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Docetaxel, carboplatino, trastuzumab y pertuzumab con o sin deprivación de estrógenos en el tratamiento de pacientes con cáncer de mama con receptor hormonal positivo, HER2 positivo operable o localmente avanzado

15 de septiembre de 2026 actualizado por: National Cancer Institute (NCI)

Un ensayo aleatorizado de fase III que evalúa las tasas de respuesta patológica completa en pacientes con cáncer de mama con receptor hormonal positivo, HER2 positivo, grande operable y localmente avanzado tratados con terapia neoadyuvante de docetaxel, carboplatino, trastuzumab y pertuzumab (TCHP) con o sin privación de estrógenos

This randomized phase III trial studies docetaxel, carboplatin, trastuzumab, and pertuzumab with estrogen deprivation to see how they work compared to docetaxel, carboplatin, trastuzumab, and pertuzumab without estrogen deprivation in treating patients with hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-positive breast cancer that is operable or has spread from where it started to nearby tissue or lymph nodes (locally advanced). Drugs used in chemotherapy, such as docetaxel, carboplatin, trastuzumab, and pertuzumab, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Estrogen can cause the growth of breast cancer cells. Hormone therapy using goserelin acetate and aromatase inhibition therapy may fight breast cancer by blocking the use of estrogen by the tumor cells. Radiation therapy uses high energy x rays to kill tumor cells. Giving combination chemotherapy and radiation therapy with or without hormone therapy may be an effective treatment for hormone receptor-positive, HER2-positive, operable or locally advanced breast cancer.

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Descripción detallada

PRIMARY OBJECTIVES:

I. To determine whether the addition of estrogen deprivation to neoadjuvant therapy consisting of therapy of docetaxel, carboplatin, trastuzumab, and pertuzumab (TCHP) yields a greater rate of pathologic complete response (pCR) (breast and nodes) than TCHP alone when administered to women with operable, hormone receptor-positive, HER2-positive breast cancer.

SECONDARY OBJECTIVES:

I. To determine whether the addition of estrogen deprivation to neoadjuvant therapy consisting of TCHP will increase the pCR rate in the breast compared to TCHP alone when administered to women with operable, hormone receptor-positive, HER2-positive breast cancer.

II. To determine whether the addition of estrogen deprivation to neoadjuvant therapy consisting of TCHP improves recurrence-free interval (RFI) in women with operable, hormone receptor-positive, HER2-positive breast cancer.

III. To determine whether the addition of estrogen deprivation to neoadjuvant therapy consisting of TCHP improves overall survival (OS) in women with operable, hormone receptor-positive, HER2-positive breast cancer.

IV. To compare the rates of second primary invasive cancer by treatment arm. V. Assessment of patterns of pCR, RFI, and OS by menopausal status. VI. To evaluate the cardiac toxicity associated with each of the regimens. VII. To compare the effect of adding estrogen deprivation to neoadjuvant therapy on endocrine-related symptoms in all patients by treatment arm.

VIII. To compare the effect of adding estrogen deprivation to neoadjuvant therapy on vasomotor symptoms, musculoskeletal, and vaginal complaints as well as quality of life.

IX. To determine a relationship between pCR and a potential mechanism of resistance/sensitivity in hormone receptor-positive, HER2-positive tumors.

X. To evaluate tumor infiltrating lymphocytes (TILs) and immune biomarkers as predictors of pCR.

XI. To study early changes in TILs and other immune biomarkers in response to TCHP.

OUTLINE: Patients are randomized to 1 of 2 treatments arms.

NEOADJUVANT:

ARM I: Patients receive docetaxel intravenously (IV) over 60 minutes, carboplatin IV over 30-60 minutes, trastuzumab IV over 30-90 minutes, and pertuzumab IV over 30-60 on day 1. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients enrolled after Amendment #4 undergo 2 core biopsies prior to course 3 of treatment.

ARM II: All patients receive docetaxel, carboplatin, trastuzumab, and pertuzumab as in arm I. Premenopausal patients also receive goserelin acetate subcutaneously (SC) every 28 days until surgery and aromatase inhibition therapy at the investigator's discretion daily until 1 day before surgery. Postmenopausal patients receive aromatase inhibition therapy at the investigator's discretion daily until 1 day before surgery. Patients enrolled after Amendment #4 undergo 2 core biopsies prior to course 3 of treatment.

SURGERY: Patients undergo lumpectomy or mastectomy.

RADIATION: Patients undergo whole breast irradiation within 8 weeks following surgery.

ADJUVANT: Patients receive trastuzumab IV over 30-60 minutes every 21 days for up to 1 year.

After completion of study treatment, patients are followed up every 6, 9, 12, and 18 months for 5 years.

Tipo de estudio

Intervencionista

Inscripción (Actual)

315

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

Estados Unidos
- Alaska
  - Fairbanks, Alaska, Estados Unidos, 99701
    - Fairbanks Memorial Hospital
- Arkansas
  - Hot Springs, Arkansas, Estados Unidos, 71913
    - CHI Saint Vincent Cancer Center Hot Springs
- 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
  - Burlingame, California, Estados Unidos, 94010
    - Mills-Peninsula Medical Center
  - Cameron Park, California, Estados Unidos, 95682
    - Sutter Cancer Centers Radiation Oncology Services-Cameron Park
  - Castro Valley, California, Estados Unidos, 94546
    - Eden Hospital Medical Center
  - Castro Valley, California, Estados Unidos, 94546
    - East Bay Radiation Oncology Center
  - Davis, California, Estados Unidos, 95616
    - Sutter Davis Hospital
  - Dublin, California, Estados Unidos, 94568
    - Epic Care-Dublin
  - Emeryville, California, Estados Unidos, 94608
    - Bay Area Breast Surgeons Inc
  - Emeryville, California, Estados Unidos, 94608
    - Epic Care Partners in Cancer Care
  - Fontana, California, Estados Unidos, 92335
    - Kaiser Permanente-Fontana
  - Fremont, California, Estados Unidos, 94538
    - Kaiser Permanente-Fremont
  - Fresno, California, Estados Unidos, 93720
    - Kaiser Permanente-Fresno
  - Harbor City, California, Estados Unidos, 90710
    - Kaiser Permanente South Bay
  - Irvine, California, Estados Unidos, 92618
    - Kaiser Permanente-Irvine
  - Loma Linda, California, Estados Unidos, 92354
    - Loma Linda University Medical Center
  - Los Angeles, California, Estados Unidos, 90027
    - Kaiser Permanente Los Angeles Medical Center
  - Los Angeles, California, Estados Unidos, 90048
    - Cedars Sinai Medical Center
  - Los Angeles, California, Estados Unidos, 90034
    - Kaiser Permanente West Los Angeles
  - Martinez, California, Estados Unidos, 94553-3156
    - Contra Costa Regional Medical Center
  - Modesto, California, Estados Unidos, 95355
    - Memorial Medical Center
  - Modesto, California, Estados Unidos, 95356
    - Kaiser Permanente-Modesto
  - Mountain View, California, Estados Unidos, 94040
    - El Camino Hospital
  - 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
  - Oakland, California, Estados Unidos, 94609
    - Alta Bates Summit Medical Center - Summit Campus
  - Oakland, California, Estados Unidos, 94609
    - Hematology and Oncology Associates-Oakland
  - Oakland, California, Estados Unidos, 94609
    - Bay Area Tumor Institute
  - Oakland, California, Estados Unidos, 94602
    - Wilma Chan Highland Hospital
  - Orange, California, Estados Unidos, 92868
    - Saint Joseph Hospital - Orange
  - 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
  - Pleasanton, California, Estados Unidos, 94588
    - Valley Medical Oncology Consultants
  - 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, 92108
    - Kaiser Permanente-San Diego Mission
  - 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 Leandro, California, Estados Unidos, 94577
    - Kaiser Permanente San Leandro
  - San Marcos, California, Estados Unidos, 92078
    - Kaiser Permanente-San Marcos
  - San Pablo, California, Estados Unidos, 94806
    - Doctors Medical Center- JC Robinson Regional Cancer Center
  - 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
  - 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
  - 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
  - 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
  - Aurora, Colorado, Estados Unidos, 80045
    - UCHealth University of Colorado Hospital
  - 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, 80909
    - UCHealth Memorial Hospital Central
  - Colorado Springs, Colorado, Estados Unidos, 80907
    - Rocky Mountain Cancer Centers-Penrose
  - 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, 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
    - Southwest Oncology PC
  - 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
  - Greeley, Colorado, Estados Unidos, 80631
    - Banner North Colorado Medical Center
  - Greenwood Village, Colorado, Estados Unidos, 80111
    - Rocky Mountain Cancer Centers-Greenwood Village
  - Lakewood, Colorado, Estados Unidos, 80228
    - Saint Anthony Hospital
  - Lakewood, Colorado, Estados Unidos, 80228
    - Rocky Mountain Cancer Centers-Lakewood
  - Littleton, Colorado, Estados Unidos, 80120
    - Rocky Mountain Cancer Centers-Littleton
  - Littleton, Colorado, Estados Unidos, 80122
    - AdventHealth Littleton
  - 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 McKee Medical Center
  - 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
  - Hartford, Connecticut, Estados Unidos, 06105
    - Smilow Cancer Hospital Care Center at Saint Francis
  - Hartford, Connecticut, Estados Unidos, 06102
    - Hartford Hospital
- 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
  - Deerfield Beach, Florida, Estados Unidos, 33442
    - UM Sylvester Comprehensive Cancer Center at Deerfield Beach
  - Gainesville, Florida, Estados Unidos, 32610
    - University of Florida Health Science Center - Gainesville
  - Miami, Florida, Estados Unidos, 33136
    - University of Miami Miller School of Medicine-Sylvester Cancer Center
  - Orlando, Florida, Estados Unidos, 32806
    - Orlando Health Cancer Institute
  - Orlando, Florida, Estados Unidos, 32803
    - AdventHealth Orlando
- Georgia
  - Athens, Georgia, Estados Unidos, 30607
    - University Cancer and Blood Center LLC
  - Atlanta, Georgia, Estados Unidos, 30342
    - Northside Hospital
  - Augusta, Georgia, Estados Unidos, 30912
    - Augusta University Medical Center
  - Cumming, Georgia, Estados Unidos, 30041
    - Northside Hospital-Forsyth
  - Decatur, Georgia, Estados Unidos, 30033
    - Emory Decatur Hospital
  - Gainesville, Georgia, Estados Unidos, 30501
    - Northeast Georgia Medical Center-Gainesville
  - Savannah, Georgia, Estados Unidos, 31405
    - Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
  - Savannah, Georgia, Estados Unidos, 31404
    - Memorial Health University Medical Center
  - Savannah, Georgia, Estados Unidos, 31404
    - Summit Cancer Care-Memorial
  - Savannah, Georgia, Estados Unidos, 31404
    - Low Country Cancer Care
- 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, 96819
    - Kaiser Permanente Moanalua Medical Center
  - Kailua, Hawaii, Estados Unidos, 96734
    - Castle 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
  - Coeur d'Alene, Idaho, Estados Unidos, 83814
    - Kootenai Health - Coeur d'Alene
  - Lewiston, Idaho, Estados Unidos, 83501
    - Saint Joseph Regional Medical Center
  - Post Falls, Idaho, Estados Unidos, 83854
    - Kootenai Clinic Cancer Services - Post Falls
  - Sandpoint, Idaho, Estados Unidos, 83864
    - Kootenai Clinic Cancer Services - Sandpoint
- 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, 60612
    - University of Illinois
  - Chicago, Illinois, Estados Unidos, 60612
    - John H Stroger Jr Hospital of Cook County
  - Chicago, Illinois, Estados Unidos, 60608
    - Mount Sinai Hospital Medical Center
  - Chicago, Illinois, Estados Unidos, 60625
    - Swedish Covenant Hospital
  - Chicago, Illinois, Estados Unidos, 60631
    - Presence Resurrection Medical Center
  - 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
  - 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, 60202
    - Saint Francis 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
  - Harvey, Illinois, Estados Unidos, 60426
    - Ingalls Memorial Hospital
  - Kankakee, Illinois, Estados Unidos, 60901
    - Presence Saint Mary's Hospital
  - Kewanee, Illinois, Estados Unidos, 61443
    - Illinois CancerCare-Kewanee Clinic
  - Macomb, Illinois, Estados Unidos, 61455
    - Illinois CancerCare-Macomb
  - Mattoon, Illinois, Estados Unidos, 61938
    - Carle Physician Group-Mattoon/Charleston
  - Mount Vernon, Illinois, Estados Unidos, 62864
    - SSM Health Good Samaritan
  - Naperville, Illinois, Estados Unidos, 60540
    - Edward Hospital/Cancer Center
  - 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
  - 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
  - Peru, Illinois, Estados Unidos, 61354
    - Illinois CancerCare-Peru
  - Peru, Illinois, Estados Unidos, 61354
    - Valley Radiation Oncology
  - Plainfield, Illinois, Estados Unidos, 60585
    - Edward Hospital/Cancer Center?Plainfield
  - Princeton, Illinois, Estados Unidos, 61356
    - Illinois CancerCare-Princeton
  - Rockford, Illinois, Estados Unidos, 61108
    - OSF Saint Anthony Medical Center
  - Rockford, Illinois, Estados Unidos, 61114
    - UW Health Carbone Cancer Center Rockford
  - 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
  - Indianapolis, Indiana, Estados Unidos, 46237
    - Franciscan Health Indianapolis
  - 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
    - Michiana Hematology Oncology PC-Mishawaka
  - Mishawaka, Indiana, Estados Unidos, 46545
    - Saint Joseph Regional Medical Center-Mishawaka
  - Munster, Indiana, Estados Unidos, 46321
    - The Community Hospital
  - Plymouth, Indiana, Estados Unidos, 46563
    - Michiana Hematology Oncology PC-Plymouth
  - Richmond, Indiana, Estados Unidos, 47374
    - Reid Health
  - South Bend, Indiana, Estados Unidos, 46628
    - Northern Indiana Cancer Research Consortium
  - Terre Haute, Indiana, Estados Unidos, 47804
    - Union Hospital
  - 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
  - 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, 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
  - Jefferson, Iowa, Estados Unidos, 50129
    - McFarland Clinic - Jefferson
  - Marshalltown, Iowa, Estados Unidos, 50158
    - McFarland Clinic - Marshalltown
  - 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
  - Fort Scott, Kansas, Estados Unidos, 66701
    - Cancer Center of Kansas - Fort Scott
  - Independence, Kansas, Estados Unidos, 67301
    - Cancer Center of Kansas-Independence
  - 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
  - Manhattan, Kansas, Estados Unidos, 66502
    - Cancer Center of Kansas-Manhattan
  - McPherson, Kansas, Estados Unidos, 67460
    - Cancer Center of Kansas - McPherson
  - Newton, Kansas, Estados Unidos, 67114
    - Cancer Center of Kansas - Newton
  - Parsons, Kansas, Estados Unidos, 67357
    - Cancer Center of Kansas - Parsons
  - Pratt, Kansas, Estados Unidos, 67124
    - Cancer Center of Kansas - Pratt
  - Salina, Kansas, Estados Unidos, 67401
    - Cancer Center of Kansas - Salina
  - 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
  - Wichita, Kansas, Estados Unidos, 67214
    - Wichita NCI Community Oncology Research Program
  - Winfield, Kansas, Estados Unidos, 67156
    - Cancer Center of Kansas - Winfield
- Kentucky
  - Bardstown, Kentucky, Estados Unidos, 40004
    - Flaget Memorial Hospital
  - Corbin, Kentucky, Estados Unidos, 40701
    - Baptist Health Corbin
  - Corbin, Kentucky, Estados Unidos, 40701
    - Commonwealth Cancer Center-Corbin
  - Crestview Hills, Kentucky, Estados Unidos, 41017
    - Oncology Hematology Care Inc-Crestview
  - Elizabethtown, Kentucky, Estados Unidos, 42701
    - Baptist Health Hardin
  - Lexington, Kentucky, Estados Unidos, 40536
    - University of Kentucky/Markey Cancer Center
  - Lexington, Kentucky, Estados Unidos, 40504
    - Saint Joseph Radiation Oncology Resource Center
  - Lexington, Kentucky, Estados Unidos, 40509
    - Saint Joseph Hospital East
  - Lexington, Kentucky, Estados Unidos, 40503
    - Baptist Health Lexington
  - Louisville, Kentucky, Estados Unidos, 40202
    - The James Graham Brown Cancer Center at University of Louisville
  - Louisville, Kentucky, Estados Unidos, 40202
    - Jewish Hospital
  - Louisville, Kentucky, Estados Unidos, 40245
    - UofL Health Medical Center Northeast
  - Louisville, Kentucky, Estados Unidos, 40207
    - Baptist Health Louisville
  - Louisville, Kentucky, Estados Unidos, 40215
    - Saints Mary and Elizabeth Hospital
  - Madisonville, Kentucky, Estados Unidos, 42431
    - Baptist Health Madisonville/Merle Mahr Cancer Center
  - Paducah, Kentucky, Estados Unidos, 42003
    - Baptist Health Paducah
  - Shepherdsville, Kentucky, Estados Unidos, 40165
    - Jewish Hospital Medical Center South
- Louisiana
  - Baton Rouge, Louisiana, Estados Unidos, 70809
    - Ochsner Health Center-Summa
  - Kenner, Louisiana, Estados Unidos, 70065
    - Ochsner Medical Center Kenner
  - New Orleans, Louisiana, Estados Unidos, 70121
    - Ochsner Medical Center Jefferson
- Maine
  - Bangor, Maine, Estados Unidos, 04401
    - Eastern Maine Medical Center
  - Brewer, Maine, Estados Unidos, 04412
    - Lafayette Family Cancer Center-EMMC
- Maryland
  - Baltimore, Maryland, Estados Unidos, 21237
    - MedStar Franklin Square Medical Center/Weinberg Cancer Institute
  - Baltimore, Maryland, Estados Unidos, 21204
    - Greater Baltimore Medical Center
  - Elkton, Maryland, Estados Unidos, 21921
    - Christiana Care - Union Hospital
  - Frederick, Maryland, Estados Unidos, 21701
    - Frederick Memorial Hospital
- Massachusetts
  - Fall River, Massachusetts, Estados Unidos, 02721
    - Saint Anne's Hospital
  - Pittsfield, Massachusetts, Estados Unidos, 01201
    - Berkshire Medical Center - Cancer Center
- 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
  - Ann Arbor, Michigan, Estados Unidos, 48109
    - University of Michigan Comprehensive Cancer Center
  - 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
  - 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, 48503
    - Hurley Medical Center
  - Flint, Michigan, Estados Unidos, 48503
    - Genesys Hurley Cancer Institute
  - 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, 48912
    - University of Michigan Health - Sparrow Lansing
  - Livonia, Michigan, Estados Unidos, 48154
    - Trinity Health Saint Mary Mercy Livonia Hospital
  - Midland, Michigan, Estados Unidos, 48670
    - MyMichigan Medical Center Midland
  - Monroe, Michigan, Estados Unidos, 48162
    - Mercy Memorial Hospital
  - Monroe, Michigan, Estados Unidos, 48162
    - Toledo Clinic Cancer Centers-Monroe
  - Pontiac, Michigan, Estados Unidos, 48341
    - Trinity Health Saint Joseph Mercy Oakland Hospital
  - Port Huron, Michigan, Estados Unidos, 48060
    - Lake Huron Medical Center
  - 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
  - Sterling Heights, Michigan, Estados Unidos, 48312
    - Premier Hematology Oncology Care
  - Sterling Heights, Michigan, Estados Unidos, 48314
    - Mitchell Folbe MD PC
  - 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
- 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
    - 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
  - New Ulm, Minnesota, Estados Unidos, 56073
    - New Ulm Medical Center
  - Robbinsdale, Minnesota, Estados Unidos, 55422
    - North Memorial Medical Health Center
  - 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
- Missouri
  - Ballwin, Missouri, Estados Unidos, 63011
    - Mercy Oncology and Hematology - Clayton-Clarkson
  - 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
  - Columbia, Missouri, Estados Unidos, 65212
    - MU Health - University Hospital/Ellis Fischel Cancer Center
  - 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
  - Rolla, Missouri, Estados Unidos, 65401
    - Mercy Clinic-Rolla-Cancer and Hematology
  - Rolla, Missouri, Estados Unidos, 65401
    - Phelps Health Delbert Day Cancer Institute
  - 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, 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
  - Sunset Hills, Missouri, Estados Unidos, 63127
    - BJC Outpatient Center at Sunset Hills
- Montana
  - Anaconda, Montana, Estados Unidos, 59711
    - Community Hospital of Anaconda
  - 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, 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, 68131
    - Creighton University Medical Center
  - 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
    - GenesisCare USA - 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, 89109
    - GenesisCare USA - Las Vegas
  - 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, 89148
    - OptumCare Cancer Care at Fort Apache
  - 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
    - GenesisCare USA - Vegas 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, 89148
    - GenesisCare USA - Fort Apache
  - 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
  - Reno, Nevada, Estados Unidos, 89502
    - Renown Regional Medical Center
  - Reno, Nevada, Estados Unidos, 89503
    - Saint Mary's Regional Medical Center
- New Hampshire
  - Lebanon, New Hampshire, Estados Unidos, 03756
    - Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
- New Jersey
  - Elizabeth, New Jersey, Estados Unidos, 07207
    - Trinitas Hospital and Comprehensive Cancer Center - Williamson Street Campus
  - Englewood, New Jersey, Estados Unidos, 07631
    - Englewood Hospital and Medical Center
  - Flemington, New Jersey, Estados Unidos, 08822
    - Hunterdon Medical Center
  - Mullica Hill, New Jersey, Estados Unidos, 08062
    - Inspira Medical Center Mullica Hill
  - Newark, New Jersey, Estados Unidos, 07112
    - Newark Beth Israel Medical Center
  - Newton, New Jersey, Estados Unidos, 07860
    - Newton Medical Center
  - Pompton, New Jersey, Estados Unidos, 07444
    - Chilton Medical Center
  - Summit, New Jersey, Estados Unidos, 07902
    - Overlook Hospital
  - Vineland, New Jersey, Estados Unidos, 08360
    - Inspira Medical Center Vineland
- New Mexico
  - Albuquerque, New Mexico, Estados Unidos, 87106
    - University of New Mexico Cancer Center
  - Albuquerque, New Mexico, Estados Unidos, 87106
    - Hematology Oncology Associates
  - Las Cruces, New Mexico, Estados Unidos, 88011
    - Memorial Medical Center-Las Cruces
  - Santa Fe, New Mexico, Estados Unidos, 87505
    - Christus Saint Vincent Regional Cancer Center
- New York
  - Buffalo, New York, Estados Unidos, 14263
    - Roswell Park Cancer Institute
  - Glens Falls, New York, Estados Unidos, 12801
    - Glens Falls 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
- North Carolina
  - Asheboro, North Carolina, Estados Unidos, 27203
    - Randolph Hospital
  - Asheville, North Carolina, Estados Unidos, 28803
    - AdventHealth Infusion Center Asheville
  - Burlington, North Carolina, Estados Unidos, 27215
    - Cone Health Cancer Center at Alamance Regional
  - Chapel Hill, North Carolina, Estados Unidos, 27599
    - UNC Lineberger Comprehensive Cancer Center
  - Clinton, North Carolina, Estados Unidos, 28328
    - Southeastern Medical Oncology Center-Clinton
  - Goldsboro, North Carolina, Estados Unidos, 27534
    - Southeastern Medical Oncology Center-Goldsboro
  - Goldsboro, North Carolina, Estados Unidos, 27534
    - Wayne Memorial Hospital
  - Greensboro, North Carolina, Estados Unidos, 27403
    - Cone Health Cancer Center
  - Hendersonville, North Carolina, Estados Unidos, 28792
    - AdventHealth Hendersonville
  - Jacksonville, North Carolina, Estados Unidos, 28546
    - Southeastern Medical Oncology Center-Jacksonville
  - Kernersville, North Carolina, Estados Unidos, 27284
    - Novant Health Cancer Institute - Kernersville
  - Kinston, North Carolina, Estados Unidos, 28501
    - ECU Health Oncology Kinston
  - Mebane, North Carolina, Estados Unidos, 27302
    - Cone Heath Cancer Center at Mebane
  - Mount Airy, North Carolina, Estados Unidos, 27030
    - Novant Health Cancer Institute - Mount Airy
  - North Wilkesboro, North Carolina, Estados Unidos, 28659
    - Novant Health Cancer Institute - Wilkesboro
  - Pinehurst, North Carolina, Estados Unidos, 28374
    - FirstHealth of the Carolinas-Moore Regional Hospital
  - Reidsville, North Carolina, Estados Unidos, 27320
    - Annie Penn Memorial Hospital
  - Salisbury, North Carolina, Estados Unidos, 28144
    - Novant Health Cancer Institute - Rowan
  - Statesville, North Carolina, Estados Unidos, 28677
    - Iredell Memorial Hospital
  - Stateville, North Carolina, Estados Unidos, 28625
    - Novant Health Cancer Institute - Statesville
  - Thomasville, North Carolina, Estados Unidos, 27360
    - Novant Health Cancer Institute - Thomasville
  - Winston-Salem, North Carolina, Estados Unidos, 27157
    - Wake Forest University Health Sciences
  - Winston-Salem, North Carolina, Estados Unidos, 27103
    - Novant Health Forsyth Medical Center
  - Winston-Salem, North Carolina, Estados Unidos, 27103
    - Novant Health Oncology Specialists
  - Winston-Salem, North Carolina, Estados Unidos, 27103
    - Winston-Salem Health Care
  - 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
  - Akron, Ohio, Estados Unidos, 44304
    - Summa Health System - Akron Campus
  - Barberton, Ohio, Estados Unidos, 44203
    - Summa Health System - Barberton Campus
  - Belpre, Ohio, Estados Unidos, 45714
    - Strecker Cancer Center-Belpre
  - Bowling Green, Ohio, Estados Unidos, 43402
    - Toledo Clinic Cancer Centers-Bowling Green
  - Canton, Ohio, Estados Unidos, 44710
    - Aultman Health Foundation
  - Centerville, Ohio, Estados Unidos, 45459
    - Miami Valley Hospital South
  - Centerville, Ohio, Estados Unidos, 45459
    - Dayton Physicians LLC-Miami Valley South
  - Chillicothe, Ohio, Estados Unidos, 45601
    - Adena Regional Medical Center
  - Cincinnati, Ohio, Estados Unidos, 45219
    - The Christ Hospital
  - 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
  - Columbus, Ohio, Estados Unidos, 43214
    - Riverside Methodist Hospital
  - 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
  - Dayton, Ohio, Estados Unidos, 45415
    - Dayton Physician LLC - Englewood
  - 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
  - Fairfield, Ohio, Estados Unidos, 45014
    - Oncology Hematology Care Inc-Healthplex
  - Findlay, Ohio, Estados Unidos, 45840
    - Blanchard Valley Hospital
  - Findlay, Ohio, Estados Unidos, 45840
    - Armes Family Cancer Center
  - Findlay, Ohio, Estados Unidos, 45840
    - Orion Cancer Care
  - Franklin, Ohio, Estados Unidos, 45005-1066
    - Atrium Medical Center-Middletown Regional Hospital
  - Franklin, Ohio, Estados Unidos, 45005
    - Dayton Physicians LLC-Atrium
  - Greenville, Ohio, Estados Unidos, 45331
    - Wayne Hospital
  - Greenville, Ohio, Estados Unidos, 45331
    - Dayton Physicians LLC-Wayne
  - Kettering, Ohio, Estados Unidos, 45429
    - Kettering Medical Center
  - Kettering, Ohio, Estados Unidos, 45409
    - Greater Dayton Cancer 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
  - 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
  - Medina, Ohio, Estados Unidos, 44256
    - Summa Health Medina Medical Center
  - Middletown, Ohio, Estados Unidos, 45042
    - Dayton Physicians LLC-Signal Point
  - 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
  - Sidney, Ohio, Estados Unidos, 45365
    - Dayton Physicians LLC-Wilson
  - Springfield, Ohio, Estados Unidos, 45504
    - Springfield Regional Cancer Center
  - Springfield, Ohio, Estados Unidos, 45504
    - Springfield Regional Medical Center
  - 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
  - Troy, Ohio, Estados Unidos, 45373
    - Dayton Physicians LLC - Troy
  - 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
  - Wpafb, 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
  - Tulsa, Oklahoma, Estados Unidos, 74136
    - Natalie Warren Bryant Cancer Center at Saint Francis
  - Tulsa, Oklahoma, Estados Unidos, 74136
    - Surgical Associates Inc
  - Tulsa, Oklahoma, Estados Unidos, 74146
    - Warren Clinic Oncology-Tulsa
- Oregon
  - Portland, Oregon, Estados Unidos, 97227
    - Kaiser Permanente Northwest
- Pennsylvania
  - Beaver, Pennsylvania, Estados Unidos, 15009
    - UPMC-Heritage Valley Health System Beaver
  - Chadds Ford, Pennsylvania, Estados Unidos, 19317
    - Christiana Care Health System-Concord Health Center
  - Danville, Pennsylvania, Estados Unidos, 17822
    - Geisinger Medical Center
  - Easton, Pennsylvania, Estados Unidos, 18042
    - Easton Hospital
  - Greensburg, Pennsylvania, Estados Unidos, 15601
    - UPMC Cancer Centers - Arnold Palmer Pavilion
  - Harrisburg, Pennsylvania, Estados Unidos, 17109
    - UPMC Pinnacle Cancer Center/Community Osteopathic Campus
  - Hazleton, Pennsylvania, Estados Unidos, 18201
    - Geisinger Medical Center-Cancer Center Hazleton
  - Hershey, Pennsylvania, Estados Unidos, 17033-0850
    - Penn State Milton S Hershey Medical Center
  - Jefferson Hills, Pennsylvania, Estados Unidos, 15025
    - Jefferson Hospital
  - Johnstown, Pennsylvania, Estados Unidos, 15901
    - UPMC-Johnstown/John P. Murtha Regional Cancer Center
  - Lewisburg, Pennsylvania, Estados Unidos, 17837
    - Geisinger Medical Oncology-Lewisburg
  - Lewistown, Pennsylvania, Estados Unidos, 17044
    - Lewistown Hospital
  - McKeesport, Pennsylvania, Estados Unidos, 15132
    - UPMC Cancer Center at UPMC McKeesport
  - Monroeville, Pennsylvania, Estados Unidos, 15146
    - Forbes Hospital
  - Moon Township, Pennsylvania, Estados Unidos, 15108
    - UPMC Hillman Cancer Center in Coraopolis
  - Philadelphia, Pennsylvania, Estados Unidos, 19107
    - Thomas Jefferson University Hospital
  - Philadelphia, Pennsylvania, Estados Unidos, 19114
    - Jefferson Torresdale Hospital
  - Phoenixville, Pennsylvania, Estados Unidos, 19460
    - Reading Hospital McGlinn Cancer Institute at Phoenixville
  - Pittsburgh, Pennsylvania, Estados Unidos, 15212
    - Allegheny General Hospital
  - Pittsburgh, Pennsylvania, Estados Unidos, 15224
    - West Penn Hospital
  - Pittsburgh, Pennsylvania, Estados Unidos, 15213
    - UPMC-Magee Womens Hospital
  - Pittsburgh, Pennsylvania, Estados Unidos, 15232
    - University of Pittsburgh Cancer Institute (UPCI)
  - 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
  - Washington, Pennsylvania, Estados Unidos, 15301
    - UPMC Washington Hospital Radiation Oncology
  - West Chester, Pennsylvania, Estados Unidos, 19380
    - Chester County Hospital
  - West Grove, Pennsylvania, Estados Unidos, 19390
    - Jennersville Regional 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
- Rhode Island
  - Providence, Rhode Island, Estados Unidos, 02905
    - Women and Infants Hospital
  - Warwick, Rhode Island, Estados Unidos, 02886
    - Kent 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
  - Easley, South Carolina, Estados Unidos, 29640
    - Prisma Health Cancer Institute - Easley
  - Georgetown, South Carolina, Estados Unidos, 29440
    - Tidelands Georgetown Memorial Hospital
  - 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
  - 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
- South Dakota
  - 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
  - Chattanooga, Tennessee, Estados Unidos, 37404
    - Memorial Hospital
  - Hixson, Tennessee, Estados Unidos, 37343
    - Pulmonary Medicine Center of Chattanooga-Hixson
  - Jackson, Tennessee, Estados Unidos, 38301
    - Jackson-Madison County General Hospital
  - Nashville, Tennessee, Estados Unidos, 37208
    - Meharry Medical College
  - Ooltewah, Tennessee, Estados Unidos, 37363
    - Memorial GYN Plus
- Texas
  - Abilene, Texas, Estados Unidos, 79601
    - Hendrick Medical Center
  - Houston, Texas, Estados Unidos, 77026-1967
    - Lyndon Baines Johnson General Hospital
  - Houston, Texas, Estados Unidos, 77030
    - Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
  - Houston, Texas, Estados Unidos, 77030
    - Ben Taub General Hospital
  - Laredo, Texas, Estados Unidos, 78041
    - Doctor's Hospital of Laredo
  - San Antonio, Texas, Estados Unidos, 78229
    - University Hospital
  - San Antonio, Texas, Estados Unidos, 78229
    - University of Texas Health Science Center at San Antonio
  - San Antonio, Texas, Estados Unidos, 78229
    - Cancer Therapy and Research Center at The UT Health Science Center at San Antonio
- Utah
  - Salt Lake City, Utah, Estados Unidos, 84112
    - Huntsman Cancer Institute/University of Utah
- Vermont
  - Berlin Corners, Vermont, Estados Unidos, 05602
    - Central Vermont Medical Center/National Life Cancer Treatment
  - Burlington, Vermont, Estados Unidos, 05401
    - University of Vermont Medical Center
  - Burlington, Vermont, Estados Unidos, 05405
    - University of Vermont and State Agricultural College
- Virginia
  - Fredericksburg, Virginia, Estados Unidos, 22401
    - Fredericksburg Oncology Inc
  - Fredericksburg, Virginia, Estados Unidos, 22408
    - Hematology Oncology Associates of Fredericksburg Inc
  - Mechanicsville, Virginia, Estados Unidos, 23116
    - Bon Secours Memorial Regional Medical Center
  - Midlothian, Virginia, Estados Unidos, 23114
    - Bon Secours Saint Francis Medical Center
  - Richmond, Virginia, Estados Unidos, 23226
    - Bon Secours Saint Mary's Hospital
  - 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
  - Auburn, Washington, Estados Unidos, 98001
    - MultiCare Auburn Medical Center
  - Bainbridge Island, Washington, Estados Unidos, 98110
    - Virginia Mason Bainbridge Island Medical Center
  - Bellevue, Washington, Estados Unidos, 98004
    - Overlake Medical Center
  - Burien, Washington, Estados Unidos, 98166
    - Highline Medical Center-Main Campus
  - Centralia, Washington, Estados Unidos, 98531
    - Providence Regional Cancer System-Centralia
  - Enumclaw, Washington, Estados Unidos, 98022
    - Saint Elizabeth Hospital
  - Everett, Washington, Estados Unidos, 98201
    - Providence Regional Cancer Partnership
  - Federal Way, Washington, Estados Unidos, 98002
    - Virginia Mason Federal Way Medical Center
  - Federal Way, Washington, Estados Unidos, 98003
    - Saint Francis Hospital
  - Gig Harbor, Washington, Estados Unidos, 98332
    - Tacoma/Valley Radiation Oncology Centers-Gig Harbor
  - Gig Harbor, Washington, Estados Unidos, 98335
    - MultiCare Gig Harbor Medical Park
  - Kennewick, Washington, Estados Unidos, 99336
    - Northwest Cancer Clinic
  - Lacey, Washington, Estados Unidos, 98503
    - Providence Regional Cancer System-Lacey
  - Lakewood, Washington, Estados Unidos, 98499
    - Saint Clare Hospital
  - Lynnwood, Washington, Estados Unidos, 98036
    - Virginia Mason Lynnwood Medical Center
  - Olympia, Washington, Estados Unidos, 98506-5166
    - Providence - Saint Peter Hospital
  - Olympia, Washington, Estados Unidos, 98507
    - Capital Medical Center
  - Port Townsend, Washington, Estados Unidos, 98368
    - Jefferson Healthcare
  - Poulsbo, Washington, Estados Unidos, 98370
    - Harrison HealthPartners Hematology and Oncology-Poulsbo
  - Poulsbo, Washington, Estados Unidos, 98370
    - Peninsula Cancer Center
  - Puyallup, Washington, Estados Unidos, 98372
    - MultiCare Good Samaritan Hospital
  - Puyallup, Washington, Estados Unidos, 98372
    - Tacoma/Valley Radiation Oncology Centers-Puyallup
  - Seattle, Washington, Estados Unidos, 98101
    - Virginia Mason Medical Center
  - Silverdale, Washington, Estados Unidos, 98383
    - Saint Michael Cancer Center
  - Tacoma, Washington, Estados Unidos, 98405
    - Northwest Medical Specialties PLLC
  - Tacoma, Washington, Estados Unidos, 98405
    - MultiCare Tacoma General Hospital
  - Tacoma, Washington, Estados Unidos, 98405
    - Tacoma/Valley Radiation Oncology Centers-Saint Joe's
  - Tacoma, Washington, Estados Unidos, 97405
    - Tacoma/Valley Radiation Oncology Centers-Jackson Hall
  - Tacoma, Washington, Estados Unidos, 98405
    - Franciscan Research Center-Northwest Medical Plaza
  - Tacoma, Washington, Estados Unidos, 98405
    - MultiCare Allenmore Hospital
  - Tacoma, Washington, Estados Unidos, 98405
    - Northwest NCI Community Oncology Research Program
  - Tacoma, Washington, Estados Unidos, 98405
    - Saint Joseph Medical Center
- West Virginia
  - Bridgeport, West Virginia, Estados Unidos, 26330
    - United Hospital Center
  - Charleston, West Virginia, Estados Unidos, 25304
    - West Virginia University Charleston Division
  - Huntington, West Virginia, Estados Unidos, 25701
    - Edwards Comprehensive Cancer Center
  - Martinsburg, West Virginia, Estados Unidos, 25401
    - WVUH-Berkely Medical Center
  - Morgantown, West Virginia, Estados Unidos, 26506
    - West Virginia University Healthcare
  - Morgantown, West Virginia, Estados Unidos, 26505
    - Monongalia Hospital
  - Parkersburg, West Virginia, Estados Unidos, 26101
    - Camden Clark Medical Center
- Wisconsin
  - 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
    - Bellin Memorial Hospital
  - Janesville, Wisconsin, Estados Unidos, 53548
    - Mercyhealth Hospital and Cancer Center - Janesville
  - Kenosha, Wisconsin, Estados Unidos, 53142
    - Aurora Cancer Care-Kenosha South
  - Ladysmith, Wisconsin, Estados Unidos, 54848
    - Marshfield Medical Center - Ladysmith
  - Marinette, Wisconsin, Estados Unidos, 54143
    - Aurora Bay Area Medical Group-Marinette
  - 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
  - New Richmond, Wisconsin, Estados Unidos, 54017
    - Cancer Center of Western Wisconsin
  - 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 - 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
  - 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
    - Aurora Cancer Care-Waukesha
  - Wausau, Wisconsin, Estados Unidos, 54401
    - Marshfield Clinic-Wausau Center
  - 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
  - Weston, Wisconsin, Estados Unidos, 54476
    - Diagnostic and Treatment Center
  - Weston, Wisconsin, Estados Unidos, 54476
    - Ascension Saint Clare's Hospital
  - 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
Puerto Rico
- - San Juan, Puerto Rico, 00936
    - San Juan City Hospital

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

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

Géneros elegibles para el estudio

Femenino

Descripción

Inclusion Criteria:

Patients should have a life expectancy of at least 10 years, excluding their diagnosis of breast cancer; (comorbid conditions should be taken into consideration, but not the diagnosis of breast cancer)
Women of reproductive potential must agree to use an effective non-hormonal method of contraception during study therapy (chemotherapy, trastuzumab, pertuzumab, and estrogen deprivation therapy) and for at least 7 months after the last dose of study therapy
Submission of tumor samples is required for all patients; the local pathology department policy regarding release of tumor samples must be considered in the screening process; patients whose tumor samples are located in a pathology department that by policy will not submit any samples for research purposes should not be approached for participation in the B-52 trial
The patient must have signed and dated an Institutional Review Board (IRB)-approved consent form that conforms to federal and institutional guidelines
The patient must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
Clinical staging for the primary tumor can be cT1c (must be 2.0 cm) or T2-T4 if clinically node negative; if the regional lymph nodes are cN1 and cytologically or histologically positive or if cN2-N3 with or without a biopsy, the primary breast tumor can be cT0-T4
The diagnosis of invasive adenocarcinoma of the breast must have been made by core needle biopsy
Ipsilateral axillary lymph nodes must be evaluated by imaging (mammogram, ultrasound, and/or magnetic resonance imaging [MRI]) within 6 weeks prior to randomization; if suspicious or abnormal, fine needle aspirate (FNA) or core biopsy is recommended, also within 6 weeks prior to randomization; findings of these evaluations will be used to determine the nodal status prior to randomization:
- Nodal status - negative
  - Imaging of the axilla is negative
  - Imaging is suspicious or abnormal but the FNA or core biopsy of the questionable node(s) on imaging is negative
- Nodal status - positive
  - FNA or core biopsy of the node(s) is cytologically or histologically suspicious or positive
  - Imaging is suspicious or abnormal but FNA or core biopsy was not performed
Patients may be premenopausal or postmenopausal at the time of randomization; for study purposes, postmenopausal is defined as:
- Age 56 or older with no spontaneous menses for at least 12 months prior to study entry; or
- Age 55 or younger with no spontaneous menses for at least 12 months prior to study entry (e.g., spontaneous or secondary to hysterectomy) and with a documented estradiol level in the postmenopausal range according to local institutional/laboratory standard; or
- Documented bilateral oophorectomy
The tumor must have been determined to be HER2-postive as follows:
- Immunohistochemistry (IHC) 3+ or
- In situ hybridization (ISH)-positive (defined by ratio of HER2 to circulating endothelial progenitors [CEP]17 >= 2.0 or HER2 gene copy number >= 6 per nucleus)
The tumor must have been determined to be estrogen receptor (ER) and/or progesterone (PgR) positive assessed by current American Society of Clinical Oncology (ASCO)/College of American Pathologist (CAP) guideline recommendations for hormone receptor testing; patients with >= 1% ER or PgR staining by IHC are considered positive
Absolute neutrophil count (ANC) must be >= 1200/mm^3
Platelet count must be >= 100,000/mm^3
Hemoglobin must be >= 10 g/dL
Total bilirubin must be =< upper limit of normal (ULN) for the lab unless the patient has a bilirubin elevation > ULN to 1.5 x ULN due to Gilbert's disease or similar syndrome involving slow conjugation of bilirubin
Alkaline phosphatase must be =< 2.5 x ULN for the lab
Aspartate aminotransferase (AST) must be =< 1.5 x ULN for the lab
Alkaline phosphatase and AST may not both be > the ULN; for example, if the alkaline phosphatase is > the ULN but =< 2.5 x ULN, the AST must be =< the ULN; if the AST is > the ULN but =< 1.5 x ULN, the alkaline phosphatase must be =< ULN; Note: If alanine aminotransferase (ALT) is performed instead of AST (per institution's standard practice), the ALT value must be =< 1.5 x ULN; if both were performed, the AST must be =< 1.5 x ULN
Patients with AST or alkaline phosphatase > ULN are eligible for inclusion in the study if liver imaging (computed tomography [CT], MRI, positron emission tomography [PET]-CT, or PET scan) performed within 6 weeks prior to randomization does not demonstrate metastatic disease and the requirements are met
Patients with alkaline phosphatase that is > ULN but =< 2.5 x ULN or unexplained bone pain are eligible for inclusion in the study if a bone scan, PET-CT scan, or PET scan performed within 6 weeks prior to randomization does not demonstrate metastatic disease
Within 6 weeks prior to randomization, the most recent serum creatinine must be =< ULN or measured or calculated creatinine clearance must be > 60 mL/min
Left ventricular ejection fraction (LVEF) assessment must be performed within 90 days prior to randomization; (LVEF assessment performed by 2-dimensional [2-D] echocardiogram is preferred; however, multi gated acquisition scan [MUGA] scan may be substituted based on institutional preferences); the LVEF must be >= 50% regardless of the cardiac imaging facility's lower limit of normal; note: since the pre-entry LVEF serves as the baseline for comparing subsequent LVEF assessments, it is critical that this baseline study be an accurate assessment; if the baseline LVEF is > 65%, the investigator is encouraged to have the accuracy of the initial LVEF result confirmed and repeat the test if the accuracy is uncertain

Exclusion Criteria:

FNA alone to diagnose the breast cancer
Excisional biopsy or lumpectomy performed prior to randomization
Surgical axillary staging procedure prior to randomization; pre-neoadjuvant therapy sentinel node biopsy is not permitted
Definitive clinical or radiologic evidence of metastatic disease; (chest imaging [mandatory for all patients] and other imaging [if required] must have been performed within 90 days prior to randomization)
Synchronous bilateral invasive breast cancer
Synchronous or previous contralateral invasive breast cancer; (patients with synchronous and/or previous contralateral ductal carcinoma in situ [DCIS] or lobular carcinoma in situ [LCIS] are eligible)
Any previous history of ipsilateral invasive breast cancer or ipsilateral DCIS; (patients with synchronous or previous ipsilateral LCIS are eligible)
Treatment including radiation therapy (RT), chemotherapy, targeted therapy, or endocrine therapy for the currently diagnosed breast cancer prior to randomization
Previous endocrine therapy such as raloxifene or tamoxifen (or other selective estrogen receptor modulator [SERM]) or an aromatase inhibitor for any malignancy
Previous therapy with anthracycline, taxanes, carboplatin, trastuzumab, or other HER2 targeted therapies for any malignancy
Any sex hormonal therapy, e.g., birth control pills, ovarian hormone replacement therapy, etc. (these patients are eligible if this therapy is discontinued prior to randomization)
History of non-breast malignancies (except for in situ cancers treated only by local excision and basal cell and squamous cell carcinomas of the skin) within 5 years prior to randomization
Cardiac disease (history of and/or active disease) that would preclude the use of the drugs included in the treatment regimens; this includes but is not confined to:
- Active cardiac disease:
  - Angina pectoris that requires the use of anti-anginal medication;
  - Ventricular arrhythmias except for benign premature ventricular contractions;
  - Supraventricular and nodal arrhythmias requiring a pacemaker or not controlled with medication;
  - Conduction abnormality requiring a pacemaker;
  - Valvular disease with documented compromise in cardiac function; and
  - Symptomatic pericarditis
- History of cardiac disease:
  - Myocardial infarction documented by elevated cardiac enzymes or persistent regional wall abnormalities on assessment of left ventricular (LV) function;
  - History of documented congestive heart failure (CHF); and
  - Documented cardiomyopathy
Uncontrolled hypertension defined as sustained systolic blood pressure (BP) > 150 mmHg or diastolic BP > 90 mmHg; (patients with initial BP elevations are eligible if initiation or adjustment of BP medication lowers pressure to meet entry criteria)
Active hepatitis B or hepatitis C with abnormal liver function tests
Intrinsic lung disease resulting in dyspnea
Poorly controlled diabetes mellitus
Active infection or chronic infection requiring chronic suppressive antibiotics
Patients known to be human immunodeficiency virus (HIV) positive with a baseline cluster of differentiation (CD)4 count of < 250 cells/mm^3 or have a history of acquired immune deficiency syndrome (AIDS) indicator conditions; patients taking anti-retroviral therapy that may have a potential overlapping toxicity with the study therapy are not eligible
Nervous system disorder (paresthesia, peripheral motor neuropathy, or peripheral sensory neuropathy) >= grade 2, per the Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v4.0)
Malabsorption syndrome, ulcerative colitis, resection of the stomach or small bowel, or other disease significantly affecting gastrointestinal function
Other non-malignant systemic disease that would preclude treatment with any of the treatment regimens or would prevent required follow-up
Conditions that would prohibit administration of corticosteroids
Chronic daily treatment with corticosteroids with a dose of >= 10 mg/day methylprednisolone equivalent (excluding inhaled steroids)
Known hypersensitivity to any of the study drugs or any of the ingredients or excipients of these drugs (e.g., polysorbate 80), including sensitivity to benzyl alcohol
Pregnancy or lactation at the time of study entry; (note: pregnancy testing must be performed within 2 weeks prior to randomization according to institutional standards for women of childbearing potential)
Psychiatric or addictive disorders or other conditions that, in the opinion of the investigator, would preclude the patient from meeting the study requirements
Use of any investigational product within 30 days prior to randomization

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 paralela
Enmascaramiento: Ninguno (etiqueta abierta)

Número de brazos

Armas e Intervenciones

Grupo de participantes/brazo	Intervención / Tratamiento
Comparador activo: Arm I (combination chemotherapy, surgery, radiation) NEOADJUVANT: Patients receive docetaxel IV over 60 minutes, carboplatin IV over 30-60 minutes, trastuzumab IV over 30-90 minutes, and pertuzumab IV over 30-60 on day 1. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients enrolled after Amendment #4 undergo 2 core biopsies prior to course 3 of treatment. SURGERY: Patients undergo lumpectomy or mastectomy. RADIATION: Patients undergo whole breast irradiation within 8 weeks following surgery. ADJUVANT: Patients receive trastuzumab IV over 30-60 minutes every 21 days for up to 1 year.	Droga: Carboplatin Given IV Otros nombres: Blastocarbo Carboplat Carboplatino Hexal Carboplatino Carbosina Carbosol Carbotec CBDCA Displata Ercar JM-8 Nealorín Novoplatino Paraplatino Paraplatino AQ Platinado Ribocarbo JM8 Biológico: Trastuzumab Given IV Otros nombres: Herceptina ABP 980 ALT02 Herceptin biosimilar PF-05280014 Herceptin Trastuzumab Biosimilar PF-05280014 Herzuma Ogivrí Entrometido PF-05280014 rhuMAb HER2 RO0452317 SB3 Trastuzumab Biosimilar ABP 980 Trastuzumab Biosimilar ALT02 trastuzumab biosimilar EG12014 Trastuzumab Biosimilar HLX02 Trastuzumab Biosimilar PF-05280014 Trastuzumab Biosimilar SB3 Trastuzumab-dkst Trastuzumab-dttb Trastuzumab-pkrb Trazimera Kanjinti Trastuzumab Biosimilar SIBP-01 Trastuzumab-anns Trastuzumab-qyp Herclon Zercepac QL 1701 QL-1701 QL1701 Trastuzumab Biosimilar QL1701 CT-P06 CT-P6 Trastuzumab Biosimilar CT-P6 Biceltis CANMab Hertraz Hercesi Trastuzumab-strf Herwenda Trastuzumab-herw Trastuzumab-zerc HL 02 HLX-02 HLX02 PF 05280014 PF05280014 Otro: Laboratory Biomarker Analysis Correlative studies Otro: Quality-of-Life Assessment Ancillary studies Otros nombres: Evaluación de la calidad de vida Droga: Docetaxel Given IV Otros nombres: Taxotere Docecad RP56976 Concentrado de inyección de taxotere RP 56976 RP-56976 Otro: Cytology Specimen Collection Procedure Undergo 2 core biopsies Otros nombres: Muestreo citológico Biológico: Pertuzumab Given IV Otros nombres: Perjeta 2C4 Anticuerpo 2C4 EG1206A HLX11 SA627 MoAb 2C4 Anticuerpo monoclonal 2C4 Omnitarg Pertuzumab Biosimilar EG1206A Pertuzumab Biosimilar HLX11 Pertuzumab Biosimilar HS627 rhuMAb2C4 RO4368451 BCD-178 Pertuzumab Biosimilar BCD-178 Rumab 2C4 Pertuzumab Biosimilar TQB2440 TQB 2440 TQB-2440 TQB2440 Procedimiento: Therapeutic Conventional Surgery Undergo lumpectomy or mastectomy Radiación: Whole Breast Irradiation Undergo whole breast irradiation
Experimental: Arm II (chemo, estrogen deprivation, surgery, radiation) NEOADJUVANT: All patients receive docetaxel, carboplatin, trastuzumab, and pertuzumab as in arm I. Premenopausal patients also receive goserelin acetate SC every 28 days until surgery and aromatase inhibition therapy at the investigator's discretion daily until 1 day before surgery. Postmenopausal patients receive aromatase inhibition therapy at the investigator's discretion daily until 1 day before surgery. Patients enrolled after Amendment #4 undergo 2 core biopsies prior to course 3 of treatment. SURGERY: Patients undergo lumpectomy or mastectomy. RADIATION: Patients undergo whole breast irradiation within 8 weeks following surgery. ADJUVANT: Patients receive trastuzumab IV over 30-60 minutes every 21 days for up to 1 year.	Droga: Carboplatin Given IV Otros nombres: Blastocarbo Carboplat Carboplatino Hexal Carboplatino Carbosina Carbosol Carbotec CBDCA Displata Ercar JM-8 Nealorín Novoplatino Paraplatino Paraplatino AQ Platinado Ribocarbo JM8 Biológico: Trastuzumab Given IV Otros nombres: Herceptina ABP 980 ALT02 Herceptin biosimilar PF-05280014 Herceptin Trastuzumab Biosimilar PF-05280014 Herzuma Ogivrí Entrometido PF-05280014 rhuMAb HER2 RO0452317 SB3 Trastuzumab Biosimilar ABP 980 Trastuzumab Biosimilar ALT02 trastuzumab biosimilar EG12014 Trastuzumab Biosimilar HLX02 Trastuzumab Biosimilar PF-05280014 Trastuzumab Biosimilar SB3 Trastuzumab-dkst Trastuzumab-dttb Trastuzumab-pkrb Trazimera Kanjinti Trastuzumab Biosimilar SIBP-01 Trastuzumab-anns Trastuzumab-qyp Herclon Zercepac QL 1701 QL-1701 QL1701 Trastuzumab Biosimilar QL1701 CT-P06 CT-P6 Trastuzumab Biosimilar CT-P6 Biceltis CANMab Hertraz Hercesi Trastuzumab-strf Herwenda Trastuzumab-herw Trastuzumab-zerc HL 02 HLX-02 HLX02 PF 05280014 PF05280014 Otro: Laboratory Biomarker Analysis Correlative studies Otro: Quality-of-Life Assessment Ancillary studies Otros nombres: Evaluación de la calidad de vida Droga: Docetaxel Given IV Otros nombres: Taxotere Docecad RP56976 Concentrado de inyección de taxotere RP 56976 RP-56976 Otro: Cytology Specimen Collection Procedure Undergo 2 core biopsies Otros nombres: Muestreo citológico Biológico: Pertuzumab Given IV Otros nombres: Perjeta 2C4 Anticuerpo 2C4 EG1206A HLX11 SA627 MoAb 2C4 Anticuerpo monoclonal 2C4 Omnitarg Pertuzumab Biosimilar EG1206A Pertuzumab Biosimilar HLX11 Pertuzumab Biosimilar HS627 rhuMAb2C4 RO4368451 BCD-178 Pertuzumab Biosimilar BCD-178 Rumab 2C4 Pertuzumab Biosimilar TQB2440 TQB 2440 TQB-2440 TQB2440 Procedimiento: Therapeutic Conventional Surgery Undergo lumpectomy or mastectomy Radiación: Whole Breast Irradiation Undergo whole breast irradiation Droga: Aromatase Inhibition Therapy Given at the investigator's discretion Otros nombres: Inhibición de la aromatasa Droga: Goserelin Acetate Given SC Otros nombres: ZDX Zoladex

Grupo de participantes/brazo

Intervención / Tratamiento

Comparador activo: Arm I (combination chemotherapy, surgery, radiation)

NEOADJUVANT: Patients receive docetaxel IV over 60 minutes, carboplatin IV over 30-60 minutes, trastuzumab IV over 30-90 minutes, and pertuzumab IV over 30-60 on day 1. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients enrolled after Amendment #4 undergo 2 core biopsies prior to course 3 of treatment.

SURGERY: Patients undergo lumpectomy or mastectomy.

RADIATION: Patients undergo whole breast irradiation within 8 weeks following surgery.

ADJUVANT: Patients receive trastuzumab IV over 30-60 minutes every 21 days for up to 1 year.

Droga: Carboplatin

Given IV

Otros nombres:

Blastocarbo
Carboplat
Carboplatino Hexal
Carboplatino
Carbosina
Carbosol
Carbotec
CBDCA
Displata
Ercar
JM-8
Nealorín
Novoplatino
Paraplatino
Paraplatino AQ
Platinado
Ribocarbo
JM8

Biológico: Trastuzumab

Given IV

Otros nombres:

Herceptina
ABP 980
ALT02
Herceptin biosimilar PF-05280014
Herceptin Trastuzumab Biosimilar PF-05280014
Herzuma
Ogivrí
Entrometido
PF-05280014
rhuMAb HER2
RO0452317
SB3
Trastuzumab Biosimilar ABP 980
Trastuzumab Biosimilar ALT02
trastuzumab biosimilar EG12014
Trastuzumab Biosimilar HLX02
Trastuzumab Biosimilar PF-05280014
Trastuzumab Biosimilar SB3
Trastuzumab-dkst
Trastuzumab-dttb
Trastuzumab-pkrb
Trazimera
Kanjinti
Trastuzumab Biosimilar SIBP-01
Trastuzumab-anns
Trastuzumab-qyp
Herclon
Zercepac
QL 1701
QL-1701
QL1701
Trastuzumab Biosimilar QL1701
CT-P06
CT-P6
Trastuzumab Biosimilar CT-P6
Biceltis
CANMab
Hertraz
Hercesi
Trastuzumab-strf
Herwenda
Trastuzumab-herw
Trastuzumab-zerc
HL 02
HLX-02
HLX02
PF 05280014
PF05280014

Otro: Laboratory Biomarker Analysis

Correlative studies

Otro: Quality-of-Life Assessment

Ancillary studies

Otros nombres:

Evaluación de la calidad de vida

Droga: Docetaxel

Given IV

Otros nombres:

Taxotere
Docecad
RP56976
Concentrado de inyección de taxotere
RP 56976
RP-56976

Otro: Cytology Specimen Collection Procedure

Undergo 2 core biopsies

Otros nombres:

Muestreo citológico

Biológico: Pertuzumab

Given IV

Otros nombres:

Perjeta
2C4
Anticuerpo 2C4
EG1206A
HLX11
SA627
MoAb 2C4
Anticuerpo monoclonal 2C4
Omnitarg
Pertuzumab Biosimilar EG1206A
Pertuzumab Biosimilar HLX11
Pertuzumab Biosimilar HS627
rhuMAb2C4
RO4368451
BCD-178
Pertuzumab Biosimilar BCD-178
Rumab 2C4
Pertuzumab Biosimilar TQB2440
TQB 2440
TQB-2440
TQB2440

Procedimiento: Therapeutic Conventional Surgery

Undergo lumpectomy or mastectomy

Radiación: Whole Breast Irradiation

Undergo whole breast irradiation

Experimental: Arm II (chemo, estrogen deprivation, surgery, radiation)

NEOADJUVANT: All patients receive docetaxel, carboplatin, trastuzumab, and pertuzumab as in arm I. Premenopausal patients also receive goserelin acetate SC every 28 days until surgery and aromatase inhibition therapy at the investigator's discretion daily until 1 day before surgery. Postmenopausal patients receive aromatase inhibition therapy at the investigator's discretion daily until 1 day before surgery. Patients enrolled after Amendment #4 undergo 2 core biopsies prior to course 3 of treatment.

SURGERY: Patients undergo lumpectomy or mastectomy.

RADIATION: Patients undergo whole breast irradiation within 8 weeks following surgery.

ADJUVANT: Patients receive trastuzumab IV over 30-60 minutes every 21 days for up to 1 year.

Droga: Carboplatin

Given IV

Otros nombres:

Blastocarbo
Carboplat
Carboplatino Hexal
Carboplatino
Carbosina
Carbosol
Carbotec
CBDCA
Displata
Ercar
JM-8
Nealorín
Novoplatino
Paraplatino
Paraplatino AQ
Platinado
Ribocarbo
JM8

Biológico: Trastuzumab

Given IV

Otros nombres:

Herceptina
ABP 980
ALT02
Herceptin biosimilar PF-05280014
Herceptin Trastuzumab Biosimilar PF-05280014
Herzuma
Ogivrí
Entrometido
PF-05280014
rhuMAb HER2
RO0452317
SB3
Trastuzumab Biosimilar ABP 980
Trastuzumab Biosimilar ALT02
trastuzumab biosimilar EG12014
Trastuzumab Biosimilar HLX02
Trastuzumab Biosimilar PF-05280014
Trastuzumab Biosimilar SB3
Trastuzumab-dkst
Trastuzumab-dttb
Trastuzumab-pkrb
Trazimera
Kanjinti
Trastuzumab Biosimilar SIBP-01
Trastuzumab-anns
Trastuzumab-qyp
Herclon
Zercepac
QL 1701
QL-1701
QL1701
Trastuzumab Biosimilar QL1701
CT-P06
CT-P6
Trastuzumab Biosimilar CT-P6
Biceltis
CANMab
Hertraz
Hercesi
Trastuzumab-strf
Herwenda
Trastuzumab-herw
Trastuzumab-zerc
HL 02
HLX-02
HLX02
PF 05280014
PF05280014

Otro: Laboratory Biomarker Analysis

Correlative studies

Otro: Quality-of-Life Assessment

Ancillary studies

Otros nombres:

Evaluación de la calidad de vida

Droga: Docetaxel

Given IV

Otros nombres:

Taxotere
Docecad
RP56976
Concentrado de inyección de taxotere
RP 56976
RP-56976

Otro: Cytology Specimen Collection Procedure

Undergo 2 core biopsies

Otros nombres:

Muestreo citológico

Biológico: Pertuzumab

Given IV

Otros nombres:

Perjeta
2C4
Anticuerpo 2C4
EG1206A
HLX11
SA627
MoAb 2C4
Anticuerpo monoclonal 2C4
Omnitarg
Pertuzumab Biosimilar EG1206A
Pertuzumab Biosimilar HLX11
Pertuzumab Biosimilar HS627
rhuMAb2C4
RO4368451
BCD-178
Pertuzumab Biosimilar BCD-178
Rumab 2C4
Pertuzumab Biosimilar TQB2440
TQB 2440
TQB-2440
TQB2440

Procedimiento: Therapeutic Conventional Surgery

Undergo lumpectomy or mastectomy

Radiación: Whole Breast Irradiation

Undergo whole breast irradiation

Droga: Aromatase Inhibition Therapy

Given at the investigator's discretion

Otros nombres:

Inhibición de la aromatasa

Droga: Goserelin Acetate

Given SC

Otros nombres:

ZDX
Zoladex

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado	Medida Descripción	Periodo de tiempo
Percent of Patients With Pathological Complete Response (pCR) in the Breast and Post Therapy Lymph Nodes Periodo de tiempo: Up to 2.8 years (when all patients completed primary breast surgery)	Proportion of patients with pCR evaluated histologically, and defined as the absence of any invasive component in the resected breast specimen and all resected lymph nodes following completion of neoadjuvant therapy.	Up to 2.8 years (when all patients completed primary breast surgery)

Medidas de resultado secundarias

Medida de resultado	Medida Descripción	Periodo de tiempo
Percent of Patients With Pathologic Complete Response (pCR) in the Breast Periodo de tiempo: Up to 2.8 years (when all patients completed primary breast surgery)	Proportion of patients with pCR in the breast, defined as the absence of any invasive component in the resected breast specimen.	Up to 2.8 years (when all patients completed primary breast surgery)
Recurrence Free Interval (RFI) Periodo de tiempo: Time from surgery to invasive local, regional or distant recurrence, or death from breast cancer for patients with operable disease and for patients with inoperable progressive disease, assessed up to 8.4 years	Kaplan-Meier estimates of the percentages of patients free from recurrence.	Time from surgery to invasive local, regional or distant recurrence, or death from breast cancer for patients with operable disease and for patients with inoperable progressive disease, assessed up to 8.4 years
Overall Survival (OS) Periodo de tiempo: Time from randomization until death from any cause, assessed up to 8.4 years	Kaplan-Meier estimates of the percentages of patients surviving.	Time from randomization until death from any cause, assessed up to 8.4 years
Second Primary Cancer of Any Type Periodo de tiempo: Time from randomization to the development of a second primary invasive cancer of any site excluding squamous and basal cell carcinoma of the skin, assessed up to 8.4 years	Number of second primary cancers for the two treatment groups	Time from randomization to the development of a second primary invasive cancer of any site excluding squamous and basal cell carcinoma of the skin, assessed up to 8.4 years
Percent of Patients With Pathological Complete Response (pCR) in the Breast and Post Therapy Lymph Nodes by Menopausal Status Periodo de tiempo: Up to 2.8 years (when all patients completed primary breast surgery)	Proportion of patients with pCR evaluated histologically, and defined as the absence of any invasive component in the resected breast specimen and all resected lymph nodes following completion of neoadjuvant therapy calculated separately for premenopausal and postmenopausal women.	Up to 2.8 years (when all patients completed primary breast surgery)
Patterns of Recurrence Free Interval (RFI) by Menopausal Status Periodo de tiempo: Time from surgery to invasive local, regional or distant recurrence, or death from breast cancer for patients with operable disease and for patients with inoperable progressive disease, assessed up to 5 years	Kaplan-Meier estimates of the percentages of patients free from recurrence by menopausal status.	Time from surgery to invasive local, regional or distant recurrence, or death from breast cancer for patients with operable disease and for patients with inoperable progressive disease, assessed up to 5 years
Patterns of Overall Survival (OS) by Menopausal Status Periodo de tiempo: Time from randomization until death from any cause, assessed up to 5 years	Kaplan-Meier estimates of the percentages of patients surviving by menopausal status.	Time from randomization until death from any cause, assessed up to 5 years
Percentage of Participants With Cardiac Toxicity Categorized According to National Cancer Institute CTCAE Version 4.0 Periodo de tiempo: Up to 6 weeks post surgery	Percentage of patients with grade 1 or higher toxicity from the Cardiac Disorders System Organ Class.	Up to 6 weeks post surgery
Median Percentage of Tumor-infiltrating Lymphocytes (sTILS) Periodo de tiempo: 2.8 years	Percentage of Tumor-infiltrating lymphocytes present in the stroma in tissue specimen.	2.8 years
Change in Endocrine-related Symptoms Using Breast Cancer Prevention Trial (BCPT) Symptom Checklist Periodo de tiempo: The outcome measure was assessed and is presented at three time points included baseline, Prior to cycle 4 (approximately 77 days), and 2-4 weeks after the last dose of chemotherapy prior to surgery (approximately 133-147 days)	The Breast Cancer Prevention Trial (BCPT) symptom checklist contains 17 endocrine-related symptoms and problems. For each item, the patient was asked how bothersome the problem or symptom was during the past four weeks. Possible answers ranged from not at all (1) to extremely (5). The summary score was calculated for each participant as the average severity of all 17 items. The total mean summary score was calculated as the average summary score by treatment group. The range is 1-5 with higher scores indicating worse outcome.	The outcome measure was assessed and is presented at three time points included baseline, Prior to cycle 4 (approximately 77 days), and 2-4 weeks after the last dose of chemotherapy prior to surgery (approximately 133-147 days)

Colaboradores e Investigadores

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

Patrocinador

National Cancer Institute (NCI)

Colaboradores

NRG Oncology

Investigadores

Investigador principal: Mothaffar F Rimawi, NRG Oncology

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)

18 de febrero de 2014

Finalización primaria (Actual)

31 de octubre de 2016

Finalización del estudio (Actual)

30 de junio de 2025

Fechas de registro del estudio

Enviado por primera vez

2 de diciembre de 2013

Primero enviado que cumplió con los criterios de control de calidad

2 de diciembre de 2013

Publicado por primera vez (Estimado)

6 de diciembre de 2013

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

6 de octubre de 2026

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

15 de septiembre de 2026

Última verificación

1 de septiembre de 2026

Más información

Términos relacionados con este estudio

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

NCI-2013-02228
U10CA180868 (Subvención/contrato del NIH de EE. UU.)
U10CA012027 (Subvención/contrato del NIH de EE. UU.)
NCI-2013-02228 (Identificador de registro: CTRP (Clinical Trial Reporting Program))
NSABP-B-52 (Otro identificador: CTEP)
NSABP-B-52 (Otro identificador: NRG Oncology)

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

Docetaxel, carboplatino, trastuzumab y pertuzumab con o sin deprivación de estrógenos en el tratamiento de pacientes con cáncer de mama con receptor hormonal positivo, HER2 positivo operable o localmente avanzado

Descripción general del estudio

Estado

Condiciones

Intervención / Tratamiento

Descripción detallada

Tipo de estudio

Inscripción (Actual)

Fase

Contactos y Ubicaciones

Ubicaciones de estudio

Criterios de participación

Criterio de elegibilidad

Edades elegibles para estudiar

Acepta Voluntarios Saludables

Géneros elegibles para el estudio

Descripción

Plan de estudios

¿Cómo está diseñado el estudio?

Detalles de diseño

Número de brazos

Armas e Intervenciones

Grupo de participantes/brazo

Intervención / Tratamiento

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado

Medida Descripción

Periodo de tiempo

Medidas de resultado secundarias

Medida de resultado

Medida Descripción

Periodo de tiempo

Colaboradores e Investigadores

Patrocinador

Colaboradores

Investigadores

Fechas de registro del estudio

Fechas importantes del estudio

Inicio del estudio (Actual)

Finalización primaria (Actual)

Finalización del estudio (Actual)

Fechas de registro del estudio

Enviado por primera vez

Primero enviado que cumplió con los criterios de control de calidad

Publicado por primera vez (Estimado)

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

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

Última verificación

Más información

Términos relacionados con este estudio

Términos MeSH relevantes adicionales

Otros números de identificación del estudio