Comparing Cisplatin Every Three Weeks to Cisplatin Weekly When Combined With Radiation for Patients With Advanced Head and Neck Cancer

Phase 2

Recruiting

• Conditions: Advanced Head and Neck Squamous Cell Carcinoma; Advanced Hypopharyngeal Squamous Cell Carcinoma; Advanced Laryngeal Squamous Cell Carcinoma; Advanced Oropharyngeal Squamous Cell Carcinoma; Clinical Stage III HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8; Clinical Stage IV HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8; Stage III Head and Neck Cutaneous Squamous Cell Carcinoma AJCC v8; Stage III Oropharyngeal (p16-Negative) Carcinoma AJCC v8; Stage IV Head and Neck Cutaneous Squamous Cell Carcinoma AJCC v8; Stage IV Oropharyngeal (p16-Negative) Carcinoma AJCC v8
• Interventions: Drug: Cisplatin; Procedure: Computed Tomography; Procedure: Magnetic Resonance Imaging; Procedure: Positron Emission Tomography; Other: Quality-of-Life Assessment; Other: Questionnaire Administration; Radiation: Radiation Therapy

• Registration Number: NCT05050162
• Lead Sponsor: NRG Oncology

Brief Summary

This phase II/III trial compares whether cisplatin given weekly with radiation therapy is better tolerated than cisplatin given every three weeks with radiation therapy for the treatment of head and neck cancer that has spread to other places in the body (advanced). The second part of this study will also help to find out if the cisplatin given weekly approach will extend patients' life by at least the same amount of time as the cisplatin given every three weeks approach. Cisplatin is in a class of medications known as platinum-containing compounds that work by killing, stopping or slowing the growth of cancer cells. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. Radiation with low-dose cisplatin given weekly may be effective in shrinking or stabilizing head and neck cancer or preventing its recurrence.

Detailed Description

PRIMARY OBJECTIVES:

I. To determine whether radiation with cisplatin weekly is superior in terms of acute toxicity, as measured by the T-scores (TAME method), to radiation with cisplatin every 3 weeks for patients with locoregionally advanced squamous cell carcinoma of the head and neck (SCCHN). (Phase II) II. To determine whether radiation with cisplatin weekly is non-inferior to radiation with cisplatin every 3 weeks in terms of overall survival (OS) for patients with locoregionally advanced SCCHN. (Phase III) III. To determine whether radiation with cisplatin weekly is superior in terms of acute toxicity, as measured by the T-scores (TAME method), to radiation with cisplatin every 3 weeks for patients with locoregionally advanced SCCHN. (Phase III)

SECONDARY OBJECTIVES:

I. To assess and compare progression-free survival (PFS) between arms. II. To assess and compare locoregional failure and distant metastasis between arms.

III. To assess acute and late toxicity (Common Terminology Criteria for Adverse Events \[CTCAE\] version 5.0).

IV. To assess patient-reported outcomes quality of life (PRO/QOL), as measured by the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H\&N) (primary PRO), between arms.

V. To assess hearing loss, as measured by audiograms and the modified TUNE grading scale between arms.

VI. To assess hearing loss, as measured by speech audiometry Consonant-Nucleus-Consonant word scores and tympanometry (subject to the modified TUNE grading scale testing results; otherwise, it will be an exploratory objective).

VII. To assess hearing-related QOL as measured by the Hearing Handicap Inventory-Screening (HHIA-S) (secondary PRO), between arms.

VIII. To assess long-term PFS, OS, and toxicity between arms. IX. To assess 3-year restricted-mean survival time for OS and PFS between arms (if long-term update is warranted).

EXPLORATORY OBJECTIVE:

I. To collect blood and tissue specimens for future translational science studies. For instance, to examine how germline and somatic genetic variants, such as TP53, CDKN2A, PIK3CA, PTEN, NFE2L2, and KEAP1, may influence cisplatin-related efficacy and toxicity, and to assess the effect of regular nonsteroidal anti-inflammatory drugs (NSAIDs) use and genomic activation of PIK3CA (mutation or amplification) or loss of PTEN, the negative regulator of PI3K, on disease-free survival or overall survival.

OUTLINE: Patients are assigned to 1 of 2 arms.

ARM I (NON-OROPHARYNGEAL CANCER \[OPC\]/p16-NEGATIVE OPC group and p16-NEGATIVE OPC/CANCER OF UNKNOWN PRIMARY \[CUP\] group): Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive cisplatin intravenously (IV) once every 3 weeks (Q3W) (on days 1, 22, and 43) during radiation therapy in the absence of disease progression or unacceptable toxicity.

ARM II (NON-OROPHARYNGEAL CANCER \[OPC\]/p16-NEGATIVE OPC group and p16-NEGATIVE OPC/CANCER OF UNKNOWN PRIMARY \[CUP\] group): Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive cisplatin IV once a week (QW) for 7 weeks during radiation therapy in the absence of disease progression or unacceptable toxicity.

Patients undergo computed tomography (CT) scan, or magnetic resonance imaging (MRI) or position emission tomography (PET) scan throughout the study.

Study Timeline

• Study First Submitted: 2021-09-09
• Study First Submitted QC: 2021-09-17
• Study First Posted: 2021-09-20
• Study Start: 2022-02-01
• Status Verified: 2025-05
• Last Update Submitted: 2025-05-06
• Last Update Posted: 2025-05-09
• Primary Completion: 2026-02-09
• Study Completion: 2026-02-09

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 1714

Inclusion Criteria

• Pathologically (histologically or cytologically) proven diagnosis of SCCHN of the oropharynx, larynx, hypopharynx, or p16-positive unknown primary prior to registration; specimen from cervical lymph nodes with a well-defined primary site documented clinically or radiologically is acceptable; in patients with carcinoma of unknown primary this will be sufficient for pathologic confirmation without a clinically or radiographically defined primary site

  • For patients with oropharyngeal cancer (OPC)/cancer of unknown primary (CUP):

P16 status based on local site immunohistochemical tissue staining is required. A cell block obtained from a fine needle aspiration (FNA) biopsy specimen may be used as the sole diagnostic tissue. Centers are encouraged to contact the pathology chair for clarification.

• Note: Institutions must screen patients for p16 status by immunohistochemistry (IHC) in order to be eligible for the trial using a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory. A rigorous laboratory accreditation process similar to the United States (U.S.) CLIA certification, such as the provincial accreditation status offered by the Ontario Laboratory Accreditation (OLA) Program in Canada, the College of American Pathologists (CAP), or an equivalent accreditation in other countries, is acceptable.

  • The p16 results must be reported on the pathology report being submitted. The p16 positivity is defined as > 70% of tumor cells showing strong nuclear and/or cytoplasmic immunostaining with p16 antibody.

  • For patients with laryngeal and hypopharyngeal primaries: Analysis of p16 status is NOT required.

    • Patients must have clinically or radiographically evident measurable disease at the primary site or at nodal stations. Simple tonsillectomy or local excision of the primary without removal of nodal disease is permitted, as is excision removing gross nodal disease but with intact primary site. Limited neck dissections retrieving =< 4 nodes are permitted and considered as non-therapeutic nodal excisions
    • Clinical stage (American Joint Committee on Cancer [AJCC], 8th ed.), including no distant metastases based on the following diagnostic workup:

  • History/physical examination within 60 days prior to registration

  • One of the following imaging studies is required within 60 days prior to registration:

• Computed tomography (CT) scan of neck (diagnostic quality with contrast, unless contraindicated) OR

• Magnetic resonance imaging (MRI) of the neck (diagnostic quality with contrast, unless contraindicated) OR

• Fludeoxyglucose F-18 (FDG)-positron emission tomography (PET)/CT of the neck; the CT component must be of diagnostic quality with contrast, unless contraindicated.

  • Note: A diagnostic quality CT or MRI with contrast or FDG-PET/CT scan of neck performed for the purposes of radiation planning may serve as both staging and planning tools

    • One of the following imaging studies is required within 60 days prior to registration:

• FDG-PET/CT of the chest; FDG-PET/CT scan is strongly preferred and highly recommended to be used for eligibility OR

• Chest CT

  • Exam with laryngopharyngoscopy (mirror or in office direct procedure acceptable) within 70 days prior to registration;

• Eligibility by patient cohort;

  • Non-OPC/p16-negative OPC Cohort; Tumor Site: Larynx/Hypopharynx; Clinical Staging (AJCC, 8th ed.): T3-4 N0 or T1-4 N1-3 T2 N0 (hypopharynx only)
  • Tumor Site: p16-negative OPC; Clinical Staging (AJCC, 8th ed.): T2N1, T1-4 N2-3, or T3-4 N0-1

• p16-positive OPC/CUP Cohort;

  • Tumor Site: OPC; Smoking Status: =< 10 pack-years; Clinical Staging (AJCC, 8th ed.): T1-3 N2-3 or T4 N0-3

  • Tumor Site: OPC; Smoking Status: > 10 pack-years; Clinical Staging (AJCC, 8th ed.): T1N2-3, T2N1-3, or T3-4 N0-3

  • Tumor Site: CUP; Smoking Status: Any; Clinical Staging (AJCC, 8th ed.): T0 N2-3 Note: Cigar and pipe tobacco consumption is not included in calculating the lifetime pack-years. Marijuana consumption is likewise not considered in this calculation. There is also no clear scientific evidence regarding the role of chewing tobacco-containing products in oropharyngeal cancer, although this is possibly more concerning given the proximity of the oral cavity and oropharynx. In any case, investigators should not count use of non-cigarette tobacco products in the pack-years calculation.

    • Age >= 18

    • Zubrod (Eastern Cooperative Oncology Group [ECOG]) performance status of 0-1 within 14 days prior to registration

    • Absolute neutrophil count (ANC) >= 1,500 cells/mm^3 (within 30 days prior to registration)

    • Platelets >= 75,000 cells/mm^3 (within 30 days prior to registration)

    • Hemoglobin >= 8.0 g/dL (within 30 days prior to registration)

      • Note: The use of transfusion or other intervention to achieve hemoglobin [Hgb] >= 8.0 g/dL is acceptable)

    • Calculated creatinine clearance (CrCl) >= 50 mL/min by the Cockcroft-Gault formula (within 30 days prior to registration)

    • Total bilirubin =< 1.5 x institutional upper limit of normal (ULN) (within 30 days prior to registration) (not applicable to patients with known Gilbert's syndrome)

    • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 1.5 x institutional ULN (within 30 days prior to registration)

    • Known human immunodeficiency virus (HIV) infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months and CD4 T Cell count > 200 cells/mm^3 are eligible for this trial. Testing is not required for entry into protocol

    • Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial

    • Negative urine or serum pregnancy test (in persons of childbearing potential) within 14 days prior to registration. Childbearing potential is defined as any person who has experienced menarche and who has not undergone surgical sterilization (hysterectomy or bilateral oophorectomy) or who is not postmenopausal. Menopause is defined clinically as 12 months of amenorrhea in a woman over 45 in the absence of other biological or physiological causes

    • Willing to use highly effective contraceptives for participants of childbearing potential (participants who may become pregnant or who may impregnate a partner) during therapy and for 14 months (females); for 11 months (males) following last dose of cisplatin; this inclusion is necessary because the treatment in this study may be significantly teratogenic.

    • The patient or a legally authorized representative must provide study-specific informed consent prior to study entry and, for patients treated in the United States (U.S.), authorization permitting release of personal health information

Exclusion Criteria

• Patients with oral cavity cancer, nasopharynx cancer, or p16-negative cancer of unknown primary (CUP)

• Recurrence of the study cancer

• Definitive clinical or radiologic evidence of distant metastatic disease

• Prior systemic chemotherapy for the study cancer; note that prior chemotherapy for a different cancer is allowable, however, any prior exposure to cisplatin is excluded

• Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields

• Severe, active co-morbidity defined as follows:

  • Unstable angina requiring hospitalization in the last 6 months
  • Myocardial infarction within the last 6 months
  • New York Heart Association Functional Classification III/IV (Note: Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification.)
  • Persistent grade 3-4 (CTCAE version 5.0) electrolyte abnormalities that cannot be reversed despite replacement as indicated by repeat testing
  • Patient must not have an active infection requiring IV antibiotics prior to registration;
  • Other chronic renal disease like nephrotic syndrome, that could be worsened by cisplatin therapy
  • History of allogenic organ transplantation
  • Any symptomatic peripheral sensory neuropathy grade >= 2 (CTCAE version 5.0);

• Pregnancy and individuals unwilling to discontinue nursing

• History of hypersensitivity to cisplatin or platinum-containing compounds

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
ARM I (radiation therapy, every 3 week cisplatin)	Cisplatin	Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive cisplatin IV once Q3W (on days 1, 22, and 43) during radiation therapy in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, or MRI or PET scan throughout the study.
ARM I (radiation therapy, every 3 week cisplatin)	Computed Tomography	Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive cisplatin IV once Q3W (on days 1, 22, and 43) during radiation therapy in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, or MRI or PET scan throughout the study.
ARM I (radiation therapy, every 3 week cisplatin)	Magnetic Resonance Imaging	Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive cisplatin IV once Q3W (on days 1, 22, and 43) during radiation therapy in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, or MRI or PET scan throughout the study.
ARM I (radiation therapy, every 3 week cisplatin)	Positron Emission Tomography	Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive cisplatin IV once Q3W (on days 1, 22, and 43) during radiation therapy in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, or MRI or PET scan throughout the study.
ARM I (radiation therapy, every 3 week cisplatin)	Quality-of-Life Assessment	Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive cisplatin IV once Q3W (on days 1, 22, and 43) during radiation therapy in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, or MRI or PET scan throughout the study.
ARM I (radiation therapy, every 3 week cisplatin)	Questionnaire Administration	Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive cisplatin IV once Q3W (on days 1, 22, and 43) during radiation therapy in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, or MRI or PET scan throughout the study.
ARM I (radiation therapy, every 3 week cisplatin)	Radiation Therapy	Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive cisplatin IV once Q3W (on days 1, 22, and 43) during radiation therapy in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, or MRI or PET scan throughout the study.
Arm II (radiation therapy, weekly cisplatin)	Cisplatin	Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive weekly cisplatin IV QW for 7 weeks during radiation therapy in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, or MRI or PET scan throughout the study.
Arm II (radiation therapy, weekly cisplatin)	Computed Tomography	Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive weekly cisplatin IV QW for 7 weeks during radiation therapy in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, or MRI or PET scan throughout the study.
Arm II (radiation therapy, weekly cisplatin)	Magnetic Resonance Imaging	Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive weekly cisplatin IV QW for 7 weeks during radiation therapy in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, or MRI or PET scan throughout the study.
Arm II (radiation therapy, weekly cisplatin)	Positron Emission Tomography	Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive weekly cisplatin IV QW for 7 weeks during radiation therapy in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, or MRI or PET scan throughout the study.
Arm II (radiation therapy, weekly cisplatin)	Quality-of-Life Assessment	Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive weekly cisplatin IV QW for 7 weeks during radiation therapy in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, or MRI or PET scan throughout the study.
Arm II (radiation therapy, weekly cisplatin)	Questionnaire Administration	Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive weekly cisplatin IV QW for 7 weeks during radiation therapy in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, or MRI or PET scan throughout the study.
Arm II (radiation therapy, weekly cisplatin)	Radiation Therapy	Patients undergo radiation therapy over 5 fractions a week for a total of 33-35 fractions in the absence of disease progression or unacceptable toxicity. Patients also receive weekly cisplatin IV QW for 7 weeks during radiation therapy in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, or MRI or PET scan throughout the study.

Primary Outcome Measures

Name	Time	Method
Incidence of acute toxicity (Phase II)	Up to 180 days post-treatment	Measured by the T-scores.
Overall survival (OS) (Phase III)	From randomization to death of any cause, assessed up to 9 years	OS rates will be estimated using the Kaplan-Meier method.
Incidence of acute toxicity (Phase III)	Up to 180 days post-treatment	Measured by the T-scores.

Secondary Outcome Measures

Name	Time	Method
Locoregional failure rates	Up to 9 years
Distant metastasis	Up to 9 years
Progression-free survival (PFS)	From randomization to locoregional failure, distant metastasis, or death due to any cause, whichever occurs first, assessed up to 9 years	PFS rates will be estimated using the Kaplan-Meier method and between-arm differences compared using the log-rank test with a two-sided alpha of 0.05 (Kaplan 1958).
Restricted mean survival time (RMST) for OS	At 3 years	Compared using a Wald-type test based on Kaplan-Meier estimates. Adjusted RMST estimates at 3 years and 95% confidence intervals will be provided using RMST regression with pseudo-observations.
RMST for PFS	At 3 years	Compared using a Wald-type test based on Kaplan-Meier estimates. Adjusted RMST estimates at 3 years and 95% confidence intervals will be provided using RMST regression with pseudo-observations.
Incidence of acute toxicity	Up to 180 days post-treatment	Measured by Common Terminology Criteria for Adverse Events (CTCAE) version (v) 5.0.
Incidence of late toxicity	Up to 9 years	Measured by the A-scores.
Quality of life	At 6 months post-radiation therapy	Measured by Functional Assessment of Cancer Therapy Head and Neck.
Hearing loss	At 6 months post-radiation therapy	Measured by Hearing Handicap Inventory for Adults-Screening.
Hearing loss (cochleotoxicity)	At 6 months post-radiation therapy	Measured by audiograms and the modified TUNE grading scale.

Trial Locations

Locations (363)

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

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

University of Arkansas for Medical Sciences; 🇺🇸 Little Rock, Arkansas, United States

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

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

Sutter Auburn Faith Hospital; 🇺🇸 Auburn, California, United States

Sutter Cancer Centers Radiation Oncology Services-Auburn; 🇺🇸 Auburn, California, United States

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

Alta Bates Summit Medical Center-Herrick Campus; 🇺🇸 Berkeley, California, United States

Tower Cancer Research Foundation; 🇺🇸 Beverly Hills, California, United States

Mercy Cancer Center - Carmichael; 🇺🇸 Carmichael, California, United States

Mercy San Juan Medical Center; 🇺🇸 Carmichael, California, United States

UC Irvine Health Cancer Center-Newport; 🇺🇸 Costa Mesa, California, United States

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

Mercy Cancer Center - Elk Grove; 🇺🇸 Elk Grove, California, United States

UC San Diego Health System - Encinitas; 🇺🇸 Encinitas, California, United States

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

Palo Alto Medical Foundation-Fremont; 🇺🇸 Fremont, California, United States

Fresno Cancer Center; 🇺🇸 Fresno, California, United States

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

UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care; 🇺🇸 Irvine, California, United States

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

UC San Diego Moores Cancer Center; 🇺🇸 La Jolla, California, United States

The Angeles Clinic and Research Institute - West Los Angeles Office; 🇺🇸 Los Angeles, California, United States

Kaiser Permanente Los Angeles Medical Center; 🇺🇸 Los Angeles, California, United States

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

Fremont - Rideout Cancer Center; 🇺🇸 Marysville, California, United States

Memorial Medical Center; 🇺🇸 Modesto, California, United States

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

Palo Alto Medical Foundation-Camino Division; 🇺🇸 Mountain View, California, United States

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

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

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

UC Irvine Health/Chao Family Comprehensive Cancer Center; 🇺🇸 Orange, California, United States

Palo Alto Medical Foundation Health Care; 🇺🇸 Palo Alto, California, United States

Stanford Cancer Institute Palo Alto; 🇺🇸 Palo Alto, California, United States

VA Palo Alto Health Care System; 🇺🇸 Palo Alto, California, United States

Kaiser Permanente-Rancho Cordova Cancer Center; 🇺🇸 Rancho Cordova, California, United States

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

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

Mercy Cancer Center - Rocklin; 🇺🇸 Rocklin, California, United States

Rohnert Park Cancer Center; 🇺🇸 Rohnert Park, California, United States

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

Sutter Cancer Centers Radiation Oncology Services-Roseville; 🇺🇸 Roseville, California, United States

Sutter Roseville Medical Center; 🇺🇸 Roseville, California, United States

The Permanente Medical Group-Roseville Radiation Oncology; 🇺🇸 Roseville, California, United States

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

Mercy Cancer Center - Sacramento; 🇺🇸 Sacramento, California, United States

Sutter Medical Center Sacramento; 🇺🇸 Sacramento, California, United States

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

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

South Sacramento Cancer Center; 🇺🇸 Sacramento, California, United States

UC San Diego Medical Center - Hillcrest; 🇺🇸 San Diego, California, United States

Kaiser Permanente-San Francisco; 🇺🇸 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

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

Stanford Cancer Center South Bay; 🇺🇸 San Jose, California, United States

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

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

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

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

Sutter Pacific Medical Foundation; 🇺🇸 Santa Rosa, California, United States

Kaiser Permanente Cancer Treatment Center; 🇺🇸 South San Francisco, California, United States

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

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

Palo Alto Medical Foundation-Sunnyvale; 🇺🇸 Sunnyvale, California, United States

Gene Upshaw Memorial Tahoe Forest Cancer Center; 🇺🇸 Truckee, 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

Woodland Memorial Hospital; 🇺🇸 Woodland, California, United States

Saint Francis Cancer Center; 🇺🇸 Colorado Springs, Colorado, United States

Kaiser Permanente-Franklin; 🇺🇸 Denver, Colorado, United States

AdventHealth Porter; 🇺🇸 Denver, Colorado, United States

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

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

Kaiser Permanente-Rock Creek; 🇺🇸 Lafayette, Colorado, United States

AdventHealth Littleton; 🇺🇸 Littleton, Colorado, United States

Kaiser Permanente-Lone Tree; 🇺🇸 Lone Tree, Colorado, United States

AdventHealth Parker; 🇺🇸 Parker, Colorado, United States

George Washington University Medical Center; 🇺🇸 Washington, District of Columbia, United States

UM Sylvester Comprehensive Cancer Center at Aventura; 🇺🇸 Aventura, Florida, United States

Veterans Administration Hospital; 🇺🇸 Bay Pines, Florida, United States

UM Sylvester Comprehensive Cancer Center at Coral Gables; 🇺🇸 Coral Gables, Florida, United States

UM Sylvester Comprehensive Cancer Center at Deerfield Beach; 🇺🇸 Deerfield Beach, Florida, United States

University of Miami Miller School of Medicine-Sylvester Cancer Center; 🇺🇸 Miami, Florida, United States

UM Sylvester Comprehensive Cancer Center at Kendall; 🇺🇸 Miami, Florida, United States

UM Sylvester Comprehensive Cancer Center at Plantation; 🇺🇸 Plantation, Florida, United States

Moffitt Cancer Center-International Plaza; 🇺🇸 Tampa, Florida, United States

Moffitt Cancer Center - McKinley Campus; 🇺🇸 Tampa, Florida, United States

Moffitt Cancer Center; 🇺🇸 Tampa, Florida, United States

Moffitt Cancer Center at Wesley Chapel; 🇺🇸 Wesley Chapel, Florida, United States

Augusta University Medical Center; 🇺🇸 Augusta, Georgia, United States

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

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

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

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

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

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

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

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

Ottawa Hospital and Cancer Center-General Campus; 🇨🇦 Ottawa, Ontario, Canada

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

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

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

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

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

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

Edward Hines Jr VA Hospital; 🇺🇸 Hines, Illinois, United States

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

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

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

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

Edward Hospital/Cancer Center; 🇺🇸 Naperville, Illinois, United States

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

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

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

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

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

Methodist Medical Center of Illinois; 🇺🇸 Peoria, Illinois, United States

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

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

UW Health Carbone Cancer Center Rockford; 🇺🇸 Rockford, 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

The Carle Foundation Hospital; 🇺🇸 Urbana, Illinois, United States

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

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

Greater Regional Medical Center; 🇺🇸 Creston, 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

Iowa Lutheran Hospital; 🇺🇸 Des Moines, Iowa, United States

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

Methodist West Hospital; 🇺🇸 West Des Moines, Iowa, United States

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

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

The University of Kansas Cancer Center - Olathe; 🇺🇸 Olathe, Kansas, United States

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

University of Kansas Cancer Center-Overland Park; 🇺🇸 Overland Park, Kansas, United States

Salina Regional Health Center; 🇺🇸 Salina, Kansas, United States

University of Kansas Health System Saint Francis Campus; 🇺🇸 Topeka, Kansas, United States

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

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

Saint Joseph Radiation Oncology Resource Center; 🇺🇸 Lexington, Kentucky, United States

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

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

Jewish Hospital; 🇺🇸 Louisville, Kentucky, United States

The James Graham Brown Cancer Center at University of Louisville; 🇺🇸 Louisville, Kentucky, United States

UofL Health Medical Center Northeast; 🇺🇸 Louisville, Kentucky, United States

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

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

MaineHealth Coastal Cancer Treatment Center; 🇺🇸 Bath, Maine, United States

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

Lafayette Family Cancer Center-EMMC; 🇺🇸 Brewer, Maine, United States

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

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

MaineHealth Cancer Care Center of York County; 🇺🇸 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

Maryland Proton Treatment Center; 🇺🇸 Baltimore, Maryland, United States

University of Maryland/Greenebaum Cancer Center; 🇺🇸 Baltimore, Maryland, United States

UM Upper Chesapeake Medical Center; 🇺🇸 Bel Air, Maryland, United States

Central Maryland Radiation Oncology in Howard County; 🇺🇸 Columbia, Maryland, United States

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

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

University of Michigan Comprehensive Cancer Center; 🇺🇸 Ann Arbor, Michigan, United States

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

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

University of Michigan - Brighton Center for Specialty Care; 🇺🇸 Brighton, Michigan, United States

Henry Ford Cancer Institute-Downriver; 🇺🇸 Brownstown, Michigan, United States

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

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

Chelsea Hospital; 🇺🇸 Chelsea, Michigan, United States

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

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

Henry Ford Macomb Hospital-Clinton Township; 🇺🇸 Clinton Township, Michigan, United States

Henry Ford Medical Center-Fairlane; 🇺🇸 Dearborn, Michigan, United States

Henry Ford Hospital; 🇺🇸 Detroit, Michigan, United States

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

Michigan Healthcare Professionals Farmington; 🇺🇸 Farmington Hills, Michigan, United States

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

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

Allegiance Health; 🇺🇸 Jackson, Michigan, United States

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

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

Michigan Healthcare Professionals Madison Heights; 🇺🇸 Madison Heights, Michigan, United States

Henry Ford Health Providence Novi Hospital; 🇺🇸 Novi, Michigan, United States

Henry Ford Medical Center-Columbus; 🇺🇸 Novi, Michigan, United States

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

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

Henry Ford Health Providence Southfield Hospital; 🇺🇸 Southfield, Michigan, United States

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

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

Henry Ford West Bloomfield Hospital; 🇺🇸 West Bloomfield, Michigan, United States

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

Sanford Joe Lueken Cancer Center; 🇺🇸 Bemidji, Minnesota, United States

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

Coborn Cancer Center at Saint Cloud Hospital; 🇺🇸 Saint Cloud, Minnesota, United States

Baptist Memorial Hospital and Cancer Center-Golden Triangle; 🇺🇸 Columbus, Mississippi, United States

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

Gulfport Memorial Hospital; 🇺🇸 Gulfport, Mississippi, United States

University of Mississippi Medical Center; 🇺🇸 Jackson, 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; 🇺🇸 Southhaven, Mississippi, United States

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

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

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

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

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

University of Kansas Cancer Center - Lee's Summit; 🇺🇸 Lee's Summit, Missouri, United States

University of Kansas Cancer Center at North Kansas City Hospital; 🇺🇸 North Kansas City, Missouri, United States

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

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

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

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

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

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

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

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

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

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

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

University of New Mexico Cancer Center; 🇺🇸 Albuquerque, New Mexico, United States

Roswell Park Cancer Institute; 🇺🇸 Buffalo, New York, United States

Glens Falls Hospital; 🇺🇸 Glens Falls, New York, United States

Highland Hospital; 🇺🇸 Rochester, New York, United States

University of Rochester; 🇺🇸 Rochester, New York, United States

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

Wilmot Cancer Institute at Webster; 🇺🇸 Webster, New York, United States

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

Novant Cancer Institute Radiation Oncology - Supply; 🇺🇸 Supply, North Carolina, United States

Wake Forest Baptist Health - Wilkes Medical Center; 🇺🇸 Wilkesboro, North Carolina, United States

Novant Health Cancer Institute Radiation Oncology - Wilmington; 🇺🇸 Wilmington, North Carolina, United States

Novant Health New Hanover Regional Medical Center; 🇺🇸 Wilmington, North Carolina, United States

Wake Forest University Health Sciences; 🇺🇸 Winston-Salem, North Carolina, United States

Sanford Bismarck Medical Center; 🇺🇸 Bismarck, North Dakota, United States

Sanford Broadway Medical Center; 🇺🇸 Fargo, North Dakota, United States

Sanford Roger Maris Cancer Center; 🇺🇸 Fargo, North Dakota, United States

Summa Health System - Akron Campus; 🇺🇸 Akron, Ohio, United States

UH Seidman Cancer Center at UH Avon Health Center; 🇺🇸 Avon, Ohio, United States

Summa Health System - Barberton Campus; 🇺🇸 Barberton, Ohio, United States

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

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

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

Case Western Reserve University; 🇺🇸 Cleveland, Ohio, United States

MetroHealth Medical Center; 🇺🇸 Cleveland, Ohio, United States

Cleveland Clinic Cancer Center/Fairview Hospital; 🇺🇸 Cleveland, Ohio, United States

Cleveland Clinic Foundation; 🇺🇸 Cleveland, Ohio, United States

Ohio State University Comprehensive Cancer Center; 🇺🇸 Columbus, Ohio, United States

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

Premier Blood and Cancer Center; 🇺🇸 Dayton, Ohio, United States

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

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

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

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

Miami Valley Cancer Care and Infusion; 🇺🇸 Greenville, Ohio, United States

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

Cleveland Clinic Cancer Center Mansfield; 🇺🇸 Mansfield, Ohio, United States

Hillcrest Hospital Cancer Center; 🇺🇸 Mayfield Heights, Ohio, United States

Summa Health Medina Medical Center; 🇺🇸 Medina, Ohio, United States

UH Seidman Cancer Center at Lake Health Mentor Campus; 🇺🇸 Mentor, Ohio, United States

University Hospitals Portage Medical Center; 🇺🇸 Ravenna, Ohio, United States

North Coast Cancer Care; 🇺🇸 Sandusky, Ohio, United States

Cleveland Clinic Cancer Center Strongsville; 🇺🇸 Strongsville, Ohio, United States

ProMedica Flower Hospital; 🇺🇸 Sylvania, Ohio, United States

ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital; 🇺🇸 Toledo, Ohio, United States

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

Cleveland Clinic Wooster Family Health and Surgery Center; 🇺🇸 Wooster, Ohio, United States

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

Bryn Mawr Hospital; 🇺🇸 Bryn Mawr, Pennsylvania, United States

Saint Vincent Hospital; 🇺🇸 Erie, Pennsylvania, United States

Penn State Milton S Hershey Medical Center; 🇺🇸 Hershey, Pennsylvania, United States

Jefferson Hospital; 🇺🇸 Jefferson Hills, Pennsylvania, United States

Riddle Memorial Hospital; 🇺🇸 Media, Pennsylvania, United States

Forbes Hospital; 🇺🇸 Monroeville, Pennsylvania, United States

Paoli Memorial Hospital; 🇺🇸 Paoli, Pennsylvania, United States

Fox Chase Cancer Center; 🇺🇸 Philadelphia, Pennsylvania, United States

Temple University Hospital; 🇺🇸 Philadelphia, Pennsylvania, United States

Allegheny General Hospital; 🇺🇸 Pittsburgh, Pennsylvania, United States

Wexford Health and Wellness Pavilion; 🇺🇸 Wexford, Pennsylvania, United States

Lankenau Medical Center; 🇺🇸 Wynnewood, Pennsylvania, United States

Medical University of South Carolina; 🇺🇸 Charleston, South Carolina, United States

Self Regional Healthcare; 🇺🇸 Greenwood, South Carolina, United States

Sanford Cancer Center Oncology Clinic; 🇺🇸 Sioux Falls, South Dakota, United States

Avera Cancer Institute; 🇺🇸 Sioux Falls, South Dakota, United States

Sanford USD Medical Center - Sioux Falls; 🇺🇸 Sioux Falls, 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

Houston Methodist San Jacinto Hospital; 🇺🇸 Baytown, Texas, United States

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

Ben Taub General Hospital; 🇺🇸 Houston, Texas, United States

Houston Methodist Hospital; 🇺🇸 Houston, Texas, United States

Michael E DeBakey VA Medical Center; 🇺🇸 Houston, Texas, United States

Methodist Willowbrook Hospital; 🇺🇸 Houston, Texas, United States

Houston Methodist West Hospital; 🇺🇸 Houston, Texas, United States

Houston Methodist Saint John Hospital; 🇺🇸 Nassau Bay, Texas, United States

Houston Methodist Sugar Land Hospital; 🇺🇸 Sugar Land, Texas, United States

Houston Methodist The Woodlands Hospital; 🇺🇸 The Woodlands, 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

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

Dartmouth Cancer Center - North; 🇺🇸 Saint Johnsbury, Vermont, United States

Inova Alexandria Hospital; 🇺🇸 Alexandria, Virginia, United States

Inova Schar Cancer Institute; 🇺🇸 Fairfax, Virginia, United States

Inova Fair Oaks Hospital; 🇺🇸 Fairfax, Virginia, United States

FHCC Overlake; 🇺🇸 Bellevue, Washington, United States

FHCC at EvergreenHealth; 🇺🇸 Kirkland, Washington, United States

Fred Hutchinson Cancer Center; 🇺🇸 Seattle, Washington, United States

FHCC at Northwest Hospital; 🇺🇸 Seattle, Washington, United States

University of Washington Medical Center - Montlake; 🇺🇸 Seattle, Washington, United States

West Virginia University Charleston Division; 🇺🇸 Charleston, West Virginia, United States

Langlade Hospital and Cancer Center; 🇺🇸 Antigo, Wisconsin, United States

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

University of Wisconsin Carbone Cancer Center - Johnson Creek; 🇺🇸 Johnson Creek, Wisconsin, United States

Gundersen Lutheran Medical Center; 🇺🇸 La Crosse, Wisconsin, United States

William S Middleton VA Medical Center; 🇺🇸 Madison, Wisconsin, United States

University of Wisconsin Carbone Cancer Center - Eastpark Medical Center; 🇺🇸 Madison, Wisconsin, United States

University of Wisconsin Carbone Cancer Center - University Hospital; 🇺🇸 Madison, Wisconsin, United States

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

Froedtert Menomonee Falls Hospital; 🇺🇸 Menomonee Falls, Wisconsin, United States

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

Zablocki Veterans Administration Medical Center; 🇺🇸 Milwaukee, Wisconsin, United States

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

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

Drexel Town Square Health Center; 🇺🇸 Oak Creek, Wisconsin, United States

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

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

Marshfield Medical Center-Rice Lake; 🇺🇸 Rice Lake, 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

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

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

Froedtert West Bend Hospital/Kraemer Cancer Center; 🇺🇸 West Bend, Wisconsin, United States

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

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

University Health Network-Princess Margaret Hospital; 🇨🇦 Toronto, Ontario, Canada

The Research Institute of the McGill University Health Centre (MUHC); 🇨🇦 Montreal, Quebec, Canada

Allan Blair Cancer Centre; 🇨🇦 Regina, Saskatchewan, Canada

Saskatoon Cancer Centre; 🇨🇦 Saskatoon, Saskatchewan, Canada

Pamela Youde Nethersole Eastern Hospital; 🇭🇰 Chai Wan, Hong Kong

Saint Lukes Hospital; 🇮🇪 Dublin, Co Dublin, Ireland

University College Hospital Galway; 🇮🇪 Galway, Co Galway, Ireland

Kantonsspital Aarau; 🇨🇭 Aarau, Switzerland