Dabrafenib Combined With Trametinib After Radiation Therapy in Treating Patients With Newly-Diagnosed High-Grade Glioma
Study Purpose
This phase II trial studies how well the combination of dabrafenib and trametinib works after radiation therapy in children and young adults with high grade glioma who have a genetic change called BRAF V600 mutation. Radiation therapy uses high energy rays to kill tumor cells and reduce the size of tumors. Dabrafenib and trametinib may stop the growth of tumor cells by blocking BRAF and MEK, respectively, which are enzymes that tumor cells need for their growth. Giving dabrafenib with trametinib after radiation therapy may work better than treatments used in the past in patients with newly-diagnosed BRAF V600-mutant high-grade glioma.
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 | 3 Years - 25 Years |
| Gender | All |
Inclusion Criteria:
- - PRE-ENROLLMENT ELIGIBILITY SCREENING: Patients must be =< 25 years of age at the time of enrollment on APEC14B1 Part A CNS/HGG pre-enrollment eligibility screening.
- - Note: This required age range applies to the pre-enrollment eligibility screening for all HGG patients.
- - PRE-ENROLLMENT ELIGIBILITY SCREENING: Patient is suspected of having localized newly-diagnosed HGG, excluding metastatic disease.
- - PRE-ENROLLMENT ELIGIBILITY SCREENING: Patient and/or their parents or legal guardians have signed informed consent for eligibility screening on APEC14B1 Part A.
- - PRE-ENROLLMENT ELIGIBILITY SCREENING: The specimens obtained at the time of diagnostic biopsy or surgery must be submitted through APEC14B1 as soon as possible (ASAP), preferably within 5 calendar days of the procedure.
- - Please note: See the APEC14B1 Manual of Procedures for a full list of detailed instructions for submitting required materials and for shipping details.
- - Patients must be >= 3 years and =< 25 years of age at the time of enrollment.
- - Patients must have eligibility confirmed by Rapid Central Pathology and Molecular Screening Reviews performed on APEC14B1: - Newly diagnosed high-grade glioma with BRAF^V600-mutation.
- - Results for H3 K27M by immunohistochemistry (IHC) or sequencing.
- - Histologically confirmed high-grade glioma (World Health Organization [WHO] grade III or IV) including but not limited to: anaplastic astrocytoma (AA), anaplastic pleomorphic xanthoastrocytoma (aPXA), anaplastic gangliogliomas (aGG), glioblastoma (GB), and high-grade astrocytoma, not otherwise specified (NOS).
- - Patients must have had histologic verification of a high-grade glioma diagnosis.
- - A pre- and post-operative brain MRI with and without contrast and a baseline spine MRI with contrast must be obtained prior to enrollment.
- - Patients must have a performance status corresponding to Eastern Cooperative Oncology Group (ECOG) scores of 0, 1, or 2.
- - Peripheral absolute neutrophil count (ANC) >= 1000/uL (within 7 days prior to enrollment).
- - Platelet count >= 100,000/uL (transfusion independent) (within 7 days prior to enrollment).
- - Hemoglobin >= 8.0 g/dL (may receive red blood cell [RBC] transfusions) (within 7 days prior to enrollment).
- - Creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70 mL/min/1.73 m^2 (within 7 days prior to enrollment) or.
- - A serum creatinine based on age/sex as follows (within 7 days prior to enrollment): - Age 3 to < 6 years (Male 0.8 mg/dL, Female 0.8 mg/dL) - Age 6 to < 10 years (Male 1 mg/dL, Female 1 mg/dL) - Age 10 to < 13 years (Male 1.2 mg/dL, Female 1.2 mg/dL) - Age 13 to < 16 years (Male 1.5 mg/dL, Female 1.4 mg/dL) - Age >= 16 years (Male 1.7 mg/dL, Female 1.4 mg/dL) - The threshold creatinine values in this table were derived from the Schwartz formula for estimating GFR utilizing child length and stature data published by the Centers for Disease Control and Prevention (CDC).
- - Total bilirubin =< 1.5 x upper limit of normal (ULN) for age (within 7 days prior to enrollment), and.
- - Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) =< 135 U/L (within 7 days prior to enrollment).
- - Patients with a seizure disorder may be enrolled if their seizures are well controlled while on non-enzyme inducing anticonvulsants permitted on this study.
- - Patients must be enrolled and protocol therapy must be projected to begin no later than 31 days after definitive surgery (day 0).
- - All patients and/or their parents or legal guardians must sign a written informed consent.
Exclusion Criteria:
- - Patients with intrinsic brainstem or primary spinal cord tumors will be excluded.
- - Patients with metastatic disease (defined as neuraxis dissemination either by imaging or by cytology) will be excluded.
- - Patients must not have received any prior tumor-directed therapy including chemotherapy, radiation therapy, immunotherapy, or bone marrow transplant for the treatment of HGG other than surgical intervention and/or corticosteroids.
- - Previous treatment with dabrafenib or another RAF inhibitor, trametinib or another MEK inhibitor, or an ERK inhibitor.
- - Patients with a history of a malignancy with confirmed activating RAS mutation.
- - History of allergic reactions attributed to compounds of similar chemical or biologic composition to dabrafenib, trametinib, and their excipients.
- - Uncontrolled medical conditions (e.g., diabetes mellitus, hypertension, liver disease, or uncontrolled infection), psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol; or unwillingness or inability to follow the procedures required in the protocol.
- - Presence of active gastrointestinal (GI) disease or other condition (e.g., small bowel or large bowel resection) that will interfere significantly with the absorption of drugs.
- - History of hepatitis B virus, or hepatitis C virus infection (patients with laboratory evidence of cleared hepatitis B virus and/or hepatitis C virus may be enrolled).
- - History or current diagnosis of cardiac disease indicating significant risk of safety for patients participating in the study such as uncontrolled or significant cardiac disease, including any of the following: - Recent myocardial infarction (within the last 6 months); - Uncontrolled congestive heart failure; - Unstable angina (within last 6 months); - Clinically significant (symptomatic) or known, uncontrolled cardiac arrhythmias (e.g., sustained ventricular tachycardia, and clinically significant second or third degree atrioventricular [AV] block without a pacemaker) except sinus arrhythmia within the past 24 weeks prior to the first dose of study treatment; - Coronary angioplasty or stenting (within last 6 months); - Intra-cardiac defibrillators; - Abnormal cardiac valve morphology (>= grade 2) documented by echocardiogram.
- - Patients with a history or current evidence of retinal vein occlusion (RVO) or central serous retinopathy (CSR), or predisposing factors to RVO or CSR (e.g., uncontrolled glaucoma or ocular hypertension).
- - Patients with presence of interstitial lung disease or pneumonitis.
- - Female patients who are pregnant are ineligible since there is yet no available information regarding human fetal or teratogenic toxicities.
- - Lactating females are not eligible unless they have agreed not to breastfeed their infants for the duration of the study and for 4 months following discontinuation of study therapy.
- - Female patients of childbearing potential are not eligible unless a negative pregnancy test result has been obtained.
- - Sexually active patients of reproductive potential (male or female) are not eligible unless they have agreed to use an effective contraceptive method for the duration of their study participation and for 4 months following discontinuation of study therapy.
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. |
NCT03919071 |
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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. |
National Cancer Institute (NCI) |
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Principal Investigator
The person who is responsible for the scientific and technical direction of the entire clinical study. |
Rishi R Lulla |
| Principal Investigator Affiliation | Children's Oncology Group |
|
Agency Class
Category of organization(s) involved as sponsor (and collaborator) supporting the trial. |
NIH |
| Overall Status | Active, not recruiting |
| Countries | Puerto Rico, United States |
|
Conditions
The disease, disorder, syndrome, illness, or injury that is being studied. |
Anaplastic Astrocytoma, Anaplastic Astrocytoma, Not Otherwise Specified, Anaplastic Ganglioglioma, Anaplastic Pleomorphic Xanthoastrocytoma, Glioblastoma, Malignant Glioma, WHO Grade 3 Glioma, WHO Grade 4 Glioma |
PRIMARY OBJECTIVE:
- I. To estimate the event-free survival (EFS) distribution for newly-diagnosed patients with BRAF^V600-mutant high-grade glioma (HGG) without H3 K27M mutations excluding anaplastic pleomorphic xanthoastrocytoma (aPXA) and anaplastic ganglioglioma (aGG) treated with radiation therapy followed by a maintenance combination of dabrafenib mesylate (dabrafenib) and trametinib dimethyl sulfoxide (trametinib) and to compare this EFS to contemporary historical controls.
- I. To describe the overall survival (OS) distribution for newly-diagnosed patients with BRAF^V600-mutant HGG without H3 K27M mutations excluding aPXA and aGG treated with radiation therapy followed by a maintenance combination of dabrafenib and trametinib.
- II. To describe the EFS and overall survival (OS) distribution for newly-diagnosed patients with BRAF^V600E-mutant aPXA and aGG without H3 K27M mutations treated with radiation therapy followed by a maintenance combination of dabrafenib and trametinib.
- III. To describe the EFS and overall survival (OS) distribution for newly-diagnosed patients with BRAF^V600E-mutant HGG including aPXA and aGG with H3 K27M mutations treated with radiation therapy followed by a maintenance combination of dabrafenib and trametinib.
- IV. To define and evaluate the toxicities of combination therapy with dabrafenib and trametinib after radiation therapy in newly-diagnosed patients with HGG.
- I. To bank tumor specimens and body fluids (blood, urine and cerebrospinal fluid) for future studies.
Arms
Experimental: Treatment (radiation therapy, dabrafenib, trametinib)
Patients undergo standardized local RT 5 days a week (Monday-Friday) for 6-7 weeks. Four weeks after completion of RT, patients receive dabrafenib mesylate PO BID and trametinib dimethyl sulfoxide PO QD on days 1-28 of each cycle. Treatment repeats every 28 days for up to 24 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo MRI at baseline, on day 1 of cycles 1, 3, 5, 7, 11, 14, 17, 20, and 23 while on treatment, then at time of relapse, every 3 months for year 1, every 4 months for year 2, every 6 months for year 3, and annually for years 4-5. Patients may also undergo lumbar puncture for CSF testing during treatment. Patients also undergo collection of blood on study.
Interventions
Procedure: - Biospecimen Collection
Undergo collection of blood
Drug: - Dabrafenib Mesylate
Given PO
Procedure: - Lumbar Puncture
Undergo lumbar puncture
Procedure: - Magnetic Resonance Imaging
Undergo MRI
Radiation: - Radiation Therapy
Undergo RT
Drug: - Trametinib Dimethyl Sulfoxide
Given PO
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
Children's Hospital of Alabama
Birmingham 4049979, Alabama 4829764, 35233
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Address
Banner Children's at Desert
Mesa 5304391, Arizona 5551752, 85202
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Address
Phoenix Childrens Hospital
Phoenix 5308655, Arizona 5551752, 85016
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Address
Arkansas Children's Hospital
Little Rock 4119403, Arkansas 4099753, 72202-3591
Status
Address
Kaiser Permanente Downey Medical Center
Downey 5343858, California 5332921, 90242
Status
Address
Loma Linda University Medical Center
Loma Linda 5367696, California 5332921, 92354
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Address
Miller Children's and Women's Hospital Long Beach
Long Beach 5367929, California 5332921, 90806
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Address
Children's Hospital Los Angeles
Los Angeles 5368361, California 5332921, 90027
Status
Address
Cedars Sinai Medical Center
Los Angeles 5368361, California 5332921, 90048
Status
Address
Kaiser Permanente-Oakland
Oakland 5378538, California 5332921, 94611
Status
Address
Children's Hospital of Orange County
Orange 5379513, California 5332921, 92868
Status
Address
Lucile Packard Children's Hospital Stanford University
Palo Alto 5380748, California 5332921, 94304
Status
Address
University of California Davis Comprehensive Cancer Center
Sacramento 5389489, California 5332921, 95817
Status
Address
UCSF Medical Center-Mission Bay
San Francisco 5391959, California 5332921, 94158
Status
Address
Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
Torrance 5403022, California 5332921, 90502
Status
Address
Children's Hospital Colorado
Aurora 5412347, Colorado 5417618, 80045
Status
Address
Connecticut Children's Medical Center
Hartford 4835797, Connecticut 4831725, 06106
Status
Address
Yale University
New Haven 4839366, Connecticut 4831725, 06520
Status
Address
Alfred I duPont Hospital for Children
Wilmington 4145381, Delaware 4142224, 19803
Status
Address
MedStar Georgetown University Hospital
Washington D.C. 4140963, District of Columbia 4138106, 20007
Status
Address
Children's National Medical Center
Washington D.C. 4140963, District of Columbia 4138106, 20010
Status
Address
Golisano Children's Hospital of Southwest Florida
Fort Myers 4155995, Florida 4155751, 33908
Status
Address
University of Florida Health Science Center - Gainesville
Gainesville 4156404, Florida 4155751, 32610
Status
Address
Memorial Regional Hospital/Joe DiMaggio Children's Hospital
Hollywood 4158928, Florida 4155751, 33021
Status
Address
Nemours Children's Clinic-Jacksonville
Jacksonville 4160021, Florida 4155751, 32207
Status
Address
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami 4164138, Florida 4155751, 33136
Status
Address
Nicklaus Children's Hospital
Miami 4164138, Florida 4155751, 33155
Status
Address
AdventHealth Orlando
Orlando 4167147, Florida 4155751, 32803
Status
Address
Arnold Palmer Hospital for Children
Orlando 4167147, Florida 4155751, 32806
Status
Address
Nemours Children's Hospital
Orlando 4167147, Florida 4155751, 32827
Status
Address
Sacred Heart Hospital
Pensacola 4168228, Florida 4155751, 32504
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Address
Johns Hopkins All Children's Hospital
St. Petersburg 4171563, Florida 4155751, 33701
Status
Address
Tampa General Hospital
Tampa 4174757, Florida 4155751, 33606
Status
Address
Saint Joseph's Hospital/Children's Hospital-Tampa
Tampa 4174757, Florida 4155751, 33607
Status
Address
Saint Mary's Medical Center
West Palm Beach 4177887, Florida 4155751, 33407
Status
Address
Children's Healthcare of Atlanta - Arthur M Blank Hospital
Atlanta 4180439, Georgia 4197000, 30329
Status
Address
Memorial Health University Medical Center
Savannah 4221552, Georgia 4197000, 31404
Status
Address
Kapiolani Medical Center for Women and Children
Honolulu 5856195, Hawaii 5855797, 96826
Status
Address
Saint Luke's Cancer Institute - Boise
Boise 5586437, Idaho 5596512, 83712
Status
Address
Lurie Children's Hospital-Chicago
Chicago 4887398, Illinois 4896861, 60611
Status
Address
University of Illinois
Chicago 4887398, Illinois 4896861, 60612
Status
Address
University of Chicago Comprehensive Cancer Center
Chicago 4887398, Illinois 4896861, 60637
Status
Address
Saint Jude Midwest Affiliate
Peoria 4905687, Illinois 4896861, 61637
Status
Address
Riley Hospital for Children
Indianapolis 4259418, Indiana 4921868, 46202
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Address
Ascension Saint Vincent Indianapolis Hospital
Indianapolis 4259418, Indiana 4921868, 46260
Status
Address
University of Iowa/Holden Comprehensive Cancer Center
Iowa City 4862034, Iowa 4862182, 52242
Status
Address
University of Kentucky/Markey Cancer Center
Lexington 4297983, Kentucky 6254925, 40536
Status
Address
Norton Children's Hospital
Louisville 4299276, Kentucky 6254925, 40202
Status
Address
Children's Hospital New Orleans
New Orleans 4335045, Louisiana 4331987, 70118
Status
Address
Ochsner Medical Center Jefferson
New Orleans 4335045, Louisiana 4331987, 70121
Status
Address
Eastern Maine Medical Center
Bangor 4957280, Maine 4971068, 04401
Status
Address
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore 4347778, Maryland 4361885, 21287
Status
Address
Walter Reed National Military Medical Center
Bethesda 4348599, Maryland 4361885, 20889-5600
Status
Address
Massachusetts General Hospital Cancer Center
Boston 4930956, Massachusetts 6254926, 02114
Status
Address
Dana-Farber Cancer Institute
Boston 4930956, Massachusetts 6254926, 02215
Status
Address
C S Mott Children's Hospital
Ann Arbor 4984247, Michigan 5001836, 48109
Status
Address
Children's Hospital of Michigan
Detroit 4990729, Michigan 5001836, 48201
Status
Address
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
Grand Rapids 4994358, Michigan 5001836, 49503
Status
Address
Bronson Methodist Hospital
Kalamazoo 4997787, Michigan 5001836, 49007
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Address
Corewell Health Children's
Royal Oak 5007804, Michigan 5001836, 48073
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Address
Children's Hospitals and Clinics of Minnesota - Minneapolis
Minneapolis 5037649, Minnesota 5037779, 55404
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Address
Mayo Clinic in Rochester
Rochester 5043473, Minnesota 5037779, 55905
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Address
University of Mississippi Medical Center
Jackson 4431410, Mississippi 4436296, 39216
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Address
Children's Mercy Hospitals and Clinics
Kansas City 4393217, Missouri 4398678, 64108
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Address
Cardinal Glennon Children's Medical Center
St Louis 4407066, Missouri 4398678, 63104
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Address
Washington University School of Medicine
St Louis 4407066, Missouri 4398678, 63110
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Address
Mercy Hospital Saint Louis
St Louis 4407066, Missouri 4398678, 63141
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Address
Children's Hospital and Medical Center of Omaha
Omaha 5074472, Nebraska 5073708, 68114
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Address
University of Nebraska Medical Center
Omaha 5074472, Nebraska 5073708, 68198
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Address
Hackensack University Medical Center
Hackensack 5098706, New Jersey 5101760, 07601
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Address
Morristown Medical Center
Morristown 5101427, New Jersey 5101760, 07960
Status
Address
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
New Brunswick 5101717, New Jersey 5101760, 08903
Status
Address
Newark Beth Israel Medical Center
Newark 5101798, New Jersey 5101760, 07112
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Address
Saint Joseph's Regional Medical Center
Paterson 5102466, New Jersey 5101760, 07503
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Address
University of New Mexico Cancer Center
Albuquerque 5454711, New Mexico 5481136, 87106
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Address
Albany Medical Center
Albany 5106834, New York 5128638, 12208
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Address
Roswell Park Cancer Institute
Buffalo 5110629, New York 5128638, 14263
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Address
The Steven and Alexandra Cohen Children's Medical Center of New York
New Hyde Park 5128514, New York 5128638, 11040
Status
Address
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
New York 5128581, New York 5128638, 10032
Status
Address
Memorial Sloan Kettering Cancer Center
New York 5128581, New York 5128638, 10065
Status
Address
State University of New York Upstate Medical University
Syracuse 5140405, New York 5128638, 13210
Status
Address
Montefiore Medical Center - Moses Campus
The Bronx 5110266, New York 5128638, 10467
Status
Address
Mission Hospital
Asheville 4453066, North Carolina 4482348, 28801
Status
Address
UNC Lineberger Comprehensive Cancer Center
Chapel Hill 4460162, North Carolina 4482348, 27599
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Address
Carolinas Medical Center/Levine Cancer Institute
Charlotte 4460243, North Carolina 4482348, 28203
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Address
Novant Health Presbyterian Medical Center
Charlotte 4460243, North Carolina 4482348, 28204
Status
Address
East Carolina University
Greenville 4469160, North Carolina 4482348, 27834
Status
Address
Wake Forest University Health Sciences
Winston-Salem 4499612, North Carolina 4482348, 27157
Status
Address
Sanford Broadway Medical Center
Fargo 5059163, North Dakota 5690763, 58122
Status
Address
Children's Hospital Medical Center of Akron
Akron 5145476, Ohio 5165418, 44308
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Address
Cincinnati Children's Hospital Medical Center
Cincinnati 4508722, Ohio 5165418, 45229
Status
Address
Rainbow Babies and Childrens Hospital
Cleveland 5150529, Ohio 5165418, 44106
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Address
Cleveland Clinic Foundation
Cleveland 5150529, Ohio 5165418, 44195
Status
Address
Nationwide Children's Hospital
Columbus 4509177, Ohio 5165418, 43205
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Address
Dayton Children's Hospital
Dayton 4509884, Ohio 5165418, 45404
Status
Address
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
Toledo 5174035, Ohio 5165418, 43606
Status
Address
University of Oklahoma Health Sciences Center
Oklahoma City 4544349, Oklahoma 4544379, 73104
Status
Address
Legacy Emanuel Children's Hospital
Portland 5746545, Oregon 5744337, 97227
Status
Address
Oregon Health and Science University
Portland 5746545, Oregon 5744337, 97239
Status
Address
Lehigh Valley Hospital-Cedar Crest
Allentown 5178127, Pennsylvania 6254927, 18103
Status
Address
Penn State Children's Hospital
Hershey 5193342, Pennsylvania 6254927, 17033
Status
Address
Children's Hospital of Philadelphia
Philadelphia 4560349, Pennsylvania 6254927, 19104
Status
Address
Children's Hospital of Pittsburgh of UPMC
Pittsburgh 5206379, Pennsylvania 6254927, 15224
Status
Address
Rhode Island Hospital
Providence 5224151, Rhode Island 5224323, 02903
Status
Address
Medical University of South Carolina
Charleston 4574324, South Carolina 4597040, 29425
Status
Address
Prisma Health Richland Hospital
Columbia 4575352, South Carolina 4597040, 29203
Status
Address
BI-LO Charities Children's Cancer Center
Greenville 4580543, South Carolina 4597040, 29605
Status
Address
East Tennessee Childrens Hospital
Knoxville 4634946, Tennessee 4662168, 37916
Status
Address
Saint Jude Children's Research Hospital
Memphis 4641239, Tennessee 4662168, 38105
Status
Address
The Children's Hospital at TriStar Centennial
Nashville 4644585, Tennessee 4662168, 37203
Status
Address
Vanderbilt University/Ingram Cancer Center
Nashville 4644585, Tennessee 4662168, 37232
Status
Address
Dell Children's Medical Center of Central Texas
Austin 4671654, Texas 4736286, 78723
Status
Address
Medical City Dallas Hospital
Dallas 4684888, Texas 4736286, 75230
Status
Address
UT Southwestern/Simmons Cancer Center-Dallas
Dallas 4684888, Texas 4736286, 75390
Status
Address
Cook Children's Medical Center
Fort Worth 4691930, Texas 4736286, 76104
Status
Address
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
Houston 4699066, Texas 4736286, 77030
Status
Address
Children's Hospital of San Antonio
San Antonio 4726206, Texas 4736286, 78207
Status
Address
University of Texas Health Science Center at San Antonio
San Antonio 4726206, Texas 4736286, 78229
Status
Address
Scott and White Memorial Hospital
Temple 4735966, Texas 4736286, 76508
Status
Address
Primary Children's Hospital
Salt Lake City 5780993, Utah 5549030, 84113
Status
Address
University of Virginia Cancer Center
Charlottesville 4752031, Virginia 6254928, 22908
Status
Address
Children's Hospital of The King's Daughters
Norfolk 4776222, Virginia 6254928, 23507
Status
Address
VCU Massey Comprehensive Cancer Center
Richmond 4781708, Virginia 6254928, 23298
Status
Address
Carilion Children's
Roanoke 4782167, Virginia 6254928, 24014
Status
Address
Seattle Children's Hospital
Seattle 5809844, Washington 5815135, 98105
Status
Address
Providence Sacred Heart Medical Center and Children's Hospital
Spokane 5811696, Washington 5815135, 99204
Status
Address
Mary Bridge Children's Hospital and Health Center
Tacoma 5812944, Washington 5815135, 98405
Status
Address
University of Wisconsin Carbone Cancer Center - University Hospital
Madison 5261457, Wisconsin 5279468, 53792
Status
Address
Marshfield Medical Center-Marshfield
Marshfield 5261969, Wisconsin 5279468, 54449
Status
Address
Children's Hospital of Wisconsin
Milwaukee 5263045, Wisconsin 5279468, 53226
International Sites
Status
Address
HIMA San Pablo Oncologic Hospital
Caguas 4563008, , 00726
