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Rytuksymab i chlorowodorek bendamustyny, rytuksymab i ibrutynib lub sam ibrutynib w leczeniu starszych pacjentów z wcześniej nieleczoną przewlekłą białaczką limfocytową

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

Randomizowane badanie III fazy Bendamustyna plus rytuksymab w porównaniu z ibrutynibem plus rytuksymab w porównaniu z samym ibrutynibem u nieleczonych starszych pacjentów (>/= 65 lat) z przewlekłą białaczką limfocytową (PBL)

This randomized phase III trial studies rituximab with bendamustine hydrochloride or ibrutinib to see how well they work compared to ibrutinib alone in treating older patients with previously untreated chronic lymphocytic leukemia. Rituximab is a monoclonal antibody that may interfere with the ability of cancer cells to grow and spread. A monoclonal antibody is a type of protein that can bind to certain targets in the body, such as molecules that cause the body to make an immune response (antigens). Chemotherapy drugs, such as bendamustine hydrochloride, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Ibrutinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. It is not yet known whether rituximab with bendamustine hydrochloride may work better than rituximab and ibrutinib or ibrutinib alone in treating chronic lymphocytic leukemia.

Przegląd badań

Status

Aktywny, nie rekrutujący

Warunki

Interwencja / Leczenie

Szczegółowy opis

PRIMARY OBJECTIVE:

I. To determine whether progression free survival (PFS) is superior after therapy with bendamustine hydrochloride (bendamustine) in combination with rituximab, ibrutinib alone, or ibrutinib in combination with rituximab in patients age 65 or older with previously untreated chronic lymphocytic leukemia (CLL).

SECONDARY OBJECTIVES:

I. To determine 2-year PFS in each of the three treatment arms. II. To determine which treatment arm produces superior overall survival (OS). III. To determine the complete response (CR) rate, complete and nodular partial response (CR/nPR) rate, and overall response (PR+nPR+CR) rate (ORR) among the three treatment arms and compare these arms.

IV. To determine the impact of minimal residual disease (MRD)-negative disease at time of CR documentation and at 2 years on PFS and OS in each of the treatment arms.

V. To determine duration of response after each of the three treatments and compare these treatment arms.

VI. To determine toxicity and tolerability of the three treatment regimens. VII. To determine response and PFS of patients initially on the bendamustine in combination with rituximab arm who cross over to ibrutinib.

OTHER PRE-SPECIFIED OBJECTIVES:

I. To determine whether baseline cytogenetic markers, Zap-70 methylation, IgVH mutational status, or select deoxyribonucleic acid (DNA) mutations predict outcomes or time to response in these three arms.

II. To determine whether local fluorescence in situ hybridization (FISH) results for del(11q22.3) and del(17p13.1) are consistent with central analysis.

III. To determine whether baseline micro ribonucleic acid (RNA) and gene expression markers are correlated with clinical outcomes of interest (e.g. progression-free and alive at 2 years versus not), as well as to explore changes in microRNA expression from baseline to post-treatment time points, with a focus on those with persistent lymphocytosis and relapse.

IV. To determine whether eradication of MRD predicts longer duration of response with standard therapy and ibrutinib-based regimens.

V. To describe the baseline functional status, comorbid medical conditions, and number of medications of older CLL patients who meet criteria for therapy.

VI. To determine how functional status changes with therapy using baseline to 3-month evaluation and end-of-study/2-year evaluation; to determine whether this change is different among the treatment groups.

VII. To determine whether geriatric assessment variables known to be associated with chemotherapy toxicity in other disease groups can also predict therapy-associated toxicity in the CLL population.

VIII. To assess whether the FCGR3A polymorphism (rs396991) is correlated with depth of response (MRD status) to ibrutinib plus rituximab after 6 cycles, with secondary endpoints CR rate, rapidity of response, and progression-free survival (PFS).

IX. To assess whether C1QA polymorphism (rs172378) is correlated with MRD status, CR rate, rapidity of response, and PFS.

OUTLINE: Patients are randomized to 1 of 3 treatment arms.

ARM I: Patients receive rituximab intravenously (IV) on day 1 (day 0 course 1) and bendamustine hydrochloride IV over 30 minutes on days 1-2. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover to Arm II.

ARM II: Patients receive ibrutinib orally (PO) daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

ARM III: Patients receive ibrutinib as in Arm II. Patients receive rituximab IV on days 1, 8, 15, and 22 of course 2 and on day 1 of courses 3-6. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and computed tomography (CT) throughout the study.

After completion of study treatment, patients are followed up every 6 months for up to 10 years.

Typ studiów

Interwencyjne

Zapisy (Rzeczywisty)

547

Faza

Faza 3

Kontakty i lokalizacje

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

Lokalizacje studiów

Kanada
- Alberta
  - Calgary, Alberta, Kanada, T2N 5G2
    - Arthur J E Child Comprehensive Cancer Centre
- New Brunswick
  - Moncton, New Brunswick, Kanada, E1C 6Z8
    - The Moncton Hospital
- Nova Scotia
  - Halifax, Nova Scotia, Kanada, B3H 2Y9
    - QEII Health Sciences Centre/Nova Scotia Health Authority
- Ontario
  - Greater Sudbury, Ontario, Kanada, P3E 5J1
    - Health Sciences North
  - Hamilton, Ontario, Kanada, L8V 5C2
    - Juravinski Cancer Centre at Hamilton Health Sciences
  - Kingston, Ontario, Kanada, K7L 2V7
    - Kingston Health Sciences Centre
  - London, Ontario, Kanada, N6A 4L6
    - London Regional Cancer Program
  - Newmarket, Ontario, Kanada, L3Y 2P9
    - Stronach Regional Health Centre at Southlake
  - Oshawa, Ontario, Kanada, L1G 2B9
    - Lakeridge Health Oshawa
  - Ottawa, Ontario, Kanada, K1H 8L6
    - Ottawa Hospital and Cancer Center-General Campus
  - Toronto, Ontario, Kanada, M4C 3E7
    - Michael Garron Hospital
  - Toronto, Ontario, Kanada, M5G 2M9
    - University Health Network-Princess Margaret Hospital
  - Toronto, Ontario, Kanada, M4N 3M5
    - Odette Cancer Centre- Sunnybrook Health Sciences Centre
  - Toronto, Ontario, Kanada, M3M 0B2
    - Humber River Hospital
- Quebec
  - Greenfield Park, Quebec, Kanada, J4V 2H1
    - CSSS Champlain-Charles Le Moyne
  - Montreal, Quebec, Kanada, H3T 1E2
    - Jewish General Hospital
  - Montreal, Quebec, Kanada, H2W 1S6
    - McGill University Department of Oncology
  - Montreal, Quebec, Kanada, H2X 3E4
    - CHUM - Centre Hospitalier de l'Universite de Montreal
- Saskatchewan
  - Regina, Saskatchewan, Kanada, S4T 7T1
    - Allan Blair Cancer Centre
  - Saskatoon, Saskatchewan, Kanada, S7N 4H4
    - Saskatoon Cancer Centre
Stany Zjednoczone
- Alabama
  - Birmingham, Alabama, Stany Zjednoczone, 35233
    - University of Alabama at Birmingham Cancer Center
- Alaska
  - 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
  - Anchorage, Alaska, Stany Zjednoczone, 99508
    - Alaska Regional Hospital
- Arizona
  - Phoenix, Arizona, Stany Zjednoczone, 85054
    - Mayo Clinic Hospital in Arizona
  - Scottsdale, Arizona, Stany Zjednoczone, 85259
    - Mayo Clinic in Arizona
  - Tucson, Arizona, Stany Zjednoczone, 85719
    - Banner University Medical Center - Tucson
  - Tucson, Arizona, Stany Zjednoczone, 85719
    - University of Arizona Cancer Center-North Campus
  - Yuma, Arizona, Stany Zjednoczone, 85364
    - Onvida Health Yuma Medical Center
- Arkansas
  - Hot Springs, Arkansas, Stany Zjednoczone, 71913
    - CHI Saint Vincent Cancer Center Hot Springs
  - Jonesboro, Arkansas, Stany Zjednoczone, 72401
    - NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
- California
  - Anaheim, California, Stany Zjednoczone, 92806
    - Kaiser Permanente-Anaheim
  - Antioch, California, Stany Zjednoczone, 94531
    - Kaiser Permanente-Deer Valley Medical Center
  - Arroyo Grande, California, Stany Zjednoczone, 93420
    - PCR Oncology
  - Auburn, California, Stany Zjednoczone, 95602
    - Sutter Auburn Faith Hospital
  - Auburn, California, Stany Zjednoczone, 95603
    - Sutter Cancer Centers Radiation Oncology Services-Auburn
  - Baldwin Park, California, Stany Zjednoczone, 91706
    - Kaiser Permanente-Baldwin Park
  - Bellflower, California, Stany Zjednoczone, 90706
    - Kaiser Permanente-Bellflower
  - 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
  - Burlingame, California, Stany Zjednoczone, 94010
    - Mills-Peninsula Medical Center
  - Cameron Park, California, Stany Zjednoczone, 95682
    - Sutter Cancer Centers Radiation Oncology Services-Cameron Park
  - Concord, California, Stany Zjednoczone, 94520
    - John Muir Medical Center-Concord
  - Davis, California, Stany Zjednoczone, 95616
    - Sutter Davis Hospital
  - Duarte, California, Stany Zjednoczone, 91010
    - City of Hope Comprehensive Cancer Center
  - Fontana, California, Stany Zjednoczone, 92335
    - Kaiser Permanente-Fontana
  - Fremont, California, Stany Zjednoczone, 94538
    - Kaiser Permanente-Fremont
  - Fresno, California, Stany Zjednoczone, 93720
    - Kaiser Permanente-Fresno
  - Greenbrae, California, Stany Zjednoczone, 94904
    - Marin Cancer Care Inc
  - Greenbrae, California, Stany Zjednoczone, 94904
    - Marin General Hospital
  - Harbor City, California, Stany Zjednoczone, 90710
    - Kaiser Permanente South Bay
  - Irvine, California, Stany Zjednoczone, 92618
    - Kaiser Permanente-Irvine
  - Los Angeles, California, Stany Zjednoczone, 90048
    - Cedars-Sinai Medical Center
  - Los Angeles, California, Stany Zjednoczone, 90027
    - Kaiser Permanente Los Angeles Medical Center
  - Los Angeles, California, Stany Zjednoczone, 90034
    - Kaiser Permanente West Los Angeles
  - Modesto, California, Stany Zjednoczone, 95355
    - Memorial Medical Center
  - Modesto, California, Stany Zjednoczone, 95356
    - Kaiser Permanente-Modesto
  - Mountain View, California, Stany Zjednoczone, 94040
    - Palo Alto Medical Foundation-Camino Division
  - Mountain View, California, Stany Zjednoczone, 94040
    - Palo Alto Medical Foundation-Gynecologic Oncology
  - Novato, California, Stany Zjednoczone, 94945
    - Sutter Cancer Research Consortium
  - Oakland, California, Stany Zjednoczone, 94611
    - Kaiser Permanente-Oakland
  - Palo Alto, California, Stany Zjednoczone, 94304
    - Stanford Cancer Institute Palo Alto
  - Palo Alto, California, Stany Zjednoczone, 94301
    - Palo Alto Medical Foundation Health Care
  - Panorama City, California, Stany Zjednoczone, 91402
    - Kaiser Permanente - Panorama City
  - Redwood City, California, Stany Zjednoczone, 94063
    - Kaiser Permanente-Redwood City
  - Richmond, California, Stany Zjednoczone, 94801
    - Kaiser Permanente-Richmond
  - Riverside, California, Stany Zjednoczone, 92505
    - Kaiser Permanente-Riverside
  - Roseville, California, Stany Zjednoczone, 95661
    - Kaiser Permanente-Roseville
  - 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
  - Sacramento, California, Stany Zjednoczone, 95823
    - Kaiser Permanente-South Sacramento
  - Sacramento, California, Stany Zjednoczone, 95825
    - Kaiser Permanente Sacramento Medical Center
  - San Diego, California, Stany Zjednoczone, 92120
    - Kaiser Permanente-San Diego Zion
  - San Diego, California, Stany Zjednoczone, 92134
    - Naval Medical Center -San Diego
  - San Francisco, California, Stany Zjednoczone, 94115
    - Kaiser Permanente-San Francisco
  - San Francisco, California, Stany Zjednoczone, 94115
    - California Pacific Medical Center-Pacific Campus
  - San Jose, California, Stany Zjednoczone, 95119
    - Kaiser Permanente-Santa Teresa-San Jose
  - San Jose, California, Stany Zjednoczone, 95124
    - Stanford Cancer Center South Bay
  - San Leandro, California, Stany Zjednoczone, 94577
    - Kaiser Permanente San Leandro
  - San Marcos, California, Stany Zjednoczone, 92078
    - Kaiser Permanente-San Marcos
  - San Rafael, California, Stany Zjednoczone, 94903
    - Kaiser Permanente-San Rafael
  - Santa Clara, California, Stany Zjednoczone, 95051
    - Kaiser Permanente Medical Center - Santa Clara
  - Santa Cruz, California, Stany Zjednoczone, 95065
    - Palo Alto Medical Foundation-Santa Cruz
  - Santa Rosa, California, Stany Zjednoczone, 95403
    - Kaiser Permanente-Santa Rosa
  - Santa Rosa, California, Stany Zjednoczone, 95403
    - Sutter Pacific Medical Foundation
  - South San Francisco, California, Stany Zjednoczone, 94080
    - Kaiser Permanente-South San Francisco
  - St. Helena, California, Stany Zjednoczone, 94574
    - Saint Helena Hospital
  - Stockton, California, Stany Zjednoczone, 95210
    - Kaiser Permanente-Stockton
  - Sunnyvale, California, Stany Zjednoczone, 94086
    - Palo Alto Medical Foundation-Sunnyvale
  - Vacaville, California, Stany Zjednoczone, 95688
    - Kaiser Permanente Medical Center-Vacaville
  - Vacaville, California, Stany Zjednoczone, 95687
    - Northbay Cancer Center
  - Vallejo, California, Stany Zjednoczone, 94589
    - Kaiser Permanente-Vallejo
  - Vallejo, California, Stany Zjednoczone, 94589
    - Sutter Solano Medical Center/Cancer Center
  - Walnut Creek, California, Stany Zjednoczone, 94596
    - Kaiser Permanente-Walnut Creek
  - Walnut Creek, California, Stany Zjednoczone, 94598
    - John Muir Medical Center-Walnut Creek
  - Whittier, California, Stany Zjednoczone, 90602
    - Presbyterian Intercommunity Hospital
  - Woodland Hills, California, Stany Zjednoczone, 91367
    - Kaiser Permanente-Woodland Hills
- Colorado
  - Aurora, Colorado, Stany Zjednoczone, 80012
    - Rocky Mountain Cancer Centers-Aurora
  - Aurora, Colorado, Stany Zjednoczone, 80012
    - The Medical Center of Aurora
  - Boulder, Colorado, Stany Zjednoczone, 80303
    - Boulder Community Foothills Hospital
  - Boulder, Colorado, Stany Zjednoczone, 80304
    - Rocky Mountain Cancer Centers-Boulder
  - Colorado Springs, Colorado, Stany Zjednoczone, 80907
    - Penrose-Saint Francis Healthcare
  - Colorado Springs, Colorado, Stany Zjednoczone, 80907
    - Rocky Mountain Cancer Centers-Penrose
  - Denver, Colorado, Stany Zjednoczone, 80205
    - Kaiser Permanente-Franklin
  - Denver, Colorado, Stany Zjednoczone, 80218
    - Presbyterian - Saint Lukes Medical Center - Health One
  - Denver, Colorado, Stany Zjednoczone, 80220
    - Rose Medical Center
  - Denver, Colorado, Stany Zjednoczone, 80218
    - Rocky Mountain Cancer Centers-Midtown
  - Denver, Colorado, Stany Zjednoczone, 80220
    - Rocky Mountain Cancer Centers-Rose
  - Denver, Colorado, Stany Zjednoczone, 80204
    - Denver Health Medical Center
  - Denver, Colorado, Stany Zjednoczone, 80218
    - Colorado Blood Cancer Institute
  - Denver, Colorado, Stany Zjednoczone, 80222
    - Western States Cancer Research NCORP
  - Denver, Colorado, Stany Zjednoczone, 80218
    - Saint Joseph Hospital - Cancer Centers of Colorado
  - Denver, Colorado, Stany Zjednoczone, 80210
    - AdventHealth Porter
  - Durango, Colorado, Stany Zjednoczone, 81301
    - Mercy Medical Center
  - Durango, Colorado, Stany Zjednoczone, 81301
    - CommonSpirit Cancer Center Mercy
  - Englewood, Colorado, Stany Zjednoczone, 80113
    - Mountain Blue Cancer Care Center - Swedish
  - Englewood, Colorado, Stany Zjednoczone, 80113
    - Swedish Medical Center
  - Fort Collins, Colorado, Stany Zjednoczone, 80524
    - Poudre Valley Hospital
  - Golden, Colorado, Stany Zjednoczone, 80401
    - Mountain Blue Cancer Care Center
  - Golden, Colorado, Stany Zjednoczone, 80401
    - National Jewish Health-Western Hematology Oncology
  - Greeley, Colorado, Stany Zjednoczone, 80631
    - Banner North Colorado Medical Center
  - Greenwood Village, Colorado, Stany Zjednoczone, 80111
    - Rocky Mountain Cancer Centers-Greenwood Village
  - Lafayette, Colorado, Stany Zjednoczone, 80026
    - Kaiser Permanente-Rock Creek
  - Lakewood, Colorado, Stany Zjednoczone, 80228
    - Rocky Mountain Cancer Centers-Lakewood
  - Lakewood, Colorado, Stany Zjednoczone, 80228
    - CommonSpirit Saint Anthony Hospital Cancer Center
  - Littleton, Colorado, Stany Zjednoczone, 80120
    - Rocky Mountain Cancer Centers-Littleton
  - Littleton, Colorado, Stany Zjednoczone, 80122
    - AdventHealth Littleton
  - Lone Tree, Colorado, Stany Zjednoczone, 80124
    - Kaiser Permanente-Lone Tree
  - Lone Tree, Colorado, Stany Zjednoczone, 80124
    - Sky Ridge Medical Center
  - Lone Tree, Colorado, Stany Zjednoczone, 80124
    - Rocky Mountain Cancer Centers-Sky Ridge
  - Longmont, Colorado, Stany Zjednoczone, 80501
    - Longmont United Hospital
  - Longmont, Colorado, Stany Zjednoczone, 80501
    - Rocky Mountain Cancer Centers-Longmont
  - Loveland, Colorado, Stany Zjednoczone, 80539
    - Banner North Colorado Medical Center - Loveland Campus
  - Parker, Colorado, Stany Zjednoczone, 80138
    - Rocky Mountain Cancer Centers-Parker
  - Parker, Colorado, Stany Zjednoczone, 80138
    - AdventHealth Parker
  - Pueblo, Colorado, Stany Zjednoczone, 81004
    - Saint Mary Corwin Medical Center
  - Pueblo, Colorado, Stany Zjednoczone, 81008
    - Rocky Mountain Cancer Centers - Pueblo
  - Thornton, Colorado, Stany Zjednoczone, 80260
    - Rocky Mountain Cancer Centers-Thornton
  - Wheat Ridge, Colorado, Stany Zjednoczone, 80401
    - Intermountain Health Lutheran Hospital
- Connecticut
  - Danbury, Connecticut, Stany Zjednoczone, 06810
    - Danbury Hospital
  - Derby, Connecticut, Stany Zjednoczone, 06418
    - Smilow Cancer Hospital-Derby Care Center
  - Fairfield, Connecticut, Stany Zjednoczone, 06824
    - Smilow Cancer Hospital Care Center-Fairfield
  - Guilford, Connecticut, Stany Zjednoczone, 06437
    - Smilow Cancer Hospital Care Center - Guilford
  - Hartford, Connecticut, Stany Zjednoczone, 06105
    - Smilow Cancer Hospital Care Center at Saint Francis
  - Middletown, Connecticut, Stany Zjednoczone, 06457
    - Middlesex Hospital
  - New Britain, Connecticut, Stany Zjednoczone, 06050
    - The Hospital of Central Connecticut
  - New Haven, Connecticut, Stany Zjednoczone, 06520
    - Yale University
  - North Haven, Connecticut, Stany Zjednoczone, 06473
    - Yale-New Haven Hospital North Haven Medical Center
  - Norwalk, Connecticut, Stany Zjednoczone, 06856
    - Norwalk Hospital
  - Orange, Connecticut, Stany Zjednoczone, 06477
    - Smilow Cancer Hospital-Orange Care Center
  - Torrington, Connecticut, Stany Zjednoczone, 06790
    - Smilow Cancer Hospital-Torrington Care Center
  - Trumbull, Connecticut, Stany Zjednoczone, 06611
    - Smilow Cancer Hospital Care Center-Trumbull
  - Waterbury, Connecticut, Stany Zjednoczone, 06708
    - Smilow Cancer Hospital-Waterbury Care Center
  - Waterford, Connecticut, Stany Zjednoczone, 06385
    - Smilow Cancer Hospital Care Center - Waterford
  - West Haven, Connecticut, Stany Zjednoczone, 06516
    - Veterans Affairs Connecticut Healthcare System-West Haven Campus
- Delaware
  - Lewes, Delaware, Stany Zjednoczone, 19958
    - Beebe Medical Center
  - Newark, Delaware, Stany Zjednoczone, 19713
    - Helen F Graham Cancer Center
  - Newark, Delaware, Stany Zjednoczone, 19713
    - Delaware Clinical and Laboratory Physicians PA
  - Newark, Delaware, Stany Zjednoczone, 19713
    - Medical Oncology Hematology Consultants PA
  - Newark, Delaware, Stany Zjednoczone, 19718
    - Christiana Care Health System-Christiana Hospital
  - Rehoboth Beach, Delaware, Stany Zjednoczone, 19971
    - Beebe Health Campus
  - Seaford, Delaware, Stany Zjednoczone, 19973
    - TidalHealth Nanticoke / Allen Cancer Center
  - Wilmington, Delaware, Stany Zjednoczone, 19801
    - Christiana Care Health System-Wilmington Hospital
- District of Columbia
  - Washington D.C., District of Columbia, Stany Zjednoczone, 20010
    - MedStar Washington Hospital Center
  - Washington D.C., District of Columbia, Stany Zjednoczone, 20007
    - MedStar Georgetown University Hospital
- Florida
  - Altamonte Springs, Florida, Stany Zjednoczone, 32701
    - AdventHealth Altamonte
  - Deerfield Beach, Florida, Stany Zjednoczone, 33442
    - UM Sylvester Comprehensive Cancer Center at Deerfield Beach
  - Fort Lauderdale, Florida, Stany Zjednoczone, 33308
    - Holy Cross Hospital
  - Jacksonville, Florida, Stany Zjednoczone, 32207
    - Baptist MD Anderson Cancer Center
  - Jupiter, Florida, Stany Zjednoczone, 33458
    - Jupiter Medical Center
  - Kissimmee, Florida, Stany Zjednoczone, 34744
    - AdventHealth Kissimmee
  - Miami, Florida, Stany Zjednoczone, 33136
    - University of Miami Miller School of Medicine-Sylvester Cancer Center
  - Miami Beach, Florida, Stany Zjednoczone, 33140
    - Mount Sinai Medical Center
  - Orlando, Florida, Stany Zjednoczone, 32806
    - Orlando Health Cancer Institute
  - Orlando, Florida, Stany Zjednoczone, 32803
    - AdventHealth Orlando
  - Orlando, Florida, Stany Zjednoczone, 32803
    - AdventHealth Medical Group Urology at Orlando
  - Orlando, Florida, Stany Zjednoczone, 32822
    - AdventHealth East Orlando
  - Pensacola, Florida, Stany Zjednoczone, 32504
    - Sacred Heart Hospital
  - Plantation, Florida, Stany Zjednoczone, 33324
    - UM Sylvester Comprehensive Cancer Center at Plantation
  - Weston, Florida, Stany Zjednoczone, 33331
    - Cleveland Clinic-Weston
  - Winter Park, Florida, Stany Zjednoczone, 32792
    - AdventHealth Winter Park
- Georgia
  - Atlanta, Georgia, Stany Zjednoczone, 30322
    - Emory University Hospital/Winship Cancer Institute
  - Atlanta, Georgia, Stany Zjednoczone, 30342
    - Northside Hospital
  - Columbus, Georgia, Stany Zjednoczone, 31904
    - John B Amos Cancer Center
  - Cumming, Georgia, Stany Zjednoczone, 30041
    - Northside Hospital-Forsyth
- 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
    - 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, 96819
    - Kaiser Permanente Moanalua Medical Center
  - Lihue, Hawaii, Stany Zjednoczone, 96766
    - Wilcox Memorial Hospital and Kauai Medical Clinic
  - ‘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
  - Coeur d'Alene, Idaho, Stany Zjednoczone, 83814
    - Kootenai Health - Coeur d'Alene
  - Fruitland, Idaho, Stany Zjednoczone, 83619
    - Saint Luke's Cancer Institute - Fruitland
  - Meridian, Idaho, Stany Zjednoczone, 83642
    - Saint Luke's Cancer Institute - Meridian
  - 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
  - Aurora, Illinois, Stany Zjednoczone, 60504
    - Rush-Copley Medical Center
  - Bloomington, Illinois, Stany Zjednoczone, 61704
    - Illinois CancerCare-Bloomington
  - Bloomington, Illinois, Stany Zjednoczone, 61701
    - OSF Saint Joseph Medical Center
  - Canton, Illinois, Stany Zjednoczone, 61520
    - Illinois CancerCare-Canton
  - Carbondale, Illinois, Stany Zjednoczone, 62902
    - Memorial Hospital of Carbondale
  - Carthage, Illinois, Stany Zjednoczone, 62321
    - Illinois CancerCare-Carthage
  - Centralia, Illinois, Stany Zjednoczone, 62801
    - Centralia Oncology Clinic
  - Chicago, Illinois, Stany Zjednoczone, 60611
    - Northwestern University
  - Chicago, Illinois, Stany Zjednoczone, 60637
    - University of Chicago Comprehensive Cancer Center
  - Chicago, Illinois, Stany Zjednoczone, 60612
    - University of Illinois
  - Danville, Illinois, Stany Zjednoczone, 61832
    - Carle at The Riverfront
  - Decatur, Illinois, Stany Zjednoczone, 62526
    - Decatur Memorial Hospital
  - Decatur, Illinois, Stany Zjednoczone, 62526
    - Cancer Care Specialists of Illinois - Decatur
  - Decatur, Illinois, Stany Zjednoczone, 62526
    - Heartland Cancer Research NCORP
  - Effingham, Illinois, Stany Zjednoczone, 62401
    - Crossroads Cancer Center
  - Effingham, Illinois, Stany Zjednoczone, 62401
    - Carle Physician Group-Effingham
  - Elk Grove Village, Illinois, Stany Zjednoczone, 60007
    - Ascension Alexian Brothers - Elk Grove Village
  - Eureka, Illinois, Stany Zjednoczone, 61530
    - Illinois CancerCare-Eureka
  - Evanston, Illinois, Stany Zjednoczone, 60201
    - NorthShore University HealthSystem-Evanston Hospital
  - Galesburg, Illinois, Stany Zjednoczone, 61401
    - Western Illinois Cancer Treatment Center
  - Galesburg, Illinois, Stany Zjednoczone, 61401
    - Illinois CancerCare-Galesburg
  - Geneva, Illinois, Stany Zjednoczone, 60134
    - Northwestern Medicine Cancer Center Delnor
  - Glenview, Illinois, Stany Zjednoczone, 60026
    - NorthShore University HealthSystem-Glenbrook Hospital
  - Highland Park, Illinois, Stany Zjednoczone, 60035
    - NorthShore University HealthSystem-Highland Park Hospital
  - Highland Park, Illinois, Stany Zjednoczone, 60035
    - Hematology Oncology Associates of Illinois-Highland Park
  - Hinsdale, Illinois, Stany Zjednoczone, 60521
    - Hinsdale Hematology Oncology Associates Incorporated
  - Joliet, Illinois, Stany Zjednoczone, 60435
    - Duly Health and Care Joliet
  - Kankakee, Illinois, Stany Zjednoczone, 60901
    - Presence Saint Mary's Hospital
  - Kewanee, Illinois, Stany Zjednoczone, 61443
    - Illinois CancerCare-Kewanee Clinic
  - Libertyville, Illinois, Stany Zjednoczone, 60048
    - AMG Libertyville - Oncology
  - Macomb, Illinois, Stany Zjednoczone, 61455
    - Illinois CancerCare-Macomb
  - Mattoon, Illinois, Stany Zjednoczone, 61938
    - Carle Physician Group-Mattoon/Charleston
  - Maywood, Illinois, Stany Zjednoczone, 60153
    - Loyola University Medical Center
  - Monmouth, Illinois, Stany Zjednoczone, 61462
    - Illinois CancerCare-Monmouth
  - Mount Vernon, Illinois, Stany Zjednoczone, 62864
    - SSM Health Good Samaritan
  - New Lenox, Illinois, Stany Zjednoczone, 60451
    - UC Comprehensive Cancer Center at Silver Cross
  - Normal, Illinois, Stany Zjednoczone, 61761
    - Carle Cancer Institute Normal
  - O'Fallon, Illinois, Stany Zjednoczone, 62269
    - Cancer Care Center of O'Fallon
  - Ottawa, Illinois, Stany Zjednoczone, 61350
    - Illinois CancerCare-Ottawa Clinic
  - Ottawa, Illinois, Stany Zjednoczone, 61350
    - Radiation Oncology of Northern Illinois
  - Ottawa, Illinois, Stany Zjednoczone, 61350
    - Ottawa Regional Hospital and Healthcare Center
  - Pekin, Illinois, Stany Zjednoczone, 61554
    - Illinois CancerCare-Pekin
  - Pekin, Illinois, Stany Zjednoczone, 61554
    - OSF Saint Francis Radiation Oncology at Pekin
  - Peoria, Illinois, Stany Zjednoczone, 61636
    - Methodist Medical Center of Illinois
  - Peoria, Illinois, Stany Zjednoczone, 61637
    - OSF Saint Francis Medical Center
  - Peoria, Illinois, Stany Zjednoczone, 61615
    - Illinois CancerCare-Peoria
  - Peoria, Illinois, Stany Zjednoczone, 61615
    - OSF Saint Francis Radiation Oncology at Peoria Cancer Center
  - Peoria, Illinois, Stany Zjednoczone, 61614
    - Proctor Hospital
  - Peru, Illinois, Stany Zjednoczone, 61354
    - Illinois CancerCare-Peru
  - Peru, Illinois, Stany Zjednoczone, 61354
    - Valley Radiation Oncology
  - Princeton, Illinois, Stany Zjednoczone, 61356
    - Illinois CancerCare-Princeton
  - Quincy, Illinois, Stany Zjednoczone, 62301
    - Quincy Medical Group-Clinic
  - Rockford, Illinois, Stany Zjednoczone, 61114
    - UW Health Carbone Cancer Center Rockford
  - Skokie, Illinois, Stany Zjednoczone, 60076
    - North Shore Medical Center
  - Springfield, Illinois, Stany Zjednoczone, 62702
    - Southern Illinois University School of Medicine
  - Springfield, Illinois, Stany Zjednoczone, 62702
    - Springfield Clinic
  - Springfield, Illinois, Stany Zjednoczone, 62702
    - Central Illinois Hematology Oncology Center
  - Springfield, Illinois, Stany Zjednoczone, 62781
    - Springfield Memorial Hospital
  - Urbana, Illinois, Stany Zjednoczone, 61801
    - Carle Cancer Center
  - Urbana, Illinois, Stany Zjednoczone, 61801
    - The Carle Foundation Hospital
  - Warrenville, Illinois, Stany Zjednoczone, 60555
    - Northwestern Medicine Cancer Center Warrenville
  - Yorkville, Illinois, Stany Zjednoczone, 60560
    - Rush-Copley Healthcare Center
- Indiana
  - Crown Point, Indiana, Stany Zjednoczone, 46307
    - Michiana Hematology Oncology PC-Crown Point
  - Elkhart, Indiana, Stany Zjednoczone, 46515
    - Elkhart General Hospital
  - Elkhart, Indiana, Stany Zjednoczone, 46514
    - Michiana Hematology Oncology PC-Elkhart
  - Elkhart, Indiana, Stany Zjednoczone, 46514-2098
    - Elkhart Clinic
  - Fort Wayne, Indiana, Stany Zjednoczone, 46845
    - Fort Wayne Medical Oncology and Hematology Inc-Parkview
  - Kokomo, Indiana, Stany Zjednoczone, 46904
    - Community Howard Regional Health
  - La Porte, Indiana, Stany Zjednoczone, 46350
    - IU Health La Porte Hospital
  - Michigan City, Indiana, Stany Zjednoczone, 46360
    - Franciscan Saint Anthony Health-Michigan City
  - Michigan City, Indiana, Stany Zjednoczone, 46360
    - Woodland Cancer Care Center
  - Mishawaka, Indiana, Stany Zjednoczone, 46545
    - Memorial Regional Cancer Center Day Road
  - Mishawaka, Indiana, Stany Zjednoczone, 46545
    - Michiana Hematology Oncology PC-Mishawaka
  - Mishawaka, Indiana, Stany Zjednoczone, 46545
    - Saint Joseph Regional Medical Center-Mishawaka
  - Plymouth, Indiana, Stany Zjednoczone, 46563
    - Michiana Hematology Oncology PC-Plymouth
  - Richmond, Indiana, Stany Zjednoczone, 47374
    - Reid Health
  - South Bend, Indiana, Stany Zjednoczone, 46601
    - Memorial Hospital of South Bend
  - South Bend, Indiana, Stany Zjednoczone, 46628
    - Northern Indiana Cancer Research Consortium
  - Westville, Indiana, Stany Zjednoczone, 46391
    - Michiana Hematology Oncology PC-Westville
- 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
  - Cedar Rapids, Iowa, Stany Zjednoczone, 52403
    - Mercy Hospital
  - Cedar Rapids, Iowa, Stany Zjednoczone, 52403
    - Oncology Associates at Mercy Medical Center
  - Cedar Rapids, Iowa, Stany Zjednoczone, 52402
    - Physicians' Clinic of Iowa PC
  - 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, 50314
    - Mercy Medical Center - Des Moines
  - Des Moines, Iowa, Stany Zjednoczone, 50309
    - Iowa-Wide Oncology Research Coalition NCORP
  - 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
  - Iowa City, Iowa, Stany Zjednoczone, 52242
    - University of Iowa/Holden Comprehensive Cancer Center
  - Iowa City, Iowa, Stany Zjednoczone, 52246
    - Iowa City VA Healthcare System
  - Jefferson, Iowa, Stany Zjednoczone, 50129
    - McFarland Clinic - Jefferson
  - Marshalltown, Iowa, Stany Zjednoczone, 50158
    - McFarland Clinic - Marshalltown
  - Mason City, Iowa, Stany Zjednoczone, 50401
    - Mercy Medical Center - North Iowa
  - Sioux City, Iowa, Stany Zjednoczone, 51101
    - Siouxland Regional Cancer Center
  - Sioux City, Iowa, Stany Zjednoczone, 51102
    - Mercy Medical Center-Sioux City
  - Sioux City, Iowa, Stany Zjednoczone, 51104
    - Saint Luke's Regional Medical Center
  - Spencer, Iowa, Stany Zjednoczone, 51301
    - Abben Cancer Center
  - Waterloo, Iowa, Stany Zjednoczone, 50702
    - MercyOne Waterloo Cancer Center
  - West Des Moines, Iowa, Stany Zjednoczone, 50266
    - Mercy Medical Center-West Lakes
- Kansas
  - Chanute, Kansas, Stany Zjednoczone, 66720
    - Cancer Center of Kansas - Chanute
  - Dodge City, Kansas, Stany Zjednoczone, 67801
    - Cancer Center of Kansas - Dodge City
  - El Dorado, Kansas, Stany Zjednoczone, 67042
    - Cancer Center of Kansas - El Dorado
  - Emporia, Kansas, Stany Zjednoczone, 66801
    - Newman Regional Health
  - Fort Scott, Kansas, Stany Zjednoczone, 66701
    - Cancer Center of Kansas - Fort Scott
  - Garden City, Kansas, Stany Zjednoczone, 67846
    - Saint Catherine Hospital
  - Great Bend, Kansas, Stany Zjednoczone, 67530
    - Saint Rose Ambulatory and Surgery Center
  - Hays, Kansas, Stany Zjednoczone, 67601
    - HaysMed
  - Independence, Kansas, Stany Zjednoczone, 67301
    - Cancer Center of Kansas-Independence
  - Kansas City, Kansas, Stany Zjednoczone, 66160
    - University of Kansas Cancer Center
  - Kansas City, Kansas, Stany Zjednoczone, 66112
    - University of Kansas Cancer Center-West
  - Kingman, Kansas, Stany Zjednoczone, 67068
    - Cancer Center of Kansas-Kingman
  - Lawrence, Kansas, Stany Zjednoczone, 66044
    - Lawrence Memorial Hospital
  - Liberal, Kansas, Stany Zjednoczone, 67905
    - Cancer Center of Kansas-Liberal
  - Newton, Kansas, Stany Zjednoczone, 67114
    - Cancer Center of Kansas - Newton
  - 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
  - Overland Park, Kansas, Stany Zjednoczone, 66209
    - Menorah Medical Center
  - Overland Park, Kansas, Stany Zjednoczone, 66213
    - Saint Luke's South Hospital
  - Parsons, Kansas, Stany Zjednoczone, 67357
    - Cancer Center of Kansas - Parsons
  - Pittsburg, Kansas, Stany Zjednoczone, 66762
    - Mercy Hospital Pittsburg
  - Prairie Village, Kansas, Stany Zjednoczone, 66208
    - Kansas City NCI Community Oncology Research Program
  - Pratt, Kansas, Stany Zjednoczone, 67124
    - Cancer Center of Kansas - Pratt
  - Salina, Kansas, Stany Zjednoczone, 67401
    - Salina Regional Health Center
  - Salina, Kansas, Stany Zjednoczone, 67401
    - Cancer Center of Kansas - Salina
  - Topeka, Kansas, Stany Zjednoczone, 66606
    - University of Kansas Health System Saint Francis Campus
  - Topeka, Kansas, Stany Zjednoczone, 66606
    - Cotton O'Neil Cancer Center / Stormont Vail Health
  - Wellington, Kansas, Stany Zjednoczone, 67152
    - Cancer Center of Kansas - Wellington
  - Wichita, Kansas, Stany Zjednoczone, 67214
    - Ascension Via Christi Hospitals Wichita
  - Wichita, Kansas, Stany Zjednoczone, 67208
    - Cancer Center of Kansas-Wichita Medical Arts Tower
  - Wichita, Kansas, Stany Zjednoczone, 67214
    - Cancer Center of Kansas - Wichita
  - Wichita, Kansas, Stany Zjednoczone, 67208
    - Associates In Womens Health
  - Winfield, Kansas, Stany Zjednoczone, 67156
    - Cancer Center of Kansas - Winfield
- Kentucky
  - Bardstown, Kentucky, Stany Zjednoczone, 40004
    - CommonSpirit Saint Joseph Hospital - Bardstown
  - Corbin, Kentucky, Stany Zjednoczone, 40701
    - Commonwealth Cancer Center-Corbin
  - Crestview Hills, Kentucky, Stany Zjednoczone, 41017
    - Oncology Hematology Care Inc-Crestview
  - Lexington, Kentucky, Stany Zjednoczone, 40504
    - Saint Joseph Radiation Oncology Resource Center
  - Lexington, Kentucky, Stany Zjednoczone, 40509
    - CommonSpirit Saint Joseph Medical Center - East Lexington
  - 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
- Louisiana
  - Baton Rouge, Louisiana, Stany Zjednoczone, 70805
    - LSU Health Baton Rouge-North Clinic
  - Baton Rouge, Louisiana, Stany Zjednoczone, 70809
    - Louisiana Hematology Oncology Associates LLC
  - Baton Rouge, Louisiana, Stany Zjednoczone, 70809
    - Mary Bird Perkins Cancer Center
  - Baton Rouge, Louisiana, Stany Zjednoczone, 70809
    - Ochsner Health Center-Summa
  - Baton Rouge, Louisiana, Stany Zjednoczone, 70808
    - Our Lady of the Lake Physician Group
  - Covington, Louisiana, Stany Zjednoczone, 70433
    - Mary Bird Perkins Cancer Center - Covington
  - Houma, Louisiana, Stany Zjednoczone, 70360
    - Mary Bird Perkins Cancer Center - Houma
  - Kenner, Louisiana, Stany Zjednoczone, 70065
    - Ochsner Medical Center Kenner
  - New Orleans, Louisiana, Stany Zjednoczone, 70121
    - Ochsner Medical Center Jefferson
- Maine
  - Augusta, Maine, Stany Zjednoczone, 04330
    - Harold Alfond Center for Cancer Care
  - Bangor, Maine, Stany Zjednoczone, 04401
    - Eastern Maine Medical Center
  - Brewer, Maine, Stany Zjednoczone, 04412
    - Lafayette Family Cancer Center-EMMC
  - Rockport, Maine, Stany Zjednoczone, 04856
    - Penobscot Bay Medical Center
  - York Village, Maine, Stany Zjednoczone, 03909
    - York Hospital
- Maryland
  - Baltimore, Maryland, Stany Zjednoczone, 21237
    - MedStar Franklin Square Medical Center/Weinberg Cancer Institute
  - Baltimore, Maryland, Stany Zjednoczone, 21215
    - Sinai Hospital of Baltimore
  - Baltimore, Maryland, Stany Zjednoczone, 21204
    - Greater Baltimore Medical Center
  - Baltimore, Maryland, Stany Zjednoczone, 21229
    - Saint Agnes Hospital
  - Cumberland, Maryland, Stany Zjednoczone, 21502
    - UPMC Western Maryland
  - Frederick, Maryland, Stany Zjednoczone, 21701
    - Frederick Memorial Hospital
  - Randallstown, Maryland, Stany Zjednoczone, 21133
    - Northwest Hospital Center
  - Salisbury, Maryland, Stany Zjednoczone, 21801
    - TidalHealth Peninsula Regional
- Massachusetts
  - Beverly, Massachusetts, Stany Zjednoczone, 01915
    - Beverly Hospital
  - Boston, Massachusetts, Stany Zjednoczone, 02215
    - Dana-Farber Cancer Institute
  - Boston, Massachusetts, Stany Zjednoczone, 02115
    - Brigham and Women's Hospital
  - Boston, Massachusetts, Stany Zjednoczone, 02111
    - Tufts Medical Center
  - Boston, Massachusetts, Stany Zjednoczone, 02118
    - Boston Medical Center
  - Boston, Massachusetts, Stany Zjednoczone, 02114
    - Massachusetts General Hospital Cancer Center
  - Burlington, Massachusetts, Stany Zjednoczone, 01805
    - Lahey Clinic
  - Fitchburg, Massachusetts, Stany Zjednoczone, 01420
    - Simonds-Sinon Regional Cancer Center
  - Gloucester, Massachusetts, Stany Zjednoczone, 01930
    - Addison Gilbert Hospital
  - Newton, Massachusetts, Stany Zjednoczone, 02462
    - Newton-Wellesley Hospital
  - Springfield, Massachusetts, Stany Zjednoczone, 01199
    - Baystate Medical Center
  - Springfield, Massachusetts, Stany Zjednoczone, 01107
    - D'Amour Center for Cancer Care
  - Winchester, Massachusetts, Stany Zjednoczone, 01890
    - Beth Israel Deaconess Medical Center/Winchester Center for Cancer Care
  - Worcester, Massachusetts, Stany Zjednoczone, 01655
    - UMass Memorial Medical Center - University Campus
- Michigan
  - Adrian, Michigan, Stany Zjednoczone, 49221
    - Bixby Medical Center
  - Adrian, Michigan, Stany Zjednoczone, 49221
    - Hickman Cancer Center
  - Ann Arbor, Michigan, Stany Zjednoczone, 48106
    - Michigan Cancer Research Consortium NCORP
  - 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
  - Brownstown, Michigan, Stany Zjednoczone, 48183
    - Henry Ford Cancer Institute-Downriver
  - Clarkston, Michigan, Stany Zjednoczone, 48346
    - McLaren Cancer Institute-Clarkston
  - Clinton Township, Michigan, Stany Zjednoczone, 48038
    - Henry Ford Macomb Hospital-Clinton Township
  - Commerce, Michigan, Stany Zjednoczone, 48382
    - Huron Valley-Sinai Hospital
  - Dearborn, Michigan, Stany Zjednoczone, 48126
    - Henry Ford Medical Center-Fairlane
  - Dearborn, Michigan, Stany Zjednoczone, 48124
    - Corewell Health Dearborn Hospital
  - Detroit, Michigan, Stany Zjednoczone, 48202
    - Henry Ford Hospital
  - Detroit, Michigan, Stany Zjednoczone, 48201
    - Wayne State University/Karmanos Cancer Institute
  - Detroit, Michigan, Stany Zjednoczone, 48236
    - Henry Ford Health Saint John Hospital
  - Escanaba, Michigan, Stany Zjednoczone, 49829
    - OSF Saint Francis Hospital and Medical Group
  - Farmington Hills, Michigan, Stany Zjednoczone, 48334
    - Weisberg Cancer Treatment Center
  - Farmington Hills, Michigan, Stany Zjednoczone, 48336
    - Corewell Health Farmington Hills Hospital
  - Flint, Michigan, Stany Zjednoczone, 48532
    - Singh and Arora Hematology Oncology PC
  - Flint, Michigan, Stany Zjednoczone, 48503
    - Hurley Medical Center
  - Flint, Michigan, Stany Zjednoczone, 48503
    - Genesys Hurley Cancer Institute
  - Grand Rapids, Michigan, Stany Zjednoczone, 49503
    - Cancer Research Consortium of West Michigan NCORP
  - Grand Rapids, Michigan, Stany Zjednoczone, 49503
    - Trinity Health Grand Rapids Hospital
  - Grand Rapids, Michigan, Stany Zjednoczone, 49503
    - Corewell Health Grand Rapids Hospitals - Butterworth Hospital
  - Grosse Pointe, Michigan, Stany Zjednoczone, 48230
    - William Beaumont Hospital-Grosse Pointe
  - Jackson, Michigan, Stany Zjednoczone, 49201
    - Allegiance Health
  - Kalamazoo, Michigan, Stany Zjednoczone, 49007
    - West Michigan Cancer Center
  - 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
  - Monroe, Michigan, Stany Zjednoczone, 48162
    - Mercy Memorial Hospital
  - Monroe, Michigan, Stany Zjednoczone, 48162
    - Toledo Clinic Cancer Centers-Monroe
  - 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
  - Novi, Michigan, Stany Zjednoczone, 48377
    - Henry Ford Medical Center-Columbus
  - Novi, Michigan, Stany Zjednoczone, 48374
    - Henry Ford Health Providence Novi Hospital
  - Petoskey, Michigan, Stany Zjednoczone, 49770
    - McLaren Cancer Institute-Northern Michigan
  - Pontiac, Michigan, Stany Zjednoczone, 48341
    - Trinity Health Saint Joseph Mercy Oakland Hospital
  - Port Huron, Michigan, Stany Zjednoczone, 48060
    - Lake Huron Medical Center
  - Reed City, Michigan, Stany Zjednoczone, 49677
    - Corewell Health Reed City Hospital
  - Roseville, Michigan, Stany Zjednoczone, 48066
    - Michigan Cancer Specialists
  - Royal Oak, Michigan, Stany Zjednoczone, 48073
    - Cancer Care Associates PC
  - Royal Oak, Michigan, Stany Zjednoczone, 48073
    - Comprehensive Medical Center PLLC
  - Royal Oak, Michigan, Stany Zjednoczone, 48073
    - Oakland Medical Group
  - Royal Oak, Michigan, Stany Zjednoczone, 48067
    - Oakland Colon Rectal Associates
  - Royal Oak, Michigan, Stany Zjednoczone, 48073
    - Hematology Oncology Consultants PC-Royal Oak
  - Royal Oak, Michigan, Stany Zjednoczone, 48073
    - Corewell Health William Beaumont University Hospital
  - Saginaw, Michigan, Stany Zjednoczone, 48601
    - MyMichigan Medical Center Saginaw
  - Southfield, Michigan, Stany Zjednoczone, 48075
    - Henry Ford Health Providence Southfield Hospital
  - Sterling Heights, Michigan, Stany Zjednoczone, 48312
    - Premier Hematology Oncology Care
  - Sterling Heights, Michigan, Stany Zjednoczone, 48314
    - Mitchell Folbe MD PC
  - Traverse City, Michigan, Stany Zjednoczone, 49684
    - Munson Medical Center
  - Troy, Michigan, Stany Zjednoczone, 48084
    - Michigan Institute of Urology-Town Center
  - Troy, Michigan, Stany Zjednoczone, 48085
    - Claudia BR Herke MD PC
  - Troy, Michigan, Stany Zjednoczone, 48098
    - Hematology Oncology Consultants PC-Troy
  - Troy, Michigan, Stany Zjednoczone, 48085
    - Corewell Health Beaumont Troy Hospital
  - Warren, Michigan, Stany Zjednoczone, 48093
    - Henry Ford Health Warren Hospital
  - West Bloomfield, Michigan, Stany Zjednoczone, 48322
    - Henry Ford West Bloomfield Hospital
- Minnesota
  - Bemidji, Minnesota, Stany Zjednoczone, 56601
    - Sanford Joe Lueken Cancer Center
  - Brainerd, Minnesota, Stany Zjednoczone, 56401
    - Essentia Health Saint Joseph's Medical Center
  - Burnsville, Minnesota, Stany Zjednoczone, 55337
    - Fairview Ridges Hospital
  - Coon Rapids, Minnesota, Stany Zjednoczone, 55433
    - Mercy Hospital
  - Duluth, Minnesota, Stany Zjednoczone, 55805
    - Saint Luke's Hospital of Duluth
  - Duluth, Minnesota, Stany Zjednoczone, 55805
    - Essentia Health Cancer Center
  - Duluth, Minnesota, Stany Zjednoczone, 55805
    - Essentia Health Saint Mary's Medical Center
  - Duluth, Minnesota, Stany Zjednoczone, 55805
    - Miller-Dwan Hospital
  - Edina, Minnesota, Stany Zjednoczone, 55435
    - Fairview Southdale Hospital
  - Fergus Falls, Minnesota, Stany Zjednoczone, 56537
    - Lake Region Healthcare Corporation-Cancer Care
  - Fridley, Minnesota, Stany Zjednoczone, 55432
    - Unity Hospital
  - Hutchinson, Minnesota, Stany Zjednoczone, 55350
    - Hutchinson Area Health Care
  - 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
  - Minneapolis, Minnesota, Stany Zjednoczone, 55417
    - Minneapolis VA Medical Center
  - New Ulm, Minnesota, Stany Zjednoczone, 56073
    - New Ulm Medical Center
  - Robbinsdale, Minnesota, Stany Zjednoczone, 55422
    - North Memorial Medical Health Center
  - Rochester, Minnesota, Stany Zjednoczone, 55905
    - Mayo Clinic in Rochester
  - Saint Cloud, Minnesota, Stany Zjednoczone, 56303
    - Coborn Cancer Center at Saint Cloud Hospital
  - Saint Cloud, Minnesota, Stany Zjednoczone, 56303
    - Saint Cloud Hospital
  - Saint Louis Park, Minnesota, Stany Zjednoczone, 55416
    - Park Nicollet Clinic - Saint Louis Park
  - Saint Louis Park, Minnesota, Stany Zjednoczone, 55416
    - Metro Minnesota Community Oncology Research Consortium
  - 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
- Mississippi
  - Jackson, Mississippi, Stany Zjednoczone, 39216
    - University of Mississippi Medical Center
- Missouri
  - Bolivar, Missouri, Stany Zjednoczone, 65613
    - Central Care Cancer Center - Bolivar
  - Bonne Terre, Missouri, Stany Zjednoczone, 63628
    - Parkland Health Center-Bonne Terre
  - Branson, Missouri, Stany Zjednoczone, 65616
    - Cox Cancer Center Branson
  - Cape Girardeau, Missouri, Stany Zjednoczone, 63703
    - Saint Francis Medical Center
  - Cape Girardeau, Missouri, Stany Zjednoczone, 63703
    - Mercy Cancer Center - Cape Girardeau
  - Chesterfield, Missouri, Stany Zjednoczone, 63017
    - Saint Luke's Hospital
  - City of Saint Peters, Missouri, Stany Zjednoczone, 63376
    - Siteman Cancer Center at Saint Peters Hospital
  - Columbia, Missouri, Stany Zjednoczone, 65212
    - MU Health - University Hospital/Ellis Fischel Cancer Center
  - Creve Coeur, Missouri, Stany Zjednoczone, 63141
    - Siteman Cancer Center at West County Hospital
  - Independence, Missouri, Stany Zjednoczone, 64057
    - Centerpoint Medical Center LLC
  - Jefferson City, Missouri, Stany Zjednoczone, 65109
    - MU Health Care Goldschmidt Cancer Center
  - Joplin, Missouri, Stany Zjednoczone, 64804
    - Freeman Health System
  - Joplin, Missouri, Stany Zjednoczone, 64804
    - Mercy Hospital Joplin
  - Kansas City, Missouri, Stany Zjednoczone, 64154
    - University of Kansas Cancer Center - North
  - Kansas City, Missouri, Stany Zjednoczone, 64116
    - North Kansas City Hospital
  - Kansas City, Missouri, Stany Zjednoczone, 64131
    - The University of Kansas Cancer Center-South
  - Kansas City, Missouri, Stany Zjednoczone, 64111
    - Saint Luke's Hospital of Kansas City
  - Kansas City, Missouri, Stany Zjednoczone, 64132
    - Research Medical Center
  - Kansas City, Missouri, Stany Zjednoczone, 64118
    - Heartland Hematology and Oncology Associates Incorporated
  - 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
  - Lee's Summit, Missouri, Stany Zjednoczone, 64086
    - Saint Luke's East - Lee's Summit
  - Liberty, Missouri, Stany Zjednoczone, 64068
    - Liberty Hospital
  - Rolla, Missouri, Stany Zjednoczone, 65401
    - Mercy Clinic-Rolla-Cancer and Hematology
  - Rolla, Missouri, Stany Zjednoczone, 65401
    - Phelps Health Delbert Day Cancer Institute
  - Saint Joseph, Missouri, Stany Zjednoczone, 64506
    - Heartland Regional Medical Center
  - Sainte Genevieve, Missouri, Stany Zjednoczone, 63670
    - Sainte Genevieve County Memorial Hospital
  - Springfield, Missouri, Stany Zjednoczone, 65807
    - CoxHealth South Hospital
  - Springfield, Missouri, Stany Zjednoczone, 65804
    - Mercy Hospital Springfield
  - St Louis, Missouri, Stany Zjednoczone, 63110
    - Washington University School of Medicine
  - St Louis, Missouri, Stany Zjednoczone, 63129
    - Siteman Cancer Center-South County
  - St Louis, Missouri, Stany Zjednoczone, 63131
    - Missouri Baptist Medical Center
  - St Louis, Missouri, Stany Zjednoczone, 63109
    - Mercy Infusion Center - Chippewa
  - St Louis, Missouri, Stany Zjednoczone, 63141
    - Mercy Hospital Saint Louis
  - Sullivan, Missouri, Stany Zjednoczone, 63080
    - Missouri Baptist Sullivan Hospital
- Montana
  - Billings, Montana, Stany Zjednoczone, 59101
    - Billings Clinic Cancer Center
  - Billings, Montana, Stany Zjednoczone, 59101
    - Saint Vincent Healthcare
  - Billings, Montana, Stany Zjednoczone, 59102
    - Montana Cancer Consortium NCORP
  - Bozeman, Montana, Stany Zjednoczone, 59715
    - Bozeman Health Deaconess Hospital
  - Butte, Montana, Stany Zjednoczone, 59701
    - Saint James Community Hospital and Cancer Treatment Center
  - Great Falls, Montana, Stany Zjednoczone, 59405
    - Benefis Sletten Cancer Institute
  - Helena, Montana, Stany Zjednoczone, 59601
    - Saint Peter's Community Hospital
  - 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
  - Kearney, Nebraska, Stany Zjednoczone, 68845
    - Fred and Pamela Buffett Cancer Center - Kearney
  - Lincoln, Nebraska, Stany Zjednoczone, 68510
    - Saint Elizabeth Regional Medical Center
  - Omaha, Nebraska, Stany Zjednoczone, 68198
    - University of Nebraska Medical Center
  - 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
  - Omaha, Nebraska, Stany Zjednoczone, 68122
    - Hematology and Oncology Consultants PC
  - Papillion, Nebraska, Stany Zjednoczone, 68046
    - Midlands Community Hospital
- Nevada
  - 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, 89074
    - Oncology Las Vegas - Henderson
  - Las Vegas, Nevada, Stany Zjednoczone, 89144
    - Summerlin Hospital Medical Center
  - 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, 89135
    - Alliance for Childhood Diseases/Cure 4 the Kids Foundation
  - 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, 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, 89121
    - Cancer Therapy and Integrative Medicine
  - 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, 89120
    - Nevada Cancer Research Foundation NCORP
  - Las Vegas, Nevada, Stany Zjednoczone, 89128
    - Oncology Las Vegas - Tenaya
  - Las Vegas, Nevada, Stany Zjednoczone, 89183
    - OptumCare Cancer Care at Fort Apache
  - Reno, Nevada, Stany Zjednoczone, 89503
    - Saint Mary's Regional Medical Center
- New Hampshire
  - Concord, New Hampshire, Stany Zjednoczone, 03301
    - New Hampshire Oncology Hematology PA-Concord
  - Derry, New Hampshire, Stany Zjednoczone, 03038
    - Parkland Medical Center
  - Dover, New Hampshire, Stany Zjednoczone, 03820
    - Wentworth-Douglass Hospital
  - Laconia, New Hampshire, Stany Zjednoczone, 03246
    - LRGHealthcare-Lakes Region General Hospital
  - Lebanon, New Hampshire, Stany Zjednoczone, 03756
    - Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
  - Manchester, New Hampshire, Stany Zjednoczone, 03103
    - Solinsky Center for Cancer Care
  - Manchester, New Hampshire, Stany Zjednoczone, 03104
    - Dartmouth Cancer Center - Manchester/ DCC Manchester
  - Nashua, New Hampshire, Stany Zjednoczone, 03063
    - Dartmouth Cancer Center - Nashua
  - Portsmouth, New Hampshire, Stany Zjednoczone, 03802
    - Portsmouth Regional Hospital
- New Jersey
  - East Orange, New Jersey, Stany Zjednoczone, 07018-1095
    - Veterans Adminstration New Jersey Health Care System
  - Englewood, New Jersey, Stany Zjednoczone, 07631
    - Englewood Hospital and Medical Center
  - New Brunswick, New Jersey, Stany Zjednoczone, 08903
    - Rutgers Cancer Institute of New Jersey
  - Newark, New Jersey, Stany Zjednoczone, 07112
    - Newark Beth Israel Medical Center
  - Paramus, New Jersey, Stany Zjednoczone, 07652
    - The Valley Hospital - Luckow Pavilion
  - Plainsboro, New Jersey, Stany Zjednoczone, 08536
    - Penn Medicine Princeton Health
  - Ridgewood, New Jersey, Stany Zjednoczone, 07450
    - Valley Health System Ridgewood Campus
  - Summit, New Jersey, Stany Zjednoczone, 07902
    - Overlook Hospital
  - Westwood, New Jersey, Stany Zjednoczone, 07675
    - Valley Health System-Hematology/Oncology
- New Mexico
  - Albuquerque, New Mexico, Stany Zjednoczone, 87106
    - University of New Mexico Cancer Center
  - Albuquerque, New Mexico, Stany Zjednoczone, 87110
    - Presbyterian Kaseman Hospital
  - Las Cruces, New Mexico, Stany Zjednoczone, 88011
    - Memorial Medical Center-Las Cruces
- New York
  - Auburn, New York, Stany Zjednoczone, 13021
    - Hematology Oncology Associates of Central New York-Auburn
  - Brooklyn, New York, Stany Zjednoczone, 11219
    - Maimonides Medical Center
  - Buffalo, New York, Stany Zjednoczone, 14263
    - Roswell Park Cancer Institute
  - Camillus, New York, Stany Zjednoczone, 13031
    - Hematology Oncology Associates of CNY at Camillus
  - East Syracuse, New York, Stany Zjednoczone, 13057
    - Hematology Oncology Associates of Central New York-East Syracuse
  - Glens Falls, New York, Stany Zjednoczone, 12801
    - Glens Falls Hospital
  - Lake Success, New York, Stany Zjednoczone, 11042
    - Northwell Health/Center for Advanced Medicine
  - Manhasset, New York, Stany Zjednoczone, 11030
    - North Shore University Hospital
  - Middletown, New York, Stany Zjednoczone, 10940
    - Garnet Health Medical Center
  - New York, New York, Stany Zjednoczone, 10032
    - NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
  - Plattsburgh, New York, Stany Zjednoczone, 12901
    - Champlain Valley Physicians Hospital Medical Center
  - Rochester, New York, Stany Zjednoczone, 14642
    - University of Rochester
  - Rome, New York, Stany Zjednoczone, 13440
    - Hematology Oncology Associates of Central New York-Rome
  - Stony Brook, New York, Stany Zjednoczone, 11794
    - Stony Brook University Medical Center
  - Syracuse, New York, Stany Zjednoczone, 13210
    - State University of New York Upstate Medical University
  - Utica, New York, Stany Zjednoczone, 13502
    - Faxton-Saint Luke's Healthcare
- North Carolina
  - Asheville, North Carolina, Stany Zjednoczone, 28801
    - Mission Hospital
  - Asheville, North Carolina, Stany Zjednoczone, 28816
    - Hope Women's Cancer Centers-Asheville
  - Asheville, North Carolina, Stany Zjednoczone, 28806
    - Messino Cancer Centers
  - Asheville, North Carolina, Stany Zjednoczone, 28801
    - Mountain Radiation Oncology PA
  - Asheville, North Carolina, Stany Zjednoczone, 28803
    - AdventHealth Infusion Center Asheville
  - Brevard, North Carolina, Stany Zjednoczone, 28712
    - Transylvania Regional Hospital
  - Chapel Hill, North Carolina, Stany Zjednoczone, 27599
    - UNC Lineberger Comprehensive Cancer Center
  - Clinton, North Carolina, Stany Zjednoczone, 28328
    - Southeastern Medical Oncology Center-Clinton
  - Clinton, North Carolina, Stany Zjednoczone, 28328
    - Sampson Radiation Oncology
  - Durham, North Carolina, Stany Zjednoczone, 27710
    - Duke University Medical Center
  - Franklin, North Carolina, Stany Zjednoczone, 28734
    - Angel Medical Center
  - Goldsboro, North Carolina, Stany Zjednoczone, 27534
    - Southeastern Medical Oncology Center-Goldsboro
  - Goldsboro, North Carolina, Stany Zjednoczone, 27534
    - Wayne Memorial Hospital
  - Goldsboro, North Carolina, Stany Zjednoczone, 27534
    - Wayne Radiation Oncology
  - Greenville, North Carolina, Stany Zjednoczone, 27834
    - East Carolina University
  - Hendersonville, North Carolina, Stany Zjednoczone, 28791
    - Margaret R Pardee Memorial Hospital
  - Hendersonville, North Carolina, Stany Zjednoczone, 28792
    - AdventHealth Hendersonville
  - Jacksonville, North Carolina, Stany Zjednoczone, 28546
    - Southeastern Medical Oncology Center-Jacksonville
  - Jacksonville, North Carolina, Stany Zjednoczone, 28546
    - Onslow Memorial Hospital
  - Kinston, North Carolina, Stany Zjednoczone, 28501
    - ECU Health Oncology Kinston
  - Marion, North Carolina, Stany Zjednoczone, 28752
    - Mission Hospital McDowell
  - Pinehurst, North Carolina, Stany Zjednoczone, 28374
    - FirstHealth of the Carolinas-Moore Regional Hospital
  - Spruce Pine, North Carolina, Stany Zjednoczone, 28777
    - Blue Ridge Regional Hospital
  - Statesville, North Carolina, Stany Zjednoczone, 28677
    - Iredell Memorial Hospital
  - Winston-Salem, North Carolina, Stany Zjednoczone, 27157
    - Wake Forest University Health Sciences
  - Winston-Salem, North Carolina, Stany Zjednoczone, 27104
    - Southeast Clinical Oncology Research Consortium NCORP
- North Dakota
  - Bismarck, North Dakota, Stany Zjednoczone, 58501
    - Sanford Bismarck Medical Center
  - Fargo, North Dakota, Stany Zjednoczone, 58122
    - Sanford Roger Maris Cancer Center
  - Fargo, North Dakota, Stany Zjednoczone, 58103
    - Essentia Health Cancer Center-South University Clinic
  - Fargo, North Dakota, Stany Zjednoczone, 58122
    - Sanford Broadway Medical Center
  - Grand Forks, North Dakota, Stany Zjednoczone, 58201
    - Altru Cancer Center
  - Minot, North Dakota, Stany Zjednoczone, 58701
    - Trinity Cancer Care Center
- Ohio
  - Akron, Ohio, Stany Zjednoczone, 44307
    - Cleveland Clinic Akron General
  - Beachwood, Ohio, Stany Zjednoczone, 44122
    - UHHS-Chagrin Highlands Medical Center
  - Beachwood, Ohio, Stany Zjednoczone, 44122
    - Cleveland Clinic Cancer Center Beachwood
  - Belpre, Ohio, Stany Zjednoczone, 45714
    - Strecker Cancer Center-Belpre
  - Bowling Green, Ohio, Stany Zjednoczone, 43402
    - Toledo Clinic Cancer Centers-Bowling Green
  - Centerville, Ohio, Stany Zjednoczone, 45459
    - Miami Valley Hospital South
  - Chardon, Ohio, Stany Zjednoczone, 44024
    - Geauga Hospital
  - Chillicothe, Ohio, Stany Zjednoczone, 45601
    - Adena Regional Medical Center
  - Cincinnati, Ohio, Stany Zjednoczone, 45219
    - University of Cincinnati Cancer Center-UC Medical Center
  - Cincinnati, Ohio, Stany Zjednoczone, 45220
    - Good Samaritan Hospital - Cincinnati
  - Cincinnati, Ohio, Stany Zjednoczone, 45242
    - Bethesda North Hospital
  - Cincinnati, Ohio, Stany Zjednoczone, 45242
    - Oncology Hematology Care Inc-Blue Ash
  - Cincinnati, Ohio, Stany Zjednoczone, 45202
    - Oncology Hematology Care Inc-Eden Park
  - Cincinnati, Ohio, Stany Zjednoczone, 45211
    - Oncology Hematology Care Inc-Mercy West
  - Cincinnati, Ohio, Stany Zjednoczone, 45230
    - Oncology Hematology Care Inc-Anderson
  - 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, 44106
    - Case Western Reserve University
  - 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
  - Columbus, Ohio, Stany Zjednoczone, 43214
    - Riverside Methodist Hospital
  - Columbus, Ohio, Stany Zjednoczone, 43210
    - Ohio State University Comprehensive Cancer Center
  - Columbus, Ohio, Stany Zjednoczone, 43219
    - The Mark H Zangmeister Center
  - Columbus, Ohio, Stany Zjednoczone, 43214
    - Columbus Oncology and Hematology Associates Inc
  - Columbus, Ohio, Stany Zjednoczone, 43228
    - Doctors Hospital
  - Columbus, Ohio, Stany Zjednoczone, 43215
    - Grant Medical Center
  - Columbus, Ohio, Stany Zjednoczone, 43222
    - Mount Carmel Health Center West
  - Columbus, Ohio, Stany Zjednoczone, 43215
    - Columbus NCI Community Oncology Research Program
  - Dayton, Ohio, Stany Zjednoczone, 45406
    - Good Samaritan Hospital - Dayton
  - Dayton, Ohio, Stany Zjednoczone, 45409
    - Miami Valley Hospital
  - Dayton, Ohio, Stany Zjednoczone, 45415
    - Miami Valley Hospital North
  - Dayton, Ohio, Stany Zjednoczone, 45459
    - Dayton NCI Community Oncology Research Program
  - Delaware, Ohio, Stany Zjednoczone, 43015
    - Delaware Health Center-Grady Cancer Center
  - Delaware, Ohio, Stany Zjednoczone, 43015
    - Delaware Radiation Oncology
  - Delaware, Ohio, Stany Zjednoczone, 43015
    - Grady Memorial Hospital
  - Elyria, Ohio, Stany Zjednoczone, 44035
    - Mercy Cancer Center-Elyria
  - Fairfield, Ohio, Stany Zjednoczone, 45014
    - Oncology Hematology Care Inc-Healthplex
  - Findlay, Ohio, Stany Zjednoczone, 45840
    - Blanchard Valley Hospital
  - Franklin, Ohio, Stany Zjednoczone, 45005-1066
    - Atrium Medical Center-Middletown Regional Hospital
  - Greenville, Ohio, Stany Zjednoczone, 45331
    - Wayne Hospital
  - Independence, Ohio, Stany Zjednoczone, 44131
    - Cleveland Clinic Cancer Center Independence
  - Kettering, Ohio, Stany Zjednoczone, 45429
    - Kettering Medical Center
  - Lancaster, Ohio, Stany Zjednoczone, 43130
    - Fairfield Medical Center
  - Lancaster, Ohio, Stany Zjednoczone, 43130
    - Lancaster Radiation Oncology
  - Lima, Ohio, Stany Zjednoczone, 45804
    - Lima Memorial Hospital
  - Mansfield, Ohio, Stany Zjednoczone, 44906
    - Cleveland Clinic Cancer Center Mansfield
  - Marietta, Ohio, Stany Zjednoczone, 45750
    - Marietta Memorial Hospital
  - Maumee, Ohio, Stany Zjednoczone, 43537
    - Toledo Clinic Cancer Centers-Maumee
  - Maumee, Ohio, Stany Zjednoczone, 43537
    - Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
  - Mayfield Heights, Ohio, Stany Zjednoczone, 44124
    - Hillcrest Hospital Cancer Center
  - Mayfield Heights, Ohio, Stany Zjednoczone, 44124
    - UH Seidman Cancer Center at Landerbrook Health Center
  - Mentor, Ohio, Stany Zjednoczone, 44060
    - UH Seidman Cancer Center at Lake Health Mentor Campus
  - Middleburg Heights, Ohio, Stany Zjednoczone, 44130
    - UH Seidman Cancer Center at Southwest General Hospital
  - Mount Vernon, Ohio, Stany Zjednoczone, 43050
    - Knox Community Hospital
  - Newark, Ohio, Stany Zjednoczone, 43055
    - Licking Memorial Hospital
  - Newark, Ohio, Stany Zjednoczone, 43055
    - Newark Radiation Oncology
  - Oregon, Ohio, Stany Zjednoczone, 43616
    - Saint Charles Hospital
  - Oregon, Ohio, Stany Zjednoczone, 43616
    - Toledo Clinic Cancer Centers-Oregon
  - Portsmouth, Ohio, Stany Zjednoczone, 45662
    - Southern Ohio Medical Center
  - Sandusky, Ohio, Stany Zjednoczone, 44870
    - North Coast Cancer Care
  - Springfield, Ohio, Stany Zjednoczone, 45504
    - Springfield Regional Cancer Center
  - Springfield, Ohio, Stany Zjednoczone, 45504
    - Springfield Regional Medical Center
  - Strongsville, Ohio, Stany Zjednoczone, 44136
    - Cleveland Clinic Cancer Center Strongsville
  - Sylvania, Ohio, Stany Zjednoczone, 43560
    - ProMedica Flower Hospital
  - Tiffin, Ohio, Stany Zjednoczone, 44883
    - Mercy Hospital of Tiffin
  - Toledo, Ohio, Stany Zjednoczone, 43606
    - ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
  - Toledo, Ohio, Stany Zjednoczone, 43623
    - Mercy Health - Saint Anne Hospital
  - Toledo, Ohio, Stany Zjednoczone, 43623
    - Toledo Clinic Cancer Centers-Toledo
  - Toledo, Ohio, Stany Zjednoczone, 43614
    - University of Toledo
  - Toledo, Ohio, Stany Zjednoczone, 43617
    - Toledo Community Hospital Oncology Program CCOP
  - Toledo, Ohio, Stany Zjednoczone, 43608
    - Mercy Health - Saint Vincent Hospital
  - Troy, Ohio, Stany Zjednoczone, 45373
    - Upper Valley Medical Center
  - Warrensville Heights, Ohio, Stany Zjednoczone, 44122
    - South Pointe Hospital
  - Wauseon, Ohio, Stany Zjednoczone, 43567
    - Fulton County Health Center
  - West Chester, Ohio, Stany Zjednoczone, 45069
    - University of Cincinnati Cancer Center-West Chester
  - Westerville, Ohio, Stany Zjednoczone, 43081
    - Saint Ann's Hospital
  - Westlake, Ohio, Stany Zjednoczone, 44145
    - UH Seidman Cancer Center at Saint John Medical Center
  - Wooster, Ohio, Stany Zjednoczone, 44691
    - Cleveland Clinic Wooster Family Health and Surgery Center
  - Wright-Patterson Air Force Base, Ohio, Stany Zjednoczone, 45433
    - Wright-Patterson Medical Center
  - Zanesville, Ohio, Stany Zjednoczone, 43701
    - Genesis Healthcare System Cancer Care Center
- Oklahoma
  - Lawton, Oklahoma, Stany Zjednoczone, 73505
    - Cancer Centers of Southwest Oklahoma Research
  - Oklahoma City, Oklahoma, Stany Zjednoczone, 73104
    - University of Oklahoma Health Sciences Center
  - Oklahoma City, Oklahoma, Stany Zjednoczone, 73120
    - Mercy Hospital Oklahoma City
  - Tulsa, Oklahoma, Stany Zjednoczone, 74146
    - Oklahoma Cancer Specialists and Research Institute-Tulsa
  - Tulsa, Oklahoma, Stany Zjednoczone, 74146
    - Warren Clinic Oncology-Tulsa
  - Tulsa, Oklahoma, Stany Zjednoczone, 74136
    - Saint Francis Children's Hospital
- Oregon
  - 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
  - Milwaukie, Oregon, Stany Zjednoczone, 97222
    - Providence Milwaukie Hospital
  - Newberg, Oregon, Stany Zjednoczone, 97132
    - Providence Newberg Medical Center
  - Oregon City, Oregon, Stany Zjednoczone, 97045
    - Providence Willamette Falls Medical Center
  - Portland, Oregon, Stany Zjednoczone, 97239
    - Oregon Health and Science University
  - Portland, Oregon, Stany Zjednoczone, 97213
    - Providence Portland Medical Center
  - Portland, Oregon, Stany Zjednoczone, 97225
    - Providence Saint Vincent Medical Center
  - Portland, Oregon, Stany Zjednoczone, 97227
    - Kaiser Permanente Northwest
- Pennsylvania
  - Allentown, Pennsylvania, Stany Zjednoczone, 18103
    - Lehigh Valley Hospital-Cedar Crest
  - Beaver, Pennsylvania, Stany Zjednoczone, 15009
    - UPMC-Heritage Valley Health System Beaver
  - Bethlehem, Pennsylvania, Stany Zjednoczone, 18017
    - Lehigh Valley Hospital - Muhlenberg
  - Bryn Mawr, Pennsylvania, Stany Zjednoczone, 19010
    - Bryn Mawr Hospital
  - Chadds Ford, Pennsylvania, Stany Zjednoczone, 19317
    - Christiana Care Health System-Concord Health Center
  - Danville, Pennsylvania, Stany Zjednoczone, 17822
    - Geisinger Medical Center
  - Drexel Hill, Pennsylvania, Stany Zjednoczone, 19026
    - Delaware County Memorial Hospital
  - East Stroudsburg, Pennsylvania, Stany Zjednoczone, 18301
    - Pocono Medical Center
  - Ephrata, Pennsylvania, Stany Zjednoczone, 17522
    - Ephrata Cancer Center
  - Ephrata, Pennsylvania, Stany Zjednoczone, 17522
    - Ephrata Community Hospital
  - Gettysburg, Pennsylvania, Stany Zjednoczone, 17325
    - Adams Cancer Center
  - Greensburg, Pennsylvania, Stany Zjednoczone, 15601
    - UPMC Cancer Centers - Arnold Palmer Pavilion
  - Hanover, Pennsylvania, Stany Zjednoczone, 17331
    - WellSpan Medical Oncology and Hematology
  - Hazleton, Pennsylvania, Stany Zjednoczone, 18201
    - Geisinger Medical Center-Cancer Center Hazleton
  - Hershey, Pennsylvania, Stany Zjednoczone, 17033-0850
    - Penn State Milton S Hershey Medical Center
  - Johnstown, Pennsylvania, Stany Zjednoczone, 15901
    - UPMC-Johnstown/John P. Murtha Regional Cancer Center
  - McKeesport, Pennsylvania, Stany Zjednoczone, 15132
    - UPMC Cancer Center at UPMC McKeesport
  - Media, Pennsylvania, Stany Zjednoczone, 19063
    - Riddle Memorial Hospital
  - Moon Township, Pennsylvania, Stany Zjednoczone, 15108
    - UPMC Hillman Cancer Center in Coraopolis
  - Paoli, Pennsylvania, Stany Zjednoczone, 19301
    - Paoli Memorial Hospital
  - Philadelphia, Pennsylvania, Stany Zjednoczone, 19111
    - Fox Chase Cancer Center
  - Philadelphia, Pennsylvania, Stany Zjednoczone, 19107
    - Thomas Jefferson University Hospital
  - Philadelphia, Pennsylvania, Stany Zjednoczone, 19114
    - Jefferson Torresdale Hospital
  - Pittsburgh, Pennsylvania, Stany Zjednoczone, 15232
    - UPMC Hillman Cancer Center
  - Pittsburgh, Pennsylvania, Stany Zjednoczone, 15213
    - UPMC-Magee Womens Hospital
  - Pittsburgh, Pennsylvania, Stany Zjednoczone, 15232
    - UPMC-Shadyside Hospital
  - Pittsburgh, Pennsylvania, Stany Zjednoczone, 15213
    - UPMC-Presbyterian Hospital
  - Pittsburgh, Pennsylvania, Stany Zjednoczone, 15215
    - UPMC-Saint Margaret
  - Pittsburgh, Pennsylvania, Stany Zjednoczone, 15236
    - UPMC Jefferson Regional Radiation Oncology
  - Pittsburgh, Pennsylvania, Stany Zjednoczone, 15237
    - UPMC-Passavant Hospital
  - Pittsburgh, Pennsylvania, Stany Zjednoczone, 15243
    - UPMC-Saint Clair Hospital Cancer Center
  - Pottsville, Pennsylvania, Stany Zjednoczone, 17901
    - Geisinger Cancer Services-Pottsville
  - Scranton, Pennsylvania, Stany Zjednoczone, 18508
    - Hematology and Oncology Associates of North East Pennsylvania
  - Seneca, Pennsylvania, Stany Zjednoczone, 16346
    - UPMC Cancer Center at UPMC Northwest
  - State College, Pennsylvania, Stany Zjednoczone, 16801
    - Geisinger Medical Group
  - Uniontown, Pennsylvania, Stany Zjednoczone, 15401
    - UPMC Uniontown Hospital Radiation Oncology
  - Upland, Pennsylvania, Stany Zjednoczone, 19013
    - Associates In Hematology Oncology PC-Upland
  - Washington, Pennsylvania, Stany Zjednoczone, 15301
    - UPMC Washington Hospital Radiation Oncology
  - West Chester, Pennsylvania, Stany Zjednoczone, 19380
    - Chester County Hospital
  - West Reading, Pennsylvania, Stany Zjednoczone, 19611
    - Reading Hospital
  - Wilkes-Barre, Pennsylvania, Stany Zjednoczone, 18711
    - Geisinger Wyoming Valley/Henry Cancer Center
  - Williamsport, Pennsylvania, Stany Zjednoczone, 17701
    - UPMC Susquehanna
  - Wynnewood, Pennsylvania, Stany Zjednoczone, 19096
    - Lankenau Medical Center
  - York, Pennsylvania, Stany Zjednoczone, 17403
    - WellSpan Health-York Cancer Center
  - York, Pennsylvania, Stany Zjednoczone, 17403
    - WellSpan Health-York Hospital
- Rhode Island
  - Pawtucket, Rhode Island, Stany Zjednoczone, 02860
    - Memorial Hospital of Rhode Island
  - Providence, Rhode Island, Stany Zjednoczone, 02903
    - Rhode Island Hospital
  - Providence, Rhode Island, Stany Zjednoczone, 02906
    - Miriam Hospital
- South Carolina
  - Anderson, South Carolina, Stany Zjednoczone, 29621
    - AnMed Health Cancer Center
  - Boiling Springs, South Carolina, Stany Zjednoczone, 29316
    - Prisma Health Cancer Institute - Spartanburg
  - Charleston, South Carolina, Stany Zjednoczone, 29425
    - Medical University of South Carolina
  - Charleston, South Carolina, Stany Zjednoczone, 29401
    - Roper Hospital
  - Charleston, South Carolina, Stany Zjednoczone, 29406
    - Lowcountry Hematology Oncology PA-North Charleston
  - Charleston, South Carolina, Stany Zjednoczone, 29414
    - Bon Secours Saint Francis Hospital
  - Charleston, South Carolina, Stany Zjednoczone, 29403
    - Charleston Oncology - Roper
  - Charleston, South Carolina, Stany Zjednoczone, 29414
    - Charleston Oncology - Saint Francis
  - Charleston, South Carolina, Stany Zjednoczone, 29414
    - Lowcountry Oncology Associates - West Ashley
  - Easley, South Carolina, Stany Zjednoczone, 29640
    - Prisma Health Cancer Institute - Easley
  - Florence, South Carolina, Stany Zjednoczone, 29506
    - McLeod Regional Medical Center
  - Gaffney, South Carolina, Stany Zjednoczone, 29341
    - Gibbs Cancer Center-Gaffney
  - Greenville, South Carolina, Stany Zjednoczone, 29605
    - Prisma Health Cancer Institute - Faris
  - Greenville, South Carolina, Stany Zjednoczone, 29607
    - Saint Francis Cancer Center
  - Greenville, South Carolina, Stany Zjednoczone, 29615
    - Prisma Health Cancer Institute - Eastside
  - Greenville, South Carolina, Stany Zjednoczone, 29605
    - Prisma Health Cancer Institute - Butternut
  - Greenville, South Carolina, Stany Zjednoczone, 29601
    - Saint Francis Hospital
  - Greenville, South Carolina, Stany Zjednoczone, 29605
    - Prisma Health Greenville Memorial Hospital
  - Greenville, South Carolina, Stany Zjednoczone, 29601
    - Greenville Health System Cancer Institute-Andrews
  - Greer, South Carolina, Stany Zjednoczone, 29650
    - Prisma Health Cancer Institute - Greer
  - Greer, South Carolina, Stany Zjednoczone, 29651
    - Gibbs Cancer Center-Pelham
  - Lancaster, South Carolina, Stany Zjednoczone, 29720
    - Carolina Blood and Cancer Care Associates PA-Lancaster
  - Mt. Pleasant, South Carolina, Stany Zjednoczone, 29464
    - Lowcountry Oncology Associates - Mount Pleasant
  - Rock Hill, South Carolina, Stany Zjednoczone, 29732
    - Carolina Blood and Cancer Care Associates PA
  - Seneca, South Carolina, Stany Zjednoczone, 29672
    - Prisma Health Cancer Institute - Seneca
  - Spartanburg, South Carolina, Stany Zjednoczone, 29303
    - Spartanburg Medical Center
  - Union, South Carolina, Stany Zjednoczone, 29379
    - SMC Center for Hematology Oncology Union
  - West Columbia, South Carolina, Stany Zjednoczone, 29169
    - Lexington Health
- South Dakota
  - Rapid City, South Dakota, Stany Zjednoczone, 57701
    - Rapid City Regional Hospital
  - Sioux Falls, South Dakota, Stany Zjednoczone, 57105
    - Avera Cancer Institute
  - Sioux Falls, South Dakota, Stany Zjednoczone, 57117-5134
    - Sanford USD Medical Center - Sioux Falls
  - Sioux Falls, South Dakota, Stany Zjednoczone, 57104
    - Sanford Cancer Center Oncology Clinic
- Tennessee
  - Bristol, Tennessee, Stany Zjednoczone, 37620
    - Wellmont Medical Associates Oncology and Hematology-Bristol
  - Bristol, Tennessee, Stany Zjednoczone, 37620
    - Bristol Regional Medical Center
  - Chattanooga, Tennessee, Stany Zjednoczone, 37404
    - Memorial Hospital
  - Chattanooga, Tennessee, Stany Zjednoczone, 37403
    - Erlanger Medical Center
  - Hixson, Tennessee, Stany Zjednoczone, 37343
    - Pulmonary Medicine Center of Chattanooga-Hixson
  - Kingsport, Tennessee, Stany Zjednoczone, 37660
    - Ballad Health Cancer Care - Kingsport
  - Kingsport, Tennessee, Stany Zjednoczone, 37660
    - Wellmont Holston Valley Hospital and Medical Center
  - Ooltewah, Tennessee, Stany Zjednoczone, 37363
    - Memorial GYN Plus
- Texas
  - Amarillo, Texas, Stany Zjednoczone, 79106
    - The Don and Sybil Harrington Cancer Center
  - Dallas, Texas, Stany Zjednoczone, 75235
    - Parkland Memorial Hospital
  - Dallas, Texas, Stany Zjednoczone, 75390
    - UT Southwestern/Simmons Cancer Center-Dallas
  - San Antonio, Texas, Stany Zjednoczone, 78229
    - University Hospital
  - San Antonio, Texas, Stany Zjednoczone, 78229
    - University of Texas Health Science Center at San Antonio
- Vermont
  - Bennington, Vermont, Stany Zjednoczone, 05201
    - Southwestern Vermont Medical Center
  - Berlin Corners, Vermont, Stany Zjednoczone, 05602
    - Central Vermont Medical Center/National Life Cancer Treatment
  - Burlington, Vermont, Stany Zjednoczone, 05405
    - University of Vermont and State Agricultural College
  - White River Junction, Vermont, Stany Zjednoczone, 05009
    - White River Junction Veteran Administration Medical Center
- Virginia
  - Charlottesville, Virginia, Stany Zjednoczone, 22908
    - University of Virginia Cancer Center
  - Fredericksburg, Virginia, Stany Zjednoczone, 22401
    - Fredericksburg Oncology Inc
  - Fredericksburg, Virginia, Stany Zjednoczone, 22408
    - Hematology Oncology Associates of Fredericksburg Inc
  - Hampton, Virginia, Stany Zjednoczone, 23666
    - Virginia Oncology Associates-Hampton
  - Lynchburg, Virginia, Stany Zjednoczone, 24501
    - Centra Alan B Pearson Regional Cancer Center
  - Norton, Virginia, Stany Zjednoczone, 24273
    - Ballad Health Cancer Care - Norton
  - Richmond, Virginia, Stany Zjednoczone, 23229
    - Virginia Cancer Institute
  - Richmond, Virginia, Stany Zjednoczone, 23298
    - VCU Massey Comprehensive Cancer Center
  - South Hill, Virginia, Stany Zjednoczone, 23970
    - VCU Community Memorial Health Center
  - Winchester, Virginia, Stany Zjednoczone, 22601
    - Shenandoah Oncology PC
- Washington
  - Aberdeen, Washington, Stany Zjednoczone, 98520
    - Providence Regional Cancer System-Aberdeen
  - Anacortes, Washington, Stany Zjednoczone, 98221
    - Cancer Care Center at Island Hospital
  - Bellevue, Washington, Stany Zjednoczone, 98005
    - Swedish Cancer Institute-Eastside Oncology Hematology
  - 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
  - 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
  - Seattle, Washington, Stany Zjednoczone, 98107
    - Swedish Medical Center-Ballard Campus
  - Seattle, Washington, Stany Zjednoczone, 98122
    - Swedish Medical Center-First Hill
  - Seattle, Washington, Stany Zjednoczone, 98112
    - Kaiser Permanente Washington
  - Seattle, Washington, Stany Zjednoczone, 98104
    - Minor and James Medical PLLC
  - Seattle, Washington, Stany Zjednoczone, 98104
    - Pacific Gynecology Specialists
  - Shelton, Washington, Stany Zjednoczone, 98584
    - Providence Regional Cancer System-Shelton
  - Silverdale, Washington, Stany Zjednoczone, 98383
    - Saint Joseph Medical Center Hematology and Oncology - Silverdale
  - Spokane, Washington, Stany Zjednoczone, 99218
    - Evergreen Hematology and Oncology PS
  - Spokane, Washington, Stany Zjednoczone, 99204
    - MultiCare Deaconess Cancer and Blood Specialty Center - Downtown
  - Spokane Valley, Washington, Stany Zjednoczone, 99216
    - MultiCare Deaconess Cancer and Blood Specialty Center - Valley
  - 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
  - Yakima, Washington, Stany Zjednoczone, 98902
    - North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
  - Yelm, Washington, Stany Zjednoczone, 98597
    - Providence Regional Cancer System-Yelm
- West Virginia
  - Bridgeport, West Virginia, Stany Zjednoczone, 26330
    - United Hospital Center
  - Charleston, West Virginia, Stany Zjednoczone, 25304
    - Vandalia Health/CAMC Institute for Academic Medicine
  - Huntington, West Virginia, Stany Zjednoczone, 25701
    - Edwards Comprehensive Cancer Center
  - Huntington, West Virginia, Stany Zjednoczone, 25702
    - Saint Mary's Medical Center
  - Martinsburg, West Virginia, Stany Zjednoczone, 25401
    - WVUH-Berkely Medical Center
  - Morgantown, West Virginia, Stany Zjednoczone, 26506
    - West Virginia University Healthcare
  - Parkersburg, West Virginia, Stany Zjednoczone, 26101
    - Camden Clark Medical Center
- Wisconsin
  - Antigo, Wisconsin, Stany Zjednoczone, 54409
    - Aspirus Cancer Care-Antigo-Volm Cancer Center
  - Burlington, Wisconsin, Stany Zjednoczone, 53105
    - Aurora Cancer Care-Southern Lakes VLCC
  - Chippewa Falls, Wisconsin, Stany Zjednoczone, 54729
    - Marshfield Clinic-Chippewa Center
  - Eau Claire, Wisconsin, Stany Zjednoczone, 54701
    - HSHS Sacred Heart Hospital
  - Eau Claire, Wisconsin, Stany Zjednoczone, 54701
    - Marshfield Clinic Cancer Center at Sacred Heart
  - Fond du Lac, Wisconsin, Stany Zjednoczone, 54937
    - Aurora Health Center-Fond du Lac
  - Germantown, Wisconsin, Stany Zjednoczone, 53022
    - Aurora Health Care Germantown Health Center
  - Grafton, Wisconsin, Stany Zjednoczone, 53024
    - Aurora Cancer Care-Grafton
  - Green Bay, Wisconsin, Stany Zjednoczone, 54311
    - Aurora BayCare Medical Center
  - Green Bay, Wisconsin, Stany Zjednoczone, 54301
    - Saint Vincent Hospital Cancer Center Green Bay
  - Green Bay, Wisconsin, Stany Zjednoczone, 54303
    - Saint Vincent Hospital Cancer Center at Saint Mary's
  - Green Bay, Wisconsin, Stany Zjednoczone, 54301
    - Bellin Memorial Hospital
  - Green Bay, Wisconsin, Stany Zjednoczone, 54301-3526
    - Green Bay Oncology at Saint Vincent Hospital
  - Kenosha, Wisconsin, Stany Zjednoczone, 53142
    - Aurora Cancer Care-Kenosha South
  - La Crosse, Wisconsin, Stany Zjednoczone, 54601
    - Gundersen Lutheran Medical Center
  - Ladysmith, Wisconsin, Stany Zjednoczone, 54848
    - Marshfield Medical Center - Ladysmith
  - Manitowoc, Wisconsin, Stany Zjednoczone, 54221
    - Holy Family Memorial Hospital
  - Marinette, Wisconsin, Stany Zjednoczone, 54143
    - Aurora Bay Area Medical Group-Marinette
  - Marinette, Wisconsin, Stany Zjednoczone, 54143
    - Bay Area Medical Center
  - Marshfield, Wisconsin, Stany Zjednoczone, 54449
    - Marshfield Medical Center-Marshfield
  - Marshfield, Wisconsin, Stany Zjednoczone, 54449
    - Marshfield Medical Center
  - Milwaukee, Wisconsin, Stany Zjednoczone, 53226
    - Medical College of Wisconsin
  - Milwaukee, Wisconsin, Stany Zjednoczone, 53209
    - Aurora Cancer Care-Milwaukee
  - Milwaukee, Wisconsin, Stany Zjednoczone, 53215
    - Aurora Saint Luke's Medical Center
  - Milwaukee, Wisconsin, Stany Zjednoczone, 53233
    - Aurora Sinai Medical Center
  - Minocqua, Wisconsin, Stany Zjednoczone, 54548
    - Marshfield Medical Center - Minocqua
  - Mukwonago, Wisconsin, Stany Zjednoczone, 53149
    - ProHealth D N Greenwald Center
  - New Richmond, Wisconsin, Stany Zjednoczone, 54017
    - Cancer Center of Western Wisconsin
  - Oconomowoc, Wisconsin, Stany Zjednoczone, 53066
    - ProHealth Oconomowoc Memorial Hospital
  - Oconto Falls, Wisconsin, Stany Zjednoczone, 54154
    - Saint Vincent Hospital Cancer Center at Oconto Falls
  - Oshkosh, Wisconsin, Stany Zjednoczone, 54904
    - Vince Lombardi Cancer Clinic - Oshkosh
  - Racine, Wisconsin, Stany Zjednoczone, 53406
    - Aurora Cancer Care-Racine
  - Rhinelander, Wisconsin, Stany Zjednoczone, 54501
    - Saint Mary's Hospital
  - Rhinelander, Wisconsin, Stany Zjednoczone, 54501
    - Aspirus Cancer Care-Rhinelander-James Beck Cancer Center
  - Rice Lake, Wisconsin, Stany Zjednoczone, 54868
    - Marshfield Medical Center-Rice Lake
  - Sheboygan, Wisconsin, Stany Zjednoczone, 53081
    - Vince Lombardi Cancer Clinic-Sheboygan
  - Sheboygan, Wisconsin, Stany Zjednoczone, 53081
    - HSHS Saint Nicholas Hospital
  - Stevens Point, Wisconsin, Stany Zjednoczone, 54481
    - Aspirus Cancer Care - Stevens Point
  - Summit, Wisconsin, Stany Zjednoczone, 53066
    - Aurora Medical Center in Summit
  - Two Rivers, Wisconsin, Stany Zjednoczone, 54241
    - Vince Lombardi Cancer Clinic-Two Rivers
  - Waukesha, Wisconsin, Stany Zjednoczone, 53188
    - UW Cancer Center at ProHealth Care
  - Waukesha, Wisconsin, Stany Zjednoczone, 53188
    - ProHealth Waukesha Memorial Hospital
  - Waukesha, Wisconsin, Stany Zjednoczone, 53188
    - Aurora Cancer Care-Waukesha
  - Wausau, Wisconsin, Stany Zjednoczone, 54401
    - Marshfield Clinic-Wausau Center
  - Wausau, Wisconsin, Stany Zjednoczone, 54401
    - Aspirus Cancer Care-Wausau
  - Wauwatosa, Wisconsin, Stany Zjednoczone, 53226
    - Aurora Cancer Care-Milwaukee West
  - West Allis, Wisconsin, Stany Zjednoczone, 53227
    - Aurora West Allis Medical Center
  - Weston, Wisconsin, Stany Zjednoczone, 54476
    - Marshfield Medical Center - Weston
  - Wisconsin Rapids, Wisconsin, Stany Zjednoczone, 54494
    - Aspirus Cancer Care - Wisconsin Rapids
  - Wisconsin Rapids, Wisconsin, Stany Zjednoczone, 54494
    - Marshfield Clinic - Wisconsin Rapids Center
- Wyoming
  - Casper, Wyoming, Stany Zjednoczone, 82609
    - Rocky Mountain Oncology
  - Cheyenne, Wyoming, Stany Zjednoczone, 82001
    - Cheyenne Regional Medical Center-West
  - Cody, Wyoming, Stany Zjednoczone, 82414
    - Big Horn Basin Cancer Center
  - 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

65 lat i starsze (Starszy dorosły)

Akceptuje zdrowych ochotników

Nie

Płeć kwalifikująca się do nauki

Wszystko

Opis

Inclusion Criteria:

PRE-REGISTRATION (STEP 0)
All patients are REQUIRED to be pre-registered to A041202 in order to submit peripheral blood to the Alliance Hematologic Malignancy Biorepository (HEME) for central Zap-70 methylation. This specimen submission is mandatory prior to registration as results will be used for stratification
REGISTRATION (STEP 1)
Patients must be diagnosed with CLL in accordance with International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2008 criteria that includes all of the following:
- >= 5 x 10^9 B lymphocytes (5000/uL) in the peripheral blood
- On morphologic review, the leukemic cells must be small mature lymphocytes, and prolymphocytes must not exceed 55% of the blood lymphocytes
- CLL cells on immunophenotype (performed locally) must reveal a clonal B-cell population, which express the B cell surface markers of CD19 and CD20, as well as the T-cell antigen CD5; patients with bright surface immunoglobulin expression or lack of CD23 expression in > 10% of cells must lack t(11;14) translocation by interphase cytogenetics
Patients must be intermediate or high-risk Rai stage CLL
- Intermediate risk (formerly Rai stage I/II) is defined by lymphocytosis plus enlarged lymph nodes at any site, with or without hepatomegaly or splenomegaly
- High risk (formerly Rai stage III/IV) is defined by lymphocytosis with or without enlarged nodes and spleen plus disease-related anemia (hemoglobin < 11 g/dL) or thrombocytopenia (platelet count < 100 x 10^9/L) that is not attributable to autoimmune hemolytic anemia or thrombocytopenia
Patients must meet criteria for treatment as defined by IWCLL 2008 guidelines which includes at least one of the following criteria:
- Evidence of marrow failure as manifested by the development or worsening of anemia or thrombocytopenia (not attributable to autoimmune hemolytic anemia or thrombocytopenia)
- Massive (>= 6 cm below the costal margin), progressive or symptomatic splenomegaly
- Massive nodes (>= 10 cm) or progressive or symptomatic lymphadenopathy
- Autoimmune anemia and/or thrombocytopenia that is poorly responsive to standard therapy
- Constitutional symptoms, which include any of the following:
  - Unintentional weight loss of 10% or more within 6 months
  - Significant fatigue
  - Fevers > 100.5 degrees F for 2 weeks or more without evidence of infection
  - Night sweats > 1 month without evidence of infection
Prior treatment
- Patients must not have had prior therapy for CLL (except palliative steroids or treatment of autoimmune complications of CLL with rituximab or steroids)
- Treatment with rituximab and/or high dose corticosteroids for autoimmune complications of CLL must be complete at least 4 weeks prior to enrollment; palliative steroids must be at a dose not higher than 20 mg/day of prednisone or equivalent corticosteroid at the time of registration
Age >= 65 years
Eastern Cooperative Oncology Group (ECOG) performance status 0-2
Patients with active hepatitis B defined by hepatitis B surface antigen positivity or core antibody positivity in the presence of hepatitis B DNA are not eligible for this study; patients with a positive hepatitis B core antibody but with negative hepatitis B DNA may participate, but must have hepatitis serologies and hepatitis B DNA monitored periodically by the treating physician
- Intravenous immunoglobulin (IVIG) can cause a false positive hepatitis B serology; if patients receiving routine IVIG have core antibody or surface antigen positivity without evidence of active viremia (negative hepatitis B DNA) they may still participate in the study, but should have hepatitis serologies and hepatitis B DNA monitored periodically by the treating physician
Patients must not be receiving active systemic anticoagulation with heparin or warfarin; patients must be off warfarin therapy for at least 30 days prior to enrollment
Patients with class III or class IV heart failure by New York Heart Association, those with unstable angina, and those with uncontrolled arrhythmia are not eligible
Patients who have had a myocardial infarction, intracranial bleed, or stroke within the past 6 months are not eligible
Patients with known human immunodeficiency virus (HIV) are eligible if their CD4 count is >= 350 cells/mm^3 and if they are not taking prohibited CYP-interacting medications
Patients must not have any history of Richter's transformation or prolymphocytic leukemia (prolymphocytes in blood > 55%)
Patients must not require more than 20 mg prednisone or equivalent corticosteroid daily
Patients must not have uncontrolled active systemic infection requiring intravenous antibiotics
Patients must not have continued requirement for therapy with a strong cytochrome P450 3A4/5 (CYP3A4/5) inhibitor or inducer
Patients must not have a known allergy to mannitol
Patients must not have prior significant hypersensitivity to rituximab (not including infusion reactions)
Patients may not have had major surgery within 10 days of enrollment, or minor surgery within 7 days of enrollment; examples of minor surgery include dental surgery, insertion of a venous access device, skin biopsy, or aspiration of a joint; the decision about whether a surgery is major or minor can be made at the discretion of the treating physician
Absolute neutrophil count (ANC) >= 1,000/uL unless due to bone marrow involvement
Aspartate aminotransferase (AST) or alanine aminotransferase (AST) =< 2.5 x upper limits of normal except if due to disease infiltration of the liver
Bilirubin =< 1.5 x upper limits of normal (unless due to liver involvement, hemolysis, or Gilbert's disease)
Creatinine clearance >= 40 mL/min
- To be calculated by modified Cockcroft-Gault formula
Platelet count (untransfused) >= 30,000/uL

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: Zadanie krzyżowe
Maskowanie: Brak (otwarta etykieta)

Liczba ramion

Broń i interwencje

Grupa uczestników / Arm	Interwencja / Leczenie
Aktywny komparator: Arm I (rituximab, bendamustine hydrochloride) Patients receive rituximab IV on day 1 (day 0 course 1) and bendamustine hydrochloride IV over 30 minutes on days 1-2. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover to Arm II. Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and CT throughout the study.	Inny: Laboratory Biomarker Analysis Correlative studies Inny: Quality-of-Life Assessment Ancillary studies Inne nazwy: Ocena jakości życia Procedura: Biospecimen Collection Undergo blood sample collection Inne nazwy: Pobieranie próbek biologicznych Zebrano próbki biologiczne Kolekcja próbek Biologiczny: Rituximab Given IV Inne nazwy: Rytuksany MabThera ABP 798 BI 695500 Przeciwciało monoklonalne C2B8 Chimeryczne przeciwciało anty-CD20 CT-P10 IDEC-102 IDEC-C2B8 Przeciwciało monoklonalne IDEC-C2B8 PF-05280586 Riabni Rytuksymab ABBS Rytuksymab ARRX Rytuksymab Biopodobny ABP 798 Rytuksymab biopodobny BI 695500 Rytuksymab Biopodobny CT-P10 Rytuksymab biopodobny GB241 Rytuksymab Biopodobny IBI301 Rytuksymab biopodobny JHL1101 Rytuksymab Biopodobny PF-05280586 Rytuksymab Biopodobny RTXM83 Rytuksymab Biopodobny SAIT101 Rytuksymab Biopodobny SIBP-02 biopodobny rytuksymab TQB2303 Rytuksymab PVVR Rytuksymab-arrx Rytuksymab-pvvr RTXM83 Ruxience Truxima Rixathon Ikgdar Mabtas Rituximab-abbs BI-695500 BI695500 Blitzima IDEC 102 IDEC102 PF 05280586 PF05280586 Rytemvia Rytuksymab-blit Rytuksymab Rytuksymab-rixa Rytuksymab-rixi Riximyo RTXM 83 RTXM-83 ABP-798 ABP798 CT P10 CTP10 GP 2013 GP-2013 GP2013 Rytuksymab Biopodobny GP2013 Procedura: Computed Tomography Undergo CT Inne nazwy: Tomografia komputerowa KOT Skanowanie CAT Tomografia komputerowa osiowa Komputerowa tomografia osiowa tomografia Komputerowa tomografia osiowa (zabieg) Tomografia komputerowa (CT). Diagnostyczny skan CAT Diagnostyczny typ usługi skanowania CAT Lek: Bendamustine Hydrochloride Given IV Inne nazwy: Treanda Bendeka CEP-18083 Chlorowodorek bendamustyny Chlorowodorek cytostazanu Levact Rybomustyna SyB L-0501 Treakisym Belrapzo CEP 18083 CEP18083 VIVIMUSTA Procedura: Bone Marrow Aspiration Undergo bone marrow aspiration and biopsy Procedura: Bone Marrow Biopsy Undergo bone marrow aspiration and biopsy Inne nazwy: Biopsja szpiku kostnego Biopsja, szpik kostny
Eksperymentalny: Arm II (ibrutinib) Patients receive ibrutinib PO daily. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and CT throughout the study.	Inny: Laboratory Biomarker Analysis Correlative studies Inny: Quality-of-Life Assessment Ancillary studies Inne nazwy: Ocena jakości życia Procedura: Biospecimen Collection Undergo blood sample collection Inne nazwy: Pobieranie próbek biologicznych Zebrano próbki biologiczne Kolekcja próbek Procedura: Computed Tomography Undergo CT Inne nazwy: Tomografia komputerowa KOT Skanowanie CAT Tomografia komputerowa osiowa Komputerowa tomografia osiowa tomografia Komputerowa tomografia osiowa (zabieg) Tomografia komputerowa (CT). Diagnostyczny skan CAT Diagnostyczny typ usługi skanowania CAT Procedura: Bone Marrow Aspiration Undergo bone marrow aspiration and biopsy Procedura: Bone Marrow Biopsy Undergo bone marrow aspiration and biopsy Inne nazwy: Biopsja szpiku kostnego Biopsja, szpik kostny Lek: Ibrutinib Given PO Inne nazwy: PCI-32765 Imbruvica Inhibitor BTK PCI-32765 CRA-032765 PCI32765 CRA 032765 CRA032765
Eksperymentalny: Arm III (ibrutinib, rituximab) Patients receive ibrutinib as in Arm II. Patients receive rituximab IV on days 1, 8, 15, and 22 of course 2 and on day 1 of courses 3-6. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo bone marrow aspiration and biopsy, blood sample collection, and CT throughout the study.	Inny: Laboratory Biomarker Analysis Correlative studies Inny: Quality-of-Life Assessment Ancillary studies Inne nazwy: Ocena jakości życia Procedura: Biospecimen Collection Undergo blood sample collection Inne nazwy: Pobieranie próbek biologicznych Zebrano próbki biologiczne Kolekcja próbek Biologiczny: Rituximab Given IV Inne nazwy: Rytuksany MabThera ABP 798 BI 695500 Przeciwciało monoklonalne C2B8 Chimeryczne przeciwciało anty-CD20 CT-P10 IDEC-102 IDEC-C2B8 Przeciwciało monoklonalne IDEC-C2B8 PF-05280586 Riabni Rytuksymab ABBS Rytuksymab ARRX Rytuksymab Biopodobny ABP 798 Rytuksymab biopodobny BI 695500 Rytuksymab Biopodobny CT-P10 Rytuksymab biopodobny GB241 Rytuksymab Biopodobny IBI301 Rytuksymab biopodobny JHL1101 Rytuksymab Biopodobny PF-05280586 Rytuksymab Biopodobny RTXM83 Rytuksymab Biopodobny SAIT101 Rytuksymab Biopodobny SIBP-02 biopodobny rytuksymab TQB2303 Rytuksymab PVVR Rytuksymab-arrx Rytuksymab-pvvr RTXM83 Ruxience Truxima Rixathon Ikgdar Mabtas Rituximab-abbs BI-695500 BI695500 Blitzima IDEC 102 IDEC102 PF 05280586 PF05280586 Rytemvia Rytuksymab-blit Rytuksymab Rytuksymab-rixa Rytuksymab-rixi Riximyo RTXM 83 RTXM-83 ABP-798 ABP798 CT P10 CTP10 GP 2013 GP-2013 GP2013 Rytuksymab Biopodobny GP2013 Procedura: Computed Tomography Undergo CT Inne nazwy: Tomografia komputerowa KOT Skanowanie CAT Tomografia komputerowa osiowa Komputerowa tomografia osiowa tomografia Komputerowa tomografia osiowa (zabieg) Tomografia komputerowa (CT). Diagnostyczny skan CAT Diagnostyczny typ usługi skanowania CAT Procedura: Bone Marrow Aspiration Undergo bone marrow aspiration and biopsy Procedura: Bone Marrow Biopsy Undergo bone marrow aspiration and biopsy Inne nazwy: Biopsja szpiku kostnego Biopsja, szpik kostny Lek: Ibrutinib Given PO Inne nazwy: PCI-32765 Imbruvica Inhibitor BTK PCI-32765 CRA-032765 PCI32765 CRA 032765 CRA032765

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku	Opis środka	Ramy czasowe
Progression Free Survival (PFS) Ramy czasowe: Time from study entry to the time of documented disease progression or death. The analysis was event driven, performed at 2.5 years after the last patient enrolled;up to 4 years.	The Kaplan-Meier method will be used to estimate the progression free survival distributions for each arm, with median estimates provided. Progression is defined as any one of the following: an increase in number of blood lymphocytes by >= 50% with >= 5000 B lymphocytes/mL in patients on Arm A or those on Arms 2 or 3 no longer receiving ibrutinib, >= 50% increase in the products of at least 2 lymph nodes on 2 consecutive determination 2 weeks apart, >= 50% increase in the size of the liver/spleen, transformation to a more aggressive histology, progression of any cytopenia (i.e. decrease of Hb levels > 2g/dL). Progression free survival time will be the time to either progression or death whichever occurs first.	Time from study entry to the time of documented disease progression or death. The analysis was event driven, performed at 2.5 years after the last patient enrolled;up to 4 years.

Miary wyników drugorzędnych

Miara wyniku	Opis środka	Ramy czasowe
Progression Free Survival (PFS) Rate at 2 Years Ramy czasowe: Time from study entry to the time of documented disease progression or death, assessed up to 2 years	The Kaplan-Meier method will be used to estimate the rate of progression free survival at 2 years in each treatment arm. Progression is defined as any one of the following: an increase in number of blood lymphocytes by >= 50%, >= 50% increase in the products of at least 2 lymph nodes on 2 consecutive determination 2 weeks apart, >= 50% increase in the size of the liver/spleen, transformation to a more aggressive histology, progression of any cytopenia (i.e. decrease of Hb levels > 2g/dL). Progression free survival time will be the time to either progression or death whichever occurs first.	Time from study entry to the time of documented disease progression or death, assessed up to 2 years
Overall Survival (OS) at 2 Years Ramy czasowe: From the date of registration to the date of death, assessed up to 2 years	The Kaplan-Meier method will be used to estimate the rate of overall survival at 2 years in each treatment arm. OS will be measured from the date of registration to the date of the event (i.e., death) or the date of last follow-up to evaluate that event. Patients who are event-free at their last follow-up evaluation will be censored at that time point.	From the date of registration to the date of death, assessed up to 2 years
Duration of Response (DOR) (Complete Response [CR], CCR, Nodular Partial Response [nPR], Partial Response [PR], and PRL) Ramy czasowe: From the date of first response until progression or death, performed at 2.5 years after the last patient enrolled; up to 4 years.	The Kaplan-Meier method will be used to estimate median DOR. DOR is the time from first objective status to progression or death. CR requires all of the following: absence of lymphadenopathy > 1.5 cm on physical exam/CT scan, no hepatomegaly/splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate & biopsy must be normocellular for age. PR requires >= 50% decrease in peripheral lymphocyte count from pre-treatment value, >= 50% reduction in lymphadenopathy, and/or ≥ 50% reduction in splenomegaly/hepatomegaly. CR with exception of having bone marrow lymphoid CLL nodules will be considered a nodular PR (nPR). CR with exception of not having a bone marrow biopsy performed will be considered a clinical CR (CCR). PR with the exception of having less than a 50% reduction in peripheral lymphocyte count will be considered a PR except persistent lymphocytosis (PRL).	From the date of first response until progression or death, performed at 2.5 years after the last patient enrolled; up to 4 years.
Percentage of Patients Achieving Any Response to Treatment (Overall Response Rate [ORR] [Complete Response [CR], CCR, Nodular Partial Response [nPR], Partial Response [PR], and PRL]) Ramy czasowe: Performed at 2.5 years after the last patient enrolled;up to 4 years.	Complete response (CR) requires all of the following: absence of lymphadenopathy >1.5 cm on physical exam/CT scan, no hepatomegaly/splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate & biopsy must be normocellular for age. Partial response (PR) requires >= 50% decrease in peripheral lymphocyte count from pre-treatment value, >= 50% reduction in lymphadenopathy, and/or ≥ 50% reduction in splenomegaly/hepatomegaly. CR with exception of having bone marrow lymphoid CLL nodules will be considered a nodular PR (nPR). CR with exception of not having a bone marrow biopsy performed will be considered a clinical CR (CCR). PR with the exception of having less than a 50% reduction in peripheral lymphocyte count will be considered a PR except persistent lymphocytosis (PRL).Overall response rate and corresponding exact binomial 95% CI provided.	Performed at 2.5 years after the last patient enrolled;up to 4 years.
Percentage of Patients Achieving a Biopsy-proven Complete Response (CR) Ramy czasowe: Performed at 2.5 years after the last patient enrolled; up to 4 years.	Complete response (CR) requires all of the following: absence of lymphadenopathy > 1.5 cm on physical exam/CT scan, no hepatomegaly or splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate and biopsy must be normocellular for age. Complete response rate and corresponding exact binomial 95% confidence intervals provided.	Performed at 2.5 years after the last patient enrolled; up to 4 years.
Percentage of Patients Achieving Complete (CR and CCR) or Nodular Partial Response (nPR) Ramy czasowe: Performed at 2.5 years after the last patient enrolled; up to 4 years.	Complete response (CR) requires all of the following: absence of lymphadenopathy > 1.5 cm on physical exam/CT scan, no hepatomegaly or splenomegaly on physical exam, no clonal B-cells in the blood, Normal CBC, bone marrow aspirate and biopsy must be normocellular for age. CR with exception of having bone marrow lymphoid CLL nodules will be considered a nodular PR (nPR). CR with exception of not having a bone marrow biopsy performed will be considered a clinical CR (CCR). Response rate and corresponding exact binomial 95% confidence intervals provided.	Performed at 2.5 years after the last patient enrolled; up to 4 years.
Percentage of Patients Who Attain Minimal Residual Disease (MRD) Negative Status Ramy czasowe: Cycle 9 Day 1 Evaluation	Estimated using the number of patients who achieve minimal residual disease divided by the total number randomized to that treatment arm. Corresponding exact binomial 95% confidence intervals for MRD rates will be calculated.	Cycle 9 Day 1 Evaluation
The Rate of Grade 3, 4, or 5 Treatment-related Non-hematologic Adverse Events (Toxicities) Ramy czasowe: Performed at 2.5 years after the last patient enrolled; up to 4 years.	The rate of grade 3, 4, or 5 treatment-related non-hematologic adverse events (toxicities) by arm; excludes adverse events occurring post-crossover for patients in Arm A	Performed at 2.5 years after the last patient enrolled; up to 4 years.

Inne miary wyników

Miara wyniku	Opis środka	Ramy czasowe
Geriatric Functional Status (Optional) Ramy czasowe: Performed at 2.5 years after the last patient enrolled	Assessed using the Older Americans' Resources and Services Multidimensional Functional Assessment Questionnaire, Activities of Daily Living, Medical Outcomes Study physical functioning, Karnofsky performance status rated by a health care professional, Karnofsky performance status rated by the patient, timed "Up and Go", and number of falls in the last six months.	Performed at 2.5 years after the last patient enrolled

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Sponsor

National Cancer Institute (NCI)

Śledczy

Główny śledczy: Jennifer A Woyach, Alliance for Clinical Trials in Oncology

Publikacje i pomocne linki

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

Publikacje ogólne

Przydatne linki

<p>Data Available: Select individual patient-level data from this trial can be requested from the NCTN/NCORP Data Archive.</p>

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)

15 stycznia 2014

Zakończenie podstawowe (Rzeczywisty)

7 sierpnia 2018

Ukończenie studiów (Szacowany)

24 czerwca 2027

Daty rejestracji na studia

Pierwszy przesłany

24 czerwca 2013

Pierwszy przesłany, który spełnia kryteria kontroli jakości

24 czerwca 2013

Pierwszy wysłany (Szacowany)

26 czerwca 2013

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

22 października 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

21 października 2026

Ostatnia weryfikacja

1 czerwca 2026

Więcej informacji

Terminy związane z tym badaniem

Dodatkowe istotne warunki MeSH

Inne numery identyfikacyjne badania

NCI-2013-01220
U10CA180821 (Grant/umowa NIH USA)
U10CA031946 (Grant/umowa NIH USA)
NCI-2013-01220 (Identyfikator rejestru: CTRP (Clinical Trial Reporting Program))
ALLIANCE A041202
A041202 (Inny identyfikator: CTEP)
K23CA178183 (Grant/umowa NIH USA)
R01CA183444 (Grant/umowa NIH USA)
A041202 (Inny identyfikator: Alliance for Clinical Trials in Oncology)

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 .

Rytuksymab i chlorowodorek bendamustyny, rytuksymab i ibrutynib lub sam ibrutynib w leczeniu starszych pacjentów z wcześniej nieleczoną przewlekłą białaczką limfocytową

Randomizowane badanie III fazy Bendamustyna plus rytuksymab w porównaniu z ibrutynibem plus rytuksymab w porównaniu z samym ibrutynibem u nieleczonych starszych pacjentów (>/= 65 lat) z przewlekłą białaczką limfocytową (PBL)

Przegląd badań

Status

Warunki

Interwencja / Leczenie

Szczegółowy opis

Typ studiów

Zapisy (Rzeczywisty)

Faza

Kontakty i lokalizacje

Lokalizacje studiów

Kryteria uczestnictwa

Kryteria kwalifikacji

Wiek uprawniający do nauki

Akceptuje zdrowych ochotników

Płeć kwalifikująca się do nauki

Opis

Plan studiów

Jak projektuje się badanie?

Szczegóły projektu

Liczba ramion

Broń i interwencje

Grupa uczestników / Arm

Interwencja / Leczenie

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku

Opis środka

Ramy czasowe

Miary wyników drugorzędnych

Miara wyniku

Opis środka

Ramy czasowe

Inne miary wyników

Miara wyniku

Opis środka

Ramy czasowe

Współpracownicy i badacze

Sponsor

Śledczy

Publikacje i pomocne linki

Publikacje ogólne

Przydatne linki

Daty zapisu na studia

Główne daty studiów

Rozpoczęcie studiów (Rzeczywisty)

Zakończenie podstawowe (Rzeczywisty)

Ukończenie studiów (Szacowany)

Daty rejestracji na studia

Pierwszy przesłany

Pierwszy przesłany, który spełnia kryteria kontroli jakości

Pierwszy wysłany (Szacowany)

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

Ostatnia weryfikacja

Więcej informacji

Terminy związane z tym badaniem

Dodatkowe istotne warunki MeSH

Inne numery identyfikacyjne badania