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Kombinasjonskjemoterapi med eller uten atezolizumab ved behandling av pasienter med stadium III tykktarmskreft og mangelfull reparasjon av DNA-mismatch

7. mai 2024 oppdatert av: National Cancer Institute (NCI)

Randomisert utprøving av standard kjemoterapi alene eller kombinert med atezolizumab som adjuvant terapi for pasienter med stadium III tykktarmskreft og mangelfull reparasjon av DNA-mismatch

Denne fase III-studien studerer kombinasjonskjemoterapi og atezolizumab for å se hvor godt det virker sammenlignet med kombinasjonskjemoterapi alene ved behandling av pasienter med stadium III tykktarmskreft og mangelfull reparasjon av deoksyribonukleinsyre (DNA) mismatch. Legemidler som brukes i kombinasjonskjemoterapi, som oksaliplatin, leucovorin kalsium og fluorouracil, 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 stoppe dem fra å spre seg. Immunterapi med monoklonale antistoffer, som atezolizumab, kan hjelpe kroppens immunsystem til å angripe kreften, og kan forstyrre tumorcellenes evne til å vokse og spre seg. Å gi kombinasjonskjemoterapi med atezolizumab kan fungere bedre enn kombinasjonskjemoterapi alene ved behandling av pasienter med tykktarmskreft.

Studieoversikt

Detaljert beskrivelse

HOVEDMÅL:

I. For å bestemme om atezolizumab kombinert med fluorouracil (FOLFOX) og dets videreføring som monoterapi kan forbedre sykdomsfri overlevelse (DFS) signifikant sammenlignet med FOLFOX alene hos pasienter med stadium III tykktarmskreft og mangelfull DNA-mismatch reparasjon (dMMR).

SEKUNDÆRE MÅL:

I. For å bestemme om atezolizumab kombinert med FOLFOX og dets videreføring som monoterapi kan forbedre den totale overlevelsen signifikant sammenlignet med FOLFOX alene hos pasienter med stadium III tykktarmskreft og dMMR.

II. For å vurdere bivirkningsprofilen (AE) og sikkerheten til hver behandlingsarm, ved å bruke Common Terminology Criteria for Adverse Events (CTCAE) og pasientrelaterte utfall (PRO)-CTCAE (blant pasienter i alderen >= 18 år).

LIVSKVALITET MÅL:

I. For å bestemme virkningen av tillegg av atezolizumab til FOLFOX på pasientrapportert nevropati, helserelatert livskvalitet (QOL) og funksjonelle domener av helserelatert QOL.

II. For å få tilgang til effekten av atezolizumab ved å justere for baseline QOL og tretthetsmålinger.

POTENSIELLE KORRELATIVA VITENSKAPSMÅL:

I. For å bestemme om "immunoscore" kan forutsi effekten av atezolizumab for sykdomsfri overlevelse blant pasienter med stadium III tykktarmskreft.

II. For å vurdere om sirkulerende immuncellepopulasjoner kan forutsi effekten av atezolizumab som adjuvant terapi for stadium III tykktarmskreft.

III. Å utforske assosiasjonene til genomiske endringer identifisert i cellefritt (cf)DNA med DFS hos pasienter behandlet med FOLFOX med eller uten atezolizumab.

IV. For å vurdere om løselige markører for systemisk betennelse i blod kan forutsi effekten av atezolizumab som adjuvant behandling for stadium III tykktarmskreft.

V. For å vurdere sammenhengen mellom baseline plasma 25(OH) D nivåer, endring i 25(OH)D nivåer og DFS og total overlevelse (OS) hos pasienter med stadium III tykktarmskreft som får FOLFOX +/- atezolizumab.

VI. For å bestemme evnen til å bruke fekal mikrobiota og deres metabolske produkter til å forutsi overlevelsesgevinst fra anti-PD-L1 antistoffterapi hos dMMR tykktarmskreftpasienter.

VII. For å bestemme om hypermutasjon eller hyper-indel-status er assosiert med respons på atezolizumab.

VIII. For å bestemme om unike budbringer ribonukleinsyre (mRNA) ekspresjonssignaturer er prediktive for sykdomsfri overlevelse blant pasienter som får adjuvant kjemoterapi for stadium III tykktarmskreft.

IX. For å avgjøre om effekten av atezolizumab er forskjellig mellom dMMR-kreft på grunn av kimlinje-MMR-mutasjon (MLH1, MSH2, MSH6, PMS2) sammenlignet med de med MLH1-hypermetylering og CIMP hos pasienter med stadium III tykktarmskreft.

X. For å identifisere total mutasjonsbyrde og antall antatte tumorneoantigener i tykktarmskarsinomprøver.

XI. For å bestemme endringer i vekstmønstre sammenlignet med baseline (i forhold til aldersspesifikke standarder for høyde og vekt). (Pasienter i alderen 12 til < 18 år for å evaluere effekten av atezolizumab på vekst- og utviklingsmønstre i denne populasjonen) XII. For å bestemme endringer i utviklingsmønstre sammenlignet med baseline (i forhold til begynnelsen av menarche [for kvinner] og pubertetsendringer). (Pasienter i alderen 12 til < 18 år for å evaluere effekten av atezolizumab på vekst- og utviklingsmønstre i denne populasjonen)

OVERSIGT: Pasienter randomiseres til 1 av 2 armer.

ARM I: Pasienter får oksaliplatin intravenøst ​​(IV) over 2 timer og leucovorin kalsium IV over 2 timer på dag 1, og fluorouracil IV som bolus på dag 1, deretter kontinuerlig over 46 timer på dag 1-3. Behandlingen gjentas hver 14. dag i opptil 12 sykluser i fravær av sykdomsprogresjon eller uakseptabel toksisitet. Pasienter får også atezolizumab IV over 30-60 minutter fra dag 1 i syklus 1 eller 2. Behandlingen gjentas hver 14. dag i opptil 25 sykluser i fravær av sykdomsprogresjon eller uakseptabel toksisitet. Pasienter gjennomgår computertomografi (CT) eller magnetisk resonanstomografi (MRI) hver 6. måned de første 2 årene, deretter i år 3-5 eller inntil tegn på tilbakefall, avhengig av hva som kommer først. Pasienter kan også gjennomgå blodprøvetaking gjennom hele forsøket.

ARM II: Pasienter får oksaliplatin IV over 2 timer og leucovorin kalsium IV over 2 timer på dag 1, og fluorouracil IV som bolus på dag 1, deretter kontinuerlig over 46 timer på dag 1-3. Behandlingen gjentas hver 14. dag i opptil 12 sykluser i fravær av sykdomsprogresjon eller uakseptabel toksisitet. Pasienter gjennomgår CT eller MR hver 6. måned de første 2 årene, deretter i 3-5 år eller inntil tegn på tilbakefall, avhengig av hva som kommer først. Pasienter kan også gjennomgå blodprøvetaking gjennom hele forsøket.

Etter avsluttet studiebehandling følges pasientene opp for residiv hver 6. måned i 2 år, deretter årlig i 3 år. Pasientene følges også opp for overlevelse hver 6. måned i opptil 8 år.

Studietype

Intervensjonell

Registrering (Antatt)

700

Fase

  • Fase 3

Kontakter og plasseringer

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

Studiesteder

    • 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
      • Fairbanks, Alaska, Forente stater, 99701
        • Fairbanks Memorial Hospital
    • Arizona
      • Phoenix, Arizona, Forente stater, 85054
        • Mayo Clinic Hospital in Arizona
      • Phoenix, Arizona, Forente stater, 85004
        • Cancer Center at Saint Joseph's
      • Scottsdale, Arizona, Forente stater, 85259
        • Mayo Clinic in Arizona
      • Tucson, Arizona, Forente stater, 85719
        • Banner University Medical Center - Tucson
      • Tucson, Arizona, Forente stater, 85719
        • University of Arizona Cancer Center-North Campus
    • Arkansas
      • Hot Springs, Arkansas, Forente stater, 71913
        • CHI Saint Vincent Cancer Center Hot Springs
      • Jonesboro, Arkansas, Forente stater, 72401
        • NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
    • California
      • Anaheim, California, Forente stater, 92806
        • Kaiser Permanente-Anaheim
      • Arroyo Grande, California, Forente stater, 93420
        • PCR Oncology
      • Auburn, California, Forente stater, 95602
        • Sutter Auburn Faith Hospital
      • Auburn, California, Forente stater, 95603
        • Sutter Cancer Centers Radiation Oncology Services-Auburn
      • Baldwin Park, California, Forente stater, 91706
        • Kaiser Permanente-Baldwin Park
      • Bellflower, California, Forente stater, 90706
        • Kaiser Permanente-Bellflower
      • Berkeley, California, Forente stater, 94704
        • Alta Bates Summit Medical Center-Herrick Campus
      • Burbank, California, Forente stater, 91505
        • Providence Saint Joseph Medical Center/Disney Family Cancer Center
      • Burlingame, California, Forente stater, 94010
        • Mills-Peninsula Medical Center
      • Cameron Park, California, Forente stater, 95682
        • Sutter Cancer Centers Radiation Oncology Services-Cameron Park
      • Castro Valley, California, Forente stater, 94546
        • Eden Hospital Medical Center
      • Clovis, California, Forente stater, 93611
        • Community Cancer Institute
      • Clovis, California, Forente stater, 93611
        • University Oncology Associates
      • Concord, California, Forente stater, 94520
        • John Muir Medical Center-Concord Campus
      • Costa Mesa, California, Forente stater, 92627
        • UC Irvine Health Cancer Center-Newport
      • Davis, California, Forente stater, 95616
        • Sutter Davis Hospital
      • Dublin, California, Forente stater, 94568
        • Epic Care-Dublin
      • Emeryville, California, Forente stater, 94608
        • Epic Care Partners in Cancer Care
      • Fontana, California, Forente stater, 92335
        • Kaiser Permanente-Fontana
      • Fremont, California, Forente stater, 94538
        • Palo Alto Medical Foundation-Fremont
      • Harbor City, California, Forente stater, 90710
        • Kaiser Permanente - Harbor City
      • Irvine, California, Forente stater, 92618
        • Kaiser Permanente-Irvine
      • Los Angeles, California, Forente stater, 90033
        • USC / Norris Comprehensive Cancer Center
      • Los Angeles, California, Forente stater, 90027
        • Kaiser Permanente Los Angeles Medical Center
      • Los Angeles, California, Forente stater, 90034
        • Kaiser Permanente West Los Angeles
      • Los Angeles, California, Forente stater, 90020
        • Keck Medicine of USC Koreatown
      • Los Angeles, California, Forente stater, 90033
        • Los Angeles General Medical Center
      • Martinez, California, Forente stater, 94553-3156
        • Contra Costa Regional Medical Center
      • Marysville, California, Forente stater, 95901
        • Fremont - Rideout Cancer Center
      • Modesto, California, Forente stater, 95355
        • Memorial Medical Center
      • 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
      • Ontario, California, Forente stater, 91761
        • Kaiser Permanente-Ontario
      • Orange, California, Forente stater, 92868
        • UC Irvine Health/Chao Family Comprehensive Cancer Center
      • Palo Alto, California, Forente stater, 94304
        • VA Palo Alto Health Care System
      • Palo Alto, California, Forente stater, 94304
        • Stanford Cancer Institute Palo Alto
      • Palo Alto, California, Forente stater, 94301
        • Palo Alto Medical Foundation Health Care
      • Panorama City, California, Forente stater, 91402
        • Kaiser Permanente - Panorama City
      • Riverside, California, Forente stater, 92505
        • Kaiser Permanente-Riverside
      • Roseville, California, Forente stater, 95661
        • Sutter Cancer Centers Radiation Oncology Services-Roseville
      • Roseville, California, Forente stater, 95661
        • Sutter Roseville Medical Center
      • Sacramento, California, Forente stater, 95816
        • Sutter Medical Center Sacramento
      • Sacramento, California, Forente stater, 95817
        • University of California Davis Comprehensive Cancer Center
      • Salinas, California, Forente stater, 93901
        • Salinas Valley Memorial
      • San Diego, California, Forente stater, 92120
        • Kaiser Permanente-San Diego Zion
      • San Diego, California, Forente stater, 92123
        • Sharp Memorial Hospital
      • San Francisco, California, Forente stater, 94115
        • California Pacific Medical Center-Pacific Campus
      • San Marcos, California, Forente stater, 92078
        • Kaiser Permanente-San Marcos
      • Santa Cruz, California, Forente stater, 95065
        • Palo Alto Medical Foundation-Santa Cruz
      • Santa Rosa, California, Forente stater, 95403
        • Sutter Pacific Medical Foundation
      • Sunnyvale, California, Forente stater, 94086
        • Palo Alto Medical Foundation-Sunnyvale
      • Vacaville, California, Forente stater, 95687
        • Sutter Cancer Centers Radiation Oncology Services-Vacaville
      • Vallejo, California, Forente stater, 94589
        • Sutter Solano Medical Center/Cancer Center
      • West Covina, California, Forente stater, 91790
        • City of Hope West Covina
      • Woodland Hills, California, Forente stater, 91367
        • Kaiser Permanente-Woodland Hills
    • Colorado
      • Aurora, Colorado, Forente stater, 80012
        • Rocky Mountain Cancer Centers-Aurora
      • Aurora, Colorado, Forente stater, 80045
        • UCHealth University of Colorado Hospital
      • Boulder, Colorado, Forente stater, 80301
        • Boulder Community Hospital
      • Boulder, Colorado, Forente stater, 80304
        • Rocky Mountain Cancer Centers-Boulder
      • Colorado Springs, Colorado, Forente stater, 80907
        • Penrose-Saint Francis Healthcare
      • Colorado Springs, Colorado, Forente stater, 80909
        • UCHealth Memorial Hospital Central
      • Colorado Springs, Colorado, Forente stater, 80907
        • Rocky Mountain Cancer Centers-Penrose
      • Colorado Springs, Colorado, Forente stater, 80920
        • Memorial Hospital North
      • Denver, Colorado, Forente stater, 80210
        • Porter Adventist Hospital
      • Denver, Colorado, Forente stater, 80205
        • Kaiser Permanente-Franklin
      • Denver, Colorado, Forente stater, 80218
        • Presbyterian - Saint Lukes Medical Center - Health One
      • Denver, Colorado, Forente stater, 80218
        • SCL Health Saint Joseph Hospital
      • Denver, Colorado, Forente stater, 80220
        • Rose Medical Center
      • Denver, Colorado, Forente stater, 80218
        • Rocky Mountain Cancer Centers-Midtown
      • Denver, Colorado, Forente stater, 80220
        • Rocky Mountain Cancer Centers-Rose
      • Denver, Colorado, Forente stater, 80204
        • Denver Health Medical Center
      • Denver, Colorado, Forente stater, 80218
        • Colorado Blood Cancer Institute
      • Denver, Colorado, Forente stater, 80209
        • The Women's Imaging Center
      • Denver, Colorado, Forente stater, 80206
        • National Jewish Health-Main Campus
      • Durango, Colorado, Forente stater, 81301
        • Mercy Medical Center
      • Durango, Colorado, Forente stater, 81301
        • Southwest Oncology PC
      • Englewood, Colorado, Forente stater, 80113
        • Mountain Blue Cancer Care Center - Swedish
      • Englewood, Colorado, Forente stater, 80113
        • Swedish Medical Center
      • Fort Collins, Colorado, Forente stater, 80524
        • Poudre Valley Hospital
      • Fort Collins, Colorado, Forente stater, 80528
        • Cancer Care and Hematology-Fort Collins
      • Golden, Colorado, Forente stater, 80401
        • Mountain Blue Cancer Care Center
      • Golden, Colorado, Forente stater, 80401
        • National Jewish Health-Western Hematology Oncology
      • Grand Junction, Colorado, Forente stater, 81501
        • Saint Mary's Hospital and Regional Medical Center
      • Grand Junction, Colorado, Forente stater, 81505
        • Grand Valley Oncology
      • Greeley, Colorado, Forente stater, 80631
        • North Colorado Medical Center
      • Greeley, Colorado, Forente stater, 80631
        • UCHealth Greeley Hospital
      • Highlands Ranch, Colorado, Forente stater, 80129
        • UCHealth Highlands Ranch Hospital
      • Lafayette, Colorado, Forente stater, 80026
        • Good Samaritan Medical Center
      • Lafayette, Colorado, Forente stater, 80026
        • Kaiser Permanente-Rock Creek
      • Lakewood, Colorado, Forente stater, 80228
        • Saint Anthony Hospital
      • Lakewood, Colorado, Forente stater, 80228
        • Rocky Mountain Cancer Centers-Lakewood
      • Littleton, Colorado, Forente stater, 80120
        • Rocky Mountain Cancer Centers-Littleton
      • Littleton, Colorado, Forente stater, 80122
        • Littleton Adventist Hospital
      • Lone Tree, Colorado, Forente stater, 80124
        • Kaiser Permanente-Lone Tree
      • Lone Tree, Colorado, Forente stater, 80124
        • Rocky Mountain Cancer Centers-Sky Ridge
      • Longmont, Colorado, Forente stater, 80501
        • Longmont United Hospital
      • Longmont, Colorado, Forente stater, 80501
        • Rocky Mountain Cancer Centers-Longmont
      • Loveland, Colorado, Forente stater, 80539
        • McKee Medical Center
      • Loveland, Colorado, Forente stater, 80538
        • Medical Center of the Rockies
      • Parker, Colorado, Forente stater, 80138
        • Parker Adventist Hospital
      • Parker, Colorado, Forente stater, 80138
        • Rocky Mountain Cancer Centers-Parker
      • Pueblo, Colorado, Forente stater, 81004
        • Saint Mary Corwin Medical Center
      • Pueblo, Colorado, Forente stater, 81008
        • Rocky Mountain Cancer Centers - Pueblo
      • Thornton, Colorado, Forente stater, 80260
        • Rocky Mountain Cancer Centers-Thornton
      • Thornton, Colorado, Forente stater, 80260
        • National Jewish Health-Northern Hematology Oncology
      • Wheat Ridge, Colorado, Forente stater, 80033
        • SCL Health Lutheran Medical Center
    • Connecticut
      • Derby, Connecticut, Forente stater, 06418
        • Smilow Cancer Hospital-Derby Care Center
      • Fairfield, Connecticut, Forente stater, 06824
        • Smilow Cancer Hospital Care Center-Fairfield
      • Glastonbury, Connecticut, Forente stater, 06033
        • Smilow Cancer Hospital Care Center at Glastonbury
      • Greenwich, Connecticut, Forente stater, 06830
        • Smilow Cancer Hospital Care Center at Greenwich
      • Guilford, Connecticut, Forente stater, 06437
        • Smilow Cancer Hospital Care Center - Guilford
      • Hartford, Connecticut, Forente stater, 06105
        • Smilow Cancer Hospital Care Center at Saint Francis
      • Middletown, Connecticut, Forente stater, 06457
        • Middlesex Hospital
      • New Haven, Connecticut, Forente stater, 06520
        • Yale University
      • North Haven, Connecticut, Forente stater, 06473
        • Yale-New Haven Hospital North Haven Medical Center
      • Torrington, Connecticut, Forente stater, 06790
        • Smilow Cancer Hospital-Torrington Care Center
      • Trumbull, Connecticut, Forente stater, 06611
        • Smilow Cancer Hospital Care Center-Trumbull
      • Waterbury, Connecticut, Forente stater, 06708
        • Smilow Cancer Hospital-Waterbury Care Center
      • Waterford, Connecticut, Forente stater, 06385
        • Smilow Cancer Hospital Care Center - Waterford
    • Delaware
      • Dover, Delaware, Forente stater, 19901
        • Bayhealth Hospital Kent Campus
      • Frankford, Delaware, Forente stater, 19945
        • Beebe South Coastal Health Campus
      • Lewes, Delaware, Forente stater, 19958
        • Beebe Medical Center
      • Milford, Delaware, Forente stater, 19963
        • Bayhealth Hospital Sussex Campus
      • Newark, Delaware, Forente stater, 19713
        • Helen F Graham Cancer Center
      • Newark, Delaware, Forente stater, 19713
        • Delaware Clinical and Laboratory Physicians PA
      • Newark, Delaware, Forente stater, 19713
        • Medical Oncology Hematology Consultants PA
      • Newark, Delaware, Forente stater, 19718
        • Christiana Care Health System-Christiana Hospital
      • Rehoboth Beach, Delaware, Forente stater, 19971
        • Beebe Health Campus
      • Seaford, Delaware, Forente stater, 19973
        • TidalHealth Nanticoke / Allen Cancer Center
      • Wilmington, Delaware, Forente stater, 19801
        • Christiana Care Health System-Wilmington Hospital
    • District of Columbia
      • Washington, District of Columbia, Forente stater, 20010
        • MedStar Washington Hospital Center
      • Washington, District of Columbia, Forente stater, 20016
        • Sibley Memorial Hospital
    • Florida
      • Aventura, Florida, Forente stater, 33180
        • Mount Sinai Comprehensive Cancer Center at Aventura
      • Celebration, Florida, Forente stater, 34747
        • AdventHealth Celebration
      • Daytona Beach, Florida, Forente stater, 32114
        • Halifax Health Medical Center-Centers for Oncology
      • Fort Lauderdale, Florida, Forente stater, 33316
        • Broward Health Medical Center
      • Fort Myers, Florida, Forente stater, 33905
        • Regional Cancer Center-Lee Memorial Health System
      • Miami Beach, Florida, Forente stater, 33140
        • Mount Sinai Medical Center
      • Orlando, Florida, Forente stater, 32803
        • AdventHealth Orlando
    • Georgia
      • Albany, Georgia, Forente stater, 31701
        • Phoebe Putney Memorial Hospital
      • Athens, Georgia, Forente stater, 30607
        • University Cancer and Blood Center LLC
      • Augusta, Georgia, Forente stater, 30901
        • Augusta Oncology Associates PC-D'Antignac
      • Augusta, Georgia, Forente stater, 30909
        • Augusta Oncology Associates PC-Wheeler
    • Hawaii
      • 'Aiea, Hawaii, Forente stater, 96701
        • Pali Momi Medical Center
      • 'Aiea, Hawaii, Forente stater, 96701
        • Queen's Cancer Center - Pearlridge
      • 'Aiea, Hawaii, Forente stater, 96701
        • The Cancer Center of Hawaii-Pali Momi
      • 'Aiea, Hawaii, Forente stater, 96701
        • Hawaii Cancer Care - Westridge
      • Honolulu, Hawaii, Forente stater, 96813
        • Queen's Medical Center
      • Honolulu, Hawaii, Forente stater, 96817
        • The Cancer Center of Hawaii-Liliha
      • Honolulu, Hawaii, Forente stater, 96813
        • Hawaii Cancer Care Inc - Waterfront Plaza
      • Honolulu, Hawaii, Forente stater, 96813
        • Queen's Cancer Cenrer - POB I
      • Honolulu, Hawaii, Forente stater, 96813
        • Straub Clinic and Hospital
      • Honolulu, Hawaii, Forente stater, 96813
        • University of Hawaii Cancer Center
      • Honolulu, Hawaii, Forente stater, 96817
        • Hawaii Cancer Care Inc-Liliha
      • Honolulu, Hawaii, Forente stater, 96817
        • Kuakini Medical Center
      • Honolulu, Hawaii, Forente stater, 96817
        • Queen's Cancer Center - Kuakini
      • Honolulu, Hawaii, Forente stater, 96826
        • Kapiolani Medical Center for Women and Children
      • Honolulu, Hawaii, Forente stater, 96813
        • Island Urology
      • Lihue, Hawaii, Forente stater, 96766
        • Wilcox Memorial Hospital and Kauai Medical Clinic
    • Idaho
      • Boise, Idaho, Forente stater, 83706
        • Saint Alphonsus Cancer Care Center-Boise
      • Boise, Idaho, Forente stater, 83712
        • Saint Luke's Cancer Institute - Boise
      • Caldwell, Idaho, Forente stater, 83605
        • Saint Alphonsus Cancer Care Center-Caldwell
      • Coeur d'Alene, Idaho, Forente stater, 83814
        • Kootenai Health - Coeur d'Alene
      • Emmett, Idaho, Forente stater, 83617
        • Walter Knox Memorial Hospital
      • Fruitland, Idaho, Forente stater, 83619
        • Saint Luke's Cancer Institute - Fruitland
      • Meridian, Idaho, Forente stater, 83642
        • Idaho Urologic Institute-Meridian
      • Meridian, Idaho, Forente stater, 83642
        • Saint Luke's Cancer Institute - Meridian
      • Nampa, Idaho, Forente stater, 83686
        • Saint Luke's Cancer Institute - Nampa
      • Nampa, Idaho, Forente stater, 83687
        • Saint Alphonsus Cancer Care Center-Nampa
      • Post Falls, Idaho, Forente stater, 83854
        • Kootenai Clinic Cancer Services - Post Falls
      • Sandpoint, Idaho, Forente stater, 83864
        • Kootenai Cancer Clinic
      • Twin Falls, Idaho, Forente stater, 83301
        • Saint Luke's Cancer Institute - Twin Falls
    • Illinois
      • Aurora, Illinois, Forente stater, 60504
        • Rush - Copley Medical Center
      • Barrington, Illinois, Forente stater, 60010
        • Advocate Good Shepherd Hospital
      • Bloomington, Illinois, Forente stater, 61704
        • Illinois CancerCare-Bloomington
      • Canton, Illinois, Forente stater, 61520
        • Illinois CancerCare-Canton
      • Carbondale, Illinois, Forente stater, 62902
        • Memorial Hospital of Carbondale
      • Carterville, Illinois, Forente stater, 62918
        • SIH Cancer Institute
      • Carthage, Illinois, Forente stater, 62321
        • Illinois CancerCare-Carthage
      • Centralia, Illinois, Forente stater, 62801
        • Centralia Oncology Clinic
      • Chicago, Illinois, Forente stater, 60611
        • Northwestern University
      • Chicago, Illinois, Forente stater, 60612
        • Rush University Medical Center
      • Chicago, Illinois, Forente stater, 60637
        • University of Chicago Comprehensive Cancer Center
      • Chicago, Illinois, Forente stater, 60612
        • John H Stroger Jr Hospital of Cook County
      • Chicago, Illinois, Forente stater, 60657
        • Advocate Illinois Masonic Medical Center
      • Crystal Lake, Illinois, Forente stater, 60014
        • AMG Crystal Lake - Oncology
      • Danville, Illinois, Forente stater, 61832
        • Carle at The Riverfront
      • DeKalb, Illinois, Forente stater, 60115
        • Northwestern Medicine Cancer Center Kishwaukee
      • Decatur, Illinois, Forente stater, 62526
        • Decatur Memorial Hospital
      • Decatur, Illinois, Forente stater, 62526
        • Cancer Care Specialists of Illinois - Decatur
      • Dixon, Illinois, Forente stater, 61021
        • Illinois CancerCare-Dixon
      • Downers Grove, Illinois, Forente stater, 60515
        • Advocate Good Samaritan Hospital
      • Effingham, Illinois, Forente stater, 62401
        • Crossroads Cancer Center
      • Effingham, Illinois, Forente stater, 62401
        • Carle Physician Group-Effingham
      • Elgin, Illinois, Forente stater, 60123
        • Advocate Sherman Hospital
      • Eureka, Illinois, Forente stater, 61530
        • Illinois CancerCare-Eureka
      • Evanston, Illinois, Forente stater, 60201
        • NorthShore University HealthSystem-Evanston Hospital
      • Evanston, Illinois, Forente stater, 60202
        • Saint Francis Hospital
      • Freeport, Illinois, Forente stater, 61032
        • Freeport Memorial Hospital/Leonard C Ferguson Cancer Center
      • Galesburg, Illinois, Forente stater, 61401
        • Western Illinois Cancer Treatment Center
      • Galesburg, Illinois, Forente stater, 61401
        • Illinois CancerCare-Galesburg
      • Geneva, Illinois, Forente stater, 60134
        • Northwestern Medicine Cancer Center Delnor
      • Glenview, Illinois, Forente stater, 60026
        • NorthShore University HealthSystem-Glenbrook Hospital
      • Harvey, Illinois, Forente stater, 60426
        • Ingalls Memorial Hospital
      • Hazel Crest, Illinois, Forente stater, 60429
        • Advocate South Suburban Hospital
      • Highland Park, Illinois, Forente stater, 60035
        • NorthShore University HealthSystem-Highland Park Hospital
      • Kewanee, Illinois, Forente stater, 61443
        • Illinois CancerCare-Kewanee Clinic
      • Lake Forest, Illinois, Forente stater, 60045
        • Northwestern Medicine Lake Forest Hospital
      • Libertyville, Illinois, Forente stater, 60048
        • Condell Memorial Hospital
      • Libertyville, Illinois, Forente stater, 60048
        • AMG Libertyville - Oncology
      • Macomb, Illinois, Forente stater, 61455
        • Illinois CancerCare-Macomb
      • Mattoon, Illinois, Forente stater, 61938
        • Carle Physician Group-Mattoon/Charleston
      • Maywood, Illinois, Forente stater, 60153
        • Loyola University Medical Center
      • Moline, Illinois, Forente stater, 61265
        • 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
      • O'Fallon, Illinois, Forente stater, 62269
        • Cancer Care Center of O'Fallon
      • Oak Lawn, Illinois, Forente stater, 60453-2699
        • Advocate Christ Medical Center
      • Orland Park, Illinois, Forente stater, 60462
        • University of Chicago Medicine-Orland Park
      • Ottawa, Illinois, Forente stater, 61350
        • Illinois CancerCare-Ottawa Clinic
      • Park Ridge, Illinois, Forente stater, 60068
        • Advocate Lutheran General Hospital
      • Pekin, Illinois, Forente stater, 61554
        • Illinois CancerCare-Pekin
      • Pekin, Illinois, Forente stater, 61554
        • OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
      • Peoria, Illinois, Forente stater, 61636
        • Methodist Medical Center of Illinois
      • Peoria, Illinois, Forente stater, 61637
        • OSF Saint Francis Medical Center
      • Peoria, Illinois, Forente stater, 61615
        • Illinois CancerCare-Peoria
      • Peoria, Illinois, Forente stater, 61615
        • OSF Saint Francis Radiation Oncology at Peoria Cancer Center
      • Peru, Illinois, Forente stater, 61354
        • Illinois CancerCare-Peru
      • Peru, Illinois, Forente stater, 61354
        • Valley Radiation Oncology
      • Princeton, Illinois, Forente stater, 61356
        • Illinois CancerCare-Princeton
      • Silvis, Illinois, Forente stater, 61282
        • Genesis Cancer Center - Silvis
      • Skokie, Illinois, Forente stater, 60076
        • Hematology Oncology Associates of Illinois - Skokie
      • Springfield, Illinois, Forente stater, 62781
        • Memorial Medical Center
      • Springfield, Illinois, Forente stater, 62702
        • Southern Illinois University School of Medicine
      • Springfield, Illinois, Forente stater, 62702
        • Springfield Clinic
      • Swansea, Illinois, Forente stater, 62226
        • Southwest Illinois Health Services LLP
      • Urbana, Illinois, Forente stater, 61801
        • Carle Cancer Center
      • Urbana, Illinois, Forente stater, 61801
        • The Carle Foundation Hospital
      • Warrenville, Illinois, Forente stater, 60555
        • Northwestern Medicine Cancer Center Warrenville
      • Washington, Illinois, Forente stater, 61571
        • Illinois CancerCare - Washington
    • Indiana
      • Carmel, Indiana, Forente stater, 46032
        • IU Health North Hospital
      • Indianapolis, Indiana, Forente stater, 46237
        • Franciscan Health Indianapolis
      • Indianapolis, Indiana, Forente stater, 46202
        • Indiana University/Melvin and Bren Simon Cancer Center
      • Indianapolis, Indiana, Forente stater, 46202
        • Sidney and Lois Eskenazi Hospital
      • Michigan City, Indiana, Forente stater, 46360
        • Woodland Cancer Care Center
      • Mooresville, Indiana, Forente stater, 46158
        • Franciscan Health Mooresville
      • New Albany, Indiana, Forente stater, 47150
        • Baptist Health Floyd
      • Richmond, Indiana, Forente stater, 47374
        • Reid Health
      • Terre Haute, Indiana, Forente stater, 47804
        • Union Hospital
    • Iowa
      • Ames, Iowa, Forente stater, 50010
        • Mary Greeley Medical Center
      • Ames, Iowa, Forente stater, 50010
        • McFarland Clinic - Ames
      • Bettendorf, Iowa, Forente stater, 52722
        • University of Iowa Healthcare Cancer Services Quad Cities
      • Boone, Iowa, Forente stater, 50036
        • McFarland Clinic - Boone
      • Carroll, Iowa, Forente stater, 51401
        • Saint Anthony Regional Hospital
      • Cedar Rapids, Iowa, Forente stater, 52403
        • Mercy Hospital
      • Cedar Rapids, Iowa, Forente stater, 52403
        • Oncology Associates at Mercy Medical Center
      • Clive, Iowa, Forente stater, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Forente stater, 50325
        • Medical Oncology and Hematology Associates-West Des Moines
      • Council Bluffs, Iowa, Forente stater, 51503
        • Alegent Health Mercy Hospital
      • Creston, Iowa, Forente stater, 50801
        • Greater Regional Medical Center
      • Davenport, Iowa, Forente stater, 52803
        • Genesis Medical Center - East Campus
      • Davenport, Iowa, Forente stater, 52804
        • Genesis Cancer Care Institute
      • Davenport, Iowa, Forente stater, 52807
        • Iowa Cancer Specialists
      • 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, 50314
        • Mission Cancer and Blood - Laurel
      • Des Moines, Iowa, Forente stater, 50316
        • Iowa Lutheran Hospital
      • Fort Dodge, Iowa, Forente stater, 50501
        • Trinity Regional Medical Center
      • Fort Dodge, Iowa, Forente stater, 50501
        • McFarland Clinic - Trinity Cancer Center
      • Iowa City, Iowa, Forente stater, 52242
        • University of Iowa/Holden Comprehensive Cancer Center
      • Jefferson, Iowa, Forente stater, 50129
        • McFarland Clinic - Jefferson
      • Marshalltown, Iowa, Forente stater, 50158
        • McFarland Clinic - Marshalltown
      • Mason City, Iowa, Forente stater, 50401
        • Mercy Medical Center - North Iowa
      • Sioux City, Iowa, Forente stater, 51101
        • Siouxland Regional Cancer Center
      • West Des Moines, Iowa, Forente stater, 50266-7700
        • Methodist West Hospital
      • West Des Moines, Iowa, Forente stater, 50266
        • Mercy Medical Center-West Lakes
    • Kansas
      • Coffeyville, Kansas, Forente stater, 67337
        • Coffeyville Regional Medical Center
      • 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
      • Hays, Kansas, Forente stater, 67601
        • HaysMed University of Kansas Health System
      • Kansas City, Kansas, Forente stater, 66112
        • University of Kansas Cancer Center-West
      • 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
      • Olathe, Kansas, Forente stater, 66061
        • Olathe Health Cancer 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
      • Pittsburg, Kansas, Forente stater, 66762
        • Ascension Via Christi - Pittsburg
      • Salina, Kansas, Forente stater, 67401
        • Salina Regional Health Center
      • Topeka, Kansas, Forente stater, 66606
        • University of Kansas Health System Saint Francis Campus
      • Topeka, Kansas, Forente stater, 66606
        • Cotton O'Neil Cancer Center / Stormont Vail Health
      • Wellington, Kansas, Forente stater, 67152
        • Cancer Center of Kansas - Wellington
      • Westwood, Kansas, Forente stater, 66205
        • University of Kansas Hospital-Westwood Cancer Center
      • Wichita, Kansas, Forente stater, 67208
        • Cancer Center of Kansas-Wichita Medical Arts Tower
      • Wichita, Kansas, Forente stater, 67214
        • Cancer Center of Kansas - Wichita
    • Kentucky
      • Bardstown, Kentucky, Forente stater, 40004
        • Flaget Memorial Hospital
      • Corbin, Kentucky, Forente stater, 40701
        • Commonwealth Cancer Center-Corbin
      • Edgewood, Kentucky, Forente stater, 41017
        • Saint Elizabeth Healthcare Edgewood
      • Fort Thomas, Kentucky, Forente stater, 41075
        • Saint Elizabeth Fort Thomas
      • Lexington, Kentucky, Forente stater, 40536
        • University of Kentucky/Markey Cancer Center
      • Lexington, Kentucky, Forente stater, 40504
        • Saint Joseph Radiation Oncology Resource Center
      • Lexington, Kentucky, Forente stater, 40509
        • Saint Joseph Hospital East
      • Lexington, Kentucky, Forente stater, 40503
        • Baptist Health Lexington
      • London, Kentucky, Forente stater, 40741
        • Saint Joseph London
      • Louisville, Kentucky, Forente stater, 40202
        • Jewish Hospital
      • Louisville, Kentucky, Forente stater, 40245
        • UofL Health Medical Center Northeast
      • Louisville, Kentucky, Forente stater, 40207
        • Baptist Health Louisville
      • Louisville, Kentucky, Forente stater, 40215
        • Saints Mary and Elizabeth Hospital
      • Madisonville, Kentucky, Forente stater, 42431
        • Baptist Health Madisonville/Merle Mahr Cancer Center
      • Shepherdsville, Kentucky, Forente stater, 40165
        • Jewish Hospital Medical Center South
    • Louisiana
      • Baton Rouge, Louisiana, Forente stater, 70805
        • LSU Health Baton Rouge-North Clinic
      • Baton Rouge, Louisiana, Forente stater, 70809
        • Louisiana Hematology Oncology Associates LLC
      • Baton Rouge, Louisiana, Forente stater, 70809
        • Mary Bird Perkins Cancer Center
      • Baton Rouge, Louisiana, Forente stater, 70809
        • Our Lady of the Lake Physicians Group - Medical Oncology
      • Baton Rouge, Louisiana, Forente stater, 70816
        • Medical Center of Baton Rouge
      • Baton Rouge, Louisiana, Forente stater, 70836
        • Ochsner High Grove
      • Baton Rouge, Louisiana, Forente stater, 70808
        • Our Lady of The Lake
      • Covington, Louisiana, Forente stater, 70433
        • Northshore Oncology Associates-Covington
      • Covington, Louisiana, Forente stater, 70433
        • Ochsner Hematology Oncology North Shore - Covington (West Region)
      • Houma, Louisiana, Forente stater, 70360
        • Oncology Center of The South Incorporated
      • Kenner, Louisiana, Forente stater, 70065
        • Ochsner Medical Center Kenner
      • New Orleans, Louisiana, Forente stater, 70121
        • Ochsner Medical Center Jefferson
      • Shreveport, Louisiana, Forente stater, 71105
        • CHRISTUS Highland Medical Center
    • Maine
      • Augusta, Maine, Forente stater, 04330
        • Harold Alfond Center for Cancer Care
      • Bangor, Maine, Forente stater, 04401
        • Eastern Maine Medical Center
      • Belfast, Maine, Forente stater, 04915
        • Waldo County General Hospital
      • Biddeford, Maine, Forente stater, 04005
        • MaineHealth/SMHC Cancer Care and Blood Disorders-Biddeford
      • Brewer, Maine, Forente stater, 04412
        • Lafayette Family Cancer Center-EMMC
      • Rockport, Maine, Forente stater, 04856
        • Penobscot Bay Medical Center
      • Sanford, Maine, Forente stater, 04073
        • MaineHealth/SMHC Cancer Care and Blood Disorders-Sanford
      • South Portland, Maine, Forente stater, 04106
        • Maine Medical Partners - South Portland
    • Maryland
      • Baltimore, Maryland, Forente stater, 21287
        • Johns Hopkins University/Sidney Kimmel Cancer Center
      • Baltimore, Maryland, Forente stater, 21201
        • University of Maryland/Greenebaum Cancer Center
      • Baltimore, Maryland, Forente stater, 21229
        • Saint Agnes Hospital
      • Glen Burnie, Maryland, Forente stater, 21061
        • UM Baltimore Washington Medical Center/Tate Cancer Center
      • Ocean Pines, Maryland, Forente stater, 21811
        • TidalHealth Richard A Henson Cancer Institute
      • Salisbury, Maryland, Forente stater, 21801
        • TidalHealth Peninsula Regional
    • Massachusetts
      • Boston, Massachusetts, Forente stater, 02215
        • Beth Israel Deaconess Medical Center
      • Boston, Massachusetts, Forente stater, 02215
        • Dana-Farber Cancer Institute
      • Boston, Massachusetts, Forente stater, 02118
        • Boston Medical Center
      • Lowell, Massachusetts, Forente stater, 01854
        • Lowell General 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
      • Bay City, Michigan, Forente stater, 48706
        • McLaren Cancer Institute-Bay City
      • Bloomfield, Michigan, Forente stater, 48302
        • McLaren Cancer Institute-Bloomfield
      • Brighton, Michigan, Forente stater, 48114
        • Saint Joseph Mercy Brighton
      • Brighton, Michigan, Forente stater, 48114
        • Trinity Health IHA Medical Group Hematology Oncology - Brighton
      • Brownstown, Michigan, Forente stater, 48183
        • Henry Ford Cancer Institute-Downriver
      • Canton, Michigan, Forente stater, 48188
        • Saint Joseph Mercy Canton
      • Canton, Michigan, Forente stater, 48188
        • Trinity Health IHA Medical Group Hematology Oncology - Canton
      • Caro, Michigan, Forente stater, 48723
        • Caro Cancer Center
      • Chelsea, Michigan, Forente stater, 48118
        • Saint Joseph Mercy Chelsea
      • Chelsea, Michigan, Forente stater, 48118
        • Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
      • Clarkston, Michigan, Forente stater, 48346
        • McLaren Cancer Institute-Clarkston
      • Clarkston, Michigan, Forente stater, 48346
        • Hematology Oncology Consultants-Clarkston
      • Clarkston, Michigan, Forente stater, 48346
        • Newland Medical Associates-Clarkston
      • Clinton Township, Michigan, Forente stater, 48038
        • Henry Ford Macomb Hospital-Clinton Township
      • Dearborn, Michigan, Forente stater, 48124
        • Beaumont Hospital - Dearborn
      • Dearborn, Michigan, Forente stater, 48126
        • Henry Ford Medical Center-Fairlane
      • Detroit, Michigan, Forente stater, 48202
        • Henry Ford Hospital
      • Detroit, Michigan, Forente stater, 48201
        • Wayne State University/Karmanos Cancer Institute
      • Detroit, Michigan, Forente stater, 48236
        • Ascension Saint John Hospital
      • East China Township, Michigan, Forente stater, 48054
        • Great Lakes Cancer Management Specialists-Doctors Park
      • East Lansing, Michigan, Forente stater, 48824
        • Michigan State University Clinical Center
      • Farmington Hills, Michigan, Forente stater, 48334
        • Weisberg Cancer Treatment Center
      • Farmington Hills, Michigan, Forente stater, 48336
        • Beaumont Hospital - Farmington Hills
      • Flint, Michigan, Forente stater, 48532
        • Singh and Arora Hematology Oncology PC
      • 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
      • Grosse Pointe, Michigan, Forente stater, 48230
        • William Beaumont Hospital-Grosse Pointe
      • 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, 49009
        • Ascension Borgess Cancer Center
      • Lansing, Michigan, Forente stater, 48912
        • Mid-Michigan Physicians-Lansing
      • Lansing, Michigan, Forente stater, 48910
        • Karmanos Cancer Institute at McLaren Greater Lansing
      • Lansing, Michigan, Forente stater, 48912
        • University of Michigan Health - Sparrow Lansing
      • Lapeer, Michigan, Forente stater, 48446
        • McLaren Cancer Institute-Lapeer Region
      • Livonia, Michigan, Forente stater, 48154
        • Trinity Health Saint Mary Mercy Livonia Hospital
      • Livonia, Michigan, Forente stater, 48154
        • Hope Cancer Clinic
      • Macomb, Michigan, Forente stater, 48044
        • 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
      • Mount Clemens, Michigan, Forente stater, 48043
        • McLaren Cancer Institute-Macomb
      • Mount Pleasant, Michigan, Forente stater, 48858
        • McLaren Cancer Institute-Central Michigan
      • Novi, Michigan, Forente stater, 48374
        • Ascension Providence Hospitals - Novi
      • Novi, Michigan, Forente stater, 48377
        • Henry Ford Medical Center-Columbus
      • Petoskey, Michigan, Forente stater, 49770
        • McLaren Cancer Institute-Northern Michigan
      • Pontiac, Michigan, Forente stater, 48341
        • Saint Joseph Mercy Oakland
      • Pontiac, Michigan, Forente stater, 48341
        • 21st Century Oncology-Pontiac
      • Pontiac, Michigan, Forente stater, 48341
        • Hope Cancer Center
      • Pontiac, Michigan, Forente stater, 48341
        • Newland Medical Associates-Pontiac
      • Port Huron, Michigan, Forente stater, 48060
        • McLaren-Port Huron
      • Port Huron, Michigan, Forente stater, 48060
        • Lake Huron Medical Center
      • Reed City, Michigan, Forente stater, 49677
        • Corewell 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, 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
      • Royal Oak, Michigan, Forente stater, 48067
        • Oakland Colon Rectal Associates
      • Saginaw, Michigan, Forente stater, 48601
        • Ascension Saint Mary's Hospital
      • Saginaw, Michigan, Forente stater, 48604
        • Oncology Hematology Associates of Saginaw Valley PC
      • Saginaw, Michigan, Forente stater, 48604
        • Covenant HealthCare Mackinaw
      • Saint Joseph, Michigan, Forente stater, 49085
        • Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
      • Southfield, Michigan, Forente stater, 48075
        • Ascension Providence Hospitals - Southfield
      • Sterling Heights, Michigan, Forente stater, 48312
        • Bhadresh Nayak MD PC-Sterling Heights
      • Sterling Heights, Michigan, Forente stater, 48312
        • Premier Hematology Oncology Care
      • Sterling Heights, Michigan, Forente stater, 48314
        • Mitchell Folbe MD PC
      • Tawas City, Michigan, Forente stater, 48764
        • Ascension Saint Joseph Hospital
      • Traverse City, Michigan, Forente stater, 49684
        • Munson Medical Center
      • Troy, Michigan, Forente stater, 48085
        • William Beaumont Hospital - Troy
      • Troy, Michigan, Forente stater, 48084
        • Michigan Institute of Urology-Town Center
      • Troy, Michigan, Forente stater, 48085
        • Claudia BR Herke MD PC
      • Troy, Michigan, Forente stater, 48098
        • Hematology Oncology Consultants PC-Troy
      • Warren, Michigan, Forente stater, 48093
        • Saint John Macomb-Oakland Hospital
      • Warren, Michigan, Forente stater, 48088
        • Advanced Breast Care Center PLLC
      • Warren, Michigan, Forente stater, 48093
        • Great Lakes Cancer Management Specialists-Macomb Professional Building
      • Warren, Michigan, Forente stater, 48093
        • Macomb Hematology Oncology PC
      • Warren, Michigan, Forente stater, 48093
        • Michigan Breast Specialists-Warren
      • West Bloomfield, Michigan, Forente stater, 48322
        • Henry Ford West Bloomfield Hospital
      • West Branch, Michigan, Forente stater, 48661
        • Saint Mary's Oncology/Hematology Associates of West Branch
      • Wyoming, Michigan, Forente stater, 49519
        • University of Michigan Health - West
      • Ypsilanti, Michigan, Forente stater, 48197
        • Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
      • Ypsilanti, Michigan, Forente stater, 48106
        • Huron Gastroenterology PC
    • Minnesota
      • Bemidji, Minnesota, Forente stater, 56601
        • Sanford Joe Lueken Cancer Center
      • Brainerd, Minnesota, Forente stater, 56401
        • Essentia Health Saint Joseph's Medical Center
      • Burnsville, Minnesota, Forente stater, 55337
        • Fairview Ridges Hospital
      • Burnsville, Minnesota, Forente stater, 55337
        • Minnesota Oncology - Burnsville
      • Coon Rapids, Minnesota, Forente stater, 55433
        • Mercy Hospital
      • Deer River, Minnesota, Forente stater, 56636
        • Essentia Health - Deer River Clinic
      • Duluth, Minnesota, Forente stater, 55805
        • Saint Luke's Hospital of Duluth
      • 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
      • Mankato, Minnesota, Forente stater, 56001
        • Mayo Clinic Health Systems-Mankato
      • Maple Grove, Minnesota, Forente stater, 55369
        • Fairview Clinics and Surgery Center Maple Grove
      • Maplewood, Minnesota, Forente stater, 55109
        • Saint John's Hospital - Healtheast
      • Maplewood, Minnesota, Forente stater, 55109
        • Minnesota Oncology Hematology PA-Maplewood
      • Minneapolis, Minnesota, Forente stater, 55415
        • Hennepin County Medical Center
      • Minneapolis, Minnesota, Forente stater, 55407
        • Abbott-Northwestern Hospital
      • Minneapolis, Minnesota, Forente stater, 55454
        • Health Partners Inc
      • Minneapolis, Minnesota, Forente stater, 55417
        • Minneapolis VA Medical Center
      • 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 in Rochester
      • Saint Cloud, Minnesota, Forente stater, 56303
        • Coborn Cancer Center at Saint Cloud Hospital
      • Saint Cloud, Minnesota, Forente stater, 56303
        • Saint Cloud Hospital
      • Saint Louis Park, Minnesota, Forente stater, 55416
        • Park Nicollet Clinic - Saint Louis Park
      • Saint Paul, Minnesota, Forente stater, 55101
        • Regions Hospital
      • Saint Paul, Minnesota, Forente stater, 55102
        • United Hospital
      • Sandstone, Minnesota, Forente stater, 55072
        • Essentia Health Sandstone
      • Shakopee, Minnesota, Forente stater, 55379
        • Saint Francis Regional Medical Center
      • Stillwater, Minnesota, Forente stater, 55082
        • Lakeview Hospital
      • 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
      • Grenada, Mississippi, Forente stater, 38901
        • Baptist Cancer Center-Grenada
      • Jackson, Mississippi, Forente stater, 39216
        • University Of Mississippi Medical Center
      • New Albany, Mississippi, Forente stater, 38652
        • Baptist Memorial Hospital and Cancer Center-Union County
      • Oxford, Mississippi, Forente stater, 38655
        • Baptist Memorial Hospital and Cancer Center-Oxford
      • Pascagoula, Mississippi, Forente stater, 39581
        • Singing River Hospital
      • 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
        • MU Health - University Hospital/Ellis Fischel Cancer Center
      • Creve Coeur, Missouri, Forente stater, 63141
        • Siteman Cancer Center at West County Hospital
      • Farmington, Missouri, Forente stater, 63640
        • Parkland Health Center - Farmington
      • Independence, Missouri, Forente stater, 64057
        • Centerpoint Medical Center LLC
      • Jefferson City, Missouri, Forente stater, 65109
        • 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, 64154
        • University of Kansas Cancer Center - North
      • 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 Centers
      • Lee's Summit, Missouri, Forente stater, 64064
        • University of Kansas Cancer Center - Lee's Summit
      • Lee's Summit, Missouri, Forente stater, 64086
        • Saint Luke's East - Lee's Summit
      • 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, 64506
        • Heartland Regional Medical Center
      • Saint Louis, Missouri, Forente stater, 63110
        • Washington University School of Medicine
      • Saint Louis, Missouri, Forente stater, 63131
        • Missouri Baptist Medical Center
      • Saint Louis, Missouri, Forente stater, 63141
        • Mercy Hospital Saint Louis
      • Saint Louis, Missouri, Forente stater, 63128
        • Mercy Hospital South
      • Saint Louis, Missouri, Forente stater, 63129
        • Siteman Cancer Center-South County
      • Saint Louis, Missouri, Forente stater, 63136
        • Siteman Cancer Center at Christian Hospital
      • Saint Louis, Missouri, Forente stater, 63109
        • Saint Louis Cancer and Breast Institute-South City
      • Saint Peters, Missouri, Forente stater, 63376
        • Siteman Cancer Center at Saint Peters Hospital
      • Sainte Genevieve, Missouri, Forente stater, 63670
        • Sainte Genevieve County Memorial Hospital
      • Springfield, Missouri, Forente stater, 65807
        • CoxHealth South Hospital
      • Springfield, Missouri, Forente stater, 65804
        • Mercy Hospital Springfield
      • Sullivan, Missouri, Forente stater, 63080
        • Missouri Baptist Sullivan Hospital
      • Sunset Hills, Missouri, Forente stater, 63127
        • BJC Outpatient Center at Sunset Hills
      • Washington, Missouri, Forente stater, 63090
        • Mercy Hospital Washington
    • Montana
      • Anaconda, Montana, Forente stater, 59711
        • Community Hospital of Anaconda
      • Billings, Montana, Forente stater, 59101
        • Billings Clinic Cancer Center
      • Bozeman, Montana, Forente stater, 59715
        • Bozeman Deaconess Hospital
      • Great Falls, Montana, Forente stater, 59405
        • Great Falls Clinic
      • Great Falls, Montana, Forente stater, 59405
        • Benefis Healthcare- Sletten Cancer Institute
      • Helena, Montana, Forente stater, 59601
        • Saint Peter's Community Hospital
      • Kalispell, Montana, Forente stater, 59901
        • Kalispell Regional Medical Center
      • Missoula, Montana, Forente stater, 59804
        • Community Medical Hospital
      • Missoula, Montana, Forente stater, 59802
        • Saint Patrick Hospital - Community Hospital
    • Nebraska
      • 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, 68118
        • Nebraska Medicine-Village Pointe
      • Omaha, Nebraska, Forente stater, 68122
        • Alegent Health Immanuel Medical Center
      • Omaha, Nebraska, Forente stater, 68130
        • Alegent Health Lakeside Hospital
      • Omaha, Nebraska, Forente stater, 68131
        • Creighton University Medical Center
      • Omaha, Nebraska, Forente stater, 68122
        • Hematology and Oncology Consultants PC
      • Omaha, Nebraska, Forente stater, 68114
        • Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
      • Papillion, Nebraska, Forente stater, 68046
        • Midlands Community Hospital
    • Nevada
      • Carson City, Nevada, Forente stater, 89703
        • Carson Tahoe Regional Medical Center
      • Henderson, Nevada, Forente stater, 89052
        • Comprehensive Cancer Centers of Nevada - Henderson
      • Henderson, Nevada, Forente stater, 89052
        • OptumCare Cancer Care at Seven Hills
      • Henderson, Nevada, Forente stater, 89052
        • Cancer and Blood Specialists-Henderson
      • Henderson, Nevada, Forente stater, 89052
        • Las Vegas Cancer Center-Henderson
      • Henderson, Nevada, Forente stater, 89074
        • Comprehensive Cancer Centers of Nevada-Southeast Henderson
      • Henderson, Nevada, Forente stater, 89074
        • GenesisCare USA - Henderson
      • Henderson, Nevada, Forente stater, 89052
        • Comprehensive Cancer Centers of Nevada-Horizon Ridge
      • Las Vegas, Nevada, Forente stater, 89144
        • Summerlin Hospital Medical Center
      • Las Vegas, Nevada, Forente stater, 89102
        • OptumCare Cancer Care at Charleston
      • Las Vegas, Nevada, Forente stater, 89106
        • Radiation Oncology Centers of Nevada Central
      • Las Vegas, Nevada, Forente stater, 89109
        • GenesisCare USA - Las Vegas
      • Las Vegas, Nevada, Forente stater, 89119
        • Radiation Oncology Centers of Nevada Southeast
      • Las Vegas, Nevada, Forente stater, 89128
        • Comprehensive Cancer Centers of Nevada - Northwest
      • Las Vegas, Nevada, Forente stater, 89128
        • OptumCare Cancer Care at MountainView
      • Las Vegas, Nevada, Forente stater, 89144
        • Comprehensive Cancer Centers of Nevada-Summerlin
      • Las Vegas, Nevada, Forente stater, 89148
        • Comprehensive Cancer Centers of Nevada
      • Las Vegas, Nevada, Forente stater, 89148
        • OptumCare Cancer Care at Fort Apache
      • Las Vegas, Nevada, Forente stater, 89169
        • Comprehensive Cancer Centers of Nevada - Central Valley
      • Las Vegas, Nevada, Forente stater, 89102
        • University Medical Center of Southern Nevada
      • Las Vegas, Nevada, Forente stater, 89106
        • Cancer and Blood Specialists-Shadow
      • Las Vegas, Nevada, Forente stater, 89109
        • HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
      • Las Vegas, Nevada, Forente stater, 89113
        • HealthCare Partners Medical Group Oncology/Hematology-San Martin
      • Las Vegas, Nevada, Forente stater, 89121
        • Cancer Therapy and Integrative Medicine
      • Las Vegas, Nevada, Forente stater, 89128
        • Cancer and Blood Specialists-Tenaya
      • Las Vegas, Nevada, Forente stater, 89128
        • GenesisCare USA - Vegas Tenaya
      • Las Vegas, Nevada, Forente stater, 89128
        • HealthCare Partners Medical Group Oncology/Hematology-Tenaya
      • Las Vegas, Nevada, Forente stater, 89148-2405
        • Las Vegas Cancer Center-Medical Center
      • Las Vegas, Nevada, Forente stater, 89148
        • GenesisCare USA - Fort Apache
      • Las Vegas, Nevada, Forente stater, 89149
        • HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
      • Las Vegas, Nevada, Forente stater, 89128
        • Ann M Wierman MD LTD
      • Las Vegas, Nevada, Forente stater, 89102
        • Desert West Surgery
      • Las Vegas, Nevada, Forente stater, 89169
        • University Cancer Center
      • Pahrump, Nevada, Forente stater, 89048
        • Hope Cancer Care of Nevada-Pahrump
      • Reno, Nevada, Forente stater, 89502
        • Renown Regional Medical Center
      • Reno, Nevada, Forente stater, 89503
        • Saint Mary's Regional Medical Center
      • Reno, Nevada, Forente stater, 89509
        • Radiation Oncology Associates
    • New Hampshire
      • Concord, New Hampshire, Forente stater, 03301
        • New Hampshire Oncology Hematology PA-Concord
      • Exeter, New Hampshire, Forente stater, 03833
        • Exeter Hospital
      • Lebanon, New Hampshire, Forente stater, 03756
        • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
      • Manchester, New Hampshire, Forente stater, 03102
        • Norris Cotton Cancer Center-Manchester
      • Manchester, New Hampshire, Forente stater, 03103
        • Solinsky Center for Cancer Care
      • Nashua, New Hampshire, Forente stater, 03063
        • Dartmouth Cancer Center - Nashua
    • New Jersey
      • Basking Ridge, New Jersey, Forente stater, 07920
        • Memorial Sloan Kettering Basking Ridge
      • Cape May Court House, New Jersey, Forente stater, 08210
        • AtlantiCare Health Park-Cape May Court House
      • Egg Harbor Township, New Jersey, Forente stater, 08234
        • AtlantiCare Surgery Center
      • Englewood, New Jersey, Forente stater, 07631
        • Englewood Hospital and Medical Center
      • Hamilton, New Jersey, Forente stater, 08690
        • The Cancer Institute of New Jersey Hamilton
      • Livingston, New Jersey, Forente stater, 07039
        • Saint Barnabas Medical Center
      • Middletown, New Jersey, Forente stater, 07748
        • Memorial Sloan Kettering Monmouth
      • Montvale, New Jersey, Forente stater, 07645
        • Memorial Sloan Kettering Bergen
      • Morristown, New Jersey, Forente stater, 07960
        • Morristown Medical Center
      • Mullica Hill, New Jersey, Forente stater, 08062
        • Inspira Medical Center Mullica Hill
      • New Brunswick, New Jersey, Forente stater, 08903
        • Rutgers Cancer Institute of New Jersey
      • Newark, New Jersey, Forente stater, 07112
        • Newark Beth Israel Medical Center
      • Paramus, New Jersey, Forente stater, 07652
        • The Valley Hospital-Luckow Pavilion
      • Ridgewood, New Jersey, Forente stater, 07450
        • Valley Hospital
      • Ridgewood, New Jersey, Forente stater, 07450
        • Neurosurgeons of New Jersey-Ridgewood
      • Somerville, New Jersey, Forente stater, 08876
        • Robert Wood Johnson University Hospital Somerset
      • Summit, New Jersey, Forente stater, 07902
        • Overlook Hospital
      • Vineland, New Jersey, Forente stater, 08360
        • Inspira Medical Center Vineland
      • Westwood, New Jersey, Forente stater, 07675
        • Valley Health System-Hematology/Oncology
    • New Mexico
      • Albuquerque, New Mexico, Forente stater, 87102
        • University of New Mexico Cancer Center
      • Albuquerque, New Mexico, Forente stater, 87102
        • Lovelace Medical Center-Saint Joseph Square
      • Albuquerque, New Mexico, Forente stater, 87110
        • Presbyterian Kaseman Hospital
      • Las Cruces, New Mexico, Forente stater, 88011
        • Memorial Medical Center - Las Cruces
      • Rio Rancho, New Mexico, Forente stater, 87124
        • Presbyterian Rust Medical Center/Jorgensen Cancer Center
    • New York
      • Auburn, New York, Forente stater, 13021
        • Hematology Oncology Associates of Central New York-Auburn
      • Brooklyn, New York, Forente stater, 11219
        • Maimonides Medical Center
      • Buffalo, New York, Forente stater, 14263
        • Roswell Park Cancer Institute
      • Commack, New York, Forente stater, 11725
        • Memorial Sloan Kettering Commack
      • Cooperstown, New York, Forente stater, 13326
        • Mary Imogene Bassett Hospital
      • East Hills, New York, Forente stater, 11548
        • Cancer Institute at Saint Francis Hospital
      • East Syracuse, New York, Forente stater, 13057
        • Hematology Oncology Associates of Central New York-East Syracuse
      • Elmira, New York, Forente stater, 14905
        • Arnot Ogden Medical Center/Falck Cancer Center
      • Harrison, New York, Forente stater, 10604
        • Memorial Sloan Kettering Westchester
      • New York, New York, Forente stater, 10065
        • Memorial Sloan Kettering Cancer Center
      • New York, New York, Forente stater, 10019
        • Mount Sinai West
      • New York, New York, Forente stater, 10029
        • Mount Sinai Hospital
      • New York, New York, Forente stater, 10032
        • NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
      • New York, New York, Forente stater, 10065
        • NYP/Weill Cornell Medical Center
      • New York, New York, Forente stater, 10016
        • Laura and Isaac Perlmutter Cancer Center at NYU Langone
      • Poughkeepsie, New York, Forente stater, 12601
        • Vassar Brothers Medical Center
      • Rochester, New York, Forente stater, 14642
        • University of Rochester
      • Rochester, New York, Forente stater, 14621
        • Rochester General Hospital
      • Stony Brook, New York, Forente stater, 11794
        • Stony Brook University Medical Center
      • Syracuse, New York, Forente stater, 13210
        • State University of New York Upstate Medical University
      • Syracuse, New York, Forente stater, 13215
        • Hematology Oncology Associates of Central New York-Onondaga Hill
      • Uniondale, New York, Forente stater, 11553
        • Memorial Sloan Kettering Nassau
      • West Islip, New York, Forente stater, 11795
        • Good Samaritan University Hospital
      • White Plains, New York, Forente stater, 10601
        • Dickstein Cancer Treatment Center
    • North Carolina
      • Albemarle, North Carolina, Forente stater, 28002
        • Atrium Health Stanly/LCI-Albemarle
      • 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
      • Chapel Hill, North Carolina, Forente stater, 27599
        • UNC Lineberger Comprehensive Cancer Center
      • Charlotte, North Carolina, Forente stater, 28203
        • Carolinas Medical Center/Levine Cancer Institute
      • Charlotte, North Carolina, Forente stater, 28210
        • Atrium Health Pineville/LCI-Pineville
      • Charlotte, North Carolina, Forente stater, 28262
        • Atrium Health University City/LCI-University
      • Charlotte, North Carolina, Forente stater, 28211
        • Levine Cancer Institute-SouthPark
      • Charlotte, North Carolina, Forente stater, 28277
        • Levine Cancer Institute-Ballantyne
      • Clinton, North Carolina, Forente stater, 28328
        • Southeastern Medical Oncology Center-Clinton
      • Clyde, North Carolina, Forente stater, 28721
        • AdventHealth Infusion Center Haywood
      • Concord, North Carolina, Forente stater, 28025
        • Atrium Health Cabarrus/LCI-Concord
      • Durham, North Carolina, Forente stater, 27710
        • Duke University Medical Center
      • Gastonia, North Carolina, Forente stater, 28054
        • Levine Cancer Institute-Gaston
      • 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
      • Greensboro, North Carolina, Forente stater, 27410
        • Cone Health Cancer Center at Drawbridge Parkway
      • Greenville, North Carolina, Forente stater, 27834
        • East Carolina University
      • Hendersonville, North Carolina, Forente stater, 28791
        • Margaret R Pardee Memorial Hospital
      • 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
      • Kenansville, North Carolina, Forente stater, 28349
        • Vidant Oncology-Kenansville
      • Kinston, North Carolina, Forente stater, 28501
        • Vidant Oncology-Kinston
      • Lincolnton, North Carolina, Forente stater, 28092
        • Atrium Health Lincoln/LCI-Lincolnton
      • Mebane, North Carolina, Forente stater, 27302
        • Cone Heath Cancer Center at Mebane
      • Monroe, North Carolina, Forente stater, 28112
        • Atrium Health Union/LCI-Union
      • Reidsville, North Carolina, Forente stater, 27320
        • Annie Penn Memorial Hospital
      • Richlands, North Carolina, Forente stater, 28574
        • Vidant Oncology-Richlands
      • Shelby, North Carolina, Forente stater, 28150
        • Atrium Health Cleveland/LCI-Cleveland
      • Washington, North Carolina, Forente stater, 27889
        • Marion L Shepard Cancer Center at Vidant Beaufort Hospital
      • Weaverville, North Carolina, Forente stater, 28787
        • AdventHealth Infusion Center Weaverville
      • Wilmington, North Carolina, Forente stater, 28401
        • Novant Health New Hanover Regional Medical Center
    • North Dakota
      • Bismarck, North Dakota, Forente stater, 58501
        • Sanford Bismarck Medical Center
      • Fargo, North Dakota, Forente stater, 58122
        • Sanford Roger Maris Cancer Center
      • Fargo, North Dakota, Forente stater, 58103
        • Essentia Health Cancer Center-South University Clinic
      • Fargo, North Dakota, Forente stater, 58122
        • Sanford Broadway Medical Center
      • Grand Forks, North Dakota, Forente stater, 58201
        • Altru Cancer Center
      • Minot, North Dakota, Forente stater, 58701
        • Trinity Cancer Care Center
    • Ohio
      • Beavercreek, Ohio, Forente stater, 45431
        • Indu and Raj Soin Medical Center
      • Belpre, Ohio, Forente stater, 45714
        • Strecker Cancer Center-Belpre
      • Canton, Ohio, Forente stater, 44708
        • Cleveland Clinic Mercy Hospital
      • Canton, Ohio, Forente stater, 44710
        • Aultman Health Foundation
      • Centerville, Ohio, Forente stater, 45459
        • Miami Valley Hospital South
      • Centerville, Ohio, Forente stater, 45459
        • Dayton Physicians LLC-Miami Valley South
      • Chillicothe, Ohio, Forente stater, 45601
        • Adena Regional Medical Center
      • Cincinnati, Ohio, Forente stater, 45219
        • The Christ Hospital
      • Cincinnati, Ohio, Forente stater, 45220
        • Good Samaritan Hospital - Cincinnati
      • Cincinnati, Ohio, Forente stater, 45242
        • Bethesda North Hospital
      • Cincinnati, Ohio, Forente stater, 45236
        • Oncology Hematology Care Inc-Kenwood
      • Cincinnati, Ohio, Forente stater, 45247
        • TriHealth Cancer Institute-Westside
      • Cincinnati, Ohio, Forente stater, 45255
        • TriHealth Cancer Institute-Anderson
      • Cleveland, Ohio, Forente stater, 44111
        • Cleveland Clinic Cancer Center/Fairview Hospital
      • Columbus, Ohio, Forente stater, 43214
        • Riverside Methodist Hospital
      • Columbus, Ohio, Forente stater, 43210
        • Ohio State University Comprehensive Cancer Center
      • Columbus, Ohio, Forente stater, 43219
        • The Mark H Zangmeister Center
      • Columbus, Ohio, Forente stater, 43214
        • Columbus Oncology and Hematology Associates Inc
      • Columbus, Ohio, Forente stater, 43228
        • Doctors Hospital
      • Columbus, Ohio, Forente stater, 43213
        • Mount Carmel East Hospital
      • Columbus, Ohio, Forente stater, 43215
        • Grant Medical Center
      • Columbus, Ohio, Forente stater, 43222
        • Mount Carmel Health Center West
      • Dayton, Ohio, Forente stater, 45406
        • Good Samaritan Hospital - Dayton
      • Dayton, Ohio, Forente stater, 45409
        • Miami Valley Hospital
      • Dayton, Ohio, Forente stater, 45415
        • Dayton Physician LLC-Miami Valley Hospital North
      • Dayton, Ohio, Forente stater, 45415
        • Miami Valley Hospital North
      • Delaware, Ohio, Forente stater, 43015
        • Delaware Health Center-Grady Cancer Center
      • Delaware, Ohio, Forente stater, 43015
        • Delaware Radiation Oncology
      • Delaware, Ohio, Forente stater, 43015
        • Grady Memorial Hospital
      • Findlay, Ohio, Forente stater, 45840
        • Blanchard Valley Hospital
      • Findlay, Ohio, Forente stater, 45840
        • Armes Family Cancer Center
      • Findlay, Ohio, Forente stater, 45840
        • Orion Cancer Care
      • Franklin, Ohio, Forente stater, 45005-1066
        • Atrium Medical Center-Middletown Regional Hospital
      • Franklin, Ohio, Forente stater, 45005
        • Dayton Physicians LLC-Atrium
      • Greenville, Ohio, Forente stater, 45331
        • Wayne Hospital
      • Greenville, Ohio, Forente stater, 45331
        • Dayton Physicians LLC-Wayne
      • Kettering, Ohio, Forente stater, 45429
        • Kettering Medical Center
      • Kettering, Ohio, Forente stater, 45409
        • Greater Dayton Cancer Center
      • Kettering, Ohio, Forente stater, 45420
        • First Dayton Cancer Care
      • Lancaster, Ohio, Forente stater, 43130
        • Fairfield Medical Center
      • Mansfield, Ohio, Forente stater, 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
      • Mount Vernon, Ohio, Forente stater, 43050
        • Knox Community Hospital
      • Newark, Ohio, Forente stater, 43055
        • Licking Memorial Hospital
      • Newark, Ohio, Forente stater, 43055
        • Newark Radiation Oncology
      • Perrysburg, Ohio, Forente stater, 43551
        • Mercy Health Perrysburg Cancer Center
      • Portsmouth, Ohio, Forente stater, 45662
        • Southern Ohio Medical Center
      • Sandusky, Ohio, Forente stater, 44870
        • North Coast Cancer Care
      • Springfield, Ohio, Forente stater, 45505
        • Springfield Regional Medical Center
      • Springfield, Ohio, Forente stater, 45504
        • Springfield Regional Cancer Center
      • Steubenville, Ohio, Forente stater, 43952
        • Trinity's Tony Teramana 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
        • Mercy Health - Saint Anne Hospital
      • Toledo, Ohio, Forente stater, 43623
        • Toledo Clinic Cancer Centers-Toledo
      • Troy, Ohio, Forente stater, 45373
        • Upper Valley Medical Center
      • Troy, Ohio, Forente stater, 45373
        • Dayton Physicians LLC - Troy
      • Warrensville Heights, Ohio, Forente stater, 44122
        • South Pointe Hospital
      • Westerville, Ohio, Forente stater, 43081
        • Saint Ann's Hospital
      • Wooster, Ohio, Forente stater, 44691
        • Cleveland Clinic Wooster Family Health and Surgery Center
      • Wright-Patterson Air Force Base, Ohio, Forente stater, 45433
        • Wright-Patterson Medical Center
      • Youngstown, Ohio, Forente stater, 44501
        • Saint Elizabeth Youngstown Hospital
      • Zanesville, Ohio, Forente stater, 43701
        • Genesis Healthcare System Cancer Care Center
    • Oklahoma
      • Lawton, Oklahoma, Forente stater, 73505
        • Cancer Centers of Southwest Oklahoma Research
      • Oklahoma City, Oklahoma, Forente stater, 73104
        • University of Oklahoma Health Sciences Center
      • Oklahoma City, Oklahoma, Forente stater, 73120
        • Mercy Hospital Oklahoma City
      • Tulsa, Oklahoma, Forente stater, 74146
        • Oklahoma Cancer Specialists and Research Institute-Tulsa
    • 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 Cancer Institute Clackamas Clinic
      • Coos Bay, Oregon, Forente stater, 97420
        • Bay Area Hospital
      • Corvallis, Oregon, Forente stater, 97330
        • Good Samaritan Hospital
      • Newberg, Oregon, Forente stater, 97132
        • Providence Newberg Medical Center
      • Ontario, Oregon, Forente stater, 97914
        • Saint Alphonsus Medical Center-Ontario
      • Portland, Oregon, Forente stater, 97213
        • Providence Portland Medical Center
      • Portland, Oregon, Forente stater, 97225
        • Providence Saint Vincent Medical Center
    • Pennsylvania
      • Abington, Pennsylvania, Forente stater, 19001
        • Jefferson Abington Hospital
      • Allentown, Pennsylvania, Forente stater, 18103
        • Lehigh Valley Hospital-Cedar Crest
      • Allentown, Pennsylvania, Forente stater, 18104
        • Saint Luke's Cancer Center - Allentown
      • Altoona, Pennsylvania, Forente stater, 16601
        • UPMC Altoona
      • Beaver, Pennsylvania, Forente stater, 15009
        • UPMC-Heritage Valley Health System Beaver
      • 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
      • Butler, Pennsylvania, Forente stater, 16001
        • UPMC Hillman Cancer Center at Butler Health System
      • Camp Hill, Pennsylvania, Forente stater, 17011
        • UPMC Camp Hill
      • Carlisle, Pennsylvania, Forente stater, 17015
        • Carlisle Regional Cancer Center
      • Chadds Ford, Pennsylvania, Forente stater, 19317
        • Christiana Care Health System-Concord Health Center
      • Chambersburg, Pennsylvania, Forente stater, 17201
        • Chambersburg Hospital
      • Chambersburg, Pennsylvania, Forente stater, 17201
        • WellSpan Medical Oncology and Hematology
      • Danville, Pennsylvania, Forente stater, 17822
        • Geisinger Medical Center
      • East Norriton, Pennsylvania, Forente stater, 19401
        • Fox Chase Cancer Center - East Norriton Hospital Outpatient Center
      • Easton, Pennsylvania, Forente stater, 18045
        • Saint Luke's Hospital-Anderson Campus
      • Ephrata, Pennsylvania, Forente stater, 17522
        • Ephrata Cancer Center
      • Ephrata, Pennsylvania, Forente stater, 17522
        • Ephrata Community Hospital
      • Erie, Pennsylvania, Forente stater, 16505
        • UPMC Hillman Cancer Center Erie
      • Farrell, Pennsylvania, Forente stater, 16121
        • UPMC Cancer Center at UPMC Horizon
      • Gettysburg, Pennsylvania, Forente stater, 17325
        • Adams Cancer Center
      • Greensburg, Pennsylvania, Forente stater, 15601
        • UPMC Cancer Centers - Arnold Palmer Pavilion
      • Greenville, Pennsylvania, Forente stater, 16125
        • Oncology Hematology Associates
      • Hanover, Pennsylvania, Forente stater, 17331
        • Cherry Tree Cancer Center
      • Harrisburg, Pennsylvania, Forente stater, 17109
        • UPMC Pinnacle Cancer Center/Community Osteopathic Campus
      • Hazleton, Pennsylvania, Forente stater, 18201
        • Geisinger Medical Center-Cancer Center Hazleton
      • Indiana, Pennsylvania, Forente stater, 15701
        • IRMC Cancer Center
      • Jefferson Hills, Pennsylvania, Forente stater, 15025
        • Jefferson Hospital
      • Johnstown, Pennsylvania, Forente stater, 15901
        • UPMC-Johnstown/John P. Murtha Regional Cancer Center
      • Lebanon, Pennsylvania, Forente stater, 17042
        • Sechler Family Cancer Center
      • Lewisburg, Pennsylvania, Forente stater, 17837
        • Geisinger Medical Oncology-Lewisburg
      • Lewistown, Pennsylvania, Forente stater, 17044
        • Lewistown Hospital
      • McKeesport, Pennsylvania, Forente stater, 15132
        • UPMC Cancer Center at UPMC McKeesport
      • Mechanicsburg, Pennsylvania, Forente stater, 17050
        • UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion
      • Media, Pennsylvania, Forente stater, 19063
        • Riddle Memorial Hospital
      • Monroeville, Pennsylvania, Forente stater, 15146
        • Forbes Hospital
      • Monroeville, Pennsylvania, Forente stater, 15146
        • UPMC Hillman Cancer Center - Monroeville
      • Moon, Pennsylvania, Forente stater, 15108
        • UPMC Hillman Cancer Center in Coraopolis
      • Mount Pleasant, Pennsylvania, Forente stater, 15666
        • UPMC Hillman Cancer Center - Part of Frick Hospital
      • N. Huntingdon, Pennsylvania, Forente stater, 15642
        • Arnold Palmer Cancer Center Medical Oncology Norwin
      • Natrona Heights, Pennsylvania, Forente stater, 15065
        • Allegheny Valley Hospital
      • New Castle, Pennsylvania, Forente stater, 16105
        • UPMC Hillman Cancer Center - New Castle
      • Paoli, Pennsylvania, Forente stater, 19301
        • Paoli Memorial Hospital
      • Philadelphia, Pennsylvania, Forente stater, 19104
        • Children's Hospital of Philadelphia
      • Philadelphia, Pennsylvania, Forente stater, 19140
        • Temple University Hospital
      • Pittsburgh, Pennsylvania, Forente stater, 15212
        • Allegheny General Hospital
      • Pittsburgh, Pennsylvania, Forente stater, 15224
        • West Penn Hospital
      • Pittsburgh, Pennsylvania, Forente stater, 15232
        • University of Pittsburgh Cancer Institute (UPCI)
      • Pittsburgh, Pennsylvania, Forente stater, 15237
        • UPMC-Passavant Hospital
      • Pittsburgh, Pennsylvania, Forente stater, 15243
        • UPMC-Saint Clair Hospital Cancer Center
      • Pittsburgh, Pennsylvania, Forente stater, 15219
        • UPMC-Mercy Hospital
      • Pottsville, Pennsylvania, Forente stater, 17901
        • Geisinger Cancer Services-Pottsville
      • Quakertown, Pennsylvania, Forente stater, 18951
        • Saint Luke's Hospital-Quakertown Campus
      • 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
      • Seneca, Pennsylvania, Forente stater, 16346
        • UPMC Cancer Center at UPMC Northwest
      • State College, Pennsylvania, Forente stater, 16801
        • Geisinger Medical Group
      • Uniontown, Pennsylvania, Forente stater, 15401
        • UPMC Cancer Center-Uniontown
      • Washington, Pennsylvania, Forente stater, 15301
        • UPMC Cancer Center-Washington
      • West Mifflin, Pennsylvania, Forente stater, 15122
        • UPMC West Mifflin-Cancer Center Jefferson
      • West Reading, Pennsylvania, Forente stater, 19611
        • Reading Hospital
      • Wilkes-Barre, Pennsylvania, Forente stater, 18711
        • Geisinger Wyoming Valley/Henry Cancer Center
      • Williamsport, Pennsylvania, Forente stater, 17754
        • Divine Providence Hospital
      • Willow Grove, Pennsylvania, Forente stater, 19090
        • Asplundh Cancer Pavilion
      • Wynnewood, Pennsylvania, Forente stater, 19096
        • Lankenau Medical Center
      • York, Pennsylvania, Forente stater, 17403
        • WellSpan Health-York Cancer Center
      • York, Pennsylvania, Forente stater, 17403
        • WellSpan Health-York Hospital
      • York, Pennsylvania, Forente stater, 17403
        • Cancer Care Associates of York
      • York, Pennsylvania, Forente stater, 17408
        • UPMC Memorial
    • Rhode Island
      • Providence, Rhode Island, Forente stater, 02903
        • Rhode Island Hospital
    • South Carolina
      • Anderson, South Carolina, Forente stater, 29621
        • AnMed Health Cancer Center
      • Boiling Springs, South Carolina, Forente stater, 29316
        • Prisma Health Cancer Institute - Spartanburg
      • Charleston, South Carolina, Forente stater, 29425
        • Medical University of South Carolina
      • Clinton, South Carolina, Forente stater, 29325
        • Prisma Health Cancer Institute - Laurens
      • Easley, South Carolina, Forente stater, 29640
        • Prisma Health Cancer Institute - Easley
      • Gaffney, South Carolina, Forente stater, 29341
        • Gibbs Cancer Center-Gaffney
      • Greenville, South Carolina, Forente stater, 29605
        • Prisma Health Cancer Institute - Faris
      • Greenville, South Carolina, Forente stater, 29607
        • Saint Francis Cancer Center
      • Greenville, South Carolina, Forente stater, 29615
        • Prisma Health Cancer Institute - Eastside
      • Greenville, South Carolina, Forente stater, 29605
        • Prisma Health Cancer Institute - Butternut
      • Greenville, South Carolina, Forente stater, 29601
        • Saint Francis Hospital
      • Greenville, South Carolina, Forente stater, 29605
        • Prisma Health Greenville Memorial Hospital
      • Greenwood, South Carolina, Forente stater, 29646
        • Self Regional Healthcare
      • Greer, South Carolina, Forente stater, 29650
        • Prisma Health Cancer Institute - Greer
      • Greer, South Carolina, Forente stater, 29651
        • Gibbs Cancer Center-Pelham
      • Rock Hill, South Carolina, Forente stater, 29732
        • Levine Cancer Institute-Rock Hill
      • Seneca, South Carolina, Forente stater, 29672
        • Prisma Health Cancer Institute - Seneca
      • Spartanburg, South Carolina, Forente stater, 29303
        • Spartanburg Medical Center
    • South Dakota
      • Aberdeen, South Dakota, Forente stater, 57401
        • Avera Cancer Institute-Aberdeen
      • Pierre, South Dakota, Forente stater, 57501
        • Avera Cancer Institute at Pierre
      • Rapid City, South Dakota, Forente stater, 57701
        • Rapid City Regional Hospital
      • Sioux Falls, South Dakota, Forente stater, 57105
        • Avera Cancer Institute
      • Sioux Falls, South Dakota, Forente stater, 57117-5134
        • Sanford USD Medical Center - Sioux Falls
      • Sioux Falls, South Dakota, Forente stater, 57104
        • Sanford Cancer Center Oncology Clinic
    • Tennessee
      • Bristol, Tennessee, Forente stater, 37620
        • Bristol Regional Medical Center
      • Chattanooga, Tennessee, Forente stater, 37404
        • Memorial Hospital
      • Collierville, Tennessee, Forente stater, 38017
        • Baptist Memorial Hospital and Cancer Center-Collierville
      • Cookeville, Tennessee, Forente stater, 38501
        • Cookeville Regional Medical Center
      • 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
        • Ballad Health Cancer Care - Kingsport
      • Kingsport, Tennessee, Forente stater, 37660
        • Wellmont Holston Valley Hospital and Medical Center
      • Knoxville, Tennessee, Forente stater, 37916
        • Thompson Cancer Survival Center
      • Knoxville, Tennessee, Forente stater, 37932
        • Thompson Cancer Survival Center - West
      • Lenoir City, Tennessee, Forente stater, 37772
        • Thompson Oncology Group-Lenoir City
      • Maryville, Tennessee, Forente stater, 37804
        • Thompson Oncology Group-Maryville
      • Memphis, Tennessee, Forente stater, 38120
        • Baptist Memorial Hospital and Cancer Center-Memphis
      • Nashville, Tennessee, Forente stater, 37208
        • Meharry Medical College
      • Oak Ridge, Tennessee, Forente stater, 37830
        • Thompson Oncology Group-Oak Ridge
      • Ooltewah, Tennessee, Forente stater, 37363
        • Memorial GYN Plus
    • Texas
      • Amarillo, Texas, Forente stater, 79106
        • The Don and Sybil Harrington Cancer Center
      • Austin, Texas, Forente stater, 78723
        • Dell Children's Medical Center of Central Texas
      • Austin, Texas, Forente stater, 78701
        • Dell Seton Medical Center at The University of Texas
      • Bryan, Texas, Forente stater, 77802
        • Saint Joseph Regional Cancer Center
      • Conroe, Texas, Forente stater, 77384
        • MD Anderson in The Woodlands
      • Dallas, Texas, Forente stater, 75235
        • Parkland Memorial Hospital
      • Dallas, Texas, Forente stater, 75390
        • UT Southwestern/Simmons Cancer Center-Dallas
      • Edinburg, Texas, Forente stater, 78539
        • STCC at DHR Health Institute for Research and Development
      • Houston, Texas, Forente stater, 77030
        • M D Anderson Cancer Center
      • Houston, Texas, Forente stater, 77079
        • MD Anderson West Houston
      • League City, Texas, Forente stater, 77573
        • MD Anderson League City
      • Round Rock, Texas, Forente stater, 78665
        • Scott and White Healthcare Round Rock
      • Sugar Land, Texas, Forente stater, 77478
        • MD Anderson in Sugar Land
      • Temple, Texas, Forente stater, 76508
        • Scott and White Memorial Hospital
    • Utah
      • American Fork, Utah, Forente stater, 84003
        • American Fork Hospital / Huntsman Intermountain Cancer Center
      • Cedar City, Utah, Forente stater, 84720
        • Sandra L Maxwell Cancer Center
      • Farmington, Utah, Forente stater, 84025
        • Farmington Health Center
      • Logan, Utah, Forente stater, 84321
        • Logan Regional Hospital
      • Murray, Utah, Forente stater, 84107
        • Intermountain Medical Center
      • Ogden, Utah, Forente stater, 84403
        • McKay-Dee Hospital Center
      • Provo, Utah, Forente stater, 84604
        • Utah Valley Regional Medical Center
      • Saint George, Utah, Forente stater, 84770
        • Saint George Regional Medical 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
      • Saint Johnsbury, Vermont, Forente stater, 05819
        • Norris Cotton Cancer Center-North
    • Virginia
      • Bristol, Virginia, Forente stater, 24201
        • Wellmont Medical Associates-Bristol
      • Charlottesville, Virginia, Forente stater, 22908
        • University of Virginia Cancer Center
      • Chesapeake, Virginia, Forente stater, 23320
        • Cancer Specialists of Tidewater Limited
      • Gloucester, Virginia, Forente stater, 23061
        • Peninsula Cancer Institute-Gloucester
      • Lynchburg, Virginia, Forente stater, 24501
        • Centra Lynchburg Hematology-Oncology Clinic Inc
      • Martinsville, Virginia, Forente stater, 24115
        • Sovah Health Martinsville
      • Mechanicsville, Virginia, Forente stater, 23116
        • Bon Secours Memorial Regional Medical Center
      • Midlothian, Virginia, Forente stater, 23114
        • Bon Secours Saint Francis Medical Center
      • Newport News, Virginia, Forente stater, 23601
        • Peninsula Cancer Institute-Newport News
      • Norfolk, Virginia, Forente stater, 23505
        • Bon Secours DePaul Medical Center
      • Norton, Virginia, Forente stater, 24273
        • Southwest VA Regional Cancer Center
      • Richmond, Virginia, Forente stater, 23235
        • VCU Massey Cancer Center at Stony Point
      • Richmond, Virginia, Forente stater, 23298
        • Virginia Commonwealth University/Massey Cancer Center
      • Richmond, Virginia, Forente stater, 23229
        • Virginia Cancer Institute
      • Richmond, Virginia, Forente stater, 23226
        • Bon Secours Saint Mary's Hospital
      • South Hill, Virginia, Forente stater, 23970
        • VCU Community Memorial Health Center
      • Suffolk, Virginia, Forente stater, 23435
        • Cancer Specialists of Tidewater-Suffolk
      • Virginia Beach, Virginia, Forente stater, 23454
        • Peninsula Cancer Institute-Cancer Specialists of Tidewater
      • Williamsburg, Virginia, Forente stater, 23185
        • Peninsula Cancer Institute-Williamsburg
      • Winchester, Virginia, Forente stater, 22601
        • Shenandoah Oncology PC
    • Washington
      • Aberdeen, Washington, Forente stater, 98520
        • Providence Regional Cancer System-Aberdeen
      • Auburn, Washington, Forente stater, 98001
        • MultiCare Auburn Medical Center
      • Bellingham, Washington, Forente stater, 98225
        • PeaceHealth Saint Joseph Medical Center
      • Bremerton, Washington, Forente stater, 98310
        • Harrison HealthPartners Hematology and Oncology-Bremerton
      • Bremerton, Washington, Forente stater, 98310
        • Harrison Medical Center
      • Burien, Washington, Forente stater, 98166
        • Highline Medical Center-Main Campus
      • Centralia, Washington, Forente stater, 98531
        • Providence Regional Cancer System-Centralia
      • Edmonds, Washington, Forente stater, 98026
        • Swedish Cancer Institute-Edmonds
      • Enumclaw, Washington, Forente stater, 98022
        • Saint Elizabeth Hospital
      • Everett, Washington, Forente stater, 98201
        • Providence Regional Cancer Partnership
      • Federal Way, Washington, Forente stater, 98003
        • Saint Francis Hospital
      • Gig Harbor, Washington, Forente stater, 98335
        • MultiCare Gig Harbor Medical Park
      • Issaquah, Washington, Forente stater, 98029
        • Swedish Cancer Institute-Issaquah
      • Kennewick, Washington, Forente stater, 99336
        • Kadlec Clinic Hematology and Oncology
      • Kirkland, Washington, Forente stater, 98034
        • Seattle Cancer Care Alliance at EvergreenHealth
      • Lacey, Washington, Forente stater, 98503
        • Providence Regional Cancer System-Lacey
      • Lakewood, Washington, Forente stater, 98499
        • Saint Clare Hospital
      • Longview, Washington, Forente stater, 98632
        • PeaceHealth Saint John Medical Center
      • Port Townsend, Washington, Forente stater, 98368
        • Jefferson Healthcare
      • Poulsbo, Washington, Forente stater, 98370
        • Harrison HealthPartners Hematology and Oncology-Poulsbo
      • Puyallup, Washington, Forente stater, 98372
        • MultiCare Good Samaritan Hospital
      • Seattle, Washington, Forente stater, 98101
        • Virginia Mason Medical Center
      • Seattle, Washington, Forente stater, 98107
        • Swedish Medical Center-Ballard Campus
      • Seattle, Washington, Forente stater, 98122
        • Swedish Medical Center-First Hill
      • Seattle, Washington, Forente stater, 98109
        • FHCC South Lake Union
      • Seattle, Washington, Forente stater, 98112
        • Kaiser Permanente Washington
      • Seattle, Washington, Forente stater, 98104
        • Pacific Gynecology Specialists
      • Seattle, Washington, Forente stater, 98122-5711
        • Swedish Medical Center-Cherry Hill
      • Seattle, Washington, Forente stater, 98133
        • FHCC at Northwest Hospital
      • Shelton, Washington, Forente stater, 98584
        • Providence Regional Cancer System-Shelton
      • Spokane, Washington, Forente stater, 99204
        • MultiCare Deaconess Cancer and Blood Specialty Center - Downtown
      • Spokane, Washington, Forente stater, 99218
        • MultiCare Deaconess Cancer and Blood Specialty Center - North
      • Spokane Valley, Washington, Forente stater, 99216
        • MultiCare Deaconess Cancer and Blood Specialty Center - Valley
      • Tacoma, Washington, Forente stater, 98405
        • Northwest Medical Specialties PLLC
      • Tacoma, Washington, Forente stater, 98405
        • MultiCare Tacoma General Hospital
      • Tacoma, Washington, Forente stater, 98405
        • Franciscan Research Center-Northwest Medical Plaza
      • Vancouver, Washington, Forente stater, 98664
        • PeaceHealth Southwest Medical Center
      • Walla Walla, Washington, Forente stater, 99362
        • Providence Saint Mary Regional Cancer Center
      • Yelm, Washington, Forente stater, 98597
        • Providence Regional Cancer System-Yelm
    • West Virginia
      • Bridgeport, West Virginia, Forente stater, 26330
        • United Hospital Center
      • Charleston, West Virginia, Forente stater, 25304
        • West Virginia University Charleston Division
      • Huntington, West Virginia, Forente stater, 25701
        • Edwards Comprehensive Cancer Center
      • Martinsburg, West Virginia, Forente stater, 25401
        • WVUH-Berkely Medical Center
      • Morgantown, West Virginia, Forente stater, 26506
        • West Virginia University Healthcare
      • Parkersburg, West Virginia, Forente stater, 26101
        • Camden Clark Medical Center
    • Wisconsin
      • Antigo, Wisconsin, Forente stater, 54409
        • Langlade Hospital and Cancer Center
      • Appleton, Wisconsin, Forente stater, 54911
        • ThedaCare Regional Cancer Center
      • Ashland, Wisconsin, Forente stater, 54806
        • Duluth Clinic Ashland
      • Brookfield, Wisconsin, Forente stater, 53045
        • Ascension Southeast Wisconsin Hospital - Elmbrook Campus
      • Burlington, Wisconsin, Forente stater, 53105
        • Aurora Cancer Care-Southern Lakes VLCC
      • 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
        • Mayo Clinic Health System-Eau Claire Clinic
      • Fond Du Lac, Wisconsin, Forente stater, 54937
        • Aurora Health Center-Fond du Lac
      • Franklin, Wisconsin, Forente stater, 53132
        • Ascension Saint Francis - Reiman Cancer Center
      • Germantown, Wisconsin, Forente stater, 53022
        • Aurora Health Care Germantown Health Center
      • Grafton, Wisconsin, Forente stater, 53024
        • Aurora Cancer Care-Grafton
      • Green Bay, Wisconsin, Forente stater, 54311
        • Aurora BayCare Medical Center
      • Green Bay, Wisconsin, Forente stater, 54301
        • Saint Vincent Hospital Cancer Center Green Bay
      • Green Bay, Wisconsin, Forente stater, 54303
        • Saint Vincent Hospital Cancer Center at Saint Mary's
      • Kenosha, Wisconsin, Forente stater, 53142
        • Aurora Cancer Care-Kenosha South
      • La Crosse, Wisconsin, Forente stater, 54601
        • Gundersen Lutheran Medical Center
      • Marinette, Wisconsin, Forente stater, 54143
        • Aurora Bay Area Medical Group-Marinette
      • Marshfield, Wisconsin, Forente stater, 54449
        • Marshfield Medical Center-Marshfield
      • Medford, Wisconsin, Forente stater, 54451
        • Aspirus Medford Hospital
      • Mequon, Wisconsin, Forente stater, 53097
        • Ascension Columbia Saint Mary's Hospital Ozaukee
      • Milwaukee, Wisconsin, Forente stater, 53226
        • Medical College of Wisconsin
      • Milwaukee, Wisconsin, Forente stater, 53209
        • Aurora Cancer Care-Milwaukee
      • Milwaukee, Wisconsin, Forente stater, 53215
        • Aurora Saint Luke's Medical Center
      • Milwaukee, Wisconsin, Forente stater, 53233
        • Aurora Sinai Medical Center
      • Milwaukee, Wisconsin, Forente stater, 53211
        • Ascension Columbia Saint Mary's Hospital - Milwaukee
      • 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
      • Oconto Falls, Wisconsin, Forente stater, 54154
        • Saint Vincent Hospital Cancer Center at Oconto Falls
      • Oshkosh, Wisconsin, Forente stater, 54904
        • Vince Lombardi Cancer Clinic - Oshkosh
      • Racine, Wisconsin, Forente stater, 53406
        • Aurora Cancer Care-Racine
      • Racine, Wisconsin, Forente stater, 53405
        • Ascension All Saints Hospital
      • Rice Lake, Wisconsin, Forente stater, 54868
        • Marshfield Medical Center-Rice Lake
      • Shawano, Wisconsin, Forente stater, 54166
        • ThedaCare Cancer Care - Shawano
      • Sheboygan, Wisconsin, Forente stater, 53081
        • Vince Lombardi Cancer Clinic-Sheboygan
      • Stevens Point, Wisconsin, Forente stater, 54481
        • Ascension Saint Michael's Hospital
      • Stevens Point, Wisconsin, Forente stater, 54482
        • Marshfield Medical Center-River Region at Stevens Point
      • Sturgeon Bay, Wisconsin, Forente stater, 54235-1495
        • Saint Vincent Hospital Cancer Center at Sturgeon Bay
      • Summit, Wisconsin, Forente stater, 53066
        • Aurora Medical Center in Summit
      • Two Rivers, Wisconsin, Forente stater, 54241
        • Vince Lombardi Cancer Clinic-Two Rivers
      • Waukesha, Wisconsin, Forente stater, 53188
        • UW Cancer Center at ProHealth Care
      • Waukesha, Wisconsin, Forente stater, 53188
        • ProHealth Waukesha Memorial Hospital
      • Wausau, Wisconsin, Forente stater, 54401
        • Aspirus Regional Cancer Center
      • Wauwatosa, Wisconsin, Forente stater, 53226
        • Aurora Cancer Care-Milwaukee West
      • Wauwatosa, Wisconsin, Forente stater, 53226
        • Ascension Medical Group Southeast Wisconsin - Mayfair Road
      • West Allis, Wisconsin, Forente stater, 53227
        • Aurora West Allis Medical Center
      • Weston, Wisconsin, Forente stater, 54476
        • Marshfield Medical Center - Weston
      • Wisconsin Rapids, Wisconsin, Forente stater, 54494
        • Aspirus Cancer Care - Wisconsin Rapids
    • Wyoming
      • Cheyenne, Wyoming, Forente stater, 82001
        • Cheyenne Regional Medical Center-West
      • Cody, Wyoming, Forente stater, 82414
        • Billings Clinic-Cody
      • Sheridan, Wyoming, Forente stater, 82801
        • Welch Cancer Center
      • Aguadilla, Puerto Rico, 00603
        • Advance Oncology Center
      • Arecibo, Puerto Rico, 00614
        • Doctor's Cancer Center-Arecibo
      • Bayamon, Puerto Rico, 00959-5060
        • Cancer Center-Metro Medical Center Bayamon
      • Bayamon, Puerto Rico, 00961
        • Hematologia Oncologia San Pablo
      • Caguas, Puerto Rico, 00726
        • HIMA San Pablo Oncologic Hospital
      • Manati, Puerto Rico, 00674
        • Doctors Cancer Center
      • Ponce, Puerto Rico, 00716
        • Instituto Oncologia Moderna Ponce
      • San Juan, Puerto Rico, 00917
        • San Juan Community Oncology Group
      • San Juan, Puerto Rico, 00936
        • San Juan City Hospital
      • San Juan, Puerto Rico, 00920
        • Primary Care Physician Group
      • Santa Isabel, Puerto Rico, 00757
        • Centro de Hematologia y Oncologia del Sur
      • Berlin, Tyskland, 10117
        • Charite Humboldt - University Hospital
      • Bochum, Tyskland, 44791
        • Saint Josef-Hospital Bochum
      • Cologne, Tyskland, 50677
        • Onkologie-Cologne
      • Esslingen, Tyskland, 73730
        • Klinikum Esslingen GmbH
      • Hamburg, Tyskland, 20249
        • Hamatologisch-Onkologische Praxis Eppendorf (HOPE)
      • Leipzig, Tyskland, 04103
        • Universitaet Leipzig
      • Mannheim, Tyskland, 68167
        • Medizinische Universitat
      • Monchengladbach, Tyskland, 41063
        • Kliniken Maria Hilf GmbH
      • Munchen, Tyskland, 81377
        • Medizinische Klinik Iii
      • Ulm, Tyskland, 89081
        • University Hospital Ulm
      • Wuerzburg, Tyskland, 97080
        • University Hospital Wuerzburg
    • Saxony
      • Dresden, Saxony, Tyskland, 01307
        • Technical University Dresden

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

12 år og eldre (Barn, Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Beskrivelse

Inklusjonskriterier:

  • Histologisk bevist stadium III colon adenokarsinom (enhver T [Tx, T1, T2, T3 eller T4], N1-2M0; inkluderer N1C); svulster må anses å stamme fra tykktarmen, inkludert svulster som strekker seg inn i/involverer tynntarmen (f. de ved ileocecal ventilen)
  • Tilstedeværelse av mangelfull (d) DNA mismatch reparasjon (dMMR); MMR-status må vurderes ved immunhistokjemi (IHC) for MMR-proteinekspresjon (MLH1, MSH2, MSH6, PMS2) der tap av ett eller flere proteiner indikerer dMMR; dMMR kan bestemmes enten lokalt eller av stedsvalgt referanselaboratorium; Merk: tap av MLH1 og PMS2 forekommer ofte sammen; formalinfiksert parafininnstøpt (FFPE) tumorvev er nødvendig for påfølgende retrospektiv sentral bekreftelse av dMMR-status
  • Pasienter som er kjent for å ha Lynch syndrom, har blitt funnet å bære en spesifikk kimlinjemutasjon i et MMR-gen (MLH1, MSH2, MSH6, PMS2), og har vist seg å være dMMR av IHC, er kvalifisert til å delta
  • Tumorer må ha blitt fullstendig resekert; hos pasienter med tumor adherent til tilstøtende strukturer, må en bloc R0-reseksjon dokumenteres i operasjonsrapporten eller på annen måte bekreftes av kirurgen; nære eller positive radielle marginer er akseptable så lenge en bloc reseksjon ble utført; proksimal eller distal marginpositivitet er ikke tillatt
  • Hele svulsten må være i tykktarmen (rektal involvering er en eksklusjon); kirurg bekreftelse på at hele svulsten var lokalisert i tykktarmen er kun nødvendig i tilfeller der det er viktig å fastslå om svulsten er en tykktarm versus (vs.) rektal primær; Pasienter med mer enn ett primært tykktarmsadenokarsinom er kvalifisert hvis den kvalifiserende stadium III-svulsten er begrenset til tykktarmen, og ikke endetarmen, og de andre kreftene i lavere stadium fjernes i en bloc R0-reseksjon
  • Basert på operasjonsrapporten og annen kildedokumentasjon vil lokaliseringen av primærtumoren kategoriseres som proksimal eller distal til miltfleksuren (inkludert med distal), og videre kategorisering vil være som følger: blindtarm/ascenderende, transversal, synkende, sigmoid tykktarm, eller rectosigmoid tykktarm
  • Ingen bevis for gjenværende involvert lymfeknutesykdom eller metastatisk sykdom på registreringstidspunktet basert på klinikerens vurdering av bildediagnostikk; den behandlende legen vil avgjøre om tilfeldige lesjoner ved bildebehandling krever opparbeiding for å utelukke metastatisk sykdom; hvis den behandlende legen, basert på gjennomgang av bilder, fastslår at pasienten er stadium III, er pasienten kvalifisert
  • Ingen tidligere medisinsk terapi (kjemoterapi, immunterapi, biologisk eller målrettet terapi) eller strålebehandling for gjeldende tykktarmskreft bortsett fra én syklus med mFOLFOX6
  • Alder >= 12 år
  • Ytelsesstatus:

    • Pasienter < 16 år: Lansky >= 50 %
    • Pasienter 16 til < 18 år: Karnofsky >= 50 %
    • Pasienter >= 18 år: Eastern Cooperative Oncology Group (ECOG) prestasjonsstatus =< 2
  • Denne studien involverer: 1) et undersøkelsesmiddel hvis genotoksiske, mutagene og teratogene effekter på fosteret og nyfødte under utvikling er ukjent; og 2) et middel som har kjente genotoksiske, mutagene og teratogene effekter; derfor, kun for kvinner i fertil alder, kreves en negativ graviditetstest utført =< 7 dager før registrering; en kvinne i fertil alder er en kjønnsmoden kvinne som: 1) ikke har gjennomgått en hysterektomi eller bilateral ooforektomi; eller 2) ikke har vært naturlig postmenopausal i minst 12 påfølgende måneder (dvs. har hatt mens når som helst i de foregående 12 påfølgende månedene)
  • Absolutt nøytrofiltall (ANC) >= 1500 mm^3
  • Blodplateantall >= 100 000 mm^3; blodplater >= 75 000 nødvendig for pasienter som mottok syklus 1 av mFOLFOX6 før registrering
  • Kreatinin =< 1,5 x øvre normalgrense (ULN) eller
  • Beregnet kreatininclearance >= 45 ml/min ved Cockcroft-Gault-ligning

    • Alternativt, for pasienter < 18 år, maksimalt serumkreatinin =< de alders-kjønnsspesifikke normene nedenfor:

      • 12 år: 1,2 (mann og kvinne)
      • 13 til <16 år: 1,5 (mann), 1,4 (kvinne)
      • 16 til <18 år: 1,7 (mann), 1,4 (kvinne)
  • Total bilirubin =< 1,5 x øvre normalgrense (ULN) bortsett fra ved Gilberts sykdom
  • Aspartataminotransferase (AST)/alaninaminotransferase (ALT) =< 2,5 x øvre normalgrense (ULN)
  • Skjoldbrusk-stimulerende hormon (TSH) innenfor normale grenser (WNL); tilskudd er akseptabelt for å oppnå en TSH WNL; hos pasienter med unormal TSH, hvis fritt T4 er normalt og pasienten er klinisk euthyroid, er pasienten kvalifisert
  • Ingen aktiv kjent autoimmun sykdom, inkludert kolitt, inflammatorisk tarmsykdom (dvs. ulcerøs kolitt eller Crohns sykdom), revmatoid artritt, panhypopituitarisme, binyrebarksvikt
  • Ingen kjent aktiv hepatitt B eller C

    • Aktiv hepatitt B kan defineres som:

      • Hepatitt B-virus overflateantigen (HBsAg) påviselig i > 6 måneder;
      • Serum hepatitt B-virus (HBV) DNA 20 000 IE/ml (105 kopier/ml); lavere verdier 2 000-20 000 IE/ml (104-105 kopier/ml) sees ofte ved hepatitt B-virus e antigen (HBeAg)-negativ kronisk hepatitt B
      • Vedvarende eller intermitterende økning i ALAT/AST-nivåer
      • Leverbiopsi som viser kronisk hepatitt med moderat eller alvorlig nekroinflammasjon
    • Aktiv hepatitt C kan defineres som:

      • Hepatitt C antistoff (AB) positiv OG
      • Tilstedeværelse av hepatitt C-virus (HCV) RNA
  • Ingen grad >= 2 perifer motorisk eller sensorisk nevropati
  • Pasienter som er positive for humant immunsviktvirus (HIV) er kun kvalifisert hvis de oppfyller alle følgende:

    • Et stabilt regime med høyaktiv antiretroviral terapi (HAART)
    • Ingen krav til samtidige antibiotika eller soppdrepende midler for forebygging av opportunistiske infeksjoner
    • Et CD4-tall over 250 celler/mcL, og en uoppdagbar HIV-virusbelastning på standard polymerasekjedereaksjon (PCR)-baserte tester
  • Ingen andre planlagte samtidige undersøkelsesmidler eller annen tumorrettet terapi (kjemoterapi, stråling) under studien
  • Ingen systemisk daglig behandling med verken kortikosteroider (> 10 mg daglige prednisonekvivalenter) eller andre immunsuppressive medisiner innen 7 dager etter registrering
  • Ingen kjent historie med alvorlige allergiske anafylaktiske reaksjoner på kimære, humane eller humaniserte antistoffer eller fusjonsproteiner
  • Ingen kjent overfølsomhet overfor ovarieceller fra kinesisk hamster (CHO) eller noen komponent i atezolizumab-formuleringen
  • Ingen kjent allergi mot 5-fluorouracil, oksaliplatin eller leukovorin

Ekskluderingskriterier:

  • Pasienter med testing som ikke viste dMMR (tap av MMR-protein) er ikke kvalifisert til å delta; pasienter hvis svulster viser MSI-H ved PCR-basert analyse er ikke kvalifisert til å delta med mindre de også har MMR-testing av IHC og har dMMR (dvs. tap av ett eller flere MMR-proteiner)
  • Ekskludert hvis kjent aktiv lungesykdom med hypoksi definert som:

    • Oksygenmetning < 85 % på romluft, eller
    • Oksygenmetning < 88 % til tross for ekstra oksygen

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 (kombinasjonskjemoterapi, atezolizumab)
Pasienter får oksaliplatin IV over 2 timer og leucovorin kalsium IV over 2 timer på dag 1, og fluorouracil IV som bolus på dag 1, deretter kontinuerlig over 46 timer på dag 1-3 i hver syklus. Behandlingen gjentas hver 14. dag i opptil 12 sykluser i fravær av sykdomsprogresjon eller uakseptabel toksisitet. Pasienter får også atezolizumab IV over 30-60 minutter på dag 1 i hver syklus, med start i syklus 1 eller 2. Behandlingen gjentas hver 14. dag i opptil 25 sykluser i fravær av sykdomsprogresjon eller uakseptabel toksisitet. Pasienter gjennomgår CT eller MR hver 6. måned de første 2 årene, deretter i 3-5 år eller inntil tegn på tilbakefall, avhengig av hva som kommer først. Pasienter kan også gjennomgå blodprøvetaking gjennom hele forsøket.
Hjelpestudier
Andre navn:
  • Livskvalitetsvurdering
Gjennomgå MR
Andre navn:
  • MR
  • Magnetisk resonans
  • Magnetic Resonance Imaging Scan
  • Medisinsk bildebehandling, magnetisk resonans / kjernemagnetisk resonans
  • MR Imaging
  • MR-skanning
  • NMR-avbildning
  • NMRI
  • Kjernemagnetisk resonansavbildning
  • Magnetisk resonanstomografi (MR)
  • sMRI
  • Magnetisk resonansavbildning (prosedyre)
  • MR-er
  • Strukturell MR
Gjennomgå CT
Andre navn:
  • CT
  • KATT
  • CAT-skanning
  • Beregnet aksial tomografi
  • Datastyrt aksialtomografi
  • Datastyrt tomografi
  • CT skann
  • tomografi
  • Datastyrt aksial tomografi (prosedyre)
  • Datastyrt tomografi (CT) skanning
Gjennomgå blodprøvetaking
Andre navn:
  • Biologisk prøvesamling
  • Bioprøve samlet
  • Prøvesamling
Gitt IV
Andre navn:
  • Tecentriq
  • MPDL3280A
  • RO5541267
  • RG7446
  • MPDL 3280A
  • MPDL 328OA
  • MPDL-3280A
  • MPDL328OA
Gitt IV
Andre navn:
  • 5-Fluracil
  • Fluracil
  • 5 Fluorouracil
  • 5 Fluorouracilum
  • 5 FU
  • 5-fluor-2,4(1H,3H)-pyrimidindion
  • 5-Fluorouracil
  • 5-Fu
  • 5FU
  • 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:
  • Leucovorin
  • Wellcovorin
  • folinsyre
  • Adinepar
  • Calcifolin
  • Kalsium (6S)-folinat
  • Kalsiumfolinat
  • Kalsiumleukovorin
  • Calfolex
  • Calinat
  • Cehafolin
  • Citofolin
  • Citrec
  • Citrovorum faktor
  • Cromatonbic Folinico
  • Dalisol
  • Disintox
  • Divical
  • Ecofol
  • Emovis
  • Faktor, Citrovorum
  • Flynoken A
  • Folaren
  • Folaxin
  • FOLI-celle
  • Foliben
  • Folidan
  • Folidar
  • Folinac
  • Folinat kalsium
  • Folinsyre Kalsium Salt Pentahydrat
  • Folinoral
  • Folinvit
  • Foliplus
  • Folix
  • Imo
  • Lederfolat
  • Lederfolin
  • Leucosar
  • Rescufolin
  • Rescuvolin
  • Tonofolin
Aktiv komparator: Arm II (kombinasjonskjemoterapi)
Pasienter får oksaliplatin IV over 2 timer og leucovorin kalsium IV over 2 timer på dag 1, og fluorouracil IV som bolus på dag 1, deretter kontinuerlig over 46 timer på dag 1-3 i hver syklus. Behandlingen gjentas hver 14. dag i opptil 12 sykluser i fravær av sykdomsprogresjon eller uakseptabel toksisitet. Pasienter gjennomgår CT eller MR hver 6. måned de første 2 årene, deretter i 3-5 år eller inntil tegn på tilbakefall, avhengig av hva som kommer først. Pasienter kan også gjennomgå blodprøvetaking gjennom hele forsøket.
Hjelpestudier
Andre navn:
  • Livskvalitetsvurdering
Gjennomgå MR
Andre navn:
  • MR
  • Magnetisk resonans
  • Magnetic Resonance Imaging Scan
  • Medisinsk bildebehandling, magnetisk resonans / kjernemagnetisk resonans
  • MR Imaging
  • MR-skanning
  • NMR-avbildning
  • NMRI
  • Kjernemagnetisk resonansavbildning
  • Magnetisk resonanstomografi (MR)
  • sMRI
  • Magnetisk resonansavbildning (prosedyre)
  • MR-er
  • Strukturell MR
Gjennomgå CT
Andre navn:
  • CT
  • KATT
  • CAT-skanning
  • Beregnet aksial tomografi
  • Datastyrt aksialtomografi
  • Datastyrt tomografi
  • CT skann
  • tomografi
  • Datastyrt aksial tomografi (prosedyre)
  • Datastyrt tomografi (CT) skanning
Gjennomgå blodprøvetaking
Andre navn:
  • Biologisk prøvesamling
  • Bioprøve samlet
  • Prøvesamling
Gitt IV
Andre navn:
  • 5-Fluracil
  • Fluracil
  • 5 Fluorouracil
  • 5 Fluorouracilum
  • 5 FU
  • 5-fluor-2,4(1H,3H)-pyrimidindion
  • 5-Fluorouracil
  • 5-Fu
  • 5FU
  • 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:
  • Leucovorin
  • Wellcovorin
  • folinsyre
  • Adinepar
  • Calcifolin
  • Kalsium (6S)-folinat
  • Kalsiumfolinat
  • Kalsiumleukovorin
  • Calfolex
  • Calinat
  • Cehafolin
  • Citofolin
  • Citrec
  • Citrovorum faktor
  • Cromatonbic Folinico
  • Dalisol
  • Disintox
  • Divical
  • Ecofol
  • Emovis
  • Faktor, Citrovorum
  • Flynoken A
  • Folaren
  • Folaxin
  • FOLI-celle
  • Foliben
  • Folidan
  • Folidar
  • Folinac
  • Folinat kalsium
  • Folinsyre Kalsium Salt Pentahydrat
  • Folinoral
  • Folinvit
  • Foliplus
  • Folix
  • Imo
  • Lederfolat
  • Lederfolin
  • Leucosar
  • Rescufolin
  • Rescuvolin
  • Tonofolin

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Sykdomsfri overlevelse (DFS)
Tidsramme: Fra tid fra randomisering til første dokumentasjon på tilbakevendende sykdom eller død, vurdert inntil 5 år
DFS vil bli sammenlignet mellom behandlingsarmer ved å bruke den stratifiserte log-rangtesten på ensidig nivå 0,025. Hvis null DFS-hendelser er observert i et bestemt stratum ved en interimanalyse og ustratifisert log-rangering brukes, vil alle påfølgende analyser for DFS bruke ustratifisert log-rank test. Hazard ratio (HR) for DFS vil bli estimert ved hjelp av en stratifisert Cox proporsjonal hazards modell og 95 prosent konfidensintervall (CI) for HR vil bli gitt. Resultater fra en ikke-stratifisert analyse vil også bli gitt. Kaplan-Meier-metodikk vil bli brukt for å estimere median DFS for hver behandlingsarm, og Kaplan-Meier-kurver vil bli produsert. Brookmeyer Crowley-metodikk vil bli brukt for å konstruere 95 prosent CI for median DFS for hver behandlingsarm.
Fra tid fra randomisering til første dokumentasjon på tilbakevendende sykdom eller død, vurdert inntil 5 år

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Total overlevelse
Tidsramme: Fra tiden fra randomisering til død, uansett årsak, vurdert opp til 5 år
Fordelingen av total overlevelse vil bli estimert ved hjelp av metoden til Kaplan-Meier. Total overlevelse vil bli sammenlignet mellom behandlingsarmene ved bruk av log-rank test, bare hvis DFS er statistisk signifikant. HR for OS vil bli estimert ved hjelp av en Cox proporsjonale faremodell og 95 prosent CI for HR vil bli gitt. Dersom det benyttes en stratifisert log-rank test, vil stratifisert HR bli vurdert, og hvis en ikke-stratifisert log-rank test blir vurdert, vil ikke-stratifisert HR bli vurdert.
Fra tiden fra randomisering til død, uansett årsak, vurdert opp til 5 år
Forekomst av uønskede hendelser
Tidsramme: Inntil 30 dager etter siste behandling
Vurdert av Common Terminology Criteria for Adverse Events versjon 4.0. Frekvenstabeller vil bli gjennomgått for å bestemme mønstrene. De totale bivirkningsratene vil bli sammenlignet mellom behandlingsarmene ved bruk av Chi-square test (eller Fishers eksakte test hvis dataene i beredskapstabellen er sparsomme).
Inntil 30 dager etter siste behandling

Samarbeidspartnere og etterforskere

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

Etterforskere

  • Hovedetterforsker: Frank A Sinicrope, Alliance for Clinical Trials in Oncology

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)

16. oktober 2017

Primær fullføring (Antatt)

2. april 2025

Studiet fullført (Antatt)

2. april 2025

Datoer for studieregistrering

Først innsendt

22. september 2016

Først innsendt som oppfylte QC-kriteriene

22. september 2016

Først lagt ut (Antatt)

23. september 2016

Oppdateringer av studieposter

Sist oppdatering lagt ut (Antatt)

8. mai 2024

Siste oppdatering sendt inn som oppfylte QC-kriteriene

7. mai 2024

Sist bekreftet

1. april 2024

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. .

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