Testing the Addition of an Anti-cancer Drug, Pembrolizumab, to the Usual Intravesical Chemotherapy Treatment (Gemcitabine) for the Treatment of BCG-Unresponsive Non-muscle Invasive Bladder Cancer

Phase 2

Recruiting

• Conditions: Bladder Flat Urothelial Carcinoma In Situ; Non-Muscle Invasive Bladder Urothelial Carcinoma; Stage 0a Bladder Cancer AJCC v8; Stage 0is Bladder Cancer AJCC v8; Stage I Bladder Cancer AJCC v8
• Interventions: Procedure: Biopsy Procedure; Procedure: Biospecimen Collection; Procedure: Computed Tomography; Procedure: Cystoscopy; Drug: Gemcitabine Hydrochloride; Procedure: Magnetic Resonance Imaging; Biological: Pembrolizumab; Procedure: Transurethral Resection of Bladder Tumor

• Registration Number: NCT04164082
• Lead Sponsor: National Cancer Institute (NCI)

Brief Summary

This phase II trial studies the effect of adding pembrolizumab to gemcitabine in treating patients with non-muscle invasive bladder cancer whose cancer does not respond to Bacillus Calmette-Guerin (BCG) treatment. Chemotherapy drugs, such as gemcitabine, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the patient's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Adding pembrolizumab to gemcitabine may delay the return of BCG-unresponsive bladder cancer for longer period compared to gemcitabine alone.

Detailed Description

PRIMARY OBJECTIVES:

I. Estimate the 6-month complete response rate of treatment with intravesical gemcitabine hydrochloride (gemcitabine) in combination with MK-3475 (pembrolizumab) in patients with Bacillus Calmette-Guerin (BCG)-unresponsive non-muscle invasive bladder cancer (NMIBC) that have a carcinoma in situ (CIS) component.

II. Estimate the 18 month event-free survival (EFS) rate for all patients with BCG-unresponsive NMIBC receiving intravesical gemcitabine in combination with MK-3475 (pembrolizumab).

SECONDARY OBJECTIVES:

I. To characterize the safety profile of the combination of intravesical gemcitabine with MK-3475 (pembrolizumab) with BCG-unresponsive NMIBC (CIS or high grade Ta and T1 with or without a CIS component).

II. To estimate progression-free survival (PFS) of patients with BCG-unresponsive NMIBC treated with intravesical gemcitabine in combination with MK-3475 (pembrolizumab).

III. To estimate overall survival (OS) of patients with BCG-unresponsive NMIBC treated with intravesical gemcitabine in combination with MK-3475 (pembrolizumab).

IV. To estimate cystectomy-free survival of patients with BCG-unresponsive NMIBC treated with intravesical gemcitabine in combination with MK-3475 (pembrolizumab).

V. To estimate recurrence-free survival (RFS) for patients with a CIS component only and those without a CIS component.

EXPLORATORY OBJECTIVES:

I. To assess correlation between tumor mutation burden (TMB) and EFS and 6-month complete response (CR) rate.

II. To assess correlation between specific genomic alterations (single nucleotide variant \[SNV\] and copy number gains/loss) and EFS and 6-month complete response rate.

III. To assess correlation between APOBEC mutational signature and EFS and 6-month complete response rate.

IV. To assess correlation between immune gene signatures (IGS) and EFS and 6-month complete response rate.

V. To assess correlation between PD-L1 ribonucleic acid (RNA) levels and EFS and 6-month complete response rate.

VI. To assess correlation between RNA molecular subtype and EFS and 6-month complete response rate.

VII. To assess correlation between intratumoral T-cell receptor (TCR) clonality and EFS and 6-month complete response rate.

VIII. To assess correlation between changes in peripheral blood TCR clonality and EFS and 6-month complete response rate.

IX. To assess EFS in patients with urine cell free deoxyribonucleic acid (DNA) (cfDNA) + versus (vs.) patients with cfDNA.

OUTLINE:

INDUCTION: Patients receive pembrolizumab intravenously (IV) over 25-40 minutes on day 1 of cycles 1-4. Patients also receive gemcitabine hydrochloride intravesically on days 1, 8 and 15 of cycles 1 and 2. Treatment repeats every 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity.

MAINTENANCE: Beginning cycle 5, patients with no evidence of disease after induction receive pembrolizumab IV over 25-40 minutes and gemcitabine intravesically on day 1 of each cycle. Treatment repeats every 3 weeks for 12 cycles in the absence of disease progression or unacceptable toxicity.

Additionally, patients with T1 tumors undergo a re-staging transurethral resection of bladder tumor (TURBT) within 60 days of registration. Patients also undergo urine and blood sample collection, bladder biopsy, cystoscopy, computed tomography (CT) and magnetic resonance imaging (MRI) throughout the study.

After completion of study treatment, patients with evidence of disease (recurrence or progression) or stop study treatment to receive non-protocol treatment during induction are followed up every 6 months for 5 years. Patients who go off treatment due to any reason other than recurrence/progression or receiving subsequent non-protocol treatment during induction will go to clinical follow-up until evidence of disease progression/recurrence. Thereafter, patients are followed up every 6 months until 5 years from registration. Patients who complete scheduled maintenance treatment according to protocol therapy are followed up every 3 months for 2 years and then every 6 months for 3 years until disease progression/recurrence or receiving subsequent non-protocol treatment. Thereafter, patients are followed up every 6 months until 5 years from registration. Patients who have evidence of disease during maintenance therapy are followed up every 6 months until 5 years from registration.

Study Timeline

• Study First Submitted: 2019-11-14
• Study First Submitted QC: 2019-11-14
• Study First Posted: 2019-11-15
• Study Start: 2020-03-18
• Status Verified: 2025-05
• Last Update Submitted: 2025-05-23
• Last Update Posted: 2025-05-25
• Primary Completion: 2026-03-31
• Study Completion: 2026-03-31

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 161

Inclusion Criteria

• High grade Ta, T1 or CIS urothelial carcinoma. Accrual of patients with Ta or T1 disease may be closed to ensure adequate patients enrollment to meet the primary endpoint

• Persistent disease (defined as not achieving disease free status) after completing therapy with at least induction BCG (>= 5 doses) and the first round of maintenance or second induction course (>= 2 doses). The subsequent round of BCG, either maintenance or repeat induction, must be given within 6 months of initial induction BCG

• Persistent high risk NMIBC (T1, high grade Ta and/or CIS) must be within 9 months of the last BCG instillation despite having received adequate BCG as defined above.

  • Registration must be within 12 months of last BCG instillation

• High grade T1 after completing therapy with at least induction BCG (>= 5 doses) or after completing therapy with at least induction BCG (>= 5 doses) and first round of maintenance or second induction course (>= 2 doses). The subsequent round of BCG, either maintenance or repeat induction, must be given within 6 months of initial induction BCG

  • Disease recurrence (T1) must be within 9 months of the last BCG instillation despite having received adequate BCG as defined above
  • Registration must be within 12 months of last BCG instillation

• Mixed variant histology (adenocarcinoma, squamous cell carcinoma) is eligible, but pure variant histology is ineligible

• Patients who are disease free at 6 months after starting BCG but have high grade recurrence (T1, Ta, CIS) while on maintenance therapy would be eligible

  • The recurrence must be within 6 months of the last BCG dose.
  • Registration must be within 12 months of last maintenance BCG instillation

• Patients must be deemed unfit for radical cystectomy by the treating physician or refuse radical cystectomy

• All patients must have histologically confirmed urothelial cancer of the bladder within 60 days prior to registration

• All visible tumor must be completely resected 60 days prior to registration (residual pure CIS is permitted)

  • All patients must have had a cystoscopy (or TURBT with complete resection) without papillary tumor and negative urinary cytology within 28 days of registration (positive cytology is allowed in patients with CIS)

• All patients with T1 tumors must undergo a re-staging transurethral resection of bladder tumor (TURBT) within 60 days of registration

  • There must be uninvolved muscularis propria present in the re-staging TURBT. The initial TURBT prior to re-staging TURBT may be greater than 60 days prior to registration

• Patients must have had imaging with CT or MRI abdomen/pelvis within 90 days of registration demonstrating no evidence of metastasis

• Patients cannot have had a history of urothelial carcinoma in the ureters or prostatic urethra 24 months prior to registration

• Patients must not be currently participating in or have participated in a study of an investigational agent or have used an investigational device within 4 weeks prior to study registration

  • Note: Participants who have entered the follow-up phase of an investigational study may participate as long as it has been more than 4 weeks after the last dose of the previous investigational agent at time of registration

• Patients must not have prior therapy with an anti-PD-1, anti-PD-L1, or anti PD L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (e.g., CTLA-4, OX 40, CD137)

• Patients must not have undergone prior allogeneic hematopoietic stem cell transplantation within the last 5 years prior to registration. (Participants who have had a transplant greater than 5 years ago are eligible as long as there are no symptoms of graft versus host disease [GVHD])

• Patients must not have received prior systemic anti-cancer therapy including investigational agents within 4 weeks prior to treatment

  • Note: Participants must have recovered from all adverse events (AEs) due to previous therapies to =< grade 1 or baseline. Participants with =< grade 2 neuropathy may be eligible
  • Note: If participant received major surgery, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting study treatment

• Patients must not have received prior radiotherapy within 2 weeks of study registration. Participants must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis

• Patients must not have received radiation therapy to the lung that is > 30 Gy within 6 months prior to trial registration

• Not pregnant and not nursing, because this study involves an agent that has known genotoxic, mutagenic and teratogenic effects

  • Women and men of reproductive potential should agree to use an appropriate method of birth control throughout their participation in this study due to the teratogenic potential of the therapy utilized in this trial. Include as applicable: Appropriate methods of birth control include abstinence, oral contraceptives, implantable hormonal contraceptives or double barrier method (diaphragm plus condom)
  • A woman of childbearing potential (WOCBP) must not have a positive urine pregnancy test within 7 days prior to registration. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required
  • Patients must not be pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with registration through the last dose of treatment

• Age >= 18 years

• Eastern Cooperative Oncology Group (ECOG) performance status 0-2

• Absolute neutrophil count (ANC) >= 1,500/mm^3

• Platelet count >= 100,000/mm^3

• Hemoglobin >= 9.0 g/dL

• Creatinine =< 1.5 x upper limit of normal (ULN)

  • In patients with creatinine > 1.5 x ULN, if measured or calculated creatinine clearance > 30 mL/min, then patient is eligible

• Total bilirubin =< 1.5 x ULN

  • In patients with a total bilirubin > 1.5 x ULN, if direct bilirubin < 1.0 X ULN, then patient is eligible

• Aspartate aminotransferase (AST)/ alanine aminotransferase (ALT) =< 2.5 x ULN

• Patients must not have had an active autoimmune disease requiring systemic treatment within 24 months prior to registration. Autoimmune diseases include, but not limited to, lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, antiphospholipid syndrome, Wegener's granulomatosis, Sjogren's syndrome, Bell's palsy, Guillain-Barre syndrome, multiple sclerosis, autoimmune thyroid disease, vasculitis, or glomerulonephritis

• Patients must not have a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to registration

  • Note: Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is allowed

• Patients must not have a known psychiatric or substance abuse disorder that would interfere with the participant's ability to cooperate with the requirements of the study

• Patients must not have active tuberculosis

• Patients must not have been treated with antibiotics for an active infection within 14 days prior to registration. Prophylactic antibiotics are permitted. Treatment for a urinary tract infection (UTI) is allowed but must be deemed adequately treated by the treating physician prior the start of cycle 1 (C1) day 1 (D1)

• Patients must not have a history of idiopathic pulmonary fibrosis or organizing pneumonia

• Patients must not have a history of (non-infectious) pneumonitis that required steroids or have current pneumonitis

• Patients with human immunodeficiency virus (HIV) are eligible with the following:

  • On effective anti-retroviral therapy with undetectable viral load within 6 months of registration

• HIV-infected participants must not have a history of Kaposi sarcoma and/or multicentric Castleman disease

• Patients must not have a known additional malignancy that has had progression or has required active treatment in the last three years. Exceptions include basal or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer. A history of prostate cancer that was treated with definitive intent is allowed, provided that the prostate-specific antigen (PSA) is undetectable for at least 1 year while off androgen deprivation therapy

• Patients must not have known active CNS metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are radiologically stable, i.e., without evidence of progression for at least 4 weeks by repeat imaging (note that the repeat imaging should be performed during study screening), clinically stable and without requirement of steroid treatment for at least 14 days prior to first dose of study treatment

• Patients must not have severe hypersensitivity (>= grade 3) to pembrolizumab and/or any of its excipients

• Patients must not have an active infection requiring systemic therapy

• Patients must not have a known history of hepatitis B (defined as hepatitis B surface antigen [HBsAg] reactive) or known active hepatitis C virus (defined as hepatitis C virus [HCV] ribonucleic acid [RNA] [qualitative] is detected) infection

  • Note: No testing for hepatitis B and hepatitis C is required unless mandated by a local health authority

• Patients must not have received live vaccines within 30 days of study drug administration. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, varicella/zoster (chicken pox), yellow fever, rabies, Bacillus Calmette-Guerin (BCG), and typhoid vaccine. Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (e.g., FluMist®) are live attenuated vaccines and are not allowed. COVID-19 vaccinations are permitted

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Treatment (pembrolizumab, gemcitabine hydrochloride)	Biopsy Procedure	INDUCTION: Patients receive pembrolizumab IV over 25-40 minutes on day 1 of cycles 1-4. Patients also receive gemcitabine hydrochloride intravesically on days 1, 8 and 15 of cycles 1 and 2. Treatment repeats every 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Beginning cycle 5, patients with no evidence of disease after induction receive pembrolizumab IV over 25-40 minutes and gemcitabine intravesically on day 1 of each cycle. Treatment repeats every 3 weeks for 12 cycles in the absence of disease progression or unacceptable toxicity. Additionally, patients with T1 tumors undergo a re-staging TURBT within 60 days of registration. Patients also undergo urine and blood sample collection, bladder biopsy, cystoscopy, CT and MRI throughout the study.
Treatment (pembrolizumab, gemcitabine hydrochloride)	Biospecimen Collection	INDUCTION: Patients receive pembrolizumab IV over 25-40 minutes on day 1 of cycles 1-4. Patients also receive gemcitabine hydrochloride intravesically on days 1, 8 and 15 of cycles 1 and 2. Treatment repeats every 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Beginning cycle 5, patients with no evidence of disease after induction receive pembrolizumab IV over 25-40 minutes and gemcitabine intravesically on day 1 of each cycle. Treatment repeats every 3 weeks for 12 cycles in the absence of disease progression or unacceptable toxicity. Additionally, patients with T1 tumors undergo a re-staging TURBT within 60 days of registration. Patients also undergo urine and blood sample collection, bladder biopsy, cystoscopy, CT and MRI throughout the study.
Treatment (pembrolizumab, gemcitabine hydrochloride)	Computed Tomography	INDUCTION: Patients receive pembrolizumab IV over 25-40 minutes on day 1 of cycles 1-4. Patients also receive gemcitabine hydrochloride intravesically on days 1, 8 and 15 of cycles 1 and 2. Treatment repeats every 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Beginning cycle 5, patients with no evidence of disease after induction receive pembrolizumab IV over 25-40 minutes and gemcitabine intravesically on day 1 of each cycle. Treatment repeats every 3 weeks for 12 cycles in the absence of disease progression or unacceptable toxicity. Additionally, patients with T1 tumors undergo a re-staging TURBT within 60 days of registration. Patients also undergo urine and blood sample collection, bladder biopsy, cystoscopy, CT and MRI throughout the study.
Treatment (pembrolizumab, gemcitabine hydrochloride)	Cystoscopy	INDUCTION: Patients receive pembrolizumab IV over 25-40 minutes on day 1 of cycles 1-4. Patients also receive gemcitabine hydrochloride intravesically on days 1, 8 and 15 of cycles 1 and 2. Treatment repeats every 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Beginning cycle 5, patients with no evidence of disease after induction receive pembrolizumab IV over 25-40 minutes and gemcitabine intravesically on day 1 of each cycle. Treatment repeats every 3 weeks for 12 cycles in the absence of disease progression or unacceptable toxicity. Additionally, patients with T1 tumors undergo a re-staging TURBT within 60 days of registration. Patients also undergo urine and blood sample collection, bladder biopsy, cystoscopy, CT and MRI throughout the study.
Treatment (pembrolizumab, gemcitabine hydrochloride)	Gemcitabine Hydrochloride	INDUCTION: Patients receive pembrolizumab IV over 25-40 minutes on day 1 of cycles 1-4. Patients also receive gemcitabine hydrochloride intravesically on days 1, 8 and 15 of cycles 1 and 2. Treatment repeats every 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Beginning cycle 5, patients with no evidence of disease after induction receive pembrolizumab IV over 25-40 minutes and gemcitabine intravesically on day 1 of each cycle. Treatment repeats every 3 weeks for 12 cycles in the absence of disease progression or unacceptable toxicity. Additionally, patients with T1 tumors undergo a re-staging TURBT within 60 days of registration. Patients also undergo urine and blood sample collection, bladder biopsy, cystoscopy, CT and MRI throughout the study.
Treatment (pembrolizumab, gemcitabine hydrochloride)	Magnetic Resonance Imaging	INDUCTION: Patients receive pembrolizumab IV over 25-40 minutes on day 1 of cycles 1-4. Patients also receive gemcitabine hydrochloride intravesically on days 1, 8 and 15 of cycles 1 and 2. Treatment repeats every 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Beginning cycle 5, patients with no evidence of disease after induction receive pembrolizumab IV over 25-40 minutes and gemcitabine intravesically on day 1 of each cycle. Treatment repeats every 3 weeks for 12 cycles in the absence of disease progression or unacceptable toxicity. Additionally, patients with T1 tumors undergo a re-staging TURBT within 60 days of registration. Patients also undergo urine and blood sample collection, bladder biopsy, cystoscopy, CT and MRI throughout the study.
Treatment (pembrolizumab, gemcitabine hydrochloride)	Pembrolizumab	INDUCTION: Patients receive pembrolizumab IV over 25-40 minutes on day 1 of cycles 1-4. Patients also receive gemcitabine hydrochloride intravesically on days 1, 8 and 15 of cycles 1 and 2. Treatment repeats every 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Beginning cycle 5, patients with no evidence of disease after induction receive pembrolizumab IV over 25-40 minutes and gemcitabine intravesically on day 1 of each cycle. Treatment repeats every 3 weeks for 12 cycles in the absence of disease progression or unacceptable toxicity. Additionally, patients with T1 tumors undergo a re-staging TURBT within 60 days of registration. Patients also undergo urine and blood sample collection, bladder biopsy, cystoscopy, CT and MRI throughout the study.
Treatment (pembrolizumab, gemcitabine hydrochloride)	Transurethral Resection of Bladder Tumor	INDUCTION: Patients receive pembrolizumab IV over 25-40 minutes on day 1 of cycles 1-4. Patients also receive gemcitabine hydrochloride intravesically on days 1, 8 and 15 of cycles 1 and 2. Treatment repeats every 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Beginning cycle 5, patients with no evidence of disease after induction receive pembrolizumab IV over 25-40 minutes and gemcitabine intravesically on day 1 of each cycle. Treatment repeats every 3 weeks for 12 cycles in the absence of disease progression or unacceptable toxicity. Additionally, patients with T1 tumors undergo a re-staging TURBT within 60 days of registration. Patients also undergo urine and blood sample collection, bladder biopsy, cystoscopy, CT and MRI throughout the study.

Primary Outcome Measures

Name	Time	Method
Complete response rate in the carcinoma in situ (CIS) subpopulation	At 6 months (end of cycle 8, week 25)	A complete response, only for patients with a CIS component, is a cystoscopy without evidence of bladder tumor and negative biopsy (including directed biopsies to any suspicious areas and in addition random bladder biopsies including trigone, left lateral wall, right lateral wall, posterior bladder, dome of bladder, and the prostatic urethra in men), and negative cytology for high grade disease.
Event-free survival at 18 months	From the date of study registration to the first documentation of an event or death whichever comes first, assessed up to 18 months	For patients without a documented event and who are still alive, they will be censored at last disease assessment. For patients who start any subsequent ant-cancer therapy without any reported events will be censored at their last disease assessment. will be obtained with a Kaplan-Meier estimator (using the Greenwood formula to estimate the variance) for the entire 153 patient group consisting of patients with CIS, CIS with Ta/T1 or Ta or T1 disease. A 90% confidence interval will be generated for the 18-month EFS estimate.

Secondary Outcome Measures

Name	Time	Method
Incidence of adverse events	Up to 5 years post treatment	Adverse events will be assessed based on the National Cancer Institute common toxicity criteria (Common Terminology Criteria for Adverse Events version 5.0).
Duration of response (DOR)	From the time a patient had a documented response (the time would start at the time a response was first noted) until disease-progression, assessed up to 5 years	Analysis will only include those patients in the CIS population who achieve a response. Patients who are alive and without a documented progression at the time of analysis will be censored at the time of the last disease status evaluation. The Kaplan-Meier product-limit estimator will be used to estimate DOR, medians and 95% confidence intervals (CI).
Progression-free survival (PFS)	From the date of study registration to the date of progression or death due to any cause, whichever occurs first, assessed up to 5 years	Surviving patients without any documented progressions will be censored at the date of last known contact. Progression will be defined as the development of muscle invasive bladder cancer or metastatic urothelial cancer (nodal and/or distant). The Kaplan-Meier product-limit estimator will be used to estimate PFS, medians and 95% CI.
Overall survival (OS)	From the date of study registration to date of death due to any cause, assessed up to 5 years	Surviving patients will be censored at the date of last known contact. The Kaplan-Meier product-limit estimator will be used to estimate OS, medians and 95% CI.
Cystectomy-free survival	From the date of study registration to the date of cystectomy for all patients	The Kaplan-Meier product-limit estimator will be used to estimate cystectomy-free survival, medians and 95% CI.
Recurrence free survival (RFS)	From the date of study registration to the first documentation of recurrence or death due to any cause, assessed up to 5 years	Surviving patients without any documented recurrence will be censored at the date of last known contact. Recurrence will be defined as the development of high-grade bladder cancer for patients with a CIS component only and those without a CIS component. The Kaplan-Meier product-limit estimator will be used to estimate RFS, medians and 95% CI.

Trial Locations

Locations (392)

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

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

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

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

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

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

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

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

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

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

Cancer Center at Saint Joseph's; 🇺🇸 Phoenix, Arizona, United States

Mayo Clinic Hospital in Arizona; 🇺🇸 Phoenix, Arizona, United States

Mayo Clinic in Arizona; 🇺🇸 Scottsdale, Arizona, United States

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

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

Cedars Sinai Medical Center; 🇺🇸 Los Angeles, California, United States

University of California Davis Comprehensive Cancer Center; 🇺🇸 Sacramento, California, United States

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Western Surgical Care; 🇺🇸 Denver, Colorado, United States

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

MedStar Georgetown University Hospital; 🇺🇸 Washington, District of Columbia, United States

MedStar Washington Hospital Center; 🇺🇸 Washington, District of Columbia, United States

Holy Cross Hospital; 🇺🇸 Fort Lauderdale, Florida, United States

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

Hawaii Cancer Care - Westridge; 🇺🇸 'Aiea, Hawaii, United States

Pali Momi Medical Center; 🇺🇸 'Aiea, Hawaii, United States

Reid Health; 🇺🇸 Richmond, Indiana, United States

Queen's Cancer Center - Pearlridge; 🇺🇸 'Aiea, Hawaii, United States

The Cancer Center of Hawaii-Pali Momi; 🇺🇸 'Aiea, Hawaii, United States

The Queen's Medical Center - West Oahu; 🇺🇸 'Ewa Beach, Hawaii, United States

Hawaii Cancer Care Inc - Waterfront Plaza; 🇺🇸 Honolulu, Hawaii, United States

Island Urology; 🇺🇸 Honolulu, Hawaii, United States

Queen's Cancer Cenrer - POB I; 🇺🇸 Honolulu, Hawaii, 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

Hawaii Cancer Care Inc-Liliha; 🇺🇸 Honolulu, Hawaii, United States

Hawaii Diagnostic Radiology Services LLC; 🇺🇸 Honolulu, Hawaii, United States

Kuakini Medical Center; 🇺🇸 Honolulu, Hawaii, United States

Queen's Cancer Center - Kuakini; 🇺🇸 Honolulu, Hawaii, United States

The Cancer Center of Hawaii-Liliha; 🇺🇸 Honolulu, Hawaii, United States

Kapiolani Medical Center for Women and Children; 🇺🇸 Honolulu, Hawaii, United States

Straub Medical Center - Kahului Clinic; 🇺🇸 Kahului, Hawaii, United States

Castle Medical Center; 🇺🇸 Kailua, Hawaii, United States

Wilcox Memorial Hospital and Kauai Medical Clinic; 🇺🇸 Lihue, Hawaii, United States

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Memorial Hospital of Carbondale; 🇺🇸 Carbondale, Illinois, United States

SIH Cancer Institute; 🇺🇸 Carterville, Illinois, United States

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

Centralia Oncology Clinic; 🇺🇸 Centralia, Illinois, United States

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

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

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

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

Crossroads Cancer Center; 🇺🇸 Effingham, Illinois, United States

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

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

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

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

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

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

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

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

Cancer Care Center of O'Fallon; 🇺🇸 O'Fallon, 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

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

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

Southern Illinois University School of Medicine; 🇺🇸 Springfield, Illinois, United States

Springfield Clinic; 🇺🇸 Springfield, Illinois, United States

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

Southwest Illinois Health Services LLP; 🇺🇸 Swansea, Illinois, United States

Memorial Hospital of South Bend; 🇺🇸 South Bend, Indiana, United States

Central Care Cancer Center - Garden City; 🇺🇸 Garden City, Kansas, United States

Central Care Cancer Center - Great Bend; 🇺🇸 Great Bend, Kansas, United States

University of Kansas Cancer Center; 🇺🇸 Kansas City, Kansas, United States

University of Kansas Hospital-Indian Creek Campus; 🇺🇸 Overland Park, Kansas, United States

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

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

Louisiana Hematology Oncology Associates LLC; 🇺🇸 Baton Rouge, Louisiana, United States

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

Mary Bird Perkins Cancer Center - Metairie; 🇺🇸 Metairie, Louisiana, United States

East Jefferson General Hospital; 🇺🇸 Metairie, Louisiana, United States

LSU Healthcare Network / Metairie Multi-Specialty Clinic; 🇺🇸 Metairie, Louisiana, United States

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

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

Touro Infirmary; 🇺🇸 New Orleans, Louisiana, United States

UM Baltimore Washington Medical Center/Tate Cancer Center; 🇺🇸 Glen Burnie, Maryland, United States

Lowell General Hospital; 🇺🇸 Lowell, Massachusetts, United States

Mercy Medical Center; 🇺🇸 Springfield, Massachusetts, United States

Hickman Cancer Center; 🇺🇸 Adrian, Michigan, United States

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

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

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

Trinity Health IHA Medical Group Hematology Oncology - Brighton; 🇺🇸 Brighton, Michigan, United States

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

Trinity Health IHA Medical Group Hematology Oncology - Canton; 🇺🇸 Canton, Michigan, United States

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

Caro Cancer Center; 🇺🇸 Caro, Michigan, United States

Chelsea Hospital; 🇺🇸 Chelsea, Michigan, United States

Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital; 🇺🇸 Chelsea, Michigan, United States

Hematology Oncology Consultants-Clarkston; 🇺🇸 Clarkston, Michigan, United States

Newland Medical Associates-Clarkston; 🇺🇸 Clarkston, Michigan, United States

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

Henry Ford River District Hospital; 🇺🇸 East China Township, Michigan, United States

Cancer Hematology Centers - Flint; 🇺🇸 Flint, Michigan, United States

Genesee Hematology Oncology PC; 🇺🇸 Flint, Michigan, United States

Genesys Hurley Cancer Institute; 🇺🇸 Flint, Michigan, United States

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

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

Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital; 🇺🇸 Grand Rapids, Michigan, United States

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

Henry Ford Saint John Hospital - Academic; 🇺🇸 Grosse Pointe Woods, Michigan, United States

Henry Ford Saint John Hospital - Breast; 🇺🇸 Grosse Pointe Woods, Michigan, United States

Henry Ford Saint John Hospital - Van Elslander; 🇺🇸 Grosse Pointe Woods, Michigan, United States

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

Ascension Borgess Cancer Center; 🇺🇸 Kalamazoo, Michigan, United States

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

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

Hope Cancer Clinic; 🇺🇸 Livonia, Michigan, United States

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

Henry Ford Saint John Hospital - Macomb Medical; 🇺🇸 Macomb, Michigan, United States

Henry Ford Warren Hospital - Breast Macomb; 🇺🇸 Macomb, Michigan, United States

Saint Mary's Oncology/Hematology Associates of Marlette; 🇺🇸 Marlette, Michigan, United States

Toledo Clinic Cancer Centers-Monroe; 🇺🇸 Monroe, Michigan, United States

Trinity Health Muskegon Hospital; 🇺🇸 Muskegon, Michigan, United States

Corewell Health Lakeland Hospitals - Niles Hospital; 🇺🇸 Niles, Michigan, United States

Cancer and Hematology Centers of Western Michigan - Norton Shores; 🇺🇸 Norton Shores, Michigan, United States

Hope Cancer Center; 🇺🇸 Pontiac, Michigan, United States

Michigan Healthcare Professionals Pontiac; 🇺🇸 Pontiac, Michigan, United States

Newland Medical Associates-Pontiac; 🇺🇸 Pontiac, Michigan, United States

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

Corewell Health Reed City Hospital; 🇺🇸 Reed City, Michigan, United States

Henry Ford Rochester Hospital; 🇺🇸 Rochester Hills, Michigan, United States

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

Oncology Hematology Associates of Saginaw Valley PC; 🇺🇸 Saginaw, Michigan, United States

Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center; 🇺🇸 Saint Joseph, Michigan, United States

Corewell Health Lakeland Hospitals - Saint Joseph Hospital; 🇺🇸 Saint Joseph, Michigan, United States

Bhadresh Nayak MD PC-Sterling Heights; 🇺🇸 Sterling Heights, Michigan, United States

MyMichigan Medical Center Tawas; 🇺🇸 Tawas City, Michigan, United States

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

Advanced Breast Care Center PLLC; 🇺🇸 Warren, Michigan, United States

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

Henry Ford Madison Heights Hospital - Breast; 🇺🇸 Warren, Michigan, United States

Henry Ford Warren Hospital - GLCMS; 🇺🇸 Warren, Michigan, United States

Macomb Hematology Oncology PC; 🇺🇸 Warren, Michigan, United States

Saint Mary's Oncology/Hematology Associates of West Branch; 🇺🇸 West Branch, Michigan, United States

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

Huron Gastroenterology PC; 🇺🇸 Ypsilanti, Michigan, United States

Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus; 🇺🇸 Ypsilanti, Michigan, United States

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

Minnesota Oncology - Burnsville; 🇺🇸 Burnsville, Minnesota, United States

Cambridge Medical Center; 🇺🇸 Cambridge, Minnesota, United States

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

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

Unity Hospital; 🇺🇸 Fridley, Minnesota, United States

Fairview Clinics and Surgery Center Maple Grove; 🇺🇸 Maple Grove, Minnesota, United States

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

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

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

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

Health Partners Inc; 🇺🇸 Minneapolis, Minnesota, United States

Monticello Cancer Center; 🇺🇸 Monticello, Minnesota, United States

New Ulm Medical Center; 🇺🇸 New Ulm, Minnesota, United States

Fairview Northland Medical Center; 🇺🇸 Princeton, Minnesota, United States

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

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

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

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

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

Lakeview Hospital; 🇺🇸 Stillwater, Minnesota, United States

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

Rice Memorial Hospital; 🇺🇸 Willmar, Minnesota, United States

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

Fairview Lakes Medical Center; 🇺🇸 Wyoming, Minnesota, United States

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

Central Care Cancer Center - Bolivar; 🇺🇸 Bolivar, Missouri, United States

Cox Cancer Center Branson; 🇺🇸 Branson, Missouri, United States

Mercy Cancer Center - Cape Girardeau; 🇺🇸 Cape Girardeau, Missouri, United States

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

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

MU Health - University Hospital/Ellis Fischel Cancer Center; 🇺🇸 Columbia, Missouri, United States

Parkland Health Center - Farmington; 🇺🇸 Farmington, Missouri, United States

MU Health Care Goldschmidt Cancer Center; 🇺🇸 Jefferson City, 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

Sainte Genevieve County Memorial Hospital; 🇺🇸 Sainte Genevieve, Missouri, United States

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

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

Missouri Baptist Sullivan Hospital; 🇺🇸 Sullivan, Missouri, United States

BJC Outpatient Center at Sunset Hills; 🇺🇸 Sunset Hills, Missouri, United States

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

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

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

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

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

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

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

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

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

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

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

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

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

Memorial Sloan Kettering Basking Ridge; 🇺🇸 Basking Ridge, New Jersey, United States

Hackensack University Medical Center; 🇺🇸 Hackensack, New Jersey, United States

Memorial Sloan Kettering Monmouth; 🇺🇸 Middletown, New Jersey, United States

Memorial Sloan Kettering Bergen; 🇺🇸 Montvale, New Jersey, United States

The Valley Hospital - Luckow Pavilion; 🇺🇸 Paramus, New Jersey, United States

Neurosurgeons of New Jersey-Ridgewood; 🇺🇸 Ridgewood, New Jersey, United States

Valley Health System Ridgewood Campus; 🇺🇸 Ridgewood, New Jersey, United States

Valley Health System-Hematology/Oncology; 🇺🇸 Westwood, New Jersey, United States

Memorial Sloan Kettering Commack; 🇺🇸 Commack, New York, United States

Arnot Ogden Medical Center/Falck Cancer Center; 🇺🇸 Elmira, New York, United States

The New York Hospital Medical Center of Queens; 🇺🇸 Flushing, New York, United States

Memorial Sloan Kettering Westchester; 🇺🇸 Harrison, New York, United States

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

NYP/Weill Cornell Medical Center; 🇺🇸 New York, New York, United States

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

Memorial Sloan Kettering Nassau; 🇺🇸 Uniondale, New York, United States

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

University of North Carolina-Hillsborough Campus; 🇺🇸 Hillsborough, North Carolina, United States

Indu and Raj Soin Medical Center; 🇺🇸 Beavercreek, Ohio, United States

Saint Elizabeth Boardman Hospital; 🇺🇸 Boardman, Ohio, United States

Dayton Physicians LLC-Miami Valley South; 🇺🇸 Centerville, Ohio, United States

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

Oncology Hematology Care Inc-Kenwood; 🇺🇸 Cincinnati, Ohio, United States

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

Dayton Physician LLC - Englewood; 🇺🇸 Dayton, Ohio, United States

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

Armes Family Cancer Center; 🇺🇸 Findlay, Ohio, United States

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

Orion Cancer Care; 🇺🇸 Findlay, Ohio, United States

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

Dayton Physicians LLC-Atrium; 🇺🇸 Franklin, Ohio, United States

Dayton Physicians LLC-Wayne; 🇺🇸 Greenville, Ohio, United States

Wayne Hospital; 🇺🇸 Greenville, Ohio, United States

Greater Dayton Cancer Center; 🇺🇸 Kettering, Ohio, United States

First Dayton Cancer Care; 🇺🇸 Kettering, Ohio, United States

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

Mercy Health - Perrysburg Hospital; 🇺🇸 Perrysburg, Ohio, United States

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

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

Mercy Health - Saint Anne Hospital; 🇺🇸 Toledo, Ohio, United States

Toledo Clinic Cancer Centers-Toledo; 🇺🇸 Toledo, Ohio, United States

Dayton Physicians LLC - Troy; 🇺🇸 Troy, Ohio, United States

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

Saint Joseph Warren Hospital; 🇺🇸 Warren, Ohio, United States

Saint Elizabeth Youngstown Hospital; 🇺🇸 Youngstown, Ohio, United States

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

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

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

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

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

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

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

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

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

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

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

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

Lehigh Valley Hospital-Cedar Crest; 🇺🇸 Allentown, Pennsylvania, United States

Lehigh Valley Hospital - Muhlenberg; 🇺🇸 Bethlehem, Pennsylvania, United States

Pocono Medical Center; 🇺🇸 East Stroudsburg, Pennsylvania, United States

Lehigh Valley Hospital-Hazleton; 🇺🇸 Hazleton, Pennsylvania, United States

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

Ralph H Johnson VA Medical Center; 🇺🇸 Charleston, South Carolina, United States

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

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

North Grove Medical Park; 🇺🇸 Spartanburg, South Carolina, United States

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

Spartanburg Medical Center - Mary Black Campus; 🇺🇸 Spartanburg, South Carolina, United States

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

University of Texas Medical Branch; 🇺🇸 Galveston, Texas, United States

Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center; 🇺🇸 Houston, Texas, United States

UTMB Cancer Center at Victory Lakes; 🇺🇸 League City, Texas, United States

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

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

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

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

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

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

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

Riverton Hospital; 🇺🇸 Riverton, Utah, United States

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cancer Center of Western Wisconsin; 🇺🇸 New Richmond, Wisconsin, United States

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

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

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

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

UW Cancer Center at ProHealth Care; 🇺🇸 Waukesha, Wisconsin, United States

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

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

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

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

FHP Health Center-Guam; 🇬🇺 Tamuning, Guam

Cancer Center-Metro Medical Center Bayamon; 🇵🇷 Bayamon, Puerto Rico

Puerto Rico Hematology Oncology Group; 🇵🇷 Bayamon, Puerto Rico

HIMA San Pablo Oncologic Hospital; 🇵🇷 Caguas, Puerto Rico

Doctors Cancer Center; 🇵🇷 Manati, Puerto Rico

Instituto Oncologia Moderna Ponce; 🇵🇷 Ponce, Puerto Rico

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