Phase II Study of Cabozantinib in Combination With Nivolumab and Ipilimumab in Rare Genitourinary Tumors

Condition: Bladder Adenocarcinoma, Bladder Mixed Adenocarcinoma, Bladder Small Cell Carcinoma, Bladder Squamous Cell Carcinoma, Chromophobe Renal Cell Carcinoma, Infiltrating Bladder Lymphoepithelioma-Like Carcinoma, Infiltrating Bladder Urothelial Carcinoma, Infiltrating Bladder Urothelial Carcinoma With Giant Cells, Infiltrating Bladder Urothelial Carcinoma, Nested Variant, Infiltrating Bladder Urothelial Carcinoma, Plasmacytoid Variant, Infiltrating Bladder Urothelial Carcinoma, Sarcomatoid Variant, Kidney Medullary Carcinoma, Large Cell Neuroendocrine Carcinoma, Metastatic Bladder Carcinoma, Metastatic Bladder Large Cell Neuroendocrine Carcinoma, Metastatic Bladder Small Cell Carcinoma, Metastatic Bladder Squamous Cell Carcinoma, Metastatic Infiltrating Bladder Urothelial Carcinoma, Clear Cell Variant, Metastatic Infiltrating Bladder Urothelial Carcinoma, Lipid-Rich Variant, Metastatic Infiltrating Bladder Urothelial Carcinoma, Micropapillary Variant, Metastatic Infiltrating Bladder Urothelial Carcinoma, Plasmacytoid Variant, Metastatic Infiltrating Bladder Urothelial Carcinoma, Sarcomatoid Variant, Metastatic Kidney Medullary Carcinoma, Metastatic Malignant Genitourinary System Neoplasm, Metastatic Penile Carcinoma, Metastatic Prostate Small Cell Carcinoma, Metastatic Sarcomatoid Renal Cell Carcinoma, Papillary Renal Cell Carcinoma, Sarcomatoid Renal Cell Carcinoma, Stage IV Bladder Cancer AJCC v8, Stage IV Penile Cancer AJCC v8, Stage IV Prostate Cancer AJCC v8, Stage IV Renal Cell Cancer AJCC v8, Stage IVA Bladder Cancer AJCC v8, Stage IVA Prostate Cancer AJCC v8, Stage IVB Bladder Cancer AJCC v8, Stage IVB Prostate Cancer AJCC v8, Testicular Leydig Cell Tumor, Testicular Sertoli Cell Tumor

Intervention:

• Drug: Cabozantinib
• Drug: Cabozantinib S-malate
• Biological: Ipilimumab
• Biological: Nivolumab

Purpose: This phase II trial studies how well cabozantinib works in combination with nivolumab and ipilimumab in treating patients with rare genitourinary (GU) tumors that have spread to other places in the body. Cabozantinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Immunotherapy with monoclonal antibodies, such as nivolumab and ipilimumab, may help the body’s immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Giving cabozantinib, nivolumab, and ipilimumab may work better in treating patients with genitourinary tumors that have no treatment options compared to giving cabozantinib, nivolumab, or ipilimumab alone.

Study Type: Interventional

Clinical Trials Identifier NCT 8-digits: NCT03866382

Sponsor: National Cancer Institute (NCI)

Primary Outcome Measures:

• Measure: Objective response rate (ORR)
• Time Frame: Up to 5 years
• Safety Issue:

Secondary Outcome Measures:

• Measure: Duration of response
• Time Frame: From time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented, assessed up to 5 years
• Safety Issue:
• Measure: Progression-free survival (PFS)
• Time Frame: From start of treatment to time of progression or death, whichever occurs first, assessed up to 5 years
• Safety Issue:
• Measure: Overall survival
• Time Frame: Up to 5 years
• Safety Issue:
• Measure: Clinical benefit rate (CBR)
• Time Frame: Up to 5 years
• Safety Issue:
• Measure: Incidence of adverse events (AE)
• Time Frame: Up to 5 years
• Safety Issue:

Estimated Enrollment: 186

Study Start Date: April 12, 2019

Phase: Phase 2

Eligibility:

• Age: minimum 18 Years maximum N/A
• Gender: All

Inclusion Criteria:

• Metastatic disease defined as new or progressive lesions on cross-sectional imaging or bone scan. Patients must have at least:
• One measurable site of disease as per Response Evaluation Criteria in Solid Tumors (RECIST) version (v) 1.1
• One bone lesion on bone scan (tec99 or sodium fluoride [NaF] positron emission tomography [PET]/computed tomography [CT], CT, or magnetic resonance imaging [MRI]) for the bone-only cohort
• Histologically confirmed diagnosis of metastatic: small cell carcinoma of the bladder; adenocarcinoma of the bladder; squamous cell carcinoma of the bladder; plasmacytoid urothelial carcinoma; any penile cancer; sarcomatoid renal cell carcinoma; sarcomatoid urothelial carcinoma; renal medullary carcinoma or other miscellaneous histologic variants of the urothelial carcinoma, such as, but not limited to micropapillary, giant cell, lipid-rich, clear cell and nested variants, large cell neuroendocrine carcinoma, lymphoepithelioma-like carcinoma and mixed patterns will be considered, as well as small cell neuroendocrine prostate cancer, testicular Sertoli or Leydig cell tumors, and papillary and chromophobe renal cell carcinoma (RCC)
• Hematoxylin and eosin (H&E) slides from diagnostic tumor tissue for retrospective central pathology review
• Patients may have received any number of prior anti-cancer treatments or be treatment naive (with the exception of patients with small cell carcinoma of the bladder, whom should have received a platinum-based combination regimen either as neoadjuvant, adjuvant or first-line treatment)
• Patients must be able to swallow oral formulation of the tablets
• Karnofsky performance status >= 70%
• Absolute neutrophil count (ANC) >= 1,200/mcL
• Platelet count >= 75,000/mcL
• Total bilirubin =< 1.5 x upper limit of normal (ULN). For subjects with known Gilbert's disease or similar syndrome with slow conjugation of bilirubin, total bilirubin =< 3.0 mg/dL
• Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 3.0 x institutional upper limit of normal (ULN) (or =< 5 x ULN for patients with liver metastases or Gilbert's disease)
• Creatinine =< 1.5 x upper limit of normal (ULN) OR creatinine clearance >= 40 mL/min/1.73 m^2 (calculated using the Chronic Kidney Disease Epidemiology [CKD-EPI] equation or Cockcroft-Gault formula) for patients with creatinine levels above institutional normal
• Hemoglobin >= 9 g/dL (transfusion of packed red blood cells [PRBCs] allowed)
• Serum albumin >= 2.8 g/dL
• Lipase and amylase =< 2.0 x ULN and no radiologic (on baseline anatomical imaging) or clinical evidence of pancreatitis
• Prior treatment with MET or VEGFR inhibitors is allowed. However, prior cabozantinib will not be allowed. Also, patients that have received both prior MET or VEGF and prior PD-1/PD-L1/CTLA-4 (sequentially or in combination) are also not allowed
• Prior treatment with any therapy on the PD-1/PD-L1 axis or anti- CTLA-4/CTLA-4 inhibitors is allowed, either in the perioperative or in the metastatic setting. However, patients that have received both prior MET or VEGF and prior PD-1/PD-L1/CTLA-4 (sequentially or in combination) are not allowed
• Human immunodeficiency virus (HIV)-positive patients are eligible if on stable dose of highly active antiretroviral therapy (HAART), no clinically significant drug-drug interactions are anticipated with the current HAART regimen, CD4 counts are greater than 350 and viral load is undetectable
• Patients with rheumatoid arthritis and other rheumatologic arthropathies, Sjogren’s syndrome and psoriasis controlled with topical medication only and patients with positive serology, such as antinuclear antibodies (ANA), anti-thyroid antibodies etc. are eligible but should be considered for rheumatologic evaluation for the presence of target organ involvement and potential need for systemic treatment
• Patients with vitiligo, endocrine deficiencies including thyroiditis managed with replacement hormones or medications (e.g. thyroiditis managed with propylthiouracil [PTU] or methimazole) including physiologic oral corticosteroids are eligible
• Patients who have evidence of active or acute diverticulitis, intra-abdominal abscess, and gastrointestinal (GI) obstruction, within 12 months are not eligible
• Women of childbearing potential must have a negative pregnancy test =< 7 days prior to registration
• Women of childbearing potential include women who have experienced menarche and who have not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or are not postmenopausal. Post menopause is defined as amenorrhea >= 12 consecutive months. Note: women who have been amenorrheic for 12 or more months are still considered to be of childbearing potential if the amenorrhea is possibly due to prior chemotherapy, antiestrogens, ovarian suppression or any other reversible reason
• Pregnant women may not participate in this study because with cabozantinib, nivolumab, and ipilimumab have potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with cabozantinib, nivolumab, and ipilimumab, breastfeeding should be discontinued if the mother is treated with these agents
• The patient has received no cytotoxic chemotherapy (including investigational cytotoxic chemotherapy) or biologic agents (e.g., cytokines or antibodies) within 2 weeks before the first dose of study treatment
• The patient has received no radiation therapy:
• To the lungs and mediastinum or abdomen within 4 weeks before the first dose of study treatment, or has ongoing complications, or is healing from prior radiation therapy
• To brain metastasis within 3 weeks for whole-brain radiotherapy (WBXRT), and 2 weeks for stereotactic body radiation therapy (SBRT) before the first dose of study treatment
• To any other site(s) within 2 weeks before the first dose of study treatment
• The patient has received no radionuclide treatment within 6 weeks of the first dose of study treatment
• The patient has received no prior treatment with a small molecule kinase inhibitor within 14 days or five half-lives of the compound or active metabolites, whichever is longer, before the first dose of study treatment
• The patient has received no prior treatment with hormonal therapy within 14 days or five half-lives of the compound or active metabolites, whichever is longer, before the first dose of study treatment. Subjects receiving gonadotropin-releasing hormone (GnRH) agonists and antagonists are allowed to participate
• The patient has not received any other type of investigational agent within 14 days before the first dose of study treatment
• The patient must have recovered to baseline or Common Terminology Criteria for Adverse Events (CTCAE) =< grade 1 from toxicity due to all prior therapies except alopecia, neuropathy and other non-clinically significant adverse events (AEs) defined as lab elevation with no associated symptoms or sequelae
• The patient may not have active brain metastases or epidural disease. Patients with brain metastases previously treated with whole brain radiation or radiosurgery or subjects with epidural disease previously treated with radiation or surgery who are asymptomatic and do not require steroid treatment for at least 2 weeks before starting study treatment are eligible. Neurosurgical resection of brain metastases or brain biopsy is permitted if completed at least 3 months before starting study treatment. Baseline brain imaging with contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) scans for subjects with known brain metastases is required to confirm eligibility
• No concomitant treatment with warfarin. Aspirin (up to 325 mg/day), thrombin or factor Xa inhibitors, low-dose warfarin (=< 1 mg/day), prophylactic and therapeutic low molecular weight heparin (LMWH) are permitted
• No chronic concomitant treatment with strong CYP3A4 inducers (e.g., dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentine, phenobarbital, and St. John’s wort) or strong CYP3A4 inhibitors
• Because the lists of these agents are constantly changing, it is important to regularly consult medical reference texts such as the Physicians’ Desk Reference may also provide this information. As part of the enrollment/informed consent procedures, the patient will be counseled on the risk of interactions with other agents, and what to do if new medications need to be prescribed or if the patient is considering a new over-the-counter medicine or herbal product
• The patient has not experienced any of the following:
• Clinically-significant gastrointestinal bleeding within 6 months before the first dose of study treatment
• Hemoptysis of >= 0.5 teaspoon (2.5 mL) of red blood per day within 1 months before the first dose of study treatment
• Any other signs indicative of pulmonary hemorrhage within 3 months before the first dose of study treatment
• The patient has no tumor invading any major blood vessels
• The patient has no evidence of tumor invading the GI tract (esophagus, stomach, small or large bowel, rectum or anus), or any evidence of endotracheal or endobronchial tumor within 28 days before the first dose of cabozantinib
• The patient has no uncontrolled, significant intercurrent or recent illness including, but not limited to, the following conditions:
• Cardiovascular disorders including:
• Congestive heart failure (CHF): New York Heart Association (NYHA) class III (moderate) or class IV (severe) at the time of screening.
• Concurrent uncontrolled hypertension defined as sustained blood pressure (BP) > 150 mm Hg systolic, or > 90 mm Hg diastolic despite optimal antihypertensive treatment within 7 days of the first dose of study treatment
• The subject has a corrected QT interval calculated by the Fridericia formula (QTcF) > 500 ms within 28 days before randomization. Note: if initial QTcF is found to be > 500 ms, two additional electrocardiograms (EKGs) separated by at least 3 minutes should be performed. If the average of these three consecutive results for QTcF is =< 500 ms, the subject meets eligibility in this regard
• Any history of congenital long QT syndrome
• Any of the following within 6 months before registration of study treatment:
• Unstable angina pectoris
• Clinically-significant cardiac arrhythmias (patients with atrial fibrillation are eligible)
• Stroke (including transient ischemic attack [TIA], or other ischemic event)
• Myocardial infarction
• Cardiomyopathy
• No significant gastrointestinal disorders particularly those associated with a high risk of perforation or fistula formation including:
• Any of the following that have not resolved within 28 days before the first dose of study treatment:
• Intra-abdominal tumor/metastases invading GI mucosa
• Active peptic ulcer disease
• Diverticulitis, cholecystitis, symptomatic cholangitis or appendicitis, or malabsorption syndrome
• None of the following within 1 year before the first dose of study treatment:
• Abdominal fistula or genitourinary fistula
• Gastrointestinal perforation
• Bowel obstruction or gastric outlet obstruction
• Intra-abdominal abscess. Note: Complete resolution of an intra-abdominal abscess must be confirmed prior to initiating treatment with cabozantinib even if the abscess occurred more than 12 months before the first dose of study treatment
• Disorders associated with a high risk of fistula formation including percutaneous endoscopic gastrostomy (PEG) tube placement are not eligible
• No other clinically significant disorders such as:
• Severe active infection requiring IV systemic treatment within 14 days before the first dose of study treatment
• Serious non-healing wound/ulcer/bone fracture within 28 days before the first dose of study treatment
• History of organ or allogeneic stem cell transplant
• Concurrent uncompensated hypothyroidism or thyroid dysfunction within 7 days before the first dose of study treatment (for asymptomatic patients with an elevated thyroid-stimulating hormone [TSH], thyroid replacement may be initiated if clinically indicated without delaying the start of study treatment)
• No history of major surgery as follows:
• Major surgery within 3 months of the first dose of cabozantinib; however, if there were no wound healing complications, patients with rapidly growing aggressive cancers, may start as soon as 6 weeks if wound has completely healed post-surgery
• Minor surgery within 1 month of the first dose of cabozantinib if there were no wound healing complications or within 3 months of the first dose of cabozantinib if there were wound complications excluding core biopsies and mediport placement
• Complete wound healing from prior surgery must be confirmed before the first dose of cabozantinib irrespective of the time from surgery
• No history of severe hypersensitivity reaction to any monoclonal antibody
• No evidence of active malignancy, requiring systemic treatment within 2 years of registration
• No history of allergic reactions attributed to compounds of similar chemical or biologic composition to cabozantinib, nivolumab, ipilimumab or other agents used in study
• No positive test for hepatitis B virus surface antigen (HBV sAg) or hepatitis C virus ribonucleic acid (HCV antibody) indicating acute or chronic infection
• No patients with active autoimmune disease or history of autoimmune disease that might recur, which may affect vital organ function or require immune suppressive treatment including systemic corticosteroids. These include, but are not limited to patients with a history of immune related neurologic disease, multiple sclerosis, autoimmune (demyelinating) neuropathy, Guillain-Barre syndrome, myasthenia gravis; systemic autoimmune disease such as systemic lupus erythematosus (SLE), connective tissue diseases, scleroderma, inflammatory bowel disease (IBD), Crohn’s, ulcerative colitis, hepatitis; and patients with a history of toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome, or phospholipid syndrome should be excluded because of the risk of recurrence or exacerbation of disease

Locations:

• University of Alabama at Birmingham Cancer Center
• Birmingham Alabama 35233 United States

• Anchorage Associates in Radiation Medicine
• Anchorage Alaska 98508 United States

• Anchorage Radiation Therapy Center
• Anchorage Alaska 99504 United States

• Alaska Breast Care and Surgery LLC
• Anchorage Alaska 99508 United States

• Alaska Oncology and Hematology LLC
• Anchorage Alaska 99508 United States

• Alaska Women’s Cancer Care
• Anchorage Alaska 99508 United States

• Anchorage Oncology Centre
• Anchorage Alaska 99508 United States

• Katmai Oncology Group
• Anchorage Alaska 99508 United States

• Providence Alaska Medical Center
• Anchorage Alaska 99508 United States

• Kingman Regional Medical Center
• Kingman Arizona 86401 United States

• Mayo Clinic Hospital
• Phoenix Arizona 85054 United States

• Mayo Clinic in Arizona
• Scottsdale Arizona 85259 United States

• Mercy Hospital Fort Smith
• Fort Smith Arkansas 72903 United States

• CHI Saint Vincent Cancer Center Hot Springs
• Hot Springs Arkansas 71913 United States

• PCR Oncology
• Arroyo Grande California 93420 United States

• Providence Saint Joseph Medical Center/Disney Family Cancer Center
• Burbank California 91505 United States

• Epic Care-Dublin
• Dublin California 94568 United States

• Bay Area Breast Surgeons Inc
• Emeryville California 94608 United States

• Epic Care Partners in Cancer Care
• Emeryville California 94608 United States

• UCLA / Jonsson Comprehensive Cancer Center
• Los Angeles California 90095 United States

• Contra Costa Regional Medical Center
• Martinez California 94553-3156 United States

• Alta Bates Summit Medical Center – Summit Campus
• Oakland California 94609 United States

• Bay Area Tumor Institute
• Oakland California 94609 United States

• Epic Care Cyberknife Center
• Walnut Creek California 94597 United States

• Penrose-Saint Francis Healthcare
• Colorado Springs Colorado 80907 United States

• Rocky Mountain Cancer Centers-Penrose
• Colorado Springs Colorado 80907 United States

• Porter Adventist Hospital
• Denver Colorado 80210 United States

• Mercy Medical Center
• Durango Colorado 81301 United States

• Southwest Oncology PC
• Durango Colorado 81301 United States

• Saint Anthony Hospital
• Lakewood Colorado 80228 United States

• Littleton Adventist Hospital
• Littleton Colorado 80122 United States

• Longmont United Hospital
• Longmont Colorado 80501 United States

• Rocky Mountain Cancer Centers-Longmont
• Longmont Colorado 80501 United States

• Parker Adventist Hospital
• Parker Colorado 80138 United States

• Saint Mary Corwin Medical Center
• Pueblo Colorado 81004 United States

• MedStar Georgetown University Hospital
• Washington District of Columbia 20007 United States

• Mayo Clinic in Florida
• Jacksonville Florida 32224-9980 United States

• UF Cancer Center at Orlando Health
• Orlando Florida 32806 United States

• Saint Alphonsus Cancer Care Center-Boise
• Boise Idaho 83706 United States

• Saint Luke’s Mountain States Tumor Institute
• Boise Idaho 83712 United States

• Saint Alphonsus Cancer Care Center-Caldwell
• Caldwell Idaho 83605 United States

• Kootenai Medical Center
• Coeur d’Alene Idaho 83814 United States

• Walter Knox Memorial Hospital
• Emmett Idaho 83617 United States

• Saint Luke’s Mountain States Tumor Institute – Fruitland
• Fruitland Idaho 83619 United States

• Idaho Urologic Institute-Meridian
• Meridian Idaho 83642 United States

• Saint Luke’s Mountain States Tumor Institute – Meridian
• Meridian Idaho 83642 United States

• Saint Alphonsus Medical Center-Nampa
• Nampa Idaho 83686 United States

• Saint Luke’s Mountain States Tumor Institute – Nampa
• Nampa Idaho 83686 United States

• Kootenai Cancer Center
• Post Falls Idaho 83854 United States

• Kootenai Cancer Clinic
• Sandpoint Idaho 83864 United States

• Saint Luke’s Mountain States Tumor Institute-Twin Falls
• Twin Falls Idaho 83301 United States

• Rush – Copley Medical Center
• Aurora Illinois 60504 United States

• Illinois CancerCare-Bloomington
• Bloomington Illinois 61704 United States

• Illinois CancerCare-Canton
• Canton Illinois 61520 United States

• Memorial Hospital of Carbondale
• Carbondale Illinois 62902 United States

• SIH Cancer Institute
• Carterville Illinois 62918 United States

• Illinois CancerCare-Carthage
• Carthage Illinois 62321 United States

• University of Illinois
• Chicago Illinois 60612 United States

• University of Chicago Comprehensive Cancer Center
• Chicago Illinois 60637 United States

• Carle on Vermilion
• Danville Illinois 61832 United States

• Cancer Care Specialists of Illinois – Decatur
• Decatur Illinois 62526 United States

• Decatur Memorial Hospital
• Decatur Illinois 62526 United States

• Illinois CancerCare-Dixon
• Dixon Illinois 61021 United States

• Carle Physician Group-Effingham
• Effingham Illinois 62401 United States

• Crossroads Cancer Center
• Effingham Illinois 62401 United States

• Illinois CancerCare-Eureka
• Eureka Illinois 61530 United States

• Illinois CancerCare-Galesburg
• Galesburg Illinois 61401 United States

• Western Illinois Cancer Treatment Center
• Galesburg Illinois 61401 United States

• Illinois CancerCare-Kewanee Clinic
• Kewanee Illinois 61443 United States

• Illinois CancerCare-Macomb
• Macomb Illinois 61455 United States

• Carle Physician Group-Mattoon/Charleston
• Mattoon Illinois 61938 United States

• Loyola University Medical Center
• Maywood Illinois 60153 United States

• Marjorie Weinberg Cancer Center at Loyola-Gottlieb
• Melrose Park Illinois 60160 United States

• Good Samaritan Regional Health Center
• Mount Vernon Illinois 62864 United States

• UC Comprehensive Cancer Center at Silver Cross
• New Lenox Illinois 60451 United States

• University of Chicago Medicine-Orland Park
• Orland Park Illinois 60462 United States

• Illinois CancerCare-Ottawa Clinic
• Ottawa Illinois 61350 United States

• Illinois CancerCare-Pekin
• Pekin Illinois 61554 United States

• Illinois CancerCare-Peoria
• Peoria Illinois 61615 United States

• Methodist Medical Center of Illinois
• Peoria Illinois 61636 United States

• Illinois CancerCare-Peru
• Peru Illinois 61354 United States

• Valley Radiation Oncology
• Peru Illinois 61354 United States

• Illinois CancerCare-Princeton
• Princeton Illinois 61356 United States

• Southern Illinois University School of Medicine
• Springfield Illinois 62702 United States

• Springfield Clinic
• Springfield Illinois 62702 United States

• Memorial Medical Center
• Springfield Illinois 62781 United States

• Cancer Care Specialists of Illinois-Swansea
• Swansea Illinois 62226 United States

• Southwest Illinois Health Services LLP
• Swansea Illinois 62226 United States

• Carle Cancer Center
• Urbana Illinois 61801 United States

• The Carle Foundation Hospital
• Urbana Illinois 61801 United States

• Rush-Copley Healthcare Center
• Yorkville Illinois 60560 United States

• Reid Health
• Richmond Indiana 47374 United States

• Mary Greeley Medical Center
• Ames Iowa 50010 United States

• McFarland Clinic PC – Ames
• Ames Iowa 50010 United States

• McFarland Clinic PC-Boone
• Boone Iowa 50036 United States

• Medical Oncology and Hematology Associates-West Des Moines
• Clive Iowa 50325 United States

• Mercy Cancer Center-West Lakes
• Clive Iowa 50325 United States

• Alegent Health Mercy Hospital
• Council Bluffs Iowa 51503 United States

• Greater Regional Medical Center
• Creston Iowa 50801 United States

• Medical Oncology and Hematology Associates-Laurel
• Des Moines Iowa 50314 United States

• Mercy Medical Center – Des Moines
• Des Moines Iowa 50314 United States

• McFarland Clinic PC-Trinity Cancer Center
• Fort Dodge Iowa 50501 United States

• McFarland Clinic PC-Jefferson
• Jefferson Iowa 50129 United States

• McFarland Clinic PC-Marshalltown
• Marshalltown Iowa 50158 United States

• Mercy Medical Center-West Lakes
• West Des Moines Iowa 50266 United States

• Cancer Center of Kansas – Chanute
• Chanute Kansas 66720 United States

• Cancer Center of Kansas – Dodge City
• Dodge City Kansas 67801 United States

• Cancer Center of Kansas – El Dorado
• El Dorado Kansas 67042 United States

• University of Kansas Clinical Research Center
• Fairway Kansas 66205 United States

• Hays Medical Center
• Hays Kansas 67601 United States

• Cancer Center of Kansas-Independence
• Independence Kansas 67301 United States

• Cancer Center of Kansas-Kingman
• Kingman Kansas 67068 United States

• Lawrence Memorial Hospital
• Lawrence Kansas 66044 United States

• Cancer Center of Kansas-Liberal
• Liberal Kansas 67905 United States

• Cancer Center of Kansas-Manhattan
• Manhattan Kansas 66502 United States

• Cancer Center of Kansas – McPherson
• McPherson Kansas 67460 United States

• Cancer Center of Kansas – Newton
• Newton Kansas 67114 United States

• Olathe Medical Center
• Olathe Kansas 66061 United States

• Cancer Center of Kansas – Parsons
• Parsons Kansas 67357 United States

• Via Christi Hospital-Pittsburg
• Pittsburg Kansas 66762 United States

• Cancer Center of Kansas – Pratt
• Pratt Kansas 67124 United States

• Cancer Center of Kansas – Salina
• Salina Kansas 67401 United States

• Salina Regional Health Center
• Salina Kansas 67401 United States

• Saint Francis Hospital and Medical Center – Topeka
• Topeka Kansas 66606 United States

• Cancer Center of Kansas – Wellington
• Wellington Kansas 67152 United States

• University of Kansas Hospital-Westwood Cancer Center
• Westwood Kansas 66205 United States

• Cancer Center of Kansas-Wichita Medical Arts Tower
• Wichita Kansas 67208 United States

• Ascension Via Christi Hospitals Wichita
• Wichita Kansas 67214 United States

• Cancer Center of Kansas – Wichita
• Wichita Kansas 67214 United States

• Cancer Center of Kansas – Winfield
• Winfield Kansas 67156 United States

• Flaget Memorial Hospital
• Bardstown Kentucky 40004 United States

• Commonwealth Cancer Center-Corbin
• Corbin Kentucky 40701 United States

• Saint Joseph Radiation Oncology Resource Center
• Lexington Kentucky 40504 United States

• Saint Joseph Hospital East
• Lexington Kentucky 40509 United States

• University of Kentucky/Markey Cancer Center
• Lexington Kentucky 40536 United States

• Saint Joseph London
• London Kentucky 40741 United States

• Jewish Hospital
• Louisville Kentucky 40202 United States

• Saints Mary and Elizabeth Hospital
• Louisville Kentucky 40215 United States

• Jewish Hospital Medical Center Northeast
• Louisville Kentucky 40245 United States

• Jewish Hospital Medical Center South
• Shepherdsville Kentucky 40165 United States

• East Jefferson General Hospital
• Metairie Louisiana 70006 United States

• LSU Healthcare Network / Metairie Multi-Specialty Clinic
• Metairie Louisiana 70006 United States

• Louisiana State University Health Science Center
• New Orleans Louisiana 70112 United States

• National Institutes of Health Clinical Center
• Bethesda Maryland 20892 United States

• Lahey Hospital and Medical Center
• Burlington Massachusetts 01805 United States

• Mercy Medical Center
• Springfield Massachusetts 01104 United States

• Saint Joseph Mercy Hospital
• Ann Arbor Michigan 48106 United States

• IHA Hematology Oncology Consultants-Brighton
• Brighton Michigan 48114 United States

• Saint Joseph Mercy Brighton
• Brighton Michigan 48114 United States

• Henry Ford Cancer Institute-Downriver
• Brownstown Michigan 48183 United States

• IHA Hematology Oncology Consultants-Canton
• Canton Michigan 48188 United States

• Saint Joseph Mercy Canton
• Canton Michigan 48188 United States

• Caro Cancer Center
• Caro Michigan 48723 United States

• IHA Hematology Oncology Consultants-Chelsea
• Chelsea Michigan 48118 United States

• Saint Joseph Mercy Chelsea
• Chelsea Michigan 48118 United States

• Hematology Oncology Consultants-Clarkston
• Clarkston Michigan 48346 United States

• Newland Medical Associates-Clarkston
• Clarkston Michigan 48346 United States

• Henry Ford Macomb Hospital-Clinton Township
• Clinton Township Michigan 48038 United States

• Henry Ford Medical Center-Fairlane
• Dearborn Michigan 48126 United States

• Henry Ford Hospital
• Detroit Michigan 48202 United States

• Ascension Saint John Hospital
• Detroit Michigan 48236 United States

• Great Lakes Cancer Management Specialists-Doctors Park
• East China Township Michigan 48054 United States

• Genesee Cancer and Blood Disease Treatment Center
• Flint Michigan 48503 United States

• Genesee Hematology Oncology PC
• Flint Michigan 48503 United States

• Genesys Hurley Cancer Institute
• Flint Michigan 48503 United States

• Hurley Medical Center
• Flint Michigan 48503 United States

• Academic Hematology Oncology Specialists
• Grosse Pointe Woods Michigan 48236 United States

• Great Lakes Cancer Management Specialists-Van Elslander Cancer Center
• Grosse Pointe Woods Michigan 48236 United States

• Michigan Breast Specialists-Grosse Pointe Woods
• Grosse Pointe Woods Michigan 48236 United States

• Allegiance Health
• Jackson Michigan 49201 United States

• Sparrow Hospital
• Lansing Michigan 48912 United States

• Hope Cancer Clinic
• Livonia Michigan 48154 United States

• Saint Mary Mercy Hospital
• Livonia Michigan 48154 United States

• Great Lakes Cancer Management Specialists-Macomb Medical Campus
• Macomb Michigan 48044 United States

• Michigan Breast Specialists-Macomb Township
• Macomb Michigan 48044 United States

• Saint Mary’s Oncology/Hematology Associates of Marlette
• Marlette Michigan 48453 United States

• Henry Ford Medical Center-Columbus
• Novi Michigan 48377 United States

• 21st Century Oncology-Pontiac
• Pontiac Michigan 48341 United States

• Hope Cancer Center
• Pontiac Michigan 48341 United States

• Newland Medical Associates-Pontiac
• Pontiac Michigan 48341 United States

• Saint Joseph Mercy Oakland
• Pontiac Michigan 48341 United States

• Huron Medical Center PC
• Port Huron Michigan 48060 United States

• Lake Huron Medical Center
• Port Huron Michigan 48060 United States

• Great Lakes Cancer Management Specialists-Rochester Hills
• Rochester Hills Michigan 48309 United States

• Ascension Saint Mary’s Hospital
• Saginaw Michigan 48601 United States

• Oncology Hematology Associates of Saginaw Valley PC
• Saginaw Michigan 48604 United States

• Bhadresh Nayak MD PC-Sterling Heights
• Sterling Heights Michigan 48312 United States

• Ascension Saint Joseph Hospital
• Tawas City Michigan 48764 United States

• Advanced Breast Care Center PLLC
• Warren Michigan 48088 United States

• Great Lakes Cancer Management Specialists-Macomb Professional Building
• Warren Michigan 48093 United States

• Macomb Hematology Oncology PC
• Warren Michigan 48093 United States

• Michigan Breast Specialists-Warren
• Warren Michigan 48093 United States

• Saint John Macomb-Oakland Hospital
• Warren Michigan 48093 United States

• Henry Ford West Bloomfield Hospital
• West Bloomfield Michigan 48322 United States

• Saint Mary’s Oncology/Hematology Associates of West Branch
• West Branch Michigan 48661 United States

• Huron Gastroenterology PC
• Ypsilanti Michigan 48106 United States

• IHA Hematology Oncology Consultants-Ann Arbor
• Ypsilanti Michigan 48197 United States

• Riverwood Healthcare Center
• Aitkin Minnesota 56431 United States

• Essentia Health Saint Joseph’s Medical Center
• Brainerd Minnesota 56401 United States

• Fairview Ridges Hospital
• Burnsville Minnesota 55337 United States

• Cambridge Medical Center
• Cambridge Minnesota 55008 United States

• Mercy Hospital
• Coon Rapids Minnesota 55433 United States

• Essentia Health – Deer River Clinic
• Deer River Minnesota 56636 United States

• Essentia Health Saint Mary’s – Detroit Lakes Clinic
• Detroit Lakes Minnesota 56501 United States

• Essentia Health Cancer Center
• Duluth Minnesota 55805 United States

• Essentia Health Saint Mary’s Medical Center
• Duluth Minnesota 55805 United States

• Miller-Dwan Hospital
• Duluth Minnesota 55805 United States

• Fairview-Southdale Hospital
• Edina Minnesota 55435 United States

• Lake Region Healthcare Corporation-Cancer Care
• Fergus Falls Minnesota 56537 United States

• Essentia Health – Fosston
• Fosston Minnesota 56542 United States

• Unity Hospital
• Fridley Minnesota 55432 United States

• Essentia Health Hibbing Clinic
• Hibbing Minnesota 55746 United States

• Fairview Maple Grove Medical Center
• Maple Grove Minnesota 55369 United States

• Minnesota Oncology Hematology PA-Maplewood
• Maplewood Minnesota 55109 United States

• Saint John’s Hospital – Healtheast
• Maplewood Minnesota 55109 United States

• Abbott-Northwestern Hospital
• Minneapolis Minnesota 55407 United States

• Hennepin County Medical Center
• Minneapolis Minnesota 55415 United States

• Health Partners Inc
• Minneapolis Minnesota 55454 United States

• Monticello Cancer Center
• Monticello Minnesota 55362 United States

• New Ulm Medical Center
• New Ulm Minnesota 56073 United States

• Essentia Health – Park Rapids
• Park Rapids Minnesota 56470 United States

• Fairview Northland Medical Center
• Princeton Minnesota 55371 United States

• North Memorial Medical Health Center
• Robbinsdale Minnesota 55422 United States

• Mayo Clinic
• Rochester Minnesota 55905 United States

• Park Nicollet Clinic – Saint Louis Park
• Saint Louis Park Minnesota 55416 United States

• Regions Hospital
• Saint Paul Minnesota 55101 United States

• United Hospital
• Saint Paul Minnesota 55102 United States

• Essentia Health Sandstone
• Sandstone Minnesota 55072 United States

• Saint Francis Regional Medical Center
• Shakopee Minnesota 55379 United States

• Lakeview Hospital
• Stillwater Minnesota 55082 United States

• Essentia Health Virginia Clinic
• Virginia Minnesota 55792 United States

• Ridgeview Medical Center
• Waconia Minnesota 55387 United States

• Rice Memorial Hospital
• Willmar Minnesota 56201 United States

• Minnesota Oncology Hematology PA-Woodbury
• Woodbury Minnesota 55125 United States

• Fairview Lakes Medical Center
• Wyoming Minnesota 55092 United States

• University of Mississippi Medical Center
• Jackson Mississippi 39216 United States

• Saint Louis Cancer and Breast Institute-Ballwin
• Ballwin Missouri 63011 United States

• Parkland Health Center-Bonne Terre
• Bonne Terre Missouri 63628 United States

• Cox Cancer Center Branson
• Branson Missouri 65616 United States

• Saint Francis Medical Center
• Cape Girardeau Missouri 63703 United States

• Southeast Cancer Center
• Cape Girardeau Missouri 63703 United States

• Siteman Cancer Center at West County Hospital
• Creve Coeur Missouri 63141 United States

• Parkland Health Center – Farmington
• Farmington Missouri 63640 United States

• Capital Region Southwest Campus
• Jefferson City Missouri 65109 United States

• Freeman Health System
• Joplin Missouri 64804 United States

• Mercy Hospital Joplin
• Joplin Missouri 64804 United States

• Truman Medical Center
• Kansas City Missouri 64108 United States

• Delbert Day Cancer Institute at PCRMC
• Rolla Missouri 65401 United States

• Mercy Clinic-Rolla-Cancer and Hematology
• Rolla Missouri 65401 United States

• Heartland Regional Medical Center
• Saint Joseph Missouri 64507 United States

• Saint Louis Cancer and Breast Institute-South City
• Saint Louis Missouri 63109 United States

• Washington University School of Medicine
• Saint Louis Missouri 63110 United States

• Mercy Hospital South
• Saint Louis Missouri 63128 United States

• Siteman Cancer Center-South County
• Saint Louis Missouri 63129 United States

• Missouri Baptist Medical Center
• Saint Louis Missouri 63131 United States

• Siteman Cancer Center at Christian Hospital
• Saint Louis Missouri 63136 United States

• Mercy Hospital Saint Louis
• Saint Louis Missouri 63141 United States

• Siteman Cancer Center at Saint Peters Hospital
• Saint Peters Missouri 63376 United States

• Sainte Genevieve County Memorial Hospital
• Sainte Genevieve Missouri 63670 United States

• Mercy Hospital Springfield
• Springfield Missouri 65804 United States

• CoxHealth South Hospital
• Springfield Missouri 65807 United States

• Missouri Baptist Sullivan Hospital
• Sullivan Missouri 63080 United States

• Missouri Baptist Outpatient Center-Sunset Hills
• Sunset Hills Missouri 63127 United States

• Mercy Hospital Washington
• Washington Missouri 63090 United States

• Community Hospital of Anaconda
• Anaconda Montana 59711 United States

• Billings Clinic Cancer Center
• Billings Montana 59101 United States

• Bozeman Deaconess Hospital
• Bozeman Montana 59715 United States

• Benefis Healthcare- Sletten Cancer Institute
• Great Falls Montana 59405 United States

• Great Falls Clinic
• Great Falls Montana 59405 United States

• Saint Peter’s Community Hospital
• Helena Montana 59601 United States

• Kalispell Regional Medical Center
• Kalispell Montana 59901 United States

• Saint Patrick Hospital – Community Hospital
• Missoula Montana 59802 United States

• Community Medical Hospital
• Missoula Montana 59804 United States

• CHI Health Saint Francis
• Grand Island Nebraska 68803 United States

• CHI Health Good Samaritan
• Kearney Nebraska 68847 United States

• Saint Elizabeth Regional Medical Center
• Lincoln Nebraska 68510 United States

• Nebraska Methodist Hospital
• Omaha Nebraska 68114 United States

• Alegent Health Immanuel Medical Center
• Omaha Nebraska 68122 United States

• Alegent Health Bergan Mercy Medical Center
• Omaha Nebraska 68124 United States

• Alegent Health Lakeside Hospital
• Omaha Nebraska 68130 United States

• Creighton University Medical Center
• Omaha Nebraska 68131 United States

• Midlands Community Hospital
• Papillion Nebraska 68046 United States

• Carson Tahoe Regional Medical Center
• Carson City Nevada 89703 United States

• Cancer and Blood Specialists-Henderson
• Henderson Nevada 89052 United States

• Comprehensive Cancer Centers of Nevada – Henderson
• Henderson Nevada 89052 United States

• Comprehensive Cancer Centers of Nevada-Horizon Ridge
• Henderson Nevada 89052 United States

• Las Vegas Cancer Center-Henderson
• Henderson Nevada 89052 United States

• OptumCare Cancer Care at Seven Hills
• Henderson Nevada 89052 United States

• 21st Century Oncology-Henderson
• Henderson Nevada 89074 United States

• Comprehensive Cancer Centers of Nevada-Southeast Henderson
• Henderson Nevada 89074 United States

• Las Vegas Urology – Green Valley
• Henderson Nevada 89074 United States

• Las Vegas Urology – Pebble
• Henderson Nevada 89074 United States

• Urology Specialists of Nevada – Green Valley
• Henderson Nevada 89074 United States

• Las Vegas Urology – Pecos
• Las Vegas Nevada 89074 United States

• Desert West Surgery
• Las Vegas Nevada 89102 United States

• University Medical Center of Southern Nevada
• Las Vegas Nevada 89102 United States

• Hope Cancer Care of Nevada
• Las Vegas Nevada 89103 United States

• Cancer and Blood Specialists-Shadow
• Las Vegas Nevada 89106 United States

• OptumCare Cancer Care at Oakey
• Las Vegas Nevada 89106 United States

• Radiation Oncology Centers of Nevada Central
• Las Vegas Nevada 89106 United States

• Urology Specialists of Nevada – Central
• Las Vegas Nevada 89106 United States

• 21st Century Oncology
• Las Vegas Nevada 89109 United States

• HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
• Las Vegas Nevada 89109 United States

• Sunrise Hospital and Medical Center
• Las Vegas Nevada 89109 United States

• HealthCare Partners Medical Group Oncology/Hematology-San Martin
• Las Vegas Nevada 89113 United States

• Las Vegas Prostate Cancer Center
• Las Vegas Nevada 89113 United States

• Las Vegas Urology – Sunset
• Las Vegas Nevada 89113 United States

• Radiation Oncology Centers of Nevada Southeast
• Las Vegas Nevada 89119 United States

• 21st Century Oncology-Vegas Tenaya
• Las Vegas Nevada 89128 United States

• Ann M Wierman MD LTD
• Las Vegas Nevada 89128 United States

• Cancer and Blood Specialists-Tenaya
• Las Vegas Nevada 89128 United States

• Comprehensive Cancer Centers of Nevada – Northwest
• Las Vegas Nevada 89128 United States

• HealthCare Partners Medical Group Oncology/Hematology-Tenaya
• Las Vegas Nevada 89128 United States

• Las Vegas Urology – Cathedral Rock
• Las Vegas Nevada 89128 United States

• Las Vegas Urology – Smoke Ranch
• Las Vegas Nevada 89128 United States

• OptumCare Cancer Care at MountainView
• Las Vegas Nevada 89128 United States

• Urology Specialists of Nevada – Northwest
• Las Vegas Nevada 89128 United States

• Alliance for Childhood Diseases/Cure 4 the Kids Foundation
• Las Vegas Nevada 89135 United States

• Comprehensive Cancer Centers of Nevada – Town Center
• Las Vegas Nevada 89144 United States

• Comprehensive Cancer Centers of Nevada-Summerlin
• Las Vegas Nevada 89144 United States

• Summerlin Hospital Medical Center
• Las Vegas Nevada 89144 United States

• Las Vegas Cancer Center-Medical Center
• Las Vegas Nevada 89148-2405 United States

• 21st Century Oncology-Fort Apache
• Las Vegas Nevada 89148 United States

• Comprehensive Cancer Centers of Nevada
• Las Vegas Nevada 89148 United States

• OptumCare Cancer Care at Fort Apache
• Las Vegas Nevada 89148 United States

• Urology Specialists of Nevada – Southwest
• Las Vegas Nevada 89148 United States

• HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
• Las Vegas Nevada 89149 United States

• Comprehensive Cancer Centers of Nevada – Central Valley
• Las Vegas Nevada 89169 United States

• University Cancer Center
• Las Vegas Nevada 89169 United States

• Hope Cancer Care of Nevada-Pahrump
• Pahrump Nevada 89048 United States

• Renown Regional Medical Center
• Reno Nevada 89502 United States

• Saint Mary’s Regional Medical Center
• Reno Nevada 89503 United States

• Radiation Oncology Associates
• Reno Nevada 89509 United States

• New York-Presbyterian/Brooklyn Methodist Hospital
• Brooklyn New York 11215 United States

• Roswell Park Cancer Institute
• Buffalo New York 14263 United States

• NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
• New York New York 10032 United States

• University of Rochester
• Rochester New York 14642 United States

• UNC Lineberger Comprehensive Cancer Center
• Chapel Hill North Carolina 27599 United States

• Margaret R Pardee Memorial Hospital
• Hendersonville North Carolina 28791 United States

• Essentia Health Cancer Center-South University Clinic
• Fargo North Dakota 58103 United States

• Essentia Health – Jamestown Clinic
• Jamestown North Dakota 58401 United States

• Indu and Raj Soin Medical Center
• Beavercreek Ohio 45431 United States

• Strecker Cancer Center-Belpre
• Belpre Ohio 45714 United States

• Saint Elizabeth Boardman Hospital
• Boardman Ohio 44512 United States

• Dayton Physicians LLC-Miami Valley South
• Centerville Ohio 45459 United States

• Miami Valley Hospital South
• Centerville Ohio 45459 United States

• Adena Regional Medical Center
• Chillicothe Ohio 45601 United States

• Good Samaritan Hospital – Cincinnati
• Cincinnati Ohio 45220 United States

• Oncology Hematology Care Inc-Kenwood
• Cincinnati Ohio 45236 United States

• Bethesda North Hospital
• Cincinnati Ohio 45242 United States

• TriHealth Cancer Institute-Westside
• Cincinnati Ohio 45247 United States

• TriHealth Cancer Institute-Anderson
• Cincinnati Ohio 45255 United States

• Ohio State University Comprehensive Cancer Center
• Columbus Ohio 43210 United States

• Mount Carmel East Hospital
• Columbus Ohio 43213 United States

• Columbus Oncology and Hematology Associates Inc
• Columbus Ohio 43214 United States

• Riverside Methodist Hospital
• Columbus Ohio 43214 United States

• Grant Medical Center
• Columbus Ohio 43215 United States

• The Mark H Zangmeister Center
• Columbus Ohio 43219 United States

• Mount Carmel Health Center West
• Columbus Ohio 43222 United States

• Doctors Hospital
• Columbus Ohio 43228 United States

• Good Samaritan Hospital – Dayton
• Dayton Ohio 45406 United States

• Miami Valley Hospital
• Dayton Ohio 45409 United States

• Dayton Physician LLC-Miami Valley Hospital North
• Dayton Ohio 45415 United States

• Miami Valley Hospital North
• Dayton Ohio 45415 United States

• Delaware Health Center-Grady Cancer Center
• Delaware Ohio 43015 United States

• Grady Memorial Hospital
• Delaware Ohio 43015 United States

• Dublin Methodist Hospital
• Dublin Ohio 43016 United States

• Armes Family Cancer Center
• Findlay Ohio 45840 United States

• Blanchard Valley Hospital
• Findlay Ohio 45840 United States

• Orion Cancer Care
• Findlay Ohio 45840 United States

• Atrium Medical Center-Middletown Regional Hospital
• Franklin Ohio 45005-1066 United States

• Dayton Physicians LLC-Atrium
• Franklin Ohio 45005 United States

• Central Ohio Breast and Endocrine Surgery
• Gahanna Ohio 43230 United States

• Dayton Physicians LLC-Wayne
• Greenville Ohio 45331 United States

• Wayne Hospital
• Greenville Ohio 45331 United States

• Greater Dayton Cancer Center
• Kettering Ohio 45409 United States

• First Dayton Cancer Care
• Kettering Ohio 45420 United States

• Kettering Medical Center
• Kettering Ohio 45429 United States

• Fairfield Medical Center
• Lancaster Ohio 43130 United States

• OhioHealth Mansfield Hospital
• Mansfield Ohio 44903 United States

• Marietta Memorial Hospital
• Marietta Ohio 45750 United States

• OhioHealth Marion General Hospital
• Marion Ohio 43302 United States

• Knox Community Hospital
• Mount Vernon Ohio 43050 United States

• Licking Memorial Hospital
• Newark Ohio 43055 United States

• Newark Radiation Oncology
• Newark Ohio 43055 United States

• Southern Ohio Medical Center
• Portsmouth Ohio 45662 United States

• Springfield Regional Cancer Center
• Springfield Ohio 45504 United States

• Springfield Regional Medical Center
• Springfield Ohio 45505 United States

• Dayton Physicians LLC-Upper Valley
• Troy Ohio 45373 United States

• Upper Valley Medical Center
• Troy Ohio 45373 United States

• Saint Joseph Warren Hospital
• Warren Ohio 44484 United States

• Saint Ann’s Hospital
• Westerville Ohio 43081 United States

• Saint Elizabeth Youngstown Hospital
• Youngstown Ohio 44501 United States

• Genesis Healthcare System Cancer Care Center
• Zanesville Ohio 43701 United States

• Cancer Centers of Southwest Oklahoma Research
• Lawton Oklahoma 73505 United States

• University of Oklahoma Health Sciences Center
• Oklahoma City Oklahoma 73104 United States

• Mercy Hospital Oklahoma City
• Oklahoma City Oklahoma 73120 United States

• Oklahoma Cancer Specialists and Research Institute-Tulsa
• Tulsa Oklahoma 74146 United States

• Saint Alphonsus Medical Center-Baker City
• Baker City Oregon 97814 United States

• Saint Charles Health System
• Bend Oregon 97701 United States

• Clackamas Radiation Oncology Center
• Clackamas Oregon 97015 United States

• Providence Oncology and Hematology Care Southeast
• Clackamas Oregon 97015 United States

• Bay Area Hospital
• Coos Bay Oregon 97420 United States

• Providence Newberg Medical Center
• Newberg Oregon 97132 United States

• Saint Alphonsus Medical Center-Ontario
• Ontario Oregon 97914 United States

• Providence Portland Medical Center
• Portland Oregon 97213 United States

• Providence Saint Vincent Medical Center
• Portland Oregon 97225 United States

• Oregon Health and Science University
• Portland Oregon 97239 United States

• Saint Charles Health System-Redmond
• Redmond Oregon 97756 United States

• Lehigh Valley Hospital-Cedar Crest
• Allentown Pennsylvania 18103 United States

• Lehigh Valley Hospital – Muhlenberg
• Bethlehem Pennsylvania 18017 United States

• Pocono Medical Center
• East Stroudsburg Pennsylvania 18301 United States

• Lehigh Valley Hospital-Hazleton
• Hazleton Pennsylvania 18201 United States

• University of Pittsburgh Cancer Institute (UPCI)
• Pittsburgh Pennsylvania 15232 United States

• UPMC-Shadyside Hospital
• Pittsburgh Pennsylvania 15232 United States

• Medical University of South Carolina
• Charleston South Carolina 29425 United States

• Saint Joseph Regional Cancer Center
• Bryan Texas 77802 United States

• UT Southwestern/Simmons Cancer Center-Dallas
• Dallas Texas 75390 United States

• UT Southwestern/Simmons Cancer Center-Fort Worth
• Fort Worth Texas 76104 United States

• UT Southwestern Clinical Center at Richardson/Plano
• Richardson Texas 75080 United States

• Providence Regional Cancer System-Aberdeen
• Aberdeen Washington 98520 United States

• Overlake Hospital Medical Center
• Bellevue Washington 98004 United States

• PeaceHealth Saint Joseph Medical Center
• Bellingham Washington 98225 United States

• Harrison HealthPartners Hematology and Oncology-Bremerton
• Bremerton Washington 98310 United States

• Harrison Medical Center
• Bremerton Washington 98310 United States

• Highline Medical Center-Main Campus
• Burien Washington 98166 United States

• Providence Regional Cancer System-Centralia
• Centralia Washington 98531 United States

• Swedish Cancer Institute-Edmonds
• Edmonds Washington 98026 United States

• Saint Elizabeth Hospital
• Enumclaw Washington 98022 United States

• Providence Regional Cancer Partnership
• Everett Washington 98201 United States

• Saint Francis Hospital
• Federal Way Washington 98003 United States

• Swedish Cancer Institute-Issaquah
• Issaquah Washington 98029 United States

• Kadlec Clinic Hematology and Oncology
• Kennewick Washington 99336 United States

• Providence Regional Cancer System-Lacey
• Lacey Washington 98503 United States

• Saint Clare Hospital
• Lakewood Washington 98499 United States

• PeaceHealth Saint John Medical Center
• Longview Washington 98632 United States

• Harrison HealthPartners Hematology and Oncology-Poulsbo
• Poulsbo Washington 98370 United States

• Valley Medical Center
• Renton Washington 98055 United States

• Pacific Gynecology Specialists
• Seattle Washington 98104 United States

• Swedish Medical Center-Ballard Campus
• Seattle Washington 98107 United States

• Swedish Medical Center-First Hill
• Seattle Washington 98122-4307 United States

• Swedish Medical Center-Cherry Hill
• Seattle Washington 98122-5711 United States

• PeaceHealth United General Medical Center
• Sedro-Woolley Washington 98284 United States

• Providence Regional Cancer System-Shelton
• Shelton Washington 98584 United States

• Franciscan Research Center-Northwest Medical Plaza
• Tacoma Washington 98405 United States

• PeaceHealth Southwest Medical Center
• Vancouver Washington 98664 United States

• Providence Saint Mary Regional Cancer Center
• Walla Walla Washington 99362 United States

• Providence Regional Cancer System-Yelm
• Yelm Washington 98597 United States

• Duluth Clinic Ashland
• Ashland Wisconsin 54806 United States

• Northwest Wisconsin Cancer Center
• Ashland Wisconsin 54806 United States

• Marshfield Medical Center-EC Cancer Center
• Eau Claire Wisconsin 54701 United States

• Mayo Clinic Health System-Eau Claire Clinic
• Eau Claire Wisconsin 54701 United States

• Marshfield Medical Center-Marshfield
• Marshfield Wisconsin 54449 United States

• Marshfield Clinic-Minocqua Center
• Minocqua Wisconsin 54548 United States

• ProHealth D N Greenwald Center
• Mukwonago Wisconsin 53149 United States

• Cancer Center of Western Wisconsin
• New Richmond Wisconsin 54017 United States

• ProHealth Oconomowoc Memorial Hospital
• Oconomowoc Wisconsin 53066 United States

• Marshfield Medical Center-Rice Lake
• Rice Lake Wisconsin 54868 United States

• Marshfield Clinic Stevens Point Center
• Stevens Point Wisconsin 54482 United States

• ProHealth Waukesha Memorial Hospital
• Waukesha Wisconsin 53188 United States

• UW Cancer Center at ProHealth Care
• Waukesha Wisconsin 53188 United States

• Marshfield Clinic – Weston Center
• Weston Wisconsin 54476 United States

• Billings Clinic-Cody
• Cody Wyoming 82414 United States

• Welch Cancer Center
• Sheridan Wyoming 82801 United States

View trial on ClinicalTrials.gov