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Nivolumab e Ipilimumab nel trattamento di pazienti con adenocarcinoma della giunzione esofagea e gastroesofagea sottoposti a intervento chirurgico

30 ottobre 2026 aggiornato da: National Cancer Institute (NCI)

Uno studio di fase II/III su nivolumab e ipilimumab perioperatori in pazienti con adenocarcinoma locoregionale della giunzione esofagea e gastroesofagea

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.

Panoramica dello studio

Stato

Sospeso

Condizioni

Intervento / Trattamento

Descrizione dettagliata

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.

Tipo di studio

Interventistico

Iscrizione (Stimato)

278

Fase

  • Fase 2
  • Fase 3

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

  • Stati Uniti
    • Alaska
      • Anchorage, Alaska, Stati Uniti, 98508
        • Anchorage Associates in Radiation Medicine
      • Anchorage, Alaska, Stati Uniti, 99508
        • Alaska Breast Care and Surgery LLC
      • Anchorage, Alaska, Stati Uniti, 99508
        • Alaska Oncology and Hematology LLC
      • Anchorage, Alaska, Stati Uniti, 99508
        • Alaska Women's Cancer Care
      • Anchorage, Alaska, Stati Uniti, 99508
        • Anchorage Oncology Centre
      • Anchorage, Alaska, Stati Uniti, 99508
        • Katmai Oncology Group
      • Anchorage, Alaska, Stati Uniti, 99508
        • Providence Alaska Medical Center
    • Arizona
      • Phoenix, Arizona, Stati Uniti, 85004
        • Cancer Center at Saint Joseph's
    • Arkansas
      • Fort Smith, Arkansas, Stati Uniti, 72903
        • Mercy Hospital Fort Smith
      • Hot Springs, Arkansas, Stati Uniti, 71913
        • CHI Saint Vincent Cancer Center Hot Springs
      • Jonesboro, Arkansas, Stati Uniti, 72401
        • NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
    • California
      • Arroyo Grande, California, Stati Uniti, 93420
        • PCR Oncology
      • Burbank, California, Stati Uniti, 91505
        • Providence Saint Joseph Medical Center/Disney Family Cancer Center
      • Clovis, California, Stati Uniti, 93611
        • Community Cancer Institute
      • Clovis, California, Stati Uniti, 93611
        • University Oncology Associates
      • Los Angeles, California, Stati Uniti, 90033
        • USC / Norris Comprehensive Cancer Center
      • Los Angeles, California, Stati Uniti, 90033
        • Los Angeles General Medical Center
      • Palo Alto, California, Stati Uniti, 94304
        • VA Palo Alto Health Care System
      • Palo Alto, California, Stati Uniti, 94304
        • Stanford Cancer Institute Palo Alto
      • Sacramento, California, Stati Uniti, 95817
        • University of California Davis Comprehensive Cancer Center
      • Sacramento, California, Stati Uniti, 95816
        • Mercy Cancer Center - Sacramento
      • San Luis Obispo, California, Stati Uniti, 93401
        • Pacific Central Coast Health Center-San Luis Obispo
      • Santa Maria, California, Stati Uniti, 93444
        • Mission Hope Medical Oncology - Santa Maria
      • St. Helena, California, Stati Uniti, 94574
        • Saint Helena Hospital
      • Whittier, California, Stati Uniti, 90602
        • Presbyterian Intercommunity Hospital
      • Woodland, California, Stati Uniti, 95695
        • Woodland Memorial Hospital
    • Colorado
      • Colorado Springs, Colorado, Stati Uniti, 80907
        • Penrose-Saint Francis Healthcare
      • Colorado Springs, Colorado, Stati Uniti, 80907
        • Rocky Mountain Cancer Centers-Penrose
      • Colorado Springs, Colorado, Stati Uniti, 80923
        • Saint Francis Cancer Center
      • Denver, Colorado, Stati Uniti, 80210
        • AdventHealth Porter
      • Lakewood, Colorado, Stati Uniti, 80228
        • CommonSpirit Saint Anthony Hospital Cancer Center
      • Littleton, Colorado, Stati Uniti, 80122
        • AdventHealth Littleton
      • Longmont, Colorado, Stati Uniti, 80501
        • Longmont United Hospital
      • Parker, Colorado, Stati Uniti, 80138
        • AdventHealth Parker
      • Pueblo, Colorado, Stati Uniti, 81004
        • Saint Mary Corwin Medical Center
    • Delaware
      • Lewes, Delaware, Stati Uniti, 19958
        • Beebe Medical Center
      • Millville, Delaware, Stati Uniti, 19967
        • Beebe South Coastal Health Campus
      • Newark, Delaware, Stati Uniti, 19713
        • Helen F Graham Cancer Center
      • Newark, Delaware, Stati Uniti, 19713
        • Delaware Clinical and Laboratory Physicians PA
      • Newark, Delaware, Stati Uniti, 19713
        • Medical Oncology Hematology Consultants PA
      • Newark, Delaware, Stati Uniti, 19718
        • Christiana Care Health System-Christiana Hospital
      • Rehoboth Beach, Delaware, Stati Uniti, 19971
        • Beebe Health Campus
      • Seaford, Delaware, Stati Uniti, 19973
        • TidalHealth Nanticoke / Allen Cancer Center
    • District of Columbia
      • Washington D.C., District of Columbia, Stati Uniti, 20007
        • MedStar Georgetown University Hospital
    • Florida
      • Altamonte Springs, Florida, Stati Uniti, 32701
        • AdventHealth Altamonte
      • Aventura, Florida, Stati Uniti, 33180
        • Mount Sinai Comprehensive Cancer Center at Aventura
      • Fort Lauderdale, Florida, Stati Uniti, 33308
        • Holy Cross Hospital
      • Fort Myers, Florida, Stati Uniti, 33905
        • Regional Cancer Center-Lee Memorial Health System
      • Gainesville, Florida, Stati Uniti, 32610
        • UF Health Cancer Institute - Gainesville
      • Kissimmee, Florida, Stati Uniti, 34744
        • AdventHealth Kissimmee
      • Miami Beach, Florida, Stati Uniti, 33140
        • Mount Sinai Medical Center
      • Orlando, Florida, Stati Uniti, 32803
        • AdventHealth Orlando
      • Orlando, Florida, Stati Uniti, 32822
        • AdventHealth East Orlando
    • Georgia
      • Atlanta, Georgia, Stati Uniti, 30308
        • Emory University Hospital Midtown
      • Atlanta, Georgia, Stati Uniti, 30322
        • Emory University Hospital/Winship Cancer Institute
      • Atlanta, Georgia, Stati Uniti, 30342
        • Emory Saint Joseph's Hospital
      • Atlanta, Georgia, Stati Uniti, 30308
        • Emory Proton Therapy Center
      • Savannah, Georgia, Stati Uniti, 31405
        • Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
    • Hawaii
      • Honolulu, Hawaii, Stati Uniti, 96813
        • Queen's Medical Center
      • Honolulu, Hawaii, Stati Uniti, 96817
        • The Cancer Center of Hawaii-Liliha
      • Honolulu, Hawaii, Stati Uniti, 96813
        • Hawaii Cancer Care Inc - Waterfront Plaza
      • Honolulu, Hawaii, Stati Uniti, 96813
        • Queen's Cancer Cenrer - POB I
      • Honolulu, Hawaii, Stati Uniti, 96813
        • Straub Clinic and Hospital
      • Honolulu, Hawaii, Stati Uniti, 96813
        • University of Hawaii Cancer Center
      • Honolulu, Hawaii, Stati Uniti, 96817
        • Hawaii Cancer Care Inc-Liliha
      • Honolulu, Hawaii, Stati Uniti, 96817
        • Kuakini Medical Center
      • Honolulu, Hawaii, Stati Uniti, 96817
        • Queen's Cancer Center - Kuakini
      • Honolulu, Hawaii, Stati Uniti, 96826
        • Kapiolani Medical Center for Women and Children
      • Honolulu, Hawaii, Stati Uniti, 96813
        • Island Urology
      • Lihue, Hawaii, Stati Uniti, 96766
        • Wilcox Memorial Hospital and Kauai Medical Clinic
      • ‘Aiea, Hawaii, Stati Uniti, 96701
        • Hawaii Cancer Care - Westridge
      • ‘Aiea, Hawaii, Stati Uniti, 96701
        • Pali Momi Medical Center
      • ‘Aiea, Hawaii, Stati Uniti, 96701
        • Queen's Cancer Center - Pearlridge
      • ‘Aiea, Hawaii, Stati Uniti, 96701
        • The Cancer Center of Hawaii-Pali Momi
    • Idaho
      • Boise, Idaho, Stati Uniti, 83712
        • Saint Luke's Cancer Institute - Boise
      • Fruitland, Idaho, Stati Uniti, 83619
        • Saint Luke's Cancer Institute - Fruitland
      • Meridian, Idaho, Stati Uniti, 83642
        • Saint Luke's Cancer Institute - Meridian
      • Nampa, Idaho, Stati Uniti, 83687
        • Saint Luke's Cancer Institute - Nampa
      • Twin Falls, Idaho, Stati Uniti, 83301
        • Saint Luke's Cancer Institute - Twin Falls
    • Illinois
      • Bloomington, Illinois, Stati Uniti, 61704
        • Illinois CancerCare-Bloomington
      • Canton, Illinois, Stati Uniti, 61520
        • Illinois CancerCare-Canton
      • Carbondale, Illinois, Stati Uniti, 62902
        • Memorial Hospital of Carbondale
      • Carterville, Illinois, Stati Uniti, 62918
        • SIH Cancer Institute
      • Carthage, Illinois, Stati Uniti, 62321
        • Illinois CancerCare-Carthage
      • Centralia, Illinois, Stati Uniti, 62801
        • Centralia Oncology Clinic
      • Chicago, Illinois, Stati Uniti, 60611
        • Northwestern University
      • Chicago, Illinois, Stati Uniti, 60612
        • University of Illinois
      • Decatur, Illinois, Stati Uniti, 62526
        • Decatur Memorial Hospital
      • Decatur, Illinois, Stati Uniti, 62526
        • Cancer Care Specialists of Illinois - Decatur
      • Dixon, Illinois, Stati Uniti, 61021
        • Illinois CancerCare-Dixon
      • Effingham, Illinois, Stati Uniti, 62401
        • Crossroads Cancer Center
      • Eureka, Illinois, Stati Uniti, 61530
        • Illinois CancerCare-Eureka
      • Galesburg, Illinois, Stati Uniti, 61401
        • Western Illinois Cancer Treatment Center
      • Galesburg, Illinois, Stati Uniti, 61401
        • Illinois CancerCare-Galesburg
      • Hines, Illinois, Stati Uniti, 60141
        • Edward Hines Jr VA Hospital
      • Kewanee, Illinois, Stati Uniti, 61443
        • Illinois CancerCare-Kewanee Clinic
      • Lake Forest, Illinois, Stati Uniti, 60045
        • Northwestern Medicine Lake Forest Hospital
      • Macomb, Illinois, Stati Uniti, 61455
        • Illinois CancerCare-Macomb
      • Maywood, Illinois, Stati Uniti, 60153
        • Loyola University Medical Center
      • Mount Vernon, Illinois, Stati Uniti, 62864
        • SSM Health Good Samaritan
      • O'Fallon, Illinois, Stati Uniti, 62269
        • Cancer Care Center of O'Fallon
      • Ottawa, Illinois, Stati Uniti, 61350
        • Illinois CancerCare-Ottawa Clinic
      • Pekin, Illinois, Stati Uniti, 61554
        • Illinois CancerCare-Pekin
      • Pekin, Illinois, Stati Uniti, 61554
        • OSF Saint Francis Radiation Oncology at Pekin
      • Peoria, Illinois, Stati Uniti, 61636
        • Methodist Medical Center of Illinois
      • Peoria, Illinois, Stati Uniti, 61637
        • OSF Saint Francis Medical Center
      • Peoria, Illinois, Stati Uniti, 61615
        • Illinois CancerCare-Peoria
      • Peoria, Illinois, Stati Uniti, 61615
        • OSF Saint Francis Radiation Oncology at Peoria Cancer Center
      • Peru, Illinois, Stati Uniti, 61354
        • Illinois CancerCare-Peru
      • Peru, Illinois, Stati Uniti, 61354
        • Valley Radiation Oncology
      • Princeton, Illinois, Stati Uniti, 61356
        • Illinois CancerCare-Princeton
      • Springfield, Illinois, Stati Uniti, 62702
        • Southern Illinois University School of Medicine
      • Springfield, Illinois, Stati Uniti, 62702
        • Springfield Clinic
      • Springfield, Illinois, Stati Uniti, 62781
        • Springfield Memorial Hospital
      • Washington, Illinois, Stati Uniti, 61571
        • Illinois CancerCare - Washington
    • Indiana
      • Carmel, Indiana, Stati Uniti, 46032
        • IU Health North Hospital
      • Indianapolis, Indiana, Stati Uniti, 46202
        • Indiana University/Melvin and Bren Simon Cancer Center
      • Richmond, Indiana, Stati Uniti, 47374
        • Reid Health
    • Iowa
      • Clive, Iowa, Stati Uniti, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Stati Uniti, 50325
        • UI Health Care Mission Cancer and Blood - West Des Moines Clinic
      • Creston, Iowa, Stati Uniti, 50801
        • Greater Regional Medical Center
      • Des Moines, Iowa, Stati Uniti, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Stati Uniti, 50314
        • UI Health Care Mission Cancer and Blood - Laurel Clinic
      • West Des Moines, Iowa, Stati Uniti, 50266
        • Mercy Medical Center-West Lakes
    • Kansas
      • Garden City, Kansas, Stati Uniti, 67846
        • Central Care Cancer Center - Garden City
      • Great Bend, Kansas, Stati Uniti, 67530
        • Central Care Cancer Center - Great Bend
    • Kentucky
      • Lexington, Kentucky, Stati Uniti, 40504
        • Saint Joseph Radiation Oncology Resource Center
      • Lexington, Kentucky, Stati Uniti, 40509
        • CommonSpirit Saint Joseph Medical Center - East Lexington
      • Lexington, Kentucky, Stati Uniti, 40504
        • CommonSpirit Saint Joseph Hospital - Lexington
      • Louisville, Kentucky, Stati Uniti, 40202
        • Jewish Hospital
      • Louisville, Kentucky, Stati Uniti, 40245
        • UofL Health Medical Center Northeast
    • Louisiana
      • Kenner, Louisiana, Stati Uniti, 70065
        • Ochsner Medical Center Kenner
      • New Orleans, Louisiana, Stati Uniti, 70121
        • Ochsner Medical Center Jefferson
    • Maine
      • Bangor, Maine, Stati Uniti, 04401
        • Eastern Maine Medical Center
      • Bath, Maine, Stati Uniti, 04530
        • MaineHealth Coastal Cancer Treatment Center
      • Biddeford, Maine, Stati Uniti, 04005
        • MaineHealth Maine Medical Center - Biddeford
      • Brewer, Maine, Stati Uniti, 04412
        • Lafayette Family Cancer Center-EMMC
      • Portland, Maine, Stati Uniti, 04102
        • MaineHealth Maine Medical Center - Portland
      • Sanford, Maine, Stati Uniti, 04073
        • MaineHealth Cancer Care Center of York County
      • Sanford, Maine, Stati Uniti, 04073
        • MaineHealth Cancer Care and IV Therapy - Sanford
      • Scarborough, Maine, Stati Uniti, 04074
        • MaineHealth Maine Medical Center- Scarborough
      • South Portland, Maine, Stati Uniti, 04106
        • MaineHealth Cancer Care and IV Therapy - South Portland
    • Massachusetts
      • Boston, Massachusetts, Stati Uniti, 02111
        • Tufts Medical Center
      • Boston, Massachusetts, Stati Uniti, 02118
        • Boston Medical Center
      • Lowell, Massachusetts, Stati Uniti, 01854
        • Lowell General Hospital
    • Michigan
      • Ann Arbor, Michigan, Stati Uniti, 48106
        • Trinity Health Saint Joseph Mercy Hospital Ann Arbor
      • Brighton, Michigan, Stati Uniti, 48114
        • Trinity Health IHA Medical Group Hematology Oncology - Brighton
      • Brighton, Michigan, Stati Uniti, 48114
        • Trinity Health Medical Center - Brighton
      • Canton, Michigan, Stati Uniti, 48188
        • Trinity Health IHA Medical Group Hematology Oncology - Canton
      • Canton, Michigan, Stati Uniti, 48188
        • Trinity Health Medical Center - Canton
      • Caro, Michigan, Stati Uniti, 48723
        • Caro Cancer Center
      • Chelsea, Michigan, Stati Uniti, 48118
        • Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
      • Chelsea, Michigan, Stati Uniti, 48118
        • Chelsea Hospital
      • Detroit, Michigan, Stati Uniti, 48236
        • Henry Ford Health Saint John Hospital
      • Flint, Michigan, Stati Uniti, 48503
        • Hurley Medical Center
      • Flint, Michigan, Stati Uniti, 48503
        • Genesys Hurley Cancer Institute
      • Grosse Pointe Woods, Michigan, Stati Uniti, 48236
        • Henry Ford Saint John Hospital - Van Elslander
      • Lansing, Michigan, Stati Uniti, 48912
        • University of Michigan Health - Sparrow Lansing
      • Livonia, Michigan, Stati Uniti, 48154
        • Trinity Health Saint Mary Mercy Livonia Hospital
      • Macomb, Michigan, Stati Uniti, 48044
        • Henry Ford Saint John Hospital - Macomb Medical
      • Marlette, Michigan, Stati Uniti, 48453
        • Saint Mary's Oncology/Hematology Associates of Marlette
      • Novi, Michigan, Stati Uniti, 48374
        • Henry Ford Health Providence Novi Hospital
      • Pontiac, Michigan, Stati Uniti, 48341
        • Trinity Health Saint Joseph Mercy Oakland Hospital
      • Pontiac, Michigan, Stati Uniti, 48341
        • Michigan Healthcare Professionals Pontiac
      • Saginaw, Michigan, Stati Uniti, 48604
        • Oncology Hematology Associates of Saginaw Valley PC
      • Saginaw, Michigan, Stati Uniti, 48601
        • MyMichigan Medical Center Saginaw
      • Southfield, Michigan, Stati Uniti, 48075
        • Henry Ford Health Providence Southfield Hospital
      • Tawas City, Michigan, Stati Uniti, 48764
        • MyMichigan Medical Center Tawas
      • Warren, Michigan, Stati Uniti, 48093
        • Henry Ford Health Warren Hospital
      • West Branch, Michigan, Stati Uniti, 48661
        • Saint Mary's Oncology/Hematology Associates of West Branch
      • Ypsilanti, Michigan, Stati Uniti, 48197
        • Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
    • Minnesota
      • Bemidji, Minnesota, Stati Uniti, 56601
        • Sanford Joe Lueken Cancer Center
      • Brainerd, Minnesota, Stati Uniti, 56401
        • Essentia Health Saint Joseph's Medical Center
      • Burnsville, Minnesota, Stati Uniti, 55337
        • Fairview Ridges Hospital
      • Burnsville, Minnesota, Stati Uniti, 55337
        • Minnesota Oncology - Burnsville
      • Coon Rapids, Minnesota, Stati Uniti, 55433
        • Mercy Hospital
      • Deer River, Minnesota, Stati Uniti, 56636
        • Essentia Health - Deer River Clinic
      • Detroit Lakes, Minnesota, Stati Uniti, 56501
        • Essentia Health Saint Mary's - Detroit Lakes Clinic
      • Duluth, Minnesota, Stati Uniti, 55805
        • Essentia Health Cancer Center
      • Duluth, Minnesota, Stati Uniti, 55805
        • Essentia Health Saint Mary's Medical Center
      • Duluth, Minnesota, Stati Uniti, 55805
        • Miller-Dwan Hospital
      • Edina, Minnesota, Stati Uniti, 55435
        • Fairview Southdale Hospital
      • Edina, Minnesota, Stati Uniti, 55435
        • Minnesota Oncology - Edina
      • Fergus Falls, Minnesota, Stati Uniti, 56537
        • Lake Region Healthcare Corporation-Cancer Care
      • Fosston, Minnesota, Stati Uniti, 56542
        • Essentia Health - Fosston
      • Fridley, Minnesota, Stati Uniti, 55432
        • Unity Hospital
      • Hibbing, Minnesota, Stati Uniti, 55746
        • Essentia Health Hibbing Clinic
      • Maple Grove, Minnesota, Stati Uniti, 55369
        • Fairview Clinics and Surgery Center Maple Grove
      • Maplewood, Minnesota, Stati Uniti, 55109
        • Saint John's Hospital - Healtheast
      • Maplewood, Minnesota, Stati Uniti, 55109
        • Minnesota Oncology Hematology PA-Maplewood
      • Minneapolis, Minnesota, Stati Uniti, 55415
        • Hennepin County Medical Center
      • Minneapolis, Minnesota, Stati Uniti, 55407
        • Abbott-Northwestern Hospital
      • Minneapolis, Minnesota, Stati Uniti, 55454
        • Health Partners Inc
      • Monticello, Minnesota, Stati Uniti, 55362
        • Monticello Cancer Center
      • Park Rapids, Minnesota, Stati Uniti, 56470
        • Essentia Health - Park Rapids
      • Robbinsdale, Minnesota, Stati Uniti, 55422
        • North Memorial Medical Health Center
      • Rochester, Minnesota, Stati Uniti, 55905
        • Mayo Clinic in Rochester
      • Saint Louis Park, Minnesota, Stati Uniti, 55416
        • Park Nicollet Clinic - Saint Louis Park
      • Saint Paul, Minnesota, Stati Uniti, 55101
        • Regions Hospital
      • Saint Paul, Minnesota, Stati Uniti, 55102
        • United Hospital
      • Sandstone, Minnesota, Stati Uniti, 55072
        • Essentia Health Sandstone
      • Shakopee, Minnesota, Stati Uniti, 55379
        • Saint Francis Regional Medical Center
      • Stillwater, Minnesota, Stati Uniti, 55082
        • Lakeview Hospital
      • Virginia, Minnesota, Stati Uniti, 55792
        • Essentia Health Virginia Clinic
      • Waconia, Minnesota, Stati Uniti, 55387
        • Ridgeview Medical Center
      • Willmar, Minnesota, Stati Uniti, 56201
        • Rice Memorial Hospital
      • Woodbury, Minnesota, Stati Uniti, 55125
        • Minnesota Oncology Hematology PA-Woodbury
    • Mississippi
      • Columbus, Mississippi, Stati Uniti, 39705
        • Baptist Memorial Hospital and Cancer Center-Golden Triangle
      • Grenada, Mississippi, Stati Uniti, 38901
        • Baptist Cancer Center-Grenada
      • New Albany, Mississippi, Stati Uniti, 38652
        • Baptist Memorial Hospital and Cancer Center-Union County
      • Oxford, Mississippi, Stati Uniti, 38655
        • Baptist Memorial Hospital and Cancer Center-Oxford
      • Southhaven, Mississippi, Stati Uniti, 38671
        • Baptist Memorial Hospital and Cancer Center-Desoto
    • Missouri
      • Ballwin, Missouri, Stati Uniti, 63011
        • Mercy Oncology and Hematology - Clayton-Clarkson
      • Bolivar, Missouri, Stati Uniti, 65613
        • Central Care Cancer Center - Bolivar
      • Cape Girardeau, Missouri, Stati Uniti, 63703
        • Saint Francis Medical Center
      • Cape Girardeau, Missouri, Stati Uniti, 63703
        • Mercy Cancer Center - Cape Girardeau
      • City of Saint Peters, Missouri, Stati Uniti, 63376
        • Siteman Cancer Center at Saint Peters Hospital
      • Creve Coeur, Missouri, Stati Uniti, 63141
        • Siteman Cancer Center at West County Hospital
      • Farmington, Missouri, Stati Uniti, 63640
        • Parkland Health Center - Farmington
      • Jefferson City, Missouri, Stati Uniti, 65109
        • MU Health Care Goldschmidt Cancer Center
      • Joplin, Missouri, Stati Uniti, 64804
        • Freeman Health System
      • Joplin, Missouri, Stati Uniti, 64804
        • Mercy Hospital Joplin
      • Rolla, Missouri, Stati Uniti, 65401
        • Mercy Clinic-Rolla-Cancer and Hematology
      • Rolla, Missouri, Stati Uniti, 65401
        • Phelps Health Delbert Day Cancer Institute
      • Saint Joseph, Missouri, Stati Uniti, 64506
        • Heartland Regional Medical Center
      • Sainte Genevieve, Missouri, Stati Uniti, 63670
        • Sainte Genevieve County Memorial Hospital
      • Springfield, Missouri, Stati Uniti, 65807
        • CoxHealth South Hospital
      • Springfield, Missouri, Stati Uniti, 65804
        • Mercy Hospital Springfield
      • St Louis, Missouri, Stati Uniti, 63110
        • Washington University School of Medicine
      • St Louis, Missouri, Stati Uniti, 63129
        • Siteman Cancer Center-South County
      • St Louis, Missouri, Stati Uniti, 63136
        • Siteman Cancer Center at Christian Hospital
      • St Louis, Missouri, Stati Uniti, 63131
        • Missouri Baptist Medical Center
      • St Louis, Missouri, Stati Uniti, 63141
        • Mercy Hospital Saint Louis
      • St Louis, Missouri, Stati Uniti, 63128
        • Mercy Hospital South
      • Sullivan, Missouri, Stati Uniti, 63080
        • Missouri Baptist Sullivan Hospital
    • Montana
      • Missoula, Montana, Stati Uniti, 59802
        • Saint Patrick Hospital - Community Hospital
    • Nebraska
      • Bellevue, Nebraska, Stati Uniti, 68123
        • Nebraska Medicine-Bellevue
      • Grand Island, Nebraska, Stati Uniti, 68803
        • Nebraska Cancer Specialists/Oncology Hematology West PC
      • Kearney, Nebraska, Stati Uniti, 68847
        • CHI Health Good Samaritan
      • Omaha, Nebraska, Stati Uniti, 68198
        • University of Nebraska Medical Center
      • Omaha, Nebraska, Stati Uniti, 68124
        • Alegent Health Bergan Mercy Medical Center
      • Omaha, Nebraska, Stati Uniti, 68118
        • Nebraska Medicine-Village Pointe
      • Omaha, Nebraska, Stati Uniti, 68122
        • Alegent Health Immanuel Medical Center
      • Omaha, Nebraska, Stati Uniti, 68130
        • Alegent Health Lakeside Hospital
    • Nevada
      • Henderson, Nevada, Stati Uniti, 89052
        • Comprehensive Cancer Centers of Nevada - Henderson
      • Henderson, Nevada, Stati Uniti, 89074
        • Oncology Las Vegas - Henderson
      • Las Vegas, Nevada, Stati Uniti, 89102
        • OptumCare Cancer Care at Charleston
      • Las Vegas, Nevada, Stati Uniti, 89106
        • Radiation Oncology Centers of Nevada Central
      • Las Vegas, Nevada, Stati Uniti, 89119
        • Radiation Oncology Centers of Nevada Southeast
      • Las Vegas, Nevada, Stati Uniti, 89128
        • Comprehensive Cancer Centers of Nevada - Northwest
      • Las Vegas, Nevada, Stati Uniti, 89128
        • OptumCare Cancer Care at MountainView
      • Las Vegas, Nevada, Stati Uniti, 89135
        • Alliance for Childhood Diseases/Cure 4 the Kids Foundation
      • Las Vegas, Nevada, Stati Uniti, 89144
        • Comprehensive Cancer Centers of Nevada - Town Center
      • Las Vegas, Nevada, Stati Uniti, 89144
        • Comprehensive Cancer Centers of Nevada-Summerlin
      • 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
      • Reno, Nevada, Stati Uniti, 89503
        • Saint Mary's Regional Medical Center
      • Reno, Nevada, Stati Uniti, 89509
        • Radiation Oncology Associates
    • New Hampshire
      • Lebanon, New Hampshire, Stati Uniti, 03756
        • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
    • New Jersey
      • Brick, New Jersey, Stati Uniti, 08724
        • Ocean University Medical Center
      • Long Branch, New Jersey, Stati Uniti, 07740
        • Monmouth Medical Center
      • Manahawkin, New Jersey, Stati Uniti, 08050
        • Southern Ocean County Medical Center
      • Neptune City, New Jersey, Stati Uniti, 07753
        • Jersey Shore Medical Center
      • New Brunswick, New Jersey, Stati Uniti, 08903
        • Rutgers Cancer Institute of New Jersey
      • Red Bank, New Jersey, Stati Uniti, 07701
        • Riverview Medical Center/Booker Cancer Center
      • Toms River, New Jersey, Stati Uniti, 08755
        • Community Medical Center
    • New Mexico
      • Albuquerque, New Mexico, Stati Uniti, 87102
        • Lovelace Medical Center-Saint Joseph Square
      • Albuquerque, New Mexico, Stati Uniti, 87109
        • New Mexico Oncology Hematology Consultants
      • Albuquerque, New Mexico, Stati Uniti, 87106
        • University of New Mexico Cancer Center
      • Albuquerque, New Mexico, Stati Uniti, 87110
        • Presbyterian Kaseman Hospital
      • Rio Rancho, New Mexico, Stati Uniti, 87124
        • Presbyterian Rust Medical Center/Jorgensen Cancer Center
    • New York
      • Canandaigua, New York, Stati Uniti, 14424
        • Sands Cancer Center
      • Dansville, New York, Stati Uniti, 14437
        • Noyes Memorial Hospital/Myers Cancer Center
      • Glens Falls, New York, Stati Uniti, 12801
        • Glens Falls Hospital
      • Lake Success, New York, Stati Uniti, 11042
        • Northwell Health/Center for Advanced Medicine
      • Middletown, New York, Stati Uniti, 10940
        • Garnet Health Medical Center
      • New York, New York, Stati Uniti, 10065
        • NYP/Weill Cornell Medical Center
      • New York, New York, Stati Uniti, 10016
        • Laura and Isaac Perlmutter Cancer Center at NYU Langone
      • Rochester, New York, Stati Uniti, 14642
        • University of Rochester
      • 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
    • North Carolina
      • Charlotte, North Carolina, Stati Uniti, 28204
        • Novant Health Presbyterian Medical Center
      • Huntersville, North Carolina, Stati Uniti, 28078
        • Novant Health Cancer Institute - Huntersville
      • Huntersville, North Carolina, Stati Uniti, 28078
        • Novant Health Presbyterian Medical Center Huntersville
      • Kernersville, North Carolina, Stati Uniti, 27284
        • Novant Health Cancer Institute - Kernersville
      • Matthews, North Carolina, Stati Uniti, 28105
        • Matthews Radiation Oncology Center
      • Matthews, North Carolina, Stati Uniti, 28105
        • Novant Health Cancer Institute - Matthews
      • Mooresville, North Carolina, Stati Uniti, 28117
        • Novant Health Cancer Institute - Mooresville
      • Mount Airy, North Carolina, Stati Uniti, 27030
        • Novant Health Cancer Institute - Mount Airy
      • North Wilkesboro, North Carolina, Stati Uniti, 28659
        • Novant Health Cancer Institute - Wilkesboro
      • Salisbury, North Carolina, Stati Uniti, 28144
        • Rowan Regional Medical Center
      • Statesville, North Carolina, Stati Uniti, 28625
        • Novant Health Cancer Institute - Statesville
      • Thomasville, North Carolina, Stati Uniti, 27360
        • Novant Health Cancer Institute - Thomasville
      • Winston-Salem, North Carolina, Stati Uniti, 27103
        • Novant Health Forsyth Medical Center
    • 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, 58103
        • Essentia Health Cancer Center-South University Clinic
      • Fargo, North Dakota, Stati Uniti, 58122
        • Sanford Broadway Medical Center
      • Jamestown, North Dakota, Stati Uniti, 58401
        • Essentia Health - Jamestown Clinic
    • Ohio
      • Beavercreek, Ohio, Stati Uniti, 45431
        • Indu and Raj Soin Medical Center
      • Boardman, Ohio, Stati Uniti, 44512
        • Saint Elizabeth Boardman Hospital
      • Centerville, Ohio, Stati Uniti, 45459
        • Miami Valley Hospital South
      • Centerville, Ohio, Stati Uniti, 45459
        • Dayton Physicians LLC-Miami Valley South
      • Cincinnati, Ohio, Stati Uniti, 45219
        • University of Cincinnati Cancer Center-UC Medical Center
      • Cincinnati, Ohio, Stati Uniti, 45220
        • Good Samaritan Hospital - Cincinnati
      • Cincinnati, Ohio, Stati Uniti, 45242
        • Bethesda North Hospital
      • Cincinnati, Ohio, Stati Uniti, 45236
        • Oncology Hematology Care Inc-Kenwood
      • Cleveland, Ohio, Stati Uniti, 44109
        • MetroHealth Medical Center
      • Cleveland, Ohio, Stati Uniti, 44195
        • Cleveland Clinic Foundation
      • Cleveland, Ohio, Stati Uniti, 44111
        • Cleveland Clinic Cancer Center/Fairview Hospital
      • Columbus, Ohio, Stati Uniti, 43210
        • Ohio State University Comprehensive Cancer Center
      • Dayton, Ohio, Stati Uniti, 45409
        • Miami Valley Hospital
      • Dayton, Ohio, Stati Uniti, 45415
        • Miami Valley Hospital North
      • Dayton, Ohio, Stati Uniti, 45415
        • Dayton Physician LLC - Englewood
      • Findlay, Ohio, Stati Uniti, 45840
        • Blanchard Valley Hospital
      • Findlay, Ohio, Stati Uniti, 45840
        • Armes Family Cancer Center
      • Findlay, Ohio, Stati Uniti, 45840
        • Orion Cancer Care
      • Franklin, Ohio, Stati Uniti, 45005-1066
        • Atrium Medical Center-Middletown Regional Hospital
      • Franklin, Ohio, Stati Uniti, 45005
        • Dayton Physicians LLC-Atrium
      • Greenville, Ohio, Stati Uniti, 45331
        • Wayne Hospital
      • Greenville, Ohio, Stati Uniti, 45331
        • Dayton Physicians LLC-Wayne
      • Independence, Ohio, Stati Uniti, 44131
        • Cleveland Clinic Cancer Center Independence
      • Kettering, Ohio, Stati Uniti, 45429
        • Kettering Medical Center
      • Kettering, Ohio, Stati Uniti, 45409
        • Greater Dayton Cancer Center
      • Mansfield, Ohio, Stati Uniti, 44906
        • Cleveland Clinic Cancer Center Mansfield
      • Mayfield Heights, Ohio, Stati Uniti, 44124
        • Hillcrest Hospital Cancer Center
      • Sandusky, Ohio, Stati Uniti, 44870
        • North Coast Cancer Care
      • Springfield, Ohio, Stati Uniti, 45504
        • Springfield Regional Cancer Center
      • Springfield, Ohio, Stati Uniti, 45504
        • Springfield Regional Medical Center
      • Strongsville, Ohio, Stati Uniti, 44136
        • Cleveland Clinic Cancer Center Strongsville
      • Sylvania, Ohio, Stati Uniti, 43560
        • ProMedica Flower Hospital
      • Toledo, Ohio, Stati Uniti, 43606
        • ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
      • Troy, Ohio, Stati Uniti, 45373
        • Upper Valley Medical Center
      • Troy, Ohio, Stati Uniti, 45373
        • Dayton Physicians LLC - Troy
      • Warren, Ohio, Stati Uniti, 44484
        • Saint Joseph Warren Hospital
      • Warrensville Heights, Ohio, Stati Uniti, 44122
        • South Pointe Hospital
      • West Chester, Ohio, Stati Uniti, 45069
        • University of Cincinnati Cancer Center-West Chester
      • Wooster, Ohio, Stati Uniti, 44691
        • Cleveland Clinic Wooster Family Health and Surgery Center
      • Youngstown, Ohio, Stati Uniti, 44501
        • Saint Elizabeth Youngstown Hospital
    • Oklahoma
      • Oklahoma City, Oklahoma, Stati Uniti, 73120
        • Mercy Hospital Oklahoma City
    • Oregon
      • Bend, Oregon, Stati Uniti, 97701
        • Saint Charles Health System
      • Clackamas, Oregon, Stati Uniti, 97015
        • Clackamas Radiation Oncology Center
      • Clackamas, Oregon, Stati Uniti, 97015
        • Providence Cancer Institute Clackamas Clinic
      • Coos Bay, Oregon, Stati Uniti, 97420
        • Bay Area Hospital
      • Newberg, Oregon, Stati Uniti, 97132
        • Providence Newberg Medical Center
      • Portland, Oregon, Stati Uniti, 97213
        • Providence Portland Medical Center
      • Portland, Oregon, Stati Uniti, 97225
        • Providence Saint Vincent Medical Center
    • Pennsylvania
      • Allentown, Pennsylvania, Stati Uniti, 18103
        • Lehigh Valley Hospital-Cedar Crest
      • Allentown, Pennsylvania, Stati Uniti, 18104
        • Saint Luke's Cancer Center - Allentown
      • 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
      • Bethlehem, Pennsylvania, Stati Uniti, 18015
        • Saint Luke's University Hospital-Bethlehem Campus
      • Butler, Pennsylvania, Stati Uniti, 16001
        • UPMC Hillman Cancer Center at Butler Health System
      • Camp Hill, Pennsylvania, Stati Uniti, 17011
        • UPMC Camp Hill
      • 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
      • East Stroudsburg, Pennsylvania, Stati Uniti, 18301
        • Pocono Medical Center
      • Easton, Pennsylvania, Stati Uniti, 18045
        • Saint Luke's Hospital-Anderson Campus
      • 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
      • Indiana, Pennsylvania, Stati Uniti, 15701
        • IRMC Cancer Center
      • Jefferson Hills, Pennsylvania, Stati Uniti, 15025
        • Jefferson Hospital
      • 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
      • Monroeville, Pennsylvania, Stati Uniti, 15146
        • Forbes Hospital
      • Monroeville, Pennsylvania, Stati Uniti, 15146
        • UPMC Hillman Cancer Center - Monroeville
      • Monroeville, Pennsylvania, Stati Uniti, 15146
        • UPMC Cancer Center - Monroeville
      • Moon Township, Pennsylvania, Stati Uniti, 15108
        • UPMC Hillman Cancer Center in Coraopolis
      • Mount Pleasant, Pennsylvania, Stati Uniti, 15666
        • UPMC Hillman Cancer Center - Part of Frick Hospital
      • N. Huntingdon, Pennsylvania, Stati Uniti, 15642
        • Arnold Palmer Cancer Center Medical Oncology Norwin
      • Natrona Heights, Pennsylvania, Stati Uniti, 15065
        • Allegheny Valley Hospital
      • New Castle, Pennsylvania, Stati Uniti, 16105
        • UPMC Hillman Cancer Center - New Castle
      • Philadelphia, Pennsylvania, Stati Uniti, 19104
        • University of Pennsylvania/Abramson Cancer Center
      • Pittsburgh, Pennsylvania, Stati Uniti, 15212
        • Allegheny General Hospital
      • Pittsburgh, Pennsylvania, Stati Uniti, 15224
        • West Penn Hospital
      • 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
      • Pottstown, Pennsylvania, Stati Uniti, 19464
        • Pottstown Hospital
      • Seneca, Pennsylvania, Stati Uniti, 16346
        • UPMC Cancer Center at UPMC Northwest
      • Uniontown, Pennsylvania, Stati Uniti, 15401
        • UPMC Uniontown Hospital Radiation Oncology
      • Uniontown, Pennsylvania, Stati Uniti, 15401
        • UPMC Cancer Center-Uniontown
      • Washington, Pennsylvania, Stati Uniti, 15301
        • UPMC Washington Hospital Radiation Oncology
      • Washington, Pennsylvania, Stati Uniti, 15301
        • UPMC Cancer Center-Washington
      • West Mifflin, Pennsylvania, Stati Uniti, 15122
        • UPMC West Mifflin-Cancer Center Jefferson
      • West Reading, Pennsylvania, Stati Uniti, 19611
        • Reading Hospital
      • Wexford, Pennsylvania, Stati Uniti, 15090
        • Wexford Health and Wellness Pavilion
      • York, Pennsylvania, Stati Uniti, 17408
        • UPMC Memorial
    • Rhode Island
      • East Greenwich, Rhode Island, Stati Uniti, 02818
        • Rhode Island Hospital at East Greenwich
      • Newport, Rhode Island, Stati Uniti, 02840
        • Newport Hospital
      • Providence, Rhode Island, Stati Uniti, 02903
        • Rhode Island Hospital
    • South Carolina
      • Charleston, South Carolina, Stati Uniti, 29425
        • Medical University of South Carolina
      • Greenville, South Carolina, Stati Uniti, 29607
        • Saint Francis Cancer Center
      • Greenville, South Carolina, Stati Uniti, 29601
        • Saint Francis Hospital
    • South Dakota
      • Sioux Falls, South Dakota, Stati Uniti, 57105
        • Avera Cancer Institute
      • 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
      • Collierville, Tennessee, Stati Uniti, 38017
        • Baptist Memorial Hospital and Cancer Center-Collierville
      • Memphis, Tennessee, Stati Uniti, 38120
        • Baptist Memorial Hospital and Cancer Center-Memphis
      • Nashville, Tennessee, Stati Uniti, 37232
        • Vanderbilt University/Ingram Cancer Center
    • Texas
      • Bryan, Texas, Stati Uniti, 77802
        • Saint Joseph Regional Cancer Center
      • Dallas, Texas, Stati Uniti, 75235
        • Parkland Memorial Hospital
      • Dallas, Texas, Stati Uniti, 75390
        • UT Southwestern/Simmons Cancer Center-Dallas
      • Fort Worth, Texas, Stati Uniti, 76104
        • UT Southwestern/Simmons Cancer Center-Fort Worth
      • Richardson, Texas, Stati Uniti, 75080
        • UT Southwestern Clinical Center at Richardson/Plano
    • Utah
      • Salt Lake City, Utah, Stati Uniti, 84112
        • Huntsman Cancer Institute/University of Utah
      • Salt Lake City, Utah, Stati Uniti, 84106
        • University of Utah Sugarhouse Health Center
    • Vermont
      • Berlin Corners, Vermont, Stati Uniti, 05602
        • Central Vermont Medical Center/National Life Cancer Treatment
      • Burlington, Vermont, Stati Uniti, 05401
        • University of Vermont Medical Center
      • Burlington, Vermont, Stati Uniti, 05405
        • University of Vermont and State Agricultural College
      • Saint Johnsbury, Vermont, Stati Uniti, 05819
        • Dartmouth Cancer Center - North
    • Virginia
      • Charlottesville, Virginia, Stati Uniti, 22908
        • University of Virginia Cancer Center
      • Richmond, Virginia, Stati Uniti, 23229
        • Virginia Cancer Institute
      • Richmond, Virginia, Stati Uniti, 23298
        • VCU Massey Comprehensive Cancer Center
      • South Hill, Virginia, Stati Uniti, 23970
        • VCU Community Memorial Health Center
    • Washington
      • Aberdeen, Washington, Stati Uniti, 98520
        • Providence Regional Cancer System-Aberdeen
      • Bellevue, Washington, Stati Uniti, 98004
        • Overlake Medical Center
      • Bellingham, Washington, Stati Uniti, 98225
        • PeaceHealth Saint Joseph Medical Center
      • Burien, Washington, Stati Uniti, 98166
        • Saint Anne Hospital
      • Centralia, Washington, Stati Uniti, 98531
        • Providence Regional Cancer System-Centralia
      • Edmonds, Washington, Stati Uniti, 98026
        • Swedish Cancer Institute-Edmonds
      • Everett, Washington, Stati Uniti, 98201
        • Providence Regional Cancer Partnership
      • Issaquah, Washington, Stati Uniti, 98029
        • Swedish Cancer Institute-Issaquah
      • Lacey, Washington, Stati Uniti, 98503
        • Providence Regional Cancer System-Lacey
      • Longview, Washington, Stati Uniti, 98632
        • PeaceHealth Saint John Medical Center
      • Renton, Washington, Stati Uniti, 98055
        • Valley Medical Center
      • Seattle, Washington, Stati Uniti, 98107
        • Swedish Medical Center-Ballard Campus
      • Seattle, Washington, Stati Uniti, 98122
        • Swedish Medical Center-First Hill
      • Sedro-Woolley, Washington, Stati Uniti, 98284
        • PeaceHealth United General Medical Center
      • Silverdale, Washington, Stati Uniti, 98383
        • Saint Joseph Medical Center Hematology and Oncology - Silverdale
      • Tacoma, Washington, Stati Uniti, 98405
        • Northwest Medical Specialties PLLC
      • Vancouver, Washington, Stati Uniti, 98664
        • PeaceHealth Southwest Medical Center
      • Walla Walla, Washington, Stati Uniti, 99362
        • Providence Saint Mary Regional Cancer Center
      • Yakima, Washington, Stati Uniti, 98902
        • North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
    • West Virginia
      • Bridgeport, West Virginia, Stati Uniti, 26330
        • United Hospital Center
      • Charleston, West Virginia, Stati Uniti, 25304
        • Vandalia Health/CAMC Institute for Academic Medicine
      • Morgantown, West Virginia, Stati Uniti, 26506
        • West Virginia University Healthcare
      • Parkersburg, West Virginia, Stati Uniti, 26101
        • Camden Clark Medical Center
    • Wisconsin
      • Appleton, Wisconsin, Stati Uniti, 54911
        • ThedaCare Regional Cancer Center
      • Ashland, Wisconsin, Stati Uniti, 54806
        • Duluth Clinic Ashland
      • 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
        • HSHS Sacred Heart Hospital
      • Fond du Lac, Wisconsin, Stati Uniti, 54937
        • Aurora Health Center-Fond du Lac
      • 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
        • Saint Vincent Hospital Cancer Center Green Bay
      • Green Bay, Wisconsin, Stati Uniti, 54303
        • Saint Vincent Hospital Cancer Center at Saint Mary's
      • Green Bay, Wisconsin, Stati Uniti, 54301
        • Bellin Memorial Hospital
      • Hayward, Wisconsin, Stati Uniti, 54843
        • Essentia Health-Hayward Clinic
      • Johnson Creek, Wisconsin, Stati Uniti, 53038
        • University of Wisconsin Carbone Cancer Center - Johnson Creek
      • Kenosha, Wisconsin, Stati Uniti, 53142
        • Aurora Cancer Care-Kenosha South
      • Madison, Wisconsin, Stati Uniti, 53792
        • University of Wisconsin Carbone Cancer Center - University Hospital
      • Marinette, Wisconsin, Stati Uniti, 54143
        • Aurora Bay Area Medical Group-Marinette
      • Marshfield, Wisconsin, Stati Uniti, 54449
        • Marshfield Medical Center-Marshfield
      • 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
      • Racine, Wisconsin, Stati Uniti, 53406
        • Aurora Cancer Care-Racine
      • Rice Lake, Wisconsin, Stati Uniti, 54868
        • Marshfield Medical Center-Rice Lake
      • Sheboygan, Wisconsin, Stati Uniti, 53081
        • Vince Lombardi Cancer Clinic-Sheboygan
      • Spooner, Wisconsin, Stati Uniti, 54801
        • Essentia Health-Spooner Clinic
      • Stevens Point, Wisconsin, Stati Uniti, 54482
        • Marshfield Medical Center-River Region at Stevens Point
      • Sturgeon Bay, Wisconsin, Stati Uniti, 54235-1495
        • Saint Vincent Hospital Cancer Center at Sturgeon Bay
      • Summit, Wisconsin, Stati Uniti, 53066
        • Aurora Medical Center in Summit
      • Superior, Wisconsin, Stati Uniti, 54880
        • Essentia Health Saint Mary's Hospital - Superior
      • Two Rivers, Wisconsin, Stati Uniti, 54241
        • Vince Lombardi Cancer Clinic-Two Rivers
      • 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

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

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

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: 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.
Droga: Carboplatin

Given IV

Altri nomi:
  • Blastocarb
  • Carboplat
  • Carboplatino Hexal
  • Carboplatino
  • Carbosina
  • Carbosol
  • Carbotec
  • CBDCA
  • Displata
  • Ercar
  • JM-8
  • Nealorin
  • Novoplatino
  • Paraplatino
  • Paraplatino AQ
  • Platino
  • Ribocarbonio
  • JM8
Droga: Paclitaxel

Given IV

Altri nomi:
  • Tassolo
  • Anzatax
  • Asotax
  • Bristaxolo
  • Praxel
  • Taxol Konzentrat
Procedura: Computed Tomography

Undergo CT scan

Altri nomi:
  • CT
  • GATTO
  • TAC
  • Tomografia assiale computerizzata
  • Tomografia computerizzata
  • tomografia
  • Tomografia assiale computerizzata (procedura)
  • Scansione tomografia computerizzata (CT).
  • Scansione CAT diagnostica
  • Tipo di servizio di scansione CAT diagnostica
Procedura: Positron Emission Tomography

Undergo PET scan

Altri nomi:
  • Imaging medico, tomografia a emissione di positroni
  • ANIMALE DOMESTICO
  • Scansione animale
  • Scansione di tomografia a emissione di positroni
  • Tomografia ad emissione di positroni
  • P.T
  • Tomografia a emissione di positroni (procedura)
Procedura: Biospecimen Collection

Undergo collection of blood sample

Altri nomi:
  • Raccolta di campioni biologici
  • Biocampione raccolto
  • Raccolta di campioni
  • Raccolta campione
Radiazione: Radiation Therapy

Undergo radiation therapy

Altri nomi:
  • Radioterapia del cancro
  • TIPO_ENERGIA
  • Irradiare
  • Irradiato
  • Irradiazione
  • Radiazione
  • Radioterapia, NAS
  • Radioterapia
  • RT
  • Terapia, radiazioni
  • Tipo di energia
Sperimentale: 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.
Droga: Carboplatin

Given IV

Altri nomi:
  • Blastocarb
  • Carboplat
  • Carboplatino Hexal
  • Carboplatino
  • Carbosina
  • Carbosol
  • Carbotec
  • CBDCA
  • Displata
  • Ercar
  • JM-8
  • Nealorin
  • Novoplatino
  • Paraplatino
  • Paraplatino AQ
  • Platino
  • Ribocarbonio
  • JM8
Droga: Paclitaxel

Given IV

Altri nomi:
  • Tassolo
  • Anzatax
  • Asotax
  • Bristaxolo
  • Praxel
  • Taxol Konzentrat
Biologico: Nivolumab

Given IV

Altri nomi:
  • BMS-936558
  • MDX-1106
  • NIVO
  • ONO-4538
  • Opdivo
  • CMAB819
  • Nivolumab biosimilare CMAB819
  • MDX 1106
  • MDX1106
  • BMS 936558
  • ABP 206
  • Nivolumab biosimilare ABP 206
  • BCD-263
  • Nivolumab biosimilare BCD-263
  • BMS936558
  • ONO4538
Procedura: Computed Tomography

Undergo CT scan

Altri nomi:
  • CT
  • GATTO
  • TAC
  • Tomografia assiale computerizzata
  • Tomografia computerizzata
  • tomografia
  • Tomografia assiale computerizzata (procedura)
  • Scansione tomografia computerizzata (CT).
  • Scansione CAT diagnostica
  • Tipo di servizio di scansione CAT diagnostica
Procedura: Positron Emission Tomography

Undergo PET scan

Altri nomi:
  • Imaging medico, tomografia a emissione di positroni
  • ANIMALE DOMESTICO
  • Scansione animale
  • Scansione di tomografia a emissione di positroni
  • Tomografia ad emissione di positroni
  • P.T
  • Tomografia a emissione di positroni (procedura)
Procedura: Biospecimen Collection

Undergo collection of blood sample

Altri nomi:
  • Raccolta di campioni biologici
  • Biocampione raccolto
  • Raccolta di campioni
  • Raccolta campione
Radiazione: Radiation Therapy

Undergo radiation therapy

Altri nomi:
  • Radioterapia del cancro
  • TIPO_ENERGIA
  • Irradiare
  • Irradiato
  • Irradiazione
  • Radiazione
  • Radioterapia, NAS
  • Radioterapia
  • RT
  • Terapia, radiazioni
  • Tipo di energia
Sperimentale: 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.
Biologico: Nivolumab

Given IV

Altri nomi:
  • BMS-936558
  • MDX-1106
  • NIVO
  • ONO-4538
  • Opdivo
  • CMAB819
  • Nivolumab biosimilare CMAB819
  • MDX 1106
  • MDX1106
  • BMS 936558
  • ABP 206
  • Nivolumab biosimilare ABP 206
  • BCD-263
  • Nivolumab biosimilare BCD-263
  • BMS936558
  • ONO4538
Procedura: Computed Tomography

Undergo CT scan

Altri nomi:
  • CT
  • GATTO
  • TAC
  • Tomografia assiale computerizzata
  • Tomografia computerizzata
  • tomografia
  • Tomografia assiale computerizzata (procedura)
  • Scansione tomografia computerizzata (CT).
  • Scansione CAT diagnostica
  • Tipo di servizio di scansione CAT diagnostica
Procedura: Biospecimen Collection

Undergo collection of blood sample

Altri nomi:
  • Raccolta di campioni biologici
  • Biocampione raccolto
  • Raccolta di campioni
  • Raccolta campione
Sperimentale: 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.
Biologico: Ipilimumab

Given IV

Altri nomi:
  • Anticorpo monoclonale antigene-4 anti-citotossico associato ai linfociti T
  • BMS-734016
  • Ipilimumab biosimilare CS1002
  • MDX-010
  • MDX-CTLA4
  • Yevoy
  • MDX010
  • BMS734016
  • BMS 734016
Biologico: Nivolumab

Given IV

Altri nomi:
  • BMS-936558
  • MDX-1106
  • NIVO
  • ONO-4538
  • Opdivo
  • CMAB819
  • Nivolumab biosimilare CMAB819
  • MDX 1106
  • MDX1106
  • BMS 936558
  • ABP 206
  • Nivolumab biosimilare ABP 206
  • BCD-263
  • Nivolumab biosimilare BCD-263
  • BMS936558
  • ONO4538
Procedura: Computed Tomography

Undergo CT scan

Altri nomi:
  • CT
  • GATTO
  • TAC
  • Tomografia assiale computerizzata
  • Tomografia computerizzata
  • tomografia
  • Tomografia assiale computerizzata (procedura)
  • Scansione tomografia computerizzata (CT).
  • Scansione CAT diagnostica
  • Tipo di servizio di scansione CAT diagnostica
Procedura: Biospecimen Collection

Undergo collection of blood sample

Altri nomi:
  • Raccolta di campioni biologici
  • Biocampione raccolto
  • Raccolta di campioni
  • Raccolta campione

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Pathologic complete response (Step I)
Lasso di tempo: 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)
Lasso di tempo: 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

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Incidence of adverse events
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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

Altre misure di risultato

Misura del risultato
Misura Descrizione
Lasso di tempo
Percent change in mean volumetric apparent diffusion coefficient (ADC)
Lasso di tempo: 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

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

National Cancer Institute (NCI)

Investigatori

  • Investigatore principale: Jennifer R Eads, ECOG-ACRIN Cancer Research Group

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

3 maggio 2019

Completamento primario (Stimato)

31 marzo 2027

Completamento dello studio (Stimato)

31 marzo 2027

Date di iscrizione allo studio

Primo inviato

27 luglio 2018

Primo inviato che soddisfa i criteri di controllo qualità

27 luglio 2018

Primo Inserito (Effettivo)

30 luglio 2018

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

2 novembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

30 ottobre 2026

Ultimo verificato

1 settembre 2026

Maggiori informazioni

Termini relativi a questo studio

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • NCI-2018-01575
  • U10CA180820 (Sovvenzione/contratto NIH degli Stati Uniti)
  • NCI-2018-01575 (Identificatore di registro: CTRP (Clinical Trial Reporting Program))
  • EA2174 (Altro identificatore: CTEP)
  • EA2174 (Altro identificatore: ECOG-ACRIN Cancer Research Group)

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

SÌ

Descrizione del piano 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

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

Sì

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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