DART: Dual Anti-CTLA-4 and Anti-PD-1 Blockade in Rare Tumors

Who is this study for? Adult patients with Rare Cancers
Status: Active_not_recruiting
Location: See all (1009) locations...
Intervention Type: Procedure, Biological
Study Type: Interventional
Study Phase: Phase 2
SUMMARY

This phase II trial studies nivolumab and ipilimumab in treating patients with rare tumors. 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. This trial enrolls participants for the following cohorts based on condition: 1. Epithelial tumors of nasal cavity, sinuses, nasopharynx: A) Squamous cell carcinoma with variants of nasal cavity, sinuses, and nasopharynx and trachea (excluding laryngeal, nasopharyngeal cancer \[NPC\], and squamous cell carcinoma of the head and neck \[SCCHN\]) B) Adenocarcinoma and variants of nasal cavity, sinuses, and nasopharynx (closed to accrual 07/27/2018) 2. Epithelial tumors of major salivary glands (closed to accrual 03/20/2018) 3. Salivary gland type tumors of head and neck, lip, esophagus, stomach, trachea and lung, breast and other location (closed to accrual) 4. Undifferentiated carcinoma of gastrointestinal (GI) tract 5. Adenocarcinoma with variants of small intestine (closed to accrual 05/10/2018) 6. Squamous cell carcinoma with variants of GI tract (stomach small intestine, colon, rectum, pancreas) (closed to accrual 10/17/2018) 7. Fibromixoma and low grade mucinous adenocarcinoma (pseudomixoma peritonei) of the appendix and ovary (closed to accrual 03/20/2018) 8. Rare pancreatic tumors including acinar cell carcinoma, mucinous cystadenocarcinoma or serous cystadenocarcinoma. Pancreatic adenocarcinoma is not eligible (closed to accrual) 9. Intrahepatic cholangiocarcinoma (closed to accrual 03/20/2018) 10. Extrahepatic cholangiocarcinoma and bile duct tumors (closed to accrual 03/20/2018) 11. Sarcomatoid carcinoma of lung 12. Bronchoalveolar carcinoma lung. This condition is now also referred to as adenocarcinoma in situ, minimally invasive adenocarcinoma, lepidic predominant adenocarcinoma, or invasive mucinous adenocarcinoma 13. Non-epithelial tumors of the ovary: A) Germ cell tumor of ovary B) Mullerian mixed tumor and adenosarcoma (closed to accrual 03/30/2018) 14. Trophoblastic tumor: A) Choriocarcinoma (closed to accrual) 15. Transitional cell carcinoma other than that of the renal, pelvis, ureter, or bladder (closed to accrual) 16. Cell tumor of the testes and extragonadal germ tumors: A) Seminoma and testicular sex cord cancer B) Non seminomatous tumor C) Teratoma with malignant transformation (closed to accrual) 17. Epithelial tumors of penis - squamous adenocarcinoma cell carcinoma with variants of penis (closed to accrual) 18. Squamous cell carcinoma variants of the genitourinary (GU) system 19. Spindle cell carcinoma of kidney, pelvis, ureter 20. Adenocarcinoma with variants of GU system (excluding prostate cancer) (closed to accrual 07/27/2018) 21. Odontogenic malignant tumors 22. Pancreatic neuroendocrine tumor (PNET) (formerly named: Endocrine carcinoma of pancreas and digestive tract.) (closed to accrual) 23. Neuroendocrine carcinoma including carcinoid of the lung (closed to accrual 12/19/2017) 24. Pheochromocytoma, malignant (closed to accrual) 25. Paraganglioma (closed to accrual 11/29/2018) 26. Carcinomas of pituitary gland, thyroid gland parathyroid gland and adrenal cortex (closed to accrual) 27. Desmoid tumors 28. Peripheral nerve sheath tumors and NF1-related tumors (closed to accrual 09/19/2018) 29. Malignant giant cell tumors 30. Chordoma (closed to accrual 11/29/2018) 31. Adrenal cortical tumors (closed to accrual 06/27/2018) 32. Tumor of unknown primary (Cancer of Unknown Primary; CuP) (closed to accrual 12/22/2017) 33. Not Otherwise Categorized (NOC) Rare Tumors \[To obtain permission to enroll in the NOC cohort, contact: S1609SC@swog.org\] (closed to accrual 03/15/2019) 34. Adenoid cystic carcinoma (closed to accrual 02/06/2018) 35. Vulvar cancer (closed to accrual) 36. MetaPLASTIC carcinoma (of the breast) (closed to accrual) 37. Gastrointestinal stromal tumor (GIST) (closed to accrual 09/26/2018) 38. Perivascular epithelioid cell tumor (PEComa) 39. Apocrine tumors/extramammary Paget's disease (closed to accrual) 40. Peritoneal mesothelioma 41. Basal cell carcinoma (temporarily closed to accrual 04/29/2020) 42. Clear cell cervical cancer 43. Esthenioneuroblastoma (closed to accrual) 44. Endometrial carcinosarcoma (malignant mixed Mullerian tumors) (closed to accrual) 45. Clear cell endometrial cancer 46. Clear cell ovarian cancer (closed to accrual) 47. Gestational trophoblastic disease (GTD) 48. Gallbladder cancer 49. Small cell carcinoma of the ovary, hypercalcemic type 50. PD-L1 amplified tumors 51. Angiosarcoma 52. High-grade neuroendocrine carcinoma (pancreatic neuroendocrine tumor \[PNET\] should be enrolled in Cohort 22; prostatic neuroendocrine carcinomas should be enrolled into Cohort 53). Small cell lung cancer is not eligible (closed to accrual) 53. Treatment-emergent small-cell neuroendocrine prostate cancer (t-SCNC)

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Patients are eligible under ONE of the following criteria:

‣ For all cohorts except the gestational trophoblastic disease (GTD) (Cohort #47), patients must have histologically and/or biochemically confirmed rare cancer and must be able to submit specimens; to be eligible for the GTD cohort: patients must have disease confirmed by quantitative serum beta-human chorionic gonadotropin (hCG) within 28 days prior to registration and must be able to submit blood specimens (tissue submission is not required for patients who will be registered to the GTD cohort \[Cohort #47\]); NOTE: Subsequent to site's Institutional Review Board (IRB) approval of revision 3, patients are NOT required to participate in EAY131 National Cancer Institute (NCI)-Molecular Analysis for Therapy Choice (MATCH) to register to S1609 OR

⁃ FOR PATIENTS WITH PD-L1 AMPLIFICATION (COHORT #50) ONLY: All solid tumors (excluding lymphoma) are allowed for the PD-L1 amplified cohort if they have PD-L1 amplification; patients may be considered for registration to the PD-L1 amplified cohort (Cohort #50) with the confirmation of at least one of the study chairs; PD-L1 amplification is defined as having deoxyribonucleic acid (DNA) copy number of equal to or greater than six by any of the following Clinical Laboratory Improvement Act (CLIA)-approved lab; (Immunohisochemistry \[IHC\] and fluorescence in situ hybridization \[FISH\] are not allowed); the assay must be done at or after the diagnosis of advanced disease, but PRIOR TO REGISTRATION; NOTE: patients with PD-L1 overexpression by IHC or PD-L1 amplification by FISH do not quality for this cohort; OR

⁃ FOR PATIENTS ENROLLED IN EAY131 NCI-MATCH PRIOR TO EAY131 ADDENDUM 10 ONLY: Patients must have histologically confirmed rare cancer that did not have a match to a molecularly-guided therapy on EAY131 NCI-MATCH protocol or who are off protocol treatment on EAY131, NCI-MATCH and have no further molecularly-matched treatment recommendations per EAY131, NCI-MATCH or who are otherwise unable to receive EAY131, NCI-MATCH therapy

• Patients who do not qualify for one of the histologic cohorts and are not on the ineligible histology list may be considered for registration in the Not Otherwise Categorized Rare Tumors cohort with confirmation of at least one of the study chairs via email

‣ NOTE: The Not Otherwise Categorized Rare Tumors cohort was permanently closed to accrual on 3/15/2019

• Patients who are determined to have a rare cancer with unknown primary site are eligible under cohort #32 (tumor of unknown primary \[cancer of unknown primary; CuP\]), provided that there is histologic documentation of metastatic malignancy with no discernible primary site identified from histopathologic review, physical exam and associated cross-sectional imaging of the chest, abdomen, and pelvis

‣ NOTE: The Tumor of unknown primary (Cancer of Unknown Primary; CuP cohort was permanently closed to accrual on 12/22/2017

• Patients must also meet one of the following:

‣ Patients must have progressed following at least one line of standard systemic therapy and there must not be other approved/standard therapy available that has been shown to prolong overall survival (i.e. in a randomized trial against another standard treatment or by comparison to historical controls); patients who cannot receive other standard therapy that has been shown to prolonged survival due to medical issues will be eligible, if other eligibility criteria are met; OR

⁃ Patients for whose disease no standard treatment exists that has been shown to prolong overall survival

• For all cohorts except the GTD cohort (Cohort #47): Patients must have a diagnostic quality computed tomography (CT) scan or magnetic resonance imaging (MRI), performed within 28 days prior to registration, which demonstrates measurable disease, as defined in RECIST v. 1.1; scans must include imaging of the chest, abdomen and pelvis, with the exception of patients with head/neck cancer, who must have imaging of the chest, abdomen, pelvis and neck; if there is clinical suspicion for bone metastases at the time of enrollment (in the judgement of the treating investigator) bone scan should be performed; bone scans done within 42 days prior to registration may be used to establish baseline condition at registration

• No other prior malignancy is allowed except for the following:

‣ Adequately managed stage I or II cancer from which the patient is currently in complete remission

⁃ Any other cancer from which the patient has been disease free for one year

⁃ Adequately managed stage I or II follicular thyroid or prostate cancer is also eligible, wherein patient is not required to be in complete remission

⁃ Note: Second primary tumors are not allowed concurrent with any of the eligible rare cancers

• For all cohorts except the PD-L1 amplified tumors cohort (Cohort # 50): Patients may have received either prior anti-CTLA4 or other prior anti-PD-1/anti-PD-L1 therapy, but not both, provided that it is completed \>= 4 weeks prior to registration. To be eligible for the PD-L1 amplified tumors cohort (Cohort #50): Patients must not have received anti-PD-1/anti-PD-L1 therapy; prior anti-CTLA-4 is allowed provided that it is completed \>= 4 weeks prior to registration

• Patients who had prior grade 3 or higher immune-related adverse event (e.g. pneumonitis, hepatitis, colitis, endocrinopathy) with prior immunotherapy (e.g. cancer vaccine, cytokine, etc.) are not eligible

• Patients with clinically controlled thyroiditis or pituitary disorders on stable replacement therapy are eligible

• Patients are not eligible if they have had or are planned for solid organ transplant

• Patients with autoimmune disease who are otherwise eligible must not have received steroid and immunosuppressive therapy within 28 days prior to registration

• Patients with brain metastases or primary brain tumors must have completed treatment, surgery or radiation therapy \>= 28 days prior to registration and have stable disease at time of registration; these patients must also have a CT or MRI of the brain to evaluate for CNS disease within 42 days prior to registration to S1609; metastatic brain parenchymal disease must have been treated and patient must be off steroids for 7 days prior to registration

• Patients must not currently be receiving any other investigational agents or any other systemic anti-cancer therapy (including radiation, excluding RANKL inhibitors and bisphosphonates); in event patient recently received any other systemic anti-cancer therapy, patient must be off therapy at least 7 days prior to registration and any therapy-induced toxicity must have recovered to =\< grade 1, except alopecia and =\< grade 2 neuropathy which are allowed; any planned radiation therapy must be completed before registration to S1609

• Patients must not have prior history of allergy or known hypersensitivity to nivolumab or ipilimumab

• Hormonal or endocrine blockade is permitted as long as patient has demonstrated progression on prior therapy (e.g. gonadotrophin releasing hormone \[GnRH\], somatostatin); long-acting somatostatin analogs (including octreotide) and androgen deprivation treatment (including long-acting leuprolide) are permitted while on protocol therapy

• Patients must be \>= 18 years of age

• Patients must have a Zubrod performance status of 0-2

• Absolute neutrophil count (ANC) \>= 1,000/mcL (within 28 days prior to registration)

• Platelets \>= 75,000/mcL (within 28 days prior to registration)

• Hemoglobin \>= 8 g/dL (within 28 days prior to registration)

• Total bilirubin =\< 2.0 x institutional upper limit of normal (IULN) or for documented/suspected Gilbert's disease, total bilirubin =\< 3.0 x IULN (within 28 days prior to registration)

• Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) both =\< 3 x IULN (within 28 days prior to registration)

• Serum creatinine =\< 2.0 x IULN (within 28 days prior to registration)

• Creatinine clearance (CrCl) \>= 50 mL/min., as estimated by the Cockcroft and Gault formula; estimated creatinine clearance is based on actual body weight (within 28 days prior to registration)

• Patients must have adequate thyroid function, as evidenced by either thyroid-stimulating hormone (TSH) or, free thyroxine (T4) serum tests demonstrating values within the normal range, within 28 days prior to registration; at pre-registration, if TSH is not within normal limits, then free T4 must be performed and must be within normal range for patient to be eligible; Note: TSH, with reflex T4 (if TSH is abnormal) is allowable if per institutional standard, provided that free T4 is within normal range; patients who have undergone thyroidectomy or who are on thyroid suppression for their cancer are not required to have normal TSH and free T4

• Patients must have adequate adrenal axis function, as evidenced by cortisol levels within institutional normal ranges (ante meridiem \[AM\] cortisol preferred), OR adrenocorticotropic hormone (ACTH) values within the institutional normal ranges within 28 days prior to registration; if cortisol levels are not within normal limits prior to registration, then ACTH must be performed and must be within normal ranges for patient to be eligible; Note: Neither cortisol nor ACTH levels are required for patients with primary adrenal tumors (e.g. adrenocortical carcinoma)

• For women of childbearing potential, the local investigator must rule out pregnancy; Except for Cohorts 13 and 47, where tumor types may express beta-hCG, women of childbearing potential must have a serum or urine pregnancy test within 7 days prior to registration; for Cohorts 13 and 47, where tumor types may produce hCG (e.g. germ cell tumors or trophoblastic disease), other pregnancy exclusion methods should be used to rule out pregnancy, such as ultrasound examination, documented history of effective contraception, or documented infertility; all females of childbearing potential must have been demonstrated not to be pregnant within 7 days prior to registration and agree to use birth control throughout study and for 23 weeks after completion of protocol therapy; patients must not be pregnant or nursing due to risk of fetal or nursing infant harm; women of childbearing potential must have agreed to use an effective contraceptive method; a woman is considered to be of childbearing potential if she has had menses at any time in the preceding 12 consecutive months; in addition to routine contraceptive methods, effective contraception also includes heterosexual celibacy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) defined as a hysterectomy, bilateral oophorectomy or bilateral tubal ligation; however, if at any point a previously celibate patient chooses to become heterosexually active during the time period for use of contraceptive measures outlined in the protocol, she is responsible for beginning contraceptive measures

• Men of reproductive potential must have agreed to use birth control throughout the study and for 31 weeks after completion of protocol therapy; in addition to routine contraceptive methods, effective contraception also includes heterosexual celibacy and surgery intended to prevent pregnancy (vasectomy); however, if at any point a previously celibate patient chooses to become heterosexually active during the time period for use of contraceptive measures outlined in the protocol, he is responsible for beginning contraceptive measures

• Patients must not have known active hepatitis B virus (HBV) or hepatitis virus (HCV) infection at time of registration; patients with HBV or HCV that have an undetectable viral load and no residual hepatic impairment are eligible

• Patients who are known to be human immunodeficiency virus (HIV)-positive at registration are eligible at the time of registration:

‣ CD4+ cell count greater or equal to 250 cells/mm\^3

⁃ No history of non-malignancy acquired immunodeficiency syndrome (AIDS)-defining conditions other than historical low CD4+ cell counts

• Patients must not have active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, immunosuppressive drugs, or corticosteroids with prednisone dose \>= 10 mg); replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment; autoimmune diseases include but are not limited to autoimmune hepatitis, inflammatory bowel disease (including ulcerative colitis and Crohn's disease), as well as symptomatic disease (e.g.: rheumatoid arthritis, systemic progressive sclerosis \[scleroderma\], systemic lupus erythematosus, autoimmune vasculitis \[e.g., Wegener's granulomatosis\]); central nervous system (CNS) or motor neuropathy considered of autoimmune origin (e.g., Guillain-Barre syndrome and Myasthenia gravis, multiple sclerosis or glomerulonephritis); vitiligo, alopecia, hypothyroidism on stable doses of thyroid replacement therapy, psoriasis not requiring systemic therapy within the past 2 years is permitted; short-term steroid premedication for contrast allergy is permitted

• Patients must not have any uncontrolled intercurrent illness including (not limited to): symptomatic congestive heart failure (CHF) (New York Heart Association \[NYHA\] III/IV), unstable angina pectoris or coronary angioplasty, or stenting within 24 weeks prior to registration, unstable cardiac arrhythmia (ongoing cardiac dysrhythmias of NCI Common Terminology Criteria for Adverse Events \[CTCAE\] version \[v\] 4 grade \>= 2), known psychiatric illness that would limit study compliance, intra-cardiac defibrillators, known cardiac metastases, or abnormal cardiac valve morphology (\>= grade 3)

‣ Note: Patients with history of CHF or patients who are deemed at risk because of underlying cardiovascular disease or exposure to cardiotoxic drugs should have an electrocardiogram (EKG) and echocardiogram (ECHO), as clinically indicated, at baseline and at the start of each cycle; patients who have evidence at baseline (or subsequently) of CHF, myocardial infarction (MI), cardiomyopathy, or myositis cardiac evaluation (NYHA I/II) should have additional consult by a cardiologist, including review of EKG, creatine phosphokinase (CPK), troponin, echocardiogram, as clinically indicated

• Patients must have amylase or lipase within =\< 1.5 x IULN without symptoms of pancreatitis at registration, within 28 days prior to registration

• Patients must not have symptomatic interstitial lung disease or pneumonitis

• Patients must have fully recovered from any adverse effects of major surgery (to =\< grade 1) at least 14 days prior to registration

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
University of South Alabama Mitchell Cancer Institute
Mobile
Arkansas
Highlands Oncology Group - Fayetteville
Fayetteville
Mercy Hospital Fort Smith
Fort Smith
CHI Saint Vincent Cancer Center Hot Springs
Hot Springs
NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
Jonesboro
University of Arkansas for Medical Sciences
Little Rock
Highlands Oncology Group - Rogers
Rogers
Highlands Oncology Group
Springdale
Arizona
CTCA at Western Regional Medical Center
Goodyear
Kingman Regional Medical Center
Kingman
Cancer Center at Saint Joseph's
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Kaiser Permanente-Anaheim
Anaheim
Kaiser Permanente-Deer Valley Medical Center
Antioch
Mission Hope Medical Oncology - Arroyo Grande
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PCR Oncology
Arroyo Grande
Sutter Auburn Faith Hospital
Auburn
Sutter Cancer Centers Radiation Oncology Services-Auburn
Auburn
AIS Cancer Center at San Joaquin Community Hospital
Bakersfield
Kaiser Permanente-Baldwin Park
Baldwin Park
Kaiser Permanente-Bellflower
Bellflower
Alta Bates Summit Medical Center-Herrick Campus
Berkeley
Keck Medicine of USC Buena Park
Buena Park
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
Mercy Cancer Center - Carmichael
Carmichael
Mercy San Juan Medical Center
Carmichael
Eden Hospital Medical Center
Castro Valley
UC Irvine Health Cancer Center-Newport
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Sutter Davis Hospital
Davis
City of Hope Comprehensive Cancer Center
Duarte
Epic Care-Dublin
Dublin
Kaiser Permanente Dublin
Dublin
Mercy Cancer Center - Elk Grove
Elk Grove
Bay Area Breast Surgeons Inc
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Epic Care Partners in Cancer Care
Emeryville
Kaiser Permanente-Fontana
Fontana
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Fremont
Palo Alto Medical Foundation-Fremont
Fremont
Kaiser Permanente-Fresno
Fresno
Kaiser Permanente South Bay
Harbor City
Keck Medicine of USC Huntington Beach
Huntington Beach
Kaiser Permanente-Irvine
Irvine
UC San Diego Moores Cancer Center
La Jolla
Loma Linda University Medical Center
Loma Linda
Cedars Sinai Medical Center
Los Angeles
Kaiser Permanente Los Angeles Medical Center
Los Angeles
Kaiser Permanente West Los Angeles
Los Angeles
Keck Medicine of USC Koreatown
Los Angeles
Los Angeles General Medical Center
Los Angeles
USC / Norris Comprehensive Cancer Center
Los Angeles
Contra Costa Regional Medical Center
Martinez
Fremont - Rideout Cancer Center
Marysville
Mercy Cancer Center
Merced
Kaiser Permanente-Modesto
Modesto
Memorial Medical Center
Modesto
Palo Alto Medical Foundation-Camino Division
Mountain View
Palo Alto Medical Foundation-Gynecologic Oncology
Mountain View
Providence Queen of The Valley
Napa
USC Norris Oncology/Hematology-Newport Beach
Newport Beach
Sutter Cancer Research Consortium
Novato
Alta Bates Summit Medical Center - Summit Campus
Oakland
Bay Area Tumor Institute
Oakland
Kaiser Permanente-Oakland
Oakland
Kaiser Permanente-Ontario
Ontario
Saint Joseph Hospital - Orange
Orange
UC Irvine Health/Chao Family Comprehensive Cancer Center
Orange
Desert Regional Medical Center
Palm Springs
Palo Alto Medical Foundation Health Care
Palo Alto
Kaiser Permanente - Panorama City
Panorama City
Keck Medical Center of USC Pasadena
Pasadena
Eisenhower Medical Center
Rancho Mirage
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Redwood City
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Redwood City
Kaiser Permanente-Richmond
Richmond
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Riverside
Mercy Cancer Center - Rocklin
Rocklin
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Roseville
Sutter Cancer Centers Radiation Oncology Services-Roseville
Roseville
Sutter Roseville Medical Center
Roseville
Kaiser Permanente Downtown Commons
Sacramento
Kaiser Permanente Sacramento Medical Center
Sacramento
Kaiser Permanente-South Sacramento
Sacramento
Mercy Cancer Center - Sacramento
Sacramento
Sutter Medical Center Sacramento
Sacramento
University of California Davis Comprehensive Cancer Center
Sacramento
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San Diego
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San Diego
Sharp Memorial Hospital
San Diego
UC San Diego Medical Center - Hillcrest
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San Jose
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San Marcos
Mills Health Center
San Mateo
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Kaiser San Rafael-Gallinas
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Santa Clara
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Santa Cruz
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Santa Maria
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Santa Rosa
Sutter Pacific Medical Foundation
Santa Rosa
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South San Francisco
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Stockton
Palo Alto Medical Foundation-Sunnyvale
Sunnyvale
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Truckee
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Vacaville
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Vallejo
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Boulder
Rocky Mountain Cancer Centers - Centennial
Centennial
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
AdventHealth Porter
Denver
Cancer Center of Colorado at Sloan's Lake
Denver
Colorado Blood Cancer Institute
Denver
Denver Health Medical Center
Denver
Kaiser Permanente-Franklin
Denver
National Jewish Health-Main Campus
Denver
Presbyterian - Saint Lukes Medical Center - Health One
Denver
Rocky Mountain Cancer Centers-Midtown
Denver
Rocky Mountain Cancer Centers-Rose
Denver
Rose Medical Center
Denver
Saint Joseph Hospital - Cancer Centers of Colorado
Denver
The Women's Imaging Center
Denver
CommonSpirit Cancer Center Mercy
Durango
Mercy Medical Center
Durango
Mountain Blue Cancer Care Center - Swedish
Englewood
Rocky Mountain Cancer Centers - Swedish
Englewood
Swedish Medical Center
Englewood
The Melanoma and Skin Cancer Institute
Englewood
Poudre Valley Hospital
Fort Collins
Valley View Hospital Cancer Center
Glenwood Springs
Mountain Blue Cancer Care Center
Golden
National Jewish Health-Western Hematology Oncology
Golden
Grand Valley Oncology
Grand Junction
Saint Mary's Hospital and Regional Medical Center
Grand Junction
Banner North Colorado Medical Center
Greeley
Rocky Mountain Cancer Centers-Greenwood Village
Greenwood Village
Good Samaritan Hospital - Cancer Centers of Colorado
Lafayette
Kaiser Permanente-Rock Creek
Lafayette
Rocky Mountain Cancer Centers-Lakewood
Lakewood
Saint Anthony Hospital
Lakewood
AdventHealth Littleton
Littleton
Rocky Mountain Cancer Centers-Littleton
Littleton
Kaiser Permanente-Lone Tree
Lone Tree
Rocky Mountain Cancer Centers-Sky Ridge
Lone Tree
Sky Ridge Medical Center
Lone Tree
Longmont United Hospital
Longmont
Rocky Mountain Cancer Centers-Longmont
Longmont
Banner North Colorado Medical Center - Loveland Campus
Loveland
AdventHealth Parker
Parker
Rocky Mountain Cancer Centers-Parker
Parker
Rocky Mountain Cancer Centers - Pueblo
Pueblo
Saint Mary Corwin Medical Center
Pueblo
National Jewish Health-Northern Hematology Oncology
Thornton
Rocky Mountain Cancer Centers-Thornton
Thornton
Intermountain Health Lutheran Hospital
Wheat Ridge
Connecticut
Smilow Cancer Hospital-Derby Care Center
Derby
Smilow Cancer Hospital Care Center-Fairfield
Fairfield
Smilow Cancer Hospital Care Center - Guilford
Guilford
Smilow Cancer Hospital Care Center at Saint Francis
Hartford
Smilow Cancer Center/Yale-New Haven Hospital
New Haven
Yale University
New Haven
Yale-New Haven Hospital North Haven Medical Center
North Haven
Stamford Hospital/Bennett Cancer Center
Stamford
Smilow Cancer Hospital Care Center-Trumbull
Trumbull
Smilow Cancer Hospital-Waterbury Care Center
Waterbury
Veterans Affairs Connecticut Healthcare System-West Haven Campus
West Haven
Washington, D.c.
MedStar Georgetown University Hospital
Washington D.c.
Sibley Memorial Hospital
Washington D.c.
Delaware
Beebe Medical Center
Lewes
Beebe South Coastal Health Campus
Millville
Christiana Care Health System-Christiana Hospital
Newark
Delaware Clinical and Laboratory Physicians PA
Newark
Helen F Graham Cancer Center
Newark
Medical Oncology Hematology Consultants PA
Newark
Beebe Health Campus
Rehoboth Beach
TidalHealth Nanticoke / Allen Cancer Center
Seaford
Christiana Care Health System-Wilmington Hospital
Wilmington
Florida
AdventHealth Altamonte
Altamonte Springs
Mount Sinai Comprehensive Cancer Center at Aventura
Aventura
Holy Cross Hospital
Fort Lauderdale
UF Health Cancer Institute - Gainesville
Gainesville
Memorial Regional Hospital/Joe DiMaggio Children's Hospital
Hollywood
AdventHealth Kissimmee
Kissimmee
Mount Sinai Medical Center
Miami Beach
AdventHealth East Orlando
Orlando
AdventHealth Medical Group Urology at Orlando
Orlando
AdventHealth Orlando
Orlando
Orlando Health Cancer Institute
Orlando
Memorial Hospital West
Pembroke Pines
Moffitt Cancer Center
Tampa
Moffitt Cancer Center - McKinley Campus
Tampa
Moffitt Cancer Center-International Plaza
Tampa
AdventHealth Winter Park
Winter Park
Georgia
Emory Saint Joseph's Hospital
Atlanta
Emory University Hospital Midtown
Atlanta
Emory University Hospital/Winship Cancer Institute
Atlanta
Piedmont Hospital
Atlanta
John B Amos Cancer Center
Columbus
Atlanta VA Medical Center
Decatur
Piedmont Fayette Hospital
Fayetteville
Harbin Clinic Medical Oncology and Clinical Research
Rome
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
Savannah
Low Country Cancer Care
Savannah
Summit Cancer Care-Candler
Savannah
South Georgia Medical Center/Pearlman Cancer Center
Valdosta
Hawaii
Hawaii Cancer Care - Westridge
‘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
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Lihue
Iowa
Mary Greeley Medical Center
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Ames
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Boone
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Carroll
Mercy Hospital
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Clive
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Clive
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Boise
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Walter Knox Memorial Hospital
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Idaho Urologic Institute-Meridian
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Carbondale
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Chicago
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Chicago
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Danville
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Decatur
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Decatur
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Dixon
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Effingham
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Effingham
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Eureka
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Galesburg
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Galesburg
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Kankakee
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Peoria
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Coffeyville
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Dodge City
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El Dorado
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Fairway
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Fort Scott
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Garden City
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Garden City
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Great Bend
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Hays
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Independence
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Lawrence
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Manhattan
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Mcpherson
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Newton
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Pittsburg
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Pratt
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Salina
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Salina
University of Kansas Health System Saint Francis Campus
Topeka
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Wellington
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Westwood
Ascension Via Christi Hospitals Wichita
Wichita
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Wichita
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Wichita
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Winfield
Kentucky
Flaget Memorial Hospital
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Corbin
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Lexington
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Lexington
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London
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Canton
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Canton
Caro Cancer Center
Caro
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Chelsea
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Chelsea
Hematology Oncology Consultants-Clarkston
Clarkston
Newland Medical Associates-Clarkston
Clarkston
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Dearborn
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Detroit
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Detroit
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OSF Saint Francis Hospital and Medical Group
Escanaba
Cancer Hematology Centers - Flint
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Genesys Hurley Cancer Institute
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Flint
Corewell Health Grand Rapids Hospitals - Butterworth Hospital
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Trinity Health Grand Rapids Hospital
Grand Rapids
Henry Ford Saint John Hospital - Academic
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Henry Ford Saint John Hospital - Van Elslander
Grosse Pointe Woods
Allegiance Health
Jackson
Beacon Kalamazoo
Kalamazoo
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Kalamazoo
Bronson Methodist Hospital
Kalamazoo
West Michigan Cancer Center
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University of Michigan Health - Sparrow Lansing
Lansing
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Livonia
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Livonia
Henry Ford Saint John Hospital - Macomb Medical
Macomb
Henry Ford Warren Hospital - Breast Macomb
Macomb
Green Bay Oncology-Manistique
Manistique
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Marlette
Monroe Cancer Center
Monroe
Toledo Clinic Cancer Centers-Monroe
Monroe
Trinity Health Muskegon Hospital
Muskegon
Corewell Health Lakeland Hospitals - Niles Hospital
Niles
Cancer and Hematology Centers of Western Michigan - Norton Shores
Norton Shores
Henry Ford Health Providence Novi Hospital
Novi
Henry Ford Medical Center-Columbus
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Hope Cancer Center
Pontiac
Michigan Healthcare Professionals Pontiac
Pontiac
Newland Medical Associates-Pontiac
Pontiac
Trinity Health Saint Joseph Mercy Oakland Hospital
Pontiac
Huron Medical Center PC
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Port Huron
Corewell Health Reed City Hospital
Reed City
Henry Ford Rochester Hospital
Rochester Hills
MyMichigan Medical Center Saginaw
Saginaw
Oncology Hematology Associates of Saginaw Valley PC
Saginaw
Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
Saint Joseph
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Saint Joseph
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Shelby
Henry Ford Health Providence Southfield Hospital
Southfield
Bhadresh Nayak MD PC-Sterling Heights
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MyMichigan Medical Center Tawas
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Munson Medical Center
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Advanced Breast Care Center PLLC
Warren
Henry Ford Health Warren Hospital
Warren
Henry Ford Madison Heights Hospital - Breast
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Henry Ford Warren Hospital - GLCMS
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Macomb Hematology Oncology PC
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Henry Ford West Bloomfield Hospital
West Bloomfield
Saint Mary's Oncology/Hematology Associates of West Branch
West Branch
Henry Ford Wyandotte Hospital
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Baxter
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Burnsville
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Cambridge
Mercy Hospital
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Essentia Health - Deer River Clinic
Deer River
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Detroit Lakes
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Duluth
Miller-Dwan Hospital
Duluth
Fairview Southdale Hospital
Edina
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Lake Region Healthcare Corporation-Cancer Care
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Fosston
Unity Hospital
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Hibbing
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International Falls
Fairview Clinics and Surgery Center Maple Grove
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Maplewood
Saint John's Hospital - Healtheast
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Abbott-Northwestern Hospital
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Health Partners Inc
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Robbinsdale
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Saint Paul
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Sandstone
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Thief River Falls
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Bolivar
Parkland Health Center-Bonne Terre
Bonne Terre
Cox Cancer Center Branson
Branson
Mercy Cancer Center - Cape Girardeau
Cape Girardeau
Saint Francis Medical Center
Cape Girardeau
Saint Luke's Hospital
Chesterfield
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City Of Saint Peters
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MU Health Care Goldschmidt Cancer Center
Jefferson City
Freeman Health System
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Mercy Hospital Joplin
Joplin
Kansas City Veterans Affairs Medical Center
Kansas City
The University of Kansas Cancer Center-South
Kansas City
University Health Truman Medical Center
Kansas City
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Kansas City
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Lee's Summit
Mercy Clinic-Rolla-Cancer and Hematology
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Phelps Health Delbert Day Cancer Institute
Rolla
Heartland Regional Medical Center
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Sainte Genevieve
CoxHealth South Hospital
Springfield
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Springfield
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St Louis
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St Louis
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Missouri Baptist Medical Center
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St Louis
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St Louis
Washington University School of Medicine
St Louis
Missouri Baptist Sullivan Hospital
Sullivan
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Sunset Hills
Mercy Hospital Washington
Washington
Mississippi
Baptist Memorial Hospital and Cancer Center-Golden Triangle
Columbus
Baptist Cancer Center-Grenada
Grenada
Gulfport Memorial Hospital
Gulfport
Forrest General Hospital / Cancer Center
Hattiesburg
Hattiesburg Clinic - Hematology/Oncology Clinic
Hattiesburg
University of Mississippi Medical Center
Jackson
Baptist Memorial Hospital and Cancer Center-Union County
New Albany
Baptist Memorial Hospital and Cancer Center-Oxford
Oxford
Baptist Memorial Hospital and Cancer Center-Desoto
Southhaven
Montana
Community Hospital of Anaconda
Anaconda
Billings Clinic Cancer Center
Billings
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Billings
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Billings
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Bozeman
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Butte
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Great Falls
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Great Falls
Saint Peter's Community Hospital
Helena
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Kalispell
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Missoula
North Carolina
AdventHealth Infusion Center Asheville
Asheville
Southeastern Medical Oncology Center-Clinton
Clinton
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Southeastern Medical Oncology Center-Goldsboro
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Wayne Memorial Hospital
Goldsboro
AdventHealth Hendersonville
Hendersonville
Margaret R Pardee Memorial Hospital
Hendersonville
Onslow Memorial Hospital
Jacksonville
Southeastern Medical Oncology Center-Jacksonville
Jacksonville
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Kenansville
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Kinston
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Richlands
AdventHealth Infusion Center Weaverville
Weaverville
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Bismarck
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Fargo
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Fargo
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Fargo
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Fargo
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Jamestown
Nebraska
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Grand Island
CHI Health Good Samaritan
Kearney
Fred and Pamela Buffett Cancer Center - Kearney
Kearney
Saint Elizabeth Regional Medical Center
Lincoln
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/Oncology Hematology West PC - MECC
Omaha
Nebraska Methodist Hospital
Omaha
Oncology Associates PC
Omaha
Midlands Community Hospital
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Lebanon
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Manchester
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Nashua
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Morristown
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Vineland
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Albuquerque
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Albuquerque
Presbyterian Kaseman Hospital
Albuquerque
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Albuquerque
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Albuquerque
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Las Cruces
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Rio Rancho
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Santa Fe
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Carson City
Cancer and Blood Specialists-Henderson
Henderson
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Henderson
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Henderson
Comprehensive Cancer Centers of Nevada-Southeast Henderson
Henderson
Las Vegas Cancer Center-Henderson
Henderson
Las Vegas Urology - Green Valley
Henderson
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Henderson
Oncology Las Vegas - Henderson
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
Cancer Therapy and Integrative Medicine
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
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Las Vegas
Comprehensive Cancer Centers of Nevada-Summerlin
Las Vegas
Desert West Surgery
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
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Las Vegas
Las Vegas Prostate Cancer Center
Las Vegas
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Las Vegas
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Las Vegas
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Las Vegas
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Las Vegas
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Las Vegas
OptumCare Cancer Care at Charleston
Las Vegas
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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
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Las Vegas
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Las Vegas
Hope Cancer Care of Nevada-Pahrump
Pahrump
Radiation Oncology Associates
Reno
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Reno
Saint Mary's Regional Medical Center
Reno
New York
Roswell Park Cancer Institute
Buffalo
Arnot Ogden Medical Center/Falck Cancer Center
Elmira
Glens Falls Hospital
Glens Falls
Laura and Isaac Perlmutter Cancer Center at NYU Langone
New York
University of Rochester
Rochester
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Stony Brook
Montefiore Medical Center - Moses Campus
The Bronx
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The Bronx
Montefiore Medical Center-Weiler Hospital
The Bronx
Ohio
Indu and Raj Soin Medical Center
Beavercreek
Strecker Cancer Center-Belpre
Belpre
Saint Elizabeth Boardman Hospital
Boardman
Cleveland Clinic Mercy Hospital
Canton
Dayton Physicians LLC-Miami Valley South
Centerville
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Centerville
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Chillicothe
Bethesda North Hospital
Cincinnati
Good Samaritan Hospital - Cincinnati
Cincinnati
Oncology Hematology Care Inc-Kenwood
Cincinnati
TriHealth Cancer Institute-Anderson
Cincinnati
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Cincinnati
Cleveland Clinic Foundation
Cleveland
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Cleveland
Columbus Oncology and Hematology Associates Inc
Columbus
Doctors Hospital
Columbus
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Columbus
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Columbus
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Columbus
Ohio State University Comprehensive Cancer Center
Columbus
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Columbus
The Mark H Zangmeister Center
Columbus
Dayton Physician LLC - Englewood
Dayton
Good Samaritan Hospital - Dayton
Dayton
Miami Valley Hospital
Dayton
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Dayton
Delaware Health Center-Grady Cancer Center
Delaware
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Delaware
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Delaware
Columbus Oncology and Hematology Associates
Dublin
Dublin Methodist Hospital
Dublin
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
Zangmeister Center Grove City
Grove City
First Dayton Cancer Care
Kettering
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Kettering
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Lancaster
Saint Rita's Medical Center
Lima
OhioHealth Mansfield Hospital
Mansfield
Marietta Memorial Hospital
Marietta
OhioHealth Marion General Hospital
Marion
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Maumee
Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
Maumee
Dayton Physicians LLC-Signal Point
Middletown
Knox Community Hospital
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Licking Memorial Hospital
Newark
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Newark
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Sandusky
Dayton Physicians LLC-Wilson
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Springfield
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Springfield
ProMedica Flower Hospital
Sylvania
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Toledo
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Toledo
Mercy Health Sylvania Radiation Oncology Center
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ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
Toledo
Toledo Clinic Cancer Centers-Toledo
Toledo
Dayton Physicians LLC - Troy
Troy
Upper Valley Medical Center
Troy
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Warren
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Warrensville Heights
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Westerville
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Youngstown
Genesis Healthcare System Cancer Care Center
Zanesville
Oklahoma
Cancer Centers of Southwest Oklahoma Research
Lawton
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Oklahoma City
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Oklahoma City
Cancer Treatment Centers of America
Tulsa
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Tulsa
Oregon
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Baker City
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Clackamas
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Clackamas
Bay Area Hospital
Coos Bay
Legacy Mount Hood Medical Center
Gresham
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Newberg
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Ontario
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Oregon City
Kaiser Permanente Northwest
Portland
Legacy Good Samaritan Hospital and Medical Center
Portland
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Redmond
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Tualatin
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Allentown
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Cranberry Township
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Doylestown
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Erie
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Greensburg
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Hazleton
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Indiana
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Jefferson Hills
UPMC-Johnstown/John P. Murtha Regional Cancer Center
Johnstown
UPMC Cancer Center at UPMC McKeesport
Mckeesport
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Monroeville
UPMC Hillman Cancer Center - Monroeville
Monroeville
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Moon Township
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Mount Pleasant
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N. Huntingdon
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Philadelphia
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Philadelphia
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Philadelphia
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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
Pottstown Hospital
Pottstown
UPMC Cancer Center at UPMC Northwest
Seneca
UPMC Uniontown Hospital Radiation Oncology
Uniontown
UPMC Cancer Center-Washington
Washington
UPMC Washington Hospital Radiation Oncology
Washington
UPMC West Mifflin-Cancer Center Jefferson
West Mifflin
Wexford Health and Wellness Pavilion
Wexford
South Carolina
Prisma Health Cancer Institute - Spartanburg
Boiling Springs
Medical University of South Carolina
Charleston
Prisma Health Cancer Institute - Laurens
Clinton
Prisma Health Cancer Institute - Easley
Easley
Gibbs Cancer Center-Gaffney
Gaffney
Tidelands Georgetown Memorial Hospital
Georgetown
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
Gibbs Cancer Center-Pelham
Greer
Prisma Health Cancer Institute - Greer
Greer
Prisma Health Cancer Institute - Seneca
Seneca
North Grove Medical Park
Spartanburg
Spartanburg Medical Center
Spartanburg
Spartanburg Medical Center - Mary Black Campus
Spartanburg
SMC Center for Hematology Oncology Union
Union
South Dakota
Sanford Cancer Center Oncology Clinic
Sioux Falls
Sanford USD Medical Center - Sioux Falls
Sioux Falls
Tennessee
Memorial Hospital
Chattanooga
Baptist Memorial Hospital and Cancer Center-Collierville
Collierville
Vanderbilt-Ingram Cancer Center Cool Springs
Franklin
Pulmonary Medicine Center of Chattanooga-Hixson
Hixson
Baptist Memorial Hospital and Cancer Center-Memphis
Memphis
Meharry Medical College
Nashville
Vanderbilt Breast Center at One Hundred Oaks
Nashville
Vanderbilt University/Ingram Cancer Center
Nashville
Memorial GYN Plus
Ooltewah
Texas
Saint Joseph Regional Cancer Center
Bryan
Baylor University Medical Center
Dallas
Parkland Memorial Hospital
Dallas
UT Southwestern/Simmons Cancer Center-Dallas
Dallas
UT Southwestern/Simmons Cancer Center-Fort Worth
Fort Worth
Lyndon Baines Johnson General Hospital
Houston
M D Anderson Cancer Center
Houston
UT Southwestern Clinical Center at Richardson/Plano
Richardson
University Hospital
San Antonio
University of Texas Health Science Center at San Antonio
San Antonio
Utah
American Fork Hospital / Huntsman Intermountain Cancer Center
American Fork
Sandra L Maxwell Cancer Center
Cedar City
Farmington Health Center
Farmington
Logan Regional Hospital
Logan
Intermountain Medical Center
Murray
McKay-Dee Hospital Center
Ogden
Utah Valley Regional Medical Center
Provo
Riverton Hospital
Riverton
Huntsman Cancer Institute/University of Utah
Salt Lake City
LDS Hospital
Salt Lake City
Utah Cancer Specialists-Salt Lake City
Salt Lake City
South Jordan Health Center
South Jordan
Saint George Regional Medical Center
St. George
Virginia
VCU Massey Comprehensive Cancer Center
Richmond
Vermont
Central Vermont Medical Center/National Life Cancer Treatment
Berlin Corners
University of Vermont and State Agricultural College
Burlington
University of Vermont Medical Center
Burlington
Dartmouth Cancer Center - North
Saint Johnsbury
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
PeaceHealth Saint Joseph Medical Center
Bellingham
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
Skagit Regional Health Cancer Care Center
Mount Vernon
Skagit Valley Hospital
Mount Vernon
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
Fred Hutchinson Cancer Center
Seattle
Kaiser Permanente Washington
Seattle
Pacific Gynecology Specialists
Seattle
Swedish Medical Center-Ballard Campus
Seattle
Swedish Medical Center-First Hill
Seattle
University of Washington Medical Center - Montlake
Seattle
Virginia Mason Medical Center
Seattle
PeaceHealth United General Medical Center
Sedro-woolley
Providence Regional Cancer System-Shelton
Shelton
Saint Michael Cancer Center
Silverdale
MultiCare Deaconess Cancer and Blood Specialty Center - Downtown
Spokane
MultiCare Deaconess Cancer and Blood Specialty Center - North
Spokane
Spokane Valley Cancer Center-Mayfair
Spokane
Spokane Valley Cancer Center-Mission
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
Legacy Cancer Institute Medical Oncology and Day Treatment
Vancouver
Legacy Salmon Creek Hospital
Vancouver
PeaceHealth Southwest Medical Center
Vancouver
Providence Saint Mary Regional Cancer Center
Walla Walla
Wenatchee Valley Hospital and Clinics
Wenatchee
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
Yakima
Providence Regional Cancer System-Yelm
Yelm
Wisconsin
Ascension Saint Elizabeth Hospital
Appleton
Duluth Clinic Ashland
Ashland
Northwest Wisconsin Cancer Center
Ashland
Ascension Southeast Wisconsin Hospital - Elmbrook Campus
Brookfield
Ascension Calumet Hospital
Chilton
Marshfield Clinic-Chippewa Center
Chippewa Falls
Marshfield Clinic Cancer Center at Sacred Heart
Eau Claire
Marshfield Medical Center-EC Cancer Center
Eau Claire
Ascension Saint Francis - Reiman Cancer Center
Franklin
Ascension Southeast Wisconsin Hospital - Franklin
Franklin
Saint Vincent Hospital Cancer Center at Saint Mary's
Green Bay
Saint Vincent Hospital Cancer Center Green Bay
Green Bay
Gundersen Lutheran Medical Center
La Crosse
Marshfield Medical Center - Ladysmith
Ladysmith
Holy Family Memorial Hospital
Manitowoc
Saint Vincent Hospital Cancer Center at Marinette
Marinette
Marshfield Medical Center-Marshfield
Marshfield
Ascension Columbia Saint Mary's Hospital Ozaukee
Mequon
Ascension Columbia Saint Mary's Hospital - Milwaukee
Milwaukee
Ascension Saint Francis Hospital
Milwaukee
Ascension Southeast Wisconsin Hospital - Saint Joseph Campus
Milwaukee
Marshfield Medical Center - Minocqua
Minocqua
Cancer Center of Western Wisconsin
New Richmond
Saint Vincent Hospital Cancer Center at Oconto Falls
Oconto Falls
Ascension Mercy Hospital
Oshkosh
Ascension All Saints Hospital
Racine
Aspirus Cancer Care - James Beck Cancer Center
Rhinelander
Marshfield Medical Center-Rice Lake
Rice Lake
HSHS Saint Nicholas Hospital
Sheboygan
Aspirus Cancer Care - Stevens Point
Stevens Point
Marshfield Medical Center-River Region at Stevens Point
Stevens Point
Saint Vincent Hospital Cancer Center at Sturgeon Bay
Sturgeon Bay
Marshfield Clinic-Wausau Center
Wausau
Ascension Medical Group Southeast Wisconsin - Mayfair Road
Wauwatosa
Marshfield Medical Center - Weston
Weston
Marshfield Clinic - Wisconsin Rapids Center
Wisconsin Rapids
West Virginia
Edwards Comprehensive Cancer Center
Huntington
Wyoming
Cheyenne Regional Medical Center-West
Cheyenne
Billings Clinic-Cody
Cody
Welch Cancer Center
Sheridan
Other Locations
Guam
FHP Health Center-Guam
Tamuning
Time Frame
Start Date: 2017-01-30
Completion Date: 2026-05-01
Participants
Target number of participants: 818
Treatments
Experimental: Arm I (nivolumab, ipilimumab)
Patients receive nivolumab IV over 30 minutes on days 1, 15, and 29 and ipilimumab IV over 60 minutes on day 1. Treatment repeats every 42 days for up to 17 cycles (2 years) in the absence of disease progression or unacceptable toxicity. Patients who complete 17 cycles (2 years) of therapy, may continue receiving the same treatment with nivolumab and ipilimumab, or receive nivolumab once every 14 or 28 days (2 weeks or 4 weeks) per physician discretion in the absence of disease progression or unacceptable toxicity. Patients who stop treatment prior to the completion of 17 cycles of therapy may receive nivolumab once every 14 or 28 days (2 weeks or 4 weeks) in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO during screening and on study. Patients also undergo MRI or CT throughout the trial. Additionally, patients undergo blood sample collection throughout the trial.
Experimental: Arm II (nivolumab)
Patients receive nivolumab IV over 30 minutes on days 1, 15 and 29. Treatment repeats every 42 days for up to 17 cycles (2 years) in the absence of disease progression or unacceptable toxicity. After 17 cycles (2 years) of therapy, patients may receive nivolumab once every 14 or 28 days (2 weeks or 4 weeks) in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO during screening and on study. Patients also undergo MRI or CT throughout the trial. Additionally, patients undergo blood sample collection throughout the trial.
Authors
Lisa Bailey, Kathleen J. Yost, William T. Muuse, Deborah W. Wilbur, Christie J. Hilton, Vijay K. Sandilya, Manisha H. Shah, Sosipatros A. Boikos, Kristin K. Zorn, Robert E. Bloom, Mark A. Taylor, Charles H. Redfern, Jose Lutzky, Sandip P. Patel, Robert J. Behrens, Matthew L. Ryan, Armando Armas, Young Kwang Chae, Parminder S. Sidhu, Eric Nadler, Ralph J. Hauke, Thomas H. Openshaw, Heidi J. Gray, Funda Meric-Bernstam, Christopher M. George, Elizabeth A. Bowhay-Carnes, Bryan A. Faller, Michael Humeniuk, Preston D. Steen, Thomas J. Reid, Carla I. Falkson, Rex B. Mowat, Vincent Chung, Asha Karippot, Louis Fehrenbacher, Wei Song, Bruce J. Averbook, Howard M. Gross, Jay W. Carlson, Donald S. Gravenor, Sachin G. Pai, Charles W. Drescher, Benjamin L. Maughan, Jeffrey L. Berenberg, Joseph Sokhn, Mark M. Zalupski, Jessica Belmonte, Saba H. Radhi, James R. Egner, Mehmet S. Copur, Joseph J. Merchant, Alan Tan, Muhammad O. Toor, Melissa A. Burgess, Howard A. Zaren, Samer S. Kasbari, Carroll D. Scroggin, Qamar U. Zaman, Mitchell B. Alden, Jeffrey K. Giguere, Missak Haigentz, Thomas E. Lad, Russell J. Schilder, Paul M. Barr, Ramya Thota, John W. McBroom, John C. McCann, Gini F. Fleming, John M. Schallenkamp, Ding Wang, Jeffrey H. Muler, Wayne B. Harris, John A. Ellerton, James N. Atkins, Nibal Saad, Sarah W. Gordon, Tareq Al Baghdadi, Atif M. Hussein, Heather R. Williams, Keren Sturtz, Nagesh H. Jayaram, Iwona Podzielinski, Mebea Aklilu, Hyunseok Kang, Abhijit B. Saste, Nicklas R. Pfanzelter, Hana F. Safah, Igor Puzanov, Edmund Folefac, Carlos A. Alemany, Kathryn C. Hourdequin, Joshua Lukenbill, Raymond Thertulien, Kurt Oettel, Alexander Menter, Mei Tang, Eric D. Whitman, Donald F. Busiek, Coty Ho, Lynn J. Howie, Chung-Tsen Hsueh, Robert D. Siegel, Misbah U. Qadir, Corrine L. Zarwan, Han A. Koh, Nicholas DiBella, Jordan D. Berlin, John A. Keech, Luca Paoluzzi, Andrew W. Pippas, Constantin A. Dasanu, Ki Y. Chung, Debra M. Prow, Juhi Mittal, Jason J. Luke, Ryan P. Griffin, Dilawar Khan, Jacqueline Vuky, Sajeve S. Thomas, Shaker R. Dakhil, Isaac K. Yeboah, Julie R. Brahmer, Theodore W. Pollock, Elizabeth R. Kessler, Andrew Poklepovic, Faye Yin, Jonathan R. Strosberg, Praveen Vashist, Stephen Mayer, Sylvia V. Velinova Falls, Weijing Sun, Tatjana Kolevska, Sarah L. Davis, Ashish Sangal, Janice M. Mehnert, Augusto C. Ochoa, Bret E. Friday, Gary E. Goodman, Jennifer L. Heaberlin, Onyekachi H. Ogbonna, Hari A. Deshpande, Kelly J. Wilkinson, Heloisa P. Soares, Julian C. Schink, Roger S. Keresztes, Richard L. Deming, Heinz-Josef Lenz, Patrick J. Mansky, Mark F. Kozloff, James H. Feusner, Suma P. Satti, Vi K. Chiu, Arturo Loaiza-Bonilla, Jeffrey A. Stevens, David M. King, Dale R. Shepard, Monica M. Mita, Nisha Unni, Haythem Y. Ali, Raid Aljumaily, Stephen V. Liu, Philip E. Lammers, Douglas K. Rovira, Chao H. Huang, John M. Wrangle, Daniela A. Bota, Ari D. Baron, Pedro M. Barata, Timothy M. Kuzel, Gregory A. Masters, Abdul H. Mansoor, Bradley C. Carthon, Naoko Takebe
Sponsors
Leads: National Cancer Institute (NCI)

This content was sourced from clinicaltrials.gov

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