A Study Testing the Effect of Immunotherapy (Ipilimumab and Nivolumab) in Patients With Recurrent Glioma With Elevated Mutational Burden
Study Purpose
This phase II trial studies the effect of immunotherapy drugs (ipilimumab and nivolumab) in treating patients with glioma that has come back (recurrent) and carries a high number of mutations (mutational burden). Cancer is caused by changes (mutations) to genes that control the way cells function. Tumors with high number of mutations may respond well to immunotherapy. Immunotherapy with monoclonal antibodies such as ipilimumab and nivolumab may help the body's immune system attack the cancer and may interfere with the ability of tumor cells to grow and spread. Giving ipilimumab and nivolumab may lower the chance of recurrent glioblastoma with high number of mutations from growing or spreading compared to usual care (surgery or chemotherapy).
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 |
Inclusion Criteria:
- - PRE-REGISTRATION ELIGIBILITY CRITERIA: - Histologically confirmed glioblastoma (World Health Organization [WHO] grade IV) presenting at first or second recurrence including secondary glioblastoma.
- - Glioblastoma IDH-wildtype central nervous system (CNS) WHO grade 4.
- - Diffuse, astrocytic glioma IDH-wildtype with one or more of the following histological or genetic features: microvascular proliferation, necrosis, TERT promoter mutation, EGFR gene amplification, +7/-10 chromosome copy-number changes.
- - Astrocytoma, IDH-mutant CNS WHO grade 4.
- - Diffuse astrocytic glioma IDH-mutant (with frequent ATRX and/or TP53 mutation and absence of 1p/19q codeletion), with necrosis and/or microvascular proliferation or one with lower grade histological features displaying homozygous deletion of CDKN2A and/or CDKN2B.
- - NOTE: The eligibility criteria were changed to include the new diagnostic language from the WHO 2021 pathology classification change.
- - Presence of measurable disease, as defined by a bidimensionally measurable lesion on magnetic resonance imaging (MRI) with a minimum diameter of 10 mm in both dimensions, prior to resection or biopsy of recurrent tumor.
- - Tissue available from surgical resection or biopsy of recurrent tumor =< 28 days prior to pre-registration, or planned surgery or biopsy of recurrent tumor =< 28 days after pre-registration.
- - Does not require > 4 mg dexamethasone beyond the perioperative period defined as the time =< 2 weeks after surgical procedure.
- - No active autoimmune disease or history of autoimmune disease.
- - These include but are not limited to patients with a history of immune related neurologic disease, multiple sclerosis, autoimmune (demyelinating) neuropathy, Guillain-Barre syndrome, myasthenia gravis; systemic autoimmune disease such as systemic lupus erythematosus (SLE), connective tissue diseases, scleroderma, inflammatory bowel disease (IBD), Crohn's, ulcerative colitis, hepatitis; and patients with a history of toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome, or phospholipid syndrome should be excluded because of the risk of recurrence or exacerbation of disease.
- - Patients with vitiligo, endocrine deficiencies including thyroiditis managed with replacement hormones including physiologic corticosteroids are eligible.
- - No prior treatment with checkpoint blockade therapies (anti-CTLA4, anti-PD1/PD-L1) or bevacizumab.
- - No prior treatment with laser ablation at the time of recurrent tumor tissue sampling.
- - Age >= 18 years.
- - Eastern Cooperative Oncology Group (ECOG) performance status =< 2.
- - Able to undergo brain MRI with contrast.
- - Absolute neutrophil count >= 1500/mm^3.
- - Platelet count >= 100,000/mm^3.
- - Total bilirubin =< 1.5 x upper limit of normal (ULN) - If Gilbert syndrome, then total bilirubin =< 3 x ULN.
- - Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< 2.0 x ULN.
- - Creatinine =< 1.5 x ULN OR creatinine clearance (CrCl) >= 50 mL/min (if using the Cockcroft-Gault formula) - History of active malignancy (outside of the patient's glioblastoma) that has required treatment within the previous 2 years.
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. |
NCT04145115 |
|
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) |
|
Principal Investigator
The person who is responsible for the scientific and technical direction of the entire clinical study. |
Gavin P Dunn |
| Principal Investigator Affiliation | Alliance for Clinical Trials in Oncology |
|
Agency Class
Category of organization(s) involved as sponsor (and collaborator) supporting the trial. |
NIH |
| Overall Status | Suspended |
| Countries | Puerto Rico, United States |
|
Conditions
The disease, disorder, syndrome, illness, or injury that is being studied. |
Astrocytoma, IDH-Mutant, Grade 4, Diffuse Glioma, Glioblastoma, IDH-Wildtype, Secondary Glioblastoma |
PRIMARY OBJECTIVE:
- I. To determine whether the combination of ipilimumab and nivolumab increases the tumor response rate assessed by modified Response Assessment in Neuro-Oncology (RANO) Criteria in patients with hypermutated recurrent glioblastoma.
- I. Estimate the overall survival distribution, median survival, and one-year survival rate of patients with hypermutated, recurrent glioblastoma who are treated with ipilimumab and nivolumab.
- II. Estimate the progression-free survival distribution and median progression-free survival of patients with hypermutated, recurrent glioblastoma who are treated with ipilimumab and nivolumab.
- III. Determine the adverse event profile of patients with hypermutated, recurrent glioblastoma who are treated with ipilimumab and nivolumab.
- I. Test whether PD-L1 or immunologic infiltrate in the tumor microenvironment are associated with objective tumor response, overall survival, progression-free survival, tumor mutational burden, or rates of grade 3 or higher adverse events.
- II. Test whether MGMT status, microsatellite instability (MSI) status, mutational signatures, or amount of tumor mutational burden (TMB) including germline analysis are associated with objective tumor response, overall survival, progression-free survival, or rates of grade 3 or higher adverse events.
- III. Evaluate associations between exome and transcriptome gene levels with objective tumor response, overall survival, progression-free survival, rates of grade 3 or higher adverse events.
- IV. Evaluate associations between the gut microbiome and objective tumor response.
- V. Response rate using immunotherapy (i)RANO.
Arms
Experimental: Treatment (nivolumab, ipilimumab)
Patients receive nivolumab IV over 30 minutes and ipilimumab IV over 30 minutes on day 1. Treatment repeats every 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. Patients then receive nivolumab IV over 30 minutes on day 1. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Patients also undergo MRI throughout the study.
Interventions
Biological: - Ipilimumab
Given IV
Procedure: - Magnetic Resonance Imaging
Undergo MRI
Biological: - Nivolumab
Given IV
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
Cancer and Hematology Centers of Western Michigan - Norton Shores
Norton Shores, Michigan, 49444
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Hope Cancer Center
Pontiac, Michigan, 48341
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Michigan Healthcare Professionals Pontiac
Pontiac, Michigan, 48341
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Address
Newland Medical Associates-Pontiac
Pontiac, Michigan, 48341
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Address
Trinity Health Saint Joseph Mercy Oakland Hospital
Pontiac, Michigan, 48341
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Address
Corewell Health Reed City Hospital
Reed City, Michigan, 49677
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Address
Henry Ford Rochester Hospital
Rochester Hills, Michigan, 48309
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Address
Corewell Health William Beaumont University Hospital
Royal Oak, Michigan, 48073
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Address
MyMichigan Medical Center Saginaw
Saginaw, Michigan, 48601
Status
Address
Oncology Hematology Associates of Saginaw Valley PC
Saginaw, Michigan, 48604
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Address
Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
Saint Joseph, Michigan, 49085
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Address
Corewell Health Lakeland Hospitals - Saint Joseph Hospital
Saint Joseph, Michigan, 49085
Status
Address
Bhadresh Nayak MD PC-Sterling Heights
Sterling Heights, Michigan, 48312
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Address
MyMichigan Medical Center Tawas
Tawas City, Michigan, 48764
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Address
Munson Medical Center
Traverse City, Michigan, 49684
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Address
Corewell Health Beaumont Troy Hospital
Troy, Michigan, 48085
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Address
Advanced Breast Care Center PLLC
Warren, Michigan, 48088
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Address
Henry Ford Health Warren Hospital
Warren, Michigan, 48093
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Address
Henry Ford Madison Heights Hospital - Breast
Warren, Michigan, 48093
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Address
Henry Ford Warren Hospital - GLCMS
Warren, Michigan, 48093
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Address
Macomb Hematology Oncology PC
Warren, Michigan, 48093
Status
Address
Saint Mary's Oncology/Hematology Associates of West Branch
West Branch, Michigan, 48661
Status
Address
University of Michigan Health - West
Wyoming, Michigan, 49519
Status
Address
Huron Gastroenterology PC
Ypsilanti, Michigan, 48106
Status
Address
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
Ypsilanti, Michigan, 48197
Status
Address
Sanford Joe Lueken Cancer Center
Bemidji, Minnesota, 56601
Status
Address
Essentia Health Saint Joseph's Medical Center
Brainerd, Minnesota, 56401
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Address
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
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Address
Minnesota Oncology - Burnsville
Burnsville, Minnesota, 55337
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Address
Cambridge Medical Center
Cambridge, Minnesota, 55008
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Address
Mercy Hospital
Coon Rapids, Minnesota, 55433
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Address
Essentia Health - Deer River Clinic
Deer River, Minnesota, 56636
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Address
Essentia Health Cancer Center
Duluth, Minnesota, 55805
Status
Address
Fairview Southdale Hospital
Edina, Minnesota, 55435
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Address
Unity Hospital
Fridley, Minnesota, 55432
Status
Address
Essentia Health Hibbing Clinic
Hibbing, Minnesota, 55746
Status
Address
Fairview Clinics and Surgery Center Maple Grove
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
Monticello Cancer Center
Monticello, Minnesota, 55362
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Address
New Ulm Medical Center
New Ulm, Minnesota, 56073
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Address
Fairview Northland Medical Center
Princeton, Minnesota, 55371
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Address
North Memorial Medical Health Center
Robbinsdale, Minnesota, 55422
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Address
Mayo Clinic in Rochester
Rochester, Minnesota, 55905
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Address
Coborn Cancer Center at Saint Cloud Hospital
Saint Cloud, Minnesota, 56303
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Address
Park Nicollet Clinic - Saint Louis Park
Saint Louis Park, Minnesota, 55416
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Address
Regions Hospital
Saint Paul, Minnesota, 55101
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Address
United Hospital
Saint Paul, Minnesota, 55102
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Address
Essentia Health Sandstone
Sandstone, Minnesota, 55072
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Address
Saint Francis Regional Medical Center
Shakopee, Minnesota, 55379
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Address
Lakeview Hospital
Stillwater, Minnesota, 55082
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Address
Sanford Thief River Falls Medical Center
Thief River Falls, Minnesota, 56701
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Address
Essentia Health Virginia Clinic
Virginia, Minnesota, 55792
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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
Sanford Cancer Center Worthington
Worthington, Minnesota, 56187
Status
Address
Fairview Lakes Medical Center
Wyoming, Minnesota, 55092
Status
Address
Saint Louis Cancer and Breast Institute-Ballwin
Ballwin, Missouri, 63011
Status
Address
Central Care Cancer Center - Bolivar
Bolivar, Missouri, 65613
Status
Address
Saint Francis Medical Center
Cape Girardeau, Missouri, 63703
Status
Address
Southeast Cancer Center
Cape Girardeau, Missouri, 63703
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Address
Siteman Cancer Center at West County Hospital
Creve Coeur, Missouri, 63141
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Address
Parkland Health Center - Farmington
Farmington, Missouri, 63640
Status
Address
MU Health Care Goldschmidt Cancer Center
Jefferson City, Missouri, 65109
Status
Address
Freeman Health System
Joplin, Missouri, 64804
Status
Address
Mercy Hospital Joplin
Joplin, Missouri, 64804
Status
Address
Delbert Day Cancer Institute at PCRMC
Rolla, Missouri, 65401
Status
Address
Mercy Clinic-Rolla-Cancer and Hematology
Rolla, Missouri, 65401
Status
Address
Heartland Regional Medical Center
Saint Joseph, Missouri, 64506
Status
Address
Saint Louis Cancer and Breast Institute-South City
Saint Louis, Missouri, 63109
Status
Address
Washington University School of Medicine
Saint Louis, Missouri, 63110
Status
Address
Mercy Hospital South
Saint Louis, Missouri, 63128
Status
Address
Siteman Cancer Center-South County
Saint Louis, Missouri, 63129
Status
Address
Missouri Baptist Medical Center
Saint Louis, Missouri, 63131
Status
Address
Mercy Hospital Saint Louis
Saint Louis, Missouri, 63141
Status
Address
Sainte Genevieve County Memorial Hospital
Sainte Genevieve, Missouri, 63670
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Address
Mercy Hospital Springfield
Springfield, Missouri, 65804
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Address
CoxHealth South Hospital
Springfield, Missouri, 65807
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Address
Missouri Baptist Sullivan Hospital
Sullivan, Missouri, 63080
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Address
BJC Outpatient Center at Sunset Hills
Sunset Hills, Missouri, 63127
Status
Address
Mercy Hospital Washington
Washington, Missouri, 63090
Status
Address
Community Hospital of Anaconda
Anaconda, Montana, 59711
Status
Address
Billings Clinic Cancer Center
Billings, Montana, 59101
Status
Address
Bozeman Health Deaconess Hospital
Bozeman, Montana, 59715
Status
Address
Benefis Sletten Cancer Institute
Great Falls, Montana, 59405
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Address
Great Falls Clinic
Great Falls, Montana, 59405
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Address
Logan Health Medical Center
Kalispell, Montana, 59901
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Address
Saint Patrick Hospital - Community Hospital
Missoula, Montana, 59802
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Address
Community Medical Center
Missoula, Montana, 59804
Status
Address
Nebraska Cancer Specialists/Oncology Hematology West PC
Grand Island, Nebraska, 68803
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Address
CHI Health Good Samaritan
Kearney, Nebraska, 68847
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Address
Saint Elizabeth Regional Medical Center
Lincoln, Nebraska, 68510
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Address
Cancer Partners of Nebraska
Lincoln, Nebraska, 68516
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Address
Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
Omaha, Nebraska, 68114
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Address
Nebraska Methodist Hospital
Omaha, Nebraska, 68114
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Address
Oncology Associates PC
Omaha, Nebraska, 68114
Status
Address
Alegent Health Immanuel Medical Center
Omaha, Nebraska, 68122
Status
Address
Alegent Health Bergan Mercy Medical Center
Omaha, Nebraska, 68124
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Address
Alegent Health Lakeside Hospital
Omaha, Nebraska, 68130
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Address
Creighton University Medical Center
Omaha, Nebraska, 68131
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Address
Midlands Community Hospital
Papillion, Nebraska, 68046
Status
Address
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon, New Hampshire, 03756
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Address
Morristown Medical Center
Morristown, New Jersey, 07960
Status
Address
Jersey Shore Medical Center
Neptune, New Jersey, 07753
Status
Address
Capital Health Medical Center-Hopewell
Pennington, New Jersey, 08534
Status
Address
Overlook Hospital
Summit, New Jersey, 07902
Status
Address
Roswell Park Cancer Institute
Buffalo, New York, 14263
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Address
Randolph Hospital
Asheboro, North Carolina, 27203
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Address
Messino Cancer Centers
Asheville, North Carolina, 28806
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Address
Cone Health Cancer Center at Alamance Regional
Burlington, North Carolina, 27215
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Address
Cone Health Cancer Center
Greensboro, North Carolina, 27403
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Address
Cone Health Cancer Center at Drawbridge Parkway
Greensboro, North Carolina, 27410
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Address
ECU Health Medical Center
Greenville, North Carolina, 27834
Status
Address
Cone Heath Cancer Center at Mebane
Mebane, North Carolina, 27302
Status
Address
Sanford Bismarck Medical Center
Bismarck, North Dakota, 58501
Status
Address
Essentia Health Cancer Center-South University Clinic
Fargo, North Dakota, 58103
Status
Address
Sanford South University Medical Center
Fargo, North Dakota, 58103
Status
Address
Southpointe-Sanford Medical Center Fargo
Fargo, North Dakota, 58103
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Address
Sanford Medical Center Fargo
Fargo, North Dakota, 58104
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Address
Sanford Broadway Medical Center
Fargo, North Dakota, 58122
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Address
Sanford Roger Maris Cancer Center
Fargo, North Dakota, 58122
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Address
Miami Valley Hospital South
Centerville, Ohio, 45459
Status
Address
University of Cincinnati Cancer Center-UC Medical 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
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210
Status
Address
Miami Valley Hospital
Dayton, Ohio, 45409
Status
Address
Premier Blood and Cancer Center
Dayton, Ohio, 45409
Status
Address
Dayton Physician LLC - Englewood
Dayton, Ohio, 45415
Status
Address
Miami Valley Hospital North
Dayton, Ohio, 45415
Status
Address
Atrium Medical Center-Middletown Regional Hospital
Franklin, Ohio, 45005-1066
Status
Address
Miami Valley Cancer Care and Infusion
Greenville, Ohio, 45331
Status
Address
Greater Dayton Cancer Center
Kettering, Ohio, 45409
Status
Address
Kettering Medical Center
Kettering, Ohio, 45429
Status
Address
Upper Valley Medical Center
Troy, Ohio, 45373
Status
Address
University of Cincinnati Cancer Center-West Chester
West Chester, Ohio, 45069
Status
Address
Cancer Centers of Southwest Oklahoma Research
Lawton, Oklahoma, 73505
Status
Address
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Status
Address
Mercy Hospital Oklahoma City
Oklahoma City, Oklahoma, 73120
Status
Address
Saint Alphonsus Cancer Care Center-Baker City
Baker City, Oregon, 97814
Status
Address
Saint Charles Health System
Bend, Oregon, 97701
Status
Address
Clackamas Radiation Oncology Center
Clackamas, Oregon, 97015
Status
Address
Providence Cancer Institute Clackamas Clinic
Clackamas, Oregon, 97015
Status
Address
Bay Area Hospital
Coos Bay, Oregon, 97420
Status
Address
Providence Newberg Medical Center
Newberg, Oregon, 97132
Status
Address
Saint Alphonsus Cancer Care Center-Ontario
Ontario, Oregon, 97914
Status
Address
Providence Portland Medical Center
Portland, Oregon, 97213
Status
Address
Providence Saint Vincent Medical Center
Portland, Oregon, 97225
Status
Address
Saint Charles Health System-Redmond
Redmond, Oregon, 97756
Status
Address
Lehigh Valley Hospital-Cedar Crest
Allentown, Pennsylvania, 18103
Status
Address
Lehigh Valley Hospital - Muhlenberg
Bethlehem, Pennsylvania, 18017
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Address
Christiana Care Health System-Concord Health Center
Chadds Ford, Pennsylvania, 19317
Status
Address
Pocono Medical Center
East Stroudsburg, Pennsylvania, 18301
Status
Address
Lehigh Valley Hospital-Hazleton
Hazleton, Pennsylvania, 18201
Status
Address
University of Pittsburgh Cancer Institute (UPCI)
Pittsburgh, Pennsylvania, 15232
Status
Address
Reading Hospital
West Reading, Pennsylvania, 19611
Status
Address
Gibbs Cancer Center-Pelham
Greer, South Carolina, 29651
Status
Address
Spartanburg Medical Center
Spartanburg, South Carolina, 29303
Status
Address
Sanford Cancer Center Oncology Clinic
Sioux Falls, South Dakota, 57104
Status
Address
Sanford USD Medical Center - Sioux Falls
Sioux Falls, South Dakota, 57117-5134
Status
Address
Saint Joseph Regional Cancer Center
Bryan, Texas, 77802
Status
Address
Parkland Memorial Hospital
Dallas, Texas, 75235
Status
Address
UT Southwestern/Simmons Cancer Center-Dallas
Dallas, Texas, 75390
Status
Address
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, 84112
Status
Address
Inova Schar Cancer Institute
Fairfax, Virginia, 22031
Status
Address
Inova Fairfax Hospital
Falls Church, Virginia, 22042
Status
Address
Providence Regional Cancer System-Aberdeen
Aberdeen, Washington, 98520
Status
Address
PeaceHealth Saint Joseph Medical Center
Bellingham, Washington, 98225
Status
Address
Highline Medical Center-Main Campus
Burien, Washington, 98166
Status
Address
Providence Regional Cancer System-Centralia
Centralia, Washington, 98531
Status
Address
Swedish Cancer Institute-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
Kadlec Clinic Hematology and Oncology
Kennewick, Washington, 99336
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
Jefferson Healthcare
Port Townsend, Washington, 98368
Status
Address
Harrison HealthPartners Hematology and Oncology-Poulsbo
Poulsbo, Washington, 98370
Status
Address
Pacific Gynecology Specialists
Seattle, Washington, 98104
Status
Address
Swedish Medical Center-Ballard Campus
Seattle, Washington, 98107
Status
Address
Swedish Medical Center-Cherry Hill
Seattle, Washington, 98122-5711
Status
Address
Swedish Medical Center-First Hill
Seattle, Washington, 98122
Status
Address
PeaceHealth United General Medical Center
Sedro-Woolley, Washington, 98284
Status
Address
Providence Regional Cancer System-Shelton
Shelton, Washington, 98584
Status
Address
Saint Michael Cancer Center
Silverdale, Washington, 98383
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
Providence Saint Mary Regional Cancer Center
Walla Walla, Washington, 99362
Status
Address
Providence Regional Cancer System-Yelm
Yelm, Washington, 98597
Status
Address
United Hospital Center
Bridgeport, West Virginia, 26330
Status
Address
WVUH-Berkely Medical Center
Martinsburg, West Virginia, 25401
Status
Address
West Virginia University Healthcare
Morgantown, West Virginia, 26506
Status
Address
Camden Clark Medical Center
Parkersburg, West Virginia, 26101
Status
Address
Duluth Clinic Ashland
Ashland, Wisconsin, 54806
Status
Address
Mayo Clinic Health System-Eau Claire Clinic
Eau Claire, Wisconsin, 54701
Status
Address
Gundersen Lutheran Medical Center
La Crosse, Wisconsin, 54601
Status
Address
ProHealth D N Greenwald Center
Mukwonago, Wisconsin, 53149
Status
Address
Cancer Center of Western Wisconsin
New Richmond, Wisconsin, 54017
Status
Address
ProHealth Oconomowoc Memorial Hospital
Oconomowoc, Wisconsin, 53066
Status
Address
ProHealth Waukesha Memorial Hospital
Waukesha, Wisconsin, 53188
Status
Address
UW Cancer Center at ProHealth Care
Waukesha, Wisconsin, 53188
Status
Address
Billings Clinic-Cody
Cody, Wyoming, 82414
Status
Address
Welch Cancer Center
Sheridan, Wyoming, 82801
Status
Address
Torrance Memorial Physician Network - Cancer Care
Torrance, California, 90505
Status
Address
Torrance Memorial Medical Center
Torrance, California, 90509
Status
Address
Woodland Memorial Hospital
Woodland, California, 95695
Status
Address
UCHealth University of Colorado Hospital
Aurora, Colorado, 80045
Status
Address
Rocky Mountain Cancer Centers-Boulder
Boulder, Colorado, 80304
Status
Address
Penrose-Saint Francis Healthcare
Colorado Springs, Colorado, 80907
Status
Address
Rocky Mountain Cancer Centers-Penrose
Colorado Springs, Colorado, 80907
Status
Address
AdventHealth Porter
Denver, Colorado, 80210
Status
Address
Mercy Medical Center
Durango, Colorado, 81301
Status
Address
Southwest Oncology PC
Durango, Colorado, 81301
Status
Address
Saint Anthony Hospital
Lakewood, Colorado, 80228
Status
Address
Littleton Adventist Hospital
Littleton, Colorado, 80122
Status
Address
Longmont United Hospital
Longmont, Colorado, 80501
Status
Address
Rocky Mountain Cancer Centers-Longmont
Longmont, Colorado, 80501
Status
Address
Parker Adventist Hospital
Parker, Colorado, 80138
Status
Address
Saint Mary Corwin Medical Center
Pueblo, Colorado, 81004
Status
Address
Beebe Medical Center
Lewes, Delaware, 19958
Status
Address
Beebe South Coastal Health Campus
Millville, Delaware, 19967
Status
Address
Delaware Clinical and Laboratory Physicians PA
Newark, Delaware, 19713
Status
Address
Helen F Graham Cancer Center
Newark, Delaware, 19713
Status
Address
Medical Oncology Hematology Consultants PA
Newark, Delaware, 19713
Status
Address
Christiana Care Health System-Christiana Hospital
Newark, Delaware, 19718
Status
Address
Beebe Health Campus
Rehoboth Beach, Delaware, 19971
Status
Address
TidalHealth Nanticoke / Allen Cancer Center
Seaford, Delaware, 19973
Status
Address
Christiana Care Health System-Wilmington Hospital
Wilmington, Delaware, 19801
Status
Address
Holy Cross Hospital
Fort Lauderdale, Florida, 33308
Status
Address
Mayo Clinic in Florida
Jacksonville, Florida, 32224-9980
Status
Address
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia, 30322
Status
Address
Low Country Cancer Care
Savannah, Georgia, 31404
Status
Address
Memorial Health University Medical Center
Savannah, Georgia, 31404
Status
Address
Saint Alphonsus Cancer Care Center-Boise
Boise, Idaho, 83706
Status
Address
Saint Luke's Cancer Institute - Boise
Boise, Idaho, 83712
Status
Address
Saint Alphonsus Cancer Care Center-Caldwell
Caldwell, Idaho, 83605
Status
Address
Kootenai Health - Coeur d'Alene
Coeur d'Alene, Idaho, 83814
Status
Address
Walter Knox Memorial Hospital
Emmett, Idaho, 83617
Status
Address
Saint Luke's Cancer Institute - Fruitland
Fruitland, Idaho, 83619
Status
Address
Idaho Urologic Institute-Meridian
Meridian, Idaho, 83642
Status
Address
Saint Luke's Cancer Institute - Meridian
Meridian, Idaho, 83642
Status
Address
Saint Alphonsus Cancer Care Center-Nampa
Nampa, Idaho, 83687
Status
Address
Saint Luke's Cancer Institute - Nampa
Nampa, Idaho, 83687
Status
Address
Kootenai Clinic Cancer Services - Post Falls
Post Falls, Idaho, 83854
Status
Address
Kootenai Clinic Cancer Services - Sandpoint
Sandpoint, Idaho, 83864
Status
Address
Saint Luke's Cancer Institute - Twin Falls
Twin Falls, Idaho, 83301
Status
Address
OSF Saint Anthony's Health Center
Alton, Illinois, 62002
Status
Address
Rush - Copley Medical Center
Aurora, Illinois, 60504
Status
Address
Illinois CancerCare-Bloomington
Bloomington, Illinois, 61704
Status
Address
Illinois CancerCare-Canton
Canton, Illinois, 61520
Status
Address
Memorial Hospital of Carbondale
Carbondale, Illinois, 62902
Status
Address
SIH Cancer Institute
Carterville, Illinois, 62918
Status
Address
Illinois CancerCare-Carthage
Carthage, Illinois, 62321
Status
Address
Centralia Oncology Clinic
Centralia, Illinois, 62801
Status
Address
University of Illinois
Chicago, Illinois, 60612
Status
Address
Carle at The Riverfront
Danville, Illinois, 61832
Status
Address
Cancer Care Specialists of Illinois - Decatur
Decatur, Illinois, 62526
Status
Address
Decatur Memorial Hospital
Decatur, Illinois, 62526
Status
Address
Illinois CancerCare-Dixon
Dixon, Illinois, 61021
Status
Address
Carle Physician Group-Effingham
Effingham, Illinois, 62401
Status
Address
Crossroads Cancer Center
Effingham, Illinois, 62401
Status
Address
Illinois CancerCare-Eureka
Eureka, Illinois, 61530
Status
Address
NorthShore University HealthSystem-Evanston Hospital
Evanston, Illinois, 60201
Status
Address
Illinois CancerCare-Galesburg
Galesburg, Illinois, 61401
Status
Address
Western Illinois Cancer Treatment Center
Galesburg, Illinois, 61401
Status
Address
NorthShore University HealthSystem-Glenbrook Hospital
Glenview, Illinois, 60026
Status
Address
NorthShore University HealthSystem-Highland Park Hospital
Highland Park, Illinois, 60035
Status
Address
Illinois CancerCare-Kewanee Clinic
Kewanee, Illinois, 61443
Status
Address
Illinois CancerCare-Macomb
Macomb, Illinois, 61455
Status
Address
Carle Physician Group-Mattoon/Charleston
Mattoon, Illinois, 61938
Status
Address
SSM Health Good Samaritan
Mount Vernon, Illinois, 62864
Status
Address
Cancer Care Center of O'Fallon
O'Fallon, Illinois, 62269
Status
Address
Illinois CancerCare-Ottawa Clinic
Ottawa, Illinois, 61350
Status
Address
Illinois CancerCare-Pekin
Pekin, Illinois, 61554
Status
Address
OSF Saint Francis Radiation Oncology at Pekin
Pekin, Illinois, 61554
Status
Address
Illinois CancerCare-Peoria
Peoria, Illinois, 61615
Status
Address
OSF Saint Francis Radiation Oncology at Peoria Cancer Center
Peoria, Illinois, 61615
Status
Address
Methodist Medical Center of Illinois
Peoria, Illinois, 61636
Status
Address
OSF Saint Francis Medical Center
Peoria, Illinois, 61637
Status
Address
Illinois CancerCare-Peru
Peru, Illinois, 61354
Status
Address
Valley Radiation Oncology
Peru, Illinois, 61354
Status
Address
Illinois CancerCare-Princeton
Princeton, Illinois, 61356
Status
Address
North Shore Medical Center
Skokie, Illinois, 60076
Status
Address
Southern Illinois University School of Medicine
Springfield, Illinois, 62702
Status
Address
Springfield Clinic
Springfield, Illinois, 62702
Status
Address
Springfield Memorial Hospital
Springfield, Illinois, 62781
Status
Address
Carle Cancer Center
Urbana, Illinois, 61801
Status
Address
The Carle Foundation Hospital
Urbana, Illinois, 61801
Status
Address
Illinois CancerCare - Washington
Washington, Illinois, 61571
Status
Address
Rush-Copley Healthcare Center
Yorkville, Illinois, 60560
Status
Address
Baptist Health Floyd
New Albany, Indiana, 47150
Status
Address
Mary Greeley Medical Center
Ames, Iowa, 50010
Status
Address
McFarland Clinic - Ames
Ames, Iowa, 50010
Status
Address
McFarland Clinic - Boone
Boone, Iowa, 50036
Status
Address
Saint Anthony Regional Hospital
Carroll, Iowa, 51401
Status
Address
Mercy Cancer Center-West Lakes
Clive, Iowa, 50325
Status
Address
Mission Cancer and Blood - West Des Moines
Clive, Iowa, 50325
Status
Address
Alegent Health Mercy Hospital
Council Bluffs, Iowa, 51503
Status
Address
Heartland Oncology and Hematology LLP
Council Bluffs, Iowa, 51503
Status
Address
Methodist Jennie Edmundson Hospital
Council Bluffs, Iowa, 51503
Status
Address
Greater Regional Medical Center
Creston, Iowa, 50801
Status
Address
Iowa Methodist Medical Center
Des Moines, Iowa, 50309
Status
Address
Mission Cancer and Blood - Des Moines
Des Moines, Iowa, 50309
Status
Address
Broadlawns Medical Center
Des Moines, Iowa, 50314
Status
Address
Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
Status
Address
Mission Cancer and Blood - Laurel
Des Moines, Iowa, 50314
Status
Address
Iowa Lutheran Hospital
Des Moines, Iowa, 50316
Status
Address
McFarland Clinic - Trinity Cancer Center
Fort Dodge, Iowa, 50501
Status
Address
Trinity Regional Medical Center
Fort Dodge, Iowa, 50501
Status
Address
McFarland Clinic - Jefferson
Jefferson, Iowa, 50129
Status
Address
McFarland Clinic - Marshalltown
Marshalltown, Iowa, 50158
Status
Address
Methodist West Hospital
West Des Moines, Iowa, 50266-7700
Status
Address
Mercy Medical Center-West Lakes
West Des Moines, Iowa, 50266
Status
Address
Cancer Center of Kansas - Chanute
Chanute, Kansas, 66720
Status
Address
Cancer Center of Kansas - Dodge City
Dodge City, Kansas, 67801
Status
Address
Cancer Center of Kansas - El Dorado
El Dorado, Kansas, 67042
Status
Address
Central Care Cancer Center - Garden City
Garden City, Kansas, 67846
Status
Address
Central Care Cancer Center - Great Bend
Great Bend, Kansas, 67530
Status
Address
Cancer Center of Kansas-Independence
Independence, Kansas, 67301
Status
Address
Cancer Center of Kansas-Kingman
Kingman, Kansas, 67068
Status
Address
Cancer Center of Kansas-Liberal
Liberal, Kansas, 67905
Status
Address
Cancer Center of Kansas-Manhattan
Manhattan, Kansas, 66502
Status
Address
Cancer Center of Kansas - McPherson
McPherson, Kansas, 67460
Status
Address
Cancer Center of Kansas - Newton
Newton, Kansas, 67114
Status
Address
Cancer Center of Kansas - Parsons
Parsons, Kansas, 67357
Status
Address
Cancer Center of Kansas - Pratt
Pratt, Kansas, 67124
Status
Address
Cancer Center of Kansas - Salina
Salina, Kansas, 67401
Status
Address
Cancer Center of Kansas - Wellington
Wellington, Kansas, 67152
Status
Address
Cancer Center of Kansas-Wichita Medical Arts Tower
Wichita, Kansas, 67208
Status
Address
Ascension Via Christi Hospitals Wichita
Wichita, Kansas, 67214
Status
Address
Cancer Center of Kansas - Wichita
Wichita, Kansas, 67214
Status
Address
Cancer Center of Kansas - Winfield
Winfield, Kansas, 67156
Status
Address
Flaget Memorial Hospital
Bardstown, Kentucky, 40004
Status
Address
Commonwealth Cancer Center-Corbin
Corbin, Kentucky, 40701
Status
Address
Baptist Health Lexington
Lexington, Kentucky, 40503
Status
Address
Saint Joseph Radiation Oncology Resource Center
Lexington, Kentucky, 40504
Status
Address
Saint Joseph Hospital East
Lexington, Kentucky, 40509
Status
Address
Saint Joseph London
London, Kentucky, 40741
Status
Address
Jewish Hospital
Louisville, Kentucky, 40202
Status
Address
Baptist Health Louisville
Louisville, Kentucky, 40207
Status
Address
Saints Mary and Elizabeth Hospital
Louisville, Kentucky, 40215
Status
Address
UofL Health Medical Center Northeast
Louisville, Kentucky, 40245
Status
Address
Jewish Hospital Medical Center South
Shepherdsville, Kentucky, 40165
Status
Address
Ochsner LSU Health Monroe Medical Center
Monroe, Louisiana, 71202
Status
Address
LSU Health Sciences Center at Shreveport
Shreveport, Louisiana, 71103
Status
Address
Trinity Health Saint Joseph Mercy Hospital Ann Arbor
Ann Arbor, Michigan, 48106
Status
Address
Bronson Battle Creek
Battle Creek, Michigan, 49017
Status
Address
Trinity Health IHA Medical Group Hematology Oncology - Brighton
Brighton, Michigan, 48114
Status
Address
Trinity Health Medical Center - Brighton
Brighton, Michigan, 48114
Status
Address
Trinity Health IHA Medical Group Hematology Oncology - Canton
Canton, Michigan, 48188
Status
Address
Trinity Health Medical Center - Canton
Canton, Michigan, 48188
Status
Address
Caro Cancer Center
Caro, Michigan, 48723
Status
Address
Chelsea Hospital
Chelsea, Michigan, 48118
Status
Address
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
Chelsea, Michigan, 48118
Status
Address
Hematology Oncology Consultants-Clarkston
Clarkston, Michigan, 48346
Status
Address
Newland Medical Associates-Clarkston
Clarkston, Michigan, 48346
Status
Address
Henry Ford Health Saint John Hospital
Detroit, Michigan, 48236
Status
Address
Henry Ford River District Hospital
East China Township, Michigan, 48054
Status
Address
Cancer Hematology Centers - Flint
Flint, Michigan, 48503
Status
Address
Genesee Hematology Oncology PC
Flint, Michigan, 48503
Status
Address
Genesys Hurley Cancer Institute
Flint, Michigan, 48503
Status
Address
Hurley Medical Center
Flint, Michigan, 48503
Status
Address
Corewell Health Grand Rapids Hospitals - Butterworth Hospital
Grand Rapids, Michigan, 49503
Status
Address
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
Grand Rapids, Michigan, 49503
Status
Address
Trinity Health Grand Rapids Hospital
Grand Rapids, Michigan, 49503
Status
Address
Henry Ford Saint John Hospital - Academic
Grosse Pointe Woods, Michigan, 48236
Status
Address
Henry Ford Saint John Hospital - Breast
Grosse Pointe Woods, Michigan, 48236
Status
Address
Henry Ford Saint John Hospital - Van Elslander
Grosse Pointe Woods, Michigan, 48236
Status
Address
Bronson Methodist Hospital
Kalamazoo, Michigan, 49007
Status
Address
West Michigan Cancer Center
Kalamazoo, Michigan, 49007
Status
Address
Ascension Borgess Cancer Center
Kalamazoo, Michigan, 49009
Status
Address
Ascension Borgess Hospital
Kalamazoo, Michigan, 49048
Status
Address
University of Michigan Health - Sparrow Lansing
Lansing, Michigan, 48912
Status
Address
Hope Cancer Clinic
Livonia, Michigan, 48154
Status
Address
Trinity Health Saint Mary Mercy Livonia Hospital
Livonia, Michigan, 48154
Status
Address
Henry Ford Saint John Hospital - Macomb Medical
Macomb, Michigan, 48044
Status
Address
Henry Ford Warren Hospital - Breast Macomb
Macomb, Michigan, 48044
Status
Address
Saint Mary's Oncology/Hematology Associates of Marlette
Marlette, Michigan, 48453
Status
Address
Trinity Health Muskegon Hospital
Muskegon, Michigan, 49444
Status
Address
Corewell Health Lakeland Hospitals - Niles Hospital
Niles, Michigan, 49120
Status
Address
Pacific Central Coast Health Center-San Luis Obispo
San Luis Obispo, California, 93401
Status
Address
Mission Hope Medical Oncology - Santa Maria
Santa Maria, California, 93444
Status
Address
Anchorage Associates in Radiation Medicine
Anchorage, Alaska, 98508
Status
Address
Anchorage Radiation Therapy Center
Anchorage, Alaska, 99504
Status
Address
Alaska Breast Care and Surgery LLC
Anchorage, Alaska, 99508
Status
Address
Alaska Oncology and Hematology LLC
Anchorage, Alaska, 99508
Status
Address
Alaska Women's Cancer Care
Anchorage, Alaska, 99508
Status
Address
Anchorage Oncology Centre
Anchorage, Alaska, 99508
Status
Address
Katmai Oncology Group
Anchorage, Alaska, 99508
Status
Address
Providence Alaska Medical Center
Anchorage, Alaska, 99508
Status
Address
Cancer Center at Saint Joseph's
Phoenix, Arizona, 85004
Status
Address
Mayo Clinic Hospital in Arizona
Phoenix, Arizona, 85054
Status
Address
Mayo Clinic in Arizona
Scottsdale, Arizona, 85259
Status
Address
Mercy Hospital Fort Smith
Fort Smith, Arkansas, 72903
Status
Address
CHI Saint Vincent Cancer Center Hot Springs
Hot Springs, Arkansas, 71913
Status
Address
Mission Hope Medical Oncology - Arroyo Grande
Arroyo Grande, California, 93420
Status
Address
Providence Saint Joseph Medical Center/Disney Family Cancer Center
Burbank, California, 91505
Status
Address
Mercy Cancer Center - Carmichael
Carmichael, California, 95608
Status
Address
Mercy San Juan Medical Center
Carmichael, California, 95608
Status
Address
Mercy Cancer Center - Elk Grove
Elk Grove, California, 95758
Status
Address
UC San Diego Moores Cancer Center
La Jolla, California, 92093
Status
Address
Cedars Sinai Medical Center
Los Angeles, California, 90048
Status
Address
Mercy Cancer Center - Rocklin
Rocklin, California, 95765
Status
Address
Mercy Cancer Center - Sacramento
Sacramento, California, 95816
Status
Address
University of California Davis Comprehensive Cancer Center
Sacramento, California, 95817
International Sites
Status
Address
Pan American Center for Oncology Trials LLC
San Juan, , 00902
