MedPath

Radiation Therapy (RT) and Temozolomide (TMZ) in Treating Patients With Newly Diagnosed Glioblastoma or Gliosarcoma

Phase 3
Completed
Conditions
Brain and Central Nervous System Tumors
Interventions
Drug: Concurrent temozolomide
Radiation: Concurrent radiation therapy
Drug: 100mg/m2 adjuvant temozolomide days 1 to 5 of 28 day cycle
Drug: 75mg/m2 adjuvant temozolomide days 1-21 of 28 day cycle
Registration Number
NCT00304031
Lead Sponsor
Radiation Therapy Oncology Group
Brief Summary

RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving radiation therapy together with temozolomide may kill more tumor cells. It is not yet known which schedule of temozolomide when given together with radiation therapy is more effective in treating glioblastoma or gliosarcoma.

PURPOSE: This randomized phase III trial is studying two different schedules of temozolomide to compare how well they work when given together with radiation therapy in treating patients with newly diagnosed glioblastoma or gliosarcoma.

Detailed Description

OBJECTIVES:

Primary

* Determine if dose-intensifying (increasing the "dose-density") the adjuvant temozolomide component of the chemoradiation treatment enhances treatment efficacy as measured by overall survival of patients with newly diagnosed glioblastoma or gliosarcoma.

Secondary

* Determine if dose-intensifying the adjuvant temozolomide component of the chemoradiation treatment enhances treatment efficacy as measured by progression-free survival.

* Determine in patients with unmethylated MGMT (O-6-methylguanine-DNA methyltransferase) if dose-intensifying the adjuvant temozolomide component of the chemoradiation treatment enhances treatment efficacy (overall and progression-free survival) compared with patients receiving conventional temozolomide dosing.

* Determine in patients with methylated MGMT if dose-intensifying the adjuvant temozolomide component of the chemoradiation treatment enhances treatment efficacy (overall and progression-free survival) compared with patients receiving conventional temozolomide dosing.

* Determine if there is an association between tumor MGMT gene methylation status and treatment response.

* Compare and record the toxicities of the conventional and dose-intense chemotherapy regimens.

* Evaluate whether 6-month progression-free survival is associated with overall survival.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to recursive partitioning analysis class (III vs IV vs V), MGMT gene methylation status (methylated vs nonmethylated vs indeterminate), and radiotherapy criteria used (standard vs revised European).

After completion of study treatment, patients are followed every 3 months for 1 year, every 4 months for 2 years, and then every 6 months thereafter.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1173
Inclusion Criteria

Not provided

Read More
Exclusion Criteria

Not provided

Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Conventional adjuvant TMZConcurrent radiation therapyConcurrent radiation therapy with concurrent temozolomide (75 mg/m2) up to 49 doses. Starting four weeks after completion of RT, 100mg/m2 adjuvant temozolomide days 1 to 5 of 28 day cycle.
Conventional adjuvant TMZ100mg/m2 adjuvant temozolomide days 1 to 5 of 28 day cycleConcurrent radiation therapy with concurrent temozolomide (75 mg/m2) up to 49 doses. Starting four weeks after completion of RT, 100mg/m2 adjuvant temozolomide days 1 to 5 of 28 day cycle.
Dose-dense adjuvant TMZConcurrent temozolomideConcurrent radiation therapy (RT) with concurrent temozolomide (75 mg/m2) up to 49 doses. Starting four weeks after completion of RT, 75mg/m2 adjuvant temozolomide days 1-21 of 28 day cycle.
Dose-dense adjuvant TMZConcurrent radiation therapyConcurrent radiation therapy (RT) with concurrent temozolomide (75 mg/m2) up to 49 doses. Starting four weeks after completion of RT, 75mg/m2 adjuvant temozolomide days 1-21 of 28 day cycle.
Dose-dense adjuvant TMZ75mg/m2 adjuvant temozolomide days 1-21 of 28 day cycleConcurrent radiation therapy (RT) with concurrent temozolomide (75 mg/m2) up to 49 doses. Starting four weeks after completion of RT, 75mg/m2 adjuvant temozolomide days 1-21 of 28 day cycle.
No adjuvant TMZ (not randomized )Concurrent radiation therapyConcurrent radiation therapy (RT) with concurrent temozolomide (75 mg/m2) up to 49 doses. Not randomized to either adjuvant TMZ arm.
Conventional adjuvant TMZConcurrent temozolomideConcurrent radiation therapy with concurrent temozolomide (75 mg/m2) up to 49 doses. Starting four weeks after completion of RT, 100mg/m2 adjuvant temozolomide days 1 to 5 of 28 day cycle.
No adjuvant TMZ (not randomized )Concurrent temozolomideConcurrent radiation therapy (RT) with concurrent temozolomide (75 mg/m2) up to 49 doses. Not randomized to either adjuvant TMZ arm.
Primary Outcome Measures
NameTimeMethod
Median Overall Survival TimeFrom randomization to last follow-up. Maximum follow-up at time of analysis was 4.4 years.

Overall survival time is defined as time from registration/randomization to the date of death from any cause. Overall survival rates are estimated by the Kaplan-Meier method. Patients last known to be alive are censored at the date of last contact. Analysis occurred after 647 deaths were reported.

Secondary Outcome Measures
NameTimeMethod
Number of Participants With Deterioration From Baseline in MD Anderson Symptom Inventory Brain Tumor (MDASI-BT) Symptom Severity Score and EORTC QLQ-C30 Global Health Status Score (GHS) at Cycle 4baseline and cycle 4 (approximately 22 weeks)

* The MDASI-BT is a 28-item patient-reported outcome measure assessing symptom severity (SS) and resulting interference with daily living in brain cancer patients. All items range from 0 (not present) to 10 (as bad as you can imagine). A SS score is the average of the SS items, given a specified minimum numbers were completed. A score worse than baseline by at least one is considered deterioration.

* Global Health Status is calculated from two questions on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire \[EORTC QLQ\]-C30. The question responses range from 1 (very poor) to 7 (excellent) such that a higher response indicates better quality of life (QOL). The mean of these responses is linearly transformed to a range of 0 (worst) to 100 (best). A score worse than baseline by at least 10 is considered deterioration.

* The 2x2 frequency table of SS deterioration vs. GHS deterioration is presented as four rows.

Mean MD Anderson Symptom Inventory Brain Tumor (MDASI-BT) Symptom Severity Score Over TimeBaseline, 10, 12, 22, 24, and 46 weeks

The MDASI-BT is a 28-item patient-reported outcome measure assessing symptom severity and resulting interference with daily living in brain cancer patients. All items range from 0 (not present) to 10 (as bad as you can imagine). The symptom severity score is the average of the symptom severity items, given a specified minimum numbers were completed.

Determination of Impactful Baseline Instruments on Overall SurvivalFrom randomization to last follow-up. Maximum follow-up at time of analysis was 4.4 years.

Overall survival time is defined as time from registration/randomization to the date of death from any cause or last known follow-up (censored). Overall survival rates are estimated by the Kaplan-Meier method. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire \[EORTC QLQ\]-C30 subscales are calculated as the mean of component items, then standardized such that subscale scores range from 0 to 100. A high score for a functional scale represents a healthy level of functioning. Controlled Oral Word Association (COWA) score is the sum of correct responses with a range of 0 to infinity. A higher score indicates better functioning. Hopkins Verbal Learning Test - Revised (HVLT-R) score ranges from 0 to 36 for total recall is 0 to 36, 0 to 12 for delayed recall, and -12 to 12 for recognition. A higher score indicates better functioning.

Number of Participants With Deterioration From Baseline in MD Anderson Symptom Inventory Brain Tumor (MDASI-BT) Cognitive Score and Hopkins Verbal Learning Test - Revised (HVLT-R) Delayed Recognition (DR) Score at Cycle 4baseline and cycle 4 (approximately 22 weeks)

* The MDASI-BT is a 28-item patient-reported outcome measure assessing symptom severity (SS) and resulting interference with daily living in brain cancer patients. All items range from 0 (not present) to 10 (as bad as you can imagine). A SS score is the average of the SS items, given a specified minimum numbers were completed. A score worse than baseline by at least one is considered deterioration.

* The HVLT-R Delayed Recognition raw score is the number of of correctly identified words minus the number of incorrectly identified words from a list of words including 12 nouns memorized 20 minutes prior. The raw score ranges from -12 to 12. with a higher score indicates better functioning. Scores are standardized (mean 0, standard deviation 1), adjusting for age,education, and gender as necessary. A score worse than baseline by at least two is considered deterioration.

* The 2x2 frequency table of SS deterioration vs. HVLT-R deterioration is presented as four rows.

Median Progression-free Survival (PFS) TimeFrom randomization to last follow-up. Maximum follow-up at time of analysis was 4.4 years.

Progression is defined as greater than 25% increase in tumor area (two diameters) provided that the patient has not had his/her dose of steroids decreased since the last evaluation period. Progression-free survival time is defined as time from registration to the date of first progression, death, or last known follow-up (censored). Progression-free survival rates are estimated using the Kaplan-Meier method. A concomitant decrease in steroid dose will rule out a progression designation during the first 2 months after completion of radiation therapy. Analysis occurred after 647 deaths were reported.

Median Overall Survival Time by MGMT StatusFrom randomization to last follow-up. Maximum follow-up at time of analysis was 4.4 years.

Overall survival time is defined as time from randomization to the date of death from any cause. Overall survival rates are estimated by the Kaplan-Meier method. Patients last known to be alive are censored at the date of last contact. Tumor tissue submitted at baseline was analyzed to determine MGMT (O\[6\]-methylguanine-DNA methyltransferase) promoter methylation status (methylated / unmethylated). Analysis occurred after 647 deaths were reported.

Median Progression-free Survival Time by MGMT StatusFrom randomization to last follow-up. Maximum follow-up at time of analysis was 4.4 years.

Progression is defined as greater than 25% increase in tumor area (two diameters) provided that the patient has not had his/her dose of steroids decreased since the last evaluation period. Progression-free survival time is defined as time from registration to the date of first progression, death, or last known follow-up (censored). Progression-free survival rates are estimated using the Kaplan-Meier method. A concomitant decrease in steroid dose will rule out a progression designation during the first 2 months after completion of radiation therapy. Tumor tissue submitted at baseline was analyzed to determine MGMT (O\[6\]-methylguanine-DNA methyltransferase) promoter methylation status (methylated / unmethylated). Analysis occurred after 647 deaths were reported.

Best Treatment Response by MGMT StatusFrom randomization to last follow-up. Maximum follow-up at time of analysis was 4.4 years.

Response assessed using Response Evaluation Criteria in Solid Tumors (RECIST v1.0): Complete Response (CR), imaging no longer shows enhancing tumor, confirmed by a second scan ≥ 4 weeks later; Partial Response (PR), \>=50% decrease in tumor area (two diameters) with patient off all steroids, or on adrenal maintenance only; Minor Response (MR), \< 50% decrease in tumor area with patient off all steroids, or on adrenal maintenance only; Stable Disease (SD): scan shows no change with patient receiving stable/decreasing doses of steroids; Progression (P): \> 25% increase in tumor area with no decrease in steroid dose since last evaluation. Tumor tissue submitted at baseline was analyzed to determine MGMT (O\[6\]-methylguanine-DNA methyltransferase) promoter methylation status (methylated / unmethylated). Analysis occurred after 647 deaths were reported.

Distribution of Highest Grade AE Reported as Possibly/Probably/Definitely Related to Protocol TreatmentFrom randomization to last follow-up. Maximum follow-up at time of analysis was 4.4 years.

Highest grade adverse event (AE) per subject was counted. Adverse events were graded using the Common Terminology Criteria for Adverse Events (CTCAE) v3.0. Grade refers to the severity of the AE. The CTCAE v3.0 assigns Grades 1 through 5 with unique clinical descriptions of severity for each AE based on this general guideline: Grade 1 Mild, Grade 2 Moderate, Grade 3 Severe, Grade 4 Life-threatening or disabling, Grade 5 Death related to AE. Analysis occurred after 647 deaths were reported.

Overall Survival Status by Progression Status at 6 MonthsFrom randomization to last follow-up. Maximum follow-up at time of analysis was 4.4 years.

Overall survival time is defined as time from registration to the date of death from any cause or last known follow-up (censored). Overall survival rates are estimated by the Kaplan-Meier method. Progression is defined as greater than 25% increase in tumor area (two diameters) provided that the patient has not had his/her dose of steroids decreased since the last evaluation period.

Mean MD Anderson Symptom Inventory Brain Tumor (MDASI-BT) Symptom Severity Score at Cycle 10 for Participants Without Progression After 6 Months of Adjuvant TherapyBaseline and cycle 10 (approximately 46 weeks)

The MDASI-BT is a 28-item patient-reported outcome measure assessing symptom severity and resulting interference with daily living in brain cancer patients. All items range from 0 (not present) to 10 (as bad as you can imagine). The symptom severity score is the average of the symptom severity items, given a specified minimum numbers were completed.

Mean Neurocognitive Function (NCF) Composite Score at Cycle 10 for Participants Without Progression After 6 Months of Adjuvant TherapyBaseline and cycle 10 (approximately 46 weeks)

The NCF Composite score is the arithmetic mean of the Hopkins Verbal Learning Test - Revised (HVLT-R) (Free Recall, Delayed Recall, Delayed Recognition), Trail Making Test Part A (TMTA), Trail Making Test Part B (TMTB), and Controlled Oral Word Association (COWA) test scores, all of which are standardized, adjusting for age, education, and gender as necessary, such that mean is 0 and standard deviation is 1. A participant must have at least 5 of the 6 scores. A higher composite score indicates better neurocognitive function.

Mean EORTC QLQ-C30 Global Health Status Score at Cycle 10 for Participants Without Progression After 6 Months of Adjuvant TherapyBaseline and cycle 10 (approximately 46 weeks)

Global Health Status is calculated from two questions on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire \[EORTC QLQ\]-C30. The question responses range from 1 "very poor" to 7 "excellent" such that a higher response indicates better quality of life (QOL). The mean of these responses is linearly transformed to a range of 0 (worst) to 100 (best).

Mean Change From Baseline in MD Anderson Symptom Inventory Brain Tumor (MDASI-BT) Symptom Severity Score at Mid-cyle for Cycle 1Baseline and mid-cycle 1 (approximately 12 weeks)

The MDASI-BT is a 28-item patient-reported outcome measure assessing symptom severity and resulting interference with daily living in brain cancer patients. All items range from 0 (not present) to 10 (as bad as you can imagine). The symptom severity score is the average of the symptom severity items, given a specified minimum numbers were completed. A score worse than baseline by at least one is considered deterioration. Change is calculated as time point - baseline such that a positive change value indicates worse symptoms compared to baseline.

Mean Change From Baseline in MD Anderson Symptom Inventory Brain Tumor (MDASI-BT) Symptom Severity Score at Mid-cyle for Cycle 4Baseline and mid-cycle 4 (approximately 24 weeks)

The MDASI-BT is a 28-item patient-reported outcome measure assessing symptom severity and resulting interference with daily living in brain cancer patients. All items range from 0 (not present) to 10 (as bad as you can imagine). The symptom severity score is the average of the symptom severity items, given a specified minimum numbers were completed. A score worse than baseline by at least one is considered deterioration. Change is calculated as time point - baseline such that a positive change value indicates worse symptoms compared to baseline.

Mean Change From Baseline in EORTC QLQ-C30 Global Health Status Score at Mid-cyle for Cycle 1Baseline and mid-cycle 1 (approximately 12 weeks)

Global Health Status is calculated from two questions on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire \[EORTC QLQ\]-C30. The question responses range from 1 "very poor" to 7 "excellent" such that a higher response indicates better quality of life (QOL). The mean of these responses is linearly transformed to a range of 0 (worst) to 100 (best). Change is calculated as time point - baseline such that a positive change value indicates worse symptoms compared to baseline.

Mean Change From Baseline in EORTC QLQ-C30 Global Health Status Score at Mid-cyle for Cycle 4Baseline and mid-cycle 4 (approximately 24 weeks)

Global Health Status is calculated from two questions on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire \[EORTC QLQ\]-C30. The question responses range from 1 "very poor" to 7 "excellent" such that a higher response indicates better quality of life (QOL). The mean of these responses is linearly transformed to a range of 0 (worst) to 100 (best). Change is calculated as time point - baseline such that a positive change value indicates worse symptoms compared to baseline.

Change From Baseline in Mean EORTC QLQ-C30 Global Health StatusBaseline, 10,12, 22, 24, and 46 weeks

Global Health Status is calculated from two questions on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire \[EORTC QLQ\]-C30. The question responses range from 1 "very poor" to 7 "excellent" such that a higher response indicates better quality of life (QOL). The mean of these responses is linearly transformed to a range of 0 (worst) to 100 (best). Change from baseline was calculated as time point value - baseline value with a positive change value indicating improved QOL from baseline.

Number of Participants With Deterioration From Baseline in MD Anderson Symptom Inventory Brain Tumor (MDASI-BT) Symptom Severity Score at Cycle 4baseline and cycle 4 (approximately 22 weeks)

The MDASI-BT is a 28-item patient-reported outcome measure assessing symptom severity and resulting interference with daily living in brain cancer patients. All items range from 0 (not present) to 10 (as bad as you can imagine). The symptom severity score is the average of the symptom severity items, given a specified minimum numbers were completed. A score worse than baseline by at least one is considered deterioration.

Number of Participants With Deterioration From Baseline in MD Anderson Symptom Inventory Brain Tumor (MDASI-BT) Interference Score at Cycle 4baseline and cycle 4 (approximately 22 weeks)

The MDASI-BT is a 28-item patient-reported outcome measure assessing symptom severity and resulting interference with daily living in brain cancer patients. All items range from 0 (did not interfere) to 10 (interfered completely). The symptom interference score is the average of the symptom interference items, given a specified minimum numbers were completed. A score worse than baseline by at least one is considered deterioration.

Number of Participants With Deterioration From Baseline in MD Anderson Symptom Inventory Brain Tumor (MDASI-BT) Symptom Severity Score and EORTC QLQ-C30 Global Health Status Score (GHS) at Cycle 10baseline and cycle 10 (approximately 46 weeks)

* The MDASI-BT is a 28-item patient-reported outcome measure assessing symptom severity (SS) and resulting interference with daily living in brain cancer patients. All items range from 0 (not present) to 10 (as bad as you can imagine). A SS score is the average of the SS items, given a specified minimum numbers were completed. A score worse than baseline by at least one is considered deterioration.

* Global Health Status is calculated from two questions on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire \[EORTC QLQ\]-C30. The question responses range from 1 (very poor) to 7 (excellent) such that a higher response indicates better quality of life (QOL). The mean of these responses is linearly transformed to a range of 0 (worst) to 100 (best). A score worse than baseline by at least 10 is considered deterioration.

* The 2x2 frequency table of SS deterioration vs. GHS deterioration is presented as four rows.

Number of Participants With Deterioration From Baseline in MD Anderson Symptom Inventory Brain Tumor (MDASI-BT) Symptom Severity Score and EORTC QLQ-C30 Global Health Status Score (GHS) at Cycle 1baseline and cycle 1 (approximately 10 weeks)

* The MDASI-BT is a 28-item patient-reported outcome measure assessing symptom severity (SS) and resulting interference with daily living in brain cancer patients. All items range from 0 (not present) to 10 (as bad as you can imagine). A SS score is the average of the SS items, given a specified minimum numbers were completed. A score worse than baseline by at least one is considered deterioration.

* Global Health Status is calculated from two questions on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire \[EORTC QLQ\]-C30. The question responses range from 1 (very poor) to 7 (excellent) such that a higher response indicates better quality of life (QOL). The mean of these responses is linearly transformed to a range of 0 (worst) to 100 (best). A score worse than baseline by at least 10 is considered deterioration.

* The 2x2 frequency table of SS deterioration vs. GHS deterioration is presented as four rows.

Mean Neurocognitive Function (NCF) Composite Score Over TimeBaseline, 10, 22, and 46 weeks

The NCF Composite score is the arithmetic mean of the HVLT-R (Free Recall, Delayed Recall, Delayed Recognition), TMTA, TMTB, and COWA scores, all of which are standardized, adjusting for age, education, and gender as necessary, such that mean is 0 and standard deviation is 1. A participant must have at least 5 of the 6 scores. A higher composite score indicates better neurocognitive function.

Number of Participants With Deterioration From Baseline in MD Anderson Symptom Inventory Brain Tumor (MDASI-BT) Cognitive Score and Hopkins Verbal Learning Test - Revised (HVLT-R) Delayed Recognition Score at Cycle 1baseline and cycle 1 (approximately 10 weeks)

* The MDASI-BT is a 28-item patient-reported outcome measure assessing symptom severity (SS) and resulting interference with daily living in brain cancer patients. All items range from 0 (not present) to 10 (as bad as you can imagine). A SS score is the average of the SS items, given a specified minimum numbers were completed. A score worse than baseline by at least one is considered deterioration.

* The HVLT-R Delayed Recognition raw score is the number of of correctly identified words minus the number of incorrectly identified words from a list of words including 12 nouns memorized 20 minutes prior. The raw score ranges from -12 to 12. with a higher score indicates better functioning. Scores are standardized (mean 0, standard deviation 1), adjusting for age,education, and gender as necessary. A score worse than baseline by at least two is considered deterioration.

* The 2x2 frequency table of SS deterioration vs. HVLT-R deterioration is presented as four rows.

Number of Participants With Deterioration From Baseline in MD Anderson Symptom Inventory Brain Tumor (MDASI-BT) Cognitive Score and Hopkins Verbal Learning Test - Revised (HVLT-R) Delayed Recognition (DR) Score at Cycle 10baseline and cycle 10 (approximately 46 weeks)

* The MDASI-BT is a 28-item patient-reported outcome measure assessing symptom severity (SS) and resulting interference with daily living in brain cancer patients. All items range from 0 (not present) to 10 (as bad as you can imagine). A SS score is the average of the SS items, given a specified minimum numbers were completed. A score worse than baseline by at least one is considered deterioration.

* The HVLT-R Delayed Recognition raw score is the number of of correctly identified words minus the number of incorrectly identified words from a list of words including 12 nouns memorized 20 minutes prior. The raw score ranges from -12 to 12. with a higher score indicates better functioning. Scores are standardized (mean 0, standard deviation 1), adjusting for age,education, and gender as necessary. A score worse than baseline by at least two is considered deterioration.

* The 2x2 frequency table of SS deterioration vs. HVLT-R deterioration is presented as four rows.

Trial Locations

Locations (347)

Riverside Methodist Hospital Cancer Care

🇺🇸

Columbus, Ohio, United States

Mount Carmel Health - West Hospital

🇺🇸

Columbus, Ohio, United States

Fox Chase Cancer Center - Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

Frankford Hospital Cancer Center - Torresdale Campus

🇺🇸

Philadelphia, Pennsylvania, United States

St. Agnes Hospital Cancer Center

🇺🇸

Baltimore, Maryland, United States

Union Hospital Cancer Program at Union Hospital

🇺🇸

Elkton, Maryland, United States

Proctor Hospital

🇺🇸

Peoria, Illinois, United States

McDonough District Hospital

🇺🇸

Macomb, Illinois, United States

BroMenn Regional Medical Center

🇺🇸

Normal, Illinois, United States

Valley Cancer Center

🇺🇸

Spring Valley, Illinois, United States

Hopedale Medical Complex

🇺🇸

Hopedale, Illinois, United States

OSF St. Francis Medical Center

🇺🇸

Peoria, Illinois, United States

Cancer Center of Kansas, PA - El Dorado

🇺🇸

El Dorado, Kansas, United States

Mason District Hospital

🇺🇸

Havana, Illinois, United States

Carle Cancer Center at Carle Foundation Hospital

🇺🇸

Urbana, Illinois, United States

CCOP - Illinois Oncology Research Association

🇺🇸

Peoria, Illinois, United States

Illinois Valley Community Hospital

🇺🇸

Peru, Illinois, United States

Community Hospital of Ottawa

🇺🇸

Ottawa, Illinois, United States

St. Margaret's Hospital

🇺🇸

Spring Valley, Illinois, United States

CCOP - Carle Cancer Center

🇺🇸

Urbana, Illinois, United States

Perry Memorial Hospital

🇺🇸

Princeton, Illinois, United States

Saint Anthony Memorial Health Centers

🇺🇸

Michigan City, Indiana, United States

Methodist Medical Center of Illinois

🇺🇸

Peoria, Illinois, United States

Cardinal Bernardin Cancer Center at Loyola University Medical Center

🇺🇸

Maywood, Illinois, United States

Memorial Hospital of South Bend

🇺🇸

South Bend, Indiana, United States

McFarland Clinic, PC

🇺🇸

Ames, Iowa, United States

Community Cancer Center

🇺🇸

Normal, Illinois, United States

Oncology Hematology Associates of Central Illinois, PC - Ottawa

🇺🇸

Ottawa, Illinois, United States

Center for Cancer Therapy at LaPorte Hospital and Health Services

🇺🇸

La Porte, Indiana, United States

Via Christi Cancer Center at Via Christi Regional Medical Center

🇺🇸

Wichita, Kansas, United States

Oncology Hematology Associates of Central Illinois, PC - Peoria

🇺🇸

Peoria, Illinois, United States

Cancer Treatment Center at Pekin Hospital

🇺🇸

Pekin, Illinois, United States

Dickinson County Healthcare System

🇺🇸

Iron Mountain, Michigan, United States

Radiation Oncology Associates Southwest

🇺🇸

Fort Wayne, Indiana, United States

CCOP - Northern Indiana CR Consortium

🇺🇸

South Bend, Indiana, United States

Kansas City Cancer Centers - Southwest

🇺🇸

Overland Park, Kansas, United States

InterCommunity Cancer Center of Western Illinois

🇺🇸

Galesburg, Illinois, United States

Oakwood Cancer Center at Oakwood Hospital and Medical Center

🇺🇸

Dearborn, Michigan, United States

Cancer Center of Kansas, PA - Kingman

🇺🇸

Kingman, Kansas, United States

Cancer Center of Kansas, PA - Pratt

🇺🇸

Pratt, Kansas, United States

Parkview Regional Cancer Center at Parkview Health

🇺🇸

Fort Wayne, Indiana, United States

Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center

🇺🇸

Robbinsdale, Minnesota, United States

Mercy Memorial Hospital - Monroe

🇺🇸

Monroe, Michigan, United States

Fairview Ridges Hospital

🇺🇸

Burnsville, Minnesota, United States

Cancer Center of Kansas, PA - Dodge City

🇺🇸

Dodge City, Kansas, United States

Mercy and Unity Cancer Center at Mercy Hospital

🇺🇸

Coon Rapids, Minnesota, United States

Saint Joseph Regional Medical Center

🇺🇸

South Bend, Indiana, United States

Bronson Methodist Hospital

🇺🇸

Kalamazoo, Michigan, United States

Cancer Center of Kansas-Independence

🇺🇸

Independence, Kansas, United States

Mercy and Unity Cancer Center at Unity Hospital

🇺🇸

Fridley, Minnesota, United States

Hurley Medical Center

🇺🇸

Flint, Michigan, United States

Menorah Medical Center

🇺🇸

Overland Park, Kansas, United States

Borgess Medical Center

🇺🇸

Kalamazoo, Michigan, United States

Genesys Hurley Cancer Institute

🇺🇸

Flint, Michigan, United States

Cancer Center of Kansas, PA - Parsons

🇺🇸

Parsons, Kansas, United States

Cancer Center of Kansas, PA - Medical Arts Tower

🇺🇸

Wichita, Kansas, United States

St. Joseph Mercy Oakland

🇺🇸

Pontiac, Michigan, United States

Van Elslander Cancer Center at St. John Hospital and Medical Center

🇺🇸

Grosse Pointe Woods, Michigan, United States

Southwest Medical Center

🇺🇸

Liberal, Kansas, United States

Ridgeview Medical Center

🇺🇸

Waconia, Minnesota, United States

CCOP - Cancer Research for the Ozarks

🇺🇸

Springfield, Missouri, United States

Community Medical Center

🇺🇸

Missoula, Montana, United States

CCOP - Montana Cancer Consortium

🇺🇸

Billings, Montana, United States

Seton Cancer Institute at Saint Mary's - Saginaw

🇺🇸

Saginaw, Michigan, United States

St. John's Regional Health Center

🇺🇸

Springfield, Missouri, United States

St. John Macomb Hospital

🇺🇸

Warren, Michigan, United States

Hulston Cancer Center at Cox Medical Center South

🇺🇸

Springfield, Missouri, United States

Fairfield Medical Center

🇺🇸

Lancaster, Ohio, United States

Rutherford Hospital

🇺🇸

Rutherfordton, North Carolina, United States

Minnesota Oncology Hematology, PA - Woodbury

🇺🇸

Woodbury, Minnesota, United States

St. Vincent Healthcare Cancer Care Services

🇺🇸

Billings, Montana, United States

Hudson Valley Oncology Associates

🇺🇸

Poughkeepsie, New York, United States

Montana Cancer Center at St. Patrick Hospital and Health Sciences Center

🇺🇸

Missoula, Montana, United States

Heartland Regional Medical Center

🇺🇸

Saint Joseph, Missouri, United States

Long Island Jewish Medical Center

🇺🇸

New Hyde Park, New York, United States

McDowell Cancer Center at Akron General Medical Center

🇺🇸

Akron, Ohio, United States

Independence Regional Health Center

🇺🇸

Independence, Missouri, United States

Hematology-Oncology Centers of the Northern Rockies - Billings

🇺🇸

Billings, Montana, United States

MeritCare Broadway

🇺🇸

Fargo, North Dakota, United States

Wayne Radiation Oncology

🇺🇸

Goldsboro, North Carolina, United States

CCOP - North Shore University Hospital

🇺🇸

Manhasset, New York, United States

Don Monti Comprehensive Cancer Center at North Shore University Hospital

🇺🇸

Manhasset, New York, United States

Toledo Clinic, Incorporated - Main Clinic

🇺🇸

Toledo, Ohio, United States

Genesis - Good Samaritan Hospital

🇺🇸

Zanesville, Ohio, United States

Natalie Warren Bryant Cancer Center at St. Francis Hospital

🇺🇸

Tulsa, Oklahoma, United States

Fulton County Health Center

🇺🇸

Wauseon, Ohio, United States

Doctors Hospital at Ohio Health

🇺🇸

Columbus, Ohio, United States

Legacy Mount Hood Medical Center

🇺🇸

Gresham, Oregon, United States

Mary Rutan Hospital

🇺🇸

Bellefontaine, Ohio, United States

Providence Milwaukie Hospital

🇺🇸

Milwaukie, Oregon, United States

Rosenfeld Cancer Center at Abington Memorial Hospital

🇺🇸

Abington, Pennsylvania, United States

Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest

🇺🇸

Allentown, Pennsylvania, United States

American Fork Hospital

🇺🇸

American Fork, Utah, United States

CCOP - Toledo Community Hospital

🇺🇸

Toledo, Ohio, United States

Thompson Cancer Survival Center

🇺🇸

Knoxville, Tennessee, United States

St. Luke's Hospital

🇺🇸

Maumee, Ohio, United States

Rapid City Regional Hospital

🇺🇸

Rapid City, South Dakota, United States

Legacy Meridian Park Hospital

🇺🇸

Tualatin, Oregon, United States

Cancer Research UK Medical Oncology Unit at Churchill Hospital & Weatherall Institute of Molecular Medicine - Oxford

🇺🇸

Salem, Ohio, United States

Penn State Cancer Institute at Milton S. Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

Gibbs Regional Cancer Center at Spartanburg Regional Medical Center

🇺🇸

Spartanburg, South Carolina, United States

Community Hospital of Springfield and Clark County

🇺🇸

Springfield, Ohio, United States

Willamette Valley Cancer Center - Eugene

🇺🇸

Eugene, Oregon, United States

Mount Carmel St. Ann's Cancer Center

🇺🇸

Westerville, Ohio, United States

Riddle Memorial Hospital Cancer Center

🇺🇸

Media, Pennsylvania, United States

Dixie Regional Medical Center - East Campus

🇺🇸

Saint George, Utah, United States

Thompson Cancer Survival Center West

🇺🇸

Knoxville, Tennessee, United States

Northeast Radiation Oncology Center

🇺🇸

Dunmore, Pennsylvania, United States

Fletcher Allen Health Care - University Health Center Campus

🇺🇸

Burlington, Vermont, United States

St. Vincent Mercy Medical Center

🇺🇸

Toledo, Ohio, United States

Medical University of Ohio Cancer Center

🇺🇸

Toledo, Ohio, United States

Upper Delaware Valley Cancer Center

🇺🇸

Milford, Pennsylvania, United States

Flower Hospital Cancer Center

🇺🇸

Sylvania, Ohio, United States

Cancer Treatment Center

🇺🇸

Wooster, Ohio, United States

Cancer Center of Paoli Memorial Hospital

🇺🇸

Paoli, Pennsylvania, United States

Somerset Oncology Center

🇺🇸

Somerset, Pennsylvania, United States

Green Bay Oncology, Limited - Oconto Falls

🇺🇸

Oconto Falls, Wisconsin, United States

Thompson Cancer Survival Center at Methodist

🇺🇸

Oak Ridge, Tennessee, United States

Avera Cancer Institute

🇺🇸

Sioux Falls, South Dakota, United States

Sanford Cancer Center at Sanford USD Medical Center

🇺🇸

Sioux Falls, South Dakota, United States

Jon and Karen Huntsman Cancer Center at Intermountain Medical Center

🇺🇸

Murray, Utah, United States

Fredericksburg Oncology, Incorporated

🇺🇸

Fredericksburg, Virginia, United States

Bryn Mawr Hospital

🇺🇸

Bryn Mawr, Pennsylvania, United States

Texas Oncology, PA at Texas Oncology Cancer Center Sugar Land

🇺🇸

Sugar Land, Texas, United States

McGlinn Family Regional Cancer Center at Reading Hospital and Medical Center

🇺🇸

Reading, Pennsylvania, United States

North Star Lodge Cancer Center at Yakima Valley Memorial Hospital

🇺🇸

Yakima, Washington, United States

Cancer Care Program at Thunder Bay Regional Health Sciences

🇨🇦

Thunder Bay, Ontario, Canada

Saint John Regional Hospital

🇨🇦

Saint John, New Brunswick, Canada

Texas Oncology, PA at Texas Cancer Center Dallas Southwest

🇺🇸

Dallas, Texas, United States

Kimmel Cancer Center at Thomas Jefferson University - Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

Intercommunity Cancer Center

🇺🇸

Monroeville, Pennsylvania, United States

Cascade Cancer Center at Evergreen Hospital Medical Center

🇺🇸

Kirkland, Washington, United States

Sandra L. Maxwell Cancer Center

🇺🇸

Cedar City, Utah, United States

Green Bay Oncology, Limited at St. Mary's Hospital

🇺🇸

Green Bay, Wisconsin, United States

St. Vincent Hospital Regional Cancer Center

🇺🇸

Green Bay, Wisconsin, United States

Geisinger Cancer Institute at Geisinger Health

🇺🇸

Danville, Pennsylvania, United States

AnMed Cancer Center

🇺🇸

Anderson, South Carolina, United States

Val and Ann Browning Cancer Center at McKay-Dee Hospital Center

🇺🇸

Ogden, Utah, United States

Green Bay Oncology, Limited - Sturgeon Bay

🇺🇸

Sturgeon Bay, Wisconsin, United States

Margaret and Charles Juravinski Cancer Centre

🇨🇦

Hamilton, Ontario, Canada

McGill Cancer Centre at McGill University

🇨🇦

Montreal, Quebec, Canada

CancerCare Manitoba

🇨🇦

Winnipeg, Manitoba, Canada

Centre Hospitalier Universitaire de Quebec

🇨🇦

Quebec City, Quebec, Canada

Waukesha Memorial Hospital Regional Cancer Center

🇺🇸

Waukesha, Wisconsin, United States

John H. Stroger, Jr. Hospital of Cook County

🇺🇸

Chicago, Illinois, United States

University of Chicago Cancer Research Center

🇺🇸

Chicago, Illinois, United States

Cleveland Clinic Cancer Center at Fairview Hospital

🇺🇸

Cleveland, Ohio, United States

M. D. Anderson Cancer Center at University of Texas

🇺🇸

Houston, Texas, United States

University Cancer Center at University of Washington Medical Center

🇺🇸

Seattle, Washington, United States

University Medical Center of Southern Nevada

🇺🇸

Las Vegas, Nevada, United States

CCOP - Nevada Cancer Research Foundation

🇺🇸

Las Vegas, Nevada, United States

Baptist-South Miami Regional Cancer Program

🇺🇸

Miami, Florida, United States

Central Indiana Cancer Centers - East

🇺🇸

Indianapolis, Indiana, United States

Virginia Piper Cancer Institute at Abbott - Northwestern Hospital

🇺🇸

Minneapolis, Minnesota, United States

LDS Hospital

🇺🇸

Salt Lake City, Utah, United States

UCSF Helen Diller Family Comprehensive Cancer Center

🇺🇸

San Francisco, California, United States

St. James Healthcare Cancer Care

🇺🇸

Butte, Montana, United States

Great Falls Clinic - Main Facility

🇺🇸

Great Falls, Montana, United States

Graham Hospital

🇺🇸

Canton, Illinois, United States

Billings Clinic - Downtown

🇺🇸

Billings, Montana, United States

Northern Montana Hospital

🇺🇸

Havre, Montana, United States

Memorial Sloan-Kettering Cancer Center

🇺🇸

New York, New York, United States

Kalispell Regional Medical Center

🇺🇸

Kalispell, Montana, United States

Guardian Oncology and Center for Wellness

🇺🇸

Missoula, Montana, United States

Montana Cancer Specialists at Montana Cancer Center

🇺🇸

Missoula, Montana, United States

Allan Blair Cancer Centre at Pasqua Hospital

🇨🇦

Regina, Saskatchewan, Canada

Arizona Oncology Services Foundation

🇺🇸

Phoenix, Arizona, United States

Josephine Ford Cancer Center at Henry Ford Hospital

🇺🇸

Detroit, Michigan, United States

Oklahoma University Cancer Institute

🇺🇸

Oklahoma City, Oklahoma, United States

Legacy Emanuel Hospital and Health Center and Children's Hospital

🇺🇸

Portland, Oregon, United States

Legacy Good Samaritan Hospital & Comprehensive Cancer Center

🇺🇸

Portland, Oregon, United States

Adventist Medical Center

🇺🇸

Portland, Oregon, United States

Providence St. Vincent Medical Center

🇺🇸

Portland, Oregon, United States

Providence Cancer Center at Providence Portland Medical Center

🇺🇸

Portland, Oregon, United States

CCOP - Columbia River Oncology Program

🇺🇸

Portland, Oregon, United States

Utah Cancer Specialists at UCS Cancer Center

🇺🇸

Salt Lake City, Utah, United States

Associates in Womens Health, PA - North Review

🇺🇸

Wichita, Kansas, United States

Cancer Center of Kansas, PA - Salina

🇺🇸

Salina, Kansas, United States

CCOP - Wichita

🇺🇸

Wichita, Kansas, United States

Wesley Medical Center

🇺🇸

Wichita, Kansas, United States

CCOP - Metro-Minnesota

🇺🇸

Saint Louis Park, Minnesota, United States

United Hospital

🇺🇸

Saint Paul, Minnesota, United States

Sparrow Regional Cancer Center

🇺🇸

Lansing, Michigan, United States

West Michigan Cancer Center

🇺🇸

Kalamazoo, Michigan, United States

Lakeland Regional Cancer Care Center - St. Joseph

🇺🇸

Saint Joseph, Michigan, United States

Allegheny Cancer Center at Allegheny General Hospital

🇺🇸

Pittsburgh, Pennsylvania, United States

Elkhart General Hospital

🇺🇸

Elkhart, Indiana, United States

Theda Care Cancer Institute

🇺🇸

Appleton, Wisconsin, United States

Utah Valley Regional Medical Center - Provo

🇺🇸

Provo, Utah, United States

Regional Cancer Center at Oconomowoc Memorial Hospital

🇺🇸

Oconomowoc, Wisconsin, United States

Norris Cotton Cancer Center - North

🇺🇸

Saint Johnsbury, Vermont, United States

Bay Area Cancer Care Center at Bay Area Medical Center

🇺🇸

Marinette, Wisconsin, United States

CCOP - Virginia Mason Research Center

🇺🇸

Seattle, Washington, United States

Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center

🇺🇸

Green Bay, Wisconsin, United States

Summa Center for Cancer Care at Akron City Hospital

🇺🇸

Akron, Ohio, United States

Cancer Center of Kansas, PA - Wichita

🇺🇸

Wichita, Kansas, United States

Minnesota Oncology Hematology, PA - Maplewood

🇺🇸

Maplewood, Minnesota, United States

Arizona Oncology - Tucson

🇺🇸

Tucson, Arizona, United States

Fairbanks Cancer Treatment Center at Fairbanks Memorial Hospital

🇺🇸

Fairbanks, Alaska, United States

Mayo Clinic Scottsdale

🇺🇸

Scottsdale, Arizona, United States

Auburn Radiation Oncology

🇺🇸

Auburn, California, United States

Mercy Cancer Center at Mercy San Juan Medical Center

🇺🇸

Carmichael, California, United States

Radiation Oncology Centers - Cameron Park

🇺🇸

Cameron Park, California, United States

Providence Saint Joseph Medical Center - Burbank

🇺🇸

Burbank, California, United States

Kaiser Permanente Medical Center - Los Angeles

🇺🇸

Los Angeles, California, United States

Radiation Oncology Center - Roseville

🇺🇸

Roseville, California, United States

Poudre Valley Radiation Oncology

🇺🇸

Fort Collins, Colorado, United States

City of Hope Comprehensive Cancer Center

🇺🇸

Duarte, California, United States

Solano Radiation Oncology Center

🇺🇸

Vacaville, California, United States

Penrose Cancer Center at Penrose Hospital

🇺🇸

Colorado Springs, Colorado, United States

CCOP - Christiana Care Health Services

🇺🇸

Newark, Delaware, United States

Eugene M. and Christine E. Lynn Cancer Institute at Boca Raton Community Hospital - Main Campus

🇺🇸

Boca Raton, Florida, United States

Tunnell Cancer Center at Beebe Medical Center

🇺🇸

Lewes, Delaware, United States

Integrated Community Oncology Network

🇺🇸

Jacksonville Beach, Florida, United States

Integrated Community Oncology Network - Orange Park

🇺🇸

Orange Park, Florida, United States

Baptist Cancer Institute - Jacksonville

🇺🇸

Jacksonville, Florida, United States

Mayo Clinic - Jacksonville

🇺🇸

Jacksonville, Florida, United States

Integrated Community Oncology Network at Southside Cancer Center

🇺🇸

Jacksonville, Florida, United States

Baptist Medical Center South

🇺🇸

Jacksonville, Florida, United States

Flagler Cancer Center

🇺🇸

Saint Augustine, Florida, United States

Florida Cancer Center - Palatka

🇺🇸

Palatka, Florida, United States

Piedmont Hospital

🇺🇸

Atlanta, Georgia, United States

John B. Amos Cancer Center

🇺🇸

Columbus, Georgia, United States

Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical Center

🇺🇸

Boise, Idaho, United States

Northwest Community Hospital

🇺🇸

Arlington Heights, Illinois, United States

Rush-Copley Cancer Care Center

🇺🇸

Aurora, Illinois, United States

Memorial Hospital

🇺🇸

Carthage, Illinois, United States

Eureka Community Hospital

🇺🇸

Eureka, Illinois, United States

Galesburg Clinic, PC

🇺🇸

Galesburg, Illinois, United States

Joliet Oncology-Hematology Associates, Limited - West

🇺🇸

Joliet, Illinois, United States

Howard Community Hospital

🇺🇸

Kokomo, Indiana, United States

South Bend Clinic

🇺🇸

South Bend, Indiana, United States

Cancer Center of Kansas, PA - Chanute

🇺🇸

Chanute, Kansas, United States

Mercy Cancer Center at Mercy Medical Center - North Iowa

🇺🇸

Mason City, Iowa, United States

Cancer Center of Kansas, PA - Newton

🇺🇸

Newton, Kansas, United States

Cancer Center of Kansas, PA - Wellington

🇺🇸

Wellington, Kansas, United States

Shawnee Mission Medical Center

🇺🇸

Shawnee Mission, Kansas, United States

DeCesaris Cancer Institute at Anne Arundel Medical Center

🇺🇸

Annapolis, Maryland, United States

Hickman Cancer Center at Bixby Medical Center

🇺🇸

Adrian, Michigan, United States

Cancer Center of Kansas, PA - Winfield

🇺🇸

Winfield, Kansas, United States

Green Bay Oncology, Limited - Escanaba

🇺🇸

Escanaba, Michigan, United States

Foote Memorial Hospital

🇺🇸

Jackson, Michigan, United States

Haematology-Oncology Associates of Ohio and Michigan, PC

🇺🇸

Lambertville, Michigan, United States

Community Cancer Center of Monroe

🇺🇸

Monroe, Michigan, United States

St. Mary Mercy Hospital

🇺🇸

Livonia, Michigan, United States

William Beaumont Hospital - Royal Oak Campus

🇺🇸

Royal Oak, Michigan, United States

Coborn Cancer Center

🇺🇸

Saint Cloud, Minnesota, United States

Providence Cancer Institute at Providence Hospital - Southfield Campus

🇺🇸

Southfield, Michigan, United States

Fairview Southdale Hospital

🇺🇸

Edina, Minnesota, United States

MeritCare Bemidji

🇺🇸

Bemidji, Minnesota, United States

Park Nicollet Cancer Center

🇺🇸

Saint Louis Park, Minnesota, United States

CentraCare Clinic - River Campus

🇺🇸

Saint Cloud, Minnesota, United States

St. John's Regional Medical Center

🇺🇸

Joplin, Missouri, United States

Liberty Hospital

🇺🇸

Liberty, Missouri, United States

Glacier Oncology, PLLC

🇺🇸

Kalispell, Montana, United States

Kalispell Medical Oncology at KRMC

🇺🇸

Kalispell, Montana, United States

Northern Rockies Radiation Oncology Center

🇺🇸

Billings, Montana, United States

Good Samaritan Cancer Center at Good Samaritan Hospital

🇺🇸

Kearney, Nebraska, United States

Cancer Resource Center - Lincoln

🇺🇸

Lincoln, Nebraska, United States

Dartmouth - Hitchcock Concord

🇺🇸

Concord, New Hampshire, United States

Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center

🇺🇸

Lebanon, New Hampshire, United States

Kingsbury Center for Cancer Care at Cheshire Medical Center

🇺🇸

Keene, New Hampshire, United States

Frederick R. and Betty M. Smith Cancer Treatment Center

🇺🇸

Sparta, New Jersey, United States

St. Barnabas Medical Center Cancer Center

🇺🇸

Livingston, New Jersey, United States

Cancer Institute of New Jersey at Cooper - Voorhees

🇺🇸

Voorhees, New Jersey, United States

Monter Cancer Center of the North Shore-LIJ Health System

🇺🇸

Lake Success, New York, United States

New York Methodist Hospital

🇺🇸

Brooklyn, New York, United States

Lipson Cancer and Blood Center at Rochester General Hospital

🇺🇸

Rochester, New York, United States

Mission Hospitals - Memorial Campus

🇺🇸

Asheville, North Carolina, United States

Wayne Memorial Hospital, Incorporated

🇺🇸

Goldsboro, North Carolina, United States

CCOP - MeritCare Hospital

🇺🇸

Fargo, North Dakota, United States

Wilmed Radiation Oncology Services

🇺🇸

Wilson, North Carolina, United States

Adena Regional Medical Center

🇺🇸

Chillicothe, Ohio, United States

Wood County Oncology Center

🇺🇸

Bowling Green, Ohio, United States

Aultman Cancer Center at Aultman Hospital

🇺🇸

Canton, Ohio, United States

Cleveland Clinic Taussig Cancer Center

🇺🇸

Cleveland, Ohio, United States

CCOP - Columbus

🇺🇸

Columbus, Ohio, United States

Grant Medical Center Cancer Care

🇺🇸

Columbus, Ohio, United States

Grady Memorial Hospital

🇺🇸

Delaware, Ohio, United States

Cleveland Clinic Cancer Center

🇺🇸

Independence, Ohio, United States

Lima Memorial Hospital

🇺🇸

Lima, Ohio, United States

Northwest Ohio Oncology Center

🇺🇸

Maumee, Ohio, United States

Strecker Cancer Center at Marietta Memorial Hospital

🇺🇸

Marietta, Ohio, United States

St. Charles Mercy Hospital

🇺🇸

Oregon, Ohio, United States

Toledo Clinic - Oregon

🇺🇸

Oregon, Ohio, United States

Licking Memorial Cancer Care Program at Licking Memorial Hospital

🇺🇸

Newark, Ohio, United States

North Coast Cancer Care, Incorporated

🇺🇸

Sandusky, Ohio, United States

Mercy Medical Center

🇺🇸

Springfield, Ohio, United States

Mercy Hospital of Tiffin

🇺🇸

Tiffin, Ohio, United States

Toledo Hospital

🇺🇸

Toledo, Ohio, United States

Salem Hospital Regional Cancer Care Services

🇺🇸

Salem, Oregon, United States

Alle-Kiski Medical Center

🇺🇸

Natrona Heights, Pennsylvania, United States

Dale and Frances Hughes Cancer Center at Pocono Medical Center

🇺🇸

East Stroudsburg, Pennsylvania, United States

CCOP - Upstate Carolina

🇺🇸

Spartanburg, South Carolina, United States

Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center

🇺🇸

Wilkes-Barre, Pennsylvania, United States

CCOP - Main Line Health

🇺🇸

Wynnewood, Pennsylvania, United States

Lankenau Cancer Center at Lankenau Hospital

🇺🇸

Wynnewood, Pennsylvania, United States

Medical X-Ray Center, PC

🇺🇸

Sioux Falls, South Dakota, United States

Joe Arrington Cancer Research and Treatment Center

🇺🇸

Lubbock, Texas, United States

Klabzuba Cancer Center at Harris Methodist Fort Worth Hospital

🇺🇸

Fort Worth, Texas, United States

Texas Oncology, PA at Texas Cancer Center - Sherman

🇺🇸

Sherman, Texas, United States

Huntsman Cancer Institute at University of Utah

🇺🇸

Salt Lake City, Utah, United States

Sentara Cancer Institute at Sentara Norfolk General Hospital

🇺🇸

Norfolk, Virginia, United States

St. Joseph Cancer Center

🇺🇸

Bellingham, Washington, United States

Southwest Washington Medical Center Cancer Center

🇺🇸

Vancouver, Washington, United States

St. Mary's Hospital Medical Center - Green Bay

🇺🇸

Green Bay, Wisconsin, United States

Gundersen Lutheran Center for Cancer and Blood

🇺🇸

La Crosse, Wisconsin, United States

Door County Cancer Center at Door County Memorial Hospital

🇺🇸

Sturgeon Bay, Wisconsin, United States

Community Memorial Hospital Cancer Care Center

🇺🇸

Menomonee Falls, Wisconsin, United States

Tom Baker Cancer Centre - Calgary

🇨🇦

Calgary, Alberta, Canada

Princess Margaret Hospital

🇨🇦

Toronto, Ontario, Canada

Saint Joseph Mercy Cancer Center

🇺🇸

Ann Arbor, Michigan, United States

CCOP - Michigan Cancer Research Consortium

🇺🇸

Ann Arbor, Michigan, United States

Mayo Clinic Cancer Center

🇺🇸

Rochester, Minnesota, United States

CCOP - Missouri Valley Cancer Consortium

🇺🇸

Omaha, Nebraska, United States

Methodist Estabrook Cancer Center

🇺🇸

Omaha, Nebraska, United States

Immanuel Medical Center

🇺🇸

Omaha, Nebraska, United States

Alegant Health Cancer Center at Bergan Mercy Medical Center

🇺🇸

Omaha, Nebraska, United States

Creighton University Medical Center

🇺🇸

Omaha, Nebraska, United States

Ottawa Hospital Regional Cancer Centre - General Campus

🇨🇦

Ottawa, Ontario, Canada

Medical City Dallas Hospital

🇺🇸

Dallas, Texas, United States

Radiological Associates of Sacramento Medical Group, Incorporated

🇺🇸

Sacramento, California, United States

Mercy General Hospital

🇺🇸

Sacramento, California, United States

H. Lee Moffitt Cancer Center and Research Institute at University of South Florida

🇺🇸

Tampa, Florida, United States

Yale Cancer Center

🇺🇸

New Haven, Connecticut, United States

Galesburg Cottage Hospital

🇺🇸

Galesburg, Illinois, United States

St. Joseph Medical Center

🇺🇸

Kansas City, Missouri, United States

Truman Medical Center - Hospital Hill

🇺🇸

Kansas City, Missouri, United States

Saint Luke's Cancer Institute at Saint Luke's Hospital

🇺🇸

Kansas City, Missouri, United States

North Kansas City Hospital

🇺🇸

Kansas City, Missouri, United States

Kansas City Cancer Centers - South

🇺🇸

Kansas City, Missouri, United States

Parvin Radiation Oncology

🇺🇸

Kansas City, Missouri, United States

CCOP - Kansas City

🇺🇸

Kansas City, Missouri, United States

Research Medical Center

🇺🇸

Kansas City, Missouri, United States

Hollings Cancer Center at Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

Medical Oncology and Hematology Associates at Mercy Cancer Center

🇺🇸

Des Moines, Iowa, United States

Mercy Cancer Center at Mercy Medical Center - Des Moines

🇺🇸

Des Moines, Iowa, United States

John Stoddard Cancer Center at Iowa Lutheran Hospital

🇺🇸

Des Moines, Iowa, United States

University of Wisconsin Paul P. Carbone Comprehensive Cancer Center

🇺🇸

Madison, Wisconsin, United States

Mercy Capitol Hospital

🇺🇸

Des Moines, Iowa, United States

CCOP - Iowa Oncology Research Association

🇺🇸

Des Moines, Iowa, United States

John Stoddard Cancer Center at Iowa Methodist Medical Center

🇺🇸

Des Moines, Iowa, United States

University of Florida Shands Cancer Center

🇺🇸

Gainesville, Florida, United States

Medical Oncology and Hematology Associates at John Stoddard Cancer Center

🇺🇸

Des Moines, Iowa, United States

Virginia Commonwealth University Massey Cancer Center

🇺🇸

Richmond, Virginia, United States

Mercy Regional Cancer Center at Mercy Hospital

🇺🇸

Port Huron, Michigan, United States

St. Francis Hospital

🇺🇸

Federal Way, Washington, United States

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