A Phase III Randomized Trial for Newly Diagnosed Multiple Myeloma (NDMM) Patients Considered Frail or in a Subset of "Intermediate Fit" Comparing Upfront Three-Drug Induction Regimens Followed by Double or Single-Agent Maintenance TRIPLET INDUCTION + 1 OR 2-DRUG MAINTENANCE

What's the purpose of this trial?

This phase III trial compares three-drug induction regimens followed by double-or single-drug maintenance therapy for the treatment of newly diagnosed multiple myeloma in patients who are not receiving a stem cell transplant and are considered frail or intermediate-fit based on age, comorbidities, and functional status.

This trial is currently open and accepting patients.


What will happen during the trial?

This phase III trial compares three-drug induction regimens followed by double-or single-drug maintenance therapy for the treatment of newly diagnosed multiple myeloma in patients who are not receiving a stem cell transplant and are considered frail or intermediate-fit based on age, comorbidities, and functional status. Treatment for multiple myeloma includes initial treatment (induction) which is the first treatment a patient receives for cancer followed by ongoing treatment (maintenance) which is given after initial treatment to help keep the cancer from coming back. There are three combinations of four different drugs being studied. Bortezomib is one of the drugs that may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Lenalidomide works by helping bone marrow to produce normal blood cells and killing cancer cells. Anti-inflammatory drugs, such as dexamethasone, lower the body's immune response and are used with other drugs in the treatment of some types of cancer. Daratumumab and hyaluronidase-fihj is a monoclonal antibody that may interfere with the ability of cancer cells to grow and spread. Patients receive 1 of 3 combinations of these drugs for treatment to determine which combination of study drugs works better to shrink and control multiple myeloma.

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:

* Participants must have documented multiple myeloma satisfying standard International Myeloma Working Group (IMWG) diagnostic criteria within 28 days prior to registration
* Participants must have measurable disease within 28 days prior to registration as defined by any of the following:

* Immunoglobulin (Ig) G myeloma (serum monoclonal paraprotein \[M-protein\] level \>= 0.5 gram/deciliter \[g/dL\] or urine M-protein level \>= 200 milligram\[mg\]/24 hours\[hrs\]); OR
* IgA, IgM, IgD, or IgE multiple myeloma (serum M-protein level \>= 0.2 g/dL or urine M-protein level \>= 200 mg/24 hrs); OR
* Light chain multiple myeloma (serum immunoglobulin free light chain \>= 10 mg/dL and abnormal serum immunoglobulin kappa lambda free light chain ratio)
* All disease must be assessed and documented on the baseline/pre-registration tumor assessment form
* Participants must have a calculated myeloma frailty index (Myeloma Frailty Score Calculator; http://www.myelomafrailtyscorecalculator.net/) categorized as frail or intermediate fit (regardless of age) within 28 days prior to registration
* For Participants Meeting "Frail" Status:

* Participants with any degree of kidney dysfunction are allowed; however, participants on dialysis are not eligible
* For Participants Meeting "Frail" Status:

* Hemoglobin \>= 7 g/dL (must be performed within 28 days prior to registration)

* Note: growth factor and transfusion utilization are allowed if cytopenias are considered secondary to bone marrow involvement from MM)
* For Participants Meeting "Frail" Status:

* Platelets \>= 50 x 10\^9/L (must be performed within 28 days prior to registration)

* Note: growth factor and transfusion utilization are allowed if cytopenias are considered secondary to bone marrow involvement from MM)
* For Participants Meeting "Frail" Status:

* Absolute neutrophil count (ANC) \>= 0.75 x10\^9/L (must be performed within 28 days prior to registration)

* Note: growth factor and transfusion utilization are allowed if cytopenias are considered secondary to bone marrow involvement from MM)
* For Participants Meeting "Intermediate Fit" Status, one or more of the following criteria must be present:

* Kidney dysfunction showing calculated creatinine clearance (CrCl) \<30 ml/min.

* Actual lab serum creatinine value with a minimum of 0.7 mg/dL.
* Participants must have bone marrow function assessed and meet the below criteria ranges:

* Hemoglobin between 7-8 g/dL, OR
* Platelets between 50-75 x10\^9/L, OR
* ANC between 0.75-1 x10\^9/L

* Note: growth factor and transfusion utilization are allowed as long as cytopenias are considered secondary to bone marrow involvement from MM)
* Revised International Staging System (R-ISS) stage III disease
* Note: All labs must be performed within 28 days prior to registration
* Participants must have a complete medical history and physical exam within 28 days prior to registration
* Participants must have whole body imaging within 60 days prior to registration. The recommended method of imaging is a positron emission tomography/computed tomography (PET/CT); a low-dose whole body CT scan or whole-body magnetic resonance imaging (MRI) or skeletal survey should be done only if a PET/CT scan cannot be done or is non-feasible. This must be documented in the comments section of the Onstudy form.
* Total bilirubin =\< 2 times institutional upper limit of normal (ULN) unless history of Gilbert's disease. Participants with history of Gilbert's disease must have total bilirubin =\< 5 x institutional ULN (within 28 days prior to registration)
* Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =\< 3 × institutional ULN (within 28 days prior to registration)
* Participants must have adequate cardiac function, as assessed by the treating physician within 14 days prior to registration. Participants with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, must have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification and must not be assessed as class 3 or 4
* Participants with known diabetes must show evidence of controlled disease within 14 days prior to registration. Uncontrolled diabetes is defined as: A glycosylated hemoglobin (Hg)A1C \> 7
* Participants with known human immunodeficiency virus (HIV)-infection must be receiving anti-retroviral therapy and have an undetectable viral load test on the most recent test result obtained, within 6 months prior to registration
* All participants with evidence of chronic hepatitis B virus (HBV) infection must have undetectable HBV viral load on suppressive therapy within 28 days prior to registration
* Participants with a history of hepatitis C virus (HCV) infection must have been treated and cured. For participants with HCV infection who are currently on treatment, participant must have an undetectable HCV viral load within 28 days prior to registration
* Participants must have an Eastern Cooperative Oncology Group (ECOG)/Zubrod performance status score of 0-2 (Note: Participants with ECOG/Zubrod performance score \[PS\] 3, especially where the deterioration of PS is considered secondary to the MM diagnosis, will be allowed)
* Participants must be offered the opportunity to participate in specimen banking. With participant consent, specimens must be collected and submitted via the Southwest Oncology Group (SWOG) specimen tracking system
* Participants who are able to complete the patient-reported outcomes measures in English or Spanish must agree to participate in the PRO portion of the study
* Participants must be informed of the investigational nature of this study and must sign and give informed consent in accordance with institutional and federal guidelines. For participants with impaired decision-making capabilities, legally authorized representatives may sign and give informed consent on behalf of study participants in accordance with applicable federal, local, and Central Institutional Review Board (CIRB) regulations

Exclusion Criteria:

* Participants must not have received any prior systemic therapy for multiple myeloma with the exception of any one or more of the following:

* An emergency use of a short course of corticosteroids (equivalent of dexamethasone 160 mg) any time before registration, or
* Up to one complete cycle of a non-daratumumab and hyaluronidase-fihj containing anti-myeloma regimen (1 cycle = 21 or 28 days depending on the regimen being used), or
* Localized palliative radiation therapy for multiple myeloma, as long as the radiation therapy is completed at least 3 days prior to starting the systemic treatment as per the study protocol.
* Participants must not have evidence of grade 4 peripheral neuropathy prior to study registration
* Participants must not have uncontrolled blood pressure within 14 days prior to registration. Uncontrolled blood pressure: systolic blood pressure (SBP) \> 140 mmHg or diastolic blood pressure (DBP) \> 90 mmHg. Participants are permitted to be receiving multiple anti-hypertensive medications (unless otherwise indicated in the study). All blood pressure measurements within the 14 days prior to registration must be SBP =\< 140 and DBP =\< 90. A participant with a single blood pressure elevation who upon rechecking has a normal blood pressure will remain eligible at the discretion of the registering investigator.
* Participants must not have a prior or concurrent malignancy whose natural history or treatment (in the opinion of the treating physician) has the potential to interfere with the safety or efficacy assessment of the investigational regimen.
* Participants must not be pregnant or nursing. Individuals who are of reproductive potential must have agreed to use an effective contraceptive method with details provided as a part of the consent process. A person who has had menses at any time in the preceding 24 consecutive months or who has semen likely to contain sperm is considered to be of "reproductive potential." In addition to routine contraceptive methods, "effective contraception" also includes refraining from sexual activity that might result in pregnancy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) including hysterectomy, bilateral oophorectomy, bilateral tubal ligation/occlusion, and vasectomy with testing showing no sperm in the semen.

Additional Trial Information

Phase 3

Enrollment: 510 patients (estimated)

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Trial Locations

All Trial Locations

View all clinical trial locations sorted by state.

Alaska

Anchorage Associates in Radiation Medicine

Anchorage, AK

Open and Accepting

Anchorage Radiation Therapy Center

Anchorage, AK

Open and Accepting

Alaska Breast Care and Surgery LLC

Anchorage, AK

Open and Accepting

Alaska Oncology and Hematology LLC

Anchorage, AK

Open and Accepting

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

Cancer Center at St. Joseph's

Phoenix, AZ

Open and Accepting

Arkansas

Mercy Hospital Fort Smith

Fort Smith, AR

Open and Accepting

CARTI Cancer Center

Little Rock, AR

Open and Accepting

Central Arkansas Veterans Healthcare System VA Central Arkansas

Little Rock, AR

Temporarily Suspended

University of Arkansas for Medical Sciences (UAMS)

Little Rock, AR

Open and Accepting

California

Dignity Health Mission Hope Cancer Center - Arroyo Grande

Arroyo Grande, CA

Open and Accepting

Marshall Cancer Center

Cameron Park, CA

Open and Accepting

Mercy Cancer Center Mercy San Juan Medical Center

Carmichael, CA

Open and Accepting

Mercy Cancer Center - Elk Grove

Elk Grove, CA

Open and Accepting

Rideout Cancer Center (Fremont)

Linda, CA

Open and Accepting

Mercy UC Davis Cancer Center

Merced, CA

Open and Accepting

Providence Queen of The Valley

Napa, CA

Open and Accepting

Mercy Cancer Center - Rocklin

Rocklin, CA

Open and Accepting

Mercy Cancer Center

Sacramento, CA

Open and Accepting

University of California Davis Comprehensive Cancer Center

Sacramento, CA

Open and Accepting

SLO Oncology & Hematology Health Center Pacific Central Coast Health Center

San Luis Obispo, CA

Open and Accepting

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

Santa Maria, CA

Open and Accepting

Providence Medical Foundation - Santa Rosa

Santa Rosa, CA

Open and Accepting

Sutter Santa Rosa Regional Hospital

Santa Rosa, CA

Open and Accepting

Tahoe Forest Cancer Center

Truckee, CA

Open and Accepting

Woodland Memorial Hospital

Woodland, CA

Open and Accepting

Colorado

Rocky Mountain Regional VA Medical Center

Aurora, CO

Open and Accepting

Littleton Adventist Hospital

Centennial, CO

Temporarily Suspended

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

Temporarily Suspended

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

Centura Parker Adventist Hospital

Parker, CO

Temporarily Suspended

Saint Mary Corwin Medical Center

Pueblo, CO

Open and Accepting

Connecticut

Smilow Cancer Hospital The Center for Cancer Care at Griffin Hospital

Derby, CT

Open and Accepting

Smilow Cancer Hospital

Fairfield, CT

Open and Accepting

Smilow Cancer Hospital Saint Francis Hospital

Glastonbury, CT

Open and Accepting

Smilow Cancer Hospital

Greenwich, CT

Open and Accepting

Smilow Cancer Hospital Shoreline Medical Center

Guilford, CT

Open and Accepting

Smilow Cancer Hospital at Yale New Haven

New Haven, CT

Open and Accepting

North Haven Medical Center Yale-New Haven Hospital

North Haven, CT

Open and Accepting

Smilow Cancer Hospital

Stamford, CT

Open and Accepting

Smilow Cancer Hospital

Torrington, CT

Open and Accepting

Smilow Cancer Hospital Park Avenue Medical Center

Trumbull, CT

Open and Accepting

Smilow Cancer Hospital The Harold Leever Regional Cancer Center

Waterbury, CT

Open and Accepting

Smilow Cancer Hospital L+M Waterford Cancer Care Center

Waterford, CT

Open and Accepting

Florida

Holy Cross Hospital

Fort Lauderdale, FL

Open and Accepting

Mayo Clinic (Jacksonville)

Jacksonville, FL

Open and Accepting

Jupiter Medical Center

Jupiter, FL

Open and Accepting

Idaho

St. Luke's Cancer Institute - Boise

Boise, 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

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

Twin Falls, ID

Open and Accepting

Illinois

OSF Saint Anthony's Health

Alton, IL

Open and Accepting

Rush - Copley Medical Center

Aurora, IL

Open and Accepting

OSF St. Joseph Medical Center (Bloomington)

Bloomington, 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

Saint Mary's Hospital

Centralia, 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

Edward Hines, Jr. VA Hospital

Hines, IL

Open and Accepting

Loyola Medicine Homer Glen

Homer Glen, 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

Cancer Care Center of O'Fallon

O'Fallon, IL

Open and Accepting

HSHS Saint Elizabeth's Hospital

O'Fallon, 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

Illinois CancerCare - Princeton

Princeton, IL

Open and Accepting

Southern Illinois University School of Medicine - Simmons Cancer Institute

Springfield, IL

Open and Accepting

Springfield Clinic Main Campus East

Springfield, IL

Open and Accepting

Memorial Medical Center

Springfield, IL

Open and Accepting

Carle Cancer Institute

Urbana, IL

Open and Accepting

Illinois CancerCare - Washington

Washington, IL

Open and Accepting

Rush - Copley Healthcare Center

Yorkville, IL

Open and Accepting

Indiana

IU Health Hematology & Oncology IU Health North Hospital

Carmel, IN

Open and Accepting

Simon Cancer Center Indiana University

Indianapolis, IN

Open and Accepting

Iowa

Mission Cancer & Blood

Ankeny, IA

Open and Accepting

Iowa Blood and Cancer Care of PCI

Cedar Rapids, IA

Open and Accepting

Medical Oncology and Hematology Associates-West Des Moines

Clive, IA

Open and Accepting

MercyOne Clive Cancer Center

Clive, IA

Open and Accepting

Alegent Health Mercy Hospital

Council Bluffs, IA

Temporarily Suspended

Greater Regional Medical Center

Creston, IA

Open and Accepting

MercyOne Des Moines Medical Center

Des Moines, IA

Open and Accepting

Mission Cancer MercyOne Cancer Center (Laurel)

Des Moines, IA

Open and Accepting

MercyOne West Des Moines Medical Center

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

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

Saint Joseph (London)

London, KY

Open and Accepting

Saint Joseph Mount Sterling

Mount Sterling, KY

Open and Accepting

Maryland

GBMC Cancer Center - Berman Cancer Institute

Baltimore, MD

Open and Accepting

Michigan

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

Caro Cancer Center

Caro, MI

Open and Accepting

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

Newland Medical Associates of Clarkston

Clarkston, MI

Open and Accepting

Great Lakes Cancer Management Specialists (Doctors Park)

East China, MI

Open and Accepting

The Cancer & Hematology Centers

Flint, MI

Open and Accepting

Genesys Hurley Cancer Institute

Flint, MI

Open and Accepting

Hurley Medical Center

Flint, MI

Open and Accepting

Academic Hematology Oncology Specialists Ascension St. John Hospital

Grosse Pointe Woods, 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

GenesisCare MHP Radiation Oncology (Pontiac)

Pontiac, MI

Open and Accepting

Newland Medical Associates (Pontiac) The Alice Gustafson Center

Pontiac, MI

Open and Accepting

St. Joseph Mercy (Oakland)

Pontiac, MI

Open and Accepting

Michigan Cancer Specialists

Roseville, MI

Open and Accepting

Ascension St. Mary's Hospital

Saginaw, MI

Open and Accepting

Oncology Hematology Associates of Saginaw Valley PC

Saginaw, MI

Open and Accepting

Bhadresh Nayak MD PC - Sterling Heights

Sterling Heights, MI

Open and Accepting

Ascension Saint Joseph Hospital

Tawas City, MI

Open and Accepting

Michigan Cancer Research Consortium - Advanced Breast Care Center PLLC

Warren, MI

Open and Accepting

Michigan Cancer Research Consortium - Macomb Professional Building

Warren, MI

Open and Accepting

Michigan Breast Specialists-Warren

Warren, MI

Open and Accepting

Ascension St. Mary's Hospital Seton Cancer Institute

West Branch, MI

Open and Accepting

Trinity Health Ann Arbor Hospital

Ypsilanti, MI

Open and Accepting

Minnesota

Sanford Clinic North-Bemidgi

Bemidji, MN

Open and Accepting

Minnesota Oncology - Burnsville

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

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 Cancer Institute

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 Clinic

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

Sanford Thief River Falls Medical Center

Thief River Falls, 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

Sanford Cancer Center Worthington

Worthington, 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

Parkland Health Center (Farmington)

Farmington, 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 Hospital Joplin

Joplin, MO

Open and Accepting

Lake Regional Hospital

Osage Beach, MO

Open and Accepting

Phelps Health Hospital Delbert Day Cancer Institute

Rolla, 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

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

Providence St. Patrick Hospital

Missoula, MT

Open and Accepting

Nebraska

CHI Health Good Samaritan Hospital

Kearney, NE

Open and Accepting

CHI Health St. Elizabeth St. Elizabeth Regional Medical Center

Lincoln, NE

Temporarily Suspended

CHI Health Immanuel Medical Center

Omaha, NE

Open and Accepting

CHI Henry Lynch Cancer Center at CUMC Bergan

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

Temporarily Suspended

New Mexico

University of New Mexico Comprehensive Cancer Center

Albuquerque, NM

Open and Accepting

New York

North Dakota

Sanford Bismarck Medical Center Bismarck Cancer Center

Bismarck, ND

Open and Accepting

Essentia Health Cancer Center - South University Clinic (Fargo)

Fargo, ND

Open and Accepting

Sanford Medical Center - Southpointe

Fargo, ND

Open and Accepting

Sanford Medical Center - Broadway

Fargo, ND

Open and Accepting

Sanford Roger Maris Cancer Center

Fargo, ND

Open and Accepting

Ohio

TriHealth Cancer Institute (Good Samaritan Hospital)

Cincinnati, OH

Open and Accepting

TriHealth Bethesda North Hospital

Cincinnati, OH

Open and Accepting

TriHealth Cancer Institute (Anderson)

Forestville, OH

Open and Accepting

TriHealth Cancer Institute (Westside)

White Oak, OH

Open and Accepting

Oklahoma

University of Oklahoma Health Sciences Center

Oklahoma City, OK

Not Yet Accepting

Mercy Hospital Oklahoma City

Oklahoma City, OK

Open and Accepting

Oregon

St. Charles (Bend Campus)

Bend, OR

Open and Accepting

Clackamas Radiation Oncology Center

Clackamas, OR

Open and Accepting

Providence Cancer Institute Clackamas Clinic

Clackamas, OR

Open and Accepting

Bay Area Hospital

Coos Bay, OR

Open and Accepting

Providence Newberg Medical Center

Newberg, OR

Open and Accepting

Providence Willamette Falls Medical Center

Oregon City, OR

Open and Accepting

Saint Charles Health System (Redmond)

Redmond, OR

Open and Accepting

Pennsylvania

Lehigh Valley Hospital-Cedar Crest

Allentown, PA

Open and Accepting

Lehigh Valley Hospital - Muhlenberg

Bethlehem, PA

Open and Accepting

Pocono Medical Center

East Stroudsburg, PA

Open and Accepting

Lehigh Valley Hospital - Hazleton

Hazleton, PA

Open and Accepting

Rhode Island

Smilow Cancer Hospital

Westerly, RI

Open and Accepting

South Carolina

Prisma Health Cancer Institute - Spartanburg

Boiling Springs, SC

Open and Accepting

Prisma Health Cancer Institute - Easley Easley

Easley, SC

Open and Accepting

Greenville Health System Cancer Institute (Butternut)

Greenville, SC

Open and Accepting

Prisma Health Cancer Institute - Faris

Greenville, SC

Open and Accepting

Prisma Health Cancer Institute - Eastside Eastside

Greenville, SC

Open and Accepting

Prisma Health Cancer Institute - Greer Greer

Greer, SC

Open and Accepting

Prisma Health Cancer Institute - Seneca Lila Doyle Drive

Seneca, SC

Open and Accepting

South Dakota

Avera Cancer Institute-Aberdeen

Aberdeen, SD

Open and Accepting

Sanford Cancer Center

Sioux Falls, SD

Open and Accepting

Avera Cancer Institute - Sioux Falls

Sioux Falls, SD

Open and Accepting

Sanford USD Medical Center (Sioux Falls)

Sioux Falls, SD

Open and Accepting

Avera Cancer Institute at Yankton

Yankton, SD

Open and Accepting

Virginia

Sovah Health Hospital

Martinsville, VA

Open and Accepting

Washington

Providence Regional Cancer System (Aberdeen)

Aberdeen, WA

Open and Accepting

PeaceHealth Medical Group

Bellingham, WA

Open and Accepting

St. Michael - Harrison Medical Center

Bremerton, WA

Open and Accepting

Providence Regional Cancer System (Centralia)

Centralia, WA

Open and Accepting

Swedish Cancer Institute Swedish Edmonds Campus

Edmonds, WA

Open and Accepting

Providence Everett Medical Center

Everett, WA

Open and Accepting

Swedish Cancer Institute

Issaquah, WA

Open and Accepting

Kadlec Clinic Hematology and Oncology

Kennewick, WA

Open and Accepting

Providence Regional Cancer System (Lacey)

Lacey, WA

Open and Accepting

Saint John Medical Center

Longview, WA

Open and Accepting

Swedish Medical Center (Ballard Campus)

Seattle, WA

Open and Accepting

Swedish Cancer Institute - Cherry Hill Campus

Seattle, WA

Open and Accepting

Swedish - First Hill Campus

Seattle, WA

Open and Accepting

PeaceHealth United General Medical Center

Sedro-Woolley, WA

Open and Accepting

Providence Regional Cancer System (Shelton)

Shelton, WA

Open and Accepting

PeaceHealth Southwest Medical Center

Vancouver, WA

Open and Accepting

Providence St. Mary Regional Cancer Center

Walla Walla, WA

Open and Accepting

Providence Regional Cancer System (Yelm)

Yelm, WA

Open and Accepting

Wisconsin

ThedaCare Regional Cancer Center

Appleton, WI

Open and Accepting

Gundersen Lutheran Medical Center

La Crosse, WI

Open and Accepting

Cancer Center of Western Wisconsin

New Richmond, WI

Open and Accepting
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