Vaccine Therapy With Bevacizumab Versus Bevacizumab Alone in Treating Patients With Recurrent Glioblastoma Multiforme That Can Be Removed by Surgery
Study Purpose
This randomized phase II trial studies how well giving vaccine therapy with or without bevacizumab works in treating patients with recurrent glioblastoma multiforme that can be removed by surgery. Vaccines consisting of heat shock protein-peptide complexes made from a person's own tumor tissue may help the body build an effective immune response to kill tumor cells that may remain after surgery. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them. It is not yet known whether giving vaccine therapy is more effective with or without bevacizumab in treating glioblastoma multiforme.
Recruitment Criteria
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Accepts Healthy Volunteers
Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms |
No |
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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 |
Pre-registration (Pre-Surgery) Eligibility Criteria.
- - Histologic documentation: Prior histologic diagnosis of GBM at first occurrence.
- - Stage: First or second recurrence of GBM or gliosarcoma considered to be surgically resectable.
- - Prior Treatment: - No radiotherapy within 90 days prior to pre-registration.
- - No prior treatment with any anti-angiogenic agent targeting the VEGF pathway including but not limited to bevacizumab, cediranib, vandetanib, sunitinib, pazopanib, aflibercept, or sorafenib.
- - No prior treatment with HSPPC-96 or other investigational immunotherapy.
- - Must have received prior treatment with radiotherapy and temozolomide for histologically confirmed GBM at initial diagnosis.
- - No tumor directed therapy for most recent progression.
- - No prior Gliadel® wafers.
- - No clinically significant cardiovascular disease: - Patients with a history of hypertension must be well controlled (<150/90) on a regimen of antihypertensive therapy.
- - History of arterial thrombotic events within the past 6 months, including transient ischemic attack (TIA), cerebrovascular accident (CVA), peripheral arterial thrombus, unstable angina or angina requiring surgical or medial intervention in the past 6 months, or myocardial infarction (MI).
- - Patients who have had a deep vein thrombosis or pulmonary embolus within the past 6 months are eligible if they are on stable therapeutic anticoagulation.
- - No current New York Heart Association classification II, III or IV congestive heart failure.
- - No significant bleeding within the past 6 months; no bleeding diathesis or coagulopathy.
- - No history of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within past 12 months.
- - No evidence of any systemic autoimmune disease (e.g. Hashimoto's thyroiditis) and/or any history of primary or secondary immunodeficiency, and no immunosuppressant therapy (with the exception of dexamethasone as noted below) for any reason.
- - Age ≥ 18 years of age.
- - Karnofsky functional status rating ≥70.
- - No more than 16 mg dexamethasone (or equivalent) per day.
- - Non-pregnant and non-nursing.
- - Pre-registration eligibility criteria continue to be met.
- - Histologic documentation: confirmed histological diagnosis of recurrent GBM or gliosarcoma.
- - ≥ 90% surgical resection of recurrent GBM confirmed by central radiology review by MRI with or without gadolinium per institutional guidelines.
- - ≥ 7 grams of resected tumor available for vaccine manufacture as determined by institutional pathologist.
- - Availability of ≥ 6 clinical vials of HSPPC-96.
- - Required Initial Laboratory Values: - Granulocytes ≥1,500/µL.
- - Platelet count ≥100,000/µL.
- - Total Bilirubin ≤ 2.0 x ULN.
- - UPC ratio <1 or Urine protein ≤ 1+ - Calculated creatinine clearance ≥ 45 ml/min.
- - SGOT/SGPT(AST/ALT) ≤ 2.5 x ULN.
- - No serious, non-healing wounds or ulcers.
- - At least 7 days since any minor surgery such as port placement.
- - No major surgical procedures, open biopsy or significant traumatic injury ≤ 28 days prior to registration or anticipation of need for elective or planned major surgical procedure during the study.
- - No active or recent hemoptysis (≥½ teaspoon of bright red blood per episode) ≤ 30 days prior to registration.
- - No new bleeding on D28 (+/-3) MRI (or CT if MRI is contraindicated) - No clinical deterioration at the time of registration/randomization.
Trial Details
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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. |
NCT01814813 |
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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 2 |
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Lead Sponsor
The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data. |
Alliance for Clinical Trials in Oncology |
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Principal Investigator
The person who is responsible for the scientific and technical direction of the entire clinical study. |
Ian Parney, MD, PhDOrin Bloch, MD |
| Principal Investigator Affiliation | Mayo ClinicNorthwestern University |
|
Agency Class
Category of organization(s) involved as sponsor (and collaborator) supporting the trial. |
Other, NIH, Industry |
| Overall Status | Terminated |
| Countries | United States |
|
Conditions
The disease, disorder, syndrome, illness, or injury that is being studied. |
Recurrent Glioblastoma, Recurrent Adult Brain Tumor, Gliosarcoma |
The purpose of this study is to compare the effects of a vaccine with bevacizumab versus bevacizumab alone on a patient's brain tumor. The vaccine is called heat shock protein peptide complex 96 (HSPPC-96). HSPPC-96 is experimental. Specifically, HSPPC-96 is a protein that may work to help the body have a response against remaining brain tumor cells. Bevacizumab has been approved by the Food and Drug administration for treating brain tumors that grow back. In this study, patients will either get HSPPC-96 vaccine at the same time as bevacizumab, HSPPC vaccine first and then bevacizumab if the tumor comes back, or bevacizumab alone. The use of HSPPC-96 and bevacizumab is investigational. The primary objective of the study is to determine whether there is an overall survival advantage of HSPPC-96 administered with bevacizumab, given concomitantly or at the point of progression, in comparison with bevacizumab alone in patients with surgically resectable recurrent glioblastoma multiforme. The secondary objectives are: 1. to evaluate the safety and tolerability of HSPPC-96 with bevacizumab. 2. to evaluate the progression free survival of HSPPC-96 with bevacizumab, given concomitantly or at the point of progression. Patients must undergo surgery within 28 days from pre-registration. There must be confirmation of adequacy of tissue for vaccine manufacture, tumor tissue submitted to Agenus, confirmation of ≥ 90% resection by central radiology review and vaccine manufacture of at least six vials. Patients will be randomized to one of three treatment arms. Please see the "Arms" section for more details. Patients will be monitored approximately 5 years post-surgery.
Arms
Experimental: Arm 1, HSPPC-96 + concomitant bevacizumab
HSPPC-96 0.4mL intradermal on days 1 and 8 of cycles 1 and 2, then on day 1 of each cycle, up to a maximum of 12 doses (10 cycles), plus bevacizumab 10 mg/kg intravenous (IV) on day 1 of each cycle, until progression. HSPPC-96 should be administered at least 60 minutes prior to starting bevacizumab infusion. (1 cycle=14 days) Note: If HSPPC-96 treatment has ended but there is no evidence of disease progression, the patient should continue to receive bevacizumab at the specified dose until progression.
Experimental: Arm 2, HSPPC-96 with bevacizumab at progression
HSPPC-96 0.4mL intradermal on days 1 and 8 of cycles 1 and 2, then on day 1 of each cycle, up to a maximum of 12 doses (10 cycles). At progression: bevacizumab 10mg/kg intravenous (IV) on day 1 of each cycle, until further progression. (1 cycle = 14 days) NOTE: It is possible that HSPPC-96 vaccination may end prior to evidence of progression. In this instance it is important to wait until there is confirmed evidence of progression before initiating treatment with bevacizumab. Upon confirmation of progression the patient should initiate bevacizumab within 7-42 days from the last dose of vaccine.
Active Comparator: Arm 3, Bevacizumab
Bevacizumab 10mg/kg intravenous (IV) on day 1 of each cycle, until progression. (1 cycle = 14 days)
Interventions
Biological: - HSPPC-96
intradermal infusion
Drug: - bevacizumab
intravenous
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.
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Anchorage Associates in Radiation Medicine
Anchorage, Alaska, 98508
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Anchorage Radiation Therapy Center
Anchorage, Alaska, 99504
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Alaska Breast Care and Surgery LLC
Anchorage, Alaska, 99508
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Alaska Oncology and Hematology LLC
Anchorage, Alaska, 99508
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Alaska Regional Hospital
Anchorage, Alaska, 99508
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Alaska Women's Cancer Care
Anchorage, Alaska, 99508
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Anchorage Oncology Centre
Anchorage, Alaska, 99508
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Katmai Oncology Group
Anchorage, Alaska, 99508
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Providence Alaska Medical Center
Anchorage, Alaska, 99508
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Mercy Cancer Center-Hot Springs
Hot Springs, Arkansas, 71913
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University of Arkansas for Medical Sciences
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Kaiser Permanente-Deer Valley Medical Center
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Sutter Auburn Faith Hospital
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Sutter Cancer Centers Radiation Oncology Services-Auburn
Auburn, California, 95603
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Alta Bates Summit Medical Center-Herrick Campus
Berkeley, California, 94704
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Providence Saint Joseph Medical Center/Disney Family Cancer Center
Burbank, California, 91505
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Mills - Peninsula Hospitals
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Sutter Cancer Centers Radiation Oncology Services-Cameron Park
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Eden Hospital Medical Center
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Epic Care-Dublin
Dublin, California, 94568
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Emeryville, California, 94608
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Epic Care Partners in Cancer Care
Emeryville, California, 94608
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Fremont, California, 94538
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Fresno Cancer Center
Fresno, California, 93720
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Kaiser Permanente
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Kaiser Permanente Los Angeles Medical Center
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Contra Costa Regional Medical Center
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Memorial Medical Center
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Kaiser Permanente-Modesto
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Palo Alto Medical Foundation-Camino Division
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Alta Bates Summit Medical Center - Summit Campus
Oakland, California, 94609
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Bay Area Tumor Institute
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Kaiser Permanente Oakland-Broadway
Oakland, California, 94611
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Kaiser Permanente-Oakland
Oakland, California, 94611
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Palo Alto Medical Foundation Health Care
Palo Alto, California, 94301
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Stanford Cancer Institute
Palo Alto, California, 94304
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Kaiser Permanente-Rancho Cordova Cancer Center
Rancho Cordova, California, 95670
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Kaiser Permanente-Redwood City
Redwood City, California, 94063
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Kaiser Permanente-Richmond
Richmond, California, 94801
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Rohnert Park Cancer Center
Rohnert Park, California, 94928
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Kaiser Permanente-Roseville
Roseville, California, 95661
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Sutter Cancer Centers Radiation Oncology Services-Roseville
Roseville, California, 95661
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Sutter Roseville Medical Center
Roseville, California, 95661
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The Permanente Medical Group-Roseville Radiation Oncology
Roseville, California, 95678
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Sutter General Hospital
Sacramento, California, 95816
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Kaiser Permanente-South Sacramento
Sacramento, California, 95823
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South Sacramento Cancer Center
Sacramento, California, 95823
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Kaiser Permanente - Sacramento
Sacramento, California, 95825
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California Pacific Medical Center-Pacific Campus
San Francisco, California, 94115
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Kaiser Permanente-San Francisco
San Francisco, California, 94115
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UCSF Medical Center-Mount Zion
San Francisco, California, 94115
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UCSF Medical Center-Parnassus
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Kaiser Permanente-Santa Teresa-San Jose
San Jose, California, 95119
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Kaiser Permanente San Leandro
San Leandro, California, 94577
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Kaiser Permanente-San Rafael
San Rafael, California, 94903
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Kaiser Permanente Medical Center - Santa Clara
Santa Clara, California, 95051
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Palo Alto Medical Foundation-Santa Cruz
Santa Cruz, California, 95065
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Kaiser Permanente-Santa Rosa
Santa Rosa, California, 95403
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Sutter Pacific Medical Foundation
Santa Rosa, California, 95403
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Kaiser Permanente Cancer Treatment Center
South San Francisco, California, 94080
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Kaiser Permanente-South San Francisco
South San Francisco, California, 94080
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Kaiser Permanente-Stockton
Stockton, California, 95210
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Palo Alto Medical Foundation-Sunnyvale
Sunnyvale, California, 94086
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Sutter Cancer Centers Radiation Oncology Services-Vacaville
Vacaville, California, 95687
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Kaiser Permanente Medical Center-Vacaville
Vacaville, California, 95688
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Kaiser Permanente-Vallejo
Vallejo, California, 94589
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Sutter Solano Medical Center/Cancer Center
Vallejo, California, 94589
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Kaiser Permanente-Walnut Creek
Walnut Creek, California, 94596
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Rocky Mountain Cancer Centers-Aurora
Aurora, Colorado, 80012
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The Medical Center of Aurora
Aurora, Colorado, 80012
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Boulder Community Hospital
Boulder, Colorado, 80301
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Rocky Mountain Cancer Centers-Boulder
Boulder, Colorado, 80304
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Penrose-Saint Francis Healthcare
Colorado Springs, Colorado, 80907
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Rocky Mountain Cancer Centers-Penrose
Colorado Springs, Colorado, 80907
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Porter Adventist Hospital
Denver, Colorado, 80210
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Colorado Blood Cancer Institute
Denver, Colorado, 80218
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Presbyterian - Saint Lukes Medical Center - Health One
Denver, Colorado, 80218
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Rocky Mountain Cancer Centers-Midtown
Denver, Colorado, 80218
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SCL Health Saint Joseph Hospital
Denver, Colorado, 80218
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Rocky Mountain Cancer Centers-Rose
Denver, Colorado, 80220
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Rose Medical Center
Denver, Colorado, 80220
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Colorado Cancer Research Program NCORP
Denver, Colorado, 80222
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Mercy Medical Center
Durango, Colorado, 81301
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Southwest Oncology PC
Durango, Colorado, 81301
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Comprehensive Cancer Care and Research Institute of Colorado LLC
Englewood, Colorado, 80113
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Swedish Medical Center
Englewood, Colorado, 80113
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Mountain Blue Cancer Care Center
Golden, Colorado, 80401
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North Colorado Medical Center
Greeley, Colorado, 80631
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Rocky Mountain Cancer Centers-Greenwood Village
Greenwood Village, Colorado, 80111
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Rocky Mountain Cancer Centers-Lakewood
Lakewood, Colorado, 80228
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Saint Anthony Hospital
Lakewood, Colorado, 80228
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Rocky Mountain Cancer Centers-Littleton
Littleton, Colorado, 80120
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Littleton Adventist Hospital
Littleton, Colorado, 80122
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Rocky Mountain Cancer Centers-Sky Ridge
Lone Tree, Colorado, 80124
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Sky Ridge Medical Center
Lone Tree, Colorado, 80124
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Longmont United Hospital
Longmont, Colorado, 80501
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Rocky Mountain Cancer Centers-Longmont
Longmont, Colorado, 80501
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McKee Medical Center
Loveland, Colorado, 80539
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Parker Adventist Hospital
Parker, Colorado, 80138
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Rocky Mountain Cancer Centers-Parker
Parker, Colorado, 80138
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Saint Mary Corwin Medical Center
Pueblo, Colorado, 81004
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Rocky Mountain Cancer Centers - Pueblo
Pueblo, Colorado, 81008
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Rocky Mountain Cancer Centers-Thornton
Thornton, Colorado, 80260
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SCL Health Lutheran Medical Center
Wheat Ridge, Colorado, 80033
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Saint Vincent's Medical Center
Bridgeport, Connecticut, 06606
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Smilow Cancer Hospital Care Center at Saint Francis
Hartford, Connecticut, 06105
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Boca Raton Regional Hospital
Boca Raton, Florida, 33486
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Memorial Regional Hospital/Joe DiMaggio Children's Hospital
Hollywood, Florida, 33021
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Mount Sinai Medical Center
Miami Beach, Florida, 33140
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University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami, Florida, 33136
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Memorial Hospital West
Pembroke Pines, Florida, 33028
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Emory University Hospital Midtown
Atlanta, Georgia, 30308
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Piedmont Hospital
Atlanta, Georgia, 30309
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Emory University/Winship Cancer Institute
Atlanta, Georgia, 30322
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Saint Alphonsus Cancer Care Center-Boise
Boise, Idaho, 83706
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Saint Luke's Mountain States Tumor Institute
Boise, Idaho, 83712
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Kootenai Medical Center
Coeur d'Alene, Idaho, 83814
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Saint Luke's Mountain States Tumor Institute - Fruitland
Fruitland, Idaho, 83619
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Saint Luke's Mountain States Tumor Institute - Meridian
Meridian, Idaho, 83642
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Saint Luke's Mountain States Tumor Institute - Nampa
Nampa, Idaho, 83686
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Kootenai Cancer Center
Post Falls, Idaho, 83854
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Kootenai Cancer Clinic
Sandpoint, Idaho, 83864
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Saint Luke's Mountain States Tumor Institute-Twin Falls
Twin Falls, Idaho, 83301
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Saint Joseph Medical Center
Bloomington, Illinois, 61701
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Illinois CancerCare-Bloomington
Bloomington, Illinois, 61704
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Illinois CancerCare-Canton
Canton, Illinois, 61520
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Memorial Hospital of Carbondale
Carbondale, Illinois, 62902
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Illinois CancerCare-Carthage
Carthage, Illinois, 62321
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Centralia Oncology Clinic
Centralia, Illinois, 62801
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Northwestern University
Chicago, Illinois, 60611
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Rush University Medical Center
Chicago, Illinois, 60612
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University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
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Cancer Care Center of Decatur
Decatur, Illinois, 62526
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Decatur Memorial Hospital
Decatur, Illinois, 62526
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Crossroads Cancer Center
Effingham, Illinois, 62401
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Illinois CancerCare-Eureka
Eureka, Illinois, 61530
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NorthShore University HealthSystem-Evanston Hospital
Evanston, Illinois, 60201
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Illinois CancerCare-Galesburg
Galesburg, Illinois, 61401
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Western Illinois Cancer Treatment Center
Galesburg, Illinois, 61401
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Northwestern Medicine Cancer Center Delnor
Geneva, Illinois, 60134
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NorthShore University HealthSystem-Glenbrook Hospital
Glenview, Illinois, 60026
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NorthShore University HealthSystem-Highland Park Hospital
Highland Park, Illinois, 60035
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Illinois CancerCare-Kewanee Clinic
Kewanee, Illinois, 61443
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Illinois CancerCare-Macomb
Macomb, Illinois, 61455
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Illinois CancerCare-Ottawa Clinic
Ottawa, Illinois, 61350
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Ottawa, Illinois, 61350
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Illinois CancerCare-Pekin
Pekin, Illinois, 61554
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OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
Pekin, Illinois, 61554
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Methodist Medical Center of Illinois
Peoria, Illinois, 61603
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Illinois CancerCare-Peoria
Peoria, Illinois, 61615
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OSF Saint Francis Radiation Oncology at Peoria Cancer Center
Peoria, Illinois, 61615
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OSF Saint Francis Medical Center
Peoria, Illinois, 61637
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Illinois CancerCare-Peru
Peru, Illinois, 61354
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Valley Radiation Oncology
Peru, Illinois, 61354
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Illinois CancerCare-Princeton
Princeton, Illinois, 61356
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Central Illinois Hematology Oncology Center
Springfield, Illinois, 62702
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Southern Illinois University School of Medicine
Springfield, Illinois, 62702
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Springfield Clinic
Springfield, Illinois, 62702
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Memorial Medical Center
Springfield, Illinois, 62781
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Cancer Care Specialists of Illinois-Swansea
Swansea, Illinois, 62226
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Northwestern Medicine Cancer Center Warrenville
Warrenville, Illinois, 60555
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Elkhart Clinic
Elkhart, Indiana, 46514-2098
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Michiana Hematology Oncology PC-Elkhart
Elkhart, Indiana, 46514
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Elkhart General Hospital
Elkhart, Indiana, 46515
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Radiation Oncology Associates PC
Fort Wayne, Indiana, 46804
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Parkview Hospital Randallia
Fort Wayne, Indiana, 46805
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Franciscan Health Indianapolis
Indianapolis, Indiana, 46237
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Community Howard Regional Health
Kokomo, Indiana, 46904
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IU Health La Porte Hospital
La Porte, Indiana, 46350
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Memorial Regional Cancer Center Day Road
Mishawaka, Indiana, 46544
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Michiana Hematology Oncology PC-Mishawaka
Mishawaka, Indiana, 46545
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Saint Joseph Regional Medical Center-Mishawaka
Mishawaka, Indiana, 46545
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Michiana Hematology Oncology PC-Plymouth
Plymouth, Indiana, 46563
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Address
Reid Health
Richmond, Indiana, 47374
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Memorial Hospital of South Bend
South Bend, Indiana, 46601
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Address
Michiana Hematology Oncology PC-South Bend
South Bend, Indiana, 46601
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Address
South Bend Clinic
South Bend, Indiana, 46617
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Northern Indiana Cancer Research Consortium
South Bend, Indiana, 46628
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Michiana Hematology Oncology PC-Westville
Westville, Indiana, 46391
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Medical Oncology and Hematology Associates-West Des Moines
Clive, Iowa, 50325
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Address
Mercy Cancer Center-West Lakes
Clive, Iowa, 50325
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Address
Alegent Health Mercy Hospital
Council Bluffs, Iowa, 51503
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Address
Greater Regional Medical Center
Creston, Iowa, 50801
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Address
Medical Oncology and Hematology Associates-Laurel
Des Moines, Iowa, 50314
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Address
Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
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Address
Mercy Medical Center-West Lakes
West Des Moines, Iowa, 50266
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Address
Kansas Institute of Medicine Cancer and Blood Center
Lenexa, Kansas, 66219
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Address
Minimally Invasive Surgery Hospital
Lenexa, Kansas, 66219
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Menorah Medical Center
Overland Park, Kansas, 66209
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Address
Saint Luke's South Hospital
Overland Park, Kansas, 66213
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Address
Kansas City NCI Community Oncology Research Program
Prairie Village, Kansas, 66208
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Address
Flaget Memorial Hospital
Bardstown, Kentucky, 40004
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Commonwealth Cancer Center-Corbin
Corbin, Kentucky, 40701
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Address
Saint Joseph Radiation Oncology Resource Center
Lexington, Kentucky, 40504
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Address
Saint Joseph Hospital East
Lexington, Kentucky, 40509
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Address
University of Kentucky/Markey Cancer Center
Lexington, Kentucky, 40536
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Address
Jewish Hospital
Louisville, Kentucky, 40202
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Address
Norton Hospital Pavilion and Medical Campus
Louisville, Kentucky, 40202
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Saints Mary and Elizabeth Hospital
Louisville, Kentucky, 40215
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Address
Jewish Hospital Medical Center Northeast
Louisville, Kentucky, 40245
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Address
Jewish Hospital Medical Center South
Shepherdsville, Kentucky, 40165
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Address
Maine Medical Center- Scarborough Campus
Scarborough, Maine, 04074
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Address
University of Maryland/Greenebaum Cancer Center
Baltimore, Maryland, 21201
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Sinai Hospital of Baltimore
Baltimore, Maryland, 21215
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Address
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore, Maryland, 21287
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Northwest Hospital Center
Randallstown, Maryland, 21133
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Tufts Medical Center
Boston, Massachusetts, 02111
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Massachusetts General Hospital Cancer Center
Boston, Massachusetts, 02114
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Bixby Medical Center
Adrian, Michigan, 49221
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Hickman Cancer Center
Adrian, Michigan, 49221
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Saint Joseph Mercy Hospital
Ann Arbor, Michigan, 48106-0995
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Michigan Cancer Research Consortium NCORP
Ann Arbor, Michigan, 48106
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Beaumont Hospital-Dearborn
Dearborn, Michigan, 48124
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Saint John Hospital and Medical Center
Detroit, Michigan, 48236
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Hurley Medical Center
Flint, Michigan, 48502
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Genesys Hurley Cancer Institute
Flint, Michigan, 48503
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Allegiance Health
Jackson, Michigan, 49201
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Sparrow Hospital
Lansing, Michigan, 48912
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Saint Mary Mercy Hospital
Livonia, Michigan, 48154
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Marquette General Hematology Oncology
Marquette, Michigan, 49855
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Address
Marquette General Hospital
Marquette, Michigan, 49855
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Mercy Memorial Hospital
Monroe, Michigan, 48162
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Toledo Clinic Cancer Centers-Monroe
Monroe, Michigan, 48162
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Saint Joseph Mercy Oakland
Pontiac, Michigan, 48341
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Address
Saint Mary's of Michigan
Saginaw, Michigan, 48601
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Address
Lakeland Hospital
Saint Joseph, Michigan, 49085
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Marie Yeager Cancer Center
Saint Joseph, Michigan, 49085
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Address
Saint John Macomb-Oakland Hospital
Warren, Michigan, 48093
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Fairview Ridges Hospital
Burnsville, Minnesota, 55337
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Mercy Hospital
Coon Rapids, Minnesota, 55433
Status
Address
Essentia Health Cancer Center
Duluth, Minnesota, 55805
Status
Address
Essentia Health Saint Mary's Medical Center
Duluth, Minnesota, 55805
Status
Address
Miller-Dwan Hospital
Duluth, Minnesota, 55805
Status
Address
Fairview-Southdale Hospital
Edina, Minnesota, 55435
Status
Address
Unity Hospital
Fridley, Minnesota, 55432
Status
Address
Fairview Maple Grove Medical Center
Maple Grove, Minnesota, 55369
Status
Address
Minnesota Oncology Hematology PA-Maplewood
Maplewood, Minnesota, 55109
Status
Address
Saint John's Hospital - Healtheast
Maplewood, Minnesota, 55109
Status
Address
Abbott-Northwestern Hospital
Minneapolis, Minnesota, 55407
Status
Address
Hennepin County Medical Center
Minneapolis, Minnesota, 55415
Status
Address
Health Partners Inc
Minneapolis, Minnesota, 55454
Status
Address
New Ulm Medical Center
New Ulm, Minnesota, 56073
Status
Address
North Memorial Medical Health Center
Robbinsdale, Minnesota, 55422
Status
Address
Mayo Clinic
Rochester, Minnesota, 55905
Status
Address
Metro Minnesota Community Oncology Research Consortium
Saint Louis Park, Minnesota, 55416
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
Saint Francis Regional Medical Center
Shakopee, Minnesota, 55379
Status
Address
Lakeview Hospital
Stillwater, Minnesota, 55082
Status
Address
Ridgeview Medical Center
Waconia, Minnesota, 55387
Status
Address
Rice Memorial Hospital
Willmar, Minnesota, 56201
Status
Address
Minnesota Oncology Hematology PA-Woodbury
Woodbury, Minnesota, 55125
Status
Address
Fairview Lakes Medical Center
Wyoming, Minnesota, 55092
Status
Address
University of Mississippi Medical Center
Jackson, Mississippi, 39216
Status
Address
Parkland Health Center-Bonne Terre
Bonne Terre, Missouri, 63628
Status
Address
Saint Francis Medical Center
Cape Girardeau, Missouri, 63703
Status
Address
Southeast Cancer Center
Cape Girardeau, Missouri, 63703
Status
Address
Centerpoint Medical Center LLC
Independence, Missouri, 64057
Status
Address
Capital Region Medical Center-Goldschmidt Cancer Center
Jefferson City, Missouri, 65109
Status
Address
Saint Luke's Hospital of Kansas City
Kansas City, Missouri, 64111
Status
Address
North Kansas City Hospital
Kansas City, Missouri, 64116
Status
Address
Heartland Hematology and Oncology Associates Incorporated
Kansas City, Missouri, 64118
Status
Address
Research Medical Center
Kansas City, Missouri, 64132
Status
Address
Saint Luke's East - Lee's Summit
Lee's Summit, Missouri, 64086
Status
Address
Liberty Radiation Oncology Center
Liberty, Missouri, 64068
Status
Address
Heartland Regional Medical Center
Saint Joseph, Missouri, 64506
Status
Address
Saint Joseph Oncology Inc
Saint Joseph, Missouri, 64507
Status
Address
Washington University School of Medicine
Saint Louis, Missouri, 63110
Status
Address
Missouri Baptist Medical Center
Saint Louis, Missouri, 63131
Status
Address
Sainte Genevieve County Memorial Hospital
Sainte Genevieve, Missouri, 63670
Status
Address
Missouri Baptist Sullivan Hospital
Sullivan, Missouri, 63080
Status
Address
Missouri Baptist Outpatient Center-Sunset Hills
Sunset Hills, Missouri, 63127
Status
Address
Community Hospital of Anaconda
Anaconda, Montana, 59711
Status
Address
Billings Clinic Cancer Center
Billings, Montana, 59101
Status
Address
Montana Cancer Consortium NCORP
Billings, Montana, 59101
Status
Address
Saint Vincent Healthcare
Billings, Montana, 59101
Status
Address
Frontier Cancer Center and Blood Institute-Billings
Billings, Montana, 59102
Status
Address
Bozeman Deaconess Hospital
Bozeman, Montana, 59715
Status
Address
Saint James Community Hospital and Cancer Treatment Center
Butte, Montana, 59701
Status
Address
Benefis Healthcare- Sletten Cancer Institute
Great Falls, Montana, 59405
Status
Address
Great Falls Clinic
Great Falls, Montana, 59405
Status
Address
Saint Peter's Community Hospital
Helena, Montana, 59601
Status
Address
Kalispell Regional Medical Center
Kalispell, Montana, 59901
Status
Address
Montana Cancer Specialists
Missoula, Montana, 59802
Status
Address
Saint Patrick Hospital - Community Hospital
Missoula, Montana, 59802
Status
Address
Community Medical Hospital
Missoula, Montana, 59804
Status
Address
CHI Health Saint Francis
Grand Island, Nebraska, 68803
Status
Address
Heartland Hematology and Oncology
Kearney, Nebraska, 68845
Status
Address
CHI Health Good Samaritan
Kearney, Nebraska, 68847
Status
Address
Nebraska Cancer Research Center
Lincoln, Nebraska, 68510
Status
Address
Saint Elizabeth Regional Medical Center
Lincoln, Nebraska, 68510
Status
Address
Missouri Valley Cancer Consortium
Omaha, Nebraska, 68106
Status
Address
Alegent Health Immanuel Medical Center
Omaha, Nebraska, 68122
Status
Address
Hemotology and Oncology Consultants PC
Omaha, Nebraska, 68122
Status
Address
Alegent Health Bergan Mercy Medical Center
Omaha, Nebraska, 68124
Status
Address
Alegent Health Lakeside Hospital
Omaha, Nebraska, 68130
Status
Address
Creighton University Medical Center
Omaha, Nebraska, 68131
Status
Address
University of Nebraska Medical Center
Omaha, Nebraska, 68198
Status
Address
Midlands Community Hospital
Papillion, Nebraska, 68046
Status
Address
Dartmouth Hitchcock Medical Center
Lebanon, New Hampshire, 03756
Status
Address
Hackensack University Medical Center
Hackensack, New Jersey, 07601
Status
Address
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
New Brunswick, New Jersey, 08903
Status
Address
Rutgers Cancer Institute of New Jersey
New Brunswick, New Jersey, 08903
Status
Address
The Valley Hospital-Luckow Pavilion
Paramus, New Jersey, 07652
Status
Address
Neurosurgeons of New Jersey-Ridgewood
Ridgewood, New Jersey, 07450
Status
Address
Valley Hospital
Ridgewood, New Jersey, 07450
Status
Address
Valley Health System-Hematology/Oncology
Westwood, New Jersey, 07675
Status
Address
Columbia University/Herbert Irving Cancer Center
New York, New York, 10032
Status
Address
University of Rochester
Rochester, New York, 14642
Status
Address
UNC Lineberger Comprehensive Cancer Center
Chapel Hill, North Carolina, 27599
Status
Address
Duke University Medical Center
Durham, North Carolina, 27710
Status
Address
East Carolina University
Greenville, North Carolina, 27858
Status
Address
Wake Forest University Health Sciences
Winston-Salem, North Carolina, 27157
Status
Address
Altru Cancer Center
Grand Forks, North Dakota, 58201
Status
Address
Toledo Clinic Cancer Centers-Bowling Green
Bowling Green, Ohio, 43402
Status
Address
University of Cincinnati/Barrett Cancer Center
Cincinnati, Ohio, 45219
Status
Address
Good Samaritan Hospital - Cincinnati
Cincinnati, Ohio, 45220
Status
Address
Bethesda North Hospital
Cincinnati, Ohio, 45242
Status
Address
TriHealth Cancer Institute-Westside
Cincinnati, Ohio, 45247
Status
Address
TriHealth Cancer Institute-Anderson
Cincinnati, Ohio, 45255
Status
Address
Case Western Reserve University
Cleveland, Ohio, 44106
Status
Address
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210
Status
Address
Grandview Hospital
Dayton, Ohio, 45405
Status
Address
Good Samaritan Hospital - Dayton
Dayton, Ohio, 45406
Status
Address
Miami Valley Hospital
Dayton, Ohio, 45409
Status
Address
Samaritan North Health Center
Dayton, Ohio, 45415
Status
Address
Blanchard Valley Hospital
Findlay, Ohio, 45840
Status
Address
Atrium Medical Center-Middletown Regional Hospital
Franklin, Ohio, 45005-1066
Status
Address
Wayne Hospital
Greenville, Ohio, 45331
Status
Address
Kettering Medical Center
Kettering, Ohio, 45429
Status
Address
Lima Memorial Hospital
Lima, Ohio, 45804
Status
Address
Toledo Clinic Cancer Centers-Maumee
Maumee, Ohio, 43537
Status
Address
Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
Maumee, Ohio, 43537
Status
Address
Saint Charles Hospital
Oregon, Ohio, 43616
Status
Address
Toledo Clinic Cancer Centers-Oregon
Oregon, Ohio, 43616
Status
Address
Flower Hospital
Sylvania, Ohio, 43560
Status
Address
Mercy Hospital of Tiffin
Tiffin, Ohio, 44883
Status
Address
The Toledo Hospital/Toledo Children's Hospital
Toledo, Ohio, 43606
Status
Address
Saint Vincent Mercy Medical Center
Toledo, Ohio, 43608
Status
Address
University of Toledo
Toledo, Ohio, 43614
Status
Address
Mercy Saint Anne Hospital
Toledo, Ohio, 43623
Status
Address
Toledo Clinic Cancer Centers-Toledo
Toledo, Ohio, 43623
Status
Address
Upper Valley Medical Center
Troy, Ohio, 45373
Status
Address
Fulton County Health Center
Wauseon, Ohio, 43567
Status
Address
University Pointe
West Chester, Ohio, 45069
Status
Address
Greene Memorial Hospital
Xenia, Ohio, 45385
Status
Address
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Status
Address
Oklahoma Cancer Specialists and Research Institute-Tulsa
Tulsa, Oklahoma, 74146
Status
Address
Saint Charles Health System
Bend, Oregon, 97701
Status
Address
Clackamas Radiation Oncology Center
Clackamas, Oregon, 97015
Status
Address
Providence Oncology and Hematology Care Southeast
Clackamas, Oregon, 97015
Status
Address
Bay Area Hospital
Coos Bay, Oregon, 97420
Status
Address
Legacy Mount Hood Medical Center
Gresham, Oregon, 97030
Status
Address
Providence Milwaukie Hospital
Milwaukie, Oregon, 97222
Status
Address
Providence Newberg Medical Center
Newberg, Oregon, 97132
Status
Address
Providence Willamette Falls Medical Center
Oregon City, Oregon, 97045
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
Legacy Meridian Park Hospital
Tualatin, Oregon, 97062
Status
Address
Lehigh Valley Hospital-Cedar Crest
Allentown, Pennsylvania, 18103
Status
Address
Lehigh Valley Hospital - Muhlenberg
Bethlehem, Pennsylvania, 18017
Status
Address
University of Pittsburgh Cancer Institute (UPCI)
Pittsburgh, Pennsylvania, 15232
Status
Address
Avera Cancer Institute
Sioux Falls, South Dakota, 57105
Status
Address
Memorial Hospital
Chattanooga, Tennessee, 37404
Status
Address
Pulmonary Medicine Center of Chattanooga-Hixson
Hixson, Tennessee, 37343
Status
Address
Memorial GYN Plus
Ooltewah, Tennessee, 37363
Status
Address
Saint Joseph Regional Cancer Center
Bryan, Texas, 77802
Status
Address
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, 84112
Status
Address
Inova Fairfax Hospital
Falls Church, Virginia, 22042
Status
Address
Fredericksburg Oncology Inc
Fredericksburg, Virginia, 22401
Status
Address
Sentara Norfolk General Hospital
Norfolk, Virginia, 23507
Status
Address
Providence Regional Cancer System-Aberdeen
Aberdeen, Washington, 98520
Status
Address
Cancer Care Center at Island Hospital
Anacortes, Washington, 98221
Status
Address
Swedish Cancer Institute-Eastside Oncology Hematology
Bellevue, Washington, 98005
Status
Address
PeaceHealth Saint Joseph Medical Center
Bellingham, Washington, 98225
Status
Address
Harrison HealthPartners Hematology and Oncology-Bremerton
Bremerton, Washington, 98310
Status
Address
Harrison Medical Center
Bremerton, Washington, 98310
Status
Address
Highline Medical Center-Main Campus
Burien, Washington, 98166
Status
Address
Providence Regional Cancer System-Centralia
Centralia, Washington, 98531
Status
Address
Swedish Medical Center-Edmonds
Edmonds, Washington, 98026
Status
Address
Saint Elizabeth Hospital
Enumclaw, Washington, 98022
Status
Address
Providence Regional Cancer Partnership
Everett, Washington, 98201
Status
Address
Saint Francis Hospital
Federal Way, Washington, 98003
Status
Address
Swedish Cancer Institute-Issaquah
Issaquah, Washington, 98029
Status
Address
Providence Regional Cancer System-Lacey
Lacey, Washington, 98503
Status
Address
Saint Clare Hospital
Lakewood, Washington, 98499
Status
Address
PeaceHealth Saint John Medical Center
Longview, Washington, 98632
Status
Address
Harrison HealthPartners Hematology and Oncology-Poulsbo
Poulsbo, Washington, 98370
Status
Address
Minor and James Medical PLLC
Seattle, Washington, 98104
Status
Address
Pacific Gynecology Specialists
Seattle, Washington, 98104
Status
Address
Swedish Medical Center-Ballard Campus
Seattle, Washington, 98107
Status
Address
Group Health Cooperative-Seattle
Seattle, Washington, 98112
Status
Address
Swedish Medical Center-First Hill
Seattle, Washington, 98122-4307
Status
Address
Providence Regional Cancer System-Shelton
Shelton, Washington, 98584
Status
Address
Rockwood Clinic Cancer Treatment Center-Valley
Spokane Valley, Washington, 99216
Status
Address
Rockwood Cancer Treatment Center-DHEC-Downtown
Spokane, Washington, 99204
Status
Address
Evergreen Hematology and Oncology PS
Spokane, Washington, 99218
Status
Address
Franciscan Research Center-Northwest Medical Plaza
Tacoma, Washington, 98405
Status
Address
Northwest Medical Specialties PLLC
Tacoma, Washington, 98405
Status
Address
PeaceHealth Southwest Medical Center
Vancouver, Washington, 98664
Status
Address
Compass Oncology Vancouver
Vancouver, Washington, 98684
Status
Address
Legacy Salmon Creek Hospital
Vancouver, Washington, 98686
Status
Address
Providence Saint Mary Regional Cancer Center
Walla Walla, Washington, 99362
Status
Address
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
Yakima, Washington, 98902
Status
Address
Providence Regional Cancer System-Yelm
Yelm, Washington, 98597
Status
Address
University of Wisconsin Hospital and Clinics
Madison, Wisconsin, 53792
Status
Address
Aurora Saint Luke's Medical Center
Milwaukee, Wisconsin, 53215
Status
Address
Cancer Center of Western Wisconsin
New Richmond, Wisconsin, 54017
Status
Address
Aurora Cancer Care-Racine
Racine, Wisconsin, 53406
Status
Address
Cheyenne Regional Medical Center-West
Cheyenne, Wyoming, 82001
Status
Address
Big Horn Basin Cancer Center
Cody, Wyoming, 82414
Status
Address
Billings Clinic-Cody
Cody, Wyoming, 82414
Status
Address
Welch Cancer Center
Sheridan, Wyoming, 82801
