A Randomized Trial of Selumetinib and Olaparib or Selumetinib Alone in Patients With Recurrent or Persistent RAS Pathway Mutant Ovarian and Endometrial Cancers: A ComboMATCH Treatment Trial
Summary
This phase II ComboMATCH treatment trial compares selumetinib plus olaparib to selumetinib alone in women with endometrial or ovarian (fallopian tube and primary peritoneal) cancer that has come back (recurrent) or that remains despite treatment (persistent) and harbors a mutation in the RAS pathway. Selumetinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Olaparib is an inhibitor of PARP, an enzyme that helps repair deoxyribonucleic acid (DNA) when it becomes damaged. Blocking PARP may help keep tumor cells from repairing their damaged DNA, causing them to die. PARP inhibitors are a type of targeted therapy. The addition of olaparib to selumetinib could increase the percentage of tumors that shrink as well as lengthen the time that the tumors remain stable (without progression) as compared to selumetinib alone.
Detailed description
PRIMARY OBJECTIVES: I. Compare progression free survival of combination of olaparib and selumetinib sulfate (selumetinib) to selumetinib alone in patients with RAS mutant ovarian cancer. (Cohort 1) II. Compare progression free survival of combination of olaparib and selumetinib to selumetinib alone in patients with RAS mutant endometrial cancer. (Cohort 2) SECONDARY OBJECTIVES: I. Determine safety of both arms per Common Terminology Criteria for Adverse Events (CTCAE) version (v)5.0. II. Compare objective response rate per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 between the two arms. III. Determine rate of objective response per RECIST 1.1 in those patients that crossover from the single agent arm to the combination arm. IV. Report duration of response of the two treatment arms. V. Collect tissue and provide it to the ComboMATCH Registration protocol to assess concordance between the diagnostic tumor mutation profile generated by the designated laboratories, the pre-treatment biopsy mutation profile, and the pre-treatment circulating tumor (ct)DNA mutation profile from plasma, as described in ComboMATCH Registration protocol. For this treatment substudy, the outcome objective will be to report the proportion of cases providing sufficient tissue for that integrated scientific activity in the ComboMATCH Registration protocol. TRANSLATIONAL OBJECTIVE: I. To assess association of baseline genomic and transcriptomic status with response and resistance to therapy. OUTLINE: Patients in both cohorts are randomized to 1 of 2 arms. ARM I: Patients receive selumetinib orally (PO) twice daily (BID) and olaparib PO BID on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo a tumor biopsy and blood collection during screening and on study, as well as echocardiogram (ECHO) or multigated acquisition (MUGA), and computed tomography (CT) scans throughout the trial. Patients may undergo bone marrow aspiration or biopsy as clinically indicated. ARM II: Patients receive selumetinib PO BID on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients who experience progression may elect to cross over to Arm I provided they have not had dose limiting toxicities to monotherapy selumetinib. Patients also undergo a tumor biopsy and blood collection during screening and on study, as well as ECHO or MUGA, and CT scans throughout the trial. Patients may undergo bone marrow aspiration or biopsy as clinically indicated. After completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months for 3 years.
Arms & interventions
- ProcedureBiopsy Procedure
Undergo tumor biopsy
- ProcedureBiospecimen Collection
Undergo blood collection
- ProcedureBone Marrow Aspiration and Biopsy
Undergo bone marrow aspiration or biopsy
- ProcedureComputed Tomography
Undergo CT scan
- ProcedureEchocardiography Test
Undergo ECHO
- ProcedureMultigated Acquisition Scan
Undergo MUGA
- DrugOlaparib
Given PO
- DrugSelumetinib Sulfate
Given PO
Outcome measures
Primary
Progression-free survival
Disease progression will be defined using Response Evaluation Criteria in Solid Tumors (RECIST) version (v)1.1 criteria, as determined by the treating physician. The primary analyses will be based on logrank tests stratified by the stratification factors as recorded at randomization. All enrolled patients will be included, regardless of compliance with their assigned study regimen. Patients will be grouped by their randomized treatment for intention-to-treat analyses. Treatment hazard ratios and 90% confidence intervals will be estimated using proportional hazards models specified with a main-effect for the randomized treatment assignment (experimental versus \[vs\] reference), and stratified using the stratification factors recorded at randomization. Treatment group differences will be graphed using Kaplan-Meier methods.
Time frame: The duration of time from enrollment to the date of progression or death, whichever occurs first, assessed up to 5 years
Secondary
Incidence of adverse events (AE)
Time frame: Up to 5 years
Objective response rate (ORR) between two arms
Time frame: Within 6 months of the date of last enrollment
ORR in crossover patients
Time frame: Up to 5 years
Duration of response of both arms
Time frame: The time from documentation of either PR or CR until disease progression or death, whichever is observed first, assessed up to 5 years
Eligibility criteria
Study locations (293)
University of Alabama at Birmingham Cancer Center
Birmingham, Alabama, 35233
University of South Alabama Mitchell Cancer Institute
Mobile, Alabama, 36688
Alaska Women's Cancer Care
Anchorage, Alaska, 99508
CTCA at Western Regional Medical Center
Goodyear, Arizona, 85338
Kingman Regional Medical Center
Kingman, Arizona, 86401
PCR Oncology
Arroyo Grande, California, 93420
Cedars-Sinai Medical Center
Los Angeles, California, 90048
Saint Joseph Hospital - Orange
Orange, California, 92868
Stanford Cancer Institute Palo Alto
Palo Alto, California, 94304
Presbyterian Intercommunity Hospital
Whittier, California, 90602
UM Sylvester Comprehensive Cancer Center at Aventura
Aventura, Florida, 33180
UM Sylvester Comprehensive Cancer Center at Coral Gables
Coral Gables, Florida, 33146
UM Sylvester Comprehensive Cancer Center at Deerfield Beach
Deerfield Beach, Florida, 33442
Mayo Clinic in Florida
Jacksonville, Florida, 32224-9980
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami, Florida, 33136
UM Sylvester Comprehensive Cancer Center at Kendall
Miami, Florida, 33176
University of Miami Sylvester Comprehensive Cancer Center at Sole Mia
North Miami, Florida, 33181
UM Sylvester Comprehensive Cancer Center at Plantation
Plantation, Florida, 33324
Queen's Cancer Cenrer - POB I
Honolulu, Hawaii, 96813
Queen's Medical Center
Honolulu, Hawaii, 96813
University of Hawaii Cancer Center
Honolulu, Hawaii, 96813
Queen's Cancer Center - Kuakini
Honolulu, Hawaii, 96817
Kapiolani Medical Center for Women and Children
Honolulu, Hawaii, 96826
The Queen's Medical Center - West Oahu
‘Ewa Beach, Hawaii, 96706
Saint Alphonsus Cancer Care Center-Boise
Boise, Idaho, 83706
Saint Luke's Cancer Institute - Boise
Boise, Idaho, 83712
Saint Alphonsus Cancer Care Center-Caldwell
Caldwell, Idaho, 83605
Kootenai Health - Coeur d'Alene
Coeur d'Alene, Idaho, 83814
Saint Luke's Cancer Institute - Fruitland
Fruitland, Idaho, 83619
Saint Luke's Cancer Institute - Meridian
Meridian, Idaho, 83642
Saint Alphonsus Cancer Care Center-Nampa
Nampa, Idaho, 83687
Saint Luke's Cancer Institute - Nampa
Nampa, Idaho, 83687
Kootenai Clinic Cancer Services - Post Falls
Post Falls, Idaho, 83854
Kootenai Clinic Cancer Services - Sandpoint
Sandpoint, Idaho, 83864
Saint Luke's Cancer Institute - Twin Falls
Twin Falls, Idaho, 83301
Advocate Good Shepherd Hospital
Barrington, Illinois, 60010
Illinois CancerCare-Bloomington
Bloomington, Illinois, 61704
Illinois CancerCare-Canton
Canton, Illinois, 61520
Illinois CancerCare-Carthage
Carthage, Illinois, 62321
Centralia Oncology Clinic
Centralia, Illinois, 62801
John H Stroger Jr Hospital of Cook County
Chicago, Illinois, 60612
University of Illinois
Chicago, Illinois, 60612
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
Advocate Illinois Masonic Medical Center
Chicago, Illinois, 60657
AMG Crystal Lake - Oncology
Crystal Lake, Illinois, 60014
Carle at The Riverfront
Danville, Illinois, 61832
Cancer Care Specialists of Illinois - Decatur
Decatur, Illinois, 62526
Decatur Memorial Hospital
Decatur, Illinois, 62526
Illinois CancerCare-Dixon
Dixon, Illinois, 61021
Advocate Good Samaritan Hospital
Downers Grove, Illinois, 60515
Carle Physician Group-Effingham
Effingham, Illinois, 62401
Crossroads Cancer Center
Effingham, Illinois, 62401
Advocate Sherman Hospital
Elgin, Illinois, 60123
Illinois CancerCare-Eureka
Eureka, Illinois, 61530
NorthShore University HealthSystem-Evanston Hospital
Evanston, Illinois, 60201
Illinois CancerCare-Galesburg
Galesburg, Illinois, 61401
NorthShore University HealthSystem-Glenbrook Hospital
Glenview, Illinois, 60026
Advocate South Suburban Hospital
Hazel Crest, Illinois, 60429
NorthShore University HealthSystem-Highland Park Hospital
Highland Park, Illinois, 60035
Illinois CancerCare-Kewanee Clinic
Kewanee, Illinois, 61443
AMG Libertyville - Oncology
Libertyville, Illinois, 60048
Condell Memorial Hospital
Libertyville, Illinois, 60048
Illinois CancerCare-Macomb
Macomb, Illinois, 61455
Carle Physician Group-Mattoon/Charleston
Mattoon, Illinois, 61938
UC Comprehensive Cancer Center at Silver Cross
New Lenox, Illinois, 60451
Carle BroMenn Medical Center
Normal, Illinois, 61761
Carle Cancer Institute Normal
Normal, Illinois, 61761
Cancer Care Center of O'Fallon
O'Fallon, Illinois, 62269
Advocate Christ Medical Center
Oak Lawn, Illinois, 60453-2699
University of Chicago Medicine-Orland Park
Orland Park, Illinois, 60462
Illinois CancerCare-Ottawa Clinic
Ottawa, Illinois, 61350
Advocate Lutheran General Hospital
Park Ridge, Illinois, 60068
Illinois CancerCare-Pekin
Pekin, Illinois, 61554
Illinois CancerCare-Peoria
Peoria, Illinois, 61615
Illinois CancerCare-Peru
Peru, Illinois, 61354
Illinois CancerCare-Princeton
Princeton, Illinois, 61356
Southern Illinois University School of Medicine
Springfield, Illinois, 62702
Springfield Clinic
Springfield, Illinois, 62702
Springfield Memorial Hospital
Springfield, Illinois, 62781
Carle Cancer Center
Urbana, Illinois, 61801
Illinois CancerCare - Washington
Washington, Illinois, 61571
UChicago Medicine Northwest Indiana
Crown Point, Indiana, 46307
UI Health Care Mission Cancer and Blood - Ankeny Clinic
Ankeny, Iowa, 50023
UI Health Care Mission Cancer and Blood - West Des Moines Clinic
Clive, Iowa, 50325
UI Health Care Mission Cancer and Blood - Des Moines Clinic
Des Moines, Iowa, 50309
Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
UI Health Care Mission Cancer and Blood - Laurel Clinic
Des Moines, Iowa, 50314
UI Health Care Mission Cancer and Blood - Waukee Clinic
Waukee, Iowa, 50263
University of Kentucky/Markey Cancer Center
Lexington, Kentucky, 40536
Ochsner Baptist Medical Center
New Orleans, Louisiana, 70115
Ochsner Medical Center Jefferson
New Orleans, Louisiana, 70121
Harold Alfond Center for Cancer Care
Augusta, Maine, 04330
Lafayette Family Cancer Center-EMMC
Brewer, Maine, 04412
MaineHealth Maine Medical Center- Scarborough
Scarborough, Maine, 04074
University of Maryland/Greenebaum Cancer Center
Baltimore, Maryland, 21201
Walter Reed National Military Medical Center
Bethesda, Maryland, 20889-5600
National Institutes of Health Clinical Center
Bethesda, Maryland, 20892
UPMC Western Maryland
Cumberland, Maryland, 21502
Tufts Medical Center
Boston, Massachusetts, 02111
Baystate Medical Center
Springfield, Massachusetts, 01199
Tufts Medical Center Cancer Center Stoneham
Stoneham, Massachusetts, 02180
Trinity Health Saint Joseph Mercy Hospital Ann Arbor
Ann Arbor, Michigan, 48106
University of Michigan Rogel Cancer Center
Ann Arbor, Michigan, 48109
Trinity Health IHA Medical Group Hematology Oncology - Brighton
Brighton, Michigan, 48114
Trinity Health Medical Center - Brighton
Brighton, Michigan, 48114
University of Michigan - Brighton Center for Specialty Care
Brighton, Michigan, 48116
Trinity Health IHA Medical Group Hematology Oncology - Canton
Canton, Michigan, 48188
Trinity Health Medical Center - Canton
Canton, Michigan, 48188
Chelsea Hospital
Chelsea, Michigan, 48118
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
Chelsea, Michigan, 48118
Corewell Health Dearborn Hospital
Dearborn, Michigan, 48124
Corewell Health Farmington Hills Hospital
Farmington Hills, Michigan, 48336
Cancer Hematology Centers - Flint
Flint, Michigan, 48503
Genesee Hematology Oncology PC
Flint, Michigan, 48503
Genesys Hurley Cancer Institute
Flint, Michigan, 48503
Hurley Medical Center
Flint, Michigan, 48503
University of Michigan Health - Sparrow Lansing
Lansing, Michigan, 48912
Trinity Health Saint Mary Mercy Livonia Hospital
Livonia, Michigan, 48154
Henry Ford Saint John Hospital - Macomb Medical
Macomb, Michigan, 48044
Trinity Health Saint Joseph Mercy Oakland Hospital
Pontiac, Michigan, 48341
Corewell Health William Beaumont University Hospital
Royal Oak, Michigan, 48073
Corewell Health Beaumont Troy Hospital
Troy, Michigan, 48085
Huron Gastroenterology PC
Ypsilanti, Michigan, 48106
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
Ypsilanti, Michigan, 48197
Mercy Hospital
Coon Rapids, Minnesota, 55433
Essentia Health - Deer River Clinic
Deer River, Minnesota, 56636
Essentia Health Cancer Center
Duluth, Minnesota, 55805
Fairview Southdale Hospital
Edina, Minnesota, 55435
Essentia Health Hibbing Clinic
Hibbing, Minnesota, 55746
Fairview Clinics and Surgery Center Maple Grove
Maple Grove, Minnesota, 55369
Abbott-Northwestern Hospital
Minneapolis, Minnesota, 55407
Mayo Clinic in Rochester
Rochester, Minnesota, 55905
Park Nicollet Clinic - Saint Louis Park
Saint Louis Park, Minnesota, 55416
Regions Hospital
Saint Paul, Minnesota, 55101
United Hospital
Saint Paul, Minnesota, 55102
Essentia Health Sandstone
Sandstone, Minnesota, 55072
Essentia Health Virginia Clinic
Virginia, Minnesota, 55792
Saint Francis Medical Center
Cape Girardeau, Missouri, 63703
Parkland Health Center - Farmington
Farmington, Missouri, 63640
Sainte Genevieve County Memorial Hospital
Sainte Genevieve, Missouri, 63670
Washington University School of Medicine
St Louis, Missouri, 63110
Missouri Baptist Medical Center
St Louis, Missouri, 63131
Missouri Baptist Sullivan Hospital
Sullivan, Missouri, 63080
BJC Outpatient Center at Sunset Hills
Sunset Hills, Missouri, 63127
Community Hospital of Anaconda
Anaconda, Montana, 59711
Billings Clinic Cancer Center
Billings, Montana, 59101
Bozeman Health Deaconess Hospital
Bozeman, Montana, 59715
Benefis Sletten Cancer Institute
Great Falls, Montana, 59405
Logan Health Medical Center
Kalispell, Montana, 59901
Community Medical Center
Missoula, Montana, 59804
OptumCare Cancer Care at Charleston
Las Vegas, Nevada, 89102
OptumCare Cancer Care at Fort Apache
Las Vegas, Nevada, 89183
Jersey City Medical Center
Jersey City, New Jersey, 07302
Monmouth Medical Center Southern Campus
Lakewood, New Jersey, 08701
Monmouth Medical Center
Long Branch, New Jersey, 07740
Memorial Sloan Kettering Monmouth
Middletown, New Jersey, 07748
Rutgers Cancer Institute of New Jersey
New Brunswick, New Jersey, 08903
Sidney Kimmel Cancer Center Washington Township
Sewell, New Jersey, 08080
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87106
Roswell Park Cancer Institute
Buffalo, New York, 14263
Memorial Sloan Kettering Commack
Commack, New York, 11725
Memorial Sloan Kettering Westchester
Harrison, New York, 10604
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
State University of New York Upstate Medical University
Syracuse, New York, 13210
Cone Health MedCenter Asheboro
Asheboro, North Carolina, 27205
Mission Hospital
Asheville, North Carolina, 28801
Hope Women's Cancer Centers-Asheville
Asheville, North Carolina, 28816
Cone Health Cancer Center at Alamance Regional
Burlington, North Carolina, 27215
Duke University Medical Center
Durham, North Carolina, 27710
Cone Health Cancer Center
Greensboro, North Carolina, 27403
Cone Health Cancer Center at Drawbridge Parkway
Greensboro, North Carolina, 27410
Duke Women's Cancer Care Raleigh
Raleigh, North Carolina, 27607
Annie Penn Memorial Hospital
Reidsville, North Carolina, 27320
Sanford Bismarck Medical Center
Bismarck, North Dakota, 58501
Sanford Broadway Medical Center
Fargo, North Dakota, 58122
Sanford Roger Maris Cancer Center
Fargo, North Dakota, 58122
UH Seidman Cancer Center at UH Avon Health Center
Avon, Ohio, 44011
UHHS-Chagrin Highlands Medical Center
Beachwood, Ohio, 44122
Strecker Cancer Center-Belpre
Belpre, Ohio, 45714
Aultman Health Foundation
Canton, Ohio, 44710
Miami Valley Hospital South
Centerville, Ohio, 45459
Adena Regional Medical Center
Chillicothe, Ohio, 45601
Good Samaritan Hospital - Cincinnati
Cincinnati, Ohio, 45220
Case Western Reserve University
Cleveland, Ohio, 44106
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210
Mount Carmel East Hospital
Columbus, Ohio, 43213
Riverside Methodist Hospital
Columbus, Ohio, 43214
The Mark H Zangmeister Center
Columbus, Ohio, 43219
Miami Valley Hospital
Dayton, Ohio, 45409
Dayton Physician LLC - Englewood
Dayton, Ohio, 45415
Miami Valley Hospital North
Dayton, Ohio, 45415
Dublin Methodist Hospital
Dublin, Ohio, 43016
Atrium Medical Center-Middletown Regional Hospital
Franklin, Ohio, 45005-1066
Miami Valley Cancer Care and Infusion
Greenville, Ohio, 45331
Kettering Medical Center
Kettering, Ohio, 45429
Fairfield Medical Center
Lancaster, Ohio, 43130
OhioHealth Mansfield Hospital
Mansfield, Ohio, 44903
Marietta Memorial Hospital
Marietta, Ohio, 45750
Memorial Hospital
Marysville, Ohio, 43040
UH Seidman Cancer Center at Lake Health Mentor Campus
Mentor, Ohio, 44060
Knox Community Hospital
Mount Vernon, Ohio, 43050
Licking Memorial Hospital
Newark, Ohio, 43055
Mercy Health - Perrysburg Hospital
Perrysburg, Ohio, 43551
OhioHealth Pickerington Methodist Hospital
Pickerington, Ohio, 43147
Southern Ohio Medical Center
Portsmouth, Ohio, 45662
Springfield Regional Cancer Center
Springfield, Ohio, 45504
Springfield Regional Medical Center
Springfield, Ohio, 45504
Mercy Health - Saint Anne Hospital
Toledo, Ohio, 43623
Upper Valley Medical Center
Troy, Ohio, 45373
Saint Ann's Hospital
Westerville, Ohio, 43081
OhioHealth Westerville Medical Campus/Westerville Cancer Center
Westerville, Ohio, 43082
UH Seidman Cancer Center at Saint John Medical Center
Westlake, Ohio, 44145
Genesis Healthcare System Cancer Care Center
Zanesville, Ohio, 43701
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Providence Newberg Medical Center
Newberg, Oregon, 97132
Saint Alphonsus Cancer Care Center-Ontario
Ontario, Oregon, 97914
Providence Willamette Falls Medical Center
Oregon City, Oregon, 97045
Providence Portland Medical Center
Portland, Oregon, 97213
Providence Saint Vincent Medical Center
Portland, Oregon, 97225
Oregon Health and Science University
Portland, Oregon, 97239
Lehigh Valley Hospital-Cedar Crest
Allentown, Pennsylvania, 18103
UPMC Altoona
Altoona, Pennsylvania, 16601
Lehigh Valley Hospital - Muhlenberg
Bethlehem, Pennsylvania, 18017
Bryn Mawr Hospital
Bryn Mawr, Pennsylvania, 19010
Pocono Medical Center
East Stroudsburg, Pennsylvania, 18301
UPMC Hillman Cancer Center Erie
Erie, Pennsylvania, 16505
UPMC Cancer Centers - Arnold Palmer Pavilion
Greensburg, Pennsylvania, 15601
UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion
Mechanicsburg, Pennsylvania, 17050
Riddle Memorial Hospital
Media, Pennsylvania, 19063
UPMC Hillman Cancer Center - Monroeville
Monroeville, Pennsylvania, 15146
Paoli Memorial Hospital
Paoli, Pennsylvania, 19301
Pennsylvania Hospital
Philadelphia, Pennsylvania, 19107
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, 19107
Fox Chase Cancer Center
Philadelphia, Pennsylvania, 19111
UPMC-Magee Womens Hospital
Pittsburgh, Pennsylvania, 15213
University of Pittsburgh Cancer Institute (UPCI)
Pittsburgh, Pennsylvania, 15232
UPMC-Passavant Hospital
Pittsburgh, Pennsylvania, 15237
Asplundh Cancer Pavilion
Willow Grove, Pennsylvania, 19090
Lankenau Medical Center
Wynnewood, Pennsylvania, 19096
Women and Infants Hospital
Providence, Rhode Island, 02905
Rapid City Regional Hospital
Rapid City, South Dakota, 57701
Sanford Cancer Center Oncology Clinic
Sioux Falls, South Dakota, 57104
Sanford USD Medical Center - Sioux Falls
Sioux Falls, South Dakota, 57117-5134
MD Anderson in The Woodlands
Conroe, Texas, 77384
UT Southwestern/Simmons Cancer Center-Dallas
Dallas, Texas, 75390
Lyndon Baines Johnson General Hospital
Houston, Texas, 77026-1967
UT MD Anderson Cancer Center
Houston, Texas, 77030
MD Anderson West Houston
Houston, Texas, 77079
UT MD Anderson - League City
League City, Texas, 77573
MD Anderson in Sugar Land
Sugar Land, Texas, 77478
University of Virginia Cancer Center
Charlottesville, Virginia, 22908
Henrico Doctor's Hospital
Richmond, Virginia, 23229
Virginia Cancer Institute
Richmond, Virginia, 23229
VCU Massey Cancer Center at Stony Point
Richmond, Virginia, 23235
VCU Massey Comprehensive Cancer Center
Richmond, Virginia, 23298
Carilion Roanoke Memorial Hospital
Roanoke, Virginia, 24033
VCU Community Memorial Health Center
South Hill, Virginia, 23970
Swedish Cancer Institute-Edmonds
Edmonds, Washington, 98026
Swedish Cancer Institute-Issaquah
Issaquah, Washington, 98029
Providence Regional Cancer System-Lacey
Lacey, Washington, 98503
Valley Medical Center
Renton, Washington, 98055
Swedish Medical Center-First Hill
Seattle, Washington, 98122
Providence Saint Mary Regional Cancer Center
Walla Walla, Washington, 99362
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
Yakima, Washington, 98902
Edwards Comprehensive Cancer Center
Huntington, West Virginia, 25701
West Virginia University Healthcare
Morgantown, West Virginia, 26506
Duluth Clinic Ashland
Ashland, Wisconsin, 54806
Aurora Cancer Care-Southern Lakes VLCC
Burlington, Wisconsin, 53105
Aurora Saint Luke's South Shore
Cudahy, Wisconsin, 53110
Aurora Health Care Germantown Health Center
Germantown, Wisconsin, 53022
Aurora Cancer Care-Grafton
Grafton, Wisconsin, 53024
Saint Vincent Hospital Cancer Center Green Bay
Green Bay, Wisconsin, 54301
Saint Vincent Hospital Cancer Center at Saint Mary's
Green Bay, Wisconsin, 54303
Aurora BayCare Medical Center
Green Bay, Wisconsin, 54311
Aurora Cancer Care-Kenosha South
Kenosha, Wisconsin, 53142
Gundersen Lutheran Medical Center
La Crosse, Wisconsin, 54601
University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
Madison, Wisconsin, 53718
University of Wisconsin Carbone Cancer Center - University Hospital
Madison, Wisconsin, 53792
Aurora Bay Area Medical Group-Marinette
Marinette, Wisconsin, 54143
Aurora Cancer Care-Milwaukee
Milwaukee, Wisconsin, 53209
Aurora Saint Luke's Medical Center
Milwaukee, Wisconsin, 53215
Aurora Sinai Medical Center
Milwaukee, Wisconsin, 53233
Cancer Center of Western Wisconsin
New Richmond, Wisconsin, 54017
Saint Vincent Hospital Cancer Center at Oconto Falls
Oconto Falls, Wisconsin, 54154
Vince Lombardi Cancer Clinic - Oshkosh
Oshkosh, Wisconsin, 54904
Aurora Cancer Care-Racine
Racine, Wisconsin, 53406
Saint Vincent Hospital Cancer Center at Sheboygan
Sheboygan, Wisconsin, 53081
Vince Lombardi Cancer Clinic-Sheboygan
Sheboygan, Wisconsin, 53081
Saint Vincent Hospital Cancer Center at Sturgeon Bay
Sturgeon Bay, Wisconsin, 54235-1495
Aurora Medical Center in Summit
Summit, Wisconsin, 53066
Vince Lombardi Cancer Clinic-Two Rivers
Two Rivers, Wisconsin, 54241
Aurora Cancer Care-Milwaukee West
Wauwatosa, Wisconsin, 53226
Aurora West Allis Medical Center
West Allis, Wisconsin, 53227