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Maintenance Chemotherapy or Observation Following Induction Chemotherapy and Radiation Therapy in Treating Patients With Newly Diagnosed Ependymoma
Study Purpose
The primary aim of this randomized phase III trial was to study whether the addition of maintenance chemotherapy delivered after surgical resection and focal radiation would be better than surgery and focal radiation alone. The trial also studied if patients who received induction chemotherapy and then either achieved a complete response or went on to have a complete resection would also benefit from maintenance chemotherapy. Children ages 1-21 years with newly diagnosed intracranial ependymoma were included. There were 2 arms that were not randomized. One arm studied patients with Grade II tumors located in the supratentorial compartment that were completely resected. One arm studied patients with residual tumor and those patients all received maintenance chemotherapy after focal radiation. Chemotherapy drugs, such as vincristine sulfate, carboplatin, cyclophosphamide, etoposide, and cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Radiation therapy uses high-energy x-rays to kill tumor cells. Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. Giving chemotherapy in combination with radiation therapy may kill more tumor cells and allow doctors to save the part of the body where the cancer started.
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 |
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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 | 12 Months - 21 Years |
| Gender | All |
Inclusion Criteria:
- - Patients must be newly diagnosed with histologically confirmed intracranial ependymoma; patients with classic ependymoma (WHO II) or anaplastic ependymoma (WHO III) are eligible, as are various subtypes described as clear cell, papillary, cellular or a combination of the above.
- - There is no minimum performance level; children with ependymoma may suffer neurologic sequelae as a result of their tumor or surgical measures taken to establish a diagnosis and resect the tumor; in the majority of cases, there is neurologic recovery; neurologic recovery is not likely to be impeded by protocol therapy.
- - REGULATORY: All patients and/or their parents or legal guardians must sign a written informed consent.
- - REGULATORY: All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met.
Exclusion Criteria:
- - Patients with evidence of metastatic disease will be excluded; any evidence of non-contiguous spread beyond the primary site as determined by pre or post-operative magnetic resonance (MR) imaging of brain, pre or post-operative MR imaging of the spine, and post-operative cerebrospinal fluid (CSF) cytology obtained from the lumbar CSF space (the requirement for lumbar CSF examination may be waived if deemed to be medically contraindicated); CSF cytology from a ventriculostomy or permanent ventriculoperitoneal (VP) shunt that reveals the presence of tumor cells is indicative of metastatic disease.
- - Patients with a diagnosis of spinal cord ependymoma, myxopapillary ependymoma, subependymoma, ependymoblastoma, or mixed glioma are NOT eligible.
- - No prior treatment other than surgical intervention and corticosteroids; patients are allowed to have had more than one attempt at resection prior to enrollment.
- - Pregnant female patients are not eligible for this study.
- - Post-menarchal females may not participate unless a pregnancy test with a negative result has been obtained.
- - Males and females of reproductive potential may not participate unless they have agreed to use an effective contraceptive method.
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. |
NCT01096368 |
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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. |
Children's Oncology Group |
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Principal Investigator
The person who is responsible for the scientific and technical direction of the entire clinical study. |
Amy A Smith |
| Principal Investigator Affiliation | Children's Oncology Group |
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Agency Class
Category of organization(s) involved as sponsor (and collaborator) supporting the trial. |
Other, NIH |
| Overall Status | Active, not recruiting |
| Countries | Australia, Canada, New Zealand, United States |
|
Conditions
The disease, disorder, syndrome, illness, or injury that is being studied. |
Anaplastic Ependymoma, Brain Ependymoma, Cellular Ependymoma, Clear Cell Ependymoma, Ependymoma, Papillary Ependymoma |
PRIMARY OBJECTIVE:
- I. To determine the event free survival (EFS) and overall survival (OS) of children with completely resected ependymoma treated with post-operative conformal radiation therapy (cRT) and then randomized to receive or not receive four cycles of post radiation maintenance chemotherapy (vincristine, cisplatin, etoposide and cyclophosphamide [VCEC]).
- I. To estimate the EFS and OS of children with incompletely resected ependymoma who are unable to achieve a complete response (CR) by post-operative induction chemotherapy or by second surgery who will then be non-randomly assigned to cRT followed by four cycles of maintenance chemotherapy (VCEC).
- II. To further evaluate the EFS and OS of children with supratentorial classic ependymoma who achieve a complete resection at first or second resection OR children who achieve a CR to short course induction chemotherapy following first surgery.
- III. To evaluate whether the addition of maintenance chemotherapy post-radiation therapy contributes to neurobehavioral morbidity and reduced functional outcomes over time, compared to patients treated with radiation therapy followed by observation alone.
- IV. To examine differences in neurobehavioral outcomes and quality of life of children treated with proton beam radiation therapy compared to children treated with conventional radiation delivery techniques.
- V. To evaluate biologic prognostic factors in childhood ependymoma by studying molecular groups as defined by deoxyribonucleic acid (DNA) methylation profiling and immunohistochemistry, copy number variants to identify 1q gain in posterior fossa ependymomas, CDKN2A loss (homozygous deletion) in supratentorial ependymomas and specific genetic alterations such as RELA fusions, YAP1 fusions and the H3 K27M mutation on initial tumor samples and correlating these data with clinical outcome.
Arms
Experimental: Arm I (chemotherapy, observation)
Patients with classic histology(WHO Grade II) supratentorial ependymoma who have undergone microscopic gross total resection (GTR1) or achieved CR either after first or second resection or after post-operative induction chemotherapy are assigned to observation. For patients without GTR1, induction chemotherapy is comprised of vincristine intravenously (IV) over 1 minute on days 1 and 8 of cycles 1 and 2, carboplatin IV over 15-60 minutes on day 1 of cycles 1 and 2, and cyclophosphamide IV over 30-60 minutes on days 1-2 of cycle 1 only. Patients also receive etoposide IV over 60-120 minutes on days 1-3 of cycle 2 only. Cycle 1 continues for 3 weeks and cycle 2 continues for 4 weeks in the absence of disease progression or unacceptable toxicity.
Experimental: Arm II (radiotherapy, chemotherapy)
Patients with supratentorial ependymoma (Grade II without GTR1 or Grade III) or any infratentorial ependymoma who have undergone gross or near total resection (GTR or NTR) or achieved CR either after first or second resection or after post-operative induction chemotherapy are randomized to undergo conformal radiotherapy over 6-7 weeks followed by maintenance chemotherapy. Maintenance chemotherapy comprised of vincristine IV on days 1, 8, and 15 of cycles 1-3 only, etoposide IV over 60-120 minutes on days 1-3, cisplatin IV over 1-8 hours on day 1, and cyclophosphamide IV over 30-60 minutes on days 2-3. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity. Patients without GTR or NTR at enrollment require induction chemotherapy (see Arm I) and possibly second surgery before randomization.
Active Comparator: Arm III (radiotherapy, observation)
Patients with supratentorial ependymoma (Grade II without GTR1 or ST Grade III) or any infratentorial ependymoma (Grade II or III) who have undergone gross or near total resection or achieved CR either after first or second resection or after post-operative induction chemotherapy are randomized to undergo conformal radiotherapy over 6-7 weeks and then undergo observation. Patients without GTR or NTR at enrollment require induction chemotherapy (see Arm I) and possibly second surgery before randomization.
Active Comparator: ARM IV (radiotherapy, chemotherapy)
Patients with subtotal resection after induction chemotherapy (see Arm I) and second surgery are nonrandomly assigned to Arm II treatment.
Interventions
Radiation: - 3-Dimensional Conformal Radiation Therapy
Patients undergo conformal radiotherapy
Drug: - Carboplatin
Given IV
Drug: - Cisplatin
Given IV
Other: - Clinical Observation
Patients undergo observation
Drug: - Cyclophosphamide
Given IV
Drug: - Etoposide
Given IV
Biological: - Filgrastim
Given SC or IV
Other: - Laboratory Biomarker Analysis
Optional correlative studies
Drug: - Mesna
Given IV
Drug: - Vincristine
Given 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
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Children's Hospital of Alabama
Birmingham, Alabama, 35233
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University of Alabama at Birmingham Cancer Center
Birmingham, Alabama, 35233
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Banner Children's at Desert
Mesa, Arizona, 85202
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Phoenix Childrens Hospital
Phoenix, Arizona, 85016
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Banner University Medical Center - Tucson
Tucson, Arizona, 85719
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Arkansas Children's Hospital
Little Rock, Arkansas, 72202-3591
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University of Arkansas for Medical Sciences
Little Rock, Arkansas, 72205
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Kaiser Permanente Downey Medical Center
Downey, California, 90242
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City of Hope Comprehensive Cancer Center
Duarte, California, 91010
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Loma Linda University Medical Center
Loma Linda, California, 92354
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Miller Children's and Women's Hospital Long Beach
Long Beach, California, 90806
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Children's Hospital Los Angeles
Los Angeles, California, 90027
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Cedars Sinai Medical Center
Los Angeles, California, 90048
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Valley Children's Hospital
Madera, California, 93636
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UCSF Benioff Children's Hospital Oakland
Oakland, California, 94609
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Kaiser Permanente-Oakland
Oakland, California, 94611
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Children's Hospital of Orange County
Orange, California, 92868
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Lucile Packard Children's Hospital Stanford University
Palo Alto, California, 94304
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Sutter Medical Center Sacramento
Sacramento, California, 95816
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University of California Davis Comprehensive Cancer Center
Sacramento, California, 95817
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Rady Children's Hospital - San Diego
San Diego, California, 92123
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UCSF Medical Center-Parnassus
San Francisco, California, 94143
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UCSF Medical Center-Mission Bay
San Francisco, California, 94158
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Children's Hospital Colorado
Aurora, Colorado, 80045
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Connecticut Children's Medical Center
Hartford, Connecticut, 06106
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Yale University
New Haven, Connecticut, 06520
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Alfred I duPont Hospital for Children
Wilmington, Delaware, 19803
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MedStar Georgetown University Hospital
Washington, District of Columbia, 20007
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Children's National Medical Center
Washington, District of Columbia, 20010
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Address
Broward Health Medical Center
Fort Lauderdale, Florida, 33316
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Lee Memorial Health System
Fort Myers, Florida, 33901
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Golisano Children's Hospital of Southwest Florida
Fort Myers, Florida, 33908
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University of Florida Health Science Center - Gainesville
Gainesville, Florida, 32610
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Memorial Regional Hospital/Joe DiMaggio Children's Hospital
Hollywood, Florida, 33021
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Nemours Children's Clinic-Jacksonville
Jacksonville, Florida, 32207
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University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami, Florida, 33136
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Nicklaus Children's Hospital
Miami, Florida, 33155
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AdventHealth Orlando
Orlando, Florida, 32803
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Arnold Palmer Hospital for Children
Orlando, Florida, 32806
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Nemours Children's Clinic - Orlando
Orlando, Florida, 32806
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Orlando Health Cancer Institute
Orlando, Florida, 32806
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Nemours Children's Hospital
Orlando, Florida, 32827
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Nemours Children's Clinic - Pensacola
Pensacola, Florida, 32504
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Johns Hopkins All Children's Hospital
Saint Petersburg, Florida, 33701
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Saint Joseph's Hospital/Children's Hospital-Tampa
Tampa, Florida, 33607
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Saint Mary's Hospital
West Palm Beach, Florida, 33407
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Children's Healthcare of Atlanta - Egleston
Atlanta, Georgia, 30322
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Augusta University Medical Center
Augusta, Georgia, 30912
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Memorial Health University Medical Center
Savannah, Georgia, 31404
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Kapiolani Medical Center for Women and Children
Honolulu, Hawaii, 96826
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Saint Luke's Cancer Institute - Boise
Boise, Idaho, 83712
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Lurie Children's Hospital-Chicago
Chicago, Illinois, 60611
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University of Illinois
Chicago, Illinois, 60612
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University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
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Loyola University Medical Center
Maywood, Illinois, 60153
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Advocate Children's Hospital-Oak Lawn
Oak Lawn, Illinois, 60453
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Saint Jude Midwest Affiliate
Peoria, Illinois, 61637
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Southern Illinois University School of Medicine
Springfield, Illinois, 62702
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Riley Hospital for Children
Indianapolis, Indiana, 46202
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Address
Ascension Saint Vincent Indianapolis Hospital
Indianapolis, Indiana, 46260
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Address
Blank Children's Hospital
Des Moines, Iowa, 50309
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Address
University of Iowa/Holden Comprehensive Cancer Center
Iowa City, Iowa, 52242
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Address
University of Kentucky/Markey Cancer Center
Lexington, Kentucky, 40536
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Address
Norton Children's Hospital
Louisville, Kentucky, 40202
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Address
Tulane University Health Sciences Center
New Orleans, Louisiana, 70112
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Address
Children's Hospital New Orleans
New Orleans, Louisiana, 70118
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Address
Ochsner Medical Center Jefferson
New Orleans, Louisiana, 70121
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Address
Eastern Maine Medical Center
Bangor, Maine, 04401
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Maine Children's Cancer Program
Scarborough, Maine, 04074
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University of Maryland/Greenebaum Cancer Center
Baltimore, Maryland, 21201
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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
Tufts Children's Hospital
Boston, Massachusetts, 02111
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Address
Massachusetts General Hospital Cancer Center
Boston, Massachusetts, 02114
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Address
Dana-Farber Cancer Institute
Boston, Massachusetts, 02215
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Address
Baystate Medical Center
Springfield, Massachusetts, 01199
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Address
C S Mott Children's Hospital
Ann Arbor, Michigan, 48109
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Address
Wayne State University/Karmanos Cancer Institute
Detroit, Michigan, 48201
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Address
Ascension Saint John Hospital
Detroit, Michigan, 48236
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Address
Michigan State University Clinical Center
East Lansing, Michigan, 48824
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Address
Hurley Medical Center
Flint, Michigan, 48503
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Address
Helen DeVos Children's Hospital at Spectrum Health
Grand Rapids, Michigan, 49503
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Address
Bronson Methodist Hospital
Kalamazoo, Michigan, 49007
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Address
Children's Hospitals and Clinics of Minnesota - Minneapolis
Minneapolis, Minnesota, 55404
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University of Minnesota/Masonic Cancer Center
Minneapolis, Minnesota, 55455
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Mayo Clinic in Rochester
Rochester, Minnesota, 55905
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Address
University of Mississippi Medical Center
Jackson, Mississippi, 39216
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Address
Columbia Regional
Columbia, Missouri, 65201
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Address
Children's Mercy Hospitals and Clinics
Kansas City, Missouri, 64108
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Cardinal Glennon Children's Medical Center
Saint Louis, Missouri, 63104
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Address
Washington University School of Medicine
Saint Louis, Missouri, 63110
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Address
Mercy Hospital Saint Louis
Saint Louis, Missouri, 63141
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Address
Children's Hospital and Medical Center of Omaha
Omaha, Nebraska, 68114
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Address
University of Nebraska Medical Center
Omaha, Nebraska, 68198
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Address
University Medical Center of Southern Nevada
Las Vegas, Nevada, 89102
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Address
Sunrise Hospital and Medical Center
Las Vegas, Nevada, 89109
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Address
Alliance for Childhood Diseases/Cure 4 the Kids Foundation
Las Vegas, Nevada, 89135
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Address
Summerlin Hospital Medical Center
Las Vegas, Nevada, 89144
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Address
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon, New Hampshire, 03756
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Hackensack University Medical Center
Hackensack, New Jersey, 07601
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Saint Barnabas Medical Center
Livingston, New Jersey, 07039
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Morristown Medical Center
Morristown, New Jersey, 07960
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Saint Peter's University Hospital
New Brunswick, New Jersey, 08901
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Address
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
New Brunswick, New Jersey, 08903
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Newark Beth Israel Medical Center
Newark, New Jersey, 07112
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Saint Joseph's Regional Medical Center
Paterson, New Jersey, 07503
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Overlook Hospital
Summit, New Jersey, 07902
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University of New Mexico Cancer Center
Albuquerque, New Mexico, 87102
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Albany Medical Center
Albany, New York, 12208
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Montefiore Medical Center - Moses Campus
Bronx, New York, 10467
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Roswell Park Cancer Institute
Buffalo, New York, 14263
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NYU Winthrop Hospital
Mineola, New York, 11501
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The Steven and Alexandra Cohen Children's Medical Center of New York
New Hyde Park, New York, 11040
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Laura and Isaac Perlmutter Cancer Center at NYU Langone
New York, New York, 10016
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Mount Sinai Hospital
New York, New York, 10029
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NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
New York, New York, 10032
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Memorial Sloan Kettering Cancer Center
New York, New York, 10065
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Address
University of Rochester
Rochester, New York, 14642
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Address
State University of New York Upstate Medical University
Syracuse, New York, 13210
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Address
New York Medical College
Valhalla, New York, 10595
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UNC Lineberger Comprehensive Cancer Center
Chapel Hill, North Carolina, 27599
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Carolinas Medical Center/Levine Cancer Institute
Charlotte, North Carolina, 28203
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Address
Novant Health Presbyterian Medical Center
Charlotte, North Carolina, 28204
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Address
Wake Forest University Health Sciences
Winston-Salem, North Carolina, 27157
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Sanford Broadway Medical Center
Fargo, North Dakota, 58122
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Address
Children's Hospital Medical Center of Akron
Akron, Ohio, 44308
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Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, 45229
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Rainbow Babies and Childrens Hospital
Cleveland, Ohio, 44106
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Address
Cleveland Clinic Foundation
Cleveland, Ohio, 44195
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Nationwide Children's Hospital
Columbus, Ohio, 43205
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Address
Dayton Children's Hospital
Dayton, Ohio, 45404
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Address
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
Toledo, Ohio, 43606
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Address
Mercy Children's Hospital
Toledo, Ohio, 43608
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Address
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
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Address
Legacy Emanuel Children's Hospital
Portland, Oregon, 97227
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Address
Lehigh Valley Hospital-Cedar Crest
Allentown, Pennsylvania, 18103
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Address
Lehigh Valley Hospital - Muhlenberg
Bethlehem, Pennsylvania, 18017
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Address
Geisinger Medical Center
Danville, Pennsylvania, 17822
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Address
Penn State Children's Hospital
Hershey, Pennsylvania, 17033
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Address
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, 19104
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Address
Saint Christopher's Hospital for Children
Philadelphia, Pennsylvania, 19134
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Children's Hospital of Pittsburgh of UPMC
Pittsburgh, Pennsylvania, 15224
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Address
Rhode Island Hospital
Providence, Rhode Island, 02903
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Address
Medical University of South Carolina
Charleston, South Carolina, 29425
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Address
Prisma Health Richland Hospital
Columbia, South Carolina, 29203
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Address
BI-LO Charities Children's Cancer Center
Greenville, South Carolina, 29605
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Greenville Cancer Treatment Center
Greenville, South Carolina, 29605
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Address
Sanford USD Medical Center - Sioux Falls
Sioux Falls, South Dakota, 57117-5134
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Address
T C Thompson Children's Hospital
Chattanooga, Tennessee, 37403
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Address
East Tennessee Childrens Hospital
Knoxville, Tennessee, 37916
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Saint Jude Children's Research Hospital
Memphis, Tennessee, 38105
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Address
The Children's Hospital at TriStar Centennial
Nashville, Tennessee, 37203
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Address
Vanderbilt University/Ingram Cancer Center
Nashville, Tennessee, 37232
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Address
Dell Children's Medical Center of Central Texas
Austin, Texas, 78723
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Address
Driscoll Children's Hospital
Corpus Christi, Texas, 78411
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Address
Medical City Dallas Hospital
Dallas, Texas, 75230
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Address
Cook Children's Medical Center
Fort Worth, Texas, 76104
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Address
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
Houston, Texas, 77030
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Address
Covenant Children's Hospital
Lubbock, Texas, 79410
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Address
UMC Cancer Center / UMC Health System
Lubbock, Texas, 79415
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Address
Children's Hospital of San Antonio
San Antonio, Texas, 78207
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Address
Methodist Children's Hospital of South Texas
San Antonio, Texas, 78229
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Address
University of Texas Health Science Center at San Antonio
San Antonio, Texas, 78229
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Address
Scott and White Memorial Hospital
Temple, Texas, 76508
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Address
Primary Children's Hospital
Salt Lake City, Utah, 84113
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Address
University of Vermont and State Agricultural College
Burlington, Vermont, 05405
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Address
Inova Fairfax Hospital
Falls Church, Virginia, 22042
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Address
Children's Hospital of The King's Daughters
Norfolk, Virginia, 23507
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Address
Naval Medical Center - Portsmouth
Portsmouth, Virginia, 23708-2197
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Address
Virginia Commonwealth University/Massey Cancer Center
Richmond, Virginia, 23298
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Address
Carilion Children's
Roanoke, Virginia, 24014
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Address
Seattle Children's Hospital
Seattle, Washington, 98105
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Address
Providence Sacred Heart Medical Center and Children's Hospital
Spokane, Washington, 99204
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Address
Mary Bridge Children's Hospital and Health Center
Tacoma, Washington, 98405
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Address
Madigan Army Medical Center
Tacoma, Washington, 98431
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Address
West Virginia University Charleston Division
Charleston, West Virginia, 25304
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Address
West Virginia University Healthcare
Morgantown, West Virginia, 26506
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Address
Saint Vincent Hospital Cancer Center Green Bay
Green Bay, Wisconsin, 54301
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Address
University of Wisconsin Carbone Cancer Center
Madison, Wisconsin, 53792
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Address
Marshfield Medical Center-Marshfield
Marshfield, Wisconsin, 54449
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Children's Hospital of Wisconsin
Milwaukee, Wisconsin, 53226
International Sites
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John Hunter Children's Hospital
Hunter Regional Mail Centre, New South Wales, 2310
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Address
Sydney Children's Hospital
Randwick, New South Wales, 2031
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Address
The Children's Hospital at Westmead
Westmead, New South Wales, 2145
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Address
Royal Brisbane and Women's Hospital
Herston, Queensland, 4029
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Address
Royal Children's Hospital-Brisbane
Herston, Queensland, 4029
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Address
Queensland Children's Hospital
South Brisbane, Queensland, 4101
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Address
Women's and Children's Hospital-Adelaide
North Adelaide, South Australia, 5006
Status
Address
Monash Medical Center-Clayton Campus
Clayton, Victoria, 3168
Status
Address
Royal Children's Hospital
Parkville, Victoria, 3052
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Address
Princess Margaret Hospital for Children
Perth, Western Australia, 6008
Status
Address
Perth Children's Hospital
Perth, Western Australia, 6009
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Address
Alberta Children's Hospital
Calgary, Alberta, T3B 6A8
Status
Address
University of Alberta Hospital
Edmonton, Alberta, T6G 2B7
Status
Address
British Columbia Children's Hospital
Vancouver, British Columbia, V6H 3V4
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Address
CancerCare Manitoba
Winnipeg, Manitoba, R3E 0V9
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Address
Janeway Child Health Centre
Saint John's, Newfoundland and Labrador, A1B 3V6
Status
Address
IWK Health Centre
Halifax, Nova Scotia, B3K 6R8
Status
Address
McMaster Children's Hospital at Hamilton Health Sciences
Hamilton, Ontario, L8N 3Z5
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Address
Kingston Health Sciences Centre
Kingston, Ontario, K7L 2V7
Status
Address
Children's Hospital
London, Ontario, N6A 5W9
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Address
Children's Hospital of Eastern Ontario
Ottawa, Ontario, K1H 8L1
Status
Address
Hospital for Sick Children
Toronto, Ontario, M5G 1X8
Status
Address
The Montreal Children's Hospital of the MUHC
Montreal, Quebec, H3H 1P3
Status
Address
Centre Hospitalier Universitaire Sainte-Justine
Montreal, Quebec, H3T 1C5
Status
Address
Saskatoon Cancer Centre
Saskatoon, Saskatchewan, S7N 4H4
Status
Address
CHU de Quebec-Centre Hospitalier de l'Universite Laval (CHUL)
Quebec, , G1V 4G2
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Address
Starship Children's Hospital
Grafton, Auckland, 1145
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Address
Christchurch Hospital
Christchurch, , 8011
