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Rituximab en Bendamustine Hydrochloride, Rituximab en Ibrutinib, of alleen Ibrutinib bij de behandeling van oudere patiënten met niet eerder behandelde chronische lymfatische leukemie

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

Een gerandomiseerde fase III-studie van alleen bendamustine plus rituximab versus ibrutinib plus rituximab versus alleen ibrutinib bij onbehandelde oudere patiënten (>/= 65 jaar) met chronische lymfatische leukemie (CLL)

This randomized phase III trial studies rituximab with bendamustine hydrochloride or ibrutinib to see how well they work compared to ibrutinib alone in treating older patients with previously untreated chronic lymphocytic leukemia. Rituximab is a monoclonal antibody that may interfere with the ability of cancer cells to grow and spread. A monoclonal antibody is a type of protein that can bind to certain targets in the body, such as molecules that cause the body to make an immune response (antigens). Chemotherapy drugs, such as bendamustine hydrochloride, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Ibrutinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. It is not yet known whether rituximab with bendamustine hydrochloride may work better than rituximab and ibrutinib or ibrutinib alone in treating chronic lymphocytic leukemia.

Studie Overzicht

Toestand

Actief, niet wervend

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

PRIMARY OBJECTIVE:

I. To determine whether progression free survival (PFS) is superior after therapy with bendamustine hydrochloride (bendamustine) in combination with rituximab, ibrutinib alone, or ibrutinib in combination with rituximab in patients age 65 or older with previously untreated chronic lymphocytic leukemia (CLL).

SECONDARY OBJECTIVES:

I. To determine 2-year PFS in each of the three treatment arms. II. To determine which treatment arm produces superior overall survival (OS). III. To determine the complete response (CR) rate, complete and nodular partial response (CR/nPR) rate, and overall response (PR+nPR+CR) rate (ORR) among the three treatment arms and compare these arms.

IV. To determine the impact of minimal residual disease (MRD)-negative disease at time of CR documentation and at 2 years on PFS and OS in each of the treatment arms.

V. To determine duration of response after each of the three treatments and compare these treatment arms.

VI. To determine toxicity and tolerability of the three treatment regimens. VII. To determine response and PFS of patients initially on the bendamustine in combination with rituximab arm who cross over to ibrutinib.

OTHER PRE-SPECIFIED OBJECTIVES:

I. To determine whether baseline cytogenetic markers, Zap-70 methylation, IgVH mutational status, or select deoxyribonucleic acid (DNA) mutations predict outcomes or time to response in these three arms.

II. To determine whether local fluorescence in situ hybridization (FISH) results for del(11q22.3) and del(17p13.1) are consistent with central analysis.

III. To determine whether baseline micro ribonucleic acid (RNA) and gene expression markers are correlated with clinical outcomes of interest (e.g. progression-free and alive at 2 years versus not), as well as to explore changes in microRNA expression from baseline to post-treatment time points, with a focus on those with persistent lymphocytosis and relapse.

IV. To determine whether eradication of MRD predicts longer duration of response with standard therapy and ibrutinib-based regimens.

V. To describe the baseline functional status, comorbid medical conditions, and number of medications of older CLL patients who meet criteria for therapy.

VI. To determine how functional status changes with therapy using baseline to 3-month evaluation and end-of-study/2-year evaluation; to determine whether this change is different among the treatment groups.

VII. To determine whether geriatric assessment variables known to be associated with chemotherapy toxicity in other disease groups can also predict therapy-associated toxicity in the CLL population.

VIII. To assess whether the FCGR3A polymorphism (rs396991) is correlated with depth of response (MRD status) to ibrutinib plus rituximab after 6 cycles, with secondary endpoints CR rate, rapidity of response, and progression-free survival (PFS).

IX. To assess whether C1QA polymorphism (rs172378) is correlated with MRD status, CR rate, rapidity of response, and PFS.

OUTLINE: Patients are randomized to 1 of 3 treatment arms.

ARM I: Patients receive rituximab intravenously (IV) on day 1 (day 0 course 1) and bendamustine hydrochloride IV over 30 minutes on days 1-2. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover to Arm II.

ARM II: Patients receive ibrutinib orally (PO) daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

ARM III: Patients receive ibrutinib as in Arm II. Patients receive rituximab IV on days 1, 8, 15, and 22 of course 2 and on day 1 of courses 3-6. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and computed tomography (CT) throughout the study.

After completion of study treatment, patients are followed up every 6 months for up to 10 years.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

547

Fase

Fase 3

Contacten en locaties

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Studie Locaties

Canada
- Alberta
  - Calgary, Alberta, Canada, T2N 5G2
    - Arthur J E Child Comprehensive Cancer Centre
- New Brunswick
  - Moncton, New Brunswick, Canada, E1C 6Z8
    - The Moncton Hospital
- Nova Scotia
  - Halifax, Nova Scotia, Canada, B3H 2Y9
    - QEII Health Sciences Centre/Nova Scotia Health Authority
- Ontario
  - Greater Sudbury, Ontario, Canada, P3E 5J1
    - Health Sciences North
  - Hamilton, Ontario, Canada, L8V 5C2
    - Juravinski Cancer Centre at Hamilton Health Sciences
  - Kingston, Ontario, Canada, K7L 2V7
    - Kingston Health Sciences Centre
  - London, Ontario, Canada, N6A 4L6
    - London Regional Cancer Program
  - Newmarket, Ontario, Canada, L3Y 2P9
    - Stronach Regional Health Centre at Southlake
  - Oshawa, Ontario, Canada, L1G 2B9
    - Lakeridge Health Oshawa
  - Ottawa, Ontario, Canada, K1H 8L6
    - Ottawa Hospital and Cancer Center-General Campus
  - Toronto, Ontario, Canada, M4C 3E7
    - Michael Garron Hospital
  - Toronto, Ontario, Canada, M5G 2M9
    - University Health Network-Princess Margaret Hospital
  - Toronto, Ontario, Canada, M4N 3M5
    - Odette Cancer Centre- Sunnybrook Health Sciences Centre
  - Toronto, Ontario, Canada, M3M 0B2
    - Humber River Hospital
- Quebec
  - Greenfield Park, Quebec, Canada, J4V 2H1
    - CSSS Champlain-Charles Le Moyne
  - Montreal, Quebec, Canada, H3T 1E2
    - Jewish General Hospital
  - Montreal, Quebec, Canada, H2W 1S6
    - McGill University Department of Oncology
  - Montreal, Quebec, Canada, H2X 3E4
    - CHUM - Centre Hospitalier de l'Universite de Montreal
- Saskatchewan
  - Regina, Saskatchewan, Canada, S4T 7T1
    - Allan Blair Cancer Centre
  - Saskatoon, Saskatchewan, Canada, S7N 4H4
    - Saskatoon Cancer Centre
Verenigde Staten
- Alabama
  - Birmingham, Alabama, Verenigde Staten, 35233
    - University of Alabama at Birmingham Cancer Center
- Alaska
  - Anchorage, Alaska, Verenigde Staten, 99508
    - Alaska Breast Care and Surgery LLC
  - Anchorage, Alaska, Verenigde Staten, 99508
    - Alaska Oncology and Hematology LLC
  - Anchorage, Alaska, Verenigde Staten, 99508
    - Alaska Women's Cancer Care
  - Anchorage, Alaska, Verenigde Staten, 99508
    - Anchorage Oncology Centre
  - Anchorage, Alaska, Verenigde Staten, 99508
    - Katmai Oncology Group
  - Anchorage, Alaska, Verenigde Staten, 99508
    - Providence Alaska Medical Center
  - Anchorage, Alaska, Verenigde Staten, 99504
    - Anchorage Radiation Therapy Center
  - Anchorage, Alaska, Verenigde Staten, 99508
    - Alaska Regional Hospital
- Arizona
  - Phoenix, Arizona, Verenigde Staten, 85054
    - Mayo Clinic Hospital in Arizona
  - Scottsdale, Arizona, Verenigde Staten, 85259
    - Mayo Clinic in Arizona
  - Tucson, Arizona, Verenigde Staten, 85719
    - Banner University Medical Center - Tucson
  - Tucson, Arizona, Verenigde Staten, 85719
    - University of Arizona Cancer Center-North Campus
  - Yuma, Arizona, Verenigde Staten, 85364
    - Onvida Health Yuma Medical Center
- Arkansas
  - Hot Springs, Arkansas, Verenigde Staten, 71913
    - CHI Saint Vincent Cancer Center Hot Springs
  - Jonesboro, Arkansas, Verenigde Staten, 72401
    - NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
- California
  - Anaheim, California, Verenigde Staten, 92806
    - Kaiser Permanente-Anaheim
  - Antioch, California, Verenigde Staten, 94531
    - Kaiser Permanente-Deer Valley Medical Center
  - Arroyo Grande, California, Verenigde Staten, 93420
    - PCR Oncology
  - Auburn, California, Verenigde Staten, 95602
    - Sutter Auburn Faith Hospital
  - Auburn, California, Verenigde Staten, 95603
    - Sutter Cancer Centers Radiation Oncology Services-Auburn
  - Baldwin Park, California, Verenigde Staten, 91706
    - Kaiser Permanente-Baldwin Park
  - Bellflower, California, Verenigde Staten, 90706
    - Kaiser Permanente-Bellflower
  - Berkeley, California, Verenigde Staten, 94704
    - Alta Bates Summit Medical Center-Herrick Campus
  - Burbank, California, Verenigde Staten, 91505
    - Providence Saint Joseph Medical Center/Disney Family Cancer Center
  - Burlingame, California, Verenigde Staten, 94010
    - Mills-Peninsula Medical Center
  - Cameron Park, California, Verenigde Staten, 95682
    - Sutter Cancer Centers Radiation Oncology Services-Cameron Park
  - Concord, California, Verenigde Staten, 94520
    - John Muir Medical Center-Concord
  - Davis, California, Verenigde Staten, 95616
    - Sutter Davis Hospital
  - Duarte, California, Verenigde Staten, 91010
    - City of Hope Comprehensive Cancer Center
  - Fontana, California, Verenigde Staten, 92335
    - Kaiser Permanente-Fontana
  - Fremont, California, Verenigde Staten, 94538
    - Kaiser Permanente-Fremont
  - Fresno, California, Verenigde Staten, 93720
    - Kaiser Permanente-Fresno
  - Greenbrae, California, Verenigde Staten, 94904
    - Marin Cancer Care Inc
  - Greenbrae, California, Verenigde Staten, 94904
    - Marin General Hospital
  - Harbor City, California, Verenigde Staten, 90710
    - Kaiser Permanente South Bay
  - Irvine, California, Verenigde Staten, 92618
    - Kaiser Permanente-Irvine
  - Los Angeles, California, Verenigde Staten, 90048
    - Cedars-Sinai Medical Center
  - Los Angeles, California, Verenigde Staten, 90027
    - Kaiser Permanente Los Angeles Medical Center
  - Los Angeles, California, Verenigde Staten, 90034
    - Kaiser Permanente West Los Angeles
  - Modesto, California, Verenigde Staten, 95355
    - Memorial Medical Center
  - Modesto, California, Verenigde Staten, 95356
    - Kaiser Permanente-Modesto
  - Mountain View, California, Verenigde Staten, 94040
    - Palo Alto Medical Foundation-Camino Division
  - Mountain View, California, Verenigde Staten, 94040
    - Palo Alto Medical Foundation-Gynecologic Oncology
  - Novato, California, Verenigde Staten, 94945
    - Sutter Cancer Research Consortium
  - Oakland, California, Verenigde Staten, 94611
    - Kaiser Permanente-Oakland
  - Palo Alto, California, Verenigde Staten, 94304
    - Stanford Cancer Institute Palo Alto
  - Palo Alto, California, Verenigde Staten, 94301
    - Palo Alto Medical Foundation Health Care
  - Panorama City, California, Verenigde Staten, 91402
    - Kaiser Permanente - Panorama City
  - Redwood City, California, Verenigde Staten, 94063
    - Kaiser Permanente-Redwood City
  - Richmond, California, Verenigde Staten, 94801
    - Kaiser Permanente-Richmond
  - Riverside, California, Verenigde Staten, 92505
    - Kaiser Permanente-Riverside
  - Roseville, California, Verenigde Staten, 95661
    - Kaiser Permanente-Roseville
  - Roseville, California, Verenigde Staten, 95661
    - Sutter Cancer Centers Radiation Oncology Services-Roseville
  - Roseville, California, Verenigde Staten, 95661
    - Sutter Roseville Medical Center
  - Sacramento, California, Verenigde Staten, 95816
    - Sutter Medical Center Sacramento
  - Sacramento, California, Verenigde Staten, 95823
    - Kaiser Permanente-South Sacramento
  - Sacramento, California, Verenigde Staten, 95825
    - Kaiser Permanente Sacramento Medical Center
  - San Diego, California, Verenigde Staten, 92120
    - Kaiser Permanente-San Diego Zion
  - San Diego, California, Verenigde Staten, 92134
    - Naval Medical Center -San Diego
  - San Francisco, California, Verenigde Staten, 94115
    - Kaiser Permanente-San Francisco
  - San Francisco, California, Verenigde Staten, 94115
    - California Pacific Medical Center-Pacific Campus
  - San Jose, California, Verenigde Staten, 95119
    - Kaiser Permanente-Santa Teresa-San Jose
  - San Jose, California, Verenigde Staten, 95124
    - Stanford Cancer Center South Bay
  - San Leandro, California, Verenigde Staten, 94577
    - Kaiser Permanente San Leandro
  - San Marcos, California, Verenigde Staten, 92078
    - Kaiser Permanente-San Marcos
  - San Rafael, California, Verenigde Staten, 94903
    - Kaiser Permanente-San Rafael
  - Santa Clara, California, Verenigde Staten, 95051
    - Kaiser Permanente Medical Center - Santa Clara
  - Santa Cruz, California, Verenigde Staten, 95065
    - Palo Alto Medical Foundation-Santa Cruz
  - Santa Rosa, California, Verenigde Staten, 95403
    - Kaiser Permanente-Santa Rosa
  - Santa Rosa, California, Verenigde Staten, 95403
    - Sutter Pacific Medical Foundation
  - South San Francisco, California, Verenigde Staten, 94080
    - Kaiser Permanente-South San Francisco
  - St. Helena, California, Verenigde Staten, 94574
    - Saint Helena Hospital
  - Stockton, California, Verenigde Staten, 95210
    - Kaiser Permanente-Stockton
  - Sunnyvale, California, Verenigde Staten, 94086
    - Palo Alto Medical Foundation-Sunnyvale
  - Vacaville, California, Verenigde Staten, 95688
    - Kaiser Permanente Medical Center-Vacaville
  - Vacaville, California, Verenigde Staten, 95687
    - Northbay Cancer Center
  - Vallejo, California, Verenigde Staten, 94589
    - Kaiser Permanente-Vallejo
  - Vallejo, California, Verenigde Staten, 94589
    - Sutter Solano Medical Center/Cancer Center
  - Walnut Creek, California, Verenigde Staten, 94596
    - Kaiser Permanente-Walnut Creek
  - Walnut Creek, California, Verenigde Staten, 94598
    - John Muir Medical Center-Walnut Creek
  - Whittier, California, Verenigde Staten, 90602
    - Presbyterian Intercommunity Hospital
  - Woodland Hills, California, Verenigde Staten, 91367
    - Kaiser Permanente-Woodland Hills
- 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, 80907
    - Rocky Mountain Cancer Centers-Penrose
  - Denver, Colorado, Verenigde Staten, 80205
    - Kaiser Permanente-Franklin
  - 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, 80204
    - Denver Health Medical Center
  - Denver, Colorado, Verenigde Staten, 80218
    - Colorado Blood Cancer Institute
  - Denver, Colorado, Verenigde Staten, 80222
    - Western States Cancer Research NCORP
  - 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
  - Fort Collins, Colorado, Verenigde Staten, 80524
    - Poudre Valley Hospital
  - Golden, Colorado, Verenigde Staten, 80401
    - Mountain Blue Cancer Care Center
  - Golden, Colorado, Verenigde Staten, 80401
    - National Jewish Health-Western Hematology Oncology
  - Greeley, Colorado, Verenigde Staten, 80631
    - Banner North Colorado Medical Center
  - Greenwood Village, Colorado, Verenigde Staten, 80111
    - Rocky Mountain Cancer Centers-Greenwood Village
  - Lafayette, Colorado, Verenigde Staten, 80026
    - Kaiser Permanente-Rock Creek
  - 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
    - Kaiser Permanente-Lone Tree
  - 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
  - Danbury, Connecticut, Verenigde Staten, 06810
    - Danbury Hospital
  - Derby, Connecticut, Verenigde Staten, 06418
    - Smilow Cancer Hospital-Derby Care Center
  - Fairfield, Connecticut, Verenigde Staten, 06824
    - Smilow Cancer Hospital Care Center-Fairfield
  - Guilford, Connecticut, Verenigde Staten, 06437
    - Smilow Cancer Hospital Care Center - Guilford
  - Hartford, Connecticut, Verenigde Staten, 06105
    - Smilow Cancer Hospital Care Center at Saint Francis
  - 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
  - North Haven, Connecticut, Verenigde Staten, 06473
    - Yale-New Haven Hospital North Haven Medical Center
  - Norwalk, Connecticut, Verenigde Staten, 06856
    - Norwalk Hospital
  - Orange, Connecticut, Verenigde Staten, 06477
    - Smilow Cancer Hospital-Orange Care Center
  - Torrington, Connecticut, Verenigde Staten, 06790
    - Smilow Cancer Hospital-Torrington Care Center
  - Trumbull, Connecticut, Verenigde Staten, 06611
    - Smilow Cancer Hospital Care Center-Trumbull
  - Waterbury, Connecticut, Verenigde Staten, 06708
    - Smilow Cancer Hospital-Waterbury Care Center
  - Waterford, Connecticut, Verenigde Staten, 06385
    - Smilow Cancer Hospital Care Center - Waterford
  - West Haven, Connecticut, Verenigde Staten, 06516
    - Veterans Affairs Connecticut Healthcare System-West Haven Campus
- Delaware
  - Lewes, Delaware, Verenigde Staten, 19958
    - Beebe Medical Center
  - Newark, Delaware, Verenigde Staten, 19713
    - Helen F Graham Cancer Center
  - Newark, Delaware, Verenigde Staten, 19713
    - Delaware Clinical and Laboratory Physicians PA
  - 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
- Florida
  - Altamonte Springs, Florida, Verenigde Staten, 32701
    - AdventHealth Altamonte
  - Deerfield Beach, Florida, Verenigde Staten, 33442
    - UM Sylvester Comprehensive Cancer Center at Deerfield Beach
  - Fort Lauderdale, Florida, Verenigde Staten, 33308
    - Holy Cross Hospital
  - Jacksonville, Florida, Verenigde Staten, 32207
    - Baptist MD Anderson Cancer Center
  - Jupiter, Florida, Verenigde Staten, 33458
    - Jupiter Medical Center
  - Kissimmee, Florida, Verenigde Staten, 34744
    - AdventHealth Kissimmee
  - Miami, Florida, Verenigde Staten, 33136
    - University of Miami Miller School of Medicine-Sylvester Cancer Center
  - Miami Beach, Florida, Verenigde Staten, 33140
    - Mount Sinai Medical Center
  - Orlando, Florida, Verenigde Staten, 32806
    - Orlando Health Cancer Institute
  - Orlando, Florida, Verenigde Staten, 32803
    - AdventHealth Orlando
  - Orlando, Florida, Verenigde Staten, 32803
    - AdventHealth Medical Group Urology at Orlando
  - Orlando, Florida, Verenigde Staten, 32822
    - AdventHealth East Orlando
  - Pensacola, Florida, Verenigde Staten, 32504
    - Sacred Heart Hospital
  - Plantation, Florida, Verenigde Staten, 33324
    - UM Sylvester Comprehensive Cancer Center at Plantation
  - Weston, Florida, Verenigde Staten, 33331
    - Cleveland Clinic-Weston
  - Winter Park, Florida, Verenigde Staten, 32792
    - AdventHealth Winter Park
- Georgia
  - Atlanta, Georgia, Verenigde Staten, 30322
    - Emory University Hospital/Winship Cancer Institute
  - Atlanta, Georgia, Verenigde Staten, 30342
    - Northside Hospital
  - Columbus, Georgia, Verenigde Staten, 31904
    - John B Amos Cancer Center
  - Cumming, Georgia, Verenigde Staten, 30041
    - Northside Hospital-Forsyth
- Hawaii
  - Honolulu, Hawaii, Verenigde Staten, 96813
    - Queen's Medical Center
  - Honolulu, Hawaii, Verenigde Staten, 96817
    - The Cancer Center of Hawaii-Liliha
  - Honolulu, Hawaii, Verenigde Staten, 96813
    - Hawaii Cancer Care Inc - Waterfront Plaza
  - 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
    - Kuakini Medical Center
  - Honolulu, Hawaii, Verenigde Staten, 96817
    - Queen's Cancer Center - Kuakini
  - Honolulu, Hawaii, Verenigde Staten, 96826
    - Kapiolani Medical Center for Women and Children
  - Honolulu, Hawaii, Verenigde Staten, 96819
    - Kaiser Permanente Moanalua Medical Center
  - Lihue, Hawaii, Verenigde Staten, 96766
    - Wilcox Memorial Hospital and Kauai Medical Clinic
  - ‘Aiea, Hawaii, Verenigde Staten, 96701
    - Pali Momi Medical Center
  - ‘Aiea, Hawaii, Verenigde Staten, 96701
    - Queen's Cancer Center - Pearlridge
  - ‘Aiea, Hawaii, Verenigde Staten, 96701
    - The Cancer Center of Hawaii-Pali Momi
- 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
  - Meridian, Idaho, Verenigde Staten, 83642
    - Saint Luke's Cancer Institute - Meridian
  - Nampa, Idaho, Verenigde Staten, 83687
    - Saint Luke's Cancer Institute - Nampa
  - 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
    - University of Illinois
  - 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
  - Decatur, Illinois, Verenigde Staten, 62526
    - Heartland Cancer Research NCORP
  - 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
  - Eureka, Illinois, Verenigde Staten, 61530
    - Illinois CancerCare-Eureka
  - Evanston, Illinois, Verenigde Staten, 60201
    - NorthShore University HealthSystem-Evanston Hospital
  - 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
  - Glenview, Illinois, Verenigde Staten, 60026
    - NorthShore University HealthSystem-Glenbrook Hospital
  - Highland Park, Illinois, Verenigde Staten, 60035
    - NorthShore University HealthSystem-Highland Park Hospital
  - Highland Park, Illinois, Verenigde Staten, 60035
    - Hematology Oncology Associates of Illinois-Highland Park
  - Hinsdale, Illinois, Verenigde Staten, 60521
    - Hinsdale Hematology Oncology Associates Incorporated
  - 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
  - Libertyville, Illinois, Verenigde Staten, 60048
    - AMG Libertyville - Oncology
  - 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
  - Monmouth, Illinois, Verenigde Staten, 61462
    - Illinois CancerCare-Monmouth
  - Mount Vernon, Illinois, Verenigde Staten, 62864
    - SSM Health Good Samaritan
  - New Lenox, Illinois, Verenigde Staten, 60451
    - UC Comprehensive Cancer Center at Silver Cross
  - Normal, Illinois, Verenigde Staten, 61761
    - Carle Cancer Institute Normal
  - O'Fallon, Illinois, Verenigde Staten, 62269
    - Cancer Care Center of O'Fallon
  - Ottawa, Illinois, Verenigde Staten, 61350
    - Illinois CancerCare-Ottawa Clinic
  - Ottawa, Illinois, Verenigde Staten, 61350
    - Radiation Oncology of Northern Illinois
  - Ottawa, Illinois, Verenigde Staten, 61350
    - Ottawa Regional Hospital and Healthcare Center
  - 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
  - Peoria, Illinois, Verenigde Staten, 61614
    - Proctor Hospital
  - Peru, Illinois, Verenigde Staten, 61354
    - Illinois CancerCare-Peru
  - Peru, Illinois, Verenigde Staten, 61354
    - Valley Radiation Oncology
  - Princeton, Illinois, Verenigde Staten, 61356
    - Illinois CancerCare-Princeton
  - Quincy, Illinois, Verenigde Staten, 62301
    - Quincy Medical Group-Clinic
  - Rockford, Illinois, Verenigde Staten, 61114
    - UW Health Carbone Cancer Center Rockford
  - Skokie, Illinois, Verenigde Staten, 60076
    - North Shore Medical Center
  - 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
  - Crown Point, Indiana, Verenigde Staten, 46307
    - Michiana Hematology Oncology PC-Crown Point
  - Elkhart, Indiana, Verenigde Staten, 46515
    - Elkhart General Hospital
  - Elkhart, Indiana, Verenigde Staten, 46514
    - Michiana Hematology Oncology PC-Elkhart
  - Elkhart, Indiana, Verenigde Staten, 46514-2098
    - Elkhart Clinic
  - Fort Wayne, Indiana, Verenigde Staten, 46845
    - Fort Wayne Medical Oncology and Hematology Inc-Parkview
  - Kokomo, Indiana, Verenigde Staten, 46904
    - Community Howard Regional Health
  - La Porte, Indiana, Verenigde Staten, 46350
    - IU Health La Porte Hospital
  - Michigan City, Indiana, Verenigde Staten, 46360
    - Franciscan Saint Anthony Health-Michigan City
  - Michigan City, Indiana, Verenigde Staten, 46360
    - Woodland Cancer Care Center
  - Mishawaka, Indiana, Verenigde Staten, 46545
    - Memorial Regional Cancer Center Day Road
  - Mishawaka, Indiana, Verenigde Staten, 46545
    - Michiana Hematology Oncology PC-Mishawaka
  - Mishawaka, Indiana, Verenigde Staten, 46545
    - Saint Joseph Regional Medical Center-Mishawaka
  - Plymouth, Indiana, Verenigde Staten, 46563
    - Michiana Hematology Oncology PC-Plymouth
  - Richmond, Indiana, Verenigde Staten, 47374
    - Reid Health
  - South Bend, Indiana, Verenigde Staten, 46601
    - Memorial Hospital of South Bend
  - South Bend, Indiana, Verenigde Staten, 46628
    - Northern Indiana Cancer Research Consortium
  - Westville, Indiana, Verenigde Staten, 46391
    - Michiana Hematology Oncology PC-Westville
- Iowa
  - Ames, Iowa, Verenigde Staten, 50010
    - Mary Greeley Medical Center
  - Ames, Iowa, Verenigde Staten, 50010
    - McFarland Clinic - Ames
  - 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
  - Cedar Rapids, Iowa, Verenigde Staten, 52402
    - Physicians' Clinic of Iowa PC
  - 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
  - Creston, Iowa, Verenigde Staten, 50801
    - Greater Regional Medical Center
  - Des Moines, Iowa, Verenigde Staten, 50314
    - Mercy Medical Center - Des Moines
  - Des Moines, Iowa, Verenigde Staten, 50309
    - Iowa-Wide Oncology Research Coalition NCORP
  - 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
  - Iowa City, Iowa, Verenigde Staten, 52242
    - University of Iowa/Holden Comprehensive Cancer Center
  - Iowa City, Iowa, Verenigde Staten, 52246
    - Iowa City VA Healthcare System
  - 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
  - Sioux City, Iowa, Verenigde Staten, 51102
    - Mercy Medical Center-Sioux City
  - Sioux City, Iowa, Verenigde Staten, 51104
    - Saint Luke's Regional Medical Center
  - Spencer, Iowa, Verenigde Staten, 51301
    - Abben Cancer Center
  - Waterloo, Iowa, Verenigde Staten, 50702
    - MercyOne Waterloo 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
  - Emporia, Kansas, Verenigde Staten, 66801
    - Newman Regional Health
  - 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
    - 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, 66160
    - University of Kansas Cancer Center
  - 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
  - Liberal, Kansas, Verenigde Staten, 67905
    - Cancer Center of Kansas-Liberal
  - 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
  - Overland Park, Kansas, Verenigde Staten, 66213
    - Saint Luke's South Hospital
  - Parsons, Kansas, Verenigde Staten, 67357
    - Cancer Center of Kansas - Parsons
  - Pittsburg, Kansas, Verenigde Staten, 66762
    - Mercy Hospital Pittsburg
  - Prairie Village, Kansas, Verenigde Staten, 66208
    - Kansas City NCI Community Oncology Research Program
  - 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
  - Topeka, Kansas, Verenigde Staten, 66606
    - Cotton O'Neil Cancer Center / Stormont Vail Health
  - 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
    - Commonwealth Cancer Center-Corbin
  - Crestview Hills, Kentucky, Verenigde Staten, 41017
    - Oncology Hematology Care Inc-Crestview
  - Lexington, Kentucky, Verenigde Staten, 40504
    - Saint Joseph Radiation Oncology Resource Center
  - 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, 40215
    - Saints Mary and Elizabeth Hospital
  - Shepherdsville, Kentucky, Verenigde Staten, 40165
    - Jewish Hospital Medical Center South
- 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, 70808
    - Our Lady of the Lake Physician Group
  - Covington, Louisiana, Verenigde Staten, 70433
    - Mary Bird Perkins Cancer Center - Covington
  - Houma, Louisiana, Verenigde Staten, 70360
    - Mary Bird Perkins Cancer Center - Houma
  - Kenner, Louisiana, Verenigde Staten, 70065
    - Ochsner Medical Center Kenner
  - New Orleans, Louisiana, Verenigde Staten, 70121
    - Ochsner Medical Center Jefferson
- 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
  - Baltimore, Maryland, Verenigde Staten, 21237
    - MedStar Franklin Square Medical Center/Weinberg Cancer Institute
  - Baltimore, Maryland, Verenigde Staten, 21215
    - Sinai Hospital of Baltimore
  - Baltimore, Maryland, Verenigde Staten, 21204
    - Greater Baltimore Medical Center
  - Baltimore, Maryland, Verenigde Staten, 21229
    - Saint Agnes Hospital
  - Cumberland, Maryland, Verenigde Staten, 21502
    - UPMC Western Maryland
  - Frederick, Maryland, Verenigde Staten, 21701
    - Frederick Memorial Hospital
  - Randallstown, Maryland, Verenigde Staten, 21133
    - Northwest Hospital Center
  - Salisbury, Maryland, Verenigde Staten, 21801
    - TidalHealth Peninsula Regional
- Massachusetts
  - Beverly, Massachusetts, Verenigde Staten, 01915
    - Beverly Hospital
  - Boston, Massachusetts, Verenigde Staten, 02215
    - Dana-Farber Cancer Institute
  - Boston, Massachusetts, Verenigde Staten, 02115
    - Brigham and Women's Hospital
  - Boston, Massachusetts, Verenigde Staten, 02111
    - Tufts Medical Center
  - Boston, Massachusetts, Verenigde Staten, 02118
    - Boston Medical Center
  - Boston, Massachusetts, Verenigde Staten, 02114
    - Massachusetts General Hospital Cancer Center
  - Burlington, Massachusetts, Verenigde Staten, 01805
    - Lahey Clinic
  - Fitchburg, Massachusetts, Verenigde Staten, 01420
    - Simonds-Sinon Regional Cancer Center
  - Gloucester, Massachusetts, Verenigde Staten, 01930
    - Addison Gilbert Hospital
  - Newton, Massachusetts, Verenigde Staten, 02462
    - Newton-Wellesley Hospital
  - Springfield, Massachusetts, Verenigde Staten, 01199
    - Baystate Medical Center
  - Springfield, Massachusetts, Verenigde Staten, 01107
    - D'Amour Center for Cancer Care
  - 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
    - Bixby Medical Center
  - Adrian, Michigan, Verenigde Staten, 49221
    - Hickman Cancer Center
  - Ann Arbor, Michigan, Verenigde Staten, 48106
    - Michigan Cancer Research Consortium NCORP
  - Ann Arbor, Michigan, Verenigde Staten, 48106
    - Trinity Health Saint Joseph Mercy Hospital Ann Arbor
  - Battle Creek, Michigan, Verenigde Staten, 49017
    - Bronson Battle Creek
  - Bay City, Michigan, Verenigde Staten, 48706
    - McLaren Cancer Institute-Bay City
  - Brownstown, Michigan, Verenigde Staten, 48183
    - Henry Ford Cancer Institute-Downriver
  - Clarkston, Michigan, Verenigde Staten, 48346
    - McLaren Cancer Institute-Clarkston
  - Clinton Township, Michigan, Verenigde Staten, 48038
    - Henry Ford Macomb Hospital-Clinton Township
  - Commerce, Michigan, Verenigde Staten, 48382
    - Huron Valley-Sinai Hospital
  - 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
  - Farmington Hills, Michigan, Verenigde Staten, 48336
    - Corewell Health Farmington Hills Hospital
  - Flint, Michigan, Verenigde Staten, 48532
    - Singh and Arora Hematology Oncology PC
  - Flint, Michigan, Verenigde Staten, 48503
    - Hurley Medical Center
  - Flint, Michigan, Verenigde Staten, 48503
    - Genesys Hurley Cancer Institute
  - Grand Rapids, Michigan, Verenigde Staten, 49503
    - Cancer Research Consortium of West Michigan NCORP
  - Grand Rapids, Michigan, Verenigde Staten, 49503
    - Trinity Health Grand Rapids Hospital
  - 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
  - Lansing, Michigan, Verenigde Staten, 48910
    - Karmanos Cancer Institute at McLaren Greater Lansing
  - Lansing, Michigan, Verenigde Staten, 48912
    - University of Michigan Health - Sparrow Lansing
  - Lapeer, Michigan, Verenigde Staten, 48446
    - McLaren Cancer Institute-Lapeer Region
  - Livonia, Michigan, Verenigde Staten, 48154
    - Trinity Health Saint Mary Mercy Livonia Hospital
  - Monroe, Michigan, Verenigde Staten, 48162
    - Mercy Memorial Hospital
  - Monroe, Michigan, Verenigde Staten, 48162
    - Toledo Clinic Cancer Centers-Monroe
  - Mount Clemens, Michigan, Verenigde Staten, 48043
    - McLaren Cancer Institute-Macomb
  - Mount Pleasant, Michigan, Verenigde Staten, 48858
    - McLaren Cancer Institute-Central Michigan
  - Muskegon, Michigan, Verenigde Staten, 49444
    - Trinity Health Muskegon Hospital
  - Novi, Michigan, Verenigde Staten, 48377
    - Henry Ford Medical Center-Columbus
  - Novi, Michigan, Verenigde Staten, 48374
    - Henry Ford Health Providence Novi Hospital
  - Petoskey, Michigan, Verenigde Staten, 49770
    - McLaren Cancer Institute-Northern Michigan
  - Pontiac, Michigan, Verenigde Staten, 48341
    - Trinity Health Saint Joseph Mercy Oakland Hospital
  - Port Huron, Michigan, Verenigde Staten, 48060
    - Lake Huron Medical Center
  - Reed City, Michigan, Verenigde Staten, 49677
    - Corewell Health Reed City Hospital
  - Roseville, Michigan, Verenigde Staten, 48066
    - Michigan Cancer Specialists
  - Royal Oak, Michigan, Verenigde Staten, 48073
    - Cancer Care Associates PC
  - Royal Oak, Michigan, Verenigde Staten, 48073
    - Comprehensive Medical Center PLLC
  - Royal Oak, Michigan, Verenigde Staten, 48073
    - Oakland Medical Group
  - Royal Oak, Michigan, Verenigde Staten, 48067
    - Oakland Colon Rectal Associates
  - Royal Oak, Michigan, Verenigde Staten, 48073
    - Hematology Oncology Consultants PC-Royal Oak
  - Royal Oak, Michigan, Verenigde Staten, 48073
    - Corewell Health William Beaumont University Hospital
  - Saginaw, Michigan, Verenigde Staten, 48601
    - MyMichigan Medical Center Saginaw
  - Southfield, Michigan, Verenigde Staten, 48075
    - Henry Ford Health Providence Southfield Hospital
  - Sterling Heights, Michigan, Verenigde Staten, 48312
    - Premier Hematology Oncology Care
  - Sterling Heights, Michigan, Verenigde Staten, 48314
    - Mitchell Folbe MD PC
  - Traverse City, Michigan, Verenigde Staten, 49684
    - Munson Medical Center
  - Troy, Michigan, Verenigde Staten, 48084
    - Michigan Institute of Urology-Town Center
  - Troy, Michigan, Verenigde Staten, 48085
    - Claudia BR Herke MD PC
  - Troy, Michigan, Verenigde Staten, 48098
    - Hematology Oncology Consultants PC-Troy
  - 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
  - Burnsville, Minnesota, Verenigde Staten, 55337
    - Fairview Ridges Hospital
  - Coon Rapids, Minnesota, Verenigde Staten, 55433
    - Mercy Hospital
  - Duluth, Minnesota, Verenigde Staten, 55805
    - Saint Luke's Hospital of Duluth
  - Duluth, Minnesota, Verenigde Staten, 55805
    - Essentia Health Cancer Center
  - Duluth, Minnesota, Verenigde Staten, 55805
    - Essentia Health Saint Mary's Medical Center
  - Duluth, Minnesota, Verenigde Staten, 55805
    - Miller-Dwan Hospital
  - Edina, Minnesota, Verenigde Staten, 55435
    - Fairview Southdale Hospital
  - Fergus Falls, Minnesota, Verenigde Staten, 56537
    - Lake Region Healthcare Corporation-Cancer Care
  - Fridley, Minnesota, Verenigde Staten, 55432
    - Unity Hospital
  - Hutchinson, Minnesota, Verenigde Staten, 55350
    - Hutchinson Area Health 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, 55415
    - Hennepin County Medical Center
  - Minneapolis, Minnesota, Verenigde Staten, 55407
    - Abbott-Northwestern Hospital
  - Minneapolis, Minnesota, Verenigde Staten, 55454
    - Health Partners Inc
  - Minneapolis, Minnesota, Verenigde Staten, 55417
    - Minneapolis VA Medical Center
  - New Ulm, Minnesota, Verenigde Staten, 56073
    - New Ulm Medical Center
  - Robbinsdale, Minnesota, Verenigde Staten, 55422
    - North Memorial Medical Health Center
  - Rochester, Minnesota, Verenigde Staten, 55905
    - Mayo Clinic in Rochester
  - Saint Cloud, Minnesota, Verenigde Staten, 56303
    - Coborn Cancer Center at Saint Cloud Hospital
  - Saint Cloud, Minnesota, Verenigde Staten, 56303
    - Saint Cloud Hospital
  - Saint Louis Park, Minnesota, Verenigde Staten, 55416
    - Park Nicollet Clinic - Saint Louis Park
  - Saint Louis Park, Minnesota, Verenigde Staten, 55416
    - Metro Minnesota Community Oncology Research Consortium
  - Saint Paul, Minnesota, Verenigde Staten, 55101
    - Regions Hospital
  - Saint Paul, Minnesota, Verenigde Staten, 55102
    - United Hospital
  - Shakopee, Minnesota, Verenigde Staten, 55379
    - Saint Francis Regional Medical Center
  - Stillwater, Minnesota, Verenigde Staten, 55082
    - Lakeview Hospital
  - Waconia, Minnesota, Verenigde Staten, 55387
    - Ridgeview Medical Center
  - Willmar, Minnesota, Verenigde Staten, 56201
    - Rice Memorial Hospital
  - Woodbury, Minnesota, Verenigde Staten, 55125
    - Minnesota Oncology Hematology PA-Woodbury
- Mississippi
  - Jackson, Mississippi, Verenigde Staten, 39216
    - University of Mississippi Medical Center
- Missouri
  - Bolivar, Missouri, Verenigde Staten, 65613
    - Central Care Cancer Center - Bolivar
  - 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
  - Joplin, Missouri, Verenigde Staten, 64804
    - Freeman Health System
  - Joplin, Missouri, Verenigde Staten, 64804
    - Mercy Hospital Joplin
  - Kansas City, Missouri, Verenigde Staten, 64154
    - University of Kansas Cancer Center - North
  - Kansas City, Missouri, Verenigde Staten, 64116
    - North Kansas City Hospital
  - Kansas City, Missouri, Verenigde Staten, 64131
    - The University of Kansas Cancer Center-South
  - Kansas City, Missouri, Verenigde Staten, 64111
    - Saint Luke's Hospital of Kansas City
  - Kansas City, Missouri, Verenigde Staten, 64132
    - Research Medical Center
  - Kansas City, Missouri, Verenigde Staten, 64118
    - Heartland Hematology and Oncology Associates Incorporated
  - 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
  - Lee's Summit, Missouri, Verenigde Staten, 64086
    - Saint Luke's East - Lee's Summit
  - Liberty, Missouri, Verenigde Staten, 64068
    - Liberty Hospital
  - Rolla, Missouri, Verenigde Staten, 65401
    - Mercy Clinic-Rolla-Cancer and Hematology
  - Rolla, Missouri, Verenigde Staten, 65401
    - Phelps Health Delbert Day Cancer Institute
  - Saint Joseph, Missouri, Verenigde Staten, 64506
    - Heartland Regional Medical Center
  - 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, 63129
    - Siteman Cancer Center-South County
  - 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
    - Billings Clinic Cancer Center
  - Billings, Montana, Verenigde Staten, 59101
    - Saint Vincent Healthcare
  - Billings, Montana, Verenigde Staten, 59102
    - Montana Cancer Consortium NCORP
  - 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
  - Missoula, Montana, Verenigde Staten, 59804
    - Community Medical Center
- Nebraska
  - Grand Island, Nebraska, Verenigde Staten, 68803
    - Nebraska Cancer Specialists/Oncology Hematology West PC
  - Kearney, Nebraska, Verenigde Staten, 68847
    - CHI Health Good Samaritan
  - Kearney, Nebraska, Verenigde Staten, 68845
    - Fred and Pamela Buffett Cancer Center - Kearney
  - Lincoln, Nebraska, Verenigde Staten, 68510
    - Saint Elizabeth Regional Medical Center
  - Omaha, Nebraska, Verenigde Staten, 68198
    - University of Nebraska Medical Center
  - 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
  - Omaha, Nebraska, Verenigde Staten, 68122
    - Hematology and Oncology Consultants PC
  - Papillion, Nebraska, Verenigde Staten, 68046
    - Midlands Community Hospital
- Nevada
  - Henderson, Nevada, Verenigde Staten, 89052
    - Comprehensive Cancer Centers of Nevada - Henderson
  - Henderson, Nevada, Verenigde Staten, 89052
    - Cancer and Blood Specialists-Henderson
  - Henderson, Nevada, Verenigde Staten, 89052
    - Las Vegas Cancer Center-Henderson
  - Henderson, Nevada, Verenigde Staten, 89074
    - Comprehensive Cancer Centers of Nevada-Southeast Henderson
  - Henderson, Nevada, Verenigde Staten, 89074
    - Oncology Las Vegas - Henderson
  - Las Vegas, Nevada, Verenigde Staten, 89144
    - Summerlin Hospital Medical Center
  - Las Vegas, Nevada, Verenigde Staten, 89106
    - Radiation Oncology Centers of Nevada Central
  - Las Vegas, Nevada, Verenigde Staten, 89119
    - Radiation Oncology Centers of Nevada Southeast
  - Las Vegas, Nevada, Verenigde Staten, 89128
    - Comprehensive Cancer Centers of Nevada - Northwest
  - Las Vegas, Nevada, Verenigde Staten, 89135
    - Alliance for Childhood Diseases/Cure 4 the Kids Foundation
  - Las Vegas, Nevada, Verenigde Staten, 89144
    - Comprehensive Cancer Centers of Nevada-Summerlin
  - Las Vegas, Nevada, Verenigde Staten, 89148
    - Comprehensive Cancer Centers of Nevada
  - Las Vegas, Nevada, Verenigde Staten, 89169
    - Comprehensive Cancer Centers of Nevada - Central Valley
  - Las Vegas, Nevada, Verenigde Staten, 89106
    - Cancer and Blood Specialists-Shadow
  - Las Vegas, Nevada, Verenigde Staten, 89109
    - HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
  - Las Vegas, Nevada, Verenigde Staten, 89113
    - HealthCare Partners Medical Group Oncology/Hematology-San Martin
  - Las Vegas, Nevada, Verenigde Staten, 89121
    - Cancer Therapy and Integrative Medicine
  - Las Vegas, Nevada, Verenigde Staten, 89128
    - Cancer and Blood Specialists-Tenaya
  - Las Vegas, Nevada, Verenigde Staten, 89128
    - HealthCare Partners Medical Group Oncology/Hematology-Tenaya
  - Las Vegas, Nevada, Verenigde Staten, 89148-2405
    - Las Vegas Cancer Center-Medical Center
  - Las Vegas, Nevada, Verenigde Staten, 89149
    - HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
  - Las Vegas, Nevada, Verenigde Staten, 89120
    - Nevada Cancer Research Foundation NCORP
  - Las Vegas, Nevada, Verenigde Staten, 89128
    - Oncology Las Vegas - Tenaya
  - Las Vegas, Nevada, Verenigde Staten, 89183
    - OptumCare Cancer Care at Fort Apache
  - Reno, Nevada, Verenigde Staten, 89503
    - Saint Mary's Regional Medical Center
- New Hampshire
  - Concord, New Hampshire, Verenigde Staten, 03301
    - New Hampshire Oncology Hematology PA-Concord
  - Derry, New Hampshire, Verenigde Staten, 03038
    - Parkland Medical Center
  - Dover, New Hampshire, Verenigde Staten, 03820
    - Wentworth-Douglass Hospital
  - Laconia, New Hampshire, Verenigde Staten, 03246
    - LRGHealthcare-Lakes Region General Hospital
  - Lebanon, New Hampshire, Verenigde Staten, 03756
    - Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
  - Manchester, New Hampshire, Verenigde Staten, 03103
    - Solinsky Center for Cancer Care
  - Manchester, New Hampshire, Verenigde Staten, 03104
    - Dartmouth Cancer Center - Manchester/ DCC Manchester
  - Nashua, New Hampshire, Verenigde Staten, 03063
    - Dartmouth Cancer Center - Nashua
  - Portsmouth, New Hampshire, Verenigde Staten, 03802
    - Portsmouth Regional Hospital
- New Jersey
  - East Orange, New Jersey, Verenigde Staten, 07018-1095
    - Veterans Adminstration New Jersey Health Care System
  - Englewood, New Jersey, Verenigde Staten, 07631
    - Englewood Hospital and Medical Center
  - New Brunswick, New Jersey, Verenigde Staten, 08903
    - Rutgers Cancer Institute of New Jersey
  - Newark, New Jersey, Verenigde Staten, 07112
    - Newark Beth Israel Medical Center
  - Paramus, New Jersey, Verenigde Staten, 07652
    - The Valley Hospital - Luckow Pavilion
  - Plainsboro, New Jersey, Verenigde Staten, 08536
    - Penn Medicine Princeton Health
  - Ridgewood, New Jersey, Verenigde Staten, 07450
    - Valley Health System Ridgewood Campus
  - Summit, New Jersey, Verenigde Staten, 07902
    - Overlook Hospital
  - Westwood, New Jersey, Verenigde Staten, 07675
    - Valley Health System-Hematology/Oncology
- New Mexico
  - 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
- New York
  - Auburn, New York, Verenigde Staten, 13021
    - Hematology Oncology Associates of Central New York-Auburn
  - Brooklyn, New York, Verenigde Staten, 11219
    - Maimonides 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
  - Glens Falls, New York, Verenigde Staten, 12801
    - Glens Falls Hospital
  - Lake Success, New York, Verenigde Staten, 11042
    - Northwell Health/Center for Advanced Medicine
  - Manhasset, New York, Verenigde Staten, 11030
    - North Shore University Hospital
  - Middletown, New York, Verenigde Staten, 10940
    - Garnet Health Medical Center
  - New York, New York, Verenigde Staten, 10032
    - NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
  - Plattsburgh, New York, Verenigde Staten, 12901
    - Champlain Valley Physicians Hospital Medical Center
  - Rochester, New York, Verenigde Staten, 14642
    - University of Rochester
  - Rome, New York, Verenigde Staten, 13440
    - Hematology Oncology Associates of Central New York-Rome
  - Stony Brook, New York, Verenigde Staten, 11794
    - Stony Brook University Medical Center
  - Syracuse, New York, Verenigde Staten, 13210
    - State University of New York Upstate Medical University
  - Utica, New York, Verenigde Staten, 13502
    - Faxton-Saint Luke's Healthcare
- North Carolina
  - 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
  - Asheville, North Carolina, Verenigde Staten, 28801
    - Mountain Radiation Oncology PA
  - Asheville, North Carolina, Verenigde Staten, 28803
    - AdventHealth Infusion Center Asheville
  - Brevard, North Carolina, Verenigde Staten, 28712
    - Transylvania Regional Hospital
  - Chapel Hill, North Carolina, Verenigde Staten, 27599
    - UNC Lineberger Comprehensive Cancer Center
  - Clinton, North Carolina, Verenigde Staten, 28328
    - Southeastern Medical Oncology Center-Clinton
  - Clinton, North Carolina, Verenigde Staten, 28328
    - Sampson Radiation Oncology
  - Durham, North Carolina, Verenigde Staten, 27710
    - Duke University Medical Center
  - Franklin, North Carolina, Verenigde Staten, 28734
    - Angel Medical Center
  - Goldsboro, North Carolina, Verenigde Staten, 27534
    - Southeastern Medical Oncology Center-Goldsboro
  - Goldsboro, North Carolina, Verenigde Staten, 27534
    - Wayne Memorial Hospital
  - Goldsboro, North Carolina, Verenigde Staten, 27534
    - Wayne Radiation Oncology
  - Greenville, North Carolina, Verenigde Staten, 27834
    - East Carolina University
  - Hendersonville, North Carolina, Verenigde Staten, 28791
    - Margaret R Pardee Memorial Hospital
  - Hendersonville, North Carolina, Verenigde Staten, 28792
    - AdventHealth Hendersonville
  - Jacksonville, North Carolina, Verenigde Staten, 28546
    - Southeastern Medical Oncology Center-Jacksonville
  - Jacksonville, North Carolina, Verenigde Staten, 28546
    - Onslow Memorial Hospital
  - Kinston, North Carolina, Verenigde Staten, 28501
    - ECU Health Oncology Kinston
  - Marion, North Carolina, Verenigde Staten, 28752
    - Mission Hospital McDowell
  - Pinehurst, North Carolina, Verenigde Staten, 28374
    - FirstHealth of the Carolinas-Moore Regional Hospital
  - Spruce Pine, North Carolina, Verenigde Staten, 28777
    - Blue Ridge Regional Hospital
  - Statesville, North Carolina, Verenigde Staten, 28677
    - Iredell Memorial Hospital
  - Winston-Salem, North Carolina, Verenigde Staten, 27157
    - Wake Forest University Health Sciences
  - Winston-Salem, North Carolina, Verenigde Staten, 27104
    - Southeast Clinical Oncology Research Consortium NCORP
- 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
  - Beachwood, Ohio, Verenigde Staten, 44122
    - UHHS-Chagrin Highlands Medical Center
  - Beachwood, Ohio, Verenigde Staten, 44122
    - Cleveland Clinic Cancer Center Beachwood
  - Belpre, Ohio, Verenigde Staten, 45714
    - Strecker Cancer Center-Belpre
  - Bowling Green, Ohio, Verenigde Staten, 43402
    - Toledo Clinic Cancer Centers-Bowling Green
  - Centerville, Ohio, Verenigde Staten, 45459
    - Miami Valley Hospital South
  - Chardon, Ohio, Verenigde Staten, 44024
    - Geauga Hospital
  - Chillicothe, Ohio, Verenigde Staten, 45601
    - Adena Regional Medical Center
  - Cincinnati, Ohio, Verenigde Staten, 45219
    - University of Cincinnati Cancer Center-UC 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, 44106
    - Case Western Reserve University
  - Cleveland, Ohio, Verenigde Staten, 44109
    - MetroHealth Medical Center
  - 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, 43215
    - Grant Medical Center
  - Columbus, Ohio, Verenigde Staten, 43222
    - Mount Carmel Health Center West
  - Columbus, Ohio, Verenigde Staten, 43215
    - Columbus NCI Community Oncology Research Program
  - Dayton, Ohio, Verenigde Staten, 45406
    - Good Samaritan Hospital - Dayton
  - Dayton, Ohio, Verenigde Staten, 45409
    - Miami Valley Hospital
  - Dayton, Ohio, Verenigde Staten, 45415
    - Miami Valley Hospital North
  - Dayton, Ohio, Verenigde Staten, 45459
    - Dayton NCI Community Oncology Research Program
  - 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
  - Elyria, Ohio, Verenigde Staten, 44035
    - Mercy Cancer Center-Elyria
  - Fairfield, Ohio, Verenigde Staten, 45014
    - Oncology Hematology Care Inc-Healthplex
  - Findlay, Ohio, Verenigde Staten, 45840
    - Blanchard Valley Hospital
  - Franklin, Ohio, Verenigde Staten, 45005-1066
    - Atrium Medical Center-Middletown Regional Hospital
  - Greenville, Ohio, Verenigde Staten, 45331
    - Wayne Hospital
  - Independence, Ohio, Verenigde Staten, 44131
    - Cleveland Clinic Cancer Center Independence
  - Kettering, Ohio, Verenigde Staten, 45429
    - Kettering Medical Center
  - Lancaster, Ohio, Verenigde Staten, 43130
    - Fairfield Medical Center
  - Lancaster, Ohio, Verenigde Staten, 43130
    - Lancaster Radiation Oncology
  - Lima, Ohio, Verenigde Staten, 45804
    - Lima Memorial Hospital
  - Mansfield, Ohio, Verenigde Staten, 44906
    - Cleveland Clinic Cancer Center Mansfield
  - Marietta, Ohio, Verenigde Staten, 45750
    - Marietta Memorial Hospital
  - Maumee, Ohio, Verenigde Staten, 43537
    - Toledo Clinic Cancer Centers-Maumee
  - Maumee, Ohio, Verenigde Staten, 43537
    - Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
  - Mayfield Heights, Ohio, Verenigde Staten, 44124
    - Hillcrest Hospital Cancer Center
  - Mayfield Heights, Ohio, Verenigde Staten, 44124
    - UH Seidman Cancer Center at Landerbrook Health Center
  - Mentor, Ohio, Verenigde Staten, 44060
    - UH Seidman Cancer Center at Lake Health Mentor Campus
  - Middleburg Heights, Ohio, Verenigde Staten, 44130
    - UH Seidman Cancer Center at Southwest General Hospital
  - 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
  - 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
  - Tiffin, Ohio, Verenigde Staten, 44883
    - Mercy Hospital of Tiffin
  - Toledo, Ohio, Verenigde Staten, 43606
    - ProMedica Toledo Hospital/Russell J Ebeid Children's 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, 43614
    - University of Toledo
  - Toledo, Ohio, Verenigde Staten, 43617
    - Toledo Community Hospital Oncology Program CCOP
  - Toledo, Ohio, Verenigde Staten, 43608
    - Mercy Health - Saint Vincent Hospital
  - Troy, Ohio, Verenigde Staten, 45373
    - Upper Valley Medical Center
  - Warrensville Heights, Ohio, Verenigde Staten, 44122
    - South Pointe Hospital
  - Wauseon, Ohio, Verenigde Staten, 43567
    - Fulton County Health Center
  - West Chester, Ohio, Verenigde Staten, 45069
    - University of Cincinnati Cancer Center-West Chester
  - Westerville, Ohio, Verenigde Staten, 43081
    - Saint Ann's Hospital
  - Westlake, Ohio, Verenigde Staten, 44145
    - UH Seidman Cancer Center at Saint John Medical Center
  - 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
  - Oklahoma City, Oklahoma, Verenigde Staten, 73120
    - Mercy Hospital Oklahoma City
  - Tulsa, Oklahoma, Verenigde Staten, 74146
    - Oklahoma Cancer Specialists and Research Institute-Tulsa
  - Tulsa, Oklahoma, Verenigde Staten, 74146
    - Warren Clinic Oncology-Tulsa
  - Tulsa, Oklahoma, Verenigde Staten, 74136
    - Saint Francis Children's Hospital
- Oregon
  - Bend, Oregon, Verenigde Staten, 97701
    - Saint Charles Health System
  - Clackamas, Oregon, Verenigde Staten, 97015
    - Clackamas Radiation Oncology Center
  - Clackamas, Oregon, Verenigde Staten, 97015
    - Providence Cancer Institute Clackamas Clinic
  - Coos Bay, Oregon, Verenigde Staten, 97420
    - Bay Area Hospital
  - Milwaukie, Oregon, Verenigde Staten, 97222
    - Providence Milwaukie Hospital
  - Newberg, Oregon, Verenigde Staten, 97132
    - Providence Newberg Medical Center
  - Oregon City, Oregon, Verenigde Staten, 97045
    - Providence Willamette Falls Medical Center
  - Portland, Oregon, Verenigde Staten, 97239
    - Oregon Health and Science University
  - Portland, Oregon, Verenigde Staten, 97213
    - Providence Portland Medical Center
  - Portland, Oregon, Verenigde Staten, 97225
    - Providence Saint Vincent Medical Center
  - Portland, Oregon, Verenigde Staten, 97227
    - Kaiser Permanente Northwest
- Pennsylvania
  - Allentown, Pennsylvania, Verenigde Staten, 18103
    - Lehigh Valley Hospital-Cedar Crest
  - Beaver, Pennsylvania, Verenigde Staten, 15009
    - UPMC-Heritage Valley Health System Beaver
  - Bethlehem, Pennsylvania, Verenigde Staten, 18017
    - Lehigh Valley Hospital - Muhlenberg
  - 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
  - Drexel Hill, Pennsylvania, Verenigde Staten, 19026
    - Delaware County Memorial Hospital
  - East Stroudsburg, Pennsylvania, Verenigde Staten, 18301
    - Pocono Medical Center
  - Ephrata, Pennsylvania, Verenigde Staten, 17522
    - Ephrata Cancer Center
  - Ephrata, Pennsylvania, Verenigde Staten, 17522
    - Ephrata Community Hospital
  - Gettysburg, Pennsylvania, Verenigde Staten, 17325
    - Adams Cancer Center
  - Greensburg, Pennsylvania, Verenigde Staten, 15601
    - UPMC Cancer Centers - Arnold Palmer Pavilion
  - Hanover, Pennsylvania, Verenigde Staten, 17331
    - WellSpan Medical Oncology and Hematology
  - Hazleton, Pennsylvania, Verenigde Staten, 18201
    - Geisinger Medical Center-Cancer Center Hazleton
  - Hershey, Pennsylvania, Verenigde Staten, 17033-0850
    - Penn State Milton S Hershey Medical Center
  - Johnstown, Pennsylvania, Verenigde Staten, 15901
    - UPMC-Johnstown/John P. Murtha Regional Cancer Center
  - McKeesport, Pennsylvania, Verenigde Staten, 15132
    - UPMC Cancer Center at UPMC McKeesport
  - Media, Pennsylvania, Verenigde Staten, 19063
    - Riddle Memorial Hospital
  - Moon Township, Pennsylvania, Verenigde Staten, 15108
    - UPMC Hillman Cancer Center in Coraopolis
  - Paoli, Pennsylvania, Verenigde Staten, 19301
    - Paoli Memorial Hospital
  - Philadelphia, Pennsylvania, Verenigde Staten, 19111
    - Fox Chase Cancer Center
  - Philadelphia, Pennsylvania, Verenigde Staten, 19107
    - Thomas Jefferson University Hospital
  - Philadelphia, Pennsylvania, Verenigde Staten, 19114
    - Jefferson Torresdale Hospital
  - Pittsburgh, Pennsylvania, Verenigde Staten, 15232
    - UPMC Hillman Cancer Center
  - Pittsburgh, Pennsylvania, Verenigde Staten, 15213
    - UPMC-Magee Womens Hospital
  - Pittsburgh, Pennsylvania, Verenigde Staten, 15232
    - UPMC-Shadyside Hospital
  - Pittsburgh, Pennsylvania, Verenigde Staten, 15213
    - UPMC-Presbyterian Hospital
  - Pittsburgh, Pennsylvania, Verenigde Staten, 15215
    - UPMC-Saint Margaret
  - Pittsburgh, Pennsylvania, Verenigde Staten, 15236
    - UPMC Jefferson Regional Radiation Oncology
  - Pittsburgh, Pennsylvania, Verenigde Staten, 15237
    - UPMC-Passavant Hospital
  - Pittsburgh, Pennsylvania, Verenigde Staten, 15243
    - UPMC-Saint Clair Hospital Cancer Center
  - Pottsville, Pennsylvania, Verenigde Staten, 17901
    - Geisinger Cancer Services-Pottsville
  - Scranton, Pennsylvania, Verenigde Staten, 18508
    - Hematology and Oncology Associates of North East Pennsylvania
  - Seneca, Pennsylvania, Verenigde Staten, 16346
    - UPMC Cancer Center at UPMC Northwest
  - State College, Pennsylvania, Verenigde Staten, 16801
    - Geisinger Medical Group
  - Uniontown, Pennsylvania, Verenigde Staten, 15401
    - UPMC Uniontown Hospital Radiation Oncology
  - Upland, Pennsylvania, Verenigde Staten, 19013
    - Associates In Hematology Oncology PC-Upland
  - Washington, Pennsylvania, Verenigde Staten, 15301
    - UPMC Washington Hospital Radiation Oncology
  - West Chester, Pennsylvania, Verenigde Staten, 19380
    - Chester County Hospital
  - West Reading, Pennsylvania, Verenigde Staten, 19611
    - Reading Hospital
  - 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
  - York, Pennsylvania, Verenigde Staten, 17403
    - WellSpan Health-York Cancer Center
  - York, Pennsylvania, Verenigde Staten, 17403
    - WellSpan Health-York Hospital
- Rhode Island
  - Pawtucket, Rhode Island, Verenigde Staten, 02860
    - Memorial Hospital of Rhode Island
  - Providence, Rhode Island, Verenigde Staten, 02903
    - Rhode Island Hospital
  - Providence, Rhode Island, Verenigde Staten, 02906
    - Miriam 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
  - Charleston, South Carolina, Verenigde Staten, 29401
    - Roper Hospital
  - Charleston, South Carolina, Verenigde Staten, 29406
    - Lowcountry Hematology Oncology PA-North Charleston
  - Charleston, South Carolina, Verenigde Staten, 29414
    - Bon Secours Saint Francis Hospital
  - Charleston, South Carolina, Verenigde Staten, 29403
    - Charleston Oncology - Roper
  - Charleston, South Carolina, Verenigde Staten, 29414
    - Charleston Oncology - Saint Francis
  - Charleston, South Carolina, Verenigde Staten, 29414
    - Lowcountry Oncology Associates - West Ashley
  - Easley, South Carolina, Verenigde Staten, 29640
    - Prisma Health Cancer Institute - Easley
  - Florence, South Carolina, Verenigde Staten, 29506
    - McLeod Regional Medical Center
  - 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
  - Greenville, South Carolina, Verenigde Staten, 29605
    - Prisma Health Greenville Memorial Hospital
  - Greenville, South Carolina, Verenigde Staten, 29601
    - Greenville Health System Cancer Institute-Andrews
  - Greer, South Carolina, Verenigde Staten, 29650
    - Prisma Health Cancer Institute - Greer
  - Greer, South Carolina, Verenigde Staten, 29651
    - Gibbs Cancer Center-Pelham
  - Lancaster, South Carolina, Verenigde Staten, 29720
    - Carolina Blood and Cancer Care Associates PA-Lancaster
  - Mt. Pleasant, South Carolina, Verenigde Staten, 29464
    - Lowcountry Oncology Associates - Mount Pleasant
  - Rock Hill, South Carolina, Verenigde Staten, 29732
    - Carolina Blood and Cancer Care Associates PA
  - Seneca, South Carolina, Verenigde Staten, 29672
    - Prisma Health Cancer Institute - Seneca
  - Spartanburg, South Carolina, Verenigde Staten, 29303
    - Spartanburg Medical Center
  - Union, South Carolina, Verenigde Staten, 29379
    - SMC Center for Hematology Oncology Union
  - West Columbia, South Carolina, Verenigde Staten, 29169
    - Lexington Health
- South Dakota
  - 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
  - Bristol, Tennessee, Verenigde Staten, 37620
    - Wellmont Medical Associates Oncology and Hematology-Bristol
  - Bristol, Tennessee, Verenigde Staten, 37620
    - Bristol Regional Medical Center
  - Chattanooga, Tennessee, Verenigde Staten, 37404
    - Memorial Hospital
  - Chattanooga, Tennessee, Verenigde Staten, 37403
    - Erlanger Medical Center
  - Hixson, Tennessee, Verenigde Staten, 37343
    - Pulmonary Medicine Center of Chattanooga-Hixson
  - Kingsport, Tennessee, Verenigde Staten, 37660
    - Ballad Health Cancer Care - Kingsport
  - Kingsport, Tennessee, Verenigde Staten, 37660
    - Wellmont Holston Valley Hospital and Medical Center
  - Ooltewah, Tennessee, Verenigde Staten, 37363
    - Memorial GYN Plus
- Texas
  - Amarillo, Texas, Verenigde Staten, 79106
    - The Don and Sybil Harrington Cancer Center
  - Dallas, Texas, Verenigde Staten, 75235
    - Parkland Memorial Hospital
  - Dallas, Texas, Verenigde Staten, 75390
    - UT Southwestern/Simmons Cancer Center-Dallas
  - San Antonio, Texas, Verenigde Staten, 78229
    - University Hospital
  - San Antonio, Texas, Verenigde Staten, 78229
    - University of Texas Health Science Center at San Antonio
- Vermont
  - Bennington, Vermont, Verenigde Staten, 05201
    - Southwestern Vermont Medical Center
  - Berlin Corners, Vermont, Verenigde Staten, 05602
    - Central Vermont Medical Center/National Life Cancer Treatment
  - Burlington, Vermont, Verenigde Staten, 05405
    - University of Vermont and State Agricultural College
  - White River Junction, Vermont, Verenigde Staten, 05009
    - White River Junction Veteran Administration Medical Center
- Virginia
  - Charlottesville, Virginia, Verenigde Staten, 22908
    - University of Virginia Cancer Center
  - Fredericksburg, Virginia, Verenigde Staten, 22401
    - Fredericksburg Oncology Inc
  - Fredericksburg, Virginia, Verenigde Staten, 22408
    - Hematology Oncology Associates of Fredericksburg Inc
  - Hampton, Virginia, Verenigde Staten, 23666
    - Virginia Oncology Associates-Hampton
  - Lynchburg, Virginia, Verenigde Staten, 24501
    - Centra Alan B Pearson Regional Cancer Center
  - Norton, Virginia, Verenigde Staten, 24273
    - Ballad Health Cancer Care - Norton
  - Richmond, Virginia, Verenigde Staten, 23229
    - Virginia Cancer Institute
  - 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
  - Aberdeen, Washington, Verenigde Staten, 98520
    - Providence Regional Cancer System-Aberdeen
  - Anacortes, Washington, Verenigde Staten, 98221
    - Cancer Care Center at Island Hospital
  - Bellevue, Washington, Verenigde Staten, 98005
    - Swedish Cancer Institute-Eastside Oncology Hematology
  - Bellingham, Washington, Verenigde Staten, 98225
    - PeaceHealth Saint Joseph Medical Center
  - Burien, Washington, Verenigde Staten, 98166
    - Saint Anne Hospital
  - Centralia, Washington, Verenigde Staten, 98531
    - Providence Regional Cancer System-Centralia
  - Edmonds, Washington, Verenigde Staten, 98026
    - Swedish Cancer Institute-Edmonds
  - Enumclaw, Washington, Verenigde Staten, 98022
    - Saint Elizabeth Hospital
  - Everett, Washington, Verenigde Staten, 98201
    - Providence Regional Cancer Partnership
  - Federal Way, Washington, Verenigde Staten, 98003
    - Saint Francis Hospital
  - Issaquah, Washington, Verenigde Staten, 98029
    - Swedish Cancer Institute-Issaquah
  - Lacey, Washington, Verenigde Staten, 98503
    - Providence Regional Cancer System-Lacey
  - Lakewood, Washington, Verenigde Staten, 98499
    - Saint Clare Hospital
  - Longview, Washington, Verenigde Staten, 98632
    - PeaceHealth Saint John Medical 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, 98112
    - Kaiser Permanente Washington
  - Seattle, Washington, Verenigde Staten, 98104
    - Minor and James Medical PLLC
  - Seattle, Washington, Verenigde Staten, 98104
    - Pacific Gynecology Specialists
  - Shelton, Washington, Verenigde Staten, 98584
    - Providence Regional Cancer System-Shelton
  - Silverdale, Washington, Verenigde Staten, 98383
    - Saint Joseph Medical Center Hematology and Oncology - Silverdale
  - Spokane, Washington, Verenigde Staten, 99218
    - Evergreen Hematology and Oncology PS
  - Spokane, Washington, Verenigde Staten, 99204
    - MultiCare Deaconess Cancer and Blood Specialty Center - Downtown
  - Spokane Valley, Washington, Verenigde Staten, 99216
    - MultiCare Deaconess Cancer and Blood Specialty Center - Valley
  - 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
  - Yelm, Washington, Verenigde Staten, 98597
    - Providence Regional Cancer System-Yelm
- West Virginia
  - Bridgeport, West Virginia, Verenigde Staten, 26330
    - United Hospital Center
  - Charleston, West Virginia, Verenigde Staten, 25304
    - Vandalia Health/CAMC Institute for Academic Medicine
  - Huntington, West Virginia, Verenigde Staten, 25701
    - Edwards Comprehensive Cancer Center
  - Huntington, West Virginia, Verenigde Staten, 25702
    - Saint Mary's Medical Center
  - Martinsburg, West Virginia, Verenigde Staten, 25401
    - WVUH-Berkely Medical Center
  - Morgantown, West Virginia, Verenigde Staten, 26506
    - West Virginia University Healthcare
  - Parkersburg, West Virginia, Verenigde Staten, 26101
    - Camden Clark Medical Center
- 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
    - HSHS Sacred Heart Hospital
  - 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
  - Green Bay, Wisconsin, Verenigde Staten, 54301-3526
    - Green Bay Oncology at Saint Vincent Hospital
  - Kenosha, Wisconsin, Verenigde Staten, 53142
    - Aurora Cancer Care-Kenosha South
  - La Crosse, Wisconsin, Verenigde Staten, 54601
    - Gundersen Lutheran Medical Center
  - Ladysmith, Wisconsin, Verenigde Staten, 54848
    - Marshfield Medical Center - Ladysmith
  - 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
    - Bay Area Medical Center
  - Marshfield, Wisconsin, Verenigde Staten, 54449
    - Marshfield Medical Center-Marshfield
  - Marshfield, Wisconsin, Verenigde Staten, 54449
    - Marshfield Medical Center
  - Milwaukee, Wisconsin, Verenigde Staten, 53226
    - Medical College of Wisconsin
  - 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
  - Rhinelander, Wisconsin, Verenigde Staten, 54501
    - Saint Mary's Hospital
  - 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, 54481
    - Aspirus Cancer Care - Stevens Point
  - 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
  - Casper, Wyoming, Verenigde Staten, 82609
    - Rocky Mountain Oncology
  - Cheyenne, Wyoming, Verenigde Staten, 82001
    - Cheyenne Regional Medical Center-West
  - Cody, Wyoming, Verenigde Staten, 82414
    - Big Horn Basin Cancer Center
  - Cody, Wyoming, Verenigde Staten, 82414
    - Billings Clinic-Cody
  - Sheridan, Wyoming, Verenigde Staten, 82801
    - Welch Cancer Center

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

65 jaar en ouder (Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

PRE-REGISTRATION (STEP 0)
All patients are REQUIRED to be pre-registered to A041202 in order to submit peripheral blood to the Alliance Hematologic Malignancy Biorepository (HEME) for central Zap-70 methylation. This specimen submission is mandatory prior to registration as results will be used for stratification
REGISTRATION (STEP 1)
Patients must be diagnosed with CLL in accordance with International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2008 criteria that includes all of the following:
- >= 5 x 10^9 B lymphocytes (5000/uL) in the peripheral blood
- On morphologic review, the leukemic cells must be small mature lymphocytes, and prolymphocytes must not exceed 55% of the blood lymphocytes
- CLL cells on immunophenotype (performed locally) must reveal a clonal B-cell population, which express the B cell surface markers of CD19 and CD20, as well as the T-cell antigen CD5; patients with bright surface immunoglobulin expression or lack of CD23 expression in > 10% of cells must lack t(11;14) translocation by interphase cytogenetics
Patients must be intermediate or high-risk Rai stage CLL
- Intermediate risk (formerly Rai stage I/II) is defined by lymphocytosis plus enlarged lymph nodes at any site, with or without hepatomegaly or splenomegaly
- High risk (formerly Rai stage III/IV) is defined by lymphocytosis with or without enlarged nodes and spleen plus disease-related anemia (hemoglobin < 11 g/dL) or thrombocytopenia (platelet count < 100 x 10^9/L) that is not attributable to autoimmune hemolytic anemia or thrombocytopenia
Patients must meet criteria for treatment as defined by IWCLL 2008 guidelines which includes at least one of the following criteria:
- Evidence of marrow failure as manifested by the development or worsening of anemia or thrombocytopenia (not attributable to autoimmune hemolytic anemia or thrombocytopenia)
- Massive (>= 6 cm below the costal margin), progressive or symptomatic splenomegaly
- Massive nodes (>= 10 cm) or progressive or symptomatic lymphadenopathy
- Autoimmune anemia and/or thrombocytopenia that is poorly responsive to standard therapy
- Constitutional symptoms, which include any of the following:
  - Unintentional weight loss of 10% or more within 6 months
  - Significant fatigue
  - Fevers > 100.5 degrees F for 2 weeks or more without evidence of infection
  - Night sweats > 1 month without evidence of infection
Prior treatment
- Patients must not have had prior therapy for CLL (except palliative steroids or treatment of autoimmune complications of CLL with rituximab or steroids)
- Treatment with rituximab and/or high dose corticosteroids for autoimmune complications of CLL must be complete at least 4 weeks prior to enrollment; palliative steroids must be at a dose not higher than 20 mg/day of prednisone or equivalent corticosteroid at the time of registration
Age >= 65 years
Eastern Cooperative Oncology Group (ECOG) performance status 0-2
Patients with active hepatitis B defined by hepatitis B surface antigen positivity or core antibody positivity in the presence of hepatitis B DNA are not eligible for this study; patients with a positive hepatitis B core antibody but with negative hepatitis B DNA may participate, but must have hepatitis serologies and hepatitis B DNA monitored periodically by the treating physician
- Intravenous immunoglobulin (IVIG) can cause a false positive hepatitis B serology; if patients receiving routine IVIG have core antibody or surface antigen positivity without evidence of active viremia (negative hepatitis B DNA) they may still participate in the study, but should have hepatitis serologies and hepatitis B DNA monitored periodically by the treating physician
Patients must not be receiving active systemic anticoagulation with heparin or warfarin; patients must be off warfarin therapy for at least 30 days prior to enrollment
Patients with class III or class IV heart failure by New York Heart Association, those with unstable angina, and those with uncontrolled arrhythmia are not eligible
Patients who have had a myocardial infarction, intracranial bleed, or stroke within the past 6 months are not eligible
Patients with known human immunodeficiency virus (HIV) are eligible if their CD4 count is >= 350 cells/mm^3 and if they are not taking prohibited CYP-interacting medications
Patients must not have any history of Richter's transformation or prolymphocytic leukemia (prolymphocytes in blood > 55%)
Patients must not require more than 20 mg prednisone or equivalent corticosteroid daily
Patients must not have uncontrolled active systemic infection requiring intravenous antibiotics
Patients must not have continued requirement for therapy with a strong cytochrome P450 3A4/5 (CYP3A4/5) inhibitor or inducer
Patients must not have a known allergy to mannitol
Patients must not have prior significant hypersensitivity to rituximab (not including infusion reactions)
Patients may not have had major surgery within 10 days of enrollment, or minor surgery within 7 days of enrollment; examples of minor surgery include dental surgery, insertion of a venous access device, skin biopsy, or aspiration of a joint; the decision about whether a surgery is major or minor can be made at the discretion of the treating physician
Absolute neutrophil count (ANC) >= 1,000/uL unless due to bone marrow involvement
Aspartate aminotransferase (AST) or alanine aminotransferase (AST) =< 2.5 x upper limits of normal except if due to disease infiltration of the liver
Bilirubin =< 1.5 x upper limits of normal (unless due to liver involvement, hemolysis, or Gilbert's disease)
Creatinine clearance >= 40 mL/min
- To be calculated by modified Cockcroft-Gault formula
Platelet count (untransfused) >= 30,000/uL

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: Crossover-opdracht
Masker: Geen (open label)

Aantal wapens

Wapens en interventies

Deelnemersgroep / Arm	Interventie / Behandeling
Actieve vergelijker: Arm I (rituximab, bendamustine hydrochloride) Patients receive rituximab IV on day 1 (day 0 course 1) and bendamustine hydrochloride IV over 30 minutes on days 1-2. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover to Arm II. Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and CT throughout the study.	Ander: Laboratory Biomarker Analysis Correlative studies Ander: Quality-of-Life Assessment Ancillary studies Andere namen: Beoordeling van de kwaliteit van leven Procedure: Biospecimen Collection Undergo blood sample collection Andere namen: Biologische monsterverzameling Biospecimen verzameld Specimenverzameling Monsterverzameling Biologisch: Rituximab Given IV Andere namen: Rituxan Mab Thera ABP 798 BI 695500 C2B8 monoklonaal antilichaam Chimeer anti-CD20-antilichaam CT-P10 IDEC-102 IDEC-C2B8 IDEC-C2B8 monoklonaal antilichaam Monoklonaal antilichaam IDEC-C2B8 PF-05280586 Riabni Rituximab ABBS Rituximab ARRX Rituximab Biosimilar ABP 798 Rituximab Biosimilar BI 695500 Rituximab Biosimilar CT-P10 Rituximab Biosimilar GB241 Rituximab Biosimilar IBI301 Rituximab Biosimilar JHL1101 Rituximab Biosimilar PF-05280586 Rituximab Biosimilar RTXM83 Rituximab Biosimilar SAIT101 Rituximab Biosimilar SIBP-02 rituximab biosimilar TQB2303 Rituximab PVVR Rituximab-arrx Rituximab-pvvr RTXM83 Rust Truxima Rixathon Ikgdar Mabtas Rituximab-abbs BI-695500 BI695500 Blitzima IDEC 102 IDEC102 PF 05280586 PF05280586 Ritemvia Rituximab-blit Rituximab-ritueel Rituximab-rixa Rituximab-rixi Riximyo RTXM 83 RTXM-83 ABP-798 ABP798 CTP10 GP 2013 GP-2013 GP2013 Rituximab Biosimilar GP2013 Procedure: Computed Tomography 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 Geneesmiddel: Bendamustine Hydrochloride Given IV Andere namen: Treanda Bendeka CEP-18083 Bendamustine Hydrochloride Cytostasanhydrochloride Levac Ribomustine SyB L-0501 Treakisym Belrapzo CEP 18083 CEP18083 VIVIMUSTA Procedure: Bone Marrow Aspiration Undergo bone marrow aspiration and biopsy Procedure: Bone Marrow Biopsy Undergo bone marrow aspiration and biopsy Andere namen: Biopsie van beenmerg Biopsie, beenmerg
Experimenteel: Arm II (ibrutinib) Patients receive ibrutinib PO daily. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and CT throughout the study.	Ander: Laboratory Biomarker Analysis Correlative studies Ander: Quality-of-Life Assessment Ancillary studies Andere namen: Beoordeling van de kwaliteit van leven Procedure: Biospecimen Collection Undergo blood sample collection Andere namen: Biologische monsterverzameling Biospecimen verzameld Specimenverzameling Monsterverzameling Procedure: Computed Tomography 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 Procedure: Bone Marrow Aspiration Undergo bone marrow aspiration and biopsy Procedure: Bone Marrow Biopsy Undergo bone marrow aspiration and biopsy Andere namen: Biopsie van beenmerg Biopsie, beenmerg Geneesmiddel: Ibrutinib Given PO Andere namen: PCI-32765 Imbruvica BTK-remmer PCI-32765 CRA-032765 PCI32765 CRA032765
Experimenteel: Arm III (ibrutinib, rituximab) Patients receive ibrutinib as in Arm II. Patients receive rituximab IV on days 1, 8, 15, and 22 of course 2 and on day 1 of courses 3-6. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and CT throughout the study.	Ander: Laboratory Biomarker Analysis Correlative studies Ander: Quality-of-Life Assessment Ancillary studies Andere namen: Beoordeling van de kwaliteit van leven Procedure: Biospecimen Collection Undergo blood sample collection Andere namen: Biologische monsterverzameling Biospecimen verzameld Specimenverzameling Monsterverzameling Biologisch: Rituximab Given IV Andere namen: Rituxan Mab Thera ABP 798 BI 695500 C2B8 monoklonaal antilichaam Chimeer anti-CD20-antilichaam CT-P10 IDEC-102 IDEC-C2B8 IDEC-C2B8 monoklonaal antilichaam Monoklonaal antilichaam IDEC-C2B8 PF-05280586 Riabni Rituximab ABBS Rituximab ARRX Rituximab Biosimilar ABP 798 Rituximab Biosimilar BI 695500 Rituximab Biosimilar CT-P10 Rituximab Biosimilar GB241 Rituximab Biosimilar IBI301 Rituximab Biosimilar JHL1101 Rituximab Biosimilar PF-05280586 Rituximab Biosimilar RTXM83 Rituximab Biosimilar SAIT101 Rituximab Biosimilar SIBP-02 rituximab biosimilar TQB2303 Rituximab PVVR Rituximab-arrx Rituximab-pvvr RTXM83 Rust Truxima Rixathon Ikgdar Mabtas Rituximab-abbs BI-695500 BI695500 Blitzima IDEC 102 IDEC102 PF 05280586 PF05280586 Ritemvia Rituximab-blit Rituximab-ritueel Rituximab-rixa Rituximab-rixi Riximyo RTXM 83 RTXM-83 ABP-798 ABP798 CTP10 GP 2013 GP-2013 GP2013 Rituximab Biosimilar GP2013 Procedure: Computed Tomography 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 Procedure: Bone Marrow Aspiration Undergo bone marrow aspiration and biopsy Procedure: Bone Marrow Biopsy Undergo bone marrow aspiration and biopsy Andere namen: Biopsie van beenmerg Biopsie, beenmerg Geneesmiddel: Ibrutinib Given PO Andere namen: PCI-32765 Imbruvica BTK-remmer PCI-32765 CRA-032765 PCI32765 CRA032765

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat	Maatregel Beschrijving	Tijdsspanne
Progression Free Survival (PFS) Tijdsspanne: Time from study entry to the time of documented disease progression or death. The analysis was event driven, performed at 2.5 years after the last patient enrolled;up to 4 years.	The Kaplan-Meier method will be used to estimate the progression free survival distributions for each arm, with median estimates provided. Progression is defined as any one of the following: an increase in number of blood lymphocytes by >= 50% with >= 5000 B lymphocytes/mL in patients on Arm A or those on Arms 2 or 3 no longer receiving ibrutinib, >= 50% increase in the products of at least 2 lymph nodes on 2 consecutive determination 2 weeks apart, >= 50% increase in the size of the liver/spleen, transformation to a more aggressive histology, progression of any cytopenia (i.e. decrease of Hb levels > 2g/dL). Progression free survival time will be the time to either progression or death whichever occurs first.	Time from study entry to the time of documented disease progression or death. The analysis was event driven, performed at 2.5 years after the last patient enrolled;up to 4 years.

Secundaire uitkomstmaten

Uitkomstmaat	Maatregel Beschrijving	Tijdsspanne
Progression Free Survival (PFS) Rate at 2 Years Tijdsspanne: Time from study entry to the time of documented disease progression or death, assessed up to 2 years	The Kaplan-Meier method will be used to estimate the rate of progression free survival at 2 years in each treatment arm. Progression is defined as any one of the following: an increase in number of blood lymphocytes by >= 50%, >= 50% increase in the products of at least 2 lymph nodes on 2 consecutive determination 2 weeks apart, >= 50% increase in the size of the liver/spleen, transformation to a more aggressive histology, progression of any cytopenia (i.e. decrease of Hb levels > 2g/dL). Progression free survival time will be the time to either progression or death whichever occurs first.	Time from study entry to the time of documented disease progression or death, assessed up to 2 years
Overall Survival (OS) at 2 Years Tijdsspanne: From the date of registration to the date of death, assessed up to 2 years	The Kaplan-Meier method will be used to estimate the rate of overall survival at 2 years in each treatment arm. OS will be measured from the date of registration to the date of the event (i.e., death) or the date of last follow-up to evaluate that event. Patients who are event-free at their last follow-up evaluation will be censored at that time point.	From the date of registration to the date of death, assessed up to 2 years
Duration of Response (DOR) (Complete Response [CR], CCR, Nodular Partial Response [nPR], Partial Response [PR], and PRL) Tijdsspanne: From the date of first response until progression or death, performed at 2.5 years after the last patient enrolled; up to 4 years.	The Kaplan-Meier method will be used to estimate median DOR. DOR is the time from first objective status to progression or death. CR requires all of the following: absence of lymphadenopathy > 1.5 cm on physical exam/CT scan, no hepatomegaly/splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate & biopsy must be normocellular for age. PR requires >= 50% decrease in peripheral lymphocyte count from pre-treatment value, >= 50% reduction in lymphadenopathy, and/or ≥ 50% reduction in splenomegaly/hepatomegaly. CR with exception of having bone marrow lymphoid CLL nodules will be considered a nodular PR (nPR). CR with exception of not having a bone marrow biopsy performed will be considered a clinical CR (CCR). PR with the exception of having less than a 50% reduction in peripheral lymphocyte count will be considered a PR except persistent lymphocytosis (PRL).	From the date of first response until progression or death, performed at 2.5 years after the last patient enrolled; up to 4 years.
Percentage of Patients Achieving Any Response to Treatment (Overall Response Rate [ORR] [Complete Response [CR], CCR, Nodular Partial Response [nPR], Partial Response [PR], and PRL]) Tijdsspanne: Performed at 2.5 years after the last patient enrolled;up to 4 years.	Complete response (CR) requires all of the following: absence of lymphadenopathy >1.5 cm on physical exam/CT scan, no hepatomegaly/splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate & biopsy must be normocellular for age. Partial response (PR) requires >= 50% decrease in peripheral lymphocyte count from pre-treatment value, >= 50% reduction in lymphadenopathy, and/or ≥ 50% reduction in splenomegaly/hepatomegaly. CR with exception of having bone marrow lymphoid CLL nodules will be considered a nodular PR (nPR). CR with exception of not having a bone marrow biopsy performed will be considered a clinical CR (CCR). PR with the exception of having less than a 50% reduction in peripheral lymphocyte count will be considered a PR except persistent lymphocytosis (PRL).Overall response rate and corresponding exact binomial 95% CI provided.	Performed at 2.5 years after the last patient enrolled;up to 4 years.
Percentage of Patients Achieving a Biopsy-proven Complete Response (CR) Tijdsspanne: Performed at 2.5 years after the last patient enrolled; up to 4 years.	Complete response (CR) requires all of the following: absence of lymphadenopathy > 1.5 cm on physical exam/CT scan, no hepatomegaly or splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate and biopsy must be normocellular for age. Complete response rate and corresponding exact binomial 95% confidence intervals provided.	Performed at 2.5 years after the last patient enrolled; up to 4 years.
Percentage of Patients Achieving Complete (CR and CCR) or Nodular Partial Response (nPR) Tijdsspanne: Performed at 2.5 years after the last patient enrolled; up to 4 years.	Complete response (CR) requires all of the following: absence of lymphadenopathy > 1.5 cm on physical exam/CT scan, no hepatomegaly or splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate and biopsy must be normocellular for age. CR with exception of having bone marrow lymphoid CLL nodules will be considered a nodular PR (nPR). CR with exception of not having a bone marrow biopsy performed will be considered a clinical CR (CCR). Response rate and corresponding exact binomial 95% confidence intervals provided.	Performed at 2.5 years after the last patient enrolled; up to 4 years.
Percentage of Patients Who Attain Minimal Residual Disease (MRD) Negative Status Tijdsspanne: Cycle 9 Day 1 Evaluation	Estimated using the number of patients who achieve minimal residual disease divided by the total number randomized to that treatment arm. Corresponding exact binomial 95% confidence intervals for MRD rates will be calculated.	Cycle 9 Day 1 Evaluation
The Rate of Grade 3, 4, or 5 Treatment-related Non-hematologic Adverse Events (Toxicities) Tijdsspanne: Performed at 2.5 years after the last patient enrolled; up to 4 years.	The rate of grade 3, 4, or 5 treatment-related non-hematologic adverse events (toxicities) by arm; excludes adverse events occurring post-crossover for patients in Arm A	Performed at 2.5 years after the last patient enrolled; up to 4 years.

Andere uitkomstmaten

Uitkomstmaat	Maatregel Beschrijving	Tijdsspanne
Geriatric Functional Status (Optional) Tijdsspanne: Performed at 2.5 years after the last patient enrolled	Assessed using the Older Americans' Resources and Services Multidimensional Functional Assessment Questionnaire, Activities of Daily Living, Medical Outcomes Study physical functioning, Karnofsky performance status rated by a health care professional, Karnofsky performance status rated by the patient, timed "Up and Go", and number of falls in the last six months.	Performed at 2.5 years after the last patient enrolled

Medewerkers en onderzoekers

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

Sponsor

National Cancer Institute (NCI)

Onderzoekers

Hoofdonderzoeker: Jennifer A Woyach, Alliance for Clinical Trials in Oncology

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.

Algemene publicaties

Nuttige links

<p>Data Available: Select individual patient-level data from this trial can be requested from the NCTN/NCORP Data Archive.</p>

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)

15 januari 2014

Primaire voltooiing (Werkelijk)

7 augustus 2018

Studie voltooiing (Geschat)

24 juni 2027

Studieregistratiedata

Eerst ingediend

24 juni 2013

Eerst ingediend dat voldeed aan de QC-criteria

24 juni 2013

Eerst geplaatst (Geschat)

26 juni 2013

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

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

NCI-2013-01220
U10CA180821 (Subsidie/contract van de Amerikaanse NIH)
U10CA031946 (Subsidie/contract van de Amerikaanse NIH)
NCI-2013-01220 (Register-ID: CTRP (Clinical Trial Reporting Program))
ALLIANCE A041202
A041202 (Andere identificatie: CTEP)
K23CA178183 (Subsidie/contract van de Amerikaanse NIH)
R01CA183444 (Subsidie/contract van de Amerikaanse NIH)
A041202 (Andere identificatie: Alliance for Clinical Trials in Oncology)

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 .

Rituximab en Bendamustine Hydrochloride, Rituximab en Ibrutinib, of alleen Ibrutinib bij de behandeling van oudere patiënten met niet eerder behandelde chronische lymfatische leukemie

Een gerandomiseerde fase III-studie van alleen bendamustine plus rituximab versus ibrutinib plus rituximab versus alleen ibrutinib bij onbehandelde oudere patiënten (>/= 65 jaar) met chronische lymfatische leukemie (CLL)

Studie Overzicht

Toestand

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Studietype

Inschrijving (Werkelijk)

Fase

Contacten en locaties

Studie Locaties

Deelname Criteria

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

Accepteert gezonde vrijwilligers

Geslachten die in aanmerking komen voor studie

Beschrijving

Studie plan

Hoe is de studie opgezet?

Ontwerpdetails

Aantal wapens

Wapens en interventies

Deelnemersgroep / Arm

Interventie / Behandeling

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat

Maatregel Beschrijving

Tijdsspanne

Secundaire uitkomstmaten

Uitkomstmaat

Maatregel Beschrijving

Tijdsspanne

Andere uitkomstmaten

Uitkomstmaat

Maatregel Beschrijving

Tijdsspanne

Medewerkers en onderzoekers

Sponsor

Onderzoekers

Publicaties en nuttige links

Algemene publicaties

Nuttige links

Studie record data

Bestudeer belangrijke data

Studie start (Werkelijk)

Primaire voltooiing (Werkelijk)

Studie voltooiing (Geschat)

Studieregistratiedata

Eerst ingediend

Eerst ingediend dat voldeed aan de QC-criteria

Eerst geplaatst (Geschat)

Updates van studierecords

Laatste update geplaatst (Werkelijk)

Laatste update ingediend die voldeed aan QC-criteria

Laatst geverifieerd

Meer informatie

Termen gerelateerd aan deze studie

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers