Rituximab With or Without Stem Cell Transplant in Treating Patients With Minimal Residual Disease-Negative Mantle Cell Lymphoma in First Complete Remission

Phase 3

Active, not recruiting

• Conditions: Mantle Cell Lymphoma
• Interventions: Procedure: Autologous Hematopoietic Stem Cell Transplantation; Procedure: Biospecimen Collection; Procedure: Bone Marrow Aspirate; Procedure: Bone Marrow Biopsy; Procedure: Computed Tomography; Procedure: Positron Emission Tomography; Biological: Rituximab; Biological: Rituximab and Hyaluronidase Human

• Registration Number: NCT03267433
• Lead Sponsor: ECOG-ACRIN Cancer Research Group

Brief Summary

This phase III trial studies rituximab after stem cell transplant and to see how well it works compared with rituximab alone in treating patients with in minimal residual disease-negative mantle cell lymphoma in first complete remission. Immunotherapy with rituximab, may induce changes in body's immune system and may interfere with the ability of tumor cells to grow and spread. Giving chemotherapy before a stem cell transplant helps kill any cancer cells that are in the body and helps make room in the patient's bone marrow for new blood-forming cells (stem cells) to grow. After treatment, stem cells are collected from the patient's blood and stored. More chemotherapy is then given to prepare the bone marrow for the stem cell transplant. The stem cells are then returned to the patient to replace the blood-forming cells that were destroyed by the chemotherapy. Giving rituximab with or without stem cell transplant may work better in treating patients with mantle cell lymphoma.

Detailed Description

PRIMARY OBJECTIVE:

I. To compare overall survival in mantle cell lymphoma (MCL) patients in minimal residual disease (MRD)-negative first complete remission (CR) who undergo autologous hematopoietic stem cell transplantation (auto-HCT) followed by maintenance rituximab versus (vs.) maintenance rituximab alone (without auto-HCT).

SECONDARY OBJECTIVES:

I. To compare progression-free survival in MCL patients in MRD-negative CR who undergo auto-HCT followed by maintenance rituximab vs. maintenance rituximab alone.

II. To define the overall survival and progression-free survival at 2 and 5 years of chemosensitive but MRD-positive CR patients who undergo auto-HCT followed by 3 years of maintenance rituximab.

III. To define the overall survival and progression-free survival at 2 and 5 years of chemosensitive but MRD-positive partial response (PR) patients who undergo auto-HCT followed by 3 years of maintenance rituximab.

IV. To define the overall survival and progression-free survival at 2 and 5 years of MRD-negative PR patients who undergo auto-HCT followed by 3 years of maintenance rituximab.

V. To define the overall survival and progression-free survival at 2 and 5 years of MRD-indeterminate patients who undergo auto-HCT followed by 3 years of maintenance rituximab.

VI. To describe the rate of complications (serious infection, hospitalization, need for intravenous immune globulin) in MCL patients undergoing maintenance rituximab following auto-HCT.

VII. To determine the prognostic impact of MRD status at day 100, in MCL patients who were MRD-positive (including MRD-positive CR and MRD-positive PR) prior to auto-HCT.

EXPLORATORY TOBACCO USE OBJECTIVES:

I. To determine the effects of tobacco, operationalized as combustible tobacco (1a), other forms of tobacco (1b), and environmental tobacco exposure (ETS) (1c) on provider-reported cancer-treatment toxicity (adverse events (both clinical and hematologic) and dose modifications).

II. To determine the effects of tobacco on patient-reported physical symptoms and psychological symptoms.

III. To examine quitting behaviors and behavioral counseling/support and cessation medication utilization.

IV. To explore the effect of tobacco use and exposure on treatment duration, relative dose intensity, and therapeutic benefit.

OUTLINE: Patients are randomized to 1 of 2 groups.

GROUP I: Patients receive standard of care preparative chemotherapy and undergo auto-HCT. Beginning 100-140 days after transplant, patients receive rituximab intravenously (IV) or rituximab and hyaluronidase human subcutaneously (SC) or any approved rituximab biosimilar at the approved dose once every 8 weeks for up to 18 cycles in the absence of disease progression or unacceptable toxicity.

GROUP II: Patients receive standard of care induction chemotherapy. Beginning 40-180 days after completion of chemotherapy, patients receive rituximab or rituximab and hyaluronidase human or any approved rituximab biosimilar at the approved dose, as in Group I.

Patients undergo positron emission tomography (PET), computed tomography (CT) or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.

After completion of study treatment, patients are followed up every 3 and 6 months for 10 years.

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study First Submitted: 2017-08-28
• Study First Submitted QC: 2017-08-29
• Study First Posted: 2017-08-30
• Study Start: 2017-11-27
• Status Verified: 2024-10
• Last Update Submitted: 2024-10-23
• Last Update Posted: 2024-10-26
• Primary Completion: 2027-01-31
• Study Completion: 2027-01-31

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 689

Inclusion Criteria

• INCLUSION CRITERIA FOR SCREENING (STEP 0 - PREREGISTRATION)

• Age >= 18 and =< 70 years

• Patients must have histologically confirmed mantle cell lymphoma, with cyclin D1 by immunohistochemical stains and/or t(11;14) by cytogenetics or fluorescence in situ hybridization (FISH). If patient has cyclin D1 negative mantle cell lymphoma with classical morphology and an expression profile (including SOX11+) that is otherwise indistinguishable from mantle cell lymphoma, communication with investigator is required for consideration of enrollment. The proliferation rate, using Ki-67 or MIB-1, should also be determined, but is not required until step 1 registration; patients may register to step 0 without a documented Ki-67 index

• In the opinion of the enrolling physician, patients must be felt to be a candidate for autologous stem cell transplantation

• Patient may be about to begin, be receiving or have completed induction therapy within 120 days prior to preregistration to step 0; no more than 300 days may have passed between the first day of induction therapy and preregistration to step 0

  • For patients who have completed induction therapy and have been restaged, restaging evaluation must show status of partial (PR) or complete response (CR); post-induction patients with evidence of clinical disease progression are not eligible for preregistration

  • Up to two regimens of therapy (conventional chemotherapy, antibody therapy, or an oral regimen) are allowed as long as a continuous response was ongoing throughout therapy; overall, a partial response needs to have been achieved (using studies at the time of diagnosis as the baseline)

    • NOTE: For example, a patient who started treatment with rituximab/bendamustine and was then switched to rituximab(R)-cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone (CHOP) (due to insufficient response or excessive toxicity) would be counted as having received 2 regimens; however, R-CHOP alternating with R-dexamethasone, high-dose cytarabine, and cisplatin (DHAP) as a planned induction regimen would count as one regimen

• Patient does not have any documented history of central nervous system (CNS) involvement by mantle cell lymphoma; this includes no evidence of parenchymal brain, spinal cord, or cerebrospinal fluid involvement; radiculopathy symptoms from nerve root compression by lymphoma do not constitute CNS involvement

• Patient must have archived formalin-fixed paraffin-embedded (FFPE) tumor tissue specimen from the original diagnostic biopsy available for submission to Adaptive Biotechnologies for ClonoSEQ ID molecular marker identification of unique clonal immunoglobulin deoxyribonucleic acid (DNA) sequence

  • NOTE: If adequate tumor tissue is not available, peripheral blood collected prior to start of treatment with high disease burden (> 5%) is acceptable for molecular marker identification (ID) testing

    • Adaptive Biotechnologies will forward results within fourteen (14) days of receipt of any stored (e.g. frozen or FFPE) tumor tissue specimen to the submitting institution and to the ECOG-American College of Radiology Imaging Network (ACRIN) Operations Office

  • NOTE: Patients for whom the molecular marker is identified will have peripheral blood collected after completion of induction (patient's disease status is PR or CR) and submitted to Adaptive Biotechnologies for minimal residual disease (MRD) assessment

    • Adaptive Biotechnologies will forward results within ten to fourteen (10-14) days of receipt of fresh peripheral blood specimen to the submitting institution and to the ECOG-ACRIN Operations Office

• INCLUSION CRITERIA FOR TREATMENT ASSIGNMENT (STEP 1): Patients must have met eligibility criteria for the screening step 0

• INCLUSION CRITERIA FOR TREATMENT ASSIGNMENT (STEP 1): The proliferation rate, using Ki-67 or MIB-1 immunohistochemistry (=< 30% versus > 30% versus "indeterminate" Ki-67 index), must be documented for a baseline tumor biopsy specimen

• INCLUSION CRITERIA FOR TREATMENT ASSIGNMENT (STEP 1): Institution has received results from Adaptive Biotechnologies as defined by one of the following criteria:

  • Patients are "MRD Indeterminate": ClonoSEQ ID molecular marker assessment did not identify any unique clonal immunoglobulin DNA sequence OR
  • ClonoSEQ ID molecular marker assessment identified unique clonal immunoglobulin DNA sequence and MRD assessment is completed

• INCLUSION CRITERIA FOR TREATMENT ASSIGNMENT (STEP 1): Patients must have completed induction therapy within 150 days prior to registration to step 1, AND no more than 300 days may have elapsed from the first dose of induction chemotherapy (cycle 1 [C1] day 1 [D1]) given, until the last day of induction chemotherapy administered; for those assigned to Arms A, C, or D, the date of transplant ("day 0") must not be greater than 365 days after the first dose of induction chemotherapy (C1D1) given

  • Patient must have received at least four (4) cycles of induction therapy

  • Up to two regimens of therapy (conventional chemotherapy, antibody therapy, or an oral regimen) are allowed as long as a continuous response was ongoing throughout therapy

    • NOTE: For example, a patient who started treatment with rituximab/bendamustine and was then switched to R-CHOP (due to insufficient response or excessive toxicity) would be counted as having received 2 regimens; however, R-CHOP alternating with R-DHAP as a planned induction regimen would count as one regimen

• INCLUSION CRITERIA FOR TREATMENT ASSIGNMENT (STEP 1): Patients must have achieved a radiologic complete or partial remission as defined by the Lugano criteria

• INCLUSION CRITERIA FOR TREATMENT ASSIGNMENT (STEP 1): In the opinion of the enrolling physician, patients must be felt to be a candidate for autologous stem cell transplantation

• INCLUSION CRITERIA FOR TREATMENT ASSIGNMENT (STEP 1): Patients have an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2

• INCLUSION CRITERIA FOR TREATMENT ASSIGNMENT (STEP 1): Human immunodeficiency virus (HIV) positive patients are not excluded, but to enroll, must meet all of the below criteria:

  • HIV is sensitive to antiretroviral therapy
  • Must be willing to take effective antiretroviral therapy that has minimal overlapping toxicity and pharmacokinetic interactions with protocol therapy
  • No history of HIV-related opportunistic disease or acquired immune deficiency syndrome (AIDS)-defining conditions within past 12 months other than historic CD4+ T-cell counts below 200 cells/mm^3
  • Expected long-term survival if lymphoma were not present

• INCLUSION CRITERIA FOR TREATMENT ASSIGNMENT (STEP 1): Patient must be disease-free >= 3 years of prior malignancies with the exception of adequately treated non-melanoma skin cancer, adequately treated in situ carcinoma, melanoma in situ post wide local excision or Mohs surgery, low grade prostate carcinoma (Gleason grade =< 6) managed with observation that has been stable for at least 6 months

• INCLUSION CRITERIA FOR TREATMENT ASSIGNMENT (STEP 1): Patient must not be pregnant or breast-feeding due to the potential for congenital abnormalities and of harm to nursing infants due to the treatment regimens used

  • All patients of childbearing potential must have a blood test or urine study within 2 weeks prior to registration to rule out pregnancy
  • A patient of childbearing potential is anyone, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)

• INCLUSION CRITERIA FOR TREATMENT ASSIGNMENT (STEP 1): Patient of childbearing potential and sexually active males must be strongly advised to use an accepted and effective method of contraception or to abstain from sexual intercourse for the duration of their participation in the study and for 12 months post rituximab treatment

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Exclusion Criteria

Not provided

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Group I (auto-HCT, rituximab)	Rituximab and Hyaluronidase Human	Patients receive standard of care preparative chemotherapy and undergo auto-HCT. Beginning 100-140 days after transplant, patients receive rituximab IV or rituximab and hyaluronidase human SC or any approved rituximab biosimilar at the approved dose once every 8 weeks for up to 18 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo PET, CT or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.
Group II (rituximab)	Rituximab and Hyaluronidase Human	Patients receive standard of care induction chemotherapy. Beginning 40-180 days after completion of chemotherapy, patients receive rituximab or rituximab and hyaluronidase human or any approved rituximab biosimilar at the approved dose, as in Group I. Patients undergo PET, CT or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.
Group I (auto-HCT, rituximab)	Autologous Hematopoietic Stem Cell Transplantation	Patients receive standard of care preparative chemotherapy and undergo auto-HCT. Beginning 100-140 days after transplant, patients receive rituximab IV or rituximab and hyaluronidase human SC or any approved rituximab biosimilar at the approved dose once every 8 weeks for up to 18 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo PET, CT or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.
Group I (auto-HCT, rituximab)	Biospecimen Collection	Patients receive standard of care preparative chemotherapy and undergo auto-HCT. Beginning 100-140 days after transplant, patients receive rituximab IV or rituximab and hyaluronidase human SC or any approved rituximab biosimilar at the approved dose once every 8 weeks for up to 18 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo PET, CT or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.
Group I (auto-HCT, rituximab)	Bone Marrow Aspirate	Patients receive standard of care preparative chemotherapy and undergo auto-HCT. Beginning 100-140 days after transplant, patients receive rituximab IV or rituximab and hyaluronidase human SC or any approved rituximab biosimilar at the approved dose once every 8 weeks for up to 18 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo PET, CT or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.
Group I (auto-HCT, rituximab)	Bone Marrow Biopsy	Patients receive standard of care preparative chemotherapy and undergo auto-HCT. Beginning 100-140 days after transplant, patients receive rituximab IV or rituximab and hyaluronidase human SC or any approved rituximab biosimilar at the approved dose once every 8 weeks for up to 18 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo PET, CT or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.
Group I (auto-HCT, rituximab)	Computed Tomography	Patients receive standard of care preparative chemotherapy and undergo auto-HCT. Beginning 100-140 days after transplant, patients receive rituximab IV or rituximab and hyaluronidase human SC or any approved rituximab biosimilar at the approved dose once every 8 weeks for up to 18 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo PET, CT or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.
Group I (auto-HCT, rituximab)	Positron Emission Tomography	Patients receive standard of care preparative chemotherapy and undergo auto-HCT. Beginning 100-140 days after transplant, patients receive rituximab IV or rituximab and hyaluronidase human SC or any approved rituximab biosimilar at the approved dose once every 8 weeks for up to 18 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo PET, CT or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.
Group I (auto-HCT, rituximab)	Rituximab	Patients receive standard of care preparative chemotherapy and undergo auto-HCT. Beginning 100-140 days after transplant, patients receive rituximab IV or rituximab and hyaluronidase human SC or any approved rituximab biosimilar at the approved dose once every 8 weeks for up to 18 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo PET, CT or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.
Group II (rituximab)	Biospecimen Collection	Patients receive standard of care induction chemotherapy. Beginning 40-180 days after completion of chemotherapy, patients receive rituximab or rituximab and hyaluronidase human or any approved rituximab biosimilar at the approved dose, as in Group I. Patients undergo PET, CT or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.
Group II (rituximab)	Bone Marrow Aspirate	Patients receive standard of care induction chemotherapy. Beginning 40-180 days after completion of chemotherapy, patients receive rituximab or rituximab and hyaluronidase human or any approved rituximab biosimilar at the approved dose, as in Group I. Patients undergo PET, CT or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.
Group II (rituximab)	Bone Marrow Biopsy	Patients receive standard of care induction chemotherapy. Beginning 40-180 days after completion of chemotherapy, patients receive rituximab or rituximab and hyaluronidase human or any approved rituximab biosimilar at the approved dose, as in Group I. Patients undergo PET, CT or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.
Group II (rituximab)	Computed Tomography	Patients receive standard of care induction chemotherapy. Beginning 40-180 days after completion of chemotherapy, patients receive rituximab or rituximab and hyaluronidase human or any approved rituximab biosimilar at the approved dose, as in Group I. Patients undergo PET, CT or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.
Group II (rituximab)	Positron Emission Tomography	Patients receive standard of care induction chemotherapy. Beginning 40-180 days after completion of chemotherapy, patients receive rituximab or rituximab and hyaluronidase human or any approved rituximab biosimilar at the approved dose, as in Group I. Patients undergo PET, CT or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.
Group II (rituximab)	Rituximab	Patients receive standard of care induction chemotherapy. Beginning 40-180 days after completion of chemotherapy, patients receive rituximab or rituximab and hyaluronidase human or any approved rituximab biosimilar at the approved dose, as in Group I. Patients undergo PET, CT or PET/CT throughout the study. Patients may undergo blood sample collection during screening and on study. Patients also may undergo bone marrow biopsy and aspirate during screening.

Primary Outcome Measures

Name	Time	Method
Overall survival (OS) in mantle cell lymphoma (MCL) patients in minimal residual disease (MRD)-negative complete remission (CR) who undergo auto-hematopoietic stem cell transplant (HCT) followed by rituximab versus (vs.) maintenance rituximab alone	Time between randomization and death from any cause, assessed up to 10 years	The Kaplan-Meier method will be used to estimate OS, including medians and confidence intervals. Comparison of OS between treatment arms will be conducted using a one-sided log-rank test stratified with mantle cell lymphoma International Prognostic Index (MIPI)-c score and induction regimen.

Secondary Outcome Measures

Name	Time	Method
Progression-free survival (PFS) in MCL patients in MRD-negative CR who undergo auto-HCT followed by rituximab vs rituximab alone	From randomization to the earliest of documented disease progression or death without progression, assessed up to 10 years	The method of Kaplan and Meier will be used to estimate PFS, and stratified log-rank test will be used to compare PFS between two arms.
MRD status in MCL patients who were MRD-positive prior to auto-HCT	At 100 days after HCT	Conversion rate will be reported together with confidence intervals.
PFS in MRD-negative PR patients, MRD-positive CR patients, MRD-positive PR patients, and MRD-indeterminate patients who undergo auto-HCT followed by rituximab	From randomization to the earliest of documented disease progression or death without progression, assessed up to 10 years	Will be estimated by the method of Kaplan and Meier.
OS in MRD-negative PR patients, MRD-positive CR patients, MRD-positive PR patients, and MRD-indeterminate patients who undergo auto-HCT followed by rituximab	Time between randomization and death from any cause, assessed up to 10 years	Will be estimated by the method of Kaplan and Meier.
Rate of complications in MCL patients undergoing maintenance rituximab	Up to 10 years
Incidence of adverse events	Up to 10 years	Will be evaluated according to National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. The primary safety analysis will be based on the toxicity population, and the analysis will be performed by treatment received.

Trial Locations

Locations (375)

Good Samaritan Hospital - Cancer Centers of Colorado; 🇺🇸 Lafayette, Colorado, United States

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

UofL Health Medical Center Northeast; 🇺🇸 Louisville, Kentucky, United States

Mercy Health - Paducah Cancer Center; 🇺🇸 Paducah, Kentucky, United States

University of Alabama at Birmingham Cancer Center; 🇺🇸 Birmingham, Alabama, United States

Anchorage Associates in Radiation Medicine; 🇺🇸 Anchorage, Alaska, United States

Anchorage Radiation Therapy Center; 🇺🇸 Anchorage, Alaska, United States

Alaska Breast Care and Surgery LLC; 🇺🇸 Anchorage, Alaska, United States

Alaska Oncology and Hematology LLC; 🇺🇸 Anchorage, Alaska, United States

Alaska Women's Cancer Care; 🇺🇸 Anchorage, Alaska, United States

Anchorage Oncology Centre; 🇺🇸 Anchorage, Alaska, United States

Katmai Oncology Group; 🇺🇸 Anchorage, Alaska, United States

Providence Alaska Medical Center; 🇺🇸 Anchorage, Alaska, United States

Fairbanks Memorial Hospital; 🇺🇸 Fairbanks, Alaska, United States

Kingman Regional Medical Center; 🇺🇸 Kingman, Arizona, United States

Idaho Urologic Institute-Meridian; 🇺🇸 Meridian, Idaho, United States

Saint Luke's Cancer Institute - Meridian; 🇺🇸 Meridian, Idaho, United States

Saint Luke's Cancer Institute - Nampa; 🇺🇸 Nampa, Idaho, United States

Saint Alphonsus Cancer Care Center-Nampa; 🇺🇸 Nampa, Idaho, United States

Kootenai Clinic Cancer Services - Post Falls; 🇺🇸 Post Falls, Idaho, United States

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

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

Nebraska Medicine-Bellevue; 🇺🇸 Bellevue, Nebraska, United States

Nebraska Medicine-Village Pointe; 🇺🇸 Omaha, Nebraska, United States

University of Nebraska Medical Center; 🇺🇸 Omaha, Nebraska, United States

Carson Tahoe Regional Medical Center; 🇺🇸 Carson City, Nevada, United States

Cancer and Blood Specialists-Henderson; 🇺🇸 Henderson, Nevada, United States

Comprehensive Cancer Centers of Nevada - Henderson; 🇺🇸 Henderson, Nevada, United States

Cleveland Clinic Foundation; 🇺🇸 Cleveland, Ohio, United States

Saint George Regional Medical Center; 🇺🇸 Saint George, Utah, United States

Utah Cancer Specialists-Salt Lake City; 🇺🇸 Salt Lake City, Utah, United States

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

LDS Hospital; 🇺🇸 Salt Lake City, Utah, United States

South Jordan Health Center; 🇺🇸 South Jordan, Utah, United States

Central Vermont Medical Center/National Life Cancer Treatment; 🇺🇸 Berlin, Vermont, United States

University of Vermont Medical Center; 🇺🇸 Burlington, Vermont, United States

University of Vermont and State Agricultural College; 🇺🇸 Burlington, Vermont, United States

MultiCare Deaconess Cancer and Blood Specialty Center - Downtown; 🇺🇸 Spokane, Washington, United States

MultiCare Deaconess Cancer and Blood Specialty Center - North; 🇺🇸 Spokane, Washington, United States

Riverton Hospital; 🇺🇸 Riverton, Utah, United States

University of Arizona Cancer Center-Orange Grove Campus; 🇺🇸 Tucson, Arizona, United States

Banner University Medical Center - Tucson; 🇺🇸 Tucson, Arizona, United States

University of Arizona Cancer Center-North Campus; 🇺🇸 Tucson, Arizona, United States

PCR Oncology; 🇺🇸 Arroyo Grande, California, 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

UC San Diego Moores Cancer Center; 🇺🇸 La Jolla, California, United States

Contra Costa Regional Medical Center; 🇺🇸 Martinez, California, United States

UC Irvine Health/Chao Family Comprehensive Cancer Center; 🇺🇸 Orange, California, United States

UC San Diego Medical Center - Hillcrest; 🇺🇸 San Diego, California, United States

UCSF Medical Center-Parnassus; 🇺🇸 San Francisco, California, United States

BASS Medical Group - Lennon; 🇺🇸 Walnut Creek, California, United States

Rocky Mountain Cancer Centers-Aurora; 🇺🇸 Aurora, Colorado, United States

The Medical Center of Aurora; 🇺🇸 Aurora, Colorado, United States

Boulder Community Hospital; 🇺🇸 Boulder, Colorado, United States

Boulder Community Foothills Hospital; 🇺🇸 Boulder, Colorado, United States

Rocky Mountain Cancer Centers-Boulder; 🇺🇸 Boulder, Colorado, United States

Rocky Mountain Cancer Centers - Centennial; 🇺🇸 Centennial, Colorado, United States

Cancer Center of Colorado at Sloan's Lake; 🇺🇸 Denver, Colorado, United States

Denver Health Medical Center; 🇺🇸 Denver, Colorado, United States

National Jewish Health-Main Campus; 🇺🇸 Denver, Colorado, United States

The Women's Imaging Center; 🇺🇸 Denver, Colorado, United States

Colorado Blood Cancer Institute; 🇺🇸 Denver, Colorado, United States

Presbyterian - Saint Lukes Medical Center - Health One; 🇺🇸 Denver, Colorado, United States

Rocky Mountain Cancer Centers-Midtown; 🇺🇸 Denver, Colorado, United States

SCL Health Saint Joseph Hospital; 🇺🇸 Denver, Colorado, United States

Rocky Mountain Cancer Centers-Rose; 🇺🇸 Denver, Colorado, United States

Rose Medical Center; 🇺🇸 Denver, Colorado, United States

Mountain Blue Cancer Care Center - Swedish; 🇺🇸 Englewood, Colorado, United States

Rocky Mountain Cancer Centers - Swedish; 🇺🇸 Englewood, Colorado, United States

The Melanoma and Skin Cancer Institute; 🇺🇸 Englewood, Colorado, United States

Swedish Medical Center; 🇺🇸 Englewood, Colorado, United States

National Jewish Health-Western Hematology Oncology; 🇺🇸 Golden, Colorado, United States

Saint Mary's Hospital and Regional Medical Center; 🇺🇸 Grand Junction, Colorado, United States

Grand Valley Oncology; 🇺🇸 Grand Junction, Colorado, United States

Banner North Colorado Medical Center; 🇺🇸 Greeley, Colorado, United States

Rocky Mountain Cancer Centers-Greenwood Village; 🇺🇸 Greenwood Village, Colorado, United States

Rocky Mountain Cancer Centers-Lakewood; 🇺🇸 Lakewood, Colorado, United States

Rocky Mountain Cancer Centers-Littleton; 🇺🇸 Littleton, Colorado, United States

Rocky Mountain Cancer Centers-Sky Ridge; 🇺🇸 Lone Tree, Colorado, United States

Sky Ridge Medical Center; 🇺🇸 Lone Tree, Colorado, United States

Rocky Mountain Cancer Centers-Longmont; 🇺🇸 Longmont, Colorado, United States

Banner McKee Medical Center; 🇺🇸 Loveland, Colorado, United States

National Jewish Health-Northern Hematology Oncology; 🇺🇸 Thornton, Colorado, United States

Rocky Mountain Cancer Centers-Thornton; 🇺🇸 Thornton, Colorado, United States

Smilow Cancer Hospital Care Center at Saint Francis; 🇺🇸 Hartford, Connecticut, United States

Smilow Cancer Center/Yale-New Haven Hospital; 🇺🇸 New Haven, Connecticut, United States

Yale University; 🇺🇸 New Haven, Connecticut, United States

Smilow Cancer Hospital-Torrington Care Center; 🇺🇸 Torrington, Connecticut, United States

University of Florida Health Science Center - Gainesville; 🇺🇸 Gainesville, Florida, United States

Memorial Regional Hospital/Joe DiMaggio Children's Hospital; 🇺🇸 Hollywood, Florida, 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

Memorial Hospital West; 🇺🇸 Pembroke Pines, Florida, United States

Moffitt Cancer Center-International Plaza; 🇺🇸 Tampa, Florida, United States

Moffitt Cancer Center - McKinley Campus; 🇺🇸 Tampa, Florida, United States

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

Emory University Hospital Midtown; 🇺🇸 Atlanta, Georgia, United States

Emory University Hospital/Winship Cancer Institute; 🇺🇸 Atlanta, Georgia, United States

Emory Saint Joseph's Hospital; 🇺🇸 Atlanta, Georgia, United States

Augusta University Medical Center; 🇺🇸 Augusta, Georgia, United States

Saint Alphonsus Cancer Care Center-Boise; 🇺🇸 Boise, Idaho, United States

Saint Luke's Cancer Institute - Boise; 🇺🇸 Boise, Idaho, United States

Saint Alphonsus Cancer Care Center-Caldwell; 🇺🇸 Caldwell, Idaho, United States

Kootenai Health - Coeur d'Alene; 🇺🇸 Coeur d'Alene, Idaho, United States

Walter Knox Memorial Hospital; 🇺🇸 Emmett, Idaho, United States

Saint Luke's Cancer Institute - Fruitland; 🇺🇸 Fruitland, Idaho, United States

Kootenai Clinic Cancer Services - Sandpoint; 🇺🇸 Sandpoint, Idaho, United States

Saint Luke's Cancer Institute - Twin Falls; 🇺🇸 Twin Falls, Idaho, United States

Loyola Center for Health at Burr Ridge; 🇺🇸 Burr Ridge, Illinois, United States

Northwestern University; 🇺🇸 Chicago, Illinois, United States

Rush University Medical Center; 🇺🇸 Chicago, Illinois, United States

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

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

Northwestern Medicine Cancer Center Kishwaukee; 🇺🇸 DeKalb, Illinois, United States

Northwestern Medicine Cancer Center Delnor; 🇺🇸 Geneva, Illinois, United States

Loyola Medicine Homer Glen; 🇺🇸 Homer Glen, Illinois, United States

Northwestern Medicine Lake Forest Hospital; 🇺🇸 Lake Forest, Illinois, United States

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

Marjorie Weinberg Cancer Center at Loyola-Gottlieb; 🇺🇸 Melrose Park, Illinois, United States

UC Comprehensive Cancer Center at Silver Cross; 🇺🇸 New Lenox, Illinois, United States

University of Chicago Medicine-Orland Park; 🇺🇸 Orland Park, Illinois, United States

Memorial Hospital East; 🇺🇸 Shiloh, Illinois, United States

Northwestern Medicine Cancer Center Warrenville; 🇺🇸 Warrenville, Illinois, United States

Indiana University/Melvin and Bren Simon Cancer Center; 🇺🇸 Indianapolis, Indiana, United States

Sidney and Lois Eskenazi Hospital; 🇺🇸 Indianapolis, Indiana, 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 - Fort Scott; 🇺🇸 Fort Scott, Kansas, United States

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

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

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

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

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

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

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

University of Kansas Cancer Center-Overland Park; 🇺🇸 Overland Park, Kansas, United States

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

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

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

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

University of Kansas Hospital-Westwood Cancer Center; 🇺🇸 Westwood, 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

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

University of Kentucky/Markey Cancer Center; 🇺🇸 Lexington, Kentucky, United States

The James Graham Brown Cancer Center at University of Louisville; 🇺🇸 Louisville, Kentucky, United States

Johns Hopkins University/Sidney Kimmel Cancer Center; 🇺🇸 Baltimore, Maryland, United States

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

Beth Israel Deaconess Medical Center; 🇺🇸 Boston, Massachusetts, United States

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

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

Wayne State University/Karmanos Cancer Institute; 🇺🇸 Detroit, Michigan, United States

Weisberg Cancer Treatment Center; 🇺🇸 Farmington Hills, Michigan, United States

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

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

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

Saint Luke's Hospital; 🇺🇸 Chesterfield, Missouri, United States

Siteman Cancer Center at West County Hospital; 🇺🇸 Creve Coeur, Missouri, United States

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

Washington University School of Medicine; 🇺🇸 Saint Louis, Missouri, United States

Siteman Cancer Center-South County; 🇺🇸 Saint Louis, Missouri, United States

Siteman Cancer Center at Saint Peters Hospital; 🇺🇸 Saint Peters, Missouri, United States

Community Hospital of Anaconda; 🇺🇸 Anaconda, Montana, United States

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

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

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

Bozeman Health Deaconess Hospital; 🇺🇸 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

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

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

Kalispell Regional Medical Center; 🇺🇸 Kalispell, Montana, United States

Comprehensive Cancer Centers of Nevada-Horizon Ridge; 🇺🇸 Henderson, Nevada, United States

Las Vegas Cancer Center-Henderson; 🇺🇸 Henderson, Nevada, United States

OptumCare Cancer Care at Seven Hills; 🇺🇸 Henderson, Nevada, United States

Comprehensive Cancer Centers of Nevada-Southeast Henderson; 🇺🇸 Henderson, Nevada, United States

GenesisCare USA - Henderson; 🇺🇸 Henderson, Nevada, United States

Las Vegas Urology - Green Valley; 🇺🇸 Henderson, Nevada, United States

Las Vegas Urology - Pebble; 🇺🇸 Henderson, Nevada, United States

Urology Specialists of Nevada - Green Valley; 🇺🇸 Henderson, Nevada, United States

Las Vegas Urology - Pecos; 🇺🇸 Las Vegas, Nevada, United States

Desert West Surgery; 🇺🇸 Las Vegas, Nevada, United States

OptumCare Cancer Care at Charleston; 🇺🇸 Las Vegas, Nevada, United States

University Medical Center of Southern Nevada; 🇺🇸 Las Vegas, Nevada, United States

Hope Cancer Care of Nevada; 🇺🇸 Las Vegas, Nevada, United States

Cancer and Blood Specialists-Shadow; 🇺🇸 Las Vegas, Nevada, United States

Radiation Oncology Centers of Nevada Central; 🇺🇸 Las Vegas, Nevada, United States

Urology Specialists of Nevada - Central; 🇺🇸 Las Vegas, Nevada, United States

GenesisCare USA - Las Vegas; 🇺🇸 Las Vegas, Nevada, United States

HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway; 🇺🇸 Las Vegas, Nevada, United States

Sunrise Hospital and Medical Center; 🇺🇸 Las Vegas, Nevada, United States

HealthCare Partners Medical Group Oncology/Hematology-San Martin; 🇺🇸 Las Vegas, Nevada, United States

Las Vegas Prostate Cancer Center; 🇺🇸 Las Vegas, Nevada, United States

Las Vegas Urology - Sunset; 🇺🇸 Las Vegas, Nevada, United States

Urology Specialists of Nevada - Southwest; 🇺🇸 Las Vegas, Nevada, United States

Radiation Oncology Centers of Nevada Southeast; 🇺🇸 Las Vegas, Nevada, United States

Ann M Wierman MD LTD; 🇺🇸 Las Vegas, Nevada, United States

Cancer and Blood Specialists-Tenaya; 🇺🇸 Las Vegas, Nevada, United States

Comprehensive Cancer Centers of Nevada - Northwest; 🇺🇸 Las Vegas, Nevada, United States

GenesisCare USA - Vegas Tenaya; 🇺🇸 Las Vegas, Nevada, United States

HealthCare Partners Medical Group Oncology/Hematology-Tenaya; 🇺🇸 Las Vegas, Nevada, United States

Las Vegas Urology - Cathedral Rock; 🇺🇸 Las Vegas, Nevada, United States

Las Vegas Urology - Smoke Ranch; 🇺🇸 Las Vegas, Nevada, United States

OptumCare Cancer Care at MountainView; 🇺🇸 Las Vegas, Nevada, United States

Urology Specialists of Nevada - Northwest; 🇺🇸 Las Vegas, Nevada, United States

Alliance for Childhood Diseases/Cure 4 the Kids Foundation; 🇺🇸 Las Vegas, Nevada, United States

Comprehensive Cancer Centers of Nevada - Town Center; 🇺🇸 Las Vegas, Nevada, United States

Comprehensive Cancer Centers of Nevada-Summerlin; 🇺🇸 Las Vegas, Nevada, United States

Summerlin Hospital Medical Center; 🇺🇸 Las Vegas, Nevada, United States

Las Vegas Cancer Center-Medical Center; 🇺🇸 Las Vegas, Nevada, United States

Comprehensive Cancer Centers of Nevada; 🇺🇸 Las Vegas, Nevada, United States

Rutgers Cancer Institute of New Jersey; 🇺🇸 New Brunswick, New Jersey, United States

GenesisCare USA - Fort Apache; 🇺🇸 Las Vegas, Nevada, United States

Comprehensive Cancer Centers of Nevada - Central Valley; 🇺🇸 Las Vegas, Nevada, United States

OptumCare Cancer Care at Fort Apache; 🇺🇸 Las Vegas, Nevada, United States

HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills; 🇺🇸 Las Vegas, Nevada, United States

Novant Health Presbyterian Medical Center; 🇺🇸 Charlotte, North Carolina, United States

University Cancer Center; 🇺🇸 Las Vegas, Nevada, United States

Hope Cancer Care of Nevada-Pahrump; 🇺🇸 Pahrump, Nevada, United States

Renown Regional Medical Center; 🇺🇸 Reno, Nevada, United States

Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center; 🇺🇸 Lebanon, New Hampshire, United States

Saint Mary's Regional Medical Center; 🇺🇸 Reno, Nevada, United States

Saint Francis Cancer Center; 🇺🇸 Greenville, South Carolina, United States

Radiation Oncology Associates; 🇺🇸 Reno, Nevada, United States

Roswell Park Cancer Institute; 🇺🇸 Buffalo, New York, United States

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

Memorial Sloan Kettering Cancer Center; 🇺🇸 New York, New York, United States

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

Wilmot Cancer Institute at Webster; 🇺🇸 Webster, New York, United States

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

UNC Lineberger Comprehensive Cancer Center; 🇺🇸 Chapel Hill, North Carolina, United States

Wake Forest University at Clemmons; 🇺🇸 Clemmons, North Carolina, United States

Atrium Health Pineville/LCI-Pineville; 🇺🇸 Charlotte, North Carolina, United States

Atrium Health Cabarrus/LCI-Concord; 🇺🇸 Concord, North Carolina, United States

Duke University Medical Center; 🇺🇸 Durham, North Carolina, United States

Novant Health Cancer Institute - Huntersville; 🇺🇸 Huntersville, North Carolina, United States

Novant Health Presbyterian Medical Center Huntersville; 🇺🇸 Huntersville, North Carolina, United States

Novant Health Cancer Institute - Kernersville; 🇺🇸 Kernersville, North Carolina, United States

Matthews Radiation Oncology Center; 🇺🇸 Matthews, North Carolina, United States

Novant Health Cancer Institute - Matthews; 🇺🇸 Matthews, North Carolina, United States

Novant Health Cancer Institute - Mooresville; 🇺🇸 Mooresville, North Carolina, United States

Novant Health Cancer Institute - Mount Airy; 🇺🇸 Mount Airy, North Carolina, United States

Novant Health Cancer Institute - Wilkesboro; 🇺🇸 North Wilkesboro, North Carolina, United States

Rowan Regional Medical Center; 🇺🇸 Salisbury, North Carolina, United States

Novant Health Cancer Institute - Statesville; 🇺🇸 Statesville, North Carolina, United States

Novant Health Cancer Institute - Thomasville; 🇺🇸 Thomasville, North Carolina, United States

Novant Health Forsyth Medical Center; 🇺🇸 Winston-Salem, North Carolina, United States

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

Miami Valley Hospital South; 🇺🇸 Centerville, Ohio, United States

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

Case Western Reserve University; 🇺🇸 Cleveland, Ohio, United States

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

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

Premier Blood and Cancer Center; 🇺🇸 Dayton, Ohio, United States

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

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

Miami Valley Cancer Care and Infusion; 🇺🇸 Greenville, Ohio, United States

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

University of Cincinnati Cancer Center-West Chester; 🇺🇸 West Chester, Ohio, United States

University of Oklahoma Health Sciences Center; 🇺🇸 Oklahoma City, Oklahoma, United States

Saint Alphonsus Cancer Care Center-Baker City; 🇺🇸 Baker City, Oregon, United States

Saint Charles Health System; 🇺🇸 Bend, Oregon, United States

Clackamas Radiation Oncology Center; 🇺🇸 Clackamas, Oregon, United States

Providence Cancer Institute Clackamas Clinic; 🇺🇸 Clackamas, Oregon, United States

Bay Area Hospital; 🇺🇸 Coos Bay, Oregon, United States

Providence Newberg Medical Center; 🇺🇸 Newberg, Oregon, United States

Saint Alphonsus Cancer Care Center-Ontario; 🇺🇸 Ontario, Oregon, United States

Providence Willamette Falls Medical Center; 🇺🇸 Oregon City, Oregon, United States

Providence Portland Medical Center; 🇺🇸 Portland, Oregon, United States

Providence Saint Vincent Medical Center; 🇺🇸 Portland, Oregon, United States

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

Saint Charles Health System-Redmond; 🇺🇸 Redmond, Oregon, United States

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

UPMC Cancer Centers - Arnold Palmer Pavilion; 🇺🇸 Greensburg, Pennsylvania, United States

UPMC Hillman Cancer Center - Monroeville; 🇺🇸 Monroeville, Pennsylvania, United States

University of Pennsylvania/Abramson Cancer Center; 🇺🇸 Philadelphia, Pennsylvania, United States

University of Pittsburgh Cancer Institute (UPCI); 🇺🇸 Pittsburgh, Pennsylvania, United States

UPMC-Passavant Hospital; 🇺🇸 Pittsburgh, Pennsylvania, United States

UPMC-Saint Clair Hospital Cancer Center; 🇺🇸 Pittsburgh, Pennsylvania, United States

UPMC Cancer Center-Uniontown; 🇺🇸 Uniontown, Pennsylvania, United States

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

Prisma Health Cancer Institute - Spartanburg; 🇺🇸 Boiling Springs, South Carolina, United States

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

Prisma Health Cancer Institute - Laurens; 🇺🇸 Clinton, South Carolina, United States

Prisma Health Cancer Institute - Easley; 🇺🇸 Easley, South Carolina, United States

Saint Francis Hospital; 🇺🇸 Greenville, South Carolina, United States

Prisma Health Cancer Institute - Butternut; 🇺🇸 Greenville, South Carolina, United States

Prisma Health Cancer Institute - Faris; 🇺🇸 Greenville, South Carolina, United States

Prisma Health Greenville Memorial Hospital; 🇺🇸 Greenville, South Carolina, United States

Prisma Health Cancer Institute - Eastside; 🇺🇸 Greenville, South Carolina, United States

Prisma Health Cancer Institute - Greer; 🇺🇸 Greer, South Carolina, United States

Prisma Health Cancer Institute - Seneca; 🇺🇸 Seneca, South Carolina, United States

Vanderbilt University/Ingram Cancer Center; 🇺🇸 Nashville, Tennessee, United States

Houston Methodist Hospital; 🇺🇸 Houston, Texas, United States

Methodist Willowbrook Hospital; 🇺🇸 Houston, Texas, United States

Houston Methodist Sugar Land Hospital; 🇺🇸 Sugar Land, Texas, United States

American Fork Hospital / Huntsman Intermountain Cancer Center; 🇺🇸 American Fork, Utah, United States

Sandra L Maxwell Cancer Center; 🇺🇸 Cedar City, Utah, United States

Farmington Health Center; 🇺🇸 Farmington, Utah, United States

Logan Regional Hospital; 🇺🇸 Logan, Utah, United States

Intermountain Medical Center; 🇺🇸 Murray, Utah, United States

McKay-Dee Hospital Center; 🇺🇸 Ogden, Utah, United States

Utah Valley Regional Medical Center; 🇺🇸 Provo, Utah, United States

University of Virginia Cancer Center; 🇺🇸 Charlottesville, Virginia, United States

Providence Regional Cancer System-Aberdeen; 🇺🇸 Aberdeen, Washington, United States

MultiCare Auburn Medical Center; 🇺🇸 Auburn, Washington, United States

Overlake Medical Center; 🇺🇸 Bellevue, Washington, United States

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

Providence Regional Cancer System-Centralia; 🇺🇸 Centralia, Washington, United States

Swedish Cancer Institute-Edmonds; 🇺🇸 Edmonds, Washington, United States

Providence Regional Cancer Partnership; 🇺🇸 Everett, Washington, United States

MultiCare Gig Harbor Medical Park; 🇺🇸 Gig Harbor, Washington, United States

Swedish Cancer Institute-Issaquah; 🇺🇸 Issaquah, Washington, United States

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

Providence Regional Cancer System-Lacey; 🇺🇸 Lacey, Washington, United States

PeaceHealth Saint John Medical Center; 🇺🇸 Longview, Washington, United States

Skagit Regional Health Cancer Care Center; 🇺🇸 Mount Vernon, Washington, United States

Jefferson Healthcare; 🇺🇸 Port Townsend, Washington, United States

MultiCare Good Samaritan Hospital; 🇺🇸 Puyallup, Washington, United States

Valley Medical Center; 🇺🇸 Renton, Washington, United States

Pacific Gynecology Specialists; 🇺🇸 Seattle, Washington, United States

Swedish Medical Center-Ballard Campus; 🇺🇸 Seattle, Washington, United States

FHCC South Lake Union; 🇺🇸 Seattle, Washington, United States

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

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

Swedish Medical Center-Cherry Hill; 🇺🇸 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

Providence Regional Cancer System-Shelton; 🇺🇸 Shelton, Washington, United States

MultiCare Deaconess Cancer and Blood Specialty Center - Valley; 🇺🇸 Spokane Valley, Washington, United States

Mary Bridge Children's Hospital and Health Center; 🇺🇸 Tacoma, Washington, United States

MultiCare Tacoma General Hospital; 🇺🇸 Tacoma, Washington, United States

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

Providence Saint Mary Regional Cancer Center; 🇺🇸 Walla Walla, Washington, United States

North Star Lodge Cancer Center at Yakima Valley Memorial Hospital; 🇺🇸 Yakima, Washington, United States

Providence Regional Cancer System-Yelm; 🇺🇸 Yelm, Washington, United States

WVUH-Berkely Medical Center; 🇺🇸 Martinsburg, West Virginia, United States

United Hospital Center; 🇺🇸 Bridgeport, West Virginia, United States

UW Cancer Center at ProHealth Care; 🇺🇸 Waukesha, 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

Cheyenne Regional Medical Center-West; 🇺🇸 Cheyenne, Wyoming, United States

Billings Clinic-Cody; 🇺🇸 Cody, Wyoming, United States

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

Camden Clark Medical Center; 🇺🇸 Parkersburg, West Virginia, United States

Wheeling Hospital/Schiffler Cancer Center; 🇺🇸 Wheeling, West Virginia, United States

Marshfield Clinic-Chippewa Center; 🇺🇸 Chippewa Falls, Wisconsin, United States

Marshfield Medical Center-EC Cancer Center; 🇺🇸 Eau Claire, Wisconsin, United States

Mayo Clinic Health System-Eau Claire Clinic; 🇺🇸 Eau Claire, Wisconsin, United States

Saint Vincent Hospital Cancer Center Green Bay; 🇺🇸 Green Bay, Wisconsin, United States

Saint Vincent Hospital Cancer Center at Saint Mary's; 🇺🇸 Green Bay, Wisconsin, United States

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

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

University of Wisconsin Carbone Cancer Center - University Hospital; 🇺🇸 Madison, 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 Clinic-Minocqua Center; 🇺🇸 Minocqua, Wisconsin, United States

ProHealth D N Greenwald Center; 🇺🇸 Mukwonago, Wisconsin, United States

Froedtert and MCW Moorland Reserve Health Center; 🇺🇸 New Berlin, Wisconsin, United States

ProHealth Oconomowoc Memorial Hospital; 🇺🇸 Oconomowoc, Wisconsin, United States

Saint Vincent Hospital Cancer Center at Oconto Falls; 🇺🇸 Oconto Falls, Wisconsin, United States

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

Marshfield Medical Center-River Region at Stevens Point; 🇺🇸 Stevens Point, Wisconsin, United States

Saint Vincent Hospital Cancer Center at Sturgeon Bay; 🇺🇸 Sturgeon Bay, Wisconsin, United States

ProHealth Waukesha Memorial Hospital; 🇺🇸 Waukesha, Wisconsin, United States

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

King Faisal Specialist Hospital and Research Centre; 🇸🇦 Riyadh, Saudi Arabia