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NCT07198074PHASE3Recruiting

Testing the Addition of an Antiangiogenic Drug (Bevacizumab) to Chemotherapy (Carboplatin and Paclitaxel) Combined With Immunotherapy (Pembrolizumab) for pMMR, TP53 Mutated Endometrial Cancer

National Cancer Institute (NCI)

Start Date

1/27/2026

Completion Date

7/1/2028

Summary

This phase III trial compares the effect of bevacizumab in combination with carboplatin, paclitaxel and pembrolizumab to the usual treatments of carboplatin and paclitaxel with or without pembrolizumab in treating patients with stage III, IVA or IVB mismatch repair protein proficient (pMMR) and TP53 mutated endometrial cancer that may have spread from where it first started to nearby tissue, lymph nodes, or distant parts of the body (advanced) or that has come back after a period of improvement (recurrent). Bevacizumab is in a class of medications called antiangiogenic agents. It works by stopping the formation of blood vessels that bring oxygen and nutrients to tumor. This may slow the growth and spread of tumor. Carboplatin is in a class of medications known as platinum-containing compounds. Carboplatin works by killing, stopping or slowing the growth of tumor cells. Paclitaxel is in a class of medications called antimicrotubule agents. It stops tumor cells from growing and dividing and may kill them. Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the tumor, and may interfere with the ability of tumor cells to grow and spread. Adding bevacizumab to the combination of carboplatin, paclitaxel and pembrolizumab may be more effective than the usual treatment combinations of carboplatin and paclitaxel with or without pembrolizumab in treating patients with advanced or recurrent pMMR and TP53 mutated endometrial cancer.

Detailed Description

PRIMARY OBJECTIVE: I. To demonstrate that bevacizumab, an anti-VEGF antibody therapy, (or an anti-VEGF antibody biosimilar) in combination with carboplatin, paclitaxel, and pembrolizumab is superior to carboplatin, paclitaxel, and pembrolizumab (the control arm) or carboplatin, paclitaxel, and bevacizumab in prolonging progression-free survival (PFS) in patients with pMMR, TP53 mutated advanced stage (III or IV) or recurrent endometrial cancer. SECONDARY OBJECTIVES: I. To demonstrate that bevacizumab in combination with carboplatin, paclitaxel, and pembrolizumab is superior to carboplatin, paclitaxel, and pembrolizumab or carboplatin, paclitaxel, and bevacizumab in prolonging overall survival (OS) in patients with pMMR, TP53 mutated advanced stage (III or IV) or recurrent endometrial cancer. II. To examine the impact of the addition of bevacizumab in combination with carboplatin and paclitaxel or with carboplatin, paclitaxel, and pembrolizumab on PFS and OS based on type of p53 immunohistochemistry (IHC) aberrancy (over expression/cytoplasmic expression versus null \[complete absence of staining\]) and mutation type. III. To evaluate toxicity on treatment with bevacizumab when combined with carboplatin, paclitaxel, and/or pembrolizumab as assessed by Common Terminology Criteria for Adverse Events (CTCAE) version (v.)5.0. IV. To explore the anti-tumor activity in each treatment arm as assessed by objective response rate in the subset of patients with measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. OUTLINE: Patients are randomized to 1 of 3 arms. ARM 1 (REFERENCE ARM): Patients receive paclitaxel intravenously (IV) over 3 hours, carboplatin IV and pembrolizumab IV over 30 minutes on day 1 of each cycle. Cycles repeat every 3 weeks for up to 6-10 cycles in the absence of disease progression or unacceptable toxicity. Starting 3 weeks after last combination phase cycle, patients may continue to receive maintenance pembrolizumab IV over 30 minutes on day 1 of each cycle. Cycles repeat every 6 weeks for up to an additional14 cycles. Additionally, patients undergo urine and blood sample collection and computed tomography (CT) or magnetic resonance imaging (MRI) throughout the study. ARM 2 (EXPERIMENTAL TRIPLET ARM): Patients receive paclitaxel IV over 3 hours, carboplatin IV, and bevacizumab IV or anti-VEGF antibody biosimilar on day 1 of each cycle. Cycles repeat every 3 weeks for up to 6-10 cycles in the absence of disease progression or unacceptable toxicity. Starting 3 weeks after last combination phase cycle, patients may continue to receive maintenance bevacizumab IV on day 1 of each cycle. Treatment repeats every 3 weeks for up to an additional 28 doses. Additionally, patients undergo urine and blood sample collection and CT or MRI throughout the study. ARM 3 (EXPERIMENTAL QUADRUPLET ARM): Patients receive paclitaxel IV over 3 hours, carboplatin IV, pembrolizumab IV over 30 minutes, and bevacizumab IV or anti-VEGF antibody biosimilar on day 1 of each cycle. Cycles repeat every 3 weeks for up to 6-10 cycles in the absence of disease progression or unacceptable toxicity. Starting 3 weeks after last combination phase cycle, patients may continue to receive maintenance pembrolizumab IV over 30 minutes every 6 weeks for up to an additional 14 cycles and bevacizumab IV every 3 weeks for up to an additional 28 doses. Additionally, patients undergo urine and blood sample collection and CT or MRI throughout the study. After completion of study treatment, patients are followed every 3 months for 2 years then every 6 months for up to 3 years.

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: * Documentation of disease: * Stage III and stage IVA endometrial cancers (with measurable disease), * Stage IVB endometrial cancer (with or without measurable disease), or * Recurrent endometrial cancer (with or without measurable disease) * In patients with measurable disease, lesions will be defined and monitored by RECIST 1.1. Measurable disease (RECIST 1.1) is defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded). Each lesion must be ≥ 10 mm when measured by CT or MRI. Lymph nodes must be ≥ 15 mm in short axis when measured by CT or MRI * Histologic confirmation of the original primary tumor is required (submission of pathology report\[s\] is required). Patients with the following histologic types are eligible: endometrioid, serous, dedifferentiated/undifferentiated, clear cell, mixed epithelial, carcinosarcoma, adenocarcinoma not otherwise specified (N.O.S.) * Patients must have: * Tumoral mismatch repair proficient (pMMR) disease as assessed by immunohistochemistry (IHC) AND * P53 IHC with aberrant staining pattern (aberrant p53 expression is consistent with mutant TP53). TP53 mutation by next-generation sequencing will also be accepted * A pathology report demonstrating results of institutional MMR IHC and p53 IHC and/or TP53 by next-generation sequencing * Patients may have received: * NO prior chemotherapy for treatment of endometrial cancer OR * Prior adjuvant chemotherapy (e.g., paclitaxel/carboplatin alone or as a component of concurrent chemotherapy and radiation therapy \[with or without cisplatin\]) provided adjuvant chemotherapy was completed ≥ 12 months prior to registration * Patients may have received prior radiation therapy for treatment of endometrial cancer. Prior radiation therapy may have included pelvic radiation therapy, extended field pelvic/para-aortic radiation therapy, intravaginal brachytherapy, and/or palliative radiation therapy. All radiation therapy must be completed at least 4 weeks prior to registration. For patients with recent radiation, they must have RECIST-evaluable disease outside of the radiation field and have recovered their marrow function * Patients may have received prior hormonal (endocrine) therapy. All hormonal (endocrine) therapy must have been completed at least 1 week prior to registration * NO prior pembrolizumab (or other anti-PD1, anti-PDL1 or anti-CTLA4 therapy) or bevacizumab (or other antiangiogenic therapy) * Interval or cytoreductive surgery, after start of treatment on this trial, and prior to documentation of disease progression, is NOT permitted * Patients with treated brain metastases are eligible if follow-up brain imaging after central nervous system (CNS)-directed therapy shows no evidence of disease progression. Patients with brain metastases must have follow up imaging demonstrating no evidence of disease progression and that the disease is stable off of steroids * Age ≥ 18 * Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2 * Not pregnant and not nursing * Absolute neutrophil count (ANC) ≥ 1,500 cells/mm\^3 * Platelets ≥ 100,000 cells/mm\^3 * Hemoglobin ≥ 8 g/dl * Creatinine clearance (CrCl) of ≥ 30 mL/min by the Cockcroft-Gault formula * Total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN) (patients with known Gilbert's disease who have bilirubin level ≤ 3 x institutional ULN may be enrolled) * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3 x institutional ULN * 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. To be eligible for this trial, patients should be class II or better * No active infection requiring parenteral antibiotics * No current evidence of intra-abdominal abscess, abdominal/pelvic fistula (not diverted), gastrointestinal perforation, gastrointestinal (GI) obstruction, and/or need for drainage nasogastric or gastrostomy tube * No clinically significant bleeding within 28 days prior to registration * No uncontrolled hypertension, defined as systolic ≥ 160 mm Hg or diastolic ≥ 100 mm Hg * No major surgery within 28 days of initiation of bevacizumab * No active autoimmune disease or history of autoimmune disease that might recur, which may affect vital organ function or require immune suppressive treatment including corticosteroids. This includes, but is not limited to, patients with a history of immune related neurologic disease, multiple sclerosis, autoimmune (demyelinating) neuropathy, Guillain-Barre syndrome, myasthenia gravis; systemic autoimmune disease such as systemic lupus erythematosus (SLE), connective tissue diseases, scleroderma, inflammatory bowel disease (IBD), Crohn's, ulcerative colitis, hepatitis; and patients with a history of toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome, or phospholipid syndrome because of the risk of recurrence or exacerbation of disease * Patients with vitiligo, endocrine deficiencies including type I diabetes mellitus, thyroiditis managed with replacement hormones including physiologic corticosteroids are eligible * Topical or inhaled steroids are allowed * Patients with rheumatoid arthritis and other arthropathies, Sjogren's syndrome and psoriasis controlled with topical medication and patients with positive serology, such as antinuclear antibodies (ANA), and anti-thyroid antibodies should be evaluated with the presence of target organ involvement and potential need for systemic treatment but should otherwise be eligible * No history of (non-infectious) pneumonitis that required steroids, or current pneumonitis * No history of stem cell or solid organ transplant * No history of allergic reaction to the study agent(s) or compounds of similar chemical or biologic composition to the study agent(s) (or any of its excipients)

Interventions

BIOLOGICAL

Bevacizumab

PROCEDURE

Biospecimen Collection

DRUG

Carboplatin

PROCEDURE

Computed Tomography

PROCEDURE

Magnetic Resonance Imaging

DRUG

Paclitaxel

BIOLOGICAL

Pembrolizumab

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Conditions

Advanced Endometrial CarcinomaRecurrent Endometrial Carcinoma

Locations

University of Alabama at Birmingham Cancer Center

Birmingham, Alabama 35233

United States

Alaska Women's Cancer Care

Anchorage, Alaska 99508

United States

Cancer Center at Saint Joseph's

Phoenix, Arizona 85004

United States

Highlands Oncology Group - Fayetteville

Fayetteville, Arkansas 72703

United States

University of Arkansas for Medical Sciences

Little Rock, Arkansas 72205

United States

Highlands Oncology Group - Rogers

Rogers, Arkansas 72758

United States

Highlands Oncology Group

Springdale, Arkansas 72762

United States

Mercy Cancer Center - Carmichael

Carmichael, California 95608

United States

Mercy San Juan Medical Center

Carmichael, California 95608

United States

Mercy Cancer Center - Elk Grove

Elk Grove, California 95758

United States

Los Angeles General Medical Center

Los Angeles, California 90033

United States

USC / Norris Comprehensive Cancer Center

Los Angeles, California 90033

United States

Stanford Cancer Institute Palo Alto

Palo Alto, California 94304

United States

Eisenhower Medical Center

Rancho Mirage, California 92270

United States

Mercy Cancer Center - Rocklin

Rocklin, California 95765

United States

Mercy Cancer Center - Sacramento

Sacramento, California 95816

United States

University of California Davis Comprehensive Cancer Center

Sacramento, California 95817

United States

Woodland Memorial Hospital

Woodland, California 95695

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

UCHealth Highlands Ranch Hospital

Highlands Ranch, Colorado 80129

United States

Medical Center of the Rockies

Loveland, Colorado 80538

United States

Hartford Hospital

Hartford, Connecticut 06102

United States

Hartford HealthCare - Manchester

Manchester, Connecticut 06042

United States

The Hospital of Central Connecticut

New Britain, Connecticut 06050

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

Emory University Hospital Midtown

Atlanta, Georgia 30308

United States

Emory University Hospital/Winship Cancer Institute

Atlanta, Georgia 30322

United States

Augusta University Medical Center

Augusta, Georgia 30912

United States

Emory Decatur Hospital

Decatur, Georgia 30033

United States

Kootenai Health - Coeur d'Alene

Coeur d'Alene, Idaho 83814

United States

Kootenai Clinic Cancer Services - Post Falls

Post Falls, Idaho 83854

United States

Kootenai Clinic Cancer Services - Sandpoint

Sandpoint, Idaho 83864

United States

Northwestern University

Chicago, Illinois 60611

United States

Rush MD Anderson Cancer Center

Chicago, Illinois 60612

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

Northwestern Medicine Cancer Center Delnor

Geneva, Illinois 60134

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

Rush MD Anderson Cancer Center at Rush Oak Park

Oak Park, Illinois 60304

United States

Northwestern Medicine Orland Park

Orland Park, Illinois 60462

United States

OSF Saint Francis Medical Center

Peoria, Illinois 61637

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

Northwestern Medicine Cancer Center Warrenville

Warrenville, Illinois 60555

United States

Goshen Center for Cancer Care

Goshen, Indiana 46526

United States

Ascension Saint Vincent Indianapolis Hospital

Indianapolis, Indiana 46260

United States

Memorial Hospital of South Bend

South Bend, Indiana 46601

United States

UI Health Care Mission Cancer and Blood - Ankeny Clinic

Ankeny, Iowa 50023

United States

Saint Anthony Regional Hospital

Carroll, Iowa 51401

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

Broadlawns Medical Center

Des Moines, Iowa 50314

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

UI Healthcare Mission Cancer and Blood - Fort Dodge

Fort Dodge, Iowa 50501

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

Baptist Health Lexington

Lexington, Kentucky 40503

United States

University of Kentucky/Markey Cancer Center

Lexington, Kentucky 40536

United States

West Jefferson Medical Center

Marrero, Louisiana 70072

United States

East Jefferson General Hospital

Metairie, Louisiana 70006

United States

LSU Healthcare Network / Metairie Multi-Specialty Clinic

Metairie, Louisiana 70006

United States

University Medical Center New Orleans

New Orleans, Louisiana 70112

United States

Lafayette Family Cancer Center-EMMC

Brewer, Maine 04412

United States

MaineHealth Maine Medical Center- Scarborough

Scarborough, Maine 04074

United States

Johns Hopkins University/Sidney Kimmel Cancer Center

Baltimore, Maryland 21287

United States

Dana-Farber Cancer Institute

Boston, Massachusetts 02215

United States

University of Michigan Rogel Cancer Center

Ann Arbor, Michigan 48109

United States

Bronson Battle Creek

Battle Creek, Michigan 49017

United States

Trinity Health IHA Medical Group Hematology Oncology - Brighton

Brighton, Michigan 48114

United States

University of Michigan - Brighton Center for Specialty Care

Brighton, Michigan 48116

United States

Trinity Health IHA Medical Group Hematology Oncology - Canton

Canton, Michigan 48188

United States

Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital

Chelsea, Michigan 48118

United States

Wayne State University/Karmanos Cancer Institute

Detroit, Michigan 48201

United States

OSF Saint Francis Hospital and Medical Group

Escanaba, Michigan 49829

United States

Weisberg Cancer Treatment Center

Farmington Hills, Michigan 48334

United States

Genesys Hurley Cancer Institute

Flint, Michigan 48503

United States

Hurley Medical Center

Flint, Michigan 48503

United States

Corewell Health Grand Rapids Hospitals - Butterworth Hospital

Grand Rapids, Michigan 49503

United States

Trinity Health Grand Rapids Hospital

Grand Rapids, Michigan 49503

United States

Bronson Methodist Hospital

Kalamazoo, Michigan 49007

United States

West Michigan Cancer Center

Kalamazoo, Michigan 49007

United States

Beacon Kalamazoo Cancer Center

Kalamazoo, Michigan 49009

United States

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 Muskegon Hospital

Muskegon, Michigan 49444

United States

Corewell Health Lakeland Hospitals - Niles Hospital

Niles, Michigan 49120

United States

Cancer and Hematology Centers of Western Michigan - Norton Shores

Norton Shores, Michigan 49444

United States

Trinity Health Saint Joseph Mercy Oakland Hospital

Pontiac, Michigan 48341

United States

Corewell Health Reed City Hospital

Reed City, Michigan 49677

United States

Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center

Saint Joseph, Michigan 49085

United States

Corewell Health Lakeland Hospitals - Saint Joseph Hospital

Saint Joseph, Michigan 49085

United States

Munson Medical Center

Traverse City, Michigan 49684

United States

University of Michigan Health - West

Wyoming, Michigan 49519

United States

Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus

Ypsilanti, Michigan 48197

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

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

MU Health - University Hospital/Ellis Fischel Cancer Center

Columbia, Missouri 65212

United States

Mercy Hospital Springfield

Springfield, Missouri 65804

United States

CoxHealth South Hospital

Springfield, Missouri 65807

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

Nebraska Medicine-Bellevue

Bellevue, Nebraska 68123

United States

Fred and Pamela Buffett Cancer Center - Kearney

Kearney, Nebraska 68845

United States

Nebraska Methodist Hospital

Omaha, Nebraska 68114

United States

Nebraska Medicine-Village Pointe

Omaha, Nebraska 68118

United States

University of Nebraska Medical Center

Omaha, Nebraska 68198

United States

Women's Cancer Center of Nevada

Las Vegas, Nevada 89106

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

Rutgers Cancer Institute of New Jersey

New Brunswick, New Jersey 08903

United States

Rutgers New Jersey Medical School

Newark, New Jersey 07101

United States

The Valley Hospital - Luckow Pavilion

Paramus, New Jersey 07652

United States

Valley Health System Ridgewood Campus

Ridgewood, New Jersey 07450

United States

Sidney Kimmel Cancer Center Washington Township

Sewell, New Jersey 08080

United States

University of New Mexico Cancer Center

Albuquerque, New Mexico 87106

United States

Northwell Health Imbert Cancer Center

Bay Shore, New York 11706

United States

Memorial Sloan Kettering Commack

Commack, New York 11725

United States

Northwell Health Physician Partners at Flushing

Flushing, New York 11354

United States

Northwell Health Cancer Institute at Huntington

Greenlawn, New York 11740

United States

Memorial Sloan Kettering Westchester

Harrison, New York 10604

United States

Northwell Health/Center for Advanced Medicine

Lake Success, New York 11042

United States

Mount Sinai Chelsea

New York, New York 10011

United States

Mount Sinai West

New York, New York 10019

United States

Mount Sinai Hospital

New York, New York 10029

United States

Manhattan Eye Ear and Throat Hospital

New York, New York 10065

United States

Memorial Sloan Kettering Cancer Center

New York, New York 10065

United States

Lenox Hill Hospital

New York, New York 10075

United States

Queens Cancer Center

Rego Park, New York 11374

United States

University of Rochester

Rochester, New York 14642

United States

Phelps Memorial Hospital Center

Sleepy Hollow, New York 10591

United States

Staten Island University Hospital

Staten Island, New York 10305

United States

Stony Brook University Medical Center

Stony Brook, New York 11794

United States

State University of New York Upstate Medical University

Syracuse, New York 13210

United States

Montefiore Medical Center-Einstein Campus

The Bronx, New York 10461

United States

Montefiore Medical Center-Weiler Hospital

The Bronx, New York 10461

United States

Montefiore Medical Center - Moses Campus

The Bronx, New York 10467

United States

Memorial Sloan Kettering Nassau

Uniondale, New York 11553

United States

Wilmot Cancer Institute at Webster

Webster, New York 14580

United States

UNC Lineberger Comprehensive Cancer Center

Chapel Hill, North Carolina 27599

United States

Southeastern Medical Oncology Center-Clinton

Clinton, North Carolina 28328

United States

Duke University Medical Center

Durham, North Carolina 27710

United States

Southeastern Medical Oncology Center-Goldsboro

Goldsboro, North Carolina 27534

United States

Southeastern Medical Oncology Center-Jacksonville

Jacksonville, North Carolina 28546

United States

Duke Women's Cancer Care Raleigh

Raleigh, North Carolina 27607

United States

Essentia Health Cancer Center-South University Clinic

Fargo, North Dakota 58103

United States

OhioHealth O'Bleness Hospital

Athens, Ohio 45701

United States

UHHS-Chagrin Highlands Medical Center

Beachwood, Ohio 44122

United States

Aultman Health Foundation

Canton, Ohio 44710

United States

Geauga Hospital

Chardon, Ohio 44024

United States

Case Western Reserve University

Cleveland, Ohio 44106

United States

Ohio State University Comprehensive Cancer Center

Columbus, Ohio 43210

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

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

OhioHealth Mansfield Hospital

Mansfield, Ohio 44903

United States

OhioHealth Marion General Hospital

Marion, Ohio 43302

United States

UH Seidman Cancer Center at Lake Health Mentor Campus

Mentor, Ohio 44060

United States

University Hospitals Parma Medical Center

Parma, Ohio 44129

United States

OhioHealth Pickerington Methodist Hospital

Pickerington, Ohio 43147

United States

ProMedica Flower Hospital

Sylvania, Ohio 43560

United States

OhioHealth Westerville Medical Campus/Westerville Cancer Center

Westerville, Ohio 43082

United States

UH Seidman Cancer Center at Saint John Medical Center

Westlake, Ohio 44145

United States

University of Oklahoma Health Sciences Center

Oklahoma City, Oklahoma 73104

United States

Legacy Good Samaritan Hospital and Medical Center

Portland, Oregon 97210

United States

Providence Portland Medical Center

Portland, Oregon 97213

United States

Providence Saint Vincent Medical Center

Portland, Oregon 97225

United States

Legacy Meridian Park Hospital

Tualatin, Oregon 97062

United States

UPMC Hillman Cancer Center Erie

Erie, Pennsylvania 16505

United States

UPMC Cancer Centers - Arnold Palmer Pavilion

Greensburg, Pennsylvania 15601

United States

Penn State Milton S Hershey Medical Center

Hershey, Pennsylvania 17033-0850

United States

UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion

Mechanicsburg, Pennsylvania 17050

United States

Thomas Jefferson University Hospital

Philadelphia, Pennsylvania 19107

United States

Jefferson Torresdale Hospital

Philadelphia, Pennsylvania 19114

United States

UPMC-Magee Womens Hospital

Pittsburgh, Pennsylvania 15213

United States

UPMC-Passavant Hospital

Pittsburgh, Pennsylvania 15237

United States

UPMC Cancer Center-Washington

Washington, Pennsylvania 15301

United States

Asplundh Cancer Pavilion

Willow Grove, Pennsylvania 19090

United States

Women and Infants Hospital

Providence, Rhode Island 02905

United States

Vanderbilt-Ingram Cancer Center Cool Springs

Franklin, Tennessee 37067

United States

Vanderbilt Breast Center at One Hundred Oaks

Nashville, Tennessee 37204

United States

Vanderbilt University/Ingram Cancer Center

Nashville, Tennessee 37232

United States

University of Utah Sugarhouse Health Center

Salt Lake City, Utah 84106

United States

Huntsman Cancer Institute/University of Utah

Salt Lake City, Utah 84112

United States

South Jordan Health Center

South Jordan, Utah 84009

United States

University of Virginia Cancer Center

Charlottesville, Virginia 22908

United States

VCU Massey Comprehensive Cancer Center

Richmond, Virginia 23298

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

Legacy Salmon Creek Hospital

Vancouver, Washington 98686

United States

United Hospital Center

Bridgeport, West Virginia 26330

United States

West Virginia University Charleston Division

Charleston, West Virginia 25304

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

Duluth Clinic Ashland

Ashland, Wisconsin 54806

United States

Saint Vincent Hospital Cancer Center Green Bay

Green Bay, Wisconsin 54301

United States

Saint Vincent Hospital Cancer Center at Saint Mary's

Green Bay, Wisconsin 54303

United States

Gundersen Lutheran Medical Center

La Crosse, Wisconsin 54601

United States

Saint Vincent Hospital Cancer Center at Oconto Falls

Oconto Falls, Wisconsin 54154

United States

Saint Vincent Hospital Cancer Center at Sheboygan

Sheboygan, Wisconsin 53081

United States

Sheboygan Physicians Group

Sheboygan, Wisconsin 53081

United States

Essentia Health-Spooner Clinic

Spooner, Wisconsin 54801

United States

Saint Vincent Hospital Cancer Center at Sturgeon Bay

Sturgeon Bay, Wisconsin 54235-1495

United States

Essentia Health Saint Mary's Hospital - Superior

Superior, Wisconsin 54880

United States