DREAMseq (Doublet, Randomized Evaluation in Advanced Melanoma Sequencing) a Phase III Trial

Who is this study for? Patients with Melanoma
Status: Active, not recruiting
Location: See all (849) locations...
Intervention Type: Other, Procedure, Biological, Drug
Study Type: Interventional
Study Phase: Phase 3
SUMMARY

This phase III trial studies how well initial treatment with ipilimumab and nivolumab followed by dabrafenib and trametinib works and compares it to initial treatment with dabrafenib and trametinib followed by ipilimumab and nivolumab in treating patients with stage III-IV melanoma that contains a mutation known as BRAFV600 and cannot be removed by surgery (unresectable). Immunotherapy with monoclonal antibodies, such as ipilimumab and nivolumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Dabrafenib and trametinib may block tumor growth by targeting the BRAFV600 gene. It is not yet known whether treating patients with ipilimumab and nivolumab followed by dabrafenib and trametinib is more effective than treatment with dabrafenib and trametinib followed by ipilimumab and nivolumab.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: No
View:

• STEP 1

• Age >= 18 years. Because no dosing or adverse event data are currently available on the use of dabrafenib or dabrafenib + trametinib or nivolumab or nivolumab + ipilimumab therapy in patients < 18 years of age, children are excluded from this study, but will be eligible for future pediatric trials.

• Eastern Cooperative Oncology Group (ECOG) performance status: 0 or 1

• The effects of dabrafenib and trametinib or ipilimumab and nivolumab on the developing human fetus are unknown; furthermore, dabrafenib has been reported to interfere with the effect of hormone based oral contraceptives; for this reason and because other therapeutic agents used in this trial are known to be teratogenic, women of child-bearing potential and sexually active males must agree to use at least two other accepted and effective methods of contraception and/or to abstain from sexual intercourse for the duration of their participation in the study, and for at least 4 weeks after treatment with dabrafenib or for 4 months after dabrafenib in combination with trametinib; women of child-bearing potential must use at least two other accepted and effective methods of contraception and/or to abstain from sexual intercourse for at least 5 months after the last dose of nivolumab and/or ipilimumab and sexually active males must use at least two other accepted and effective methods of contraception and/or abstain from sexual intercourse for at least 7 months after the last dose of nivolumab and/or ipilimumab; should a woman become pregnant or suspect she is pregnant while she is participating in this study, she should inform her treating physician immediately

• Patients must have unresectable stage III or stage IV disease

• Patients must have measurable disease; all sites of disease must be evaluated within 4 weeks prior to randomization

• Patients must have histological or cytological confirmation of melanoma that is metastatic or unresectable and clearly progressive

• NOTE: Any patient with BRAF V600 mutant melanoma (whether cutaneous, acral or mucosal primary) who meets the eligibility criteria is eligible for participation in this trial; patients with uveal melanoma are not eligible for this trial

• Patients must have BRAF V600 mutation, identified by a Food and Drug Administration (FDA)-approved test at a Clinical Laboratory Improvement Act (CLIA)-certified lab; if test at CLIA-certified lab used a non-FDA approved method, information about the assay must be provided (FDA approved tests for BRAF V600 mutations in melanoma include: THxID BRAF Detection Kit and Cobas 4800 BRAF V600 Mutation Test, Foundation Medicine); prompt information on tumor BRAF mutation status can also be obtained via Novartis knowNow Program

• Patients may have had prior systemic therapy in the adjuvant setting; however this adjuvant treatment must not have included a CTLA4 or PD1 pathway blocking antibody or a BRAF/MEK inhibitor. Also, patients may not have had any prior systemic treatment for advanced (measurable metastatic) disease

• Patients must have discontinued chemotherapy, immunotherapy or other investigational agents used in the adjuvant setting >= 4 weeks prior to entering the study and recovered from adverse events due to those agents; mitomycin and nitrosoureas must have been discontinued at least 6 weeks prior to entering the study; patients must have discontinued radiation therapy >= 1 week prior to entering the study and recovered from any adverse events associated with treatment; prior surgery must be >= 2 weeks from registration and patients must be fully recovered from post-surgical complications

• White blood count >= 3,000/uL (obtained within 4 weeks prior to randomization)

• Absolute neutrophil count (ANC) >= 1,500/uL (obtained within 4 weeks prior to randomization)

• Platelet count >= 100,000/uL (obtained within 4 weeks prior to randomization)

• Hemoglobin > 8 g/dL (obtained within 4 weeks prior to randomization)

• Serum creatinine =< 1.5 x upper limit of normal (ULN) or serum creatinine clearance (CrCl) >= 40 ml/min (obtained within 4 weeks prior to randomization)

• Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 3 x ULN (=< 5 x ULN for patients with documented liver metastases)

• Alkaline phosphatase =< 2 x ULN (=< 5 x ULN for patients with known liver involvement and =< 7 x ULN for patients with known bone involvement) (obtained within 4 weeks prior to randomization)

• Total bilirubin =< 1.5 x ULN except subjects with normal direct bilirubin or those with known Gilbert's syndrome (obtained within 4 weeks prior to randomization)

• STEP 2 (CROSSOVER ARMS): The patient must have met all eligibility criteria (except as detailed below) at the time of crossover

• RECIST defined measurable disease is not required

• Only prior systemic therapy as part of step 1 is allowed; patients who received allowed systemic therapy in the adjuvant setting prior to Step 1 and were eligible for Step 1 are not excluded from proceeding to Step 2 if they meet other eligibility criteria

• Malabsorption, swallowing difficulty, or other conditions that would interfere with the ingestion or absorption of dabrafenib or trametinib, or history of retinal vein occlusion are acceptable for patients crossing over to Arm D (ipilimumab + nivolumab) treatment

• History of autoimmune disease, excluding interstitial lung disease or pneumonitis, is allowed in patients crossing over to Arm C (dabrafenib/trametinib) therapy

• Patients crossing over from Arm A (nivolumab/ipilimumab) to Arm C (dabrafenib/trametinib) who underwent surgery or SRS to CNS metastases need not be off of steroids to start treatment

• There is no restriction on serum lactate dehydrogenase (LDH) at crossover

• Patients with a history of cardiovascular risks that developed during step 1 of therapy should be discussed with study principal investigator (PI) at time of crossover

• STEP 2 (CROSSOVER ARMS): Patients randomized to Arm A on Step 1 must have melanoma that is metastatic and clearly progressive on Step 1 therapy prior to crossing over to Arm C

• NOTE: Patients should (if possible) be at least 1 week from documented PD on Step 1 of current study. All sites of disease must be evaluated within 4 weeks prior to registration

• STEP 2 (CROSSOVER ARMS): Patients randomized to Arm B on Step 1 may cross over to Arm D at or prior to disease progression

• NOTE: If possible, patients should wait to cross over until after the cycle with the next protocol-required imaging assessment is completed; all sites of disease must be evaluated within 4 weeks prior to Step 2 registration

• NOTE: Patients should start Arm D treatment at least 1 week after stopping dabrafenib and trametinib, unless otherwise clinically indicated

• NOTE: Baseline labs and QOL assessments should be completed, and patients should follow the Arm D schedule

• STEP 2 (CROSSOVER ARMS): Patients must have recovered from adverse events (toxicities resolved to grade 1 or less) of prior therapy; patients with immune related toxicities from ipilimumab + nivolumab may continue onto Step 2 even if still on steroids to control side effects, so long as toxicity has resolved to grade 1 or less

• STEP 2 (CROSSOVER ARMS): Patients must have discontinued radiation therapy prior to registering to Step 2 of the study and recovered from any adverse events associated with treatment; prior surgery must be >= 2 weeks from registration to Step 2 and patients must be fully recovered from post-surgical complications

• STEP 2 (CROSSOVER ARMS): The effects of dabrafenib and trametinib or ipilimumab and nivolumab on the developing human fetus are unknown; furthermore, dabrafenib has been reported to interfere with the effect of hormone based oral contraceptives; for this reason and because other therapeutic agents used in this trial are known to be teratogenic, women of child-bearing potential and sexually active males must agree to continue to use the same contraception requirements as on Step 1 of this study (i.e.: use at least two other accepted and effective methods of contraception and/or to abstain from sexual intercourse for the duration of their participation in the study, and for at least 4 weeks after treatment with dabrafenib or for 4 months after dabrafenib in combination with trametinib; women of child-bearing potential must use at least two other accepted and effective methods of contraception and/or to abstain from sexual intercourse for at least 5 months after the last dose of nivolumab and/or ipilimumab and sexually active males must use at least two other accepted and effective methods of contraception and/or to abstain from sexual intercourse for at least 7 months after the last dose of nivolumab and/or ipilimumab); should a woman become pregnant or suspect she is pregnant while she is participating in this study, she should inform her treating physician immediately

Locations
United States
Alaska
Alaska Breast Care and Surgery LLC
Anchorage
Alaska Oncology and Hematology LLC
Anchorage
Alaska Women's Cancer Care
Anchorage
Anchorage Associates in Radiation Medicine
Anchorage
Anchorage Oncology Centre
Anchorage
Anchorage Radiation Therapy Center
Anchorage
Katmai Oncology Group
Anchorage
Providence Alaska Medical Center
Anchorage
Fairbanks Memorial Hospital
Fairbanks
Alabama
University of Alabama at Birmingham Cancer Center
Birmingham
Arkansas
CHI Saint Vincent Cancer Center Hot Springs
Hot Springs
University of Arkansas for Medical Sciences
Little Rock
Arizona
CTCA at Western Regional Medical Center
Goodyear
Kingman Regional Medical Center
Kingman
Cancer Center at Saint Joseph's
Phoenix
California
Kaiser Permanente-Anaheim
Anaheim
Mission Hope Medical Oncology - Arroyo Grande
Arroyo Grande
PCR Oncology
Arroyo Grande
Sutter Auburn Faith Hospital
Auburn
Sutter Cancer Centers Radiation Oncology Services-Auburn
Auburn
Kaiser Permanente-Baldwin Park
Baldwin Park
Kaiser Permanente-Bellflower
Bellflower
Alta Bates Summit Medical Center-Herrick Campus
Berkeley
Providence Saint Joseph Medical Center/Disney Family Cancer Center
Burbank
Mills-Peninsula Medical Center
Burlingame
Sutter Cancer Centers Radiation Oncology Services-Cameron Park
Cameron Park
Eden Hospital Medical Center
Castro Valley
Adventist Health Cancer Care Center Chico
Chico
Sutter Davis Hospital
Davis
City of Hope Comprehensive Cancer Center
Duarte
Kaiser Permanente Dublin
Dublin
Kaiser Permanente-Fontana
Fontana
Palo Alto Medical Foundation-Fremont
Fremont
Kaiser Permanente-Fresno
Fresno
Kaiser Permanente - Harbor City
Harbor City
Kaiser Permanente-Irvine
Irvine
Kaiser Permanente Los Angeles Medical Center
Los Angeles
Kaiser Permanente West Los Angeles
Los Angeles
UCLA / Jonsson Comprehensive Cancer Center
Los Angeles
Kaiser Permanente-Modesto
Modesto
Memorial Medical Center
Modesto
Palo Alto Medical Foundation-Camino Division
Mountain View
Palo Alto Medical Foundation-Gynecologic Oncology
Mountain View
Sutter Cancer Research Consortium
Novato
Kaiser Permanente-Oakland
Oakland
Kaiser Permanente-Ontario
Ontario
Palo Alto Medical Foundation Health Care
Palo Alto
Kaiser Permanente - Panorama City
Panorama City
Eisenhower Medical Center
Rancho Mirage
Kaiser Permanente-Richmond
Richmond
Kaiser Permanente-Riverside
Riverside
Kaiser Permanente-Roseville
Roseville
Sutter Cancer Centers Radiation Oncology Services-Roseville
Roseville
Sutter Roseville Medical Center
Roseville
Kaiser Permanente - Sacramento
Sacramento
Kaiser Permanente Downtown Commons
Sacramento
Kaiser Permanente-South Sacramento
Sacramento
Sutter Medical Center Sacramento
Sacramento
Kaiser Permanente-San Diego Mission
San Diego
Kaiser Permanente-San Diego Zion
San Diego
California Pacific Medical Center-Pacific Campus
San Francisco
Kaiser Permanente-Santa Teresa-San Jose
San Jose
Kaiser Permanente San Leandro
San Leandro
Pacific Central Coast Health Center-San Luis Obispo
San Luis Obispo
Kaiser Permanente-San Marcos
San Marcos
Mills Health Center
San Mateo
Kaiser Permanente-San Rafael
San Rafael
Kaiser San Rafael-Gallinas
San Rafael
Kaiser Permanente Medical Center - Santa Clara
Santa Clara
Palo Alto Medical Foundation-Santa Cruz
Santa Cruz
Mission Hope Medical Oncology - Santa Maria
Santa Maria
Sutter Pacific Medical Foundation
Santa Rosa
Kaiser Permanente-Stockton
Stockton
Palo Alto Medical Foundation-Sunnyvale
Sunnyvale
City of Hope Upland
Upland
Kaiser Permanente Medical Center-Vacaville
Vacaville
Sutter Cancer Centers Radiation Oncology Services-Vacaville
Vacaville
Kaiser Permanente-Vallejo
Vallejo
Sutter Solano Medical Center/Cancer Center
Vallejo
Kaiser Permanente-Walnut Creek
Walnut Creek
Kaiser Permanente-Woodland Hills
Woodland Hills
Colorado
The Medical Center of Aurora
Aurora
University of Colorado Hospital
Aurora
Boulder Community Hospital
Boulder
Memorial Hospital North
Colorado Springs
Penrose-Saint Francis Healthcare
Colorado Springs
Rocky Mountain Cancer Centers-Penrose
Colorado Springs
Saint Francis Cancer Center
Colorado Springs
UCHealth Memorial Hospital Central
Colorado Springs
Porter Adventist Hospital
Denver
Presbyterian - Saint Lukes Medical Center - Health One
Denver
Rose Medical Center
Denver
SCL Health Saint Joseph Hospital
Denver
Mercy Medical Center
Durango
Southwest Oncology PC
Durango
Mountain Blue Cancer Care Center - Swedish
Englewood
Swedish Medical Center
Englewood
Poudre Valley Hospital
Fort Collins
Mountain Blue Cancer Care Center
Golden
Grand Valley Oncology
Grand Junction
North Colorado Medical Center
Greeley
Rocky Mountain Cancer Centers-Lakewood
Lakewood
Saint Anthony Hospital
Lakewood
Littleton Adventist Hospital
Littleton
Sky Ridge Medical Center
Lone Tree
Longmont United Hospital
Longmont
Rocky Mountain Cancer Centers-Longmont
Longmont
McKee Medical Center
Loveland
Parker Adventist Hospital
Parker
Rocky Mountain Cancer Centers-Parker
Parker
Rocky Mountain Cancer Centers - Pueblo
Pueblo
Saint Mary Corwin Medical Center
Pueblo
Rocky Mountain Cancer Centers-Thornton
Thornton
SCL Health Lutheran Medical Center
Wheat Ridge
Connecticut
Smilow Cancer Hospital Care Center at Saint Francis
Hartford
Smilow Cancer Center/Yale-New Haven Hospital
New Haven
Yale University
New Haven
Eastern Connecticut Hematology and Oncology Associates
Norwich
Stamford Hospital/Bennett Cancer Center
Stamford
Washington, D.c.
MedStar Georgetown University Hospital
Washington
MedStar Washington Hospital Center
Washington
Delaware
Christiana Care Health System-Christiana Hospital
Newark
Christiana Gynecologic Oncology LLC
Newark
Delaware Clinical and Laboratory Physicians PA
Newark
Helen F Graham Cancer Center
Newark
Medical Oncology Hematology Consultants PA
Newark
Christiana Care Health System-Wilmington Hospital
Wilmington
Florida
Mount Sinai Comprehensive Cancer Center at Aventura
Aventura
UM Sylvester Comprehensive Cancer Center at Coral Gables
Coral Gables
Halifax Health Medical Center-Centers for Oncology
Daytona Beach
UM Sylvester Comprehensive Cancer Center at Deerfield Beach
Deerfield Beach
Holy Cross Hospital
Fort Lauderdale
Lakeland Regional Health Hollis Cancer Center
Lakeland
UM Sylvester Comprehensive Cancer Center at Kendall
Miami
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami
Mount Sinai Medical Center
Miami Beach
Orlando Health Cancer Institute
Orlando
UM Sylvester Comprehensive Cancer Center at Plantation
Plantation
Georgia
University Cancer and Blood Center LLC
Athens
Emory Saint Joseph's Hospital
Atlanta
Emory University Hospital/Winship Cancer Institute
Atlanta
Northside Hospital
Atlanta
Augusta University Medical Center
Augusta
Northside Hospital-Forsyth
Cumming
Dekalb Medical Center
Decatur
Northside Hospital - Duluth
Duluth
Northside Hospital - Gwinnett
Lawrenceville
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
Savannah
Summit Cancer Care-Candler
Savannah
Suburban Hematology Oncology Associates - Snellville
Snellville
Hawaii
Hawaii Cancer Care - Savio
'aiea
Pali Momi Medical Center
'aiea
Queen's Cancer Center - Pearlridge
'aiea
Straub Pearlridge Clinic
'aiea
The Cancer Center of Hawaii-Pali Momi
'aiea
The Queen's Medical Center - West Oahu
'ewa Beach
Hawaii Cancer Care Inc - Waterfront Plaza
Honolulu
Hawaii Cancer Care Inc-Liliha
Honolulu
Hawaii Diagnostic Radiology Services LLC
Honolulu
Island Urology
Honolulu
Kaiser Permanente Moanalua Medical Center
Honolulu
Kapiolani Medical Center for Women and Children
Honolulu
Kuakini Medical Center
Honolulu
Queen's Cancer Cenrer - POB I
Honolulu
Queen's Cancer Center - Kuakini
Honolulu
Queen's Medical Center
Honolulu
Straub Clinic and Hospital
Honolulu
The Cancer Center of Hawaii-Liliha
Honolulu
University of Hawaii Cancer Center
Honolulu
Straub Medical Center - Kahului Clinic
Kahului
Castle Medical Center
Kailua
Wilcox Memorial Hospital and Kauai Medical Clinic
Lihue
Iowa
Mary Greeley Medical Center
Ames
McFarland Clinic PC - Ames
Ames
McFarland Clinic PC-Boone
Boone
Medical Oncology and Hematology Associates-West Des Moines
Clive
Mercy Cancer Center-West Lakes
Clive
Alegent Health Mercy Hospital
Council Bluffs
Greater Regional Medical Center
Creston
Mercy Medical Center - Des Moines
Des Moines
Mission Cancer and Blood - Laurel
Des Moines
McFarland Clinic PC-Trinity Cancer Center
Fort Dodge
McFarland Clinic PC-Jefferson
Jefferson
McFarland Clinic PC-Marshalltown
Marshalltown
Siouxland Regional Cancer Center
Sioux City
Mercy Medical Center-West Lakes
West Des Moines
Idaho
Saint Alphonsus Cancer Care Center-Boise
Boise
Saint Luke's Cancer Institute - Boise
Boise
Saint Alphonsus Cancer Care Center-Caldwell
Caldwell
Kootenai Health - Coeur d'Alene
Coeur D'alene
Walter Knox Memorial Hospital
Emmett
Saint Luke's Cancer Institute - Fruitland
Fruitland
Idaho Urologic Institute-Meridian
Meridian
Saint Luke's Cancer Institute - Meridian
Meridian
Saint Alphonsus Medical Center-Nampa
Nampa
Saint Luke's Cancer Institute - Nampa
Nampa
Kootenai Clinic Cancer Services - Post Falls
Post Falls
Kootenai Cancer Clinic
Sandpoint
Saint Luke's Cancer Institute - Twin Falls
Twin Falls
Illinois
Rush - Copley Medical Center
Aurora
Illinois CancerCare-Bloomington
Bloomington
Saint Joseph Medical Center
Bloomington
Illinois CancerCare-Canton
Canton
Memorial Hospital of Carbondale
Carbondale
SIH Cancer Institute
Carterville
Illinois CancerCare-Carthage
Carthage
Centralia Oncology Clinic
Centralia
Northwestern University
Chicago
Rush University Medical Center
Chicago
Carle on Vermilion
Danville
Cancer Care Specialists of Illinois - Decatur
Decatur
Decatur Memorial Hospital
Decatur
Northwestern Medicine Cancer Center Kishwaukee
Dekalb
Illinois CancerCare-Dixon
Dixon
Carle Physician Group-Effingham
Effingham
Crossroads Cancer Center
Effingham
Illinois CancerCare-Eureka
Eureka
NorthShore University HealthSystem-Evanston Hospital
Evanston
Illinois CancerCare-Galesburg
Galesburg
Western Illinois Cancer Treatment Center
Galesburg
Northwestern Medicine Cancer Center Delnor
Geneva
NorthShore University HealthSystem-Glenbrook Hospital
Glenview
NorthShore University HealthSystem-Highland Park Hospital
Highland Park
Duly Health and Care Joliet
Joliet
Illinois CancerCare-Kewanee Clinic
Kewanee
Northwestern Medicine Lake Forest Hospital
Lake Forest
Illinois CancerCare-Macomb
Macomb
Carle Physician Group-Mattoon/Charleston
Mattoon
Loyola University Medical Center
Maywood
Cancer Care Center of O'Fallon
O'fallon
Illinois CancerCare-Ottawa Clinic
Ottawa
Illinois CancerCare-Pekin
Pekin
OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
Pekin
Illinois CancerCare-Peoria
Peoria
Methodist Medical Center of Illinois
Peoria
OSF Saint Francis Medical Center
Peoria
OSF Saint Francis Radiation Oncology at Peoria Cancer Center
Peoria
Illinois CancerCare-Peru
Peru
Valley Radiation Oncology
Peru
Illinois CancerCare-Princeton
Princeton
Memorial Medical Center
Springfield
Southern Illinois University School of Medicine
Springfield
Springfield Clinic
Springfield
Southwest Illinois Health Services LLP
Swansea
Carle Cancer Center
Urbana
The Carle Foundation Hospital
Urbana
Northwestern Medicine Cancer Center Warrenville
Warrenville
Illinois CancerCare - Washington
Washington
Rush-Copley Healthcare Center
Yorkville
Indiana
Deaconess Clinic Downtown
Evansville
Franciscan Health Indianapolis
Indianapolis
Indiana University/Melvin and Bren Simon Cancer Center
Indianapolis
Kendrick Colon and Rectal Center-Indianapolis
Indianapolis
Sidney and Lois Eskenazi Hospital
Indianapolis
Springmill Medical Center
Indianapolis
Woodland Cancer Care Center
Michigan City
Franciscan Health Mooresville
Mooresville
Chancellor Center for Oncology
Newburgh
Reid Health
Richmond
Kansas
Cancer Center of Kansas - Chanute
Chanute
Coffeyville Regional Medical Center
Coffeyville
Cancer Center of Kansas - Dodge City
Dodge City
Cancer Center of Kansas - El Dorado
El Dorado
Cancer Center of Kansas - Fort Scott
Fort Scott
Central Care Cancer Center - Garden City
Garden City
Saint Catherine Hospital
Garden City
Central Care Cancer Center - Great Bend
Great Bend
Saint Rose Ambulatory and Surgery Center
Great Bend
HaysMed University of Kansas Health System
Hays
Cancer Center of Kansas-Independence
Independence
University of Kansas Cancer Center
Kansas City
University of Kansas Cancer Center-West
Kansas City
Cancer Center of Kansas-Kingman
Kingman
Lawrence Memorial Hospital
Lawrence
Cancer Center of Kansas-Liberal
Liberal
Cancer Center of Kansas-Manhattan
Manhattan
Cancer Center of Kansas - McPherson
Mcpherson
Cancer Center of Kansas - Newton
Newton
Olathe Health Cancer Center
Olathe
Menorah Medical Center
Overland Park
University of Kansas Cancer Center-Overland Park
Overland Park
Cancer Center of Kansas - Parsons
Parsons
Ascension Via Christi - Pittsburg
Pittsburg
Cancer Center of Kansas - Pratt
Pratt
Cancer Center of Kansas - Salina
Salina
Salina Regional Health Center
Salina
University of Kansas Health System Saint Francis Campus
Topeka
Cancer Center of Kansas - Wellington
Wellington
University of Kansas Hospital-Westwood Cancer Center
Westwood
Ascension Via Christi Hospitals Wichita
Wichita
Associates In Womens Health
Wichita
Cancer Center of Kansas - Wichita
Wichita
Cancer Center of Kansas-Wichita Medical Arts Tower
Wichita
Cancer Center of Kansas - Winfield
Winfield
Kentucky
Flaget Memorial Hospital
Bardstown
Commonwealth Cancer Center-Corbin
Corbin
Oncology Hematology Care Inc-Crestview
Crestview Hills
Saint Joseph Hospital East
Lexington
Saint Joseph Radiation Oncology Resource Center
Lexington
Saint Joseph London
London
Jewish Hospital
Louisville
Saints Mary and Elizabeth Hospital
Louisville
The James Graham Brown Cancer Center at University of Louisville
Louisville
UofL Health Medical Center Northeast
Louisville
Jewish Hospital Medical Center South
Shepherdsville
Louisiana
Louisiana Hematology Oncology Associates LLC
Baton Rouge
LSU Health Baton Rouge-North Clinic
Baton Rouge
Mary Bird Perkins Cancer Center
Baton Rouge
Medical Center of Baton Rouge
Baton Rouge
Ochsner Health Center-Summa
Baton Rouge
Ochsner High Grove
Baton Rouge
Our Lady of the Lake Physicians Group - Medical Oncology
Baton Rouge
Mary Bird Perkins Cancer Center - Covington
Covington
Northshore Oncology Associates-Covington
Covington
Mary Bird Perkins Cancer Center - Houma
Houma
Oncology Center of The South Incorporated
Houma
Ochsner Medical Center Kenner
Kenner
Ochsner LSU Health Monroe Medical Center
Monroe
Louisiana State University Health Science Center
New Orleans
Ochsner Medical Center Jefferson
New Orleans
University Medical Center New Orleans
New Orleans
LSU Health Sciences Center at Shreveport
Shreveport
Massachusetts
Baystate Medical Center
Springfield
Mercy Medical Center
Springfield
UMass Memorial Medical Center - University Campus
Worcester
Maryland
Greater Baltimore Medical Center
Baltimore
MedStar Franklin Square Medical Center/Weinberg Cancer Institute
Baltimore
Saint Agnes Hospital
Baltimore
FMH James M Stockman Cancer Institute
Frederick
Frederick Memorial Hospital
Frederick
Michigan
Hickman Cancer Center
Adrian
Saint Joseph Mercy Hospital
Ann Arbor
University of Michigan Comprehensive Cancer Center
Ann Arbor
Bronson Battle Creek
Battle Creek
Saint Joseph Mercy Brighton
Brighton
Trinity Health IHA Medical Group Hematology Oncology - Brighton
Brighton
Saint Joseph Mercy Canton
Canton
Trinity Health IHA Medical Group Hematology Oncology - Canton
Canton
Caro Cancer Center
Caro
Saint Joseph Mercy Chelsea
Chelsea
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
Chelsea
Hematology Oncology Consultants-Clarkston
Clarkston
Newland Medical Associates-Clarkston
Clarkston
Beaumont Hospital - Dearborn
Dearborn
Ascension Saint John Hospital
Detroit
Wayne State University/Karmanos Cancer Institute
Detroit
Great Lakes Cancer Management Specialists-Doctors Park
East China Township
Green Bay Oncology - Escanaba
Escanaba
Weisberg Cancer Treatment Center
Farmington Hills
Genesee Cancer and Blood Disease Treatment Center
Flint
Genesee Hematology Oncology PC
Flint
Genesys Hurley Cancer Institute
Flint
Hurley Medical Center
Flint
Mercy Health Saint Mary's
Grand Rapids
Spectrum Health at Butterworth Campus
Grand Rapids
Academic Hematology Oncology Specialists
Grosse Pointe Woods
Great Lakes Cancer Management Specialists-Van Elslander Cancer Center
Grosse Pointe Woods
Michigan Breast Specialists-Grosse Pointe Woods
Grosse Pointe Woods
Allegiance Health
Jackson
Borgess Medical Center
Kalamazoo
Bronson Methodist Hospital
Kalamazoo
West Michigan Cancer Center
Kalamazoo
Sparrow Hospital
Lansing
Hope Cancer Clinic
Livonia
Trinity Health Saint Mary Mercy Livonia Hospital
Livonia
Great Lakes Cancer Management Specialists-Macomb Medical Campus
Macomb
Michigan Breast Specialists-Macomb Township
Macomb
Saint Mary's Oncology/Hematology Associates of Marlette
Marlette
Toledo Clinic Cancer Centers-Monroe
Monroe
Mercy Health Mercy Campus
Muskegon
Cancer and Hematology Centers of Western Michigan - Norton Shores
Norton Shores
21st Century Oncology-Pontiac
Pontiac
Hope Cancer Center
Pontiac
Newland Medical Associates-Pontiac
Pontiac
Saint Joseph Mercy Oakland
Pontiac
Huron Medical Center PC
Port Huron
Lake Huron Medical Center
Port Huron
Spectrum Health Reed City Hospital
Reed City
Great Lakes Cancer Management Specialists-Rochester Hills
Rochester Hills
Ascension Saint Mary's Hospital
Saginaw
Oncology Hematology Associates of Saginaw Valley PC
Saginaw
Bhadresh Nayak MD PC-Sterling Heights
Sterling Heights
Ascension Saint Joseph Hospital
Tawas City
Munson Medical Center
Traverse City
Advanced Breast Care Center PLLC
Warren
Great Lakes Cancer Management Specialists-Macomb Professional Building
Warren
Macomb Hematology Oncology PC
Warren
Michigan Breast Specialists-Warren
Warren
Saint John Macomb-Oakland Hospital
Warren
Saint Mary's Oncology/Hematology Associates of West Branch
West Branch
Metro Health Hospital
Wyoming
Huron Gastroenterology PC
Ypsilanti
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
Ypsilanti
Minnesota
Riverwood Healthcare Center
Aitkin
Sanford Joe Lueken Cancer Center
Bemidji
Essentia Health Saint Joseph's Medical Center
Brainerd
Mercy Hospital
Coon Rapids
Essentia Health - Deer River Clinic
Deer River
Essentia Health Saint Mary's - Detroit Lakes Clinic
Detroit Lakes
Essentia Health Cancer Center
Duluth
Essentia Health Saint Mary's Medical Center
Duluth
Miller-Dwan Hospital
Duluth
Fairview Southdale Hospital
Edina
Lake Region Healthcare Corporation-Cancer Care
Fergus Falls
Essentia Health - Fosston
Fosston
Unity Hospital
Fridley
Essentia Health Hibbing Clinic
Hibbing
Minnesota Oncology Hematology PA-Maplewood
Maplewood
Abbott-Northwestern Hospital
Minneapolis
Health Partners Inc
Minneapolis
Hennepin County Medical Center
Minneapolis
Essentia Health - Park Rapids
Park Rapids
North Memorial Medical Health Center
Robbinsdale
Regions Hospital
Saint Paul
United Hospital
Saint Paul
Essentia Health Sandstone
Sandstone
Saint Francis Regional Medical Center
Shakopee
Lakeview Hospital
Stillwater
Sanford Thief River Falls Medical Center
Thief River Falls
Essentia Health Virginia Clinic
Virginia
Ridgeview Medical Center
Waconia
Minnesota Oncology Hematology PA-Woodbury
Woodbury
Sanford Cancer Center Worthington
Worthington
Missouri
Central Care Cancer Center - Bolivar
Bolivar
Parkland Health Center-Bonne Terre
Bonne Terre
Saint Francis Medical Center
Cape Girardeau
Southeast Cancer Center
Cape Girardeau
Parkland Health Center - Farmington
Farmington
Capital Region Southwest Campus
Jefferson City
Kansas City Veterans Affairs Medical Center
Kansas City
Research Medical Center
Kansas City
The University of Kansas Cancer Center-South
Kansas City
Truman Medical Centers
Kansas City
University of Kansas Cancer Center - North
Kansas City
University of Kansas Cancer Center - Lee's Summit
Lee's Summit
Heartland Regional Medical Center
Saint Joseph
Missouri Baptist Medical Center
Saint Louis
Sainte Genevieve County Memorial Hospital
Sainte Genevieve
CoxHealth South Hospital
Springfield
Mercy Hospital Springfield
Springfield
Missouri Baptist Sullivan Hospital
Sullivan
Missouri Baptist Outpatient Center-Sunset Hills
Sunset Hills
Mississippi
University of Mississippi Medical Center
Jackson
Singing River Hospital
Pascagoula
Montana
Community Hospital of Anaconda
Anaconda
Saint Vincent Frontier Cancer Center
Billings
Bozeman Deaconess Hospital
Bozeman
Saint James Community Hospital and Cancer Treatment Center
Butte
Benefis Healthcare- Sletten Cancer Institute
Great Falls
Saint Peter's Community Hospital
Helena
Kalispell Regional Medical Center
Kalispell
Saint Patrick Hospital - Community Hospital
Missoula
North Carolina
AdventHealth Infusion Center Asheville
Asheville
Wake Forest University at Clemmons
Clemmons
Southeastern Medical Oncology Center-Clinton
Clinton
Southeastern Medical Oncology Center-Goldsboro
Goldsboro
Wayne Memorial Hospital
Goldsboro
Margaret R Pardee Memorial Hospital
Hendersonville
Onslow Memorial Hospital
Jacksonville
Southeastern Medical Oncology Center-Jacksonville
Jacksonville
Vidant Oncology-Kenansville
Kenansville
Vidant Oncology-Kinston
Kinston
Vidant Oncology-Richlands
Richlands
Wake Forest Baptist Health - Hematology Oncology - Statesville
Statesville
Wake Forest Baptist Health - Wilkes Medical Center
Wilkesboro
Wake Forest University Health Sciences
Winston-salem
North Dakota
Sanford Bismarck Medical Center
Bismarck
Essentia Health Cancer Center-South University Clinic
Fargo
Sanford Broadway Medical Center
Fargo
Sanford Clinic North-Fargo
Fargo
Sanford Roger Maris Cancer Center
Fargo
Sanford South University Medical Center
Fargo
Essentia Health - Jamestown Clinic
Jamestown
Nebraska
Nebraska Medicine-Bellevue
Bellevue
CHI Health Saint Francis
Grand Island
CHI Health Good Samaritan
Kearney
Heartland Hematology and Oncology
Kearney
Nebraska Cancer Research Center
Lincoln
Nebraska Hematology and Oncology
Lincoln
Saint Elizabeth Regional Medical Center
Lincoln
Southeast Nebraska Cancer Center - 68th Street Place
Lincoln
Faith Regional Health Services Carson Cancer Center
Norfolk
Great Plains Health Callahan Cancer Center
North Platte
Alegent Health Bergan Mercy Medical Center
Omaha
Alegent Health Immanuel Medical Center
Omaha
Alegent Health Lakeside Hospital
Omaha
Creighton University Medical Center
Omaha
Hematology and Oncology Consultants PC
Omaha
Nebraska Cancer Specialists - Omaha
Omaha
Nebraska Medicine-Village Pointe
Omaha
Nebraska Methodist Hospital
Omaha
Oncology Hematology West PC
Omaha
University of Nebraska Medical Center
Omaha
Midlands Community Hospital
Papillion
Regional West Medical Center Cancer Center
Scottsbluff
New Jersey
Hackensack University Medical Center
Hackensack
New Mexico
Lovelace Medical Center-Saint Joseph Square
Albuquerque
New Mexico Oncology Hematology Consultants
Albuquerque
Presbyterian Kaseman Hospital
Albuquerque
University of New Mexico Cancer Center
Albuquerque
Memorial Medical Center - Las Cruces
Las Cruces
Presbyterian Rust Medical Center/Jorgensen Cancer Center
Rio Rancho
Nevada
Carson Tahoe Regional Medical Center
Carson City
Cancer and Blood Specialists-Henderson
Henderson
Comprehensive Cancer Centers of Nevada - Henderson
Henderson
Comprehensive Cancer Centers of Nevada-Horizon Ridge
Henderson
Comprehensive Cancer Centers of Nevada-Southeast Henderson
Henderson
GenesisCare USA - Henderson
Henderson
Las Vegas Cancer Center-Henderson
Henderson
Las Vegas Urology - Green Valley
Henderson
Las Vegas Urology - Pebble
Henderson
OptumCare Cancer Care at Seven Hills
Henderson
Urology Specialists of Nevada - Green Valley
Henderson
Alliance for Childhood Diseases/Cure 4 the Kids Foundation
Las Vegas
Ann M Wierman MD LTD
Las Vegas
Cancer and Blood Specialists-Shadow
Las Vegas
Cancer and Blood Specialists-Tenaya
Las Vegas
Comprehensive Cancer Centers of Nevada
Las Vegas
Comprehensive Cancer Centers of Nevada - Central Valley
Las Vegas
Comprehensive Cancer Centers of Nevada - Northwest
Las Vegas
Comprehensive Cancer Centers of Nevada - Town Center
Las Vegas
Comprehensive Cancer Centers of Nevada-Summerlin
Las Vegas
Desert West Surgery
Las Vegas
GenesisCare USA - Fort Apache
Las Vegas
GenesisCare USA - Las Vegas
Las Vegas
GenesisCare USA - Vegas Tenaya
Las Vegas
HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
Las Vegas
HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
Las Vegas
HealthCare Partners Medical Group Oncology/Hematology-San Martin
Las Vegas
HealthCare Partners Medical Group Oncology/Hematology-Tenaya
Las Vegas
Hope Cancer Care of Nevada
Las Vegas
Las Vegas Cancer Center-Medical Center
Las Vegas
Las Vegas Prostate Cancer Center
Las Vegas
Las Vegas Urology - Cathedral Rock
Las Vegas
Las Vegas Urology - Pecos
Las Vegas
Las Vegas Urology - Smoke Ranch
Las Vegas
Las Vegas Urology - Sunset
Las Vegas
OptumCare Cancer Care at Charleston
Las Vegas
OptumCare Cancer Care at Fort Apache
Las Vegas
OptumCare Cancer Care at MountainView
Las Vegas
Radiation Oncology Centers of Nevada Central
Las Vegas
Radiation Oncology Centers of Nevada Southeast
Las Vegas
Summerlin Hospital Medical Center
Las Vegas
Sunrise Hospital and Medical Center
Las Vegas
University Cancer Center
Las Vegas
University Medical Center of Southern Nevada
Las Vegas
Urology Specialists of Nevada - Central
Las Vegas
Urology Specialists of Nevada - Northwest
Las Vegas
Urology Specialists of Nevada - Southwest
Las Vegas
Hope Cancer Care of Nevada-Pahrump
Pahrump
Radiation Oncology Associates
Reno
Renown Regional Medical Center
Reno
Saint Mary's Regional Medical Center
Reno
New York
New York Oncology Hematology PC - Albany Medical Center
Albany
Roswell Park Cancer Institute
Buffalo
Mary Imogene Bassett Hospital
Cooperstown
University of Rochester
Rochester
Stony Brook University Medical Center
Stony Brook
State University of New York Upstate Medical University
Syracuse
Ohio
UHHS-Chagrin Highlands Medical Center
Beachwood
Indu and Raj Soin Medical Center
Beavercreek
Strecker Cancer Center-Belpre
Belpre
Saint Elizabeth Boardman Hospital
Boardman
Dayton Physicians LLC-Miami Valley South
Centerville
Miami Valley Hospital South
Centerville
Adena Regional Medical Center
Chillicothe
Bethesda North Hospital
Cincinnati
Good Samaritan Hospital - Cincinnati
Cincinnati
Oncology Hematology Care Inc-Anderson
Cincinnati
Oncology Hematology Care Inc-Blue Ash
Cincinnati
Oncology Hematology Care Inc-Eden Park
Cincinnati
Oncology Hematology Care Inc-Kenwood
Cincinnati
Oncology Hematology Care Inc-Mercy West
Cincinnati
TriHealth Cancer Institute-Anderson
Cincinnati
TriHealth Cancer Institute-Westside
Cincinnati
University of Cincinnati Cancer Center-UC Medical Center
Cincinnati
Case Western Reserve University
Cleveland
Cleveland Clinic Cancer Center/Fairview Hospital
Cleveland
Cleveland Clinic Foundation
Cleveland
MetroHealth Medical Center
Cleveland
Columbus Oncology and Hematology Associates Inc
Columbus
Doctors Hospital
Columbus
Grant Medical Center
Columbus
Mount Carmel East Hospital
Columbus
Mount Carmel Health Center West
Columbus
Ohio State University Comprehensive Cancer Center
Columbus
Riverside Methodist Hospital
Columbus
The Mark H Zangmeister Center
Columbus
Dayton Physician LLC-Miami Valley Hospital North
Dayton
Good Samaritan Hospital - Dayton
Dayton
Miami Valley Hospital
Dayton
Miami Valley Hospital North
Dayton
Delaware Health Center-Grady Cancer Center
Delaware
Grady Memorial Hospital
Delaware
Dublin Methodist Hospital
Dublin
Oncology Hematology Care Inc-Healthplex
Fairfield
Armes Family Cancer Center
Findlay
Blanchard Valley Hospital
Findlay
Orion Cancer Care
Findlay
Atrium Medical Center-Middletown Regional Hospital
Franklin
Dayton Physicians LLC-Atrium
Franklin
Dayton Physicians LLC-Wayne
Greenville
Wayne Hospital
Greenville
Mount Carmel Grove City Hospital
Grove City
Cleveland Clinic Cancer Center Independence
Independence
Greater Dayton Cancer Center
Kettering
Kettering Medical Center
Kettering
Fairfield Medical Center
Lancaster
Saint Rita's Medical Center
Lima
Cleveland Clinic Cancer Center Mansfield
Mansfield
Marietta Memorial Hospital
Marietta
OhioHealth Marion General Hospital
Marion
Toledo Clinic Cancer Centers-Maumee
Maumee
Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
Maumee
Hillcrest Hospital Cancer Center
Mayfield Heights
Dayton Physicians LLC-Signal Point
Middletown
Knox Community Hospital
Mount Vernon
Licking Memorial Hospital
Newark
Newark Radiation Oncology
Newark
Saint Charles Hospital
Oregon
Mercy Health Perrysburg Cancer Center
Perrysburg
Southern Ohio Medical Center
Portsmouth
North Coast Cancer Care
Sandusky
Dayton Physicians LLC-Wilson
Sidney
Springfield Regional Cancer Center
Springfield
Springfield Regional Medical Center
Springfield
Cleveland Clinic Cancer Center Strongsville
Strongsville
Mercy Health - Saint Anne Hospital
Toledo
Saint Vincent Mercy Medical Center
Toledo
Toledo Clinic Cancer Centers-Toledo
Toledo
University of Toledo
Toledo
Dayton Physicians LLC-Upper Valley
Troy
Upper Valley Medical Center
Troy
Saint Joseph Warren Hospital
Warren
South Pointe Hospital
Warrensville Heights
University of Cincinnati Cancer Center-West Chester
West Chester
Saint Ann's Hospital
Westerville
UHHS-Westlake Medical Center
Westlake
Cleveland Clinic Wooster Family Health and Surgery Center
Wooster
Saint Elizabeth Youngstown Hospital
Youngstown
Genesis Healthcare System Cancer Care Center
Zanesville
Oklahoma
Integris Southwest Medical Center
Oklahoma City
University of Oklahoma Health Sciences Center
Oklahoma City
Oregon
Saint Alphonsus Medical Center-Baker City
Baker City
Saint Charles Health System
Bend
Clackamas Radiation Oncology Center
Clackamas
Providence Cancer Institute Clackamas Clinic
Clackamas
Bay Area Hospital
Coos Bay
Providence Newberg Medical Center
Newberg
Saint Alphonsus Medical Center-Ontario
Ontario
Providence Willamette Falls Medical Center
Oregon City
Oregon Health and Science University
Portland
Providence Portland Medical Center
Portland
Providence Saint Vincent Medical Center
Portland
Saint Charles Health System-Redmond
Redmond
Pennsylvania
Lehigh Valley Hospital-Cedar Crest
Allentown
UPMC-Heritage Valley Health System Beaver
Beaver
Lehigh Valley Hospital - Muhlenberg
Bethlehem
Saint Luke's University Hospital-Bethlehem Campus
Bethlehem
Christiana Care Health System-Concord Health Center
Chadds Ford
Chambersburg Hospital
Chambersburg
Geisinger Medical Center
Danville
Pocono Medical Center
East Stroudsburg
Ephrata Cancer Center
Ephrata
Ephrata Community Hospital
Ephrata
Adams Cancer Center
Gettysburg
UPMC Cancer Centers - Arnold Palmer Pavilion
Greensburg
Cherry Tree Cancer Center
Hanover
Geisinger Medical Center-Cancer Center Hazleton
Hazleton
Lehigh Valley Hospital-Hazleton
Hazleton
Penn State Milton S Hershey Medical Center
Hershey
UPMC-Johnstown/John P. Murtha Regional Cancer Center
Johnstown
Sechler Family Cancer Center
Lebanon
Geisinger Medical Oncology-Lewisburg
Lewisburg
Lewistown Hospital
Lewistown
UPMC Cancer Center at UPMC McKeesport
Mckeesport
UPMC-Coraopolis/Heritage Valley Radiation Oncology
Moon
Allegheny General Hospital
Pittsburgh
University of Pittsburgh Cancer Institute (UPCI)
Pittsburgh
UPMC-Magee Womens Hospital
Pittsburgh
UPMC-Passavant Hospital
Pittsburgh
UPMC-Presbyterian Hospital
Pittsburgh
UPMC-Saint Clair Hospital Cancer Center
Pittsburgh
UPMC-Saint Margaret
Pittsburgh
UPMC-Shadyside Hospital
Pittsburgh
West Penn Hospital
Pittsburgh
Geisinger Cancer Services-Pottsville
Pottsville
Guthrie Medical Group PC-Robert Packer Hospital
Sayre
Community Medical Center
Scranton
Geisinger Medical Oncology-Selinsgrove
Selinsgrove
UPMC Cancer Center at UPMC Northwest
Seneca
Geisinger Medical Group
State College
UPMC Uniontown Hospital Radiation Oncology
Uniontown
UPMC Washington Hospital Radiation Oncology
Washington
Reading Hospital
West Reading
Wexford Health and Wellness Pavilion
Wexford
Geisinger Wyoming Valley/Henry Cancer Center
Wilkes-barre
WellSpan Health-York Cancer Center
York
WellSpan Health-York Hospital
York
Rhode Island
Rhode Island Hospital
Providence
South Carolina
AnMed Health Cancer Center
Anderson
Saint Joseph's/Candler - Bluffton Campus
Bluffton
Prisma Health Cancer Institute - Spartanburg
Boiling Springs
Charleston Oncology - Roper
Charleston
Charleston Oncology - Saint Francis
Charleston
Medical University of South Carolina
Charleston
Roper Hospital
Charleston
Prisma Health Cancer Institute - Easley
Easley
Prisma Health Cancer Institute - Butternut
Greenville
Prisma Health Cancer Institute - Eastside
Greenville
Prisma Health Cancer Institute - Faris
Greenville
Prisma Health Greenville Memorial Hospital
Greenville
Saint Francis Cancer Center
Greenville
Saint Francis Hospital
Greenville
Prisma Health Cancer Institute - Greer
Greer
South Carolina Cancer Specialists PC
Hilton Head Island
The Radiation Oncology Center-Hilton Head/Bluffton
Hilton Head Island
Prisma Health Cancer Institute - Seneca
Seneca
South Dakota
Avera Cancer Institute
Sioux Falls
Sanford Cancer Center Oncology Clinic
Sioux Falls
Sanford USD Medical Center - Sioux Falls
Sioux Falls
Tennessee
Bristol Regional Medical Center
Bristol
Wellmont Medical Associates Oncology and Hematology-Bristol
Bristol
Erlanger Medical Center
Chattanooga
Memorial Hospital
Chattanooga
Vanderbilt-Ingram Cancer Center Cool Springs
Franklin
Pulmonary Medicine Center of Chattanooga-Hixson
Hixson
Ballad Health Cancer Care - Kingsport
Kingsport
Wellmont Holston Valley Hospital and Medical Center
Kingsport
Thompson Cancer Survival Center
Knoxville
Thompson Cancer Survival Center - West
Knoxville
Thompson Oncology Group-Maryville
Maryville
Vanderbilt Breast Center at One Hundred Oaks
Nashville
Vanderbilt University/Ingram Cancer Center
Nashville
Thompson Oncology Group-Oak Ridge
Oak Ridge
Memorial GYN Plus
Ooltewah
Texas
Saint Joseph Regional Cancer Center
Bryan
Parkland Memorial Hospital
Dallas
UT Southwestern/Simmons Cancer Center-Dallas
Dallas
Utah
American Fork Hospital / Huntsman Intermountain Cancer Center
American Fork
Sandra L Maxwell Cancer Center
Cedar City
Logan Regional Hospital
Logan
Intermountain Medical Center
Murray
McKay-Dee Hospital Center
Ogden
Utah Valley Regional Medical Center
Provo
Riverton Hospital
Riverton
Saint George Regional Medical Center
Saint George
Huntsman Cancer Institute/University of Utah
Salt Lake City
LDS Hospital
Salt Lake City
Utah Cancer Specialists-Salt Lake City
Salt Lake City
Virginia
Wellmont Medical Associates-Bristol
Bristol
University of Virginia Cancer Center
Charlottesville
Centra Lynchburg Hematology-Oncology Clinic Inc
Lynchburg
Southwest VA Regional Cancer Center
Norton
Virginia Commonwealth University/Massey Cancer Center
Richmond
Washington
Providence Regional Cancer System-Aberdeen
Aberdeen
Cancer Care Center at Island Hospital
Anacortes
MultiCare Auburn Medical Center
Auburn
Virginia Mason Bainbridge Island Medical Center
Bainbridge Island
Overlake Medical Center
Bellevue
Swedish Cancer Institute-Eastside Oncology Hematology
Bellevue
PeaceHealth Saint Joseph Medical Center
Bellingham
Harrison HealthPartners Hematology and Oncology-Bremerton
Bremerton
Harrison Medical Center
Bremerton
Highline Medical Center-Main Campus
Burien
Providence Regional Cancer System-Centralia
Centralia
Swedish Cancer Institute-Edmonds
Edmonds
Saint Elizabeth Hospital
Enumclaw
Providence Regional Cancer Partnership
Everett
Saint Francis Hospital
Federal Way
Virginia Mason Federal Way Medical Center
Federal Way
MultiCare Gig Harbor Medical Park
Gig Harbor
Tacoma/Valley Radiation Oncology Centers-Gig Harbor
Gig Harbor
Swedish Cancer Institute-Issaquah
Issaquah
Kadlec Clinic Hematology and Oncology
Kennewick
Northwest Cancer Clinic
Kennewick
Providence Regional Cancer System-Lacey
Lacey
Saint Clare Hospital
Lakewood
PeaceHealth Saint John Medical Center
Longview
Virginia Mason Lynnwood Medical Center
Lynnwood
Jefferson Healthcare
Port Townsend
Harrison HealthPartners Hematology and Oncology-Poulsbo
Poulsbo
Peninsula Cancer Center
Poulsbo
MultiCare Good Samaritan Hospital
Puyallup
Tacoma/Valley Radiation Oncology Centers-Puyallup
Puyallup
Valley Medical Center
Renton
Kaiser Permanente Washington
Seattle
Minor and James Medical PLLC
Seattle
Pacific Gynecology Specialists
Seattle
Swedish Medical Center-Ballard Campus
Seattle
Swedish Medical Center-Cherry Hill
Seattle
Swedish Medical Center-First Hill
Seattle
Virginia Mason Medical Center
Seattle
PeaceHealth United General Medical Center
Sedro-woolley
Providence Regional Cancer System-Shelton
Shelton
MultiCare Deaconess Cancer and Blood Specialty Center - Downtown
Spokane
MultiCare Deaconess Cancer and Blood Specialty Center - North
Spokane
MultiCare Deaconess Cancer and Blood Specialty Center - Valley
Spokane Valley
Franciscan Research Center-Northwest Medical Plaza
Tacoma
Mary Bridge Children's Hospital and Health Center
Tacoma
MultiCare Tacoma General Hospital
Tacoma
Northwest Medical Specialties PLLC
Tacoma
Tacoma/Valley Radiation Oncology Centers-Jackson Hall
Tacoma
Tacoma/Valley Radiation Oncology Centers-Saint Joe's
Tacoma
PeaceHealth Southwest Medical Center
Vancouver
Providence Saint Mary Regional Cancer Center
Walla Walla
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
Yakima
Providence Regional Cancer System-Yelm
Yelm
Wisconsin
Langlade Hospital and Cancer Center
Antigo
Duluth Clinic Ashland
Ashland
Northwest Wisconsin Cancer Center
Ashland
Marshfield Clinic-Chippewa Center
Chippewa Falls
Marshfield Clinic Cancer Center at Sacred Heart
Eau Claire
Marshfield Medical Center-EC Cancer Center
Eau Claire
Bellin Memorial Hospital
Green Bay
Green Bay Oncology at Saint Vincent Hospital
Green Bay
Green Bay Oncology Limited at Saint Mary's Hospital
Green Bay
Saint Vincent Hospital Cancer Center at Saint Mary's
Green Bay
Saint Vincent Hospital Cancer Center Green Bay
Green Bay
UW Cancer Center Johnson Creek
Johnson Creek
Gundersen Lutheran Medical Center
La Crosse
Marshfield Clinic - Ladysmith Center
Ladysmith
University of Wisconsin Carbone Cancer Center
Madison
Holy Family Memorial Hospital
Manitowoc
Saint Vincent Hospital Cancer Center at Marinette
Marinette
Marshfield Medical Center-Marshfield
Marshfield
Aspirus Medford Hospital
Medford
Ascension Southeast Wisconsin Hospital - Saint Joseph Campus
Milwaukee
Medical College of Wisconsin
Milwaukee
Marshfield Clinic-Minocqua Center
Minocqua
Cancer Center of Western Wisconsin
New Richmond
Saint Vincent Hospital Cancer Center at Oconto Falls
Oconto Falls
Lakeview Medical Center-Marshfield Clinic
Rice Lake
Marshfield Medical Center-Rice Lake
Rice Lake
HSHS Saint Nicholas Hospital
Sheboygan
Marshfield Medical Center-River Region at Stevens Point
Stevens Point
Green Bay Oncology - Sturgeon Bay
Sturgeon Bay
Saint Vincent Hospital Cancer Center at Sturgeon Bay
Sturgeon Bay
Aspirus Regional Cancer Center
Wausau
Marshfield Clinic-Wausau Center
Wausau
Marshfield Medical Center - Weston
Weston
Aspirus Cancer Care - Wisconsin Rapids
Wisconsin Rapids
Marshfield Clinic - Wisconsin Rapids Center
Wisconsin Rapids
West Virginia
United Hospital Center
Bridgeport
West Virginia University Charleston Division
Charleston
Edwards Comprehensive Cancer Center
Huntington
WVUH-Berkely Medical Center
Martinsburg
West Virginia University Healthcare
Morgantown
Camden Clark Medical Center
Parkersburg
Time Frame
Start Date: July 13, 2015
Estimated Completion Date: October 2, 2023
Participants
Target number of participants: 300
Treatments
Experimental: Arm A (immunotherapy)
IMMUNOTHERAPY INDUCTION (CYCLES 1-2): Patients receive nivolumab IV over 30-60 minutes and ipilimumab IV over 30-90 minutes on days 1 and 22. Treatment repeats every 6 weeks for 2 cycles in the absence of disease progression or unacceptable toxicity.~IMMUNOTHERAPY MAINTENANCE (CYCLES 3-14): Patients receive nivolumab IV over 30-60 minutes on days 1, 15, and 29. Treatment repeats every 6 weeks for up to 12 cycles in the absence of disease progression or unacceptable toxicity. Upon disease progression (or before), patients re-register and cross over to Arm C.~Patients undergo CT at baseline, and day 1 of cycles 3-14. Patients undergo ECHO or MUGA at baseline and end of treatment.
Experimental: Arm B (BRAF inhibitor therapy)
Patients receive dabrafenib mesylate PO BID and trametinib dimethyl sulfoxide PO daily on days 1-42. Cycles repeat every 6 weeks in the absence of disease progression or unacceptable toxicity. Upon disease progression (or before), patients re-register and cross over to Arm D. Patients undergo CT at baseline, and day 1 of each cycle.~Patients undergo ECHO or MUGA day 1 of each cycle and end of treatment.
Experimental: Arm C (BRAF inhibitor therapy)
Patients receive dabrafenib mesylate PO BID and trametinib dimethyl sulfoxide PO daily on days 1-42. Cycles repeat every 6 weeks in the absence of disease progression or unacceptable toxicity.~Patients undergo CT at baseline, and day 1 of each cycle. Patients undergo ECHO or MUGA day 1 of each cycle and end of treatment.
Experimental: Arm D (immunotherapy)
IMMUNOTHERAPY INDUCTION (CYCLES 1-2): Patients receive nivolumab IV over 30-60 minutes and ipilimumab IV over 30-90 minutes on days 1 and 22. Treatment repeats every 6 weeks for 2 cycles in the absence of disease progression or unacceptable toxicity.~IMMUNOTHERAPY MAINTENANCE (CYCLES 3-14): Patients receive nivolumab IV over 30-60 minutes on days 1, 15, and 29. Treatment repeats every 6 weeks for up to 12 cycles in the absence of disease progression or unacceptable toxicity.~Patients undergo CT at baseline, and day 1 of cycles 3-14. Patients undergo ECHO or MUGA at end of treatment.
Authors
Matthew H. Taylor, Dennis E. Slater, Kristin K. Ancell, Joseph J. Drabick, Jennifer Slim, Jonathan S. Treisman, Jason A. Chesney, Michael A. Finan, Stephen E. Rubenstein, Alexandra P. Ikeguchi, Elizabeth M. Gaughan, Hassan I. Tahsildar, Ronald G. Steis, Ralph J. Hauke, John D. Ayers, Larisa Greenberg, Bryan A. Faller, Pierre L. Triozzi, Preston D. Steen, Philip A. Lowry, Jashmin K. Patel, Andrzej P. Kudelka, Rex B. Mowat, Joseph W. Leach, Bruce J. Averbook, Asheesh Shipstone, Howard M. Gross, Jay W. Carlson, Bartosz Chmielowski, Ruby Anne E. Deveras, Daniel Y. Reuben, Jeffrey L. Berenberg, Steven J. Jubelirer, Natale T. Sheehan, Saba H. Radhi, Lynn G. Feun, Sunandana Chandra, Amy K. Krie, Alissa S. Marr, Mehmet S. Copur, Joseph J. Merchant, Ian Rabinowitz, Donna M. McNamara, Melinda L. Yushak, Meghana Raghavendra, Alan Tan, Marc R. Matrana, Matthew T. Oliver, Madhavi L. Venigalla, Michael A. Schwartz, Furhan Yunus, Amy K. Harker-Murray, Pauline Funchain, Jonathan R. Sporn, David D. Chism, Howard A. Zaren, James E. Radford, Tasneem Ali, Samer S. Kasbari, Jeffrey K. Giguere, Charles H. Weissman, Timothy D. Moore, Bruce E. Brockstein, Yan Xing, Paul M. Barr, John C. McCann, John M. Schallenkamp, Bradley W. Lash, James N. Atkins, Sam Mazj, Gregory A. Masters, Joseph I. Clark, Keren Sturtz, Nagesh H. Jayaram, Helen H. Moon, Mark R. Albertini, Prateek Mendiratta, Karl D. Lewis, Leslie A. Fecher, Steven A. Akman, Marc S. Ernstoff, Kendrith M. Rowland, Kim A. Margolin, David H. Lawson, Gary L. Buchschacher, Raymond Thertulien, Kurt Oettel, Aaron R. Alizadeh, James E. Clarkson, Roland T. Skeel, Steven R. Schuster, Lawrence E. Flaherty, Brian L. Burnette, Lynn J. Howie, Alison K. Conlin, Eric Bravin, Robert D. Siegel, Misbah U. Qadir, Gary C. Doolittle, Maria Constantinou, Wenqing Zhang, Nisreen A. Haideri, Nicholas DiBella, Jay B. Nayak, Harish G. Ahuja, Donald B. Wender, Ki Y. Chung, Terrence P. Cescon, Nafisa D. Burhani, Debra M. Prow, Ahmad Tarhini, Varun Gupta, Seth O. Fagbemi, Larry L. Schlabach, Peter R. Watson, Diwakar Davar, Lawrence E. Garbo, Sajeve S. Thomas, Shaker R. Dakhil, Sanjiv S. Agarwala, Timothy M. Kuzel, Jonathan D. King, Rahul Seth, Joseph J. Vadakara, Inderjit Mehmi, Andrew Poklepovic, David S. Hanson, Aaron T. Gerds, Benjamin M. Solomon, Theodore F. Logan, Carole B. Miller, Warren A. Chow, Maya Khalil, Arthur E. Frankel, Tatjana Kolevska, James L. Wade, Benjamin T. Marchello, Ashish Sangal, Augusto C. Ochoa, Hamied R. Rezazadeh, Robert M. Conry, Issam Makhoul, Fade A. Mahmoud, Bret E. Friday, Srinivas S. Devarakonda, Joanne M. Jeter, Dan Sotirescu, Joanna A. Kolodney, Richard L. Deming, Patrick J. Mansky, David M. King, Mark G. Goldstein, Salvatore A. Del Prete, Rakesh Gaur, Constantin A. Dasanu, Maria R. Tria Tirona, Sharad A. Ghamande, Christopher J. Hoimes, Nicolas Acquavella Pesantes, Jorge A. Garcia-Young, Donna T. McNamara, Michael B. Atkins, Nagla Abdel Karim, Kathleen J. Yost, John A. Ellerton, Kari L. Kendra, Christopher M. Reynolds, Gary Lu, Henry B. Koon, John A. Keech, Mei Tang, Samuel S. McCachren, William Tse, Kenneth F. Grossmann, Gamini S. Soori
Related Therapeutic Areas
Sponsors
Leads: National Cancer Institute (NCI)

This content was sourced from clinicaltrials.gov

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