Study Evaluating Safety and Efficacy of JCAR017 in Subjects With Relapsed or Refractory Chronic Lymphocytic Leukemia (CLL) or Small Lymphocytic Lymphoma (SLL)

Phase 1

Recruiting

• Conditions: Lymphoma, Small Lymphocytic; Leukemia, Lymphocytic, Chronic, B-Cell
• Interventions: Biological: JCAR017 (lisocabtagene maraleucel); Biological: JCAR017 (lisocabtagene maraleucel) + ibrutinib; Biological: JCAR017 (lisocabtagene maraleucel) + venetoclax

• Registration Number: NCT03331198
• Lead Sponsor: Juno Therapeutics, a Subsidiary of Celgene

Brief Summary

This is a Phase 1/2, open-label, multicenter study to determine the efficacy and safety of JCAR017 in adult subjects with relapsed or refractory CLL or SLL. The study will include a Phase 1 part to determine the recommended dose of JCAR017 monotherapy in subjects with relapsed or refractory CLL or SLL, followed by a Phase 2 part to further assess the efficacy and safety of JCAR017 monotherapy treatment at the recommended dose. A separate Phase 1 cohort will assess the combination of JCAR017 and concurrent ibrutinib. Another separate Phase 1 cohort will assess the combination of JCAR017 and concurrent venetoclax. In all subjects, the safety, efficacy, and pharmacokinetics (PK) of JCAR017 will be evaluated.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2017-10-29
• Study First Submitted QC: 2017-11-02
• Study First Posted: 2017-11-06
• Study Start: 2017-11-27
• Status Verified: 2024-12
• Last Update Submitted: 2024-12-10
• Last Update Posted: 2024-12-13
• Primary Completion: 2027-11-26
• Study Completion: 2027-11-26

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 320

Inclusion Criteria

• Diagnosis of:

  1. CLL with an indication for treatment based on the Investigator's opinion and measurable disease, or
  2. SLL (lymphadenopathy and/or splenomegaly and < 5×10^9 CD19+ CD5+ clonal B lymphocytes/L [< 5000/µL] in the peripheral blood at diagnosis with measurable disease that is biopsy-proven SLL)

• Subjects (other than those in the ibrutinib + JCAR017 combination therapy and DEME cohort) must have received and failed Bruton tyrosine kinase inhibitor (BTKi) treatment or have been deemed ineligible for BTKi therapy.

• Subjects in the JCAR017 monotherapy cohorts must have received previous treatment as follows:

  1. Monotherapy cohorts EXCEPT DEME cohort: Subjects with CLL or SLL and high-risk features must have failed at least 2 lines of prior therapy.
  2. Monotherapy cohorts EXCEPT DEME cohort: Subjects with CLL or SLL and standard-risk features must have failed at least 3 lines of prior therapy.
  3. DEME cohort ONLY: Subjects with relapsed or refractory CLL or SLL, irrespective of cytogenetic risk features, must have received at least 2 lines of prior therapy including a BTKi and a BCL2i.

• Subjects in the ibrutinib + JCAR017 combination therapy cohort must either:

  1. be receiving ibrutinib and progressing at the time of study enrollment
  2. be receiving ibrutinib for at least 6 months with a response less than complete response/remission (CR) and have high-risk features as defined in inclusion criterion 5a
  3. have BTK or PLCgamma2 mutations per local laboratory assessment, with or without progression on ibrutinib
  4. have previously received ibrutinib and have no contraindications to restarting ibrutinib

• Eastern Cooperative Oncology Group performance status of ≤ 1

• Assessed by the Investigator to have adequate bone marrow function to receive lymphodepleting chemotherapy

• Adequate organ function, defined as:

  1. Serum creatinine ≤ 1.5 × age-adjusted upper limit of normal (ULN) OR calculated creatinine clearance > 30 mL/min
  2. Alanine aminotransferase ≤ 5 × ULN and total bilirubin < 2.0 mg/dL (or < 3.0 mg/dL for subjects with Gilbert's syndrome or leukemic infiltration of the liver)
  3. Adequate pulmonary function, defined as ≤ Common Terminology Criteria for Adverse Events (CTCAE) Grade 1 dyspnea and saturated oxygen (SaO2) ≥ 92% on room air
  4. Adequate cardiac function, defined as left ventricular ejection fraction ≥ 40% as assessed by echocardiogram or multiple uptake gated acquisition scan performed within 30 days prior to determination of eligibility

• Subject either currently has central vascular access or is a candidate to receive central vascular access or peripheral vascular access for leukapheresis procedure.

• If prior CD19-targeted therapy has been administered, subject must have CD19-positive disease confirmed by immunohistochemistry or flow cytometry since completing the prior CD19-targeted therapy.

• Subjects in ibrutinib + JCAR017 combination cohort must have progressed on a BTKi and have received prior therapy with venetoclax

• Subjects in venetoclax + JCAR017 combination cohort must:

  1. have failed at least 1 prior line of therapy, including failed BTKi therapy or have been deemed ineligible to receive BTKi
  2. be venetoclax naive (required for dose expansion) or
  3. if prior venetoclax (only for dose escalation)
  4. have no contraindictions to re-initiation of venetoclax based on prior intolerance and have had at least 6 months elapsed since the last dose of venetoclax, if either, best response was stable disease, or subject experienced disease progression on venetoclax, or within 6 months of venetoclax discontinuation

• subjects in the venetoclax + JCAR017 combination must have hemoglobin >=9 g/dL, absolute neutrophil count >=500mm3 and platelets>= 75,000/mm3, unless cytopenias are judged by investigator to be due to CLL infiltration of the bone marrow

• must have diagnosis of CLL or SLL with an indication for treatment based on the investigator's opinion and measurable disease (any of the following measurable lymph nodes ≥1.5 cm in the greatest transverse diameter and/or hepatomegaly or splenomegaly) and demonstration of CLL cells in the peripheral blood by flow cytometry

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Exclusion Criteria

• Subjects with known active central nervous system (CNS) involvement by malignancy. Those with prior CNS disease that has been effectively treated will be eligible if treatment was completed at least 3 months prior to enrollment with no evidence of symptomatic disease and stable abnormalities on repeat imaging.

• History of another primary malignancy that has not been in remission for at least 2 years. (The following are exempt from the 2-year limit: nonmelanoma skin cancer, completely resected stage 1 solid tumor with low risk for recurrence, curatively treated localized prostate cancer, cervical carcinoma in situ on biopsy or a squamous intraepithelial lesion on Pap smear, and in situ breast cancer that has been completely resected.)

• Subjects with Richter's transformation

• Prior treatment with any gene therapy product

• Active hepatitis B, active hepatitis C, or active human immunodeficiency virus (HIV) infection

• Systemic fungal, bacterial, viral, or other infection that is not controlled

• Presence of acute or extensive chronic graft versus host disease (GVHD)

• 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 (NYHA), cardiac angioplasty or stenting, myocardial infarction, unstable angina, or other clinically significant cardiac disease

• History or presence of clinically relevant CNS pathology such as epilepsy, generalized seizure disorder, aphasia, stroke with current neurologic sequelae, severe brain injuries, dementia, Parkinson's disease, cerebellar disease,cerebral edema, or psychosis

• Pregnant or nursing (lactating) women

• Use of any of the following medications or treatments within the noted time prior to leukapheresis:

  1. Alemtuzumab within 6 months prior to leukapheresis
  2. Allogeneic hematopoietic stem cell transplant within 100 days prior to leukapheresis
  3. Cladribine within 3 months prior to leukapheresis
  4. Donor lymphocyte infusions (DLI) within 2 months prior to leukapheresis
  5. Radiation including large bone marrow fields such as sternum or pelvis within 6 weeks prior to leukapheresis
  6. Fludarabine within 4 weeks prior to leukapheresis
  7. GVHD therapies such as calcineurin inhibitors, methotrexate or other chemotherapeutics, mycophenolate mofetil, rapamycin, or immunosuppressive antibodies (such as anti-tumor necrosis factor-α [TNFα], anti-interleukin-6 [IL-6], or anti-interleukin-6 receptor [IL 6R]) within 4 weeks prior to leukapheresis
  8. Cyclophosphamide, ifosfamide, bendamustine, chlorambucil, or melphalan within 2 weeks prior to leukapheresis
  9. Therapeutic doses of corticosteroids (defined as > 20 mg/day prednisone or equivalent) within 7 days prior to leukapheresis
  10. Anti-CD20 monoclonal antibodies within 7 days prior to leukapheresis
  11. Venetoclax within 4 days prior to leukapheresis
  12. Idelalisib or duvelisib within 2 days prior to leukapheresis
  13. Lenalidomide or covalent and non-covalent BTKi within 1 day prior to leukapheresis
  14. Experimental agents, including off-label use of approved drugs (with the exception of acalabrutinib which may be continued up to the day before leukapheresis), within 4 weeks prior to leukapheresis unless progression is documented on the experimental therapy and at least 3 half-lives have elapsed prior to leukapheresis

• Uncontrolled medical, psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol, as judged by the Investigator; or subject unwillingness or inability to follow the procedures required in the protocol

• Progressive vascular tumor invasion, thrombosis, or embolism

• Deep vein thrombosis or embolism not managed on a stable regimen of anticoagulation

• Use of any of the following medications or treatments within the noted time prior to leukapheresis lenalidomide or acalabrutinib within 1 day prior to leukapheresis experimental agents, including off-label use of approved drugs, within 4 weeks prior to leukapheresis.

• Venous thrombosis or embolism requiring treatment but not managed on a stable regimen of anticoagulation

• For subjects in the venetoclax + JCAR017 combination cohorts only, concomitant treatment with CYP3A moderate/strong inducers or moderate/strong inhibitors which cannot be discontinued

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Phase 1 JCAR017 monotherapy	JCAR017 (lisocabtagene maraleucel)	Subjects will be assigned to receive JCAR017 (lisocabtagene maraleucel)
Phase 1 JCAR017 + ibrutinib	JCAR017 (lisocabtagene maraleucel) + ibrutinib	Subjects receiving ibrutinib at baseline will be assigned to receive JCAR017 (lisocabtagene maraleucel) at the recommended dose from the Phase 1 monotherapy arm + ibrutinib
Phase 2 JCAR017 monotherapy	JCAR017 (lisocabtagene maraleucel)	Subjects will receive JCAR017 (lisocabtagene maraleucel) at the recommended dose from the Phase 1 monotherapy arm
Phase 1 JCAR017 + venetoclax	JCAR017 (lisocabtagene maraleucel) + venetoclax	Subjects will receive venetoclax as bridging anticancer therapy until lymphodepletion chemotherapy/ JCAR017 (lisocabtagene maraleucel) at the recommended dose from the Phase 1 monotherapy arm. After JCAR017 infusion subjects will receive venetoclax until Day 90.
Phase 2 JCAR017 Double-Exposed Monotherapy Expansion (DEME)	JCAR017 (lisocabtagene maraleucel)	Subjects will receive JCAR017 monotherapy

Primary Outcome Measures

Name	Time	Method
Phase 1 JCAR017 monotherapy arm: adverse events	Up to 48 months post treatment	Proportion of subjects experiencing adverse events
Phase 2 JCAR017 Double exposed monotherapy expansion arm: overall response rate (ORR)	Up to approximately 24 months	ORR defined as the rate of complete response/remission (CR) \[including complete response/remission with incomplete marrow recovery (Cri)\] plus PR \[including nodular partial response (nPR)\] based on Independent Review Committee (IRC) assessment using International Workshop on Chronic Lymphocytic Leukemia (iwCLL) 2018 guidelines
Phase 1 JCAR017 and ibrutinib combination dose escalation therapy arm: adverse events	Up to 48 months post treatment	Proportion of subjects experiencing adverse events
Phase 1 JCAR017 and ibrutinib combination dose escalation therapy arm: laboratory abnormalities	Up to 48 months post treatment	Proportion of subjects experiencing laboratory abnormalities
Phase 1 JCAR017 and ibrutinib combination dose expansion therapy arm	Through post treatment up to Month 48	Proportion of subjects who have CR after treatment with JCAR017 + ibrutinib using iwCLL 2018 guidelines
Phase 1 JCAR017 and venetoclax combination dose escalation therapy arm: adverse events	Up to 48 months post treatment	Proportion of subjects experiencing adverse events
Phase 1 JCAR017 and venetoclax combination dose expansion therapy arm	Through post treatment up to Month 48	Proportion of subjects who have CR after treatment with JCAR017 + venetoclax using iwCLL 2018 guidelines
Phase 1 JCAR017 monotherapy arm: laboratory abnormalities	Up to 48 months post treatment	Proportion of subjects experiencing laboratory abnormalities
Phase 2 JCAR017 monotherapy expansion arm	Through post treatment up to Month 48	Proportion of subjects who have CR after treatment with JCAR017 using iwCLL 2018 guidelines
Phase 1 JCAR017 and venetoclax combination dose escalation therapy arm: laboratory abnormalities	Up to 48 months post treatment	Proportion of subjects experiencing laboratory abnormalities

Secondary Outcome Measures

Name	Time	Method
Phase 1 JCAR017 and ibrutinib combination dose expansion therapy arm: adverse events	Up to 48 months post treatment	Proportion of subjects experiencing adverse events
Phase 1 JCAR017 and ibrutinib combination dose expansion therapy arm: Time to complete response (TTCR)	Up to 48 months post treatment	Defined as the interval from JCAR017 infusion to the first documentation of CR
Phase 1 JCAR017 and ibrutinib combination dose expansion therapy arm: Duration of response (DOR)	Up to 48 months post treatment	Defined as the time from first response (CR, CRi, nPR, or PR) to the earlier date of PD or death due to any cause
Phase 1 JCAR017 and ibrutinib combination dose expansion therapy arm: PFS	Up to 48 months post treatment	Defined as the time from JCAR017 infusion to the earlier date of PD or death due to any cause
Phase 1 JCAR017 and ibrutinib combination dose expansion therapy arm: laboratory abnormalities	Up to 48 months post treatment	Proportion of subjects experiencing laboratory abnormalities
Phase 1 JCAR017 and ibrutinib combination dose expansion therapy arm: ORR	Up to 48 months post treatment	Defined as the rate of CR (including CRi)
Phase 1 JCAR017 and ibrutinib combination dose expansion therapy arm: MRD negative response rate in peripheral blood	Up to 48 months post treatment	Proportion of subjects who achieve MRD CR
Phase 1 JCAR017 and ibrutinib combination dose expansion therapy arm: MRD-negative CR rate in peripheral blood	Up to 48 months post treatment	Proportion of subjects who achieve MRD CR
Phase 1 JCAR017 and ibrutinib combination dose expansion therapy arm: Duration of complete response (DoCR)	Up to 48 months post treatment	Defined as the time from first CR or CRi to the earlier date of PD or death due to any cause
Phase 1 JCAR017 and ibrutinib combination dose expansion therapy arm: OS	Up to 48 months post treatment	Defined as the time from JCAR017 infusion to the date of death due to any cause
Phase 1 JCAR017 and ibrutinib combination dose expansion therapy arm: Time to response (TTR)	Up to 48 months post treatment	Defined as the interval from JCAR017 infusion to the first documentation of CR, CRi, nPR, or PR
Phase 1 JCAR017 and venetoclax combination dose expansion therapy arm: adverse events	Up to 48 months post treatment	Proportion of subject experiencing adverse events
Phase 1 JCAR017 and venetoclax combination dose expansion therapy arm: MRD-negative response rate in peripheral blood	Up to 48 months post treatment	Proportion of subjects who achieve MRD CR
Phase 1 JCAR017 and venetoclax combination dose expansion therapy arm: Duration of complete response (DoCR)	Up to 48 months post treatment	Defined as the time from first CR or CRi to the earlier date of PD or death due to any cause
Phase 1 JCAR017 and venetoclax combination dose expansion therapy arm: lab abnormalities	Up to 48 months post treatment	Proportion of subjects experiencing laboratory abnormalities
Phase 1 JCAR017 and venetoclax combination dose expansion therapy arm: ORR	Through post treatment Day 90	Defined as the rate of CR (including CRi)
Phase 1 JCAR017 and venetoclax combination dose expansion therapy arm: Time to response (TTR)	Up to 48 months post treatment	Defined as the interval from JCAR017 infusion to the first documentation of CR, CRi, nPR, or PR
Phase 1 JCAR017 and venetoclax combination dose expansion therapy arm: Time to complete response (TTCR)	Up to 48 months post treatment	Defined as the interval from JCAR017 infusion to the first documentation of CR
Phase 1 JCAR017 and venetoclax combination dose expansion therapy arm: PFS	Up to 48 months post treatment	Defined as the time from JCAR017 infusion to the earlier date of PD or death due to any cause
Phase 1 JCAR017 and venetoclax combination dose expansion therapy arm: OS	Up to 48 months post treatment	Defined as the time from JCAR017 infusion to the date of death due to any cause
Phase 2 JCAR017 Monotherapy Expansion Arm: MRD negative response rate in peripheral blood	Up to 48 months post treatment	Proportion of subjects who achieve MRD CR
Phase 1 JCAR017 and venetoclax combination dose escalation therapy arm: MRD-negative CR rate in peripheral blood	Through post treatment Day 90	Proportion of subjects who achieve MRD CR
Phase 1 JCAR017 and venetoclax combination dose expansion therapy arm: Duration of response (DOR)	Up to 48 months post treatment	Defined as the time from first response (CR, CRi, nPR, or PR) to the earlier date of PD or death due to any cause
Phase 2 JCAR017 Monotherapy Expansion Arm: laboratory abnormalities	Up to 48 months post treatment	Proportion of subjects experiencing laboratory abnormalities
Phase 2 JCAR017 Monotherapy Expansion Arm: ORR	Up to 48 months post treatment	Defined as the rate of CR (including CRi)
Phase 2 JCAR017 Monotherapy Expansion Arm: MRD-negative CR rate in peripheral blood	Up to 48 months post treatment	Proportion of subjects who achieve MRD CR
Phase 2 JCAR017 Monotherapy Expansion Arm: adverse events	Up to 48 months post treatment	Proportion of subjects experiencing adverse events
Phase 2 JCAR017 Monotherapy Expansion Arm: Time to response (TTR)	Up to 48 months post treatment	Defined as the interval from JCAR017 infusion to the first documentation of CR, CRi, nPR, or PR
Phase 2 JCAR017 Monotherapy Expansion Arm: Time to complete response (TTCR)	Up to 48 months post treatment	Defined as the interval from JCAR017 infusion to the first documentation of CR
Phase 2 JCAR017 Monotherapy Expansion Arm: OS	Up to 48 months post treatment	Defined as the time from JCAR017 infusion to the date of death due to any cause
Phase 2 JCAR017 Double-Exposed Monotherapy Expansion Arm: adverse events	Up to approximately 24 months	Proportion of subjects experiencing adverse events
Phase 2 JCAR017 Double-Exposed Monotherapy Expansion Arm: MRD-negative response rate in peripheral blood	Up to approximately 24 months	Proportion of subjects who achieve MRD negative status
Phase 2 JCAR017 Double-Exposed Monotherapy Expansion Arm: Time to complete response (TTCR)	Up to approximately 24 months	Define as the interval from JCAR017 infusion to the first documentation of CR
Phase 2 JCAR017 Double-Exposed Monotherapy Expansion Arm: Time to response (TTR)	Up to approximately 24 months	Defined as the interval from JCAR017 infusion to the first documentation of CR, CRi, nPR, or PR
Phase 2 JCAR017 Monotherapy Expansion Arm: Duration of response (DOR)	Up to 48 months post treatment	Defined as the time from first response (CR, CRi, nPR, or PR) to the earlier date of PD or death due to any cause
Phase 2 JCAR017 Monotherapy Expansion Arm: Duration of complete response (DoCR)	Up to 48 months post treatment	Defined as the time from first CR or CRi to the earlier date of PD or death due to any cause
Phase 2 JCAR017 Monotherapy Expansion Arm: PFS	Up to 48 months post treatment	Defined as the time from JCAR017 infusion to the earlier date of PD or death due to any cause
Phase 2 JCAR017 Monotherapy Expansion Arm: Health-related quality of life (HRQoL) questionnaire	Up to 48 months post treatment	Change from baseline in HRQoL assessed using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30
Phase 2 JCAR017 Monotherapy Expansion Arm: Health economics and outcomes research (HEOR) questionnaire	Up to 48 months post treatment	Change from baseline in measurement of health utility values using EuroQol instrument EQ-5D-5L
Phase 2 JCAR017 Monotherapy Expansion Arm: HEOR questionnaire	Up to 48 months post treatment	Proportion of participants with non-ICU inpatient days
Phase 2 JCAR017 Double-Exposed Monotherapy Expansion Arm: Progression free survival (PFS)	Up to approximately 24 months	Defined as the time from JCAR017 infusion to the earlier date of PD or death due to any cause
Phase 2 JCAR017 Monotherapy Expansion Arm: HRQoL questionnaire	Up to 48 months post treatment	Change from baseline in HRQoL assessed using the EORTC chronic lymphocytic leukemia (CLL)-specific module QLQ-CLL-17
Phase 2 JCAR017 Double-Exposed Monotherapy Expansion Arm: MRD-negative CR rate in peripheral blood	Up to approximately 24 months	Proportion of subjects who achieve MRD-negative CR
Phase 2 JCAR017 Double-Exposed Monotherapy Expansion Arm: laboratory abnormalities	Up to approximately 24 months	Proportion of subjects experiencing laboratory abnormalities
Phase 2 JCAR017 Double-Exposed Monotherapy Expansion Arm: Duration of response (DOR)	Up to approximately 24 months	Defined as the time from first response (CR, CRi, nPR, or PR) to the earlier date of PD or death due to any cause
Phase 2 JCAR017 Double-Exposed Monotherapy Expansion Arm: CR rate	Up to approximately 24 months	Defined as the rate of CR (including CRi) based on IRC assessment using iwCLL 2018 guidelines
Phase 2 JCAR017 Double-Exposed Monotherapy Expansion Arm: Overall Survival (OS)	Up to approximately 24 months	Defined as the time from JCAR017 infusion to the date of death due to any cause

Trial Locations

Locations (78)

The James Cancer Hospital and Solove Research Institute at The Ohio State University Comprehensive Cancer Center; 🇺🇸 Columbus, Ohio, United States

Banner MD Anderson Cancer Center; 🇺🇸 Gilbert, Arizona, United States

City Of Hope; 🇺🇸 Duarte, California, United States

Local Institution - 0006; 🇺🇸 Birmingham, Alabama, United States

Local Institution - 0104; 🇺🇸 Atlanta, Georgia, United States

Local Institution - 0019; 🇺🇸 Atlanta, Georgia, United States

University of Alabama at Birmingham; 🇺🇸 Birmingham, Alabama, United States

City of Hope; 🇺🇸 Duarte, California, United States

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

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

Local Institution - 0059; 🇺🇸 Los Angeles, California, United States

University of California, Los Angeles; 🇺🇸 Los Angeles, California, United States

Local Institution - 0010; 🇺🇸 San Francisco, California, United States

Local Institution - 0111; 🇺🇸 Denver, Colorado, United States

Local Institution - 0110; 🇺🇸 Newark, Delaware, United States

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

Local Institution - 0085; 🇺🇸 Washington, District of Columbia, United States

Local Institution - 0080; 🇺🇸 Jacksonville, Florida, United States

Mayo Clinic; 🇺🇸 Rochester, Minnesota, United States

University of California, San Francisco; 🇺🇸 San Francisco, California, United States

The Blood and Marrow Transplant Group of Georgia (BMTGA); 🇺🇸 Atlanta, Georgia, United States

Northwestern Memorial Hospital; 🇺🇸 Chicago, Illinois, United States

Northwestern University; 🇺🇸 Chicago, Illinois, United States

University of Chicago Medical Center; 🇺🇸 Chicago, Illinois, United States

University Of Chicago Medical Center; 🇺🇸 Chicago, Illinois, United States

Local Institution - 0105; 🇺🇸 Indianapolis, Indiana, United States

Local Institution - 0107; 🇺🇸 Wichita, Kansas, United States

Norton Healthcare - Norton Cancer Institute; 🇺🇸 Louisville, Kentucky, United States

Local Institution - 0005; 🇺🇸 Boston, Massachusetts, United States

Massachusetts General Hospital; 🇺🇸 Boston, Massachusetts, United States

Beth Israel Deaconess Medical Center; 🇺🇸 Boston, Massachusetts, United States

Local Institution - 0015; 🇺🇸 Boston, Massachusetts, United States

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

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

Barbara Ann Karmanos Cancer Institute; 🇺🇸 Detroit, Michigan, United States

Local Institution - 0062; 🇺🇸 Detroit, Michigan, United States

Local Institution - 0109; 🇺🇸 Detroit, Michigan, United States

University of Nebraska Medical Center; 🇺🇸 Omaha, Nebraska, United States

University Of Nebraska Medical Center; 🇺🇸 Omaha, Nebraska, United States

Local Institution - 0001; 🇺🇸 Basking Ridge, New Jersey, United States

John Theurer Cancer Center; 🇺🇸 Hackensack, New Jersey, United States

Hackensack University Medical Center; 🇺🇸 Hackensack, New Jersey, United States

Local Institution - 0106; 🇺🇸 Morristown, New Jersey, United States

Local Institution - 0077; 🇺🇸 New Brunswick, New Jersey, United States

Rutgers Cancer Institute of New Jersey; 🇺🇸 New Brunswick, New Jersey, United States

Local Institution - 0035; 🇺🇸 New York, New York, United States

Columbia University Medical Center; 🇺🇸 New York, New York, United States

Local Institution - 0026; 🇺🇸 New York, New York, United States

Weill Cornell Medical College; 🇺🇸 New York, New York, United States

Local Institution - 0089; 🇺🇸 Stony Brook, New York, United States

Duke University Medical Center; 🇺🇸 Durham, North Carolina, United States

University Hospitals Seidman Cancer Center (Case Western); 🇺🇸 Cleveland, Ohio, United States

University Hospitals Cleveland Medical Center; 🇺🇸 Cleveland, Ohio, United States

University of Oklahoma Health Sciences Center (Stephenson Cancer Center); 🇺🇸 Oklahoma City, Oklahoma, United States

University of Oklahoma Peggy and Charles Stephenson Cancer Center; 🇺🇸 Oklahoma City, Oklahoma, United States

Local Institution - 0098; 🇺🇸 Eugene, Oregon, United States

University of Pennsylvania - Perelman Center for Advanced Medicine; 🇺🇸 Philadelphia, Pennsylvania, United States

University of Pennsylvania Perelman Center for Advanced Medicine; 🇺🇸 Philadelphia, Pennsylvania, United States

Thomas Jefferson University - Clinical Research Institute; 🇺🇸 Philadelphia, Pennsylvania, United States

Thomas Jefferson University; 🇺🇸 Philadelphia, Pennsylvania, United States

Local Institution - 0029; 🇺🇸 Pittsburgh, Pennsylvania, United States

UPMC Hillman Cancer Center; 🇺🇸 Pittsburgh, Pennsylvania, United States

Baylor University Medical Center; 🇺🇸 Dallas, Texas, United States

Local Institution - 0083; 🇺🇸 Dallas, Texas, United States

University of Texas Southwestern Medical Center; 🇺🇸 Dallas, Texas, United States

Local Institution - 0079; 🇺🇸 Dallas, Texas, United States

The University of Texas - MD Anderson Cancer Center; 🇺🇸 Houston, Texas, United States

The University of Texas MD Anderson Cancer Center; 🇺🇸 Houston, Texas, United States

Huntsman Cancer Institute; 🇺🇸 Salt Lake City, Utah, United States

Local Institution - 0028; 🇺🇸 Salt Lake City, Utah, United States

Local Institution - 0113; 🇺🇸 Charlottesville, Virginia, United States

Local Institution - 0087; 🇺🇸 Richmond, Virginia, United States

Virginia Commonwealth University; 🇺🇸 Richmond, Virginia, United States

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

Local Institution - 0018; 🇺🇸 Seattle, Washington, United States

Froedtert Hospital BMT Medical College of Wisconsin; 🇺🇸 Milwaukee, Wisconsin, United States

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

Local Institution - 0112; 🇨🇦 Toronto, Ontario, Canada