Vaccine Therapy With Bevacizumab Versus Bevacizumab Alone in Treating Patients With Recurrent Glioblastoma Multiforme That Can Be Removed by Surgery
- Conditions
- Recurrent GlioblastomaRecurrent Adult Brain TumorGliosarcoma
- Interventions
- Biological: HSPPC-96Drug: bevacizumab
- Registration Number
- NCT01814813
- Lead Sponsor
- Alliance for Clinical Trials in Oncology
- Brief Summary
This randomized phase II trial studies how well giving vaccine therapy with or without bevacizumab works in treating patients with recurrent glioblastoma multiforme that can be removed by surgery. Vaccines consisting of heat shock protein-peptide complexes made from a person's own tumor tissue may help the body build an effective immune response to kill tumor cells that may remain after surgery. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them. It is not yet known whether giving vaccine therapy is more effective with or without bevacizumab in treating glioblastoma multiforme.
- Detailed Description
The purpose of this study is to compare the effects of a vaccine with bevacizumab versus bevacizumab alone on a patient's brain tumor. The vaccine is called heat shock protein peptide complex 96 (HSPPC-96). HSPPC-96 is experimental. Specifically, HSPPC-96 is a protein that may work to help the body have a response against remaining brain tumor cells. Bevacizumab has been approved by the Food and Drug administration for treating brain tumors that grow back. In this study, patients will either get HSPPC-96 vaccine at the same time as bevacizumab, HSPPC vaccine first and then bevacizumab if the tumor comes back, or bevacizumab alone. The use of HSPPC-96 and bevacizumab is investigational.
The primary objective of the study is to determine whether there is an overall survival advantage of HSPPC-96 administered with bevacizumab, given concomitantly or at the point of progression, in comparison with bevacizumab alone in patients with surgically resectable recurrent glioblastoma multiforme.
The secondary objectives are:
1. to evaluate the safety and tolerability of HSPPC-96 with bevacizumab
2. to evaluate the progression free survival of HSPPC-96 with bevacizumab, given concomitantly or at the point of progression.
Patients must undergo surgery within 28 days from pre-registration. There must be confirmation of adequacy of tissue for vaccine manufacture, tumor tissue submitted to Agenus, confirmation of ≥ 90% resection by central radiology review and vaccine manufacture of at least six vials. Patients will be randomized to one of three treatment arms. Please see the "Arms" section for more details.
Patients will be monitored approximately 5 years post-surgery.
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 90
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Arm 2, HSPPC-96 with bevacizumab at progression HSPPC-96 HSPPC-96 0.4mL intradermal on days 1 and 8 of cycles 1 and 2, then on day 1 of each cycle, up to a maximum of 12 doses (10 cycles). At progression: bevacizumab 10mg/kg intravenous (IV) on day 1 of each cycle, until further progression. (1 cycle = 14 days) NOTE: It is possible that HSPPC-96 vaccination may end prior to evidence of progression. In this instance it is important to wait until there is confirmed evidence of progression before initiating treatment with bevacizumab. Upon confirmation of progression the patient should initiate bevacizumab within 7-42 days from the last dose of vaccine. Arm 1, HSPPC-96 + concomitant bevacizumab HSPPC-96 HSPPC-96 0.4mL intradermal on days 1 and 8 of cycles 1 and 2, then on day 1 of each cycle, up to a maximum of 12 doses (10 cycles), plus bevacizumab 10 mg/kg intravenous (IV) on day 1 of each cycle, until progression. HSPPC-96 should be administered at least 60 minutes prior to starting bevacizumab infusion. (1 cycle=14 days) Note: If HSPPC-96 treatment has ended but there is no evidence of disease progression, the patient should continue to receive bevacizumab at the specified dose until progression. Arm 1, HSPPC-96 + concomitant bevacizumab bevacizumab HSPPC-96 0.4mL intradermal on days 1 and 8 of cycles 1 and 2, then on day 1 of each cycle, up to a maximum of 12 doses (10 cycles), plus bevacizumab 10 mg/kg intravenous (IV) on day 1 of each cycle, until progression. HSPPC-96 should be administered at least 60 minutes prior to starting bevacizumab infusion. (1 cycle=14 days) Note: If HSPPC-96 treatment has ended but there is no evidence of disease progression, the patient should continue to receive bevacizumab at the specified dose until progression. Arm 2, HSPPC-96 with bevacizumab at progression bevacizumab HSPPC-96 0.4mL intradermal on days 1 and 8 of cycles 1 and 2, then on day 1 of each cycle, up to a maximum of 12 doses (10 cycles). At progression: bevacizumab 10mg/kg intravenous (IV) on day 1 of each cycle, until further progression. (1 cycle = 14 days) NOTE: It is possible that HSPPC-96 vaccination may end prior to evidence of progression. In this instance it is important to wait until there is confirmed evidence of progression before initiating treatment with bevacizumab. Upon confirmation of progression the patient should initiate bevacizumab within 7-42 days from the last dose of vaccine. Arm 3, Bevacizumab bevacizumab Bevacizumab 10mg/kg intravenous (IV) on day 1 of each cycle, until progression. (1 cycle = 14 days)
- Primary Outcome Measures
Name Time Method Overall Survival (OS) Up to 5 years post-surgery The primary endpoint is overall survival (OS), which is defined as the date from study\> registration to the date of death, due to any cause.
- Secondary Outcome Measures
Name Time Method Progression Free Survival (PFS) Up to 5 years post-surgery Time to progression free survival: which is defined as the date from study registration to the date of first observation of disease progression or death due to any cause (whichever comes first). Progressive disease is defined as one or more of the following:New contrast-enhancing lesion outside of radiation field on decreasing, stable, or increasing doses of corticosteroids, increase by \> 50% enhancement from the first post-surgical scan, or a subsequent scan with smaller tumor size, and the scan 8 weeks or later on stable or increasing doses of corticosteroids, clinical deterioration not attributable to concurrent medication or comorbid conditions is sufficient to declare progression on current treatment, for patients receiving bevacizumab therapy, significant increase in T2/FLAIR non-enhancing lesion.
Toxicity, Assessed Using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 (v5) Up to 3 years The maximum grade for each type of toxicity will be recorded for each patient, and frequency tables will be reviewed to determine toxicity patterns within patient groups. In addition, we will review all adverse event data that is graded as 3, 4, or 5 and classified as either "unrelated" or "unlikely to be related" to study treatment in the event of an actual relationship developing. The overall toxicity rates (percentages) for grade 3 or higher adverse events considered at least possibly related to treatment are reported below.
Trial Locations
- Locations (416)
Emory University Hospital Midtown
🇺🇸Atlanta, Georgia, United States
Piedmont Hospital
🇺🇸Atlanta, Georgia, United States
Emory University/Winship Cancer Institute
🇺🇸Atlanta, Georgia, United States
Sinai Hospital of Baltimore
🇺🇸Baltimore, Maryland, United States
Alta Bates Summit Medical Center-Herrick Campus
🇺🇸Berkeley, California, United States
Kaiser Permanente-San Rafael
🇺🇸San Rafael, California, United States
Palo Alto Medical Foundation-Gynecologic Oncology
🇺🇸Mountain View, California, United States
Hurley Medical Center
🇺🇸Flint, Michigan, United States
Wayne Hospital
🇺🇸Greenville, Ohio, United States
Sutter Solano Medical Center/Cancer Center
🇺🇸Vallejo, California, United States
Illinois CancerCare-Galesburg
🇺🇸Galesburg, Illinois, United States
Radiation Oncology Associates PC
🇺🇸Fort Wayne, Indiana, United States
Michiana Hematology Oncology PC-South Bend
🇺🇸South Bend, Indiana, United States
Decatur Memorial Hospital
🇺🇸Decatur, Illinois, United States
Illinois CancerCare-Eureka
🇺🇸Eureka, Illinois, United States
Western Illinois Cancer Treatment Center
🇺🇸Galesburg, Illinois, United States
Memorial Hospital of South Bend
🇺🇸South Bend, Indiana, United States
Mercy Hospital
🇺🇸Coon Rapids, Minnesota, United States
Toledo Clinic Cancer Centers-Maumee
🇺🇸Maumee, Ohio, United States
Lehigh Valley Hospital-Cedar Crest
🇺🇸Allentown, Pennsylvania, United States
Northwestern University
🇺🇸Chicago, Illinois, United States
Rush University Medical Center
🇺🇸Chicago, Illinois, United States
University of Chicago Comprehensive Cancer Center
🇺🇸Chicago, Illinois, United States
Tufts Medical Center
🇺🇸Boston, Massachusetts, United States
Massachusetts General Hospital Cancer Center
🇺🇸Boston, Massachusetts, United States
Case Western Reserve University
🇺🇸Cleveland, Ohio, United States
Pacific Gynecology Specialists
🇺🇸Seattle, Washington, United States
Group Health Cooperative-Seattle
🇺🇸Seattle, Washington, United States
Franciscan Health Indianapolis
🇺🇸Indianapolis, Indiana, United States
University of Miami Miller School of Medicine-Sylvester Cancer Center
🇺🇸Miami, Florida, United States
Good Samaritan Hospital - Cincinnati
🇺🇸Cincinnati, Ohio, United States
Kaiser Permanente San Leandro
🇺🇸San Leandro, California, United States
Hennepin County Medical Center
🇺🇸Minneapolis, Minnesota, United States
Health Partners Inc
🇺🇸Minneapolis, Minnesota, United States
Duke University Medical Center
🇺🇸Durham, North Carolina, United States
Big Horn Basin Cancer Center
🇺🇸Cody, Wyoming, United States
Kaiser Permanente-San Francisco
🇺🇸San Francisco, California, United States
California Pacific Medical Center-Pacific Campus
🇺🇸San Francisco, California, United States
Huntsman Cancer Institute/University of Utah
🇺🇸Salt Lake City, Utah, United States
Saint James Community Hospital and Cancer Treatment Center
🇺🇸Butte, Montana, United States
Frontier Cancer Center and Blood Institute-Billings
🇺🇸Billings, Montana, United States
Montana Cancer Consortium NCORP
🇺🇸Billings, Montana, United States
Benefis Healthcare- Sletten Cancer Institute
🇺🇸Great Falls, Montana, United States
Kalispell Regional Medical Center
🇺🇸Kalispell, Montana, United States
Great Falls Clinic
🇺🇸Great Falls, Montana, United States
Community Hospital of Anaconda
🇺🇸Anaconda, Montana, United States
Montana Cancer Specialists
🇺🇸Missoula, Montana, United States
Community Medical Hospital
🇺🇸Missoula, Montana, United States
East Carolina University
🇺🇸Greenville, North Carolina, United States
Saint John Hospital and Medical Center
🇺🇸Detroit, Michigan, United States
University of Oklahoma Health Sciences Center
🇺🇸Oklahoma City, Oklahoma, United States
Anchorage Oncology Centre
🇺🇸Anchorage, Alaska, United States
Anchorage Associates in Radiation Medicine
🇺🇸Anchorage, Alaska, United States
Anchorage Radiation Therapy Center
🇺🇸Anchorage, Alaska, United States
Sutter Cancer Centers Radiation Oncology Services-Auburn
🇺🇸Auburn, California, United States
Alaska Breast Care and Surgery LLC
🇺🇸Anchorage, Alaska, United States
Alaska Regional Hospital
🇺🇸Anchorage, Alaska, United States
Mills - Peninsula Hospitals
🇺🇸Burlingame, California, United States
Katmai Oncology Group
🇺🇸Anchorage, Alaska, United States
Sutter Cancer Centers Radiation Oncology Services-Vacaville
🇺🇸Vacaville, California, United States
Smilow Cancer Hospital Care Center at Saint Francis
🇺🇸Hartford, Connecticut, United States
Penrose-Saint Francis Healthcare
🇺🇸Colorado Springs, Colorado, United States
Saint Mary Corwin Medical Center
🇺🇸Pueblo, Colorado, United States
Cancer Care Specialists of Illinois-Swansea
🇺🇸Swansea, Illinois, United States
Illinois CancerCare-Canton
🇺🇸Canton, Illinois, United States
Methodist Medical Center of Illinois
🇺🇸Peoria, Illinois, United States
OSF Saint Francis Radiation Oncology at Peoria Cancer Center
🇺🇸Peoria, Illinois, United States
Central Illinois Hematology Oncology Center
🇺🇸Springfield, Illinois, United States
Saint Luke's Mountain States Tumor Institute - Meridian
🇺🇸Meridian, Idaho, United States
Mount Sinai Medical Center
🇺🇸Miami Beach, Florida, United States
IU Health La Porte Hospital
🇺🇸La Porte, Indiana, United States
Saint Vincent's Medical Center
🇺🇸Bridgeport, Connecticut, United States
Saint Luke's Mountain States Tumor Institute - Nampa
🇺🇸Nampa, Idaho, United States
Crossroads Cancer Center
🇺🇸Effingham, Illinois, United States
Boca Raton Regional Hospital
🇺🇸Boca Raton, Florida, United States
Saint Luke's Mountain States Tumor Institute
🇺🇸Boise, Idaho, United States
Saint Alphonsus Cancer Care Center-Boise
🇺🇸Boise, Idaho, United States
Saint Joseph Medical Center
🇺🇸Bloomington, Illinois, United States
Memorial Hospital of Carbondale
🇺🇸Carbondale, Illinois, United States
NorthShore University HealthSystem-Evanston Hospital
🇺🇸Evanston, Illinois, United States
Elkhart General Hospital
🇺🇸Elkhart, Indiana, United States
Northwestern Medicine Cancer Center Warrenville
🇺🇸Warrenville, Illinois, United States
OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
🇺🇸Pekin, Illinois, United States
Northwestern Medicine Cancer Center Delnor
🇺🇸Geneva, Illinois, United States
NorthShore University HealthSystem-Glenbrook Hospital
🇺🇸Glenview, Illinois, United States
Illinois CancerCare-Peru
🇺🇸Peru, Illinois, United States
Valley Radiation Oncology
🇺🇸Peru, Illinois, United States
NorthShore University HealthSystem-Highland Park Hospital
🇺🇸Highland Park, Illinois, United States
Illinois CancerCare-Kewanee Clinic
🇺🇸Kewanee, Illinois, United States
Illinois CancerCare-Pekin
🇺🇸Pekin, Illinois, United States
Illinois CancerCare-Princeton
🇺🇸Princeton, Illinois, United States
Elkhart Clinic
🇺🇸Elkhart, Indiana, United States
Community Howard Regional Health
🇺🇸Kokomo, Indiana, United States
Memorial Regional Cancer Center Day Road
🇺🇸Mishawaka, Indiana, United States
Michiana Hematology Oncology PC-Mishawaka
🇺🇸Mishawaka, Indiana, United States
Saint Joseph Regional Medical Center-Mishawaka
🇺🇸Mishawaka, Indiana, United States
South Bend Clinic
🇺🇸South Bend, Indiana, United States
Mercy Medical Center-West Lakes
🇺🇸West Des Moines, Iowa, United States
Johns Hopkins University/Sidney Kimmel Cancer Center
🇺🇸Baltimore, Maryland, United States
Hickman Cancer Center
🇺🇸Adrian, Michigan, United States
Mercy Memorial Hospital
🇺🇸Monroe, Michigan, United States
Fairview Lakes Medical Center
🇺🇸Wyoming, Minnesota, United States
University of Mississippi Medical Center
🇺🇸Jackson, Mississippi, United States
Southeast Cancer Center
🇺🇸Cape Girardeau, Missouri, United States
Capital Region Medical Center-Goldschmidt Cancer Center
🇺🇸Jefferson City, Missouri, United States
Saint Patrick Hospital - Community Hospital
🇺🇸Missoula, Montana, United States
Dartmouth Hitchcock Medical Center
🇺🇸Lebanon, New Hampshire, United States
Rutgers Cancer Institute of New Jersey
🇺🇸New Brunswick, New Jersey, United States
Clackamas Radiation Oncology Center
🇺🇸Clackamas, Oregon, United States
The Valley Hospital-Luckow Pavilion
🇺🇸Paramus, New Jersey, United States
Pulmonary Medicine Center of Chattanooga-Hixson
🇺🇸Hixson, Tennessee, United States
Samaritan North Health Center
🇺🇸Dayton, Ohio, United States
TriHealth Cancer Institute-Westside
🇺🇸Cincinnati, Ohio, United States
Providence Milwaukie Hospital
🇺🇸Milwaukie, Oregon, United States
Bay Area Hospital
🇺🇸Coos Bay, Oregon, United States
Memorial GYN Plus
🇺🇸Ooltewah, Tennessee, United States
Saint Charles Health System
🇺🇸Bend, Oregon, United States
Legacy Mount Hood Medical Center
🇺🇸Gresham, Oregon, United States
Providence Newberg Medical Center
🇺🇸Newberg, Oregon, United States
Providence Willamette Falls Medical Center
🇺🇸Oregon City, Oregon, United States
Swedish Medical Center-Edmonds
🇺🇸Edmonds, Washington, United States
Harrison Medical Center
🇺🇸Bremerton, Washington, United States
Saint Elizabeth Hospital
🇺🇸Enumclaw, Washington, United States
Saint Clare Hospital
🇺🇸Lakewood, Washington, United States
Swedish Cancer Institute-Issaquah
🇺🇸Issaquah, Washington, United States
Providence Regional Cancer System-Lacey
🇺🇸Lacey, Washington, United States
PeaceHealth Southwest Medical Center
🇺🇸Vancouver, Washington, United States
Providence Regional Cancer Partnership
🇺🇸Everett, Washington, United States
PeaceHealth Saint John Medical Center
🇺🇸Longview, Washington, United States
Minor and James Medical PLLC
🇺🇸Seattle, Washington, United States
Legacy Salmon Creek Hospital
🇺🇸Vancouver, Washington, United States
Compass Oncology Vancouver
🇺🇸Vancouver, Washington, United States
Cheyenne Regional Medical Center-West
🇺🇸Cheyenne, Wyoming, United States
Aurora Cancer Care-Racine
🇺🇸Racine, Wisconsin, United States
Rocky Mountain Cancer Centers - Pueblo
🇺🇸Pueblo, Colorado, United States
McKee Medical Center
🇺🇸Loveland, Colorado, United States
Parker Adventist Hospital
🇺🇸Parker, Colorado, United States
United Hospital
🇺🇸Saint Paul, Minnesota, United States
Providence Oncology and Hematology Care Southeast
🇺🇸Clackamas, Oregon, United States
Providence Regional Cancer System-Centralia
🇺🇸Centralia, Washington, United States
Swedish Medical Center-Ballard Campus
🇺🇸Seattle, Washington, United States
Franciscan Research Center-Northwest Medical Plaza
🇺🇸Tacoma, Washington, United States
Evergreen Hematology and Oncology PS
🇺🇸Spokane, Washington, United States
Providence Regional Cancer System-Shelton
🇺🇸Shelton, Washington, United States
Providence Regional Cancer System-Yelm
🇺🇸Yelm, Washington, United States
Lakeland Hospital
🇺🇸Saint Joseph, Michigan, United States
Epic Care Partners in Cancer Care
🇺🇸Emeryville, California, United States
Memorial Hospital West
🇺🇸Pembroke Pines, Florida, United States
Providence Alaska Medical Center
🇺🇸Anchorage, Alaska, United States
Michiana Hematology Oncology PC-Elkhart
🇺🇸Elkhart, Indiana, United States
Cancer Care Center of Decatur
🇺🇸Decatur, Illinois, United States
Sutter Davis Hospital
🇺🇸Davis, California, United States
Swedish Medical Center-First Hill
🇺🇸Seattle, Washington, United States
Northwest Medical Specialties PLLC
🇺🇸Tacoma, Washington, United States
Alaska Women's Cancer Care
🇺🇸Anchorage, Alaska, United States
Alaska Oncology and Hematology LLC
🇺🇸Anchorage, Alaska, United States
University of Arkansas for Medical Sciences
🇺🇸Little Rock, Arkansas, United States
Kaiser Permanente-Deer Valley Medical Center
🇺🇸Antioch, California, United States
Mercy Cancer Center-Hot Springs
🇺🇸Hot Springs, Arkansas, United States
Sutter Auburn Faith Hospital
🇺🇸Auburn, California, United States
Providence Saint Joseph Medical Center/Disney Family Cancer Center
🇺🇸Burbank, California, United States
Epic Care-Dublin
🇺🇸Dublin, California, United States
Bay Area Breast Surgeons Inc
🇺🇸Emeryville, California, United States
Eden Hospital Medical Center
🇺🇸Castro Valley, California, United States
Kaiser Permanente-Fremont
🇺🇸Fremont, California, United States
Sutter Cancer Centers Radiation Oncology Services-Cameron Park
🇺🇸Cameron Park, California, United States
Fresno Cancer Center
🇺🇸Fresno, California, United States
Kaiser Permanente
🇺🇸Fresno, California, United States
Memorial Medical Center
🇺🇸Springfield, Illinois, United States
Contra Costa Regional Medical Center
🇺🇸Martinez, California, United States
Kaiser Permanente Los Angeles Medical Center
🇺🇸Los Angeles, California, United States
Kaiser Permanente-Modesto
🇺🇸Modesto, California, United States
Palo Alto Medical Foundation-Camino Division
🇺🇸Mountain View, California, United States
Alta Bates Summit Medical Center - Summit Campus
🇺🇸Oakland, California, United States
Kaiser Permanente Oakland-Broadway
🇺🇸Oakland, California, United States
Palo Alto Medical Foundation Health Care
🇺🇸Palo Alto, California, United States
Bay Area Tumor Institute
🇺🇸Oakland, California, United States
Kaiser Permanente-Rancho Cordova Cancer Center
🇺🇸Rancho Cordova, California, United States
Stanford Cancer Institute
🇺🇸Palo Alto, California, United States
Kaiser Permanente-Oakland
🇺🇸Oakland, 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
Sutter Cancer Centers Radiation Oncology Services-Roseville
🇺🇸Roseville, California, United States
Sutter Roseville Medical Center
🇺🇸Roseville, California, United States
The Permanente Medical Group-Roseville Radiation Oncology
🇺🇸Roseville, California, United States
UCSF Medical Center-Mount Zion
🇺🇸San Francisco, California, United States
UCSF Medical Center-Parnassus
🇺🇸San Francisco, California, United States
Kaiser Permanente-Santa Teresa-San Jose
🇺🇸San Jose, 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
Palo Alto Medical Foundation-Santa Cruz
🇺🇸Santa Cruz, California, United States
Kaiser Permanente-South San Francisco
🇺🇸South San Francisco, California, United States
Kaiser Permanente-Stockton
🇺🇸Stockton, California, United States
Sutter Pacific Medical Foundation
🇺🇸Santa Rosa, California, United States
Palo Alto Medical Foundation-Sunnyvale
🇺🇸Sunnyvale, California, United States
Kaiser Permanente-Walnut Creek
🇺🇸Walnut Creek, California, United States
Boulder Community Hospital
🇺🇸Boulder, Colorado, United States
Kaiser Permanente Medical Center-Vacaville
🇺🇸Vacaville, California, United States
Kaiser Permanente-Vallejo
🇺🇸Vallejo, California, United States
Rocky Mountain Cancer Centers-Boulder
🇺🇸Boulder, Colorado, United States
Rocky Mountain Cancer Centers-Penrose
🇺🇸Colorado Springs, Colorado, United States
Mercy Medical Center
🇺🇸Durango, Colorado, United States
Southwest Oncology PC
🇺🇸Durango, Colorado, United States
Comprehensive Cancer Care and Research Institute of Colorado LLC
🇺🇸Englewood, Colorado, United States
Swedish Medical Center
🇺🇸Englewood, Colorado, United States
North Colorado Medical Center
🇺🇸Greeley, Colorado, United States
Mountain Blue Cancer Care Center
🇺🇸Golden, Colorado, United States
Rocky Mountain Cancer Centers-Greenwood Village
🇺🇸Greenwood Village, Colorado, United States
Rocky Mountain Cancer Centers-Lakewood
🇺🇸Lakewood, Colorado, United States
Saint Anthony Hospital
🇺🇸Lakewood, Colorado, United States
Rocky Mountain Cancer Centers-Littleton
🇺🇸Littleton, Colorado, United States
Littleton Adventist Hospital
🇺🇸Littleton, Colorado, United States
Rocky Mountain Cancer Centers-Sky Ridge
🇺🇸Lone Tree, Colorado, United States
Sky Ridge Medical Center
🇺🇸Lone Tree, Colorado, United States
Rocky Mountain Cancer Centers-Longmont
🇺🇸Longmont, Colorado, United States
Longmont United Hospital
🇺🇸Longmont, Colorado, United States
SCL Health Lutheran Medical Center
🇺🇸Wheat Ridge, Colorado, United States
Memorial Regional Hospital/Joe DiMaggio Children's Hospital
🇺🇸Hollywood, Florida, United States
Kootenai Cancer Clinic
🇺🇸Sandpoint, Idaho, United States
Saint Luke's Mountain States Tumor Institute-Twin Falls
🇺🇸Twin Falls, Idaho, United States
Saint Luke's Mountain States Tumor Institute - Fruitland
🇺🇸Fruitland, Idaho, United States
Kootenai Medical Center
🇺🇸Coeur d'Alene, Idaho, United States
Kootenai Cancer Center
🇺🇸Post Falls, Idaho, United States
Illinois CancerCare-Carthage
🇺🇸Carthage, Illinois, United States
Illinois CancerCare-Bloomington
🇺🇸Bloomington, Illinois, United States
Centralia Oncology Clinic
🇺🇸Centralia, Illinois, United States
Illinois CancerCare-Macomb
🇺🇸Macomb, Illinois, United States
Radiation Oncology of Northern Illinois
🇺🇸Ottawa, Illinois, United States
Illinois CancerCare-Peoria
🇺🇸Peoria, Illinois, United States
Illinois CancerCare-Ottawa Clinic
🇺🇸Ottawa, Illinois, United States
OSF Saint Francis Medical Center
🇺🇸Peoria, Illinois, United States
Springfield Clinic
🇺🇸Springfield, Illinois, United States
Southern Illinois University School of Medicine
🇺🇸Springfield, Illinois, United States
Parkview Hospital Randallia
🇺🇸Fort Wayne, Indiana, United States
Reid Health
🇺🇸Richmond, Indiana, United States
Michiana Hematology Oncology PC-Plymouth
🇺🇸Plymouth, Indiana, United States
Alegent Health Mercy Hospital
🇺🇸Council Bluffs, Iowa, United States
Northern Indiana Cancer Research Consortium
🇺🇸South Bend, Indiana, United States
Michiana Hematology Oncology PC-Westville
🇺🇸Westville, Indiana, United States
Medical Oncology and Hematology Associates-West Des Moines
🇺🇸Clive, Iowa, United States
Greater Regional Medical Center
🇺🇸Creston, Iowa, United States
Mercy Cancer Center-West Lakes
🇺🇸Clive, Iowa, United States
Minimally Invasive Surgery Hospital
🇺🇸Lenexa, Kansas, United States
Kansas Institute of Medicine Cancer and Blood Center
🇺🇸Lenexa, Kansas, United States
Flaget Memorial Hospital
🇺🇸Bardstown, Kentucky, United States
Saint Luke's South Hospital
🇺🇸Overland Park, Kansas, United States
Commonwealth Cancer Center-Corbin
🇺🇸Corbin, Kentucky, United States
Menorah Medical Center
🇺🇸Overland Park, Kansas, United States
Kansas City NCI Community Oncology Research Program
🇺🇸Prairie Village, Kansas, United States
Northwest Hospital Center
🇺🇸Randallstown, Maryland, United States
Jewish Hospital Medical Center South
🇺🇸Shepherdsville, Kentucky, United States
University of Maryland/Greenebaum Cancer Center
🇺🇸Baltimore, Maryland, United States
Maine Medical Center- Scarborough Campus
🇺🇸Scarborough, Maine, United States
Bixby Medical Center
🇺🇸Adrian, Michigan, United States
Saint Joseph Mercy Hospital
🇺🇸Ann Arbor, Michigan, United States
Beaumont Hospital-Dearborn
🇺🇸Dearborn, Michigan, United States
Genesys Hurley Cancer Institute
🇺🇸Flint, Michigan, United States
Sparrow Hospital
🇺🇸Lansing, Michigan, United States
Allegiance Health
🇺🇸Jackson, Michigan, United States
Saint Mary Mercy Hospital
🇺🇸Livonia, Michigan, United States
Marquette General Hematology Oncology
🇺🇸Marquette, Michigan, United States
Marquette General Hospital
🇺🇸Marquette, Michigan, United States
Saint Mary's of Michigan
🇺🇸Saginaw, Michigan, United States
Marie Yeager Cancer Center
🇺🇸Saint Joseph, Michigan, United States
Saint Joseph Mercy Oakland
🇺🇸Pontiac, Michigan, United States
Toledo Clinic Cancer Centers-Monroe
🇺🇸Monroe, Michigan, United States
Essentia Health Saint Mary's Medical Center
🇺🇸Duluth, Minnesota, United States
Essentia Health Cancer Center
🇺🇸Duluth, Minnesota, United States
Fairview Ridges Hospital
🇺🇸Burnsville, Minnesota, United States
Saint John Macomb-Oakland Hospital
🇺🇸Warren, Michigan, United States
Miller-Dwan Hospital
🇺🇸Duluth, Minnesota, United States
Minnesota Oncology Hematology PA-Maplewood
🇺🇸Maplewood, Minnesota, United States
Saint John's Hospital - Healtheast
🇺🇸Maplewood, Minnesota, United States
Fairview-Southdale Hospital
🇺🇸Edina, Minnesota, United States
Fairview Maple Grove Medical Center
🇺🇸Maple Grove, Minnesota, United States
Unity Hospital
🇺🇸Fridley, Minnesota, United States
New Ulm Medical Center
🇺🇸New Ulm, Minnesota, United States
North Memorial Medical Health Center
🇺🇸Robbinsdale, Minnesota, United States
Abbott-Northwestern Hospital
🇺🇸Minneapolis, Minnesota, United States
Metro Minnesota Community Oncology Research Consortium
🇺🇸Saint Louis Park, Minnesota, United States
Regions Hospital
🇺🇸Saint Paul, Minnesota, United States
Park Nicollet Clinic - Saint Louis Park
🇺🇸Saint Louis Park, Minnesota, United States
Saint Francis Regional Medical Center
🇺🇸Shakopee, Minnesota, United States
Lakeview Hospital
🇺🇸Stillwater, Minnesota, United States
Ridgeview Medical Center
🇺🇸Waconia, Minnesota, United States
Rice Memorial Hospital
🇺🇸Willmar, Minnesota, United States
Minnesota Oncology Hematology PA-Woodbury
🇺🇸Woodbury, Minnesota, United States
Saint Francis Medical Center
🇺🇸Cape Girardeau, Missouri, United States
Parkland Health Center-Bonne Terre
🇺🇸Bonne Terre, Missouri, United States
Saint Luke's East - Lee's Summit
🇺🇸Lee's Summit, Missouri, United States
Liberty Radiation Oncology Center
🇺🇸Liberty, Missouri, United States
Washington University School of Medicine
🇺🇸Saint Louis, Missouri, United States
Heartland Regional Medical Center
🇺🇸Saint Joseph, Missouri, United States
Saint Joseph Oncology Inc
🇺🇸Saint Joseph, Missouri, United States
Missouri Baptist Medical Center
🇺🇸Saint Louis, Missouri, United States
Sainte Genevieve County Memorial Hospital
🇺🇸Sainte Genevieve, Missouri, United States
Missouri Baptist Sullivan Hospital
🇺🇸Sullivan, Missouri, United States
Billings Clinic Cancer Center
🇺🇸Billings, Montana, United States
Missouri Baptist Outpatient Center-Sunset Hills
🇺🇸Sunset Hills, Missouri, United States
Saint Vincent Healthcare
🇺🇸Billings, Montana, United States
Heartland Hematology and Oncology
🇺🇸Kearney, Nebraska, United States
CHI Health Good Samaritan
🇺🇸Kearney, Nebraska, United States
CHI Health Saint Francis
🇺🇸Grand Island, Nebraska, United States
Nebraska Cancer Research Center
🇺🇸Lincoln, Nebraska, United States
Saint Elizabeth Regional Medical Center
🇺🇸Lincoln, Nebraska, United States
Alegent Health Lakeside Hospital
🇺🇸Omaha, Nebraska, United States
Hackensack University Medical Center
🇺🇸Hackensack, New Jersey, United States
Midlands Community Hospital
🇺🇸Papillion, Nebraska, United States
Neurosurgeons of New Jersey-Ridgewood
🇺🇸Ridgewood, New Jersey, United States
University of Rochester
🇺🇸Rochester, New York, United States
Valley Hospital
🇺🇸Ridgewood, New Jersey, United States
Valley Health System-Hematology/Oncology
🇺🇸Westwood, New Jersey, United States
Columbia University/Herbert Irving Cancer Center
🇺🇸New York, New York, United States
Toledo Clinic Cancer Centers-Bowling Green
🇺🇸Bowling Green, Ohio, United States
Altru Cancer Center
🇺🇸Grand Forks, North Dakota, United States
University of Cincinnati/Barrett Cancer Center
🇺🇸Cincinnati, Ohio, United States
Bethesda North Hospital
🇺🇸Cincinnati, Ohio, United States
TriHealth Cancer Institute-Anderson
🇺🇸Cincinnati, Ohio, United States
Ohio State University Comprehensive Cancer Center
🇺🇸Columbus, Ohio, United States
Grandview Hospital
🇺🇸Dayton, Ohio, United States
Good Samaritan Hospital - Dayton
🇺🇸Dayton, Ohio, United States
Blanchard Valley Hospital
🇺🇸Findlay, Ohio, United States
Miami Valley Hospital
🇺🇸Dayton, Ohio, United States
Atrium Medical Center-Middletown Regional Hospital
🇺🇸Franklin, Ohio, United States
Kettering Medical Center
🇺🇸Kettering, Ohio, United States
Lima Memorial Hospital
🇺🇸Lima, Ohio, United States
Saint Charles Hospital
🇺🇸Oregon, Ohio, United States
Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
🇺🇸Maumee, Ohio, United States
Toledo Clinic Cancer Centers-Oregon
🇺🇸Oregon, Ohio, United States
Flower Hospital
🇺🇸Sylvania, Ohio, United States
University of Toledo
🇺🇸Toledo, Ohio, United States
Mercy Hospital of Tiffin
🇺🇸Tiffin, Ohio, United States
Upper Valley Medical Center
🇺🇸Troy, Ohio, United States
The Toledo Hospital/Toledo Children's Hospital
🇺🇸Toledo, Ohio, United States
Saint Vincent Mercy Medical Center
🇺🇸Toledo, Ohio, United States
Mercy Saint Anne Hospital
🇺🇸Toledo, Ohio, United States
Fulton County Health Center
🇺🇸Wauseon, Ohio, United States
Toledo Clinic Cancer Centers-Toledo
🇺🇸Toledo, Ohio, United States
Greene Memorial Hospital
🇺🇸Xenia, Ohio, United States
University Pointe
🇺🇸West Chester, Ohio, United States
Oklahoma Cancer Specialists and Research Institute-Tulsa
🇺🇸Tulsa, Oklahoma, United States
Legacy Meridian Park Hospital
🇺🇸Tualatin, Oregon, United States
Lehigh Valley Hospital - Muhlenberg
🇺🇸Bethlehem, Pennsylvania, United States
Memorial Hospital
🇺🇸Chattanooga, Tennessee, United States
Avera Cancer Institute
🇺🇸Sioux Falls, South Dakota, United States
University of Pittsburgh Cancer Institute (UPCI)
🇺🇸Pittsburgh, Pennsylvania, United States
Saint Joseph Regional Cancer Center
🇺🇸Bryan, Texas, United States
Inova Fairfax Hospital
🇺🇸Falls Church, Virginia, United States
Fredericksburg Oncology Inc
🇺🇸Fredericksburg, Virginia, United States
Sentara Norfolk General Hospital
🇺🇸Norfolk, Virginia, United States
Providence Regional Cancer System-Aberdeen
🇺🇸Aberdeen, Washington, United States
Cancer Care Center at Island Hospital
🇺🇸Anacortes, Washington, United States
Swedish Cancer Institute-Eastside Oncology Hematology
🇺🇸Bellevue, Washington, United States
PeaceHealth Saint Joseph Medical Center
🇺🇸Bellingham, Washington, United States
Harrison HealthPartners Hematology and Oncology-Bremerton
🇺🇸Bremerton, Washington, United States
Saint Francis Hospital
🇺🇸Federal Way, Washington, United States
Rockwood Clinic Cancer Treatment Center-Valley
🇺🇸Spokane Valley, Washington, United States
Harrison HealthPartners Hematology and Oncology-Poulsbo
🇺🇸Poulsbo, Washington, United States
Rockwood Cancer Treatment Center-DHEC-Downtown
🇺🇸Spokane, Washington, United States
Sutter General Hospital
🇺🇸Sacramento, California, United States
Kaiser Permanente-South Sacramento
🇺🇸Sacramento, California, United States
South Sacramento Cancer Center
🇺🇸Sacramento, California, United States
Rocky Mountain Cancer Centers-Midtown
🇺🇸Denver, Colorado, United States
SCL Health Saint Joseph Hospital
🇺🇸Denver, Colorado, United States
Rocky Mountain Cancer Centers-Rose
🇺🇸Denver, Colorado, United States
Kaiser Permanente - Sacramento
🇺🇸Sacramento, California, United States
Rocky Mountain Cancer Centers-Aurora
🇺🇸Aurora, Colorado, United States
The Medical Center of Aurora
🇺🇸Aurora, Colorado, United States
Porter Adventist Hospital
🇺🇸Denver, Colorado, United States
Colorado Blood Cancer Institute
🇺🇸Denver, Colorado, United States
Presbyterian - Saint Lukes Medical Center - Health One
🇺🇸Denver, Colorado, United States
Rose Medical Center
🇺🇸Denver, Colorado, United States
Colorado Cancer Research Program NCORP
🇺🇸Denver, Colorado, United States
Michigan Cancer Research Consortium NCORP
🇺🇸Ann Arbor, Michigan, United States
Mayo Clinic
🇺🇸Rochester, Minnesota, United States
Alegent Health Immanuel Medical Center
🇺🇸Omaha, Nebraska, United States
Alegent Health Bergan Mercy Medical Center
🇺🇸Omaha, Nebraska, United States
Missouri Valley Cancer Consortium
🇺🇸Omaha, Nebraska, United States
Hemotology and Oncology Consultants PC
🇺🇸Omaha, Nebraska, United States
Creighton University Medical Center
🇺🇸Omaha, Nebraska, United States
University of Nebraska Medical Center
🇺🇸Omaha, Nebraska, United States
Wake Forest University Health Sciences
🇺🇸Winston-Salem, North Carolina, United States
Legacy Good Samaritan Hospital and Medical Center
🇺🇸Portland, Oregon, United States
Providence Portland Medical Center
🇺🇸Portland, Oregon, United States
Providence Saint Vincent Medical Center
🇺🇸Portland, Oregon, United States
Aurora Saint Luke's Medical Center
🇺🇸Milwaukee, Wisconsin, United States
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
🇺🇸New Brunswick, New Jersey, United States
Jewish Hospital
🇺🇸Louisville, Kentucky, United States
Saints Mary and Elizabeth Hospital
🇺🇸Louisville, Kentucky, United States
Norton Hospital Pavilion and Medical Campus
🇺🇸Louisville, Kentucky, United States
Jewish Hospital Medical Center Northeast
🇺🇸Louisville, Kentucky, United States
Saint Luke's Hospital of Kansas City
🇺🇸Kansas City, Missouri, United States
North Kansas City Hospital
🇺🇸Kansas City, Missouri, United States
Heartland Hematology and Oncology Associates Incorporated
🇺🇸Kansas City, Missouri, United States
Research Medical Center
🇺🇸Kansas City, Missouri, United States
UNC Lineberger Comprehensive Cancer Center
🇺🇸Chapel Hill, North Carolina, United States
Medical Oncology and Hematology Associates-Laurel
🇺🇸Des Moines, Iowa, United States
Mercy Medical Center - Des Moines
🇺🇸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 Kentucky/Markey Cancer Center
🇺🇸Lexington, Kentucky, United States
University of Wisconsin Hospital and Clinics
🇺🇸Madison, Wisconsin, United States
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
🇺🇸Yakima, Washington, United States
Rocky Mountain Cancer Centers-Thornton
🇺🇸Thornton, Colorado, United States
Highline Medical Center-Main Campus
🇺🇸Burien, Washington, United States
Cancer Center of Western Wisconsin
🇺🇸New Richmond, Wisconsin, United States
Billings Clinic-Cody
🇺🇸Cody, Wyoming, United States
Welch Cancer Center
🇺🇸Sheridan, Wyoming, United States
Bozeman Deaconess Hospital
🇺🇸Bozeman, Montana, United States
Saint Peter's Community Hospital
🇺🇸Helena, Montana, United States
Rocky Mountain Cancer Centers-Parker
🇺🇸Parker, Colorado, United States
Providence Saint Mary Regional Cancer Center
🇺🇸Walla Walla, Washington, United States
Centerpoint Medical Center LLC
🇺🇸Independence, Missouri, United States