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Immunterapi med Nivolumab og Ipilimumab etterfulgt av Nivolumab eller Nivolumab med Cabozantinib for pasienter med avansert nyrekreft, PDIGREE-studien

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

PD-hemmer (Nivolumab) og Ipilimumab etterfulgt av Nivolumab vs. VEGF TKI Cabozantinib med Nivolumab: En fase III-studie i metastatisk ubehandlet nyrecellekreft [PDIGREE]

This phase III trial compares the usual treatment (treatment with ipilimumab and nivolumab followed by nivolumab alone) to treatment with ipilimumab and nivolumab, followed by nivolumab with cabozantinib in patients with untreated renal cell carcinoma that has spread to other parts of the body. The addition of cabozantinib to the usual treatment may make it work better. Immunotherapy with monoclonal antibodies, such as nivolumab and ipilimumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Cabozantinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known how well the combination of cabozantinib and nivolumab after initial treatment with ipilimumab and nivolumab works in treating patients with renal cell cancer that has spread to other parts of the body.

Studieoversikt

Status

Status

Indikerer gjeldende rekrutteringsstatus eller utvidet tilgangsstatus.
Aktiv, ikke rekrutterende

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 OBJECTIVE:

I. To compare the overall survival (OS) in patients with metastatic renal cell cancer (RCC) treated with ipilimumab-nivolumab followed by either nivolumab versus cabozantinib-nivolumab.

SECONDARY OBJECTIVES:

I. To determine progression free survival (PFS) of patients treated with nivolumab versus nivolumab-cabozantinib.

II. To evaluate the 12-month complete response rate in patients treated with ipilimumab-nivolumab followed by cabozantinib-nivolumab versus ipilimumab-nivolumab followed by nivolumab (patients who have complete response [CR] and relapse before 12 months will not be counted as a CR at 12-months).

III. To evaluate the rates of discontinuing therapy at 1 year. IV. To compare objective response rates (ORR, assessed by Response Evaluation Criteria in Solid Tumors [RECIST] 1.1 and Immune Response Evaluation Criteria in Solid Tumors [iRECIST] criteria) for patients treated with ipilimumab-nivolumab followed by cabozantinib-nivolumab versus ipilimumab-nivolumab followed by nivolumab.

V. To document the adverse event profile of ipilimumab-nivolumab followed by cabozantinib-nivolumab.

BIOMARKER OBJECTIVES:

I. To evaluate biomarkers associated with exceptional responses in both arms (exceptional responses defined as CRs with treatment discontinuation at 12 months or 24 months).

II. To evaluate whether baseline IL-6 is predictive of outcome in patients treated with cabozantinib-containing regimen.

QUALITY OF LIFE (QOL) OBJECTIVES:

I. To compare health-related quality of life at 18 months post-registration as assessed by the Functional Assessment of Cancer Therapy (FACT)-Kidney Symptom Index 19 (FKSI-19) between patients randomized to nivolumab (nivo) versus (vs) cabozantinib (cabo)/nivo.

II. To compare health-related quality of life as assessed by the FKSI-19 between patients randomized to nivo vs cabo/nivo at other time points.

III. To compare patient-reported fatigue using Patient-Reported Outcomes Measurement Information System (PROMIS)-Fatigue between patients randomized to nivo vs cabo/nivo.

IV. To compare quality-adjusted survival (overall survival x utility score assessed by EuroQol five-dimensional questionnaire [EQ5D-5L]) between patients randomized to nivo vs cabo/nivo.

OUTLINE:

INDUCTION: Patients receive nivolumab intravenously (IV) over 30 minutes and ipilimumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity.

TREATMENT:

Patients with unconfirmed but clinical progression of disease (iuPD) with clinical instability receive cabozantinib orally (PO) daily on days 1-28. Treatment repeats every 28 days until further disease progression or unacceptable toxicity.

Patients with unconfirmed CR (iCR) receive nivolumab IV between 30-60 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Patients with non-CR/non-PD or iuPD with clinical stability are randomized to 1 of 2 arms.

ARM A: Patients receive nivolumab IV between 30-60 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

ARM B: Patients receive nivolumab IV between 30-60 minutes on day 1 and cabozantinib PO daily on days 1-28. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Patients undergo computed tomography (CT) scan, magnetic resonance imaging (MRI) and blood and urine sample collection, and may also undergo a bone scan as clinically indicated throughout the study.

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.
1175

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 3

Kontakter og plasseringer

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

Studiesteder

  • Forente stater
    • Alabama
      • Mobile, Alabama, Forente stater, 36688
        • University of South Alabama Mitchell Cancer Institute
    • 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
      • Anchorage, Alaska, Forente stater, 99504
        • Anchorage Radiation Therapy Center
      • Fairbanks, Alaska, Forente stater, 99701
        • Fairbanks Memorial Hospital
    • Arizona
      • Kingman, Arizona, Forente stater, 86401
        • Kingman Regional Medical Center
      • Phoenix, Arizona, Forente stater, 85004
        • Cancer Center at Saint Joseph's
    • Arkansas
      • Fayetteville, Arkansas, Forente stater, 72703
        • Highlands Oncology Group - Fayetteville
      • Fort Smith, Arkansas, Forente stater, 72903
        • Mercy Hospital Fort Smith
      • Hot Springs, Arkansas, Forente stater, 71913
        • CHI Saint Vincent Cancer Center Hot Springs
      • Rogers, Arkansas, Forente stater, 72758
        • Highlands Oncology Group - Rogers
      • Springdale, Arkansas, Forente stater, 72762
        • Highlands Oncology Group
    • California
      • Anaheim, California, Forente stater, 92806
        • Kaiser Permanente-Anaheim
      • Arroyo Grande, California, Forente stater, 93420
        • PCR Oncology
      • Arroyo Grande, California, Forente stater, 93420
        • Mission Hope Medical Oncology - Arroyo Grande
      • Baldwin Park, California, Forente stater, 91706
        • Kaiser Permanente-Baldwin Park
      • Bellflower, California, Forente stater, 90706
        • Kaiser Permanente-Bellflower
      • 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
      • Fontana, California, Forente stater, 92335
        • Kaiser Permanente-Fontana
      • Harbor City, California, Forente stater, 90710
        • Kaiser Permanente South Bay
      • Irvine, California, Forente stater, 92618
        • Kaiser Permanente-Irvine
      • La Jolla, California, Forente stater, 92093
        • UC San Diego Moores Cancer Center
      • Los Angeles, California, Forente stater, 90027
        • Kaiser Permanente Los Angeles Medical Center
      • Los Angeles, California, Forente stater, 90034
        • Kaiser Permanente West Los Angeles
      • Ontario, California, Forente stater, 91761
        • Kaiser Permanente-Ontario
      • Panorama City, California, Forente stater, 91402
        • Kaiser Permanente - Panorama City
      • Riverside, California, Forente stater, 92505
        • Kaiser Permanente-Riverside
      • Sacramento, California, Forente stater, 95817
        • University of California Davis Comprehensive Cancer Center
      • San Diego, California, Forente stater, 92120
        • Kaiser Permanente-San Diego Zion
      • San Diego, California, Forente stater, 92134
        • Naval Medical Center -San Diego
      • San Diego, California, Forente stater, 92123
        • Sharp Memorial Hospital
      • San Diego, California, Forente stater, 92108
        • Kaiser Permanente-Rio San Diego
      • San Francisco, California, Forente stater, 94158
        • UCSF Medical Center-Mission Bay
      • San Luis Obispo, California, Forente stater, 93401
        • Pacific Central Coast Health Center-San Luis Obispo
      • San Marcos, California, Forente stater, 92078
        • Kaiser Permanente-San Marcos
      • Santa Maria, California, Forente stater, 93444
        • Mission Hope Medical Oncology - Santa Maria
      • Woodland Hills, California, Forente stater, 91367
        • Kaiser Permanente-Woodland Hills
    • Colorado
      • Aurora, Colorado, Forente stater, 80012
        • Rocky Mountain Cancer Centers-Aurora
      • Aurora, Colorado, Forente stater, 80012
        • The Medical Center of Aurora
      • Aurora, Colorado, Forente stater, 80045
        • UCHealth University of Colorado Hospital
      • Boulder, Colorado, Forente stater, 80303
        • Boulder Community Foothills Hospital
      • Boulder, Colorado, Forente stater, 80304
        • Rocky Mountain Cancer Centers-Boulder
      • Centennial, Colorado, Forente stater, 80112
        • Rocky Mountain Cancer Centers - Centennial
      • Colorado Springs, Colorado, Forente stater, 80907
        • Penrose-Saint Francis Healthcare
      • Colorado Springs, Colorado, Forente stater, 80909
        • UCHealth Memorial Hospital Central
      • Colorado Springs, Colorado, Forente stater, 80907
        • Rocky Mountain Cancer Centers-Penrose
      • Colorado Springs, Colorado, Forente stater, 80920
        • Memorial Hospital North
      • Denver, Colorado, Forente stater, 80205
        • Kaiser Permanente-Franklin
      • Denver, Colorado, Forente stater, 80218
        • Presbyterian - Saint Lukes Medical Center - Health One
      • Denver, Colorado, Forente stater, 80220
        • Rose Medical Center
      • Denver, Colorado, Forente stater, 80218
        • Rocky Mountain Cancer Centers-Midtown
      • Denver, Colorado, Forente stater, 80220
        • Rocky Mountain Cancer Centers-Rose
      • Denver, Colorado, Forente stater, 80218
        • Colorado Blood Cancer Institute
      • Denver, Colorado, Forente stater, 80204
        • Cancer Center of Colorado at Sloan's Lake
      • Denver, Colorado, Forente stater, 80209
        • The Women's Imaging Center
      • Denver, Colorado, Forente stater, 80206
        • National Jewish Health-Main Campus
      • Denver, Colorado, Forente stater, 80220
        • Western Surgical Care
      • Denver, Colorado, Forente stater, 80206
        • UCHealth - Cherry Creek
      • Denver, Colorado, Forente stater, 80218
        • Saint Joseph Hospital - Cancer Centers of Colorado
      • Denver, Colorado, Forente stater, 80210
        • AdventHealth Porter
      • Durango, Colorado, Forente stater, 81301
        • Mercy Medical Center
      • Durango, Colorado, Forente stater, 81301
        • CommonSpirit Cancer Center Mercy
      • Englewood, Colorado, Forente stater, 80113
        • Mountain Blue Cancer Care Center - Swedish
      • Englewood, Colorado, Forente stater, 80113
        • Swedish Medical Center
      • Englewood, Colorado, Forente stater, 80113
        • Rocky Mountain Cancer Centers - Swedish
      • Englewood, Colorado, Forente stater, 80113
        • The Melanoma and Skin Cancer Institute
      • Fort Collins, Colorado, Forente stater, 80524
        • Poudre Valley Hospital
      • Fort Collins, Colorado, Forente stater, 80528
        • Cancer Care and Hematology-Fort Collins
      • Golden, Colorado, Forente stater, 80401
        • National Jewish Health-Western Hematology Oncology
      • Grand Junction, Colorado, Forente stater, 81501
        • Saint Mary's Hospital and Regional Medical Center
      • Greeley, Colorado, Forente stater, 80631
        • UCHealth Greeley Hospital
      • Greeley, Colorado, Forente stater, 80631
        • Banner North Colorado Medical Center
      • Highlands Ranch, Colorado, Forente stater, 80129
        • UCHealth Highlands Ranch Hospital
      • Lafayette, Colorado, Forente stater, 80026
        • Kaiser Permanente-Rock Creek
      • Lafayette, Colorado, Forente stater, 80026
        • Good Samaritan Hospital - Cancer Centers of Colorado
      • Lakewood, Colorado, Forente stater, 80228
        • Rocky Mountain Cancer Centers-Lakewood
      • Lakewood, Colorado, Forente stater, 80228
        • CommonSpirit Saint Anthony Hospital Cancer Center
      • Littleton, Colorado, Forente stater, 80120
        • Rocky Mountain Cancer Centers-Littleton
      • Littleton, Colorado, Forente stater, 80122
        • AdventHealth Littleton
      • Lone Tree, Colorado, Forente stater, 80124
        • Kaiser Permanente-Lone Tree
      • Lone Tree, Colorado, Forente stater, 80124
        • Sky Ridge Medical Center
      • Lone Tree, Colorado, Forente stater, 80124
        • Rocky Mountain Cancer Centers-Sky Ridge
      • Lone Tree, Colorado, Forente stater, 80124
        • UCHealth Lone Tree Health Center
      • Longmont, Colorado, Forente stater, 80501
        • Longmont United Hospital
      • Longmont, Colorado, Forente stater, 80501
        • Rocky Mountain Cancer Centers-Longmont
      • Loveland, Colorado, Forente stater, 80538
        • Medical Center of the Rockies
      • Loveland, Colorado, Forente stater, 80539
        • Banner North Colorado Medical Center - Loveland Campus
      • Parker, Colorado, Forente stater, 80138
        • AdventHealth Parker
      • Pueblo, Colorado, Forente stater, 81004
        • Saint Mary Corwin Medical Center
      • Thornton, Colorado, Forente stater, 80260
        • Rocky Mountain Cancer Centers-Thornton
      • Thornton, Colorado, Forente stater, 80260
        • National Jewish Health-Northern Hematology Oncology
      • Wheat Ridge, Colorado, Forente stater, 80401
        • Intermountain Health Lutheran Hospital
    • Connecticut
      • Stamford, Connecticut, Forente stater, 06904
        • Stamford Hospital/Bennett Cancer Center
    • Delaware
      • Lewes, Delaware, Forente stater, 19958
        • Beebe Medical Center
      • Millville, Delaware, Forente stater, 19967
        • Beebe South Coastal Health Campus
      • Newark, Delaware, Forente stater, 19713
        • 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
      • Rehoboth Beach, Delaware, Forente stater, 19971
        • Beebe Health Campus
      • Seaford, Delaware, Forente stater, 19973
        • TidalHealth Nanticoke / Allen Cancer Center
      • Wilmington, Delaware, Forente stater, 19801
        • Christiana Care Health System-Wilmington Hospital
    • District of Columbia
      • Washington D.C., District of Columbia, Forente stater, 20037
        • George Washington University Medical Center
      • Washington D.C., District of Columbia, Forente stater, 20010
        • MedStar Washington Hospital Center
      • Washington D.C., District of Columbia, Forente stater, 20007
        • MedStar Georgetown University Hospital
    • Florida
      • Coral Gables, Florida, Forente stater, 33146
        • UM Sylvester Comprehensive Cancer Center at Coral Gables
      • Deerfield Beach, Florida, Forente stater, 33442
        • UM Sylvester Comprehensive Cancer Center at Deerfield Beach
      • Fort Lauderdale, Florida, Forente stater, 33308
        • Holy Cross Hospital
      • Gainesville, Florida, Forente stater, 32610
        • UF Health Cancer Institute - Gainesville
      • Miami, Florida, Forente stater, 33136
        • University of Miami Miller School of Medicine-Sylvester Cancer Center
      • Miami, Florida, Forente stater, 33176
        • UM Sylvester Comprehensive Cancer Center at Kendall
      • Orlando, Florida, Forente stater, 32806
        • Orlando Health Cancer Institute
      • Plantation, Florida, Forente stater, 33324
        • UM Sylvester Comprehensive Cancer Center at Plantation
    • Georgia
      • Atlanta, Georgia, Forente stater, 30342
        • Northside Hospital
      • Duluth, Georgia, Forente stater, 30096
        • Northside Hospital - Duluth
      • Lawrenceville, Georgia, Forente stater, 30046
        • Northside Hospital - Gwinnett
      • Savannah, Georgia, Forente stater, 31405
        • Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
      • Snellville, Georgia, Forente stater, 30078
        • Suburban Hematology Oncology Associates - Snellville
    • 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
        • 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, 83706
        • Saint Alphonsus Cancer Care Center-Boise
      • Boise, Idaho, Forente stater, 83712
        • Saint Luke's Cancer Institute - Boise
      • Caldwell, Idaho, Forente stater, 83605
        • Saint Alphonsus Cancer Care Center-Caldwell
      • Coeur d'Alene, Idaho, Forente stater, 83814
        • Kootenai Health - Coeur d'Alene
      • Emmett, Idaho, Forente stater, 83617
        • Walter Knox Memorial Hospital
      • Fruitland, Idaho, Forente stater, 83619
        • Saint Luke's Cancer Institute - Fruitland
      • Meridian, Idaho, Forente stater, 83642
        • Idaho Urologic Institute-Meridian
      • Meridian, Idaho, Forente stater, 83642
        • Saint Luke's Cancer Institute - Meridian
      • Nampa, Idaho, Forente stater, 83687
        • Saint Alphonsus Cancer Care Center-Nampa
      • Nampa, Idaho, Forente stater, 83687
        • Saint Luke's Cancer Institute - Nampa
      • Post Falls, Idaho, Forente stater, 83854
        • Kootenai Clinic Cancer Services - Post Falls
      • Sandpoint, Idaho, Forente stater, 83864
        • Kootenai Clinic Cancer Services - Sandpoint
      • Twin Falls, Idaho, Forente stater, 83301
        • Saint Luke's Cancer Institute - Twin Falls
    • Illinois
      • Alton, Illinois, Forente stater, 62002
        • OSF Saint Anthony's Health Center
      • Aurora, Illinois, Forente stater, 60504
        • Rush-Copley Medical Center
      • Bloomington, Illinois, Forente stater, 61704
        • Illinois CancerCare-Bloomington
      • Burr Ridge, Illinois, Forente stater, 60527
        • Loyola Center for Health at Burr Ridge
      • 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, 60637
        • University of Chicago Comprehensive Cancer Center
      • Chicago, Illinois, Forente stater, 60612
        • John H Stroger Jr Hospital of Cook County
      • Chicago, Illinois, Forente stater, 60612
        • Rush MD Anderson Cancer Center
      • Danville, Illinois, Forente stater, 61832
        • Carle at The Riverfront
      • DeKalb, Illinois, Forente stater, 60115
        • Northwestern Medicine Cancer Center Kishwaukee
      • 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
      • Effingham, Illinois, Forente stater, 62401
        • Carle Physician Group-Effingham
      • Elmhurst, Illinois, Forente stater, 60126
        • Elmhurst Memorial Hospital
      • 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
      • Geneva, Illinois, Forente stater, 60134
        • Northwestern Medicine Cancer Center Delnor
      • Harvey, Illinois, Forente stater, 60426
        • Ingalls Memorial Hospital
      • Homer Glen, Illinois, Forente stater, 60491
        • Loyola Medicine Homer Glen
      • Joliet, Illinois, Forente stater, 60435
        • Duly Health and Care Joliet
      • 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
      • Mattoon, Illinois, Forente stater, 61938
        • Carle Physician Group-Mattoon/Charleston
      • Maywood, Illinois, Forente stater, 60153
        • Loyola University Medical Center
      • Melrose Park, Illinois, Forente stater, 60160
        • Marjorie Weinberg Cancer Center at Loyola-Gottlieb
      • Mount Vernon, Illinois, Forente stater, 62864
        • SSM Health Good Samaritan
      • Naperville, Illinois, Forente stater, 60540
        • Edward Hospital/Cancer Center
      • New Lenox, Illinois, Forente stater, 60451
        • UC Comprehensive Cancer Center at Silver Cross
      • O'Fallon, Illinois, Forente stater, 62269
        • Cancer Care Center of O'Fallon
      • Orland Park, Illinois, Forente stater, 60462
        • University of Chicago Medicine-Orland Park
      • Orland Park, Illinois, Forente stater, 60462
        • Northwestern Medicine Orland Park
      • Ottawa, Illinois, Forente stater, 61350
        • Illinois CancerCare-Ottawa Clinic
      • Pekin, Illinois, Forente stater, 61554
        • Illinois CancerCare-Pekin
      • Peoria, Illinois, Forente stater, 61636
        • Methodist Medical Center of Illinois
      • Peoria, Illinois, Forente stater, 61615
        • Illinois CancerCare-Peoria
      • Peru, Illinois, Forente stater, 61354
        • Illinois CancerCare-Peru
      • Peru, Illinois, Forente stater, 61354
        • Valley Radiation Oncology
      • Plainfield, Illinois, Forente stater, 60585
        • Edward Hospital/Cancer Center?Plainfield
      • Princeton, Illinois, Forente stater, 61356
        • Illinois CancerCare-Princeton
      • Rockford, Illinois, Forente stater, 61114
        • UW Health Carbone Cancer Center Rockford
      • Shiloh, Illinois, Forente stater, 62269
        • Memorial Hospital East
      • 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
      • Swansea, Illinois, Forente stater, 62226
        • Southwest Illinois Health Services LLP
      • Urbana, Illinois, Forente stater, 61801
        • Carle Cancer Center
      • Urbana, Illinois, Forente stater, 61801
        • The Carle Foundation Hospital
      • Warrenville, Illinois, Forente stater, 60555
        • Northwestern Medicine Cancer Center Warrenville
      • Washington, Illinois, Forente stater, 61571
        • Illinois CancerCare - Washington
      • Yorkville, Illinois, Forente stater, 60560
        • Rush-Copley Healthcare Center
    • Indiana
      • Indianapolis, Indiana, Forente stater, 46237
        • Franciscan Health Indianapolis
      • Indianapolis, Indiana, Forente stater, 46202
        • Indiana University/Melvin and Bren Simon Cancer Center
      • Indianapolis, Indiana, Forente stater, 46202
        • Sidney and Lois Eskenazi Hospital
      • Michigan City, Indiana, Forente stater, 46360
        • Woodland Cancer Care Center
      • Mooresville, Indiana, Forente stater, 46158
        • Franciscan Health Mooresville
      • Richmond, Indiana, Forente stater, 47374
        • Reid Health
    • Iowa
      • Ames, Iowa, Forente stater, 50010
        • Mary Greeley Medical Center
      • Ames, Iowa, Forente stater, 50010
        • McFarland Clinic - Ames
      • Ankeny, Iowa, Forente stater, 50023
        • UI Health Care Mission Cancer and Blood - Ankeny Clinic
      • Boone, Iowa, Forente stater, 50036
        • McFarland Clinic - Boone
      • Carroll, Iowa, Forente stater, 51401
        • Saint Anthony Regional Hospital
      • 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
      • Council Bluffs, Iowa, Forente stater, 51503
        • Alegent Health Mercy Hospital
      • Creston, Iowa, Forente stater, 50801
        • Greater Regional Medical Center
      • Des Moines, Iowa, Forente stater, 50309
        • Iowa Methodist Medical Center
      • Des Moines, Iowa, Forente stater, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Forente stater, 50314
        • Broadlawns Medical Center
      • Des Moines, Iowa, Forente stater, 50316
        • Iowa Lutheran Hospital
      • Des Moines, Iowa, Forente stater, 50309
        • UI Health Care Mission Cancer and Blood - Des Moines Clinic
      • Des Moines, Iowa, Forente stater, 50314
        • UI Health Care Mission Cancer and Blood - Laurel Clinic
      • Fort Dodge, Iowa, Forente stater, 50501
        • McFarland Clinic - Trinity Cancer Center
      • Fort Dodge, Iowa, Forente stater, 50501
        • UI Healthcare Mission Cancer and Blood - Fort Dodge
      • Jefferson, Iowa, Forente stater, 50129
        • McFarland Clinic - Jefferson
      • Marshalltown, Iowa, Forente stater, 50158
        • McFarland Clinic - Marshalltown
      • Sioux City, Iowa, Forente stater, 51101
        • Siouxland Regional Cancer Center
      • West Des Moines, Iowa, Forente stater, 50266-7700
        • Methodist West Hospital
      • West Des Moines, Iowa, Forente stater, 50266
        • Mercy Medical Center-West Lakes
    • Kansas
      • Fairway, Kansas, Forente stater, 66205
        • University of Kansas Clinical Research Center
      • Garden City, Kansas, Forente stater, 67846
        • Central Care Cancer Center - Garden City
      • Great Bend, Kansas, Forente stater, 67530
        • Central Care Cancer Center - Great Bend
      • Hays, Kansas, Forente stater, 67601
        • HaysMed
      • Lawrence, Kansas, Forente stater, 66044
        • Lawrence Memorial Hospital
      • Lenexa, Kansas, Forente stater, 66219
        • Kansas Institute of Medicine Cancer and Blood Center
      • Lenexa, Kansas, Forente stater, 66219
        • Minimally Invasive Surgery Hospital
      • Olathe, Kansas, Forente stater, 66061
        • The University of Kansas Cancer Center - Olathe
      • Overland Park, Kansas, Forente stater, 66210
        • University of Kansas Cancer Center-Overland Park
      • Overland Park, Kansas, Forente stater, 66209
        • Menorah Medical Center
      • Parsons, Kansas, Forente stater, 67357
        • Cancer Center of Kansas - Parsons
      • Pittsburg, Kansas, Forente stater, 66762
        • Freeman Physician Group of Pittsburg
      • Pittsburg, Kansas, Forente stater, 66762
        • Mercy Hospital Pittsburg
      • Salina, Kansas, Forente stater, 67401
        • Salina Regional Health Center
      • Topeka, Kansas, Forente stater, 66606
        • University of Kansas Health System Saint Francis Campus
      • Westwood, Kansas, Forente stater, 66205
        • University of Kansas Hospital-Westwood Cancer Center
      • Wichita, Kansas, Forente stater, 67214
        • Ascension Via Christi Hospitals Wichita
      • Wichita, Kansas, Forente stater, 67208
        • Cancer Center of Kansas-Wichita Medical Arts Tower
      • Wichita, Kansas, Forente stater, 67214
        • Cancer Center of Kansas - Wichita
    • Kentucky
      • Bardstown, Kentucky, Forente stater, 40004
        • CommonSpirit Saint Joseph Hospital - Bardstown
      • Corbin, Kentucky, Forente stater, 40701
        • Commonwealth Cancer Center-Corbin
      • Lexington, Kentucky, Forente stater, 40536
        • University of Kentucky/Markey Cancer Center
      • Lexington, Kentucky, Forente stater, 40504
        • Saint Joseph Radiation Oncology Resource Center
      • Lexington, Kentucky, Forente stater, 40509
        • CommonSpirit Saint Joseph Medical Center - East Lexington
      • London, Kentucky, Forente stater, 40741
        • CommonSpirit Saint Joseph Hospital London
      • Louisville, Kentucky, Forente stater, 40202
        • Jewish Hospital
      • Louisville, Kentucky, Forente stater, 40245
        • UofL Health Medical Center Northeast
      • Louisville, Kentucky, Forente stater, 40207
        • Baptist Health Louisville
      • Louisville, Kentucky, Forente stater, 40215
        • Saints Mary and Elizabeth Hospital
      • Shepherdsville, Kentucky, Forente stater, 40165
        • Jewish Hospital Medical Center South
    • Louisiana
      • Baton Rouge, Louisiana, Forente stater, 70805
        • LSU Health Baton Rouge-North Clinic
      • Baton Rouge, Louisiana, Forente stater, 70809
        • Louisiana Hematology Oncology Associates LLC
      • Baton Rouge, Louisiana, Forente stater, 70809
        • Mary Bird Perkins Cancer Center
      • Baton Rouge, Louisiana, Forente stater, 70836
        • Ochsner High Grove
      • Baton Rouge, Louisiana, Forente stater, 70809
        • Hematology/Oncology Clinic PLLC
      • Baton Rouge, Louisiana, Forente stater, 70808
        • Our Lady of The Lake
      • Baton Rouge, Louisiana, Forente stater, 70808
        • Our Lady of the Lake Physician Group
      • Covington, Louisiana, Forente stater, 70433
        • Northshore Oncology Associates-Covington
      • Covington, Louisiana, Forente stater, 70433
        • Ochsner Hematology Oncology North Shore - Covington (West Region)
      • Houma, Louisiana, Forente stater, 70360
        • Terrebonne General Medical Center
      • Houma, Louisiana, Forente stater, 70360
        • Oncology Center of The South Incorporated
      • Metairie, Louisiana, Forente stater, 70006
        • East Jefferson General Hospital
      • Metairie, Louisiana, Forente stater, 70006
        • LSU Healthcare Network / Metairie Multi-Specialty Clinic
      • Monroe, Louisiana, Forente stater, 71202
        • Ochsner LSU Health Monroe Medical Center
      • New Orleans, Louisiana, Forente stater, 70112
        • Tulane University School of Medicine
      • New Orleans, Louisiana, Forente stater, 70121
        • Ochsner Medical Center Jefferson
      • New Orleans, Louisiana, Forente stater, 70112
        • University Medical Center New Orleans
      • New Orleans, Louisiana, Forente stater, 70112
        • Louisiana State University Health Science Center
      • New Orleans, Louisiana, Forente stater, 70115
        • Touro Infirmary
      • Shreveport, Louisiana, Forente stater, 71103
        • LSU Health Sciences Center at Shreveport
    • Maine
      • Augusta, Maine, Forente stater, 04330
        • Harold Alfond Center for Cancer Care
      • Belfast, Maine, Forente stater, 04915
        • MaineHealth Waldo Hospital
      • Biddeford, Maine, Forente stater, 04005
        • MaineHealth Maine Medical Center - Biddeford
      • Brewer, Maine, Forente stater, 04412
        • Lafayette Family Cancer Center-EMMC
      • Norway, Maine, Forente stater, 04268
        • MaineHealth Stephens Hospital
      • Rockport, Maine, Forente stater, 04856
        • Penobscot Bay Medical Center
      • Sanford, Maine, Forente stater, 04073
        • MaineHealth Cancer Care and IV Therapy - Sanford
      • South Portland, Maine, Forente stater, 04106
        • MaineHealth Cancer Care and IV Therapy - South Portland
    • Maryland
      • Baltimore, Maryland, Forente stater, 21204
        • Greater Baltimore Medical Center
    • Massachusetts
      • Boston, Massachusetts, Forente stater, 02215
        • Dana-Farber Cancer Institute
      • Newton, Massachusetts, Forente stater, 02467
        • Dana-Farber Cancer Institute - Chestnut Hill
      • Springfield, Massachusetts, Forente stater, 01104
        • Mercy Medical Center
    • Michigan
      • Adrian, Michigan, Forente stater, 49221
        • Hickman Cancer Center
      • Ann Arbor, Michigan, Forente stater, 48106
        • Trinity Health Saint Joseph Mercy Hospital Ann Arbor
      • Battle Creek, Michigan, Forente stater, 49017
        • Bronson Battle Creek
      • Brighton, Michigan, Forente stater, 48114
        • Trinity Health IHA Medical Group Hematology Oncology - Brighton
      • Brighton, Michigan, Forente stater, 48114
        • Trinity Health Medical Center - Brighton
      • Brownstown, Michigan, Forente stater, 48183
        • Henry Ford Cancer Institute-Downriver
      • 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
      • Clarkston, Michigan, Forente stater, 48346
        • Hematology Oncology Consultants-Clarkston
      • Clarkston, Michigan, Forente stater, 48346
        • Newland Medical Associates-Clarkston
      • Clinton Township, Michigan, Forente stater, 48038
        • Henry Ford Macomb Hospital-Clinton Township
      • Dearborn, Michigan, Forente stater, 48126
        • Henry Ford Medical Center-Fairlane
      • Detroit, Michigan, Forente stater, 48202
        • Henry Ford Hospital
      • Detroit, Michigan, Forente stater, 48236
        • Henry Ford Health Saint John Hospital
      • East China Township, Michigan, Forente stater, 48054
        • Henry Ford River District Hospital
      • Escanaba, Michigan, Forente stater, 49829
        • OSF Saint Francis Hospital and Medical Group
      • Flint, Michigan, Forente stater, 48503
        • Hurley Medical Center
      • Flint, Michigan, Forente stater, 48503
        • Genesee Hematology Oncology PC
      • Flint, Michigan, Forente stater, 48503
        • Genesys Hurley Cancer Institute
      • Flint, Michigan, Forente stater, 48503
        • Cancer Hematology Centers - Flint
      • Grand Rapids, Michigan, Forente stater, 49503
        • Trinity Health Grand Rapids Hospital
      • Grand Rapids, Michigan, Forente stater, 49503
        • Corewell Health Grand Rapids Hospitals - Butterworth Hospital
      • Grand Rapids, Michigan, Forente stater, 49503
        • Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
      • Grosse Pointe Woods, Michigan, Forente stater, 48236
        • Henry Ford Saint John Hospital - Academic
      • Grosse Pointe Woods, Michigan, Forente stater, 48236
        • Henry Ford Saint John Hospital - Breast
      • Grosse Pointe Woods, Michigan, Forente stater, 48236
        • Henry Ford Saint John Hospital - Van Elslander
      • Jackson, Michigan, Forente stater, 49201
        • Allegiance Health
      • Kalamazoo, Michigan, Forente stater, 49007
        • West Michigan Cancer Center
      • Kalamazoo, Michigan, Forente stater, 49007
        • Bronson Methodist Hospital
      • Kalamazoo, Michigan, Forente stater, 49009
        • Beacon Kalamazoo Cancer Center
      • Kalamazoo, Michigan, Forente stater, 49048
        • Beacon Kalamazoo
      • Lansing, Michigan, Forente stater, 48912
        • University of Michigan Health - Sparrow Lansing
      • Livonia, Michigan, Forente stater, 48154
        • Trinity Health Saint Mary Mercy Livonia Hospital
      • Livonia, Michigan, Forente stater, 48154
        • Hope Cancer Clinic
      • Macomb, Michigan, Forente stater, 48044
        • Henry Ford Warren Hospital - Breast Macomb
      • 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
      • Monroe, Michigan, Forente stater, 48162
        • Toledo Clinic Cancer Centers-Monroe
      • Muskegon, Michigan, Forente stater, 49444
        • Trinity Health Muskegon Hospital
      • Niles, Michigan, Forente stater, 49120
        • Corewell Health Lakeland Hospitals - Niles Hospital
      • Norton Shores, Michigan, Forente stater, 49444
        • Cancer and Hematology Centers of Western Michigan - Norton Shores
      • Novi, Michigan, Forente stater, 48377
        • Henry Ford Medical Center-Columbus
      • Novi, Michigan, Forente stater, 48374
        • Henry Ford Health Providence Novi Hospital
      • Pontiac, Michigan, Forente stater, 48341
        • Hope Cancer Center
      • Pontiac, Michigan, Forente stater, 48341
        • Trinity Health Saint Joseph Mercy Oakland Hospital
      • Pontiac, Michigan, Forente stater, 48341
        • Michigan Healthcare Professionals Pontiac
      • Pontiac, Michigan, Forente stater, 48341
        • Trinity Health IHA Medical Group-Alice Gustafson Center
      • Port Huron, Michigan, Forente stater, 48060
        • Lake Huron Medical Center
      • Port Huron, Michigan, Forente stater, 48060
        • Huron Medical Center PC
      • Reed City, Michigan, Forente stater, 49677
        • Corewell Health Reed City Hospital
      • Rochester Hills, Michigan, Forente stater, 48309
        • Henry Ford Rochester Hospital
      • Saginaw, Michigan, Forente stater, 48604
        • Oncology Hematology Associates of Saginaw Valley PC
      • Saginaw, Michigan, Forente stater, 48601
        • MyMichigan Medical Center Saginaw
      • Saint Joseph, Michigan, Forente stater, 49085
        • Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
      • Saint Joseph, Michigan, Forente stater, 49085
        • Corewell Health Lakeland Hospitals - Saint Joseph Hospital
      • Shelby, Michigan, Forente stater, 48315
        • Henry Ford Macomb Health Center - Shelby Township
      • Southfield, Michigan, Forente stater, 48075
        • Henry Ford Health Providence Southfield Hospital
      • Sterling Heights, Michigan, Forente stater, 48312
        • Bhadresh Nayak MD PC-Sterling Heights
      • Tawas City, Michigan, Forente stater, 48764
        • MyMichigan Medical Center Tawas
      • Traverse City, Michigan, Forente stater, 49684
        • Munson Medical Center
      • Warren, Michigan, Forente stater, 48088
        • Advanced Breast Care Center PLLC
      • Warren, Michigan, Forente stater, 48093
        • Macomb Hematology Oncology PC
      • Warren, Michigan, Forente stater, 48093
        • Henry Ford Madison Heights Hospital - Breast
      • Warren, Michigan, Forente stater, 48093
        • Henry Ford Health Warren Hospital
      • Warren, Michigan, Forente stater, 48093
        • Henry Ford Warren Hospital - GLCMS
      • West Bloomfield, Michigan, Forente stater, 48322
        • Henry Ford West Bloomfield Hospital
      • West Branch, Michigan, Forente stater, 48661
        • Saint Mary's Oncology/Hematology Associates of West Branch
      • Wyoming, Michigan, Forente stater, 49519
        • University of Michigan Health - West
      • Ypsilanti, Michigan, Forente stater, 48197
        • Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
      • Ypsilanti, Michigan, Forente stater, 48106
        • Huron Gastroenterology PC
    • Minnesota
      • Aitkin, Minnesota, Forente stater, 56431
        • Riverwood Healthcare Center
      • 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
      • Cambridge, Minnesota, Forente stater, 55008
        • Cambridge Medical Center
      • 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
      • 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
      • Minneapolis, Minnesota, Forente stater, 55417
        • Minneapolis VA Medical Center
      • Monticello, Minnesota, Forente stater, 55362
        • Monticello Cancer Center
      • New Ulm, Minnesota, Forente stater, 56073
        • New Ulm Medical Center
      • Park Rapids, Minnesota, Forente stater, 56470
        • Essentia Health - Park Rapids
      • Princeton, Minnesota, Forente stater, 55371
        • Fairview Northland Medical Center
      • Robbinsdale, Minnesota, Forente stater, 55422
        • North Memorial Medical Health Center
      • Saint Cloud, Minnesota, Forente stater, 56303
        • Coborn Cancer Center at Saint Cloud Hospital
      • 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
      • Thief River Falls, Minnesota, Forente stater, 56701
        • Sanford Thief River Falls Medical Center
      • 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
      • Worthington, Minnesota, Forente stater, 56187
        • Sanford Cancer Center Worthington
      • Wyoming, Minnesota, Forente stater, 55092
        • Fairview Lakes Medical Center
    • Mississippi
      • Columbus, Mississippi, Forente stater, 39705
        • Baptist Memorial Hospital and Cancer Center-Golden Triangle
      • Grenada, Mississippi, Forente stater, 38901
        • Baptist Cancer Center-Grenada
      • Gulfport, Mississippi, Forente stater, 39502
        • Gulfport Memorial Hospital
      • Jackson, Mississippi, Forente stater, 39216
        • University of Mississippi Medical Center
      • 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
      • Bonne Terre, Missouri, Forente stater, 63628
        • Parkland Health Center-Bonne Terre
      • Branson, Missouri, Forente stater, 65616
        • Cox Cancer Center Branson
      • Cape Girardeau, Missouri, Forente stater, 63703
        • Saint Francis Medical Center
      • Cape Girardeau, Missouri, Forente stater, 63703
        • Mercy Cancer Center - Cape Girardeau
      • Chesterfield, Missouri, Forente stater, 63017
        • Saint Luke's Hospital
      • City of Saint Peters, Missouri, Forente stater, 63376
        • Siteman Cancer Center at Saint Peters Hospital
      • Columbia, Missouri, Forente stater, 65212
        • MU Health - University Hospital/Ellis Fischel Cancer Center
      • Creve Coeur, Missouri, Forente stater, 63141
        • Siteman Cancer Center at West County Hospital
      • Farmington, Missouri, Forente stater, 63640
        • Parkland Health Center - Farmington
      • Independence, Missouri, Forente stater, 64057
        • Centerpoint Medical Center LLC
      • 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
      • Kansas City, Missouri, Forente stater, 64154
        • University of Kansas Cancer Center - North
      • Kansas City, Missouri, Forente stater, 64132
        • Research Medical Center
      • Kansas City, Missouri, Forente stater, 64108
        • University Health Truman Medical Center
      • Lee's Summit, Missouri, Forente stater, 64064
        • University of Kansas Cancer Center - Lee's Summit
      • North Kansas City, Missouri, Forente stater, 64116
        • University of Kansas Cancer Center at North Kansas City Hospital
      • 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, 63109
        • Mercy Infusion Center - Chippewa
      • 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
      • Washington, Missouri, Forente stater, 63090
        • Mercy Hospital Washington
    • Montana
      • Anaconda, Montana, Forente stater, 59711
        • Community Hospital of Anaconda
      • Billings, Montana, Forente stater, 59101
        • Billings Clinic Cancer Center
      • Billings, Montana, Forente stater, 59101
        • Saint Vincent Healthcare
      • Billings, Montana, Forente stater, 59102
        • Saint Vincent Frontier Cancer Center
      • Bozeman, Montana, Forente stater, 59715
        • Bozeman Health Deaconess Hospital
      • Butte, Montana, Forente stater, 59701
        • Saint James Community Hospital and Cancer Treatment Center
      • Great Falls, Montana, Forente stater, 59405
        • Great Falls Clinic
      • Great Falls, Montana, Forente stater, 59405
        • Benefis Sletten Cancer Institute
      • Helena, Montana, Forente stater, 59601
        • Saint Peter's Community Hospital
      • Kalispell, Montana, Forente stater, 59901
        • Logan Health Medical Center
      • Missoula, Montana, Forente stater, 59802
        • Saint Patrick Hospital - Community Hospital
      • Missoula, Montana, Forente stater, 59804
        • Community Medical Center
    • 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
      • Lincoln, Nebraska, Forente stater, 68510
        • Saint Elizabeth Regional Medical Center
      • Lincoln, Nebraska, Forente stater, 68516
        • Cancer Partners of Nebraska
      • Omaha, Nebraska, Forente stater, 68114
        • Nebraska Methodist Hospital
      • 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
      • Omaha, Nebraska, Forente stater, 68114
        • Oncology Associates PC
      • Omaha, Nebraska, Forente stater, 68114
        • Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
      • Papillion, Nebraska, Forente stater, 68046
        • Midlands Community Hospital
    • Nevada
      • Carson City, Nevada, Forente stater, 89703
        • Carson Tahoe Regional Medical Center
      • Henderson, Nevada, Forente stater, 89052
        • Comprehensive Cancer Centers of Nevada - Henderson
      • Henderson, Nevada, Forente stater, 89052
        • Cancer and Blood Specialists-Henderson
      • Henderson, Nevada, Forente stater, 89052
        • Las Vegas Cancer Center-Henderson
      • Henderson, Nevada, Forente stater, 89074
        • Comprehensive Cancer Centers of Nevada-Southeast Henderson
      • Henderson, Nevada, Forente stater, 89052
        • Comprehensive Cancer Centers of Nevada-Horizon Ridge
      • Henderson, Nevada, Forente stater, 89074
        • Las Vegas Urology - Green Valley
      • Henderson, Nevada, Forente stater, 89074
        • Las Vegas Urology - Pebble
      • Henderson, Nevada, Forente stater, 89074
        • Urology Specialists of Nevada - Green Valley
      • Henderson, Nevada, Forente stater, 89074
        • Oncology Las Vegas - Henderson
      • Las Vegas, Nevada, Forente stater, 89144
        • Summerlin Hospital Medical Center
      • Las Vegas, Nevada, Forente stater, 89109
        • Sunrise Hospital and Medical Center
      • 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, 89102
        • University Medical Center of Southern Nevada
      • Las Vegas, Nevada, Forente stater, 89106
        • Cancer and Blood Specialists-Shadow
      • Las Vegas, Nevada, Forente stater, 89109
        • HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
      • Las Vegas, Nevada, Forente stater, 89113
        • HealthCare Partners Medical Group Oncology/Hematology-San Martin
      • Las Vegas, Nevada, Forente stater, 89128
        • Cancer and Blood Specialists-Tenaya
      • Las Vegas, Nevada, Forente stater, 89128
        • HealthCare Partners Medical Group Oncology/Hematology-Tenaya
      • Las Vegas, Nevada, Forente stater, 89148-2405
        • Las Vegas Cancer Center-Medical Center
      • Las Vegas, Nevada, Forente stater, 89149
        • HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
      • Las Vegas, Nevada, Forente stater, 89128
        • Ann M Wierman MD LTD
      • Las Vegas, Nevada, Forente stater, 89074
        • Las Vegas Urology - Pecos
      • Las Vegas, Nevada, Forente stater, 89102
        • Desert West Surgery
      • Las Vegas, Nevada, Forente stater, 89103
        • Hope Cancer Care of Nevada
      • Las Vegas, Nevada, Forente stater, 89106
        • Urology Specialists of Nevada - Central
      • Las Vegas, Nevada, Forente stater, 89113
        • Las Vegas Prostate Cancer Center
      • Las Vegas, Nevada, Forente stater, 89113
        • Las Vegas Urology - Sunset
      • Las Vegas, Nevada, Forente stater, 89128
        • Las Vegas Urology - Cathedral Rock
      • Las Vegas, Nevada, Forente stater, 89128
        • Las Vegas Urology - Smoke Ranch
      • Las Vegas, Nevada, Forente stater, 89128
        • Urology Specialists of Nevada - Northwest
      • Las Vegas, Nevada, Forente stater, 89169
        • University Cancer Center
      • Las Vegas, Nevada, Forente stater, 89113
        • Urology Specialists of Nevada - Southwest
      • Las Vegas, Nevada, Forente stater, 89128
        • Oncology Las Vegas - Tenaya
      • Las Vegas, Nevada, Forente stater, 89183
        • OptumCare Cancer Care at Fort Apache
      • Pahrump, Nevada, Forente stater, 89048
        • Hope Cancer Care of Nevada-Pahrump
      • 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
      • Concord, New Hampshire, Forente stater, 03301
        • New Hampshire Oncology Hematology PA-Concord
      • Manchester, New Hampshire, Forente stater, 03103
        • Solinsky Center for Cancer Care
      • Manchester, New Hampshire, Forente stater, 03103
        • Elliot Hospital
    • New Jersey
      • Brick, New Jersey, Forente stater, 08724
        • Ocean University Medical Center
      • Cape May Court House, New Jersey, Forente stater, 08210
        • AtlantiCare Health Park-Cape May Court House
      • Egg Harbor, New Jersey, Forente stater, 08234
        • AtlantiCare Surgery Center
      • Hackensack, New Jersey, Forente stater, 07601
        • Hackensack University Medical Center
      • Livingston, New Jersey, Forente stater, 07039
        • Cooperman Barnabas Medical Center
      • Manahawkin, New Jersey, Forente stater, 08050
        • Southern Ocean County Medical Center
      • Mullica Hill, New Jersey, Forente stater, 08062
        • Inspira Medical Center Mullica Hill
      • 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
    • New Mexico
      • Albuquerque, New Mexico, Forente stater, 87106
        • University of New Mexico Cancer Center
    • New York
      • Auburn, New York, Forente stater, 13021
        • Hematology Oncology Associates of Central New York-Auburn
      • Camillus, New York, Forente stater, 13031
        • Hematology Oncology Associates of CNY at Camillus
      • Cooperstown, New York, Forente stater, 13326
        • Mary Imogene Bassett Hospital
      • East Syracuse, New York, Forente stater, 13057
        • Hematology Oncology Associates of Central New York-East Syracuse
      • Glens Falls, New York, Forente stater, 12801
        • Glens Falls Hospital
      • Lake Success, New York, Forente stater, 11042
        • Northwell Health/Center for Advanced Medicine
      • New York, New York, Forente stater, 10065
        • NYP/Weill Cornell Medical Center
      • Rochester, New York, Forente stater, 14642
        • University of Rochester
      • Stony Brook, New York, Forente stater, 11794
        • Stony Brook University Medical Center
      • 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
      • Asheville, North Carolina, Forente stater, 28803
        • AdventHealth Infusion Center Asheville
      • Chapel Hill, North Carolina, Forente stater, 27599
        • UNC Lineberger Comprehensive Cancer Center
      • Charlotte, North Carolina, Forente stater, 28204
        • Novant Health Presbyterian Medical Center
      • Clemmons, North Carolina, Forente stater, 27012
        • Wake Forest University at Clemmons
      • Clinton, North Carolina, Forente stater, 28328
        • Southeastern Medical Oncology Center-Clinton
      • Clyde, North Carolina, Forente stater, 28721
        • AdventHealth Infusion Center Haywood
      • Durham, North Carolina, Forente stater, 27710
        • Duke University Medical Center
      • Durham, North Carolina, Forente stater, 27705
        • Durham VA Medical Center
      • Goldsboro, North Carolina, Forente stater, 27534
        • Southeastern Medical Oncology Center-Goldsboro
      • Greenville, North Carolina, Forente stater, 27834
        • ECU Health Medical Center
      • Hendersonville, North Carolina, Forente stater, 28791
        • Margaret R Pardee Memorial Hospital
      • Hendersonville, North Carolina, Forente stater, 28792
        • AdventHealth Hendersonville
      • Huntersville, North Carolina, Forente stater, 28078
        • Novant Health Cancer Institute - Huntersville
      • Huntersville, North Carolina, Forente stater, 28078
        • Novant Health Presbyterian Medical Center Huntersville
      • Jacksonville, North Carolina, Forente stater, 28546
        • Southeastern Medical Oncology Center-Jacksonville
      • Kenansville, North Carolina, Forente stater, 28349
        • ECU Health Oncology Kenansville
      • Kernersville, North Carolina, Forente stater, 27284
        • Novant Health Cancer Institute - Kernersville
      • Kinston, North Carolina, Forente stater, 28501
        • ECU Health Oncology Kinston
      • 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
      • Richlands, North Carolina, Forente stater, 28574
        • ECU Health Oncology Richlands
      • Statesville, North Carolina, Forente stater, 28625
        • Novant Health Cancer Institute - Statesville
      • Statesville, North Carolina, Forente stater, 28677
        • Wake Forest Baptist Health - Hematology Oncology - Statesville
      • Thomasville, North Carolina, Forente stater, 27360
        • Novant Health Cancer Institute - Thomasville
      • Weaverville, North Carolina, Forente stater, 28787
        • AdventHealth Infusion Center Weaverville
      • Wilkesboro, North Carolina, Forente stater, 28659
        • Wake Forest Baptist Health - Wilkes Medical Center
      • Winston-Salem, North Carolina, Forente stater, 27157
        • Wake Forest University Health Sciences
      • 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
      • Fargo, North Dakota, Forente stater, 58103
        • Sanford South University Medical Center
      • Fargo, North Dakota, Forente stater, 58103
        • Southpointe-Sanford Medical Center Fargo
      • Fargo, North Dakota, Forente stater, 58104
        • Sanford Medical Center Fargo
      • Grand Forks, North Dakota, Forente stater, 58201
        • Altru Cancer Center
      • Jamestown, North Dakota, Forente stater, 58401
        • Essentia Health - Jamestown Clinic
      • Minot, North Dakota, Forente stater, 58701
        • Trinity Cancer Care Center
    • Ohio
      • Beavercreek, Ohio, Forente stater, 45431
        • Indu and Raj Soin Medical Center
      • Belpre, Ohio, Forente stater, 45714
        • Strecker Cancer Center-Belpre
      • 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
      • Chillicothe, Ohio, Forente stater, 45601
        • Adena Regional Medical Center
      • 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
      • Cincinnati, Ohio, Forente stater, 45247
        • TriHealth Cancer Institute-Westside
      • Cincinnati, Ohio, Forente stater, 45255
        • TriHealth Cancer Institute-Anderson
      • Cleveland, Ohio, Forente stater, 44109
        • MetroHealth Medical Center
      • Columbus, Ohio, Forente stater, 43214
        • Riverside Methodist Hospital
      • Columbus, Ohio, Forente stater, 43210
        • Ohio State University Comprehensive Cancer Center
      • Columbus, Ohio, Forente stater, 43219
        • The Mark H Zangmeister Center
      • Columbus, Ohio, Forente stater, 43214
        • Columbus Oncology and Hematology Associates Inc
      • Columbus, Ohio, Forente stater, 43228
        • Doctors Hospital
      • Columbus, Ohio, Forente stater, 43213
        • Mount Carmel East Hospital
      • Columbus, Ohio, Forente stater, 43215
        • Grant Medical Center
      • Columbus, Ohio, Forente stater, 43222
        • Mount Carmel Health Center West
      • Dayton, Ohio, Forente stater, 45406
        • Good Samaritan Hospital - Dayton
      • 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
      • Dayton, Ohio, Forente stater, 45409
        • Premier Blood and Cancer Center
      • Delaware, Ohio, Forente stater, 43015
        • Delaware Health Center-Grady Cancer Center
      • Delaware, Ohio, Forente stater, 43015
        • Grady Memorial Hospital
      • Dublin, Ohio, Forente stater, 43016
        • Dublin Methodist Hospital
      • Dublin, Ohio, Forente stater, 43016
        • Columbus Oncology and Hematology Associates
      • 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
      • Gahanna, Ohio, Forente stater, 43230
        • Central Ohio Breast and Endocrine Surgery
      • Greenville, Ohio, Forente stater, 45331
        • Wayne Hospital
      • Greenville, Ohio, Forente stater, 45331
        • Dayton Physicians LLC-Wayne
      • Greenville, Ohio, Forente stater, 45331
        • Miami Valley Cancer Care and Infusion
      • Grove City, Ohio, Forente stater, 43123
        • Mount Carmel Grove City Hospital
      • Kettering, Ohio, Forente stater, 45429
        • Kettering Medical Center
      • Kettering, Ohio, Forente stater, 45409
        • Greater Dayton Cancer Center
      • Kettering, Ohio, Forente stater, 45420
        • First Dayton Cancer Care
      • Lancaster, Ohio, Forente stater, 43130
        • Fairfield Medical Center
      • Lima, Ohio, Forente stater, 45801
        • Saint Rita's Medical Center
      • Mansfield, Ohio, Forente stater, 44903
        • OhioHealth Mansfield Hospital
      • Marietta, Ohio, Forente stater, 45750
        • Marietta Memorial Hospital
      • Marion, Ohio, Forente stater, 43302
        • OhioHealth Marion General Hospital
      • Marysville, Ohio, Forente stater, 43040
        • Memorial Hospital
      • Mount Vernon, Ohio, Forente stater, 43050
        • Knox Community Hospital
      • Newark, Ohio, Forente stater, 43055
        • Licking Memorial Hospital
      • Newark, Ohio, Forente stater, 43055
        • Newark Radiation Oncology
      • Perrysburg, Ohio, Forente stater, 43551
        • Mercy Health - Perrysburg Hospital
      • Portsmouth, Ohio, Forente stater, 45662
        • Southern Ohio Medical Center
      • Springfield, Ohio, Forente stater, 45504
        • Springfield Regional Cancer Center
      • Springfield, Ohio, Forente stater, 45504
        • Springfield Regional Medical Center
      • Toledo, Ohio, Forente stater, 43623
        • Mercy Health - Saint Anne Hospital
      • Toledo, Ohio, Forente stater, 43623
        • Toledo Clinic Cancer Centers-Toledo
      • Toledo, Ohio, Forente stater, 43608
        • Mercy Health - Saint Vincent 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
      • West Chester, Ohio, Forente stater, 45069
        • University of Cincinnati Cancer Center-West Chester
      • Westerville, Ohio, Forente stater, 43081
        • Saint Ann's Hospital
      • Youngstown, Ohio, Forente stater, 44501
        • Saint Elizabeth Youngstown Hospital
      • Zanesville, Ohio, Forente stater, 43701
        • Genesis Healthcare System Cancer Care Center
    • Oklahoma
      • Lawton, Oklahoma, Forente stater, 73505
        • Cancer Centers of Southwest Oklahoma Research
      • Oklahoma City, Oklahoma, Forente stater, 73104
        • University of Oklahoma Health Sciences Center
      • Oklahoma City, Oklahoma, Forente stater, 73120
        • Mercy Hospital Oklahoma City
      • Tulsa, Oklahoma, Forente stater, 74146
        • Oklahoma Cancer Specialists and Research Institute-Tulsa
    • Oregon
      • Baker City, Oregon, Forente stater, 97814
        • Saint Alphonsus Cancer Care Center-Baker City
      • 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
      • Gresham, Oregon, Forente stater, 97030
        • Legacy Mount Hood Medical Center
      • Newberg, Oregon, Forente stater, 97132
        • Providence Newberg Medical Center
      • Ontario, Oregon, Forente stater, 97914
        • Saint Alphonsus Cancer Care Center-Ontario
      • Oregon City, Oregon, Forente stater, 97045
        • Providence Willamette Falls Medical Center
      • Portland, Oregon, Forente stater, 97239
        • Oregon Health and Science University
      • Portland, Oregon, Forente stater, 97210
        • Legacy Good Samaritan Hospital and Medical Center
      • Portland, Oregon, Forente stater, 97213
        • Providence Portland Medical Center
      • Portland, Oregon, Forente stater, 97225
        • Providence Saint Vincent Medical Center
      • Redmond, Oregon, Forente stater, 97756
        • Saint Charles Health System-Redmond
      • Tualatin, Oregon, Forente stater, 97062
        • Legacy Meridian Park Hospital
    • Pennsylvania
      • Allentown, Pennsylvania, Forente stater, 18103
        • Lehigh Valley Hospital-Cedar Crest
      • Bethlehem, Pennsylvania, Forente stater, 18017
        • Lehigh Valley Hospital - Muhlenberg
      • Bryn Mawr, Pennsylvania, Forente stater, 19010
        • Bryn Mawr Hospital
      • Chadds Ford, Pennsylvania, Forente stater, 19317
        • Christiana Care Health System-Concord Health Center
      • Collegeville, Pennsylvania, Forente stater, 19426
        • Main Line Health Center-Collegeville
      • Danville, Pennsylvania, Forente stater, 17822
        • Geisinger Medical Center
      • East Stroudsburg, Pennsylvania, Forente stater, 18301
        • Pocono Medical Center
      • Exton, Pennsylvania, Forente stater, 19341
        • Main Line Health Center-Exton
      • Hazleton, Pennsylvania, Forente stater, 18201
        • Geisinger Medical Center-Cancer Center Hazleton
      • Hazleton, Pennsylvania, Forente stater, 18201
        • Lehigh Valley Hospital-Hazleton
      • Hershey, Pennsylvania, Forente stater, 17033-0850
        • Penn State Milton S Hershey Medical Center
      • Lewisburg, Pennsylvania, Forente stater, 17837
        • Geisinger Medical Oncology-Lewisburg
      • Lewistown, Pennsylvania, Forente stater, 17044
        • Lewistown Hospital
      • Media, Pennsylvania, Forente stater, 19063
        • Riddle Memorial Hospital
      • Newtown Square, Pennsylvania, Forente stater, 19073
        • Bryn Mawr Health Center
      • Paoli, Pennsylvania, Forente stater, 19301
        • Paoli Memorial Hospital
      • Philadelphia, Pennsylvania, Forente stater, 19107
        • Thomas Jefferson University Hospital
      • Philadelphia, Pennsylvania, Forente stater, 19148
        • Jefferson Methodist Hospital
      • Pottsville, Pennsylvania, Forente stater, 17901
        • Geisinger Cancer Services-Pottsville
      • Sayre, Pennsylvania, Forente stater, 18840
        • Guthrie Medical Group PC-Robert Packer Hospital
      • Scranton, Pennsylvania, Forente stater, 18510
        • Community Medical Center
      • Selinsgrove, Pennsylvania, Forente stater, 17870
        • Geisinger Medical Oncology-Selinsgrove
      • State College, Pennsylvania, Forente stater, 16801
        • Geisinger Medical Group
      • Wilkes-Barre, Pennsylvania, Forente stater, 18711
        • Geisinger Wyoming Valley/Henry Cancer Center
      • Wynnewood, Pennsylvania, Forente stater, 19096
        • Lankenau Medical Center
    • South Carolina
      • Boiling Springs, South Carolina, Forente stater, 29316
        • Prisma Health Cancer Institute - Spartanburg
      • Charleston, South Carolina, Forente stater, 29425
        • Medical University of South Carolina
      • Easley, South Carolina, Forente stater, 29640
        • Prisma Health Cancer Institute - Easley
      • Gaffney, South Carolina, Forente stater, 29341
        • Gibbs Cancer Center-Gaffney
      • Greenville, South Carolina, Forente stater, 29605
        • Prisma Health Cancer Institute - Faris
      • Greenville, South Carolina, Forente stater, 29607
        • Saint Francis Cancer Center
      • Greenville, South Carolina, Forente stater, 29615
        • Prisma Health Cancer Institute - Eastside
      • Greenville, South Carolina, Forente stater, 29605
        • Prisma Health Cancer Institute - Butternut
      • Greenville, South Carolina, Forente stater, 29601
        • Saint Francis Hospital
      • Greenville, South Carolina, Forente stater, 29605
        • Prisma Health Greenville Memorial Hospital
      • Greer, South Carolina, Forente stater, 29650
        • Prisma Health Cancer Institute - Greer
      • Greer, South Carolina, Forente stater, 29651
        • Gibbs Cancer Center-Pelham
      • Seneca, South Carolina, Forente stater, 29672
        • Prisma Health Cancer Institute - Seneca
      • Spartanburg, South Carolina, Forente stater, 29303
        • Spartanburg Medical Center
      • Spartanburg, South Carolina, Forente stater, 29307
        • Spartanburg Medical Center - Mary Black Campus
      • Spartanburg, South Carolina, Forente stater, 29303
        • North Grove Medical Park
      • Union, South Carolina, Forente stater, 29379
        • SMC Center for Hematology Oncology Union
    • South Dakota
      • Aberdeen, South Dakota, Forente stater, 57401
        • Avera Cancer Institute-Aberdeen
      • Rapid City, South Dakota, Forente stater, 57701
        • Rapid City Regional Hospital
      • 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
      • Alcoa, Tennessee, Forente stater, 37701
        • University Cancer Specialists - Alcoa
      • Bristol, Tennessee, Forente stater, 37620
        • Bristol Regional Medical Center
      • Collierville, Tennessee, Forente stater, 38017
        • Baptist Memorial Hospital and Cancer Center-Collierville
      • Cookeville, Tennessee, Forente stater, 38501
        • Cookeville Regional Medical Center
      • Kingsport, Tennessee, Forente stater, 37660
        • Ballad Health Cancer Care - Kingsport
      • Kingsport, Tennessee, Forente stater, 37660
        • Wellmont Holston Valley Hospital and Medical Center
      • Knoxville, Tennessee, Forente stater, 37920
        • University of Tennessee - Knoxville
      • Memphis, Tennessee, Forente stater, 38120
        • Baptist Memorial Hospital and Cancer Center-Memphis
    • Texas
      • Austin, Texas, Forente stater, 78701
        • Dell Seton Medical Center at The University of 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
      • Dallas, Texas, Forente stater, 75237
        • UT Southwestern Simmons Cancer Center - RedBird
      • Fort Worth, Texas, Forente stater, 76104
        • UT Southwestern/Simmons Cancer Center-Fort Worth
      • Galveston, Texas, Forente stater, 77555-0565
        • University of Texas Medical Branch
      • Houston, Texas, Forente stater, 77030
        • Memorial Hermann Texas Medical Center
      • Laredo, Texas, Forente stater, 78041
        • Doctor's Hospital of Laredo
      • Richardson, Texas, Forente stater, 75080
        • UT Southwestern Clinical Center at Richardson/Plano
    • Utah
      • American Fork, Utah, Forente stater, 84003
        • American Fork Hospital / Huntsman Intermountain Cancer Center
      • Cedar City, Utah, Forente stater, 84720
        • Sandra L Maxwell Cancer Center
      • Logan, Utah, Forente stater, 84321
        • Logan Regional Hospital
      • Murray, Utah, Forente stater, 84107
        • Intermountain Medical Center
      • Ogden, Utah, Forente stater, 84403
        • McKay-Dee Hospital Center
      • Provo, Utah, Forente stater, 84604
        • Utah Valley Regional Medical Center
      • Riverton, Utah, Forente stater, 84065
        • Riverton Hospital
      • Salt Lake City, Utah, Forente stater, 84106
        • Utah Cancer Specialists-Salt Lake City
      • Salt Lake City, Utah, Forente stater, 84143
        • LDS Hospital
      • St. George, Utah, Forente stater, 84770
        • Saint George Regional Medical 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
    • Virginia
      • Bristol, Virginia, Forente stater, 24201
        • Ballad Health Cancer Care - Bristol
      • Fishersville, Virginia, Forente stater, 22939
        • Augusta Health Center for Cancer and Blood Disorders
      • Lynchburg, Virginia, Forente stater, 24501
        • Centra Alan B Pearson Regional Cancer Center
      • Mechanicsville, Virginia, Forente stater, 23116
        • Bon Secours Memorial Regional Medical Center
      • Midlothian, Virginia, Forente stater, 23114
        • Bon Secours Saint Francis Medical Center
      • Midlothian, Virginia, Forente stater, 23113
        • Bon Secours Westchester Emergency Center
      • Norfolk, Virginia, Forente stater, 23505
        • Bon Secours DePaul Medical Center
      • Norton, Virginia, Forente stater, 24273
        • Ballad Health Cancer Care - Norton
      • Portsmouth, Virginia, Forente stater, 23707
        • Bon Secours Maryview Medical Center
      • Richmond, Virginia, Forente stater, 23226
        • Bon Secours Saint Mary's Hospital
      • Richmond, Virginia, Forente stater, 23230
        • Bon Secours Cancer Institute at Reynolds Crossing
      • Richmond, Virginia, Forente stater, 23298
        • VCU Massey Comprehensive Cancer Center
      • South Hill, Virginia, Forente stater, 23970
        • VCU Community Memorial Health Center
      • Suffolk, Virginia, Forente stater, 23435
        • Bon Secours Health Center at Harbour View
    • Washington
      • Aberdeen, Washington, Forente stater, 98520
        • Providence Regional Cancer System-Aberdeen
      • Auburn, Washington, Forente stater, 98001
        • MultiCare Auburn Medical Center
      • 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
      • Enumclaw, Washington, Forente stater, 98022
        • Saint Elizabeth Hospital
      • Everett, Washington, Forente stater, 98201
        • Providence Regional Cancer Partnership
      • Federal Way, Washington, Forente stater, 98003
        • Saint Francis Hospital
      • Gig Harbor, Washington, Forente stater, 98335
        • MultiCare Gig Harbor Medical Park
      • Issaquah, Washington, Forente stater, 98029
        • Swedish Cancer Institute-Issaquah
      • Kennewick, Washington, Forente stater, 99336
        • Kadlec Clinic Hematology and Oncology
      • Lacey, Washington, Forente stater, 98503
        • Providence Regional Cancer System-Lacey
      • Lakewood, Washington, Forente stater, 98499
        • Saint Clare Hospital
      • Longview, Washington, Forente stater, 98632
        • PeaceHealth Saint John Medical Center
      • Port Townsend, Washington, Forente stater, 98368
        • Jefferson Healthcare
      • Poulsbo, Washington, Forente stater, 98370
        • Harrison HealthPartners Hematology and Oncology-Poulsbo
      • Puyallup, Washington, Forente stater, 98372
        • MultiCare Good Samaritan Hospital
      • 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
      • Seattle, Washington, Forente stater, 98104
        • Pacific Gynecology Specialists
      • Seattle, Washington, Forente stater, 98122-5711
        • Swedish Medical Center-Cherry Hill
      • Sedro-Woolley, Washington, Forente stater, 98284
        • PeaceHealth United General Medical Center
      • Shelton, Washington, Forente stater, 98584
        • Providence Regional Cancer System-Shelton
      • Silverdale, Washington, Forente stater, 98383
        • Saint Joseph Medical Center Hematology and Oncology - Silverdale
      • Spokane, Washington, Forente stater, 99204
        • MultiCare Deaconess Cancer and Blood Specialty Center - Downtown
      • Spokane, Washington, Forente stater, 99218
        • MultiCare Deaconess Cancer and Blood Specialty Center - North
      • Spokane Valley, Washington, Forente stater, 99216
        • MultiCare Deaconess Cancer and Blood Specialty Center - Valley
      • Tacoma, Washington, Forente stater, 98405
        • Mary Bridge Children's Hospital and Health Center
      • Tacoma, Washington, Forente stater, 98405
        • Northwest Medical Specialties PLLC
      • Tacoma, Washington, Forente stater, 98405
        • MultiCare Tacoma General Hospital
      • Tacoma, Washington, Forente stater, 98405
        • Franciscan Research Center-Northwest Medical Plaza
      • Vancouver, Washington, Forente stater, 98686
        • Legacy Salmon Creek Hospital
      • Vancouver, Washington, Forente stater, 98664
        • PeaceHealth Southwest Medical Center
      • Vancouver, Washington, Forente stater, 98684
        • Legacy Cancer Institute Medical Oncology and Day Treatment
      • 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
      • Yelm, Washington, Forente stater, 98597
        • Providence Regional Cancer System-Yelm
    • West Virginia
      • Bridgeport, West Virginia, Forente stater, 26330
        • United Hospital Center
      • Charleston, West Virginia, Forente stater, 25304
        • Vandalia Health/CAMC Institute for Academic Medicine
      • Huntington, West Virginia, Forente stater, 25701
        • Edwards Comprehensive Cancer Center
      • Martinsburg, West Virginia, Forente stater, 25401
        • WVUH-Berkely Medical Center
      • Morgantown, West Virginia, Forente stater, 26506
        • West Virginia University Healthcare
      • Parkersburg, West Virginia, Forente stater, 26101
        • Camden Clark Medical Center
    • Wisconsin
      • Antigo, Wisconsin, Forente stater, 54409
        • Aspirus Cancer Care-Antigo-Volm Cancer Center
      • 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
      • Eau Claire, Wisconsin, Forente stater, 54701
        • Marshfield Medical Center-EC Cancer Center
      • Eau Claire, Wisconsin, Forente stater, 54701
        • HSHS Sacred Heart Hospital
      • 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
      • Madison, Wisconsin, Forente stater, 53792
        • University of Wisconsin Carbone Cancer Center - University Hospital
      • Madison, Wisconsin, Forente stater, 53715
        • SSM Health Dean Medical Group - South Madison Campus
      • Manitowoc, Wisconsin, Forente stater, 54221
        • Holy Family Memorial Hospital
      • Marshfield, Wisconsin, Forente stater, 54449
        • Marshfield Medical Center-Marshfield
      • Medford, Wisconsin, Forente stater, 54451
        • Aspirus Medford Hospital
      • Menomonee Falls, Wisconsin, Forente stater, 53051
        • Froedtert Menomonee Falls Hospital
      • Milwaukee, Wisconsin, Forente stater, 53226
        • Medical College of Wisconsin
      • Minocqua, Wisconsin, Forente stater, 54548
        • Marshfield Medical Center - Minocqua
      • Mukwonago, Wisconsin, Forente stater, 53149
        • ProHealth D N Greenwald Center
      • New Richmond, Wisconsin, Forente stater, 54017
        • Cancer Center of Western Wisconsin
      • Oconomowoc, Wisconsin, Forente stater, 53066
        • ProHealth Oconomowoc Memorial Hospital
      • Oconto Falls, Wisconsin, Forente stater, 54154
        • Saint Vincent Hospital Cancer Center at Oconto Falls
      • Rhinelander, Wisconsin, Forente stater, 54501
        • Aspirus Cancer Care-Rhinelander-James Beck Cancer Center
      • Rice Lake, Wisconsin, Forente stater, 54868
        • Marshfield Medical Center-Rice Lake
      • Sheboygan, Wisconsin, Forente stater, 53081
        • HSHS Saint Nicholas Hospital
      • Stevens Point, Wisconsin, Forente stater, 54482
        • Marshfield Medical Center-River Region at Stevens Point
      • Stevens Point, Wisconsin, Forente stater, 54481
        • Aspirus Cancer Care - Stevens Point
      • Sturgeon Bay, Wisconsin, Forente stater, 54235-1495
        • Saint Vincent Hospital Cancer Center at Sturgeon Bay
      • Waukesha, Wisconsin, Forente stater, 53188
        • UW Cancer Center at ProHealth Care
      • Waukesha, Wisconsin, Forente stater, 53188
        • ProHealth Waukesha Memorial Hospital
      • Wausau, Wisconsin, Forente stater, 54401
        • Aspirus Cancer Care-Wausau
      • West Bend, Wisconsin, Forente stater, 53095
        • Froedtert West Bend Hospital/Kraemer Cancer Center
      • Weston, Wisconsin, Forente stater, 54476
        • Marshfield Medical Center - Weston
      • Wisconsin Rapids, Wisconsin, Forente stater, 54494
        • Aspirus Cancer Care - Wisconsin Rapids
    • Wyoming
      • Cheyenne, Wyoming, Forente stater, 82001
        • Cheyenne Regional Medical Center-West
      • Cody, Wyoming, Forente stater, 82414
        • Billings Clinic-Cody
      • Sheridan, Wyoming, Forente stater, 82801
        • Welch Cancer Center
  • Puerto Rico
      • San Juan, Puerto Rico, 00902
        • Pan American Center for Oncology Trials LLC

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 I REGISTRATION CRITERIA

  • Histologically documented renal cell carcinoma with clear cell component, including patients who have sarcomatoid or rhabdoid features

  • Any metastatic disease, including visceral, lymph node, other soft tissue and bone, measurable per RECIST 1.1

  • Measurable disease as defined in the protocol

  • Must be intermediate or poor risk patient per International Metastatic Renal Cell Carcinoma Database (IMDC) criteria (1 or more of the following): Karnofsky performance status [KPS] < 80, < 1 year from diagnosis [including initial nephrectomy] to systemic treatment for metastatic disease, hemoglobin less than lower limit of normal [LLN], corrected calcium concentration greater than upper limit of normal [ULN], absolute neutrophil count greater than ULN, platelet count > ULN)

  • Central nervous system (CNS) disease permitted, if stable and not otherwise causing symptoms or needing active treatment

  • Karnofsky performance status >= 70%

  • No prior treatment with PD-1, PD-L1, or CTLA-4 targeting agents (including but not limited to nivolumab, pembrolizumab, pidilizumab, durvalumab, atezolizumab, tremelimumab, and ipilimumab), or any other drug or antibody specifically targeting T-cell co-stimulation or checkpoint pathways. The only exception is for prior treatment with nivolumab or other PD-1/PD-L1/CTLA-4 targeting therapy on pre- or post-operative trials, as long as > 1 year since completion of systemic therapy

  • No prior previous systemic therapy for renal cell carcinoma (prior HD IL-2 [>28 days]. Prior adjuvant sunitinib >180 days since completion and prior immunotherapy as above are allowed).

  • No systemic cancer therapy less than 28 days prior to registration; no radiation therapy less than 14 days prior to registration. There must be a complete recovery and no ongoing complications from radiotherapy

  • Not pregnant and not nursing, because this study involves an agent that has known genotoxic, mutagenic and teratogenic effects. Therefore, for women of childbearing potential only, a negative serum or urine pregnancy test done =< 14 days prior to registration is required

  • Age >= 18 years

  • None of the following:

    • Active autoimmune disease requiring ongoing therapy
    • Ongoing acute toxicity > grade 2 from previous treatment
    • History of severe allergic, anaphylactic or other hypersensitivity reactions to chimeric or humanized antibodies
    • Active hepatitis B/C, or active tuberculosis (purified protein derivative [PPD] response without active tuberculosis [TB] is allowed)
    • HIV-infected patients with detectable viral load within 6 months prior to registration. Patients on effective anti-retroviral therapy with undetectable viral load within 6 months prior to registration are eligible
    • Concurrent use of immunosuppressive medication including prednisone above 10 mg daily
    • Uncontrolled adrenal insufficiency
    • Uncontrolled hypertension (systolic blood pressure [BP] > 150mmHg or diastolic BP > 90mmHg)
    • Major surgery less than 28 days prior to registration
    • Any serious non-healing wound, ulcer, or bone fracture within 28 days prior to registration
    • Any arterial thrombotic events within 180 days prior to registration
    • Clinically significant hematuria, hematemesis, or hemoptysis within 12 weeks prior to registration
    • Cavitating pulmonary lesions or known endotracheal or endobronchial disease manifestations
    • Lesions encasing or invading any major blood vessels (this does not include tumor thrombus extending into/through renal vein/inferior vena cava [IVC]). Patients with tumor thrombus extending into/through renal vein are considered eligible
    • Moderate of severe hepatic impairment (child-Pugh B or C)
    • Any history of untreated pulmonary embolism or deep venous thrombosis (DVT) in the 180 days prior to registration. (Any asymptomatic, treated pulmonary embolism or asymptomatic, treated deep venous thrombosis > 30 days prior to registration allowed)
    • Corrected QT interval calculated by the Fridericia formula (QTcF) > 500 ms
    • Unstable cardiac arrhythmia within 6 months prior to registration
    • Any gastrointestinal (GI) bleeding =< 180 days, hemoptysis, or other signs of pulmonary hemorrhage =< 90 days prior to registration
    • History of abdominal fistula, gastrointestinal perforation, intra-abdominal abscess, bowel obstruction, or gastric outlet obstruction within 180 days prior to registration
    • Active peptic ulcer disease, inflammatory bowel disease, or malabsorption syndrome within 28 days prior to registration
    • Untreated hypothyroidism (treated hypothyroidism on thyroid replacement therapy is allowed. Abnormal thyroid-stimulating hormone [TSH] is acceptable with normal T3/free T4 if treated on thyroid replacement therapy)
    • Evidence of pancreatitis, history of organ transplant, or history of congenital QT syndrome
    • Active treatment with coumarin agents (e.g., warfarin), direct thrombin inhibitors (e.g., dabigatran), direct Xa inhibitor betrixaban or platelet inhibitors (e.g., clopidogrel) within 5 days of registration Allowed anticoagulants include: prophylactic use of low-dose aspirin for cardio-protection (per local applicable guidelines) and low-dose low molecular weight heparins (LMWH), therapeutic doses of LMWH or anticoagulation with direct factor Xa inhibitors rivaroxaban, edoxaban, apixaban. Allowed also in patients with known brain metastases who are on a stable dose of the anticoagulant for at least 1 week prior to registration without clinically significant hemorrhagic complications from the anticoagulation regimen or the tumor
    • Significant cardiac ischemia events (ST elevation myocardial infarction [STEMI] or non-ST-elevation myocardial infarction [NSTEMI]) within 6 months or active New York (NY) Heart Association class 3-4 heart failure symptoms

  • Absolute neutrophil count (ANC) >= 1,500/mm^3

  • Platelet count >= 100,000/mm^3

  • Hemoglobin >= 8 g/dL

  • Calculated (Calc.) creatinine clearance >= 30 mL/min

  • Urine protein =< 1+ or urine protein to creatinine (UPC) ratio < 1

  • Total bilirubin =< 1.5 x upper limit of normal (ULN) (except for patients with known or likely Gilbert's syndrome, for whom total bilirubin up to 3 mg/dL is allowed with direct bilirubin =< 20% total bilirubin)

  • Aspartate aminotransferase/alanine aminotransferase (AST/ALT) =< 2.5 x upper limit of normal (ULN) or < 5 x ULN if hepatic metastases present

  • STEP 2 REGISTRATION ELIGIBILITY CRITERIA

  • Successful completion of at least 1 cycle of ipilimumab/nivolumab

  • Resolution of any treatment-related adverse events to grade 1 or less per dose modification section (this criteria does not include any adverse events [AEs] not attributable to treatment which are present due to disease), with prednisone-equivalent dosing at 10 mg daily or less. Exceptions for this criteria include patients receiving replacement hormone treatments (such as levothyroxine for treatment-related hypothyroidism or glucocorticoid replacement for adrenal insufficiency). Please contact study chair if further discussion is needed

  • No more than 80 days from last dose of ipilimumab/nivolumab

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.
Aktiv komparator: Arm A (nivolumab)

INDUCTION: Patients receive nivolumab IV over 30 minutes and ipilimumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity.

TREATMENT:

Patients with iuPD with clinical instability receive cabozantinib PO daily on days 1-28. Treatment repeats every 28 days until further disease progression or unacceptable toxicity

Patients with iCR receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Patients with non-CR/non-PD with clinical stability receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Patients undergo CT scan, MRI and blood and urine sample collection, and may also undergo a bone scan as clinically indicated throughout the study.
Annen: Quality-of-Life Assessment

Ancillary studies

Andre navn:
  • Livskvalitetsvurdering
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
Fremgangsmåte: Magnetic Resonance Imaging

Undergo MRI

Andre navn:
  • MR
  • Magnetisk resonans
  • Magnetic Resonance Imaging Scan
  • Medisinsk bildebehandling, magnetisk resonans / kjernemagnetisk resonans
  • MR Imaging
  • MR-skanning
  • NMR-avbildning
  • NMRI
  • Kjernemagnetisk resonansavbildning
  • Magnetisk resonanstomografi (MR)
  • sMRI
  • Magnetisk resonansavbildning (prosedyre)
  • MR-er
  • Strukturell MR
Annen: Questionnaire Administration

Ancillary studies

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: Bone Scan

Undergo bone scan

Andre navn:
  • Benscintigrafi
Fremgangsmåte: Biospecimen Collection

Undergo blood and urine sample collection

Andre navn:
  • Biologisk prøvesamling
  • Bioprøve samlet
  • Prøvesamling
Eksperimentell: Arm B (nivolumab, cabozantinib)

INDUCTION: Patients receive nivolumab IV over 30 minutes and ipilimumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity.

TREATMENT:

Patients with iuPD with clinical instability receive cabozantinib PO daily on days 1-28. Treatment repeats every 28 days until further disease progression or unacceptable toxicity.

Patients with iCR receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Patients with non-CR/non-PD rwith clinical stability eceive nivolumab IV over 30 minutes on day 1 and cabozantinib PO daily on days 1-28. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Patients undergo CT scan, MRI and blood and urine sample collection, and may also undergo a bone scan as clinically indicated throughout the study.
Annen: Quality-of-Life Assessment

Ancillary studies

Andre navn:
  • Livskvalitetsvurdering
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
Fremgangsmåte: Magnetic Resonance Imaging

Undergo MRI

Andre navn:
  • MR
  • Magnetisk resonans
  • Magnetic Resonance Imaging Scan
  • Medisinsk bildebehandling, magnetisk resonans / kjernemagnetisk resonans
  • MR Imaging
  • MR-skanning
  • NMR-avbildning
  • NMRI
  • Kjernemagnetisk resonansavbildning
  • Magnetisk resonanstomografi (MR)
  • sMRI
  • Magnetisk resonansavbildning (prosedyre)
  • MR-er
  • Strukturell MR
Annen: Questionnaire Administration

Ancillary studies

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 blood and urine sample collection

Andre navn:
  • Biologisk prøvesamling
  • Bioprøve samlet
  • Prøvesamling
Legemiddel: Cabozantinib

Given PO

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
Overall survival (OS)
Tidsramme: From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years

OS of patients who achieve complete response (CR) and progressive disease (PD) from ipilimumab-nivolumab induction phase will be summarized. The stratified log-rank statistic will be the primary analysis to compare the hypothesis on OS with the stratification factors (presence of bone metastases and IMDC risk criteria). The Kaplan-Meier product-limit estimator will be used to estimate the OS. A stratified proportional hazards model will be used to generate estimates for the OS hazard ratio. For the randomized patients, OS will be calculated and compared from the time of randomization until the time of an OS event or time of last-follow-up, whatever occurs first. For the patients who were initially CR or PD, OS will be measured from the time of study registration. A comparison of OS will be made across the patient groups (randomized patients, patients initially CR, and patients initially PD).
From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 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
Progression-free survival (PFS)
Tidsramme: From date of registration to date of progression (or disease recurrence) or death due to any cause, whichever occurs first, assessed up to 5 years

Progression will be defined using the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. PFS of patients who achieve CR and PD from ipilimumab-nivolumab induction phase will be summarized (secondary analysis). The Kaplan-Meier product-limit estimator will be used to estimate the PFS distribution. A stratified proportional hazards model will be used to generate estimates for the PFS hazard ratio. For the randomized patients, PFS will be calculated and compared from the time of randomization until the time of a PFS event or time of last-follow-up, whatever occurs first. For the patients who were initially CR or PD, PFS will be measured from the time of study registration. A comparison of PFS will be made across the patient groups (randomized patients, patients initially CR, and patients initially PD). For this comparison, PFS will be measured from time of study registration all the patients, regardless of whether they were randomized or not.
From date of registration to date of progression (or disease recurrence) or death due to any cause, whichever occurs first, assessed up to 5 years
Complete response (CR) (randomized patients)
Tidsramme: At 12 months from date of randomization

Patients who had a CR prior to 12 months but have experienced a disease recurrence prior to 12 months, will not be considered to be a CR at 12 months. The Cochran-Mantel-Haenszel test will be used to compare the two arms on the proportion of patients who have a 12-month CR adjusting on the stratification factors.
At 12 months from date of randomization
Objective response
Tidsramme: Up to 5 years

Defined as the best response observed that has been confirmed by a scan performed 4 or more weeks after the observation of the initial response. The objective response will be confirmed using RECIST 1.1. In addition, objective responses will also be confirmed using Immune Response Evaluation Criteria in Solid Tumors (iRECIST).
Up to 5 years
Proportion of patients who discontinue protocol-directed treatment prior to 1 year from date of study registration
Tidsramme: Up to 5 years

Patients who stop their protocol directed treatment for any reason prior to one year from study registration will be considered to have discontinued their treatment. The Cochran-Mantel-Haenszel test will also be used to compare the proportion of patients who discontinue their treatment prior to one-year after study registration.
Up to 5 years
Incidence of adverse events
Tidsramme: Up to 5 years

Assessed with National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. A Fisher's exact test will be used to compare the two treatment arms on the proportion of patient with a grade 3 or higher adverse event.
Up to 5 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
Estimates of OS by sex
Tidsramme: From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years

Estimates of OS and the corresponding 95% confidence intervals (CIs) by sex will be provided (with an understanding that sometimes the CI or estimate will not be computable because of scant data).
From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years
Estimates of OS by race
Tidsramme: From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years

Estimates of OS and the corresponding 95% CIs by race will be provided (with an understanding that sometimes the CI or estimate will not be computable because of scant data).
From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years
Estimates of OS by ethnicity
Tidsramme: From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years

Estimates of OS and the corresponding 95% CIs by ethnicity will be provided (with an understanding that sometimes the CI or estimate will not be computable because of scant data).
From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years

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: Tian Zhang, Alliance for Clinical Trials in Oncology

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

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.
7. juni 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.
1. mars 2028

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.
1. mars 2028

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).
3. januar 2019

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.
3. januar 2019

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.
4. januar 2019

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.
26. oktober 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.
23. 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. oktober 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-2018-03694
  • U10CA180821 (U.S. NIH-stipend/kontrakt)
  • NCI-2018-03694 (Registeridentifikator: CTRP (Clinical Trial Reporting Program))
  • A031704 (Annen identifikator: CTEP)
  • A031704 (Annen identifikator: Alliance for Clinical Trials in Oncology)

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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