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Radiation Therapy With Concomitant and Adjuvant Temozolomide Versus Radiation Therapy With Adjuvant PCV Chemotherapy in Patients With Anaplastic Glioma or Low Grade Glioma
Study Purpose
Radiation therapy uses high-energy x-rays to kill tumor cells. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. It is not yet known whether giving radiation with concomitant and adjuvant temozolomide versus radiation with adjuvant PCV is more effective in treating anaplastic glioma or low grade glioma.
Recruitment Criteria
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Accepts Healthy Volunteers
Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms |
No |
|
Study Type
An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes. An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes. Searching Both is inclusive of interventional and observational studies. |
Interventional |
| Eligible Ages | 18 Years and Over |
| Gender | All |
Pre-Registration
Inclusion Criteria:
- - United States (US) and Canadian sites: * This review is mandatory prior to registration to confirm eligibility; patients must be willing to submit tissue samples for mandatory central pathology review submission; it should be initiated as soon after surgery as possible.
- - Tissue must have been determined to have local 1p/9q co-deletion and IDH mutation prior to submission for central path review.
- - Tumor tissue must show co-deletion of chromosomes 1p and 19q; for eligibility, the 1p/19q analysis results will be accepted from the local site, as determined by either a locally available or reference laboratory (for US, must be Clinical Laboratory Improvement Act [CLIA] certified); acceptable methods for determination of 1p/19q loss include fluorescent in-situ hybridization (FISH), by genomic sequencing or methylomic analyses; US and Canadian sites must send a copy of the official report to the pathology coordinator and quality assurance specialist (QAS) - Tumor must also show evidence of IDH mutation by immunohistochemistry or genomic analyses; this should be performed at the local site (US: performed in a CLIA certified laboratory); the site must send a copy of the official report to the pathology coordinator and QAS.
Inclusion Criteria:
- - Newly diagnosed and =< 3 months from surgical diagnosis; patients are also eligible if they have had a prior surgical procedure > 3 months earlier for low grade glioma, as long as the patient has not received prior radiation or prior chemotherapy.
- - Histological evidence of World Health Organization (WHO) grade III anaplastic glioma or WHO grade II low grade glioma with locally diagnosed combined 1p/19q loss and the presence of an either IDH1 or IDH2, both as established by a local or referenced laboratory qualified for the study.
- - Patients with codeleted low grade gliomas must also be considered "high risk" by exhibiting one or more of the following characteristics: - Age >= 40 and any surgical therapy.
- - Age < 40 with prior and subtotal resection or biopsy (i.e., anything less than gross total resection) - Documented growth following prior surgery (NOTE: patients with prior surgery cannot have received prior radiation, chemotherapy or targeted therapy) - Intractable seizures.
- - Surgery (partial or gross total resection or biopsy) must be performed >= 2 weeks prior to registration; patient must have recovered adequately from the effects of surgery.
- - Absolute neutrophil count (ANC) >= 1,500/mm^3 obtained =< 21 days prior to registration.
- - Platelet (PLTs) count >= 100,000/mm^3 obtained =< 21 days prior to registration.
- - Hemoglobin (Hgb) > 9.0 g/dL obtained =< 21 days prior to registration.
- - Total bilirubin =< 1.5 x institutional upper limit of normal (ULN) obtained =< 21 days prior to registration.
- - Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) =< 3 x ULN obtained =< 21 days prior to registration.
- - Creatinine =< 1.5 x ULN obtained =< 21 days prior to registration.
- - Negative serum or urine pregnancy test done =< 7 days prior to registration, for women of childbearing potential only.
- - Willingness and ability to personally complete neurocognitive testing (without assistance) and willingness to complete the QOL testing, (either personally or with assistance) - Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0, 1 or 2.
- - Written informed consent.
- - Willingness to return to enrolling institution for follow-up during the active monitoring phase (that is, the active treatment and observation portion) of the study); patients who have been formally transferred to another active and approved site participating in this study would not need to return to the enrolling institution for this purpose.
- - Willingness to allow the provision of tissue samples for correlative research, as long as adequate tissues are available; patients will not be excluded from participation in the study, if they are willing to allow provision of tissues for the correlative research, but there are insufficient quantities of tissue for the correlative analyses (e.g., a patient otherwise eligible and willing who had biopsy only) Willingness to allow the provision of blood samples for correlative research; patients are not excluded from participation in the study, if they are willing to provide the mandatory biospecimens for translational/correlative research, but for logistical reasons the specimens(s) were not obtainable or if the volume collected was insufficient.
Exclusion Criteria:
- - The following categories are ineligible: - Pregnant women.
- - Nursing women.
- - Men or women of childbearing potential who are unwilling to employ adequate contraception or contraceptive method during this study and 6 months following the completion of chemotherapy treatments.
- - History of prior radiation therapy or chemotherapy for glioma; note: patients who have a history of prior low grade glioma (with or without a distant history of prior surgery for that glioma), but who have never received prior chemotherapy or radiation therapy for the glioma are eligible for the study.
- - Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens.
- - Concomitant serious immunocompromised status (other than that related to concomitant steroids) that would compromise the safety of the patient on the study.
- - Patients known to be human immunodeficiency virus (HIV) positive and currently receiving retroviral therapy are not eligible; note: patients known to be HIV positive, but without clinical evidence of an immunocompromised state, are eligible for the study.
- - Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
- - Receiving any other investigational agent that would be considered as a treatment for the primary neoplasm.
- - Other active malignancy within 5 years of registration; exceptions: non-melanotic skin cancer or carcinoma-in-situ of the cervix; note: if there is a history of prior malignancy, the patient is not eligible if they are receiving other specific treatment (with the exclusion of hormonal therapy or Her-2 inhibitors) for their cancer or if they have received prior total body irradiation which included the brain.
- - History of myocardial infarction =< 6 months, or congestive heart failure requiring use of ongoing maintenance therapy for life-threatening ventricular arrhythmias.
Trial Details
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Trial ID:
This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries. |
NCT00887146 |
|
Phase
Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans. Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data. Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs. Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use. |
Phase 3 |
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Lead Sponsor
The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data. |
Alliance for Clinical Trials in Oncology |
|
Principal Investigator
The person who is responsible for the scientific and technical direction of the entire clinical study. |
Kurt Jaeckle, MD |
| Principal Investigator Affiliation | Mayo Clinic |
|
Agency Class
Category of organization(s) involved as sponsor (and collaborator) supporting the trial. |
Other, NIH |
| Overall Status | Active, not recruiting |
| Countries | Austria, Belgium, Canada, France, Netherlands, United States |
|
Conditions
The disease, disorder, syndrome, illness, or injury that is being studied. |
Brain and Central Nervous System Tumors |
| Study Website: | View Trial Website |
This study will be a randomized phase III for patients with newly diagnosed co-deleted 1p/19q anaplastic glioma or high risk low grade glioma. The trial will only enroll patients with 1p/19q co-deletion. This study includes two arms as described in the "Arms" section. A dynamic allocation procedure will be used to allocate an equal number of patients to different arms (Arms A:B = 1:1). This procedure will balance the marginal distributions of the stratification factors among arms. The stratification factors that will be used are cooperative groups (EORTC vs.#46; all North American groups), age (≤ 50 vs.#46; > 50), performance score (ECOG 0-1 vs.#46; 2), and tumor grade (anaplastic glioma vs.#46; low grade glioma). The primary goal is to determine whether patients who receive radiotherapy with concomitant temozolomide (TMZ) followed by adjuvant temozolomide (RT + TMZ --> TMZ) (Arm B) have a marginally better progression free survival (PFS) as compared with patients who receive radiotherapy followed by PCV chemotherapy (RT --> PCV)(Arm A). Secondary Goals: 1. Time to Progression
- - To determine whether patients who receive (RT + TMZ --> TMZ) have a significantly longer time to progression (clinical or radiographic progression) as compared with patients who receive radiotherapy followed by adjuvant PCV chemotherapy (RT --> PCV).
- - To determine whether there is a difference in survival based on t(1;19)(q10, p10) translocation status and MGMT promoter hypermethylation status.
- - To perform descriptive comparisons of additional secondary outcome endpoints, including overall survival, objective tumor response, prognostic factor analysis and quality of life.
- - To determine the toxicity of the treatment in each arm and perform descriptive comparisons.
- - To determine the neurocognitive and QOL effects in patients treated on this protocol and correlate these results with outcome endpoints.
- - To store blood products (i.e., plasma, DNA and buffy coat), tumor tissue and MRI/CT images for future scientific investigations.
Arms
Experimental: Arm A (RT, procarbazine, lomustine, vincristine)
Patients undergo 3D-CRT or IMRT on days 1-5 for 5-7 weeks. Patients also receive procarbazine hydrochloride PO on days 8-21, lomustine PO on day 1 and vincristine sulfate IV on days 8 and 29 of courses 3-8. Treatment repeats every 6-7 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Experimental: Arm B (RT, temozolomide)
Patients undergo RT as in arm I and receive temozolomide PO QD on days 1-5 for 5-7 weeks. Beginning 4 weeks after completion of concurrent chemoradiotherapy, patients receive adjuvant temozolomide PO QD days 1-5. Treatment with adjuvant temozolomide repeats every 4 weeks for 6-12 courses in the absence of disease progression and unacceptable toxicity.
Interventions
Drug: - concomitant temozolomide (TMZ)
75 mg/m^2, orally daily
Radiation: - radiotherapy
Drug: - procarbazine
Days 8-21: 60 mg/m^2 orally
Drug: - adjuvant temozolomide (TMZ)
150 or 200 mg/m^2 orally
Drug: - CCNU
Day 1: 110 mg/m^2 orally
Drug: - vincristine
Days 8 and 29: 1.4 mg/m^2 IV
Contact a Trial Team
If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.
Status
Address
University of Alabama at Birmingham Cancer Center
Birmingham, Alabama, 35233
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Providence Hospital
Mobile, Alabama, 36608
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Anchorage Associates in Radiation Medicine
Anchorage, Alaska, 98508
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Address
Alaska Oncology and Hematology LLC
Anchorage, Alaska, 99508
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Address
Alaska Women's Cancer Care
Anchorage, Alaska, 99508
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Address
Anchorage Oncology Centre
Anchorage, Alaska, 99508
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Address
Katmai Oncology Group
Anchorage, Alaska, 99508
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Address
Providence Alaska Medical Center
Anchorage, Alaska, 99508
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Address
Saint Joseph's Hospital and Medical Center
Phoenix, Arizona, 85013
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Address
Arizona Oncology-Deer Valley Center
Phoenix, Arizona, 85027
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Address
Arizona Oncology Services Foundation
Scottsdale, Arizona, 85260
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Address
Kaiser Permanente-Anaheim
Anaheim, California, 92806
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Address
Sutter Cancer Centers Radiation Oncology Services-Auburn
Auburn, California, 95603
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Address
Mills-Peninsula Medical Center
Burlingame, California, 94010
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Address
Sutter Cancer Centers Radiation Oncology Services-Cameron Park
Cameron Park, California, 95682
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Address
Community Cancer Institute
Clovis, California, 93611
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Address
University Oncology Associates
Clovis, California, 93611
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Address
UC San Diego Moores Cancer Center
La Jolla, California, 92093
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Address
Kaiser Permanente Los Angeles Medical Center
Los Angeles, California, 90027
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Cedars Sinai Medical Center
Los Angeles, California, 90048
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Address
Memorial Medical Center
Modesto, California, 95355
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Address
Kaiser Permanente Oakland-Broadway
Oakland, California, 94611
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Address
Kaiser Permanente-Ontario
Ontario, California, 91761
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Address
UC Irvine Health/Chao Family Comprehensive Cancer Center
Orange, California, 92868
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Address
Sutter Cancer Centers Radiation Oncology Services-Roseville
Roseville, California, 95661
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Address
Sutter Roseville Medical Center
Roseville, California, 95661
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Address
Sutter Medical Center Sacramento
Sacramento, California, 95816
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Address
University of California Davis Comprehensive Cancer Center
Sacramento, California, 95817
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Address
Kaiser Permanente Medical Center - Santa Clara
Santa Clara, California, 95051
Status
Address
Kaiser Permanente-South San Francisco
South San Francisco, California, 94080
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Address
Sutter Cancer Centers Radiation Oncology Services-Vacaville
Vacaville, California, 95687
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Address
Sutter Solano Medical Center/Cancer Center
Vallejo, California, 94589
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Address
The Medical Center of Aurora
Aurora, Colorado, 80012
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Address
UCHealth University of Colorado Hospital
Aurora, Colorado, 80045
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Address
Penrose-Saint Francis Healthcare
Colorado Springs, Colorado, 80907
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Address
Rocky Mountain Cancer Centers-Penrose
Colorado Springs, Colorado, 80907
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Address
UCHealth Memorial Hospital Central
Colorado Springs, Colorado, 80909
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Address
Saint Francis Cancer Center
Colorado Springs, Colorado, 80923
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Address
Porter Adventist Hospital
Denver, Colorado, 80210
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Address
Saint Anthony Hospital
Lakewood, Colorado, 80228
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Address
Littleton Adventist Hospital
Littleton, Colorado, 80122
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Longmont United Hospital
Longmont, Colorado, 80501
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Address
Banner McKee Medical Center
Loveland, Colorado, 80539
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Address
Parker Adventist Hospital
Parker, Colorado, 80138
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Address
Saint Mary Corwin Medical Center
Pueblo, Colorado, 81004
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Address
Yale University
New Haven, Connecticut, 06520
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Address
Smilow Cancer Hospital Care Center-Trumbull
Trumbull, Connecticut, 06611
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Address
Sibley Memorial Hospital
Washington, District of Columbia, 20016
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Address
Boca Raton Regional Hospital
Boca Raton, Florida, 33486
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Address
University of Florida Health Science Center - Gainesville
Gainesville, Florida, 32610
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Address
Baptist MD Anderson Cancer Center
Jacksonville, Florida, 32207
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Address
Mayo Clinic in Florida
Jacksonville, Florida, 32224-9980
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Address
AdventHealth Orlando
Orlando, Florida, 32803
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Address
Orlando Health Cancer Institute
Orlando, Florida, 32806
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Address
Emory Proton Therapy Center
Atlanta, Georgia, 30308
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Address
Emory University Hospital Midtown
Atlanta, Georgia, 30308
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Address
Piedmont Hospital
Atlanta, Georgia, 30309
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Address
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia, 30322
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Address
Saint Alphonsus Cancer Care Center-Caldwell
Caldwell, Idaho, 83605
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Address
Saint Alphonsus Cancer Care Center-Nampa
Nampa, Idaho, 83687
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Address
Kootenai Clinic Cancer Services - Post Falls
Post Falls, Idaho, 83854
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Address
Illinois CancerCare-Bloomington
Bloomington, Illinois, 61704
Status
Address
Illinois CancerCare-Canton
Canton, Illinois, 61520
Status
Address
Illinois CancerCare-Carthage
Carthage, Illinois, 62321
Status
Address
Centralia Oncology Clinic
Centralia, Illinois, 62801
Status
Address
Northwestern University
Chicago, Illinois, 60611
Status
Address
University of Illinois
Chicago, Illinois, 60612
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Address
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
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Address
Cancer Care Specialists of Illinois - Decatur
Decatur, Illinois, 62526
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Address
Decatur Memorial Hospital
Decatur, Illinois, 62526
Status
Address
Crossroads Cancer Center
Effingham, Illinois, 62401
Status
Address
Illinois CancerCare-Eureka
Eureka, Illinois, 61530
Status
Address
Illinois CancerCare-Galesburg
Galesburg, Illinois, 61401
Status
Address
Western Illinois Cancer Treatment Center
Galesburg, Illinois, 61401
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Address
Illinois CancerCare-Kewanee Clinic
Kewanee, Illinois, 61443
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Address
AMITA Health Adventist Medical Center
La Grange, Illinois, 60525
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Address
Illinois CancerCare-Macomb
Macomb, Illinois, 61455
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Address
Loyola University Medical Center
Maywood, Illinois, 60153
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Address
Cancer Care Center of O'Fallon
O'Fallon, Illinois, 62269
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Address
Illinois CancerCare-Ottawa Clinic
Ottawa, Illinois, 61350
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Address
Advocate Lutheran General Hospital
Park Ridge, Illinois, 60068
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Address
Illinois CancerCare-Pekin
Pekin, Illinois, 61554
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Address
OSF Saint Francis Radiation Oncology at Pekin
Pekin, Illinois, 61554
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Address
Illinois CancerCare-Peoria
Peoria, Illinois, 61615
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Address
OSF Saint Francis Radiation Oncology at Peoria Cancer Center
Peoria, Illinois, 61615
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Address
Methodist Medical Center of Illinois
Peoria, Illinois, 61636
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Address
OSF Saint Francis Medical Center
Peoria, Illinois, 61637
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Address
Illinois CancerCare-Peru
Peru, Illinois, 61354
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Address
Valley Radiation Oncology
Peru, Illinois, 61354
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Address
Illinois CancerCare-Princeton
Princeton, Illinois, 61356
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Address
Memorial Medical Center
Springfield, Illinois, 62781
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Address
Parkview Hospital Randallia
Fort Wayne, Indiana, 46805
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Address
Parkview Regional Medical Center
Fort Wayne, Indiana, 46845
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Address
Memorial Regional Cancer Center Day Road
Mishawaka, Indiana, 46545
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Address
Memorial Hospital of South Bend
South Bend, Indiana, 46601
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Address
McFarland Clinic - Ames
Ames, Iowa, 50010
Status
Address
Mercy Cancer Center-West Lakes
Clive, Iowa, 50325
Status
Address
Mission Cancer and Blood - West Des Moines
Clive, Iowa, 50325
Status
Address
Greater Regional Medical Center
Creston, Iowa, 50801
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Address
Iowa Methodist Medical Center
Des Moines, Iowa, 50309
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Address
Mission Cancer and Blood - Des Moines
Des Moines, Iowa, 50309
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Address
Broadlawns Medical Center
Des Moines, Iowa, 50314
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Address
Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
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Address
Mission Cancer and Blood - Laurel
Des Moines, Iowa, 50314
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Address
Iowa Lutheran Hospital
Des Moines, Iowa, 50316
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Address
Methodist West Hospital
West Des Moines, Iowa, 50266-7700
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Address
Mercy Medical Center-West Lakes
West Des Moines, Iowa, 50266
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Address
University of Kansas Cancer Center
Kansas City, Kansas, 66160
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Address
University of Kansas Cancer Center-Overland Park
Overland Park, Kansas, 66210
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Address
University of Kansas Hospital-Indian Creek Campus
Overland Park, Kansas, 66211
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Address
University of Kansas Hospital-Westwood Cancer Center
Westwood, Kansas, 66205
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Address
University of Kentucky/Markey Cancer Center
Lexington, Kentucky, 40536
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Address
Norton Hospital Pavilion and Medical Campus
Louisville, Kentucky, 40202
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Address
Norton Brownsboro Hospital and Medical Campus
Louisville, Kentucky, 40241
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Address
West Jefferson Medical Center
Marrero, Louisiana, 70072
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Address
Maine Medical Center-Bramhall Campus
Portland, Maine, 04102
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Address
Maine Medical Center- Scarborough Campus
Scarborough, Maine, 04074
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Address
Maine Medical Partners Neurology
Scarborough, Maine, 04074
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Address
Maine Medical Partners - South Portland
South Portland, Maine, 04106
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Address
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore, Maryland, 21287
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Address
Walter Reed National Military Medical Center
Bethesda, Maryland, 20889-5600
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Address
Cancer Trials Support Unit
Rockville, Maryland, 20850-2062
Status
Address
Massachusetts General Hospital Cancer Center
Boston, Massachusetts, 02114
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Address
Bixby Medical Center
Adrian, Michigan, 49221
Status
Address
University of Michigan Comprehensive Cancer Center
Ann Arbor, Michigan, 48109
Status
Address
Henry Ford Hospital
Detroit, Michigan, 48202
Status
Address
Corewell Health Grand Rapids Hospitals - Butterworth Hospital
Grand Rapids, Michigan, 49503
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Address
Trinity Health Grand Rapids Hospital
Grand Rapids, Michigan, 49503
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Address
West Michigan Cancer Center
Kalamazoo, Michigan, 49007
Status
Address
Corewell Health William Beaumont University Hospital
Royal Oak, Michigan, 48073
Status
Address
Munson Medical Center
Traverse City, Michigan, 49684
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Address
Corewell Health Beaumont Troy Hospital
Troy, Michigan, 48085
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Address
University of Michigan Health - West
Wyoming, Michigan, 49519
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Address
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
Status
Address
Mercy Hospital
Coon Rapids, Minnesota, 55433
Status
Address
Essentia Health Cancer Center
Duluth, Minnesota, 55805
Status
Address
Miller-Dwan Hospital
Duluth, Minnesota, 55805
Status
Address
Fairview Southdale Hospital
Edina, Minnesota, 55435
Status
Address
Unity Hospital
Fridley, Minnesota, 55432
Status
Address
Minnesota Oncology Hematology PA-Maplewood
Maplewood, Minnesota, 55109
Status
Address
Saint John's Hospital - Healtheast
Maplewood, Minnesota, 55109
Status
Address
Abbott-Northwestern Hospital
Minneapolis, Minnesota, 55407
Status
Address
Hennepin County Medical Center
Minneapolis, Minnesota, 55415
Status
Address
North Memorial Medical Health Center
Robbinsdale, Minnesota, 55422
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Address
Mayo Clinic in Rochester
Rochester, Minnesota, 55905
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Address
Coborn Cancer Center at Saint Cloud Hospital
Saint Cloud, Minnesota, 56303
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Address
Park Nicollet Clinic - Saint Louis Park
Saint Louis Park, Minnesota, 55416
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Address
Regions Hospital
Saint Paul, Minnesota, 55101
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Address
United Hospital
Saint Paul, Minnesota, 55102
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Address
Saint Francis Regional Medical Center
Shakopee, Minnesota, 55379
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Address
Lakeview Hospital
Stillwater, Minnesota, 55082
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Address
Ridgeview Medical Center
Waconia, Minnesota, 55387
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Address
Rice Memorial Hospital
Willmar, Minnesota, 56201
Status
Address
Minnesota Oncology Hematology PA-Woodbury
Woodbury, Minnesota, 55125
Status
Address
Saint Francis Medical Center
Cape Girardeau, Missouri, 63703
Status
Address
MU Health - University Hospital/Ellis Fischel Cancer Center
Columbia, Missouri, 65212
Status
Address
University of Kansas Cancer Center - North
Kansas City, Missouri, 64154
Status
Address
University of Kansas Cancer Center - Lee's Summit
Lee's Summit, Missouri, 64064
Status
Address
University of Kansas Cancer Center at North Kansas City Hospital
North Kansas City, Missouri, 64116
Status
Address
Washington University School of Medicine
Saint Louis, Missouri, 63110
Status
Address
Mercy Hospital Saint Louis
Saint Louis, Missouri, 63141
Status
Address
Billings Clinic Cancer Center
Billings, Montana, 59101
Status
Address
Saint Vincent Healthcare
Billings, Montana, 59101
Status
Address
Benefis Sletten Cancer Institute
Great Falls, Montana, 59405
Status
Address
Great Falls Clinic
Great Falls, Montana, 59405
Status
Address
Nebraska Cancer Specialists/Oncology Hematology West PC
Grand Island, Nebraska, 68803
Status
Address
CHI Health Good Samaritan
Kearney, Nebraska, 68847
Status
Address
Nebraska Hematology and Oncology
Lincoln, Nebraska, 68506
Status
Address
Cancer Partners of Nebraska
Lincoln, Nebraska, 68516
Status
Address
Missouri Valley Cancer Consortium
Omaha, Nebraska, 68106
Status
Address
Alegent Health Immanuel Medical Center
Omaha, Nebraska, 68122
Status
Address
Alegent Health Bergan Mercy Medical Center
Omaha, Nebraska, 68124
Status
Address
Nebraska Cancer Specialists - Omaha
Omaha, Nebraska, 68124
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Address
Alegent Health Lakeside Hospital
Omaha, Nebraska, 68130
Status
Address
University of Nebraska Medical Center
Omaha, Nebraska, 68198
Status
Address
Midlands Community Hospital
Papillion, Nebraska, 68046
Status
Address
Regional West Medical Center Cancer Center
Scottsbluff, Nebraska, 69361
Status
Address
Radiation Oncology Centers of Nevada Central
Las Vegas, Nevada, 89106
Status
Address
GenesisCare USA - Las Vegas
Las Vegas, Nevada, 89109
Status
Address
Radiation Oncology Centers of Nevada Southeast
Las Vegas, Nevada, 89119
Status
Address
Comprehensive Cancer Centers of Nevada
Las Vegas, Nevada, 89148
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Address
Comprehensive Cancer Centers of Nevada - Central Valley
Las Vegas, Nevada, 89169
Status
Address
Renown Regional Medical Center
Reno, Nevada, 89502
Status
Address
Saint Mary's Regional Medical Center
Reno, Nevada, 89503
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Address
Radiation Oncology Associates
Reno, Nevada, 89509
Status
Address
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon, New Hampshire, 03756
Status
Address
Jersey Shore Medical Center
Neptune, New Jersey, 07753
Status
Address
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
New Brunswick, New Jersey, 08903
Status
Address
Rutgers Cancer Institute of New Jersey
New Brunswick, New Jersey, 08903
Status
Address
Overlook Hospital
Summit, New Jersey, 07902
Status
Address
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87106
Status
Address
New York-Presbyterian/Brooklyn Methodist Hospital
Brooklyn, New York, 11215
Status
Address
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
New York, New York, 10032
Status
Address
Highland Hospital
Rochester, New York, 14620
Status
Address
University of Rochester
Rochester, New York, 14642
Status
Address
State University of New York Upstate Medical University
Syracuse, New York, 13210
Status
Address
Wake Forest University Health Sciences
Winston-Salem, North Carolina, 27157
Status
Address
Altru Cancer Center
Grand Forks, North Dakota, 58201
Status
Address
Case Western Reserve University
Cleveland, Ohio, 44106
Status
Address
MetroHealth Medical Center
Cleveland, Ohio, 44109
Status
Address
Cleveland Clinic Foundation
Cleveland, Ohio, 44195
Status
Address
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210
Status
Address
Riverside Methodist Hospital
Columbus, Ohio, 43214
Status
Address
The Mark H Zangmeister Center
Columbus, Ohio, 43219
Status
Address
Mount Carmel Health Center West
Columbus, Ohio, 43222
Status
Address
Hillcrest Hospital Cancer Center
Mayfield Heights, Ohio, 44124
Status
Address
ProMedica Flower Hospital
Sylvania, Ohio, 43560
Status
Address
Saint Ann's Hospital
Westerville, Ohio, 43081
Status
Address
Cleveland Clinic Wooster Family Health and Surgery Center
Wooster, Ohio, 44691
Status
Address
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Status
Address
Oklahoma Cancer Specialists and Research Institute-Tulsa
Tulsa, Oklahoma, 74146
Status
Address
Clackamas Radiation Oncology Center
Clackamas, Oregon, 97015
Status
Address
Legacy Mount Hood Medical Center
Gresham, Oregon, 97030
Status
Address
Legacy Good Samaritan Hospital and Medical Center
Portland, Oregon, 97210
Status
Address
Providence Portland Medical Center
Portland, Oregon, 97213
Status
Address
Providence Saint Vincent Medical Center
Portland, Oregon, 97225
Status
Address
Jefferson Abington Hospital
Abington, Pennsylvania, 19001
Status
Address
Lehigh Valley Hospital-Cedar Crest
Allentown, Pennsylvania, 18103
Status
Address
Saint Luke's University Hospital-Bethlehem Campus
Bethlehem, Pennsylvania, 18015
Status
Address
Geisinger Medical Center
Danville, Pennsylvania, 17822
Status
Address
Saint Luke's Hospital-Anderson Campus
Easton, Pennsylvania, 18045
Status
Address
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, 19107
Status
Address
Temple University Hospital
Philadelphia, Pennsylvania, 19140
Status
Address
Allegheny General Hospital
Pittsburgh, Pennsylvania, 15212
Status
Address
University of Pittsburgh Cancer Institute (UPCI)
Pittsburgh, Pennsylvania, 15232
Status
Address
Reading Hospital
West Reading, Pennsylvania, 19611
Status
Address
Geisinger Wyoming Valley/Henry Cancer Center
Wilkes-Barre, Pennsylvania, 18711
Status
Address
Prisma Health Cancer Institute - Spartanburg
Boiling Springs, South Carolina, 29316
Status
Address
Medical University of South Carolina
Charleston, South Carolina, 29425
Status
Address
Greenville Health System Cancer Institute-Andrews
Greenville, South Carolina, 29601
Status
Address
Prisma Health Cancer Institute - Butternut
Greenville, South Carolina, 29605
Status
Address
Prisma Health Cancer Institute - Faris
Greenville, South Carolina, 29605
Status
Address
Prisma Health Cancer Institute - Eastside
Greenville, South Carolina, 29615
Status
Address
Prisma Health Cancer Institute - Greer
Greer, South Carolina, 29650
Status
Address
Prisma Health Cancer Institute - Seneca
Seneca, South Carolina, 29672
Status
Address
Spartanburg Medical Center
Spartanburg, South Carolina, 29303
Status
Address
Rapid City Regional Hospital
Rapid City, South Dakota, 57701
Status
Address
Vanderbilt University/Ingram Cancer Center
Nashville, Tennessee, 37232
Status
Address
Parkland Memorial Hospital
Dallas, Texas, 75235
Status
Address
UT Southwestern/Simmons Cancer Center-Dallas
Dallas, Texas, 75390
Status
Address
University of Texas Medical Branch
Galveston, Texas, 77555-0565
Status
Address
UTMB Cancer Center at Victory Lakes
League City, Texas, 77573
Status
Address
Sandra L Maxwell Cancer Center
Cedar City, Utah, 84720
Status
Address
Intermountain Medical Center
Murray, Utah, 84107
Status
Address
Utah Valley Regional Medical Center
Provo, Utah, 84604
Status
Address
Saint George Regional Medical Center
Saint George, Utah, 84770
Status
Address
Utah Cancer Specialists-Salt Lake City
Salt Lake City, Utah, 84106
Status
Address
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, 84112
Status
Address
LDS Hospital
Salt Lake City, Utah, 84143
Status
Address
Dartmouth Cancer Center - North
Saint Johnsbury, Vermont, 05819
Status
Address
Virginia Commonwealth University/Massey Cancer Center
Richmond, Virginia, 23298
Status
Address
VCU Community Memorial Health Center
South Hill, Virginia, 23970
Status
Address
PeaceHealth Saint Joseph Medical Center
Bellingham, Washington, 98225
Status
Address
Kadlec Clinic Hematology and Oncology
Kennewick, Washington, 99336
Status
Address
Tri-Cities Cancer Center
Kennewick, Washington, 99336
Status
Address
Skagit Regional Health Cancer Care Center
Mount Vernon, Washington, 98274
Status
Address
Skagit Valley Hospital
Mount Vernon, Washington, 98274
Status
Address
Virginia Mason Medical Center
Seattle, Washington, 98101
Status
Address
FHCC South Lake Union
Seattle, Washington, 98109
Status
Address
Fred Hutchinson Cancer Center
Seattle, Washington, 98109
Status
Address
University of Washington Medical Center - Montlake
Seattle, Washington, 98195
Status
Address
PeaceHealth Southwest Medical Center
Vancouver, Washington, 98664
Status
Address
West Virginia University Healthcare
Morgantown, West Virginia, 26506
Status
Address
Northwest Wisconsin Cancer Center
Ashland, Wisconsin, 54806
Status
Address
Gundersen Lutheran Medical Center
La Crosse, Wisconsin, 54601
Status
Address
Aurora Saint Luke's Medical Center
Milwaukee, Wisconsin, 53215
Status
Address
Medical College of Wisconsin
Milwaukee, Wisconsin, 53226
Status
Address
ProHealth D N Greenwald Center
Mukwonago, Wisconsin, 53149
Status
Address
ProHealth Oconomowoc Memorial Hospital
Oconomowoc, Wisconsin, 53066
Status
Address
ProHealth Waukesha Memorial Hospital
Waukesha, Wisconsin, 53188
Status
Address
UW Cancer Center at ProHealth Care
Waukesha, Wisconsin, 53188
International Sites
Status
Address
Medical University Vienna
Vienna, , A-1090
Status
Address
Alegemeen Ziekenhuis Middelheim
Antwerpen, , 2020
Status
Address
Tom Baker Cancer Centre
Calgary, Alberta, T2N 4N2
Status
Address
Cross Cancer Institute
Edmonton, Alberta, T6G 1Z2
Status
Address
BCCA-Vancouver Cancer Centre
Vancouver, British Columbia, V5Z 4E6
Status
Address
CancerCare Manitoba
Winnipeg, Manitoba, R3E 0V9
Status
Address
London Regional Cancer Program
London, Ontario, N6A 4L6
Status
Address
Ottawa Hospital and Cancer Center-General Campus
Ottawa, Ontario, K1H 8L6
Status
Address
Odette Cancer Centre- Sunnybrook Health Sciences Centre
Toronto, Ontario, M4N 3M5
Status
Address
University Health Network-Princess Margaret Hospital
Toronto, Ontario, M5G 2M9
Status
Address
CHUM - Hopital Notre-Dame
Montreal, Quebec, H2L 4M1
Status
Address
CHUM - Centre Hospitalier de l'Universite de Montreal
Montreal, Quebec, H2X 3E4
Status
Address
Allan Blair Cancer Centre
Regina, Saskatchewan, S4T 7T1
Status
Address
Centre Leon Berard
Lyon, , 69373
Status
Address
Centre Antoine Lacassagne
Nice, , 06189
Status
Address
Gustave Roussy
Villejuif, , 94805
Status
Address
Academ Zienkenhuis Bij De University
Amsterdam, , 1007 MB
Status
Address
University Medical Center Groningen
Groningen, , 9700 GZ
Status
Address
Maastro Clinic-Maastricht Radiation Oncology
Maastricht, , 6229 NA
Status
Address
Erasmus University Medical Center
Rotterdam, , 3015 CE
