Nivolumab et Ipilimumab dans le traitement des patients atteints d'adénocarcinome de la jonction œsophagienne et gastro-œsophagienne subissant une intervention chirurgicale
Une étude de phase II/III sur le nivolumab et l'ipilimumab en périopératoire chez des patients atteints d'un adénocarcinome de la jonction œsophagienne et gastro-œsophagienne locorégionale
This phase II/III trial studies the usefulness of treatment with nivolumab and ipilimumab in addition to standard of care chemotherapy and radiation therapy in patients with esophageal and gastroesophageal junction adenocarcinoma who are undergoing surgery. Immunotherapy with antibodies, such as nivolumab and ipilimumab, may remove the brake on the body's immune system and may interfere with the ability of tumor cells to grow and spread. Chemotherapy and radiation therapy may reduce the tumor size and the amount of normal tissue that needs to be removed during surgery. A combined treatment with nivolumab and ipilimumab, chemotherapy, and radiation therapy might be more effective in patients with esophageal and gastroesophageal junction adenocarcinoma who are undergoing surgery.
Aperçu de l'étude
Statut
Les conditions
- Adénocarcinome de l'œsophage
- Adénocarcinome de la jonction gastro-oesophagienne de stade clinique III AJCC v8
- Adénocarcinome de la jonction gastro-oesophagienne
- Adénocarcinome de l'œsophage de stade clinique II AJCC v8
- Adénocarcinome de l'œsophage de stade clinique III AJCC v8
- Stade clinique IVA Adénocarcinome oesophagien AJCC v8
- Adénocarcinome de la jonction gastro-œsophagienne de stade clinique II AJCC v8
- Stade clinique IVA Adénocarcinome de la jonction gastro-oesophagienne AJCC v8
Description détaillée
PRIMARY OBJECTIVES:
I. To assess the pathologic complete response (pathCR) rate following administration of neoadjuvant carboplatin, paclitaxel and radiation therapy versus neoadjuvant carboplatin, paclitaxel, radiation therapy and nivolumab in patients with a resected locoregionally advanced esophageal or gastroesophageal junction adenocarcinoma.
II. To assess the disease-free survival (DFS) following administration of adjuvant nivolumab and ipilimumab versus adjuvant nivolumab in patients with a resected locoregionally advanced esophageal or gastroesophageal junction adenocarcinoma who received neoadjuvant treatment with carboplatin, paclitaxel and radiation therapy with or without nivolumab.
SECONDARY OBJECTIVES:
I. To assess the overall survival (OS) following administration of adjuvant nivolumab and ipilimumab versus nivolumab in patients with a resected locoregional esophageal or gastroesophageal junctional adenocarcinoma who received neoadjuvant treatment with carboplatin, paclitaxel and radiation therapy with or without nivolumab.
II. To assess the disease free survival (DFS) following administration of neoadjuvant carboplatin, paclitaxel, and radiation therapy with or without nivolumab in patients with a locoregional esophageal or gastroesophageal junction adenocarcinoma.
III. To assess the toxicity associated with the administration of neoadjuvant nivolumab in combination with carboplatin, paclitaxel and radiation therapy in patients with a locoregional esophageal or gastroesophageal junction adenocarcinoma.
IV. To assess the toxicity associated with the administration of adjuvant nivolumab and ipilimumab versus adjuvant nivolumab in patients with a resected locoregional esophageal or gastroesophageal junction adenocarcinoma who received neoadjuvant treatment with carboplatin, paclitaxel and radiation therapy with or without nivolumab.
OUTLINE:
STEP I: Patients are randomized to 1 of 2 arms.
ARM A: Patients receive carboplatin intravenously (IV) and paclitaxel IV once weekly and undergo radiation therapy once daily (QD) (Monday-Friday) beginning on day 1 of each cycle. Cycles repeat every week for up to 5 weeks in the absence of disease progression or unacceptable toxicity. Patients undergo a computed tomography (CT) or positron emission tomography (PET) scan during screening and follow-up and undergo collection of blood samples throughout the trial.
ARM B: Patients receive carboplatin, paclitaxel, and radiation therapy as in Arm A. Patients also receive nivolumab IV over 30 minutes on days 1 and 15 of each cycle. Cycles repeat every week for up to 5 weeks in the absence of disease progression or unacceptable toxicity. Patients undergo a CT or PET scan during screening and follow-up and undergo collection of blood samples throughout the trial.
STEP II: Patients are randomized to 1 of 2 arms following standard of care surgery.
ARM C: Patients receive nivolumab IV over 30 minutes on day 1 of each cycle. Treatment repeats every 4 weeks for up to 13 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo a CT scan and collection of blood samples throughout the trial.
ARM D: Patients receive nivolumab as in Arm C and receive ipilimumab IV over 90 minutes on day 1 of cycles 1 and 4 and day 15 of cycles 2 and 5. Treatment repeats every 4 weeks for up to 13 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo a CT scan and collection of blood samples throughout the trial.
After completion of study treatment, patients are followed up every 3 months for 2 years, and then every 6 months for up to 5 years.
Type d'étude
Inscription (Estimé)
Phase
- Phase 2
- Phase 3
Contacts et emplacements
Lieux d'étude
-
-
Alaska
-
Anchorage, Alaska, États-Unis, 98508
- Anchorage Associates in Radiation Medicine
-
Anchorage, Alaska, États-Unis, 99508
- Alaska Breast Care and Surgery LLC
-
Anchorage, Alaska, États-Unis, 99508
- Alaska Oncology and Hematology LLC
-
Anchorage, Alaska, États-Unis, 99508
- Alaska Women's Cancer Care
-
Anchorage, Alaska, États-Unis, 99508
- Anchorage Oncology Centre
-
Anchorage, Alaska, États-Unis, 99508
- Katmai Oncology Group
-
Anchorage, Alaska, États-Unis, 99508
- Providence Alaska Medical Center
-
-
Arizona
-
Phoenix, Arizona, États-Unis, 85004
- Cancer Center at Saint Joseph's
-
-
Arkansas
-
Fort Smith, Arkansas, États-Unis, 72903
- Mercy Hospital Fort Smith
-
Hot Springs, Arkansas, États-Unis, 71913
- CHI Saint Vincent Cancer Center Hot Springs
-
Jonesboro, Arkansas, États-Unis, 72401
- NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
-
-
California
-
Arroyo Grande, California, États-Unis, 93420
- PCR Oncology
-
Burbank, California, États-Unis, 91505
- Providence Saint Joseph Medical Center/Disney Family Cancer Center
-
Clovis, California, États-Unis, 93611
- Community Cancer Institute
-
Clovis, California, États-Unis, 93611
- University Oncology Associates
-
Los Angeles, California, États-Unis, 90033
- USC / Norris Comprehensive Cancer Center
-
Los Angeles, California, États-Unis, 90033
- Los Angeles General Medical Center
-
Palo Alto, California, États-Unis, 94304
- VA Palo Alto Health Care System
-
Palo Alto, California, États-Unis, 94304
- Stanford Cancer Institute Palo Alto
-
Sacramento, California, États-Unis, 95817
- University of California Davis Comprehensive Cancer Center
-
Sacramento, California, États-Unis, 95816
- Mercy Cancer Center - Sacramento
-
San Luis Obispo, California, États-Unis, 93401
- Pacific Central Coast Health Center-San Luis Obispo
-
Santa Maria, California, États-Unis, 93444
- Mission Hope Medical Oncology - Santa Maria
-
St. Helena, California, États-Unis, 94574
- Saint Helena Hospital
-
Whittier, California, États-Unis, 90602
- Presbyterian Intercommunity Hospital
-
Woodland, California, États-Unis, 95695
- Woodland Memorial Hospital
-
-
Colorado
-
Colorado Springs, Colorado, États-Unis, 80907
- Penrose-Saint Francis Healthcare
-
Colorado Springs, Colorado, États-Unis, 80907
- Rocky Mountain Cancer Centers-Penrose
-
Colorado Springs, Colorado, États-Unis, 80923
- Saint Francis Cancer Center
-
Denver, Colorado, États-Unis, 80210
- AdventHealth Porter
-
Lakewood, Colorado, États-Unis, 80228
- CommonSpirit Saint Anthony Hospital Cancer Center
-
Littleton, Colorado, États-Unis, 80122
- AdventHealth Littleton
-
Longmont, Colorado, États-Unis, 80501
- Longmont United Hospital
-
Parker, Colorado, États-Unis, 80138
- AdventHealth Parker
-
Pueblo, Colorado, États-Unis, 81004
- Saint Mary Corwin Medical Center
-
-
Delaware
-
Lewes, Delaware, États-Unis, 19958
- Beebe Medical Center
-
Millville, Delaware, États-Unis, 19967
- Beebe South Coastal Health Campus
-
Newark, Delaware, États-Unis, 19713
- Helen F Graham Cancer Center
-
Newark, Delaware, États-Unis, 19713
- Delaware Clinical and Laboratory Physicians PA
-
Newark, Delaware, États-Unis, 19713
- Medical Oncology Hematology Consultants PA
-
Newark, Delaware, États-Unis, 19718
- Christiana Care Health System-Christiana Hospital
-
Rehoboth Beach, Delaware, États-Unis, 19971
- Beebe Health Campus
-
Seaford, Delaware, États-Unis, 19973
- TidalHealth Nanticoke / Allen Cancer Center
-
-
District of Columbia
-
Washington D.C., District of Columbia, États-Unis, 20007
- MedStar Georgetown University Hospital
-
-
Florida
-
Altamonte Springs, Florida, États-Unis, 32701
- AdventHealth Altamonte
-
Aventura, Florida, États-Unis, 33180
- Mount Sinai Comprehensive Cancer Center at Aventura
-
Fort Lauderdale, Florida, États-Unis, 33308
- Holy Cross Hospital
-
Fort Myers, Florida, États-Unis, 33905
- Regional Cancer Center-Lee Memorial Health System
-
Gainesville, Florida, États-Unis, 32610
- UF Health Cancer Institute - Gainesville
-
Kissimmee, Florida, États-Unis, 34744
- AdventHealth Kissimmee
-
Miami Beach, Florida, États-Unis, 33140
- Mount Sinai Medical Center
-
Orlando, Florida, États-Unis, 32803
- AdventHealth Orlando
-
Orlando, Florida, États-Unis, 32822
- AdventHealth East Orlando
-
-
Georgia
-
Atlanta, Georgia, États-Unis, 30308
- Emory University Hospital Midtown
-
Atlanta, Georgia, États-Unis, 30322
- Emory University Hospital/Winship Cancer Institute
-
Atlanta, Georgia, États-Unis, 30342
- Emory Saint Joseph's Hospital
-
Atlanta, Georgia, États-Unis, 30308
- Emory Proton Therapy Center
-
Savannah, Georgia, États-Unis, 31405
- Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
-
-
Hawaii
-
Honolulu, Hawaii, États-Unis, 96813
- Queen's Medical Center
-
Honolulu, Hawaii, États-Unis, 96817
- The Cancer Center of Hawaii-Liliha
-
Honolulu, Hawaii, États-Unis, 96813
- Hawaii Cancer Care Inc - Waterfront Plaza
-
Honolulu, Hawaii, États-Unis, 96813
- Queen's Cancer Cenrer - POB I
-
Honolulu, Hawaii, États-Unis, 96813
- Straub Clinic and Hospital
-
Honolulu, Hawaii, États-Unis, 96813
- University of Hawaii Cancer Center
-
Honolulu, Hawaii, États-Unis, 96817
- Hawaii Cancer Care Inc-Liliha
-
Honolulu, Hawaii, États-Unis, 96817
- Kuakini Medical Center
-
Honolulu, Hawaii, États-Unis, 96817
- Queen's Cancer Center - Kuakini
-
Honolulu, Hawaii, États-Unis, 96826
- Kapiolani Medical Center for Women and Children
-
Honolulu, Hawaii, États-Unis, 96813
- Island Urology
-
Lihue, Hawaii, États-Unis, 96766
- Wilcox Memorial Hospital and Kauai Medical Clinic
-
‘Aiea, Hawaii, États-Unis, 96701
- Hawaii Cancer Care - Westridge
-
‘Aiea, Hawaii, États-Unis, 96701
- Pali Momi Medical Center
-
‘Aiea, Hawaii, États-Unis, 96701
- Queen's Cancer Center - Pearlridge
-
‘Aiea, Hawaii, États-Unis, 96701
- The Cancer Center of Hawaii-Pali Momi
-
-
Idaho
-
Boise, Idaho, États-Unis, 83712
- Saint Luke's Cancer Institute - Boise
-
Fruitland, Idaho, États-Unis, 83619
- Saint Luke's Cancer Institute - Fruitland
-
Meridian, Idaho, États-Unis, 83642
- Saint Luke's Cancer Institute - Meridian
-
Nampa, Idaho, États-Unis, 83687
- Saint Luke's Cancer Institute - Nampa
-
Twin Falls, Idaho, États-Unis, 83301
- Saint Luke's Cancer Institute - Twin Falls
-
-
Illinois
-
Bloomington, Illinois, États-Unis, 61704
- Illinois CancerCare-Bloomington
-
Canton, Illinois, États-Unis, 61520
- Illinois CancerCare-Canton
-
Carbondale, Illinois, États-Unis, 62902
- Memorial Hospital of Carbondale
-
Carterville, Illinois, États-Unis, 62918
- SIH Cancer Institute
-
Carthage, Illinois, États-Unis, 62321
- Illinois CancerCare-Carthage
-
Centralia, Illinois, États-Unis, 62801
- Centralia Oncology Clinic
-
Chicago, Illinois, États-Unis, 60611
- Northwestern University
-
Chicago, Illinois, États-Unis, 60612
- University of Illinois
-
Decatur, Illinois, États-Unis, 62526
- Decatur Memorial Hospital
-
Decatur, Illinois, États-Unis, 62526
- Cancer Care Specialists of Illinois - Decatur
-
Dixon, Illinois, États-Unis, 61021
- Illinois CancerCare-Dixon
-
Effingham, Illinois, États-Unis, 62401
- Crossroads Cancer Center
-
Eureka, Illinois, États-Unis, 61530
- Illinois CancerCare-Eureka
-
Galesburg, Illinois, États-Unis, 61401
- Western Illinois Cancer Treatment Center
-
Galesburg, Illinois, États-Unis, 61401
- Illinois CancerCare-Galesburg
-
Hines, Illinois, États-Unis, 60141
- Edward Hines Jr VA Hospital
-
Kewanee, Illinois, États-Unis, 61443
- Illinois CancerCare-Kewanee Clinic
-
Lake Forest, Illinois, États-Unis, 60045
- Northwestern Medicine Lake Forest Hospital
-
Macomb, Illinois, États-Unis, 61455
- Illinois CancerCare-Macomb
-
Maywood, Illinois, États-Unis, 60153
- Loyola University Medical Center
-
Mount Vernon, Illinois, États-Unis, 62864
- SSM Health Good Samaritan
-
O'Fallon, Illinois, États-Unis, 62269
- Cancer Care Center of O'Fallon
-
Ottawa, Illinois, États-Unis, 61350
- Illinois CancerCare-Ottawa Clinic
-
Pekin, Illinois, États-Unis, 61554
- Illinois CancerCare-Pekin
-
Pekin, Illinois, États-Unis, 61554
- OSF Saint Francis Radiation Oncology at Pekin
-
Peoria, Illinois, États-Unis, 61636
- Methodist Medical Center of Illinois
-
Peoria, Illinois, États-Unis, 61637
- OSF Saint Francis Medical Center
-
Peoria, Illinois, États-Unis, 61615
- Illinois CancerCare-Peoria
-
Peoria, Illinois, États-Unis, 61615
- OSF Saint Francis Radiation Oncology at Peoria Cancer Center
-
Peru, Illinois, États-Unis, 61354
- Illinois CancerCare-Peru
-
Peru, Illinois, États-Unis, 61354
- Valley Radiation Oncology
-
Princeton, Illinois, États-Unis, 61356
- Illinois CancerCare-Princeton
-
Springfield, Illinois, États-Unis, 62702
- Southern Illinois University School of Medicine
-
Springfield, Illinois, États-Unis, 62702
- Springfield Clinic
-
Springfield, Illinois, États-Unis, 62781
- Springfield Memorial Hospital
-
Washington, Illinois, États-Unis, 61571
- Illinois CancerCare - Washington
-
-
Indiana
-
Carmel, Indiana, États-Unis, 46032
- IU Health North Hospital
-
Indianapolis, Indiana, États-Unis, 46202
- Indiana University/Melvin and Bren Simon Cancer Center
-
Richmond, Indiana, États-Unis, 47374
- Reid Health
-
-
Iowa
-
Clive, Iowa, États-Unis, 50325
- Mercy Cancer Center-West Lakes
-
Clive, Iowa, États-Unis, 50325
- UI Health Care Mission Cancer and Blood - West Des Moines Clinic
-
Creston, Iowa, États-Unis, 50801
- Greater Regional Medical Center
-
Des Moines, Iowa, États-Unis, 50314
- Mercy Medical Center - Des Moines
-
Des Moines, Iowa, États-Unis, 50314
- UI Health Care Mission Cancer and Blood - Laurel Clinic
-
West Des Moines, Iowa, États-Unis, 50266
- Mercy Medical Center-West Lakes
-
-
Kansas
-
Garden City, Kansas, États-Unis, 67846
- Central Care Cancer Center - Garden City
-
Great Bend, Kansas, États-Unis, 67530
- Central Care Cancer Center - Great Bend
-
-
Kentucky
-
Lexington, Kentucky, États-Unis, 40504
- Saint Joseph Radiation Oncology Resource Center
-
Lexington, Kentucky, États-Unis, 40509
- CommonSpirit Saint Joseph Medical Center - East Lexington
-
Lexington, Kentucky, États-Unis, 40504
- CommonSpirit Saint Joseph Hospital - Lexington
-
Louisville, Kentucky, États-Unis, 40202
- Jewish Hospital
-
Louisville, Kentucky, États-Unis, 40245
- UofL Health Medical Center Northeast
-
-
Louisiana
-
Kenner, Louisiana, États-Unis, 70065
- Ochsner Medical Center Kenner
-
New Orleans, Louisiana, États-Unis, 70121
- Ochsner Medical Center Jefferson
-
-
Maine
-
Bangor, Maine, États-Unis, 04401
- Eastern Maine Medical Center
-
Bath, Maine, États-Unis, 04530
- MaineHealth Coastal Cancer Treatment Center
-
Biddeford, Maine, États-Unis, 04005
- MaineHealth Maine Medical Center - Biddeford
-
Brewer, Maine, États-Unis, 04412
- Lafayette Family Cancer Center-EMMC
-
Portland, Maine, États-Unis, 04102
- MaineHealth Maine Medical Center - Portland
-
Sanford, Maine, États-Unis, 04073
- MaineHealth Cancer Care Center of York County
-
Sanford, Maine, États-Unis, 04073
- MaineHealth Cancer Care and IV Therapy - Sanford
-
Scarborough, Maine, États-Unis, 04074
- MaineHealth Maine Medical Center- Scarborough
-
South Portland, Maine, États-Unis, 04106
- MaineHealth Cancer Care and IV Therapy - South Portland
-
-
Massachusetts
-
Boston, Massachusetts, États-Unis, 02111
- Tufts Medical Center
-
Boston, Massachusetts, États-Unis, 02118
- Boston Medical Center
-
Lowell, Massachusetts, États-Unis, 01854
- Lowell General Hospital
-
-
Michigan
-
Ann Arbor, Michigan, États-Unis, 48106
- Trinity Health Saint Joseph Mercy Hospital Ann Arbor
-
Brighton, Michigan, États-Unis, 48114
- Trinity Health IHA Medical Group Hematology Oncology - Brighton
-
Brighton, Michigan, États-Unis, 48114
- Trinity Health Medical Center - Brighton
-
Canton, Michigan, États-Unis, 48188
- Trinity Health IHA Medical Group Hematology Oncology - Canton
-
Canton, Michigan, États-Unis, 48188
- Trinity Health Medical Center - Canton
-
Caro, Michigan, États-Unis, 48723
- Caro Cancer Center
-
Chelsea, Michigan, États-Unis, 48118
- Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
-
Chelsea, Michigan, États-Unis, 48118
- Chelsea Hospital
-
Detroit, Michigan, États-Unis, 48236
- Henry Ford Health Saint John Hospital
-
Flint, Michigan, États-Unis, 48503
- Hurley Medical Center
-
Flint, Michigan, États-Unis, 48503
- Genesys Hurley Cancer Institute
-
Grosse Pointe Woods, Michigan, États-Unis, 48236
- Henry Ford Saint John Hospital - Van Elslander
-
Lansing, Michigan, États-Unis, 48912
- University of Michigan Health - Sparrow Lansing
-
Livonia, Michigan, États-Unis, 48154
- Trinity Health Saint Mary Mercy Livonia Hospital
-
Macomb, Michigan, États-Unis, 48044
- Henry Ford Saint John Hospital - Macomb Medical
-
Marlette, Michigan, États-Unis, 48453
- Saint Mary's Oncology/Hematology Associates of Marlette
-
Novi, Michigan, États-Unis, 48374
- Henry Ford Health Providence Novi Hospital
-
Pontiac, Michigan, États-Unis, 48341
- Trinity Health Saint Joseph Mercy Oakland Hospital
-
Pontiac, Michigan, États-Unis, 48341
- Michigan Healthcare Professionals Pontiac
-
Saginaw, Michigan, États-Unis, 48604
- Oncology Hematology Associates of Saginaw Valley PC
-
Saginaw, Michigan, États-Unis, 48601
- MyMichigan Medical Center Saginaw
-
Southfield, Michigan, États-Unis, 48075
- Henry Ford Health Providence Southfield Hospital
-
Tawas City, Michigan, États-Unis, 48764
- MyMichigan Medical Center Tawas
-
Warren, Michigan, États-Unis, 48093
- Henry Ford Health Warren Hospital
-
West Branch, Michigan, États-Unis, 48661
- Saint Mary's Oncology/Hematology Associates of West Branch
-
Ypsilanti, Michigan, États-Unis, 48197
- Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
-
-
Minnesota
-
Bemidji, Minnesota, États-Unis, 56601
- Sanford Joe Lueken Cancer Center
-
Brainerd, Minnesota, États-Unis, 56401
- Essentia Health Saint Joseph's Medical Center
-
Burnsville, Minnesota, États-Unis, 55337
- Fairview Ridges Hospital
-
Burnsville, Minnesota, États-Unis, 55337
- Minnesota Oncology - Burnsville
-
Coon Rapids, Minnesota, États-Unis, 55433
- Mercy Hospital
-
Deer River, Minnesota, États-Unis, 56636
- Essentia Health - Deer River Clinic
-
Detroit Lakes, Minnesota, États-Unis, 56501
- Essentia Health Saint Mary's - Detroit Lakes Clinic
-
Duluth, Minnesota, États-Unis, 55805
- Essentia Health Cancer Center
-
Duluth, Minnesota, États-Unis, 55805
- Essentia Health Saint Mary's Medical Center
-
Duluth, Minnesota, États-Unis, 55805
- Miller-Dwan Hospital
-
Edina, Minnesota, États-Unis, 55435
- Fairview Southdale Hospital
-
Edina, Minnesota, États-Unis, 55435
- Minnesota Oncology - Edina
-
Fergus Falls, Minnesota, États-Unis, 56537
- Lake Region Healthcare Corporation-Cancer Care
-
Fosston, Minnesota, États-Unis, 56542
- Essentia Health - Fosston
-
Fridley, Minnesota, États-Unis, 55432
- Unity Hospital
-
Hibbing, Minnesota, États-Unis, 55746
- Essentia Health Hibbing Clinic
-
Maple Grove, Minnesota, États-Unis, 55369
- Fairview Clinics and Surgery Center Maple Grove
-
Maplewood, Minnesota, États-Unis, 55109
- Saint John's Hospital - Healtheast
-
Maplewood, Minnesota, États-Unis, 55109
- Minnesota Oncology Hematology PA-Maplewood
-
Minneapolis, Minnesota, États-Unis, 55415
- Hennepin County Medical Center
-
Minneapolis, Minnesota, États-Unis, 55407
- Abbott-Northwestern Hospital
-
Minneapolis, Minnesota, États-Unis, 55454
- Health Partners Inc
-
Monticello, Minnesota, États-Unis, 55362
- Monticello Cancer Center
-
Park Rapids, Minnesota, États-Unis, 56470
- Essentia Health - Park Rapids
-
Robbinsdale, Minnesota, États-Unis, 55422
- North Memorial Medical Health Center
-
Rochester, Minnesota, États-Unis, 55905
- Mayo Clinic in Rochester
-
Saint Louis Park, Minnesota, États-Unis, 55416
- Park Nicollet Clinic - Saint Louis Park
-
Saint Paul, Minnesota, États-Unis, 55101
- Regions Hospital
-
Saint Paul, Minnesota, États-Unis, 55102
- United Hospital
-
Sandstone, Minnesota, États-Unis, 55072
- Essentia Health Sandstone
-
Shakopee, Minnesota, États-Unis, 55379
- Saint Francis Regional Medical Center
-
Stillwater, Minnesota, États-Unis, 55082
- Lakeview Hospital
-
Virginia, Minnesota, États-Unis, 55792
- Essentia Health Virginia Clinic
-
Waconia, Minnesota, États-Unis, 55387
- Ridgeview Medical Center
-
Willmar, Minnesota, États-Unis, 56201
- Rice Memorial Hospital
-
Woodbury, Minnesota, États-Unis, 55125
- Minnesota Oncology Hematology PA-Woodbury
-
-
Mississippi
-
Columbus, Mississippi, États-Unis, 39705
- Baptist Memorial Hospital and Cancer Center-Golden Triangle
-
Grenada, Mississippi, États-Unis, 38901
- Baptist Cancer Center-Grenada
-
New Albany, Mississippi, États-Unis, 38652
- Baptist Memorial Hospital and Cancer Center-Union County
-
Oxford, Mississippi, États-Unis, 38655
- Baptist Memorial Hospital and Cancer Center-Oxford
-
Southhaven, Mississippi, États-Unis, 38671
- Baptist Memorial Hospital and Cancer Center-Desoto
-
-
Missouri
-
Ballwin, Missouri, États-Unis, 63011
- Mercy Oncology and Hematology - Clayton-Clarkson
-
Bolivar, Missouri, États-Unis, 65613
- Central Care Cancer Center - Bolivar
-
Cape Girardeau, Missouri, États-Unis, 63703
- Saint Francis Medical Center
-
Cape Girardeau, Missouri, États-Unis, 63703
- Mercy Cancer Center - Cape Girardeau
-
City of Saint Peters, Missouri, États-Unis, 63376
- Siteman Cancer Center at Saint Peters Hospital
-
Creve Coeur, Missouri, États-Unis, 63141
- Siteman Cancer Center at West County Hospital
-
Farmington, Missouri, États-Unis, 63640
- Parkland Health Center - Farmington
-
Jefferson City, Missouri, États-Unis, 65109
- MU Health Care Goldschmidt Cancer Center
-
Joplin, Missouri, États-Unis, 64804
- Freeman Health System
-
Joplin, Missouri, États-Unis, 64804
- Mercy Hospital Joplin
-
Rolla, Missouri, États-Unis, 65401
- Mercy Clinic-Rolla-Cancer and Hematology
-
Rolla, Missouri, États-Unis, 65401
- Phelps Health Delbert Day Cancer Institute
-
Saint Joseph, Missouri, États-Unis, 64506
- Heartland Regional Medical Center
-
Sainte Genevieve, Missouri, États-Unis, 63670
- Sainte Genevieve County Memorial Hospital
-
Springfield, Missouri, États-Unis, 65807
- CoxHealth South Hospital
-
Springfield, Missouri, États-Unis, 65804
- Mercy Hospital Springfield
-
St Louis, Missouri, États-Unis, 63110
- Washington University School of Medicine
-
St Louis, Missouri, États-Unis, 63129
- Siteman Cancer Center-South County
-
St Louis, Missouri, États-Unis, 63136
- Siteman Cancer Center at Christian Hospital
-
St Louis, Missouri, États-Unis, 63131
- Missouri Baptist Medical Center
-
St Louis, Missouri, États-Unis, 63141
- Mercy Hospital Saint Louis
-
St Louis, Missouri, États-Unis, 63128
- Mercy Hospital South
-
Sullivan, Missouri, États-Unis, 63080
- Missouri Baptist Sullivan Hospital
-
-
Montana
-
Missoula, Montana, États-Unis, 59802
- Saint Patrick Hospital - Community Hospital
-
-
Nebraska
-
Bellevue, Nebraska, États-Unis, 68123
- Nebraska Medicine-Bellevue
-
Grand Island, Nebraska, États-Unis, 68803
- Nebraska Cancer Specialists/Oncology Hematology West PC
-
Kearney, Nebraska, États-Unis, 68847
- CHI Health Good Samaritan
-
Omaha, Nebraska, États-Unis, 68198
- University of Nebraska Medical Center
-
Omaha, Nebraska, États-Unis, 68124
- Alegent Health Bergan Mercy Medical Center
-
Omaha, Nebraska, États-Unis, 68118
- Nebraska Medicine-Village Pointe
-
Omaha, Nebraska, États-Unis, 68122
- Alegent Health Immanuel Medical Center
-
Omaha, Nebraska, États-Unis, 68130
- Alegent Health Lakeside Hospital
-
-
Nevada
-
Henderson, Nevada, États-Unis, 89052
- Comprehensive Cancer Centers of Nevada - Henderson
-
Henderson, Nevada, États-Unis, 89074
- Oncology Las Vegas - Henderson
-
Las Vegas, Nevada, États-Unis, 89102
- OptumCare Cancer Care at Charleston
-
Las Vegas, Nevada, États-Unis, 89106
- Radiation Oncology Centers of Nevada Central
-
Las Vegas, Nevada, États-Unis, 89119
- Radiation Oncology Centers of Nevada Southeast
-
Las Vegas, Nevada, États-Unis, 89128
- Comprehensive Cancer Centers of Nevada - Northwest
-
Las Vegas, Nevada, États-Unis, 89128
- OptumCare Cancer Care at MountainView
-
Las Vegas, Nevada, États-Unis, 89135
- Alliance for Childhood Diseases/Cure 4 the Kids Foundation
-
Las Vegas, Nevada, États-Unis, 89144
- Comprehensive Cancer Centers of Nevada - Town Center
-
Las Vegas, Nevada, États-Unis, 89144
- Comprehensive Cancer Centers of Nevada-Summerlin
-
Las Vegas, Nevada, États-Unis, 89148
- Comprehensive Cancer Centers of Nevada
-
Las Vegas, Nevada, États-Unis, 89169
- Comprehensive Cancer Centers of Nevada - Central Valley
-
Las Vegas, Nevada, États-Unis, 89183
- OptumCare Cancer Care at Fort Apache
-
Reno, Nevada, États-Unis, 89502
- Renown Regional Medical Center
-
Reno, Nevada, États-Unis, 89503
- Saint Mary's Regional Medical Center
-
Reno, Nevada, États-Unis, 89509
- Radiation Oncology Associates
-
-
New Hampshire
-
Lebanon, New Hampshire, États-Unis, 03756
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
-
-
New Jersey
-
Brick, New Jersey, États-Unis, 08724
- Ocean University Medical Center
-
Long Branch, New Jersey, États-Unis, 07740
- Monmouth Medical Center
-
Manahawkin, New Jersey, États-Unis, 08050
- Southern Ocean County Medical Center
-
Neptune City, New Jersey, États-Unis, 07753
- Jersey Shore Medical Center
-
New Brunswick, New Jersey, États-Unis, 08903
- Rutgers Cancer Institute of New Jersey
-
Red Bank, New Jersey, États-Unis, 07701
- Riverview Medical Center/Booker Cancer Center
-
Toms River, New Jersey, États-Unis, 08755
- Community Medical Center
-
-
New Mexico
-
Albuquerque, New Mexico, États-Unis, 87102
- Lovelace Medical Center-Saint Joseph Square
-
Albuquerque, New Mexico, États-Unis, 87109
- New Mexico Oncology Hematology Consultants
-
Albuquerque, New Mexico, États-Unis, 87106
- University of New Mexico Cancer Center
-
Albuquerque, New Mexico, États-Unis, 87110
- Presbyterian Kaseman Hospital
-
Rio Rancho, New Mexico, États-Unis, 87124
- Presbyterian Rust Medical Center/Jorgensen Cancer Center
-
-
New York
-
Canandaigua, New York, États-Unis, 14424
- Sands Cancer Center
-
Dansville, New York, États-Unis, 14437
- Noyes Memorial Hospital/Myers Cancer Center
-
Glens Falls, New York, États-Unis, 12801
- Glens Falls Hospital
-
Lake Success, New York, États-Unis, 11042
- Northwell Health/Center for Advanced Medicine
-
Middletown, New York, États-Unis, 10940
- Garnet Health Medical Center
-
New York, New York, États-Unis, 10065
- NYP/Weill Cornell Medical Center
-
New York, New York, États-Unis, 10016
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
-
Rochester, New York, États-Unis, 14642
- University of Rochester
-
Syracuse, New York, États-Unis, 13210
- State University of New York Upstate Medical University
-
The Bronx, New York, États-Unis, 10461
- Montefiore Medical Center-Einstein Campus
-
The Bronx, New York, États-Unis, 10467
- Montefiore Medical Center - Moses Campus
-
The Bronx, New York, États-Unis, 10461
- Montefiore Medical Center-Weiler Hospital
-
-
North Carolina
-
Charlotte, North Carolina, États-Unis, 28204
- Novant Health Presbyterian Medical Center
-
Huntersville, North Carolina, États-Unis, 28078
- Novant Health Cancer Institute - Huntersville
-
Huntersville, North Carolina, États-Unis, 28078
- Novant Health Presbyterian Medical Center Huntersville
-
Kernersville, North Carolina, États-Unis, 27284
- Novant Health Cancer Institute - Kernersville
-
Matthews, North Carolina, États-Unis, 28105
- Matthews Radiation Oncology Center
-
Matthews, North Carolina, États-Unis, 28105
- Novant Health Cancer Institute - Matthews
-
Mooresville, North Carolina, États-Unis, 28117
- Novant Health Cancer Institute - Mooresville
-
Mount Airy, North Carolina, États-Unis, 27030
- Novant Health Cancer Institute - Mount Airy
-
North Wilkesboro, North Carolina, États-Unis, 28659
- Novant Health Cancer Institute - Wilkesboro
-
Salisbury, North Carolina, États-Unis, 28144
- Rowan Regional Medical Center
-
Statesville, North Carolina, États-Unis, 28625
- Novant Health Cancer Institute - Statesville
-
Thomasville, North Carolina, États-Unis, 27360
- Novant Health Cancer Institute - Thomasville
-
Winston-Salem, North Carolina, États-Unis, 27103
- Novant Health Forsyth Medical Center
-
-
North Dakota
-
Bismarck, North Dakota, États-Unis, 58501
- Sanford Bismarck Medical Center
-
Fargo, North Dakota, États-Unis, 58122
- Sanford Roger Maris Cancer Center
-
Fargo, North Dakota, États-Unis, 58103
- Essentia Health Cancer Center-South University Clinic
-
Fargo, North Dakota, États-Unis, 58122
- Sanford Broadway Medical Center
-
Jamestown, North Dakota, États-Unis, 58401
- Essentia Health - Jamestown Clinic
-
-
Ohio
-
Beavercreek, Ohio, États-Unis, 45431
- Indu and Raj Soin Medical Center
-
Boardman, Ohio, États-Unis, 44512
- Saint Elizabeth Boardman Hospital
-
Centerville, Ohio, États-Unis, 45459
- Miami Valley Hospital South
-
Centerville, Ohio, États-Unis, 45459
- Dayton Physicians LLC-Miami Valley South
-
Cincinnati, Ohio, États-Unis, 45219
- University of Cincinnati Cancer Center-UC Medical Center
-
Cincinnati, Ohio, États-Unis, 45220
- Good Samaritan Hospital - Cincinnati
-
Cincinnati, Ohio, États-Unis, 45242
- Bethesda North Hospital
-
Cincinnati, Ohio, États-Unis, 45236
- Oncology Hematology Care Inc-Kenwood
-
Cleveland, Ohio, États-Unis, 44109
- MetroHealth Medical Center
-
Cleveland, Ohio, États-Unis, 44195
- Cleveland Clinic Foundation
-
Cleveland, Ohio, États-Unis, 44111
- Cleveland Clinic Cancer Center/Fairview Hospital
-
Columbus, Ohio, États-Unis, 43210
- Ohio State University Comprehensive Cancer Center
-
Dayton, Ohio, États-Unis, 45409
- Miami Valley Hospital
-
Dayton, Ohio, États-Unis, 45415
- Miami Valley Hospital North
-
Dayton, Ohio, États-Unis, 45415
- Dayton Physician LLC - Englewood
-
Findlay, Ohio, États-Unis, 45840
- Blanchard Valley Hospital
-
Findlay, Ohio, États-Unis, 45840
- Armes Family Cancer Center
-
Findlay, Ohio, États-Unis, 45840
- Orion Cancer Care
-
Franklin, Ohio, États-Unis, 45005-1066
- Atrium Medical Center-Middletown Regional Hospital
-
Franklin, Ohio, États-Unis, 45005
- Dayton Physicians LLC-Atrium
-
Greenville, Ohio, États-Unis, 45331
- Wayne Hospital
-
Greenville, Ohio, États-Unis, 45331
- Dayton Physicians LLC-Wayne
-
Independence, Ohio, États-Unis, 44131
- Cleveland Clinic Cancer Center Independence
-
Kettering, Ohio, États-Unis, 45429
- Kettering Medical Center
-
Kettering, Ohio, États-Unis, 45409
- Greater Dayton Cancer Center
-
Mansfield, Ohio, États-Unis, 44906
- Cleveland Clinic Cancer Center Mansfield
-
Mayfield Heights, Ohio, États-Unis, 44124
- Hillcrest Hospital Cancer Center
-
Sandusky, Ohio, États-Unis, 44870
- North Coast Cancer Care
-
Springfield, Ohio, États-Unis, 45504
- Springfield Regional Cancer Center
-
Springfield, Ohio, États-Unis, 45504
- Springfield Regional Medical Center
-
Strongsville, Ohio, États-Unis, 44136
- Cleveland Clinic Cancer Center Strongsville
-
Sylvania, Ohio, États-Unis, 43560
- ProMedica Flower Hospital
-
Toledo, Ohio, États-Unis, 43606
- ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
-
Troy, Ohio, États-Unis, 45373
- Upper Valley Medical Center
-
Troy, Ohio, États-Unis, 45373
- Dayton Physicians LLC - Troy
-
Warren, Ohio, États-Unis, 44484
- Saint Joseph Warren Hospital
-
Warrensville Heights, Ohio, États-Unis, 44122
- South Pointe Hospital
-
West Chester, Ohio, États-Unis, 45069
- University of Cincinnati Cancer Center-West Chester
-
Wooster, Ohio, États-Unis, 44691
- Cleveland Clinic Wooster Family Health and Surgery Center
-
Youngstown, Ohio, États-Unis, 44501
- Saint Elizabeth Youngstown Hospital
-
-
Oklahoma
-
Oklahoma City, Oklahoma, États-Unis, 73120
- Mercy Hospital Oklahoma City
-
-
Oregon
-
Bend, Oregon, États-Unis, 97701
- Saint Charles Health System
-
Clackamas, Oregon, États-Unis, 97015
- Clackamas Radiation Oncology Center
-
Clackamas, Oregon, États-Unis, 97015
- Providence Cancer Institute Clackamas Clinic
-
Coos Bay, Oregon, États-Unis, 97420
- Bay Area Hospital
-
Newberg, Oregon, États-Unis, 97132
- Providence Newberg Medical Center
-
Portland, Oregon, États-Unis, 97213
- Providence Portland Medical Center
-
Portland, Oregon, États-Unis, 97225
- Providence Saint Vincent Medical Center
-
-
Pennsylvania
-
Allentown, Pennsylvania, États-Unis, 18103
- Lehigh Valley Hospital-Cedar Crest
-
Allentown, Pennsylvania, États-Unis, 18104
- Saint Luke's Cancer Center - Allentown
-
Altoona, Pennsylvania, États-Unis, 16601
- UPMC Altoona
-
Beaver, Pennsylvania, États-Unis, 15009
- UPMC-Heritage Valley Health System Beaver
-
Bethlehem, Pennsylvania, États-Unis, 18017
- Lehigh Valley Hospital - Muhlenberg
-
Bethlehem, Pennsylvania, États-Unis, 18015
- Saint Luke's University Hospital-Bethlehem Campus
-
Butler, Pennsylvania, États-Unis, 16001
- UPMC Hillman Cancer Center at Butler Health System
-
Camp Hill, Pennsylvania, États-Unis, 17011
- UPMC Camp Hill
-
Carlisle, Pennsylvania, États-Unis, 17015
- Carlisle Regional Cancer Center
-
Chadds Ford, Pennsylvania, États-Unis, 19317
- Christiana Care Health System-Concord Health Center
-
Danville, Pennsylvania, États-Unis, 17822
- Geisinger Medical Center
-
East Stroudsburg, Pennsylvania, États-Unis, 18301
- Pocono Medical Center
-
Easton, Pennsylvania, États-Unis, 18045
- Saint Luke's Hospital-Anderson Campus
-
Erie, Pennsylvania, États-Unis, 16505
- UPMC Hillman Cancer Center Erie
-
Farrell, Pennsylvania, États-Unis, 16121
- UPMC Cancer Center at UPMC Horizon
-
Greensburg, Pennsylvania, États-Unis, 15601
- UPMC Cancer Centers - Arnold Palmer Pavilion
-
Harrisburg, Pennsylvania, États-Unis, 17109
- UPMC Pinnacle Cancer Center/Community Osteopathic Campus
-
Hershey, Pennsylvania, États-Unis, 17033-0850
- Penn State Milton S Hershey Medical Center
-
Indiana, Pennsylvania, États-Unis, 15701
- IRMC Cancer Center
-
Jefferson Hills, Pennsylvania, États-Unis, 15025
- Jefferson Hospital
-
Johnstown, Pennsylvania, États-Unis, 15901
- UPMC-Johnstown/John P. Murtha Regional Cancer Center
-
Lewisburg, Pennsylvania, États-Unis, 17837
- Geisinger Medical Oncology-Lewisburg
-
McKeesport, Pennsylvania, États-Unis, 15132
- UPMC Cancer Center at UPMC McKeesport
-
Monroeville, Pennsylvania, États-Unis, 15146
- Forbes Hospital
-
Monroeville, Pennsylvania, États-Unis, 15146
- UPMC Hillman Cancer Center - Monroeville
-
Monroeville, Pennsylvania, États-Unis, 15146
- UPMC Cancer Center - Monroeville
-
Moon Township, Pennsylvania, États-Unis, 15108
- UPMC Hillman Cancer Center in Coraopolis
-
Mount Pleasant, Pennsylvania, États-Unis, 15666
- UPMC Hillman Cancer Center - Part of Frick Hospital
-
N. Huntingdon, Pennsylvania, États-Unis, 15642
- Arnold Palmer Cancer Center Medical Oncology Norwin
-
Natrona Heights, Pennsylvania, États-Unis, 15065
- Allegheny Valley Hospital
-
New Castle, Pennsylvania, États-Unis, 16105
- UPMC Hillman Cancer Center - New Castle
-
Philadelphia, Pennsylvania, États-Unis, 19104
- University of Pennsylvania/Abramson Cancer Center
-
Pittsburgh, Pennsylvania, États-Unis, 15212
- Allegheny General Hospital
-
Pittsburgh, Pennsylvania, États-Unis, 15224
- West Penn Hospital
-
Pittsburgh, Pennsylvania, États-Unis, 15232
- UPMC Hillman Cancer Center
-
Pittsburgh, Pennsylvania, États-Unis, 15213
- UPMC-Magee Womens Hospital
-
Pittsburgh, Pennsylvania, États-Unis, 15232
- UPMC-Shadyside Hospital
-
Pittsburgh, Pennsylvania, États-Unis, 15215
- UPMC-Saint Margaret
-
Pittsburgh, Pennsylvania, États-Unis, 15237
- UPMC-Passavant Hospital
-
Pittsburgh, Pennsylvania, États-Unis, 15243
- UPMC-Saint Clair Hospital Cancer Center
-
Pottstown, Pennsylvania, États-Unis, 19464
- Pottstown Hospital
-
Seneca, Pennsylvania, États-Unis, 16346
- UPMC Cancer Center at UPMC Northwest
-
Uniontown, Pennsylvania, États-Unis, 15401
- UPMC Uniontown Hospital Radiation Oncology
-
Uniontown, Pennsylvania, États-Unis, 15401
- UPMC Cancer Center-Uniontown
-
Washington, Pennsylvania, États-Unis, 15301
- UPMC Washington Hospital Radiation Oncology
-
Washington, Pennsylvania, États-Unis, 15301
- UPMC Cancer Center-Washington
-
West Mifflin, Pennsylvania, États-Unis, 15122
- UPMC West Mifflin-Cancer Center Jefferson
-
West Reading, Pennsylvania, États-Unis, 19611
- Reading Hospital
-
Wexford, Pennsylvania, États-Unis, 15090
- Wexford Health and Wellness Pavilion
-
York, Pennsylvania, États-Unis, 17408
- UPMC Memorial
-
-
Rhode Island
-
East Greenwich, Rhode Island, États-Unis, 02818
- Rhode Island Hospital at East Greenwich
-
Newport, Rhode Island, États-Unis, 02840
- Newport Hospital
-
Providence, Rhode Island, États-Unis, 02903
- Rhode Island Hospital
-
-
South Carolina
-
Charleston, South Carolina, États-Unis, 29425
- Medical University of South Carolina
-
Greenville, South Carolina, États-Unis, 29607
- Saint Francis Cancer Center
-
Greenville, South Carolina, États-Unis, 29601
- Saint Francis Hospital
-
-
South Dakota
-
Sioux Falls, South Dakota, États-Unis, 57105
- Avera Cancer Institute
-
Sioux Falls, South Dakota, États-Unis, 57117-5134
- Sanford USD Medical Center - Sioux Falls
-
Sioux Falls, South Dakota, États-Unis, 57104
- Sanford Cancer Center Oncology Clinic
-
-
Tennessee
-
Collierville, Tennessee, États-Unis, 38017
- Baptist Memorial Hospital and Cancer Center-Collierville
-
Memphis, Tennessee, États-Unis, 38120
- Baptist Memorial Hospital and Cancer Center-Memphis
-
Nashville, Tennessee, États-Unis, 37232
- Vanderbilt University/Ingram Cancer Center
-
-
Texas
-
Bryan, Texas, États-Unis, 77802
- Saint Joseph Regional Cancer Center
-
Dallas, Texas, États-Unis, 75235
- Parkland Memorial Hospital
-
Dallas, Texas, États-Unis, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Fort Worth, Texas, États-Unis, 76104
- UT Southwestern/Simmons Cancer Center-Fort Worth
-
Richardson, Texas, États-Unis, 75080
- UT Southwestern Clinical Center at Richardson/Plano
-
-
Utah
-
Salt Lake City, Utah, États-Unis, 84112
- Huntsman Cancer Institute/University of Utah
-
Salt Lake City, Utah, États-Unis, 84106
- University of Utah Sugarhouse Health Center
-
-
Vermont
-
Berlin Corners, Vermont, États-Unis, 05602
- Central Vermont Medical Center/National Life Cancer Treatment
-
Burlington, Vermont, États-Unis, 05401
- University of Vermont Medical Center
-
Burlington, Vermont, États-Unis, 05405
- University of Vermont and State Agricultural College
-
Saint Johnsbury, Vermont, États-Unis, 05819
- Dartmouth Cancer Center - North
-
-
Virginia
-
Charlottesville, Virginia, États-Unis, 22908
- University of Virginia Cancer Center
-
Richmond, Virginia, États-Unis, 23229
- Virginia Cancer Institute
-
Richmond, Virginia, États-Unis, 23298
- VCU Massey Comprehensive Cancer Center
-
South Hill, Virginia, États-Unis, 23970
- VCU Community Memorial Health Center
-
-
Washington
-
Aberdeen, Washington, États-Unis, 98520
- Providence Regional Cancer System-Aberdeen
-
Bellevue, Washington, États-Unis, 98004
- Overlake Medical Center
-
Bellingham, Washington, États-Unis, 98225
- PeaceHealth Saint Joseph Medical Center
-
Burien, Washington, États-Unis, 98166
- Saint Anne Hospital
-
Centralia, Washington, États-Unis, 98531
- Providence Regional Cancer System-Centralia
-
Edmonds, Washington, États-Unis, 98026
- Swedish Cancer Institute-Edmonds
-
Everett, Washington, États-Unis, 98201
- Providence Regional Cancer Partnership
-
Issaquah, Washington, États-Unis, 98029
- Swedish Cancer Institute-Issaquah
-
Lacey, Washington, États-Unis, 98503
- Providence Regional Cancer System-Lacey
-
Longview, Washington, États-Unis, 98632
- PeaceHealth Saint John Medical Center
-
Renton, Washington, États-Unis, 98055
- Valley Medical Center
-
Seattle, Washington, États-Unis, 98107
- Swedish Medical Center-Ballard Campus
-
Seattle, Washington, États-Unis, 98122
- Swedish Medical Center-First Hill
-
Sedro-Woolley, Washington, États-Unis, 98284
- PeaceHealth United General Medical Center
-
Silverdale, Washington, États-Unis, 98383
- Saint Joseph Medical Center Hematology and Oncology - Silverdale
-
Tacoma, Washington, États-Unis, 98405
- Northwest Medical Specialties PLLC
-
Vancouver, Washington, États-Unis, 98664
- PeaceHealth Southwest Medical Center
-
Walla Walla, Washington, États-Unis, 99362
- Providence Saint Mary Regional Cancer Center
-
Yakima, Washington, États-Unis, 98902
- North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
-
-
West Virginia
-
Bridgeport, West Virginia, États-Unis, 26330
- United Hospital Center
-
Charleston, West Virginia, États-Unis, 25304
- Vandalia Health/CAMC Institute for Academic Medicine
-
Morgantown, West Virginia, États-Unis, 26506
- West Virginia University Healthcare
-
Parkersburg, West Virginia, États-Unis, 26101
- Camden Clark Medical Center
-
-
Wisconsin
-
Appleton, Wisconsin, États-Unis, 54911
- ThedaCare Regional Cancer Center
-
Ashland, Wisconsin, États-Unis, 54806
- Duluth Clinic Ashland
-
Ashland, Wisconsin, États-Unis, 54806
- Northwest Wisconsin Cancer Center
-
Burlington, Wisconsin, États-Unis, 53105
- Aurora Cancer Care-Southern Lakes VLCC
-
Eau Claire, Wisconsin, États-Unis, 54701
- Marshfield Medical Center-EC Cancer Center
-
Eau Claire, Wisconsin, États-Unis, 54701
- HSHS Sacred Heart Hospital
-
Fond du Lac, Wisconsin, États-Unis, 54937
- Aurora Health Center-Fond du Lac
-
Germantown, Wisconsin, États-Unis, 53022
- Aurora Health Care Germantown Health Center
-
Grafton, Wisconsin, États-Unis, 53024
- Aurora Cancer Care-Grafton
-
Green Bay, Wisconsin, États-Unis, 54311
- Aurora BayCare Medical Center
-
Green Bay, Wisconsin, États-Unis, 54301
- Saint Vincent Hospital Cancer Center Green Bay
-
Green Bay, Wisconsin, États-Unis, 54303
- Saint Vincent Hospital Cancer Center at Saint Mary's
-
Green Bay, Wisconsin, États-Unis, 54301
- Bellin Memorial Hospital
-
Hayward, Wisconsin, États-Unis, 54843
- Essentia Health-Hayward Clinic
-
Johnson Creek, Wisconsin, États-Unis, 53038
- University of Wisconsin Carbone Cancer Center - Johnson Creek
-
Kenosha, Wisconsin, États-Unis, 53142
- Aurora Cancer Care-Kenosha South
-
Madison, Wisconsin, États-Unis, 53792
- University of Wisconsin Carbone Cancer Center - University Hospital
-
Marinette, Wisconsin, États-Unis, 54143
- Aurora Bay Area Medical Group-Marinette
-
Marshfield, Wisconsin, États-Unis, 54449
- Marshfield Medical Center-Marshfield
-
Milwaukee, Wisconsin, États-Unis, 53209
- Aurora Cancer Care-Milwaukee
-
Milwaukee, Wisconsin, États-Unis, 53215
- Aurora Saint Luke's Medical Center
-
Milwaukee, Wisconsin, États-Unis, 53233
- Aurora Sinai Medical Center
-
Minocqua, Wisconsin, États-Unis, 54548
- Marshfield Medical Center - Minocqua
-
New Richmond, Wisconsin, États-Unis, 54017
- Cancer Center of Western Wisconsin
-
Oshkosh, Wisconsin, États-Unis, 54904
- Vince Lombardi Cancer Clinic - Oshkosh
-
Racine, Wisconsin, États-Unis, 53406
- Aurora Cancer Care-Racine
-
Rice Lake, Wisconsin, États-Unis, 54868
- Marshfield Medical Center-Rice Lake
-
Sheboygan, Wisconsin, États-Unis, 53081
- Vince Lombardi Cancer Clinic-Sheboygan
-
Spooner, Wisconsin, États-Unis, 54801
- Essentia Health-Spooner Clinic
-
Stevens Point, Wisconsin, États-Unis, 54482
- Marshfield Medical Center-River Region at Stevens Point
-
Sturgeon Bay, Wisconsin, États-Unis, 54235-1495
- Saint Vincent Hospital Cancer Center at Sturgeon Bay
-
Summit, Wisconsin, États-Unis, 53066
- Aurora Medical Center in Summit
-
Superior, Wisconsin, États-Unis, 54880
- Essentia Health Saint Mary's Hospital - Superior
-
Two Rivers, Wisconsin, États-Unis, 54241
- Vince Lombardi Cancer Clinic-Two Rivers
-
Wauwatosa, Wisconsin, États-Unis, 53226
- Aurora Cancer Care-Milwaukee West
-
West Allis, Wisconsin, États-Unis, 53227
- Aurora West Allis Medical Center
-
Weston, Wisconsin, États-Unis, 54476
- Marshfield Medical Center - Weston
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
-
STEP 1 RANDOMIZATION: Patients must be age >= 18 years
-
STEP 1 RANDOMIZATION: Patients must have histologically confirmed T1N1-3M0 or T2-3N0-2M0 esophageal or gastroesophageal junctional adenocarcinoma (Siewert I and II)
-
STEP 1 RANDOMIZATION: Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status 0-1
-
STEP 1 RANDOMIZATION: Patents must be deemed a surgical candidate by a thoracic surgeon, surgical oncologist, or surgeon who is qualified to perform an esophagectomy
-
STEP 1 RANDOMIZATION: Absolute neutrophil count >= 1,500/mcL (within less than or equal to 14 days prior to randomization)
-
STEP 1 RANDOMIZATION: Platelets >= 100,000/mcL (within less than or equal to 14 days prior to randomization)
-
STEP 1 RANDOMIZATION: Total bilirubin =< institutional upper limit of normal (ULN) (within less than or equal to 14 days prior to randomization)
-
STEP 1 RANDOMIZATION: Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x institutional ULN (within less than or equal to 14 days prior to randomization)
-
STEP 1 RANDOMIZATION: Serum creatinine =< 1.5 x institutional ULN (within less than or equal to 14 days prior to randomization)
-
STEP 1 RANDOMIZATION: Hemoglobin (Hgb) >= 9 g/dL (within less than or equal to 14 days prior to randomization)
-
STEP 1 RANDOMIZATION: Leukocytes >= 3,000/mm^3 (within less than or equal to 14 days prior to randomization)
-
STEP 1 RANDOMIZATION: Patients may not have received prior chemotherapy or radiation therapy for management for this malignancy
-
STEP 1 RANDOMIZATION: Patients may not have received prior immunotherapy for management of this malignancy or for any other past malignancy
-
STEP 1 RANDOMIZATION: Patients must have no contraindication to receiving either carboplatin or paclitaxel chemotherapy
-
STEP 1 RANDOMIZATION: Patients must have no contraindication to receiving radiation therapy
-
STEP 1 RANDOMIZATION: Patients with active autoimmune disease or history of autoimmune disease that might recur, which may affect vital organ function or require immune suppressive treatment including systemic corticosteroids, must be excluded. These include but are not limited to patients with a history of immune related neurologic disease, multiple sclerosis, autoimmune (demyelinating) neuropathy, Guillain-Barre syndrome, myasthenia gravis; systemic autoimmune disease such as systemic lupus erythematosus (SLE), connective tissue disease, scleroderma, inflammatory bowel disease (IBD), Crohn's, ulcerative colitis, hepatitis; and patients with a history of toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome, or phospholipid syndrome must be excluded because of the risk of recurrence or exacerbation of disease. Patients with vitiligo, endocrine deficiencies including thyroiditis managed with replacement hormones including physiologic corticosteroids are eligible. Patients with rheumatoid arthritis and other arthropathies, Sjogren's syndrome and psoriasis controlled with topical medication and patients with positive serology, such as antinuclear antibodies (ANA), anti-thyroid antibodies must be evaluated for the presence of target organ involvement and potential need for systemic treatment but should otherwise be eligible
-
STEP 1 RANDOMIZATION: Patients are permitted to enroll if they have vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger (precipitating event)
-
STEP 1 RANDOMIZATION: Patient must NOT have previous or concurrent malignancy. Exceptions are made for patients who meet any of the following conditions:
- Non-melanoma skin cancer, in situ cervical cancer, superficial bladder cancer, or breast cancer in situ OR
- Prior malignancy completely excised or removed and patient has been continuously disease free for > 5 years OR
- Date of last evidence of disease
-
STEP 1 RANDOMIZATION: Patients must not have a condition requiring systemic treatment with either corticosteroids (> 10 mg/day prednisone equivalents) or other immunosuppressive medications within 14 days of study drug administration. Inhaled or topical steroids and adrenal replacement doses =< 10 mg/day prednisone equivalents are permitted in the absence of active autoimmune disease
-
STEP 1 RANDOMIZATION: Patients must have adequate cardiac function including electrocardiogram (EKG) and echocardiogram for any patient with a history of congestive heart failure (CHF) or at risk because of underlying cardiovascular disease or exposure to cardiotoxic drugs
-
STEP 1 RANDOMIZATION: For patients with evidence of uncontrolled CHF, myocardial infarction (MI), cardiomyopathy, or myositis, require a cardiac evaluation and clearance including lab tests and cardiology consultation (EKG, creatinine phosphokinase [CPK], troponin, and echocardiogram)
-
STEP 1 RANDOMIZATION: Patients must not have a positive test result for hepatitis B virus surface antigen (HBV sAg) or hepatitis C virus ribonucleic acid (HCV RNA) indicating acute or chronic infection. Testing should be conducted to determine eligibility
-
STEP 1 RANDOMIZATION: Patients with a known history of testing positive for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS) must have no detectable viral load on a stable anti-viral regimen
-
STEP 1 RANDOMIZATION: Patients must not be receiving any other investigational agents
-
STEP 1 RANDOMIZATION: Patients with an uncontrolled intercurrent illness such as ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia or psychiatric illness/social situations that would limit compliance with study requirements will be excluded
-
STEP 1 RANDOMIZATION: Patients must not be pregnant or breast-feeding due to potential harm to an unborn fetus and possible risk for adverse events in nursing infants from carboplatin, paclitaxel, ipilimumab or nivolumab
- All patients of childbearing potential must have a blood test or urine study done within 2 weeks prior to randomization to rule out pregnancy. Those enrolled on Arm B with nivolumab must agree to have a pregnancy test (minimum sensitivity 25 IU/L or equivalent units of human chorionic gonadotropin [HCG]) within 24 hours of starting nivolumab to rule out pregnancy
- A patient of childbearing potential is defined as anyone, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has achieved menarche at some point 2) has not undergone a hysterectomy or bilateral oophorectomy; or 3) has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)
-
STEP 1 RANDOMIZATION: Patients of childbearing potential must not expect to conceive children by either abstaining from sexual intercourse for the duration of their participation in the study or by agreeing to use both double barrier contraception and birth control pills or implants for at least one month prior to the start of the study drug and continuing for 5 months after the last dose of study drug. Investigators shall counsel patients of childbearing potential on the importance of pregnancy prevention and the implications of an unexpected pregnancy
-
STEP 2 RANDOMIZATION: Patient registration must not exceed 12 weeks from time of esophagectomy
-
STEP 2 RANDOMIZATION: Patients must have a post-operative ECOG performance status of 0-2
-
STEP 2 RANDOMIZATION: Absolute neutrophil count >= 1,500/mcL (within less than or equal to 14 days prior to randomization)
-
STEP 2 RANDOMIZATION: Platelets >= 100,000/mcL (within less than or equal to 14 days prior to randomization)
-
STEP 2 RANDOMIZATION: Total bilirubin =< institutional upper limit of normal (ULN) (within less than or equal to 14 days prior to randomization)
-
STEP 2 RANDOMIZATION: AST (SGOT)/ ALT (SGPT) =< 2.5 x institutional ULN (within less than or equal to 14 days prior to randomization)
-
STEP 2 RANDOMIZATION: Serum creatinine =< 1.5 x institutional ULN (within less than or equal to 14 days prior to randomization)
-
STEP 2 RANDOMIZATION: Patients must be disease free following esophagectomy as is demonstrated by having no evidence of disease on a post-surgical CT scan. Patients must also have a negative surgical margin (R0 resection)
-
STEP 2 RANDOMIZATION: Patients must not have an active, known or suspected autoimmune disease or a condition requiring treatment with steroids or immunosuppressive agents. Patients are permitted to enroll if they have vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger
-
STEP 2 RANDOMIZATION: Patients must not have a condition requiring systemic treatment with either corticosteroids (> 10 mg/day prednisone equivalents) or other immunosuppressive medications with 14 days of study drug administration. Inhaled or topical steroids and adrenal replacement doses > 10 mg/day prednisone equivalents are permitted in the absence of active autoimmune disease
-
STEP 2 RANDOMIZATION: Patients must not be receiving any other investigational agents
-
STEP 2 RANDOMIZATION: Patients with an uncontrolled intercurrent illness such as ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia or psychiatric illness/social situations that would limit compliance with study requirements will be excluded
-
STEP 2 RANDOMIZATION: Patients must not be pregnant or breast-feeding due to potential harm to an unborn fetus and possible risks for adverse events in nursing infants from nivolumab or ipilimumab
- All patients of childbearing potential must have a blood test or urine study done (minimum sensitivity 25 IU/L or equivalent units of HCG) within 2 weeks prior to randomization to rule out pregnancy. All patients must also agree to have a pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) within 24 hours of starting nivolumab to rule out pregnancy. Those enrolled on Arm D with ipilimumab must agree to have pregnancy tests within 72 hours of each ipilimumab administration to rule out pregnancy
-
STEP 2 RANDOMIZATION: Patients of childbearing potential must not expect to conceive children by either abstaining from sexual intercourse for the duration of their participation in the study or by agreeing to use both double barrier contraception and birth control pills or implants for at least one month prior to the start of the study drug and continuing for 5 months after the last dose of study drug. Investigators shall counsel patients of childbearing potential on the importance of pregnancy prevention and the implications of an unexpected pregnancy
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: Arm A (carboplatin, paclitaxel, radiation therapy)
Patients receive carboplatin IV and paclitaxel IV once weekly and undergo radiation therapy QD (Monday-Friday) beginning on day 1 of each cycle. Cycles repeat every week for up to 5 weeks in the absence of disease progression or unacceptable toxicity. Patients undergo a CT or PET scan during screening and follow-up and undergo collection of blood samples throughout the trial. |
Given IV
Autres noms:
Given IV
Autres noms:
Undergo CT scan
Autres noms:
Undergo PET scan
Autres noms:
Undergo collection of blood sample
Autres noms:
Undergo radiation therapy
Autres noms:
|
|
Expérimental: Arm B (carboplatin, paclitaxel, radiation therapy, nivolumab)
Patients receive carboplatin, paclitaxel, and radiation therapy as in Arm A. Patients also receive nivolumab IV over 30 minutes on days 1 and 15 of each cycle. Cycles repeat every week for up to 5 weeks in the absence of disease progression or unacceptable toxicity. Patients undergo a CT or PET scan during screening and follow-up and undergo collection of blood samples throughout the trial. |
Given IV
Autres noms:
Given IV
Autres noms:
Given IV
Autres noms:
Undergo CT scan
Autres noms:
Undergo PET scan
Autres noms:
Undergo collection of blood sample
Autres noms:
Undergo radiation therapy
Autres noms:
|
|
Expérimental: Arm C (nivolumab)
Patients receive nivolumab IV over 30 minutes on day 1 of each cycle. Treatment repeats every 4 weeks for up to 13 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo a CT scan and collection of blood samples throughout the trial. |
Given IV
Autres noms:
Undergo CT scan
Autres noms:
Undergo collection of blood sample
Autres noms:
|
|
Expérimental: Arm D (nivolumab, ipilimumab)
Patients receive nivolumab as in Arm C and receive ipilimumab IV over 90 minutes on day 1 of cycles 1 and 4 and day 15 of cycles 2 and 5. Treatment repeats every 4 weeks for up to 13 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo a CT scan and collection of blood samples throughout the trial. |
Given IV
Autres noms:
Given IV
Autres noms:
Undergo CT scan
Autres noms:
Undergo collection of blood sample
Autres noms:
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Pathologic complete response (Step I)
Délai: Up to 5 weeks
|
The study with compare the pathologic complete response of Arm A and Arm B using a one-sided 0.10 level chi-squared test for proportions. |
Up to 5 weeks
|
|
Disease-free survival (DFS) (Step 2)
Délai: From the adjuvant treatment randomization assessed for up to 7 years
|
DFS measured from the adjuvant treatment randomization will be the endpoint of the adjuvant portion of the study and to achieve the desired power it is expected that patients will be followed for an additional year post completion of accrual to the adjuvant portion. The DFS comparison will be between patients randomized to Arm C (nivolumab) versus Arm D (nivolumab plus ipilimumab) using a one-sided 0.10 level stratified log rank test. |
From the adjuvant treatment randomization assessed for up to 7 years
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Incidence of adverse events
Délai: Up to 7 years
|
Graded according to Common Terminology Criteria for Adverse Events version 5.0. Toxicity will be evaluated among all treated patients regardless of eligibility and interim analyses of toxicity are performed twice yearly. The study will have sufficient precision to provide 95% confidence intervals on toxicity |
Up to 7 years
|
|
Overall survival
Délai: From the time of first randomization up to 7 years
|
Analyses will be descriptive in nature and will not follow any formal interim monitoring. |
From the time of first randomization up to 7 years
|
|
DFS
Délai: From the time of first randomization up to 7 years
|
The DFS comparison will be between patients randomized to Arm C (nivolumab) versus Arm D (nivolumab plus ipilimumab) using a one-sided 0.10 level stratified log rank test. |
From the time of first randomization up to 7 years
|
Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Percent change in mean volumetric apparent diffusion coefficient (ADC)
Délai: Baseline to mid-treatment
|
The study will assess the area under the receiver operating characteristic curve of the changes of ADC value. |
Baseline to mid-treatment
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Jennifer R Eads, ECOG-ACRIN Cancer Research Group
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Adénocarcinome de l'oesophage
- Acides aminés, peptides et protéines
- Protéines
- Produits chimiques organiques
- Techniques d'investigation
- Thérapeutique
- Techniques de laboratoire clinique
- Techniques et procédures de diagnostic
- Diagnostic
- Hydrocarbures
- Cycloparaffines
- Hydrocarbures, alicyclique
- Hydrocarbures, cyclique
- Terpènes
- Facteurs biologiques
- Phénomènes physiques
- Anticorps, monoclonal, humanisé
- Anticorps, monoclonal
- Anticorps
- Immunoglobulines
- Immunoprotéines
- Protéines sanguines
- Globulines sériques
- Globulines
- Complexes de coordination
- Taxes
- Cyclodécanes
- Diterpènes
- Économie et organisations des soins de santé
- Techniques de chimie, analytique
- Analyse du spectre
- Récepteurs, surface cellulaire
- Protéines membranaires
- Antigènes
- Antigènes, surface
- Biomarqueurs
- Récepteurs, immunologique
- Antigènes, différenciation, lymphocyte T
- Antigènes, différenciation
- Économie
- Protéines de point de contrôle immunitaire
- Récepteurs costimulants et inhibiteurs des cellules T
- Nivolumab
- Ipilimumab
- Carboplatine
- Paclitaxel
- Radiothérapie
- Radiation
- Manipulation des échantillons
- Spectroscopie de résonance magnétique
- Antigène CTLA-4
- Taxes
Autres numéros d'identification d'étude
- NCI-2018-01575
- U10CA180820 (Subvention/contrat des NIH des États-Unis)
- NCI-2018-01575 (Identificateur de registre: CTRP (Clinical Trial Reporting Program))
- EA2174 (Autre identifiant: CTEP)
- EA2174 (Autre identifiant: ECOG-ACRIN Cancer Research Group)
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Description du régime IPD
NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Étudie un produit d'appareil réglementé par la FDA américaine
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .