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Exemestane met of zonder entinostat bij de behandeling van patiënten met recidiverende hormoonreceptor-positieve borstkanker die lokaal gevorderd of gemetastaseerd is

21 oktober 2026 bijgewerkt door: National Cancer Institute (NCI)

Een gerandomiseerde fase III-studie van endocriene therapie plus entinostat/placebo bij patiënten met hormoonreceptorpositieve borstkanker in een gevorderd stadium

This randomized phase III trial studies exemestane and entinostat to see how well they work compared to exemestane alone in treating patients with hormone receptor-positive breast cancer that has spread to nearby tissue or lymph nodes (locally advanced) or another place in the body (metastatic). Estrogen can cause the growth of breast cancer cells. Endocrine therapy using exemestane may fight breast cancer by lowering the amount of estrogen the body makes. Entinostat may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known whether exemestane is more effective with or without entinostat in treating breast cancer.

Studie Overzicht

Toestand

Actief, niet wervend

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

PRIMARY OBJECTIVES:

I. To evaluate whether the addition of entinostat to endocrine therapy (exemestane) improves progression-free survival (PFS) and/or overall survival (OS) in patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative locally advanced or metastatic breast cancer who have previously progressed on a non-steroidal aromatase inhibitor (Al).

SECONDARY OBJECTIVES:

I. To evaluate the safety and tolerability of entinostat in combination with exemestane, and to compare the safety profile to that of endocrine therapy with placebo.

II. To evaluate the objective response rate of exemestane in combination with entinostat or placebo.

III. To evaluate whether the efficacy of exemestane with entinostat varies with changes in acetylation status in peripheral blood mononuclear cells (PBMCs).

IV. To evaluate the time to treatment deterioration (as defined by decrease in health-related quality of life [HRQL], progression, death) of exemestane + entinostat versus exemestane + placebo arms.

V. To evaluate the differences in overall health-related quality of life (HRQL) between the exemestane + entinostat versus exemestane + placebo arms.

VI. To evaluate the difference with respect to specific symptoms that are associated with entinostat, i.e., fatigue, nausea, anorexia and diarrhea, between the exemestane + entinostat versus exemestane + placebo arms.

VII. To measure adherence to protocol therapy. VIII. To evaluate the pharmacokinetics of entinostat in patients with advanced breast cancer.

IX. To evaluate what, if any, patient variables alter the pharmacokinetic profile of entinostat in patients with advanced breast cancer.

EXPLORATORY OBJECTIVES:

I. To collect archival tumor samples and germline deoxyribonucleic acid (DNA) to explore other potential biomarkers of therapeutic efficacy.

II. To collect patient ratings of adverse events (AEs) using select patient-reported outcomes (PRO)-Common Terminology Criteria for Adverse Events (CTCAE) items to evaluate the psychometric properties of PRO-CTCAE items and explore the incorporation of PRO-CTCAE items into a phase III double-blind placebo-controlled trial.

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

ARM A: Patients receive exemestane orally (PO) once daily (QD) on days 1-28 and entinostat PO on days 1, 8, 15, and 22. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo computed tomography (CT) or magnetic resonance imaging (MRI) at baseline, at the end of cycle 3, every 3 cycles, at treatment discontinuation, and during follow-up, collection of blood samples at baseline and day 15 of cycle 1, and collection of archived tissue at baseline.

ARM B: Patients receive exemestane as in Arm A and placebo PO on days 1, 8, 15, and 22. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT or MRI at baseline, at the end of cycle 3, every 3 cycles, at treatment discontinuation, and during follow-up, collection of blood samples at baseline and day 15 of cycle 1, and collection of archived tissue at baseline.

In both arms, pre/perimenopausal female patients and all male patients also receive goserelin acetate subcutaneously (SC) on day 1.

After completion of study treatment, patients are followed up every 3 months for 2 years, every 6 months for 3 years, and then annually for 5 years.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

608

Fase

  • Fase 3

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Studie Locaties

    • Alabama
      • Birmingham, Alabama, Verenigde Staten, 35233
        • University of Alabama at Birmingham Cancer Center
    • Arkansas
      • Jonesboro, Arkansas, Verenigde Staten, 72401
        • NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
    • California
      • Carmichael, California, Verenigde Staten, 95608
        • Mercy San Juan Medical Center
      • Chico, California, Verenigde Staten, 95973
        • Adventist Health Cancer Care Center Chico
      • Chico, California, Verenigde Staten, 95926
        • Enloe Medical Center
      • Clovis, California, Verenigde Staten, 93611
        • Community Cancer Institute
      • Clovis, California, Verenigde Staten, 93611
        • University Oncology Associates
      • Rancho Mirage, California, Verenigde Staten, 92270
        • Eisenhower Medical Center
      • Sacramento, California, Verenigde Staten, 95816
        • Mercy Cancer Center - Sacramento
      • St. Helena, California, Verenigde Staten, 94574
        • Saint Helena Hospital
      • Whittier, California, Verenigde Staten, 90602
        • Presbyterian Intercommunity Hospital
      • Woodland, California, Verenigde Staten, 95695
        • Woodland Memorial Hospital
    • Colorado
      • Aurora, Colorado, Verenigde Staten, 80012
        • Rocky Mountain Cancer Centers-Aurora
      • Aurora, Colorado, Verenigde Staten, 80012
        • The Medical Center of Aurora
      • Boulder, Colorado, Verenigde Staten, 80303
        • Boulder Community Foothills Hospital
      • Boulder, Colorado, Verenigde Staten, 80304
        • Rocky Mountain Cancer Centers-Boulder
      • Colorado Springs, Colorado, Verenigde Staten, 80907
        • Penrose-Saint Francis Healthcare
      • Colorado Springs, Colorado, Verenigde Staten, 80909
        • UCHealth Memorial Hospital Central
      • Colorado Springs, Colorado, Verenigde Staten, 80907
        • Rocky Mountain Cancer Centers-Penrose
      • Denver, Colorado, Verenigde Staten, 80218
        • Presbyterian - Saint Lukes Medical Center - Health One
      • Denver, Colorado, Verenigde Staten, 80220
        • Rose Medical Center
      • Denver, Colorado, Verenigde Staten, 80218
        • Rocky Mountain Cancer Centers-Midtown
      • Denver, Colorado, Verenigde Staten, 80220
        • Rocky Mountain Cancer Centers-Rose
      • Denver, Colorado, Verenigde Staten, 80218
        • Colorado Blood Cancer Institute
      • Denver, Colorado, Verenigde Staten, 80218
        • Saint Joseph Hospital - Cancer Centers of Colorado
      • Denver, Colorado, Verenigde Staten, 80210
        • AdventHealth Porter
      • Durango, Colorado, Verenigde Staten, 81301
        • Mercy Medical Center
      • Durango, Colorado, Verenigde Staten, 81301
        • CommonSpirit Cancer Center Mercy
      • Englewood, Colorado, Verenigde Staten, 80113
        • Mountain Blue Cancer Care Center - Swedish
      • Englewood, Colorado, Verenigde Staten, 80113
        • Swedish Medical Center
      • Golden, Colorado, Verenigde Staten, 80401
        • Mountain Blue Cancer Care Center
      • Greeley, Colorado, Verenigde Staten, 80631
        • Banner North Colorado Medical Center
      • Greenwood Village, Colorado, Verenigde Staten, 80111
        • Rocky Mountain Cancer Centers-Greenwood Village
      • Lakewood, Colorado, Verenigde Staten, 80228
        • Rocky Mountain Cancer Centers-Lakewood
      • Lakewood, Colorado, Verenigde Staten, 80228
        • CommonSpirit Saint Anthony Hospital Cancer Center
      • Littleton, Colorado, Verenigde Staten, 80120
        • Rocky Mountain Cancer Centers-Littleton
      • Littleton, Colorado, Verenigde Staten, 80122
        • AdventHealth Littleton
      • Lone Tree, Colorado, Verenigde Staten, 80124
        • Sky Ridge Medical Center
      • Lone Tree, Colorado, Verenigde Staten, 80124
        • Rocky Mountain Cancer Centers-Sky Ridge
      • Longmont, Colorado, Verenigde Staten, 80501
        • Longmont United Hospital
      • Longmont, Colorado, Verenigde Staten, 80501
        • Rocky Mountain Cancer Centers-Longmont
      • Loveland, Colorado, Verenigde Staten, 80539
        • Banner North Colorado Medical Center - Loveland Campus
      • Parker, Colorado, Verenigde Staten, 80138
        • Rocky Mountain Cancer Centers-Parker
      • Parker, Colorado, Verenigde Staten, 80138
        • AdventHealth Parker
      • Pueblo, Colorado, Verenigde Staten, 81004
        • Saint Mary Corwin Medical Center
      • Pueblo, Colorado, Verenigde Staten, 81008
        • Rocky Mountain Cancer Centers - Pueblo
      • Thornton, Colorado, Verenigde Staten, 80260
        • Rocky Mountain Cancer Centers-Thornton
      • Wheat Ridge, Colorado, Verenigde Staten, 80401
        • Intermountain Health Lutheran Hospital
    • Connecticut
      • Guilford, Connecticut, Verenigde Staten, 06437
        • Smilow Cancer Hospital Care Center - Guilford
      • Hartford, Connecticut, Verenigde Staten, 06105
        • Smilow Cancer Hospital Care Center at Saint Francis
      • Manchester, Connecticut, Verenigde Staten, 06040
        • Manchester Memorial Hospital
      • Middletown, Connecticut, Verenigde Staten, 06457
        • Middlesex Hospital
      • New Britain, Connecticut, Verenigde Staten, 06050
        • The Hospital of Central Connecticut
      • New Haven, Connecticut, Verenigde Staten, 06520
        • Yale University
      • Orange, Connecticut, Verenigde Staten, 06477
        • Smilow Cancer Hospital-Orange Care Center
      • Torrington, Connecticut, Verenigde Staten, 06790
        • Smilow Cancer Hospital-Torrington Care Center
      • Waterford, Connecticut, Verenigde Staten, 06385
        • Smilow Cancer Hospital Care Center - Waterford
    • Delaware
      • Dover, Delaware, Verenigde Staten, 19901
        • Bayhealth Hospital Kent Campus
      • Lewes, Delaware, Verenigde Staten, 19958
        • Beebe Medical Center
      • Newark, Delaware, Verenigde Staten, 19713
        • Helen F Graham Cancer Center
      • Newark, Delaware, Verenigde Staten, 19713
        • Medical Oncology Hematology Consultants PA
      • Newark, Delaware, Verenigde Staten, 19718
        • Christiana Care Health System-Christiana Hospital
      • Rehoboth Beach, Delaware, Verenigde Staten, 19971
        • Beebe Health Campus
      • Seaford, Delaware, Verenigde Staten, 19973
        • TidalHealth Nanticoke / Allen Cancer Center
      • Wilmington, Delaware, Verenigde Staten, 19801
        • Christiana Care Health System-Wilmington Hospital
    • District of Columbia
      • Washington D.C., District of Columbia, Verenigde Staten, 20010
        • MedStar Washington Hospital Center
      • Washington D.C., District of Columbia, Verenigde Staten, 20007
        • MedStar Georgetown University Hospital
      • Washington D.C., District of Columbia, Verenigde Staten, 20016
        • Sibley Memorial Hospital
    • Florida
      • Deerfield Beach, Florida, Verenigde Staten, 33442
        • UM Sylvester Comprehensive Cancer Center at Deerfield Beach
      • Gainesville, Florida, Verenigde Staten, 32610
        • UF Health Cancer Institute - Gainesville
      • Jacksonville, Florida, Verenigde Staten, 32207
        • Baptist MD Anderson Cancer Center
      • Lakeland, Florida, Verenigde Staten, 33805
        • Lakeland Regional Health Hollis Cancer Center
      • Miami, Florida, Verenigde Staten, 33136
        • University of Miami Miller School of Medicine-Sylvester Cancer Center
      • Miami, Florida, Verenigde Staten, 33176
        • UM Sylvester Comprehensive Cancer Center at Kendall
      • Plantation, Florida, Verenigde Staten, 33324
        • UM Sylvester Comprehensive Cancer Center at Plantation
      • Weston, Florida, Verenigde Staten, 33331
        • Cleveland Clinic-Weston
    • Georgia
      • Atlanta, Georgia, Verenigde Staten, 30308
        • Emory University Hospital Midtown
      • Atlanta, Georgia, Verenigde Staten, 30322
        • Emory University Hospital/Winship Cancer Institute
      • Atlanta, Georgia, Verenigde Staten, 30342
        • Emory Saint Joseph's Hospital
      • Atlanta, Georgia, Verenigde Staten, 30303
        • Grady Health System
      • Columbus, Georgia, Verenigde Staten, 31904
        • John B Amos Cancer Center
      • Macon, Georgia, Verenigde Staten, 31201
        • Atrium Health Navicent
      • Savannah, Georgia, Verenigde Staten, 31405
        • Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
    • Hawaii
      • Honolulu, Hawaii, Verenigde Staten, 96813
        • Queen's Medical Center
      • Honolulu, Hawaii, Verenigde Staten, 96813
        • Hawaii Cancer Care Inc - Waterfront Plaza
      • Honolulu, Hawaii, Verenigde Staten, 96813
        • Queen's Cancer Cenrer - POB I
      • Honolulu, Hawaii, Verenigde Staten, 96813
        • Straub Clinic and Hospital
      • Honolulu, Hawaii, Verenigde Staten, 96813
        • University of Hawaii Cancer Center
      • Honolulu, Hawaii, Verenigde Staten, 96817
        • Hawaii Cancer Care Inc-Liliha
      • Honolulu, Hawaii, Verenigde Staten, 96817
        • Queen's Cancer Center - Kuakini
      • ‘Aiea, Hawaii, Verenigde Staten, 96701
        • Pali Momi Medical Center
      • ‘Aiea, Hawaii, Verenigde Staten, 96701
        • Queen's Cancer Center - Pearlridge
    • Idaho
      • Boise, Idaho, Verenigde Staten, 83706
        • Saint Alphonsus Cancer Care Center-Boise
      • Boise, Idaho, Verenigde Staten, 83712
        • Saint Luke's Cancer Institute - Boise
      • Coeur d'Alene, Idaho, Verenigde Staten, 83814
        • Kootenai Health - Coeur d'Alene
      • Fruitland, Idaho, Verenigde Staten, 83619
        • Saint Luke's Cancer Institute - Fruitland
      • Post Falls, Idaho, Verenigde Staten, 83854
        • Kootenai Clinic Cancer Services - Post Falls
      • Sandpoint, Idaho, Verenigde Staten, 83864
        • Kootenai Clinic Cancer Services - Sandpoint
      • Twin Falls, Idaho, Verenigde Staten, 83301
        • Saint Luke's Cancer Institute - Twin Falls
    • Illinois
      • Aurora, Illinois, Verenigde Staten, 60504
        • Rush-Copley Medical Center
      • Bloomington, Illinois, Verenigde Staten, 61704
        • Illinois CancerCare-Bloomington
      • Bloomington, Illinois, Verenigde Staten, 61701
        • OSF Saint Joseph Medical Center
      • Canton, Illinois, Verenigde Staten, 61520
        • Illinois CancerCare-Canton
      • Carbondale, Illinois, Verenigde Staten, 62902
        • Memorial Hospital of Carbondale
      • Carthage, Illinois, Verenigde Staten, 62321
        • Illinois CancerCare-Carthage
      • Centralia, Illinois, Verenigde Staten, 62801
        • Centralia Oncology Clinic
      • Chicago, Illinois, Verenigde Staten, 60611
        • Northwestern University
      • Chicago, Illinois, Verenigde Staten, 60637
        • University of Chicago Comprehensive Cancer Center
      • Chicago, Illinois, Verenigde Staten, 60612
        • John H Stroger Jr Hospital of Cook County
      • Chicago, Illinois, Verenigde Staten, 60657
        • UChicago Medicine Comprehensive Cancer Center - Saint Joseph Hospital
      • Chicago, Illinois, Verenigde Staten, 60625
        • Swedish Covenant Hospital
      • Chicago, Illinois, Verenigde Staten, 60640
        • Weiss Memorial Hospital
      • Danville, Illinois, Verenigde Staten, 61832
        • Carle at The Riverfront
      • Decatur, Illinois, Verenigde Staten, 62526
        • Decatur Memorial Hospital
      • Decatur, Illinois, Verenigde Staten, 62526
        • Cancer Care Specialists of Illinois - Decatur
      • Effingham, Illinois, Verenigde Staten, 62401
        • Crossroads Cancer Center
      • Effingham, Illinois, Verenigde Staten, 62401
        • Carle Physician Group-Effingham
      • Elk Grove Village, Illinois, Verenigde Staten, 60007
        • Ascension Alexian Brothers - Elk Grove Village
      • Elmhurst, Illinois, Verenigde Staten, 60126
        • Elmhurst Memorial Hospital
      • Eureka, Illinois, Verenigde Staten, 61530
        • Illinois CancerCare-Eureka
      • Evanston, Illinois, Verenigde Staten, 60202
        • Saint Francis Hospital
      • Freeport, Illinois, Verenigde Staten, 61032
        • Freeport Memorial Hospital/Leonard C Ferguson Cancer Center
      • Galesburg, Illinois, Verenigde Staten, 61401
        • Western Illinois Cancer Treatment Center
      • Galesburg, Illinois, Verenigde Staten, 61401
        • Illinois CancerCare-Galesburg
      • Geneva, Illinois, Verenigde Staten, 60134
        • Northwestern Medicine Cancer Center Delnor
      • Harvey, Illinois, Verenigde Staten, 60426
        • Ingalls Memorial Hospital
      • Joliet, Illinois, Verenigde Staten, 60435
        • Duly Health and Care Joliet
      • Kankakee, Illinois, Verenigde Staten, 60901
        • Presence Saint Mary's Hospital
      • Kewanee, Illinois, Verenigde Staten, 61443
        • Illinois CancerCare-Kewanee Clinic
      • Macomb, Illinois, Verenigde Staten, 61455
        • Illinois CancerCare-Macomb
      • Mattoon, Illinois, Verenigde Staten, 61938
        • Carle Physician Group-Mattoon/Charleston
      • Maywood, Illinois, Verenigde Staten, 60153
        • Loyola University Medical Center
      • Mount Vernon, Illinois, Verenigde Staten, 62864
        • SSM Health Good Samaritan
      • Naperville, Illinois, Verenigde Staten, 60540
        • Edward Hospital/Cancer Center
      • Normal, Illinois, Verenigde Staten, 61761
        • Carle Cancer Institute Normal
      • Oak Lawn, Illinois, Verenigde Staten, 60453-2699
        • Advocate Christ Medical Center
      • Ottawa, Illinois, Verenigde Staten, 61350
        • Illinois CancerCare-Ottawa Clinic
      • Ottawa, Illinois, Verenigde Staten, 61350
        • Radiation Oncology of Northern Illinois
      • Pekin, Illinois, Verenigde Staten, 61554
        • Illinois CancerCare-Pekin
      • Pekin, Illinois, Verenigde Staten, 61554
        • OSF Saint Francis Radiation Oncology at Pekin
      • Peoria, Illinois, Verenigde Staten, 61636
        • Methodist Medical Center of Illinois
      • Peoria, Illinois, Verenigde Staten, 61637
        • OSF Saint Francis Medical Center
      • Peoria, Illinois, Verenigde Staten, 61615
        • Illinois CancerCare-Peoria
      • Peoria, Illinois, Verenigde Staten, 61615
        • OSF Saint Francis Radiation Oncology at Peoria Cancer Center
      • Peru, Illinois, Verenigde Staten, 61354
        • Illinois CancerCare-Peru
      • Peru, Illinois, Verenigde Staten, 61354
        • Valley Radiation Oncology
      • Plainfield, Illinois, Verenigde Staten, 60585
        • Edward Hospital/Cancer Center?Plainfield
      • Princeton, Illinois, Verenigde Staten, 61356
        • Illinois CancerCare-Princeton
      • River Forest, Illinois, Verenigde Staten, 60305
        • West Suburban Medical Center
      • Rockford, Illinois, Verenigde Staten, 61114
        • UW Health Carbone Cancer Center Rockford
      • Springfield, Illinois, Verenigde Staten, 62702
        • Southern Illinois University School of Medicine
      • Springfield, Illinois, Verenigde Staten, 62702
        • Springfield Clinic
      • Springfield, Illinois, Verenigde Staten, 62702
        • Central Illinois Hematology Oncology Center
      • Springfield, Illinois, Verenigde Staten, 62781
        • Springfield Memorial Hospital
      • Urbana, Illinois, Verenigde Staten, 61801
        • Carle Cancer Center
      • Urbana, Illinois, Verenigde Staten, 61801
        • The Carle Foundation Hospital
      • Warrenville, Illinois, Verenigde Staten, 60555
        • Northwestern Medicine Cancer Center Warrenville
      • Yorkville, Illinois, Verenigde Staten, 60560
        • Rush-Copley Healthcare Center
    • Indiana
      • Carmel, Indiana, Verenigde Staten, 46032
        • IU Health North Hospital
      • Fishers, Indiana, Verenigde Staten, 46037
        • IU Health Central Indiana Cancer Centers-Fishers
      • Fort Wayne, Indiana, Verenigde Staten, 46845
        • Fort Wayne Medical Oncology and Hematology Inc-Parkview
      • Indianapolis, Indiana, Verenigde Staten, 46237
        • Franciscan Health Indianapolis
      • Indianapolis, Indiana, Verenigde Staten, 46202
        • Indiana University/Melvin and Bren Simon Cancer Center
      • Indianapolis, Indiana, Verenigde Staten, 46202
        • Sidney and Lois Eskenazi Hospital
      • Indianapolis, Indiana, Verenigde Staten, 46219
        • IU Health Central Indiana Cancer Centers-East
      • Indianapolis, Indiana, Verenigde Staten, 46290
        • Springmill Medical Center
      • Indianapolis, Indiana, Verenigde Staten, 46202
        • IU Health Methodist Hospital
      • Lafayette, Indiana, Verenigde Staten, 47904
        • IU Health Arnett Cancer Care
      • Michigan City, Indiana, Verenigde Staten, 46360
        • Woodland Cancer Care Center
      • Mooresville, Indiana, Verenigde Staten, 46158
        • Franciscan Health Mooresville
      • Muncie, Indiana, Verenigde Staten, 47303
        • IU Health Ball Memorial Hospital
      • Richmond, Indiana, Verenigde Staten, 47374
        • Reid Health
      • Terre Haute, Indiana, Verenigde Staten, 47804
        • Union Hospital
    • Iowa
      • Ames, Iowa, Verenigde Staten, 50010
        • Mary Greeley Medical Center
      • Ames, Iowa, Verenigde Staten, 50010
        • McFarland Clinic - Ames
      • Bettendorf, Iowa, Verenigde Staten, 52722
        • University of Iowa Healthcare Cancer Services Quad Cities
      • Boone, Iowa, Verenigde Staten, 50036
        • McFarland Clinic - Boone
      • Cedar Rapids, Iowa, Verenigde Staten, 52403
        • Mercy Hospital
      • Cedar Rapids, Iowa, Verenigde Staten, 52403
        • Oncology Associates at Mercy Medical Center
      • Clive, Iowa, Verenigde Staten, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Verenigde Staten, 50325
        • UI Health Care Mission Cancer and Blood - West Des Moines Clinic
      • Council Bluffs, Iowa, Verenigde Staten, 51503
        • Alegent Health Mercy Hospital
      • Davenport, Iowa, Verenigde Staten, 52803
        • MercyOne Genesis Davenport Medical Center
      • Des Moines, Iowa, Verenigde Staten, 50309
        • Iowa Methodist Medical Center
      • Des Moines, Iowa, Verenigde Staten, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Verenigde Staten, 50314
        • Broadlawns Medical Center
      • Des Moines, Iowa, Verenigde Staten, 50309
        • UI Health Care Mission Cancer and Blood - Des Moines Clinic
      • Des Moines, Iowa, Verenigde Staten, 50314
        • UI Health Care Mission Cancer and Blood - Laurel Clinic
      • Fort Dodge, Iowa, Verenigde Staten, 50501
        • McFarland Clinic - Trinity Cancer Center
      • Fort Dodge, Iowa, Verenigde Staten, 50501
        • UI Healthcare Mission Cancer and Blood - Fort Dodge
      • Iowa City, Iowa, Verenigde Staten, 52242
        • University of Iowa/Holden Comprehensive Cancer Center
      • Jefferson, Iowa, Verenigde Staten, 50129
        • McFarland Clinic - Jefferson
      • Marshalltown, Iowa, Verenigde Staten, 50158
        • McFarland Clinic - Marshalltown
      • Mason City, Iowa, Verenigde Staten, 50401
        • Mercy Medical Center - North Iowa
      • Sioux City, Iowa, Verenigde Staten, 51101
        • Siouxland Regional Cancer Center
      • West Des Moines, Iowa, Verenigde Staten, 50266
        • Mercy Medical Center-West Lakes
    • Kansas
      • Chanute, Kansas, Verenigde Staten, 66720
        • Cancer Center of Kansas - Chanute
      • Dodge City, Kansas, Verenigde Staten, 67801
        • Cancer Center of Kansas - Dodge City
      • El Dorado, Kansas, Verenigde Staten, 67042
        • Cancer Center of Kansas - El Dorado
      • Fort Scott, Kansas, Verenigde Staten, 66701
        • Cancer Center of Kansas - Fort Scott
      • Garden City, Kansas, Verenigde Staten, 67846
        • Saint Catherine Hospital
      • Great Bend, Kansas, Verenigde Staten, 67530
        • Central Care Cancer Center - Great Bend
      • Great Bend, Kansas, Verenigde Staten, 67530
        • Saint Rose Ambulatory and Surgery Center
      • Hays, Kansas, Verenigde Staten, 67601
        • HaysMed
      • Independence, Kansas, Verenigde Staten, 67301
        • Cancer Center of Kansas-Independence
      • Kansas City, Kansas, Verenigde Staten, 66112
        • University of Kansas Cancer Center-West
      • Kingman, Kansas, Verenigde Staten, 67068
        • Cancer Center of Kansas-Kingman
      • Lawrence, Kansas, Verenigde Staten, 66044
        • Lawrence Memorial Hospital
      • Lenexa, Kansas, Verenigde Staten, 66219
        • Kansas Institute of Medicine Cancer and Blood Center
      • Lenexa, Kansas, Verenigde Staten, 66219
        • Minimally Invasive Surgery Hospital
      • Liberal, Kansas, Verenigde Staten, 67905
        • Cancer Center of Kansas-Liberal
      • Manhattan, Kansas, Verenigde Staten, 66502
        • Cancer Center of Kansas-Manhattan
      • McPherson, Kansas, Verenigde Staten, 67460
        • Cancer Center of Kansas - McPherson
      • Newton, Kansas, Verenigde Staten, 67114
        • Cancer Center of Kansas - Newton
      • Olathe, Kansas, Verenigde Staten, 66061
        • The University of Kansas Cancer Center - Olathe
      • Overland Park, Kansas, Verenigde Staten, 66210
        • University of Kansas Cancer Center-Overland Park
      • Overland Park, Kansas, Verenigde Staten, 66209
        • Menorah Medical Center
      • Parsons, Kansas, Verenigde Staten, 67357
        • Cancer Center of Kansas - Parsons
      • Pratt, Kansas, Verenigde Staten, 67124
        • Cancer Center of Kansas - Pratt
      • Salina, Kansas, Verenigde Staten, 67401
        • Salina Regional Health Center
      • Salina, Kansas, Verenigde Staten, 67401
        • Cancer Center of Kansas - Salina
      • Topeka, Kansas, Verenigde Staten, 66606
        • University of Kansas Health System Saint Francis Campus
      • Wellington, Kansas, Verenigde Staten, 67152
        • Cancer Center of Kansas - Wellington
      • Wichita, Kansas, Verenigde Staten, 67214
        • Ascension Via Christi Hospitals Wichita
      • Wichita, Kansas, Verenigde Staten, 67208
        • Cancer Center of Kansas-Wichita Medical Arts Tower
      • Wichita, Kansas, Verenigde Staten, 67214
        • Cancer Center of Kansas - Wichita
      • Wichita, Kansas, Verenigde Staten, 67208
        • Associates In Womens Health
      • Winfield, Kansas, Verenigde Staten, 67156
        • Cancer Center of Kansas - Winfield
    • Kentucky
      • Bardstown, Kentucky, Verenigde Staten, 40004
        • CommonSpirit Saint Joseph Hospital - Bardstown
      • Corbin, Kentucky, Verenigde Staten, 40701
        • Baptist Health Corbin
      • Crestview Hills, Kentucky, Verenigde Staten, 41017
        • Oncology Hematology Care Inc-Crestview
      • Edgewood, Kentucky, Verenigde Staten, 41017
        • Saint Elizabeth Healthcare Edgewood
      • Elizabethtown, Kentucky, Verenigde Staten, 42701
        • Baptist Health Hardin
      • Fort Thomas, Kentucky, Verenigde Staten, 41075
        • Saint Elizabeth Healthcare Fort Thomas
      • Lexington, Kentucky, Verenigde Staten, 40536
        • University of Kentucky/Markey Cancer Center
      • Lexington, Kentucky, Verenigde Staten, 40504
        • Saint Joseph Radiation Oncology Resource Center
      • Lexington, Kentucky, Verenigde Staten, 40503
        • Baptist Health Lexington
      • Lexington, Kentucky, Verenigde Staten, 40509
        • CommonSpirit Saint Joseph Medical Center - East Lexington
      • Louisville, Kentucky, Verenigde Staten, 40202
        • Jewish Hospital
      • Louisville, Kentucky, Verenigde Staten, 40245
        • UofL Health Medical Center Northeast
      • Louisville, Kentucky, Verenigde Staten, 40207
        • Baptist Health Louisville
      • Madisonville, Kentucky, Verenigde Staten, 42431
        • Baptist Health Madisonville/Merle Mahr Cancer Center
      • Paducah, Kentucky, Verenigde Staten, 42003
        • Baptist Health Paducah
    • Louisiana
      • Baton Rouge, Louisiana, Verenigde Staten, 70805
        • LSU Health Baton Rouge-North Clinic
      • Baton Rouge, Louisiana, Verenigde Staten, 70809
        • Louisiana Hematology Oncology Associates LLC
      • Baton Rouge, Louisiana, Verenigde Staten, 70809
        • Mary Bird Perkins Cancer Center
      • Baton Rouge, Louisiana, Verenigde Staten, 70809
        • Ochsner Health Center-Summa
      • Baton Rouge, Louisiana, Verenigde Staten, 70816
        • Medical Center of Baton Rouge
      • Baton Rouge, Louisiana, Verenigde Staten, 70809
        • Hematology/Oncology Clinic PLLC
      • Baton Rouge, Louisiana, Verenigde Staten, 70808
        • Our Lady of the Lake Physician Group
      • Covington, Louisiana, Verenigde Staten, 70433
        • Mary Bird Perkins Cancer Center - Covington
      • Covington, Louisiana, Verenigde Staten, 70433
        • Northshore Oncology Associates-Covington
      • Houma, Louisiana, Verenigde Staten, 70360
        • Mary Bird Perkins Cancer Center - Houma
      • Houma, Louisiana, Verenigde Staten, 70360
        • Oncology Center of The South Incorporated
      • New Orleans, Louisiana, Verenigde Staten, 70121
        • Ochsner Medical Center Jefferson
      • New Orleans, Louisiana, Verenigde Staten, 70112
        • University Medical Center New Orleans
      • New Orleans, Louisiana, Verenigde Staten, 70112
        • Louisiana State University Health Science Center
    • Maine
      • Augusta, Maine, Verenigde Staten, 04330
        • Harold Alfond Center for Cancer Care
      • Bangor, Maine, Verenigde Staten, 04401
        • Eastern Maine Medical Center
      • Brewer, Maine, Verenigde Staten, 04412
        • Lafayette Family Cancer Center-EMMC
      • Rockport, Maine, Verenigde Staten, 04856
        • Penobscot Bay Medical Center
      • York Village, Maine, Verenigde Staten, 03909
        • York Hospital
    • Maryland
      • Annapolis, Maryland, Verenigde Staten, 21401
        • Luminis Health Anne Arundel Medical Center
      • Baltimore, Maryland, Verenigde Staten, 21237
        • MedStar Franklin Square Medical Center/Weinberg Cancer Institute
      • Baltimore, Maryland, Verenigde Staten, 21287
        • Johns Hopkins University/Sidney Kimmel Cancer Center
      • Baltimore, Maryland, Verenigde Staten, 21215
        • Sinai Hospital of Baltimore
      • Baltimore, Maryland, Verenigde Staten, 21204
        • Greater Baltimore Medical Center
      • Baltimore, Maryland, Verenigde Staten, 21201
        • University of Maryland/Greenebaum Cancer Center
      • Bel Air, Maryland, Verenigde Staten, 21014
        • UM Upper Chesapeake Medical Center
      • Cumberland, Maryland, Verenigde Staten, 21502
        • UPMC Western Maryland
      • Easton, Maryland, Verenigde Staten, 21601
        • University of Maryland Shore Medical Center at Easton
      • Olney, Maryland, Verenigde Staten, 20832
        • MedStar Montgomery Medical Center
      • Randallstown, Maryland, Verenigde Staten, 21133
        • Northwest Hospital Center
    • Massachusetts
      • Beverly, Massachusetts, Verenigde Staten, 01915
        • Beverly Hospital
      • Burlington, Massachusetts, Verenigde Staten, 01805
        • Lahey Clinic
      • Fall River, Massachusetts, Verenigde Staten, 02721
        • Saint Anne's Hospital
      • Gloucester, Massachusetts, Verenigde Staten, 01930
        • Addison Gilbert Hospital
      • Newton, Massachusetts, Verenigde Staten, 02462
        • Newton-Wellesley Hospital
      • Pittsfield, Massachusetts, Verenigde Staten, 01201
        • Berkshire Medical Center - Cancer Center
      • Winchester, Massachusetts, Verenigde Staten, 01890
        • Beth Israel Deaconess Medical Center/Winchester Center for Cancer Care
      • Worcester, Massachusetts, Verenigde Staten, 01655
        • UMass Memorial Medical Center - University Campus
    • Michigan
      • Adrian, Michigan, Verenigde Staten, 49221
        • Hickman Cancer Center
      • Ann Arbor, Michigan, Verenigde Staten, 48106
        • Trinity Health Saint Joseph Mercy Hospital Ann Arbor
      • Brownstown, Michigan, Verenigde Staten, 48183
        • Henry Ford Cancer Institute-Downriver
      • Chelsea, Michigan, Verenigde Staten, 48118
        • Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
      • Clinton Township, Michigan, Verenigde Staten, 48038
        • Henry Ford Macomb Hospital-Clinton Township
      • Dearborn, Michigan, Verenigde Staten, 48126
        • Henry Ford Medical Center-Fairlane
      • Dearborn, Michigan, Verenigde Staten, 48124
        • Corewell Health Dearborn Hospital
      • Detroit, Michigan, Verenigde Staten, 48202
        • Henry Ford Hospital
      • Detroit, Michigan, Verenigde Staten, 48201
        • Wayne State University/Karmanos Cancer Institute
      • Detroit, Michigan, Verenigde Staten, 48236
        • Henry Ford Health Saint John Hospital
      • Escanaba, Michigan, Verenigde Staten, 49829
        • OSF Saint Francis Hospital and Medical Group
      • Farmington Hills, Michigan, Verenigde Staten, 48334
        • Weisberg Cancer Treatment Center
      • Flint, Michigan, Verenigde Staten, 48503
        • Hurley Medical Center
      • Flint, Michigan, Verenigde Staten, 48503
        • Genesys Hurley Cancer Institute
      • Grand Rapids, Michigan, Verenigde Staten, 49503
        • Corewell Health Grand Rapids Hospitals - Butterworth Hospital
      • Grosse Pointe, Michigan, Verenigde Staten, 48230
        • William Beaumont Hospital-Grosse Pointe
      • Jackson, Michigan, Verenigde Staten, 49201
        • Allegiance Health
      • Kalamazoo, Michigan, Verenigde Staten, 49007
        • West Michigan Cancer Center
      • Kalamazoo, Michigan, Verenigde Staten, 49048
        • Beacon Kalamazoo
      • Livonia, Michigan, Verenigde Staten, 48154
        • Trinity Health Saint Mary Mercy Livonia Hospital
      • Novi, Michigan, Verenigde Staten, 48377
        • Henry Ford Medical Center-Columbus
      • Pontiac, Michigan, Verenigde Staten, 48341
        • Trinity Health Saint Joseph Mercy Oakland Hospital
      • Port Huron, Michigan, Verenigde Staten, 48060
        • Lake Huron Medical Center
      • Royal Oak, Michigan, Verenigde Staten, 48073
        • Corewell Health William Beaumont University Hospital
      • Saginaw, Michigan, Verenigde Staten, 48601
        • MyMichigan Medical Center Saginaw
      • Troy, Michigan, Verenigde Staten, 48085
        • Corewell Health Beaumont Troy Hospital
      • Warren, Michigan, Verenigde Staten, 48093
        • Henry Ford Health Warren Hospital
      • West Bloomfield, Michigan, Verenigde Staten, 48322
        • Henry Ford West Bloomfield Hospital
    • Minnesota
      • Bemidji, Minnesota, Verenigde Staten, 56601
        • Sanford Joe Lueken Cancer Center
      • Brainerd, Minnesota, Verenigde Staten, 56401
        • Essentia Health Saint Joseph's Medical Center
      • Coon Rapids, Minnesota, Verenigde Staten, 55433
        • Mercy Hospital
      • Duluth, Minnesota, Verenigde Staten, 55805
        • Essentia Health Cancer Center
      • Fergus Falls, Minnesota, Verenigde Staten, 56537
        • Lake Region Healthcare Corporation-Cancer Care
      • Maplewood, Minnesota, Verenigde Staten, 55109
        • Saint John's Hospital - Healtheast
      • Maplewood, Minnesota, Verenigde Staten, 55109
        • Minnesota Oncology Hematology PA-Maplewood
      • Minneapolis, Minnesota, Verenigde Staten, 55407
        • Abbott-Northwestern Hospital
      • Minneapolis, Minnesota, Verenigde Staten, 55454
        • Health Partners Inc
      • New Ulm, Minnesota, Verenigde Staten, 56073
        • New Ulm Medical Center
      • Saint Cloud, Minnesota, Verenigde Staten, 56303
        • Coborn Cancer Center at Saint Cloud Hospital
      • Saint Paul, Minnesota, Verenigde Staten, 55101
        • Regions Hospital
      • Stillwater, Minnesota, Verenigde Staten, 55082
        • Lakeview Hospital
      • Willmar, Minnesota, Verenigde Staten, 56201
        • Rice Memorial Hospital
    • Mississippi
      • Columbus, Mississippi, Verenigde Staten, 39705
        • Baptist Memorial Hospital and Cancer Center-Golden Triangle
      • Grenada, Mississippi, Verenigde Staten, 38901
        • Baptist Cancer Center-Grenada
      • Hattiesburg, Mississippi, Verenigde Staten, 39401
        • Hattiesburg Clinic - Hematology/Oncology Clinic
      • Hattiesburg, Mississippi, Verenigde Staten, 39404
        • Forrest General Hospital / Cancer Center
      • Jackson, Mississippi, Verenigde Staten, 39216
        • University of Mississippi Medical Center
      • New Albany, Mississippi, Verenigde Staten, 38652
        • Baptist Memorial Hospital and Cancer Center-Union County
      • Oxford, Mississippi, Verenigde Staten, 38655
        • Baptist Memorial Hospital and Cancer Center-Oxford
      • Pascagoula, Mississippi, Verenigde Staten, 39581
        • Singing River Hospital
      • Southhaven, Mississippi, Verenigde Staten, 38671
        • Baptist Memorial Hospital and Cancer Center-Desoto
    • Missouri
      • Ballwin, Missouri, Verenigde Staten, 63011
        • Mercy Oncology and Hematology - Clayton-Clarkson
      • Bonne Terre, Missouri, Verenigde Staten, 63628
        • Parkland Health Center-Bonne Terre
      • Branson, Missouri, Verenigde Staten, 65616
        • Cox Cancer Center Branson
      • Cape Girardeau, Missouri, Verenigde Staten, 63703
        • Saint Francis Medical Center
      • Cape Girardeau, Missouri, Verenigde Staten, 63703
        • Mercy Cancer Center - Cape Girardeau
      • Chesterfield, Missouri, Verenigde Staten, 63017
        • Saint Luke's Hospital
      • City of Saint Peters, Missouri, Verenigde Staten, 63376
        • Siteman Cancer Center at Saint Peters Hospital
      • Columbia, Missouri, Verenigde Staten, 65212
        • MU Health - University Hospital/Ellis Fischel Cancer Center
      • Creve Coeur, Missouri, Verenigde Staten, 63141
        • Siteman Cancer Center at West County Hospital
      • Independence, Missouri, Verenigde Staten, 64057
        • Centerpoint Medical Center LLC
      • Jefferson City, Missouri, Verenigde Staten, 65109
        • MU Health Care Goldschmidt Cancer Center
      • Kansas City, Missouri, Verenigde Staten, 64154
        • University of Kansas Cancer Center - North
      • Kansas City, Missouri, Verenigde Staten, 64131
        • The University of Kansas Cancer Center-South
      • Kansas City, Missouri, Verenigde Staten, 64132
        • Research Medical Center
      • Kansas City, Missouri, Verenigde Staten, 64108
        • University Health Truman Medical Center
      • Lee's Summit, Missouri, Verenigde Staten, 64064
        • University of Kansas Cancer Center - Lee's Summit
      • Sainte Genevieve, Missouri, Verenigde Staten, 63670
        • Sainte Genevieve County Memorial Hospital
      • Springfield, Missouri, Verenigde Staten, 65807
        • CoxHealth South Hospital
      • Springfield, Missouri, Verenigde Staten, 65804
        • Mercy Hospital Springfield
      • St Louis, Missouri, Verenigde Staten, 63110
        • Washington University School of Medicine
      • St Louis, Missouri, Verenigde Staten, 63131
        • Missouri Baptist Medical Center
      • St Louis, Missouri, Verenigde Staten, 63109
        • Mercy Infusion Center - Chippewa
      • St Louis, Missouri, Verenigde Staten, 63141
        • Mercy Hospital Saint Louis
      • Sullivan, Missouri, Verenigde Staten, 63080
        • Missouri Baptist Sullivan Hospital
    • Montana
      • Billings, Montana, Verenigde Staten, 59101
        • Saint Vincent Healthcare
      • Bozeman, Montana, Verenigde Staten, 59715
        • Bozeman Health Deaconess Hospital
      • Butte, Montana, Verenigde Staten, 59701
        • Saint James Community Hospital and Cancer Treatment Center
      • Great Falls, Montana, Verenigde Staten, 59405
        • Benefis Sletten Cancer Institute
      • Helena, Montana, Verenigde Staten, 59601
        • Saint Peter's Community Hospital
      • Kalispell, Montana, Verenigde Staten, 59901
        • Logan Health Medical Center
      • Missoula, Montana, Verenigde Staten, 59802
        • Saint Patrick Hospital - Community Hospital
    • Nebraska
      • Grand Island, Nebraska, Verenigde Staten, 68803
        • Nebraska Cancer Specialists/Oncology Hematology West PC
      • Kearney, Nebraska, Verenigde Staten, 68847
        • CHI Health Good Samaritan
      • Omaha, Nebraska, Verenigde Staten, 68124
        • Alegent Health Bergan Mercy Medical Center
      • Omaha, Nebraska, Verenigde Staten, 68122
        • Alegent Health Immanuel Medical Center
      • Omaha, Nebraska, Verenigde Staten, 68130
        • Alegent Health Lakeside Hospital
    • New Hampshire
      • Dover, New Hampshire, Verenigde Staten, 03820
        • Wentworth-Douglass Hospital
      • Keene, New Hampshire, Verenigde Staten, 03431
        • Cheshire Medical Center-Dartmouth-Hitchcock Keene
      • Lebanon, New Hampshire, Verenigde Staten, 03756
        • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
      • Manchester, New Hampshire, Verenigde Staten, 03104
        • Dartmouth Cancer Center - Manchester/ DCC Manchester
      • Nashua, New Hampshire, Verenigde Staten, 03060
        • Saint Joseph Hospital
      • Nashua, New Hampshire, Verenigde Staten, 03063
        • Dartmouth Cancer Center - Nashua
    • New Jersey
      • Cape May Court House, New Jersey, Verenigde Staten, 08210
        • AtlantiCare Health Park-Cape May Court House
      • Egg Harbor, New Jersey, Verenigde Staten, 08234
        • AtlantiCare Surgery Center
      • Englewood, New Jersey, Verenigde Staten, 07631
        • Englewood Hospital and Medical Center
      • Hackensack, New Jersey, Verenigde Staten, 07601
        • Hackensack University Medical Center
      • Hamilton, New Jersey, Verenigde Staten, 08690
        • The Cancer Institute of New Jersey Hamilton
      • Long Branch, New Jersey, Verenigde Staten, 07740
        • Monmouth Medical Center
      • Mount Holly, New Jersey, Verenigde Staten, 08060
        • Virtua Memorial
      • Mullica Hill, New Jersey, Verenigde Staten, 08062
        • Inspira Medical Center Mullica Hill
      • Neptune City, New Jersey, Verenigde Staten, 07753
        • Jersey Shore Medical Center
      • Somerville, New Jersey, Verenigde Staten, 08876
        • Robert Wood Johnson University Hospital Somerset
      • Vineland, New Jersey, Verenigde Staten, 08360
        • Inspira Medical Center Vineland
      • Voorhees Township, New Jersey, Verenigde Staten, 08043
        • Virtua Voorhees
    • New Mexico
      • Albuquerque, New Mexico, Verenigde Staten, 87109
        • New Mexico Oncology Hematology Consultants
      • Albuquerque, New Mexico, Verenigde Staten, 87106
        • University of New Mexico Cancer Center
      • Albuquerque, New Mexico, Verenigde Staten, 87110
        • Presbyterian Kaseman Hospital
      • Las Cruces, New Mexico, Verenigde Staten, 88011
        • Memorial Medical Center-Las Cruces
      • Santa Fe, New Mexico, Verenigde Staten, 87505
        • Christus Saint Vincent Regional Cancer Center
    • New York
      • Auburn, New York, Verenigde Staten, 13021
        • Hematology Oncology Associates of Central New York-Auburn
      • Brooklyn, New York, Verenigde Staten, 11203
        • Kings County Hospital
      • Brooklyn, New York, Verenigde Staten, 11203
        • State University of New York Downstate Medical Center
      • Buffalo, New York, Verenigde Staten, 14263
        • Roswell Park Cancer Institute
      • Camillus, New York, Verenigde Staten, 13031
        • Hematology Oncology Associates of CNY at Camillus
      • East Syracuse, New York, Verenigde Staten, 13057
        • Hematology Oncology Associates of Central New York-East Syracuse
      • Elmira, New York, Verenigde Staten, 14905
        • Arnot Ogden Medical Center/Falck Cancer Center
      • New York, New York, Verenigde Staten, 10019
        • Mount Sinai West
      • New York, New York, Verenigde Staten, 10032
        • NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
      • New York, New York, Verenigde Staten, 10065
        • NYP/Weill Cornell Medical Center
      • New York, New York, Verenigde Staten, 10003
        • Mount Sinai Union Square
      • Rochester, New York, Verenigde Staten, 14642
        • University of Rochester
      • Staten Island, New York, Verenigde Staten, 10305
        • Staten Island University Hospital
      • The Bronx, New York, Verenigde Staten, 10461
        • Montefiore Medical Center-Einstein Campus
      • The Bronx, New York, Verenigde Staten, 10467
        • Montefiore Medical Center - Moses Campus
      • The Bronx, New York, Verenigde Staten, 10461
        • Montefiore Medical Center-Weiler Hospital
      • White Plains, New York, Verenigde Staten, 10601
        • Dickstein Cancer Treatment Center
    • North Carolina
      • Asheboro, North Carolina, Verenigde Staten, 27203
        • Randolph Hospital
      • Asheville, North Carolina, Verenigde Staten, 28801
        • Mission Hospital
      • Asheville, North Carolina, Verenigde Staten, 28816
        • Hope Women's Cancer Centers-Asheville
      • Asheville, North Carolina, Verenigde Staten, 28806
        • Messino Cancer Centers
      • Burlington, North Carolina, Verenigde Staten, 27215
        • Cone Health Cancer Center at Alamance Regional
      • Chapel Hill, North Carolina, Verenigde Staten, 27599
        • UNC Lineberger Comprehensive Cancer Center
      • Clinton, North Carolina, Verenigde Staten, 28328
        • Southeastern Medical Oncology Center-Clinton
      • Goldsboro, North Carolina, Verenigde Staten, 27534
        • Southeastern Medical Oncology Center-Goldsboro
      • Goldsboro, North Carolina, Verenigde Staten, 27534
        • Wayne Memorial Hospital
      • Greensboro, North Carolina, Verenigde Staten, 27403
        • Cone Health Cancer Center
      • Hendersonville, North Carolina, Verenigde Staten, 28791
        • Margaret R Pardee Memorial Hospital
      • Jacksonville, North Carolina, Verenigde Staten, 28546
        • Southeastern Medical Oncology Center-Jacksonville
      • Kinston, North Carolina, Verenigde Staten, 28501
        • ECU Health Oncology Kinston
      • Mebane, North Carolina, Verenigde Staten, 27302
        • Cone Heath Cancer Center at Mebane
      • Reidsville, North Carolina, Verenigde Staten, 27320
        • Annie Penn Memorial Hospital
      • Washington, North Carolina, Verenigde Staten, 27889
        • Marion L Shepard Cancer Center - ECU Health Beaufort Hospital
      • Winston-Salem, North Carolina, Verenigde Staten, 27157
        • Wake Forest University Health Sciences
    • North Dakota
      • Bismarck, North Dakota, Verenigde Staten, 58501
        • Sanford Bismarck Medical Center
      • Fargo, North Dakota, Verenigde Staten, 58122
        • Sanford Roger Maris Cancer Center
      • Fargo, North Dakota, Verenigde Staten, 58103
        • Essentia Health Cancer Center-South University Clinic
      • Fargo, North Dakota, Verenigde Staten, 58122
        • Sanford Broadway Medical Center
      • Grand Forks, North Dakota, Verenigde Staten, 58201
        • Altru Cancer Center
      • Minot, North Dakota, Verenigde Staten, 58701
        • Trinity Cancer Care Center
    • Ohio
      • Akron, Ohio, Verenigde Staten, 44307
        • Cleveland Clinic Akron General
      • Akron, Ohio, Verenigde Staten, 44304
        • Summa Health System - Akron Campus
      • Belpre, Ohio, Verenigde Staten, 45714
        • Strecker Cancer Center-Belpre
      • Bowling Green, Ohio, Verenigde Staten, 43402
        • Toledo Clinic Cancer Centers-Bowling Green
      • Chillicothe, Ohio, Verenigde Staten, 45601
        • Adena Regional Medical Center
      • Cincinnati, Ohio, Verenigde Staten, 45220
        • Good Samaritan Hospital - Cincinnati
      • Cincinnati, Ohio, Verenigde Staten, 45242
        • Bethesda North Hospital
      • Cincinnati, Ohio, Verenigde Staten, 45242
        • Oncology Hematology Care Inc-Blue Ash
      • Cincinnati, Ohio, Verenigde Staten, 45202
        • Oncology Hematology Care Inc-Eden Park
      • Cincinnati, Ohio, Verenigde Staten, 45211
        • Oncology Hematology Care Inc-Mercy West
      • Cincinnati, Ohio, Verenigde Staten, 45230
        • Oncology Hematology Care Inc-Anderson
      • Cincinnati, Ohio, Verenigde Staten, 45236
        • Oncology Hematology Care Inc-Kenwood
      • Cincinnati, Ohio, Verenigde Staten, 45247
        • TriHealth Cancer Institute-Westside
      • Cincinnati, Ohio, Verenigde Staten, 45255
        • TriHealth Cancer Institute-Anderson
      • Cleveland, Ohio, Verenigde Staten, 44195
        • Cleveland Clinic Foundation
      • Cleveland, Ohio, Verenigde Staten, 44111
        • Cleveland Clinic Cancer Center/Fairview Hospital
      • Columbus, Ohio, Verenigde Staten, 43214
        • Riverside Methodist Hospital
      • Columbus, Ohio, Verenigde Staten, 43210
        • Ohio State University Comprehensive Cancer Center
      • Columbus, Ohio, Verenigde Staten, 43219
        • The Mark H Zangmeister Center
      • Columbus, Ohio, Verenigde Staten, 43214
        • Columbus Oncology and Hematology Associates Inc
      • Columbus, Ohio, Verenigde Staten, 43228
        • Doctors Hospital
      • Columbus, Ohio, Verenigde Staten, 43213
        • Mount Carmel East Hospital
      • Columbus, Ohio, Verenigde Staten, 43215
        • Grant Medical Center
      • Columbus, Ohio, Verenigde Staten, 43222
        • Mount Carmel Health Center West
      • Delaware, Ohio, Verenigde Staten, 43015
        • Delaware Health Center-Grady Cancer Center
      • Delaware, Ohio, Verenigde Staten, 43015
        • Delaware Radiation Oncology
      • Delaware, Ohio, Verenigde Staten, 43015
        • Grady Memorial Hospital
      • Fairfield, Ohio, Verenigde Staten, 45014
        • Oncology Hematology Care Inc-Healthplex
      • Independence, Ohio, Verenigde Staten, 44131
        • Cleveland Clinic Cancer Center Independence
      • Lancaster, Ohio, Verenigde Staten, 43130
        • Fairfield Medical Center
      • Lima, Ohio, Verenigde Staten, 45801
        • Saint Rita's Medical Center
      • Mansfield, Ohio, Verenigde Staten, 44906
        • Cleveland Clinic Cancer Center Mansfield
      • Marietta, Ohio, Verenigde Staten, 45750
        • Marietta Memorial Hospital
      • Marion, Ohio, Verenigde Staten, 43302
        • OhioHealth Marion General Hospital
      • Maumee, Ohio, Verenigde Staten, 43537
        • Toledo Clinic Cancer Centers-Maumee
      • Mayfield Heights, Ohio, Verenigde Staten, 44124
        • Hillcrest Hospital Cancer Center
      • Mount Vernon, Ohio, Verenigde Staten, 43050
        • Knox Community Hospital
      • Newark, Ohio, Verenigde Staten, 43055
        • Licking Memorial Hospital
      • Newark, Ohio, Verenigde Staten, 43055
        • Newark Radiation Oncology
      • Oregon, Ohio, Verenigde Staten, 43616
        • Saint Charles Hospital
      • Oregon, Ohio, Verenigde Staten, 43616
        • Toledo Clinic Cancer Centers-Oregon
      • Perrysburg, Ohio, Verenigde Staten, 43551
        • Mercy Health - Perrysburg Hospital
      • Portsmouth, Ohio, Verenigde Staten, 45662
        • Southern Ohio Medical Center
      • Sandusky, Ohio, Verenigde Staten, 44870
        • North Coast Cancer Care
      • Springfield, Ohio, Verenigde Staten, 45504
        • Springfield Regional Cancer Center
      • Springfield, Ohio, Verenigde Staten, 45504
        • Springfield Regional Medical Center
      • Strongsville, Ohio, Verenigde Staten, 44136
        • Cleveland Clinic Cancer Center Strongsville
      • Sylvania, Ohio, Verenigde Staten, 43560
        • ProMedica Flower Hospital
      • Toledo, Ohio, Verenigde Staten, 43623
        • Mercy Health - Saint Anne Hospital
      • Toledo, Ohio, Verenigde Staten, 43623
        • Toledo Clinic Cancer Centers-Toledo
      • Toledo, Ohio, Verenigde Staten, 43617
        • Toledo Community Hospital Oncology Program CCOP
      • Troy, Ohio, Verenigde Staten, 45373
        • Upper Valley Medical Center
      • Warrensville Heights, Ohio, Verenigde Staten, 44122
        • South Pointe Hospital
      • Westerville, Ohio, Verenigde Staten, 43081
        • Saint Ann's Hospital
      • Wooster, Ohio, Verenigde Staten, 44691
        • Cleveland Clinic Wooster Family Health and Surgery Center
      • Wright-Patterson Air Force Base, Ohio, Verenigde Staten, 45433
        • Wright-Patterson Medical Center
      • Zanesville, Ohio, Verenigde Staten, 43701
        • Genesis Healthcare System Cancer Care Center
    • Oklahoma
      • Lawton, Oklahoma, Verenigde Staten, 73505
        • Cancer Centers of Southwest Oklahoma Research
      • Oklahoma City, Oklahoma, Verenigde Staten, 73104
        • University of Oklahoma Health Sciences Center
    • Oregon
      • Bend, Oregon, Verenigde Staten, 97701
        • Saint Charles Health System
      • Clackamas, Oregon, Verenigde Staten, 97015
        • Providence Cancer Institute Clackamas Clinic
      • Coos Bay, Oregon, Verenigde Staten, 97420
        • Bay Area Hospital
      • Medford, Oregon, Verenigde Staten, 97504
        • Asante Rogue Regional Medical Center
      • Newberg, Oregon, Verenigde Staten, 97132
        • Providence Newberg Medical Center
      • Oregon City, Oregon, Verenigde Staten, 97045
        • Providence Willamette Falls Medical Center
      • Portland, Oregon, Verenigde Staten, 97213
        • Providence Portland Medical Center
      • Portland, Oregon, Verenigde Staten, 97225
        • Providence Saint Vincent Medical Center
    • Pennsylvania
      • Bryn Mawr, Pennsylvania, Verenigde Staten, 19010
        • Bryn Mawr Hospital
      • Chadds Ford, Pennsylvania, Verenigde Staten, 19317
        • Christiana Care Health System-Concord Health Center
      • Danville, Pennsylvania, Verenigde Staten, 17822
        • Geisinger Medical Center
      • Doylestown, Pennsylvania, Verenigde Staten, 18901
        • Doylestown Hospital
      • Harrisburg, Pennsylvania, Verenigde Staten, 17109
        • UPMC Pinnacle Cancer Center/Community Osteopathic Campus
      • Hazleton, Pennsylvania, Verenigde Staten, 18201
        • Geisinger Medical Center-Cancer Center Hazleton
      • Hershey, Pennsylvania, Verenigde Staten, 17033-0850
        • Penn State Milton S Hershey Medical Center
      • Jefferson Hills, Pennsylvania, Verenigde Staten, 15025
        • Jefferson Hospital
      • Lancaster, Pennsylvania, Verenigde Staten, 17602
        • Lancaster General Hospital
      • Lewisburg, Pennsylvania, Verenigde Staten, 17837
        • Geisinger Medical Oncology-Lewisburg
      • Lewistown, Pennsylvania, Verenigde Staten, 17044
        • Lewistown Hospital
      • Media, Pennsylvania, Verenigde Staten, 19063
        • Riddle Memorial Hospital
      • Monroeville, Pennsylvania, Verenigde Staten, 15146
        • Forbes Hospital
      • Natrona Heights, Pennsylvania, Verenigde Staten, 15065
        • Allegheny Valley Hospital
      • Paoli, Pennsylvania, Verenigde Staten, 19301
        • Paoli Memorial Hospital
      • Philadelphia, Pennsylvania, Verenigde Staten, 19111
        • Fox Chase Cancer Center
      • Philadelphia, Pennsylvania, Verenigde Staten, 19140
        • Temple University Hospital
      • Philadelphia, Pennsylvania, Verenigde Staten, 19141
        • Einstein Medical Center Philadelphia
      • Phoenixville, Pennsylvania, Verenigde Staten, 19460
        • Reading Hospital McGlinn Cancer Institute at Phoenixville
      • Pittsburgh, Pennsylvania, Verenigde Staten, 15212
        • Allegheny General Hospital
      • Pittsburgh, Pennsylvania, Verenigde Staten, 15224
        • West Penn Hospital
      • Pittsburgh, Pennsylvania, Verenigde Staten, 15232
        • UPMC Hillman Cancer Center
      • Pottsville, Pennsylvania, Verenigde Staten, 17901
        • Geisinger Cancer Services-Pottsville
      • Reading, Pennsylvania, Verenigde Staten, 19605
        • Penn State Health Saint Joseph Medical Center
      • Sayre, Pennsylvania, Verenigde Staten, 18840
        • Guthrie Medical Group PC-Robert Packer Hospital
      • State College, Pennsylvania, Verenigde Staten, 16801
        • Geisinger Medical Group
      • State College, Pennsylvania, Verenigde Staten, 16803
        • Mount Nittany Medical Center
      • West Chester, Pennsylvania, Verenigde Staten, 19380
        • Chester County Hospital
      • West Reading, Pennsylvania, Verenigde Staten, 19611
        • Reading Hospital
      • Wexford, Pennsylvania, Verenigde Staten, 15090
        • Wexford Health and Wellness Pavilion
      • Wilkes-Barre, Pennsylvania, Verenigde Staten, 18711
        • Geisinger Wyoming Valley/Henry Cancer Center
      • Williamsport, Pennsylvania, Verenigde Staten, 17701
        • UPMC Susquehanna
      • Wynnewood, Pennsylvania, Verenigde Staten, 19096
        • Lankenau Medical Center
    • Rhode Island
      • Providence, Rhode Island, Verenigde Staten, 02905
        • Women and Infants Hospital
    • South Carolina
      • Anderson, South Carolina, Verenigde Staten, 29621
        • AnMed Health Cancer Center
      • Boiling Springs, South Carolina, Verenigde Staten, 29316
        • Prisma Health Cancer Institute - Spartanburg
      • Charleston, South Carolina, Verenigde Staten, 29425
        • Medical University of South Carolina
      • Easley, South Carolina, Verenigde Staten, 29640
        • Prisma Health Cancer Institute - Easley
      • Gaffney, South Carolina, Verenigde Staten, 29341
        • Gibbs Cancer Center-Gaffney
      • Greenville, South Carolina, Verenigde Staten, 29605
        • Prisma Health Cancer Institute - Faris
      • Greenville, South Carolina, Verenigde Staten, 29607
        • Saint Francis Cancer Center
      • Greenville, South Carolina, Verenigde Staten, 29615
        • Prisma Health Cancer Institute - Eastside
      • Greenville, South Carolina, Verenigde Staten, 29605
        • Prisma Health Cancer Institute - Butternut
      • Greenville, South Carolina, Verenigde Staten, 29601
        • Saint Francis Hospital
      • Greer, South Carolina, Verenigde Staten, 29650
        • Prisma Health Cancer Institute - Greer
      • Greer, South Carolina, Verenigde Staten, 29651
        • Gibbs Cancer Center-Pelham
      • Seneca, South Carolina, Verenigde Staten, 29672
        • Prisma Health Cancer Institute - Seneca
      • Spartanburg, South Carolina, Verenigde Staten, 29303
        • Spartanburg Medical Center
    • South Dakota
      • Aberdeen, South Dakota, Verenigde Staten, 57401
        • Avera Cancer Institute-Aberdeen
      • Rapid City, South Dakota, Verenigde Staten, 57701
        • Rapid City Regional Hospital
      • Sioux Falls, South Dakota, Verenigde Staten, 57105
        • Avera Cancer Institute
      • Sioux Falls, South Dakota, Verenigde Staten, 57117-5134
        • Sanford USD Medical Center - Sioux Falls
      • Sioux Falls, South Dakota, Verenigde Staten, 57104
        • Sanford Cancer Center Oncology Clinic
    • Tennessee
      • Jackson, Tennessee, Verenigde Staten, 38301
        • Jackson-Madison County General Hospital
      • Kingsport, Tennessee, Verenigde Staten, 37660
        • Ballad Health Cancer Care - Kingsport
      • Kingsport, Tennessee, Verenigde Staten, 37660
        • Wellmont Holston Valley Hospital and Medical Center
      • Memphis, Tennessee, Verenigde Staten, 38120
        • Baptist Memorial Hospital and Cancer Center-Memphis
      • Memphis, Tennessee, Verenigde Staten, 38120
        • Baptist Memorial Hospital for Women
      • Memphis, Tennessee, Verenigde Staten, 38120
        • Family Cancer Center-Memphis
      • Nashville, Tennessee, Verenigde Staten, 37208
        • Meharry Medical College
    • Texas
      • Abilene, Texas, Verenigde Staten, 79601
        • Hendrick Medical Center
      • Dallas, Texas, Verenigde Staten, 75235
        • Parkland Memorial Hospital
      • Dallas, Texas, Verenigde Staten, 75390
        • UT Southwestern/Simmons Cancer Center-Dallas
      • El Paso, Texas, Verenigde Staten, 79905
        • Texas Tech University Health Sciences Center-El Paso
      • Fort Worth, Texas, Verenigde Staten, 76104
        • UT Southwestern/Simmons Cancer Center-Fort Worth
      • Tyler, Texas, Verenigde Staten, 75708
        • University of Texas Health Science Center at Tyler
    • Vermont
      • Saint Johnsbury, Vermont, Verenigde Staten, 05819
        • Dartmouth Cancer Center - North
    • Virginia
      • Charlottesville, Virginia, Verenigde Staten, 22908
        • University of Virginia Cancer Center
      • Fredericksburg, Virginia, Verenigde Staten, 22408
        • Hematology Oncology Associates of Fredericksburg Inc
      • Lynchburg, Virginia, Verenigde Staten, 24501
        • Centra Alan B Pearson Regional Cancer Center
      • Martinsville, Virginia, Verenigde Staten, 24112
        • Sovah Health Martinsville
      • Mechanicsville, Virginia, Verenigde Staten, 23116
        • Bon Secours Memorial Regional Medical Center
      • Midlothian, Virginia, Verenigde Staten, 23114
        • Bon Secours Saint Francis Medical Center
      • Norton, Virginia, Verenigde Staten, 24273
        • Ballad Health Cancer Care - Norton
      • Richmond, Virginia, Verenigde Staten, 23229
        • Virginia Cancer Institute
      • Richmond, Virginia, Verenigde Staten, 23226
        • Bon Secours Saint Mary's Hospital
      • Richmond, Virginia, Verenigde Staten, 23298
        • VCU Massey Comprehensive Cancer Center
      • South Hill, Virginia, Verenigde Staten, 23970
        • VCU Community Memorial Health Center
      • Winchester, Virginia, Verenigde Staten, 22601
        • Shenandoah Oncology PC
    • Washington
      • Burien, Washington, Verenigde Staten, 98166
        • Saint Anne Hospital
      • Edmonds, Washington, Verenigde Staten, 98026
        • Swedish Cancer Institute-Edmonds
      • Issaquah, Washington, Verenigde Staten, 98029
        • Swedish Cancer Institute-Issaquah
      • Kennewick, Washington, Verenigde Staten, 99336
        • Kadlec Clinic Hematology and Oncology
      • Kirkland, Washington, Verenigde Staten, 98034
        • FHCC at EvergreenHealth
      • Longview, Washington, Verenigde Staten, 98632
        • PeaceHealth Saint John Medical Center
      • Mount Vernon, Washington, Verenigde Staten, 98274
        • Skagit Valley Hospital
      • Mount Vernon, Washington, Verenigde Staten, 98274
        • Skagit Regional Health Cancer Care Center
      • Poulsbo, Washington, Verenigde Staten, 98370
        • Harrison HealthPartners Hematology and Oncology-Poulsbo
      • Seattle, Washington, Verenigde Staten, 98107
        • Swedish Medical Center-Ballard Campus
      • Seattle, Washington, Verenigde Staten, 98122
        • Swedish Medical Center-First Hill
      • Seattle, Washington, Verenigde Staten, 98195
        • University of Washington Medical Center - Montlake
      • Seattle, Washington, Verenigde Staten, 98112
        • Kaiser Permanente Washington
      • Seattle, Washington, Verenigde Staten, 98104
        • Minor and James Medical PLLC
      • Seattle, Washington, Verenigde Staten, 98109
        • Fred Hutchinson Cancer Center
      • Silverdale, Washington, Verenigde Staten, 98383
        • Saint Joseph Medical Center Hematology and Oncology - Silverdale
      • Tacoma, Washington, Verenigde Staten, 98405
        • Northwest Medical Specialties PLLC
      • Tacoma, Washington, Verenigde Staten, 98405
        • Franciscan Research Center-Northwest Medical Plaza
      • Vancouver, Washington, Verenigde Staten, 98664
        • PeaceHealth Southwest Medical Center
      • Walla Walla, Washington, Verenigde Staten, 99362
        • Providence Saint Mary Regional Cancer Center
      • Yakima, Washington, Verenigde Staten, 98902
        • North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
    • West Virginia
      • Charleston, West Virginia, Verenigde Staten, 25304
        • Vandalia Health/CAMC Institute for Academic Medicine
      • Huntington, West Virginia, Verenigde Staten, 25701
        • Edwards Comprehensive Cancer Center
      • Morgantown, West Virginia, Verenigde Staten, 26506
        • West Virginia University Healthcare
    • Wisconsin
      • Antigo, Wisconsin, Verenigde Staten, 54409
        • Aspirus Cancer Care-Antigo-Volm Cancer Center
      • Burlington, Wisconsin, Verenigde Staten, 53105
        • Aurora Cancer Care-Southern Lakes VLCC
      • Chippewa Falls, Wisconsin, Verenigde Staten, 54729
        • Marshfield Clinic-Chippewa Center
      • Eau Claire, Wisconsin, Verenigde Staten, 54701
        • Marshfield Clinic Cancer Center at Sacred Heart
      • Fond du Lac, Wisconsin, Verenigde Staten, 54937
        • Aurora Health Center-Fond du Lac
      • Germantown, Wisconsin, Verenigde Staten, 53022
        • Aurora Health Care Germantown Health Center
      • Grafton, Wisconsin, Verenigde Staten, 53024
        • Aurora Cancer Care-Grafton
      • Green Bay, Wisconsin, Verenigde Staten, 54311
        • Aurora BayCare Medical Center
      • Green Bay, Wisconsin, Verenigde Staten, 54301
        • Saint Vincent Hospital Cancer Center Green Bay
      • Green Bay, Wisconsin, Verenigde Staten, 54303
        • Saint Vincent Hospital Cancer Center at Saint Mary's
      • Green Bay, Wisconsin, Verenigde Staten, 54301
        • Bellin Memorial Hospital
      • Janesville, Wisconsin, Verenigde Staten, 53548
        • Mercyhealth Hospital and Cancer Center - Janesville
      • Johnson Creek, Wisconsin, Verenigde Staten, 53038
        • University of Wisconsin Carbone Cancer Center - Johnson Creek
      • Kenosha, Wisconsin, Verenigde Staten, 53142
        • Aurora Cancer Care-Kenosha South
      • La Crosse, Wisconsin, Verenigde Staten, 54601
        • Gundersen Lutheran Medical Center
      • Madison, Wisconsin, Verenigde Staten, 53792
        • University of Wisconsin Carbone Cancer Center - University Hospital
      • Manitowoc, Wisconsin, Verenigde Staten, 54221
        • Holy Family Memorial Hospital
      • Marinette, Wisconsin, Verenigde Staten, 54143
        • Aurora Bay Area Medical Group-Marinette
      • Marinette, Wisconsin, Verenigde Staten, 54143
        • Saint Vincent Hospital Cancer Center at Marinette
      • Marshfield, Wisconsin, Verenigde Staten, 54449
        • Marshfield Medical Center-Marshfield
      • Milwaukee, Wisconsin, Verenigde Staten, 53209
        • Aurora Cancer Care-Milwaukee
      • Milwaukee, Wisconsin, Verenigde Staten, 53215
        • Aurora Saint Luke's Medical Center
      • Milwaukee, Wisconsin, Verenigde Staten, 53233
        • Aurora Sinai Medical Center
      • Minocqua, Wisconsin, Verenigde Staten, 54548
        • Marshfield Medical Center - Minocqua
      • Mukwonago, Wisconsin, Verenigde Staten, 53149
        • ProHealth D N Greenwald Center
      • New Richmond, Wisconsin, Verenigde Staten, 54017
        • Cancer Center of Western Wisconsin
      • Oconomowoc, Wisconsin, Verenigde Staten, 53066
        • ProHealth Oconomowoc Memorial Hospital
      • Oconto Falls, Wisconsin, Verenigde Staten, 54154
        • Saint Vincent Hospital Cancer Center at Oconto Falls
      • Oshkosh, Wisconsin, Verenigde Staten, 54904
        • Vince Lombardi Cancer Clinic - Oshkosh
      • Racine, Wisconsin, Verenigde Staten, 53406
        • Aurora Cancer Care-Racine
      • Racine, Wisconsin, Verenigde Staten, 53405
        • Ascension All Saints Hospital-Spring Street-Racine
      • Rhinelander, Wisconsin, Verenigde Staten, 54501
        • Aspirus Cancer Care-Rhinelander-James Beck Cancer Center
      • Rice Lake, Wisconsin, Verenigde Staten, 54868
        • Marshfield Medical Center-Rice Lake
      • Sheboygan, Wisconsin, Verenigde Staten, 53081
        • Vince Lombardi Cancer Clinic-Sheboygan
      • Sheboygan, Wisconsin, Verenigde Staten, 53081
        • HSHS Saint Nicholas Hospital
      • Stevens Point, Wisconsin, Verenigde Staten, 54482
        • Marshfield Medical Center-River Region at Stevens Point
      • Stevens Point, Wisconsin, Verenigde Staten, 54481
        • Aspirus Cancer Care - Stevens Point
      • Sturgeon Bay, Wisconsin, Verenigde Staten, 54235-1495
        • Saint Vincent Hospital Cancer Center at Sturgeon Bay
      • Summit, Wisconsin, Verenigde Staten, 53066
        • Aurora Medical Center in Summit
      • Two Rivers, Wisconsin, Verenigde Staten, 54241
        • Vince Lombardi Cancer Clinic-Two Rivers
      • Waukesha, Wisconsin, Verenigde Staten, 53188
        • UW Cancer Center at ProHealth Care
      • Waukesha, Wisconsin, Verenigde Staten, 53188
        • ProHealth Waukesha Memorial Hospital
      • Waukesha, Wisconsin, Verenigde Staten, 53188
        • Aurora Cancer Care-Waukesha
      • Wausau, Wisconsin, Verenigde Staten, 54401
        • Marshfield Clinic-Wausau Center
      • Wausau, Wisconsin, Verenigde Staten, 54401
        • Aspirus Cancer Care-Wausau
      • Wauwatosa, Wisconsin, Verenigde Staten, 53226
        • Aurora Cancer Care-Milwaukee West
      • West Allis, Wisconsin, Verenigde Staten, 53227
        • Aurora West Allis Medical Center
      • Weston, Wisconsin, Verenigde Staten, 54476
        • Marshfield Medical Center - Weston
      • Wisconsin Rapids, Wisconsin, Verenigde Staten, 54494
        • Aspirus Cancer Care - Wisconsin Rapids
      • Wisconsin Rapids, Wisconsin, Verenigde Staten, 54494
        • Marshfield Clinic - Wisconsin Rapids Center
    • Wyoming
      • Cheyenne, Wyoming, Verenigde Staten, 82001
        • Cheyenne Regional Medical Center-West
      • Pretoria, Zuid-Afrika, 0002
        • University Of Pretoria

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • Estrogen receptor (ER) and/or progesterone receptor (PR) positive histologically confirmed adenocarcinoma of the breast with staining of >= 1% cells will be considered positive; receptor status may be based on any time during treatment prior to study randomization, and from any site (i.e. primary, recurrent, or metastatic)

  • Patients whose tumors have HER2 immunohistochemistry (IHC) 3+, in situ hybridization (ISH) >= 2.0, or average HER2 copy number >= 6.0 signals per cell are not eligible; receptor status may be based on any time during treatment prior to study randomization, and from any site (i.e. primary, recurrent, or metastatic)

  • Patients must have measurable or non-measurable stage III/locally advanced or metastatic carcinoma of the breast where local therapy with curative intent is not possible; lesions must be evaluated =< 4 weeks prior to study randomization; diagnostic-quality computed tomography (CT) scans with both oral and intravenous (IV) contrast are the expected radiologic method, unless an alternative is approved

    • NOTE: Where baseline imaging has already been performed =< 6 weeks prior to study randomization, repeat imaging may not be required
    • NOTE: As of October 16, 2016, accrual of new patients having non-measurable disease has stopped; the planned accrual for this target population has been reached
  • Pre/peri- and postmenopausal women and all men are eligible for this trial; postmenopausal is defined as:

    • Age >= 55 years and one year or more of amenorrhea

    • Age < 55 years and one year or more of amenorrhea, with estradiol < 20 pg/ml

    • Age < 55 with prior hysterectomy but intact ovaries, with estradiol < 20 pg/ml

    • Prior bilateral oophorectomy

      • NOTE: Women who do not fit the criteria for being postmenopausal as above are deemed pre-or peri-menopausal; pre/perimenopausal women and all men can enroll provided they agree to receive concomitant luteinizing hormone-releasing hormone (LHRH) agonist; pre/perimenopausal women must have commenced treatment with LHRH agonist at least 4 weeks prior to randomization; if patients have received alternative LHRH agonist prior to study entry, they must switch to goserelin for the duration of the trial
  • Sexually active males and pre/perimenopausal women must agree to use an accepted and effective method of contraception or to abstain from sexual intercourse for the duration of their participation in the study and for 3 months after discontinuation of therapy

  • Women must not be pregnant or breast-feeding; all females of childbearing potential must have a blood test or urine study =< 2 weeks prior to randomization

    • A female of childbearing potential is any woman, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) 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)
  • Patients must not have known central nervous system metastasis or a history of central nervous system (CNS) metastases; patients with leptomeningeal disease are not eligible

  • Patients must be disease-free of prior invasive malignancies for > 5 years with the exception of curatively-treated basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix

    • NOTE: If there is a history of prior malignancy, patients must not be receiving other specific treatment for that cancer
  • Patients must meet at least one of the following criteria:

    • Disease progression any time after non-steroidal AI use in the advanced disease setting
    • Relapse while on or within =< 12 months of end of adjuvant non-steroidal AI therapy with or without prior endocrine therapy for advanced disease
    • NOTE: In either setting, treatment with any prior endocrine therapy must be completed >= 2 weeks prior to cycle 1 day 1 (C1D1) of study treatment with the exception of exemestane which is permitted in the advanced disease setting within =< 4 weeks immediately prior to C1D1; prior adjuvant exemestane is allowed if the disease free interval is > 12 months from the discontinuation of exemestane; prior faslodex, everolimus, palbociclib or other cyclin-dependent kinase (CDK) inhibitor (e.g. ribociclib, abemaciclib) use are allowed and must have been completed >= 2 weeks prior to C1D1; failure to adhere to this washout guideline will result in a protocol violation
  • Patients may have received only one prior chemotherapy regimen for metastatic disease provided treatment was completed >= 3 weeks prior to randomization

  • Patients may be treated with bone modifying agents such as bisphosphonates or RANK-ligand agents (e.g. denosumab) per American Society of Clinical Oncology (ASCO) guidelines; whenever possible, patients requiring bone modifying agents should start treatment >= 7 days prior to study therapy and should continue the same agent throughout study unless clinically compelled to change

  • Prior radiotherapy must in general have been completed >= 2 weeks prior to randomization and patients must have recovered from the toxicity of the radiation

    • NOTE: Patients may receive concurrent radiation therapy to painful sites of bony disease or areas of impending fracture as long as sites of measurable or non-measurable disease outside the radiation therapy port are available to follow
  • Patients must NOT receive concurrent anti-cancer therapy or investigational agent unless specified in protocol

  • Patients must NOT be receiving valproic acid, an histone deacetylase (HDAC) inhibitor, and may not have previously received any HDAC inhibitor prior to enrollment (e.g. valproic acid, entinostat, vorinostat) unless discussed with the study chair; patients must not have received prior HDAC therapy for the treatment of their malignancy

  • Patients must have no known allergies to exemestane, entinostat, or medications that have a benzamide structure (e.g., tiapride, remoxipride, clebropride)

  • Patients must NOT suffer from medical or psychiatric conditions that would interfere with protocol compliance, the ability to provide informed consent, or assessment of response or anticipated toxicities; this includes uncontrolled intercurrent illness including, but not limited to ongoing or active infection

  • Patients must have recovered from all clinically relevant adverse events to grade 1 or baseline due to previous agents administered (except alopecia)

  • Patients must have adequate hematologic, liver and renal function =< 28 days prior to randomization

    • NOTE: It is preferred that laboratory values for eligibility be assessed after the last dose of prior treatment, especially in cases where most-recent treatment prior to study entry is chemotherapy
  • Hemoglobin (HgB) >= 9.0 g/dL (=< 28 days prior to randomization)

  • Platelet count >= 100,000/mcL (=< 28 days prior to randomization)

  • Absolute neutrophil count >= 1,500/mcL (=< 28 days prior to randomization)

  • Creatinine =< 2.0 mg/dL (=< 28 days prior to randomization)

  • Total bilirubin < 1.5 x institutional upper limit of normal (=< 3 mg/dL in case of Gilbert's syndrome) (=< 28 days prior to randomization)

  • Transaminases (alanine aminotransferase [ALT], aspartate aminotransferase [AST]) =< 2.5 x institutional upper limit normal (=< 28 days prior to randomization)

  • Known human immunodeficiency virus (HIV)-positive patients should have a cluster of differentiation (CD)4 count > 250/mm^3

  • Patients must have Eastern Cooperative Oncology Group (ECOG) performance status 0-1

  • Patients must have a life expectancy >= 12 weeks

  • Patients must be able to swallow tablets

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Dubbele

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Arm A (exemestane, entinostat)

Patients receive exemestane PO QD on days 1-28 and entinostat PO on days 1, 8, 15, and 22. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT or MRI at baseline, at the end of cycle 3, every 3 cycles, at treatment discontinuation, and during follow-up, collection of blood samples at baseline and day 15 of cycle 1, and collection of archived tissue at baseline.

Pre/perimenopausal female patients and all male patients also receive goserelin acetate SC on day 1.

Given PO

Andere namen:
  • Aromasin
  • FCE-24304

Ancillary studies

Andere namen:
  • Beoordeling van de kwaliteit van leven

Undergo CT

Andere namen:
  • CT
  • KAT
  • CT-scan
  • Axiale computertomografie
  • Computergestuurde axiale tomografie
  • Computergestuurde tomografie
  • tomografie
  • Geautomatiseerde axiale tomografie (procedure)
  • Computertomografie (CT)-scan
  • Diagnostische kattencan
  • Diagnostisch CAT -scanservice type

Undergo MRI

Andere namen:
  • MRI
  • Magnetische resonantie
  • Magnetic Resonance Imaging-scan
  • Medische beeldvorming, magnetische resonantie / nucleaire magnetische resonantie
  • DHR
  • MR-beeldvorming
  • MRI scan
  • NMR-beeldvorming
  • NMRI
  • Nucleaire magnetische resonantie beeldvorming
  • Magnetische resonantiebeeldvorming (MRI)
  • sMRI
  • Magnetische resonantiebeeldvorming (procedure)
  • MRI's
  • Structurele MRI

Given SC

Andere namen:
  • ZDX
  • Zoladex

Undergo collection of blood and archived tissue samples

Andere namen:
  • Biologische monsterverzameling
  • Biospecimen verzameld
  • Specimenverzameling
  • Monsterverzameling

Given PO

Andere namen:
  • HDAC-remmer SNDX-275
  • MS 27-275
  • MS-275
  • SNDX-275
  • MS275
  • MS 275
  • SNDX 275
  • SNDX275

Given PO

Andere namen:
  • ICI-118630
Placebo-vergelijker: Arm B (exemestane, placebo)

Patients receive exemestane as in Arm A and placebo PO on days 1, 8, 15, and 22. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT or MRI at baseline, at the end of cycle 3, every 3 cycles, at treatment discontinuation, and during follow-up, collection of blood samples at baseline and day 15 of cycle 1, and collection of archived tissue at baseline.

Pre/perimenopausal female patients and all male patients also receive goserelin acetate SC on day 1.

Given PO

Andere namen:
  • Aromasin
  • FCE-24304

Ancillary studies

Andere namen:
  • Beoordeling van de kwaliteit van leven

Undergo CT

Andere namen:
  • CT
  • KAT
  • CT-scan
  • Axiale computertomografie
  • Computergestuurde axiale tomografie
  • Computergestuurde tomografie
  • tomografie
  • Geautomatiseerde axiale tomografie (procedure)
  • Computertomografie (CT)-scan
  • Diagnostische kattencan
  • Diagnostisch CAT -scanservice type

Undergo MRI

Andere namen:
  • MRI
  • Magnetische resonantie
  • Magnetic Resonance Imaging-scan
  • Medische beeldvorming, magnetische resonantie / nucleaire magnetische resonantie
  • DHR
  • MR-beeldvorming
  • MRI scan
  • NMR-beeldvorming
  • NMRI
  • Nucleaire magnetische resonantie beeldvorming
  • Magnetische resonantiebeeldvorming (MRI)
  • sMRI
  • Magnetische resonantiebeeldvorming (procedure)
  • MRI's
  • Structurele MRI

Given PO

Given SC

Andere namen:
  • ZDX
  • Zoladex

Undergo collection of blood and archived tissue samples

Andere namen:
  • Biologische monsterverzameling
  • Biospecimen verzameld
  • Specimenverzameling
  • Monsterverzameling

Given PO

Andere namen:
  • ICI-118630

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Progression-free Survival (PFS)
Tijdsspanne: Assessed at baseline, then every 12 weeks until treatment discontinuation, then every 3 months within 2 years from study entry, every 6 months between 2-5 years and annually between 6-10 years from study entry, until first disease progression

Progression-free survival (PFS) was defined to be time from randomization to the earliest documented disease progression as defined by the RECIST criteria, new primary breast cancer, or death without progression. Disease assessment was to continue until disease progression, even after non-protocol anti-cancer therapy was started. Cases with incomplete follow up or without adequate disease evaluations were censored at the date last documented to be free of progression, regardless of whether non-protocol anti-cancer therapy was started or not. Disease progression was based on central review, and defined as at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. In addition, the appearance of one or more new lesions was also considered progression. Kaplan-Meier method was used to estimate PFS rate.

Assessed at baseline, then every 12 weeks until treatment discontinuation, then every 3 months within 2 years from study entry, every 6 months between 2-5 years and annually between 6-10 years from study entry, until first disease progression
Overall Survival (OS)
Tijdsspanne: Assessed every 3 months within 2 years from study entry, every 6 months between 2-5 years and annually between 6-10 years from study entry, until death

Overall survival (OS) was defined to be time from randomization to death from any cause. Cases who were still alive were censored at the date last known alive.

Assessed every 3 months within 2 years from study entry, every 6 months between 2-5 years and annually between 6-10 years from study entry, until death

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Objective Response Rate (ORR)
Tijdsspanne: Assessed at baseline, then every 12 weeks until treatment discontinuation, then every 3 months within 2 years from study entry, every 6 months between 2-5 years and annually between 6-10 years from study entry, until first disease progression

Objective response rate was defined as number of patients with complete response (CR) or partial response (PR) divided by all randomized patients. Responses were evaluated using the revised Response Evaluation Criteria in Solid Tumors (RECIST) guideline. CR was defined as disappearance of all target and non-target lesions. PR was defined as at least a 30% decrease in the sum of the diameters of target lesions (taking as reference the baseline sum diameters), and/or persistence of one or more non-target lesion(s).

Assessed at baseline, then every 12 weeks until treatment discontinuation, then every 3 months within 2 years from study entry, every 6 months between 2-5 years and annually between 6-10 years from study entry, until first disease progression
Time-to-treatment Deterioration (TTD)
Tijdsspanne: Disease assessed at baseline, then every 12 weeks until treatment discontinuation, then every 3 months within 2 years from study entry, every 6 months between 2-5 years and annually between 6-10 years from study entry, until first disease progression

Time-to-treatment deterioration (TTD) was defined as time from randomization to disease progression or death or worsening of symptoms, whichever occurred first. Disease progression was assessed per RECIST v1.1. Symptoms deterioration was measured by 6 items (GP1, GP2, GP4, GF7, B1, P2, scored 0-24) from the 8-item FACT-Breast Symptom Index (FBSI). Symptom deterioration was defined as two consecutive available decreases of at least 3 points from baseline using the 6-item FBSI in this trial, and the second visit time was used as the time of symptom deterioration in this case, unless it was the final score, for which one decrease was sufficient. Kaplan-Meier method was used to estimate the median TTD and TTD rate at a certain time point. Symptoms were assessed every cycle for the first six months after randomization, every two cycles between 6 months and 1 year. It then were assessed based on the same schedule for tumor assessments until disease progression as specified below.

Disease assessed at baseline, then every 12 weeks until treatment discontinuation, then every 3 months within 2 years from study entry, every 6 months between 2-5 years and annually between 6-10 years from study entry, until first disease progression
Lysine Acetylation Change in CD45 Blood Mononuclear Cells Between C1D1 and C1D15 and PFS in Patients on Arm A
Tijdsspanne: Disease assessed at baseline, then every 12 weeks until treatment discontinuation, then every 3 months within 2 years from study entry, every 6 months between 2-5 years and annually between 6-10 years from study entry, until first disease progression

Peripheral blood samples (PBMCs) were collected prior to therapy and on Days 8 and 15 of cycle 1, for assessment of lysine acetylation, using an assay developed by the Trepel Laboratory, NCI/NIH. CD45 blood mononuclear cells were measured. Patients with lysine acetylation change of 1.5 folds or higher were compared to patients with lysine acetylation change of less than 1.5 folds.

Disease assessed at baseline, then every 12 weeks until treatment discontinuation, then every 3 months within 2 years from study entry, every 6 months between 2-5 years and annually between 6-10 years from study entry, until first disease progression
Patient-reported Health-related Quality of Life
Tijdsspanne: Assessed at baseline and end of cycle 3

Health-related quality of life (HRQL) was measured using Functional Assessment of Cancer Therapy - General (FACT-G). The primary endpoint for HRQL was the FACT-G Trial Outcome Index (TOI) which was an aggregate score of 5 items from the FACT-G-Physical subscale (GP2, GP3, GP4, GP6, and GP7) and 6 items from the FACT-G-Functional subscale (GF1, GF2, GF3, GF4, GF6, and GF7). All items were rated on a 5-point Likert scale from 0 to 4. FACT-G TOI subscale score was calculated based on the scoring manual, subscale score ranges from 0 to 44, and higher scores indicate better quality of life. The primary comparison of HRQL between treatment arms was based on the end of cycle 3 assessment.

Assessed at baseline and end of cycle 3
Patient-reported Diarrhea
Tijdsspanne: Assessed at baseline and end of cycle 3

Diarrhea was measured by Functional Assessment of Chronic Illness Therapy for Patients With Diarrhea (FACIT-Diarrhea) subscale form, which had 11 items, all items were rated on a 5-point Likert scale from 0 to 4. FACIT-Diarrhea subscale score was calculated based on the scoring manual, subscale score ranges from 0 to 44, and higher score indicates less diarrhea. The primary comparison of patient-reported diarrhea between treatment arms was based on the end of cycle 3 assessment.

Assessed at baseline and end of cycle 3
Patient-reported Fatigue
Tijdsspanne: Assessed at baseline and end of cycle 3

Fatigue was measured by PROMIS Fatigue short form, it had 7 items and all items were rated on a 5-point Likert scale from 1 to 5. The PROMIS Fatigue total score and T score were calculated based on the scoring manual. The total score ranges from 7 to 35, the T score ranges from 29.4 to 83.2, higher scores indicate more fatigue. The PROMIS Fatigue T score was used for arm comparison. The primary comparison of patient-reported fatigue between treatment arms was based on the end of cycle 3 assessment.

Assessed at baseline and end of cycle 3
Patient-reported Nausea and Anorexia
Tijdsspanne: Assessed at baseline and end of cycle 3

Nausea and anorexia were measured by The Functional Assessment of Anorexia/Cachexia Treatment (FAACT)-additional concerns, which had 12 items, all items were rated on a 5-point Likert scale from 0 to 4. FAACT-additional concerns subscale score was calculated based on scoring manual. Subscale score ranges from 0 to 48, and higher scores indicate less nausea and anorexia. The primary comparison of patient-reported nausea and anorexia between treatment arms was based on the end of cycle 3 assessment.

Assessed at baseline and end of cycle 3

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Onderzoekers

  • Hoofdonderzoeker: Roisin M Connolly, ECOG-ACRIN Cancer Research Group

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

29 maart 2014

Primaire voltooiing (Werkelijk)

5 mei 2020

Studie voltooiing (Geschat)

2 juni 2027

Studieregistratiedata

Eerst ingediend

14 april 2014

Eerst ingediend dat voldeed aan de QC-criteria

14 april 2014

Eerst geplaatst (Geschat)

16 april 2014

Updates van studierecords

Laatste update geplaatst (Werkelijk)

22 oktober 2026

Laatste update ingediend die voldeed aan QC-criteria

21 oktober 2026

Laatst geverifieerd

1 juni 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • NCI-2014-00746
  • U10CA180820 (Subsidie/contract van de Amerikaanse NIH)
  • U24CA196172 (Subsidie/contract van de Amerikaanse NIH)
  • U10CA021115 (Subsidie/contract van de Amerikaanse NIH)
  • NCI-2014-00746 (Register-ID: CTRP (Clinical Trial Reporting Program))
  • E2112 (Andere identificatie: CTEP)
  • ECOG-E2112
  • E2112 (Andere identificatie: ECOG-ACRIN Cancer Research Group)

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .