A Randomized Phase II/III Study of Docetaxel and Ramucirumab With or Without Cemiplimab for Participants Previously Treated With Platinum-Based Chemotherapy and Immunotherapy for Stage IV or Recurrent Non-Small Cell Lung Cancer (Lung-MAP Non-Matched Sub-Study)
Summary
This phase II/III Expanded Lung-MAP treatment trial compares the effect of adding cemiplimab to docetaxel and ramucirumab versus docetaxel and ramucirumab alone in treating patients with non-small cell lung cancer that is stage IV or that has come back after a period of improvement (recurrent). Cemiplimab is a monoclonal antibody that stimulates the immune system by blocking the PD-1 pathway. Tumors use the PD-1 pathway to escape attacks from the immune system. By blocking the PD-1 pathway, cemiplimab may help the immune system recognize and attack tumor cells. Docetaxel is in a class of medications called taxanes. It stops tumor cells from growing and dividing and may kill them. Ramucirumab is a monoclonal antibody that may prevent the growth of new blood vessels that tumors need to grow. Adding cemiplimab to usual treatment, docetaxel and ramucirumab, may kill more tumor cells compared to docetaxel and ramucirumab alone in treating patients with stage IV or recurrent non-small cell lung cancer.
Detailed description
PRIMARY OBJECTIVE: I. To compare overall survival (OS) between participants randomized to docetaxel and ramucirumab with or without cemiplimab (REGN2810) who have acquired resistance to platinum-based chemotherapy and immunotherapy for stage IV or recurrent non-small cell lung cancer (NSCLC). SECONDARY OBJECTIVES: I. To compare investigator-assessed progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 between the arms. II. To compare investigator-assessed response rates (confirmed or unconfirmed, complete response \[CR\] or partial response \[PR\]) per RECIST 1.1 between the arms among participants with measurable disease. III. To compare the investigator-assessed disease control rate (confirmed or unconfirmed, complete response \[CR\], or partial response \[PR\], and stable disease) between the arms. IV. To evaluate the duration of response (DoR) among responders within each arm. V. To evaluate the frequency and severity of toxicities within each arm. VI. To compare investigator-assessed PFS between the arms within the subgroups defined by the stratification factors (histology and performance status) and by PD-L1 subgroups defined as PD-L1 negative (\< 1% tumor proportion score \[TPS\]), intermediate PD-L1 (1-49% TPS), and PD-L1 high (\>= 50% TPS). VII. To compare OS between the arms within the subgroups defined by the stratification factors (histology and performance status) and by PD-L1 subgroups defined as PD-L1 negative (\< 1% TPS), intermediate PD-L1 (1-49% TPS), and PD-L1 high (\>= 50% TPS). TRANSLATIONAL MEDICINE OBJECTIVES: I. To collect, process, and bank cell-free deoxyribonucleic acid (cfDNA) at baseline, cycle 3 day 1, and progression for future development of a proposal to evaluate comprehensive next-generation sequencing of circulating tumor DNA (ctDNA). II. To establish a tissue/blood repository to pursue future studies. OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients receive dexamethasone orally (PO) twice daily (BID) on days 0-2, ramucirumab intravenously (IV) over 30-60 minutes on day 1 and docetaxel IV over 60 minutes on day 1 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo blood sample collection, and computed tomography (CT) or magnetic resonance imaging (MRI) throughout the study. ARM II: Patients receive dexamethasone PO BID on days 0-2, ramucirumab IV over 30-60 minutes on day 1, docetaxel IV over 60 minutes on day 1, and cemiplimab IV over 30 minutes on day 1 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo blood sample collection, and CT or MRI throughout the study. After completion of study treatment, patients are followed up every 3-6 months for up to 3 years after randomization.
Arms & interventions
- ProcedureBiospecimen Collection
Undergo blood sample collection
- BiologicalCemiplimab
Given IV
- ProcedureComputed Tomography
Undergo CT
- DrugDexamethasone
Given PO
- DrugDocetaxel
Given IV
- ProcedureMagnetic Resonance Imaging
Undergo MRI
- BiologicalRamucirumab
Given IV
Outcome measures
Primary
Overall survival (OS)
OS will be compared between arms and within the subgroups defined by the stratification factors and by PD-L1 subgroups. Distributions of OS will be estimated using the method of Kaplan-Meier. Hazard ratios for comparisons of OS will be estimated using a Cox Proportional Hazards regression model, with baseline hazard stratification using the stratification factors. Testing will be done using a stratified log-rank test. Confidence intervals (CIs) about medians will be estimated using the method of Brookmeyer-Crowley. For point estimates at landmark times, the associated CIs will be calculated using Greenwood's formula and based on a log-log transformation applied on the survival function.
Time frame: From date of randomization to date of death due to any cause, assessed up to 3 years
Secondary
Progression-free survival (PFS)
Time frame: From date of randomization to date of first documentation of progression, symptomatic deterioration, or death, whichever comes first, assessed up to 3 years
Response rates
Time frame: Up to 3 years
Disease control rates
Time frame: Up to 3 years
Duration of response (DOR)
Time frame: From date of first documentation of response by RECIST 1.1 (CR or PR, confirmed or unconfirmed) to date of first documentation of progression or symptomatic deterioration, or death due to any cause, assessed up to 3 years
Incidence of adverse events
Time frame: Up to 90 days after last dose of study treatment
Eligibility criteria
Study locations (386)
Gulf Health Hospitals Inc/Infirmary Cancer Care - Malbis
Daphne, Alabama, 36526
Thomas Hospital
Fairhope, Alabama, 36532
Mobile Infirmary Medical Center
Mobile, Alabama, 36607
Gulf Health Hospitals Inc/Infirmary Cancer Care - Saraland
Saraland, Alabama, 36571
Katmai Oncology Group
Anchorage, Alaska, 99508
Banner University Medical Center - Tucson
Tucson, Arizona, 85719
University of Arizona Cancer Center-North Campus
Tucson, Arizona, 85719
NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
Jonesboro, Arkansas, 72401
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
Enloe Medical Center
Chico, California, 95926
City of Hope Comprehensive Cancer Center
Duarte, California, 91010
Kaiser Permanente-Fontana
Fontana, California, 92335
Kaiser Permanente Fresno Orchard Plaza
Fresno, California, 93720
Kaiser Permanente-Fresno
Fresno, California, 93720
Kaiser Permanente South Bay
Harbor City, California, 90710
City of Hope at Irvine Lennar
Irvine, California, 92618
Kaiser Permanente-Irvine
Irvine, California, 92618
UC San Diego Moores Cancer Center
La Jolla, California, 92093
City of Hope Antelope Valley
Lancaster, California, 93534
Loma Linda University Medical Center
Loma Linda, California, 92354
Kaiser Permanente Los Angeles Medical Center
Los Angeles, California, 90027
Kaiser Permanente West Los Angeles
Los Angeles, California, 90034
Cedars-Sinai Medical Center
Los Angeles, California, 90048
Fremont - Rideout Cancer Center
Marysville, California, 95901
Mather Veteran Affairs Medical Center
Mather, California, 95655
Kaiser Permanente-Oakland
Oakland, California, 94611
Kaiser Permanente-Ontario
Ontario, California, 91761
VA Palo Alto Health Care System
Palo Alto, California, 94304
Kaiser Permanente - Panorama City
Panorama City, California, 91402
Eisenhower Medical Center
Rancho Mirage, California, 92270
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-San Diego Zion
San Diego, California, 92120
Kaiser Permanente-San Francisco
San Francisco, California, 94115
Veterans Affairs Medical Center - San Francisco
San Francisco, California, 94121
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
Mills Health Center
San Mateo, California, 94401
Kaiser San Rafael-Gallinas
San Rafael, California, 94903
Kaiser Permanente Medical Center - Santa Clara
Santa Clara, California, 95051
Kaiser Permanente-South San Francisco
South San Francisco, California, 94080
Cedars-Sinai Cancer - Tarzana
Tarzana, California, 91356
City of Hope South Bay
Torrance, California, 90503
Torrance Memorial Physician Network - Cancer Care
Torrance, California, 90505
Gene Upshaw Memorial Tahoe Forest Cancer Center
Truckee, California, 96161
City of Hope Upland
Upland, California, 91786
Kaiser Permanente-Vallejo
Vallejo, California, 94589
Kaiser Permanente-Walnut Creek
Walnut Creek, California, 94596
Presbyterian Intercommunity Hospital
Whittier, California, 90602
Kaiser Permanente-Woodland Hills
Woodland Hills, California, 91367
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
Kaiser Permanente-Capitol Hill Medical Center
Washington D.C., District of Columbia, 20002
Malcom Randall Veterans Administration Medical Center
Gainesville, Florida, 32610
Moffitt Cancer Center
Tampa, Florida, 33612
Grady Health System
Atlanta, Georgia, 30303
Emory University Hospital Midtown
Atlanta, Georgia, 30308
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia, 30322
Emory Saint Joseph's Hospital
Atlanta, Georgia, 30342
Northside Hospital
Atlanta, Georgia, 30342
Atlanta VA Medical Center
Decatur, Georgia, 30033
Northside Hospital - Duluth
Duluth, Georgia, 30096
Northeast Georgia Medical Center-Gainesville
Gainesville, Georgia, 30501
Emory Johns Creek Hospital
Johns Creek, Georgia, 30097
Northside Hospital - Gwinnett
Lawrenceville, Georgia, 30046
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
Savannah, Georgia, 31405
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
Idaho Urologic Institute-Meridian
Meridian, Idaho, 83642
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
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
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
Illinois CancerCare-Galesburg
Galesburg, Illinois, 61401
Northwestern Medicine Cancer Center Delnor
Geneva, Illinois, 60134
Northwestern Medicine Glenview Outpatient Center
Glenview, Illinois, 60026
Northwestern Medicine Grayslake Outpatient Center
Grayslake, Illinois, 60030
Advocate South Suburban Hospital
Hazel Crest, Illinois, 60429
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
Loyola University Medical Center
Maywood, Illinois, 60153
Carle BroMenn Medical Center
Normal, Illinois, 61761
Carle Cancer Institute Normal
Normal, Illinois, 61761
Cancer Care Center of O'Fallon
O'Fallon, Illinois, 62269
HSHS Saint Elizabeth's Hospital
O'Fallon, Illinois, 62269
Northwestern Medicine Oak Brook
Oak Brook, Illinois, 60523
Advocate Christ Medical Center
Oak Lawn, Illinois, 60453-2699
Advocate Outpatient Center - Oak Lawn
Oak Lawn, Illinois, 60453
Northwestern Medicine Orland Park
Orland Park, Illinois, 60462
Illinois CancerCare-Ottawa Clinic
Ottawa, Illinois, 61350
Advocate High Tech Medical Park
Palos Heights, Illinois, 60463
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
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
Indiana University/Melvin and Bren Simon Cancer Center
Indianapolis, Indiana, 46202
Richard L. Roudebush Veterans Affairs Medical Center
Indianapolis, Indiana, 46202
University of Kansas Clinical Research Center
Fairway, Kansas, 66205
HaysMed
Hays, Kansas, 67601
University of Kansas Cancer Center
Kansas City, Kansas, 66160
Lawrence Memorial Hospital
Lawrence, Kansas, 66044
Veteran Administration Eastern Kansas Healthcare
Leavenworth, Kansas, 66048
The University of Kansas Cancer Center - Olathe
Olathe, Kansas, 66061
University of Kansas Cancer Center-Overland Park
Overland Park, Kansas, 66210
University of Kansas Hospital-Indian Creek Campus
Overland Park, Kansas, 66211
Salina Regional Health Center
Salina, Kansas, 67401
University of Kansas Health System Saint Francis Campus
Topeka, Kansas, 66606
University of Kansas Hospital-Westwood Cancer Center
Westwood, Kansas, 66205
University of Kentucky/Markey Cancer Center
Lexington, Kentucky, 40536
Harold Alfond Center for Cancer Care
Augusta, Maine, 04330
MaineHealth Waldo Hospital
Belfast, Maine, 04915
Lafayette Family Cancer Center-EMMC
Brewer, Maine, 04412
MaineHealth Cancer Care and IV Therapy - Brunswick
Brunswick, Maine, 04011
MaineHealth LincolnHealth Hospital
Damariscotta, Maine, 04543
Penobscot Bay Medical Center
Rockport, Maine, 04856
MaineHealth Cancer Care Center of York County
Sanford, Maine, 04073
MaineHealth Cancer Care and IV Therapy - South Portland
South Portland, Maine, 04106
Saint Agnes Hospital
Baltimore, Maryland, 21229
Kaiser Permanente-Woodlawn Medical Center
Baltimore, Maryland, 21244
UPMC Western Maryland
Cumberland, Maryland, 21502
Kaiser Permanente-Gaithersburg Medical Center
Gaithersburg, Maryland, 20879
Kaiser Permanente - Largo Medical Center
Largo, Maryland, 20774
Kaiser Permanente Lutherville - Timonium Medical Center
Lutherville, Maryland, 21093
Beverly Hospital
Beverly, Massachusetts, 01915
Lahey Hospital and Medical Center
Burlington, Massachusetts, 01805
Addison Gilbert Hospital
Gloucester, Massachusetts, 01930
Lahey Medical Center-Peabody
Peabody, Massachusetts, 01960
Baystate Medical Center
Springfield, Massachusetts, 01199
UMass Memorial Medical Center - University Campus
Worcester, Massachusetts, 01655
Trinity Health IHA Medical Group Hematology Oncology - Brighton
Brighton, Michigan, 48114
Trinity Health IHA Medical Group Hematology Oncology - Canton
Canton, Michigan, 48188
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
Chelsea, Michigan, 48118
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
University of Michigan Health - Sparrow Lansing
Lansing, Michigan, 48912
Trinity Health Saint Mary Mercy Livonia Hospital
Livonia, Michigan, 48154
Trinity Health Saint Joseph Mercy Oakland Hospital
Pontiac, Michigan, 48341
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
Abbott-Northwestern Hospital
Minneapolis, Minnesota, 55407
North Memorial Medical Health Center
Robbinsdale, Minnesota, 55422
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
Sanford Cancer Center Worthington
Worthington, Minnesota, 56187
Baptist Memorial Hospital and Cancer Center-Golden Triangle
Columbus, Mississippi, 39705
Baptist Cancer Center-Grenada
Grenada, Mississippi, 38901
Gulfport Memorial Hospital
Gulfport, Mississippi, 39502
Baptist Memorial Hospital and Cancer Center-Union County
New Albany, Mississippi, 38652
Baptist Memorial Hospital and Cancer Center-Oxford
Oxford, Mississippi, 38655
Baptist Memorial Hospital and Cancer Center-Desoto
Southhaven, Mississippi, 38671
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
Parkland Health Center - Farmington
Farmington, Missouri, 63640
University Health Truman Medical Center
Kansas City, Missouri, 64108
University of Kansas Cancer Center - Briarcliff
Kansas City, Missouri, 64116
Kansas City Veterans Affairs Medical Center
Kansas City, Missouri, 64128
University of Kansas Cancer Center - North
Kansas City, Missouri, 64154
University of Kansas Cancer Center - Lee's Summit
Lee's Summit, Missouri, 64064
Lake Regional Hospital
Osage Beach, Missouri, 65065
Sainte Genevieve County Memorial Hospital
Sainte Genevieve, Missouri, 63670
Washington University School of Medicine
St Louis, Missouri, 63110
Mercy Hospital South
St Louis, Missouri, 63128
Siteman Cancer Center-South County
St Louis, Missouri, 63129
Missouri Baptist Medical Center
St Louis, Missouri, 63131
Siteman Cancer Center at Christian Hospital
St Louis, Missouri, 63136
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
New Hampshire Oncology Hematology PA-Concord
Concord, New Hampshire, 03301
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon, New Hampshire, 03756
Solinsky Center for Cancer Care
Manchester, New Hampshire, 03103
Virtua Samson Cancer Center
Moorestown, New Jersey, 08057
Virtua Voorhees
Voorhees Township, New Jersey, 08043
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87106
The Cancer Institute at Saint Francis Hospital
East Hills, New York, 11548
University of Rochester
Rochester, New York, 14642
Montefiore Medical Center-Einstein Campus
The Bronx, New York, 10461
James J Peters VA Medical Center
The Bronx, New York, 10468
Wilmot Cancer Institute at Webster
Webster, New York, 14580
Good Samaritan University Hospital
West Islip, New York, 11795
Durham VA Medical Center
Durham, North Carolina, 27705
FirstHealth of the Carolinas-Moore Regional Hospital
Pinehurst, North Carolina, 28374
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
OhioHealth O'Bleness Hospital
Athens, Ohio, 45701
Aultman Health Foundation
Canton, Ohio, 44710
Miami Valley Hospital South
Centerville, Ohio, 45459
Columbus Oncology and Hematology Associates Inc
Columbus, Ohio, 43214
Riverside Methodist Hospital
Columbus, Ohio, 43214
Grant Medical Center
Columbus, Ohio, 43215
Doctors Hospital
Columbus, Ohio, 43228
Miami Valley Hospital
Dayton, Ohio, 45409
Premier Blood and Cancer Center
Dayton, Ohio, 45409
Miami Valley Hospital North
Dayton, Ohio, 45415
Delaware Health Center-Grady Cancer Center
Delaware, Ohio, 43015
Grady Memorial Hospital
Delaware, Ohio, 43015
Columbus Oncology and Hematology Associates
Dublin, Ohio, 43016
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
OhioHealth Mansfield Hospital
Mansfield, Ohio, 44903
OhioHealth Marion General Hospital
Marion, Ohio, 43302
OhioHealth Pickerington Methodist Hospital
Pickerington, Ohio, 43147
ProMedica Flower Hospital
Sylvania, Ohio, 43560
Upper Valley Medical Center
Troy, Ohio, 45373
OhioHealth Westerville Medical Campus/Westerville Cancer Center
Westerville, Ohio, 43082
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
Mercy Hospital Oklahoma City
Oklahoma City, Oklahoma, 73120
Saint Alphonsus Cancer Care Center-Baker City
Baker City, Oregon, 97814
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
Salem Hospital
Salem, Oregon, 97301
UPMC-Heritage Valley Health System Beaver
Beaver, Pennsylvania, 15009
UPMC Hillman Cancer Center at Butler Health System
Butler, Pennsylvania, 16001
WellSpan Medical Oncology and Hematology
Chambersburg, Pennsylvania, 17201
UPMC Hillman Cancer Center - Passavant - Cranberry
Cranberry Township, Pennsylvania, 16066
Ephrata Cancer Center
Ephrata, Pennsylvania, 17522
UPMC Hillman Cancer Center Erie
Erie, Pennsylvania, 16505
UPMC Cancer Center at UPMC Horizon
Farrell, Pennsylvania, 16121
Adams Cancer Center
Gettysburg, Pennsylvania, 17325
UPMC Cancer Centers - Arnold Palmer Pavilion
Greensburg, Pennsylvania, 15601
UPMC Pinnacle Cancer Center/Community Osteopathic Campus
Harrisburg, Pennsylvania, 17109
IRMC Cancer Center
Indiana, Pennsylvania, 15701
UPMC-Johnstown/John P. Murtha Regional Cancer Center
Johnstown, Pennsylvania, 15901
Sechler Family Cancer Center
Lebanon, Pennsylvania, 17042
UPMC Cancer Center at UPMC McKeesport
McKeesport, Pennsylvania, 15132
UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion
Mechanicsburg, Pennsylvania, 17050
UPMC Hillman Cancer Center - Monroeville
Monroeville, Pennsylvania, 15146
UPMC Hillman Cancer Center in Coraopolis
Moon Township, Pennsylvania, 15108
UPMC Hillman Cancer Center - Part of Frick Hospital
Mount Pleasant, Pennsylvania, 15666
Arnold Palmer Cancer Center Medical Oncology Norwin
N. Huntingdon, Pennsylvania, 15642
UPMC Cancer Center-Natrona Heights
Natrona Heights, Pennsylvania, 15065
UPMC Hillman Cancer Center - New Castle
New Castle, Pennsylvania, 16105
Fox Chase Cancer Center
Philadelphia, Pennsylvania, 19111
Temple University Hospital
Philadelphia, Pennsylvania, 19140
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
UPMC Cancer Center at UPMC Northwest
Seneca, Pennsylvania, 16346
UPMC Cancer Center-Uniontown
Uniontown, Pennsylvania, 15401
UPMC Cancer Center-Washington
Washington, Pennsylvania, 15301
UPMC Susquehanna
Williamsport, Pennsylvania, 17701
Divine Providence Hospital
Williamsport, Pennsylvania, 17754
Cancer Care Associates of York
York, Pennsylvania, 17403
AnMed Health Cancer Center
Anderson, South Carolina, 29621
Saint Joseph's/Candler - Bluffton Campus
Bluffton, South Carolina, 29910
Medical University of South Carolina
Charleston, South Carolina, 29425
Gibbs Cancer Center-Gaffney
Gaffney, South Carolina, 29341
Gibbs Cancer Center-Pelham
Greer, South Carolina, 29651
South Carolina Cancer Specialists PC
Hilton Head Island, South Carolina, 29926-3827
Spartanburg Medical Center
Spartanburg, South Carolina, 29303
SMC Center for Hematology Oncology Union
Union, South Carolina, 29379
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
Baptist Memorial Hospital and Cancer Center-Collierville
Collierville, Tennessee, 38017
Baptist Memorial Hospital and Cancer Center-Memphis
Memphis, Tennessee, 38120
The Don and Sybil Harrington Cancer Center
Amarillo, Texas, 79106
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, 84112
Dartmouth Cancer Center - North
Saint Johnsbury, Vermont, 05819
White River Junction Veteran Administration Medical Center
White River Junction, Vermont, 05009
University of Virginia Cancer Center
Charlottesville, Virginia, 22908
Centra Alan B Pearson Regional Cancer Center
Lynchburg, Virginia, 24501
Kaiser Permanente Tysons Corner Medical Center
McLean, Virginia, 22102
Virginia Cancer Institute
Richmond, Virginia, 23229
VCU Massey Cancer Center at Stony Point
Richmond, Virginia, 23235
VCU Massey Comprehensive Cancer Center
Richmond, Virginia, 23298
VCU Community Memorial Health Center
South Hill, Virginia, 23970
Kaiser Permanente-Caton Hill Medical Center
Woodbridge, Virginia, 22192
United Hospital Center
Bridgeport, West Virginia, 26330
Edwards Comprehensive Cancer Center
Huntington, West Virginia, 25701
WVUH-Berkely Medical Center
Martinsburg, West Virginia, 25401
West Virginia University Healthcare
Morgantown, West Virginia, 26506
Camden Clark Medical Center
Parkersburg, West Virginia, 26101
Wheeling Hospital/Schiffler Cancer Center
Wheeling, West Virginia, 26003
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
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
Sheboygan Physicians Group
Sheboygan, Wisconsin, 53081
Vince Lombardi Cancer Clinic-Sheboygan
Sheboygan, Wisconsin, 53081
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
Aurora Cancer Care-Milwaukee West
Wauwatosa, Wisconsin, 53226
Aurora West Allis Medical Center
West Allis, Wisconsin, 53227
Marshfield Medical Center - Weston
Weston, Wisconsin, 54476