MedPath

S1501 Carvedilol in Preventing Cardiac Toxicity in Patients With Metastatic HER-2-Positive Breast Cancer

Phase 3
Recruiting
Conditions
Stage IV Breast Cancer AJCC v6 and v7
Recurrent Breast Carcinoma
HER2/Neu Positive
Metastatic Malignant Neoplasm in the Brain
Cardiotoxicity
Interventions
Other: Laboratory Biomarker Analysis
Drug: Carvedilol
Other: Patient Observation
Registration Number
NCT03418961
Lead Sponsor
SWOG Cancer Research Network
Brief Summary

This phase III trial studies how well carvedilol works in preventing cardiac toxicity in patients with human epidermal growth factor receptor (HER)-2-positive breast cancer that has spread to other places in the body. A beta-blocker, such as carvedilol, is used to treat heart failure and high blood pressure, and it may prevent the heart from side effects of chemotherapy.

Detailed Description

PRIMARY OBJECTIVES:

I. To assess whether prophylactic beta blocker therapy with carvedilol compared with no intervention reduces the risk of subsequent cardiac dysfunction in patients with metastatic breast cancer receiving trastuzumab?based HER-2 targeted therapy.

SECONDARY OBJECTIVES:

I. To assess whether prophylactic beta blocker therapy with carvedilol compared with no intervention reduces the risk of predefined subsequent cardiac events in patients with metastatic breast cancer receiving trastuzumab?based HER-2 targeted therapy.

II. To evaluate if prophylactic carvedilol compared with no intervention results in a longer time to first interruption of trastuzumab?based HER-2 targeted therapy due to either cardiac dysfunction or events.

III. To assess whether prophylactic beta blocker therapy with carvedilol compared with no intervention reduces the risk of subsequent cardiac dysfunction OR events in this population.

IV. To establish and prospectively collect a predefined panel of baseline core cardiovascular measures and develop a predictive model of cardiac dysfunction.

V. To evaluate the rate of cardiac dysfunction in an observational arm consisting of individuals otherwise eligible for the study except for use of beta blockers, angiotensin receptor blocker (ARB), or angiotensin converting enzyme (ACE) inhibitors for other medical reasons.

TERTIARY OBJECTIVES:

I. To evaluate the isoleucine (lle) 655 valine (Val) and and alanine (Ala)ll70 proline (Pro) single nucleotide polymorphisms (SNPs) of the HER-2 gene as a predictive biomarker of study-defined cardiac dysfunction.

II. To evaluate plasma neuregulin-1 at baseline and over study time as a predictive biomarker of study-defined cardiac dysfunction.

III. To evaluate the feasibility of performing serial left ventricular strain in a National Clinical Trials Network (NCTN) group setting, with the goal of 75% of patients contributing both a baseline and at least one follow-up strain measurement.

IV. To bank blood for future translational medicine studies such as brain natriuretic peptide (BNP), additional SNPs, and high sensitivity troponin.

OUTLINE: Patients are randomized to 1 of 2 arms. Patients taking beta blocker, ARB, or ACE inhibitor at registration are assigned to Arm III.

ARM I: Patients not taking beta blocker, ARB, or ACE inhibitor at registration receive carvedilol orally (PO) twice daily (BID). Courses repeat every 12 weeks for 108 weeks in the absence of disease progression or unacceptable toxicity.

ARM II: Patients not taking beta blocker, ARB, or ACE inhibitor at registration receive no study intervention for up to 108 weeks.

ARM III: Patients undergo observation for up to 108 weeks.

After completion of study, patients are followed up for up to 108 weeks.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
817
Inclusion Criteria
  • STEP 1 REGISTRATION

  • Patients must have metastatic breast cancer and be initiating within 7 days of step 1 registration or continuing trastuzumab?based HER-2 targeted therapy without concurrent anthracyclines in first or second line setting; patients may have brain metastasis; there is no limit for number of doses of HER-2 targeted therapy prior to registration; examples of eligible HER-2 targeted therapy:

    • Trastuzumab
    • Trastuzumab + chemotherapy or hormonal therapy
    • Trastuzumab + other HER-2 targeted agent with or without chemotherapy (such as pertuzumab)
    • Ado-trastuzumab (Kadcyla)
    • NOTE: Patients on lapatinib without trastuzumab are not eligible; planned treatment with concurrent HER-2 targeted therapy and anthracyclines is not permitted
  • Patients must be at increased risk for cardiotoxicity defined by at least one of the following:

    • Previous anthracycline exposure, OR

    • 1 or more of the following risk factors for heart disease:

      • Left ventricular ejection fraction (LVEF) 50-54% by local echocardiography (ECHO) read
      • Age >= 65
      • Body mass index (BMI) >= 30 kg/m^2
      • Current or prior anti-hypertensive therapy
      • Diagnosis of coronary artery disease (CAD)
      • Diabetes mellitus
      • Atrial fibrillation/flutter
  • Patients must not have taken within 21 days prior to step 1 registration, be currently taking at the time of step 1 registration, or planning to take once registered to step 1 a beta blocker, ARB, or ACE inhibitor in order to be randomized (Arms 1 and 2)

    • Patients currently taking a beta blocker, ARB, or ACE inhibitor at the time of step 1 registration are eligible to register for the non-randomized observational cohort (Arm 3)
  • Patients must not be currently taking or planning to take during study treatment the following medications:

    • B2 agonists
    • Bosutinib
    • Ceritinib
    • Floctafenine
    • Methacholine
    • Pazopanib
    • Rivastigmine
    • Vincristine
    • Silodosin
  • Patients must have a Zubrod Performance status of 0-2

  • Patients must have a complete physical examination and medical history within 28 days prior to registration

  • Patients must have LVEF >= 50% by 2-dimensional (D) echocardiogram within 28 days prior to registration; the echocardiogram must be obtained from a S1501 validated ECHO laboratory (lab) and submitted for central review by the S1501 ECHO core lab; ECHO should not be submitted for central read until patient has been otherwise deemed eligible

  • Serum bilirubin < 3.0 x institutional upper limit of normal (IULN)

  • Serum glutamic oxaloacetic transaminase (SGOT)/aspartate aminotransferase (AST) and serum glutamic pyruvic transaminase (SGPT)/alanine aminotransferase (ALT) < 5.0 x IULN

  • Patients must have electrocardiogram with corrected QT (QTc) with correction within 28 days prior to registration

  • Patients must have a systolic blood pressure >= 80 mm Hg within 14 days prior to registration

  • Patients must not be dialysis dependent

  • Patients must be able to swallow tablets

  • Patients must not have uncontrolled asthma

  • Patients must not co-enroll on other treatment trials

  • No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, prostate cancer on active surveillance, adequately treated stage I or II cancer from which the patient is currently in complete remission, or any other cancer from which the patient has been disease free for five years

  • Patients must not be pregnant or nursing due to potential fetal or nursing infant harm; women/men of reproductive potential must have agreed to use an effective contraceptive method, a woman is considered to be of "reproductive potential" if she has had menses at any time in the preceding 12 consecutive months; in addition to routine contraceptive methods, "effective contraception" also includes heterosexual celibacy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) defined as a hysterectomy, bilateral oophorectomy or bilateral tubal ligation; however, if at any point a previously celibate patient chooses to become heterosexually active during the time period for use of contraceptive measures outlined in the protocol, he/she is responsible for beginning contraceptive measures

  • Patients must be willing to submit blood specimens

  • Sites must seek additional patient consent for the future use of specimens

  • Patients must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines

  • As a part of the OPEN registration process the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the system

  • STEP 2 REGISTRATION (Randomization)

  • Patients must not be registered to step 2 until receiving confirmation from the ECHO Core Lab that the patient?s LVEF by echocardiogram was >= 50% by central review; patients must be registered within 5 calendar days of receiving the e-mail notification

  • Site must verify that there is no known change in the step 1 eligibility since initial registration

Read More
Exclusion Criteria

Not provided

Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm III (observation)Laboratory Biomarker AnalysisPatients undergo observation for up to 108 weeks.
Arm II (no intervention)Laboratory Biomarker AnalysisPatients not taking beta blocker, ARB, or ACE inhibitor at registration receive no study intervention for up to 108 weeks.
Arm III (observation)Patient ObservationPatients undergo observation for up to 108 weeks.
Arm I (carvedilol)Laboratory Biomarker AnalysisPatients not taking beta blocker, ARB, or ACE inhibitor at registration receive carvedilol PO BID. Courses repeat every 12 weeks for 108 weeks in the absence of disease progression or unacceptable toxicity.
Arm I (carvedilol)CarvedilolPatients not taking beta blocker, ARB, or ACE inhibitor at registration receive carvedilol PO BID. Courses repeat every 12 weeks for 108 weeks in the absence of disease progression or unacceptable toxicity.
Primary Outcome Measures
NameTimeMethod
Time to the first identification of cardiac dysfunctionUp to 108 weeks

Real-time, blinded, central echocardiography (ECHO) read as a decrease in the left ventricular ejection fraction (LVEF) of \>= 10 percentage points from baseline to a value of \< 50% OR decrease of LVEF by \>= 5 percentage points from baseline to LVEF \< 50% in those baselines having a baseline LVEF of 50-54%. The distributions of time to cardiac dysfunction will be described using cumulative incidence estimates, with the statistical significance of treatment arm differences assessed by Cox and Fine-Gray regression models with adjustment for stratification factors. Gray's test will also be applied

Secondary Outcome Measures
NameTimeMethod
Incidence of adverse events associated with beta blocker treatmentUp to 108 weeks

Adverse events associated with beta blocker treatment will be assessed.

Drug adherenceUp to 108 weeks

Patients on the active arm will be asked to record study drug consumption on a monthly intake calendar. Amount of study drug taken among patients randomized to the active arm and study drug adoption among patients randomized to the no intervention arm (i.e., contamination) will be recorded by study site staff on a case report form at each follow-up visit to assess the sensitivity of the primary treatment effect to observed conditions.

Rate of first interruption of trastuzumabUp to 108 weeks

The distributions of time to interruption of trastuzumab-based therapy will be described using cumulative incidence estimates, with the statistical significance of treatment arm differences assessed by Cox and Fine-Gray regression models with adjustment for stratification factors. Gray?s test will also be applied to the primary endpoint to assess whether the results are sensitive to different model assumptions.

Rate of deathUp to 108 weeks

Will compare rate of death from competing causes between treatment arms via Cox regression to evaluate whether those rates impact the primary analysis comparison.

Time to first occurrence of cardiac eventUp to 108 weeks

any of the following treating physician documented events requiring hospitalization or medical treatment, and subsequent temporary or permanent discontinuation of trastuzumab- based HER-2 targeted therapy: arrhythmia, unstable angina, non-ST segment elevated myocardial infarction, myocardial infarction, or congestive heart failure.

Trial Locations

Locations (590)

USC / Norris Comprehensive Cancer Center

🇺🇸

Los Angeles, California, United States

John H Stroger Jr Hospital of Cook County

🇺🇸

Chicago, Illinois, United States

Cleveland Clinic Cancer Center/Fairview Hospital

🇺🇸

Cleveland, Ohio, United States

Swedish Medical Center-Ballard Campus

🇺🇸

Seattle, Washington, United States

FHCC South Lake Union

🇺🇸

Seattle, Washington, United States

Swedish Medical Center-Cherry Hill

🇺🇸

Seattle, Washington, United States

Franciscan Health Indianapolis

🇺🇸

Indianapolis, Indiana, United States

Community Medical Hospital

🇺🇸

Missoula, Montana, United States

Hennepin County Medical Center

🇺🇸

Minneapolis, Minnesota, United States

Health Partners Inc

🇺🇸

Minneapolis, Minnesota, United States

The Christ Hospital

🇺🇸

Cincinnati, Ohio, United States

University of Cincinnati Cancer Center-UC Medical Center

🇺🇸

Cincinnati, Ohio, United States

TriHealth Cancer Institute-Anderson

🇺🇸

Cincinnati, Ohio, United States

University Hospital

🇺🇸

San Antonio, Texas, United States

Kaiser Permanente San Leandro

🇺🇸

San Leandro, California, United States

Heartland Hematology and Oncology

🇺🇸

Kearney, Nebraska, United States

Illinois CancerCare-Princeton

🇺🇸

Princeton, Illinois, United States

Anchorage Associates in Radiation Medicine

🇺🇸

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

Providence Alaska Medical Center

🇺🇸

Anchorage, Alaska, United States

Anchorage Oncology Centre

🇺🇸

Anchorage, Alaska, United States

Katmai Oncology Group

🇺🇸

Anchorage, Alaska, United States

Fairbanks Memorial Hospital

🇺🇸

Fairbanks, Alaska, United States

Kaiser Permanente-Deer Valley Medical Center

🇺🇸

Antioch, California, United States

CHI Saint Vincent Cancer Center Hot Springs

🇺🇸

Hot Springs, Arkansas, United States

Providence Saint Joseph Medical Center/Disney Family Cancer Center

🇺🇸

Burbank, California, United States

Enloe Medical Center

🇺🇸

Chico, California, United States

Epic Care-Dublin

🇺🇸

Dublin, California, United States

City of Hope Comprehensive Cancer Center

🇺🇸

Duarte, California, United States

Epic Care Partners in Cancer Care

🇺🇸

Emeryville, California, United States

Bay Area Breast Surgeons Inc

🇺🇸

Emeryville, California, United States

Fresno Cancer Center

🇺🇸

Fresno, California, United States

Kaiser Permanente-Fremont

🇺🇸

Fremont, California, United States

Kaiser Permanente-Fresno

🇺🇸

Fresno, California, United States

City of Hope Mission Hills

🇺🇸

Mission Hills, California, United States

Contra Costa Regional Medical Center

🇺🇸

Martinez, California, United States

Kaiser Permanente-Modesto

🇺🇸

Modesto, California, United States

Bay Area Tumor Institute

🇺🇸

Oakland, California, United States

Alta Bates Summit Medical Center - Summit Campus

🇺🇸

Oakland, California, United States

City of Hope Newport Beach

🇺🇸

Newport Beach, California, United States

Kaiser Permanente Oakland-Broadway

🇺🇸

Oakland, California, United States

Kaiser Permanente-Oakland

🇺🇸

Oakland, California, United States

Kaiser Permanente-Rancho Cordova Cancer Center

🇺🇸

Rancho Cordova, California, United States

Kaiser Permanente-Redwood City

🇺🇸

Redwood City, California, United States

Kaiser Permanente-Richmond

🇺🇸

Richmond, California, United States

Rohnert Park Cancer Center

🇺🇸

Rohnert Park, California, United States

Kaiser Permanente-Roseville

🇺🇸

Roseville, California, United States

The Permanente Medical Group-Roseville Radiation Oncology

🇺🇸

Roseville, California, United States

Kaiser Permanente-San Rafael

🇺🇸

San Rafael, California, United States

Kaiser Permanente-Santa Teresa-San Jose

🇺🇸

San Jose, 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 Cancer Treatment Center

🇺🇸

South San Francisco, California, United States

Kaiser Permanente-Santa Rosa

🇺🇸

Santa Rosa, California, United States

City of Hope South Pasadena

🇺🇸

South Pasadena, California, United States

Kaiser Permanente-South San Francisco

🇺🇸

South San Francisco, California, United States

Kaiser Permanente Medical Center-Vacaville

🇺🇸

Vacaville, California, United States

Kaiser Permanente-Stockton

🇺🇸

Stockton, California, United States

City of Hope Upland

🇺🇸

Upland, California, United States

City of Hope South Bay

🇺🇸

Torrance, California, United States

Kaiser Permanente-Walnut Creek

🇺🇸

Walnut Creek, California, United States

Kaiser Permanente-Vallejo

🇺🇸

Vallejo, California, United States

Mercy Medical Center

🇺🇸

Durango, Colorado, United States

Penrose-Saint Francis Healthcare

🇺🇸

Colorado Springs, Colorado, United States

Southwest Oncology PC

🇺🇸

Durango, Colorado, United States

Rocky Mountain Cancer Centers-Penrose

🇺🇸

Colorado Springs, Colorado, United States

Mountain Blue Cancer Care Center

🇺🇸

Golden, Colorado, United States

Good Samaritan Medical Center

🇺🇸

Lafayette, Colorado, United States

Kaiser Permanente-Rock Creek

🇺🇸

Lafayette, Colorado, United States

Rocky Mountain Cancer Centers-Lakewood

🇺🇸

Lakewood, Colorado, United States

Kaiser Permanente-Lone Tree

🇺🇸

Lone Tree, Colorado, United States

Littleton Adventist Hospital

🇺🇸

Littleton, Colorado, United States

Saint Anthony Hospital

🇺🇸

Lakewood, Colorado, United States

Rocky Mountain Cancer Centers - Pueblo

🇺🇸

Pueblo, Colorado, United States

Longmont United Hospital

🇺🇸

Longmont, Colorado, United States

Rocky Mountain Cancer Centers-Longmont

🇺🇸

Longmont, Colorado, United States

Middlesex Hospital

🇺🇸

Middletown, Connecticut, United States

Bayhealth Hospital Kent Campus

🇺🇸

Dover, Delaware, United States

Stamford Hospital/Bennett Cancer Center

🇺🇸

Stamford, Connecticut, United States

Beebe South Coastal Health Campus

🇺🇸

Frankford, Delaware, United States

Beebe Medical Center

🇺🇸

Lewes, Delaware, United States

Helen F Graham Cancer Center

🇺🇸

Newark, Delaware, United States

Delaware Clinical and Laboratory Physicians PA

🇺🇸

Newark, Delaware, United States

Medical Oncology Hematology Consultants PA

🇺🇸

Newark, Delaware, United States

Broward Health Medical Center

🇺🇸

Fort Lauderdale, Florida, 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

Christiana Care Health System-Christiana Hospital

🇺🇸

Newark, Delaware, United States

Mount Sinai Medical Center

🇺🇸

Miami Beach, Florida, United States

Cleveland Clinic-Weston

🇺🇸

Weston, Florida, United States

Emory University Hospital Midtown

🇺🇸

Atlanta, Georgia, United States

Emory Saint Joseph's Hospital

🇺🇸

Atlanta, Georgia, United States

Emory University Hospital/Winship Cancer Institute

🇺🇸

Atlanta, Georgia, United States

Northside Hospital

🇺🇸

Atlanta, Georgia, United States

John B Amos Cancer Center

🇺🇸

Columbus, Georgia, United States

Lewis Cancer and Research Pavilion at Saint Joseph's/Candler

🇺🇸

Savannah, Georgia, United States

Northeast Georgia Medical Center-Gainesville

🇺🇸

Gainesville, Georgia, United States

Low Country Cancer Care

🇺🇸

Savannah, Georgia, United States

Summit Cancer Care-Candler

🇺🇸

Savannah, Georgia, United States

Lewis Hall Singletary Oncology Center

🇺🇸

Thomasville, Georgia, United States

Pali Momi Medical Center

🇺🇸

'Aiea, Hawaii, United States

Queen's Cancer Center - Pearlridge

🇺🇸

'Aiea, Hawaii, United States

The Cancer Center of Hawaii-Pali Momi

🇺🇸

'Aiea, Hawaii, United States

Wilcox Memorial Hospital and Kauai Medical Clinic

🇺🇸

Lihue, Hawaii, United States

Saint Alphonsus Cancer Care Center-Boise

🇺🇸

Boise, Idaho, United States

Saint Luke's Cancer Institute - Boise

🇺🇸

Boise, Idaho, United States

Kootenai Health - Coeur d'Alene

🇺🇸

Coeur d'Alene, Idaho, United States

Saint Alphonsus Cancer Care Center-Caldwell

🇺🇸

Caldwell, Idaho, United States

Walter Knox Memorial Hospital

🇺🇸

Emmett, Idaho, United States

Idaho Urologic Institute-Meridian

🇺🇸

Meridian, Idaho, United States

Saint Luke's Cancer Institute - Fruitland

🇺🇸

Fruitland, Idaho, United States

Saint Luke's Cancer Institute - Nampa

🇺🇸

Nampa, Idaho, United States

Saint Alphonsus Cancer Care Center-Nampa

🇺🇸

Nampa, Idaho, United States

Saint Luke's Cancer Institute - Meridian

🇺🇸

Meridian, Idaho, United States

Kootenai Cancer Clinic

🇺🇸

Sandpoint, Idaho, United States

Saint Luke's Cancer Institute - Twin Falls

🇺🇸

Twin Falls, Idaho, United States

Illinois CancerCare-Bloomington

🇺🇸

Bloomington, Illinois, United States

Rush - Copley Medical Center

🇺🇸

Aurora, Illinois, United States

Illinois CancerCare-Canton

🇺🇸

Canton, Illinois, United States

SIH Cancer Institute

🇺🇸

Carterville, Illinois, United States

Illinois CancerCare-Carthage

🇺🇸

Carthage, Illinois, United States

Memorial Hospital of Carbondale

🇺🇸

Carbondale, Illinois, United States

Centralia Oncology Clinic

🇺🇸

Centralia, Illinois, United States

University of Illinois

🇺🇸

Chicago, Illinois, United States

Cancer Care Specialists of Illinois - Decatur

🇺🇸

Decatur, Illinois, United States

Carle at The Riverfront

🇺🇸

Danville, Illinois, United States

Carle Physician Group-Effingham

🇺🇸

Effingham, Illinois, United States

Decatur Memorial Hospital

🇺🇸

Decatur, Illinois, United States

Crossroads Cancer Center

🇺🇸

Effingham, Illinois, United States

Illinois CancerCare-Galesburg

🇺🇸

Galesburg, Illinois, United States

Illinois CancerCare-Eureka

🇺🇸

Eureka, Illinois, United States

Western Illinois Cancer Treatment Center

🇺🇸

Galesburg, Illinois, United States

Carle Physician Group-Mattoon/Charleston

🇺🇸

Mattoon, Illinois, United States

Loyola University Medical Center

🇺🇸

Maywood, Illinois, United States

Illinois CancerCare-Macomb

🇺🇸

Macomb, Illinois, United States

Illinois CancerCare-Kewanee Clinic

🇺🇸

Kewanee, Illinois, United States

Good Samaritan Regional Health Center

🇺🇸

Mount Vernon, Illinois, United States

Cancer Care Center of O'Fallon

🇺🇸

O'Fallon, Illinois, United States

Illinois CancerCare-Ottawa Clinic

🇺🇸

Ottawa, Illinois, United States

Illinois CancerCare-Pekin

🇺🇸

Pekin, Illinois, United States

OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center

🇺🇸

Pekin, Illinois, United States

Illinois CancerCare-Peoria

🇺🇸

Peoria, Illinois, United States

OSF Saint Francis Radiation Oncology at Peoria Cancer Center

🇺🇸

Peoria, Illinois, United States

OSF Saint Francis Medical Center

🇺🇸

Peoria, Illinois, United States

Methodist Medical Center of Illinois

🇺🇸

Peoria, Illinois, United States

Illinois CancerCare-Peru

🇺🇸

Peru, Illinois, United States

Kaiser Permanente-San Francisco

🇺🇸

San Francisco, California, United States

Coffeyville Regional Medical Center

🇺🇸

Coffeyville, Kansas, United States

Saint Catherine Hospital

🇺🇸

Garden City, Kansas, United States

University of Kansas Cancer Center

🇺🇸

Kansas City, Kansas, United States

Kansas Institute of Medicine Cancer and Blood Center

🇺🇸

Lenexa, Kansas, United States

Minimally Invasive Surgery Hospital

🇺🇸

Lenexa, Kansas, United States

University of Kansas Cancer Center-Overland Park

🇺🇸

Overland Park, Kansas, United States

University of Kansas Hospital-Westwood Cancer Center

🇺🇸

Westwood, Kansas, United States

Central Care Cancer Center - Garden City

🇺🇸

Garden City, Kansas, United States

University of Kansas Cancer Center-West

🇺🇸

Kansas City, Kansas, United States

Central Care Cancer Center - Great Bend

🇺🇸

Great Bend, Kansas, United States

Olathe Health Cancer Center

🇺🇸

Olathe, Kansas, United States

Salina Regional Health Center

🇺🇸

Salina, Kansas, United States

Menorah Medical Center

🇺🇸

Overland Park, Kansas, United States

Billings Clinic Cancer Center

🇺🇸

Billings, Montana, United States

Mercy Hospital Springfield

🇺🇸

Springfield, Missouri, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Kalispell Regional Medical Center

🇺🇸

Kalispell, Montana, United States

University of Mississippi Medical Center

🇺🇸

Jackson, Mississippi, United States

Community Hospital of Anaconda

🇺🇸

Anaconda, Montana, United States

Benefis Healthcare- Sletten Cancer Institute

🇺🇸

Great Falls, Montana, United States

Saint Patrick Hospital - Community Hospital

🇺🇸

Missoula, Montana, United States

Newton Medical Center

🇺🇸

Newton, New Jersey, United States

Christiana Care Health System-Concord Health Center

🇺🇸

Chadds Ford, Pennsylvania, United States

Baptist Memorial Hospital and Cancer Center-Memphis

🇺🇸

Memphis, Tennessee, United States

UT Southwestern/Simmons Cancer Center-Fort Worth

🇺🇸

Fort Worth, Texas, United States

Wayne Memorial Hospital

🇺🇸

Goldsboro, North Carolina, United States

Harrison Medical Center

🇺🇸

Bremerton, Washington, United States

NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center

🇺🇸

New York, New York, United States

Lehigh Valley Hospital - Muhlenberg

🇺🇸

Bethlehem, Pennsylvania, United States

Dickstein Cancer Treatment Center

🇺🇸

White Plains, New York, United States

Saint Charles Health System-Redmond

🇺🇸

Redmond, Oregon, United States

Southeastern Medical Oncology Center-Clinton

🇺🇸

Clinton, North Carolina, United States

Pocono Medical Center

🇺🇸

East Stroudsburg, Pennsylvania, United States

Onslow Memorial Hospital

🇺🇸

Jacksonville, North Carolina, United States

Southeastern Medical Oncology Center-Jacksonville

🇺🇸

Jacksonville, North Carolina, United States

UT Southwestern/Simmons Cancer Center-Dallas

🇺🇸

Dallas, Texas, United States

Swedish Cancer Institute-Edmonds

🇺🇸

Edmonds, Washington, United States

Saint Joseph Regional Cancer Center

🇺🇸

Bryan, Texas, United States

North Coast Cancer Care

🇺🇸

Sandusky, Ohio, United States

Bryn Mawr Hospital

🇺🇸

Bryn Mawr, Pennsylvania, United States

UHHS-Chagrin Highlands Medical Center

🇺🇸

Beachwood, Ohio, United States

Cleveland Clinic Akron General

🇺🇸

Akron, Ohio, United States

Aultman Health Foundation

🇺🇸

Canton, Ohio, United States

Good Samaritan Hospital - Cincinnati

🇺🇸

Cincinnati, Ohio, United States

Oncology Hematology Care Inc-Kenwood

🇺🇸

Cincinnati, Ohio, United States

Indu and Raj Soin Medical Center

🇺🇸

Beavercreek, Ohio, United States

Cleveland Clinic Cancer Center Strongsville

🇺🇸

Strongsville, Ohio, United States

Miami Valley Hospital South

🇺🇸

Centerville, Ohio, United States

Lehigh Valley Hospital-Hazleton

🇺🇸

Hazleton, Pennsylvania, United States

Prisma Health Cancer Institute - Easley

🇺🇸

Easley, South Carolina, United States

Overlake Medical Center

🇺🇸

Bellevue, Washington, United States

Phoenixville Hospital

🇺🇸

Phoenixville, Pennsylvania, United States

Riddle Memorial Hospital

🇺🇸

Media, Pennsylvania, United States

University of Oklahoma Health Sciences Center

🇺🇸

Oklahoma City, Oklahoma, United States

Cleveland Clinic Wooster Family Health and Surgery Center

🇺🇸

Wooster, Ohio, United States

Clackamas Radiation Oncology Center

🇺🇸

Clackamas, Oregon, United States

Oklahoma Cancer Specialists and Research Institute-Tulsa

🇺🇸

Tulsa, Oklahoma, United States

South Pointe Hospital

🇺🇸

Warrensville Heights, Ohio, United States

Robert Wood Johnson University Hospital Somerset

🇺🇸

Somerville, New Jersey, United States

Southeastern Medical Oncology Center-Goldsboro

🇺🇸

Goldsboro, North Carolina, United States

Sanford Bismarck Medical Center

🇺🇸

Bismarck, North Dakota, United States

Midlands Community Hospital

🇺🇸

Papillion, Nebraska, United States

Prisma Health Cancer Institute - Faris

🇺🇸

Greenville, South Carolina, United States

Prisma Health Cancer Institute - Spartanburg

🇺🇸

Boiling Springs, South Carolina, United States

Prisma Health Cancer Institute - Laurens

🇺🇸

Clinton, South Carolina, United States

PeaceHealth Saint Joseph Medical Center

🇺🇸

Bellingham, Washington, United States

University of Cincinnati Cancer Center-West Chester

🇺🇸

West Chester, Ohio, United States

University of Texas Health Science Center at San Antonio

🇺🇸

San Antonio, Texas, United States

Nyack Hospital

🇺🇸

Nyack, New York, United States

UHHS-Westlake Medical Center

🇺🇸

Westlake, Ohio, United States

Mercy Hospital Oklahoma City

🇺🇸

Oklahoma City, Oklahoma, United States

Augusta Health Center for Cancer and Blood Disorders

🇺🇸

Fishersville, Virginia, United States

Saint Alphonsus Medical Center-Baker City

🇺🇸

Baker City, Oregon, United States

Bay Area Hospital

🇺🇸

Coos Bay, Oregon, United States

Greater Dayton Cancer Center

🇺🇸

Kettering, Ohio, United States

Providence Newberg Medical Center

🇺🇸

Newberg, Oregon, United States

Mercy Cancer Center-Elyria

🇺🇸

Elyria, Ohio, United States

Saint Alphonsus Medical Center-Ontario

🇺🇸

Ontario, Oregon, United States

Memorial Hospital

🇺🇸

Chattanooga, Tennessee, United States

Providence Regional Cancer System-Centralia

🇺🇸

Centralia, Washington, United States

Kadlec Clinic Hematology and Oncology

🇺🇸

Kennewick, Washington, United States

Providence Regional Cancer System-Aberdeen

🇺🇸

Aberdeen, Washington, United States

Harrison HealthPartners Hematology and Oncology-Bremerton

🇺🇸

Bremerton, Washington, United States

Northwest Cancer Clinic

🇺🇸

Kennewick, Washington, United States

Armes Family Cancer Center

🇺🇸

Findlay, Ohio, United States

Dayton Physicians LLC-Atrium

🇺🇸

Franklin, Ohio, United States

Lehigh Valley Hospital-Cedar Crest

🇺🇸

Allentown, Pennsylvania, United States

Guthrie Medical Group PC-Robert Packer Hospital

🇺🇸

Sayre, Pennsylvania, United States

Memorial GYN Plus

🇺🇸

Ooltewah, Tennessee, United States

Baptist Memorial Hospital for Women

🇺🇸

Memphis, Tennessee, United States

Morristown Medical Center

🇺🇸

Morristown, New Jersey, United States

Overlook Hospital

🇺🇸

Summit, New Jersey, United States

Baptist Memorial Hospital and Cancer Center-Collierville

🇺🇸

Collierville, Tennessee, United States

Saint Elizabeth Regional Medical Center

🇺🇸

Lincoln, Nebraska, United States

Saint Clare Hospital

🇺🇸

Lakewood, Washington, United States

Virginia Mason Lynnwood Medical Center

🇺🇸

Lynnwood, Washington, United States

WVUH-Berkely Medical Center

🇺🇸

Martinsburg, West Virginia, United States

Bellin Memorial Hospital

🇺🇸

Green Bay, Wisconsin, United States

MultiCare Good Samaritan Hospital

🇺🇸

Puyallup, Washington, United States

Pacific Gynecology Specialists

🇺🇸

Seattle, Washington, United States

Welch Cancer Center

🇺🇸

Sheridan, Wyoming, United States

Doctors Cancer Center

🇵🇷

Manati, Puerto Rico

Tacoma/Valley Radiation Oncology Centers-Jackson Hall

🇺🇸

Tacoma, Washington, United States

Cancer Center of Western Wisconsin

🇺🇸

New Richmond, Wisconsin, United States

MultiCare Deaconess Cancer and Blood Specialty Center - North

🇺🇸

Spokane, Washington, United States

King Faisal Specialist Hospital and Research Centre

🇸🇦

Riyadh, Saudi Arabia

Southern Illinois University School of Medicine

🇺🇸

Springfield, Illinois, United States

Springfield Clinic

🇺🇸

Springfield, Illinois, United States

Memorial Medical Center

🇺🇸

Springfield, Illinois, United States

Southwest Illinois Health Services LLP

🇺🇸

Swansea, Illinois, United States

Carle Cancer Center

🇺🇸

Urbana, Illinois, United States

The Carle Foundation Hospital

🇺🇸

Urbana, Illinois, United States

Rush-Copley Healthcare Center

🇺🇸

Yorkville, Illinois, United States

Reid Health

🇺🇸

Richmond, Indiana, United States

Franciscan Health Mooresville

🇺🇸

Mooresville, Indiana, United States

Union Hospital

🇺🇸

Terre Haute, Indiana, United States

Alegent Health Mercy Hospital

🇺🇸

Council Bluffs, Iowa, United States

Greater Regional Medical Center

🇺🇸

Creston, Iowa, United States

Methodist West Hospital

🇺🇸

West Des Moines, Iowa, United States

Mercy Medical Center-West Lakes

🇺🇸

West Des Moines, Iowa, United States

HaysMed University of Kansas Health System

🇺🇸

Hays, Kansas, United States

University of Kansas Hospital-Indian Creek Campus

🇺🇸

Overland Park, Kansas, United States

Saint Luke's South Hospital

🇺🇸

Overland Park, Kansas, United States

Ascension Via Christi - Pittsburg

🇺🇸

Pittsburg, Kansas, United States

University of Kansas Health System Saint Francis Campus

🇺🇸

Topeka, Kansas, United States

Flaget Memorial Hospital

🇺🇸

Bardstown, Kentucky, United States

Commonwealth Cancer Center-Corbin

🇺🇸

Corbin, Kentucky, United States

Saint Joseph London

🇺🇸

London, Kentucky, United States

LSU Health Baton Rouge-North Clinic

🇺🇸

Baton Rouge, Louisiana, United States

Jewish Hospital Medical Center South

🇺🇸

Shepherdsville, Kentucky, United States

Louisiana Hematology Oncology Associates LLC

🇺🇸

Baton Rouge, Louisiana, United States

Mary Bird Perkins Cancer Center

🇺🇸

Baton Rouge, Louisiana, United States

Our Lady of the Lake Physicians Group - Medical Oncology

🇺🇸

Baton Rouge, Louisiana, United States

Louisiana Hematology Oncology Associates

🇺🇸

Baton Rouge, Louisiana, United States

Medical Center of Baton Rouge

🇺🇸

Baton Rouge, Louisiana, United States

Our Lady of the Lake Medical Oncology

🇺🇸

Baton Rouge, Louisiana, United States

Ochsner Hematology Oncology North Shore - Covington (West Region)

🇺🇸

Covington, Louisiana, United States

LSU Health Sciences Center at Shreveport

🇺🇸

Shreveport, Louisiana, United States

UM Upper Chesapeake Medical Center

🇺🇸

Bel Air, Maryland, United States

Lahey Hospital and Medical Center

🇺🇸

Burlington, Massachusetts, United States

McLaren Cancer Institute-Bay City

🇺🇸

Bay City, Michigan, United States

Bronson Battle Creek

🇺🇸

Battle Creek, Michigan, United States

Saint Joseph Mercy Brighton

🇺🇸

Brighton, Michigan, United States

McLaren Cancer Institute-Bloomfield

🇺🇸

Bloomfield, Michigan, United States

Essentia Health Cancer Center-South University Clinic

🇺🇸

Fargo, North Dakota, United States

Sanford Roger Maris Cancer Center

🇺🇸

Fargo, North Dakota, United States

Trinity Health IHA Medical Group Hematology Oncology - Brighton

🇺🇸

Brighton, Michigan, United States

Saint Joseph Mercy Canton

🇺🇸

Canton, Michigan, United States

Trinity Health IHA Medical Group Hematology Oncology - Canton

🇺🇸

Canton, Michigan, United States

Caro Cancer Center

🇺🇸

Caro, Michigan, United States

McLaren Cancer Institute-Clarkston

🇺🇸

Clarkston, Michigan, United States

Newland Medical Associates-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

Ascension Saint John Hospital

🇺🇸

Detroit, Michigan, United States

Great Lakes Cancer Management Specialists-Doctors Park

🇺🇸

East China Township, Michigan, United States

Genesee Cancer and Blood Disease Treatment Center

🇺🇸

Flint, Michigan, United States

Genesee Hematology Oncology PC

🇺🇸

Flint, Michigan, United States

Genesys Hurley Cancer Institute

🇺🇸

Flint, Michigan, United States

Hurley Medical Center

🇺🇸

Flint, Michigan, United States

Stony Brook University Medical Center

🇺🇸

Stony Brook, New York, United States

Spectrum Health at Butterworth Campus

🇺🇸

Grand Rapids, Michigan, United States

Parker Adventist Hospital

🇺🇸

Parker, Colorado, United States

Saint Mary Corwin Medical Center

🇺🇸

Pueblo, Colorado, United States

Pulmonary Medicine Center of Chattanooga-Hixson

🇺🇸

Hixson, Tennessee, United States

UT Southwestern Clinical Center at Richardson/Plano

🇺🇸

Richardson, Texas, United States

Dayton Physicians LLC-Miami Valley South

🇺🇸

Centerville, Ohio, United States

Geauga Hospital

🇺🇸

Chardon, Ohio, United States

Bethesda North Hospital

🇺🇸

Cincinnati, Ohio, United States

TriHealth Cancer Institute-Westside

🇺🇸

Cincinnati, Ohio, United States

Atrium Medical Center-Middletown Regional Hospital

🇺🇸

Franklin, Ohio, United States

Cleveland Clinic Foundation

🇺🇸

Cleveland, Ohio, United States

Blanchard Valley Hospital

🇺🇸

Findlay, Ohio, United States

Dayton Physicians LLC-Wayne

🇺🇸

Greenville, Ohio, United States

Wayne Hospital

🇺🇸

Greenville, Ohio, United States

First Dayton Cancer Care

🇺🇸

Kettering, Ohio, United States

Cleveland Clinic Cancer Center Independence

🇺🇸

Independence, Ohio, United States

Henry Ford Cancer Institute-Downriver

🇺🇸

Brownstown, Michigan, United States

Saint Joseph Mercy Chelsea

🇺🇸

Chelsea, Michigan, United States

Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital

🇺🇸

Chelsea, Michigan, United States

Hematology Oncology Consultants-Clarkston

🇺🇸

Clarkston, Michigan, United States

Trinity Health Grand Rapids Hospital

🇺🇸

Grand Rapids, Michigan, United States

Wayne State University/Karmanos Cancer Institute

🇺🇸

Detroit, Michigan, United States

Kettering Medical Center

🇺🇸

Kettering, Ohio, United States

Singh and Arora Hematology Oncology PC

🇺🇸

Flint, Michigan, United States

McLaren Cancer Institute-Flint

🇺🇸

Flint, Michigan, United States

Hillcrest Hospital Cancer Center

🇺🇸

Mayfield Heights, Ohio, United States

Bhadresh Nayak MD PC-Sterling Heights

🇺🇸

Sterling Heights, Michigan, United States

Springfield Regional Cancer Center

🇺🇸

Springfield, Ohio, United States

UH Seidman Cancer Center at Southwest General Hospital

🇺🇸

Middleburg Heights, Ohio, United States

Springfield Regional Medical Center

🇺🇸

Springfield, Ohio, United States

Dayton Physicians LLC - Troy

🇺🇸

Troy, Ohio, United States

UH Seidman Cancer Center at Saint John Medical Center

🇺🇸

Westlake, Ohio, United States

University Hospitals Sharon Health Center

🇺🇸

Wadsworth, Ohio, United States

Saint Charles Health System

🇺🇸

Bend, Oregon, United States

Prisma Health Cancer Institute - Butternut

🇺🇸

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

Prisma Health Greenville Memorial Hospital

🇺🇸

Greenville, South Carolina, United States

Sanford Cancer Center Oncology Clinic

🇺🇸

Sioux Falls, South Dakota, United States

Academic Hematology Oncology Specialists

🇺🇸

Grosse Pointe Woods, Michigan, United States

Great Lakes Cancer Management Specialists-Van Elslander Cancer Center

🇺🇸

Grosse Pointe Woods, Michigan, United States

Allegiance Health

🇺🇸

Jackson, Michigan, United States

Paoli Memorial Hospital

🇺🇸

Paoli, Pennsylvania, United States

Penn State Milton S Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

Lankenau Medical Center

🇺🇸

Wynnewood, Pennsylvania, United States

Bronson Methodist Hospital

🇺🇸

Kalamazoo, Michigan, United States

West Michigan Cancer Center

🇺🇸

Kalamazoo, Michigan, United States

Karmanos Cancer Institute at McLaren Greater Lansing

🇺🇸

Lansing, Michigan, United States

Medical Oncology and Hematology Associates-West Des Moines

🇺🇸

Clive, Iowa, United States

Borgess Medical Center

🇺🇸

Kalamazoo, Michigan, United States

Sparrow Hospital

🇺🇸

Lansing, Michigan, United States

McLaren Cancer Institute-Lapeer Region

🇺🇸

Lapeer, Michigan, United States

Trinity Health Saint Mary Mercy Livonia Hospital

🇺🇸

Livonia, Michigan, United States

Hope Cancer Clinic

🇺🇸

Livonia, Michigan, United States

Great Lakes Cancer Management Specialists-Macomb Medical Campus

🇺🇸

Macomb, Michigan, United States

McLaren Cancer Institute-Macomb

🇺🇸

Mount Clemens, Michigan, United States

Trinity Health Muskegon Hospital

🇺🇸

Muskegon, Michigan, United States

Lakeland Hospital Niles

🇺🇸

Niles, Michigan, United States

Ascension Providence Hospitals - Novi

🇺🇸

Novi, Michigan, United States

Henry Ford Medical Center-Columbus

🇺🇸

Novi, Michigan, United States

21st Century Oncology-Pontiac

🇺🇸

Pontiac, Michigan, United States

Hope Cancer Center

🇺🇸

Pontiac, Michigan, United States

Newland Medical Associates-Pontiac

🇺🇸

Pontiac, Michigan, United States

Holy Name Hospital

🇺🇸

Teaneck, New Jersey, United States

Spectrum Health Reed City Hospital

🇺🇸

Reed City, Michigan, United States

Saint Joseph Mercy Oakland

🇺🇸

Pontiac, Michigan, United States

Great Lakes Cancer Management Specialists-Rochester Hills

🇺🇸

Rochester Hills, Michigan, United States

Lakeland Medical Center Saint Joseph

🇺🇸

Saint Joseph, Michigan, United States

Ascension Saint Mary's Hospital

🇺🇸

Saginaw, Michigan, United States

Marie Yeager Cancer Center

🇺🇸

Saint Joseph, Michigan, United States

Ascension Saint Joseph Hospital

🇺🇸

Tawas City, Michigan, United States

Munson Medical Center

🇺🇸

Traverse City, Michigan, United States

Advanced Breast Care Center PLLC

🇺🇸

Warren, Michigan, United States

Great Lakes Cancer Management Specialists-Macomb Professional Building

🇺🇸

Warren, Michigan, United States

Macomb Hematology Oncology PC

🇺🇸

Warren, Michigan, United States

Michigan Breast Specialists-Warren

🇺🇸

Warren, Michigan, United States

Saint John Macomb-Oakland Hospital

🇺🇸

Warren, Michigan, United States

Henry Ford West Bloomfield Hospital

🇺🇸

West Bloomfield, Michigan, United States

University of Michigan Health - West

🇺🇸

Wyoming, Michigan, United States

Huron Gastroenterology PC

🇺🇸

Ypsilanti, Michigan, United States

Sanford Joe Lueken Cancer Center

🇺🇸

Bemidji, Minnesota, United States

Essentia Health Saint Joseph's Medical Center

🇺🇸

Brainerd, Minnesota, United States

Fairview Ridges Hospital

🇺🇸

Burnsville, Minnesota, United States

Mercy Hospital

🇺🇸

Coon Rapids, Minnesota, United States

Essentia Health Cancer Center

🇺🇸

Duluth, Minnesota, United States

Essentia Health Saint Mary's Medical Center

🇺🇸

Duluth, Minnesota, United States

Miller-Dwan Hospital

🇺🇸

Duluth, Minnesota, United States

Fairview Southdale Hospital

🇺🇸

Edina, Minnesota, United States

Minnesota Oncology Hematology PA-Maplewood

🇺🇸

Maplewood, Minnesota, United States

Unity Hospital

🇺🇸

Fridley, Minnesota, United States

Lake Region Healthcare Corporation-Cancer Care

🇺🇸

Fergus Falls, Minnesota, United States

Fairview Clinics and Surgery Center Maple Grove

🇺🇸

Maple Grove, Minnesota, United States

Essentia Health Hibbing Clinic

🇺🇸

Hibbing, Minnesota, United States

Saint John's Hospital - Healtheast

🇺🇸

Maplewood, Minnesota, United States

Abbott-Northwestern Hospital

🇺🇸

Minneapolis, Minnesota, United States

New Ulm Medical Center

🇺🇸

New Ulm, Minnesota, United States

Monticello Cancer Center

🇺🇸

Monticello, Minnesota, United States

Park Nicollet Clinic - Saint Louis Park

🇺🇸

Saint Louis Park, Minnesota, United States

North Memorial Medical Health Center

🇺🇸

Robbinsdale, Minnesota, United States

Regions Hospital

🇺🇸

Saint Paul, Minnesota, United States

United Hospital

🇺🇸

Saint Paul, Minnesota, United States

Saint Francis Regional Medical Center

🇺🇸

Shakopee, Minnesota, United States

Essentia Health Virginia Clinic

🇺🇸

Virginia, Minnesota, United States

Ridgeview Medical Center

🇺🇸

Waconia, Minnesota, United States

Rice Memorial Hospital

🇺🇸

Willmar, Minnesota, United States

Fairview Lakes Medical Center

🇺🇸

Wyoming, Minnesota, 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

Singing River Hospital

🇺🇸

Pascagoula, Mississippi, United States

Baptist Memorial Hospital and Cancer Center-Desoto

🇺🇸

Southhaven, Mississippi, United States

Central Care Cancer Center - Bolivar

🇺🇸

Bolivar, Missouri, United States

Saint Louis Cancer and Breast Institute-Ballwin

🇺🇸

Ballwin, Missouri, United States

Parkland Health Center-Bonne Terre

🇺🇸

Bonne Terre, Missouri, United States

Cox Cancer Center Branson

🇺🇸

Branson, Missouri, United States

Saint Francis Medical Center

🇺🇸

Cape Girardeau, Missouri, United States

Southeast Cancer Center

🇺🇸

Cape Girardeau, 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

UH Seidman Cancer Center at Lake Health Mentor Campus

🇺🇸

Mentor, Ohio, United States

Upper Valley Medical Center

🇺🇸

Troy, Ohio, United States

Siteman Cancer Center at West County Hospital

🇺🇸

Creve Coeur, Missouri, United States

Centerpoint Medical Center LLC

🇺🇸

Independence, Missouri, United States

Capital Region Southwest Campus

🇺🇸

Jefferson City, Missouri, United States

Freeman Health System

🇺🇸

Joplin, Missouri, United States

Mercy Hospital Joplin

🇺🇸

Joplin, Missouri, United States

Saint Luke's East - Lee's Summit

🇺🇸

Lee's Summit, Missouri, United States

Delbert Day Cancer Institute at PCRMC

🇺🇸

Rolla, Missouri, United States

Kaiser Permanente-Franklin

🇺🇸

Denver, Colorado, United States

Porter Adventist Hospital

🇺🇸

Denver, Colorado, United States

SCL Health Saint Joseph Hospital

🇺🇸

Denver, Colorado, United States

Moffitt Cancer Center

🇺🇸

Tampa, Florida, United States

Alegent Health Immanuel Medical Center

🇺🇸

Omaha, Nebraska, United States

Alegent Health Bergan Mercy Medical Center

🇺🇸

Omaha, Nebraska, United States

Alegent Health Lakeside Hospital

🇺🇸

Omaha, Nebraska, United States

Creighton University Medical Center

🇺🇸

Omaha, Nebraska, United States

Providence Portland Medical Center

🇺🇸

Portland, Oregon, United States

Kaiser Permanente Northwest

🇺🇸

Portland, Oregon, United States

Providence Saint Vincent Medical Center

🇺🇸

Portland, Oregon, United States

Oregon Health and Science University

🇺🇸

Portland, Oregon, United States

Heartland Regional Medical Center

🇺🇸

Saint Joseph, Missouri, United States

Saint Louis Cancer and Breast Institute-South City

🇺🇸

Saint Louis, Missouri, United States

Mercy Hospital South

🇺🇸

Saint Louis, Missouri, United States

Siteman Cancer Center-South County

🇺🇸

Saint Louis, Missouri, United States

Missouri Baptist Medical Center

🇺🇸

Saint Louis, Missouri, United States

Siteman Cancer Center at Christian Hospital

🇺🇸

Saint Louis, Missouri, United States

Siteman Cancer Center at Saint Peters Hospital

🇺🇸

Saint Peters, Missouri, United States

Mercy Hospital Saint Louis

🇺🇸

Saint Louis, Missouri, United States

CoxHealth South Hospital

🇺🇸

Springfield, Missouri, United States

Sainte Genevieve County Memorial Hospital

🇺🇸

Sainte Genevieve, Missouri, United States

Missouri Baptist Sullivan Hospital

🇺🇸

Sullivan, Missouri, United States

Missouri Baptist Outpatient Center-Sunset Hills

🇺🇸

Sunset Hills, Missouri, United States

Virginia Mason Bainbridge Island Medical Center

🇺🇸

Bainbridge Island, Washington, United States

Highline Medical Center-Main Campus

🇺🇸

Burien, Washington, United States

Saint Elizabeth Hospital

🇺🇸

Enumclaw, Washington, United States

Swedish Cancer Institute-Issaquah

🇺🇸

Issaquah, Washington, United States

MultiCare Gig Harbor Medical Park

🇺🇸

Gig Harbor, Washington, United States

Harrison HealthPartners Hematology and Oncology-Poulsbo

🇺🇸

Poulsbo, Washington, United States

Peninsula Cancer Center

🇺🇸

Poulsbo, Washington, United States

Providence Regional Cancer System-Lacey

🇺🇸

Lacey, Washington, United States

Tacoma/Valley Radiation Oncology Centers-Puyallup

🇺🇸

Puyallup, Washington, United States

Virginia Mason Medical Center

🇺🇸

Seattle, Washington, United States

Valley Medical Center

🇺🇸

Renton, Washington, United States

Kaiser Permanente Washington

🇺🇸

Seattle, Washington, United States

University of Washington Medical Center - Montlake

🇺🇸

Seattle, Washington, United States

Franciscan Research Center-Northwest Medical Plaza

🇺🇸

Tacoma, Washington, United States

MultiCare Deaconess Cancer and Blood Specialty Center - Valley

🇺🇸

Spokane Valley, Washington, United States

Northwest Medical Specialties PLLC

🇺🇸

Tacoma, Washington, United States

MultiCare Deaconess Cancer and Blood Specialty Center - Downtown

🇺🇸

Spokane, Washington, United States

Tacoma/Valley Radiation Oncology Centers-Saint Joe's

🇺🇸

Tacoma, Washington, United States

Providence Saint Mary Regional Cancer Center

🇺🇸

Walla Walla, Washington, United States

North Star Lodge Cancer Center at Yakima Valley Memorial Hospital

🇺🇸

Yakima, Washington, United States

Providence Regional Cancer System-Yelm

🇺🇸

Yelm, Washington, United States

Mercy Hospital Washington

🇺🇸

Washington, Missouri, United States

Bozeman Deaconess Hospital

🇺🇸

Bozeman, Montana, United States

Hematology and Oncology Consultants PC

🇺🇸

Omaha, Nebraska, United States

Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus

🇺🇸

Ypsilanti, Michigan, United States

Baptist Cancer Center-Grenada

🇺🇸

Grenada, Mississippi, United States

Providence Regional Cancer System-Shelton

🇺🇸

Shelton, Washington, United States

National Cancer Center-Korea

🇰🇷

Goyang-si, Gyeonggi-do, Korea, Republic of

Michigan Breast Specialists-Macomb Township

🇺🇸

Macomb, Michigan, United States

Saint Mary's Oncology/Hematology Associates of Marlette

🇺🇸

Marlette, Michigan, United States

Lakeview Hospital

🇺🇸

Stillwater, Minnesota, United States

Saint Mary's Oncology/Hematology Associates of West Branch

🇺🇸

West Branch, Michigan, United States

Orion Cancer Care

🇺🇸

Findlay, Ohio, United States

Minnesota Oncology Hematology PA-Woodbury

🇺🇸

Woodbury, Minnesota, United States

Baptist Memorial Hospital and Cancer Center-Golden Triangle

🇺🇸

Columbus, Mississippi, United States

Providence Cancer Institute Clackamas Clinic

🇺🇸

Clackamas, Oregon, United States

Swedish Medical Center-First Hill

🇺🇸

Seattle, Washington, United States

PeaceHealth United General Medical Center

🇺🇸

Sedro-Woolley, Washington, United States

Kaiser Permanente - Sacramento

🇺🇸

Sacramento, California, United States

Kaiser Permanente-South Sacramento

🇺🇸

Sacramento, California, United States

University of California Davis Comprehensive Cancer Center

🇺🇸

Sacramento, California, United States

South Sacramento Cancer Center

🇺🇸

Sacramento, California, United States

Saint Joseph Mercy Hospital

🇺🇸

Ann Arbor, Michigan, United States

University of Michigan Comprehensive Cancer Center

🇺🇸

Ann Arbor, Michigan, United States

Mercy Clinic-Rolla-Cancer and Hematology

🇺🇸

Rolla, Missouri, United States

Case Western Reserve University

🇺🇸

Cleveland, Ohio, United States

Michigan Breast Specialists-Grosse Pointe Woods

🇺🇸

Grosse Pointe Woods, Michigan, United States

Prisma Health Cancer Institute - Eastside

🇺🇸

Greenville, South Carolina, United States

Providence Regional Cancer Partnership

🇺🇸

Everett, Washington, United States

Tacoma/Valley Radiation Oncology Centers-Gig Harbor

🇺🇸

Gig Harbor, Washington, United States

West Virginia University Healthcare

🇺🇸

Morgantown, West Virginia, United States

Virginia Mason Federal Way Medical Center

🇺🇸

Federal Way, Washington, United States

Saint Francis Hospital

🇺🇸

Federal Way, Washington, United States

Oncology Hematology Associates of Saginaw Valley PC

🇺🇸

Saginaw, Michigan, United States

Ochsner Health Center-Summa

🇺🇸

Baton Rouge, Louisiana, United States

Franciscan Saint Elizabeth Health - Lafayette East

🇺🇸

Lafayette, Indiana, United States

Sanford USD Medical Center - Sioux Falls

🇺🇸

Sioux Falls, South Dakota, United States

Sanford Broadway Medical Center

🇺🇸

Fargo, North Dakota, United States

Woman's Hospital

🇺🇸

Baton Rouge, Louisiana, United States

MultiCare Tacoma General Hospital

🇺🇸

Tacoma, Washington, United States

Winchester Hospital

🇺🇸

Winchester, Massachusetts, United States

Ascension Providence Hospitals - Southfield

🇺🇸

Southfield, Michigan, United States

PeaceHealth Southwest Medical Center

🇺🇸

Vancouver, Washington, United States

Great Falls Clinic

🇺🇸

Great Falls, Montana, United States

Saint Peter's Community Hospital

🇺🇸

Helena, Montana, United States

CHI Health Good Samaritan

🇺🇸

Kearney, Nebraska, United States

CHI Health Saint Francis

🇺🇸

Grand Island, Nebraska, United States

PeaceHealth Saint John Medical Center

🇺🇸

Longview, Washington, United States

Kootenai Clinic Cancer Services - Post Falls

🇺🇸

Post Falls, Idaho, United States

Doctor's Cancer Center-Arecibo

🇵🇷

Arecibo, Puerto Rico

Hematologia Oncologia San Pablo

🇵🇷

Bayamon, Puerto Rico

Primary Care Physician Group

🇵🇷

San Juan, Puerto Rico

Cancer Center-Metro Medical Center Bayamon

🇵🇷

Bayamon, Puerto Rico

Advance Oncology Center

🇵🇷

Aguadilla, Puerto Rico

HIMA San Pablo Oncologic Hospital

🇵🇷

Caguas, Puerto Rico

San Juan City Hospital

🇵🇷

San Juan, Puerto Rico

Instituto Oncologia Moderna Ponce

🇵🇷

Ponce, Puerto Rico

San Juan Community Oncology Group

🇵🇷

San Juan, Puerto Rico

Centro de Hematologia y Oncologia del Sur

🇵🇷

Santa Isabel, Puerto Rico

Hawaii Cancer Care Inc - Waterfront Plaza

🇺🇸

Honolulu, Hawaii, United States

Queen's Cancer Center - Kuakini

🇺🇸

Honolulu, Hawaii, United States

Kaiser Permanente Moanalua Medical Center

🇺🇸

Honolulu, Hawaii, United States

Jewish Hospital

🇺🇸

Louisville, Kentucky, United States

Saint Luke's Hospital of Kansas City

🇺🇸

Kansas City, Missouri, United States

Hawaii Cancer Care Inc-Liliha

🇺🇸

Honolulu, Hawaii, United States

Kuakini Medical Center

🇺🇸

Honolulu, Hawaii, United States

Saints Mary and Elizabeth Hospital

🇺🇸

Louisville, Kentucky, United States

Ochsner Medical Center Jefferson

🇺🇸

New Orleans, Louisiana, United States

Queen's Cancer Cenrer - POB I

🇺🇸

Honolulu, Hawaii, United States

Queen's Medical Center

🇺🇸

Honolulu, Hawaii, United States

The Cancer Center of Hawaii-Liliha

🇺🇸

Honolulu, Hawaii, United States

Kapiolani Medical Center for Women and Children

🇺🇸

Honolulu, Hawaii, United States

Island Urology

🇺🇸

Honolulu, Hawaii, United States

UofL Health Medical Center Northeast

🇺🇸

Louisville, Kentucky, United States

University of Kansas Cancer Center - North

🇺🇸

Kansas City, Missouri, United States

Straub Clinic and Hospital

🇺🇸

Honolulu, Hawaii, United States

University of Hawaii Cancer Center

🇺🇸

Honolulu, Hawaii, United States

Truman Medical Centers

🇺🇸

Kansas City, Missouri, United States

Research Medical Center

🇺🇸

Kansas City, Missouri, United States

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

Iowa Methodist Medical Center

🇺🇸

Des Moines, Iowa, United States

Medical Oncology and Hematology Associates-Des Moines

🇺🇸

Des Moines, Iowa, United States

Broadlawns Medical Center

🇺🇸

Des Moines, Iowa, United States

Mercy Medical Center - Des Moines

🇺🇸

Des Moines, Iowa, United States

Mission Cancer and Blood - Laurel

🇺🇸

Des Moines, Iowa, United States

Iowa Lutheran Hospital

🇺🇸

Des Moines, Iowa, United States

Saint Joseph Radiation Oncology Resource Center

🇺🇸

Lexington, Kentucky, United States

Saint Joseph Hospital East

🇺🇸

Lexington, Kentucky, United States

University of New Mexico Cancer Center

🇺🇸

Albuquerque, New Mexico, United States

Good Samaritan Hospital - Dayton

🇺🇸

Dayton, Ohio, United States

Miami Valley Hospital

🇺🇸

Dayton, Ohio, United States

Dayton Physician LLC-Miami Valley Hospital North

🇺🇸

Dayton, Ohio, United States

Miami Valley Hospital North

🇺🇸

Dayton, Ohio, United States

Valley Radiation Oncology

🇺🇸

Peru, Illinois, United States

UMC Cancer Center / UMC Health System

🇺🇸

Lubbock, Texas, United States

Mercy Cancer Center-West Lakes

🇺🇸

Clive, Iowa, United States

Billings Clinic-Cody

🇺🇸

Cody, Wyoming, United States

Cleveland Clinic Cancer Center Mansfield

🇺🇸

Mansfield, Ohio, United States

Rocky Mountain Cancer Centers-Parker

🇺🇸

Parker, Colorado, United States

Rocky Mountain Cancer Centers-Thornton

🇺🇸

Thornton, Colorado, United States

Wheeling Hospital/Schiffler Cancer Center

🇺🇸

Wheeling, West Virginia, United States

Self Regional Healthcare

🇺🇸

Greenwood, South Carolina, United States

Jefferson Healthcare

🇺🇸

Port Townsend, Washington, United States

MultiCare Auburn Medical Center

🇺🇸

Auburn, Washington, United States

Camden Clark Medical Center

🇺🇸

Parkersburg, West Virginia, United States

Duluth Clinic Ashland

🇺🇸

Ashland, Wisconsin, United States

Mercyhealth Hospital and Cancer Center - Janesville

🇺🇸

Janesville, Wisconsin, United States

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