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 |
|
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.
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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 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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Cancer Center at Saint Joseph's
Phoenix, Arizona, 85004
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Mayo Clinic Hospital in Arizona
Phoenix, Arizona, 85054
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Mayo Clinic in Arizona
Scottsdale, Arizona, 85259
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Mercy Hospital Fort Smith
Fort Smith, Arkansas, 72903
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CHI Saint Vincent Cancer Center Hot Springs
Hot Springs, Arkansas, 71913
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Mission Hope Medical Oncology - Arroyo Grande
Arroyo Grande, California, 93420
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Providence Saint Joseph Medical Center/Disney Family Cancer Center
Burbank, California, 91505
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Mercy Cancer Center - Carmichael
Carmichael, California, 95608
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Mercy San Juan Medical Center
Carmichael, California, 95608
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Mercy Cancer Center - Elk Grove
Elk Grove, California, 95758
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UC San Diego Moores Cancer Center
La Jolla, California, 92093
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Cedars Sinai Medical Center
Los Angeles, California, 90048
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Mercy Cancer Center - Rocklin
Rocklin, California, 95765
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Mercy Cancer Center - Sacramento
Sacramento, California, 95816
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University of California Davis Comprehensive Cancer Center
Sacramento, California, 95817
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Pacific Central Coast Health Center-San Luis Obispo
San Luis Obispo, California, 93401
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Mission Hope Medical Oncology - Santa Maria
Santa Maria, California, 93444
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Torrance Memorial Physician Network - Cancer Care
Torrance, California, 90505
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Torrance Memorial Medical Center
Torrance, California, 90509
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Woodland Memorial Hospital
Woodland, California, 95695
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UCHealth University of Colorado Hospital
Aurora, Colorado, 80045
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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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Mercy Medical Center
Durango, Colorado, 81301
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Southwest Oncology PC
Durango, Colorado, 81301
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Saint Anthony Hospital
Lakewood, Colorado, 80228
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Littleton Adventist Hospital
Littleton, Colorado, 80122
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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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Parker Adventist Hospital
Parker, Colorado, 80138
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Saint Mary Corwin Medical Center
Pueblo, Colorado, 81004
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Beebe South Coastal Health Campus
Frankford, Delaware, 19945
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Address
Beebe Medical Center
Lewes, Delaware, 19958
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Address
Delaware Clinical and Laboratory Physicians PA
Newark, Delaware, 19713
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Helen F Graham Cancer Center
Newark, Delaware, 19713
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Medical Oncology Hematology Consultants PA
Newark, Delaware, 19713
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Christiana Care Health System-Christiana Hospital
Newark, Delaware, 19718
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Beebe Health Campus
Rehoboth Beach, Delaware, 19971
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TidalHealth Nanticoke / Allen Cancer Center
Seaford, Delaware, 19973
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Christiana Care Health System-Wilmington Hospital
Wilmington, Delaware, 19801
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Holy Cross Hospital
Fort Lauderdale, Florida, 33308
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Mayo Clinic in Florida
Jacksonville, Florida, 32224-9980
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Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia, 30322
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Low Country Cancer Care
Savannah, Georgia, 31404
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Memorial Health University Medical Center
Savannah, Georgia, 31404
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Saint Alphonsus Cancer Care Center-Boise
Boise, Idaho, 83706
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Saint Luke's Cancer Institute - Boise
Boise, Idaho, 83712
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Saint Alphonsus Cancer Care Center-Caldwell
Caldwell, Idaho, 83605
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Kootenai Health - Coeur d'Alene
Coeur d'Alene, Idaho, 83814
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Walter Knox Memorial Hospital
Emmett, Idaho, 83617
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Saint Luke's Cancer Institute - Fruitland
Fruitland, Idaho, 83619
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Idaho Urologic Institute-Meridian
Meridian, Idaho, 83642
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Saint Luke's Cancer Institute - Meridian
Meridian, Idaho, 83642
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Saint Luke's Cancer Institute - Nampa
Nampa, Idaho, 83686
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Saint Alphonsus Cancer Care Center-Nampa
Nampa, Idaho, 83687
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Kootenai Clinic Cancer Services - Post Falls
Post Falls, Idaho, 83854
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Kootenai Cancer Clinic
Sandpoint, Idaho, 83864
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Saint Luke's Cancer Institute - Twin Falls
Twin Falls, Idaho, 83301
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Saint Anthony's Health
Alton, Illinois, 62002
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Address
Rush - Copley Medical Center
Aurora, Illinois, 60504
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Address
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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SIH Cancer Institute
Carterville, Illinois, 62918
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Address
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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University of Illinois
Chicago, Illinois, 60612
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Carle at The Riverfront
Danville, Illinois, 61832
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Cancer Care Specialists of Illinois - Decatur
Decatur, Illinois, 62526
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Decatur Memorial Hospital
Decatur, Illinois, 62526
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Illinois CancerCare-Dixon
Dixon, Illinois, 61021
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Carle Physician Group-Effingham
Effingham, Illinois, 62401
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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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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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Northwestern Medicine Lake Forest Hospital
Lake Forest, Illinois, 60045
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Illinois CancerCare-Macomb
Macomb, Illinois, 61455
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Carle Physician Group-Mattoon/Charleston
Mattoon, Illinois, 61938
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Good Samaritan Regional Health Center
Mount Vernon, Illinois, 62864
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Cancer Care Center of O'Fallon
O'Fallon, Illinois, 62269
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Illinois CancerCare-Ottawa Clinic
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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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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Methodist Medical Center of Illinois
Peoria, Illinois, 61636
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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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North Shore Medical Center
Skokie, Illinois, 60076
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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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Carle Cancer Center
Urbana, Illinois, 61801
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The Carle Foundation Hospital
Urbana, Illinois, 61801
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Illinois CancerCare - Washington
Washington, Illinois, 61571
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Rush-Copley Healthcare Center
Yorkville, Illinois, 60560
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Baptist Health Floyd
New Albany, Indiana, 47150
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Mary Greeley Medical Center
Ames, Iowa, 50010
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McFarland Clinic - Ames
Ames, Iowa, 50010
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McFarland Clinic - Boone
Boone, Iowa, 50036
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Address
Saint Anthony Regional Hospital
Carroll, Iowa, 51401
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Address
Medical Oncology and Hematology Associates-West Des Moines
Clive, Iowa, 50325
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Mercy Cancer Center-West Lakes
Clive, Iowa, 50325
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Alegent Health Mercy Hospital
Council Bluffs, Iowa, 51503
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Heartland Oncology and Hematology LLP
Council Bluffs, Iowa, 51503
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Methodist Jennie Edmundson Hospital
Council Bluffs, Iowa, 51503
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Greater Regional Medical Center
Creston, Iowa, 50801
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Iowa Methodist Medical Center
Des Moines, Iowa, 50309
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Medical Oncology and Hematology Associates-Des Moines
Des Moines, Iowa, 50309
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Broadlawns Medical Center
Des Moines, Iowa, 50314
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Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
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Mission Cancer and Blood - Laurel
Des Moines, Iowa, 50314
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Iowa Lutheran Hospital
Des Moines, Iowa, 50316
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Address
McFarland Clinic - Trinity Cancer Center
Fort Dodge, Iowa, 50501
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Trinity Regional Medical Center
Fort Dodge, Iowa, 50501
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McFarland Clinic - Jefferson
Jefferson, Iowa, 50129
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McFarland Clinic - Marshalltown
Marshalltown, Iowa, 50158
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Methodist West Hospital
West Des Moines, Iowa, 50266-7700
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Address
Mercy Medical Center-West Lakes
West Des Moines, Iowa, 50266
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Cancer Center of Kansas - Chanute
Chanute, Kansas, 66720
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Cancer Center of Kansas - Dodge City
Dodge City, Kansas, 67801
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Cancer Center of Kansas - El Dorado
El Dorado, Kansas, 67042
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Central Care Cancer Center - Garden City
Garden City, Kansas, 67846
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Central Care Cancer Center - Great Bend
Great Bend, Kansas, 67530
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Cancer Center of Kansas-Independence
Independence, Kansas, 67301
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Cancer Center of Kansas-Kingman
Kingman, Kansas, 67068
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Cancer Center of Kansas-Liberal
Liberal, Kansas, 67905
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Cancer Center of Kansas-Manhattan
Manhattan, Kansas, 66502
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Cancer Center of Kansas - McPherson
McPherson, Kansas, 67460
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Cancer Center of Kansas - Newton
Newton, Kansas, 67114
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Cancer Center of Kansas - Parsons
Parsons, Kansas, 67357
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Cancer Center of Kansas - Pratt
Pratt, Kansas, 67124
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Cancer Center of Kansas - Salina
Salina, Kansas, 67401
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Cancer Center of Kansas - Wellington
Wellington, Kansas, 67152
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Cancer Center of Kansas-Wichita Medical Arts Tower
Wichita, Kansas, 67208
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Ascension Via Christi Hospitals Wichita
Wichita, Kansas, 67214
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Cancer Center of Kansas - Wichita
Wichita, Kansas, 67214
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Cancer Center of Kansas - Winfield
Winfield, Kansas, 67156
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Flaget Memorial Hospital
Bardstown, Kentucky, 40004
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Address
Commonwealth Cancer Center-Corbin
Corbin, Kentucky, 40701
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Address
Baptist Health Lexington
Lexington, Kentucky, 40503
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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
Saint Joseph London
London, Kentucky, 40741
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Jewish Hospital
Louisville, Kentucky, 40202
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Address
Baptist Health Louisville
Louisville, Kentucky, 40207
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Address
Saints Mary and Elizabeth Hospital
Louisville, Kentucky, 40215
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Address
UofL Health Medical Center Northeast
Louisville, Kentucky, 40245
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Address
Jewish Hospital Medical Center South
Shepherdsville, Kentucky, 40165
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Address
Ochsner LSU Health Monroe Medical Center
Monroe, Louisiana, 71202
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LSU Health Sciences Center at Shreveport
Shreveport, Louisiana, 71103
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Saint Joseph Mercy Hospital
Ann Arbor, Michigan, 48106
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Address
Bronson Battle Creek
Battle Creek, Michigan, 49017
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Address
Saint Joseph Mercy Brighton
Brighton, Michigan, 48114
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Address
Trinity Health IHA Medical Group Hematology Oncology - Brighton
Brighton, Michigan, 48114
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Address
Saint Joseph Mercy Canton
Canton, Michigan, 48188
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Address
Trinity Health IHA Medical Group Hematology Oncology - Canton
Canton, Michigan, 48188
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Address
Caro Cancer Center
Caro, Michigan, 48723
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Address
Saint Joseph Mercy Chelsea
Chelsea, Michigan, 48118
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Address
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
Chelsea, Michigan, 48118
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Address
Hematology Oncology Consultants-Clarkston
Clarkston, Michigan, 48346
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Address
Newland Medical Associates-Clarkston
Clarkston, Michigan, 48346
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Address
Ascension Saint John Hospital
Detroit, Michigan, 48236
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Address
Great Lakes Cancer Management Specialists-Doctors Park
East China Township, Michigan, 48054
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Address
Genesee Cancer and Blood Disease Treatment Center
Flint, Michigan, 48503
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Address
Genesee Hematology Oncology PC
Flint, Michigan, 48503
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Address
Genesys Hurley Cancer Institute
Flint, Michigan, 48503
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Address
Hurley Medical Center
Flint, Michigan, 48503
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Address
Helen DeVos Children's Hospital at Spectrum Health
Grand Rapids, Michigan, 49503
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Address
Spectrum Health at Butterworth Campus
Grand Rapids, Michigan, 49503
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Address
Trinity Health Grand Rapids Hospital
Grand Rapids, Michigan, 49503
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Address
Academic Hematology Oncology Specialists
Grosse Pointe Woods, Michigan, 48236
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Address
Great Lakes Cancer Management Specialists-Van Elslander Cancer Center
Grosse Pointe Woods, Michigan, 48236
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Address
Michigan Breast Specialists-Grosse Pointe Woods
Grosse Pointe Woods, Michigan, 48236
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Address
Bronson Methodist Hospital
Kalamazoo, Michigan, 49007
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Address
West Michigan Cancer Center
Kalamazoo, Michigan, 49007
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Address
Ascension Borgess Cancer Center
Kalamazoo, Michigan, 49009
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Address
Borgess Medical Center
Kalamazoo, Michigan, 49048
Status
Address
University of Michigan Health - Sparrow Lansing
Lansing, Michigan, 48912
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Address
Hope Cancer Clinic
Livonia, Michigan, 48154
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Address
Trinity Health Saint Mary Mercy Livonia Hospital
Livonia, Michigan, 48154
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Address
Great Lakes Cancer Management Specialists-Macomb Medical Campus
Macomb, Michigan, 48044
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Address
Michigan Breast Specialists-Macomb Township
Macomb, Michigan, 48044
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Address
Saint Mary's Oncology/Hematology Associates of Marlette
Marlette, Michigan, 48453
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Address
Trinity Health Muskegon Hospital
Muskegon, Michigan, 49444
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Address
Corewell Health Lakeland Hospitals - Niles Hospital
Niles, Michigan, 49120
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Address
Cancer and Hematology Centers of Western Michigan - Norton Shores
Norton Shores, Michigan, 49444
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Address
21st Century Oncology-Pontiac
Pontiac, Michigan, 48341
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Address
Hope Cancer Center
Pontiac, Michigan, 48341
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Address
Newland Medical Associates-Pontiac
Pontiac, Michigan, 48341
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Address
Saint Joseph Mercy Oakland
Pontiac, Michigan, 48341
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Address
Corewell Health Reed City Hospital
Reed City, Michigan, 49677
Status
Address
Great Lakes Cancer Management Specialists-Rochester Hills
Rochester Hills, Michigan, 48309
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Address
William Beaumont Hospital-Royal Oak
Royal Oak, Michigan, 48073
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Address
Ascension Saint Mary's Hospital
Saginaw, Michigan, 48601
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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
Lakeland Medical Center Saint Joseph
Saint Joseph, Michigan, 49085
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Address
Bhadresh Nayak MD PC-Sterling Heights
Sterling Heights, Michigan, 48312
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Address
Ascension Saint Joseph Hospital
Tawas City, Michigan, 48764
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Address
Munson Medical Center
Traverse City, Michigan, 49684
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Address
William Beaumont Hospital - Troy
Troy, Michigan, 48085
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Address
Advanced Breast Care Center PLLC
Warren, Michigan, 48088
Status
Address
Great Lakes Cancer Management Specialists-Macomb Professional Building
Warren, Michigan, 48093
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Address
Macomb Hematology Oncology PC
Warren, Michigan, 48093
Status
Address
Michigan Breast Specialists-Warren
Warren, Michigan, 48093
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Address
Saint John Macomb-Oakland Hospital
Warren, Michigan, 48093
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Address
Saint Mary's Oncology/Hematology Associates of West Branch
West Branch, Michigan, 48661
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Address
University of Michigan Health - West
Wyoming, Michigan, 49519
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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
Status
Address
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
Status
Address
Minnesota Oncology - Burnsville
Burnsville, Minnesota, 55337
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Address
Cambridge Medical Center
Cambridge, Minnesota, 55008
Status
Address
Mercy Hospital
Coon Rapids, Minnesota, 55433
Status
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
Status
Address
New Ulm Medical Center
New Ulm, Minnesota, 56073
Status
Address
Fairview Northland Medical Center
Princeton, Minnesota, 55371
Status
Address
North Memorial Medical Health Center
Robbinsdale, Minnesota, 55422
Status
Address
Mayo Clinic in Rochester
Rochester, Minnesota, 55905
Status
Address
Coborn Cancer Center at Saint Cloud Hospital
Saint Cloud, Minnesota, 56303
Status
Address
Park Nicollet Clinic - Saint Louis Park
Saint Louis Park, Minnesota, 55416
Status
Address
Regions Hospital
Saint Paul, Minnesota, 55101
Status
Address
United Hospital
Saint Paul, Minnesota, 55102
Status
Address
Essentia Health Sandstone
Sandstone, Minnesota, 55072
Status
Address
Saint Francis Regional Medical Center
Shakopee, Minnesota, 55379
Status
Address
Lakeview Hospital
Stillwater, Minnesota, 55082
Status
Address
Sanford Thief River Falls Medical Center
Thief River Falls, Minnesota, 56701
Status
Address
Essentia Health Virginia Clinic
Virginia, Minnesota, 55792
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
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
Status
Address
Siteman Cancer Center at West County Hospital
Creve Coeur, Missouri, 63141
Status
Address
Parkland Health Center - Farmington
Farmington, Missouri, 63640
Status
Address
Capital Region Southwest Campus
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
Status
Address
Mercy Hospital Springfield
Springfield, Missouri, 65804
Status
Address
CoxHealth South Hospital
Springfield, Missouri, 65807
Status
Address
Missouri Baptist Sullivan Hospital
Sullivan, Missouri, 63080
Status
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 Deaconess Hospital
Bozeman, Montana, 59715
Status
Address
Benefis Healthcare- Sletten Cancer Institute
Great Falls, Montana, 59405
Status
Address
Great Falls Clinic
Great Falls, Montana, 59405
Status
Address
Kalispell Regional Medical Center
Kalispell, Montana, 59901
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
CHI Health Good Samaritan
Kearney, Nebraska, 68847
Status
Address
Saint Elizabeth Regional Medical Center
Lincoln, Nebraska, 68510
Status
Address
Cancer Partners of Nebraska - Pine Lake
Lincoln, Nebraska, 68516
Status
Address
Southeast Nebraska Cancer Center - 68th Street Place
Lincoln, Nebraska, 68516
Status
Address
Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
Omaha, Nebraska, 68114
Status
Address
Nebraska Methodist Hospital
Omaha, Nebraska, 68114
Status
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
Status
Address
Alegent Health Lakeside Hospital
Omaha, Nebraska, 68130
Status
Address
Creighton University Medical Center
Omaha, Nebraska, 68131
Status
Address
Midlands Community Hospital
Papillion, Nebraska, 68046
Status
Address
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon, New Hampshire, 03756
Status
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
Status
Address
Randolph Hospital
Asheboro, North Carolina, 27203
Status
Address
Messino Cancer Centers
Asheville, North Carolina, 28806
Status
Address
Cone Health Cancer Center at Alamance Regional
Burlington, North Carolina, 27215
Status
Address
Cone Health Cancer Center
Greensboro, North Carolina, 27403
Status
Address
Cone Health Cancer Center at Drawbridge Parkway
Greensboro, North Carolina, 27410
Status
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
Status
Address
Sanford Medical Center Fargo
Fargo, North Dakota, 58104
Status
Address
Sanford Broadway Medical Center
Fargo, North Dakota, 58122
Status
Address
Sanford Roger Maris Cancer Center
Fargo, North Dakota, 58122
Status
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
Dayton Blood and Cancer Center
Dayton, Ohio, 45409
Status
Address
Miami Valley Hospital
Dayton, Ohio, 45409
Status
Address
Dayton Physician LLC-Miami Valley Hospital North
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 Medical 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 Medical 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
Status
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
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 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
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
International Sites
Status
Address
Pan American Center for Oncology Trials LLC
San Juan, , 00902
