Temozolomide and Radiation Therapy With or Without Bevacizumab in Treating Patients With Newly Diagnosed Glioblastoma
Study Purpose
This randomized phase III trial studies temozolomide (TMZ) and radiation therapy (RT) to compare how well they work with or without bevacizumab in treating patients with newly diagnosed glioblastoma or gliosarcoma. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Radiation therapy uses high-energy x-rays to kill tumor cells. Monoclonal antibodies, such as bevacizumab, may find tumor cells and help kill them. It is not yet known whether temozolomide and radiation therapy are more effective when given together with or without bevacizumab in treating glioblastoma or gliosarcoma.
Recruitment Criteria
|
Accepts Healthy Volunteers
Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms |
No |
|
Study Type
An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes. An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes. Searching Both is inclusive of interventional and observational studies. |
Interventional |
| Eligible Ages | 18 Years and Over |
| Gender | All |
Inclusion Criteria:
- - Histologically proven diagnosis of glioblastoma or gliosarcoma (World Health Organization [WHO] grade IV) confirmed by central review prior to step 2 registration.
- - Tumor tissue that is determined by central pathology review prior to step 2 registration to be of sufficient size for analysis of O-6-methylguanine-DNA methyltransferase (MGMT) and determination of molecular profile.
- - Patients must have at least 1 block of tumor tissue; submission of 2 blocks is strongly encouraged to maximize the chances of eligibility; at least 1 cubic centimeter of tissue composed primarily of tumor must be present.
- - CUSA (Cavitron ultrasonic aspirator)-derived material is not allowed; fresh frozen tumor tissue acquisition is encouraged.
- - Diagnosis must be made by surgical excision, either partial or complete; stereotactic biopsy is not allowed because it will not provide sufficient tissue for MGMT analysis.
- - The tumor tissue should be sent as soon as possible to maximize the likelihood of eligibility; tumor tissue should be submitted by 4 weeks after the surgical procedure so that the study registration and treatment can commence by the mandatory 5 week post-surgery outer limit.
- - Sites must submit tissue fir central review in order to obtain the MGMT analysis; patients from sites not following protocol-specified process for obtaining MGMT results will be made ineligible.
- - The tumor must have a supratentorial component.
- - History/physical examination within 14 days prior to step 2 registration.
- - The patient must have recovered from the effects of surgery, postoperative infection, and other complications before step 2 registration.
- - A diagnostic contrast-enhanced MRI of the brain must be performed preoperatively and postoperatively prior to the initiation of radiotherapy; the postoperative scan must be performed within 28 days prior to step 1 registration.
- - An MRI or computed tomography (CT) scan (potentially in addition to the postoperative scan) must be obtained within 10 days prior to the start of radiation therapy and must not demonstrate significant postoperative hemorrhage defined as > 1 cm diameter of blood; if > 1 cm of acute blood is detected, the patient will be ineligible for this trial; the radiation planning MRI or CT scan may be used to determine presence of hemorrhage.
- - Patients unable to undergo MR imaging because of non-compatible devices can be enrolled, provided pre- and postoperative contrast-enhanced CT scans are obtained and are of sufficient quality; preoperative and postoperative scans must be the same type; such patients cannot be enrolled into the advanced imaging component.
- - Documentation of steroid doses within 14 days prior to step 2 registration.
- - Karnofsky performance status >= 70.
- - Absolute neutrophil count (ANC) >= 1,800 cells/mm^3.
- - Platelets >= 100,000 cells/mm^3.
- - Hemoglobin >= 10.0 g/dL (Note: the use of transfusion or other intervention to achieve hemoglobin [Hgb] >= 10.0 g/dl is acceptable) - Blood urea nitrogen (BUN) =< 30 mg/dL within 14 days prior to step 2 registration.
- - Creatinine =< 1.7 mg/dl within 14 days prior to step 2 registration.
- - Urine protein screened by urine analysis for urine protein creatinine (UPC) ratio; for UPC ratio > 0.5, 24-hour urine protein should be obtained and the level should be < 1000 mg.
- - Bilirubin =< 2.0 mg/dl within 14 days prior to step 2 registration.
- - Alanine aminotransferase (ALT)/aspartate aminotransferase (AST) =< 3 x normal range within 14 days prior to step 2 registration.
- - Systolic blood pressure =< 160 mg Hg or diastolic pressure =< 90 mm Hg within 14 days prior to step 2 registration.
- - Electrocardiogram without evidence of acute cardiac ischemia within 14 days prior to step 2 registration.
- - Prothrombin time/international normalized ratio (PT INR) < 1.4 for patients not on warfarin confirmed by testing within 14 days prior to step 2 registration.
- - Patients on full-dose anticoagulants (e.g., warfarin or low molecular weight [LMW] heparin) must meet both of the following criteria: - No active bleeding or pathological condition that carries a high risk of bleeding (e.g., tumor involving major vessels or known varices) - In-range INR (between 2 and 3) on a stable dose of oral anticoagulant or on a stable dose of LMW heparin.
- - Patient must provide study specific informed consent prior to study entry.
- - Women of childbearing potential and male participants must practice adequate contraception.
- - For females of child-bearing potential, negative serum pregnancy test within 14 days prior to step 2 registration.
Exclusion Criteria:
- - Prior invasive malignancy (except for non-melanomatous skin cancer) unless disease free for >= 3 years; (for example, carcinoma in situ of the breast, oral cavity, and cervix are all permissible) - Recurrent or multifocal malignant gliomas.
- - Metastases detected below the tentorium or beyond the cranial vault.
- - Prior chemotherapy or radiosensitizers for cancers of the head and neck region; note that prior chemotherapy for a different cancer is allowable, except prior temozolomide or bevacizumab; prior use of Gliadel wafers or any other intratumoral or intracavitary treatment are not permitted.
- - Prior radiotherapy to the head or neck (except for T1 glottic cancer), resulting in overlap of radiation fields.
- - Severe, active co-morbidity, defined as follows: - Unstable angina and/or congestive heart failure within the last 6 months.
- - Transmural myocardial infarction within the last 6 months.
- - Evidence of recent myocardial infarction or ischemia by the findings of S-T elevations of >= 2 mm using the analysis of an electrocardiogram (EKG) performed within 14 days of step 2 registration.
- - New York Heart Association grade II or greater congestive heart failure requiring hospitalization within 12 months prior to step 2 registration.
- - History of stroke, cerebral vascular accident (CVA) or transient ischemic attack within 6 months.
- - Serious and inadequately controlled cardiac arrhythmia.
- - Significant vascular disease (e.g., aortic aneurysm, history of aortic dissection) or clinically significant peripheral vascular disease.
- - Evidence of bleeding diathesis or coagulopathy.
- - Serious or non-healing wound, ulcer, or bone fracture or history of abdominal fistula, gastrointestinal perforation, intra-abdominal abscess major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to step 2 registration, with the exception of the craniotomy for tumor resection.
- - Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration.
- - Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of step 2 registration.
- - Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects; note, however, that laboratory tests for liver function and coagulation parameters are not required for entry into this protocol.
- - Acquired immune deficiency syndrome (AIDS) based upon current Center for Disease Control (CDC) definition; note, however, that HIV testing is not required for entry into this protocol; the need to exclude patients with AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive.
- - Active connective tissue disorders, such as lupus or scleroderma, that in the opinion of the treating physician may put the patient at high risk for radiation toxicity.
- - Any other major medical illnesses or psychiatric impairments that in the investigator's opinion will prevent administration or completion of protocol therapy.
- - Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception.
- - Pregnant or lactating women.
- - Patients treated on any other therapeutic clinical protocols within 30 days prior to study entry or during participation in the study.
Trial Details
|
Trial ID:
This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries. |
NCT00884741 |
|
Phase
Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans. Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data. Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs. Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use. |
Phase 3 |
|
Lead Sponsor
The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data. |
National Cancer Institute (NCI) |
|
Principal Investigator
The person who is responsible for the scientific and technical direction of the entire clinical study. |
Mark Gilbert |
| Principal Investigator Affiliation | NRG Oncology |
|
Agency Class
Category of organization(s) involved as sponsor (and collaborator) supporting the trial. |
NIH, Other |
| Overall Status | Completed |
| Countries | Canada, Israel, United States |
|
Conditions
The disease, disorder, syndrome, illness, or injury that is being studied. |
Glioblastoma, Gliosarcoma, Supratentorial Glioblastoma |
PRIMARY OBJECTIVES:
- I. To determine whether the addition of bevacizumab to temozolomide and radiation improves efficacy as measured by progression-free and/or overall survival.
- II. To assess the association between overall survival and K^trans change from T1 to T2.
- III. To assess the association between overall survival and spin echo cerebral blood volume (CBV) change from T1 to T2.
- I. To determine whether the tumor molecular profile conferring a mesenchymal/angiogenic phenotype is associated with a selective increase in benefit, as measured by either overall survival or progression-free survival, from the addition of bevacizumab.
- II. To compare and record the toxicities of the conventional and bevacizumab-containing regimens.
- III. To assess the association between progression-free survival and K^trans change from T1 to T2.
- IV. To assess the association between progression-free survival and spin echo CBV change from T1 to T2.
- V. To assess the association between values of K^trans and spin echo CBV measured separately at T0 and at T1, and overall and progression-free survival.
- VI. To assess the association between overall survival and K^trans changes from T0 to T1 and from T2 to T3.
- VII. To assess the association between overall survival and spin echo CBV changes from T0 to T1 and from T2 to T3.
- VIII. To assess the association between overall survival and apparent diffusion coefficient (ADC) change from T0 to T1.
- IX. To assess the association between overall survival and ADC change from T1 to T2.
- X. To assess the association between progression-free survival and ADC change from T0 to T1.
- I. To determine the differential acute effects associated with the addition of bevacizumab to temozolomide and radiation, as compared to the conventional arm, on measures of neurocognitive function, health-related quality of life, and symptoms during radiation and across the longitudinal progression-free interval.
- II. To determine the relationship of neurocognitive function, health-related quality of life, and symptoms, with progression-free and overall survival.
- III. To determine the association between tumor molecular profile (i.e., mesenchymal/angiogenic phenotype and proneural phenotype) and neurocognitive function, health-related quality of life, and symptoms.
- IV. To describe the association between health-related quality of life as measured by the European Organization for Research and Treatment Quality of Life Questionnaire-Core 30/Brain Cancer Module-20 (EORTC-QL30/BCM20) and mean symptom severity as measured by the M.
- V. To evaluate the relationship between self-reported neurocognitive function and objectively measured tests of neurocognitive function (NCF).
- VI. To assess the association between measures of change in enhancing tumor size at week 22 and overall survival in participants with glioma receiving chemoradiotherapy with and without bevacizumab.
- VII. To assess the association between measures of change in T2-based tumor size at week 22 and overall survival in participants with glioma receiving chemoradiotherapy with and without bevacizumab.
- VIII. To assess the association between changes in ADC values and overall survival in participants with glioma receiving chemoradiotherapy with and without bevacizumab.
- I. Patients also receive bevacizumab IV over 30-90 minutes once every 2 weeks beginning in week 4 of chemoradiotherapy and continuing until the completion of adjuvant temozolomide.
Arms
Active Comparator: Arm I (radiation therapy, temozolomide, placebo)
Patients undergo intensity-modulated radiation therapy or 3-dimensional conformal radiation therapy 5 days a week for 6 weeks and receive temozolomide PO QD for up to 7 weeks. Beginning 4 weeks after completion of chemotherapy and radiation therapy, patients receive temozolomide PO QD on days 1-5. Treatment with temozolomide repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity. Patients also receive placebo IV over 30-90 minutes once every 2 weeks beginning in week 4 of chemotherapy and radiation therapy and continuing until the completion of temozolomide.
Experimental: Arm II (radiation therapy, temozolomide, bevacizumab)
Patients undergo radiation therapy and receive temozolomide as in Arm I. Patients also receive bevacizumab IV over 30-90 minutes once every 2 weeks beginning in week 4 of chemoradiotherapy and continuing until the completion of adjuvant temozolomide.
Interventions
Radiation: - 3-Dimensional Conformal Radiation Therapy
Undergo 3-dimentional conformal radiation therapy
Biological: - Bevacizumab
Given IV
Radiation: - Intensity-Modulated Radiation Therapy
Undergo intensity-modulated radiation therapy
Other: - Laboratory Biomarker Analysis
Correlative studies
Other: - Placebo
Given IV
Other: - Quality-of-Life Assessment
Ancillary studies
Drug: - Temozolomide
Given orally
Contact a Trial Team
If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.
Status
Address
Providence Hospital
Mobile, Alabama, 36608
Status
Address
Providence Alaska Medical Center
Anchorage, Alaska, 99508
Status
Address
Mayo Clinic in Arizona
Scottsdale, Arizona, 85259
Status
Address
Arizona Oncology Services Foundation
Scottsdale, Arizona, 85260
Status
Address
Arizona Oncology Associates-West Orange Grove
Tucson, Arizona, 85704
Status
Address
Sutter Cancer Centers Radiation Oncology Services-Auburn
Auburn, California, 95603
Status
Address
Alta Bates Summit Medical Center-Herrick Campus
Berkeley, California, 94704
Status
Address
Sutter Cancer Centers Radiation Oncology Services-Cameron Park
Cameron Park, California, 95682
Status
Address
Mercy San Juan Medical Center
Carmichael, California, 95608
Status
Address
John Muir Medical Center-Concord Campus
Concord, California, 94520
Status
Address
City of Hope Comprehensive Cancer Center
Duarte, California, 91010
Status
Address
California Cancer Center - North Fresno
Fresno, California, 93720
Status
Address
Cancer Care Associates of Fresno Medical Group Inc
Fresno, California, 93720
Status
Address
Saint Jude Medical Center
Fullerton, California, 92835
Status
Address
UC San Diego Moores Cancer Center
La Jolla, California, 92093
Status
Address
USC / Norris Comprehensive Cancer Center
Los Angeles, California, 90033
Status
Address
Memorial Medical Center
Modesto, California, 95355
Status
Address
Bay Area Tumor Institute
Oakland, California, 94609
Status
Address
Kaiser Permanente Oakland-Broadway
Oakland, California, 94611
Status
Address
Saint Joseph Hospital - Orange
Orange, California, 92868
Status
Address
Pomona Valley Hospital Medical Center
Pomona, California, 91767
Status
Address
Kaiser Permanente-Rancho Cordova Cancer Center
Rancho Cordova, California, 95670
Status
Address
Rohnert Park Cancer Center
Rohnert Park, California, 94928
Status
Address
Sutter Cancer Centers Radiation Oncology Services-Roseville
Roseville, California, 95661
Status
Address
The Permanente Medical Group-Roseville Radiation Oncology
Roseville, California, 95678
Status
Address
Sutter Medical Center Sacramento
Sacramento, California, 95816
Status
Address
Mercy General Hospital Radiation Oncology Center
Sacramento, California, 95819
Status
Address
South Sacramento Cancer Center
Sacramento, California, 95823
Status
Address
University of California San Diego
San Diego, California, 92103
Status
Address
California Pacific Medical Center-Pacific Campus
San Francisco, California, 94115
Status
Address
Kaiser Permanente Medical Center - Santa Clara
Santa Clara, California, 95051
Status
Address
Kaiser Permanente Cancer Treatment Center
South San Francisco, California, 94080
Status
Address
Sutter Cancer Centers Radiation Oncology Services-Vacaville
Vacaville, California, 95687
Status
Address
John Muir Medical Center-Walnut Creek
Walnut Creek, California, 94598
Status
Address
Rocky Mountain Cancer Centers-Aurora
Aurora, Colorado, 80012
Status
Address
Boulder Community Hospital
Boulder, Colorado, 80301
Status
Address
Penrose-Saint Francis Healthcare
Colorado Springs, Colorado, 80907
Status
Address
Porter Adventist Hospital
Denver, Colorado, 80210
Status
Address
Swedish Medical Center
Englewood, Colorado, 80113
Status
Address
Poudre Valley Hospital
Fort Collins, Colorado, 80524
Status
Address
Rocky Mountain Cancer Centers-Littleton
Littleton, Colorado, 80120
Status
Address
North Suburban Medical Center
Thornton, Colorado, 80229
Status
Address
SCL Health Lutheran Medical Center
Wheat Ridge, Colorado, 80033
Status
Address
Saint Vincent's Medical Center
Bridgeport, Connecticut, 06606
Status
Address
Hartford Hospital
Hartford, Connecticut, 06102
Status
Address
The Hospital of Central Connecticut
New Britain, Connecticut, 06050
Status
Address
Yale University
New Haven, Connecticut, 06520
Status
Address
William Backus Hospital
Norwich, Connecticut, 06360
Status
Address
Broward Health Medical Center
Fort Lauderdale, Florida, 33316
Status
Address
Memorial Regional Hospital/Joe DiMaggio Children's Hospital
Hollywood, Florida, 33021
Status
Address
Integrated Community Oncology Network-Florida Cancer Center Beaches
Jacksonville Beach, Florida, 32250
Status
Address
Baptist MD Anderson Cancer Center
Jacksonville, Florida, 32207
Status
Address
Integrated Community Oncology Network-Southside Cancer Center
Jacksonville, Florida, 32207
Status
Address
Mayo Clinic in Florida
Jacksonville, Florida, 32224-9980
Status
Address
Baptist Medical Center South
Jacksonville, Florida, 32258
Status
Address
Mount Sinai Medical Center
Miami Beach, Florida, 33140
Status
Address
Baptist Hospital of Miami
Miami, Florida, 33176
Status
Address
21st Century Oncology-Orange Park
Orange Park, Florida, 32073
Status
Address
Florida Hospital Orlando
Orlando, Florida, 32803
Status
Address
UF Cancer Center at Orlando Health
Orlando, Florida, 32806
Status
Address
21st Century Oncology-Palatka
Palatka, Florida, 32177
Status
Address
Sacred Heart Hospital
Pensacola, Florida, 32504
Status
Address
Integrated Community Oncology Network-Flager Cancer Center
Saint Augustine, Florida, 32086
Status
Address
Robert and Carol Weissman Cancer Center at Martin Health
Stuart, Florida, 34994
Status
Address
Piedmont Hospital
Atlanta, Georgia, 30309
Status
Address
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia, 30322
Status
Address
John B Amos Cancer Center
Columbus, Georgia, 31904
Status
Address
Dekalb Medical Center
Decatur, Georgia, 30033
Status
Address
Northeast Georgia Medical Center-Gainesville
Gainesville, Georgia, 30501
Status
Address
Southern Regional Medical Center
Riverdale, Georgia, 30274
Status
Address
Memorial University Medical Center
Savannah, Georgia, 31404
Status
Address
University of Hawaii Cancer Center
Honolulu, Hawaii, 96813
Status
Address
Saint Alphonsus Cancer Care Center-Boise
Boise, Idaho, 83706
Status
Address
Northwest Community Hospital
Arlington Heights, Illinois, 60005
Status
Address
Northwestern University
Chicago, Illinois, 60611
Status
Address
John H Stroger Jr Hospital of Cook County
Chicago, Illinois, 60612
Status
Address
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
Status
Address
Decatur Memorial Hospital
Decatur, Illinois, 62526
Status
Address
Ingalls Memorial Hospital
Harvey, Illinois, 60426
Status
Address
Loyola University Medical Center
Maywood, Illinois, 60153
Status
Address
Trinity Medical Center
Moline, Illinois, 61265
Status
Address
Edward Hospital/Cancer Center
Naperville, Illinois, 60540
Status
Address
Advocate Lutheran General Hospital
Park Ridge, Illinois, 60068
Status
Address
Methodist Medical Center of Illinois
Peoria, Illinois, 61603
Status
Address
Memorial Medical Center
Springfield, Illinois, 62781
Status
Address
IU Health Bloomington
Bloomington, Indiana, 47403
Status
Address
Radiation Oncology Associates PC
Fort Wayne, Indiana, 46804
Status
Address
Parkview Hospital Randallia
Fort Wayne, Indiana, 46805
Status
Address
IU Health Methodist Hospital
Indianapolis, Indiana, 46202
Status
Address
Community Cancer Center East
Indianapolis, Indiana, 46219
Status
Address
IU Health Central Indiana Cancer Centers-East
Indianapolis, Indiana, 46219
Status
Address
Community Cancer Center North
Indianapolis, Indiana, 46256
Status
Address
Saint Vincent Hospital and Health Care Center
Indianapolis, Indiana, 46260
Status
Address
IU Health Ball Memorial Hospital
Muncie, Indiana, 47303
Status
Address
Northern Indiana Cancer Research Consortium
South Bend, Indiana, 46628
Status
Address
McFarland Clinic PC-William R Bliss Cancer Center
Ames, Iowa, 50010
Status
Address
Physicians' Clinic of Iowa PC
Cedar Rapids, Iowa, 52402
Status
Address
Iowa Methodist Medical Center
Des Moines, Iowa, 50309
Status
Address
Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
Status
Address
University of Iowa/Holden Comprehensive Cancer Center
Iowa City, Iowa, 52242
Status
Address
Mercy Medical Center - North Iowa
Mason City, Iowa, 50401
Status
Address
University of Kansas Cancer Center
Kansas City, Kansas, 66160
Status
Address
University of Kansas Cancer Center-Overland Park
Overland Park, Kansas, 66210
Status
Address
Kansas City NCI Community Oncology Research Program
Prairie Village, Kansas, 66208
Status
Address
Via Christi Regional Medical Center
Wichita, Kansas, 67214
Status
Address
Wesley Medical Center
Wichita, Kansas, 67214
Status
Address
The James Graham Brown Cancer Center at University of Louisville
Louisville, Kentucky, 40202
Status
Address
Mary Bird Perkins Cancer Center
Baton Rouge, Louisiana, 70809
Status
Address
Ochsner Medical Center Jefferson
New Orleans, Louisiana, 70121
Status
Address
Louisiana State University Health Sciences Center Shreveport
Shreveport, Louisiana, 71103
Status
Address
Central Maine Medical Center
Lewiston, Maine, 04240
Status
Address
Maine Medical Center- Scarborough Campus
Scarborough, Maine, 04074
Status
Address
Anne Arundel Medical Center
Annapolis, Maryland, 21401
Status
Address
University of Maryland/Greenebaum Cancer Center
Baltimore, Maryland, 21201
Status
Address
Saint Agnes Hospital
Baltimore, Maryland, 21229
Status
Address
Massachusetts General Hospital Cancer Center
Boston, Massachusetts, 02114
Status
Address
Saint Anne's Hospital
Fall River, Massachusetts, 02721
Status
Address
Cape Cod Hospital
Hyannis, Massachusetts, 02601
Status
Address
Lowell General Hospital
Lowell, Massachusetts, 01854
Status
Address
D'Amour Center for Cancer Care
Springfield, Massachusetts, 01107
Status
Address
Saint Joseph Mercy Hospital
Ann Arbor, Michigan, 48106
Status
Address
Beaumont Hospital-Dearborn
Dearborn, Michigan, 48124
Status
Address
Saint John Hospital and Medical Center
Detroit, Michigan, 48236
Status
Address
Genesys Regional Medical Center-West Flint Campus
Flint, Michigan, 48532
Status
Address
West Michigan Cancer Center
Kalamazoo, Michigan, 49007
Status
Address
Sparrow Hospital
Lansing, Michigan, 48912
Status
Address
William Beaumont Hospital-Royal Oak
Royal Oak, Michigan, 48073
Status
Address
Saint Mary's of Michigan
Saginaw, Michigan, 48601
Status
Address
Saint John Macomb-Oakland Hospital
Warren, Michigan, 48093
Status
Address
Sanford Clinic North-Bemidgi
Bemidji, Minnesota, 56601
Status
Address
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
Status
Address
Mercy Hospital
Coon Rapids, Minnesota, 55433
Status
Address
Saint Luke's Hospital of Duluth
Duluth, Minnesota, 55805
Status
Address
Minnesota Oncology Hematology PA-Maplewood
Maplewood, Minnesota, 55109
Status
Address
Abbott-Northwestern Hospital
Minneapolis, Minnesota, 55407
Status
Address
North Memorial Medical Health Center
Robbinsdale, Minnesota, 55422
Status
Address
Mayo Clinic
Rochester, Minnesota, 55905
Status
Address
Coborn Cancer Center at Saint Cloud Hospital
Saint Cloud, Minnesota, 56303
Status
Address
Park Nicollet Clinic - Saint Louis Park
Saint Louis Park, Minnesota, 55416
Status
Address
Regions Hospital
Saint Paul, Minnesota, 55101
Status
Address
United Hospital
Saint Paul, Minnesota, 55102
Status
Address
Ridgeview Medical Center
Waconia, Minnesota, 55387
Status
Address
Singing River Hospital
Pascagoula, Mississippi, 39581
Status
Address
Cape Radiation Oncology
Cape Girardeau, Missouri, 63703
Status
Address
Siteman Cancer Center at West County Hospital
Creve Coeur, Missouri, 63141
Status
Address
Truman Medical Center
Kansas City, Missouri, 64108
Status
Address
The University of Kansas Cancer Center-South
Kansas City, Missouri, 64131
Status
Address
The University of Kansas Cancer Center-North
Kansas City, Missouri, 64154
Status
Address
Washington University School of Medicine
Saint Louis, Missouri, 63110
Status
Address
Siteman Cancer Center at Saint Peters Hospital
Saint Peters, Missouri, 63376
Status
Address
Billings Clinic Cancer Center
Billings, Montana, 59101
Status
Address
CHI Health Good Samaritan
Kearney, Nebraska, 68847
Status
Address
Saint Elizabeth Regional Medical Center
Lincoln, Nebraska, 68510
Status
Address
Nebraska Methodist Hospital
Omaha, Nebraska, 68114
Status
Address
Alegent Health Immanuel Medical Center
Omaha, Nebraska, 68122
Status
Address
Alegent Health Bergan Mercy Medical Center
Omaha, Nebraska, 68124
Status
Address
University of Nebraska Medical Center
Omaha, Nebraska, 68198
Status
Address
Nevada Cancer Research Foundation CCOP
Las Vegas, Nevada, 89106
Status
Address
Renown Regional Medical Center
Reno, Nevada, 89502
Status
Address
Concord Hospital
Concord, New Hampshire, 03301
Status
Address
Dartmouth Hitchcock Medical Center
Lebanon, New Hampshire, 03756
Status
Address
Elliot Hospital
Manchester, New Hampshire, 03103
Status
Address
Saint Barnabas Medical Center
Livingston, New Jersey, 07039
Status
Address
Monmouth Medical Center
Long Branch, New Jersey, 07740
Status
Address
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
New Brunswick, New Jersey, 08903
Status
Address
Riverview Medical Center/Booker Cancer Center
Red Bank, New Jersey, 07701
Status
Address
Sparta Cancer Treatment Center
Sparta, New Jersey, 07871
Status
Address
Lovelace Medical Center-Downtown
Albuquerque, New Mexico, 87102
Status
Address
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87102
Status
Address
New Mexico Oncology Hematology Consultants
Albuquerque, New Mexico, 87109
Status
Address
New York Oncology Hematology PC - Albany
Albany, New York, 12206
Status
Address
Montefiore Medical Center - Moses Campus
Bronx, New York, 10467-2490
Status
Address
Maimonides Medical Center
Brooklyn, New York, 11219
Status
Address
Sands Cancer Center
Canandaigua, New York, 14424
Status
Address
Memorial Sloan-Kettering Cancer Center
New York, New York, 10065
Status
Address
South Nassau Communities
Oceanside, New York, 11572
Status
Address
Hudson Valley Oncology Associates
Poughkeepsie, New York, 12601
Status
Address
Highland Hospital
Rochester, New York, 14620
Status
Address
University Radiation Oncology
Rochester, New York, 14626
Status
Address
University of Rochester
Rochester, New York, 14642
Status
Address
Stony Brook University Medical Center
Stony Brook, New York, 11794
Status
Address
State University of New York Upstate Medical University
Syracuse, New York, 13210
Status
Address
Mission Hospital-Memorial Campus
Asheville, North Carolina, 28801
Status
Address
Carolinas Medical Center/Levine Cancer Institute
Charlotte, North Carolina, 28203
Status
Address
Novant Health Presbyterian Medical Center
Charlotte, North Carolina, 28204
Status
Address
Margaret R Pardee Memorial Hospital
Hendersonville, North Carolina, 28791
Status
Address
FirstHealth of the Carolinas-Moore Regional Hosiptal
Pinehurst, North Carolina, 28374
Status
Address
Duke Women's Cancer Care Raleigh
Raleigh, North Carolina, 27607
Status
Address
Novant Health Forsyth Medical Center
Winston-Salem, North Carolina, 27103
Status
Address
Southeast Clinical Oncology Research (SCOR) Consortium NCORP
Winston-Salem, North Carolina, 27104
Status
Address
Sanford Broadway Medical Center
Fargo, North Dakota, 58122
Status
Address
Summa Akron City Hospital/Cooper Cancer Center
Akron, Ohio, 44304
Status
Address
Akron General Medical Center
Akron, Ohio, 44307
Status
Address
Summa Barberton Hospital
Barberton, Ohio, 44203
Status
Address
UHHS-Chagrin Highlands Medical Center
Beachwood, Ohio, 44122
Status
Address
Mercy Medical Center
Canton, Ohio, 44708
Status
Address
Aultman Health Foundation
Canton, Ohio, 44710
Status
Address
University of Cincinnati/Barrett Cancer Center
Cincinnati, Ohio, 45219
Status
Address
Case Western Reserve University
Cleveland, Ohio, 44106
Status
Address
MetroHealth Medical Center
Cleveland, Ohio, 44109
Status
Address
Cleveland Clinic Cancer Center/Fairview Hospital
Cleveland, Ohio, 44111
Status
Address
Cleveland Clinic Foundation
Cleveland, Ohio, 44195
Status
Address
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210
Status
Address
Riverside Methodist Hospital
Columbus, Ohio, 43214
Status
Address
Grant Medical Center
Columbus, Ohio, 43215
Status
Address
The Mark H Zangmeister Center
Columbus, Ohio, 43219
Status
Address
Toledo Clinic Cancer Centers-Maumee
Maumee, Ohio, 43537
Status
Address
Hillcrest Hospital Cancer Center
Mayfield Heights, Ohio, 44124
Status
Address
Lake University Ireland Cancer Center
Mentor, Ohio, 44060
Status
Address
Southwest General Health Center Ireland Cancer Center
Middleburg Heights, Ohio, 44130
Status
Address
Saint Charles Hospital
Oregon, Ohio, 43616
Status
Address
Cancer Care Center, Incorporated
Salem, Ohio, 44460
Status
Address
North Coast Cancer Care
Sandusky, Ohio, 44870
Status
Address
Trinity's Tony Teramana Cancer Center
Steubenville, Ohio, 43952
Status
Address
Flower Hospital
Sylvania, Ohio, 43560
Status
Address
Mercy Saint Anne Hospital
Toledo, Ohio, 43623
Status
Address
University Pointe
West Chester, Ohio, 45069
Status
Address
UHHS-Westlake Medical Center
Westlake, Ohio, 44145
Status
Address
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Status
Address
Natalie Warren Bryant Cancer Center at Saint Francis
Tulsa, Oklahoma, 74136
Status
Address
Willamette Valley Cancer Center
Eugene, Oregon, 97401
Status
Address
Legacy Good Samaritan Hospital and Medical Center
Portland, Oregon, 97210
Status
Address
Providence Portland Medical Center
Portland, Oregon, 97213
Status
Address
Providence Saint Vincent Medical Center
Portland, Oregon, 97225
Status
Address
Salem Hospital
Salem, Oregon, 97301
Status
Address
Abington Memorial Hospital
Abington, Pennsylvania, 19001
Status
Address
Lehigh Valley Hospital-Cedar Crest
Allentown, Pennsylvania, 18103
Status
Address
UPMC-Heritage Valley Health System Beaver
Beaver, Pennsylvania, 15009
Status
Address
Saint Luke's University Hospital-Bethlehem Campus
Bethlehem, Pennsylvania, 18015
Status
Address
Bryn Mawr Hospital
Bryn Mawr, Pennsylvania, 19010
Status
Address
Geisinger Medical Center
Danville, Pennsylvania, 17822
Status
Address
Northeast Radiation Oncology Center
Dunmore, Pennsylvania, 18512
Status
Address
Pocono Medical Center
East Stroudsburg, Pennsylvania, 18301
Status
Address
The Regional Cancer Center
Erie, Pennsylvania, 16505
Status
Address
Fox Chase Cancer Center Buckingham
Furlong, Pennsylvania, 18925
Status
Address
Adams Cancer Center
Gettysburg, Pennsylvania, 17325
Status
Address
UPMC Cancer Centers - Arnold Palmer Pavilion
Greensburg, Pennsylvania, 15601
Status
Address
Cherry Tree Cancer Center
Hanover, Pennsylvania, 17331
Status
Address
Penn State Milton S Hershey Medical Center
Hershey, Pennsylvania, 17033-0850
Status
Address
UPMC-Johnstown/John P. Murtha Regional Cancer Center
Johnstown, Pennsylvania, 15901
Status
Address
Armstrong Center for Medicine and Health
Kittanning, Pennsylvania, 16201
Status
Address
Lancaster General Hospital
Lancaster, Pennsylvania, 17604
Status
Address
UPMC Cancer Center at UPMC McKeesport
McKeesport, Pennsylvania, 15132
Status
Address
Intercommunity Cancer Center
Monroeville, Pennsylvania, 15146
Status
Address
Allegheny Valley Hospital
Natrona Heights, Pennsylvania, 15065
Status
Address
UPMC Jameson
New Castle, Pennsylvania, 16105
Status
Address
Paoli Memorial Hospital
Paoli, Pennsylvania, 19301
Status
Address
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, 19107
Status
Address
Fox Chase Cancer Center
Philadelphia, Pennsylvania, 19111
Status
Address
Aria Health-Torresdale Campus
Philadelphia, Pennsylvania, 19114
Status
Address
Allegheny General Hospital
Pittsburgh, Pennsylvania, 15212
Status
Address
UPMC-Shadyside Hospital
Pittsburgh, Pennsylvania, 15232
Status
Address
UPMC Jefferson Regional Radiation Oncology
Pittsburgh, Pennsylvania, 15236
Status
Address
UPMC-Passavant Hospital
Pittsburgh, Pennsylvania, 15237
Status
Address
UPMC Cancer Center at UPMC Northwest
Seneca, Pennsylvania, 16346
Status
Address
UPMC Washington Hospital Radiation Oncology
Washington, Pennsylvania, 15301
Status
Address
Reading Hospital
West Reading, Pennsylvania, 19611
Status
Address
Lankenau Medical Center
Wynnewood, Pennsylvania, 19096
Status
Address
WellSpan Health-York Hospital
York, Pennsylvania, 17403
Status
Address
Rhode Island Hospital
Providence, Rhode Island, 02903
Status
Address
Spartanburg Medical Center
Spartanburg, South Carolina, 29303
Status
Address
Rapid City Regional Hospital
Rapid City, South Dakota, 57701
Status
Address
Sanford Cancer Center-Oncology Clinic
Sioux Falls, South Dakota, 57104
Status
Address
Erlanger Medical Center
Chattanooga, Tennessee, 37403
Status
Address
Jackson-Madison County General Hospital
Jackson, Tennessee, 38301
Status
Address
Thompson Cancer Survival Center
Knoxville, Tennessee, 37916
Status
Address
Texas Oncology-Arlington South
Arlington, Texas, 76014
Status
Address
Texas Oncology Bedford
Bedford, Texas, 76022
Status
Address
Saint Joseph Regional Cancer Center
Bryan, Texas, 77802
Status
Address
Texas Oncology Methodist Charlton Cancer Center
Dallas, Texas, 75237
Status
Address
UT Southwestern/Simmons Cancer Center-Dallas
Dallas, Texas, 75390
Status
Address
Texas Oncology-Denton South
Denton, Texas, 76210
Status
Address
The Klabzuba Cancer Center
Fort Worth, Texas, 76104
Status
Address
University of Texas Medical Branch
Galveston, Texas, 77555-0565
Status
Address
M D Anderson Cancer Center
Houston, Texas, 77030
Status
Address
Texas Oncology-Longview Cancer Center
Longview, Texas, 75601
Status
Address
Covenant Medical Center-Lakeside
Lubbock, Texas, 79410
Status
Address
West Texas Cancer Center
Odessa, Texas, 79761
Status
Address
University of Texas Health Science Center at San Antonio
San Antonio, Texas, 78229
Status
Address
Texas Cancer Center-Sherman
Sherman, Texas, 75090
Status
Address
Texas Oncology Cancer Center Sugar Land
Sugar Land, Texas, 77479
Status
Address
Tyler Cancer Center
Tyler, Texas, 75702
Status
Address
Intermountain Medical Center
Murray, Utah, 84107
Status
Address
McKay-Dee Hospital Center
Ogden, Utah, 84403
Status
Address
Utah Valley Regional Medical Center
Provo, Utah, 84604
Status
Address
Dixie Medical Center Regional Cancer Center
Saint George, Utah, 84770
Status
Address
Utah Cancer Specialists-Salt Lake City
Salt Lake City, Utah, 84106
Status
Address
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, 84112
Status
Address
LDS Hospital
Salt Lake City, Utah, 84143
Status
Address
University of Vermont Medical Center
Burlington, Vermont, 05401
Status
Address
Inova Alexandria Hospital
Alexandria, Virginia, 22304
Status
Address
Sentara Norfolk General Hospital
Norfolk, Virginia, 23507
Status
Address
Naval Medical Center - Portsmouth
Portsmouth, Virginia, 23708-2197
Status
Address
PeaceHealth Saint Joseph Medical Center
Bellingham, Washington, 98225
Status
Address
Harrison Medical Center
Bremerton, Washington, 98310
Status
Address
Virginia Mason Medical Center
Seattle, Washington, 98101
Status
Address
Swedish Medical Center-First Hill
Seattle, Washington, 98122-4307
Status
Address
Cancer Care Northwest - Spokane South
Spokane, Washington, 99202
Status
Address
PeaceHealth Southwest Medical Center
Vancouver, Washington, 98664
Status
Address
Compass Oncology Vancouver
Vancouver, Washington, 98684
Status
Address
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
Yakima, Washington, 98902
Status
Address
Wheeling Hospital/Schiffler Cancer Center
Wheeling, West Virginia, 26003
Status
Address
Langlade Hospital and Cancer Center
Antigo, Wisconsin, 54409
Status
Address
Radiology Associates of Appleton/ThedaCare Regional Medical Center
Appleton, Wisconsin, 54911
Status
Address
Marshfield Clinic Cancer Center at Sacred Heart
Eau Claire, Wisconsin, 54701
Status
Address
Sacred Heart Hospital
Eau Claire, Wisconsin, 54701
Status
Address
Bellin Memorial Hospital
Green Bay, Wisconsin, 54301
Status
Address
Saint Vincent Hospital Cancer Center Green Bay
Green Bay, Wisconsin, 54301
Status
Address
Saint Vincent Hospital Cancer Center at Saint Mary's
Green Bay, Wisconsin, 54303
Status
Address
UW Cancer Center Johnson Creek
Johnson Creek, Wisconsin, 53038
Status
Address
Gundersen Lutheran Medical Center
La Crosse, Wisconsin, 54601
Status
Address
Dean Hematology and Oncology Clinic
Madison, Wisconsin, 53717
Status
Address
University of Wisconsin Hospital and Clinics
Madison, Wisconsin, 53792
Status
Address
Bay Area Medical Center
Marinette, Wisconsin, 54143
Status
Address
Marshfield Clinic
Marshfield, Wisconsin, 54449
Status
Address
Marshfield Medical Center
Marshfield, Wisconsin, 54449
Status
Address
Froedtert and the Medical College of Wisconsin
Milwaukee, Wisconsin, 53226
Status
Address
Marshfield Clinic-Minocqua Center
Minocqua, Wisconsin, 54548
Status
Address
Saint Michael's Hospital
Stevens Point, Wisconsin, 54481
Status
Address
ProHealth Waukesha Memorial Hospital
Waukesha, Wisconsin, 53188
Status
Address
Aspirus Regional Cancer Center
Wausau, Wisconsin, 54401
Status
Address
Diagnostic and Treatment Center
Weston, Wisconsin, 54476
Status
Address
Marshfield Clinic - Weston Center
Weston, Wisconsin, 54476
Status
Address
Aspirus UW Cancer Center
Wisconsin Rapids, Wisconsin, 54494
International Sites
Status
Address
Doctor H. Bliss Murphy Cancer Centre
St. John's, Newfoundland and Labrador, A1B 3V6
Status
Address
Health Sciences North
Sudbury, Ontario, P3E 5J1
Status
Address
CHUM - Hopital Notre-Dame
Montreal, Quebec, H2L 4M1
Status
Address
McGill University Department of Oncology
Montreal, Quebec, H2W 1S6
Status
Address
Allan Blair Cancer Centre
Regina, Saskatchewan, S4T 7T1
Status
Address
Tel Aviv Sourasky Medical Center
Tel Aviv, , 64239
