Comparing Capecitabine and Temozolomide in Combination to Lutetium Lu 177 Dotatate in Patients With Advanced Pancreatic Neuroendocrine Tumors

Study Purpose

This phase II trial compares capecitabine and temozolomide to lutetium Lu 177 dotatate for the treatment of pancreatic neuroendocrine tumors that have spread to other parts of the body (advanced) or are not able to be removed by surgery (unresectable). Chemotherapy drugs, such as capecitabine and temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Radioactive drugs, such as lutetium Lu 177 dotatate, may carry radiation directly to tumor cells and may reduce harm to normal cells. The purpose of this study is to find out whether capecitabine and temozolomide or lutetium Lu 177 dotatate may kill more tumor cells in patients with advanced pancreatic neuroendocrine tumors.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 18 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Histologic or pathologic documentation: well-differentiated pancreatic neuroendocrine tumor (G1, G2, or well-differentiated G3) confirmed by local histology and/or pathology.
  • - Functional or nonfunctional tumors are allowed.
  • - Stage: locally unresectable or metastatic disease.
  • - Tumor Site: neuroendocrine tumor of pancreatic primary site.
  • - Radiologic evaluation: tumor must have shown somatostatin receptor (SSTR) positivity on 68Ga-DOTATATE PET or other SSTR-PET scan in the 12 months prior to registration; however, documentation of SSTR positivity in the 6 months prior to registration is preferred.
SSTR positivity is defined as uptake greater than background liver in all measurable lesions.
  • - Patients are eligible if they meet one of the following criteria: - Previously untreated patients with grade 2 or 3 disease AND with symptoms of either disease bulk causing pain, anorexia, early satiety, large effusions/ascites, abdominal pain, abdominal fullness due to hepatomegaly, dyspnea) OR incompletely controlled symptoms of hormone excess despite somatostatin analogue (SSA) and supportive care (including but not limited to: diarrhea, hypercalcemia, hypoglycemia, hyperglycemia, flushing, Cushing's syndrome).
Patient may have been started on SSA for up to 2 months for attempted symptom control without disease progression prior to registration.
  • - Patients previously treated with SSA only and with disease progression by RECIST in prior 12 months.
  • - Patients previously treated with SSA and one or more prior systemic therapy must have received prior anti-vascular endothelial growth factor (VEGF) pathway therapy inhibitor OR have contraindication to anti-VEGF therapy (including but not limited to: uncontrolled hypertension [systolic blood pressure [SBP] > 150 and/or diastolic blood pressure [DBP] > 90 despite medical management], stage IIB or greater heart disease, angina pectoris, prior arterial [ATE] and venous thromboembolic [VTE] events in the past 6 months, gastrointestinal [GI] bleed in the last 6 months) and disease progression by RECIST in prior 12 months.
  • - Patients previously treated with more than 2 lines of therapy, not including anti VEGF therapy, but with NET related symptoms as outlined in first bullet (pain, anorexia, early satiety, large effusions/ascites, abdominal pain, abdominal fullness due to hepatomegaly, anorexia, early satiety, dyspnea) OR incompletely controlled symptoms of hormone excess despite somatostatin analogue (SSA) and supportive care (including but not limited to: diarrhea, hypercalcemia, hypoglycemia, hyperglycemia, flushing, Cushing's syndrome).
  • - Any patient with disease progression by RECIST criteria in < 4 months.
  • - Patients must have measurable disease per RECIST v1.1 by computer tomography (CT) scan or magnetic imaging (MRI).
Any lesions which have undergone percutaneous therapies or radiotherapy after starting protocol therapy should not be considered measurable unless the lesion has clearly progressed since the procedure. * Lesions must be accurately measured in at least one dimension (longest diameter to be recorded) as >= 1 cm with CT or MRI (or shortest diameter >= 1.5 cm for lymph nodes). Non-measurable disease includes disease smaller than these dimensions or lesions considered truly non- measurable including: leptomeningeal disease, bone metastases, ascites, pleural or pericardial effusion, lymphangitic involvement of skin or lung.
  • - Prior treatment with tyrosine kinase inhibitors (TKIs) such as mammalian target of rapamycin (mTOR) inhibitors (e.g. everolimus, temsirolimus, etc.) or VEGF pathway inhibitors (e.g. sunitinib, pazopanib, cabozantinib, bevacizumab, etc.) are allowed.
  • - Prior treatment with hepatic intra-arterial embolic therapies is allowed if there is recovery from all toxicities, measurable lesions do not include embolized liver unless there has been clear subsequent progression, all measurable lesions are somatostatin receptor avid, and treatment completed at least 2 months prior to registration.
  • - Prior treatment with cryoablation or thermal/radiofrequency ablation of metastases is allowed if there is recovery from all toxicities, measurable lesions do not include treated metastases, and treatment completed at least 2 months prior to registration.
  • - Age >= 18 years.
  • - Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
  • - Absolute neutrophil count (ANC) >= 1,500/mm^3.
  • - Platelet count >= 100,000/mm^3.
  • - Hemoglobin >= 9.0 g/dL.
  • - Creatinine =< 1.5 x upper limit of normal (ULN) OR calculated (calc.
) creatinine clearance >= 30 mL/min (calculated by the Cockcroft-Gault equation)
  • - Total bilirubin =< 1.5 x ULN (in patients with liver metastases or known Gilbert's syndrome, total bilirubin must be =< 3.0 x ULN) - Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 3.0 x ULN.
  • - Albumin >= 3.0 g/dL.
  • - Concurrent somatostatin analog use while on protocol therapy is allowed provided that the patient: - Has a functional tumor (evidence of peptide hormones and/or bioactive substances associated with a clinical hormone syndrome such as carcinoid syndrome or Cushing's syndrome) - Has been on a stable dose of somatostatin analog therapy for at least three months.
  • - Has previously demonstrated radiographic disease progression while on somatostatin analog therapy.
For subjects receiving lutetium Lu 177 dotatate, there should be a minimum of 14 days between long-acting somatostatin analogue and lutetium Lu 177 dotatate dosing. Short-acting somatostatin analogs should not be administered within 24 hours of lutetium Lu 177 dotatate dosing. Following lutetium Lu 177 dotatate dosing, long-acting somatostatin analogs may be administered between 4 and 24 hours after each dose.

Exclusion Criteria:

  • - Patients with poorly differentiated neuroendocrine carcinoma (large cell histology or small cell histology) are not eligible.
  • - No prior temozolomide, dacarbazine, capecitabine, 5-FU, or any PRRT for treatment of the pNET.
  • - Not pregnant and not nursing, because this study involves an agent that has known genotoxic, mutagenic, and teratogenic effects.
* Therefore, for women of childbearing potential only, a negative pregnancy test done =< 14 days prior to registration is required.
  • - No known brain metastases unless adequately treated, demonstrated to be stable, and off all treatment (including steroids) for at least 2 months prior to registration.
  • - No uncontrolled congestive heart failure (New York Heart Association [NYHA] II, III, IV).
  • - No significant medical, psychiatric, or surgical condition, currently uncontrolled by treatment, which may pose a risk to patient safety.
  • - No "currently active" second malignancy other than non-melanoma skin cancers or cervical carcinoma in situ.
Patients are not considered to have a "currently active" malignancy if they have completed therapy or are on adjuvant hormonal therapy and are free of disease for >= 3 years. - No known medical condition causing an inability to swallow and no known impairment of gastrointestinal function that may significantly alter the absorption of an oral agent

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT05247905
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 2
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Alliance for Clinical Trials in Oncology
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Timothy J. b, MD
Principal Investigator Affiliation Mayo Clinic
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Other, NIH
Overall Status Active, not recruiting
Countries United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Metastatic Pancreatic Neuroendocrine Tumor, Unresectable Pancreatic Neuroendocrine Carcinoma
Additional Details

This phase II trial compares capecitabine and temozolomide to lutetium Lu 177 dotatate for the treatment of pancreatic neuroendocrine tumors that have spread to other parts of the body (advanced) or are not able to be removed by surgery (unresectable). Chemotherapy drugs, such as capecitabine and temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Radioactive drugs, such as lutetium Lu 177 dotatate, may carry radiation directly to tumor cells and may reduce harm to normal cells. The purpose of this study is to find out whether capecitabine and temozolomide or lutetium Lu 177 dotatate may kill more tumor cells in patients with advanced pancreatic neuroendocrine tumors. The primary and secondary objectives of the study: PRIMARY OBJECTIVE:

  • I. To determine the differences in median progression-free survival (PFS) for lutetium Lu 177 dotatate peptide receptor radionuclide therapy (PRRT) when compared to capecitabine and temozolomide (CAPTEM) in patients with locally advanced or metastatic progressive, well-differentiated pancreatic neuroendocrine tumors (pNETs).
SECONDARY OBJECTIVES:
  • I. To evaluate and compare the overall survival (OS) of patients receiving lutetium Lu 177 dotatate versus (vs.#46;) CAPTEM.
  • II. To evaluate and compare time to response, time to maximum response, and overall response rates (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 between both arms.
  • III. To evaluate and compare duration of response and time to progression among both arms.
  • IV. To evaluate and compare treatment related toxicities between the arms.
  • V. To compare global health status/quality of life as measured with the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-C30 from baseline through 18 months between patients with pNET treated with lutetium Lu 177 dotatate PRRT versus capecitabine and temozolomide.
OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients receive lutetium Lu 177 dotatate intravenously (IV) over 30 minutes on day 1. Treatment repeats every 8 weeks for up to 4 cycles in the absence of disease progression or unacceptable toxicity. ARM II: Patients receive capecitabine orally (PO) twice daily (BID) days 1-14 and temozolomide PO once daily (QD) on days 10-14. Treatment repeats every 4 weeks for up to 12 cycles in the absence of disease progression or unacceptable toxicity.

Arms & Interventions

Arms

Experimental: Arm I (lutetium Lu 177 dotatate)

Patients receive lutetium Lu 177 dotatate IV over 30 minutes on day 1. Treatment repeats every 8 weeks for up to 4 cycles in the absence of disease progression or unacceptable toxicity.

Experimental: Arm II (capecitabin, temozolomide)

Patients receive capecitabine PO BID days 1-14 and temozolomide PO QD on days 10-14. Treatment repeats every 4 weeks for up to 12 cycles in the absence of disease progression or unacceptable toxicity.

Interventions

Drug: - Lutetium Lu 177 Dotatate

Given IV

Drug: - Capecitabine

Given PO

Drug: - Temozolomide

Given PO

Other: - Quality-of-Life Assessment

Ancillary studies

Other: - Questionnaire Administration

Ancillary studies

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

Fairbanks Memorial Hospital, Fairbanks, Alaska

Status

Address

Fairbanks Memorial Hospital

Fairbanks, Alaska, 99701

Mayo Clinic Hospital in Arizona, Phoenix, Arizona

Status

Address

Mayo Clinic Hospital in Arizona

Phoenix, Arizona, 85054

Tower Cancer Research Foundation, Beverly Hills, California

Status

Address

Tower Cancer Research Foundation

Beverly Hills, California, 90211

Epic Care-Dublin, Dublin, California

Status

Address

Epic Care-Dublin

Dublin, California, 94568

Bay Area Breast Surgeons Inc, Emeryville, California

Status

Address

Bay Area Breast Surgeons Inc

Emeryville, California, 94608

Epic Care Partners in Cancer Care, Emeryville, California

Status

Address

Epic Care Partners in Cancer Care

Emeryville, California, 94608

Cedars Sinai Medical Center, Los Angeles, California

Status

Address

Cedars Sinai Medical Center

Los Angeles, California, 90048

Contra Costa Regional Medical Center, Martinez, California

Status

Address

Contra Costa Regional Medical Center

Martinez, California, 94553-3156

Bay Area Tumor Institute, Oakland, California

Status

Address

Bay Area Tumor Institute

Oakland, California, 94609

Torrance, California

Status

Address

Torrance Memorial Physician Network - Cancer Care

Torrance, California, 90505

Epic Care Cyberknife Center, Walnut Creek, California

Status

Address

Epic Care Cyberknife Center

Walnut Creek, California, 94597

BASS Medical Group - Lennon, Walnut Creek, California

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BASS Medical Group - Lennon

Walnut Creek, California, 94598

Rocky Mountain Cancer Centers-Aurora, Aurora, Colorado

Status

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Rocky Mountain Cancer Centers-Aurora

Aurora, Colorado, 80012

Boulder Community Foothills Hospital, Boulder, Colorado

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Boulder Community Foothills Hospital

Boulder, Colorado, 80303

Rocky Mountain Cancer Centers-Boulder, Boulder, Colorado

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Rocky Mountain Cancer Centers-Boulder

Boulder, Colorado, 80304

Centennial, Colorado

Status

Address

Rocky Mountain Cancer Centers - Centennial

Centennial, Colorado, 80112

The Women's Imaging Center, Denver, Colorado

Status

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The Women's Imaging Center

Denver, Colorado, 80209

Colorado Blood Cancer Institute, Denver, Colorado

Status

Address

Colorado Blood Cancer Institute

Denver, Colorado, 80218

Denver, Colorado

Status

Address

Presbyterian - Saint Lukes Medical Center - Health One

Denver, Colorado, 80218

Rocky Mountain Cancer Centers-Midtown, Denver, Colorado

Status

Address

Rocky Mountain Cancer Centers-Midtown

Denver, Colorado, 80218

Rocky Mountain Cancer Centers-Rose, Denver, Colorado

Status

Address

Rocky Mountain Cancer Centers-Rose

Denver, Colorado, 80220

Englewood, Colorado

Status

Address

Mountain Blue Cancer Care Center - Swedish

Englewood, Colorado, 80113

Rocky Mountain Cancer Centers - Swedish, Englewood, Colorado

Status

Address

Rocky Mountain Cancer Centers - Swedish

Englewood, Colorado, 80113

The Melanoma and Skin Cancer Institute, Englewood, Colorado

Status

Address

The Melanoma and Skin Cancer Institute

Englewood, Colorado, 80113

Rocky Mountain Cancer Centers-Lakewood, Lakewood, Colorado

Status

Address

Rocky Mountain Cancer Centers-Lakewood

Lakewood, Colorado, 80228

Rocky Mountain Cancer Centers-Littleton, Littleton, Colorado

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Address

Rocky Mountain Cancer Centers-Littleton

Littleton, Colorado, 80120

Rocky Mountain Cancer Centers-Sky Ridge, Lone Tree, Colorado

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Address

Rocky Mountain Cancer Centers-Sky Ridge

Lone Tree, Colorado, 80124

Rocky Mountain Cancer Centers-Longmont, Longmont, Colorado

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Address

Rocky Mountain Cancer Centers-Longmont

Longmont, Colorado, 80501

Rocky Mountain Cancer Centers-Thornton, Thornton, Colorado

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Address

Rocky Mountain Cancer Centers-Thornton

Thornton, Colorado, 80260

Smilow Cancer Hospital-Derby Care Center, Derby, Connecticut

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Address

Smilow Cancer Hospital-Derby Care Center

Derby, Connecticut, 06418

Fairfield, Connecticut

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Address

Smilow Cancer Hospital Care Center-Fairfield

Fairfield, Connecticut, 06824

Glastonbury, Connecticut

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Smilow Cancer Hospital Care Center at Glastonbury

Glastonbury, Connecticut, 06033

Greenwich, Connecticut

Status

Address

Smilow Cancer Hospital Care Center at Greenwich

Greenwich, Connecticut, 06830

Guilford, Connecticut

Status

Address

Smilow Cancer Hospital Care Center - Guilford

Guilford, Connecticut, 06437

Hartford, Connecticut

Status

Address

Smilow Cancer Hospital Care Center at Saint Francis

Hartford, Connecticut, 06105

Yale University, New Haven, Connecticut

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Address

Yale University

New Haven, Connecticut, 06520

North Haven, Connecticut

Status

Address

Yale-New Haven Hospital North Haven Medical Center

North Haven, Connecticut, 06473

Orange, Connecticut

Status

Address

Smilow Cancer Hospital-Orange Care Center

Orange, Connecticut, 06477

Stamford, Connecticut

Status

Address

Smilow Cancer Hospital Care Center at Long Ridge

Stamford, Connecticut, 06902

Torrington, Connecticut

Status

Address

Smilow Cancer Hospital-Torrington Care Center

Torrington, Connecticut, 06790

Trumbull, Connecticut

Status

Address

Smilow Cancer Hospital Care Center-Trumbull

Trumbull, Connecticut, 06611

Waterbury, Connecticut

Status

Address

Smilow Cancer Hospital-Waterbury Care Center

Waterbury, Connecticut, 06708

Waterford, Connecticut

Status

Address

Smilow Cancer Hospital Care Center - Waterford

Waterford, Connecticut, 06385

Sibley Memorial Hospital, Washington, District of Columbia

Status

Address

Sibley Memorial Hospital

Washington, District of Columbia, 20016

Mayo Clinic in Florida, Jacksonville, Florida

Status

Address

Mayo Clinic in Florida

Jacksonville, Florida, 32224-9980

Advocate Outpatient Center - Aurora, Aurora, Illinois

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Address

Advocate Outpatient Center - Aurora

Aurora, Illinois, 60506

Advocate Good Shepherd Hospital, Barrington, Illinois

Status

Address

Advocate Good Shepherd Hospital

Barrington, Illinois, 60010

Illinois CancerCare-Bloomington, Bloomington, Illinois

Status

Address

Illinois CancerCare-Bloomington

Bloomington, Illinois, 61704

Illinois CancerCare-Canton, Canton, Illinois

Status

Address

Illinois CancerCare-Canton

Canton, Illinois, 61520

Memorial Hospital of Carbondale, Carbondale, Illinois

Status

Address

Memorial Hospital of Carbondale

Carbondale, Illinois, 62902

SIH Cancer Institute, Carterville, Illinois

Status

Address

SIH Cancer Institute

Carterville, Illinois, 62918

Illinois CancerCare-Carthage, Carthage, Illinois

Status

Address

Illinois CancerCare-Carthage

Carthage, Illinois, 62321

Centralia Oncology Clinic, Centralia, Illinois

Status

Address

Centralia Oncology Clinic

Centralia, Illinois, 62801

Northwestern University, Chicago, Illinois

Status

Address

Northwestern University

Chicago, Illinois, 60611

University of Illinois, Chicago, Illinois

Status

Address

University of Illinois

Chicago, Illinois, 60612

Chicago, Illinois

Status

Address

University of Chicago Comprehensive Cancer Center

Chicago, Illinois, 60637

Advocate Illinois Masonic Medical Center, Chicago, Illinois

Status

Address

Advocate Illinois Masonic Medical Center

Chicago, Illinois, 60657

AMG Crystal Lake - Oncology, Crystal Lake, Illinois

Status

Address

AMG Crystal Lake - Oncology

Crystal Lake, Illinois, 60014

Decatur, Illinois

Status

Address

Cancer Care Specialists of Illinois - Decatur

Decatur, Illinois, 62526

Decatur Memorial Hospital, Decatur, Illinois

Status

Address

Decatur Memorial Hospital

Decatur, Illinois, 62526

DeKalb, Illinois

Status

Address

Northwestern Medicine Cancer Center Kishwaukee

DeKalb, Illinois, 60115

Illinois CancerCare-Dixon, Dixon, Illinois

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Address

Illinois CancerCare-Dixon

Dixon, Illinois, 61021

Advocate Good Samaritan Hospital, Downers Grove, Illinois

Status

Address

Advocate Good Samaritan Hospital

Downers Grove, Illinois, 60515

Crossroads Cancer Center, Effingham, Illinois

Status

Address

Crossroads Cancer Center

Effingham, Illinois, 62401

Advocate Sherman Hospital, Elgin, Illinois

Status

Address

Advocate Sherman Hospital

Elgin, Illinois, 60123

Illinois CancerCare-Eureka, Eureka, Illinois

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Address

Illinois CancerCare-Eureka

Eureka, Illinois, 61530

Illinois CancerCare-Galesburg, Galesburg, Illinois

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Address

Illinois CancerCare-Galesburg

Galesburg, Illinois, 61401

Western Illinois Cancer Treatment Center, Galesburg, Illinois

Status

Address

Western Illinois Cancer Treatment Center

Galesburg, Illinois, 61401

Geneva, Illinois

Status

Address

Northwestern Medicine Cancer Center Delnor

Geneva, Illinois, 60134

Advocate South Suburban Hospital, Hazel Crest, Illinois

Status

Address

Advocate South Suburban Hospital

Hazel Crest, Illinois, 60429

Illinois CancerCare-Kewanee Clinic, Kewanee, Illinois

Status

Address

Illinois CancerCare-Kewanee Clinic

Kewanee, Illinois, 61443

AMG Libertyville - Oncology, Libertyville, Illinois

Status

Address

AMG Libertyville - Oncology

Libertyville, Illinois, 60048

Condell Memorial Hospital, Libertyville, Illinois

Status

Address

Condell Memorial Hospital

Libertyville, Illinois, 60048

Illinois CancerCare-Macomb, Macomb, Illinois

Status

Address

Illinois CancerCare-Macomb

Macomb, Illinois, 61455

New Lenox, Illinois

Status

Address

UC Comprehensive Cancer Center at Silver Cross

New Lenox, Illinois, 60451

Cancer Care Center of O'Fallon, O'Fallon, Illinois

Status

Address

Cancer Care Center of O'Fallon

O'Fallon, Illinois, 62269

Advocate Christ Medical Center, Oak Lawn, Illinois

Status

Address

Advocate Christ Medical Center

Oak Lawn, Illinois, 60453-2699

Advocate Outpatient Center - Oak Lawn, Oak Lawn, Illinois

Status

Address

Advocate Outpatient Center - Oak Lawn

Oak Lawn, Illinois, 60453

Northwestern Medicine Orland Park, Orland Park, Illinois

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Address

Northwestern Medicine Orland Park

Orland Park, Illinois, 60462

Orland Park, Illinois

Status

Address

University of Chicago Medicine-Orland Park

Orland Park, Illinois, 60462

Illinois CancerCare-Ottawa Clinic, Ottawa, Illinois

Status

Address

Illinois CancerCare-Ottawa Clinic

Ottawa, Illinois, 61350

Advocate Lutheran General Hospital, Park Ridge, Illinois

Status

Address

Advocate Lutheran General Hospital

Park Ridge, Illinois, 60068

Illinois CancerCare-Pekin, Pekin, Illinois

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Address

Illinois CancerCare-Pekin

Pekin, Illinois, 61554

Illinois CancerCare-Peoria, Peoria, Illinois

Status

Address

Illinois CancerCare-Peoria

Peoria, Illinois, 61615

Methodist Medical Center of Illinois, Peoria, Illinois

Status

Address

Methodist Medical Center of Illinois

Peoria, Illinois, 61636

Illinois CancerCare-Peru, Peru, Illinois

Status

Address

Illinois CancerCare-Peru

Peru, Illinois, 61354

Valley Radiation Oncology, Peru, Illinois

Status

Address

Valley Radiation Oncology

Peru, Illinois, 61354

Illinois CancerCare-Princeton, Princeton, Illinois

Status

Address

Illinois CancerCare-Princeton

Princeton, Illinois, 61356

Springfield, Illinois

Status

Address

Southern Illinois University School of Medicine

Springfield, Illinois, 62702

Springfield Clinic, Springfield, Illinois

Status

Address

Springfield Clinic

Springfield, Illinois, 62702

Springfield Memorial Hospital, Springfield, Illinois

Status

Address

Springfield Memorial Hospital

Springfield, Illinois, 62781

Warrenville, Illinois

Status

Address

Northwestern Medicine Cancer Center Warrenville

Warrenville, Illinois, 60555

Illinois CancerCare - Washington, Washington, Illinois

Status

Address

Illinois CancerCare - Washington

Washington, Illinois, 61571

Mercy Health - Paducah Cancer Center, Paducah, Kentucky

Status

Address

Mercy Health - Paducah Cancer Center

Paducah, Kentucky, 42003

Baltimore, Maryland

Status

Address

Johns Hopkins University/Sidney Kimmel Cancer Center

Baltimore, Maryland, 21287

Boston Medical Center, Boston, Massachusetts

Status

Address

Boston Medical Center

Boston, Massachusetts, 02118

Hickman Cancer Center, Adrian, Michigan

Status

Address

Hickman Cancer Center

Adrian, Michigan, 49221

Toledo Clinic Cancer Centers-Monroe, Monroe, Michigan

Status

Address

Toledo Clinic Cancer Centers-Monroe

Monroe, Michigan, 48162

Mayo Clinic in Rochester, Rochester, Minnesota

Status

Address

Mayo Clinic in Rochester

Rochester, Minnesota, 55905

Sanford Cancer Center Worthington, Worthington, Minnesota

Status

Address

Sanford Cancer Center Worthington

Worthington, Minnesota, 56187

Southhaven, Mississippi

Status

Address

Baptist Memorial Hospital and Cancer Center-Desoto

Southhaven, Mississippi, 38671

Mercy Cancer Center - Cape Girardeau, Cape Girardeau, Missouri

Status

Address

Mercy Cancer Center - Cape Girardeau

Cape Girardeau, Missouri, 63703

Saint Francis Medical Center, Cape Girardeau, Missouri

Status

Address

Saint Francis Medical Center

Cape Girardeau, Missouri, 63703

Parkland Health Center - Farmington, Farmington, Missouri

Status

Address

Parkland Health Center - Farmington

Farmington, Missouri, 63640

MU Health Care Goldschmidt Cancer Center, Jefferson City, Missouri

Status

Address

MU Health Care Goldschmidt Cancer Center

Jefferson City, Missouri, 65109

Missouri Baptist Medical Center, Saint Louis, Missouri

Status

Address

Missouri Baptist Medical Center

Saint Louis, Missouri, 63131

Sainte Genevieve, Missouri

Status

Address

Sainte Genevieve County Memorial Hospital

Sainte Genevieve, Missouri, 63670

Missouri Baptist Sullivan Hospital, Sullivan, Missouri

Status

Address

Missouri Baptist Sullivan Hospital

Sullivan, Missouri, 63080

BJC Outpatient Center at Sunset Hills, Sunset Hills, Missouri

Status

Address

BJC Outpatient Center at Sunset Hills

Sunset Hills, Missouri, 63127

Nebraska Medicine-Bellevue, Bellevue, Nebraska

Status

Address

Nebraska Medicine-Bellevue

Bellevue, Nebraska, 68123

Cancer Partners of Nebraska, Lincoln, Nebraska

Status

Address

Cancer Partners of Nebraska

Lincoln, Nebraska, 68516

Nebraska Medicine-Village Pointe, Omaha, Nebraska

Status

Address

Nebraska Medicine-Village Pointe

Omaha, Nebraska, 68118

University of Nebraska Medical Center, Omaha, Nebraska

Status

Address

University of Nebraska Medical Center

Omaha, Nebraska, 68198

Lebanon, New Hampshire

Status

Address

Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center

Lebanon, New Hampshire, 03756

Bronx, New York

Status

Address

Montefiore Medical Center-Einstein Campus

Bronx, New York, 10461

Bronx, New York

Status

Address

Montefiore Medical Center-Weiler Hospital

Bronx, New York, 10461

Montefiore Medical Center - Moses Campus, Bronx, New York

Status

Address

Montefiore Medical Center - Moses Campus

Bronx, New York, 10467

Mount Sinai Hospital, New York, New York

Status

Address

Mount Sinai Hospital

New York, New York, 10029

Syracuse, New York

Status

Address

State University of New York Upstate Medical University

Syracuse, New York, 13210

Toledo Clinic Cancer Centers-Maumee, Maumee, Ohio

Status

Address

Toledo Clinic Cancer Centers-Maumee

Maumee, Ohio, 43537

Toledo Clinic Cancer Centers-Toledo, Toledo, Ohio

Status

Address

Toledo Clinic Cancer Centers-Toledo

Toledo, Ohio, 43623

Saint Vincent Hospital, Erie, Pennsylvania

Status

Address

Saint Vincent Hospital

Erie, Pennsylvania, 16544

Jefferson Hospital, Jefferson Hills, Pennsylvania

Status

Address

Jefferson Hospital

Jefferson Hills, Pennsylvania, 15025

Forbes Hospital, Monroeville, Pennsylvania

Status

Address

Forbes Hospital

Monroeville, Pennsylvania, 15146

Allegheny General Hospital, Pittsburgh, Pennsylvania

Status

Address

Allegheny General Hospital

Pittsburgh, Pennsylvania, 15212

West Penn Hospital, Pittsburgh, Pennsylvania

Status

Address

West Penn Hospital

Pittsburgh, Pennsylvania, 15224

Wexford Health and Wellness Pavilion, Wexford, Pennsylvania

Status

Address

Wexford Health and Wellness Pavilion

Wexford, Pennsylvania, 15090

Westerly, Rhode Island

Status

Address

Smilow Cancer Hospital Care Center - Westerly

Westerly, Rhode Island, 02891

Boiling Springs, South Carolina

Status

Address

Prisma Health Cancer Institute - Spartanburg

Boiling Springs, South Carolina, 29316

Prisma Health Cancer Institute - Easley, Easley, South Carolina

Status

Address

Prisma Health Cancer Institute - Easley

Easley, South Carolina, 29640

Greenville, South Carolina

Status

Address

Prisma Health Cancer Institute - Butternut

Greenville, South Carolina, 29605

Prisma Health Cancer Institute - Faris, Greenville, South Carolina

Status

Address

Prisma Health Cancer Institute - Faris

Greenville, South Carolina, 29605

Greenville, South Carolina

Status

Address

Prisma Health Greenville Memorial Hospital

Greenville, South Carolina, 29605

Greenville, South Carolina

Status

Address

Prisma Health Cancer Institute - Eastside

Greenville, South Carolina, 29615

Prisma Health Cancer Institute - Greer, Greer, South Carolina

Status

Address

Prisma Health Cancer Institute - Greer

Greer, South Carolina, 29650

Prisma Health Cancer Institute - Seneca, Seneca, South Carolina

Status

Address

Prisma Health Cancer Institute - Seneca

Seneca, South Carolina, 29672

Sanford Cancer Center Oncology Clinic, Sioux Falls, South Dakota

Status

Address

Sanford Cancer Center Oncology Clinic

Sioux Falls, South Dakota, 57104

Sanford USD Medical Center - Sioux Falls, Sioux Falls, South Dakota

Status

Address

Sanford USD Medical Center - Sioux Falls

Sioux Falls, South Dakota, 57117-5134

Collierville, Tennessee

Status

Address

Baptist Memorial Hospital and Cancer Center-Collierville

Collierville, Tennessee, 38017

Memphis, Tennessee

Status

Address

Baptist Memorial Hospital and Cancer Center-Memphis

Memphis, Tennessee, 38120

Salt Lake City, Utah

Status

Address

Huntsman Cancer Institute/University of Utah

Salt Lake City, Utah, 84112

Jefferson Healthcare, Port Townsend, Washington

Status

Address

Jefferson Healthcare

Port Townsend, Washington, 98368

Aurora Cancer Care-Southern Lakes VLCC, Burlington, Wisconsin

Status

Address

Aurora Cancer Care-Southern Lakes VLCC

Burlington, Wisconsin, 53105

Marshfield Clinic-Chippewa Center, Chippewa Falls, Wisconsin

Status

Address

Marshfield Clinic-Chippewa Center

Chippewa Falls, Wisconsin, 54729

Aurora Saint Luke's South Shore, Cudahy, Wisconsin

Status

Address

Aurora Saint Luke's South Shore

Cudahy, Wisconsin, 53110

Eau Claire, Wisconsin

Status

Address

Marshfield Medical Center-EC Cancer Center

Eau Claire, Wisconsin, 54701

Germantown, Wisconsin

Status

Address

Aurora Health Care Germantown Health Center

Germantown, Wisconsin, 53022

Aurora Cancer Care-Grafton, Grafton, Wisconsin

Status

Address

Aurora Cancer Care-Grafton

Grafton, Wisconsin, 53024

Aurora BayCare Medical Center, Green Bay, Wisconsin

Status

Address

Aurora BayCare Medical Center

Green Bay, Wisconsin, 54311

Aurora Health Center - Greenfield, Greenfield, Wisconsin

Status

Address

Aurora Health Center - Greenfield

Greenfield, Wisconsin, 53228

Aurora Cancer Care-Kenosha South, Kenosha, Wisconsin

Status

Address

Aurora Cancer Care-Kenosha South

Kenosha, Wisconsin, 53142

Marshfield Medical Center - Ladysmith, Ladysmith, Wisconsin

Status

Address

Marshfield Medical Center - Ladysmith

Ladysmith, Wisconsin, 54848

Aurora Bay Area Medical Group-Marinette, Marinette, Wisconsin

Status

Address

Aurora Bay Area Medical Group-Marinette

Marinette, Wisconsin, 54143

Marshfield Medical Center-Marshfield, Marshfield, Wisconsin

Status

Address

Marshfield Medical Center-Marshfield

Marshfield, Wisconsin, 54449

Aurora Cancer Care-Milwaukee, Milwaukee, Wisconsin

Status

Address

Aurora Cancer Care-Milwaukee

Milwaukee, Wisconsin, 53209

Aurora Saint Luke's Medical Center, Milwaukee, Wisconsin

Status

Address

Aurora Saint Luke's Medical Center

Milwaukee, Wisconsin, 53215

Medical College of Wisconsin, Milwaukee, Wisconsin

Status

Address

Medical College of Wisconsin

Milwaukee, Wisconsin, 53226

Aurora Sinai Medical Center, Milwaukee, Wisconsin

Status

Address

Aurora Sinai Medical Center

Milwaukee, Wisconsin, 53233

Marshfield Medical Center - Minocqua, Minocqua, Wisconsin

Status

Address

Marshfield Medical Center - Minocqua

Minocqua, Wisconsin, 54548

Vince Lombardi Cancer Clinic - Oshkosh, Oshkosh, Wisconsin

Status

Address

Vince Lombardi Cancer Clinic - Oshkosh

Oshkosh, Wisconsin, 54904

Aurora Cancer Care-Racine, Racine, Wisconsin

Status

Address

Aurora Cancer Care-Racine

Racine, Wisconsin, 53406

Marshfield Medical Center-Rice Lake, Rice Lake, Wisconsin

Status

Address

Marshfield Medical Center-Rice Lake

Rice Lake, Wisconsin, 54868

Vince Lombardi Cancer Clinic-Sheboygan, Sheboygan, Wisconsin

Status

Address

Vince Lombardi Cancer Clinic-Sheboygan

Sheboygan, Wisconsin, 53081

Stevens Point, Wisconsin

Status

Address

Marshfield Medical Center-River Region at Stevens Point

Stevens Point, Wisconsin, 54482

Aurora Medical Center in Summit, Summit, Wisconsin

Status

Address

Aurora Medical Center in Summit

Summit, Wisconsin, 53066

Vince Lombardi Cancer Clinic-Two Rivers, Two Rivers, Wisconsin

Status

Address

Vince Lombardi Cancer Clinic-Two Rivers

Two Rivers, Wisconsin, 54241

Marshfield Clinic-Wausau Center, Wausau, Wisconsin

Status

Address

Marshfield Clinic-Wausau Center

Wausau, Wisconsin, 54401

Aurora Cancer Care-Milwaukee West, Wauwatosa, Wisconsin

Status

Address

Aurora Cancer Care-Milwaukee West

Wauwatosa, Wisconsin, 53226

Aurora West Allis Medical Center, West Allis, Wisconsin

Status

Address

Aurora West Allis Medical Center

West Allis, Wisconsin, 53227

Marshfield Medical Center - Weston, Weston, Wisconsin

Status

Address

Marshfield Medical Center - Weston

Weston, Wisconsin, 54476

Wisconsin Rapids, Wisconsin

Status

Address

Marshfield Clinic - Wisconsin Rapids Center

Wisconsin Rapids, Wisconsin, 54494

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