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Nivolumab og Ipilimumab i behandling av pasienter med esophageal og gastroøsofageal Junction Adenocarcinoma som gjennomgår kirurgi

30. oktober 2026 oppdatert av: National Cancer Institute (NCI)

En fase II/III-studie av perioperativt nivolumab og ipilimumab hos pasienter med lokoregionalt adenokarsinom i spiserøret og gastroøsofagealt.

This phase II/III trial studies the usefulness of treatment with nivolumab and ipilimumab in addition to standard of care chemotherapy and radiation therapy in patients with esophageal and gastroesophageal junction adenocarcinoma who are undergoing surgery. Immunotherapy with antibodies, such as nivolumab and ipilimumab, may remove the brake on the body's immune system and may interfere with the ability of tumor cells to grow and spread. Chemotherapy and radiation therapy may reduce the tumor size and the amount of normal tissue that needs to be removed during surgery. A combined treatment with nivolumab and ipilimumab, chemotherapy, and radiation therapy might be more effective in patients with esophageal and gastroesophageal junction adenocarcinoma who are undergoing surgery.

Studieoversikt

Status

Status

Indikerer gjeldende rekrutteringsstatus eller utvidet tilgangsstatus.
Suspendert

Forhold

Forhold

Sykdommen, lidelsen, syndromet, sykdommen eller skaden som studeres. På ClinicalTrials.gov kan tilstander også inkludere andre helserelaterte problemer, som levetid, livskvalitet og helserisiko.

Intervensjon / Behandling

Intervensjon / Behandling

En prosess eller handling som er fokus for en klinisk studie. Intervensjoner inkluderer legemidler, medisinsk utstyr, prosedyrer, vaksiner og andre produkter som enten er undersøkende eller allerede er tilgjengelige. Intervensjoner kan også inkludere ikke-invasive tilnærminger, som utdanning eller modifisering av kosthold og trening.

Detaljert beskrivelse

PRIMARY OBJECTIVES:

I. To assess the pathologic complete response (pathCR) rate following administration of neoadjuvant carboplatin, paclitaxel and radiation therapy versus neoadjuvant carboplatin, paclitaxel, radiation therapy and nivolumab in patients with a resected locoregionally advanced esophageal or gastroesophageal junction adenocarcinoma.

II. To assess the disease-free survival (DFS) following administration of adjuvant nivolumab and ipilimumab versus adjuvant nivolumab in patients with a resected locoregionally advanced esophageal or gastroesophageal junction adenocarcinoma who received neoadjuvant treatment with carboplatin, paclitaxel and radiation therapy with or without nivolumab.

SECONDARY OBJECTIVES:

I. To assess the overall survival (OS) following administration of adjuvant nivolumab and ipilimumab versus nivolumab in patients with a resected locoregional esophageal or gastroesophageal junctional adenocarcinoma who received neoadjuvant treatment with carboplatin, paclitaxel and radiation therapy with or without nivolumab.

II. To assess the disease free survival (DFS) following administration of neoadjuvant carboplatin, paclitaxel, and radiation therapy with or without nivolumab in patients with a locoregional esophageal or gastroesophageal junction adenocarcinoma.

III. To assess the toxicity associated with the administration of neoadjuvant nivolumab in combination with carboplatin, paclitaxel and radiation therapy in patients with a locoregional esophageal or gastroesophageal junction adenocarcinoma.

IV. To assess the toxicity associated with the administration of adjuvant nivolumab and ipilimumab versus adjuvant nivolumab in patients with a resected locoregional esophageal or gastroesophageal junction adenocarcinoma who received neoadjuvant treatment with carboplatin, paclitaxel and radiation therapy with or without nivolumab.

OUTLINE:

STEP I: Patients are randomized to 1 of 2 arms.

ARM A: Patients receive carboplatin intravenously (IV) and paclitaxel IV once weekly and undergo radiation therapy once daily (QD) (Monday-Friday) beginning on day 1 of each cycle. Cycles repeat every week for up to 5 weeks in the absence of disease progression or unacceptable toxicity. Patients undergo a computed tomography (CT) or positron emission tomography (PET) scan during screening and follow-up and undergo collection of blood samples throughout the trial.

ARM B: Patients receive carboplatin, paclitaxel, and radiation therapy as in Arm A. Patients also receive nivolumab IV over 30 minutes on days 1 and 15 of each cycle. Cycles repeat every week for up to 5 weeks in the absence of disease progression or unacceptable toxicity. Patients undergo a CT or PET scan during screening and follow-up and undergo collection of blood samples throughout the trial.

STEP II: Patients are randomized to 1 of 2 arms following standard of care surgery.

ARM C: Patients receive nivolumab IV over 30 minutes on day 1 of each cycle. Treatment repeats every 4 weeks for up to 13 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo a CT scan and collection of blood samples throughout the trial.

ARM D: Patients receive nivolumab as in Arm C and receive ipilimumab IV over 90 minutes on day 1 of cycles 1 and 4 and day 15 of cycles 2 and 5. Treatment repeats every 4 weeks for up to 13 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo a CT scan and collection of blood samples throughout the trial.

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

Studietype

Studietype

Beskriver arten av en klinisk studie. Studietyper inkluderer intervensjonsstudier (også kalt kliniske studier), observasjonsstudier (inkludert pasientregistre) og utvidet tilgang.
Intervensjonell

Registrering (Antatt)

Registrering

Antall deltakere i en klinisk studie. Den "forventede" påmeldingen er måltallet for deltakere som forskerne trenger for studien.
278

Fase

Fase

Stadiet av en klinisk studie som studerer et medikament eller biologisk produkt, basert på definisjoner utviklet av U.S. Food and Drug Administration (FDA). Fasen er basert på studiens målsetting, antall deltakere og andre egenskaper. Det er fem faser: Tidlig fase 1 (tidligere oppført som fase 0), fase 1, fase 2, fase 3 og fase 4. Ikke relevant brukes til å beskrive studier uten FDA-definerte faser, inkludert utprøving av enheter eller atferdsintervensjoner.
  • Fase 2
  • Fase 3

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Forente stater
    • Alaska
      • Anchorage, Alaska, Forente stater, 98508
        • Anchorage Associates in Radiation Medicine
      • Anchorage, Alaska, Forente stater, 99508
        • Alaska Breast Care and Surgery LLC
      • Anchorage, Alaska, Forente stater, 99508
        • Alaska Oncology and Hematology LLC
      • Anchorage, Alaska, Forente stater, 99508
        • Alaska Women's Cancer Care
      • Anchorage, Alaska, Forente stater, 99508
        • Anchorage Oncology Centre
      • Anchorage, Alaska, Forente stater, 99508
        • Katmai Oncology Group
      • Anchorage, Alaska, Forente stater, 99508
        • Providence Alaska Medical Center
    • Arizona
      • Phoenix, Arizona, Forente stater, 85004
        • Cancer Center at Saint Joseph's
    • Arkansas
      • Fort Smith, Arkansas, Forente stater, 72903
        • Mercy Hospital Fort Smith
      • Hot Springs, Arkansas, Forente stater, 71913
        • CHI Saint Vincent Cancer Center Hot Springs
      • Jonesboro, Arkansas, Forente stater, 72401
        • NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
    • California
      • Arroyo Grande, California, Forente stater, 93420
        • PCR Oncology
      • Burbank, California, Forente stater, 91505
        • Providence Saint Joseph Medical Center/Disney Family Cancer Center
      • Clovis, California, Forente stater, 93611
        • Community Cancer Institute
      • Clovis, California, Forente stater, 93611
        • University Oncology Associates
      • Los Angeles, California, Forente stater, 90033
        • USC / Norris Comprehensive Cancer Center
      • Los Angeles, California, Forente stater, 90033
        • Los Angeles General Medical Center
      • Palo Alto, California, Forente stater, 94304
        • VA Palo Alto Health Care System
      • Palo Alto, California, Forente stater, 94304
        • Stanford Cancer Institute Palo Alto
      • Sacramento, California, Forente stater, 95817
        • University of California Davis Comprehensive Cancer Center
      • Sacramento, California, Forente stater, 95816
        • Mercy Cancer Center - Sacramento
      • San Luis Obispo, California, Forente stater, 93401
        • Pacific Central Coast Health Center-San Luis Obispo
      • Santa Maria, California, Forente stater, 93444
        • Mission Hope Medical Oncology - Santa Maria
      • St. Helena, California, Forente stater, 94574
        • Saint Helena Hospital
      • Whittier, California, Forente stater, 90602
        • Presbyterian Intercommunity Hospital
      • Woodland, California, Forente stater, 95695
        • Woodland Memorial Hospital
    • Colorado
      • Colorado Springs, Colorado, Forente stater, 80907
        • Penrose-Saint Francis Healthcare
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        • Rocky Mountain Cancer Centers-Penrose
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        • Saint Francis Cancer Center
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        • AdventHealth Porter
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        • CommonSpirit Saint Anthony Hospital Cancer Center
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        • Helen F Graham Cancer Center
      • Newark, Delaware, Forente stater, 19713
        • Delaware Clinical and Laboratory Physicians PA
      • Newark, Delaware, Forente stater, 19713
        • Medical Oncology Hematology Consultants PA
      • Newark, Delaware, Forente stater, 19718
        • Christiana Care Health System-Christiana Hospital
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        • Mount Sinai Comprehensive Cancer Center at Aventura
      • Fort Lauderdale, Florida, Forente stater, 33308
        • Holy Cross Hospital
      • Fort Myers, Florida, Forente stater, 33905
        • Regional Cancer Center-Lee Memorial Health System
      • Gainesville, Florida, Forente stater, 32610
        • UF Health Cancer Institute - Gainesville
      • Kissimmee, Florida, Forente stater, 34744
        • AdventHealth Kissimmee
      • Miami Beach, Florida, Forente stater, 33140
        • Mount Sinai Medical Center
      • Orlando, Florida, Forente stater, 32803
        • AdventHealth Orlando
      • Orlando, Florida, Forente stater, 32822
        • AdventHealth East Orlando
    • Georgia
      • Atlanta, Georgia, Forente stater, 30308
        • Emory University Hospital Midtown
      • Atlanta, Georgia, Forente stater, 30322
        • Emory University Hospital/Winship Cancer Institute
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        • Emory Saint Joseph's Hospital
      • Atlanta, Georgia, Forente stater, 30308
        • Emory Proton Therapy Center
      • Savannah, Georgia, Forente stater, 31405
        • Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
    • Hawaii
      • Honolulu, Hawaii, Forente stater, 96813
        • Queen's Medical Center
      • Honolulu, Hawaii, Forente stater, 96817
        • The Cancer Center of Hawaii-Liliha
      • Honolulu, Hawaii, Forente stater, 96813
        • Hawaii Cancer Care Inc - Waterfront Plaza
      • Honolulu, Hawaii, Forente stater, 96813
        • Queen's Cancer Cenrer - POB I
      • Honolulu, Hawaii, Forente stater, 96813
        • Straub Clinic and Hospital
      • Honolulu, Hawaii, Forente stater, 96813
        • University of Hawaii Cancer Center
      • Honolulu, Hawaii, Forente stater, 96817
        • Hawaii Cancer Care Inc-Liliha
      • Honolulu, Hawaii, Forente stater, 96817
        • Kuakini Medical Center
      • Honolulu, Hawaii, Forente stater, 96817
        • Queen's Cancer Center - Kuakini
      • Honolulu, Hawaii, Forente stater, 96826
        • Kapiolani Medical Center for Women and Children
      • Honolulu, Hawaii, Forente stater, 96813
        • Island Urology
      • Lihue, Hawaii, Forente stater, 96766
        • Wilcox Memorial Hospital and Kauai Medical Clinic
      • ‘Aiea, Hawaii, Forente stater, 96701
        • Hawaii Cancer Care - Westridge
      • ‘Aiea, Hawaii, Forente stater, 96701
        • Pali Momi Medical Center
      • ‘Aiea, Hawaii, Forente stater, 96701
        • Queen's Cancer Center - Pearlridge
      • ‘Aiea, Hawaii, Forente stater, 96701
        • The Cancer Center of Hawaii-Pali Momi
    • Idaho
      • Boise, Idaho, Forente stater, 83712
        • Saint Luke's Cancer Institute - Boise
      • Fruitland, Idaho, Forente stater, 83619
        • Saint Luke's Cancer Institute - Fruitland
      • Meridian, Idaho, Forente stater, 83642
        • Saint Luke's Cancer Institute - Meridian
      • Nampa, Idaho, Forente stater, 83687
        • Saint Luke's Cancer Institute - Nampa
      • Twin Falls, Idaho, Forente stater, 83301
        • Saint Luke's Cancer Institute - Twin Falls
    • Illinois
      • Bloomington, Illinois, Forente stater, 61704
        • Illinois CancerCare-Bloomington
      • Canton, Illinois, Forente stater, 61520
        • Illinois CancerCare-Canton
      • Carbondale, Illinois, Forente stater, 62902
        • Memorial Hospital of Carbondale
      • Carterville, Illinois, Forente stater, 62918
        • SIH Cancer Institute
      • Carthage, Illinois, Forente stater, 62321
        • Illinois CancerCare-Carthage
      • Centralia, Illinois, Forente stater, 62801
        • Centralia Oncology Clinic
      • Chicago, Illinois, Forente stater, 60611
        • Northwestern University
      • Chicago, Illinois, Forente stater, 60612
        • University of Illinois
      • Decatur, Illinois, Forente stater, 62526
        • Decatur Memorial Hospital
      • Decatur, Illinois, Forente stater, 62526
        • Cancer Care Specialists of Illinois - Decatur
      • Dixon, Illinois, Forente stater, 61021
        • Illinois CancerCare-Dixon
      • Effingham, Illinois, Forente stater, 62401
        • Crossroads Cancer Center
      • Eureka, Illinois, Forente stater, 61530
        • Illinois CancerCare-Eureka
      • Galesburg, Illinois, Forente stater, 61401
        • Western Illinois Cancer Treatment Center
      • Galesburg, Illinois, Forente stater, 61401
        • Illinois CancerCare-Galesburg
      • Hines, Illinois, Forente stater, 60141
        • Edward Hines Jr VA Hospital
      • Kewanee, Illinois, Forente stater, 61443
        • Illinois CancerCare-Kewanee Clinic
      • Lake Forest, Illinois, Forente stater, 60045
        • Northwestern Medicine Lake Forest Hospital
      • Macomb, Illinois, Forente stater, 61455
        • Illinois CancerCare-Macomb
      • Maywood, Illinois, Forente stater, 60153
        • Loyola University Medical Center
      • Mount Vernon, Illinois, Forente stater, 62864
        • SSM Health Good Samaritan
      • O'Fallon, Illinois, Forente stater, 62269
        • Cancer Care Center of O'Fallon
      • Ottawa, Illinois, Forente stater, 61350
        • Illinois CancerCare-Ottawa Clinic
      • Pekin, Illinois, Forente stater, 61554
        • Illinois CancerCare-Pekin
      • Pekin, Illinois, Forente stater, 61554
        • OSF Saint Francis Radiation Oncology at Pekin
      • Peoria, Illinois, Forente stater, 61636
        • Methodist Medical Center of Illinois
      • Peoria, Illinois, Forente stater, 61637
        • OSF Saint Francis Medical Center
      • Peoria, Illinois, Forente stater, 61615
        • Illinois CancerCare-Peoria
      • Peoria, Illinois, Forente stater, 61615
        • OSF Saint Francis Radiation Oncology at Peoria Cancer Center
      • Peru, Illinois, Forente stater, 61354
        • Illinois CancerCare-Peru
      • Peru, Illinois, Forente stater, 61354
        • Valley Radiation Oncology
      • Princeton, Illinois, Forente stater, 61356
        • Illinois CancerCare-Princeton
      • Springfield, Illinois, Forente stater, 62702
        • Southern Illinois University School of Medicine
      • Springfield, Illinois, Forente stater, 62702
        • Springfield Clinic
      • Springfield, Illinois, Forente stater, 62781
        • Springfield Memorial Hospital
      • Washington, Illinois, Forente stater, 61571
        • Illinois CancerCare - Washington
    • Indiana
      • Carmel, Indiana, Forente stater, 46032
        • IU Health North Hospital
      • Indianapolis, Indiana, Forente stater, 46202
        • Indiana University/Melvin and Bren Simon Cancer Center
      • Richmond, Indiana, Forente stater, 47374
        • Reid Health
    • Iowa
      • Clive, Iowa, Forente stater, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Forente stater, 50325
        • UI Health Care Mission Cancer and Blood - West Des Moines Clinic
      • Creston, Iowa, Forente stater, 50801
        • Greater Regional Medical Center
      • Des Moines, Iowa, Forente stater, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Forente stater, 50314
        • UI Health Care Mission Cancer and Blood - Laurel Clinic
      • West Des Moines, Iowa, Forente stater, 50266
        • Mercy Medical Center-West Lakes
    • Kansas
      • Garden City, Kansas, Forente stater, 67846
        • Central Care Cancer Center - Garden City
      • Great Bend, Kansas, Forente stater, 67530
        • Central Care Cancer Center - Great Bend
    • Kentucky
      • Lexington, Kentucky, Forente stater, 40504
        • Saint Joseph Radiation Oncology Resource Center
      • Lexington, Kentucky, Forente stater, 40509
        • CommonSpirit Saint Joseph Medical Center - East Lexington
      • Lexington, Kentucky, Forente stater, 40504
        • CommonSpirit Saint Joseph Hospital - Lexington
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        • Jewish Hospital
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        • UofL Health Medical Center Northeast
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        • Eastern Maine Medical Center
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        • MaineHealth Coastal Cancer Treatment Center
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        • MaineHealth Maine Medical Center - Biddeford
      • Brewer, Maine, Forente stater, 04412
        • Lafayette Family Cancer Center-EMMC
      • Portland, Maine, Forente stater, 04102
        • MaineHealth Maine Medical Center - Portland
      • Sanford, Maine, Forente stater, 04073
        • MaineHealth Cancer Care Center of York County
      • Sanford, Maine, Forente stater, 04073
        • MaineHealth Cancer Care and IV Therapy - Sanford
      • Scarborough, Maine, Forente stater, 04074
        • MaineHealth Maine Medical Center- Scarborough
      • South Portland, Maine, Forente stater, 04106
        • MaineHealth Cancer Care and IV Therapy - South Portland
    • Massachusetts
      • Boston, Massachusetts, Forente stater, 02111
        • Tufts Medical Center
      • Boston, Massachusetts, Forente stater, 02118
        • Boston Medical Center
      • Lowell, Massachusetts, Forente stater, 01854
        • Lowell General Hospital
    • Michigan
      • Ann Arbor, Michigan, Forente stater, 48106
        • Trinity Health Saint Joseph Mercy Hospital Ann Arbor
      • Brighton, Michigan, Forente stater, 48114
        • Trinity Health IHA Medical Group Hematology Oncology - Brighton
      • Brighton, Michigan, Forente stater, 48114
        • Trinity Health Medical Center - Brighton
      • Canton, Michigan, Forente stater, 48188
        • Trinity Health IHA Medical Group Hematology Oncology - Canton
      • Canton, Michigan, Forente stater, 48188
        • Trinity Health Medical Center - Canton
      • Caro, Michigan, Forente stater, 48723
        • Caro Cancer Center
      • Chelsea, Michigan, Forente stater, 48118
        • Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
      • Chelsea, Michigan, Forente stater, 48118
        • Chelsea Hospital
      • Detroit, Michigan, Forente stater, 48236
        • Henry Ford Health Saint John Hospital
      • Flint, Michigan, Forente stater, 48503
        • Hurley Medical Center
      • Flint, Michigan, Forente stater, 48503
        • Genesys Hurley Cancer Institute
      • Grosse Pointe Woods, Michigan, Forente stater, 48236
        • Henry Ford Saint John Hospital - Van Elslander
      • Lansing, Michigan, Forente stater, 48912
        • University of Michigan Health - Sparrow Lansing
      • Livonia, Michigan, Forente stater, 48154
        • Trinity Health Saint Mary Mercy Livonia Hospital
      • Macomb, Michigan, Forente stater, 48044
        • Henry Ford Saint John Hospital - Macomb Medical
      • Marlette, Michigan, Forente stater, 48453
        • Saint Mary's Oncology/Hematology Associates of Marlette
      • Novi, Michigan, Forente stater, 48374
        • Henry Ford Health Providence Novi Hospital
      • Pontiac, Michigan, Forente stater, 48341
        • Trinity Health Saint Joseph Mercy Oakland Hospital
      • Pontiac, Michigan, Forente stater, 48341
        • Michigan Healthcare Professionals Pontiac
      • Saginaw, Michigan, Forente stater, 48604
        • Oncology Hematology Associates of Saginaw Valley PC
      • Saginaw, Michigan, Forente stater, 48601
        • MyMichigan Medical Center Saginaw
      • Southfield, Michigan, Forente stater, 48075
        • Henry Ford Health Providence Southfield Hospital
      • Tawas City, Michigan, Forente stater, 48764
        • MyMichigan Medical Center Tawas
      • Warren, Michigan, Forente stater, 48093
        • Henry Ford Health Warren Hospital
      • West Branch, Michigan, Forente stater, 48661
        • Saint Mary's Oncology/Hematology Associates of West Branch
      • Ypsilanti, Michigan, Forente stater, 48197
        • Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
    • Minnesota
      • Bemidji, Minnesota, Forente stater, 56601
        • Sanford Joe Lueken Cancer Center
      • Brainerd, Minnesota, Forente stater, 56401
        • Essentia Health Saint Joseph's Medical Center
      • Burnsville, Minnesota, Forente stater, 55337
        • Fairview Ridges Hospital
      • Burnsville, Minnesota, Forente stater, 55337
        • Minnesota Oncology - Burnsville
      • Coon Rapids, Minnesota, Forente stater, 55433
        • Mercy Hospital
      • Deer River, Minnesota, Forente stater, 56636
        • Essentia Health - Deer River Clinic
      • Detroit Lakes, Minnesota, Forente stater, 56501
        • Essentia Health Saint Mary's - Detroit Lakes Clinic
      • Duluth, Minnesota, Forente stater, 55805
        • Essentia Health Cancer Center
      • Duluth, Minnesota, Forente stater, 55805
        • Essentia Health Saint Mary's Medical Center
      • Duluth, Minnesota, Forente stater, 55805
        • Miller-Dwan Hospital
      • Edina, Minnesota, Forente stater, 55435
        • Fairview Southdale Hospital
      • Edina, Minnesota, Forente stater, 55435
        • Minnesota Oncology - Edina
      • Fergus Falls, Minnesota, Forente stater, 56537
        • Lake Region Healthcare Corporation-Cancer Care
      • Fosston, Minnesota, Forente stater, 56542
        • Essentia Health - Fosston
      • Fridley, Minnesota, Forente stater, 55432
        • Unity Hospital
      • Hibbing, Minnesota, Forente stater, 55746
        • Essentia Health Hibbing Clinic
      • Maple Grove, Minnesota, Forente stater, 55369
        • Fairview Clinics and Surgery Center Maple Grove
      • Maplewood, Minnesota, Forente stater, 55109
        • Saint John's Hospital - Healtheast
      • Maplewood, Minnesota, Forente stater, 55109
        • Minnesota Oncology Hematology PA-Maplewood
      • Minneapolis, Minnesota, Forente stater, 55415
        • Hennepin County Medical Center
      • Minneapolis, Minnesota, Forente stater, 55407
        • Abbott-Northwestern Hospital
      • Minneapolis, Minnesota, Forente stater, 55454
        • Health Partners Inc
      • Monticello, Minnesota, Forente stater, 55362
        • Monticello Cancer Center
      • Park Rapids, Minnesota, Forente stater, 56470
        • Essentia Health - Park Rapids
      • Robbinsdale, Minnesota, Forente stater, 55422
        • North Memorial Medical Health Center
      • Rochester, Minnesota, Forente stater, 55905
        • Mayo Clinic in Rochester
      • Saint Louis Park, Minnesota, Forente stater, 55416
        • Park Nicollet Clinic - Saint Louis Park
      • Saint Paul, Minnesota, Forente stater, 55101
        • Regions Hospital
      • Saint Paul, Minnesota, Forente stater, 55102
        • United Hospital
      • Sandstone, Minnesota, Forente stater, 55072
        • Essentia Health Sandstone
      • Shakopee, Minnesota, Forente stater, 55379
        • Saint Francis Regional Medical Center
      • Stillwater, Minnesota, Forente stater, 55082
        • Lakeview Hospital
      • Virginia, Minnesota, Forente stater, 55792
        • Essentia Health Virginia Clinic
      • Waconia, Minnesota, Forente stater, 55387
        • Ridgeview Medical Center
      • Willmar, Minnesota, Forente stater, 56201
        • Rice Memorial Hospital
      • Woodbury, Minnesota, Forente stater, 55125
        • Minnesota Oncology Hematology PA-Woodbury
    • Mississippi
      • Columbus, Mississippi, Forente stater, 39705
        • Baptist Memorial Hospital and Cancer Center-Golden Triangle
      • Grenada, Mississippi, Forente stater, 38901
        • Baptist Cancer Center-Grenada
      • New Albany, Mississippi, Forente stater, 38652
        • Baptist Memorial Hospital and Cancer Center-Union County
      • Oxford, Mississippi, Forente stater, 38655
        • Baptist Memorial Hospital and Cancer Center-Oxford
      • Southhaven, Mississippi, Forente stater, 38671
        • Baptist Memorial Hospital and Cancer Center-Desoto
    • Missouri
      • Ballwin, Missouri, Forente stater, 63011
        • Mercy Oncology and Hematology - Clayton-Clarkson
      • Bolivar, Missouri, Forente stater, 65613
        • Central Care Cancer Center - Bolivar
      • Cape Girardeau, Missouri, Forente stater, 63703
        • Saint Francis Medical Center
      • Cape Girardeau, Missouri, Forente stater, 63703
        • Mercy Cancer Center - Cape Girardeau
      • City of Saint Peters, Missouri, Forente stater, 63376
        • Siteman Cancer Center at Saint Peters Hospital
      • Creve Coeur, Missouri, Forente stater, 63141
        • Siteman Cancer Center at West County Hospital
      • Farmington, Missouri, Forente stater, 63640
        • Parkland Health Center - Farmington
      • Jefferson City, Missouri, Forente stater, 65109
        • MU Health Care Goldschmidt Cancer Center
      • Joplin, Missouri, Forente stater, 64804
        • Freeman Health System
      • Joplin, Missouri, Forente stater, 64804
        • Mercy Hospital Joplin
      • Rolla, Missouri, Forente stater, 65401
        • Mercy Clinic-Rolla-Cancer and Hematology
      • Rolla, Missouri, Forente stater, 65401
        • Phelps Health Delbert Day Cancer Institute
      • Saint Joseph, Missouri, Forente stater, 64506
        • Heartland Regional Medical Center
      • Sainte Genevieve, Missouri, Forente stater, 63670
        • Sainte Genevieve County Memorial Hospital
      • Springfield, Missouri, Forente stater, 65807
        • CoxHealth South Hospital
      • Springfield, Missouri, Forente stater, 65804
        • Mercy Hospital Springfield
      • St Louis, Missouri, Forente stater, 63110
        • Washington University School of Medicine
      • St Louis, Missouri, Forente stater, 63129
        • Siteman Cancer Center-South County
      • St Louis, Missouri, Forente stater, 63136
        • Siteman Cancer Center at Christian Hospital
      • St Louis, Missouri, Forente stater, 63131
        • Missouri Baptist Medical Center
      • St Louis, Missouri, Forente stater, 63141
        • Mercy Hospital Saint Louis
      • St Louis, Missouri, Forente stater, 63128
        • Mercy Hospital South
      • Sullivan, Missouri, Forente stater, 63080
        • Missouri Baptist Sullivan Hospital
    • Montana
      • Missoula, Montana, Forente stater, 59802
        • Saint Patrick Hospital - Community Hospital
    • Nebraska
      • Bellevue, Nebraska, Forente stater, 68123
        • Nebraska Medicine-Bellevue
      • Grand Island, Nebraska, Forente stater, 68803
        • Nebraska Cancer Specialists/Oncology Hematology West PC
      • Kearney, Nebraska, Forente stater, 68847
        • CHI Health Good Samaritan
      • Omaha, Nebraska, Forente stater, 68198
        • University of Nebraska Medical Center
      • Omaha, Nebraska, Forente stater, 68124
        • Alegent Health Bergan Mercy Medical Center
      • Omaha, Nebraska, Forente stater, 68118
        • Nebraska Medicine-Village Pointe
      • Omaha, Nebraska, Forente stater, 68122
        • Alegent Health Immanuel Medical Center
      • Omaha, Nebraska, Forente stater, 68130
        • Alegent Health Lakeside Hospital
    • Nevada
      • Henderson, Nevada, Forente stater, 89052
        • Comprehensive Cancer Centers of Nevada - Henderson
      • Henderson, Nevada, Forente stater, 89074
        • Oncology Las Vegas - Henderson
      • Las Vegas, Nevada, Forente stater, 89102
        • OptumCare Cancer Care at Charleston
      • Las Vegas, Nevada, Forente stater, 89106
        • Radiation Oncology Centers of Nevada Central
      • Las Vegas, Nevada, Forente stater, 89119
        • Radiation Oncology Centers of Nevada Southeast
      • Las Vegas, Nevada, Forente stater, 89128
        • Comprehensive Cancer Centers of Nevada - Northwest
      • Las Vegas, Nevada, Forente stater, 89128
        • OptumCare Cancer Care at MountainView
      • Las Vegas, Nevada, Forente stater, 89135
        • Alliance for Childhood Diseases/Cure 4 the Kids Foundation
      • Las Vegas, Nevada, Forente stater, 89144
        • Comprehensive Cancer Centers of Nevada - Town Center
      • Las Vegas, Nevada, Forente stater, 89144
        • Comprehensive Cancer Centers of Nevada-Summerlin
      • Las Vegas, Nevada, Forente stater, 89148
        • Comprehensive Cancer Centers of Nevada
      • Las Vegas, Nevada, Forente stater, 89169
        • Comprehensive Cancer Centers of Nevada - Central Valley
      • Las Vegas, Nevada, Forente stater, 89183
        • OptumCare Cancer Care at Fort Apache
      • Reno, Nevada, Forente stater, 89502
        • Renown Regional Medical Center
      • Reno, Nevada, Forente stater, 89503
        • Saint Mary's Regional Medical Center
      • Reno, Nevada, Forente stater, 89509
        • Radiation Oncology Associates
    • New Hampshire
      • Lebanon, New Hampshire, Forente stater, 03756
        • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
    • New Jersey
      • Brick, New Jersey, Forente stater, 08724
        • Ocean University Medical Center
      • Long Branch, New Jersey, Forente stater, 07740
        • Monmouth Medical Center
      • Manahawkin, New Jersey, Forente stater, 08050
        • Southern Ocean County Medical Center
      • Neptune City, New Jersey, Forente stater, 07753
        • Jersey Shore Medical Center
      • New Brunswick, New Jersey, Forente stater, 08903
        • Rutgers Cancer Institute of New Jersey
      • Red Bank, New Jersey, Forente stater, 07701
        • Riverview Medical Center/Booker Cancer Center
      • Toms River, New Jersey, Forente stater, 08755
        • Community Medical Center
    • New Mexico
      • Albuquerque, New Mexico, Forente stater, 87102
        • Lovelace Medical Center-Saint Joseph Square
      • Albuquerque, New Mexico, Forente stater, 87109
        • New Mexico Oncology Hematology Consultants
      • Albuquerque, New Mexico, Forente stater, 87106
        • University of New Mexico Cancer Center
      • Albuquerque, New Mexico, Forente stater, 87110
        • Presbyterian Kaseman Hospital
      • Rio Rancho, New Mexico, Forente stater, 87124
        • Presbyterian Rust Medical Center/Jorgensen Cancer Center
    • New York
      • Canandaigua, New York, Forente stater, 14424
        • Sands Cancer Center
      • Dansville, New York, Forente stater, 14437
        • Noyes Memorial Hospital/Myers Cancer Center
      • Glens Falls, New York, Forente stater, 12801
        • Glens Falls Hospital
      • Lake Success, New York, Forente stater, 11042
        • Northwell Health/Center for Advanced Medicine
      • Middletown, New York, Forente stater, 10940
        • Garnet Health Medical Center
      • New York, New York, Forente stater, 10065
        • NYP/Weill Cornell Medical Center
      • New York, New York, Forente stater, 10016
        • Laura and Isaac Perlmutter Cancer Center at NYU Langone
      • Rochester, New York, Forente stater, 14642
        • University of Rochester
      • Syracuse, New York, Forente stater, 13210
        • State University of New York Upstate Medical University
      • The Bronx, New York, Forente stater, 10461
        • Montefiore Medical Center-Einstein Campus
      • The Bronx, New York, Forente stater, 10467
        • Montefiore Medical Center - Moses Campus
      • The Bronx, New York, Forente stater, 10461
        • Montefiore Medical Center-Weiler Hospital
    • North Carolina
      • Charlotte, North Carolina, Forente stater, 28204
        • Novant Health Presbyterian Medical Center
      • Huntersville, North Carolina, Forente stater, 28078
        • Novant Health Cancer Institute - Huntersville
      • Huntersville, North Carolina, Forente stater, 28078
        • Novant Health Presbyterian Medical Center Huntersville
      • Kernersville, North Carolina, Forente stater, 27284
        • Novant Health Cancer Institute - Kernersville
      • Matthews, North Carolina, Forente stater, 28105
        • Matthews Radiation Oncology Center
      • Matthews, North Carolina, Forente stater, 28105
        • Novant Health Cancer Institute - Matthews
      • Mooresville, North Carolina, Forente stater, 28117
        • Novant Health Cancer Institute - Mooresville
      • Mount Airy, North Carolina, Forente stater, 27030
        • Novant Health Cancer Institute - Mount Airy
      • North Wilkesboro, North Carolina, Forente stater, 28659
        • Novant Health Cancer Institute - Wilkesboro
      • Salisbury, North Carolina, Forente stater, 28144
        • Rowan Regional Medical Center
      • Statesville, North Carolina, Forente stater, 28625
        • Novant Health Cancer Institute - Statesville
      • Thomasville, North Carolina, Forente stater, 27360
        • Novant Health Cancer Institute - Thomasville
      • Winston-Salem, North Carolina, Forente stater, 27103
        • Novant Health Forsyth Medical Center
    • North Dakota
      • Bismarck, North Dakota, Forente stater, 58501
        • Sanford Bismarck Medical Center
      • Fargo, North Dakota, Forente stater, 58122
        • Sanford Roger Maris Cancer Center
      • Fargo, North Dakota, Forente stater, 58103
        • Essentia Health Cancer Center-South University Clinic
      • Fargo, North Dakota, Forente stater, 58122
        • Sanford Broadway Medical Center
      • Jamestown, North Dakota, Forente stater, 58401
        • Essentia Health - Jamestown Clinic
    • Ohio
      • Beavercreek, Ohio, Forente stater, 45431
        • Indu and Raj Soin Medical Center
      • Boardman, Ohio, Forente stater, 44512
        • Saint Elizabeth Boardman Hospital
      • Centerville, Ohio, Forente stater, 45459
        • Miami Valley Hospital South
      • Centerville, Ohio, Forente stater, 45459
        • Dayton Physicians LLC-Miami Valley South
      • Cincinnati, Ohio, Forente stater, 45219
        • University of Cincinnati Cancer Center-UC Medical Center
      • Cincinnati, Ohio, Forente stater, 45220
        • Good Samaritan Hospital - Cincinnati
      • Cincinnati, Ohio, Forente stater, 45242
        • Bethesda North Hospital
      • Cincinnati, Ohio, Forente stater, 45236
        • Oncology Hematology Care Inc-Kenwood
      • Cleveland, Ohio, Forente stater, 44109
        • MetroHealth Medical Center
      • Cleveland, Ohio, Forente stater, 44195
        • Cleveland Clinic Foundation
      • Cleveland, Ohio, Forente stater, 44111
        • Cleveland Clinic Cancer Center/Fairview Hospital
      • Columbus, Ohio, Forente stater, 43210
        • Ohio State University Comprehensive Cancer Center
      • Dayton, Ohio, Forente stater, 45409
        • Miami Valley Hospital
      • Dayton, Ohio, Forente stater, 45415
        • Miami Valley Hospital North
      • Dayton, Ohio, Forente stater, 45415
        • Dayton Physician LLC - Englewood
      • Findlay, Ohio, Forente stater, 45840
        • Blanchard Valley Hospital
      • Findlay, Ohio, Forente stater, 45840
        • Armes Family Cancer Center
      • Findlay, Ohio, Forente stater, 45840
        • Orion Cancer Care
      • Franklin, Ohio, Forente stater, 45005-1066
        • Atrium Medical Center-Middletown Regional Hospital
      • Franklin, Ohio, Forente stater, 45005
        • Dayton Physicians LLC-Atrium
      • Greenville, Ohio, Forente stater, 45331
        • Wayne Hospital
      • Greenville, Ohio, Forente stater, 45331
        • Dayton Physicians LLC-Wayne
      • Independence, Ohio, Forente stater, 44131
        • Cleveland Clinic Cancer Center Independence
      • Kettering, Ohio, Forente stater, 45429
        • Kettering Medical Center
      • Kettering, Ohio, Forente stater, 45409
        • Greater Dayton Cancer Center
      • Mansfield, Ohio, Forente stater, 44906
        • Cleveland Clinic Cancer Center Mansfield
      • Mayfield Heights, Ohio, Forente stater, 44124
        • Hillcrest Hospital Cancer Center
      • Sandusky, Ohio, Forente stater, 44870
        • North Coast Cancer Care
      • Springfield, Ohio, Forente stater, 45504
        • Springfield Regional Cancer Center
      • Springfield, Ohio, Forente stater, 45504
        • Springfield Regional Medical Center
      • Strongsville, Ohio, Forente stater, 44136
        • Cleveland Clinic Cancer Center Strongsville
      • Sylvania, Ohio, Forente stater, 43560
        • ProMedica Flower Hospital
      • Toledo, Ohio, Forente stater, 43606
        • ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
      • Troy, Ohio, Forente stater, 45373
        • Upper Valley Medical Center
      • Troy, Ohio, Forente stater, 45373
        • Dayton Physicians LLC - Troy
      • Warren, Ohio, Forente stater, 44484
        • Saint Joseph Warren Hospital
      • Warrensville Heights, Ohio, Forente stater, 44122
        • South Pointe Hospital
      • West Chester, Ohio, Forente stater, 45069
        • University of Cincinnati Cancer Center-West Chester
      • Wooster, Ohio, Forente stater, 44691
        • Cleveland Clinic Wooster Family Health and Surgery Center
      • Youngstown, Ohio, Forente stater, 44501
        • Saint Elizabeth Youngstown Hospital
    • Oklahoma
      • Oklahoma City, Oklahoma, Forente stater, 73120
        • Mercy Hospital Oklahoma City
    • Oregon
      • Bend, Oregon, Forente stater, 97701
        • Saint Charles Health System
      • Clackamas, Oregon, Forente stater, 97015
        • Clackamas Radiation Oncology Center
      • Clackamas, Oregon, Forente stater, 97015
        • Providence Cancer Institute Clackamas Clinic
      • Coos Bay, Oregon, Forente stater, 97420
        • Bay Area Hospital
      • Newberg, Oregon, Forente stater, 97132
        • Providence Newberg Medical Center
      • Portland, Oregon, Forente stater, 97213
        • Providence Portland Medical Center
      • Portland, Oregon, Forente stater, 97225
        • Providence Saint Vincent Medical Center
    • Pennsylvania
      • Allentown, Pennsylvania, Forente stater, 18103
        • Lehigh Valley Hospital-Cedar Crest
      • Allentown, Pennsylvania, Forente stater, 18104
        • Saint Luke's Cancer Center - Allentown
      • Altoona, Pennsylvania, Forente stater, 16601
        • UPMC Altoona
      • Beaver, Pennsylvania, Forente stater, 15009
        • UPMC-Heritage Valley Health System Beaver
      • Bethlehem, Pennsylvania, Forente stater, 18017
        • Lehigh Valley Hospital - Muhlenberg
      • Bethlehem, Pennsylvania, Forente stater, 18015
        • Saint Luke's University Hospital-Bethlehem Campus
      • Butler, Pennsylvania, Forente stater, 16001
        • UPMC Hillman Cancer Center at Butler Health System
      • Camp Hill, Pennsylvania, Forente stater, 17011
        • UPMC Camp Hill
      • Carlisle, Pennsylvania, Forente stater, 17015
        • Carlisle Regional Cancer Center
      • Chadds Ford, Pennsylvania, Forente stater, 19317
        • Christiana Care Health System-Concord Health Center
      • Danville, Pennsylvania, Forente stater, 17822
        • Geisinger Medical Center
      • East Stroudsburg, Pennsylvania, Forente stater, 18301
        • Pocono Medical Center
      • Easton, Pennsylvania, Forente stater, 18045
        • Saint Luke's Hospital-Anderson Campus
      • Erie, Pennsylvania, Forente stater, 16505
        • UPMC Hillman Cancer Center Erie
      • Farrell, Pennsylvania, Forente stater, 16121
        • UPMC Cancer Center at UPMC Horizon
      • Greensburg, Pennsylvania, Forente stater, 15601
        • UPMC Cancer Centers - Arnold Palmer Pavilion
      • Harrisburg, Pennsylvania, Forente stater, 17109
        • UPMC Pinnacle Cancer Center/Community Osteopathic Campus
      • Hershey, Pennsylvania, Forente stater, 17033-0850
        • Penn State Milton S Hershey Medical Center
      • Indiana, Pennsylvania, Forente stater, 15701
        • IRMC Cancer Center
      • Jefferson Hills, Pennsylvania, Forente stater, 15025
        • Jefferson Hospital
      • Johnstown, Pennsylvania, Forente stater, 15901
        • UPMC-Johnstown/John P. Murtha Regional Cancer Center
      • Lewisburg, Pennsylvania, Forente stater, 17837
        • Geisinger Medical Oncology-Lewisburg
      • McKeesport, Pennsylvania, Forente stater, 15132
        • UPMC Cancer Center at UPMC McKeesport
      • Monroeville, Pennsylvania, Forente stater, 15146
        • Forbes Hospital
      • Monroeville, Pennsylvania, Forente stater, 15146
        • UPMC Hillman Cancer Center - Monroeville
      • Monroeville, Pennsylvania, Forente stater, 15146
        • UPMC Cancer Center - Monroeville
      • Moon Township, Pennsylvania, Forente stater, 15108
        • UPMC Hillman Cancer Center in Coraopolis
      • Mount Pleasant, Pennsylvania, Forente stater, 15666
        • UPMC Hillman Cancer Center - Part of Frick Hospital
      • N. Huntingdon, Pennsylvania, Forente stater, 15642
        • Arnold Palmer Cancer Center Medical Oncology Norwin
      • Natrona Heights, Pennsylvania, Forente stater, 15065
        • Allegheny Valley Hospital
      • New Castle, Pennsylvania, Forente stater, 16105
        • UPMC Hillman Cancer Center - New Castle
      • Philadelphia, Pennsylvania, Forente stater, 19104
        • University of Pennsylvania/Abramson Cancer Center
      • Pittsburgh, Pennsylvania, Forente stater, 15212
        • Allegheny General Hospital
      • Pittsburgh, Pennsylvania, Forente stater, 15224
        • West Penn Hospital
      • Pittsburgh, Pennsylvania, Forente stater, 15232
        • UPMC Hillman Cancer Center
      • Pittsburgh, Pennsylvania, Forente stater, 15213
        • UPMC-Magee Womens Hospital
      • Pittsburgh, Pennsylvania, Forente stater, 15232
        • UPMC-Shadyside Hospital
      • Pittsburgh, Pennsylvania, Forente stater, 15215
        • UPMC-Saint Margaret
      • Pittsburgh, Pennsylvania, Forente stater, 15237
        • UPMC-Passavant Hospital
      • Pittsburgh, Pennsylvania, Forente stater, 15243
        • UPMC-Saint Clair Hospital Cancer Center
      • Pottstown, Pennsylvania, Forente stater, 19464
        • Pottstown Hospital
      • Seneca, Pennsylvania, Forente stater, 16346
        • UPMC Cancer Center at UPMC Northwest
      • Uniontown, Pennsylvania, Forente stater, 15401
        • UPMC Uniontown Hospital Radiation Oncology
      • Uniontown, Pennsylvania, Forente stater, 15401
        • UPMC Cancer Center-Uniontown
      • Washington, Pennsylvania, Forente stater, 15301
        • UPMC Washington Hospital Radiation Oncology
      • Washington, Pennsylvania, Forente stater, 15301
        • UPMC Cancer Center-Washington
      • West Mifflin, Pennsylvania, Forente stater, 15122
        • UPMC West Mifflin-Cancer Center Jefferson
      • West Reading, Pennsylvania, Forente stater, 19611
        • Reading Hospital
      • Wexford, Pennsylvania, Forente stater, 15090
        • Wexford Health and Wellness Pavilion
      • York, Pennsylvania, Forente stater, 17408
        • UPMC Memorial
    • Rhode Island
      • East Greenwich, Rhode Island, Forente stater, 02818
        • Rhode Island Hospital at East Greenwich
      • Newport, Rhode Island, Forente stater, 02840
        • Newport Hospital
      • Providence, Rhode Island, Forente stater, 02903
        • Rhode Island Hospital
    • South Carolina
      • Charleston, South Carolina, Forente stater, 29425
        • Medical University of South Carolina
      • Greenville, South Carolina, Forente stater, 29607
        • Saint Francis Cancer Center
      • Greenville, South Carolina, Forente stater, 29601
        • Saint Francis Hospital
    • South Dakota
      • Sioux Falls, South Dakota, Forente stater, 57105
        • Avera Cancer Institute
      • Sioux Falls, South Dakota, Forente stater, 57117-5134
        • Sanford USD Medical Center - Sioux Falls
      • Sioux Falls, South Dakota, Forente stater, 57104
        • Sanford Cancer Center Oncology Clinic
    • Tennessee
      • Collierville, Tennessee, Forente stater, 38017
        • Baptist Memorial Hospital and Cancer Center-Collierville
      • Memphis, Tennessee, Forente stater, 38120
        • Baptist Memorial Hospital and Cancer Center-Memphis
      • Nashville, Tennessee, Forente stater, 37232
        • Vanderbilt University/Ingram Cancer Center
    • Texas
      • Bryan, Texas, Forente stater, 77802
        • Saint Joseph Regional Cancer Center
      • Dallas, Texas, Forente stater, 75235
        • Parkland Memorial Hospital
      • Dallas, Texas, Forente stater, 75390
        • UT Southwestern/Simmons Cancer Center-Dallas
      • Fort Worth, Texas, Forente stater, 76104
        • UT Southwestern/Simmons Cancer Center-Fort Worth
      • Richardson, Texas, Forente stater, 75080
        • UT Southwestern Clinical Center at Richardson/Plano
    • Utah
      • Salt Lake City, Utah, Forente stater, 84112
        • Huntsman Cancer Institute/University of Utah
      • Salt Lake City, Utah, Forente stater, 84106
        • University of Utah Sugarhouse Health Center
    • Vermont
      • Berlin Corners, Vermont, Forente stater, 05602
        • Central Vermont Medical Center/National Life Cancer Treatment
      • Burlington, Vermont, Forente stater, 05401
        • University of Vermont Medical Center
      • Burlington, Vermont, Forente stater, 05405
        • University of Vermont and State Agricultural College
      • Saint Johnsbury, Vermont, Forente stater, 05819
        • Dartmouth Cancer Center - North
    • Virginia
      • Charlottesville, Virginia, Forente stater, 22908
        • University of Virginia Cancer Center
      • Richmond, Virginia, Forente stater, 23229
        • Virginia Cancer Institute
      • Richmond, Virginia, Forente stater, 23298
        • VCU Massey Comprehensive Cancer Center
      • South Hill, Virginia, Forente stater, 23970
        • VCU Community Memorial Health Center
    • Washington
      • Aberdeen, Washington, Forente stater, 98520
        • Providence Regional Cancer System-Aberdeen
      • Bellevue, Washington, Forente stater, 98004
        • Overlake Medical Center
      • Bellingham, Washington, Forente stater, 98225
        • PeaceHealth Saint Joseph Medical Center
      • Burien, Washington, Forente stater, 98166
        • Saint Anne Hospital
      • Centralia, Washington, Forente stater, 98531
        • Providence Regional Cancer System-Centralia
      • Edmonds, Washington, Forente stater, 98026
        • Swedish Cancer Institute-Edmonds
      • Everett, Washington, Forente stater, 98201
        • Providence Regional Cancer Partnership
      • Issaquah, Washington, Forente stater, 98029
        • Swedish Cancer Institute-Issaquah
      • Lacey, Washington, Forente stater, 98503
        • Providence Regional Cancer System-Lacey
      • Longview, Washington, Forente stater, 98632
        • PeaceHealth Saint John Medical Center
      • Renton, Washington, Forente stater, 98055
        • Valley Medical Center
      • Seattle, Washington, Forente stater, 98107
        • Swedish Medical Center-Ballard Campus
      • Seattle, Washington, Forente stater, 98122
        • Swedish Medical Center-First Hill
      • Sedro-Woolley, Washington, Forente stater, 98284
        • PeaceHealth United General Medical Center
      • Silverdale, Washington, Forente stater, 98383
        • Saint Joseph Medical Center Hematology and Oncology - Silverdale
      • Tacoma, Washington, Forente stater, 98405
        • Northwest Medical Specialties PLLC
      • Vancouver, Washington, Forente stater, 98664
        • PeaceHealth Southwest Medical Center
      • Walla Walla, Washington, Forente stater, 99362
        • Providence Saint Mary Regional Cancer Center
      • Yakima, Washington, Forente stater, 98902
        • North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
    • West Virginia
      • Bridgeport, West Virginia, Forente stater, 26330
        • United Hospital Center
      • Charleston, West Virginia, Forente stater, 25304
        • Vandalia Health/CAMC Institute for Academic Medicine
      • Morgantown, West Virginia, Forente stater, 26506
        • West Virginia University Healthcare
      • Parkersburg, West Virginia, Forente stater, 26101
        • Camden Clark Medical Center
    • Wisconsin
      • Appleton, Wisconsin, Forente stater, 54911
        • ThedaCare Regional Cancer Center
      • Ashland, Wisconsin, Forente stater, 54806
        • Duluth Clinic Ashland
      • Ashland, Wisconsin, Forente stater, 54806
        • Northwest Wisconsin Cancer Center
      • Burlington, Wisconsin, Forente stater, 53105
        • Aurora Cancer Care-Southern Lakes VLCC
      • Eau Claire, Wisconsin, Forente stater, 54701
        • Marshfield Medical Center-EC Cancer Center
      • Eau Claire, Wisconsin, Forente stater, 54701
        • HSHS Sacred Heart Hospital
      • Fond du Lac, Wisconsin, Forente stater, 54937
        • Aurora Health Center-Fond du Lac
      • Germantown, Wisconsin, Forente stater, 53022
        • Aurora Health Care Germantown Health Center
      • Grafton, Wisconsin, Forente stater, 53024
        • Aurora Cancer Care-Grafton
      • Green Bay, Wisconsin, Forente stater, 54311
        • Aurora BayCare Medical Center
      • Green Bay, Wisconsin, Forente stater, 54301
        • Saint Vincent Hospital Cancer Center Green Bay
      • Green Bay, Wisconsin, Forente stater, 54303
        • Saint Vincent Hospital Cancer Center at Saint Mary's
      • Green Bay, Wisconsin, Forente stater, 54301
        • Bellin Memorial Hospital
      • Hayward, Wisconsin, Forente stater, 54843
        • Essentia Health-Hayward Clinic
      • Johnson Creek, Wisconsin, Forente stater, 53038
        • University of Wisconsin Carbone Cancer Center - Johnson Creek
      • Kenosha, Wisconsin, Forente stater, 53142
        • Aurora Cancer Care-Kenosha South
      • Madison, Wisconsin, Forente stater, 53792
        • University of Wisconsin Carbone Cancer Center - University Hospital
      • Marinette, Wisconsin, Forente stater, 54143
        • Aurora Bay Area Medical Group-Marinette
      • Marshfield, Wisconsin, Forente stater, 54449
        • Marshfield Medical Center-Marshfield
      • Milwaukee, Wisconsin, Forente stater, 53209
        • Aurora Cancer Care-Milwaukee
      • Milwaukee, Wisconsin, Forente stater, 53215
        • Aurora Saint Luke's Medical Center
      • Milwaukee, Wisconsin, Forente stater, 53233
        • Aurora Sinai Medical Center
      • Minocqua, Wisconsin, Forente stater, 54548
        • Marshfield Medical Center - Minocqua
      • New Richmond, Wisconsin, Forente stater, 54017
        • Cancer Center of Western Wisconsin
      • Oshkosh, Wisconsin, Forente stater, 54904
        • Vince Lombardi Cancer Clinic - Oshkosh
      • Racine, Wisconsin, Forente stater, 53406
        • Aurora Cancer Care-Racine
      • Rice Lake, Wisconsin, Forente stater, 54868
        • Marshfield Medical Center-Rice Lake
      • Sheboygan, Wisconsin, Forente stater, 53081
        • Vince Lombardi Cancer Clinic-Sheboygan
      • Spooner, Wisconsin, Forente stater, 54801
        • Essentia Health-Spooner Clinic
      • Stevens Point, Wisconsin, Forente stater, 54482
        • Marshfield Medical Center-River Region at Stevens Point
      • Sturgeon Bay, Wisconsin, Forente stater, 54235-1495
        • Saint Vincent Hospital Cancer Center at Sturgeon Bay
      • Summit, Wisconsin, Forente stater, 53066
        • Aurora Medical Center in Summit
      • Superior, Wisconsin, Forente stater, 54880
        • Essentia Health Saint Mary's Hospital - Superior
      • Two Rivers, Wisconsin, Forente stater, 54241
        • Vince Lombardi Cancer Clinic-Two Rivers
      • Wauwatosa, Wisconsin, Forente stater, 53226
        • Aurora Cancer Care-Milwaukee West
      • West Allis, Wisconsin, Forente stater, 53227
        • Aurora West Allis Medical Center
      • Weston, Wisconsin, Forente stater, 54476
        • Marshfield Medical Center - Weston

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Kvalifikasjonskriterier

Nøkkelkravene som personer som ønsker å delta i en klinisk studie må oppfylle eller egenskapene de må ha. Kvalifikasjonskriterier består av både inklusjonskriterier (som kreves for at en person skal delta i studien) og eksklusjonskriterier (som hindrer en person i å delta). Typer kvalifikasjonskriterier inkluderer om en studie godtar friske frivillige, har alders- eller aldersgruppekrav, eller er begrenset av kjønn.

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • STEP 1 RANDOMIZATION: Patients must be age >= 18 years

  • STEP 1 RANDOMIZATION: Patients must have histologically confirmed T1N1-3M0 or T2-3N0-2M0 esophageal or gastroesophageal junctional adenocarcinoma (Siewert I and II)

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

  • STEP 1 RANDOMIZATION: Patents must be deemed a surgical candidate by a thoracic surgeon, surgical oncologist, or surgeon who is qualified to perform an esophagectomy

  • STEP 1 RANDOMIZATION: Absolute neutrophil count >= 1,500/mcL (within less than or equal to 14 days prior to randomization)

  • STEP 1 RANDOMIZATION: Platelets >= 100,000/mcL (within less than or equal to 14 days prior to randomization)

  • STEP 1 RANDOMIZATION: Total bilirubin =< institutional upper limit of normal (ULN) (within less than or equal to 14 days prior to randomization)

  • STEP 1 RANDOMIZATION: Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x institutional ULN (within less than or equal to 14 days prior to randomization)

  • STEP 1 RANDOMIZATION: Serum creatinine =< 1.5 x institutional ULN (within less than or equal to 14 days prior to randomization)

  • STEP 1 RANDOMIZATION: Hemoglobin (Hgb) >= 9 g/dL (within less than or equal to 14 days prior to randomization)

  • STEP 1 RANDOMIZATION: Leukocytes >= 3,000/mm^3 (within less than or equal to 14 days prior to randomization)

  • STEP 1 RANDOMIZATION: Patients may not have received prior chemotherapy or radiation therapy for management for this malignancy

  • STEP 1 RANDOMIZATION: Patients may not have received prior immunotherapy for management of this malignancy or for any other past malignancy

  • STEP 1 RANDOMIZATION: Patients must have no contraindication to receiving either carboplatin or paclitaxel chemotherapy

  • STEP 1 RANDOMIZATION: Patients must have no contraindication to receiving radiation therapy

  • STEP 1 RANDOMIZATION: Patients with active autoimmune disease or history of autoimmune disease that might recur, which may affect vital organ function or require immune suppressive treatment including systemic corticosteroids, must be excluded. These include but are not limited to patients with a history of immune related neurologic disease, multiple sclerosis, autoimmune (demyelinating) neuropathy, Guillain-Barre syndrome, myasthenia gravis; systemic autoimmune disease such as systemic lupus erythematosus (SLE), connective tissue disease, scleroderma, inflammatory bowel disease (IBD), Crohn's, ulcerative colitis, hepatitis; and patients with a history of toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome, or phospholipid syndrome must be excluded because of the risk of recurrence or exacerbation of disease. Patients with vitiligo, endocrine deficiencies including thyroiditis managed with replacement hormones including physiologic corticosteroids are eligible. Patients with rheumatoid arthritis and other arthropathies, Sjogren's syndrome and psoriasis controlled with topical medication and patients with positive serology, such as antinuclear antibodies (ANA), anti-thyroid antibodies must be evaluated for the presence of target organ involvement and potential need for systemic treatment but should otherwise be eligible

  • STEP 1 RANDOMIZATION: Patients are permitted to enroll if they have vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger (precipitating event)

  • STEP 1 RANDOMIZATION: Patient must NOT have previous or concurrent malignancy. Exceptions are made for patients who meet any of the following conditions:

    • Non-melanoma skin cancer, in situ cervical cancer, superficial bladder cancer, or breast cancer in situ OR
    • Prior malignancy completely excised or removed and patient has been continuously disease free for > 5 years OR
    • Date of last evidence of disease

  • STEP 1 RANDOMIZATION: Patients must not have a condition requiring systemic treatment with either corticosteroids (> 10 mg/day prednisone equivalents) or other immunosuppressive medications within 14 days of study drug administration. Inhaled or topical steroids and adrenal replacement doses =< 10 mg/day prednisone equivalents are permitted in the absence of active autoimmune disease

  • STEP 1 RANDOMIZATION: Patients must have adequate cardiac function including electrocardiogram (EKG) and echocardiogram for any patient with a history of congestive heart failure (CHF) or at risk because of underlying cardiovascular disease or exposure to cardiotoxic drugs

  • STEP 1 RANDOMIZATION: For patients with evidence of uncontrolled CHF, myocardial infarction (MI), cardiomyopathy, or myositis, require a cardiac evaluation and clearance including lab tests and cardiology consultation (EKG, creatinine phosphokinase [CPK], troponin, and echocardiogram)

  • STEP 1 RANDOMIZATION: Patients must not have a positive test result for hepatitis B virus surface antigen (HBV sAg) or hepatitis C virus ribonucleic acid (HCV RNA) indicating acute or chronic infection. Testing should be conducted to determine eligibility

  • STEP 1 RANDOMIZATION: Patients with a known history of testing positive for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS) must have no detectable viral load on a stable anti-viral regimen

  • STEP 1 RANDOMIZATION: Patients must not be receiving any other investigational agents

  • STEP 1 RANDOMIZATION: Patients with an uncontrolled intercurrent illness such as ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia or psychiatric illness/social situations that would limit compliance with study requirements will be excluded

  • STEP 1 RANDOMIZATION: Patients must not be pregnant or breast-feeding due to potential harm to an unborn fetus and possible risk for adverse events in nursing infants from carboplatin, paclitaxel, ipilimumab or nivolumab

    • All patients of childbearing potential must have a blood test or urine study done within 2 weeks prior to randomization to rule out pregnancy. Those enrolled on Arm B with nivolumab must agree to have a pregnancy test (minimum sensitivity 25 IU/L or equivalent units of human chorionic gonadotropin [HCG]) within 24 hours of starting nivolumab to rule out pregnancy
    • A patient of childbearing potential is defined as anyone, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has achieved menarche at some point 2) has not undergone a hysterectomy or bilateral oophorectomy; or 3) has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)

  • STEP 1 RANDOMIZATION: Patients of childbearing potential must not expect to conceive children by either abstaining from sexual intercourse for the duration of their participation in the study or by agreeing to use both double barrier contraception and birth control pills or implants for at least one month prior to the start of the study drug and continuing for 5 months after the last dose of study drug. Investigators shall counsel patients of childbearing potential on the importance of pregnancy prevention and the implications of an unexpected pregnancy

  • STEP 2 RANDOMIZATION: Patient registration must not exceed 12 weeks from time of esophagectomy

  • STEP 2 RANDOMIZATION: Patients must have a post-operative ECOG performance status of 0-2

  • STEP 2 RANDOMIZATION: Absolute neutrophil count >= 1,500/mcL (within less than or equal to 14 days prior to randomization)

  • STEP 2 RANDOMIZATION: Platelets >= 100,000/mcL (within less than or equal to 14 days prior to randomization)

  • STEP 2 RANDOMIZATION: Total bilirubin =< institutional upper limit of normal (ULN) (within less than or equal to 14 days prior to randomization)

  • STEP 2 RANDOMIZATION: AST (SGOT)/ ALT (SGPT) =< 2.5 x institutional ULN (within less than or equal to 14 days prior to randomization)

  • STEP 2 RANDOMIZATION: Serum creatinine =< 1.5 x institutional ULN (within less than or equal to 14 days prior to randomization)

  • STEP 2 RANDOMIZATION: Patients must be disease free following esophagectomy as is demonstrated by having no evidence of disease on a post-surgical CT scan. Patients must also have a negative surgical margin (R0 resection)

  • STEP 2 RANDOMIZATION: Patients must not have an active, known or suspected autoimmune disease or a condition requiring treatment with steroids or immunosuppressive agents. Patients are permitted to enroll if they have vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger

  • STEP 2 RANDOMIZATION: Patients must not have a condition requiring systemic treatment with either corticosteroids (> 10 mg/day prednisone equivalents) or other immunosuppressive medications with 14 days of study drug administration. Inhaled or topical steroids and adrenal replacement doses > 10 mg/day prednisone equivalents are permitted in the absence of active autoimmune disease

  • STEP 2 RANDOMIZATION: Patients must not be receiving any other investigational agents

  • STEP 2 RANDOMIZATION: Patients with an uncontrolled intercurrent illness such as ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia or psychiatric illness/social situations that would limit compliance with study requirements will be excluded

  • STEP 2 RANDOMIZATION: Patients must not be pregnant or breast-feeding due to potential harm to an unborn fetus and possible risks for adverse events in nursing infants from nivolumab or ipilimumab

    • All patients of childbearing potential must have a blood test or urine study done (minimum sensitivity 25 IU/L or equivalent units of HCG) within 2 weeks prior to randomization to rule out pregnancy. All patients must also agree to have a pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) within 24 hours of starting nivolumab to rule out pregnancy. Those enrolled on Arm D with ipilimumab must agree to have pregnancy tests within 72 hours of each ipilimumab administration to rule out pregnancy

  • STEP 2 RANDOMIZATION: Patients of childbearing potential must not expect to conceive children by either abstaining from sexual intercourse for the duration of their participation in the study or by agreeing to use both double barrier contraception and birth control pills or implants for at least one month prior to the start of the study drug and continuing for 5 months after the last dose of study drug. Investigators shall counsel patients of childbearing potential on the importance of pregnancy prevention and the implications of an unexpected pregnancy

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm

Deltakergruppe / Arm

En gruppe eller undergruppe av deltakere i en klinisk studie som mottar en spesifikk intervensjon/behandling, eller ingen intervensjon, i henhold til studiens protokoll.
Intervensjon / Behandling

Intervensjon / Behandling

En prosess eller handling som er fokus for en klinisk studie. Intervensjoner inkluderer legemidler, medisinsk utstyr, prosedyrer, vaksiner og andre produkter som enten er undersøkende eller allerede er tilgjengelige. Intervensjoner kan også inkludere ikke-invasive tilnærminger, som utdanning eller modifisering av kosthold og trening.
Eksperimentell: Arm A (carboplatin, paclitaxel, radiation therapy)

Patients receive carboplatin IV and paclitaxel IV once weekly and undergo radiation therapy QD (Monday-Friday) beginning on day 1 of each cycle. Cycles repeat every week for up to 5 weeks in the absence of disease progression or unacceptable toxicity. Patients undergo a CT or PET scan during screening and follow-up and undergo collection of blood samples throughout the trial.
Legemiddel: Carboplatin

Given IV

Andre navn:
  • Blastokarb
  • Carboplat
  • Carboplatin Hexal
  • Carboplatino
  • Karboplatina
  • Karbosin
  • Karbosol
  • Carbotec
  • CBDCA
  • Displata
  • Ercar
  • JM-8
  • Nealorin
  • Novoplatinum
  • Paraplatin
  • Paraplatin AQ
  • Platinwas
  • Ribocarbo
  • JM8
Legemiddel: Paclitaxel

Given IV

Andre navn:
  • Taxol
  • Anzatax
  • Asotax
  • Bristaxol
  • Praxel
  • Taxol Konzentrat
Fremgangsmåte: Computed Tomography

Undergo CT scan

Andre navn:
  • CT
  • KATT
  • CAT-skanning
  • Beregnet aksial tomografi
  • Datastyrt aksialtomografi
  • Datastyrt tomografi
  • CT skann
  • tomografi
  • Datastyrt aksial tomografi (prosedyre)
  • Datastyrt tomografi (CT) skanning
  • Diagnostisk CAT -skanning
  • Diagnostisk CAT -skannertype
Fremgangsmåte: Positron Emission Tomography

Undergo PET scan

Andre navn:
  • Medisinsk bildebehandling, positronemisjonstomografi
  • KJÆLEDYR
  • PET-skanning
  • Positron Emission Tomography Scan
  • Positron-utslippstomografi
  • PT
  • Positronemisjonstomografi (prosedyre)
Fremgangsmåte: Biospecimen Collection

Undergo collection of blood sample

Andre navn:
  • Biologisk prøvesamling
  • Bioprøve samlet
  • Prøvesamling
Stråling: Radiation Therapy

Undergo radiation therapy

Andre navn:
  • Kreft Strålebehandling
  • ENERGY_TYPE
  • Bestråle
  • Bestrålt
  • Bestråling
  • Stråling
  • Stråleterapi, NOS
  • Radioterapeutika
  • Strålebehandling
  • RT
  • Terapi, stråling
  • Energitype
Eksperimentell: Arm B (carboplatin, paclitaxel, radiation therapy, nivolumab)

Patients receive carboplatin, paclitaxel, and radiation therapy as in Arm A. Patients also receive nivolumab IV over 30 minutes on days 1 and 15 of each cycle. Cycles repeat every week for up to 5 weeks in the absence of disease progression or unacceptable toxicity. Patients undergo a CT or PET scan during screening and follow-up and undergo collection of blood samples throughout the trial.
Legemiddel: Carboplatin

Given IV

Andre navn:
  • Blastokarb
  • Carboplat
  • Carboplatin Hexal
  • Carboplatino
  • Karboplatina
  • Karbosin
  • Karbosol
  • Carbotec
  • CBDCA
  • Displata
  • Ercar
  • JM-8
  • Nealorin
  • Novoplatinum
  • Paraplatin
  • Paraplatin AQ
  • Platinwas
  • Ribocarbo
  • JM8
Legemiddel: Paclitaxel

Given IV

Andre navn:
  • Taxol
  • Anzatax
  • Asotax
  • Bristaxol
  • Praxel
  • Taxol Konzentrat
Biologisk: Nivolumab

Given IV

Andre navn:
  • BMS-936558
  • MDX-1106
  • NIVO
  • ONO-4538
  • Opdivo
  • CMAB819
  • Nivolumab Biosimilar CMAB819
  • MDX 1106
  • MDX1106
  • BMS 936558
  • ABP 206
  • Nivolumab Biosimilar ABP 206
  • BCD-263
  • Nivolumab Biosimilar BCD-263
  • BMS936558
  • ONO 4538
  • ONO4538
Fremgangsmåte: Computed Tomography

Undergo CT scan

Andre navn:
  • CT
  • KATT
  • CAT-skanning
  • Beregnet aksial tomografi
  • Datastyrt aksialtomografi
  • Datastyrt tomografi
  • CT skann
  • tomografi
  • Datastyrt aksial tomografi (prosedyre)
  • Datastyrt tomografi (CT) skanning
  • Diagnostisk CAT -skanning
  • Diagnostisk CAT -skannertype
Fremgangsmåte: Positron Emission Tomography

Undergo PET scan

Andre navn:
  • Medisinsk bildebehandling, positronemisjonstomografi
  • KJÆLEDYR
  • PET-skanning
  • Positron Emission Tomography Scan
  • Positron-utslippstomografi
  • PT
  • Positronemisjonstomografi (prosedyre)
Fremgangsmåte: Biospecimen Collection

Undergo collection of blood sample

Andre navn:
  • Biologisk prøvesamling
  • Bioprøve samlet
  • Prøvesamling
Stråling: Radiation Therapy

Undergo radiation therapy

Andre navn:
  • Kreft Strålebehandling
  • ENERGY_TYPE
  • Bestråle
  • Bestrålt
  • Bestråling
  • Stråling
  • Stråleterapi, NOS
  • Radioterapeutika
  • Strålebehandling
  • RT
  • Terapi, stråling
  • Energitype
Eksperimentell: Arm C (nivolumab)

Patients receive nivolumab IV over 30 minutes on day 1 of each cycle. Treatment repeats every 4 weeks for up to 13 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo a CT scan and collection of blood samples throughout the trial.
Biologisk: Nivolumab

Given IV

Andre navn:
  • BMS-936558
  • MDX-1106
  • NIVO
  • ONO-4538
  • Opdivo
  • CMAB819
  • Nivolumab Biosimilar CMAB819
  • MDX 1106
  • MDX1106
  • BMS 936558
  • ABP 206
  • Nivolumab Biosimilar ABP 206
  • BCD-263
  • Nivolumab Biosimilar BCD-263
  • BMS936558
  • ONO 4538
  • ONO4538
Fremgangsmåte: Computed Tomography

Undergo CT scan

Andre navn:
  • CT
  • KATT
  • CAT-skanning
  • Beregnet aksial tomografi
  • Datastyrt aksialtomografi
  • Datastyrt tomografi
  • CT skann
  • tomografi
  • Datastyrt aksial tomografi (prosedyre)
  • Datastyrt tomografi (CT) skanning
  • Diagnostisk CAT -skanning
  • Diagnostisk CAT -skannertype
Fremgangsmåte: Biospecimen Collection

Undergo collection of blood sample

Andre navn:
  • Biologisk prøvesamling
  • Bioprøve samlet
  • Prøvesamling
Eksperimentell: Arm D (nivolumab, ipilimumab)

Patients receive nivolumab as in Arm C and receive ipilimumab IV over 90 minutes on day 1 of cycles 1 and 4 and day 15 of cycles 2 and 5. Treatment repeats every 4 weeks for up to 13 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo a CT scan and collection of blood samples throughout the trial.
Biologisk: Ipilimumab

Given IV

Andre navn:
  • Anti-cytotoksisk T-lymfocytt-assosiert antigen-4 monoklonalt antistoff
  • BMS-734016
  • Ipilimumab Biosimilar CS1002
  • MDX-010
  • MDX-CTLA4
  • Yervoy
  • MDX010
  • BMS734016
  • BMS 734016
  • MDX 010
Biologisk: Nivolumab

Given IV

Andre navn:
  • BMS-936558
  • MDX-1106
  • NIVO
  • ONO-4538
  • Opdivo
  • CMAB819
  • Nivolumab Biosimilar CMAB819
  • MDX 1106
  • MDX1106
  • BMS 936558
  • ABP 206
  • Nivolumab Biosimilar ABP 206
  • BCD-263
  • Nivolumab Biosimilar BCD-263
  • BMS936558
  • ONO 4538
  • ONO4538
Fremgangsmåte: Computed Tomography

Undergo CT scan

Andre navn:
  • CT
  • KATT
  • CAT-skanning
  • Beregnet aksial tomografi
  • Datastyrt aksialtomografi
  • Datastyrt tomografi
  • CT skann
  • tomografi
  • Datastyrt aksial tomografi (prosedyre)
  • Datastyrt tomografi (CT) skanning
  • Diagnostisk CAT -skanning
  • Diagnostisk CAT -skannertype
Fremgangsmåte: Biospecimen Collection

Undergo collection of blood sample

Andre navn:
  • Biologisk prøvesamling
  • Bioprøve samlet
  • Prøvesamling

Hva måler studien?

Primære resultatmål

Primære resultatmål

I en klinisk studies protokoll er det planlagte utfallsmålet som er det viktigste for å evaluere effekten av en intervensjon/behandling. De fleste kliniske studier har ett primært utfallsmål, men noen har mer enn ett.
Resultatmål
Tiltaksbeskrivelse
Tidsramme
Pathologic complete response (Step I)
Tidsramme: Up to 5 weeks

The study with compare the pathologic complete response of Arm A and Arm B using a one-sided 0.10 level chi-squared test for proportions.
Up to 5 weeks
Disease-free survival (DFS) (Step 2)
Tidsramme: From the adjuvant treatment randomization assessed for up to 7 years

DFS measured from the adjuvant treatment randomization will be the endpoint of the adjuvant portion of the study and to achieve the desired power it is expected that patients will be followed for an additional year post completion of accrual to the adjuvant portion. The DFS comparison will be between patients randomized to Arm C (nivolumab) versus Arm D (nivolumab plus ipilimumab) using a one-sided 0.10 level stratified log rank test.
From the adjuvant treatment randomization assessed for up to 7 years

Sekundære resultatmål

Sekundære resultatmål

I en klinisk studies protokoll, et planlagt utfallsmål som ikke er like viktig som det primære utfallsmålet for å evaluere effekten av en intervensjon, men som fortsatt er av interesse. De fleste kliniske studier har mer enn ett sekundært utfallsmål.
Resultatmål
Tiltaksbeskrivelse
Tidsramme
Incidence of adverse events
Tidsramme: Up to 7 years

Graded according to Common Terminology Criteria for Adverse Events version 5.0. Toxicity will be evaluated among all treated patients regardless of eligibility and interim analyses of toxicity are performed twice yearly. The study will have sufficient precision to provide 95% confidence intervals on toxicity
Up to 7 years
Overall survival
Tidsramme: From the time of first randomization up to 7 years

Analyses will be descriptive in nature and will not follow any formal interim monitoring.
From the time of first randomization up to 7 years
DFS
Tidsramme: From the time of first randomization up to 7 years

The DFS comparison will be between patients randomized to Arm C (nivolumab) versus Arm D (nivolumab plus ipilimumab) using a one-sided 0.10 level stratified log rank test.
From the time of first randomization up to 7 years

Andre resultatmål

Andre resultatmål

For kliniske studier, en planlagt måling beskrevet i protokollen som brukes for å bestemme effekten av en intervensjon/behandling på deltakerne. For observasjonsstudier, en måling eller observasjon som brukes til å beskrive mønstre av sykdommer eller egenskaper, eller assosiasjoner til eksponeringer, risikofaktorer eller behandling. Typer utfallsmål inkluderer primært resultatmål og sekundært resultatmål.
Resultatmål
Tiltaksbeskrivelse
Tidsramme
Percent change in mean volumetric apparent diffusion coefficient (ADC)
Tidsramme: Baseline to mid-treatment

The study will assess the area under the receiver operating characteristic curve of the changes of ADC value.
Baseline to mid-treatment

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Sponsor

Organisasjonen eller personen som initierer studien og som har myndighet og kontroll over studien.
National Cancer Institute (NCI)

Etterforskere

Etterforskere

En forsker involvert i en klinisk studie. Beslektede termer inkluderer stedets hovedetterforsker, stedsunderetterforsker, studieleder, studieleder og studiehovedetterforsker.
  • Hovedetterforsker: Jennifer R Eads, ECOG-ACRIN Cancer Research Group

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

Studiestart

Den faktiske datoen da den første deltakeren ble registrert i en klinisk studie. Den "forventede" studiestartdatoen er datoen som forskerne tror vil være studiestartdatoen.
3. mai 2019

Primær fullføring (Antatt)

Primær fullføring

Datoen da den siste deltakeren i en klinisk studie ble undersøkt eller mottok en intervensjon for å samle inn endelige data for det primære utfallsmålet. Hvorvidt den kliniske studien ble avsluttet i henhold til protokollen eller ble avsluttet, påvirker ikke denne datoen. For kliniske studier med mer enn ett primært utfallsmål med ulike fullføringsdatoer, refererer dette begrepet til datoen da datainnsamlingen er fullført for alle de primære utfallsmålene. Den "forventede" primære fullføringsdatoen er datoen som forskerne tror vil være den primære fullføringsdatoen for studien.
31. mars 2027

Studiet fullført (Antatt)

Studiet fullført

Datoen da den siste deltakeren i en klinisk studie ble undersøkt eller mottok en intervensjon/behandling for å samle inn endelige data for de primære utfallsmålene, sekundære utfallsmålene og uønskede hendelsene (det vil si siste deltakers siste besøk). Den "forventede" studiens fullføringsdato er datoen som forskerne tror vil være studiens fullføringsdato.
31. mars 2027

Datoer for studieregistrering

Først innsendt

Først innsendt

Datoen da studiesponsoren eller etterforskeren først sendte inn en studiepost til ClinicalTrials.gov. Det er vanligvis en forsinkelse på noen dager mellom første innsendte dato og postens tilgjengelighet på ClinicalTrials.gov (den første postedatoen).
27. juli 2018

Først innsendt som oppfylte QC-kriteriene

Først innsendt som oppfylte QC-kriteriene

Datoen da studiesponsoren eller etterforskeren først sender inn en studiepost som er i samsvar med gjennomgangskriteriene for National Library of Medicine (NLM) kvalitetskontroll (QC). Sponsoren eller etterforskeren må kanskje revidere og sende inn en studiepost én eller flere ganger før NLMs kvalitetskontrollkriterier oppfylles. Det er sponsorens eller etterforskerens ansvar å sikre at studieposten er i samsvar med NLM QC-gjennomgangskriteriene.
27. juli 2018

Først lagt ut (Faktiske)

Først lagt ut

Datoen da studieposten først var tilgjengelig på ClinicalTrials.gov etter at National Library of Medicine (NLM) kvalitetskontroll (QC) gjennomgang har konkludert. Det er vanligvis en forsinkelse på noen dager mellom datoen studiesponsoren eller etterforskeren sendte inn studieposten og den første postedatoen.
30. juli 2018

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

Sist oppdatering lagt ut

Den siste datoen da endringer i en studiepost ble gjort tilgjengelig på ClinicalTrials.gov. Det kan være en forsinkelse mellom når endringene ble sendt til ClinicalTrials.gov av studiens sponsor eller etterforsker (datoen for siste innsending av oppdatering) og datoen for siste oppdatering.
2. november 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

Siste oppdatering sendt inn som oppfylte QC-kriteriene

Den siste datoen da studiesponsoren eller etterforskeren sendte inn endringer i en studiepost som er i samsvar med gjennomgangskriteriene for National Library of Medicine (NLM) kvalitetskontroll (QC). Det er sponsorens eller etterforskerens ansvar å sikre at studieposten er i samsvar med NLM QC-gjennomgangskriteriene.
30. oktober 2026

Sist bekreftet

Sist bekreftet

Den siste datoen da studiesponsoren eller etterforskeren bekreftet at informasjonen om en klinisk studie på ClinicalTrials.gov var nøyaktig og oppdatert. Hvis en studie med rekrutteringsstatus for rekruttering; ikke rekrutterer ennå; eller aktiv, ikke rekruttering har ikke blitt bekreftet de siste 2 årene, studiens rekrutteringsstatus vises som ukjent.
1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

Andre studie-ID-numre

Identifikatorer eller ID-numre andre enn NCT-nummeret som er tildelt en klinisk studie av studiens sponsor, finansierere eller andre. Disse tallene kan inkludere unike identifikatorer fra andre prøveregistre og National Institutes of Health-stipendnumre.
  • NCI-2018-01575
  • U10CA180820 (U.S. NIH-stipend/kontrakt)
  • NCI-2018-01575 (Registeridentifikator: CTRP (Clinical Trial Reporting Program))
  • EA2174 (Annen identifikator: CTEP)
  • EA2174 (Annen identifikator: ECOG-ACRIN Cancer Research Group)

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

JA

IPD-planbeskrivelse

NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Ja

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

Innstillinger for informasjonskapsler

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