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RecruitingInterventionalPhase 3

Phase III Trial of Stereotactic Radiosurgery (SRS) Versus Hippocampal-Avoidant Whole Brain Radiotherapy (HA-WBRT) for Brain Metastases From Small Cell Lung Cancer

NCT ID: NCT04804644Sponsor: NRG OncologyLast updated: 2026-05-04

Summary

This phase III trial compares the effect of stereotactic radiosurgery to standard of care memantine and whole brain radiation therapy that avoids the hippocampus (the memory zone of the brain) for the treatment of small cell lung cancer that has spread to the brain. Stereotactic radiosurgery is a specialized radiation therapy that delivers a single, high dose of radiation directly to the tumor and may cause less damage to normal tissue. Whole brain radiation therapy delivers a low dose of radiation to the entire brain including the normal brain tissue. Hippocampal avoidance during whole-brain radiation therapy (HA-WBRT) decreases the amount of radiation that is delivered to the hippocampus which is a brain structure that is important for memory. The drug, memantine, is also often given with whole brain radiotherapy because it may decrease the risk of side effects related to thinking and memory. Stereotactic radiosurgery may decrease side effects related to memory and thinking compared to standard of care HA-WBRT plus memantine.

Detailed description

PRIMARY OBJECTIVE: I. Determine whether stereotactic radiosurgery (SRS) relative to whole brain radiotherapy with hippocampal avoidance (HA-WBRT) plus memantine hydrochloride (memantine) for brain metastases from small cell lung cancer (SCLC) prevents cognitive function failure as measured by cognitive decline on a battery of tests: the Hopkins Verbal Learning Test - Revised (HVLT-R), Controlled Oral Word Association (COWA) test, and the Trail Making Test (TMT). SECONDARY OBJECTIVES: I. Determine whether SRS relative to HA-WBRT plus memantine for brain metastases from SCLC preserves cognitive function as separately measured by the HVLT-R, COWA, TMT Parts A and B, and Clinical Trial Battery Composite (CTB COMP). II. Assess perceived difficulties in cognitive abilities using Patient Reported Outcomes Measurement Information System (PROMIS) after SRS relative to HA-WBRT plus memantine for brain metastases from SCLC. III. Assess symptom burden using the MD Anderson Symptom Inventory for brain tumor (MDASI-BT) after SRS relative to HA-WBRT plus memantine for brain metastases from SCLC. IV. Compare cumulative incidence of intracranial disease progression after SRS relative to HA-WBRT plus memantine for brain metastases from SCLC. V. Compare overall survival after SRS relative to HA-WBRT plus memantine for brain metastases from SCLC. VI. Compare cumulative incidence of neurologic death after SRS relative to HA-WBRT plus memantine for brain metastases from SCLC. VII. Compare the number of salvage procedures used to manage recurrent intracranial disease following SRS relative to HA-WBRT plus memantine for SCLC brain metastases. VIII. Compare adverse events between the treatment arms according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version (v)5.0 criteria. IX. Compare the risk of developing cerebral necrosis between SRS and HA-WBRT plus memantine in patients receiving concurrent immunotherapy. EXPLORATORY OBJECTIVES: I. Compare cumulative incidence of local brain recurrence, distant brain relapse, and leptomeningeal dissemination after SRS relative to HA-WBRT plus memantine for brain metastases from SCLC. II. Compare the cost of brain-related therapies and quality-adjusted life years in patients who receive SRS relative to HA-WBRT plus memantine for brain metastases from SCLC. III. Evaluate the time delay to salvage WBRT or HA-WBRT in patients enrolled on the SRS arm. IV. Evaluate whether a time delay for chemotherapy has an effect on overall survival in patients receiving HA WBRT plus memantine relative to SRS for brain metastases from SCLC. V. Evaluate baseline magnetic resonance (MR) imaging biomarkers of white matter injury and hippocampal volumetry as potential predictors of cognitive decline and differential benefit from SRS relative to HA-WBRT plus memantine for brain metastases from SCLC. VI. Evaluate the correlation between neurocognitive functioning and patient-reported outcomes. VII. Collect serum, plasma and imaging studies for future translational research analyses. OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients undergo SRS over 1 day (in some cases several days). ARM II: Patients undergo HA-WBRT once daily (QD) for 2 weeks in the absence of disease progression or unacceptable toxicity. Patients also receive memantine orally (PO) QD or twice daily (BID) for up to 24 weeks in the absence of disease progression or unacceptable toxicity. Patients undergo blood sample collection and magnetic resonance imaging (MRI) throughout the study. After completion of study treatment, patients are followed up every 2-3 months for 1 year, and then every 6 months thereafter.

Arms & interventions

  • ProcedureBiospecimen Collection

    Undergo blood sample collection

  • ProcedureMagnetic Resonance Imaging

    Undergo MRI

  • DrugMemantine Hydrochloride

    Given PO

  • OtherNeurocognitive Assessment

    Ancillary studies

  • RadiationStereotactic Radiosurgery

    Undergo SRS

  • OtherSurvey Administration

    Ancillary studies

  • RadiationWhole-Brain Radiotherapy

    Undergo HA-WBRT

Outcome measures

Primary

  • Time to neurocognitive failure

    A failure is defined using the reliable change index (RCI) criteria, as measured by the Hopkins Verbal Learning Test - Revised (HVLT-R), Controlled Oral Word Association (COWA) test, and Trail Making Test (TMT) Parts A and B. The cumulative incidence approach will be used to estimate the percentage of failures while accounting for the competing risk of death.

    Time frame: Up to 1 year

Secondary

  • Preservation of neurocognitive function

    Time frame: 1 year

  • Perceived difficulties in cognition

    Time frame: Up to 1 year

  • Symptom burden

    Time frame: Up to 1 year

  • Time to intracranial disease progression

    Time frame: From the date of randomization to the date of intracranial disease progression, assessed up to 10 years

  • Overall survival

    Time frame: From the date of randomization to the date of death, or otherwise, the last follow-up date on which the patient was reported alive, assessed up to 10 years

  • Time to neurologic death

    Time frame: From the date of randomization to the date of neurologic death, assessed up to 10 years

  • Salvage procedures used to manage recurrent intracranial disease

    Time frame: Up to 10 years

  • Incidence of adverse events

    Time frame: Up to 10 years

  • Development of cerebral necrosis

    Time frame: Up to 10 years

Eligibility criteria

Sex: AllAge: 18 Years and olderHealthy volunteers: No
Inclusion Criteria: * Pathologically (histologically or cytologically) proven diagnosis of small cell lung cancer within 5 years of registration. If the original histologic proof of malignancy is greater than 5 years, then pathological (i.e., more recent) confirmation is required (e.g., from a systemic or brain metastasis); * Patients with de novo or recurrent small cell lung cancer are permitted. * Brain metastases =\< 4 cm in largest diameter and outside a 5-mm margin around either hippocampus must be visible on contrast-enhanced magnetic resonance imaging (MRI) performed =\< 21 days prior to study entry. * The total tumor volume must be 30 cm\^3 or less. Lesion volume will be approximated by measuring the lesion's three perpendicular diameters on contrast enhanced, T1-weighted MRI and the product of those diameters will be divided by 2 to estimate the lesion volume (e.g. xyz/2). Alternatively, direct volumetric measurements via slice by slice contouring on a treatment planning software package can be used to calculate the total tumor volume. * Brain metastases can be diagnosed synchronous to the initial diagnosis of small cell lung cancer or metachronous to the initial diagnosis and management of small cell lung cancer. * Brain metastases must be diagnosed on MRI, which will include the following elements: * REQUIRED MRI ELEMENTS * Post gadolinium contrast-enhanced T1-weighted three-dimensional (3D) spoiled gradient (SPGR). Acceptable 3D SPGR sequences include magnetization prepared 3D gradient recalled echo (GRE) rapid gradient echo (MP-RAGE), turbo field echo (TFE) MRI, BRAVO (Brain Volume Imaging) or 3D Fast FE (field echo). The T1-weighted 3D scan should use the smallest possible axial slice thickness, not to exceed 1.5 mm. * Pre-contrast T1 weighted imaging (3D imaging sequence strongly encouraged). * A minimum of one axial T2 FLAIR (preferred) or T2 sequence is required. This can be acquired as a two dimensional (2D) or 3D image. If 2D, the images should be obtained in the axial plane. * ADDITIONAL RECOMMENDATIONS * Recommendation is that an axial T2 FLAIR (preferred) sequence be performed instead of a T2 sequence. * Recommendation is that that pre-contrast 3D T1 be performed with the same parameters as the post-contrast 3D T1. * Recommendation is that imaging be performed on a 3 Tesla (3T) MRI. * Recommendation is that the study participants be scanned on the same MRI instrument at each time point. * Recommendation is that if additional sequences are obtained, these should meet the criteria outlined in Kaufmann et al., 2020. * If additional sequences are obtained, total imaging time should not exceed 60 minutes. * If additional metastases not known at the time of registration/randomization or seen in the MRI used for eligibility are subsequently found on the radiation therapy (RT) planning MRI such that the total intacranial volume exceeds 30 cm\^3, the patient is still considered eligible. * History/physical examination * Age \>= 18 * Karnofsky performance status of \>= 70 * Creatinine clearance \>= 30 ml/min * Following the diagnosis of brain metastases, patients can initiate and treat with systemic (chemotherapy and/or immunotherapy) before enrollment only if their brain metastases are asymptomatic and not located in eloquent locations (e.g., brainstem, pre-/post-central gyrus, visual cortex). However, within 21 days prior to enrollment, brain MRI must be repeated to confirm eligibility. * Patients with symptomatic brain metastases and/or brain metastases in eloquent locations (e.g., brainstem, pre-/post central gyrus, visual cortex) are eligible for enrollment on the trial; however, the specific treatment approach of starting with systemic therapy alone and delaying brain radiation is not recommended for these patients. * Concurrent immunotherapy with brain radiation (SRS or HA-WBRT) is permitted. * Negative urine or serum pregnancy test (in women of childbearing potential) within 14 days prior to registration. Women of childbearing potential and men who are sexually active must use contraception while on study. * Patients may have had prior intracranial surgical resection. * Because neurocognitive testing is the primary goal of this study, patients must be proficient in English or French Canadian. * The patient must provide study-specific informed consent prior to study entry. * Patients with impaired decision-making capacity are not permitted on study. * ELIGIBILITY CRITERIA PRIOR TO STEP 2 REGISTRATION * The following baseline neurocognitive tests must be completed within 21 days prior to Step 2 registration: HVLT-R, TMT, and COWA. The neurocognitive test will be uploaded into RAVE for evaluation by Dr. Wefel. Once the upload is complete, within 3 business days a notification will be sent via email to the RA to proceed to Step 2. * NOTE: Completed baseline neurocognitive tests can be uploaded at the time of Step 1 registration. * PRIOR TO STEP 2 REGISTRATION: The following baseline neurocognitive tests must be completed within 21 days prior to Step 2 registration: HVLT-R, TMT, and COWA. The neurocognitive tests will be uploaded into RAVE for evaluation by Dr. Wefel. Once the upload is complete, within 3 business days a notification will be sent via email to the RA to proceed to Step 2. NOTE: Completed baseline neurocognitive tests can be uploaded at the time of Step 1 registration. Exclusion Criteria: * Planned infusion of cytotoxic chemotherapy on the same day as SRS or HA-WBRT treatment. Patients may have had prior chemotherapy. Concurrent immunotherapy is permitted. * For patients receiving fractionated SRS on an every-other-day basis, planned infusion of cytotoxic chemotherapy is not permitted between SRS treatments. * Brainstem metastasis \> 10 cm\^3 * Prior allergic reaction to memantine. * Patients with definitive leptomeningeal metastases. * Known history of demyelinating disease such as multiple sclerosis. * Contraindication to MR imaging such as implanted metal devices that are MRI-incompatible, allergy to MRI contrast that cannot be adequately addressed with pre-contrast medications, or foreign bodies that preclude MRI imaging. (Questions regarding MRI compatibility of implanted objects should be reviewed with the Radiology Department performing the MRI). * Current use of (other N-methyl-D-aspartate \[NMDA\] antagonists) amantadine, ketamine, or dextromethorphan. * Radiographic evidence of hydrocephalus or other architectural change of the ventricular system resulting in significant anatomic distortion of the hippocampus, including placement of external ventricular drain or ventriculoperitoneal shunt. * Mild cases of hydrocephalus not resulting in significant anatomic distortion of the hippocampus are permitted. * Prior radiotherapy to the brain, including SRS, WBRT, or prophylactic cranial irradiation (PCI).

Study locations (223)

Mayo Clinic Hospital in Arizona

Phoenix, Arizona, 85054

Active Not Recruiting

Kaiser Permanente-Anaheim

Anaheim, California, 92806

Recruiting
Site Public Contact · Contact
Aakash Batra · Principal Investigator

Kaiser Permanente-Bellflower

Bellflower, California, 90706

Recruiting
Site Public Contact · Contact
Aakash Batra · Principal Investigator

Kaiser Permanente Los Angeles Medical Center

Los Angeles, California, 90027

Recruiting
Site Public Contact · Contact
Aakash Batra · Principal Investigator

Los Angeles General Medical Center

Los Angeles, California, 90033

Recruiting
Site Public Contact · Contact
Jason C. Ye · Principal Investigator

USC / Norris Comprehensive Cancer Center

Los Angeles, California, 90033

Recruiting
Site Public Contact · Contact
Jason C. Ye · Principal Investigator

Kaiser Permanente-Ontario

Ontario, California, 91761

Recruiting
Site Public Contact · Contact
Aakash Batra · Principal Investigator

UCHealth University of Colorado Hospital

Aurora, Colorado, 80045

Active Not Recruiting

UCHealth Memorial Hospital Central

Colorado Springs, Colorado, 80909

Active Not Recruiting

Memorial Hospital North

Colorado Springs, Colorado, 80920

Active Not Recruiting

Smilow Cancer Hospital Care Center at Greenwich

Greenwich, Connecticut, 06830

Terminated

Smilow Cancer Hospital Care Center - Guilford

Guilford, Connecticut, 06437

Terminated

Smilow Cancer Center/Yale-New Haven Hospital

New Haven, Connecticut, 06510

Terminated

Yale University

New Haven, Connecticut, 06520

Terminated

Smilow Cancer Hospital Care Center-Trumbull

Trumbull, Connecticut, 06611

Terminated

Smilow Cancer Hospital Care Center - Waterford

Waterford, Connecticut, 06385

Terminated

Beebe Medical Center

Lewes, Delaware, 19958

Active Not Recruiting

Delaware Clinical and Laboratory Physicians PA

Newark, Delaware, 19713

Active Not Recruiting

Helen F Graham Cancer Center

Newark, Delaware, 19713

Active Not Recruiting

Medical Oncology Hematology Consultants PA

Newark, Delaware, 19713

Active Not Recruiting

Christiana Care Health System-Christiana Hospital

Newark, Delaware, 19718

Active Not Recruiting

Beebe Health Campus

Rehoboth Beach, Delaware, 19971

Active Not Recruiting

Christiana Care Health System-Wilmington Hospital

Wilmington, Delaware, 19801

Active Not Recruiting

UM Sylvester Comprehensive Cancer Center at Coral Gables

Coral Gables, Florida, 33146

Active Not Recruiting

UM Sylvester Comprehensive Cancer Center at Deerfield Beach

Deerfield Beach, Florida, 33442

Active Not Recruiting

UF Health Cancer Institute - Gainesville

Gainesville, Florida, 32610

Active Not Recruiting

University of Miami Miller School of Medicine-Sylvester Cancer Center

Miami, Florida, 33136

Active Not Recruiting

Moffitt Cancer Center-International Plaza

Tampa, Florida, 33607

Recruiting
Site Public Contact · Contact
Hsiang-Hsuan M. Yu · Principal Investigator

Moffitt Cancer Center - McKinley Campus

Tampa, Florida, 33612

Recruiting
Site Public Contact · Contact
Hsiang-Hsuan M. Yu · Principal Investigator

Moffitt Cancer Center

Tampa, Florida, 33612

Recruiting
Site Public Contact · Contact
Hsiang-Hsuan M. Yu · Principal Investigator

Moffitt Cancer Center at Wesley Chapel

Wesley Chapel, Florida, 33544

Recruiting
Site Public Contact · Contact
Hsiang-Hsuan M. Yu · Principal Investigator

Emory University Hospital Midtown

Atlanta, Georgia, 30308

Active Not Recruiting

Emory University Hospital/Winship Cancer Institute

Atlanta, Georgia, 30322

Active Not Recruiting

Emory Saint Joseph's Hospital

Atlanta, Georgia, 30342

Active Not Recruiting

Northside Hospital

Atlanta, Georgia, 30342

Recruiting
Site Public Contact · Contact
Gena H. Volas-Redd · Principal Investigator

Northside Hospital-Cherokee

Canton, Georgia, 30115

Recruiting
Site Public Contact · Contact
Gena H. Volas-Redd · Principal Investigator

Northside Hospital-Forsyth

Cumming, Georgia, 30041

Recruiting
Site Public Contact · Contact
Gena H. Volas-Redd · Principal Investigator

Memorial Health University Medical Center

Savannah, Georgia, 31404

Suspended

Rush-Copley Medical Center

Aurora, Illinois, 60504

Recruiting
Site Public Contact · Contact
Kalika P. Sarma · Principal Investigator

Centralia Oncology Clinic

Centralia, Illinois, 62801

Recruiting
Site Public Contact · Contact
Bryan A. Faller · Principal Investigator

Rush MD Anderson Cancer Center

Chicago, Illinois, 60612

Active Not Recruiting

University of Chicago Comprehensive Cancer Center

Chicago, Illinois, 60637

Recruiting
Steven J. Chmura · Principal Investigator

Carle at The Riverfront

Danville, Illinois, 61832

Recruiting
Site Public Contact · Contact
Kalika P. Sarma · Principal Investigator

Cancer Care Specialists of Illinois - Decatur

Decatur, Illinois, 62526

Recruiting
Site Public Contact · Contact
Bryan A. Faller · Principal Investigator

Decatur Memorial Hospital

Decatur, Illinois, 62526

Recruiting
Site Public Contact · Contact
Bryan A. Faller · Principal Investigator

Northwestern Medicine Cancer Center Kishwaukee

DeKalb, Illinois, 60115

Recruiting
Site Public Contact · Contact
Vinai Gondi · Principal Investigator

Carle Physician Group-Effingham

Effingham, Illinois, 62401

Recruiting
Site Public Contact · Contact
Kalika P. Sarma · Principal Investigator

Crossroads Cancer Center

Effingham, Illinois, 62401

Recruiting
Site Public Contact · Contact
Bryan A. Faller · Principal Investigator

Northwestern Medicine Cancer Center Delnor

Geneva, Illinois, 60134

Recruiting
Site Public Contact · Contact
Vinai Gondi · Principal Investigator

Carle Physician Group-Mattoon/Charleston

Mattoon, Illinois, 61938

Recruiting
Site Public Contact · Contact
Kalika P. Sarma · Principal Investigator

UC Comprehensive Cancer Center at Silver Cross

New Lenox, Illinois, 60451

Recruiting
Steven J. Chmura · Principal Investigator

Cancer Care Center of O'Fallon

O'Fallon, Illinois, 62269

Recruiting
Site Public Contact · Contact
Bryan A. Faller · Principal Investigator

HSHS Saint Elizabeth's Hospital

O'Fallon, Illinois, 62269

Recruiting
Site Public Contact · Contact
Bryan A. Faller · Principal Investigator

OSF Saint Francis Medical Center

Peoria, Illinois, 61637

Recruiting
Site Public Contact · Contact
Bryan A. Faller · Principal Investigator

Carle Cancer Center

Urbana, Illinois, 61801

Recruiting
Site Public Contact · Contact
Kalika P. Sarma · Principal Investigator

The Carle Foundation Hospital

Urbana, Illinois, 61801

Recruiting
Site Public Contact · Contact
Kalika P. Sarma · Principal Investigator

Northwestern Medicine Cancer Center Warrenville

Warrenville, Illinois, 60555

Recruiting
Site Public Contact · Contact
Vinai Gondi · Principal Investigator

IU Health West Hospital

Avon, Indiana, 46123

Recruiting
Site Public Contact · Contact
Kevin Shiue · Principal Investigator

IU Health North Hospital

Carmel, Indiana, 46032

Recruiting
Site Public Contact · Contact
Kevin Shiue · Principal Investigator

Goshen Center for Cancer Care

Goshen, Indiana, 46526

Recruiting
Site Public Contact · Contact
Irina Sparks · Principal Investigator

Indiana University/Melvin and Bren Simon Cancer Center

Indianapolis, Indiana, 46202

Recruiting
Site Public Contact · Contact
Kevin Shiue · Principal Investigator

IU Health Methodist Hospital

Indianapolis, Indiana, 46202

Recruiting
Site Public Contact · Contact
Kevin Shiue · Principal Investigator

Mary Greeley Medical Center

Ames, Iowa, 50010

Recruiting
Site Public Contact · Contact
Joseph J. Merchant · Principal Investigator

McFarland Clinic - Ames

Ames, Iowa, 50010

Recruiting
Site Public Contact · Contact
Joseph J. Merchant · Principal Investigator

Baptist Health Lexington

Lexington, Kentucky, 40503

Active Not Recruiting

The James Graham Brown Cancer Center at University of Louisville

Louisville, Kentucky, 40202

Recruiting
Site Public Contact · Contact
Neal E. Dunlap · Principal Investigator

UofL Health Medical Center Northeast

Louisville, Kentucky, 40245

Recruiting
Site Public Contact · Contact
Neal E. Dunlap · Principal Investigator

Mary Bird Perkins Cancer Center

Baton Rouge, Louisiana, 70809

Recruiting
Site Public Contact · Contact
Victor T. Lin · Principal Investigator

Luminis Health Anne Arundel Medical Center

Annapolis, Maryland, 21401

Active Not Recruiting

University of Maryland/Greenebaum Cancer Center

Baltimore, Maryland, 21201

Recruiting
Site Public Contact · Contact
Mark V. Mishra · Principal Investigator

MedStar Franklin Square Medical Center/Weinberg Cancer Institute

Baltimore, Maryland, 21237

Suspended

UM Upper Chesapeake Medical Center

Bel Air, Maryland, 21014

Recruiting
Site Public Contact · Contact
Kamila Nowak Choi · Principal Investigator

Central Maryland Radiation Oncology in Howard County

Columbia, Maryland, 21044

Recruiting
Site Public Contact · Contact
Mark V. Mishra · Principal Investigator

University of Maryland Shore Medical Center at Easton

Easton, Maryland, 21601

Recruiting
Site Public Contact · Contact
Mark V. Mishra · Principal Investigator

UM Baltimore Washington Medical Center/Tate Cancer Center

Glen Burnie, Maryland, 21061

Recruiting
Site Public Contact · Contact
Mark V. Mishra · Principal Investigator

TidalHealth Richard A Henson Cancer Institute

Ocean Pines, Maryland, 21811

Active Not Recruiting

TidalHealth Peninsula Regional

Salisbury, Maryland, 21801

Active Not Recruiting

Boston Medical Center

Boston, Massachusetts, 02118

Recruiting
Site Public Contact · Contact
Kimberley S. Mak · Principal Investigator

Trinity Health Saint Joseph Mercy Hospital Ann Arbor

Ann Arbor, Michigan, 48106

Recruiting
Samir Narayan · Principal Investigator

McLaren Cancer Institute-Bay City

Bay City, Michigan, 48706

Recruiting
Site Public Contact · Contact
Michael M. Dominello · Principal Investigator

Trinity Health IHA Medical Group Hematology Oncology - Brighton

Brighton, Michigan, 48114

Recruiting
Samir Narayan · Principal Investigator

Trinity Health Medical Center - Brighton

Brighton, Michigan, 48114

Recruiting
Samir Narayan · Principal Investigator

Trinity Health IHA Medical Group Hematology Oncology - Canton

Canton, Michigan, 48188

Recruiting
Samir Narayan · Principal Investigator

Trinity Health Medical Center - Canton

Canton, Michigan, 48188

Recruiting
Samir Narayan · Principal Investigator

Caro Cancer Center

Caro, Michigan, 48723

Suspended

Chelsea Hospital

Chelsea, Michigan, 48118

Recruiting
Samir Narayan · Principal Investigator

Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital

Chelsea, Michigan, 48118

Recruiting
Samir Narayan · Principal Investigator

Wayne State University/Karmanos Cancer Institute

Detroit, Michigan, 48201

Recruiting
Site Public Contact · Contact
Michael M. Dominello · Principal Investigator

Weisberg Cancer Treatment Center

Farmington Hills, Michigan, 48334

Recruiting
Site Public Contact · Contact
Michael M. Dominello · Principal Investigator

McLaren Cancer Institute-Flint

Flint, Michigan, 48532

Recruiting
Site Public Contact · Contact
Michael M. Dominello · Principal Investigator

Karmanos Cancer Institute at McLaren Greater Lansing

Lansing, Michigan, 48910

Recruiting
Site Public Contact · Contact
Michael M. Dominello · Principal Investigator

McLaren Cancer Institute-Lapeer Region

Lapeer, Michigan, 48446

Recruiting
Site Public Contact · Contact
Michael M. Dominello · Principal Investigator

Trinity Health Saint Mary Mercy Livonia Hospital

Livonia, Michigan, 48154

Recruiting
Samir Narayan · Principal Investigator

Saint Mary's Oncology/Hematology Associates of Marlette

Marlette, Michigan, 48453

Suspended

McLaren Cancer Institute-Macomb

Mount Clemens, Michigan, 48043

Recruiting
Site Public Contact · Contact
Michael M. Dominello · Principal Investigator

McLaren Cancer Institute-Central Michigan

Mount Pleasant, Michigan, 48858

Recruiting
Site Public Contact · Contact
Michael M. Dominello · Principal Investigator

McLaren Cancer Institute-Northern Michigan

Petoskey, Michigan, 49770

Recruiting
Site Public Contact · Contact
Michael M. Dominello · Principal Investigator

McLaren-Port Huron

Port Huron, Michigan, 48060

Recruiting
Site Public Contact · Contact
Michael M. Dominello · Principal Investigator

MyMichigan Medical Center Saginaw

Saginaw, Michigan, 48601

Suspended

Oncology Hematology Associates of Saginaw Valley PC

Saginaw, Michigan, 48604

Suspended

MyMichigan Medical Center Tawas

Tawas City, Michigan, 48764

Suspended

Saint Mary's Oncology/Hematology Associates of West Branch

West Branch, Michigan, 48661

Suspended

Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus

Ypsilanti, Michigan, 48197

Recruiting
Samir Narayan · Principal Investigator

Sanford Joe Lueken Cancer Center

Bemidji, Minnesota, 56601

Recruiting
Daniel Almquist · Principal Investigator

Minnesota Oncology - Burnsville

Burnsville, Minnesota, 55337

Recruiting
Site Public Contact · Contact
Yan Ji · Principal Investigator

Mercy Hospital

Coon Rapids, Minnesota, 55433

Recruiting
Site Public Contact · Contact
Yan Ji · Principal Investigator

Fairview Southdale Hospital

Edina, Minnesota, 55435

Recruiting
Site Public Contact · Contact
Yan Ji · Principal Investigator

Unity Hospital

Fridley, Minnesota, 55432

Active Not Recruiting

Fairview Clinics and Surgery Center Maple Grove

Maple Grove, Minnesota, 55369

Recruiting
Site Public Contact · Contact
Yan Ji · Principal Investigator

Minnesota Oncology Hematology PA-Maplewood

Maplewood, Minnesota, 55109

Recruiting
Site Public Contact · Contact
Yan Ji · Principal Investigator

Abbott-Northwestern Hospital

Minneapolis, Minnesota, 55407

Recruiting
Site Public Contact · Contact
Yan Ji · Principal Investigator

Monticello Cancer Center

Monticello, Minnesota, 55362

Recruiting
Site Public Contact · Contact
Yan Ji · Principal Investigator

Coborn Cancer Center at Saint Cloud Hospital

Saint Cloud, Minnesota, 56303

Recruiting
Site Public Contact · Contact
Donald J. Jurgens · Principal Investigator

Regions Hospital

Saint Paul, Minnesota, 55101

Recruiting
Site Public Contact · Contact
Yan Ji · Principal Investigator

United Hospital

Saint Paul, Minnesota, 55102

Recruiting
Site Public Contact · Contact
Yan Ji · Principal Investigator

Lakeview Hospital

Stillwater, Minnesota, 55082

Recruiting
Site Public Contact · Contact
Yan Ji · Principal Investigator

Minnesota Oncology Hematology PA-Woodbury

Woodbury, Minnesota, 55125

Recruiting
Site Public Contact · Contact
Yan Ji · Principal Investigator

Saint Francis Medical Center

Cape Girardeau, Missouri, 63703

Recruiting
Site Public Contact · Contact
Bryan A. Faller · Principal Investigator

Parkland Health Center - Farmington

Farmington, Missouri, 63640

Recruiting
Site Public Contact · Contact
Bryan A. Faller · Principal Investigator

Freeman Health System

Joplin, Missouri, 64804

Recruiting
Site Public Contact · Contact
Jay W. Carlson · Principal Investigator

Sainte Genevieve County Memorial Hospital

Sainte Genevieve, Missouri, 63670

Recruiting
Site Public Contact · Contact
Bryan A. Faller · Principal Investigator

Mercy Hospital Springfield

Springfield, Missouri, 65804

Recruiting
Site Public Contact · Contact
Jay W. Carlson · Principal Investigator

Missouri Baptist Medical Center

St Louis, Missouri, 63131

Recruiting
Site Public Contact · Contact
Bryan A. Faller · Principal Investigator

Missouri Baptist Sullivan Hospital

Sullivan, Missouri, 63080

Recruiting
Site Public Contact · Contact
Bryan A. Faller · Principal Investigator

BJC Outpatient Center at Sunset Hills

Sunset Hills, Missouri, 63127

Recruiting
Site Public Contact · Contact
Bryan A. Faller · Principal Investigator

Billings Clinic Cancer Center

Billings, Montana, 59101

Suspended

Benefis Sletten Cancer Institute

Great Falls, Montana, 59405

Suspended

Logan Health Medical Center

Kalispell, Montana, 59901

Suspended

Cooper Hospital University Medical Center

Camden, New Jersey, 08103

Recruiting
Site Public Contact · Contact
Justin Mann · Principal Investigator

Sands Cancer Center

Canandiaqua, New York, 14424

Active Not Recruiting

Northwell Health/Center for Advanced Medicine

Lake Success, New York, 11042

Active Not Recruiting

Northern Westchester Hospital

Mount Kisco, New York, 10549

Active Not Recruiting

NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center

New York, New York, 10032

Active Not Recruiting

Upstate Cancer Center Radiation Oncology at Oswego

Oswego, New York, 13126

Recruiting
Site Public Contact · Contact
Michael D. Mix · Principal Investigator

Wilmot Cancer Institute Radiation Oncology at Greece

Rochester, New York, 14606

Active Not Recruiting

University of Rochester

Rochester, New York, 14642

Active Not Recruiting

State University of New York Upstate Medical University

Syracuse, New York, 13210

Recruiting
Site Public Contact · Contact
Michael D. Mix · Principal Investigator

Upstate Cancer Center at Hill Radiation Oncology

Syracuse, New York, 13210

Recruiting
Site Public Contact · Contact
Michael D. Mix · Principal Investigator

Montefiore Medical Center-Einstein Campus

The Bronx, New York, 10461

Active Not Recruiting

Montefiore Medical Center-Weiler Hospital

The Bronx, New York, 10461

Active Not Recruiting

Montefiore Medical Center - Moses Campus

The Bronx, New York, 10467

Active Not Recruiting

Upstate Cancer Center at Verona

Verona, New York, 13478

Suspended

Wilmot Cancer Institute at Webster

Webster, New York, 14580

Active Not Recruiting

Wake Forest University Health Sciences

Winston-Salem, North Carolina, 27157

Recruiting
Site Public Contact · Contact
Christina K. Cramer · Principal Investigator

Sanford Bismarck Medical Center

Bismarck, North Dakota, 58501

Recruiting
Daniel Almquist · Principal Investigator

Sanford Broadway Medical Center

Fargo, North Dakota, 58122

Recruiting
Daniel Almquist · Principal Investigator

Sanford Roger Maris Cancer Center

Fargo, North Dakota, 58122

Recruiting
Daniel Almquist · Principal Investigator

UH Seidman Cancer Center at UH Avon Health Center

Avon, Ohio, 44011

Recruiting
Site Public Contact · Contact
Haley K. Perlow · Principal Investigator

University of Cincinnati Cancer Center-UC Medical Center

Cincinnati, Ohio, 45219

Recruiting
Site Public Contact · Contact
Kyle Wang · Principal Investigator

Case Western Reserve University

Cleveland, Ohio, 44106

Recruiting
Site Public Contact · Contact
Haley K. Perlow · Principal Investigator

Ohio State University Comprehensive Cancer Center

Columbus, Ohio, 43210

Recruiting
Site Public Contact · Contact
Simeng Zhu · Principal Investigator

Riverside Methodist Hospital

Columbus, Ohio, 43214

Active Not Recruiting

Grant Medical Center

Columbus, Ohio, 43215

Active Not Recruiting

Delaware Health Center-Grady Cancer Center

Delaware, Ohio, 43015

Active Not Recruiting

Grady Memorial Hospital

Delaware, Ohio, 43015

Active Not Recruiting

UH Seidman Cancer Center at Lake Health Mentor Campus

Mentor, Ohio, 44060

Recruiting
Site Public Contact · Contact
Haley K. Perlow · Principal Investigator

Mercy Health - Perrysburg Hospital

Perrysburg, Ohio, 43551

Recruiting
Site Public Contact · Contact
Aruna C. Gowda · Principal Investigator

Mercy Health - Saint Anne Hospital

Toledo, Ohio, 43623

Suspended

University of Cincinnati Cancer Center-West Chester

West Chester, Ohio, 45069

Recruiting
Site Public Contact · Contact
Kyle Wang · Principal Investigator

University of Oklahoma Health Sciences Center

Oklahoma City, Oklahoma, 73104

Recruiting
Site Public Contact · Contact
Tyler Gunter · Principal Investigator

Saint Luke's Cancer Center - Allentown

Allentown, Pennsylvania, 18104

Active Not Recruiting

UPMC Altoona

Altoona, Pennsylvania, 16601

Recruiting
Site Public Contact · Contact
Serah Choi · Principal Investigator

Saint Luke's University Hospital-Bethlehem Campus

Bethlehem, Pennsylvania, 18015

Active Not Recruiting

Carlisle Regional Cancer Center

Carlisle, Pennsylvania, 17015

Recruiting
Site Public Contact · Contact
Serah Choi · Principal Investigator

Christiana Care Health System-Concord Health Center

Chadds Ford, Pennsylvania, 19317

Active Not Recruiting

Chambersburg Hospital

Chambersburg, Pennsylvania, 17201

Recruiting
Site Public Contact · Contact
Amit B. Shah · Principal Investigator

Geisinger Medical Center

Danville, Pennsylvania, 17822

Recruiting
Site Public Contact · Contact
Fiori Alite · Principal Investigator

Saint Luke's Hospital-Anderson Campus

Easton, Pennsylvania, 18045

Active Not Recruiting

Ephrata Cancer Center

Ephrata, Pennsylvania, 17522

Recruiting
Site Public Contact · Contact
Amit B. Shah · Principal Investigator

UPMC Hillman Cancer Center Erie

Erie, Pennsylvania, 16505

Recruiting
Site Public Contact · Contact
Serah Choi · Principal Investigator

Saint Vincent Hospital

Erie, Pennsylvania, 16544

Active Not Recruiting

UPMC Cancer Center at UPMC Horizon

Farrell, Pennsylvania, 16121

Recruiting
Site Public Contact · Contact
Serah Choi · Principal Investigator

Adams Cancer Center

Gettysburg, Pennsylvania, 17325

Recruiting
Site Public Contact · Contact
Amit B. Shah · Principal Investigator

UPMC Cancer Centers - Arnold Palmer Pavilion

Greensburg, Pennsylvania, 15601

Recruiting
Site Public Contact · Contact
Serah Choi · Principal Investigator

UPMC Pinnacle Cancer Center/Community Osteopathic Campus

Harrisburg, Pennsylvania, 17109

Recruiting
Site Public Contact · Contact
Serah Choi · Principal Investigator

Sechler Family Cancer Center

Lebanon, Pennsylvania, 17042

Recruiting
Site Public Contact · Contact
Amit B. Shah · Principal Investigator

Geisinger Medical Oncology-Lewisburg

Lewisburg, Pennsylvania, 17837

Recruiting
Site Public Contact · Contact
Fiori Alite · Principal Investigator

UPMC Cancer Center - Monroeville

Monroeville, Pennsylvania, 15146

Recruiting
Site Public Contact · Contact
Serah Choi · Principal Investigator

Thomas Jefferson University Hospital

Philadelphia, Pennsylvania, 19107

Active Not Recruiting

Jefferson Torresdale Hospital

Philadelphia, Pennsylvania, 19114

Active Not Recruiting

Allegheny General Hospital

Pittsburgh, Pennsylvania, 15212

Active Not Recruiting

UPMC-Magee Womens Hospital

Pittsburgh, Pennsylvania, 15213

Recruiting
Site Public Contact · Contact
Serah Choi · Principal Investigator

UPMC-Presbyterian Hospital

Pittsburgh, Pennsylvania, 15213

Recruiting
Site Public Contact · Contact
Serah Choi · Principal Investigator

UPMC-Saint Margaret

Pittsburgh, Pennsylvania, 15215

Recruiting
Site Public Contact · Contact
Serah Choi · Principal Investigator

UPMC-Shadyside Hospital

Pittsburgh, Pennsylvania, 15232

Recruiting
Site Public Contact · Contact
Serah Choi · Principal Investigator

UPMC-Passavant Hospital

Pittsburgh, Pennsylvania, 15237

Recruiting
Site Public Contact · Contact
Serah Choi · Principal Investigator

UPMC-Saint Clair Hospital Cancer Center

Pittsburgh, Pennsylvania, 15243

Recruiting
Site Public Contact · Contact
Serah Choi · Principal Investigator

Saint Luke's Hospital - Upper Bucks Campus

Quakertown, Pennsylvania, 18951

Active Not Recruiting

Saint Luke's Hospital-Quakertown Campus

Quakertown, Pennsylvania, 18951

Suspended

Saint Luke's Hospital - Monroe Campus

Stroudsburg, Pennsylvania, 18360

Active Not Recruiting

Geisinger Wyoming Valley/Henry Cancer Center

Wilkes-Barre, Pennsylvania, 18711

Recruiting
Site Public Contact · Contact
Fiori Alite · Principal Investigator

Divine Providence Hospital

Williamsport, Pennsylvania, 17754

Recruiting
Site Public Contact · Contact
Serah Choi · Principal Investigator

WellSpan Health-York Cancer Center

York, Pennsylvania, 17403

Recruiting
Site Public Contact · Contact
Amit B. Shah · Principal Investigator

WellSpan Health-York Hospital

York, Pennsylvania, 17403

Recruiting
Site Public Contact · Contact
Amit B. Shah · Principal Investigator

UPMC Memorial

York, Pennsylvania, 17408

Recruiting
Site Public Contact · Contact
Serah Choi · Principal Investigator

McLeod Regional Medical Center

Florence, South Carolina, 29506

Recruiting
Site Public Contact · Contact
Rajesh Bajaj · Principal Investigator

Gibbs Cancer Center-Gaffney

Gaffney, South Carolina, 29341

Active Not Recruiting

Self Regional Healthcare

Greenwood, South Carolina, 29646

Active Not Recruiting

Gibbs Cancer Center-Pelham

Greer, South Carolina, 29651

Active Not Recruiting

Spartanburg Medical Center

Spartanburg, South Carolina, 29303

Active Not Recruiting

SMC Center for Hematology Oncology Union

Union, South Carolina, 29379

Active Not Recruiting

Sanford Cancer Center Oncology Clinic

Sioux Falls, South Dakota, 57104

Recruiting
Daniel Almquist · Principal Investigator

Avera Cancer Institute

Sioux Falls, South Dakota, 57105

Active Not Recruiting

Sanford USD Medical Center - Sioux Falls

Sioux Falls, South Dakota, 57117-5134

Recruiting
Daniel Almquist · Principal Investigator

MD Anderson in The Woodlands

Conroe, Texas, 77384

Recruiting
Site Public Contact · Contact
Martin C. Tom · Principal Investigator

M D Anderson Cancer Center

Houston, Texas, 77030

Recruiting
Site Public Contact · Contact
Martin C. Tom · Principal Investigator

MD Anderson West Houston

Houston, Texas, 77079

Recruiting
Site Public Contact · Contact
Martin C. Tom · Principal Investigator

MD Anderson League City

League City, Texas, 77573

Recruiting
Site Public Contact · Contact
Martin C. Tom · Principal Investigator

MD Anderson in Sugar Land

Sugar Land, Texas, 77478

Recruiting
Site Public Contact · Contact
Martin C. Tom · Principal Investigator

VCU Massey Comprehensive Cancer Center

Richmond, Virginia, 23298

Active Not Recruiting

Langlade Hospital and Cancer Center

Antigo, Wisconsin, 54409

Recruiting
Site Public Contact · Contact
Andrew J. Huang · Principal Investigator

ThedaCare Regional Cancer Center

Appleton, Wisconsin, 54911

Recruiting
Site Public Contact · Contact
Joseph A. Bovi · Principal Investigator

Gundersen Lutheran Medical Center

La Crosse, Wisconsin, 54601

Active Not Recruiting

University of Wisconsin Carbone Cancer Center - Eastpark Medical Center

Madison, Wisconsin, 53718

Recruiting
Site Public Contact · Contact
Andrew M. Baschnagel · Principal Investigator

University of Wisconsin Carbone Cancer Center - University Hospital

Madison, Wisconsin, 53792

Recruiting
Site Public Contact · Contact
Andrew M. Baschnagel · Principal Investigator

Froedtert Menomonee Falls Hospital

Menomonee Falls, Wisconsin, 53051

Recruiting
Site Public Contact · Contact
Michael W. Straza · Principal Investigator

Medical College of Wisconsin

Milwaukee, Wisconsin, 53226

Recruiting
Site Public Contact · Contact
Michael W. Straza · Principal Investigator

Cancer Center of Western Wisconsin

New Richmond, Wisconsin, 54017

Recruiting
Site Public Contact · Contact
Yan Ji · Principal Investigator

Drexel Town Square Health Center

Oak Creek, Wisconsin, 53154

Recruiting
Site Public Contact · Contact
Michael W. Straza · Principal Investigator

Aspirus Cancer Care - James Beck Cancer Center

Rhinelander, Wisconsin, 54501

Recruiting
Site Public Contact · Contact
Andrew J. Huang · Principal Investigator

Aspirus Cancer Care - Stevens Point

Stevens Point, Wisconsin, 54481

Recruiting
Site Public Contact · Contact
Andrew J. Huang · Principal Investigator

Aspirus Regional Cancer Center

Wausau, Wisconsin, 54401

Recruiting
Site Public Contact · Contact
Andrew J. Huang · Principal Investigator

Froedtert West Bend Hospital/Kraemer Cancer Center

West Bend, Wisconsin, 53095

Recruiting
Site Public Contact · Contact
Michael W. Straza · Principal Investigator