Armodafinil in Reducing Cancer-Related Fatigue in Patients With High Grade Glioma
- Conditions
- Fatigue
- Interventions
- Registration Number
- NCT01781468
- Lead Sponsor
- Alliance for Clinical Trials in Oncology
- Brief Summary
This randomized phase III trial studies armodafinil to see how well it works in reducing cancer-related fatigue in patients with high grade glioma. Armodafinil may help relieve fatigue in patients with high grade glioma.
- Detailed Description
Patients experiencing fatigue related to cancer will be asked to take part in this study. Cancer-related fatigue is a very common symptom in patients with cancer. Patients will receive armodafinil or placebo. Please see the "Arms" section for more details regarding the treatment assignments. The primary objective of this study is to determine preliminary efficacy measured by patient reported fatigue Brief Fatigue Inventory (BFI) at 8 weeks of two doses (150 mg and 250 mg) of armodafinil in treating moderate fatigue compared to placebo in patients with high grade glioma.
The secondary objectives of the study are listed below.
1. To evaluate the tolerability at 8 weeks of 150 mg and 250 mg armodafinil in this patient population.
2. To assess the effect of armodafinil at 8 weeks on cognitive function in patients with high grade glioma.
3. To assess the impact of armodafinil on global quality of life and other fatigue endpoints in this patient population with high grade glioma.
4. Explore the correlation between the BFI, Patient-Reported Outcomes Measurement Information System (PROMIS), and Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) measures, as well as, the relationship of fatigue and cognitive difficulties.
Patients will receive armodafinil or placebo for a total of 8 weeks.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 328
- Diagnosed with glioblastoma, gliosarcoma, small cell or large cell glioblastoma, glioblastoma with oligo features, glioblastoma with primitive neuroectodermal tumor-like components (GBM-PNET) features, anaplastic astrocytoma, anaplastic oligodendroglioma, or anaplastic oligoastrocytoma who are clinically stable and have completed radiation therapy (excluding stereotactic radiosurgery) > 21 days and =< 24 months prior to enrollment; NOTE: clinical stability will be defined as a stable or improved Karnofsky performance status (KPS) compared to the prior month
- >= 6 score on the worst fatigue question of the BFI (Brief Fatigue Inventory, question 3); it is not required for the patient to complete the entire BFI to meet this criterion
- Undergone surgery (gross total or subtotal resection) or biopsy and will have been treated with concurrent radiation therapy and chemotherapy as standard of care for glioblastoma, gliosarcoma, small cell or large cell glioblastoma, glioblastoma with oligo features, glioblastoma with primitive neuroectodermal tumor-like components (GBM-PNET) features, anaplastic astrocytoma, anaplastic oligodendroglioma, or anaplastic oligoastrocytoma patients; Note: radiation must be completed, but chemotherapy is allowed; patients who are currently using Optune device will be eligible to participate in this trial
- Negative serum pregnancy test done =< 7 days prior to registration only for women determined to be of childbearing potential by their treating physician
- Ability to complete questionnaire(s) by themselves or with assistance
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0, 1, 2 or 3
- Provide informed written consent
- Willing to return to enrolling institution for follow-up (during the Active Monitoring Phase of the study)
- Stable dose of corticosteroid >= 14 days prior to registration
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Arm III armodafinil 250 mg Patients receive 250 mg armodafinil orally every day in the morning for 8 weeks. Arm I armodafinil 150 mg Patients receive 150 mg armodafinil orally every day in the morning for 8 weeks. Arm II Placebo Patients receive placebo orally every day in the morning for 8 weeks.
- Primary Outcome Measures
Name Time Method The Number of Participants With a Response in Terms of a Clinically Meaningful Improvement in Patient-reported Fatigue at 8 Weeks. At 8 weeks A response is defined as an improvement of 2 points on the 0-10 scale of the usual fatigue on the Brief Fatigue Inventory (BFI). The number of participants with a response in terms of a clinically meaningful improvement in patient-reported fatigue at 8 weeks.
Scale: 0 (No fatigue) - 10 (As bad as you can imagine) Interpretation: higher scores mean a worse outcome
- Secondary Outcome Measures
Name Time Method Fatigue: Brief Fatigue Inventory (BFI): The Number of Participants With a Response in Terms of a Clinically Meaningful Improvement in Patient-reported Fatigue at 4 Weeks. Up to 4 weeks A response is defined as an improvement of 2 points on the 0-10 scale of the usual fatigue on the Brief Fatigue Inventory (BFI). The number of participants with a response in terms of a clinically meaningful improvement in patient-reported fatigue at 4 weeks Scale: 0 (No fatigue) - 10 (As bad as you can imagine) Interpretation: higher scores mean a worse outcome
Number of Participants Who Experienced at Least One Grade 3 or Higher Adverse Events Deemed at Least Possibly Related to Treatment Via the CTCAE Version 4.0 Up to 8 weeks The number of participants who experienced at least one grade 3 or higher adverse events deemed at least possibly related to treatment via the CTCAE version 4.0
Change in Quality of Life as Measured by Linear Analogue Self Assessment (LASA) From Baseline to End of Weeks 4 and 8 Up to 8 weeks Quality of life: Linear Analogue Self Assessment (LASA) will be analyzed comparing the total score for each treatment testing for change from baseline to four and eight weeks. Linear Analogue Self Assessment (LASA) is a 12 global QOL tool to which measures 10 subscales: overall QOL, physical well-being, fatigue, frequency and severity of pain, as well as social functioning and spiritual, emotional and mental well-being. All subscales were converted to a scale of 0-100, with higher scores indicating better QOL. Total score is the average of all 10 subscales.
Cognitive Function: Assessed by the Change in Z Score for Symbol Digit Modalities Test (SDMT) From Baseline to End of Week 8 Up to 8 weeks The participant is presented with a page headed by a key that pairs the single digits 1-9 with nine symbols. Rows below contain only symbols, the subject's task is to orally report the correct number in the spaces below. After completing the first 10 items with guidance, the subject is timed to determine how many responses can be made in 90 seconds. Range score: not applicable. Higher scores mean a better outcome. Explored domain: Sustained attention and information processing speed. Each neuropsychological measure was converted to an age-normative z score using published normative data. Impaired SDMT performance was defined as falling one standard deviation or more below the normative mean.
Trial Locations
- Locations (363)
Piedmont Hospital
🇺🇸Atlanta, Georgia, United States
Northside Hospital
🇺🇸Atlanta, Georgia, United States
John Muir Medical Center-Concord Campus
🇺🇸Concord, California, United States
NorthShore University HealthSystem-Glenbrook Hospital
🇺🇸Glenview, Illinois, United States
UT Southwestern/Simmons Cancer Center-Dallas
🇺🇸Dallas, Texas, United States
Novant Health Oncology Specialists-Statesville
🇺🇸Statesville, North Carolina, United States
Vince Lombardi Cancer Clinic - Oshkosh
🇺🇸Oshkosh, Wisconsin, United States
Northwestern University
🇺🇸Chicago, Illinois, United States
Tufts Medical Center
🇺🇸Boston, Massachusetts, United States
Riverside Methodist Hospital
🇺🇸Columbus, Ohio, United States
Radiation Oncology Centers of Nevada Central
🇺🇸Las Vegas, Nevada, United States
21st Century Oncology-Fort Apache
🇺🇸Las Vegas, Nevada, United States
21st Century Oncology
🇺🇸Las Vegas, Nevada, United States
21st Century Oncology-Vegas Tenaya
🇺🇸Las Vegas, Nevada, United States
Las Vegas Cancer Center-Medical Center
🇺🇸Las Vegas, Nevada, United States
Ann M Wierman MD LTD
🇺🇸Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada - Northwest
🇺🇸Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada-Summerlin
🇺🇸Las Vegas, Nevada, United States
OptumCare Cancer Care at Fort Apache
🇺🇸Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada - Central Valley
🇺🇸Las Vegas, Nevada, United States
University of Miami Miller School of Medicine-Sylvester Cancer Center
🇺🇸Miami, Florida, United States
Mercy Medical Center-West Lakes
🇺🇸West Des Moines, Iowa, United States
Essentia Health Cancer Center
🇺🇸Duluth, Minnesota, United States
Unity Hospital
🇺🇸Fridley, Minnesota, United States
Mills-Peninsula Medical Center
🇺🇸Burlingame, California, United States
Regional Hematology and Oncology PA
🇺🇸Newark, Delaware, United States
Saint John's Hospital - Healtheast
🇺🇸Maplewood, Minnesota, United States
Kootenai Cancer Center
🇺🇸Post Falls, Idaho, United States
Huntsman Cancer Institute/University of Utah
🇺🇸Salt Lake City, Utah, United States
Cancer Center of Kansas - Dodge City
🇺🇸Dodge City, Kansas, United States
Cancer Center of Kansas-Independence
🇺🇸Independence, Kansas, United States
Cancer Center of Kansas - Wichita
🇺🇸Wichita, Kansas, United States
Via Christi Regional Medical Center
🇺🇸Wichita, Kansas, United States
Cancer Center of Kansas - Newton
🇺🇸Newton, Kansas, United States
Cancer Center of Kansas - McPherson
🇺🇸McPherson, Kansas, United States
Hawaii Oncology Inc-Pali Momi
🇺🇸'Aiea, Hawaii, United States
Cancer Center of Kansas - Salina
🇺🇸Salina, Kansas, United States
Pali Momi Medical Center
🇺🇸'Aiea, Hawaii, United States
The Cancer Center of Hawaii-Pali Momi
🇺🇸'Aiea, Hawaii, United States
Lawrence Memorial Hospital
🇺🇸Lawrence, Kansas, United States
Cancer Center of Kansas-Manhattan
🇺🇸Manhattan, Kansas, United States
Cancer Center of Kansas - Chanute
🇺🇸Chanute, Kansas, United States
Cancer Center of Kansas - El Dorado
🇺🇸El Dorado, Kansas, United States
Cancer Center of Kansas-Kingman
🇺🇸Kingman, Kansas, United States
Cancer Center of Kansas - Fort Scott
🇺🇸Fort Scott, Kansas, United States
Associates In Womens Health
🇺🇸Wichita, Kansas, United States
Cancer Center of Kansas-Wichita Medical Arts Tower
🇺🇸Wichita, Kansas, United States
Cotton O'Neil Cancer Center / Stormont Vail Health
🇺🇸Topeka, Kansas, United States
Cancer Center of Kansas - Parsons
🇺🇸Parsons, Kansas, United States
Cancer Center of Kansas - Wellington
🇺🇸Wellington, Kansas, United States
University of Rochester
🇺🇸Rochester, New York, United States
Boston Medical Center
🇺🇸Boston, Massachusetts, United States
Mayo Clinic in Arizona
🇺🇸Scottsdale, Arizona, United States
Kaiser Permanente-Capitol Hill Medical Center
🇺🇸Washington, District of Columbia, United States
Culicchia Neurological Clinic LLC
🇺🇸Marrero, Louisiana, United States
Cancer and Blood Specialists-Shadow
🇺🇸Las Vegas, Nevada, United States
Cancer Therapy and Integrative Medicine
🇺🇸Las Vegas, Nevada, United States
Providence Alaska Medical Center
🇺🇸Anchorage, Alaska, United States
Las Vegas Cancer Center-Henderson
🇺🇸Henderson, Nevada, United States
Billings Clinic Cancer Center
🇺🇸Billings, Montana, United States
Kootenai Medical Center
🇺🇸Coeur d'Alene, Idaho, United States
Kootenai Cancer Clinic
🇺🇸Sandpoint, Idaho, United States
Greenville Health System Cancer Institute-Butternut
🇺🇸Greenville, South Carolina, United States
Avera Cancer Institute
🇺🇸Sioux Falls, South Dakota, United States
Rapid City Regional Hospital
🇺🇸Rapid City, South Dakota, United States
Alaska Women's Cancer Care
🇺🇸Anchorage, Alaska, United States
Katmai Oncology Group
🇺🇸Anchorage, Alaska, United States
CHI Health Saint Francis
🇺🇸Grand Island, Nebraska, United States
New Hampshire Oncology Hematology PA-Hooksett
🇺🇸Hooksett, New Hampshire, United States
Avera Cancer Institute-Aberdeen
🇺🇸Aberdeen, South Dakota, United States
HealthCare Partners Medical Group Oncology/Hematology-San Martin
🇺🇸Las Vegas, Nevada, United States
HealthCare Partners Medical Group Oncology/Hematology-Tenaya
🇺🇸Las Vegas, Nevada, United States
Benefis Healthcare- Sletten Cancer Institute
🇺🇸Great Falls, Montana, United States
Anchorage Oncology Centre
🇺🇸Anchorage, Alaska, United States
Thompson Cancer Survival Center
🇺🇸Knoxville, Tennessee, United States
Comprehensive Cancer Centers of Nevada - Henderson
🇺🇸Henderson, Nevada, United States
Saint Alphonsus Cancer Care Center-Boise
🇺🇸Boise, Idaho, United States
Arizona Oncology Services Foundation
🇺🇸Scottsdale, Arizona, United States
LRGHealthcare-Lakes Region General Hospital
🇺🇸Laconia, New Hampshire, United States
Radiation Oncology Centers of Nevada Southeast
🇺🇸Las Vegas, Nevada, United States
Helen F Graham Cancer Center
🇺🇸Newark, Delaware, United States
OptumCare Cancer Care at Seven Hills
🇺🇸Henderson, Nevada, United States
Greenville Health System Cancer Institute-Spartanburg
🇺🇸Spartanburg, South Carolina, United States
Greenville Health System Cancer Institute-Andrews
🇺🇸Greenville, South Carolina, United States
Greenville Health System Cancer Institute-Faris
🇺🇸Greenville, South Carolina, United States
Fairbanks Memorial Hospital
🇺🇸Fairbanks, Alaska, United States
Greenville Health System Cancer Institute-Easley
🇺🇸Easley, South Carolina, United States
Greenville Health System Cancer Institute-Eastside
🇺🇸Greenville, South Carolina, United States
Thompson Oncology Group-Oak Ridge
🇺🇸Oak Ridge, Tennessee, United States
West Virginia University Healthcare
🇺🇸Morgantown, West Virginia, United States
Dartmouth Hitchcock Medical Center
🇺🇸Lebanon, New Hampshire, United States
Mercy Hospital Springfield
🇺🇸Springfield, Missouri, United States
Central Maine Medical Center
🇺🇸Lewiston, Maine, United States
New Hampshire Oncology Hematology PA-Concord
🇺🇸Concord, New Hampshire, United States
Spartanburg Medical Center
🇺🇸Spartanburg, South Carolina, United States
Greenville Memorial Hospital
🇺🇸Greenville, South Carolina, United States
Regional Cancer Center at Indian Path Community Hospital
🇺🇸Kingsport, Tennessee, United States
Gibbs Cancer Center-Pelham
🇺🇸Greer, South Carolina, United States
Robert Wood Johnson University Hospital Somerset
🇺🇸Somerville, New Jersey, United States
Greenville Health System Cancer Institute-Seneca
🇺🇸Seneca, South Carolina, United States
Saint Joseph's Hospital and Medical Center
🇺🇸Phoenix, Arizona, United States
Arizona Oncology-Deer Valley Center
🇺🇸Phoenix, Arizona, United States
Ascension Saint John Hospital
🇺🇸Detroit, Michigan, United States
Legacy Good Samaritan Hospital and Medical Center
🇺🇸Portland, Oregon, United States
Providence Portland Medical Center
🇺🇸Portland, Oregon, United States
Providence Saint Vincent Medical Center
🇺🇸Portland, Oregon, United States
Kaiser Permanente Northwest
🇺🇸Portland, Oregon, United States
Hawaii Cancer Care Inc-POB II
🇺🇸Honolulu, Hawaii, United States
Hawaii Cancer Care Inc-Liliha
🇺🇸Honolulu, Hawaii, United States
Hawaii Oncology Inc-Kuakini
🇺🇸Honolulu, Hawaii, United States
Baptist Health Lexington
🇺🇸Lexington, Kentucky, United States
Saint Joseph Mercy Hospital
🇺🇸Ann Arbor, Michigan, United States
Mayo Clinic
🇺🇸Rochester, Minnesota, United States
Alegent Health Bergan Mercy Medical Center
🇺🇸Omaha, Nebraska, United States
Alegent Health Lakeside Hospital
🇺🇸Omaha, Nebraska, United States
Creighton University Medical Center
🇺🇸Omaha, Nebraska, United States
Novant Health Forsyth Medical Center
🇺🇸Winston-Salem, North Carolina, United States
Novant Health Oncology Specialists
🇺🇸Winston-Salem, North Carolina, United States
Aurora Saint Luke's Medical Center
🇺🇸Milwaukee, Wisconsin, United States
Froedtert and the Medical College of Wisconsin
🇺🇸Milwaukee, Wisconsin, United States
Alta Bates Summit Medical Center-Herrick Campus
🇺🇸Berkeley, California, United States
UC San Diego Moores Cancer Center
🇺🇸La Jolla, California, United States
Memorial Medical Center
🇺🇸Springfield, Illinois, United States
Community Cancer Institute
🇺🇸Clovis, California, United States
University Oncology Associates
🇺🇸Clovis, California, United States
Saint Joseph Hospital - Orange
🇺🇸Orange, California, United States
Loma Linda University Medical Center
🇺🇸Loma Linda, California, United States
UC Irvine Health/Chao Family Comprehensive Cancer Center
🇺🇸Orange, California, United States
Kaiser Permanente-Vallejo
🇺🇸Vallejo, California, United States
Kaiser Permanente Medical Center - Santa Clara
🇺🇸Santa Clara, California, United States
SCL Health Lutheran Medical Center
🇺🇸Wheat Ridge, Colorado, United States
Boca Raton Regional Hospital
🇺🇸Boca Raton, Florida, United States
Florida Hospital Memorial Medical Center
🇺🇸Daytona Beach, Florida, United States
Lakeland Regional Health Hollis Cancer Center
🇺🇸Lakeland, Florida, United States
Sacred Heart Hospital
🇺🇸Pensacola, Florida, United States
Northeast Georgia Medical Center-Gainesville
🇺🇸Gainesville, Georgia, United States
Augusta University Medical Center
🇺🇸Augusta, Georgia, United States
Illinois CancerCare-Bloomington
🇺🇸Bloomington, Illinois, United States
Illinois CancerCare-Carthage
🇺🇸Carthage, Illinois, United States
Carle on Vermilion
🇺🇸Danville, Illinois, United States
Carle Physician Group-Effingham
🇺🇸Effingham, Illinois, United States
Centralia Oncology Clinic
🇺🇸Centralia, Illinois, United States
Cancer Care Specialists of Illinois - Decatur
🇺🇸Decatur, Illinois, United States
Decatur Memorial Hospital
🇺🇸Decatur, Illinois, United States
Crossroads Cancer Center
🇺🇸Effingham, Illinois, United States
Illinois CancerCare-Eureka
🇺🇸Eureka, Illinois, United States
Illinois CancerCare-Kewanee Clinic
🇺🇸Kewanee, Illinois, United States
NorthShore University HealthSystem-Highland Park Hospital
🇺🇸Highland Park, Illinois, United States
NorthShore University HealthSystem-Evanston Hospital
🇺🇸Evanston, Illinois, United States
Illinois CancerCare-Galesburg
🇺🇸Galesburg, Illinois, United States
Carle Physician Group-Mattoon/Charleston
🇺🇸Mattoon, Illinois, United States
Good Samaritan Regional Health Center
🇺🇸Mount Vernon, Illinois, United States
Trinity Medical Center
🇺🇸Moline, Illinois, United States
Illinois CancerCare-Macomb
🇺🇸Macomb, Illinois, United States
OSF Saint Francis Medical Center
🇺🇸Peoria, Illinois, United States
Illinois CancerCare-Ottawa Clinic
🇺🇸Ottawa, Illinois, United States
Illinois CancerCare-Pekin
🇺🇸Pekin, Illinois, United States
Illinois CancerCare-Peoria
🇺🇸Peoria, Illinois, United States
Methodist Medical Center of Illinois
🇺🇸Peoria, Illinois, United States
Illinois CancerCare-Peru
🇺🇸Peru, Illinois, United States
Southern Illinois University School of Medicine
🇺🇸Springfield, Illinois, United States
Illinois CancerCare-Princeton
🇺🇸Princeton, Illinois, United States
Springfield Clinic
🇺🇸Springfield, Illinois, United States
The Carle Foundation Hospital
🇺🇸Urbana, Illinois, United States
Northwestern Medicine Cancer Center Warrenville
🇺🇸Warrenville, Illinois, United States
Michiana Hematology Oncology PC-Crown Point
🇺🇸Crown Point, Indiana, United States
Elkhart Clinic
🇺🇸Elkhart, Indiana, United States
Community Howard Regional Health
🇺🇸Kokomo, Indiana, United States
Michiana Hematology Oncology PC-Elkhart
🇺🇸Elkhart, Indiana, United States
Michiana Hematology Oncology PC-Mishawaka
🇺🇸Mishawaka, Indiana, United States
Michiana Hematology Oncology PC-Plymouth
🇺🇸Plymouth, Indiana, United States
Memorial Regional Cancer Center Day Road
🇺🇸Mishawaka, Indiana, United States
Saint Joseph Regional Medical Center-Mishawaka
🇺🇸Mishawaka, Indiana, United States
IU Health La Porte Hospital
🇺🇸La Porte, Indiana, United States
Memorial Hospital of South Bend
🇺🇸South Bend, Indiana, United States
Michiana Hematology Oncology PC-Westville
🇺🇸Westville, Indiana, United States
Mary Greeley Medical Center
🇺🇸Ames, Iowa, United States
McFarland Clinic PC - Ames
🇺🇸Ames, Iowa, United States
Mercy Hospital
🇺🇸Coon Rapids, Minnesota, United States
Oncology Associates at Mercy Medical Center
🇺🇸Cedar Rapids, Iowa, United States
Medical Oncology and Hematology Associates-West Des Moines
🇺🇸Clive, Iowa, United States
Mercy Cancer Center-West Lakes
🇺🇸Clive, Iowa, United States
Greater Regional Medical Center
🇺🇸Creston, Iowa, United States
Mercy Medical Center - North Iowa
🇺🇸Mason City, Iowa, United States
Cancer Center of Kansas-Liberal
🇺🇸Liberal, Kansas, United States
Cancer Center of Kansas - Pratt
🇺🇸Pratt, Kansas, United States
Cancer Center of Kansas - Winfield
🇺🇸Winfield, Kansas, United States
Baptist Health Corbin
🇺🇸Corbin, Kentucky, United States
Baptist Health Paducah
🇺🇸Paducah, Kentucky, United States
Baptist Health Madisonville/Merle Mahr Cancer Center
🇺🇸Madisonville, Kentucky, United States
Kaiser Permanente-Gaithersburg Medical Center
🇺🇸Gaithersburg, Maryland, United States
West Jefferson Medical Center
🇺🇸Marrero, Louisiana, United States
Unspecified Site
🇺🇸Rockville, Maryland, United States
Kaiser Permanente - Largo Medical Center
🇺🇸Largo, Maryland, United States
Bronson Battle Creek
🇺🇸Battle Creek, Michigan, United States
Caro Cancer Center
🇺🇸Caro, Michigan, United States
Genesee Cancer and Blood Disease Treatment Center
🇺🇸Flint, Michigan, United States
Genesee Hematology Oncology PC
🇺🇸Flint, Michigan, United States
Cancer Research Consortium of West Michigan NCORP
🇺🇸Grand Rapids, Michigan, United States
Mercy Health Saint Mary's
🇺🇸Grand Rapids, Michigan, United States
Spectrum Health at Butterworth Campus
🇺🇸Grand Rapids, Michigan, United States
West Michigan Cancer Center
🇺🇸Kalamazoo, Michigan, United States
Saint Mary's Oncology/Hematology Associates of Marlette
🇺🇸Marlette, Michigan, United States
UP Health System Hematology Oncology Marquette
🇺🇸Marquette, Michigan, United States
Oncology Hematology Associates of Saginaw Valley PC
🇺🇸Saginaw, Michigan, United States
Lakeland Medical Center Saint Joseph
🇺🇸Saint Joseph, Michigan, United States
Ascension Saint Mary's Hospital
🇺🇸Saginaw, Michigan, United States
UP Health System Marquette
🇺🇸Marquette, Michigan, United States
William Beaumont Hospital-Royal Oak
🇺🇸Royal Oak, Michigan, United States
Marie Yeager Cancer Center
🇺🇸Saint Joseph, Michigan, United States
Saint John Macomb-Oakland Hospital
🇺🇸Warren, Michigan, United States
Metro Health Hospital
🇺🇸Wyoming, Michigan, United States
Saint Mary's Oncology/Hematology Associates of West Branch
🇺🇸West Branch, Michigan, United States
Fairview-Southdale Hospital
🇺🇸Edina, Minnesota, United States
Fairview Ridges Hospital
🇺🇸Burnsville, Minnesota, United States
Minnesota Oncology Hematology PA-Maplewood
🇺🇸Maplewood, Minnesota, United States
Hennepin County Medical Center
🇺🇸Minneapolis, Minnesota, United States
Abbott-Northwestern Hospital
🇺🇸Minneapolis, Minnesota, United States
Health Partners Inc
🇺🇸Minneapolis, Minnesota, United States
Monticello Cancer Center
🇺🇸Monticello, Minnesota, United States
Park Nicollet Clinic - Saint Louis Park
🇺🇸Saint Louis Park, Minnesota, United States
Central Care Cancer Center - Bolivar
🇺🇸Bolivar, Missouri, United States
Minnesota Oncology Hematology PA-Woodbury
🇺🇸Woodbury, Minnesota, United States
Mercy Hospital Saint Louis
🇺🇸Saint Louis, Missouri, United States
United Hospital
🇺🇸Saint Paul, Minnesota, United States
Saint Luke's Hospital
🇺🇸Chesterfield, Missouri, United States
University of Missouri - Ellis Fischel
🇺🇸Columbia, Missouri, United States
Freeman Health System
🇺🇸Joplin, Missouri, United States
Heartland Regional Medical Center
🇺🇸Saint Joseph, Missouri, United States
CHI Health Good Samaritan
🇺🇸Kearney, Nebraska, United States
Nebraska Cancer Research Center
🇺🇸Lincoln, Nebraska, United States
Cancer and Blood Specialists-Henderson
🇺🇸Henderson, Nevada, United States
Comprehensive Cancer Centers of Nevada-Southeast Henderson
🇺🇸Henderson, Nevada, United States
21st Century Oncology-Henderson
🇺🇸Henderson, Nevada, United States
HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
🇺🇸Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada
🇺🇸Las Vegas, Nevada, United States
Highland Hospital
🇺🇸Rochester, New York, United States
Hematology Oncology Associates of Central New York-East Syracuse
🇺🇸East Syracuse, New York, United States
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
🇺🇸New York, New York, United States
Memorial Sloan Kettering Cancer Center
🇺🇸New York, New York, United States
University Radiation Oncology
🇺🇸Rochester, New York, United States
Mission Hospital Inc-Memorial Campus
🇺🇸Asheville, North Carolina, United States
Novant Health Presbyterian Medical Center
🇺🇸Charlotte, North Carolina, United States
Southeastern Medical Oncology Center-Goldsboro
🇺🇸Goldsboro, North Carolina, United States
Southeastern Medical Oncology Center-Clinton
🇺🇸Clinton, North Carolina, United States
Wayne Memorial Hospital
🇺🇸Goldsboro, North Carolina, United States
AdventHealth Hendersonville
🇺🇸Hendersonville, North Carolina, United States
Southeastern Medical Oncology Center-Jacksonville
🇺🇸Jacksonville, North Carolina, United States
Novant Health Oncology Specialists-Kernersville
🇺🇸Kernersville, North Carolina, United States
Novant Health Oncology Specialists-Mount Airy
🇺🇸Mount Airy, North Carolina, United States
Vidant Oncology-Kinston
🇺🇸Kinston, North Carolina, United States
Novant Health Oncology Specialists-Davidson County
🇺🇸Thomasville, North Carolina, United States
Novant Health Oncology Specialists-Wilkesboro
🇺🇸Wilkesboro, North Carolina, United States
Southeastern Medical Oncology Center-Wilson
🇺🇸Wilson, North Carolina, United States
Altru Cancer Center
🇺🇸Grand Forks, North Dakota, United States
Cleveland Clinic Akron General
🇺🇸Akron, Ohio, United States
Saint Charles Hospital
🇺🇸Oregon, Ohio, United States
ProMedica Flower Hospital
🇺🇸Sylvania, Ohio, United States
Mercy Cancer Center-Elyria
🇺🇸Elyria, Ohio, United States
Toledo Clinic Cancer Centers-Maumee
🇺🇸Maumee, Ohio, United States
Mercy Health Perrysburg Cancer Center
🇺🇸Perrysburg, Ohio, United States
University of Toledo
🇺🇸Toledo, Ohio, United States
Toledo Clinic Cancer Centers-Toledo
🇺🇸Toledo, Ohio, United States
University of Oklahoma Health Sciences Center
🇺🇸Oklahoma City, Oklahoma, United States
Mercy Saint Anne Hospital
🇺🇸Toledo, Ohio, United States
Saint Charles Health System
🇺🇸Bend, Oregon, United States
Saint John Medical Center
🇺🇸Tulsa, Oklahoma, United States
Clackamas Radiation Oncology Center
🇺🇸Clackamas, Oregon, United States
Legacy Mount Hood Medical Center
🇺🇸Gresham, Oregon, United States
Providence Newberg Medical Center
🇺🇸Newberg, Oregon, United States
Providence Willamette Falls Medical Center
🇺🇸Oregon City, Oregon, United States
Legacy Meridian Park Hospital
🇺🇸Tualatin, Oregon, United States
Lehigh Valley Hospital-Cedar Crest
🇺🇸Allentown, Pennsylvania, United States
Lehigh Valley Hospital - Muhlenberg
🇺🇸Bethlehem, Pennsylvania, United States
Geisinger Medical Center
🇺🇸Danville, Pennsylvania, United States
Adams Cancer Center
🇺🇸Gettysburg, Pennsylvania, United States
Cherry Tree Cancer Center
🇺🇸Hanover, Pennsylvania, United States
AnMed Health Cancer Center
🇺🇸Anderson, South Carolina, United States
Geisinger Wyoming Valley/Henry Cancer Center
🇺🇸Wilkes-Barre, Pennsylvania, United States
WellSpan Health-York Hospital
🇺🇸York, Pennsylvania, United States
Gibbs Cancer Center-Gaffney
🇺🇸Gaffney, South Carolina, United States
Greenville Health System Cancer Institute-Greer
🇺🇸Greer, South Carolina, United States
Thompson Oncology Group-Lenoir City
🇺🇸Lenoir City, Tennessee, United States
University of Texas Health Science Center at San Antonio
🇺🇸San Antonio, Texas, United States
Harrison HealthPartners Hematology and Oncology-Bremerton
🇺🇸Bremerton, Washington, United States
Highline Medical Center-Main Campus
🇺🇸Burien, Washington, United States
Providence Regional Cancer System-Centralia
🇺🇸Centralia, Washington, United States
Kaiser Permanente Tysons Corner Medical Center
🇺🇸McLean, Virginia, United States
Southwest VA Regional Cancer Center
🇺🇸Norton, Virginia, United States
MultiCare Auburn Medical Center
🇺🇸Auburn, Washington, United States
PeaceHealth Saint Joseph Medical Center
🇺🇸Bellingham, Washington, United States
Providence Regional Cancer System-Aberdeen
🇺🇸Aberdeen, Washington, United States
MultiCare Gig Harbor Medical Park
🇺🇸Gig Harbor, Washington, United States
Providence Regional Cancer System-Lacey
🇺🇸Lacey, Washington, United States
MultiCare Good Samaritan Hospital
🇺🇸Puyallup, Washington, United States
PeaceHealth Saint John Medical Center
🇺🇸Longview, Washington, United States
Jefferson Healthcare
🇺🇸Port Townsend, Washington, United States
Swedish Medical Center-Cherry Hill
🇺🇸Seattle, Washington, United States
Northwest NCI Community Oncology Research Program
🇺🇸Tacoma, Washington, United States
Providence Regional Cancer System-Shelton
🇺🇸Shelton, Washington, United States
PeaceHealth Southwest Medical Center
🇺🇸Vancouver, Washington, United States
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
🇺🇸Yakima, Washington, United States
Legacy Salmon Creek Hospital
🇺🇸Vancouver, Washington, United States
Providence Regional Cancer System-Yelm
🇺🇸Yelm, Washington, United States
Aurora Health Center-Fond du Lac
🇺🇸Fond Du Lac, Wisconsin, United States
Green Bay Oncology at Saint Vincent Hospital
🇺🇸Green Bay, 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
Aurora BayCare Medical Center
🇺🇸Green Bay, Wisconsin, United States
Holy Family Memorial Hospital
🇺🇸Manitowoc, Wisconsin, United States
Marshfield Medical Center-Marshfield
🇺🇸Marshfield, Wisconsin, United States
Marshfield Clinic-Minocqua Center
🇺🇸Minocqua, Wisconsin, United States
ProHealth D N Greenwald Center
🇺🇸Mukwonago, Wisconsin, United States
ProHealth Oconomowoc Memorial Hospital
🇺🇸Oconomowoc, Wisconsin, United States
Marshfield Medical Center-Rice Lake
🇺🇸Rice Lake, Wisconsin, United States
Marshfield Clinic Stevens Point Center
🇺🇸Stevens Point, Wisconsin, United States
Marshfield Clinic - Weston Center
🇺🇸Weston, Wisconsin, United States
HSHS Saint Nicholas Hospital
🇺🇸Sheboygan, Wisconsin, United States
Billings Clinic-Cody
🇺🇸Cody, Wyoming, United States
Michiana Hematology Oncology PC-South Bend
🇺🇸South Bend, Indiana, United States
Alaska Breast Care and Surgery LLC
🇺🇸Anchorage, Alaska, United States
Penrose-Saint Francis Healthcare
🇺🇸Colorado Springs, Colorado, United States
Rocky Mountain Cancer Centers-Penrose
🇺🇸Colorado Springs, Colorado, United States
Medical Oncology Hematology Consultants PA
🇺🇸Newark, Delaware, United States
Christiana Care Health System-Christiana Hospital
🇺🇸Newark, Delaware, United States
Green Bay Oncology Limited at Saint Mary's Hospital
🇺🇸Green Bay, Wisconsin, United States
Illinois CancerCare-Canton
🇺🇸Canton, Illinois, United States
Providence Saint Joseph Medical Center/Disney Family Cancer Center
🇺🇸Burbank, California, United States
Elkhart General Hospital
🇺🇸Elkhart, Indiana, United States
Hurley Medical Center
🇺🇸Flint, Michigan, United States
North Memorial Medical Health Center
🇺🇸Robbinsdale, Minnesota, United States
UW Cancer Center at ProHealth Care
🇺🇸Waukesha, Wisconsin, United States
Siouxland Regional Cancer Center
🇺🇸Sioux City, Iowa, United States
Genesys Hurley Cancer Institute
🇺🇸Flint, Michigan, United States
Ascension Providence Hospitals - Southfield
🇺🇸Southfield, Michigan, United States
ProHealth Waukesha Memorial Hospital
🇺🇸Waukesha, Wisconsin, United States
The NeuroMedical Center-Clinic
🇺🇸Baton Rouge, Louisiana, United States
Thompson Cancer Survival Center - West
🇺🇸Knoxville, Tennessee, United States
Washington University School of Medicine
🇺🇸Saint Louis, Missouri, United States
Carle Cancer Center
🇺🇸Urbana, Illinois, United States
Regions Hospital
🇺🇸Saint Paul, Minnesota, United States
Saint Patrick Hospital - Community Hospital
🇺🇸Missoula, Montana, United States
Florida Hospital Orlando
🇺🇸Orlando, Florida, United States
Baptist Health Louisville
🇺🇸Louisville, Kentucky, United States
Saint Luke's Hospital of Kansas City
🇺🇸Kansas City, Missouri, United States
Louisiana State University Health Science Center
🇺🇸New Orleans, Louisiana, United States
Dell Seton Medical Center at The University of Texas
🇺🇸Austin, Texas, United States
Austin Cancer Centers-Central Austin
🇺🇸Austin, Texas, United States
Austin Cancer Centers-North
🇺🇸Austin, Texas, United States
Queen's Medical Center
🇺🇸Honolulu, Hawaii, United States
Straub Clinic and Hospital
🇺🇸Honolulu, Hawaii, United States
University of Hawaii Cancer Center
🇺🇸Honolulu, Hawaii, United States
The Cancer Center of Hawaii-Liliha
🇺🇸Honolulu, Hawaii, United States
Medical Oncology and Hematology Associates-Laurel
🇺🇸Des Moines, Iowa, United States
Mercy Medical Center - Des Moines
🇺🇸Des Moines, Iowa, United States
University of Kentucky/Markey Cancer Center
🇺🇸Lexington, Kentucky, United States
Montefiore Medical Center-Einstein Campus
🇺🇸Bronx, New York, United States
Montefiore Medical Center - Moses Campus
🇺🇸Bronx, New York, United States
University of Wisconsin Hospital and Clinics
🇺🇸Madison, Wisconsin, United States
Carolinas Medical Center/Levine Cancer Institute
🇺🇸Charlotte, North Carolina, United States
MultiCare Tacoma General Hospital
🇺🇸Tacoma, Washington, United States
William Beaumont Hospital - Troy
🇺🇸Troy, Michigan, United States