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Pazopanibhydroklorid vid behandling av patienter med progressiva karcinoida tumörer

11 september 2026 uppdaterad av: National Cancer Institute (NCI)

Prospektiv randomiserad fas II-studie av Pazopanib (NSC # 737754) kontra placebo hos patienter med progressiva karcinoida tumörer

This randomized phase II trial studies how well pazopanib hydrochloride works in treating patients with carcinoid tumors that are growing, spreading, or getting worse. Pazopanib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

Studieöversikt

Status

Aktiv, inte rekryterande

Betingelser

Intervention / Behandling

Detaljerad beskrivning

PRIMARY OBJECTIVE:

I. For patients with progressive carcinoid tumors, progression-free survival (PFS defined by central review according to Response Evaluation Criteria in Solid Tumors [RECIST] 1.1) will be compared between patients randomized to treatment with pazopanib (pazopanib hydrochloride) versus placebo.

SECONDARY OBJECTIVES:

I. Overall survival (OS) will be compared between treatment arms. II. Objective response rate, duration of response, and time to treatment failure will be compared between treatment arms.

III. Progression free survival (PFS) as assessed by central radiology review and local radiology review will be compared overall and within treatment arms.

IV. Safety and tolerability of treatment with pazopanib/placebo will be evaluated within each treatment arm.

V. PFS and other indicators of efficacy will be estimated in patients who crossover to pazopanib from placebo.

VI. To determine the turn-around time for timely adjudicated central review. VII. To characterize the nature of discordance between local and central radiology review in assessment of progression.

VIII. To characterize the type and rate of progression in carcinoid (at study entry, on-study, and at progression).

IX. To develop new methods for modeling carcinoid growth and detecting treatment effects, and to perform simulations that advance new clinical trial designs to apply to future trials of carcinoid therapeutics.

X. To assess for differences in quality of life (QOL)-related domains between the two treatment groups (pazopanib versus placebo).

XI. To determine if the more brief measures of QOL-related domains provide comparable information to that which is provided by the longer assessments (European Organization for Research and Treatment of Cancer [EORTC], neuroendocrine tumors [NET]21).

XII. To provide validation data for the EORTC NET21 module in terms of responsiveness over time and differences across arms.

XIII. To determine whether components of the plasma angiome panel that have been shown to be predictive previously (interleukin-6 [IL-6] and vascular endothelial growth factor [VEGF]-D) are predictive of a therapeutic advantage for pazopanib treatment in baseline samples from the patients treated on A021202.

XIV. To determine whether other components of the plasma angiome panel tested (not IL-6 and VEGF-D) are predictive of a therapeutic advantage for pazopanib treatment in baseline samples from the patients treated on A021202.

XV. To evaluate the changes in the plasma angiome markers after treatment with or without pazopanib over time.

EXPLORATORY OBJECTIVES:

I. PFS at 6 months will be estimated within each treatment arm. II. Biochemical response (for chromogranin A, defined as a decrease of 50% or more in chromogranin A levels from baseline and for 5-hydroxyindoleacetic acid [5-HIAA], defined as a decrease of 50% or more in urinary 5-HIAA levels from baseline) will be compared between treatment arms among patients with elevated baseline levels of chromogranin A (CGA) and 5-HIAA.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive pazopanib hydrochloride orally (PO) once daily (QD) on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo echocardiography (ECHO) or multigated acquisition scan (MUGA) during screening. Patients also undergo computed tomography (CT), magnetic resonance imaging (MRI), and chest x-ray throughout the trial. Patients may optionally undergo blood sample collection during screening and on study.

ARM II: Patients receive placebo PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. At the time of progressive disease, patients may cross-over to Arm I. Patients undergo ECHO or MUGA during screening. Patients also undergo CT, MRI, and chest x-ray throughout the trial. Patients may optionally undergo blood sample collection during screening and on study.

After completion of study treatment, patients are followed up every 3-6 months for 5 years.

Studietyp

Interventionell

Inskrivning (Faktisk)

171

Fas

  • Fas 2

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Studieorter

  • Förenta staterna
    • Alaska
      • Anchorage, Alaska, Förenta staterna, 99508
        • Alaska Breast Care and Surgery LLC
      • Anchorage, Alaska, Förenta staterna, 99508
        • Alaska Women's Cancer Care
      • Anchorage, Alaska, Förenta staterna, 99508
        • Anchorage Oncology Centre
      • Anchorage, Alaska, Förenta staterna, 99508
        • Katmai Oncology Group
      • Anchorage, Alaska, Förenta staterna, 99508
        • Providence Alaska Medical Center
    • Arizona
      • Scottsdale, Arizona, Förenta staterna, 85259
        • Mayo Clinic in Arizona
    • California
      • Anaheim, California, Förenta staterna, 92806
        • Kaiser Permanente-Anaheim
      • Baldwin Park, California, Förenta staterna, 91706
        • Kaiser Permanente-Baldwin Park
      • Fontana, California, Förenta staterna, 92335
        • Kaiser Permanente-Fontana
      • Harbor City, California, Förenta staterna, 90710
        • Kaiser Permanente South Bay
      • Irvine, California, Förenta staterna, 92618
        • Kaiser Permanente-Irvine
      • Los Angeles, California, Förenta staterna, 90033
        • USC / Norris Comprehensive Cancer Center
      • Los Angeles, California, Förenta staterna, 90048
        • Cedars-Sinai Medical Center
      • Los Angeles, California, Förenta staterna, 90027
        • Kaiser Permanente Los Angeles Medical Center
      • Los Angeles, California, Förenta staterna, 90034
        • Kaiser Permanente West Los Angeles
      • Los Angeles, California, Förenta staterna, 90033
        • Los Angeles General Medical Center
      • Palo Alto, California, Förenta staterna, 94304
        • Stanford Cancer Institute Palo Alto
      • Palo Alto, California, Förenta staterna, 94301
        • Palo Alto Medical Foundation Health Care
      • Panorama City, California, Förenta staterna, 91402
        • Kaiser Permanente - Panorama City
      • Riverside, California, Förenta staterna, 92505
        • Kaiser Permanente-Riverside
      • San Diego, California, Förenta staterna, 92120
        • Kaiser Permanente-San Diego Zion
      • San Diego, California, Förenta staterna, 92108
        • Kaiser Permanente-Rio San Diego
      • San Francisco, California, Förenta staterna, 94158
        • UCSF Medical Center-Mission Bay
      • San Francisco, California, Förenta staterna, 94115
        • UCSF Medical Center-Mount Zion
      • San Marcos, California, Förenta staterna, 92078
        • Kaiser Permanente-San Marcos
      • Santa Cruz, California, Förenta staterna, 95065
        • Palo Alto Medical Foundation-Santa Cruz
      • Sunnyvale, California, Förenta staterna, 94086
        • Palo Alto Medical Foundation-Sunnyvale
      • Woodland Hills, California, Förenta staterna, 91367
        • Kaiser Permanente-Woodland Hills
    • Colorado
      • Aurora, Colorado, Förenta staterna, 80012
        • The Medical Center of Aurora
      • Boulder, Colorado, Förenta staterna, 80303
        • Boulder Community Foothills Hospital
      • Boulder, Colorado, Förenta staterna, 80304
        • Rocky Mountain Cancer Centers-Boulder
      • Colorado Springs, Colorado, Förenta staterna, 80907
        • Penrose-Saint Francis Healthcare
      • Colorado Springs, Colorado, Förenta staterna, 80907
        • Rocky Mountain Cancer Centers-Penrose
      • Denver, Colorado, Förenta staterna, 80218
        • Presbyterian - Saint Lukes Medical Center - Health One
      • Denver, Colorado, Förenta staterna, 80220
        • Rose Medical Center
      • Denver, Colorado, Förenta staterna, 80218
        • Rocky Mountain Cancer Centers-Midtown
      • Denver, Colorado, Förenta staterna, 80220
        • Rocky Mountain Cancer Centers-Rose
      • Denver, Colorado, Förenta staterna, 80218
        • Colorado Blood Cancer Institute
      • Denver, Colorado, Förenta staterna, 80222
        • Western States Cancer Research NCORP
      • Denver, Colorado, Förenta staterna, 80218
        • Saint Joseph Hospital - Cancer Centers of Colorado
      • Denver, Colorado, Förenta staterna, 80210
        • AdventHealth Porter
      • Durango, Colorado, Förenta staterna, 81301
        • Mercy Medical Center
      • Englewood, Colorado, Förenta staterna, 80113
        • Mountain Blue Cancer Care Center - Swedish
      • Englewood, Colorado, Förenta staterna, 80113
        • Swedish Medical Center
      • Fort Collins, Colorado, Förenta staterna, 80524
        • Poudre Valley Hospital
      • Golden, Colorado, Förenta staterna, 80401
        • Mountain Blue Cancer Care Center
      • Greeley, Colorado, Förenta staterna, 80631
        • Banner North Colorado Medical Center
      • Greenwood Village, Colorado, Förenta staterna, 80111
        • Rocky Mountain Cancer Centers-Greenwood Village
      • Lakewood, Colorado, Förenta staterna, 80228
        • Rocky Mountain Cancer Centers-Lakewood
      • Lakewood, Colorado, Förenta staterna, 80228
        • CommonSpirit Saint Anthony Hospital Cancer Center
      • Littleton, Colorado, Förenta staterna, 80122
        • AdventHealth Littleton
      • Lone Tree, Colorado, Förenta staterna, 80124
        • Sky Ridge Medical Center
      • Lone Tree, Colorado, Förenta staterna, 80124
        • Rocky Mountain Cancer Centers-Sky Ridge
      • Longmont, Colorado, Förenta staterna, 80501
        • Longmont United Hospital
      • Longmont, Colorado, Förenta staterna, 80501
        • Rocky Mountain Cancer Centers-Longmont
      • Loveland, Colorado, Förenta staterna, 80539
        • Banner North Colorado Medical Center - Loveland Campus
      • Parker, Colorado, Förenta staterna, 80138
        • Rocky Mountain Cancer Centers-Parker
      • Parker, Colorado, Förenta staterna, 80138
        • AdventHealth Parker
      • Pueblo, Colorado, Förenta staterna, 81004
        • Saint Mary Corwin Medical Center
      • Pueblo, Colorado, Förenta staterna, 81008
        • Rocky Mountain Cancer Centers - Pueblo
      • Wheat Ridge, Colorado, Förenta staterna, 80401
        • Intermountain Health Lutheran Hospital
    • Connecticut
      • Hartford, Connecticut, Förenta staterna, 06105
        • Smilow Cancer Hospital Care Center at Saint Francis
    • Delaware
      • Lewes, Delaware, Förenta staterna, 19958
        • Beebe Medical Center
      • Newark, Delaware, Förenta staterna, 19713
        • Helen F Graham Cancer Center
      • Newark, Delaware, Förenta staterna, 19713
        • Delaware Clinical and Laboratory Physicians PA
      • Newark, Delaware, Förenta staterna, 19713
        • Medical Oncology Hematology Consultants PA
      • Newark, Delaware, Förenta staterna, 19718
        • Christiana Care Health System-Christiana Hospital
      • Rehoboth Beach, Delaware, Förenta staterna, 19971
        • Beebe Health Campus
      • Seaford, Delaware, Förenta staterna, 19973
        • TidalHealth Nanticoke / Allen Cancer Center
      • Wilmington, Delaware, Förenta staterna, 19801
        • Christiana Care Health System-Wilmington Hospital
    • Florida
      • Tampa, Florida, Förenta staterna, 33612
        • Moffitt Cancer Center
    • Georgia
      • Columbus, Georgia, Förenta staterna, 31904
        • John B Amos Cancer Center
      • Savannah, Georgia, Förenta staterna, 31404
        • Memorial Health University Medical Center
    • Hawaii
      • Honolulu, Hawaii, Förenta staterna, 96813
        • Queen's Medical Center
      • Honolulu, Hawaii, Förenta staterna, 96813
        • Hawaii Cancer Care Inc - Waterfront Plaza
      • Honolulu, Hawaii, Förenta staterna, 96813
        • Straub Clinic and Hospital
      • Honolulu, Hawaii, Förenta staterna, 96813
        • University of Hawaii Cancer Center
      • Honolulu, Hawaii, Förenta staterna, 96817
        • Hawaii Cancer Care Inc-Liliha
      • Honolulu, Hawaii, Förenta staterna, 96817
        • Queen's Cancer Center - Kuakini
      • Honolulu, Hawaii, Förenta staterna, 96826
        • Kapiolani Medical Center for Women and Children
      • Kailua, Hawaii, Förenta staterna, 96734
        • Castle Medical Center
      • Lihue, Hawaii, Förenta staterna, 96766
        • Wilcox Memorial Hospital and Kauai Medical Clinic
      • ‘Aiea, Hawaii, Förenta staterna, 96701
        • Pali Momi Medical Center
      • ‘Aiea, Hawaii, Förenta staterna, 96701
        • Queen's Cancer Center - Pearlridge
    • Idaho
      • Boise, Idaho, Förenta staterna, 83706
        • Saint Alphonsus Cancer Care Center-Boise
      • Post Falls, Idaho, Förenta staterna, 83854
        • Kootenai Clinic Cancer Services - Post Falls
    • Illinois
      • Bloomington, Illinois, Förenta staterna, 61704
        • Illinois CancerCare-Bloomington
      • Canton, Illinois, Förenta staterna, 61520
        • Illinois CancerCare-Canton
      • Carthage, Illinois, Förenta staterna, 62321
        • Illinois CancerCare-Carthage
      • Chicago, Illinois, Förenta staterna, 60611
        • Northwestern University
      • Chicago, Illinois, Förenta staterna, 60637
        • University of Chicago Comprehensive Cancer Center
      • Decatur, Illinois, Förenta staterna, 62526
        • Decatur Memorial Hospital
      • Decatur, Illinois, Förenta staterna, 62526
        • Cancer Care Specialists of Illinois - Decatur
      • Eureka, Illinois, Förenta staterna, 61530
        • Illinois CancerCare-Eureka
      • Galesburg, Illinois, Förenta staterna, 61401
        • Illinois CancerCare-Galesburg
      • Harvey, Illinois, Förenta staterna, 60426
        • Ingalls Memorial Hospital
      • Kewanee, Illinois, Förenta staterna, 61443
        • Illinois CancerCare-Kewanee Clinic
      • Macomb, Illinois, Förenta staterna, 61455
        • Illinois CancerCare-Macomb
      • Maywood, Illinois, Förenta staterna, 60153
        • Loyola University Medical Center
      • Mount Vernon, Illinois, Förenta staterna, 62864
        • SSM Health Good Samaritan
      • Ottawa, Illinois, Förenta staterna, 61350
        • Illinois CancerCare-Ottawa Clinic
      • Pekin, Illinois, Förenta staterna, 61554
        • Illinois CancerCare-Pekin
      • Peoria, Illinois, Förenta staterna, 61615
        • Illinois CancerCare-Peoria
      • Peru, Illinois, Förenta staterna, 61354
        • Illinois CancerCare-Peru
      • Princeton, Illinois, Förenta staterna, 61356
        • Illinois CancerCare-Princeton
    • Indiana
      • Elkhart, Indiana, Förenta staterna, 46515
        • Elkhart General Hospital
      • Elkhart, Indiana, Förenta staterna, 46514
        • Michiana Hematology Oncology PC-Elkhart
      • Elkhart, Indiana, Förenta staterna, 46514-2098
        • Elkhart Clinic
      • Indianapolis, Indiana, Förenta staterna, 46202
        • Indiana University/Melvin and Bren Simon Cancer Center
      • Kokomo, Indiana, Förenta staterna, 46904
        • Community Howard Regional Health
      • La Porte, Indiana, Förenta staterna, 46350
        • IU Health La Porte Hospital
      • Mishawaka, Indiana, Förenta staterna, 46545
        • Michiana Hematology Oncology PC-Mishawaka
      • Mishawaka, Indiana, Förenta staterna, 46545
        • Saint Joseph Regional Medical Center-Mishawaka
      • Plymouth, Indiana, Förenta staterna, 46563
        • Michiana Hematology Oncology PC-Plymouth
      • Richmond, Indiana, Förenta staterna, 47374
        • Reid Health
      • South Bend, Indiana, Förenta staterna, 46601
        • Memorial Hospital of South Bend
      • South Bend, Indiana, Förenta staterna, 46628
        • Northern Indiana Cancer Research Consortium
      • South Bend, Indiana, Förenta staterna, 46617
        • South Bend Clinic
      • Westville, Indiana, Förenta staterna, 46391
        • Michiana Hematology Oncology PC-Westville
    • Iowa
      • Ames, Iowa, Förenta staterna, 50010
        • Mary Greeley Medical Center
      • Ames, Iowa, Förenta staterna, 50010
        • McFarland Clinic - Ames
      • Bettendorf, Iowa, Förenta staterna, 52722
        • University of Iowa Healthcare Cancer Services Quad Cities
      • Boone, Iowa, Förenta staterna, 50036
        • McFarland Clinic - Boone
      • Cedar Rapids, Iowa, Förenta staterna, 52403
        • Mercy Hospital
      • Cedar Rapids, Iowa, Förenta staterna, 52403
        • Oncology Associates at Mercy Medical Center
      • Clive, Iowa, Förenta staterna, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Förenta staterna, 50325
        • UI Health Care Mission Cancer and Blood - West Des Moines Clinic
      • Des Moines, Iowa, Förenta staterna, 50309
        • Iowa Methodist Medical Center
      • Des Moines, Iowa, Förenta staterna, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Förenta staterna, 50316
        • Iowa Lutheran Hospital
      • Des Moines, Iowa, Förenta staterna, 50309
        • Iowa-Wide Oncology Research Coalition NCORP
      • Des Moines, Iowa, Förenta staterna, 50309
        • UI Health Care Mission Cancer and Blood - Des Moines Clinic
      • Des Moines, Iowa, Förenta staterna, 50314
        • UI Health Care Mission Cancer and Blood - Laurel Clinic
      • Iowa City, Iowa, Förenta staterna, 52242
        • University of Iowa/Holden Comprehensive Cancer Center
      • Jefferson, Iowa, Förenta staterna, 50129
        • McFarland Clinic - Jefferson
      • Marshalltown, Iowa, Förenta staterna, 50158
        • McFarland Clinic - Marshalltown
      • Sioux City, Iowa, Förenta staterna, 51101
        • Siouxland Regional Cancer Center
      • Sioux City, Iowa, Förenta staterna, 51102
        • Mercy Medical Center-Sioux City
      • Sioux City, Iowa, Förenta staterna, 51104
        • Saint Luke's Regional Medical Center
      • West Des Moines, Iowa, Förenta staterna, 50266-7700
        • Methodist West Hospital
      • West Des Moines, Iowa, Förenta staterna, 50266
        • Mercy Medical Center-West Lakes
    • Kansas
      • Emporia, Kansas, Förenta staterna, 66801
        • Newman Regional Health
      • Garden City, Kansas, Förenta staterna, 67846
        • Saint Catherine Hospital
      • Great Bend, Kansas, Förenta staterna, 67530
        • Saint Rose Ambulatory and Surgery Center
      • Hays, Kansas, Förenta staterna, 67601
        • HaysMed
      • Kansas City, Kansas, Förenta staterna, 66160
        • University of Kansas Cancer Center
      • Kansas City, Kansas, Förenta staterna, 66112
        • University of Kansas Cancer Center-West
      • Olathe, Kansas, Förenta staterna, 66061
        • The University of Kansas Cancer Center - Olathe
      • Overland Park, Kansas, Förenta staterna, 66210
        • University of Kansas Cancer Center-Overland Park
      • Overland Park, Kansas, Förenta staterna, 66209
        • Menorah Medical Center
      • Overland Park, Kansas, Förenta staterna, 66213
        • Saint Luke's South Hospital
      • Pittsburg, Kansas, Förenta staterna, 66762
        • Mercy Hospital Pittsburg
      • Prairie Village, Kansas, Förenta staterna, 66208
        • Kansas City NCI Community Oncology Research Program
      • Salina, Kansas, Förenta staterna, 67401
        • Salina Regional Health Center
      • Topeka, Kansas, Förenta staterna, 66606
        • University of Kansas Health System Saint Francis Campus
      • Wichita, Kansas, Förenta staterna, 67214
        • Cancer Center of Kansas - Wichita
    • Kentucky
      • Crestview Hills, Kentucky, Förenta staterna, 41017
        • Oncology Hematology Care Inc-Crestview
      • Elizabethtown, Kentucky, Förenta staterna, 42701
        • Baptist Health Hardin
      • Lexington, Kentucky, Förenta staterna, 40503
        • Baptist Health Lexington
    • Louisiana
      • Baton Rouge, Louisiana, Förenta staterna, 70809
        • Ochsner Health Center-Summa
      • New Orleans, Louisiana, Förenta staterna, 70121
        • Ochsner Medical Center Jefferson
    • Michigan
      • Adrian, Michigan, Förenta staterna, 49221
        • Bixby Medical Center
      • Adrian, Michigan, Förenta staterna, 49221
        • Hickman Cancer Center
      • Ann Arbor, Michigan, Förenta staterna, 48106
        • Michigan Cancer Research Consortium NCORP
      • Ann Arbor, Michigan, Förenta staterna, 48106
        • Trinity Health Saint Joseph Mercy Hospital Ann Arbor
      • Battle Creek, Michigan, Förenta staterna, 49017
        • Bronson Battle Creek
      • Dearborn, Michigan, Förenta staterna, 48124
        • Corewell Health Dearborn Hospital
      • Detroit, Michigan, Förenta staterna, 48236
        • Henry Ford Health Saint John Hospital
      • Escanaba, Michigan, Förenta staterna, 49829
        • OSF Saint Francis Hospital and Medical Group
      • Flint, Michigan, Förenta staterna, 48503
        • Hurley Medical Center
      • Flint, Michigan, Förenta staterna, 48503
        • Genesys Hurley Cancer Institute
      • Grand Rapids, Michigan, Förenta staterna, 49503
        • Cancer Research Consortium of West Michigan NCORP
      • Grand Rapids, Michigan, Förenta staterna, 49503
        • Trinity Health Grand Rapids Hospital
      • Grand Rapids, Michigan, Förenta staterna, 49503
        • Corewell Health Grand Rapids Hospitals - Butterworth Hospital
      • Jackson, Michigan, Förenta staterna, 49201
        • Allegiance Health
      • Lansing, Michigan, Förenta staterna, 48912
        • University of Michigan Health - Sparrow Lansing
      • Livonia, Michigan, Förenta staterna, 48154
        • Trinity Health Saint Mary Mercy Livonia Hospital
      • Monroe, Michigan, Förenta staterna, 48162
        • Mercy Memorial Hospital
      • Monroe, Michigan, Förenta staterna, 48162
        • Toledo Clinic Cancer Centers-Monroe
      • Muskegon, Michigan, Förenta staterna, 49444
        • Trinity Health Muskegon Hospital
      • Niles, Michigan, Förenta staterna, 49120
        • Corewell Health Lakeland Hospitals - Niles Hospital
      • Pontiac, Michigan, Förenta staterna, 48341
        • Trinity Health Saint Joseph Mercy Oakland Hospital
      • Port Huron, Michigan, Förenta staterna, 48060
        • Lake Huron Medical Center
      • Reed City, Michigan, Förenta staterna, 49677
        • Corewell Health Reed City Hospital
      • Saginaw, Michigan, Förenta staterna, 48601
        • MyMichigan Medical Center Saginaw
      • Saint Joseph, Michigan, Förenta staterna, 49085
        • Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
      • Saint Joseph, Michigan, Förenta staterna, 49085
        • Corewell Health Lakeland Hospitals - Saint Joseph Hospital
      • Traverse City, Michigan, Förenta staterna, 49684
        • Munson Medical Center
      • Warren, Michigan, Förenta staterna, 48093
        • Henry Ford Health Warren Hospital
    • Minnesota
      • Burnsville, Minnesota, Förenta staterna, 55337
        • Fairview Ridges Hospital
      • Coon Rapids, Minnesota, Förenta staterna, 55433
        • Mercy Hospital
      • Duluth, Minnesota, Förenta staterna, 55805
        • Essentia Health Cancer Center
      • Duluth, Minnesota, Förenta staterna, 55805
        • Essentia Health Saint Mary's Medical Center
      • Duluth, Minnesota, Förenta staterna, 55805
        • Miller-Dwan Hospital
      • Edina, Minnesota, Förenta staterna, 55435
        • Fairview Southdale Hospital
      • Fridley, Minnesota, Förenta staterna, 55432
        • Unity Hospital
      • Hutchinson, Minnesota, Förenta staterna, 55350
        • Hutchinson Area Health Care
      • Maplewood, Minnesota, Förenta staterna, 55109
        • Saint John's Hospital - Healtheast
      • Maplewood, Minnesota, Förenta staterna, 55109
        • Minnesota Oncology Hematology PA-Maplewood
      • Minneapolis, Minnesota, Förenta staterna, 55415
        • Hennepin County Medical Center
      • Minneapolis, Minnesota, Förenta staterna, 55407
        • Abbott-Northwestern Hospital
      • Minneapolis, Minnesota, Förenta staterna, 55454
        • Health Partners Inc
      • New Ulm, Minnesota, Förenta staterna, 56073
        • New Ulm Medical Center
      • Robbinsdale, Minnesota, Förenta staterna, 55422
        • North Memorial Medical Health Center
      • Rochester, Minnesota, Förenta staterna, 55905
        • Mayo Clinic in Rochester
      • Saint Louis Park, Minnesota, Förenta staterna, 55416
        • Park Nicollet Clinic - Saint Louis Park
      • Saint Louis Park, Minnesota, Förenta staterna, 55416
        • Metro Minnesota Community Oncology Research Consortium
      • Saint Paul, Minnesota, Förenta staterna, 55101
        • Regions Hospital
      • Saint Paul, Minnesota, Förenta staterna, 55102
        • United Hospital
      • Shakopee, Minnesota, Förenta staterna, 55379
        • Saint Francis Regional Medical Center
      • Stillwater, Minnesota, Förenta staterna, 55082
        • Lakeview Hospital
      • Waconia, Minnesota, Förenta staterna, 55387
        • Ridgeview Medical Center
      • Willmar, Minnesota, Förenta staterna, 56201
        • Rice Memorial Hospital
      • Woodbury, Minnesota, Förenta staterna, 55125
        • Minnesota Oncology Hematology PA-Woodbury
    • Missouri
      • Branson, Missouri, Förenta staterna, 65616
        • Cox Cancer Center Branson
      • Cape Girardeau, Missouri, Förenta staterna, 63703
        • Mercy Cancer Center - Cape Girardeau
      • Columbia, Missouri, Förenta staterna, 65212
        • MU Health - University Hospital/Ellis Fischel Cancer Center
      • Independence, Missouri, Förenta staterna, 64057
        • Centerpoint Medical Center LLC
      • Jefferson City, Missouri, Förenta staterna, 65109
        • MU Health Care Goldschmidt Cancer Center
      • Joplin, Missouri, Förenta staterna, 64804
        • Mercy Hospital Joplin
      • Kansas City, Missouri, Förenta staterna, 64154
        • University of Kansas Cancer Center - North
      • Kansas City, Missouri, Förenta staterna, 64131
        • The University of Kansas Cancer Center-South
      • Kansas City, Missouri, Förenta staterna, 64111
        • Saint Luke's Hospital of Kansas City
      • Kansas City, Missouri, Förenta staterna, 64132
        • Research Medical Center
      • Kansas City, Missouri, Förenta staterna, 64118
        • Heartland Hematology and Oncology Associates Incorporated
      • Kansas City, Missouri, Förenta staterna, 64108
        • University Health Truman Medical Center
      • Lee's Summit, Missouri, Förenta staterna, 64064
        • University of Kansas Cancer Center - Lee's Summit
      • Lee's Summit, Missouri, Förenta staterna, 64086
        • Saint Luke's East - Lee's Summit
      • Liberty, Missouri, Förenta staterna, 64068
        • Liberty Hospital
      • Rolla, Missouri, Förenta staterna, 65401
        • Mercy Clinic-Rolla-Cancer and Hematology
      • Rolla, Missouri, Förenta staterna, 65401
        • Phelps Health Delbert Day Cancer Institute
      • Saint Joseph, Missouri, Förenta staterna, 64506
        • Heartland Regional Medical Center
      • Springfield, Missouri, Förenta staterna, 65804
        • Cancer Research for the Ozarks NCORP
      • Springfield, Missouri, Förenta staterna, 65807
        • CoxHealth South Hospital
      • Springfield, Missouri, Förenta staterna, 65804
        • Mercy Hospital Springfield
      • St Louis, Missouri, Förenta staterna, 63110
        • Washington University School of Medicine
      • St Louis, Missouri, Förenta staterna, 63131
        • Missouri Baptist Medical Center
      • St Louis, Missouri, Förenta staterna, 63109
        • Mercy Infusion Center - Chippewa
      • St Louis, Missouri, Förenta staterna, 63141
        • Mercy Hospital Saint Louis
    • Montana
      • Billings, Montana, Förenta staterna, 59101
        • Billings Clinic Cancer Center
      • Billings, Montana, Förenta staterna, 59101
        • Saint Vincent Healthcare
      • Billings, Montana, Förenta staterna, 59102
        • Montana Cancer Consortium NCORP
      • Bozeman, Montana, Förenta staterna, 59715
        • Bozeman Health Deaconess Hospital
      • Butte, Montana, Förenta staterna, 59701
        • Saint James Community Hospital and Cancer Treatment Center
      • Great Falls, Montana, Förenta staterna, 59405
        • Benefis Sletten Cancer Institute
      • Helena, Montana, Förenta staterna, 59601
        • Saint Peter's Community Hospital
      • Kalispell, Montana, Förenta staterna, 59901
        • Logan Health Medical Center
      • Missoula, Montana, Förenta staterna, 59802
        • Saint Patrick Hospital - Community Hospital
    • Nebraska
      • Lincoln, Nebraska, Förenta staterna, 68510
        • Nebraska Cancer Research Center
      • Omaha, Nebraska, Förenta staterna, 68114
        • Nebraska Methodist Hospital
      • Omaha, Nebraska, Förenta staterna, 68124
        • Alegent Health Bergan Mercy Medical Center
      • Omaha, Nebraska, Förenta staterna, 68122
        • Alegent Health Immanuel Medical Center
      • Omaha, Nebraska, Förenta staterna, 68130
        • Alegent Health Lakeside Hospital
      • Omaha, Nebraska, Förenta staterna, 68106
        • Missouri Valley Cancer Consortium
    • Nevada
      • Henderson, Nevada, Förenta staterna, 89052
        • Comprehensive Cancer Centers of Nevada - Henderson
      • Henderson, Nevada, Förenta staterna, 89052
        • Cancer and Blood Specialists-Henderson
      • Henderson, Nevada, Förenta staterna, 89052
        • Las Vegas Cancer Center-Henderson
      • Henderson, Nevada, Förenta staterna, 89074
        • Comprehensive Cancer Centers of Nevada-Southeast Henderson
      • Henderson, Nevada, Förenta staterna, 89074
        • Oncology Las Vegas - Henderson
      • Las Vegas, Nevada, Förenta staterna, 89106
        • Radiation Oncology Centers of Nevada Central
      • Las Vegas, Nevada, Förenta staterna, 89119
        • Radiation Oncology Centers of Nevada Southeast
      • Las Vegas, Nevada, Förenta staterna, 89128
        • Comprehensive Cancer Centers of Nevada - Northwest
      • Las Vegas, Nevada, Förenta staterna, 89144
        • Comprehensive Cancer Centers of Nevada-Summerlin
      • Las Vegas, Nevada, Förenta staterna, 89148
        • Comprehensive Cancer Centers of Nevada
      • Las Vegas, Nevada, Förenta staterna, 89169
        • Comprehensive Cancer Centers of Nevada - Central Valley
      • Las Vegas, Nevada, Förenta staterna, 89102
        • University Medical Center of Southern Nevada
      • Las Vegas, Nevada, Förenta staterna, 89106
        • Cancer and Blood Specialists-Shadow
      • Las Vegas, Nevada, Förenta staterna, 89109
        • HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
      • Las Vegas, Nevada, Förenta staterna, 89113
        • HealthCare Partners Medical Group Oncology/Hematology-San Martin
      • Las Vegas, Nevada, Förenta staterna, 89121
        • Cancer Therapy and Integrative Medicine
      • Las Vegas, Nevada, Förenta staterna, 89128
        • Cancer and Blood Specialists-Tenaya
      • Las Vegas, Nevada, Förenta staterna, 89128
        • HealthCare Partners Medical Group Oncology/Hematology-Tenaya
      • Las Vegas, Nevada, Förenta staterna, 89148-2405
        • Las Vegas Cancer Center-Medical Center
      • Las Vegas, Nevada, Förenta staterna, 89149
        • HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
      • Las Vegas, Nevada, Förenta staterna, 89120
        • Nevada Cancer Research Foundation NCORP
      • Las Vegas, Nevada, Förenta staterna, 89128
        • Oncology Las Vegas - Tenaya
      • Las Vegas, Nevada, Förenta staterna, 89183
        • OptumCare Cancer Care at Fort Apache
    • New Hampshire
      • Lebanon, New Hampshire, Förenta staterna, 03756
        • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
    • New Jersey
      • Camden, New Jersey, Förenta staterna, 08103
        • Cooper Hospital University Medical Center
      • New Brunswick, New Jersey, Förenta staterna, 08903
        • Rutgers Cancer Institute of New Jersey
    • New Mexico
      • Albuquerque, New Mexico, Förenta staterna, 87106
        • University of New Mexico Cancer Center
      • Las Cruces, New Mexico, Förenta staterna, 88011
        • Memorial Medical Center-Las Cruces
    • New York
      • Glens Falls, New York, Förenta staterna, 12801
        • Glens Falls Hospital
      • Rochester, New York, Förenta staterna, 14642
        • University of Rochester
      • Syracuse, New York, Förenta staterna, 13210
        • Syracuse Veterans Administration Medical Center
      • The Bronx, New York, Förenta staterna, 10461
        • Montefiore Medical Center-Einstein Campus
      • The Bronx, New York, Förenta staterna, 10467
        • Montefiore Medical Center - Moses Campus
    • North Carolina
      • Chapel Hill, North Carolina, Förenta staterna, 27599
        • UNC Lineberger Comprehensive Cancer Center
      • Goldsboro, North Carolina, Förenta staterna, 27534
        • Wayne Memorial Hospital
      • Hendersonville, North Carolina, Förenta staterna, 28791
        • Margaret R Pardee Memorial Hospital
      • Kinston, North Carolina, Förenta staterna, 28501
        • ECU Health Oncology Kinston
      • Statesville, North Carolina, Förenta staterna, 28677
        • Iredell Memorial Hospital
    • North Dakota
      • Fargo, North Dakota, Förenta staterna, 58103
        • Essentia Health Cancer Center-South University Clinic
    • Ohio
      • Belpre, Ohio, Förenta staterna, 45714
        • Strecker Cancer Center-Belpre
      • Bowling Green, Ohio, Förenta staterna, 43402
        • Toledo Clinic Cancer Centers-Bowling Green
      • Chillicothe, Ohio, Förenta staterna, 45601
        • Adena Regional Medical Center
      • Cincinnati, Ohio, Förenta staterna, 45242
        • Oncology Hematology Care Inc-Blue Ash
      • Cincinnati, Ohio, Förenta staterna, 45202
        • Oncology Hematology Care Inc-Eden Park
      • Cincinnati, Ohio, Förenta staterna, 45211
        • Oncology Hematology Care Inc-Mercy West
      • Cincinnati, Ohio, Förenta staterna, 45230
        • Oncology Hematology Care Inc-Anderson
      • Cincinnati, Ohio, Förenta staterna, 45236
        • Oncology Hematology Care Inc-Kenwood
      • Cleveland, Ohio, Förenta staterna, 44106
        • Case Western Reserve University
      • Columbus, Ohio, Förenta staterna, 43214
        • Riverside Methodist Hospital
      • Columbus, Ohio, Förenta staterna, 43210
        • Ohio State University Comprehensive Cancer Center
      • Columbus, Ohio, Förenta staterna, 43219
        • The Mark H Zangmeister Center
      • Columbus, Ohio, Förenta staterna, 43214
        • Columbus Oncology and Hematology Associates Inc
      • Columbus, Ohio, Förenta staterna, 43228
        • Doctors Hospital
      • Columbus, Ohio, Förenta staterna, 43215
        • Grant Medical Center
      • Columbus, Ohio, Förenta staterna, 43222
        • Mount Carmel Health Center West
      • Columbus, Ohio, Förenta staterna, 43215
        • Columbus NCI Community Oncology Research Program
      • Dayton, Ohio, Förenta staterna, 45406
        • Good Samaritan Hospital - Dayton
      • Dayton, Ohio, Förenta staterna, 45409
        • Miami Valley Hospital
      • Dayton, Ohio, Förenta staterna, 45415
        • Miami Valley Hospital North
      • Dayton, Ohio, Förenta staterna, 45459
        • Dayton NCI Community Oncology Research Program
      • Delaware, Ohio, Förenta staterna, 43015
        • Delaware Health Center-Grady Cancer Center
      • Delaware, Ohio, Förenta staterna, 43015
        • Delaware Radiation Oncology
      • Delaware, Ohio, Förenta staterna, 43015
        • Grady Memorial Hospital
      • Fairfield, Ohio, Förenta staterna, 45014
        • Oncology Hematology Care Inc-Healthplex
      • Findlay, Ohio, Förenta staterna, 45840
        • Blanchard Valley Hospital
      • Franklin, Ohio, Förenta staterna, 45005-1066
        • Atrium Medical Center-Middletown Regional Hospital
      • Greenville, Ohio, Förenta staterna, 45331
        • Wayne Hospital
      • Kettering, Ohio, Förenta staterna, 45429
        • Kettering Medical Center
      • Lancaster, Ohio, Förenta staterna, 43130
        • Fairfield Medical Center
      • Lancaster, Ohio, Förenta staterna, 43130
        • Lancaster Radiation Oncology
      • Lima, Ohio, Förenta staterna, 45804
        • Lima Memorial Hospital
      • Marietta, Ohio, Förenta staterna, 45750
        • Marietta Memorial Hospital
      • Maumee, Ohio, Förenta staterna, 43537
        • Toledo Clinic Cancer Centers-Maumee
      • Maumee, Ohio, Förenta staterna, 43537
        • Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
      • Mount Vernon, Ohio, Förenta staterna, 43050
        • Knox Community Hospital
      • Newark, Ohio, Förenta staterna, 43055
        • Licking Memorial Hospital
      • Newark, Ohio, Förenta staterna, 43055
        • Newark Radiation Oncology
      • Oregon, Ohio, Förenta staterna, 43616
        • Saint Charles Hospital
      • Oregon, Ohio, Förenta staterna, 43616
        • Toledo Clinic Cancer Centers-Oregon
      • Portsmouth, Ohio, Förenta staterna, 45662
        • Southern Ohio Medical Center
      • Springfield, Ohio, Förenta staterna, 45504
        • Springfield Regional Medical Center
      • Sylvania, Ohio, Förenta staterna, 43560
        • ProMedica Flower Hospital
      • Tiffin, Ohio, Förenta staterna, 44883
        • Mercy Hospital of Tiffin
      • Toledo, Ohio, Förenta staterna, 43623
        • Mercy Health - Saint Anne Hospital
      • Toledo, Ohio, Förenta staterna, 43623
        • Toledo Clinic Cancer Centers-Toledo
      • Toledo, Ohio, Förenta staterna, 43614
        • University of Toledo
      • Toledo, Ohio, Förenta staterna, 43617
        • Toledo Community Hospital Oncology Program CCOP
      • Toledo, Ohio, Förenta staterna, 43608
        • Mercy Health - Saint Vincent Hospital
      • Troy, Ohio, Förenta staterna, 45373
        • Upper Valley Medical Center
      • Wauseon, Ohio, Förenta staterna, 43567
        • Fulton County Health Center
      • Westerville, Ohio, Förenta staterna, 43081
        • Saint Ann's Hospital
      • Zanesville, Ohio, Förenta staterna, 43701
        • Genesis Healthcare System Cancer Care Center
    • Oklahoma
      • Lawton, Oklahoma, Förenta staterna, 73505
        • Cancer Centers of Southwest Oklahoma Research
      • Oklahoma City, Oklahoma, Förenta staterna, 73104
        • University of Oklahoma Health Sciences Center
      • Tulsa, Oklahoma, Förenta staterna, 74146
        • Oklahoma Cancer Specialists and Research Institute-Tulsa
    • Oregon
      • Clackamas, Oregon, Förenta staterna, 97015
        • Clackamas Radiation Oncology Center
      • Milwaukie, Oregon, Förenta staterna, 97222
        • Providence Milwaukie Hospital
      • Newberg, Oregon, Förenta staterna, 97132
        • Providence Newberg Medical Center
      • Oregon City, Oregon, Förenta staterna, 97045
        • Providence Willamette Falls Medical Center
      • Portland, Oregon, Förenta staterna, 97213
        • Providence Portland Medical Center
      • Portland, Oregon, Förenta staterna, 97225
        • Providence Saint Vincent Medical Center
    • Pennsylvania
      • Bethlehem, Pennsylvania, Förenta staterna, 18015
        • Saint Luke's University Hospital-Bethlehem Campus
      • Danville, Pennsylvania, Förenta staterna, 17822
        • Geisinger Medical Center
      • Hazleton, Pennsylvania, Förenta staterna, 18201
        • Geisinger Medical Center-Cancer Center Hazleton
      • Sayre, Pennsylvania, Förenta staterna, 18840
        • Guthrie Medical Group PC-Robert Packer Hospital
      • State College, Pennsylvania, Förenta staterna, 16801
        • Geisinger Medical Group
      • Wilkes-Barre, Pennsylvania, Förenta staterna, 18711
        • Geisinger Wyoming Valley/Henry Cancer Center
      • Williamsport, Pennsylvania, Förenta staterna, 17701
        • UPMC Susquehanna
    • South Carolina
      • Boiling Springs, South Carolina, Förenta staterna, 29316
        • Prisma Health Cancer Institute - Spartanburg
      • Florence, South Carolina, Förenta staterna, 29506
        • McLeod Regional Medical Center
      • Greenville, South Carolina, Förenta staterna, 29605
        • Prisma Health Cancer Institute - Faris
      • Greenville, South Carolina, Förenta staterna, 29615
        • Prisma Health Cancer Institute - Eastside
      • Greenville, South Carolina, Förenta staterna, 29605
        • Prisma Health Cancer Institute - Butternut
      • Greenville, South Carolina, Förenta staterna, 29605
        • Prisma Health Greenville Memorial Hospital
      • Greer, South Carolina, Förenta staterna, 29650
        • Prisma Health Cancer Institute - Greer
      • Seneca, South Carolina, Förenta staterna, 29672
        • Prisma Health Cancer Institute - Seneca
    • South Dakota
      • Rapid City, South Dakota, Förenta staterna, 57701
        • Rapid City Regional Hospital
    • Texas
      • Dallas, Texas, Förenta staterna, 75246
        • Baylor University Medical Center
      • Houston, Texas, Förenta staterna, 77030
        • Houston Methodist Hospital
      • San Antonio, Texas, Förenta staterna, 78229
        • University of Texas Health Science Center at San Antonio
    • Utah
      • American Fork, Utah, Förenta staterna, 84003
        • American Fork Hospital / Huntsman Intermountain Cancer Center
      • Cedar City, Utah, Förenta staterna, 84720
        • Sandra L Maxwell Cancer Center
      • Logan, Utah, Förenta staterna, 84321
        • Logan Regional Hospital
      • Murray, Utah, Förenta staterna, 84107
        • Intermountain Medical Center
      • Ogden, Utah, Förenta staterna, 84403
        • McKay-Dee Hospital Center
      • Provo, Utah, Förenta staterna, 84604
        • Utah Valley Regional Medical Center
      • Salt Lake City, Utah, Förenta staterna, 84106
        • Utah Cancer Specialists-Salt Lake City
      • Salt Lake City, Utah, Förenta staterna, 84143
        • LDS Hospital
      • St. George, Utah, Förenta staterna, 84770
        • Saint George Regional Medical Center
    • Vermont
      • Bennington, Vermont, Förenta staterna, 05201
        • Southwestern Vermont Medical Center
    • Virginia
      • Fredericksburg, Virginia, Förenta staterna, 22401
        • Fredericksburg Oncology Inc
    • Washington
      • Vancouver, Washington, Förenta staterna, 98664
        • PeaceHealth Southwest Medical Center
      • Vancouver, Washington, Förenta staterna, 98684
        • Compass Oncology Vancouver
    • West Virginia
      • Huntington, West Virginia, Förenta staterna, 25701
        • Edwards Comprehensive Cancer Center
    • Wisconsin
      • Chippewa Falls, Wisconsin, Förenta staterna, 54729
        • Marshfield Clinic-Chippewa Center
      • Eau Claire, Wisconsin, Förenta staterna, 54701
        • HSHS Sacred Heart Hospital
      • Eau Claire, Wisconsin, Förenta staterna, 54701
        • Marshfield Clinic Cancer Center at Sacred Heart
      • Green Bay, Wisconsin, Förenta staterna, 54301
        • Saint Vincent Hospital Cancer Center Green Bay
      • Green Bay, Wisconsin, Förenta staterna, 54303
        • Saint Vincent Hospital Cancer Center at Saint Mary's
      • Green Bay, Wisconsin, Förenta staterna, 54301-3526
        • Green Bay Oncology at Saint Vincent Hospital
      • Madison, Wisconsin, Förenta staterna, 53792
        • University of Wisconsin Carbone Cancer Center - University Hospital
      • Manitowoc, Wisconsin, Förenta staterna, 54221
        • Holy Family Memorial Hospital
      • Marshfield, Wisconsin, Förenta staterna, 54449
        • Marshfield Medical Center-Marshfield
      • Marshfield, Wisconsin, Förenta staterna, 54449
        • Marshfield Medical Center
      • Milwaukee, Wisconsin, Förenta staterna, 53226
        • Medical College of Wisconsin
      • Minocqua, Wisconsin, Förenta staterna, 54548
        • Marshfield Medical Center - Minocqua
      • New Richmond, Wisconsin, Förenta staterna, 54017
        • Cancer Center of Western Wisconsin
      • Oconto Falls, Wisconsin, Förenta staterna, 54154
        • Saint Vincent Hospital Cancer Center at Oconto Falls
      • Rhinelander, Wisconsin, Förenta staterna, 54501
        • Saint Mary's Hospital
      • Rhinelander, Wisconsin, Förenta staterna, 54501
        • Aspirus Cancer Care-Rhinelander-James Beck Cancer Center
      • Rice Lake, Wisconsin, Förenta staterna, 54868
        • Marshfield Medical Center-Rice Lake
      • Sheboygan, Wisconsin, Förenta staterna, 53081
        • HSHS Saint Nicholas Hospital
      • Stevens Point, Wisconsin, Förenta staterna, 54481
        • Aspirus Cancer Care - Stevens Point
      • Wausau, Wisconsin, Förenta staterna, 54401
        • Marshfield Clinic-Wausau Center
      • Weston, Wisconsin, Förenta staterna, 54476
        • Marshfield Medical Center - Weston
      • Wisconsin Rapids, Wisconsin, Förenta staterna, 54494
        • Marshfield Clinic - Wisconsin Rapids Center
    • Wyoming
      • Casper, Wyoming, Förenta staterna, 82609
        • Rocky Mountain Oncology
      • Sheridan, Wyoming, Förenta staterna, 82801
        • Welch Cancer Center
  • Kanada
    • Alberta
      • Calgary, Alberta, Kanada, T2N 5G2
        • Arthur J E Child Comprehensive Cancer Centre
    • British Columbia
      • Vancouver, British Columbia, Kanada, V5Z 4E6
        • BCCA-Vancouver Cancer Centre
    • New Brunswick
      • Moncton, New Brunswick, Kanada, E1C 8X3
        • The Vitalite Health Network - Dr Leon Richard Oncology Centre
    • Nova Scotia
      • Halifax, Nova Scotia, Kanada, B3H 2Y9
        • QEII Health Sciences Centre/Nova Scotia Health Authority
    • Ontario
      • Hamilton, Ontario, Kanada, L8V 5C2
        • Juravinski Cancer Centre at Hamilton Health Sciences
      • Kitchener, Ontario, Kanada, N2G 1G3
        • Waterloo Regional Health Network
      • Ottawa, Ontario, Kanada, K1H 8L6
        • Ottawa Hospital and Cancer Center-General Campus
      • Toronto, Ontario, Kanada, M5G 2M9
        • University Health Network-Princess Margaret Hospital
    • Quebec
      • 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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • Low- or intermediate-grade neuroendocrine carcinoma, including the following subtypes: carcinoid tumor, low- to intermediate-grade or well- to moderately-differentiated neuroendocrine carcinoma or tumor, atypical carcinoid tumor; documentation from a primary tumor or metastatic site is sufficient; patients with poorly differentiated neuroendocrine carcinoma, high-grade neuroendocrine carcinoma, adenocarcinoid tumor, or goblet cell carcinoid tumor are not eligible

  • Locally unresectable or metastatic carcinoid tumors

  • Patients must have histologic documentation or clinical evidence of a carcinoid tumor of primary site (including foregut, midgut, hindgut or other non-pancreatic site); tumors of unknown primary site are eligible provided the treating physician does not suspect medullary thyroid cancer, pancreatic neuroendocrine tumor, paraganglioma, or pheochromocytoma; unknown primary tumors will be classified as small bowel tumors for the purpose of stratification; functional (associated with a clinical syndrome) or nonfunctional tumors are allowed; target lesions must have shown disease progression if therapy included peptide receptor radiotherapy (PRRT) and PRRT must be completed at least 8 weeks prior to registration

  • Radiological evidence for progressive disease (measurable or non-measurable) within 12 months prior to registration; patients who have received anti-tumor therapy during the past 12 months (including octreotide analogs) must have had radiological documentation of progression of disease while on or after receiving therapy

  • No known endobronchial lesions and/or lesions infiltrating major pulmonary vessels that increase the risk of pulmonary hemorrhage; patients with lesions infiltrating major pulmonary vessels (contiguous tumor and vessels) are excluded; however, the presence of a tumor that is touching, but not infiltrating (abutting) the vessels is acceptable (computed tomography [CT] with contrast is strongly recommended to evaluate such lesions); patients with large protruding endobronchial lesions in the main or lobar bronchi are excluded; however, endobronchial lesions in the segmented bronchi are allowed

  • Patients must have measurable disease per RECIST 1.1 by computed tomography (CT) scan or magnetic resonance imaging (MRI); lesions must be accurately measured in at least one dimension (longest diameter to be recorded) as >= 1 cm with CT or MRI (or >= 1.5 cm for lymph nodes); index lesions for the purpose of RECIST 1.1 measurements will not be selected from within the radiation therapy treatment field; however, if there is evidence of disease progression within the radiation treatment field, measurement of the progressing lesions will be documented

  • No prior treatment with an inhibitor of vascular endothelial growth factor (VEGF) or vascular endothelial growth factor receptor (VEGFR)

  • Prior treatment (somatostatin analogs excepted) must be completed at least 2 weeks prior to registration; in addition, prior treatment (somatostatin analogs excepted) must be completed at least 4 weeks prior to initiation of study drug; treatment-related toxicities must have improved to =< grade 1 prior to registration, with the exception of alopecia

  • Concurrent use of somatostatin analogs (SSTa) is allowed, provided that the patient is on a stable dose for at least two months and progressive disease on somatostatin analog has been documented; progression on octreotide is required for patients with tumors arising in the midgut

  • Prior treatment with embolization (including bland embolization, chemoembolization, and selective internal radiation therapy) or ablative therapies is allowed if measurable disease remains outside of the treated area or there is documented disease progression in a treated site; there is no limit on the prior number of procedures; prior liver-directed or other ablative treatment must be completed at least 8 weeks prior to registration; index lesions for the purpose of RECIST 1.1 measurements will not be selected from within the radiation therapy treatment field; however, if there is evidence of disease progression within the radiation treatment field, measurement of the progressing lesions will be documented

  • Patients should have completed any major surgery >= 4 weeks prior to registration and must have completed any minor surgery >= 2 weeks prior to registration; patients must have fully recovered from the procedure

    • The following are examples of procedures considered to be minor: port placement, laparoscopy, thoracoscopy, bronchoscopy, mediastinoscopy, skin biopsies, incisional biopsies, imaging-guided biopsy for diagnostic purposes, and dental extraction procedures
    • Insertion of a vascular access device, thoracentesis, paracentesis, and endoscopic ultrasonographic procedures are not considered to be major or minor surgeries

  • No concurrent condition resulting in immune compromise, including chronic treatment with corticosteroids or other immunosuppressive agents

  • No clinical evidence of central nervous system (CNS) metastases (including carcinomatous meningitis) at baseline, with the exception of those patients who have previously-treated CNS metastases (surgery +/- radiotherapy, radiosurgery, or gamma knife) and who meet both of the following criteria: a) are asymptomatic and b) had no requirement for steroids or enzyme-inducing anticonvulsants within 6 months prior to registration

  • No history of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 28 days prior to registration

  • No clinically significant gastrointestinal abnormalities that may increase the risk for gastrointestinal bleeding within 28 days prior to registration including, but not limited to:

    • Active peptic ulcer
    • Known endoluminal metastatic lesion(s) with history of bleeding
    • Inflammatory bowel disease (e.g. ulcerative colitis, Crohn's disease), or other gastrointestinal conditions with increased risk of perforation

  • No history of serious (i.e., requiring active medical therapy with medication or medical device under the supervision of a physician) non-healing wound, ulcer, trauma, or bone fracture within 28 days prior to study entry

  • Patients with a history of hypertension must have blood pressure that is adequately controlled on antihypertensives; (< 140/90 mm Hg)

  • No symptomatic congestive heart failure (New York Heart Association class II, III, or IV) within 6 months prior to registration

  • No arterial thrombotic events within 6 months of registration, including transient ischemic attack (TIA), cerebrovascular accident (CVA), peripheral arterial thrombus, myocardial infarction (MI), or unstable angina or angina requiring surgical or medical intervention in 6 months prior to registration; patients with clinically significant peripheral artery disease (i.e., claudication on less than one block) are ineligible; patients who have experienced a deep venous thrombosis or pulmonary embolus within 6 months prior to registration must be on stable therapeutic anticoagulation for at least 6 weeks prior to enrollment of this study

  • Patients on therapeutic anticoagulation with low molecular weight heparins, fondaparinux, rivaroxaban or warfarin are eligible, provided that they are on a stable dose of anticoagulants; patients who are currently receiving antiplatelet therapy of prasugrel or clopidogrel or antiaggregation agents (e.g., eptifibatide, epoprostenol, dipyridamole) or low doses of acetylsalicylic acid (up to 100 mg daily) are also eligible

  • No ongoing cardiac dysrhythmias, atrial fibrillation, or prolongation of corrected QT (QTc) interval to > 480 msec

  • No evidence of active bleeding, bleeding diathesis, or hemoptysis (>= 1/2 teaspoon of red blood) within 8 weeks prior to registration

  • No currently unstable angina and/or uncontrolled cardiac arrhythmias

  • Patients with symptomatic peripheral vascular disease are ineligible

  • Ejection fraction on echocardiogram (Echo) or multi gated acquisition scan (MUGA) > 50%

  • Chronic concomitant treatment with strong inhibitors of cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) is not allowed on this trial; patients on strong CYP3A4 inhibitors must discontinue the drug 14 days prior to the start of study treatment

  • Women must not be pregnant or nursing; women of child bearing potential must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of human chorionic gonadotropin [HCG]) within 72 hours prior to registration; women of child-bearing potential include any female who has experienced menarche and who has not undergone surgical sterilization (hysterectomy, bilateral tubal ligation or bilateral oophorectomy) or is not postmenopausal (defined as amenorrhea >= 12 consecutive months; or women on hormone replacement therapy [HRT] with documented serum follicle stimulating hormone [FSH] level > 35 mIU/mL)

  • Age >= 18 years of age

  • Eastern Cooperative Oncology Group (ECOG) performance status 0-1

  • Granulocytes >= 1,500/mcL

  • Platelets >= 100,000/mcL

  • International normalized ratio (INR) =< 1.2 X upper limit of normal (ULN); only required for patients receiving anticoagulant therapy; patients are eligible if their INR is stable and within the recommended range for the desired level of anticoagulation

  • QTc =< 480 msecs

  • Thyroid stimulating hormone (TSH) within normal limits (WNL); medications for thyroid dysfunction are allowed as long as TSH is normal at registration; in patients with abnormal TSH, if the free thyroxine (free T4) and free thyroxine index (FTI) are normal and patient is clinically euthyroid, patient is eligible

  • Bilirubin =< 1.5 x ULN

  • Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) & alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x ULN; concomitant elevations in bilirubin and AST/ALT above 1.0 X ULN are NOT permitted; also, if liver metastases are present, AST & ALT =< 5 x ULN is allowed

  • Serum creatinine =< 1.5 x ULN

  • Urine protein to creatinine ratio < 1, or, 24-hour urine protein < 1 g; if urine protein to creatinine (UPC) >= 1, then a 24-hour urine protein must be assessed; patients must have a 24-hour urine protein value < 1 g to be eligible; use of urine dipstick for renal function assessment is not acceptable

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Crossover tilldelning
  • Maskning: Dubbel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Arm I (pazopanib hydrochloride)

Patients receive pazopanib hydrochloride PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO or MUGA during screening. Patients also undergo CT, MRI, and chest x-ray throughout the trial. Patients may optionally undergo blood sample collection during screening and on study.
Övrig: Laboratory Biomarker Analysis

Correlative studies

Övrig: Quality-of-Life Assessment

Ancillary studies

Andra namn:
  • Livskvalitetsbedömning
Procedur: Biospecimen Collection

Undergo blood sample collection

Andra namn:
  • Biologisk provsamling
  • Bioprov insamlat
  • Provsamling
  • Provuppsamling
Procedur: Computed Tomography

Undergo CT

Andra namn:
  • CT
  • KATT
  • Datortomografi
  • Beräknad axiell tomografi
  • Datoriserad axialtomografi
  • tomografi
  • Datoriserad axiell tomografi (förfarande)
  • Datortomografi (CT) skanning
  • Diagnostisk kattskanning
  • Diagnostisk kattskanningstjänsttyp
Procedur: Magnetic Resonance Imaging

Undergo MRI

Andra namn:
  • MRI
  • Magnetisk resonans
  • Magnetic Resonance Imaging Scan
  • Medicinsk bildbehandling, magnetisk resonans / kärnmagnetisk resonans
  • HERR
  • MR-avbildning
  • MRI-skanning
  • NMR-avbildning
  • NMRI
  • Kärnmagnetisk resonanstomografi
  • Magnetisk resonanstomografi (MRT)
  • sMRI
  • Magnetisk resonanstomografi (förfarande)
  • Strukturell MRI
Läkemedel: Pazopanib Hydrochloride

Given PO

Andra namn:
  • GW786034B
  • Votrient
  • Pazopater
  • GW 786034B
  • GW-786034B
Procedur: Echocardiography Test

Undergo ECHO

Andra namn:
  • Ekokardiografi
  • EC
Procedur: Multigated Acquisition Scan

Undergo MUGA

Andra namn:
  • Blood Pool Scan
  • Jämviktsradionuklidangiografi
  • Gated Blood Pool Imaging
  • MUGA
  • Radionuklidventrikulografi
  • RNVG
  • SYMA-skanning
  • Synchronized Multigated Acquisition Scanning
  • MUGA Scan
  • Multi-Gated Acquisition Scan
  • Radionuklid Ventrikulogram Scan
  • Gated Heart Pool Scan
  • RNV Scan
Procedur: X-Ray Imaging

Undergo chest x-ray

Andra namn:
  • Konventionell röntgen
  • Diagnostisk radiologi
  • Medicinsk bildbehandling, röntgen
  • Röntgenbild
  • Radiografi
  • RG
  • Statisk röntgen
  • Röntgen
  • Enkla filmröntgenbilder
  • Röntgenbildprocedur (procedur)
Placebo-jämförare: Arm II (placebo)

Patients receive placebo PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. At the time of progressive disease, patients may cross-over to Arm I. Patients undergo ECHO or MUGA during screening. Patients also undergo CT, MRI, and chest x-ray throughout the trial. Patients may optionally undergo blood sample collection during screening and on study.
Övrig: Laboratory Biomarker Analysis

Correlative studies

Övrig: Quality-of-Life Assessment

Ancillary studies

Andra namn:
  • Livskvalitetsbedömning
Procedur: Biospecimen Collection

Undergo blood sample collection

Andra namn:
  • Biologisk provsamling
  • Bioprov insamlat
  • Provsamling
  • Provuppsamling
Procedur: Computed Tomography

Undergo CT

Andra namn:
  • CT
  • KATT
  • Datortomografi
  • Beräknad axiell tomografi
  • Datoriserad axialtomografi
  • tomografi
  • Datoriserad axiell tomografi (förfarande)
  • Datortomografi (CT) skanning
  • Diagnostisk kattskanning
  • Diagnostisk kattskanningstjänsttyp
Procedur: Magnetic Resonance Imaging

Undergo MRI

Andra namn:
  • MRI
  • Magnetisk resonans
  • Magnetic Resonance Imaging Scan
  • Medicinsk bildbehandling, magnetisk resonans / kärnmagnetisk resonans
  • HERR
  • MR-avbildning
  • MRI-skanning
  • NMR-avbildning
  • NMRI
  • Kärnmagnetisk resonanstomografi
  • Magnetisk resonanstomografi (MRT)
  • sMRI
  • Magnetisk resonanstomografi (förfarande)
  • Strukturell MRI
Övrig: Placebo Administration

Given PO

Procedur: Echocardiography Test

Undergo ECHO

Andra namn:
  • Ekokardiografi
  • EC
Procedur: Multigated Acquisition Scan

Undergo MUGA

Andra namn:
  • Blood Pool Scan
  • Jämviktsradionuklidangiografi
  • Gated Blood Pool Imaging
  • MUGA
  • Radionuklidventrikulografi
  • RNVG
  • SYMA-skanning
  • Synchronized Multigated Acquisition Scanning
  • MUGA Scan
  • Multi-Gated Acquisition Scan
  • Radionuklid Ventrikulogram Scan
  • Gated Heart Pool Scan
  • RNV Scan
Procedur: X-Ray Imaging

Undergo chest x-ray

Andra namn:
  • Konventionell röntgen
  • Diagnostisk radiologi
  • Medicinsk bildbehandling, röntgen
  • Röntgenbild
  • Radiografi
  • RG
  • Statisk röntgen
  • Röntgen
  • Enkla filmröntgenbilder
  • Röntgenbildprocedur (procedur)

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Progression-free Survival (PFS)
Tidsram: From date of patient entry until documented progression of disease or death from any cause, assessed up to 5 years

PFS will be measured from date of patient entry until documented progression of disease as determined by central review or death from any cause. If a patient does not have a documented date of progression or death, then PFS will be censored at the date of last adequate assessment. PFS will be estimated within treatment arm using the Kaplan-Meier method. Progression is defined as any new lesion or increase by ≥20% of previously involved sites from nadir based on RECIST criteria.
From date of patient entry until documented progression of disease or death from any cause, assessed up to 5 years

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Best Response
Tidsram: Up to 5 years

The best response per RECIST 1.1 criteria of participants receiving randomized treatment assignment. Complete response (CR): Disappearance of all evidence of disease, Partial response (PR): Regression of measurable disease and no new sites, Stable disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD taking as references the smallest sum diameters while on study. Progressive disease (PD): Any new lesion or increase by ≥20% of previously involved sites from nadir. Note that those considered evaluable for best response here were those who had disease measurements while on treatment. Those who discontinued therapy early prior to a disease evaluation were not included.
Up to 5 years
Overall Survival
Tidsram: From randomization until death from any cause, assessed up to 5 years

Overall survival (OS) will be measured from randomization until death from any cause. A patient who is alive at the time of the statistical analysis will be considered censored at the last date of known contact. OS will be estimated by the Kaplan-Meier method within each treatment arm.
From randomization until death from any cause, assessed up to 5 years
Duration of Response for the Subset of Patients With a Confirmed Complete Response or Partial Response
Tidsram: From first documented evidence of complete response or partial response until first documented disease progression or death from any cause, assessed up to 5 years

Duration of response is defined as the time from documented response to time of progression and/or death. This time-to-event outcome will be summarized descriptively using the methods of Kaplan and Meier to characterize the cohort and distribution of this outcome.
From first documented evidence of complete response or partial response until first documented disease progression or death from any cause, assessed up to 5 years
Time to Treatment Failure
Tidsram: From randomization until termination of protocol therapy for any reason including progression of disease, adverse events, and death, assessed up to 5 years

Time to treatment failure is defined as the time from randomization to the time that treatment is terminated, including the reasons of disease progression, adverse events, withdrawal from study, or death. This time-to-event outcome will be evaluated using the methods of Kaplan and Meier.
From randomization until termination of protocol therapy for any reason including progression of disease, adverse events, and death, assessed up to 5 years

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Time to Second Progression for Patients Who Crossover From Placebo to Active Therapy
Tidsram: Up to 5 years

Time to second progression will be defined as the progression free survival from crossover re-registration to documented progression of disease as determined by central review or death from any cause. If a patient does not have a documented date of progression or death, then PFS will be censored at the date of last adequate assessment. PFS will be estimated within treatment arm using the Kaplan-Meier method. Progression is defined as any new lesion or increase by ≥20% of previously involved sites from nadir based on RECIST criteria.
Up to 5 years
PFS Within Each Arm
Tidsram: At 6 months

Kaplan-Meier methods will be used including calculations of 95% confidence intervals.
At 6 months
Biochemical Response
Tidsram: Up to 5 years

Biochemical response (for chromogranin A, defined as a decrease of 50% or more in chromogranin A levels from baseline, and for 5-hydroxyindoleacetic acid [5-HIAA], defined as a decrease of 50% or more in urinary 5-HIAA levels from baseline) will be compared between treatment arms among patients with elevated baseline levels of serum chromogranin A (CGA) and 5-HIAA.
Up to 5 years

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

National Cancer Institute (NCI)

Utredare

  • Huvudutredare: Emily K Bergsland, Alliance for Clinical Trials in Oncology

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

20 september 2013

Primärt slutförande (Faktisk)

5 mars 2019

Avslutad studie (Beräknad)

10 september 2027

Studieregistreringsdatum

Först inskickad

24 april 2013

Först inskickad som uppfyllde QC-kriterierna

24 april 2013

Första postat (Beräknad)

26 april 2013

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

6 oktober 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

11 september 2026

Senast verifierad

1 september 2026

Mer information

Termer relaterade till denna studie

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • NCI-2013-00831
  • U10CA180821 (U.S.S. NIH-anslag/kontrakt)
  • U10CA180830 (U.S.S. NIH-anslag/kontrakt)
  • U10CA031946 (U.S.S. NIH-anslag/kontrakt)
  • NCI-2013-00831 (Registeridentifierare: CTRP (Clinical Trial Reporting Program))
  • ALLIANCE A021202
  • CALGB-A021202
  • A021202 (Annan identifierare: CTEP)
  • A021202 (Annan identifierare: Alliance for Clinical Trials in Oncology)

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

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