Dasatinib in Treating Patients With Recurrent or Persistent Ovarian, Fallopian Tube, Endometrial or Peritoneal Cancer

Phase 2

Terminated

Conditions: Endometrial Clear Cell Adenocarcinoma
Recurrent Fallopian Tube Carcinoma
Recurrent Primary Peritoneal Carcinoma
Recurrent Ovarian Carcinoma
Recurrent Uterine Corpus Cancer
Ovarian Clear Cell Cystadenocarcinoma

Interventions: Drug: Dasatinib
Other: Laboratory Biomarker Analysis

Registration Number: NCT02059265

Lead Sponsor: National Cancer Institute (NCI)

Brief Summary: This phase II trial studies how well dasatinib works in treating patients with ovarian, fallopian tube, endometrial, or peritoneal cancer that has come back or is persistent. Dasatinib may shrink patients' tumors by blocking some of the enzymes needed for cell growth.

Detailed Description: PRIMARY OBJECTIVES:

I. To assess the clinical activity of dasatinib in patients with recurrent or persistent ovarian, fallopian tube, primary peritoneal, and endometrial clear cell carcinoma using objective tumor response (complete and partial): in patients without loss of BRG-associated factor 250a (BAF250a) expression and in patients with loss of BAF250a expression.

SECONDARY OBJECTIVES:

I. To examine the nature and degree of toxicity in this patient population treated with this regimen in patients with and without loss of BAF250a expression.

II. To examine the progression-free survival and overall survival for this patient population receiving dasatinib in patients with and without loss of BAF250a expression.

TERTIARY OBJECTIVES:

I. To examine the agreement between BAF250a immunohistochemistry and AT rich interactive domain 1A (SWI-like) (ARID1A) mutation status using next generation sequencing performed in formalin-fixed, paraffin-embedded tumor tissue.

OUTLINE:

Patients receive dasatinib orally (PO) once daily (QD) on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months for 3 years.

Recruitment & Eligibility

Status: TERMINATED

Sex: Female

Target Recruitment: 35

Inclusion Criteria

Patients must have recurrent or persistent ovarian, fallopian tube, peritoneum, and endometrial clear cell carcinoma; primary tumors must be at least 50% clear cell histomorphology in order to be eligible or have a histologically documented recurrence with at least 50% clear cell histomorphology; in addition, the tumors should be negative for expression of Wilms tumor 1 (WT-1) antigen (with the exception of endometrial cancers where WT-1 stains are not required) and estrogen receptor (ER) antigen by immunohistochemistry; focal, weak, ER staining of tumor cells (< 5%) is permitted; appropriate tissue sections must be available for histologic evaluation for central pathology review by Gynecologic Oncology Group (GOG); immunohistochemical stained slides for ER and WT-1 antigen must be available for review by GOG
- If the primary tumor had at least 50% clear cell histomorphology, a biopsy of the recurrent or persistent tumor is not required; however, immunohistochemical studies of the primary tumor for ER and WT-1 antigens should be performed and the slides submitted to the GOG for review; the percentage of clear cell histomorphology must be documented in the pathology report or in an addendum to the original report; if slides of the primary tumor are not available for review due to disposal of slides by the histology laboratory (typically 10 years after diagnosis), biopsy of recurrent or persistent disease is required
- If the primary tumor had less than 50% clear cell histomorphology (or if slides of the primary tumor are not available for review), a biopsy of the recurrent or persistent tumor is required to confirm at least 50% clear cell histomorphology and lack of immuno-reactivity for ER and WT-1 antigens by immunohistochemistry; the percentage of involvement must be documented in the pathology report or in an addendum to the original report
Patients must have results from the determination of BAF250a immunohistochemistry (IHC) status and must have a BAF250a expression status that is currently open to enrollment
All patients must have measurable disease; measurable disease is defined by Response Evaluation Criteria in Solid Tumors (RECIST) (version 1.1); measurable disease is defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded); each lesion must be >= 10 mm when measured by computed tomography [CT], magnetic resonance imaging [MRI] or caliper measurement by clinical exam; or >= 20 mm when measured by chest x-ray; lymph nodes must be > 15 mm in short axis when measured by CT or MRI
Patients must have had one prior platinum-based chemotherapeutic regimen for management of primary disease; patients are allowed to receive, but are not required to receive, two additional cytotoxic regimens for management of recurrent or persistent disease
Patients must be >= 3 weeks from last chemotherapy or radiation (6 weeks for nitrosoureas or mitomycin)
Patients must have progressed on, be ineligible for, or have declined participation in GOG-0254 provided that protocol is actively accruing patients
Leukocytes >= 3,000/mcL
Absolute neutrophil count >= 1,500/mcL
Platelets >= 100,000/mcL
Creatinine =< 1.5 times the upper limit of normal (ULN) OR creatinine clearance >= 60 mL/min/1.73 m^2
Bilirubin =< 1.5 ULN
Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) and alanine aminotransferase ALT (serum glutamate pyruvate transaminase [SGPT]) =< 3 x ULN
Patients who are on concomitant medications that are STRONG inducers or inhibitors of the cytochrome P450 family 3, subfamily A, polypeptide 4 (CYP3A4) enzyme should stop 2 weeks prior to first dose of dasatinib, if all other eligibility has been confirmed
Corrected QT (QTc) interval on electrocardiogram must be =< 480 msec (Fridericia correction)
Patients who have received one prior regimen must have a GOG performance status of 0, 1 or 2; patients who have received two or more prior regimens must have GOG performance status of 0 or 1
Patients who have met the pre-entry requirements
Patients must have signed an approved informed consent and authorization permitting release of personal health information

Exclusion Criteria

Prior treatment with dasatinib, imatinib or nilotinib
Patients with symptomatic effusions (pleural, pericardial, or peritoneal) and/or those who have required a procedure for symptomatic effusions within 4 weeks of start of dasatinib are ineligible
Patients with a history of cardiac disease including: (1) uncontrolled angina, congestive heart failure, or myocardial infarction within six months prior to study entry, (2) congenital long QT syndrome, (3) clinical significant ventricular arrhythmias
The concomitant use of histamine (H)2 blockers and proton pump inhibitors (PPIs) with dasatinib is not recommended; the use of antacids should be considered in place of H2 blockers or proton pump inhibitors in patients receiving dasatinib therapy; if antacid therapy is needed, the antacid dose should be administered two hours before or after the dose of dasatinib; patients who cannot tolerate discontinuation of H2 blockers or PPIs are ineligible
Therapeutic anticoagulation is not contraindicated, but for those patients on therapeutic anticoagulation, alteration in coagulation parameters is expected following initiation of dasatinib; for patients on therapeutic anticoagulation, coagulation parameters should be assessed weekly for the first cycle following initiation of dasatinib, weekly for the first cycle following a dose reduction, and weekly for a minimum of two weeks after stopping dasatinib
Patients whose circumstances do not permit completion of the study or the required follow-up
Patients who are pregnant or nursing; women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation and for 3 months after completion of therapy; should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately; a negative serum pregnancy test within 72 hours of starting drug is required
Patients who have a major surgical procedure, or significant traumatic injury within 28 days prior to the first date of treatment on this study, or anticipation of need for major surgical procedure during the course of the study; patients with placement of vascular access device or core biopsy within 7 days prior to the first date of treatment on this study
Patients with other invasive malignancies, with the exception of non-melanoma skin cancer, who had (or have) any evidence of other cancer present within the last 5 years or whose previous cancer treatment contraindicates this protocol therapy
Human immunodeficiency virus (HIV)-positive patients on combination antiretroviral therapy are ineligible
Patients who are unable to swallow pills

Study & Design

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Treatment (dasatinib)	Laboratory Biomarker Analysis	Patients receive dasatinib PO QD on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Treatment (dasatinib)	Dasatinib	Patients receive dasatinib PO QD on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Primary Outcome Measures

Name	Time	Method
Proportion of Patients With Objective Tumor Response Rate (Complete Response [CR] or Partial Response [PR]) Using RECIST Version 1.1	CT scan or MRI if used to follow lesion for measurable disease every other cycle for the first 6 months; then every 3 months x 2; then every 6 months thereafter until disease progression for up to 5 years.	Complete and Partial Tumor Response by RECIST 1.1. RECIST 1.1 defines complete response as the disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm and the disappearance of all non-target lesions and normalization of tumor marker level. Partial response is defined as at least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. Only those patients who have measurable disease present at baseline, have received at least one cycle of therapy, and have had their disease re-evaluated will be considered evaluable for response. These patients will have their response classified according to the definitions stated above. Complete and partial responses are included in the objective tumor response rate.

Secondary Outcome Measures

Name	Time	Method
Duration of Overall Survival (OS)	Every cycle during treatment, then every 3 months for the first 2 years, then every six months for the next three years and then annually for the next 5 years.	Overall survival is defined as the duration of time from study entry to time of death or the date of last contact.
Duration of Progression-free Survival (PFS)	Duration of time from start of treatment to time of progression or death, whichever occurs first, assessed up to 5 years	PFS will be characterized with Kaplan-Meier plots and estimates of the median time until death or progression.
Incidence of Adverse Effects as Assessed by Common Terminology Criteria for Adverse Events Version 4.0	Up to 5 years	The frequency and severity of all toxicities are tabulated.

Trial Locations

Locations (226): Illinois CancerCare-Princeton
🇺🇸
Princeton, Illinois, United States
Aurora Cancer Care-Kenosha South
🇺🇸
Kenosha, Wisconsin, United States
Columbus Oncology and Hematology Associates Inc
🇺🇸
Columbus, Ohio, United States
Case Western Reserve University
🇺🇸
Cleveland, Ohio, United States
Cleveland Clinic Foundation
🇺🇸
Cleveland, Ohio, United States
Cleveland Clinic Cancer Center/Fairview Hospital
🇺🇸
Cleveland, Ohio, United States
Eden Hospital Medical Center
🇺🇸
Castro Valley, California, United States
Palo Alto Medical Foundation-Camino Division
🇺🇸
Mountain View, California, United States
Sutter Auburn Faith Hospital
🇺🇸
Auburn, California, United States
Alta Bates Summit Medical Center-Herrick Campus
🇺🇸
Berkeley, California, United States
Memorial Medical Center
🇺🇸
Springfield, Illinois, United States
Palo Alto Medical Foundation-Gynecologic Oncology
🇺🇸
Mountain View, California, United States
Sutter Cancer Centers Radiation Oncology Services-Auburn
🇺🇸
Auburn, California, United States
Sutter Cancer Centers Radiation Oncology Services-Cameron Park
🇺🇸
Cameron Park, California, United States
Katmai Oncology Group
🇺🇸
Anchorage, Alaska, United States
Sutter Davis Hospital
🇺🇸
Davis, California, United States
Saint Alphonsus Cancer Care Center-Boise
🇺🇸
Boise, Idaho, United States
Saint Luke's Cancer Institute - Nampa
🇺🇸
Nampa, Idaho, United States
Carle at The Riverfront
🇺🇸
Danville, Illinois, United States
Decatur Memorial Hospital
🇺🇸
Decatur, Illinois, United States
Illinois CancerCare-Canton
🇺🇸
Canton, Illinois, United States
Illinois CancerCare-Carthage
🇺🇸
Carthage, Illinois, United States
Fairview Southdale Hospital
🇺🇸
Edina, Minnesota, United States
Cancer Care Specialists of Illinois - Decatur
🇺🇸
Decatur, Illinois, United States
Memorial Hospital of Carbondale
🇺🇸
Carbondale, Illinois, United States
Centralia Oncology Clinic
🇺🇸
Centralia, Illinois, United States
Illinois CancerCare-Kewanee Clinic
🇺🇸
Kewanee, Illinois, United States
Cancer Care Center of O'Fallon
🇺🇸
O'Fallon, Illinois, United States
University of Chicago Comprehensive Cancer Center
🇺🇸
Chicago, Illinois, United States
OSF Saint Francis Medical Center
🇺🇸
Peoria, Illinois, United States
Illinois CancerCare-Bloomington
🇺🇸
Bloomington, Illinois, United States
Fairview Ridges Hospital
🇺🇸
Burnsville, Minnesota, United States
Illinois CancerCare-Galesburg
🇺🇸
Galesburg, Illinois, United States
Illinois CancerCare-Ottawa Clinic
🇺🇸
Ottawa, Illinois, United States
Allegiance Health
🇺🇸
Jackson, Michigan, United States
New Ulm Medical Center
🇺🇸
New Ulm, Minnesota, United States
Delbert Day Cancer Institute at PCRMC
🇺🇸
Rolla, Missouri, United States
Unity Hospital
🇺🇸
Fridley, Minnesota, United States
Memorial Sloan Kettering Cancer Center
🇺🇸
New York, New York, United States
Ascension Saint Mary's Hospital
🇺🇸
Saginaw, Michigan, United States
Washington University School of Medicine
🇺🇸
Saint Louis, Missouri, United States
Hutchinson Area Health Care
🇺🇸
Hutchinson, Minnesota, United States
Rice Memorial Hospital
🇺🇸
Willmar, Minnesota, United States
Memorial Sloan Kettering Westchester
🇺🇸
Harrison, New York, United States
North Memorial Medical Health Center
🇺🇸
Robbinsdale, Minnesota, United States
Riverside Methodist Hospital
🇺🇸
Columbus, Ohio, United States
Mount Carmel Health Center West
🇺🇸
Columbus, Ohio, United States
Minnesota Oncology Hematology PA-Maplewood
🇺🇸
Maplewood, Minnesota, United States
Southeast Cancer Center
🇺🇸
Cape Girardeau, Missouri, United States
Carson Tahoe Regional Medical Center
🇺🇸
Carson City, Nevada, United States
Mount Carmel East Hospital
🇺🇸
Columbus, Ohio, United States
The Mark H Zangmeister Center
🇺🇸
Columbus, Ohio, United States
Saint Francis Regional Medical Center
🇺🇸
Shakopee, Minnesota, United States
Lakeview Hospital
🇺🇸
Stillwater, Minnesota, United States
Cox Cancer Center Branson
🇺🇸
Branson, Missouri, United States
AdventHealth Hendersonville
🇺🇸
Hendersonville, North Carolina, United States
Adena Regional Medical Center
🇺🇸
Chillicothe, Ohio, United States
United Hospital
🇺🇸
Saint Paul, Minnesota, United States
Aurora Bay Area Medical Group-Marinette
🇺🇸
Marinette, Wisconsin, United States
Memorial Sloan Kettering Commack
🇺🇸
Commack, New York, United States
Memorial Sloan Kettering Nassau
🇺🇸
Uniondale, New York, United States
Grady Memorial Hospital
🇺🇸
Delaware, Ohio, United States
Cancer Research for the Ozarks NCORP
🇺🇸
Springfield, Missouri, United States
Barnes-Jewish Hospital
🇺🇸
Saint Louis, Missouri, United States
Newark Radiation Oncology
🇺🇸
Newark, Ohio, United States
Oklahoma Cancer Specialists and Research Institute-Tulsa
🇺🇸
Tulsa, Oklahoma, United States
Parkland Memorial Hospital
🇺🇸
Dallas, Texas, United States
Aurora West Allis Medical Center
🇺🇸
West Allis, Wisconsin, United States
Aurora Cancer Care-Southern Lakes VLCC
🇺🇸
Burlington, Wisconsin, United States
Aurora Health Care Germantown Health Center
🇺🇸
Germantown, Wisconsin, United States
Aurora Cancer Care-Waukesha
🇺🇸
Waukesha, Wisconsin, United States
Aurora Cancer Care-Grafton
🇺🇸
Grafton, Wisconsin, United States
Aurora Medical Center in Summit
🇺🇸
Summit, Wisconsin, United States
Vince Lombardi Cancer Clinic-Two Rivers
🇺🇸
Two Rivers, Wisconsin, United States
Indiana University/Melvin and Bren Simon Cancer Center
🇺🇸
Indianapolis, Indiana, United States
Ascension Saint Vincent Indianapolis Hospital
🇺🇸
Indianapolis, Indiana, United States
Mills-Peninsula Medical Center
🇺🇸
Burlingame, California, United States
Sutter Cancer Centers Radiation Oncology Services-Roseville
🇺🇸
Roseville, California, United States
Sutter Pacific Medical Foundation
🇺🇸
Santa Rosa, California, United States
Palo Alto Medical Foundation-Sunnyvale
🇺🇸
Sunnyvale, California, United States
Sutter Cancer Centers Radiation Oncology Services-Vacaville
🇺🇸
Vacaville, California, United States
Sutter Solano Medical Center/Cancer Center
🇺🇸
Vallejo, California, United States
Hartford Hospital
🇺🇸
Hartford, Connecticut, United States
Northside Hospital-Forsyth
🇺🇸
Cumming, Georgia, United States
Northside Hospital
🇺🇸
Atlanta, Georgia, United States
Northeast Georgia Medical Center-Gainesville
🇺🇸
Gainesville, Georgia, United States
The Cancer Center of Hawaii-Pali Momi
🇺🇸
'Aiea, Hawaii, United States
Borgess Medical Center
🇺🇸
Kalamazoo, Michigan, United States
Mercy Hospital
🇺🇸
Coon Rapids, Minnesota, United States
Parkland Health Center-Bonne Terre
🇺🇸
Bonne Terre, Missouri, United States
Women and Infants Hospital
🇺🇸
Providence, Rhode Island, United States
AnMed Health Cancer Center
🇺🇸
Anderson, South Carolina, United States
Gibbs Cancer Center-Gaffney
🇺🇸
Gaffney, South Carolina, United States
Spartanburg Medical Center
🇺🇸
Spartanburg, South Carolina, United States
Cancer Center of Western Wisconsin
🇺🇸
New Richmond, Wisconsin, United States
Vince Lombardi Cancer Clinic-Sheboygan
🇺🇸
Sheboygan, Wisconsin, United States
Aurora Cancer Care-Milwaukee West
🇺🇸
Wauwatosa, Wisconsin, United States
California Pacific Medical Center-Pacific Campus
🇺🇸
San Francisco, California, United States
UCSF Medical Center-Mount Zion
🇺🇸
San Francisco, California, United States
UCSF Medical Center-Mission Bay
🇺🇸
San Francisco, California, United States
Abbott-Northwestern Hospital
🇺🇸
Minneapolis, Minnesota, United States
Health Partners Inc
🇺🇸
Minneapolis, Minnesota, United States
Pali Momi Medical Center
🇺🇸
'Aiea, Hawaii, United States
Queen's Cancer Center - Pearlridge
🇺🇸
'Aiea, Hawaii, United States
Wilcox Memorial Hospital and Kauai Medical Clinic
🇺🇸
Lihue, Hawaii, United States
Ascension Saint John Hospital
🇺🇸
Detroit, Michigan, United States
University of Oklahoma Health Sciences Center
🇺🇸
Oklahoma City, Oklahoma, United States
Providence Alaska Medical Center
🇺🇸
Anchorage, Alaska, United States
Mercy Hospital Springfield
🇺🇸
Springfield, Missouri, United States
Anchorage Oncology Centre
🇺🇸
Anchorage, Alaska, United States
Saint Luke's Cancer Institute - Boise
🇺🇸
Boise, Idaho, United States
Saint Luke's Cancer Institute - Fruitland
🇺🇸
Fruitland, Idaho, United States
Smilow Cancer Hospital Care Center at Saint Francis
🇺🇸
Hartford, Connecticut, United States
Saint Luke's Cancer Institute - Meridian
🇺🇸
Meridian, Idaho, United States
The Hospital of Central Connecticut
🇺🇸
New Britain, Connecticut, United States
Maine Medical Center- Scarborough Campus
🇺🇸
Scarborough, Maine, United States
University of Rochester
🇺🇸
Rochester, New York, United States
Gibbs Cancer Center-Pelham
🇺🇸
Greer, South Carolina, United States
Alaska Women's Cancer Care
🇺🇸
Anchorage, Alaska, United States
Women's Cancer Center of Nevada
🇺🇸
Las Vegas, Nevada, United States
Memorial Sloan Kettering Basking Ridge
🇺🇸
Basking Ridge, New Jersey, United States
Saint Francis Hospital
🇺🇸
Greenville, South Carolina, United States
Rapid City Regional Hospital
🇺🇸
Rapid City, South Dakota, United States
Renown Regional Medical Center
🇺🇸
Reno, Nevada, United States
Center of Hope at Renown Medical Center
🇺🇸
Reno, Nevada, United States
Black Hills Obstetrics and Gynecology
🇺🇸
Rapid City, South Dakota, United States
Nebraska Methodist Hospital
🇺🇸
Omaha, Nebraska, United States
Aurora Cancer Care-Milwaukee
🇺🇸
Milwaukee, Wisconsin, United States
Aurora Sinai Medical Center
🇺🇸
Milwaukee, Wisconsin, United States
Capital Region Southwest Campus
🇺🇸
Jefferson City, Missouri, United States
CoxHealth South Hospital
🇺🇸
Springfield, 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
Missouri Baptist Sullivan Hospital
🇺🇸
Sullivan, Missouri, United States
Missouri Baptist Outpatient Center-Sunset Hills
🇺🇸
Sunset Hills, Missouri, United States
Palo Alto Medical Foundation Health Care
🇺🇸
Palo Alto, California, United States
Sutter Roseville Medical Center
🇺🇸
Roseville, California, United States
Saint Joseph Medical Center
🇺🇸
Bloomington, Illinois, United States
Carle Physician Group-Effingham
🇺🇸
Effingham, Illinois, United States
Crossroads Cancer Center
🇺🇸
Effingham, Illinois, United States
Illinois CancerCare-Eureka
🇺🇸
Eureka, Illinois, United States
Western Illinois Cancer Treatment Center
🇺🇸
Galesburg, Illinois, United States
Sudarshan K Sharma MD Limited-Gynecologic Oncology
🇺🇸
Hinsdale, Illinois, United States
Carle Physician Group-Mattoon/Charleston
🇺🇸
Mattoon, Illinois, United States
Illinois CancerCare-Macomb
🇺🇸
Macomb, Illinois, United States
Good Samaritan Regional Health Center
🇺🇸
Mount Vernon, Illinois, United States
UC Comprehensive Cancer Center at Silver Cross
🇺🇸
New Lenox, Illinois, United States
Radiation Oncology of Northern Illinois
🇺🇸
Ottawa, Illinois, United States
Illinois CancerCare-Peoria
🇺🇸
Peoria, Illinois, United States
OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
🇺🇸
Pekin, Illinois, United States
OSF Saint Francis Radiation Oncology at Peoria Cancer Center
🇺🇸
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
Central Illinois Hematology Oncology Center
🇺🇸
Springfield, Illinois, United States
Southern Illinois University School of Medicine
🇺🇸
Springfield, Illinois, United States
Carle Cancer Center
🇺🇸
Urbana, Illinois, United States
The Carle Foundation Hospital
🇺🇸
Urbana, Illinois, United States
Methodist West Hospital
🇺🇸
West Des Moines, Iowa, United States
Beaumont Hospital - Dearborn
🇺🇸
Dearborn, Michigan, United States
Genesys Hurley Cancer Institute
🇺🇸
Flint, Michigan, United States
Hurley Medical Center
🇺🇸
Flint, Michigan, United States
Saint Joseph Mercy Oakland
🇺🇸
Pontiac, Michigan, United States
Bronson Methodist Hospital
🇺🇸
Kalamazoo, Michigan, United States
Trinity Health Saint Mary Mercy Livonia Hospital
🇺🇸
Livonia, Michigan, United States
West Michigan Cancer Center
🇺🇸
Kalamazoo, Michigan, United States
Lake Huron Medical Center
🇺🇸
Port Huron, Michigan, United States
Saint John Macomb-Oakland Hospital
🇺🇸
Warren, Michigan, United States
Ohio State University Comprehensive Cancer Center
🇺🇸
Columbus, Ohio, United States
Doctors Hospital
🇺🇸
Columbus, Ohio, United States
Delaware Health Center-Grady Cancer Center
🇺🇸
Delaware, Ohio, United States
Delaware Radiation Oncology
🇺🇸
Delaware, Ohio, United States
Fairfield Medical Center
🇺🇸
Lancaster, Ohio, United States
OhioHealth Mansfield Hospital
🇺🇸
Mansfield, Ohio, United States
Hillcrest Hospital Cancer Center
🇺🇸
Mayfield Heights, Ohio, United States
Marietta Memorial Hospital
🇺🇸
Marietta, Ohio, United States
Licking Memorial Hospital
🇺🇸
Newark, Ohio, United States
UT Southwestern/Simmons Cancer Center-Dallas
🇺🇸
Dallas, Texas, United States
Knox Community Hospital
🇺🇸
Mount Vernon, Ohio, United States
Southern Ohio Medical Center
🇺🇸
Portsmouth, Ohio, United States
Aurora Saint Luke's Medical Center
🇺🇸
Milwaukee, Wisconsin, United States
Aurora BayCare Medical Center
🇺🇸
Green Bay, Wisconsin, United States
Park Nicollet Clinic - Saint Louis Park
🇺🇸
Saint Louis Park, Minnesota, United States
Hennepin County Medical Center
🇺🇸
Minneapolis, Minnesota, United States
Regions Hospital
🇺🇸
Saint Paul, Minnesota, United States
Saint John's Hospital - Healtheast
🇺🇸
Maplewood, Minnesota, United States
Metro Minnesota Community Oncology Research Consortium
🇺🇸
Saint Louis Park, Minnesota, United States
Minnesota Oncology Hematology PA-Woodbury
🇺🇸
Woodbury, Minnesota, United States
UH Seidman Cancer Center at Lake Health Mentor Campus
🇺🇸
Mentor, Ohio, United States
Michigan Cancer Research Consortium NCORP
🇺🇸
Ann Arbor, Michigan, United States
Sutter Medical Center Sacramento
🇺🇸
Sacramento, California, United States
Saint Joseph Mercy Hospital
🇺🇸
Ann Arbor, Michigan, United States
Southeast Clinical Oncology Research Consortium NCORP
🇺🇸
Winston-Salem, North Carolina, United States
Vince Lombardi Cancer Clinic - Oshkosh
🇺🇸
Oshkosh, Wisconsin, United States
Jefferson Abington Hospital
🇺🇸
Abington, Pennsylvania, United States
M D Anderson Cancer Center
🇺🇸
Houston, Texas, United States
Grant Medical Center
🇺🇸
Columbus, Ohio, United States
Springfield Clinic
🇺🇸
Springfield, Illinois, United States
Sparrow Hospital
🇺🇸
Lansing, Michigan, United States
Hawaii Cancer Care Inc - Waterfront Plaza
🇺🇸
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
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
Iowa Methodist Medical Center
🇺🇸
Des Moines, Iowa, United States
Iowa-Wide Oncology Research Coalition NCORP
🇺🇸
Des Moines, Iowa, United States
Medical Oncology and Hematology Associates-Des Moines
🇺🇸
Des Moines, Iowa, United States
Iowa Lutheran Hospital
🇺🇸
Des Moines, Iowa, United States
Palo Alto Medical Foundation-Santa Cruz
🇺🇸
Santa Cruz, California, United States
Saint Luke's Cancer Institute - Twin Falls
🇺🇸
Twin Falls, Idaho, United States
Illinois CancerCare-Pekin
🇺🇸
Pekin, Illinois, United States
Ridgeview Medical Center
🇺🇸
Waconia, Minnesota, United States
Saint Francis Medical Center
🇺🇸
Cape Girardeau, Missouri, United States
Memorial Sloan Kettering Sleepy Hollow
🇺🇸
Sleepy Hollow, New York, United States
Strecker Cancer Center-Belpre
🇺🇸
Belpre, Ohio, United States
OhioHealth Marion General Hospital
🇺🇸
Marion, Ohio, United States
Springfield Regional Medical Center
🇺🇸
Springfield, Ohio, United States
Saint Ann's Hospital
🇺🇸
Westerville, Ohio, United States
Aurora Cancer Care-Racine
🇺🇸
Racine, Wisconsin, United States
Genesis Healthcare System Cancer Care Center
🇺🇸
Zanesville, Ohio, United States
Aurora Health Center-Fond du Lac
🇺🇸
Fond Du Lac, Wisconsin, United States