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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
Address
Children's Hospital of Alabama
Birmingham 4049979, Alabama 4829764, 35233
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University of Alabama at Birmingham Cancer Center
Birmingham 4049979, Alabama 4829764, 35233
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Address
Banner Children's at Desert
Mesa 5304391, Arizona 5551752, 85202
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Address
Phoenix Childrens Hospital
Phoenix 5308655, Arizona 5551752, 85016
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Address
Banner University Medical Center - Tucson
Tucson 5318313, Arizona 5551752, 85719
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Address
Arkansas Children's Hospital
Little Rock 4119403, Arkansas 4099753, 72202-3591
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Address
University of Arkansas for Medical Sciences
Little Rock 4119403, Arkansas 4099753, 72205
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Address
Kaiser Permanente Downey Medical Center
Downey 5343858, California 5332921, 90242
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Address
City of Hope Comprehensive Cancer Center
Duarte 5344147, California 5332921, 91010
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Address
Loma Linda University Medical Center
Loma Linda 5367696, California 5332921, 92354
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Address
Miller Children's and Women's Hospital Long Beach
Long Beach 5367929, California 5332921, 90806
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Address
Children's Hospital Los Angeles
Los Angeles 5368361, California 5332921, 90027
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Address
Cedars Sinai Medical Center
Los Angeles 5368361, California 5332921, 90048
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Address
Valley Children's Hospital
Madera 5369568, California 5332921, 93636
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Address
UCSF Benioff Children's Hospital Oakland
Oakland 5378538, California 5332921, 94609
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Address
Kaiser Permanente-Oakland
Oakland 5378538, California 5332921, 94611
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Address
Children's Hospital of Orange County
Orange 5379513, California 5332921, 92868
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Address
Lucile Packard Children's Hospital Stanford University
Palo Alto 5380748, California 5332921, 94304
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Address
Sutter Medical Center Sacramento
Sacramento 5389489, California 5332921, 95816
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Address
University of California Davis Comprehensive Cancer Center
Sacramento 5389489, California 5332921, 95817
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Address
Rady Children's Hospital - San Diego
San Diego 5391811, California 5332921, 92123
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Address
UCSF Medical Center-Parnassus
San Francisco 5391959, California 5332921, 94143
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Address
UCSF Medical Center-Mission Bay
San Francisco 5391959, California 5332921, 94158
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Address
Children's Hospital Colorado
Aurora 5412347, Colorado 5417618, 80045
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Address
Connecticut Children's Medical Center
Hartford 4835797, Connecticut 4831725, 06106
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Address
Yale University
New Haven 4839366, Connecticut 4831725, 06520
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Address
Alfred I duPont Hospital for Children
Wilmington 4145381, Delaware 4142224, 19803
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Address
MedStar Georgetown University Hospital
Washington D.C. 4140963, District of Columbia 4138106, 20007
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Address
Children's National Medical Center
Washington D.C. 4140963, District of Columbia 4138106, 20010
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Address
Broward Health Medical Center
Fort Lauderdale 4155966, Florida 4155751, 33316
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Address
Lee Memorial Health System
Fort Myers 4155995, Florida 4155751, 33901
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Address
Golisano Children's Hospital of Southwest Florida
Fort Myers 4155995, Florida 4155751, 33908
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Address
University of Florida Health Science Center - Gainesville
Gainesville 4156404, Florida 4155751, 32610
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Address
Memorial Regional Hospital/Joe DiMaggio Children's Hospital
Hollywood 4158928, Florida 4155751, 33021
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Address
Nemours Children's Clinic-Jacksonville
Jacksonville 4160021, Florida 4155751, 32207
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Address
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami 4164138, Florida 4155751, 33136
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Address
Nicklaus Children's Hospital
Miami 4164138, Florida 4155751, 33155
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Address
AdventHealth Orlando
Orlando 4167147, Florida 4155751, 32803
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Arnold Palmer Hospital for Children
Orlando 4167147, Florida 4155751, 32806
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Address
Nemours Children's Clinic - Orlando
Orlando 4167147, Florida 4155751, 32806
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Address
Orlando Health Cancer Institute
Orlando 4167147, Florida 4155751, 32806
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Address
Nemours Children's Hospital
Orlando 4167147, Florida 4155751, 32827
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Address
Nemours Children's Clinic - Pensacola
Pensacola 4168228, Florida 4155751, 32504
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Address
Johns Hopkins All Children's Hospital
St. Petersburg 4171563, Florida 4155751, 33701
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Address
Saint Joseph's Hospital/Children's Hospital-Tampa
Tampa 4174757, Florida 4155751, 33607
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Address
Saint Mary's Hospital
West Palm Beach 4177887, Florida 4155751, 33407
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Address
Children's Healthcare of Atlanta - Egleston
Atlanta 4180439, Georgia 4197000, 30322
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Address
Augusta University Medical Center
Augusta 4180531, Georgia 4197000, 30912
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Address
Memorial Health University Medical Center
Savannah 4221552, Georgia 4197000, 31404
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Address
Kapiolani Medical Center for Women and Children
Honolulu 5856195, Hawaii 5855797, 96826
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Address
Saint Luke's Cancer Institute - Boise
Boise 5586437, Idaho 5596512, 83712
Status
Address
Lurie Children's Hospital-Chicago
Chicago 4887398, Illinois 4896861, 60611
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Address
University of Illinois
Chicago 4887398, Illinois 4896861, 60612
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Address
University of Chicago Comprehensive Cancer Center
Chicago 4887398, Illinois 4896861, 60637
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Address
Loyola University Medical Center
Maywood 4901514, Illinois 4896861, 60153
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Address
Advocate Children's Hospital-Oak Lawn
Oak Lawn 4904365, Illinois 4896861, 60453
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Address
Saint Jude Midwest Affiliate
Peoria 4905687, Illinois 4896861, 61637
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Address
Southern Illinois University School of Medicine
Springfield 4250542, Illinois 4896861, 62702
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Address
Riley Hospital for Children
Indianapolis 4259418, Indiana 4921868, 46202
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Address
Ascension Saint Vincent Indianapolis Hospital
Indianapolis 4259418, Indiana 4921868, 46260
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Address
Blank Children's Hospital
Des Moines 4853828, Iowa 4862182, 50309
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Address
University of Iowa/Holden Comprehensive Cancer Center
Iowa City 4862034, Iowa 4862182, 52242
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Address
University of Kentucky/Markey Cancer Center
Lexington 4297983, Kentucky 6254925, 40536
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Address
Norton Children's Hospital
Louisville 4299276, Kentucky 6254925, 40202
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Address
Tulane University Health Sciences Center
New Orleans 4335045, Louisiana 4331987, 70112
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Address
Children's Hospital New Orleans
New Orleans 4335045, Louisiana 4331987, 70118
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Address
Ochsner Medical Center Jefferson
New Orleans 4335045, Louisiana 4331987, 70121
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Address
Eastern Maine Medical Center
Bangor 4957280, Maine 4971068, 04401
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Address
Maine Children's Cancer Program
Scarborough 4977882, Maine 4971068, 04074
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Address
University of Maryland/Greenebaum Cancer Center
Baltimore 4347778, Maryland 4361885, 21201
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Address
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore 4347778, Maryland 4361885, 21287
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Address
Walter Reed National Military Medical Center
Bethesda 4348599, Maryland 4361885, 20889-5600
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Address
Tufts Children's Hospital
Boston 4930956, Massachusetts 6254926, 02111
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Address
Massachusetts General Hospital Cancer Center
Boston 4930956, Massachusetts 6254926, 02114
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Address
Dana-Farber Cancer Institute
Boston 4930956, Massachusetts 6254926, 02215
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Address
Baystate Medical Center
Springfield 4951788, Massachusetts 6254926, 01199
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Address
C S Mott Children's Hospital
Ann Arbor 4984247, Michigan 5001836, 48109
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Address
Wayne State University/Karmanos Cancer Institute
Detroit 4990729, Michigan 5001836, 48201
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Address
Ascension Saint John Hospital
Detroit 4990729, Michigan 5001836, 48236
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Address
Michigan State University Clinical Center
East Lansing 4991640, Michigan 5001836, 48824
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Address
Hurley Medical Center
Flint 4992982, Michigan 5001836, 48503
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Address
Helen DeVos Children's Hospital at Spectrum Health
Grand Rapids 4994358, Michigan 5001836, 49503
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Address
Bronson Methodist Hospital
Kalamazoo 4997787, Michigan 5001836, 49007
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Address
Children's Hospitals and Clinics of Minnesota - Minneapolis
Minneapolis 5037649, Minnesota 5037779, 55404
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Address
University of Minnesota/Masonic Cancer Center
Minneapolis 5037649, Minnesota 5037779, 55455
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Address
Mayo Clinic in Rochester
Rochester 5043473, Minnesota 5037779, 55905
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Address
University of Mississippi Medical Center
Jackson 4431410, Mississippi 4436296, 39216
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Address
Columbia Regional
Columbia 4381982, Missouri 4398678, 65201
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Address
Children's Mercy Hospitals and Clinics
Kansas City 4393217, Missouri 4398678, 64108
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Address
Cardinal Glennon Children's Medical Center
St Louis 4407066, Missouri 4398678, 63104
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Address
Washington University School of Medicine
St Louis 4407066, Missouri 4398678, 63110
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Address
Mercy Hospital Saint Louis
St Louis 4407066, Missouri 4398678, 63141
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Address
Children's Hospital and Medical Center of Omaha
Omaha 5074472, Nebraska 5073708, 68114
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Address
University of Nebraska Medical Center
Omaha 5074472, Nebraska 5073708, 68198
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Address
University Medical Center of Southern Nevada
Las Vegas 5506956, Nevada 5509151, 89102
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Address
Sunrise Hospital and Medical Center
Las Vegas 5506956, Nevada 5509151, 89109
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Address
Alliance for Childhood Diseases/Cure 4 the Kids Foundation
Las Vegas 5506956, Nevada 5509151, 89135
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Address
Summerlin Hospital Medical Center
Las Vegas 5506956, Nevada 5509151, 89144
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Address
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon 5088597, New Hampshire 5090174, 03756
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Address
Hackensack University Medical Center
Hackensack 5098706, New Jersey 5101760, 07601
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Address
Saint Barnabas Medical Center
Livingston 5100572, New Jersey 5101760, 07039
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Address
Morristown Medical Center
Morristown 5101427, New Jersey 5101760, 07960
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Address
Saint Peter's University Hospital
New Brunswick 5101717, New Jersey 5101760, 08901
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Address
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
New Brunswick 5101717, New Jersey 5101760, 08903
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Address
Newark Beth Israel Medical Center
Newark 5101798, New Jersey 5101760, 07112
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Address
Saint Joseph's Regional Medical Center
Paterson 5102466, New Jersey 5101760, 07503
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Address
Overlook Hospital
Summit 5105127, New Jersey 5101760, 07902
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Address
University of New Mexico Cancer Center
Albuquerque 5454711, New Mexico 5481136, 87102
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Address
Albany Medical Center
Albany 5106834, New York 5128638, 12208
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Address
Roswell Park Cancer Institute
Buffalo 5110629, New York 5128638, 14263
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Address
NYU Winthrop Hospital
Mineola 5127134, New York 5128638, 11501
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Address
The Steven and Alexandra Cohen Children's Medical Center of New York
New Hyde Park 5128514, New York 5128638, 11040
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Address
Laura and Isaac Perlmutter Cancer Center at NYU Langone
New York 5128581, New York 5128638, 10016
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Address
Mount Sinai Hospital
New York 5128581, New York 5128638, 10029
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Address
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
New York 5128581, New York 5128638, 10032
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Address
Memorial Sloan Kettering Cancer Center
New York 5128581, New York 5128638, 10065
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Address
University of Rochester
Rochester 5134086, New York 5128638, 14642
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Address
State University of New York Upstate Medical University
Syracuse 5140405, New York 5128638, 13210
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Address
Montefiore Medical Center - Moses Campus
The Bronx 5110266, New York 5128638, 10467
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Address
New York Medical College
Valhalla 5142090, New York 5128638, 10595
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Address
UNC Lineberger Comprehensive Cancer Center
Chapel Hill 4460162, North Carolina 4482348, 27599
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Address
Carolinas Medical Center/Levine Cancer Institute
Charlotte 4460243, North Carolina 4482348, 28203
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Address
Novant Health Presbyterian Medical Center
Charlotte 4460243, North Carolina 4482348, 28204
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Address
Wake Forest University Health Sciences
Winston-Salem 4499612, North Carolina 4482348, 27157
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Address
Sanford Broadway Medical Center
Fargo 5059163, North Dakota 5690763, 58122
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Address
Children's Hospital Medical Center of Akron
Akron 5145476, Ohio 5165418, 44308
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Address
Cincinnati Children's Hospital Medical Center
Cincinnati 4508722, Ohio 5165418, 45229
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Address
Rainbow Babies and Childrens Hospital
Cleveland 5150529, Ohio 5165418, 44106
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Address
Cleveland Clinic Foundation
Cleveland 5150529, Ohio 5165418, 44195
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Address
Nationwide Children's Hospital
Columbus 4509177, Ohio 5165418, 43205
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Address
Dayton Children's Hospital
Dayton 4509884, Ohio 5165418, 45404
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Address
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
Toledo 5174035, Ohio 5165418, 43606
Status
Address
Mercy Children's Hospital
Toledo 5174035, Ohio 5165418, 43608
Status
Address
University of Oklahoma Health Sciences Center
Oklahoma City 4544349, Oklahoma 4544379, 73104
Status
Address
Legacy Emanuel Children's Hospital
Portland 5746545, Oregon 5744337, 97227
Status
Address
Lehigh Valley Hospital-Cedar Crest
Allentown 5178127, Pennsylvania 6254927, 18103
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Address
Lehigh Valley Hospital - Muhlenberg
Bethlehem 5180225, Pennsylvania 6254927, 18017
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Address
Geisinger Medical Center
Danville 5186327, Pennsylvania 6254927, 17822
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Address
Penn State Children's Hospital
Hershey 5193342, Pennsylvania 6254927, 17033
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Address
Children's Hospital of Philadelphia
Philadelphia 4560349, Pennsylvania 6254927, 19104
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Address
Saint Christopher's Hospital for Children
Philadelphia 4560349, Pennsylvania 6254927, 19134
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Address
Children's Hospital of Pittsburgh of UPMC
Pittsburgh 5206379, Pennsylvania 6254927, 15224
Status
Address
Rhode Island Hospital
Providence 5224151, Rhode Island 5224323, 02903
Status
Address
Medical University of South Carolina
Charleston 4574324, South Carolina 4597040, 29425
Status
Address
Prisma Health Richland Hospital
Columbia 4575352, South Carolina 4597040, 29203
Status
Address
BI-LO Charities Children's Cancer Center
Greenville 4580543, South Carolina 4597040, 29605
Status
Address
Greenville Cancer Treatment Center
Greenville 4580543, South Carolina 4597040, 29605
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Address
Sanford USD Medical Center - Sioux Falls
Sioux Falls 5231851, South Dakota 5769223, 57117-5134
Status
Address
T C Thompson Children's Hospital
Chattanooga 4612862, Tennessee 4662168, 37403
Status
Address
East Tennessee Childrens Hospital
Knoxville 4634946, Tennessee 4662168, 37916
Status
Address
Saint Jude Children's Research Hospital
Memphis 4641239, Tennessee 4662168, 38105
Status
Address
The Children's Hospital at TriStar Centennial
Nashville 4644585, Tennessee 4662168, 37203
Status
Address
Vanderbilt University/Ingram Cancer Center
Nashville 4644585, Tennessee 4662168, 37232
Status
Address
Dell Children's Medical Center of Central Texas
Austin 4671654, Texas 4736286, 78723
Status
Address
Driscoll Children's Hospital
Corpus Christi 4683416, Texas 4736286, 78411
Status
Address
Medical City Dallas Hospital
Dallas 4684888, Texas 4736286, 75230
Status
Address
Cook Children's Medical Center
Fort Worth 4691930, Texas 4736286, 76104
Status
Address
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
Houston 4699066, Texas 4736286, 77030
Status
Address
Covenant Children's Hospital
Lubbock 5525577, Texas 4736286, 79410
Status
Address
UMC Cancer Center / UMC Health System
Lubbock 5525577, Texas 4736286, 79415
Status
Address
Children's Hospital of San Antonio
San Antonio 4726206, Texas 4736286, 78207
Status
Address
Methodist Children's Hospital of South Texas
San Antonio 4726206, Texas 4736286, 78229
Status
Address
University of Texas Health Science Center at San Antonio
San Antonio 4726206, Texas 4736286, 78229
Status
Address
Scott and White Memorial Hospital
Temple 4735966, Texas 4736286, 76508
Status
Address
Primary Children's Hospital
Salt Lake City 5780993, Utah 5549030, 84113
Status
Address
University of Vermont and State Agricultural College
Burlington 5234372, Vermont 5242283, 05405
Status
Address
Inova Fairfax Hospital
Falls Church 4758390, Virginia 6254928, 22042
Status
Address
Children's Hospital of The King's Daughters
Norfolk 4776222, Virginia 6254928, 23507
Status
Address
Naval Medical Center - Portsmouth
Portsmouth 4779999, Virginia 6254928, 23708-2197
Status
Address
Virginia Commonwealth University/Massey Cancer Center
Richmond 4781708, Virginia 6254928, 23298
Status
Address
Carilion Children's
Roanoke 4782167, Virginia 6254928, 24014
Status
Address
Seattle Children's Hospital
Seattle 5809844, Washington 5815135, 98105
Status
Address
Providence Sacred Heart Medical Center and Children's Hospital
Spokane 5811696, Washington 5815135, 99204
Status
Address
Mary Bridge Children's Hospital and Health Center
Tacoma 5812944, Washington 5815135, 98405
Status
Address
Madigan Army Medical Center
Tacoma 5812944, Washington 5815135, 98431
Status
Address
West Virginia University Charleston Division
Charleston 4801859, West Virginia 4826850, 25304
Status
Address
West Virginia University Healthcare
Morgantown 4815352, West Virginia 4826850, 26506
Status
Address
Saint Vincent Hospital Cancer Center Green Bay
Green Bay 5254962, Wisconsin 5279468, 54301
Status
Address
University of Wisconsin Carbone Cancer Center
Madison 5261457, Wisconsin 5279468, 53792
Status
Address
Marshfield Medical Center-Marshfield
Marshfield 5261969, Wisconsin 5279468, 54449
Status
Address
Children's Hospital of Wisconsin
Milwaukee 5263045, Wisconsin 5279468, 53226
International Sites
Status
Address
John Hunter Children's Hospital
Hunter Regional Mail Centre, New South Wales 2155400, 2310
Status
Address
Sydney Children's Hospital
Randwick 2208285, New South Wales 2155400, 2031
Status
Address
The Children's Hospital at Westmead
Westmead 2143973, New South Wales 2155400, 2145
Status
Address
Royal Brisbane and Women's Hospital
Herston 6931014, Queensland 2152274, 4029
Status
Address
Royal Children's Hospital-Brisbane
Herston 6931014, Queensland 2152274, 4029
Status
Address
Queensland Children's Hospital
South Brisbane 2207259, Queensland 2152274, 4101
Status
Address
Women's and Children's Hospital-Adelaide
North Adelaide 8469169, South Australia 2061327, 5006
Status
Address
Monash Medical Center-Clayton Campus
Clayton 2171400, Victoria 2145234, 3168
Status
Address
Royal Children's Hospital
Parkville 2153770, Victoria 2145234, 3052
Status
Address
Princess Margaret Hospital for Children
Perth 2063523, Western Australia 2058645, 6008
Status
Address
Perth Children's Hospital
Perth 2063523, Western Australia 2058645, 6009
Status
Address
Alberta Children's Hospital
Calgary 5913490, Alberta 5883102, T3B 6A8
Status
Address
University of Alberta Hospital
Edmonton 5946768, Alberta 5883102, T6G 2B7
Status
Address
British Columbia Children's Hospital
Vancouver 6173331, British Columbia 5909050, V6H 3V4
Status
Address
CancerCare Manitoba
Winnipeg 6183235, Manitoba 6065171, R3E 0V9
Status
Address
Janeway Child Health Centre
St. John's 6324733, Newfoundland and Labrador 6354959, A1B 3V6
Status
Address
IWK Health Centre
Halifax 6324729, Nova Scotia 6091530, B3K 6R8
Status
Address
McMaster Children's Hospital at Hamilton Health Sciences
Hamilton 5969782, Ontario 6093943, L8N 3Z5
Status
Address
Kingston Health Sciences Centre
Kingston 5992500, Ontario 6093943, K7L 2V7
Status
Address
Children's Hospital
London 6058560, Ontario 6093943, N6A 5W9
Status
Address
Children's Hospital of Eastern Ontario
Ottawa 6094817, Ontario 6093943, K1H 8L1
Status
Address
Hospital for Sick Children
Toronto 6167865, Ontario 6093943, M5G 1X8
Status
Address
The Montreal Children's Hospital of the MUHC
Montreal 6077243, Quebec 6115047, H3H 1P3
Status
Address
Centre Hospitalier Universitaire Sainte-Justine
Montreal 6077243, Quebec 6115047, H3T 1C5
Status
Address
Saskatoon Cancer Centre
Saskatoon 6141256, Saskatchewan 6141242, S7N 4H4
Status
Address
CHU de Quebec-Centre Hospitalier de l'Universite Laval (CHUL)
Québec 6325494, , G1V 4G2
Status
Address
Starship Children's Hospital
Grafton 6232401, Auckland 2193734, 1145
Status
Address
Christchurch Hospital
Christchurch 2192362, , 8011
