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NCT06532279PHASE2Recruiting

Testing the Addition of the Drug BMX-001, a Radioprotector, or a Placebo to the Usual Chemoradiation Therapy for Patients With Head and Neck Cancer

NRG Oncology

Start Date

6/23/2025

Completion Date

1/1/2027

Summary

This phase II trial compares the effectiveness of adding BMX-001 to usual symptom management versus usual symptom management alone for reducing oral mucositis in patients who are receiving chemoradiation for head and neck cancer. Oral mucositis (inflammation and mouth sores) is a common side effect of chemoradiation that can cause pain and difficulty swallowing. Usual management of these side effects typically consists of using mouth rinses and pain medications during treatment and for several weeks after completion of treatment. BMX-001 neutralizes harmful substances in the body, preventing damage to macromolecules such as DNA and minimizes free radical-related toxicity in normal tissues. Adding BMX-001 to usual symptom management may be more effective than usual symptom management alone at reducing oral mucositis in patients receiving chemoradiation for head and neck cancer.

Detailed Description

PRIMARY OBJECTIVE: I. To compare the incidence of severe oral mucositis (SOM) between manganese superoxide dismutase (MnSOD) mimetic BMX-001 (BMX-001) and placebo, defined as \>= grade 3 per World Health Organization (WHO) criteria from the start of radiation through 4 weeks after completion of study treatment, with additional assessments at 6, 8 and 12 weeks after completion of study treatment. SECONDARY OBJECTIVES: I. To compare the duration of SOM in the BMX-001 arm versus (vs.) placebo arm. II. To assess the difference between arms in the Oral Mucositis Weekly Questionnaire-Head and Neck (OMWQ-HN) change score from baseline to 4 weeks after the end of chemoradiation. III. To describe the incidence and severity of xerostomia and radiation dermatitis, as measured by Common Terminology Criteria for Adverse Events (CTCAE) version (v)5.0, in both arms. IV. To compare the duration of radiation dermatitis in the BMX-001 arm vs. placebo arm. V. To describe toxicity, as measured by CTCAE v5.0 and Patient Reported Outcome (PRO)-CTCAE, in both arms. EXPLORATORY OBJECTIVES: I. To assess the between arm difference in progression-free survival (PFS). II. To assess the between arm difference in overall survival (OS). III. Data demonstrating improvement in pain, as measured by reduction in narcotic use between BMX-001 versus usual care. IV. Collect serum and plasma for future translational research analyses. OUTLINE: Patients are randomized to 1 of 2 arms. ARM 1: Patients receive cisplatin once weekly (QW) or once every 3 weeks (Q3W) and undergo image-guided intensity-modulated radiation therapy once daily (QD) 5 days per week for 7 weeks per standard of care (SOC). In addition to usual symptom management, patients receive placebo subcutaneously (SC) as early as 96 hours and no later than one hour prior to their first dose of radiation therapy, and as early as 96 hours and no later than 48 hours prior to first dose of cisplatin. Patients then receive placebo SC twice a week (BIW) for 8 weeks (16 doses). Patients also undergo computed tomography (CT) and/or magnetic resonance imaging (MRI) on study and may optionally undergo collection of blood, serum, and/or plasma throughout the study. ARM 2: Patients receive cisplatin QW or Q3W and undergo image-guided intensity-modulated radiation therapy QD 5 days per week for 7 weeks per SOC. In addition to usual symptom management, patients receive BMX-001 SC as early as 96 hours and no later than one hour prior to their first dose of radiation therapy, and as early as 96 hours and no later than 48 hours prior to first dose of cisplatin. Patients then receive BMX-001 SC BIW for 8 weeks (16 doses). Patients also undergo CT and/or MRI on study and may optionally undergo collection of blood, serum, and/or plasma throughout the study. After completion of study treatment, patients are followed up at 1, 2, 3, 6, 12, and 24 months.

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: * Patients must be planned to receive radiation and concurrent cisplatin chemotherapy as definitive therapy. Patients planned to receive concurrent cisplatin and radiation therapy in the adjuvant setting are not eligible. * At least two subsites (buccal mucosa, lips, retromolar trigone, floor of mouth, oral tongue, tonsil, soft palate, or hard palate) must have at least 1cc or 1% of the subsite volume receiving \>= 50 Gy. In cases of uncertainty, the enrolling clinician can ensure coverage by inspecting the 50 Gy isodose line and using the table describing the anatomic boundaries of the individual subsites contained within the extended cavity contour. The two or more subsites receiving \>= 50 Gy must be documented by the enrolling physician. * Pathologically confirmed (histologically or cytologically) squamous cell carcinoma of the oropharynx, larynx, hypopharynx, nasopharynx, or oral cavity. * P16 and/or human papillomavirus (HPV) status (via polymerase chain reaction \[PCR\] or in situ hybridization \[ISH\]) must be documented for patients with oropharynx cancer. * No patients with T0/Tx/unknown primary disease. * No definitive clinical or radiologic evidence of metastatic (M1) disease related to current diagnosis. * Able to receive intensity-modulated radiation therapy (IMRT) delivered as daily fractions of 2.0 Gy once per weekday with a cumulative radiation dose of 70 Gy. * Age \>= 18. * Zubrod performance status of 0-2. * Potassium ≥ institutional lower limit of normal (LLN) and magnesium ≥ institutional LLN. Oral or intravenous (IV) replacement therapy of potassium or magnesium is permitted if parameters can be met after repletion. * Absolute neutrophil count (ANC) \>= 1,500 cells/mm\^3. * Platelets \>= 100,000 cells/mm\^3. * Hemoglobin \>= 9.0 g/dl (Note: The use of transfusion or other intervention to achieve hemoglobin \[Hgb\] \>= 10.0 g/dl is acceptable). * Adequate renal function defined as creatinine clearance (CrCL) \> 50 mL/min by the Cockcroft-Gault formula. * Total bilirubin =\< 2 x institutional upper limit of normal (ULN) (not applicable to patients with known Gilbert's syndrome). * Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase \[SGOT\]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 3 x institutional ULN. * No prior radiotherapy that would result in overlap of radiation treatment fields with planned treatment for study cancer, e.g., breast cancer with irradiation of the supraclavicular fossa/level 4 neck. * No concurrent treatment with nitrates or other drugs that may, in the judgment of the treating investigator, create a risk for a precipitous decrease in blood pressure. * No prior history of gross total excision of both primary and nodal disease; this includes tonsillectomy, local excision of primary site, and nodal excision that removes all clinically and radiographically evident disease. In other words, to participate in this protocol, the patient must have clinically or radiographically evident gross disease for which disease response can be assessed. * No current treatment of adjuvant post-operative (op) chemoradiation. * No systemic treatment with inducers or strong inhibitors of cytochrome P450 =\< 4 days before registration. Note: Patients undergoing steroid treatment as a component of the anti-emetic regimen for cisplatin are eligible for the study. Treatment with the antifungal medications, nystatin, fluconazole , miconazole and clotrimazole are allowed. * No prior induction chemotherapy treatment. * No prior unrelated malignancy requiring current active treatment with the exception of cervical carcinoma in situ, basal cell skin carcinoma, resected T1-2N0M0 differentiated thyroid cancers, Ta bladder cancers, or low risk prostate cancer. * No clinically significant hearing impairment that precludes cisplatin, as per physician assessment. * No serious cardiovascular disease or cerebrovascular disease in the last 6 months prior to study enrollment; defined as a cerebrovascular accident, myocardial infarction, unstable angina, serious cardiac arrhythmia uncontrolled by medication or with the potential to interfere with protocol treatment, or current New York Heart Association (NYHA) grade II or greater congestive heart failure (CHF), or admission within last 6 months for CHF exacerbation; (Note: Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification). * No valvular heart disease. * No significant vascular disease (e.g., aortic aneurysm requiring surgical repair or recent arterial thrombosis) within 6 months prior to enrollment. * No history or evidence upon physical/neurological examination of central nervous system disease (e.g., seizures) unrelated to cancer unless adequately controlled by medication. * No acute bacterial, viral, or fungal infection requiring intravenous antimicrobials within 7 days of enrollment. * No history of chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy within 30 days of registration. * No known personal or family history of long QT Syndrome; no marked baseline prolongation of QT/corrected QT (QTc) interval (i.e., ≥ 2 electrocardiograms \[EKGs\] in prior 3 months of a QTc interval \> 450 milliseconds (ms) for males and \> 470 ms for females using the specific/usual choice by clinical center for correction factor. * Persistent grade 3-4 (CTCAE version 5.0) electrolyte abnormalities must be reversible to ≤ grade 1 with supplementation. * No poorly controlled hypertension (systolic blood pressure \[SBP\] \> 160 and/or diastolic blood pressure \[DBP\] \> 95) over 2 repeated measures within 30 days prior to registration. * No grade \>= 2 oral mucositis per CTCAE version 5.0. * No grade \>= 2 hypotension per CTCAE v. 5.0. * No medical necessity for anti-arrhythmics with significant risk of QTc prolongation such as class I and class III anti-arrhythmics. These include but are not limited to amiodarone, quinidine, dofetilide, sotalol, flecainide, and lidocaine. * No medical necessity for medications listed as prohibited. * For standard management of oral mucositis, clinicians may consult the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for the Management of Mucositis Secondary to Cancer Therapy. The only intervention against mucositis that is supported by level I evidence is low-level laser therapy (LLLT). Honey is rated at level II and benzydamine, which isn't available in the United States (US), is rated at level III. There are no other positively rated interventions. * LLLT is prohibited in this study as its availability remains limited, it is not Food and Drug Administration (FDA) approved in the US, and it is considered investigational in many circumstances requiring enrollment in a dedicated protocol who requirements could conflict with this one. Therefore, institutions that use LLLT should only enroll patients who would not be eligible for (or do not want) that intervention. Honey is not on the list of prohibited medications for this study. Given the MASCC recommendation, benzydamine is allowed, although there is lack of availability in the United States of America (USA). The other listed prohibited medications are not recommended by MASCC and some are potentially harmful, such as glutamine, which is associated with mortality in patients receiving stem cell transplant. * No history of allergic reaction to the study agent(s), compounds of similar chemical or biologic composition to the study agent (s) (or any of its excipients). * Childbearing potential is defined as any person who has experienced menarche and who has not undergone surgical sterilization (hysterectomy or bilateral oophorectomy) or who is not postmenopausal.

Interventions

OTHER

Best Practice

PROCEDURE

Biospecimen Collection

DRUG

Cisplatin

PROCEDURE

Computed Tomography

RADIATION

Image Guided Radiation Therapy

RADIATION

Intensity-Modulated Radiation Therapy

PROCEDURE

Magnetic Resonance Imaging

DRUG

MnSOD Mimetic BMX-001

DRUG

Placebo Administration

OTHER

Questionnaire Administration

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Conditions

Clinical Stage I HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8Clinical Stage II HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8Clinical Stage III HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8Head and Neck Squamous Cell CarcinomaHypopharyngeal Squamous Cell CarcinomaLaryngeal Squamous Cell CarcinomaNasopharyngeal Squamous Cell CarcinomaOral Cavity Squamous Cell CarcinomaOropharyngeal Squamous Cell CarcinomaStage 0 Head and Neck Cutaneous Squamous Cell Carcinoma AJCC v8Stage 0 Hypopharyngeal Carcinoma AJCC v8Stage 0 Nasopharyngeal Carcinoma AJCC v8Stage 0 Oropharyngeal (p16-Negative) Carcinoma AJCC v8Stage I Head and Neck Cutaneous Squamous Cell Carcinoma AJCC v8Stage I Hypopharyngeal Carcinoma AJCC v8Stage I Laryngeal Cancer AJCC v8Stage I Lip and Oral Cavity Cancer AJCC v8Stage I Nasopharyngeal Carcinoma AJCC v8Stage I Oropharyngeal (p16-Negative) Carcinoma AJCC v8Stage II Head and Neck Cutaneous Squamous Cell Carcinoma AJCC v8Stage II Hypopharyngeal Carcinoma AJCC v8Stage II Laryngeal Cancer AJCC v8Stage II Lip and Oral Cavity Cancer AJCC v8Stage II Nasopharyngeal Carcinoma AJCC v8Stage II Oropharyngeal (p16-Negative) Carcinoma AJCC v8Stage III Head and Neck Cutaneous Squamous Cell Carcinoma AJCC v8Stage III Hypopharyngeal Carcinoma AJCC v8Stage III Laryngeal Cancer AJCC v8Stage III Lip and Oral Cavity Cancer AJCC v8Stage III Nasopharyngeal Carcinoma AJCC v8Stage III Oropharyngeal (p16-Negative) Carcinoma AJCC v8Stage IVA Hypopharyngeal Carcinoma AJCC v8Stage IVA Laryngeal Cancer AJCC v8Stage IVA Lip and Oral Cavity Cancer AJCC v8Stage IVA Nasopharyngeal Carcinoma AJCC v8Stage IVA Oropharyngeal (p16-Negative) Carcinoma AJCC v8Stage IVB Hypopharyngeal Carcinoma AJCC v8Stage IVB Laryngeal Cancer AJCC v8Stage IVB Lip and Oral Cavity Cancer AJCC v8Stage IVB Oropharyngeal (p16-Negative) Carcinoma AJCC v8Stomatitis

Locations

Arizona Center for Cancer Care - Gilbert

Gilbert, Arizona 85297

United States

Arizona Center for Cancer Care-Peoria

Peoria, Arizona 85381

United States

Arizona Center for Cancer Care - Phoenix

Phoenix, Arizona 85027

United States

Arizona Center for Cancer Care - Scottsdale

Scottsdale, Arizona 85258

United States

Arizona Center for Cancer Care-Surprise

Surprise, Arizona 85374

United States

Arizona Center for Cancer Care

Tempe, Arizona 85284

United States

NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro

Jonesboro, Arkansas 72401

United States

Keck Medicine of USC Buena Park

Buena Park, California 90621

United States

UC San Diego Health System - Encinitas

Encinitas, California 92024

United States

UC San Diego Moores Cancer Center

La Jolla, California 92093

United States

Los Angeles General Medical Center

Los Angeles, California 90033

United States

USC / Norris Comprehensive Cancer Center

Los Angeles, California 90033

United States

USC Norris Oncology/Hematology-Newport Beach

Newport Beach, California 92663

United States

UC San Diego Medical Center - Hillcrest

San Diego, California 92103

United States

Shaw Cancer Center

Edwards, Colorado 81632

United States

George Washington University Medical Center

Washington D.C., District of Columbia 20037

United States

Sarasota Memorial Hospital-Venice

N. Venice, Florida 34275

United States

Moffitt Cancer Center at SouthShore

Ruskin, Florida 33570

United States

Florida Cancer Specialists - Sarasota

Sarasota, Florida 34232

United States

Florida Cancer Specialists - Sarasota Downtown

Sarasota, Florida 34239

United States

Sarasota Memorial Hospital

Sarasota, Florida 34239

United States

Sarasota Memorial Health Care Center at University Parkway

Sarasota, Florida 34243

United States

Moffitt Cancer Center-International Plaza

Tampa, Florida 33607

United States

Moffitt Cancer Center - McKinley Campus

Tampa, Florida 33612

United States

Moffitt Cancer Center

Tampa, Florida 33612

United States

Florida Cancer Specialists - Venice Pinebrook

Venice, Florida 34275

United States

Moffitt Cancer Center at Wesley Chapel

Wesley Chapel, Florida 33544

United States

OSF Saint Joseph Medical Center

Bloomington, Illinois 61701

United States

Illinois CancerCare-Bloomington

Bloomington, Illinois 61704

United States

Illinois CancerCare-Canton

Canton, Illinois 61520

United States

Northwestern University

Chicago, Illinois 60611

United States

Carle at The Riverfront

Danville, Illinois 61832

United States

Northwestern Medicine Cancer Center Kishwaukee

DeKalb, Illinois 60115

United States

Carle Physician Group-Effingham

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

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

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

OSF Saint Francis Medical Center

Peoria, Illinois 61637

United States

Illinois CancerCare-Peru

Peru, Illinois 61354

United States

Illinois CancerCare-Princeton

Princeton, Illinois 61356

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

Baptist Health Floyd

New Albany, Indiana 47150

United States

McFarland Clinic - Ames

Ames, Iowa 50010

United States

UI Health Care Mission Cancer and Blood - Ankeny Clinic

Ankeny, Iowa 50023

United States

Mercy Hospital

Cedar Rapids, Iowa 52403

United States

Oncology Associates at Mercy Medical Center

Cedar Rapids, Iowa 52403

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

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

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

University of Kansas Cancer Center

Kansas City, Kansas 66160

United States

Salina Regional Health Center

Salina, Kansas 67401

United States

University of Kansas Hospital-Westwood Cancer Center

Westwood, Kansas 66205

United States

Baptist Health Hardin

Elizabethtown, Kentucky 42701

United States

Greater Baltimore Medical Center

Baltimore, Maryland 21204

United States

Boston Medical Center

Boston, Massachusetts 02118

United States

McLaren Cancer Institute-Bay City

Bay City, Michigan 48706

United States

McLaren Cancer Institute-Clarkston

Clarkston, Michigan 48346

United States

Wayne State University/Karmanos Cancer Institute

Detroit, Michigan 48201

United States

Weisberg Cancer Treatment Center

Farmington Hills, Michigan 48334

United States

McLaren Cancer Institute-Flint

Flint, Michigan 48532

United States

Karmanos Cancer Institute at McLaren Greater Lansing

Lansing, Michigan 48910

United States

McLaren Cancer Institute-Lapeer Region

Lapeer, Michigan 48446

United States

McLaren Cancer Institute-Macomb

Mount Clemens, Michigan 48043

United States

McLaren Cancer Institute-Central Michigan

Mount Pleasant, Michigan 48858

United States

McLaren Cancer Institute-Northern Michigan

Petoskey, Michigan 49770

United States

McLaren-Port Huron

Port Huron, Michigan 48060

United States

Miller-Dwan Hospital

Duluth, Minnesota 55805

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

Lake Regional Hospital

Osage Beach, Missouri 65065

United States

Renown Regional Medical Center

Reno, Nevada 89502

United States

Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center

Lebanon, New Hampshire 03756

United States

University of New Mexico Cancer Center

Albuquerque, New Mexico 87106

United States

Montefiore Medical Center-Einstein Campus

The Bronx, New York 10461

United States

Montefiore Medical Center - Moses Campus

The Bronx, New York 10467

United States

Atrium Health Stanly/LCI-Albemarle

Albemarle, North Carolina 28002

United States

Carolinas Medical Center/Levine Cancer Institute

Charlotte, North Carolina 28203

United States

Atrium Health Pineville/LCI-Pineville

Charlotte, North Carolina 28210

United States

Atrium Health University City/LCI-University

Charlotte, North Carolina 28262

United States

Atrium Health Cabarrus/LCI-Concord

Concord, North Carolina 28025

United States

Duke University Medical Center

Durham, North Carolina 27710

United States

CaroMont Regional Medical Center

Gastonia, North Carolina 28054

United States

Levine Cancer Institute-Gaston

Gastonia, North Carolina 28054

United States

Hayworth Cancer Center

High Point, North Carolina 27262

United States

Atrium Health Union/LCI-Union

Monroe, North Carolina 28112

United States

Atrium Health Cleveland/LCI-Cleveland

Shelby, North Carolina 28150

United States

Wake Forest University Health Sciences

Winston-Salem, North Carolina 27157

United States

Summa Health System - Akron Campus

Akron, Ohio 44304

United States

Aultman Health Foundation

Canton, Ohio 44710

United States

University of Cincinnati Cancer Center-UC Medical Center

Cincinnati, Ohio 45219

United States

Ohio State University Comprehensive Cancer Center

Columbus, Ohio 43210

United States

University of Cincinnati Cancer Center-West Chester

West Chester, Ohio 45069

United States

University of Oklahoma Health Sciences Center

Oklahoma City, Oklahoma 73104

United States

Chambersburg Hospital

Chambersburg, Pennsylvania 17201

United States

Ephrata Cancer Center

Ephrata, Pennsylvania 17522

United States

UPMC Hillman Cancer Center Erie

Erie, Pennsylvania 16505

United States

UPMC Cancer Center at UPMC Horizon

Farrell, Pennsylvania 16121

United States

Adams Cancer Center

Gettysburg, Pennsylvania 17325

United States

UPMC Cancer Centers - Arnold Palmer Pavilion

Greensburg, Pennsylvania 15601

United States

UPMC Pinnacle Cancer Center/Community Osteopathic Campus

Harrisburg, Pennsylvania 17109

United States

Penn State Milton S Hershey Medical Center

Hershey, Pennsylvania 17033-0850

United States

Sechler Family Cancer Center

Lebanon, Pennsylvania 17042

United States

UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion

Mechanicsburg, Pennsylvania 17050

United States

UPMC Cancer Center - Monroeville

Monroeville, Pennsylvania 15146

United States

UPMC Hillman Cancer Center - Monroeville

Monroeville, Pennsylvania 15146

United States

UPMC Hillman Cancer Center - New Castle

New Castle, Pennsylvania 16105

United States

UPMC-Saint Margaret

Pittsburgh, Pennsylvania 15215

United States

University of Pittsburgh Cancer Institute (UPCI)

Pittsburgh, Pennsylvania 15232

United States

UPMC-Shadyside Hospital

Pittsburgh, Pennsylvania 15232

United States

UPMC-Passavant Hospital

Pittsburgh, Pennsylvania 15237

United States

UPMC-Saint Clair Hospital Cancer Center

Pittsburgh, Pennsylvania 15243

United States

WellSpan Health-York Cancer Center

York, Pennsylvania 17403

United States

Lancaster Radiation Therapy Center

Lancaster, South Carolina 29720

United States

Rock Hill Radiation Therapy Center

Rock Hill, South Carolina 29730

United States

Levine Cancer Institute-Rock Hill

Rock Hill, South Carolina 29732

United States

Baptist Memorial Hospital and Cancer Center-Collierville

Collierville, Tennessee 38017

United States

University of Tennessee - Knoxville

Knoxville, Tennessee 37920

United States

Baptist Memorial Hospital and Cancer Center-Memphis

Memphis, Tennessee 38120

United States

Dartmouth Cancer Center - North

Saint Johnsbury, Vermont 05819

United States

VCU Massey Cancer Center at Stony Point

Richmond, Virginia 23235

United States

VCU Massey Comprehensive Cancer Center

Richmond, Virginia 23298

United States

Langlade Hospital and Cancer Center

Antigo, Wisconsin 54409

United States

Northwest Wisconsin Cancer Center

Ashland, Wisconsin 54806

United States

Froedtert Menomonee Falls Hospital

Menomonee Falls, Wisconsin 53051

United States

Medical College of Wisconsin

Milwaukee, Wisconsin 53226

United States

Zablocki Veterans Administration Medical Center

Milwaukee, Wisconsin 53295

United States

ProHealth D N Greenwald Center

Mukwonago, Wisconsin 53149

United States

Drexel Town Square Health Center

Oak Creek, Wisconsin 53154

United States

ProHealth Oconomowoc Memorial Hospital

Oconomowoc, Wisconsin 53066

United States

Aspirus Cancer Care - James Beck Cancer Center

Rhinelander, Wisconsin 54501

United States

Aspirus Cancer Care - Stevens Point

Stevens Point, Wisconsin 54481

United States

UW Cancer Center at ProHealth Care

Waukesha, Wisconsin 53188

United States

Aspirus Regional Cancer Center

Wausau, Wisconsin 54401

United States

Froedtert West Bend Hospital/Kraemer Cancer Center

West Bend, Wisconsin 53095

United States

Aspirus Cancer Care - Wisconsin Rapids

Wisconsin Rapids, Wisconsin 54494

United States