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A Study to Compare Standard Therapy to Treat Hodgkin Lymphoma to the Use of Two Drugs, Brentuximab Vedotin and Nivolumab

RecruitingPhase 3

A Randomized Phase 3 Interim Response Adapted Trial Comparing Standard Therapy With Immuno-oncology Therapy for Children and Adults With Newly Diagnosed Stage I and II Classic Hodgkin Lymphoma

Who can join

Ages 5 to 60 · All sexes

Full eligibility criteria
Inclusion Criteria:

* Patients must be 5 to 60 years of age at the time of enrollment
* Patients with newly diagnosed untreated histologically confirmed classic Hodgkin lymphoma (cHL) (nodular sclerosis, mixed cellularity, lymphocyte-rich, or lymphocyte-depleted, or not otherwise specified \[NOS\]) with stage I or II disease
* Patients must have bidimensionally measurable disease (at least one lesion with longest diameter \>= 1.5 cm)
* Patients must have a whole body or limited whole body PET scan performed within 42 days prior to enrollment. PET-CT is strongly preferred. PET-MRI allowed if intravenous contrast enhanced CT is also obtained
* Pediatric patients (age 5-17 years) with known or suspected mediastinal disease must have an upright posteroanterior (PA) chest X-ray (CXR) for assessment of bulky mediastinal disease.

  * Note: Pediatric patients who have received both a CT chest and upright PA CXR may meet the definition of bulk through either modality.
* Patients \>= 18 years must have a performance status corresponding to Zubrod scores of 0, 1 or 2
* Patients =\< 17 years of age must have a Lansky performance score of \>= 50
* Pediatric patients (age 5-17 years): A serum creatinine based on age/sex as follows (within 28 days prior to enrollment):

  * 2 to \< 6 years (age): 0.8 mg/dL (male), 0.8 mg/dL (female)
  * 6 to \< 10 years (age): 1 mg/dL (male), 1 mg/dL (female)
  * 10 to \< 13 years (age): 1.2 mg/dL (male), 1.2 mg/dL (female)
  * 13 to \< 16 years (age): 1.5 mg/dL (male), 1.4 mg/dL (female)
  * \>= 16 years (age): 1.7 mg/dL (male), 1.4 mg/dL (female) OR a 24 hour urine creatinine clearance \>= 50 mL/min/1.73 m\^2 (within 28 days prior to enrollment) OR a glomerular filtration rate (GFR) \>= 50 mL/min/1.73 m\^2 (within 28 days prior to enrollment). GFR must be performed using direct measurement with a nuclear blood sampling method OR direct small molecule clearance method (iothalamate or other molecule per institutional standard)
  * Note: Estimated GFR (eGFR) from serum or plasma creatinine, cystatin C or other estimates are not acceptable for determining eligibility
* For adult patients (age 18 years or older) (within 28 days prior to enrollment): Creatinine clearance \>= 30 mL/min, as estimated by the Cockcroft and Gault formula or a 24-hour urine collection. The creatinine value used in the calculation must have been obtained within 28 days prior to registration. Estimated creatinine clearance is based on actual body weight
* Total bilirubin =\< 2 x upper limit of normal (ULN) (within 28 days prior to enrollment)

  * Unless due to Gilbert's disease, lymphomatous involvement of liver or vanishing bile duct syndrome
* Aspartate aminotransferase (AST) =\< 3 x ULN (within 28 days prior to enrollment)

  * Unless due to Gilbert's disease, lymphomatous involvement of liver or vanishing bile duct syndrome
* Alanine aminotransferase (ALT) =\< 3 x ULN (within 28 days prior to enrollment)

  * Unless due to Gilbert's disease, lymphomatous involvement of liver or vanishing bile duct syndrome
* Shortening fraction of \>= 27% by echocardiogram (ECHO), multigated acquisition scan (MUGA), or functional cardiac imaging scan (within 28 days prior to enrollment) or ejection fraction of \>= 50% by radionuclide angiogram, ECHO, MUGA, or cardiac imaging scan (within 28 days prior to enrollment)
* Diffusion capacity of the lung for carbon monoxide (DLCO) \>= 50% of predicted value as corrected for hemoglobin by pulmonary function test (PFT) (within 28 days prior to enrollment). If unable to obtain PFTs, the criterion is: a pulse oximetry reading of \> 92% on room air
* Known human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial
* For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated. 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

Exclusion Criteria:

* Patients with nodular lymphocyte predominant Hodgkin lymphoma
* Patients with a history of active interstitial pneumonitis or interstitial lung disease
* Patients with a diagnosis of inherited or acquired immunodeficiency that is poorly controlled or requiring active medications, such as primary immunodeficiency syndromes or organ transplant recipients
* Patients with any known uncontrolled intercurrent illness that would jeopardize the patient's safety such as infection, autoimmune conditions, cardiac arrhythmias, angina pectoris, and gastrointestinal disorders affecting swallowing and/or absorption of pills
* Patients with a condition requiring systemic treatment with either corticosteroids (defined as equivalent to \> 10 mg daily predniSONE for patients \>= 18 years or \> 0.5 mg/kg \[up to 10 mg/day\] for patients \< 18 years) or other immunosuppressive medications within 14 days prior to enrollment

  * Note: Replacement therapy such as thyroxine, insulin, or physiologic corticosteroid for adrenal or pituitary insufficiency is not considered a form of systemic treatment. Inhaled or topical steroids, and adrenal replacement doses (=\< 10 mg daily for patients \>= 18 years or =\< 0.5 mg/kg \[up to 10 mg/day\] predniSONE equivalents) are permitted in the absence of active autoimmune disease
  * Note: Steroid use for the control of Hodgkin lymphoma symptoms is allowable, but must be discontinued by cycle 1, day 1
  * Short term use of corticosteroids for premedication or treatment of an allergy or hypersensitivity is considered an acceptable use of corticosteroids.
* Patients with peripheral neuropathy \> grade 1 at the time of enrollment or patients with known Charcot-Marie-Tooth syndrome
* Patients with a prior or concurrent malignancy whose natural history or treatment has the potential to interfere with the safety or efficacy assessment of the investigational regimen
* Administration of prior chemotherapy, radiation, or antibody-based treatment for cHL
* Prior solid organ transplant
* Prior allogeneic stem cell transplantation
* Live vaccine within 30 days prior to planned day 1 of protocol therapy (e.g., measles, mumps, rubella, varicella, yellow fever, rabies, bacillus Calmette Guerin \[BCG\], oral polio vaccine, and oral typhoid). Administration of messenger ribonucleic acid (mRNA) vaccines are permitted
* Female patients who are pregnant since fetal toxicities and teratogenic effects have been noted for several of the study drugs. A pregnancy test within 28 days prior to enrollment is required for female patients of childbearing potential
* Lactating females who plan to breastfeed their infants starting with the first dose of study therapy and for at least 6 months after the last treatment
* Sexually active patients of reproductive potential who have not agreed to use a highly effective contraceptive method for the duration of their study drug therapy. Following therapy, patients will be advised to use contraception as per institutional practice or as listed below for investigational agents, whichever is longer

  * Men and women of childbearing potential (WOCBP) must use effective contraception during the study and for 2 months for WOCBP and 4 months for men, after last dose of brentuximab vedotin
  * WOCBP must continue contraception for a period of at least 5 months after the last dose of nivolumab
* All patients and/or their parents or legal guardians must sign a written informed consent
* All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met

About the study

This phase III trial compares the effect of adding immunotherapy (brentuximab vedotin and nivolumab) to standard treatment (chemotherapy with or without radiation) to the standard treatment alone in improving survival in patients with stage I and II classical Hodgkin lymphoma. Brentuximab vedotin is in a class of medications called antibody-drug conjugates. It is made of a monoclonal antibody called brentuximab that is linked to a cytotoxic agent called vedotin. Brentuximab attaches to CD30 positive lymphoma cells in a targeted way and delivers vedotin to kill them. A monoclonal antibody is a type of protein that can bind to certain targets in the body, such as molecules that cause the body to make an immune response (antigens). Immunotherapy with monoclonal antibodies, such as nivolumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Chemotherapy drugs such as doxorubicin hydrochloride, bleomycin sulfate, vinblastine sulfate, dacarbazine, and procarbazine hydrochloride 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. Cyclophosphamide is in a class of medications called alkylating agents. It works by damaging the cell's deoxyribonucleic acid (DNA) and may kill cancer cells. It may also lower the body's immune response. 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 cancer cells. Vincristine is in a class of medications called vinca alkaloids. It works by stopping cancer cells from growing and dividing and may kill them. Prednisone is in a class of medications called corticosteroids. It is used to reduce inflammation and lower the body's immune response to help lessen the side effects of chemotherapy drugs. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. Adding immunotherapy to the standard treatment of chemotherapy with or without radiation may increase survival and/or fewer short-term or long-term side effects in patients with classical Hodgkin lymphoma compared to the standard treatment alone.

What is being tested

Sponsor: National Cancer Institute (NCI) · Participants: 1,875 · Started: May 11, 2023

Contact the study team

Official record on ClinicalTrials.gov — NCT05675410

Locations in the U.S.

AlabamaChildren's Hospital of Alabama, Birmingham
USA Health Strada Patient Care Center, Mobile
AlaskaProvidence Alaska Medical Center, Anchorage
ArizonaCTCA at Western Regional Medical Center, Goodyear
Banner Children's at Desert, Mesa
Phoenix Childrens Hospital, Phoenix
ArkansasArkansas Children's Hospital, Little Rock
CaliforniaMercy Cancer Center - Carmichael, Carmichael
Mercy San Juan Medical Center, Carmichael
City of Hope Corona, Corona
UC Irvine Health Cancer Center-Newport, Costa Mesa
Kaiser Permanente Downey Medical Center, Downey
City of Hope Comprehensive Cancer Center, Duarte
Kaiser Permanente Dublin, Dublin
Mercy Cancer Center - Elk Grove, Elk Grove
Kaiser Permanente-Fremont, Fremont
Kaiser Permanente-Fresno, Fresno
City of Hope Seacliff, Huntington Beach
City of Hope at Irvine Lennar, Irvine
UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care, Irvine
City of Hope Antelope Valley, Lancaster
Loma Linda University Medical Center, Loma Linda
City of Hope at Long Beach Elm, Long Beach
Miller Children's and Women's Hospital Long Beach, Long Beach
Cedars-Sinai Medical Center, Los Angeles
Children's Hospital Los Angeles, Los Angeles
Valley Children's Hospital, Madera
Kaiser Permanente-Modesto, Modesto
City of Hope Newport Beach, Newport Beach
Kaiser Permanente-Oakland, Oakland
Children's Hospital of Orange County, Orange
UC Irvine Health/Chao Family Comprehensive Cancer Center, Orange
Mercy Cancer Center - Rocklin, Rocklin
Kaiser Permanente Downtown Commons, Sacramento
Kaiser Permanente-South Sacramento, Sacramento
Mercy Cancer Center - Sacramento, Sacramento
Sutter Medical Center Sacramento, Sacramento
Naval Medical Center -San Diego, San Diego
Rady Children's Hospital - San Diego, San Diego
Kaiser Permanente-San Francisco, San Francisco
Kaiser Permanente-Santa Teresa-San Jose, San Jose
Kaiser Permanente San Leandro, San Leandro
Kaiser San Rafael-Gallinas, San Rafael
Santa Barbara Cottage Hospital, Santa Barbara
Kaiser Permanente-Santa Rosa, Santa Rosa
City of Hope South Pasadena, South Pasadena
Kaiser Permanente-South San Francisco, South San Francisco
City of Hope South Bay, Torrance
City of Hope Upland, Upland
Kaiser Permanente-Vallejo, Vallejo
Kaiser Permanente-Walnut Creek, Walnut Creek
Woodland Memorial Hospital, Woodland
ColoradoChildren's Hospital Colorado, Aurora
UCHealth University of Colorado Hospital, Aurora
Memorial Hospital North, Colorado Springs
UCHealth Memorial Hospital Central, Colorado Springs
Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center, Denver
Cancer Care and Hematology-Fort Collins, Fort Collins
Poudre Valley Hospital, Fort Collins
UCHealth Greeley Hospital, Greeley
Medical Center of the Rockies, Loveland
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
Connecticut Children's Medical Center, Hartford
Smilow Cancer Hospital Care Center at Saint Francis, Hartford
Yale University, New Haven
Yale-New Haven Hospital North Haven Medical Center, North Haven
Smilow Cancer Hospital Care Center at Long Ridge, Stamford
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
DelawareAlfred I duPont Hospital for Children, Wilmington
District of ColumbiaChildren's National Medical Center, Washington D.C.
MedStar Georgetown University Hospital, Washington D.C.
FloridaBroward Health Medical Center, Fort Lauderdale
Golisano Children's Hospital of Southwest Florida, Fort Myers
UF Health Cancer Institute - Gainesville, Gainesville
Memorial Regional Hospital/Joe DiMaggio Children's Hospital, Hollywood
Mayo Clinic in Florida, Jacksonville
Nemours Children's Clinic-Jacksonville, Jacksonville
Nicklaus Children's Hospital, Miami
University of Miami Miller School of Medicine-Sylvester Cancer Center, Miami
Mount Sinai Medical Center, Miami Beach
AdventHealth Orlando, Orlando
Arnold Palmer Hospital for Children, Orlando
Nemours Children's Hospital, Orlando
Nemours Children's Clinic - Pensacola, Pensacola
Johns Hopkins All Children's Hospital, St. Petersburg
Saint Joseph's Hospital/Children's Hospital-Tampa, Tampa
Tampa General Hospital, Tampa
Saint Mary's Medical Center, West Palm Beach
GeorgiaChildren's Healthcare of Atlanta - Arthur M Blank Hospital, Atlanta
Emory Proton Therapy Center, Atlanta
Emory Saint Joseph's Hospital, Atlanta
Emory University Hospital Midtown, Atlanta
Emory University Hospital/Winship Cancer Institute, Atlanta
Grady Health System, Atlanta
Augusta University Medical Center, Augusta
Atrium Health Navicent, Macon
Memorial Health University Medical Center, Savannah
HawaiiKapiolani Medical Center for Women and Children, Honolulu
IdahoSaint Alphonsus Cancer Care Center-Boise, Boise
Saint Luke's Cancer Institute - Boise, Boise
Saint Alphonsus Cancer Care Center-Caldwell, Caldwell
Saint Luke's Cancer Institute - Fruitland, Fruitland
Idaho Urologic Institute-Meridian, Meridian
Saint Luke's Cancer Institute - Meridian, Meridian
Saint Alphonsus Cancer Care Center-Nampa, Nampa
Saint Luke's Cancer Institute - Nampa, Nampa
Saint Luke's Cancer Institute - Twin Falls, Twin Falls
IllinoisRush-Copley Medical Center, Aurora
Advocate Good Shepherd Hospital, Barrington
Advocate Illinois Masonic Medical Center, Chicago
Lurie Children's Hospital-Chicago, Chicago
Mount Sinai Hospital Medical Center, Chicago
Northwestern University, Chicago
Swedish Covenant Hospital, Chicago
University of Chicago Comprehensive Cancer Center, Chicago
University of Illinois, Chicago
AMG Crystal Lake - Oncology, Crystal Lake
Carle at The Riverfront, Danville
Northwestern Medicine Cancer Center Kishwaukee, DeKalb
Decatur Memorial Hospital, Decatur
Advocate Good Samaritan Hospital, Downers Grove
Carle Physician Group-Effingham, Effingham
Crossroads Cancer Center, Effingham
Advocate Sherman Hospital, Elgin
Elmhurst Memorial Hospital, Elmhurst
NorthShore University HealthSystem-Evanston Hospital, Evanston
Northwestern Medicine Cancer Center Delnor, Geneva
NorthShore University HealthSystem-Glenbrook Hospital, Glenview
Advocate South Suburban Hospital, Hazel Crest
NorthShore University HealthSystem-Highland Park Hospital, Highland Park
AMG Libertyville - Oncology, Libertyville
Condell Memorial Hospital, Libertyville
Carle Physician Group-Mattoon/Charleston, Mattoon
Loyola University Medical Center, Maywood
Edward Hospital/Cancer Center, Naperville
HSHS Saint Elizabeth's Hospital, O'Fallon
Advocate Children's Hospital-Oak Lawn, Oak Lawn
Advocate Christ Medical Center, Oak Lawn
Northwestern Medicine Orland Park, Orland Park
Advocate Children's Hospital-Park Ridge, Park Ridge
Advocate Lutheran General Hospital, Park Ridge
OSF Children's Hospital of Illinois, Peoria
Edward Hospital/Cancer Center?Plainfield, Plainfield
UW Health Carbone Cancer Center Rockford, Rockford
Memorial Hospital East, Shiloh
Southern Illinois University School of Medicine, Springfield
Carle Cancer Center, Urbana
Northwestern Medicine Cancer Center Warrenville, Warrenville
Rush-Copley Healthcare Center, Yorkville
IndianaAscension Saint Vincent Indianapolis Hospital, Indianapolis
Riley Hospital for Children, Indianapolis
IowaUI Health Care Mission Cancer and Blood - Ankeny Clinic, Ankeny
Saint Anthony Regional Hospital, Carroll
UI Health Care Mission Cancer and Blood - West Des Moines Clinic, Clive
Blank Children's Hospital, Des Moines
Iowa Methodist Medical Center, 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
KansasWesley Medical Center, Wichita
KentuckyUniversity of Kentucky/Markey Cancer Center, Lexington
Norton Children's Hospital, Louisville
The James Graham Brown Cancer Center at University of Louisville, Louisville
UofL Health Medical Center Northeast, Louisville
LouisianaChildren's Hospital New Orleans, New Orleans
Ochsner Medical Center Jefferson, New Orleans
MaineEastern Maine Medical Center, Bangor
MaineHealth Coastal Cancer Treatment Center, Bath
MaineHealth Maine Medical Center - Portland, Portland
MaineHealth Cancer Care Center of York County, Sanford
Maine Children's Cancer Program, Scarborough
MaineHealth Maine Medical Center- Scarborough, Scarborough
MaineHealth Cancer Care and IV Therapy - South Portland, South Portland
MarylandJohns Hopkins University/Sidney Kimmel Cancer Center, Baltimore
Sinai Hospital of Baltimore, Baltimore
University of Maryland/Greenebaum Cancer Center, Baltimore
Walter Reed National Military Medical Center, Bethesda
MassachusettsDana-Farber Cancer Institute, Boston
UMass Memorial Medical Center - University Campus, Worcester
MichiganC S Mott Children's Hospital, Ann Arbor
Trinity Health Saint Joseph Mercy Hospital Ann Arbor, Ann Arbor
Bronson Battle Creek, Battle Creek
Trinity Health IHA Medical Group Hematology Oncology - Brighton, Brighton
Henry Ford Cancer Institute-Downriver, Brownstown
Trinity Health IHA Medical Group Hematology Oncology - Canton, Canton
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital, Chelsea
Henry Ford Macomb Hospital-Clinton Township, Clinton Township
Corewell Health Dearborn Hospital, Dearborn
Henry Ford Medical Center-Fairlane, Dearborn
Children's Hospital of Michigan, Detroit
Henry Ford Hospital, Detroit
Wayne State University/Karmanos Cancer Institute, Detroit
Corewell Health Farmington Hills Hospital, Farmington Hills
Weisberg Cancer Treatment Center, Farmington Hills
Corewell Health Grand Rapids Hospitals - Butterworth Hospital, Grand Rapids
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital, Grand Rapids
Allegiance Health, Jackson
Bronson Methodist Hospital, Kalamazoo
West Michigan Cancer Center, Kalamazoo
Trinity Health Saint Mary Mercy Livonia Hospital, Livonia
Henry Ford Medical Center-Columbus, Novi
Trinity Health Saint Joseph Mercy Oakland Hospital, Pontiac
Corewell Health Reed City Hospital, Reed City
Corewell Health Children's, Royal Oak
Corewell Health William Beaumont University Hospital, Royal Oak
Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center, Saint Joseph
Henry Ford Health Providence Southfield Hospital, Southfield
Munson Medical Center, Traverse City
Corewell Health Beaumont Troy Hospital, Troy
Henry Ford West Bloomfield Hospital, West Bloomfield
Henry Ford Wyandotte Hospital, Wyandotte
University of Michigan Health - West, Wyoming
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus, Ypsilanti
MinnesotaMercy Hospital, Coon Rapids
Fairview Southdale Hospital, Edina
Abbott-Northwestern Hospital, Minneapolis
Children's Hospitals and Clinics of Minnesota - Minneapolis, Minneapolis
University of Minnesota/Masonic Cancer Center, Minneapolis
Mayo Clinic in Rochester, Rochester
Park Nicollet Clinic - Saint Louis Park, Saint Louis Park
Regions Hospital, Saint Paul
United Hospital, Saint Paul
Minnesota Oncology Hematology PA-Woodbury, Woodbury
MississippiUniversity of Mississippi Medical Center, Jackson
MissouriSaint Francis Medical Center, Cape Girardeau
Saint Luke's Hospital, Chesterfield
Siteman Cancer Center at Saint Peters Hospital, City of Saint Peters
University of Missouri Children's Hospital, Columbia
Siteman Cancer Center at West County Hospital, Creve Coeur
Children's Mercy Hospitals and Clinics, Kansas City
Cardinal Glennon Children's Medical Center, St Louis
Mercy Hospital Saint Louis, St Louis
Siteman Cancer Center at Christian Hospital, St Louis
Siteman Cancer Center-South County, St Louis
Washington University School of Medicine, St Louis
NebraskaNebraska Medicine-Bellevue, Bellevue
Children's Hospital and Medical Center of Omaha, Omaha
Nebraska Medicine-Village Pointe, Omaha
University of Nebraska Medical Center, Omaha
NevadaAlliance for Childhood Diseases/Cure 4 the Kids Foundation, Las Vegas
Renown Regional Medical Center, Reno
New HampshireDartmouth Hitchcock Medical Center/Dartmouth Cancer Center, Lebanon
New JerseyCooper Hospital University Medical Center, Camden
Trinitas Hospital and Comprehensive Cancer Center - Williamson Street Campus, Elizabeth
Hunterdon Medical Center, Flemington
Hackensack University Medical Center, Hackensack
Jersey City Medical Center, Jersey City
Monmouth Medical Center, Long Branch
Morristown Medical Center, Morristown
Jersey Shore Medical Center, Neptune City
Rutgers Cancer Institute of New Jersey, New Brunswick
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital, New Brunswick
Saint Peter's University Hospital, New Brunswick
Newark Beth Israel Medical Center, Newark
Saint Joseph's Regional Medical Center, Paterson
Community Medical Center, Toms River
New MexicoPresbyterian Hospital, Albuquerque
New YorkAlbany Medical Center, Albany
Roswell Park Cancer Institute, Buffalo
Hematology Oncology Associates of CNY at Camillus, Camillus
Hematology Oncology Associates of Central New York-East Syracuse, East Syracuse
NYU Langone Hospital - Long Island, Mineola
The Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park
Laura and Isaac Perlmutter Cancer Center at NYU Langone, New York
Memorial Sloan Kettering Cancer Center, New York
Mount Sinai Hospital, New York
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center, New York
NYP/Weill Cornell Medical Center, New York
University of Rochester, Rochester
Stony Brook University Medical Center, Stony Brook
State University of New York Upstate Medical University, Syracuse
Montefiore Medical Center - Moses Campus, The Bronx
Wilmot Cancer Institute at Webster, Webster
Roswell Park Amherst Center, Williamsville
North CarolinaMission Hospital, Asheville
UNC Lineberger Comprehensive Cancer Center, Chapel Hill
Carolinas Medical Center/Levine Cancer Institute, Charlotte
Novant Health Presbyterian Medical Center, Charlotte
Duke University Medical Center, Durham
East Carolina University, Greenville
Wake Forest University Health Sciences, Winston-Salem
North DakotaSanford Broadway Medical Center, Fargo
OhioChildren's Hospital Medical Center of Akron, Akron
Cincinnati Children's Hospital Medical Center, Cincinnati
Cleveland Clinic Foundation, Cleveland
Rainbow Babies and Childrens Hospital, Cleveland
Nationwide Children's Hospital, Columbus
Dayton Children's Hospital, Dayton
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital, Toledo
OklahomaUniversity of Oklahoma Health Sciences Center, Oklahoma City
Saint Francis Children's Hospital, Tulsa
OregonSaint Alphonsus Cancer Care Center-Baker City, Baker City
Saint Alphonsus Cancer Care Center-Ontario, Ontario
Legacy Emanuel Children's Hospital, Portland
Oregon Health and Science University, Portland
Providence Portland Medical Center, Portland
Providence Saint Vincent Medical Center, Portland
PennsylvaniaLehigh Valley Hospital-Cedar Crest, Allentown
Geisinger Medical Center, Danville
Penn State Children's Hospital, Hershey
Children's Hospital of Philadelphia, Philadelphia
Saint Christopher's Hospital for Children, Philadelphia
Thomas Jefferson University Hospital, Philadelphia
Children's Hospital of Pittsburgh of UPMC, Pittsburgh
Rhode IslandRhode Island Hospital, Providence
Smilow Cancer Hospital Care Center - Westerly, Westerly
South CarolinaPrisma Health Cancer Institute - Spartanburg, Boiling Springs
Medical University of South Carolina, Charleston
Prisma Health Richland Hospital, Columbia
BI-LO Charities Children's Cancer Center, Greenville
Prisma Health Cancer Institute - Eastside, Greenville
Saint Francis Cancer Center, Greenville
Saint Francis Hospital, Greenville
South DakotaSanford USD Medical Center - Sioux Falls, Sioux Falls
TennesseeT C Thompson Children's Hospital, Chattanooga
East Tennessee Childrens Hospital, Knoxville
The Children's Hospital at TriStar Centennial, Nashville
Vanderbilt University/Ingram Cancer Center, Nashville
TexasDell Children's Medical Center of Central Texas, Austin
Driscoll Children's Hospital, Corpus Christi
Medical City Dallas Hospital, Dallas
UT Southwestern/Simmons Cancer Center-Dallas, Dallas
El Paso Children's Hospital, El Paso
Cook Children's Medical Center, Fort Worth
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center, Houston
UT MD Anderson Cancer Center, Houston
Covenant Children's Hospital, Lubbock
UMC Cancer Center / UMC Health System, Lubbock
Children's Hospital of San Antonio, San Antonio
Methodist Children's Hospital of South Texas, San Antonio
University of Texas Health Science Center at San Antonio, San Antonio
Scott and White Memorial Hospital, Temple
UtahHuntsman Cancer Institute/University of Utah, Salt Lake City
Primary Children's Hospital, Salt Lake City
VermontUniversity of Vermont and State Agricultural College, Burlington
VirginiaUniversity of Virginia Cancer Center, Charlottesville
Inova Fairfax Hospital, Falls Church
Children's Hospital of The King's Daughters, Norfolk
Naval Medical Center - Portsmouth, Portsmouth
VCU Massey Comprehensive Cancer Center, Richmond
Carilion Children's, Roanoke
WashingtonValley Medical Center, Renton
Seattle Children's Hospital, Seattle
Providence Sacred Heart Medical Center and Children's Hospital, Spokane
Mary Bridge Children's Hospital and Health Center, Tacoma
West VirginiaWest Virginia University Charleston Division, Charleston
Edwards Comprehensive Cancer Center, Huntington
WisconsinAurora Cancer Care-Southern Lakes VLCC, Burlington
Aurora Saint Luke's South Shore, Cudahy
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
Aurora Cancer Care-Kenosha South, Kenosha
Gundersen Lutheran Medical Center, La Crosse
University of Wisconsin Carbone Cancer Center - Eastpark Medical Center, Madison
University of Wisconsin Carbone Cancer Center - University Hospital, Madison
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
Children's Hospital of Wisconsin, Milwaukee
ProHealth D N Greenwald Center, Mukwonago
ProHealth Oconomowoc Memorial Hospital, Oconomowoc
Vince Lombardi Cancer Clinic - Oshkosh, Oshkosh
Aurora Cancer Care-Racine, Racine
Saint Vincent Hospital Cancer Center at Sheboygan, Sheboygan
Vince Lombardi Cancer Clinic-Sheboygan, Sheboygan
Saint Vincent Hospital Cancer Center at Sturgeon Bay, Sturgeon Bay
Aurora Medical Center in Summit, Summit
Vince Lombardi Cancer Clinic-Two Rivers, Two Rivers
UW Cancer Center at ProHealth Care, Waukesha
Aurora Cancer Care-Milwaukee West, Wauwatosa
Aurora West Allis Medical Center, West Allis

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