Prophylactic Antiviral Therapy in Patients With Current or Past Hepatitis B Virus Infection Receiving Anti-Cancer Therapy for Solid Tumors

Last updated: May 17, 2024
Sponsor: SWOG Cancer Research Network
Overall Status: Terminated

Phase

3

Condition

Hepatitis B

Hepatitis

Liver Disorders

Treatment

Best Practice

Entecavir

Tenofovir Alafenamide

Clinical Study ID

NCT03887702
S1614
SWOG-S1614
NCI-2018-00592
UG1CA189974
S1614
  • Ages > 18
  • All Genders

Study Summary

This phase III trial studies the effect of hepatitis B antiviral (anti-HBV) therapy in preventing liver complications in patients with chronic or past hepatitis B virus (HBV) who are receiving anti-cancer therapy for solid tumors. People with chronic or past HBV who are undergoing therapy for cancer are at an increased risk for changes in the liver which could be minor or severe. Anti-HBV therapy acts against infections caused by HBV and may help reduce the chance that HBV gets worse or comes back in patients receiving anti-cancer therapy for solid tumors.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Patients must be diagnosed with stage I-III solid tumor malignancy; patients with only carcinoma in situ or with stage IV disease are excluded

  • Patients must not have lymphoma, leukemia, or myeloma

  • Patients must not have primary liver cancer, known cirrhosis, or evidence of any malignancy that involves the liver

  • Patients must be planning to receive systemic anti-cancer therapy (either single agent or some combination of systemic cytotoxic therapy, systemic immunotherapy or systemic targeted therapy) for this solid tumor

  • Patients must not have been previously treated with the same anti-cancer therapy regimen that is now anticipated; the anti-cancer therapy does not have to be first-line therapy; prior and/or concurrent radiotherapy is allowed

  • Patients must be registered <= 28 days prior to the planned start date of anti-cancer therapy; if the patient has started systemic anti-cancer therapy, patient must be registered <= 42 days after the initiation of first cycle of anti-cancer therapy

  • Patients who have received prior anti-cancer therapy must have discontinued all previous therapies (excluding planned anti-cancer therapy to occur in conjunction with this study) >= 1 day prior to registration to this study

  • Patients must not have had any cancer therapy regimen that includes anti-CD20

  • Patients must not be receiving antiviral medications active against HBV, including: adefovir, entecavir, lamivudine, telbivudine, tenofovir disoproxil fumarate, tenofovir alafenamide (TAF), or any other Food and Drug Administration (FDA) approved agents for the treatment of hepatitis B; patients who have previously received antiviral medication must not have required any antiviral medication active against HBV >= 90 days prior to registration to this study

  • Patients must not have had hematopoietic stem cell transplantation therapy

  • Patients must not be taking or planning to take warfarin

  • Patients who will be treated with TAF must not be taking or planning to take oxcarbazepine, phenobarbital, phenytoin, rifabutin, rifampin, rifapentine, or St. John's Wort

  • Patients who will be treated with TAF and are concomitantly taking or plan to take carbamazepine must be given an increased dose of TAF or alternatively be given ETV or TDF

  • Patients must have results for the following HBV tests done within 28 days prior to registration: HBsAg AND anti-HBc (total immunoglobulin [Ig] or IgG, but not IgM only) AND hepatitis B surface antibody (anti-HBs); for the anti-HBs test, quantitative or qualitative (including "indeterminate") results are allowable

  • Patients must have tested positive for HBsAg or anti-HBc (total Ig, IgG, but not IgM) and must have baseline HBV deoxyribonucleic acid (DNA) completed <= 42 days prior to registration

  • Complete blood count (CBC) must be completed <= 28 days prior to registration; results do not need to be in the institutional limits of normal

  • International normalized ratio (INR) must be completed <= 28 days prior to registration; results must <= 1.2 x institutional limits of normal

  • Alanine aminotransferase (ALT) must be obtained <= 28 days prior to registration; ALT must be < 1.5 x institutional ULN

  • Total bilirubin must be obtained <= 28 days prior to registration; total bilirubin must be < 1.5 x institutional ULN

  • Creatinine results must be obtained <= 28 days prior to registration

  • Patients must not have known current active hepatitis C infection (HCV); active HCV is defined by a detectable HCV ribonucleic acid (RNA) level; Note: HCV testing is not required for eligibility

  • Patients must not have a history of human immunodeficiency (HIV) infection; patients with unknown HIV status must have HIV testing completed <= 365 days prior to registration

  • Patients must have Zubrod performance status of 0-2

  • Patients must not be pregnant or nursing, as the safety of the study drug in pregnant and nursing women has not been established; women/men of reproductive potential must have agreed to use an effective contraceptive method; a woman is considered to be of "reproductive potential" if she has had menses at any time in the preceding 12 consecutive months; in addition to routine contraceptive methods, "effective contraception" also includes heterosexual celibacy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) defined as a hysterectomy, bilateral oophorectomy or bilateral tubal ligation; however, if at any point a previously celibate patient chooses to become heterosexually active during the time period for use of contraceptive measures outlined in the protocol, he/she is responsible for beginning contraceptive measures

  • Patients must have specimens collected for submission as outlined

  • Patients must be offered the opportunity to participate in optional translational medicine studies as outlined

  • Patients with impaired decision-making capacity are eligible as long as their neurological or psychological condition does not preclude their safe participation in the study (e.g., tracking pill consumption and reporting adverse events to the investigator)

  • Patients may have concurrent participation in other clinical trials that entail cytotoxic, immunotherapy, targeted therapy; surgical treatment; radiotherapy treatment; or any combination thereof

  • Patients must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines

  • As a part of the Oncology Patient Enrollment Network (OPEN) registration process the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the system

Study Design

Total Participants: 4
Treatment Group(s): 4
Primary Treatment: Best Practice
Phase: 3
Study Start date:
January 17, 2020
Estimated Completion Date:
December 20, 2022

Study Description

Co-Primary Objectives

  1. To compare the effect of prophylactic anti-HBV therapy versus upon indication anti-HBV therapy on time-to-adverse liver outcomes of liver failure or liver-related death in patients with chronic HBV infection (HBsAg+ and anti-HBc+) receiving anti-cancer therapy for solid tumors.

  2. To compare the effect of upon indication anti-HBV therapy versus usual care on time-to-adverse liver outcomes of liver failure or liver-related death in patients with past HBV infection (HBsAg- and anti-HBc+) receiving anti-cancer therapy for solid tumors.

Secondary Objectives

  1. Using time-to-event analysis, to compare the effect of anti-HBV therapy versus upon indication anti-HBV therapy on HBV reactivation, on the combined endpoint of adverse liver outcomes (liver failure or liver-related death) and HBV reactivation, and on HBV flare by arm in patients with chronic HBV infection receiving anticancer therapy for solid tumors.

  2. Using time-to-event analysis, to compare the effect of upon indication anti-HBV therapy versus usual care on HBV reactivation, on the combined endpoint of adverse liver outcomes (liver failure or liver-related death) and HBV reactivation, and on HBV flare by arm in patients with past HBV infection receiving anti-cancer therapy for solid tumors.

Translational Objectives

  1. To compare baseline and changes in overall immune status and HBV-specific immune response in patients with solid tumors and chronic or past HBV infection receiving anti-cancer therapy, and to compare the differences in these immune responses by HBV reactivation status.

  2. To identify demographic and clinical predictors and correlative immunologic biomarkers of HBV reactivation after receipt of anti-cancer therapy in patients with solid tumors and chronic or past HBV infection.

OUTLINE: Patients are recruited in two cohorts (Cohort 1: chronic HBV infection, Cohort 2: past HBV infection), with each cohort randomized equally to one of two potential treatment arms.

Chronic HBV Infection (Cohort 1) Arms:

Arm 1: Patients receive tenofovir alafenamide (TAF) orally (PO) once daily (QD) or tenofovir disoproxil fumarate (TDF) PO QD or entecavir PO QD immediately or within 42 days after initial dose of chemotherapy. Treatment continues for up to 6 months after the last dose of chemotherapy or a maximum of 24 months in the absence of disease progression or unacceptable toxicity.

Arm 2: Patients receive TAF PO QD or TDF PO QD or entecavir PO QD after HBV reactivation during chemotherapy. Treatment continues for up to 6 months after the last dose of chemotherapy or a maximum of 24 months in the absence of disease progression or unacceptable toxicity.

Past HBV infection (Cohort 2) Arms:

Arm 3: Patients receive TAF PO QD or TDF PO QD or entecavir PO QD after HBV reactivation during chemotherapy. Treatment continues for up to 6 months after the last dose of chemotherapy or a maximum of 24 months in the absence of disease progression or unacceptable toxicity.

Arm 4: Patients receive anti-HBV therapy at the discretion of the physician. Any Food and Drug Administration (FDA) approved anti-viral medication for HBV may be used.

(Cohort 1: Arm 2 and Cohort 2: Arm 3 follow the same treatment plan, but are considered part of separate parallel studies and are therefore identified as separate arms.)

Patients are followed for 24 months: every 4 weeks from randomization to week 24, then every 8 weeks thereafter up to week 104.

Connect with a study center

  • FHP Health Center-Guam

    Tamuning, 96913
    Guam

    Site Not Available

  • Mercy Hospital Fort Smith

    Fort Smith, Arkansas 72903
    United States

    Site Not Available

  • Kaiser Permanente-Anaheim

    Anaheim, California 92806
    United States

    Site Not Available

  • Kaiser Permanente-Deer Valley Medical Center

    Antioch, California 94531
    United States

    Site Not Available

  • Kaiser Permanente-Baldwin Park

    Baldwin Park, California 91706
    United States

    Site Not Available

  • Kaiser Permanente-Bellflower

    Bellflower, California 90706
    United States

    Site Not Available

  • Epic Care-Dublin

    Dublin, California 94568
    United States

    Site Not Available

  • Kaiser Permanente Dublin

    Dublin, California 94568
    United States

    Site Not Available

  • Bay Area Breast Surgeons Inc

    Emeryville, California 94608
    United States

    Site Not Available

  • Epic Care Partners in Cancer Care

    Emeryville, California 94608
    United States

    Site Not Available

  • Kaiser Permanente-Fontana

    Fontana, California 92335
    United States

    Site Not Available

  • Kaiser Permanente-Fremont

    Fremont, California 94538
    United States

    Site Not Available

  • Fresno Cancer Center

    Fresno, California 93720
    United States

    Site Not Available

  • Kaiser Permanente-Fresno

    Fresno, California 93720
    United States

    Site Not Available

  • Kaiser Permanente - Harbor City

    Harbor City, California 90710
    United States

    Site Not Available

  • Kaiser Permanente-Irvine

    Irvine, California 92618
    United States

    Site Not Available

  • Tibor Rubin VA Medical Center

    Long Beach, California 90822
    United States

    Site Not Available

  • Kaiser Permanente Los Angeles Medical Center

    Los Angeles, California 90027
    United States

    Site Not Available

  • Kaiser Permanente West Los Angeles

    Los Angeles, California 90034
    United States

    Site Not Available

  • Los Angeles County-USC Medical Center

    Los Angeles, California 90033
    United States

    Site Not Available

  • USC / Norris Comprehensive Cancer Center

    Los Angeles, California 90033
    United States

    Site Not Available

  • Contra Costa Regional Medical Center

    Martinez, California 94553-3156
    United States

    Site Not Available

  • Kaiser Permanente-Modesto

    Modesto, California 95356
    United States

    Site Not Available

  • USC Norris Oncology/Hematology-Newport Beach

    Newport Beach, California 92663
    United States

    Site Not Available

  • Alta Bates Summit Medical Center - Summit Campus

    Oakland, California 94609
    United States

    Site Not Available

  • Bay Area Tumor Institute

    Oakland, California 94609
    United States

    Site Not Available

  • Kaiser Permanente Oakland-Broadway

    Oakland, California 94611
    United States

    Site Not Available

  • Kaiser Permanente-Oakland

    Oakland, California 94611
    United States

    Site Not Available

  • Kaiser Permanente-Ontario

    Ontario, California 91761
    United States

    Site Not Available

  • Kaiser Permanente - Panorama City

    Panorama City, California 91402
    United States

    Site Not Available

  • Keck Medical Center of USC Pasadena

    Pasadena, California 91105
    United States

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    Rancho Cordova, California 95670
    United States

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    Redwood City, California 94063
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  • Kaiser Permanente-Richmond

    Richmond, California 94801
    United States

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  • Kaiser Permanente-Riverside

    Riverside, California 92505
    United States

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  • Rohnert Park Cancer Center

    Rohnert Park, California 94928
    United States

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    Roseville, California 95661
    United States

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    Roseville, California 95678
    United States

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  • Kaiser Permanente - Sacramento

    Sacramento, California 95825
    United States

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    Sacramento, California 95814
    United States

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  • Kaiser Permanente-South Sacramento

    Sacramento, California 95823
    United States

    Site Not Available

  • South Sacramento Cancer Center

    Sacramento, California 95823
    United States

    Site Not Available

  • Kaiser Permanente-San Diego Zion

    San Diego, California 92120
    United States

    Site Not Available

  • Kaiser Permanente-San Francisco

    San Francisco, California 94115
    United States

    Site Not Available

  • Kaiser Permanente-Santa Teresa-San Jose

    San Jose, California 95119
    United States

    Site Not Available

  • Kaiser Permanente San Leandro

    San Leandro, California 94577
    United States

    Site Not Available

  • Kaiser Permanente-San Marcos

    San Marcos, California 92078
    United States

    Site Not Available

  • Kaiser Permanente-San Rafael

    San Rafael, California 94903
    United States

    Site Not Available

  • Kaiser San Rafael-Gallinas

    San Rafael, California 94903
    United States

    Site Not Available

  • Kaiser Permanente Medical Center - Santa Clara

    Santa Clara, California 95051
    United States

    Site Not Available

  • Kaiser Permanente-Santa Rosa

    Santa Rosa, California 95403
    United States

    Site Not Available

  • Kaiser Permanente Cancer Treatment Center

    South San Francisco, California 94080
    United States

    Site Not Available

  • Kaiser Permanente-South San Francisco

    South San Francisco, California 94080
    United States

    Site Not Available

  • Kaiser Permanente-Stockton

    Stockton, California 95210
    United States

    Site Not Available

  • Kaiser Permanente Medical Center-Vacaville

    Vacaville, California 95688
    United States

    Site Not Available

  • Kaiser Permanente-Vallejo

    Vallejo, California 94589
    United States

    Site Not Available

  • Epic Care Cyberknife Center

    Walnut Creek, California 94597
    United States

    Site Not Available

  • Kaiser Permanente-Walnut Creek

    Walnut Creek, California 94596
    United States

    Site Not Available

  • Kaiser Permanente-Woodland Hills

    Woodland Hills, California 91367
    United States

    Site Not Available

  • Broward Health North

    Deerfield Beach, Florida 33064
    United States

    Site Not Available

  • Broward Health Medical Center

    Fort Lauderdale, Florida 33316
    United States

    Site Not Available

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

    Savannah, Georgia 31405
    United States

    Site Not Available

  • Hawaii Cancer Care - Savio

    'Aiea, Hawaii 96701
    United States

    Site Not Available

  • Pali Momi Medical Center

    'Aiea, Hawaii 96701
    United States

    Site Not Available

  • Queen's Cancer Center - Pearlridge

    'Aiea, Hawaii 96701
    United States

    Site Not Available

  • The Cancer Center of Hawaii-Pali Momi

    'Aiea, Hawaii 96701
    United States

    Site Not Available

  • The Queen's Medical Center - West Oahu

    'Ewa Beach, Hawaii 96706
    United States

    Site Not Available

  • Hawaii Cancer Care Inc - Waterfront Plaza

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • Hawaii Cancer Care Inc-Liliha

    Honolulu, Hawaii 96817
    United States

    Site Not Available

  • Hawaii Diagnostic Radiology Services LLC

    Honolulu, Hawaii 96817
    United States

    Site Not Available

  • Island Urology

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • Kaiser Permanente Moanalua Medical Center

    Honolulu, Hawaii 96819
    United States

    Site Not Available

  • Kapiolani Medical Center for Women and Children

    Honolulu, Hawaii 96826
    United States

    Site Not Available

  • Kuakini Medical Center

    Honolulu, Hawaii 96817
    United States

    Site Not Available

  • Queen's Cancer Cenrer - POB I

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • Queen's Cancer Center - Kuakini

    Honolulu, Hawaii 96817
    United States

    Site Not Available

  • Queen's Medical Center

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • Straub Clinic and Hospital

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • The Cancer Center of Hawaii-Liliha

    Honolulu, Hawaii 96817
    United States

    Site Not Available

  • University of Hawaii Cancer Center

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • Castle Medical Center

    Kailua, Hawaii 96734
    United States

    Site Not Available

  • Wilcox Memorial Hospital and Kauai Medical Clinic

    Lihue, Hawaii 96766
    United States

    Site Not Available

  • Saint Alphonsus Cancer Care Center-Boise

    Boise, Idaho 83706
    United States

    Site Not Available

  • Saint Alphonsus Cancer Care Center-Caldwell

    Caldwell, Idaho 83605
    United States

    Site Not Available

  • Kootenai Health - Coeur d'Alene

    Coeur d'Alene, Idaho 83814
    United States

    Site Not Available

  • Walter Knox Memorial Hospital

    Emmett, Idaho 83617
    United States

    Site Not Available

  • Idaho Urologic Institute-Meridian

    Meridian, Idaho 83642
    United States

    Site Not Available

  • Saint Alphonsus Medical Center-Nampa

    Nampa, Idaho 83686
    United States

    Site Not Available

  • Kootenai Clinic Cancer Services - Post Falls

    Post Falls, Idaho 83854
    United States

    Site Not Available

  • Kootenai Cancer Clinic

    Sandpoint, Idaho 83864
    United States

    Site Not Available

  • Saint Anthony's Health

    Alton, Illinois 62002
    United States

    Site Not Available

  • Rush - Copley Medical Center

    Aurora, Illinois 60504
    United States

    Site Not Available

  • Northwestern University

    Chicago, Illinois 60611
    United States

    Site Not Available

  • Carle on Vermilion

    Danville, Illinois 61832
    United States

    Site Not Available

  • Carle Physician Group-Effingham

    Effingham, Illinois 62401
    United States

    Site Not Available

  • Carle Physician Group-Mattoon/Charleston

    Mattoon, Illinois 61938
    United States

    Site Not Available

  • Good Samaritan Regional Health Center

    Mount Vernon, Illinois 62864
    United States

    Site Not Available

  • Carle Cancer Center

    Urbana, Illinois 61801
    United States

    Site Not Available

  • The Carle Foundation Hospital

    Urbana, Illinois 61801
    United States

    Site Not Available

  • Rush-Copley Healthcare Center

    Yorkville, Illinois 60560
    United States

    Site Not Available

  • Cancer Center of Kansas - Chanute

    Chanute, Kansas 66720
    United States

    Site Not Available

  • Cancer Center of Kansas - Dodge City

    Dodge City, Kansas 67801
    United States

    Site Not Available

  • Cancer Center of Kansas - El Dorado

    El Dorado, Kansas 67042
    United States

    Site Not Available

  • Central Care Cancer Center - Garden City

    Garden City, Kansas 67846
    United States

    Site Not Available

  • Central Care Cancer Center - Great Bend

    Great Bend, Kansas 67530
    United States

    Site Not Available

  • Cancer Center of Kansas-Independence

    Independence, Kansas 67301
    United States

    Site Not Available

  • Cancer Center of Kansas-Kingman

    Kingman, Kansas 67068
    United States

    Site Not Available

  • Lawrence Memorial Hospital

    Lawrence, Kansas 66044
    United States

    Site Not Available

  • Kansas Institute of Medicine Cancer and Blood Center

    Lenexa, Kansas 66219
    United States

    Site Not Available

  • Minimally Invasive Surgery Hospital

    Lenexa, Kansas 66219
    United States

    Site Not Available

  • Cancer Center of Kansas-Liberal

    Liberal, Kansas 67905
    United States

    Site Not Available

  • Cancer Center of Kansas-Manhattan

    Manhattan, Kansas 66502
    United States

    Site Not Available

  • Cancer Center of Kansas - McPherson

    McPherson, Kansas 67460
    United States

    Site Not Available

  • Cancer Center of Kansas - Newton

    Newton, Kansas 67114
    United States

    Site Not Available

  • Menorah Medical Center

    Overland Park, Kansas 66209
    United States

    Site Not Available

  • Cancer Center of Kansas - Parsons

    Parsons, Kansas 67357
    United States

    Site Not Available

  • Cancer Center of Kansas - Pratt

    Pratt, Kansas 67124
    United States

    Site Not Available

  • Cancer Center of Kansas - Salina

    Salina, Kansas 67401
    United States

    Site Not Available

  • Cancer Center of Kansas - Wellington

    Wellington, Kansas 67152
    United States

    Site Not Available

  • Associates In Womens Health

    Wichita, Kansas 67208
    United States

    Site Not Available

  • Cancer Center of Kansas - Wichita

    Wichita, Kansas 67214
    United States

    Site Not Available

  • Cancer Center of Kansas-Wichita Medical Arts Tower

    Wichita, Kansas 67208
    United States

    Site Not Available

  • Cancer Center of Kansas - Winfield

    Winfield, Kansas 67156
    United States

    Site Not Available

  • Ochsner LSU Health Monroe Medical Center

    Monroe, Louisiana 71202
    United States

    Site Not Available

  • LSU Health Sciences Center at Shreveport

    Shreveport, Louisiana 71103
    United States

    Site Not Available

  • Fairview Ridges Hospital

    Burnsville, Minnesota 55337
    United States

    Site Not Available

  • Minnesota Oncology - Burnsville

    Burnsville, Minnesota 55337
    United States

    Site Not Available

  • Cambridge Medical Center

    Cambridge, Minnesota 55008
    United States

    Site Not Available

  • Mercy Hospital

    Coon Rapids, Minnesota 55433
    United States

    Site Not Available

  • Fairview Southdale Hospital

    Edina, Minnesota 55435
    United States

    Site Not Available

  • Unity Hospital

    Fridley, Minnesota 55432
    United States

    Site Not Available

  • Fairview Clinics and Surgery Center Maple Grove

    Maple Grove, Minnesota 55369
    United States

    Site Not Available

  • Minnesota Oncology Hematology PA-Maplewood

    Maplewood, Minnesota 55109
    United States

    Site Not Available

  • Saint John's Hospital - Healtheast

    Maplewood, Minnesota 55109
    United States

    Site Not Available

  • Abbott-Northwestern Hospital

    Minneapolis, Minnesota 55407
    United States

    Site Not Available

  • Health Partners Inc

    Minneapolis, Minnesota 55454
    United States

    Site Not Available

  • Hennepin County Medical Center

    Minneapolis, Minnesota 55415
    United States

    Site Not Available

  • Monticello Cancer Center

    Monticello, Minnesota 55362
    United States

    Site Not Available

  • New Ulm Medical Center

    New Ulm, Minnesota 56073
    United States

    Site Not Available

  • Fairview Northland Medical Center

    Princeton, Minnesota 55371
    United States

    Site Not Available

  • North Memorial Medical Health Center

    Robbinsdale, Minnesota 55422
    United States

    Site Not Available

  • Park Nicollet Clinic - Saint Louis Park

    Saint Louis Park, Minnesota 55416
    United States

    Site Not Available

  • Regions Hospital

    Saint Paul, Minnesota 55101
    United States

    Site Not Available

  • United Hospital

    Saint Paul, Minnesota 55102
    United States

    Site Not Available

  • Saint Francis Regional Medical Center

    Shakopee, Minnesota 55379
    United States

    Site Not Available

  • Lakeview Hospital

    Stillwater, Minnesota 55082
    United States

    Site Not Available

  • Ridgeview Medical Center

    Waconia, Minnesota 55387
    United States

    Site Not Available

  • Rice Memorial Hospital

    Willmar, Minnesota 56201
    United States

    Site Not Available

  • Minnesota Oncology Hematology PA-Woodbury

    Woodbury, Minnesota 55125
    United States

    Site Not Available

  • Fairview Lakes Medical Center

    Wyoming, Minnesota 55092
    United States

    Site Not Available

  • University of Mississippi Medical Center

    Jackson, Mississippi 39216
    United States

    Site Not Available

  • Saint Louis Cancer and Breast Institute-Ballwin

    Ballwin, Missouri 63011
    United States

    Site Not Available

  • Central Care Cancer Center - Bolivar

    Bolivar, Missouri 65613
    United States

    Site Not Available

  • Cox Cancer Center Branson

    Branson, Missouri 65616
    United States

    Site Not Available

  • Centerpoint Medical Center LLC

    Independence, Missouri 64057
    United States

    Site Not Available

  • Freeman Health System

    Joplin, Missouri 64804
    United States

    Site Not Available

  • Mercy Hospital Joplin

    Joplin, Missouri 64804
    United States

    Site Not Available

  • Research Medical Center

    Kansas City, Missouri 64132
    United States

    Site Not Available

  • Delbert Day Cancer Institute at PCRMC

    Rolla, Missouri 65401
    United States

    Site Not Available

  • Mercy Clinic-Rolla-Cancer and Hematology

    Rolla, Missouri 65401
    United States

    Site Not Available

  • Heartland Regional Medical Center

    Saint Joseph, Missouri 64506
    United States

    Site Not Available

  • Mercy Hospital Saint Louis

    Saint Louis, Missouri 63141
    United States

    Site Not Available

  • Mercy Hospital South

    Saint Louis, Missouri 63128
    United States

    Site Not Available

  • Saint Louis Cancer and Breast Institute-South City

    Saint Louis, Missouri 63109
    United States

    Site Not Available

  • CoxHealth South Hospital

    Springfield, Missouri 65807
    United States

    Site Not Available

  • Mercy Hospital Springfield

    Springfield, Missouri 65804
    United States

    Site Not Available

  • Mercy Hospital Washington

    Washington, Missouri 63090
    United States

    Site Not Available

  • Community Hospital of Anaconda

    Anaconda, Montana 59711
    United States

    Site Not Available

  • Billings Clinic Cancer Center

    Billings, Montana 59101
    United States

    Site Not Available

  • Bozeman Deaconess Hospital

    Bozeman, Montana 59715
    United States

    Site Not Available

  • Benefis Healthcare- Sletten Cancer Institute

    Great Falls, Montana 59405
    United States

    Site Not Available

  • Great Falls Clinic

    Great Falls, Montana 59405
    United States

    Site Not Available

  • Saint Peter's Community Hospital

    Helena, Montana 59601
    United States

    Site Not Available

  • Kalispell Regional Medical Center

    Kalispell, Montana 59901
    United States

    Site Not Available

  • Community Medical Hospital

    Missoula, Montana 59804
    United States

    Site Not Available

  • NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center

    New York, New York 10032
    United States

    Site Not Available

  • Mercy Hospital Oklahoma City

    Oklahoma City, Oklahoma 73120
    United States

    Site Not Available

  • Saint Alphonsus Medical Center-Baker City

    Baker City, Oregon 97814
    United States

    Site Not Available

  • Saint Alphonsus Medical Center-Ontario

    Ontario, Oregon 97914
    United States

    Site Not Available

  • Kaiser Permanente Northwest

    Portland, Oregon 97227
    United States

    Site Not Available

  • Prisma Health Cancer Institute - Spartanburg

    Boiling Springs, South Carolina 29316
    United States

    Site Not Available

  • Prisma Health Cancer Institute - Easley

    Easley, South Carolina 29640
    United States

    Site Not Available

  • Prisma Health Cancer Institute - Butternut

    Greenville, South Carolina 29605
    United States

    Site Not Available

  • Prisma Health Cancer Institute - Eastside

    Greenville, South Carolina 29615
    United States

    Site Not Available

  • Prisma Health Cancer Institute - Faris

    Greenville, South Carolina 29605
    United States

    Site Not Available

  • Prisma Health Greenville Memorial Hospital

    Greenville, South Carolina 29605
    United States

    Site Not Available

  • Prisma Health Cancer Institute - Greer

    Greer, South Carolina 29650
    United States

    Site Not Available

  • Prisma Health Cancer Institute - Seneca

    Seneca, South Carolina 29672
    United States

    Site Not Available

  • Greenville Health System Cancer Institute-Spartanburg

    Spartanburg, South Carolina 29307
    United States

    Site Not Available

  • M D Anderson Cancer Center

    Houston, Texas 77030
    United States

    Site Not Available

  • Kaiser Permanente Washington

    Seattle, Washington 98112
    United States

    Site Not Available

  • Cancer Center of Western Wisconsin

    New Richmond, Wisconsin 54017
    United States

    Site Not Available

  • Billings Clinic-Cody

    Cody, Wyoming 82414
    United States

    Site Not Available

  • Welch Cancer Center

    Sheridan, Wyoming 82801
    United States

    Site Not Available

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