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S1505: Kombinasjonskjemoterapi eller gemcitabinhydroklorid og paklitakselalbuminstabilisert nanopartikkelformulering før kirurgi ved behandling av pasienter med kreft i bukspyttkjertelen som kan fjernes ved kirurgi

18. oktober 2022 oppdatert av: Southwest Oncology Group

En randomisert fase II-studie av perioperativ mFOLFIRINOX versus Gemcitabin/Nab-Paclitaxel som terapi for resektabelt pankreasadenokarsinom

Denne randomiserte fase II-studien studerer hvor godt fluorouracil, irinotekanhydroklorid og oksaliplatin (kombinasjonskjemoterapi) virker og sammenlignes med gemcitabinhydroklorid og paklitakselalbuminstabilisert nanopartikkelformulering før kirurgi ved behandling av pasienter med kreft i bukspyttkjertelen som kan fjernes ved kirurgi. Legemidler som brukes i kjemoterapi, som fluorouracil, irinotekanhydroklorid, oksaliplatin, gemcitabinhydroklorid og paklitakselalbuminstabilisert nanopartikkelformulering, virker på forskjellige måter for å stoppe veksten av tumorceller, enten ved å drepe cellene, ved å stoppe dem fra å dele seg, eller ved å hindre dem i å spre seg. Å gi mer enn ett medikament (kombinasjonskjemoterapi) kan drepe flere tumorceller. Det er ennå ikke kjent om kombinasjonskjemoterapi er mer effektiv enn gemcitabinhydroklorid og paklitakselalbuminstabilisert nanopartikkelformulering før kirurgi ved behandling av kreft i bukspyttkjertelen.

Studieoversikt

Detaljert beskrivelse

PRIMÆRE MÅL:

I. For å vurdere 2-års total overlevelse i hver behandlingsarm (fluorouracil, irinotekanhydroklorid og oksaliplatin [modifisert (m)FOLFIRINOX] og gemcitabin [gemcitabinhydroklorid]/nab-paclitaxel [paklitaksel albuminstabilisert nanopartikkelformulering]) hos pasienter med resektabel kreft i bukspyttkjertelen.

II. Hvis den oppgitte terskelen er oppfylt i en eller begge armer: å velge det bedre regimet med hensyn til 2-års total overlevelse.

SEKUNDÆRE MÅL:

I. For å estimere, for alle pasienter og innenfor behandlingsarmer: frekvens og alvorlighetsgrad av uønskede hendelser forbundet med kjemoterapi i perioperativ setting.

II. For å estimere, for alle pasienter og innenfor behandlingsarmer: andel pasienter som skal til operasjon for reseksjon etter preoperativ kjemoterapi.

III. For å estimere, for alle pasienter og innenfor behandlingsarmer: andel pasienter som oppnår makroskopisk fullstendig fjerning av tumor med negative mikroskopiske kirurgiske marginer (R0) reseksjon etter preoperativ kjemoterapi.

IV. For å estimere, for alle pasienter og innenfor behandlingsarmene: total responsrate etter preoperativ kjemoterapi, inkludert bekreftet og ubekreftet, fullstendig og delvis respons, per responsevalueringskriterier i solide svulster (RECIST) 1.1.

V. For å estimere, for alle pasienter og innen behandlingsarmer: patologisk responsrate etter R0 eller makroskopisk fullstendig fjerning av tumor med eventuell positiv mikroskopisk kirurgisk margin (R1) reseksjon.

VI. For å estimere, for alle pasienter og innenfor behandlingsarmer: mønstre av tilbakefall (lokoregionalt, fjernt) etter R0- eller R1-reseksjon.

VII. For å estimere, for alle pasienter og innenfor behandlingsarmer: sykdomsfri overlevelse fra tidspunktet for R0 eller R1 reseksjon.

OVERSIKT: Pasienter er randomisert til 1 av 2 behandlingsarmer.

ARM I: Pasienter får oksaliplatin intravenøst ​​(IV) over 2 timer og irinotekanhydroklorid IV over 90 minutter på dag 1 og 15. Pasienter får også fluorouracil IV over 46 timer på dag 1-3 og 15-17. Behandlingen gjentas hver 28. dag i 3 kurer i fravær av sykdomsprogresjon eller uakseptabel toksisitet. Pasienter som oppnår stabil sykdom eller bedre gjennomgår pankreatektomi 4-8 uker etter fullførte første 3 behandlingskurer. Innen 4-8 uker etter pankreatektomi får pasientene ytterligere 3 kurer med oksaliplatin, irinotekanhydroklorid og fluorouracil i fravær av sykdomsprogresjon eller uakseptabel toksisitet.

ARM II: Pasienter får paklitakselalbuminstabilisert nanopartikkelformulering IV over 30 minutter og gemcitabinhydroklorid IV over 30 minutter på dag 1, 8 og 15. Behandlingen gjentas hver 28. dag i 3 kurer i fravær av sykdomsprogresjon eller uakseptabel toksisitet. Pasienter som oppnår stabil sykdom eller bedre gjennomgår pankreatektomi 4-8 uker etter fullførte første 3 behandlingskurer. Innen 4-8 uker etter pankreatektomi får pasientene ytterligere 3 kurer med paklitakselalbuminstabilisert nanopartikkelformulering og gemcitabinhydrokloridbehandling i fravær av sykdomsprogresjon eller uakseptabel toksisitet.

Etter avsluttet studiebehandling følges pasientene opp hver 3. måned i 2 år og deretter hver 6. måned i 2 år.

Studietype

Intervensjonell

Registrering (Faktiske)

147

Fase

  • Fase 2

Kontakter og plasseringer

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

Studiesteder

    • 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, 85004
        • University of Arizona Cancer Center at Saint Joseph's
      • Tucson, Arizona, Forente stater, 85704
        • University of Arizona Cancer Center-Orange Grove Campus
      • Tucson, Arizona, Forente stater, 85719
        • Banner University Medical Center - Tucson
      • Tucson, Arizona, Forente stater, 85719
        • University of Arizona Cancer Center-North Campus
    • Arkansas
      • Hot Springs, Arkansas, Forente stater, 71913
        • CHI Saint Vincent Cancer Center Hot Springs
      • Jonesboro, Arkansas, Forente stater, 72401
        • Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
    • California
      • Anaheim, California, Forente stater, 92806
        • Kaiser Permanente-Anaheim
      • Antioch, California, Forente stater, 94531
        • Kaiser Permanente-Deer Valley Medical Center
      • Auburn, California, Forente stater, 95602
        • Sutter Auburn Faith Hospital
      • Auburn, California, Forente stater, 95603
        • Sutter Cancer Centers Radiation Oncology Services-Auburn
      • Baldwin Park, California, Forente stater, 91706
        • Kaiser Permanente-Baldwin Park
      • Bellflower, California, Forente stater, 90706
        • Kaiser Permanente-Bellflower
      • Berkeley, California, Forente stater, 94704
        • Alta Bates Summit Medical Center-Herrick Campus
      • Burbank, California, Forente stater, 91505
        • Providence Saint Joseph Medical Center/Disney Family Cancer Center
      • Burlingame, California, Forente stater, 94010
        • Mills-Peninsula Medical Center
      • Cameron Park, California, Forente stater, 95682
        • Sutter Cancer Centers Radiation Oncology Services-Cameron Park
      • Castro Valley, California, Forente stater, 94546
        • Eden Hospital Medical Center
      • 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
      • Fontana, California, Forente stater, 92335
        • Kaiser Permanente-Fontana
      • Fremont, California, Forente stater, 94538
        • Kaiser Permanente-Fremont
      • Fremont, California, Forente stater, 94538
        • Palo Alto Medical Foundation-Fremont
      • Fresno, California, Forente stater, 93720
        • Kaiser Permanente-Fresno
      • 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
      • 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
      • 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
        • Palo Alto Medical Foundation-Camino Division
      • Mountain View, California, Forente stater, 94040
        • Palo Alto Medical Foundation-Gynecologic Oncology
      • Newport Beach, California, Forente stater, 92663
        • USC Norris Oncology/Hematology-Newport Beach
      • Novato, California, Forente stater, 94945
        • Sutter Cancer Research Consortium
      • Oakland, California, Forente stater, 94611
        • Kaiser Permanente-Oakland
      • Oakland, California, Forente stater, 94609
        • Alta Bates Summit Medical Center - Summit Campus
      • Oakland, California, Forente stater, 94609
        • Bay Area Tumor Institute
      • Orange, California, Forente stater, 92868
        • UC Irvine Health/Chao Family Comprehensive Cancer Center
      • Orange, California, Forente stater, 92868
        • Saint Joseph Hospital - Orange
      • Palo Alto, California, Forente stater, 94301
        • Palo Alto Medical Foundation Health Care
      • Panorama City, California, Forente stater, 91402
        • Kaiser Permanente - Panorama City
      • Pasadena, California, Forente stater, 91105
        • Keck Medical Center of USC Pasadena
      • Redwood City, California, Forente stater, 94063
        • Kaiser Permanente-Redwood City
      • Richmond, California, Forente stater, 94801
        • Kaiser Permanente-Richmond
      • Riverside, California, Forente stater, 92505
        • Kaiser Permanente-Riverside
      • Roseville, California, Forente stater, 95661
        • Kaiser Permanente-Roseville
      • Roseville, California, Forente stater, 95661
        • Sutter Cancer Centers Radiation Oncology Services-Roseville
      • Roseville, California, Forente stater, 95661
        • Sutter Roseville Medical Center
      • Sacramento, California, Forente stater, 95816
        • Sutter Medical Center Sacramento
      • Sacramento, California, Forente stater, 95823
        • Kaiser Permanente-South Sacramento
      • Sacramento, California, Forente stater, 95825
        • Kaiser Permanente - Sacramento
      • San Diego, California, Forente stater, 92120
        • Kaiser Permanente-San Diego Zion
      • San Diego, California, Forente stater, 92108
        • Kaiser Permanente-San Diego Mission
      • San Diego, California, Forente stater, 92103
        • University of California San Diego
      • 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 Marcos, California, Forente stater, 92078
        • Kaiser Permanente-San Marcos
      • San Rafael, California, Forente stater, 94903
        • Kaiser San Rafael-Gallinas
      • San Rafael, California, Forente stater, 94903
        • Kaiser Permanente-San Rafael
      • Santa Clara, California, Forente stater, 95051
        • Kaiser Permanente Medical Center - Santa Clara
      • Santa Cruz, California, Forente stater, 95065
        • Palo Alto Medical Foundation-Santa Cruz
      • Santa Rosa, California, Forente stater, 95403
        • Kaiser Permanente-Santa Rosa
      • Santa Rosa, California, Forente stater, 95403
        • Sutter Pacific Medical Foundation
      • South San Francisco, California, Forente stater, 94080
        • Kaiser Permanente-South San Francisco
      • Stockton, California, Forente stater, 95210
        • Kaiser Permanente-Stockton
      • Sunnyvale, California, Forente stater, 94086
        • Palo Alto Medical Foundation-Sunnyvale
      • Vacaville, California, Forente stater, 95688
        • Kaiser Permanente Medical Center-Vacaville
      • Vacaville, California, Forente stater, 95687
        • 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
      • Woodland Hills, California, Forente stater, 91367
        • Kaiser Permanente-Woodland Hills
    • Colorado
      • Aurora, Colorado, Forente stater, 80045
        • University of Colorado Hospital
      • Colorado Springs, Colorado, Forente stater, 80907
        • Penrose-Saint Francis Healthcare
      • Colorado Springs, Colorado, Forente stater, 80909
        • UCHealth Memorial Hospital Central
      • Colorado Springs, Colorado, Forente stater, 80907
        • Rocky Mountain Cancer Centers-Penrose
      • Denver, Colorado, Forente stater, 80210
        • Porter Adventist Hospital
      • Durango, Colorado, Forente stater, 81301
        • Mercy Medical Center
      • Durango, Colorado, Forente stater, 81301
        • Southwest Oncology PC
      • Fort Collins, Colorado, Forente stater, 80524
        • Poudre Valley Hospital
      • Golden, Colorado, Forente stater, 80401
        • Mountain Blue Cancer Care Center
      • Grand Junction, Colorado, Forente stater, 81505
        • Grand Valley Oncology
      • Lakewood, Colorado, Forente stater, 80228
        • Saint Anthony Hospital
      • Lakewood, Colorado, Forente stater, 80228
        • Rocky Mountain Cancer Centers-Lakewood
      • Littleton, Colorado, Forente stater, 80122
        • Littleton Adventist Hospital
      • Longmont, Colorado, Forente stater, 80501
        • Longmont United Hospital
      • Longmont, Colorado, Forente stater, 80501
        • Rocky Mountain Cancer Centers-Longmont
      • 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
    • Connecticut
      • Hartford, Connecticut, Forente stater, 06105
        • Smilow Cancer Hospital Care Center at Saint Francis
      • West Haven, Connecticut, Forente stater, 06516
        • Veterans Affairs Connecticut Healthcare System-West Haven Campus
    • Delaware
      • Lewes, Delaware, Forente stater, 19958
        • Beebe Medical Center
      • Newark, Delaware, Forente stater, 19713
        • Helen F Graham Cancer Center
      • Newark, Delaware, Forente stater, 19713
        • Delaware Clinical and Laboratory Physicians PA
      • Newark, Delaware, Forente stater, 19713
        • Medical Oncology Hematology Consultants PA
      • Newark, Delaware, Forente stater, 19718
        • Christiana Care Health System-Christiana Hospital
      • Newark, Delaware, Forente stater, 19713
        • Christiana Gynecologic Oncology LLC
      • 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
    • Florida
      • Coral Springs, Florida, Forente stater, 33065
        • UM Sylvester Comprehensive Cancer Center at Coral Springs
      • Deerfield Beach, Florida, Forente stater, 33442
        • UM Sylvester Comprehensive Cancer Center at Deerfield Beach
      • Fort Myers, Florida, Forente stater, 33905
        • Regional Cancer Center-Lee Memorial Health System
      • Hollywood, Florida, Forente stater, 33021
        • UM Sylvester Comprehensive Cancer Center at Hollywood
      • Lakeland, Florida, Forente stater, 33805
        • The Watson Clinic
      • Miami, Florida, Forente stater, 33136
        • University of Miami Miller School of Medicine-Sylvester Cancer Center
      • Miami, Florida, Forente stater, 33176
        • UM Sylvester Comprehensive Cancer Center at Kendall
      • Miami, Florida, Forente stater, 33136
        • Jackson Memorial Hospital-Holtz Children's Hospital
      • Plantation, Florida, Forente stater, 33324
        • UM Sylvester Comprehensive Cancer Center at Plantation
      • Weston, Florida, Forente stater, 33331
        • Cleveland Clinic-Weston
    • Georgia
      • Atlanta, Georgia, Forente stater, 30308
        • Emory University Hospital Midtown
      • Atlanta, Georgia, Forente stater, 30322
        • Emory University Hospital/Winship Cancer Institute
      • Atlanta, Georgia, Forente stater, 30342
        • Emory Saint Joseph's Hospital
      • Atlanta, Georgia, Forente stater, 30303
        • Grady Health System
    • Hawaii
      • 'Aiea, Hawaii, Forente stater, 96701
        • Pali Momi Medical Center
      • 'Aiea, Hawaii, Forente stater, 96701
        • The Cancer Center of Hawaii-Pali Momi
      • 'Aiea, Hawaii, Forente stater, 96701
        • Hawaii Oncology Inc-Pali Momi
      • Honolulu, Hawaii, Forente stater, 96813
        • Queen's Medical Center
      • Honolulu, Hawaii, Forente stater, 96817
        • The Cancer Center of Hawaii-Liliha
      • Honolulu, Hawaii, Forente stater, 96813
        • Straub Clinic and Hospital
      • Honolulu, Hawaii, Forente stater, 96813
        • University of Hawaii Cancer Center
      • Honolulu, Hawaii, Forente stater, 96817
        • Hawaii Cancer Care Inc-Liliha
      • Honolulu, Hawaii, Forente stater, 96817
        • Kuakini Medical Center
      • Honolulu, Hawaii, Forente stater, 96826
        • Kapiolani Medical Center for Women and Children
      • Honolulu, Hawaii, Forente stater, 96813
        • Island Urology
      • Honolulu, Hawaii, Forente stater, 96819
        • Kaiser Permanente Moanalua Medical Center
      • Honolulu, Hawaii, Forente stater, 96813
        • Hawaii Cancer Care Inc-POB II
      • Honolulu, Hawaii, Forente stater, 96813
        • Hawaii Oncology Inc-POB I
      • Honolulu, Hawaii, Forente stater, 96817
        • Hawaii Oncology Inc-Kuakini
      • Lihue, Hawaii, Forente stater, 96766
        • Wilcox Memorial Hospital and Kauai Medical Clinic
    • Idaho
      • Boise, Idaho, Forente stater, 83706
        • Saint Alphonsus Cancer Care Center-Boise
      • Boise, Idaho, Forente stater, 83712
        • Saint Luke's Mountain States Tumor Institute
      • Caldwell, Idaho, Forente stater, 83605
        • Saint Alphonsus Cancer Care Center-Caldwell
      • Coeur d'Alene, Idaho, Forente stater, 83814
        • Kootenai Medical Center
      • Emmett, Idaho, Forente stater, 83617
        • Walter Knox Memorial Hospital
      • Fruitland, Idaho, Forente stater, 83619
        • Saint Luke's Mountain States Tumor Institute - Fruitland
      • 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
      • Danville, Illinois, Forente stater, 61832
        • Carle on Vermilion
      • DeKalb, Illinois, Forente stater, 60115
        • Northwestern Medicine Cancer Center Kishwaukee
      • Decatur, Illinois, Forente stater, 62526
        • Decatur Memorial Hospital
      • Decatur, Illinois, Forente stater, 62526
        • Cancer Care Specialists of Illinois - Decatur
      • 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
      • 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
      • 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
      • Moline, Illinois, Forente stater, 61265
        • Garneau, Stewart C MD (UIA Investigator)
      • Moline, Illinois, Forente stater, 61265
        • Spector, David MD (UIA Investigator)
      • Moline, Illinois, Forente stater, 61265
        • Trinity Medical Center
      • Mount Vernon, Illinois, Forente stater, 62864
        • Good Samaritan Regional Health Center
      • New Lenox, Illinois, Forente stater, 60451
        • UC Comprehensive Cancer Center at Silver Cross
      • 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
      • Pekin, Illinois, Forente stater, 61554
        • Illinois CancerCare-Pekin
      • Pekin, Illinois, Forente stater, 61554
        • OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
      • Peoria, Illinois, Forente stater, 61636
        • Methodist Medical Center of Illinois
      • Peoria, Illinois, Forente stater, 61637
        • OSF Saint Francis Medical Center
      • Peoria, Illinois, Forente stater, 61615
        • Illinois CancerCare-Peoria
      • Peoria, Illinois, Forente stater, 61615
        • OSF Saint Francis Radiation Oncology at Peoria Cancer Center
      • Peru, Illinois, Forente stater, 61354
        • Illinois CancerCare-Peru
      • Peru, Illinois, Forente stater, 61354
        • Valley Radiation Oncology
      • Princeton, Illinois, Forente stater, 61356
        • Illinois CancerCare-Princeton
      • 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
      • Evansville, Indiana, Forente stater, 47713
        • Deaconess Clinic Downtown
      • Fort Wayne, Indiana, Forente stater, 46805
        • Parkview Hospital Randallia
      • Fort Wayne, Indiana, Forente stater, 46804
        • Radiation Oncology Associates PC
      • Indianapolis, Indiana, Forente stater, 46202
        • Indiana University/Melvin and Bren Simon Cancer Center
      • Indianapolis, Indiana, Forente stater, 46202
        • Sidney and Lois Eskenazi Hospital
      • Michigan City, Indiana, Forente stater, 46360
        • Franciscan Saint Anthony Health-Michigan City
      • Michigan City, Indiana, Forente stater, 46360
        • Woodland Cancer Care Center
      • Newburgh, Indiana, Forente stater, 47630
        • Chancellor Center for Oncology
      • Richmond, Indiana, Forente stater, 47374
        • Reid Health
    • Iowa
      • Ames, Iowa, Forente stater, 50010
        • McFarland Clinic PC - Ames
      • Ames, Iowa, Forente stater, 50010
        • Mary Greeley Medical Center
      • Bettendorf, Iowa, Forente stater, 52722
        • Constantinou, Costas L MD (UIA Investigator)
      • Boone, Iowa, Forente stater, 50036
        • McFarland Clinic PC-Boone
      • Clive, Iowa, Forente stater, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Forente stater, 50325
        • Medical Oncology and Hematology Associates-West Des Moines
      • Council Bluffs, Iowa, Forente stater, 51503
        • Alegent Health Mercy Hospital
      • Creston, Iowa, Forente stater, 50801
        • Greater Regional Medical Center
      • Des Moines, Iowa, Forente stater, 50309
        • Iowa Methodist Medical Center
      • Des Moines, Iowa, Forente stater, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Forente stater, 50309
        • Medical Oncology and Hematology Associates-Des Moines
      • Des Moines, Iowa, Forente stater, 50314
        • Broadlawns Medical Center
      • Des Moines, Iowa, Forente stater, 50316
        • Iowa Lutheran Hospital
      • Des Moines, Iowa, Forente stater, 50314
        • Medical Oncology and Hematology Associates-Laurel
      • Fort Dodge, Iowa, Forente stater, 50501
        • McFarland Clinic PC-Trinity Cancer Center
      • Jefferson, Iowa, Forente stater, 50129
        • McFarland Clinic PC-Jefferson
      • Marshalltown, Iowa, Forente stater, 50158
        • McFarland Clinic PC-Marshalltown
      • West Des Moines, Iowa, Forente stater, 50266-7700
        • Methodist West Hospital
      • West Des Moines, Iowa, Forente stater, 50266
        • Mercy Medical Center-West Lakes
    • Kansas
      • Chanute, Kansas, Forente stater, 66720
        • Cancer Center of Kansas - Chanute
      • Coffeyville, Kansas, Forente stater, 67337
        • Coffeyville Regional Medical Center
      • Dodge City, Kansas, Forente stater, 67801
        • Cancer Center of Kansas - Dodge City
      • El Dorado, Kansas, Forente stater, 67042
        • Cancer Center of Kansas - El Dorado
      • Fort Scott, Kansas, Forente stater, 66701
        • Cancer Center of Kansas - Fort Scott
      • Garden City, Kansas, Forente stater, 67846
        • Central Care Cancer Center - Garden City
      • Garden City, Kansas, Forente stater, 67846
        • Saint Catherine Hospital
      • Great Bend, Kansas, Forente stater, 67530
        • Central Care Cancer Center - Great Bend
      • 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
      • Lawrence, Kansas, Forente stater, 66044
        • Lawrence Memorial Hospital
      • Lenexa, Kansas, Forente stater, 66219
        • Kansas Institute of Medicine Cancer and Blood Center
      • Lenexa, Kansas, Forente stater, 66219
        • Minimally Invasive Surgery Hospital
      • Liberal, Kansas, Forente stater, 67905
        • Cancer Center of Kansas-Liberal
      • Manhattan, Kansas, Forente stater, 66502
        • Cancer Center of Kansas-Manhattan
      • McPherson, Kansas, Forente stater, 67460
        • Cancer Center of Kansas - McPherson
      • Newton, Kansas, Forente stater, 67114
        • Cancer Center of Kansas - Newton
      • Olathe, Kansas, Forente stater, 66061
        • Olathe Medical Center
      • Overland Park, Kansas, Forente stater, 66210
        • University of Kansas Cancer Center-Overland Park
      • Overland Park, Kansas, Forente stater, 66209
        • Menorah Medical Center
      • Overland Park, Kansas, Forente stater, 66213
        • Saint Luke's South Hospital
      • Parsons, Kansas, Forente stater, 67357
        • Cancer Center of Kansas - Parsons
      • Pittsburg, Kansas, Forente stater, 66762
        • Via Christi Hospital-Pittsburg
      • Prairie Village, Kansas, Forente stater, 66208
        • Kansas City NCI Community Oncology Research Program
      • 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
      • Westwood, Kansas, Forente stater, 66205
        • University of Kansas Hospital-Westwood Cancer Center
      • Wichita, Kansas, Forente stater, 67214
        • Ascension Via Christi Hospitals Wichita
      • Wichita, Kansas, Forente stater, 67208
        • Cancer Center of Kansas-Wichita Medical Arts Tower
      • Wichita, Kansas, Forente stater, 67214
        • Cancer Center of Kansas - Wichita
      • Wichita, Kansas, Forente stater, 67208
        • Associates In Womens Health
      • Winfield, Kansas, Forente stater, 67156
        • Cancer Center of Kansas - Winfield
    • Kentucky
      • Bardstown, Kentucky, Forente stater, 40004
        • Flaget Memorial Hospital
      • Corbin, Kentucky, Forente stater, 40701
        • Baptist Health Corbin
      • Corbin, Kentucky, Forente stater, 40701
        • Commonwealth Cancer Center-Corbin
      • Crestview Hills, Kentucky, Forente stater, 41017
        • Oncology Hematology Care Inc-Crestview
      • Elizabethtown, Kentucky, Forente stater, 42701
        • Hardin Memorial Hospital
      • Lexington, Kentucky, Forente stater, 40536
        • University of Kentucky/Markey Cancer Center
      • Lexington, Kentucky, Forente stater, 40504
        • Saint Joseph Radiation Oncology Resource Center
      • Lexington, Kentucky, Forente stater, 40509
        • Saint Joseph Hospital East
      • Lexington, Kentucky, Forente stater, 40503
        • Baptist Health Lexington
      • London, Kentucky, Forente stater, 40741
        • Saint Joseph London
      • Louisville, Kentucky, Forente stater, 40202
        • The James Graham Brown Cancer Center at University of Louisville
      • Louisville, Kentucky, Forente stater, 40202
        • Jewish Hospital
      • Louisville, Kentucky, Forente stater, 40207
        • Baptist Health Louisville
      • Louisville, Kentucky, Forente stater, 40215
        • Saints Mary and Elizabeth Hospital
      • Louisville, Kentucky, Forente stater, 40245
        • Jewish Hospital Medical Center Northeast
      • Madisonville, Kentucky, Forente stater, 42431
        • Baptist Health Madisonville/Merle Mahr Cancer Center
      • Paducah, Kentucky, Forente stater, 42003
        • Baptist Health Paducah
      • Shepherdsville, Kentucky, Forente stater, 40165
        • Jewish Hospital Medical Center South
    • Louisiana
      • Baton Rouge, Louisiana, Forente stater, 70809
        • Ochsner Health Center-Summa
      • Baton Rouge, Louisiana, Forente stater, 70816
        • Medical Center of Baton Rouge
      • Kenner, Louisiana, Forente stater, 70065
        • Ochsner Medical Center Kenner
      • Monroe, Louisiana, Forente stater, 71202
        • University Health-Conway
      • New Orleans, Louisiana, Forente stater, 70121
        • Ochsner Medical Center Jefferson
      • New Orleans, Louisiana, Forente stater, 70112
        • University Medical Center New Orleans
      • New Orleans, Louisiana, Forente stater, 70112
        • Louisiana State University Health Science Center
      • Shreveport, Louisiana, Forente stater, 71103
        • Louisiana State University Health Sciences Center Shreveport
    • Maine
      • Augusta, Maine, Forente stater, 04330
        • Harold Alfond Center for Cancer Care
      • Brewer, Maine, Forente stater, 04412
        • Lafayette Family Cancer Center-EMMC
      • Rockport, Maine, Forente stater, 04856
        • Penobscot Bay Medical Center
    • Maryland
      • Frederick, Maryland, Forente stater, 21701
        • Frederick Memorial Hospital
    • Massachusetts
      • Boston, Massachusetts, Forente stater, 02118
        • Boston Medical Center
      • Burlington, Massachusetts, Forente stater, 01805
        • Lahey Hospital and Medical Center
      • Springfield, Massachusetts, Forente stater, 01199
        • Baystate Medical Center
      • Winchester, Massachusetts, Forente stater, 01890
        • Winchester Hospital
    • Michigan
      • Adrian, Michigan, Forente stater, 49221
        • Hickman Cancer Center
      • Ann Arbor, Michigan, Forente stater, 48109
        • University of Michigan Comprehensive Cancer Center
      • 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, 48201
        • Wayne State University/Karmanos Cancer Institute
      • Detroit, Michigan, Forente stater, 48236
        • Ascension Saint John Hospital
      • East China Township, Michigan, Forente stater, 48054
        • Great Lakes Cancer Management Specialists-Doctors Park
      • Farmington Hills, Michigan, Forente stater, 48334
        • Weisberg Cancer Treatment Center
      • 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
        • 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
      • Monroe, Michigan, Forente stater, 48162
        • Toledo Clinic Cancer Centers-Monroe
      • 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
      • 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
      • 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
      • 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
      • Bemidji, Minnesota, Forente stater, 56601
        • Sanford Joe Lueken Cancer Center
      • Brainerd, Minnesota, Forente stater, 56401
        • Essentia Health Saint Joseph's Medical Center
      • Burnsville, Minnesota, Forente stater, 55337
        • Fairview Ridges Hospital
      • Coon Rapids, Minnesota, Forente stater, 55433
        • Mercy Hospital
      • Duluth, Minnesota, Forente stater, 55805
        • Essentia Health Cancer Center
      • Duluth, Minnesota, Forente stater, 55805
        • Essentia Health Saint Mary's Medical Center
      • Duluth, Minnesota, Forente stater, 55805
        • Miller-Dwan Hospital
      • Edina, Minnesota, Forente stater, 55435
        • Fairview-Southdale Hospital
      • Fergus Falls, Minnesota, Forente stater, 56537
        • Lake Region Healthcare Corporation-Cancer Care
      • Fridley, Minnesota, Forente stater, 55432
        • Unity Hospital
      • Hibbing, Minnesota, Forente stater, 55746
        • Essentia Health Hibbing Clinic
      • 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
      • 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
      • Virginia, Minnesota, Forente stater, 55792
        • Essentia Health Virginia Clinic
      • Waconia, Minnesota, Forente stater, 55387
        • Ridgeview Medical Center
      • Willmar, Minnesota, Forente stater, 56201
        • Rice Memorial Hospital
      • Woodbury, Minnesota, Forente stater, 55125
        • Minnesota Oncology Hematology PA-Woodbury
      • 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
      • Hattiesburg, Mississippi, Forente stater, 39401
        • Hattiesburg Clinic - Hematology/Oncology Clinic
      • 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
      • 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, 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, 64118
        • Heartland Hematology and Oncology Associates Incorporated
      • Kansas City, Missouri, Forente stater, 64154
        • The University of Kansas Cancer Center-North
      • Lee's Summit, Missouri, Forente stater, 64086
        • Saint Luke's East - Lee's Summit
      • Lee's Summit, Missouri, Forente stater, 64064
        • The University of Kansas Cancer Center-Lee's Summit
      • Liberty, Missouri, Forente stater, 64068
        • Liberty Radiation Oncology Center
      • Rolla, Missouri, Forente stater, 65401
        • Delbert Day Cancer Institute at PCRMC
      • Rolla, Missouri, Forente stater, 65401
        • Mercy Clinic-Rolla-Cancer and Hematology
      • Saint Joseph, Missouri, Forente stater, 64507
        • Heartland Regional Medical Center
      • Saint Louis, Missouri, Forente stater, 63110
        • Washington University School of Medicine
      • Saint Louis, Missouri, Forente stater, 63131
        • Missouri Baptist Medical Center
      • Saint Louis, Missouri, Forente stater, 63141
        • Mercy Hospital Saint Louis
      • Saint Louis, Missouri, Forente stater, 63129
        • Siteman Cancer Center-South County
      • Saint Louis, Missouri, Forente stater, 63136
        • Siteman Cancer Center at Christian Hospital
      • Saint Louis, Missouri, Forente stater, 63109
        • Saint Louis Cancer and Breast Institute-South City
      • Saint Peters, Missouri, Forente stater, 63376
        • Siteman Cancer Center at Saint Peters Hospital
      • Sainte Genevieve, Missouri, Forente stater, 63670
        • Sainte Genevieve County Memorial Hospital
      • Springfield, Missouri, Forente stater, 65807
        • CoxHealth South Hospital
      • Springfield, Missouri, Forente stater, 65804
        • Mercy Hospital Springfield
      • Sullivan, Missouri, Forente stater, 63080
        • Missouri Baptist Sullivan Hospital
      • Sunset Hills, Missouri, Forente stater, 63127
        • Missouri Baptist Outpatient Center-Sunset Hills
      • Washington, Missouri, Forente stater, 63090
        • Mercy Hospital Washington
    • Montana
      • Billings, Montana, Forente stater, 59101
        • Billings Clinic Cancer Center
      • 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
      • 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
      • Grand Island, Nebraska, Forente stater, 68803
        • CHI Health Saint Francis
      • Kearney, Nebraska, Forente stater, 68847
        • CHI Health Good Samaritan
      • Kearney, Nebraska, Forente stater, 68845
        • Heartland Hematology and Oncology
      • Lincoln, Nebraska, Forente stater, 68510
        • Saint Elizabeth Regional Medical Center
      • Omaha, Nebraska, Forente stater, 68114
        • Nebraska Methodist Hospital
      • Omaha, Nebraska, Forente stater, 68198
        • University of Nebraska Medical Center
      • Omaha, Nebraska, Forente stater, 68124
        • Alegent Health Bergan Mercy Medical Center
      • Omaha, Nebraska, Forente stater, 68122
        • Alegent Health Immanuel Medical Center
      • Omaha, Nebraska, Forente stater, 68130
        • Alegent Health Lakeside Hospital
      • Omaha, Nebraska, Forente stater, 68131
        • Creighton University Medical Center
      • Omaha, Nebraska, Forente stater, 68122
        • Hematology and Oncology Consultants PC
      • Papillion, Nebraska, Forente stater, 68046
        • Midlands Community Hospital
    • New Hampshire
      • 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
    • New Jersey
      • Englewood, New Jersey, Forente stater, 07631
        • Englewood Hospital and Medical Center
      • 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, 87102
        • Lovelace Medical Center-Saint Joseph Square
      • Las Cruces, New Mexico, Forente stater, 88011
        • Memorial Medical Center - Las Cruces
    • New York
      • Auburn, New York, Forente stater, 13021
        • Hematology Oncology Associates of Central New York-Auburn
      • Bronx, New York, Forente stater, 10461
        • Montefiore Medical Center-Einstein Campus
      • Bronx, New York, Forente stater, 10467
        • Montefiore Medical Center - Moses Campus
      • Bronx, New York, Forente stater, 10461
        • Montefiore Medical Center-Weiler Hospital
      • East Syracuse, New York, Forente stater, 13057
        • Hematology Oncology Associates of Central New York-East Syracuse
      • Glens Falls, New York, Forente stater, 12801
        • Glens Falls Hospital
      • Middletown, New York, Forente stater, 10940
        • Orange Regional Medical Center
      • Mineola, New York, Forente stater, 11501
        • NYU Winthrop Hospital
      • Poughkeepsie, New York, Forente stater, 12601
        • Vassar Brothers Medical Center
      • 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
        • Hematology Oncology Associates of Central New York-Onondaga Hill
    • North Carolina
      • Asheboro, North Carolina, Forente stater, 27203
        • Randolph Hospital
      • Asheville, North Carolina, Forente stater, 28803
        • AdventHealth Infusion Center Asheville
      • Burlington, North Carolina, Forente stater, 27215
        • Cone Health Cancer Center at Alamance Regional
      • Clinton, North Carolina, Forente stater, 28328
        • Southeastern Medical Oncology Center-Clinton
      • Durham, North Carolina, Forente stater, 27710
        • Duke University Medical Center
      • Goldsboro, North Carolina, Forente stater, 27534
        • Southeastern Medical Oncology Center-Goldsboro
      • Goldsboro, North Carolina, Forente stater, 27534
        • Wayne Memorial Hospital
      • Greensboro, North Carolina, Forente stater, 27403
        • Cone Health Cancer Center
      • Hendersonville, North Carolina, Forente stater, 28792
        • AdventHealth Hendersonville
      • Jacksonville, North Carolina, Forente stater, 28546
        • Southeastern Medical Oncology Center-Jacksonville
      • Jacksonville, North Carolina, Forente stater, 28546
        • Onslow Memorial Hospital
      • Kinston, North Carolina, Forente stater, 28501
        • Vidant Oncology-Kinston
      • Leland, North Carolina, Forente stater, 28451
        • Cape Fear Cancer Specialists-Leland
      • Mebane, North Carolina, Forente stater, 27302
        • Cone Heath Cancer Center at Mebane
      • Reidsville, North Carolina, Forente stater, 27320
        • Annie Penn Memorial Hospital
      • Wilmington, North Carolina, Forente stater, 28401
        • New Hanover Regional Medical Center/Zimmer Cancer Center
      • Wilmington, North Carolina, Forente stater, 28401
        • Cape Fear Cancer Specialists
      • Winston-Salem, North Carolina, Forente stater, 27104
        • Southeast Clinical Oncology Research Consortium NCORP
    • North Dakota
      • Bismarck, North Dakota, Forente stater, 58501
        • Sanford Bismarck Medical Center
      • Fargo, North Dakota, Forente stater, 58122
        • Sanford Roger Maris Cancer Center
      • Fargo, North Dakota, Forente stater, 58103
        • Essentia Health Cancer Center-South University Clinic
      • Fargo, North Dakota, Forente stater, 58122
        • Sanford Broadway Medical Center
    • Ohio
      • Akron, Ohio, Forente stater, 44307
        • Cleveland Clinic Akron General
      • 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
      • 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, 45219
        • University of Cincinnati/Barrett Cancer Center
      • Cincinnati, Ohio, Forente stater, 45230
        • Oncology Hematology Care Inc - Anderson
      • Cincinnati, Ohio, Forente stater, 45247
        • TriHealth Cancer Institute-Westside
      • Cincinnati, Ohio, Forente stater, 45255
        • TriHealth Cancer Institute-Anderson
      • Cleveland, Ohio, Forente stater, 44106
        • Case Western Reserve University
      • Cleveland, Ohio, Forente stater, 44109
        • MetroHealth Medical Center
      • Cleveland, Ohio, Forente stater, 44195
        • Cleveland Clinic Foundation
      • Cleveland, Ohio, Forente stater, 44111
        • Cleveland Clinic Cancer Center/Fairview Hospital
      • Columbus, Ohio, Forente stater, 43214
        • Riverside Methodist Hospital
      • 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
      • Independence, Ohio, Forente stater, 44131
        • Cleveland Clinic Cancer Center Independence
      • Kettering, Ohio, Forente stater, 45429
        • Kettering Medical Center
      • Kettering, Ohio, Forente stater, 45409
        • Greater Dayton Cancer Center
      • Kettering, Ohio, Forente stater, 45420
        • First Dayton Cancer Care
      • Lancaster, Ohio, Forente stater, 43130
        • Fairfield Medical Center
      • Mansfield, Ohio, Forente stater, 44906
        • Cleveland Clinic Cancer Center Mansfield
      • 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
      • Maumee, Ohio, Forente stater, 43537
        • Toledo Clinic Cancer Centers-Maumee
      • Maumee, Ohio, Forente stater, 43537
        • Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
      • Mayfield Heights, Ohio, Forente stater, 44124
        • Hillcrest Hospital Cancer Center
      • 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
      • Oregon, Ohio, Forente stater, 43616
        • Saint Charles Hospital
      • Parma, Ohio, Forente stater, 44129
        • University Hospitals Parma Medical Center
      • Perrysburg, Ohio, Forente stater, 43551
        • Mercy Health Perrysburg Cancer Center
      • Portsmouth, Ohio, Forente stater, 45662
        • Southern Ohio Medical Center
      • Sandusky, Ohio, Forente stater, 44870
        • North Coast Cancer Care
      • 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
      • Strongsville, Ohio, Forente stater, 44136
        • Cleveland Clinic Cancer Center Strongsville
      • Sylvania, Ohio, Forente stater, 43560
        • ProMedica Flower Hospital
      • Toledo, Ohio, Forente stater, 43623
        • Toledo Clinic Cancer Centers-Toledo
      • Toledo, Ohio, Forente stater, 43606
        • The Toledo Hospital/Toledo Children's Hospital
      • Toledo, Ohio, Forente stater, 43623
        • Mercy Saint Anne 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
      • 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
        • UH Seidman Cancer Center at Saint John Medical Center
      • Westlake, Ohio, Forente stater, 44145
        • UHHS-Westlake Medical Center
      • Wooster, Ohio, Forente stater, 44691
        • Cleveland Clinic Wooster Family Health and Surgery Center
      • 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
      • Salem, Oregon, Forente stater, 97301
        • Salem Hospital
      • Tualatin, Oregon, Forente stater, 97062
        • Legacy Meridian Park Hospital
    • 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
      • Bethlehem, Pennsylvania, Forente stater, 18015
        • Saint Luke's University Hospital-Bethlehem Campus
      • Bryn Mawr, Pennsylvania, Forente stater, 19010
        • Bryn Mawr Hospital
      • Chadds Ford, Pennsylvania, Forente stater, 19317
        • Christiana Care Health System-Concord Health Center
      • Danville, Pennsylvania, Forente stater, 17822
        • Geisinger Medical Center
      • Hazleton, Pennsylvania, Forente stater, 18201
        • Geisinger Medical Center-Cancer Center Hazleton
      • Hershey, Pennsylvania, Forente stater, 17033-0850
        • Penn State Milton S Hershey Medical Center
      • Lewisburg, Pennsylvania, Forente stater, 17837
        • Geisinger Medical Oncology-Lewisburg
      • Lewistown, Pennsylvania, Forente stater, 17044
        • Lewistown Hospital
      • Media, Pennsylvania, Forente stater, 19063
        • Riddle Memorial Hospital
      • Paoli, Pennsylvania, Forente stater, 19301
        • Paoli Memorial Hospital
      • Philadelphia, Pennsylvania, Forente stater, 19111
        • Fox Chase Cancer Center
      • Philadelphia, Pennsylvania, Forente stater, 19107
        • Thomas Jefferson University Hospital
      • Philadelphia, Pennsylvania, Forente stater, 19140
        • Temple University Hospital
      • Pottsville, Pennsylvania, Forente stater, 17901
        • Geisinger Cancer Services-Pottsville
      • Sayre, Pennsylvania, Forente stater, 18840
        • Guthrie Medical Group PC-Robert Packer Hospital
      • Scranton, Pennsylvania, Forente stater, 18510
        • Community Medical Center
      • Selinsgrove, Pennsylvania, Forente stater, 17870
        • Geisinger Medical Oncology-Selinsgrove
      • Sellersville, Pennsylvania, Forente stater, 18960
        • Grand View Hospital
      • State College, Pennsylvania, Forente stater, 16801
        • Geisinger Medical Group
      • West Reading, Pennsylvania, Forente stater, 19611
        • Reading Hospital
      • Wilkes-Barre, Pennsylvania, Forente stater, 18711
        • Geisinger Wyoming Valley/Henry Cancer Center
      • Wynnewood, Pennsylvania, Forente stater, 19096
        • Lankenau Medical Center
    • South Carolina
      • Charleston, South Carolina, Forente stater, 29425
        • Medical University of South Carolina
      • Charleston, South Carolina, Forente stater, 29401
        • Roper Hospital
      • 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, 29403
        • Charleston Oncology - Roper
      • Charleston, South Carolina, Forente stater, 29414
        • Charleston Oncology - Saint Francis
      • Easley, South Carolina, Forente stater, 29640
        • Prisma Health Cancer Institute - Easley
      • Greenville, South Carolina, Forente stater, 29605
        • Prisma Health Cancer Institute - Faris
      • Greenville, South Carolina, Forente stater, 29607
        • Saint Francis Cancer Center
      • Greenville, South Carolina, Forente stater, 29615
        • Prisma Health Cancer Institute - Eastside
      • Greenville, South Carolina, Forente stater, 29605
        • Prisma Health Cancer Institute - Butternut
      • Greenville, South Carolina, Forente stater, 29601
        • Saint Francis Hospital
      • Greenville, South Carolina, Forente stater, 29605
        • Prisma Health Greenville Memorial Hospital
      • Greenville, South Carolina, Forente stater, 29601
        • Greenville Health System Cancer Institute-Andrews
      • Greenwood, South Carolina, Forente stater, 29646
        • Self Regional Healthcare
      • Greer, South Carolina, Forente stater, 29650
        • Prisma Health Cancer Institute - Greer
      • Mount Pleasant, South Carolina, Forente stater, 29464
        • Lowcountry Hematology Oncology PA-Mount Pleasant
      • Seneca, South Carolina, Forente stater, 29672
        • Prisma Health Cancer Institute - Seneca
      • Spartanburg, South Carolina, Forente stater, 29307
        • Prisma Health Cancer Institute - Spartanburg
    • South Dakota
      • Sioux Falls, South Dakota, Forente stater, 57117-5134
        • Sanford USD Medical Center - Sioux Falls
      • Sioux Falls, South Dakota, Forente stater, 57104
        • Sanford Cancer Center Oncology Clinic
    • Tennessee
      • Bristol, Tennessee, Forente stater, 37620
        • Wellmont Medical Associates Oncology and Hematology-Bristol
      • Bristol, Tennessee, Forente stater, 37620
        • Wellmont Bristol Regional Medical Center
      • Chattanooga, Tennessee, Forente stater, 37404
        • Memorial Hospital
      • Collierville, Tennessee, Forente stater, 38017
        • Integrity Oncology PLLC-Collierville
      • Franklin, Tennessee, Forente stater, 37067
        • Vanderbilt-Ingram Cancer Center Cool Springs
      • Hixson, Tennessee, Forente stater, 37343
        • Pulmonary Medicine Center of Chattanooga-Hixson
      • Johnson City, Tennessee, Forente stater, 37604
        • Wellmont Medical Associates Oncology and Hematology-Johnson City
      • Kingsport, Tennessee, Forente stater, 37660
        • Wellmont Holston Valley Hospital and Medical Center
      • Kingsport, Tennessee, Forente stater, 37660
        • Regional Cancer Center at Indian Path Community Hospital
      • 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, 37232
        • Vanderbilt University/Ingram Cancer Center
      • Nashville, Tennessee, Forente stater, 37204
        • Vanderbilt Breast Center at One Hundred Oaks
      • Nashville, Tennessee, Forente stater, 37208
        • Meharry Medical College
      • Ooltewah, Tennessee, Forente stater, 37363
        • Memorial GYN Plus
    • Texas
      • Austin, Texas, Forente stater, 78705
        • Texas Oncology-Austin Midtown
      • Austin, Texas, Forente stater, 78731
        • Texas Oncology - Central Austin Cancer Center
      • Austin, Texas, Forente stater, 78745
        • Texas Oncology - South Austin Cancer Center
      • Bryan, Texas, Forente stater, 77802
        • Saint Joseph Regional Cancer Center
      • Dallas, Texas, Forente stater, 75235
        • Parkland Memorial Hospital
      • Dallas, Texas, Forente stater, 75390
        • UT Southwestern/Simmons Cancer Center-Dallas
      • Fort Worth, Texas, Forente stater, 76104
        • UT Southwestern/Simmons Cancer Center-Fort Worth
      • Houston, Texas, Forente stater, 77030
        • Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
      • Houston, Texas, Forente stater, 77030
        • Ben Taub General Hospital
      • Round Rock, Texas, Forente stater, 78681
        • Texas Oncology - Round Rock Cancer Center
      • San Antonio, Texas, Forente stater, 78229
        • University Hospital
      • San Antonio, Texas, Forente stater, 78229
        • University of Texas Health Science Center at San Antonio
      • San Antonio, Texas, Forente stater, 78229
        • Cancer Therapy and Research Center at The UT Health Science Center at San Antonio
    • Utah
      • Farmington, Utah, Forente stater, 84025
        • Farmington Health Center
      • Salt Lake City, Utah, Forente stater, 84112
        • Huntsman Cancer Institute/University of Utah
      • South Jordan, Utah, Forente stater, 84009
        • South Jordan Health Center
    • Vermont
      • Berlin, Vermont, Forente stater, 05602
        • Central Vermont Medical Center/National Life Cancer Treatment
      • Burlington, Vermont, Forente stater, 05401
        • University of Vermont Medical Center
      • Burlington, Vermont, Forente stater, 05405
        • University of Vermont and State Agricultural College
      • Saint Johnsbury, Vermont, Forente stater, 05819
        • Norris Cotton Cancer Center-North
    • Virginia
      • Bristol, Virginia, Forente stater, 24201
        • Wellmont Medical Associates-Bristol
      • Mechanicsville, Virginia, Forente stater, 23116
        • Bon Secours Memorial Regional Medical Center
      • Midlothian, Virginia, Forente stater, 23114
        • Bon Secours Saint Francis Medical Center
      • Norton, Virginia, Forente stater, 24273
        • Southwest VA Regional Cancer Center
      • Richmond, Virginia, Forente stater, 23226
        • Bon Secours Saint Mary's Hospital
    • 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
      • 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
      • 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
        • 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
      • Ashland, Wisconsin, Forente stater, 54806
        • Duluth Clinic Ashland
      • Burlington, Wisconsin, Forente stater, 53105
        • Aurora Cancer Care-Southern Lakes VLCC
      • Chippewa Falls, Wisconsin, Forente stater, 54729
        • Marshfield Clinic-Chippewa Center
      • Eau Claire, Wisconsin, Forente stater, 54701
        • Marshfield Medical Center-EC Cancer Center
      • Eau Claire, Wisconsin, Forente stater, 54701
        • HSHS Sacred Heart Hospital
      • Eau Claire, Wisconsin, Forente stater, 54701
        • Marshfield Clinic Cancer Center at Sacred Heart
      • Fond Du Lac, Wisconsin, Forente stater, 54937
        • Aurora Health Center-Fond du Lac
      • Germantown, Wisconsin, Forente stater, 53022
        • Aurora Health Care Germantown Health Center
      • Grafton, Wisconsin, Forente stater, 53024
        • Aurora Cancer Care-Grafton
      • Green Bay, Wisconsin, Forente stater, 54311
        • Aurora BayCare Medical Center
      • Green Bay, Wisconsin, Forente stater, 54301
        • Bellin Memorial Hospital
      • 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
      • Marinette, Wisconsin, Forente stater, 54143
        • Aurora Bay Area Medical Group-Marinette
      • Marinette, Wisconsin, Forente stater, 54143
        • Bay Area Medical Center
      • Marshfield, Wisconsin, Forente stater, 54449
        • Marshfield Medical Center-Marshfield
      • Marshfield, Wisconsin, Forente stater, 54449
        • Marshfield Medical Center
      • Milwaukee, Wisconsin, Forente stater, 53209
        • Aurora Cancer Care-Milwaukee
      • Milwaukee, Wisconsin, Forente stater, 53215
        • Aurora Saint Luke's Medical Center
      • Milwaukee, Wisconsin, Forente stater, 53233
        • Aurora Sinai Medical Center
      • Minocqua, Wisconsin, Forente stater, 54548
        • Marshfield Clinic-Minocqua Center
      • Mukwonago, Wisconsin, Forente stater, 53149
        • ProHealth D N Greenwald Center
      • New Richmond, Wisconsin, Forente stater, 54017
        • Cancer Center of Western Wisconsin
      • Oconomowoc, Wisconsin, Forente stater, 53066
        • ProHealth Oconomowoc Memorial Hospital
      • Oshkosh, Wisconsin, Forente stater, 54904
        • Vince Lombardi Cancer Clinic - Oshkosh
      • Racine, Wisconsin, Forente stater, 53406
        • Aurora Cancer Care-Racine
      • Rice Lake, Wisconsin, Forente stater, 54868
        • Marshfield Medical Center-Rice Lake
      • Rice Lake, Wisconsin, Forente stater, 54868
        • Lakeview Medical Center-Marshfield Clinic
      • Sheboygan, Wisconsin, Forente stater, 53081
        • Vince Lombardi Cancer Clinic-Sheboygan
      • Stevens Point, Wisconsin, Forente stater, 54482
        • Marshfield Clinic Stevens Point Center
      • Stevens Point, Wisconsin, Forente stater, 54481
        • Ascension Saint Michael's Hospital
      • 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
        • UW Cancer Center at ProHealth Care
      • 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
      • Wausau, Wisconsin, Forente stater, 54401
        • Marshfield Clinic-Wausau Center
      • Wauwatosa, Wisconsin, Forente stater, 53226
        • Aurora Cancer Care-Milwaukee West
      • West Allis, Wisconsin, Forente stater, 53227
        • Aurora West Allis Medical Center
      • Weston, Wisconsin, Forente stater, 54476
        • Ascension Saint Clare's Hospital
      • Weston, Wisconsin, Forente stater, 54476
        • Marshfield Clinic - Weston Center
      • Wisconsin Rapids, Wisconsin, Forente stater, 54494
        • Marshfield Clinic - Wisconsin Rapids Center
      • Wisconsin Rapids, Wisconsin, Forente stater, 54494
        • Aspirus UW Cancer Center
    • Wyoming
      • 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

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 til 75 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inklusjonskriterier:

  • Pasienter må ha histologisk eller cytologisk påvist adenokarsinom i bukspyttkjertelen; andre histologier enn adenokarsinom, eller noen blandede histologier, vil IKKE være kvalifisert
  • Pasienter må ha målbar sykdom i bukspyttkjertelen; datatomografi (CT)-skanning eller magnetisk resonansavbildning (MRI) brukt til å vurdere målbar sykdom må ha blitt fullført innen 28 dager før registrering; all sykdom må vurderes og dokumenteres på baseline tumorvurderingsskjema
  • Pasienter må ha resektabel primærtumor basert på kontrastforsterket CT eller MR (CT eller MR uten kontrast som en del av positronemisjonstomografi [PET]/CT eller PET/MRI er IKKE akseptabelt; CT eller MR med kontrast som en del av PET/CT eller PET/MRI er akseptabelt) av brystet, magen og bekkenet, der resektabel er definert som:

    • Ingen involvering av cøliakiarterien, vanlig leverarterie og mesenterial arterie superior (og, hvis tilstede, erstattet høyre leverarterie)
    • Ingen involvering, eller < 180° grensesnitt mellom svulst og karvegg, av portvenen og/eller mesenterialvenen superior; og patentert sammenløp av portalvene/miltvene
    • Ingen tegn på metastatisk sykdom
    • Merk: for svulster i kroppen og halen av bukspyttkjertelen, anses involvering av miltarterien og venen uansett grad som resektabel sykdom
  • CT-skanninger eller MR som brukes til å vurdere sykdom ved baseline må sendes inn for sentral gjennomgang
  • Pasienter må ha kirurgisk konsultasjon for å bekrefte at pasienten er en kirurgisk kandidat innen 21 dager før registrering
  • Pasienter må ikke ha mottatt tidligere kirurgi, strålebehandling, kjemoterapi, målrettet terapi eller noen utredningsbehandling for kreft i bukspyttkjertelen
  • Pasienter må ha en Zubrod-ytelsesstatus på 0-1
  • Absolutt nøytrofiltall (ANC) >= 1500/mcL
  • Blodplater >= 100 000/mcL
  • Hemoglobin >= 9 g/dL
  • Total bilirubin =< 1,5 x institusjonell øvre normalgrense (IULN)
  • Aspartataminotransferase (AST) og alaninaminotransferase (ALT) =< 2,5 x IULN
  • Serumalbumin >= 3 g/dL
  • Serumkreatinin =< IULN innen 14 dager før registrering
  • Pasienter med ukontrollert interkurrent sykdom inkludert, men ikke begrenset til pågående eller aktiv infeksjon, symptomatisk kongestiv hjertesvikt, ustabil angina pectoris, hjertearytmi eller psykiatrisk sykdom/sosiale situasjoner som vil begrense overholdelse av studiekravene, vil IKKE være kvalifisert
  • Ingen tidligere malignitet er tillatt med unntak av tilstrekkelig behandlet basal (eller plateepitel) hudkreft, in situ livmorhalskreft, in situ brystkreft (ductal eller lobulær) eller annen kreft som pasienten har vært sykdoms- og behandlingsfri for i to år.
  • Pasienter må ikke være gravide eller ammende; kvinner/menn med reproduksjonspotensial må ha samtykket til å bruke en effektiv prevensjonsmetode i opptil 3 måneder etter den siste administrerte dosen av kjemoterapi; en kvinne anses å ha "reproduktivt potensial" hvis hun har hatt menstruasjon på noe tidspunkt i løpet av de foregående 12 påfølgende månedene; i tillegg til rutineprevensjonsmetoder, inkluderer "effektiv prevensjon" også heteroseksuelt sølibat og kirurgi ment å forhindre graviditet (eller med en bivirkning av graviditetsforebygging) definert som hysterektomi, bilateral ooforektomi eller bilateral tubal ligering; men hvis en tidligere sølibatpasient på noe tidspunkt velger å bli heteroseksuelt aktiv i løpet av tidsperioden for bruk av prevensjonstiltak, er han/hun ansvarlig for å starte prevensjonstiltak
  • Nettstedene må søke ytterligere pasientsamtykke for fremtidig bruk av prøver
  • Pasienter må informeres om undersøkelseskarakteren til denne studien og må signere og gi skriftlig informert samtykke i samsvar med institusjonelle og føderale retningslinjer
  • Som en del av OPEN-registreringsprosessen oppgis den behandlende institusjonens identitet for å sikre at den gjeldende (innen 365 dager) datoen for godkjenning av institusjonsutvalget for denne studien er lagt inn i systemet

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 I (mFOLFIRINOX, kirurgi)
Pasienter får oksaliplatin IV over 2 timer og irinotekanhydroklorid IV over 90 minutter på dag 1 og 15. Pasienter får også 5-fluorouracil IV over 46 timer på dag 1-3 og 15-17. Behandlingen gjentas hver 28. dag i 3 kurer i fravær av sykdomsprogresjon eller uakseptabel toksisitet. Pasienter som oppnår stabil sykdom eller bedre gjennomgår pankreatektomi 4-8 uker etter fullførte første 3 behandlingskurer. Innen 4-8 uker etter pankreatektomi får pasientene ytterligere 3 kurer med oksaliplatin, irinotekanhydroklorid og fluorouracil i fravær av sykdomsprogresjon eller uakseptabel toksisitet.
Gitt IV
Andre navn:
  • 5-FU
  • 5-Fluracil
  • Fluracil
  • 5-fluor-2,4(1H,3H)-pyrimidindion
  • 5-Fluorouracil
  • AccuSite
  • Carac
  • Fluoro Uracil
  • Fluouracil
  • Flurablastin
  • Fluracedyl
  • Fluril
  • Fluroblastin
  • Ribofluor
  • Ro 2-9757
  • Ro-2-9757
Gitt IV
Andre navn:
  • 1-OHP
  • Dakotin
  • Dacplat
  • Eloxatin
  • Ai Heng
  • Aiheng
  • Diaminocykloheksan oksalatoplatina
  • JM-83
  • Oksalatoplatin
  • Oksalatoplatina
  • RP 54780
  • RP-54780
  • SR-96669
Gitt IV
Andre navn:
  • Campto
  • Camptosar
  • U-101440E
  • CPT-11
  • Camptothecin 11
  • Camptothecin-11
  • CPT 11
  • Irinomedac
Gjennomgå pankreatektomi
Andre navn:
  • Eksisjon av bukspyttkjertelen
Eksperimentell: Arm II (gemcitabin, nab-paklitaksel og kirurgi)
Pasienter får paklitakselalbuminstabilisert nanopartikkelformulering IV over 30 minutter og gemcitabinhydroklorid IV over 30 minutter på dag 1, 8 og 15. Behandlingen gjentas hver 28. dag i 3 kurer i fravær av sykdomsprogresjon eller uakseptabel toksisitet. Pasienter som oppnår stabil sykdom eller bedre gjennomgår pankreatektomi 4-8 uker etter fullførte første 3 behandlingskurer. Innen 4-8 uker etter pankreatektomi får pasientene ytterligere 3 kurer med paklitakselalbuminstabilisert nanopartikkelformulering og gemcitabinhydrokloridbehandling i fravær av sykdomsprogresjon eller uakseptabel toksisitet.
Gitt IV
Andre navn:
  • Gemzar
  • dFdCyd
  • Difluordeoksycytidinhydroklorid
  • LY-188011
Gitt IV
Andre navn:
  • ABI-007
  • Abraxane
  • Albuminbundet Paclitaxel
  • ABI 007
  • Albumin-stabilisert nanopartikkel Paclitaxel
  • Nanopartikkel Albumin-bundet Paclitaxel
  • Nanopartikkel Paclitaxel
  • nab-paklitaksel
  • proteinbundet paklitaksel
Gjennomgå pankreatektomi
Andre navn:
  • Eksisjon av bukspyttkjertelen

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Total overlevelse (OS)
Tidsramme: Opptil 4 år for estimater av median total overlevelse. Opptil 2 år for statistisk analyse 1 og 2, sammenlignet med observert 2-års total overlevelse (OS) med nullhypotesen på 40 %, i hver arm.
OS er lengden mellom protokollregistrering og pasientens død
Opptil 4 år for estimater av median total overlevelse. Opptil 2 år for statistisk analyse 1 og 2, sammenlignet med observert 2-års total overlevelse (OS) med nullhypotesen på 40 %, i hver arm.

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Antall pasienter med uønskede hendelser av grad 3 til og med grad 5 som er relatert til studiemedikament
Tidsramme: Behandlingsvarighet og oppfølging frem til død eller 4 år etter registrering.
Kun uønskede hendelser som er mulig, sannsynligvis eller definitivt relatert til preoperativ og postoperativ kjemoterapi er rapportert.
Behandlingsvarighet og oppfølging frem til død eller 4 år etter registrering.
Antall pasienter som skal til operasjon for reseksjon etter preoperativ kjemoterapi.
Tidsramme: Inntil 8 måneder etter registrering (og innen 4 til 8 uker etter siste dose av syklus 3 preoperativ kjemoterapi).
Inntil 8 måneder etter registrering (og innen 4 til 8 uker etter siste dose av syklus 3 preoperativ kjemoterapi).
Antall pasienter som oppnår R0-reseksjon etter preoperativ kjemoterapi.
Tidsramme: Inntil 8 måneder etter registrering (og innen 4 til 8 uker etter siste dose av syklus 3 preoperativ kjemoterapi).
R0 reseksjonsklassifisering er definert som makroskopisk fullstendig fjerning av svulster med negative mikroskopiske kirurgiske marginer (gallegang, pankreasparenkym og mesenteriske arteriemarginer superior).
Inntil 8 måneder etter registrering (og innen 4 til 8 uker etter siste dose av syklus 3 preoperativ kjemoterapi).
Antall deltakere med respons etter preoperativ kjemoterapi, inkludert bekreftet og ubekreftet, fullstendig og delvis respons, per RECIST 1.1.
Tidsramme: Inntil 6 måneder etter registrering (og innen 2 til 4 uker etter siste dose av syklus 3 preoperativ kjemoterapi.).
Evalueringskriterier per respons i solide svulster (RECIST v1.1) for mållesjoner og vurdert ved MR: Komplett respons (CR), forsvinning av alle mållesjoner; Delvis respons (PR), >=30 % reduksjon i summen av den lengste diameteren til mållesjonene; Samlet respons (OR) = CR + PR.
Inntil 6 måneder etter registrering (og innen 2 til 4 uker etter siste dose av syklus 3 preoperativ kjemoterapi.).
Antall deltakere med fullstendig respons, moderat respons, minimal respons og dårlig eller ingen respons etter reseksjon.
Tidsramme: Inntil 8 måneder etter registrering (og innen 4 til 8 uker etter siste dose av syklus 3 preoperativ kjemoterapi).

Patologisk respons ble evaluert etter at pasienten ble operert, og var basert på lokal patologigjennomgang av den resekerte kirurgiske prøven, i henhold til følgende definisjoner av tumorregresjonsgrad:

0: Fullstendig respons - ingen gjenværende svulst

  1. Moderat respons - minimal gjenværende kreft (enkeltceller eller små grupper av kreftceller)
  2. Minimal respons - gjenværende kreft vokst ut av fibrose
  3. Dårlig eller ingen respons - ingen sikker respons identifisert (minimalt eller ingen svulstdrap; omfattende gjenværende kreft)
Inntil 8 måneder etter registrering (og innen 4 til 8 uker etter siste dose av syklus 3 preoperativ kjemoterapi).
Antall deltakere med loko-regionalt og fjernt tilbakefall etter R0 eller R1 reseksjon.
Tidsramme: Inntil 4 år

Lokoregionalt residiv er definert som ethvert bevis på ny sykdom i bukspyttkjertelsvulsten basert på overvåkingsskanninger. Bukspyttkjertelsvulstsengen inkluderer:

  1. Superior mesenteriske arterie og vene lymfeknuter
  2. Lymfeknuter i porta hepatis (gallegang, portvene, leverarterielymfeknuter)
  3. Lymfeknuter rundt venstre nyrevene, inferior vena cava eller aorta
  4. Cøliakiakse lymfeknuter.

Fjernt tilbakefall er definert som ethvert tegn på ny sykdom utenfor den primære tumorsengen (lever, lunger, etc.) basert på overvåkingsskanninger.

Inntil 4 år
Sykdomsfri overlevelse fra tidspunktet for R0 eller R1 reseksjon.
Tidsramme: Inntil 4 år
Sykdomsfri overlevelse (DFS) beregnes for pasienter som gjennomgår kirurgisk reseksjon (R0/R1). DFS vil bli målt fra datoen for kirurgisk reseksjon til datoen for første dokumentasjon av tilbakefall (lokalregionalt eller fjernt) eller død på grunn av en hvilken som helst årsak. Pasienter sist kjent for å være i live og fri for sykdom vil bli sensurert på datoen for siste kontakt.
Inntil 4 år

Samarbeidspartnere og etterforskere

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

Samarbeidspartnere

Etterforskere

  • Hovedetterforsker: Davendra Sohal, Southwest Oncology Group

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.

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)

6. januar 2016

Primær fullføring (Faktiske)

31. mai 2020

Studiet fullført (Faktiske)

26. september 2022

Datoer for studieregistrering

Først innsendt

25. september 2015

Først innsendt som oppfylte QC-kriteriene

25. september 2015

Først lagt ut (Anslag)

29. september 2015

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

19. oktober 2022

Siste oppdatering sendt inn som oppfylte QC-kriteriene

18. oktober 2022

Sist bekreftet

1. oktober 2022

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 Adenokarsinom i bukspyttkjertelen

Kliniske studier på Gemcitabinhydroklorid

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