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Testowanie połączenia pevonedistatu z chemioterapią raka dróg żółciowych wątroby

23 października 2026 zaktualizowane przez: National Cancer Institute (NCI)

Badanie fazy 2 pevonedistatu w skojarzeniu z karboplatyną i paklitakselem w zaawansowanym raku dróg żółciowych wewnątrzwątrobowych

This phase II trial studies how well pevonedistat alone or in combination with chemotherapy (paclitaxel and carboplatin) works in treating patients with bile duct cancer of the liver. Pevonedistat may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Chemotherapy drugs, such as paclitaxel and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. This study may help the study doctors find out how well pevonedistat shrinks bile duct cancer of the liver when given alone and when in combination with paclitaxel and carboplatin.

Przegląd badań

Status

Aktywny, nie rekrutujący

Interwencja / Leczenie

Szczegółowy opis

PRIMARY OBJECTIVE:

I. To determine the objective response rate of pevonedistat as a single agent and in combination with carboplatin and paclitaxel in patients with unresectable intrahepatic cholangiocarcinoma.

SECONDARY OBJECTIVES:

I. To evaluate the safety profile of pevonedistat alone and in combination with carboplatin and paclitaxel in patients with intrahepatic cholangiocarcinoma.

II. To determine the clinical benefit rate of patients with advanced intrahepatic cholangiocarcinoma (ICC) treated with pevonedistat monotherapy and in combination with carboplatin and paclitaxel.

III. To determine progression-free survival of patients treated with pevonedistat monotherapy and in combination with carboplatin and paclitaxel.

IV. To determine overall survival of patients treated with pevonedistat monotherapy and in combination with carboplatin and paclitaxel.

EXPLORATORY OBJECTIVES:

I. To determine whether overexpression of NEDD8, NAE1, and UBC12 predict response to treatment.

II. To identify the mutation profile of those cholangiocarcinomas with overexpression of the neddylation pathway.

III. To bank specimens for further future investigations.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM A: Patients receive pevonedistat intravenously (IV) over 60 minutes on days 1, 3, and 5. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity.

ARM B: Patients receive pevonedistat IV over 1 hour on days 1, 3, and 5, paclitaxel IV over 3 hours on day 1, and carboplatin IV over 15-60 minutes on day 1. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Starting cycle 5, patients may receive pevonedistat monotherapy at the discretion of treating physician.

After completion of study treatment, patients are followed up at 30 days after last dose of study treatment, then every 3 months for the first year and every 6 months for years 2-3.

Typ studiów

Interwencyjne

Zapisy (Rzeczywisty)

40

Faza

  • Faza 2

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Lokalizacje studiów

    • Alaska
      • Anchorage, Alaska, Stany Zjednoczone, 98508
        • Anchorage Associates in Radiation Medicine
      • Anchorage, Alaska, Stany Zjednoczone, 99508
        • Alaska Breast Care and Surgery LLC
      • Anchorage, Alaska, Stany Zjednoczone, 99508
        • Alaska Oncology and Hematology LLC
      • Anchorage, Alaska, Stany Zjednoczone, 99508
        • Alaska Women's Cancer Care
      • Anchorage, Alaska, Stany Zjednoczone, 99508
        • Anchorage Oncology Centre
      • Anchorage, Alaska, Stany Zjednoczone, 99508
        • Katmai Oncology Group
      • Anchorage, Alaska, Stany Zjednoczone, 99508
        • Providence Alaska Medical Center
      • Anchorage, Alaska, Stany Zjednoczone, 99504
        • Anchorage Radiation Therapy Center
    • Arizona
      • Kingman, Arizona, Stany Zjednoczone, 86401
        • Kingman Regional Medical Center
      • Phoenix, Arizona, Stany Zjednoczone, 85004
        • Cancer Center at Saint Joseph's
    • Arkansas
      • Hot Springs, Arkansas, Stany Zjednoczone, 71913
        • CHI Saint Vincent Cancer Center Hot Springs
    • California
      • Arroyo Grande, California, Stany Zjednoczone, 93420
        • PCR Oncology
      • Arroyo Grande, California, Stany Zjednoczone, 93420
        • Mission Hope Medical Oncology - Arroyo Grande
      • Auburn, California, Stany Zjednoczone, 95602
        • Sutter Auburn Faith Hospital
      • Auburn, California, Stany Zjednoczone, 95603
        • Sutter Cancer Centers Radiation Oncology Services-Auburn
      • Berkeley, California, Stany Zjednoczone, 94704
        • Alta Bates Summit Medical Center-Herrick Campus
      • Burbank, California, Stany Zjednoczone, 91505
        • Providence Saint Joseph Medical Center/Disney Family Cancer Center
      • Cameron Park, California, Stany Zjednoczone, 95682
        • Sutter Cancer Centers Radiation Oncology Services-Cameron Park
      • Castro Valley, California, Stany Zjednoczone, 94546
        • Eden Hospital Medical Center
      • Davis, California, Stany Zjednoczone, 95616
        • Sutter Davis Hospital
      • Duarte, California, Stany Zjednoczone, 91010
        • City of Hope Comprehensive Cancer Center
      • Fremont, California, Stany Zjednoczone, 94538
        • Palo Alto Medical Foundation-Fremont
      • Modesto, California, Stany Zjednoczone, 95355
        • Memorial Medical Center
      • Mountain View, California, Stany Zjednoczone, 94040
        • Palo Alto Medical Foundation-Camino Division
      • Mountain View, California, Stany Zjednoczone, 94040
        • Palo Alto Medical Foundation-Gynecologic Oncology
      • Palo Alto, California, Stany Zjednoczone, 94301
        • Palo Alto Medical Foundation Health Care
      • Roseville, California, Stany Zjednoczone, 95661
        • Sutter Cancer Centers Radiation Oncology Services-Roseville
      • Roseville, California, Stany Zjednoczone, 95661
        • Sutter Roseville Medical Center
      • Sacramento, California, Stany Zjednoczone, 95816
        • Sutter Medical Center Sacramento
      • San Francisco, California, Stany Zjednoczone, 94115
        • California Pacific Medical Center-Pacific Campus
      • San Mateo, California, Stany Zjednoczone, 94401
        • Mills Health Center
      • Santa Cruz, California, Stany Zjednoczone, 95065
        • Palo Alto Medical Foundation-Santa Cruz
      • Santa Maria, California, Stany Zjednoczone, 93444
        • Mission Hope Medical Oncology - Santa Maria
      • Santa Rosa, California, Stany Zjednoczone, 95403
        • Sutter Pacific Medical Foundation
      • Sunnyvale, California, Stany Zjednoczone, 94086
        • Palo Alto Medical Foundation-Sunnyvale
      • Vallejo, California, Stany Zjednoczone, 94589
        • Sutter Solano Medical Center/Cancer Center
    • Colorado
      • Colorado Springs, Colorado, Stany Zjednoczone, 80907
        • Penrose-Saint Francis Healthcare
      • Colorado Springs, Colorado, Stany Zjednoczone, 80909
        • UCHealth Memorial Hospital Central
      • Colorado Springs, Colorado, Stany Zjednoczone, 80907
        • Rocky Mountain Cancer Centers-Penrose
      • Colorado Springs, Colorado, Stany Zjednoczone, 80920
        • Memorial Hospital North
      • Denver, Colorado, Stany Zjednoczone, 80210
        • AdventHealth Porter
      • Durango, Colorado, Stany Zjednoczone, 81301
        • Mercy Medical Center
      • Durango, Colorado, Stany Zjednoczone, 81301
        • CommonSpirit Cancer Center Mercy
      • Fort Collins, Colorado, Stany Zjednoczone, 80524
        • Poudre Valley Hospital
      • Fort Collins, Colorado, Stany Zjednoczone, 80528
        • Cancer Care and Hematology-Fort Collins
      • Greeley, Colorado, Stany Zjednoczone, 80631
        • UCHealth Greeley Hospital
      • Lakewood, Colorado, Stany Zjednoczone, 80228
        • CommonSpirit Saint Anthony Hospital Cancer Center
      • Littleton, Colorado, Stany Zjednoczone, 80122
        • AdventHealth Littleton
      • Longmont, Colorado, Stany Zjednoczone, 80501
        • Longmont United Hospital
      • Longmont, Colorado, Stany Zjednoczone, 80501
        • Rocky Mountain Cancer Centers-Longmont
      • Loveland, Colorado, Stany Zjednoczone, 80538
        • Medical Center of the Rockies
      • Parker, Colorado, Stany Zjednoczone, 80138
        • AdventHealth Parker
      • Pueblo, Colorado, Stany Zjednoczone, 81004
        • Saint Mary Corwin Medical Center
    • Florida
      • Coral Gables, Florida, Stany Zjednoczone, 33146
        • UM Sylvester Comprehensive Cancer Center at Coral Gables
      • Deerfield Beach, Florida, Stany Zjednoczone, 33442
        • UM Sylvester Comprehensive Cancer Center at Deerfield Beach
      • Fort Lauderdale, Florida, Stany Zjednoczone, 33308
        • Holy Cross Hospital
      • Miami, Florida, Stany Zjednoczone, 33136
        • University of Miami Miller School of Medicine-Sylvester Cancer Center
      • Miami, Florida, Stany Zjednoczone, 33176
        • UM Sylvester Comprehensive Cancer Center at Kendall
      • Plantation, Florida, Stany Zjednoczone, 33324
        • UM Sylvester Comprehensive Cancer Center at Plantation
    • Hawaii
      • Honolulu, Hawaii, Stany Zjednoczone, 96813
        • Queen's Medical Center
      • Honolulu, Hawaii, Stany Zjednoczone, 96817
        • The Cancer Center of Hawaii-Liliha
      • Honolulu, Hawaii, Stany Zjednoczone, 96813
        • Hawaii Cancer Care Inc - Waterfront Plaza
      • Honolulu, Hawaii, Stany Zjednoczone, 96813
        • Queen's Cancer Cenrer - POB I
      • Honolulu, Hawaii, Stany Zjednoczone, 96813
        • Straub Clinic and Hospital
      • Honolulu, Hawaii, Stany Zjednoczone, 96813
        • University of Hawaii Cancer Center
      • Honolulu, Hawaii, Stany Zjednoczone, 96817
        • Hawaii Cancer Care Inc-Liliha
      • Honolulu, Hawaii, Stany Zjednoczone, 96817
        • Kuakini Medical Center
      • Honolulu, Hawaii, Stany Zjednoczone, 96817
        • Queen's Cancer Center - Kuakini
      • Honolulu, Hawaii, Stany Zjednoczone, 96826
        • Kapiolani Medical Center for Women and Children
      • Honolulu, Hawaii, Stany Zjednoczone, 96813
        • Island Urology
      • Lihue, Hawaii, Stany Zjednoczone, 96766
        • Wilcox Memorial Hospital and Kauai Medical Clinic
      • ‘Aiea, Hawaii, Stany Zjednoczone, 96701
        • Hawaii Cancer Care - Westridge
      • ‘Aiea, Hawaii, Stany Zjednoczone, 96701
        • Pali Momi Medical Center
      • ‘Aiea, Hawaii, Stany Zjednoczone, 96701
        • Queen's Cancer Center - Pearlridge
      • ‘Aiea, Hawaii, Stany Zjednoczone, 96701
        • The Cancer Center of Hawaii-Pali Momi
    • Idaho
      • Boise, Idaho, Stany Zjednoczone, 83706
        • Saint Alphonsus Cancer Care Center-Boise
      • Boise, Idaho, Stany Zjednoczone, 83712
        • Saint Luke's Cancer Institute - Boise
      • Caldwell, Idaho, Stany Zjednoczone, 83605
        • Saint Alphonsus Cancer Care Center-Caldwell
      • Coeur d'Alene, Idaho, Stany Zjednoczone, 83814
        • Kootenai Health - Coeur d'Alene
      • Emmett, Idaho, Stany Zjednoczone, 83617
        • Walter Knox Memorial Hospital
      • Fruitland, Idaho, Stany Zjednoczone, 83619
        • Saint Luke's Cancer Institute - Fruitland
      • Meridian, Idaho, Stany Zjednoczone, 83642
        • Idaho Urologic Institute-Meridian
      • Meridian, Idaho, Stany Zjednoczone, 83642
        • Saint Luke's Cancer Institute - Meridian
      • Nampa, Idaho, Stany Zjednoczone, 83687
        • Saint Alphonsus Cancer Care Center-Nampa
      • Nampa, Idaho, Stany Zjednoczone, 83687
        • Saint Luke's Cancer Institute - Nampa
      • Post Falls, Idaho, Stany Zjednoczone, 83854
        • Kootenai Clinic Cancer Services - Post Falls
      • Sandpoint, Idaho, Stany Zjednoczone, 83864
        • Kootenai Clinic Cancer Services - Sandpoint
      • Twin Falls, Idaho, Stany Zjednoczone, 83301
        • Saint Luke's Cancer Institute - Twin Falls
    • Illinois
      • Chicago, Illinois, Stany Zjednoczone, 60611
        • Northwestern University
      • Lake Forest, Illinois, Stany Zjednoczone, 60045
        • Northwestern Medicine Lake Forest Hospital
    • Indiana
      • Indianapolis, Indiana, Stany Zjednoczone, 46237
        • Franciscan Health Indianapolis
      • Indianapolis, Indiana, Stany Zjednoczone, 46202
        • Indiana University/Melvin and Bren Simon Cancer Center
      • Mooresville, Indiana, Stany Zjednoczone, 46158
        • Franciscan Health Mooresville
      • Richmond, Indiana, Stany Zjednoczone, 47374
        • Reid Health
      • Terre Haute, Indiana, Stany Zjednoczone, 47804
        • Union Hospital
    • Iowa
      • Ames, Iowa, Stany Zjednoczone, 50010
        • Mary Greeley Medical Center
      • Ames, Iowa, Stany Zjednoczone, 50010
        • McFarland Clinic - Ames
      • Boone, Iowa, Stany Zjednoczone, 50036
        • McFarland Clinic - Boone
      • Clive, Iowa, Stany Zjednoczone, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Stany Zjednoczone, 50325
        • UI Health Care Mission Cancer and Blood - West Des Moines Clinic
      • Council Bluffs, Iowa, Stany Zjednoczone, 51503
        • Alegent Health Mercy Hospital
      • Creston, Iowa, Stany Zjednoczone, 50801
        • Greater Regional Medical Center
      • Des Moines, Iowa, Stany Zjednoczone, 50309
        • Iowa Methodist Medical Center
      • Des Moines, Iowa, Stany Zjednoczone, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Stany Zjednoczone, 50314
        • Broadlawns Medical Center
      • Des Moines, Iowa, Stany Zjednoczone, 50316
        • Iowa Lutheran Hospital
      • Des Moines, Iowa, Stany Zjednoczone, 50309
        • UI Health Care Mission Cancer and Blood - Des Moines Clinic
      • Des Moines, Iowa, Stany Zjednoczone, 50314
        • UI Health Care Mission Cancer and Blood - Laurel Clinic
      • Fort Dodge, Iowa, Stany Zjednoczone, 50501
        • McFarland Clinic - Trinity Cancer Center
      • Fort Dodge, Iowa, Stany Zjednoczone, 50501
        • UI Healthcare Mission Cancer and Blood - Fort Dodge
      • Jefferson, Iowa, Stany Zjednoczone, 50129
        • McFarland Clinic - Jefferson
      • Marshalltown, Iowa, Stany Zjednoczone, 50158
        • McFarland Clinic - Marshalltown
      • West Des Moines, Iowa, Stany Zjednoczone, 50266-7700
        • Methodist West Hospital
      • West Des Moines, Iowa, Stany Zjednoczone, 50266
        • Mercy Medical Center-West Lakes
    • Kansas
      • Fairway, Kansas, Stany Zjednoczone, 66205
        • University of Kansas Clinical Research Center
      • Hays, Kansas, Stany Zjednoczone, 67601
        • HaysMed
      • Kansas City, Kansas, Stany Zjednoczone, 66160
        • University of Kansas Cancer Center
      • Kansas City, Kansas, Stany Zjednoczone, 66112
        • University of Kansas Cancer Center-West
      • Lawrence, Kansas, Stany Zjednoczone, 66044
        • Lawrence Memorial Hospital
      • Olathe, Kansas, Stany Zjednoczone, 66061
        • The University of Kansas Cancer Center - Olathe
      • Overland Park, Kansas, Stany Zjednoczone, 66210
        • University of Kansas Cancer Center-Overland Park
      • Pittsburg, Kansas, Stany Zjednoczone, 66762
        • Mercy Hospital Pittsburg
      • Salina, Kansas, Stany Zjednoczone, 67401
        • Salina Regional Health Center
      • Topeka, Kansas, Stany Zjednoczone, 66606
        • University of Kansas Health System Saint Francis Campus
      • Westwood, Kansas, Stany Zjednoczone, 66205
        • University of Kansas Hospital-Westwood Cancer Center
    • Kentucky
      • Bardstown, Kentucky, Stany Zjednoczone, 40004
        • CommonSpirit Saint Joseph Hospital - Bardstown
      • Corbin, Kentucky, Stany Zjednoczone, 40701
        • Commonwealth Cancer Center-Corbin
      • Lexington, Kentucky, Stany Zjednoczone, 40504
        • Saint Joseph Radiation Oncology Resource Center
      • Lexington, Kentucky, Stany Zjednoczone, 40509
        • CommonSpirit Saint Joseph Medical Center - East Lexington
      • London, Kentucky, Stany Zjednoczone, 40741
        • CommonSpirit Saint Joseph Hospital London
      • Louisville, Kentucky, Stany Zjednoczone, 40202
        • Jewish Hospital
      • Louisville, Kentucky, Stany Zjednoczone, 40245
        • UofL Health Medical Center Northeast
      • Louisville, Kentucky, Stany Zjednoczone, 40215
        • Saints Mary and Elizabeth Hospital
      • Shepherdsville, Kentucky, Stany Zjednoczone, 40165
        • Jewish Hospital Medical Center South
    • Maine
      • Brewer, Maine, Stany Zjednoczone, 04412
        • Lafayette Family Cancer Center-EMMC
    • Massachusetts
      • Springfield, Massachusetts, Stany Zjednoczone, 01104
        • Mercy Medical Center
      • Worcester, Massachusetts, Stany Zjednoczone, 01655
        • UMass Memorial Medical Center - University Campus
    • Michigan
      • Ann Arbor, Michigan, Stany Zjednoczone, 48106
        • Trinity Health Saint Joseph Mercy Hospital Ann Arbor
      • Battle Creek, Michigan, Stany Zjednoczone, 49017
        • Bronson Battle Creek
      • Bay City, Michigan, Stany Zjednoczone, 48706
        • McLaren Cancer Institute-Bay City
      • Brighton, Michigan, Stany Zjednoczone, 48114
        • Trinity Health IHA Medical Group Hematology Oncology - Brighton
      • Brighton, Michigan, Stany Zjednoczone, 48114
        • Trinity Health Medical Center - Brighton
      • Canton, Michigan, Stany Zjednoczone, 48188
        • Trinity Health IHA Medical Group Hematology Oncology - Canton
      • Canton, Michigan, Stany Zjednoczone, 48188
        • Trinity Health Medical Center - Canton
      • Caro, Michigan, Stany Zjednoczone, 48723
        • Caro Cancer Center
      • Chelsea, Michigan, Stany Zjednoczone, 48118
        • Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
      • Chelsea, Michigan, Stany Zjednoczone, 48118
        • Chelsea Hospital
      • Clarkston, Michigan, Stany Zjednoczone, 48346
        • McLaren Cancer Institute-Clarkston
      • Clarkston, Michigan, Stany Zjednoczone, 48346
        • Hematology Oncology Consultants-Clarkston
      • Clarkston, Michigan, Stany Zjednoczone, 48346
        • Newland Medical Associates-Clarkston
      • Detroit, Michigan, Stany Zjednoczone, 48201
        • Wayne State University/Karmanos Cancer Institute
      • Detroit, Michigan, Stany Zjednoczone, 48236
        • Henry Ford Health Saint John Hospital
      • East China Township, Michigan, Stany Zjednoczone, 48054
        • Henry Ford River District Hospital
      • Farmington Hills, Michigan, Stany Zjednoczone, 48334
        • Weisberg Cancer Treatment Center
      • Flint, Michigan, Stany Zjednoczone, 48532
        • McLaren Cancer Institute-Flint
      • Flint, Michigan, Stany Zjednoczone, 48532
        • Singh and Arora Hematology Oncology PC
      • Flint, Michigan, Stany Zjednoczone, 48503
        • Hurley Medical Center
      • Flint, Michigan, Stany Zjednoczone, 48503
        • Genesee Hematology Oncology PC
      • Flint, Michigan, Stany Zjednoczone, 48503
        • Genesys Hurley Cancer Institute
      • Flint, Michigan, Stany Zjednoczone, 48503
        • Cancer Hematology Centers - Flint
      • Grand Rapids, Michigan, Stany Zjednoczone, 49503
        • Trinity Health Grand Rapids Hospital
      • Grand Rapids, Michigan, Stany Zjednoczone, 49503
        • Corewell Health Grand Rapids Hospitals - Butterworth Hospital
      • Grand Rapids, Michigan, Stany Zjednoczone, 49503
        • Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
      • Grosse Pointe Woods, Michigan, Stany Zjednoczone, 48236
        • Henry Ford Saint John Hospital - Academic
      • Grosse Pointe Woods, Michigan, Stany Zjednoczone, 48236
        • Henry Ford Saint John Hospital - Breast
      • Grosse Pointe Woods, Michigan, Stany Zjednoczone, 48236
        • Henry Ford Saint John Hospital - Van Elslander
      • Kalamazoo, Michigan, Stany Zjednoczone, 49007
        • West Michigan Cancer Center
      • Kalamazoo, Michigan, Stany Zjednoczone, 49007
        • Bronson Methodist Hospital
      • Kalamazoo, Michigan, Stany Zjednoczone, 49048
        • Beacon Kalamazoo
      • Lansing, Michigan, Stany Zjednoczone, 48912
        • Mid-Michigan Physicians-Lansing
      • Lansing, Michigan, Stany Zjednoczone, 48910
        • Karmanos Cancer Institute at McLaren Greater Lansing
      • Lansing, Michigan, Stany Zjednoczone, 48912
        • University of Michigan Health - Sparrow Lansing
      • Lapeer, Michigan, Stany Zjednoczone, 48446
        • McLaren Cancer Institute-Lapeer Region
      • Livonia, Michigan, Stany Zjednoczone, 48154
        • Trinity Health Saint Mary Mercy Livonia Hospital
      • Livonia, Michigan, Stany Zjednoczone, 48154
        • Hope Cancer Clinic
      • Macomb, Michigan, Stany Zjednoczone, 48044
        • Henry Ford Warren Hospital - Breast Macomb
      • Macomb, Michigan, Stany Zjednoczone, 48044
        • Henry Ford Saint John Hospital - Macomb Medical
      • Marlette, Michigan, Stany Zjednoczone, 48453
        • Saint Mary's Oncology/Hematology Associates of Marlette
      • Mount Clemens, Michigan, Stany Zjednoczone, 48043
        • McLaren Cancer Institute-Macomb
      • Mount Pleasant, Michigan, Stany Zjednoczone, 48858
        • McLaren Cancer Institute-Central Michigan
      • Muskegon, Michigan, Stany Zjednoczone, 49444
        • Trinity Health Muskegon Hospital
      • Niles, Michigan, Stany Zjednoczone, 49120
        • Corewell Health Lakeland Hospitals - Niles Hospital
      • Norton Shores, Michigan, Stany Zjednoczone, 49444
        • Cancer and Hematology Centers of Western Michigan - Norton Shores
      • Petoskey, Michigan, Stany Zjednoczone, 49770
        • McLaren Cancer Institute-Northern Michigan
      • Pontiac, Michigan, Stany Zjednoczone, 48341
        • Hope Cancer Center
      • Pontiac, Michigan, Stany Zjednoczone, 48341
        • Trinity Health Saint Joseph Mercy Oakland Hospital
      • Pontiac, Michigan, Stany Zjednoczone, 48341
        • Michigan Healthcare Professionals Pontiac
      • Pontiac, Michigan, Stany Zjednoczone, 48341
        • Trinity Health IHA Medical Group-Alice Gustafson Center
      • Port Huron, Michigan, Stany Zjednoczone, 48060
        • McLaren-Port Huron
      • Reed City, Michigan, Stany Zjednoczone, 49677
        • Corewell Health Reed City Hospital
      • Rochester Hills, Michigan, Stany Zjednoczone, 48309
        • Henry Ford Rochester Hospital
      • Saginaw, Michigan, Stany Zjednoczone, 48604
        • Oncology Hematology Associates of Saginaw Valley PC
      • Saginaw, Michigan, Stany Zjednoczone, 48601
        • MyMichigan Medical Center Saginaw
      • Saint Joseph, Michigan, Stany Zjednoczone, 49085
        • Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
      • Saint Joseph, Michigan, Stany Zjednoczone, 49085
        • Corewell Health Lakeland Hospitals - Saint Joseph Hospital
      • Sterling Heights, Michigan, Stany Zjednoczone, 48312
        • Bhadresh Nayak MD PC-Sterling Heights
      • Tawas City, Michigan, Stany Zjednoczone, 48764
        • MyMichigan Medical Center Tawas
      • Traverse City, Michigan, Stany Zjednoczone, 49684
        • Munson Medical Center
      • Warren, Michigan, Stany Zjednoczone, 48088
        • Advanced Breast Care Center PLLC
      • Warren, Michigan, Stany Zjednoczone, 48093
        • Macomb Hematology Oncology PC
      • Warren, Michigan, Stany Zjednoczone, 48093
        • Henry Ford Madison Heights Hospital - Breast
      • Warren, Michigan, Stany Zjednoczone, 48093
        • Henry Ford Health Warren Hospital
      • Warren, Michigan, Stany Zjednoczone, 48093
        • Henry Ford Warren Hospital - GLCMS
      • West Branch, Michigan, Stany Zjednoczone, 48661
        • Saint Mary's Oncology/Hematology Associates of West Branch
      • Wyoming, Michigan, Stany Zjednoczone, 49519
        • University of Michigan Health - West
      • Ypsilanti, Michigan, Stany Zjednoczone, 48197
        • Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
      • Ypsilanti, Michigan, Stany Zjednoczone, 48106
        • Huron Gastroenterology PC
    • Minnesota
      • Burnsville, Minnesota, Stany Zjednoczone, 55337
        • Fairview Ridges Hospital
      • Burnsville, Minnesota, Stany Zjednoczone, 55337
        • Minnesota Oncology - Burnsville
      • Cambridge, Minnesota, Stany Zjednoczone, 55008
        • Cambridge Medical Center
      • Coon Rapids, Minnesota, Stany Zjednoczone, 55433
        • Mercy Hospital
      • Edina, Minnesota, Stany Zjednoczone, 55435
        • Fairview Southdale Hospital
      • Fridley, Minnesota, Stany Zjednoczone, 55432
        • Unity Hospital
      • Maple Grove, Minnesota, Stany Zjednoczone, 55369
        • Fairview Clinics and Surgery Center Maple Grove
      • Maplewood, Minnesota, Stany Zjednoczone, 55109
        • Saint John's Hospital - Healtheast
      • Maplewood, Minnesota, Stany Zjednoczone, 55109
        • Minnesota Oncology Hematology PA-Maplewood
      • Minneapolis, Minnesota, Stany Zjednoczone, 55415
        • Hennepin County Medical Center
      • Minneapolis, Minnesota, Stany Zjednoczone, 55407
        • Abbott-Northwestern Hospital
      • Minneapolis, Minnesota, Stany Zjednoczone, 55454
        • Health Partners Inc
      • Monticello, Minnesota, Stany Zjednoczone, 55362
        • Monticello Cancer Center
      • New Ulm, Minnesota, Stany Zjednoczone, 56073
        • New Ulm Medical Center
      • Princeton, Minnesota, Stany Zjednoczone, 55371
        • Fairview Northland Medical Center
      • Robbinsdale, Minnesota, Stany Zjednoczone, 55422
        • North Memorial Medical Health Center
      • Saint Louis Park, Minnesota, Stany Zjednoczone, 55416
        • Park Nicollet Clinic - Saint Louis Park
      • Saint Paul, Minnesota, Stany Zjednoczone, 55101
        • Regions Hospital
      • Saint Paul, Minnesota, Stany Zjednoczone, 55102
        • United Hospital
      • Shakopee, Minnesota, Stany Zjednoczone, 55379
        • Saint Francis Regional Medical Center
      • Stillwater, Minnesota, Stany Zjednoczone, 55082
        • Lakeview Hospital
      • Waconia, Minnesota, Stany Zjednoczone, 55387
        • Ridgeview Medical Center
      • Willmar, Minnesota, Stany Zjednoczone, 56201
        • Rice Memorial Hospital
      • Woodbury, Minnesota, Stany Zjednoczone, 55125
        • Minnesota Oncology Hematology PA-Woodbury
      • Wyoming, Minnesota, Stany Zjednoczone, 55092
        • Fairview Lakes Medical Center
    • Missouri
      • Kansas City, Missouri, Stany Zjednoczone, 64154
        • University of Kansas Cancer Center - North
      • Kansas City, Missouri, Stany Zjednoczone, 64108
        • University Health Truman Medical Center
      • Lee's Summit, Missouri, Stany Zjednoczone, 64064
        • University of Kansas Cancer Center - Lee's Summit
      • North Kansas City, Missouri, Stany Zjednoczone, 64116
        • University of Kansas Cancer Center at North Kansas City Hospital
    • Montana
      • Anaconda, Montana, Stany Zjednoczone, 59711
        • Community Hospital of Anaconda
      • Billings, Montana, Stany Zjednoczone, 59101
        • Billings Clinic Cancer Center
      • Bozeman, Montana, Stany Zjednoczone, 59715
        • Bozeman Health Deaconess Hospital
      • Great Falls, Montana, Stany Zjednoczone, 59405
        • Great Falls Clinic
      • Great Falls, Montana, Stany Zjednoczone, 59405
        • Benefis Sletten Cancer Institute
      • Kalispell, Montana, Stany Zjednoczone, 59901
        • Logan Health Medical Center
      • Missoula, Montana, Stany Zjednoczone, 59802
        • Saint Patrick Hospital - Community Hospital
      • Missoula, Montana, Stany Zjednoczone, 59804
        • Community Medical Center
    • Nebraska
      • Grand Island, Nebraska, Stany Zjednoczone, 68803
        • Nebraska Cancer Specialists/Oncology Hematology West PC
      • Kearney, Nebraska, Stany Zjednoczone, 68847
        • CHI Health Good Samaritan
      • Lincoln, Nebraska, Stany Zjednoczone, 68510
        • Saint Elizabeth Regional Medical Center
      • Omaha, Nebraska, Stany Zjednoczone, 68114
        • Nebraska Methodist Hospital
      • Omaha, Nebraska, Stany Zjednoczone, 68124
        • Alegent Health Bergan Mercy Medical Center
      • Omaha, Nebraska, Stany Zjednoczone, 68122
        • Alegent Health Immanuel Medical Center
      • Omaha, Nebraska, Stany Zjednoczone, 68130
        • Alegent Health Lakeside Hospital
      • Papillion, Nebraska, Stany Zjednoczone, 68046
        • Midlands Community Hospital
    • Nevada
      • Carson City, Nevada, Stany Zjednoczone, 89703
        • Carson Tahoe Regional Medical Center
      • Henderson, Nevada, Stany Zjednoczone, 89052
        • Comprehensive Cancer Centers of Nevada - Henderson
      • Henderson, Nevada, Stany Zjednoczone, 89052
        • Cancer and Blood Specialists-Henderson
      • Henderson, Nevada, Stany Zjednoczone, 89052
        • Las Vegas Cancer Center-Henderson
      • Henderson, Nevada, Stany Zjednoczone, 89074
        • Comprehensive Cancer Centers of Nevada-Southeast Henderson
      • Henderson, Nevada, Stany Zjednoczone, 89052
        • Comprehensive Cancer Centers of Nevada-Horizon Ridge
      • Henderson, Nevada, Stany Zjednoczone, 89074
        • Las Vegas Urology - Green Valley
      • Henderson, Nevada, Stany Zjednoczone, 89074
        • Las Vegas Urology - Pebble
      • Henderson, Nevada, Stany Zjednoczone, 89074
        • Urology Specialists of Nevada - Green Valley
      • Henderson, Nevada, Stany Zjednoczone, 89074
        • Oncology Las Vegas - Henderson
      • Las Vegas, Nevada, Stany Zjednoczone, 89144
        • Summerlin Hospital Medical Center
      • Las Vegas, Nevada, Stany Zjednoczone, 89109
        • Sunrise Hospital and Medical Center
      • Las Vegas, Nevada, Stany Zjednoczone, 89102
        • OptumCare Cancer Care at Charleston
      • Las Vegas, Nevada, Stany Zjednoczone, 89106
        • Radiation Oncology Centers of Nevada Central
      • Las Vegas, Nevada, Stany Zjednoczone, 89119
        • Radiation Oncology Centers of Nevada Southeast
      • Las Vegas, Nevada, Stany Zjednoczone, 89128
        • Comprehensive Cancer Centers of Nevada - Northwest
      • Las Vegas, Nevada, Stany Zjednoczone, 89128
        • OptumCare Cancer Care at MountainView
      • Las Vegas, Nevada, Stany Zjednoczone, 89135
        • Alliance for Childhood Diseases/Cure 4 the Kids Foundation
      • Las Vegas, Nevada, Stany Zjednoczone, 89144
        • Comprehensive Cancer Centers of Nevada - Town Center
      • Las Vegas, Nevada, Stany Zjednoczone, 89144
        • Comprehensive Cancer Centers of Nevada-Summerlin
      • Las Vegas, Nevada, Stany Zjednoczone, 89148
        • Comprehensive Cancer Centers of Nevada
      • Las Vegas, Nevada, Stany Zjednoczone, 89169
        • Comprehensive Cancer Centers of Nevada - Central Valley
      • Las Vegas, Nevada, Stany Zjednoczone, 89102
        • University Medical Center of Southern Nevada
      • Las Vegas, Nevada, Stany Zjednoczone, 89106
        • Cancer and Blood Specialists-Shadow
      • Las Vegas, Nevada, Stany Zjednoczone, 89109
        • HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
      • Las Vegas, Nevada, Stany Zjednoczone, 89113
        • HealthCare Partners Medical Group Oncology/Hematology-San Martin
      • Las Vegas, Nevada, Stany Zjednoczone, 89128
        • Cancer and Blood Specialists-Tenaya
      • Las Vegas, Nevada, Stany Zjednoczone, 89128
        • HealthCare Partners Medical Group Oncology/Hematology-Tenaya
      • Las Vegas, Nevada, Stany Zjednoczone, 89148-2405
        • Las Vegas Cancer Center-Medical Center
      • Las Vegas, Nevada, Stany Zjednoczone, 89149
        • HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
      • Las Vegas, Nevada, Stany Zjednoczone, 89128
        • Ann M Wierman MD LTD
      • Las Vegas, Nevada, Stany Zjednoczone, 89074
        • Las Vegas Urology - Pecos
      • Las Vegas, Nevada, Stany Zjednoczone, 89102
        • Desert West Surgery
      • Las Vegas, Nevada, Stany Zjednoczone, 89103
        • Hope Cancer Care of Nevada
      • Las Vegas, Nevada, Stany Zjednoczone, 89106
        • Urology Specialists of Nevada - Central
      • Las Vegas, Nevada, Stany Zjednoczone, 89113
        • Las Vegas Prostate Cancer Center
      • Las Vegas, Nevada, Stany Zjednoczone, 89113
        • Las Vegas Urology - Sunset
      • Las Vegas, Nevada, Stany Zjednoczone, 89128
        • Las Vegas Urology - Cathedral Rock
      • Las Vegas, Nevada, Stany Zjednoczone, 89128
        • Las Vegas Urology - Smoke Ranch
      • Las Vegas, Nevada, Stany Zjednoczone, 89128
        • Urology Specialists of Nevada - Northwest
      • Las Vegas, Nevada, Stany Zjednoczone, 89169
        • University Cancer Center
      • Las Vegas, Nevada, Stany Zjednoczone, 89113
        • Urology Specialists of Nevada - Southwest
      • Las Vegas, Nevada, Stany Zjednoczone, 89128
        • Oncology Las Vegas - Tenaya
      • Las Vegas, Nevada, Stany Zjednoczone, 89183
        • OptumCare Cancer Care at Fort Apache
      • Pahrump, Nevada, Stany Zjednoczone, 89048
        • Hope Cancer Care of Nevada-Pahrump
      • Reno, Nevada, Stany Zjednoczone, 89502
        • Renown Regional Medical Center
      • Reno, Nevada, Stany Zjednoczone, 89503
        • Saint Mary's Regional Medical Center
      • Reno, Nevada, Stany Zjednoczone, 89509
        • Radiation Oncology Associates
    • New Hampshire
      • Lebanon, New Hampshire, Stany Zjednoczone, 03756
        • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
    • New Jersey
      • Teaneck, New Jersey, Stany Zjednoczone, 07666
        • Holy Name Hospital
    • New York
      • Buffalo, New York, Stany Zjednoczone, 14263
        • Roswell Park Cancer Institute
      • Rochester, New York, Stany Zjednoczone, 14642
        • University of Rochester
    • North Carolina
      • Chapel Hill, North Carolina, Stany Zjednoczone, 27599
        • UNC Lineberger Comprehensive Cancer Center
      • Greenville, North Carolina, Stany Zjednoczone, 27834
        • East Carolina University
      • Hillsborough, North Carolina, Stany Zjednoczone, 27278
        • University of North Carolina-Hillsborough Campus
    • Ohio
      • Beavercreek, Ohio, Stany Zjednoczone, 45431
        • Indu and Raj Soin Medical Center
      • Boardman, Ohio, Stany Zjednoczone, 44512
        • Saint Elizabeth Boardman Hospital
      • Centerville, Ohio, Stany Zjednoczone, 45459
        • Miami Valley Hospital South
      • Centerville, Ohio, Stany Zjednoczone, 45459
        • Dayton Physicians LLC-Miami Valley South
      • Cincinnati, Ohio, Stany Zjednoczone, 45220
        • Good Samaritan Hospital - Cincinnati
      • Cincinnati, Ohio, Stany Zjednoczone, 45242
        • Bethesda North Hospital
      • Cincinnati, Ohio, Stany Zjednoczone, 45236
        • Oncology Hematology Care Inc-Kenwood
      • Cincinnati, Ohio, Stany Zjednoczone, 45247
        • TriHealth Cancer Institute-Westside
      • Cincinnati, Ohio, Stany Zjednoczone, 45255
        • TriHealth Cancer Institute-Anderson
      • Cleveland, Ohio, Stany Zjednoczone, 44109
        • MetroHealth Medical Center
      • Cleveland, Ohio, Stany Zjednoczone, 44195
        • Cleveland Clinic Foundation
      • Cleveland, Ohio, Stany Zjednoczone, 44111
        • Cleveland Clinic Cancer Center/Fairview Hospital
      • Dayton, Ohio, Stany Zjednoczone, 45409
        • Miami Valley Hospital
      • Dayton, Ohio, Stany Zjednoczone, 45415
        • Miami Valley Hospital North
      • Dayton, Ohio, Stany Zjednoczone, 45415
        • Dayton Physician LLC - Englewood
      • Findlay, Ohio, Stany Zjednoczone, 45840
        • Blanchard Valley Hospital
      • Findlay, Ohio, Stany Zjednoczone, 45840
        • Armes Family Cancer Center
      • Findlay, Ohio, Stany Zjednoczone, 45840
        • Orion Cancer Care
      • Franklin, Ohio, Stany Zjednoczone, 45005-1066
        • Atrium Medical Center-Middletown Regional Hospital
      • Franklin, Ohio, Stany Zjednoczone, 45005
        • Dayton Physicians LLC-Atrium
      • Greenville, Ohio, Stany Zjednoczone, 45331
        • Wayne Hospital
      • Greenville, Ohio, Stany Zjednoczone, 45331
        • Dayton Physicians LLC-Wayne
      • Kettering, Ohio, Stany Zjednoczone, 45429
        • Kettering Medical Center
      • Kettering, Ohio, Stany Zjednoczone, 45409
        • Greater Dayton Cancer Center
      • Kettering, Ohio, Stany Zjednoczone, 45420
        • First Dayton Cancer Care
      • Mansfield, Ohio, Stany Zjednoczone, 44906
        • Cleveland Clinic Cancer Center Mansfield
      • Mayfield Heights, Ohio, Stany Zjednoczone, 44124
        • Hillcrest Hospital Cancer Center
      • Sandusky, Ohio, Stany Zjednoczone, 44870
        • North Coast Cancer Care
      • Strongsville, Ohio, Stany Zjednoczone, 44136
        • Cleveland Clinic Cancer Center Strongsville
      • Troy, Ohio, Stany Zjednoczone, 45373
        • Upper Valley Medical Center
      • Troy, Ohio, Stany Zjednoczone, 45373
        • Dayton Physicians LLC - Troy
      • Warren, Ohio, Stany Zjednoczone, 44484
        • Saint Joseph Warren Hospital
      • Warrensville Heights, Ohio, Stany Zjednoczone, 44122
        • South Pointe Hospital
      • Wooster, Ohio, Stany Zjednoczone, 44691
        • Cleveland Clinic Wooster Family Health and Surgery Center
      • Youngstown, Ohio, Stany Zjednoczone, 44501
        • Saint Elizabeth Youngstown Hospital
    • Oklahoma
      • Lawton, Oklahoma, Stany Zjednoczone, 73505
        • Cancer Centers of Southwest Oklahoma Research
      • Oklahoma City, Oklahoma, Stany Zjednoczone, 73104
        • University of Oklahoma Health Sciences Center
    • Oregon
      • Baker City, Oregon, Stany Zjednoczone, 97814
        • Saint Alphonsus Cancer Care Center-Baker City
      • Bend, Oregon, Stany Zjednoczone, 97701
        • Saint Charles Health System
      • Clackamas, Oregon, Stany Zjednoczone, 97015
        • Clackamas Radiation Oncology Center
      • Clackamas, Oregon, Stany Zjednoczone, 97015
        • Providence Cancer Institute Clackamas Clinic
      • Coos Bay, Oregon, Stany Zjednoczone, 97420
        • Bay Area Hospital
      • Newberg, Oregon, Stany Zjednoczone, 97132
        • Providence Newberg Medical Center
      • Ontario, Oregon, Stany Zjednoczone, 97914
        • Saint Alphonsus Cancer Care Center-Ontario
      • Portland, Oregon, Stany Zjednoczone, 97213
        • Providence Portland Medical Center
      • Portland, Oregon, Stany Zjednoczone, 97225
        • Providence Saint Vincent Medical Center
      • Redmond, Oregon, Stany Zjednoczone, 97756
        • Saint Charles Health System-Redmond
    • Pennsylvania
      • Allentown, Pennsylvania, Stany Zjednoczone, 18103
        • Lehigh Valley Hospital-Cedar Crest
      • Bethlehem, Pennsylvania, Stany Zjednoczone, 18017
        • Lehigh Valley Hospital - Muhlenberg
      • East Stroudsburg, Pennsylvania, Stany Zjednoczone, 18301
        • Pocono Medical Center
      • Hazleton, Pennsylvania, Stany Zjednoczone, 18201
        • Lehigh Valley Hospital-Hazleton
      • Philadelphia, Pennsylvania, Stany Zjednoczone, 19104
        • University of Pennsylvania/Abramson Cancer Center
      • Philadelphia, Pennsylvania, Stany Zjednoczone, 19140
        • Temple University Hospital
      • Pittsburgh, Pennsylvania, Stany Zjednoczone, 15232
        • UPMC Hillman Cancer Center
    • South Carolina
      • Boiling Springs, South Carolina, Stany Zjednoczone, 29316
        • Prisma Health Cancer Institute - Spartanburg
      • Easley, South Carolina, Stany Zjednoczone, 29640
        • Prisma Health Cancer Institute - Easley
      • Greenville, South Carolina, Stany Zjednoczone, 29605
        • Prisma Health Cancer Institute - Faris
      • Greenville, South Carolina, Stany Zjednoczone, 29615
        • Prisma Health Cancer Institute - Eastside
      • Greenville, South Carolina, Stany Zjednoczone, 29605
        • Prisma Health Cancer Institute - Butternut
      • Greer, South Carolina, Stany Zjednoczone, 29650
        • Prisma Health Cancer Institute - Greer
      • Seneca, South Carolina, Stany Zjednoczone, 29672
        • Prisma Health Cancer Institute - Seneca
    • South Dakota
      • Sioux Falls, South Dakota, Stany Zjednoczone, 57105
        • Avera Cancer Institute
    • Tennessee
      • Bristol, Tennessee, Stany Zjednoczone, 37620
        • Bristol Regional Medical Center
      • Franklin, Tennessee, Stany Zjednoczone, 37067
        • Vanderbilt-Ingram Cancer Center Cool Springs
      • Franklin, Tennessee, Stany Zjednoczone, 37067
        • Vanderbilt-Ingram Cancer Center at Franklin
      • Kingsport, Tennessee, Stany Zjednoczone, 37660
        • Ballad Health Cancer Care - Kingsport
      • Kingsport, Tennessee, Stany Zjednoczone, 37660
        • Wellmont Holston Valley Hospital and Medical Center
      • Nashville, Tennessee, Stany Zjednoczone, 37232
        • Vanderbilt University/Ingram Cancer Center
      • Nashville, Tennessee, Stany Zjednoczone, 37204
        • Vanderbilt Breast Center at One Hundred Oaks
    • Texas
      • Bryan, Texas, Stany Zjednoczone, 77802
        • Saint Joseph Regional Cancer Center
      • Dallas, Texas, Stany Zjednoczone, 75235
        • Parkland Memorial Hospital
      • Dallas, Texas, Stany Zjednoczone, 75390
        • UT Southwestern/Simmons Cancer Center-Dallas
      • Fort Worth, Texas, Stany Zjednoczone, 76104
        • UT Southwestern/Simmons Cancer Center-Fort Worth
      • Richardson, Texas, Stany Zjednoczone, 75080
        • UT Southwestern Clinical Center at Richardson/Plano
    • Virginia
      • Bristol, Virginia, Stany Zjednoczone, 24201
        • Ballad Health Cancer Care - Bristol
      • Martinsville, Virginia, Stany Zjednoczone, 24112
        • Sovah Health Martinsville
      • Norton, Virginia, Stany Zjednoczone, 24273
        • Ballad Health Cancer Care - Norton
    • Washington
      • Aberdeen, Washington, Stany Zjednoczone, 98520
        • Providence Regional Cancer System-Aberdeen
      • Bellevue, Washington, Stany Zjednoczone, 98004
        • Overlake Medical Center
      • Bellingham, Washington, Stany Zjednoczone, 98225
        • PeaceHealth Saint Joseph Medical Center
      • Burien, Washington, Stany Zjednoczone, 98166
        • Saint Anne Hospital
      • Centralia, Washington, Stany Zjednoczone, 98531
        • Providence Regional Cancer System-Centralia
      • Edmonds, Washington, Stany Zjednoczone, 98026
        • Swedish Cancer Institute-Edmonds
      • Enumclaw, Washington, Stany Zjednoczone, 98022
        • Saint Elizabeth Hospital
      • Everett, Washington, Stany Zjednoczone, 98201
        • Providence Regional Cancer Partnership
      • Federal Way, Washington, Stany Zjednoczone, 98003
        • Saint Francis Hospital
      • Issaquah, Washington, Stany Zjednoczone, 98029
        • Swedish Cancer Institute-Issaquah
      • Kennewick, Washington, Stany Zjednoczone, 99336
        • Kadlec Clinic Hematology and Oncology
      • Lacey, Washington, Stany Zjednoczone, 98503
        • Providence Regional Cancer System-Lacey
      • Lakewood, Washington, Stany Zjednoczone, 98499
        • Saint Clare Hospital
      • Longview, Washington, Stany Zjednoczone, 98632
        • PeaceHealth Saint John Medical Center
      • Poulsbo, Washington, Stany Zjednoczone, 98370
        • Harrison HealthPartners Hematology and Oncology-Poulsbo
      • Renton, Washington, Stany Zjednoczone, 98055
        • Valley Medical Center
      • Seattle, Washington, Stany Zjednoczone, 98107
        • Swedish Medical Center-Ballard Campus
      • Seattle, Washington, Stany Zjednoczone, 98122
        • Swedish Medical Center-First Hill
      • Seattle, Washington, Stany Zjednoczone, 98104
        • Pacific Gynecology Specialists
      • Seattle, Washington, Stany Zjednoczone, 98122-5711
        • Swedish Medical Center-Cherry Hill
      • Sedro-Woolley, Washington, Stany Zjednoczone, 98284
        • PeaceHealth United General Medical Center
      • Shelton, Washington, Stany Zjednoczone, 98584
        • Providence Regional Cancer System-Shelton
      • Silverdale, Washington, Stany Zjednoczone, 98383
        • Saint Joseph Medical Center Hematology and Oncology - Silverdale
      • Tacoma, Washington, Stany Zjednoczone, 98405
        • Northwest Medical Specialties PLLC
      • Tacoma, Washington, Stany Zjednoczone, 98405
        • Franciscan Research Center-Northwest Medical Plaza
      • Vancouver, Washington, Stany Zjednoczone, 98664
        • PeaceHealth Southwest Medical Center
      • Walla Walla, Washington, Stany Zjednoczone, 99362
        • Providence Saint Mary Regional Cancer Center
      • Yelm, Washington, Stany Zjednoczone, 98597
        • Providence Regional Cancer System-Yelm
    • Wisconsin
      • Madison, Wisconsin, Stany Zjednoczone, 53792
        • University of Wisconsin Carbone Cancer Center - University Hospital
      • Menomonee Falls, Wisconsin, Stany Zjednoczone, 53051
        • Froedtert Menomonee Falls Hospital
      • Milwaukee, Wisconsin, Stany Zjednoczone, 53226
        • Medical College of Wisconsin
      • New Richmond, Wisconsin, Stany Zjednoczone, 54017
        • Cancer Center of Western Wisconsin
      • West Bend, Wisconsin, Stany Zjednoczone, 53095
        • Froedtert West Bend Hospital/Kraemer Cancer Center
    • Wyoming
      • Cody, Wyoming, Stany Zjednoczone, 82414
        • Billings Clinic-Cody
      • Sheridan, Wyoming, Stany Zjednoczone, 82801
        • Welch Cancer Center

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

18 lat i starsze (Dorosły, Starszy dorosły)

Akceptuje zdrowych ochotników

Nie

Płeć kwalifikująca się do nauki

Wszystko

Opis

Inclusion Criteria:

  • Patient must be >= 18 years of age

  • Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status 0-1

  • Patient must have a life expectancy >= 12 weeks

  • Patient must have histologically confirmed intrahepatic cholangiocarcinoma or biphasic hepatocellular carcinoma and cholangiocarcinoma that is metastatic or unresectable and who have progressed on or been intolerant of one prior line of systemic gemcitabine containing chemotherapy regimen.

    • NOTE: Prior immunotherapy or targeted therapies are allowed and will not be considered a line of therapy unless administered with cytotoxic chemotherapy
  • Patient must have measurable disease. For patients who have received localized therapy (embolization, chemoembolization, radiofrequency ablation or radiation) are eligible if measurable disease is not within the treatment field or the treated disease has clearly progressed since last localized therapy

  • Leukocytes >= 3,000/mcL (obtained within 14 days prior to randomization)

  • Absolute neutrophil count >= 1,500/mcL (obtained within 14 days prior to randomization)

  • Platelets >= 100,000/mcL (obtained within 14 days prior to randomization)

  • Total bilirubin =< institutional upper limit of normal (ULN) except in patients with Gilbert's syndrome. Patients with Gilbert's syndrome may enroll if direct bilirubin =< 1.5 x ULN of the direct bilirubin (obtained within 14 days prior to randomization)

  • Hemoglobin >= 9 g/dL (obtained within 14 days prior to randomization)

  • Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x institutional ULN (obtained within 14 days prior to randomization)

  • Creatinine =< institutional ULN, OR glomerular filtration rate (GFR) >= 40 mL/min/1.73 m^2 (obtained within 14 days prior to randomization)

  • Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial. Known HIV positive patients who meet the following criteria will be considered eligible:

    • CD4 count >= 350 cells/mm^3
    • Undetectable viral load
    • Maintained on modern therapeutic regimens utilizing non-CYP interactive agents (i.e. excluding ritonavir)
    • No history of acquired immunodeficiency syndrome (AIDS)-defining opportunistic infections
  • For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated

  • Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load

  • Patients who received prior platinum or taxane chemotherapy are eligible

  • Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial

  • Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class 2B or better. In addition, patients with any of the known cardiopulmonary disease, defined as follows, would be ineligible for this trial:

    • Unstable angina

    • Congestive heart failure (New York Heart Association [NYHA] class III or IV;);

    • Myocardial infarction within 6 months prior to randomization (patients who had ischemic heart disease such as acute coronary syndrome [ACS], myocardial infarction, and/or revascularization greater than 6 months before randomization and who are without cardiac symptoms may enroll)

    • Symptomatic cardiomyopathy

    • Clinically symptomatic pulmonary hypertension requiring pharmacologic therapy

    • Clinically significant arrhythmia, defined as:

      • History of polymorphic ventricular fibrillation or torsade de pointes,
      • Permanent atrial fibrillation, defined as continuous atrial fibrillation for >= 6 months,
      • Persistent atrial fibrillation, defined as sustained atrial fibrillation lasting > 7 days and/or requiring cardioversion in the 4 weeks before randomization,
      • Grade 3 atrial fibrillation defined as symptomatic and incompletely controlled medically, or controlled with device (e.g., pacemaker), or ablation
      • Patients with paroxysmal atrial fibrillation or grade < 3 atrial fibrillation for period of at least 6 months are permitted to enroll provided that their rate is controlled on a stable regimen
  • Patients must have the ability to understand and the willingness to sign a written informed consent document

  • Participants with impaired decision-making capacity (IDMC) who have a legally authorized representative (LAR) or caregiver and/or family member available will also be considered eligible

Exclusion Criteria:

  • Patients must not have had major surgery within 14 days before randomization. Patients with surgery planned during study period are ineligible
  • Women must not be pregnant or breast-feeding due to the potential harm to an unborn fetus and possible risk for adverse events in nursing infants with the treatment regimens being used. Patients must also not expect to conceive or father children from the time of registration, while on study treatment, and until at least 4 months after the last dose of study treatment. All females of childbearing potential must have a blood test or urine study within 14 days prior to randomization to rule out pregnancy. A female of childbearing potential is any woman, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy; or 3) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)
  • Women of childbearing potential and sexually active males must not expect to conceive or father children by using accepted and effective method(s) of contraception or by abstaining from sexual intercourse for the duration of their participation in the study and continue for at least 4 months after the last dose of protocol treatment
  • Male patients must not donate sperm during the course of this study or within 4 months after receiving their last dose of protocol treatment
  • Female patients must not donate eggs (ova) during the course of this study or within 4 months after receiving their last dose of protocol treatment
  • Patient must not have a prolonged rate corrected QT (QTc) interval >= 480 msec calculated according to institutional guideline
  • Patients who have not recovered from adverse events due to prior anti-cancer therapy (i.e. have residual toxicities > grade 1) are ineligible with the exception of alopecia
  • Patients with persistent >= grade 2 diarrhea lasting more than 3 days within 14 weeks of randomization are ineligible
  • Patients with known central nervous system (CNS) involvement are ineligible
  • Patients must not be receiving any other investigational agents
  • Patients must not have received chemotherapy or radiotherapy within 2 weeks prior to randomization. Prior treatment with radiation therapy involving >= 25% of hematopoietically active bone marrow will be ineligible
  • Patients must not have received immunotherapy within 8 weeks prior to randomization
  • Patients must not have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to pevonedistat, carboplatin, or paclitaxel
  • Patient must not be receiving any treatment with clinically significant metabolic enzyme inducers within 14 days before the first dose of the study drug as below. Clinically significant metabolic enzyme inducers are not permitted during the study. Patients must not be receiving any medications or substances that are strong inducers of CYP3A4/5 (i.e. phenytoin, rifampin, St. Johns wort) or inhibitors of breast cancer resistance protein (BCRP) (i.e. cyclosporine). Because the lists of these agents are constantly changing, it is important to regularly consult a frequently-updated medical reference. As part of enrollment/informed consent procedures, the patient will be counseled on the risk of interactions with other agents, and what to do if a new medication need to be prescribed or if the patient is considering a new over-the-counter medicine or herbal product. Inhibitors of CYP3A4/5 are allowed
  • Patients must not have uncontrolled intercurrent illness
  • Patients must not have uncontrolled coagulopathy or bleeding disorder
  • Patients must not have active, uncontrolled infection or severe infectious disease such as severe pneumonia, meningitis, or septicemia
  • Patients with known moderate chronic obstructive pulmonary disease, interstitial lung disease, and pulmonary fibrosis are ineligible
  • Patients must not have psychiatric illness/social situations that would limit compliance with study requirements
  • Participants must not have had prior pevonedistat treatment

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Brak (otwarta etykieta)

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Arm A (pevonedistat)

Patients receive pevonedistat IV over 60 minutes on days 1, 3, and 5. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Given IV

Inne nazwy:
  • MLN4924
  • Inhibitor enzymu aktywujący Nedd8 MLN4924
Eksperymentalny: Arm B (pevonedistat, paclitaxel, carboplatin)

Patients receive pevonedistat IV over 1 hour on days 1, 3, and 5, paclitaxel IV over 3 hours on day 1, and carboplatin IV over 15-60 minutes on day 1. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Starting cycle 5, patients may receive pevonedistat monotherapy at the discretion of treating physician.

Given IV

Inne nazwy:
  • Blastokarb
  • Karboplat
  • Karboplatyna Hexal
  • Karboplatyna
  • Karbozyna
  • Karbozol
  • Carbotec
  • CBDCA
  • Displata
  • Erkar
  • JM-8
  • Nealorin
  • Nowoplatyna
  • Paraplatyna
  • Paraplatyna AQ
  • Platyna
  • Rybokarbo
  • JM8

Given IV

Inne nazwy:
  • Taksol
  • Anzatax
  • Asotaks
  • Bristaksol
  • Praksel
  • Taxol Konzentrat

Given IV

Inne nazwy:
  • MLN4924
  • Inhibitor enzymu aktywujący Nedd8 MLN4924

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Objective Response
Ramy czasowe: Every 3 months for the first year and every 6 months for years 2-3

Response was evaluated using the revised Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1). Objective response includes complete response (CR) and partial response (PR).

CR is defined as disappearance of all target and non-target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to < 10 mm.

PR is defined as at least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters.

Every 3 months for the first year and every 6 months for years 2-3

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Clinical Benefit
Ramy czasowe: Every 3 months for the first year and every 6 months for years 2-3

Clinical benefit was evaluated using the revised Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1), including complete response (CR), partial response (PR) and stable disease (SD) that lasted greater than or equal to 24 weeks.

CR is defined as disappearance of all target and non-target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to < 10 mm.

PR is defined as at least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters.

SD is defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease, taking as reference the smallest sum diameters while on study.

Every 3 months for the first year and every 6 months for years 2-3
Progression-free Survival (PFS)
Ramy czasowe: Every 3 months for the first year and every 6 months for years 2-3

PFS was defined as the time from randomization to progression or death, whichever came first; patients alive without evidence of disease progression were censored at the date of last disease assessment. Patients who died without documented progression and the death occurred > 6 weeks of last disease assessment will be censored at the date of last disease assessment that showed progression-free.

Progression was evaluated using the revised Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1), defined as at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. Appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions is also considered as progression.

Every 3 months for the first year and every 6 months for years 2-3
Overall Survival (OS)
Ramy czasowe: Every 3 months for the first year and every 6 months for years 2-3

OS was defined as the time from randomization to death from any cause, and patients still living were censored at the date last known alive.

Every 3 months for the first year and every 6 months for years 2-3

Inne miary wyników

Miara wyniku
Opis środka
Ramy czasowe
Występowanie zdarzenia niepożądanego
Ramy czasowe: Oceniane co 3 tygodnie w trakcie leczenia i przez 30 dni po zakończeniu leczenia, do 3 lat
Oceniane co 3 tygodnie w trakcie leczenia i przez 30 dni po zakończeniu leczenia, do 3 lat
Associations Between Response and Overexpression of NEDD8, NAE1, and UBC12
Ramy czasowe: Assessed every 3 months for the first year and every 6 months for years 2-3

Associations between response and overexpression of NEDD8, NAE1, and UBC12 will be evaluated.

Assessed every 3 months for the first year and every 6 months for years 2-3
Mutation Profile of Those Cholangiocarcinomas
Ramy czasowe: Assessed at baseline

To identify the mutation profile of those cholangiocarcinomas with overexpression of the neddylation pathway

Assessed at baseline
Specimens Banking
Ramy czasowe: Baseline

To bank specimens for further future investigations

Baseline

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Sponsor

Śledczy

  • Główny śledczy: Dustin A Deming, ECOG-ACRIN Cancer Research Group

Publikacje i pomocne linki

Osoba odpowiedzialna za wprowadzenie informacji o badaniu dobrowolnie udostępnia te publikacje. Mogą one dotyczyć wszystkiego, co jest związane z badaniem.

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Rzeczywisty)

16 marca 2020

Zakończenie podstawowe (Rzeczywisty)

27 listopada 2023

Ukończenie studiów (Szacowany)

3 września 2027

Daty rejestracji na studia

Pierwszy przesłany

22 listopada 2019

Pierwszy przesłany, który spełnia kryteria kontroli jakości

22 listopada 2019

Pierwszy wysłany (Rzeczywisty)

25 listopada 2019

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

26 października 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

23 października 2026

Ostatnia weryfikacja

1 września 2026

Więcej informacji

Terminy związane z tym badaniem

Inne numery identyfikacyjne badania

  • NCI-2019-07769
  • U10CA180820 (Grant/umowa NIH USA)
  • NCI-2019-07769 (Identyfikator rejestru: CTRP (Clinical Trial Reporting Program))
  • EA2187 (Inny identyfikator: CTEP)
  • EA2187 (Inny identyfikator: ECOG-ACRIN Cancer Research Group)

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

TAK

Opis planu IPD

NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Tak

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .