Trastutsumabin tai trastutsumabin/pertutsumabin tavanomaiseen kemoterapiaan lisäämisen testaus HER2-positiivisen kohdun limakalvon seroosisen karsinooman tai karsinosarkooman yhteydessä
Vaiheen II/III tutkimus paklitakselista/karboplatiinista yksinään tai yhdessä joko trastutsumabin ja hyaluronidaasi-Oyskin (HERCEPTIN HYLECTA) tai pertutsumabin, trastutsumabin ja hyaluronidaasi-Zzxf:n (PHESGO) kanssa HER2-positiivisessa, I-IV-vaiheen endometriaalisessa karsinoosikarsinoomassa
This phase III trial tests whether adding trastuzumab and hyaluronidase-oysk (Herceptin Hylecta [TM]) or pertuzumab, trastuzumab and hyaluronidase-zzxf (Phesgo [TM]) to the usual chemotherapy (paclitaxel and carboplatin) works to shrink tumors in patients with HER2 positive endometrial cancer. Trastuzumab and pertuzumab are monoclonal antibodies and forms of targeted therapy that attach to specific molecules (receptors) on the surface of tumor cells, known as HER2 receptors. When trastuzumab or pertuzumab attach to HER2 receptors, the signals that tell the cells to grow are blocked and the tumor cell may be marked for destruction by the body's immune system. Hyaluronidase is an endoglycosidase. It helps to keep pertuzumab and trastuzumab in the body longer, so that these medications will have a greater effect. Hyaluronidase also allows trastuzumab and trastuzumab/pertuzumab to be given by injection under the skin and shortens their administration time compared to trastuzumab or pertuzumab alone. Paclitaxel is a taxane and in a class of medications called antimicrotubule agents. It stops tumor cells from growing and dividing and may kill them. Carboplatin is in a class of medications known as platinum-containing compounds. It works in a way similar to the anticancer drug cisplatin, but may be better tolerated than cisplatin. Carboplatin works by killing, stopping or slowing the growth of tumor cells. Giving Herceptin Hylecta or Phesgo in combination with paclitaxel and carboplatin may shrink the tumor and prevent the cancer from coming back in patients with HER2 positive endometrial cancer.
Tutkimuksen yleiskatsaus
Tila
Ehdot
- Endometriumin karsinooma
- Endometriumin kirkassoluinen adenokarsinooma
- Endometriumin erilaistuva karsinooma
- Endometriumin endometrioidinen adenokarsinooma
- Endometriumin sekasoluinen adenokarsinooma
- Endometriumin seroosi adenokarsinooma
- Endometriumin erilaistumaton karsinooma
- Kohdun ruumiin pahanlaatuinen sekoitettu mesodermaalinen (Müllerin) kasvain
Interventio / Hoito
- Lääke: Carboplatin
- Lääke: Paclitaxel
- Menettely: Computed Tomography
- Menettely: Echocardiography Test
- Menettely: Multigated Acquisition Scan
- Menettely: Biospecimen Collection
- Säteily: High-Dose-Rate Vaginal Cuff Brachytherapy
- Muut: Survey Administration
- Lääke: Trastuzumab/Hyaluronidase-oysk
- Lääke: Hyaluronidase-zzxf/Pertuzumab/Trastuzumab
Yksityiskohtainen kuvaus
PRIMARY OBJECTIVES:
I. To evaluate the efficacy of trastuzumab and hyaluronidase-oysk (HERCEPTIN HYLECTA) and pertuzumab, trastuzumab, and hyaluronidase-zzxf (PHESGO) in combination with paclitaxel/carboplatin in patients with HER2 positive endometrial cancer.
SECONDARY OBJECTIVES:
I. To evaluate the efficacy of trastuzumab and hyaluronidase-oysk (HERCEPTIN HYLECTA) and pertuzumab, trastuzumab, and hyaluronidase-zzxf (PHESGO) in combination with paclitaxel/carboplatin in patients with HER2 positive endometrial cancer.
II. To evaluate the overall response rate (ORR) in patients with measurable disease.
III. To evaluate the duration of objective response in patients with measurable disease as assessed by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1.
IV. To determine the nature, frequency and degree of toxicity as assessed by Common Terminology Criteria for Adverse Events (CTCAE) version (v.) 5.0 for each treatment arm.
V. To compare quality of life (QOL), as measured by Functional Assessment of Cancer Therapy - Endometrial Trial Outcome Index (FACT-En-TOI), in the experimental versus control arms.
VI. To compare patient-reported treatment-associated symptoms (diarrhea and rash) as measured with the Patient Reported Outcomes (PRO) - CTCAE, patient-reported fatigue as measured with the Patient Reported Outcomes Measurement Information System (PROMIS)-Fatigue short form, and worry concerning side effects of treatment as measured by the item 'bothered by side effect', in the FACT-En TOI, respectively, in the experimental and control arms.
VII. To assess the correlation of HER2 immunohistochemistry (IHC) expression and in situ hybridization (ISH) amplification with clinical outcome and response to HER2 targeted therapies.
EXPLORATORY OBJECTIVE:
I. To explore time to sustained deterioration in quality of life, as measured by a drop in the FACT-En-TOI by 6 or more points lasting for more than one PRO time point, in the experimental and control arms.
OUTLINE: Patients are randomized to 1 of 3 arms.
ARM I: Patients receive paclitaxel intravenously (IV) over 3 hours and carboplatin IV over 30-60 minutes on day 1 of each cycle. Cycles repeat every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. Patients with stable disease (SD) or partial response (PR) who still have measurable disease after completion of cycle 6 may receive 4 additional cycles of this treatment at the discretion of the treating physician.
ARM II: Patients receive paclitaxel IV over 3 hours, carboplatin IV over 30-60 minutes, and trastuzumab/hyaluronidase-oysk subcutaneously (SC) over 2-5 minutes on day 1 of each cycle. Cycles repeat every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. Patients with SD or PR who still have measurable disease after completion of cycle 6 may receive 4 additional cycles of this treatment at the discretion of the treating physician.
MAINTENANCE: Patients receive trastuzumab/hyaluronidase-oysk SC over 2-5 minutes on day 1 of each cycle. Cycles repeat every 3 weeks for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients with SD or PR may continue maintenance therapy for up to 3 years from the start of treatment.
ARM III: Patients receive paclitaxel IV over 3 hours, carboplatin IV over 30-60 minutes, and pertuzumab/trastuzumab/hyaluronidase-zzxf SC over 5-8 minutes on day 1 of each cycle. Cycles repeat every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. Patients with SD or PR who still have measurable disease after completion of cycle 6 may receive 4 additional cycles of this treatment at the discretion of the treating physician.
MAINTENANCE: Patients receive pertuzumab/trastuzumab/ hyaluronidase-zzxf SC over 5 minutes on day 1 of each cycle. Cycles repeat every 3 weeks for up to 1 year in absence of disease progression or unacceptable toxicity. Patients with SD or PR may continue maintenance for up to 3 years from the start of treatment.
Patients undergo echocardiography (ECHO) or multigated acquisition scan (MUGA) and computed tomography (CT) throughout the study. Additionally, patients may optionally undergo blood sample collection throughout the study, vaginal brachytherapy on study, and urine sample collection prior to treatment.
After completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months for 3 years.
Opintotyyppi
Ilmoittautuminen (Arvioitu)
Vaihe
- Vaihe 3
Yhteystiedot ja paikat
Opiskelupaikat
-
-
-
Seoul, Etelä -Korea, 06273
- Gangnam Severance Hospital
-
-
Daegu
-
Dalseo-gu, Daegu, Etelä -Korea, 42601
- Keimyung University-Dongsan Medical Center
-
-
Gyeongsangnam-do
-
Seoul, Gyeongsangnam-do, Etelä -Korea, 51353
- Samsung Changwon Hospital
-
-
Kyeonggi-do
-
Seongnam, Kyeonggi-do, Etelä -Korea, 463-707
- Seoul National University Bundang Hospital
-
-
-
-
-
San Juan, Puerto Rico, 00927
- Centro Comprensivo de Cancer de UPR
-
-
-
-
Alabama
-
Birmingham, Alabama, Yhdysvallat, 35233
- University of Alabama at Birmingham Cancer Center
-
-
Alaska
-
Anchorage, Alaska, Yhdysvallat, 99508
- Alaska Women's Cancer Care
-
-
Arizona
-
Tucson, Arizona, Yhdysvallat, 85719
- Banner University Medical Center - Tucson
-
Tucson, Arizona, Yhdysvallat, 85719
- University of Arizona Cancer Center-North Campus
-
-
Arkansas
-
Little Rock, Arkansas, Yhdysvallat, 72205
- University of Arkansas for Medical Sciences
-
-
California
-
Auburn, California, Yhdysvallat, 95602
- Sutter Auburn Faith Hospital
-
Berkeley, California, Yhdysvallat, 94704
- Alta Bates Summit Medical Center-Herrick Campus
-
Concord, California, Yhdysvallat, 94520
- John Muir Medical Center-Concord
-
Duarte, California, Yhdysvallat, 91010
- City of Hope Comprehensive Cancer Center
-
Huntington Beach, California, Yhdysvallat, 92648
- City of Hope Seacliff
-
Irvine, California, Yhdysvallat, 92618
- Kaiser Permanente-Irvine
-
Irvine, California, Yhdysvallat, 92618
- City of Hope at Irvine Lennar
-
Irvine, California, Yhdysvallat, 92612
- UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care
-
Long Beach, California, Yhdysvallat, 90813
- City of Hope at Long Beach Elm
-
Los Angeles, California, Yhdysvallat, 90027
- Kaiser Permanente Los Angeles Medical Center
-
Modesto, California, Yhdysvallat, 95355
- Memorial Medical Center
-
Mountain View, California, Yhdysvallat, 94040
- Palo Alto Medical Foundation-Gynecologic Oncology
-
Orange, California, Yhdysvallat, 92868
- UC Irvine Health/Chao Family Comprehensive Cancer Center
-
Orange, California, Yhdysvallat, 92868
- Saint Joseph Hospital - Orange
-
Palo Alto, California, Yhdysvallat, 94304
- Stanford Cancer Institute Palo Alto
-
Panorama City, California, Yhdysvallat, 91402
- Kaiser Permanente - Panorama City
-
Riverside, California, Yhdysvallat, 92505
- Kaiser Permanente-Riverside
-
Roseville, California, Yhdysvallat, 95661
- Sutter Roseville Medical Center
-
Sacramento, California, Yhdysvallat, 95816
- Sutter Medical Center Sacramento
-
Sacramento, California, Yhdysvallat, 95817
- University of California Davis Comprehensive Cancer Center
-
San Francisco, California, Yhdysvallat, 94115
- California Pacific Medical Center-Pacific Campus
-
Santa Cruz, California, Yhdysvallat, 95065
- Palo Alto Medical Foundation-Santa Cruz
-
Sunnyvale, California, Yhdysvallat, 94086
- Palo Alto Medical Foundation-Sunnyvale
-
Upland, California, Yhdysvallat, 91786
- City of Hope Upland
-
Walnut Creek, California, Yhdysvallat, 94598
- John Muir Medical Center-Walnut Creek
-
-
Colorado
-
Aurora, Colorado, Yhdysvallat, 80045
- UCHealth University of Colorado Hospital
-
Denver, Colorado, Yhdysvallat, 80206
- UCHealth - Cherry Creek
-
Denver, Colorado, Yhdysvallat, 80210
- AdventHealth Porter
-
Grand Junction, Colorado, Yhdysvallat, 81505
- Grand Valley Oncology
-
Greeley, Colorado, Yhdysvallat, 80631
- Banner North Colorado Medical Center
-
Highlands Ranch, Colorado, Yhdysvallat, 80129
- UCHealth Highlands Ranch Hospital
-
Loveland, Colorado, Yhdysvallat, 80539
- Banner North Colorado Medical Center - Loveland Campus
-
-
Connecticut
-
Danbury, Connecticut, Yhdysvallat, 06810
- Danbury Hospital
-
Derby, Connecticut, Yhdysvallat, 06418
- Smilow Cancer Hospital-Derby Care Center
-
Fairfield, Connecticut, Yhdysvallat, 06824
- Smilow Cancer Hospital Care Center-Fairfield
-
Glastonbury, Connecticut, Yhdysvallat, 06033
- Smilow Cancer Hospital Care Center at Glastonbury
-
Greenwich, Connecticut, Yhdysvallat, 06830
- Smilow Cancer Hospital Care Center at Greenwich
-
Guilford, Connecticut, Yhdysvallat, 06437
- Smilow Cancer Hospital Care Center - Guilford
-
Hartford, Connecticut, Yhdysvallat, 06105
- Smilow Cancer Hospital Care Center at Saint Francis
-
New Haven, Connecticut, Yhdysvallat, 06520
- Yale University
-
North Haven, Connecticut, Yhdysvallat, 06473
- Yale-New Haven Hospital North Haven Medical Center
-
Norwalk, Connecticut, Yhdysvallat, 06856
- Norwalk Hospital
-
Stamford, Connecticut, Yhdysvallat, 06902
- Smilow Cancer Hospital Care Center at Long Ridge
-
Torrington, Connecticut, Yhdysvallat, 06790
- Smilow Cancer Hospital-Torrington Care Center
-
Trumbull, Connecticut, Yhdysvallat, 06611
- Smilow Cancer Hospital Care Center-Trumbull
-
Waterbury, Connecticut, Yhdysvallat, 06708
- Smilow Cancer Hospital-Waterbury Care Center
-
Waterford, Connecticut, Yhdysvallat, 06385
- Smilow Cancer Hospital Care Center - Waterford
-
-
Delaware
-
Newark, Delaware, Yhdysvallat, 19713
- Helen F Graham Cancer Center
-
Newark, Delaware, Yhdysvallat, 19713
- Medical Oncology Hematology Consultants PA
-
-
District of Columbia
-
Washington D.C., District of Columbia, Yhdysvallat, 20037
- George Washington University Medical Center
-
Washington D.C., District of Columbia, Yhdysvallat, 20016
- Sibley Memorial Hospital
-
-
Florida
-
Fort Lauderdale, Florida, Yhdysvallat, 33316
- Broward Health Medical Center
-
Jupiter, Florida, Yhdysvallat, 33458
- Jupiter Medical Center
-
N. Venice, Florida, Yhdysvallat, 34275
- Sarasota Memorial Hospital-Venice
-
Orlando, Florida, Yhdysvallat, 32803
- AdventHealth Orlando
-
Sarasota, Florida, Yhdysvallat, 34239
- Sarasota Memorial Hospital
-
Sarasota, Florida, Yhdysvallat, 34239
- Florida Cancer Specialists - Sarasota Downtown
-
Sarasota, Florida, Yhdysvallat, 34239
- FPG - Surgical Oncology Clinics Gynecologic Oncology Surgery
-
Venice, Florida, Yhdysvallat, 34275
- Florida Cancer Specialists - Venice Pinebrook
-
-
Georgia
-
Atlanta, Georgia, Yhdysvallat, 30308
- Emory University Hospital Midtown
-
Atlanta, Georgia, Yhdysvallat, 30322
- Emory University Hospital/Winship Cancer Institute
-
Atlanta, Georgia, Yhdysvallat, 30342
- Emory Saint Joseph's Hospital
-
Atlanta, Georgia, Yhdysvallat, 30303
- Grady Health System
-
Atlanta, Georgia, Yhdysvallat, 30309
- Piedmont Hospital
-
Augusta, Georgia, Yhdysvallat, 30912
- Augusta University Medical Center
-
Decatur, Georgia, Yhdysvallat, 30033
- Emory Decatur Hospital
-
Savannah, Georgia, Yhdysvallat, 31405
- Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
-
-
Hawaii
-
Honolulu, Hawaii, Yhdysvallat, 96813
- Queen's Medical Center
-
Honolulu, Hawaii, Yhdysvallat, 96826
- Kapiolani Medical Center for Women and Children
-
-
Idaho
-
Boise, Idaho, Yhdysvallat, 83706
- Saint Alphonsus Cancer Care Center-Boise
-
Boise, Idaho, Yhdysvallat, 83712
- Saint Luke's Cancer Institute - Boise
-
Caldwell, Idaho, Yhdysvallat, 83605
- Saint Alphonsus Cancer Care Center-Caldwell
-
Coeur d'Alene, Idaho, Yhdysvallat, 83814
- Kootenai Health - Coeur d'Alene
-
Fruitland, Idaho, Yhdysvallat, 83619
- Saint Luke's Cancer Institute - Fruitland
-
Meridian, Idaho, Yhdysvallat, 83642
- Saint Luke's Cancer Institute - Meridian
-
Nampa, Idaho, Yhdysvallat, 83687
- Saint Alphonsus Cancer Care Center-Nampa
-
Nampa, Idaho, Yhdysvallat, 83687
- Saint Luke's Cancer Institute - Nampa
-
Post Falls, Idaho, Yhdysvallat, 83854
- Kootenai Clinic Cancer Services - Post Falls
-
Sandpoint, Idaho, Yhdysvallat, 83864
- Kootenai Clinic Cancer Services - Sandpoint
-
Twin Falls, Idaho, Yhdysvallat, 83301
- Saint Luke's Cancer Institute - Twin Falls
-
-
Illinois
-
Arlington Heights, Illinois, Yhdysvallat, 60005
- Northwest Community Hospital
-
Aurora, Illinois, Yhdysvallat, 60504
- Rush-Copley Medical Center
-
Centralia, Illinois, Yhdysvallat, 62801
- Centralia Oncology Clinic
-
Chicago, Illinois, Yhdysvallat, 60611
- Northwestern University
-
Chicago, Illinois, Yhdysvallat, 60637
- University of Chicago Comprehensive Cancer Center
-
Chicago, Illinois, Yhdysvallat, 60612
- John H Stroger Jr Hospital of Cook County
-
Chicago, Illinois, Yhdysvallat, 60612
- Rush MD Anderson Cancer Center
-
Danville, Illinois, Yhdysvallat, 61832
- Carle at The Riverfront
-
DeKalb, Illinois, Yhdysvallat, 60115
- Northwestern Medicine Cancer Center Kishwaukee
-
Decatur, Illinois, Yhdysvallat, 62526
- Decatur Memorial Hospital
-
Decatur, Illinois, Yhdysvallat, 62526
- Cancer Care Specialists of Illinois - Decatur
-
Effingham, Illinois, Yhdysvallat, 62401
- Crossroads Cancer Center
-
Effingham, Illinois, Yhdysvallat, 62401
- Carle Physician Group-Effingham
-
Evanston, Illinois, Yhdysvallat, 60201
- NorthShore University HealthSystem-Evanston Hospital
-
Geneva, Illinois, Yhdysvallat, 60134
- Northwestern Medicine Cancer Center Delnor
-
Glenview, Illinois, Yhdysvallat, 60026
- NorthShore University HealthSystem-Glenbrook Hospital
-
Glenview, Illinois, Yhdysvallat, 60026
- Northwestern Medicine Glenview Outpatient Center
-
Grayslake, Illinois, Yhdysvallat, 60030
- Northwestern Medicine Grayslake Outpatient Center
-
Harvey, Illinois, Yhdysvallat, 60426
- Ingalls Memorial Hospital
-
Highland Park, Illinois, Yhdysvallat, 60035
- NorthShore University HealthSystem-Highland Park Hospital
-
Hinsdale, Illinois, Yhdysvallat, 60521
- Sudarshan K Sharma MD Limited-Gynecologic Oncology
-
Lake Forest, Illinois, Yhdysvallat, 60045
- Northwestern Medicine Lake Forest Hospital
-
Mattoon, Illinois, Yhdysvallat, 61938
- Carle Physician Group-Mattoon/Charleston
-
New Lenox, Illinois, Yhdysvallat, 60451
- UC Comprehensive Cancer Center at Silver Cross
-
Normal, Illinois, Yhdysvallat, 61761
- Carle Cancer Institute Normal
-
O'Fallon, Illinois, Yhdysvallat, 62269
- Cancer Care Center of O'Fallon
-
Orland Park, Illinois, Yhdysvallat, 60462
- University of Chicago Medicine-Orland Park
-
Orland Park, Illinois, Yhdysvallat, 60462
- Northwestern Medicine Orland Park
-
Rockford, Illinois, Yhdysvallat, 61114
- UW Health Carbone Cancer Center Rockford
-
Springfield, Illinois, Yhdysvallat, 62702
- Southern Illinois University School of Medicine
-
Springfield, Illinois, Yhdysvallat, 62702
- Springfield Clinic
-
Springfield, Illinois, Yhdysvallat, 62781
- Springfield Memorial Hospital
-
Urbana, Illinois, Yhdysvallat, 61801
- Carle Cancer Center
-
Warrenville, Illinois, Yhdysvallat, 60555
- Northwestern Medicine Cancer Center Warrenville
-
Yorkville, Illinois, Yhdysvallat, 60560
- Rush-Copley Healthcare Center
-
-
Indiana
-
Carmel, Indiana, Yhdysvallat, 46032
- IU Health North Hospital
-
Crown Point, Indiana, Yhdysvallat, 46307
- UChicago Medicine Northwest Indiana
-
Crown Point, Indiana, Yhdysvallat, 46307
- Northwest Cancer Center - Crown Point
-
Dyer, Indiana, Yhdysvallat, 46311
- Northwest Oncology LLC
-
Goshen, Indiana, Yhdysvallat, 46526
- Goshen Center for Cancer Care
-
Hobart, Indiana, Yhdysvallat, 46342
- Northwest Cancer Center - Hobart
-
Hobart, Indiana, Yhdysvallat, 46342
- Saint Mary Medical Center
-
Indianapolis, Indiana, Yhdysvallat, 46237
- Franciscan Health Indianapolis
-
Indianapolis, Indiana, Yhdysvallat, 46202
- Indiana University/Melvin and Bren Simon Cancer Center
-
Indianapolis, Indiana, Yhdysvallat, 46260
- Ascension Saint Vincent Indianapolis Hospital
-
Indianapolis, Indiana, Yhdysvallat, 46312
- Saint Catherine Hospital
-
Lafayette, Indiana, Yhdysvallat, 47905
- Franciscan Saint Elizabeth Health - Lafayette East
-
Mooresville, Indiana, Yhdysvallat, 46158
- Franciscan Health Mooresville
-
Munster, Indiana, Yhdysvallat, 46321
- The Community Hospital
-
Munster, Indiana, Yhdysvallat, 46321
- Women's Diagnostic Center - Munster
-
South Bend, Indiana, Yhdysvallat, 46601
- Memorial Hospital of South Bend
-
Valparaiso, Indiana, Yhdysvallat, 46383
- Northwest Cancer Center - Valparaiso
-
-
Iowa
-
Ames, Iowa, Yhdysvallat, 50010
- Mary Greeley Medical Center
-
Ames, Iowa, Yhdysvallat, 50010
- McFarland Clinic - Ames
-
Boone, Iowa, Yhdysvallat, 50036
- McFarland Clinic - Boone
-
Council Bluffs, Iowa, Yhdysvallat, 51503
- Heartland Oncology and Hematology LLP
-
Council Bluffs, Iowa, Yhdysvallat, 51503
- Nebraska Cancer Specialists/Oncology Hematology West PC - MEJ
-
Fort Dodge, Iowa, Yhdysvallat, 50501
- McFarland Clinic - Trinity Cancer Center
-
Iowa City, Iowa, Yhdysvallat, 52242
- University of Iowa/Holden Comprehensive Cancer Center
-
Jefferson, Iowa, Yhdysvallat, 50129
- McFarland Clinic - Jefferson
-
Marshalltown, Iowa, Yhdysvallat, 50158
- McFarland Clinic - Marshalltown
-
-
Kansas
-
Shawnee Mission, Kansas, Yhdysvallat, 66204
- AdventHealth Shawnee Mission
-
-
Kentucky
-
Edgewood, Kentucky, Yhdysvallat, 41017
- Saint Elizabeth Healthcare Edgewood
-
Lexington, Kentucky, Yhdysvallat, 40503
- Baptist Health Lexington
-
Louisville, Kentucky, Yhdysvallat, 40207
- Baptist Health Louisville
-
-
Louisiana
-
Baton Rouge, Louisiana, Yhdysvallat, 70805
- LSU Health Baton Rouge-North Clinic
-
Baton Rouge, Louisiana, Yhdysvallat, 70817
- Our Lady of the Lake Medical Oncology
-
Baton Rouge, Louisiana, Yhdysvallat, 70808
- Our Lady of the Lake Physician Group
-
Covington, Louisiana, Yhdysvallat, 70433
- Ochsner Hematology Oncology North Shore - Covington (West Region)
-
Marrero, Louisiana, Yhdysvallat, 70072
- West Jefferson Medical Center
-
Metairie, Louisiana, Yhdysvallat, 70006
- East Jefferson General Hospital
-
Metairie, Louisiana, Yhdysvallat, 70006
- LSU Healthcare Network / Metairie Multi-Specialty Clinic
-
New Orleans, Louisiana, Yhdysvallat, 70121
- Ochsner Medical Center Jefferson
-
New Orleans, Louisiana, Yhdysvallat, 70112
- University Medical Center New Orleans
-
New Orleans, Louisiana, Yhdysvallat, 70115
- Ochsner Baptist Medical Center
-
-
Maine
-
Augusta, Maine, Yhdysvallat, 04330
- Harold Alfond Center for Cancer Care
-
Scarborough, Maine, Yhdysvallat, 04074
- MaineHealth Maine Medical Center- Scarborough
-
-
Maryland
-
Baltimore, Maryland, Yhdysvallat, 21237
- MedStar Franklin Square Medical Center/Weinberg Cancer Institute
-
Baltimore, Maryland, Yhdysvallat, 21287
- Johns Hopkins University/Sidney Kimmel Cancer Center
-
Baltimore, Maryland, Yhdysvallat, 21215
- Sinai Hospital of Baltimore
-
Baltimore, Maryland, Yhdysvallat, 21204
- Greater Baltimore Medical Center
-
Bethesda, Maryland, Yhdysvallat, 20889-5600
- Walter Reed National Military Medical Center
-
Westminster, Maryland, Yhdysvallat, 21157
- William E Kahlert Regional Cancer Center/Sinai Hospital
-
-
Massachusetts
-
Springfield, Massachusetts, Yhdysvallat, 01199
- Baystate Medical Center
-
-
Michigan
-
Ann Arbor, Michigan, Yhdysvallat, 48109
- University of Michigan Rogel Cancer Center
-
Battle Creek, Michigan, Yhdysvallat, 49017
- Bronson Battle Creek
-
Brighton, Michigan, Yhdysvallat, 48114
- Trinity Health IHA Medical Group Hematology Oncology - Brighton
-
Canton, Michigan, Yhdysvallat, 48188
- Trinity Health IHA Medical Group Hematology Oncology - Canton
-
Chelsea, Michigan, Yhdysvallat, 48118
- Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
-
Detroit, Michigan, Yhdysvallat, 48201
- Wayne State University/Karmanos Cancer Institute
-
Farmington Hills, Michigan, Yhdysvallat, 48334
- Weisberg Cancer Treatment Center
-
Farmington Hills, Michigan, Yhdysvallat, 48336
- Corewell Health Farmington Hills Hospital
-
Flint, Michigan, Yhdysvallat, 48503
- Hurley Medical Center
-
Flint, Michigan, Yhdysvallat, 48503
- Genesee Hematology Oncology PC
-
Flint, Michigan, Yhdysvallat, 48503
- Genesys Hurley Cancer Institute
-
Flint, Michigan, Yhdysvallat, 48503
- Cancer Hematology Centers - Flint
-
Grand Rapids, Michigan, Yhdysvallat, 49503
- Trinity Health Grand Rapids Hospital
-
Grand Rapids, Michigan, Yhdysvallat, 49503
- Corewell Health Grand Rapids Hospitals - Butterworth Hospital
-
Kalamazoo, Michigan, Yhdysvallat, 49007
- West Michigan Cancer Center
-
Kalamazoo, Michigan, Yhdysvallat, 49007
- Bronson Methodist Hospital
-
Kalamazoo, Michigan, Yhdysvallat, 49009
- Beacon Kalamazoo Cancer Center
-
Lansing, Michigan, Yhdysvallat, 48912
- University of Michigan Health - Sparrow Lansing
-
Livonia, Michigan, Yhdysvallat, 48154
- Trinity Health Saint Mary Mercy Livonia Hospital
-
Muskegon, Michigan, Yhdysvallat, 49444
- Trinity Health Muskegon Hospital
-
Niles, Michigan, Yhdysvallat, 49120
- Corewell Health Lakeland Hospitals - Niles Hospital
-
Norton Shores, Michigan, Yhdysvallat, 49444
- Cancer and Hematology Centers of Western Michigan - Norton Shores
-
Pontiac, Michigan, Yhdysvallat, 48341
- Trinity Health Saint Joseph Mercy Oakland Hospital
-
Reed City, Michigan, Yhdysvallat, 49677
- Corewell Health Reed City Hospital
-
Royal Oak, Michigan, Yhdysvallat, 48073
- Corewell Health William Beaumont University Hospital
-
Saginaw, Michigan, Yhdysvallat, 48604
- Oncology Hematology Associates of Saginaw Valley PC
-
Saginaw, Michigan, Yhdysvallat, 48601
- MyMichigan Medical Center Saginaw
-
Saint Joseph, Michigan, Yhdysvallat, 49085
- Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
-
Saint Joseph, Michigan, Yhdysvallat, 49085
- Corewell Health Lakeland Hospitals - Saint Joseph Hospital
-
Tawas City, Michigan, Yhdysvallat, 48764
- MyMichigan Medical Center Tawas
-
Traverse City, Michigan, Yhdysvallat, 49684
- Munson Medical Center
-
Troy, Michigan, Yhdysvallat, 48085
- Corewell Health Beaumont Troy Hospital
-
West Branch, Michigan, Yhdysvallat, 48661
- Saint Mary's Oncology/Hematology Associates of West Branch
-
Wyoming, Michigan, Yhdysvallat, 49519
- University of Michigan Health - West
-
Ypsilanti, Michigan, Yhdysvallat, 48197
- Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
-
-
Minnesota
-
Coon Rapids, Minnesota, Yhdysvallat, 55433
- Mercy Hospital
-
Edina, Minnesota, Yhdysvallat, 55435
- Fairview Southdale Hospital
-
Edina, Minnesota, Yhdysvallat, 55435
- Minnesota Oncology - Edina
-
Maplewood, Minnesota, Yhdysvallat, 55109
- Minnesota Oncology Hematology PA-Maplewood
-
Marshall, Minnesota, Yhdysvallat, 56258
- Avera Cancer Institute at Marshall
-
Minneapolis, Minnesota, Yhdysvallat, 55407
- Abbott-Northwestern Hospital
-
Minneapolis, Minnesota, Yhdysvallat, 55455
- University of Minnesota/Masonic Cancer Center
-
Saint Louis Park, Minnesota, Yhdysvallat, 55416
- Park Nicollet Clinic - Saint Louis Park
-
Saint Paul, Minnesota, Yhdysvallat, 55101
- Regions Hospital
-
Saint Paul, Minnesota, Yhdysvallat, 55102
- United Hospital
-
Woodbury, Minnesota, Yhdysvallat, 55125
- Minnesota Oncology Hematology PA-Woodbury
-
-
Missouri
-
Columbia, Missouri, Yhdysvallat, 65212
- MU Health - University Hospital/Ellis Fischel Cancer Center
-
Rolla, Missouri, Yhdysvallat, 65401
- Phelps Health Delbert Day Cancer Institute
-
Springfield, Missouri, Yhdysvallat, 65807
- CoxHealth South Hospital
-
St Louis, Missouri, Yhdysvallat, 63110
- Washington University School of Medicine
-
St Louis, Missouri, Yhdysvallat, 63141
- Mercy Hospital Saint Louis
-
St Louis, Missouri, Yhdysvallat, 63128
- Mercy Hospital South
-
-
Montana
-
Anaconda, Montana, Yhdysvallat, 59711
- Community Hospital of Anaconda
-
Billings, Montana, Yhdysvallat, 59101
- Billings Clinic Cancer Center
-
Billings, Montana, Yhdysvallat, 59102
- Saint Vincent Frontier Cancer Center
-
Billings, Montana, Yhdysvallat, 59106
- Intermountain Health West End Clinic
-
Bozeman, Montana, Yhdysvallat, 59715
- Bozeman Health Deaconess Hospital
-
Great Falls, Montana, Yhdysvallat, 59405
- Benefis Sletten Cancer Institute
-
Kalispell, Montana, Yhdysvallat, 59901
- Logan Health Medical Center
-
Missoula, Montana, Yhdysvallat, 59802
- Saint Patrick Hospital - Community Hospital
-
Missoula, Montana, Yhdysvallat, 59804
- Community Medical Center
-
-
Nebraska
-
Omaha, Nebraska, Yhdysvallat, 68114
- Nebraska Methodist Hospital
-
Omaha, Nebraska, Yhdysvallat, 68198
- University of Nebraska Medical Center
-
Omaha, Nebraska, Yhdysvallat, 68124
- Alegent Health Bergan Mercy Medical Center
-
Omaha, Nebraska, Yhdysvallat, 68114
- Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
-
-
Nevada
-
Las Vegas, Nevada, Yhdysvallat, 89102
- OptumCare Cancer Care at Charleston
-
Las Vegas, Nevada, Yhdysvallat, 89106
- Women's Cancer Center of Nevada
-
Las Vegas, Nevada, Yhdysvallat, 89183
- OptumCare Cancer Care at Fort Apache
-
-
New Jersey
-
Basking Ridge, New Jersey, Yhdysvallat, 07920
- Memorial Sloan Kettering Basking Ridge
-
Camden, New Jersey, Yhdysvallat, 08103
- Cooper Hospital University Medical Center
-
Hackensack, New Jersey, Yhdysvallat, 07601
- Hackensack University Medical Center
-
Lakewood, New Jersey, Yhdysvallat, 08701
- Monmouth Medical Center Southern Campus
-
Livingston, New Jersey, Yhdysvallat, 07039
- Cooperman Barnabas Medical Center
-
Long Branch, New Jersey, Yhdysvallat, 07740
- Monmouth Medical Center
-
Middletown, New Jersey, Yhdysvallat, 07748
- Memorial Sloan Kettering Monmouth
-
Montvale, New Jersey, Yhdysvallat, 07645
- Memorial Sloan Kettering Bergen
-
Moorestown, New Jersey, Yhdysvallat, 08057
- Virtua Samson Cancer Center
-
Neptune City, New Jersey, Yhdysvallat, 07753
- Jersey Shore Medical Center
-
New Brunswick, New Jersey, Yhdysvallat, 08903
- Rutgers Cancer Institute of New Jersey
-
Newark, New Jersey, Yhdysvallat, 07101
- Rutgers New Jersey Medical School
-
Red Bank, New Jersey, Yhdysvallat, 07701
- Riverview Medical Center/Booker Cancer Center
-
Sewell, New Jersey, Yhdysvallat, 08080
- Sidney Kimmel Cancer Center Washington Township
-
Somerville, New Jersey, Yhdysvallat, 08876
- Robert Wood Johnson University Hospital Somerset
-
Toms River, New Jersey, Yhdysvallat, 08755
- Community Medical Center
-
Voorhees Township, New Jersey, Yhdysvallat, 08043
- Virtua Voorhees
-
-
New Mexico
-
Albuquerque, New Mexico, Yhdysvallat, 87106
- University of New Mexico Cancer Center
-
Albuquerque, New Mexico, Yhdysvallat, 87110
- Presbyterian Kaseman Hospital
-
Rio Rancho, New Mexico, Yhdysvallat, 87124
- Presbyterian Rust Medical Center/Jorgensen Cancer Center
-
-
New York
-
Albany, New York, Yhdysvallat, 12208
- Women's Cancer Care Associates LLC
-
Commack, New York, Yhdysvallat, 11725
- Memorial Sloan Kettering Commack
-
Harrison, New York, Yhdysvallat, 10604
- Memorial Sloan Kettering Westchester
-
Mineola, New York, Yhdysvallat, 11501
- NYU Langone Hospital - Long Island
-
New York, New York, Yhdysvallat, 10065
- Memorial Sloan Kettering Cancer Center
-
New York, New York, Yhdysvallat, 10029
- Mount Sinai Hospital
-
New York, New York, Yhdysvallat, 10011
- Mount Sinai Chelsea
-
New York, New York, Yhdysvallat, 10016
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
-
Rochester, New York, Yhdysvallat, 14642
- University of Rochester
-
Syracuse, New York, Yhdysvallat, 13210
- State University of New York Upstate Medical University
-
The Bronx, New York, Yhdysvallat, 10461
- Montefiore Medical Center-Einstein Campus
-
The Bronx, New York, Yhdysvallat, 10467
- Montefiore Medical Center - Moses Campus
-
The Bronx, New York, Yhdysvallat, 10461
- Montefiore Medical Center-Weiler Hospital
-
Uniondale, New York, Yhdysvallat, 11553
- Memorial Sloan Kettering Nassau
-
Webster, New York, Yhdysvallat, 14580
- Wilmot Cancer Institute at Webster
-
-
North Carolina
-
Cary, North Carolina, Yhdysvallat, 27518
- Duke Cancer Center Cary
-
Chapel Hill, North Carolina, Yhdysvallat, 27599
- UNC Lineberger Comprehensive Cancer Center
-
Durham, North Carolina, Yhdysvallat, 27710
- Duke University Medical Center
-
Greenville, North Carolina, Yhdysvallat, 27834
- ECU Health Medical Center
-
High Point, North Carolina, Yhdysvallat, 27262
- Hayworth Cancer Center
-
Raleigh, North Carolina, Yhdysvallat, 27607
- Duke Women's Cancer Care Raleigh
-
Wilmington, North Carolina, Yhdysvallat, 28401
- Novant Health New Hanover Regional Medical Center
-
Winston-Salem, North Carolina, Yhdysvallat, 27157
- Wake Forest University Health Sciences
-
-
North Dakota
-
Bismarck, North Dakota, Yhdysvallat, 58501
- Sanford Bismarck Medical Center
-
Fargo, North Dakota, Yhdysvallat, 58122
- Sanford Roger Maris Cancer Center
-
Fargo, North Dakota, Yhdysvallat, 58122
- Sanford Broadway Medical Center
-
-
Ohio
-
Beachwood, Ohio, Yhdysvallat, 44122
- UHHS-Chagrin Highlands Medical Center
-
Belpre, Ohio, Yhdysvallat, 45714
- Strecker Cancer Center-Belpre
-
Canton, Ohio, Yhdysvallat, 44710
- Aultman Health Foundation
-
Centerville, Ohio, Yhdysvallat, 45459
- Miami Valley Hospital South
-
Chardon, Ohio, Yhdysvallat, 44024
- Geauga Hospital
-
Chillicothe, Ohio, Yhdysvallat, 45601
- Adena Regional Medical Center
-
Cincinnati, Ohio, Yhdysvallat, 45220
- Good Samaritan Hospital - Cincinnati
-
Cleveland, Ohio, Yhdysvallat, 44106
- Case Western Reserve University
-
Cleveland, Ohio, Yhdysvallat, 44109
- MetroHealth Medical Center
-
Columbus, Ohio, Yhdysvallat, 43214
- Riverside Methodist Hospital
-
Columbus, Ohio, Yhdysvallat, 43210
- Ohio State University Comprehensive Cancer Center
-
Columbus, Ohio, Yhdysvallat, 43219
- The Mark H Zangmeister Center
-
Columbus, Ohio, Yhdysvallat, 43213
- Mount Carmel East Hospital
-
Dayton, Ohio, Yhdysvallat, 45409
- Miami Valley Hospital
-
Dayton, Ohio, Yhdysvallat, 45415
- Miami Valley Hospital North
-
Franklin, Ohio, Yhdysvallat, 45005-1066
- Atrium Medical Center-Middletown Regional Hospital
-
Greenville, Ohio, Yhdysvallat, 45331
- Miami Valley Cancer Care and Infusion
-
Grove City, Ohio, Yhdysvallat, 43123
- Mount Carmel Grove City Hospital
-
Lancaster, Ohio, Yhdysvallat, 43130
- Fairfield Medical Center
-
Lima, Ohio, Yhdysvallat, 45801
- Saint Rita's Medical Center
-
Marietta, Ohio, Yhdysvallat, 45750
- Marietta Memorial Hospital
-
Marysville, Ohio, Yhdysvallat, 43040
- Memorial Hospital
-
Mentor, Ohio, Yhdysvallat, 44060
- UH Seidman Cancer Center at Lake Health Mentor Campus
-
Mount Vernon, Ohio, Yhdysvallat, 43050
- Knox Community Hospital
-
Newark, Ohio, Yhdysvallat, 43055
- Licking Memorial Hospital
-
Parma, Ohio, Yhdysvallat, 44129
- University Hospitals Parma Medical Center
-
Perrysburg, Ohio, Yhdysvallat, 43551
- Mercy Health - Perrysburg Hospital
-
Portsmouth, Ohio, Yhdysvallat, 45662
- Southern Ohio Medical Center
-
Springfield, Ohio, Yhdysvallat, 45504
- Springfield Regional Cancer Center
-
Springfield, Ohio, Yhdysvallat, 45504
- Springfield Regional Medical Center
-
Sylvania, Ohio, Yhdysvallat, 43560
- ProMedica Flower Hospital
-
Toledo, Ohio, Yhdysvallat, 43623
- Mercy Health - Saint Anne Hospital
-
Toledo, Ohio, Yhdysvallat, 43608
- Mercy Health - Saint Vincent Hospital
-
Troy, Ohio, Yhdysvallat, 45373
- Upper Valley Medical Center
-
Westerville, Ohio, Yhdysvallat, 43081
- Saint Ann's Hospital
-
Westlake, Ohio, Yhdysvallat, 44145
- UH Seidman Cancer Center at Saint John Medical Center
-
Zanesville, Ohio, Yhdysvallat, 43701
- Genesis Healthcare System Cancer Care Center
-
-
Oklahoma
-
Oklahoma City, Oklahoma, Yhdysvallat, 73104
- University of Oklahoma Health Sciences Center
-
Oklahoma City, Oklahoma, Yhdysvallat, 73120
- Mercy Hospital Oklahoma City
-
Tulsa, Oklahoma, Yhdysvallat, 74146
- Oklahoma Cancer Specialists and Research Institute-Tulsa
-
-
Oregon
-
Clackamas, Oregon, Yhdysvallat, 97015
- Providence Cancer Institute Clackamas Clinic
-
Newberg, Oregon, Yhdysvallat, 97132
- Providence Newberg Medical Center
-
Ontario, Oregon, Yhdysvallat, 97914
- Saint Alphonsus Cancer Care Center-Ontario
-
Portland, Oregon, Yhdysvallat, 97239
- Oregon Health and Science University
-
Portland, Oregon, Yhdysvallat, 97210
- Legacy Good Samaritan Hospital and Medical Center
-
Portland, Oregon, Yhdysvallat, 97213
- Providence Portland Medical Center
-
Portland, Oregon, Yhdysvallat, 97225
- Providence Saint Vincent Medical Center
-
Tualatin, Oregon, Yhdysvallat, 97062
- Legacy Meridian Park Hospital
-
-
Pennsylvania
-
Allentown, Pennsylvania, Yhdysvallat, 18103
- Lehigh Valley Hospital-Cedar Crest
-
Allentown, Pennsylvania, Yhdysvallat, 18104
- Saint Luke's Cancer Center - Allentown
-
Bethlehem, Pennsylvania, Yhdysvallat, 18017
- Lehigh Valley Hospital - Muhlenberg
-
Bethlehem, Pennsylvania, Yhdysvallat, 18015
- Saint Luke's University Hospital-Bethlehem Campus
-
Bryn Mawr, Pennsylvania, Yhdysvallat, 19010
- Bryn Mawr Hospital
-
East Stroudsburg, Pennsylvania, Yhdysvallat, 18301
- Pocono Medical Center
-
Easton, Pennsylvania, Yhdysvallat, 18045
- Saint Luke's Hospital-Anderson Campus
-
Erie, Pennsylvania, Yhdysvallat, 16544
- Saint Vincent Hospital
-
Hazleton, Pennsylvania, Yhdysvallat, 18201
- Lehigh Valley Hospital-Hazleton
-
Jefferson Hills, Pennsylvania, Yhdysvallat, 15025
- Jefferson Hospital
-
Media, Pennsylvania, Yhdysvallat, 19063
- Riddle Memorial Hospital
-
Monroeville, Pennsylvania, Yhdysvallat, 15146
- Forbes Hospital
-
Paoli, Pennsylvania, Yhdysvallat, 19301
- Paoli Memorial Hospital
-
Philadelphia, Pennsylvania, Yhdysvallat, 19111
- Fox Chase Cancer Center
-
Philadelphia, Pennsylvania, Yhdysvallat, 19107
- Thomas Jefferson University Hospital
-
Philadelphia, Pennsylvania, Yhdysvallat, 19107
- Pennsylvania Hospital
-
Pittsburgh, Pennsylvania, Yhdysvallat, 15224
- West Penn Hospital
-
Quakertown, Pennsylvania, Yhdysvallat, 18951
- Saint Luke's Hospital - Upper Bucks Campus
-
West Chester, Pennsylvania, Yhdysvallat, 19380
- Chester County Hospital
-
Wexford, Pennsylvania, Yhdysvallat, 15090
- Wexford Health and Wellness Pavilion
-
Willow Grove, Pennsylvania, Yhdysvallat, 19090
- Asplundh Cancer Pavilion
-
Wynnewood, Pennsylvania, Yhdysvallat, 19096
- Lankenau Medical Center
-
-
Rhode Island
-
Providence, Rhode Island, Yhdysvallat, 02905
- Women and Infants Hospital
-
Westerly, Rhode Island, Yhdysvallat, 02891
- Smilow Cancer Hospital Care Center - Westerly
-
-
South Carolina
-
Bluffton, South Carolina, Yhdysvallat, 29910
- Saint Joseph's/Candler - Bluffton Campus
-
Charleston, South Carolina, Yhdysvallat, 29425
- Medical University of South Carolina
-
-
South Dakota
-
Aberdeen, South Dakota, Yhdysvallat, 57401
- Avera Cancer Institute-Aberdeen
-
Rapid City, South Dakota, Yhdysvallat, 57701
- Rapid City Regional Hospital
-
Sioux Falls, South Dakota, Yhdysvallat, 57105
- Avera Cancer Institute
-
Sioux Falls, South Dakota, Yhdysvallat, 57117-5134
- Sanford USD Medical Center - Sioux Falls
-
Sioux Falls, South Dakota, Yhdysvallat, 57104
- Sanford Cancer Center Oncology Clinic
-
-
Tennessee
-
Germantown, Tennessee, Yhdysvallat, 38138
- The West Clinic - Wolf River
-
-
Texas
-
Austin, Texas, Yhdysvallat, 78712
- University of Texas at Austin
-
Austin, Texas, Yhdysvallat, 78701
- Dell Seton Medical Center at The University of Texas
-
Dallas, Texas, Yhdysvallat, 75235
- Parkland Memorial Hospital
-
Dallas, Texas, Yhdysvallat, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Fort Worth, Texas, Yhdysvallat, 76104
- UT Southwestern/Simmons Cancer Center-Fort Worth
-
Fort Worth, Texas, Yhdysvallat, 76104
- Tarrant County Hospital District/JPS Health Network
-
Houston, Texas, Yhdysvallat, 77030
- Houston Methodist Hospital
-
Houston, Texas, Yhdysvallat, 77030
- Memorial Hermann Texas Medical Center
-
Houston, Texas, Yhdysvallat, 77070
- Methodist Willowbrook Hospital
-
Houston, Texas, Yhdysvallat, 77094
- Houston Methodist West Hospital
-
Nassau Bay, Texas, Yhdysvallat, 77058
- Houston Methodist Saint John Hospital
-
Richardson, Texas, Yhdysvallat, 75080
- UT Southwestern Clinical Center at Richardson/Plano
-
Sugar Land, Texas, Yhdysvallat, 77479
- Houston Methodist Sugar Land Hospital
-
The Woodlands, Texas, Yhdysvallat, 77385
- Houston Methodist The Woodlands Hospital
-
-
Utah
-
Salt Lake City, Utah, Yhdysvallat, 84112
- Huntsman Cancer Institute/University of Utah
-
South Jordan, Utah, Yhdysvallat, 84009
- South Jordan Health Center
-
-
Virginia
-
Charlottesville, Virginia, Yhdysvallat, 22908
- University of Virginia Cancer Center
-
Richmond, Virginia, Yhdysvallat, 23235
- VCU Massey Cancer Center at Stony Point
-
Richmond, Virginia, Yhdysvallat, 23229
- Henrico Doctor's Hospital
-
Richmond, Virginia, Yhdysvallat, 23298
- VCU Massey Comprehensive Cancer Center
-
Roanoke, Virginia, Yhdysvallat, 24033
- Carilion Roanoke Memorial Hospital
-
-
Washington
-
Edmonds, Washington, Yhdysvallat, 98026
- Swedish Cancer Institute-Edmonds
-
Seattle, Washington, Yhdysvallat, 98122
- Swedish Medical Center-First Hill
-
Vancouver, Washington, Yhdysvallat, 98686
- Legacy Salmon Creek Hospital
-
-
West Virginia
-
Charleston, West Virginia, Yhdysvallat, 25304
- Vandalia Health/CAMC Institute for Academic Medicine
-
Morgantown, West Virginia, Yhdysvallat, 26506
- West Virginia University Healthcare
-
-
Wisconsin
-
Eau Claire, Wisconsin, Yhdysvallat, 54701
- Marshfield Medical Center-EC Cancer Center
-
Green Bay, Wisconsin, Yhdysvallat, 54301
- Saint Vincent Hospital Cancer Center Green Bay
-
Green Bay, Wisconsin, Yhdysvallat, 54303
- Saint Vincent Hospital Cancer Center at Saint Mary's
-
La Crosse, Wisconsin, Yhdysvallat, 54601
- Gundersen Lutheran Medical Center
-
Madison, Wisconsin, Yhdysvallat, 53792
- University of Wisconsin Carbone Cancer Center - University Hospital
-
Madison, Wisconsin, Yhdysvallat, 53718
- University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
-
Marshfield, Wisconsin, Yhdysvallat, 54449
- Marshfield Medical Center-Marshfield
-
Milwaukee, Wisconsin, Yhdysvallat, 53226
- Medical College of Wisconsin
-
Minocqua, Wisconsin, Yhdysvallat, 54548
- Marshfield Medical Center - Minocqua
-
Mukwonago, Wisconsin, Yhdysvallat, 53149
- ProHealth D N Greenwald Center
-
New Richmond, Wisconsin, Yhdysvallat, 54017
- Cancer Center of Western Wisconsin
-
Oconomowoc, Wisconsin, Yhdysvallat, 53066
- ProHealth Oconomowoc Memorial Hospital
-
Oconto Falls, Wisconsin, Yhdysvallat, 54154
- Saint Vincent Hospital Cancer Center at Oconto Falls
-
Rice Lake, Wisconsin, Yhdysvallat, 54868
- Marshfield Medical Center-Rice Lake
-
Sheboygan, Wisconsin, Yhdysvallat, 53081
- Saint Vincent Hospital Cancer Center at Sheboygan
-
Sheboygan, Wisconsin, Yhdysvallat, 53081
- Sheboygan Physicians Group
-
Stevens Point, Wisconsin, Yhdysvallat, 54482
- Marshfield Medical Center-River Region at Stevens Point
-
Sturgeon Bay, Wisconsin, Yhdysvallat, 54235-1495
- Saint Vincent Hospital Cancer Center at Sturgeon Bay
-
Waukesha, Wisconsin, Yhdysvallat, 53188
- UW Cancer Center at ProHealth Care
-
Weston, Wisconsin, Yhdysvallat, 54476
- Marshfield Medical Center - Weston
-
-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
Inclusion Criteria:
-
Federation of Gynecology and Obstetrics (FIGO) 2009 stage IA-IVB, non-recurrent, chemotherapy (chemo)-naive, HER2-positive endometrial cancer. The following endometrial cancer types are eligible:
-
Serous
-
Other endometrial cancers (including clear cell, endometrioid, mixed epithelial, dedifferentiated/undifferentiated)
-
Carcinosarcoma
- NOTE: Endometrial cancers that are mismatch repair deficient (dMMR) by IHC are not eligible
-
-
Histologic confirmation of the original primary tumor is required. Submission of surgical pathology report (or endometrial biopsy pathology report in patients who never undergo hysterectomy) is required
-
Patients must be within 8 weeks of primary surgery (or endometrial biopsy in patients who never undergo hysterectomy) at the time of study registration
-
Patients may have measurable disease, non-measurable disease, or no measurable disease. In patients with measurable disease, lesions will be defined and monitored by RECIST v 1.1. Measurable disease is defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded). Each lesion must be >= 10 mm when measured by CT or magnetic resonance imaging (MRI). Lymph nodes must be >= 15 mm in short axis when measured by CT or MRI
-
For patients with uterine-confined (stage I) disease, the tumor must be invasive into the myometrium. Any amount of myoinvasion is acceptable for eligibility. Patients with non-invasive disease, endometrial intraepithelial carcinoma alone, or disease confined to a polyp will be excluded
-
All patients must have tumors that are HER2 positive as defined by American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) 2018 Breast Cancer guidelines. IHC and ISH testing will be done locally, at each participating institution and interpreted by local pathologists. In general HER2 positivity is defined as any of the following:
- 3+ immunohistochemistry (IHC),
- 2+ IHC with positive in situ hybridization (ISH) Alternatively, patients could be eligible if next generation sequencing (NGS) demonstrates HER2 (ERBB2) amplification. NGS testing can be performed through any designated labs as per the National Cancer Institute (NCI) MATCH/NCI Combo-MATCH trial.
Pathology report showing results of institutional HER2 testing (or NGS testing results) must be submitted.
Sites must submit all results available (IHC, ISH, and NGS)
-
Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2
-
Age >= 18
-
Platelets >= 100,000/mcl (within 14 days prior to registration)
-
Absolute neutrophil count (ANC) >= 1,500/mcl (within 14 days prior to registration)
-
Creatinine =< 1.5 x institutional/laboratory upper limit of normal (ULN) or estimated Glomerular filtration rate (eGFR) >= 50 mL/min using either the Cockcroft-Gault equation, the Modification of Diet in Renal Disease Study, or as reported in the comprehensive metabolic panel/basic metabolic panel (eGFR) (within 14 days prior to registration)
-
Total serum bilirubin level =< 1.5 x ULN (patients with known Gilbert's disease who have bilirubin level =< 3 x ULN may be enrolled) (within 14 days prior to registration)
-
Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 3 x ULN (within 14 days prior to registration)
-
Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months of registration are eligible for this trial
-
Although the uterus will have been removed in the vast majority of patients, for patients of child-bearing potential: negative urine or serum pregnancy test. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test is required. Patients will be considered of non-reproductive potential if they are either:
- Postmenopausal (defined as at least 12 months with no menses without an alternative medical cause; in women < 45 years of age, a high follicle stimulating hormone [FSH] level in the postmenopausal range may be used to confirm a postmenopausal state in women not using hormonal contraception or hormonal replacement therapy. In the absence of 12 months of amenorrhea, a single FSH measurement is insufficient); OR
- Have had a hysterectomy and/or bilateral oophorectomy, bilateral salpingectomy or bilateral tubal ligation/occlusion at least 6 weeks prior to registration
- Have a congenital or acquired condition that prevents childbearing
-
Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
-
Patients with evidence of chronic hepatitis B virus (HBV) infection must have an undetectable HBV viral load on suppressive therapy, if indicated
-
Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load
-
Patients with treated brain metastases are eligible if follow-up brain imaging after central nervous system (CNS)-directed therapy shows no evidence of progression
-
The patient or a legally authorized representative must provide study-specific informed consent prior to study entry and, for patients treated in the United States (U.S.), authorization permitting release of personal health information
Exclusion Criteria:
-
Prior Therapy:
-
Patients must NOT have received prior chemotherapy, biologic therapy, or targeted therapy for treatment of endometrial carcinoma
-
Patients must NOT have received prior radiation therapy for treatment of endometrial carcinoma. Prior radiation includes external beam pelvic radiation therapy, external beam extended field pelvic/para-aortic radiation therapy, and/or intravaginal brachytherapy
- NOTE: Vaginal brachytherapy for treatment of endometrial cancer is permitted during study treatment. Planned use of vaginal brachytherapy must be declared at time of registration
-
Patients may have received prior hormonal therapy for treatment of endometrial carcinoma. All hormonal therapy must be discontinued at least one week prior to registration
-
-
Patients may not have a planned interval cytoreduction or hysterectomy, prior to documentation of progression, after study registration
-
Patients may not have planned external beam radiotherapy, prior to documentation of progression, after study registration
-
Significant cardiovascular disease including:
- Uncontrolled hypertension, defined as systolic > 150 mm Hg or diastolic > 90 mm Hg despite antihypertensive medications
- Myocardial infarction or unstable angina within 6 months prior to registration
- New York Heart Association functional classification II, III or IV
- Serious cardiac arrhythmia requiring medication. This does not include asymptomatic, atrial fibrillation with controlled ventricular rate
-
Significant lung disease: dyspnea at rest grade 2 or greater (resulting from extensive tumor involvement or other causes), pneumonitis grade 2 or greater, interstitial lung disease grade 2 or greater, idiopathic pulmonary fibrosis, cystic fibrosis, Aspergillosis, active tuberculosis, or history of opportunistic infections (pneumocystis pneumonia or cytomegalovirus pneumonia)
-
Patients with uncontrolled intercurrent illness including, but not limited to: ongoing or active infection (except for uncomplicated urinary tract infection), uncontrolled interstitial lung disease, symptomatic congestive heart failure, or psychiatric illness/social situations that would limit compliance with study requirements
-
Treatment with strong CYP2C8 or CYP3A4 inhibitors or inducers within 14 days or 5 drug-elimination half-lives, whichever is longer, prior to registration
-
Women who are unwilling to discontinue nursing
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
|---|---|
|
Active Comparator: Arm I (paclitaxel, carboplatin)
Patients receive paclitaxel IV over 3 hours and carboplatin IV over 30-60 minutes on day 1 of each cycle. Cycles repeat every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. Patients with SD or PR who still have measurable disease after completion of cycle 6 may receive 4 additional cycles of this treatment at the discretion of the treating physician. Patients undergo ECHO or MUGA and CT throughout the study. Additionally, patients may optionally undergo blood sample collection throughout the study, vaginal brachytherapy on study, and urine sample collection prior to treatment. |
Given IV
Muut nimet:
Given IV
Muut nimet:
Undergo CT
Muut nimet:
Undergo ECHO
Muut nimet:
Undergo MUGA
Muut nimet:
Undergo blood and urine sample collection
Muut nimet:
Undergo vaginal brachytherapy
Muut nimet:
|
|
Kokeellinen: Arm II (paclitaxel, carboplatin, Herceptin Hylecta)
Patients receive paclitaxel IV over 3 hours, carboplatin IV over 30-60 minutes, and trastuzumab/hyaluronidase-oysk SC over 2-5 minutes on day 1 of each cycle. Cycles repeat every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. Patients with SD or PR who still have measurable disease after completion of cycle 6 may receive 4 additional cycles of this treatment at the discretion of the treating physician. MAINTENANCE: Patients receive trastuzumab/hyaluronidase-oysk SC over 2-5 minutes on day 1 of each cycle. Cycles repeat every 3 weeks for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients with SD or PR may continue maintenance therapy for up to 3 years from the start of treatment. Patients undergo ECHO or MUGA and CT throughout the study. Additionally patients may optionally undergo blood sample collection throughout the study, vaginal brachytherapy on study, and urine sample collection prior to treatment. |
Given IV
Muut nimet:
Given IV
Muut nimet:
Undergo CT
Muut nimet:
Undergo ECHO
Muut nimet:
Undergo MUGA
Muut nimet:
Undergo blood and urine sample collection
Muut nimet:
Undergo vaginal brachytherapy
Muut nimet:
Ancillary studies Given SC
Muut nimet:
|
|
Kokeellinen: Arm III (paclitaxel, carboplatin, Phesgo)
See Detailed Description. |
Given IV
Muut nimet:
Given IV
Muut nimet:
Undergo CT
Muut nimet:
Undergo ECHO
Muut nimet:
Undergo MUGA
Muut nimet:
Undergo blood and urine sample collection
Muut nimet:
Undergo vaginal brachytherapy
Muut nimet:
Ancillary studies Given SC
Muut nimet:
|
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Progression free survival
Aikaikkuna: From study entry to time of progression or death, whichever occurs first, or date of last contact if neither progression nor death has occurred, assessed up to 5 years from randomization
|
At the end of Phase 2 analysis, if both experimental arms demonstrate superiority to the reference, the experimental arms will be compared to each other. |
From study entry to time of progression or death, whichever occurs first, or date of last contact if neither progression nor death has occurred, assessed up to 5 years from randomization
|
|
Overall survival
Aikaikkuna: From study entry to time of death or the date of last contact, assessed up to 5 years from randomization
|
If both experimental arms demonstrate superiority to the reference arm, the experimental arms will be compared to each other. |
From study entry to time of death or the date of last contact, assessed up to 5 years from randomization
|
|
Incidence of dose limiting toxicities
Aikaikkuna: Up to end of cycle 3 (week 12)
|
A dose limiting toxicity is any treatment-related adverse event requiring permanent discontinuation of the experimental therapy prior to the completion of treatment cycle 3. |
Up to end of cycle 3 (week 12)
|
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Objective response rate (ORR)
Aikaikkuna: Within 12 months of initiating maintenance therapy
|
Defined as the binomial proportion of evaluable patients with a best overall response of complete response or partial response (by Response Evaluation Criteria in Solid Tumors 1.1) within 12 months of initiating maintenance therapy. Responses reported by the treating physician will be used for these analyses. The ORR estimates by treatment arm will be supported by their 2-sided, 95% Wilson-Score confidence intervals (Wilson, 1927; Agresti, 1998). The relative odds of response in each experimental group (versus [vs] the reference group) will be estimated using a multivariable logistic regression model specified with main effects for the treatment groups and covariate adjustments for the stratification factors reported at baseline. |
Within 12 months of initiating maintenance therapy
|
|
Duration of objective response
Aikaikkuna: From documentation of either partial response or complete response until disease progression or death, whichever is observed first, assessed up to 5 years from randomization
|
Treatment group differences in response duration will be graphed using Kaplan-Meier methods and compared using logrank tests, stratified by the minimization factors defined at randomization. The relative hazards of progression or death in each experimental group (vs the reference group) will be estimated using a multivariable proportional hazards regression model specified with main effects for the treatment indicators and covariate adjustments for the stratification factors reported at baseline. |
From documentation of either partial response or complete response until disease progression or death, whichever is observed first, assessed up to 5 years from randomization
|
|
Incidence of adverse events (AEs)
Aikaikkuna: Up to 5 years from randomization
|
The nature, frequency, and degree of toxicity will be tabulated at the System Organ Class and AE-specific term levels using Common Terminology Criteria version 5.0. Each patient will be represented according to the maximum grade observed for each term. Tabulations will show the number and percentage of patients by maximum grade, within the treatment group received, regardless of the randomized treatment assignment. |
Up to 5 years from randomization
|
|
HER2 expression
Aikaikkuna: Up to 5 years from randomization
|
Correlation of HER2 immunohistochemistry expression and in situ hybridization amplification with clinical outcome and response to HER2 targeted therapies will be explored. |
Up to 5 years from randomization
|
|
Quality of life (QoL)
Aikaikkuna: Up to 5 years from randomization
|
Measured by Functional Assessment of Cancer Therapy - Endometrial Trial Outcome Index (FACT-En TOI). |
Up to 5 years from randomization
|
Muut tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
QoL deterioration
Aikaikkuna: Baseline up to 5 years
|
The deterioration in QoL will be measured by a drop of >= 6 points in the FACT-En TOI score from baseline and lasting for more than one patient reported outcome time point in experimental and control arms. |
Baseline up to 5 years
|
Yhteistyökumppanit ja tutkijat
Sponsori
Yhteistyökumppanit
Tutkijat
- Päätutkija: Britt K Erickson, NRG Oncology
Julkaisuja ja hyödyllisiä linkkejä
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Ensisijainen valmistuminen (Arvioitu)
Opintojen valmistuminen (Arvioitu)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Muita asiaankuuluvia MeSH-ehtoja
- Urogenitaaliset sairaudet
- Sukuelinten sairaudet
- Urogenitaaliset kasvaimet
- Neoplasmat sivustoittain
- Naisten virtsa- ja sukupuolielinten sairaudet
- Naisten virtsa- ja sukupuolielinten sairaudet ja raskauden komplikaatiot
- Kohdun sairaudet
- Sukuelinten sairaudet, naiset
- Sukuelinten kasvaimet, naiset
- Kohdun kasvaimet
- Neoplasmat
- Endometriumin kasvaimet
- Aminohapot, peptidit ja proteiinit
- Proteiinit
- Orgaaniset kemikaalit
- Tutkintatekniikat
- Kliiniset laboratoriotekniikat
- Diagnostiikkatekniikat ja menettelyt
- Diagnoosi
- Hiilivety
- Sykloparaffiinit
- Hiilivedyt, aliisykliset
- Hiilivedyt, sykliset
- Terpeenit
- Glykosidihydrolaasit
- Hydrolaasit
- Entsyymit
- Entsyymit ja koentsyymit
- Polysakkaridilyaasit
- Hiilihappio-lyaasit
- Lyaasit
- Vasta -aineet, monoklonaalinen, humanisoitu
- Vasta -aineet, monoklonaalinen
- Vasta -aineet
- Immunoglobuliinit
- Immunoproteiinit
- Veriproteiinit
- Seerumin globuliinit
- Globuliinit
- Koordinointikompleksit
- Taksoidit
- Syklodekaanit
- Diterpeenit
- Terveydenhuollon taloustiede ja organisaatiot
- Taloustiede
- Trastutsumabi
- Karboplatiini
- Paklitakseli
- Hyaluronoglukosaminidaasi
- Näytteenkäsittely
- pertuzumabi
- Verot
Muut tutkimustunnusnumerot
- NCI-2022-01540
- U10CA180868 (Yhdysvaltain NIH-apuraha/sopimus)
- NCI-2022-01540 (Rekisterin tunniste: CTRP (Clinical Trial Reporting Program))
- NRG-GY026 (Muu tunniste: CTEP)
- NRG-GY026 (Muu tunniste: NRG Oncology)
Yksittäisten osallistujien tietojen suunnitelma (IPD)
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IPD-suunnitelman kuvaus
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