Last updated on September 2018

Azacitidine With or Without Nivolumab or Midostaurin or Decitabine and Cytarabine Alone in Treating Older Patients With Newly Diagnosed Acute Myeloid Leukemia or High-Risk Myelodysplastic Syndrome


Brief description of study

This randomized phase II/III trial studies how well azacitidine with or without nivolumab or midostaurin, or decitabine and cytarabine alone work in treating older patients with newly diagnosed acute myeloid leukemia or high-risk myelodysplastic syndrome. Drugs used in chemotherapy, such as azacitidine, decitabine, and cytarabine, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Monoclonal antibodies, such as nivolumab, may interfere with the ability of cancer cells to grow and spread. Midostaurin may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving azacitidine with or without nivolumab or midostaurin, or decitabine and cytarabine alone may kill more cancer cells.

Detailed Study Description

PRIMARY OBJECTIVES:

I. To select, based on overall survival, any or all of the "Novel Therapeutic" regimens for further testing against azacitidine in patients age 60 and older with newly diagnosed acute myeloid leukemia (AML) or myelodysplastic syndrome with excessive blasts-2 (MDS-EB-2). (Phase II) II. To compare overall survival of the "Novel Therapeutic" regimens selected in the phase II portion of the trial to azacitidine in these patient populations. (Phase III)

SECONDARY OBJECTIVES:

I. To estimate the frequency and severity of toxicities of the regimens in these patient populations.

II. To estimate response rates, event-free survival, and relapse-free survival for these regimens in these patient populations.

TERTIARY OBJECTIVES:

I. To investigate associations between cytogenetic and molecular abnormalities (including FLT3) and outcomes for each of the regimens in these patient populations.

II. To bank specimens for future correlative studies.

OUTLINE: Patients are randomized to 1 of 4 arms.

ARM A: Patients receive azacitidine subcutaneously (SC) or intravenously (IV) daily on days 1-7 or days 1-5 and 8-9. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

ARM B: Patients receive azacitidine as in Arm A and nivolumab IV over 30-60 minutes on days 1 and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

ARM C: Patients receive azacitidine as in Arm A and midostaurin orally (PO) twice daily (BID) on days 8-21. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

ARM D:

INDUCTION: Patients receive decitabine IV over 2 hours on days 1-5 and cytarabine IV continuously on days 6-11. Treatment repeats every 28 days for up to 2 courses in the absence of disease progression or unacceptable toxicity.

MAINTENANCE: Patients deemed stable at the discretion of the treating physician receive decitabine as in Induction. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 3 months for 1 year, every 6 months for 2 years, then annually for 2 years.

Clinical Study Identifier: NCT03092674

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Benjamin T. Marchello

Kootenai Medical Center
Coeur d'Alene, ID United States
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Benjamin T. Marchello

Kootenai Cancer Center
Post Falls, ID United States
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Benefis Healthcare- Sletten Cancer Institute
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Benjamin T. Marchello

Great Falls Clinic
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Brownstown, MI United States
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Essentia Health Saint Joseph's Medical Center
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Parkland Health Center-Bonne Terre
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Kearney, NE United States
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Essentia Health Cancer Center-South University Clinic
Fargo, ND United States
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Roger Maris Cancer Center
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Sanford Broadway Medical Center
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Good Samaritan Hospital - Cincinnati
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TriHealth Cancer Institute-Westside
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TriHealth Cancer Institute-Anderson
Cincinnati, OH United States
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University of Oklahoma Health Sciences Center
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Saint Charles Health System
Bend, OR United States
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Ephrata Cancer Center
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Ephrata Community Hospital
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Adams Cancer Center
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Fresno, CA United States
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Tatjana Kolevska

Kaiser Permanente-Modesto
Modesto, CA United States
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Tatjana Kolevska

Kaiser Permanente Oakland-Broadway
Oakland, CA United States
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Tatjana Kolevska

Kaiser Permanente-Oakland
Oakland, CA United States
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Tatjana Kolevska

Kaiser Permanente-Rancho Cordova Cancer Center
Rancho Cordova, CA United States
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Tatjana Kolevska

Kaiser Permanente-Redwood City
Redwood City, CA United States
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Tatjana Kolevska

Kaiser Permanente-Richmond
Richmond, CA United States
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Tatjana Kolevska

Rohnert Park Cancer Center
Rohnert Park, CA United States
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Tatjana Kolevska

Kaiser Permanente-Roseville
Roseville, CA United States
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Tatjana Kolevska

The Permanente Medical Group-Roseville Radiation Oncology
Roseville, CA United States
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Tatjana Kolevska

Kaiser Permanente-South Sacramento
Sacramento, CA United States
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Tatjana Kolevska

South Sacramento Cancer Center
Sacramento, CA United States
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Tatjana Kolevska

Kaiser Permanente - Sacramento
Sacramento, CA United States
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Tatjana Kolevska

Kaiser Permanente-San Francisco
San Francisco, CA United States
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Tatjana Kolevska

Kaiser Permanente-Santa Teresa-San Jose
San Jose, CA United States
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Tatjana Kolevska

Kaiser Permanente San Leandro
San Leandro, CA United States
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Tatjana Kolevska

Kaiser Permanente-San Rafael
San Rafael, CA United States
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Tatjana Kolevska

Kaiser San Rafael-Gallinas
San Rafael, CA United States
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Tatjana Kolevska

Kaiser Permanente Medical Center - Santa Clara
Santa Clara, CA United States
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Tatjana Kolevska

Kaiser Permanente-Santa Rosa
Santa Rosa, CA United States
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Tatjana Kolevska

Kaiser Permanente Cancer Treatment Center
South San Francisco, CA United States
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Tatjana Kolevska

Kaiser Permanente-South San Francisco
South San Francisco, CA United States
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Tatjana Kolevska

Kaiser Permanente-Stockton
Stockton, CA United States
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Tatjana Kolevska

Kaiser Permanente Medical Center-Vacaville
Vacaville, CA United States
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Tatjana Kolevska

Kaiser Permanente-Vallejo
Vallejo, CA United States
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Tatjana Kolevska

Kaiser Permanente-Walnut Creek
Walnut Creek, CA United States
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Tatjana Kolevska

Kaiser Permanente Moanalua Medical Center
Honolulu, HI United States
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Lovelace Medical Center-Saint Joseph Square
Albuquerque, NM United States
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Cecilia Y. Arana Yi

University of New Mexico Cancer Center
Albuquerque, NM United States
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Cecilia Y. Arana Yi

Presbyterian Kaseman Hospital
Albuquerque, NM United States
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Paul M. Barr

University of Rochester
Rochester, NY United States
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Geoffrey L. Uy

Siteman Cancer Center at West County Hospital
Creve Coeur, MO United States
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Geoffrey L. Uy

Washington University School of Medicine
Saint Louis, MO United States
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Geoffrey L. Uy

Siteman Cancer Center-South County
Saint Louis, MO United States
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Geoffrey L. Uy

Siteman Cancer Center at Christian Hospital
Saint Louis, MO United States
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Aaron T. Gerds

Cleveland Clinic Cancer Center/Fairview Hospital
Cleveland, OH United States
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Aaron T. Gerds

Cleveland Clinic Foundation
Cleveland, OH United States
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Aaron T. Gerds

Cleveland Clinic Cancer Center Independence
Independence, OH United States
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Aaron T. Gerds

Cleveland Clinic Cancer Center Mansfield
Mansfield, OH United States
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Aaron T. Gerds

Hillcrest Hospital Cancer Center
Mayfield Heights, OH United States
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Aaron T. Gerds

North Coast Cancer Care
Sandusky, OH United States
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Aaron T. Gerds

Cleveland Clinic Cancer Center Strongsville
Strongsville, OH United States
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Aaron T. Gerds

South Pointe Hospital
Warrensville Heights, OH United States
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Aaron T. Gerds

Cleveland Clinic Wooster Family Health and Surgery Center
Wooster, OH United States
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Galina Vugman

The Watson Clinic
Lakeland, FL United States
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Joseph J. Merchant

McFarland Clinic PC - Ames
Ames, IA United States
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David M. King

Fairview Ridges Hospital
Burnsville, MN United States
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David M. King

Mercy Hospital
Coon Rapids, MN United States
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David M. King

Fairview-Southdale Hospital
Edina, MN United States
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David M. King

Unity Hospital
Fridley, MN United States
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David M. King

Fairview Maple Grove Medical Center
Maple Grove, MN United States
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David M. King

Minnesota Oncology Hematology PA-Maplewood
Maplewood, MN United States
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David M. King

Abbott-Northwestern Hospital
Minneapolis, MN United States
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David M. King

Hennepin County Medical Center
Minneapolis, MN United States
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David M. King

Health Partners Inc
Minneapolis, MN United States
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David M. King

New Ulm Medical Center
New Ulm, MN United States
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David M. King

North Memorial Medical Health Center
Robbinsdale, MN United States
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David M. King

Park Nicollet Clinic - Saint Louis Park
Saint Louis Park, MN United States
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David M. King

Regions Hospital
Saint Paul, MN United States
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David M. King

United Hospital
Saint Paul, MN United States
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David M. King

Saint Francis Regional Medical Center
Shakopee, MN United States
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David M. King

Lakeview Hospital
Stillwater, MN United States
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David M. King

Ridgeview Medical Center
Waconia, MN United States
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David M. King

Rice Memorial Hospital
Willmar, MN United States
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David M. King

Minnesota Oncology Hematology PA-Woodbury
Woodbury, MN United States
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David M. King

Fairview Lakes Medical Center
Wyoming, MN United States
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Marc A. Rovito

Penn State Health Saint Joseph Medical Center
Reading, PA United States
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David E. Marinier

Gundersen Lutheran Medical Center
La Crosse, WI United States
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David M. King

Cancer Center of Western Wisconsin
New Richmond, WI United States
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Alexander Menter

Kaiser Permanente-Franklin
Denver, CO United States
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Alexander Menter

SCL Health Saint Joseph Hospital
Denver, CO United States
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Alexander Menter

Good Samaritan Medical Center
Lafayette, CO United States
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Alexander Menter

Kaiser Permanente-Rock Creek
Lafayette, CO United States
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Alexander Menter

Kaiser Permanente-Lone Tree
Lone Tree, CO United States
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Geoffrey L. Uy

Siteman Cancer Center at Saint Peters Hospital
Saint Peters, MO United States
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Jay W. Carlson

Good Samaritan Regional Health Center
Mount Vernon, IL United States
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Jay W. Carlson

Saint Louis Cancer and Breast Institute-Ballwin
Ballwin, MO United States
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Jay W. Carlson

Cox Cancer Center Branson
Branson, MO United States
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Bryan A. Faller

Capital Region Southwest Campus
Jefferson City, MO United States
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Jay W. Carlson

Freeman Health System
Joplin, MO United States
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Jay W. Carlson

Mercy Hospital Joplin
Joplin, MO United States
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Jay W. Carlson

Delbert Day Cancer Institute at PCRMC
Rolla, MO United States
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Jay W. Carlson

Mercy Clinic-Rolla-Cancer and Hematology
Rolla, MO United States
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Jay W. Carlson

Heartland Regional Medical Center
Saint Joseph, MO United States
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Jay W. Carlson

Saint Louis Cancer and Breast Institute-South City
Saint Louis, MO United States
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Jay W. Carlson

Mercy Hospital Saint Louis
Saint Louis, MO United States
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Jay W. Carlson

Mercy Hospital Springfield
Springfield, MO United States
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Jay W. Carlson

CoxHealth South Hospital
Springfield, MO United States
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Jay W. Carlson

Mercy Hospital Washington
Washington, MO United States
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Jay W. Carlson

Mercy Hospital Oklahoma City
Oklahoma City, OK United States
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Kiran K. Yalamanchili

Covenant Medical Center-Lakeside
Lubbock, TX United States
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Peter Rubin

Harold Alfond Center for Cancer Care
Augusta, ME United States
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Peter Rubin

Waldo County General Hospital
Belfast, ME United States
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Peter Rubin

MaineHealth/SMHC Cancer Care and Blood Disorders-Biddeford
Biddeford, ME United States
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Peter Rubin

Penobscot Bay Medical Center
Rockport, ME United States
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Peter Rubin

MaineHealth/SMHC Cancer Care and Blood Disorders-Sanford
Sanford, ME United States
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Jay Yang

Wayne State University/Karmanos Cancer Institute
Detroit, MI United States
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Jay Yang

Weisberg Cancer Treatment Center
Farmington Hills, MI United States
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Kendra L. Sweet

Moffitt Cancer Center
Tampa, FL United States
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Tareq Al Baghdadi

Saint Alphonsus Cancer Care Center-Boise
Boise, ID United States
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Tareq Al Baghdadi

Saint Alphonsus Cancer Care Center-Caldwell
Caldwell, ID United States
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Tareq Al Baghdadi

Walter Knox Memorial Hospital
Emmett, ID United States
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Tareq Al Baghdadi

Idaho Urologic Institute-Meridian
Meridian, ID United States
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Tareq Al Baghdadi

Saint Alphonsus Medical Center-Nampa
Nampa, ID United States
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Larry D. Cripe

Indiana University/Melvin and Bren Simon Cancer Center
Indianapolis, IN United States
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Larry D. Cripe

Sidney and Lois Eskenazi Hospital
Indianapolis, IN United States
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Tareq Al Baghdadi

Saint Joseph Mercy Hospital
Ann Arbor, MI United States
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Tareq Al Baghdadi

IHA Hematology Oncology Consultants-Brighton
Brighton, MI United States
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Tareq Al Baghdadi

Saint Joseph Mercy Brighton
Brighton, MI United States
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Tareq Al Baghdadi

IHA Hematology Oncology Consultants-Canton
Canton, MI United States
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Tareq Al Baghdadi

Saint Joseph Mercy Canton
Canton, MI United States
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Tareq Al Baghdadi

Caro Cancer Center
Caro, MI United States
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Tareq Al Baghdadi

IHA Hematology Oncology Consultants-Chelsea
Chelsea, MI United States
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Tareq Al Baghdadi

Saint Joseph Mercy Chelsea
Chelsea, MI United States
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Tareq Al Baghdadi

Hematology Oncology Consultants-Clarkston
Clarkston, MI United States
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Tareq Al Baghdadi

Newland Medical Associates-Clarkston
Clarkston, MI United States
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Tareq Al Baghdadi

Great Lakes Cancer Management Specialists-Doctors Park
East China Township, MI United States
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Tareq Al Baghdadi

Genesee Cancer and Blood Disease Treatment Center
Flint, MI United States
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Tareq Al Baghdadi

Genesee Hematology Oncology PC
Flint, MI United States
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Tareq Al Baghdadi

Genesys Hurley Cancer Institute
Flint, MI United States
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Tareq Al Baghdadi

Hurley Medical Center
Flint, MI United States
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Tareq Al Baghdadi

Great Lakes Cancer Management Specialists-Van Elslander Cancer Center
Grosse Pointe Woods, MI United States
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Tareq Al Baghdadi

Lymphoma Clinic of Michigan
Grosse Pointe Woods, MI United States
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Tareq Al Baghdadi

Michigan Breast Specialists-Grosse Pointe Woods
Grosse Pointe Woods, MI United States
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Tareq Al Baghdadi

Sparrow Hospital
Lansing, MI United States
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Tareq Al Baghdadi

Hope Cancer Clinic
Livonia, MI United States
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Tareq Al Baghdadi

Saint Mary Mercy Hospital
Livonia, MI United States
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Tareq Al Baghdadi

Great Lakes Cancer Management Specialists-Macomb Medical Campus
Macomb, MI United States
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Tareq Al Baghdadi

Michigan Breast Specialists-Macomb Township
Macomb, MI United States
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Tareq Al Baghdadi

Saint Mary's Oncology/Hematology Associates of Marlette
Marlette, MI United States
  Connect »

Tareq Al Baghdadi

21st Century Oncology-Pontiac
Pontiac, MI United States
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Tareq Al Baghdadi

Hope Cancer Center
Pontiac, MI United States
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Tareq Al Baghdadi

Newland Medical Associates-Pontiac
Pontiac, MI United States
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Tareq Al Baghdadi

Saint Joseph Mercy Oakland
Pontiac, MI United States
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Tareq Al Baghdadi

Great Lakes Cancer Management Specialists-Rochester Hills
Rochester Hills, MI United States
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Tareq Al Baghdadi

Saint Mary's of Michigan
Saginaw, MI United States
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Tareq Al Baghdadi

Oncology Hematology Associates of Saginaw Valley PC
Saginaw, MI United States
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Tareq Al Baghdadi

Bhadresh Nayak MD PC-Sterling Heights
Sterling Heights, MI United States
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Tareq Al Baghdadi

Saint Joseph Health System-Tawas City
Tawas City, MI United States
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Tareq Al Baghdadi

Advanced Breast Care Center PLLC
Warren, MI United States
  Connect »

Tareq Al Baghdadi

Great Lakes Cancer Management Specialists-Macomb Professional Building
Warren, MI United States
  Connect »

Tareq Al Baghdadi

Macomb Hematology Oncology PC
Warren, MI United States
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Tareq Al Baghdadi

Michigan Breast Specialists-Warren
Warren, MI United States
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Tareq Al Baghdadi

Saint John Macomb-Oakland Hospital
Warren, MI United States
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Tareq Al Baghdadi

Saint Mary's Oncology/Hematology Associates of West Branch
West Branch, MI United States
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Tareq Al Baghdadi

Huron Gastroenterology PC
Ypsilanti, MI United States
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Tareq Al Baghdadi

IHA Hematology Oncology Consultants-Ann Arbor
Ypsilanti, MI United States
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Tareq Al Baghdadi

Saint Alphonsus Medical Center-Baker City
Baker City, OR United States
  Connect »

Tareq Al Baghdadi

Saint Alphonsus Medical Center-Ontario
Ontario, OR United States
  Connect »

Tareq Al Baghdadi

Lehigh Valley Hospital-Cedar Crest
Allentown, PA United States
  Connect »

Tareq Al Baghdadi

Lehigh Valley Hospital - Muhlenberg
Bethlehem, PA United States
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Tareq Al Baghdadi

Pocono Medical Center
East Stroudsburg, PA United States
  Connect »

Tareq Al Baghdadi

Lehigh Valley Hospital-Hazleton
Hazleton, PA United States
  Connect »

Andrew W. Pippas

John B Amos Cancer Center
Columbus, GA United States
  Connect »

Gary E. Goodman

Saint Charles Health System-Redmond
Redmond, OR United States
  Connect »

Danielle A. Shafer

Virginia Commonwealth University/Massey Cancer Center
Richmond, VA United States
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Gary E. Goodman

PeaceHealth United General Medical Center
Sedro-Woolley, WA United States
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Mohamad Cherry

Morristown Medical Center
Morristown, NJ United States
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Mohamad Cherry

Overlook Hospital
Summit, NJ United States
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Selina M. Luger

University of Pennsylvania/Abramson Cancer Center
Philadelphia, PA United States
  Connect »

Kathleen W. Phelan

Loyola University Medical Center
Maywood, IL United States
  Connect »

Kathleen W. Phelan

Marjorie Weinberg Cancer Center at Loyola-Gottlieb
Melrose Park, IL United States
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Rakesh Gaur

Central Care Cancer Center - Garden City
Garden City, KS United States
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Rakesh Gaur

Central Care Cancer Center - Great Bend
Great Bend, KS United States
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Rakesh Gaur

Kansas Institute of Medicine Cancer and Blood Center
Lenexa, KS United States
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Rakesh Gaur

Minimally Invasive Surgery Hospital
Lenexa, KS United States
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Rakesh Gaur

Menorah Medical Center
Overland Park, KS United States
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Rakesh Gaur

Central Care Cancer Center - Bolivar
Bolivar, MO United States
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Rakesh Gaur

Centerpoint Medical Center LLC
Independence, MO United States
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Rakesh Gaur

Research Medical Center
Kansas City, MO United States
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Priyank P. Patel

Rush - Copley Medical Center
Aurora, IL United States
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Priyank P. Patel

Carle on Vermilion
Danville, IL United States
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Priyank P. Patel

Carle Physician Group-Effingham
Effingham, IL United States
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Priyank P. Patel

Carle Physician Group-Mattoon/Charleston
Mattoon, IL United States
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Priyank P. Patel

Carle Cancer Center
Urbana, IL United States
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Priyank P. Patel

The Carle Foundation Hospital
Urbana, IL United States
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Priyank P. Patel

Rush-Copley Healthcare Center
Yorkville, IL United States
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Bret E. Friday

Essentia Health Hibbing Clinic
Hibbing, MN United States
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Benjamin T. Marchello

Welch Cancer Center
Sheridan, WY United States
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Tatjana Kolevska

Kaiser Permanente Downtown Commons
Sacramento, CA United States
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Darla K. Liles

East Carolina University
Greenville, NC United States
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Steven E. Coutre

Stanford Cancer Institute Palo Alto
Palo Alto, CA United States
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Steven E. Coutre

Stanford Cancer Center South Bay
San Jose, CA United States
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Gregory A. Masters

Beebe Medical Center
Lewes, DE United States
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Gregory A. Masters

Delaware Clinical and Laboratory Physicians PA
Newark, DE United States
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Gregory A. Masters

Helen F Graham Cancer Center
Newark, DE United States
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Gregory A. Masters

Medical Oncology Hematology Consultants PA
Newark, DE United States
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Gregory A. Masters

Regional Hematology and Oncology PA
Newark, DE United States
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Gregory A. Masters

Christiana Care Health System-Christiana Hospital
Newark, DE United States
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Gregory A. Masters

Beebe Health Campus
Rehoboth Beach, DE United States
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Gregory A. Masters

Nanticoke Memorial Hospital
Seaford, DE United States
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Gregory A. Masters

Christiana Care Health System-Wilmington Hospital
Wilmington, DE United States
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Robert J. Behrens

Trinity Regional Medical Center
Fort Dodge, IA United States
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Gregory A. Masters

Christiana Care Health System-Concord Health Center
Chadds Ford, PA United States
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Sameem M. Abedin

Froedtert and the Medical College of Wisconsin
Milwaukee, WI United States
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Bryan A. Faller

Cancer Care Specialists of Illinois - Decatur
Decatur, IL United States
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Bryan A. Faller

Southwest Illinois Health Services LLP
Swansea, IL United States
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Robert F. Manges

Parkview Hospital Randallia
Fort Wayne, IN United States
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Bret E. Friday

Essentia Health - Deer River Clinic
Deer River, MN United States
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Bret E. Friday

Essentia Health Saint Mary's - Detroit Lakes Clinic
Detroit Lakes, MN United States
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Bret E. Friday

Essentia Health - Fosston
Fosston, MN United States
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Bret E. Friday

Essentia Health - Park Rapids
Park Rapids, MN United States
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Bret E. Friday

Essentia Health Sandstone
Sandstone, MN United States
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Cecilia Y. Arana Yi

New Mexico Oncology Hematology Consultants
Albuquerque, NM United States
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Bret E. Friday

Essentia Health - Jamestown Clinic
Jamestown, ND United States
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Bret E. Friday

Ashland Memorial Medical Center
Ashland, WI United States
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Brian A. Jonas

Fremont - Rideout Cancer Center
Marysville, CA United States
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Brian A. Jonas

University of California Davis Comprehensive Cancer Center
Sacramento, CA United States
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Brian A. Jonas

Gene Upshaw Memorial Tahoe Forest Cancer Center
Truckee, CA United States
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Kathleen W. Phelan

Hines Veterans Administration Hospital
Hines, IL United States
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Preston D. Steen

Sanford Thief River Falls Medical Center
Thief River Falls, MN United States
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Preston D. Steen

Sanford South University Medical Center
Fargo, ND United States
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David M. King

Saint John's Hospital - Healtheast
Maplewood, MN United States
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Preston D. Steen

Sanford Cancer Center Worthington
Worthington, MN United States
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Rangaswamy Govindarajan

Veteran's Administration Medical Center
Little Rock, AR United States
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Salil Goorha

Baptist Memorial Hospital and Cancer Center-Oxford
Oxford, MS United States
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Salil Goorha

Baptist Memorial Hospital and Cancer Center-Desoto
Southhaven, MS United States
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Salil Goorha

Baptist Memorial Hospital and Cancer Center-Memphis
Memphis, TN United States
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Ryan J. Mattison

University of Wisconsin Hospital and Clinics
Madison, WI United States
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Shaker R. Dakhil

Lawrence Memorial Hospital
Lawrence, KS United States
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Shaker R. Dakhil

Cancer Center of Kansas-Wichita Medical Arts Tower
Wichita, KS United States
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Shaker R. Dakhil

Cancer Center of Kansas - Wichita
Wichita, KS United States
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Shaker R. Dakhil

Via Christi Regional Medical Center
Wichita, KS United States
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Shaker R. Dakhil

Wesley Medical Center
Wichita, KS United States
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Tareq Al Baghdadi

Ascension Saint John Hospital
Detroit, MI United States
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Willard G. Andrews

Abington Memorial Hospital
Abington, PA United States
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Willard G. Andrews

Abington Memorial Hospital-Asplundh Cancer Pavilion
Willow Grove, PA United States
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