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NCT05256225PHASE3Recruiting

Testing the Addition of Herceptin Hylecta or Phesgo to the Usual Chemotherapy for HER2 Positive Endometrial Serous Carcinoma or Carcinosarcoma

National Cancer Institute (NCI)

Start Date

11/16/2022

Completion Date

10/31/2027

Summary

This phase III trial tests whether adding trastuzumab and hyaluronidase-oysk (Herceptin Hylecta \[TM\]) or pertuzumab, trastuzumab and hyaluronidase-zzxf (Phesgo \[TM\]) to the usual chemotherapy (paclitaxel and carboplatin) works to shrink tumors in patients with HER2 positive endometrial cancer. Trastuzumab and pertuzumab are monoclonal antibodies and forms of targeted therapy that attach to specific molecules (receptors) on the surface of tumor cells, known as HER2 receptors. When trastuzumab or pertuzumab attach to HER2 receptors, the signals that tell the cells to grow are blocked and the tumor cell may be marked for destruction by the body's immune system. Hyaluronidase is an endoglycosidase. It helps to keep pertuzumab and trastuzumab in the body longer, so that these medications will have a greater effect. Hyaluronidase also allows trastuzumab and trastuzumab/pertuzumab to be given by injection under the skin and shortens their administration time compared to trastuzumab or pertuzumab alone. Paclitaxel is a taxane and in a class of medications called antimicrotubule agents. It stops tumor cells from growing and dividing and may kill them. Carboplatin is in a class of medications known as platinum-containing compounds. It works in a way similar to the anticancer drug cisplatin, but may be better tolerated than cisplatin. Carboplatin works by killing, stopping or slowing the growth of tumor cells. Giving Herceptin Hylecta or Phesgo in combination with paclitaxel and carboplatin may shrink the tumor and prevent the cancer from coming back in patients with HER2 positive endometrial cancer.

Detailed Description

PRIMARY OBJECTIVES: I. To evaluate the efficacy of trastuzumab and hyaluronidase-oysk (HERCEPTIN HYLECTA) and pertuzumab, trastuzumab, and hyaluronidase-zzxf (PHESGO) in combination with paclitaxel/carboplatin in patients with HER2 positive endometrial cancer. SECONDARY OBJECTIVES: I. To evaluate the efficacy of trastuzumab and hyaluronidase-oysk (HERCEPTIN HYLECTA) and pertuzumab, trastuzumab, and hyaluronidase-zzxf (PHESGO) in combination with paclitaxel/carboplatin in patients with HER2 positive endometrial cancer. II. To evaluate the overall response rate (ORR) in patients with measurable disease. III. To evaluate the duration of objective response in patients with measurable disease as assessed by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. IV. To determine the nature, frequency and degree of toxicity as assessed by Common Terminology Criteria for Adverse Events (CTCAE) version (v.) 5.0 for each treatment arm. V. To compare quality of life (QOL), as measured by Functional Assessment of Cancer Therapy - Endometrial Trial Outcome Index (FACT-En-TOI), in the experimental versus control arms. VI. To compare patient-reported treatment-associated symptoms (diarrhea and rash) as measured with the Patient Reported Outcomes (PRO) - CTCAE, patient-reported fatigue as measured with the Patient Reported Outcomes Measurement Information System (PROMIS)-Fatigue short form, and worry concerning side effects of treatment as measured by the item 'bothered by side effect', in the FACT-En TOI, respectively, in the experimental and control arms. VII. To assess the correlation of HER2 immunohistochemistry (IHC) expression and in situ hybridization (ISH) amplification with clinical outcome and response to HER2 targeted therapies. EXPLORATORY OBJECTIVE: I. To explore time to sustained deterioration in quality of life, as measured by a drop in the FACT-En-TOI by 6 or more points lasting for more than one PRO time point, in the experimental and control arms. OUTLINE: Patients are randomized to 1 of 3 arms. ARM I: Patients receive paclitaxel intravenously (IV) over 3 hours and carboplatin IV over 30-60 minutes on day 1 of each cycle. Cycles repeat every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. Patients with stable disease (SD) or partial response (PR) who still have measurable disease after completion of cycle 6 may receive 4 additional cycles of this treatment at the discretion of the treating physician. ARM II: Patients receive paclitaxel IV over 3 hours, carboplatin IV over 30-60 minutes, and trastuzumab/hyaluronidase-oysk subcutaneously (SC) over 2-5 minutes on day 1 of each cycle. Cycles repeat every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. Patients with SD or PR who still have measurable disease after completion of cycle 6 may receive 4 additional cycles of this treatment at the discretion of the treating physician. MAINTENANCE: Patients receive trastuzumab/hyaluronidase-oysk SC over 2-5 minutes on day 1 of each cycle. Cycles repeat every 3 weeks for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients with SD or PR may continue maintenance therapy for up to 3 years from the start of treatment. ARM III: Patients receive paclitaxel IV over 3 hours, carboplatin IV over 30-60 minutes, and pertuzumab/trastuzumab/hyaluronidase-zzxf SC over 5-8 minutes on day 1 of each cycle. Cycles repeat every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. Patients with SD or PR who still have measurable disease after completion of cycle 6 may receive 4 additional cycles of this treatment at the discretion of the treating physician. MAINTENANCE: Patients receive pertuzumab/trastuzumab/ hyaluronidase-zzxf SC over 5 minutes on day 1 of each cycle. Cycles repeat every 3 weeks for up to 1 year in absence of disease progression or unacceptable toxicity. Patients with SD or PR may continue maintenance for up to 3 years from the start of treatment. Patients undergo echocardiography (ECHO) or multigated acquisition scan (MUGA) and computed tomography (CT) throughout the study. Additionally, patients may optionally undergo blood sample collection throughout the study, vaginal brachytherapy on study, and urine sample collection prior to treatment. After completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months for 3 years.

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: * Federation of Gynecology and Obstetrics (FIGO) 2009 stage IA-IVB, non-recurrent, chemotherapy (chemo)-naive, HER2-positive endometrial cancer. The following endometrial cancer types are eligible: * Serous * Other endometrial cancers (including clear cell, endometrioid, mixed epithelial, dedifferentiated/undifferentiated) * Carcinosarcoma * NOTE: Endometrial cancers that are mismatch repair deficient (dMMR) by IHC are not eligible * Histologic confirmation of the original primary tumor is required. Submission of surgical pathology report (or endometrial biopsy pathology report in patients who never undergo hysterectomy) is required * Patients must be within 8 weeks of primary surgery (or endometrial biopsy in patients who never undergo hysterectomy) at the time of study registration * Patients may have measurable disease, non-measurable disease, or no measurable disease. In patients with measurable disease, lesions will be defined and monitored by RECIST v 1.1. Measurable disease is defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded). Each lesion must be \>= 10 mm when measured by CT or magnetic resonance imaging (MRI). Lymph nodes must be \>= 15 mm in short axis when measured by CT or MRI * For patients with uterine-confined (stage I) disease, the tumor must be invasive into the myometrium. Any amount of myoinvasion is acceptable for eligibility. Patients with non-invasive disease, endometrial intraepithelial carcinoma alone, or disease confined to a polyp will be excluded * All patients must have tumors that are HER2 positive as defined by American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) 2018 Breast Cancer guidelines. IHC and ISH testing will be done locally, at each participating institution and interpreted by local pathologists. In general HER2 positivity is defined as any of the following: * 3+ immunohistochemistry (IHC), * 2+ IHC with positive in situ hybridization (ISH) Alternatively, patients could be eligible if next generation sequencing (NGS) demonstrates HER2 (ERBB2) amplification. NGS testing can be performed through any designated labs as per the National Cancer Institute (NCI) MATCH/NCI Combo-MATCH trial. Pathology report showing results of institutional HER2 testing (or NGS testing results) must be submitted. Sites must submit all results available (IHC, ISH, and NGS) * Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2 * Age \>= 18 * Platelets \>= 100,000/mcl (within 14 days prior to registration) * Absolute neutrophil count (ANC) \>= 1,500/mcl (within 14 days prior to registration) * Creatinine =\< 1.5 x institutional/laboratory upper limit of normal (ULN) or estimated Glomerular filtration rate (eGFR) \>= 50 mL/min using either the Cockcroft-Gault equation, the Modification of Diet in Renal Disease Study, or as reported in the comprehensive metabolic panel/basic metabolic panel (eGFR) (within 14 days prior to registration) * Total serum bilirubin level =\< 1.5 x ULN (patients with known Gilbert's disease who have bilirubin level =\< 3 x ULN may be enrolled) (within 14 days prior to registration) * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =\< 3 x ULN (within 14 days prior to registration) * Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months of registration are eligible for this trial * Although the uterus will have been removed in the vast majority of patients, for patients of child-bearing potential: negative urine or serum pregnancy test. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test is required. Patients will be considered of non-reproductive potential if they are either: * Postmenopausal (defined as at least 12 months with no menses without an alternative medical cause; in women \< 45 years of age, a high follicle stimulating hormone \[FSH\] level in the postmenopausal range may be used to confirm a postmenopausal state in women not using hormonal contraception or hormonal replacement therapy. In the absence of 12 months of amenorrhea, a single FSH measurement is insufficient); OR * Have had a hysterectomy and/or bilateral oophorectomy, bilateral salpingectomy or bilateral tubal ligation/occlusion at least 6 weeks prior to registration * Have a congenital or acquired condition that prevents childbearing * Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial * Patients with evidence of chronic hepatitis B virus (HBV) infection must have an undetectable HBV viral load on suppressive therapy, if indicated * Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load * Patients with treated brain metastases are eligible if follow-up brain imaging after central nervous system (CNS)-directed therapy shows no evidence of progression * The patient or a legally authorized representative must provide study-specific informed consent prior to study entry and, for patients treated in the United States (U.S.), authorization permitting release of personal health information Exclusion Criteria: * Prior Therapy: * Patients must NOT have received prior chemotherapy, biologic therapy, or targeted therapy for treatment of endometrial carcinoma * Patients must NOT have received prior radiation therapy for treatment of endometrial carcinoma. Prior radiation includes external beam pelvic radiation therapy, external beam extended field pelvic/para-aortic radiation therapy, and/or intravaginal brachytherapy * NOTE: Vaginal brachytherapy for treatment of endometrial cancer is permitted during study treatment. Planned use of vaginal brachytherapy must be declared at time of registration * Patients may have received prior hormonal therapy for treatment of endometrial carcinoma. All hormonal therapy must be discontinued at least one week prior to registration * Patients may not have a planned interval cytoreduction or hysterectomy, prior to documentation of progression, after study registration * Patients may not have planned external beam radiotherapy, prior to documentation of progression, after study registration * Significant cardiovascular disease including: * Uncontrolled hypertension, defined as systolic \> 150 mm Hg or diastolic \> 90 mm Hg despite antihypertensive medications * Myocardial infarction or unstable angina within 6 months prior to registration * New York Heart Association functional classification II, III or IV * Serious cardiac arrhythmia requiring medication. This does not include asymptomatic, atrial fibrillation with controlled ventricular rate * Significant lung disease: dyspnea at rest grade 2 or greater (resulting from extensive tumor involvement or other causes), pneumonitis grade 2 or greater, interstitial lung disease grade 2 or greater, idiopathic pulmonary fibrosis, cystic fibrosis, Aspergillosis, active tuberculosis, or history of opportunistic infections (pneumocystis pneumonia or cytomegalovirus pneumonia) * Patients with uncontrolled intercurrent illness including, but not limited to: ongoing or active infection (except for uncomplicated urinary tract infection), uncontrolled interstitial lung disease, symptomatic congestive heart failure, or psychiatric illness/social situations that would limit compliance with study requirements * Treatment with strong CYP2C8 or CYP3A4 inhibitors or inducers within 14 days or 5 drug-elimination half-lives, whichever is longer, prior to registration * Women who are unwilling to discontinue nursing

Interventions

PROCEDURE

Biospecimen Collection

DRUG

Carboplatin

PROCEDURE

Computed Tomography

PROCEDURE

Echocardiography Test

RADIATION

High-Dose-Rate Vaginal Cuff Brachytherapy

DRUG

Hyaluronidase-zzxf/Pertuzumab/Trastuzumab

PROCEDURE

Multigated Acquisition Scan

DRUG

Paclitaxel

OTHER

Survey Administration

DRUG

Trastuzumab/Hyaluronidase-oysk

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Conditions

Endometrial CarcinomaEndometrial Clear Cell AdenocarcinomaEndometrial Dedifferentiated CarcinomaEndometrial Endometrioid AdenocarcinomaEndometrial Mixed Cell AdenocarcinomaEndometrial Serous AdenocarcinomaEndometrial Undifferentiated CarcinomaUterine Corpus Malignant Mixed Mesodermal (Mullerian) Tumor

Locations

University of Alabama at Birmingham Cancer Center

Birmingham, Alabama 35233

United States

Alaska Women's Cancer Care

Anchorage, Alaska 99508

United States

Banner University Medical Center - Tucson

Tucson, Arizona 85719

United States

University of Arizona Cancer Center-North Campus

Tucson, Arizona 85719

United States

University of Arkansas for Medical Sciences

Little Rock, Arkansas 72205

United States

Sutter Auburn Faith Hospital

Auburn, California 95602

United States

Alta Bates Summit Medical Center-Herrick Campus

Berkeley, California 94704

United States

John Muir Medical Center-Concord

Concord, California 94520

United States

City of Hope Comprehensive Cancer Center

Duarte, California 91010

United States

City of Hope Seacliff

Huntington Beach, California 92648

United States

UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care

Irvine, California 92612

United States

City of Hope at Irvine Lennar

Irvine, California 92618

United States

Kaiser Permanente-Irvine

Irvine, California 92618

United States

City of Hope at Long Beach Elm

Long Beach, California 90813

United States

Kaiser Permanente Los Angeles Medical Center

Los Angeles, California 90027

United States

Memorial Medical Center

Modesto, California 95355

United States

Palo Alto Medical Foundation-Gynecologic Oncology

Mountain View, California 94040

United States

Saint Joseph Hospital - Orange

Orange, California 92868

United States

UC Irvine Health/Chao Family Comprehensive Cancer Center

Orange, California 92868

United States

Stanford Cancer Institute Palo Alto

Palo Alto, California 94304

United States

Kaiser Permanente - Panorama City

Panorama City, California 91402

United States

Kaiser Permanente-Riverside

Riverside, California 92505

United States

Sutter Roseville Medical Center

Roseville, California 95661

United States

Sutter Medical Center Sacramento

Sacramento, California 95816

United States

University of California Davis Comprehensive Cancer Center

Sacramento, California 95817

United States

California Pacific Medical Center-Pacific Campus

San Francisco, California 94115

United States

Palo Alto Medical Foundation-Santa Cruz

Santa Cruz, California 95065

United States

Palo Alto Medical Foundation-Sunnyvale

Sunnyvale, California 94086

United States

City of Hope Upland

Upland, California 91786

United States

John Muir Medical Center-Walnut Creek

Walnut Creek, California 94598

United States

UCHealth University of Colorado Hospital

Aurora, Colorado 80045

United States

UCHealth - Cherry Creek

Denver, Colorado 80206

United States

AdventHealth Porter

Denver, Colorado 80210

United States

Grand Valley Oncology

Grand Junction, Colorado 81505

United States

Banner North Colorado Medical Center

Greeley, Colorado 80631

United States

UCHealth Highlands Ranch Hospital

Highlands Ranch, Colorado 80129

United States

Banner North Colorado Medical Center - Loveland Campus

Loveland, Colorado 80539

United States

Danbury Hospital

Danbury, Connecticut 06810

United States

Smilow Cancer Hospital-Derby Care Center

Derby, Connecticut 06418

United States

Smilow Cancer Hospital Care Center-Fairfield

Fairfield, Connecticut 06824

United States

Smilow Cancer Hospital Care Center at Glastonbury

Glastonbury, Connecticut 06033

United States

Smilow Cancer Hospital Care Center at Greenwich

Greenwich, Connecticut 06830

United States

Smilow Cancer Hospital Care Center - Guilford

Guilford, Connecticut 06437

United States

Smilow Cancer Hospital Care Center at Saint Francis

Hartford, Connecticut 06105

United States

Yale University

New Haven, Connecticut 06520

United States

Yale-New Haven Hospital North Haven Medical Center

North Haven, Connecticut 06473

United States

Norwalk Hospital

Norwalk, Connecticut 06856

United States

Smilow Cancer Hospital Care Center at Long Ridge

Stamford, Connecticut 06902

United States

Smilow Cancer Hospital-Torrington Care Center

Torrington, Connecticut 06790

United States

Smilow Cancer Hospital Care Center-Trumbull

Trumbull, Connecticut 06611

United States

Smilow Cancer Hospital-Waterbury Care Center

Waterbury, Connecticut 06708

United States

Smilow Cancer Hospital Care Center - Waterford

Waterford, Connecticut 06385

United States

Helen F Graham Cancer Center

Newark, Delaware 19713

United States

Medical Oncology Hematology Consultants PA

Newark, Delaware 19713

United States

Sibley Memorial Hospital

Washington D.C., District of Columbia 20016

United States

George Washington University Medical Center

Washington D.C., District of Columbia 20037

United States

Broward Health Medical Center

Fort Lauderdale, Florida 33316

United States

Jupiter Medical Center

Jupiter, Florida 33458

United States

Sarasota Memorial Hospital-Venice

N. Venice, Florida 34275

United States

AdventHealth Orlando

Orlando, Florida 32803

United States

Florida Cancer Specialists - Sarasota Downtown

Sarasota, Florida 34239

United States

FPG - Surgical Oncology Clinics Gynecologic Oncology Surgery

Sarasota, Florida 34239

United States

Sarasota Memorial Hospital

Sarasota, Florida 34239

United States

Florida Cancer Specialists - Venice Pinebrook

Venice, Florida 34275

United States

Grady Health System

Atlanta, Georgia 30303

United States

Emory University Hospital Midtown

Atlanta, Georgia 30308

United States

Piedmont Hospital

Atlanta, Georgia 30309

United States

Emory University Hospital/Winship Cancer Institute

Atlanta, Georgia 30322

United States

Emory Saint Joseph's Hospital

Atlanta, Georgia 30342

United States

Augusta University Medical Center

Augusta, Georgia 30912

United States

Emory Decatur Hospital

Decatur, Georgia 30033

United States

Lewis Cancer and Research Pavilion at Saint Joseph's/Candler

Savannah, Georgia 31405

United States

Queen's Medical Center

Honolulu, Hawaii 96813

United States

Kapiolani Medical Center for Women and Children

Honolulu, Hawaii 96826

United States

Saint Alphonsus Cancer Care Center-Boise

Boise, Idaho 83706

United States

Saint Luke's Cancer Institute - Boise

Boise, Idaho 83712

United States

Saint Alphonsus Cancer Care Center-Caldwell

Caldwell, Idaho 83605

United States

Kootenai Health - Coeur d'Alene

Coeur d'Alene, Idaho 83814

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 Alphonsus Cancer Care Center-Nampa

Nampa, Idaho 83687

United States

Saint Luke's Cancer Institute - Nampa

Nampa, Idaho 83687

United States

Kootenai Clinic Cancer Services - Post Falls

Post Falls, Idaho 83854

United States

Kootenai Clinic Cancer Services - Sandpoint

Sandpoint, Idaho 83864

United States

Saint Luke's Cancer Institute - Twin Falls

Twin Falls, Idaho 83301

United States

Northwest Community Hospital

Arlington Heights, Illinois 60005

United States

Rush-Copley Medical Center

Aurora, Illinois 60504

United States

Centralia Oncology Clinic

Centralia, Illinois 62801

United States

Northwestern University

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 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

Northwestern Medicine Cancer Center Kishwaukee

DeKalb, Illinois 60115

United States

Carle Physician Group-Effingham

Effingham, Illinois 62401

United States

Crossroads Cancer Center

Effingham, Illinois 62401

United States

NorthShore University HealthSystem-Evanston Hospital

Evanston, Illinois 60201

United States

Northwestern Medicine Cancer Center Delnor

Geneva, Illinois 60134

United States

NorthShore University HealthSystem-Glenbrook Hospital

Glenview, Illinois 60026

United States

Northwestern Medicine Glenview Outpatient Center

Glenview, Illinois 60026

United States

Northwestern Medicine Grayslake Outpatient Center

Grayslake, Illinois 60030

United States

Ingalls Memorial Hospital

Harvey, Illinois 60426

United States

NorthShore University HealthSystem-Highland Park Hospital

Highland Park, Illinois 60035

United States

Sudarshan K Sharma MD Limited-Gynecologic Oncology

Hinsdale, Illinois 60521

United States

Northwestern Medicine Lake Forest Hospital

Lake Forest, Illinois 60045

United States

Carle Physician Group-Mattoon/Charleston

Mattoon, Illinois 61938

United States

UC Comprehensive Cancer Center at Silver Cross

New Lenox, Illinois 60451

United States

Carle Cancer Institute Normal

Normal, Illinois 61761

United States

Cancer Care Center of O'Fallon

O'Fallon, Illinois 62269

United States

Northwestern Medicine Orland Park

Orland Park, Illinois 60462

United States

University of Chicago Medicine-Orland Park

Orland Park, Illinois 60462

United States

UW Health Carbone Cancer Center Rockford

Rockford, Illinois 61114

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

Carle Cancer Center

Urbana, Illinois 61801

United States

Northwestern Medicine Cancer Center Warrenville

Warrenville, Illinois 60555

United States

Rush-Copley Healthcare Center

Yorkville, Illinois 60560

United States

IU Health North Hospital

Carmel, Indiana 46032

United States

Northwest Cancer Center - Crown Point

Crown Point, Indiana 46307

United States

UChicago Medicine Northwest Indiana

Crown Point, Indiana 46307

United States

Northwest Oncology LLC

Dyer, Indiana 46311

United States

Goshen Center for Cancer Care

Goshen, Indiana 46526

United States

Northwest Cancer Center - Hobart

Hobart, Indiana 46342

United States

Saint Mary Medical Center

Hobart, Indiana 46342

United States

Indiana University/Melvin and Bren Simon Cancer Center

Indianapolis, Indiana 46202

United States

Franciscan Health Indianapolis

Indianapolis, Indiana 46237

United States

Ascension Saint Vincent Indianapolis Hospital

Indianapolis, Indiana 46260

United States

Saint Catherine Hospital

Indianapolis, Indiana 46312

United States

Franciscan Saint Elizabeth Health - Lafayette East

Lafayette, Indiana 47905

United States

Franciscan Health Mooresville

Mooresville, Indiana 46158

United States

The Community Hospital

Munster, Indiana 46321

United States

Women's Diagnostic Center - Munster

Munster, Indiana 46321

United States

Memorial Hospital of South Bend

South Bend, Indiana 46601

United States

Northwest Cancer Center - Valparaiso

Valparaiso, Indiana 46383

United States

Mary Greeley Medical Center

Ames, Iowa 50010

United States

McFarland Clinic - Ames

Ames, Iowa 50010

United States

McFarland Clinic - Boone

Boone, Iowa 50036

United States

Heartland Oncology and Hematology LLP

Council Bluffs, Iowa 51503

United States

Nebraska Cancer Specialists/Oncology Hematology West PC - MEJ

Council Bluffs, Iowa 51503

United States

McFarland Clinic - Trinity Cancer Center

Fort Dodge, Iowa 50501

United States

University of Iowa/Holden Comprehensive Cancer Center

Iowa City, Iowa 52242

United States

McFarland Clinic - Jefferson

Jefferson, Iowa 50129

United States

McFarland Clinic - Marshalltown

Marshalltown, Iowa 50158

United States

Saint Elizabeth Healthcare Edgewood

Edgewood, Kentucky 41017

United States

Baptist Health Lexington

Lexington, Kentucky 40503

United States

Baptist Health Louisville

Louisville, Kentucky 40207

United States

LSU Health Baton Rouge-North Clinic

Baton Rouge, Louisiana 70805

United States

Our Lady of the Lake Physician Group

Baton Rouge, Louisiana 70808

United States

Our Lady of the Lake Medical Oncology

Baton Rouge, Louisiana 70817

United States

Ochsner Hematology Oncology North Shore - Covington (West Region)

Covington, Louisiana 70433

United States

West Jefferson Medical Center

Marrero, Louisiana 70072

United States

East Jefferson General Hospital

Metairie, Louisiana 70006

United States

LSU Healthcare Network / Metairie Multi-Specialty Clinic

Metairie, Louisiana 70006

United States

University Medical Center New Orleans

New Orleans, Louisiana 70112

United States

Ochsner Baptist Medical Center

New Orleans, Louisiana 70115

United States

Ochsner Medical Center Jefferson

New Orleans, Louisiana 70121

United States

Harold Alfond Center for Cancer Care

Augusta, Maine 04330

United States

MaineHealth Maine Medical Center- Scarborough

Scarborough, Maine 04074

United States

Greater Baltimore Medical Center

Baltimore, Maryland 21204

United States

Sinai Hospital of Baltimore

Baltimore, Maryland 21215

United States

MedStar Franklin Square Medical Center/Weinberg Cancer Institute

Baltimore, Maryland 21237

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

William E Kahlert Regional Cancer Center/Sinai Hospital

Westminster, Maryland 21157

United States

Baystate Medical Center

Springfield, Massachusetts 01199

United States

University of Michigan Rogel Cancer Center

Ann Arbor, Michigan 48109

United States

Bronson Battle Creek

Battle Creek, Michigan 49017

United States

Trinity Health IHA Medical Group Hematology Oncology - Brighton

Brighton, Michigan 48114

United States

Trinity Health IHA Medical Group Hematology Oncology - Canton

Canton, Michigan 48188

United States

Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital

Chelsea, Michigan 48118

United States

Wayne State University/Karmanos Cancer Institute

Detroit, Michigan 48201

United States

Weisberg Cancer Treatment Center

Farmington Hills, Michigan 48334

United States

Corewell Health Farmington Hills Hospital

Farmington Hills, Michigan 48336

United States

Cancer Hematology Centers - Flint

Flint, Michigan 48503

United States

Genesee Hematology Oncology PC

Flint, Michigan 48503

United States

Genesys Hurley Cancer Institute

Flint, Michigan 48503

United States

Hurley Medical Center

Flint, Michigan 48503

United States

Corewell Health Grand Rapids Hospitals - Butterworth 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 Cancer Center

Kalamazoo, Michigan 49009

United States

Trinity Health Saint Mary Mercy Livonia Hospital

Livonia, Michigan 48154

United States

Trinity Health Muskegon Hospital

Muskegon, Michigan 49444

United States

Corewell Health Lakeland Hospitals - Niles Hospital

Niles, Michigan 49120

United States

Cancer and Hematology Centers of Western Michigan - Norton Shores

Norton Shores, Michigan 49444

United States

Trinity Health Saint Joseph Mercy Oakland Hospital

Pontiac, Michigan 48341

United States

Corewell Health Reed City Hospital

Reed City, Michigan 49677

United States

Corewell Health William Beaumont University Hospital

Royal Oak, Michigan 48073

United States

MyMichigan Medical Center Saginaw

Saginaw, Michigan 48601

United States

Oncology Hematology Associates of Saginaw Valley PC

Saginaw, Michigan 48604

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

MyMichigan Medical Center Tawas

Tawas City, Michigan 48764

United States

Munson Medical Center

Traverse City, Michigan 49684

United States

Corewell Health Beaumont Troy Hospital

Troy, Michigan 48085

United States

Saint Mary's Oncology/Hematology Associates of West Branch

West Branch, Michigan 48661

United States

University of Michigan Health - West

Wyoming, Michigan 49519

United States

Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus

Ypsilanti, Michigan 48197

United States

Mercy Hospital

Coon Rapids, Minnesota 55433

United States

Fairview Southdale Hospital

Edina, Minnesota 55435

United States

Minnesota Oncology - Edina

Edina, Minnesota 55435

United States

Minnesota Oncology Hematology PA-Maplewood

Maplewood, Minnesota 55109

United States

Avera Cancer Institute at Marshall

Marshall, Minnesota 56258

United States

Abbott-Northwestern Hospital

Minneapolis, Minnesota 55407

United States

University of Minnesota/Masonic Cancer Center

Minneapolis, Minnesota 55455

United States

Park Nicollet Clinic - Saint Louis Park

Saint Louis Park, Minnesota 55416

United States

Regions Hospital

Saint Paul, Minnesota 55101

United States

United Hospital

Saint Paul, Minnesota 55102

United States

Minnesota Oncology Hematology PA-Woodbury

Woodbury, Minnesota 55125

United States

MU Health - University Hospital/Ellis Fischel Cancer Center

Columbia, Missouri 65212

United States

Phelps Health Delbert Day Cancer Institute

Rolla, Missouri 65401

United States

CoxHealth South Hospital

Springfield, Missouri 65807

United States

Washington University School of Medicine

St Louis, Missouri 63110

United States

Mercy Hospital South

St Louis, Missouri 63128

United States

Mercy Hospital Saint Louis

St Louis, Missouri 63141

United States

Community Hospital of Anaconda

Anaconda, Montana 59711

United States

Billings Clinic Cancer Center

Billings, Montana 59101

United States

Saint Vincent Frontier Cancer Center

Billings, Montana 59102

United States

Intermountain Health West End Clinic

Billings, Montana 59106

United States

Bozeman Health Deaconess Hospital

Bozeman, Montana 59715

United States

Benefis Sletten Cancer Institute

Great Falls, Montana 59405

United States

Logan Health Medical Center

Kalispell, Montana 59901

United States

Saint Patrick Hospital - Community Hospital

Missoula, Montana 59802

United States

Community Medical Center

Missoula, Montana 59804

United States

Nebraska Cancer Specialists/Oncology Hematology West PC - MECC

Omaha, Nebraska 68114

United States

Nebraska Methodist Hospital

Omaha, Nebraska 68114

United States

Alegent Health Bergan Mercy Medical Center

Omaha, Nebraska 68124

United States

University of Nebraska Medical Center

Omaha, Nebraska 68198

United States

OptumCare Cancer Care at Charleston

Las Vegas, Nevada 89102

United States

Women's Cancer Center of Nevada

Las Vegas, Nevada 89106

United States

OptumCare Cancer Care at Fort Apache

Las Vegas, Nevada 89183

United States

Memorial Sloan Kettering Basking Ridge

Basking Ridge, New Jersey 07920

United States

Cooper Hospital University Medical Center

Camden, New Jersey 08103

United States

Hackensack University Medical Center

Hackensack, New Jersey 07601

United States

Monmouth Medical Center Southern Campus

Lakewood, New Jersey 08701

United States

Cooperman Barnabas Medical Center

Livingston, New Jersey 07039

United States

Monmouth Medical Center

Long Branch, New Jersey 07740

United States

Memorial Sloan Kettering Monmouth

Middletown, New Jersey 07748

United States

Memorial Sloan Kettering Bergen

Montvale, New Jersey 07645

United States

Virtua Samson Cancer Center

Moorestown, New Jersey 08057

United States

Jersey Shore Medical Center

Neptune City, New Jersey 07753

United States

Rutgers Cancer Institute of New Jersey

New Brunswick, New Jersey 08903

United States

Rutgers New Jersey Medical School

Newark, New Jersey 07101

United States

Riverview Medical Center/Booker Cancer Center

Red Bank, New Jersey 07701

United States

Sidney Kimmel Cancer Center Washington Township

Sewell, New Jersey 08080

United States

Robert Wood Johnson University Hospital Somerset

Somerville, New Jersey 08876

United States

Community Medical Center

Toms River, New Jersey 08755

United States

Virtua Voorhees

Voorhees Township, New Jersey 08043

United States

University of New Mexico Cancer Center

Albuquerque, New Mexico 87106

United States

Presbyterian Kaseman Hospital

Albuquerque, New Mexico 87110

United States

Presbyterian Rust Medical Center/Jorgensen Cancer Center

Rio Rancho, New Mexico 87124

United States

Women's Cancer Care Associates LLC

Albany, New York 12208

United States

Memorial Sloan Kettering Commack

Commack, New York 11725

United States

Memorial Sloan Kettering Westchester

Harrison, New York 10604

United States

NYU Langone Hospital - Long Island

Mineola, New York 11501

United States

Mount Sinai Chelsea

New York, New York 10011

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

Memorial Sloan Kettering Cancer Center

New York, New York 10065

United States

University of Rochester

Rochester, New York 14642

United States

State University of New York Upstate Medical University

Syracuse, New York 13210

United States

Memorial Sloan Kettering Nassau

Uniondale, New York 11553

United States

Wilmot Cancer Institute at Webster

Webster, New York 14580

United States

Duke Cancer Center Cary

Cary, North Carolina 27518

United States

UNC Lineberger Comprehensive Cancer Center

Chapel Hill, North Carolina 27599

United States

Duke University Medical Center

Durham, North Carolina 27710

United States

ECU Health Medical Center

Greenville, North Carolina 27834

United States

Hayworth Cancer Center

High Point, North Carolina 27262

United States

Duke Women's Cancer Care Raleigh

Raleigh, North Carolina 27607

United States

Novant Health New Hanover Regional Medical Center

Wilmington, North Carolina 28401

United States

Wake Forest University Health Sciences

Winston-Salem, North Carolina 27157

United States

Sanford Bismarck Medical Center

Bismarck, North Dakota 58501

United States

Sanford Broadway Medical Center

Fargo, North Dakota 58122

United States

Sanford Roger Maris Cancer Center

Fargo, North Dakota 58122

United States

UHHS-Chagrin Highlands Medical Center

Beachwood, Ohio 44122

United States

Strecker Cancer Center-Belpre

Belpre, Ohio 45714

United States

Aultman Health Foundation

Canton, Ohio 44710

United States

Miami Valley Hospital South

Centerville, Ohio 45459

United States

Geauga Hospital

Chardon, Ohio 44024

United States

Adena Regional Medical Center

Chillicothe, Ohio 45601

United States

Good Samaritan Hospital - Cincinnati

Cincinnati, Ohio 45220

United States

Case Western Reserve University

Cleveland, Ohio 44106

United States

MetroHealth Medical Center

Cleveland, Ohio 44109

United States

Ohio State University Comprehensive Cancer Center

Columbus, Ohio 43210

United States

Mount Carmel East Hospital

Columbus, Ohio 43213

United States

Riverside Methodist Hospital

Columbus, Ohio 43214

United States

The Mark H Zangmeister Center

Columbus, Ohio 43219

United States

Miami Valley Hospital

Dayton, Ohio 45409

United States

Miami Valley Hospital North

Dayton, Ohio 45415

United States

Atrium Medical Center-Middletown Regional Hospital

Franklin, Ohio 45005-1066

United States

Miami Valley Cancer Care and Infusion

Greenville, Ohio 45331

United States

Mount Carmel Grove City Hospital

Grove City, Ohio 43123

United States

Fairfield Medical Center

Lancaster, Ohio 43130

United States

Saint Rita's Medical Center

Lima, Ohio 45801

United States

Marietta Memorial Hospital

Marietta, Ohio 45750

United States

Memorial Hospital

Marysville, Ohio 43040

United States

UH Seidman Cancer Center at Lake Health Mentor Campus

Mentor, Ohio 44060

United States

Knox Community Hospital

Mount Vernon, Ohio 43050

United States

Licking Memorial Hospital

Newark, Ohio 43055

United States

University Hospitals Parma Medical Center

Parma, Ohio 44129

United States

Mercy Health - Perrysburg Hospital

Perrysburg, Ohio 43551

United States

Southern Ohio Medical Center

Portsmouth, Ohio 45662

United States

Springfield Regional Cancer Center

Springfield, Ohio 45504

United States

Springfield Regional Medical Center

Springfield, Ohio 45504

United States

ProMedica Flower Hospital

Sylvania, Ohio 43560

United States

Mercy Health - Saint Vincent Hospital

Toledo, Ohio 43608

United States

Mercy Health - Saint Anne Hospital

Toledo, Ohio 43623

United States

Upper Valley Medical Center

Troy, Ohio 45373

United States

Saint Ann's Hospital

Westerville, Ohio 43081

United States

UH Seidman Cancer Center at Saint John Medical Center

Westlake, Ohio 44145

United States

Genesis Healthcare System Cancer Care Center

Zanesville, Ohio 43701

United States

University of Oklahoma Health Sciences Center

Oklahoma City, Oklahoma 73104

United States

Mercy Hospital Oklahoma City

Oklahoma City, Oklahoma 73120

United States

Oklahoma Cancer Specialists and Research Institute-Tulsa

Tulsa, Oklahoma 74146

United States

Providence Cancer Institute Clackamas Clinic

Clackamas, Oregon 97015

United States

Providence Newberg Medical Center

Newberg, Oregon 97132

United States

Saint Alphonsus Cancer Care Center-Ontario

Ontario, Oregon 97914

United States

Legacy Good Samaritan Hospital and Medical Center

Portland, Oregon 97210

United States

Providence Portland Medical Center

Portland, Oregon 97213

United States

Providence Saint Vincent Medical Center

Portland, Oregon 97225

United States

Oregon Health and Science University

Portland, Oregon 97239

United States

Legacy Meridian Park Hospital

Tualatin, Oregon 97062

United States

Lehigh Valley Hospital-Cedar Crest

Allentown, Pennsylvania 18103

United States

Saint Luke's Cancer Center - Allentown

Allentown, Pennsylvania 18104

United States

Saint Luke's University Hospital-Bethlehem Campus

Bethlehem, Pennsylvania 18015

United States

Lehigh Valley Hospital - Muhlenberg

Bethlehem, Pennsylvania 18017

United States

Bryn Mawr Hospital

Bryn Mawr, Pennsylvania 19010

United States

Pocono Medical Center

East Stroudsburg, Pennsylvania 18301

United States

Saint Luke's Hospital-Anderson Campus

Easton, Pennsylvania 18045

United States

Saint Vincent Hospital

Erie, Pennsylvania 16544

United States

Lehigh Valley Hospital-Hazleton

Hazleton, Pennsylvania 18201

United States

Jefferson Hospital

Jefferson Hills, Pennsylvania 15025

United States

Riddle Memorial Hospital

Media, Pennsylvania 19063

United States

Forbes Hospital

Monroeville, Pennsylvania 15146

United States

Paoli Memorial Hospital

Paoli, Pennsylvania 19301

United States

Pennsylvania Hospital

Philadelphia, Pennsylvania 19107

United States

Thomas Jefferson University Hospital

Philadelphia, Pennsylvania 19107

United States

Fox Chase Cancer Center

Philadelphia, Pennsylvania 19111

United States

West Penn Hospital

Pittsburgh, Pennsylvania 15224

United States

Saint Luke's Hospital - Upper Bucks Campus

Quakertown, Pennsylvania 18951

United States

Chester County Hospital

West Chester, Pennsylvania 19380

United States

Wexford Health and Wellness Pavilion

Wexford, Pennsylvania 15090

United States

Asplundh Cancer Pavilion

Willow Grove, Pennsylvania 19090

United States

Lankenau Medical Center

Wynnewood, Pennsylvania 19096

United States

Women and Infants Hospital

Providence, Rhode Island 02905

United States

Smilow Cancer Hospital Care Center - Westerly

Westerly, Rhode Island 02891

United States

Saint Joseph's/Candler - Bluffton Campus

Bluffton, South Carolina 29910

United States

Medical University of South Carolina

Charleston, South Carolina 29425

United States

Avera Cancer Institute-Aberdeen

Aberdeen, South Dakota 57401

United States

Rapid City Regional Hospital

Rapid City, South Dakota 57701

United States

Sanford Cancer Center Oncology Clinic

Sioux Falls, South Dakota 57104

United States

Avera Cancer Institute

Sioux Falls, South Dakota 57105

United States

Sanford USD Medical Center - Sioux Falls

Sioux Falls, South Dakota 57117-5134

United States

The West Clinic - Wolf River

Germantown, Tennessee 38138

United States

Dell Seton Medical Center at The University of Texas

Austin, Texas 78701

United States

University of Texas at Austin

Austin, Texas 78712

United States

Parkland Memorial Hospital

Dallas, Texas 75235

United States

UT Southwestern/Simmons Cancer Center-Dallas

Dallas, Texas 75390

United States

Tarrant County Hospital District/JPS Health Network

Fort Worth, Texas 76104

United States

UT Southwestern/Simmons Cancer Center-Fort Worth

Fort Worth, Texas 76104

United States

Houston Methodist Hospital

Houston, Texas 77030

United States

Memorial Hermann Texas Medical Center

Houston, Texas 77030

United States

Methodist Willowbrook Hospital

Houston, Texas 77070

United States

Houston Methodist West Hospital

Houston, Texas 77094

United States

Houston Methodist Saint John Hospital

Nassau Bay, Texas 77058

United States

UT Southwestern Clinical Center at Richardson/Plano

Richardson, Texas 75080

United States

Houston Methodist Sugar Land Hospital

Sugar Land, Texas 77479

United States

Houston Methodist The Woodlands Hospital

The Woodlands, Texas 77385

United States

Huntsman Cancer Institute/University of Utah

Salt Lake City, Utah 84112

United States

South Jordan Health Center

South Jordan, Utah 84009

United States

University of Virginia Cancer Center

Charlottesville, Virginia 22908

United States

Henrico Doctor's Hospital

Richmond, Virginia 23229

United States

VCU Massey Cancer Center at Stony Point

Richmond, Virginia 23235

United States

VCU Massey Comprehensive Cancer Center

Richmond, Virginia 23298

United States

Carilion Roanoke Memorial Hospital

Roanoke, Virginia 24033

United States

Swedish Cancer Institute-Edmonds

Edmonds, Washington 98026

United States

Swedish Medical Center-First Hill

Seattle, Washington 98122

United States

Legacy Salmon Creek Hospital

Vancouver, Washington 98686

United States

West Virginia University Charleston Division

Charleston, West Virginia 25304

United States

West Virginia University Healthcare

Morgantown, West Virginia 26506

United States

Marshfield Medical Center-EC Cancer Center

Eau Claire, Wisconsin 54701

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

Gundersen Lutheran Medical Center

La Crosse, Wisconsin 54601

United States

University of Wisconsin Carbone Cancer Center - Eastpark Medical Center

Madison, Wisconsin 53718

United States

University of Wisconsin Carbone Cancer Center - University Hospital

Madison, Wisconsin 53792

United States

Marshfield Medical Center-Marshfield

Marshfield, Wisconsin 54449

United States

Medical College of Wisconsin

Milwaukee, Wisconsin 53226

United States

Marshfield Medical Center - Minocqua

Minocqua, Wisconsin 54548

United States

ProHealth D N Greenwald Center

Mukwonago, Wisconsin 53149

United States

Cancer Center of Western Wisconsin

New Richmond, Wisconsin 54017

United States

ProHealth Oconomowoc Memorial Hospital

Oconomowoc, Wisconsin 53066

United States

Saint Vincent Hospital Cancer Center at Oconto Falls

Oconto Falls, Wisconsin 54154

United States

Marshfield Medical Center-Rice Lake

Rice Lake, Wisconsin 54868

United States

Saint Vincent Hospital Cancer Center at Sheboygan

Sheboygan, Wisconsin 53081

United States

Sheboygan Physicians Group

Sheboygan, Wisconsin 53081

United States

Marshfield Medical Center-River Region at Stevens Point

Stevens Point, Wisconsin 54482

United States

Saint Vincent Hospital Cancer Center at Sturgeon Bay

Sturgeon Bay, Wisconsin 54235-1495

United States

UW Cancer Center at ProHealth Care

Waukesha, Wisconsin 53188

United States

Marshfield Medical Center - Weston

Weston, Wisconsin 54476

United States

Centro Comprensivo de Cancer de UPR

San Juan, 00927

Puerto Rico

Keimyung University-Dongsan Medical Center

Dalseo-gu, Daegu 42601

South Korea

Samsung Changwon Hospital

Seoul, Gyeongsangnam-do 51353

South Korea

Seoul National University Bundang Hospital

Seongnam, Kyeonggi-do 463-707

South Korea

Gangnam Severance Hospital

Seoul, 06273

South Korea