Assessing Benefits and Harms of Cannabis/Cannabinoid Use Among Cancer Patients Treated in Community Oncology Clinics

Recruiting

• Conditions: Breast Carcinoma; Lung Non-Small Cell Carcinoma; Non-Hodgkin Lymphoma; Colorectal Carcinoma; Melanoma
• Interventions: Other: Non-interventional Study

• Registration Number: NCT06418204
• Lead Sponsor: Wake Forest University Health Sciences

Brief Summary

This is a multi-site clinical study enrolling 2000 newly diagnosed patients with breast, colorectal, melanoma, non-Hodgkin lymphoma, or non-small cell lung cancer, who are planning to receive one or more systemic cancer directed therapies with chemotherapy and/or (immune checkpoint inhibitors) ICIs.

Detailed Description

The objective of this study is to examine the association between cannabis and/or cannabinoid use and cancer-related symptoms assessed monthly for one year in adults newly diagnosed with breast, colorectal, melanoma, non-Hodgkin lymphoma, or non-small cell lung cancer who are planning or recently started to receive one or more systemic cancer directed therapies with chemotherapy and/or immune check point inhibitors (ICIs) targeting PD-1, PD-L1 or CTLA-4.

Participants complete surveys and have their medical records reviewed on study.

Study Timeline

• Study First Submitted: 2024-05-08
• Study First Submitted QC: 2024-05-15
• Study First Posted: 2024-05-17
• Study Start: 2025-01-30
• Status Verified: 2025-05
• Last Update Submitted: 2025-05-08
• Last Update Posted: 2025-05-11
• Primary Completion: 2028-08
• Study Completion: 2028-08

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 2000

Inclusion Criteria

• Adults aged 18 years or older with one of the following newly diagnosed cancers: breast cancer, colorectal cancer, melanoma, non-Hodgkin lymphoma, or non-small cell lung cancer.
• Planned treatment with systemic chemotherapy (single or multi-agent, includes targeted therapy) and/or immune checkpoint inhibitor therapy (targeting PD-1, PD-L1 or CTLA-4). If unable to engage participant before treatment starts, enrollment is allowed up to the start of Cycle 2 treatment.
• Participants must be able to comprehend English or Spanish (for survey completion).
• Participants must have a working email address and be must be willing to complete surveys online. This can be completed at home, in the clinic or other location.
• Completion of the confidential Self-Reported Screening Survey and receipt of a screening result - eligible for enrollment.

Optional Sub-study (available at select sites only):

• Must be willing to participate in both the main study and the sub-study at the Wake Forest University Comprehensive Cancer Center (WF CCC) and Virginia Commonwealth University (VCU).
• Must be receiving treatment at the WF CCC and VCU.
• Must be diagnosed with non-small cell lung cancer.
• Must be receiving paclitaxel as part of their chemotherapy in conjunction with Immune Checkpoint Inhibitor (ICIs) PD-1, PD-L1 or CTLA-4.
• Must be enrolled and complete baseline survey before cycle 1 begins

Exclusion Criteria

• Currently enrolled in an interventional supportive treatment trial to manage cancer symptoms.
• Participants with known pregnancy.

Optional Substudy (available at select sites only):

• Participants with chronic or ongoing steroid or immunomodulatory agents (i.e., prednisone, dexamethasone, etanercept, infliximab, etc.). The use of glucocorticoids as pre-medications for chemotherapy treatment is allowed.
• Participants with a history of HIV, hepatitis B or hepatitis C.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Observational	Non-interventional Study	Participants complete surveys and have their medical records reviewed on study.

Primary Outcome Measures

Name	Time	Method
Cancer-related symptoms	Baseline and re-assessed monthly up to 12 months post-enrollment	Will use the National Cancer Institute Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events to measure cancer-related symptoms. Will examine the longitudinal relationship between cannabis and/or cannabinoid use and the likelihood of exhibiting individual symptoms using three-level GLMMs to account for the nested data. The investigators will model continuous measures (e.g., symptom severity) using a linear generalized linear mixed-effects models (GLMM) and the prevalence of symptoms or moderate to severe symptoms using a logistic GLMM. Cannabis and/or cannabinoid use at each monthly assessment will be included as a time-varying covariate and an interaction with time will be included to assess its impact on symptoms over time. Analyses will consider dichotomous definitions of use (yes/no past month), frequency of use (# days in the past month) as well as mode of administration, dose/potency, and cannabinoid type.

Secondary Outcome Measures

Name	Time	Method
Cannabis and Cannabinoid Use from Cannabis Engagement Assessment	Baseline and re-assessed monthly up to 12 months post-enrollment	Cannabis and cannabinoid use will be measured monthly using items from the Cannabis Engagement Assessment (CEA). The CEA contains 30 questions that assess the quantity, frequency of use, and method of consumption for dried cannabis products (excluding edibles), cannabis concentrates, and edible products in the previous 30 days. Two additional sections assess other factors associated with cannabis use and history of use. Estimates of consumption can be calculated from responses, with a lower limit of 0 and no upper limit. Higher values represent higher consumption in that month.
Cannabis and Cannabinoid Use from the International Cannabis Policy Study survey	Baseline and re-assessed monthly up to 12 months post-enrollment	Cannabis and cannabinoid use will be measured monthly using items from the International Cannabis Policy Study (ICPS) survey. The ICPS surveys provide a comprehensive assessment of cannabis use, includes detailed patterns of consumption, purchasing, adverse outcomes, as well as attitudes and beliefs towards cannabis. Results from this survey will help quantify amount of cannabis use, if any.
Cannabis and Cannabinoid Perceived Benefits and Harms	Baseline and re-assessed monthly up to 12 months post-enrollment	The NCI Cannabis Core Measures survey will be used to ask cannabis and cannabinoid users each month whether they think cannabis or cannabinoid use worsened or improved their symptoms. Using the NCI Cannabis Core Measures survey, the investigators will ask cannabis and cannabinoid users each month whether they think cannabis or cannabinoid use worsened or improved their symptoms. The investigators will define this as a nominal outcome where 0=no change; 1=worsened quite a bit or somewhat worsened, and 2=somewhat improved or improved quite a bit.
Cannabis and Cannabinoid Adverse Effects	Baseline and re-assessed monthly up to 12 months post-enrollment	The Adverse Reactions Scale will be used to ask cannabis and cannabinoid users each month whether they have experienced a checklist of potential adverse reactions. The investigators will participants using cannabis and/or cannabinoids each month whether they have experienced a checklist of potential adverse reactions. These are defined as presence or absence of the adverse effect. The investigators will also consider the frequency of time they experience the effect (% of time they experience the effect when consuming cannabis or cannabinoids) and the severity of the effect (0 = Not at all distressing; 1 = Mildly distressing; 2 = Moderately distressing; 3 = Quite distressing 4 = Severely distressing) as continuous measures.

Trial Locations

Locations (278)

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

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

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

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

NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro; 🇺🇸 Jonesboro, Arkansas, United States

Kaiser Permanente-Deer Valley Medical Center; 🇺🇸 Antioch, California, United States

Mission Hope Medical Oncology - Arroyo Grande; 🇺🇸 Arroyo Grande, California, United States

Kaiser Permanente Dublin; 🇺🇸 Dublin, California, United States

Kaiser Permanente-Fremont; 🇺🇸 Fremont, California, United States

Kaiser Permanente-Fresno; 🇺🇸 Fresno, California, United States

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

Kaiser Permanente-Modesto; 🇺🇸 Modesto, California, United States

Kaiser Permanente-Oakland; 🇺🇸 Oakland, California, United States

Kaiser Permanente- Marshall Medical Offices; 🇺🇸 Redwood City, California, United States

Kaiser Permanente-Richmond; 🇺🇸 Richmond, California, United States

Kaiser Permanente-Roseville; 🇺🇸 Roseville, California, United States

Kaiser Permanente Downtown Commons; 🇺🇸 Sacramento, California, United States

Kaiser Permanente-South Sacramento; 🇺🇸 Sacramento, California, United States

Kaiser Permanente-San Francisco; 🇺🇸 San Francisco, California, United States

Kaiser Permanente-Santa Teresa-San Jose; 🇺🇸 San Jose, California, United States

Kaiser Permanente San Leandro; 🇺🇸 San Leandro, California, United States

Pacific Central Coast Health Center-San Luis Obispo; 🇺🇸 San Luis Obispo, California, United States

Kaiser San Rafael-Gallinas; 🇺🇸 San Rafael, California, United States

Kaiser Permanente Medical Center - Santa Clara; 🇺🇸 Santa Clara, California, United States

Mission Hope Medical Oncology - Santa Maria; 🇺🇸 Santa Maria, California, United States

Kaiser Permanente-Santa Rosa; 🇺🇸 Santa Rosa, California, United States

Kaiser Permanente-South San Francisco; 🇺🇸 South San Francisco, California, United States

Kaiser Permanente-Stockton; 🇺🇸 Stockton, California, United States

Kaiser Permanente Medical Center-Vacaville; 🇺🇸 Vacaville, California, United States

Kaiser Permanente-Vallejo; 🇺🇸 Vallejo, California, United States

Kaiser Permanente-Walnut Creek; 🇺🇸 Walnut Creek, California, United States

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

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

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

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

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

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

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

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

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

Saint Anthony North Hospital; 🇺🇸 Westminster, Colorado, United States

Beebe South Coastal Health Campus; 🇺🇸 Millville, Delaware, United States

Helen F Graham Cancer Center; 🇺🇸 Newark, Delaware, United States

Medical Oncology Hematology Consultants PA; 🇺🇸 Newark, Delaware, United States

Beebe Health Campus; 🇺🇸 Rehoboth Beach, Delaware, United States

Kaiser Permanente Moanalua Medical Center; 🇺🇸 Honolulu, Hawaii, United States

Saint Alphonsus Cancer Care Center-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

Saint Alphonsus Cancer Care Center-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

Rush-Copley Medical Center; 🇺🇸 Aurora, Illinois, United States

Advocate Outpatient Center - Aurora; 🇺🇸 Aurora, Illinois, United States

Advocate Good Shepherd Hospital; 🇺🇸 Barrington, Illinois, United States

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

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

Advocate Illinois Masonic Medical Center; 🇺🇸 Chicago, Illinois, United States

AMG Crystal Lake - Oncology; 🇺🇸 Crystal Lake, 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

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

Advocate Good Samaritan Hospital; 🇺🇸 Downers Grove, Illinois, United States

Carle Physician Group-Effingham; 🇺🇸 Effingham, Illinois, United States

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

Advocate Sherman Hospital; 🇺🇸 Elgin, Illinois, United States

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

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

Advocate South Suburban Hospital; 🇺🇸 Hazel Crest, Illinois, United States

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

AMG Libertyville - Oncology; 🇺🇸 Libertyville, Illinois, United States

Condell Memorial Hospital; 🇺🇸 Libertyville, Illinois, United States

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

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

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

Carle Cancer Institute Normal; 🇺🇸 Normal, Illinois, United States

Cancer Care Center of O'Fallon; 🇺🇸 O'Fallon, Illinois, United States

HSHS Saint Elizabeth's Hospital; 🇺🇸 O'Fallon, Illinois, United States

Advocate Christ Medical Center; 🇺🇸 Oak Lawn, Illinois, United States

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

Advocate High Tech Medical Park; 🇺🇸 Palos Heights, Illinois, United States

Advocate Lutheran General Hospital; 🇺🇸 Park Ridge, Illinois, United States

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

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

Illinois CancerCare-Peru; 🇺🇸 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

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

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

Rush-Copley Healthcare Center; 🇺🇸 Yorkville, Illinois, United States

Reid Health; 🇺🇸 Richmond, Indiana, United States

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

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

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

Mercy Cancer Center-West Lakes; 🇺🇸 Clive, Iowa, United States

UI Health Care Mission Cancer and Blood - West Des Moines Clinic; 🇺🇸 Clive, 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

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

Mercy Medical Center - Des Moines; 🇺🇸 Des Moines, Iowa, United States

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

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

Flaget Memorial Hospital; 🇺🇸 Bardstown, Kentucky, United States

Saint Joseph Hospital East; 🇺🇸 Lexington, Kentucky, United States

Saint Joseph London; 🇺🇸 London, Kentucky, 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 Penobscot Bay Hospital; 🇺🇸 Rockport, Maine, United States

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

Sinai Hospital of Baltimore; 🇺🇸 Baltimore, Maryland, United States

Christiana Care - Union Hospital; 🇺🇸 Elkton, Maryland, United States

William E Kahlert Regional Cancer Center/Sinai Hospital; 🇺🇸 Westminster, Maryland, United States

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

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

OSF Saint Francis Hospital and Medical Group; 🇺🇸 Escanaba, Michigan, United States

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

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

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

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

Marshfield Medical Center Dickinson; 🇺🇸 Iron Mountain, Michigan, United States

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

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

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

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

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

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

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

Essentia Health Saint Joseph's Medical Center; 🇺🇸 Brainerd, Minnesota, United States

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

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

Essentia Health - Deer River Clinic; 🇺🇸 Deer River, Minnesota, United States

Essentia Health Saint Mary's - Detroit Lakes Clinic; 🇺🇸 Detroit Lakes, Minnesota, United States

Essentia Health Cancer Center; 🇺🇸 Duluth, Minnesota, United States

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

Essentia Health - Fosston; 🇺🇸 Fosston, Minnesota, United States

Essentia Health Hibbing Clinic; 🇺🇸 Hibbing, 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

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

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

Essentia Health - Park Rapids; 🇺🇸 Park Rapids, Minnesota, United States

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

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

Coborn Cancer Center at Saint Cloud Hospital; 🇺🇸 Saint Cloud, 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

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

Lakeview Hospital; 🇺🇸 Stillwater, Minnesota, United States

Essentia Health Virginia Clinic; 🇺🇸 Virginia, Minnesota, United States

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

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

Baptist Cancer Center-Grenada; 🇺🇸 Grenada, Mississippi, United States

Baptist Memorial Hospital and Cancer Center-Union County; 🇺🇸 New Albany, Mississippi, United States

Baptist Memorial Hospital and Cancer Center-Oxford; 🇺🇸 Oxford, Mississippi, United States

Baptist Memorial Hospital and Cancer Center-Desoto; 🇺🇸 Southaven, Mississippi, United States

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

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

Lake Regional Hospital; 🇺🇸 Osage Beach, Missouri, United States

Heartland Regional Medical Center; 🇺🇸 Saint Joseph, 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

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

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

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

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

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

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

Montana Cancer Consortium NCORP; 🇺🇸 Billings, Montana, United States

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

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

Hi-Line Sletten Cancer Center; 🇺🇸 Havre, Montana, United States

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

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

CHI Health Good Samaritan; 🇺🇸 Kearney, Nebraska, United States

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

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

Holy Name Hospital; 🇺🇸 Teaneck, New Jersey, United States

Wake Forest NCORP Research Base; 🇺🇸 Winston-Salem, North Carolina, United States

Essentia Health Cancer Center-South University Clinic; 🇺🇸 Fargo, North Dakota, United States

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

Strecker Cancer Center-Belpre; 🇺🇸 Belpre, Ohio, United States

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

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

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

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

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

Memorial Hospital; 🇺🇸 Marysville, Ohio, United States

Licking Memorial Hospital; 🇺🇸 Newark, Ohio, United States

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

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

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

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

Kaiser Permanente Northwest; 🇺🇸 Portland, Oregon, United States

WellSpan Medical Oncology and Hematology; 🇺🇸 Chambersburg, Pennsylvania, United States

Ephrata Cancer Center; 🇺🇸 Ephrata, Pennsylvania, United States

Adams Cancer Center; 🇺🇸 Gettysburg, Pennsylvania, United States

Sechler Family Cancer Center; 🇺🇸 Lebanon, Pennsylvania, United States

WellSpan Health - York Cancer Center; 🇺🇸 York, Pennsylvania, United States

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

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

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

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

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

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

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

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

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

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

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

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

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

Monument Health Rapid City Hospital; 🇺🇸 Rapid City, South Dakota, United States

Baptist Memorial Hospital and Cancer Center-Collierville; 🇺🇸 Collierville, Tennessee, United States

Baptist Memorial Hospital and Cancer Center-Memphis; 🇺🇸 Memphis, Tennessee, United States

Baptist Memorial Hospital for Women; 🇺🇸 Memphis, Tennessee, United States

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

Aspirus Langlade Hospital; 🇺🇸 Antigo, Wisconsin, United States

ThedaCare Regional Cancer Center; 🇺🇸 Appleton, Wisconsin, United States

Duluth Clinic Ashland; 🇺🇸 Ashland, Wisconsin, United States

ThedaCare Cancer Care - Berlin; 🇺🇸 Berlin, Wisconsin, United States

Aurora Cancer Care-Southern Lakes VLCC; 🇺🇸 Burlington, Wisconsin, United States

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

Aurora Saint Luke's South Shore; 🇺🇸 Cudahy, Wisconsin, United States

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

Aurora Health Care Germantown Health Center; 🇺🇸 Germantown, Wisconsin, United States

Aurora Cancer Care-Grafton; 🇺🇸 Grafton, 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

Aurora BayCare Medical Center; 🇺🇸 Green Bay, Wisconsin, United States

Aurora Cancer Care-Kenosha South; 🇺🇸 Kenosha, Wisconsin, United States

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

Aurora Bay Area Medical Group-Marinette; 🇺🇸 Marinette, Wisconsin, United States

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

Aspirus Medford Hospital; 🇺🇸 Medford, Wisconsin, United States

Aurora Cancer Care-Milwaukee; 🇺🇸 Milwaukee, Wisconsin, United States

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

Aurora Sinai Medical Center; 🇺🇸 Milwaukee, Wisconsin, United States

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

ThedaCare Regional Medical Center - Neenah; 🇺🇸 Neenah, Wisconsin, United States

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

ThedaCare Cancer Care - New London; 🇺🇸 New London, Wisconsin, United States

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

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

ThedaCare Cancer Care - Oshkosh; 🇺🇸 Oshkosh, Wisconsin, United States

Vince Lombardi Cancer Clinic - Oshkosh; 🇺🇸 Oshkosh, Wisconsin, United States

Aurora Cancer Care-Racine; 🇺🇸 Racine, Wisconsin, United States

Aspirus Cancer Care - James Beck Cancer Center; 🇺🇸 Rhinelander, Wisconsin, United States

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

ThedaCare Cancer Care - Shawano; 🇺🇸 Shawano, Wisconsin, United States

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

Sheboygan Physicians Group; 🇺🇸 Sheboygan, Wisconsin, United States

Vince Lombardi Cancer Clinic-Sheboygan; 🇺🇸 Sheboygan, Wisconsin, United States

Aspirus Cancer Care - Stevens Point; 🇺🇸 Stevens Point, Wisconsin, United States

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

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

Aurora Medical Center in Summit; 🇺🇸 Summit, Wisconsin, United States

Vince Lombardi Cancer Clinic-Two Rivers; 🇺🇸 Two Rivers, Wisconsin, United States

ThedaCare Cancer Care - Waupaca; 🇺🇸 Waupaca, Wisconsin, United States

Aspirus Regional Cancer Center; 🇺🇸 Wausau, Wisconsin, United States

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

Aurora Cancer Care-Milwaukee West; 🇺🇸 Wauwatosa, Wisconsin, United States

Aurora West Allis Medical Center; 🇺🇸 West Allis, Wisconsin, United States

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

Aspirus Cancer Care - Wisconsin Rapids; 🇺🇸 Wisconsin Rapids, Wisconsin, United States

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