Lenalidomide, and Dexamethasone With or Without Daratumumab in Treating Patients With High-Risk Smoldering Myeloma

DETER-SMM

Overview

This phase III trial studies how well lenalidomide and dexamethasone works with or without daratumumab in treating patients with high-risk smoldering myeloma. Drugs used in chemotherapy, such as lenalidomide and dexamethasone, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Immunotherapy with monoclonal antibodies, such as daratumumab, may induce changes in the body's immune system and may interfere with the ability of tumor cells to grow and spread. Giving lenalidomide and dexamethasone with daratumumab may work better in treating patients with smoldering myeloma.

SparkCures ID 999
Trial Phase Phase 3
Enrollment 288 Patients
Treatments
Tags
Trial Sponsors
  • Eastern Cooperative Oncology Group (ECOG)
Trial Collaborators
  • National Cancer Institute (NCI)
NCT Identifier

NCT03937635

Am I Eligible?

The following criteria is a partial list of reasons why patients may or may not be eligible to participate in this clinical trial. Further evaluation with a medical professional will be required to determine full eligibility.

The following criteria is provided for health care professionals.

Inclusion Criteria:

  • Patients must be diagnosed with asymptomatic high-risk smoldering multiple myeloma (SMM) within the past 12 months. High-risk is defined by any one of the following factors:
    • Abnormal serum free light chain ratio (≤ 0.125 or ≥ 8.0 and involved chain < 100 mg/L) by serum free light chain (FLC) assay
    • Serum M-protein level ≥ 3 gm/dL
    • Presence of t(4;14) or del 17p or 1q gain by conventional cytogenetics or fluorescence in situ hybridization (FISH) studies.
  • Bone marrow aspirate and/or biopsy is required to be performed within 28 days prior to randomization and must demonstrate 10-59% clonal plasma cells.
  • ≥ 1 g/dL on serum protein electrophoresis (within 28 days prior to randomization).
  • ≥ 200 mg of monoclonal protein on a 24 hour urine protein electrophoresis (within 28 days prior to randomization).
    • NOTE: In the rare situation where the serum protein electrophoresis (SPEP) is felt to be unreliable, then quantitative immunoglobulin levels on nephelometry or turbidometry can be accepted.
  • SPEP, urine protein electrophoresis (UPEP), and serum FLC are required to be performed within 28 days prior to randomization.
    • 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 hour (hr), and urine in addition to serum must be followed in order to confirm a very good partial response (VGPR) or higher response.
  • Patients must have no lytic lesions, no known plasmacytoma, and no unexplained hypercalcemia (i.e., > 11 mg/dL or 1mg/dL above upper limit of normal [ULN]).
  • Hemoglobin >= 11 g/dL (within 28 days prior to randomization).
  • Platelet count >= 100,000 cells/mm^3 (within 28 days prior to randomization).
  • Absolute neutrophil count >= 1500 cells/mm^3 (within 28 days prior to randomization).
  • Calculated creatinine clearance >= 30 mL/min (within 28 days prior to randomization).
  • Bilirubin =< 1.5 mg/dL (within 28 days prior to randomization).
  • Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) and serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) =< 2.5 times the upper limit of normal (within 28 days prior to randomization).
  • Patients must not have any prior or concurrent systemic or radiation therapy for the treatment of myeloma. Patients must also not have contraindication to deep vein thrombosis (DVT) prophylaxis/aspirin.
  • Patients must not have more than one focal marrow lesion on magnetic resonance imaging (MRI) of either pelvis or spine.
  • Concurrent use of erythropoietin is not allowed while on study therapy.
  • Prior or glucocorticosteroid therapy for the treatment of multiple myeloma is not permitted. Prior systemic glucocorticosteroid use for the treatment of non-malignant disorders is permitted; concurrent use after registration on the study should be restricted to the equivalent of prednisone 10 mg per day. Prior or concurrent topical or localized glucocorticosteroid therapy to treat non-malignant comorbid disorders is permitted.
  • Patients must not have active, uncontrolled seizure disorder. Patients must not have had a seizure in the last 6 months.
  • Patients must not have uncontrolled intercurrent illness including uncontrolled hypertension, symptomatic congestive heart failure, unstable angina, uncontrolled cardiac arrhythmia, uncontrolled psychiatric illness or social situation that would limit compliance with the study, or a prior history of Stevens Johnson syndrome.
  • Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or 2.
  • Patients with monoclonal gammopathy of undetermined significance are not eligible.
  • Patients must not have grade 2 or higher peripheral neuropathy per CTCAE.
  • Patients must not have active, uncontrolled infection.
  • Patients may have a history of current or previous deep vein thrombosis or pulmonary embolism but are required to take some form of anti-coagulation as prophylaxis if they are not currently on full-dose anticoagulation.
  • Patients should not have New York Heart Association classification III or IV heart failure at baseline.
  • Patients with a history of prior malignancy are eligible provided they were treated with curative intent and have been free of disease for the time period considered appropriate for cure of the specific cancer. For most diseases this time frame is 5 years.
  • Patients must agree to register into the mandatory Risk Evaluation and Mitigation Strategy (REMS) program and be willing and able to comply with the requirements of REMS.
  • Women must not be pregnant due to potential harm to the fetus from daratumumab and lenalidomide. All females of childbearing potential (FCBP) must have a blood test or urine study with a sensitivity of at least 25 mIU/mL within 10-14 days prior to the first dose of lenalidomide and again within 24 hours prior to the first dose of lenalidomide. FCBP must also agree to ongoing pregnancy testing while on treatment. A female of childbearing potential is any woman, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy, or 3) 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).
  • Females of childbearing potential (FCBP) must either abstain from sexual intercourse for the duration of their participation in the study or agree to use 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 study treatment; 2) while participating in the study; 3) during dose interruptions; and 4) for at least 28 days after the last dose of protocol treatment (FCBP who are assigned to Arm A and receive daratumumab must extend this contraception requirement to 3 months after the last dose of protocol treatment). Women must also agree to not breastfeed during this same time period. Men must agree to either abstain from sexual intercourse for the duration of their participation in the study or use a latex condom during sexual contact with a FCBP while participating in the study and for 28 days 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 28 days 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.
  • Human immunodeficiency virus (HIV)+ patients with undetectable HIV viral loads tested within 6 months are eligible.
  • Patients should not have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to daratumumab, lenalidomide, or dexamethasone.

US Trial Locations

Accepting Patients

The following is a listing of trial locations that are open and accepting patients.

SparkCures Verified Accurate, up-to-date information. Learn more


Anchorage Oncology Centre

Anchorage, AK

Alaska Breast Care and Surgery LLC

Anchorage, AK

Alaska Women's Cancer Care

Anchorage, AK

Katmai Oncology Group

Anchorage, AK

Providence Alaska Medical Center

Anchorage, AK

Alta Bates Summit Comprehensive Cancer Center (Berkeley)

Berkeley, CA

Providence St. Joseph's Hospital

Burbank, CA

Mission Hope Cancer Center

Santa Maria, CA

Rocky Mountain Cancer Center Aurora

Aurora, CO

The Medical Center of Aurora

Aurora, CO

Boulder Community Hospital

Boulder, CO

Rocky Mountain Cancer Center Boulder

Boulder, CO

Littleton Adventist Hospital

Centennial, CO

Penrose-Saint Francis Healthcare

Colorado Springs, CO

Rocky Mountain Cancer Center Colorado Springs

Colorado Springs, CO

Porter Adventist Hospital

Denver, CO

Presbyterian/St. Luke's Medical Center

Denver, CO

Swedish Medical Center

Englewood, CO

Mountain Blue Cancer Care Center

Golden, CO

North Colorado Medical Center

Greeley, CO

Saint Anthony Hospital

Lakewood, CO

Rocky Mountain Cancer Center Littleton

Littleton, CO

Sky Ridge Medical Center

Lone Tree, CO

Longmont United Hospital

Longmont, CO

Rocky Mountain Cancer Center Longmont

Longmont, CO

McKee Medical Center

Loveland, CO

Parker Adventist Hospital

Parker, CO

Saint Mary Corwin Medical Center

Pueblo, CO

Rocky Mountain Cancer Center Thornton

Thornton, CO

Smilow Cancer Hospital Care Center (Fairfield)

Fairfield, CT

Smilow Cancer Hospital - Yale-New Haven Shoreline Medical Center

Guilford, CT

Smilow Cancer Hospital Care Center (Saint Francis)

Hartford, CT

Yale-New Haven Hospital - North Haven Medical Center

North Haven, CT

Smilow Cancer Hospital Care Center (Orange)

Orange, CT

Smilow Cancer Hospital Care Center (Trumbull)

Trumbull, CT

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

Waterbury, CT

Holy Cross Hospital (Michigan Cancer Research Consortium)

Fort Lauderdale, FL

Saint Joseph's-Candler Health System

Savannah, GA

Mary Greeley Medical Center

Ames, IA

McFarland Clinic PC

Ames, IA

McFarland Clinic PC (Boone)

Boone, IA

Mercy Cancer Center (West Lakes)

Clive, IA

Medical Oncology and Hematology Associates (West Des Moines)

Clive, IA

Greater Regional Medical Center

Creston, IA

Medical Oncology and Hematology Associates (Des Moines)

Des Moines, IA

Broadlawns Medical Center

Des Moines, IA

Medical Oncology and Hematology Associates (Laurel)

Des Moines, IA

Mercy Medical Center (Des Moines)

Des Moines, IA

Mercy Medical Center (West Lakes)

West Des Moines, IA

Methodist West Hospital

West Des Moines, IA

St. Luke's Regional Medical Center - Mountain States Tumor Institute (Boise)

Boise, ID

Saint Alphonsus Cancer Care Center (Boise)

Boise City, ID

Kootenai Medical Center

Coeur dAlene, ID

Saint Luke's Mountain States Tumor Institute (Fruitland)

Fruitland, ID

Saint Luke's Mountain States Tumor Institute (Meridian)

Meridian, ID

Saint Luke's Mountain States Tumor Institute (Nampa)

Nampa, ID

Kootenai Cancer Center

Post Falls, ID

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

Twin Falls, ID

Rush - Copley Medical Center

Aurora, IL

Carle Foundation Hospital (Vermilion)

Danville, IL

Carle Foundation Hospital (Effingham)

Effingham, IL

Northshore University Health System

Evanston, IL

Northwestern Medicine Cancer Center Delnor

Geneva, IL

Ingalls Memorial Hospital

Harvey, IL

Carle Foundation Hospital (Mattoon)

Mattoon, IL

Loyola University Medical Center Cardinal Bernardin Cancer Center

Maywood, IL

Good Samaritan Regional Health Center

Mount Vernon, IL

Illinois Cancer Specialists

Niles, IL

Carle Foundation Hospital

Urbana, IL

Northwestern Medicine Cancer Center Warrenville

Warrenville, IL

Indiana University Health

Indianapolis, IN

Saint Joseph Hospital East

Lexington, KY

Jewish Hospital

Louisville, KY

Jewish Hospital Medical Center Northeast

Louisville, KY

KentuckyOne Health - James Graham Brown Cancer Center

Louisville, KY

LSU Health Baton Rouge (North Clinic)

Baton Rouge, LA

Ochsner Medical Center

Jefferson, LA

Tulane Cancer Center Tulane University School of Medicine

New Orleans, LA

Tufts Medical Center Cancer Center

Boston, MA

Saint Agnes Hospital Saint Agnes Healthcare

Baltimore, MD

Hickman Cancer Center

Adrian, MI

Saint Joseph Mercy (Ann Arbor)

Ann Arbor, MI

Bronson Battle Creek Cancer Care Center

Battle Creek, MI

Saint Joseph Mercy (Brighton)

Brighton, MI

Saint Joseph Mercy (Canton)

Canton, MI

Caro Cancer Center

Caro, MI

Saint Joseph Mercy (Chelsea)

Chelsea, MI

Henry Ford Macomb Hospital

Clinton Township, MI

Henry Ford Medical Center (Fairlane)

Dearborn, MI

Henry Ford Hospital

Detroit, MI

Genesys Hurley Cancer Institute

Flint, MI

Hurley Medical Center

Flint, MI

Helen DeVos Children's Hospital

Grand Rapids, MI

Mercy Health Saint Mary's

Grand Rapids, MI

Spectrum Health

Grand Rapids, MI

Allegiance Health

Jackson, MI

Bronson Methodist Hospital

Kalamazoo, MI

West Michigan Cancer Center

Kalamazoo, MI

Borgess Medical Center

Kalamazoo, MI

Sparrow Hospital

Lansing, MI

Saint Mary Mercy Hospital

Livonia, MI

Saint Mary's Oncology/Hematology Associates of Marlette

Marlette, MI

Mercy Health Mercy Campus

Muskegon Heights, MI

Lakeland Community Hospital

Niles, MI

Henry Ford Medical Center (Columbus)

Novi, MI

Saint Joseph Mercy (Oakland)

Pontiac, MI

Spectrum Health Reed City Hospital

Reed City, MI

Saint Mary's of Michigan

Saginaw, MI

Oncology Hematology Associates of Saginaw Valley PC

Saginaw Valley, MI

Lakeland Hospital

Saint Joseph, MI

Marie Yeager Cancer Center

Saint Joseph, MI

Ascension Saint Joseph Hospital

Tawas City, MI

Munson Medical Center

Traverse City, MI

Saint John Macomb-Oakland Hospital

Warren, MI

Henry Ford Medical Center (West Bloomfield)

West Bloomfield, MI

Essentia Health Saint Joseph's Medical Center

Brainerd, MN

Fairview Ridges Hospital

Burnsville, MN

Mercy Hospital

Coon Rapids, MN

Essentia Health

Deer River, MN

Essentia Health Saint Mary's Medical Center

Duluth, MN

Essentia Health (Miller-Dwan Building)

Duluth, MN

Fairview Southdale Hospital

Edina, MN

Lake Region Healthcare Corporation-Cancer Care

Fergus Falls, MN

Unity Hospital

Fridley, MN

Essentia Health Hibbing Clinic

Hibbing, MN

Fairview Maple Grove Medical Center

Maple Grove, MN

Minnesota Oncology and Hematology PA (Maplewood)

Maplewood, MN

Saint John's Hospital - Healtheast

Maplewood, MN

Abbott-Northwestern Hospital

Minneapolis, MN

Hennepin County Medical Center

Minneapolis, MN

Health Partners Inc.

Minneapolis, MN

Monticello Cancer Center

Monticello, MN

North Memorial Medical Health Center

Robbinsdale, MN

Mayo Clinic (Rochester)

Rochester, MN

Saint Francis Regional Medical Center

Shakopee, MN

Park Nicollet Clinic (Saint Louis Park)

St. Louis Park, MN

Regions Hospital

St. Paul, MN

United Hospital

St. Paul, MN

Lakeview Hospital

Stillwater, MN

Essentia Health Virginia Clinic

Virginia, MN

Ridgeview Medical Center

Waconia, MN

Rice Memorial Hospital

Willmar, MN

Minnesota Oncology and Hematology PA (Woodbury)

Woodbury, MN

Saint Louis Cancer and Breast Institute

Ballwin, MO

Central Care Cancer Center

Bolivar, MO

Siteman Cancer Center at West County Hospital

Creve Coeur, MO

Freeman Health System

Joplin, MO

Saint Luke's Hospital of Kansas City

Kansas City, MO

Saint Luke's East (Lee's Summit)

Lees Summit, MO

Saint John's Clinic-Rolla-Cancer and Hematology

Rolla, MO

Siteman Cancer Center at Saint Peters Hospital

Saint Peters, MO

Mercy Hospital Springfield

Springfield, MO

CoxHealth South Hospital

Springfield, MO

Heartland Regional Medical Center

St. Joseph, MO

Siteman Cancer Center South County

St. Louis, MO

Mercy Hospital South

St. Louis, MO

Bozeman Deaconess Hospital

Bozeman, MT

Benefis Healthcare (Sletten Cancer Institute)

Great Falls, MT

Great Falls Clinic

Great Falls, MT

Kalispell Regional Medical Center

Kalispell, MT

Community Medical Hospital

Missoula, MT

Essentia Health Cancer Center - South University Clinic (Fargo)

Fargo, ND

CHI Health Saint Francis Medical Center

Grand Island, NE

CHI Health Good Samaritan Hospital

Kearney, NE

CHI Health Creighton University Medical Center

Omaha, NE

Morristown Medical Center Atlantic Health System

Morristown, NJ

Radiation Oncology Centers of Nevada Central

Las Vegas, NV

21st Century Oncology (Vegas Tenaya)

Las Vegas, NV

Comprehensive Cancer Centers of Nevada (Northwest)

Las Vegas, NV

Comprehensive Cancer Centers of Nevada (Summerlin)

Las Vegas, NV

Radiation Oncology Centers of Nevada Southeast

Paradise, NV

Comprehensive Cancer Centers of Nevada (Central Valley)

Paradise, NV

Saint Mary's Regional Medical Center

Reno, NV

Comprehensive Cancer Centers of Nevada

Spring Valley, NV

Glen Falls Hospital

Glen Falls, NY

Bethesda North Hospital

Blue Ash, OH

Saint Elizabeth Boardman Hospital

Boardman, OH

Geaugra Hospital

Chardon, OH

Adena Regional Medical Center

Chillicothe, OH

TriHealth Cancer Institute (Good Samaritan Hospital)

Cincinnati, OH

Case Western Reserve University

Cleveland, OH

MetroHealth Medical Center

Cleveland, OH

University Hospitals Seidman Cancer Center at UH Case Medical

Cleveland, OH

Mount Carmel Health Center West

Columbus, OH

Riverside Methodist Hospital

Columbus, OH

Grant Medical Center

Columbus, OH

The Mark H. Zangmeister Center

Columbus, OH

Doctors Hospital

Columbus, OH

Dayton Physicians (Miami Valley Hospital South)

Dayton, OH

Miami Valley Hospital (South)

Dayton, OH

Miami Valley Hospital

Dayton, OH

Oncology Hematology Care Inc. (Kenwood)

Deer Park, OH

Delaware Health Center (Grady Cancer Center)

Delaware, OH

Blanchard Valley Hospital

Findlay, OH

Atrium Medical Center (Middletown Regional Hospital)

Franklin, OH

Dayton Physicians (Atrium Medical Center)

Franklin, OH

Dayton Physicians (Wilson Memorial Hospital)

Greenville, OH

Wayne Hospital

Greenville, OH

Kettering Medical Center

Kettering, OH

Saint Rita's Medical Center

Lima, OH

Marietta Memorial Hospital

Marietta, OH

Ireland Cancer Center (Landerbrook Health Center)

Mayfield Heights, OH

Ireland Cancer Center (Lake University)

Mentor, OH

Licking Memorial Hospital

Newark, OH

Newark Radiation Oncology

Newark, OH

Southern Ohio Medical Center

Portsmouth, OH

Ireland Cancer Center (Firelands Regional Medical Center)

Sandusky, OH

Springfield Regional Medical Center

Springfield, OH

Saint Vincent Mercy Medical Center

Toledo, OH

Toledo Clinic Cancer Centers (Toledo)

Toledo, OH

Dayton Physicians (Upper Valley Medical Center)

Troy, OH

Upper Valley Medical Center

Troy, OH

Saint Ann's Hospital

Westerville, OH

Mount Carmel Health Center (East)

Whitehall, OH

Genesis HealthCare System

Zanesville, OH

Mercy Hospital Oklahoma City

Oklahoma City, OK

Clackamas Radiation Oncology Center

Clackamas, OR

Bay Area Hospital

Coos Bay, OR

Providence Newberg Medical Center

Newberg, OR

Providence Portland Medical Center

Portland, OR

Lehigh Valley Health Network Cancer Institute

Allentown, PA

Geisinger Medical Center (Danville)

Geisinger Med - Danville, PA

Geisinger Medical Center (Hazleton)

Hazleton, PA

Geisinger Medical Oncology (Evangelical Community Hospital)

Lewisburg, PA

Geisinger Health System (Lewistown Hospital)

Lewistown, PA

Allegheny Health Network (West Penn)

Pittsburgh, PA

Pottstown Memorial Medical Center

Pottstown, PA

Geisinger Medical Oncology (Pottsville)

Pottsville, PA

Reading Hospital and Medical Center

Reading, PA

Geisinger Medical Center (Wilkes-Barre)

Wilkes-Barre, PA

Self Regional Healthcare

Greenwood, SC

Prisma Health Greer

Greer, SC

Prisma Health Seneca

Seneca, SC

University of Texas Southwest Medical Center (Fort Worth)

Fort Worth, TX

PeaceHealth Medical Group

Bellingham, WA

Harrison HealthPartners Hematology and Oncology-Bremerton

Bremerton, WA

Harrison Medical Center

Bremerton, WA

Highline Medical Center (Main Campus)

Burien, WA

Swedish Medical Center (Edmonds Campus)

Edmonds, WA

Providence Everett Medical Center

Everett, WA

Saint John Medical Center

Longview, WA

Swedish Medical Center (Ballard Campus)

Seattle, WA

Seattle Cancer Care Alliance

Seattle, WA

Swedish Medical Center (First Hill Campus)

Seattle, WA

University of Washington School of Medicine

Seattle, WA

Providence St. Mary Regional Cancer Center

Walla Walla, WA

North Star Lodge Cancer Center

Yakima, WA

Duluth Clinic Ashland

Ashland, WI

Aurora Cancer Care (Burlington)

Burlington, WI

Marshfield Clinic Cancer Center (Sacred Heart)

Eau Claire, WI

Aurora Health Center (Fond du Lac)

Fond Du Lac, WI

Aurora Cancer Care (Grafton)

Grafton, WI

Aurora BayCare Medical Center

Green Bay, WI

Aurora Cancer Care (Kenosha South)

Kenosha, WI

Gundersen Lutheran Medical Center

La Crosse, WI

Marshfield Clinic (Marshfield)

Marshfield, WI

Aurora Cancer Care (Milwaukee)

Milwaukee, WI

Aurora Saint Luke's Medical Center

Milwaukee, WI

Aurora Sinai Medical Center

Milwaukee, WI

Marshfield Clinic (Minocqua Center)

Minocqua, WI

Aurora Cancer Care (Racine)

Mount Pleasant, WI

D. N. Greenwald Center

Mukwonago, WI

Cancer Center of Western Wisconsin

New Richmond, WI

Oconomowoc Memorial Hospital-ProHealth Care Inc

Oconomowoc, WI

Aurora Medical Center (Summit)

Oconomowoc, WI

Vince Lombardi Cancer Clinic (Oshkosh)

Oshkosh, WI

Marshfield Clinic (Rice Lake Center)

Rice Lake, WI

Vince Lombardi Cancer Clinic (Sheboygan)

Sheboygan, WI

Marshfield Clinic Cancer Care (Saint Michael's Hospital)

Stevens Point, WI

Vince Lombardi Cancer Clinic (Two Rivers)

Two Rivers, WI

Aurora Cancer Care (Milwaukee West)

Wauwatosa, WI

Aurora West Allis Medical Center

West Allis, WI

Marshfield Clinic (Weston Center)

Weston, WI

West Virginia University

Morgantown, WV

Welch Cancer Center

Sheridan, WY

Not Currently Accepting Patients

The following is a listing of trial locations that are not currently open and accepting patients.

Mayo Clinic Hospital

Phoenix, AZ

National Jewish Health (Main Campus)

Denver, CO

SCL Health Saint Joseph Hospital

Denver, CO

Rose Medical Center

Denver, CO

Mercy Medical Center

Durango, CO

Southwest Oncology PC

Durango, CO

National Jewish Health (Western Hematology Oncology)

Golden, CO

St. Mary's Medical Center

Grand Junction, CO

Rocky Mountain Cancer Centers Lone Tree - Skyridge

Lone Tree, CO

SCL Health Lutheran Medical Center

Wheat Ridge, CO

Lewis Cancer and Research Pavilion at Saint Joseph's/Candler

Savannah, GA

Alegent Health Mercy Hospital

Council Bluffs, IA

McFarland Clinic PC (Trinity Cancer Center)

Fort Dodge, IA

McFarland Clinic PC (Jefferson)

Jefferson, IA

McFarland Clinic PC (Marshalltown)

Marshalltown, IA

Kootenai Clinic

Sandpoint, ID

Loyola Center for Health at Burr Ridge

Burr Ridge, IL

Marjorie Weinberg Cancer Center at Loyola-Gottlieb

Melrose Park, IL

Loyola Center for Cancer Care and Research

Orland Park, IL

Rush - Copley Healthcare Center

Yorkville, IL

Springmill Medical Center

Carmel, IN

Saint Luke's South Hospital

Overland Park, KS

Flaget Memorial Hospital

Bardstown, KY

Commonwealth Cancer Center (Corbin)

Corbin, KY

Saints Mary and Elizabeth Hospital

Louisville, KY

Jewish Hospital Medical Center South

Shepherdsville, KY

Hematology Oncology Clinic

Baton Rouge, LA

Hematology/Oncology Clinic LLP

Baton Rouge, LA

Mercy Medical Center

Springfield, MA

Cambridge Medical Center

Cambridge, MN

New Ulm Medical Center

New Ulm, MN

Fairview Northland Medical Center

Princeton, MN

Fairview Lakes Medical Center

Wyoming, MN

Mercy Hospital Washington

Washington, MO

Community Hospital of Anaconda

Anaconda, MT

Saint Vincent Healthcare

Billings, MT

Saint James Community Hospital and Cancer Treatment Center

Butte, MT

Saint Patrick Hospital - Community Hospital

Missoula, MT

Saint Elizabeth Regional Medical Center

Lincoln, NE

CHI Health Midlands

Papillion, NE

Comprehensive Cancer Centers of Nevada (Henderson)

Henderson, NV

Las Vegas Cancer Center (Henderson)

Henderson, NV

Cancer and Blood Specialists (Henderson)

Henderson, NV

21st Century Oncology (Henderson)

Henderson, NV

University Medical Center of Southern Nevada

Las Vegas, NV

Cancer and Blood Specialists (Shadow)

Las Vegas, NV

Cancer and Blood Specialists (Tenaya)

Las Vegas, NV

HealthCare Partners Medical Group Oncology/Hematology (Tenaya)

Las Vegas, NV

Summerlin Hospital Medical Center

Las Vegas, NV

HealthCare Partners Medical Group Oncology/Hematology (Centennial Hills)

Las Vegas, NV

HealthCare Partners Medical Group Oncology/Hematology (San Martin)

Spring Valley, NV

Las Vegas Cancer Center (Medical Center)

Spring Valley, NV

21st Century Oncology (Fort Apache)

Spring Valley, NV

HealthCare Partners Medical Group Oncology/Hematology (Maryland Parkway)

Winchester, NV

Strecker Cancer Center (Belpre)

Belpre, OH

Columbus Oncology and Hematology Associates Inc

Columbus, OH

Good Samaritan Hospital (Dayton)

Dayton, OH

Grady Memorial Hospital

Delaware, OH

TriHealth Cancer Institute (Anderson)

Forestville, OH

Fairfield Medical Center

Lancaster, OH

OhioHealth Marion General Hospital

Marion, OH

Knox Community Hospital

Mount Vernon, OH

Mercy Saint Anne Hospital

Toledo, OH

TriHealth Cancer Institute (Westside)

White Oak, OH

Geisinger Medical Group

State College, PA

Prisma Health Boiling Springs

Boiling Springs, SC

Prisma Health Easley

Easley, SC

Revere Health (American Fork Main Campus)

American Fork, UT

Intermountain Medical Center

Murray, UT

Utah Cancer Specialists UCS Cancer Center

Salt Lake City, UT

Saint Elizabeth Hospital

Enumclaw, WA

Saint Francis Hospital

Federal Way, WA

Saint Clare Hospital - CHI Franciscan Health

Lakewood, WA

Harrison HealthPartners Hematology and Oncology-Poulsbo

Poulsbo, WA

MultiCare Good Samaritan Hospital

Puyallup, WA

Multicare Health System

Tacoma, WA

Waukesha Memorial Hospital - ProHealth Care

Waukesha, WI

Cheyenne Regional Medical Center (West)

Cheyenne, WY

Billings Clinic (Cody)

Cody, WY

Alaska
Anchorage Oncology Centre

Anchorage, AK

Alaska Breast Care and Surgery LLC

Anchorage, AK

Alaska Women's Cancer Care

Anchorage, AK

Katmai Oncology Group

Anchorage, AK

Providence Alaska Medical Center

Anchorage, AK

Arizona
Mayo Clinic Hospital

Phoenix, AZ

California
Alta Bates Summit Comprehensive Cancer Center (Berkeley)

Berkeley, CA

Providence St. Joseph's Hospital

Burbank, CA

Mission Hope Cancer Center

Santa Maria, CA

Colorado
Rocky Mountain Cancer Center Aurora

Aurora, CO

The Medical Center of Aurora

Aurora, CO

Boulder Community Hospital

Boulder, CO

Rocky Mountain Cancer Center Boulder

Boulder, CO

Littleton Adventist Hospital

Centennial, CO

Penrose-Saint Francis Healthcare

Colorado Springs, CO

Rocky Mountain Cancer Center Colorado Springs

Colorado Springs, CO

National Jewish Health (Main Campus)

Denver, CO

Porter Adventist Hospital

Denver, CO

Presbyterian/St. Luke's Medical Center

Denver, CO

SCL Health Saint Joseph Hospital

Denver, CO

Rose Medical Center

Denver, CO

Mercy Medical Center

Durango, CO

Southwest Oncology PC

Durango, CO

Swedish Medical Center

Englewood, CO

National Jewish Health (Western Hematology Oncology)

Golden, CO

Mountain Blue Cancer Care Center

Golden, CO

St. Mary's Medical Center

Grand Junction, CO

North Colorado Medical Center

Greeley, CO

Saint Anthony Hospital

Lakewood, CO

Rocky Mountain Cancer Center Littleton

Littleton, CO

Rocky Mountain Cancer Centers Lone Tree - Skyridge

Lone Tree, CO

Sky Ridge Medical Center

Lone Tree, CO

Longmont United Hospital

Longmont, CO

Rocky Mountain Cancer Center Longmont

Longmont, CO

McKee Medical Center

Loveland, CO

Parker Adventist Hospital

Parker, CO

Saint Mary Corwin Medical Center

Pueblo, CO

Rocky Mountain Cancer Center Thornton

Thornton, CO

SCL Health Lutheran Medical Center

Wheat Ridge, CO

Connecticut
Smilow Cancer Hospital Care Center (Fairfield)

Fairfield, CT

Smilow Cancer Hospital - Yale-New Haven Shoreline Medical Center

Guilford, CT

Smilow Cancer Hospital Care Center (Saint Francis)

Hartford, CT

Yale-New Haven Hospital - North Haven Medical Center

North Haven, CT

Smilow Cancer Hospital Care Center (Orange)

Orange, CT

Smilow Cancer Hospital Care Center (Trumbull)

Trumbull, CT

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

Waterbury, CT

Florida
Holy Cross Hospital (Michigan Cancer Research Consortium)

Fort Lauderdale, FL

Georgia
Verified Winship Cancer Institute of Emory University

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Lewis Cancer and Research Pavilion at Saint Joseph's/Candler

Savannah, GA

Saint Joseph's-Candler Health System

Savannah, GA

Idaho
St. Luke's Regional Medical Center - Mountain States Tumor Institute (Boise)

Boise, ID

Saint Alphonsus Cancer Care Center (Boise)

Boise City, ID

Kootenai Medical Center

Coeur dAlene, ID

Saint Luke's Mountain States Tumor Institute (Fruitland)

Fruitland, ID

Saint Luke's Mountain States Tumor Institute (Meridian)

Meridian, ID

Saint Luke's Mountain States Tumor Institute (Nampa)

Nampa, ID

Kootenai Cancer Center

Post Falls, ID

Kootenai Clinic

Sandpoint, ID

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

Twin Falls, ID

Illinois
Rush - Copley Medical Center

Aurora, IL

Loyola Center for Health at Burr Ridge

Burr Ridge, IL

Carle Foundation Hospital (Vermilion)

Danville, IL

Carle Foundation Hospital (Effingham)

Effingham, IL

Northshore University Health System

Evanston, IL

Northwestern Medicine Cancer Center Delnor

Geneva, IL

Ingalls Memorial Hospital

Harvey, IL

Carle Foundation Hospital (Mattoon)

Mattoon, IL

Loyola University Medical Center Cardinal Bernardin Cancer Center

Maywood, IL

Marjorie Weinberg Cancer Center at Loyola-Gottlieb

Melrose Park, IL

Good Samaritan Regional Health Center

Mount Vernon, IL

Illinois Cancer Specialists

Niles, IL

Loyola Center for Cancer Care and Research

Orland Park, IL

Carle Foundation Hospital

Urbana, IL

Northwestern Medicine Cancer Center Warrenville

Warrenville, IL

Rush - Copley Healthcare Center

Yorkville, IL

Indiana
Springmill Medical Center

Carmel, IN

Indiana University Health

Indianapolis, IN

Iowa
Mary Greeley Medical Center

Ames, IA

McFarland Clinic PC

Ames, IA

McFarland Clinic PC (Boone)

Boone, IA

Mercy Cancer Center (West Lakes)

Clive, IA

Medical Oncology and Hematology Associates (West Des Moines)

Clive, IA

Alegent Health Mercy Hospital

Council Bluffs, IA

Greater Regional Medical Center

Creston, IA

Medical Oncology and Hematology Associates (Des Moines)

Des Moines, IA

Broadlawns Medical Center

Des Moines, IA

Medical Oncology and Hematology Associates (Laurel)

Des Moines, IA

Mercy Medical Center (Des Moines)

Des Moines, IA

McFarland Clinic PC (Trinity Cancer Center)

Fort Dodge, IA

McFarland Clinic PC (Jefferson)

Jefferson, IA

McFarland Clinic PC (Marshalltown)

Marshalltown, IA

Mercy Medical Center (West Lakes)

West Des Moines, IA

Methodist West Hospital

West Des Moines, IA

Kansas
Saint Luke's South Hospital

Overland Park, KS

Kentucky
Flaget Memorial Hospital

Bardstown, KY

Commonwealth Cancer Center (Corbin)

Corbin, KY

Saint Joseph Hospital East

Lexington, KY

Jewish Hospital

Louisville, KY

Jewish Hospital Medical Center Northeast

Louisville, KY

KentuckyOne Health - James Graham Brown Cancer Center

Louisville, KY

Saints Mary and Elizabeth Hospital

Louisville, KY

Jewish Hospital Medical Center South

Shepherdsville, KY

Louisiana
Hematology Oncology Clinic

Baton Rouge, LA

LSU Health Baton Rouge (North Clinic)

Baton Rouge, LA

Hematology/Oncology Clinic LLP

Baton Rouge, LA

Ochsner Medical Center

Jefferson, LA

Tulane Cancer Center Tulane University School of Medicine

New Orleans, LA

Maryland
Saint Agnes Hospital Saint Agnes Healthcare

Baltimore, MD

Massachusetts
Tufts Medical Center Cancer Center

Boston, MA

Mercy Medical Center

Springfield, MA

Michigan
Hickman Cancer Center

Adrian, MI

Saint Joseph Mercy (Ann Arbor)

Ann Arbor, MI

Bronson Battle Creek Cancer Care Center

Battle Creek, MI

Saint Joseph Mercy (Brighton)

Brighton, MI

Saint Joseph Mercy (Canton)

Canton, MI

Caro Cancer Center

Caro, MI

Saint Joseph Mercy (Chelsea)

Chelsea, MI

Henry Ford Macomb Hospital

Clinton Township, MI

Henry Ford Medical Center (Fairlane)

Dearborn, MI

Henry Ford Hospital

Detroit, MI

Genesys Hurley Cancer Institute

Flint, MI

Hurley Medical Center

Flint, MI

Helen DeVos Children's Hospital

Grand Rapids, MI

Mercy Health Saint Mary's

Grand Rapids, MI

Spectrum Health

Grand Rapids, MI

Allegiance Health

Jackson, MI

Bronson Methodist Hospital

Kalamazoo, MI

West Michigan Cancer Center

Kalamazoo, MI

Borgess Medical Center

Kalamazoo, MI

Sparrow Hospital

Lansing, MI

Saint Mary Mercy Hospital

Livonia, MI

Saint Mary's Oncology/Hematology Associates of Marlette

Marlette, MI

Mercy Health Mercy Campus

Muskegon Heights, MI

Lakeland Community Hospital

Niles, MI

Henry Ford Medical Center (Columbus)

Novi, MI

Saint Joseph Mercy (Oakland)

Pontiac, MI

Spectrum Health Reed City Hospital

Reed City, MI

Saint Mary's of Michigan

Saginaw, MI

Oncology Hematology Associates of Saginaw Valley PC

Saginaw Valley, MI

Lakeland Hospital

Saint Joseph, MI

Marie Yeager Cancer Center

Saint Joseph, MI

Ascension Saint Joseph Hospital

Tawas City, MI

Munson Medical Center

Traverse City, MI

Saint John Macomb-Oakland Hospital

Warren, MI

Henry Ford Medical Center (West Bloomfield)

West Bloomfield, MI

Minnesota
Essentia Health Saint Joseph's Medical Center

Brainerd, MN

Fairview Ridges Hospital

Burnsville, MN

Cambridge Medical Center

Cambridge, MN

Mercy Hospital

Coon Rapids, MN

Essentia Health

Deer River, MN

Essentia Health Saint Mary's Medical Center

Duluth, MN

Essentia Health (Miller-Dwan Building)

Duluth, MN

Fairview Southdale Hospital

Edina, MN

Lake Region Healthcare Corporation-Cancer Care

Fergus Falls, MN

Unity Hospital

Fridley, MN

Essentia Health Hibbing Clinic

Hibbing, MN

Fairview Maple Grove Medical Center

Maple Grove, MN

Minnesota Oncology and Hematology PA (Maplewood)

Maplewood, MN

Saint John's Hospital - Healtheast

Maplewood, MN

Abbott-Northwestern Hospital

Minneapolis, MN

Hennepin County Medical Center

Minneapolis, MN

Health Partners Inc.

Minneapolis, MN

Monticello Cancer Center

Monticello, MN

New Ulm Medical Center

New Ulm, MN

Fairview Northland Medical Center

Princeton, MN

North Memorial Medical Health Center

Robbinsdale, MN

Mayo Clinic (Rochester)

Rochester, MN

Saint Francis Regional Medical Center

Shakopee, MN

Park Nicollet Clinic (Saint Louis Park)

St. Louis Park, MN

Regions Hospital

St. Paul, MN

United Hospital

St. Paul, MN

Lakeview Hospital

Stillwater, MN

Essentia Health Virginia Clinic

Virginia, MN

Ridgeview Medical Center

Waconia, MN

Rice Memorial Hospital

Willmar, MN

Minnesota Oncology and Hematology PA (Woodbury)

Woodbury, MN

Fairview Lakes Medical Center

Wyoming, MN

Missouri
Verified Alvin J. Siteman Cancer Center Washington University Medical Campus

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Saint Louis Cancer and Breast Institute

Ballwin, MO

Central Care Cancer Center

Bolivar, MO

Siteman Cancer Center at West County Hospital

Creve Coeur, MO

Freeman Health System

Joplin, MO

Saint Luke's Hospital of Kansas City

Kansas City, MO

Saint Luke's East (Lee's Summit)

Lees Summit, MO

Saint John's Clinic-Rolla-Cancer and Hematology

Rolla, MO

Siteman Cancer Center at Saint Peters Hospital

Saint Peters, MO

Mercy Hospital Springfield

Springfield, MO

CoxHealth South Hospital

Springfield, MO

Heartland Regional Medical Center

St. Joseph, MO

Siteman Cancer Center South County

St. Louis, MO

Mercy Hospital South

St. Louis, MO

Mercy Hospital Washington

Washington, MO

Montana
Community Hospital of Anaconda

Anaconda, MT

Saint Vincent Healthcare

Billings, MT

Bozeman Deaconess Hospital

Bozeman, MT

Saint James Community Hospital and Cancer Treatment Center

Butte, MT

Benefis Healthcare (Sletten Cancer Institute)

Great Falls, MT

Great Falls Clinic

Great Falls, MT

Kalispell Regional Medical Center

Kalispell, MT

Saint Patrick Hospital - Community Hospital

Missoula, MT

Community Medical Hospital

Missoula, MT

Nebraska
CHI Health Saint Francis Medical Center

Grand Island, NE

CHI Health Good Samaritan Hospital

Kearney, NE

Saint Elizabeth Regional Medical Center

Lincoln, NE

CHI Health Creighton University Medical Center

Omaha, NE

CHI Health Midlands

Papillion, NE

Nevada
Comprehensive Cancer Centers of Nevada (Henderson)

Henderson, NV

Las Vegas Cancer Center (Henderson)

Henderson, NV

Cancer and Blood Specialists (Henderson)

Henderson, NV

21st Century Oncology (Henderson)

Henderson, NV

University Medical Center of Southern Nevada

Las Vegas, NV

Cancer and Blood Specialists (Shadow)

Las Vegas, NV

Radiation Oncology Centers of Nevada Central

Las Vegas, NV

21st Century Oncology (Vegas Tenaya)

Las Vegas, NV

Cancer and Blood Specialists (Tenaya)

Las Vegas, NV

Comprehensive Cancer Centers of Nevada (Northwest)

Las Vegas, NV

HealthCare Partners Medical Group Oncology/Hematology (Tenaya)

Las Vegas, NV

Comprehensive Cancer Centers of Nevada (Summerlin)

Las Vegas, NV

Summerlin Hospital Medical Center

Las Vegas, NV

HealthCare Partners Medical Group Oncology/Hematology (Centennial Hills)

Las Vegas, NV

Radiation Oncology Centers of Nevada Southeast

Paradise, NV

Comprehensive Cancer Centers of Nevada (Central Valley)

Paradise, NV

Saint Mary's Regional Medical Center

Reno, NV

HealthCare Partners Medical Group Oncology/Hematology (San Martin)

Spring Valley, NV

Las Vegas Cancer Center (Medical Center)

Spring Valley, NV

21st Century Oncology (Fort Apache)

Spring Valley, NV

Comprehensive Cancer Centers of Nevada

Spring Valley, NV

HealthCare Partners Medical Group Oncology/Hematology (Maryland Parkway)

Winchester, NV

New Jersey
Morristown Medical Center Atlantic Health System

Morristown, NJ