Ibrutinib Before and After Stem Cell Transplant in Treating Patients With Relapsed or Refractory Diffuse Large B-cell Lymphoma

Registration Number
NCT02443077
Lead Sponsor
National Cancer Institute (NCI)
Brief Summary

This randomized phase III trial studies ibrutinib to see how well it works compared to placebo when given before and after stem cell transplant in treating patients with diffuse large B-cell lymphoma that has returned after a period of improvement (relapsed) or does not respond to treatment (refractory). Before transplant, stem cells are taken from patients ...

Detailed Description

PRIMARY OBJECTIVE:

I. To evaluate the ability of ibrutinib to improve 24-month progression free survival (PFS) compared to placebo in patients with non-germinal center B-cell-like (GCB) diffuse large B-cell lymphoma (DLBCL) as determined by immunohistochemistry (IHC).

SECONDARY OBJECTIVES:
...

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
302
Inclusion Criteria

  • PRE-REGISTRATION ELIGIBILITY CRITERIA (STEP 0)

  • Patients must have paraffin tissue from the diagnostic or relapse biopsy available to be submitted for central pathology review; this review is mandatory prior to registration to confirm eligibility and should be initiated as soon as possible

  • ELIGIBILITY CRITERIA (STEP 1)

  • Diagnosis of World Health Organization (WHO) diffuse large B-cell lymphoma, non-GCB by central review confirmation

  • Patient must be deemed eligible to proceed with high-dose chemotherapy and autologous stem cell transplantation by local transplant center

  • New York Heart Association class I or less; ordinary physical activity does not cause undue fatigue, palpitations, dyspnea, or angina pain; patients 60 years or older must have a left ventricular ejection fraction (LVEF) at rest >= 40% measured by echocardiogram or multi-gated acquisition (MUGA)

  • Diffusion capacity of the lung for carbon monoxide (DLCO) >= 40% of predicted (corrected or uncorrected for hemoglobin per institutional standards)

  • Forced expiratory volume in 1 second (FEV1) >= 40% of predicted (corrected or uncorrected for hemoglobin per institutional standards)

  • Forced vital capacity (FVC) >= 40% of predicted (corrected or uncorrected for hemoglobin per institutional standards)

  • Total bilirubin =< 1.5 x upper limit of normal (ULN) unless isolated hyperbilirubinemia attributed to Gilbert's syndrome

  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 3 x upper limit of normal (ULN)

  • Creatinine =< 2.0 mg/dL OR creatinine clearance (calculated clearance permitted) >= 40 mL/min by Cockcroft-Gault formula

  • Prothrombin time (PT)/ international normalized ration (INR) < 1.5 x ULN and partial thromboplastin time (PTT) (activated [a]PTT) < 1.5 x ULN

  • Patient must have progressed or be refractory to prior anthracycline-containing chemotherapy (e.g. rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisone [R-CHOP], dose adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab [DA-EPOCH-R], etc)

  • No more than 3 prior regimens for large cell component (e.g. one induction and two salvage therapies); monoclonal antibody alone or involved field/involved site radiotherapy do not count as lines of therapy. Prior CART therapy is allowed and counts as one line of therapy

  • Prior use of ibrutinib is allowed unless patient has had disease progression while receiving ibrutinib

  • Patient must have chemosensitive disease as defined by at least a partial response to salvage therapy at their latest assessment

  • No major surgery =< 7 days prior to registration and no minor surgery =< 3 days prior to registration (with the exception of intravenous access placement, e.g. Hickman or peripherally inserted central catheter [PICC])

  • Not pregnant and not nursing, because this study involves an agent that has known genotoxic, mutagenic and teratogenic effects; therefore, for women of childbearing potential only, a negative serum pregnancy test must be obtained within 14 days prior to registration

    • Women of childbearing potential must use adequate contraception from study start to one month after the last dose of protocol therapy; adequate contraception is defined as hormonal birth control, intrauterine device, double barrier method or total abstinence; men must practice complete abstinence or agree to use an adequate contraception method from study start to one month after the last dose of protocol therapy

  • Age >= 18 years

  • Patients should not require chronic use of strong CYP3A inhibitors or strong CYP3A inducers

  • Patients should not require concurrent therapeutic doses of steroids (> 20 mg of prednisone/day or equivalent) unless they need them for the indications; steroids should be discontinued for 14 days before starting protocol treatment

  • Human immunodeficiency virus (HIV) infected patients are eligible provided they meet all other eligibility criteria, and:

    • There is no prior history of acquired immunodeficiency syndrome (AIDS) defining conditions other than historically low CD4+ T-cell count or B-cell lymphoma
    • In the opinion of an expert in HIV disease, prospects for long-term survival are excellent were it not for the diagnosis of lymphoma
    • Use of HIV protease inhibitors as part of the anti-HIV regimen OR as a pharmacologic booster is not allowed
    • Zidovudine is not allowed
    • Once daily combination pills for HIV containing a pharmacologic booster such as cobicistat are not allowed
    • Patients with multi-drug resistant HIV are not eligible

  • Patients cannot have:

    • Active central nervous system or meningeal involvement by lymphoma; patients with a history of central nervous system (CNS) or meningeal involvement must be in a documented remission by cerebrospinal fluid (CSF) evaluation and contrast-enhanced magnetic resonance imaging (MRI) imaging for at least 91 days prior to registration
    • Evidence of myelodysplasia or cytogenetic abnormality indicative of myelodysplasia on any bone marrow biopsy prior to initiation of therapy
    • A known bleeding diathesis
    • Requirement for warfarin or similar vitamin K antagonists; these drugs are prohibited 28 days prior to the first treatment and throughout the trial
    • History of stroke or intracranial hemorrhage =< 6 months before treatment
    • Currently active, clinically significant hepatic impairment (Child-Pugh class B or C according to the Child Pugh classification
    • History of allergic reactions attributed to compounds of similar chemical or biologic composition to ibrutinib or other agents used in study
    • Serologic status reflecting active hepatitis B or C infection; patients that are positive for hepatitis B core antibody, hepatitis B surface antigen (HBsAg), or hepatitis C antibody must have a negative polymerase chain reaction (PCR) prior to enrollment; (PCR positive patients will be excluded)

  • Eastern Cooperative Oncology Group (ECOG) performance status must be =< 2

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Exclusion Criteria

Not provided

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Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Arm I (ibrutinib, chemotherapy, autoHCT)Autologous Hematopoietic Stem Cell TransplantationCONDITIONING REGIMEN: Investigators may choose to use either the BEAMi or CBVi regimen. BEAMi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV BID over 1-2 hours and cytarabine IV BID over 1-2 hours on days -5 to -2, and melphalan IV over 20-30 minutes on day -1. CBVi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV over 4 hours on day -4, and cyclophosphamide IV on day -2. TRANSPLANT: In both arms, patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive ibrutinib PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity.
Arm II (placebo, chemotherapy, autoHCT)Autologous Bone Marrow TransplantationCONDITIONING REGIMEN: Patients receive placebo PO on days -6 to -1 and receive 1 of the 2 conditioning regimens as in Arm I. TRANSPLANT: Patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive placebo PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover Arm I.
Arm II (placebo, chemotherapy, autoHCT)Autologous Hematopoietic Stem Cell TransplantationCONDITIONING REGIMEN: Patients receive placebo PO on days -6 to -1 and receive 1 of the 2 conditioning regimens as in Arm I. TRANSPLANT: Patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive placebo PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover Arm I.
Arm II (placebo, chemotherapy, autoHCT)Placebo AdministrationCONDITIONING REGIMEN: Patients receive placebo PO on days -6 to -1 and receive 1 of the 2 conditioning regimens as in Arm I. TRANSPLANT: Patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive placebo PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover Arm I.
Arm I (ibrutinib, chemotherapy, autoHCT)Autologous Bone Marrow TransplantationCONDITIONING REGIMEN: Investigators may choose to use either the BEAMi or CBVi regimen. BEAMi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV BID over 1-2 hours and cytarabine IV BID over 1-2 hours on days -5 to -2, and melphalan IV over 20-30 minutes on day -1. CBVi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV over 4 hours on day -4, and cyclophosphamide IV on day -2. TRANSPLANT: In both arms, patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive ibrutinib PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity.
Arm I (ibrutinib, chemotherapy, autoHCT)Laboratory Biomarker AnalysisCONDITIONING REGIMEN: Investigators may choose to use either the BEAMi or CBVi regimen. BEAMi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV BID over 1-2 hours and cytarabine IV BID over 1-2 hours on days -5 to -2, and melphalan IV over 20-30 minutes on day -1. CBVi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV over 4 hours on day -4, and cyclophosphamide IV on day -2. TRANSPLANT: In both arms, patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive ibrutinib PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity.
Arm I (ibrutinib, chemotherapy, autoHCT)Pharmacogenomic StudyCONDITIONING REGIMEN: Investigators may choose to use either the BEAMi or CBVi regimen. BEAMi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV BID over 1-2 hours and cytarabine IV BID over 1-2 hours on days -5 to -2, and melphalan IV over 20-30 minutes on day -1. CBVi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV over 4 hours on day -4, and cyclophosphamide IV on day -2. TRANSPLANT: In both arms, patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive ibrutinib PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity.
Arm II (placebo, chemotherapy, autoHCT)Pharmacogenomic StudyCONDITIONING REGIMEN: Patients receive placebo PO on days -6 to -1 and receive 1 of the 2 conditioning regimens as in Arm I. TRANSPLANT: Patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive placebo PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover Arm I.
Arm II (placebo, chemotherapy, autoHCT)Laboratory Biomarker AnalysisCONDITIONING REGIMEN: Patients receive placebo PO on days -6 to -1 and receive 1 of the 2 conditioning regimens as in Arm I. TRANSPLANT: Patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive placebo PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover Arm I.
Arm II (placebo, chemotherapy, autoHCT)CyclophosphamideCONDITIONING REGIMEN: Patients receive placebo PO on days -6 to -1 and receive 1 of the 2 conditioning regimens as in Arm I. TRANSPLANT: Patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive placebo PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover Arm I.
Arm I (ibrutinib, chemotherapy, autoHCT)CarmustineCONDITIONING REGIMEN: Investigators may choose to use either the BEAMi or CBVi regimen. BEAMi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV BID over 1-2 hours and cytarabine IV BID over 1-2 hours on days -5 to -2, and melphalan IV over 20-30 minutes on day -1. CBVi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV over 4 hours on day -4, and cyclophosphamide IV on day -2. TRANSPLANT: In both arms, patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive ibrutinib PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity.
Arm I (ibrutinib, chemotherapy, autoHCT)CyclophosphamideCONDITIONING REGIMEN: Investigators may choose to use either the BEAMi or CBVi regimen. BEAMi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV BID over 1-2 hours and cytarabine IV BID over 1-2 hours on days -5 to -2, and melphalan IV over 20-30 minutes on day -1. CBVi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV over 4 hours on day -4, and cyclophosphamide IV on day -2. TRANSPLANT: In both arms, patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive ibrutinib PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity.
Arm I (ibrutinib, chemotherapy, autoHCT)CytarabineCONDITIONING REGIMEN: Investigators may choose to use either the BEAMi or CBVi regimen. BEAMi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV BID over 1-2 hours and cytarabine IV BID over 1-2 hours on days -5 to -2, and melphalan IV over 20-30 minutes on day -1. CBVi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV over 4 hours on day -4, and cyclophosphamide IV on day -2. TRANSPLANT: In both arms, patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive ibrutinib PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity.
Arm I (ibrutinib, chemotherapy, autoHCT)EtoposideCONDITIONING REGIMEN: Investigators may choose to use either the BEAMi or CBVi regimen. BEAMi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV BID over 1-2 hours and cytarabine IV BID over 1-2 hours on days -5 to -2, and melphalan IV over 20-30 minutes on day -1. CBVi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV over 4 hours on day -4, and cyclophosphamide IV on day -2. TRANSPLANT: In both arms, patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive ibrutinib PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity.
Arm I (ibrutinib, chemotherapy, autoHCT)IbrutinibCONDITIONING REGIMEN: Investigators may choose to use either the BEAMi or CBVi regimen. BEAMi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV BID over 1-2 hours and cytarabine IV BID over 1-2 hours on days -5 to -2, and melphalan IV over 20-30 minutes on day -1. CBVi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV over 4 hours on day -4, and cyclophosphamide IV on day -2. TRANSPLANT: In both arms, patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive ibrutinib PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity.
Arm I (ibrutinib, chemotherapy, autoHCT)MelphalanCONDITIONING REGIMEN: Investigators may choose to use either the BEAMi or CBVi regimen. BEAMi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV BID over 1-2 hours and cytarabine IV BID over 1-2 hours on days -5 to -2, and melphalan IV over 20-30 minutes on day -1. CBVi: Patients receive ibrutinib PO on days -6 to -1 or days -7 to -2 if a day of rest is planned, carmustine IV over 2 hours on day -6, etoposide IV over 4 hours on day -4, and cyclophosphamide IV on day -2. TRANSPLANT: In both arms, patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive ibrutinib PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity.
Arm II (placebo, chemotherapy, autoHCT)CarmustineCONDITIONING REGIMEN: Patients receive placebo PO on days -6 to -1 and receive 1 of the 2 conditioning regimens as in Arm I. TRANSPLANT: Patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive placebo PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover Arm I.
Arm II (placebo, chemotherapy, autoHCT)EtoposideCONDITIONING REGIMEN: Patients receive placebo PO on days -6 to -1 and receive 1 of the 2 conditioning regimens as in Arm I. TRANSPLANT: Patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive placebo PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover Arm I.
Arm II (placebo, chemotherapy, autoHCT)CytarabineCONDITIONING REGIMEN: Patients receive placebo PO on days -6 to -1 and receive 1 of the 2 conditioning regimens as in Arm I. TRANSPLANT: Patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive placebo PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover Arm I.
Arm II (placebo, chemotherapy, autoHCT)MelphalanCONDITIONING REGIMEN: Patients receive placebo PO on days -6 to -1 and receive 1 of the 2 conditioning regimens as in Arm I. TRANSPLANT: Patients undergo autologous hematopoietic progenitor cell or bone marrow transplant on day 0. CONTINUATION REGIMEN: Beginning 30-60 days after transplant, patients receive placebo PO on days 1-28. Treatment repeats every 28 days for 12 cycles in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression may crossover Arm I.
Primary Outcome Measures
NameTimeMethod
24-month progression-free survival (PFS), defined as the proportion of patients who are alive and progression-free 2 years from randomizationTime between registration and disease progression or death, whichever comes first, assessed at 24 months

Will be assessed using the Lugano classification.

Secondary Outcome Measures
NameTimeMethod
Time to hematopoietic engraftmentFirst day of one week without platelet transfusion, assessed up to 5 years

Will be defined as platelet count greater than or equal to 20,000/uL following nadir.

Response rate using the Lugano classificationUp to 60 months

The metabolic response proportion following AutoHCT will be compared between the two arms using chi-squared test.

Treatment-related mortalityUp to 60 months

Treatment-related mortality will be summarized using contingency tables.

Incidence of secondary malignanciesUp to 60 months

Incidence of secondary malignancies will be summarized using contingency tables.

PFSTime between registration and disease progression or death, whichever comes first, assessed up to 5 years (60 months)

For each arm, the distribution of PFS will be estimated using the Kaplan-Meier method. PFS will be compared between the two arms using the log-rank test and Cox regression method adjusting for the known predictors.

Overall survival (OS)The time between randomization and death from any cause, assessed up to 5 years (60 months)

For each arm, the distribution of OS will be estimated using the Kaplan-Meier method. OS will be compared between the two arms using the log-rank test and Cox regression method adjusting for the known predictors.

Incidence of hematologic toxicity of ibrutinib therapyUp to 60 months

Hematologic toxicity will be summarized using contingency tables.

Trial Locations

Locations (282)

Logan Health Medical Center

🇺🇸

Kalispell, Montana, United States

Marshfield Medical Center - Minocqua

🇺🇸

Minocqua, Wisconsin, United States

Anchorage Associates in Radiation Medicine

🇺🇸

Anchorage, Alaska, United States

Anchorage Radiation Therapy Center

🇺🇸

Anchorage, Alaska, United States

Alaska Breast Care and Surgery LLC

🇺🇸

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

Banner University Medical Center - Tucson

🇺🇸

Tucson, Arizona, United States

University of Arizona Cancer Center-North Campus

🇺🇸

Tucson, Arizona, United States

Providence Saint Joseph Medical Center/Disney Family Cancer Center

🇺🇸

Burbank, California, United States

City of Hope Comprehensive Cancer Center

🇺🇸

Duarte, California, United States

UC San Diego Moores Cancer Center

🇺🇸

La Jolla, California, United States

Loma Linda University Medical Center

🇺🇸

Loma Linda, California, United States

Cedars Sinai Medical Center

🇺🇸

Los Angeles, California, United States

UC Irvine Health/Chao Family Comprehensive Cancer Center

🇺🇸

Orange, California, United States

University of California Davis Comprehensive Cancer Center

🇺🇸

Sacramento, California, United States

UCSF Medical Center-Parnassus

🇺🇸

San Francisco, California, United States

Rocky Mountain Cancer Centers-Aurora

🇺🇸

Aurora, Colorado, United States

The Medical Center of Aurora

🇺🇸

Aurora, Colorado, United States

UCHealth University of Colorado Hospital

🇺🇸

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

UCHealth Memorial Hospital Central

🇺🇸

Colorado Springs, Colorado, United States

Denver Health Medical Center

🇺🇸

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

Presbyterian - Saint Lukes Medical Center - Health One

🇺🇸

Denver, Colorado, United States

Rocky Mountain Cancer Centers-Midtown

🇺🇸

Denver, Colorado, United States

SCL Health Saint Joseph Hospital

🇺🇸

Denver, Colorado, United States

Rocky Mountain Cancer Centers-Rose

🇺🇸

Denver, Colorado, United States

Mountain Blue Cancer Care Center - Swedish

🇺🇸

Englewood, Colorado, United States

Swedish Medical Center

🇺🇸

Englewood, Colorado, United States

Poudre Valley Hospital

🇺🇸

Fort Collins, 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

Grand Valley Oncology

🇺🇸

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-Littleton

🇺🇸

Littleton, Colorado, United States

Rocky Mountain Cancer Centers-Sky Ridge

🇺🇸

Lone Tree, Colorado, United States

Banner McKee Medical Center

🇺🇸

Loveland, Colorado, United States

Intermountain Health Lutheran Hospital

🇺🇸

Wheat Ridge, Colorado, United States

Smilow Cancer Center/Yale-New Haven Hospital

🇺🇸

New Haven, Connecticut, United States

Yale University

🇺🇸

New Haven, Connecticut, United States

Beebe Medical Center

🇺🇸

Lewes, Delaware, United States

Delaware Clinical and Laboratory Physicians PA

🇺🇸

Newark, Delaware, United States

Helen F Graham Cancer Center

🇺🇸

Newark, Delaware, United States

Medical Oncology Hematology Consultants PA

🇺🇸

Newark, Delaware, United States

Christiana Care Health System-Christiana Hospital

🇺🇸

Newark, Delaware, United States

Beebe Health Campus

🇺🇸

Rehoboth Beach, Delaware, United States

TidalHealth Nanticoke / Allen Cancer Center

🇺🇸

Seaford, Delaware, United States

Christiana Care Health System-Wilmington Hospital

🇺🇸

Wilmington, Delaware, United States

UM Sylvester Comprehensive Cancer Center at Deerfield Beach

🇺🇸

Deerfield Beach, Florida, United States

University of Florida Health Science Center - Gainesville

🇺🇸

Gainesville, Florida, United States

University of Miami Miller School of Medicine-Sylvester Cancer Center

🇺🇸

Miami, Florida, United States

UM Sylvester Comprehensive Cancer Center at Plantation

🇺🇸

Plantation, Florida, United States

Moffitt Cancer Center

🇺🇸

Tampa, Florida, United States

Emory University Hospital/Winship Cancer Institute

🇺🇸

Atlanta, Georgia, United States

Northside Hospital

🇺🇸

Atlanta, Georgia, United States

Augusta University Medical Center

🇺🇸

Augusta, Georgia, 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

Saint Luke's Cancer Institute - Fruitland

🇺🇸

Fruitland, 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

Northwestern University

🇺🇸

Chicago, Illinois, United States

Rush University Medical Center

🇺🇸

Chicago, Illinois, United States

University of Illinois

🇺🇸

Chicago, Illinois, United States

University of Chicago Comprehensive Cancer Center

🇺🇸

Chicago, Illinois, United States

Loyola University Medical Center

🇺🇸

Maywood, Illinois, United States

UC Comprehensive Cancer Center at Silver Cross

🇺🇸

New Lenox, Illinois, United States

Cancer Center of Kansas - Chanute

🇺🇸

Chanute, Kansas, United States

Cancer Center of Kansas - Dodge City

🇺🇸

Dodge City, Kansas, United States

Cancer Center of Kansas - El Dorado

🇺🇸

El Dorado, Kansas, United States

Cancer Center of Kansas - Fort Scott

🇺🇸

Fort Scott, Kansas, United States

Cancer Center of Kansas-Independence

🇺🇸

Independence, Kansas, United States

University of Kansas Cancer Center

🇺🇸

Kansas City, Kansas, United States

Cancer Center of Kansas-Kingman

🇺🇸

Kingman, Kansas, United States

Lawrence Memorial Hospital

🇺🇸

Lawrence, Kansas, United States

Cancer Center of Kansas-Liberal

🇺🇸

Liberal, Kansas, United States

Cancer Center of Kansas-Manhattan

🇺🇸

Manhattan, Kansas, United States

Cancer Center of Kansas - McPherson

🇺🇸

McPherson, Kansas, United States

Cancer Center of Kansas - Newton

🇺🇸

Newton, Kansas, United States

Cancer Center of Kansas - Parsons

🇺🇸

Parsons, Kansas, United States

Cancer Center of Kansas - Pratt

🇺🇸

Pratt, Kansas, United States

Cancer Center of Kansas - Salina

🇺🇸

Salina, Kansas, United States

Cancer Center of Kansas - Wellington

🇺🇸

Wellington, Kansas, United States

University of Kansas Hospital-Westwood Cancer Center

🇺🇸

Westwood, Kansas, United States

Associates In Womens Health

🇺🇸

Wichita, Kansas, United States

Cancer Center of Kansas-Wichita Medical Arts Tower

🇺🇸

Wichita, Kansas, United States

Ascension Via Christi Hospitals Wichita

🇺🇸

Wichita, Kansas, United States

Cancer Center of Kansas - Wichita

🇺🇸

Wichita, Kansas, United States

Cancer Center of Kansas - Winfield

🇺🇸

Winfield, Kansas, United States

The James Graham Brown Cancer Center at University of Louisville

🇺🇸

Louisville, Kentucky, United States

Baton Rouge General Medical Center

🇺🇸

Baton Rouge, Louisiana, United States

Hematology/Oncology Clinic PLLC

🇺🇸

Baton Rouge, Louisiana, United States

Tulane University School of Medicine

🇺🇸

New Orleans, Louisiana, United States

Ochsner Medical Center Jefferson

🇺🇸

New Orleans, Louisiana, United States

LSU Health Sciences Center at Shreveport

🇺🇸

Shreveport, Louisiana, United States

Johns Hopkins University/Sidney Kimmel Cancer Center

🇺🇸

Baltimore, Maryland, United States

Simonds-Sinon Regional Cancer Center

🇺🇸

Fitchburg, Massachusetts, United States

UMass Memorial Medical Center - University Campus

🇺🇸

Worcester, Massachusetts, United States

University of Michigan Comprehensive Cancer Center

🇺🇸

Ann Arbor, Michigan, United States

Bronson Battle Creek

🇺🇸

Battle Creek, Michigan, United States

Wayne State University/Karmanos Cancer Institute

🇺🇸

Detroit, 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

Bronson Methodist Hospital

🇺🇸

Kalamazoo, 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

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

Corewell Health Reed City Hospital

🇺🇸

Reed City, 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

Munson Medical Center

🇺🇸

Traverse City, Michigan, United States

University of Michigan Health - West

🇺🇸

Wyoming, Michigan, United States

University of Minnesota/Masonic Cancer Center

🇺🇸

Minneapolis, Minnesota, United States

Mayo Clinic in Rochester

🇺🇸

Rochester, Minnesota, United States

Siteman Cancer Center at West County Hospital

🇺🇸

Creve Coeur, Missouri, United States

SSM Health Saint Louis University Hospital

🇺🇸

Saint Louis, Missouri, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Siteman Cancer Center-South County

🇺🇸

Saint Louis, 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

Benefis Sletten Cancer Institute

🇺🇸

Great Falls, Montana, United States

Great Falls Clinic

🇺🇸

Great Falls, Montana, United States

Saint Peter's Community Hospital

🇺🇸

Helena, Montana, United States

Saint Patrick Hospital - Community Hospital

🇺🇸

Missoula, Montana, United States

Community Medical Center

🇺🇸

Scranton, Pennsylvania, United States

Nebraska Medicine-Bellevue

🇺🇸

Bellevue, Nebraska, United States

Nebraska Medicine-Village Pointe

🇺🇸

Omaha, Nebraska, United States

University of Nebraska Medical Center

🇺🇸

Omaha, Nebraska, United States

Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center

🇺🇸

Lebanon, New Hampshire, United States

Montefiore Medical Center-Einstein Campus

🇺🇸

Bronx, New York, United States

Montefiore Medical Center-Weiler Hospital

🇺🇸

Bronx, New York, United States

Children's Hospital at Montefiore

🇺🇸

Bronx, New York, United States

Montefiore Medical Center - Moses Campus

🇺🇸

Bronx, New York, United States

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

NYP/Weill Cornell Medical Center

🇺🇸

New York, New York, United States

Upstate Cancer Center at Oswego

🇺🇸

Oswego, New York, United States

University of Rochester

🇺🇸

Rochester, New York, United States

State University of New York Upstate Medical University

🇺🇸

Syracuse, New York, United States

UNC Lineberger Comprehensive Cancer Center

🇺🇸

Chapel Hill, North Carolina, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Wake Forest University Health Sciences

🇺🇸

Winston-Salem, North Carolina, United States

University of Cincinnati Cancer Center-UC Medical Center

🇺🇸

Cincinnati, Ohio, United States

Case Western Reserve University

🇺🇸

Cleveland, Ohio, United States

Cleveland Clinic Foundation

🇺🇸

Cleveland, Ohio, United States

Ohio State University Comprehensive Cancer Center

🇺🇸

Columbus, Ohio, United States

University of Cincinnati Cancer Center-West Chester

🇺🇸

West Chester, Ohio, United States

University of Oklahoma Health Sciences Center

🇺🇸

Oklahoma City, Oklahoma, 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 Willamette Falls Medical Center

🇺🇸

Oregon City, Oregon, United States

Legacy Good Samaritan Hospital and Medical Center

🇺🇸

Portland, Oregon, United States

Providence Portland Medical Center

🇺🇸

Portland, Oregon, United States

Providence Saint Vincent Medical Center

🇺🇸

Portland, Oregon, United States

Oregon Health and Science University

🇺🇸

Portland, Oregon, United States

Christiana Care Health System-Concord Health Center

🇺🇸

Chadds Ford, Pennsylvania, United States

Geisinger Medical Center

🇺🇸

Danville, Pennsylvania, United States

Geisinger Medical Center-Cancer Center Hazleton

🇺🇸

Hazleton, Pennsylvania, United States

Geisinger Medical Oncology-Lewisburg

🇺🇸

Lewisburg, Pennsylvania, United States

Lewistown Hospital

🇺🇸

Lewistown, Pennsylvania, United States

Fox Chase Cancer Center

🇺🇸

Philadelphia, Pennsylvania, United States

University of Pittsburgh Cancer Institute (UPCI)

🇺🇸

Pittsburgh, Pennsylvania, United States

Geisinger Cancer Services-Pottsville

🇺🇸

Pottsville, Pennsylvania, United States

Geisinger Medical Oncology-Selinsgrove

🇺🇸

Selinsgrove, Pennsylvania, United States

Geisinger Medical Group

🇺🇸

State College, Pennsylvania, United States

Geisinger Wyoming Valley/Henry Cancer Center

🇺🇸

Wilkes-Barre, Pennsylvania, United States

Prisma Health Cancer Institute - Spartanburg

🇺🇸

Boiling Springs, South Carolina, United States

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

Prisma Health Cancer Institute - Laurens

🇺🇸

Clinton, South Carolina, United States

Prisma Health Cancer Institute - Easley

🇺🇸

Easley, 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

Prisma Health Greenville Memorial Hospital

🇺🇸

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

Prisma Health Cancer Institute - Seneca

🇺🇸

Seneca, South Carolina, United States

Avera Cancer Institute

🇺🇸

Sioux Falls, South Dakota, United States

Vanderbilt-Ingram Cancer Center Cool Springs

🇺🇸

Franklin, Tennessee, United States

Baptist Memorial Hospital and Cancer Center-Memphis

🇺🇸

Memphis, Tennessee, United States

Vanderbilt Breast Center at One Hundred Oaks

🇺🇸

Nashville, Tennessee, United States

Vanderbilt University/Ingram Cancer Center

🇺🇸

Nashville, Tennessee, United States

Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center

🇺🇸

Houston, Texas, United States

American Fork Hospital / Huntsman Intermountain Cancer Center

🇺🇸

American Fork, Utah, United States

Sandra L Maxwell Cancer Center

🇺🇸

Cedar City, Utah, United States

Farmington Health Center

🇺🇸

Farmington, 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

Huntsman Cancer Institute/University of Utah

🇺🇸

Salt Lake City, Utah, United States

LDS Hospital

🇺🇸

Salt Lake City, Utah, United States

South Jordan Health Center

🇺🇸

South Jordan, Utah, United States

University of Virginia Cancer Center

🇺🇸

Charlottesville, Virginia, United States

Virginia Commonwealth University/Massey Cancer Center

🇺🇸

Richmond, Virginia, United States

Providence Regional Cancer System-Aberdeen

🇺🇸

Aberdeen, Washington, United States

Cancer Care Center at Island Hospital

🇺🇸

Anacortes, 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

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

Pacific Gynecology Specialists

🇺🇸

Seattle, Washington, United States

Swedish Medical Center-Ballard Campus

🇺🇸

Seattle, Washington, United States

FHCC South Lake Union

🇺🇸

Seattle, Washington, United States

Fred Hutchinson Cancer Center

🇺🇸

Seattle, Washington, United States

Kaiser Permanente Washington

🇺🇸

Seattle, Washington, United States

Swedish Medical Center-Cherry Hill

🇺🇸

Seattle, Washington, United States

Swedish Medical Center-First Hill

🇺🇸

Seattle, Washington, United States

University of Washington Medical Center - Montlake

🇺🇸

Seattle, 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

MultiCare Deaconess Cancer and Blood Specialty Center - North

🇺🇸

Spokane, 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

Aurora Cancer Care-Southern Lakes VLCC

🇺🇸

Burlington, Wisconsin, United States

Marshfield Clinic-Chippewa Center

🇺🇸

Chippewa Falls, Wisconsin, United States

Marshfield Clinic Cancer Center at Sacred Heart

🇺🇸

Eau Claire, Wisconsin, United States

Marshfield Medical Center-EC Cancer Center

🇺🇸

Eau Claire, Wisconsin, United States

Aurora Health Center-Fond du Lac

🇺🇸

Fond Du Lac, Wisconsin, United States

Aurora Health Care Germantown Health Center

🇺🇸

Germantown, Wisconsin, United States

Aurora Cancer Care-Grafton

🇺🇸

Grafton, 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

University of Wisconsin Carbone Cancer Center - University Hospital

🇺🇸

Madison, Wisconsin, United States

Aurora Bay Area Medical Group-Marinette

🇺🇸

Marinette, Wisconsin, United States

Marshfield Medical Center-Marshfield

🇺🇸

Marshfield, Wisconsin, United States

Marshfield Medical Center

🇺🇸

Marshfield, Wisconsin, United States

Aurora Cancer Care-Milwaukee

🇺🇸

Milwaukee, Wisconsin, United States

Aurora Saint Luke's Medical Center

🇺🇸

Milwaukee, Wisconsin, United States

Medical College of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

Aurora Sinai Medical Center

🇺🇸

Milwaukee, Wisconsin, United States

Vince Lombardi Cancer Clinic - Oshkosh

🇺🇸

Oshkosh, Wisconsin, United States

Aurora Cancer Care-Racine

🇺🇸

Racine, Wisconsin, United States

Marshfield Medical Center-Rice Lake

🇺🇸

Rice Lake, Wisconsin, United States

Vince Lombardi Cancer Clinic-Sheboygan

🇺🇸

Sheboygan, Wisconsin, United States

Marshfield Medical Center-River Region at Stevens Point

🇺🇸

Stevens Point, Wisconsin, United States

Aurora Medical Center in Summit

🇺🇸

Summit, Wisconsin, United States

Vince Lombardi Cancer Clinic-Two Rivers

🇺🇸

Two Rivers, 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

Marshfield Clinic - Wisconsin Rapids Center

🇺🇸

Wisconsin Rapids, Wisconsin, United States

Cheyenne Regional Medical Center-West

🇺🇸

Cheyenne, Wyoming, United States

Billings Clinic-Cody

🇺🇸

Cody, Wyoming, United States

King Faisal Specialist Hospital and Research Centre

🇸🇦

Riyadh, Saudi Arabia

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