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Enzalutamid med eller uten abirateron og prednison ved behandling av pasienter med kastrasjonsresistent metastatisk prostatakreft

13. september 2023 oppdatert av: Alliance for Clinical Trials in Oncology

Fase III-forsøk med Enzalutamid (NSC# 766085) versus Enzalutamid, Abiraterone og Prednison for kastreringsresistent metastatisk prostatakreft

Denne randomiserte fase III-studien studerer enzalutamid for å se hvor godt det virker sammenlignet med enzalutamid, abirateron og prednison ved behandling av pasienter med kastrasjonsresistent metastatisk prostatakreft. Androgener kan forårsake vekst av prostatakreftceller. Legemidler, som enzalutamid, abirateronacetat og prednison, kan redusere mengden androgener laget av kroppen.

Studieoversikt

Detaljert beskrivelse

Pasientene er randomisert til en av to behandlingsgrupper: enzalutamid eller enzalutamid, abirateron og prednison. Behandlingen vil fortsette inntil sykdomsprogresjon eller uakseptabel toksisitet. Pasienter følges for kliniske utfall i maksimalt 5 år etter studiebehandling. De primære og sekundære målene er beskrevet nedenfor.

  1. Hovedmål:

    For å sammenligne den totale overlevelsen til pasienter med progressiv metastatisk kastrasjonsresistent prostatakreft (CRPC) behandlet med enten enzalutamid eller enzalutamid med abirateron og prednison

  2. Sekundære mål:

    • For å vurdere toksisitetsprofilen grad 3 eller høyere og sammenligne sikkerhet etter behandlingsarm.
    • For å vurdere og sammenligne nedgang av prostataspesifikt antigen (PSA) etter behandling etter behandlingsarm.
    • For å sammenligne radiografisk progresjonsfri overlevelse definert av Prostate Cancer Working Group 2 (PCWG2), og objektiv responsrate, etter behandlingsarm.
    • For å teste for radiografisk progresjonsfri overlevelse (rPFS) behandlingsinteraksjon for å forutsi total overlevelse.
    • For å vurdere før- og etterbehandlingsmålinger av tumorbelastning og beinaktivitet ved bruk av natriumfluorid (NaF) positronemisjonstomografi (PET)/datatomografi (CT) og technetium (Tc) metylendifosfonat (MDP) benscintigrafi og korrelere disse målene med total overlevelse.
    • Å utvikle og validere prognostiske og prediktive modeller for total overlevelse som inkluderer baseline kliniske og molekylære markører.

Studietype

Intervensjonell

Registrering (Faktiske)

1311

Fase

  • Fase 3

Kontakter og plasseringer

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

Studiesteder

    • Alberta
      • Edmonton, Alberta, Canada, T6G 1Z2
        • Cross Cancer Institute
    • British Columbia
      • Vancouver, British Columbia, Canada, V5Z 4E6
        • BCCA-Vancouver Cancer Centre
    • New Brunswick
      • Moncton, New Brunswick, Canada, E1C 6Z8
        • The Moncton Hospital
      • Moncton, New Brunswick, Canada, E1C 8X3
        • The Vitalite Health Network - Dr Leon Richard Oncology Centre
      • Saint John, New Brunswick, Canada, E2L 4L2
        • Atlantic Health Sciences Corporation-Saint John Regional Hospital
    • Newfoundland and Labrador
      • St. John's, Newfoundland and Labrador, Canada, A1B 3V6
        • Doctor H. Bliss Murphy Cancer Centre
    • Ontario
      • Cambridge, Ontario, Canada, N1R 3G2
        • Cambridge Memorial Hospital
      • Kitchener, Ontario, Canada, N2G 1G3
        • Grand River Regional Cancer Centre at Grand River Hospital
    • Saskatchewan
      • Regina, Saskatchewan, Canada, S4T 7T1
        • Allan Blair Cancer Centre
    • Alabama
      • Birmingham, Alabama, Forente stater, 35233
        • University of Alabama at Birmingham Cancer Center
      • Mobile, Alabama, Forente stater, 36608
        • Southern Cancer Center PC-Providence
    • Alaska
      • Anchorage, Alaska, Forente stater, 99508
        • Katmai Oncology Group
      • Anchorage, Alaska, Forente stater, 99508
        • Providence Alaska Medical Center
    • Arizona
      • 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
    • Arkansas
      • Jonesboro, Arkansas, Forente stater, 72401
        • Fowler Family Center for Cancer Care
      • Little Rock, Arkansas, Forente stater, 72205
        • University of Arkansas for Medical Sciences
      • Little Rock, Arkansas, Forente stater, 72205
        • Veteran's Administration Medical Center
    • California
      • Anaheim, California, Forente stater, 92807
        • Kaiser Permanente-Anaheim
      • Antioch, California, Forente stater, 94531
        • Kaiser Permanente-Deer Valley Medical Center
      • 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
      • Duarte, California, Forente stater, 91010
        • City of Hope Comprehensive Cancer Center
      • Fontana, California, Forente stater, 92335
        • Kaiser Permanente Hospital
      • Fremont, California, Forente stater, 94538
        • Kaiser Permanente-Fremont
      • Fresno, California, Forente stater, 93720
        • Kaiser Permanente
      • Fresno, California, Forente stater, 93701
        • University Oncology Associates
      • Fresno, California, Forente stater, 93720
        • California Cancer Center - North Fresno
      • Greenbrae, California, Forente stater, 94904
        • Marin Cancer Care Inc
      • Harbor City, California, Forente stater, 90710
        • Kaiser Permanente - Harbor City
      • Irvine, California, Forente stater, 92618
        • Kaiser Permanente-Irvine
      • La Jolla, California, Forente stater, 92093
        • UC San Diego Moores Cancer Center
      • Loma Linda, California, Forente stater, 92354
        • Loma Linda University Medical 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, 90034
        • Kaiser Permanente-Cadillac
      • Marysville, California, Forente stater, 95901
        • Fremont - Rideout Cancer Center
      • Modesto, California, Forente stater, 95355
        • Memorial Medical Center
      • Modesto, California, Forente stater, 95356
        • Kaiser Permanente-Modesto
      • Newport Beach, California, Forente stater, 92663
        • USC Norris Oncology/Hematology-Newport Beach
      • Oakland, California, Forente stater, 94611
        • Kaiser Permanente-Oakland
      • Orange, California, Forente stater, 92868
        • UC Irvine Health/Chao Family Comprehensive Cancer Center
      • Palo Alto, California, Forente stater, 94301
        • Palo Alto Medical Foundation Health Care
      • Panorama City, California, Forente stater, 91402
        • Kaiser Permanente - Panorama City
      • Paradise, California, Forente stater, 95969
        • Feather River Cancer Center
      • 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
      • Sacramento, California, Forente stater, 95817
        • University of California Davis Comprehensive Cancer Center
      • 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, 92123
        • Sharp Memorial Hospital
      • San Diego, California, Forente stater, 92161
        • Veterans Administration-San Diego Medical Center
      • San Francisco, California, Forente stater, 94121
        • Veterans Affairs Medical Center - San Francisco
      • 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
        • 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, 92069
        • Kaiser Permanente-San Marcos
      • 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
      • South San Francisco, California, Forente stater, 94080
        • Kaiser Permanente-South San Francisco
      • Stockton, California, Forente stater, 95210
        • Kaiser Permanente-Stockton
      • Stockton, California, Forente stater, 95204
        • Saint Joseph's Medical Center
      • Sunnyvale, California, Forente stater, 94086
        • Palo Alto Medical Foundation-Sunnyvale
      • Vacaville, California, Forente stater, 95688
        • Kaiser Permanente Medical Center-Vacaville
      • Vallejo, California, Forente stater, 94589
        • Kaiser Permanente-Vallejo
      • Walnut Creek, California, Forente stater, 94596
        • Kaiser Permanente-Walnut Creek
      • Woodland Hills, California, Forente stater, 91367
        • Kaiser Permanente
    • Colorado
      • Boulder, Colorado, Forente stater, 80304
        • Rocky Mountain Cancer Centers-Boulder
      • Colorado Springs, Colorado, Forente stater, 80909
        • Memorial Hospital Colorado Springs
      • Denver, Colorado, Forente stater, 80205
        • Kaiser Permanente-Franklin
      • Durango, Colorado, Forente stater, 81301
        • Southwest Oncology PC
      • Edwards, Colorado, Forente stater, 81632
        • The Shaw Regional Cancer Center
      • Fort Collins, Colorado, Forente stater, 80524
        • Poudre Valley Hospital
      • Lakewood, Colorado, Forente stater, 80228
        • Rocky Mountain Cancer Centers-Lakewood
    • Connecticut
      • Greenwich, Connecticut, Forente stater, 06830
        • Greenwich Hospital
      • Hartford, Connecticut, Forente stater, 06105
        • Smilow Cancer Hospital Care Center at Saint Francis
      • Middletown, Connecticut, Forente stater, 06457
        • Middlesex Hospital
      • Norwalk, Connecticut, Forente stater, 06856
        • Norwalk Hospital
      • Norwich, Connecticut, Forente stater, 06360
        • Eastern Connecticut Hematology and Oncology Associates
      • Stamford, Connecticut, Forente stater, 06904
        • Stamford Hospital/Bennett Cancer Center
      • West Haven, Connecticut, Forente stater, 06516
        • Veterans Affairs Connecticut Healthcare System-West Haven Campus
    • Delaware
      • Newark, Delaware, Forente stater, 19713
        • Medical Oncology Hematology Consultants PA
    • District of Columbia
      • Washington, District of Columbia, Forente stater, 20007
        • MedStar Georgetown University Hospital
      • Washington, District of Columbia, Forente stater, 20016
        • Sibley Memorial Hospital
      • Washington, District of Columbia, Forente stater, 20422
        • Veterans Affairs Medical Center -Washington DC
    • Florida
      • Jacksonville, Florida, Forente stater, 32207
        • Baptist MD Anderson Cancer Center
      • Lakeland, Florida, Forente stater, 33805
        • Lakeland Regional Cancer Center
      • Miami Beach, Florida, Forente stater, 33140
        • Mount Sinai Medical Center
      • Orlando, Florida, Forente stater, 32803
        • Florida Hospital Orlando
      • Orlando, Florida, Forente stater, 32806
        • UF Cancer Center at Orlando Health
      • Pensacola, Florida, Forente stater, 32504
        • Sacred Heart Hospital
    • Georgia
      • Atlanta, Georgia, Forente stater, 30342
        • Northside Hospital
      • Columbus, Georgia, Forente stater, 31904
        • John B Amos Cancer Center
      • Decatur, Georgia, Forente stater, 30033
        • Atlanta VA Medical Center
      • Macon, Georgia, Forente stater, 31201
        • Medical Center of Central Georgia
      • Savannah, Georgia, Forente stater, 31405
        • Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
      • Valdosta, Georgia, Forente stater, 31602
        • South Georgia Medical Center/Pearlman Cancer Center
    • Hawaii
      • 'Aiea, Hawaii, Forente stater, 96701
        • Pali Momi Medical Center
      • 'Aiea, Hawaii, Forente stater, 96701
        • Hawaii Oncology Inc-Pali Momi
      • Honolulu, Hawaii, Forente stater, 96813
        • Queen's Medical Center
      • 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, 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
      • Honolulu, Hawaii, Forente stater, 96859
        • Tripler Army Medical Center
      • Lihue, Hawaii, Forente stater, 96766
        • Wilcox Memorial Hospital and Kauai Medical Clinic
    • Idaho
      • Boise, Idaho, Forente stater, 83706
        • Saint Alphonsus Cancer Care Center-Boise
      • Post Falls, Idaho, Forente stater, 83854
        • Kootenai Cancer Center
    • Illinois
      • Aurora, Illinois, Forente stater, 60504
        • Rush - Copley Medical Center
      • Bloomington, Illinois, Forente stater, 61704
        • Illinois CancerCare-Bloomington
      • Chicago, Illinois, Forente stater, 60611
        • Northwestern University
      • Chicago, Illinois, Forente stater, 60612
        • Rush University Medical Center
      • Chicago, Illinois, Forente stater, 60608
        • Mount Sinai Hospital Medical Center
      • Chicago, Illinois, Forente stater, 60640
        • Weiss Memorial Hospital
      • Chicago, Illinois, Forente stater, 60657
        • Advocate Illinois Masonic Medical Center
      • Decatur, Illinois, Forente stater, 62526
        • Decatur Memorial Hospital
      • Decatur, Illinois, Forente stater, 62526
        • Cancer Care Center of Decatur
      • Effingham, Illinois, Forente stater, 62401
        • Crossroads Cancer Center
      • Evanston, Illinois, Forente stater, 60201
        • NorthShore University HealthSystem-Evanston Hospital
      • 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
      • Hines, Illinois, Forente stater, 60141
        • Hines Veterans Administration Hospital
      • Maywood, Illinois, Forente stater, 60153
        • Loyola University Medical Center
      • Peoria, Illinois, Forente stater, 61615
        • Illinois CancerCare-Peoria
      • Quincy, Illinois, Forente stater, 62301
        • Quincy Medical Group-Clinic
      • River Forest, Illinois, Forente stater, 60305
        • West Suburban Medical Center
      • Rockford, Illinois, Forente stater, 61108
        • OSF Saint Anthony Medical Center
      • Springfield, Illinois, Forente stater, 62781
        • Memorial Medical Center
      • Springfield, Illinois, Forente stater, 62702
        • Southern Illinois University School of Medicine
      • Springfield, Illinois, Forente stater, 62702
        • Central Illinois Hematology Oncology Center
      • Urbana, Illinois, Forente stater, 61801
        • Carle Cancer Center
      • Warrenville, Illinois, Forente stater, 60555
        • Northwestern Medicine Cancer Center Warrenville
    • Indiana
      • Fort Wayne, Indiana, Forente stater, 46845
        • Fort Wayne Medical Oncology and Hematology Inc-Parkview
      • Fort Wayne, Indiana, Forente stater, 46804
        • Fort Wayne Medical Oncology and Hematology Inc - Jefferson Boulevard
      • Mishawaka, Indiana, Forente stater, 46545
        • Michiana Hematology Oncology PC-Mishawaka
      • Munster, Indiana, Forente stater, 46321
        • The Community Hospital
      • South Bend, Indiana, Forente stater, 46601
        • Memorial Hospital of South Bend
      • Westville, Indiana, Forente stater, 46391
        • Michiana Hematology Oncology PC-Westville
    • Iowa
      • Ames, Iowa, Forente stater, 50010
        • McFarland Clinic PC-William R Bliss Cancer Center
      • Bettendorf, Iowa, Forente stater, 52722
        • Hematology Oncology Associates-Quad Cities
      • 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
      • Davenport, Iowa, Forente stater, 52803
        • Genesis Medical Center - East Campus
      • Des Moines, Iowa, Forente stater, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Forente stater, 50314
        • Medical Oncology and Hematology Associates-Laurel
      • Iowa City, Iowa, Forente stater, 52242
        • University of Iowa/Holden Comprehensive Cancer Center
      • Iowa City, Iowa, Forente stater, 52246
        • Iowa City VA Healthcare System
      • Mason City, Iowa, Forente stater, 50401
        • Mercy Medical Center - North Iowa
      • Sioux City, Iowa, Forente stater, 51101
        • Siouxland Regional Cancer Center
      • 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
      • Emporia, Kansas, Forente stater, 66801
        • Newman Regional Health
      • Fort Scott, Kansas, Forente stater, 66701
        • Cancer Center of Kansas - Fort Scott
      • Garden City, Kansas, Forente stater, 67846
        • Saint Catherine Hospital
      • Great Bend, Kansas, Forente stater, 67530
        • Saint Rose Ambulatory and Surgery Center
      • Hays, Kansas, Forente stater, 67601
        • Hays Medical Center
      • Independence, Kansas, Forente stater, 67301
        • Cancer Center of Kansas-Independence
      • Kansas City, Kansas, Forente stater, 66160
        • University of Kansas Cancer Center
      • Kansas City, Kansas, Forente stater, 66112
        • University of Kansas Cancer Center-West
      • Kingman, Kansas, Forente stater, 67068
        • Cancer Center of Kansas-Kingman
      • Liberal, Kansas, Forente stater, 67905
        • Cancer Center of Kansas-Liberal
      • 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
        • Saint Francis Hospital and Medical Center - Topeka
      • Wellington, Kansas, Forente stater, 67152
        • Cancer Center of Kansas - Wellington
      • Wichita, Kansas, Forente stater, 67208
        • Cancer Center of Kansas-Wichita Medical Arts Tower
      • Wichita, Kansas, Forente stater, 67214
        • Cancer Center of Kansas - Wichita
      • Winfield, Kansas, Forente stater, 67156
        • Cancer Center of Kansas - Winfield
    • Kentucky
      • Lexington, Kentucky, Forente stater, 40509
        • Saint Joseph Hospital East
    • Louisiana
      • Alexandria, Louisiana, Forente stater, 71301
        • Christus Saint Frances Cabrini Hospital
      • Baton Rouge, Louisiana, Forente stater, 70809
        • Ochsner Health Center-Summa
      • Baton Rouge, Louisiana, Forente stater, 70809
        • Hematology/Oncology Clinic LLP
      • Kenner, Louisiana, Forente stater, 70065
        • Ochsner Medical Center Kenner
      • Metairie, Louisiana, Forente stater, 70006
        • East Jefferson General Hospital
      • New Orleans, Louisiana, Forente stater, 70121
        • Ochsner Medical Center Jefferson
      • New Orleans, Louisiana, Forente stater, 70112
        • Tulane University Health Sciences Center
    • Maine
      • Augusta, Maine, Forente stater, 04330
        • Harold Alfond Center for Cancer Care
      • Bangor, Maine, Forente stater, 04401
        • Eastern Maine Medical Center
      • Brewer, Maine, Forente stater, 04412
        • Lafayette Family Cancer Center-EMMC
      • Rockport, Maine, Forente stater, 04856
        • Penobscot Bay Medical Center
    • 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
      • Frederick, Maryland, Forente stater, 21701
        • Frederick Memorial Hospital
      • Olney, Maryland, Forente stater, 20832
        • Montgomery General Hospital-Olney
      • Westminster, Maryland, Forente stater, 21157
        • William E Kahlert Regional Cancer Center/Sinai Hospital
    • Massachusetts
      • Boston, Massachusetts, Forente stater, 02111
        • Tufts Medical Center
      • Fitchburg, Massachusetts, Forente stater, 01420
        • Simonds-Sinon Regional Cancer Center
      • Newton, Massachusetts, Forente stater, 02462
        • Newton-Wellesley Hospital
      • Springfield, Massachusetts, Forente stater, 01199
        • Baystate Medical Center
      • Worcester, Massachusetts, Forente stater, 01655
        • University of Massachusetts Medical School
    • Michigan
      • Ann Arbor, Michigan, Forente stater, 48106-0995
        • Saint Joseph Mercy Hospital
      • Ann Arbor, Michigan, Forente stater, 48109
        • University of Michigan Comprehensive Cancer Center
      • Detroit, Michigan, Forente stater, 48202
        • Henry Ford Hospital
      • Detroit, Michigan, Forente stater, 48201
        • Wayne State University/Karmanos Cancer Institute
      • Escanaba, Michigan, Forente stater, 49829
        • Green Bay Oncology - Escanaba
      • Grand Rapids, Michigan, Forente stater, 49503
        • Spectrum Health at Butterworth Campus
      • Grand Rapids, Michigan, Forente stater, 49503
        • Mercy Health Saint Mary's
      • Iron Mountain, Michigan, Forente stater, 49801
        • Green Bay Oncology - Iron Mountain
      • Kalamazoo, Michigan, Forente stater, 49007
        • West Michigan Cancer Center
      • Lansing, Michigan, Forente stater, 48912
        • Sparrow Hospital
      • Livonia, Michigan, Forente stater, 48154
        • Saint Mary Mercy Hospital
      • Reed City, Michigan, Forente stater, 49677
        • Spectrum Health Reed City Hospital
      • Saginaw, Michigan, Forente stater, 48601
        • Saint Mary's of Michigan
      • Traverse City, Michigan, Forente stater, 49684
        • Munson Medical Center
    • Minnesota
      • Bemidji, Minnesota, Forente stater, 56601
        • Sanford Clinic North-Bemidgi
      • Burnsville, Minnesota, Forente stater, 55337
        • Fairview Ridges Hospital
      • Coon Rapids, Minnesota, Forente stater, 55433
        • Mercy Hospital
      • Duluth, Minnesota, Forente stater, 55805
        • Saint Luke's Hospital of Duluth
      • Duluth, Minnesota, Forente stater, 55805
        • Essentia Health Cancer Center
      • Edina, Minnesota, Forente stater, 55435
        • Fairview-Southdale Hospital
      • Fergus Falls, Minnesota, Forente stater, 56537
        • Lake Region Healthcare Corporation-Cancer Care
      • Fridley, Minnesota, Forente stater, 55432
        • Unity Hospital
      • Mankato, Minnesota, Forente stater, 56001
        • Mayo Clinic Health Systems-Mankato
      • 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 Veterans Medical Center
      • Rochester, Minnesota, Forente stater, 55905
        • Mayo Clinic
      • Saint Cloud, Minnesota, Forente stater, 56303
        • Coborn Cancer Center at Saint Cloud Hospital
      • Saint Louis Park, Minnesota, Forente stater, 55416
        • Park Nicollet Clinic - Saint Louis Park
      • Saint Paul, Minnesota, Forente stater, 55101
        • Regions Hospital
      • Shakopee, Minnesota, Forente stater, 55379
        • Saint Francis Regional Medical Center
      • Stillwater, Minnesota, Forente stater, 55082
        • Lakeview Hospital
      • Woodbury, Minnesota, Forente stater, 55125
        • Minnesota Oncology Hematology PA-Woodbury
    • Mississippi
      • Corinth, Mississippi, Forente stater, 38834
        • The West Clinic - Corinth
    • Missouri
      • 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
        • Barnes-Jewish West County Hospital
      • Jefferson City, Missouri, Forente stater, 65109
        • Capital Region Medical Center-Goldschmidt Cancer Center
      • Kansas City, Missouri, Forente stater, 64128
        • Kansas City Veterans Affairs Medical Center
      • 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, 64108
        • Truman Medical Center
      • 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
      • 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
      • Springfield, Missouri, Forente stater, 65804
        • Mercy Hospital Springfield
    • Montana
      • Anaconda, Montana, Forente stater, 59711
        • Community Hospital of Anaconda
      • Billings, Montana, Forente stater, 59101
        • Saint Vincent Healthcare
      • 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
        • Benefis Healthcare- Sletten Cancer Institute
      • Kalispell, Montana, Forente stater, 59901
        • Kalispell Regional Medical Center
    • Nebraska
      • Grand Island, Nebraska, Forente stater, 68803
        • CHI Health Saint Francis
      • Kearney, Nebraska, Forente stater, 68847
        • CHI Health Good Samaritan
      • Lincoln, Nebraska, Forente stater, 68506
        • Nebraska Hematology and Oncology
      • Lincoln, Nebraska, Forente stater, 68510
        • Southeast Nebraska Cancer Center
      • Omaha, Nebraska, Forente stater, 68114
        • Nebraska Methodist Hospital
    • Nevada
      • Las Vegas, Nevada, Forente stater, 89148
        • Comprehensive Cancer Centers of Nevada
      • Las Vegas, Nevada, Forente stater, 89169
        • Comprehensive Cancer Centers of Nevada - Central Valley
      • Las Vegas, Nevada, Forente stater, 89113
        • HealthCare Partners Medical Group Oncology/Hematology-San Martin
      • Las Vegas, Nevada, Forente stater, 89128
        • HealthCare Partners Medical Group Oncology/Hematology-Tenaya
    • New Hampshire
      • Concord, New Hampshire, Forente stater, 03301
        • New Hampshire Oncology Hematology PA-Concord
      • Dover, New Hampshire, Forente stater, 03820
        • Wentworth-Douglass Hospital
      • Hooksett, New Hampshire, Forente stater, 03106
        • New Hampshire Oncology Hematology PA-Hooksett
      • Laconia, New Hampshire, Forente stater, 03246
        • LRGHealthcare-Lakes Region General Hospital
      • Lebanon, New Hampshire, Forente stater, 03756
        • Dartmouth Hitchcock Medical Center
      • Manchester, New Hampshire, Forente stater, 03102
        • Norris Cotton Cancer Center-Manchester
      • Nashua, New Hampshire, Forente stater, 03063
        • Norris Cotton Cancer Center-Nashua
      • Nashua, New Hampshire, Forente stater, 03060
        • Saint Joseph Hospital
      • Portsmouth, New Hampshire, Forente stater, 03802
        • Portsmouth Regional Hospital
    • New Jersey
      • Basking Ridge, New Jersey, Forente stater, 07920
        • Memorial Sloan Kettering Cancer Center at Basking Ridge
      • East Orange, New Jersey, Forente stater, 07018-1095
        • Veterans Adminstration New Jersey Health Care System
      • Hackensack, New Jersey, Forente stater, 07601
        • Hackensack University Medical Center
      • Mount Holly, New Jersey, Forente stater, 08060
        • Virtua Memorial
      • Paramus, New Jersey, Forente stater, 07652
        • The Valley Hospital-Luckow Pavilion
      • Voorhees, New Jersey, Forente stater, 08043
        • Virtua Voorhees
      • Westwood, New Jersey, Forente stater, 07675
        • Valley Health System-Hematology/Oncology
    • New Mexico
      • Albuquerque, New Mexico, Forente stater, 87102
        • University of New Mexico Cancer Center
      • Las Cruces, New Mexico, Forente stater, 88011
        • Memorial Medical Center - Las Cruces
      • Santa Fe, New Mexico, Forente stater, 87505
        • Christus Saint Vincent Regional Cancer Center
    • New York
      • Bronx, New York, Forente stater, 10461
        • Montefiore Medical Center-Einstein Campus
      • Bronx, New York, Forente stater, 10467-2490
        • Montefiore Medical Center - Moses Campus
      • Bronx, New York, Forente stater, 10468
        • Bronx Veterans Administration Medical Center
      • Brooklyn, New York, Forente stater, 11219
        • Maimonides Medical Center
      • Brooklyn, New York, Forente stater, 11203
        • Kings County Hospital
      • Buffalo, New York, Forente stater, 14263
        • Roswell Park Cancer Institute
      • Buffalo, New York, Forente stater, 14215
        • Veterans Affairs Western New York Health Care System-Buffalo
      • Commack, New York, Forente stater, 11725
        • Memorial Sloan Kettering Cancer Center Commack
      • Elmira, New York, Forente stater, 14905
        • Arnot Ogden Medical Center/Falck Cancer Center
      • Harrison, New York, Forente stater, 10604
        • Memorial Sloan-Kettering Cancer Center West Harrison
      • New Hyde Park, New York, Forente stater, 11040
        • North Shore-LIJ Health System/Center for Advanced Medicine
      • 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, 10016
        • Laura and Isaac Perlmutter Cancer Center at NYU Langone
      • New York, New York, Forente stater, 10032
        • Columbia University/Herbert Irving Cancer Center
      • Rochester, New York, Forente stater, 14642
        • University of Rochester
      • Rockville Centre, New York, Forente stater, 11570
        • Memorial Sloan Kettering Cancer Center Rockville Centre
      • Sleepy Hollow, New York, Forente stater, 10591
        • Memorial Sloan Kettering Cancer Center Sleepy Hollow
      • Stony Brook, New York, Forente stater, 11794
        • Stony Brook University Medical Center
      • Syracuse, New York, Forente stater, 13210
        • State University of New York Upstate Medical University
      • Syracuse, New York, Forente stater, 13210
        • Syracuse Veterans Administration Medical Center
    • North Carolina
      • Asheboro, North Carolina, Forente stater, 27203
        • Randolph Hospital
      • Burlington, North Carolina, Forente stater, 27215
        • Cone Health Cancer Center at Alamance Regional
      • 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, 28262
        • Southern Oncology Specialists-Charlotte
      • Durham, North Carolina, Forente stater, 27710
        • Duke University Medical Center
      • Durham, North Carolina, Forente stater, 27705
        • Durham Veterans Affairs Medical Center
      • Goldsboro, North Carolina, Forente stater, 27534
        • Wayne Memorial Hospital
      • Greensboro, North Carolina, Forente stater, 27403
        • Cone Health Cancer Center
      • Huntersville, North Carolina, Forente stater, 28078
        • Southern Oncology Specialists-Huntersville
      • Huntersville, North Carolina, Forente stater, 28078
        • Lake Norman Hematology Oncology Specialists-Huntersville
      • Kernersville, North Carolina, Forente stater, 27284
        • Novant Health Oncology Specialists-Kernersville
      • Kinston, North Carolina, Forente stater, 28501
        • Kinston Medical Specialists PA
      • Matthews, North Carolina, Forente stater, 28105
        • Novant Health Cancer Specialists-Matthews
      • Mooresville, North Carolina, Forente stater, 28117
        • Lake Norman Hematology Oncology Specialists-Mooresville
      • Mount Airy, North Carolina, Forente stater, 27030
        • Novant Health Oncology Specialists-Mount Airy
      • Reidsville, North Carolina, Forente stater, 27320
        • Annie Penn Memorial Hospital
      • Salisbury, North Carolina, Forente stater, 28144
        • Carolina Oncology Associates PA
      • Salisbury, North Carolina, Forente stater, 28144
        • Veterans Administration Medical Center
      • Statesville, North Carolina, Forente stater, 28625
        • Novant Health Oncology Specialists-Statesville
      • Thomasville, North Carolina, Forente stater, 27360
        • Novant Health Oncology Specialists-Davidson County
      • Washington, North Carolina, Forente stater, 27889
        • Marion L Shepard Cancer Center at Vidant Beaufort Hospital
      • Wilkesboro, North Carolina, Forente stater, 28659
        • Novant Health Oncology Specialists-Wilkesboro
      • Winston-Salem, North Carolina, Forente stater, 27157
        • Wake Forest University Health Sciences
      • Winston-Salem, North Carolina, Forente stater, 27103
        • Novant Health Forsyth Medical Center
      • Winston-Salem, North Carolina, Forente stater, 27103
        • Novant Health Oncology Specialists
      • Winston-Salem, North Carolina, Forente stater, 27103
        • Winston-Salem Health Care
    • North Dakota
      • Bismarck, North Dakota, Forente stater, 58501
        • Sanford Bismarck Medical Center
      • Fargo, North Dakota, Forente stater, 58122
        • Sanford Clinic North-Fargo
      • Fargo, North Dakota, Forente stater, 58122
        • Sanford Medical Center-Fargo
      • Grand Forks, North Dakota, Forente stater, 58201
        • Altru Cancer Center
      • Minot, North Dakota, Forente stater, 58701
        • Trinity Cancer Care 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
      • Canton, Ohio, Forente stater, 44708
        • Mercy Medical Center
      • Centerville, Ohio, Forente stater, 45459
        • Dayton Physicians LLC-Miami Valley South
      • Chardon, Ohio, Forente stater, 44024
        • Geaugra Hospital
      • Cincinnati, Ohio, Forente stater, 45219
        • University of Cincinnati/Barrett Cancer Center
      • Cleveland, Ohio, Forente stater, 44106
        • Case Western Reserve University
      • Cleveland, Ohio, Forente stater, 44109
        • MetroHealth Medical Center
      • Cleveland, Ohio, Forente stater, 44195
        • Cleveland Clinic Foundation
      • Cleveland, Ohio, Forente stater, 44111
        • Cleveland Clinic Cancer Center/Fairview Hospital
      • Columbus, Ohio, Forente stater, 43210
        • Ohio State University Comprehensive Cancer Center
      • Columbus, Ohio, Forente stater, 43219
        • The Mark H Zangmeister 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
        • Samaritan North Health Center
      • Elyria, Ohio, Forente stater, 44035
        • Mercy Cancer Center-Elyria
      • Elyria, Ohio, Forente stater, 44035
        • Hematology Oncology Center Incorporated
      • 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
      • Independence, Ohio, Forente stater, 44131
        • Cleveland Clinic Cancer Center Independence
      • Kettering, Ohio, Forente stater, 45409
        • Greater Dayton Cancer Center
      • Mansfield, Ohio, Forente stater, 44906
        • Cleveland Clinic Cancer Center Mansfield
      • Maumee, Ohio, Forente stater, 43537
        • Toledo Clinic Cancer Centers-Maumee
      • Mayfield Heights, Ohio, Forente stater, 44124
        • Hillcrest Hospital Cancer Center
      • Mayfield Heights, Ohio, Forente stater, 44124
        • Ireland Cancer Center Landerbrook Health Center
      • Medina, Ohio, Forente stater, 44256
        • Summa Health Center at Lake Medina
      • Mentor, Ohio, Forente stater, 44060
        • Lake University Ireland Cancer Center
      • Middleburg Heights, Ohio, Forente stater, 44130
        • Southwest General Health Center Ireland Cancer Center
      • Parma, Ohio, Forente stater, 44129
        • University Hospitals Parma Medical Center
      • Portsmouth, Ohio, Forente stater, 45662
        • Southern Ohio Medical Center
      • Sandusky, Ohio, Forente stater, 44870
        • North Coast Cancer Care
      • Sandusky, Ohio, Forente stater, 44870
        • Ireland Cancer Center at Firelands Regional Medical Center
      • Strongsville, Ohio, Forente stater, 44136
        • Cleveland Clinic Cancer Center Strongsville
      • Toledo, Ohio, Forente stater, 43623
        • Toledo Clinic Cancer Centers-Toledo
      • Toledo, Ohio, Forente stater, 43614
        • University of Toledo
      • Wadsworth, Ohio, Forente stater, 44281
        • University Hospitals Sharon Health Center
      • Warrensville Heights, Ohio, Forente stater, 44122
        • South Pointe Hospital
      • 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
      • Westlake, Ohio, Forente stater, 44145
        • UH-Seidman Cancer Center at Saint John Medical Center
      • Wooster, Ohio, Forente stater, 44691
        • Cleveland Clinic Wooster Family Health and Surgery Center
      • Wright-Patterson Air Force Base, Ohio, Forente stater, 45433-5529
        • Wright-Patterson Medical Center
    • Oklahoma
      • Lawton, Oklahoma, Forente stater, 73505
        • Cancer Centers of Southwest Oklahoma Research
      • Oklahoma City, Oklahoma, Forente stater, 73104
        • University of Oklahoma Health Sciences Center
      • Oklahoma City, Oklahoma, Forente stater, 73120
        • Mercy Hospital Oklahoma City
      • Tulsa, Oklahoma, Forente stater, 74146
        • Oklahoma Cancer Specialists and Research Institute-Tulsa
    • Oregon
      • Corvallis, Oregon, Forente stater, 97330
        • Good Samaritan Hospital
      • Milwaukie, Oregon, Forente stater, 97222
        • Providence Milwaukie Hospital
      • Newberg, Oregon, Forente stater, 97132
        • Providence Newberg Medical Center
      • Oregon City, Oregon, Forente stater, 97045
        • Providence Willamette Falls Medical Center
      • Portland, Oregon, Forente stater, 97210
        • Legacy Good Samaritan Hospital and Medical Center
      • Portland, Oregon, Forente stater, 97213
        • Providence Portland Medical Center
      • Portland, Oregon, Forente stater, 97225
        • Providence Saint Vincent Medical Center
      • Portland, Oregon, Forente stater, 97227
        • Kaiser Permanente Northwest
    • Pennsylvania
      • Abington, Pennsylvania, Forente stater, 19001
        • Abington Memorial Hospital
      • Allentown, Pennsylvania, Forente stater, 18103
        • Lehigh Valley Hospital-Cedar Crest
      • Bethlehem, Pennsylvania, Forente stater, 18017
        • Lehigh Valley Hospital - Muhlenberg
      • Danville, Pennsylvania, Forente stater, 17822
        • Geisinger Medical Center
      • Gettysburg, Pennsylvania, Forente stater, 17325
        • Adams Cancer Center
      • Langhorne, Pennsylvania, Forente stater, 19047
        • Saint Mary Medical and Regional Cancer Center
      • Natrona Heights, Pennsylvania, Forente stater, 15065
        • Allegheny Valley Hospital
      • Pittsburgh, Pennsylvania, Forente stater, 15212
        • Allegheny General Hospital
      • Pittsburgh, Pennsylvania, Forente stater, 15232
        • University of Pittsburgh Cancer Institute (UPCI)
      • York, Pennsylvania, Forente stater, 17403
        • WellSpan Health-York Hospital
    • Rhode Island
      • Providence, Rhode Island, Forente stater, 02908
        • Roger Williams Medical Center
    • South Carolina
      • Charleston, South Carolina, Forente stater, 29401
        • Roper Hospital
      • Charleston, South Carolina, Forente stater, 29403
        • Charleston Hematology Oncology Associates-Roper
      • Charleston, South Carolina, Forente stater, 29406
        • Lowcountry Hematology Oncology PA-North Charleston
      • Charleston, South Carolina, Forente stater, 29414
        • Bon Secours Saint Francis Hospital
      • Charleston, South Carolina, Forente stater, 29414
        • Charleston Hematology Oncology Associates PA-St. Francis
      • Charleston, South Carolina, Forente stater, 29414
        • Lowcountry Hematology Oncology PA-West Ashley
      • Easley, South Carolina, Forente stater, 29640
        • Greenville Health System Cancer Institute-Easley
      • Greenville, South Carolina, Forente stater, 29607
        • Saint Francis Cancer Center
      • Greenville, South Carolina, Forente stater, 29601
        • Saint Francis Hospital
      • Greenville, South Carolina, Forente stater, 29605
        • Greenville Health System Cancer Institute-Faris
      • 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
      • Lancaster, South Carolina, Forente stater, 29720
        • Carolina Blood and Cancer Care Associates PA-Lancaster
      • Mount Pleasant, South Carolina, Forente stater, 29464
        • Lowcountry Hematology Oncology PA-Mount Pleasant
      • 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
      • Aberdeen, South Dakota, Forente stater, 57401
        • Avera Cancer Institute-Aberdeen
      • Rapid City, South Dakota, Forente stater, 57701
        • Rapid City Regional Hospital
      • Sioux Falls, South Dakota, Forente stater, 57105
        • Avera Cancer Institute
      • Sioux Falls, South Dakota, Forente stater, 57104
        • Sanford Cancer Center-Oncology Clinic
    • Tennessee
      • Germantown, Tennessee, Forente stater, 38138
        • The West Clinic - Wolf River
      • Memphis, Tennessee, Forente stater, 38163
        • University of Tennessee Health Science Center
    • Texas
      • Dallas, Texas, Forente stater, 75235
        • Parkland Memorial Hospital
      • Dallas, Texas, Forente stater, 75390
        • UT Southwestern/Simmons Cancer Center-Dallas
      • Fort Worth, Texas, Forente stater, 76104
        • UT Southwestern/Simmons Cancer Center-Fort Worth
      • Galveston, Texas, Forente stater, 77555-0565
        • University of Texas Medical Branch
      • Houston, Texas, Forente stater, 77030
        • Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
      • Houston, Texas, Forente stater, 77030
        • Ben Taub General Hospital
      • League City, Texas, Forente stater, 77573
        • UTMB Cancer Center at Victory Lakes
      • San Antonio, Texas, Forente stater, 78229
        • University of Texas Health Science Center at San Antonio
    • Vermont
      • Burlington, Vermont, Forente stater, 05405
        • University of Vermont College of Medicine
      • White River Junction, Vermont, Forente stater, 05009
        • White River Junction Veteran Administration Medical Center
    • Virginia
      • Charlottesville, Virginia, Forente stater, 22908
        • University of Virginia Cancer Center
      • Hampton, Virginia, Forente stater, 23666
        • Virginia Oncology Associates-Hampton
      • Lynchburg, Virginia, Forente stater, 24501
        • Lynchburg Hematology-Oncology Clinic
      • Martinsville, Virginia, Forente stater, 24115
        • Memorial Hospital Of Martinsville
      • Mechanicsville, Virginia, Forente stater, 23116
        • Bon Secours Memorial Regional Medical Center
      • Midlothian, Virginia, Forente stater, 23114
        • Bon Secours Saint Francis Medical Center
      • Richmond, Virginia, Forente stater, 23298
        • Virginia Commonwealth University/Massey Cancer Center
      • Richmond, Virginia, Forente stater, 23230
        • Virginia Cancer Institute
      • Winchester, Virginia, Forente stater, 22601
        • Shenandoah Oncology Associates PC
    • Washington
      • Bellingham, Washington, Forente stater, 98225
        • PeaceHealth Saint Joseph Medical Center
      • Everett, Washington, Forente stater, 98201
        • Providence Regional Cancer Partnership
      • Issaquah, Washington, Forente stater, 98029
        • Swedish Cancer Institute-Issaquah
      • Poulsbo, Washington, Forente stater, 98370
        • Harrison HealthPartners Hematology and Oncology-Poulsbo
      • Seattle, Washington, Forente stater, 98104
        • Minor and James Medical PLLC
      • Seattle, Washington, Forente stater, 98122-4307
        • Swedish Medical Center-First Hill
    • West Virginia
      • Charleston, West Virginia, Forente stater, 25304
        • West Virginia University Charleston
      • Huntington, West Virginia, Forente stater, 25702
        • Saint Mary's Medical Center
    • Wisconsin
      • Antigo, Wisconsin, Forente stater, 54409
        • Langlade Hospital and Cancer Center
      • Burlington, Wisconsin, Forente stater, 53105
        • Aurora Cancer Care-Southern Lakes VLCC
      • Eau Claire, Wisconsin, Forente stater, 54701
        • Mayo Clinic Health System-Eau Claire Clinic
      • Eau Claire, Wisconsin, Forente stater, 54701
        • Marshfield Clinic Cancer Center at Sacred Heart
      • Eau Claire, Wisconsin, Forente stater, 54701
        • Sacred Heart Hospital
      • Fond Du Lac, Wisconsin, Forente stater, 54935
        • Saint Agnes Hospital/Agnesian Cancer Center
      • Germantown, Wisconsin, Forente stater, 53022
        • Aurora Health Care Germantown Health Center
      • Grafton, Wisconsin, Forente stater, 53024
        • Aurora Cancer Care-Grafton
      • Green Bay, Wisconsin, Forente stater, 54311
        • Aurora BayCare Medical Center
      • Green Bay, Wisconsin, Forente stater, 54301
        • Saint Vincent Hospital Cancer Center Green Bay
      • Green Bay, Wisconsin, Forente stater, 54303
        • Saint Vincent Hospital Cancer Center at Saint Mary's
      • Green Bay, Wisconsin, Forente stater, 54303
        • Green Bay Oncology Limited at Saint Mary's Hospital
      • Green Bay, Wisconsin, Forente stater, 54301-3526
        • Green Bay Oncology at Saint Vincent Hospital
      • Janesville, Wisconsin, Forente stater, 53547
        • Mercy Health System
      • Kenosha, Wisconsin, Forente stater, 53142
        • Aurora Cancer Care-Kenosha South
      • La Crosse, Wisconsin, Forente stater, 54601
        • Gundersen Lutheran Medical Center
      • Madison, Wisconsin, Forente stater, 53792
        • University of Wisconsin Hospital and Clinics
      • Madison, Wisconsin, Forente stater, 53705
        • William S Middleton VA Medical Center
      • Manitowoc, Wisconsin, Forente stater, 54221
        • Holy Family Memorial Hospital
      • Marinette, Wisconsin, Forente stater, 54143
        • Vince Lombardi Cancer Clinic-Marinette
      • Marshfield, Wisconsin, Forente stater, 54449
        • Marshfield Clinic
      • Marshfield, Wisconsin, Forente stater, 54449
        • Saint Joseph's Hospital
      • 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
      • Milwaukee, Wisconsin, Forente stater, 53295
        • Zablocki Veterans Administration Medical Center
      • Minocqua, Wisconsin, Forente stater, 54548
        • Marshfield Clinic-Minocqua Center
      • Mukwonago, Wisconsin, Forente stater, 53149
        • ProHealth D N Greenwald Center
      • Oconomowoc, Wisconsin, Forente stater, 53066
        • ProHealth Oconomowoc Memorial Hospital
      • Oconto Falls, Wisconsin, Forente stater, 54154
        • Green Bay Oncology - Oconto Falls
      • Oshkosh, Wisconsin, Forente stater, 54904
        • Vince Lombardi Cancer Clinic - Oshkosh
      • Racine, Wisconsin, Forente stater, 53406
        • Aurora Cancer Care-Racine
      • Racine, Wisconsin, Forente stater, 53405
        • Wheaton Franciscan Cancer Care - All Saints
      • Rice Lake, Wisconsin, Forente stater, 54868
        • Marshfield Clinic-Rice Lake Center
      • Sheboygan, Wisconsin, Forente stater, 53081
        • Vince Lombardi Cancer Clinic-Sheboygan
      • Sheboygan, Wisconsin, Forente stater, 53081
        • HSHS Saint Nicholas Hospital
      • Stevens Point, Wisconsin, Forente stater, 54481
        • Saint Michael's Hospital
      • Stevens Point, Wisconsin, Forente stater, 54481
        • Marshfield Clinic Cancer Care at Saint Michael's Hospital
      • Sturgeon Bay, Wisconsin, Forente stater, 54235
        • Green Bay Oncology - Sturgeon Bay
      • 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
        • ProHealth Waukesha Memorial Hospital
      • Waukesha, Wisconsin, Forente stater, 53188
        • Aurora Cancer Care-Waukesha
      • Wausau, Wisconsin, Forente stater, 54401
        • Aspirus Regional Cancer 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
      • Wisconsin Rapids, Wisconsin, Forente stater, 54494
        • Aspirus UW Cancer Center
      • San Juan, Puerto Rico, 00936
        • San Juan City Hospital
      • San Juan, Puerto Rico, 00927
        • Fundacion de Investigacion de Diego
      • San Juan, Puerto Rico, 00921-3201
        • San Juan Veterans Affairs Medical Center

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

Kvalifikasjonskriterier:

  1. Dokumentasjon av sykdom - Progressiv kastrasjonsresistent metastatisk prostatakreft med histologisk eller cytologisk bekreftet adenokarsinom i prostata uten nevroendokrin differensiering eller småcelletrekk
  2. Pasienter må ha målbar eller ikke-målbar sykdom:

    1. Målbar sykdom - For at viscerale eller ekstra nodale lesjoner skal anses som målbare, må de være ≥ 10 mm i én dimensjon ved bruk av spiral-CT. For at lymfeknuter skal anses som målbare (dvs. mål- eller evaluerbare lesjoner), må de være ≥ 20 mm i minst én dimensjon ved bruk av spiral-CT.
    2. Ikke-målbar sykdom - Alle andre lesjoner, inkludert små lesjoner (lengste diameter < 20 mm med konvensjonelle teknikker eller < 10 mm med spiral CT-skanning) og virkelig ikke-målbare lesjoner. Lesjoner som anses som ikke-målbare inkluderer benlesjoner (bare).
    3. Pasienter med kun nodesykdom (dvs. ingen tilstedeværelse av viscerale, ekstra nodale lesjoner eller beinlesjoner) må ha node(r) som måler ≥ 15 mm i kort akse.
  3. Progressiv sykdom - Pasienter må ha progressiv sykdom ved studiestart definert som ett eller flere av følgende tre kriterier som oppstod mens pasienten var på androgen-deprivasjonsterapi. For pasienter som registrerer seg på grunnlag av progresjon av bløtvev eller ben, må baseline-skanningen vise progresjon i forhold til en sammenligningsskanning. Hvis sammenligningsskanningen ikke er tilgjengelig, må baselineskanningsrapporten referere til forrige skanning for å dokumentere progresjon.

    1. PSA-progresjon definert av minimum to stigende PSA-nivåer med et intervall på ≥ 1 uke mellom hver bestemmelse. Pasienter som mottok et antiandrogen må ha progresjon dokumentert ved minimum to stigende PSA-nivåer med et intervall på ≥ 1 uke mellom hver bestemmelse slik at minst den andre av disse økningene er ≥ 4 uker siden siste flutamid, bicalutamid eller nilutamid.

      PSA-verdien ved screeningen bør være ≥ 2 µg/L (2 ng/mL).

    2. Bløtvevssykdomsprogresjon definert av protokollen
    3. Bensykdomsprogresjon definert av Prostate Cancer Working Group 2 (PCWG2) med to eller flere nye lesjoner på beinskanning
  4. Tidligere behandling

    1. Ingen behandling med tidligere taxanbasert kjemoterapi for metastatisk sykdom

      • Pasienter som tidligere har mottatt taxan-basert kjemoterapi som neoadjuvant eller adjuvant terapi for lokal sykdom, eller som har mottatt taxan-basert terapi i PSA klinisk (ikke-metastatisk) tilstand er tillatt forutsatt at den totale varigheten av eksponeringen var seks sykluser eller mindre og kjemoterapi ble fullført mer enn 6 måneder før registrering
      • Taxanbasert kjemoterapi som ble avbrutt på grunn av allergiske reaksjoner eller intoleranse mot kjemoterapi og derfor mottok én syklus med tidligere terapi er tillatt
    2. Ingen tidligere enzalutamid, abirateron eller andre nye antiandrogen- eller androgensyntesehemmere
    3. Ingen behandling med noen av følgende for prostatakreft innen 4 uker før påmelding:

      • Hormonbehandling (f.eks. androgenreseptor [AR]-antagonister, 5 alfa-reduktasehemmere, østrogener) Merk: Behandling med bicalutamid og nilutamid innen 4 uker før registrering er ikke tillatt. Behandling med flutamid innen 4 uker før påmelding er ikke tillatt. Behandling med alle andre gonadotropinfrigjørende hormon (GnRH) analoger eller antagonister er tillatt.
      • Kjemoterapi
      • Biologisk terapi
      • Utredningsterapi
      • Immunterapi
    4. Ingen bruk av urteprodukter som kan redusere PSA-nivåer innen 4 uker før påmelding
    5. Ingen bruk av systemiske steroider større enn tilsvarende 10 mg prednison/prednisolon per dag innen 4 uker før innmelding
    6. Ingen tidligere bruk av ketokonazol i mer enn 7 dager
    7. Ingen tidligere strålebehandling eller radionuklidbehandling for behandling av metastaser innen fire uker før påmelding
    8. Pasienter som får bisfosfonatbehandling eller denosumab må ha vært på en stabil dose i minst 4 uker før innrullering
    9. Pasienter må opprettholde pågående androgen-deprivasjonsterapi med en GnRH-analog, antagonist eller bilateral orkiektomi (dvs. kirurgisk eller medisinsk kastrering)
  5. Pasienthistorie

    1. Ingen kjente eller mistenkte hjernemetastaser (MERK: pasienter med behandlet epidural sykdom er tillatt)
    2. Ingen planlagte palliative prosedyrer for lindring av beinsmerter som strålebehandling eller kirurgi
    3. Ingen strukturelt ustabile beinlesjoner som tyder på forestående brudd
    4. Ingen historie med anfall eller noen tilstand som kan øke pasientens anfallsrisiko (f.eks. tidligere kortikalt slag, betydelig hjernetraume). Ingen historie med forbigående iskemisk angrep (TIA) innen 12 måneder etter registrering
    5. Ingen klinisk signifikant kardiovaskulær sykdom inkludert:

      • Hjerteinfarkt (MI) innen 6 måneder
      • Ukontrollert angina innen 3 måneder
      • Kongestiv hjertesvikt (CHF) med New York Heart Association (NYHA) klasse 3 eller 4, eller pasienter med NYHA klasse 3 eller 4 tidligere, med mindre et screening-ekkokardiogram (ekko) eller multigated acquisition scan (MUGA) utført innen tre måneder viser en ejeksjonsfraksjon (EF) > 45 %
      • Anamnese med klinisk signifikante ventrikulære arytmier (f.eks. ventrikkeltakykardi, ventrikkelflimmer, torsades de pointes)
      • Historie med Mobitz II andregrads eller tredjegrads hjerteblokk uten permanent pacemaker på plass
      • Hypotensjon (systolisk blodtrykk [BP] < 86 mmHg) eller bradykardi (< 50 bpm) ved screening
      • Ukontrollert hypertensjon (systolisk BP > 170 mmHg eller diastolisk BP > 105 mmHg ved screening)
    6. Ingen gastrointestinal (GI) lidelse som påvirker absorpsjonen negativt
    7. Ingen større operasjon innen 4 uker før påmelding
  6. Alder og prestasjonsstatus

    1. Alder ≥ 18 år
    2. Eastern Cooperative Oncology Group (ECOG) ytelsesstatus 0-1
    3. Asymptomatisk eller mildt symptomatisk fra prostatakreft
  7. Nødvendige innledende laboratorieverdier

    1. Granulocytter ≥ 1500/µL
    2. Blodplateantall ≥ 100 000/µL
    3. Hemoglobin ≥ 9 g/dL
    4. Kreatinin ≤ 2 x øvre normalgrense (ULN)
    5. Bilirubin ≤ 1,5 x ULN
    6. Aspartataminotransferase (AST) eller alaninaminotransferase (ALT) ≤ 2 x ULN
    7. Albumin ≥ 3 g/dl
    8. Totalt testosteron ≤ 50 ng/dL (1,7 nmol/L)

Studieplan

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

Hvordan er studiet utformet?

Designdetaljer

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

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Arm A: (enzalutamid)
Pasienter får enzalutamid 160 mg PO QD. Behandlingen vil fortsette til bekreftet sykdomsprogresjon eller uakseptabel toksisitet.
Enzalutamid 160 mg daglig, oralt
Eksperimentell: Arm B: (enzalutamid, abirateron, prednison)
Pasienter får enzalutamid 160 mg PO QD, abirateron 1000 mg PO QD og prednison 5 mg PO BID. Behandlingen vil fortsette til bekreftet sykdomsprogresjon eller uakseptabel toksisitet.
Enzalutamid 160 mg daglig, oralt
abirateron 1000 mg daglig, oralt
prednison 5 mg to ganger daglig, oralt

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Total overlevelse (OS)
Tidsramme: Inntil 5 år etter behandling
Total overlevelse er definert som tiden fra studieregistrering til død på grunn av en hvilken som helst årsak.
Inntil 5 år etter behandling

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Antall deltakere som har opplevd minst én toksisitet (definert som en grad 3 eller høyere bivirkning som anses som minst mulig relatert til behandling)
Tidsramme: Inntil 5 år etter behandling
Antall deltakere som har opplevd minst én toksisitet (definert som en grad 3 eller høyere uønsket hendelse som anses som minst mulig relatert til behandling)
Inntil 5 år etter behandling
Nedgang i prostataspesifikt antigen (PSA)
Tidsramme: Inntil 5 år etter behandling
Inntil 5 år etter behandling
Progresjonsfri overlevelse (PFS)
Tidsramme: Inntil 5 år etter behandling
Inntil 5 år etter behandling
Objektiv responsrate
Tidsramme: Inntil 5 år etter behandling
Inntil 5 år etter behandling
Radiografisk progresjonsfri overlevelse (rPFS)
Tidsramme: Inntil 5 år etter behandling
Inntil 5 år etter behandling
Tumorbelastning og beinaktivitet
Tidsramme: Inntil 5 år etter behandling
Inntil 5 år etter behandling

Samarbeidspartnere og etterforskere

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

Etterforskere

  • Studiestol: Michael Morris, M.D., Memorial Sloan Kettering Cancer Center

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)

22. januar 2014

Primær fullføring (Faktiske)

2. november 2018

Studiet fullført (Antatt)

31. august 2024

Datoer for studieregistrering

Først innsendt

20. september 2013

Først innsendt som oppfylte QC-kriteriene

20. september 2013

Først lagt ut (Antatt)

24. september 2013

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

28. september 2023

Siste oppdatering sendt inn som oppfylte QC-kriteriene

13. september 2023

Sist bekreftet

1. september 2023

Mer informasjon

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. .

Kliniske studier på enzalutamid

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