A Randomized Phase 3 Interim Response Adapted Trial Comparing Standard Therapy With Immuno-oncology Therapy for Children and Adults With Newly Diagnosed Stage I and II Classic Hodgkin Lymphoma
Summary
This phase III trial compares the effect of adding immunotherapy (brentuximab vedotin and nivolumab) to standard treatment (chemotherapy with or without radiation) to the standard treatment alone in improving survival in patients with stage I and II classical Hodgkin lymphoma. Brentuximab vedotin is in a class of medications called antibody-drug conjugates. It is made of a monoclonal antibody called brentuximab that is linked to a cytotoxic agent called vedotin. Brentuximab attaches to CD30 positive lymphoma cells in a targeted way and delivers vedotin to kill them. A monoclonal antibody is a type of protein that can bind to certain targets in the body, such as molecules that cause the body to make an immune response (antigens). Immunotherapy with monoclonal antibodies, such as nivolumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Chemotherapy drugs such as doxorubicin hydrochloride, bleomycin sulfate, vinblastine sulfate, dacarbazine, and procarbazine hydrochloride work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Cyclophosphamide is in a class of medications called alkylating agents. It works by damaging the cell's deoxyribonucleic acid (DNA) and may kill cancer cells. It may also lower the body's immune response. Etoposide is in a class of medications known as podophyllotoxin derivatives. It blocks a certain enzyme needed for cell division and DNA repair and may kill cancer cells. Vincristine is in a class of medications called vinca alkaloids. It works by stopping cancer cells from growing and dividing and may kill them. Prednisone is in a class of medications called corticosteroids. It is used to reduce inflammation and lower the body's immune response to help lessen the side effects of chemotherapy drugs. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. Adding immunotherapy to the standard treatment of chemotherapy with or without radiation may increase survival and/or fewer short-term or long-term side effects in patients with classical Hodgkin lymphoma compared to the standard treatment alone.
Detailed description
PRIMARY OBJECTIVES: I. To compare the progression-free survival (PFS) of a standard chemotherapy approach versus an immunotherapy (IO) approach (brentuximab vedotin and nivolumab) in patients with newly diagnosed early stage classic Hodgkin lymphoma (cHL) who have a rapid early response (RER) as determined by position emission tomography post cycle 2 (PET2) after 2 cycles of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) chemotherapy. II. To compare the PFS of a standard chemotherapy approach versus an IO therapy approach (brentuximab vedotin and nivolumab) plus involved site radiation therapy (ISRT) in patients with newly diagnosed early stage cHL who have a slow early response (SER) as determined by PET2 after 2 cycles of ABVD chemotherapy. SECONDARY OBJECTIVES: I. To demonstrate non-inferiority of overall survival (OS) at 12 years of IO therapy versus standard therapy in early stage cHL patients who have a RER as determined by PET2 after 2 cycles of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) chemotherapy. II. To evaluate the overall survival (OS) at 12 years of IO therapy versus standard therapy in early stage cHL patients who have a SER as determined by PET2 after 2 cycles of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) chemotherapy. III. To demonstrate non-inferiority of overall survival (OS) at 12 years of IO therapy versus standard therapy in early stage cHL patients. IV. To evaluate in patients with newly diagnosed early stage cHL the PFS of a standard chemotherapy approach versus an IO therapy approach (brentuximab vedotin and nivolumab) in the overall cohort, in the favorable risk cohort, and in the unfavorable risk cohort. V. To evaluate the event-free survival (EFS) at 12 years of patients undergoing standard chemotherapy versus an IO therapy approach (brentuximab vedotin and nivolumab). VI. To compare the physician-reported treatment-related adverse event (AE) rates between a standard chemotherapy approach and an IO therapy approach (brentuximab vedotin and nivolumab) in patients with newly diagnosed early stage cHL. VII. To compare patient-reported adverse events using pediatric and adult versions of Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE), stratified by age groups, therapeutic arms, and receipt of radiation therapy (RT) over time. VIII. To evaluate changes in patient-reported fatigue, cognitive functioning, and health-related quality of life (HRQoL), e.g., emotional, physical, and role functioning, by treatment arm, using validated adult and pediatric measurement systems. IX. To evaluate self-reported late morbidities (e.g., cardiovascular, pulmonary and endocrine) over time for children, adolescents and adults undergoing standard chemotherapy versus an IO therapy approach (brentuximab vedotin and nivolumab) with and without RT using measures from the St. Jude Lifetime Cohort Study (SJLIFE). X. To evaluate fludeoxyglucose F-18 (FDG)-position emission tomography (PET) measurements of metabolic tumor burden (MTV and total lesion glycolysis \[TLG\]) at PET at baseline (PET1) as a predictive marker of PFS. XI. To evaluate the associations between race/ethnicity and key outcomes including early response to therapy, PFS and OS. EXPLORATORY OBJECTIVES: I. To evaluate the PFS of a standard chemotherapy approach versus an IO therapy approach (brentuximab vedotin and nivolumab) in patients with newly diagnosed early stage cHL across different age groups (ages 5-11 years, 12-21 years, 22-39 years, 40-60 years). II. To bank specimens for future correlative studies. III. To assess concordance and discordance of rapid central review and local institutional review of FDG PET 5-point score (5-PS; previously referred to as Deauville score) at baseline PET1, interim PET2 and end of systemic therapy PET-end of systemic therapy (EST) SER. IV. To assess the association between PFS and the quantitative FDG-PET/computed tomography (CT) parameters (PET MTV, TLG, delta-standardized uptake value \[SUV\] and PET SUV-based quantitative surrogates \[qPET\] of visual qualitative 5-PS) on measurements by automated measurements using convolutional neural networks (CNNs) through artificial-intelligence (AI) machine learning in the entire population. V. To assess the agreement between quantitative FDG-PET/CT parameters obtained using AI and those based on measurements by a trained imaging physician. VI. To compare patient-reported adverse events (via pediatric \[Ped\]-PRO-CTCAE and PRO-CTCAE) to provider adverse event reporting. VII. To evaluate the association between self-reported race/ethnicity and social determinants of health. VIII. To evaluate the associations between race/ethnicity and post-progression/post-relapse overall survival. IX. To evaluate the completion rates of PRO and health-related quality of life (HRQoL) contact forms at 1 year off treatment for the first 450 eligible patients. X. To collect contact information from participants for future re-contact. OUTLINE: Patients are stratified by risk status (favorable versus unfavorable) and then all patients receive the ABVD regimen (doxorubicin hydrochloride intravenously \[IV\] over 3-15 minutes, bleomycin sulfate IV over at least 10 minutes, vinblastine sulfate IV, and dacarbazine IV over 15-60 minutes) on days 1 and 15 of each treatment cycle. Cycles repeat every 28 days for up to 2 cycles in the absence of disease progression or unacceptable toxicity. Patients then undergo FDG-PET/CT or magnetic resonance imaging (MRI) and are identified as RER or SER. Patients with a favorable risk status and RER are randomized to Arm A or Arm B. Patients with a favorable risk status and SER are randomized to Arm C or Arm D. Patients with an unfavorable risk status and RER are randomized to Arm E or Arm F. Patients with an unfavorable risk status and SER are randomized to Arm G or Arm H. ARM A (RER, FAVORABLE): Patients receive ABVD IV for an additional 2 cycles on study. Each cycle lasts 28 days and ABVD is administered on days 1 and 15 of each cycle in the absence of disease progression or unacceptable toxicity. Patients also undergo FDG-PET, PET, PET-CT, PET-MRI, CT, and/or MRI throughout the trial. Patients may also undergo blood sample collection on trial. ARM B (RER, FAVORABLE): Patients receive brentuximab vedotin IV over 30 minutes and nivolumab IV over 30 minutes once during each treatment cycle. Cycles repeat every 28 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo FDG-PET, PET, PET-CT, PET-MRI, CT, and/or MRI throughout the trial. Patients may also undergo blood sample collection on trial. ARM C (SER, FAVORABLE): Patients receive either the eBEACOPP regimen (doxorubicin hydrochloride IV over 3-15 minutes on day 1, cyclophosphamide IV over 30-60 minutes on day 1, etoposide or etoposide phosphate IV over 2-4 hours on days 1-3, prednisone or prednisolone orally \[PO\] twice daily \[BID\] on days 1-14, procarbazine hydrochloride PO on days 1-7, bleomycin sulfate IV over at least 10 minutes on day 8, and vincristine sulfate IV on day 8 of each cycle) or the eBPDac regimen (doxorubicin hydrochloride IV 3-15 minutes on day 1, cyclophosphamide IV 30-60 minutes on day 1, etoposide or etoposide phosphate IV over 2-4 hours on days 1-3, prednisone or prednisolone PO BID on days 1-14, dacarbazine IV over 15-60 minutes on days 2 \& 3, bleomycin sulfate IV over at least 10 minutes on day 4, 5, 6, 7, or 8, vincristine sulfate IV on day 4, 5, 6, 7, or 8 of each cycle). Cycles repeat every 28 days for up to 2 cycles in the absence of disease progression or unacceptable toxicity. Subsequently, patients undergo ISRT. Patients also undergo FDG-PET, PET, PET-CT, PET-MRI, CT, and/or MRI throughout the trial. Patients may also undergo blood sample collection on trial. ARM D (SER, FAVORABLE): Patients receive brentuximab vedotin IV and nivolumab IV as in arm B followed by ISRT. Patients also undergo FDG-PET, PET, PET-CT, PET-MRI, CT, and/or MRI throughout the trial. Patients may also undergo blood sample collection on trial. ARM E (RER, UNFAVORABLE): Patients receive AVD regimen (doxorubicin hydrochloride IV over 3-15 minutes, vinblastine IV, and dacarbazine IV over 15-60 minutes) on days 1 and 15 of each treatment cycle. Cycles repeat every 28 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo FDG-PET, PET, PET-CT, PET-MRI, CT, and/or MRI throughout the trial. Patients may also undergo blood sample collection on trial. ARM F (RER, UNFAVORABLE): Patients receive treatment as in arm B. Patients also undergo FDG-PET, PET, PET-CT, PET-MRI, CT, and/or MRI throughout the trial. Patients may also undergo blood sample collection on trial. ARM G (SER, UNFAVORABLE): Patients receive treatment and imaging, and may undergo blood sample collection as in arm C. ARM H (SER, UNFAVORABLE): Patients receive treatment and imaging, and may undergo blood sample collection as in arm D. After completion of study treatment, patients are followed up every 3 months for the first year, then every 6 months for the second and third year, then annually until 12 years from date of registration.
Arms & interventions
- ProcedureBiospecimen Collection
Undergo blood sample collection
- BiologicalBleomycin Sulfate
Given IV
- DrugBrentuximab Vedotin
Given IV
- ProcedureComputed Tomography
Undergo CT and/or PET-CT
- DrugCyclophosphamide
Given IV
- DrugDacarbazine
Given IV
- DrugDoxorubicin Hydrochloride
Given IV
- DrugEtoposide
Given IV
- DrugEtoposide Phosphate
Given IV
- OtherFludeoxyglucose F-18
Undergo FDG-PET
- RadiationInvolved-site Radiation Therapy
Undergo ISRT
- ProcedureMagnetic Resonance Imaging
Undergo MRI and/or PET-MRI
- BiologicalNivolumab
Given IV
- ProcedurePositron Emission Tomography
Undergo FDG-PET, PET, PET-CT, and/or PET-MRI
- DrugPrednisolone
Given PO
- DrugPrednisone
Given PO
- DrugProcarbazine Hydrochloride
Given PO
- OtherQuestionnaire Administration
Ancillary studies
- DrugVinblastine Sulfate
Given IV
- DrugVincristine Sulfate
Given IV
Outcome measures
Primary
Progression-free survival (PFS) in rapid early responder (RER) patients
Will compare the PFS of RER patients randomized to immunotherapy (IO) therapy (brentuximab vedotin-nivolumab) against those randomized to standard therapy. PFS curves will be estimated separately by arm using Kaplan Meier methodology, and the test will be a 1-sided log-rank test between the (pooled) IO and standard arms, stratified according to the stratification factors at randomization and including all eligible and evaluable randomized patients.
Time frame: From the time of randomization to the earliest time of disease relapse, progression, or death due to any cause, assessed up to 3 years after the randomization of the last patient or when reaching 124 events, whichever comes first
PFS in slow-early responder (SER) patients
Will compare PFS among SER patients randomized to IO therapy and involved-site radiation therapy against arms containing standard therapy. PFS curves will be estimated separately by arm using Kaplan Meier methodology, and the test will be a 1-sided log-rank test between the (pooled) IO and standard arms, stratified according to the stratification factors at randomization and including all eligible and evaluable randomized patients.
Time frame: From the time of randomization to the earliest time of disease relapse, progression, or death due to any cause, assessed up to 3 years after the randomization of the last patient or when reaching 71 events, whichever comes first
Secondary
Overall survival (OS) in RER patients
Time frame: Time from randomization to death due to any cause, assessed up to 12 years after the last enrollment
OS in SER patients
Time frame: Time from randomization to death due to any cause, assessed up to 12 years after the last enrollment
OS for entire patient population
Time frame: Time from randomization to death due to any cause, assessed at 12 years after the last enrollment
PFS for favorable risk patients
Time frame: Up to 12 years
PFS for unfavorable risk patients
Time frame: Up to 12 years
PFS for entire population
Time frame: Up to 12 years
Event-free survival (EFS)
Time frame: Time from randomization to the earliest of progression, relapse, second malignancy, or death due to any cause, assessed up to 12 years from last enrollment
Incidence of adverse events (AEs)
Time frame: Assessed up to 12 years from last enrollment
Patient reported outcomes (PRO)-CTCAE
Time frame: Assessed up to 12 years from last enrollment
Patient-reported fatigue
Time frame: Baseline up to 1 year from end of study treatment
Patient-reported cognitive deficits
Time frame: Baseline up to 1 year from end of study treatment
Patient-reported health-related quality of life
Time frame: Baseline up to 1 year from end of study treatment
Incidence of self-reported late morbidities
Time frame: Assessed up to 12 years from last enrollment
Effect of metabolic tumor burden (MTV) on PFS
Time frame: At baseline prior to initiation of therapy
Effect of total lesion glycolysis (TLG) on PFS
Time frame: At baseline prior to initiation of therapy
Contribution of social determinants of health (SDOH) to PET2 response by race and ethnicity
Time frame: After Cycle 2 of treatment (1 cycle = 28 days)
Contribution of SDOH to PFS by race and ethnicity
Time frame: Assessed up to 12 years after last enrollment
Contribution of SDOH to OS by race and ethnicity
Time frame: Assessed up to 12 years after last enrollment
Eligibility criteria
Study locations (390)
Children's Hospital of Alabama
Birmingham, Alabama, 35233
USA Health Strada Patient Care Center
Mobile, Alabama, 36604
Providence Alaska Medical Center
Anchorage, Alaska, 99508
CTCA at Western Regional Medical Center
Goodyear, Arizona, 85338
Banner Children's at Desert
Mesa, Arizona, 85202
Phoenix Childrens Hospital
Phoenix, Arizona, 85016
Arkansas Children's Hospital
Little Rock, Arkansas, 72202-3591
Mercy Cancer Center - Carmichael
Carmichael, California, 95608
Mercy San Juan Medical Center
Carmichael, California, 95608
City of Hope Corona
Corona, California, 92882
UC Irvine Health Cancer Center-Newport
Costa Mesa, California, 92627
Kaiser Permanente Downey Medical Center
Downey, California, 90242
City of Hope Comprehensive Cancer Center
Duarte, California, 91010
Kaiser Permanente Dublin
Dublin, California, 94568
Mercy Cancer Center - Elk Grove
Elk Grove, California, 95758
Kaiser Permanente-Fremont
Fremont, California, 94538
Kaiser Permanente Fresno Orchard Plaza
Fresno, California, 93720
Kaiser Permanente-Fresno
Fresno, California, 93720
City of Hope Seacliff
Huntington Beach, California, 92648
UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care
Irvine, California, 92612
City of Hope at Irvine Lennar
Irvine, California, 92618
City of Hope Antelope Valley
Lancaster, California, 93534
Loma Linda University Medical Center
Loma Linda, California, 92354
Miller Children's and Women's Hospital Long Beach
Long Beach, California, 90806
City of Hope at Long Beach Elm
Long Beach, California, 90813
Children's Hospital Los Angeles
Los Angeles, California, 90027
Cedars-Sinai Medical Center
Los Angeles, California, 90048
Kaiser Permanente- Modesto MOB II
Modesto, California, 95356
Kaiser Permanente-Modesto
Modesto, California, 95356
City of Hope Newport Beach
Newport Beach, California, 92660
Kaiser Permanente-Oakland
Oakland, California, 94611
Children's Hospital of Orange County
Orange, California, 92868
UC Irvine Health/Chao Family Comprehensive Cancer Center
Orange, California, 92868
Mercy Cancer Center - Rocklin
Rocklin, California, 95765
Kaiser Permanente Downtown Commons
Sacramento, California, 95814
Mercy Cancer Center - Sacramento
Sacramento, California, 95816
Kaiser Permanente-South Sacramento
Sacramento, California, 95823
Rady Children's Hospital - San Diego
San Diego, California, 92123
Naval Medical Center -San Diego
San Diego, California, 92134
Kaiser Permanente-San Francisco
San Francisco, California, 94115
Kaiser Permanente-Santa Teresa-San Jose
San Jose, California, 95119
Kaiser Permanente San Leandro
San Leandro, California, 94577
Kaiser San Rafael-Gallinas
San Rafael, California, 94903
Santa Barbara Cottage Hospital
Santa Barbara, California, 93102
Kaiser Permanente-Santa Rosa
Santa Rosa, California, 95403
City of Hope South Pasadena
South Pasadena, California, 91030
Kaiser Permanente-South San Francisco
South San Francisco, California, 94080
City of Hope South Bay
Torrance, California, 90503
City of Hope Upland
Upland, California, 91786
Kaiser Permanente-Vallejo
Vallejo, California, 94589
Kaiser Permanente-Walnut Creek
Walnut Creek, California, 94596
Woodland Memorial Hospital
Woodland, California, 95695
Children's Hospital Colorado
Aurora, Colorado, 80045
UCHealth University of Colorado Hospital
Aurora, Colorado, 80045
UCHealth Memorial Hospital Central
Colorado Springs, Colorado, 80909
Memorial Hospital North
Colorado Springs, Colorado, 80920
Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center
Denver, Colorado, 80218
Poudre Valley Hospital
Fort Collins, Colorado, 80524
Cancer Care and Hematology-Fort Collins
Fort Collins, Colorado, 80528
UCHealth Greeley Hospital
Greeley, Colorado, 80631
Medical Center of the Rockies
Loveland, Colorado, 80538
Smilow Cancer Hospital-Derby Care Center
Derby, Connecticut, 06418
Smilow Cancer Hospital Care Center-Fairfield
Fairfield, Connecticut, 06824
Smilow Cancer Hospital Care Center at Glastonbury
Glastonbury, Connecticut, 06033
Smilow Cancer Hospital Care Center at Greenwich
Greenwich, Connecticut, 06830
Smilow Cancer Hospital Care Center - Guilford
Guilford, Connecticut, 06437
Smilow Cancer Hospital Care Center at Saint Francis
Hartford, Connecticut, 06105
Connecticut Children's Medical Center
Hartford, Connecticut, 06106
Yale University
New Haven, Connecticut, 06520
Yale-New Haven Hospital North Haven Medical Center
North Haven, Connecticut, 06473
Smilow Cancer Hospital Care Center at Long Ridge
Stamford, Connecticut, 06902
Smilow Cancer Hospital-Torrington Care Center
Torrington, Connecticut, 06790
Smilow Cancer Hospital Care Center-Trumbull
Trumbull, Connecticut, 06611
Smilow Cancer Hospital-Waterbury Care Center
Waterbury, Connecticut, 06708
Smilow Cancer Hospital Care Center - Waterford
Waterford, Connecticut, 06385
Alfred I duPont Hospital for Children
Wilmington, Delaware, 19803
MedStar Georgetown University Hospital
Washington D.C., District of Columbia, 20007
Children's National Medical Center
Washington D.C., District of Columbia, 20010
Broward Health Medical Center
Fort Lauderdale, Florida, 33316
Golisano Children's Hospital of Southwest Florida
Fort Myers, Florida, 33908
UF Health Cancer Institute - Gainesville
Gainesville, Florida, 32610
Memorial Regional Hospital/Joe DiMaggio Children's Hospital
Hollywood, Florida, 33021
Nemours Children's Clinic-Jacksonville
Jacksonville, Florida, 32207
Mayo Clinic in Florida
Jacksonville, Florida, 32224-9980
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami, Florida, 33136
Nicklaus Children's Hospital
Miami, Florida, 33155
Mount Sinai Medical Center
Miami Beach, Florida, 33140
AdventHealth Orlando
Orlando, Florida, 32803
Arnold Palmer Hospital for Children
Orlando, Florida, 32806
Nemours Children's Hospital
Orlando, Florida, 32827
Nemours Children's Clinic - Pensacola
Pensacola, Florida, 32504
Sacred Heart Hospital
Pensacola, Florida, 32504
Johns Hopkins All Children's Hospital
St. Petersburg, Florida, 33701
Tampa General Hospital
Tampa, Florida, 33606
Saint Joseph's Hospital/Children's Hospital-Tampa
Tampa, Florida, 33607
Saint Mary's Medical Center
West Palm Beach, Florida, 33407
Grady Health System
Atlanta, Georgia, 30303
Emory Proton Therapy Center
Atlanta, Georgia, 30308
Emory University Hospital Midtown
Atlanta, Georgia, 30308
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia, 30322
Children's Healthcare of Atlanta - Arthur M Blank Hospital
Atlanta, Georgia, 30329
Emory Saint Joseph's Hospital
Atlanta, Georgia, 30342
Augusta University Medical Center
Augusta, Georgia, 30912
Atrium Health Navicent
Macon, Georgia, 31201
Memorial Health University Medical Center
Savannah, Georgia, 31404
Kapiolani Medical Center for Women and Children
Honolulu, Hawaii, 96826
Saint Luke's Cancer Institute - Boise
Boise, Idaho, 83712
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
Saint Luke's Cancer Institute - Twin Falls
Twin Falls, Idaho, 83301
Rush-Copley Medical Center
Aurora, Illinois, 60504
Advocate Good Shepherd Hospital
Barrington, Illinois, 60010
Mount Sinai Hospital Medical Center
Chicago, Illinois, 60608
Lurie Children's Hospital-Chicago
Chicago, Illinois, 60611
Northwestern University
Chicago, Illinois, 60611
University of Illinois
Chicago, Illinois, 60612
Swedish Covenant Hospital
Chicago, Illinois, 60625
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
Decatur Memorial Hospital
Decatur, Illinois, 62526
Northwestern Medicine Cancer Center Kishwaukee
DeKalb, Illinois, 60115
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
Elmhurst Memorial Hospital
Elmhurst, Illinois, 60126
NorthShore University HealthSystem-Evanston Hospital
Evanston, Illinois, 60201
Northwestern Medicine Cancer Center Delnor
Geneva, Illinois, 60134
NorthShore University HealthSystem-Glenbrook Hospital
Glenview, Illinois, 60026
Northwestern Medicine Glenview Outpatient Center
Glenview, Illinois, 60026
Northwestern Medicine Grayslake Outpatient Center
Grayslake, Illinois, 60030
Advocate South Suburban Hospital
Hazel Crest, Illinois, 60429
NorthShore University HealthSystem-Highland Park Hospital
Highland Park, Illinois, 60035
Northwestern Medicine Lake Forest Hospital
Lake Forest, Illinois, 60045
AMG Libertyville - Oncology
Libertyville, Illinois, 60048
Condell Memorial Hospital
Libertyville, Illinois, 60048
Carle Physician Group-Mattoon/Charleston
Mattoon, Illinois, 61938
Loyola University Medical Center
Maywood, Illinois, 60153
Edward Hospital/Cancer Center
Naperville, Illinois, 60540
HSHS Saint Elizabeth's Hospital
O'Fallon, Illinois, 62269
Advocate Christ Medical Center
Oak Lawn, Illinois, 60453-2699
Advocate Children's Hospital-Oak Lawn
Oak Lawn, Illinois, 60453
Northwestern Medicine Orland Park
Orland Park, Illinois, 60462
Advocate Children's Hospital-Park Ridge
Park Ridge, Illinois, 60068
Advocate Lutheran General Hospital
Park Ridge, Illinois, 60068
OSF Children's Hospital of Illinois
Peoria, Illinois, 61637
Edward Hospital/Cancer Center?Plainfield
Plainfield, Illinois, 60585
UW Health Carbone Cancer Center Rockford
Rockford, Illinois, 61114
Memorial Hospital East
Shiloh, Illinois, 62269
Southern Illinois University School of Medicine
Springfield, Illinois, 62702
Carle Cancer Center
Urbana, Illinois, 61801
Northwestern Medicine Cancer Center Warrenville
Warrenville, Illinois, 60555
Rush-Copley Healthcare Center
Yorkville, Illinois, 60560
Riley Hospital for Children
Indianapolis, Indiana, 46202
Ascension Saint Vincent Indianapolis Hospital
Indianapolis, Indiana, 46260
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
Blank Children's Hospital
Des Moines, Iowa, 50309
Iowa Methodist Medical Center
Des Moines, Iowa, 50309
UI Health Care Mission Cancer and Blood - Des Moines Clinic
Des Moines, Iowa, 50309
UI Health Care Mission Cancer and Blood - Laurel Clinic
Des Moines, Iowa, 50314
University of Iowa/Holden Comprehensive Cancer Center
Iowa City, Iowa, 52242
UI Health Care Mission Cancer and Blood - Waukee Clinic
Waukee, Iowa, 50263
Wesley Medical Center
Wichita, Kansas, 67214
University of Kentucky/Markey Cancer Center
Lexington, Kentucky, 40536
Norton Children's Hospital
Louisville, Kentucky, 40202
The James Graham Brown Cancer Center at University of Louisville
Louisville, Kentucky, 40202
UofL Health Medical Center Northeast
Louisville, Kentucky, 40245
Children's Hospital New Orleans
New Orleans, Louisiana, 70118
Ochsner Medical Center Jefferson
New Orleans, Louisiana, 70121
Eastern Maine Medical Center
Bangor, Maine, 04401
MaineHealth Coastal Cancer Treatment Center
Bath, Maine, 04530
MaineHealth Maine Medical Center - Portland
Portland, Maine, 04102
MaineHealth Cancer Care Center of York County
Sanford, Maine, 04073
Maine Children's Cancer Program
Scarborough, Maine, 04074
MaineHealth Maine Medical Center- Scarborough
Scarborough, Maine, 04074
MaineHealth Cancer Care and IV Therapy - South Portland
South Portland, Maine, 04106
University of Maryland/Greenebaum Cancer Center
Baltimore, Maryland, 21201
Sinai Hospital of Baltimore
Baltimore, Maryland, 21215
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore, Maryland, 21287
Walter Reed National Military Medical Center
Bethesda, Maryland, 20889-5600
Dana-Farber Cancer Institute
Boston, Massachusetts, 02215
UMass Memorial Medical Center - University Campus
Worcester, Massachusetts, 01655
Trinity Health Saint Joseph Mercy Hospital Ann Arbor
Ann Arbor, Michigan, 48106
C S Mott Children's Hospital
Ann Arbor, Michigan, 48109
Bronson Battle Creek
Battle Creek, Michigan, 49017
Trinity Health IHA Medical Group Hematology Oncology - Brighton
Brighton, Michigan, 48114
Henry Ford Cancer Institute-Downriver
Brownstown, Michigan, 48183
Trinity Health IHA Medical Group Hematology Oncology - Canton
Canton, Michigan, 48188
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
Chelsea, Michigan, 48118
Henry Ford Macomb Hospital-Clinton Township
Clinton Township, Michigan, 48038
Corewell Health Dearborn Hospital
Dearborn, Michigan, 48124
Henry Ford Medical Center-Fairlane
Dearborn, Michigan, 48126
Children's Hospital of Michigan
Detroit, Michigan, 48201
Wayne State University/Karmanos Cancer Institute
Detroit, Michigan, 48201
Henry Ford Hospital
Detroit, Michigan, 48202
Michigan State University
East Lansing, Michigan, 48823
Weisberg Cancer Treatment Center
Farmington Hills, Michigan, 48334
Corewell Health Farmington Hills Hospital
Farmington Hills, Michigan, 48336
Corewell Health Grand Rapids Hospitals - Butterworth Hospital
Grand Rapids, Michigan, 49503
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
Grand Rapids, Michigan, 49503
Trinity Health Grand Rapids Hospital
Grand Rapids, Michigan, 49503
Allegiance Health
Jackson, Michigan, 49201
Bronson Methodist Hospital
Kalamazoo, Michigan, 49007
West Michigan Cancer Center
Kalamazoo, Michigan, 49007
Beacon Kalamazoo Cancer Center
Kalamazoo, Michigan, 49009
Trinity Health Saint Mary Mercy Livonia Hospital
Livonia, Michigan, 48154
Trinity Health Muskegon Hospital
Muskegon, Michigan, 49444
Cancer and Hematology Centers of Western Michigan - Norton Shores
Norton Shores, Michigan, 49444
Henry Ford Health Providence Novi Hospital
Novi, Michigan, 48374
Henry Ford Medical Center-Columbus
Novi, Michigan, 48377
Trinity Health Saint Joseph Mercy Oakland Hospital
Pontiac, Michigan, 48341
Corewell Health Reed City Hospital
Reed City, Michigan, 49677
Corewell Health Children's
Royal Oak, Michigan, 48073
Corewell Health William Beaumont University Hospital
Royal Oak, Michigan, 48073
Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
Saint Joseph, Michigan, 49085
Henry Ford Health Providence Southfield Hospital
Southfield, Michigan, 48075
Munson Medical Center
Traverse City, Michigan, 49684
Corewell Health Beaumont Troy Hospital
Troy, Michigan, 48085
Henry Ford West Bloomfield Hospital
West Bloomfield, Michigan, 48322
Henry Ford Wyandotte Hospital
Wyandotte, Michigan, 48192
University of Michigan Health - West
Wyoming, Michigan, 49519
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
Ypsilanti, Michigan, 48197
Mercy Hospital
Coon Rapids, Minnesota, 55433
Fairview Southdale Hospital
Edina, Minnesota, 55435
Children's Hospitals and Clinics of Minnesota - Minneapolis
Minneapolis, Minnesota, 55404
Abbott-Northwestern Hospital
Minneapolis, Minnesota, 55407
University of Minnesota/Masonic Cancer Center
Minneapolis, Minnesota, 55455
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
Minnesota Oncology Hematology PA-Woodbury
Woodbury, Minnesota, 55125
University of Mississippi Medical Center
Jackson, Mississippi, 39216
Saint Francis Medical Center
Cape Girardeau, Missouri, 63703
Saint Luke's Hospital
Chesterfield, Missouri, 63017
Siteman Cancer Center at Saint Peters Hospital
City of Saint Peters, Missouri, 63376
University of Missouri Children's Hospital
Columbia, Missouri, 65212
Siteman Cancer Center at West County Hospital
Creve Coeur, Missouri, 63141
Children's Mercy Hospitals and Clinics
Kansas City, Missouri, 64108
Cardinal Glennon Children's Medical Center
St Louis, Missouri, 63104
Washington University School of Medicine
St Louis, Missouri, 63110
Siteman Cancer Center-South County
St Louis, Missouri, 63129
Siteman Cancer Center at Christian Hospital
St Louis, Missouri, 63136
Mercy Hospital Saint Louis
St Louis, Missouri, 63141
Nebraska Medicine-Bellevue
Bellevue, Nebraska, 68123
Children's Hospital and Medical Center of Omaha
Omaha, Nebraska, 68114
Nebraska Medicine-Village Pointe
Omaha, Nebraska, 68118
University of Nebraska Medical Center
Omaha, Nebraska, 68198
Alliance for Childhood Diseases/Cure 4 the Kids Foundation
Las Vegas, Nevada, 89135
Renown Regional Medical Center
Reno, Nevada, 89502
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon, New Hampshire, 03756
Cooper Hospital University Medical Center
Camden, New Jersey, 08103
Trinitas Hospital and Comprehensive Cancer Center - Williamson Street Campus
Elizabeth, New Jersey, 07207
Hunterdon Medical Center
Flemington, New Jersey, 08822
Hackensack University Medical Center
Hackensack, New Jersey, 07601
Jersey City Medical Center
Jersey City, New Jersey, 07302
Saint Barnabas Medical Center
Livingston, New Jersey, 07039
Monmouth Medical Center
Long Branch, New Jersey, 07740
Morristown Medical Center
Morristown, New Jersey, 07960
Jersey Shore Medical Center
Neptune City, New Jersey, 07753
Saint Peter's University Hospital
New Brunswick, New Jersey, 08901
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
New Brunswick, New Jersey, 08903
Rutgers Cancer Institute of New Jersey
New Brunswick, New Jersey, 08903
Newark Beth Israel Medical Center
Newark, New Jersey, 07112
Saint Joseph's Regional Medical Center
Paterson, New Jersey, 07503
Community Medical Center
Toms River, New Jersey, 08755
Presbyterian Hospital
Albuquerque, New Mexico, 87106
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87106
Albany Medical Center
Albany, New York, 12208
Roswell Park Cancer Institute
Buffalo, New York, 14263
Hematology Oncology Associates of CNY at Camillus
Camillus, New York, 13031
Hematology Oncology Associates of Central New York-East Syracuse
East Syracuse, New York, 13057
Glens Falls Hospital
Glens Falls, New York, 12801
NYU Langone Hospital - Long Island
Mineola, New York, 11501
The Steven and Alexandra Cohen Children's Medical Center of New York
New Hyde Park, New York, 11040
Laura and Isaac Perlmutter Cancer Center at NYU Langone
New York, New York, 10016
Mount Sinai Hospital
New York, New York, 10029
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
New York, New York, 10032
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
NYP/Weill Cornell Medical Center
New York, New York, 10065
University of Rochester
Rochester, New York, 14642
Stony Brook University Medical Center
Stony Brook, New York, 11794
State University of New York Upstate Medical University
Syracuse, New York, 13210
Montefiore Medical Center - Moses Campus
The Bronx, New York, 10467
Wilmot Cancer Institute at Webster
Webster, New York, 14580
Mission Hospital
Asheville, North Carolina, 28801
UNC Lineberger Comprehensive Cancer Center
Chapel Hill, North Carolina, 27599
Carolinas Medical Center/Levine Cancer Institute
Charlotte, North Carolina, 28203
Duke University Medical Center
Durham, North Carolina, 27710
East Carolina University
Greenville, North Carolina, 27834
Wake Forest University Health Sciences
Winston-Salem, North Carolina, 27157
Sanford Broadway Medical Center
Fargo, North Dakota, 58122
Children's Hospital Medical Center of Akron
Akron, Ohio, 44308
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, 45229
Rainbow Babies and Childrens Hospital
Cleveland, Ohio, 44106
Cleveland Clinic Foundation
Cleveland, Ohio, 44195
Nationwide Children's Hospital
Columbus, Ohio, 43205
Dayton Children's Hospital
Dayton, Ohio, 45404
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
Toledo, Ohio, 43606
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Natalie Warren Bryant Cancer Center at Saint Francis
Tulsa, Oklahoma, 74136
Providence Newberg Medical Center
Newberg, Oregon, 97132
Providence Willamette Falls Medical Center
Oregon City, Oregon, 97045
Providence Portland Medical Center
Portland, Oregon, 97213
Providence Saint Vincent Medical Center
Portland, Oregon, 97225
Legacy Emanuel Children's Hospital
Portland, Oregon, 97227
Oregon Health and Science University
Portland, Oregon, 97239
Lehigh Valley Hospital-Cedar Crest
Allentown, Pennsylvania, 18103
Geisinger Medical Center
Danville, Pennsylvania, 17822
Penn State Children's Hospital
Hershey, Pennsylvania, 17033
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, 19104
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, 19107
Saint Christopher's Hospital for Children
Philadelphia, Pennsylvania, 19134
Children's Hospital of Pittsburgh of UPMC
Pittsburgh, Pennsylvania, 15224
Rhode Island Hospital
Providence, Rhode Island, 02903
Smilow Cancer Hospital Care Center - Westerly
Westerly, Rhode Island, 02891
Prisma Health Cancer Institute - Spartanburg
Boiling Springs, South Carolina, 29316
Medical University of South Carolina
Charleston, South Carolina, 29425
Prisma Health Richland Hospital
Columbia, South Carolina, 29203
Saint Francis Hospital
Greenville, South Carolina, 29601
BI-LO Charities Children's Cancer Center
Greenville, South Carolina, 29605
Saint Francis Cancer Center
Greenville, South Carolina, 29607
Prisma Health Cancer Institute - Eastside
Greenville, South Carolina, 29615
Sanford USD Medical Center - Sioux Falls
Sioux Falls, South Dakota, 57117-5134
T C Thompson Children's Hospital
Chattanooga, Tennessee, 37403
East Tennessee Childrens Hospital
Knoxville, Tennessee, 37916
The Children's Hospital at TriStar Centennial
Nashville, Tennessee, 37203
Vanderbilt University/Ingram Cancer Center
Nashville, Tennessee, 37232
Dell Children's Medical Center of Central Texas
Austin, Texas, 78723
Driscoll Children's Hospital
Corpus Christi, Texas, 78411
Medical City Dallas Hospital
Dallas, Texas, 75230
UT Southwestern/Simmons Cancer Center-Dallas
Dallas, Texas, 75390
El Paso Children's Hospital
El Paso, Texas, 79905
Cook Children's Medical Center
Fort Worth, Texas, 76104
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
Houston, Texas, 77030
UT MD Anderson Cancer Center
Houston, Texas, 77030
Covenant Children's Hospital
Lubbock, Texas, 79410
UMC Cancer Center / UMC Health System
Lubbock, Texas, 79415
Children's Hospital of San Antonio
San Antonio, Texas, 78207
Methodist Children's Hospital of South Texas
San Antonio, Texas, 78229
University of Texas Health Science Center at San Antonio
San Antonio, Texas, 78229
Scott and White Memorial Hospital
Temple, Texas, 76508
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, 84112
Primary Children's Hospital
Salt Lake City, Utah, 84113
University of Vermont and State Agricultural College
Burlington, Vermont, 05405
University of Virginia Cancer Center
Charlottesville, Virginia, 22908
Inova Fairfax Hospital
Falls Church, Virginia, 22042
Children's Hospital of The King's Daughters
Norfolk, Virginia, 23507
Naval Medical Center - Portsmouth
Portsmouth, Virginia, 23708-2197
VCU Massey Comprehensive Cancer Center
Richmond, Virginia, 23298
Carilion Children's
Roanoke, Virginia, 24014
Valley Medical Center
Renton, Washington, 98055
Seattle Children's Hospital
Seattle, Washington, 98105
Providence Sacred Heart Medical Center and Children's Hospital
Spokane, Washington, 99204
Mary Bridge Children's Hospital and Health Center
Tacoma, Washington, 98405
West Virginia University Charleston Division
Charleston, West Virginia, 25304
Edwards Comprehensive Cancer Center
Huntington, West Virginia, 25701
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
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
Marshfield Medical Center-Marshfield
Marshfield, Wisconsin, 54449
Aurora Cancer Care-Milwaukee
Milwaukee, Wisconsin, 53209
Aurora Saint Luke's Medical Center
Milwaukee, Wisconsin, 53215
Children's Hospital of Wisconsin
Milwaukee, Wisconsin, 53226
Aurora Sinai Medical Center
Milwaukee, Wisconsin, 53233
ProHealth D N Greenwald Center
Mukwonago, Wisconsin, 53149
ProHealth Oconomowoc Memorial Hospital
Oconomowoc, Wisconsin, 53066
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
UW Cancer Center at ProHealth Care
Waukesha, Wisconsin, 53188
Aurora Cancer Care-Milwaukee West
Wauwatosa, Wisconsin, 53226
Aurora West Allis Medical Center
West Allis, Wisconsin, 53227
References
- Castellino SM, Giulino-Roth L, Harker-Murray P, Kahn JM, Forlenza C, Cho S, Hoppe B, Parsons SK, Kelly KM; COG Hodgkin Lymphoma Committee. Children's Oncology Group's 2023 blueprint for research: Hodgkin lymphoma. Pediatr Blood Cancer. 2023 Sep;70 Suppl 6(Suppl 6):e30580. doi: 10.1002/pbc.30580. Epub 2023 Jul 28.(PubMed)