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Pembrolizumab in Treating Patients With Desmoplastic Melanoma That Can or Cannot Be Removed by Surgery
Study Purpose
This pilot phase II trial studies how well pembrolizumab works in treating patients with desmoplastic melanoma (DM) that can be removed by surgery (resectable) or cannot be removed by surgery (unresectable). Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread.
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 |
Inclusion Criteria:
- - COHORT A: Patients must have histologically or cytologically confirmed primary desmoplastic melanoma that is deemed resectable; the decision to perform surgery on patients must be based on good clinical judgment; eligible patients for surgical resection must have disease that, in the judgment of the surgeon, is deemed completely resectable resulting in free surgical margins; patients must have residual disease after initial biopsy which can be measurable or non-measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1; residual disease can either be confirmed with fine-needle aspiration (FNA) or if measurable disease is present, no FNA needs to be obtained OR.
- - COHORT B: Patients must have histologically or cytologically confirmed primary desmoplastic melanoma that is unresectable; patients in Cohort B must have measurable disease per RECIST 1.1.
- - Contrast-enhanced computed tomography (CT) scans of the chest, abdomen and pelvis are required; a whole body positron emission tomography (PET)/CT scan with diagnostic quality images and intravenous iodinated contrast may be used in lieu of a contrast enhanced CT of the chest, abdomen and pelvis; imaging of the head and neck is required only if the patient has a head/neck primary; contrast may be omitted if the treating investigator believes that exposure to contrast poses an excessive risk to the patient; if skin lesions are being followed as measurable disease, photograph with a ruler included and physician measurements, must be kept in the patient's chart as source documentation; all measurable lesions must be assessed within 28 days prior to registration; tests to assess non-measurable disease must be performed within 42 days prior to registration; all disease must be assessed and documented on the baseline tumor assessment form (RECIST 1.1) - Patients must not have known brain metastases unless brain metastases have been treated and patient is asymptomatic with no residual neurological dysfunction and has not received enzyme-reducing anti-epileptic drugs or corticosteroids for at least 14 days prior to registration.
- - Patients must not have received prior systemic treatment for this melanoma.
- - Patients must not be planning to receive concomitant other biologic therapy, hormonal therapy, other chemotherapy, anti-cancer surgery or other anti-cancer therapy while on this protocol.
- - Patients must not have received radiation therapy, non-cytotoxic agents or investigational agents or systemic corticosteroids within 14 days prior to registration.
- - Patients may have received prior surgery; all adverse events associated with prior surgery must have resolved to =< grade 1 (per Common Terminology Criteria for Adverse Events [CTCAE] 4.0) prior to registration.
- - Patients must be >= 18 years of age.
- - Absolute neutrophil count (ANC) >= 1,500/mcl (obtained within 28 days prior to registration) - Platelets >= 50,000/mcl (obtained within 28 days prior to registration) - Hemoglobin >= 8 g/dL (obtained within 28 days prior to registration) - Total bilirubin =< 1.5 x institutional upper limit of normal (IULN) (or =< 3.0 x IULN with Gilbert's syndrome) (obtained within 28 days prior to registration) - Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 2.5 x IULN (or < 5 x IULN for patients with known liver metastases) (obtained within 28 days prior to registration) - Patients must have lactate dehydrogenase (LDH) performed within 28 days prior to registration.
- - Patients must have Zubrod performance status =< 2.
- - Patients must not have history of (non-infectious) pneumonitis that required steroids or current pneumonitis.
- - Patients must not have an active infection requiring systemic therapy.
- - Patients must not have active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs); replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
- - Patients must not have received live vaccines within 42 days prior to registration; examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, chicken pox, shingles, yellow fever, rabies, Bacillus Calmette-Guerin (BCG), and typhoid (oral) vaccine; seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (e.g., Flu-Mist) are live attenuated vaccines, and are not allowed.
- - Patients known to be human immunodeficiency virus (HIV) positive prior to registration are eligible if they meet the following criteria within 30 days prior to registration: stable and adequate CD4 counts (>= 350 mm^3), and serum HIV viral load of < 25,000 IU/ml; patients must be on a stable anti-viral therapy.
- - No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, adequately treated in situ cancer, adequately treated stage I or II cancer (including multiple primary melanomas) from which the patient is currently in complete remission, or any other cancer from which the patient has been disease free for three years.
- - Women of childbearing potential must have a negative urine or serum pregnancy test within 28 days prior to registration; women/men of reproductive potential must have agreed to use an effective contraceptive method for the course of the study through 120 days after the last dose of study medication; should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately; a woman is considered to be of "reproductive potential" if she has had menses at any time in the preceding 12 consecutive months; in addition to routine contraceptive methods, "effective contraception" also includes heterosexual celibacy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) defined as a hysterectomy, bilateral oophorectomy, or bilateral tubal ligation; however, if at any point a previously celibate patient chooses to become heterosexually active during the time period for use of contraceptive measures outlined in the protocol, he/she is responsible for beginning contraceptive measures; patients must not be pregnant or nursing due to unknown teratogenic side effects.
- - Patients must have specimens available and institutions must be planning to submit for centralized pathology review and for integrated translational medicine objectives.
- - Patients must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines.
Trial Details
|
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. |
NCT02775851 |
|
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 2 |
|
Lead Sponsor
The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data. |
National Cancer Institute (NCI) |
|
Principal Investigator
The person who is responsible for the scientific and technical direction of the entire clinical study. |
Kari L Kendra |
| Principal Investigator Affiliation | SWOG Cancer Research Network |
|
Agency Class
Category of organization(s) involved as sponsor (and collaborator) supporting the trial. |
NIH |
| Overall Status | Active, not recruiting |
| Countries | United States |
|
Conditions
The disease, disorder, syndrome, illness, or injury that is being studied. |
Desmoplastic Melanoma |
PRIMARY OBJECTIVES:
- I. To evaluate the pathologic complete response rate (pCR) in patients with resectable desmoplastic melanoma treated with neoadjuvant pembrolizumab (MK-3475).
- II. To evaluate the complete response rate (confirmed and unconfirmed) in patients with unresectable desmoplastic melanoma treated with pembrolizumab (MK-3475).
- I. To estimate the 9 week response rate (RR) (unconfirmed complete and partial responses) among patients with measurable disease.
- II. To estimate the median overall survival (OS).
- III. To evaluate safety and tolerability of pembrolizumab (MK-3475) in the neoadjuvant setting.
- IV. To estimate the median progression-free survival (PFS).
- V. To estimate the median overall survival (OS).
- VI. To evaluate safety and tolerability of pembrolizumab (MK-3475) in this setting.
- I. To evaluate the hypothesis that higher mutational load in the patient derived baseline tumor biopsy samples is associated with higher pathologic complete response (pCR).
- II. To evaluate T cell infiltration into the tumors and circulating tumor deoxyribonucleic acid (DNA) profile from blood samples in DM patients and correlate with response to programmed cell death protein 1 (PD-1) blockade.
- III. To evaluate the clonality of tumor infiltrating T cells in DM patients and correlate with response to PD-1 blockade.
- IV. To evaluate adaptive immune resistant mechanism in DM tumors.
Arms
Experimental: Cohort A (pembrolizumab, surgery)
Patients receive pembrolizumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 3 cycles. Patients with potentially resectable disease undergo surgery. Patients with tumor progression and unresectable disease may receive one additional cycle of pembrolizumab. Patients undergo CT scan and may undergo PET and MRI throughout the study. Patients also undergo blood sample collection at screening and tumor biopsy throughout the study.
Experimental: Cohort B (pembrolizumab)
Patients with unresectable disease receive pembrolizumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 34 cycles in the absence of disease progression or toxicity. Patients undergo CT scan and may undergo PET and MRI throughout the study. Patients also undergo blood sample collection at screening and tumor biopsy throughout the study.
Interventions
Procedure: - Biopsy Procedure
Undergo tumor biopsy
Procedure: - Biospecimen Collection
Undergo blood sample collection
Procedure: - Computed Tomography
Undergo CT scan
Procedure: - Magnetic Resonance Elastography
Undergo MRI
Biological: - Pembrolizumab
Given IV
Procedure: - Positron Emission Tomography
Undergo PET scan
Procedure: - Therapeutic Conventional Surgery
Undergo surgical resection
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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Fairbanks Memorial Hospital
Fairbanks, Alaska, 99701
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Cancer Center at Saint Joseph's
Phoenix, Arizona, 85004
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Mercy Hospital Fort Smith
Fort Smith, Arkansas, 72903
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Address
CHI Saint Vincent Cancer Center Hot Springs
Hot Springs, Arkansas, 71913
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Address
Mission Hope Medical Oncology - Arroyo Grande
Arroyo Grande, California, 93420
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Address
City of Hope Comprehensive Cancer Center
Duarte, California, 91010
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Address
Epic Care-Dublin
Dublin, California, 94568
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Address
Bay Area Breast Surgeons Inc
Emeryville, California, 94608
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Epic Care Partners in Cancer Care
Emeryville, California, 94608
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Los Angeles General Medical Center
Los Angeles, California, 90033
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Address
USC / Norris Comprehensive Cancer Center
Los Angeles, California, 90033
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Address
UCLA / Jonsson Comprehensive Cancer Center
Los Angeles, California, 90095
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Contra Costa Regional Medical Center
Martinez, California, 94553-3156
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Address
USC Norris Oncology/Hematology-Newport Beach
Newport Beach, California, 92663
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Alta Bates Summit Medical Center - Summit Campus
Oakland, California, 94609
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Bay Area Tumor Institute
Oakland, California, 94609
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Address
Keck Medical Center of USC Pasadena
Pasadena, California, 91105
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Pacific Central Coast Health Center-San Luis Obispo
San Luis Obispo, California, 93401
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Mission Hope Medical Oncology - Santa Maria
Santa Maria, California, 93444
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City of Hope South Pasadena
South Pasadena, California, 91030
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City of Hope Upland
Upland, California, 91786
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Epic Care Cyberknife Center
Walnut Creek, California, 94597
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Rocky Mountain Cancer Centers-Aurora
Aurora, Colorado, 80012
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The Medical Center of Aurora
Aurora, Colorado, 80012
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Address
Boulder Community Foothills Hospital
Boulder, Colorado, 80303
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Address
Rocky Mountain Cancer Centers-Boulder
Boulder, Colorado, 80304
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Rocky Mountain Cancer Centers - Centennial
Centennial, Colorado, 80112
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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
Cancer Center of Colorado at Sloan's Lake
Denver, Colorado, 80204
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Address
National Jewish Health-Main Campus
Denver, Colorado, 80206
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Address
The Women's Imaging Center
Denver, Colorado, 80209
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AdventHealth Porter
Denver, Colorado, 80210
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Address
Colorado Blood Cancer Institute
Denver, Colorado, 80218
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Address
Presbyterian - Saint Lukes Medical Center - Health One
Denver, Colorado, 80218
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Address
Rocky Mountain Cancer Centers-Midtown
Denver, Colorado, 80218
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Saint Joseph Hospital - Cancer Centers of Colorado
Denver, Colorado, 80218
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Rocky Mountain Cancer Centers-Rose
Denver, Colorado, 80220
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Rose Medical Center
Denver, Colorado, 80220
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Address
Western Surgical Care
Denver, Colorado, 80220
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Address
Mercy Medical Center
Durango, Colorado, 81301
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Southwest Oncology PC
Durango, Colorado, 81301
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Address
Mountain Blue Cancer Care Center - Swedish
Englewood, Colorado, 80113
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Address
Swedish Medical Center
Englewood, Colorado, 80113
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Address
National Jewish Health-Western Hematology Oncology
Golden, Colorado, 80401
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Saint Mary's Hospital and Regional Medical Center
Grand Junction, Colorado, 81501
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Grand Valley Oncology
Grand Junction, Colorado, 81505
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Banner North Colorado Medical Center
Greeley, Colorado, 80631
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Good Samaritan Hospital - Cancer Centers of Colorado
Lafayette, Colorado, 80026
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Saint Anthony Hospital
Lakewood, Colorado, 80228
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Rocky Mountain Cancer Centers-Littleton
Littleton, Colorado, 80120
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AdventHealth Littleton
Littleton, Colorado, 80122
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Rocky Mountain Cancer Centers-Sky Ridge
Lone Tree, Colorado, 80124
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Sky Ridge Medical Center
Lone Tree, Colorado, 80124
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Longmont United Hospital
Longmont, Colorado, 80501
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Rocky Mountain Cancer Centers-Longmont
Longmont, Colorado, 80501
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Banner McKee Medical Center
Loveland, Colorado, 80539
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AdventHealth Parker
Parker, Colorado, 80138
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Address
Saint Mary Corwin Medical Center
Pueblo, Colorado, 81004
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Address
National Jewish Health-Northern Hematology Oncology
Thornton, Colorado, 80260
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Address
Intermountain Health Lutheran Hospital
Wheat Ridge, Colorado, 80401
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Address
Hartford Hospital
Hartford, Connecticut, 06102
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Address
Mount Sinai Comprehensive Cancer Center at Aventura
Aventura, Florida, 33180
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Address
Holy Cross Hospital
Fort Lauderdale, Florida, 33308
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Address
Mount Sinai Medical Center
Miami Beach, Florida, 33140
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Address
Moffitt Cancer Center-International Plaza
Tampa, Florida, 33607
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Address
Moffitt Cancer Center - McKinley Campus
Tampa, Florida, 33612
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Address
Moffitt Cancer Center
Tampa, Florida, 33612
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Address
Low Country Cancer Care
Savannah, Georgia, 31404
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Address
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
Savannah, Georgia, 31405
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Address
Summit Cancer Care-Candler
Savannah, Georgia, 31405
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Address
Saint Alphonsus Cancer Care Center-Boise
Boise, Idaho, 83706
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Address
Saint Alphonsus Cancer Care Center-Caldwell
Caldwell, Idaho, 83605
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Address
Kootenai Health - Coeur d'Alene
Coeur d'Alene, Idaho, 83814
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Address
Walter Knox Memorial Hospital
Emmett, Idaho, 83617
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Idaho Urologic Institute-Meridian
Meridian, Idaho, 83642
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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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Kootenai Clinic Cancer Services - Sandpoint
Sandpoint, Idaho, 83864
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Address
OSF Saint Anthony's Health Center
Alton, Illinois, 62002
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Address
Rush - Copley Medical Center
Aurora, Illinois, 60504
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Address
Northwestern University
Chicago, Illinois, 60611
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Address
Carle at The Riverfront
Danville, Illinois, 61832
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Address
Carle Physician Group-Effingham
Effingham, Illinois, 62401
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Address
Northwestern Medicine Cancer Center Delnor
Geneva, Illinois, 60134
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Address
Northwestern Medicine Lake Forest Hospital
Lake Forest, Illinois, 60045
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Address
Carle Physician Group-Mattoon/Charleston
Mattoon, Illinois, 61938
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Address
SSM Health Good Samaritan
Mount Vernon, Illinois, 62864
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Address
Carle Cancer Center
Urbana, Illinois, 61801
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Address
The Carle Foundation Hospital
Urbana, Illinois, 61801
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Address
Northwestern Medicine Cancer Center Warrenville
Warrenville, Illinois, 60555
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Address
Rush-Copley Healthcare Center
Yorkville, Illinois, 60560
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Address
Deaconess Clinic Downtown
Evansville, Indiana, 47713
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Address
Chancellor Center for Oncology
Newburgh, Indiana, 47630
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Address
Mercy Cancer Center-West Lakes
Clive, Iowa, 50325
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Address
UI Health Care Mission Cancer and Blood - West Des Moines Clinic
Clive, Iowa, 50325
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Address
Alegent Health Mercy Hospital
Council Bluffs, Iowa, 51503
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Greater Regional Medical Center
Creston, Iowa, 50801
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Address
Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
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Address
UI Health Care Mission Cancer and Blood - Laurel Clinic
Des Moines, Iowa, 50314
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Address
Mercy Medical Center-West Lakes
West Des Moines, Iowa, 50266
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Address
Coffeyville Regional Medical Center
Coffeyville, Kansas, 67337
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Address
University of Kansas Clinical Research Center
Fairway, Kansas, 66205
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Address
Central Care Cancer Center - Garden City
Garden City, Kansas, 67846
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Address
Central Care Cancer Center - Great Bend
Great Bend, Kansas, 67530
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Address
HaysMed
Hays, Kansas, 67601
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Address
University of Kansas Cancer Center-West
Kansas City, Kansas, 66112
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Address
University of Kansas Cancer Center
Kansas City, Kansas, 66160
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Address
Lawrence Memorial Hospital
Lawrence, Kansas, 66044
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Address
Kansas Institute of Medicine Cancer and Blood Center
Lenexa, Kansas, 66219
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Address
Minimally Invasive Surgery Hospital
Lenexa, Kansas, 66219
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Address
The University of Kansas Cancer Center - Olathe
Olathe, Kansas, 66061
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Address
Menorah Medical Center
Overland Park, Kansas, 66209
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Address
University of Kansas Cancer Center-Overland Park
Overland Park, Kansas, 66210
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Address
Mercy Hospital Pittsburg
Pittsburg, Kansas, 66762
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Address
Salina Regional Health Center
Salina, Kansas, 67401
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Address
University of Kansas Health System Saint Francis Campus
Topeka, Kansas, 66606
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Address
University of Kansas Hospital-Westwood Cancer Center
Westwood, Kansas, 66205
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Address
Flaget Memorial Hospital
Bardstown, Kentucky, 40004
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Address
Commonwealth Cancer Center-Corbin
Corbin, Kentucky, 40701
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Address
Saint Joseph Radiation Oncology Resource Center
Lexington, Kentucky, 40504
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Address
Saint Joseph Hospital East
Lexington, Kentucky, 40509
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Address
Saint Joseph London
London, Kentucky, 40741
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Address
Jewish Hospital
Louisville, Kentucky, 40202
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Address
Saints Mary and Elizabeth Hospital
Louisville, Kentucky, 40215
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Address
UofL Health Medical Center Northeast
Louisville, Kentucky, 40245
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Address
Jewish Hospital Medical Center South
Shepherdsville, Kentucky, 40165
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Address
Henry Ford Cancer Institute-Downriver
Brownstown, Michigan, 48183
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Address
Henry Ford Macomb Hospital-Clinton Township
Clinton Township, Michigan, 48038
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Address
Henry Ford Medical Center-Fairlane
Dearborn, Michigan, 48126
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Address
Henry Ford Hospital
Detroit, Michigan, 48202
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Address
Allegiance Health
Jackson, Michigan, 49201
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Address
Monroe Cancer Center
Monroe, Michigan, 48162
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Address
Henry Ford Medical Center-Columbus
Novi, Michigan, 48377
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Address
Henry Ford Macomb Health Center - Shelby Township
Shelby, Michigan, 48315
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Address
Henry Ford West Bloomfield Hospital
West Bloomfield, Michigan, 48322
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Address
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
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Address
Minnesota Oncology - Burnsville
Burnsville, Minnesota, 55337
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Address
Cambridge Medical Center
Cambridge, Minnesota, 55008
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Address
Mercy Hospital
Coon Rapids, Minnesota, 55433
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Address
Fairview Southdale Hospital
Edina, Minnesota, 55435
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Address
Unity Hospital
Fridley, Minnesota, 55432
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Address
Fairview Clinics and Surgery Center Maple Grove
Maple Grove, Minnesota, 55369
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Address
Minnesota Oncology Hematology PA-Maplewood
Maplewood, Minnesota, 55109
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Address
Saint John's Hospital - Healtheast
Maplewood, Minnesota, 55109
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Address
Abbott-Northwestern Hospital
Minneapolis, Minnesota, 55407
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Address
Hennepin County Medical Center
Minneapolis, Minnesota, 55415
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Address
Health Partners Inc
Minneapolis, Minnesota, 55454
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Address
Monticello Cancer Center
Monticello, Minnesota, 55362
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Address
New Ulm Medical Center
New Ulm, Minnesota, 56073
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Address
Fairview Northland Medical Center
Princeton, Minnesota, 55371
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Address
North Memorial Medical Health Center
Robbinsdale, Minnesota, 55422
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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
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Address
Minnesota Oncology Hematology PA-Woodbury
Woodbury, Minnesota, 55125
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Address
Fairview Lakes Medical Center
Wyoming, Minnesota, 55092
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Address
Singing River Hospital
Pascagoula, Mississippi, 39581
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Address
Saint Louis Cancer and Breast Institute-Ballwin
Ballwin, Missouri, 63011
Status
Address
Central Care Cancer Center - Bolivar
Bolivar, Missouri, 65613
Status
Address
Cox Cancer Center Branson
Branson, Missouri, 65616
Status
Address
Centerpoint Medical Center LLC
Independence, Missouri, 64057
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Address
Freeman Health System
Joplin, Missouri, 64804
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Address
Mercy Hospital Joplin
Joplin, Missouri, 64804
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Address
University Health Truman Medical Center
Kansas City, Missouri, 64108
Status
Address
The University of Kansas Cancer Center-South
Kansas City, Missouri, 64131
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Address
Research Medical Center
Kansas City, Missouri, 64132
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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
Mercy Clinic-Rolla-Cancer and Hematology
Rolla, Missouri, 65401
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Address
Phelps Health Delbert Day Cancer Institute
Rolla, Missouri, 65401
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Address
Heartland Regional Medical Center
Saint Joseph, Missouri, 64506
Status
Address
Saint Louis Cancer and Breast Institute-South City
Saint Louis, Missouri, 63109
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Address
Mercy Hospital South
Saint Louis, Missouri, 63128
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Address
Mercy Hospital Saint Louis
Saint Louis, Missouri, 63141
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Address
Mercy Hospital Springfield
Springfield, Missouri, 65804
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Address
CoxHealth South Hospital
Springfield, Missouri, 65807
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Address
Mercy Hospital Washington
Washington, Missouri, 63090
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Address
Community Hospital of Anaconda
Anaconda, Montana, 59711
Status
Address
Billings Clinic Cancer Center
Billings, Montana, 59101
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Address
Saint Vincent Healthcare
Billings, Montana, 59101
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Address
Saint Vincent Frontier Cancer Center
Billings, Montana, 59102
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Address
Bozeman Health Deaconess Hospital
Bozeman, Montana, 59715
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Address
Saint James Community Hospital and Cancer Treatment Center
Butte, Montana, 59701
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Address
Benefis Sletten Cancer Institute
Great Falls, Montana, 59405
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Address
Great Falls Clinic
Great Falls, Montana, 59405
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Address
Saint Peter's Community Hospital
Helena, Montana, 59601
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Address
Logan Health Medical Center
Kalispell, Montana, 59901
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Address
Community Medical Center
Missoula, Montana, 59804
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Address
Nebraska Cancer Specialists/Oncology Hematology West PC
Grand Island, Nebraska, 68803
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Address
CHI Health Good Samaritan
Kearney, Nebraska, 68847
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Address
Saint Elizabeth Regional Medical Center
Lincoln, Nebraska, 68510
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Address
Alegent Health Immanuel Medical Center
Omaha, Nebraska, 68122
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Address
Alegent Health Bergan Mercy Medical Center
Omaha, Nebraska, 68124
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Address
Alegent Health Lakeside Hospital
Omaha, Nebraska, 68130
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Address
Creighton University Medical Center
Omaha, Nebraska, 68131
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Address
Midlands Community Hospital
Papillion, Nebraska, 68046
Status
Address
Roswell Park Cancer Institute
Buffalo, New York, 14263
Status
Address
Southeastern Medical Oncology Center-Clinton
Clinton, North Carolina, 28328
Status
Address
Southeastern Medical Oncology Center-Goldsboro
Goldsboro, North Carolina, 27534
Status
Address
Wayne Memorial Hospital
Goldsboro, North Carolina, 27534
Status
Address
Onslow Memorial Hospital
Jacksonville, North Carolina, 28546
Status
Address
Southeastern Medical Oncology Center-Jacksonville
Jacksonville, North Carolina, 28546
Status
Address
Strecker Cancer Center-Belpre
Belpre, Ohio, 45714
Status
Address
Adena Regional Medical Center
Chillicothe, Ohio, 45601
Status
Address
Good Samaritan Hospital - Cincinnati
Cincinnati, Ohio, 45220
Status
Address
Bethesda North Hospital
Cincinnati, Ohio, 45242
Status
Address
TriHealth Cancer Institute-Westside
Cincinnati, Ohio, 45247
Status
Address
TriHealth Cancer Institute-Anderson
Cincinnati, Ohio, 45255
Status
Address
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210
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Address
Mount Carmel East Hospital
Columbus, Ohio, 43213
Status
Address
Columbus Oncology and Hematology Associates Inc
Columbus, Ohio, 43214
Status
Address
Riverside Methodist Hospital
Columbus, Ohio, 43214
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Address
Grant Medical Center
Columbus, Ohio, 43215
Status
Address
The Mark H Zangmeister Center
Columbus, Ohio, 43219
Status
Address
Mount Carmel Health Center West
Columbus, Ohio, 43222
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Address
Doctors Hospital
Columbus, Ohio, 43228
Status
Address
Delaware Health Center-Grady Cancer Center
Delaware, Ohio, 43015
Status
Address
Delaware Radiation Oncology
Delaware, Ohio, 43015
Status
Address
Grady Memorial Hospital
Delaware, Ohio, 43015
Status
Address
Dublin Methodist Hospital
Dublin, Ohio, 43016
Status
Address
Mount Carmel Grove City Hospital
Grove City, Ohio, 43123
Status
Address
Fairfield Medical Center
Lancaster, Ohio, 43130
Status
Address
Saint Rita's Medical Center
Lima, Ohio, 45801
Status
Address
OhioHealth Mansfield Hospital
Mansfield, Ohio, 44903
Status
Address
Marietta Memorial Hospital
Marietta, Ohio, 45750
Status
Address
OhioHealth Marion General Hospital
Marion, Ohio, 43302
Status
Address
Knox Community Hospital
Mount Vernon, Ohio, 43050
Status
Address
Licking Memorial Hospital
Newark, Ohio, 43055
Status
Address
Newark Radiation Oncology
Newark, Ohio, 43055
Status
Address
Mercy Health - Perrysburg Hospital
Perrysburg, Ohio, 43551
Status
Address
Southern Ohio Medical Center
Portsmouth, Ohio, 45662
Status
Address
ProMedica Flower Hospital
Sylvania, Ohio, 43560
Status
Address
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
Toledo, Ohio, 43606
Status
Address
Mercy Health - Saint Vincent Hospital
Toledo, Ohio, 43608
Status
Address
Mercy Health - Saint Anne Hospital
Toledo, Ohio, 43623
Status
Address
Saint Ann's Hospital
Westerville, Ohio, 43081
Status
Address
Genesis Healthcare System Cancer Care Center
Zanesville, Ohio, 43701
Status
Address
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Status
Address
Mercy Hospital Oklahoma City
Oklahoma City, Oklahoma, 73120
Status
Address
Saint Alphonsus Cancer Care Center-Baker City
Baker City, Oregon, 97814
Status
Address
Saint Alphonsus Cancer Care Center-Ontario
Ontario, Oregon, 97914
Status
Address
Saint Joseph Regional Cancer Center
Bryan, Texas, 77802
Status
Address
American Fork Hospital / Huntsman Intermountain Cancer Center
American Fork, Utah, 84003
Status
Address
Sandra L Maxwell Cancer Center
Cedar City, Utah, 84720
Status
Address
Farmington Health Center
Farmington, Utah, 84025
Status
Address
Logan Regional Hospital
Logan, Utah, 84321
Status
Address
Intermountain Medical Center
Murray, Utah, 84107
Status
Address
McKay-Dee Hospital Center
Ogden, Utah, 84403
Status
Address
Utah Valley Regional Medical Center
Provo, Utah, 84604
Status
Address
Riverton Hospital
Riverton, Utah, 84065
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
South Jordan Health Center
South Jordan, Utah, 84009
Status
Address
MultiCare Auburn Medical Center
Auburn, Washington, 98001
Status
Address
Highline Medical Center-Main Campus
Burien, Washington, 98166
Status
Address
Saint Elizabeth Hospital
Enumclaw, Washington, 98022
Status
Address
Saint Francis Hospital
Federal Way, Washington, 98003
Status
Address
MultiCare Gig Harbor Medical Park
Gig Harbor, Washington, 98335
Status
Address
Saint Clare Hospital
Lakewood, Washington, 98499
Status
Address
Jefferson Healthcare
Port Townsend, Washington, 98368
Status
Address
Harrison HealthPartners Hematology and Oncology-Poulsbo
Poulsbo, Washington, 98370
Status
Address
MultiCare Good Samaritan Hospital
Puyallup, Washington, 98372
Status
Address
Saint Michael Cancer Center
Silverdale, Washington, 98383
Status
Address
MultiCare Deaconess Cancer and Blood Specialty Center - Valley
Spokane Valley, Washington, 99216
Status
Address
MultiCare Deaconess Cancer and Blood Specialty Center - Downtown
Spokane, Washington, 99204
Status
Address
MultiCare Deaconess Cancer and Blood Specialty Center - North
Spokane, Washington, 99218
Status
Address
Franciscan Research Center-Northwest Medical Plaza
Tacoma, Washington, 98405
Status
Address
Mary Bridge Children's Hospital and Health Center
Tacoma, Washington, 98405
Status
Address
MultiCare Tacoma General Hospital
Tacoma, Washington, 98405
Status
Address
Northwest Medical Specialties PLLC
Tacoma, Washington, 98405
Status
Address
Cancer Center of Western Wisconsin
New Richmond, Wisconsin, 54017
Status
Address
Cheyenne Regional Medical Center-West
Cheyenne, Wyoming, 82001
Status
Address
Billings Clinic-Cody
Cody, Wyoming, 82414
Status
Address
Welch Cancer Center
Sheridan, Wyoming, 82801
