Imatinib Mesylate or Dasatinib in Treating Patients With Previously Untreated Chronic Phase Chronic Myelogenous Leukemia

Phase 2

Active, not recruiting

• Conditions: Chronic Myeloid Leukemia, BCR-ABL1 Positive
• Interventions: Drug: Imatinib Mesylate; Drug: Dasatinib; Other: Laboratory Biomarker Analysis

• Registration Number: NCT00070499
• Lead Sponsor: National Cancer Institute (NCI)

Brief Summary

This randomized phase IIB trial studies imatinib mesylate at two different doses and dasatinib to see how well they work in treating patients with previously untreated chronic phase chronic myelogenous leukemia. Imatinib mesylate or dasatinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.

Detailed Description

PRIMARY OBJECTIVES:

I. To compare the molecular response rates, as measured by the decrease in breakpoint cluster region-Abelson murine leukemia viral oncogene homolog 1 (BCR-ABL) transcripts after 12 months of treatment, in patients with previously untreated chronic myelogenous leukemia (CML) in chronic phase who are treated with either dasatinib 100 mg/day or imatinib (STI571, Gleevec) (imatinib mesylate) 400 mg/day.

II. To test whether increasing the dose of imatinib (STI571, Gleevec®) from 400 mg/day to 800 mg/day increases the rate of molecular response, as measured by the decrease in BCR-ABL transcripts after 12 months of treatment, in patients with previously untreated CML in chronic phase.

III. To estimate rates of cytogenetic and hematologic responses to imatinib 400 mg/day, imatinib 800 mg/day, and dasatinib 100 mg/day.

IV. To evaluate in a preliminary manner the prognostic effects of derivative (der)(9) and der(22) chromosomal deletions for response in CML patients treated with imatinib and dasatinib.

V. To investigate in a preliminary manner changes in gene expression at relapse or progression compared to pre-treatment.

VI. To estimate the frequency and severity of toxicities of the three treatment regimens.

VII. To evaluate, in a preliminary manner, the overall survival and relapse-free survival of patients treated with these regimens.

OUTLINE: Patients are randomized to 1 of 3 treatment arms.

ARM I: Patients receive imatinib mesylate orally (PO) once daily (QD). Treatment repeats every 4 weeks for up to 5 years in the absence of disease progression or unacceptable toxicity.

ARM II: Patients receive imatinib mesylate PO twice daily (BID). Treatment repeats every 4 weeks for up to 12 months in the absence of disease progression or unacceptable toxicity.

ARM III: Patients receive dasatinib PO BID. Treatment repeats every 4 weeks for up to 5 years in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up for 15 years.

Study Timeline

• Study First Submitted: 2003-10-03
• Study First Submitted QC: 2003-10-06
• Study First Posted: 2003-10-07
• Study Start: 2004-08-15
• Primary Completion: 2010-11-01
• Results First Submitted: 2012-06-05
• Results First Submitted QC: 2012-06-05
• Results First Posted: 2012-07-10
• Status Verified: 2025-02
• Last Update Submitted: 2025-05-09
• Last Update Posted: 2025-05-11
• Study Completion: 2026-03-10

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 406

Inclusion Criteria

• Patients must have CML in chronic phase based on bone marrow aspiration and biopsy and peripheral blood counts obtained within 28 days before registration

• Patients must be registered on this study within 180 days after the date of first being diagnosed with CML, based on a cytogenetic or molecular analysis of peripheral blood or bone marrow, demonstrating the presence of the Philadelphia chromosome or variants of the (9;22) translocation or testing positive for Bcr-Abl by real time-polymerase chain reaction (RT-PCR); patients may have secondary chromosomal abnormalities in addition to the Philadelphia chromosome and remain eligible

• Patients must have Zubrod performance status 0-2

• Patients must not have received prior treatment for CML with the exception of hydroxyurea and/or anagrelide

• Patients must not have received any prior chemotherapy regimen for peripheral blood stem cell mobilization; (prior collection of unmobilized peripheral blood stem cells is permitted)

• Serum bilirubin =< 2.0 x the institutional upper limit of the normal (IULN)

• Serum glutamic oxaloacetic transaminase (SGOT)/aspartate aminotransferase (AST) or serum glutamate pyruvate transaminase (SGPT)/alanine transaminase (ALT) =< 2.0 x the IULN

• Patients (Southwestern Oncology Group [SWOG] institutions only) must be registered on SWOG-9007, "Cytogenetic Studies in Leukemia Patients;" collection of the pretreatment bone marrow specimen must be completed within 28 days prior to registration; the pretreatment bone marrow specimen must be submitted to an approved Southwest Oncology Group Cytogenetics Laboratory for cytogenetic analysis as described, and an aliquot of the bone marrow (or peripheral blood if the marrow aspiration is a dry tap) must be submitted for fluorescent in situ hybridization (FISH) analysis; note that protocol SWOG-9007 also requires submission of bone marrow specimens at the time of progression to the accelerated or blastic phase of CML or the loss of complete hematologic response and every six months while the patient is on this study

• Patients (SWOG institutions only) must be registered on S9910, "Leukemia Centralized Reference Laboratories and Tissue Repositories, Ancillary;" specimens of peripheral blood and bone marrow must be submitted to the Southwest Oncology Group Lymphoid Leukemia and CML Centralized Laboratory in Seattle, Washington; collection of pretreatment blood and marrow specimens must be completed within 28 days prior to registration; note that this study also requires submission of peripheral blood and bone marrow specimens at various times after entry into the study

• Patients must not have undergone major surgery within 28 days before registration, and must have fully recovered from any other prior major surgery

• Patients must not be pregnant or nursing; women/men of reproductive potential must have agreed to use an effective contraceptive method

• No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, cervical carcinoma in situ, adequately treated stage I or II cancer from which the patient is currently in complete remission, or any other cancer from which the patient has been disease-free for five years

• Patients must have an electrocardiogram (ECG) within 42 days prior to registration, and must not have any of the following cardiac symptoms prior to entry on study:

  • Uncontrolled angina, congestive heart failure or myocardial infarction (MI) within 6 months of study entry
  • Diagnosed or suspected congenital long QT syndrome
  • Any history of clinically significant ventricular arrhythmias (such as ventricular tachycardia, ventricular fibrillation, or Torsades de pointes)
  • Prolonged corrected QT (QTc) interval on pre-entry electrocardiogram (> 450 msec)
  • Uncontrolled hypertension

• Patients must not have a history of significant bleeding disorder unrelated to cancer, including:

  • Congenital bleeding disorders (e.g., von Willebrand's disease)
  • Acquired bleeding disorder within one year (e.g., acquired anti-factor VIII antibodies)

• All patients must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines

• At the time of patient registration, the treating institution's name and identification (ID) number must be provided to the Data Operations Center in Seattle in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered into the data base

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Arm I (QD imatinib mesylate)	Imatinib Mesylate	Patients receive imatinib mesylate PO QD. Treatment repeats every 4 weeks for up to 5 years in the absence of disease progression or unacceptable toxicity.
Arm I (QD imatinib mesylate)	Laboratory Biomarker Analysis	Patients receive imatinib mesylate PO QD. Treatment repeats every 4 weeks for up to 5 years in the absence of disease progression or unacceptable toxicity.
Arm II (BID imatinib mesylate)	Imatinib Mesylate	Patients receive imatinib mesylate PO BID. Treatment repeats every 4 weeks for up to 12 months in the absence of disease progression or unacceptable toxicity.
Arm II (BID imatinib mesylate)	Laboratory Biomarker Analysis	Patients receive imatinib mesylate PO BID. Treatment repeats every 4 weeks for up to 12 months in the absence of disease progression or unacceptable toxicity.
Arm III (dasatinib)	Dasatinib	Patients receive dasatinib PO BID. Treatment repeats every 4 weeks for up to 5 years in the absence of disease progression or unacceptable toxicity.
Arm III (dasatinib)	Laboratory Biomarker Analysis	Patients receive dasatinib PO BID. Treatment repeats every 4 weeks for up to 5 years in the absence of disease progression or unacceptable toxicity.

Primary Outcome Measures

Name	Time	Method
Molecular Response Rate at 12 Months	pretreatment and after 12 months of treatment	Median value of baseline bcr-abl/bcr ratio from pretreatment was used as the baseline value for assessing each patient's molecular response. Molecular response criteria were: 1) not failed treatment on or before 12-month evaluation; 2) met criteria for hemalotogic response; 3) bcr-abl/bcr ration at 12-months must be 10,000 times smaller than the pretreatment ratio.

Secondary Outcome Measures

Name	Time	Method
Hematologic Response	1 month after starting treatment	Hematologic response assesses whether patients' blood counts return to normal
2-year Overall Survival (OS)	Every three months for the first year, every six months in years 2 and 3, and annually for years 4 and 5	Overall survival was measured from the date of registration to study until death from any cause with observations censored at the date of last contact for patients last known to be alive.
Two Year Relapse-free Survival	every 3 months for the first year, every six months for years 2 and 3, annually for years 4 and 5	Relapse-free survival is measured from the date of documented (possibly unconfirmed) hematologic complete remission until loss of hematologic complete remission or death from any cause. Observations are censored at the date of last contact for patients last known to be alive with report of loss of hematologic complete remission.
Toxicity	Patients were assessed for adverse events monthly every 4 weeks for the first year, every 6 months for years 2 and 3, and annually for years 4 and 5.	Number of patients with Grade 3-5 adverse events that are related to study drug by given type of adverse event

Trial Locations

Locations (341)

Eureka Hospital; 🇺🇸 Eureka, Illinois, United States

Galesburg Cottage Hospital; 🇺🇸 Galesburg, Illinois, United States

Valley Radiation Oncology; 🇺🇸 Peru, Illinois, United States

Providence Saint Joseph Medical Center/Disney Family Cancer Center; 🇺🇸 Burbank, California, United States

City of Hope Comprehensive Cancer Center; 🇺🇸 Duarte, California, United States

Kaiser Permanente-Fremont; 🇺🇸 Fremont, California, United States

USC / Norris Comprehensive Cancer Center; 🇺🇸 Los Angeles, California, United States

Kaiser Permanente-Oakland; 🇺🇸 Oakland, California, United States

Kaiser Permanente-Redwood City; 🇺🇸 Redwood City, California, United States

Kaiser Permanente-Richmond; 🇺🇸 Richmond, California, United States

Kaiser Permanente-Roseville; 🇺🇸 Roseville, California, United States

Kaiser Permanente-South Sacramento; 🇺🇸 Sacramento, California, United States

Kaiser Permanente Sacramento Medical Center; 🇺🇸 Sacramento, California, United States

Kaiser Permanente-San Francisco; 🇺🇸 San Francisco, California, United States

Kaiser Permanente-Santa Teresa-San Jose; 🇺🇸 San Jose, California, United States

Kaiser Permanente San Leandro; 🇺🇸 San Leandro, California, United States

Kaiser Permanente-San Rafael; 🇺🇸 San Rafael, California, United States

Kaiser Permanente Medical Center - Santa Clara; 🇺🇸 Santa Clara, California, United States

Kaiser Permanente-Santa Rosa; 🇺🇸 Santa Rosa, California, United States

Kaiser Permanente-South San Francisco; 🇺🇸 South San Francisco, California, United States

Kaiser Permanente-Stockton; 🇺🇸 Stockton, California, United States

Kaiser Permanente-Vallejo; 🇺🇸 Vallejo, California, United States

Kaiser Permanente-Walnut Creek; 🇺🇸 Walnut Creek, California, United States

Perry Memorial Hospital; 🇺🇸 Princeton, Illinois, United States

Rocky Mountain Regional VA Medical Center; 🇺🇸 Aurora, Colorado, United States

University of Colorado; 🇺🇸 Denver, Colorado, United States

Poudre Valley Hospital; 🇺🇸 Fort Collins, Colorado, United States

Montrose Memorial Hospital; 🇺🇸 Montrose, Colorado, United States

Intermountain Health Lutheran Hospital; 🇺🇸 Wheat Ridge, Colorado, United States

Beebe Medical Center; 🇺🇸 Lewes, Delaware, United States

Christiana Care Health System-Christiana Hospital; 🇺🇸 Newark, Delaware, United States

Saint Francis Hospital - Wilmington; 🇺🇸 Wilmington, Delaware, United States

Baptist MD Anderson Cancer Center; 🇺🇸 Jacksonville, Florida, United States

Mayo Clinic in Florida; 🇺🇸 Jacksonville, Florida, United States

University of Miami Miller School of Medicine-Sylvester Cancer Center; 🇺🇸 Miami, Florida, United States

Orlando Health Cancer Institute; 🇺🇸 Orlando, Florida, United States

Moffitt Cancer Center; 🇺🇸 Tampa, Florida, United States

OSF Saint Anthony's Health Center; 🇺🇸 Alton, Illinois, United States

Rush - Copley Medical Center; 🇺🇸 Aurora, Illinois, United States

OSF Saint Joseph Medical Center; 🇺🇸 Bloomington, Illinois, United States

Graham Hospital Association; 🇺🇸 Canton, Illinois, United States

Memorial Hospital; 🇺🇸 Carthage, Illinois, United States

Hematology and Oncology Associates; 🇺🇸 Chicago, Illinois, United States

Northwestern University; 🇺🇸 Chicago, Illinois, United States

Jesse Brown Veterans Affairs Medical Center; 🇺🇸 Chicago, Illinois, United States

University of Illinois; 🇺🇸 Chicago, Illinois, United States

Mercy Hospital and Medical Center; 🇺🇸 Chicago, Illinois, United States

Swedish Covenant Hospital; 🇺🇸 Chicago, Illinois, United States

University of Chicago Comprehensive Cancer Center; 🇺🇸 Chicago, Illinois, United States

Decatur Memorial Hospital; 🇺🇸 Decatur, Illinois, United States

Heartland Cancer Research NCORP; 🇺🇸 Decatur, Illinois, United States

Illinois CancerCare-Galesburg; 🇺🇸 Galesburg, Illinois, United States

Western Illinois Cancer Treatment Center; 🇺🇸 Galesburg, Illinois, United States

Mason District Hospital; 🇺🇸 Havana, Illinois, United States

Hopedale Medical Complex - Hospital; 🇺🇸 Hopedale, Illinois, United States

Midwest Center for Hematology Oncology; 🇺🇸 Joliet, Illinois, United States

Duly Health and Care Joliet; 🇺🇸 Joliet, Illinois, United States

Kewanee Hospital; 🇺🇸 Kewanee, Illinois, United States

Deerpath Medical Associates; 🇺🇸 Lake Forest, Illinois, United States

AMG Libertyville - Oncology; 🇺🇸 Libertyville, Illinois, United States

Mcdonough District Hospital; 🇺🇸 Macomb, Illinois, United States

Loyola University Medical Center; 🇺🇸 Maywood, Illinois, United States

SSM Health Good Samaritan; 🇺🇸 Mount Vernon, Illinois, United States

DuPage Medical Group-Ogden; 🇺🇸 Naperville, Illinois, United States

Illinois Cancer Specialists-Niles; 🇺🇸 Niles, Illinois, United States

Carle BroMenn Medical Center; 🇺🇸 Normal, Illinois, United States

Carle Cancer Institute Normal; 🇺🇸 Normal, Illinois, United States

Illinois CancerCare-Ottawa Clinic; 🇺🇸 Ottawa, Illinois, United States

Ottawa Regional Hospital and Healthcare Center; 🇺🇸 Ottawa, Illinois, United States

OSF Saint Francis Radiation Oncology at Pekin; 🇺🇸 Pekin, Illinois, United States

Pekin Hospital; 🇺🇸 Pekin, Illinois, United States

Proctor Hospital; 🇺🇸 Peoria, Illinois, United States

Illinois CancerCare-Peoria; 🇺🇸 Peoria, Illinois, United States

Methodist Medical Center of Illinois; 🇺🇸 Peoria, Illinois, United States

OSF Saint Francis Medical Center; 🇺🇸 Peoria, Illinois, United States

Illinois Valley Hospital; 🇺🇸 Peru, Illinois, United States

Swedish American Hospital; 🇺🇸 Rockford, Illinois, United States

Edward H Kaplan MD and Associates; 🇺🇸 Skokie, Illinois, United States

Hematology Oncology Associates of Illinois - Skokie; 🇺🇸 Skokie, Illinois, United States

Midwest Cancer Research Group Incorporated; 🇺🇸 Skokie, Illinois, United States

Saint Margaret's Hospital; 🇺🇸 Spring Valley, Illinois, United States

Springfield Memorial Hospital; 🇺🇸 Springfield, Illinois, United States

Carle Cancer Center; 🇺🇸 Urbana, Illinois, United States

Franciscan Saint Francis Health-Beech Grove; 🇺🇸 Beech Grove, Indiana, United States

Fort Wayne Medical Oncology and Hematology Inc-Parkview; 🇺🇸 Fort Wayne, Indiana, United States

Franciscan Saint Anthony Health-Michigan City; 🇺🇸 Michigan City, Indiana, United States

Reid Health; 🇺🇸 Richmond, Indiana, United States

McFarland Clinic - Ames; 🇺🇸 Ames, Iowa, United States

Memorial Hospital of Arkansas City; 🇺🇸 Arkansas City, Kansas, United States

Cancer Center of Kansas - Chanute; 🇺🇸 Chanute, Kansas, United States

Cancer Center of Kansas - Dodge City; 🇺🇸 Dodge City, Kansas, United States

Cancer Center of Kansas - El Dorado; 🇺🇸 El Dorado, Kansas, United States

Cancer Center of Kansas-Independence; 🇺🇸 Independence, Kansas, United States

Providence Medical Center; 🇺🇸 Kansas City, Kansas, United States

Cancer Center of Kansas-Kingman; 🇺🇸 Kingman, Kansas, United States

Lawrence Memorial Hospital; 🇺🇸 Lawrence, Kansas, United States

Southwest Medical Center; 🇺🇸 Liberal, Kansas, United States

Cancer Center of Kansas - Newton; 🇺🇸 Newton, Kansas, United States

Cancer Center of Kansas - Ottawa; 🇺🇸 Ottawa, Kansas, United States

Menorah Medical Center; 🇺🇸 Overland Park, Kansas, United States

Radiation Oncology Practice Corporation Southwest; 🇺🇸 Overland Park, Kansas, United States

Cancer Center of Kansas - Parsons; 🇺🇸 Parsons, Kansas, United States

Kansas City NCI Community Oncology Research Program; 🇺🇸 Prairie Village, Kansas, United States

Cancer Center of Kansas - Pratt; 🇺🇸 Pratt, Kansas, United States

Cancer Center of Kansas - Salina; 🇺🇸 Salina, Kansas, United States

Salina Regional Health Center; 🇺🇸 Salina, Kansas, United States

AdventHealth Shawnee Mission; 🇺🇸 Shawnee Mission, Kansas, United States

Cotton O'Neil Cancer Center / Stormont Vail Health; 🇺🇸 Topeka, Kansas, United States

University of Kansas Health System Saint Francis Campus; 🇺🇸 Topeka, Kansas, United States

Cancer Center of Kansas - Wellington; 🇺🇸 Wellington, Kansas, United States

Associates In Womens Health; 🇺🇸 Wichita, Kansas, United States

Cancer Center of Kansas-Wichita Medical Arts Tower; 🇺🇸 Wichita, Kansas, United States

Ascension Via Christi Hospitals Wichita; 🇺🇸 Wichita, Kansas, United States

Cancer Center of Kansas - Wichita; 🇺🇸 Wichita, Kansas, United States

Wichita NCI Community Oncology Research Program; 🇺🇸 Wichita, Kansas, United States

Cancer Center of Kansas - Winfield; 🇺🇸 Winfield, Kansas, United States

Baton Rouge General Medical Center; 🇺🇸 Baton Rouge, Louisiana, United States

Mary Bird Perkins Cancer Center; 🇺🇸 Baton Rouge, Louisiana, United States

Louisiana State University Health Science Center; 🇺🇸 New Orleans, Louisiana, United States

University Medical Center New Orleans; 🇺🇸 New Orleans, Louisiana, United States

Eastern Maine Medical Center; 🇺🇸 Bangor, Maine, United States

York Hospital; 🇺🇸 York, Maine, United States

Christiana Care - Union Hospital; 🇺🇸 Elkton, Maryland, United States

Unspecified Site; 🇺🇸 Rockville, Maryland, United States

Massachusetts General Hospital Cancer Center; 🇺🇸 Boston, Massachusetts, United States

Brigham and Women's Hospital; 🇺🇸 Boston, Massachusetts, United States

Dana-Farber Cancer Institute; 🇺🇸 Boston, Massachusetts, United States

Michigan Cancer Research Consortium NCORP; 🇺🇸 Ann Arbor, Michigan, United States

Blanchard Valley Hospital; 🇺🇸 Findlay, Ohio, United States

Trinity Health Saint Joseph Mercy Hospital Ann Arbor; 🇺🇸 Ann Arbor, Michigan, United States

University of Michigan Comprehensive Cancer Center; 🇺🇸 Ann Arbor, Michigan, United States

Bronson Battle Creek; 🇺🇸 Battle Creek, Michigan, United States

Spectrum Health Big Rapids Hospital; 🇺🇸 Big Rapids, Michigan, United States

Corewell Health Dearborn Hospital; 🇺🇸 Dearborn, Michigan, United States

Henry Ford Hospital; 🇺🇸 Detroit, Michigan, United States

Henry Ford Health Saint John Hospital; 🇺🇸 Detroit, Michigan, United States

Hurley Medical Center; 🇺🇸 Flint, Michigan, United States

Genesys Regional Medical Center-West Flint Campus; 🇺🇸 Flint, Michigan, United States

Cancer Research Consortium of West Michigan NCORP; 🇺🇸 Grand Rapids, Michigan, United States

Corewell Health Grand Rapids Hospitals - Butterworth Hospital; 🇺🇸 Grand Rapids, Michigan, United States

Trinity Health Grand Rapids Hospital; 🇺🇸 Grand Rapids, Michigan, United States

Holland Community Hospital; 🇺🇸 Holland, Michigan, United States

Allegiance Health; 🇺🇸 Jackson, Michigan, United States

Bronson Methodist Hospital; 🇺🇸 Kalamazoo, Michigan, United States

West Michigan Cancer Center; 🇺🇸 Kalamazoo, Michigan, United States

Ascension Borgess Hospital; 🇺🇸 Kalamazoo, Michigan, United States

University of Michigan Health - Sparrow Lansing; 🇺🇸 Lansing, Michigan, United States

Trinity Health Saint Mary Mercy Livonia Hospital; 🇺🇸 Livonia, Michigan, United States

Mercy Health Partners-Hackley Campus; 🇺🇸 Muskegon, Michigan, United States

McLaren Cancer Institute-Northern Michigan; 🇺🇸 Petoskey, Michigan, United States

Trinity Health Saint Joseph Mercy Oakland Hospital; 🇺🇸 Pontiac, Michigan, United States

Lake Huron Medical Center; 🇺🇸 Port Huron, Michigan, United States

MyMichigan Medical Center Saginaw; 🇺🇸 Saginaw, Michigan, United States

Henry Ford Health Providence Southfield Hospital; 🇺🇸 Southfield, Michigan, United States

Munson Medical Center; 🇺🇸 Traverse City, Michigan, United States

Henry Ford Health Warren Hospital; 🇺🇸 Warren, Michigan, United States

University of Michigan Health - West; 🇺🇸 Wyoming, Michigan, United States

Fairview Ridges Hospital; 🇺🇸 Burnsville, Minnesota, United States

Mercy Hospital; 🇺🇸 Coon Rapids, Minnesota, United States

Fairview Southdale Hospital; 🇺🇸 Edina, Minnesota, United States

Unity Hospital; 🇺🇸 Fridley, Minnesota, United States

Hutchinson Area Health Care; 🇺🇸 Hutchinson, Minnesota, United States

Meeker County Memorial Hospital; 🇺🇸 Litchfield, Minnesota, United States

Minnesota Oncology Hematology PA-Maplewood; 🇺🇸 Maplewood, Minnesota, United States

Saint John's Hospital - Healtheast; 🇺🇸 Maplewood, Minnesota, United States

Abbott-Northwestern Hospital; 🇺🇸 Minneapolis, Minnesota, United States

Virginia Piper Cancer Institute; 🇺🇸 Minneapolis, Minnesota, United States

Hennepin County Medical Center; 🇺🇸 Minneapolis, Minnesota, United States

North Memorial Medical Health Center; 🇺🇸 Robbinsdale, Minnesota, United States

Mayo Clinic in Rochester; 🇺🇸 Rochester, Minnesota, United States

Metro Minnesota Community Oncology Research Consortium; 🇺🇸 Saint Louis Park, Minnesota, United States

Park Nicollet Clinic - Saint Louis Park; 🇺🇸 Saint Louis Park, Minnesota, United States

Regions Hospital; 🇺🇸 Saint Paul, Minnesota, United States

Saint Joseph's Hospital - Healtheast; 🇺🇸 Saint Paul, Minnesota, United States

United Hospital; 🇺🇸 Saint Paul, Minnesota, United States

Saint Francis Regional Medical Center; 🇺🇸 Shakopee, Minnesota, United States

Ridgeview Medical Center; 🇺🇸 Waconia, Minnesota, United States

Minnesota Oncology Hematology PA-Woodbury; 🇺🇸 Woodbury, Minnesota, United States

Woodwinds Health Campus; 🇺🇸 Woodbury, Minnesota, United States

Singing River Hospital; 🇺🇸 Pascagoula, Mississippi, United States

Southeast Missouri Hospital; 🇺🇸 Cape Girardeau, Missouri, United States

Saint Francis Medical Center; 🇺🇸 Cape Girardeau, Missouri, United States

Missouri Cancer Associates; 🇺🇸 Columbia, Missouri, United States

Centerpoint Medical Center LLC; 🇺🇸 Independence, Missouri, United States

University Health Truman Medical Center; 🇺🇸 Kansas City, Missouri, United States

Saint Luke's Hospital of Kansas City; 🇺🇸 Kansas City, Missouri, United States

Radiation Oncology Practice Corporation South; 🇺🇸 Kansas City, Missouri, United States

Saint Joseph Health Center; 🇺🇸 Kansas City, Missouri, United States

North Kansas City Hospital; 🇺🇸 Kansas City, Missouri, United States

Research Medical Center; 🇺🇸 Kansas City, Missouri, United States

Radiation Oncology Practice Corporation - North; 🇺🇸 Kansas City, Missouri, United States

Liberty Hospital; 🇺🇸 Liberty, Missouri, United States

Heartland Regional Medical Center; 🇺🇸 Saint Joseph, Missouri, United States

SSM Health Saint Louis University Hospital; 🇺🇸 Saint Louis, Missouri, United States

Saint Louis Cancer and Breast Institute-South City; 🇺🇸 Saint Louis, Missouri, United States

Mercy Hospital Saint Louis; 🇺🇸 Saint Louis, Missouri, United States

Saint Louis-Cape Girardeau CCOP; 🇺🇸 Saint Louis, Missouri, United States

Billings Clinic Cancer Center; 🇺🇸 Billings, Montana, United States

Northern Rockies Radiation Oncology Center; 🇺🇸 Billings, Montana, United States

Saint Vincent Healthcare; 🇺🇸 Billings, Montana, United States

Montana Cancer Consortium NCORP; 🇺🇸 Billings, Montana, United States

Saint Vincent Frontier Cancer Center; 🇺🇸 Billings, Montana, United States

Deaconess Medical Center; 🇺🇸 Billings, Montana, United States

Bozeman Health Deaconess Hospital; 🇺🇸 Bozeman, Montana, United States

Internal Medicine of Bozeman; 🇺🇸 Bozeman, Montana, United States

Saint James Community Hospital and Cancer Treatment Center; 🇺🇸 Butte, Montana, United States

Benefis Sletten Cancer Institute; 🇺🇸 Great Falls, Montana, United States

Berdeaux, Donald MD (UIA Investigator); 🇺🇸 Great Falls, Montana, United States

Great Falls Clinic; 🇺🇸 Great Falls, Montana, United States

Saint Peter's Community Hospital; 🇺🇸 Helena, Montana, United States

Glacier Oncology PLLC; 🇺🇸 Kalispell, Montana, United States

Kalispell Medical Oncology; 🇺🇸 Kalispell, Montana, United States

Logan Health Medical Center; 🇺🇸 Kalispell, Montana, United States

Eastern Montana Cancer Center; 🇺🇸 Miles City, Montana, United States

Montana Cancer Specialists; 🇺🇸 Missoula, Montana, United States

Saint Patrick Hospital - Community Hospital; 🇺🇸 Missoula, Montana, United States

Community Medical Center; 🇺🇸 Missoula, Montana, United States

Guardian Oncology and Center for Wellness; 🇺🇸 Missoula, Montana, United States

Cooper Hospital University Medical Center; 🇺🇸 Camden, New Jersey, United States

Riverview Medical Center/Booker Cancer Center; 🇺🇸 Red Bank, New Jersey, United States

University of New Mexico Cancer Center; 🇺🇸 Albuquerque, New Mexico, United States

Montefiore Medical Center-Wakefield Campus; 🇺🇸 Bronx, New York, United States

Mary Imogene Bassett Hospital; 🇺🇸 Cooperstown, New York, United States

Hematology Oncology Associates of Central New York-East Syracuse; 🇺🇸 East Syracuse, New York, United States

Adirondack Cancer Center; 🇺🇸 Glens Falls, New York, United States

Glens Falls Hospital; 🇺🇸 Glens Falls, New York, United States

Interlakes Foundation Inc-Rochester; 🇺🇸 Rochester, New York, United States

University of Rochester; 🇺🇸 Rochester, New York, United States

Stony Brook University Medical Center; 🇺🇸 Stony Brook, New York, United States

State University of New York Upstate Medical University; 🇺🇸 Syracuse, New York, United States

Syracuse Veterans Administration Medical Center; 🇺🇸 Syracuse, New York, United States

Carolinas Medical Center/Levine Cancer Institute; 🇺🇸 Charlotte, North Carolina, United States

Wayne Memorial Hospital; 🇺🇸 Goldsboro, North Carolina, United States

Wayne Radiation Oncology; 🇺🇸 Goldsboro, North Carolina, United States

ECU Health Oncology Kinston; 🇺🇸 Kinston, North Carolina, United States

Lenoir Memorial Hospital; 🇺🇸 Kinston, North Carolina, United States

Rutherford Hospital; 🇺🇸 Rutherfordton, North Carolina, United States

Iredell Memorial Hospital; 🇺🇸 Statesville, North Carolina, United States

Wilson Medical Center; 🇺🇸 Wilson, North Carolina, United States

Southeast Clinical Oncology Research Consortium NCORP; 🇺🇸 Winston-Salem, North Carolina, United States

Wake Forest University Health Sciences; 🇺🇸 Winston-Salem, North Carolina, United States

Mary Rutan Hospital; 🇺🇸 Bellefontaine, Ohio, United States

Aultman Health Foundation; 🇺🇸 Canton, Ohio, United States

Adena Regional Medical Center; 🇺🇸 Chillicothe, Ohio, United States

University of Cincinnati Cancer Center-UC Medical Center; 🇺🇸 Cincinnati, Ohio, United States

Ohio State University Comprehensive Cancer Center; 🇺🇸 Columbus, Ohio, United States

Riverside Methodist Hospital; 🇺🇸 Columbus, Ohio, United States

Columbus NCI Community Oncology Research Program; 🇺🇸 Columbus, Ohio, United States

Grant Medical Center; 🇺🇸 Columbus, Ohio, United States

Mount Carmel Health Center West; 🇺🇸 Columbus, Ohio, United States

Doctors Hospital; 🇺🇸 Columbus, Ohio, United States

Grandview Hospital; 🇺🇸 Dayton, Ohio, United States

Good Samaritan Hospital - Dayton; 🇺🇸 Dayton, Ohio, United States

Miami Valley Hospital; 🇺🇸 Dayton, Ohio, United States

Miami Valley Hospital North; 🇺🇸 Dayton, Ohio, United States

Dayton Veterans Affairs Medical Center; 🇺🇸 Dayton, Ohio, United States

Dayton NCI Community Oncology Research Program; 🇺🇸 Dayton, Ohio, United States

Grady Memorial Hospital; 🇺🇸 Delaware, Ohio, United States

Atrium Medical Center-Middletown Regional Hospital; 🇺🇸 Franklin, Ohio, United States

Kettering Medical Center; 🇺🇸 Kettering, Ohio, United States

Fairfield Medical Center; 🇺🇸 Lancaster, Ohio, United States

Saint Rita's Medical Center; 🇺🇸 Lima, Ohio, United States

OhioHealth Mansfield Hospital; 🇺🇸 Mansfield, Ohio, United States

Marietta Memorial Hospital; 🇺🇸 Marietta, Ohio, United States

Licking Memorial Hospital; 🇺🇸 Newark, Ohio, United States

Springfield Regional Medical Center; 🇺🇸 Springfield, Ohio, United States

Upper Valley Medical Center; 🇺🇸 Troy, Ohio, United States

Saint Ann's Hospital; 🇺🇸 Westerville, Ohio, United States

Wright-Patterson Medical Center; 🇺🇸 Wright-Patterson Air Force Base, Ohio, United States

Greene Memorial Hospital; 🇺🇸 Xenia, Ohio, United States

Tod Children's Hospital - Forum Health; 🇺🇸 Youngstown, Ohio, United States

Genesis Healthcare System Cancer Care Center; 🇺🇸 Zanesville, Ohio, United States

Natalie Warren Bryant Cancer Center at Saint Francis; 🇺🇸 Tulsa, Oklahoma, United States

Kaiser Permanente Northwest; 🇺🇸 Portland, Oregon, United States

Oregon Health and Science University; 🇺🇸 Portland, Oregon, United States

Saint Luke's University Hospital-Bethlehem Campus; 🇺🇸 Bethlehem, Pennsylvania, United States

Geisinger Medical Center; 🇺🇸 Danville, Pennsylvania, United States

Penn State Milton S Hershey Medical Center; 🇺🇸 Hershey, Pennsylvania, United States

Lewistown Hospital; 🇺🇸 Lewistown, Pennsylvania, United States

Jefferson Torresdale Hospital; 🇺🇸 Philadelphia, Pennsylvania, United States

West Penn Hospital; 🇺🇸 Pittsburgh, Pennsylvania, United States

Geisinger Medical Group; 🇺🇸 State College, Pennsylvania, United States

Mount Nittany Medical Center; 🇺🇸 State College, Pennsylvania, United States

Geisinger Wyoming Valley/Henry Cancer Center; 🇺🇸 Wilkes-Barre, Pennsylvania, United States

AnMed Health Hospital; 🇺🇸 Anderson, South Carolina, United States

Medical University of South Carolina; 🇺🇸 Charleston, South Carolina, United States

McLeod Regional Medical Center; 🇺🇸 Florence, South Carolina, United States

Spartanburg Medical Center; 🇺🇸 Spartanburg, South Carolina, United States

Sanford Cancer Center Oncology Clinic; 🇺🇸 Sioux Falls, South Dakota, United States

Avera Cancer Institute; 🇺🇸 Sioux Falls, South Dakota, United States

Medical X-Ray Center; 🇺🇸 Sioux Falls, South Dakota, United States

Avera McKennan Hospital and University Health Center; 🇺🇸 Sioux Falls, South Dakota, United States

Sanford USD Medical Center - Sioux Falls; 🇺🇸 Sioux Falls, South Dakota, United States

Brooke Army Medical Center; 🇺🇸 Fort Sam Houston, Texas, United States

Wilford Hall Medical Center; 🇺🇸 Lackland Air Force Base, Texas, United States

Audie L Murphy VA Hospital; 🇺🇸 San Antonio, Texas, United States

Cancer Therapy and Research Center at The UT Health Science Center at San Antonio; 🇺🇸 San Antonio, Texas, United States

University Hospital; 🇺🇸 San Antonio, Texas, United States

University of Texas Health Science Center at San Antonio; 🇺🇸 San Antonio, Texas, United States

Huntsman Cancer Institute/University of Utah; 🇺🇸 Salt Lake City, Utah, United States

PeaceHealth Saint Joseph Medical Center; 🇺🇸 Bellingham, Washington, United States

Kadlec Clinic Hematology and Oncology; 🇺🇸 Kennewick, Washington, United States

Skagit Valley Hospital; 🇺🇸 Mount Vernon, Washington, United States

Harborview Medical Center; 🇺🇸 Seattle, Washington, United States

Minor and James Medical PLLC; 🇺🇸 Seattle, Washington, United States

Fred Hutchinson Cancer Center; 🇺🇸 Seattle, Washington, United States

Kaiser Permanente Washington; 🇺🇸 Seattle, Washington, United States

Swedish Medical Center-First Hill; 🇺🇸 Seattle, Washington, United States

University of Washington Medical Center - Montlake; 🇺🇸 Seattle, Washington, United States

PeaceHealth United General Medical Center; 🇺🇸 Sedro-Woolley, Washington, United States

Saint Michael Cancer Center; 🇺🇸 Silverdale, Washington, United States

Cancer Care Northwest - Spokane South; 🇺🇸 Spokane, Washington, United States

PeaceHealth Southwest Medical Center; 🇺🇸 Vancouver, Washington, United States

Central Washington Hospital; 🇺🇸 Wenatchee, Washington, United States

Wenatchee Valley Hospital and Clinics; 🇺🇸 Wenatchee, Washington, United States

West Virginia University Healthcare; 🇺🇸 Morgantown, West Virginia, United States

HSHS Sacred Heart Hospital; 🇺🇸 Eau Claire, Wisconsin, United States

Marshfield Clinic Cancer Center at Sacred Heart; 🇺🇸 Eau Claire, Wisconsin, United States

Gundersen Lutheran Medical Center; 🇺🇸 La Crosse, Wisconsin, United States

Marshfield Medical Center-Marshfield; 🇺🇸 Marshfield, Wisconsin, United States

Marshfield Medical Center; 🇺🇸 Marshfield, Wisconsin, United States

Medical College of Wisconsin; 🇺🇸 Milwaukee, Wisconsin, United States

Marshfield Medical Center - Minocqua; 🇺🇸 Minocqua, Wisconsin, United States

Aspirus Cancer Care - James Beck Cancer Center; 🇺🇸 Rhinelander, Wisconsin, United States

Marshfield Medical Center-Rice Lake; 🇺🇸 Rice Lake, Wisconsin, United States

Aspirus Cancer Care - Stevens Point; 🇺🇸 Stevens Point, Wisconsin, United States

Marshfield Clinic-Wausau Center; 🇺🇸 Wausau, Wisconsin, United States

Marshfield Medical Center - Weston; 🇺🇸 Weston, Wisconsin, United States

Marshfield Clinic - Wisconsin Rapids Center; 🇺🇸 Wisconsin Rapids, Wisconsin, United States

Welch Cancer Center; 🇺🇸 Sheridan, Wyoming, United States

Cross Cancer Institute; 🇨🇦 Edmonton, Alberta, Canada

CancerCare Manitoba; 🇨🇦 Winnipeg, Manitoba, Canada

The Moncton Hospital; 🇨🇦 Moncton, New Brunswick, Canada

Doctor H. Bliss Murphy Cancer Centre; 🇨🇦 St. John's, Newfoundland and Labrador, Canada

QEII Health Sciences Centre/Nova Scotia Health Authority; 🇨🇦 Halifax, Nova Scotia, Canada

Juravinski Cancer Centre at Hamilton Health Sciences; 🇨🇦 Hamilton, Ontario, Canada

London Regional Cancer Program; 🇨🇦 London, Ontario, Canada

University Health Network-Princess Margaret Hospital; 🇨🇦 Toronto, Ontario, Canada

Verdun Hospital Centre; 🇨🇦 Montreal, Quebec, Canada

Allan Blair Cancer Centre; 🇨🇦 Regina, Saskatchewan, Canada

Saskatoon Cancer Centre; 🇨🇦 Saskatoon, Saskatchewan, Canada