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NCT03067181PHASE3Recruiting

Active Surveillance, Bleomycin, Etoposide, Carboplatin or Cisplatin in Treating Pediatric and Adult Patients With Germ Cell Tumors

Children's Oncology Group

Start Date

5/25/2017

Completion Date

6/30/2027

Summary

This phase III trial studies how well active surveillance help doctors to monitor subjects with low risk germ cell tumors for recurrence after their tumor is removed. When the germ cell tumor has spread outside of the organ in which it developed, it is considered metastatic. Chemotherapy drugs, such as bleomycin, carboplatin, etoposide, and cisplatin, 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. The trial studies whether carboplatin or cisplatin is the preferred chemotherapy to use in treating metastatic standard risk germ cell tumors.

Detailed Description

PRIMARY OBJECTIVES: I. To evaluate whether a strategy of complete surgical resection followed by surveillance can maintain an overall survival rate of at least 95.7% at two years for pediatric, adolescent and adult patients with stage I (low risk) malignant germ cell tumors (Stratum 2), and at least 88% for patients with all stage/grade ovarian pure immature teratoma (Stratum 1). II. To compare the event-free survival of a carboplatin versus (vs.) cisplatin-based regimen in the treatment of pediatric, adolescent and young adult patients with standard risk non-seminomatous germ cell tumors. IIa. To compare the event free survival (EFS) of a carboplatin-based regimen (carboplatin \[C\] etoposide \[E\] bleomycin \[b\]) vs. a cisplatin-based regimen (cisplatin \[P\]Eb) in children (less than 11 years in age) with standard risk germ cell tumors (GCT). IIb. To compare the EFS of a carboplatin-based regimen (BEC) vs. a cisplatin-based regimen (BEP) in adolescents and young adults (ages 11 - \< 25 years) with standard risk GCT. SECONDARY OBJECTIVES: I. To compare the incidence of ototoxicity in children, adolescents and young adults with standard risk germ cell tumors treated with carboplatin-based chemotherapy as compared to cisplatin-based chemotherapy. II. To refine and validate a novel patient-reported measure of hearing outcomes for children, adolescents and young adults with standard risk germ cell tumors. III. To determine whether radiomic measures of body composition at diagnosis, end of therapy, and one year after end of therapy is better correlated with adverse events compared to body surface area in patients receiving chemotherapy for germ cell tumors. EXPLORATORY OBJECTIVES: I. To prospectively determine the correlation of tumor marker decline (alpha-fetoprotein \[FP\] and beta-human chorionic gonadotropin \[HCG\]) with clinical outcome in low and standard risk germ cell tumor patients. II. To compare self-reported peripheral neuropathy and other patient-reported outcomes between children, adolescents and young adults with standard risk germ cell tumors treated with carboplatin-based chemotherapy as compared to cisplatin-based chemotherapy. III. Assess the relationship between hearing loss as measured by audiometry with the effects of tinnitus as assessed on the Adolescent and Young Adult Hearing Screening (AYA-HEARS) instrument. IV. To evaluate the prognostic significance of serum micro ribonucleic acid (miRNA)s in stage I seminoma patients by collecting clinical data and serum specimens for future analysis. V. To compare differences in the proportion of patients with residual mass(es) ≥ 1 cm at the completion of chemotherapy among patients randomized to the cisplatin and carboplatin-containing arms and to compare the proportion undergoing post-chemotherapy surgery for residual mass(es), and the proportion of resected masses with viable malignancy, teratoma, or necrosis. VI. To investigate whether there is an association between serum miRNAs measured immediately post-operatively and time-to-relapse in stage I non-seminomatous germ cell tumor patients and to estimate the trajectory of miRNA over time. OUTLINE: Patients with low-risk stage I grade 2, 3 ovarian immature teratoma or stage I non-seminoma malignant germ cell tumors (MGCT)s undergo observation and can transfer to standard risk arm at time of recurrence if eligibility criteria are met. Patients with stage I seminoma testicular MGCT undergo observation, and those with residual/recurrent disease are treated at the discretion of their physician. Patients undergo computed tomography (CT), magnetic resonance imaging (MRI), and/or chest x-ray as well as blood sample collection throughout the trial to monitor for response and recurrence. Patients may also undergo a tumor biopsy throughout the trial. Patients with standard risk 1 are randomized into 1 of 2 arms. ARM I (CEb): Patients receive bleomycin intravenously (IV) over 10 minutes and carboplatin IV over 1 hour on day 1. Patients also receive etoposide IV over 1-2 hours on days 1-5. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo CT, MRI, and/or chest x-ray as well as blood sample collection throughout the trial. Patients may also undergo a tumor biopsy throughout the trial. Patients undergo a pulmonary function test on study. ARM II (PEb): Patients receive bleomycin IV over 10 minutes on day 1. Patients also receive etoposide IV over 1-2 hours and cisplatin IV over 1-3 hours on days 1-5. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo CT, MRI, and/or chest x-ray as well as blood sample collection throughout the trial. Patients may also undergo a tumor biopsy throughout the trial. Patients undergo a pulmonary function test on study. Patients with standard risk 2 are randomized into 1 of 2 arms. ARM III (BEC): Patients receive bleomycin IV over 10 minutes on days 1, 8, and 15, etoposide IV over 1-2 hours on days 1-5, and carboplatin IV over 1 hour on day 1. Treatment repeats every 21 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo CT, MRI, and/or chest x-ray as well as blood sample collection throughout the trial. Patients may also undergo a tumor biopsy throughout the trial. Patients undergo a pulmonary function test on study. ARM IV (BEP): Patients receive bleomycin IV over 10 minutes on days 1, 8, and 15, etoposide IV over 1-2 hours on days 1-5, and cisplatin IV over 1-3 hours on days 1-5. Treatment repeats every 21 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo CT, MRI, and/or chest x-ray as well as blood sample collection throughout the trial. Patients may also undergo a tumor biopsy throughout the trial. Patients undergo a pulmonary function test on study. After completion of study treatment, patients are followed up every 2 months for 12 months, every 3-6 months to 24 months, every 6 months for years 3-5, and then annually for up to 10 years.

Eligibility Criteria

Age Range: No minimum to No maximum

Inclusion Criteria: * There is no age limit for the low risk stratum (stage I ovarian immature teratoma and stage I non-seminoma or seminoma malignant GCT \[all sites\]) * Standard risk 1: Patients must be \< 11 years of age at enrollment * Standard risk 2: Patients must be \>= 11 and \< 25 years of age at enrollment * Patients enrolling on one of the low risk arms must be newly diagnosed with a stage I germ cell tumor; for the standard risk arms, patients must be newly diagnosed with malignant germ cell tumor (stage II or higher). * Histologic confirmation of a primary extracranial germ cell tumor in any of the categories outlined below is required of all patients at enrollment , with the following exceptions: * Among patients were initially diagnosed with completely resected non-seminoma malignant GCT and later recur during observation post surgery, a diagnostic biopsy is not required for enrollment if elevated tumor markers rise to \> 5 x upper limit of normal (ULN) on at least 2 measurements taken at least 1 week apart. The pathology report of initial surgery should be provided * Patients may be enrolled without histologic or cytologic confirmation in the rare case where there are exceptionally raised tumor markers (alpha fetoprotein \[AFP- ≥ 500 ng/mL or HCG ≥ 500 IU/L) and radiologic features consistent with GCT. In addition, the treating clinician must deem that the patient's tumor is not suitable for upfront resection and that a biopsy is not in the patient's best interest; or that there is a need to start therapy urgently * Low risk immature teratoma (IT); site: ovarian; stage: any; grade: any; histology: pure immature teratoma, mixed immature and mature teratoma, (may contain microscopic foci of yolk sac tumor \[\< 3 mm\], but no other pathological evidence of MGCT); tumor markers: alpha-FP =\< 1,000 ng/mL, beta-HCG institutional normal; all ages * Low risk stage I non-seminoma MGCT; site: ovarian, testicular, or extragonadal; stage: COG stage I, FIGO stage IA and IB, American Joint Committee on Cancer (AJCC) testicular stage IA, IB and IS; histology: must contain at least one of the following: yolk sac tumor, embryonal carcinoma, or choriocarcinoma (pure or mixed); all ages * Low risk stage I seminoma-MGCT; site: testicular; stage: COG stage I; AJCC testicular stage IA IB, and IS; histology: must contain only seminoma; may contain immature/mature teratoma; may NOT contain yolk sac tumor, embryonal carcinoma, or choriocarcinoma; all ages * Standard risk 1 (SR1); site: ovarian, testicular, or extragonadal; stage: COG stage II-IV, FIGO stage IC-IV, (International Germ Cell Consensus Classification \[IGCCC\] criteria DO NOT apply); histology: must contain at least one of the following: yolk sac tumor, embryonal carcinoma, or choriocarcinoma; age (years) \< 11 * Standard risk 2 (SR2) * Site: ovarian; stage: COG stage II, III, and III-X, FIGO stage IC, II and III; histology: must contain at least one of the following: yolk sac tumor, embryonal carcinoma, or choriocarcinoma; age (years) \>= 11 and \< 25 * Site: testicular; stage: COG stage II-IV, AJCC stage II, III, IGCCC good risk; histology: must contain at least one of the following: yolk sac tumor, embryonal carcinoma, or choriocarcinoma: must be IGCCC good risk; post op: alpha-FP \< 1,000 ng/mL, beta-HCG \< 5,000 IU/mL and lactate dehydrogenase (LDH) \< 3.0 x normal; age (years) \>= 11 and \< 25 * Notes: * IGCCC criteria only apply to SR2 patients with a testicular primary tumor * Use post-op tumor marker levels to determine IGCCC risk group * Pure seminoma patients are not eligible for the standard risk arms of the study * For the low risk stage I non-seminoma MGCT and the standard risk arms, components of yolk sac tumor, embryonal carcinoma, or choriocarcinoma can be mixed with other forms of GCT, such as seminoma or mature or immature teratoma; if yolk sac tumor is the only malignant component present, then it must be deemed by the pathologist to be greater than a "microscopic component" of yolk sac tumor * Patients must have a performance status corresponding to Eastern Cooperative Oncology Group (ECOG) scores of 0, 1, 2 or 3; use Karnofsky for patients \> 16 years of age and Lansky for patients =\< 16 years of age * Organ function requirements apply ONLY to patients who will receive chemotherapy (SR1 and SR2 patients) * Adequate renal function defined as: * Creatinine clearance or radioisotope glomerular filtration rate (GFR) \>= 70 mL/min/1.73 m\^2 (within 7 days prior to enrollment) OR * A serum creatinine based on age/sex as follows (within 7 days prior to enrollment): (mg/dL) * 1 month to \< 6 months male: 0.4 female: 0.4 * 6 months to \< 1 year male: 0.5 female: 0.5 * 1 to \< 2 years male: 0.6 female: 0.6 * 2 to \< 6 years male: 0.8 female: 0.8 * 6 to \< 10 years male: 1 female: 1 * 10 to \< 13 years male: 1.2 female: 1.2 * 13 to \< 16 years: male: 1.5 female: 1.4 * \>= 16 years male: 1.7 female: 1.4 * Total bilirubin =\< 2 x upper limit of normal (ULN) for age (within 7 days prior to enrollment) * Unless due to Gilbert's disease, malignant involvement of liver or vanishing bile duct syndrome * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) \< 3 x upper limit of normal (ULN) (within 7 days prior to enrollment) * Unless due to Gilbert's disease, malignant involvement of liver or vanishing bile duct syndrome * Peripheral absolute neutrophil count (ANC) \>= 750/mm\^3 (within 7 days prior to enrollment) AND * Platelet count \>= 75,000/mm\^3 (within 7 days prior to enrollment) * Patients enrolling on the standard risk arms must be medically fit to receive protocol treatment and with no contraindications to protocol treatment * Eligibility criteria to participate in the pilot study of the AYA-Hears instrument (patient reported outcomes \[PROs\] of ototoxicity) Note: participants in group 1 will not receive AGCT1531 protocol-directed therapy; all other AYA-HEARS patients must be enrolled on the AGCT1531 SR2 arm in order to participate * \>= 11 and \< 25 years old at enrollment * Able to fluently speak and read English * Has received prior cisplatin- or carboplatin-based chemotherapy regimen for malignancy including diagnoses other than germ cell tumor * Followed for cancer or survivorship care at one of the following institutions: * Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center * Dana Farber/Harvard Cancer Center * Hospital for Sick Children * Children's Hospital of Eastern Ontario * Oregon Health and Science University * Seattle Children's Hospital * Yale University Exclusion Criteria: * Patients with any diagnoses not listed including: * Stage I testicular cancer patients who have undergone primary RPLND (retroperitoneal lymph node dissection) * Pure ovarian or extragonadal dysgerminoma/seminoma * Pure mature teratoma * Pure immature teratoma with alpha-fetoprotein (AFP) \>= 1000 ng/mL * "Poor risk" GCT (age \>= 11 years old and COG stage IV ovarian, COG stage II- IV extragonadal, or IGCCC intermediate or poor risk testicular), or * Primary central nervous system (CNS) germ cell tumor * Germ cell tumor with somatic malignant transformation * Spermatocytic seminoma * Patients must have had no prior systemic therapy for the current cancer diagnosis * Patients must have had no prior radiation therapy with the exception of CNS irradiation of brain metastases; (this exception only applies to SR1 patients; any patients over age 11 with distant metastases to brain \[stage IV disease\] would be considered poor risk and therefore not eligible for this trial) * Patients with significant, pre-existing co-morbid respiratory disease that contraindicate the use of bleomycin are ineligible for the standard risk arms of the trial * Female patients who are pregnant since fetal toxicities and teratogenic effects have been noted for several of the study drugs; a pregnancy test is required for female patients of childbearing potential; (this criteria applies ONLY to patients who will receive chemotherapy \[SR1 and SR2 patients\]) * Lactating females who plan to breastfeed their infants; (this criteria applies ONLY to patients who will receive chemotherapy \[SR1 and SR2 patients\]) * Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method for the duration of their study participation; (this criteria applies ONLY to patients who will receive chemotherapy \[SR1 and SR2 patients\])

Interventions

OTHER

Best Practice

PROCEDURE

Biopsy Procedure

PROCEDURE

Biospecimen Collection

BIOLOGICAL

Bleomycin Sulfate

DRUG

Carboplatin

DRUG

Cisplatin

PROCEDURE

Computed Tomography

DRUG

Etoposide

PROCEDURE

Magnetic Resonance Imaging

PROCEDURE

Pulmonary Function Test

OTHER

Questionnaire Administration

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Conditions

Childhood Extracranial Germ Cell TumorExtragonadal Embryonal CarcinomaGerm Cell TumorMalignant Germ Cell TumorMalignant Ovarian TeratomaStage I Ovarian ChoriocarcinomaStage I Ovarian Embryonal Carcinoma AJCC v6 and v7Stage I Ovarian Yolk Sac Tumor AJCC v6 and v7Stage I Testicular Choriocarcinoma AJCC v6 and v7Stage I Testicular Embryonal Carcinoma AJCC v6 and v7Stage I Testicular Seminoma AJCC v6 and v7Stage I Testicular Yolk Sac Tumor AJCC v6 and v7Stage II Ovarian ChoriocarcinomaStage II Ovarian Embryonal Carcinoma AJCC v6 and v7Stage II Ovarian Yolk Sac Tumor AJCC v6 and v7Stage II Testicular Choriocarcinoma AJCC v6 and v7Stage II Testicular Embryonal Carcinoma AJCC v6 and v7Stage II Testicular Yolk Sac Tumor AJCC v6 and v7Stage III Ovarian ChoriocarcinomaStage III Ovarian Embryonal Carcinoma AJCC v6 and v7Stage III Ovarian Yolk Sac Tumor AJCC v6 and v7Stage III Testicular Choriocarcinoma AJCC v6 and v7Stage III Testicular Embryonal Carcinoma AJCC v6 and v7Stage III Testicular Yolk Sac Tumor AJCC v6 and v7Stage IV Ovarian ChoriocarcinomaStage IV Ovarian Embryonal Carcinoma AJCC v6 and v7Stage IV Ovarian Yolk Sac Tumor AJCC v6 and v7Testicular Mixed Choriocarcinoma and Embryonal CarcinomaTesticular Mixed Choriocarcinoma and TeratomaTesticular Mixed Choriocarcinoma and Yolk Sac Tumor

Locations

Children's Hospital of Alabama

Birmingham, Alabama 35233

United States

USA Health Strada Patient Care Center

Mobile, Alabama 36604

United States

Anchorage Associates in Radiation Medicine

Anchorage, Alaska 98508

United States

Anchorage Radiation Therapy Center

Anchorage, Alaska 99504

United States

Alaska Breast Care and Surgery LLC

Anchorage, Alaska 99508

United States

Alaska Oncology and Hematology LLC

Anchorage, Alaska 99508

United States

Alaska Women's Cancer Care

Anchorage, Alaska 99508

United States

Anchorage Oncology Centre

Anchorage, Alaska 99508

United States

Katmai Oncology Group

Anchorage, Alaska 99508

United States

Providence Alaska Medical Center

Anchorage, Alaska 99508

United States

Kingman Regional Medical Center

Kingman, Arizona 86401

United States

Banner Children's at Desert

Mesa, Arizona 85202

United States

Cancer Center at Saint Joseph's

Phoenix, Arizona 85004

United States

Phoenix Childrens Hospital

Phoenix, Arizona 85016

United States

Banner University Medical Center - Tucson

Tucson, Arizona 85719

United States

University of Arizona Cancer Center-North Campus

Tucson, Arizona 85719

United States

CHI Saint Vincent Cancer Center Hot Springs

Hot Springs, Arkansas 71913

United States

Arkansas Children's Hospital

Little Rock, Arkansas 72202-3591

United States

CARTI Cancer Center

Little Rock, Arkansas 72205

United States

University of Arkansas for Medical Sciences

Little Rock, Arkansas 72205

United States

Kaiser Permanente-Anaheim

Anaheim, California 92806

United States

Mission Hope Medical Oncology - Arroyo Grande

Arroyo Grande, California 93420

United States

PCR Oncology

Arroyo Grande, California 93420

United States

Kaiser Permanente-Bellflower

Bellflower, California 90706

United States

Providence Saint Joseph Medical Center/Disney Family Cancer Center

Burbank, California 91505

United States

Mercy Cancer Center - Carmichael

Carmichael, California 95608

United States

Mercy San Juan Medical Center

Carmichael, California 95608

United States

Kaiser Permanente Downey Medical Center

Downey, California 90242

United States

City of Hope Comprehensive Cancer Center

Duarte, California 91010

United States

Mercy Cancer Center - Elk Grove

Elk Grove, California 95758

United States

Kaiser Permanente-Fontana

Fontana, California 92335

United States

UC San Diego Moores Cancer Center

La Jolla, California 92093

United States

Loma Linda University Medical Center

Loma Linda, California 92354

United States

Miller Children's and Women's Hospital Long Beach

Long Beach, California 90806

United States

Children's Hospital Los Angeles

Los Angeles, California 90027

United States

Kaiser Permanente Los Angeles Medical Center

Los Angeles, California 90027

United States

Los Angeles General Medical Center

Los Angeles, California 90033

United States

USC / Norris Comprehensive Cancer Center

Los Angeles, California 90033

United States

Cedars-Sinai Medical Center

Los Angeles, California 90048

United States

Mattel Children's Hospital UCLA

Los Angeles, California 90095

United States

UCLA / Jonsson Comprehensive Cancer Center

Los Angeles, California 90095

United States

Valley Children's Hospital

Madera, California 93636

United States

Providence Queen of The Valley

Napa, California 94558

United States

USC Norris Oncology/Hematology-Newport Beach

Newport Beach, California 92663

United States

UCSF Benioff Children's Hospital Oakland

Oakland, California 94609

United States

Kaiser Permanente-Oakland

Oakland, California 94611

United States

Children's Hospital of Orange County

Orange, California 92868

United States

Lucile Packard Children's Hospital Stanford University

Palo Alto, California 94304

United States

Stanford Cancer Institute Palo Alto

Palo Alto, California 94304

United States

Mercy Cancer Center - Rocklin

Rocklin, California 95765

United States

Kaiser Permanente-Roseville

Roseville, California 95661

United States

Mercy Cancer Center - Sacramento

Sacramento, California 95816

United States

Sutter Medical Center Sacramento

Sacramento, California 95816

United States

University of California Davis Comprehensive Cancer Center

Sacramento, California 95817

United States

Kaiser Permanente-San Diego Mission

San Diego, California 92108

United States

Rady Children's Hospital - San Diego

San Diego, California 92123

United States

Naval Medical Center -San Diego

San Diego, California 92134

United States

UCSF Medical Center-Mission Bay

San Francisco, California 94158

United States

Pacific Central Coast Health Center-San Luis Obispo

San Luis Obispo, California 93401

United States

Kaiser Permanente Medical Center - Santa Clara

Santa Clara, California 95051

United States

Mission Hope Medical Oncology - Santa Maria

Santa Maria, California 93444

United States

Providence Medical Foundation - Santa Rosa

Santa Rosa, California 95403

United States

Providence Santa Rosa Memorial Hospital

Santa Rosa, California 95405

United States

Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center

Torrance, California 90502

United States

Woodland Memorial Hospital

Woodland, California 95695

United States

Children's Hospital Colorado

Aurora, Colorado 80045

United States

UCHealth University of Colorado Hospital

Aurora, Colorado 80045

United States

Penrose-Saint Francis Healthcare

Colorado Springs, Colorado 80907

United States

Rocky Mountain Cancer Centers-Penrose

Colorado Springs, Colorado 80907

United States

UCHealth Memorial Hospital Central

Colorado Springs, Colorado 80909

United States

Memorial Hospital North

Colorado Springs, Colorado 80920

United States

Saint Francis Cancer Center

Colorado Springs, Colorado 80923

United States

AdventHealth Porter

Denver, Colorado 80210

United States

Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center

Denver, Colorado 80218

United States

CommonSpirit Cancer Center Mercy

Durango, Colorado 81301

United States

Mercy Medical Center

Durango, Colorado 81301

United States

Poudre Valley Hospital

Fort Collins, Colorado 80524

United States

Cancer Care and Hematology-Fort Collins

Fort Collins, Colorado 80528

United States

Mountain Blue Cancer Care Center

Golden, Colorado 80401

United States

UCHealth Greeley Hospital

Greeley, Colorado 80631

United States

CommonSpirit Saint Anthony Hospital Cancer Center

Lakewood, Colorado 80228

United States

Rocky Mountain Cancer Centers-Lakewood

Lakewood, Colorado 80228

United States

AdventHealth Littleton

Littleton, Colorado 80122

United States

UCHealth Lone Tree Health Center

Lone Tree, Colorado 80124

United States

Longmont United Hospital

Longmont, Colorado 80501

United States

Rocky Mountain Cancer Centers-Longmont

Longmont, Colorado 80501

United States

Medical Center of the Rockies

Loveland, Colorado 80538

United States

AdventHealth Parker

Parker, Colorado 80138

United States

Rocky Mountain Cancer Centers-Parker

Parker, Colorado 80138

United States

Saint Mary Corwin Medical Center

Pueblo, Colorado 81004

United States

Rocky Mountain Cancer Centers - Pueblo

Pueblo, Colorado 81008

United States

Rocky Mountain Cancer Centers-Thornton

Thornton, Colorado 80260

United States

Connecticut Children's Medical Center

Hartford, Connecticut 06106

United States

Yale University

New Haven, Connecticut 06520

United States

Alfred I duPont Hospital for Children

Wilmington, Delaware 19803

United States

Kaiser Permanente-Capitol Hill Medical Center

Washington D.C., District of Columbia 20002

United States

MedStar Georgetown University Hospital

Washington D.C., District of Columbia 20007

United States

Children's National Medical Center

Washington D.C., District of Columbia 20010

United States

Broward Health Medical Center

Fort Lauderdale, Florida 33316

United States

Golisano Children's Hospital of Southwest Florida

Fort Myers, Florida 33908

United States

UF Health Cancer Institute - Gainesville

Gainesville, Florida 32610

United States

Memorial Regional Hospital/Joe DiMaggio Children's Hospital

Hollywood, Florida 33021

United States

Nemours Children's Clinic-Jacksonville

Jacksonville, Florida 32207

United States

University of Miami Miller School of Medicine-Sylvester Cancer Center

Miami, Florida 33136

United States

Nicklaus Children's Hospital

Miami, Florida 33155

United States

Miami Cancer Institute

Miami, Florida 33176

United States

AdventHealth Orlando

Orlando, Florida 32803

United States

Arnold Palmer Hospital for Children

Orlando, Florida 32806

United States

Nemours Children's Hospital

Orlando, Florida 32827

United States

Nemours Children's Clinic - Pensacola

Pensacola, Florida 32504

United States

Sacred Heart Hospital

Pensacola, Florida 32504

United States

Johns Hopkins All Children's Hospital

St. Petersburg, Florida 33701

United States

Tampa General Hospital

Tampa, Florida 33606

United States

Saint Joseph's Hospital/Children's Hospital-Tampa

Tampa, Florida 33607

United States

Saint Mary's Medical Center

West Palm Beach, Florida 33407

United States

Children's Healthcare of Atlanta - Arthur M Blank Hospital

Atlanta, Georgia 30329

United States

Augusta University Medical Center

Augusta, Georgia 30912

United States

Atrium Health Navicent

Macon, Georgia 31201

United States

Memorial Health University Medical Center

Savannah, Georgia 31404

United States

Straub Clinic and Hospital

Honolulu, Hawaii 96813

United States

Kaiser Permanente Moanalua Medical Center

Honolulu, Hawaii 96819

United States

Kapiolani Medical Center for Women and Children

Honolulu, Hawaii 96826

United States

Tripler Army Medical Center

Honolulu, Hawaii 96859

United States

Saint Luke's Cancer Institute - Boise

Boise, Idaho 83712

United States

Saint Luke's Cancer Institute - Fruitland

Fruitland, Idaho 83619

United States

Saint Luke's Cancer Institute - Meridian

Meridian, Idaho 83642

United States

Saint Luke's Cancer Institute - Nampa

Nampa, Idaho 83687

United States

Saint Luke's Cancer Institute - Twin Falls

Twin Falls, Idaho 83301

United States

Rush-Copley Medical Center

Aurora, Illinois 60504

United States

Illinois CancerCare-Bloomington

Bloomington, Illinois 61704

United States

Illinois CancerCare-Canton

Canton, Illinois 61520

United States

Memorial Hospital of Carbondale

Carbondale, Illinois 62902

United States

SIH Cancer Institute

Carterville, Illinois 62918

United States

Illinois CancerCare-Carthage

Carthage, Illinois 62321

United States

Centralia Oncology Clinic

Centralia, Illinois 62801

United States

Lurie Children's Hospital-Chicago

Chicago, Illinois 60611

United States

John H Stroger Jr Hospital of Cook County

Chicago, Illinois 60612

United States

Rush MD Anderson Cancer Center

Chicago, Illinois 60612

United States

University of Illinois

Chicago, Illinois 60612

United States

University of Chicago Comprehensive Cancer Center

Chicago, Illinois 60637

United States

Carle at The Riverfront

Danville, Illinois 61832

United States

Cancer Care Specialists of Illinois - Decatur

Decatur, Illinois 62526

United States

Decatur Memorial Hospital

Decatur, Illinois 62526

United States

Illinois CancerCare-Dixon

Dixon, Illinois 61021

United States

Carle Physician Group-Effingham

Effingham, Illinois 62401

United States

Crossroads Cancer Center

Effingham, Illinois 62401

United States

Illinois CancerCare-Eureka

Eureka, Illinois 61530

United States

NorthShore University HealthSystem-Evanston Hospital

Evanston, Illinois 60201

United States

Illinois CancerCare-Galesburg

Galesburg, Illinois 61401

United States

Western Illinois Cancer Treatment Center

Galesburg, Illinois 61401

United States

NorthShore University HealthSystem-Glenbrook Hospital

Glenview, Illinois 60026

United States

NorthShore University HealthSystem-Highland Park Hospital

Highland Park, Illinois 60035

United States

Illinois CancerCare-Kewanee Clinic

Kewanee, Illinois 61443

United States

Illinois CancerCare-Macomb

Macomb, Illinois 61455

United States

Carle Physician Group-Mattoon/Charleston

Mattoon, Illinois 61938

United States

Loyola University Medical Center

Maywood, Illinois 60153

United States

Cancer Care Center of O'Fallon

O'Fallon, Illinois 62269

United States

HSHS Saint Elizabeth's Hospital

O'Fallon, Illinois 62269

United States

Advocate Children's Hospital-Oak Lawn

Oak Lawn, Illinois 60453

United States

Illinois CancerCare-Ottawa Clinic

Ottawa, Illinois 61350

United States

Advocate Children's Hospital-Park Ridge

Park Ridge, Illinois 60068

United States

Illinois CancerCare-Pekin

Pekin, Illinois 61554

United States

OSF Saint Francis Radiation Oncology at Pekin

Pekin, Illinois 61554

United States

Illinois CancerCare-Peoria

Peoria, Illinois 61615

United States

OSF Saint Francis Radiation Oncology at Peoria Cancer Center

Peoria, Illinois 61615

United States

Methodist Medical Center of Illinois

Peoria, Illinois 61636

United States

OSF Children's Hospital of Illinois

Peoria, Illinois 61637

United States

OSF Saint Francis Medical Center

Peoria, Illinois 61637

United States

Illinois CancerCare-Peru

Peru, Illinois 61354

United States

Valley Radiation Oncology

Peru, Illinois 61354

United States

Illinois CancerCare-Princeton

Princeton, Illinois 61356

United States

North Shore Medical Center

Skokie, Illinois 60076

United States

Saint John's Hospital

Springfield, Illinois 62702

United States

Southern Illinois University School of Medicine

Springfield, Illinois 62702

United States

Springfield Clinic

Springfield, Illinois 62702

United States

Springfield Memorial Hospital

Springfield, Illinois 62781

United States

Southwest Illinois Health Services LLP

Swansea, Illinois 62226

United States

Carle Cancer Center

Urbana, Illinois 61801

United States

The Carle Foundation Hospital

Urbana, Illinois 61801

United States

Illinois CancerCare - Washington

Washington, Illinois 61571

United States

Rush-Copley Healthcare Center

Yorkville, Illinois 60560

United States

IU Health North Hospital

Carmel, Indiana 46032

United States

Deaconess Clinic Downtown

Evansville, Indiana 47713

United States

Indiana University/Melvin and Bren Simon Cancer Center

Indianapolis, Indiana 46202

United States

Riley Hospital for Children

Indianapolis, Indiana 46202

United States

Ascension Saint Vincent Indianapolis Hospital

Indianapolis, Indiana 46260

United States

Chancellor Center for Oncology

Newburgh, Indiana 47630

United States

Memorial Hospital of South Bend

South Bend, Indiana 46601

United States

UI Health Care Mission Cancer and Blood - Ankeny Clinic

Ankeny, Iowa 50023

United States

Mercy Cancer Center-West Lakes

Clive, Iowa 50325

United States

UI Health Care Mission Cancer and Blood - West Des Moines Clinic

Clive, Iowa 50325

United States

Alegent Health Mercy Hospital

Council Bluffs, Iowa 51503

United States

Greater Regional Medical Center

Creston, Iowa 50801

United States

Blank Children's Hospital

Des Moines, Iowa 50309

United States

Iowa Methodist Medical Center

Des Moines, Iowa 50309

United States

UI Health Care Mission Cancer and Blood - Des Moines Clinic

Des Moines, Iowa 50309

United States

Mercy Medical Center - Des Moines

Des Moines, Iowa 50314

United States

UI Health Care Mission Cancer and Blood - Laurel Clinic

Des Moines, Iowa 50314

United States

Iowa Lutheran Hospital

Des Moines, Iowa 50316

United States

University of Iowa/Holden Comprehensive Cancer Center

Iowa City, Iowa 52242

United States

UI Health Care Mission Cancer and Blood - Waukee Clinic

Waukee, Iowa 50263

United States

Mercy Medical Center-West Lakes

West Des Moines, Iowa 50266

United States

The Iowa Clinic PC

West Des Moines, Iowa 50266

United States

Wesley Medical Center

Wichita, Kansas 67214

United States

CommonSpirit Saint Joseph Hospital - Bardstown

Bardstown, Kentucky 40004

United States

Commonwealth Cancer Center-Corbin

Corbin, Kentucky 40701

United States

CommonSpirit Saint Joseph Hospital - Lexington

Lexington, Kentucky 40504

United States

Saint Joseph Radiation Oncology Resource Center

Lexington, Kentucky 40504

United States

CommonSpirit Saint Joseph Medical Center - East Lexington

Lexington, Kentucky 40509

United States

University of Kentucky/Markey Cancer Center

Lexington, Kentucky 40536

United States

CommonSpirit Saint Joseph Hospital London

London, Kentucky 40741

United States

Jewish Hospital

Louisville, Kentucky 40202

United States

Norton Children's Hospital

Louisville, Kentucky 40202

United States

Saints Mary and Elizabeth Hospital

Louisville, Kentucky 40215

United States

UofL Health Medical Center Northeast

Louisville, Kentucky 40245

United States

CommonSpirit Saint Joseph Hospital Mount Sterling

Mount Sterling, Kentucky 40353

United States

Jewish Hospital Medical Center South

Shepherdsville, Kentucky 40165

United States

University Medical Center New Orleans

New Orleans, Louisiana 70112

United States

Children's Hospital New Orleans

New Orleans, Louisiana 70118

United States

Ochsner Medical Center Jefferson

New Orleans, Louisiana 70121

United States

Eastern Maine Medical Center

Bangor, Maine 04401

United States

Lafayette Family Cancer Center-EMMC

Brewer, Maine 04412

United States

MaineHealth Maine Medical Center - Portland

Portland, Maine 04102

United States

Maine Children's Cancer Program

Scarborough, Maine 04074

United States

MaineHealth Maine Medical Center- Scarborough

Scarborough, Maine 04074

United States

University of Maryland/Greenebaum Cancer Center

Baltimore, Maryland 21201

United States

Sinai Hospital of Baltimore

Baltimore, Maryland 21215

United States

Johns Hopkins University/Sidney Kimmel Cancer Center

Baltimore, Maryland 21287

United States

Walter Reed National Military Medical Center

Bethesda, Maryland 20889-5600

United States

Tufts Children's Hospital

Boston, Massachusetts 02111

United States

Tufts Medical Center

Boston, Massachusetts 02111

United States

Massachusetts General Hospital Cancer Center

Boston, Massachusetts 02114

United States

Dana-Farber Cancer Institute

Boston, Massachusetts 02215

United States

Baystate Medical Center

Springfield, Massachusetts 01199

United States

UMass Memorial Medical Center - University Campus

Worcester, Massachusetts 01655

United States

C S Mott Children's Hospital

Ann Arbor, Michigan 48109

United States

University of Michigan Rogel Cancer Center

Ann Arbor, Michigan 48109

United States

Bronson Battle Creek

Battle Creek, Michigan 49017

United States

Children's Hospital of Michigan

Detroit, Michigan 48201

United States

Henry Ford Health Saint John Hospital

Detroit, Michigan 48236

United States

Michigan State University

East Lansing, Michigan 48823

United States

OSF Saint Francis Hospital and Medical Group

Escanaba, Michigan 49829

United States

Hurley Medical Center

Flint, Michigan 48503

United States

Corewell Health Grand Rapids Hospitals - Butterworth Hospital

Grand Rapids, Michigan 49503

United States

Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital

Grand Rapids, Michigan 49503

United States

Trinity Health Grand Rapids Hospital

Grand Rapids, Michigan 49503

United States

Bronson Methodist Hospital

Kalamazoo, Michigan 49007

United States

West Michigan Cancer Center

Kalamazoo, Michigan 49007

United States

Beacon Kalamazoo

Kalamazoo, Michigan 49048

United States

Trinity Health Muskegon Hospital

Muskegon, Michigan 49444

United States

Corewell Health Lakeland Hospitals - Niles Hospital

Niles, Michigan 49120

United States

Lake Huron Medical Center

Port Huron, Michigan 48060

United States

Corewell Health Reed City Hospital

Reed City, Michigan 49677

United States

Corewell Health Children's

Royal Oak, Michigan 48073

United States

Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center

Saint Joseph, Michigan 49085

United States

Corewell Health Lakeland Hospitals - Saint Joseph Hospital

Saint Joseph, Michigan 49085

United States

Munson Medical Center

Traverse City, Michigan 49684

United States

University of Michigan Health - West

Wyoming, Michigan 49519

United States

Essentia Health Cancer Center

Duluth, Minnesota 55805

United States

Children's Hospitals and Clinics of Minnesota - Minneapolis

Minneapolis, Minnesota 55404

United States

University of Minnesota/Masonic Cancer Center

Minneapolis, Minnesota 55455

United States

Mayo Clinic in Rochester

Rochester, Minnesota 55905

United States

University of Mississippi Medical Center

Jackson, Mississippi 39216

United States

Parkland Health Center-Bonne Terre

Bonne Terre, Missouri 63628

United States

Mercy Cancer Center - Cape Girardeau

Cape Girardeau, Missouri 63703

United States

Saint Francis Medical Center

Cape Girardeau, Missouri 63703

United States

University of Missouri Children's Hospital

Columbia, Missouri 65212

United States

Parkland Health Center - Farmington

Farmington, Missouri 63640

United States

MU Health Care Goldschmidt Cancer Center

Jefferson City, Missouri 65109

United States

Children's Mercy Hospitals and Clinics

Kansas City, Missouri 64108

United States

Lake Regional Hospital

Osage Beach, Missouri 65065

United States

Sainte Genevieve County Memorial Hospital

Sainte Genevieve, Missouri 63670

United States

Washington University School of Medicine

St Louis, Missouri 63110

United States

Missouri Baptist Medical Center

St Louis, Missouri 63131

United States

Mercy Hospital Saint Louis

St Louis, Missouri 63141

United States

Missouri Baptist Sullivan Hospital

Sullivan, Missouri 63080

United States

BJC Outpatient Center at Sunset Hills

Sunset Hills, Missouri 63127

United States

Saint Patrick Hospital - Community Hospital

Missoula, Montana 59802

United States

Nebraska Cancer Specialists/Oncology Hematology West PC

Grand Island, Nebraska 68803

United States

Fred and Pamela Buffett Cancer Center - Kearney

Kearney, Nebraska 68845

United States

CHI Health Good Samaritan

Kearney, Nebraska 68847

United States

Saint Elizabeth Regional Medical Center

Lincoln, Nebraska 68510

United States

Children's Hospital and Medical Center of Omaha

Omaha, Nebraska 68114

United States

Alegent Health Immanuel Medical Center

Omaha, Nebraska 68122

United States

Hematology and Oncology Consultants PC

Omaha, Nebraska 68122

United States

Alegent Health Bergan Mercy Medical Center

Omaha, Nebraska 68124

United States

Alegent Health Lakeside Hospital

Omaha, Nebraska 68130

United States

University of Nebraska Medical Center

Omaha, Nebraska 68198

United States

Midlands Community Hospital

Papillion, Nebraska 68046

United States

Carson Tahoe Regional Medical Center

Carson City, Nevada 89703

United States

Cancer and Blood Specialists-Henderson

Henderson, Nevada 89052

United States

Comprehensive Cancer Centers of Nevada - Henderson

Henderson, Nevada 89052

United States

Comprehensive Cancer Centers of Nevada-Horizon Ridge

Henderson, Nevada 89052

United States

Las Vegas Cancer Center-Henderson

Henderson, Nevada 89052

United States

Comprehensive Cancer Centers of Nevada-Southeast Henderson

Henderson, Nevada 89074

United States

Las Vegas Urology - Green Valley

Henderson, Nevada 89074

United States

Las Vegas Urology - Pebble

Henderson, Nevada 89074

United States

Urology Specialists of Nevada - Green Valley

Henderson, Nevada 89074

United States

Las Vegas Urology - Pecos

Las Vegas, Nevada 89074

United States

Desert West Surgery

Las Vegas, Nevada 89102

United States

OptumCare Cancer Care at Charleston

Las Vegas, Nevada 89102

United States

University Medical Center of Southern Nevada

Las Vegas, Nevada 89102

United States

Hope Cancer Care of Nevada

Las Vegas, Nevada 89103

United States

Cancer and Blood Specialists-Shadow

Las Vegas, Nevada 89106

United States

Radiation Oncology Centers of Nevada Central

Las Vegas, Nevada 89106

United States

Urology Specialists of Nevada - Central

Las Vegas, Nevada 89106

United States

Women's Cancer Center of Nevada

Las Vegas, Nevada 89106

United States

Sunrise Hospital and Medical Center

Las Vegas, Nevada 89109

United States

Las Vegas Urology - Sunset

Las Vegas, Nevada 89113

United States

Urology Specialists of Nevada - Southwest

Las Vegas, Nevada 89113

United States

Radiation Oncology Centers of Nevada Southeast

Las Vegas, Nevada 89119

United States

Cancer Therapy and Integrative Medicine

Las Vegas, Nevada 89121

United States

Ann M Wierman MD LTD

Las Vegas, Nevada 89128

United States

Cancer and Blood Specialists-Tenaya

Las Vegas, Nevada 89128

United States

Comprehensive Cancer Centers of Nevada - Northwest

Las Vegas, Nevada 89128

United States

Las Vegas Urology - Cathedral Rock

Las Vegas, Nevada 89128

United States

Las Vegas Urology - Smoke Ranch

Las Vegas, Nevada 89128

United States

OptumCare Cancer Care at MountainView

Las Vegas, Nevada 89128

United States

Urology Specialists of Nevada - Northwest

Las Vegas, Nevada 89128

United States

Alliance for Childhood Diseases/Cure 4 the Kids Foundation

Las Vegas, Nevada 89135

United States

Comprehensive Cancer Centers of Nevada - Town Center

Las Vegas, Nevada 89144

United States

Comprehensive Cancer Centers of Nevada-Summerlin

Las Vegas, Nevada 89144

United States

Summerlin Hospital Medical Center

Las Vegas, Nevada 89144

United States

Las Vegas Cancer Center-Medical Center

Las Vegas, Nevada 89148-2405

United States

Comprehensive Cancer Centers of Nevada

Las Vegas, Nevada 89148

United States

Comprehensive Cancer Centers of Nevada - Central Valley

Las Vegas, Nevada 89169

United States

University Cancer Center

Las Vegas, Nevada 89169

United States

OptumCare Cancer Care at Fort Apache

Las Vegas, Nevada 89183

United States

Hope Cancer Care of Nevada-Pahrump

Pahrump, Nevada 89048

United States

Renown Regional Medical Center

Reno, Nevada 89502

United States

Saint Mary's Regional Medical Center

Reno, Nevada 89503

United States

Radiation Oncology Associates

Reno, Nevada 89509

United States

Cancer Care Specialists - Reno

Reno, Nevada 89511

United States

Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center

Lebanon, New Hampshire 03756

United States

Hackensack University Medical Center

Hackensack, New Jersey 07601

United States

Morristown Medical Center

Morristown, New Jersey 07960

United States

Jersey Shore Medical Center

Neptune City, New Jersey 07753

United States

Saint Peter's University Hospital

New Brunswick, New Jersey 08901

United States

Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital

New Brunswick, New Jersey 08903

United States

Newark Beth Israel Medical Center

Newark, New Jersey 07112

United States

Saint Joseph's Regional Medical Center

Paterson, New Jersey 07503

United States

Presbyterian Hospital

Albuquerque, New Mexico 87106

United States

University of New Mexico Cancer Center

Albuquerque, New Mexico 87106

United States

Albany Medical Center

Albany, New York 12208

United States

Maimonides Medical Center

Brooklyn, New York 11219

United States

Roswell Park Cancer Institute

Buffalo, New York 14263

United States

Glens Falls Hospital

Glens Falls, New York 12801

United States

NYU Langone Hospital - Long Island

Mineola, New York 11501

United States

The Steven and Alexandra Cohen Children's Medical Center of New York

New Hyde Park, New York 11040

United States

Laura and Isaac Perlmutter Cancer Center at NYU Langone

New York, New York 10016

United States

Mount Sinai Hospital

New York, New York 10029

United States

NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center

New York, New York 10032

United States

Memorial Sloan Kettering Cancer Center

New York, New York 10065

United States

University of Rochester

Rochester, New York 14642

United States

Stony Brook University Medical Center

Stony Brook, New York 11794

United States

State University of New York Upstate Medical University

Syracuse, New York 13210

United States

Montefiore Medical Center-Einstein Campus

The Bronx, New York 10461

United States

Montefiore Medical Center-Weiler Hospital

The Bronx, New York 10461

United States

Children's Hospital at Montefiore

The Bronx, New York 10467

United States

Montefiore Medical Center - Moses Campus

The Bronx, New York 10467

United States

New York Medical College

Valhalla, New York 10595

United States

Westchester Medical Center

Valhalla, New York 10595

United States

Mission Hospital

Asheville, North Carolina 28801

United States

UNC Lineberger Comprehensive Cancer Center

Chapel Hill, North Carolina 27599

United States

Carolinas Medical Center/Levine Cancer Institute

Charlotte, North Carolina 28203

United States

Novant Health Presbyterian Medical Center

Charlotte, North Carolina 28204

United States

Oncology Specialists of Charlotte

Charlotte, North Carolina 28207

United States

Southern Oncology Specialists-Charlotte

Charlotte, North Carolina 28262

United States

Southeastern Medical Oncology Center-Clinton

Clinton, North Carolina 28328

United States

Duke University Medical Center

Durham, North Carolina 27710

United States

Southeastern Medical Oncology Center-Goldsboro

Goldsboro, North Carolina 27534

United States

Wayne Memorial Hospital

Goldsboro, North Carolina 27534

United States

East Carolina University

Greenville, North Carolina 27834

United States

Novant Health Cancer Institute - Huntersville

Huntersville, North Carolina 28078

United States

Southern Oncology Specialists-Huntersville

Huntersville, North Carolina 28078

United States

Southeastern Medical Oncology Center-Jacksonville

Jacksonville, North Carolina 28546

United States

Matthews Radiation Oncology Center

Matthews, North Carolina 28105

United States

Novant Health Cancer Institute - Matthews

Matthews, North Carolina 28105

United States

Novant Health Cancer Institute - Mooresville

Mooresville, North Carolina 28117

United States

Novant Health Cancer Institute - Rowan

Salisbury, North Carolina 28144

United States

Rowan Regional Medical Center

Salisbury, North Carolina 28144

United States

Wake Forest University Health Sciences

Winston-Salem, North Carolina 27157

United States

Sanford Broadway Medical Center

Fargo, North Dakota 58122

United States

Children's Hospital Medical Center of Akron

Akron, Ohio 44308

United States

OhioHealth O'Bleness Hospital

Athens, Ohio 45701

United States

Strecker Cancer Center-Belpre

Belpre, Ohio 45714

United States

Adena Regional Medical Center

Chillicothe, Ohio 45601

United States

Good Samaritan Hospital - Cincinnati

Cincinnati, Ohio 45220

United States

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio 45229

United States

Bethesda North Hospital

Cincinnati, Ohio 45242

United States

TriHealth Cancer Institute-Westside

Cincinnati, Ohio 45247

United States

TriHealth Cancer Institute-Anderson

Cincinnati, Ohio 45255

United States

Case Western Reserve University

Cleveland, Ohio 44106

United States

Rainbow Babies and Childrens Hospital

Cleveland, Ohio 44106

United States

Cleveland Clinic Foundation

Cleveland, Ohio 44195

United States

Nationwide Children's Hospital

Columbus, Ohio 43205

United States

Ohio State University Comprehensive Cancer Center

Columbus, Ohio 43210

United States

Mount Carmel East Hospital

Columbus, Ohio 43213

United States

Columbus Oncology and Hematology Associates Inc

Columbus, Ohio 43214

United States

Riverside Methodist Hospital

Columbus, Ohio 43214

United States

Grant Medical Center

Columbus, Ohio 43215

United States

The Mark H Zangmeister Center

Columbus, Ohio 43219

United States

Mount Carmel Health Center West

Columbus, Ohio 43222

United States

Doctors Hospital

Columbus, Ohio 43228

United States

Dayton Children's Hospital

Dayton, Ohio 45404

United States

Delaware Health Center-Grady Cancer Center

Delaware, Ohio 43015

United States

Grady Memorial Hospital

Delaware, Ohio 43015

United States

Columbus Oncology and Hematology Associates

Dublin, Ohio 43016

United States

Dublin Methodist Hospital

Dublin, Ohio 43016

United States

Mount Carmel Grove City Hospital

Grove City, Ohio 43123

United States

Saint Rita's Medical Center

Lima, Ohio 45801

United States

OhioHealth Mansfield Hospital

Mansfield, Ohio 44903

United States

Marietta Memorial Hospital

Marietta, Ohio 45750

United States

OhioHealth Marion General Hospital

Marion, Ohio 43302

United States

Memorial Hospital

Marysville, Ohio 43040

United States

Knox Community Hospital

Mount Vernon, Ohio 43050

United States

Licking Memorial Hospital

Newark, Ohio 43055

United States

Mercy Health - Perrysburg Hospital

Perrysburg, Ohio 43551

United States

OhioHealth Pickerington Methodist Hospital

Pickerington, Ohio 43147

United States

Southern Ohio Medical Center

Portsmouth, Ohio 45662

United States

ProMedica Flower Hospital

Sylvania, Ohio 43560

United States

ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital

Toledo, Ohio 43606

United States

Mercy Health - Saint Vincent Hospital

Toledo, Ohio 43608

United States

Mercy Health - Saint Anne Hospital

Toledo, Ohio 43623

United States

Saint Ann's Hospital

Westerville, Ohio 43081

United States

OhioHealth Westerville Medical Campus/Westerville Cancer Center

Westerville, Ohio 43082

United States

Clinton Memorial Hospital/Foster J Boyd Regional Cancer Center

Wilmington, Ohio 45177

United States

Genesis Healthcare System Cancer Care Center

Zanesville, Ohio 43701

United States

Cancer Centers of Southwest Oklahoma Research

Lawton, Oklahoma 73505

United States

University of Oklahoma Health Sciences Center

Oklahoma City, Oklahoma 73104

United States

Natalie Warren Bryant Cancer Center at Saint Francis

Tulsa, Oklahoma 74136

United States

Saint Charles Health System

Bend, Oregon 97701

United States

Clackamas Radiation Oncology Center

Clackamas, Oregon 97015

United States

Providence Cancer Institute Clackamas Clinic

Clackamas, Oregon 97015

United States

Bay Area Hospital

Coos Bay, Oregon 97420

United States

Asante Rogue Regional Medical Center

Medford, Oregon 97504

United States

Providence Newberg Medical Center

Newberg, Oregon 97132

United States

Providence Willamette Falls Medical Center

Oregon City, Oregon 97045

United States

Providence Portland Medical Center

Portland, Oregon 97213

United States

Providence Saint Vincent Medical Center

Portland, Oregon 97225

United States

Legacy Emanuel Children's Hospital

Portland, Oregon 97227

United States

Oregon Health and Science University

Portland, Oregon 97239

United States

Jefferson Abington Hospital

Abington, Pennsylvania 19001

United States

Lehigh Valley Hospital-Cedar Crest

Allentown, Pennsylvania 18103

United States

Lehigh Valley Hospital - Muhlenberg

Bethlehem, Pennsylvania 18017

United States

Geisinger Medical Center

Danville, Pennsylvania 17822

United States

Penn State Children's Hospital

Hershey, Pennsylvania 17033

United States

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania 19104

United States

University of Pennsylvania/Abramson Cancer Center

Philadelphia, Pennsylvania 19104

United States

Saint Christopher's Hospital for Children

Philadelphia, Pennsylvania 19134

United States

UPMC-Magee Womens Hospital

Pittsburgh, Pennsylvania 15213

United States

Children's Hospital of Pittsburgh of UPMC

Pittsburgh, Pennsylvania 15224

United States

University of Pittsburgh Cancer Institute (UPCI)

Pittsburgh, Pennsylvania 15232

United States

UPMC-Passavant Hospital

Pittsburgh, Pennsylvania 15237

United States

Asplundh Cancer Pavilion

Willow Grove, Pennsylvania 19090

United States

Rhode Island Hospital

Providence, Rhode Island 02903

United States

Prisma Health Cancer Institute - Spartanburg

Boiling Springs, South Carolina 29316

United States

Medical University of South Carolina

Charleston, South Carolina 29425

United States

Prisma Health Richland Hospital

Columbia, South Carolina 29203

United States

Gibbs Cancer Center-Gaffney

Gaffney, South Carolina 29341

United States

Saint Francis Hospital

Greenville, South Carolina 29601

United States

BI-LO Charities Children's Cancer Center

Greenville, South Carolina 29605

United States

Prisma Health Cancer Institute - Butternut

Greenville, South Carolina 29605

United States

Prisma Health Cancer Institute - Faris

Greenville, South Carolina 29605

United States

Prisma Health Greenville Memorial Hospital

Greenville, South Carolina 29605

United States

Saint Francis Cancer Center

Greenville, South Carolina 29607

United States

Prisma Health Cancer Institute - Eastside

Greenville, South Carolina 29615

United States

Prisma Health Cancer Institute - Greer

Greer, South Carolina 29650

United States

Gibbs Cancer Center-Pelham

Greer, South Carolina 29651

United States

Prisma Health Cancer Institute - Seneca

Seneca, South Carolina 29672

United States

North Grove Medical Park

Spartanburg, South Carolina 29303

United States

Spartanburg Medical Center

Spartanburg, South Carolina 29303

United States

Spartanburg Medical Center - Mary Black Campus

Spartanburg, South Carolina 29307

United States

SMC Center for Hematology Oncology Union

Union, South Carolina 29379

United States

Sanford USD Medical Center - Sioux Falls

Sioux Falls, South Dakota 57117-5134

United States

T C Thompson Children's Hospital

Chattanooga, Tennessee 37403

United States

Memorial Hospital

Chattanooga, Tennessee 37404

United States

Pulmonary Medicine Center of Chattanooga-Hixson

Hixson, Tennessee 37343

United States

East Tennessee Childrens Hospital

Knoxville, Tennessee 37916

United States

Saint Jude Children's Research Hospital

Memphis, Tennessee 38105

United States

The Children's Hospital at TriStar Centennial

Nashville, Tennessee 37203

United States

Vanderbilt University/Ingram Cancer Center

Nashville, Tennessee 37232

United States

Memorial GYN Plus

Ooltewah, Tennessee 37363

United States

Texas Tech University Health Sciences Center-Amarillo

Amarillo, Texas 79106

United States

The Don and Sybil Harrington Cancer Center

Amarillo, Texas 79106

United States

Dell Children's Medical Center of Central Texas

Austin, Texas 78723

United States

Saint Joseph Regional Cancer Center

Bryan, Texas 77802

United States

Driscoll Children's Hospital

Corpus Christi, Texas 78411

United States

Medical City Dallas Hospital

Dallas, Texas 75230

United States

Parkland Memorial Hospital

Dallas, Texas 75235

United States

UT Southwestern/Simmons Cancer Center-Dallas

Dallas, Texas 75390

United States

El Paso Children's Hospital

El Paso, Texas 79905

United States

Texas Tech University Health Sciences Center-El Paso

El Paso, Texas 79905

United States

Cook Children's Medical Center

Fort Worth, Texas 76104

United States

Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center

Houston, Texas 77030

United States

UT MD Anderson Cancer Center

Houston, Texas 77030

United States

Covenant Children's Hospital

Lubbock, Texas 79410

United States

UMC Cancer Center / UMC Health System

Lubbock, Texas 79415

United States

Texas Tech University Health Sciences Center-Lubbock

Lubbock, Texas 79430

United States

Children's Hospital of San Antonio

San Antonio, Texas 78207

United States

Methodist Children's Hospital of South Texas

San Antonio, Texas 78229

United States

University Hospital

San Antonio, Texas 78229

United States

University of Texas Health Science Center at San Antonio

San Antonio, Texas 78229

United States

Scott and White Memorial Hospital

Temple, Texas 76508

United States

Primary Children's Hospital

Salt Lake City, Utah 84113

United States

Central Vermont Medical Center/National Life Cancer Treatment

Berlin Corners, Vermont 05602

United States

University of Vermont Medical Center

Burlington, Vermont 05401

United States

University of Vermont and State Agricultural College

Burlington, Vermont 05405

United States

University of Virginia Cancer Center

Charlottesville, Virginia 22908

United States

Children's Hospital of The King's Daughters

Norfolk, Virginia 23507

United States

Naval Medical Center - Portsmouth

Portsmouth, Virginia 23708-2197

United States

VCU Massey Comprehensive Cancer Center

Richmond, Virginia 23298

United States

Carilion Children's

Roanoke, Virginia 24014

United States

Providence Regional Cancer System-Aberdeen

Aberdeen, Washington 98520

United States

Overlake Medical Center

Bellevue, Washington 98004

United States

PeaceHealth Saint Joseph Medical Center

Bellingham, Washington 98225

United States

Highline Medical Center-Main Campus

Burien, Washington 98166

United States

Providence Regional Cancer System-Centralia

Centralia, Washington 98531

United States

Swedish Cancer Institute-Edmonds

Edmonds, Washington 98026

United States

Saint Elizabeth Hospital

Enumclaw, Washington 98022

United States

Providence Regional Cancer Partnership

Everett, Washington 98201

United States

Saint Francis Hospital

Federal Way, Washington 98003

United States

Swedish Cancer Institute-Issaquah

Issaquah, Washington 98029

United States

Kadlec Clinic Hematology and Oncology

Kennewick, Washington 99336

United States

Providence Regional Cancer System-Lacey

Lacey, Washington 98503

United States

Saint Clare Hospital

Lakewood, Washington 98499

United States

PeaceHealth Saint John Medical Center

Longview, Washington 98632

United States

Harrison HealthPartners Hematology and Oncology-Poulsbo

Poulsbo, Washington 98370

United States

Pacific Gynecology Specialists

Seattle, Washington 98104

United States

Seattle Children's Hospital

Seattle, Washington 98105

United States

Swedish Medical Center-Ballard Campus

Seattle, Washington 98107

United States

Kaiser Permanente Washington

Seattle, Washington 98112

United States

Swedish Medical Center-Cherry Hill

Seattle, Washington 98122-5711

United States

Swedish Medical Center-First Hill

Seattle, Washington 98122

United States

Providence Regional Cancer System-Shelton

Shelton, Washington 98584

United States

Saint Joseph Medical Center Hematology and Oncology - Silverdale

Silverdale, Washington 98383

United States

MultiCare Deaconess Cancer and Blood Specialty Center - Downtown

Spokane, Washington 99204

United States

Providence Sacred Heart Medical Center and Children's Hospital

Spokane, Washington 99204

United States

MultiCare Deaconess Cancer and Blood Specialty Center - North

Spokane, Washington 99218

United States

MultiCare Deaconess Cancer and Blood Specialty Center - Valley

Spokane Valley, Washington 99216

United States

Franciscan Research Center-Northwest Medical Plaza

Tacoma, Washington 98405

United States

Mary Bridge Children's Hospital and Health Center

Tacoma, Washington 98405

United States

Northwest Medical Specialties PLLC

Tacoma, Washington 98405

United States

Madigan Army Medical Center

Tacoma, Washington 98431

United States

PeaceHealth Southwest Medical Center

Vancouver, Washington 98664

United States

Providence Saint Mary Regional Cancer Center

Walla Walla, Washington 99362

United States

North Star Lodge Cancer Center at Yakima Valley Memorial Hospital

Yakima, Washington 98902

United States

Providence Regional Cancer System-Yelm

Yelm, Washington 98597

United States

United Hospital Center

Bridgeport, West Virginia 26330

United States

West Virginia University Charleston Division

Charleston, West Virginia 25304

United States

Edwards Comprehensive Cancer Center

Huntington, West Virginia 25701

United States

WVUH-Berkely Medical Center

Martinsburg, West Virginia 25401

United States

West Virginia University Healthcare

Morgantown, West Virginia 26506

United States

Camden Clark Medical Center

Parkersburg, West Virginia 26101

United States

Green Bay Oncology at Saint Vincent Hospital

Green Bay, Wisconsin 54301-3526

United States

Saint Vincent Hospital Cancer Center Green Bay

Green Bay, Wisconsin 54301

United States

Saint Vincent Hospital Cancer Center at Saint Mary's

Green Bay, Wisconsin 54303

United States

University of Wisconsin Carbone Cancer Center - Johnson Creek

Johnson Creek, Wisconsin 53038

United States

University of Wisconsin Carbone Cancer Center - University Hospital

Madison, Wisconsin 53792

United States

Holy Family Memorial Hospital

Manitowoc, Wisconsin 54221

United States

Saint Vincent Hospital Cancer Center at Marinette

Marinette, Wisconsin 54143

United States

Marshfield Medical Center-Marshfield

Marshfield, Wisconsin 54449

United States

Children's Hospital of Wisconsin

Milwaukee, Wisconsin 53226

United States

Saint Vincent Hospital Cancer Center at Oconto Falls

Oconto Falls, Wisconsin 54154

United States

HSHS Saint Nicholas Hospital

Sheboygan, Wisconsin 53081

United States

Saint Vincent Hospital Cancer Center at Sturgeon Bay

Sturgeon Bay, Wisconsin 54235-1495

United States

John Hunter Children's Hospital

Hunter Regional Mail Centre, New South Wales 2310

Australia

Sydney Children's Hospital

Randwick, New South Wales 2031

Australia

The Children's Hospital at Westmead

Westmead, New South Wales 2145

Australia

Queensland Children's Hospital

South Brisbane, Queensland 4101

Australia

Monash Medical Center-Clayton Campus

Clayton, Victoria 3168

Australia

Royal Children's Hospital

Parkville, Victoria 3052

Australia

Princess Margaret Hospital for Children

Perth, Western Australia 6008

Australia

Perth Children's Hospital

Perth, Western Australia 6009

Australia

Alberta Children's Hospital

Calgary, Alberta T3B 6A8

Canada

University of Alberta Hospital

Edmonton, Alberta T6G 2B7

Canada

British Columbia Children's Hospital

Vancouver, British Columbia V6H 3V4

Canada

CancerCare Manitoba

Winnipeg, Manitoba R3E 0V9

Canada

Janeway Child Health Centre

St. John's, Newfoundland and Labrador A1B 3V6

Canada

IWK Health Centre

Halifax, Nova Scotia B3K 6R8

Canada

McMaster Children's Hospital at Hamilton Health Sciences

Hamilton, Ontario L8N 3Z5

Canada

Kingston Health Sciences Centre

Kingston, Ontario K7L 2V7

Canada

Children's Hospital

London, Ontario N6A 5W9

Canada

Children's Hospital of Eastern Ontario

Ottawa, Ontario K1H 8L1

Canada

Odette Cancer Centre- Sunnybrook Health Sciences Centre

Toronto, Ontario M4N 3M5

Canada

Hospital for Sick Children

Toronto, Ontario M5G 1X8

Canada

University Health Network-Princess Margaret Hospital

Toronto, Ontario M5G 2M9

Canada

The Montreal Children's Hospital of the MUHC

Montreal, Quebec H3H 1P3

Canada

Centre Hospitalier Universitaire Sainte-Justine

Montreal, Quebec H3T 1C5

Canada

Centre Hospitalier Universitaire de Sherbrooke-Fleurimont

Sherbrooke, Quebec J1H 5N4

Canada

CHU de Quebec-Centre Hospitalier de l'Universite Laval (CHUL)

Québec, G1V 4G2

Canada

Tata Memorial Hospital

Mumbai, 400 012

India

Tohoku University School of Medicine

Sendai, Aoba-ku 980-8574

Japan

Chiba University

Chiba-sgi, Chiba 263-8522

Japan

Niigata Cancer Centre

Niigata, Chuo-ku 951-8566

Japan

Kyushu Univeristy

Higashiku, Fukuoka 812-8581

Japan

Hokkaido University Hospital

Sapporo, Hokkaido 060-8648

Japan

Hyogo Prefectural Kobe Children's Hospital

Kobe, Hyōgo 650-0047

Japan

University of Tsukuba Hospital

Tsukuba, Ibaraki 305-8576

Japan

Kanagawa Children's Medical Center

Yokohama, Kanagawa 232-8555

Japan

Saitama Children's Medical Center

Chuo-ku, Saitama 330-8777

Japan

Keio University

Shinjuku-ku, Tokyo 160-8582

Japan

Hiroshima University Hospital

Hiroshima, 734-8551

Japan

Kyoto Perfectural University of Medicine

Kyoto, 602-8566

Japan

Hyogo College of Medicine

Nishinomiya, Hyogo, 663-8501

Japan

Osaka City General Hospital

Osaka, 534-0021

Japan

Saitama Medical University International Medical Center

Saitama, 350-1298

Japan

National Cancer Center Hospital

Tokyo, 104 0045

Japan

Kokuritsu Seiiku Medical Research Center Hospital

Tokyo, 157-8535

Japan

Starship Children's Hospital

Grafton, Auckland 1145

New Zealand

Christchurch Hospital

Christchurch, 8011

New Zealand

HIMA San Pablo Oncologic Hospital

Caguas, 00726

Puerto Rico

San Jorge Children's Hospital

San Juan, 00912

Puerto Rico

King Faisal Specialist Hospital and Research Centre

Riyadh, 11211

Saudi Arabia

Sheffield Children's Hospital

Broomhall, England S10 2TH

United Kingdom

Addenbrookes Hospital-Medical School

Cambridge, England CB2 0QQ

United Kingdom

Saint Bartholomew's Hospital

London, England EC1A 7BE

United Kingdom

University College London Hospitals NHS Trust - Foley Street

London, England W1W 6DN

United Kingdom

Royal Manchester Children Hospital

Manchester, England M27 4HA

United Kingdom

Royal Victoria Infirmary

Newcastle, England NE1 4LP

United Kingdom

Freeman Hospital

Newcastle upon Tyne, England NE7 7DN

United Kingdom

John Radcliffe Hospital

Oxford, England OX3 9DU

United Kingdom

Weston Park Hospital

Sheffield, England S10 2SJ

United Kingdom

Saint James's University Hospital

West Yorkshire, England LS9 7TF

United Kingdom

Western General Hospital

Edinburgh, Scotland EH4 2XU

United Kingdom

Royal Hospital for Children and Young People

Edinburgh, Scotland EH9 1LF

United Kingdom

Beatson Oncology Center

Glasgow, Scotland G12 0YN

United Kingdom

Royal Hospital for Children

Glasgow, Scotland G51 4TF

United Kingdom

Leeds General Infirmary

West Yorkshire, LS1 3EX

United Kingdom