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PDIGREE 研究，Nivolumab 和 Ipilimumab 的免疫疗法，然后是 Nivolumab 或 Nivolumab 和 Cabozantinib 用于晚期肾癌患者

2026年10月23日更新者：National Cancer Institute (NCI)

PD 抑制剂 (Nivolumab) 和 Ipilimumab 随后是 Nivolumab 对比 VEGF TKI Cabozantinib 和 Nivolumab：转移性未治疗肾细胞癌的 III 期试验 [PDIGREE]

This phase III trial compares the usual treatment (treatment with ipilimumab and nivolumab followed by nivolumab alone) to treatment with ipilimumab and nivolumab, followed by nivolumab with cabozantinib in patients with untreated renal cell carcinoma that has spread to other parts of the body. The addition of cabozantinib to the usual treatment may make it work better. Immunotherapy with monoclonal antibodies, such as nivolumab and ipilimumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Cabozantinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known how well the combination of cabozantinib and nivolumab after initial treatment with ipilimumab and nivolumab works in treating patients with renal cell cancer that has spread to other parts of the body.

研究概览

地位

主动，不招人

条件

干预/治疗

详细说明

PRIMARY OBJECTIVE:

I. To compare the overall survival (OS) in patients with metastatic renal cell cancer (RCC) treated with ipilimumab-nivolumab followed by either nivolumab versus cabozantinib-nivolumab.

SECONDARY OBJECTIVES:

I. To determine progression free survival (PFS) of patients treated with nivolumab versus nivolumab-cabozantinib.

II. To evaluate the 12-month complete response rate in patients treated with ipilimumab-nivolumab followed by cabozantinib-nivolumab versus ipilimumab-nivolumab followed by nivolumab (patients who have complete response [CR] and relapse before 12 months will not be counted as a CR at 12-months).

III. To evaluate the rates of discontinuing therapy at 1 year. IV. To compare objective response rates (ORR, assessed by Response Evaluation Criteria in Solid Tumors [RECIST] 1.1 and Immune Response Evaluation Criteria in Solid Tumors [iRECIST] criteria) for patients treated with ipilimumab-nivolumab followed by cabozantinib-nivolumab versus ipilimumab-nivolumab followed by nivolumab.

V. To document the adverse event profile of ipilimumab-nivolumab followed by cabozantinib-nivolumab.

BIOMARKER OBJECTIVES:

I. To evaluate biomarkers associated with exceptional responses in both arms (exceptional responses defined as CRs with treatment discontinuation at 12 months or 24 months).

II. To evaluate whether baseline IL-6 is predictive of outcome in patients treated with cabozantinib-containing regimen.

QUALITY OF LIFE (QOL) OBJECTIVES:

I. To compare health-related quality of life at 18 months post-registration as assessed by the Functional Assessment of Cancer Therapy (FACT)-Kidney Symptom Index 19 (FKSI-19) between patients randomized to nivolumab (nivo) versus (vs) cabozantinib (cabo)/nivo.

II. To compare health-related quality of life as assessed by the FKSI-19 between patients randomized to nivo vs cabo/nivo at other time points.

III. To compare patient-reported fatigue using Patient-Reported Outcomes Measurement Information System (PROMIS)-Fatigue between patients randomized to nivo vs cabo/nivo.

IV. To compare quality-adjusted survival (overall survival x utility score assessed by EuroQol five-dimensional questionnaire [EQ5D-5L]) between patients randomized to nivo vs cabo/nivo.

OUTLINE:

INDUCTION: Patients receive nivolumab intravenously (IV) over 30 minutes and ipilimumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity.

TREATMENT:

Patients with unconfirmed but clinical progression of disease (iuPD) with clinical instability receive cabozantinib orally (PO) daily on days 1-28. Treatment repeats every 28 days until further disease progression or unacceptable toxicity.

Patients with unconfirmed CR (iCR) receive nivolumab IV between 30-60 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Patients with non-CR/non-PD or iuPD with clinical stability are randomized to 1 of 2 arms.

ARM A: Patients receive nivolumab IV between 30-60 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

ARM B: Patients receive nivolumab IV between 30-60 minutes on day 1 and cabozantinib PO daily on days 1-28. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Patients undergo computed tomography (CT) scan, magnetic resonance imaging (MRI) and blood and urine sample collection, and may also undergo a bone scan as clinically indicated throughout the study.

研究类型

介入性

注册 (估计的)

1175

阶段

第三阶段

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习地点

波多黎各
- - San Juan、波多黎各、00902
    - Pan American Center for Oncology Trials LLC
美国
- Alabama
  - Mobile、Alabama、美国、36688
    - University of South Alabama Mitchell Cancer Institute
- Alaska
  - Anchorage、Alaska、美国、98508
    - Anchorage Associates in Radiation Medicine
  - Anchorage、Alaska、美国、99508
    - Alaska Breast Care and Surgery LLC
  - Anchorage、Alaska、美国、99508
    - Alaska Oncology and Hematology LLC
  - Anchorage、Alaska、美国、99508
    - Alaska Women's Cancer Care
  - Anchorage、Alaska、美国、99508
    - Anchorage Oncology Centre
  - Anchorage、Alaska、美国、99508
    - Katmai Oncology Group
  - Anchorage、Alaska、美国、99508
    - Providence Alaska Medical Center
  - Anchorage、Alaska、美国、99504
    - Anchorage Radiation Therapy Center
  - Fairbanks、Alaska、美国、99701
    - Fairbanks Memorial Hospital
- Arizona
  - Kingman、Arizona、美国、86401
    - Kingman Regional Medical Center
  - Phoenix、Arizona、美国、85004
    - Cancer Center at Saint Joseph's
- Arkansas
  - Fayetteville、Arkansas、美国、72703
    - Highlands Oncology Group - Fayetteville
  - Fort Smith、Arkansas、美国、72903
    - Mercy Hospital Fort Smith
  - Hot Springs、Arkansas、美国、71913
    - CHI Saint Vincent Cancer Center Hot Springs
  - Rogers、Arkansas、美国、72758
    - Highlands Oncology Group - Rogers
  - Springdale、Arkansas、美国、72762
    - Highlands Oncology Group
- California
  - Anaheim、California、美国、92806
    - Kaiser Permanente-Anaheim
  - Arroyo Grande、California、美国、93420
    - PCR Oncology
  - Arroyo Grande、California、美国、93420
    - Mission Hope Medical Oncology - Arroyo Grande
  - Baldwin Park、California、美国、91706
    - Kaiser Permanente-Baldwin Park
  - Bellflower、California、美国、90706
    - Kaiser Permanente-Bellflower
  - Burbank、California、美国、91505
    - Providence Saint Joseph Medical Center/Disney Family Cancer Center
  - Clovis、California、美国、93611
    - Community Cancer Institute
  - Clovis、California、美国、93611
    - University Oncology Associates
  - Fontana、California、美国、92335
    - Kaiser Permanente-Fontana
  - Harbor City、California、美国、90710
    - Kaiser Permanente South Bay
  - Irvine、California、美国、92618
    - Kaiser Permanente-Irvine
  - La Jolla、California、美国、92093
    - UC San Diego Moores Cancer Center
  - Los Angeles、California、美国、90027
    - Kaiser Permanente Los Angeles Medical Center
  - Los Angeles、California、美国、90034
    - Kaiser Permanente West Los Angeles
  - Ontario、California、美国、91761
    - Kaiser Permanente-Ontario
  - Panorama City、California、美国、91402
    - Kaiser Permanente - Panorama City
  - Riverside、California、美国、92505
    - Kaiser Permanente-Riverside
  - Sacramento、California、美国、95817
    - University of California Davis Comprehensive Cancer Center
  - San Diego、California、美国、92120
    - Kaiser Permanente-San Diego Zion
  - San Diego、California、美国、92134
    - Naval Medical Center -San Diego
  - San Diego、California、美国、92123
    - Sharp Memorial Hospital
  - San Diego、California、美国、92108
    - Kaiser Permanente-Rio San Diego
  - San Francisco、California、美国、94158
    - UCSF Medical Center-Mission Bay
  - San Luis Obispo、California、美国、93401
    - Pacific Central Coast Health Center-San Luis Obispo
  - San Marcos、California、美国、92078
    - Kaiser Permanente-San Marcos
  - Santa Maria、California、美国、93444
    - Mission Hope Medical Oncology - Santa Maria
  - Woodland Hills、California、美国、91367
    - Kaiser Permanente-Woodland Hills
- Colorado
  - Aurora、Colorado、美国、80012
    - Rocky Mountain Cancer Centers-Aurora
  - Aurora、Colorado、美国、80012
    - The Medical Center of Aurora
  - Aurora、Colorado、美国、80045
    - UCHealth University of Colorado Hospital
  - Boulder、Colorado、美国、80303
    - Boulder Community Foothills Hospital
  - Boulder、Colorado、美国、80304
    - Rocky Mountain Cancer Centers-Boulder
  - Centennial、Colorado、美国、80112
    - Rocky Mountain Cancer Centers - Centennial
  - Colorado Springs、Colorado、美国、80907
    - Penrose-Saint Francis Healthcare
  - Colorado Springs、Colorado、美国、80909
    - UCHealth Memorial Hospital Central
  - Colorado Springs、Colorado、美国、80907
    - Rocky Mountain Cancer Centers-Penrose
  - Colorado Springs、Colorado、美国、80920
    - Memorial Hospital North
  - Denver、Colorado、美国、80205
    - Kaiser Permanente-Franklin
  - Denver、Colorado、美国、80218
    - Presbyterian - Saint Lukes Medical Center - Health One
  - Denver、Colorado、美国、80220
    - Rose Medical Center
  - Denver、Colorado、美国、80218
    - Rocky Mountain Cancer Centers-Midtown
  - Denver、Colorado、美国、80220
    - Rocky Mountain Cancer Centers-Rose
  - Denver、Colorado、美国、80218
    - Colorado Blood Cancer Institute
  - Denver、Colorado、美国、80204
    - Cancer Center of Colorado at Sloan's Lake
  - Denver、Colorado、美国、80209
    - The Women's Imaging Center
  - Denver、Colorado、美国、80206
    - National Jewish Health-Main Campus
  - Denver、Colorado、美国、80220
    - Western Surgical Care
  - Denver、Colorado、美国、80206
    - UCHealth - Cherry Creek
  - Denver、Colorado、美国、80218
    - Saint Joseph Hospital - Cancer Centers of Colorado
  - Denver、Colorado、美国、80210
    - AdventHealth Porter
  - Durango、Colorado、美国、81301
    - Mercy Medical Center
  - Durango、Colorado、美国、81301
    - CommonSpirit Cancer Center Mercy
  - Englewood、Colorado、美国、80113
    - Mountain Blue Cancer Care Center - Swedish
  - Englewood、Colorado、美国、80113
    - Swedish Medical Center
  - Englewood、Colorado、美国、80113
    - Rocky Mountain Cancer Centers - Swedish
  - Englewood、Colorado、美国、80113
    - The Melanoma and Skin Cancer Institute
  - Fort Collins、Colorado、美国、80524
    - Poudre Valley Hospital
  - Fort Collins、Colorado、美国、80528
    - Cancer Care and Hematology-Fort Collins
  - Golden、Colorado、美国、80401
    - National Jewish Health-Western Hematology Oncology
  - Grand Junction、Colorado、美国、81501
    - Saint Mary's Hospital and Regional Medical Center
  - Greeley、Colorado、美国、80631
    - UCHealth Greeley Hospital
  - Greeley、Colorado、美国、80631
    - Banner North Colorado Medical Center
  - Highlands Ranch、Colorado、美国、80129
    - UCHealth Highlands Ranch Hospital
  - Lafayette、Colorado、美国、80026
    - Kaiser Permanente-Rock Creek
  - Lafayette、Colorado、美国、80026
    - Good Samaritan Hospital - Cancer Centers of Colorado
  - Lakewood、Colorado、美国、80228
    - Rocky Mountain Cancer Centers-Lakewood
  - Lakewood、Colorado、美国、80228
    - CommonSpirit Saint Anthony Hospital Cancer Center
  - Littleton、Colorado、美国、80120
    - Rocky Mountain Cancer Centers-Littleton
  - Littleton、Colorado、美国、80122
    - AdventHealth Littleton
  - Lone Tree、Colorado、美国、80124
    - Kaiser Permanente-Lone Tree
  - Lone Tree、Colorado、美国、80124
    - Sky Ridge Medical Center
  - Lone Tree、Colorado、美国、80124
    - Rocky Mountain Cancer Centers-Sky Ridge
  - Lone Tree、Colorado、美国、80124
    - UCHealth Lone Tree Health Center
  - Longmont、Colorado、美国、80501
    - Longmont United Hospital
  - Longmont、Colorado、美国、80501
    - Rocky Mountain Cancer Centers-Longmont
  - Loveland、Colorado、美国、80538
    - Medical Center of the Rockies
  - Loveland、Colorado、美国、80539
    - Banner North Colorado Medical Center - Loveland Campus
  - Parker、Colorado、美国、80138
    - AdventHealth Parker
  - Pueblo、Colorado、美国、81004
    - Saint Mary Corwin Medical Center
  - Thornton、Colorado、美国、80260
    - Rocky Mountain Cancer Centers-Thornton
  - Thornton、Colorado、美国、80260
    - National Jewish Health-Northern Hematology Oncology
  - Wheat Ridge、Colorado、美国、80401
    - Intermountain Health Lutheran Hospital
- Connecticut
  - Stamford、Connecticut、美国、06904
    - Stamford Hospital/Bennett Cancer Center
- Delaware
  - Lewes、Delaware、美国、19958
    - Beebe Medical Center
  - Millville、Delaware、美国、19967
    - Beebe South Coastal Health Campus
  - Newark、Delaware、美国、19713
    - Helen F Graham Cancer Center
  - Newark、Delaware、美国、19713
    - Delaware Clinical and Laboratory Physicians PA
  - Newark、Delaware、美国、19713
    - Medical Oncology Hematology Consultants PA
  - Newark、Delaware、美国、19718
    - Christiana Care Health System-Christiana Hospital
  - Rehoboth Beach、Delaware、美国、19971
    - Beebe Health Campus
  - Seaford、Delaware、美国、19973
    - TidalHealth Nanticoke / Allen Cancer Center
  - Wilmington、Delaware、美国、19801
    - Christiana Care Health System-Wilmington Hospital
- District of Columbia
  - Washington D.C.、District of Columbia、美国、20037
    - George Washington University Medical Center
  - Washington D.C.、District of Columbia、美国、20010
    - MedStar Washington Hospital Center
  - Washington D.C.、District of Columbia、美国、20007
    - MedStar Georgetown University Hospital
- Florida
  - Coral Gables、Florida、美国、33146
    - UM Sylvester Comprehensive Cancer Center at Coral Gables
  - Deerfield Beach、Florida、美国、33442
    - UM Sylvester Comprehensive Cancer Center at Deerfield Beach
  - Fort Lauderdale、Florida、美国、33308
    - Holy Cross Hospital
  - Gainesville、Florida、美国、32610
    - UF Health Cancer Institute - Gainesville
  - Miami、Florida、美国、33136
    - University of Miami Miller School of Medicine-Sylvester Cancer Center
  - Miami、Florida、美国、33176
    - UM Sylvester Comprehensive Cancer Center at Kendall
  - Orlando、Florida、美国、32806
    - Orlando Health Cancer Institute
  - Plantation、Florida、美国、33324
    - UM Sylvester Comprehensive Cancer Center at Plantation
- Georgia
  - Atlanta、Georgia、美国、30342
    - Northside Hospital
  - Duluth、Georgia、美国、30096
    - Northside Hospital - Duluth
  - Lawrenceville、Georgia、美国、30046
    - Northside Hospital - Gwinnett
  - Savannah、Georgia、美国、31405
    - Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
  - Snellville、Georgia、美国、30078
    - Suburban Hematology Oncology Associates - Snellville
- Hawaii
  - Honolulu、Hawaii、美国、96813
    - Queen's Medical Center
  - Honolulu、Hawaii、美国、96817
    - The Cancer Center of Hawaii-Liliha
  - Honolulu、Hawaii、美国、96813
    - Hawaii Cancer Care Inc - Waterfront Plaza
  - Honolulu、Hawaii、美国、96813
    - Queen's Cancer Cenrer - POB I
  - Honolulu、Hawaii、美国、96813
    - Straub Clinic and Hospital
  - Honolulu、Hawaii、美国、96813
    - University of Hawaii Cancer Center
  - Honolulu、Hawaii、美国、96817
    - Queen's Cancer Center - Kuakini
  - Honolulu、Hawaii、美国、96826
    - Kapiolani Medical Center for Women and Children
  - Honolulu、Hawaii、美国、96813
    - Island Urology
  - Lihue、Hawaii、美国、96766
    - Wilcox Memorial Hospital and Kauai Medical Clinic
  - ‘Aiea、Hawaii、美国、96701
    - Hawaii Cancer Care - Westridge
  - ‘Aiea、Hawaii、美国、96701
    - Pali Momi Medical Center
  - ‘Aiea、Hawaii、美国、96701
    - Queen's Cancer Center - Pearlridge
  - ‘Aiea、Hawaii、美国、96701
    - The Cancer Center of Hawaii-Pali Momi
- Idaho
  - Boise、Idaho、美国、83706
    - Saint Alphonsus Cancer Care Center-Boise
  - Boise、Idaho、美国、83712
    - Saint Luke's Cancer Institute - Boise
  - Caldwell、Idaho、美国、83605
    - Saint Alphonsus Cancer Care Center-Caldwell
  - Coeur d'Alene、Idaho、美国、83814
    - Kootenai Health - Coeur d'Alene
  - Emmett、Idaho、美国、83617
    - Walter Knox Memorial Hospital
  - Fruitland、Idaho、美国、83619
    - Saint Luke's Cancer Institute - Fruitland
  - Meridian、Idaho、美国、83642
    - Idaho Urologic Institute-Meridian
  - Meridian、Idaho、美国、83642
    - Saint Luke's Cancer Institute - Meridian
  - Nampa、Idaho、美国、83687
    - Saint Alphonsus Cancer Care Center-Nampa
  - Nampa、Idaho、美国、83687
    - Saint Luke's Cancer Institute - Nampa
  - Post Falls、Idaho、美国、83854
    - Kootenai Clinic Cancer Services - Post Falls
  - Sandpoint、Idaho、美国、83864
    - Kootenai Clinic Cancer Services - Sandpoint
  - Twin Falls、Idaho、美国、83301
    - Saint Luke's Cancer Institute - Twin Falls
- Illinois
  - Alton、Illinois、美国、62002
    - OSF Saint Anthony's Health Center
  - Aurora、Illinois、美国、60504
    - Rush-Copley Medical Center
  - Bloomington、Illinois、美国、61704
    - Illinois CancerCare-Bloomington
  - Burr Ridge、Illinois、美国、60527
    - Loyola Center for Health at Burr Ridge
  - Canton、Illinois、美国、61520
    - Illinois CancerCare-Canton
  - Carbondale、Illinois、美国、62902
    - Memorial Hospital of Carbondale
  - Carterville、Illinois、美国、62918
    - SIH Cancer Institute
  - Carthage、Illinois、美国、62321
    - Illinois CancerCare-Carthage
  - Centralia、Illinois、美国、62801
    - Centralia Oncology Clinic
  - Chicago、Illinois、美国、60611
    - Northwestern University
  - Chicago、Illinois、美国、60637
    - University of Chicago Comprehensive Cancer Center
  - Chicago、Illinois、美国、60612
    - John H Stroger Jr Hospital of Cook County
  - Chicago、Illinois、美国、60612
    - Rush MD Anderson Cancer Center
  - Danville、Illinois、美国、61832
    - Carle at The Riverfront
  - DeKalb、Illinois、美国、60115
    - Northwestern Medicine Cancer Center Kishwaukee
  - Decatur、Illinois、美国、62526
    - Decatur Memorial Hospital
  - Decatur、Illinois、美国、62526
    - Cancer Care Specialists of Illinois - Decatur
  - Dixon、Illinois、美国、61021
    - Illinois CancerCare-Dixon
  - Effingham、Illinois、美国、62401
    - Crossroads Cancer Center
  - Effingham、Illinois、美国、62401
    - Carle Physician Group-Effingham
  - Elmhurst、Illinois、美国、60126
    - Elmhurst Memorial Hospital
  - Eureka、Illinois、美国、61530
    - Illinois CancerCare-Eureka
  - Galesburg、Illinois、美国、61401
    - Western Illinois Cancer Treatment Center
  - Galesburg、Illinois、美国、61401
    - Illinois CancerCare-Galesburg
  - Geneva、Illinois、美国、60134
    - Northwestern Medicine Cancer Center Delnor
  - Harvey、Illinois、美国、60426
    - Ingalls Memorial Hospital
  - Homer Glen、Illinois、美国、60491
    - Loyola Medicine Homer Glen
  - Joliet、Illinois、美国、60435
    - Duly Health and Care Joliet
  - Kewanee、Illinois、美国、61443
    - Illinois CancerCare-Kewanee Clinic
  - Lake Forest、Illinois、美国、60045
    - Northwestern Medicine Lake Forest Hospital
  - Macomb、Illinois、美国、61455
    - Illinois CancerCare-Macomb
  - Mattoon、Illinois、美国、61938
    - Carle Physician Group-Mattoon/Charleston
  - Maywood、Illinois、美国、60153
    - Loyola University Medical Center
  - Melrose Park、Illinois、美国、60160
    - Marjorie Weinberg Cancer Center at Loyola-Gottlieb
  - Mount Vernon、Illinois、美国、62864
    - SSM Health Good Samaritan
  - Naperville、Illinois、美国、60540
    - Edward Hospital/Cancer Center
  - New Lenox、Illinois、美国、60451
    - UC Comprehensive Cancer Center at Silver Cross
  - O'Fallon、Illinois、美国、62269
    - Cancer Care Center of O'Fallon
  - Orland Park、Illinois、美国、60462
    - University of Chicago Medicine-Orland Park
  - Orland Park、Illinois、美国、60462
    - Northwestern Medicine Orland Park
  - Ottawa、Illinois、美国、61350
    - Illinois CancerCare-Ottawa Clinic
  - Pekin、Illinois、美国、61554
    - Illinois CancerCare-Pekin
  - Peoria、Illinois、美国、61636
    - Methodist Medical Center of Illinois
  - Peoria、Illinois、美国、61615
    - Illinois CancerCare-Peoria
  - Peru、Illinois、美国、61354
    - Illinois CancerCare-Peru
  - Peru、Illinois、美国、61354
    - Valley Radiation Oncology
  - Plainfield、Illinois、美国、60585
    - Edward Hospital/Cancer Center?Plainfield
  - Princeton、Illinois、美国、61356
    - Illinois CancerCare-Princeton
  - Rockford、Illinois、美国、61114
    - UW Health Carbone Cancer Center Rockford
  - Shiloh、Illinois、美国、62269
    - Memorial Hospital East
  - Springfield、Illinois、美国、62702
    - Southern Illinois University School of Medicine
  - Springfield、Illinois、美国、62702
    - Springfield Clinic
  - Springfield、Illinois、美国、62781
    - Springfield Memorial Hospital
  - Swansea、Illinois、美国、62226
    - Southwest Illinois Health Services LLP
  - Urbana、Illinois、美国、61801
    - Carle Cancer Center
  - Urbana、Illinois、美国、61801
    - The Carle Foundation Hospital
  - Warrenville、Illinois、美国、60555
    - Northwestern Medicine Cancer Center Warrenville
  - Washington、Illinois、美国、61571
    - Illinois CancerCare - Washington
  - Yorkville、Illinois、美国、60560
    - Rush-Copley Healthcare Center
- Indiana
  - Indianapolis、Indiana、美国、46237
    - Franciscan Health Indianapolis
  - Indianapolis、Indiana、美国、46202
    - Indiana University/Melvin and Bren Simon Cancer Center
  - Indianapolis、Indiana、美国、46202
    - Sidney and Lois Eskenazi Hospital
  - Michigan City、Indiana、美国、46360
    - Woodland Cancer Care Center
  - Mooresville、Indiana、美国、46158
    - Franciscan Health Mooresville
  - Richmond、Indiana、美国、47374
    - Reid Health
- Iowa
  - Ames、Iowa、美国、50010
    - Mary Greeley Medical Center
  - Ames、Iowa、美国、50010
    - McFarland Clinic - Ames
  - Ankeny、Iowa、美国、50023
    - UI Health Care Mission Cancer and Blood - Ankeny Clinic
  - Boone、Iowa、美国、50036
    - McFarland Clinic - Boone
  - Carroll、Iowa、美国、51401
    - Saint Anthony Regional Hospital
  - Clive、Iowa、美国、50325
    - Mercy Cancer Center-West Lakes
  - Clive、Iowa、美国、50325
    - UI Health Care Mission Cancer and Blood - West Des Moines Clinic
  - Council Bluffs、Iowa、美国、51503
    - Alegent Health Mercy Hospital
  - Creston、Iowa、美国、50801
    - Greater Regional Medical Center
  - Des Moines、Iowa、美国、50309
    - Iowa Methodist Medical Center
  - Des Moines、Iowa、美国、50314
    - Mercy Medical Center - Des Moines
  - Des Moines、Iowa、美国、50314
    - Broadlawns Medical Center
  - Des Moines、Iowa、美国、50316
    - Iowa Lutheran Hospital
  - Des Moines、Iowa、美国、50309
    - UI Health Care Mission Cancer and Blood - Des Moines Clinic
  - Des Moines、Iowa、美国、50314
    - UI Health Care Mission Cancer and Blood - Laurel Clinic
  - Fort Dodge、Iowa、美国、50501
    - McFarland Clinic - Trinity Cancer Center
  - Fort Dodge、Iowa、美国、50501
    - UI Healthcare Mission Cancer and Blood - Fort Dodge
  - Jefferson、Iowa、美国、50129
    - McFarland Clinic - Jefferson
  - Marshalltown、Iowa、美国、50158
    - McFarland Clinic - Marshalltown
  - Sioux City、Iowa、美国、51101
    - Siouxland Regional Cancer Center
  - West Des Moines、Iowa、美国、50266-7700
    - Methodist West Hospital
  - West Des Moines、Iowa、美国、50266
    - Mercy Medical Center-West Lakes
- Kansas
  - Fairway、Kansas、美国、66205
    - University of Kansas Clinical Research Center
  - Garden City、Kansas、美国、67846
    - Central Care Cancer Center - Garden City
  - Great Bend、Kansas、美国、67530
    - Central Care Cancer Center - Great Bend
  - Hays、Kansas、美国、67601
    - HaysMed
  - Lawrence、Kansas、美国、66044
    - Lawrence Memorial Hospital
  - Lenexa、Kansas、美国、66219
    - Kansas Institute of Medicine Cancer and Blood Center
  - Lenexa、Kansas、美国、66219
    - Minimally Invasive Surgery Hospital
  - Olathe、Kansas、美国、66061
    - The University of Kansas Cancer Center - Olathe
  - Overland Park、Kansas、美国、66210
    - University of Kansas Cancer Center-Overland Park
  - Overland Park、Kansas、美国、66209
    - Menorah Medical Center
  - Parsons、Kansas、美国、67357
    - Cancer Center of Kansas - Parsons
  - Pittsburg、Kansas、美国、66762
    - Freeman Physician Group of Pittsburg
  - Pittsburg、Kansas、美国、66762
    - Mercy Hospital Pittsburg
  - Salina、Kansas、美国、67401
    - Salina Regional Health Center
  - Topeka、Kansas、美国、66606
    - University of Kansas Health System Saint Francis Campus
  - Westwood、Kansas、美国、66205
    - University of Kansas Hospital-Westwood Cancer Center
  - Wichita、Kansas、美国、67214
    - Ascension Via Christi Hospitals Wichita
  - Wichita、Kansas、美国、67208
    - Cancer Center of Kansas-Wichita Medical Arts Tower
  - Wichita、Kansas、美国、67214
    - Cancer Center of Kansas - Wichita
- Kentucky
  - Bardstown、Kentucky、美国、40004
    - CommonSpirit Saint Joseph Hospital - Bardstown
  - Corbin、Kentucky、美国、40701
    - Commonwealth Cancer Center-Corbin
  - Lexington、Kentucky、美国、40536
    - University of Kentucky/Markey Cancer Center
  - Lexington、Kentucky、美国、40504
    - Saint Joseph Radiation Oncology Resource Center
  - Lexington、Kentucky、美国、40509
    - CommonSpirit Saint Joseph Medical Center - East Lexington
  - London、Kentucky、美国、40741
    - CommonSpirit Saint Joseph Hospital London
  - Louisville、Kentucky、美国、40202
    - Jewish Hospital
  - Louisville、Kentucky、美国、40245
    - UofL Health Medical Center Northeast
  - Louisville、Kentucky、美国、40207
    - Baptist Health Louisville
  - Louisville、Kentucky、美国、40215
    - Saints Mary and Elizabeth Hospital
  - Shepherdsville、Kentucky、美国、40165
    - Jewish Hospital Medical Center South
- Louisiana
  - Baton Rouge、Louisiana、美国、70805
    - LSU Health Baton Rouge-North Clinic
  - Baton Rouge、Louisiana、美国、70809
    - Louisiana Hematology Oncology Associates LLC
  - Baton Rouge、Louisiana、美国、70809
    - Mary Bird Perkins Cancer Center
  - Baton Rouge、Louisiana、美国、70836
    - Ochsner High Grove
  - Baton Rouge、Louisiana、美国、70809
    - Hematology/Oncology Clinic PLLC
  - Baton Rouge、Louisiana、美国、70808
    - Our Lady of The Lake
  - Baton Rouge、Louisiana、美国、70808
    - Our Lady of the Lake Physician Group
  - Covington、Louisiana、美国、70433
    - Northshore Oncology Associates-Covington
  - Covington、Louisiana、美国、70433
    - Ochsner Hematology Oncology North Shore - Covington (West Region)
  - Houma、Louisiana、美国、70360
    - Terrebonne General Medical Center
  - Houma、Louisiana、美国、70360
    - Oncology Center of The South Incorporated
  - Metairie、Louisiana、美国、70006
    - East Jefferson General Hospital
  - Metairie、Louisiana、美国、70006
    - LSU Healthcare Network / Metairie Multi-Specialty Clinic
  - Monroe、Louisiana、美国、71202
    - Ochsner LSU Health Monroe Medical Center
  - New Orleans、Louisiana、美国、70112
    - Tulane University School of Medicine
  - New Orleans、Louisiana、美国、70121
    - Ochsner Medical Center Jefferson
  - New Orleans、Louisiana、美国、70112
    - University Medical Center New Orleans
  - New Orleans、Louisiana、美国、70112
    - Louisiana State University Health Science Center
  - New Orleans、Louisiana、美国、70115
    - Touro Infirmary
  - Shreveport、Louisiana、美国、71103
    - LSU Health Sciences Center at Shreveport
- Maine
  - Augusta、Maine、美国、04330
    - Harold Alfond Center for Cancer Care
  - Belfast、Maine、美国、04915
    - MaineHealth Waldo Hospital
  - Biddeford、Maine、美国、04005
    - MaineHealth Maine Medical Center - Biddeford
  - Brewer、Maine、美国、04412
    - Lafayette Family Cancer Center-EMMC
  - Norway、Maine、美国、04268
    - MaineHealth Stephens Hospital
  - Rockport、Maine、美国、04856
    - Penobscot Bay Medical Center
  - Sanford、Maine、美国、04073
    - MaineHealth Cancer Care and IV Therapy - Sanford
  - South Portland、Maine、美国、04106
    - MaineHealth Cancer Care and IV Therapy - South Portland
- Maryland
  - Baltimore、Maryland、美国、21204
    - Greater Baltimore Medical Center
- Massachusetts
  - Boston、Massachusetts、美国、02215
    - Dana-Farber Cancer Institute
  - Newton、Massachusetts、美国、02467
    - Dana-Farber Cancer Institute - Chestnut Hill
  - Springfield、Massachusetts、美国、01104
    - Mercy Medical Center
- Michigan
  - Adrian、Michigan、美国、49221
    - Hickman Cancer Center
  - Ann Arbor、Michigan、美国、48106
    - Trinity Health Saint Joseph Mercy Hospital Ann Arbor
  - Battle Creek、Michigan、美国、49017
    - Bronson Battle Creek
  - Brighton、Michigan、美国、48114
    - Trinity Health IHA Medical Group Hematology Oncology - Brighton
  - Brighton、Michigan、美国、48114
    - Trinity Health Medical Center - Brighton
  - Brownstown、Michigan、美国、48183
    - Henry Ford Cancer Institute-Downriver
  - Canton、Michigan、美国、48188
    - Trinity Health IHA Medical Group Hematology Oncology - Canton
  - Canton、Michigan、美国、48188
    - Trinity Health Medical Center - Canton
  - Caro、Michigan、美国、48723
    - Caro Cancer Center
  - Chelsea、Michigan、美国、48118
    - Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
  - Chelsea、Michigan、美国、48118
    - Chelsea Hospital
  - Clarkston、Michigan、美国、48346
    - Hematology Oncology Consultants-Clarkston
  - Clarkston、Michigan、美国、48346
    - Newland Medical Associates-Clarkston
  - Clinton Township、Michigan、美国、48038
    - Henry Ford Macomb Hospital-Clinton Township
  - Dearborn、Michigan、美国、48126
    - Henry Ford Medical Center-Fairlane
  - Detroit、Michigan、美国、48202
    - Henry Ford Hospital
  - Detroit、Michigan、美国、48236
    - Henry Ford Health Saint John Hospital
  - East China Township、Michigan、美国、48054
    - Henry Ford River District Hospital
  - Escanaba、Michigan、美国、49829
    - OSF Saint Francis Hospital and Medical Group
  - Flint、Michigan、美国、48503
    - Hurley Medical Center
  - Flint、Michigan、美国、48503
    - Genesee Hematology Oncology PC
  - Flint、Michigan、美国、48503
    - Genesys Hurley Cancer Institute
  - Flint、Michigan、美国、48503
    - Cancer Hematology Centers - Flint
  - Grand Rapids、Michigan、美国、49503
    - Trinity Health Grand Rapids Hospital
  - Grand Rapids、Michigan、美国、49503
    - Corewell Health Grand Rapids Hospitals - Butterworth Hospital
  - Grand Rapids、Michigan、美国、49503
    - Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
  - Grosse Pointe Woods、Michigan、美国、48236
    - Henry Ford Saint John Hospital - Academic
  - Grosse Pointe Woods、Michigan、美国、48236
    - Henry Ford Saint John Hospital - Breast
  - Grosse Pointe Woods、Michigan、美国、48236
    - Henry Ford Saint John Hospital - Van Elslander
  - Jackson、Michigan、美国、49201
    - Allegiance Health
  - Kalamazoo、Michigan、美国、49007
    - West Michigan Cancer Center
  - Kalamazoo、Michigan、美国、49007
    - Bronson Methodist Hospital
  - Kalamazoo、Michigan、美国、49009
    - Beacon Kalamazoo Cancer Center
  - Kalamazoo、Michigan、美国、49048
    - Beacon Kalamazoo
  - Lansing、Michigan、美国、48912
    - University of Michigan Health - Sparrow Lansing
  - Livonia、Michigan、美国、48154
    - Trinity Health Saint Mary Mercy Livonia Hospital
  - Livonia、Michigan、美国、48154
    - Hope Cancer Clinic
  - Macomb、Michigan、美国、48044
    - Henry Ford Warren Hospital - Breast Macomb
  - Macomb、Michigan、美国、48044
    - Henry Ford Saint John Hospital - Macomb Medical
  - Marlette、Michigan、美国、48453
    - Saint Mary's Oncology/Hematology Associates of Marlette
  - Monroe、Michigan、美国、48162
    - Toledo Clinic Cancer Centers-Monroe
  - Muskegon、Michigan、美国、49444
    - Trinity Health Muskegon Hospital
  - Niles、Michigan、美国、49120
    - Corewell Health Lakeland Hospitals - Niles Hospital
  - Norton Shores、Michigan、美国、49444
    - Cancer and Hematology Centers of Western Michigan - Norton Shores
  - Novi、Michigan、美国、48377
    - Henry Ford Medical Center-Columbus
  - Novi、Michigan、美国、48374
    - Henry Ford Health Providence Novi Hospital
  - Pontiac、Michigan、美国、48341
    - Hope Cancer Center
  - Pontiac、Michigan、美国、48341
    - Trinity Health Saint Joseph Mercy Oakland Hospital
  - Pontiac、Michigan、美国、48341
    - Michigan Healthcare Professionals Pontiac
  - Pontiac、Michigan、美国、48341
    - Trinity Health IHA Medical Group-Alice Gustafson Center
  - Port Huron、Michigan、美国、48060
    - Lake Huron Medical Center
  - Port Huron、Michigan、美国、48060
    - Huron Medical Center PC
  - Reed City、Michigan、美国、49677
    - Corewell Health Reed City Hospital
  - Rochester Hills、Michigan、美国、48309
    - Henry Ford Rochester Hospital
  - Saginaw、Michigan、美国、48604
    - Oncology Hematology Associates of Saginaw Valley PC
  - Saginaw、Michigan、美国、48601
    - MyMichigan Medical Center Saginaw
  - Saint Joseph、Michigan、美国、49085
    - Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
  - Saint Joseph、Michigan、美国、49085
    - Corewell Health Lakeland Hospitals - Saint Joseph Hospital
  - Shelby、Michigan、美国、48315
    - Henry Ford Macomb Health Center - Shelby Township
  - Southfield、Michigan、美国、48075
    - Henry Ford Health Providence Southfield Hospital
  - Sterling Heights、Michigan、美国、48312
    - Bhadresh Nayak MD PC-Sterling Heights
  - Tawas City、Michigan、美国、48764
    - MyMichigan Medical Center Tawas
  - Traverse City、Michigan、美国、49684
    - Munson Medical Center
  - Warren、Michigan、美国、48088
    - Advanced Breast Care Center PLLC
  - Warren、Michigan、美国、48093
    - Macomb Hematology Oncology PC
  - Warren、Michigan、美国、48093
    - Henry Ford Madison Heights Hospital - Breast
  - Warren、Michigan、美国、48093
    - Henry Ford Health Warren Hospital
  - Warren、Michigan、美国、48093
    - Henry Ford Warren Hospital - GLCMS
  - West Bloomfield、Michigan、美国、48322
    - Henry Ford West Bloomfield Hospital
  - West Branch、Michigan、美国、48661
    - Saint Mary's Oncology/Hematology Associates of West Branch
  - Wyoming、Michigan、美国、49519
    - University of Michigan Health - West
  - Ypsilanti、Michigan、美国、48197
    - Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
  - Ypsilanti、Michigan、美国、48106
    - Huron Gastroenterology PC
- Minnesota
  - Aitkin、Minnesota、美国、56431
    - Riverwood Healthcare Center
  - Bemidji、Minnesota、美国、56601
    - Sanford Joe Lueken Cancer Center
  - Brainerd、Minnesota、美国、56401
    - Essentia Health Saint Joseph's Medical Center
  - Burnsville、Minnesota、美国、55337
    - Fairview Ridges Hospital
  - Burnsville、Minnesota、美国、55337
    - Minnesota Oncology - Burnsville
  - Cambridge、Minnesota、美国、55008
    - Cambridge Medical Center
  - Coon Rapids、Minnesota、美国、55433
    - Mercy Hospital
  - Deer River、Minnesota、美国、56636
    - Essentia Health - Deer River Clinic
  - Detroit Lakes、Minnesota、美国、56501
    - Essentia Health Saint Mary's - Detroit Lakes Clinic
  - Duluth、Minnesota、美国、55805
    - Essentia Health Cancer Center
  - Duluth、Minnesota、美国、55805
    - Essentia Health Saint Mary's Medical Center
  - Duluth、Minnesota、美国、55805
    - Miller-Dwan Hospital
  - Edina、Minnesota、美国、55435
    - Fairview Southdale Hospital
  - Fergus Falls、Minnesota、美国、56537
    - Lake Region Healthcare Corporation-Cancer Care
  - Fosston、Minnesota、美国、56542
    - Essentia Health - Fosston
  - Fridley、Minnesota、美国、55432
    - Unity Hospital
  - Hibbing、Minnesota、美国、55746
    - Essentia Health Hibbing Clinic
  - Maple Grove、Minnesota、美国、55369
    - Fairview Clinics and Surgery Center Maple Grove
  - Maplewood、Minnesota、美国、55109
    - Saint John's Hospital - Healtheast
  - Maplewood、Minnesota、美国、55109
    - Minnesota Oncology Hematology PA-Maplewood
  - Minneapolis、Minnesota、美国、55415
    - Hennepin County Medical Center
  - Minneapolis、Minnesota、美国、55407
    - Abbott-Northwestern Hospital
  - Minneapolis、Minnesota、美国、55454
    - Health Partners Inc
  - Minneapolis、Minnesota、美国、55417
    - Minneapolis VA Medical Center
  - Monticello、Minnesota、美国、55362
    - Monticello Cancer Center
  - New Ulm、Minnesota、美国、56073
    - New Ulm Medical Center
  - Park Rapids、Minnesota、美国、56470
    - Essentia Health - Park Rapids
  - Princeton、Minnesota、美国、55371
    - Fairview Northland Medical Center
  - Robbinsdale、Minnesota、美国、55422
    - North Memorial Medical Health Center
  - Saint Cloud、Minnesota、美国、56303
    - Coborn Cancer Center at Saint Cloud Hospital
  - Saint Louis Park、Minnesota、美国、55416
    - Park Nicollet Clinic - Saint Louis Park
  - Saint Paul、Minnesota、美国、55101
    - Regions Hospital
  - Saint Paul、Minnesota、美国、55102
    - United Hospital
  - Sandstone、Minnesota、美国、55072
    - Essentia Health Sandstone
  - Shakopee、Minnesota、美国、55379
    - Saint Francis Regional Medical Center
  - Stillwater、Minnesota、美国、55082
    - Lakeview Hospital
  - Thief River Falls、Minnesota、美国、56701
    - Sanford Thief River Falls Medical Center
  - Virginia、Minnesota、美国、55792
    - Essentia Health Virginia Clinic
  - Waconia、Minnesota、美国、55387
    - Ridgeview Medical Center
  - Willmar、Minnesota、美国、56201
    - Rice Memorial Hospital
  - Woodbury、Minnesota、美国、55125
    - Minnesota Oncology Hematology PA-Woodbury
  - Worthington、Minnesota、美国、56187
    - Sanford Cancer Center Worthington
  - Wyoming、Minnesota、美国、55092
    - Fairview Lakes Medical Center
- Mississippi
  - Columbus、Mississippi、美国、39705
    - Baptist Memorial Hospital and Cancer Center-Golden Triangle
  - Grenada、Mississippi、美国、38901
    - Baptist Cancer Center-Grenada
  - Gulfport、Mississippi、美国、39502
    - Gulfport Memorial Hospital
  - Jackson、Mississippi、美国、39216
    - University of Mississippi Medical Center
  - New Albany、Mississippi、美国、38652
    - Baptist Memorial Hospital and Cancer Center-Union County
  - Oxford、Mississippi、美国、38655
    - Baptist Memorial Hospital and Cancer Center-Oxford
  - Southhaven、Mississippi、美国、38671
    - Baptist Memorial Hospital and Cancer Center-Desoto
- Missouri
  - Ballwin、Missouri、美国、63011
    - Mercy Oncology and Hematology - Clayton-Clarkson
  - Bolivar、Missouri、美国、65613
    - Central Care Cancer Center - Bolivar
  - Bonne Terre、Missouri、美国、63628
    - Parkland Health Center-Bonne Terre
  - Branson、Missouri、美国、65616
    - Cox Cancer Center Branson
  - Cape Girardeau、Missouri、美国、63703
    - Saint Francis Medical Center
  - Cape Girardeau、Missouri、美国、63703
    - Mercy Cancer Center - Cape Girardeau
  - Chesterfield、Missouri、美国、63017
    - Saint Luke's Hospital
  - City of Saint Peters、Missouri、美国、63376
    - Siteman Cancer Center at Saint Peters Hospital
  - Columbia、Missouri、美国、65212
    - MU Health - University Hospital/Ellis Fischel Cancer Center
  - Creve Coeur、Missouri、美国、63141
    - Siteman Cancer Center at West County Hospital
  - Farmington、Missouri、美国、63640
    - Parkland Health Center - Farmington
  - Independence、Missouri、美国、64057
    - Centerpoint Medical Center LLC
  - Jefferson City、Missouri、美国、65109
    - MU Health Care Goldschmidt Cancer Center
  - Joplin、Missouri、美国、64804
    - Freeman Health System
  - Joplin、Missouri、美国、64804
    - Mercy Hospital Joplin
  - Kansas City、Missouri、美国、64154
    - University of Kansas Cancer Center - North
  - Kansas City、Missouri、美国、64132
    - Research Medical Center
  - Kansas City、Missouri、美国、64108
    - University Health Truman Medical Center
  - Lee's Summit、Missouri、美国、64064
    - University of Kansas Cancer Center - Lee's Summit
  - North Kansas City、Missouri、美国、64116
    - University of Kansas Cancer Center at North Kansas City Hospital
  - Rolla、Missouri、美国、65401
    - Mercy Clinic-Rolla-Cancer and Hematology
  - Rolla、Missouri、美国、65401
    - Phelps Health Delbert Day Cancer Institute
  - Saint Joseph、Missouri、美国、64506
    - Heartland Regional Medical Center
  - Sainte Genevieve、Missouri、美国、63670
    - Sainte Genevieve County Memorial Hospital
  - Springfield、Missouri、美国、65807
    - CoxHealth South Hospital
  - Springfield、Missouri、美国、65804
    - Mercy Hospital Springfield
  - St Louis、Missouri、美国、63110
    - Washington University School of Medicine
  - St Louis、Missouri、美国、63129
    - Siteman Cancer Center-South County
  - St Louis、Missouri、美国、63136
    - Siteman Cancer Center at Christian Hospital
  - St Louis、Missouri、美国、63131
    - Missouri Baptist Medical Center
  - St Louis、Missouri、美国、63109
    - Mercy Infusion Center - Chippewa
  - St Louis、Missouri、美国、63141
    - Mercy Hospital Saint Louis
  - St Louis、Missouri、美国、63128
    - Mercy Hospital South
  - Sullivan、Missouri、美国、63080
    - Missouri Baptist Sullivan Hospital
  - Washington、Missouri、美国、63090
    - Mercy Hospital Washington
- Montana
  - Anaconda、Montana、美国、59711
    - Community Hospital of Anaconda
  - Billings、Montana、美国、59101
    - Billings Clinic Cancer Center
  - Billings、Montana、美国、59101
    - Saint Vincent Healthcare
  - Billings、Montana、美国、59102
    - Saint Vincent Frontier Cancer Center
  - Bozeman、Montana、美国、59715
    - Bozeman Health Deaconess Hospital
  - Butte、Montana、美国、59701
    - Saint James Community Hospital and Cancer Treatment Center
  - Great Falls、Montana、美国、59405
    - Great Falls Clinic
  - Great Falls、Montana、美国、59405
    - Benefis Sletten Cancer Institute
  - Helena、Montana、美国、59601
    - Saint Peter's Community Hospital
  - Kalispell、Montana、美国、59901
    - Logan Health Medical Center
  - Missoula、Montana、美国、59802
    - Saint Patrick Hospital - Community Hospital
  - Missoula、Montana、美国、59804
    - Community Medical Center
- Nebraska
  - Bellevue、Nebraska、美国、68123
    - Nebraska Medicine-Bellevue
  - Grand Island、Nebraska、美国、68803
    - Nebraska Cancer Specialists/Oncology Hematology West PC
  - Kearney、Nebraska、美国、68847
    - CHI Health Good Samaritan
  - Lincoln、Nebraska、美国、68510
    - Saint Elizabeth Regional Medical Center
  - Lincoln、Nebraska、美国、68516
    - Cancer Partners of Nebraska
  - Omaha、Nebraska、美国、68114
    - Nebraska Methodist Hospital
  - Omaha、Nebraska、美国、68198
    - University of Nebraska Medical Center
  - Omaha、Nebraska、美国、68124
    - Alegent Health Bergan Mercy Medical Center
  - Omaha、Nebraska、美国、68118
    - Nebraska Medicine-Village Pointe
  - Omaha、Nebraska、美国、68122
    - Alegent Health Immanuel Medical Center
  - Omaha、Nebraska、美国、68130
    - Alegent Health Lakeside Hospital
  - Omaha、Nebraska、美国、68114
    - Oncology Associates PC
  - Omaha、Nebraska、美国、68114
    - Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
  - Papillion、Nebraska、美国、68046
    - Midlands Community Hospital
- Nevada
  - Carson City、Nevada、美国、89703
    - Carson Tahoe Regional Medical Center
  - Henderson、Nevada、美国、89052
    - Comprehensive Cancer Centers of Nevada - Henderson
  - Henderson、Nevada、美国、89052
    - Cancer and Blood Specialists-Henderson
  - Henderson、Nevada、美国、89052
    - Las Vegas Cancer Center-Henderson
  - Henderson、Nevada、美国、89074
    - Comprehensive Cancer Centers of Nevada-Southeast Henderson
  - Henderson、Nevada、美国、89052
    - Comprehensive Cancer Centers of Nevada-Horizon Ridge
  - Henderson、Nevada、美国、89074
    - Las Vegas Urology - Green Valley
  - Henderson、Nevada、美国、89074
    - Las Vegas Urology - Pebble
  - Henderson、Nevada、美国、89074
    - Urology Specialists of Nevada - Green Valley
  - Henderson、Nevada、美国、89074
    - Oncology Las Vegas - Henderson
  - Las Vegas、Nevada、美国、89144
    - Summerlin Hospital Medical Center
  - Las Vegas、Nevada、美国、89109
    - Sunrise Hospital and Medical Center
  - Las Vegas、Nevada、美国、89102
    - OptumCare Cancer Care at Charleston
  - Las Vegas、Nevada、美国、89106
    - Radiation Oncology Centers of Nevada Central
  - Las Vegas、Nevada、美国、89119
    - Radiation Oncology Centers of Nevada Southeast
  - Las Vegas、Nevada、美国、89128
    - Comprehensive Cancer Centers of Nevada - Northwest
  - Las Vegas、Nevada、美国、89128
    - OptumCare Cancer Care at MountainView
  - Las Vegas、Nevada、美国、89135
    - Alliance for Childhood Diseases/Cure 4 the Kids Foundation
  - Las Vegas、Nevada、美国、89144
    - Comprehensive Cancer Centers of Nevada - Town Center
  - Las Vegas、Nevada、美国、89144
    - Comprehensive Cancer Centers of Nevada-Summerlin
  - Las Vegas、Nevada、美国、89148
    - Comprehensive Cancer Centers of Nevada
  - Las Vegas、Nevada、美国、89169
    - Comprehensive Cancer Centers of Nevada - Central Valley
  - Las Vegas、Nevada、美国、89102
    - University Medical Center of Southern Nevada
  - Las Vegas、Nevada、美国、89106
    - Cancer and Blood Specialists-Shadow
  - Las Vegas、Nevada、美国、89109
    - HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
  - Las Vegas、Nevada、美国、89113
    - HealthCare Partners Medical Group Oncology/Hematology-San Martin
  - Las Vegas、Nevada、美国、89128
    - Cancer and Blood Specialists-Tenaya
  - Las Vegas、Nevada、美国、89128
    - HealthCare Partners Medical Group Oncology/Hematology-Tenaya
  - Las Vegas、Nevada、美国、89148-2405
    - Las Vegas Cancer Center-Medical Center
  - Las Vegas、Nevada、美国、89149
    - HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
  - Las Vegas、Nevada、美国、89128
    - Ann M Wierman MD LTD
  - Las Vegas、Nevada、美国、89074
    - Las Vegas Urology - Pecos
  - Las Vegas、Nevada、美国、89102
    - Desert West Surgery
  - Las Vegas、Nevada、美国、89103
    - Hope Cancer Care of Nevada
  - Las Vegas、Nevada、美国、89106
    - Urology Specialists of Nevada - Central
  - Las Vegas、Nevada、美国、89113
    - Las Vegas Prostate Cancer Center
  - Las Vegas、Nevada、美国、89113
    - Las Vegas Urology - Sunset
  - Las Vegas、Nevada、美国、89128
    - Las Vegas Urology - Cathedral Rock
  - Las Vegas、Nevada、美国、89128
    - Las Vegas Urology - Smoke Ranch
  - Las Vegas、Nevada、美国、89128
    - Urology Specialists of Nevada - Northwest
  - Las Vegas、Nevada、美国、89169
    - University Cancer Center
  - Las Vegas、Nevada、美国、89113
    - Urology Specialists of Nevada - Southwest
  - Las Vegas、Nevada、美国、89128
    - Oncology Las Vegas - Tenaya
  - Las Vegas、Nevada、美国、89183
    - OptumCare Cancer Care at Fort Apache
  - Pahrump、Nevada、美国、89048
    - Hope Cancer Care of Nevada-Pahrump
  - Reno、Nevada、美国、89502
    - Renown Regional Medical Center
  - Reno、Nevada、美国、89503
    - Saint Mary's Regional Medical Center
  - Reno、Nevada、美国、89509
    - Radiation Oncology Associates
- New Hampshire
  - Concord、New Hampshire、美国、03301
    - New Hampshire Oncology Hematology PA-Concord
  - Manchester、New Hampshire、美国、03103
    - Solinsky Center for Cancer Care
  - Manchester、New Hampshire、美国、03103
    - Elliot Hospital
- New Jersey
  - Brick、New Jersey、美国、08724
    - Ocean University Medical Center
  - Cape May Court House、New Jersey、美国、08210
    - AtlantiCare Health Park-Cape May Court House
  - Egg Harbor、New Jersey、美国、08234
    - AtlantiCare Surgery Center
  - Hackensack、New Jersey、美国、07601
    - Hackensack University Medical Center
  - Livingston、New Jersey、美国、07039
    - Cooperman Barnabas Medical Center
  - Manahawkin、New Jersey、美国、08050
    - Southern Ocean County Medical Center
  - Mullica Hill、New Jersey、美国、08062
    - Inspira Medical Center Mullica Hill
  - Neptune City、New Jersey、美国、07753
    - Jersey Shore Medical Center
  - New Brunswick、New Jersey、美国、08903
    - Rutgers Cancer Institute of New Jersey
  - Red Bank、New Jersey、美国、07701
    - Riverview Medical Center/Booker Cancer Center
- New Mexico
  - Albuquerque、New Mexico、美国、87106
    - University of New Mexico Cancer Center
- New York
  - Auburn、New York、美国、13021
    - Hematology Oncology Associates of Central New York-Auburn
  - Camillus、New York、美国、13031
    - Hematology Oncology Associates of CNY at Camillus
  - Cooperstown、New York、美国、13326
    - Mary Imogene Bassett Hospital
  - East Syracuse、New York、美国、13057
    - Hematology Oncology Associates of Central New York-East Syracuse
  - Glens Falls、New York、美国、12801
    - Glens Falls Hospital
  - Lake Success、New York、美国、11042
    - Northwell Health/Center for Advanced Medicine
  - New York、New York、美国、10065
    - NYP/Weill Cornell Medical Center
  - Rochester、New York、美国、14642
    - University of Rochester
  - Stony Brook、New York、美国、11794
    - Stony Brook University Medical Center
  - The Bronx、New York、美国、10461
    - Montefiore Medical Center-Einstein Campus
  - The Bronx、New York、美国、10467
    - Montefiore Medical Center - Moses Campus
  - The Bronx、New York、美国、10461
    - Montefiore Medical Center-Weiler Hospital
- North Carolina
  - Asheville、North Carolina、美国、28803
    - AdventHealth Infusion Center Asheville
  - Chapel Hill、North Carolina、美国、27599
    - UNC Lineberger Comprehensive Cancer Center
  - Charlotte、North Carolina、美国、28204
    - Novant Health Presbyterian Medical Center
  - Clemmons、North Carolina、美国、27012
    - Wake Forest University at Clemmons
  - Clinton、North Carolina、美国、28328
    - Southeastern Medical Oncology Center-Clinton
  - Clyde、North Carolina、美国、28721
    - AdventHealth Infusion Center Haywood
  - Durham、North Carolina、美国、27710
    - Duke University Medical Center
  - Durham、North Carolina、美国、27705
    - Durham VA Medical Center
  - Goldsboro、North Carolina、美国、27534
    - Southeastern Medical Oncology Center-Goldsboro
  - Greenville、North Carolina、美国、27834
    - ECU Health Medical Center
  - Hendersonville、North Carolina、美国、28791
    - Margaret R Pardee Memorial Hospital
  - Hendersonville、North Carolina、美国、28792
    - AdventHealth Hendersonville
  - Huntersville、North Carolina、美国、28078
    - Novant Health Cancer Institute - Huntersville
  - Huntersville、North Carolina、美国、28078
    - Novant Health Presbyterian Medical Center Huntersville
  - Jacksonville、North Carolina、美国、28546
    - Southeastern Medical Oncology Center-Jacksonville
  - Kenansville、North Carolina、美国、28349
    - ECU Health Oncology Kenansville
  - Kernersville、North Carolina、美国、27284
    - Novant Health Cancer Institute - Kernersville
  - Kinston、North Carolina、美国、28501
    - ECU Health Oncology Kinston
  - Matthews、North Carolina、美国、28105
    - Novant Health Cancer Institute - Matthews
  - Mooresville、North Carolina、美国、28117
    - Novant Health Cancer Institute - Mooresville
  - Mount Airy、North Carolina、美国、27030
    - Novant Health Cancer Institute - Mount Airy
  - North Wilkesboro、North Carolina、美国、28659
    - Novant Health Cancer Institute - Wilkesboro
  - Richlands、North Carolina、美国、28574
    - ECU Health Oncology Richlands
  - Statesville、North Carolina、美国、28625
    - Novant Health Cancer Institute - Statesville
  - Statesville、North Carolina、美国、28677
    - Wake Forest Baptist Health - Hematology Oncology - Statesville
  - Thomasville、North Carolina、美国、27360
    - Novant Health Cancer Institute - Thomasville
  - Weaverville、North Carolina、美国、28787
    - AdventHealth Infusion Center Weaverville
  - Wilkesboro、North Carolina、美国、28659
    - Wake Forest Baptist Health - Wilkes Medical Center
  - Winston-Salem、North Carolina、美国、27157
    - Wake Forest University Health Sciences
  - Winston-Salem、North Carolina、美国、27103
    - Novant Health Forsyth Medical Center
- North Dakota
  - Bismarck、North Dakota、美国、58501
    - Sanford Bismarck Medical Center
  - Fargo、North Dakota、美国、58122
    - Sanford Roger Maris Cancer Center
  - Fargo、North Dakota、美国、58103
    - Essentia Health Cancer Center-South University Clinic
  - Fargo、North Dakota、美国、58122
    - Sanford Broadway Medical Center
  - Fargo、North Dakota、美国、58103
    - Sanford South University Medical Center
  - Fargo、North Dakota、美国、58103
    - Southpointe-Sanford Medical Center Fargo
  - Fargo、North Dakota、美国、58104
    - Sanford Medical Center Fargo
  - Grand Forks、North Dakota、美国、58201
    - Altru Cancer Center
  - Jamestown、North Dakota、美国、58401
    - Essentia Health - Jamestown Clinic
  - Minot、North Dakota、美国、58701
    - Trinity Cancer Care Center
- Ohio
  - Beavercreek、Ohio、美国、45431
    - Indu and Raj Soin Medical Center
  - Belpre、Ohio、美国、45714
    - Strecker Cancer Center-Belpre
  - Boardman、Ohio、美国、44512
    - Saint Elizabeth Boardman Hospital
  - Centerville、Ohio、美国、45459
    - Miami Valley Hospital South
  - Centerville、Ohio、美国、45459
    - Dayton Physicians LLC-Miami Valley South
  - Chillicothe、Ohio、美国、45601
    - Adena Regional Medical Center
  - Cincinnati、Ohio、美国、45219
    - University of Cincinnati Cancer Center-UC Medical Center
  - Cincinnati、Ohio、美国、45220
    - Good Samaritan Hospital - Cincinnati
  - Cincinnati、Ohio、美国、45242
    - Bethesda North Hospital
  - Cincinnati、Ohio、美国、45236
    - Oncology Hematology Care Inc-Kenwood
  - Cincinnati、Ohio、美国、45247
    - TriHealth Cancer Institute-Westside
  - Cincinnati、Ohio、美国、45255
    - TriHealth Cancer Institute-Anderson
  - Cleveland、Ohio、美国、44109
    - MetroHealth Medical Center
  - Columbus、Ohio、美国、43214
    - Riverside Methodist Hospital
  - Columbus、Ohio、美国、43210
    - Ohio State University Comprehensive Cancer Center
  - Columbus、Ohio、美国、43219
    - The Mark H Zangmeister Center
  - Columbus、Ohio、美国、43214
    - Columbus Oncology and Hematology Associates Inc
  - Columbus、Ohio、美国、43228
    - Doctors Hospital
  - Columbus、Ohio、美国、43213
    - Mount Carmel East Hospital
  - Columbus、Ohio、美国、43215
    - Grant Medical Center
  - Columbus、Ohio、美国、43222
    - Mount Carmel Health Center West
  - Dayton、Ohio、美国、45406
    - Good Samaritan Hospital - Dayton
  - Dayton、Ohio、美国、45409
    - Miami Valley Hospital
  - Dayton、Ohio、美国、45415
    - Miami Valley Hospital North
  - Dayton、Ohio、美国、45415
    - Dayton Physician LLC - Englewood
  - Dayton、Ohio、美国、45409
    - Premier Blood and Cancer Center
  - Delaware、Ohio、美国、43015
    - Delaware Health Center-Grady Cancer Center
  - Delaware、Ohio、美国、43015
    - Grady Memorial Hospital
  - Dublin、Ohio、美国、43016
    - Dublin Methodist Hospital
  - Dublin、Ohio、美国、43016
    - Columbus Oncology and Hematology Associates
  - Findlay、Ohio、美国、45840
    - Blanchard Valley Hospital
  - Findlay、Ohio、美国、45840
    - Armes Family Cancer Center
  - Findlay、Ohio、美国、45840
    - Orion Cancer Care
  - Franklin、Ohio、美国、45005-1066
    - Atrium Medical Center-Middletown Regional Hospital
  - Franklin、Ohio、美国、45005
    - Dayton Physicians LLC-Atrium
  - Gahanna、Ohio、美国、43230
    - Central Ohio Breast and Endocrine Surgery
  - Greenville、Ohio、美国、45331
    - Wayne Hospital
  - Greenville、Ohio、美国、45331
    - Dayton Physicians LLC-Wayne
  - Greenville、Ohio、美国、45331
    - Miami Valley Cancer Care and Infusion
  - Grove City、Ohio、美国、43123
    - Mount Carmel Grove City Hospital
  - Kettering、Ohio、美国、45429
    - Kettering Medical Center
  - Kettering、Ohio、美国、45409
    - Greater Dayton Cancer Center
  - Kettering、Ohio、美国、45420
    - First Dayton Cancer Care
  - Lancaster、Ohio、美国、43130
    - Fairfield Medical Center
  - Lima、Ohio、美国、45801
    - Saint Rita's Medical Center
  - Mansfield、Ohio、美国、44903
    - OhioHealth Mansfield Hospital
  - Marietta、Ohio、美国、45750
    - Marietta Memorial Hospital
  - Marion、Ohio、美国、43302
    - OhioHealth Marion General Hospital
  - Marysville、Ohio、美国、43040
    - Memorial Hospital
  - Mount Vernon、Ohio、美国、43050
    - Knox Community Hospital
  - Newark、Ohio、美国、43055
    - Licking Memorial Hospital
  - Newark、Ohio、美国、43055
    - Newark Radiation Oncology
  - Perrysburg、Ohio、美国、43551
    - Mercy Health - Perrysburg Hospital
  - Portsmouth、Ohio、美国、45662
    - Southern Ohio Medical Center
  - Springfield、Ohio、美国、45504
    - Springfield Regional Cancer Center
  - Springfield、Ohio、美国、45504
    - Springfield Regional Medical Center
  - Toledo、Ohio、美国、43623
    - Mercy Health - Saint Anne Hospital
  - Toledo、Ohio、美国、43623
    - Toledo Clinic Cancer Centers-Toledo
  - Toledo、Ohio、美国、43608
    - Mercy Health - Saint Vincent Hospital
  - Troy、Ohio、美国、45373
    - Upper Valley Medical Center
  - Troy、Ohio、美国、45373
    - Dayton Physicians LLC - Troy
  - Warren、Ohio、美国、44484
    - Saint Joseph Warren Hospital
  - West Chester、Ohio、美国、45069
    - University of Cincinnati Cancer Center-West Chester
  - Westerville、Ohio、美国、43081
    - Saint Ann's Hospital
  - Youngstown、Ohio、美国、44501
    - Saint Elizabeth Youngstown Hospital
  - Zanesville、Ohio、美国、43701
    - Genesis Healthcare System Cancer Care Center
- Oklahoma
  - Lawton、Oklahoma、美国、73505
    - Cancer Centers of Southwest Oklahoma Research
  - Oklahoma City、Oklahoma、美国、73104
    - University of Oklahoma Health Sciences Center
  - Oklahoma City、Oklahoma、美国、73120
    - Mercy Hospital Oklahoma City
  - Tulsa、Oklahoma、美国、74146
    - Oklahoma Cancer Specialists and Research Institute-Tulsa
- Oregon
  - Baker City、Oregon、美国、97814
    - Saint Alphonsus Cancer Care Center-Baker City
  - Bend、Oregon、美国、97701
    - Saint Charles Health System
  - Clackamas、Oregon、美国、97015
    - Clackamas Radiation Oncology Center
  - Clackamas、Oregon、美国、97015
    - Providence Cancer Institute Clackamas Clinic
  - Coos Bay、Oregon、美国、97420
    - Bay Area Hospital
  - Gresham、Oregon、美国、97030
    - Legacy Mount Hood Medical Center
  - Newberg、Oregon、美国、97132
    - Providence Newberg Medical Center
  - Ontario、Oregon、美国、97914
    - Saint Alphonsus Cancer Care Center-Ontario
  - Oregon City、Oregon、美国、97045
    - Providence Willamette Falls Medical Center
  - Portland、Oregon、美国、97239
    - Oregon Health and Science University
  - Portland、Oregon、美国、97210
    - Legacy Good Samaritan Hospital and Medical Center
  - Portland、Oregon、美国、97213
    - Providence Portland Medical Center
  - Portland、Oregon、美国、97225
    - Providence Saint Vincent Medical Center
  - Redmond、Oregon、美国、97756
    - Saint Charles Health System-Redmond
  - Tualatin、Oregon、美国、97062
    - Legacy Meridian Park Hospital
- Pennsylvania
  - Allentown、Pennsylvania、美国、18103
    - Lehigh Valley Hospital-Cedar Crest
  - Bethlehem、Pennsylvania、美国、18017
    - Lehigh Valley Hospital - Muhlenberg
  - Bryn Mawr、Pennsylvania、美国、19010
    - Bryn Mawr Hospital
  - Chadds Ford、Pennsylvania、美国、19317
    - Christiana Care Health System-Concord Health Center
  - Collegeville、Pennsylvania、美国、19426
    - Main Line Health Center-Collegeville
  - Danville、Pennsylvania、美国、17822
    - Geisinger Medical Center
  - East Stroudsburg、Pennsylvania、美国、18301
    - Pocono Medical Center
  - Exton、Pennsylvania、美国、19341
    - Main Line Health Center-Exton
  - Hazleton、Pennsylvania、美国、18201
    - Geisinger Medical Center-Cancer Center Hazleton
  - Hazleton、Pennsylvania、美国、18201
    - Lehigh Valley Hospital-Hazleton
  - Hershey、Pennsylvania、美国、17033-0850
    - Penn State Milton S Hershey Medical Center
  - Lewisburg、Pennsylvania、美国、17837
    - Geisinger Medical Oncology-Lewisburg
  - Lewistown、Pennsylvania、美国、17044
    - Lewistown Hospital
  - Media、Pennsylvania、美国、19063
    - Riddle Memorial Hospital
  - Newtown Square、Pennsylvania、美国、19073
    - Bryn Mawr Health Center
  - Paoli、Pennsylvania、美国、19301
    - Paoli Memorial Hospital
  - Philadelphia、Pennsylvania、美国、19107
    - Thomas Jefferson University Hospital
  - Philadelphia、Pennsylvania、美国、19148
    - Jefferson Methodist Hospital
  - Pottsville、Pennsylvania、美国、17901
    - Geisinger Cancer Services-Pottsville
  - Sayre、Pennsylvania、美国、18840
    - Guthrie Medical Group PC-Robert Packer Hospital
  - Scranton、Pennsylvania、美国、18510
    - Community Medical Center
  - Selinsgrove、Pennsylvania、美国、17870
    - Geisinger Medical Oncology-Selinsgrove
  - State College、Pennsylvania、美国、16801
    - Geisinger Medical Group
  - Wilkes-Barre、Pennsylvania、美国、18711
    - Geisinger Wyoming Valley/Henry Cancer Center
  - Wynnewood、Pennsylvania、美国、19096
    - Lankenau Medical Center
- South Carolina
  - Boiling Springs、South Carolina、美国、29316
    - Prisma Health Cancer Institute - Spartanburg
  - Charleston、South Carolina、美国、29425
    - Medical University of South Carolina
  - Easley、South Carolina、美国、29640
    - Prisma Health Cancer Institute - Easley
  - Gaffney、South Carolina、美国、29341
    - Gibbs Cancer Center-Gaffney
  - Greenville、South Carolina、美国、29605
    - Prisma Health Cancer Institute - Faris
  - Greenville、South Carolina、美国、29607
    - Saint Francis Cancer Center
  - Greenville、South Carolina、美国、29615
    - Prisma Health Cancer Institute - Eastside
  - Greenville、South Carolina、美国、29605
    - Prisma Health Cancer Institute - Butternut
  - Greenville、South Carolina、美国、29601
    - Saint Francis Hospital
  - Greenville、South Carolina、美国、29605
    - Prisma Health Greenville Memorial Hospital
  - Greer、South Carolina、美国、29650
    - Prisma Health Cancer Institute - Greer
  - Greer、South Carolina、美国、29651
    - Gibbs Cancer Center-Pelham
  - Seneca、South Carolina、美国、29672
    - Prisma Health Cancer Institute - Seneca
  - Spartanburg、South Carolina、美国、29303
    - Spartanburg Medical Center
  - Spartanburg、South Carolina、美国、29307
    - Spartanburg Medical Center - Mary Black Campus
  - Spartanburg、South Carolina、美国、29303
    - North Grove Medical Park
  - Union、South Carolina、美国、29379
    - SMC Center for Hematology Oncology Union
- South Dakota
  - Aberdeen、South Dakota、美国、57401
    - Avera Cancer Institute-Aberdeen
  - Rapid City、South Dakota、美国、57701
    - Rapid City Regional Hospital
  - Sioux Falls、South Dakota、美国、57105
    - Avera Cancer Institute
  - Sioux Falls、South Dakota、美国、57117-5134
    - Sanford USD Medical Center - Sioux Falls
  - Sioux Falls、South Dakota、美国、57104
    - Sanford Cancer Center Oncology Clinic
- Tennessee
  - Alcoa、Tennessee、美国、37701
    - University Cancer Specialists - Alcoa
  - Bristol、Tennessee、美国、37620
    - Bristol Regional Medical Center
  - Collierville、Tennessee、美国、38017
    - Baptist Memorial Hospital and Cancer Center-Collierville
  - Cookeville、Tennessee、美国、38501
    - Cookeville Regional Medical Center
  - Kingsport、Tennessee、美国、37660
    - Ballad Health Cancer Care - Kingsport
  - Kingsport、Tennessee、美国、37660
    - Wellmont Holston Valley Hospital and Medical Center
  - Knoxville、Tennessee、美国、37920
    - University of Tennessee - Knoxville
  - Memphis、Tennessee、美国、38120
    - Baptist Memorial Hospital and Cancer Center-Memphis
- Texas
  - Austin、Texas、美国、78701
    - Dell Seton Medical Center at The University of Texas
  - Bryan、Texas、美国、77802
    - Saint Joseph Regional Cancer Center
  - Dallas、Texas、美国、75235
    - Parkland Memorial Hospital
  - Dallas、Texas、美国、75390
    - UT Southwestern/Simmons Cancer Center-Dallas
  - Dallas、Texas、美国、75237
    - UT Southwestern Simmons Cancer Center - RedBird
  - Fort Worth、Texas、美国、76104
    - UT Southwestern/Simmons Cancer Center-Fort Worth
  - Galveston、Texas、美国、77555-0565
    - University of Texas Medical Branch
  - Houston、Texas、美国、77030
    - Memorial Hermann Texas Medical Center
  - Laredo、Texas、美国、78041
    - Doctor's Hospital of Laredo
  - Richardson、Texas、美国、75080
    - UT Southwestern Clinical Center at Richardson/Plano
- Utah
  - American Fork、Utah、美国、84003
    - American Fork Hospital / Huntsman Intermountain Cancer Center
  - Cedar City、Utah、美国、84720
    - Sandra L Maxwell Cancer Center
  - Logan、Utah、美国、84321
    - Logan Regional Hospital
  - Murray、Utah、美国、84107
    - Intermountain Medical Center
  - Ogden、Utah、美国、84403
    - McKay-Dee Hospital Center
  - Provo、Utah、美国、84604
    - Utah Valley Regional Medical Center
  - Riverton、Utah、美国、84065
    - Riverton Hospital
  - Salt Lake City、Utah、美国、84106
    - Utah Cancer Specialists-Salt Lake City
  - Salt Lake City、Utah、美国、84143
    - LDS Hospital
  - St. George、Utah、美国、84770
    - Saint George Regional Medical Center
- Vermont
  - Berlin Corners、Vermont、美国、05602
    - Central Vermont Medical Center/National Life Cancer Treatment
  - Burlington、Vermont、美国、05401
    - University of Vermont Medical Center
  - Burlington、Vermont、美国、05405
    - University of Vermont and State Agricultural College
- Virginia
  - Bristol、Virginia、美国、24201
    - Ballad Health Cancer Care - Bristol
  - Fishersville、Virginia、美国、22939
    - Augusta Health Center for Cancer and Blood Disorders
  - Lynchburg、Virginia、美国、24501
    - Centra Alan B Pearson Regional Cancer Center
  - Mechanicsville、Virginia、美国、23116
    - Bon Secours Memorial Regional Medical Center
  - Midlothian、Virginia、美国、23114
    - Bon Secours Saint Francis Medical Center
  - Midlothian、Virginia、美国、23113
    - Bon Secours Westchester Emergency Center
  - Norfolk、Virginia、美国、23505
    - Bon Secours DePaul Medical Center
  - Norton、Virginia、美国、24273
    - Ballad Health Cancer Care - Norton
  - Portsmouth、Virginia、美国、23707
    - Bon Secours Maryview Medical Center
  - Richmond、Virginia、美国、23226
    - Bon Secours Saint Mary's Hospital
  - Richmond、Virginia、美国、23230
    - Bon Secours Cancer Institute at Reynolds Crossing
  - Richmond、Virginia、美国、23298
    - VCU Massey Comprehensive Cancer Center
  - South Hill、Virginia、美国、23970
    - VCU Community Memorial Health Center
  - Suffolk、Virginia、美国、23435
    - Bon Secours Health Center at Harbour View
- Washington
  - Aberdeen、Washington、美国、98520
    - Providence Regional Cancer System-Aberdeen
  - Auburn、Washington、美国、98001
    - MultiCare Auburn Medical Center
  - Bellevue、Washington、美国、98004
    - Overlake Medical Center
  - Bellingham、Washington、美国、98225
    - PeaceHealth Saint Joseph Medical Center
  - Burien、Washington、美国、98166
    - Saint Anne Hospital
  - Centralia、Washington、美国、98531
    - Providence Regional Cancer System-Centralia
  - Edmonds、Washington、美国、98026
    - Swedish Cancer Institute-Edmonds
  - Enumclaw、Washington、美国、98022
    - Saint Elizabeth Hospital
  - Everett、Washington、美国、98201
    - Providence Regional Cancer Partnership
  - Federal Way、Washington、美国、98003
    - Saint Francis Hospital
  - Gig Harbor、Washington、美国、98335
    - MultiCare Gig Harbor Medical Park
  - Issaquah、Washington、美国、98029
    - Swedish Cancer Institute-Issaquah
  - Kennewick、Washington、美国、99336
    - Kadlec Clinic Hematology and Oncology
  - Lacey、Washington、美国、98503
    - Providence Regional Cancer System-Lacey
  - Lakewood、Washington、美国、98499
    - Saint Clare Hospital
  - Longview、Washington、美国、98632
    - PeaceHealth Saint John Medical Center
  - Port Townsend、Washington、美国、98368
    - Jefferson Healthcare
  - Poulsbo、Washington、美国、98370
    - Harrison HealthPartners Hematology and Oncology-Poulsbo
  - Puyallup、Washington、美国、98372
    - MultiCare Good Samaritan Hospital
  - Renton、Washington、美国、98055
    - Valley Medical Center
  - Seattle、Washington、美国、98107
    - Swedish Medical Center-Ballard Campus
  - Seattle、Washington、美国、98122
    - Swedish Medical Center-First Hill
  - Seattle、Washington、美国、98104
    - Pacific Gynecology Specialists
  - Seattle、Washington、美国、98122-5711
    - Swedish Medical Center-Cherry Hill
  - Sedro-Woolley、Washington、美国、98284
    - PeaceHealth United General Medical Center
  - Shelton、Washington、美国、98584
    - Providence Regional Cancer System-Shelton
  - Silverdale、Washington、美国、98383
    - Saint Joseph Medical Center Hematology and Oncology - Silverdale
  - Spokane、Washington、美国、99204
    - MultiCare Deaconess Cancer and Blood Specialty Center - Downtown
  - Spokane、Washington、美国、99218
    - MultiCare Deaconess Cancer and Blood Specialty Center - North
  - Spokane Valley、Washington、美国、99216
    - MultiCare Deaconess Cancer and Blood Specialty Center - Valley
  - Tacoma、Washington、美国、98405
    - Mary Bridge Children's Hospital and Health Center
  - Tacoma、Washington、美国、98405
    - Northwest Medical Specialties PLLC
  - Tacoma、Washington、美国、98405
    - MultiCare Tacoma General Hospital
  - Tacoma、Washington、美国、98405
    - Franciscan Research Center-Northwest Medical Plaza
  - Vancouver、Washington、美国、98686
    - Legacy Salmon Creek Hospital
  - Vancouver、Washington、美国、98664
    - PeaceHealth Southwest Medical Center
  - Vancouver、Washington、美国、98684
    - Legacy Cancer Institute Medical Oncology and Day Treatment
  - Walla Walla、Washington、美国、99362
    - Providence Saint Mary Regional Cancer Center
  - Yakima、Washington、美国、98902
    - North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
  - Yelm、Washington、美国、98597
    - Providence Regional Cancer System-Yelm
- West Virginia
  - Bridgeport、West Virginia、美国、26330
    - United Hospital Center
  - Charleston、West Virginia、美国、25304
    - Vandalia Health/CAMC Institute for Academic Medicine
  - Huntington、West Virginia、美国、25701
    - Edwards Comprehensive Cancer Center
  - Martinsburg、West Virginia、美国、25401
    - WVUH-Berkely Medical Center
  - Morgantown、West Virginia、美国、26506
    - West Virginia University Healthcare
  - Parkersburg、West Virginia、美国、26101
    - Camden Clark Medical Center
- Wisconsin
  - Antigo、Wisconsin、美国、54409
    - Aspirus Cancer Care-Antigo-Volm Cancer Center
  - Appleton、Wisconsin、美国、54911
    - ThedaCare Regional Cancer Center
  - Ashland、Wisconsin、美国、54806
    - Duluth Clinic Ashland
  - Ashland、Wisconsin、美国、54806
    - Northwest Wisconsin Cancer Center
  - Eau Claire、Wisconsin、美国、54701
    - Marshfield Medical Center-EC Cancer Center
  - Eau Claire、Wisconsin、美国、54701
    - HSHS Sacred Heart Hospital
  - Green Bay、Wisconsin、美国、54301
    - Saint Vincent Hospital Cancer Center Green Bay
  - Green Bay、Wisconsin、美国、54303
    - Saint Vincent Hospital Cancer Center at Saint Mary's
  - Green Bay、Wisconsin、美国、54301
    - Bellin Memorial Hospital
  - Madison、Wisconsin、美国、53792
    - University of Wisconsin Carbone Cancer Center - University Hospital
  - Madison、Wisconsin、美国、53715
    - SSM Health Dean Medical Group - South Madison Campus
  - Manitowoc、Wisconsin、美国、54221
    - Holy Family Memorial Hospital
  - Marshfield、Wisconsin、美国、54449
    - Marshfield Medical Center-Marshfield
  - Medford、Wisconsin、美国、54451
    - Aspirus Medford Hospital
  - Menomonee Falls、Wisconsin、美国、53051
    - Froedtert Menomonee Falls Hospital
  - Milwaukee、Wisconsin、美国、53226
    - Medical College of Wisconsin
  - Minocqua、Wisconsin、美国、54548
    - Marshfield Medical Center - Minocqua
  - Mukwonago、Wisconsin、美国、53149
    - ProHealth D N Greenwald Center
  - New Richmond、Wisconsin、美国、54017
    - Cancer Center of Western Wisconsin
  - Oconomowoc、Wisconsin、美国、53066
    - ProHealth Oconomowoc Memorial Hospital
  - Oconto Falls、Wisconsin、美国、54154
    - Saint Vincent Hospital Cancer Center at Oconto Falls
  - Rhinelander、Wisconsin、美国、54501
    - Aspirus Cancer Care-Rhinelander-James Beck Cancer Center
  - Rice Lake、Wisconsin、美国、54868
    - Marshfield Medical Center-Rice Lake
  - Sheboygan、Wisconsin、美国、53081
    - HSHS Saint Nicholas Hospital
  - Stevens Point、Wisconsin、美国、54482
    - Marshfield Medical Center-River Region at Stevens Point
  - Stevens Point、Wisconsin、美国、54481
    - Aspirus Cancer Care - Stevens Point
  - Sturgeon Bay、Wisconsin、美国、54235-1495
    - Saint Vincent Hospital Cancer Center at Sturgeon Bay
  - Waukesha、Wisconsin、美国、53188
    - UW Cancer Center at ProHealth Care
  - Waukesha、Wisconsin、美国、53188
    - ProHealth Waukesha Memorial Hospital
  - Wausau、Wisconsin、美国、54401
    - Aspirus Cancer Care-Wausau
  - West Bend、Wisconsin、美国、53095
    - Froedtert West Bend Hospital/Kraemer Cancer Center
  - Weston、Wisconsin、美国、54476
    - Marshfield Medical Center - Weston
  - Wisconsin Rapids、Wisconsin、美国、54494
    - Aspirus Cancer Care - Wisconsin Rapids
- Wyoming
  - Cheyenne、Wyoming、美国、82001
    - Cheyenne Regional Medical Center-West
  - Cody、Wyoming、美国、82414
    - Billings Clinic-Cody
  - Sheridan、Wyoming、美国、82801
    - Welch Cancer Center

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年及以上 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

描述

Inclusion Criteria:

STEP I REGISTRATION CRITERIA
Histologically documented renal cell carcinoma with clear cell component, including patients who have sarcomatoid or rhabdoid features
Any metastatic disease, including visceral, lymph node, other soft tissue and bone, measurable per RECIST 1.1
Measurable disease as defined in the protocol
Must be intermediate or poor risk patient per International Metastatic Renal Cell Carcinoma Database (IMDC) criteria (1 or more of the following): Karnofsky performance status [KPS] < 80, < 1 year from diagnosis [including initial nephrectomy] to systemic treatment for metastatic disease, hemoglobin less than lower limit of normal [LLN], corrected calcium concentration greater than upper limit of normal [ULN], absolute neutrophil count greater than ULN, platelet count > ULN)
Central nervous system (CNS) disease permitted, if stable and not otherwise causing symptoms or needing active treatment
Karnofsky performance status >= 70%
No prior treatment with PD-1, PD-L1, or CTLA-4 targeting agents (including but not limited to nivolumab, pembrolizumab, pidilizumab, durvalumab, atezolizumab, tremelimumab, and ipilimumab), or any other drug or antibody specifically targeting T-cell co-stimulation or checkpoint pathways. The only exception is for prior treatment with nivolumab or other PD-1/PD-L1/CTLA-4 targeting therapy on pre- or post-operative trials, as long as > 1 year since completion of systemic therapy
No prior previous systemic therapy for renal cell carcinoma (prior HD IL-2 [>28 days]. Prior adjuvant sunitinib >180 days since completion and prior immunotherapy as above are allowed).
No systemic cancer therapy less than 28 days prior to registration; no radiation therapy less than 14 days prior to registration. There must be a complete recovery and no ongoing complications from radiotherapy
Not pregnant and not nursing, because this study involves an agent that has known genotoxic, mutagenic and teratogenic effects. Therefore, for women of childbearing potential only, a negative serum or urine pregnancy test done =< 14 days prior to registration is required
Age >= 18 years
None of the following:
- Active autoimmune disease requiring ongoing therapy
- Ongoing acute toxicity > grade 2 from previous treatment
- History of severe allergic, anaphylactic or other hypersensitivity reactions to chimeric or humanized antibodies
- Active hepatitis B/C, or active tuberculosis (purified protein derivative [PPD] response without active tuberculosis [TB] is allowed)
- HIV-infected patients with detectable viral load within 6 months prior to registration. Patients on effective anti-retroviral therapy with undetectable viral load within 6 months prior to registration are eligible
- Concurrent use of immunosuppressive medication including prednisone above 10 mg daily
- Uncontrolled adrenal insufficiency
- Uncontrolled hypertension (systolic blood pressure [BP] > 150mmHg or diastolic BP > 90mmHg)
- Major surgery less than 28 days prior to registration
- Any serious non-healing wound, ulcer, or bone fracture within 28 days prior to registration
- Any arterial thrombotic events within 180 days prior to registration
- Clinically significant hematuria, hematemesis, or hemoptysis within 12 weeks prior to registration
- Cavitating pulmonary lesions or known endotracheal or endobronchial disease manifestations
- Lesions encasing or invading any major blood vessels (this does not include tumor thrombus extending into/through renal vein/inferior vena cava [IVC]). Patients with tumor thrombus extending into/through renal vein are considered eligible
- Moderate of severe hepatic impairment (child-Pugh B or C)
- Any history of untreated pulmonary embolism or deep venous thrombosis (DVT) in the 180 days prior to registration. (Any asymptomatic, treated pulmonary embolism or asymptomatic, treated deep venous thrombosis > 30 days prior to registration allowed)
- Corrected QT interval calculated by the Fridericia formula (QTcF) > 500 ms
- Unstable cardiac arrhythmia within 6 months prior to registration
- Any gastrointestinal (GI) bleeding =< 180 days, hemoptysis, or other signs of pulmonary hemorrhage =< 90 days prior to registration
- History of abdominal fistula, gastrointestinal perforation, intra-abdominal abscess, bowel obstruction, or gastric outlet obstruction within 180 days prior to registration
- Active peptic ulcer disease, inflammatory bowel disease, or malabsorption syndrome within 28 days prior to registration
- Untreated hypothyroidism (treated hypothyroidism on thyroid replacement therapy is allowed. Abnormal thyroid-stimulating hormone [TSH] is acceptable with normal T3/free T4 if treated on thyroid replacement therapy)
- Evidence of pancreatitis, history of organ transplant, or history of congenital QT syndrome
- Active treatment with coumarin agents (e.g., warfarin), direct thrombin inhibitors (e.g., dabigatran), direct Xa inhibitor betrixaban or platelet inhibitors (e.g., clopidogrel) within 5 days of registration Allowed anticoagulants include: prophylactic use of low-dose aspirin for cardio-protection (per local applicable guidelines) and low-dose low molecular weight heparins (LMWH), therapeutic doses of LMWH or anticoagulation with direct factor Xa inhibitors rivaroxaban, edoxaban, apixaban. Allowed also in patients with known brain metastases who are on a stable dose of the anticoagulant for at least 1 week prior to registration without clinically significant hemorrhagic complications from the anticoagulation regimen or the tumor
- Significant cardiac ischemia events (ST elevation myocardial infarction [STEMI] or non-ST-elevation myocardial infarction [NSTEMI]) within 6 months or active New York (NY) Heart Association class 3-4 heart failure symptoms
Absolute neutrophil count (ANC) >= 1,500/mm^3
Platelet count >= 100,000/mm^3
Hemoglobin >= 8 g/dL
Calculated (Calc.) creatinine clearance >= 30 mL/min
Urine protein =< 1+ or urine protein to creatinine (UPC) ratio < 1
Total bilirubin =< 1.5 x upper limit of normal (ULN) (except for patients with known or likely Gilbert's syndrome, for whom total bilirubin up to 3 mg/dL is allowed with direct bilirubin =< 20% total bilirubin)
Aspartate aminotransferase/alanine aminotransferase (AST/ALT) =< 2.5 x upper limit of normal (ULN) or < 5 x ULN if hepatic metastases present
STEP 2 REGISTRATION ELIGIBILITY CRITERIA
Successful completion of at least 1 cycle of ipilimumab/nivolumab
Resolution of any treatment-related adverse events to grade 1 or less per dose modification section (this criteria does not include any adverse events [AEs] not attributable to treatment which are present due to disease), with prednisone-equivalent dosing at 10 mg daily or less. Exceptions for this criteria include patients receiving replacement hormone treatments (such as levothyroxine for treatment-related hypothyroidism or glucocorticoid replacement for adrenal insufficiency). Please contact study chair if further discussion is needed
No more than 80 days from last dose of ipilimumab/nivolumab

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

主要用途：治疗
分配：随机化
介入模型：并行分配
屏蔽：无（打开标签）

手臂数量

武器和干预

参与者组/臂	干预/治疗
有源比较器：Arm A (nivolumab) INDUCTION: Patients receive nivolumab IV over 30 minutes and ipilimumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. TREATMENT: Patients with iuPD with clinical instability receive cabozantinib PO daily on days 1-28. Treatment repeats every 28 days until further disease progression or unacceptable toxicity Patients with iCR receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Patients with non-CR/non-PD with clinical stability receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, MRI and blood and urine sample collection, and may also undergo a bone scan as clinically indicated throughout the study.	其他：Quality-of-Life Assessment Ancillary studies 其他名称：生活质量评估生物：Ipilimumab Given IV 其他名称：抗细胞毒性 T 淋巴细胞相关抗原 4 单克隆抗体 BMS-734016 易普利姆玛生物仿制药 CS1002 MDX-010 MDX-CTLA4 耶沃伊 MDX010 BMS734016 建筑管理系统 734016 MDX 010 程序：Magnetic Resonance Imaging Undergo MRI 其他名称：核磁共振磁共振磁共振成像扫描医学影像、磁共振/核磁共振先生磁共振成像核磁共振成像扫描核磁共振成像磁共振成像 (MRI) 磁共振成像（程序）结构核磁共振其他：Questionnaire Administration Ancillary studies 生物：Nivolumab Given IV 其他名称： BMS-936558 MDX-1106 尼沃 ONO-4538 欧狄沃 CMAB819 Nivolumab 生物类似药 CMAB819 MDX 1106 MDX1106 电池管理系统 936558 总部血压206 纳武单抗生物仿制药 ABP 206 BCD-263 纳武单抗生物仿制药 BCD-263 BMS936558 小野4538 程序：Computed Tomography Undergo CT scan 其他名称： CT 猫电脑扫描计算机轴向断层扫描计算机断层扫描 CT扫描断层扫描计算机轴向断层扫描（程序）计算机断层扫描 (CT) 扫描诊断猫扫描诊断猫扫描服务类型程序：Bone Scan Undergo bone scan 其他名称：骨闪烁显像程序：Biospecimen Collection Undergo blood and urine sample collection 其他名称：生物样本采集收集的生物样本标本采集样本收集
实验性的：Arm B (nivolumab, cabozantinib) INDUCTION: Patients receive nivolumab IV over 30 minutes and ipilimumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. TREATMENT: Patients with iuPD with clinical instability receive cabozantinib PO daily on days 1-28. Treatment repeats every 28 days until further disease progression or unacceptable toxicity. Patients with iCR receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Patients with non-CR/non-PD rwith clinical stability eceive nivolumab IV over 30 minutes on day 1 and cabozantinib PO daily on days 1-28. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, MRI and blood and urine sample collection, and may also undergo a bone scan as clinically indicated throughout the study.	其他：Quality-of-Life Assessment Ancillary studies 其他名称：生活质量评估生物：Ipilimumab Given IV 其他名称：抗细胞毒性 T 淋巴细胞相关抗原 4 单克隆抗体 BMS-734016 易普利姆玛生物仿制药 CS1002 MDX-010 MDX-CTLA4 耶沃伊 MDX010 BMS734016 建筑管理系统 734016 MDX 010 程序：Magnetic Resonance Imaging Undergo MRI 其他名称：核磁共振磁共振磁共振成像扫描医学影像、磁共振/核磁共振先生磁共振成像核磁共振成像扫描核磁共振成像磁共振成像 (MRI) 磁共振成像（程序）结构核磁共振其他：Questionnaire Administration Ancillary studies 生物：Nivolumab Given IV 其他名称： BMS-936558 MDX-1106 尼沃 ONO-4538 欧狄沃 CMAB819 Nivolumab 生物类似药 CMAB819 MDX 1106 MDX1106 电池管理系统 936558 总部血压206 纳武单抗生物仿制药 ABP 206 BCD-263 纳武单抗生物仿制药 BCD-263 BMS936558 小野4538 程序：Computed Tomography Undergo CT scan 其他名称： CT 猫电脑扫描计算机轴向断层扫描计算机断层扫描 CT扫描断层扫描计算机轴向断层扫描（程序）计算机断层扫描 (CT) 扫描诊断猫扫描诊断猫扫描服务类型程序：Biospecimen Collection Undergo blood and urine sample collection 其他名称：生物样本采集收集的生物样本标本采集样本收集药品：Cabozantinib Given PO

参与者组/臂

干预/治疗

有源比较器：Arm A (nivolumab)

INDUCTION: Patients receive nivolumab IV over 30 minutes and ipilimumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity.

TREATMENT:

Patients with iuPD with clinical instability receive cabozantinib PO daily on days 1-28. Treatment repeats every 28 days until further disease progression or unacceptable toxicity

Patients with iCR receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Patients with non-CR/non-PD with clinical stability receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Patients undergo CT scan, MRI and blood and urine sample collection, and may also undergo a bone scan as clinically indicated throughout the study.

其他：Quality-of-Life Assessment

Ancillary studies

其他名称：

生活质量评估

生物：Ipilimumab

Given IV

其他名称：

抗细胞毒性 T 淋巴细胞相关抗原 4 单克隆抗体
BMS-734016
易普利姆玛生物仿制药 CS1002
MDX-010
MDX-CTLA4
耶沃伊
MDX010
BMS734016
建筑管理系统 734016
MDX 010

程序：Magnetic Resonance Imaging

Undergo MRI

其他名称：

核磁共振
磁共振
磁共振成像扫描
医学影像、磁共振/核磁共振
先生
磁共振成像
核磁共振成像扫描
核磁共振成像
磁共振成像 (MRI)
磁共振成像（程序）
结构核磁共振

其他：Questionnaire Administration

Ancillary studies

生物：Nivolumab

Given IV

其他名称：

BMS-936558
MDX-1106
尼沃
ONO-4538
欧狄沃
CMAB819
Nivolumab 生物类似药 CMAB819
MDX 1106
MDX1106
电池管理系统 936558
总部血压206
纳武单抗生物仿制药 ABP 206
BCD-263
纳武单抗生物仿制药 BCD-263
BMS936558
小野4538

程序：Computed Tomography

Undergo CT scan

其他名称：

CT
猫
电脑扫描
计算机轴向断层扫描
计算机断层扫描
CT扫描
断层扫描
计算机轴向断层扫描（程序）
计算机断层扫描 (CT) 扫描
诊断猫扫描
诊断猫扫描服务类型

程序：Bone Scan

Undergo bone scan

其他名称：

骨闪烁显像

程序：Biospecimen Collection

Undergo blood and urine sample collection

其他名称：

生物样本采集
收集的生物样本
标本采集
样本收集

实验性的：Arm B (nivolumab, cabozantinib)

TREATMENT:

Patients with iuPD with clinical instability receive cabozantinib PO daily on days 1-28. Treatment repeats every 28 days until further disease progression or unacceptable toxicity.

Patients with iCR receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Patients with non-CR/non-PD rwith clinical stability eceive nivolumab IV over 30 minutes on day 1 and cabozantinib PO daily on days 1-28. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Patients undergo CT scan, MRI and blood and urine sample collection, and may also undergo a bone scan as clinically indicated throughout the study.

其他：Quality-of-Life Assessment

Ancillary studies

其他名称：

生活质量评估

生物：Ipilimumab

Given IV

其他名称：

抗细胞毒性 T 淋巴细胞相关抗原 4 单克隆抗体
BMS-734016
易普利姆玛生物仿制药 CS1002
MDX-010
MDX-CTLA4
耶沃伊
MDX010
BMS734016
建筑管理系统 734016
MDX 010

程序：Magnetic Resonance Imaging

Undergo MRI

其他名称：

核磁共振
磁共振
磁共振成像扫描
医学影像、磁共振/核磁共振
先生
磁共振成像
核磁共振成像扫描
核磁共振成像
磁共振成像 (MRI)
磁共振成像（程序）
结构核磁共振

其他：Questionnaire Administration

Ancillary studies

生物：Nivolumab

Given IV

其他名称：

BMS-936558
MDX-1106
尼沃
ONO-4538
欧狄沃
CMAB819
Nivolumab 生物类似药 CMAB819
MDX 1106
MDX1106
电池管理系统 936558
总部血压206
纳武单抗生物仿制药 ABP 206
BCD-263
纳武单抗生物仿制药 BCD-263
BMS936558
小野4538

程序：Computed Tomography

Undergo CT scan

其他名称：

CT
猫
电脑扫描
计算机轴向断层扫描
计算机断层扫描
CT扫描
断层扫描
计算机轴向断层扫描（程序）
计算机断层扫描 (CT) 扫描
诊断猫扫描
诊断猫扫描服务类型

程序：Biospecimen Collection

Undergo blood and urine sample collection

其他名称：

生物样本采集
收集的生物样本
标本采集
样本收集

药品：Cabozantinib

Given PO

研究衡量的是什么？

主要结果指标

结果测量	措施说明	大体时间
Overall survival (OS) 大体时间：From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years	OS of patients who achieve complete response (CR) and progressive disease (PD) from ipilimumab-nivolumab induction phase will be summarized. The stratified log-rank statistic will be the primary analysis to compare the hypothesis on OS with the stratification factors (presence of bone metastases and IMDC risk criteria). The Kaplan-Meier product-limit estimator will be used to estimate the OS. A stratified proportional hazards model will be used to generate estimates for the OS hazard ratio. For the randomized patients, OS will be calculated and compared from the time of randomization until the time of an OS event or time of last-follow-up, whatever occurs first. For the patients who were initially CR or PD, OS will be measured from the time of study registration. A comparison of OS will be made across the patient groups (randomized patients, patients initially CR, and patients initially PD).	From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years

次要结果测量

结果测量	措施说明	大体时间
Progression-free survival (PFS) 大体时间：From date of registration to date of progression (or disease recurrence) or death due to any cause, whichever occurs first, assessed up to 5 years	Progression will be defined using the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. PFS of patients who achieve CR and PD from ipilimumab-nivolumab induction phase will be summarized (secondary analysis). The Kaplan-Meier product-limit estimator will be used to estimate the PFS distribution. A stratified proportional hazards model will be used to generate estimates for the PFS hazard ratio. For the randomized patients, PFS will be calculated and compared from the time of randomization until the time of a PFS event or time of last-follow-up, whatever occurs first. For the patients who were initially CR or PD, PFS will be measured from the time of study registration. A comparison of PFS will be made across the patient groups (randomized patients, patients initially CR, and patients initially PD). For this comparison, PFS will be measured from time of study registration all the patients, regardless of whether they were randomized or not.	From date of registration to date of progression (or disease recurrence) or death due to any cause, whichever occurs first, assessed up to 5 years
Complete response (CR) (randomized patients) 大体时间：At 12 months from date of randomization	Patients who had a CR prior to 12 months but have experienced a disease recurrence prior to 12 months, will not be considered to be a CR at 12 months. The Cochran-Mantel-Haenszel test will be used to compare the two arms on the proportion of patients who have a 12-month CR adjusting on the stratification factors.	At 12 months from date of randomization
Objective response 大体时间：Up to 5 years	Defined as the best response observed that has been confirmed by a scan performed 4 or more weeks after the observation of the initial response. The objective response will be confirmed using RECIST 1.1. In addition, objective responses will also be confirmed using Immune Response Evaluation Criteria in Solid Tumors (iRECIST).	Up to 5 years
Proportion of patients who discontinue protocol-directed treatment prior to 1 year from date of study registration 大体时间：Up to 5 years	Patients who stop their protocol directed treatment for any reason prior to one year from study registration will be considered to have discontinued their treatment. The Cochran-Mantel-Haenszel test will also be used to compare the proportion of patients who discontinue their treatment prior to one-year after study registration.	Up to 5 years
Incidence of adverse events 大体时间：Up to 5 years	Assessed with National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. A Fisher's exact test will be used to compare the two treatment arms on the proportion of patient with a grade 3 or higher adverse event.	Up to 5 years

其他结果措施

结果测量	措施说明	大体时间
Estimates of OS by sex 大体时间：From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years	Estimates of OS and the corresponding 95% confidence intervals (CIs) by sex will be provided (with an understanding that sometimes the CI or estimate will not be computable because of scant data).	From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years
Estimates of OS by race 大体时间：From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years	Estimates of OS and the corresponding 95% CIs by race will be provided (with an understanding that sometimes the CI or estimate will not be computable because of scant data).	From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years
Estimates of OS by ethnicity 大体时间：From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years	Estimates of OS and the corresponding 95% CIs by ethnicity will be provided (with an understanding that sometimes the CI or estimate will not be computable because of scant data).	From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

National Cancer Institute (NCI)

调查人员

首席研究员：Tian Zhang、Alliance for Clinical Trials in Oncology

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

一般刊物

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2019年6月7日

初级完成 (估计的)

2028年3月1日

研究完成 (估计的)

2028年3月1日

研究注册日期

首次提交

2019年1月3日

首先提交符合 QC 标准的

2019年1月3日

首次发布 (实际的)

2019年1月4日

研究记录更新

最后更新发布 (实际的)

2026年10月26日

上次提交的符合 QC 标准的更新

2026年10月23日

最后验证

2026年10月1日

PDIGREE 研究，Nivolumab 和 Ipilimumab 的免疫疗法，然后是 Nivolumab 或 Nivolumab 和 Cabozantinib 用于晚期肾癌患者

PD 抑制剂 (Nivolumab) 和 Ipilimumab 随后是 Nivolumab 对比 VEGF TKI Cabozantinib 和 Nivolumab：转移性未治疗肾细胞癌的 III 期试验 [PDIGREE]

研究概览

地位

条件

干预/治疗

详细说明

研究类型

注册 (估计的)

阶段

联系人和位置

学习地点

参与标准

资格标准

适合学习的年龄

接受健康志愿者

有资格学习的性别

描述

学习计划

研究是如何设计的？

设计细节

手臂数量

武器和干预

参与者组/臂

干预/治疗

研究衡量的是什么？

主要结果指标

结果测量

措施说明

大体时间

次要结果测量

结果测量

措施说明

大体时间

其他结果措施

结果测量

措施说明

大体时间

合作者和调查者

赞助

调查人员

出版物和有用的链接

一般刊物

研究记录日期

研究主要日期

学习开始 (实际的)

初级完成 (估计的)

研究完成 (估计的)

研究注册日期

首次提交

首先提交符合 QC 标准的

首次发布 (实际的)

研究记录更新

最后更新发布 (实际的)

上次提交的符合 QC 标准的更新

最后验证

更多信息

与本研究相关的术语

其他相关的 MeSH 术语

其他研究编号

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

IPD 计划说明

药物和器械信息、研究文件

研究美国 FDA 监管的药品

研究美国 FDA 监管的设备产品