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

What's the purpose of this trial?

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).

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.

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

Additional Trial Information

Phase 3

Enrollment: 1,450 patients (estimated)

View More
Need Help?

Interested in joining or learning more about this trial?

(888) 828-2206

Trial Locations

This clinical trial is not limited to the sites that you find listed below. If you are a patient and do not see your center listed as a participating site below, please contact SparkCures at (888) 828-2206 for additional assistance.

All Trial Locations

View all clinical trial locations sorted by state.

Alaska

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

University of Arizona Cancer Center - North Campus

Tucson, AZ

Open and Accepting

Banner - University Medical Center Tucson Banner Health

Tucson, AZ

Open and Accepting

California

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

Burbank, CA

Open and Accepting

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

Santa Maria, 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

Porter Adventist Hospital

Denver, CO

Open and Accepting

Centura Mercy Hospital

Durango, CO

Open and Accepting

Centura Southwest Oncology

Durango, CO

Open and Accepting

Centura St. Anthony Hospital

Lakewood, CO

Open and Accepting

Centura Longmont United Hospital

Longmont, CO

Open and Accepting

Rocky Mountain Cancer Centers (Longmont) Longmont

Longmont, CO

Open and Accepting

Centura Parker Adventist Hospital

Parker, CO

Open and Accepting

Saint Mary Corwin Medical Center

Pueblo, CO

Open and Accepting

Connecticut

Smilow Cancer Hospital Care Center (Derby)

Derby, CT

Open and Accepting

Yale Cancer Center - Smilow Cancer Hospital Care Center Fairfield

Fairfield, CT

Open and Accepting

Smilow Cancer Hospital Care Center (Glastonbury)

Glastonbury, CT

Open and Accepting

Smilow Cancer Hospital Care Center

Greenwich, CT

Open and Accepting

Smilow Cancer Hospital - Shoreline Medical Center Yale New Haven Health

Guilford, CT

Open and Accepting

Smilow Cancer Hospital at Saint Francis Hospital Trinity Health of New England

Hartford, CT

Open and Accepting

Yale Cancer Center Smilow Cancer Hospital at Yale-New Haven

New Haven, CT

Open and Accepting

Yale-New Haven Hospital - North Haven Medical Center

North Haven, CT

Open and Accepting

Smilow Cancer Hospital Care Center (Orange)

Orange, CT

Open and Accepting

Smilow Cancer Hospital Care Center (Torrington)

Torrington, CT

Open and Accepting

Smilow Cancer Hospital Care Center (Trumbull)

Trumbull, CT

Open and Accepting

Smilow Cancer Hospital - The Harold Leever Regional Cancer Center (Waterbury)

Waterbury, CT

Open and Accepting

Smilow Cancer Hospital Care Center (Waterford)

Waterford, CT

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

Holy Cross Hospital Holy Cross Health, A Member of Trinity Health

Fort Lauderdale, FL

Open and Accepting

Sacred Heart Medical Oncology Group

Pensacola, FL

Open and Accepting

Georgia

Grady Memorial Hospital

Atlanta, GA

Open and Accepting

Idaho

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

Rush - Copley Medical Center

Aurora, IL

Open and Accepting

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

University of Illinois at Chicago

Chicago, IL

Open and Accepting

Carle Foundation Hospital (Vermilion)

Danville, 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

Carle (Effingham)

Effingham, 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

Northwestern Medicine Cancer Center Delnor

Geneva, IL

Open and Accepting

Illinois CancerCare (Kewanee)

Kewanee, IL

Open and Accepting

Illinois CancerCare (Macomb)

Macomb, IL

Open and Accepting

Carle Foundation Hospital (Mattoon)

Mattoon, 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

Loyola Center for Cancer Care and Research

Orland Park, IL

Open and Accepting

Illinois CancerCare - Fox River Cancer Center

Ottawa, 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

Carle Cancer Institute

Urbana, IL

Open and Accepting

Northwestern Medicine Cancer Center Warrenville

Warrenville, IL

Open and Accepting

Rush - Copley Healthcare Center

Yorkville, IL

Open and Accepting

Indiana

IU Simon Cancer Center Indiana University

Indianapolis, IN

Not Yet Accepting

Reid Health

Richmond, IN

Open and Accepting

Iowa

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

Oncology Associates at Hall-Perrine Cancer Center Mercy Cedar Rapids

Cedar Rapids, IA

Open and Accepting

Mission Cancer & Blood (Clive) In Clive Cancer Center

Clive, IA

Open and Accepting

MercyOne Clive Cancer Center

Clive, IA

Open and Accepting

Alegent Health Mercy Hospital

Council Bluffs, IA

Open and Accepting

Greater Regional Medical Center

Creston, IA

Open and Accepting

Medical Oncology and Hematology Associates (Des Moines) in UnityPoint Health - John Stoddard Cancer Center

Des Moines, 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

McFarland Clinic Trinity Cancer 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

UnityPoint Health - Methodist West Hospital

West Des Moines, IA

Open and Accepting

MercyOne West Des Moines Medical Center

West Des Moines, IA

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

U of L Health - Jewish Hospital

Louisville, KY

Open and Accepting

Saints Mary and Elizabeth Hospital

Louisville, KY

Open and Accepting

Jewish Hospital Medical Center Northeast

Louisville, KY

Open and Accepting

Jewish Hospital Medical Center South

Shepherdsville, KY

Open and Accepting

Louisiana

Ochsner LSU Health Shreveport Ochsner Louisiana State University

Shreveport, LA

Open and Accepting

Maryland

Frederick Health Hospital

Frederick, MD

Open and Accepting

Massachusetts

Tufts Medical Center Cancer Center

Boston, MA

Open and Accepting

Michigan

ProMedica Hickman Cancer Center Grace Christman Medical Building

Adrian, 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

St. Joseph Mercy Canton Health Center

Canton, MI

Open and Accepting

St. Joseph Mercy Chelsea Hospital

Chelsea, MI

Open and Accepting

Genesys Hurley Cancer Institute

Flint, MI

Open and Accepting

Hurley Medical Center

Flint, MI

Open and Accepting

Mercy Health Saint Mary's

Grand Rapids, MI

Open and Accepting

Spectrum Health

Grand Rapids, 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

Mercy Health Mercy Campus

Muskegon, MI

Open and Accepting

Lakeland Community Hospital

Niles, MI

Open and Accepting

St. Joseph Mercy (Oakland)

Pontiac, MI

Open and Accepting

Spectrum Health Reed City Hospital

Reed City, MI

Open and Accepting

Saint Mary's of Michigan

Saginaw, 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

Ascension Macomb-Oakland Hospital - Webber Cancer Center

Warren, MI

Open and Accepting

St. Joseph Mercy Ann Arbor Hospital

Ypsilanti, MI

Open and Accepting

Minnesota

Sanford Clinic North-Bemidgi

Bemidji, 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

Fairview Southdale Hospital

Edina, MN

Open and Accepting

Unity Hospital

Fridley, 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

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

Park Nicollet Specialty Center at Methodist Hospital

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

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

Saint Louis Cancer and Breast Institute

Ballwin, MO

Open and Accepting

Central Care Cancer Center

Bolivar, 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

Capital Region Medical Center (Goldschmidt Cancer Center)

Jefferson City, MO

Open and Accepting

Freeman Cornell-Beshore Cancer Institute

Joplin, MO

Open and Accepting

Mercy Clinic Cancer and Hematology (Rolla)

Rolla, 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

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

Missouri Baptist Medical 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

Benefis Sletten Cancer Institute

Great Falls, MT

Open and Accepting

Great Falls Clinic Specialty Center

Great Falls, MT

Open and Accepting

Kalispell Regional Medical Center

Kalispell, MT

Open and Accepting

Providence St. Patrick Hospital

Missoula, MT

Open and Accepting

Community Medical Hospital

Missoula, MT

Open and Accepting

Nebraska

CHI Health St. Francis

Grand Island, NE

Open and Accepting

CHI Health Good Samaritan Hospital

Kearney, NE

Open and Accepting

CHI Health St. Elizabeth St. Elizabeth Regional Medical Center

Lincoln, NE

Open and Accepting

CHI Health Immanuel Medical Center

Omaha, NE

Open and Accepting

CHI Health Creighton University Medical Center (Bergan Mercy)

Omaha, NE

Open and Accepting

CHI Health Lakeside Hospital

Omaha, NE

Open and Accepting

CHI Health Creighton University Medical Center

Omaha, NE

Open and Accepting

CHI Health Midlands

Papillion, NE

Open and Accepting

New Mexico

University of New Mexico Comprehensive Cancer Center

Albuquerque, NM

Open and Accepting

New York

Glens Falls Hospital

Glens Falls, NY

Open and Accepting

Stony Brook University Hospital

Stony Brook, NY

Open and Accepting

North Carolina

Southeastern Medical Oncology Center (Clinton)

Clinton, NC

Open and Accepting

Southeastern Medical Oncology Center (Goldsboro)

Goldsboro, NC

Open and Accepting

Southeastern Medical Oncology Center (Jacksonville)

Jacksonville, NC

Open and Accepting

North Dakota

Sanford Bismarck Medical Center

Bismarck, ND

Open and Accepting

Sanford Medical Center

Fargo, ND

Open and Accepting

Sanford Roger Maris Cancer Center

Fargo, ND

Open and Accepting

Sanford North Fargo Clinic

Fargo, ND

Open and Accepting

Ohio

Strecker Cancer Center (Belpre)

Belpre, OH

Open and Accepting

Miami Valley Hospital South

Centerville, OH

Open and Accepting

Adena Regional Medical Center

Chillicothe, OH

Open and Accepting

Barrett Cancer Center University of Cincinnati Health

Cincinnati, OH

Open and Accepting

TriHealth Cancer Institute (Good Samaritan Hospital)

Cincinnati, OH

Open and Accepting

Oncology Hematology Care Inc. (Kenwood)

Cincinnati, OH

Open and Accepting

TriHealth Bethesda North Hospital

Cincinnati, OH

Open and Accepting

University of Cincinnati College of Medicine

Cincinnati, OH

Open and Accepting

Case Western Reserve University

Cleveland, OH

Open and Accepting

Columbus Oncology and Hematology Associates

Columbus, OH

Open and Accepting

OhioHealth Riverside Methodist Hospital

Columbus, OH

Open and Accepting

OhioHealth Grant Medical Center

Columbus, OH

Open and Accepting

The Mark H. Zangmeister Center

Columbus, OH

Open and Accepting

Mount Carmel Health Center West

Columbus, OH

Open and Accepting

Doctors Hospital

Columbus, OH

Open and Accepting

Dayton Physicians, LLC

Dayton, OH

Open and Accepting

Miami Valley Hospital

Dayton, OH

Open and Accepting

OhioHealth Grady Memorial Hospital Cancer Center

Delaware, OH

Open and Accepting

Blanchard Valley Hospital

Findlay, OH

Open and Accepting

TriHealth Cancer Institute (Anderson)

Forestville, OH

Open and Accepting

Dayton Physicians (Atrium Medical Center)

Franklin, OH

Open and Accepting

Wayne Healthcare

Greenville, OH

Open and Accepting

Kettering Medical Center

Kettering, OH

Open and Accepting

Fairfield Medical Center

Lancaster, OH

Open and Accepting

Saint Rita's Medical Center

Lima, OH

Open and Accepting

Marietta Memorial Hospital

Marietta, OH

Open and Accepting

OhioHealth Marion General Hospital

Marion, OH

Open and Accepting

UH Seidman Cancer Center (Landerbrook)

Mayfield Heights, OH

Temporarily Suspended

Premier Health Atrium Medical Center - Middletown

Middletown, OH

Open and Accepting

Knox Community Hospital

Mount Vernon, OH

Open and Accepting

Licking Memorial Hospital

Newark, OH

Open and Accepting

Newark Radiation Oncology

Newark, OH

Open and Accepting

Southern Ohio Medical Center

Portsmouth, OH

Open and Accepting

Dayton Physicians (Wilson Memorial Hospital)

Sidney, OH

Open and Accepting

Springfield Regional Medical Center

Springfield, OH

Open and Accepting

Saint Vincent Mercy Medical Center

Toledo, OH

Open and Accepting

Mercy Health - St. Anne Hospital

Toledo, OH

Open and Accepting

Toledo Clinic Cancer Centers - Toledo

Toledo, OH

Open and Accepting

Dayton Physicians - Upper Valley Medical Center

Troy, OH

Open and Accepting

Premier Health Upper Valley Medical Center

Troy, OH

Open and Accepting

Saint Ann's Hospital

Westerville, OH

Open and Accepting

TriHealth Cancer Institute (Westside)

White Oak, OH

Open and Accepting

Mount Carmel Health Center (East)

Whitehall, OH

Open and Accepting

Genesis HealthCare System

Zanesville, OH

Open and Accepting

Oklahoma

Mercy Hospital Oklahoma City

Oklahoma City, OK

Open and Accepting

Oregon

Clackamas Radiation Oncology Center

Clackamas, OR

Open and Accepting

Bay Area Hospital

Coos Bay, OR

Open and Accepting

Providence Newberg Medical Center

Newberg, OR

Open and Accepting

Oregon Health and Science University (OHSU) Knight Cancer Institute

Portland, OR

Open and Accepting

Pennsylvania

Lehigh Valley Health Network Cancer Institute

Allentown, PA

Open and Accepting

Christiana Care Health System-Concord Health Center

Chadds Ford, PA

Open and Accepting

Tower Health Reading Hospital

West Reading, PA

Open and Accepting

Rhode Island

Smilow Cancer Hospital Care Center

Westerly, RI

Open and Accepting

South Carolina

Ralph H Johnson VA Medical Center VA Charleston

Charleston, SC

Open and Accepting

Medical University of South Carolina

Charleston, SC

Open and Accepting

Bon Secours St. Francis Hospital (Downtown)

Greenville, SC

Open and Accepting

Saint Francis Hospital Cancer Center

Greenville, SC

Open and Accepting

South Dakota

Avera Cancer Institute - Sioux Falls

Sioux Falls, SD

Open and Accepting

Texas

St. Joseph Regional Cancer Center

Bryan, TX

Open and Accepting

Utah

Huntsman Cancer Institute University of Utah

Salt Lake City, UT

Open and Accepting

Virginia

UVA Cancer Center University of Virginia Health System

Charlottesville, VA

Open and Accepting

Virginia Cancer Institute Reynolds Crossing

Richmond, VA

Open and Accepting

Massey Cancer Center Virginia Commonwealth University (VCU Health)

Richmond, VA

Open and Accepting

Washington

PeaceHealth Medical Group

Bellingham, WA

Open and Accepting

St. Michael - Harrison Medical Center

Bremerton, WA

Open and Accepting

Highline Medical Center (Main Campus)

Burien, WA

Open and Accepting

Swedish Medical Center (Edmonds Campus)

Edmonds, WA

Open and Accepting

Saint Elizabeth Hospital

Enumclaw, WA

Open and Accepting

Providence Everett Medical Center

Everett, WA

Open and Accepting

Saint Francis Hospital

Federal Way, WA

Open and Accepting

Saint Clare Hospital - CHI Franciscan Health

Lakewood, WA

Open and Accepting

Saint John Medical Center

Longview, WA

Open and Accepting

Harrison HealthPartners Hematology and Oncology-Poulsbo

Poulsbo, WA

Temporarily Suspended

Swedish Medical Center (Ballard Campus)

Seattle, WA

Open and Accepting

Swedish - First Hill Campus

Seattle, WA

Open and Accepting

Swedish - Cherry Hill Campus Cherry Hill Campus

Seattle, WA

Open and Accepting

St. Michael Cancer Center Virginia Mason Franciscan Health

Silverdale, WA

Open and Accepting

Virginia Mason Franciscan Health Research Center (Tacoma) CHI Franciscan

Tacoma, WA

Open and Accepting

Northwest Medical Specialties (Tacoma) NWMS Tacoma — Medical Oncology & Infectious Diseases

Tacoma, WA

Temporarily Suspended

PeaceHealth Southwest Medical Center

Vancouver, WA

Open and Accepting

Providence St. Mary Regional Cancer Center

Walla Walla, WA

Open and Accepting

Wisconsin

UW Carbone Cancer Center University of Wisconsin Health

Madison, WI

Open and Accepting

SSM Health Dean Medical Group

Baraboo, WI

Open and Accepting

Aurora Cancer Care (Burlington)

Burlington, WI

Open and Accepting

Marshfield Clinic (Chippewa Center)

Chippewa Falls, WI

Open and Accepting

Marshfield Medical Center Cancer Center - Eau Claire

Eau Claire, WI

Open and Accepting

Aurora Cancer Care (Grafton)

Grafton, WI

Open and Accepting

Aurora BayCare Medical Center

Green Bay, WI

Open and Accepting

Aurora Cancer Care (Kenosha South)

Kenosha, WI

Open and Accepting

Gundersen Lutheran Medical Center

La Crosse, WI

Open and Accepting

Marshfield Clinic (Ladysmith Center)

Ladysmith, WI

Open and Accepting

Dean Hematology and Oncology Clinic

Madison, WI

Open and Accepting

Marshfield Medical Center - Medical Offices Building

Marshfield, WI

Open and Accepting

Aurora Cancer Care (Milwaukee)

Milwaukee, WI

Open and Accepting

Aurora St. Luke's Medical Center

Milwaukee, WI

Open and Accepting

Aurora Sinai Medical Center

Milwaukee, WI

Open and Accepting

Marshfield Clinic (Minocqua Center)

Minocqua, WI

Open and Accepting

Aurora Cancer Care (Racine)

Mount Pleasant, WI

Open and Accepting

D. N. Greenwald Center

Mukwonago, WI

Open and Accepting

ProHealth Oconomowoc Memorial Hospital

Oconomowoc, WI