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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05174169
Other study ID # NRG-GI008
Secondary ID U10CA180868NRG-G
Status Recruiting
Phase Phase 2/Phase 3
First received
Last updated
Start date March 10, 2022
Est. completion date March 10, 2030

Study information

Verified date June 2024
Source NRG Oncology
Contact Judy Langer, MD, MS
Phone 412-339-5300
Email langerj@nrgoncology.org
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This Phase II/III trial will evaluate the what kind of chemotherapy to recommend to patients based on the presence or absences of circulating tumor DNA (ctDNA) after surgery for colon cancer.


Description:

Currently, there are no biomarkers validated prospectively in randomized studies for resected colon cancer to determine need for adjuvant chemotherapy. However, circulating tumor DNA (ctDNA) shed into the bloodstream represents a highly specific and sensitive approach (especially with serial monitoring) for identifying microscopic or residual tumor cells in colon cancer patients and may outperform traditional clinical and pathological features in prognosticating risk for recurrence. Colon cancer patients who do not have detectable ctDNA (ctDNA-) are at a much lower risk of recurrence and may not need adjuvant chemotherapy. Furthermore, for colon cancer pts with detectable ctDNA (ctDNA+) who are at a very high risk of recurrence, the optimal adjuvant chemotherapy regimen has not been established. We hypothesize that for pts whose colon cancer has been resected, ctDNA status may be used to risk stratify for making decisions about adjuvant chemotherapy.


Recruitment information / eligibility

Status Recruiting
Enrollment 1912
Est. completion date March 10, 2030
Est. primary completion date March 10, 2029
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: The patient must have an ECOG performance status of 0 or 1. Patients must have histologically/pathologically confirmed colon adenocarcinoma (T1-3, N1/N1c) with R0 resection accordingly to AJCC 8th edition criteria. NOTE: Patients with pathologic stages II or IIIC colon adenocarcinoma with R0 resection who have a commercially obtained Signatera™ ctDNA+ve assay result post-operatively meeting all timelines and eligibility requirements otherwise, are eligible for enrollment and inclusion in Cohort B. No radiographic evidence of overt metastatic disease within 28 days prior to study entry (CT with IV contrast or MRI imaging is acceptable and must include chest, abdomen, and pelvis). The distal extent of the tumor must be greater than or equal to 12 cm from the anal verge on colonoscopy or above the peritoneal reflection as documented during surgery or on pathology specimen (i.e., excluding rectal adenocarcinomas warranting treatment with chemoradiation). The patient must have had an en bloc complete gross resection of tumor (curative resection). Patients who have had a two-stage surgical procedure, to first provide a decompressive colostomy and then in a later procedure to have the definitive surgical resection, are eligible. The resected tumor specimen and a blood specimen from patients with Stage IIIA or Stage IIIB colon cancer must have central testing for ctDNA using the Signatera™ assay by Natera. NOTE: Patients with stage IIIA or IIIB colon cancer who otherwise meet eligibility criteria and have had ctDNA status checked with the Signatera™ assay as routine care outside of the study, are allowed to be enrolled, and will be retested and placed in either Cohort A or Cohort B depending on the central ctDNA testing result. NOTE: Patients with stage II or IIIC colon cancer who otherwise meet eligibility criteria and have had ctDNA status checked with the Signatera™ assay as routine care outside of the study AND have a ctDNA+ve result, are allowed to be enrolled. Patients will have central ctDNA testing, confirmed to be ctDNA+ve, and placed in Cohort B. Tumor must be documented as microsatellite stable or have intact mismatch repair proteins through CLIA-approved laboratory testing. Patients whose tumors are MSI-H or dMMR are excluded. The treating investigator must deem the patient a candidate for all potential agents used in this trial (5FU, LV, oxaliplatin and irinotecan). The interval between surgery (post-operative Day 7) and study entry must be no more than 60 days. Availability and provision of adequate surgical tumor tissue for molecular diagnostics and confirmatory profiling. Adequate hematologic function within 28 days before study entry defined as follows: - Absolute neutrophil count (ANC) must be greater than or equal to 1500/mm3; - Platelet count must be greater than or equal to 100,000/mm3; and - Hemoglobin must be greater than or equal to 9 g/dL. Adequate hepatic function within 28 days before study entry defined as follows: - total bilirubin must be less than or equal to ULN (upper limit of normal) for the lab and - alkaline phosphatase must be less than 2.5 x ULN for the lab; and - AST and ALT must be less than 2.5 x ULN for the lab. Adequate renal function within 28 days before study entry defined as serum creatinine less than or equal to 1.5 x ULN for the lab or measured or calculated creatinine clearance greater than or equal to 50 mL/min using the Cockroft-Gault formula for patients with creatinine levels greater than 1.5 x ULN for the lab. For Women Creatinine Clearance (mL/min) = (140 - age) x weight (kg) x 0.85 72 x serum creatinine (mg/dL) For Men Creatinine Clearance (mL/min) = (140 - age) x weight (kg) 72 x serum creatinine (mg/dL) HIV-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial. Pregnancy test (urine or serum according to institutional standard) done within 14 days before study entry must be negative (for women of childbearing potential only). Patients receiving a coumarin-derivative anticoagulant must agree to weekly monitoring of INR if they are randomized to Arm 1 or Arm 3 and receive capecitabine. Eligibility Criteria for Cohort A Arm-2 patients on Second Randomization Patient must have developed a ctDNA +ve assay during serial monitoring. Patient's willingness to be re-randomized affirmed. The patient must continue to have an ECOG performance status of 0 or 1. No radiographic evidence of overt metastatic disease. Pregnancy test (urine or serum according to institutional standard) done within 14 days before study entry must be negative (for women of childbearing potential only). Adequate hematologic function within 28 days before randomization defined as follows: - Absolute neutrophil count (ANC) must be greater than or equal to 1500/mm3; - Platelet count must be greater than or equal to 100,000/mm3; and - Hemoglobin must be greater than or equal to 9 g/dL. Adequate hepatic function within 28 days before randomization defined as follows: - total bilirubin must be less than or equal to ULN (upper limit of normal) for the lab and - alkaline phosphatase must be less than 2.5 x ULN for the lab; and - AST and ALT must be less than 2.5 x ULN for the lab. Adequate renal function within 28 days before randomization defined as serum creatinine less than or equal to 1.5 x ULN for the lab or measured or calculated creatinine clearance greater than or equal to 50 mL/min using the Cockroft-Gault formula for patients with creatinine levels greater than 1.5 x ULN for the lab. For Women Creatinine Clearance (mL/min) = (140 - age) x weight (kg) x 0.85 72 x serum creatinine (mg/dL) For Men Creatinine Clearance (mL/min) = (140 - age) x weight (kg) 72 x serum creatinine (mg/dL) Exclusion Criteria: Colon cancer histology other than adenocarcinoma (i.e., neuroendocrine carcinoma, sarcoma, lymphoma, squamous cell carcinoma, etc.). Pathologic, clinical, or radiologic overt evidence of metastatic disease. This includes isolated, distant, or non-contiguous intra-abdominal metastases, even if resected. Tumor-related bowel perforation. History of prior invasive colon malignancy, regardless of disease-free interval. History of bone marrow or solid organ transplantation (regardless of current immunosuppressive therapy needs). Bone grafts, skin grafts, corneal transplants and organ/tissue donation are not exclusionary. Any prior systemic chemotherapy, targeted therapy, or immunotherapy; or radiation therapy administered as treatment for colorectal cancer (e.g., primary colon adenocarcinomas for which treatment with neoadjuvant chemotherapy and/or radiation is warranted are not permitted). Other invasive malignancy within 5 years before study entry. Exceptions are colonic polyps, non-melanoma skin cancer or any carcinoma-in-situ. Synchronous primary rectal and/ or colon cancers. 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. Sensory or motor neuropathy greater than or equal to grade 2, according to CTCAE v5.0. Blood transfusion within two weeks before collection of blood for central ctDNA testing. Active seizure disorder uncontrolled by medication. Active or chronic infection requiring systemic therapy. Known homozygous DPD (dihydropyrimidine dehydrogenase) deficiency. Patients known to have Gilbert's Syndrome or homozygosity for UGT1A1*28 polymorphism. Pregnancy or lactation at the time of study entry. Co-morbid illnesses or other concurrent disease that would make the patient inappropriate for entry into this study (i.e., unable to tolerate 6 months of combination chemotherapy or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens or prevent required follow-up). Ineligibility Criteria for Cohort A Arm-2 patients on Second Randomization Pregnancy or lactation at the time of randomization. No longer a candidate for systemic chemotherapy (FOLFOX, CAPOX, and mFOLFIRINOX) in the opinion of the treating investigator.

Study Design


Related Conditions & MeSH terms


Intervention

Device:
Signatera test
Central ctDNA testing for all patients
Drug:
mFOLFOX6 3-6 month
Oxaliplatin 85 mg/m2 IV + Leucovorin 400mg/m2 IV + 5-Fluorouracil (5-FU) 400mg/m2 bolus + 5-Fluorouracil (5-FU) 2400mg/m2 IV continuous infusion over 46-48 hours (total dose) Day1 every 2 weeks for 6-12 cycles
CAPOX 3 month
Oxaliplatin 130 mg/m2 IV Day 1 every 3 weeks + Capecitabine 1000 mg/m2 BID by mouth days 1-14 every 3 weeks for 4 cycles
mFOLFIRINOX
Oxaliplatin 85 mg/m2 IV + Leucovorin 400mg/m2 IV + Irinotecan 150 mg/m2 IV continuous infusion (30-90 minutes) + 5-Fluorouracil (5-FU) 2400mg/m2 IV continuous infusion over 46-48 hours (total dose) Day1 every 2 weeks for 12 cycles
mFOLFOX6 6 month
Oxaliplatin 85 mg/m2 IV + Leucovorin 400mg/m2 IV + 5-Fluorouracil (5-FU) 400mg/m2 bolus + 5-Fluorouracil (5-FU) 2400mg/m2 IV continuous infusion over 46-48 hours (total dose) Day1 every 2 weeks for 12 cycles
CAPOX 6 month
Oxaliplatin 130 mg/m2 IV Day 1 every 3 weeks + Capecitabine 1000 mg/m2 BID by mouth days 1-14 every 3 weeks for 8 cycles

Locations

Country Name City State
Canada CSSS Champlain-Charles Le Moyne Greenfield Park Quebec
Canada Juravinski Cancer Centre at Hamilton Health Sciences Hamilton Ontario
Canada Hotel-Dieu De Levis Levis Quebec
Canada London Regional Cancer Program London Ontario
Canada Hopital Du Sacre-Coeur de Montreal Montreal Quebec
Canada Jewish General Hospital Montreal Quebec
Canada Lakeridge Health Oshawa Oshawa Ontario
Canada BCCA-Cancer Centre for the North Prince George British Columbia
Canada CHU de Quebec-L'Hotel-Dieu de Quebec (HDQ) Quebec City Quebec
Canada Allan Blair Cancer Centre Regina Saskatchewan
Canada Niagara Health System-Saint Catharines General Saint Catharines Ontario
Canada Saskatoon Cancer Centre Saskatoon Saskatchewan
Canada North York General Hospital Toronto Ontario
Canada BCCA-Vancouver Cancer Centre Vancouver British Columbia
Canada BCCA-Vancouver Island Cancer Centre Victoria British Columbia
United States Hawaii Cancer Care - Westridge 'Aiea Hawaii
United States Pali Momi Medical Center 'Aiea Hawaii
United States Avera Cancer Institute-Aberdeen Aberdeen South Dakota
United States Cleveland Clinic Akron General Akron Ohio
United States Summa Health System - Akron Campus Akron Ohio
United States Presbyterian Kaseman Hospital Albuquerque New Mexico
United States University of New Mexico Cancer Center Albuquerque New Mexico
United States Lehigh Valley Hospital-Cedar Crest Allentown Pennsylvania
United States Saint Anthony's Health Alton Illinois
United States UPMC Altoona Altoona Pennsylvania
United States Mary Greeley Medical Center Ames Iowa
United States McFarland Clinic - Ames Ames Iowa
United States Community Hospital of Anaconda Anaconda Montana
United States Kaiser Permanente-Anaheim Anaheim California
United States Trinity Health Saint Joseph Mercy Hospital Ann Arbor Ann Arbor Michigan
United States University of Michigan Comprehensive Cancer Center Ann Arbor Michigan
United States Langlade Hospital and Cancer Center Antigo Wisconsin
United States Kaiser Permanente-Deer Valley Medical Center Antioch California
United States ThedaCare Regional Cancer Center Appleton Wisconsin
United States Mission Hope Medical Oncology - Arroyo Grande Arroyo Grande California
United States PCR Oncology Arroyo Grande California
United States University Cancer and Blood Center LLC Athens Georgia
United States Northside Hospital Atlanta Georgia
United States Piedmont Hospital Atlanta Georgia
United States Harold Alfond Center for Cancer Care Augusta Maine
United States Rush - Copley Medical Center Aurora Illinois
United States UCHealth University of Colorado Hospital Aurora Colorado
United States Dell Seton Medical Center at The University of Texas Austin Texas
United States University of Texas at Austin Austin Texas
United States UH Seidman Cancer Center at UH Avon Health Center Avon Ohio
United States AIS Cancer Center at San Joaquin Community Hospital Bakersfield California
United States Kaiser Permanente-Baldwin Park Baldwin Park California
United States Saint Louis Cancer and Breast Institute-Ballwin Ballwin Missouri
United States Greater Baltimore Medical Center Baltimore Maryland
United States Kaiser Permanente-Woodlawn Medical Center Baltimore Maryland
United States MedStar Franklin Square Medical Center/Weinberg Cancer Institute Baltimore Maryland
United States MedStar Good Samaritan Hospital Baltimore Maryland
United States Saint Agnes Hospital Baltimore Maryland
United States Sinai Hospital of Baltimore Baltimore Maryland
United States Summa Health System - Barberton Campus Barberton Ohio
United States Flaget Memorial Hospital Bardstown Kentucky
United States Advocate Good Shepherd Hospital Barrington Illinois
United States LSU Health Baton Rouge-North Clinic Baton Rouge Louisiana
United States Medical Center of Baton Rouge Baton Rouge Louisiana
United States Our Lady of the Lake Physician Group Baton Rouge Louisiana
United States Bronson Battle Creek Battle Creek Michigan
United States UHHS-Chagrin Highlands Medical Center Beachwood Ohio
United States UPMC-Heritage Valley Health System Beaver Beaver Pennsylvania
United States Indu and Raj Soin Medical Center Beavercreek Ohio
United States UM Upper Chesapeake Medical Center Bel Air Maryland
United States Kaiser Permanente-Bellflower Bellflower California
United States Strecker Cancer Center-Belpre Belpre Ohio
United States Sanford Joe Lueken Cancer Center Bemidji Minnesota
United States Central Vermont Medical Center/National Life Cancer Treatment Berlin Vermont
United States ThedaCare Cancer Care - Berlin Berlin Wisconsin
United States Lehigh Valley Hospital - Muhlenberg Bethlehem Pennsylvania
United States University of Iowa Healthcare Cancer Services Quad Cities Bettendorf Iowa
United States Beverly Hospital Beverly Massachusetts
United States Tower Cancer Research Foundation Beverly Hills California
United States MaineHealth/SMHC Cancer Care and Blood Disorders-Biddeford Biddeford Maine
United States Billings Clinic Cancer Center Billings Montana
United States University of Alabama at Birmingham Cancer Center Birmingham Alabama
United States Sanford Bismarck Medical Center Bismarck North Dakota
United States Illinois CancerCare-Bloomington Bloomington Illinois
United States Saint Elizabeth Boardman Hospital Boardman Ohio
United States Saint Alphonsus Cancer Care Center-Boise Boise Idaho
United States Central Care Cancer Center - Bolivar Bolivar Missouri
United States McFarland Clinic - Boone Boone Iowa
United States Boston Medical Center Boston Massachusetts
United States Tufts Medical Center Boston Massachusetts
United States Bozeman Health Deaconess Hospital Bozeman Montana
United States Cox Cancer Center Branson Branson Missouri
United States Steward Saint Elizabeth's Medical Center Brighton Massachusetts
United States Trinity Health IHA Medical Group Hematology Oncology - Brighton Brighton Michigan
United States Trinity Health Medical Center - Brighton Brighton Michigan
United States Montefiore Medical Center-Einstein Campus Bronx New York
United States New York-Presbyterian/Brooklyn Methodist Hospital Brooklyn New York
United States Saint Joseph Regional Cancer Center Bryan Texas
United States Highline Medical Center-Main Campus Burien Washington
United States Kaiser Permanente-Burke Medical Center Burke Virginia
United States Aurora Cancer Care-Southern Lakes VLCC Burlington Wisconsin
United States Lahey Hospital and Medical Center Burlington Massachusetts
United States University of Vermont Medical Center Burlington Vermont
United States Fairview Ridges Hospital Burnsville Minnesota
United States Minnesota Oncology - Burnsville Burnsville Minnesota
United States UPMC Hillman Cancer Center at Butler Health System Butler Pennsylvania
United States Saint Alphonsus Cancer Care Center-Caldwell Caldwell Idaho
United States Cambridge Medical Center Cambridge Minnesota
United States Marshall Cancer Center Cameron Park California
United States UPMC Camp Hill Camp Hill Pennsylvania
United States Cleveland Clinic Mercy Hospital Canton Ohio
United States Illinois CancerCare-Canton Canton Illinois
United States Trinity Health IHA Medical Group Hematology Oncology - Canton Canton Michigan
United States Trinity Health Medical Center - Canton Canton Michigan
United States Saint Francis Medical Center Cape Girardeau Missouri
United States Southeast Cancer Center Cape Girardeau Missouri
United States Memorial Hospital of Carbondale Carbondale Illinois
United States Carlisle Regional Cancer Center Carlisle Pennsylvania
United States Mercy Cancer Center - Carmichael Carmichael California
United States Mercy San Juan Medical Center Carmichael California
United States Caro Cancer Center Caro Michigan
United States Carson Tahoe Regional Medical Center Carson City Nevada
United States SIH Cancer Institute Carterville Illinois
United States Illinois CancerCare-Carthage Carthage Illinois
United States Duke Cancer Institute Cary Cary North Carolina
United States Rex Hematology Oncology Associates-Cary Cary North Carolina
United States Mercy Hospital Cedar Rapids Iowa
United States Oncology Associates at Mercy Medical Center Cedar Rapids Iowa
United States Dayton Physicians LLC-Miami Valley South Centerville Ohio
United States Miami Valley Hospital South Centerville Ohio
United States Centralia Oncology Clinic Centralia Illinois
United States WellSpan Medical Oncology and Hematology Chambersburg Pennsylvania
United States UNC Lineberger Comprehensive Cancer Center Chapel Hill North Carolina
United States Geauga Hospital Chardon Ohio
United States Saint Joseph Mercy Chelsea Chelsea Michigan
United States Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital Chelsea Michigan
United States Cancer Specialists of Tidewater Limited Chesapeake Virginia
United States Advocate Illinois Masonic Medical Center Chicago Illinois
United States Mount Sinai Hospital Medical Center Chicago Illinois
United States Northwestern University Chicago Illinois
United States Rush University Medical Center Chicago Illinois
United States University of Chicago Comprehensive Cancer Center Chicago Illinois
United States University of Illinois Chicago Illinois
United States Adena Regional Medical Center Chillicothe Ohio
United States Marshfield Clinic-Chippewa Center Chippewa Falls Wisconsin
United States Bethesda North Hospital Cincinnati Ohio
United States Good Samaritan Hospital - Cincinnati Cincinnati Ohio
United States Oncology Hematology Care Inc-Kenwood Cincinnati Ohio
United States TriHealth Cancer Institute-Anderson Cincinnati Ohio
United States TriHealth Cancer Institute-Westside Cincinnati Ohio
United States University of Cincinnati Cancer Center-UC Medical Center Cincinnati Ohio
United States Clackamas Radiation Oncology Center Clackamas Oregon
United States Providence Cancer Institute Clackamas Clinic Clackamas Oregon
United States Hematology Oncology Consultants-Clarkston Clarkston Michigan
United States Newland Medical Associates-Clarkston Clarkston Michigan
United States Case Western Reserve University Cleveland Ohio
United States Cleveland Clinic Cancer Center/Fairview Hospital Cleveland Ohio
United States Cleveland Clinic Foundation Cleveland Ohio
United States MetroHealth Medical Center Cleveland Ohio
United States Southeastern Medical Oncology Center-Clinton Clinton North Carolina
United States Mercy Cancer Center-West Lakes Clive Iowa
United States Mission Cancer and Blood - West Des Moines Clive Iowa
United States Kootenai Health - Coeur d'Alene Coeur d'Alene Idaho
United States Baptist Memorial Hospital and Cancer Center-Collierville Collierville Tennessee
United States Memorial Hospital North Colorado Springs Colorado
United States Penrose-Saint Francis Healthcare Colorado Springs Colorado
United States Rocky Mountain Cancer Centers-Penrose Colorado Springs Colorado
United States Saint Francis Cancer Center Colorado Springs Colorado
United States UCHealth Memorial Hospital Central Colorado Springs Colorado
United States MU Health - University Hospital/Ellis Fischel Cancer Center Columbia Missouri
United States Baptist Memorial Hospital and Cancer Center-Golden Triangle Columbus Mississippi
United States Columbus Oncology and Hematology Associates Inc Columbus Ohio
United States Doctors Hospital Columbus Ohio
United States Grant Medical Center Columbus Ohio
United States Mount Carmel East Hospital Columbus Ohio
United States Mount Carmel Health Center West Columbus Ohio
United States Ohio State University Comprehensive Cancer Center Columbus Ohio
United States Riverside Methodist Hospital Columbus Ohio
United States The Mark H Zangmeister Center Columbus Ohio
United States New Hampshire Oncology Hematology PA-Concord Concord New Hampshire
United States MD Anderson in The Woodlands Conroe Texas
United States Mercy Hospital Coon Rapids Minnesota
United States Commonwealth Cancer Center-Corbin Corbin Kentucky
United States Alegent Health Mercy Hospital Council Bluffs Iowa
United States Ochsner Hematology Oncology North Shore - Covington (West Region) Covington Louisiana
United States UPMC Hillman Cancer Center - Passavant - Cranberry Cranberry Township Pennsylvania
United States Greater Regional Medical Center Creston Iowa
United States Siteman Cancer Center at West County Hospital Creve Coeur Missouri
United States Northwest Cancer Center - Main Campus Crown Point Indiana
United States AMG Crystal Lake - Oncology Crystal Lake Illinois
United States UPMC Western Maryland Cumberland Maryland
United States Parkland Memorial Hospital Dallas Texas
United States UT Southwestern Simmons Cancer Center - RedBird Dallas Texas
United States UT Southwestern/Simmons Cancer Center-Dallas Dallas Texas
United States Carle at The Riverfront Danville Illinois
United States Dayton Physician LLC - Englewood Dayton Ohio
United States Miami Valley Hospital Dayton Ohio
United States Miami Valley Hospital North Dayton Ohio
United States Premier Blood and Cancer Center Dayton Ohio
United States Beaumont Hospital - Dearborn Dearborn Michigan
United States Cancer Care Specialists of Illinois - Decatur Decatur Illinois
United States Decatur Memorial Hospital Decatur Illinois
United States Northwestern Medicine Cancer Center Kishwaukee DeKalb Illinois
United States Delaware Health Center-Grady Cancer Center Delaware Ohio
United States Grady Memorial Hospital Delaware Ohio
United States Kaiser Permanente-Franklin Denver Colorado
United States Porter Adventist Hospital Denver Colorado
United States SCL Health Saint Joseph Hospital Denver Colorado
United States UCHealth - Cherry Creek Denver Colorado
United States Smilow Cancer Hospital-Derby Care Center Derby Connecticut
United States Mercy Medical Center - Des Moines Des Moines Iowa
United States Mission Cancer and Blood - Laurel Des Moines Iowa
United States Ascension Saint John Hospital Detroit Michigan
United States Dillon Health Center/Shaw Cancer Center Dillon Colorado
United States Illinois CancerCare-Dixon Dixon Illinois
United States Bayhealth Hospital Kent Campus Dover Delaware
United States Advocate Good Samaritan Hospital Downers Grove Illinois
United States City of Hope Comprehensive Cancer Center Duarte California
United States Columbus Oncology and Hematology Associates Dublin Ohio
United States Dublin Methodist Hospital Dublin Ohio
United States Epic Care-Dublin Dublin California
United States Kaiser Permanente Dublin Dublin California
United States Northside Hospital - Duluth Duluth Georgia
United States Mercy Medical Center Durango Colorado
United States Southwest Oncology PC Durango Colorado
United States Duke University Medical Center Durham North Carolina
United States Northwest Oncology LLC Dyer Indiana
United States Great Lakes Cancer Management Specialists-Doctors Park East China Township Michigan
United States Pocono Medical Center East Stroudsburg Pennsylvania
United States HSHS Sacred Heart Hospital Eau Claire Wisconsin
United States Marshfield Medical Center-EC Cancer Center Eau Claire Wisconsin
United States Mayo Clinic Health System-Eau Claire Clinic Eau Claire Wisconsin
United States Fairview Southdale Hospital Edina Minnesota
United States STCC at DHR Health Institute for Research and Development Edinburg Texas
United States Shaw Cancer Center Edwards Colorado
United States Carle Physician Group-Effingham Effingham Illinois
United States Crossroads Cancer Center Effingham Illinois
United States Advocate Sherman Hospital Elgin Illinois
United States Trinitas Hospital and Comprehensive Cancer Center - Williamson Street Campus Elizabeth New Jersey
United States Mercy Cancer Center - Elk Grove Elk Grove California
United States Elmhurst Memorial Hospital Elmhurst Illinois
United States Epic Care Partners in Cancer Care Emeryville California
United States Saint Elizabeth Hospital Enumclaw Washington
United States Ephrata Cancer Center Ephrata Pennsylvania
United States Saint Vincent Hospital Erie Pennsylvania
United States UPMC Hillman Cancer Center Erie Erie Pennsylvania
United States Illinois CancerCare-Eureka Eureka Illinois
United States NorthShore University HealthSystem-Evanston Hospital Evanston Illinois
United States Exeter Hospital Exeter New Hampshire
United States Smilow Cancer Hospital Care Center-Fairfield Fairfield Connecticut
United States Thomas Hospital Fairhope Alabama
United States Sanford Broadway Medical Center Fargo North Dakota
United States Sanford Roger Maris Cancer Center Fargo North Dakota
United States Farmington Health Center Farmington Utah
United States Parkland Health Center - Farmington Farmington Missouri
United States UPMC Cancer Center at UPMC Horizon Farrell Pennsylvania
United States Piedmont Fayette Hospital Fayetteville Georgia
United States Saint Francis Hospital Federal Way Washington
United States Armes Family Cancer Center Findlay Ohio
United States Blanchard Valley Hospital Findlay Ohio
United States Orion Cancer Care Findlay Ohio
United States Genesee Cancer and Blood Disease Treatment Center Flint Michigan
United States Genesee Hematology Oncology PC Flint Michigan
United States Genesys Hurley Cancer Institute Flint Michigan
United States Hurley Medical Center Flint Michigan
United States The New York Hospital Medical Center of Queens Flushing New York
United States Kaiser Permanente-Fontana Fontana California
United States Cancer Care and Hematology-Fort Collins Fort Collins Colorado
United States Poudre Valley Hospital Fort Collins Colorado
United States McFarland Clinic - Trinity Cancer Center Fort Dodge Iowa
United States Holy Cross Hospital Fort Lauderdale Florida
United States Mercy Hospital Fort Smith Fort Smith Arkansas
United States Parkview Regional Medical Center Fort Wayne Indiana
United States UT Southwestern/Simmons Cancer Center-Fort Worth Fort Worth Texas
United States Orange Coast Memorial Medical Center Fountain Valley California
United States Dana-Farber Cancer Institute at Foxborough Foxboro Massachusetts
United States Atrium Medical Center-Middletown Regional Hospital Franklin Ohio
United States Dayton Physicians LLC-Atrium Franklin Ohio
United States FMH James M Stockman Cancer Institute Frederick Maryland
United States Frederick Memorial Hospital Frederick Maryland
United States Kaiser Permanente-Fremont Fremont California
United States Washington Hospital Fremont California
United States Kaiser Permanente-Fresno Fresno California
United States Unity Hospital Fridley Minnesota
United States Central Ohio Breast and Endocrine Surgery Gahanna Ohio
United States University of Florida Health Science Center - Gainesville Gainesville Florida
United States Kaiser Permanente-Gaithersburg Medical Center Gaithersburg Maryland
United States Illinois CancerCare-Galesburg Galesburg Illinois
United States Western Illinois Cancer Treatment Center Galesburg Illinois
United States University of Texas Medical Branch Galveston Texas
United States Central Care Cancer Center - Garden City Garden City Kansas
United States Rex Hematology Oncology Associates-Garner Garner North Carolina
United States Northwestern Medicine Cancer Center Delnor Geneva Illinois
United States Aurora Health Care Germantown Health Center Germantown Wisconsin
United States The West Clinic - Wolf River Germantown Tennessee
United States Adams Cancer Center Gettysburg Pennsylvania
United States Smilow Cancer Hospital Care Center at Glastonbury Glastonbury Connecticut
United States UM Baltimore Washington Medical Center/Tate Cancer Center Glen Burnie Maryland
United States Glens Falls Hospital Glens Falls New York
United States NorthShore University HealthSystem-Glenbrook Hospital Glenview Illinois
United States Addison Gilbert Hospital Gloucester Massachusetts
United States Peninsula Cancer Institute-Gloucester Gloucester Virginia
United States SCL Health Cancer Centers of Colorado - Lutheran Medical Center Golden Colorado
United States Southeastern Medical Oncology Center-Goldsboro Goldsboro North Carolina
United States Aurora Cancer Care-Grafton Grafton Wisconsin
United States Nebraska Cancer Specialists/Oncology Hematology West PC Grand Island Nebraska
United States Saint Mary's Hospital and Regional Medical Center Grand Junction Colorado
United States Corewell Health Grand Rapids Hospitals - Butterworth Hospital Grand Rapids Michigan
United States Trinity Health Grand Rapids Hospital Grand Rapids Michigan
United States Central Care Cancer Center - Great Bend Great Bend Kansas
United States Benefis Sletten Cancer Institute Great Falls Montana
United States Great Falls Clinic Great Falls Montana
United States UCHealth Greeley Hospital Greeley Colorado
United States Aurora BayCare Medical Center Green Bay Wisconsin
United States Saint Vincent Hospital Cancer Center at Saint Mary's Green Bay Wisconsin
United States Saint Vincent Hospital Cancer Center Green Bay Green Bay Wisconsin
United States Northwell Health Cancer Institute at Huntington Greenlawn New York
United States UPMC Cancer Centers - Arnold Palmer Pavilion Greensburg Pennsylvania
United States Dayton Physicians LLC-Wayne Greenville Ohio
United States Miami Valley Cancer Care and Infusion Greenville Ohio
United States Wayne Hospital Greenville Ohio
United States Smilow Cancer Hospital Care Center at Greenwich Greenwich Connecticut
United States Baptist Cancer Center-Grenada Grenada Mississippi
United States Academic Hematology Oncology Specialists Grosse Pointe Woods Michigan
United States Great Lakes Cancer Management Specialists-Van Elslander Cancer Center Grosse Pointe Woods Michigan
United States Michigan Breast Specialists-Grosse Pointe Woods Grosse Pointe Woods Michigan
United States Mount Carmel Grove City Hospital Grove City Ohio
United States Smilow Cancer Hospital Care Center - Guilford Guilford Connecticut
United States The Cancer Institute of New Jersey Hamilton Hamilton New Jersey
United States Kaiser Permanente - Harbor City Harbor City California
United States UPMC Pinnacle Cancer Center/Community Osteopathic Campus Harrisburg Pennsylvania
United States Smilow Cancer Hospital Care Center at Saint Francis Hartford Connecticut
United States Ingalls Memorial Hospital Harvey Illinois
United States Advocate South Suburban Hospital Hazel Crest Illinois
United States Lehigh Valley Hospital-Hazleton Hazleton Pennsylvania
United States Comprehensive Cancer Centers of Nevada - Henderson Henderson Nevada
United States OptumCare Cancer Care at Seven Hills Henderson Nevada
United States Margaret R Pardee Memorial Hospital Hendersonville North Carolina
United States Penn State Milton S Hershey Medical Center Hershey Pennsylvania
United States NorthShore University HealthSystem-Highland Park Hospital Highland Park Illinois
United States UCHealth Highlands Ranch Hospital Highlands Ranch Colorado
United States Edward Hines Jr VA Hospital Hines Illinois
United States Northwest Cancer Center - Hobart Hobart Indiana
United States Saint Mary Medical Center Hobart Indiana
United States Memorial Regional Hospital/Joe DiMaggio Children's Hospital Hollywood Florida
United States Hawaii Cancer Care Inc - Waterfront Plaza Honolulu Hawaii
United States Kaiser Permanente Moanalua Medical Center Honolulu Hawaii
United States Queen's Cancer Cenrer - POB I Honolulu Hawaii
United States Queen's Cancer Center - Kuakini Honolulu Hawaii
United States Queen's Medical Center Honolulu Hawaii
United States Straub Clinic and Hospital Honolulu Hawaii
United States University of Hawaii Cancer Center Honolulu Hawaii
United States CHI Saint Vincent Cancer Center Hot Springs Hot Springs Arkansas
United States Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center Houston Texas
United States Ben Taub General Hospital Houston Texas
United States Lyndon Baines Johnson General Hospital Houston Texas
United States M D Anderson Cancer Center Houston Texas
United States MD Anderson West Houston Houston Texas
United States Cleveland Clinic Cancer Center Independence Independence Ohio
United States IRMC Cancer Center Indiana Pennsylvania
United States Saint Catherine Hospital Indianapolis Indiana
United States University of Iowa/Holden Comprehensive Cancer Center Iowa City Iowa
United States City of Hope at Irvine Lennar Irvine California
United States Kaiser Permanente-Irvine Irvine California
United States University of Mississippi Medical Center Jackson Mississippi
United States Southeastern Medical Oncology Center-Jacksonville Jacksonville North Carolina
United States Mercyhealth Hospital and Cancer Center - Janesville Janesville Wisconsin
United States McFarland Clinic - Jefferson Jefferson Iowa
United States MU Health Care Goldschmidt Cancer Center Jefferson City Missouri
United States Jefferson Hospital Jefferson Hills Pennsylvania
United States Jersey City Medical Center Jersey City New Jersey
United States University of Wisconsin Carbone Cancer Center Johnson Creek Johnson Creek Wisconsin
United States UPMC-Johnstown/John P. Murtha Regional Cancer Center Johnstown Pennsylvania
United States NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro Jonesboro Arkansas
United States Freeman Health System Joplin Missouri
United States Mercy Hospital Joplin Joplin Missouri
United States Jupiter Medical Center Jupiter Florida
United States Ascension Borgess Cancer Center Kalamazoo Michigan
United States Bronson Methodist Hospital Kalamazoo Michigan
United States West Michigan Cancer Center Kalamazoo Michigan
United States Kalispell Regional Medical Center Kalispell Montana
United States Saint Luke's Hospital of Kansas City Kansas City Missouri
United States CHI Health Good Samaritan Kearney Nebraska
United States Kadlec Clinic Hematology and Oncology Kennewick Washington
United States Aurora Cancer Care-Kenosha South Kenosha Wisconsin
United States Greater Dayton Cancer Center Kettering Ohio
United States Kettering Medical Center Kettering Ohio
United States Illinois CancerCare-Kewanee Clinic Kewanee Illinois
United States Kingman Regional Medical Center Kingman Arizona
United States Gundersen Lutheran Medical Center La Crosse Wisconsin
United States Mayo Clinic Health System-Franciscan Healthcare La Crosse Wisconsin
United States Marshfield Medical Center - Ladysmith Ladysmith Wisconsin
United States Kaiser Permanente-Rock Creek Lafayette Colorado
United States Saddleback Memorial Medical Center Laguna Hills California
United States UCI Health Laguna Hills Laguna Hills California
United States Northwestern Medicine Lake Forest Hospital Lake Forest Illinois
United States Northwell Health/Center for Advanced Medicine Lake Success New York
United States Monmouth Medical Center Southern Campus Lakewood New Jersey
United States Saint Anthony Hospital Lakewood Colorado
United States Saint Clare Hospital Lakewood Washington
United States City of Hope Antelope Valley Lancaster California
United States Fairfield Medical Center Lancaster Ohio
United States Lancaster General Ann B Barshinger Cancer Institute Lancaster Pennsylvania
United States Lancaster General Hospital Lancaster Pennsylvania
United States University of Michigan Health - Sparrow Lansing Lansing Michigan
United States Kaiser Permanente - Largo Medical Center Largo Maryland
United States Memorial Medical Center - Las Cruces Las Cruces New Mexico
United States Comprehensive Cancer Centers of Nevada Las Vegas Nevada
United States Comprehensive Cancer Centers of Nevada - Central Valley Las Vegas Nevada
United States OptumCare Cancer Care at Charleston Las Vegas Nevada
United States OptumCare Cancer Care at Fort Apache Las Vegas Nevada
United States Northside Hospital - Gwinnett Lawrenceville Georgia
United States MD Anderson League City League City Texas
United States Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center Lebanon New Hampshire
United States Sechler Family Cancer Center Lebanon Pennsylvania
United States Saint Luke's East - Lee's Summit Lee's Summit Missouri
United States Baptist Health Lexington Lexington Kentucky
United States Saint Joseph Hospital East Lexington Kentucky
United States Saint Joseph Radiation Oncology Resource Center Lexington Kentucky
United States AMG Libertyville - Oncology Libertyville Illinois
United States Saint Rita's Medical Center Lima Ohio
United States Saint Elizabeth Regional Medical Center Lincoln Nebraska
United States University of Arkansas for Medical Sciences Little Rock Arkansas
United States Littleton Adventist Hospital Littleton Colorado
United States Saint Barnabas Medical Center Livingston New Jersey
United States Trinity Health Saint Mary Mercy Livonia Hospital Livonia Michigan
United States Loma Linda University Medical Center Loma Linda California
United States Saint Joseph London London Kentucky
United States The Dana-Farber Cancer Institute at Londonderry Londonderry New Hampshire
United States Kaiser Permanente-Lone Tree Lone Tree Colorado
United States UCHealth Lone Tree Health Center Lone Tree Colorado
United States Long Beach Memorial Medical Center-Todd Cancer Institute Long Beach California
United States Monmouth Medical Center Long Branch New Jersey
United States Longmont United Hospital Longmont Colorado
United States Rocky Mountain Cancer Centers-Longmont Longmont Colorado
United States Cedars Sinai Medical Center Los Angeles California
United States Kaiser Permanente Los Angeles Medical Center Los Angeles California
United States Kaiser Permanente West Los Angeles Los Angeles California
United States Keck Medicine of USC Koreatown Los Angeles California
United States Los Angeles General Medical Center Los Angeles California
United States USC / Norris Comprehensive Cancer Center Los Angeles California
United States Jewish Hospital Louisville Kentucky
United States Norton Audubon Hospital and Medical Campus Louisville Kentucky
United States Norton Brownsboro Hospital and Medical Campus Louisville Kentucky
United States Norton Hospital Pavilion and Medical Campus Louisville Kentucky
United States Saints Mary and Elizabeth Hospital Louisville Kentucky
United States The James Graham Brown Cancer Center at University of Louisville Louisville Kentucky
United States UofL Health Medical Center Northeast Louisville Kentucky
United States Medical Center of the Rockies Loveland Colorado
United States Kaiser Permanente Lutherville - Timonium Medical Center Lutherville Maryland
United States Centra Alan B Pearson Regional Cancer Center Lynchburg Virginia
United States Great Lakes Cancer Management Specialists-Macomb Medical Campus Macomb Michigan
United States Illinois CancerCare-Macomb Macomb Illinois
United States Michigan Breast Specialists-Macomb Township Macomb Michigan
United States University of Wisconsin Carbone Cancer Center - University Hospital Madison Wisconsin
United States Solinsky Center for Cancer Care Manchester New Hampshire
United States Cleveland Clinic Cancer Center Mansfield Mansfield Ohio
United States OhioHealth Mansfield Hospital Mansfield Ohio
United States Fairview Clinics and Surgery Center Maple Grove Maple Grove Minnesota
United States Minnesota Oncology Hematology PA-Maplewood Maplewood Minnesota
United States Saint John's Hospital - Healtheast Maplewood Minnesota
United States Marietta Memorial Hospital Marietta Ohio
United States Aurora Bay Area Medical Group-Marinette Marinette Wisconsin
United States OhioHealth Marion General Hospital Marion Ohio
United States Saint Mary's Oncology/Hematology Associates of Marlette Marlette Michigan
United States West Jefferson Medical Center Marrero Louisiana
United States McFarland Clinic - Marshalltown Marshalltown Iowa
United States Marshfield Medical Center-Marshfield Marshfield Wisconsin
United States Contra Costa Regional Medical Center Martinez California
United States WVUH-Berkely Medical Center Martinsburg West Virginia
United States Fremont - Rideout Cancer Center Marysville California
United States Carle Physician Group-Mattoon/Charleston Mattoon Illinois
United States Hillcrest Hospital Cancer Center Mayfield Heights Ohio
United States Loyola University Medical Center Maywood Illinois
United States UPMC Cancer Center at UPMC McKeesport McKeesport Pennsylvania
United States Kaiser Permanente Tysons Corner Medical Center McLean Virginia
United States UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion Mechanicsburg Pennsylvania
United States Aspirus Medford Hospital Medford Wisconsin
United States Summa Health Medina Medical Center Medina Ohio
United States Baptist Memorial Hospital and Cancer Center-Memphis Memphis Tennessee
United States UH Seidman Cancer Center at Lake Health Mentor Campus Mentor Ohio
United States Dana Farber-Merrimack Valley Methuen Massachusetts
United States UH Seidman Cancer Center at Southwest General Hospital Middleburg Heights Ohio
United States Garnet Health Medical Center Middletown New York
United States Bayhealth Hospital Sussex Campus Milford Delaware
United States Dana-Farber/Brigham and Women's Cancer Center at Milford Regional Milford Massachusetts
United States Aurora Cancer Care-Milwaukee Milwaukee Wisconsin
United States Aurora Saint Luke's Medical Center Milwaukee Wisconsin
United States Aurora Sinai Medical Center Milwaukee Wisconsin
United States NYU Langone Hospital - Long Island Mineola New York
United States Abbott-Northwestern Hospital Minneapolis Minnesota
United States Health Partners Inc Minneapolis Minnesota
United States Hennepin County Medical Center Minneapolis Minnesota
United States Marshfield Clinic-Minocqua Center Minocqua Wisconsin
United States Community Medical Center Missoula Montana
United States Mobile Infirmary Medical Center Mobile Alabama
United States University of South Alabama Mitchell Cancer Institute Mobile Alabama
United States Kaiser Permanente-Modesto Modesto California
United States Trinity Medical Center Moline Illinois
United States Forbes Hospital Monroeville Pennsylvania
United States UPMC Hillman Cancer Center - Monroeville Monroeville Pennsylvania
United States Monticello Cancer Center Monticello Minnesota
United States UPMC Hillman Cancer Center in Coraopolis Moon Pennsylvania
United States West Virginia University Healthcare Morgantown West Virginia
United States Northern Westchester Hospital Mount Kisco New York
United States Good Samaritan Regional Health Center Mount Vernon Illinois
United States Knox Community Hospital Mount Vernon Ohio
United States ProHealth D N Greenwald Center Mukwonago Wisconsin
United States The Community Hospital Munster Indiana
United States Women's Diagnostic Center - Munster Munster Indiana
United States Trinity Health Muskegon Hospital Muskegon Michigan
United States Arnold Palmer Cancer Center Medical Oncology Norwin N. Huntingdon Pennsylvania
United States Saint Alphonsus Cancer Care Center-Nampa Nampa Idaho
United States Edward Hospital/Cancer Center Naperville Illinois
United States Vanderbilt University/Ingram Cancer Center Nashville Tennessee
United States Allegheny Valley Hospital Natrona Heights Pennsylvania
United States UPMC Cancer Center-Natrona Heights Natrona Heights Pennsylvania
United States ThedaCare Regional Medical Center - Neenah Neenah Wisconsin
United States Marshfield Medical Center - Neillsville Neillsville Wisconsin
United States Baptist Memorial Hospital and Cancer Center-Union County New Albany Mississippi
United States Mount Carmel New Albany Surgical Hospital New Albany Ohio
United States Rutgers Cancer Institute of New Jersey New Brunswick New Jersey
United States UPMC Hillman Cancer Center - New Castle New Castle Pennsylvania
United States Smilow Cancer Center/Yale-New Haven Hospital New Haven Connecticut
United States Yale University New Haven Connecticut
United States UC Comprehensive Cancer Center at Silver Cross New Lenox Illinois
United States Louisiana State University Health Science Center New Orleans Louisiana
United States Ochsner Medical Center Jefferson New Orleans Louisiana
United States University Medical Center New Orleans New Orleans Louisiana
United States Cancer Center of Western Wisconsin New Richmond Wisconsin
United States New Ulm Medical Center New Ulm Minnesota
United States Laura and Isaac Perlmutter Cancer Center at NYU Langone New York New York
United States Lenox Hill Hospital New York New York
United States Manhattan Eye Ear and Throat Hospital New York New York
United States Mount Sinai Hospital New York New York
United States Mount Sinai West New York New York
United States NYP/Weill Cornell Medical Center New York New York
United States Helen F Graham Cancer Center Newark Delaware
United States Licking Memorial Hospital Newark Ohio
United States Medical Oncology Hematology Consultants PA Newark Delaware
United States Newark Beth Israel Medical Center Newark New Jersey
United States Newark Radiation Oncology Newark Ohio
United States Rutgers New Jersey Medical School Newark New Jersey
United States Providence Newberg Medical Center Newberg Oregon
United States Piedmont Newnan Hospital Newnan Georgia
United States USC Norris Oncology/Hematology-Newport Beach Newport Beach California
United States Peninsula Cancer Institute-Newport News Newport News Virginia
United States Yale-New Haven Hospital North Haven Medical Center North Haven Connecticut
United States Cancer and Hematology Centers of Western Michigan - Norton Shores Norton Shores Michigan
United States Ascension Providence Hospitals - Novi Novi Michigan
United States Cancer Care Center of O'Fallon O'Fallon Illinois
United States Advocate Christ Medical Center Oak Lawn Illinois
United States Bay Area Tumor Institute Oakland California
United States Kaiser Permanente-Oakland Oakland California
United States ProHealth Oconomowoc Memorial Hospital Oconomowoc Wisconsin
United States Saint Vincent Hospital Cancer Center at Oconto Falls Oconto Falls Wisconsin
United States Integris Cancer Institute of Oklahoma Oklahoma City Oklahoma
United States Integris Southwest Medical Center Oklahoma City Oklahoma
United States Mercy Hospital Oklahoma City Oklahoma City Oklahoma
United States University of Oklahoma Health Sciences Center Oklahoma City Oklahoma
United States Alegent Health Bergan Mercy Medical Center Omaha Nebraska
United States Alegent Health Immanuel Medical Center Omaha Nebraska
United States Alegent Health Lakeside Hospital Omaha Nebraska
United States Creighton University Medical Center Omaha Nebraska
United States Kaiser Permanente-Ontario Ontario California
United States Saint Alphonsus Medical Center-Ontario Ontario Oregon
United States Saint Joseph Hospital - Orange Orange California
United States Smilow Cancer Hospital-Orange Care Center Orange Connecticut
United States UC Irvine Health/Chao Family Comprehensive Cancer Center Orange California
United States Providence Willamette Falls Medical Center Oregon City Oregon
United States Northwestern Medicine Orland Park Orland Park Illinois
United States University of Chicago Medicine-Orland Park Orland Park Illinois
United States AdventHealth Orlando Orlando Florida
United States Orlando Health Cancer Institute Orlando Florida
United States ThedaCare Cancer Care - Oshkosh Oshkosh Wisconsin
United States Vince Lombardi Cancer Clinic - Oshkosh Oshkosh Wisconsin
United States Illinois CancerCare-Ottawa Clinic Ottawa Illinois
United States Baptist Memorial Hospital and Cancer Center-Oxford Oxford Mississippi
United States Kaiser Permanente - Panorama City Panorama City California
United States Midlands Community Hospital Papillion Nebraska
United States Advocate Lutheran General Hospital Park Ridge Illinois
United States Parker Adventist Hospital Parker Colorado
United States Camden Clark Medical Center Parkersburg West Virginia
United States University Hospitals Parma Medical Center Parma Ohio
United States Lahey Medical Center-Peabody Peabody Massachusetts
United States Illinois CancerCare-Pekin Pekin Illinois
United States Memorial Hospital West Pembroke Pines Florida
United States Illinois CancerCare-Peoria Peoria Illinois
United States Methodist Medical Center of Illinois Peoria Illinois
United States Mercy Health Perrysburg Cancer Center Perrysburg Ohio
United States Illinois CancerCare-Peru Peru Illinois
United States Valley Radiation Oncology Peru Illinois
United States Fox Chase Cancer Center Philadelphia Pennsylvania
United States Jefferson Methodist Hospital Philadelphia Pennsylvania
United States Jefferson Torresdale Hospital Philadelphia Pennsylvania
United States Pennsylvania Hospital Philadelphia Pennsylvania
United States Thomas Jefferson University Hospital Philadelphia Pennsylvania
United States University of Pennsylvania/Abramson Cancer Center Philadelphia Pennsylvania
United States Cancer Center at Saint Joseph's Phoenix Arizona
United States Mayo Clinic Hospital in Arizona Phoenix Arizona
United States Avera Cancer Institute at Pierre Pierre South Dakota
United States Allegheny General Hospital Pittsburgh Pennsylvania
United States University of Pittsburgh Cancer Institute (UPCI) Pittsburgh Pennsylvania
United States UPMC-Mercy Hospital Pittsburgh Pennsylvania
United States UPMC-Passavant Hospital Pittsburgh Pennsylvania
United States UPMC-Presbyterian Hospital Pittsburgh Pennsylvania
United States UPMC-Saint Clair Hospital Cancer Center Pittsburgh Pennsylvania
United States UPMC-Saint Margaret Pittsburgh Pennsylvania
United States UPMC-Shadyside Hospital Pittsburgh Pennsylvania
United States West Penn Hospital Pittsburgh Pennsylvania
United States Edward Hospital/Cancer Center?Plainfield Plainfield Illinois
United States Hope Cancer Center Pontiac Michigan
United States Michigan Healthcare Professionals Pontiac Pontiac Michigan
United States Newland Medical Associates-Pontiac Pontiac Michigan
United States Trinity Health Saint Joseph Mercy Oakland Hospital Pontiac Michigan
United States Kaiser Permanente Northwest Portland Oregon
United States Providence Portland Medical Center Portland Oregon
United States Providence Saint Vincent Medical Center Portland Oregon
United States Southern Ohio Medical Center Portsmouth Ohio
United States Kootenai Clinic Cancer Services - Post Falls Post Falls Idaho
United States Fairview Northland Medical Center Princeton Minnesota
United States Illinois CancerCare-Princeton Princeton Illinois
United States Saint Mary Corwin Medical Center Pueblo Colorado
United States Aurora Cancer Care-Racine Racine Wisconsin
United States Duke Raleigh Hospital Raleigh North Carolina
United States UNC Rex Cancer Center of Wakefield Raleigh North Carolina
United States UNC Rex Healthcare Raleigh North Carolina
United States University Hospitals Portage Medical Center Ravenna Ohio
United States Kaiser Permanente- Marshall Medical Offices Redwood City California
United States Corewell Health Reed City Hospital Reed City Michigan
United States Queens Cancer Center Rego Park New York
United States Renown Regional Medical Center Reno Nevada
United States Saint Mary's Regional Medical Center Reno Nevada
United States Valley Medical Center Renton Washington
United States Ascension Saint Mary's Hospital Rhinelander Wisconsin
United States Marshfield Medical Center-Rice Lake Rice Lake Wisconsin
United States UT Southwestern Clinical Center at Richardson/Plano Richardson Texas
United States Kaiser Permanente-Richmond Richmond California
United States Reid Health Richmond Indiana
United States VCU Massey Cancer Center at Stony Point Richmond Virginia
United States Virginia Cancer Institute Richmond Virginia
United States Virginia Commonwealth University/Massey Cancer Center Richmond Virginia
United States Presbyterian Rust Medical Center/Jorgensen Cancer Center Rio Rancho New Mexico
United States Kaiser Permanente-Riverside Riverside California
United States North Memorial Medical Health Center Robbinsdale Minnesota
United States Mayo Clinic in Rochester Rochester Minnesota
United States University of Rochester Rochester New York
United States UW Health Carbone Cancer Center Rockford Rockford Illinois
United States Mercy Cancer Center - Rocklin Rocklin California
United States Delbert Day Cancer Institute at PCRMC Rolla Missouri
United States Mercy Clinic-Rolla-Cancer and Hematology Rolla Missouri
United States Kaiser Permanente-Roseville Roseville California
United States William Beaumont Hospital-Royal Oak Royal Oak Michigan
United States Kaiser Permanente Downtown Commons Sacramento California
United States Kaiser Permanente-South Sacramento Sacramento California
United States Mercy Cancer Center - Sacramento Sacramento California
United States University of California Davis Comprehensive Cancer Center Sacramento California
United States Ascension Saint Mary's Hospital Saginaw Michigan
United States Oncology Hematology Associates of Saginaw Valley PC Saginaw Michigan
United States Coborn Cancer Center at Saint Cloud Hospital Saint Cloud Minnesota
United States Dartmouth Cancer Center - North Saint Johnsbury Vermont
United States Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center Saint Joseph Michigan
United States Heartland Regional Medical Center Saint Joseph Missouri
United States Mercy Hospital Saint Louis Saint Louis Missouri
United States Mercy Hospital South Saint Louis Missouri
United States Missouri Baptist Medical Center Saint Louis Missouri
United States Saint Louis Cancer and Breast Institute-South City Saint Louis Missouri
United States Siteman Cancer Center at Christian Hospital Saint Louis Missouri
United States Siteman Cancer Center-South County Saint Louis Missouri
United States Washington University School of Medicine Saint Louis Missouri
United States Park Nicollet Clinic - Saint Louis Park Saint Louis Park Minnesota
United States Regions Hospital Saint Paul Minnesota
United States United Hospital Saint Paul Minnesota
United States Siteman Cancer Center at Saint Peters Hospital Saint Peters Missouri
United States Sainte Genevieve County Memorial Hospital Sainte Genevieve Missouri
United States Salinas Valley Memorial Salinas California
United States Huntsman Cancer Institute/University of Utah Salt Lake City Utah
United States Kaiser Permanente-San Diego Zion San Diego California
United States Kaiser Permanente-San Francisco San Francisco California
United States Kaiser Permanente-Santa Teresa-San Jose San Jose California
United States Kaiser Permanente San Leandro San Leandro California
United States Pacific Central Coast Health Center-San Luis Obispo San Luis Obispo California
United States Kaiser Permanente-San Marcos San Marcos California
United States Kaiser San Rafael-Gallinas San Rafael California
United States Kootenai Cancer Clinic Sandpoint Idaho
United States North Coast Cancer Care Sandusky Ohio
United States MaineHealth/SMHC Cancer Care and Blood Disorders-Sanford Sanford Maine
United States Kaiser Permanente Medical Center - Santa Clara Santa Clara California
United States Mission Hope Medical Oncology - Santa Maria Santa Maria California
United States Kaiser Permanente-Santa Rosa Santa Rosa California
United States Memorial Health University Medical Center Savannah Georgia
United States Grand View Hospital Sellersville Pennsylvania
United States UPMC Cancer Center at UPMC Northwest Seneca Pennsylvania
United States Saint Francis Regional Medical Center Shakopee Minnesota
United States ThedaCare Cancer Care - Shawano Shawano Wisconsin
United States Vince Lombardi Cancer Clinic-Sheboygan Sheboygan Wisconsin
United States Jewish Hospital Medical Center South Shepherdsville Kentucky
United States Memorial Hospital East Shiloh Illinois
United States Saint Michael Cancer Center Silverdale Washington
United States Siouxland Regional Cancer Center Sioux City Iowa
United States Avera Cancer Institute Sioux Falls South Dakota
United States Sanford Cancer Center Oncology Clinic Sioux Falls South Dakota
United States Sanford USD Medical Center - Sioux Falls Sioux Falls South Dakota
United States Phelps Memorial Hospital Center Sleepy Hollow New York
United States Robert Wood Johnson University Hospital Somerset Somerville New Jersey
United States VCU Community Memorial Health Center South Hill Virginia
United States South Jordan Health Center South Jordan Utah
United States City of Hope South Pasadena South Pasadena California
United States Maine Medical Partners - South Portland South Portland Maine
United States Kaiser Permanente-South San Francisco South San Francisco California
United States Dana-Farber/Brigham and Women's Cancer Center at South Shore South Weymouth Massachusetts
United States Ascension Providence Hospitals - Southfield Southfield Michigan
United States Baptist Memorial Hospital and Cancer Center-Desoto Southhaven Mississippi
United States CoxHealth South Hospital Springfield Missouri
United States Memorial Medical Center Springfield Illinois
United States Mercy Hospital Springfield Springfield Missouri
United States Southern Illinois University School of Medicine Springfield Illinois
United States Springfield Clinic Springfield Illinois
United States Springfield Regional Cancer Center Springfield Ohio
United States Springfield Regional Medical Center Springfield Ohio
United States Smilow Cancer Hospital Care Center at Long Ridge Stamford Connecticut
United States Bhadresh Nayak MD PC-Sterling Heights Sterling Heights Michigan
United States Trinity's Tony Teramana Cancer Center Steubenville Ohio
United States Ascension Saint Michael's Hospital Stevens Point Wisconsin
United States Marshfield Medical Center-River Region at Stevens Point Stevens Point Wisconsin
United States Lakeview Hospital Stillwater Minnesota
United States Piedmont Henry Hospital Stockbridge Georgia
United States Kaiser Permanente-Stockton Stockton California
United States Stony Brook University Medical Center Stony Brook New York
United States Cleveland Clinic Cancer Center Strongsville Strongsville Ohio
United States Saint Vincent Hospital Cancer Center at Sturgeon Bay Sturgeon Bay Wisconsin
United States Cancer Specialists of Tidewater-Suffolk Suffolk Virginia
United States MD Anderson in Sugar Land Sugar Land Texas
United States Missouri Baptist Sullivan Hospital Sullivan Missouri
United States Aurora Medical Center in Summit Summit Wisconsin
United States BJC Outpatient Center at Sunset Hills Sunset Hills Missouri
United States ProMedica Flower Hospital Sylvania Ohio
United States Franciscan Research Center-Northwest Medical Plaza Tacoma Washington
United States Moffitt Cancer Center Tampa Florida
United States Moffitt Cancer Center - McKinley Campus Tampa Florida
United States Moffitt Cancer Center-International Plaza Tampa Florida
United States Tampa General Hospital Tampa Florida
United States Ascension Saint Joseph Hospital Tawas City Michigan
United States Sanford Thief River Falls Medical Center Thief River Falls Minnesota
United States Mercy Health - Saint Anne Hospital Toledo Ohio
United States Mercy Health - Saint Vincent Hospital Toledo Ohio
United States Mercy Health Sylvania Radiation Oncology Center Toledo Ohio
United States ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital Toledo Ohio
United States Community Medical Center Toms River New Jersey
United States City of Hope South Bay Torrance California
United States Torrance Memorial Physician Network - Cancer Care Torrance California
United States Smilow Cancer Hospital-Torrington Care Center Torrington Connecticut
United States Munson Medical Center Traverse City Michigan
United States Dayton Physicians LLC - Troy Troy Ohio
United States Upper Valley Medical Center Troy Ohio
United States William Beaumont Hospital - Troy Troy Michigan
United States Gene Upshaw Memorial Tahoe Forest Cancer Center Truckee California
United States Smilow Cancer Hospital Care Center-Trumbull Trumbull Connecticut
United States Banner University Medical Center - Tucson Tucson Arizona
United States University of Arizona Cancer Center-North Campus Tucson Arizona
United States Oklahoma Cancer Specialists and Research Institute-Tulsa Tulsa Oklahoma
United States Vince Lombardi Cancer Clinic-Two Rivers Two Rivers Wisconsin
United States UPMC Cancer Center-Uniontown Uniontown Pennsylvania
United States City of Hope Upland Upland California
United States Carle Cancer Center Urbana Illinois
United States The Carle Foundation Hospital Urbana Illinois
United States Kaiser Permanente Medical Center-Vacaville Vacaville California
United States Kaiser Permanente-Vallejo Vallejo California
United States Northwest Cancer Center - Valparaiso Valparaiso Indiana
United States Peninsula Cancer Institute-Cancer Specialists of Tidewater Virginia Beach Virginia
United States Ridgeview Medical Center Waconia Minnesota
United States University Hospitals Sharon Health Center Wadsworth Ohio
United States Epic Care Cyberknife Center Walnut Creek California
United States Kaiser Permanente-Walnut Creek Walnut Creek California
United States Advanced Breast Care Center PLLC Warren Michigan
United States Great Lakes Cancer Management Specialists-Macomb Professional Building Warren Michigan
United States Macomb Hematology Oncology PC Warren Michigan
United States Michigan Breast Specialists-Warren Warren Michigan
United States Saint John Macomb-Oakland Hospital Warren Michigan
United States Saint Joseph Warren Hospital Warren Ohio
United States South Pointe Hospital Warrensville Heights Ohio
United States Northwestern Medicine Cancer Center Warrenville Warrenville Illinois
United States Illinois CancerCare - Washington Washington Illinois
United States Kaiser Permanente-Capitol Hill Medical Center Washington District of Columbia
United States MedStar Georgetown University Hospital Washington District of Columbia
United States MedStar Washington Hospital Center Washington District of Columbia
United States Mercy Hospital Washington Washington Missouri
United States UPMC Cancer Center-Washington Washington Pennsylvania
United States Smilow Cancer Hospital-Waterbury Care Center Waterbury Connecticut
United States Smilow Cancer Hospital Care Center - Waterford Waterford Connecticut
United States UW Cancer Center at ProHealth Care Waukesha Wisconsin
United States ThedaCare Cancer Care - Waupaca Waupaca Wisconsin
United States Aspirus Regional Cancer Center Wausau Wisconsin
United States Marshfield Clinic-Wausau Center Wausau Wisconsin
United States Aurora Cancer Care-Milwaukee West Wauwatosa Wisconsin
United States Wilmot Cancer Institute at Webster Webster New York
United States Aurora West Allis Medical Center West Allis Wisconsin
United States Saint Mary's Oncology/Hematology Associates of West Branch West Branch Michigan
United States Chester County Hospital West Chester Pennsylvania
United States University of Cincinnati Cancer Center-West Chester West Chester Ohio
United States Mercy Medical Center-West Lakes West Des Moines Iowa
United States Reading Hospital West Reading Pennsylvania
United States Smilow Cancer Hospital Care Center - Westerly Westerly Rhode Island
United States Saint Ann's Hospital Westerville Ohio
United States UH Seidman Cancer Center at Saint John Medical Center Westlake Ohio
United States William E Kahlert Regional Cancer Center/Sinai Hospital Westminster Maryland
United States Cleveland Clinic-Weston Weston Florida
United States Marshfield Medical Center - Weston Weston Wisconsin
United States Wexford Health and Wellness Pavilion Wexford Pennsylvania
United States Wheeling Hospital/Schiffler Cancer Center Wheeling West Virginia
United States Ascension Via Christi Hospitals Wichita Wichita Kansas
United States Cancer Center of Kansas-Wichita Medical Arts Tower Wichita Kansas
United States Peninsula Cancer Institute-Williamsburg Williamsburg Virginia
United States Divine Providence Hospital Williamsport Pennsylvania
United States Rice Memorial Hospital Willmar Minnesota
United States Asplundh Cancer Pavilion Willow Grove Pennsylvania
United States Winchester Hospital Winchester Massachusetts
United States Wake Forest University Health Sciences Winston-Salem North Carolina
United States Aspirus Cancer Care - Wisconsin Rapids Wisconsin Rapids Wisconsin
United States Marshfield Clinic - Wisconsin Rapids Center Wisconsin Rapids Wisconsin
United States Kaiser Permanente-Caton Hill Medical Center Woodbridge Virginia
United States Minnesota Oncology Hematology PA-Woodbury Woodbury Minnesota
United States Woodland Memorial Hospital Woodland California
United States Kaiser Permanente-Woodland Hills Woodland Hills California
United States Cleveland Clinic Wooster Family Health and Surgery Center Wooster Ohio
United States Sanford Cancer Center Worthington Worthington Minnesota
United States Fairview Lakes Medical Center Wyoming Minnesota
United States University of Michigan Health - West Wyoming Michigan
United States North Star Lodge Cancer Center at Yakima Valley Memorial Hospital Yakima Washington
United States UPMC Memorial York Pennsylvania
United States WellSpan Health-York Cancer Center York Pennsylvania
United States WellSpan Health-York Hospital York Pennsylvania
United States Rush-Copley Healthcare Center Yorkville Illinois
United States Saint Elizabeth Youngstown Hospital Youngstown Ohio
United States Huron Gastroenterology PC Ypsilanti Michigan
United States Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus Ypsilanti Michigan
United States Genesis Healthcare System Cancer Care Center Zanesville Ohio

Sponsors (3)

Lead Sponsor Collaborator
NRG Oncology Natera, Inc., National Cancer Institute (NCI)

Countries where clinical trial is conducted

United States,  Canada, 

Outcome

Type Measure Description Time frame Safety issue
Primary ctDNA positive status (TTPos) TTPos is defined as time from randomization until ctDNA positive event: TTPos events are first ctDNA positive result after randomization for the immediate adjuvant chemo arm (Arm 1), 2nd ctDNA positive result after randomization for the delayed adjuvant chemo (Arm 2) and recurrence without a positive ctDNA result for both arms. Time from randomization to the first TTPos event, a maximum of 3 years
Primary Disease-Free Survival (DFS) Time from randomization to first disease-free survival event (recurrence, second primary colorectal cancer or death from any cause). Time from randomization to disease-free survival event, a maximum of 5 years]
Secondary Baseline post-surgery ctDNA positivity rate percentage of patients with ctDNA positive results post-surgery at study entry. At time of randomization
Secondary Overall Survival (OS) Time from randomization to death of any cause. Time from randomization to death, a maximum of 5 years.
Secondary Recurrence Time from randomization to disease recurrence. Time from randomization to disease recurrence, a maximum of 5 years
Secondary Compliance with adjuvant chemotherapy number of cycles of chemotherapy received. from randomization to the last cycle of chemotherapy, a maximum of 6 months.
See also
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