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Fulvestrant og/eller Anastrozol ved behandling av postmenopausale pasienter med stadium II-III brystkreft som gjennomgår kirurgi

4. juni 2026 oppdatert av: Alliance for Clinical Trials in Oncology

Alternative tilnærminger for klinisk stadium II eller III østrogenreseptorpositiv brystkreft neoadjuvant behandling (ALTERNATIV) hos postmenopausale kvinner: En fase III-studie

Studien utføres for å finne ut om neoadjuvant endokrin terapi med fulvestrant eller kombinasjonen av anastrozol og fulvestrant, er bedre enn anastrozol når det gis før operasjon for å krympe kreften og stoppe den fra å vokse. Anastrozol hemmer tumorvekst ved å redusere nivåene av østrogen og har blitt godkjent av Food and Drug Administration (FDA) i USA for bruk etter kirurgi for postmenopausale kvinner med østrogenreseptorpositiv brystkreft. Det regnes også som en standard for omsorg å gi anastrozol i noen måneder før operasjon for å krympe svulsten. Fulvestrant hemmer tumorcellevekst ved å redusere nivåene av østrogenreseptor i tumorcellen. Det er ikke godkjent av FDA for bruk hos kvinner med tidlig brystkreft før eller etter operasjonen, men er godkjent av FDA for pasienter med avansert (stadium 4) østrogenreseptorpositiv brystkreft som har spredt seg til andre deler av kroppen.

Studieoversikt

Status

Aktiv, ikke rekrutterende

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Denne kliniske studien ble designet for å undersøke de patologiske resultatene til pasienter hvis neoadjuvante behandlingsforløp bestemmes ved bruk av en tidlig markør for endokrin resistens (nemlig Ki67 etter 4 eller 12 uker med neoadjuvant terapi), samt å vurdere klinisk utfall av pasienter hvis sykdomsbyrde etter fullført neoadjuvant endokrin terapi er klassifisert som modifisert PEPI 0.

De primære og sekundære målene for studien er beskrevet nedenfor.

Primære mål:

For å bestemme om fulvestrant administrert i 24 uker som neoadjuvant endokrin behandling reduserer andelen endokrine resistente svulster* i forhold til pasienter behandlet med anastrozol.
For å bestemme om fulvestrant i kombinasjon med anastrozol, administrert i 24 uker som neoadjuvant endokrin behandling, reduserer andelen endokrinresistente svulster* i forhold til pasienter behandlet med anastrozol.
For å vurdere om 5-års RFS-raten blant kvinner med en modifisert preoperativ endokrin prognostisk indeks (PEPI) score på 0 etter 24 uker med neoadjuvant anastrozolbehandling er minst 95 %.
For å vurdere om 5-års RFS-frekvensen blant kvinner med en modifisert PEPI-skåre på 0 etter 24 uker med neoadjuvant fulvestrant, eller fulvestrant i kombinasjon med anastrozol, er minst 95 %. Merk at dette objektivet kun vil bli testet hvis den valgte fulvestrantarmen ble vist å være overlegen anastrozol i mål 1 eller 2.

Endokrin resistent svulst er definert av ett av følgende kriterier*:

Ki67> 10 % etter 4 uker på neoadjuvant endokrin behandling
Ki67> 10 % etter 12 uker på neoadjuvant endokrin behandling
Progressiv sykdom er dokumentert når som helst under neoadjuvant endokrin behandling
Kirurgiske funn 22-24 uker etter neoadjuvant endokrin terapi er slik at:
- pT-stadiet er 3/4
- positive lymfeknuter er tilstede eller Ki67 > 2,7 % (dvs. modifisert PEPI-score som ikke er 0)
Seponert neoadjuvant endokrin behandling uansett årsak

Sekundære mål:

For å vurdere om 5-års RFS-raten blant kvinner med en preoperativ endokrin prognostisk indeks PEPI-score på 0 etter 24 uker med neoadjuvant anastrozolbehandling er minst 95 %.
For å undersøke forskjellene i kirurgisk utfall, kliniske og radiologiske responsrater og sikkerhetsprofil mellom fulvestrant-armen og anastrozol-armen.
Å undersøke forskjellene i kirurgisk utfall, kliniske og radiologiske responsrater og sikkerhetsprofil mellom pasienter randomisert til fulvestrant i kombinasjon med anastrozol og de som er randomisert til anastrozol.
For å undersøke frekvensen av patologisk fullstendig respons (pCR) av 12 uker med neoadjuvant paklitaksel hos pasienter med endokrin resistent sykdom etter 4 uker eller 12 uker med neoadjuvant endokrin behandling (med enten fulvestrant eller anastrozol eller kombinasjonen av fulvestrant og anastrozol).
For å undersøke graden av patologisk fullstendig respons (pCR) blant de pasientene med endokrin resistent sykdom, etter 4 uker eller 12 uker med neoadjuvant endokrin behandling (med enten fulvestrant eller anastrozol eller kombinasjonen av fulvestrant og anastrozol), som velger å ikke få neoadjuvant paklitaksel, men en annen standard neoadjuvans-taksan og/eller antracyklinholdig kur eller CMF.
For å oppsummere frekvensen av alvorlige (NCI CTCAE grad > 3) bivirkninger som oppstår ved administrering av paklitaksel i neoadjuvant setting.
For å vurdere RFS for pasienter med endokrine resistente svulster definert som: 1) Ki67 > 10 % ved uke 4, 2) Ki67 > 10 % ved uke 12 og 3) modifisert PEPI-score på ikke-null på neoadjuvant endokrin terapi, med alle tre gruppene kombinert eller separert.

Studietype

Intervensjonell

Registrering (Faktiske)

1473

Fase

Fase 3

Kontakter og plasseringer

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

Studiesteder

Forente stater
- Alabama
  - Birmingham, Alabama, Forente stater, 35233
    - University of Alabama at Birmingham Cancer Center
  - Mobile, Alabama, Forente stater, 36688
    - University of South Alabama Mitchell Cancer Institute
- Alaska
  - Anchorage, Alaska, Forente stater, 98508
    - Anchorage Associates in Radiation Medicine
  - Anchorage, Alaska, Forente stater, 99508
    - Alaska Breast Care and Surgery LLC
  - Anchorage, Alaska, Forente stater, 99508
    - Alaska Oncology and Hematology LLC
  - Anchorage, Alaska, Forente stater, 99508
    - Alaska Women's Cancer Care
  - Anchorage, Alaska, Forente stater, 99508
    - Anchorage Oncology Centre
  - Anchorage, Alaska, Forente stater, 99508
    - Katmai Oncology Group
  - Anchorage, Alaska, Forente stater, 99508
    - Providence Alaska Medical Center
  - Anchorage, Alaska, Forente stater, 99504
    - Anchorage Radiation Therapy Center
  - Anchorage, Alaska, Forente stater, 99508
    - Alaska Regional Hospital
- Arizona
  - Phoenix, Arizona, Forente stater, 85054
    - Mayo Clinic Hospital
  - Phoenix, Arizona, Forente stater, 85004
    - University of Arizona Cancer Center at Saint Joseph's
  - Scottsdale, Arizona, Forente stater, 85259
    - Mayo Clinic in Arizona
  - Tucson, Arizona, Forente stater, 85719
    - Banner University Medical Center - Tucson
  - Tucson, Arizona, Forente stater, 85719
    - University of Arizona Cancer Center-North Campus
  - Yuma, Arizona, Forente stater, 85364
    - Yuma Cancer Center
- Arkansas
  - Fort Smith, Arkansas, Forente stater, 72903
    - Mercy Hospital Fort Smith
  - Hot Springs, Arkansas, Forente stater, 71913
    - CHI Saint Vincent Cancer Center Hot Springs
  - Jonesboro, Arkansas, Forente stater, 72401
    - Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
  - Rogers, Arkansas, Forente stater, 72758
    - Highlands Oncology Group-Rogers
- California
  - 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
  - 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
  - Castro Valley, California, Forente stater, 94546
    - Valley Medical Oncology Consultants-Castro Valley
  - Clovis, California, Forente stater, 93611
    - Community Cancer Institute
  - Clovis, California, Forente stater, 93611
    - University Oncology Associates
  - 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
    - Valley Medical Oncology Consultants-Fremont
  - Fremont, California, Forente stater, 94538
    - Palo Alto Medical Foundation-Fremont
  - Fresno, California, Forente stater, 93720
    - Kaiser Permanente-Fresno
  - Fullerton, California, Forente stater, 92835
    - Saint Jude Medical Center
  - Loma Linda, California, Forente stater, 92354
    - Loma Linda University 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
  - 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
    - Tom K Lee Inc
  - Oakland, California, Forente stater, 94609
    - Bay Area Tumor Institute
  - Palo Alto, California, Forente stater, 94301
    - Palo Alto Medical Foundation Health Care
  - Pleasant Hill, California, Forente stater, 94523
    - East Bay Medical Oncology Hematology Medical Associates Inc-Pleasant Hill
  - 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
  - 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, 95814
    - Kaiser Permanente Downtown Commons
  - Sacramento, California, Forente stater, 95823
    - Kaiser Permanente-South Sacramento
  - Sacramento, California, Forente stater, 95825
    - Kaiser Permanente - Sacramento
  - San Francisco, California, Forente stater, 94115
    - Kaiser Permanente-San Francisco
  - San Francisco, California, Forente stater, 94115
    - California Pacific Medical Center-Pacific Campus
  - San Jose, California, Forente stater, 95119
    - Kaiser Permanente-Santa Teresa-San Jose
  - San Leandro, California, Forente stater, 94577
    - Kaiser Permanente San Leandro
  - 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
  - St. Helena, California, Forente stater, 94574
    - Saint Helena Hospital
  - 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
    - 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, 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
  - Colorado Springs, Colorado, Forente stater, 80920
    - Memorial Hospital North
  - 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
  - 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
  - Fairfield, Connecticut, Forente stater, 06824
    - Smilow Cancer Hospital Care Center-Fairfield
  - Guilford, Connecticut, Forente stater, 06437
    - Yale-New Haven Shoreline Medical Center
  - Hartford, Connecticut, Forente stater, 06105
    - Smilow Cancer Hospital Care Center at Saint Francis
  - 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
  - Torrington, Connecticut, Forente stater, 06790
    - Smilow Cancer Hospital-Torrington Care Center
  - Trumbull, Connecticut, Forente stater, 06611
    - Smilow Cancer Hospital Care Center-Trumbull
  - Waterbury, Connecticut, Forente stater, 06708
    - Smilow Cancer Hospital-Waterbury Care Center
  - 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
    - 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 D.C., District of Columbia, Forente stater, 20010
    - MedStar Washington Hospital Center
  - Washington D.C., District of Columbia, Forente stater, 20007
    - MedStar Georgetown University Hospital
- Florida
  - Clearwater, Florida, Forente stater, 33756
    - Morton Plant Hospital
  - Jacksonville, Florida, Forente stater, 32207
    - Baptist MD Anderson Cancer Center
- Georgia
  - Athens, Georgia, Forente stater, 30607
    - University Cancer and Blood Center LLC
  - Augusta, Georgia, Forente stater, 30912
    - Augusta University Medical Center
  - Augusta, Georgia, Forente stater, 30901
    - Augusta Oncology Associates PC-D'Antignac
  - Augusta, Georgia, Forente stater, 30909
    - Augusta Oncology Associates PC-Wheeler
  - Columbus, Georgia, Forente stater, 31904
    - John B Amos Cancer Center
  - Decatur, Georgia, Forente stater, 30033
    - Dekalb Medical Center
- Hawaii
  - Honolulu, Hawaii, Forente stater, 96819
    - Kaiser Permanente Moanalua Medical Center
- 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
  - 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, 60637
    - University of Chicago Comprehensive Cancer Center
  - Chicago, Illinois, Forente stater, 60612
    - University of Illinois
  - Chicago, Illinois, Forente stater, 60608
    - Mount Sinai Hospital Medical Center
  - Chicago, Illinois, Forente stater, 60625
    - Swedish Covenant Hospital
  - Chicago, Illinois, Forente stater, 60657
    - Advocate Illinois Masonic Medical Center
  - 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
  - Evanston, Illinois, Forente stater, 60202
    - Saint Francis 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
  - Kankakee, Illinois, Forente stater, 60901
    - Presence Saint Mary's Hospital
  - Kewanee, Illinois, Forente stater, 61443
    - Illinois CancerCare-Kewanee Clinic
  - 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
  - Monmouth, Illinois, Forente stater, 61462
    - Illinois CancerCare-Monmouth
  - Mount Vernon, Illinois, Forente stater, 62864
    - Good Samaritan Regional Health Center
  - New Lenox, Illinois, Forente stater, 60451
    - UC Comprehensive Cancer Center at Silver Cross
  - Normal, Illinois, Forente stater, 61761
    - Community Cancer Center Foundation
  - Oak Lawn, Illinois, Forente stater, 60453-2699
    - Advocate Christ Medical Center
  - 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
  - Ottawa, Illinois, Forente stater, 61350
    - Ottawa Regional Hospital and Healthcare Center
  - 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
  - Peoria, Illinois, Forente stater, 61614
    - Proctor Hospital
  - 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
  - Skokie, Illinois, Forente stater, 60076
    - North Shore 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
    - 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
  - Crown Point, Indiana, Forente stater, 46307
    - Michiana Hematology Oncology PC-Crown Point
  - 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
  - Fishers, Indiana, Forente stater, 46037
    - IU Health Central Indiana Cancer Centers-Fishers
  - Fort Wayne, Indiana, Forente stater, 46805
    - Parkview Hospital Randallia
  - Fort Wayne, Indiana, Forente stater, 46845
    - Parkview Regional Medical Center
  - 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, 46219
    - IU Health Central Indiana Cancer Centers-East
  - Indianapolis, Indiana, Forente stater, 46290
    - Springmill Medical Center
  - Indianapolis, Indiana, Forente stater, 46202
    - IU Health Methodist Hospital
  - 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
    - Franciscan Saint Anthony Health-Michigan City
  - 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
  - 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
  - Westville, Indiana, Forente stater, 46391
    - Michiana Hematology Oncology PC-Westville
- Iowa
  - 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, 50314
    - Mercy Medical Center - Des Moines
  - Des Moines, Iowa, Forente stater, 50314
    - Medical Oncology and Hematology Associates-Laurel
  - Sioux City, Iowa, Forente stater, 51101
    - Siouxland Regional Cancer Center
  - Sioux City, Iowa, Forente stater, 51102
    - Mercy Medical Center-Sioux City
  - Sioux City, Iowa, Forente stater, 51104
    - Saint Luke's Regional Medical Center
  - West Des Moines, Iowa, Forente stater, 50266
    - Mercy Medical Center-West Lakes
- Kansas
  - Garden City, Kansas, Forente stater, 67846
    - Central Care Cancer Center - Garden City
  - Great Bend, Kansas, Forente stater, 67530
    - Central Care Cancer Center - Great Bend
  - Lenexa, Kansas, Forente stater, 66219
    - Kansas Institute of Medicine Cancer and Blood Center
  - Lenexa, Kansas, Forente stater, 66219
    - Minimally Invasive Surgery Hospital
  - Overland Park, Kansas, Forente stater, 66209
    - Menorah Medical Center
  - Overland Park, Kansas, Forente stater, 66213
    - Saint Luke's South Hospital
  - Topeka, Kansas, Forente stater, 66606
    - Cotton O'Neil Cancer Center / Stormont Vail Health
- 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
  - Edgewood, Kentucky, Forente stater, 41017
    - Saint Elizabeth Medical Center South
  - Fort Thomas, Kentucky, Forente stater, 41075
    - Saint Elizabeth Fort Thomas
  - 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
- 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, 21237
    - MedStar Franklin Square Medical Center/Weinberg Cancer Institute
  - Baltimore, Maryland, Forente stater, 21215
    - Sinai Hospital of Baltimore
  - Baltimore, Maryland, Forente stater, 21204
    - Greater Baltimore Medical Center
  - Baltimore, Maryland, Forente stater, 21218
    - MedStar Union Memorial Hospital
  - Baltimore, Maryland, Forente stater, 21239
    - MedStar Good Samaritan Hospital
  - Bethesda, Maryland, Forente stater, 20889-5600
    - Walter Reed National Military Medical Center
  - Cumberland, Maryland, Forente stater, 21502
    - Western Maryland Regional Medical Center
  - Glen Burnie, Maryland, Forente stater, 21061
    - UM Baltimore Washington Medical Center/Tate Cancer Center
  - Randallstown, Maryland, Forente stater, 21133
    - Northwest Hospital Center
  - Salisbury, Maryland, Forente stater, 21801
    - Peninsula Regional Medical Center
  - Silver Spring, Maryland, Forente stater, 20910
    - Holy Cross Hospital
  - Westminster, Maryland, Forente stater, 21157
    - William E Kahlert Regional Cancer Center/Sinai Hospital
- Massachusetts
  - 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
  - Framingham, Massachusetts, Forente stater, 01702
    - MetroWest Medical Center-Framingham Union Hospital
  - Springfield, Massachusetts, Forente stater, 01104
    - Mercy Medical Center
- Michigan
  - Ann Arbor, Michigan, Forente stater, 48106
    - Saint Joseph Mercy Hospital
  - Battle Creek, Michigan, Forente stater, 49017
    - Bronson Battle Creek
  - Brighton, Michigan, Forente stater, 48114
    - Saint Joseph Mercy Brighton
  - Brighton, Michigan, Forente stater, 48114
    - IHA Hematology Oncology Consultants-Brighton
  - 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
  - Dearborn, Michigan, Forente stater, 48124
    - Beaumont Hospital ? Dearborn
  - Detroit, Michigan, Forente stater, 48202
    - Henry Ford Hospital
  - Detroit, Michigan, Forente stater, 48236
    - Ascension Saint John Hospital
  - East China, 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
  - Grand Rapids, Michigan, Forente stater, 49503
    - Spectrum Health at Butterworth Campus
  - Grand Rapids, Michigan, Forente stater, 49503
    - Helen DeVos Children's Hospital at Spectrum Health
  - Grand Rapids, Michigan, Forente stater, 49503
    - Mercy Health Saint Mary's
  - Grosse Pointe, Michigan, Forente stater, 48230
    - William Beaumont Hospital-Grosse Point
  - Grosse Pointe Woods, Michigan, Forente stater, 48236
    - Academic Hematology Oncology Specialists
  - 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
  - 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
  - Muskegon, Michigan, Forente stater, 49444
    - Mercy Health Mercy Campus
  - Niles, Michigan, Forente stater, 49120
    - Lakeland Hospital Niles
  - Novi, Michigan, Forente stater, 48374
    - Ascension Providence Hospitals - Novi
  - 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
  - Reed City, Michigan, Forente stater, 49677
    - Spectrum Health Reed City Hospital
  - 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
    - Ascension Saint Mary's Hospital
  - 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
  - Southfield, Michigan, Forente stater, 48075
    - Ascension Providence Hospitals - Southfield
  - 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
    - Ascension Saint Joseph Hospital
  - Traverse City, Michigan, Forente stater, 49684
    - Munson Medical Center
  - 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
  - West Branch, Michigan, Forente stater, 48661
    - Saint Mary's Oncology/Hematology Associates of West Branch
  - Wyoming, Michigan, Forente stater, 49519
    - Metro Health Hospital
  - Ypsilanti, Michigan, Forente stater, 48106
    - Huron Gastroenterology PC
  - Ypsilanti, Michigan, Forente stater, 48197
    - IHA Hematology Oncology Consultants-Ann Arbor
- Minnesota
  - 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
  - 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
  - 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 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
  - Wyoming, Minnesota, Forente stater, 55092
    - Fairview Lakes Medical Center
- Mississippi
  - Columbus, Mississippi, Forente stater, 39705
    - Baptist Memorial Hospital and Cancer Center-Golden Triangle
  - Grenada, Mississippi, Forente stater, 38901
    - Baptist Cancer Center-Grenada
  - New Albany, Mississippi, Forente stater, 38652
    - Baptist Memorial Hospital and Cancer Center-Union County
  - Oxford, Mississippi, Forente stater, 38655
    - Baptist Memorial Hospital and Cancer Center-Oxford
  - Southhaven, Mississippi, Forente stater, 38671
    - Baptist Memorial Hospital and Cancer Center-Desoto
- Missouri
  - Ballwin, Missouri, Forente stater, 63011
    - Saint Louis Cancer and Breast Institute-Ballwin
  - 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
  - City of Saint Peters, Missouri, Forente stater, 63376
    - Siteman Cancer Center at Saint Peters 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, 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
  - Lee's Summit, Missouri, Forente stater, 64086
    - Saint Luke's East - 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
    - Heartland Regional Medical Center
  - Sainte Genevieve, Missouri, Forente stater, 63670
    - Sainte Genevieve County Memorial Hospital
  - Springfield, Missouri, Forente stater, 65807
    - CoxHealth South Hospital
  - Springfield, Missouri, Forente stater, 65804
    - Mercy Hospital Springfield
  - St Louis, Missouri, Forente stater, 63110
    - Washington University School of Medicine
  - St Louis, Missouri, Forente stater, 63129
    - Siteman Cancer Center-South County
  - St Louis, Missouri, Forente stater, 63136
    - Siteman Cancer Center at Christian Hospital
  - St Louis, Missouri, Forente stater, 63131
    - Missouri Baptist Medical Center
  - St Louis, Missouri, Forente stater, 63141
    - Mercy Hospital Saint Louis
  - St Louis, Missouri, Forente stater, 63128
    - Mercy Hospital South
  - St Louis, Missouri, Forente stater, 63109
    - Saint Louis Cancer and Breast Institute-South City
  - 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
- 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, 68506
    - Nebraska Hematology and Oncology
  - Lincoln, Nebraska, Forente stater, 68510
    - Nebraska Cancer Research Center
  - Lincoln, Nebraska, Forente stater, 68510
    - Saint Elizabeth Regional Medical Center
  - Lincoln, Nebraska, Forente stater, 68510
    - Southeast Nebraska Cancer Center
  - Norfolk, Nebraska, Forente stater, 68701
    - Faith Regional Health Services Carson Cancer Center
  - North Platte, Nebraska, Forente stater, 69101
    - Great Plains Health Callahan Cancer 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, 68124
    - Nebraska Cancer Specialists - Omaha
  - Omaha, Nebraska, Forente stater, 68130
    - Oncology Hematology West PC
  - Omaha, Nebraska, Forente stater, 68122
    - Hematology and Oncology Consultants PC
  - Papillion, Nebraska, Forente stater, 68046
    - Midlands Community Hospital
  - Scottsbluff, Nebraska, Forente stater, 69361
    - Regional West Medical Center Cancer Center
- 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, 89109
    - Sunrise Hospital and 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 - Town Center
  - Las Vegas, Nevada, Forente stater, 89144
    - Comprehensive Cancer Centers of Nevada-Summerlin
  - Las Vegas, Nevada, Forente stater, 89148
    - Comprehensive Cancer Centers of Nevada
  - Las Vegas, Nevada, Forente stater, 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, 89103
    - Hope Cancer Care of Nevada
  - 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
- New Hampshire
  - Concord, New Hampshire, Forente stater, 03301
    - New Hampshire Oncology Hematology PA-Concord
  - 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
- New Jersey
  - Hackensack, New Jersey, Forente stater, 07601
    - Hackensack University Medical Center
  - Mount Holly, New Jersey, Forente stater, 08060
    - Virtua Memorial
  - Sewell, New Jersey, Forente stater, 08080
    - Kennedy Health Systems-Cancer Center
  - Teaneck, New Jersey, Forente stater, 07666
    - Holy Name Hospital
  - Vineland, New Jersey, Forente stater, 08360
    - Inspira Medical Center Vineland
  - Voorhees Township, New Jersey, Forente stater, 08043
    - Virtua Voorhees
  - Woodbury, New Jersey, Forente stater, 08096
    - Inspira Medical Center Woodbury
- New Mexico
  - Albuquerque, New Mexico, Forente stater, 87102
    - University of New Mexico Cancer Center
  - Albuquerque, New Mexico, Forente stater, 87109
    - New Mexico Oncology Hematology Consultants
  - Albuquerque, New Mexico, Forente stater, 87110
    - Presbyterian Kaseman Hospital
  - Rio Rancho, New Mexico, Forente stater, 87124
    - Presbyterian Rust Medical Center/Jorgensen Cancer Center
  - Santa Fe, New Mexico, Forente stater, 87505
    - Christus Saint Vincent Regional Cancer Center
- New York
  - Brooklyn, New York, Forente stater, 11203
    - State University of New York Downstate Medical Center
  - Buffalo, New York, Forente stater, 14263
    - Roswell Park Cancer Institute
  - Elmira, New York, Forente stater, 14905
    - Arnot Ogden Medical Center/Falck Cancer Center
  - Glens Falls, New York, Forente stater, 12801
    - Glens Falls Hospital
  - 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, 10003
    - Mount Sinai Union Square
  - Rochester, New York, Forente stater, 14642
    - University of Rochester
  - Syracuse, New York, Forente stater, 13210
    - State University of New York Upstate Medical University
  - Syracuse, New York, Forente stater, 13215
    - SUNY Upstate Medical Center-Community Campus
  - The Bronx, New York, Forente stater, 10461
    - Montefiore Medical Center-Einstein Campus
  - The Bronx, New York, Forente stater, 10467
    - Montefiore Medical Center - Moses Campus
  - The Bronx, New York, Forente stater, 10461
    - Montefiore Medical Center-Weiler Hospital
  - White Plains, New York, Forente stater, 10601
    - Dickstein Cancer Treatment Center
- 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
  - Hillsborough, North Carolina, Forente stater, 27278
    - University of North Carolina-Hillsborough Campus
  - 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
  - Statesville, North Carolina, Forente stater, 28677
    - Iredell Memorial Hospital
  - Wilson, North Carolina, Forente stater, 27893
    - Southeastern Medical Oncology Center-Wilson
  - Winston-Salem, North Carolina, Forente stater, 27157
    - Wake Forest University Health Sciences
- Ohio
  - 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
  - Boardman, Ohio, Forente stater, 44512
    - Saint Elizabeth Boardman Hospital
  - Centerville, Ohio, Forente stater, 45459
    - Miami Valley Hospital South
  - Centerville, Ohio, Forente stater, 45459
    - Dayton Physicians LLC-Miami Valley South
  - Chardon, Ohio, Forente stater, 44024
    - Geauga Hospital
  - 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, 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
  - 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
  - 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
  - Elyria, Ohio, Forente stater, 44035
    - Mercy Cancer Center-Elyria
  - 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
  - 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
  - Mayfield Heights, Ohio, Forente stater, 44124
    - UH Seidman Cancer Center at Landerbrook Health Center
  - Mentor, Ohio, Forente stater, 44060
    - UH Seidman Cancer Center at Lake Health Mentor Campus
  - Middleburg Heights, Ohio, Forente stater, 44130
    - UH Seidman Cancer Center at Southwest 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
  - Parma, Ohio, Forente stater, 44129
    - University Hospitals Parma Medical Center
  - Portsmouth, Ohio, Forente stater, 45662
    - Southern Ohio Medical Center
  - Sandusky, Ohio, Forente stater, 44870
    - UH Seidman Cancer Center at Firelands Regional 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
  - Wadsworth, Ohio, Forente stater, 44281
    - University Hospitals Sharon Health Center
  - Warren, Ohio, Forente stater, 44484
    - Saint Joseph Warren Hospital
  - Westerville, Ohio, Forente stater, 43081
    - Saint Ann's Hospital
  - Westlake, Ohio, Forente stater, 44145
    - UH Seidman Cancer Center at Saint John Medical Center
  - Westlake, Ohio, Forente stater, 44145
    - UHHS-Westlake Medical Center
  - Wpafb, Ohio, Forente stater, 45433-5529
    - Wright-Patterson Medical Center
  - Youngstown, Ohio, Forente stater, 44501
    - Saint Elizabeth Youngstown Hospital
  - Zanesville, Ohio, Forente stater, 43701
    - Genesis Healthcare System Cancer Care Center
- Oklahoma
  - Lawton, Oklahoma, Forente stater, 73505
    - Cancer Centers of Southwest Oklahoma Research
  - Oklahoma City, Oklahoma, Forente stater, 73104
    - University of Oklahoma Health Sciences Center
  - Oklahoma City, Oklahoma, Forente stater, 73120
    - Mercy Hospital Oklahoma City
- 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
  - Gresham, Oregon, Forente stater, 97030
    - Legacy Mount Hood Medical Center
  - Newberg, Oregon, Forente stater, 97132
    - Providence Newberg Medical Center
  - Ontario, Oregon, Forente stater, 97914
    - Saint Alphonsus Medical Center-Ontario
  - 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
  - Redmond, Oregon, Forente stater, 97756
    - Saint Charles Health System-Redmond
  - Tualatin, Oregon, Forente stater, 97062
    - Legacy Meridian Park Hospital
- Pennsylvania
  - Allentown, Pennsylvania, Forente stater, 18103
    - Lehigh Valley Hospital-Cedar Crest
  - Beaver, Pennsylvania, Forente stater, 15009
    - UPMC-Heritage Valley Health System Beaver
  - Bethlehem, Pennsylvania, Forente stater, 18017
    - Lehigh Valley Hospital - Muhlenberg
  - Chadds Ford, Pennsylvania, Forente stater, 19317
    - Christiana Care Health System-Concord Health Center
  - Danville, Pennsylvania, Forente stater, 17822
    - Geisinger Medical Center
  - East Stroudsburg, Pennsylvania, Forente stater, 18301
    - Pocono Medical Center
  - Greensburg, Pennsylvania, Forente stater, 15601
    - UPMC Cancer Centers - Arnold Palmer Pavilion
  - Hazleton, Pennsylvania, Forente stater, 18201
    - Geisinger Medical Center-Cancer Center Hazleton
  - Hazleton, Pennsylvania, Forente stater, 18201
    - Lehigh Valley Hospital-Hazleton
  - Hershey, Pennsylvania, Forente stater, 17033-0850
    - Penn State Milton S Hershey Medical Center
  - 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 Township, Pennsylvania, Forente stater, 15108
    - UPMC-Coraopolis/Heritage Valley Radiation Oncology
  - Pittsburgh, Pennsylvania, Forente stater, 15212
    - Allegheny General Hospital
  - Pittsburgh, Pennsylvania, Forente stater, 15224
    - West Penn 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
  - Pottsville, Pennsylvania, Forente stater, 17901
    - Geisinger Cancer Services-Pottsville
  - Scranton, Pennsylvania, Forente stater, 18510
    - Community Medical Center
  - Selinsgrove, Pennsylvania, Forente stater, 17870
    - Geisinger Medical Oncology-Selinsgrove
  - Seneca, Pennsylvania, Forente stater, 16346
    - UPMC Cancer Center at UPMC Northwest
  - State College, Pennsylvania, Forente stater, 16801
    - Geisinger Medical Group
  - 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
- Rhode Island
  - Providence, Rhode Island, Forente stater, 02905
    - Women and Infants Hospital
  - Warwick, Rhode Island, Forente stater, 02886
    - Kent Hospital
- South Carolina
  - Anderson, South Carolina, Forente stater, 29621
    - AnMed Health Cancer Center
  - Charleston, South Carolina, Forente stater, 29425
    - Medical University of 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
    - Lowcountry Hematology Oncology PA-West Ashley
  - Charleston, South Carolina, Forente stater, 29414
    - Charleston Hematology Oncology Associates PA-Saint Francis
  - Easley, South Carolina, Forente stater, 29640
    - Greenville Health System Cancer Institute-Easley
  - Gaffney, South Carolina, Forente stater, 29341
    - Gibbs Cancer Center-Gaffney
  - Greenville, South Carolina, Forente stater, 29607
    - Saint Francis Cancer Center
  - Greenville, South Carolina, Forente stater, 29601
    - Saint Francis Hospital
  - Greenville, South Carolina, Forente stater, 29601
    - Greenville Health System Cancer Institute-Andrews
  - 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, 29651
    - Gibbs Cancer Center-Pelham
  - 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
  - Mt. Pleasant, South Carolina, Forente stater, 29464
    - Lowcountry Hematology Oncology PA-Mount Pleasant
  - Rock Hill, South Carolina, Forente stater, 29732
    - Carolina Blood and Cancer Care Associates PA
  - Seneca, South Carolina, Forente stater, 29672
    - Greenville Health System Cancer Institute-Seneca
  - Spartanburg, South Carolina, Forente stater, 29303
    - Spartanburg Medical Center
  - Spartanburg, South Carolina, Forente stater, 29307
    - Greenville Health System Cancer Institute-Spartanburg
  - Union, South Carolina, Forente stater, 29379
    - MGC Hematology Oncology-Union
- Tennessee
  - Chattanooga, Tennessee, Forente stater, 37404
    - Memorial Hospital
  - Hixson, Tennessee, Forente stater, 37343
    - Pulmonary Medicine Center of Chattanooga-Hixson
  - Memphis, Tennessee, Forente stater, 38120
    - Baptist Memorial Hospital and Cancer Center-Memphis
  - Memphis, Tennessee, Forente stater, 38120
    - Baptist Memorial Hospital for Women
  - Memphis, Tennessee, Forente stater, 38120
    - Family Cancer Center-Memphis
  - Nashville, Tennessee, Forente stater, 37208
    - Meharry Medical College
  - Nashville, Tennessee, Forente stater, 37203
    - Nashville Breast Center
  - Ooltewah, Tennessee, Forente stater, 37363
    - Memorial GYN Plus
- Texas
  - Abilene, Texas, Forente stater, 79601
    - Hendrick Medical Center
  - Austin, Texas, Forente stater, 78702
    - Austin Cancer Centers-Central Austin
  - Austin, Texas, Forente stater, 78705
    - Austin Cancer Centers-Saint David's
  - Austin, Texas, Forente stater, 78759
    - Austin Cancer Centers-Northwest
  - Austin, Texas, Forente stater, 78705
    - Austin Cancer Centers-Central Park
  - Bryan, Texas, Forente stater, 77802
    - Saint Joseph Regional Cancer Center
  - Dallas, Texas, Forente stater, 75235
    - Parkland Memorial Hospital
  - Dallas, Texas, Forente stater, 75390
    - UT Southwestern/Simmons Cancer Center-Dallas
  - El Paso, Texas, Forente stater, 79905
    - Texas Tech University Health Sciences Center-El Paso
  - Fort Worth, Texas, Forente stater, 76104
    - UT Southwestern/Simmons Cancer Center-Fort Worth
  - Houston, Texas, Forente stater, 77030
    - M D Anderson Cancer Center
  - Houston, Texas, Forente stater, 77094
    - MD Anderson in Katy
  - Houston, Texas, Forente stater, 77030
    - Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
  - Houston, Texas, Forente stater, 77030
    - Ben Taub General Hospital
  - Laredo, Texas, Forente stater, 78041
    - Doctor's Hospital of Laredo
  - Nassau Bay, Texas, Forente stater, 77058
    - MD Anderson League City
  - Sugar Land, Texas, Forente stater, 77478
    - MD Anderson in Sugar Land
  - The Woodlands, Texas, Forente stater, 77384
    - MD Anderson in The Woodlands
- Vermont
  - Berlin Corners, Vermont, Forente stater, 05602
    - Central Vermont Medical Center/National Life Cancer Treatment
  - Burlington, Vermont, Forente stater, 05401
    - University of Vermont Medical Center
  - Burlington, Vermont, Forente stater, 05405
    - University of Vermont and State Agricultural College
- Virginia
  - Fairfax, Virginia, Forente stater, 22031
    - IMG Hematology Oncology 8501
  - Fredericksburg, Virginia, Forente stater, 22408
    - Hematology Oncology Associates of Fredericksburg Inc
  - Richmond, Virginia, Forente stater, 23298
    - Virginia Commonwealth University/Massey Cancer 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
  - Bellevue, Washington, Forente stater, 98005
    - Swedish Cancer Institute-Eastside Oncology Hematology
  - 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 Cancer Institute-Edmonds
  - Enumclaw, Washington, Forente stater, 98022
    - Saint Elizabeth Hospital
  - Everett, Washington, Forente stater, 98201
    - Providence Regional Cancer Partnership
  - Federal Way, Washington, Forente stater, 98003
    - Saint Francis Hospital
  - Issaquah, Washington, Forente stater, 98029
    - Swedish Cancer Institute-Issaquah
  - Kennewick, Washington, Forente stater, 99336
    - Kadlec Clinic Hematology and Oncology
  - Lacey, Washington, Forente stater, 98503
    - Providence Regional Cancer System-Lacey
  - Lakewood, Washington, Forente stater, 98499
    - Saint Clare Hospital
  - Longview, Washington, Forente stater, 98632
    - PeaceHealth Saint John Medical Center
  - Poulsbo, Washington, Forente stater, 98370
    - Harrison HealthPartners Hematology and Oncology-Poulsbo
  - 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, 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, 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, 98431
    - Madigan Army Medical Center
  - Tacoma, Washington, Forente stater, 98405
    - Franciscan Research Center-Northwest Medical Plaza
  - Vancouver, Washington, Forente stater, 98686
    - Legacy Salmon Creek Hospital
  - Vancouver, Washington, Forente stater, 98664
    - PeaceHealth Southwest Medical Center
  - Walla Walla, Washington, Forente stater, 99362
    - Providence Saint Mary Regional Cancer Center
  - Yakima, Washington, Forente stater, 98902
    - North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
  - Yelm, Washington, Forente stater, 98597
    - Providence Regional Cancer System-Yelm
- West Virginia
  - Charleston, West Virginia, Forente stater, 25304
    - West Virginia University Charleston Division
- Wisconsin
  - Antigo, Wisconsin, Forente stater, 54409
    - Langlade Hospital and Cancer Center
  - Burlington, Wisconsin, Forente stater, 53105
    - Aurora Cancer Care-Southern Lakes VLCC
  - 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
  - Janesville, Wisconsin, Forente stater, 53547
    - Mercy Health System
  - 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
  - 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
  - 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
  - Sheboygan, Wisconsin, Forente stater, 53081
    - Vince Lombardi Cancer Clinic-Sheboygan
  - Summit, Wisconsin, Forente stater, 53066
    - Aurora Medical Center in Summit
  - Two Rivers, Wisconsin, Forente stater, 54241
    - Vince Lombardi Cancer Clinic-Two Rivers
  - 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
  - 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
Puerto Rico
- - Bayamón, Puerto Rico, 00959-5060
    - Cancer Center-Metro Medical Center Bayamon
  - Manati, Puerto Rico, 00674
    - Doctors Cancer Center
  - San Juan, Puerto Rico, 00917
    - San Juan Community Oncology Group
  - San Juan, Puerto Rico, 00936
    - San Juan City Hospital

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

14 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Beskrivelse

Inklusjonskriterier:

Kvinne ≥18 år
Eastern Cooperative Oncology Group (ECOG) ytelsesstatus 0-2
Postmenopausal, verifisert av:
- post bilateral kirurgisk ooforektomi eller
- ingen spontan menstruasjon ≥ 1 år eller
- ingen menstruasjon i < 1 år med follikkelstimulerende hormon (FSH) og østradiolnivåer i postmenopausalt område, i henhold til institusjonelle standarder
Patologisk bekreftelse av invasiv brystkreft diagnostisert ved kjernenålbiopsi
Klinisk T2-T4c, enhver N, M0 invasiv brystkreft, av AJCC 7. utgave klinisk iscenesettelse, med målet om kirurgi for å fullføre utskjæring av svulsten i brystet og lymfeknuten. Primær svulst må være:
- håndgripelig
- dens største diameter er minst 2,0 cm ved fysisk undersøkelse eller ved radiologisk vurdering
Merk:
- Pasienter med kontralateralt duktalt karsinom in situ og/eller invasiv brystkreft er ikke kvalifisert.
- Pasienter med multisentrisk brystkreft (definert som mer enn én lesjon er invasiv brystkreft i samme bryst atskilt med ≥ 2 cm normalt brystvev er ikke kvalifisert.
Invasiv brystkreft er østrogenreseptorpositiv med en Allred-score på 6, 7 eller 8 i henhold til lokal institusjons standardprotokoll. Hvis en Allred Score ikke er rapportert i den diagnostiske patologirapporten, er ER-positivitet i > 66 % celler kvalifisert. Hvis ER-positivitet er ≤ 66 %, er fargingsintensiteten (svak, middels, sterk) nødvendig for å beregne Allred-score for å bestemme kvalifisering.
Invasiv brystkreft er Human Epidermal Growth Factor Receptor 2 (HER2) - En pasient anses å ha HER2 negativ brystkreft hvis ett av følgende gjelder:
- 0 eller 1+ av immunhistokjemi (IHC) og ISH ikke utført
- 0 eller 1+ ved IHC og ISH-forhold (HER2-genkopi/kromosom 17) < 2
- 2+ etter IHC og ISH-forhold (HER2-genkopi/kromosom 17) < 2
Dokumentasjon av mammografi og ultralyd (inkludert ductal carcinoma in situ (DCIS) og invasiv cancer) av det syke brystet utført innen 56 dager før registrering. Mammogram for det upåvirkede kontralaterale brystet er nødvendig innen 12 måneder før registrering.
Laboratorieverdier (≤ 14 dager før registrering):
1. Absolutt nøytrofiltall (ANC) > 1000/mm^3
2. Blodplateantall > 100 000/mm^3
3. Totalt bilirubin < 1,5 x øvre normalgrense (ULN)
4. Kreatinin < 1,5 x ULN
5. Serumalanintransaminase (ALT) < 2,5 x ULN
Vevsanskaffelse: Pasienten må godta å gi de nødvendige forskningsbiopsiene ved baseline, uke 4 og ved operasjonen for integrerte og integrerte biomarkører og korrelative studier.

Ekskluderingskriterier:

Premenopausal status
Inflammatorisk brystkreft definert som klinisk signifikant erytem i brystet og/eller dokumentert dermal lymfatisk invasjon (ikke direkte hudinvasjon av tumor eller peau d'oransje uten erytem).
En eksisjonsbiopsi av denne brystkreften.
Hormonerstatningsterapi av enhver type, megestrolacetat eller raloksifen innen en uke før registrering.
Tumor østrogenreseptor (ER) Allred score mellom 0-5 eller HER2 positiv av IHC (3+) eller amplifisert av FISH > 2,0.
Kirurgisk aksillær stadieinngrep før studiestart. Merk: Finnålaspirasjon (FNA) eller kjernenålbiopsi av aksillærknute er tillatt.
Klinisk eller radiografisk bevis på metastatisk sykdom. Metastatisk opparbeiding er ikke nødvendig, men anbefales for pasienter med klinisk stadium III sykdom. Merk: Involvering av isolert ipsilateral supraklavikulær node er tillatt.
Brystimplantater er kun kontraindisert hvis implantatet utelukker nødvendige forskningsbiopsier eller forstyrrer palpering av brystlesjonen.
Behandling for denne kreftsykdommen inkludert kirurgi, strålebehandling, kjemoterapi, bioterapi, hormonbehandling eller undersøkelsesmiddel før studiestart.
Anamnese med invasiv brystkreft eller kontralateral DCIS.

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
Aktiv komparator: Arm I (anastrozol) Pasienter får anastrozol daglig i 6 sykluser etterfulgt av kirurgi. En behandlingssyklus er 4 uker lang. Etter fullført analyse av endokrine resistente data, vil pasientene fortsette behandlingen som definert i protokollen.	Legemiddel: anastrozol Anastrozol 1 mg oral tablett Andre navn: Arimidex®
Aktiv komparator: Arm II (fulvestrant) Pasienter får fulvestrant på dag 1 og 15 i syklus 1 og dag 1 i syklus 2-6 etterfulgt av operasjon. En behandlingssyklus er 4 uker lang. Etter fullført analyse av endokrine resistente data, vil pasientene fortsette behandlingen som definert i protokollen.	Legemiddel: fulvestrant Fulvestrant 500 mg im Andre navn: Faslodex®
Aktiv komparator: Arm III (anastrozol og fulvestrant) Pasienter får anastrozol daglig i kombinasjon med fulvestrant på dag 1 og 15 i syklus 1, og på dag 1 i syklus 2-6 etterfulgt av kirurgi. En behandlingssyklus er 4 uker lang. Etter fullført analyse av endokrine resistente data, vil pasientene fortsette behandlingen som definert i protokollen.	Legemiddel: anastrozol Anastrozol 1 mg oral tablett Andre navn: Arimidex® Legemiddel: fulvestrant Fulvestrant 500 mg im Andre navn: Faslodex®

Hva måler studien?

Primære resultatmål

Resultatmål	Tidsramme
Hyppighet av endokrin resistent sykdom - (første fase) Tidsramme: Inntil 24 uker	Inntil 24 uker
Gjentaksfri overlevelse (RFS) - (andre fase) Tidsramme: Inntil 5 år	Inntil 5 år

Sekundære resultatmål

Resultatmål	Tidsramme
Patologisk fullstendig responsrate - (pCR rate) Tidsramme: Inntil 24 uker	Inntil 24 uker

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)

Etterforskere

Studiestol: Cynthia Ma, MD, PhD, Washington University School of Medicine

Publikasjoner og nyttige lenker

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

Generelle publikasjoner

Studierekorddatoer

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

Studer hoveddatoer

Studiestart (Faktiske)

27. februar 2014

Primær fullføring (Antatt)

1. april 2027

Studiet fullført (Antatt)

1. april 2027

Datoer for studieregistrering

Først innsendt

25. september 2013

Først innsendt som oppfylte QC-kriteriene

25. september 2013

Først lagt ut (Antatt)

1. oktober 2013

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

5. juni 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

4. juni 2026

Sist bekreftet

1. juni 2026

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

A011106
U10CA031946 (U.S. NIH-stipend/kontrakt)
NCI-2013-01340 (Registeridentifikator: Clinical Trial Reporting Program)

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. .

Fulvestrant og/eller Anastrozol ved behandling av postmenopausale pasienter med stadium II-III brystkreft som gjennomgår kirurgi

Alternative tilnærminger for klinisk stadium II eller III østrogenreseptorpositiv brystkreft neoadjuvant behandling (ALTERNATIV) hos postmenopausale kvinner: En fase III-studie

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

Tidsramme

Sekundære resultatmål

Resultatmål

Tidsramme

Samarbeidspartnere og etterforskere

Sponsor

Samarbeidspartnere

Etterforskere

Publikasjoner og nyttige lenker

Generelle publikasjoner

Studierekorddatoer

Studer hoveddatoer

Studiestart (Faktiske)

Primær fullføring (Antatt)

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 (Faktiske)

Siste oppdatering sendt inn som oppfylte QC-kriteriene

Sist bekreftet

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre