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NCT06616584PHASE2, PHASE3Recruiting

Adding the Immunotherapy Drug Cemiplimab to Usual Treatment for People With Advanced Non-Small Cell Lung Cancer Who Had Previous Treatment With Platinum Chemotherapy and Immunotherapy (An Expanded Lung-MAP Treatment Trial)

SWOG Cancer Research Network

Start Date

5/22/2025

Completion Date

12/31/2028

Summary

This phase II/III Expanded Lung-MAP treatment trial compares the effect of adding cemiplimab to docetaxel and ramucirumab versus docetaxel and ramucirumab alone in treating patients with non-small cell lung cancer that is stage IV or that has come back after a period of improvement (recurrent). Cemiplimab is a monoclonal antibody that stimulates the immune system by blocking the PD-1 pathway. Tumors use the PD-1 pathway to escape attacks from the immune system. By blocking the PD-1 pathway, cemiplimab may help the immune system recognize and attack tumor cells. Docetaxel is in a class of medications called taxanes. It stops tumor cells from growing and dividing and may kill them. Ramucirumab is a monoclonal antibody that may prevent the growth of new blood vessels that tumors need to grow. Adding cemiplimab to usual treatment, docetaxel and ramucirumab, may kill more tumor cells compared to docetaxel and ramucirumab alone in treating patients with stage IV or recurrent non-small cell lung cancer.

Detailed Description

PRIMARY OBJECTIVE: I. To compare overall survival (OS) between participants randomized to docetaxel and ramucirumab with or without cemiplimab (REGN2810) who have acquired resistance to platinum-based chemotherapy and immunotherapy for stage IV or recurrent non-small cell lung cancer (NSCLC). SECONDARY OBJECTIVES: I. To compare investigator-assessed progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 between the arms. II. To compare investigator-assessed response rates (confirmed or unconfirmed, complete response \[CR\] or partial response \[PR\]) per RECIST 1.1 between the arms among participants with measurable disease. III. To compare the investigator-assessed disease control rate (confirmed or unconfirmed, complete response \[CR\], or partial response \[PR\], and stable disease) between the arms. IV. To evaluate the duration of response (DoR) among responders within each arm. V. To evaluate the frequency and severity of toxicities within each arm. VI. To compare investigator-assessed PFS between the arms within the subgroups defined by the stratification factors (histology and performance status) and by PD-L1 subgroups defined as PD-L1 negative (\< 1% tumor proportion score \[TPS\]), intermediate PD-L1 (1-49% TPS), and PD-L1 high (\>= 50% TPS). VII. To compare OS between the arms within the subgroups defined by the stratification factors (histology and performance status) and by PD-L1 subgroups defined as PD-L1 negative (\< 1% TPS), intermediate PD-L1 (1-49% TPS), and PD-L1 high (\>= 50% TPS). TRANSLATIONAL MEDICINE OBJECTIVES: I. To collect, process, and bank cell-free deoxyribonucleic acid (cfDNA) at baseline, cycle 3 day 1, and progression for future development of a proposal to evaluate comprehensive next-generation sequencing of circulating tumor DNA (ctDNA). II. To establish a tissue/blood repository to pursue future studies. OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients receive dexamethasone orally (PO) twice daily (BID) on days 0-2, ramucirumab intravenously (IV) over 30-60 minutes on day 1 and docetaxel IV over 60 minutes on day 1 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo blood sample collection, and computed tomography (CT) or magnetic resonance imaging (MRI) throughout the study. ARM II: Patients receive dexamethasone PO BID on days 0-2, ramucirumab IV over 30-60 minutes on day 1, docetaxel IV over 60 minutes on day 1, and cemiplimab IV over 30 minutes on day 1 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo blood sample collection, and CT or MRI throughout the study. After completion of study treatment, patients are followed up every 3-6 months for up to 3 years after randomization.

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: * Participants must have been assigned to S1800E by the Southwest Oncology Group (SWOG) Statistics and Data Management Center (SDMC). Assignment to S1800E is determined by the LUNGMAP protocol * Participants must have measurable or non-measurable disease documented by CT or MRI. The CT from a combined positron emission tomography (PET)/CT may be used to document only non-measurable disease unless it is of diagnostic quality. Measurable disease must be assessed within 28 days prior to 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 randomization. All 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 registration * Participants must have a CT or MRI scan of the brain to evaluate for central nervous system (CNS) disease within 42 days prior to randomization * Participants must have received exactly one anti-PD-1 or anti-PD-L1 therapy for advanced disease (stage IV or recurrent disease, or stage I-III disease in certain circumstances outlined below). Anti-PD-1 or anti-PD-L1 therapy may have been given alone or in combination with other therapy. For participants who received neoadjuvant, adjuvant, and/or consolidation anti-PD-1 or anti-PD-L1 therapy for stage I-III disease: * If they experienced disease progression within (≤) 365 days from initiation (cycle 1 day 1) or anti-PD-1 or anti-PD-L1 therapy, this counts as the single allowed anti-PD-1 or anti-PD-L1 therapy for advanced disease * If they experienced disease progression more than (\>) 365 days from initiation (cycle 1 day 1) or anti-PD-1 or anti-PD-L1 therapy, this is not considered anti-PD-1 or anti-PD-L1 therapy for advance disease. These participants must have received anti-PD-1 or anti-PD-L1 therapy for stage IV or recurrent disease * Participants must have experienced disease progression (in the opinion of the treating investigator) more than (\>) 84 days following initiation (cycle 1 day 1) of their most recent anti-PD-1 or anti-PD-L1 therapy * Participants who received anti-PD-1 or anti-PD-L1 therapy for stage IV or recurrent disease must have had a best response of stable disease, partial response or complete response (in the opinion of the treating investigator) on the anti-PD-1 or anti-PD-L1 therapy for stage IV or recurrent disease * Participants must have received platinum-based chemotherapy and experienced disease progression (in the opinion of the treating investigator) during or after this regimen * Participants with a known sensitizing molecular alteration for which a Food and Drug Administration (FDA)-approved targeted therapy for NSCLC exists (e.g., EGFR, ALK, ROS1, BRAF, RET, NTRK, KRAS, HER2, and MET sensitizing mutations), must have previously received at least one of the approved therapy(s). Prior targeted therapy for participants with targetable alterations is allowed if all other eligibility criteria are also met * Participants must have recovered (≤ grade 1) from any side effects from the most recent anti-cancer treatment prior to randomization * Participants must not have received prior therapy with docetaxel for this disease * Participants must not have received any palliative radiation therapy within 14 days (or palliative bone radiation therapy within 7 days) prior to randomization * Participants must not be planning to receive any concurrent chemotherapy, immunotherapy, or biologic therapy for cancer treatment while receiving treatment on this study * Participants must not have undergone major surgery within 28 days prior to randomization, or subcutaneous venous access device placement within 7 days prior to randomization. Participants must not have postoperative bleeding complications or wound complications from a surgical procedure performed within 2 months prior to randomization. The participant must not have elective or planned major surgery to be performed during the course of this study * Absolute neutrophil count ≥ 1.5 x 10\^3/uL (within 28 days prior to randomization) * Hemoglobin ≥ 9.0 g/dL (within 28 days prior to randomization) * Platelets ≥ 100 x 10\^3/uL (within 28 days prior to randomization) * Total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN) (within 28 days prior to randomization) unless history of Gilbert's disease. Participants with history of Gilbert's disease must have total bilirubin ≤ 5 x institutional ULN * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3 x institutional ULN (within 28 days prior to randomization). Participants with history of liver metastasis must have AST and ALT ≤ 5 x ULN * Participants must have a creatinine ≤ the institutional (I)ULN or calculated creatinine clearance ≥ 50 mL/min using the following Cockcroft-Gault formula. This specimen must have been drawn and processed within 28 days prior to randomization * Participants must have a urinary protein test performed within 28 days prior to randomization * Participants' most recent Zubrod/Eastern Cooperative Oncology Group (ECOG) performance status must be 0-1 and be documented within 28 days prior to randomization * Participants must have a completed medical history and physical exam within 28 days prior to 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 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 randomization, if indicated by the treating investigator * Participants with known human immunodeficiency virus (HIV) infection are eligible, provided they are on effective anti-retroviral therapy and have undetectable viral load at their most recent viral load test and within 6 months prior to randomization * Participants must not have a prior or concurrent malignancy whose natural history or treatment has the potential to interfere with the safety or efficacy assessment of the investigational regimen * Participants must not have an active autoimmune disease that has required systemic treatment within 730 days prior to randomization (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is allowed * Participants must not have any history of primary immunodeficiency * Participants must be able to safely receive study therapy and must not have experienced the following: * Any grade 3 or worse immune-mediated adverse event. Exception: asymptomatic nonbullous/nonexfoliative rash * Any unresolved grade 2 immune-mediated adverse event * Any toxicity that led to permanent discontinuation of prior anti-PD-1/PD-L1 immunotherapy * Exception to the above: Toxicities of any grade that requires replacement therapy and has stabilized on therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) are allowed * Participants must not have any history of organ transplant that requires use of immunosuppressives * Participants must not have received a live or live attenuated vaccine within 28 days prior to randomization. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, varicella/zoster, yellow fever rabies, Bacillus Calmette-Guerin (BCG) and typhoid vaccine. Seasonal influenza vaccines and COVID-19 vaccines are allowed, however, intranasal influenza vaccines (e.g. Flu-Mist) are live attenuated and are not allowed * Participants must not have clinical signs or symptoms of active tuberculosis infection * Participants must not have a history of (non-infectious) pneumonitis that required steroids or current pneumonitis/interstitial lung disease * Participants must not have had a serious or nonhealing wound, ulcer, or bone fracture within 28 days prior to randomization * Participants must not have a history of gastrointestinal perforation or fistula within 6 months prior to randomization * Participants must not have grade 3-4 gastrointestinal bleeding (defined by National Cancer Institute \[NCI\] Common Terminology Criteria for Adverse Events \[CTCAE\] version \[v\]5) within 3 months prior to randomization. No history of gastrointestinal (GI) bleed within 3 months prior to randomization * Participants must not have any grade III/IV cardiac disease as defined by the New York Heart Association criteria (i.e., participants with cardiac disease resulting in marked limitation of physical activity or resulting in inability to carry on any physical activity without discomfort), unstable angina pectoris, and myocardial infarction within 6 months prior to randomization, or serious uncontrolled cardiac arrhythmia * Participants must not have experienced any arterial thromboembolic events, including but not limited to myocardial infarction, transient ischemic attack, cerebrovascular accident, or unstable angina, within 6 months prior to randomization * Participants must not have gross hemoptysis within two months prior to randomization (defined as bright red blood or ≥ 1/2 teaspoon) or with radiographic evidence of intratumor cavitation or has radiologically documented evidence of major blood vessel invasion or encasement by cancer * Participants must not have been diagnosed with venous thrombosis within 3 months prior to randomization. Participants with venous thrombosis diagnosed more than 3 months prior to randomization must be on stable doses of anticoagulants * Participants must not have cirrhosis at a level of Child-Pugh B (or worse) AND a history of hepatic encephalopathy or clinically meaningful ascites resulting from cirrhosis, OR any degree of cirrhosis * 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 agree to have blood specimens submitted for circulating tumor DNA (ctDNA) * Participants must be offered participation in specimen banking. With participant consent, specimens must be collected and submitted via the SWOG specimen tracking system * NOTE: As a part of the Oncology Patient Enrollment Network (OPEN) registration process the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the 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

BIOLOGICAL

Cemiplimab

PROCEDURE

Computed Tomography

DRUG

Dexamethasone

DRUG

Docetaxel

PROCEDURE

Magnetic Resonance Imaging

BIOLOGICAL

Ramucirumab

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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

Katmai Oncology Group

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

NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro

Jonesboro, Arkansas 72401

United States

Kaiser Permanente-Anaheim

Anaheim, California 92806

United States

Kaiser Permanente-Baldwin Park

Baldwin Park, California 91706

United States

Kaiser Permanente-Bellflower

Bellflower, California 90706

United States

Tower Cancer Research Foundation

Beverly Hills, California 90211

United States

Enloe Medical Center

Chico, California 95926

United States

City of Hope Comprehensive Cancer Center

Duarte, California 91010

United States

Kaiser Permanente-Fontana

Fontana, California 92335

United States

Kaiser Permanente Fresno Orchard Plaza

Fresno, California 93720

United States

Kaiser Permanente-Fresno

Fresno, California 93720

United States

Kaiser Permanente South Bay

Harbor City, California 90710

United States

City of Hope at Irvine Lennar

Irvine, California 92618

United States

Kaiser Permanente-Irvine

Irvine, California 92618

United States

UC San Diego Moores Cancer Center

La Jolla, California 92093

United States

City of Hope Antelope Valley

Lancaster, California 93534

United States

Loma Linda University Medical Center

Loma Linda, California 92354

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

Fremont - Rideout Cancer Center

Marysville, California 95901

United States

Mather Veteran Affairs Medical Center

Mather, California 95655

United States

Kaiser Permanente-Oakland

Oakland, California 94611

United States

Kaiser Permanente-Ontario

Ontario, California 91761

United States

VA Palo Alto Health Care System

Palo Alto, California 94304

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

Kaiser Permanente-Roseville

Roseville, California 95661

United States

Kaiser Permanente Downtown Commons

Sacramento, California 95814

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

Kaiser Permanente-San Francisco

San Francisco, California 94115

United States

Veterans Affairs Medical Center - San Francisco

San Francisco, California 94121

United States

Kaiser Permanente-Santa Teresa-San Jose

San Jose, California 95119

United States

Kaiser Permanente San Leandro

San Leandro, California 94577

United States

Kaiser Permanente-San Marcos

San Marcos, California 92078

United States

Mills Health Center

San Mateo, California 94401

United States

Kaiser San Rafael-Gallinas

San Rafael, California 94903

United States

Kaiser Permanente Medical Center - Santa Clara

Santa Clara, California 95051

United States

Kaiser Permanente-South San Francisco

South San Francisco, California 94080

United States

Cedars-Sinai Cancer - Tarzana

Tarzana, California 91356

United States

City of Hope South Bay

Torrance, California 90503

United States

Torrance Memorial Physician Network - Cancer Care

Torrance, California 90505

United States

Gene Upshaw Memorial Tahoe Forest Cancer Center

Truckee, California 96161

United States

City of Hope Upland

Upland, California 91786

United States

Kaiser Permanente-Vallejo

Vallejo, California 94589

United States

Kaiser Permanente-Walnut Creek

Walnut Creek, California 94596

United States

Presbyterian Intercommunity Hospital

Whittier, California 90602

United States

Kaiser Permanente-Woodland Hills

Woodland Hills, California 91367

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

Beebe South Coastal Health Campus

Millville, Delaware 19967

United States

Helen F Graham Cancer Center

Newark, Delaware 19713

United States

Medical Oncology Hematology Consultants PA

Newark, Delaware 19713

United States

Beebe Health Campus

Rehoboth Beach, Delaware 19971

United States

Kaiser Permanente-Capitol Hill Medical Center

Washington D.C., District of Columbia 20002

United States

Malcom Randall Veterans Administration Medical Center

Gainesville, Florida 32610

United States

Moffitt Cancer Center

Tampa, Florida 33612

United States

Grady Health System

Atlanta, Georgia 30303

United States

Emory University Hospital Midtown

Atlanta, Georgia 30308

United States

Emory University Hospital/Winship Cancer Institute

Atlanta, Georgia 30322

United States

Emory Saint Joseph's Hospital

Atlanta, Georgia 30342

United States

Northside Hospital

Atlanta, Georgia 30342

United States

Atlanta VA Medical Center

Decatur, Georgia 30033

United States

Northside Hospital - Duluth

Duluth, Georgia 30096

United States

Northeast Georgia Medical Center-Gainesville

Gainesville, Georgia 30501

United States

Emory Johns Creek Hospital

Johns Creek, Georgia 30097

United States

Northside Hospital - Gwinnett

Lawrenceville, Georgia 30046

United States

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

Savannah, Georgia 31405

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

Idaho Urologic Institute-Meridian

Meridian, Idaho 83642

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

Advocate Outpatient Center - Aurora

Aurora, Illinois 60506

United States

Advocate Good Shepherd Hospital

Barrington, Illinois 60010

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

Advocate Illinois Masonic Medical Center

Chicago, Illinois 60657

United States

AMG Crystal Lake - Oncology

Crystal Lake, Illinois 60014

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

Advocate Good Samaritan Hospital

Downers Grove, Illinois 60515

United States

Carle Physician Group-Effingham

Effingham, Illinois 62401

United States

Crossroads Cancer Center

Effingham, Illinois 62401

United States

Advocate Sherman Hospital

Elgin, Illinois 60123

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

Advocate South Suburban Hospital

Hazel Crest, Illinois 60429

United States

Illinois CancerCare-Kewanee Clinic

Kewanee, Illinois 61443

United States

Northwestern Medicine Lake Forest Hospital

Lake Forest, Illinois 60045

United States

AMG Libertyville - Oncology

Libertyville, Illinois 60048

United States

Condell Memorial Hospital

Libertyville, Illinois 60048

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

Carle BroMenn Medical Center

Normal, Illinois 61761

United States

Carle Cancer Institute Normal

Normal, Illinois 61761

United States

Cancer Care Center of O'Fallon

O'Fallon, Illinois 62269

United States

HSHS Saint Elizabeth's Hospital

O'Fallon, Illinois 62269

United States

Northwestern Medicine Oak Brook

Oak Brook, Illinois 60523

United States

Advocate Christ Medical Center

Oak Lawn, Illinois 60453-2699

United States

Advocate Outpatient Center - Oak Lawn

Oak Lawn, Illinois 60453

United States

Northwestern Medicine Orland Park

Orland Park, Illinois 60462

United States

Illinois CancerCare-Ottawa Clinic

Ottawa, Illinois 61350

United States

Advocate High Tech Medical Park

Palos Heights, Illinois 60463

United States

Advocate Lutheran General Hospital

Park Ridge, Illinois 60068

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

Richard L. Roudebush Veterans Affairs Medical Center

Indianapolis, Indiana 46202

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

Veteran Administration Eastern Kansas Healthcare

Leavenworth, Kansas 66048

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

Harold Alfond Center for Cancer Care

Augusta, Maine 04330

United States

MaineHealth Waldo Hospital

Belfast, Maine 04915

United States

Lafayette Family Cancer Center-EMMC

Brewer, Maine 04412

United States

MaineHealth Cancer Care and IV Therapy - Brunswick

Brunswick, Maine 04011

United States

MaineHealth LincolnHealth Hospital

Damariscotta, Maine 04543

United States

Penobscot Bay Medical Center

Rockport, Maine 04856

United States

MaineHealth Cancer Care Center of York County

Sanford, Maine 04073

United States

MaineHealth Cancer Care and IV Therapy - South Portland

South Portland, Maine 04106

United States

Saint Agnes Hospital

Baltimore, Maryland 21229

United States

Kaiser Permanente-Woodlawn Medical Center

Baltimore, Maryland 21244

United States

UPMC Western Maryland

Cumberland, Maryland 21502

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

Beverly Hospital

Beverly, Massachusetts 01915

United States

Lahey Hospital and Medical Center

Burlington, Massachusetts 01805

United States

Addison Gilbert Hospital

Gloucester, Massachusetts 01930

United States

Lahey Medical Center-Peabody

Peabody, Massachusetts 01960

United States

Baystate Medical Center

Springfield, Massachusetts 01199

United States

UMass Memorial Medical Center - University Campus

Worcester, Massachusetts 01655

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

OSF Saint Francis Hospital and Medical Group

Escanaba, Michigan 49829

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

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

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 Saint Joseph's Medical Center

Brainerd, Minnesota 56401

United States

Mercy Hospital

Coon Rapids, Minnesota 55433

United States

Essentia Health - Deer River Clinic

Deer River, Minnesota 56636

United States

Essentia Health Cancer Center

Duluth, Minnesota 55805

United States

Fairview Southdale Hospital

Edina, Minnesota 55435

United States

Essentia Health Hibbing Clinic

Hibbing, Minnesota 55746

United States

Abbott-Northwestern Hospital

Minneapolis, Minnesota 55407

United States

North Memorial Medical Health Center

Robbinsdale, Minnesota 55422

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

Essentia Health Sandstone

Sandstone, Minnesota 55072

United States

Essentia Health Virginia Clinic

Virginia, Minnesota 55792

United States

Minnesota Oncology Hematology PA-Woodbury

Woodbury, Minnesota 55125

United States

Sanford Cancer Center Worthington

Worthington, Minnesota 56187

United States

Baptist Memorial Hospital and Cancer Center-Golden Triangle

Columbus, Mississippi 39705

United States

Baptist Cancer Center-Grenada

Grenada, Mississippi 38901

United States

Gulfport Memorial Hospital

Gulfport, Mississippi 39502

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

Parkland Health Center - Farmington

Farmington, Missouri 63640

United States

University Health Truman Medical Center

Kansas City, Missouri 64108

United States

University of Kansas Cancer Center - Briarcliff

Kansas City, Missouri 64116

United States

Kansas City Veterans Affairs Medical Center

Kansas City, Missouri 64128

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

Lake Regional Hospital

Osage Beach, Missouri 65065

United States

Sainte Genevieve County Memorial Hospital

Sainte Genevieve, Missouri 63670

United States

Washington University School of Medicine

St Louis, Missouri 63110

United States

Mercy Hospital South

St Louis, Missouri 63128

United States

Siteman Cancer Center-South County

St Louis, Missouri 63129

United States

Missouri Baptist Medical Center

St Louis, Missouri 63131

United States

Siteman Cancer Center at Christian Hospital

St Louis, Missouri 63136

United States

Missouri Baptist Sullivan Hospital

Sullivan, Missouri 63080

United States

BJC Outpatient Center at Sunset Hills

Sunset Hills, Missouri 63127

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

New Hampshire Oncology Hematology PA-Concord

Concord, New Hampshire 03301

United States

Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center

Lebanon, New Hampshire 03756

United States

Solinsky Center for Cancer Care

Manchester, New Hampshire 03103

United States

Virtua Samson Cancer Center

Moorestown, New Jersey 08057

United States

Virtua Voorhees

Voorhees Township, New Jersey 08043

United States

University of New Mexico Cancer Center

Albuquerque, New Mexico 87106

United States

The Cancer Institute at Saint Francis Hospital

East Hills, New York 11548

United States

University of Rochester

Rochester, New York 14642

United States

Montefiore Medical Center-Einstein Campus

The Bronx, New York 10461

United States

James J Peters VA Medical Center

The Bronx, New York 10468

United States

Wilmot Cancer Institute at Webster

Webster, New York 14580

United States

Good Samaritan University Hospital

West Islip, New York 11795

United States

Durham VA Medical Center

Durham, North Carolina 27705

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

Essentia Health Cancer Center-South University Clinic

Fargo, North Dakota 58103

United States

Sanford Broadway Medical Center

Fargo, North Dakota 58122

United States

Sanford Roger Maris Cancer Center

Fargo, North Dakota 58122

United States

OhioHealth O'Bleness Hospital

Athens, Ohio 45701

United States

Aultman Health Foundation

Canton, Ohio 44710

United States

Miami Valley Hospital South

Centerville, Ohio 45459

United States

Columbus Oncology and Hematology Associates Inc

Columbus, Ohio 43214

United States

Riverside Methodist Hospital

Columbus, Ohio 43214

United States

Grant Medical Center

Columbus, Ohio 43215

United States

Doctors Hospital

Columbus, Ohio 43228

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

Delaware Health Center-Grady Cancer Center

Delaware, Ohio 43015

United States

Grady Memorial Hospital

Delaware, Ohio 43015

United States

Columbus Oncology and Hematology Associates

Dublin, Ohio 43016

United States

Dublin Methodist Hospital

Dublin, Ohio 43016

United States

Atrium Medical Center-Middletown Regional Hospital

Franklin, Ohio 45005-1066

United States

Miami Valley Cancer Care and Infusion

Greenville, Ohio 45331

United States

OhioHealth Mansfield Hospital

Mansfield, Ohio 44903

United States

OhioHealth Marion General Hospital

Marion, Ohio 43302

United States

OhioHealth Pickerington Methodist Hospital

Pickerington, Ohio 43147

United States

ProMedica Flower Hospital

Sylvania, Ohio 43560

United States

Upper Valley Medical Center

Troy, Ohio 45373

United States

OhioHealth Westerville Medical Campus/Westerville Cancer Center

Westerville, Ohio 43082

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

Integris Southwest Medical Center

Oklahoma City, Oklahoma 73109

United States

Mercy Hospital Oklahoma City

Oklahoma City, Oklahoma 73120

United States

Saint Alphonsus Cancer Care Center-Baker City

Baker City, Oregon 97814

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

Oregon Health and Science University

Portland, Oregon 97239

United States

Salem Hospital

Salem, Oregon 97301

United States

UPMC-Heritage Valley Health System Beaver

Beaver, Pennsylvania 15009

United States

UPMC Hillman Cancer Center at Butler Health System

Butler, Pennsylvania 16001

United States

WellSpan Medical Oncology and Hematology

Chambersburg, Pennsylvania 17201

United States

UPMC Hillman Cancer Center - Passavant - Cranberry

Cranberry Township, Pennsylvania 16066

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

IRMC Cancer Center

Indiana, Pennsylvania 15701

United States

UPMC-Johnstown/John P. Murtha Regional Cancer Center

Johnstown, Pennsylvania 15901

United States

Sechler Family Cancer Center

Lebanon, Pennsylvania 17042

United States

UPMC Cancer Center at UPMC McKeesport

McKeesport, Pennsylvania 15132

United States

UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion

Mechanicsburg, Pennsylvania 17050

United States

UPMC Hillman Cancer Center - Monroeville

Monroeville, Pennsylvania 15146

United States

UPMC Hillman Cancer Center in Coraopolis

Moon Township, Pennsylvania 15108

United States

UPMC Hillman Cancer Center - Part of Frick Hospital

Mount Pleasant, Pennsylvania 15666

United States

Arnold Palmer Cancer Center Medical Oncology Norwin

N. Huntingdon, Pennsylvania 15642

United States

UPMC Cancer Center-Natrona Heights

Natrona Heights, Pennsylvania 15065

United States

UPMC Hillman Cancer Center - New Castle

New Castle, Pennsylvania 16105

United States

Fox Chase Cancer Center

Philadelphia, Pennsylvania 19111

United States

Temple University Hospital

Philadelphia, Pennsylvania 19140

United States

UPMC-Saint Margaret

Pittsburgh, Pennsylvania 15215

United States

University of Pittsburgh Cancer Institute (UPCI)

Pittsburgh, Pennsylvania 15232

United States

UPMC-Passavant Hospital

Pittsburgh, Pennsylvania 15237

United States

UPMC-Saint Clair Hospital Cancer Center

Pittsburgh, Pennsylvania 15243

United States

UPMC Cancer Center at UPMC Northwest

Seneca, Pennsylvania 16346

United States

UPMC Cancer Center-Uniontown

Uniontown, Pennsylvania 15401

United States

UPMC Cancer Center-Washington

Washington, Pennsylvania 15301

United States

UPMC Susquehanna

Williamsport, Pennsylvania 17701

United States

Divine Providence Hospital

Williamsport, Pennsylvania 17754

United States

Cancer Care Associates of York

York, Pennsylvania 17403

United States

AnMed Health Cancer Center

Anderson, South Carolina 29621

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

Gibbs Cancer Center-Gaffney

Gaffney, South Carolina 29341

United States

Gibbs Cancer Center-Pelham

Greer, South Carolina 29651

United States

South Carolina Cancer Specialists PC

Hilton Head Island, South Carolina 29926-3827

United States

Spartanburg Medical Center

Spartanburg, South Carolina 29303

United States

SMC Center for Hematology Oncology Union

Union, South Carolina 29379

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

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

Dartmouth Cancer Center - North

Saint Johnsbury, Vermont 05819

United States

White River Junction Veteran Administration Medical Center

White River Junction, Vermont 05009

United States

University of Virginia Cancer Center

Charlottesville, Virginia 22908

United States

Centra Alan B Pearson Regional Cancer Center

Lynchburg, Virginia 24501

United States

Kaiser Permanente Tysons Corner Medical Center

McLean, Virginia 22102

United States

Virginia Cancer Institute

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

VCU Community Memorial Health Center

South Hill, Virginia 23970

United States

Kaiser Permanente-Caton Hill Medical Center

Woodbridge, Virginia 22192

United States

United Hospital Center

Bridgeport, West Virginia 26330

United States

Edwards Comprehensive Cancer Center

Huntington, West Virginia 25701

United States

WVUH-Berkely Medical Center

Martinsburg, West Virginia 25401

United States

West Virginia University Healthcare

Morgantown, West Virginia 26506

United States

Camden Clark Medical Center

Parkersburg, West Virginia 26101

United States

Wheeling Hospital/Schiffler Cancer Center

Wheeling, West Virginia 26003

United States

Duluth Clinic Ashland

Ashland, Wisconsin 54806

United States

Aurora Cancer Care-Southern Lakes VLCC

Burlington, Wisconsin 53105

United States

Aurora Saint Luke's South Shore

Cudahy, Wisconsin 53110

United States

Aurora Health Care Germantown Health Center

Germantown, Wisconsin 53022

United States

Aurora Cancer Care-Grafton

Grafton, Wisconsin 53024

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

Aurora BayCare Medical Center

Green Bay, Wisconsin 54311

United States

Aurora Cancer Care-Kenosha South

Kenosha, Wisconsin 53142

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

Aurora Bay Area Medical Group-Marinette

Marinette, Wisconsin 54143

United States

Aurora Cancer Care-Milwaukee

Milwaukee, Wisconsin 53209

United States

Aurora Saint Luke's Medical Center

Milwaukee, Wisconsin 53215

United States

Aurora Sinai Medical Center

Milwaukee, Wisconsin 53233

United States

Saint Vincent Hospital Cancer Center at Oconto Falls

Oconto Falls, Wisconsin 54154

United States

Vince Lombardi Cancer Clinic - Oshkosh

Oshkosh, Wisconsin 54904

United States

Aurora Cancer Care-Racine

Racine, Wisconsin 53406

United States

Saint Vincent Hospital Cancer Center at Sheboygan

Sheboygan, Wisconsin 53081

United States

Sheboygan Physicians Group

Sheboygan, Wisconsin 53081

United States

Vince Lombardi Cancer Clinic-Sheboygan

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

Aurora Medical Center in Summit

Summit, Wisconsin 53066

United States

Vince Lombardi Cancer Clinic-Two Rivers

Two Rivers, Wisconsin 54241

United States

Aurora Cancer Care-Milwaukee West

Wauwatosa, Wisconsin 53226

United States

Aurora West Allis Medical Center

West Allis, Wisconsin 53227

United States

Marshfield Medical Center - Weston

Weston, Wisconsin 54476

United States