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Vismodegib, FAK Inhibitor GSK2256098, Capivasertib, and Abemaciclib in Treating Patients With Progressive Meningiomas

RecruitingPhase 2

Phase II Trial of SMO/ AKT/ NF2/CDK Inhibitors in Progressive Meningiomas With SMO/ AKT/ NF2/CDK Pathway Mutations

Who can join

Ages 18 and older · All sexes

Full eligibility criteria
* Documentation of disease:

  * Histologic documentation: histologically proven intracranial meningioma as documented by central pathology review
  * Molecular documentation: Presence of SMO, PTCH1, NF2, CDKN2A, AKT1, PIK3CA, PTEN mutations, CDKN2A copy number loss, CDK4, CDK6, CCND1, CCND2, CCND3, or CCNE1 copy number gain in tumor sample as documented specifically by the central laboratory, regardless of whether prior genotype testing outside of the central laboratory was performed
  * Progressive OR residual disease, as defined by the following:

    * Residual measurable disease: residual measurable disease immediately after surgery without requirement for progression; for grade I disease, progression pre-operatively needs to be documented, with an increase in size of the measurable primary lesion on imaging by 25% or more (bidirectional area); the change must occur between scans separated by no more than 25 months; for patients with SMO/PTCH1 mutations enrolling to receive vismodegib, the change can occur between scans separated by up to 25 months; residual measurable disease will be defined by bidimensionally measurable lesions with clearly defined margins by MRI scans, with a minimum diameter of 10 mm in both dimensions
    * Progressive measurable disease: progression defined as an increase in size of the measurable primary lesion on imaging by 25% or more (bidirectional area); the change must occur between scans separated by no more than 25 months
    * Post radiation patients: patients with measurable and progressive meningioma who have received radiation are potentially eligible, but need to show evidence of progressive disease after completion of radiation; if the progressive meningioma lesion has been radiated, at least 24 weeks must have elapsed from completion of radiation to registration; if the progressive lesion is outside of the radiation field, then an interval of at least 2 weeks must have elapsed from completion of radiation to registration
* Measurable disease: measurable disease is defined by a bidimensionally measurable main lesion on MRI or computed tomography (CT) images (MRI preferred) with clearly defined margins and a minimum diameter of 10 mm in both dimensions; multifocal disease is allowed
* Prior treatment

  * Prior medical therapy is allowed but not required
  * No limit on number of prior therapies
  * No chemotherapy, or other investigational agents within 28 days prior to registration
  * No other concurrent investigational agents or other meningioma-directed therapy (chemotherapy, radiation) while on study; additionally, no cases of nitrosourea or mitomycin C within 6 weeks prior to registration
  * For patients treated with external beam radiation, interstitial brachytherapy or radiosurgery, an interval \> 4 weeks must have elapsed from completion of radiation therapy to registration; if the progressive lesion is outside of the radiation field, then an interval of at least 2 weeks must have elapsed from completion of radiation to registration
  * Steroid dosing stable for at least 4 days
  * Recovered to Common Terminology Criteria for Adverse Events (CTCAE) grade 1 or less toxicity from other agents with exception of alopecia and fatigue
  * No craniotomy 28 days prior to and after registration
* Not pregnant and not nursing:

  \* A female of childbearing potential is a sexually mature female who: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months)
* For patients with NF2/CDKN2A/AKT1/PIK3CA/PTEN mutation, CKDN2A copy number loss, or CDK4/CDK6/CCND1/CCND2/CCND3/CCNE1 copy number gain: Age \>= 18 years
* For patients with SMO/PTCH1 mutation: Age \>= 30 years
* Eastern Cooperative Oncology Group (ECOG) performance status =\< 2
* Patient history:

  * Patients with history of neurofibromatosis (NF) may have other stable central nervous system (CNS) tumors (schwannoma, acoustic neuroma or ependymoma) if lesions have been stable for 6 months
  * No metastatic meningiomas (as defined by extracranial meningiomas outside of CNS) allowed; spinal meningiomas are allowed
  * No history of allergic reactions attributed to compounds of similar or biologic composition to assigned study drug
  * No known active hepatitis B or C
  * No current Child Pugh class B or C liver disease
  * No uncontrolled gastric ulcer disease (grade 3 gastric ulcer disease within 28 days of registration)
  * No uncontrolled hypertension defined as blood pressure (BP) \> 140/90
  * No abdominal fistula, gastrointestinal (GI) perforation, or intra-abdominal abscess within 28 days prior to registration
  * No major surgery within 28 days prior to registration for any patients with AKT1/PIK3CA/PTEN mutations receiving capivasertib
  * For patients going on to receive capivasertib (i.e. enrolled after Update #08)

    * Patients should not have any of the following cardiac criteria:

      * Any clinically important abnormalities in rhythm, conduction, or morphology of resting electrocardiogram (EKG) (e.g., complete left bundle branch block, third degree heart block)
      * Any factors that increase the risk of corrected QT (QTc) prolongation or risk of arrhythmic events such as heart failure, hypokalemia, potential for Torsade de Pointes, congenital long QT syndrome, family history of long QT syndrome, or unexplained sudden death under 40 years of age, or any concomitant medication known to prolong the QT interval
      * Experience any of the following procedures or conditions in the preceding 6 months: coronary artery bypass graft, angioplasty, vascular stent, myocardial infarction, angina pectoris, congestive heart failure New York Heart Association (NYHA) class \>= II
      * Uncontrolled hypertension (systolic blood pressure \[SBP\] \< 90 mmHg and/or diastolic blood pressure \[DBP\] \< 50 mmHg)
      * Cardiac ejection fraction outside institutional range of normal or \< 50% (whichever is higher) as measured by echocardiogram (or multigated acquisition \[MUGA\] scan if an echocardiogram can't be performed or is inconclusive); left ventricular ejection fraction (LVEF) below lower limit of normal for site
    * Patients should not have any of the following criteria:

      * With the exception of alopecia, any unresolved toxicities from prior therapy greater than Common Terminology Criteria for Adverse Events (CTCAE) grade 1 at the time of registration
      * Hemoglobin \< 9 g/dL (\< 5.59 mmol/L); note: any blood transfusion must be \>= 14 days prior to the determination of a hemoglobin \>= 9 g/dL (\>= 5.59 mmol/L)
      * Proteinuria 3+ on dipstick analysis or \> 500 mg/24 hours
      * Refractory nausea and vomiting, chronic gastrointestinal diseases, inability to swallow the formulated product or previous significant bowel resection that would preclude adequate absorption of capivasertib
      * History of hypersensitivity to active or inactive excipients of capivasertib or drugs with a similar chemical structure or class to capivasertib
      * Current disease or condition known to interfere with absorption, distribution, metabolism, or excretion of drugs
      * Past medical history of interstitial lung disease, drug-induced interstitial lung disease, radiation pneumonitis which required steroid treatment, or any evidence of clinically active interstitial lung disease
      * Previous allogeneic bone marrow transplant
      * Known immunodeficiency syndrome
* Concomitant medications (only regarding NF2/CDKN2A/CDK4/CDK6/CCND1/CCND2/CCND3/CCNE1/AKT1/PIK3CA/PTEN genetic alterations):

  * Chronic concomitant treatment with strong inhibitors of cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) inhibitors must discontinue the drug for 14 days prior to registration on the study for patients with NF2 mutation enrolled to GSK2256098, as well as for patients with AKT1/PIK3CA/PTEN mutations enrolled to capivasertib
  * For NF2 patients going on to receive GSK2256098 and for patients with AKT1/PIK3CA/PTEN mutations enrolled to capivasertib: concomitant treatment with strong CYP3A4 inducers or CYP2D6 substrates is not allowed; patients must discontinue the drug 14 days prior to registration
  * For NF2 patients going on to receive abemaciclib: avoid concomitant use of CYP3A inducers and strong CYP3A inhibitors; use caution with coadministered moderate or weak CYP3A inhibitors
* Diabetic status:

  * For patients with NF2 or SMO/PTCH1 mutations: No uncontrolled diabetes defined as a known diabetic with HBA1C \> 7.5 OR fasting glucose \> 140 mg/dL.
  * For patients with AKT1/PIK3CA/PTEN mutations:

    * Glycosylated hemoglobin (HbA1C) \< 8.0% (63.9 mmol/mol)
    * No type 1 diabetes mellitus
    * No requirement for insulin for routine diabetic management and control
    * No requirement for more than two oral hypoglycemic medications for routine diabetic management and control
    * Patients with a pre-existing diagnosis of type 2 diabetes mellitus must have fasting glucose \< 9.3 mmol/L (167mg/dL); fasting is defined as no caloric intake for at least 8 hours
  * Patients without a pre-existing diagnosis of type 2 diabetes mellitus must have fasting glucose =\< 7.0 mmol/L (126 mg/dL); fasting is defined as no caloric intake for at least 8 hours
* Absolute neutrophil count (ANC) \>= 1,500/mm\^3
* Platelet count \>= 100,000/mm\^3
* Creatinine OR =\< 1.5 mg/dl x upper limit of normal (ULN) OR calculated (calc.) creatinine clearance \> 50 mL/min
* Urine protein:creatinine ratio (UPC) =\< 45 mg/mmol
* Total bilirubin =\< 1.5 x upper limit of normal (ULN); except in case of Gilbert's disease
* Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =\< 2.5 x ULN
* Sodium, potassium, total calcium (corrected for serum albumin) \& phosphorus within normal limits per institutional guidelines
* QTcF \< 450 msec (QT calculated using Fridericia formula)
* Mean resting heart rate (determined from EKG) 50-100 beats per minute (BMP) (must be obtained from 12-lead EKG defined by a triplicate EKG for patients assigned to the capivasertib arm; patients assigned to all other arms will require a single EKG
* No uncontrolled medical comorbidities per investigator discretion (e.g. interstitial lung disease, severe dyspnea at rest or requiring oxygen therapy, history of major surgical resection involving the stomach or small bowel, or pre-existing Crohn's disease or ulcerative colitis or a preexisting chronic condition resulting in baseline Grade 2 or higher diarrhea)
* ADDITIONAL REGISTRATION ELIGIBILITY CRITERIA FOR ABEMACICLIB ARM: Hemoglobin \>= 8 g/dL

  \* Patients may receive erythrocyte transfusions to achieve this hemoglobin level at the discretion of the investigator; initial treatment must not begin earlier than the day after the erythrocyte transfusion
* ADDITIONAL REGISTRATION ELIGIBILITY CRITERIA FOR ABEMACICLIB ARM: Prior Treatment

  * Patients who received chemotherapy must have recovered (Common Terminology Criteria for Adverse Events \[CTCAE\] grade =\< 1) from the acute effects of chemotherapy except for residual alopecia or grade 2 peripheral neuropathy prior to registration; a washout period of at least 28 days is required between last chemotherapy dose and registration (provided the patient did not receive radiotherapy)
  * Patients who received adjuvant radiotherapy must have completed and fully recovered from the acute effects of radiotherapy; a washout period of at least 28 days is required between end of radiotherapy and registration
* ADDITIONAL REGISTRATION ELIGIBILITY CRITERIA FOR ABEMACICLIB ARM: No active bacterial infection (requiring intravenous \[IV\] antibiotics at time of initiating study treatment), fungal infection, or detectable viral infection (such as known human immunodeficiency virus positivity or with known active hepatitis B or C \[for example, hepatitis B surface antigen positive\]); screening is not required for enrollment in the absence of symptoms
* ADDITIONAL REGISTRATION ELIGIBILITY CRITERIA FOR ABEMACICLIB ARM: No personal history of any of the following conditions: syncope of cardiovascular etiology, ventricular arrhythmia of pathological origin (including, but not limited to, ventricular tachycardia and ventricular fibrillation), or sudden cardiac arrest

About the study

This phase II trial studies how well vismodegib, focal adhesion kinase (FAK) inhibitor GSK2256098, and capivasertib work in treating patients with meningioma that is growing, spreading, or getting worse (progressive). Vismodegib, FAK inhibitor GSK2256098, capivasertib, and abemaciclib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

What is being tested

Sponsor: Alliance for Clinical Trials in Oncology · Participants: 124 · Started: Sep 28, 2015

Contact the study team

Official record on ClinicalTrials.gov — NCT02523014

Locations in the U.S.

AlaskaAlaska Breast Care and Surgery LLC, Anchorage
Alaska Oncology and Hematology LLC, Anchorage
Alaska Women's Cancer Care, Anchorage
Anchorage Associates in Radiation Medicine, Anchorage
Katmai Oncology Group, Anchorage
Providence Alaska Medical Center, Anchorage
Fairbanks Memorial Hospital, Fairbanks
ArizonaKingman Regional Medical Center, Kingman
Cancer Center at Saint Joseph's, Phoenix
ArkansasMercy Hospital Fort Smith, Fort Smith
CARTI Cancer Center, Little Rock
CaliforniaMission Hope Medical Oncology - Arroyo Grande, Arroyo Grande
PCR Oncology, Arroyo Grande
Providence Saint Joseph Medical Center/Disney Family Cancer Center, Burbank
Mercy Cancer Center - Carmichael, Carmichael
Mercy San Juan Medical Center, Carmichael
Mercy Cancer Center - Elk Grove, Elk Grove
UC San Diego Moores Cancer Center, La Jolla
Cedars-Sinai Medical Center, Los Angeles
Kaiser Permanente Los Angeles Medical Center, Los Angeles
Mercy Cancer Center, Merced
Mercy Cancer Center - Rocklin, Rocklin
Mercy Cancer Center - Sacramento, Sacramento
Pacific Central Coast Health Center-San Luis Obispo, San Luis Obispo
Mission Hope Medical Oncology - Santa Maria, Santa Maria
Saint Joseph's Medical Center, Stockton
Torrance Memorial Medical Center, Torrance
Torrance Memorial Physician Network - Cancer Care, Torrance
Woodland Memorial Hospital, Woodland
ColoradoUCHealth University of Colorado Hospital, Aurora
Penrose-Saint Francis Healthcare, Colorado Springs
Rocky Mountain Cancer Centers-Penrose, Colorado Springs
Saint Francis Cancer Center, Colorado Springs
CommonSpirit Cancer Center Mercy, Durango
Mercy Medical Center, Durango
CommonSpirit Saint Anthony Hospital Cancer Center, Lakewood
Longmont United Hospital, Longmont
Saint Mary Corwin Medical Center, Pueblo
Saint Anthony North Hospital, Westminster
ConnecticutSmilow Cancer Hospital Care Center at Saint Francis, Hartford
Yale University, New Haven
Smilow Cancer Hospital Care Center-Trumbull, Trumbull
FloridaBoca Raton Regional Hospital, Boca Raton
UM Sylvester Comprehensive Cancer Center at Deerfield Beach, Deerfield Beach
Holy Cross Hospital, Fort Lauderdale
Memorial Regional Hospital/Joe DiMaggio Children's Hospital, Hollywood
Mayo Clinic in Florida, Jacksonville
University of Miami Miller School of Medicine-Sylvester Cancer Center, Miami
Memorial Hospital West, Pembroke Pines
UM Sylvester Comprehensive Cancer Center at Plantation, Plantation
Tampa General Hospital, Tampa
GeorgiaEmory University Hospital Midtown, Atlanta
Emory University Hospital/Winship Cancer Institute, Atlanta
Grady Health System, Atlanta
Piedmont Hospital, Atlanta
IdahoSaint Alphonsus Cancer Care Center-Boise, Boise
Saint Luke's Cancer Institute - Boise, Boise
Saint Alphonsus Cancer Care Center-Caldwell, Caldwell
Kootenai Health - Coeur d'Alene, Coeur d'Alene
Saint Luke's Cancer Institute - Fruitland, Fruitland
Idaho Urologic Institute-Meridian, Meridian
Saint Luke's Cancer Institute - Meridian, Meridian
Saint Luke's Cancer Institute - Nampa, Nampa
Kootenai Clinic Cancer Services - Post Falls, Post Falls
Kootenai Clinic Cancer Services - Sandpoint, Sandpoint
Saint Luke's Cancer Institute - Twin Falls, Twin Falls
IllinoisOSF Saint Anthony's Health Center, Alton
Rush-Copley Medical Center, Aurora
Advocate Good Shepherd Hospital, Barrington
Illinois CancerCare-Bloomington, Bloomington
Illinois CancerCare-Canton, Canton
Memorial Hospital of Carbondale, Carbondale
SIH Cancer Institute, Carterville
Illinois CancerCare-Carthage, Carthage
Centralia Oncology Clinic, Centralia
Advocate Illinois Masonic Medical Center, Chicago
Rush MD Anderson Cancer Center, Chicago
AMG Crystal Lake - Oncology, Crystal Lake
Carle at The Riverfront, Danville
Cancer Care Specialists of Illinois - Decatur, Decatur
Decatur Memorial Hospital, Decatur
Illinois CancerCare-Dixon, Dixon
Advocate Good Samaritan Hospital, Downers Grove
Carle Physician Group-Effingham, Effingham
Crossroads Cancer Center, Effingham
Advocate Sherman Hospital, Elgin
Illinois CancerCare-Eureka, Eureka
Illinois CancerCare-Galesburg, Galesburg
Advocate South Suburban Hospital, Hazel Crest
Illinois CancerCare-Kewanee Clinic, Kewanee
AMG Libertyville - Oncology, Libertyville
Condell Memorial Hospital, Libertyville
Illinois CancerCare-Macomb, Macomb
Carle Physician Group-Mattoon/Charleston, Mattoon
SSM Health Good Samaritan, Mount Vernon
Cancer Care Center of O'Fallon, O'Fallon
HSHS Saint Elizabeth's Hospital, O'Fallon
Advocate Christ Medical Center, Oak Lawn
Advocate Outpatient Center - Oak Lawn, Oak Lawn
Rush MD Anderson Cancer Center at Rush Oak Park, Oak Park
Illinois CancerCare-Ottawa Clinic, Ottawa
Advocate High Tech Medical Park, Palos Heights
Advocate Lutheran General Hospital, Park Ridge
Illinois CancerCare-Pekin, Pekin
OSF Saint Francis Radiation Oncology at Pekin, Pekin
Illinois CancerCare-Peoria, Peoria
Methodist Medical Center of Illinois, Peoria
OSF Saint Francis Medical Center, Peoria
OSF Saint Francis Radiation Oncology at Peoria Cancer Center, Peoria
Illinois CancerCare-Peru, Peru
Valley Radiation Oncology, Peru
Illinois CancerCare-Princeton, Princeton
Southern Illinois University School of Medicine, Springfield
Springfield Clinic, Springfield
Springfield Memorial Hospital, Springfield
Carle Cancer Center, Urbana
The Carle Foundation Hospital, Urbana
Illinois CancerCare - Washington, Washington
Rush-Copley Healthcare Center, Yorkville
IowaUI Health Care Mission Cancer and Blood - Ankeny Clinic, Ankeny
Mercy Cancer Center-West Lakes, Clive
UI Health Care Mission Cancer and Blood - West Des Moines Clinic, Clive
Greater Regional Medical Center, Creston
Mercy Medical Center - Des Moines, Des Moines
UI Health Care Mission Cancer and Blood - Des Moines Clinic, Des Moines
UI Health Care Mission Cancer and Blood - Laurel Clinic, Des Moines
University of Iowa/Holden Comprehensive Cancer Center, Iowa City
UI Health Care Mission Cancer and Blood - Waukee Clinic, Waukee
Mercy Medical Center-West Lakes, West Des Moines
KansasCentral Care Cancer Center - Great Bend, Great Bend
Mercy Hospital Pittsburg, Pittsburg
KentuckyCommonSpirit Saint Joseph Hospital - Bardstown, Bardstown
Commonwealth Cancer Center-Corbin, Corbin
CommonSpirit Saint Joseph Hospital - Lexington, Lexington
CommonSpirit Saint Joseph Medical Center - East Lexington, Lexington
Saint Joseph Radiation Oncology Resource Center, Lexington
CommonSpirit Saint Joseph Hospital London, London
Norton Brownsboro Hospital and Medical Campus, Louisville
CommonSpirit Saint Joseph Hospital Mount Sterling, Mount Sterling
MarylandJohns Hopkins University/Sidney Kimmel Cancer Center, Baltimore
MassachusettsDana-Farber Cancer Institute, Boston
Massachusetts General Hospital Cancer Center, Boston
MichiganMyMichigan Medical Center Gratiot, Alma
MyMichigan Medical Center Alpena, Alpena
Trinity Health Saint Joseph Mercy Hospital Ann Arbor, Ann Arbor
Bronson Battle Creek, Battle Creek
Trinity Health IHA Medical Group Hematology Oncology - Brighton, Brighton
Trinity Health Medical Center - Brighton, Brighton
Henry Ford Cancer Institute-Downriver, Brownstown
Trinity Health IHA Medical Group Hematology Oncology - Canton, Canton
Trinity Health Medical Center - Canton, Canton
Chelsea Hospital, Chelsea
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital, Chelsea
Hematology Oncology Consultants-Clarkston, Clarkston
Henry Ford Macomb Hospital-Clinton Township, Clinton Township
Henry Ford Medical Center-Fairlane, Dearborn
Henry Ford Health Saint John Hospital, Detroit
Henry Ford Hospital, Detroit
Henry Ford River District Hospital, East China Township
Cancer Hematology Centers - Flint, Flint
Genesee Hematology Oncology PC, Flint
Genesys Hurley Cancer Institute, Flint
Hurley Medical Center, Flint
MyMichigan Medical Center Gladwin, Gladwin
Corewell Health Grand Rapids Hospitals - Butterworth Hospital, Grand Rapids
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital, Grand Rapids
Trinity Health Grand Rapids Hospital, Grand Rapids
Henry Ford Saint John Hospital - Academic, Grosse Pointe Woods
Henry Ford Saint John Hospital - Breast, Grosse Pointe Woods
Henry Ford Saint John Hospital - Van Elslander, Grosse Pointe Woods
Allegiance Health, Jackson
Beacon Kalamazoo, Kalamazoo
Beacon Kalamazoo Cancer Center, Kalamazoo
Bronson Methodist Hospital, Kalamazoo
West Michigan Cancer Center, Kalamazoo
University of Michigan Health - Sparrow Lansing, Lansing
Trinity Health Saint Mary Mercy Livonia Hospital, Livonia
Henry Ford Saint John Hospital - Macomb Medical, Macomb
Henry Ford Warren Hospital - Breast Macomb, Macomb
MyMichigan Medical Center Midland, Midland
MyMichigan Medical Center Mount Pleasant, Mount Pleasant
Trinity Health Muskegon Hospital, Muskegon
Corewell Health Lakeland Hospitals - Niles Hospital, Niles
Henry Ford Medical Center-Columbus, Novi
Michigan Healthcare Professionals Pontiac, Pontiac
Newland Medical Associates-Pontiac, Pontiac
Trinity Health Saint Joseph Mercy Oakland Hospital, Pontiac
Corewell Health Reed City Hospital, Reed City
MyMichigan Medical Center Saginaw, Saginaw
Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center, Saint Joseph
Corewell Health Lakeland Hospitals - Saint Joseph Hospital, Saint Joseph
MyMichigan Medical Center Tawas, Tawas City
Munson Medical Center, Traverse City
Henry Ford Health Warren Hospital, Warren
Henry Ford Madison Heights Hospital - Breast, Warren
Henry Ford Warren Hospital - GLCMS, Warren
Henry Ford West Bloomfield Hospital, West Bloomfield
Henry Ford Wyandotte Hospital, Wyandotte
University of Michigan Health - West, Wyoming
Huron Gastroenterology PC, Ypsilanti
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus, Ypsilanti
MinnesotaRiverwood Healthcare Center, Aitkin
Essentia Health - Baxter Clinic, Baxter
Essentia Health Saint Joseph's Medical Center, Brainerd
Minnesota Oncology - Burnsville, Burnsville
Minnesota Oncology Hematology PA-Chaska, Chaska
Mercy Hospital, Coon Rapids
Minnesota Oncology - Coon Rapids, Coon Rapids
Essentia Health - Saint Joseph's Crosslake Clinic, Crosslake
Essentia Health - Deer River Clinic, Deer River
Essentia Health Saint Mary's - Detroit Lakes Clinic, Detroit Lakes
Essentia Health Cancer Center, Duluth
Essentia Health Saint Mary's Medical Center, Duluth
Miller-Dwan Hospital, Duluth
Fairview Southdale Hospital, Edina
Minnesota Oncology - Edina, Edina
Essentia Health - Ely Clinic, Ely
Essentia Health - Fosston, Fosston
Essentia Health Hibbing Clinic, Hibbing
Essentia Health - International Falls Clinic, International Falls
Fairview Clinics and Surgery Center Maple Grove, Maple Grove
Minnesota Oncology - Maple Grove, Maple Grove
Minnesota Oncology Hematology PA-Maplewood, Maplewood
Saint John's Hospital - Healtheast, Maplewood
Abbott-Northwestern Hospital, Minneapolis
Hennepin County Medical Center, Minneapolis
Monticello Cancer Center, Monticello
Essentia Health - Moose Lake Clinic, Moose Lake
New Ulm Medical Center, New Ulm
Essentia Health - Park Rapids, Park Rapids
Essentia Health - Saint Joseph's Pequot Lakes Clinic, Pequot Lakes
Essentia Health - Saint Joseph's Pine River Clinic, Pine River
Fairview Northland Medical Center, Princeton
North Memorial Medical Health Center, Robbinsdale
Park Nicollet Clinic - Saint Louis Park, Saint Louis Park
Regions Hospital, Saint Paul
United Hospital, Saint Paul
Essentia Health Sandstone, Sandstone
Saint Francis Regional Medical Center, Shakopee
Essentia Health - Saint Joseph's Staples Clinic, Staples
Lakeview Hospital, Stillwater
Essentia Health Virginia Clinic, Virginia
Ridgeview Medical Center, Waconia
Rice Memorial Hospital, Willmar
Minnesota Oncology Hematology PA-Woodbury, Woodbury
Fairview Lakes Medical Center, Wyoming
MississippiUniversity of Mississippi Medical Center, Jackson
MissouriMercy Oncology and Hematology - Clayton-Clarkson, Ballwin
Cox Cancer Center Branson, Branson
Mercy Cancer Center - Cape Girardeau, Cape Girardeau
Saint Francis Medical Center, Cape Girardeau
Parkland Health Center - Farmington, Farmington
Freeman Health System, Joplin
Mercy Hospital Joplin, Joplin
Lake Regional Hospital, Osage Beach
Mercy Clinic-Rolla-Cancer and Hematology, Rolla
Phelps Health Delbert Day Cancer Institute, Rolla
Heartland Regional Medical Center, Saint Joseph
Sainte Genevieve County Memorial Hospital, Sainte Genevieve
CoxHealth South Hospital, Springfield
Mercy Hospital Springfield, Springfield
Mercy Hospital Saint Louis, St Louis
Mercy Hospital South, St Louis
Mercy Infusion Center - Chippewa, St Louis
Missouri Baptist Medical Center, St Louis
Washington University School of Medicine, St Louis
Missouri Baptist Sullivan Hospital, Sullivan
Mercy Hospital Washington, Washington
MontanaBillings Clinic Cancer Center, Billings
Bozeman Health Deaconess Hospital, Bozeman
Benefis Sletten Cancer Institute, Great Falls
Hi-Line Sletten Cancer Center, Havre
Benefis Helena Specialty Center, Helena
Logan Health Medical Center, Kalispell
Community Medical Center, Missoula
Saint Patrick Hospital - Community Hospital, Missoula
NebraskaCHI Health Saint Francis, Grand Island
CHI Health Good Samaritan, Kearney
Alegent Health Bergan Mercy Medical Center, Omaha
Alegent Health Immanuel Medical Center, Omaha
Alegent Health Lakeside Hospital, Omaha
NevadaCarson Tahoe Regional Medical Center, Carson City
Comprehensive Cancer Centers of Nevada - Henderson, Henderson
Comprehensive Cancer Centers of Nevada-Horizon Ridge, Henderson
Comprehensive Cancer Centers of Nevada-Southeast Henderson, Henderson
Oncology Las Vegas - Henderson, Henderson
Urology Specialists of Nevada - Green Valley, Henderson
Alliance for Childhood Diseases/Cure 4 the Kids Foundation, Las Vegas
Comprehensive Cancer Centers of Nevada, Las Vegas
Comprehensive Cancer Centers of Nevada - Central Valley, Las Vegas
Comprehensive Cancer Centers of Nevada - Northwest, Las Vegas
Comprehensive Cancer Centers of Nevada - Town Center, Las Vegas
Comprehensive Cancer Centers of Nevada-Summerlin, Las Vegas
Hope Cancer Care of Nevada, Las Vegas
Oncology Las Vegas - Tenaya, Las Vegas
OptumCare Cancer Care at Charleston, Las Vegas
OptumCare Cancer Care at Fort Apache, Las Vegas
OptumCare Cancer Care at MountainView, Las Vegas
Radiation Oncology Centers of Nevada Central, Las Vegas
Radiation Oncology Centers of Nevada Southeast, Las Vegas
Summerlin Hospital Medical Center, Las Vegas
Sunrise Hospital and Medical Center, Las Vegas
University Medical Center of Southern Nevada, Las Vegas
Urology Specialists of Nevada - Central, Las Vegas
Urology Specialists of Nevada - Northwest, Las Vegas
Urology Specialists of Nevada - Southwest, Las Vegas
Hope Cancer Care of Nevada-Pahrump, Pahrump
Renown Regional Medical Center, Reno
Saint Mary's Regional Medical Center, Reno
New HampshireDartmouth Hitchcock Medical Center/Dartmouth Cancer Center, Lebanon
New JerseyMemorial Sloan Kettering Monmouth, Middletown
Memorial Sloan Kettering Bergen, Montvale
Jersey Shore Medical Center, Neptune City
Overlook Hospital, Summit
New MexicoUniversity of New Mexico Cancer Center, Albuquerque
New YorkNorthwell Health/Center for Advanced Medicine, Lake Success
Laura and Isaac Perlmutter Cancer Center at NYU Langone, New York
NYP/Weill Cornell Medical Center, New York
Memorial Sloan Kettering Nassau, Uniondale
North CarolinaWake Forest University Health Sciences, Winston-Salem
North DakotaEssentia Health Cancer Center-South University Clinic, Fargo
Essentia Health - Jamestown Clinic, Jamestown
OhioStrecker Cancer Center-Belpre, Belpre
Adena Regional Medical Center, Chillicothe
Bethesda North Hospital, Cincinnati
Good Samaritan Hospital - Cincinnati, Cincinnati
TriHealth Cancer Institute-Anderson, Cincinnati
TriHealth Cancer Institute-Westside, Cincinnati
University of Cincinnati Cancer Center-UC Medical Center, Cincinnati
Case Western Reserve University, Cleveland
Cleveland Clinic Foundation, Cleveland
Mount Carmel East Hospital, Columbus
Mount Carmel Health Center West, Columbus
The Mark H Zangmeister Center, Columbus
Mount Carmel Grove City Hospital, Grove City
Zangmeister Center Grove City, Grove City
Fairfield Medical Center, Lancaster
Saint Rita's Medical Center, Lima
Marietta Memorial Hospital, Marietta
Memorial Hospital, Marysville
Knox Community Hospital, Mount Vernon
Mount Carmel New Albany Surgical Hospital, New Albany
Licking Memorial Hospital, Newark
Newark Radiation Oncology, Newark
Mercy Health - Perrysburg Hospital, Perrysburg
Southern Ohio Medical Center, Portsmouth
Springfield Regional Cancer Center, Springfield
Springfield Regional Medical Center, Springfield
Mercy Health - Saint Anne Hospital, Toledo
Mercy Health - Saint Vincent Hospital, Toledo
Mercy Health Sylvania Radiation Oncology Center, Toledo
University of Cincinnati Cancer Center-West Chester, West Chester
Saint Ann's Hospital, Westerville
Clinton Memorial Hospital/Foster J Boyd Regional Cancer Center, Wilmington
Genesis Healthcare System Cancer Care Center, Zanesville
OklahomaMercy Hospital Oklahoma City, Oklahoma City
University of Oklahoma Health Sciences Center, Oklahoma City
OregonSaint Alphonsus Cancer Care Center-Baker City, Baker City
Saint Charles Health System, Bend
Clackamas Radiation Oncology Center, Clackamas
Bay Area Hospital, Coos Bay
Providence Hood River Memorial Hospital, Hood River
Providence Newberg Medical Center, Newberg
Saint Alphonsus Cancer Care Center-Ontario, Ontario
Providence Willamette Falls Medical Center, Oregon City
Providence Portland Medical Center, Portland
Providence Saint Vincent Medical Center, Portland
Saint Charles Health System-Redmond, Redmond
PennsylvaniaLehigh Valley Hospital-Cedar Crest, Allentown
Lehigh Valley Hospital - Muhlenberg, Bethlehem
Pocono Medical Center, East Stroudsburg
Lehigh Valley Hospital-Hazleton, Hazleton
Penn State Milton S Hershey Medical Center, Hershey
University of Pennsylvania/Abramson Cancer Center, Philadelphia
UPMC Hillman Cancer Center, Pittsburgh
South CarolinaPrisma Health Cancer Institute - Spartanburg, Boiling Springs
Prisma Health Cancer Institute - Easley, Easley
Prisma Health Cancer Institute - Butternut, Greenville
Prisma Health Cancer Institute - Eastside, Greenville
Prisma Health Cancer Institute - Faris, Greenville
Prisma Health Greenville Memorial Hospital, Greenville
Prisma Health Cancer Institute - Greer, Greer
Prisma Health Cancer Institute - Seneca, Seneca
TexasMemorial Hermann Texas Medical Center, Houston
UT MD Anderson Cancer Center, Houston
Memorial Hermann Northeast Hospital, Humble
Memorial Hermann The Woodlands Hospital, The Woodlands
VermontCentral Vermont Medical Center/National Life Cancer Treatment, Berlin Corners
University of Vermont Medical Center, Burlington
University of Vermont and State Agricultural College, Burlington
Dartmouth Cancer Center - North, Saint Johnsbury
VirginiaUniversity of Virginia Cancer Center, Charlottesville
Inova Schar Cancer Institute, Fairfax
VCU Massey Comprehensive Cancer Center, Richmond
WashingtonProvidence Regional Cancer System-Aberdeen, Aberdeen
PeaceHealth Saint Joseph Medical Center, Bellingham
Providence Regional Cancer System-Centralia, Centralia
Swedish Cancer Institute-Edmonds, Edmonds
Providence Regional Cancer Partnership, Everett
Swedish Cancer Institute-Issaquah, Issaquah
Kadlec Clinic Hematology and Oncology, Kennewick
Providence Regional Cancer System-Lacey, Lacey
PeaceHealth Saint John Medical Center, Longview
Skagit Regional Health Cancer Care Center, Mount Vernon
Valley Medical Center, Renton
Swedish Medical Center-Ballard Campus, Seattle
Swedish Medical Center-Cherry Hill, Seattle
Swedish Medical Center-First Hill, Seattle
PeaceHealth United General Medical Center, Sedro-Woolley
Saint Joseph Medical Center Hematology and Oncology - Silverdale, Silverdale
Cancer Care Northwest - Spokane South, Spokane
Cancer Care Northwest-North Spokane, Spokane
Cancer Care Northwest-Valley, Spokane
PeaceHealth Southwest Medical Center, Vancouver
Providence Saint Mary Regional Cancer Center, Walla Walla
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital, Yakima
WisconsinDuluth Clinic Ashland, Ashland
Northwest Wisconsin Cancer Center, Ashland
Aurora Cancer Care-Southern Lakes VLCC, Burlington
Marshfield Clinic-Chippewa Center, Chippewa Falls
Aurora Saint Luke's South Shore, Cudahy
Marshfield Medical Center-EC Cancer Center, Eau Claire
Aurora Health Center-Fond du Lac, Fond du Lac
Aurora Health Care Germantown Health Center, Germantown
Aurora Cancer Care-Grafton, Grafton
Aurora BayCare Medical Center, Green Bay
Tamarack Health Hayward Medical Center, Hayward
Aurora Cancer Care-Kenosha South, Kenosha
Aurora Bay Area Medical Group-Marinette, Marinette
Marshfield Medical Center-Marshfield, Marshfield
Aurora Cancer Care-Milwaukee, Milwaukee
Aurora Saint Luke's Medical Center, Milwaukee
Aurora Sinai Medical Center, Milwaukee
Marshfield Medical Center - Minocqua, Minocqua
Cancer Center of Western Wisconsin, New Richmond
Vince Lombardi Cancer Clinic - Oshkosh, Oshkosh
Aurora Cancer Care-Racine, Racine
Marshfield Medical Center-Rice Lake, Rice Lake
Vince Lombardi Cancer Clinic-Sheboygan, Sheboygan
Marshfield Medical Center-River Region at Stevens Point, Stevens Point
Aurora Medical Center in Summit, Summit
Vince Lombardi Cancer Clinic-Two Rivers, Two Rivers
Marshfield Clinic-Wausau Center, Wausau
Aurora Cancer Care-Milwaukee West, Wauwatosa
Aurora West Allis Medical Center, West Allis
Marshfield Medical Center - Weston, Weston
WyomingMemorial Hospital of Laramie County, Cheyenne
Billings Clinic-Cody, Cody

Conditions

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.