Chemioradioterapia con o senza atezolizumab nel trattamento di pazienti con carcinoma della vescica muscolo invasivo localizzato
Studio di fase III randomizzato sulla chemioradioterapia concomitante con o senza atezolizumab nel carcinoma della vescica muscolo invasivo localizzato
This phase III trial studies how well chemotherapy and radiation therapy work with or without atezolizumab in treating patients with localized muscle invasive bladder cancer. Radiation therapy uses high energy rays to kill tumor cells and shrink tumors. Chemotherapy drugs, such as gemcitabine, cisplatin, fluorouracil and mitomycin-C, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving chemotherapy with radiation therapy may kill more tumor cells. Immunotherapy with monoclonal antibodies, such as atezolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Giving atezolizumab with radiation therapy and chemotherapy may work better in treating patients with localized muscle invasive bladder cancer compared to radiation therapy and chemotherapy without atezolizumab.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
- Altro: Quality-of-Life Assessment
- Droga: Cisplatin
- Droga: Fluorouracil
- Droga: Gemcitabine
- Droga: Atezolizumab
- Procedura: Cystoscopy
- Droga: Mitomycin
- Altro: Survey Administration
- Procedura: Biopsy of Bladder
- Procedura: Computed Tomography
- Procedura: Magnetic Resonance Imaging
- Radiazione: Radiation Therapy
- Procedura: Transurethral Resection of Bladder Tumor
Descrizione dettagliata
PRIMARY OBJECTIVE:
I. To compare bladder intact event-free survival (BI-EFS) for concurrent chemoradiation therapy (CRT) with and without atezolizumab in localized muscle invasive bladder cancer (MIBC).
SECONDARY OBJECTIVES:
I. To compare overall survival between the two arms. II. To compare modified bladder intact event-free survival including cancer related death between arms.
III. To compare complete and partial pathologic response between arms at 3 months after completing chemoradiation therapy.
IV. To estimate metastases-free survival by arm. V. To compare the qualitative and quantitative adverse events from each arm. VI. To estimate the rate of non-muscle invasive bladder cancer recurrence by arm.
VII. To estimate the rate of salvage cystectomy and reasons for cystectomy by arm.
VIII. To compare mean patient-reported global quality of life (QOL) at week 54 using the European Organization for Research and Treatment (EORTC) Quality of Life Questionnaire (QLQ)-Core (C)30 Global Health Status (GHS) subscale score between patients with localized muscle-invasive bladder cancer randomized to chemoradiation with versus (vs.) without atezolizumab.
TRANSLATIONAL MEDICINE OBJECTIVES:
I. To test the hypothesis that a panel of validated biomarkers of concurrent CRT involving nuclear MRE11, impaired deoxyribonucleic acid damage response (DDR) function and tumor subtyping will be prognostic for BI-EFS among patients receiving either concurrent CRT or chemoimmuno-radiotherapy (CIRT) of the primary tumor.
II. To test the hypothesis that tumor total mutation burden, neoantigen burden, infiltrating immune response, PD-L1 expression and T cell response are associated with augmented response after concurrent CIRT.
III. To bank urine specimens for future use.
PATIENT-REPORTED OUTCOMES (PROs) OBJECTIVES:
I. To compare mean patient-reported global QOL as measured by the EORTC QLQ-C30 Global Health Status subscale scores at week 54 between patients with localized muscle-invasive bladder cancer randomized to chemoradiation with vs. without atezolizumab. (Primary) II. To compare mean patient-reported bowel symptoms at each assessment time by arm using the Expanded Prostate Cancer Index Composite (EPIC) Bowel Assessment from the Expanded Prostate Index, the bladder-specific supplement to the QLQ-C30, the EORTC QLQ-Muscle Invasive Bladder Cancer (BLM30), the Physical Functioning subscale of the EORTC QLQ-C30, and overall health status using the EuroQol Five Dimension Five Level Scale (EQ-5D-5L). (Exploratory) III. To compare longitudinal change over time by arm in patient-reported global QOL using the EORTC QLQ-C30, the Bowel Domain of the Expanded Prostate Index (EPIC Bowel Assessment), the bladder-specific supplement to the QLQ-C30, the EORTC QLQ-BLM30, the Physical Functioning subscale of the EORTC QLQ-C30, and overall health status using the EQ-5D-5L. (Exploratory)
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM I: Patients undergo radiation therapy (RT) (3 dimensional [D] CRT or intensity-modulated radiation therapy [IMRT]) daily Monday-Friday for up to 7-8 weeks. Patients also receive chemotherapy based on physician's choice of gemcitabine intravenously (IV) twice weekly for 6 weeks concurrent with RT, or cisplatin IV weekly for 6 weeks concurrent with RT, or fluorouracil IV on same days as doses 1-5 and 16-20 of radiation therapy and mitomycin IV on day 1 of radiation therapy in the absence of disease progression or unacceptable toxicity. Patients also undergo a transurethral resection of bladder tumor (TURBT) at randomization and week 18 as well as cystoscopy at randomization, at weeks 18, 30, 42, 54, then every 3 months through year 2, followed by every 6 months through year 5 and computed tomography (CT) or magnetic resonance imaging (MRI) at randomization, at weeks 18, 30, 42, 54, then every 6 months through year 2, followed by every 12 months through year 5.
ARM II: Patients undergo RT (3DCRT or IMRT) daily Monday-Friday for up to 7-8 weeks and receive chemotherapy based on physician's choice as in Arm I. Patients also receive atezolizumab IV over 30-60 minutes on day 1 of each cycle. Treatment repeats every 21 days for up to 9 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo a TURBT with bladder biopsy at randomization and week 18 as well as cystoscopy at randomization, at weeks 18, 30, 42, 54, then every 3 months through year 2, followed by every 6 months through year 5 and CT or MRI at randomization, at weeks 18, 30, 42, 54, then every 6 months through year 2, followed by every 12 months through year 5.
After completion of study treatment, patients are followed up every 3 months for 2 years, then every 6 months for 3 years.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 3
Contatti e Sedi
Luoghi di studio
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Arizona
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Phoenix, Arizona, Stati Uniti, 85054
- Mayo Clinic Hospital in Arizona
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Scottsdale, Arizona, Stati Uniti, 85259
- Mayo Clinic in Arizona
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Tucson, Arizona, Stati Uniti, 85719
- Banner University Medical Center - Tucson
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Tucson, Arizona, Stati Uniti, 85719
- University of Arizona Cancer Center-North Campus
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California
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Auburn, California, Stati Uniti, 95602
- Sutter Auburn Faith Hospital
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Auburn, California, Stati Uniti, 95603
- Sutter Cancer Centers Radiation Oncology Services-Auburn
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Berkeley, California, Stati Uniti, 94704
- Alta Bates Summit Medical Center-Herrick Campus
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Carmichael, California, Stati Uniti, 95608
- Mercy San Juan Medical Center
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Carmichael, California, Stati Uniti, 95608
- Mercy Cancer Center - Carmichael
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Elk Grove, California, Stati Uniti, 95758
- Mercy Cancer Center - Elk Grove
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La Jolla, California, Stati Uniti, 92093
- UC San Diego Moores Cancer Center
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Los Angeles, California, Stati Uniti, 90033
- USC / Norris Comprehensive Cancer Center
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Los Angeles, California, Stati Uniti, 90048
- Cedars-Sinai Medical Center
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Los Angeles, California, Stati Uniti, 90033
- Los Angeles General Medical Center
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Marysville, California, Stati Uniti, 95901
- Fremont - Rideout Cancer Center
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Modesto, California, Stati Uniti, 95355
- Memorial Medical Center
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Orange, California, Stati Uniti, 92868
- UC Irvine Health/Chao Family Comprehensive Cancer Center
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Palo Alto, California, Stati Uniti, 94301
- Palo Alto Medical Foundation Health Care
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Rocklin, California, Stati Uniti, 95765
- Mercy Cancer Center - Rocklin
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Roseville, California, Stati Uniti, 95661
- Sutter Cancer Centers Radiation Oncology Services-Roseville
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Roseville, California, Stati Uniti, 95661
- Sutter Roseville Medical Center
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Sacramento, California, Stati Uniti, 95816
- Sutter Medical Center Sacramento
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Sacramento, California, Stati Uniti, 95817
- University of California Davis Comprehensive Cancer Center
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Sacramento, California, Stati Uniti, 95816
- Mercy Cancer Center - Sacramento
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San Luis Obispo, California, Stati Uniti, 93401
- Pacific Central Coast Health Center-San Luis Obispo
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Sunnyvale, California, Stati Uniti, 94086
- Palo Alto Medical Foundation-Sunnyvale
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Woodland, California, Stati Uniti, 95695
- Woodland Memorial Hospital
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Colorado
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Aurora, Colorado, Stati Uniti, 80045
- UCHealth University of Colorado Hospital
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Boulder, Colorado, Stati Uniti, 80304
- Rocky Mountain Cancer Centers-Boulder
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Colorado Springs, Colorado, Stati Uniti, 80909
- UCHealth Memorial Hospital Central
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Colorado Springs, Colorado, Stati Uniti, 80920
- Memorial Hospital North
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Edwards, Colorado, Stati Uniti, 81632
- Shaw Cancer Center
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Fort Collins, Colorado, Stati Uniti, 80524
- Poudre Valley Hospital
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Fort Collins, Colorado, Stati Uniti, 80528
- Cancer Care and Hematology-Fort Collins
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Greeley, Colorado, Stati Uniti, 80631
- UCHealth Greeley Hospital
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Greeley, Colorado, Stati Uniti, 80631
- Banner North Colorado Medical Center
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Loveland, Colorado, Stati Uniti, 80538
- Medical Center of the Rockies
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Loveland, Colorado, Stati Uniti, 80539
- Banner North Colorado Medical Center - Loveland Campus
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Connecticut
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Greenwich, Connecticut, Stati Uniti, 06830
- Smilow Cancer Hospital Care Center at Greenwich
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Guilford, Connecticut, Stati Uniti, 06437
- Smilow Cancer Hospital Care Center - Guilford
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Hartford, Connecticut, Stati Uniti, 06102
- Hartford Hospital
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Meriden, Connecticut, Stati Uniti, 06451
- Midstate Medical Center
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New Britain, Connecticut, Stati Uniti, 06050
- The Hospital of Central Connecticut
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New Haven, Connecticut, Stati Uniti, 06520
- Yale University
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North Haven, Connecticut, Stati Uniti, 06473
- Yale-New Haven Hospital North Haven Medical Center
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Trumbull, Connecticut, Stati Uniti, 06611
- Smilow Cancer Hospital Care Center-Trumbull
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Waterford, Connecticut, Stati Uniti, 06385
- Smilow Cancer Hospital Care Center - Waterford
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Delaware
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Millville, Delaware, Stati Uniti, 19967
- Beebe South Coastal Health Campus
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Newark, Delaware, Stati Uniti, 19713
- Helen F Graham Cancer Center
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Newark, Delaware, Stati Uniti, 19713
- Medical Oncology Hematology Consultants PA
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Rehoboth Beach, Delaware, Stati Uniti, 19971
- Beebe Health Campus
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District of Columbia
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Washington D.C., District of Columbia, Stati Uniti, 20016
- Sibley Memorial Hospital
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Florida
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Aventura, Florida, Stati Uniti, 33180
- Mount Sinai Comprehensive Cancer Center at Aventura
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Coral Gables, Florida, Stati Uniti, 33146
- UM Sylvester Comprehensive Cancer Center at Coral Gables
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Deerfield Beach, Florida, Stati Uniti, 33442
- UM Sylvester Comprehensive Cancer Center at Deerfield Beach
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Gainesville, Florida, Stati Uniti, 32610
- UF Health Cancer Institute - Gainesville
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Miami, Florida, Stati Uniti, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
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Miami Beach, Florida, Stati Uniti, 33140
- Mount Sinai Medical Center
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N. Venice, Florida, Stati Uniti, 34275
- Sarasota Memorial Hospital-Venice
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Sarasota, Florida, Stati Uniti, 34239
- Sarasota Memorial Hospital
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Sarasota, Florida, Stati Uniti, 34232
- Florida Cancer Specialists - Sarasota
-
Sarasota, Florida, Stati Uniti, 34239
- First Physicians Group - Urology Robotic and Minimally Invasive Surgery
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Sarasota, Florida, Stati Uniti, 34243
- Sarasota Memorial Health Care Center at University Parkway
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Sarasota, Florida, Stati Uniti, 34239
- Florida Cancer Specialists - Sarasota Downtown
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Tampa, Florida, Stati Uniti, 33612
- Moffitt Cancer Center
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Georgia
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Atlanta, Georgia, Stati Uniti, 30308
- Emory University Hospital Midtown
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Atlanta, Georgia, Stati Uniti, 30322
- Emory University Hospital/Winship Cancer Institute
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Atlanta, Georgia, Stati Uniti, 30342
- Emory Saint Joseph's Hospital
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Newnan, Georgia, Stati Uniti, 30265
- CTCA at Southeastern Regional Medical Center
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Hawaii
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Honolulu, Hawaii, Stati Uniti, 96813
- Queen's Medical Center
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Honolulu, Hawaii, Stati Uniti, 96817
- The Cancer Center of Hawaii-Liliha
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Honolulu, Hawaii, Stati Uniti, 96813
- Hawaii Cancer Care Inc - Waterfront Plaza
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Honolulu, Hawaii, Stati Uniti, 96813
- Queen's Cancer Cenrer - POB I
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Honolulu, Hawaii, Stati Uniti, 96813
- Straub Clinic and Hospital
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Honolulu, Hawaii, Stati Uniti, 96817
- Queen's Cancer Center - Kuakini
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‘Aiea, Hawaii, Stati Uniti, 96701
- Hawaii Cancer Care - Westridge
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‘Aiea, Hawaii, Stati Uniti, 96701
- Pali Momi Medical Center
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‘Aiea, Hawaii, Stati Uniti, 96701
- The Cancer Center of Hawaii-Pali Momi
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Illinois
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Barrington, Illinois, Stati Uniti, 60010
- Advocate Good Shepherd Hospital
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Bloomington, Illinois, Stati Uniti, 61704
- Illinois CancerCare-Bloomington
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Canton, Illinois, Stati Uniti, 61520
- Illinois CancerCare-Canton
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Carthage, Illinois, Stati Uniti, 62321
- Illinois CancerCare-Carthage
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Chicago, Illinois, Stati Uniti, 60611
- Northwestern University
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Chicago, Illinois, Stati Uniti, 60657
- Advocate Illinois Masonic Medical Center
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Chicago, Illinois, Stati Uniti, 60612
- Rush MD Anderson Cancer Center
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Crystal Lake, Illinois, Stati Uniti, 60014
- AMG Crystal Lake - Oncology
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DeKalb, Illinois, Stati Uniti, 60115
- Northwestern Medicine Cancer Center Kishwaukee
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Decatur, Illinois, Stati Uniti, 62526
- Decatur Memorial Hospital
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Downers Grove, Illinois, Stati Uniti, 60515
- Advocate Good Samaritan Hospital
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Effingham, Illinois, Stati Uniti, 62401
- Crossroads Cancer Center
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Elgin, Illinois, Stati Uniti, 60123
- Advocate Sherman Hospital
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Elmhurst, Illinois, Stati Uniti, 60126
- Elmhurst Memorial Hospital
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Eureka, Illinois, Stati Uniti, 61530
- Illinois CancerCare-Eureka
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Evanston, Illinois, Stati Uniti, 60201
- NorthShore University HealthSystem-Evanston Hospital
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Galesburg, Illinois, Stati Uniti, 61401
- Western Illinois Cancer Treatment Center
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Galesburg, Illinois, Stati Uniti, 61401
- Illinois CancerCare-Galesburg
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Geneva, Illinois, Stati Uniti, 60134
- Northwestern Medicine Cancer Center Delnor
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Glenview, Illinois, Stati Uniti, 60026
- NorthShore University HealthSystem-Glenbrook Hospital
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Hazel Crest, Illinois, Stati Uniti, 60429
- Advocate South Suburban Hospital
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Highland Park, Illinois, Stati Uniti, 60035
- NorthShore University HealthSystem-Highland Park Hospital
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Hines, Illinois, Stati Uniti, 60141
- Edward Hines Jr VA Hospital
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Kewanee, Illinois, Stati Uniti, 61443
- Illinois CancerCare-Kewanee Clinic
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Libertyville, Illinois, Stati Uniti, 60048
- Condell Memorial Hospital
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Libertyville, Illinois, Stati Uniti, 60048
- AMG Libertyville - Oncology
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Macomb, Illinois, Stati Uniti, 61455
- Illinois CancerCare-Macomb
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Maywood, Illinois, Stati Uniti, 60153
- Loyola University Medical Center
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Naperville, Illinois, Stati Uniti, 60540
- Edward Hospital/Cancer Center
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Oak Lawn, Illinois, Stati Uniti, 60453-2699
- Advocate Christ Medical Center
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Ottawa, Illinois, Stati Uniti, 61350
- Illinois CancerCare-Ottawa Clinic
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Park Ridge, Illinois, Stati Uniti, 60068
- Advocate Lutheran General Hospital
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Pekin, Illinois, Stati Uniti, 61554
- Illinois CancerCare-Pekin
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Peoria, Illinois, Stati Uniti, 61636
- Methodist Medical Center of Illinois
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Peoria, Illinois, Stati Uniti, 61637
- OSF Saint Francis Medical Center
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Peoria, Illinois, Stati Uniti, 61615
- Illinois CancerCare-Peoria
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Peru, Illinois, Stati Uniti, 61354
- Illinois CancerCare-Peru
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Princeton, Illinois, Stati Uniti, 61356
- Illinois CancerCare-Princeton
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Springfield, Illinois, Stati Uniti, 62702
- Springfield Clinic
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Springfield, Illinois, Stati Uniti, 62781
- Springfield Memorial Hospital
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Urbana, Illinois, Stati Uniti, 61801
- Carle Cancer Center
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Warrenville, Illinois, Stati Uniti, 60555
- Northwestern Medicine Cancer Center Warrenville
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Washington, Illinois, Stati Uniti, 61571
- Illinois CancerCare - Washington
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Indiana
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Indianapolis, Indiana, Stati Uniti, 46219
- Community Cancer Center East
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Indianapolis, Indiana, Stati Uniti, 46227
- Community Cancer Center South
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Indianapolis, Indiana, Stati Uniti, 46256
- Community Cancer Center North
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Richmond, Indiana, Stati Uniti, 47374
- Reid Health
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Iowa
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Ames, Iowa, Stati Uniti, 50010
- Mary Greeley Medical Center
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Ames, Iowa, Stati Uniti, 50010
- McFarland Clinic - Ames
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Clive, Iowa, Stati Uniti, 50325
- Mercy Cancer Center-West Lakes
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Clive, Iowa, Stati Uniti, 50325
- UI Health Care Mission Cancer and Blood - West Des Moines Clinic
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Creston, Iowa, Stati Uniti, 50801
- Greater Regional Medical Center
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Des Moines, Iowa, Stati Uniti, 50309
- Iowa Methodist Medical Center
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Des Moines, Iowa, Stati Uniti, 50314
- Mercy Medical Center - Des Moines
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Des Moines, Iowa, Stati Uniti, 50314
- UI Health Care Mission Cancer and Blood - Laurel Clinic
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West Des Moines, Iowa, Stati Uniti, 50266
- Mercy Medical Center-West Lakes
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Kansas
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Kansas City, Kansas, Stati Uniti, 66160
- University of Kansas Cancer Center
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Overland Park, Kansas, Stati Uniti, 66210
- University of Kansas Cancer Center-Overland Park
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Westwood, Kansas, Stati Uniti, 66205
- University of Kansas Hospital-Westwood Cancer Center
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Wichita, Kansas, Stati Uniti, 67214
- Ascension Via Christi Hospitals Wichita
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Kentucky
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Lexington, Kentucky, Stati Uniti, 40536
- University of Kentucky/Markey Cancer Center
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Lexington, Kentucky, Stati Uniti, 40503
- Baptist Health Lexington
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Louisville, Kentucky, Stati Uniti, 40202
- The James Graham Brown Cancer Center at University of Louisville
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Louisville, Kentucky, Stati Uniti, 40207
- Baptist Health Louisville
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Louisiana
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Baton Rouge, Louisiana, Stati Uniti, 70809
- Louisiana Hematology Oncology Associates LLC
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Baton Rouge, Louisiana, Stati Uniti, 70809
- Mary Bird Perkins Cancer Center
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Metairie, Louisiana, Stati Uniti, 70006
- East Jefferson General Hospital
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Metairie, Louisiana, Stati Uniti, 70006
- LSU Healthcare Network / Metairie Multi-Specialty Clinic
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New Orleans, Louisiana, Stati Uniti, 70112
- University Medical Center New Orleans
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Maine
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Bath, Maine, Stati Uniti, 04530
- MaineHealth Coastal Cancer Treatment Center
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Belfast, Maine, Stati Uniti, 04915
- MaineHealth Waldo Hospital
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Biddeford, Maine, Stati Uniti, 04005
- MaineHealth Maine Medical Center - Biddeford
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Norway, Maine, Stati Uniti, 04268
- MaineHealth Stephens Hospital
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Portland, Maine, Stati Uniti, 04102
- MaineHealth Maine Medical Center - Portland
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Rockport, Maine, Stati Uniti, 04856
- Penobscot Bay Medical Center
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Sanford, Maine, Stati Uniti, 04073
- MaineHealth Cancer Care Center of York County
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Sanford, Maine, Stati Uniti, 04073
- MaineHealth Cancer Care and IV Therapy - Sanford
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Scarborough, Maine, Stati Uniti, 04074
- MaineHealth Maine Medical Center- Scarborough
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South Portland, Maine, Stati Uniti, 04106
- MaineHealth Cancer Care and IV Therapy - South Portland
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Maryland
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Baltimore, Maryland, Stati Uniti, 21287
- Johns Hopkins University/Sidney Kimmel Cancer Center
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Massachusetts
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Boston, Massachusetts, Stati Uniti, 02215
- Dana-Farber Cancer Institute
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Boston, Massachusetts, Stati Uniti, 02114
- Massachusetts General Hospital Cancer Center
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Lowell, Massachusetts, Stati Uniti, 01854
- Lowell General Hospital
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Michigan
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Ann Arbor, Michigan, Stati Uniti, 48109
- University of Michigan Rogel Cancer Center
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Ann Arbor, Michigan, Stati Uniti, 48106
- Trinity Health Saint Joseph Mercy Hospital Ann Arbor
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Battle Creek, Michigan, Stati Uniti, 49017
- Bronson Battle Creek
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Brighton, Michigan, Stati Uniti, 48116
- University of Michigan - Brighton Center for Specialty Care
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Brighton, Michigan, Stati Uniti, 48114
- Trinity Health Medical Center - Brighton
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Canton, Michigan, Stati Uniti, 48188
- Trinity Health Medical Center - Canton
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Chelsea, Michigan, Stati Uniti, 48118
- Chelsea Hospital
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Clarkston, Michigan, Stati Uniti, 48346
- Michigan Healthcare Professionals Clarkston
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Dearborn, Michigan, Stati Uniti, 48124
- Corewell Health Dearborn Hospital
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Detroit, Michigan, Stati Uniti, 48202
- Henry Ford Hospital
-
Detroit, Michigan, Stati Uniti, 48201
- Wayne State University/Karmanos Cancer Institute
-
Detroit, Michigan, Stati Uniti, 48236
- Henry Ford Health Saint John Hospital
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Farmington Hills, Michigan, Stati Uniti, 48334
- Weisberg Cancer Treatment Center
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Farmington Hills, Michigan, Stati Uniti, 48334
- Michigan Healthcare Professionals Farmington
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Farmington Hills, Michigan, Stati Uniti, 48336
- Corewell Health Farmington Hills Hospital
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Kalamazoo, Michigan, Stati Uniti, 49007
- West Michigan Cancer Center
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Lansing, Michigan, Stati Uniti, 48912
- University of Michigan Health - Sparrow Lansing
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Livonia, Michigan, Stati Uniti, 48154
- Trinity Health Saint Mary Mercy Livonia Hospital
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Macomb, Michigan, Stati Uniti, 48044
- Henry Ford Saint John Hospital - Macomb Medical
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Madison Heights, Michigan, Stati Uniti, 48071
- Michigan Healthcare Professionals Madison Heights
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Pontiac, Michigan, Stati Uniti, 48341
- Trinity Health Saint Joseph Mercy Oakland Hospital
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Pontiac, Michigan, Stati Uniti, 48341
- Michigan Healthcare Professionals Pontiac
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Royal Oak, Michigan, Stati Uniti, 48073
- Corewell Health William Beaumont University Hospital
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Saginaw, Michigan, Stati Uniti, 48601
- MyMichigan Medical Center Saginaw
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Traverse City, Michigan, Stati Uniti, 49684
- Munson Medical Center
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Troy, Michigan, Stati Uniti, 48098
- Michigan Healthcare Professionals Troy
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Troy, Michigan, Stati Uniti, 48085
- Corewell Health Beaumont Troy Hospital
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Warren, Michigan, Stati Uniti, 48093
- Henry Ford Health Warren Hospital
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West Bloomfield, Michigan, Stati Uniti, 48322
- Henry Ford West Bloomfield Hospital
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Wyoming, Michigan, Stati Uniti, 49519
- University of Michigan Health - West
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Minnesota
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Bemidji, Minnesota, Stati Uniti, 56601
- Sanford Joe Lueken Cancer Center
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Coon Rapids, Minnesota, Stati Uniti, 55433
- Mercy Hospital
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Duluth, Minnesota, Stati Uniti, 55805
- Miller-Dwan Hospital
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Edina, Minnesota, Stati Uniti, 55435
- Fairview Southdale Hospital
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Fridley, Minnesota, Stati Uniti, 55432
- Unity Hospital
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Monticello, Minnesota, Stati Uniti, 55362
- Monticello Cancer Center
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Rochester, Minnesota, Stati Uniti, 55905
- Mayo Clinic in Rochester
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Saint Cloud, Minnesota, Stati Uniti, 56303
- Coborn Cancer Center at Saint Cloud Hospital
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Saint Louis Park, Minnesota, Stati Uniti, 55416
- Park Nicollet Clinic - Saint Louis Park
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Saint Paul, Minnesota, Stati Uniti, 55101
- Regions Hospital
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Missouri
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Bonne Terre, Missouri, Stati Uniti, 63628
- Parkland Health Center-Bonne Terre
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Cape Girardeau, Missouri, Stati Uniti, 63703
- Saint Francis Medical Center
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City of Saint Peters, Missouri, Stati Uniti, 63376
- Siteman Cancer Center at Saint Peters Hospital
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Creve Coeur, Missouri, Stati Uniti, 63141
- Siteman Cancer Center at West County Hospital
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Kansas City, Missouri, Stati Uniti, 64154
- University of Kansas Cancer Center - North
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Lee's Summit, Missouri, Stati Uniti, 64064
- University of Kansas Cancer Center - Lee's Summit
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Saint Joseph, Missouri, Stati Uniti, 64506
- Heartland Regional Medical Center
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Sainte Genevieve, Missouri, Stati Uniti, 63670
- Sainte Genevieve County Memorial Hospital
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Springfield, Missouri, Stati Uniti, 65807
- CoxHealth South Hospital
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St Louis, Missouri, Stati Uniti, 63110
- Washington University School of Medicine
-
St Louis, Missouri, Stati Uniti, 63129
- Siteman Cancer Center-South County
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St Louis, Missouri, Stati Uniti, 63131
- Missouri Baptist Medical Center
-
St Louis, Missouri, Stati Uniti, 63141
- Mercy Hospital Saint Louis
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St Louis, Missouri, Stati Uniti, 63128
- Mercy Hospital South
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Sullivan, Missouri, Stati Uniti, 63080
- Missouri Baptist Sullivan Hospital
-
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Montana
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Billings, Montana, Stati Uniti, 59101
- Billings Clinic Cancer Center
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Bozeman, Montana, Stati Uniti, 59715
- Bozeman Health Deaconess Hospital
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Great Falls, Montana, Stati Uniti, 59405
- Benefis Sletten Cancer Institute
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Nebraska
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Bellevue, Nebraska, Stati Uniti, 68123
- Nebraska Medicine-Bellevue
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Kearney, Nebraska, Stati Uniti, 68847
- CHI Health Good Samaritan
-
Omaha, Nebraska, Stati Uniti, 68114
- Nebraska Methodist Hospital
-
Omaha, Nebraska, Stati Uniti, 68198
- University of Nebraska Medical Center
-
Omaha, Nebraska, Stati Uniti, 68118
- Nebraska Medicine-Village Pointe
-
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Nevada
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Las Vegas, Nevada, Stati Uniti, 89102
- OptumCare Cancer Care at Charleston
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Las Vegas, Nevada, Stati Uniti, 89106
- Radiation Oncology Centers of Nevada Central
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Las Vegas, Nevada, Stati Uniti, 89119
- Radiation Oncology Centers of Nevada Southeast
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Las Vegas, Nevada, Stati Uniti, 89128
- Comprehensive Cancer Centers of Nevada - Northwest
-
Las Vegas, Nevada, Stati Uniti, 89144
- Comprehensive Cancer Centers of Nevada - Town Center
-
Las Vegas, Nevada, Stati Uniti, 89148
- Comprehensive Cancer Centers of Nevada
-
Las Vegas, Nevada, Stati Uniti, 89169
- Comprehensive Cancer Centers of Nevada - Central Valley
-
Las Vegas, Nevada, Stati Uniti, 89183
- OptumCare Cancer Care at Fort Apache
-
Reno, Nevada, Stati Uniti, 89502
- Renown Regional Medical Center
-
-
New Hampshire
-
Lebanon, New Hampshire, Stati Uniti, 03756
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
-
-
New Jersey
-
Basking Ridge, New Jersey, Stati Uniti, 07920
- Memorial Sloan Kettering Basking Ridge
-
Camden, New Jersey, Stati Uniti, 08103
- Cooper Hospital University Medical Center
-
Hackensack, New Jersey, Stati Uniti, 07601
- Hackensack University Medical Center
-
Middletown, New Jersey, Stati Uniti, 07748
- Memorial Sloan Kettering Monmouth
-
Montvale, New Jersey, Stati Uniti, 07645
- Memorial Sloan Kettering Bergen
-
Voorhees Township, New Jersey, Stati Uniti, 08043
- MD Anderson Cancer Center at Cooper-Voorhees
-
-
New York
-
Commack, New York, Stati Uniti, 11725
- Memorial Sloan Kettering Commack
-
Harrison, New York, Stati Uniti, 10604
- Memorial Sloan Kettering Westchester
-
Lake Success, New York, Stati Uniti, 11042
- Northwell Health/Center for Advanced Medicine
-
New York, New York, Stati Uniti, 10065
- Memorial Sloan Kettering Cancer Center
-
Rochester, New York, Stati Uniti, 14642
- University of Rochester
-
Rochester, New York, Stati Uniti, 14620
- Highland Hospital
-
Sleepy Hollow, New York, Stati Uniti, 10591
- Phelps Memorial Hospital Center
-
Stony Brook, New York, Stati Uniti, 11794
- Stony Brook University Medical Center
-
Syracuse, New York, Stati Uniti, 13210
- State University of New York Upstate Medical University
-
The Bronx, New York, Stati Uniti, 10461
- Montefiore Medical Center-Einstein Campus
-
The Bronx, New York, Stati Uniti, 10467
- Montefiore Medical Center - Moses Campus
-
The Bronx, New York, Stati Uniti, 10461
- Montefiore Medical Center-Weiler Hospital
-
Uniondale, New York, Stati Uniti, 11553
- Memorial Sloan Kettering Nassau
-
West Islip, New York, Stati Uniti, 11795
- Good Samaritan University Hospital
-
-
North Carolina
-
Hendersonville, North Carolina, Stati Uniti, 28791
- Margaret R Pardee Memorial Hospital
-
Kenansville, North Carolina, Stati Uniti, 28349
- ECU Health Oncology Kenansville
-
Kinston, North Carolina, Stati Uniti, 28501
- ECU Health Oncology Kinston
-
Richlands, North Carolina, Stati Uniti, 28574
- ECU Health Oncology Richlands
-
-
North Dakota
-
Bismarck, North Dakota, Stati Uniti, 58501
- Sanford Bismarck Medical Center
-
Fargo, North Dakota, Stati Uniti, 58122
- Sanford Roger Maris Cancer Center
-
Fargo, North Dakota, Stati Uniti, 58122
- Sanford Broadway Medical Center
-
-
Ohio
-
Cincinnati, Ohio, Stati Uniti, 45219
- University of Cincinnati Cancer Center-UC Medical Center
-
Cleveland, Ohio, Stati Uniti, 44109
- MetroHealth Medical Center
-
Columbus, Ohio, Stati Uniti, 43210
- Ohio State University Comprehensive Cancer Center
-
Dayton, Ohio, Stati Uniti, 45415
- Dayton Physician LLC - Englewood
-
Kettering, Ohio, Stati Uniti, 45429
- Kettering Medical Center
-
Kettering, Ohio, Stati Uniti, 45409
- Greater Dayton Cancer Center
-
West Chester, Ohio, Stati Uniti, 45069
- University of Cincinnati Cancer Center-West Chester
-
-
Oklahoma
-
Lawton, Oklahoma, Stati Uniti, 73505
- Cancer Centers of Southwest Oklahoma Research
-
Oklahoma City, Oklahoma, Stati Uniti, 73104
- University of Oklahoma Health Sciences Center
-
Oklahoma City, Oklahoma, Stati Uniti, 73120
- Mercy Hospital Oklahoma City
-
-
Oregon
-
Portland, Oregon, Stati Uniti, 97239
- Oregon Health and Science University
-
-
Pennsylvania
-
Allentown, Pennsylvania, Stati Uniti, 18103
- Lehigh Valley Hospital-Cedar Crest
-
Altoona, Pennsylvania, Stati Uniti, 16601
- UPMC Altoona
-
Beaver, Pennsylvania, Stati Uniti, 15009
- UPMC-Heritage Valley Health System Beaver
-
Bethlehem, Pennsylvania, Stati Uniti, 18017
- Lehigh Valley Hospital - Muhlenberg
-
Carlisle, Pennsylvania, Stati Uniti, 17015
- Carlisle Regional Cancer Center
-
Chadds Ford, Pennsylvania, Stati Uniti, 19317
- Christiana Care Health System-Concord Health Center
-
Danville, Pennsylvania, Stati Uniti, 17822
- Geisinger Medical Center
-
Erie, Pennsylvania, Stati Uniti, 16505
- UPMC Hillman Cancer Center Erie
-
Farrell, Pennsylvania, Stati Uniti, 16121
- UPMC Cancer Center at UPMC Horizon
-
Greensburg, Pennsylvania, Stati Uniti, 15601
- UPMC Cancer Centers - Arnold Palmer Pavilion
-
Harrisburg, Pennsylvania, Stati Uniti, 17109
- UPMC Pinnacle Cancer Center/Community Osteopathic Campus
-
Hershey, Pennsylvania, Stati Uniti, 17033-0850
- Penn State Milton S Hershey Medical Center
-
Johnstown, Pennsylvania, Stati Uniti, 15901
- UPMC-Johnstown/John P. Murtha Regional Cancer Center
-
Lewisburg, Pennsylvania, Stati Uniti, 17837
- Geisinger Medical Oncology-Lewisburg
-
McKeesport, Pennsylvania, Stati Uniti, 15132
- UPMC Cancer Center at UPMC McKeesport
-
Mechanicsburg, Pennsylvania, Stati Uniti, 17050
- UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion
-
Monroeville, Pennsylvania, Stati Uniti, 15146
- UPMC Cancer Center - Monroeville
-
Moon Township, Pennsylvania, Stati Uniti, 15108
- UPMC Hillman Cancer Center in Coraopolis
-
N. Huntingdon, Pennsylvania, Stati Uniti, 15642
- Arnold Palmer Cancer Center Medical Oncology Norwin
-
New Castle, Pennsylvania, Stati Uniti, 16105
- UPMC Hillman Cancer Center - New Castle
-
Pittsburgh, Pennsylvania, Stati Uniti, 15232
- UPMC Hillman Cancer Center
-
Pittsburgh, Pennsylvania, Stati Uniti, 15213
- UPMC-Magee Womens Hospital
-
Pittsburgh, Pennsylvania, Stati Uniti, 15232
- UPMC-Shadyside Hospital
-
Pittsburgh, Pennsylvania, Stati Uniti, 15215
- UPMC-Saint Margaret
-
Pittsburgh, Pennsylvania, Stati Uniti, 15237
- UPMC-Passavant Hospital
-
Pittsburgh, Pennsylvania, Stati Uniti, 15243
- UPMC-Saint Clair Hospital Cancer Center
-
Seneca, Pennsylvania, Stati Uniti, 16346
- UPMC Cancer Center at UPMC Northwest
-
Uniontown, Pennsylvania, Stati Uniti, 15401
- UPMC Uniontown Hospital Radiation Oncology
-
Washington, Pennsylvania, Stati Uniti, 15301
- UPMC Washington Hospital Radiation Oncology
-
Wilkes-Barre, Pennsylvania, Stati Uniti, 18711
- Geisinger Wyoming Valley/Henry Cancer Center
-
York, Pennsylvania, Stati Uniti, 17408
- UPMC Memorial
-
-
South Carolina
-
Charleston, South Carolina, Stati Uniti, 29425
- Medical University of South Carolina
-
Greenville, South Carolina, Stati Uniti, 29605
- Prisma Health Cancer Institute - Faris
-
Greenville, South Carolina, Stati Uniti, 29615
- Prisma Health Cancer Institute - Eastside
-
Greer, South Carolina, Stati Uniti, 29650
- Prisma Health Cancer Institute - Greer
-
Greer, South Carolina, Stati Uniti, 29651
- Gibbs Cancer Center-Pelham
-
Myrtle Beach, South Carolina, Stati Uniti, 29577
- Carolina Regional Cancer Center
-
Spartanburg, South Carolina, Stati Uniti, 29303
- Spartanburg Medical Center
-
-
South Dakota
-
Sioux Falls, South Dakota, Stati Uniti, 57117-5134
- Sanford USD Medical Center - Sioux Falls
-
Sioux Falls, South Dakota, Stati Uniti, 57104
- Sanford Cancer Center Oncology Clinic
-
-
Tennessee
-
Nashville, Tennessee, Stati Uniti, 37232
- Vanderbilt University/Ingram Cancer Center
-
-
Texas
-
Dallas, Texas, Stati Uniti, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Galveston, Texas, Stati Uniti, 77555-0565
- University of Texas Medical Branch
-
Houston, Texas, Stati Uniti, 77030
- Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
-
Houston, Texas, Stati Uniti, 77030
- Michael E DeBakey VA Medical Center
-
Richardson, Texas, Stati Uniti, 75080
- UT Southwestern Clinical Center at Richardson/Plano
-
-
Vermont
-
Saint Johnsbury, Vermont, Stati Uniti, 05819
- Dartmouth Cancer Center - North
-
-
Virginia
-
Fishersville, Virginia, Stati Uniti, 22939
- Augusta Health Center for Cancer and Blood Disorders
-
-
Washington
-
Auburn, Washington, Stati Uniti, 98001
- MultiCare Auburn Medical Center
-
Gig Harbor, Washington, Stati Uniti, 98335
- MultiCare Gig Harbor Medical Park
-
Kirkland, Washington, Stati Uniti, 98034
- FHCC at EvergreenHealth
-
Puyallup, Washington, Stati Uniti, 98372
- MultiCare Good Samaritan Hospital
-
Renton, Washington, Stati Uniti, 98055
- Valley Medical Center
-
Seattle, Washington, Stati Uniti, 98195
- University of Washington Medical Center - Montlake
-
Seattle, Washington, Stati Uniti, 98109
- Fred Hutchinson Cancer Center
-
Silverdale, Washington, Stati Uniti, 98383
- Saint Joseph Medical Center Hematology and Oncology - Silverdale
-
Tacoma, Washington, Stati Uniti, 98405
- MultiCare Tacoma General Hospital
-
-
West Virginia
-
Morgantown, West Virginia, Stati Uniti, 26506
- West Virginia University Healthcare
-
-
Wisconsin
-
Antigo, Wisconsin, Stati Uniti, 54409
- Aspirus Cancer Care-Antigo-Volm Cancer Center
-
Appleton, Wisconsin, Stati Uniti, 54915
- Ascension Northeast Wisconsin-Saint Elizabeth Cancer Center-Appleton
-
Ashland, Wisconsin, Stati Uniti, 54806
- Northwest Wisconsin Cancer Center
-
Burlington, Wisconsin, Stati Uniti, 53105
- Aurora Cancer Care-Southern Lakes VLCC
-
Eau Claire, Wisconsin, Stati Uniti, 54701
- Marshfield Medical Center-EC Cancer Center
-
Eau Claire, Wisconsin, Stati Uniti, 54701
- Mayo Clinic Health System-Eau Claire Clinic
-
Germantown, Wisconsin, Stati Uniti, 53022
- Aurora Health Care Germantown Health Center
-
Grafton, Wisconsin, Stati Uniti, 53024
- Aurora Cancer Care-Grafton
-
Green Bay, Wisconsin, Stati Uniti, 54311
- Aurora BayCare Medical Center
-
Green Bay, Wisconsin, Stati Uniti, 54301
- Bellin Memorial Hospital
-
Kenosha, Wisconsin, Stati Uniti, 53142
- Aurora Cancer Care-Kenosha South
-
La Crosse, Wisconsin, Stati Uniti, 54601
- Mayo Clinic Health System-Franciscan Healthcare
-
Marinette, Wisconsin, Stati Uniti, 54143
- Aurora Bay Area Medical Group-Marinette
-
Marshfield, Wisconsin, Stati Uniti, 54449
- Marshfield Medical Center-Marshfield
-
Medford, Wisconsin, Stati Uniti, 54451
- Aspirus Medford Hospital
-
Milwaukee, Wisconsin, Stati Uniti, 53209
- Aurora Cancer Care-Milwaukee
-
Milwaukee, Wisconsin, Stati Uniti, 53215
- Aurora Saint Luke's Medical Center
-
Milwaukee, Wisconsin, Stati Uniti, 53233
- Aurora Sinai Medical Center
-
Minocqua, Wisconsin, Stati Uniti, 54548
- Marshfield Medical Center - Minocqua
-
New Richmond, Wisconsin, Stati Uniti, 54017
- Cancer Center of Western Wisconsin
-
Oshkosh, Wisconsin, Stati Uniti, 54904
- Vince Lombardi Cancer Clinic - Oshkosh
-
Oshkosh, Wisconsin, Stati Uniti, 54904
- Ascension Northeast Wisconsin-Mercy Hospital-Oshkosh
-
Racine, Wisconsin, Stati Uniti, 53406
- Aurora Cancer Care-Racine
-
Racine, Wisconsin, Stati Uniti, 53405
- Ascension All Saints Hospital-Spring Street-Racine
-
Rice Lake, Wisconsin, Stati Uniti, 54868
- Marshfield Medical Center-Rice Lake
-
Sheboygan, Wisconsin, Stati Uniti, 53081
- Vince Lombardi Cancer Clinic-Sheboygan
-
Stevens Point, Wisconsin, Stati Uniti, 54482
- Marshfield Medical Center-River Region at Stevens Point
-
Stevens Point, Wisconsin, Stati Uniti, 54481
- Aspirus Cancer Care - Stevens Point
-
Summit, Wisconsin, Stati Uniti, 53066
- Aurora Medical Center in Summit
-
Two Rivers, Wisconsin, Stati Uniti, 54241
- Vince Lombardi Cancer Clinic-Two Rivers
-
Wausau, Wisconsin, Stati Uniti, 54401
- Aspirus Cancer Care-Wausau
-
Wauwatosa, Wisconsin, Stati Uniti, 53226
- Aurora Cancer Care-Milwaukee West
-
West Allis, Wisconsin, Stati Uniti, 53227
- Aurora West Allis Medical Center
-
Weston, Wisconsin, Stati Uniti, 54476
- Marshfield Medical Center - Weston
-
Wisconsin Rapids, Wisconsin, Stati Uniti, 54494
- Aspirus Cancer Care - Wisconsin Rapids
-
-
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
-
STEP 1 REGISTRATION: If this will be the first patient from a registering site to receive a given RT modality (3DCRT vs. IMRT), the site must first submit pre-RT planning documents within 3 days of Step 1 registration and receive approval from Imaging and Radiation Oncology Core (IROC) before randomizing the patient to Step 2. If this will not be the first patient to receive a specific RT modality, the patient should be immediately randomized to Step 2 on the same day.
-
STEP 2 RANDOMIZATION: If patient required review of pre-RT planning, randomization must occur within 14 days of initial registration.
-
Patients must have histologically proven, T2-T4a N0M0 urothelial carcinoma of the bladder within 120 days prior to randomization and no intervening treatment between the histologic proof and randomization. Patients with mixed urothelial carcinoma will be eligible for the trial, but the presence of small cell carcinoma will make a patient ineligible. Patients with lymph nodes >= 1.0 cm in shortest cross-sectional diameter on imaging (computed tomography [CT]/magnetic resonance imaging [MRI] of abdomen and pelvis) must have a biopsy of the enlarged lymph node showing no tumor involvement within 70 days prior to randomization. These patients may be suitable for neoadjuvant chemotherapy and radical cystectomy and are eligible for this trial if they seek out a bladder sparing treatment strategy, however patients who have received prior systemic chemotherapy for bladder cancer are not eligible for the trial.
-
Patients must undergo a transurethral resection of bladder tumor (TURBT) within 70 days prior to randomization. In a situation where a patient is referred from outside to the enrolling institution, patient must have a repeat office cystoscopy by the urologist who will be following the patient on the clinical trial to assess the adequacy of the prior TURBT. This cystoscopy can be performed in urologist office without general anesthesia. Patient may then undergo repeat TURBT if deemed necessary as standard of care by the treating urologist. Patients may have either completely or partially resected tumors as long as the treating urologist attempted maximal resection. Patient must not have T4b disease
-
Patients must undergo radiological staging within 70 days prior to randomization. Imaging of chest, abdomen, and pelvis must be performed using CT or MRI. Patients must not have evidence of T4bN1-3 disease. Eligibility is based on the local radiology report.
-
Patients with hydronephrosis are eligible if they have unilateral hydronephrosis and kidney function meets criteria specified.
-
Patients must not have had urothelial carcinoma or histological variant at any site outside of the urinary bladder within the previous 24 months except Ta/T1/carcinoma in situ (CIS) of the upper urinary tract including renal pelvis and ureter if the patient had undergone complete nephroureterectomy.
-
Patients must not have diffuse CIS based on cystoscopy and biopsy.
-
Patient must be planning to receive one of the protocol specified chemotherapy regimens.
-
All adverse events associated with any prior surgery and intravesical therapy must have resolved to Common Terminology Criteria for Adverse Events (CTCAE) grade =< 2 prior to randomization.
-
Patient must not have received any systemic chemotherapy for their bladder cancer.
-
Patient must not have had prior pelvic radiation.
-
Patients must not have received prior treatment for muscle invasive bladder cancer including neoadjuvant chemotherapy for the current tumor.
-
Patients must not have received any systemic therapy (including, but not limited to, interferon alfa-2b, high dose IL-2, pegylated interferon [PEG-IFN], anti-PD-1, anti-PD-L1), for non-muscle invasive bladder cancer. Prior intravesical bacillus Calmette-Guerin (BCG), interferon, and intravesical chemotherapy are allowed.
-
Patients must not have received any of the following prohibited therapies within 28 days prior to randomization or be planning to receive any of the following prohibited therapies during protocol treatment:
- Anti-cancer systemic chemotherapy or biological therapy not specified in the protocol.
- Immunotherapy not specified in this protocol.
- Systemic or intravesical use of any non-study anti-cancer agent (investigational or non-investigational).
- Investigational agents other than atezolizumab.
- Live vaccines: Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, chicken pox, shingles, yellow fever, rabies, BCG, and typhoid (oral) vaccine. Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (e.g. Flu-Mist®) are live attenuated vaccines, and are not allowed. Prior administration of intravesical BCG is allowed.
- Glucocorticoids for any purpose other than to modulate symptoms from an event of suspected immunologic etiology. The use of physiologic doses of corticosteroids (defined as 10 mg prednisone) are acceptable, however site investigators should consult with the study chair for any dose higher than 10 mg prednisone. Dexamethasone 4 mg IV with chemotherapy to prevent nausea is allowed.
- RANKL infusion: Concurrent denosumab (which binds the cytokine RANKL) for any known indication is prohibited due to interaction with study medication.
-
Patients must not have a major surgical procedure within 28 days prior to randomization. If patient had any surgical procedure then they should have recovered to full presurgical performance status and surgical adverse events should have resolved to grade =< 2. TURBT is not considered a major surgical procedure.
-
Patients must not have received treatment with systemic immunosuppressive medications (including, but not limited to, prednisone, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor [anti-TNF] agents) within 14 days prior to randomization. Exceptions:
- Patients may have received acute, low dose, systemic immunosuppressant medications (e.g., a one-time dose of dexamethasone for nausea).
- The use of inhaled corticosteroids and mineralocorticoids (e.g., fludrocortisone) for patients with orthostatic hypotension or adrenocortical insufficiency is allowed. Physiological doses equivalent of 10 mg prednisone daily are allowed. Short term steroids given as antiemetic therapy, e.g. 4 mg dexamethasone or equivalent once a week, is allowed.
-
Patients must not have received a live, attenuated vaccine within 4 weeks prior to randomization or anticipate that such a live, attenuated vaccine will be required while on protocol treatment and up to 5 months after the last dose of protocol treatment.
- Inactivated influenza vaccination should be given during influenza season only (approximately October to March). Patients must not receive live, attenuated influenza vaccine within 4 weeks prior to randomization or while on protocol treatment and up to 5 months after the last dose of protocol treatment.
-
Patients must not have undergone prior allogeneic bone marrow transplantation or prior solid organ transplantation.
-
Patients must be >= 18 years of age
-
Patient may or may not be radical cystectomy candidates.
-
Absolute neutrophil count (ANC) >= 1,500/microliter (mcL) (within 28 days prior to randomization).
-
Platelets >= 100,000/mcL (within 28 days prior to randomization).
-
Hemoglobin >= 9 g/dL (within 28 days prior to randomization).
-
Total bilirubin =< 1.5 x institutional upper limit of normal (IULN) (except patients with Gilbert's syndrome, who must have a total bilirubin < 3.0 mg/dL) (within 28 days prior to randomization).
-
Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) < 2.5 x IULN (within 28 days prior to randomization).
-
Patients must not have clinically significant liver disease that precludes patient from treatment regimens prescribed on the study (including, but not limited to, active viral, alcoholic or other autoimmune hepatitis, cirrhosis or inherited liver disease).
-
Patients must have adequate renal function as evidenced by calculated creatinine clearance >= 25 mL/min. The creatinine used to calculate the clearance result must have been obtained within 28 days prior to randomization.
-
Patients must have Zubrod performance status =< 2.
-
Patients must have a baseline electrocardiography (ECG) performed within 30 days prior to randomization.
-
Patient must not have history of idiopathic pulmonary fibrosis, pneumonitis (including drug induced), organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia, etc.), or evidence of active pneumonitis.
-
Patients must not have an active infection requiring oral or IV antibiotics within 14 days prior to randomization. Patients receiving prophylactic antibiotics (e.g., for prevention of a urinary tract infection or chronic obstructive pulmonary disease) are not eligible. If patient develops urinary tract infection after TURBT they must have recovered from the infection prior to registration.
-
Patients must not have active autoimmune disease that has required systemic treatment in past two years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment. Autoimmune diseases include, but are not limited to, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with antiphospholipid syndrome, Wegener's granulomatosis, Sjogren's syndrome, Bell's palsy, Guillain-Barre syndrome, multiple sclerosis, autoimmune thyroid disease, vasculitis, Graves' disease treated with methimazole or glomerulonephritis.
-
Patient must not have a history of active tuberculosis.
-
If patient has a known history of hepatitis B virus (HBV) or hepatitis C virus (HCV), they must meet the following criteria within 28 days prior to randomization.
- Patients with past or resolved hepatitis B infection (defined as having a negative hepatitis B surface antigen [HBsAg] test and a positive anti-HBc [antibody to hepatitis B core antigen] antibody test) are eligible.
- Patients positive for hepatitis C virus (HCV) antibody are eligible only if polymerase chain reaction (PCR) is negative for HCV ribonucleic acid (RNA).
-
Patients who are known to be positive for human immunodeficiency virus (HIV) are eligible only if they have all of the following:
- A stable regimen of highly active anti-retroviral therapy (HAART)
- No requirement for concurrent antibiotics or antifungal agents for the prevention of opportunistic infections
- A CD4 count above 250 cells/mcL and an undetectable HIV viral load on standard PCR-based tests within 28 days prior to randomization.
-
No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, adequately treated Stage I or II cancer from which the patient is currently in complete remission, or any other cancer from which the patient has been disease free for two years. Patients with localized prostate cancer who are being followed by an active surveillance program are also eligible.
-
Female patients of childbearing potential must have a serum pregnancy test prior to randomization. Patients must not be pregnant or nursing due to the potential teratogenic side effects of the protocol treatment. Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of protocol treatment, and for 5 months (150 days) after the last dose of all study drugs. A woman is considered to be of "reproductive potential" if she has had a menses at any time in the preceding 12 consecutive months.
-
Patients must not be known to be allergic to Chinese hamster egg or ovary cell products and must not have any known major allergic reactions to any study drug.
-
Patients must be offered the opportunity to participate in specimen banking for future studies.
-
Patients who can complete Patient-Reported Outcome instruments in English or Spanish must agree to complete the EORTC QLQ-C30, the EORTC QLQ-BLM30, the EPIC Bowel Assessment, and the EQ-5D-5L per protocol schedule of assessment.
-
As a part of the Oncology Patient Enrollment Network (OPEN) registration process the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the system.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Comparatore attivo: Arm I (RT, chemotherapy)
Patients undergo RT (3DCRT or IMRT) daily Monday-Friday for up to 7-8 weeks. Patients also receive chemotherapy based on physician's choice of gemcitabine IV twice weekly for 6 weeks concurrent with RT, or cisplatin IV weekly for 6 weeks concurrent with RT, or fluorouracil IV on same days as doses 1-5 and 16-20 of radiation therapy and mitomycin IV on day 1 of radiation therapy in the absence of disease progression or unacceptable toxicity. Patients also undergo a TURBT with bladder biopsy at randomization and week 18 as well as cystoscopy at randomization, at weeks 18, 30, 42, 54, then every 3 months through year 2, followed by every 6months through year 5 and CT or MRI at randomization, at weeks 18, 30, 42, 54, then every 6 months through year 2, followed by every 12 months through year 5. |
Ancillary studies
Altri nomi:
Given IV
Altri nomi:
Given IV
Altri nomi:
Given IV
Altri nomi:
Undergo a cystoscopy
Altri nomi:
Given IV
Altri nomi:
Ancillary studies Undergo a bladder biopsy
Altri nomi:
Undergo CT or MRI
Altri nomi:
Undergo CT or MRI
Altri nomi:
Undergo 3DCRT or IMRT
Altri nomi:
Undergo a TURBT
Altri nomi:
|
|
Sperimentale: Arm II (RT, chemotherapy, atezolizumab)
Patients undergo RT (3DCRT or IMRT) daily Monday-Friday for up to 7-8 weeks and receive chemotherapy based on physician's choice as in Arm I. Patients also receive atezolizumab IV over 30-60 minutes on day 1 of each cycle. Treatment repeats every 21 days for up to 9 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo a TURBT with bladder biopsy at randomization and week 18 as well as cystoscopy at randomization, at weeks 18, 30, 42, 54, then every 3 months through year 2, followed by every 6months through year 5 and CT or MRI at randomization, at weeks 18, 30, 42, 54, then every 6 months through year 2, followed by every 12 months through year 5. |
Ancillary studies
Altri nomi:
Given IV
Altri nomi:
Given IV
Altri nomi:
Given IV
Altri nomi:
Given IV
Altri nomi:
Undergo a cystoscopy
Altri nomi:
Given IV
Altri nomi:
Ancillary studies Undergo a bladder biopsy
Altri nomi:
Undergo CT or MRI
Altri nomi:
Undergo CT or MRI
Altri nomi:
Undergo 3DCRT or IMRT
Altri nomi:
Undergo a TURBT
Altri nomi:
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Bladder intact event-free survival (BI-EFS)
Lasso di tempo: From the date of randomization to the first documentation of a BI-EFS event, assessed up to 5 years
|
At each time point, futility will be evaluated, and in the latter two analyses, efficacy will also be evaluated as specified. The final BI-EFS intent-to-treat analysis will be conducted using a stratified logrank test stratifying on stratification factors, and testing treatment at the one-sided significance level of 0.022 to account for multiple interim testing. The hazard ratio (HR) will be estimated using a stratified Cox proportional hazards model and the 95% confidence interval (CI) for the HR will be provided. Results from an unstratified analysis will also be provided. Kaplan-Meier methodology will be used to estimate the median BI-EFS for each treatment arm. |
From the date of randomization to the first documentation of a BI-EFS event, assessed up to 5 years
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Sopravvivenza cancro-specifica
Lasso di tempo: Dalla data di randomizzazione alla data di morte per cancro alla vescica, valutata fino a 5 anni
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Dalla data di randomizzazione alla data di morte per cancro alla vescica, valutata fino a 5 anni
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Overall survival (OS)
Lasso di tempo: From date of randomization to death from any cause, assessed up to 5 years
|
Will be estimated using Kaplan-Meier methodology for each treatment arm. Will be analyzed using a similar method as for BI-EFS. |
From date of randomization to death from any cause, assessed up to 5 years
|
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Modified bladder intact event-free survival (mBI-EFS)
Lasso di tempo: From date of randomization to the first documentation of a mBI-EFS event, assessed within 90 days
|
Analysis of modified BI-EFS, i.e., a sensitivity analysis of BI-EFS, where bladder cancer event is defined as histologically proven presence of muscle invasive bladder cancer, clinical evidence of nodal or metastatic disease, radical cystectomy, or death within 90 days of receiving protocol specified treatment, will also be conducted. |
From date of randomization to the first documentation of a mBI-EFS event, assessed within 90 days
|
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Biopsy response
Lasso di tempo: At 18 weeks
|
The Cochran-Mantel-Haenszel statistic will be used with modified ridit scores to evaluate the biopsy outcomes of complete response versus (vs.) down-staging vs. no response for the two treatment arms. |
At 18 weeks
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Complete response duration
Lasso di tempo: From the date of the biopsy documenting the complete response to the time of muscle invasive recurrence, local progression, evidence of metastatic disease or death due to any cause, assessed at 18 weeks
|
For the subset of patients who achieve a complete response during the week 18 biopsy window, complete response duration is defined from the date of the biopsy documenting the complete response to the time of muscle invasive recurrence, local progression, evidence of metastatic disease or death due to any cause. Will be analyzed using a similar method as for BI-EFS. |
From the date of the biopsy documenting the complete response to the time of muscle invasive recurrence, local progression, evidence of metastatic disease or death due to any cause, assessed at 18 weeks
|
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Progression-free survival
Lasso di tempo: From date of randomization to first radiologic or histologic evidence of local progression, nodal or distant metastasis, or death due to any cause, assessed up to 5 years
|
Will be estimated using Kaplan-Meier methodology for each treatment arm. Will be analyzed using a similar method as for BI-EFS. |
From date of randomization to first radiologic or histologic evidence of local progression, nodal or distant metastasis, or death due to any cause, assessed up to 5 years
|
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Metastasis-free survival
Lasso di tempo: From date of randomization to first radiologic or histologic evidence of metastatic disease or death due to any cause, assessed up to 5 years
|
Will be estimated using Kaplan-Meier methodology for each treatment arm. Will be analyzed using a similar method as for BI-EFS. |
From date of randomization to first radiologic or histologic evidence of metastatic disease or death due to any cause, assessed up to 5 years
|
|
Quality of life
Lasso di tempo: Baseline up to 5 years
|
Assessed with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life (QLQ)-C30. Will be examined using linear mixed models with patient considered as the random effect. The baseline physical function score and the stratification factors will be included in the regression model as adjustment covariates. |
Baseline up to 5 years
|
Altre misure di risultato
Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Treatment interactions
Lasso di tempo: Up to 5 years
|
A Cox regression model will be used to evaluate the main effects of treatment arm and the main effect for each stratification factor and the interaction of the stratification factor with treatment in terms of both the primary endpoint and secondary endpoints. The stratification factors to be evaluated include: (1) clinical stage T2 vs. T3/T4a, (2) intended chemotherapy regimen cisplatin vs. 5-FU + mitomycin-C vs. gemcitabine, (3) radiation field small pelvis vs. bladder only and (4) performance status 0-1 vs. 2. There may be other radiation summary measures that may also be explored in terms of their modification of the experimental treatment effect including extent of radiation to lymph node fields. Subgroup analysis defined by stratification factors will also be conducted for primary endpoint and key secondary. |
Up to 5 years
|
Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Investigatore principale: Parminder Singh, SWOG Cancer Research Network
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
- Malattie urogenitali
- Neoplasie urogenitali
- Neoplasie per sede
- Neoplasie
- Malattie urogenitali maschili
- Malattie urologiche
- Malattie urogenitali femminili
- Malattie urogenitali femminili e complicanze della gravidanza
- Neoplasie urologiche
- Malattie della vescica urinaria
- Neoplasie della vescica urinaria
- Prodotti chimici organici
- Composti eterociclici, 1-anello
- Composti eterociclici
- Composti eterociclici, 2 anelli
- Composti eterociclici, anello fuso
- Tecniche investigative
- Terapie
- Tecniche e procedure diagnostiche
- Diagnosi
- Procedure chirurgiche, operative
- Procedure chirurgiche minimamente invasive
- Fenomeni fisici
- Indoli
- Prodotti chimici inorganici
- Composti di cloro
- Composti di azoto
- Deossictidina
- Citidina
- Nucleosidi di pirimidina
- Pirimidine
- Elementi
- Metalli
- Tecniche diagnostiche, chirurgiche
- Endoscopia
- Tecniche di chimica, analitiche
- Analisi dello spettro
- Uracile
- Pirimidinoni
- Metalli, pesante
- Composti di platino
- Quinones
- Elementi di transizione
- Azirines
- Procedure chirurgiche urologiche
- Procedure chirurgiche urogenitali
- Tecniche diagnostiche, urologiche
- Mitomicina
- Indolequinoni
- Gemcitabina
- Fluorouracile
- Cisplatino
- Mitomicina
- 1,2-diamminocicloesaneplatino II citrato
- Radioterapia
- Radiazione
- Spettroscopia di risonanza magnetica
- Platino
- Resezione transuretrale della vescica
- atezolizumab
- deidroftorafur
- Cistoscopia
- Mitozytrex
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- NCI-2018-03264
- U10CA180888 (Sovvenzione/contratto NIH degli Stati Uniti)
- NCI-2018-03264 (Identificatore di registro: CTRP (Clinical Trial Reporting Program))
- S1806 (Altro identificatore: CTEP)
- S1806 (Altro identificatore: SWOG)
Piano per i dati dei singoli partecipanti (IPD)
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Descrizione del piano IPD
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Informazioni su farmaci e dispositivi, documenti di studio
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Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
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