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PROSPECT: Kjemoterapi alene eller kjemoterapi pluss strålebehandling ved behandling av pasienter med lokalt avansert rektalkreft som gjennomgår kirurgi

5. januar 2024 oppdatert av: Alliance for Clinical Trials in Oncology

En fase II/III-studie av Neoadjuvant FOLFOX med selektiv bruk av kombinert modalitet kjemoradiasjon versus preoperativ kombinert modalitet kjemoradiasjon for lokalt avanserte rektalkreftpasienter som gjennomgår lav fremre reseksjon med total mesorektal eksisjon (PROSPECT)

Standardbehandlingen for lokalt avansert endetarmskreft involverer kjemoterapi og stråling, kjent som 5FUCMT, (kjemoterapimidlene 5-fluorouracil/capecitabin og strålebehandling) før operasjonen. Selv om strålebehandling mot bekkenet har vært en standard og viktig del av behandlingen for endetarmskreft og har vist seg å redusere risikoen for at kreften kommer tilbake i samme område i bekkenet, opplever noen pasienter uønskede bivirkninger fra strålingen og har vært viktige fremskritt innen kjemoterapi, kirurgi og stråling som kan være til nytte. Hensikten med denne studien er å sammenligne effektene, både gode og dårlige, av standardbehandling av kjemoterapi og stråling med kjemoterapi ved bruk av et kombinasjonsregime kjent som FOLFOX, (medikamentene 5-fluorouracil (5-FU), oksaliplatin og leukovorin) og selektiv bruk av standardbehandlingen, avhengig av respons på FOLFOX. Legemidlene i FOLFOX-kuren er alle FDA-godkjente (Food and Drug Administration) og har blitt brukt rutinemessig for å behandle pasienter med avansert kolorektal kreft.

Studieoversikt

Status

Aktiv, ikke rekrutterende

Forhold

Tykktarmskreft

Intervensjon / Behandling

Detaljert beskrivelse

OVERSIKT: Dette er en multisenter, fase II/III studie. Pasientene er stratifisert i henhold til ECOG-ytelsesstatus (0 eller 1 mot 2) og randomisert til 1 av 2 behandlingsregimer. Pasienter vil motta full støttende behandling mens de er på denne studien.

MÅL:

Hoved

Fase II-komponent: For å sikre at neoadjuvant FOLFOX etterfulgt av selektiv bruk av 5FUCMT-gruppen (gruppe 1) opprettholder den nåværende høye raten av bekken R0-reseksjon og er konsistent med non-inferiority for tid til lokalt tilbakefall (TLR).
Fase III-komponent: For å sammenligne neoadjuvant FOLFOX etterfulgt av selektiv bruk av 5FUCMT (gruppe 1) med standard 5FUCMT (gruppe 2) med hensyn til det primære endepunktet for sykdomsfri overlevelse (DFS).

Sekundær

For å avgjøre om den neoadjuvante FOLFOX etterfulgt av selektiv bruk av 5FUCMT (Gruppe 1) ikke er dårligere enn standardgruppen 5FUCMT (Gruppe 2) med hensyn til andelen pasienter som oppnår en patologisk fullstendig respons (pCR) på tidspunktet for kirurgisk inngrep. reseksjon.
For å bestemme om den neoadjuvante FOLFOX etterfulgt av selektiv bruk av 5FUCMT (gruppe 1) ikke er dårligere enn standard 5FUCMT (gruppe 2) med hensyn til total overlevelse.
For å evaluere og sammenligne bivirkningsprofilen og kirurgiske komplikasjoner mellom to grupper.
For å estimere andelen pasienter i den selektive gruppen (gruppe 1) som mottar: 1) preoperativ 5FUCMT; 2) postoperativ 5FUCMT; 3) enten pre- eller postoperativ 5FUCMT.
For å bestemme om den neoadjuvante FOLFOX etterfulgt av selektiv bruk av 5FUCMT (Gruppe 1) ikke er dårligere enn standard 5FUCMT (Gruppe 2) med hensyn til lokalt tilbakefall (TLR)
For å bestemme om den neoadjuvante FOLFOX etterfulgt av selektiv bruk av 5FUCMT (Gruppe 1) ikke er dårligere enn standard 5FUCMT (Gruppe 2) med hensyn til Neoadjuvant Response Score (NAR)

Hendelsesovervåking av pasienter vil fortsette inntil 8 år etter randomisering.

Studietype

Intervensjonell

Registrering (Faktiske)

1194

Fase

Fase 2
Fase 3

Kontakter og plasseringer

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

Studiesteder

Canada
- Alberta
  - Calgary, Alberta, Canada, T2N 4N2
    - Tom Baker Cancer Centre
  - Edmonton, Alberta, Canada, T6G 1Z2
    - Cross Cancer Institute
- British Columbia
  - Kelowna, British Columbia, Canada, V1Y 5L3
    - BCCA-Cancer Centre for the Southern Interior
  - Vancouver, British Columbia, Canada, V5Z 4E6
    - BCCA-Vancouver Cancer Centre
- Manitoba
  - Winnipeg, Manitoba, Canada, R3E 0V9
    - CancerCare Manitoba
- New Brunswick
  - Saint John, New Brunswick, Canada, E2L 4L2
    - Atlantic Health Sciences Corporation-Saint John Regional Hospital
- Ontario
  - London, Ontario, Canada, N6A 4L6
    - London Regional Cancer Program
  - Oshawa, Ontario, Canada, L1G 2B9
    - Lakeridge Health Oshawa
  - Ottawa, Ontario, Canada, K1H 8L6
    - Ottawa Hospital and Cancer Center-General Campus
  - Saint Catharines, Ontario, Canada, L2S 0A9
    - Niagara Health System-Saint Catharines General
  - Toronto, Ontario, Canada, M4N 3M5
    - Odette Cancer Centre- Sunnybrook Health Sciences Centre
- Prince Edward Island
  - Charlottetown, Prince Edward Island, Canada, C1A 8T5
    - PEI Cancer Treatment Centre-Queen Elizabeth Hospital
- Quebec
  - Montreal, Quebec, Canada, H3H 2R9
    - The Research Institute of the McGill University Health Centre (MUHC)
  - Montreal, Quebec, Canada, H2W 1S6
    - McGill University Department of Oncology
- Saskatchewan
  - Regina, Saskatchewan, Canada, S4T 7T1
    - Allan Blair Cancer Centre
  - Saskatoon, Saskatchewan, Canada, S7N 4H4
    - Saskatoon Cancer Centre
Forente stater
- Alabama
  - Birmingham, Alabama, Forente stater, 35233
    - University of Alabama at Birmingham Cancer Center
  - Daphne, Alabama, Forente stater, 36526
    - Southern Cancer Center PC-Daphne
  - Mobile, Alabama, Forente stater, 36688
    - University of South Alabama Mitchell Cancer Institute
  - Mobile, Alabama, Forente stater, 36607
    - Southern Cancer Center PC-Mobile
  - Mobile, Alabama, Forente stater, 36608
    - Southern Cancer Center PC-Providence
  - Mobile, Alabama, Forente stater, 36608
    - Southern Cancer Center PC-Springhill
- 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
  - Anchorage, Alaska, Forente stater, 99508
    - Alaska Regional Hospital
  - Fairbanks, Alaska, Forente stater, 99701
    - Fairbanks Memorial Hospital
- Arizona
  - Phoenix, Arizona, Forente stater, 85054
    - Mayo Clinic Hospital
  - Scottsdale, Arizona, Forente stater, 85259
    - Mayo Clinic in Arizona
  - Tucson, Arizona, Forente stater, 85704
    - University of Arizona Cancer Center-Orange Grove Campus
  - Tucson, Arizona, Forente stater, 85719
    - University of Arizona Cancer Center-North Campus
  - Tucson, Arizona, Forente stater, 85724
    - The University of Arizona Medical Center-University Campus
  - Yuma, Arizona, Forente stater, 85364
    - Yuma Cancer Center
- Arkansas
  - Hot Springs, Arkansas, Forente stater, 71913
    - CHI Saint Vincent Cancer Center Hot Springs
  - Jonesboro, Arkansas, Forente stater, 72401
    - Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
  - Rogers, Arkansas, Forente stater, 72758
    - Highlands Oncology Group-Rogers
- California
  - Anaheim, California, Forente stater, 92806
    - Kaiser Permanente-Anaheim
  - Antioch, California, Forente stater, 94531
    - Kaiser Permanente-Deer Valley Medical Center
  - Arroyo Grande, California, Forente stater, 93420
    - PCR Oncology
  - Auburn, California, Forente stater, 95602
    - Sutter Auburn Faith Hospital
  - Auburn, California, Forente stater, 95603
    - Sutter Cancer Centers Radiation Oncology Services-Auburn
  - Baldwin Park, California, Forente stater, 91706
    - Kaiser Permanente-Baldwin Park
  - Bellflower, California, Forente stater, 90706
    - Kaiser Permanente-Bellflower
  - Berkeley, California, Forente stater, 94704
    - Alta Bates Summit Medical Center-Herrick Campus
  - Burbank, California, Forente stater, 91505
    - Providence Saint Joseph Medical Center/Disney Family Cancer Center
  - Burlingame, California, Forente stater, 94010
    - Mills-Peninsula Medical Center
  - Cameron Park, California, Forente stater, 95682
    - Sutter Cancer Centers Radiation Oncology Services-Cameron Park
  - Castro Valley, California, Forente stater, 94546
    - Eden Hospital Medical Center
  - Castro Valley, California, Forente stater, 94546
    - East Bay Radiation Oncology Center
  - Chico, California, Forente stater, 95928
    - Feather River Cancer Center
  - Clovis, California, Forente stater, 93611
    - Community Cancer Institute
  - Clovis, California, Forente stater, 93611
    - University Oncology Associates
  - Concord, California, Forente stater, 94520
    - John Muir Medical Center-Concord Campus
  - Costa Mesa, California, Forente stater, 92627
    - UC Irvine Health Cancer Center-Newport
  - Davis, California, Forente stater, 95616
    - Sutter Davis Hospital
  - Dublin, California, Forente stater, 94568
    - Epic Care-Dublin
  - Emeryville, California, Forente stater, 94608
    - Bay Area Breast Surgeons Inc
  - Emeryville, California, Forente stater, 94608
    - Epic Care Partners in Cancer Care
  - Fremont, California, Forente stater, 94538
    - Kaiser Permanente-Fremont
  - Fremont, California, Forente stater, 94538
    - Palo Alto Medical Foundation-Fremont
  - Fresno, California, Forente stater, 93720
    - Kaiser Permanente-Fresno
  - Fresno, California, Forente stater, 93720
    - Fresno Cancer Center
  - Greenbrae, California, Forente stater, 94904
    - Marin Cancer Care Inc
  - Greenbrae, California, Forente stater, 94904
    - Marin General Hospital
  - La Jolla, California, Forente stater, 92093
    - UC San Diego Moores Cancer Center
  - Los Angeles, California, Forente stater, 90033
    - USC / Norris Comprehensive Cancer Center
  - Los Angeles, California, Forente stater, 90033
    - Los Angeles County-USC Medical Center
  - Los Angeles, California, Forente stater, 90027
    - Kaiser Permanente Los Angeles Medical Center
  - Los Angeles, California, Forente stater, 90048
    - Cedars Sinai Medical Center
  - Martinez, California, Forente stater, 94553-3156
    - Contra Costa Regional Medical Center
  - Modesto, California, Forente stater, 95355
    - Memorial Medical Center
  - Modesto, California, Forente stater, 95356
    - Kaiser Permanente-Modesto
  - Mountain View, California, Forente stater, 94040
    - El Camino Hospital
  - Mountain View, California, Forente stater, 94040
    - Palo Alto Medical Foundation-Camino Division
  - Mountain View, California, Forente stater, 94040
    - Palo Alto Medical Foundation-Gynecologic Oncology
  - Newport Beach, California, Forente stater, 92663
    - USC Norris Oncology/Hematology-Newport Beach
  - Novato, California, Forente stater, 94945
    - Sutter Cancer Research Consortium
  - Oakland, California, Forente stater, 94611
    - Kaiser Permanente-Oakland
  - Oakland, California, Forente stater, 94609
    - Alta Bates Summit Medical Center - Summit Campus
  - Oakland, California, Forente stater, 94609
    - Hematology and Oncology Associates-Oakland
  - Oakland, California, Forente stater, 94602
    - Highland General Hospital
  - Oakland, California, Forente stater, 94609
    - Bay Area Tumor Institute
  - Orange, California, Forente stater, 92868
    - UC Irvine Health/Chao Family Comprehensive Cancer Center
  - Orange, California, Forente stater, 92868
    - Saint Joseph Hospital - Orange
  - Palo Alto, California, Forente stater, 94304
    - Stanford Cancer Institute Palo Alto
  - Palo Alto, California, Forente stater, 94301
    - Palo Alto Medical Foundation Health Care
  - Pasadena, California, Forente stater, 91105
    - Keck Medical Center of USC Pasadena
  - Pleasanton, California, Forente stater, 94588
    - Valley Medical Oncology Consultants
  - Redwood City, California, Forente stater, 94063
    - Kaiser Permanente-Redwood City
  - Richmond, California, Forente stater, 94801
    - Kaiser Permanente-Richmond
  - Riverside, California, Forente stater, 92505
    - Kaiser Permanente-Riverside
  - Roseville, California, Forente stater, 95661
    - Kaiser Permanente-Roseville
  - Roseville, California, Forente stater, 95661
    - Sutter Cancer Centers Radiation Oncology Services-Roseville
  - Roseville, California, Forente stater, 95661
    - Sutter Roseville Medical Center
  - Sacramento, California, Forente stater, 95816
    - Sutter Medical Center Sacramento
  - Sacramento, California, Forente stater, 95817
    - University of California Davis Comprehensive Cancer Center
  - Sacramento, California, Forente stater, 95814
    - Kaiser Permanente Downtown Commons
  - Sacramento, California, Forente stater, 95823
    - Kaiser Permanente-South Sacramento
  - Sacramento, California, Forente stater, 95825
    - Kaiser Permanente - Sacramento
  - Saint Helena, California, Forente stater, 94574
    - Saint Helena Hospital
  - 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, 92108
    - Kaiser Permanente-San Diego Mission
  - San Francisco, California, Forente stater, 94115
    - Kaiser Permanente-San Francisco
  - San Francisco, California, Forente stater, 94158
    - UCSF Medical Center-Mission Bay
  - San Francisco, California, Forente stater, 94115
    - California Pacific Medical Center-Pacific Campus
  - San Francisco, California, Forente stater, 94115
    - UCSF Medical Center-Mount Zion
  - San Jose, California, Forente stater, 95119
    - Kaiser Permanente-Santa Teresa-San Jose
  - San Leandro, California, Forente stater, 94577
    - Kaiser Permanente San Leandro
  - San Marcos, California, Forente stater, 92078
    - Kaiser Permanente-San Marcos
  - San Pablo, California, Forente stater, 94806
    - Doctors Medical Center- JC Robinson Regional Cancer Center
  - San Rafael, California, Forente stater, 94903
    - Kaiser San Rafael-Gallinas
  - San Rafael, California, Forente stater, 94903
    - Kaiser Permanente-San Rafael
  - Santa Clara, California, Forente stater, 95051
    - Kaiser Permanente Medical Center - Santa Clara
  - Santa Cruz, California, Forente stater, 95065
    - Palo Alto Medical Foundation-Santa Cruz
  - Santa Rosa, California, Forente stater, 95403
    - Kaiser Permanente-Santa Rosa
  - Santa Rosa, California, Forente stater, 95403
    - Sutter Pacific Medical Foundation
  - South San Francisco, California, Forente stater, 94080
    - Kaiser Permanente-South San Francisco
  - Stockton, California, Forente stater, 95210
    - Kaiser Permanente-Stockton
  - Sunnyvale, California, Forente stater, 94086
    - Palo Alto Medical Foundation-Sunnyvale
  - Vacaville, California, Forente stater, 95688
    - Kaiser Permanente Medical Center-Vacaville
  - Vacaville, California, Forente stater, 95687
    - Northbay Cancer Center
  - Vacaville, California, Forente stater, 95687
    - Sutter Cancer Centers Radiation Oncology Services-Vacaville
  - Vallejo, California, Forente stater, 94589
    - Kaiser Permanente-Vallejo
  - Vallejo, California, Forente stater, 94589
    - Sutter Solano Medical Center/Cancer Center
  - Walnut Creek, California, Forente stater, 94596
    - Kaiser Permanente-Walnut Creek
  - Walnut Creek, California, Forente stater, 94598
    - John Muir Medical Center-Walnut Creek
  - Walnut Creek, California, Forente stater, 94597
    - Epic Care Cyberknife Center
- Colorado
  - Aurora, Colorado, Forente stater, 80045
    - University Of Colorado Hospital
  - Aurora, Colorado, Forente stater, 80012
    - Rocky Mountain Cancer Centers-Aurora
  - Aurora, Colorado, Forente stater, 80012
    - The Medical Center of Aurora
  - Boulder, Colorado, Forente stater, 80301
    - Boulder Community Hospital
  - Boulder, Colorado, Forente stater, 80304
    - Rocky Mountain Cancer Centers-Boulder
  - 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
  - Denver, Colorado, Forente stater, 80210
    - Porter Adventist Hospital
  - Denver, Colorado, Forente stater, 80218
    - Presbyterian - Saint Lukes Medical Center - Health One
  - Denver, Colorado, Forente stater, 80218
    - SCL Health Saint Joseph Hospital
  - 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, 80204
    - Denver Health Medical Center
  - Denver, Colorado, Forente stater, 80218
    - Colorado Blood Cancer Institute
  - Denver, Colorado, Forente stater, 80209
    - The Women's Imaging Center
  - Denver, Colorado, Forente stater, 80206
    - National Jewish Health-Main Campus
  - Durango, Colorado, Forente stater, 81301
    - Mercy Medical Center
  - Durango, Colorado, Forente stater, 81301
    - Southwest Oncology PC
  - Englewood, Colorado, Forente stater, 80113
    - Swedish Medical Center
  - Englewood, Colorado, Forente stater, 80113
    - Comprehensive Cancer Care and Research Institute of Colorado LLC
  - Fort Collins, Colorado, Forente stater, 80524
    - Poudre Valley Hospital
  - Golden, Colorado, Forente stater, 80401
    - Mountain Blue Cancer Care Center
  - 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
    - North Colorado Medical Center
  - Greenwood Village, Colorado, Forente stater, 80111
    - Rocky Mountain Cancer Centers-Greenwood Village
  - Lafayette, Colorado, Forente stater, 80026
    - Good Samaritan Medical Center
  - Lakewood, Colorado, Forente stater, 80228
    - Saint Anthony Hospital
  - Lakewood, Colorado, Forente stater, 80228
    - Rocky Mountain Cancer Centers-Lakewood
  - Littleton, Colorado, Forente stater, 80120
    - Rocky Mountain Cancer Centers-Littleton
  - Littleton, Colorado, Forente stater, 80122
    - Littleton Adventist Hospital
  - Lone Tree, Colorado, Forente stater, 80124
    - Sky Ridge Medical Center
  - Lone Tree, Colorado, Forente stater, 80124
    - Rocky Mountain Cancer Centers-Sky Ridge
  - Longmont, Colorado, Forente stater, 80501
    - Longmont United Hospital
  - Longmont, Colorado, Forente stater, 80501
    - Rocky Mountain Cancer Centers-Longmont
  - Loveland, Colorado, Forente stater, 80539
    - McKee Medical Center
  - Parker, Colorado, Forente stater, 80138
    - Parker Adventist Hospital
  - Parker, Colorado, Forente stater, 80138
    - Rocky Mountain Cancer Centers-Parker
  - Pueblo, Colorado, Forente stater, 81004
    - Saint Mary Corwin Medical Center
  - Pueblo, Colorado, Forente stater, 81008
    - Rocky Mountain Cancer Centers - Pueblo
  - 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, 80033
    - SCL Health Lutheran Medical Center
- Connecticut
  - Guilford, Connecticut, Forente stater, 06437
    - Yale-New Haven Shoreline Medical Center
  - Hartford, Connecticut, Forente stater, 06105
    - Smilow Cancer Hospital Care Center at Saint Francis
  - Hartford, Connecticut, Forente stater, 06102
    - Hartford Hospital
  - Meriden, Connecticut, Forente stater, 06451
    - Midstate Medical Center
  - New Britain, Connecticut, Forente stater, 06050
    - The Hospital of Central Connecticut
  - New Haven, Connecticut, Forente stater, 06520
    - Yale University
  - New Haven, Connecticut, Forente stater, 06510
    - Smilow Cancer Center/Yale-New Haven Hospital
  - North Haven, Connecticut, Forente stater, 06473
    - Yale-New Haven Hospital North Haven Medical Center
  - Norwalk, Connecticut, Forente stater, 06856
    - Norwalk Hospital
  - Norwich, Connecticut, Forente stater, 06360
    - Eastern Connecticut Hematology and Oncology Associates
  - Trumbull, Connecticut, Forente stater, 06611
    - Smilow Cancer Hospital Care Center-Trumbull
  - Waterford, Connecticut, Forente stater, 06385
    - Lawrence and Memorial Cancer Center
- Delaware
  - Lewes, Delaware, Forente stater, 19958
    - Beebe Medical Center
  - 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
  - Newark, Delaware, Forente stater, 19713
    - Christiana Gynecologic Oncology LLC
  - Newark, Delaware, Forente stater, 19713
    - Regional Hematology and Oncology PA
  - Rehoboth Beach, Delaware, Forente stater, 19971
    - Beebe Health Campus
  - Seaford, Delaware, Forente stater, 19973
    - Nanticoke Memorial Hospital
  - Wilmington, Delaware, Forente stater, 19801
    - Christiana Care Health System-Wilmington Hospital
- District of Columbia
  - Washington, District of Columbia, Forente stater, 20010
    - MedStar Washington Hospital Center
  - Washington, District of Columbia, Forente stater, 20007
    - MedStar Georgetown University Hospital
- Florida
  - Altamonte Springs, Florida, Forente stater, 32701
    - Florida Hospital Cancer Institute Altamonte
  - Aventura, Florida, Forente stater, 33180
    - Mount Sinai Comprehensive Cancer Center at Aventura
  - 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
    - University of Florida Health Science Center - Gainesville
  - Hollywood, Florida, Forente stater, 33021
    - Memorial Regional Hospital/Joe DiMaggio Children's Hospital
  - Jacksonville, Florida, Forente stater, 32207
    - Baptist MD Anderson Cancer Center
  - Jacksonville, Florida, Forente stater, 32224-9980
    - Mayo Clinic in Florida
  - Jacksonville, Florida, Forente stater, 32258
    - Baptist Medical Center South
  - Jacksonville, Florida, Forente stater, 32207
    - Integrated Community Oncology Network-Southside Cancer Center
  - Jacksonville Beach, Florida, Forente stater, 32250
    - Integrated Community Oncology Network-Florida Cancer Center Beaches
  - Jupiter, Florida, Forente stater, 33458
    - Jupiter Medical Center
  - Kissimmee, Florida, Forente stater, 34744
    - Florida Hospital Kissimmee
  - Lakeland, Florida, Forente stater, 33805
    - Lakeland Regional Health Hollis Cancer Center
  - Lakeland, Florida, Forente stater, 33805
    - The Watson Clinic
  - Miami, Florida, Forente stater, 33136
    - University of Miami Miller School of Medicine-Sylvester Cancer Center
  - Miami Beach, Florida, Forente stater, 33140
    - Mount Sinai Medical Center
  - Orange Park, Florida, Forente stater, 32073
    - 21st Century Oncology-Orange Park
  - Orlando, Florida, Forente stater, 32803
    - Florida Hospital Orlando
  - Orlando, Florida, Forente stater, 32803
    - Florida Urology Associates-Orlando
  - Orlando, Florida, Forente stater, 32822
    - Florida Hospital East Orlando
  - Palatka, Florida, Forente stater, 32177
    - 21st Century Oncology-Palatka
  - Pembroke Pines, Florida, Forente stater, 33028
    - Memorial Hospital West
  - Plantation, Florida, Forente stater, 33324
    - UM Sylvester Comprehensive Cancer Center at Plantation
  - Saint Augustine, Florida, Forente stater, 32086
    - Integrated Community Oncology Network-Flager Cancer Center
  - Tampa, Florida, Forente stater, 33606
    - Tampa General Hospital
  - Winter Park, Florida, Forente stater, 32792
    - Florida Hospital Cancer Institute Winter Park
- Georgia
  - Atlanta, Georgia, Forente stater, 30308
    - Emory University Hospital Midtown
  - Atlanta, Georgia, Forente stater, 30322
    - Emory University Hospital/Winship Cancer Institute
  - Atlanta, Georgia, Forente stater, 30342
    - Emory Saint Joseph's Hospital
  - Columbus, Georgia, Forente stater, 31904
    - John B Amos Cancer Center
  - Decatur, Georgia, Forente stater, 30033
    - Atlanta VA Medical Center
  - Savannah, Georgia, Forente stater, 31404
    - Memorial Health University Medical Center
  - Savannah, Georgia, Forente stater, 31404
    - Summit Cancer Care-Memorial
  - Savannah, Georgia, Forente stater, 31405
    - Low Country Cancer Care Associates PC
  - Thomasville, Georgia, Forente stater, 31792
    - Lewis Hall Singletary Oncology Center
- Hawaii
  - 'Aiea, Hawaii, Forente stater, 96701
    - Pali Momi Medical Center
  - 'Aiea, Hawaii, Forente stater, 96701
    - The Cancer Center of Hawaii-Pali Momi
  - 'Aiea, Hawaii, Forente stater, 96701
    - Hawaii Oncology Inc-Pali Momi
  - 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
    - Straub Clinic and Hospital
  - Honolulu, Hawaii, Forente stater, 96813
    - University of Hawaii Cancer Center
  - Honolulu, Hawaii, Forente stater, 96817
    - Hawaii Cancer Care Inc-Liliha
  - Honolulu, Hawaii, Forente stater, 96817
    - Kuakini Medical Center
  - Honolulu, Hawaii, Forente stater, 96826
    - Kapiolani Medical Center for Women and Children
  - Honolulu, Hawaii, Forente stater, 96813
    - Island Urology
  - Honolulu, Hawaii, Forente stater, 96819
    - Kaiser Permanente Moanalua Medical Center
  - Honolulu, Hawaii, Forente stater, 96813
    - Hawaii Cancer Care Inc-POB II
  - Honolulu, Hawaii, Forente stater, 96813
    - Hawaii Oncology Inc-POB I
  - Honolulu, Hawaii, Forente stater, 96817
    - Hawaii Oncology Inc-Kuakini
  - Lihue, Hawaii, Forente stater, 96766
    - Wilcox Memorial Hospital and Kauai Medical Clinic
- Idaho
  - Boise, Idaho, Forente stater, 83706
    - Saint Alphonsus Cancer Care Center-Boise
  - Boise, Idaho, Forente stater, 83712
    - Saint Luke's Mountain States Tumor Institute
  - Caldwell, Idaho, Forente stater, 83605
    - Saint Alphonsus Cancer Care Center-Caldwell
  - Coeur d'Alene, Idaho, Forente stater, 83814
    - Kootenai Medical Center
  - Emmett, Idaho, Forente stater, 83617
    - Walter Knox Memorial Hospital
  - Fruitland, Idaho, Forente stater, 83619
    - Saint Luke's Mountain States Tumor Institute - Fruitland
  - Lewiston, Idaho, Forente stater, 83501
    - Saint Joseph Regional Medical Center
  - Meridian, Idaho, Forente stater, 83642
    - Idaho Urologic Institute-Meridian
  - Meridian, Idaho, Forente stater, 83642
    - Saint Luke's Mountain States Tumor Institute - Meridian
  - Nampa, Idaho, Forente stater, 83686
    - Saint Alphonsus Medical Center-Nampa
  - Nampa, Idaho, Forente stater, 83686
    - Saint Luke's Mountain States Tumor Institute - Nampa
  - Post Falls, Idaho, Forente stater, 83854
    - Kootenai Cancer Center
  - Sandpoint, Idaho, Forente stater, 83864
    - Kootenai Cancer Clinic
  - Twin Falls, Idaho, Forente stater, 83301
    - Saint Luke's Mountain States Tumor Institute-Twin Falls
- Illinois
  - Aurora, Illinois, Forente stater, 60504
    - Rush - Copley Medical Center
  - Bloomington, Illinois, Forente stater, 61704
    - Illinois CancerCare-Bloomington
  - Bloomington, Illinois, Forente stater, 61701
    - Saint Joseph Medical Center
  - Canton, Illinois, Forente stater, 61520
    - Illinois CancerCare-Canton
  - Carbondale, Illinois, Forente stater, 62902
    - Memorial Hospital of Carbondale
  - Carterville, Illinois, Forente stater, 62918
    - SIH Cancer Institute
  - Carthage, Illinois, Forente stater, 62321
    - Illinois CancerCare-Carthage
  - Centralia, Illinois, Forente stater, 62801
    - Centralia Oncology Clinic
  - Chicago, Illinois, Forente stater, 60611
    - Northwestern University
  - Chicago, Illinois, Forente stater, 60612
    - Rush University Medical Center
  - Chicago, Illinois, Forente stater, 60637
    - University of Chicago Comprehensive Cancer Center
  - Chicago, Illinois, Forente stater, 60612
    - University of Illinois
  - Chicago, Illinois, Forente stater, 60612
    - John H Stroger Jr Hospital of Cook County
  - Chicago, Illinois, Forente stater, 60608
    - Mount Sinai Hospital Medical Center
  - Chicago, Illinois, Forente stater, 60625
    - Swedish Covenant Hospital
  - Chicago, Illinois, Forente stater, 60611
    - Hematology and Oncology Associates
  - Chicago, Illinois, Forente stater, 60631
    - Presence Resurrection Medical Center
  - Chicago, Illinois, Forente stater, 60657
    - Presence Saint Joseph Hospital-Chicago
  - Danville, Illinois, Forente stater, 61832
    - Carle on Vermilion
  - Decatur, Illinois, Forente stater, 62526
    - Decatur Memorial Hospital
  - Decatur, Illinois, Forente stater, 62526
    - Cancer Care Specialists of Illinois - Decatur
  - Effingham, Illinois, Forente stater, 62401
    - Crossroads Cancer Center
  - Effingham, Illinois, Forente stater, 62401
    - Carle Physician Group-Effingham
  - Eureka, Illinois, Forente stater, 61530
    - Illinois CancerCare-Eureka
  - Evanston, Illinois, Forente stater, 60201
    - NorthShore University HealthSystem-Evanston Hospital
  - 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
  - Glenview, Illinois, Forente stater, 60026
    - NorthShore University HealthSystem-Glenbrook Hospital
  - Harvey, Illinois, Forente stater, 60426
    - Ingalls Memorial Hospital
  - Highland Park, Illinois, Forente stater, 60035
    - NorthShore University HealthSystem-Highland Park Hospital
  - Highland Park, Illinois, Forente stater, 60035
    - Hematology Oncology Associates of Illinois-Highland Park
  - Hines, Illinois, Forente stater, 60141
    - Edward Hines Jr VA Hospital
  - Kankakee, Illinois, Forente stater, 60901
    - Presence Saint Mary's Hospital
  - Kewanee, Illinois, Forente stater, 61443
    - Illinois CancerCare-Kewanee Clinic
  - Libertyville, Illinois, Forente stater, 60048
    - NorthShore Hematology Oncology-Libertyville
  - 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
  - Moline, Illinois, Forente stater, 61265
    - Garneau, Stewart C MD (UIA Investigator)
  - Moline, Illinois, Forente stater, 61265
    - Porubcin, Michael MD (UIA Investigator)
  - Moline, Illinois, Forente stater, 61265
    - Spector, David MD (UIA Investigator)
  - Moline, Illinois, Forente stater, 61265
    - Trinity Medical Center
  - Mount Vernon, Illinois, Forente stater, 62864
    - Good Samaritan Regional Health Center
  - New Lenox, Illinois, Forente stater, 60451
    - UC Comprehensive Cancer Center at Silver Cross
  - Niles, Illinois, Forente stater, 60714
    - Illinois Cancer Specialists-Niles
  - Orland Park, Illinois, Forente stater, 60462
    - University of Chicago Medicine-Orland Park
  - Ottawa, Illinois, Forente stater, 61350
    - Illinois CancerCare-Ottawa Clinic
  - Ottawa, Illinois, Forente stater, 61350
    - Radiation Oncology of Northern Illinois
  - Park Ridge, Illinois, Forente stater, 60068
    - Advocate Lutheran General Hospital
  - Pekin, Illinois, Forente stater, 61554
    - Illinois CancerCare-Pekin
  - Pekin, Illinois, Forente stater, 61554
    - OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
  - Peoria, Illinois, Forente stater, 61636
    - Methodist Medical Center of Illinois
  - Peoria, Illinois, Forente stater, 61637
    - OSF Saint Francis Medical Center
  - Peoria, Illinois, Forente stater, 61615
    - Illinois CancerCare-Peoria
  - Peoria, Illinois, Forente stater, 61615
    - OSF Saint Francis Radiation Oncology at Peoria Cancer Center
  - Peru, Illinois, Forente stater, 61354
    - Illinois CancerCare-Peru
  - Peru, Illinois, Forente stater, 61354
    - Valley Radiation Oncology
  - Princeton, Illinois, Forente stater, 61356
    - Illinois CancerCare-Princeton
  - Rockford, Illinois, Forente stater, 61114
    - SwedishAmerican Regional Cancer Center/ACT
  - Rockford, Illinois, Forente stater, 61104
    - Swedish American Hospital
  - Skokie, Illinois, Forente stater, 60076
    - Hematology Oncology Associates of Illinois - Skokie
  - Springfield, Illinois, Forente stater, 62781
    - Memorial Medical Center
  - Springfield, Illinois, Forente stater, 62702
    - Southern Illinois University School of Medicine
  - Springfield, Illinois, Forente stater, 62702
    - Springfield Clinic
  - Springfield, Illinois, Forente stater, 62702
    - Central Illinois Hematology Oncology Center
  - Swansea, Illinois, Forente stater, 62226
    - Southwest Illinois Health Services LLP
  - Swansea, Illinois, Forente stater, 62226
    - Cancer Care Specialists of Illinois-Swansea
  - 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
  - Yorkville, Illinois, Forente stater, 60560
    - Rush-Copley Healthcare Center
- Indiana
  - Carmel, Indiana, Forente stater, 46032
    - IU Health North Hospital
  - Elkhart, Indiana, Forente stater, 46515
    - Elkhart General Hospital
  - Elkhart, Indiana, Forente stater, 46514
    - Michiana Hematology Oncology PC-Elkhart
  - Elkhart, Indiana, Forente stater, 46514-2098
    - Elkhart Clinic
  - Evansville, Indiana, Forente stater, 47713
    - Deaconess Clinic Downtown
  - Fort Wayne, Indiana, Forente stater, 46805
    - Parkview Hospital Randallia
  - Fort Wayne, Indiana, Forente stater, 46804
    - Radiation Oncology Associates PC
  - Fort Wayne, Indiana, Forente stater, 46845
    - Fort Wayne Medical Oncology and Hematology Inc-Parkview
  - 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
  - Indianapolis, Indiana, Forente stater, 46290
    - Springmill Medical Center
  - Indianapolis, Indiana, Forente stater, 46237
    - Kendrick Colon and Rectal Center-Indianapolis
  - Kokomo, Indiana, Forente stater, 46904
    - Community Howard Regional Health
  - La Porte, Indiana, Forente stater, 46350
    - IU Health La Porte Hospital
  - Michigan City, Indiana, Forente stater, 46360
    - Woodland Cancer Care Center
  - Mishawaka, Indiana, Forente stater, 46545
    - Memorial Regional Cancer Center Day Road
  - Mishawaka, Indiana, Forente stater, 46545
    - Michiana Hematology Oncology PC-Mishawaka
  - Mishawaka, Indiana, Forente stater, 46545
    - Saint Joseph Regional Medical Center-Mishawaka
  - Mooresville, Indiana, Forente stater, 46158
    - Franciscan Health Mooresville
  - Newburgh, Indiana, Forente stater, 47630
    - Chancellor Center for Oncology
  - Plymouth, Indiana, Forente stater, 46563
    - Michiana Hematology Oncology PC-Plymouth
  - Richmond, Indiana, Forente stater, 47374
    - Reid Health
  - South Bend, Indiana, Forente stater, 46601
    - Memorial Hospital of South Bend
  - South Bend, Indiana, Forente stater, 46601
    - Michiana Hematology Oncology PC-South Bend
  - South Bend, Indiana, Forente stater, 46617
    - South Bend Clinic
  - Terre Haute, Indiana, Forente stater, 47804
    - Union Hospital
  - Westville, Indiana, Forente stater, 46391
    - Michiana Hematology Oncology PC-Westville
- Iowa
  - Bettendorf, Iowa, Forente stater, 52722
    - Constantinou, Costas L MD (UIA Investigator)
  - Cedar Rapids, Iowa, Forente stater, 52403
    - Mercy Hospital
  - Cedar Rapids, Iowa, Forente stater, 52403
    - Oncology Associates at Mercy Medical Center
  - Clive, Iowa, Forente stater, 50325
    - Mercy Cancer Center-West Lakes
  - Clive, Iowa, Forente stater, 50325
    - Medical Oncology and Hematology Associates-West Des Moines
  - 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, 50309
    - Medical Oncology and Hematology Associates-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, 50314
    - Medical Oncology and Hematology Associates-Laurel
  - Fort Dodge, Iowa, Forente stater, 50501
    - Trinity Regional Medical 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
  - Chanute, Kansas, Forente stater, 66720
    - Cancer Center of Kansas - Chanute
  - Dodge City, Kansas, Forente stater, 67801
    - Cancer Center of Kansas - Dodge City
  - El Dorado, Kansas, Forente stater, 67042
    - Cancer Center of Kansas - El Dorado
  - Fort Scott, Kansas, Forente stater, 66701
    - Cancer Center of Kansas - Fort Scott
  - Garden City, Kansas, Forente stater, 67846
    - Central Care Cancer Center - Garden City
  - Garden City, Kansas, Forente stater, 67846
    - Saint Catherine Hospital
  - Great Bend, Kansas, Forente stater, 67530
    - Central Care Cancer Center - Great Bend
  - Independence, Kansas, Forente stater, 67301
    - Cancer Center of Kansas-Independence
  - Kansas City, Kansas, Forente stater, 66160
    - University of Kansas Cancer Center
  - Kingman, Kansas, Forente stater, 67068
    - Cancer Center of Kansas-Kingman
  - 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
  - Liberal, Kansas, Forente stater, 67905
    - Cancer Center of Kansas-Liberal
  - Manhattan, Kansas, Forente stater, 66502
    - Cancer Center of Kansas-Manhattan
  - McPherson, Kansas, Forente stater, 67460
    - Cancer Center of Kansas - McPherson
  - Newton, Kansas, Forente stater, 67114
    - Cancer Center of Kansas - Newton
  - Olathe, Kansas, Forente stater, 66061
    - Olathe Medical Center
  - Overland Park, Kansas, Forente stater, 66210
    - University of Kansas Cancer Center-Overland Park
  - Overland Park, Kansas, Forente stater, 66209
    - Menorah Medical Center
  - Overland Park, Kansas, Forente stater, 66213
    - Saint Luke's South Hospital
  - Parsons, Kansas, Forente stater, 67357
    - Cancer Center of Kansas - Parsons
  - Pittsburg, Kansas, Forente stater, 66762
    - Via Christi Hospital-Pittsburg
  - Pratt, Kansas, Forente stater, 67124
    - Cancer Center of Kansas - Pratt
  - Salina, Kansas, Forente stater, 67401
    - Salina Regional Health Center
  - Salina, Kansas, Forente stater, 67401
    - Cancer Center of Kansas - Salina
  - Topeka, Kansas, Forente stater, 66606
    - Cotton O'Neil Cancer Center / Stormont Vail Health
  - Topeka, Kansas, Forente stater, 66606
    - Saint Francis Hospital and Medical Center - Topeka
  - Wellington, Kansas, Forente stater, 67152
    - Cancer Center of Kansas - Wellington
  - Westwood, Kansas, Forente stater, 66205
    - University of Kansas Hospital-Westwood Cancer Center
  - Wichita, Kansas, Forente stater, 67208
    - Cancer Center of Kansas-Wichita Medical Arts Tower
  - Wichita, Kansas, Forente stater, 67214
    - Cancer Center of Kansas - Wichita
  - Wichita, Kansas, Forente stater, 67208
    - Associates In Womens Health
  - Wichita, Kansas, Forente stater, 67214
    - Via Christi Regional Medical Center
  - Wichita, Kansas, Forente stater, 67214
    - Wesley Medical Center
  - Winfield, Kansas, Forente stater, 67156
    - Cancer Center of Kansas - Winfield
- Kentucky
  - Bardstown, Kentucky, Forente stater, 40004
    - Flaget Memorial Hospital
  - Corbin, Kentucky, Forente stater, 40701
    - Baptist Health Corbin
  - Corbin, Kentucky, Forente stater, 40701
    - Commonwealth Cancer Center-Corbin
  - Crestview Hills, Kentucky, Forente stater, 41017
    - Oncology Hematology Care Inc-Crestview
  - 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
    - Saint Joseph Hospital East
  - Lexington, Kentucky, Forente stater, 40503
    - Baptist Health Lexington
  - London, Kentucky, Forente stater, 40741
    - Saint Joseph London
  - Louisville, Kentucky, Forente stater, 40202
    - Jewish Hospital
  - Louisville, Kentucky, Forente stater, 40207
    - Baptist Health Louisville
  - Louisville, Kentucky, Forente stater, 40215
    - Saints Mary and Elizabeth Hospital
  - Louisville, Kentucky, Forente stater, 40245
    - Jewish Hospital Medical Center Northeast
  - Madisonville, Kentucky, Forente stater, 42431
    - Baptist Health Madisonville/Merle Mahr Cancer Center
  - Paducah, Kentucky, Forente stater, 42003
    - Baptist Health Paducah
  - 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, 70809
    - Our Lady of the Lake Physicians Group - Medical Oncology
  - 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
- Maine
  - Bangor, Maine, Forente stater, 04401
    - Eastern Maine Medical Center
  - Brewer, Maine, Forente stater, 04412
    - Lafayette Family Cancer Center-EMMC
- Maryland
  - Baltimore, Maryland, Forente stater, 21287
    - Johns Hopkins University/Sidney Kimmel Cancer Center
  - Baltimore, Maryland, Forente stater, 21215
    - Sinai Hospital of Baltimore
  - Baltimore, Maryland, Forente stater, 21201
    - University of Maryland/Greenebaum Cancer Center
  - Baltimore, Maryland, Forente stater, 21218
    - MedStar Union Memorial Hospital
  - Baltimore, Maryland, Forente stater, 21239
    - MedStar Good Samaritan Hospital
  - Bel Air, Maryland, Forente stater, 21014
    - UM Upper Chesapeake Medical Center
  - Glen Burnie, Maryland, Forente stater, 21061
    - UM Baltimore Washington Medical Center/Tate Cancer Center
  - Salisbury, Maryland, Forente stater, 21801
    - Peninsula Regional Medical Center
- Massachusetts
  - Beverly, Massachusetts, Forente stater, 01915
    - Beverly Hospital
  - Boston, Massachusetts, Forente stater, 02215
    - Beth Israel Deaconess Medical Center
  - Boston, Massachusetts, Forente stater, 02215
    - Dana-Farber Cancer Institute
  - Boston, Massachusetts, Forente stater, 02115
    - Brigham and Women's Hospital
  - Boston, Massachusetts, Forente stater, 02118
    - Boston Medical Center
  - Boston, Massachusetts, Forente stater, 02114
    - Massachusetts General Hospital Cancer Center
  - Burlington, Massachusetts, Forente stater, 01805
    - Lahey Hospital and Medical Center
  - Gloucester, Massachusetts, Forente stater, 01930
    - Addison Gilbert Hospital
  - Milford, Massachusetts, Forente stater, 01757
    - Dana-Farber/Brigham and Women's Cancer Center at Milford Regional
  - Pittsfield, Massachusetts, Forente stater, 01201
    - Berkshire Hematology Oncology PC
  - South Weymouth, Massachusetts, Forente stater, 02190
    - Dana-Farber/Brigham and Women's Cancer Center at South Shore
  - Springfield, Massachusetts, Forente stater, 01199
    - Baystate Medical Center
  - Springfield, Massachusetts, Forente stater, 01104
    - Mercy Medical Center
  - Winchester, Massachusetts, Forente stater, 01890
    - Winchester Hospital
- Michigan
  - Ann Arbor, Michigan, Forente stater, 48109
    - University Of Michigan Comprehensive Cancer Center
  - Ann Arbor, Michigan, Forente stater, 48106
    - Saint Joseph Mercy Hospital
  - Brighton, Michigan, Forente stater, 48114
    - Saint Joseph Mercy Brighton
  - Brighton, Michigan, Forente stater, 48114
    - IHA Hematology Oncology Consultants-Brighton
  - Brownstown, Michigan, Forente stater, 48183
    - Henry Ford Cancer Institute-Downriver
  - Canton, Michigan, Forente stater, 48188
    - Saint Joseph Mercy Canton
  - Canton, Michigan, Forente stater, 48188
    - IHA Hematology Oncology Consultants-Canton
  - Caro, Michigan, Forente stater, 48723
    - Caro Cancer Center
  - Chelsea, Michigan, Forente stater, 48118
    - Saint Joseph Mercy Chelsea
  - Chelsea, Michigan, Forente stater, 48118
    - IHA Hematology Oncology Consultants-Chelsea
  - 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
  - Dearborn, Michigan, Forente stater, 48124
    - Beaumont Hospital-Dearborn
  - Detroit, Michigan, Forente stater, 48202
    - Henry Ford Hospital
  - Detroit, Michigan, Forente stater, 48201
    - Wayne State University/Karmanos Cancer Institute
  - Detroit, Michigan, Forente stater, 48236
    - Ascension Saint John Hospital
  - East China Township, Michigan, Forente stater, 48054
    - Great Lakes Cancer Management Specialists-Doctors Park
  - Farmington Hills, Michigan, Forente stater, 48336
    - Beaumont Hospital - Farmington Hills
  - Flint, Michigan, Forente stater, 48503
    - Hurley Medical Center
  - Flint, Michigan, Forente stater, 48503
    - Genesee Cancer and Blood Disease Treatment Center
  - Flint, Michigan, Forente stater, 48503
    - Genesee Hematology Oncology PC
  - Flint, Michigan, Forente stater, 48503
    - Genesys Hurley Cancer Institute
  - Grosse Pointe, Michigan, Forente stater, 48230
    - William Beaumont Hospital-Grosse Point
  - Grosse Pointe Woods, Michigan, Forente stater, 48236
    - Great Lakes Cancer Management Specialists-Van Elslander Cancer Center
  - Grosse Pointe Woods, Michigan, Forente stater, 48236
    - Michigan Breast Specialists-Grosse Pointe Woods
  - Grosse Pointe Woods, Michigan, Forente stater, 48236
    - Lymphoma Clinic of Michigan
  - 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, 49048
    - Borgess Medical Center
  - Lansing, Michigan, Forente stater, 48912
    - Sparrow Hospital
  - Livonia, Michigan, Forente stater, 48154
    - Saint Mary Mercy Hospital
  - Livonia, Michigan, Forente stater, 48154
    - Hope Cancer Clinic
  - Macomb, Michigan, Forente stater, 48044
    - Great Lakes Cancer Management Specialists-Macomb Medical Campus
  - Macomb, Michigan, Forente stater, 48044
    - Michigan Breast Specialists-Macomb Township
  - Marlette, Michigan, Forente stater, 48453
    - Saint Mary's Oncology/Hematology Associates of Marlette
  - Midland, Michigan, Forente stater, 48670
    - Mid-Michigan Medical Center - Midland
  - Monroe, Michigan, Forente stater, 48162
    - Monroe Cancer Center
  - Niles, Michigan, Forente stater, 49120
    - Lakeland Hospital Niles
  - Novi, Michigan, Forente stater, 48377
    - Henry Ford Medical Center-Columbus
  - Pontiac, Michigan, Forente stater, 48341
    - Saint Joseph Mercy Oakland
  - Pontiac, Michigan, Forente stater, 48341
    - 21st Century Oncology-Pontiac
  - Pontiac, Michigan, Forente stater, 48341
    - Hope Cancer Center
  - Pontiac, Michigan, Forente stater, 48341
    - Newland Medical Associates-Pontiac
  - Port Huron, Michigan, Forente stater, 48060
    - Lake Huron Medical Center
  - Port Huron, Michigan, Forente stater, 48060
    - Huron Medical Center PC
  - Rochester Hills, Michigan, Forente stater, 48309
    - Great Lakes Cancer Management Specialists-Rochester Hills
  - Roseville, Michigan, Forente stater, 48066
    - Michigan Cancer Specialists
  - Royal Oak, Michigan, Forente stater, 48073
    - William Beaumont Hospital-Royal Oak
  - Royal Oak, Michigan, Forente stater, 48067
    - Oakland Colon and Rectal Association
  - Royal Oak, Michigan, Forente stater, 48073
    - Cancer Care Associates PC
  - Royal Oak, Michigan, Forente stater, 48073
    - Comprehensive Medical Center PLLC
  - Royal Oak, Michigan, Forente stater, 48073
    - Hematology Oncology Consultants PC
  - Royal Oak, Michigan, Forente stater, 48073
    - Oakland Medical Group
  - Saginaw, Michigan, Forente stater, 48601
    - Saint Mary's of Michigan
  - Saginaw, Michigan, Forente stater, 48604
    - Oncology Hematology Associates of Saginaw Valley PC
  - Saint Joseph, Michigan, Forente stater, 49085
    - Lakeland Medical Center Saint Joseph
  - Saint Joseph, Michigan, Forente stater, 49085
    - Marie Yeager Cancer Center
  - Sterling Heights, Michigan, Forente stater, 48312
    - Bhadresh Nayak MD PC-Sterling Heights
  - Sterling Heights, Michigan, Forente stater, 48312
    - Premier Hematology Oncology Care
  - Sterling Heights, Michigan, Forente stater, 48314
    - Mitchell Folbe MD PC
  - Tawas City, Michigan, Forente stater, 48764
    - Saint Joseph Health System-Tawas City
  - Troy, Michigan, Forente stater, 48085
    - William Beaumont Hospital - Troy
  - Troy, Michigan, Forente stater, 48084
    - Michigan Institute of Urology-Town Center
  - Troy, Michigan, Forente stater, 48085
    - Claudia BR Herke MD PC
  - Troy, Michigan, Forente stater, 48098
    - Hematology Oncology Consultants PC-Troy
  - Warren, Michigan, Forente stater, 48093
    - Saint John Macomb-Oakland Hospital
  - Warren, Michigan, Forente stater, 48088
    - Advanced Breast Care Center PLLC
  - Warren, Michigan, Forente stater, 48093
    - Great Lakes Cancer Management Specialists-Macomb Professional Building
  - Warren, Michigan, Forente stater, 48093
    - Macomb Hematology Oncology PC
  - Warren, Michigan, Forente stater, 48093
    - Michigan Breast Specialists-Warren
  - Warren, Michigan, Forente stater, 48093
    - Bhadresh Nayak MD PC-Warren
  - 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
  - Ypsilanti, Michigan, Forente stater, 48106
    - Huron Gastroenterology PC
  - Ypsilanti, Michigan, Forente stater, 48197
    - IHA Hematology Oncology Consultants-Ann Arbor
- Minnesota
  - Bemidji, Minnesota, Forente stater, 56601
    - Sanford Joe Lueken Cancer Center
  - Burnsville, Minnesota, Forente stater, 55337
    - Fairview Ridges Hospital
  - Coon Rapids, Minnesota, Forente stater, 55433
    - Mercy Hospital
  - Edina, Minnesota, Forente stater, 55435
    - Fairview-Southdale Hospital
  - Fridley, Minnesota, Forente stater, 55432
    - Unity Hospital
  - Hutchinson, Minnesota, Forente stater, 55350
    - Hutchinson Area Health Care
  - Mankato, Minnesota, Forente stater, 56001
    - Mayo Clinic Health Systems-Mankato
  - Maple Grove, Minnesota, Forente stater, 55369
    - Fairview Maple Grove Medical Center
  - 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
  - Robbinsdale, Minnesota, Forente stater, 55422
    - North Memorial Medical Health Center
  - Rochester, Minnesota, Forente stater, 55905
    - Mayo Clinic
  - Saint Cloud, Minnesota, Forente stater, 56303
    - Coborn Cancer Center at Saint Cloud Hospital
  - Saint Cloud, Minnesota, Forente stater, 56303
    - 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
  - Shakopee, Minnesota, Forente stater, 55379
    - Saint Francis Regional Medical Center
  - Stillwater, Minnesota, Forente stater, 55082
    - Lakeview Hospital
  - 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
  - Gulfport, Mississippi, Forente stater, 39502
    - Gulfport Memorial Hospital
- Missouri
  - 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
    - Southeast Cancer Center
  - Chesterfield, Missouri, Forente stater, 63017
    - Saint Luke's Hospital
  - Columbia, Missouri, Forente stater, 65212
    - University of Missouri - Ellis Fischel
  - Creve Coeur, Missouri, Forente stater, 63141
    - Siteman Cancer Center at West County Hospital
  - Independence, Missouri, Forente stater, 64057
    - Centerpoint Medical Center LLC
  - Jefferson City, Missouri, Forente stater, 65109
    - Capital Region Southwest Campus
  - Joplin, Missouri, Forente stater, 64804
    - Freeman Health System
  - Joplin, Missouri, Forente stater, 64804
    - Mercy Hospital Joplin
  - Kansas City, Missouri, Forente stater, 64131
    - The University of Kansas Cancer Center-South
  - Kansas City, Missouri, Forente stater, 64111
    - Saint Luke's Hospital of Kansas City
  - Kansas City, Missouri, Forente stater, 64132
    - Research Medical Center
  - Kansas City, Missouri, Forente stater, 64118
    - Heartland Hematology and Oncology Associates Incorporated
  - Kansas City, Missouri, Forente stater, 64154
    - The University of Kansas Cancer Center-North
  - Lee's Summit, Missouri, Forente stater, 64086
    - Saint Luke's East - Lee's Summit
  - Lee's Summit, Missouri, Forente stater, 64064
    - The University of Kansas Cancer Center-Lee's Summit
  - Liberty, Missouri, Forente stater, 64068
    - Liberty Radiation Oncology Center
  - Rolla, Missouri, Forente stater, 65401
    - Delbert Day Cancer Institute at PCRMC
  - Rolla, Missouri, Forente stater, 65401
    - Mercy Clinic-Rolla-Cancer and Hematology
  - Saint Joseph, Missouri, Forente stater, 64507
    - Saint Joseph Oncology Inc
  - Saint Joseph, Missouri, Forente stater, 64507
    - Heartland Regional Medical Center
  - Saint Louis, Missouri, Forente stater, 63110
    - Washington University School of Medicine
  - Saint Louis, Missouri, Forente stater, 63131
    - Missouri Baptist Medical Center
  - Saint Louis, Missouri, Forente stater, 63141
    - Mercy Hospital Saint Louis
  - Saint Louis, Missouri, Forente stater, 63128
    - Mercy Hospital South
  - Saint Louis, Missouri, Forente stater, 63129
    - Siteman Cancer Center-South County
  - Saint Louis, Missouri, Forente stater, 63136
    - Siteman Cancer Center at Christian Hospital
  - Saint Louis, Missouri, Forente stater, 63109
    - Saint Louis Cancer and Breast Institute-South City
  - Saint Peters, Missouri, Forente stater, 63376
    - Siteman Cancer Center at Saint Peters Hospital
  - 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
  - Sullivan, Missouri, Forente stater, 63080
    - Missouri Baptist Sullivan Hospital
  - Sunset Hills, Missouri, Forente stater, 63127
    - Missouri Baptist Outpatient Center-Sunset Hills
- 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 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 Healthcare- Sletten Cancer Institute
  - Helena, Montana, Forente stater, 59601
    - Saint Peter's Community Hospital
  - Kalispell, Montana, Forente stater, 59901
    - Kalispell Regional Medical Center
  - Missoula, Montana, Forente stater, 59804
    - Community Medical Hospital
  - Missoula, Montana, Forente stater, 59802
    - Saint Patrick Hospital - Community Hospital
  - Missoula, Montana, Forente stater, 59802
    - Montana Cancer Specialists
- Nebraska
  - Bellevue, Nebraska, Forente stater, 68123
    - Nebraska Medicine-Bellevue
  - Grand Island, Nebraska, Forente stater, 68803
    - CHI Health Saint Francis
  - Kearney, Nebraska, Forente stater, 68847
    - CHI Health Good Samaritan
  - Kearney, Nebraska, Forente stater, 68845
    - Heartland Hematology and Oncology
  - Lincoln, Nebraska, Forente stater, 68510
    - Saint Elizabeth Regional Medical Center
  - 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, 68131
    - Creighton University Medical Center
  - Omaha, Nebraska, Forente stater, 68122
    - Hematology and Oncology Consultants PC
  - 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
    - OptumCare Cancer Care at Seven Hills
  - 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, 89074
    - 21st Century Oncology-Henderson
  - Henderson, Nevada, Forente stater, 89052
    - Comprehensive Cancer Centers of Nevada-Horizon Ridge
  - Las Vegas, Nevada, Forente stater, 89144
    - Summerlin Hospital Medical Center
  - 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, 89144
    - Comprehensive Cancer Centers of Nevada-Summerlin
  - Las Vegas, Nevada, Forente stater, 89148
    - Comprehensive Cancer Centers of Nevada
  - Las Vegas, Nevada, Forente stater, 89148
    - OptumCare Cancer Care at Fort Apache
  - 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, 89121
    - Cancer Therapy and Integrative Medicine
  - 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, 89109
    - 21st Century Oncology
  - Las Vegas, Nevada, Forente stater, 89128
    - 21st Century Oncology-Vegas Tenaya
  - Las Vegas, Nevada, Forente stater, 89148
    - 21st Century Oncology-Fort Apache
  - Las Vegas, Nevada, Forente stater, 89128
    - Ann M Wierman MD LTD
  - Las Vegas, Nevada, Forente stater, 89102
    - Desert West Surgery
  - Las Vegas, Nevada, Forente stater, 89169
    - University Cancer Center
  - Las Vegas, Nevada, Forente stater, 89106
    - OptumCare Cancer Care at Oakey
  - 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
  - Reno, Nevada, Forente stater, 89511
    - Cancer Care Specialists - Reno
  - Reno, Nevada, Forente stater, 89503
    - Alpine Hematology-Oncology
- New Hampshire
  - Lebanon, New Hampshire, Forente stater, 03756
    - Dartmouth Hitchcock Medical Center
  - Nashua, New Hampshire, Forente stater, 03060
    - Saint Joseph Hospital
- New Jersey
  - Basking Ridge, New Jersey, Forente stater, 07920
    - Memorial Sloan Kettering Basking Ridge
  - Camden, New Jersey, Forente stater, 08103
    - Cooper Hospital University Medical Center
  - Englewood, New Jersey, Forente stater, 07631
    - Englewood Hospital and Medical Center
  - Lakewood, New Jersey, Forente stater, 08701
    - Monmouth Medical Center Southern Campus
  - Long Branch, New Jersey, Forente stater, 07740
    - Monmouth Medical Center
  - Middletown, New Jersey, Forente stater, 07748
    - Memorial Sloan Kettering Monmouth
  - Morristown, New Jersey, Forente stater, 07960
    - Morristown Medical Center
  - Mount Holly, New Jersey, Forente stater, 08060
    - Virtua Memorial
  - New Brunswick, New Jersey, Forente stater, 08901
    - Saint Peter's University Hospital
  - Summit, New Jersey, Forente stater, 07902
    - Overlook Hospital
  - Voorhees, New Jersey, Forente stater, 08043
    - Virtua Voorhees
- New Mexico
  - Albuquerque, New Mexico, Forente stater, 87102
    - University of New Mexico Cancer Center
- New York
  - Auburn, New York, Forente stater, 13021
    - Hematology Oncology Associates of Central New York-Auburn
  - Bay Shore, New York, Forente stater, 11706
    - Southside Hospital
  - Bronx, New York, Forente stater, 10461
    - Montefiore Medical Center-Einstein Campus
  - Bronx, New York, Forente stater, 10467
    - Montefiore Medical Center - Moses Campus
  - Brooklyn, New York, Forente stater, 11219
    - Maimonides Medical Center
  - Buffalo, New York, Forente stater, 14263
    - Roswell Park Cancer Institute
  - Commack, New York, Forente stater, 11725
    - Memorial Sloan Kettering Commack
  - East Syracuse, New York, Forente stater, 13057
    - Hematology Oncology Associates of Central New York-East Syracuse
  - Elmira, New York, Forente stater, 14905
    - Arnot Ogden Medical Center/Falck Cancer Center
  - Glens Falls, New York, Forente stater, 12801
    - Glens Falls Hospital
  - Harrison, New York, Forente stater, 10604
    - Memorial Sloan Kettering Westchester
  - Huntington, New York, Forente stater, 11743
    - Huntington Hospital
  - Lake Success, New York, Forente stater, 11042
    - Northwell Health/Center for Advanced Medicine
  - Manhasset, New York, Forente stater, 11030
    - North Shore University Hospital
  - Middletown, New York, Forente stater, 10940
    - Orange Regional Medical Center
  - Mineola, New York, Forente stater, 11501
    - NYU Winthrop Hospital
  - New York, New York, Forente stater, 10065
    - Memorial Sloan Kettering Cancer Center
  - New York, New York, Forente stater, 10065
    - Weill Medical College of Cornell University
  - New York, New York, Forente stater, 10019
    - Mount Sinai West
  - New York, New York, Forente stater, 10029
    - Mount Sinai Hospital
  - New York, New York, Forente stater, 10016
    - Laura and Isaac Perlmutter Cancer Center at NYU Langone
  - New York, New York, Forente stater, 10003
    - Mount Sinai Union Square
  - Poughkeepsie, New York, Forente stater, 12601
    - Vassar Brothers Medical Center
  - Rochester, New York, Forente stater, 14642
    - University of Rochester
  - Rockville Centre, New York, Forente stater, 11570
    - Memorial Sloan Kettering Rockville Centre
  - Sleepy Hollow, New York, Forente stater, 10591
    - Memorial Sloan Kettering Sleepy Hollow
  - Stony Brook, New York, Forente stater, 11794
    - Stony Brook University Medical Center
  - Syracuse, New York, Forente stater, 13215
    - Hematology Oncology Associates of Central New York-Onondaga Hill
- 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
  - Charlotte, North Carolina, Forente stater, 28207
    - Oncology Specialists of Charlotte
  - Charlotte, North Carolina, Forente stater, 28207
    - Carolina Surgical Clinic of Charlotte PA
  - Charlotte, North Carolina, Forente stater, 28262
    - Southern Oncology Specialists-Charlotte
  - Clinton, North Carolina, Forente stater, 28328
    - Southeastern Medical Oncology Center-Clinton
  - Clinton, North Carolina, Forente stater, 28328
    - Sampson Radiation Oncology
  - Clyde, North Carolina, Forente stater, 28721
    - AdventHealth Infusion Center Haywood
  - Goldsboro, North Carolina, Forente stater, 27534
    - Southeastern Medical Oncology Center-Goldsboro
  - Goldsboro, North Carolina, Forente stater, 27534
    - Wayne Memorial Hospital
  - Goldsboro, North Carolina, Forente stater, 27534
    - Wayne Radiation Oncology
  - Greenville, North Carolina, Forente stater, 27834
    - East Carolina University
  - Hendersonville, North Carolina, Forente stater, 28792
    - AdventHealth Hendersonville
  - Huntersville, North Carolina, Forente stater, 28078
    - Southern Oncology Specialists-Huntersville
  - Huntersville, North Carolina, Forente stater, 28078
    - Lake Norman Hematology Oncology Specialists-Huntersville
  - Jacksonville, North Carolina, Forente stater, 28546
    - Southeastern Medical Oncology Center-Jacksonville
  - Jacksonville, North Carolina, Forente stater, 28546
    - Onslow Memorial Hospital
  - Kenansville, North Carolina, Forente stater, 28349
    - Vidant Oncology-Kenansville
  - Kinston, North Carolina, Forente stater, 28501
    - Vidant Oncology-Kinston
  - Matthews, North Carolina, Forente stater, 28105
    - Novant Health Cancer Specialists-Matthews
  - Matthews, North Carolina, Forente stater, 28105
    - Matthews Radiation Oncology Center
  - Mooresville, North Carolina, Forente stater, 28117
    - Lake Norman Hematology Oncology Specialists-Mooresville
  - Richlands, North Carolina, Forente stater, 28574
    - Vidant Oncology-Richlands
  - Salisbury, North Carolina, Forente stater, 28144
    - Carolina Oncology Associates PA
  - Wilson, North Carolina, Forente stater, 27893
    - Southeastern Medical Oncology Center-Wilson
  - 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
  - Fargo, North Dakota, Forente stater, 58122
    - Sanford Broadway Medical Center
  - Fargo, North Dakota, Forente stater, 58122
    - Sanford Clinic North-Fargo
  - Fargo, North Dakota, Forente stater, 58122
    - Roger Maris Cancer Center
  - Grand Forks, North Dakota, Forente stater, 58201
    - Altru Cancer Center
- Ohio
  - Akron, Ohio, Forente stater, 44304
    - Summa Akron City Hospital/Cooper Cancer Center
  - Barberton, Ohio, Forente stater, 44203
    - Summa Barberton Hospital
  - Beachwood, Ohio, Forente stater, 44122
    - UHHS-Chagrin Highlands Medical Center
  - Beavercreek, Ohio, Forente stater, 45431
    - Indu and Raj Soin Medical Center
  - Belpre, Ohio, Forente stater, 45714
    - Strecker Cancer Center-Belpre
  - Canton, Ohio, Forente stater, 44710
    - Aultman Health Foundation
  - Canton, Ohio, Forente stater, 44708
    - Mercy Medical Center
  - 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, 45220
    - Good Samaritan Hospital - Cincinnati
  - Cincinnati, Ohio, Forente stater, 45242
    - Bethesda North Hospital
  - Cincinnati, Ohio, Forente stater, 45242
    - Oncology Hematology Care Inc-Blue Ash
  - Cincinnati, Ohio, Forente stater, 45202
    - Oncology Hematology Care Inc-Eden Park
  - Cincinnati, Ohio, Forente stater, 45211
    - Oncology Hematology Care Inc-Mercy West
  - Cincinnati, Ohio, Forente stater, 45236
    - Oncology Hematology Care Inc-Kenwood
  - Cincinnati, Ohio, Forente stater, 45219
    - University of Cincinnati/Barrett Cancer Center
  - Cincinnati, Ohio, Forente stater, 45230
    - Oncology Hematology Care Inc - Anderson
  - Cincinnati, Ohio, Forente stater, 45247
    - TriHealth Cancer Institute-Westside
  - Cincinnati, Ohio, Forente stater, 45255
    - TriHealth Cancer Institute-Anderson
  - Cleveland, Ohio, Forente stater, 44106
    - Case Western Reserve University
  - 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
    - Dayton Physician LLC-Miami Valley Hospital North
  - Dayton, Ohio, Forente stater, 45415
    - Miami Valley Hospital North
  - Dayton, Ohio, Forente stater, 45405
    - Grandview Hospital
  - Delaware, Ohio, Forente stater, 43015
    - Delaware Health Center-Grady Cancer Center
  - Delaware, Ohio, Forente stater, 43015
    - Delaware Radiation Oncology
  - Delaware, Ohio, Forente stater, 43015
    - Grady Memorial Hospital
  - Fairfield, Ohio, Forente stater, 45014
    - Oncology Hematology Care Inc-Healthplex
  - Findlay, Ohio, Forente stater, 45840
    - Blanchard Valley Hospital
  - Findlay, Ohio, Forente stater, 45840
    - Armes Family Cancer Center
  - Findlay, Ohio, Forente stater, 45840
    - Orion Cancer Care
  - Franklin, Ohio, Forente stater, 45005-1066
    - Atrium Medical Center-Middletown Regional Hospital
  - Franklin, Ohio, Forente stater, 45005
    - Dayton Physicians LLC-Atrium
  - Greenville, Ohio, Forente stater, 45331
    - Wayne Hospital
  - Greenville, Ohio, Forente stater, 45331
    - Dayton Physicians LLC-Wayne
  - 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
  - Lancaster, Ohio, Forente stater, 43130
    - Lancaster Radiation Oncology
  - 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
  - Middletown, Ohio, Forente stater, 45042
    - Dayton Physicians LLC-Signal Point
  - 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
  - Portsmouth, Ohio, Forente stater, 45662
    - Southern Ohio Medical Center
  - Sidney, Ohio, Forente stater, 45365
    - Dayton Physicians LLC-Wilson
  - Springfield, Ohio, Forente stater, 45505
    - Springfield Regional Medical Center
  - Springfield, Ohio, Forente stater, 45504
    - Springfield Regional Cancer Center
  - Sylvania, Ohio, Forente stater, 43560
    - ProMedica Flower Hospital
  - Toledo, Ohio, Forente stater, 43606
    - The Toledo Hospital/Toledo Children's Hospital
  - Troy, Ohio, Forente stater, 45373
    - Upper Valley Medical Center
  - Troy, Ohio, Forente stater, 45373
    - Dayton Physicians LLC-Upper Valley
  - West Chester, Ohio, Forente stater, 45069
    - University Pointe
  - Westerville, Ohio, Forente stater, 43081
    - Saint Ann's Hospital
  - Westlake, Ohio, Forente stater, 44145
    - UHHS-Westlake Medical Center
  - Wright-Patterson Air Force Base, Ohio, Forente stater, 45433-5529
    - Wright-Patterson Medical Center
  - Xenia, Ohio, Forente stater, 45385
    - Greene Memorial 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
  - Oklahoma City, Oklahoma, Forente stater, 73142
    - Integris Cancer Institute of Oklahoma
- Oregon
  - Baker City, Oregon, Forente stater, 97814
    - Saint Alphonsus Medical 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 Oncology and Hematology Care Southeast
  - Coos Bay, Oregon, Forente stater, 97420
    - Bay Area Hospital
  - Milwaukie, Oregon, Forente stater, 97222
    - Providence Milwaukie Hospital
  - Newberg, Oregon, Forente stater, 97132
    - Providence Newberg Medical Center
  - Ontario, Oregon, Forente stater, 97914
    - Saint Alphonsus Medical Center-Ontario
  - Oregon City, Oregon, Forente stater, 97045
    - Providence Willamette Falls Medical Center
  - Portland, Oregon, Forente stater, 97213
    - Providence Portland Medical Center
  - Portland, Oregon, Forente stater, 97225
    - Providence Saint Vincent Medical Center
  - Portland, Oregon, Forente stater, 97227
    - Kaiser Permanente Northwest
  - Redmond, Oregon, Forente stater, 97756
    - Saint Charles Health System-Redmond
- Pennsylvania
  - Abington, Pennsylvania, Forente stater, 19001
    - Abington Memorial Hospital
  - Allentown, Pennsylvania, Forente stater, 18103
    - Lehigh Valley Hospital-Cedar Crest
  - Beaver, Pennsylvania, Forente stater, 15009
    - UPMC-Heritage Valley Health System Beaver
  - Bethlehem, Pennsylvania, Forente stater, 18017
    - Lehigh Valley Hospital - Muhlenberg
  - Danville, Pennsylvania, Forente stater, 17822
    - Geisinger Medical Center
  - Easton, Pennsylvania, Forente stater, 18042
    - Easton Hospital
  - Erie, Pennsylvania, Forente stater, 16544
    - Saint Vincent Hospital
  - Erie, Pennsylvania, Forente stater, 16505
    - The Regional Cancer Center
  - Furlong, Pennsylvania, Forente stater, 18925
    - Fox Chase Cancer Center Buckingham
  - Greensburg, Pennsylvania, Forente stater, 15601
    - UPMC Cancer Centers - Arnold Palmer Pavilion
  - Hershey, Pennsylvania, Forente stater, 17033-0850
    - Penn State Milton S Hershey Medical Center
  - Jefferson Hills, Pennsylvania, Forente stater, 15025
    - Jefferson Hospital
  - Johnstown, Pennsylvania, Forente stater, 15901
    - UPMC-Johnstown/John P. Murtha Regional Cancer Center
  - Kittanning, Pennsylvania, Forente stater, 16201
    - Armstrong Center for Medicine and Health
  - Lewisburg, Pennsylvania, Forente stater, 17837
    - Geisinger Medical Oncology-Lewisburg
  - Lewistown, Pennsylvania, Forente stater, 17044
    - Lewistown Hospital
  - McKeesport, Pennsylvania, Forente stater, 15132
    - UPMC Cancer Center at UPMC McKeesport
  - Monroeville, Pennsylvania, Forente stater, 15146
    - Forbes Hospital
  - Moon, Pennsylvania, Forente stater, 15108
    - UPMC-Coraopolis/Heritage Valley Radiation Oncology
  - Philadelphia, Pennsylvania, Forente stater, 19111
    - Fox Chase Cancer Center
  - Philadelphia, Pennsylvania, Forente stater, 19107
    - Thomas Jefferson University Hospital
  - Philadelphia, Pennsylvania, Forente stater, 19140
    - Temple University Hospital
  - Philadelphia, Pennsylvania, Forente stater, 19102
    - Drexel University School of Medicine
  - Pittsburgh, Pennsylvania, Forente stater, 15212
    - Allegheny General Hospital
  - Pittsburgh, Pennsylvania, Forente stater, 15213
    - UPMC-Magee Womens Hospital
  - Pittsburgh, Pennsylvania, Forente stater, 15232
    - University of Pittsburgh Cancer Institute (UPCI)
  - Pittsburgh, Pennsylvania, Forente stater, 15232
    - UPMC-Shadyside Hospital
  - Pittsburgh, Pennsylvania, Forente stater, 15213
    - UPMC-Presbyterian Hospital
  - Pittsburgh, Pennsylvania, Forente stater, 15215
    - UPMC-Saint Margaret
  - Pittsburgh, Pennsylvania, Forente stater, 15236
    - UPMC Jefferson Regional Radiation Oncology
  - Pittsburgh, Pennsylvania, Forente stater, 15237
    - UPMC-Passavant Hospital
  - Pittsburgh, Pennsylvania, Forente stater, 15243
    - UPMC-Saint Clair Hospital Cancer Center
  - Pottstown, Pennsylvania, Forente stater, 19464
    - Pottstown Hospital
  - Seneca, Pennsylvania, Forente stater, 16346
    - UPMC Cancer Center at UPMC Northwest
  - Uniontown, Pennsylvania, Forente stater, 15401
    - UPMC Uniontown Hospital Radiation Oncology
  - Washington, Pennsylvania, Forente stater, 15301
    - UPMC Washington Hospital Radiation Oncology
  - Wilkes-Barre, Pennsylvania, Forente stater, 18711
    - Geisinger Wyoming Valley/Henry Cancer Center
  - Willow Grove, Pennsylvania, Forente stater, 19090
    - Abington Memorial Hospital-Asplundh Cancer Pavilion
- South Carolina
  - Clinton, South Carolina, Forente stater, 29325
    - Greenville Health System Cancer Institute-Laurens
  - Easley, South Carolina, Forente stater, 29640
    - Greenville Health System Cancer Institute-Easley
  - Greenville, South Carolina, Forente stater, 29605
    - Greenville Health System Cancer Institute-Faris
  - Greenville, South Carolina, Forente stater, 29605
    - Greenville Memorial Hospital
  - Greenville, South Carolina, Forente stater, 29615
    - Greenville Health System Cancer Institute-Eastside
  - Greenville, South Carolina, Forente stater, 29605
    - Greenville Health System Cancer Institute-Butternut
  - Greer, South Carolina, Forente stater, 29650
    - Greenville Health System Cancer Institute-Greer
  - Seneca, South Carolina, Forente stater, 29672
    - Greenville Health System Cancer Institute-Seneca
  - Spartanburg, South Carolina, Forente stater, 29307
    - Greenville Health System Cancer Institute-Spartanburg
- South Dakota
  - Sioux Falls, South Dakota, Forente stater, 57105
    - Avera Cancer Institute
- Tennessee
  - Chattanooga, Tennessee, Forente stater, 37404
    - Memorial Hospital
  - Hixson, Tennessee, Forente stater, 37343
    - Pulmonary Medicine Center of Chattanooga-Hixson
  - Nashville, Tennessee, Forente stater, 37208
    - Meharry Medical College
  - Ooltewah, Tennessee, Forente stater, 37363
    - Memorial GYN Plus
- Texas
  - Amarillo, Texas, Forente stater, 79106
    - The Don and Sybil Harrington Cancer Center
  - 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, 75246
    - Baylor University Medical Center
  - Houston, Texas, Forente stater, 77030
    - M D Anderson Cancer Center
  - Houston, Texas, Forente stater, 77026-1967
    - Lyndon Baines Johnson General Hospital
  - Houston, Texas, Forente stater, 77030
    - Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
  - Houston, Texas, Forente stater, 77070
    - Methodist Willowbrook Hospital
  - Houston, Texas, Forente stater, 77030
    - Michael E DeBakey VA Medical Center
  - Houston, Texas, Forente stater, 77030
    - The Methodist Hospital System
  - Houston, Texas, Forente stater, 77094
    - MD Anderson Regional Care Center-Katy
  - Houston, Texas, Forente stater, 77030
    - Ben Taub General Hospital
  - Nassau Bay, Texas, Forente stater, 77058
    - MD Anderson Regional Care Center-Bay Area
  - Sugar Land, Texas, Forente stater, 77479
    - Houston Methodist Sugar Land Hospital
  - Sugar Land, Texas, Forente stater, 77478
    - MD Anderson Regional Care Center-Sugar Land
  - Temple, Texas, Forente stater, 76508
    - Scott and White Memorial Hospital
  - The Woodlands, Texas, Forente stater, 77384
    - MD Anderson Regional Care Center-The Woodlands
- 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
  - Saint George, Utah, Forente stater, 84770
    - Dixie Medical Center Regional Cancer Center
  - Salt Lake City, Utah, Forente stater, 84112
    - Huntsman Cancer Institute/University of Utah
  - Salt Lake City, Utah, Forente stater, 84106
    - Utah Cancer Specialists-Salt Lake City
  - Salt Lake City, Utah, Forente stater, 84143
    - LDS Hospital
- Vermont
  - Berlin, 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 College of Medicine
  - Saint Johnsbury, Vermont, Forente stater, 05819
    - Norris Cotton Cancer Center-North
- Virginia
  - Charlottesville, Virginia, Forente stater, 22908
    - University of Virginia Cancer Center
  - Charlottesville, Virginia, Forente stater, 22901
    - Sentara Martha Jefferson Hospital
  - Falls Church, Virginia, Forente stater, 22042
    - INOVA Fairfax Hospital
  - Fredericksburg, Virginia, Forente stater, 22408
    - Hematology Oncology Associates of Fredericksburg Inc
  - Hampton, Virginia, Forente stater, 23666
    - Sentara Cancer Institute at Sentara CarePlex Hospital
  - Lynchburg, Virginia, Forente stater, 24501
    - Centra Lynchburg Hematology-Oncology Clinic Inc
  - Midlothian, Virginia, Forente stater, 23114
    - Bon Secours Saint Francis Medical Center
  - Norfolk, Virginia, Forente stater, 23507
    - Sentara Norfolk General Hospital
  - Norfolk, Virginia, Forente stater, 23502
    - Sentara Leigh Hospital
  - Richmond, Virginia, Forente stater, 23298
    - Virginia Commonwealth University/Massey Cancer Center
  - Richmond, Virginia, Forente stater, 23226
    - Bon Secours Saint Mary's Hospital
  - South Hill, Virginia, Forente stater, 23970
    - VCU Community Memorial Health Center
  - Winchester, Virginia, Forente stater, 22601
    - Shenandoah Oncology PC
- Washington
  - Aberdeen, Washington, Forente stater, 98520
    - Providence Regional Cancer System-Aberdeen
  - Anacortes, Washington, Forente stater, 98221
    - Cancer Care Center at Island Hospital
  - Auburn, Washington, Forente stater, 98001
    - MultiCare Auburn Medical Center
  - Bainbridge Island, Washington, Forente stater, 98110
    - Virginia Mason Bainbridge Island Medical Center
  - Bellevue, Washington, Forente stater, 98005
    - Swedish Cancer Institute-Eastside Oncology Hematology
  - Bellevue, Washington, Forente stater, 98004
    - Overlake Hospital Medical Center
  - Bellingham, Washington, Forente stater, 98225
    - PeaceHealth Saint Joseph Medical Center
  - Bremerton, Washington, Forente stater, 98310
    - Harrison HealthPartners Hematology and Oncology-Bremerton
  - Bremerton, Washington, Forente stater, 98310
    - Harrison Medical Center
  - Burien, Washington, Forente stater, 98166
    - Highline Medical Center-Main Campus
  - Centralia, Washington, Forente stater, 98531
    - Providence Regional Cancer System-Centralia
  - Edmonds, Washington, Forente stater, 98026
    - Swedish Medical Center-Edmonds
  - Enumclaw, Washington, Forente stater, 98022
    - Saint Elizabeth Hospital
  - Everett, Washington, Forente stater, 98201
    - Providence Regional Cancer Partnership
  - Federal Way, Washington, Forente stater, 98002
    - Virginia Mason Federal Way Medical Center
  - Federal Way, Washington, Forente stater, 98003
    - Saint Francis Hospital
  - Gig Harbor, Washington, Forente stater, 98332
    - Tacoma/Valley Radiation Oncology Centers-Gig Harbor
  - 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
  - Kennewick, Washington, Forente stater, 99336
    - Northwest Cancer Clinic
  - Kennewick, Washington, Forente stater, 99336
    - Tri-Cities Cancer Center
  - Kirkland, Washington, Forente stater, 98034
    - Seattle Cancer Care Alliance at EvergreenHealth
  - Kirkland, Washington, Forente stater, 98033
    - EvergreenHealth Medical Center
  - 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
  - Lynnwood, Washington, Forente stater, 98036
    - Virginia Mason Lynnwood Medical Center
  - Mount Vernon, Washington, Forente stater, 98274
    - Skagit Valley Hospital
  - Mount Vernon, Washington, Forente stater, 98274
    - Skagit Valley Hospital Regional Cancer Care Center
  - Port Townsend, Washington, Forente stater, 98368
    - Jefferson Healthcare
  - Poulsbo, Washington, Forente stater, 98370
    - Harrison HealthPartners Hematology and Oncology-Poulsbo
  - Poulsbo, Washington, Forente stater, 98370
    - Peninsula Cancer Center
  - Puyallup, Washington, Forente stater, 98372
    - MultiCare Good Samaritan Hospital
  - Puyallup, Washington, Forente stater, 98372
    - Tacoma/Valley Radiation Oncology Centers-Puyallup
  - Renton, Washington, Forente stater, 98055
    - Valley Medical Center
  - Seattle, Washington, Forente stater, 98109
    - Fred Hutchinson Cancer Research Center
  - Seattle, Washington, Forente stater, 98109
    - Seattle Cancer Care Alliance
  - Seattle, Washington, Forente stater, 98195
    - University of Washington Medical Center
  - Seattle, Washington, Forente stater, 98101
    - Virginia Mason Medical Center
  - Seattle, Washington, Forente stater, 98107
    - Swedish Medical Center-Ballard Campus
  - Seattle, Washington, Forente stater, 98112
    - Kaiser Permanente Washington
  - Seattle, Washington, Forente stater, 98104
    - Minor and James Medical PLLC
  - Seattle, Washington, Forente stater, 98104
    - Pacific Gynecology Specialists
  - Seattle, Washington, Forente stater, 98122-4307
    - Swedish Medical Center-First Hill
  - Seattle, Washington, Forente stater, 98133
    - Seattle Cancer Care Alliance at Northwest Hospital
  - 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
  - Spokane, Washington, Forente stater, 99204
    - Rockwood Cancer Treatment Center-DHEC-Downtown
  - Spokane, Washington, Forente stater, 99218
    - Evergreen Hematology and Oncology PS
  - Spokane, Washington, Forente stater, 99202
    - Cancer Care Northwest - Spokane South
  - Spokane, Washington, Forente stater, 99208
    - Spokane Valley Cancer Center-Mayfair
  - Spokane, Washington, Forente stater, 99216
    - Cancer Care Northwest-Valley
  - Spokane, Washington, Forente stater, 99218
    - Cancer Care Northwest-North Spokane
  - Spokane, Washington, Forente stater, 99216
    - Spokane Valley Cancer Center-Mission
  - Spokane, Washington, Forente stater, 99218
    - Rockwood North Cancer Treatment Center
  - Spokane Valley, Washington, Forente stater, 99216
    - Rockwood Clinic Cancer Treatment Center-Valley
  - Tacoma, Washington, Forente stater, 98405
    - Northwest Medical Specialties PLLC
  - Tacoma, Washington, Forente stater, 98405
    - MultiCare Tacoma General Hospital
  - Tacoma, Washington, Forente stater, 98405
    - Tacoma/Valley Radiation Oncology Centers-Saint Joe's
  - Tacoma, Washington, Forente stater, 97405
    - Tacoma/Valley Radiation Oncology Centers-Jackson Hall
  - Tacoma, Washington, Forente stater, 98405
    - Franciscan Research Center-Northwest Medical Plaza
  - Tacoma, Washington, Forente stater, 98405
    - Saint Joseph Medical Center
  - Vancouver, Washington, Forente stater, 98664
    - PeaceHealth Southwest Medical Center
  - Vancouver, Washington, Forente stater, 98684
    - Compass Oncology Vancouver
  - Walla Walla, Washington, Forente stater, 99362
    - Providence Saint Mary Regional Cancer Center
  - Wenatchee, Washington, Forente stater, 98801
    - Wenatchee Valley Hospital and Clinics
  - 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
  - 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
    - Langlade Hospital and Cancer Center
  - Burlington, Wisconsin, Forente stater, 53105
    - Aurora Cancer Care-Southern Lakes VLCC
  - Chippewa Falls, Wisconsin, Forente stater, 54729
    - Marshfield Clinic-Chippewa Center
  - Eau Claire, Wisconsin, Forente stater, 54701
    - HSHS Sacred Heart Hospital
  - Eau Claire, Wisconsin, Forente stater, 54701
    - Mayo Clinic Health System-Eau Claire Clinic
  - Eau Claire, Wisconsin, Forente stater, 54703
    - Mayo Clinic Health System Eau Claire Hospital-Luther Campus
  - Eau Claire, Wisconsin, Forente stater, 54701
    - Marshfield Clinic Cancer Center at Sacred Heart
  - Eau Claire, Wisconsin, Forente stater, 54701
    - Marshfield Clinic Cancer Center - Eau Claire
  - Fond Du Lac, Wisconsin, Forente stater, 54937
    - Aurora Health Center-Fond du Lac
  - Germantown, Wisconsin, Forente stater, 53022
    - Aurora Health Care Germantown Health Center
  - Grafton, Wisconsin, Forente stater, 53024
    - Aurora Cancer Care-Grafton
  - Green Bay, Wisconsin, Forente stater, 54311
    - Aurora BayCare Medical Center
  - Kenosha, Wisconsin, Forente stater, 53142
    - Aurora Cancer Care-Kenosha South
  - Madison, Wisconsin, Forente stater, 53792
    - University of Wisconsin Hospital and Clinics
  - Marinette, Wisconsin, Forente stater, 54143
    - Aurora Bay Area Medical Group-Marinette
  - Marinette, Wisconsin, Forente stater, 54143
    - Bay Area Medical Center
  - Marshfield, Wisconsin, Forente stater, 54449
    - Marshfield Medical Center-Marshfield
  - Marshfield, Wisconsin, Forente stater, 54449
    - Marshfield Medical Center
  - Milwaukee, Wisconsin, Forente stater, 53226
    - Froedtert and The Medical College of Wisconsin
  - Milwaukee, Wisconsin, Forente stater, 53209
    - Aurora Cancer Care-Milwaukee
  - Milwaukee, Wisconsin, Forente stater, 53215
    - Aurora Saint Luke's Medical Center
  - Milwaukee, Wisconsin, Forente stater, 53233
    - Aurora Sinai Medical Center
  - Minocqua, Wisconsin, Forente stater, 54548
    - Marshfield Clinic-Minocqua Center
  - New Richmond, Wisconsin, Forente stater, 54017
    - Cancer Center of Western Wisconsin
  - Oshkosh, Wisconsin, Forente stater, 54904
    - Vince Lombardi Cancer Clinic - Oshkosh
  - Racine, Wisconsin, Forente stater, 53406
    - Aurora Cancer Care-Racine
  - Rhinelander, Wisconsin, Forente stater, 54501
    - Ascension Saint Mary's Hospital
  - Rhinelander, Wisconsin, Forente stater, 54501
    - Saint Mary's Hospital
  - Rice Lake, Wisconsin, Forente stater, 54868
    - Marshfield Medical Center-Rice Lake
  - Sheboygan, Wisconsin, Forente stater, 53081
    - Vince Lombardi Cancer Clinic-Sheboygan
  - Stevens Point, Wisconsin, Forente stater, 54482
    - Marshfield Clinic Stevens Point Center
  - Stevens Point, Wisconsin, Forente stater, 54481
    - Ascension Saint Michael's Hospital
  - Stevens Point, Wisconsin, Forente stater, 54481
    - Saint Michael's Hospital
  - Summit, Wisconsin, Forente stater, 53066
    - Aurora Medical Center in Summit
  - Two Rivers, Wisconsin, Forente stater, 54241
    - Vince Lombardi Cancer Clinic-Two Rivers
  - Waukesha, Wisconsin, Forente stater, 53188
    - Aurora Cancer Care-Waukesha
  - Wausau, Wisconsin, Forente stater, 54401
    - Aspirus Regional Cancer Center
  - Wausau, Wisconsin, Forente stater, 54401
    - Marshfield Clinic-Wausau Center
  - Wauwatosa, Wisconsin, Forente stater, 53226
    - Aurora Cancer Care-Milwaukee West
  - West Allis, Wisconsin, Forente stater, 53227
    - Aurora West Allis Medical Center
  - Weston, Wisconsin, Forente stater, 54476
    - Diagnostic and Treatment Center
  - Weston, Wisconsin, Forente stater, 54476
    - Marshfield Clinic - Weston Center
  - Weston, Wisconsin, Forente stater, 54476
    - Saint Clare's Hospital
  - Wisconsin Rapids, Wisconsin, Forente stater, 54494
    - Marshfield Clinic - Wisconsin Rapids Center
  - Wisconsin Rapids, Wisconsin, Forente stater, 54494
    - Aspirus UW Cancer Center
- Wyoming
  - Casper, Wyoming, Forente stater, 82609
    - Rocky Mountain Oncology
  - Cheyenne, Wyoming, Forente stater, 82001
    - Cheyenne Regional Medical Center-West
  - Cody, Wyoming, Forente stater, 82414
    - Big Horn Basin Cancer Center
  - Cody, Wyoming, Forente stater, 82414
    - Billings Clinic-Cody
  - Sheridan, Wyoming, Forente stater, 82801
    - Welch Cancer Center
Israel
- - Jerusalem, Israel, 91031
    - Shaare Zedek Medical Center
Sveits
- - Aarau, Sveits, 5001
    - Kantonsspital Aarau
  - Basel, Sveits, 4031
    - University Hospital Basel
  - Bellinzona, Sveits, CH-6500
    - Oncology Institute of Southern Switzerland
  - Chur, Sveits, 7000
    - Kantonsspital Graubunden
  - Lausanne, Sveits, CH 1011
    - University Hospital of Lausanne
  - Winterthur, Sveits, 8401
    - Kantonsspital Winterthur
  - Zurich, Sveits, 8027
    - Zurich Im Park
  - Zurich, Sveits, 8032
    - Zurich Hirslanden Klinik

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

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Beskrivelse

Registreringsinkluderingskriterier:

Alder ≥ 18 år ved diagnose
Diagnose av rektal adenokarsinom
Radiologisk målbar eller klinisk evaluerbar sykdom som definert i protokollen
ECOG Ytelsesstatus (PS): 0, 1 eller 2
For denne pasienten vil standard behandlingsanbefaling i fravær av en klinisk studie være kombinert modalitet neoadjuvant kjemoradiasjon etterfulgt av kurativ intensjonskirurgisk reseksjon
Kandidat for lukkemuskelbesparende kirurgisk reseksjon før neoadjuvant terapi ifølge primærkirurg
Primærkirurg er legitimert eller villig til å bli legitimert i Total Mesorectal Excision (TME), som innebærer innsending av bilder av en enkelt TME-prøve enten før registrering av den første pasienten eller ved å bruke kirurgens første påløpte tilfelle.
Klinisk stadium: T2N1, T3N0, T3N1.
- N2 sykdom skal estimeres som fire eller flere lymfeknuter som er ≥ 10 mm.
- Klinisk stadieinndeling bør estimeres basert på kombinasjonen av følgende vurderinger: fysisk undersøkelse av primærkirurgen, CT- eller PET/CT-skanning av bryst/buk/bekken og enten en bekken-MR eller en ultralyd (ERUS). Hvis det utføres en bekken-MR, er det akseptabelt å utføre CT av brystet/abdomen, og utelate CT-avbildning av bekkenet.
Følgende laboratorieverdier oppnådd ≤ 28 dager før registrering:
- Absolutt nøytrofiltall (ANC) ≥ 1500/mm^3
- Blodplateantall ≥ 100 000/mm^3
- Hemoglobin > 8,0 g/dL
- Total bilirubin ≤ 1,5 x øvre normalgrense (ULN)
- SGOT (AST) ≤ 3 x ULN
- SGPT (ALT) ≤ 3 x ULN
- Kreatinin ≤1,5 x ULN
Negativ graviditetstest utført ≤ 7 dager før registrering, kun for kvinner i fertil alder
Pasienter i fertil alder er villig til å bruke adekvat prevensjon
Gi informert skriftlig samtykke
Villig til å gå tilbake til det medisinske nettstedet for alle studievurderinger

Utelukkelseskriterier for registrering:

Kliniske T4-svulster
Primærkirurg indikerer behov for abdominoperineal (APR) ved baseline
Bevis på at svulsten er adherent til eller invaderer den mesorektale fascia på bildestudier slik at kirurgen ikke ville være i stand til å utføre en R0-reseksjon (en med negative marginer)
Tumor forårsaker symptomatisk tarmobstruksjon (pasienter som har hatt en midlertidig avledende stomi er kvalifisert).
Kjemoterapi innen 5 år før registrering. Hormonbehandling er tillatt dersom sykdomsfri intervall er ≥ 5 år.
Eventuell tidligere bekkenstråling
Annen invasiv malignitet ≤ 5 år før registrering. Unntak er tykktarmspolypper, ikke-melanom hudkreft, duktalt karsinom in situ, blærekarsinom in situ eller karsinom-in-situ i livmorhalsen.
Noen av følgende fordi denne studien involverer et middel som har kjente genotoksiske, mutagene og teratogene effekter.
- Gravide kvinner
- Sykepleie kvinner
- Menn eller kvinner i fertil alder som ikke er villige til å bruke adekvat prevensjon
Komorbide sykdommer eller andre samtidige sykdommer som, etter klinikerens vurdering som innhenter informert samtykke, ville gjøre pasienten upassende for å delta i denne studien eller vesentlig forstyrre den riktige vurderingen av sikkerhet og toksisitet til de foreskrevne regimene.

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)

Antall våpen

Våpen og intervensjoner

Deltakergruppe / Arm	Intervensjon / Behandling
Eksperimentell: Gruppe 1 Pasienter vil motta FOLFOX kjemoterapi en gang annenhver uke i totalt 6 sykluser over en periode på 12 uker. Etter fullført FOLFOX-kjemoterapi vil pasienten ha en MR-skanning eller endorektal ultralyd (ERUS) for å undersøke svulsten. Dersom svulsten ikke har redusert i størrelse med minst 20 %, vil pasienten få 5FUCMT (stråling med kjemoterapi). Hvis svulsten har redusert i størrelse med 20%, vil pasienten fortsette direkte til operasjonen. Hvis alle kanter av svulsten er normale etter kirurgi, får pasienten seks ekstra sykluser med FOLFOX kjemoterapi. Hvis alle kanter av svulsten ikke er normale, får pasienten cellegiftbehandling i 5,5 uker etter operasjonen. Etter kjemoterapi vil ytterligere sykluser med FOLFOX eller lignende kjemoterapi anbefales i 4 sykluser eller 8 uker. Pasientobservasjon med oppfølgingsevalueringer og hendelsesovervåking vil skje opptil 8 år etter randomisering.	Legemiddel: FOLFOX (kjemoterapi) Oksaliplatin 85 mg/m^2 IV over 2 timer på dag 1, leucovorin 400 mg/m^2 bolus IV over 2 timer på dag 1 og 5-fluorouracil 400 mg/m^2 bolus over 5-15 minutter deretter 2400 mg/ m^2 kontinuerlig over 46-48 timer total dose IV på dag 1-2. Behandlingsplanen gjentas basert på gruppen. Doseendringer er tillatt basert på uønskede hendelser. Annen: 5 FUCMT (kjemoradiasjon) 5-fluorouracil 225 mg/m^2 per dag kontinuerlig IV-infusjon administrert samtidig med strålebehandling i 5 eller 7 dager per uke ELLER capecitabin 825 mg/m^2 to ganger daglig administrert oralt og samtidig med strålebehandling i 5 dager per uke. Doseendringer er tillatt basert på uønskede hendelser. Fremgangsmåte: kirurgi lav fremre reseksjon med total mesorektal eksisjon Fremgangsmåte: magnetisk resonansavbildning eller endorektal ultralyd
Aktiv komparator: Gruppe 2 Pasienter får 5FUCMT inkludert kjemoterapi og strålebehandling i 5,5 uker. Pasienter vil få enten 5-fluorouracil eller capecitabin og strålebehandling. Etter at cellegiftbehandlingen er fullført, vil pasientene gå direkte til operasjonen. Etter operasjonen vil pasienter motta FOLFOX kjemoterapi en gang annenhver uke i 8 sykluser totalt over en periode på 16 uker. Pasientobservasjon med oppfølgingsevalueringer og hendelsesovervåking vil skje opptil 8 år etter randomisering.	Legemiddel: FOLFOX (kjemoterapi) Oksaliplatin 85 mg/m^2 IV over 2 timer på dag 1, leucovorin 400 mg/m^2 bolus IV over 2 timer på dag 1 og 5-fluorouracil 400 mg/m^2 bolus over 5-15 minutter deretter 2400 mg/ m^2 kontinuerlig over 46-48 timer total dose IV på dag 1-2. Behandlingsplanen gjentas basert på gruppen. Doseendringer er tillatt basert på uønskede hendelser. Annen: 5 FUCMT (kjemoradiasjon) 5-fluorouracil 225 mg/m^2 per dag kontinuerlig IV-infusjon administrert samtidig med strålebehandling i 5 eller 7 dager per uke ELLER capecitabin 825 mg/m^2 to ganger daglig administrert oralt og samtidig med strålebehandling i 5 dager per uke. Doseendringer er tillatt basert på uønskede hendelser. Fremgangsmåte: kirurgi lav fremre reseksjon med total mesorektal eksisjon

Deltakergruppe / Arm

Intervensjon / Behandling

Eksperimentell: Gruppe 1

Pasienter vil motta FOLFOX kjemoterapi en gang annenhver uke i totalt 6 sykluser over en periode på 12 uker. Etter fullført FOLFOX-kjemoterapi vil pasienten ha en MR-skanning eller endorektal ultralyd (ERUS) for å undersøke svulsten. Dersom svulsten ikke har redusert i størrelse med minst 20 %, vil pasienten få 5FUCMT (stråling med kjemoterapi). Hvis svulsten har redusert i størrelse med 20%, vil pasienten fortsette direkte til operasjonen.

Hvis alle kanter av svulsten er normale etter kirurgi, får pasienten seks ekstra sykluser med FOLFOX kjemoterapi. Hvis alle kanter av svulsten ikke er normale, får pasienten cellegiftbehandling i 5,5 uker etter operasjonen. Etter kjemoterapi vil ytterligere sykluser med FOLFOX eller lignende kjemoterapi anbefales i 4 sykluser eller 8 uker. Pasientobservasjon med oppfølgingsevalueringer og hendelsesovervåking vil skje opptil 8 år etter randomisering.

Legemiddel: FOLFOX (kjemoterapi)

Oksaliplatin 85 mg/m^2 IV over 2 timer på dag 1, leucovorin 400 mg/m^2 bolus IV over 2 timer på dag 1 og 5-fluorouracil 400 mg/m^2 bolus over 5-15 minutter deretter 2400 mg/ m^2 kontinuerlig over 46-48 timer total dose IV på dag 1-2. Behandlingsplanen gjentas basert på gruppen. Doseendringer er tillatt basert på uønskede hendelser.

Annen: 5 FUCMT (kjemoradiasjon)

5-fluorouracil 225 mg/m^2 per dag kontinuerlig IV-infusjon administrert samtidig med strålebehandling i 5 eller 7 dager per uke ELLER capecitabin 825 mg/m^2 to ganger daglig administrert oralt og samtidig med strålebehandling i 5 dager per uke. Doseendringer er tillatt basert på uønskede hendelser.

Fremgangsmåte: kirurgi

lav fremre reseksjon med total mesorektal eksisjon

Fremgangsmåte: magnetisk resonansavbildning eller endorektal ultralyd

Aktiv komparator: Gruppe 2

Pasienter får 5FUCMT inkludert kjemoterapi og strålebehandling i 5,5 uker. Pasienter vil få enten 5-fluorouracil eller capecitabin og strålebehandling. Etter at cellegiftbehandlingen er fullført, vil pasientene gå direkte til operasjonen. Etter operasjonen vil pasienter motta FOLFOX kjemoterapi en gang annenhver uke i 8 sykluser totalt over en periode på 16 uker. Pasientobservasjon med oppfølgingsevalueringer og hendelsesovervåking vil skje opptil 8 år etter randomisering.

Legemiddel: FOLFOX (kjemoterapi)

Annen: 5 FUCMT (kjemoradiasjon)

Fremgangsmåte: kirurgi

lav fremre reseksjon med total mesorektal eksisjon

Hva måler studien?

Primære resultatmål

Resultatmål	Tiltaksbeskrivelse	Tidsramme
Bekken R0 reseksjonsfrekvens Tidsramme: Inntil 5 år	Antall deltakere med bekken R0 reseksjon	Inntil 5 år
DFS Tidsramme: Inntil 5 år	Sykdomsfri overlevelse (DFS): Fordelingen av DFS etter gruppe vil bli estimert ved å bruke metoden til Kaplan-Meier. 5 års sykdomsfrie rater etter behandlingsgruppe med konfidensintervall basert på Kaplan-Meier-kurver vil bli rapportert. Log-rank test vil bli brukt for å sammenligne DFS mellom to behandlingsgrupper. Hazard ratio med konfidensintervall vil bli estimert basert på Cox proporsjonal hazard modell. Cox proporsjonal faremodell vil bli brukt for multivariat analyse.	Inntil 5 år

Sekundære resultatmål

Resultatmål	Tiltaksbeskrivelse	Tidsramme
Patologisk fullstendig respons Tidsramme: Inntil 8 år	Patologisk fullstendig respons (pCR): pCR-raten er definert som antall pasienter som oppnår pCR delt på totalt antall pasienter inkludert i analysepopulasjonen (se definisjon i avsnitt 16.3.3.1) i hver gruppe. Pasienter som ikke ble operert vil bli klassifisert som ikke-pCR. Punktestimat og konfidensintervall (i henhold til tilnærmingen til Duffy og Santner) vil bli beregnet av behandlingsgrupper. Chi-kvadrattest vil bli brukt for å sammenligne pCR-hastighetene mellom grupper.	Inntil 8 år
Samlet overlevelse Tidsramme: Inntil 5 år	Total overlevelse (OS): OS er definert som tiden fra randomisering til dødsdato på grunn av alle årsaker. Fordelingen av OS etter gruppe vil bli estimert ved å bruke metoden til Kaplan-Meier. Fem års overlevelsesrater etter behandlingsgruppe med konfidensintervall basert på Kaplan-Meier-kurver vil bli rapportert. Logrank test vil bli brukt til å sammenligne OS mellom to behandlingsgrupper. Hazard ratio med konfidensintervall vil bli estimert basert på Cox proporsjonal hazard modell. Cox proporsjonal faremodell vil bli brukt for multivariat analyse.	Inntil 5 år
Frekvenser for mottak pre- eller postoperativ 5FUCMT Tidsramme: Inntil 5 år	Frekvenser for mottak av 5FUCMT: For selektive gruppepasienter, andelen pasienter som fikk 1) preoperativ 5FUCMT, 2) postoperativ 5FUCMT, 3) enten pre- eller postoperativ 5FUCMT, og konfidensintervaller (i henhold til tilnærmingen til Duffy og Santner) vil bli rapportert.	Inntil 5 år
Lokal gjentakelse (TLR): Tidsramme: Inntil 5 år	Tid til lokal gjentakelse (TLR): Fordelingen av TLR etter gruppe vil bli estimert ved å bruke metoden til Kaplan-Meier. 5 års lokale residivfrie rater etter behandlingsgruppe med konfidensintervall basert på Kaplan-Meier-kurver vil bli rapportert. Sammenligningen av den kumulative forekomsten av lokalt tilbakefall mellom grupper, behandling av fjernt tilbakefall og død som konkurrerende risiko ved å bruke Gray-testen (Annals of Statistics, 1988) vil bli utført.	Inntil 5 år
Neoadjuvant rektalscore Tidsramme: Inntil 5 år	neoadjuvant rektal (NAR) score =[5 * pN - 3(cT - pT) + 12]^2/9,61. cT er et element i settet {1, 2, 3, 4}, pT er i {0, 1, 2, 3, 4}, og pN er i {0, 1, 2}. cT klinisk tumorstadium, pT patologisk tumorstadium, pN patologisk nodalstadium. Lav (NAR <8), middels (NAR = 8-16) og høy (NAR >16). Lavt er bedre og høyt er verre.	Inntil 5 år

Samarbeidspartnere og etterforskere

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

Sponsor

Alliance for Clinical Trials in Oncology

Samarbeidspartnere

National Cancer Institute (NCI)

Canadian Cancer Trials Group

Etterforskere

Studiestol: Deborah Schrag, MD, Dana-Farber Cancer Institute

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

Schrag D, Weiser M, Saltz L, Mamon H, Gollub M, Basch E, Venook A, Shi Q. Challenges and solutions in the design and execution of the PROSPECT Phase II/III neoadjuvant rectal cancer trial (NCCTG N1048/Alliance). Clin Trials. 2019 Apr;16(2):165-175. doi: 10.1177/1740774518824539. Epub 2019 Jan 28.

Hjelpsomme linker

Clinical trial summary from the National Cancer Institute's PDQ® database

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)

12. juni 2012

Primær fullføring (Faktiske)

31. desember 2022

Studiet fullført (Antatt)

30. juni 2024

Datoer for studieregistrering

Først innsendt

18. januar 2012

Først innsendt som oppfylte QC-kriteriene

18. januar 2012

Først lagt ut (Antatt)

24. januar 2012

Oppdateringer av studieposter

Sist oppdatering lagt ut (Antatt)

2. februar 2024

Siste oppdatering sendt inn som oppfylte QC-kriteriene

5. januar 2024

Sist bekreftet

1. januar 2024

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

N1048
U10CA031946 (U.S. NIH-stipend/kontrakt)
CDR0000715321 (Registeridentifikator: PDQ (Physician Data Query))
NCI-2012-00234 (Registeridentifikator: CTRP (Clinical Trials Reporting System))

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. .

PROSPECT: Kjemoterapi alene eller kjemoterapi pluss strålebehandling ved behandling av pasienter med lokalt avansert rektalkreft som gjennomgår kirurgi

En fase II/III-studie av Neoadjuvant FOLFOX med selektiv bruk av kombinert modalitet kjemoradiasjon versus preoperativ kombinert modalitet kjemoradiasjon for lokalt avanserte rektalkreftpasienter som gjennomgår lav fremre reseksjon med total mesorektal eksisjon (PROSPECT)

Studieoversikt

Status

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Studietype

Registrering (Faktiske)

Fase

Kontakter og plasseringer

Studiesteder

Deltakelseskriterier

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

Tar imot friske frivillige

Beskrivelse

Studieplan

Hvordan er studiet utformet?

Designdetaljer

Antall våpen

Våpen og intervensjoner

Deltakergruppe / Arm

Intervensjon / Behandling

Hva måler studien?

Primære resultatmål

Resultatmål

Tiltaksbeskrivelse

Tidsramme

Sekundære resultatmål

Resultatmål

Tiltaksbeskrivelse

Tidsramme

Samarbeidspartnere og etterforskere

Sponsor

Samarbeidspartnere

Etterforskere

Publikasjoner og nyttige lenker

Generelle publikasjoner

Hjelpsomme linker

Studierekorddatoer

Studer hoveddatoer

Studiestart (Faktiske)

Primær fullføring (Faktiske)

Studiet fullført (Antatt)

Datoer for studieregistrering

Først innsendt

Først innsendt som oppfylte QC-kriteriene

Først lagt ut (Antatt)

Oppdateringer av studieposter

Sist oppdatering lagt ut (Antatt)

Siste oppdatering sendt inn som oppfylte QC-kriteriene

Sist bekreftet

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre