Randomized Phase II/III Trial of 2nd Line Nivolumab + Paclitaxel + Ramucirumab Versus Paclitaxel + Ramucirumab in Patients With PD-L1 CPS >/= 1 Advanced Gastric and Esophageal Adenocarcinoma (PARAMUNE)
Summary
This phase II/III trial compares the addition of nivolumab to the usual treatment of paclitaxel and ramucirumab to paclitaxel and ramucirumab alone in treating patients with gastric or esophageal adenocarcinoma that may have spread from where it first started to nearby tissue, lymph nodes, or distant parts of the body (advanced). 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. Ramucirumab is a monoclonal antibody that may prevent the growth of new blood vessels that tumors need to grow. Paclitaxel is in a class of medications called antimicrotubule agents. It stops cancer cells from growing and dividing and may kill them. Adding nivolumab to ramucirumab and paclitaxel may work better to treat patients with advanced stomach or esophageal cancer.
Detailed description
PRIMARY OBJECTIVES: I. To assess whether progression-free survival (PFS) is sufficiently improved in participants randomized to nivolumab + paclitaxel + ramucirumab compared to those randomized to paclitaxel + ramucirumab to warrant a phase III study with overall survival (OS) as the primary endpoint. (Phase II) II. To compare OS in participants randomized to nivolumab + paclitaxel + ramucirumab versus those randomized to paclitaxel + ramucirumab. (Phase III) SECONDARY OBJECTIVES: I. To compare PFS between those randomized to nivolumab + paclitaxel + ramucirumab versus those randomized to paclitaxel + ramucirumab. (Phase III) II. To compare OS between participants randomized to nivolumab + paclitaxel + ramucirumab compared to those randomized to paclitaxel + ramucirumab in the event that the trial is completed before the phase III portion. III. To compare the overall response rate (ORR, including confirmed and unconfirmed, complete, and partial response, according to Response Evaluation Criteria in Solid Tumors \[RECIST 1.1\] criteria) between those randomized to nivolumab + paclitaxel + ramucirumab compared to those randomized to paclitaxel + ramucirumab among participants with measurable disease. IV. To compare the overall disease control rate (DCR = ORR + stable disease) between those randomized to nivolumab + paclitaxel + ramucirumab compared to those randomized to paclitaxel + ramucirumab among participants with measurable disease. V. To evaluate the safety and tolerability of each treatment regimen. VI. To compare health-related quality of life (QOL) by treatment arm at 8 weeks after randomization, measured using the Functional Assessment of Cancer Therapy - Gastric (FACT-Ga) Trial Outcome Index (TOI). VII. To compare health-related QOL between treatment arms at 8 weeks after randomization using the FACT-Ga total score. VIII. To compare longitudinal changes in health-related QOL between treatment arms using FACT-Ga TOI up to 24 weeks after randomization. IX. To compare patient-reported symptoms using selected Patient-Reported Outcomes-Common Terminology Criteria for Adverse Events (PRO-CTCAE) items including gastrointestinal as well as constitutional symptoms of fatigue, anorexia, and weight loss between treatment arms. OUTLINE: Patients are randomized to 1 of 2 arms. ARM 1: Patients receive nivolumab intravenously (IV) over 30 minutes on day 1 of each cycle, ramucirumab IV over 30-60 minutes on days 1 and 15 of each cycle, and paclitaxel IV over 60 minutes on days 1, 8 and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo computed tomography (CT) scan and magnetic resonance imaging (MRI) throughout the study. Patients may also optionally undergo blood sample collection on study. ARM 2: Patients receive ramucirumab IV over 30-60 minutes on days 1 and 15 of each cycle and paclitaxel IV over 60 minutes on days 1, 8 and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan and MRI throughout the study. Patients may also optionally undergo blood sample collection on study. After completion of study treatment, patients are followed up at 30, 60, 90 days and then every 6 months for up to 3 years.
Arms & interventions
- ProcedureBiospecimen Collection
Undergo optional blood sample collection
- ProcedureComputed Tomography
Undergo CT scan
- ProcedureMagnetic Resonance Imaging
Undergo MRI
- BiologicalNivolumab
Given IV
- DrugPaclitaxel
Given IV
- OtherQuestionnaire Administration
Ancillary studies
- BiologicalRamucirumab
Given IV
Outcome measures
Primary
Progression free survival (PFS) (Phase II)
The distribution of PFS will be estimated using the method of Kaplan-Meier and compared using a 1-sided stratified log-rank test.
Time frame: From date of randomization to date of first documentation of progression or symptomatic deterioration or death due to any cause, assessed up to 3 years
Overall survival (OS) (Phase III)
The distribution of OS will be estimated using the method of Kaplan-Meier and compared using a 1-sided stratified log-rank test.
Time frame: From date of randomization to date of death due to any cause, assessed up to 3 years
Secondary
Objective response rate (ORR)
Time frame: Up to 3 years
Disease control rate (DCR)
Time frame: Up to 3 years
Incidence of adverse events
Time frame: Up to 3 years
Eligibility criteria
Study locations (372)
Baptist Health Medical Center - Little Rock
Little Rock, Arkansas, 72205
University of Arkansas for Medical Sciences
Little Rock, Arkansas, 72205
Kaiser Permanente-Anaheim
Anaheim, California, 92806
Kaiser Permanente-Baldwin Park
Baldwin Park, California, 91706
Kaiser Permanente-Bellflower
Bellflower, California, 90706
Tower Cancer Research Foundation
Beverly Hills, California, 90211
Kaiser Permanente Dublin
Dublin, California, 94568
Kaiser Permanente-Fontana
Fontana, California, 92335
Kaiser Permanente-Fremont
Fremont, California, 94538
Kaiser Permanente Fresno Orchard Plaza
Fresno, California, 93720
Kaiser Permanente-Fresno
Fresno, California, 93720
Kaiser Permanente South Bay
Harbor City, California, 90710
Kaiser Permanente-Irvine
Irvine, California, 92618
UC San Diego Moores Cancer Center
La Jolla, California, 92093
Keck Medicine of USC Koreatown
Los Angeles, California, 90020
Kaiser Permanente Los Angeles Medical Center
Los Angeles, California, 90027
Los Angeles General Medical Center
Los Angeles, California, 90033
USC / Norris Comprehensive Cancer Center
Los Angeles, California, 90033
Kaiser Permanente West Los Angeles
Los Angeles, California, 90034
Cedars-Sinai Medical Center
Los Angeles, California, 90048
Kaiser Permanente- Modesto MOB II
Modesto, California, 95356
Kaiser Permanente-Modesto
Modesto, California, 95356
USC Norris Oncology/Hematology-Newport Beach
Newport Beach, California, 92663
Kaiser Permanente-Oakland
Oakland, California, 94611
Kaiser Permanente-Ontario
Ontario, California, 91761
Kaiser Permanente - Panorama City
Panorama City, California, 91402
Kaiser Permanente-Riverside
Riverside, California, 92505
Kaiser Permanente-Roseville
Roseville, California, 95661
Kaiser Permanente Downtown Commons
Sacramento, California, 95814
University of California Davis Comprehensive Cancer Center
Sacramento, California, 95817
Kaiser Permanente-South Sacramento
Sacramento, California, 95823
Kaiser Permanente-San Diego Zion
San Diego, California, 92120
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 Permanente-San Marcos
San Marcos, California, 92078
Kaiser San Rafael-Gallinas
San Rafael, California, 94903
Kaiser Permanente Medical Center - Santa Clara
Santa Clara, California, 95051
Kaiser Permanente-Santa Rosa
Santa Rosa, California, 95403
Kaiser Permanente-South San Francisco
South San Francisco, California, 94080
Kaiser Permanente-Vallejo
Vallejo, California, 94589
Kaiser Permanente-Walnut Creek
Walnut Creek, California, 94596
Kaiser Permanente-Woodland Hills
Woodland Hills, California, 91367
UCHealth Memorial Hospital Central
Colorado Springs, Colorado, 80909
Memorial Hospital North
Colorado Springs, Colorado, 80920
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
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
Beebe South Coastal Health Campus
Millville, Delaware, 19967
Helen F Graham Cancer Center
Newark, Delaware, 19713
Medical Oncology Hematology Consultants PA
Newark, Delaware, 19713
Beebe Health Campus
Rehoboth Beach, Delaware, 19971
MedStar Georgetown University Hospital
Washington D.C., District of Columbia, 20007
AdventHealth Orlando
Orlando, Florida, 32803
Emory University Hospital Midtown
Atlanta, Georgia, 30308
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia, 30322
Emory Saint Joseph's Hospital
Atlanta, Georgia, 30342
Emory Decatur Hospital
Decatur, Georgia, 30033
Emory Johns Creek Hospital
Johns Creek, Georgia, 30097
Hawaii Cancer Care Inc - Waterfront Plaza
Honolulu, Hawaii, 96813
Queen's Cancer Cenrer - POB I
Honolulu, Hawaii, 96813
Queen's Medical Center
Honolulu, Hawaii, 96813
Straub Clinic and Hospital
Honolulu, Hawaii, 96813
Queen's Cancer Center - Kuakini
Honolulu, Hawaii, 96817
Kaiser Permanente Moanalua Medical Center
Honolulu, Hawaii, 96819
Kapiolani Medical Center for Women and Children
Honolulu, Hawaii, 96826
Hawaii Cancer Care - Westridge
‘Aiea, Hawaii, 96701
Pali Momi Medical Center
‘Aiea, Hawaii, 96701
The Queen's Medical Center - West Oahu
‘Ewa Beach, Hawaii, 96706
Saint Alphonsus Cancer Care Center-Boise
Boise, Idaho, 83706
Saint Alphonsus Cancer Care Center-Caldwell
Caldwell, Idaho, 83605
Kootenai Health - Coeur d'Alene
Coeur d'Alene, Idaho, 83814
Saint Alphonsus Cancer Care Center-Nampa
Nampa, Idaho, 83687
Kootenai Clinic Cancer Services - Post Falls
Post Falls, Idaho, 83854
Kootenai Clinic Cancer Services - Sandpoint
Sandpoint, Idaho, 83864
Rush-Copley Medical Center
Aurora, Illinois, 60504
Advocate Outpatient Center - Aurora
Aurora, Illinois, 60506
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
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
Cancer Care Specialists of Illinois - Decatur
Decatur, Illinois, 62526
Decatur Memorial Hospital
Decatur, Illinois, 62526
Northwestern Medicine Cancer Center Kishwaukee
DeKalb, Illinois, 60115
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
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
Ingalls Memorial Hospital
Harvey, Illinois, 60426
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
Northwestern Medicine Lake Forest Hospital
Lake Forest, Illinois, 60045
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
Cancer Care Center of O'Fallon
O'Fallon, Illinois, 62269
Northwestern Medicine Oak Brook
Oak Brook, Illinois, 60523
Advocate Christ Medical Center
Oak Lawn, Illinois, 60453-2699
Northwestern Medicine Orland Park
Orland Park, Illinois, 60462
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
Mercyhealth Cancer Institute - Rockford
Rockford, Illinois, 61114
UW Health Carbone Cancer Center Rockford
Rockford, Illinois, 61114
Memorial Hospital East
Shiloh, Illinois, 62269
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
Northwestern Medicine Cancer Center Warrenville
Warrenville, Illinois, 60555
Illinois CancerCare - Washington
Washington, Illinois, 61571
Northwest Cancer Center - Crown Point
Crown Point, Indiana, 46307
UChicago Medicine Northwest Indiana
Crown Point, Indiana, 46307
Northwest Oncology LLC
Dyer, Indiana, 46311
Northwest Cancer Center - Hobart
Hobart, Indiana, 46342
Saint Mary Medical Center
Hobart, Indiana, 46342
Saint Catherine Hospital
Indianapolis, Indiana, 46312
The Community Hospital
Munster, Indiana, 46321
Women's Diagnostic Center - Munster
Munster, Indiana, 46321
Northwest Cancer Center - Valparaiso
Valparaiso, Indiana, 46383
UI Health Care Mission Cancer and Blood - Ankeny Clinic
Ankeny, Iowa, 50023
Saint Anthony Regional Hospital
Carroll, Iowa, 51401
Mercy Hospital
Cedar Rapids, Iowa, 52403
Oncology Associates at Mercy Medical Center
Cedar Rapids, Iowa, 52403
UI Health Care Mission Cancer and Blood - West Des Moines Clinic
Clive, Iowa, 50325
Iowa Methodist Medical Center
Des Moines, Iowa, 50309
UI Health Care Mission Cancer and Blood - Des Moines Clinic
Des Moines, Iowa, 50309
Broadlawns Medical Center
Des Moines, Iowa, 50314
UI Health Care Mission Cancer and Blood - Laurel Clinic
Des Moines, Iowa, 50314
UI Healthcare Mission Cancer and Blood - Fort Dodge
Fort Dodge, Iowa, 50501
UI Health Care Mission Cancer and Blood - Waukee Clinic
Waukee, Iowa, 50263
HaysMed
Hays, Kansas, 67601
Lawrence Memorial Hospital
Lawrence, Kansas, 66044
The University of Kansas Cancer Center - Olathe
Olathe, Kansas, 66061
Salina Regional Health Center
Salina, Kansas, 67401
University of Kansas Health System Saint Francis Campus
Topeka, Kansas, 66606
Saint Joseph Hospital East
Lexington, Kentucky, 40509
Ochsner Hematology Oncology North Shore - Covington (West Region)
Covington, Louisiana, 70433
Ochsner Medical Center Jefferson
New Orleans, Louisiana, 70121
UPMC Western Maryland
Cumberland, Maryland, 21502
Trinity Health Saint Joseph Mercy Hospital Ann Arbor
Ann Arbor, Michigan, 48106
Trinity Health IHA Medical Group Hematology Oncology - Brighton
Brighton, Michigan, 48114
Trinity Health Medical Center - 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 Medical Center - Canton
Canton, Michigan, 48188
Chelsea Hospital
Chelsea, Michigan, 48118
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
Chelsea, Michigan, 48118
Henry Ford Macomb Hospital-Clinton Township
Clinton Township, Michigan, 48038
Henry Ford Medical Center-Fairlane
Dearborn, Michigan, 48126
Henry Ford Hospital
Detroit, Michigan, 48202
OSF Saint Francis Hospital and Medical Group
Escanaba, Michigan, 49829
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
Allegiance Health
Jackson, Michigan, 49201
University of Michigan Health - Sparrow Lansing
Lansing, Michigan, 48912
Trinity Health Saint Mary Mercy Livonia Hospital
Livonia, Michigan, 48154
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
Henry Ford Health Providence Southfield Hospital
Southfield, Michigan, 48075
Henry Ford West Bloomfield Hospital
West Bloomfield, Michigan, 48322
Henry Ford Wyandotte Hospital
Wyandotte, Michigan, 48192
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
Ypsilanti, Michigan, 48197
Sanford Joe Lueken Cancer Center
Bemidji, Minnesota, 56601
Essentia Health Saint Joseph's Medical Center
Brainerd, Minnesota, 56401
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
Saint John's Hospital - Healtheast
Maplewood, Minnesota, 55109
Abbott-Northwestern Hospital
Minneapolis, Minnesota, 55407
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
Minnesota Oncology Hematology PA-Woodbury
Woodbury, Minnesota, 55125
Saint Francis Medical Center
Cape Girardeau, Missouri, 63703
Siteman Cancer Center at Saint Peters Hospital
City of Saint Peters, Missouri, 63376
Siteman Cancer Center at West County Hospital
Creve Coeur, Missouri, 63141
University Health Truman Medical Center
Kansas City, Missouri, 64108
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
Community Hospital of Anaconda
Anaconda, Montana, 59711
Billings Clinic Cancer Center
Billings, Montana, 59101
Saint Vincent Frontier Cancer Center
Billings, Montana, 59102
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
Nebraska Medicine-Bellevue
Bellevue, Nebraska, 68123
Nebraska Medicine-Village Pointe
Omaha, Nebraska, 68118
University of Nebraska Medical Center
Omaha, Nebraska, 68198
OptumCare Cancer Care at Charleston
Las Vegas, Nevada, 89102
OptumCare Cancer Care at Fort Apache
Las Vegas, Nevada, 89183
Renown Regional Medical Center
Reno, Nevada, 89502
Jefferson Cherry Hill Hospital
Cherry Hill, New Jersey, 08002
Englewood Hospital and Medical Center
Englewood, New Jersey, 07631
Sidney Kimmel Cancer Center Washington Township
Sewell, New Jersey, 08080
Lovelace Medical Center-Saint Joseph Square
Albuquerque, New Mexico, 87102
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87106
Northwell Health Imbert Cancer Center
Bay Shore, New York, 11706
Roswell Park Cancer Institute
Buffalo, New York, 14263
Glens Falls Hospital
Glens Falls, New York, 12801
Northwell Health Cancer Institute at Huntington
Greenlawn, New York, 11740
Northwell Health/Center for Advanced Medicine
Lake Success, New York, 11042
NYU Langone Hospital - Long Island
Mineola, New York, 11501
Northern Westchester Hospital
Mount Kisco, New York, 10549
Laura and Isaac Perlmutter Cancer Center at NYU Langone
New York, New York, 10016
University of Rochester
Rochester, New York, 14642
Phelps Memorial Hospital Center
Sleepy Hollow, New York, 10591
Cone Health Cancer Center at Asheboro
Asheboro, North Carolina, 27203
Cone Health MedCenter Asheboro
Asheboro, North Carolina, 27205
Cone Health Cancer Center at Alamance Regional
Burlington, North Carolina, 27215
Southeastern Medical Oncology Center-Clinton
Clinton, North Carolina, 28328
Southeastern Medical Oncology Center-Goldsboro
Goldsboro, North Carolina, 27534
Cone Health Cancer Center
Greensboro, North Carolina, 27403
Cone Health Cancer Center at Drawbridge Parkway
Greensboro, North Carolina, 27410
Southeastern Medical Oncology Center-Jacksonville
Jacksonville, North Carolina, 28546
FirstHealth of the Carolinas-Moore Regional Hospital
Pinehurst, North Carolina, 28374
Annie Penn Memorial Hospital
Reidsville, North Carolina, 27320
Sanford Bismarck Medical Center
Bismarck, North Dakota, 58501
Essentia Health Cancer Center-South University Clinic
Fargo, North Dakota, 58103
Sanford Broadway Medical Center
Fargo, North Dakota, 58122
Sanford Roger Maris Cancer Center
Fargo, North Dakota, 58122
Miami Valley Hospital South
Centerville, Ohio, 45459
Good Samaritan Hospital - Cincinnati
Cincinnati, Ohio, 45220
Miami Valley Hospital
Dayton, Ohio, 45409
Premier Blood and Cancer Center
Dayton, Ohio, 45409
Miami Valley Hospital North
Dayton, Ohio, 45415
Atrium Medical Center-Middletown Regional Hospital
Franklin, Ohio, 45005-1066
Miami Valley Cancer Care and Infusion
Greenville, Ohio, 45331
Upper Valley Medical Center
Troy, Ohio, 45373
Cancer Centers of Southwest Oklahoma Research
Lawton, Oklahoma, 73505
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Integris Southwest Medical Center
Oklahoma City, Oklahoma, 73109
Integris Cancer Institute of Oklahoma
Oklahoma City, Oklahoma, 73142
Oklahoma Cancer Specialists and Research Institute-Tulsa
Tulsa, Oklahoma, 74146
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-Heritage Valley Health System Beaver
Beaver, Pennsylvania, 15009
Lehigh Valley Hospital - Muhlenberg
Bethlehem, Pennsylvania, 18017
Geisinger Medical Center
Danville, Pennsylvania, 17822
Geisinger Cancer Center Dickson City
Dickson City, Pennsylvania, 18519
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 Pinnacle Cancer Center/Community Osteopathic Campus
Harrisburg, Pennsylvania, 17109
Lehigh Valley Hospital-Hazleton
Hazleton, Pennsylvania, 18201
UPMC-Johnstown/John P. Murtha Regional Cancer Center
Johnstown, Pennsylvania, 15901
Lancaster General Ann B Barshinger Cancer Institute
Lancaster, Pennsylvania, 17601
Geisinger Medical Oncology-Lewisburg
Lewisburg, Pennsylvania, 17837
UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion
Mechanicsburg, Pennsylvania, 17050
UPMC Hillman Cancer Center - Monroeville
Monroeville, Pennsylvania, 15146
Arnold Palmer Cancer Center Medical Oncology Norwin
N. Huntingdon, Pennsylvania, 15642
UPMC Hillman Cancer Center - New Castle
New Castle, Pennsylvania, 16105
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, 19107
Jefferson Torresdale Hospital
Philadelphia, Pennsylvania, 19114
UPMC-Saint Margaret
Pittsburgh, Pennsylvania, 15215
University of Pittsburgh Cancer Institute (UPCI)
Pittsburgh, Pennsylvania, 15232
UPMC-Passavant Hospital
Pittsburgh, Pennsylvania, 15237
UPMC-Saint Clair Hospital Cancer Center
Pittsburgh, Pennsylvania, 15243
Community Medical Center
Scranton, Pennsylvania, 18510
UPMC Cancer Center at UPMC Northwest
Seneca, Pennsylvania, 16346
UPMC Cancer Center-Uniontown
Uniontown, Pennsylvania, 15401
Geisinger Wyoming Valley/Henry Cancer Center
Wilkes-Barre, Pennsylvania, 18711
Asplundh Cancer Pavilion
Willow Grove, Pennsylvania, 19090
Smilow Cancer Hospital Care Center - Westerly
Westerly, Rhode Island, 02891
Ralph H Johnson VA Medical Center
Charleston, South Carolina, 29401
Medical University of South Carolina
Charleston, South Carolina, 29425
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
Vanderbilt University/Ingram Cancer Center
Nashville, Tennessee, 37232
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
Houston, Texas, 77030
Ben Taub General Hospital
Houston, Texas, 77030
Farmington Health Center
Farmington, Utah, 84025
University of Utah Sugarhouse Health Center
Salt Lake City, Utah, 84106
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, 84112
Central Vermont Medical Center/National Life Cancer Treatment
Berlin Corners, Vermont, 05602
University of Vermont Medical Center
Burlington, Vermont, 05401
University of Vermont and State Agricultural College
Burlington, Vermont, 05405
VCU Massey Cancer Center at Stony Point
Richmond, Virginia, 23235
VCU Massey Comprehensive Cancer Center
Richmond, Virginia, 23298
Langlade Hospital and Cancer Center
Antigo, Wisconsin, 54409
Duluth Clinic Ashland
Ashland, Wisconsin, 54806
Aurora Cancer Care-Southern Lakes VLCC
Burlington, Wisconsin, 53105
Aurora Saint Luke's South Shore
Cudahy, Wisconsin, 53110
Marshfield Medical Center-EC Cancer Center
Eau Claire, Wisconsin, 54701
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
William S Middleton VA Medical Center
Madison, Wisconsin, 53705
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
Aspirus Medford Hospital
Medford, Wisconsin, 54451
Aurora Cancer Care-Milwaukee
Milwaukee, Wisconsin, 53209
Aurora Saint Luke's Medical Center
Milwaukee, Wisconsin, 53215
Aurora Sinai Medical Center
Milwaukee, Wisconsin, 53233
Marshfield Medical Center - Minocqua
Minocqua, Wisconsin, 54548
ProHealth D N Greenwald Center
Mukwonago, Wisconsin, 53149
ProHealth Oconomowoc Memorial Hospital
Oconomowoc, Wisconsin, 53066
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
Aspirus Cancer Care - James Beck Cancer Center
Rhinelander, Wisconsin, 54501
Saint Vincent Hospital Cancer Center at Sheboygan
Sheboygan, Wisconsin, 53081
Sheboygan Physicians Group
Sheboygan, Wisconsin, 53081
Vince Lombardi Cancer Clinic-Sheboygan
Sheboygan, Wisconsin, 53081
Aspirus Cancer Care - Stevens Point
Stevens Point, Wisconsin, 54481
Marshfield Medical Center-River Region at Stevens Point
Stevens Point, Wisconsin, 54482
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
ProHealth Waukesha Memorial Hospital
Waukesha, Wisconsin, 53188
UW Cancer Center at ProHealth Care
Waukesha, Wisconsin, 53188
Aspirus Regional Cancer Center
Wausau, Wisconsin, 54401
Aurora Cancer Care-Milwaukee West
Wauwatosa, Wisconsin, 53226
Aurora West Allis Medical Center
West Allis, Wisconsin, 53227
Marshfield Medical Center - Weston
Weston, Wisconsin, 54476
Aspirus Cancer Care - Wisconsin Rapids
Wisconsin Rapids, Wisconsin, 54494
References
- Saeed A, Colby S, Oberstein PE, Duda DG, Park R, Agarwal R, Figueroa-Moseley C, Vaidya R, Unger JM, Guthrie KA, Rocha FG, Senthil M, Safyan RA, Wainberg ZA, Iqbal S, Chiorean EG, Philip PA. S2303: phase II/III trial of paclitaxel + ramucirumab +/- nivolumab in gastric and esophageal adenocarcinoma (PARAMUNE). Future Oncol. 2025 May;21(11):1325-1331. doi: 10.1080/14796694.2025.2485020. Epub 2025 Mar 28.(PubMed)