Testing the Addition of High Dose, Targeted Radiation to the Usual Treatment for Locally-Advanced Inoperable Non-small Cell Lung Cancer
Purpose
This phase III trial compares the effect of adding stereotactic body radiation therapy (SBRT) to standard treatment (image guided radiation therapy [IGRT] and chemotherapy followed by immunotherapy with durvalumab) versus standard treatment alone in treating patients with non-small cell lung cancer that cannot be treated by surgery (inoperable). SBRT uses special equipment to position a patient and deliver radiation to tumors with high precision. This method may kill tumor cells with fewer doses over a shorter period and cause less damage to normal tissue. IGRT is a type of radiation that uses a computer to create picture of the tumor, to help guide the radiation beam during therapy, making it more accurate and causing less damage to healthy tissue. Standard chemotherapy used in this trial consists of combinations of the following drugs: cisplatin, carboplatin, paclitaxel, pemetrexed, and etoposide. Cisplatin is in a class of medications known as platinum-containing compounds. It works by killing, stopping or slowing the growth of tumor cells. Carboplatin is in a class of medications known as platinum-containing compounds. It works in a way similar to the anticancer drug cisplatin, but may be better tolerated than cisplatin. Carboplatin works by killing, stopping or slowing the growth of tumor cells. Paclitaxel is in a class of medications called antimicrotubule agents. It works by stopping the growth and spread of tumor cells. Pemetrexed is in a class of medications called antifolate antineoplastic agents. It works by blocking the action of a certain substance in the body that may help tumor cells multiply. 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 tumor cells. Immunotherapy with durvalumab, may induce changes in body's immune system and may interfere with the ability of tumor cells to grow and spread. Adding SBRT to the standard treatment of IGRT with chemotherapy and immunotherapy may be more effective at treating patients with inoperable non-small cell lung cancer than giving the standard treatment alone.
Conditions
- Locally Advanced Lung Non-Small Cell Carcinoma
- Stage IIB Lung Cancer AJCC v8
- Stage III Lung Cancer AJCC v8
Eligibility
- Eligible Ages
- Over 18 Years
- Eligible Genders
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- Pathologically (histologically or cytologically) proven diagnosis of stage II or III (American Joint Committee on Cancer [AJCC] eighth edition) non-small cell lung cancer (NSCLC) with known PD-L1 status prior to registration - Patients must have an identified primary tumor and at least one nodal metastasis (peribronchial/hilar/intrapulmonary, mediastinal/subcarinal, supraclavicular/scalene) - Up to 4 cycles of systemic therapy received prior to registration for the current study cancer is allowable; any prior chemotherapy for a different cancer is also permissible - The patient must be deemed clinically appropriate for curative intent definitive combined modality therapy, based on the following staging assessments: - History/physical examination prior to registration; - Magnetic resonance imaging (MRI) scan of the brain (preferred) or CT scan of the brain (if available, contrast is preferred for all neuroimaging) prior to registration; - CT chest with IV contrast (if contrast is available and unless contraindicated, such as for abnormal kidney function) prior to registration. PET/CT may be used if the CT portion is of identical diagnostic quality as achieved in a stand-alone CT - No evidence of distant metastases based on FDG PET/CT scan obtain within 60 days of registration - Primary tumor =< 7 cm - Age >= 18 - Eastern Cooperative Oncology Group (ECOG) performance status 0-2 - Hematologic function (e.g. platelets, leukocytes, hemoglobin) amenable, at the discretion of the treating physician, to allow for treatment with chemotherapy and concurrent radiation therapy - Creatinine clearance >= 25 mL/min by the Cockcroft-Gault (C-G) equation - Subjects with non-malignant pleural effusion are eligible provided the effusion is not known or demonstrated to be an exudative effusion - If a pleural effusion is present, the following criteria must be met to exclude malignant involvement: - When pleural fluid is visible on both the CT scan and on a chest x-ray, a pleuracentesis is required to confirm that the pleural fluid is cytologically negative; - Effusions that are minimal (i.e., not visible on chest x-ray) that are too small to safely tap are eligible - Medical history consistent with the patient being amenable, at the discretion of the treating physician, to allow for treating with consolidation immunotherapy. Patients with known EGFR/ALK mutation at the time of registration are eligible, and these patients can be treated with consolidation durvalumab or chemotherapy at the discretion of the treating physician - Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen - Negative pregnancy test =< 14 days prior to registration for participants of childbearing potential - The patient or a legally authorized representative must provide study-specific informed consent prior to study entry and, for patients treated in the United States (U.S.), authorization permitting release of personal health information
Exclusion Criteria
- Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields that is determined by the treating physician to impede the treatment of the study malignancy - Patients without identifiable primary tumor and at least 1 pathologically enlarged lymph node are not eligible (T3-4N0 or T0N1-3 patients are not eligible). At least 1 radiographically-involved lymph node is required, but pathologic confirmation of involvement is not mandated - Centrally located primary tumor < 2 cm from involved nodal disease which would result in significant overlap of the primary SBRT and nodal radiation fields. Centrally located is defined as within or touching the zone of the proximal bronchial tree, which is a volume 2 cm in all directions around the proximal bronchial tree (carina, right and left main bronchi, right and left upper lobe bronchi, intermedius bronchus, right middle lobe bronchus, lingular bronchus right and left lower lobe bronchi) - Participants who are pregnant or unwilling to discontinue nursing - Participants of childbearing potential (participants who may become pregnant or who may impregnate a partner) unwilling to use highly effective contraceptives during therapy and for the Food and Drug Administration (FDA)-labeled contraception timeframe required after the final dose of the selected chemotherapy regimen, because the treatment in this study may be significantly teratogenic
Study Design
- Phase
- Phase 3
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel Assignment
- Primary Purpose
- Treatment
- Masking
- None (Open Label)
Arm Groups
| Arm | Description | Assigned Intervention |
|---|---|---|
|
Active Comparator Arm I (image guided RT, chemotherapy, immunotherapy) |
Patients undergo conventional IGRT and receive standard of care chemotherapy consisting of paclitaxel IV and carboplatin IV or pemetrexed IV and carboplatin IV or etoposide IV and cisplatin IV or pemetrexed IV and cisplatin IV and then receive durvalumab IV on study. Patients also undergo CT and/or PET/CT during follow up. |
|
|
Experimental Arm II (SBRT, image guided RT, chemotherapy, immunotherapy) |
Patients undergo SBRT and conventional IGRT and receive standard of care chemotherapy consisting of paclitaxel IV and carboplatin IV or pemetrexed IV and carboplatin IV or etoposide IV and cisplatin IV or pemetrexed IV and cisplatin IV and then receive durvalumab IV on study. Patients also undergo CT and/or PET/CT during follow up. |
|
Recruiting Locations
Cancer Center at Saint Joseph's
Phoenix, Arizona 85004
Phoenix, Arizona 85004
Banner University Medical Center - Tucson
Tucson, Arizona 85719
Tucson, Arizona 85719
University of Arizona Cancer Center-North Campus
Tucson, Arizona 85719
Tucson, Arizona 85719
University of Arkansas for Medical Sciences
Little Rock, Arkansas 72205
Little Rock, Arkansas 72205
Contact:
Site Public Contact
501-686-8274
Site Public Contact
501-686-8274
AIS Cancer Center at San Joaquin Community Hospital
Bakersfield, California 93301
Bakersfield, California 93301
Contact:
Site Public Contact
661-323-4673
Site Public Contact
661-323-4673
Mills-Peninsula Medical Center
Burlingame, California 94010
Burlingame, California 94010
Fremont - Rideout Cancer Center
Marysville, California 95901
Marysville, California 95901
Contact:
Site Public Contact
530-749-4400
Site Public Contact
530-749-4400
Memorial Medical Center
Modesto, California 95355
Modesto, California 95355
Sutter Cancer Centers Radiation Oncology Services-Roseville
Roseville, California 95661
Roseville, California 95661
Sutter Roseville Medical Center
Roseville, California 95661
Roseville, California 95661
Sutter Medical Center Sacramento
Sacramento, California 95816
Sacramento, California 95816
California Pacific Medical Center-Pacific Campus
San Francisco, California 94115
San Francisco, California 94115
Mills Health Center
San Mateo, California 94401
San Mateo, California 94401
Sutter Solano Medical Center/Cancer Center
Vallejo, California 94589
Vallejo, California 94589
UCHealth University of Colorado Hospital
Aurora, Colorado 80045
Aurora, Colorado 80045
Contact:
Site Public Contact
720-848-0650
Site Public Contact
720-848-0650
Rocky Mountain Cancer Centers-Penrose
Colorado Springs, Colorado 80907
Colorado Springs, Colorado 80907
UCHealth Memorial Hospital Central
Colorado Springs, Colorado 80909
Colorado Springs, Colorado 80909
Contact:
Site Public Contact
719-365-2406
Site Public Contact
719-365-2406
Memorial Hospital North
Colorado Springs, Colorado 80920
Colorado Springs, Colorado 80920
Contact:
Site Public Contact
719-364-6700
Site Public Contact
719-364-6700
UCHealth - Cherry Creek
Denver, Colorado 80206
Denver, Colorado 80206
Poudre Valley Hospital
Fort Collins, Colorado 80524
Fort Collins, Colorado 80524
Contact:
Site Public Contact
970-297-6150
Site Public Contact
970-297-6150
Cancer Care and Hematology-Fort Collins
Fort Collins, Colorado 80528
Fort Collins, Colorado 80528
UCHealth Greeley Hospital
Greeley, Colorado 80631
Greeley, Colorado 80631
UCHealth Highlands Ranch Hospital
Highlands Ranch, Colorado 80129
Highlands Ranch, Colorado 80129
Contact:
Site Public Contact
720-848-0650
Site Public Contact
720-848-0650
UCHealth Lone Tree Health Center
Lone Tree, Colorado 80124
Lone Tree, Colorado 80124
Medical Center of the Rockies
Loveland, Colorado 80538
Loveland, Colorado 80538
Contact:
Site Public Contact
970-203-7083
Site Public Contact
970-203-7083
Helen F Graham Cancer Center
Newark, Delaware 19713
Newark, Delaware 19713
Medical Oncology Hematology Consultants PA
Newark, Delaware 19713
Newark, Delaware 19713
Christiana Care Health System-Christiana Hospital
Newark, Delaware 19718
Newark, Delaware 19718
Morton Plant Hospital
Clearwater, Florida 33756
Clearwater, Florida 33756
Contact:
Site Public Contact
855-314-8646
Site Public Contact
855-314-8646
Mayo Clinic in Florida
Jacksonville, Florida 32224-9980
Jacksonville, Florida 32224-9980
Contact:
Site Public Contact
855-776-0015
Site Public Contact
855-776-0015
Jupiter Medical Center
Jupiter, Florida 33458
Jupiter, Florida 33458
Contact:
Site Public Contact
561-745-5768
Site Public Contact
561-745-5768
Orlando Health Cancer Institute
Orlando, Florida 32806
Orlando, Florida 32806
Saint Joseph's Hospital/Children's Hospital-Tampa
Tampa, Florida 33607
Tampa, Florida 33607
Grady Health System
Atlanta, Georgia 30303
Atlanta, Georgia 30303
Contact:
Site Public Contact
404-489-9164
Site Public Contact
404-489-9164
Emory Proton Therapy Center
Atlanta, Georgia 30308
Atlanta, Georgia 30308
Emory University Hospital Midtown
Atlanta, Georgia 30308
Atlanta, Georgia 30308
Contact:
Site Public Contact
888-946-7447
Site Public Contact
888-946-7447
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia 30322
Atlanta, Georgia 30322
Contact:
Site Public Contact
404-778-1868
Site Public Contact
404-778-1868
Emory Saint Joseph's Hospital
Atlanta, Georgia 30342
Atlanta, Georgia 30342
Contact:
Site Public Contact
404-851-7115
Site Public Contact
404-851-7115
Augusta University Medical Center
Augusta, Georgia 30912
Augusta, Georgia 30912
CTCA at Southeastern Regional Medical Center
Newnan, Georgia 30265
Newnan, Georgia 30265
Contact:
Site Public Contact
770-400-6629
Site Public Contact
770-400-6629
Hawaii Cancer Care - Westridge
'Aiea, Hawaii 96701
'Aiea, Hawaii 96701
Pali Momi Medical Center
'Aiea, Hawaii 96701
'Aiea, Hawaii 96701
Contact:
Site Public Contact
808-486-6000
Site Public Contact
808-486-6000
Hawaii Cancer Care Inc - Waterfront Plaza
Honolulu, Hawaii 96813
Honolulu, Hawaii 96813
Queen's Cancer Cenrer - POB I
Honolulu, Hawaii 96813
Honolulu, Hawaii 96813
Contact:
Site Public Contact
808-532-0315
Site Public Contact
808-532-0315
Queen's Medical Center
Honolulu, Hawaii 96813
Honolulu, Hawaii 96813
Contact:
Site Public Contact
808-545-8548
Site Public Contact
808-545-8548
Straub Clinic and Hospital
Honolulu, Hawaii 96813
Honolulu, Hawaii 96813
Contact:
Site Public Contact
808-522-4333
Site Public Contact
808-522-4333
University of Hawaii Cancer Center
Honolulu, Hawaii 96813
Honolulu, Hawaii 96813
Contact:
Site Public Contact
808-586-2979
Site Public Contact
808-586-2979
Kuakini Medical Center
Honolulu, Hawaii 96817
Honolulu, Hawaii 96817
Contact:
Site Public Contact
808-547-9816
Site Public Contact
808-547-9816
Queen's Cancer Center - Kuakini
Honolulu, Hawaii 96817
Honolulu, Hawaii 96817
Contact:
Site Public Contact
808-531-8521
Site Public Contact
808-531-8521
The Cancer Center of Hawaii-Liliha
Honolulu, Hawaii 96817
Honolulu, Hawaii 96817
Contact:
Site Public Contact
808-547-6881
Site Public Contact
808-547-6881
Rush - Copley Medical Center
Aurora, Illinois 60504
Aurora, Illinois 60504
Advocate Good Shepherd Hospital
Barrington, Illinois 60010
Barrington, Illinois 60010
Contact:
Site Public Contact
847-842-4847
Site Public Contact
847-842-4847
OSF Saint Joseph Medical Center
Bloomington, Illinois 61701
Bloomington, Illinois 61701
Illinois CancerCare-Bloomington
Bloomington, Illinois 61704
Bloomington, Illinois 61704
Illinois CancerCare-Canton
Canton, Illinois 61520
Canton, Illinois 61520
Illinois CancerCare-Carthage
Carthage, Illinois 62321
Carthage, Illinois 62321
Centralia Oncology Clinic
Centralia, Illinois 62801
Centralia, Illinois 62801
Northwestern University
Chicago, Illinois 60611
Chicago, Illinois 60611
Advocate Illinois Masonic Medical Center
Chicago, Illinois 60657
Chicago, Illinois 60657
Contact:
Site Public Contact
773-296-5360
Site Public Contact
773-296-5360
AMG Crystal Lake - Oncology
Crystal Lake, Illinois 60014
Crystal Lake, Illinois 60014
Carle at The Riverfront
Danville, Illinois 61832
Danville, Illinois 61832
Cancer Care Specialists of Illinois - Decatur
Decatur, Illinois 62526
Decatur, Illinois 62526
Decatur Memorial Hospital
Decatur, Illinois 62526
Decatur, Illinois 62526
Northwestern Medicine Cancer Center Kishwaukee
DeKalb, Illinois 60115
DeKalb, Illinois 60115
Advocate Good Samaritan Hospital
Downers Grove, Illinois 60515
Downers Grove, Illinois 60515
Carle Physician Group-Effingham
Effingham, Illinois 62401
Effingham, Illinois 62401
Crossroads Cancer Center
Effingham, Illinois 62401
Effingham, Illinois 62401
Advocate Sherman Hospital
Elgin, Illinois 60123
Elgin, Illinois 60123
Contact:
Site Public Contact
847-429-2907
Site Public Contact
847-429-2907
Illinois CancerCare-Eureka
Eureka, Illinois 61530
Eureka, Illinois 61530
Illinois CancerCare-Galesburg
Galesburg, Illinois 61401
Galesburg, Illinois 61401
Northwestern Medicine Cancer Center Delnor
Geneva, Illinois 60134
Geneva, Illinois 60134
Advocate South Suburban Hospital
Hazel Crest, Illinois 60429
Hazel Crest, Illinois 60429
Contact:
Site Public Contact
708-799-9995
Site Public Contact
708-799-9995
Illinois CancerCare-Kewanee Clinic
Kewanee, Illinois 61443
Kewanee, Illinois 61443
AMG Libertyville - Oncology
Libertyville, Illinois 60048
Libertyville, Illinois 60048
Condell Memorial Hospital
Libertyville, Illinois 60048
Libertyville, Illinois 60048
Illinois CancerCare-Macomb
Macomb, Illinois 61455
Macomb, Illinois 61455
Carle Physician Group-Mattoon/Charleston
Mattoon, Illinois 61938
Mattoon, Illinois 61938
Cancer Care Center of O'Fallon
O'Fallon, Illinois 62269
O'Fallon, Illinois 62269
HSHS Saint Elizabeth's Hospital
O'Fallon, Illinois 62269
O'Fallon, Illinois 62269
Advocate Christ Medical Center
Oak Lawn, Illinois 60453-2699
Oak Lawn, Illinois 60453-2699
Contact:
Site Public Contact
800-323-8622
Site Public Contact
800-323-8622
Illinois CancerCare-Ottawa Clinic
Ottawa, Illinois 61350
Ottawa, Illinois 61350
Advocate High Tech Medical Park
Palos Heights, Illinois 60463
Palos Heights, Illinois 60463
Advocate Lutheran General Hospital
Park Ridge, Illinois 60068
Park Ridge, Illinois 60068
Contact:
Site Public Contact
847-384-3621
Site Public Contact
847-384-3621
Illinois CancerCare-Pekin
Pekin, Illinois 61554
Pekin, Illinois 61554
Illinois CancerCare-Peoria
Peoria, Illinois 61615
Peoria, Illinois 61615
OSF Saint Francis Radiation Oncology at Peoria Cancer Center
Peoria, Illinois 61615
Peoria, Illinois 61615
Methodist Medical Center of Illinois
Peoria, Illinois 61636
Peoria, Illinois 61636
OSF Saint Francis Medical Center
Peoria, Illinois 61637
Peoria, Illinois 61637
Illinois CancerCare-Peru
Peru, Illinois 61354
Peru, Illinois 61354
Illinois CancerCare-Princeton
Princeton, Illinois 61356
Princeton, Illinois 61356
UW Health Carbone Cancer Center Rockford
Rockford, Illinois 61114
Rockford, Illinois 61114
Memorial Hospital East
Shiloh, Illinois 62269
Shiloh, Illinois 62269
Southern Illinois University School of Medicine
Springfield, Illinois 62702
Springfield, Illinois 62702
Contact:
Site Public Contact
217-545-7929
Site Public Contact
217-545-7929
Springfield Clinic
Springfield, Illinois 62702
Springfield, Illinois 62702
Contact:
Site Public Contact
800-444-7541
Site Public Contact
800-444-7541
Memorial Medical Center
Springfield, Illinois 62781
Springfield, Illinois 62781
Carle Cancer Center
Urbana, Illinois 61801
Urbana, Illinois 61801
Northwestern Medicine Cancer Center Warrenville
Warrenville, Illinois 60555
Warrenville, Illinois 60555
Illinois CancerCare - Washington
Washington, Illinois 61571
Washington, Illinois 61571
Midwestern Regional Medical Center
Zion, Illinois 60099
Zion, Illinois 60099
Contact:
Site Public Contact
844-793-0745
Site Public Contact
844-793-0745
Mary Greeley Medical Center
Ames, Iowa 50010
Ames, Iowa 50010
Contact:
Site Public Contact
515-956-4132
Site Public Contact
515-956-4132
McFarland Clinic - Ames
Ames, Iowa 50010
Ames, Iowa 50010
Mission Cancer and Blood - Ankeny
Ankeny, Iowa 50023
Ankeny, Iowa 50023
Contact:
Site Public Contact
515-282-2921
Site Public Contact
515-282-2921
Saint Luke's Hospital
Cedar Rapids, Iowa 52402
Cedar Rapids, Iowa 52402
Mission Cancer and Blood - West Des Moines
Clive, Iowa 50325
Clive, Iowa 50325
Contact:
Site Public Contact
515-241-3305
Site Public Contact
515-241-3305
Iowa Methodist Medical Center
Des Moines, Iowa 50309
Des Moines, Iowa 50309
Contact:
Site Public Contact
515-241-6727
Site Public Contact
515-241-6727
Mission Cancer and Blood - Des Moines
Des Moines, Iowa 50309
Des Moines, Iowa 50309
Contact:
Site Public Contact
515-241-3305
Site Public Contact
515-241-3305
Mission Cancer and Blood - Laurel
Des Moines, Iowa 50314
Des Moines, Iowa 50314
Contact:
Site Public Contact
515-241-3305
Site Public Contact
515-241-3305
Ascension Via Christi Hospitals Wichita
Wichita, Kansas 67214
Wichita, Kansas 67214
University of Kentucky/Markey Cancer Center
Lexington, Kentucky 40536
Lexington, Kentucky 40536
Contact:
Site Public Contact
859-257-3379
Site Public Contact
859-257-3379
Louisiana State University Health Science Center
New Orleans, Louisiana 70112
New Orleans, Louisiana 70112
University Medical Center New Orleans
New Orleans, Louisiana 70112
New Orleans, Louisiana 70112
Luminis Health Anne Arundel Medical Center
Annapolis, Maryland 21401
Annapolis, Maryland 21401
TidalHealth Richard A Henson Cancer Institute
Ocean Pines, Maryland 21811
Ocean Pines, Maryland 21811
TidalHealth Peninsula Regional
Salisbury, Maryland 21801
Salisbury, Maryland 21801
Trinity Health Saint Joseph Mercy Hospital Ann Arbor
Ann Arbor, Michigan 48106
Ann Arbor, Michigan 48106
McLaren Cancer Institute-Bay City
Bay City, Michigan 48706
Bay City, Michigan 48706
Trinity Health IHA Medical Group Hematology Oncology - Brighton
Brighton, Michigan 48114
Brighton, Michigan 48114
Trinity Health Medical Center - Brighton
Brighton, Michigan 48114
Brighton, Michigan 48114
Chelsea Hospital
Chelsea, Michigan 48118
Chelsea, Michigan 48118
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
Chelsea, Michigan 48118
Chelsea, Michigan 48118
McLaren Cancer Institute-Clarkston
Clarkston, Michigan 48346
Clarkston, Michigan 48346
Michigan Healthcare Professionals Clarkston
Clarkston, Michigan 48346
Clarkston, Michigan 48346
Wayne State University/Karmanos Cancer Institute
Detroit, Michigan 48201
Detroit, Michigan 48201
Michigan Healthcare Professionals Farmington
Farmington Hills, Michigan 48334
Farmington Hills, Michigan 48334
Weisberg Cancer Treatment Center
Farmington Hills, Michigan 48334
Farmington Hills, Michigan 48334
Corewell Health Farmington Hills Hospital
Farmington Hills, Michigan 48336
Farmington Hills, Michigan 48336
Contact:
Site Public Contact
248-551-7695
Site Public Contact
248-551-7695
McLaren Cancer Institute-Flint
Flint, Michigan 48532
Flint, Michigan 48532
Trinity Health Grand Rapids Hospital
Grand Rapids, Michigan 49503
Grand Rapids, Michigan 49503
Bronson Methodist Hospital
Kalamazoo, Michigan 49007
Kalamazoo, Michigan 49007
West Michigan Cancer Center
Kalamazoo, Michigan 49007
Kalamazoo, Michigan 49007
Borgess Medical Center
Kalamazoo, Michigan 49048
Kalamazoo, Michigan 49048
Karmanos Cancer Institute at McLaren Greater Lansing
Lansing, Michigan 48910
Lansing, Michigan 48910
University of Michigan Health - Sparrow Lansing
Lansing, Michigan 48912
Lansing, Michigan 48912
McLaren Cancer Institute-Lapeer Region
Lapeer, Michigan 48446
Lapeer, Michigan 48446
Trinity Health Saint Mary Mercy Livonia Hospital
Livonia, Michigan 48154
Livonia, Michigan 48154
Michigan Healthcare Professionals Macomb
Macomb, Michigan 48044
Macomb, Michigan 48044
Michigan Healthcare Professionals Madison Heights
Madison Heights, Michigan 48071
Madison Heights, Michigan 48071
McLaren Cancer Institute-Macomb
Mount Clemens, Michigan 48043
Mount Clemens, Michigan 48043
McLaren Cancer Institute-Northern Michigan
Petoskey, Michigan 49770
Petoskey, Michigan 49770
Michigan Healthcare Professionals Pontiac
Pontiac, Michigan 48341
Pontiac, Michigan 48341
Trinity Health Saint Joseph Mercy Oakland Hospital
Pontiac, Michigan 48341
Pontiac, Michigan 48341
McLaren-Port Huron
Port Huron, Michigan 48060
Port Huron, Michigan 48060
Corewell Health William Beaumont University Hospital
Royal Oak, Michigan 48073
Royal Oak, Michigan 48073
Contact:
Site Public Contact
248-551-7695
Site Public Contact
248-551-7695
Munson Medical Center
Traverse City, Michigan 49684
Traverse City, Michigan 49684
Corewell Health Beaumont Troy Hospital
Troy, Michigan 48085
Troy, Michigan 48085
Contact:
Site Public Contact
248-551-7695
Site Public Contact
248-551-7695
Michigan Healthcare Professionals Troy
Troy, Michigan 48098
Troy, Michigan 48098
University of Michigan Health - West
Wyoming, Michigan 49519
Wyoming, Michigan 49519
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
Ypsilanti, Michigan 48197
Ypsilanti, Michigan 48197
Sanford Joe Lueken Cancer Center
Bemidji, Minnesota 56601
Bemidji, Minnesota 56601
Mayo Clinic in Rochester
Rochester, Minnesota 55905
Rochester, Minnesota 55905
Contact:
Site Public Contact
855-776-0015
Site Public Contact
855-776-0015
Coborn Cancer Center at Saint Cloud Hospital
Saint Cloud, Minnesota 56303
Saint Cloud, Minnesota 56303
Baptist Memorial Hospital and Cancer Center-Desoto
Southhaven, Mississippi 38671
Southhaven, Mississippi 38671
Saint Francis Medical Center
Cape Girardeau, Missouri 63703
Cape Girardeau, Missouri 63703
Siteman Cancer Center at West County Hospital
Creve Coeur, Missouri 63141
Creve Coeur, Missouri 63141
Parkland Health Center - Farmington
Farmington, Missouri 63640
Farmington, Missouri 63640
Contact:
Site Public Contact
314-996-5569
Site Public Contact
314-996-5569
Freeman Health System
Joplin, Missouri 64804
Joplin, Missouri 64804
Washington University School of Medicine
Saint Louis, Missouri 63110
Saint Louis, Missouri 63110
Mercy Hospital South
Saint Louis, Missouri 63128
Saint Louis, Missouri 63128
Siteman Cancer Center-South County
Saint Louis, Missouri 63129
Saint Louis, Missouri 63129
Missouri Baptist Medical Center
Saint Louis, Missouri 63131
Saint Louis, Missouri 63131
Contact:
Site Public Contact
314-996-5569
Site Public Contact
314-996-5569
Siteman Cancer Center at Christian Hospital
Saint Louis, Missouri 63136
Saint Louis, Missouri 63136
Mercy Hospital Saint Louis
Saint Louis, Missouri 63141
Saint Louis, Missouri 63141
Contact:
Site Public Contact
314-251-7066
Site Public Contact
314-251-7066
Siteman Cancer Center at Saint Peters Hospital
Saint Peters, Missouri 63376
Saint Peters, Missouri 63376
Sainte Genevieve County Memorial Hospital
Sainte Genevieve, Missouri 63670
Sainte Genevieve, Missouri 63670
Contact:
Site Public Contact
314-996-5569
Site Public Contact
314-996-5569
Mercy Hospital Springfield
Springfield, Missouri 65804
Springfield, Missouri 65804
Contact:
Site Public Contact
417-269-4520
Site Public Contact
417-269-4520
Missouri Baptist Sullivan Hospital
Sullivan, Missouri 63080
Sullivan, Missouri 63080
Contact:
Site Public Contact
314-996-5569
Site Public Contact
314-996-5569
BJC Outpatient Center at Sunset Hills
Sunset Hills, Missouri 63127
Sunset Hills, Missouri 63127
Contact:
Site Public Contact
314-996-5569
Site Public Contact
314-996-5569
Bozeman Health Deaconess Hospital
Bozeman, Montana 59715
Bozeman, Montana 59715
Renown Regional Medical Center
Reno, Nevada 89502
Reno, Nevada 89502
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon, New Hampshire 03756
Lebanon, New Hampshire 03756
Memorial Sloan Kettering Basking Ridge
Basking Ridge, New Jersey 07920
Basking Ridge, New Jersey 07920
Contact:
Site Public Contact
212-639-7592
Site Public Contact
212-639-7592
Cooper Hospital University Medical Center
Camden, New Jersey 08103
Camden, New Jersey 08103
Contact:
Site Public Contact
856-325-6757
Site Public Contact
856-325-6757
Memorial Sloan Kettering Monmouth
Middletown, New Jersey 07748
Middletown, New Jersey 07748
Contact:
Site Public Contact
212-639-7592
Site Public Contact
212-639-7592
Memorial Sloan Kettering Bergen
Montvale, New Jersey 07645
Montvale, New Jersey 07645
Contact:
Site Public Contact
212-639-7592
Site Public Contact
212-639-7592
Wilmot Cancer Center at Batavia
Batavia, New York 14020
Batavia, New York 14020
Montefiore Medical Center-Einstein Campus
Bronx, New York 10461
Bronx, New York 10461
Montefiore Medical Center-Weiler Hospital
Bronx, New York 10461
Bronx, New York 10461
Montefiore Medical Center - Moses Campus
Bronx, New York 10467
Bronx, New York 10467
Sands Cancer Center
Canandaigua, New York 14424
Canandaigua, New York 14424
Contact:
Site Public Contact
585-396-6161
Site Public Contact
585-396-6161
Memorial Sloan Kettering Commack
Commack, New York 11725
Commack, New York 11725
Contact:
Site Public Contact
212-639-7592
Site Public Contact
212-639-7592
Glens Falls Hospital
Glens Falls, New York 12801
Glens Falls, New York 12801
Contact:
Site Public Contact
518-926-6700
Site Public Contact
518-926-6700
Memorial Sloan Kettering Westchester
Harrison, New York 10604
Harrison, New York 10604
Contact:
Site Public Contact
212-639-7592
Site Public Contact
212-639-7592
New York Proton Center
New York, New York 10035
New York, New York 10035
Memorial Sloan Kettering Cancer Center
New York, New York 10065
New York, New York 10065
Contact:
Site Public Contact
212-639-7592
Site Public Contact
212-639-7592
Wilmot Cancer Institute Radiation Oncology at Greece
Rochester, New York 14606
Rochester, New York 14606
Contact:
Site Public Contact
585-758-7877
Site Public Contact
585-758-7877
Highland Hospital
Rochester, New York 14620
Rochester, New York 14620
Contact:
Site Public Contact
585-341-8113
Site Public Contact
585-341-8113
University of Rochester
Rochester, New York 14642
Rochester, New York 14642
Contact:
Site Public Contact
585-275-5830
Site Public Contact
585-275-5830
State University of New York Upstate Medical University
Syracuse, New York 13210
Syracuse, New York 13210
Contact:
Site Public Contact
315-464-5476
Site Public Contact
315-464-5476
Memorial Sloan Kettering Nassau
Uniondale, New York 11553
Uniondale, New York 11553
Contact:
Site Public Contact
212-639-7592
Site Public Contact
212-639-7592
Westchester Medical Center
Valhalla, New York 10595
Valhalla, New York 10595
Wilmot Cancer Institute at Webster
Webster, New York 14580
Webster, New York 14580
Atrium Health Stanly/LCI-Albemarle
Albemarle, North Carolina 28002
Albemarle, North Carolina 28002
Contact:
Site Public Contact
800-804-9376
Site Public Contact
800-804-9376
UNC Lineberger Comprehensive Cancer Center
Chapel Hill, North Carolina 27599
Chapel Hill, North Carolina 27599
Carolinas Medical Center/Levine Cancer Institute
Charlotte, North Carolina 28203
Charlotte, North Carolina 28203
Contact:
Site Public Contact
800-804-9376
Site Public Contact
800-804-9376
Novant Health Presbyterian Medical Center
Charlotte, North Carolina 28204
Charlotte, North Carolina 28204
Atrium Health Pineville/LCI-Pineville
Charlotte, North Carolina 28210
Charlotte, North Carolina 28210
Contact:
Site Public Contact
980-442-2000
Site Public Contact
980-442-2000
Atrium Health University City/LCI-University
Charlotte, North Carolina 28262
Charlotte, North Carolina 28262
Contact:
Site Public Contact
800-804-9376
Site Public Contact
800-804-9376
Wake Forest University at Clemmons
Clemmons, North Carolina 27012
Clemmons, North Carolina 27012
Contact:
Site Public Contact
888-716-9259
Site Public Contact
888-716-9259
Atrium Health Cabarrus/LCI-Concord
Concord, North Carolina 28025
Concord, North Carolina 28025
Contact:
Site Public Contact
800-804-9376
Site Public Contact
800-804-9376
Levine Cancer Institute - Rutherford
Forest City, North Carolina 28043
Forest City, North Carolina 28043
Contact:
Site Public Contact
800-804-9376
Site Public Contact
800-804-9376
CaroMont Regional Medical Center
Gastonia, North Carolina 28054
Gastonia, North Carolina 28054
Novant Health Cancer Institute - Huntersville
Huntersville, North Carolina 28078
Huntersville, North Carolina 28078
Novant Health Presbyterian Medical Center Huntersville
Huntersville, North Carolina 28078
Huntersville, North Carolina 28078
Novant Health Cancer Institute - Kernersville
Kernersville, North Carolina 27284
Kernersville, North Carolina 27284
Levine Cancer Institute - Union West
Matthews, North Carolina 28104
Matthews, North Carolina 28104
Contact:
Site Public Contact
980-442-0600
Site Public Contact
980-442-0600
Matthews Radiation Oncology Center
Matthews, North Carolina 28105
Matthews, North Carolina 28105
Novant Health Cancer Institute - Matthews
Matthews, North Carolina 28105
Matthews, North Carolina 28105
Atrium Health Union/LCI-Union
Monroe, North Carolina 28112
Monroe, North Carolina 28112
Contact:
Site Public Contact
980-442-2000
Site Public Contact
980-442-2000
Novant Health Cancer Institute - Mooresville
Mooresville, North Carolina 28117
Mooresville, North Carolina 28117
Novant Health Cancer Institute - Mount Airy
Mount Airy, North Carolina 27030
Mount Airy, North Carolina 27030
Novant Health Cancer Institute - Wilkesboro
North Wilkesboro, North Carolina 28659
North Wilkesboro, North Carolina 28659
Novant Health Cancer Institute - Rowan
Salisbury, North Carolina 28144
Salisbury, North Carolina 28144
Rowan Regional Medical Center
Salisbury, North Carolina 28144
Salisbury, North Carolina 28144
Atrium Health Cleveland/LCI-Cleveland
Shelby, North Carolina 28150
Shelby, North Carolina 28150
Contact:
Site Public Contact
800-804-9376
Site Public Contact
800-804-9376
Novant Health Cancer Institute - Statesville
Statesville, North Carolina 28625
Statesville, North Carolina 28625
Wake Forest Baptist Health - Hematology Oncology - Statesville
Statesville, North Carolina 28677
Statesville, North Carolina 28677
Contact:
Site Public Contact
704-872-3630
Site Public Contact
704-872-3630
Novant Cancer Institute Radiation Oncology - Supply
Supply, North Carolina 28462
Supply, North Carolina 28462
Contact:
Site Public Contact
910-754-4716
Site Public Contact
910-754-4716
Novant Health Cancer Institute - Thomasville
Thomasville, North Carolina 27360
Thomasville, North Carolina 27360
Wake Forest Baptist Health - Wilkes Medical Center
Wilkesboro, North Carolina 28659
Wilkesboro, North Carolina 28659
Contact:
Site Public Contact
888-716-9253
Site Public Contact
888-716-9253
Novant Health Cancer Institute Radiation Oncology - Wilmington
Wilmington, North Carolina 28401
Wilmington, North Carolina 28401
Contact:
Site Public Contact
910-251-1839
Site Public Contact
910-251-1839
Novant Health New Hanover Regional Medical Center
Wilmington, North Carolina 28401
Wilmington, North Carolina 28401
Contact:
Site Public Contact
910-342-3000
Site Public Contact
910-342-3000
Novant Health Forsyth Medical Center
Winston-Salem, North Carolina 27103
Winston-Salem, North Carolina 27103
Wake Forest University Health Sciences
Winston-Salem, North Carolina 27157
Winston-Salem, North Carolina 27157
Contact:
Site Public Contact
336-713-6771
Site Public Contact
336-713-6771
Sanford Bismarck Medical Center
Bismarck, North Dakota 58501
Bismarck, North Dakota 58501
Sanford Broadway Medical Center
Fargo, North Dakota 58122
Fargo, North Dakota 58122
Sanford Roger Maris Cancer Center
Fargo, North Dakota 58122
Fargo, North Dakota 58122
Altru Cancer Center
Grand Forks, North Dakota 58201
Grand Forks, North Dakota 58201
Contact:
Site Public Contact
701-780-6520
Site Public Contact
701-780-6520
Cleveland Clinic Akron General
Akron, Ohio 44307
Akron, Ohio 44307
UH Seidman Cancer Center at UH Avon Health Center
Avon, Ohio 44011
Avon, Ohio 44011
Contact:
Site Public Contact
800-641-2422
Site Public Contact
800-641-2422
UHHS-Chagrin Highlands Medical Center
Beachwood, Ohio 44122
Beachwood, Ohio 44122
Cleveland Clinic Mercy Hospital
Canton, Ohio 44708
Canton, Ohio 44708
Contact:
Site Public Contact
888-293-4673
Site Public Contact
888-293-4673
Miami Valley Hospital South
Centerville, Ohio 45459
Centerville, Ohio 45459
University of Cincinnati Cancer Center-UC Medical Center
Cincinnati, Ohio 45219
Cincinnati, Ohio 45219
Case Western Reserve University
Cleveland, Ohio 44106
Cleveland, Ohio 44106
Miami Valley Hospital
Dayton, Ohio 45409
Dayton, Ohio 45409
Premier Blood and Cancer Center
Dayton, Ohio 45409
Dayton, Ohio 45409
Contact:
Site Public Contact
937-276-8320
Site Public Contact
937-276-8320
Dayton Physician LLC - Englewood
Dayton, Ohio 45415
Dayton, Ohio 45415
Miami Valley Hospital North
Dayton, Ohio 45415
Dayton, Ohio 45415
Atrium Medical Center-Middletown Regional Hospital
Franklin, Ohio 45005-1066
Franklin, Ohio 45005-1066
Miami Valley Cancer Care and Infusion
Greenville, Ohio 45331
Greenville, Ohio 45331
Contact:
Site Public Contact
937-569-7515
Site Public Contact
937-569-7515
UH Seidman Cancer Center at Lake Health Mentor Campus
Mentor, Ohio 44060
Mentor, Ohio 44060
Mercy Health Perrysburg Cancer Center
Perrysburg, Ohio 43551
Perrysburg, Ohio 43551
Upper Valley Medical Center
Troy, Ohio 45373
Troy, Ohio 45373
University of Cincinnati Cancer Center-West Chester
West Chester, Ohio 45069
West Chester, Ohio 45069
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma 73104
Oklahoma City, Oklahoma 73104
Legacy Mount Hood Medical Center
Gresham, Oregon 97030
Gresham, Oregon 97030
Contact:
Site Public Contact
503-413-2150
Site Public Contact
503-413-2150
Legacy Good Samaritan Hospital and Medical Center
Portland, Oregon 97210
Portland, Oregon 97210
Legacy Meridian Park Hospital
Tualatin, Oregon 97062
Tualatin, Oregon 97062
Contact:
Site Public Contact
503-413-1742
Site Public Contact
503-413-1742
Christiana Care Health System-Concord Health Center
Chadds Ford, Pennsylvania 19317
Chadds Ford, Pennsylvania 19317
Chambersburg Hospital
Chambersburg, Pennsylvania 17201
Chambersburg, Pennsylvania 17201
Geisinger Medical Center
Danville, Pennsylvania 17822
Danville, Pennsylvania 17822
Ephrata Cancer Center
Ephrata, Pennsylvania 17522
Ephrata, Pennsylvania 17522
Contact:
Site Public Contact
717-721-4840
Site Public Contact
717-721-4840
Adams Cancer Center
Gettysburg, Pennsylvania 17325
Gettysburg, Pennsylvania 17325
Contact:
Site Public Contact
877-441-7957
Site Public Contact
877-441-7957
Penn State Milton S Hershey Medical Center
Hershey, Pennsylvania 17033-0850
Hershey, Pennsylvania 17033-0850
Sechler Family Cancer Center
Lebanon, Pennsylvania 17042
Lebanon, Pennsylvania 17042
Geisinger Medical Oncology-Lewisburg
Lewisburg, Pennsylvania 17837
Lewisburg, Pennsylvania 17837
University of Pennsylvania/Abramson Cancer Center
Philadelphia, Pennsylvania 19104
Philadelphia, Pennsylvania 19104
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania 19107
Philadelphia, Pennsylvania 19107
Reading Hospital
West Reading, Pennsylvania 19611
West Reading, Pennsylvania 19611
Contact:
Site Public Contact
610-988-9323
Site Public Contact
610-988-9323
Geisinger Wyoming Valley/Henry Cancer Center
Wilkes-Barre, Pennsylvania 18711
Wilkes-Barre, Pennsylvania 18711
Asplundh Cancer Pavilion
Willow Grove, Pennsylvania 19090
Willow Grove, Pennsylvania 19090
WellSpan Health-York Cancer Center
York, Pennsylvania 17403
York, Pennsylvania 17403
Contact:
Site Public Contact
877-441-7957
Site Public Contact
877-441-7957
WellSpan Health-York Hospital
York, Pennsylvania 17403
York, Pennsylvania 17403
Contact:
Site Public Contact
877-441-7957
Site Public Contact
877-441-7957
Gibbs Cancer Center-Gaffney
Gaffney, South Carolina 29341
Gaffney, South Carolina 29341
Gibbs Cancer Center-Pelham
Greer, South Carolina 29651
Greer, South Carolina 29651
Rock Hill Radiation Therapy Center
Rock Hill, South Carolina 29730
Rock Hill, South Carolina 29730
Contact:
Site Public Contact
800-804-9376
Site Public Contact
800-804-9376
Levine Cancer Institute-Rock Hill
Rock Hill, South Carolina 29732
Rock Hill, South Carolina 29732
Contact:
Site Public Contact
800-804-9376
Site Public Contact
800-804-9376
Spartanburg Medical Center
Spartanburg, South Carolina 29303
Spartanburg, South Carolina 29303
MGC Hematology Oncology-Union
Union, South Carolina 29379
Union, South Carolina 29379
Sanford Cancer Center Oncology Clinic
Sioux Falls, South Dakota 57104
Sioux Falls, South Dakota 57104
Sanford USD Medical Center - Sioux Falls
Sioux Falls, South Dakota 57117-5134
Sioux Falls, South Dakota 57117-5134
Baptist Memorial Hospital and Cancer Center-Collierville
Collierville, Tennessee 38017
Collierville, Tennessee 38017
Baptist Memorial Hospital and Cancer Center-Memphis
Memphis, Tennessee 38120
Memphis, Tennessee 38120
MD Anderson in The Woodlands
Conroe, Texas 77384
Conroe, Texas 77384
M D Anderson Cancer Center
Houston, Texas 77030
Houston, Texas 77030
MD Anderson West Houston
Houston, Texas 77079
Houston, Texas 77079
MD Anderson League City
League City, Texas 77573
League City, Texas 77573
MD Anderson in Sugar Land
Sugar Land, Texas 77478
Sugar Land, Texas 77478
Central Vermont Medical Center/National Life Cancer Treatment
Berlin, Vermont 05602
Berlin, Vermont 05602
Contact:
Site Public Contact
802-225-5400
Site Public Contact
802-225-5400
University of Vermont Medical Center
Burlington, Vermont 05401
Burlington, Vermont 05401
University of Vermont and State Agricultural College
Burlington, Vermont 05405
Burlington, Vermont 05405
Dartmouth Cancer Center - North
Saint Johnsbury, Vermont 05819
Saint Johnsbury, Vermont 05819
Legacy Cancer Institute Medical Oncology and Day Treatment
Vancouver, Washington 98684
Vancouver, Washington 98684
Legacy Salmon Creek Hospital
Vancouver, Washington 98686
Vancouver, Washington 98686
Contact:
Site Public Contact
503-413-2150
Site Public Contact
503-413-2150
Edwards Comprehensive Cancer Center
Huntington, West Virginia 25701
Huntington, West Virginia 25701
Langlade Hospital and Cancer Center
Antigo, Wisconsin 54409
Antigo, Wisconsin 54409
Aurora Cancer Care-Southern Lakes VLCC
Burlington, Wisconsin 53105
Burlington, Wisconsin 53105
HSHS Sacred Heart Hospital
Eau Claire, Wisconsin 54701
Eau Claire, Wisconsin 54701
Marshfield Medical Center-EC Cancer Center
Eau Claire, Wisconsin 54701
Eau Claire, Wisconsin 54701
Aurora Health Care Germantown Health Center
Germantown, Wisconsin 53022
Germantown, Wisconsin 53022
Aurora Cancer Care-Grafton
Grafton, Wisconsin 53024
Grafton, Wisconsin 53024
Saint Vincent Hospital Cancer Center Green Bay
Green Bay, Wisconsin 54301
Green Bay, Wisconsin 54301
Aurora BayCare Medical Center
Green Bay, Wisconsin 54311
Green Bay, Wisconsin 54311
University of Wisconsin Carbone Cancer Center - Johnson Creek
Johnson Creek, Wisconsin 53038
Johnson Creek, Wisconsin 53038
Aurora Cancer Care-Kenosha South
Kenosha, Wisconsin 53142
Kenosha, Wisconsin 53142
University of Wisconsin Carbone Cancer Center - University Hospital
Madison, Wisconsin 53792
Madison, Wisconsin 53792
Aurora Bay Area Medical Group-Marinette
Marinette, Wisconsin 54143
Marinette, Wisconsin 54143
Froedtert Menomonee Falls Hospital
Menomonee Falls, Wisconsin 53051
Menomonee Falls, Wisconsin 53051
Contact:
Site Public Contact
262-257-5100
Site Public Contact
262-257-5100
Aurora Cancer Care-Milwaukee
Milwaukee, Wisconsin 53209
Milwaukee, Wisconsin 53209
Aurora Saint Luke's Medical Center
Milwaukee, Wisconsin 53215
Milwaukee, Wisconsin 53215
Medical College of Wisconsin
Milwaukee, Wisconsin 53226
Milwaukee, Wisconsin 53226
Contact:
Site Public Contact
414-805-3666
Site Public Contact
414-805-3666
Aurora Sinai Medical Center
Milwaukee, Wisconsin 53233
Milwaukee, Wisconsin 53233
Zablocki Veterans Administration Medical Center
Milwaukee, Wisconsin 53295
Milwaukee, Wisconsin 53295
Contact:
Site Public Contact
888-469-6614
Site Public Contact
888-469-6614
Marshfield Clinic-Minocqua Center
Minocqua, Wisconsin 54548
Minocqua, Wisconsin 54548
ProHealth D N Greenwald Center
Mukwonago, Wisconsin 53149
Mukwonago, Wisconsin 53149
Drexel Town Square Health Center
Oak Creek, Wisconsin 53154
Oak Creek, Wisconsin 53154
Contact:
Site Public Contact
414-805-0505
Site Public Contact
414-805-0505
ProHealth Oconomowoc Memorial Hospital
Oconomowoc, Wisconsin 53066
Oconomowoc, Wisconsin 53066
Contact:
Site Public Contact
262-928-7878
Site Public Contact
262-928-7878
Vince Lombardi Cancer Clinic - Oshkosh
Oshkosh, Wisconsin 54904
Oshkosh, Wisconsin 54904
Aurora Cancer Care-Racine
Racine, Wisconsin 53406
Racine, Wisconsin 53406
Ascension Saint Mary's Hospital
Rhinelander, Wisconsin 54501
Rhinelander, Wisconsin 54501
Marshfield Medical Center-Rice Lake
Rice Lake, Wisconsin 54868
Rice Lake, Wisconsin 54868
Saint Vincent Hospital Cancer Center at Sheboygan
Sheboygan, Wisconsin 53081
Sheboygan, Wisconsin 53081
Vince Lombardi Cancer Clinic-Sheboygan
Sheboygan, Wisconsin 53081
Sheboygan, Wisconsin 53081
Ascension Saint Michael's Hospital
Stevens Point, Wisconsin 54481
Stevens Point, Wisconsin 54481
Marshfield Medical Center-River Region at Stevens Point
Stevens Point, Wisconsin 54482
Stevens Point, Wisconsin 54482
Saint Vincent Hospital Cancer Center at Sturgeon Bay
Sturgeon Bay, Wisconsin 54235-1495
Sturgeon Bay, Wisconsin 54235-1495
Aurora Medical Center in Summit
Summit, Wisconsin 53066
Summit, Wisconsin 53066
UW Cancer Center at ProHealth Care
Waukesha, Wisconsin 53188
Waukesha, Wisconsin 53188
Aspirus Regional Cancer Center
Wausau, Wisconsin 54401
Wausau, Wisconsin 54401
Contact:
Site Public Contact
877-405-6866
Site Public Contact
877-405-6866
Aurora Cancer Care-Milwaukee West
Wauwatosa, Wisconsin 53226
Wauwatosa, Wisconsin 53226
Aurora West Allis Medical Center
West Allis, Wisconsin 53227
West Allis, Wisconsin 53227
Froedtert West Bend Hospital/Kraemer Cancer Center
West Bend, Wisconsin 53095
West Bend, Wisconsin 53095
Contact:
Site Public Contact
414-805-0505
Site Public Contact
414-805-0505
Marshfield Medical Center - Weston
Weston, Wisconsin 54476
Weston, Wisconsin 54476
Aspirus Cancer Care - Wisconsin Rapids
Wisconsin Rapids, Wisconsin 54494
Wisconsin Rapids, Wisconsin 54494
Contact:
Site Public Contact
715-422-7718
Site Public Contact
715-422-7718
More Details
- NCT ID
- NCT05624996
- Status
- Recruiting
- Sponsor
- NRG Oncology
Detailed Description
PRIMARY OBJECTIVES: I. To compare the overall survival in patients with stage II-IIIC inoperable node-positive non-small cell lung cancer (NSCLC) after image guided, motion-managed conventional radiotherapy to the primary tumor and nodal metastases (arm 1) or after image guided, motion-managed stereotactic body radiation therapy (SBRT) to the primary tumor followed by conventionally fractionated radiotherapy to nodal metastases (arm 2) both given with concurrent platinum-based chemotherapy. II. To compare progression-free survival between the experimental arm (arm 2) and control arm (arm 1). SECONDARY OBJECTIVES: I. To compare objective response rate (as defined by Response Evaluation Criteria in Solid Tumors [RECIST] version [v] 1.1) between the experimental arm and control arm. II. To compare the rate of local control between the experimental arm and control arm. III. To compare patterns of failure (primary, locoregional, or distant) between the experimental arm and control arm. IV. To compare changes in pulmonary function (forced expiratory volume in 1 second [FEV1] and diffusion capacity of the lung for carbon monoxide [DLCO] assessed at randomization and at 6 and 12 months following completion of radiation therapy) between the experimental arm and control arm. V. To compare changes in quality of life and patient-reported outcomes assessed from pre-treatment to 3 months following radiation therapy of each treatment arm. VI. To determine acute and late toxicity profiles of each treatment arm as measured by the Common Terminology Criteria for Adverse Events (CTCAE) v5. EXPLORATORY OBJECTIVES: I. To characterize and compare longitudinal quality of life and patient-reported outcomes of each treatment arm. II. To collect biospecimens at baseline, after SBRT (for arm 2 patients), during last 2 weeks of chemoradiation, and after first dose of consolidation therapy, to allow for future analyses. III. To collect 4-dimensional (4D) computed tomography (CT) planning scans and radiation dose to calculate regional lung ventilation and explore pre-treatment 4D-CT based ventilation to predict pulmonary toxicity. IV. To characterize clinical outcomes, toxicities and changes in pulmonary function and quality of life among patients receiving proton and photon radiotherapy. OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients undergo conventional IGRT and receive standard of care chemotherapy consisting of paclitaxel intravenously (IV) and carboplatin IV or pemetrexed IV and carboplatin IV or etoposide IV and cisplatin IV or pemetrexed IV and cisplatin IV and then receive durvalumab IV on study. Patients also undergo CT and/or positron emission tomography (PET)/CT during follow up. ARM II: Patients undergo SBRT and conventional IGRT and receive standard of care chemotherapy consisting of paclitaxel IV and carboplatin IV or pemetrexed IV and carboplatin IV or etoposide IV and cisplatin IV or pemetrexed IV and cisplatin IV and then receive durvalumab IV on study. Patients also undergo CT and/or PET/CT during follow up.