wisconsin, Estados Unidos, 53081
    - Vince Lombardi Cancer Clinic-Sheboygan
  - Sheboygan, Wisconsin, Estados Unidos, 53081
    - HSHS Saint Nicholas Hospital
  - Stevens Point, Wisconsin, Estados Unidos, 54481
    - Aspirus Cancer Care - Stevens Point
  - Summit, Wisconsin, Estados Unidos, 53066
    - Aurora Medical Center in Summit
  - Two Rivers, Wisconsin, Estados Unidos, 54241
    - Vince Lombardi Cancer Clinic-Two Rivers
  - Waukesha, Wisconsin, Estados Unidos, 53188
    - UW Cancer Center at ProHealth Care
  - Waukesha, Wisconsin, Estados Unidos, 53188
    - ProHealth Waukesha Memorial Hospital
  - Waukesha, Wisconsin, Estados Unidos, 53188
    - Aurora Cancer Care-Waukesha
  - Wausau, Wisconsin, Estados Unidos, 54401
    - Marshfield Clinic-Wausau Center
  - Wausau, Wisconsin, Estados Unidos, 54401
    - Aspirus Cancer Care-Wausau
  - Wauwatosa, Wisconsin, Estados Unidos, 53226
    - Aurora Cancer Care-Milwaukee West
  - West Allis, Wisconsin, Estados Unidos, 53227
    - Aurora West Allis Medical Center
  - Weston, Wisconsin, Estados Unidos, 54476
    - Marshfield Medical Center - Weston
  - Wisconsin Rapids, Wisconsin, Estados Unidos, 54494
    - Aspirus Cancer Care - Wisconsin Rapids
  - Wisconsin Rapids, Wisconsin, Estados Unidos, 54494
    - Marshfield Clinic - Wisconsin Rapids Center
- Wyoming
  - Casper, Wyoming, Estados Unidos, 82609
    - Rocky Mountain Oncology
  - Cheyenne, Wyoming, Estados Unidos, 82001
    - Cheyenne Regional Medical Center-West
  - Cody, Wyoming, Estados Unidos, 82414
    - Big Horn Basin Cancer Center
  - Cody, Wyoming, Estados Unidos, 82414
    - Billings Clinic-Cody
  - Sheridan, Wyoming, Estados Unidos, 82801
    - Welch Cancer Center

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

65 años y mayores (Adulto Mayor)

Acepta Voluntarios Saludables

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

PRE-REGISTRATION (STEP 0)
All patients are REQUIRED to be pre-registered to A041202 in order to submit peripheral blood to the Alliance Hematologic Malignancy Biorepository (HEME) for central Zap-70 methylation. This specimen submission is mandatory prior to registration as results will be used for stratification
REGISTRATION (STEP 1)
Patients must be diagnosed with CLL in accordance with International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2008 criteria that includes all of the following:
- >= 5 x 10^9 B lymphocytes (5000/uL) in the peripheral blood
- On morphologic review, the leukemic cells must be small mature lymphocytes, and prolymphocytes must not exceed 55% of the blood lymphocytes
- CLL cells on immunophenotype (performed locally) must reveal a clonal B-cell population, which express the B cell surface markers of CD19 and CD20, as well as the T-cell antigen CD5; patients with bright surface immunoglobulin expression or lack of CD23 expression in > 10% of cells must lack t(11;14) translocation by interphase cytogenetics
Patients must be intermediate or high-risk Rai stage CLL
- Intermediate risk (formerly Rai stage I/II) is defined by lymphocytosis plus enlarged lymph nodes at any site, with or without hepatomegaly or splenomegaly
- High risk (formerly Rai stage III/IV) is defined by lymphocytosis with or without enlarged nodes and spleen plus disease-related anemia (hemoglobin < 11 g/dL) or thrombocytopenia (platelet count < 100 x 10^9/L) that is not attributable to autoimmune hemolytic anemia or thrombocytopenia
Patients must meet criteria for treatment as defined by IWCLL 2008 guidelines which includes at least one of the following criteria:
- Evidence of marrow failure as manifested by the development or worsening of anemia or thrombocytopenia (not attributable to autoimmune hemolytic anemia or thrombocytopenia)
- Massive (>= 6 cm below the costal margin), progressive or symptomatic splenomegaly
- Massive nodes (>= 10 cm) or progressive or symptomatic lymphadenopathy
- Autoimmune anemia and/or thrombocytopenia that is poorly responsive to standard therapy
- Constitutional symptoms, which include any of the following:
  - Unintentional weight loss of 10% or more within 6 months
  - Significant fatigue
  - Fevers > 100.5 degrees F for 2 weeks or more without evidence of infection
  - Night sweats > 1 month without evidence of infection
Prior treatment
- Patients must not have had prior therapy for CLL (except palliative steroids or treatment of autoimmune complications of CLL with rituximab or steroids)
- Treatment with rituximab and/or high dose corticosteroids for autoimmune complications of CLL must be complete at least 4 weeks prior to enrollment; palliative steroids must be at a dose not higher than 20 mg/day of prednisone or equivalent corticosteroid at the time of registration
Age >= 65 years
Eastern Cooperative Oncology Group (ECOG) performance status 0-2
Patients with active hepatitis B defined by hepatitis B surface antigen positivity or core antibody positivity in the presence of hepatitis B DNA are not eligible for this study; patients with a positive hepatitis B core antibody but with negative hepatitis B DNA may participate, but must have hepatitis serologies and hepatitis B DNA monitored periodically by the treating physician
- Intravenous immunoglobulin (IVIG) can cause a false positive hepatitis B serology; if patients receiving routine IVIG have core antibody or surface antigen positivity without evidence of active viremia (negative hepatitis B DNA) they may still participate in the study, but should have hepatitis serologies and hepatitis B DNA monitored periodically by the treating physician
Patients must not be receiving active systemic anticoagulation with heparin or warfarin; patients must be off warfarin therapy for at least 30 days prior to enrollment
Patients with class III or class IV heart failure by New York Heart Association, those with unstable angina, and those with uncontrolled arrhythmia are not eligible
Patients who have had a myocardial infarction, intracranial bleed, or stroke within the past 6 months are not eligible
Patients with known human immunodeficiency virus (HIV) are eligible if their CD4 count is >= 350 cells/mm^3 and if they are not taking prohibited CYP-interacting medications
Patients must not have any history of Richter's transformation or prolymphocytic leukemia (prolymphocytes in blood > 55%)
Patients must not require more than 20 mg prednisone or equivalent corticosteroid daily
Patients must not have uncontrolled active systemic infection requiring intravenous antibiotics
Patients must not have continued requirement for therapy with a strong cytochrome P450 3A4/5 (CYP3A4/5) inhibitor or inducer
Patients must not have a known allergy to mannitol
Patients must not have prior significant hypersensitivity to rituximab (not including infusion reactions)
Patients may not have had major surgery within 10 days of enrollment, or minor surgery within 7 days of enrollment; examples of minor surgery include dental surgery, insertion of a venous access device, skin biopsy, or aspiration of a joint; the decision about whether a surgery is major or minor can be made at the discretion of the treating physician
Absolute neutrophil count (ANC) >= 1,000/uL unless due to bone marrow involvement
Aspartate aminotransferase (AST) or alanine aminotransferase (AST) =< 2.5 x upper limits of normal except if due to disease infiltration of the liver
Bilirubin =< 1.5 x upper limits of normal (unless due to liver involvement, hemolysis, or Gilbert's disease)
Creatinine clearance >= 40 mL/min
- To be calculated by modified Cockcroft-Gault formula
Platelet count (untransfused) >= 30,000/uL

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

Propósito principal: Tratamiento
Asignación: Aleatorizado
Modelo Intervencionista: Asignación cruzada
Enmascaramiento: Ninguno (etiqueta abierta)

Número de brazos

Armas e Intervenciones

Grupo de participantes/brazo	Intervención / Tratamiento
Comparador activo: Arm I (rituximab, bendamustine hydrochloride) Patients receive rituximab IV on day 1 (day 0 course 1) and bendamustine hydrochloride IV over 30 minutes on days 1-2. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover to Arm II. Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and CT throughout the study.	Otro: Laboratory Biomarker Analysis Correlative studies Otro: Quality-of-Life Assessment Ancillary studies Otros nombres: Evaluación de la calidad de vida Procedimiento: Biospecimen Collection Undergo blood sample collection Otros nombres: Recolección de muestras biológicas Muestra biológica recolectada Coleccion de especimenes Recolección de muestras Biológico: Rituximab Given IV Otros nombres: Rituxan MabThera ABP 798 BI 695500 Anticuerpo monoclonal C2B8 Anticuerpo quimérico anti-CD20 CT-P10 IDEC-102 IDEC-C2B8 Anticuerpo monoclonal IDEC-C2B8 PF-05280586 Riabni Rituximab ABBS Rituximab ARRX Rituximab Biosimilar ABP 798 Rituximab Biosimilar BI 695500 Rituximab Biosimilar CT-P10 Rituximab Biosimilar GB241 Rituximab Biosimilar IBI301 Rituximab Biosimilar JHL1101 Rituximab Biosimilar PF-05280586 Rituximab Biosimilar RTXM83 Rituximab Biosimilar SAIT101 Rituximab Biosimilar SIBP-02 rituximab biosimilar TQB2303 Rituximab PVVR Rituximab-arrx Rituximab-pvvr RTXM83 Ruxencia Truxima Rixathon Ikdar Mabtas Rituximab-abbs BI-695500 BI695500 Blitzima IDEC 102 IDEC102 PF 05280586 PF05280586 Ritemvía Rituximab-blit Rituximab-rito Rituximab-rixa Rituximab-rixi Riximyo RTXM 83 RTXM-83 ABP-798 ABP798 TC P10 CTP10 GP 2013 GP-2013 GP2013 Rituximab Biosimilar GP2013 Procedimiento: Computed Tomography Undergo CT Otros nombres: Connecticut GATO Análisis de gato Tomografía Axial Computarizada Tomografía axial computarizada Tomografía computarizada tomografía Tomografía axial computarizada (procedimiento) Tomografía computarizada (TC) Escaneo de gato de diagnóstico Tipo de servicio de escaneo de gato de diagnóstico Droga: Bendamustine Hydrochloride Given IV Otros nombres: Treanda Bendeka CEP-18083 Clorhidrato de bendamustina Clorhidrato de citostasán Levante Ribomustina SyB L-0501 Treakisim Belrapzo CEP 18083 CEP18083 VIVIMUSTA Procedimiento: Bone Marrow Aspiration Undergo bone marrow aspiration and biopsy Procedimiento: Bone Marrow Biopsy Undergo bone marrow aspiration and biopsy Otros nombres: Biopsia de Médula Ósea Biopsia De Médula Ósea
Experimental: Arm II (ibrutinib) Patients receive ibrutinib PO daily. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and CT throughout the study.	Otro: Laboratory Biomarker Analysis Correlative studies Otro: Quality-of-Life Assessment Ancillary studies Otros nombres: Evaluación de la calidad de vida Procedimiento: Biospecimen Collection Undergo blood sample collection Otros nombres: Recolección de muestras biológicas Muestra biológica recolectada Coleccion de especimenes Recolección de muestras Procedimiento: Computed Tomography Undergo CT Otros nombres: Connecticut GATO Análisis de gato Tomografía Axial Computarizada Tomografía axial computarizada Tomografía computarizada tomografía Tomografía axial computarizada (procedimiento) Tomografía computarizada (TC) Escaneo de gato de diagnóstico Tipo de servicio de escaneo de gato de diagnóstico Procedimiento: Bone Marrow Aspiration Undergo bone marrow aspiration and biopsy Procedimiento: Bone Marrow Biopsy Undergo bone marrow aspiration and biopsy Otros nombres: Biopsia de Médula Ósea Biopsia De Médula Ósea Droga: Ibrutinib Given PO Otros nombres: PCI-32765 Imbrúvica Inhibidor BTK PCI-32765 CRA-032765 PCI32765 CRA 032765 CRA032765 PCI 32765
Experimental: Arm III (ibrutinib, rituximab) Patients receive ibrutinib as in Arm II. Patients receive rituximab IV on days 1, 8, 15, and 22 of course 2 and on day 1 of courses 3-6. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and CT throughout the study.	Otro: Laboratory Biomarker Analysis Correlative studies Otro: Quality-of-Life Assessment Ancillary studies Otros nombres: Evaluación de la calidad de vida Procedimiento: Biospecimen Collection Undergo blood sample collection Otros nombres: Recolección de muestras biológicas Muestra biológica recolectada Coleccion de especimenes Recolección de muestras Biológico: Rituximab Given IV Otros nombres: Rituxan MabThera ABP 798 BI 695500 Anticuerpo monoclonal C2B8 Anticuerpo quimérico anti-CD20 CT-P10 IDEC-102 IDEC-C2B8 Anticuerpo monoclonal IDEC-C2B8 PF-05280586 Riabni Rituximab ABBS Rituximab ARRX Rituximab Biosimilar ABP 798 Rituximab Biosimilar BI 695500 Rituximab Biosimilar CT-P10 Rituximab Biosimilar GB241 Rituximab Biosimilar IBI301 Rituximab Biosimilar JHL1101 Rituximab Biosimilar PF-05280586 Rituximab Biosimilar RTXM83 Rituximab Biosimilar SAIT101 Rituximab Biosimilar SIBP-02 rituximab biosimilar TQB2303 Rituximab PVVR Rituximab-arrx Rituximab-pvvr RTXM83 Ruxencia Truxima Rixathon Ikdar Mabtas Rituximab-abbs BI-695500 BI695500 Blitzima IDEC 102 IDEC102 PF 05280586 PF05280586 Ritemvía Rituximab-blit Rituximab-rito Rituximab-rixa Rituximab-rixi Riximyo RTXM 83 RTXM-83 ABP-798 ABP798 TC P10 CTP10 GP 2013 GP-2013 GP2013 Rituximab Biosimilar GP2013 Procedimiento: Computed Tomography Undergo CT Otros nombres: Connecticut GATO Análisis de gato Tomografía Axial Computarizada Tomografía axial computarizada Tomografía computarizada tomografía Tomografía axial computarizada (procedimiento) Tomografía computarizada (TC) Escaneo de gato de diagnóstico Tipo de servicio de escaneo de gato de diagnóstico Procedimiento: Bone Marrow Aspiration Undergo bone marrow aspiration and biopsy Procedimiento: Bone Marrow Biopsy Undergo bone marrow aspiration and biopsy Otros nombres: Biopsia de Médula Ósea Biopsia De Médula Ósea Droga: Ibrutinib Given PO Otros nombres: PCI-32765 Imbrúvica Inhibidor BTK PCI-32765 CRA-032765 PCI32765 CRA 032765 CRA032765 PCI 32765

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado	Medida Descripción	Periodo de tiempo
Progression Free Survival (PFS) Periodo de tiempo: Time from study entry to the time of documented disease progression or death. The analysis was event driven, performed at 2.5 years after the last patient enrolled;up to 4 years.	The Kaplan-Meier method will be used to estimate the progression free survival distributions for each arm, with median estimates provided. Progression is defined as any one of the following: an increase in number of blood lymphocytes by >= 50% with >= 5000 B lymphocytes/mL in patients on Arm A or those on Arms 2 or 3 no longer receiving ibrutinib, >= 50% increase in the products of at least 2 lymph nodes on 2 consecutive determination 2 weeks apart, >= 50% increase in the size of the liver/spleen, transformation to a more aggressive histology, progression of any cytopenia (i.e. decrease of Hb levels > 2g/dL). Progression free survival time will be the time to either progression or death whichever occurs first.	Time from study entry to the time of documented disease progression or death. The analysis was event driven, performed at 2.5 years after the last patient enrolled;up to 4 years.

Medidas de resultado secundarias

Medida de resultado	Medida Descripción	Periodo de tiempo
Progression Free Survival (PFS) Rate at 2 Years Periodo de tiempo: Time from study entry to the time of documented disease progression or death, assessed up to 2 years	The Kaplan-Meier method will be used to estimate the rate of progression free survival at 2 years in each treatment arm. Progression is defined as any one of the following: an increase in number of blood lymphocytes by >= 50%, >= 50% increase in the products of at least 2 lymph nodes on 2 consecutive determination 2 weeks apart, >= 50% increase in the size of the liver/spleen, transformation to a more aggressive histology, progression of any cytopenia (i.e. decrease of Hb levels > 2g/dL). Progression free survival time will be the time to either progression or death whichever occurs first.	Time from study entry to the time of documented disease progression or death, assessed up to 2 years
Overall Survival (OS) at 2 Years Periodo de tiempo: From the date of registration to the date of death, assessed up to 2 years	The Kaplan-Meier method will be used to estimate the rate of overall survival at 2 years in each treatment arm. OS will be measured from the date of registration to the date of the event (i.e., death) or the date of last follow-up to evaluate that event. Patients who are event-free at their last follow-up evaluation will be censored at that time point.	From the date of registration to the date of death, assessed up to 2 years
Duration of Response (DOR) (Complete Response [CR], CCR, Nodular Partial Response [nPR], Partial Response [PR], and PRL) Periodo de tiempo: From the date of first response until progression or death, performed at 2.5 years after the last patient enrolled; up to 4 years.	The Kaplan-Meier method will be used to estimate median DOR. DOR is the time from first objective status to progression or death. CR requires all of the following: absence of lymphadenopathy > 1.5 cm on physical exam/CT scan, no hepatomegaly/splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate & biopsy must be normocellular for age. PR requires >= 50% decrease in peripheral lymphocyte count from pre-treatment value, >= 50% reduction in lymphadenopathy, and/or ≥ 50% reduction in splenomegaly/hepatomegaly. CR with exception of having bone marrow lymphoid CLL nodules will be considered a nodular PR (nPR). CR with exception of not having a bone marrow biopsy performed will be considered a clinical CR (CCR). PR with the exception of having less than a 50% reduction in peripheral lymphocyte count will be considered a PR except persistent lymphocytosis (PRL).	From the date of first response until progression or death, performed at 2.5 years after the last patient enrolled; up to 4 years.
Percentage of Patients Achieving Any Response to Treatment (Overall Response Rate [ORR] [Complete Response [CR], CCR, Nodular Partial Response [nPR], Partial Response [PR], and PRL]) Periodo de tiempo: Performed at 2.5 years after the last patient enrolled;up to 4 years.	Complete response (CR) requires all of the following: absence of lymphadenopathy >1.5 cm on physical exam/CT scan, no hepatomegaly/splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate & biopsy must be normocellular for age. Partial response (PR) requires >= 50% decrease in peripheral lymphocyte count from pre-treatment value, >= 50% reduction in lymphadenopathy, and/or ≥ 50% reduction in splenomegaly/hepatomegaly. CR with exception of having bone marrow lymphoid CLL nodules will be considered a nodular PR (nPR). CR with exception of not having a bone marrow biopsy performed will be considered a clinical CR (CCR). PR with the exception of having less than a 50% reduction in peripheral lymphocyte count will be considered a PR except persistent lymphocytosis (PRL).Overall response rate and corresponding exact binomial 95% CI provided.	Performed at 2.5 years after the last patient enrolled;up to 4 years.
Percentage of Patients Achieving a Biopsy-proven Complete Response (CR) Periodo de tiempo: Performed at 2.5 years after the last patient enrolled; up to 4 years.	Complete response (CR) requires all of the following: absence of lymphadenopathy > 1.5 cm on physical exam/CT scan, no hepatomegaly or splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate and biopsy must be normocellular for age. Complete response rate and corresponding exact binomial 95% confidence intervals provided.	Performed at 2.5 years after the last patient enrolled; up to 4 years.
Percentage of Patients Achieving Complete (CR and CCR) or Nodular Partial Response (nPR) Periodo de tiempo: Performed at 2.5 years after the last patient enrolled; up to 4 years.	Complete response (CR) requires all of the following: absence of lymphadenopathy > 1.5 cm on physical exam/CT scan, no hepatomegaly or splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate and biopsy must be normocellular for age. CR with exception of having bone marrow lymphoid CLL nodules will be considered a nodular PR (nPR). CR with exception of not having a bone marrow biopsy performed will be considered a clinical CR (CCR). Response rate and corresponding exact binomial 95% confidence intervals provided.	Performed at 2.5 years after the last patient enrolled; up to 4 years.
Percentage of Patients Who Attain Minimal Residual Disease (MRD) Negative Status Periodo de tiempo: Cycle 9 Day 1 Evaluation	Estimated using the number of patients who achieve minimal residual disease divided by the total number randomized to that treatment arm. Corresponding exact binomial 95% confidence intervals for MRD rates will be calculated.	Cycle 9 Day 1 Evaluation
The Rate of Grade 3, 4, or 5 Treatment-related Non-hematologic Adverse Events (Toxicities) Periodo de tiempo: Performed at 2.5 years after the last patient enrolled; up to 4 years.	The rate of grade 3, 4, or 5 treatment-related non-hematologic adverse events (toxicities) by arm; excludes adverse events occurring post-crossover for patients in Arm A	Performed at 2.5 years after the last patient enrolled; up to 4 years.

Otras medidas de resultado

Medida de resultado	Medida Descripción	Periodo de tiempo
Geriatric Functional Status (Optional) Periodo de tiempo: Performed at 2.5 years after the last patient enrolled	Assessed using the Older Americans' Resources and Services Multidimensional Functional Assessment Questionnaire, Activities of Daily Living, Medical Outcomes Study physical functioning, Karnofsky performance status rated by a health care professional, Karnofsky performance status rated by the patient, timed "Up and Go", and number of falls in the last six months.	Performed at 2.5 years after the last patient enrolled

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

National Cancer Institute (NCI)

Investigadores

Investigador principal: Jennifer A Woyach, Alliance for Clinical Trials in Oncology

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Publicaciones Generales

Enlaces Útiles

<p>Data Available: Select individual patient-level data from this trial can be requested from the NCTN/NCORP Data Archive.</p>

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

15 de enero de 2014

Finalización primaria (Actual)

7 de agosto de 2018

Finalización del estudio (Estimado)

24 de junio de 2027

Fechas de registro del estudio

Enviado por primera vez

24 de junio de 2013

Primero enviado que cumplió con los criterios de control de calidad

24 de junio de 2013

Publicado por primera vez (Estimado)

26 de junio de 2013

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

22 de octubre de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

21 de octubre de 2026

Última verificación

1 de junio de 2026

Más información

Términos relacionados con este estudio

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

NCI-2013-01220
U10CA180821 (Subvención/contrato del NIH de EE. UU.)
U10CA031946 (Subvención/contrato del NIH de EE. UU.)
NCI-2013-01220 (Identificador de registro: CTRP (Clinical Trial Reporting Program))
ALLIANCE A041202
A041202 (Otro identificador: CTEP)
K23CA178183 (Subvención/contrato del NIH de EE. UU.)
R01CA183444 (Subvención/contrato del NIH de EE. UU.)
A041202 (Otro identificador: Alliance for Clinical Trials in Oncology)

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Rituximab y clorhidrato de bendamustina, rituximab e ibrutinib, o ibrutinib solo en el tratamiento de pacientes mayores con leucemia linfocítica crónica sin tratamiento previo

Un estudio aleatorizado de fase III de bendamustina más rituximab versus ibrutinib más rituximab versus ibrutinib solo en pacientes mayores no tratados (>/= 65 años de edad) con leucemia linfocítica crónica (LLC)

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