National Cancer Institute "Cancer Moonshot Biobank"

Recruiting

• Conditions: Acute Myeloid Leukemia; Anatomic Stage III Breast Cancer AJCC v8; Anatomic Stage IV Breast Cancer AJCC v8; Clinical Stage IV Esophageal Adenocarcinoma AJCC v8; Clinical Stage IV Gastric Cancer AJCC v8; Clinical Stage IV Gastroesophageal Junction Adenocarcinoma AJCC v8; Invasive Breast Carcinoma; Lung Small Cell Carcinoma; Primary Peritoneal Carcinoma; Stage III Fallopian Tube Cancer AJCC v8
• Interventions: Procedure: Biospecimen Collection; Other: Medical Chart Review

• Registration Number: NCT04314401
• Lead Sponsor: National Cancer Institute (NCI)

Brief Summary

This trial collects multiple tissue and blood samples, along with medical information, from cancer patients. The "Cancer Moonshot Biobank" is a longitudinal study. This means it collects and stores samples and information over time, throughout the course of a patient's cancer treatment. By looking at samples and information collected from the same people over time, researchers hope to better understand how cancer changes over time and over the course of medical treatments.

Detailed Description

PRIMARY OBJECTIVE:

I. To support current and future investigations into drug resistance and sensitivity and other National Cancer Institute (NCI)-sponsored cancer research initiatives through the procurement and distribution of multiple longitudinal biospecimens and associated data from a diverse group of cancer patients who are undergoing standard of care treatment at NCI Community Oncology Research Program (NCORP) sites and other National Clinical Trials Network (NCTN) sites.

SECONDARY OBJECTIVES:

I. To provide a service of value to study participants and their medical providers through the performance of molecular profiling assays on tumor samples in a Clinical Laboratory Improvement Act (CLIA)-certified laboratory and reporting of results to physicians and patients that they may opt to use in clinical management, including analysis of data for acquired resistance mechanisms.

II. To enable the development of patient-derived models such as cell lines and xenografts for cancer researchers through the provision of biospecimens from up to 20% of study participants to the NCI's Patient Derived Models Repository (PDMR), a national resource available to investigators.

III. To develop and implement robust approaches in patient and provider engagement to improve understanding of biobanking and its relationship to cancer research and increase representation of minority and underserved study participants in cancer research.

IV. To develop increased capabilities in United States (U.S.) community hospitals and clinics for contribution to cancer research through biobanking activities.

V. To enable secondary research generated from the project through deposition of data in public repositories such as Cancer Research Data Commons (CRDC), The Cancer Imaging Archive (TCIA) and database of Genotypes and Phenotypes (dbGAP), including clinical, radiology and pathology data with an emphasis on treatment response and outcome data.

VI. To provide residual biospecimens and associated data from the project to the cancer research community.

OUTLINE:

Patients undergo collection of tissue samples during baseline and at time of disease progression and collection of blood samples throughout the study, including at time of disease progression. Patients with hematological malignancies also undergo collection of bone marrow and cerebral spinal fluid at the same time points. Archival blood and tissue, as well as bone marrow of patients with hematological malignancies, is also collected if available. Additionally, patients may undergo computed tomography (CT), positron emission tomography (PET)/CT and/or magnetic resonance imaging (MRI) throughout the study, and may undergo paracentesis on study. Patient medical records are reviewed, and data is collected for at least 5 years.

Study Timeline

• Study First Submitted: 2020-03-18
• Study First Submitted QC: 2020-03-18
• Study First Posted: 2020-03-19
• Study Start: 2020-11-11
• Status Verified: 2025-05
• Last Update Submitted: 2025-05-21
• Last Update Posted: 2025-05-22
• Primary Completion: 2025-09-16
• Study Completion: 2025-09-16

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 1000

Inclusion Criteria

• Is consistent with OR has been diagnosed with one of the following:

  • Colorectal cancer: stage IV

  • Non-small cell or small cell lung cancer: stage III/IV

  • Prostate cancer: metastatic prostate cancer

  • Gastric cancer, not otherwise specified (NOS): stage IV

  • Esophageal cancer, NOS: stage IV

  • Adenocarcinoma of gastroesophageal junction: stage IV

  • High grade serous ovarian cancer: stage III/IV

  • Invasive breast carcinoma: stage III/IV

  • Melanoma: stage III/IV

  • Acute myeloid leukemia

  • Multiple myeloma

    • For the purposes of this study,

      • Re-staging is allowed
      • Having more than one primary cancer is allowed, if the patient is being treated solely for one of the eligible cancers listed above

• Patient should fit in one of the following four clinical scenarios (a-d)

  • Undergoing diagnostic workup for one of the diseases listed for which treatment will likely include a new regimen of standard of care therapy OR
  • Scheduled to begin treatment with a new regimen of standard of care therapy OR
  • Currently progressing on a regimen of standard of care therapy OR
  • Currently being treated with a regimen standard of care therapy, without evidence of progression

• Requirements for fresh tissue biospecimen collections at enrollment:

  • For clinical scenarios a, b, and c above, freshly collected tumor tissue or bone marrow (BM) aspirate must be submitted at enrollment

    • For clinical scenarios a and b, the fresh tissue collection must be prior to starting therapy

    • For clinical scenario a, the biospecimen collection must be part of a standard of care medical procedure

    • For clinical scenarios b or c, the biospecimen collection may be part of a standard of care medical procedure OR

    • The biospecimen collection may be part of a study-specific procedure ("research only biopsy"), when the patient has a tumor amenable to image guided or direct vision biopsy and is willing and able to undergo a tumor biopsy for molecular profiling

      • Note: For research-only biopsies, the biopsy must not be associated with a significant risk of severe or major complications or death; the procedure cannot be a mediastinal, laparoscopic, open or endoscopic biopsy; nor can the procedure be a brain biopsy; nor can the patient be under the age of majority as determined by each U.S. state

• Requirements for archival tissue:

  • For clinical scenarios a and b above, archival tissue as outlined below must be submitted IF AVAILABLE

  • For clinical scenarios c and d above, archival tissue as outlined below is REQUIRED

  • Pre-existing archival material (formalin-fixed, paraffin-embedded [FFPE] block, BM aspirate, or unstained slides) that:

    • Contains the cancer type for which the participant is enrolled, and
    • Was collected no more than 5 years prior to initiation of therapy, and
    • Contains at least a surface area of 5 mm^2 and optimal surface area of 25 mm^2 or 3-5 mL cryopreserved bone marrow aspirate to yield 200 million bone marrow mononuclear cells, and
    • Contains at least 10% tumor content. 70% tumor content is optimal, and
    • No more than 1 line of standard of care systemic therapy was administered from the date of archival material collection to the date of initiation of therapy

• Requirements for blood collection: ALL scenarios require fresh blood collection at enrollment

  • Blood collection for clinical scenarios a, b, and c must take place within 1 week of fresh tumor specimen collection
  • Blood collection for clinical scenario d must take place within 4 weeks of enrollment, and while patient is on treatment

• Age 13 or older

• Any sex

• Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0, 1, or 2

• Ability to understand and willingness to sign an informed consent document. Consent may be provided by a Legally Authorized Representative (LAR) in accordance with 45 CFR 46.102(i)

• NCI PDMR INCLUSION CRITERIA: Patients with CRC with mismatch repair deficient (dMMR) or microsatellite instability-high (MSI-H) status

• NCI PDMR INCLUSION CRITERIA: Patients with CRC who are 40 years old or younger at time of collection irrespective of mismatch repair deficient (dMMR) or microsatellite instability-high (MSI-H) status

• NCI PDMR INCLUSION CRITERIA: Patients with BRCA that are either

  • Any race/ethnicity with hormone receptor positive (ER+PR+, ER+PR-, or ER-PR+)
  • African American with triple negative (ER-PR-HER2-)

• NCI PDMR INCLUSION CRITERIA: Patients with lung cancer (LCA), prostate cancer (PCA), gastroesophageal cancer (GEC), ovarian cancer (OV), acute myeloid leukemia (AML), multiple myeloma (MML)

Exclusion Criteria

• Treated with or has already begun treatment with a non-standard of care therapeutic agent (investigational) in an interventional clinical trial

  • For the purposes of this study, past enrollment in clinical trials whereby the patient was randomized and treated with standard-of-care anti-cancer treatment (chemotherapy regimen, surgery and radiation therapy) is allowed

• Uncontrolled intercurrent illness that in the physician's assessment would pose undue risk for biopsy

• Use of full dose coumarin-derivative anticoagulants such as warfarin are prohibited. Patients may be switched to low molecular weight (LMW) heparin at physician discretion

  • Low molecular weight (LMW) heparin is permitted for prophylactic or therapeutic use

  • Factor X inhibitors are permitted

  • Use of anti-platelet drugs are permitted

    • Stopping the anticoagulation treatment for biopsy, bone marrow aspirate, or resection should be per site standard operating procedure (SOP)

• NCI PDMR EXCLUSION CRITERIA: Patients with complete response

• NCI PDMR EXCLUSION CRITERIA: Patients with invasive fungal infections

• NCI PDMR EXCLUSION CRITERIA: Patients with active and/or uncontrolled infections or who are still recovering from an infection

  • Actively febrile patients with uncertain etiology of febrile episode
  • All antibiotics for non-prophylactic treatment of infection should be completed at least 1 week (7 days) prior to collection
  • No recurrence of fever or other symptoms related to infection for at least 1 week (7 days) following completion of antibiotics

• NCI PDMR EXCLUSION CRITERIA: Patients with human immunodeficiency virus (HIV), active or chronic hepatitis (i.e. quantifiable hepatitis B virus [HBV]-deoxyribonucleic acid [DNA] and/or positive hepatitis B surface antigen [HbsAg], quantifiable hepatitis C virus [HCV]-ribonucleic acid [RNA]) or known history of HBV/HCV without documented resolution

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Ancillary-correlative (biospecimen collection, chart review)	Biospecimen Collection	Patients undergo collection of tissue and blood samples prior to initiation of treatment, during treatment, post treatment and at disease progression. Patients with hematological malignancies also undergo collection of bone marrow and cerebral spinal fluid at the same time points. Archival blood and tissue, as well as bone marrow of patients with hematological malignancies, is also collected, if available. Patient medical records are reviewed, and data is collected for at least 5 years.
Ancillary-correlative (biospecimen collection, chart review)	Medical Chart Review	Patients undergo collection of tissue and blood samples prior to initiation of treatment, during treatment, post treatment and at disease progression. Patients with hematological malignancies also undergo collection of bone marrow and cerebral spinal fluid at the same time points. Archival blood and tissue, as well as bone marrow of patients with hematological malignancies, is also collected, if available. Patient medical records are reviewed, and data is collected for at least 5 years.

Primary Outcome Measures

Name	Time	Method
Procure, store and distribute longitudinal biospecimens and associated clinical data	Up to 10 years	Will procure, store and distribute longitudinal biospecimens and associated clinical data for current and future cancer research in order to elucidate molecular mechanisms of sensitivity and intrinsic or acquired resistance to standard of care systemic therapies, including immunotherapy. Cases will be grouped according to patient demographics, cancer type and treatment regimen. Statistical analysis will be descriptive and will be analyzed for each Biospecimen Source Site (BSS) as well as study aggregate.
Percentage of enrolled patients by cancer type and treatment regimen overall	Until completion of biospecimen collection, up to 3 years	Will assess the percentage of enrolled patients by cancer type and treatment regimen overall and those who contribute samples to the Drug Resistance and Sensitivity Network and other approved investigators. Statistical analysis will be descriptive and will be analyzed for each BSS as well as study aggregate.
Percentage of minority and underserved study participants accrued	Until completion of biospecimen collection, up to 3 years	Statistical analysis will be descriptive and will be analyzed for each BSS as well as study aggregate.

Secondary Outcome Measures

Name	Time	Method
Pan-cancer gene panel tumor next generation sequencing test	Until completion of biospecimen collection, up to 3 years	Statistical analysis will be descriptive and will be analyzed for each BSS as well as study aggregate.
Percentage of enrolled patients for whom molecular profiling is attempted	Until completion of biospecimen collection, up to 3 years	Statistical analysis will be descriptive and will be analyzed for each BSS as well as study aggregate. Will also be assessed by patient demographics, cancer type and treatment regimen.
Percentage of enrolled patients for whom molecular profiling results are generated	Until completion of biospecimen collection, up to 3 years	Statistical analysis will be descriptive and will be analyzed for each BSS as well as study aggregate. Will also be assessed by patient demographics, cancer type and treatment regimen.
Cancer Research Data Commons, The Cancer Imaging Archive and database of Genotypes and Phenotypes data contribution	Until completion of biospecimen collection, up to 3 years	Statistical analysis will be descriptive and will be analyzed for each BSS as well as study aggregate.
Percentage of minority and underserved study participants accrued	Until completion of biospecimen collection, up to 3 years	Statistical analysis will be descriptive and will be analyzed for each BSS as well as study aggregate.
Percentage of enrolled patients for whom samples are obtained at each longitudinal timepoint	Until completion of biospecimen collection, up to 3 years	Statistical analysis will be descriptive and will be analyzed for each BSS as well as study aggregate. Will also be assessed by patient demographics, cancer type and treatment regimen.
Percentage of collected biospecimens that are delivered to the Patient Derived Models Repository	Until completion of biospecimen collection, up to 3 years	Statistical analysis will be descriptive and will be analyzed for each BSS as well as study aggregate. Will also be assessed by patient demographics, cancer type and treatment regimen.

Trial Locations

Locations (150)

Gulf Health Hospitals Inc/Infirmary Cancer Care - Malbis; 🇺🇸 Daphne, Alabama, United States

Thomas Hospital; 🇺🇸 Fairhope, Alabama, United States

Mobile Infirmary Medical Center; 🇺🇸 Mobile, Alabama, United States

Gulf Health Hospitals Inc/Infirmary Cancer Care - Saraland; 🇺🇸 Saraland, Alabama, United States

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

Mercy Hospital Fort Smith; 🇺🇸 Fort Smith, Arkansas, United States

PCR Oncology; 🇺🇸 Arroyo Grande, California, United States

AIS Cancer Center at San Joaquin Community Hospital; 🇺🇸 Bakersfield, California, United States

Veterans Affairs Loma Linda Healthcare System; 🇺🇸 Loma Linda, California, United States

Salinas Valley Memorial; 🇺🇸 Salinas, California, United States

Intermountain Health Platte Valley Hospital; 🇺🇸 Brighton, Colorado, United States

Saint Joseph Hospital - Cancer Centers of Colorado; 🇺🇸 Denver, Colorado, United States

Lutheran Hospital - Cancer Centers of Colorado; 🇺🇸 Golden, Colorado, United States

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

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

Hartford Hospital; 🇺🇸 Hartford, Connecticut, United States

Bayhealth Hospital Kent Campus; 🇺🇸 Dover, Delaware, United States

Bayhealth Hospital Sussex Campus; 🇺🇸 Milford, Delaware, United States

Boca Raton Regional Hospital; 🇺🇸 Boca Raton, Florida, United States

Broward Health North; 🇺🇸 Deerfield Beach, Florida, United States

Broward Health Medical Center; 🇺🇸 Fort Lauderdale, Florida, United States

Tampa General Hospital; 🇺🇸 Tampa, Florida, United States

Northside Hospital; 🇺🇸 Atlanta, Georgia, United States

Lewis Cancer and Research Pavilion at Saint Joseph's/Candler; 🇺🇸 Savannah, Georgia, United States

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

John H Stroger Jr Hospital of Cook County; 🇺🇸 Chicago, Illinois, United States

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

Carle at The Riverfront; 🇺🇸 Danville, Illinois, United States

Cancer Care Specialists of Illinois - Decatur; 🇺🇸 Decatur, Illinois, United States

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

NorthShore University HealthSystem-Evanston Hospital; 🇺🇸 Evanston, Illinois, United States

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

NorthShore University HealthSystem-Glenbrook Hospital; 🇺🇸 Glenview, Illinois, United States

NorthShore University HealthSystem-Highland Park Hospital; 🇺🇸 Highland Park, Illinois, United States

Carle Physician Group-Mattoon/Charleston; 🇺🇸 Mattoon, Illinois, United States

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

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

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

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

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

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

University of Iowa Healthcare Cancer Services Quad Cities; 🇺🇸 Bettendorf, Iowa, United States

Physicians' Clinic of Iowa PC; 🇺🇸 Cedar Rapids, Iowa, United States

Oncology Associates at Mercy Medical Center; 🇺🇸 Cedar Rapids, Iowa, United States

Blank Children's Hospital; 🇺🇸 Des Moines, Iowa, United States

Iowa Methodist Medical Center; 🇺🇸 Des Moines, Iowa, United States

UI Health Care Mission Cancer and Blood - Des Moines Clinic; 🇺🇸 Des Moines, Iowa, United States

University of Iowa/Holden Comprehensive Cancer Center; 🇺🇸 Iowa City, Iowa, United States

Our Lady of the Lake Physician Group; 🇺🇸 Baton Rouge, Louisiana, United States

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

Children's Hospital New Orleans; 🇺🇸 New Orleans, Louisiana, United States

LSU Health Sciences Center at Shreveport; 🇺🇸 Shreveport, Louisiana, United States

Harold Alfond Center for Cancer Care; 🇺🇸 Augusta, Maine, United States

MaineHealth Waldo Hospital; 🇺🇸 Belfast, Maine, United States

MaineHealth Maine Medical Center - Biddeford; 🇺🇸 Biddeford, Maine, United States

MaineHealth Cancer Care and IV Therapy - Brunswick; 🇺🇸 Brunswick, Maine, United States

Mid Coast Hospital; 🇺🇸 Brunswick, Maine, United States

MaineHealth LincolnHealth Hospital; 🇺🇸 Damariscotta, Maine, United States

MaineHealth Franklin Hospital; 🇺🇸 Farmington, Maine, United States

Saint Mary's Regional Medical Center; 🇺🇸 Lewiston, Maine, United States

MaineHealth Stephens Hospital; 🇺🇸 Norway, Maine, United States

Maine Medical Partners Surgical Care; 🇺🇸 Portland, Maine, United States

MaineHealth Maine Medical Center - Portland; 🇺🇸 Portland, Maine, United States

MMP Surgical Care Casco Bay; 🇺🇸 Portland, Maine, United States

Penobscot Bay Medical Center; 🇺🇸 Rockport, Maine, United States

MaineHealth Cancer Care and IV Therapy - Sanford; 🇺🇸 Sanford, Maine, United States

Maine Children's Cancer Program; 🇺🇸 Scarborough, Maine, United States

Maine Medical Partners Neurology; 🇺🇸 Scarborough, Maine, United States

MaineHealth Maine Medical Center- Scarborough; 🇺🇸 Scarborough, Maine, United States

MaineHealth Cancer Care and IV Therapy - South Portland; 🇺🇸 South Portland, Maine, United States

MaineHealth Urology - South Portland; 🇺🇸 South Portland, Maine, United States

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

Trinity Health Medical Center - Brighton; 🇺🇸 Brighton, Michigan, United States

Trinity Health Medical Center - Canton; 🇺🇸 Canton, Michigan, United States

Chelsea Hospital; 🇺🇸 Chelsea, Michigan, United States

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

Dickinson County Healthcare System; 🇺🇸 Iron Mountain, Michigan, United States

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

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

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

Freeman Health System; 🇺🇸 Joplin, Missouri, United States

Mercy Hospital Joplin; 🇺🇸 Joplin, Missouri, United States

Mercy Clinic-Rolla-Cancer and Hematology; 🇺🇸 Rolla, Missouri, United States

Phelps Health Delbert Day Cancer Institute; 🇺🇸 Rolla, Missouri, United States

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

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

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

Missouri Baptist Medical Center; 🇺🇸 Saint Louis, Missouri, United States

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

Mercy Hospital Springfield; 🇺🇸 Springfield, Missouri, United States

CoxHealth South Hospital; 🇺🇸 Springfield, Missouri, United States

Mercy Hospital Washington; 🇺🇸 Washington, Missouri, United States

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

Nebraska Cancer Specialists/Oncology Hematology West PC; 🇺🇸 Grand Island, Nebraska, United States

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

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

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

Hope Cancer Care of Nevada; 🇺🇸 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; 🇺🇸 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

Saint Joseph Hospital; 🇺🇸 Nashua, New Hampshire, United States

Morristown Medical Center; 🇺🇸 Morristown, New Jersey, United States

Newton Medical Center; 🇺🇸 Newton, New Jersey, United States

Chilton Medical Center; 🇺🇸 Pompton, New Jersey, United States

Overlook Hospital; 🇺🇸 Summit, New Jersey, United States

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

Montefiore Medical Center-Weiler Hospital; 🇺🇸 Bronx, New York, United States

Children's Hospital at Montefiore; 🇺🇸 Bronx, New York, United States

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

NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center; 🇺🇸 New York, New York, United States

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

East Carolina University; 🇺🇸 Greenville, North Carolina, United States

ECU Health Medical Center; 🇺🇸 Greenville, North Carolina, United States

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

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

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

FirstHealth of the Carolinas-Moore Regional Hospital; 🇺🇸 Pinehurst, North Carolina, United States

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

Marion L Shepard Cancer Center - ECU Health Beaufort Hospital; 🇺🇸 Washington, North Carolina, United States

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

Mercy Hospital Oklahoma City; 🇺🇸 Oklahoma City, Oklahoma, United States

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

Roger Williams Medical Center; 🇺🇸 Providence, Rhode Island, United States

Prisma Health Richland Hospital; 🇺🇸 Columbia, South Carolina, United States

Prisma Health Baptist Hospital; 🇺🇸 Columbia, South Carolina, United States

Gibbs Cancer Center-Gaffney; 🇺🇸 Gaffney, South Carolina, United States

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

Gibbs Cancer Center-Pelham; 🇺🇸 Greer, South Carolina, United States

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

SMC Center for Hematology Oncology Union; 🇺🇸 Union, South Carolina, United States

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

Centra Alan B Pearson Regional Cancer Center; 🇺🇸 Lynchburg, Virginia, United States

VCU Massey Cancer Center at Stony Point; 🇺🇸 Richmond, Virginia, United States

Virginia Commonwealth University/Massey Cancer Center; 🇺🇸 Richmond, Virginia, United States

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

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

Edwards Comprehensive Cancer Center; 🇺🇸 Huntington, West Virginia, United States

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

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

Aurora Saint Luke's Medical Center; 🇺🇸 Milwaukee, Wisconsin, United States

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

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

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

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

San Juan Community Oncology Group; 🇵🇷 San Juan, Puerto Rico

Centro Comprensivo de Cancer de UPR; 🇵🇷 San Juan, Puerto Rico

San Juan City Hospital; 🇵🇷 San Juan, Puerto Rico