Management of Tobacco Treatment Intervention in Reducing Surgical Complications in Patients With Newly Diagnosed Lung Cancer Who Smoke Cigarettes
- Conditions
- Lung Carcinoma
- Interventions
- Registration Number
- NCT02856581
- Lead Sponsor
- Alliance for Clinical Trials in Oncology
- Brief Summary
This randomized phase III trial studies how well management of a tobacco treatment intervention works in reducing surgical complications in patients with newly diagnosed lung cancer who smoke cigarettes. Management of a tobacco treatment intervention compares varenicline (a drug that reduces the craving and withdrawal symptoms that occur with abstinence from nicotine) and behavioral interventions (consisting of a brief clinician-delivered intervention and tobacco quitline \[tobacco cessation service available through a toll-free telephone number\] follow-up) with placebo (a pill with no active medication) along with similar behavioral interventions. It is not yet known whether management of a tobacco treatment intervention is more effective in reducing surgical complications than placebo.
- Detailed Description
PRIMARY OBJECTIVES:
I. To determine if varenicline plus a behavioral intervention consisting of a brief clinician-delivered intervention and tobacco quitline follow-up, decreases postsurgical complications through 24 weeks after surgery when compared to placebo plus the behavioral intervention in lung cancer patients who undergo surgery and are motivated to stop smoking.
SECONDARY OBJECTIVES:
I. To compare changes from baseline to 12 and 24 weeks after surgery in the patient quality of life (Linear Analogue Self-Assessment \[LASA\]-12) domains between the intervention (varenicline) and control group (placebo).
II. To compare changes from baseline to 6, 12 and 24 weeks after surgery in the patient quality of life related domains (LASA) for the Patient Health Questionnaire (PHQ)-9 and Smoking Self Efficacy Questionnaire (SEQ)12 between the intervention and control groups.
III. To compare the proportion of patients 12 weeks and 24 weeks after surgery who endorse ("Was It Worth It") each treatment (intervention versus \[vs\] control groups).
IV. To compare post-operative care (as measured by length of hospital and high dependency unit stay) between the intervention and control groups.
V. To compare treatment adherence between the intervention and control groups. VI. To compare rates of smoking abstinence between the intervention and control groups as a covariate of the primary outcome only.
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 23
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Control group (placebo and behavioral intervention) Placebo Patients receive placebo PO QD on days 1-3 and BID on days 4-84 for 12 weeks in the absence of disease progression or unacceptable toxicity. Patients also complete behavioral intervention consisting of no smoking message from surgical team member and how to use NCI quitline at surgical consult. Control group (placebo and behavioral intervention) Tobacco Cessation Counseling Patients receive placebo PO QD on days 1-3 and BID on days 4-84 for 12 weeks in the absence of disease progression or unacceptable toxicity. Patients also complete behavioral intervention consisting of no smoking message from surgical team member and how to use NCI quitline at surgical consult. Intervention group (varenicline and behavioral intervention) Tobacco Cessation Counseling Patients receive varenicline PO QD on days 1-3 and BID on days 4-84 for 12 weeks in the absence of disease progression or unacceptable toxicity. Patients also complete behavioral intervention consisting of no smoking message from surgical team member and how to use NCI quitline at surgical consult. Intervention group (varenicline and behavioral intervention) Varenicline Patients receive varenicline PO QD on days 1-3 and BID on days 4-84 for 12 weeks in the absence of disease progression or unacceptable toxicity. Patients also complete behavioral intervention consisting of no smoking message from surgical team member and how to use NCI quitline at surgical consult.
- Primary Outcome Measures
Name Time Method Mortality Up to 30 days post-surgery Number of patients that died within 30 days of surgery
Number of Paticipants With Incidence of Pulmonary Complications Up to 24 weeks post-surgery Surgical complication incidence rates at 24 weeks after surgery will be compared between the intervention vs. control groups using a Fisher's exact test. Logistic regression models will supplement the univariate analysis, using complication incidence as the dependent variable and will include smoking status at the time of surgery as an independent variable and also adjust for age, gender, Fagerström Test for Nicotine Dependence (FTND), time between randomization and surgery, and presence of adjuvant chemotherapy and/or radiation therapy. We will also explore the collinear relationship between arm and smoking status to see whether they can be included together in the logistic models.
Number of Participants With Incidence of Anastomotic Failure Up to 24 weeks post-surgery Surgical complication incidence rates at 24 weeks after surgery will be compared between the intervention vs. control groups using a Fisher's exact test. Logistic regression models will supplement the univariate analysis, using complication incidence as the dependent variable and will include smoking status at the time of surgery as an independent variable and also adjust for age, gender, FTND, time between randomization and surgery, and presence of adjuvant chemotherapy and/or radiation therapy. A separate logistic model will be created including treatment arm instead of smoking status. We will also explore the collinear relationship between arm and smoking status to see whether they can be included together in the logistic models.
Number of Participants With Incidence of Unspecified Wound Infection Up to 24 weeks post-surgery Surgical complication incidence rates at 24 weeks after surgery will be compared between the intervention vs. control groups using a Fisher's exact test. Logistic regression models will supplement the univariate analysis, using complication incidence as the dependent variable and will include smoking status at the time of surgery as an independent variable and also adjust for age, gender, FTND, time between randomization and surgery, and presence of adjuvant chemotherapy and/or radiation therapy. A separate logistic model will be created including treatment arm instead of smoking status. We will also explore the collinear relationship between arm and smoking status to see whether they can be included together in the logistic models.
Re-hospitalization Up to 30 days post-surgery Number of patients re-hospitalized within 30 days of surgery
Number of Participants With Incidence of Intensive Care Unit Readmission Up to 24 weeks post-surgery Surgical complication incidence rates at 24 weeks after surgery will be compared between the intervention vs. control groups using a Fisher's exact test. Logistic regression models will supplement the univariate analysis, using complication incidence as the dependent variable and will include smoking status at the time of surgery as an independent variable and also adjust for age, gender, FTND, time between randomization and surgery, and presence of adjuvant chemotherapy and/or radiation therapy. A separate logistic model will be created including treatment arm instead of smoking status. We will also explore the collinear relationship between arm and smoking status to see whether they can be included together in the logistic models.
- Secondary Outcome Measures
Name Time Method Change in QOL as Measured by the LASA-12, PHQ-9, SEQ-12 Baseline up to 24 weeks after surgery Analysis of covariance and linear mixed model repeated measures analysis will be used for each assessment domain (LASA-12, PHQ-9, SEQ12).
Expanded Complication Rate Up to 1 year Treatment Adherence Rates Related to Visits, Medication Compliance, Quitline Usage, and Surgeon Teachable Moment Delivery Up to 12 weeks Length of Hospital Stay The time from surgery until the patient is released from the hospital Logrank testing of Kaplan-Meier estimates will be used for length of hospital stay and supplemented by Cox models to control for concomitant covariates.
Change in QOL as Measured by Was It Worth It Assessments At 24 weeks after surgery Length of High Dependency Unit Stay The time from surgery until the patient is released from the hospital Logrank testing of Kaplan-Meier estimates will be used for length of high dependency unit stay and supplemented by Cox models to control for concomitant covariates.
Smoking Abstinence Rates as Measured by Self-report Up to 12 weeks Smoking Abstinence Rates as Measured by Salivary Cotinine Testing Up to 12 weeks
Trial Locations
- Locations (374)
Baptist Health Paducah
🇺🇸Paducah, Kentucky, United States
Bhadresh Nayak MD PC-Sterling Heights
🇺🇸Sterling Heights, Michigan, United States
Coborn Cancer Center at Saint Cloud Hospital
🇺🇸Saint Cloud, Minnesota, United States
Baylor University Medical Center
🇺🇸Dallas, Texas, United States
Saint Elizabeth Youngstown Hospital
🇺🇸Youngstown, Ohio, United States
Saint Helena Hospital
🇺🇸Saint Helena, California, United States
Rocky Mountain Cancer Centers-Boulder
🇺🇸Boulder, Colorado, United States
Veterans Affairs Loma Linda Healthcare System
🇺🇸Loma Linda, California, United States
Memorial Hospital North
🇺🇸Colorado Springs, Colorado, United States
Rocky Mountain Cancer Centers-Littleton
🇺🇸Littleton, Colorado, United States
Rocky Mountain Cancer Centers-Sky Ridge
🇺🇸Lone Tree, Colorado, United States
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
🇺🇸Savannah, Georgia, United States
Memorial Hospital West
🇺🇸Pembroke Pines, Florida, United States
Boulder Community Hospital
🇺🇸Boulder, Colorado, United States
North Colorado Medical Center
🇺🇸Greeley, Colorado, United States
Illinois CancerCare-Canton
🇺🇸Canton, Illinois, United States
National Jewish Health-Northern Hematology Oncology
🇺🇸Thornton, Colorado, United States
Summit Cancer Care-Candler
🇺🇸Savannah, Georgia, United States
Broward Health Medical Center
🇺🇸Fort Lauderdale, Florida, United States
Illinois CancerCare-Carthage
🇺🇸Carthage, Illinois, United States
Sky Ridge Medical Center
🇺🇸Lone Tree, Colorado, United States
Piedmont Hospital
🇺🇸Atlanta, Georgia, United States
SCL Health Lutheran Medical Center
🇺🇸Wheat Ridge, Colorado, United States
SIH Cancer Institute
🇺🇸Carterville, Illinois, United States
Memorial Regional Hospital/Joe DiMaggio Children's Hospital
🇺🇸Hollywood, Florida, United States
Illinois CancerCare-Ottawa Clinic
🇺🇸Ottawa, Illinois, United States
Loyola University Medical Center
🇺🇸Maywood, Illinois, United States
Carle Cancer Center
🇺🇸Urbana, Illinois, United States
Good Samaritan Medical Center
🇺🇸Lafayette, Colorado, United States
Carle on Vermilion
🇺🇸Danville, Illinois, United States
Illinois CancerCare-Kewanee Clinic
🇺🇸Kewanee, Illinois, United States
Saint Joseph Mercy Chelsea
🇺🇸Chelsea, Michigan, United States
Memorial Hospital of Carbondale
🇺🇸Carbondale, Illinois, United States
Carle Physician Group-Mattoon/Charleston
🇺🇸Mattoon, Illinois, United States
Illinois CancerCare-Pekin
🇺🇸Pekin, Illinois, United States
IHA Hematology Oncology Consultants-Canton
🇺🇸Canton, Michigan, United States
Decatur Memorial Hospital
🇺🇸Decatur, Illinois, United States
Genesee Hematology Oncology PC
🇺🇸Flint, Michigan, United States
The Carle Foundation Hospital
🇺🇸Urbana, Illinois, United States
Springfield Clinic
🇺🇸Springfield, Illinois, United States
OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
🇺🇸Pekin, Illinois, United States
Cancer Care Specialists of Illinois-Swansea
🇺🇸Swansea, Illinois, United States
Baptist Health Madisonville/Merle Mahr Cancer Center
🇺🇸Madisonville, Kentucky, United States
Ochsner High Grove
🇺🇸Baton Rouge, Louisiana, United States
Saint Cloud Hospital
🇺🇸Saint Cloud, Minnesota, United States
Saint Joseph Mercy Brighton
🇺🇸Brighton, Michigan, United States
Great Lakes Cancer Management Specialists-Doctors Park
🇺🇸East China Township, Michigan, United States
Parkland Health Center - Farmington
🇺🇸Farmington, Missouri, United States
UM Upper Chesapeake Medical Center
🇺🇸Bel Air, Maryland, United States
IHA Hematology Oncology Consultants-Brighton
🇺🇸Brighton, Michigan, United States
Saint Elizabeth Boardman Hospital
🇺🇸Boardman, Ohio, United States
Saint Francis Medical Center
🇺🇸Cape Girardeau, Missouri, United States
Allegiance Health
🇺🇸Jackson, Michigan, United States
UP Health System Marquette
🇺🇸Marquette, Michigan, United States
Saint Mary's Oncology/Hematology Associates of Marlette
🇺🇸Marlette, Michigan, United States
21st Century Oncology-Pontiac
🇺🇸Pontiac, Michigan, United States
Huron Medical Center PC
🇺🇸Port Huron, Michigan, United States
Mayo Clinic Health Systems-Mankato
🇺🇸Mankato, Minnesota, United States
Sainte Genevieve County Memorial Hospital
🇺🇸Sainte Genevieve, Missouri, United States
Good Samaritan Hospital - Dayton
🇺🇸Dayton, Ohio, United States
Vassar Brothers Medical Center
🇺🇸Poughkeepsie, New York, United States
Aultman Health Foundation
🇺🇸Canton, Ohio, United States
University of Rochester
🇺🇸Rochester, New York, United States
Miami Valley Hospital North
🇺🇸Dayton, Ohio, United States
Thomas Jefferson University Hospital
🇺🇸Philadelphia, Pennsylvania, United States
Dayton Physicians LLC-Atrium
🇺🇸Franklin, Ohio, United States
Dayton Physician LLC-Miami Valley Hospital North
🇺🇸Dayton, Ohio, United States
Orion Cancer Care
🇺🇸Findlay, Ohio, United States
Dayton Physicians LLC-Miami Valley South
🇺🇸Centerville, Ohio, United States
Oklahoma Cancer Specialists and Research Institute-Tulsa
🇺🇸Tulsa, Oklahoma, United States
Dayton Physicians LLC-Wayne
🇺🇸Greenville, Ohio, United States
Saint Alphonsus Medical Center-Baker City
🇺🇸Baker City, Oregon, United States
Atrium Medical Center-Middletown Regional Hospital
🇺🇸Franklin, Ohio, United States
Greater Dayton Cancer Center
🇺🇸Kettering, Ohio, United States
Mount Nittany Medical Center
🇺🇸State College, Pennsylvania, United States
Saint Alphonsus Medical Center-Ontario
🇺🇸Ontario, Oregon, United States
Blanchard Valley Hospital
🇺🇸Findlay, Ohio, United States
Springfield Regional Medical Center
🇺🇸Springfield, Ohio, United States
First Dayton Cancer Care
🇺🇸Kettering, Ohio, United States
Lehigh Valley Hospital-Cedar Crest
🇺🇸Allentown, Pennsylvania, United States
Geisinger Medical Center
🇺🇸Danville, Pennsylvania, United States
Prisma Health Cancer Institute - Seneca
🇺🇸Seneca, South Carolina, United States
Riverton Hospital
🇺🇸Riverton, Utah, United States
Tacoma/Valley Radiation Oncology Centers-Gig Harbor
🇺🇸Gig Harbor, Washington, United States
Mayo Clinic Health System-Franciscan Healthcare
🇺🇸La Crosse, Wisconsin, United States
Alliance for Childhood Diseases/Cure 4 the Kids Foundation
🇺🇸Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada - Town Center
🇺🇸Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada-Summerlin
🇺🇸Las Vegas, Nevada, United States
Summerlin Hospital Medical Center
🇺🇸Las Vegas, Nevada, United States
Las Vegas Cancer Center-Medical Center
🇺🇸Las Vegas, Nevada, United States
21st Century Oncology-Fort Apache
🇺🇸Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada
🇺🇸Las Vegas, Nevada, United States
OptumCare Cancer Care at Fort Apache
🇺🇸Las Vegas, Nevada, United States
Urology Specialists of Nevada - Southwest
🇺🇸Las Vegas, Nevada, United States
HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
🇺🇸Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada - Central Valley
🇺🇸Las Vegas, Nevada, United States
University Cancer Center
🇺🇸Las Vegas, Nevada, United States
Desert West Surgery
🇺🇸Las Vegas, Nevada, United States
University Medical Center of Southern Nevada
🇺🇸Las Vegas, Nevada, United States
Hope Cancer Care of Nevada
🇺🇸Las Vegas, Nevada, United States
Cancer and Blood Specialists-Shadow
🇺🇸Las Vegas, Nevada, United States
OptumCare Cancer Care at Oakey
🇺🇸Las Vegas, Nevada, United States
Radiation Oncology Centers of Nevada Central
🇺🇸Las Vegas, Nevada, United States
HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
🇺🇸Las Vegas, Nevada, United States
Sunrise Hospital and Medical Center
🇺🇸Las Vegas, Nevada, United States
HealthCare Partners Medical Group Oncology/Hematology-San Martin
🇺🇸Las Vegas, Nevada, United States
Las Vegas Prostate Cancer Center
🇺🇸Las Vegas, Nevada, United States
Las Vegas Urology - Sunset
🇺🇸Las Vegas, Nevada, United States
Cancer Therapy and Integrative Medicine
🇺🇸Las Vegas, Nevada, United States
21st Century Oncology-Vegas Tenaya
🇺🇸Las Vegas, Nevada, United States
Ann M Wierman MD LTD
🇺🇸Las Vegas, Nevada, United States
Cancer and Blood Specialists-Tenaya
🇺🇸Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada - Northwest
🇺🇸Las Vegas, Nevada, United States
HealthCare Partners Medical Group Oncology/Hematology-Tenaya
🇺🇸Las Vegas, Nevada, United States
Las Vegas Urology - Cathedral Rock
🇺🇸Las Vegas, Nevada, United States
Las Vegas Urology - Smoke Ranch
🇺🇸Las Vegas, Nevada, United States
OptumCare Cancer Care at MountainView
🇺🇸Las Vegas, Nevada, United States
Urology Specialists of Nevada - Northwest
🇺🇸Las Vegas, Nevada, United States
Oncology Hematology Care Inc-Kenwood
🇺🇸Cincinnati, Ohio, United States
University of Mississippi Medical Center
🇺🇸Jackson, Mississippi, United States
Kingman Regional Medical Center
🇺🇸Kingman, Arizona, United States
PCR Oncology
🇺🇸Arroyo Grande, California, United States
Eisenhower Medical Center
🇺🇸Rancho Mirage, California, United States
UCHealth Memorial Hospital Central
🇺🇸Colorado Springs, Colorado, United States
Swedish Medical Center
🇺🇸Englewood, Colorado, United States
Saint Mary's Hospital and Regional Medical Center
🇺🇸Grand Junction, Colorado, United States
National Jewish Health-Western Hematology Oncology
🇺🇸Golden, Colorado, United States
McKee Medical Center
🇺🇸Loveland, Colorado, United States
Indian River Medical Center
🇺🇸Vero Beach, Florida, United States
Saint Alphonsus Cancer Care Center-Boise
🇺🇸Boise, Idaho, United States
Kootenai Cancer Center
🇺🇸Post Falls, Idaho, United States
Northwest Community Hospital
🇺🇸Arlington Heights, Illinois, United States
Rush - Copley Medical Center
🇺🇸Aurora, Illinois, United States
Illinois CancerCare-Bloomington
🇺🇸Bloomington, Illinois, United States
John H Stroger Jr Hospital of Cook County
🇺🇸Chicago, Illinois, United States
University of Illinois
🇺🇸Chicago, Illinois, United States
Cancer Care Specialists of Illinois - Decatur
🇺🇸Decatur, Illinois, United States
Crossroads Cancer Center
🇺🇸Effingham, Illinois, United States
Eastern Maine Medical Center
🇺🇸Bangor, Maine, United States
Illinois CancerCare-Dixon
🇺🇸Dixon, Illinois, United States
Illinois CancerCare-Eureka
🇺🇸Eureka, Illinois, United States
Marjorie Weinberg Cancer Center at Loyola-Gottlieb
🇺🇸Melrose Park, Illinois, United States
Illinois CancerCare-Galesburg
🇺🇸Galesburg, Illinois, United States
Trinity Medical Center
🇺🇸Moline, Illinois, United States
Western Illinois Cancer Treatment Center
🇺🇸Galesburg, Illinois, United States
OSF Saint Francis Radiation Oncology at Peoria Cancer Center
🇺🇸Peoria, Illinois, United States
Methodist Medical Center of Illinois
🇺🇸Peoria, Illinois, United States
Franciscan Health Indianapolis
🇺🇸Indianapolis, Indiana, United States
Hematology Oncology Consultants-Clarkston
🇺🇸Clarkston, Michigan, United States
Great Lakes Cancer Management Specialists-Van Elslander Cancer Center
🇺🇸Grosse Pointe Woods, Michigan, United States
Academic Hematology Oncology Specialists
🇺🇸Grosse Pointe Woods, Michigan, United States
UP Health System Hematology Oncology Marquette
🇺🇸Marquette, Michigan, United States
Hope Cancer Center
🇺🇸Pontiac, Michigan, United States
Oncology Hematology Associates of Saginaw Valley PC
🇺🇸Saginaw, Michigan, United States
Macomb Hematology Oncology PC
🇺🇸Warren, Michigan, United States
Parkland Health Center-Bonne Terre
🇺🇸Bonne Terre, Missouri, United States
Las Vegas Urology - Green Valley
🇺🇸Henderson, Nevada, United States
21st Century Oncology
🇺🇸Las Vegas, Nevada, United States
Urology Specialists of Nevada - Central
🇺🇸Las Vegas, Nevada, United States
Radiation Oncology Centers of Nevada Southeast
🇺🇸Las Vegas, Nevada, United States
Saint Mary's Regional Medical Center
🇺🇸Reno, Nevada, United States
Alliance Cancer Center
🇺🇸Alliance, Ohio, United States
Indu and Raj Soin Medical Center
🇺🇸Beavercreek, Ohio, United States
Miami Valley Hospital South
🇺🇸Centerville, Ohio, United States
Springfield Regional Cancer Center
🇺🇸Springfield, Ohio, United States
Saint Joseph Warren Hospital
🇺🇸Warren, Ohio, United States
Upper Valley Medical Center
🇺🇸Troy, Ohio, United States
Geisinger Medical Oncology-Lewisburg
🇺🇸Lewisburg, Pennsylvania, United States
Geisinger Medical Center-Cancer Center Hazleton
🇺🇸Hazleton, Pennsylvania, United States
Lehigh Valley Hospital-Hazleton
🇺🇸Hazleton, Pennsylvania, United States
Fox Chase Cancer Center
🇺🇸Philadelphia, Pennsylvania, United States
Community Medical Center
🇺🇸Scranton, Pennsylvania, United States
Geisinger Medical Oncology-Selinsgrove
🇺🇸Selinsgrove, Pennsylvania, United States
Geisinger Wyoming Valley/Henry Cancer Center
🇺🇸Wilkes-Barre, Pennsylvania, United States
Prisma Health Cancer Institute - Laurens
🇺🇸Clinton, South Carolina, United States
Prisma Health Cancer Institute - Easley
🇺🇸Easley, South Carolina, United States
Prisma Health Cancer Institute - Butternut
🇺🇸Greenville, South Carolina, United States
Prisma Health Cancer Institute - Faris
🇺🇸Greenville, South Carolina, United States
Prisma Health Greenville Memorial Hospital
🇺🇸Greenville, South Carolina, United States
Prisma Health Cancer Institute - Eastside
🇺🇸Greenville, South Carolina, United States
Baptist Memorial Hospital and Cancer Center-Memphis
🇺🇸Memphis, Tennessee, United States
UTMB Cancer Center at Victory Lakes
🇺🇸League City, Texas, United States
University of Texas Medical Branch
🇺🇸Galveston, Texas, United States
American Fork Hospital / Huntsman Intermountain Cancer Center
🇺🇸American Fork, Utah, United States
Sandra L Maxwell Cancer Center
🇺🇸Cedar City, Utah, United States
Logan Regional Hospital
🇺🇸Logan, Utah, United States
Intermountain Medical Center
🇺🇸Murray, Utah, United States
McKay-Dee Hospital Center
🇺🇸Ogden, Utah, United States
Utah Valley Regional Medical Center
🇺🇸Provo, Utah, United States
LDS Hospital
🇺🇸Salt Lake City, Utah, United States
Utah Cancer Specialists-Salt Lake City
🇺🇸Salt Lake City, Utah, United States
University of Vermont Medical Center
🇺🇸Burlington, Vermont, United States
Sentara Martha Jefferson Hospital
🇺🇸Charlottesville, Virginia, United States
University of Vermont and State Agricultural College
🇺🇸Burlington, Vermont, United States
University of Virginia Cancer Center
🇺🇸Charlottesville, Virginia, United States
Augusta Health Center for Cancer and Blood Disorders
🇺🇸Fishersville, Virginia, United States
Sentara Norfolk General Hospital
🇺🇸Norfolk, Virginia, United States
MultiCare Auburn Medical Center
🇺🇸Auburn, Washington, United States
Virginia Mason Bainbridge Island Medical Center
🇺🇸Bainbridge Island, Washington, United States
Overlake Hospital Medical Center
🇺🇸Bellevue, Washington, United States
Virginia Mason Federal Way Medical Center
🇺🇸Federal Way, Washington, United States
MultiCare Gig Harbor Medical Park
🇺🇸Gig Harbor, Washington, United States
Northwest Cancer Clinic
🇺🇸Kennewick, Washington, United States
Virginia Mason Lynnwood Medical Center
🇺🇸Lynnwood, Washington, United States
Jefferson Healthcare
🇺🇸Port Townsend, Washington, United States
Peninsula Cancer Center
🇺🇸Poulsbo, Washington, United States
MultiCare Good Samaritan Hospital
🇺🇸Puyallup, Washington, United States
Virginia Mason Medical Center
🇺🇸Seattle, Washington, United States
Valley Medical Center
🇺🇸Renton, Washington, United States
Tacoma/Valley Radiation Oncology Centers-Puyallup
🇺🇸Puyallup, Washington, United States
Rockwood Clinic Cancer Treatment Center-Valley
🇺🇸Spokane Valley, Washington, United States
Rockwood Cancer Treatment Center-DHEC-Downtown
🇺🇸Spokane, Washington, United States
Rockwood North Cancer Treatment Center
🇺🇸Spokane, Washington, United States
Mary Bridge Children's Hospital and Health Center
🇺🇸Tacoma, Washington, United States
MultiCare Tacoma General Hospital
🇺🇸Tacoma, Washington, United States
Tacoma/Valley Radiation Oncology Centers-Saint Joe's
🇺🇸Tacoma, Washington, United States
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
🇺🇸Yakima, Washington, United States
Billings Clinic-Cody
🇺🇸Cody, Wyoming, United States
Cheyenne Regional Medical Center-West
🇺🇸Cheyenne, Wyoming, United States
Welch Cancer Center
🇺🇸Sheridan, Wyoming, United States
Dixie Medical Center Regional Cancer Center
🇺🇸Saint George, Utah, United States
Missouri Baptist Sullivan Hospital
🇺🇸Sullivan, Missouri, United States
Missouri Baptist Outpatient Center-Sunset Hills
🇺🇸Sunset Hills, Missouri, United States
Missouri Baptist Medical Center
🇺🇸Saint Louis, Missouri, United States
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
🇺🇸New York, New York, United States
Mountain Blue Cancer Care Center - Swedish
🇺🇸Englewood, Colorado, United States
Saint James Community Hospital and Cancer Treatment Center
🇺🇸Butte, Montana, United States
East Carolina University
🇺🇸Greenville, North Carolina, United States
Centralia Oncology Clinic
🇺🇸Centralia, Illinois, United States
Illinois CancerCare-Macomb
🇺🇸Macomb, Illinois, United States
Carle Physician Group-Effingham
🇺🇸Effingham, Illinois, United States
Chancellor Center for Oncology
🇺🇸Newburgh, Indiana, United States
Illinois CancerCare-Peoria
🇺🇸Peoria, Illinois, United States
OSF Saint Francis Medical Center
🇺🇸Peoria, Illinois, United States
Baptist Health Corbin
🇺🇸Corbin, Kentucky, United States
Illinois CancerCare-Princeton
🇺🇸Princeton, Illinois, United States
Southwest Illinois Health Services LLP
🇺🇸Swansea, Illinois, United States
Rush-Copley Healthcare Center
🇺🇸Yorkville, Illinois, United States
Deaconess Clinic Downtown
🇺🇸Evansville, Indiana, United States
Parkview Hospital Randallia
🇺🇸Fort Wayne, Indiana, United States
Memorial Regional Cancer Center Day Road
🇺🇸Mishawaka, Indiana, United States
Franciscan Health Mooresville
🇺🇸Mooresville, Indiana, United States
Reid Health
🇺🇸Richmond, Indiana, United States
Memorial Hospital of South Bend
🇺🇸South Bend, Indiana, United States
Mercy Medical Center
🇺🇸Springfield, Massachusetts, United States
Miami Valley Hospital
🇺🇸Dayton, Ohio, United States
Wayne Hospital
🇺🇸Greenville, Ohio, United States
Dayton Physicians LLC-Upper Valley
🇺🇸Troy, Ohio, United States
Lehigh Valley Hospital - Muhlenberg
🇺🇸Bethlehem, Pennsylvania, United States
Pocono Medical Center
🇺🇸East Stroudsburg, Pennsylvania, United States
Lewistown Hospital
🇺🇸Lewistown, Pennsylvania, United States
Geisinger Medical Group
🇺🇸State College, Pennsylvania, United States
Geisinger Cancer Services-Pottsville
🇺🇸Pottsville, Pennsylvania, United States
Saint Joseph Mercy Canton
🇺🇸Canton, Michigan, United States
IHA Hematology Oncology Consultants-Chelsea
🇺🇸Chelsea, Michigan, United States
Caro Cancer Center
🇺🇸Caro, Michigan, United States
Genesee Cancer and Blood Disease Treatment Center
🇺🇸Flint, Michigan, United States
Genesys Hurley Cancer Institute
🇺🇸Flint, Michigan, United States
Hurley Medical Center
🇺🇸Flint, Michigan, United States
Michigan Breast Specialists-Grosse Pointe Woods
🇺🇸Grosse Pointe Woods, Michigan, United States
Ascension Saint Joseph Hospital
🇺🇸Tawas City, Michigan, United States
Hope Cancer Clinic
🇺🇸Livonia, Michigan, United States
Sparrow Hospital
🇺🇸Lansing, Michigan, United States
Lake Huron Medical Center
🇺🇸Port Huron, Michigan, United States
Saint Mary Mercy Hospital
🇺🇸Livonia, Michigan, United States
Great Lakes Cancer Management Specialists-Macomb Medical Campus
🇺🇸Macomb, Michigan, United States
Ascension Saint Mary's Hospital
🇺🇸Saginaw, Michigan, United States
Great Lakes Cancer Management Specialists-Rochester Hills
🇺🇸Rochester Hills, Michigan, United States
Michigan Breast Specialists-Warren
🇺🇸Warren, Michigan, United States
Saint John Macomb-Oakland Hospital
🇺🇸Warren, Michigan, United States
Saint Mary's Oncology/Hematology Associates of West Branch
🇺🇸West Branch, Michigan, United States
Huron Gastroenterology PC
🇺🇸Ypsilanti, Michigan, United States
IHA Hematology Oncology Consultants-Ann Arbor
🇺🇸Ypsilanti, Michigan, United States
Parkview Regional Medical Center
🇺🇸Fort Wayne, Indiana, United States
Valley Radiation Oncology
🇺🇸Peru, Illinois, United States
Illinois CancerCare-Peru
🇺🇸Peru, Illinois, United States
Beaumont Hospital - Dearborn
🇺🇸Dearborn, Michigan, United States
Woodland Cancer Care Center
🇺🇸Michigan City, Indiana, United States
Memorial Medical Center
🇺🇸Springfield, Illinois, United States
Newland Medical Associates-Clarkston
🇺🇸Clarkston, Michigan, United States
Southern Illinois University School of Medicine
🇺🇸Springfield, Illinois, United States
Lafayette Family Cancer Center-EMMC
🇺🇸Brewer, Maine, United States
Advanced Breast Care Center PLLC
🇺🇸Warren, Michigan, United States
Saint Joseph Mercy Oakland
🇺🇸Pontiac, Michigan, United States
Michigan Breast Specialists-Macomb Township
🇺🇸Macomb, Michigan, United States
Newland Medical Associates-Pontiac
🇺🇸Pontiac, Michigan, United States
Great Lakes Cancer Management Specialists-Macomb Professional Building
🇺🇸Warren, Michigan, United States
Kettering Medical Center
🇺🇸Kettering, Ohio, United States
Rocky Mountain Cancer Centers-Aurora
🇺🇸Aurora, Colorado, United States
The Medical Center of Aurora
🇺🇸Aurora, Colorado, United States
University of Colorado Hospital
🇺🇸Aurora, Colorado, United States
Cancer Center of Colorado at Sloan's Lake
🇺🇸Denver, Colorado, United States
National Jewish Health-Main Campus
🇺🇸Denver, Colorado, United States
The Women's Imaging Center
🇺🇸Denver, Colorado, United States
Colorado Blood Cancer Institute
🇺🇸Denver, Colorado, United States
Presbyterian - Saint Lukes Medical Center - Health One
🇺🇸Denver, Colorado, United States
Western Surgical Care
🇺🇸Denver, Colorado, United States
University of Michigan Comprehensive Cancer Center
🇺🇸Ann Arbor, Michigan, United States
Ascension Saint John Hospital
🇺🇸Detroit, Michigan, 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
Rose Medical Center
🇺🇸Denver, Colorado, United States
Saint Joseph Mercy Hospital
🇺🇸Ann Arbor, Michigan, United States
Mayo Clinic
🇺🇸Rochester, Minnesota, United States
Nebraska Methodist Hospital
🇺🇸Omaha, Nebraska, United States
University of Oklahoma Health Sciences Center
🇺🇸Oklahoma City, Oklahoma, United States
Aurora Saint Luke's Medical Center
🇺🇸Milwaukee, Wisconsin, United States
Comprehensive Cancer Centers of Nevada - Henderson
🇺🇸Henderson, Nevada, United States
21st Century Oncology-Henderson
🇺🇸Henderson, Nevada, United States
Comprehensive Cancer Centers of Nevada-Southeast Henderson
🇺🇸Henderson, Nevada, United States
Comprehensive Cancer Centers of Nevada-Horizon Ridge
🇺🇸Henderson, Nevada, United States
OptumCare Cancer Care at Seven Hills
🇺🇸Henderson, Nevada, United States
Las Vegas Cancer Center-Henderson
🇺🇸Henderson, Nevada, United States
Las Vegas Urology - Pebble
🇺🇸Henderson, Nevada, United States
Urology Specialists of Nevada - Green Valley
🇺🇸Henderson, Nevada, United States
Baptist Health Louisville
🇺🇸Louisville, Kentucky, United States
Ralph H Johnson VA Medical Center
🇺🇸Charleston, South Carolina, United States
Kootenai Cancer Clinic
🇺🇸Sandpoint, Idaho, United States
Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
🇺🇸Jonesboro, Arkansas, United States
Fairbanks Memorial Hospital
🇺🇸Fairbanks, Alaska, United States
Saint Alphonsus Medical Center-Nampa
🇺🇸Nampa, Idaho, United States
Idaho Urologic Institute-Meridian
🇺🇸Meridian, Idaho, United States
Veterans Affairs Connecticut Healthcare System-West Haven Campus
🇺🇸West Haven, Connecticut, United States
Kootenai Medical Center
🇺🇸Coeur d'Alene, Idaho, United States
Middlesex Hospital
🇺🇸Middletown, Connecticut, United States
Saint Alphonsus Cancer Care Center-Caldwell
🇺🇸Caldwell, Idaho, United States
Walter Knox Memorial Hospital
🇺🇸Emmett, Idaho, United States
Mary Bird Perkins Cancer Center
🇺🇸Baton Rouge, Louisiana, United States
Medical Center of Baton Rouge
🇺🇸Baton Rouge, Louisiana, United States
Baptist Memorial Hospital and Cancer Center-Golden Triangle
🇺🇸Columbus, Mississippi, United States
Baptist Memorial Hospital and Cancer Center-Union County
🇺🇸New Albany, Mississippi, United States
Saint Peter's Community Hospital
🇺🇸Helena, Montana, United States
Bozeman Deaconess Hospital
🇺🇸Bozeman, Montana, United States
Community Hospital of Anaconda
🇺🇸Anaconda, Montana, United States
Cancer and Blood Specialists-Henderson
🇺🇸Henderson, Nevada, United States
Benefis Healthcare- Sletten Cancer Institute
🇺🇸Great Falls, Montana, United States
Great Falls Clinic
🇺🇸Great Falls, Montana, United States
Kalispell Regional Medical Center
🇺🇸Kalispell, Montana, United States
Community Medical Hospital
🇺🇸Missoula, Montana, United States
Carson Tahoe Regional Medical Center
🇺🇸Carson City, Nevada, United States
Las Vegas Urology - Pecos
🇺🇸Las Vegas, Nevada, United States
Hunterdon Medical Center
🇺🇸Flemington, New Jersey, United States
Hope Cancer Care of Nevada-Pahrump
🇺🇸Pahrump, Nevada, United States
Renown Regional Medical Center
🇺🇸Reno, Nevada, United States
Radiation Oncology Associates
🇺🇸Reno, Nevada, United States
Prisma Health Cancer Institute - Spartanburg
🇺🇸Spartanburg, South Carolina, United States
Ocean Medical Center
🇺🇸Brick, New Jersey, United States
Dartmouth Hitchcock Medical Center
🇺🇸Lebanon, New Hampshire, United States
Southern Ocean County Medical Center
🇺🇸Manahawkin, New Jersey, United States
The Cancer Institute of New Jersey Hamilton
🇺🇸Hamilton, New Jersey, United States
Bayshore Community Hospital
🇺🇸Holmdel, New Jersey, United States
Jersey Shore Medical Center
🇺🇸Neptune, New Jersey, United States
Riverview Medical Center/Booker Cancer Center
🇺🇸Red Bank, New Jersey, United States
Virtua Voorhees
🇺🇸Voorhees, New Jersey, United States
Baptist Memorial Hospital for Women
🇺🇸Memphis, Tennessee, United States
Prisma Health Cancer Institute - Greer
🇺🇸Greer, South Carolina, United States
Central Vermont Medical Center/National Life Cancer Treatment
🇺🇸Berlin, Vermont, United States
University of Florida Health Science Center - Gainesville
🇺🇸Gainesville, Florida, United States
Baptist Health Lexington
🇺🇸Lexington, Kentucky, United States
Ochsner Medical Center Jefferson
🇺🇸New Orleans, Louisiana, United States
Tacoma/Valley Radiation Oncology Centers-Jackson Hall
🇺🇸Tacoma, Washington, United States
Billings Clinic Cancer Center
🇺🇸Billings, Montana, United States
Saint Vincent Healthcare
🇺🇸Billings, Montana, United States
Saint Vincent Frontier Cancer Center
🇺🇸Billings, Montana, United States
Southeast Cancer Center
🇺🇸Cape Girardeau, Missouri, United States
Armes Family Cancer Center
🇺🇸Findlay, Ohio, United States
Capital Region Southwest Campus
🇺🇸Jefferson City, Missouri, United States
Baptist Memorial Hospital and Cancer Center-Desoto
🇺🇸Southhaven, Mississippi, United States
Robert Wood Johnson University Hospital Somerset
🇺🇸Somerville, New Jersey, United States
Singing River Hospital
🇺🇸Pascagoula, Mississippi, United States
Glens Falls Hospital
🇺🇸Glens Falls, New York, United States
Baptist Memorial Hospital and Cancer Center-Oxford
🇺🇸Oxford, Mississippi, United States
Virtua Memorial
🇺🇸Mount Holly, New Jersey, United States