S1803, Lenalidomide +/- Daratumumab/rHuPh20 as Post-ASCT Maintenance for MM w/MRD to Direct Therapy Duration (DRAMMATIC) DRAMMATIC

What's the purpose of this trial?

Patients are randomized between Lenalidomide for 2 years and Lenalidomide + Daratumumab/rHuPH20. After 2 years of Maintenance, MRD is assessed to guide further therapy. MRD-positive patients will continue with the assigned treatment. MRD-negative patients will be further randomized (Reg Step 3) to either continue or discontinue the assigned treatment. 

This trial is currently open and accepting patients.

What will happen during the trial?

You may be able to join this trial if you:

The following criteria is a partial list of reasons why patients may be eligible to participate in this clinical trial. Further evaluation with a medical professional is required.

Registration Step 1 Except where otherwise indicated below that test is required in a shorter timeframe, all tests for establishing baseline disease status must be completed within 60 days prior to registration. All test results must be documented on the Baseline Tumor Assessment Form for Multiple Myeloma and the Onstudy Form.

Inclusion Criteria

  • Patients must have had a confirmed diagnosis of symptomatic multiple myeloma (See Section 4.1) that required systemic induction therapy prior to autologous stem cell transplantation (ASCT).
  • Patients with disease measurable by serum light chain assay alone are eligible (defined as >/= 100 mg/L on involved light chain).
  • Patients must be registered to Step 1 prior to registration to Step 2. Registration to Step 1 may take place prior to or after autologous stem cell transplant (ASCT), but after completion of induction therapy.
  • Patients must have initiated induction therapy within 12 months prior to registration Step 1 and have received at least two cycles of induction therapy.
  • Patients must be willing and able to take DVT prophylaxis (aspirin, low molecular weight heparin, warfarin, or equivalent oral anticoagulation).
  • Patients must be >/= 18 and </= 75 years of age at time of registration to Step 1.
  • Patients must have history and physical exam within 28 days prior to registration.
  • Patients must have Zubrod Performance Status </= 2.
  • Patients must have evidence of adequate renal function, as defined by (1) creatinine clearance (CrCl) >/= 30 mL/min., as measured by a 24-hour urine collection, or estimated by the Cockcroft and Gault formula, or (2) serum creatinine < 2.5 mg/dL. Values must be obtained within 28 days prior to registration.
  • Patients must have adequate hepatic function defined by the following within 42 days prior to registration:
    • Total bilirubin </=1.5 x IULN (institutional upper limit of the norm) AND
    • AST and ALT </=3.0 x IULN
  • Patients must meet one of the following criteria:
    • Be acceptable for transplant per institutional guidelines and the criteria evidencing this must be documented on the S1803 Onstudy Form. (See Appendix 18.3 for standard transplant eligibility guidelines. Note that these are guidelines and not required criteria.) OR
    • Have completed autologous stem cell transplant within 180 days prior to registration (see also Section 5.2a).
  • Patient's with human immunodeficiency virus (HIV) are eligible providing they are on effective antiretroviral therapy and have undetectable viral load at their most previous viral load test and within 6 months prior to registration.
  • Patients must be able to take and swallow oral medication (capsules) whole. Patients may not have any known impairment of gastrointestinal function or gastrointestinal disease that may significantly alter the absorption of study drug (e.g. ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection).
  • For patients who have not yet received transplant: Patients must be willing and able to return to the transplant center for their assigned treatment after randomization. Note that patients need not have a direct relationship with the transplant center in order to register.
  • Patients must submit specimens for MRD as outlined in Section 15.1. See Section 15.1 for further information, including specimen submission timepoints. Note that patients are not ineligible based solely on archival specimens being unavailable.
  • Patients must be offered participation in specimen banking for future research. With patient's consent, specimens must be submitted as outlined in Section 15.2.
  • Patients must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines.
  • As a part of the OPEN registration process (see Section 13.3 for OPEN access instructions) the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the system.

Exclusion Criteria

  • Patients with smoldering myeloma are not eligible. Patients with purely non-secretory MM as measured by electrophoresis and immunofixation and the absence of Bence Jones proteins in the urine are not eligible. Patients must have measurable M protein in the serum (defined as >/= 0.5g/dL) or urine (defined as >/= 200 mg/24h). Patients with plasma cell leukemia are not eligible.
  • Patients must not have any organ involvement by amyloidosis or evidence of amyloidosis related organ dysfunction.
  • Patients must not have progressive disease at any time prior to registration.
  • Patients must not be refractory to either lenalidomide or daratumumab/rHuPH20.
  • Patients must not be intolerant to either lenalidomide or daratumumab/rHuPH20.
  • Patients must not have received any investigational agents within 14 days prior to registration.
  • Patients must not have chronic obstructive pulmonary disease with a forced expiratory volume in 1 second (FEV1) < 50% of predicted normal. FEV1 is required for patients suspected of having chronic obstructive pulmonary disease and are not eligible if FEV1 is < 50% of predicted normal.
  • Patients must not have moderate or severe persistent asthma within the past 2 years and must not have currently uncontrolled asthma of any classification.
  • Patients must not have had prior autograft or allograft, or prior organ transplant requiring immunosuppressive therapy.
  • Patients must not have known allergy to any of the study drugs.
  • Patients with uncontrolled bacterial, viral or fungal infections (currently taking medication and with progression or no clinical improvement) at time of enrollment are not eligible.
  • Patients must not have known central nervous system (CNS) involvement with multiple myeloma, defined as CSF positivity for plasma cells at any time or a parenchymal CNS plasmacytoma at time of enrollment. Lumbar puncture is not required.
  • Patients must not be seropositive for hepatitis C (except in the setting of sustained virologic response, defined as undetectable viral load at least 12 weeks after completion of antiviral therapy). HCV testing is only required if clinically indicated or if the patient has a history of HCV.
  • No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, adequately treated Stage I or II cancer from which the patient is currently in complete remission, or any other cancer from which the patient has been disease free for three years.
  • Patients must not have any uncontrolled intercurrent illness including (not limited to): Symptomatic CHF (NYHA III/IV), unstable angina pectoris or coronary angioplasty, or stenting within 6 months prior to registration, Unstable cardiac arrhythmia (ongoing cardiac dysrhythmias of NCI CTCAE v5.0 Grade >/= 2), intra-cardiac defibrillators, known cardiac metastases, or abnormal cardiac valve morphology (>/= Grade 3), or known psychiatric illness that would limit study compliance.

Registration Step 2 - First Randomization (Post-ASCT, Pre-Maintenance)

Inclusion Criteria:

  • Patients must have completed ASCT within 180 days prior to registering to Step 2.
  • Patients must have one of the following performed within 60 days prior to registration for disease assessment: diagnostic quality skeletal survey, whole body CT scan, MRI, or PET.
  • Patients must have Zubrod Performance Status </= 2
  • Patients must have adequate bone marrow function as evidenced by platelets >/= 75,000/mm3 and ANC >/= 1,000/mm3 within 28 days prior to first randomization:
  • Patients must have adequate hepatic function defined by the following within 28 days prior to first randomization:
  • Total bilirubin </=1.5 x IULN (institutional upper limit of the norm) AND AST and ALT </=3.0 x IULN
  • Patients must have evidence of adequate renal function, as defined by creatinine clearance (CrCl) >/= 30 mL/min., as measured by a 24-hour urine collection, or estimated by the Cockcroft and Gault formula, or have a serum creatinine < 2.5 mg/dL within 28 days prior to first randomization.
  • All ASCT-related toxicities must have recovered to </=Grade 1 (except for alopecia, fatigue and amenorrhea) prior to first randomization.
  • Mucositis and gastrointestinal symptoms must have resolved to </=Grade 1.
  • Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 25 mIU/mL within 10-14 days prior to registration.
  • FCBP must agree to have a second pregnancy test within 24 hours prior to starting Cycle 1. Further, FCBP must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control: one highly effective method and one additional effective method AT THE SAME TIME, at least 28 days before starting lenalidomide. FCBP must also agree to ongoing pregnancy testing and must agree to not become pregnant for at least 3 months after the last dose of study treatment.
  • Men must agree to use a latex condom during sexual contact with a FCBP, even if they have had a successful vasectomy, during the study treatment and for 3 months after the last dose of study treatment.
  • Patients must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines.

Exclusion Criteria:

  • Patients must not have received any other maintenance therapy post-ASCT and prior to Step 2 registration.
  • Patients must not have had progressive disease between induction and registration to Registration Step 2. (See Section 10.1b).

Registration Step 3 - Second Randomization (Post 24 Months Maintenance)

Inclusion Criteria:

  • Patients must have completed 24 cycles of protocol maintenance with either lenalidomide or lenalidomide + daratumumab/rHuPH20.
  • Patients must have 24-month MRD by NGS test results available and must be MRD negative. Patients whose PCR results are indeterminable will be considered to have positive results.
  • Patients must be in very good partial remission (VGPR) or better by IMWG response criteria (see Section 10.1b).

Additional Trial Information

Phase 3

Enrollment: 1,100 patients (estimated)

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Trial Locations

All Trial Locations

View all clinical trial locations sorted by state.

Alaska

Alaska Women's Cancer Care

Anchorage, AK

Open and Accepting

Anchorage Oncology Centre

Anchorage, AK

Open and Accepting

Katmai Oncology Group

Anchorage, AK

Open and Accepting

Providence Alaska Medical Center

Anchorage, AK

Open and Accepting

Arizona

Mayo Clinic (Arizona)

Phoenix, AZ

Open and Accepting

University of Arizona Cancer Center North Campus

Tucson, AZ

Open and Accepting

Banner - University Medical Center Tucson Banner Health

Tucson, AZ

Open and Accepting

Arkansas

Mercy Hospital Fort Smith

Fort Smith, AR

Open and Accepting

California

Kaiser Permanente (Antioch Medical Center)

Antioch, CA

Open and Accepting

Alta Bates Summit Medical Center - Alta Bates Campus

Berkeley, CA

Open and Accepting

Roy and Patricia Disney Family Cancer Center Providence Saint Joseph Medical Center

Burbank, CA

Open and Accepting

City of Hope Comprehensive Cancer Center Beckman Research Institute

Duarte, CA

Open and Accepting

Kaiser Permanente (Dublin)

Dublin, CA

Open and Accepting

Kaiser Permanente (Fremont Medical Center)

Fremont, CA

Open and Accepting

Kaiser Permanente (Fresno Medical Center)

Fresno, CA

Open and Accepting

Rideout Cancer Center (Fremont)

Linda, CA

Open and Accepting

Cedars-Sinai Medical Center Samuel Oschin Comprehensive Cancer Institute

Los Angeles, CA

Open and Accepting

Kaiser Permanente (Modesto Medical Center)

Modesto, CA

Open and Accepting

Kaiser Permanente (Oakland Medical Center)

Oakland, CA

Open and Accepting

Chao Family Comprehensive Cancer Center University of California, Irvine

Orange, CA

Open and Accepting

Kaiser Permanente (Redwood City Medical Center)

Redwood City, CA

Open and Accepting

Kaiser Permanente (Richmond Medical Center)

Richmond, CA

Open and Accepting

Kaiser Permanente - Roseville Medical Center

Roseville, CA

Open and Accepting

Kaiser Permanente (Sacramento Medical Center)

Sacramento, CA

Open and Accepting

University of California Davis Comprehensive Cancer Center

Sacramento, CA

Open and Accepting

Kaiser Permanente (South Sacramento Medical Center)

Sacramento, CA

Open and Accepting

Kaiser Permanente (San Francisco Medical Center)

San Francisco, CA

Open and Accepting

Kaiser Permanente (San Jose Medical Center)

San Jose, CA

Open and Accepting

Kaiser Permanente - San Leandro Medical Center

San Leandro, CA

Open and Accepting

Kaiser Permanente (San Rafael Medical Center)

San Rafael, CA

Open and Accepting

Kaiser Permanente (Santa Clara Medical Center)

Santa Clara, CA

Open and Accepting

Mission Hope Cancer Center (Santa Maria) Central Coast Medical Oncology

Santa Maria, CA

Open and Accepting

Kaiser Permanente (Santa Rosa Medical Center)

Santa Rosa, CA

Open and Accepting

Kaiser Permanente (South San Francisco Medical Center)

South San Francisco, CA

Open and Accepting

Kaiser Permanente (Stockton Medical Center)

Stockton, CA

Open and Accepting

Tahoe Forest Cancer Center

Truckee, CA

Open and Accepting

Kaiser Permanente (Vacaville Medical Center)

Vacaville, CA

Open and Accepting

Kaiser Permanente (Vallejo Medical Center)

Vallejo, CA

Open and Accepting

Kaiser Permanente (Walnut Creek Medical Center)

Walnut Creek, CA

Open and Accepting

Colorado

Littleton Adventist Hospital

Centennial, CO

Open and Accepting

Centura Penrose Hospital

Colorado Springs, CO

Open and Accepting

Rocky Mountain Cancer Center - Penrose Hospital Colorado Springs

Colorado Springs, CO

Open and Accepting

St. Francis Medical Center Catholic Health Initiatives

Colorado Springs, CO

Open and Accepting

Kaiser Permanente (Franklin)

Denver, CO

Open and Accepting

Porter Adventist Hospital

Denver, CO

Open and Accepting

Centura Mercy Hospital

Durango, CO

Open and Accepting

Centura Southwest Oncology

Durango, CO

Open and Accepting

Kaiser Permanente - Rock Creek

Lafayette, CO

Open and Accepting

Centura St. Anthony Hospital

Lakewood, CO

Open and Accepting

Kaiser Permanente (Lone Tree) Lone Tree Medical Offices

Lone Tree, CO

Open and Accepting

Centura Longmont United Hospital

Longmont, CO

Open and Accepting

Rocky Mountain Cancer Centers (Longmont) Longmont

Longmont, CO

Temporarily Suspended

Centura Parker Adventist Hospital

Parker, CO

Open and Accepting

Saint Mary Corwin Medical Center

Pueblo, CO

Open and Accepting

Delaware

Beebe Medical Center

Lewes, DE

Open and Accepting

ChristianaCare Hematology

Newark, DE

Open and Accepting

ChristianaCare Helen F. Graham Cancer Center Christiana Hospital

Newark, DE

Open and Accepting

Medical Oncology Hematology Consultants PA in ChristianaCare Helen F. Graham Cancer Center & Research Institute

Newark, DE

Open and Accepting

Christiana Care Health System (Christiana Hospital)

Newark, DE

Open and Accepting

Beebe Health Campus

Rehoboth Beach, DE

Open and Accepting

Nanticoke Memorial Hospital

Seaford, DE

Temporarily Suspended

Christiana Care Health System (Wilmington Hospital)

Wilmington, DE

Open and Accepting

Florida

Shands Hospital University of Florida Health

Gainesville, FL

Open and Accepting

Sylvester Comprehensive Cancer Center (Main) University of Miami Health System

Miami, FL

Open and Accepting

Advent Health Cancer Institute (Orlando)

Orlando, FL

Open and Accepting

Moffitt Cancer Center Magnolia Campus

Tampa, FL

Open and Accepting

Georgia

Northside Hospital (Atlanta)

Atlanta, GA

Open and Accepting

Grady Memorial Hospital

Atlanta, GA

Open and Accepting

Hawaii

Pali Momi Medical Center

Aiea, HI

Open and Accepting

Kaiser Permanente (Moanalua Medical Center)

Honolulu, HI

Open and Accepting

Kapiolani Medical Center for Women and Children

Honolulu, HI

Open and Accepting

Idaho

St. Luke's Cancer Institute - Boise

Boise, ID

Open and Accepting

Saint Alphonsus Cancer Care Center (Boise)

Boise City, ID

Open and Accepting

Kootenai Clinic Cancer Services - Coeur d'Alene

Coeur d'Alene, ID

Open and Accepting

Saint Luke's Mountain States Tumor Institute (Fruitland)

Fruitland, ID

Open and Accepting

St. Luke's Cancer Institute (Meridian)

Meridian, ID

Open and Accepting

Saint Luke's Mountain States Tumor Institute (Nampa)

Nampa, ID

Open and Accepting

Kootenai Cancer Center

Post Falls, ID

Open and Accepting

Kootenai Clinic

Sandpoint, ID

Open and Accepting

Saint Luke's Mountain States Tumor Institute (Twin Falls)

Twin Falls, ID

Open and Accepting

Illinois

Illinois CancerCare (Bloomington)

Bloomington, IL

Open and Accepting

Loyola Center for Health at Burr Ridge

Burr Ridge, IL

Open and Accepting

Illinois CancerCare (Canton)

Canton, IL

Open and Accepting

Memorial Hospital of Carbondale

Carbondale, IL

Open and Accepting

SIH Cancer Institute

Carterville, IL

Open and Accepting

Illinois CancerCare (Carthage)

Carthage, IL

Open and Accepting

Centralia Oncology Clinic

Centralia, IL

Open and Accepting

Advocate Illinois Masonic Medical Center

Chicago, IL

Open and Accepting

Cancer Care Specialists of IL - Cancer Care Center of Decatur

Decatur, IL

Open and Accepting

Memorial Health - Decatur Memorial Hospital Memorial Health

Decatur, IL

Open and Accepting

Illinois CancerCare-Dixon

Dixon, IL

Open and Accepting

Cancer Care Specialists (Crossroads Cancer Center)

Effingham, IL

Open and Accepting

Illinois CancerCare (Eureka)

Eureka, IL

Open and Accepting

Illinois CancerCare (Galesburg)

Galesburg, IL

Open and Accepting

Western Illinois Cancer Treatment Center

Galesburg, IL

Open and Accepting

Illinois CancerCare (Kewanee)

Kewanee, IL

Open and Accepting

Illinois CancerCare (Macomb)

Macomb, IL

Open and Accepting

Loyola University Medical Center Cardinal Bernardin Cancer Center

Maywood, IL

Open and Accepting

Marjorie Weinberg Cancer Center at Loyola-Gottlieb

Melrose Park, IL

Open and Accepting

Good Samaritan Regional Health Center

Mount Vernon, IL

Open and Accepting

Illinois CancerCare - Fox River Cancer Center

Ottawa, IL

Open and Accepting

Advocate Lutheran General Hospital

Park Ridge, IL

Open and Accepting

Illinois CancerCare - Pekin

Pekin, IL

Open and Accepting

Illinois CancerCare - Peoria

Peoria, IL

Open and Accepting

Methodist Medical Center of Illinois

Peoria, IL

Open and Accepting

Illinois CancerCare - Peru In Valley Regional Cancer Center

Peru, IL

Open and Accepting

US Oncology - Valley Regional Cancer Center

Peru, IL

Open and Accepting

Illinois CancerCare - Princeton

Princeton, IL

Open and Accepting

Southern Illinois University School of Medicine - Simmons Cancer Institute

Springfield, IL

Open and Accepting

Springfield Clinic

Springfield, IL

Open and Accepting

Memorial Medical Center

Springfield, IL

Open and Accepting

Cancer Care Specialists of Illinois (Swansea)

Swansea, IL

Open and Accepting

Indiana

IU Simon Cancer Center Indiana University

Indianapolis, IN

Open and Accepting

Springmill Medical Center

Indianapolis, IN

Temporarily Suspended

Iowa

Holden Comprehensive Cancer Center University of Iowa Hospitals and Clinics

Iowa City, IA

Open and Accepting

Mary Greeley Medical Center

Ames, IA

Open and Accepting

McFarland Clinic PC

Ames, IA

Open and Accepting

McFarland Clinic PC (Boone)

Boone, IA

Open and Accepting

Broadlawns Medical Center

Des Moines, IA

Open and Accepting

Mission Cancer MercyOne Cancer Center (Laurel)

Des Moines, IA

Open and Accepting

MercyOne Des Moines Medical Center

Des Moines, IA

Open and Accepting

Iowa Lutheran Hospital

Des Moines, IA

Open and Accepting

McFarland Clinic Trinity Cancer Center

Fort Dodge, IA

Open and Accepting

UnityPoint Health - Trinity Regional Medical Center

Fort Dodge, IA

Open and Accepting

McFarland Clinic PC (Jefferson)

Jefferson, IA

Open and Accepting

McFarland Clinic PC (Marshalltown)

Marshalltown, IA

Open and Accepting

MercyOne West Des Moines Medical Center

West Des Moines, IA

Open and Accepting

UnityPoint Health - Methodist West Hospital

West Des Moines, IA

Open and Accepting

Kansas

Central Care Cancer Center (Heartland)

Garden City, KS

Open and Accepting

Central Care Cancer Center - Great Bend

Great Bend, KS

Open and Accepting

University of Kansas Cancer Center

Kansas City, KS

Open and Accepting

Kentucky

Flaget Memorial Hospital

Bardstown, KY

Open and Accepting

Commonwealth Cancer Center (Corbin)

Corbin, KY

Open and Accepting

Saint Joseph Hospital

Lexington, KY

Open and Accepting

Saint Joseph Hospital East

Lexington, KY

Open and Accepting

UK Markey Cancer Center University of Kentucky

Lexington, KY

Open and Accepting

U of L Health - Jewish Hospital

Louisville, KY

Open and Accepting

U of L Health - Brown Cancer Center University of Louisville

Louisville, KY

Open and Accepting

Saints Mary and Elizabeth Hospital

Louisville, KY

Temporarily Suspended

Jewish Hospital Medical Center Northeast

Louisville, KY

Temporarily Suspended

Jewish Hospital Medical Center South

Shepherdsville, KY

Temporarily Suspended

Louisiana

Hematology Oncology Clinic

Baton Rouge, LA

Temporarily Suspended

Tulane Cancer Center Tulane University School of Medicine

New Orleans, LA

Open and Accepting

Ochsner LSU Health Shreveport Ochsner Louisiana State University

Shreveport, LA

Open and Accepting

Maine

Eastern Maine Medical Center

Bangor, ME

Open and Accepting

Northern Light Cancer Center: Lafayette Family Cancer Institute - Jackson Laboratory-Maine Cancer Genomics Initiative Lafayette Family Cancer Institute

Brewer, ME

Open and Accepting

Maryland

Walter Reed National Military Medical Center

Bethesda, MD

Open and Accepting

Massachusetts

Boston Medical Center

Boston, MA

Open and Accepting

Lahey Hospital and Medical Center

Burlington, MA

Open and Accepting

University of Massachusetts Medical School

Worcester, MA

Open and Accepting

Michigan

University of Michigan Comprehensive Cancer Center Rogel Cancer Center

Ann Arbor, MI

Open and Accepting

Bronson Battle Creek Cancer Care Center

Battle Creek, MI

Open and Accepting

St. Joseph Mercy Brighton Health Center

Brighton, MI

Open and Accepting

IHA Hematology Oncology at St. Joe's Brighton

Brighton, MI

Open and Accepting

St. Joseph Mercy Canton Health Center

Canton, MI

Open and Accepting

IHA Hematology Oncology at St. Joe's Canton

Canton, MI

Open and Accepting

Caro Cancer Center

Caro, MI

Open and Accepting

St. Joseph Mercy Chelsea Hospital Michigan Cancer Research Consortium

Chelsea, MI

Open and Accepting

IHA Hematology Oncology at St. Joe's Chelsea

Chelsea, MI

Open and Accepting

Hematology Oncology Consultants (Clarkston)

Clarkston, MI

Open and Accepting

Karmanos Cancer Institute at McLaren Clarkston

Clarkston, MI

Open and Accepting

Newland Medical Associates of Clarkston

Clarkston, MI

Open and Accepting

Barbara Ann Karmanos Cancer Institute Wayne State University

Detroit, MI

Open and Accepting

Great Lakes Cancer Management Specialists (Doctors Park)

East China, MI

Open and Accepting

Karmanos-Weisberg Cancer Treatment Center

Farmington Hills, MI

Open and Accepting

Beaumont Hospital

Farmington Hills, MI

Open and Accepting

McLaren Regional Medical Center (Flint)

Flint, MI

Open and Accepting

Genesee Cancer and Blood Disease Treatment Center Genesys Hurley Cancer Institute

Flint, MI

Open and Accepting

Genesee Hematology Oncology PC Genesys Hurley Cancer Institute

Flint, MI

Open and Accepting

Michigan Cancer Research Consortium - Genesys Hurley Cancer Institute (Genesee Hematology Oncology, PC)

Flint, MI

Open and Accepting

Hurley Medical Center

Flint, MI

Open and Accepting

Karmanos Cancer Institute at McLaren Flint

Flint, MI

Open and Accepting

Mercy Health Saint Mary's

Grand Rapids, MI

Open and Accepting

Spectrum Health

Grand Rapids, MI

Open and Accepting

Academic Hematology Oncology Specialists Ascension St. John Hospital

Grosse Pointe Woods, MI

Open and Accepting

Great Lakes Cancer Management Specialists (Van Elslander Cancer Center) Ascension St. John Hospital

Grosse Pointe Woods, MI

Open and Accepting

Bronson Methodist Hospital

Kalamazoo, MI

Open and Accepting

West Michigan Cancer Center

Kalamazoo, MI

Open and Accepting

Borgess Medical Center

Kalamazoo, MI

Open and Accepting

Sparrow Hospital

Lansing, MI

Open and Accepting

St. Mary Mercy Hospital St. Joe's Health

Livonia, MI

Open and Accepting

Great Lakes Cancer Management Specialists (Macomb Medical Campus)

Macomb, MI

Open and Accepting

Michigan Cancer Research Consortium - Saint Mary's Oncology/Hematology Associates of Marlette

Marlette, MI

Open and Accepting

Trinity Health Muskegon Hospital

Muskegon, MI

Open and Accepting

Lakeland Community Hospital

Niles, MI

Open and Accepting

Newland Medical Associates (Pontiac) The Alice Gustafson Center

Pontiac, MI

Open and Accepting

Spectrum Health Reed City Hospital

Reed City, MI

Open and Accepting

Spectrum Health Lakeland Medical Center

St. Joseph, MI

Open and Accepting

Spectrum Health Marie Yeager Cancer Center

St. Joseph, MI

Open and Accepting

Munson Medical Center

Traverse City, MI

Open and Accepting

Minnesota

Essentia Health Saint Joseph's Medical Center

Brainerd, MN

Open and Accepting

M Health Fairview Ridges Hospital

Burnsville, MN

Open and Accepting

Cambridge Medical Center

Cambridge, MN

Open and Accepting

Mercy Hospital

Coon Rapids, MN

Open and Accepting

Essentia Health

Deer River, MN

Open and Accepting

Essentia Health (Duluth Clinic)

Duluth, MN

Open and Accepting

Essentia Health Saint Mary's Medical Center

Duluth, MN

Open and Accepting

Essentia Health (Miller-Dwan Building)

Duluth, MN

Open and Accepting

Fairview Southdale Hospital

Edina, MN

Open and Accepting

Lake Region Healthcare Corporation-Cancer Care

Fergus Falls, MN

Open and Accepting

Unity Hospital

Fridley, MN

Open and Accepting

Essentia Health Hibbing Clinic

Hibbing, MN

Open and Accepting

Fairview Maple Grove Medical Center

Maple Grove, MN

Open and Accepting

Minnesota Oncology Maplewood Cancer Center

Maplewood, MN

Open and Accepting

M Health Fairview St. John's Hospital

Maplewood, MN

Open and Accepting

Abbott-Northwestern Hospital Allina Health

Minneapolis, MN

Open and Accepting

Hennepin County Medical Center

Minneapolis, MN

Open and Accepting

Health Partners Inc.

Minneapolis, MN

Open and Accepting

University of Minnesota - Masonic Cancer Center University of Minnesota

Minneapolis, MN

Open and Accepting

Monticello Cancer Center

Monticello, MN

Open and Accepting

New Ulm Medical Center

New Ulm, MN

Open and Accepting

Fairview Northland Medical Center

Princeton, MN

Open and Accepting

North Memorial Medical Health Center

Robbinsdale, MN

Open and Accepting

Mayo Clinic (Rochester)

Rochester, MN

Open and Accepting

Saint Francis Regional Medical Center

Shakopee, MN

Open and Accepting

Coborn Cancer Center at Saint Cloud Hospital

St. Cloud, MN

Open and Accepting

Park Nicollet Specialty Center at Methodist Hospital

St. Louis Park, MN

Open and Accepting

Park Nicollet Institute (Louisiana Avenue)

St. Louis Park, MN

Open and Accepting

Regions Hospital

St. Paul, MN

Open and Accepting

United Hospital

St. Paul, MN

Open and Accepting

Lakeview Hospital

Stillwater, MN

Open and Accepting

Essentia Health Virginia Clinic

Virginia, MN

Open and Accepting

Ridgeview Medical Center

Waconia, MN

Open and Accepting

Rice Memorial Hospital

Willmar, MN

Open and Accepting

Minnesota Oncology and Hematology PA (Woodbury)

Woodbury, MN

Open and Accepting

Fairview Lakes Medical Center

Wyoming, MN

Open and Accepting

Missouri

Alvin J. Siteman Cancer Center Washington University Medical Campus

St. Louis, MO

Open and Accepting

Saint Louis Cancer and Breast Institute

Ballwin, MO

Open and Accepting

Central Care Cancer Center

Bolivar, MO

Open and Accepting

Parkland Health Center (Bonne Terre)

Bonne Terre, MO

Open and Accepting

CoxHealth Cancer Center

Branson, MO

Open and Accepting

Saint Francis Medical Center (Cape Girardeau)

Cape Girardeau, MO

Open and Accepting

Southeast Cancer Center Southeast Health

Cape Girardeau, MO

Open and Accepting

Siteman Cancer Center at Barnes-Jewish West County Hospital

Creve Coeur, MO

Open and Accepting

Capital Region Medical Center (Goldschmidt Cancer Center)

Jefferson City, MO

Open and Accepting

Freeman Cornell-Beshore Cancer Institute

Joplin, MO

Open and Accepting

Phelps Health Hospital

Rolla, MO

Open and Accepting

Mercy Clinic Cancer and Hematology (Rolla)

Rolla, MO

Open and Accepting

Siteman Cancer Center at Saint Peters Hospital

Saint Peters, MO

Open and Accepting

Sainte Genevieve County Memorial Hospital

Sainte Genevieve, MO

Open and Accepting

Mercy Hospital Springfield

Springfield, MO

Open and Accepting

CoxHealth South Hospital Cox Medical Center South

Springfield, MO

Open and Accepting

St. Joseph Oncology

St. Joseph, MO

Open and Accepting

Heartland Regional Medical Center

St. Joseph, MO

Open and Accepting

Saint Louis Cancer and Breast Institute (South City)

St. Louis, MO

Open and Accepting

Mercy Hospital South

St. Louis, MO

Open and Accepting

Siteman Cancer Center (South St. Louis County)

St. Louis, MO

Open and Accepting

Missouri Baptist Medical Cancer Center

St. Louis, MO

Open and Accepting

Mercy Hospital St. Louis David C. Pratt Cancer Center

St. Louis, MO

Open and Accepting

Missouri Baptist Sullivan Hospital

Sullivan, MO

Open and Accepting

Missouri Baptist Outpatient Center (Sunset Hills)

Sunset Hills, MO

Open and Accepting

Mercy Hospital Washington

Washington, MO

Open and Accepting

Montana

Community Hospital of Anaconda

Anaconda, MT

Open and Accepting

Billings Clinic Cancer Center

Billings, MT

Open and Accepting

Bozeman Deaconess Hospital

Bozeman, MT

Open and Accepting