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NCT06031688PHASE2Recruiting

Targeted Treatment for Advanced Non-Small Cell Lung Cancer That Has a MET Exon 14 Skipping Gene Change (An Expanded Lung-MAP Treatment Trial)

SWOG Cancer Research Network

Start Date

8/8/2024

Completion Date

5/31/2028

Summary

This phase II Expanded Lung-MAP treatment trial tests tepotinib with or without ramucirumab for the treatment of patients with advanced non-small cell lung cancer that has spread from where it first started (primary site) to other places in the body (stage IV) or that has come back after a period of improvement (recurrent). Tepotinib is used in patients whose cancer has a mutated (changed) form of a gene called MET. It is in a class of medications called kinase inhibitors. It works by blocking the action of the abnormal MET protein that signals tumor cells to multiply. This helps slow or stop the spread of tumor cells. Ramucirumab is a monoclonal antibody that may prevent the growth of new blood vessels that tumors need to grow. Giving tepotinib with ramucirumab may lower the chance of the cancer from growing or spreading in patients with stage IV or recurrent non-small cell lung cancer.

Detailed Description

PRIMARY OBJECTIVE: I. To compare the response rate (confirmed or unconfirmed, complete or partial) between participants with MET exon 14 skipping positive non-small cell lung cancer (NSCLC) randomized to tepotinib with or without ramucirumab. SECONDARY OBJECTIVES: I. To compare the frequency of all-grade treatment- related peripheral edema as defined by Common Terminology Criteria for Adverse Events (CTCAE) between the arms. II. To evaluate the frequency and severity of toxicities within each arm. III. To compare progression-free survival between the arms. IV. To compare overall survival between the arms. V. To estimate the duration of response (DoR) among responders within each arm. TRANSLATIONAL MEDICINE OBJECTIVE: I. To establish a tissue/blood repository for participants with MET exon 14 skipping non-small cell lung cancer (NSCLC). OUTLINE: Patients are randomized to 1 of 2 arms. ARM A: Patients receive ramucirumab intravenously (IV) over 30-60 minutes on day 1 of each cycle and tepotinib orally (PO) once daily (QD) on days 1-21 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. ARM B: Patients receive tepotinib PO QD on days 1-21 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients optionally undergo lymphoscintigraphy scan at screening prior to treatment, at the first occurrence of peripheral edema (defined as the development of grade ≥ 1 CTCAE Edema Limbs affecting either the arms, hands, or legs), and if peripheral edema increases in attribution. Patients also undergo blood collection, computed tomography (CT) scan and/or magnetic resonance imaging (MRI) throughout the trial. Additionally, patients undergo urine collection during screening and on study. After completion of study treatment, patients are followed-up every 12 weeks or more often as clinically indicated until progression and then every 6 months for 2 years and at the end of 3 years from date of sub-study randomization.

Eligibility Criteria

Age Range: No minimum to No maximum

Inclusion Criteria: * Participants must have been assigned to S1900K by the Southwest Oncology Group (SWOG) Statistics and Data Management Center (SDMC). Assignment to S1900K is determined by the LUNGMAP protocol * Participants must have documentation of stage IV or recurrent NSCLC with a MET exon 14 skipping mutation determined by tissue-based or blood-based (circulating tumor DNA \[ctDNA\]) next generation sequencing (NGS) assay done within a laboratory with Clinical Laboratory Improvement Act (CLIA), International Organization for Standardization (ISO)/ International Electrotechnical Commission (IEC), College of American Pathologists (CAP), or similar certification. Documentation must either be: * NGS test results from tissue submitted for LUNGMAP screening, or * Submitted documentation in the LUNGMAP Rave Electronic Data Capture System of a MET exon 14 skipping mutation from a previously completed tissue or blood-based NGS test * Participants must have measurable disease documented by CT or MRI. The CT from a combined positron emission tomography (PET)/CT may be used to document measurable disease ONLY if it is of diagnostic quality, otherwise, it may be used to document non-measurable disease only. Measurable disease must be assessed within 28 days prior to sub-study randomization. Pleural effusions, ascites and laboratory parameters are not acceptable as the only evidence of disease. Non-measurable disease must be assessed within 42 days prior to sub-study randomization. All known sites of disease must be assessed and documented on the Baseline Tumor Assessment Form. Participants whose only measurable disease is within a previous radiation therapy port must demonstrate clearly progressive disease (in the opinion of the treating investigator) prior to sub-study randomization to be considered measurable * Participants must have a CT or MRI scan of the brain to evaluate for central nervous system (CNS) disease within 42 days prior to sub-study randomization * Participants must not have leptomeningeal disease, spinal cord compression or brain metastases unless: * Metastases have been locally treated and have remained clinically controlled and asymptomatic for at least 3 days following the stereotactic radiation and/or 14 days following whole brain radiation, and prior to sub-study randomization, AND * Participant has no residual neurological dysfunction and has been off corticosteroids for at least 24 hours prior to sub-study randomization * Participants must not have other known actionable oncogenic alterations, such as (but not limited to) EGFR sensitizing mutations, EGFR T790M mutation, ALK gene fusion, ROS1 gene rearrangement, RET gene rearrangement, NTRK rearrangement, HER2 mutation, KRAS activating mutations, and BRAF V600E mutation * Participants who have received at least one line of systemic treatment for stage IV or recurrent NSCLC must have progressed (in the opinion of the treating physician) following the most recent line of therapy. Participants who have not yet received systemic treatment for their stage IV or recurrent NSCLC are allowed * Participants may have received any number of lines of therapy for stage IV or recurrent NSCLC (including zero) and must be able to report prior treatment information * Participants must have recovered (=\< grade 1) from any side effects of prior therapy for NSCLC except alopecia and vitiligo * Participants must not have received any prior systemic therapy (systemic chemotherapy, immunotherapy or investigational drug) within 21 days prior to sub-study randomization * Participants must not have received treatment with prior MET inhibitor therapies (e.g., crizotinib, tivantinib, savolitinib, tepotinib, cabozantinib, and foretinib). * Participants must not have received treatment with prior angiogenesis inhibitor therapies (including but not limited to bevacizumab and ramucirumab) * Participants must not have a history of interstitial lung disease that required steroid treatment * Participants must not have received any radiation therapy within 7 days prior to sub-study randomization with the exceptions of * Stereotactic radiation to CNS metastases which must have been completed at least 3 days prior to sub-study randomization and * Palliative radiotherapy to bone metastases which must have been completed at least 1 day prior to sub-study randomization * Participants must not be planning to receive any concurrent chemotherapy, immunotherapy, biologic or hormonal therapy for cancer treatment while receiving treatment on this study * Participants must not have had a major surgery within 14 days prior to sub-study randomization. Participants must have fully recovered from the effects of prior surgery in the opinion of the treating investigator * Participants must not have a prior or concurrent malignancy whose natural history or treatment (in the opinion of the treating physician) has the potential to interfere with the safety or efficacy assessment of the investigational regimen * Absolute neutrophil count \>= 1.5 x 10\^3/uL (within 28 days prior to sub-study randomization) * Hemoglobin \>= 9.0 g/dL (within 28 days prior to sub-study randomization) * Platelets \>= 100 x 10\^3/uL (within 28 days prior to sub-study randomization) * Total bilirubin =\< 1.5 x institutional upper limit of normal (ULN) unless history of Gilbert's disease. Participants with history of Gilbert's disease must have total bilirubin =\< 5 x institutional ULN (within 28 days prior to sub-study randomization) * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =\< 2.5 × institutional ULN. Participants with history of liver metastasis must have AST and ALT =\< 5 x ULN (within 28 days prior to sub-study randomization) * Participants must have a serum creatinine =\< the institutional upper limit of normal (IULN) or calculated creatinine clearance \>= 30 mL/min using the following Cockcroft-Gault Formula. This specimen must have been drawn and processed within 28 days prior to sub-study randomization * Participants must have a cystatin C test performed to obtain baseline value within 28 days prior to sub-study randomization * Participants' most recent Zubrod performance status must be 0-1 and be documented within 28 days prior to sub-study randomization * Participants must have a completed medical history and physical exam within 28 days prior to sub-study randomization * Participants must have adequate cardiac function. Participants with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, must have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, participants must be class 2B or better * Participants with known human immunodeficiency virus (HIV)-infection must be on effective anti-retroviral therapy and have undetectable viral load test on the most recent test results obtained within 6 months prior to sub-study randomization * Participants with evidence of chronic hepatitis B virus (HBV) infection must have undetectable HBV viral load while on suppressive therapy on the most recent test results obtained within 6 months prior to sub-study randomization, if indicated by the treating investigator * Participants with a history of hepatitis C virus (HCV) infection must have been treated and cured. Participants currently being treated for HCV infection must have undetectable HCV viral load test on the most recent test results obtained within 6 months prior to sub-study randomization, if indicated by the treating investigator * Participants must not have cirrhosis at a level of Child-Pugh B (or worse) OR any degree of cirrhosis AND a history of hepatic encephalopathy or clinically meaningful ascites resulting from cirrhosis * Participants must not have grade \< 0 of peripheral edema within 28 days prior to sub-study randomization * Participants must not have experienced any arterial thromboembolic events, including but not limited to transient ischemic attack or cerebrovascular accident within 6 months prior to sub-study randomization * Participants must not have uncontrolled blood pressure and hypertension within 28 days prior to sub-study randomization * Participants must not be pregnant or breastfeeding (nursing includes breast milk fed to an infant by any means, including from the breast, milk expressed by hand, or pumped). Individuals who are of reproductive potential must have agreed to use an effective contraceptive method with details provided as a part of the consent process. A person who has had menses at any time in the preceding 12 consecutive months or who has semen likely to contain sperm is considered to be of "reproductive potential." In addition to routine contraceptive methods, "effective contraception" also includes refraining from sexual activity that might result in pregnancy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) including hysterectomy, bilateral oophorectomy, bilateral tubal ligation/occlusion, and vasectomy with testing showing no sperm in the semen * Participants must also be offered participation in specimen banking. With participant consent, specimens must be collected and submitted via the SWOG Specimen Tracking System * Participants must be informed of the investigational nature of this study and must sign and give informed consent in accordance with institutional and federal guidelines * NOTE: Participants with impaired decision-making capabilities, legally authorized representatives may sign and give informed consent on behalf of study participants in accordance with applicable federal, local, and Central Institutional Review Board (CIRB) regulations

Interventions

PROCEDURE

Biospecimen Collection

PROCEDURE

Computed Tomography

PROCEDURE

Lymphoscintigraphy

PROCEDURE

Magnetic Resonance Imaging

BIOLOGICAL

Ramucirumab

DRUG

Tepotinib

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Conditions

Recurrent Lung Non-Small Cell CarcinomaStage IV Lung Cancer AJCC v8

Locations

Gulf Health Hospitals Inc/Infirmary Cancer Care - Malbis

Daphne, Alabama 36526

United States

Thomas Hospital

Fairhope, Alabama 36532

United States

Mobile Infirmary Medical Center

Mobile, Alabama 36607

United States

Gulf Health Hospitals Inc/Infirmary Cancer Care - Saraland

Saraland, Alabama 36571

United States

NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro

Jonesboro, Arkansas 72401

United States

University of Arkansas for Medical Sciences

Little Rock, Arkansas 72205

United States

Kaiser Permanente-Anaheim

Anaheim, California 92806

United States

Sutter Auburn Faith Hospital

Auburn, California 95602

United States

Kaiser Permanente-Baldwin Park

Baldwin Park, California 91706

United States

Kaiser Permanente-Bellflower

Bellflower, California 90706

United States

Alta Bates Summit Medical Center-Herrick Campus

Berkeley, California 94704

United States

Tower Cancer Research Foundation

Beverly Hills, California 90211

United States

Kaiser Permanente-Fontana

Fontana, California 92335

United States

Palo Alto Medical Foundation-Fremont

Fremont, California 94538

United States

Kaiser Permanente South Bay

Harbor City, California 90710

United States

Kaiser Permanente-Irvine

Irvine, California 92618

United States

UC San Diego Moores Cancer Center

La Jolla, California 92093

United States

Kaiser Permanente Los Angeles Medical Center

Los Angeles, California 90027

United States

Kaiser Permanente West Los Angeles

Los Angeles, California 90034

United States

Cedars-Sinai Medical Center

Los Angeles, California 90048

United States

Memorial Medical Center

Modesto, California 95355

United States

Kaiser Permanente-Ontario

Ontario, California 91761

United States

Palo Alto Medical Foundation Health Care

Palo Alto, California 94301

United States

Kaiser Permanente - Panorama City

Panorama City, California 91402

United States

Eisenhower Medical Center

Rancho Mirage, California 92270

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

Kaiser Permanente-San Diego Zion

San Diego, California 92120

United States

California Pacific Medical Center-Pacific Campus

San Francisco, California 94115

United States

Kaiser Permanente-San Francisco

San Francisco, California 94115

United States

Kaiser Permanente-San Marcos

San Marcos, California 92078

United States

Mills Health Center

San Mateo, California 94401

United States

Palo Alto Medical Foundation-Santa Cruz

Santa Cruz, California 95065

United States

Sutter Pacific Medical Foundation

Santa Rosa, California 95403

United States

Palo Alto Medical Foundation-Sunnyvale

Sunnyvale, California 94086

United States

Cedars-Sinai Cancer - Tarzana

Tarzana, California 91356

United States

Torrance Memorial Physician Network - Cancer Care

Torrance, California 90505

United States

Kaiser Permanente-Vallejo

Vallejo, California 94589

United States

Sutter Solano Medical Center/Cancer Center

Vallejo, California 94589

United States

Kaiser Permanente-Woodland Hills

Woodland Hills, California 91367

United States

UCHealth University of Colorado Hospital

Aurora, Colorado 80045

United States

UCHealth Memorial Hospital Central

Colorado Springs, Colorado 80909

United States

Memorial Hospital North

Colorado Springs, Colorado 80920

United States

Poudre Valley Hospital

Fort Collins, Colorado 80524

United States

Cancer Care and Hematology-Fort Collins

Fort Collins, Colorado 80528

United States

UCHealth Greeley Hospital

Greeley, Colorado 80631

United States

Medical Center of the Rockies

Loveland, Colorado 80538

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

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

Bayhealth Hospital Kent Campus

Dover, Delaware 19901

United States

Bayhealth Hospital Sussex Campus

Milford, Delaware 19963

United States

Kaiser Permanente-Capitol Hill Medical Center

Washington D.C., District of Columbia 20002

United States

Moffitt Cancer Center

Tampa, Florida 33612

United States

University Cancer and Blood Center LLC

Athens, Georgia 30607

United States

Northeast Georgia Medical Center-Gainesville

Gainesville, Georgia 30501

United States

Saint Alphonsus Cancer Care Center-Boise

Boise, Idaho 83706

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 Alphonsus Cancer Care Center-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

Illinois CancerCare-Bloomington

Bloomington, Illinois 61704

United States

Illinois CancerCare-Canton

Canton, Illinois 61520

United States

Illinois CancerCare-Carthage

Carthage, Illinois 62321

United States

Northwestern University

Chicago, Illinois 60611

United States

John H Stroger Jr Hospital of Cook County

Chicago, Illinois 60612

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

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

Illinois CancerCare-Galesburg

Galesburg, Illinois 61401

United States

Northwestern Medicine Cancer Center Delnor

Geneva, Illinois 60134

United States

Northwestern Medicine Glenview Outpatient Center

Glenview, Illinois 60026

United States

Northwestern Medicine Grayslake Outpatient Center

Grayslake, Illinois 60030

United States

Edward Hines Jr VA Hospital

Hines, Illinois 60141

United States

Illinois CancerCare-Kewanee Clinic

Kewanee, Illinois 61443

United States

Northwestern Medicine Lake Forest Hospital

Lake Forest, Illinois 60045

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

Northwestern Medicine Oak Brook

Oak Brook, Illinois 60523

United States

Northwestern Medicine Orland Park

Orland Park, Illinois 60462

United States

Illinois CancerCare-Ottawa Clinic

Ottawa, Illinois 61350

United States

Illinois CancerCare-Pekin

Pekin, Illinois 61554

United States

Illinois CancerCare-Peoria

Peoria, Illinois 61615

United States

Illinois CancerCare-Peru

Peru, Illinois 61354

United States

Illinois CancerCare-Princeton

Princeton, Illinois 61356

United States

Memorial Hospital East

Shiloh, Illinois 62269

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

Illinois CancerCare - Washington

Washington, Illinois 61571

United States

Indiana University/Melvin and Bren Simon Cancer Center

Indianapolis, Indiana 46202

United States

Mary Greeley Medical Center

Ames, Iowa 50010

United States

McFarland Clinic - Ames

Ames, Iowa 50010

United States

UI Health Care Mission Cancer and Blood - Ankeny Clinic

Ankeny, Iowa 50023

United States

McFarland Clinic - Boone

Boone, Iowa 50036

United States

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

Clive, Iowa 50325

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

UI Health Care Mission Cancer and Blood - Laurel Clinic

Des Moines, Iowa 50314

United States

McFarland Clinic - Trinity Cancer Center

Fort Dodge, Iowa 50501

United States

McFarland Clinic - Jefferson

Jefferson, Iowa 50129

United States

McFarland Clinic - Marshalltown

Marshalltown, Iowa 50158

United States

UI Health Care Mission Cancer and Blood - Waukee Clinic

Waukee, Iowa 50263

United States

University of Kansas Clinical Research Center

Fairway, Kansas 66205

United States

HaysMed

Hays, Kansas 67601

United States

University of Kansas Cancer Center

Kansas City, Kansas 66160

United States

Lawrence Memorial Hospital

Lawrence, Kansas 66044

United States

The University of Kansas Cancer Center - Olathe

Olathe, Kansas 66061

United States

University of Kansas Cancer Center-Overland Park

Overland Park, Kansas 66210

United States

University of Kansas Hospital-Indian Creek Campus

Overland Park, Kansas 66211

United States

Salina Regional Health Center

Salina, Kansas 67401

United States

University of Kansas Health System Saint Francis Campus

Topeka, Kansas 66606

United States

University of Kansas Hospital-Westwood Cancer Center

Westwood, Kansas 66205

United States

University of Kentucky/Markey Cancer Center

Lexington, Kentucky 40536

United States

Lafayette Family Cancer Center-EMMC

Brewer, Maine 04412

United States

Kaiser Permanente-Woodlawn Medical Center

Baltimore, Maryland 21244

United States

Kaiser Permanente-Gaithersburg Medical Center

Gaithersburg, Maryland 20879

United States

Kaiser Permanente - Largo Medical Center

Largo, Maryland 20774

United States

Kaiser Permanente Lutherville - Timonium Medical Center

Lutherville, Maryland 21093

United States

UMass Memorial Medical Center - University Campus

Worcester, Massachusetts 01655

United States

Trinity Health Saint Joseph Mercy Hospital Ann Arbor

Ann Arbor, Michigan 48106

United States

Trinity Health IHA Medical Group Hematology Oncology - Brighton

Brighton, Michigan 48114

United States

Trinity Health Medical Center - Brighton

Brighton, Michigan 48114

United States

Trinity Health IHA Medical Group Hematology Oncology - Canton

Canton, Michigan 48188

United States

Trinity Health Medical Center - Canton

Canton, Michigan 48188

United States

Chelsea Hospital

Chelsea, Michigan 48118

United States

Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital

Chelsea, Michigan 48118

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

University of Michigan Health - Sparrow Lansing

Lansing, Michigan 48912

United States

Trinity Health Saint Mary Mercy Livonia Hospital

Livonia, Michigan 48154

United States

Trinity Health Saint Joseph Mercy Oakland Hospital

Pontiac, Michigan 48341

United States

MyMichigan Medical Center Saginaw

Saginaw, Michigan 48601

United States

Oncology Hematology Associates of Saginaw Valley PC

Saginaw, Michigan 48604

United States

MyMichigan Medical Center Tawas

Tawas City, Michigan 48764

United States

Saint Mary's Oncology/Hematology Associates of West Branch

West Branch, Michigan 48661

United States

Huron Gastroenterology PC

Ypsilanti, Michigan 48106

United States

Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus

Ypsilanti, Michigan 48197

United States

Sanford Joe Lueken Cancer Center

Bemidji, Minnesota 56601

United States

Essentia Health - Deer River Clinic

Deer River, Minnesota 56636

United States

Essentia Health Cancer Center

Duluth, Minnesota 55805

United States

Essentia Health Hibbing Clinic

Hibbing, Minnesota 55746

United States

Essentia Health Sandstone

Sandstone, Minnesota 55072

United States

Essentia Health Virginia Clinic

Virginia, Minnesota 55792

United States

Baptist Memorial Hospital and Cancer Center-Golden Triangle

Columbus, Mississippi 39705

United States

Baptist Cancer Center-Grenada

Grenada, Mississippi 38901

United States

Baptist Memorial Hospital and Cancer Center-Union County

New Albany, Mississippi 38652

United States

Baptist Memorial Hospital and Cancer Center-Oxford

Oxford, Mississippi 38655

United States

Baptist Memorial Hospital and Cancer Center-Desoto

Southhaven, Mississippi 38671

United States

Saint Francis Medical Center

Cape Girardeau, Missouri 63703

United States

Siteman Cancer Center at Saint Peters Hospital

City of Saint Peters, Missouri 63376

United States

Siteman Cancer Center at West County Hospital

Creve Coeur, Missouri 63141

United States

University Health Truman Medical Center

Kansas City, Missouri 64108

United States

Saint Luke's Hospital of Kansas City

Kansas City, Missouri 64111

United States

University of Kansas Cancer Center - Briarcliff

Kansas City, Missouri 64116

United States

University of Kansas Cancer Center - North

Kansas City, Missouri 64154

United States

University of Kansas Cancer Center - Lee's Summit

Lee's Summit, Missouri 64064

United States

Saint Luke's East - Lee's Summit

Lee's Summit, Missouri 64086

United States

University of Kansas Cancer Center at North Kansas City Hospital

North Kansas City, Missouri 64116

United States

Washington University School of Medicine

St Louis, Missouri 63110

United States

Mercy Hospital South

St Louis, Missouri 63128

United States

Siteman Cancer Center-South County

St Louis, Missouri 63129

United States

Siteman Cancer Center at Christian Hospital

St Louis, Missouri 63136

United States

Community Hospital of Anaconda

Anaconda, Montana 59711

United States

Billings Clinic Cancer Center

Billings, Montana 59101

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

Community Medical Center

Missoula, Montana 59804

United States

OptumCare Cancer Care at Charleston

Las Vegas, Nevada 89102

United States

OptumCare Cancer Care at Fort Apache

Las Vegas, Nevada 89183

United States

New Hampshire Oncology Hematology PA-Concord

Concord, New Hampshire 03301

United States

Solinsky Center for Cancer Care

Manchester, New Hampshire 03103

United States

Memorial Sloan Kettering Basking Ridge

Basking Ridge, New Jersey 07920

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

Virtua Voorhees

Voorhees Township, New Jersey 08043

United States

Memorial Sloan Kettering Commack

Commack, New York 11725

United States

Mary Imogene Bassett Hospital

Cooperstown, New York 13326

United States

Memorial Sloan Kettering Westchester

Harrison, New York 10604

United States

Memorial Sloan Kettering Cancer Center

New York, New York 10065

United States

University of Rochester

Rochester, New York 14642

United States

Memorial Sloan Kettering Nassau

Uniondale, New York 11553

United States

FirstHealth of the Carolinas-Moore Regional Hospital

Pinehurst, North Carolina 28374

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

Aultman Health Foundation

Canton, Ohio 44710

United States

Miami Valley Hospital South

Centerville, Ohio 45459

United States

Ohio State University Comprehensive Cancer Center

Columbus, Ohio 43210

United States

Miami Valley Hospital

Dayton, Ohio 45409

United States

Premier Blood and Cancer Center

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

ProMedica Flower Hospital

Sylvania, Ohio 43560

United States

Upper Valley Medical Center

Troy, Ohio 45373

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

Providence Newberg Medical Center

Newberg, Oregon 97132

United States

Saint Alphonsus Cancer Care Center-Ontario

Ontario, Oregon 97914

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

Kaiser Permanente Northwest

Portland, Oregon 97227

United States

Oregon Health and Science University

Portland, Oregon 97239

United States

WellSpan Medical Oncology and Hematology

Chambersburg, Pennsylvania 17201

United States

Geisinger Medical Center

Danville, Pennsylvania 17822

United States

Geisinger Cancer Center Dickson City

Dickson City, Pennsylvania 18519

United States

Ephrata Cancer Center

Ephrata, Pennsylvania 17522

United States

Adams Cancer Center

Gettysburg, Pennsylvania 17325

United States

Sechler Family Cancer Center

Lebanon, Pennsylvania 17042

United States

Geisinger Medical Oncology-Lewisburg

Lewisburg, Pennsylvania 17837

United States

Community Medical Center

Scranton, Pennsylvania 18510

United States

Geisinger Wyoming Valley/Henry Cancer Center

Wilkes-Barre, Pennsylvania 18711

United States

Cancer Care Associates of York

York, Pennsylvania 17403

United States

WellSpan Health-York Cancer Center

York, Pennsylvania 17403

United States

WellSpan Health-York Hospital

York, Pennsylvania 17403

United States

AnMed Health Cancer Center

Anderson, South Carolina 29621

United States

Medical University of South Carolina

Charleston, South Carolina 29425

United States

Sanford Cancer Center Oncology Clinic

Sioux Falls, South Dakota 57104

United States

Sanford USD Medical Center - Sioux Falls

Sioux Falls, South Dakota 57117-5134

United States

Baptist Memorial Hospital and Cancer Center-Collierville

Collierville, Tennessee 38017

United States

Baptist Memorial Hospital and Cancer Center-Memphis

Memphis, Tennessee 38120

United States

The Don and Sybil Harrington Cancer Center

Amarillo, Texas 79106

United States

Huntsman Cancer Institute/University of Utah

Salt Lake City, Utah 84112

United States

Kaiser Permanente Tysons Corner Medical Center

McLean, Virginia 22102

United States

Kaiser Permanente-Caton Hill Medical Center

Woodbridge, Virginia 22192

United States

Swedish Cancer Institute-Edmonds

Edmonds, Washington 98026

United States

Swedish Cancer Institute-Issaquah

Issaquah, Washington 98029

United States

Swedish Medical Center-First Hill

Seattle, Washington 98122

United States

Edwards Comprehensive Cancer Center

Huntington, West Virginia 25701

United States

West Virginia University Healthcare

Morgantown, West Virginia 26506

United States

Duluth Clinic Ashland

Ashland, Wisconsin 54806

United States

Marshfield Medical Center-EC Cancer Center

Eau Claire, Wisconsin 54701

United States

Gundersen Lutheran Medical Center

La Crosse, Wisconsin 54601

United States

Marshfield Medical Center-Marshfield

Marshfield, Wisconsin 54449

United States

Marshfield Medical Center - Minocqua

Minocqua, Wisconsin 54548

United States

Marshfield Medical Center-Rice Lake

Rice Lake, Wisconsin 54868

United States

Marshfield Medical Center-River Region at Stevens Point

Stevens Point, Wisconsin 54482

United States

Marshfield Medical Center - Weston

Weston, Wisconsin 54476

United States