MedPath

Lisocabtagene Maraleucel (JCAR017) as Second-Line Therapy (TRANSCEND-PILOT-017006)

Phase 2
Completed
Conditions
Lymphoma, Non-Hodgkin
Lymphoma, Nonhodgkin
Lymphoma, B-Cell
Lymphoma, Large B-Cell, Diffuse
Interventions
Biological: lisocabtagene maraleucel
Registration Number
NCT03483103
Lead Sponsor
Juno Therapeutics, a Subsidiary of Celgene
Brief Summary

This is a Phase 2, open-label, multicenter study to determine the efficacy and safety of lisocabtagene maraleucel (JCAR017) in adult subjects who have relapsed from, or are refractory to, a single line of immunochemotherapy for aggressive B-cell non-Hodgkin lymphoma (NHL) and are ineligible for hematopoietic stem cell transplant (based on age, performance status, and/or comorbidities). Subjects will receive treatment with lisocabtagene maraleucel and will be followed for 2 years for safety, pharmacokinetics and biomarkers, disease status, quality of life, and survival.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
74
Inclusion Criteria
  • Confirmation of relapsed or refractory aggressive B-cell non-Hodgkin lymphoma of the following histology at relapse: diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS; de novo or transformed follicular lymphoma [tFL]), high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements with DLBCL histology (double/triple hit lymphoma [DHL/THL]), and follicular lymphoma Grade 3B per WHO 2016 classification
  • Previous treatment must include treatment with a single line of chemoimmunotherapy containing an anthracycline and a CD20-targeted agent
  • Subjects must be deemed ineligible for both high-dose chemotherapy and hematopoietic stem cell transplant (based on age, performance status and/or comorbidities) while also having adequate organ function for CAR T cell treatment.
  • Positron emission tomography (PET)-positive disease
  • Histological confirmation of diagnosis at last relapse. Enough tumor material must be available for central confirmation of diagnosis, otherwise a new tumor biopsy is mandated.
  • ECOG performance status of 0, or 1, or 2
  • Adequate vascular access for leukapheresis procedure (either peripheral line or surgically-placed line)
  • Subjects must agree to use appropriate contraception
  • Subjects must agree to not donate blood, organs, semen, and egg cells for usage in other individuals for at least 1 year following lymphodepleting chemotherapy
Exclusion Criteria
  • Subjects with central nervous system (CNS)-only involvement by malignancy (note: subjects with secondary CNS involvement are allowed on study)
  • History of another primary malignancy that has not been in remission for at least 2 years.
  • Previous treatment with CD19-targeted therapy, with the exception of prior lisocabtagene maraleucel treatment in this protocol for subjects receiving retreatment
  • Active hepatitis B or hepatitis C infection at the time of screening
  • History of or active human immunodeficiency virus (HIV) infection at the time of screening
  • Uncontrolled systemic fungal, bacterial, viral or other infection despite appropriate antibiotics or other treatment at the time of leukapheresis or lisocabtagene maraleucel administration
  • History of any one of the following cardiovascular conditions within the past 6 months: Class III or IV heart failure as defined by the New York Heart Association, cardiac angioplasty or stenting, myocardial infarction, unstable angina, or other clinically significant cardiac disease
  • History or presence of clinically relevant CNS pathology
  • Pregnant or nursing women
  • Subject does not meet protocol-specified washout periods for prior treatments
  • Prior hematopoietic stem cell transplant
  • Progressive vascular tumor invasion, thrombosis, or embolism
  • Venous thrombosis or embolism not managed on stable regimen of anticoagulation
  • Uncontrolled medical, psychological, familial, sociological, or geographical conditions

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Treatmentlisocabtagene maraleucelLisocabtagene maraleucel at a dose of 100×10\^6 CAR+ T cells (50×10\^6 CD8+ CAR+ T cells and 50×10\^6 CD4+ CAR+ T cells), will be given IV in a single-dose schedule on Day 1 (between 2 and 7 days following the completion of lymphodepleting chemotherapy).
Primary Outcome Measures
NameTimeMethod
Overall Response Rate (ORR)From first dose to disease progression, end of study, the start of another anticancer therapy, or hematopoietic stem cell transplantation (up to approximately 24 months)

Overall response rate is the percent of participants with a best overall response (BOR) of either complete response (CR) or partial reasons (PR) based on the Independent Review Committee (IRC) assessment recorded from the time of JCAR017 treatment until disease progression, end of study, the start of another anticancer therapy or JCAR017 retreatment.

CR = Score 1, 2, or 3 with or without a residual mass on the positron emission tomography 5-point scale (PET 5PS). A score of 3 in many patients indicates a good prognosis with standard treatment.

PR = Score 4 or 5b with reduced uptake compared with baseline and residual mass(es) of any size.

PET 5PS = 1- no uptake above background; 2- uptake ≤ mediastinum; 3- uptake \> mediastinum but ≤ liver; 4- uptake moderately \> liver; 5- uptake markedly higher than liver and/or new lesions; X- new areas of uptake unlikely to be related to lymphoma.

Secondary Outcome Measures
NameTimeMethod
Number of Participants With Any Treatment-Emergent Adverse Events (TEAEs)From first dose to 90 days following first dose (up to approximately 90 days)

A TEAE was defined as an adverse event that started any time from initiation of product administration through and including 90 days following product administration. AEs that occurred after the initiation of subsequent anticancer therapy or product retreatment were not considered as product TEAE. AEs are graded according to National Cancer Institute Common Terminology Criteria for Adverse Events (Version 4.03) (NCI CTCAE) guidelines where Grade 3= Severe, Grade 4= Life-threatening, and 5 = Death.

Overall Survival (OS)From first dose to date of death (up to approximately 24 months)

OS is defined as the time from JCAR017 infusion to the date of death. Kaplan-Meier (KM) methodology will be used to analyze OS.

Change From Baseline of Hematology Laboratory Results: HemoglobinBaseline and Day 29

Change from baseline in Hematology laboratory analysis. Includes Hemoglobin. Baseline is the last observation collected prior to or on the date of product infusion.

Progression-Free Survival (PFS)From first dose to progressive disease (PD) or death (up to approximately 24 months)

PFS is defined as the time from JCAR017 infusion to progressive disease (PD) or death. Kaplan-Meier (KM) methodology will be used to analyze PFS.

PD = Score 4 or 5b on the positron emission tomography 5-point scale (PET 5PS) with an increase in intensity of uptake from baseline and/or new fluorodeoxyglucose-avid foci consistent with lymphoma at interim or end-of-treatment assessment.

PET 5PS = 1- no uptake above background; 2- uptake ≤ mediastinum; 3- uptake \> mediastinum but ≤ liver; 4- uptake moderately \> liver; 5- uptake markedly higher than liver and/or new lesions; X- new areas of uptake unlikely to be related to lymphoma.

PK Parameters of JCAR017 in Blood as Assessed by qPCR: TmaxFrom first dose to up to 24 months

Pharmacokinetic (PK) analyses were based on quantitative polymerase chain reaction (qPCR). Tmax = Time of maximum observed blood concentration.

Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Fatigue SubscaleBaseline and Day 29

* Health Related Quality of Life (HRQoL) was assessed using the EORTC QLQ-C30 questionnaire.

* The EORTC QLQ-C30 is a 30-item scale composed of both multi-item scales and single-item measures.

* All of the scales and single-item measures range in score from 0 to 100. A 10-point change in the scoring is considered to be a meaningful change in HRQoL.

* Symptom scale/item higher score represents a high level of symptomatic problem.

Change From Baseline of Chemistry Laboratory Results: AlbuminBaseline and Day 29

Change from baseline in Chemistry laboratory analysis. Includes Albumin. Baseline is the last observation collected prior to or on the date of product infusion.

Change From Baseline of Hematology Laboratory Results: Leukocytes, Lymphocytes, Neutrophils, PlateletsBaseline and Day 29

Change from baseline in Hematology laboratory analysis. Includes Leukocytes, Lymphocytes, Neutrophils, and Platelets. Baseline is the last observation collected prior to or on the date of product infusion.

Numbers of Intensive Care Unit (ICU) Inpatient DaysFrom first dose after JCAR017 infusion to up to approximately 24 months

The numbers of ICU inpatient days.

Duration of Response (DOR)From first dose to up to approximately 24 months

Duration of response (DOR) is defined as the time from first complete response(CR) or partial response (PR) to progressive disease (PD) or death, whichever occurred first.

CR = Score 1, 2, or 3 on the positron emission tomography 5-point scale (PET 5PS). A score of 3 indicates a good prognosis with standard treatment.

PR = Score 4 or 5b with reduced uptake compared with baseline and residual mass(es) of any size.

PD = Score 4 or 5b on PET 5PS with an increase in intensity of uptake from baseline and/or new fluorodeoxyglucose-avid foci consistent with lymphoma at interim or end-of-treatment assessment.

PET 5PS = 1-no uptake above background; 2-uptake ≤ mediastinum; 3-uptake \> mediastinum but ≤ liver; 4-uptake moderately \> liver; 5-uptake markedly higher than liver and/or new lesions; X- new areas of uptake unlikely to be related to lymphoma.

Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Pain SubscaleBaseline and Day 29

* Health Related Quality of Life (HRQoL) was assessed using the EORTC QLQ-C30 questionnaire.

* The EORTC QLQ-C30 is a 30-item scale composed of both multi-item scales and single-item measures.

* All of the scales and single-item measures range in score from 0 to 100. A 10-point change in the scoring is considered to be a meaningful change in HRQoL.

* Symptom scale/item higher score represents a high level of symptomatic problem.

Change From Baseline of Chemistry Laboratory Results: Alanine Aminotransferase, Aspartate Aminotransferase, Lactate DehydrogenaseBaseline and Day 29

Change from baseline in Chemistry laboratory analysis. Includes Alanine Aminotransferase, Aspartate Aminotransferase, and Lactate Dehydrogenase. Baseline is the last observation collected prior to or on the date of product infusion.

Change From Baseline of Chemistry Laboratory Results: Bilirubin, Creatinine, Direct Bilirubin, UrateBaseline and Day 29

Change from baseline in Chemistry laboratory analysis. Includes Bilirubin, Creatinine, Direct Bilirubin, and Urate. Baseline is the last observation collected prior to or on the date of product infusion.

Change From Baseline of Chemistry Laboratory Results: Calcium Corrected, Magnesium, Phosphate, Potassium, SodiumBaseline and Day 29

Change from baseline in Chemistry laboratory analysis. Includes Calcium Corrected, Magnesium, Phosphate, Potassium, and Sodium. Baseline is the last observation collected prior to or on the date of product infusion.

PK Parameters of JCAR017 in Blood as Assessed by qPCR: CmaxFrom first dose to up to 24 months

Pharmacokinetic (PK) analyses were based on quantitative polymerase chain reaction (qPCR).

Cmax = Maximum observed blood concentration.

PK Parameters of JCAR017 in Blood as Assessed by qPCR: AUC (0-28)From first dose to up to 24 months

Pharmacokinetic (PK) analyses were based on quantitative polymerase chain reaction (qPCR). AUC (0-28) = Area under the curve for concentration.

Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Physical Functioning SubscaleBaseline and Day 29

* Health Related Quality of Life (HRQoL) was assessed using the EORTC QLQ-C30 questionnaire.

* The EORTC QLQ-C30 is a 30-item scale composed of both multi-item scales and single-item measures.

* All of the scales and single-item measures range in score from 0 to 100. A 10-point change in the scoring is considered to be a meaningful change in HRQoL.

* Functional scale and global health status/HRQoL higher scale score represents a higher level of well-being and better ability of daily functioning.

Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Cognitive Functioning SubscaleBaseline and Day 29

* Health Related Quality of Life (HRQoL) was assessed using the EORTC QLQ-C30 questionnaire.

* The EORTC QLQ-C30 is a 30-item scale composed of both multi-item scales and single-item measures.

* All of the scales and single-item measures range in score from 0 to 100. A 10-point change in the scoring is considered to be a meaningful change in HRQoL.

* Functional scale and global health status/HRQoL higher scale score represents a higher level of well-being and better ability of daily functioning.

Complete Response (CR) RateFrom first dose to disease progression, end of study, the start of another anticancer therapy, or hematopoietic stem cell transplant (up to approximately 24 months)

Complete response rate (CRR) was defined as the percent of participants with a best overall response (BOR) of complete response (CR) based on the Independent Review Committee (IRC) assessment recorded from the time of JCAR017 treatment until disease progression, end of study, the start of another anticancer therapy or JCAR017 retreatment.

CR = Score 1, 2, or 3 with or without a residual mass on the positron emission tomography 5-point scale (PET 5PS). A score of 3 in many patients indicates a good prognosis with standard treatment.

PET 5PS = 1- no uptake above background; 2- uptake ≤ mediastinum; 3- uptake \> mediastinum but ≤ liver; 4- uptake moderately \> liver; 5- uptake markedly higher than liver and/or new lesions; X- new areas of uptake unlikely to be related to lymphoma.

Duration of Response (DOR) in Participants With Complete Response (CR)From first dose to up to approximately 24 months

DOR for participants with a best overall response of CR was defined as the time from documentation of first response (or CR) to progressive disease (PD) or death, whichever occurred first. The first documentation of CR/PR is the latest of all dates of required measurements to establish the response. The progression date is the earliest date of all assessments that led to a response assessment of PD.

CR = Score 1, 2, or 3 on the positron emission tomography 5-point scale (PET 5PS). A score of 3 indicates a good prognosis with standard treatment.

PD = Score 4 or 5b on PET 5PS with an increase in intensity of uptake from baseline and/or new fluorodeoxyglucose-avid foci consistent with lymphoma at interim or end-of-treatment assessment.

PET 5PS = 1-no uptake above background; 2-uptake ≤ mediastinum; 3-uptake \> mediastinum but ≤ liver; 4-uptake moderately \> liver; 5-uptake markedly higher than liver and/or new lesions; X- new areas of uptake unlikely to be related to lymphoma.

Event-Free Survival (EFS)From first dose to death from any cause, progressive disease (PD), or starting a new anticancer therapy (up to approximately 24 months)

EFS is defined as the time from JCAR017 infusion to the earliest of the following events: death from any cause, progressive disease (PD), or starting a new anticancer therapy. Kaplan-Meier (KM) methodology will be used to analyze EFS.

PD = Score 4 or 5b on PET 5PS with an increase in intensity of uptake from baseline and/or new fluorodeoxyglucose-avid foci consistent with lymphoma at interim or end-of-treatment assessment.

PET 5PS = 1-no uptake above background; 2-uptake ≤ mediastinum; 3-uptake \> mediastinum but ≤ liver; 4-uptake moderately \> liver; 5-uptake markedly higher than liver and/or new lesions; X- new areas of uptake unlikely to be related to lymphoma.

Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Insomnia SubscaleBaseline and Day 29

* Health Related Quality of Life (HRQoL) was assessed using the EORTC QLQ-C30 questionnaire.

* The EORTC QLQ-C30 is a 30-item scale composed of both multi-item scales and single-item measures.

* All of the scales and single-item measures range in score from 0 to 100. A 10-point change in the scoring is considered to be a meaningful change in HRQoL.

* Symptom scale/item higher score represents a high level of symptomatic problem.

Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Global Health/QoL SubscaleBaseline and Day 29

* Health Related Quality of Life (HRQoL) was assessed using the EORTC QLQ-C30 questionnaire.

* The EORTC QLQ-C30 is a 30-item scale composed of both multi-item scales and single-item measures.

* All of the scales and single-item measures range in score from 0 to 100. A 10-point change in the scoring is considered to be a meaningful change in HRQoL.

* Functional scale and global health status/HRQoL higher scale score represents a higher level of well-being and better ability of daily functioning.

Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Diarrhea SubscaleBaseline and Day 29

* Health Related Quality of Life (HRQoL) was assessed using the EORTC QLQ-C30 questionnaire.

* The EORTC QLQ-C30 is a 30-item scale composed of both multi-item scales and single-item measures.

* All of the scales and single-item measures range in score from 0 to 100. A 10-point change in the scoring is considered to be a meaningful change in HRQoL.

* Symptom scale/item higher score represents a high level of symptomatic problem.

Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Dyspnea SubscaleBaseline and Day 29

* Health Related Quality of Life (HRQoL) was assessed using the EORTC QLQ-C30 questionnaire.

* The EORTC QLQ-C30 is a 30-item scale composed of both multi-item scales and single-item measures.

* All of the scales and single-item measures range in score from 0 to 100. A 10-point change in the scoring is considered to be a meaningful change in HRQoL.

* Symptom scale/item higher score represents a high level of symptomatic problem.

The Number of Participants That Were Hospitalized For Adverse Events, Prophylaxis, OtherFrom first dose after JCAR017 infusion to up to approximately 24 months

Length of hospitalization stay was reported for up to 24 months post liso-cel infusion. Reasons for hospitalization include adverse events, prophylaxis, and other. Adverse events were reported for up to 90 days post liso-cel infusion.

Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Role Functioning SubscaleBaseline and Day 29

* Health Related Quality of Life (HRQoL) was assessed using the EORTC QLQ-C30 questionnaire.

* The EORTC QLQ-C30 is a 30-item scale composed of both multi-item scales and single-item measures.

* All of the scales and single-item measures range in score from 0 to 100. A 10-point change in the scoring is considered to be a meaningful change in HRQoL.

* Functional scale and global health status/HRQoL higher scale score represents a higher level of well-being and better ability of daily functioning.

Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Constipation SubscaleBaseline and Day 29

* Health Related Quality of Life (HRQoL) was assessed using the EORTC QLQ-C30 questionnaire.

* The EORTC QLQ-C30 is a 30-item scale composed of both multi-item scales and single-item measures.

* All of the scales and single-item measures range in score from 0 to 100. A 10-point change in the scoring is considered to be a meaningful change in HRQoL.

* Symptom scale/item higher score represents a high level of symptomatic problem.

Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Financial Difficulties SubscaleBaseline and Day 29

* Health Related Quality of Life (HRQoL) was assessed using the EORTC QLQ-C30 questionnaire.

* The EORTC QLQ-C30 is a 30-item scale composed of both multi-item scales and single-item measures.

* All of the scales and single-item measures range in score from 0 to 100. A 10-point change in the scoring is considered to be a meaningful change in HRQoL.

* Functional scale and global health status/HRQoL higher scale score represents a higher level of well-being and better ability of daily functioning.

Health-Related Quality of Life (HRQoL) Assessed by the EuroQol Instrument EQ-5D-5LBaseline and Day 29

The European Quality of Life 5D-5L Scale (EQ-5D-5L) assesses general health-related quality of life. Health is defined in 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. Responses are coded so that a '1' indicates no problem, and '5' indicates the most serious problem. The responses for the 5 dimensions are combined in a 5-digit number. These health states are converted to a single index value using the crosswalk method to the EQ-5D-3L value set from the United Kingdom (UK). The EQ-5D-5L health states ranged from -.594 for the worst (55555) to 1 for the best (11111) for UK value set with an optimal health state is assigned a score of 1.00, death is assigned a score of 0.00 and negative values representing values as worse than dead. A change of .08 is considered to be a clinically meaningful change in health utility.

Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Emotional Functioning SubscaleBaseline and Day 29

* Health Related Quality of Life (HRQoL) was assessed using the EORTC QLQ-C30 questionnaire.

* The EORTC QLQ-C30 is a 30-item scale composed of both multi-item scales and single-item measures.

* All of the scales and single-item measures range in score from 0 to 100. A 10-point change in the scoring is considered to be a meaningful change in HRQoL.

* Functional scale and global health status/HRQoL higher scale score represents a higher level of well-being and better ability of daily functioning.

Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Social Functioning SubscaleBaseline and Day 29

* Health Related Quality of Life (HRQoL) was assessed using the EORTC QLQ-C30 questionnaire.

* The EORTC QLQ-C30 is a 30-item scale composed of both multi-item scales and single-item measures.

* All of the scales and single-item measures range in score from 0 to 100. A 10-point change in the scoring is considered to be a meaningful change in HRQoL.

* Functional scale and global health status/HRQoL higher scale score represents a higher level of well-being and better ability of daily functioning.

Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Appetite Loss SubscaleBaseline and Day 29

* Health Related Quality of Life (HRQoL) was assessed using the EORTC QLQ-C30 questionnaire.

* The EORTC QLQ-C30 is a 30-item scale composed of both multi-item scales and single-item measures.

* All of the scales and single-item measures range in score from 0 to 100. A 10-point change in the scoring is considered to be a meaningful change in HRQoL.

* Symptom scale/item higher score represents a high level of symptomatic problem.

Mean Score in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-30) Nausea/Vomiting SubscaleBaseline and Day 29

* Health Related Quality of Life (HRQoL) was assessed using the EORTC QLQ-C30 questionnaire.

* The EORTC QLQ-C30 is a 30-item scale composed of both multi-item scales and single-item measures.

* All of the scales and single-item measures range in score from 0 to 100. A 10-point change in the scoring is considered to be a meaningful change in HRQoL.

* Symptom scale/item higher score represents a high level of symptomatic problem.

Health-Related Quality of Life (HRQoL) Assessed by the FACT-Lym SubscaleBaseline and Day 29

The Functional Assessment of Cancer Treatment-Lymphoma (FACT-Lym) consists of the FACT-General scale and a 15-item lymphoma-specific additional concerns subscale (LYM). This scale addresses symptoms and functional limitations that are important to lymphoma patients. The LYM items are scored on a 0 ("Not at all") to 4 ("Very much") response scale. Items are aggregated to a single score on a 0-60 scale.

Numbers of Non-intensive Care Unit (ICU) Inpatient DaysFrom first dose after JCAR017 infusion to up to approximately 24 months

Number of non-ICU inpatient days.

Trial Locations

Locations (53)

Local Institution - 0003

🇺🇸

Chicago, Illinois, United States

University of Chicago

🇺🇸

Chicago, Illinois, United States

University of Chicago Comprehensive Cancer Center

🇺🇸

Chicago, Illinois, United States

Banner MD Anderson Cancer Center

🇺🇸

Gilbert, Arizona, United States

Local Institution - 0043

🇺🇸

Gilbert, Arizona, United States

The Blood and Marrow Transplant Group of Georgia

🇺🇸

Atlanta, Georgia, United States

Johns Hopkins Oncology Center Bunting Blaustein Building

🇺🇸

Baltimore, Maryland, United States

Local Institution - 0009

🇺🇸

Baltimore, Maryland, United States

New York Oncology Hematology - Albany Cancer Center

🇺🇸

Albany, New York, United States

New York Oncology Hematology P.C.

🇺🇸

Albany, New York, United States

University of Pittsburgh Medical Center Hillman Cancer Center

🇺🇸

Pittsburgh, Pennsylvania, United States

The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

🇺🇸

Baltimore, Maryland, United States

University of California Los Angeles

🇺🇸

Los Angeles, California, United States

Local Institution - 0092

🇺🇸

Stanford, California, United States

Stanford Cancer Genetics Clinic

🇺🇸

Stanford, California, United States

Stanford Cancer Center

🇺🇸

Stanford, California, United States

Local Institution - 0019

🇺🇸

Atlanta, Georgia, United States

Northwestern University Feinberg School of Medicine

🇺🇸

Chicago, Illinois, United States

Northwestern University

🇺🇸

Chicago, Illinois, United States

Local Institution - 0016

🇺🇸

Chicago, Illinois, United States

Local Institution - 0046

🇺🇸

Lexington, Kentucky, United States

University of Kentucky/Markey Cancer Center

🇺🇸

Lexington, Kentucky, United States

University of Kentucky

🇺🇸

Lexington, Kentucky, United States

Local Institution - 0052

🇺🇸

East Brunswick, New Jersey, United States

Regional Cancer Care Associates

🇺🇸

East Brunswick, New Jersey, United States

University of Rochester Medical Center

🇺🇸

Rochester, New York, United States

Local Institution - 0021

🇺🇸

Charlotte, North Carolina, United States

Local Institution - 0029

🇺🇸

Pittsburgh, Pennsylvania, United States

Greenville Health System - Cancer Institute - Faris Road

🇺🇸

Greenville, South Carolina, United States

Local Institution - 0037

🇺🇸

Greenville, South Carolina, United States

Greenville Health System

🇺🇸

Greenville, South Carolina, United States

Northwest Medical Specialties

🇺🇸

Tacoma, Washington, United States

Local Institution - 0083

🇺🇸

Dallas, Texas, United States

UNC School of Medicine

🇺🇸

Milwaukee, Wisconsin, United States

Sutter Hematology and Oncology

🇺🇸

Sacramento, California, United States

Sutter Medical Center

🇺🇸

Sacramento, California, United States

Local Institution - 0064

🇺🇸

Louisville, Kentucky, United States

Norton Cancer Institute - Brownsboro

🇺🇸

Louisville, Kentucky, United States

Local Institution - 0039

🇺🇸

Cincinnati, Ohio, United States

Oncology Hematology Care, Inc.

🇺🇸

Cincinnati, Ohio, United States

Oncology Hematology Care

🇺🇸

Cincinnati, Ohio, United States

Local Institution - 0051

🇺🇸

Portland, Oregon, United States

Providence Cancer Center/Earle A. Chiles Res. Inst.

🇺🇸

Portland, Oregon, United States

Providence Portland Medical Center

🇺🇸

Portland, Oregon, United States

Intermountain Healthcare - LDS Hospital

🇺🇸

Salt Lake City, Utah, United States

Intermountain Healthcare - LDS Hospital Blood and Marrow Transplant

🇺🇸

Salt Lake City, Utah, United States

Local Institution - 0074

🇺🇸

Salt Lake City, Utah, United States

Local Institution - 0055

🇺🇸

Milwaukee, Wisconsin, United States

Medical College of Wisconsin, Froedtert Hospital

🇺🇸

Milwaukee, Wisconsin, United States

Scripps Clinic

🇺🇸

La Jolla, California, United States

Local Institution - 0090

🇺🇸

Rochester, New York, United States

University of Rochester Cancer Center

🇺🇸

Rochester, New York, United States

Levine Cancer Institute

🇺🇸

Charlotte, North Carolina, United States

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