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Testing the Use of Combination Therapy in Adult Patients With Newly Diagnosed Multiple Myeloma, the EQUATE Trial

RecruitingPhase 3

Effective Quadruplet Utilization After Treatment Evaluation (EQUATE): A Randomized Phase 3 Trial for Newly Diagnosed Multiple Myeloma Not Intended for Early Autologous Transplantation

Who can join

Ages 18 and older · All sexes

Full eligibility criteria
Inclusion Criteria:

* STEP 0 - Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0-2 (PS 3 allowed if secondary to pain)
* STEP 0 - Patient must have newly diagnosed multiple myeloma (MM) by International Myeloma Working Group (IMWG) criteria
* STEP 0 - Patient must agree to register to the mandatory REVLIMID Risk Evaluation and Mitigation Strategy (RevREMS) program and be willing and able to comply with the requirements of RevREMS
* STEP 0 - Patient must be able to undergo diagnostic bone marrow aspirate following preregistration.

  * NOTE: Bone marrow aspirate specimen must be submitted to Adaptive Biotechnologies for clonoSEQ Assay
  * NOTE: Adaptive Biotechnologies will release results to the diagnostic Portal from the Clonality (ID) test within fourteen (14) days of receipt and reconciliation of fresh bone marrow specimen to the submitting institution
* STEP 1 - Patient must meet all eligibility criteria in STEP 0 with exception of allergy requirement
* STEP 1 - Institution must have received the Clonality (ID) test results from Adaptive Biotechnologies and dominant sequences were identified
* STEP 1 - Patient must have standard risk MM as defined by the Revised International Staging System (RISS) stage I or II

  * NOTE: R-ISS stage is based on serum beta2 microglobulin, albumin and lactate dehydrogenase (LDH) levels along with presence of chromosomal abnormalities (CA) detected by interphase fluorescent in situ hybridization (iFISH). Presence of del(17p), t(4;14), and/or t(14;16) is considered high risk and absence of these, including any other findings, are standard risk
  * R-ISS stage

    * Stage I: ISS stage I \[beta2 macroglobulin \< 3.5 mg/L, albumin \> 3.5 g/dL\] AND standard-risk CA AND normal LDH
    * Stage II: Not R-ISS stage I or III
    * Stage III: ISS stage III \[beta2 macroglobulin \> 5.5 mg/L\] AND high-risk CA OR high LDH (\> upper limit of normal) \[patients with stage III are ineligible\]
* STEP 1 - Patient must have measurable or evaluable disease as defined by having one or more of the following, obtained within 28 days prior to registration:

  * \>= 1 g/dL monoclonal protein (M-protein) on serum protein electrophoresis
  * \>= 200 mg/24 hours of monoclonal protein on a 24-hour urine protein electrophoresis
  * Involved free light chain \>= 10 mg/dL or \>= 100 mg/L AND abnormal serum immunoglobulin kappa to lambda free light chain ratio (\< 0.26 or \> 1.65)
  * Monoclonal bone marrow plasmacytosis \>= 30% (evaluable disease)
* STEP 1 - Patients must have a serum protein electrophoresis (SPEP), urine protein electrophoresis (UPEP), and serum free light chain (FLC) assay performed within 28 days prior to registration. In addition, a bone marrow biopsy and/or aspirate is required within 28 days if bone marrow is being followed for response

  * NOTE: UPEP (on a 24-hour collection) is required, no substitute method is acceptable. Urine must be followed monthly if the baseline urine M-spike is \>= 200 mg/24 hr. Please note that if both serum and urine M-components are present, both must be followed in order to evaluate response
  * NOTE: The serum free light chain test is required to be done if the patient does not have measurable disease in the serum or urine. Measurable disease in the serum is defined as having a serum M-spike \>= 1 g/dL. Measurable disease in the urine is defined as having a urine M-spike \>= 200 mg/24 hr
* STEP 1 - Calculated creatinine clearance \> 30 mL/min (obtained =\< 14 days prior to Step 1 registration)
* STEP 1 - Absolute neutrophil count (ANC) \>= 1000/mm\^3 (obtained =\< 14 days prior to Step 1 registration)
* STEP 1 - Untransfused platelet count \>= 75,000/mm\^3 (obtained =\< 14 days prior to Step 1 registration)
* STEP 1 - Hemoglobin \>= 8.0 g/dL (obtained =\< 14 days prior to Step 1 registration)
* STEP 1 - Total bilirubin =\< 1.5 x ULN (institutional upper limit of normal) (obtained =\< 14 days prior to Step 1 registration)
* STEP 1 - Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =\< 3 x ULN (obtained =\< 14 days prior to Step 1 registration)
* STEP 1 - Patient must have received no more than one cycle (28 days or less) of prior chemotherapy and no more than 160 mg of prior dexamethasone (or equivalent dose of prednisone) for treatment of symptomatic myeloma. Patient must not have been exposed to daratumumab for treatment of symptomatic myeloma. Prior radiation therapy to symptomatic lesions is allowed provided there are no residual toxicity related to radiation and blood counts meet the study requirements. Radiation treatment must be completed at least 14 days prior to Step 1 registration
* STEP 1 - Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months of randomization are eligible for this trial
* STEP 1 - For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated
* STEP 1 - Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load
* STEP 1 - 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 are eligible for this trial
* STEP 1 - Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class 2B or better. Patients must not have evidence of current uncontrolled cardiovascular conditions, including hypertension, cardiac arrhythmias, congestive heart failure, unstable angina, or myocardial infarction within 6 months prior to Step 1 registration
* STEP 1 - Patient may have a history of current or previous deep vein thrombosis (DVT) or pulmonary embolism (PE) but must be willing to take some form of anti-coagulation as prophylaxis if they are not currently on full-dose anticoagulation
* STEP 1 - Patients with a history of chronic obstructive pulmonary disease (COPD) must have FEV1 testing done within 28 days prior to Step 1 registration and the forced expiratory volume in 1 second (FEV1) must be \> 50% of predicted normal
* STEP 2 - Institution must have received Tracking (MRD) test results from Adaptive Biotechnologies
* STEP 2 - Patient must have completed the Step 1 Induction phase of this protocol without experiencing progression
* STEP 2 - Patient must be registered to Step 2 within 8 weeks of completing Step 1 Induction Treatment, counting from last day of completion of last cycle
* STEP 2 - Patient must have an ECOG performance status (PS) of 0-2 (PS 3 allowed if secondary to pain)
* STEP 2 - Any adverse event(s) related to Step 1 Induction Treatment must have resolved to grade 2 or less
* STEP 2 - Hemoglobin \>= 8 g/dL (obtained within 14 days prior to Step 2 randomization)
* STEP 2 - Platelet count \>= 50,000/mm\^3 (obtained within 14 days prior to Step 2 randomization)
* STEP 2 - Absolute neutrophil count (ANC) \>= 1000/mm\^3 (obtained within 14 days prior to Step 2 randomization)
* STEP 2 - Calculated creatinine clearance \>= 30 mL/min (obtained within 14 days prior to Step 2 randomization)
* STEP 2 - Total bilirubin =\< 1.5 x ULN (Institutional upper limit of normal) (obtained within 14 days prior to Step 2 randomization)
* STEP 2 - ALT and AST \< 3 x ULN (obtained within 14 days prior to Step 2 randomization)

Exclusion Criteria:

* STEP 0 - Patient must not have any known allergies, hypersensitivity, or intolerance to corticosteroids, monoclonal antibodies or human proteins, or their excipients (refer to respective package inserts or Investigator's Brochure), or known sensitivity to mammalian-derived products
* STEP 1 - Women must not be pregnant or breast-feeding due to the potential harm and teratogenic effects to an unborn fetus and possible risk for adverse events in nursing infants with the treatment regimens being used. All females of childbearing potential must have a blood test or urine study with a sensitivity of at least 25 mIU/mL within 10-14 days prior to Step 1 registration to rule out pregnancy and again within 24 hours prior to the first dose of lenalidomide. Females of childbearing potential must also agree to ongoing pregnancy testing while on protocol treatment. A female of childbearing potential is defined as any woman, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria:

  * Has achieved menarche at some point,
  * Has not undergone a hysterectomy or bilateral oophorectomy; or
  * Has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)
* STEP 1 - Women of childbearing potential must not expect to conceive children by using accepted and effective method(s) of contraception (for this protocol defined as the use of TWO acceptable methods of birth control, one highly effective method and one additional effective method AT THE SAME TIME for 1) at least 28 days before starting protocol treatment; 2) while participating in the study; 3) during dose interruptions; and 4) for at least 3 months days after the last dose of protocol treatment) OR by practicing true abstinence from sexual intercourse for the duration of their participation in the study (periodic abstinence \[e.g., calendar, ovulation, symptothermal, post-ovulation methods\] and withdrawal are not acceptable methods of contraception). Men must not expect to father children by practicing true abstinence from sexual intercourse for the duration of their participation in the study (periodic abstinence \[e.g., calendar, ovulation, symptothermal, post-ovulation methods\] and withdrawal are not acceptable methods of contraception) OR use a latex condom during sexual contact with a female of child bearing potential while participating in the study and for at least 3 months after the last dose of protocol treatment even if they have had a successful vasectomy. Men must also agree to abstain from donating sperm while on study treatment and for 3 months after the last dose of protocol treatment even if they have had a successful vasectomy. Both women and men must both agree to abstain from donating blood during study participation and for at least 28 days after the last dose of protocol treatment
* STEP 1 - Patient must not have peripheral neuropathy \>= grade 2 on clinical examination or grade 1 with pain at time of Step 1 registration
* STEP 1 - Patient must not have any serious medical or psychiatric illness that could, in the investigator's opinion, potentially interfere with the completion of treatment according to this protocol
* STEP 1 - Patient must not have moderate or severe persistent asthma within the past 2 years, or uncontrolled asthma of any classification

  * NOTE: Patients who currently have controlled intermittent asthma or controlled mild persistent asthma are allowed to register
* STEP 1 - Patient must not receive any other concurrent chemotherapy, or any ancillary therapy considered investigational while on this protocol

  * NOTE: Bisphosphonates are considered to be supportive care rather than therapy, and are thus allowed while on protocol treatment
* STEP 2 - Patient must not have received any non-protocol therapy outside of the assigned Step 1 Induction treatment including stem cell transplant
* STEP 2 - Women must not be pregnant or breast-feeding due to the potential harm and teratogenic effects to an unborn fetus and possible risk for adverse events in nursing infants with the treatment regimens being used. All females of childbearing potential must have a blood test or urine study with a sensitivity of at least 25 mIU/mL within 10-14 days prior to Step 2 randomization to rule out pregnancy and again within 24 hours prior to the first dose of lenalidomide. Females of childbearing potential must also agree to ongoing pregnancy testing while on protocol treatment. A female of childbearing potential is defined as any woman, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria:

  * Has achieved menarche at some point,
  * Has not undergone a hysterectomy or bilateral oophorectomy; or
  * Has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months).
* STEP 2 - Women of childbearing potential must not expect to conceive children by using accepted and effective method(s) of contraception (for this protocol defined as the use of TWO acceptable methods of birth control, one highly effective method and one additional effective method AT THE SAME TIME for 1) at least 28 days before starting protocol treatment; 2) while participating in the study; 3) during dose interruptions; and 4) for at least 3 months days after the last dose of protocol treatment) OR by practicing true abstinence from sexual intercourse for the duration of their participation in the study (periodic abstinence \[e.g., calendar, ovulation, symptothermal, post-ovulation methods\] and withdrawal are not acceptable methods of contraception).

Men must not expect to father children by practicing true abstinence from sexual intercourse for the duration of their participation in the study (periodic abstinence \[e.g., calendar, ovulation, symptothermal, post-ovulation methods\] and withdrawal are not acceptable methods of contraception) OR use a latex condom during sexual contact with a female of child bearing potential while participating in the study and for at least 3 months after the last dose of protocol treatment even if they have had a successful vasectomy. Men must also agree to abstain from donating sperm while on study treatment and for 3 months after the last dose of protocol treatment even if they have had a successful vasectomy. Both women and men must both agree to abstain from donating blood during study participation and for at least 28 days after the last dose of protocol treatment

About the study

This phase III trial compares the combination of four drugs (daratumumab, bortezomib, lenalidomide and dexamethasone) to the use of a three drug combination (daratumumab, lenalidomide and dexamethasone). Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Chemotherapy drugs, such as lenalidomide, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Daratumumab is a monoclonal antibody that may interfere with the ability of cancer cells to grow and spread. Anti-inflammatory drugs, such as dexamethasone lower the body's immune response and are used with other drugs in the treatment of some types of cancer. Adding bortezomib to daratumumab, lenalidomide, and dexamethasone may be more effective in shrinking the cancer or preventing it from returning, compared to continuing on daratumumab, lenalidomide, and dexamethasone.

What is being tested

Sponsor: ECOG-ACRIN Cancer Research Group · Participants: 1,450 · Started: Feb 24, 2021

Contact the study team

Official record on ClinicalTrials.gov — NCT04566328

Locations in the U.S.

ArizonaCancer 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
Mercy Cancer Center - Carmichael, Carmichael
Mercy San Juan Medical Center, Carmichael
Mercy Cancer Center - Elk Grove, Elk Grove
Washington Health, Fremont
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
Woodland Memorial Hospital, Woodland
ColoradoPenrose-Saint Francis Healthcare, Colorado Springs
Rocky Mountain Cancer Centers-Penrose, Colorado Springs
Saint Francis Cancer Center, Colorado Springs
CommonSpirit Saint Anthony Hospital Cancer Center, Lakewood
Saint Mary Corwin Medical Center, Pueblo
Saint Anthony North Hospital, Westminster
ConnecticutSmilow Cancer Hospital-Derby Care Center, Derby
Smilow Cancer Hospital Care Center-Fairfield, Fairfield
Smilow Cancer Hospital Care Center at Glastonbury, Glastonbury
Smilow Cancer Hospital Care Center at Greenwich, Greenwich
Smilow Cancer Hospital Care Center - Guilford, Guilford
Smilow Cancer Hospital Care Center at Saint Francis, Hartford
Smilow Cancer Center/Yale-New Haven Hospital, New Haven
Yale University, New Haven
Yale-New Haven Hospital North Haven Medical Center, North Haven
Smilow Cancer Hospital-Orange Care Center, Orange
Smilow Cancer Hospital-Torrington Care Center, Torrington
Smilow Cancer Hospital Care Center-Trumbull, Trumbull
Smilow Cancer Hospital-Waterbury Care Center, Waterbury
Smilow Cancer Hospital Care Center - Waterford, Waterford
District of ColumbiaSibley Memorial Hospital, Washington D.C.
FloridaHoly Cross Hospital, Fort Lauderdale
IdahoSaint Alphonsus Cancer Care Center-Boise, Boise
Saint Alphonsus Cancer Care Center-Caldwell, Caldwell
Saint Alphonsus Cancer Care Center-Nampa, Nampa
IllinoisOSF Saint Anthony's Health Center, Alton
Advocate Outpatient Center - Aurora, 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
AMG Crystal Lake - Oncology, Crystal Lake
Northwestern Medicine Cancer Center Kishwaukee, DeKalb
Cancer Care Specialists of Illinois - Decatur, Decatur
Decatur Memorial Hospital, Decatur
Illinois CancerCare-Dixon, Dixon
Advocate Good Samaritan Hospital, Downers Grove
Crossroads Cancer Center, Effingham
Advocate Sherman Hospital, Elgin
Illinois CancerCare-Eureka, Eureka
Illinois CancerCare-Galesburg, Galesburg
Northwestern Medicine Cancer Center Delnor, Geneva
Advocate South Suburban Hospital, Hazel Crest
Illinois CancerCare-Kewanee Clinic, Kewanee
AMG Libertyville - Oncology, Libertyville
Condell Memorial Hospital, Libertyville
Illinois CancerCare-Macomb, Macomb
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
Illinois CancerCare-Ottawa Clinic, Ottawa
Advocate Lutheran General Hospital, Park Ridge
Illinois CancerCare-Pekin, Pekin
Illinois CancerCare-Peoria, Peoria
Methodist Medical Center of Illinois, 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
Northwestern Medicine Cancer Center Warrenville, Warrenville
Illinois CancerCare - Washington, Washington
IndianaIU Health North Hospital, Carmel (Not yet recruiting)
IU Health Methodist Hospital, Indianapolis (Not yet recruiting)
Indiana University/Melvin and Bren Simon Cancer Center, Indianapolis
IowaMary Greeley Medical Center, Ames
McFarland Clinic - Ames, Ames
UI Health Care Mission Cancer and Blood - Ankeny Clinic, Ankeny
Saint Anthony Regional Hospital, Carroll
Mercy Hospital, Cedar Rapids
Oncology Associates at Mercy Medical Center, Cedar Rapids
Mercy Cancer Center-West Lakes, Clive
UI Health Care Mission Cancer and Blood - West Des Moines Clinic, Clive
Greater Regional Medical Center, Creston
Broadlawns Medical Center, Des Moines
Iowa Lutheran Hospital, Des Moines
Iowa Methodist Medical Center, Des Moines
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
McFarland Clinic - Trinity Cancer Center, Fort Dodge
UI Healthcare Mission Cancer and Blood - Fort Dodge, Fort Dodge
McFarland Clinic - Marshalltown, Marshalltown
UI Health Care Mission Cancer and Blood - Waukee Clinic, Waukee
Mercy Medical Center-West Lakes, West Des Moines
Methodist West Hospital, West Des Moines
KansasCentral Care Cancer Center - Garden City, Garden City
Central 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 Medical Center - East Lexington, Lexington
Saint Joseph Radiation Oncology Resource Center, Lexington
CommonSpirit Saint Joseph Hospital London, London
CommonSpirit Saint Joseph Hospital Mount Sterling, Mount Sterling
MassachusettsTufts Medical Center, Boston
Tufts Medical Center Cancer Center Stoneham, Stoneham
MichiganMyMichigan Medical Center Gratiot, Alma
MyMichigan Medical Center Alpena, Alpena
Trinity Health Saint Joseph Mercy Hospital Ann Arbor, Ann Arbor
Trinity Health IHA Medical Group Hematology Oncology - Brighton, Brighton
Trinity Health Medical Center - Brighton, Brighton
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 Health Saint John Hospital, Detroit
Henry Ford River District Hospital, East China Township
OSF Saint Francis Hospital and Medical Group, Escanaba
Cancer Hematology Centers - Flint, Flint
Genesee Hematology Oncology PC, Flint
Genesys Hurley Cancer Institute, Flint
Hurley Medical Center, Flint
MyMichigan Medical Center Gladwin, Gladwin
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
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
Henry Ford Health Providence Novi Hospital, Novi
Michigan Healthcare Professionals Pontiac, Pontiac
Newland Medical Associates-Pontiac, Pontiac
Trinity Health Saint Joseph Mercy Oakland Hospital, Pontiac
MyMichigan Medical Center Saginaw, Saginaw
Henry Ford Health Providence Southfield Hospital, Southfield
MyMichigan Medical Center Tawas, Tawas City
Henry Ford Health Warren Hospital, Warren
Henry Ford Madison Heights Hospital - Breast, Warren
Henry Ford Warren Hospital - GLCMS, Warren
Huron Gastroenterology PC, Ypsilanti
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus, Ypsilanti
MinnesotaMinnesota Oncology - Burnsville, Burnsville
Cambridge Medical Center, Cambridge
Minnesota Oncology Hematology PA-Chaska, Chaska
Mercy Hospital, Coon Rapids
Minnesota Oncology - Coon Rapids, Coon Rapids
Fairview Southdale Hospital, Edina
Minnesota Oncology - Edina, Edina
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
New Ulm Medical Center, New Ulm
Fairview Northland Medical Center, Princeton
North Memorial Medical Health Center, Robbinsdale
Mayo Clinic in Rochester, Rochester
Park Nicollet Clinic - Saint Louis Park, Saint Louis Park
Regions Hospital, Saint Paul
United Hospital, Saint Paul
Saint Francis Regional Medical Center, Shakopee
Lakeview Hospital, Stillwater
Ridgeview Medical Center, Waconia
Rice Memorial Hospital, Willmar
Minnesota Oncology Hematology PA-Woodbury, Woodbury
Fairview Lakes Medical Center, Wyoming
MississippiGulfport Memorial Hospital, Gulfport
MissouriMercy Oncology and Hematology - Clayton-Clarkson, Ballwin
Central Care Cancer Center - Bolivar, Bolivar
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
Kansas City Veterans Affairs Medical Center, Kansas City
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
Missouri Baptist Sullivan Hospital, Sullivan
Mercy Hospital Washington, Washington
MontanaSaint 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
New JerseyJefferson Cherry Hill Hospital, Cherry Hill
Sidney Kimmel Cancer Center Washington Township, Sewell
New YorkUniversity of Rochester, Rochester
State University of New York Upstate Medical University, Syracuse
Upstate Cancer Center at Verona, Verona
North CarolinaSoutheastern Medical Oncology Center-Clinton, Clinton
Southeastern Medical Oncology Center-Goldsboro, Goldsboro
Southeastern Medical Oncology Center-Jacksonville, Jacksonville
OhioOhioHealth O'Bleness Hospital, Athens
Bethesda North Hospital, Cincinnati
Good Samaritan Hospital - Cincinnati, Cincinnati
TriHealth Cancer Institute-Anderson, Cincinnati
TriHealth Cancer Institute-Westside, Cincinnati
MetroHealth Medical Center, Cleveland
Columbus Oncology and Hematology Associates Inc, Columbus
Doctors Hospital, Columbus
Grant Medical Center, Columbus
Riverside Methodist Hospital, Columbus
Delaware Health Center-Grady Cancer Center, Delaware
Grady Memorial Hospital, Delaware
Columbus Oncology and Hematology Associates, Dublin
Dublin Methodist Hospital, Dublin
OhioHealth Mansfield Hospital, Mansfield
OhioHealth Marion General Hospital, Marion
OhioHealth Pickerington Methodist Hospital, Pickerington
OhioHealth Westerville Medical Campus/Westerville Cancer Center, Westerville
OklahomaMercy Hospital Oklahoma City, Oklahoma City
OregonSaint Alphonsus Cancer Care Center-Baker City, Baker City
Saint Alphonsus Cancer Care Center-Ontario, Ontario
PennsylvaniaLehigh Valley Hospital-Cedar Crest, Allentown
Lehigh Valley Hospital - Muhlenberg, Bethlehem
Pocono Medical Center, East Stroudsburg
Penn State Health Medical Group - Andrews Patel Hematology/Oncology East, Harrisburg
Lehigh Valley Hospital-Hazleton, Hazleton
Thomas Jefferson University Hospital, Philadelphia
Rhode IslandSmilow Cancer Hospital Care Center - Westerly, Westerly
South CarolinaRalph H Johnson VA Medical Center, Charleston
South DakotaRapid City Regional Hospital, Rapid City
VermontUniversity of Vermont Medical Center, Burlington
University of Vermont and State Agricultural College, Burlington
White River Junction Veteran Administration Medical Center, White River Junction
WashingtonSaint Joseph Medical Center Hematology and Oncology - Silverdale, Silverdale
WisconsinAscension Northeast Wisconsin-Saint Elizabeth Cancer Center-Appleton, Appleton
ThedaCare Regional Cancer Center, Appleton
Ascension Southeast Wisconsin Hospital-Elmbrook Campus-Brookfield, Brookfield
Aurora Cancer Care-Southern Lakes VLCC, Burlington
Ascension Calumet Hospital-Chilton, Chilton
Marshfield Clinic-Chippewa Center, Chippewa Falls
Aurora Saint Luke's South Shore, Cudahy
Marshfield Medical Center-EC Cancer Center, Eau Claire
Ascension Southeast Wisconsin Hospital - Franklin, Franklin
Reiman Cancer Center-Ascension Wisconsin Health Center-Rawson, Franklin
Aurora Health Care Germantown Health Center, Germantown
Aurora Cancer Care-Grafton, Grafton
Aurora BayCare Medical Center, Green Bay
Saint Vincent Hospital Cancer Center Green Bay, Green Bay
Saint Vincent Hospital Cancer Center at Saint Mary's, Green Bay
Aurora Cancer Care-Kenosha South, Kenosha
Gundersen Lutheran Medical Center, La Crosse
Marshfield Medical Center - Ladysmith, Ladysmith
University of Wisconsin Carbone Cancer Center - University Hospital, Madison
William S Middleton VA Medical Center, Madison
Aurora Bay Area Medical Group-Marinette, Marinette
Marshfield Medical Center-Marshfield, Marshfield
Ascension Columbia Saint Mary's Hospital-Ozaukee Campus-Mequon, Mequon
Ascension Columbia Saint Mary's Hospital-Milwaukee Campus, Milwaukee
Ascension Saint Francis Hospital-Milwaukee, Milwaukee
Ascension Southeast Wisconsin Hospital-Saint Joseph-Milwaukee, Milwaukee
Aurora Cancer Care-Milwaukee, Milwaukee
Aurora Saint Luke's Medical Center, Milwaukee
Aurora Sinai Medical Center, Milwaukee
Marshfield Medical Center - Minocqua, Minocqua
ThedaCare Regional Medical Center - Neenah, Neenah
Marshfield Medical Center - Neillsville, Neillsville
Cancer Center of Western Wisconsin, New Richmond
Saint Vincent Hospital Cancer Center at Oconto Falls, Oconto Falls
Ascension Northeast Wisconsin-Mercy Hospital-Oshkosh, Oshkosh
Vince Lombardi Cancer Clinic - Oshkosh, Oshkosh
Ascension All Saints Hospital-Spring Street-Racine, Racine
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
Saint Vincent Hospital Cancer Center at Sturgeon Bay, Sturgeon Bay
Aurora Medical Center in Summit, Summit
Vince Lombardi Cancer Clinic-Two Rivers, Two Rivers
Marshfield Clinic-Wausau Center, Wausau
Ascension Southeast Wisconsin Hospital-Mayfair Road-Wauwatosa, Wauwatosa
Aurora Cancer Care-Milwaukee West, Wauwatosa
Aurora West Allis Medical Center, West Allis
Marshfield Medical Center - Weston, Weston
Marshfield Clinic - Wisconsin Rapids Center, Wisconsin Rapids

Conditions

From ClinicalTrials.gov, data retrieved Sep 29, 2026. Each study sets its own eligibility; the study team decides who can join.