Immunotherapy boosts bladder cancer treatment, early trial shows promise

NCT ID NCT04216290

Disease control Sponsor: National Cancer Institute (NCI) Source: ClinicalTrials.gov ↗

First seen Jun 27, 2026 · Last updated Jun 27, 2026

Summary

This study tests whether adding the immunotherapy drug durvalumab to standard chemotherapy and radiation can improve outcomes for people with stage III bladder cancer that has spread to nearby lymph nodes. The goal is to see if the combination helps shrink tumors and allows patients to keep their bladder. About 11 adults with this type of cancer are taking part in this early-phase trial.

This is an AI summary of the original study and may miss details. Read our disclaimer.

Study facts

What this study's own registry entry says, in plain language.

Phase

Phase 2

Tests whether the treatment actually works, and watches for side effects, in a larger group.

Participants

11 people

The number who actually took part.

Started

Mar 2021

Expected to finish

May 2027

An estimate. End dates often move.

Lead sponsor

A government research agency

The lead sponsor is the US National Institutes of Health.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Ages

18 years and older

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * STEP 1 (RANDOMIZATION) ELIGIBILITY CRITERIA: * Patient must be \>= 18 years of age. * Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 at the time of step 1 randomization. * Patient must have histologically proven pure or mixed urothelial cancer of the bladder. * NOTE: Small cell carcinoma is excluded, however other variant histologies are permitted provided a component of urothelial carcinoma is present. * Patient must have documented node-positive and non-metastatic disease (any T, any N, M0). Node positivity must have been defined prior to receiving any systemic chemotherapy or induction chemotherapy. Node positivity can fall into either of the following categories and will be defined by imaging and/or biopsy: * A lymph node \>= 1.0 cm in short axis on imaging (i.e., CT or MRI or positron emission tomography \[PET\]/CT). * A lymph node that is \< 1 cm on imaging with either a biopsy confirming involvement with cancer or high suspicion of cancer. * For patients who have received induction chemotherapy (any type of systemic chemotherapy) for node positive bladder cancer prior to enrollment, there must be no signs of disease progression (CR/partial response \[PR\] or stable disease \[SD\]) based on restaging imaging and cystoscopy, which consists of: * CT chest, abdomen, and pelvis obtained after completion of induction chemotherapy and within 8 weeks prior to step 1 randomization. * NOTE: MRI can be used instead of CT per treating physician discretion. * Cystoscopic evaluation and attempt to perform maximal transurethral resection of bladder tumor (TURBT) performed by the participating urologist after completion of induction chemotherapy and within 12 weeks prior to step 1 randomization. If maximal TURBT is not possible for medical reasons, the enrollment must be discussed and approved with the study chair. Documentation of correspondences with the study chair must be kept on file. * Patients who achieve CR upon cystoscopy per urologist with no visible tumor (i.e., no need for additional TURBT), are allowed to proceed in the study as adequate resection with no residual disease in bladder. * For patients who have did not receive induction chemotherapy (any type of systemic chemotherapy) for node positive bladder cancer prior to enrollment, the following must be obtained: * CT chest, abdomen, and pelvis completed within 8 weeks prior to step 1 randomization. * NOTE: MRI can be used instead of CT per treating physician discretion. * Cystoscopic evaluation and attempt to perform maximal TURBT performed by the participating urologist within 12 weeks prior to step 1 randomization. If maximal TURBT is not possible for medical reasons, the enrollment must be discussed and approved with the study chair. Documentation of correspondences with the study chair must be kept on file. * For patients who may need repeat TURBT if their old TURBT has fallen out of window: If urologist determine no visible tumor (i.e., no need for additional resection) upon cystoscopy, they are allowed to proceed in the study as complete resection. * Patient must not have received any previous radiation therapy to the pelvic area. * Patient must agree to undergo CT simulation and treatment planning. If this is the first case registered at the site, then a pre-treatment radiation therapy (RT) review will be required and will take up to 3 business days. The patient cannot start radiation treatment prior to successful completion of this pre-treatment review. Therefore, careful planning is necessary to meet the deadline of starting radiation within 20 business days of step 1 randomization. * Patient must not have presence of concomitant active upper tract tumors or urethra tumors. History of previously adequately treated non-muscle invasive bladder cancer (NMIBC) are eligible. Previously treated urothelial cancer or histological variant at any site outside of the urinary bladder are allowed, provided they have been Ta/T1/carcinoma in situ (CIS) and post treatment follow up imaging and endoscopic evaluation shows no evidence of disease. * Patients with previous exposure to immune checkpoint inhibitor for non-muscle invasive disease are eligible. If given for NMIBC, the last dose must have been completed \> 12 months prior to step 1 randomization. * Patient must not be pregnant or breast-feeding due to the potential harm to an unborn fetus and possible risk for adverse events in nursing infants with the treatment regimens being used. All patients of childbearing potential must have a blood test or urine study within 14 days prior to step 1 randomization to rule out pregnancy. A patient of childbearing potential is defined as any patient, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy; or 3) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months). * Patients must not expect to conceive or father children by using accepted and effected method(s) of contraception or by abstaining from sexual intercourse from the time of step 1 randomization for the duration of their participation in the study and continue for at least 3 months after the last dose of protocol treatment. * Leukocytes \>= 3,000/mcL (obtained \< 14 days prior to step 1 randomization). * Absolute neutrophil count (ANC) \>= 1,500/mcL (obtained \< 14 days prior to step 1 randomization). * Hemoglobin \>= 9 g/dL (obtained \< 14 days prior to step 1 randomization). * Platelets \>= 100,000/mcL (obtained \< 14 days prior to step 1 randomization). * Total bilirubin =\< 1.5 x institutional upper limit of normal (ULN) (obtained \< 14 days prior to step 1 randomization). * Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase \[SGOT\])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 2.5 x institutional ULN (obtained \< 14 days prior to step 1 randomization). * Adequate renal function as evidenced by calculated (Cockcroft's formula) creatinine clearance or 24 hours actual creatinine clearance \>= 30mL/min. The creatinine used to calculate the clearance result must have been obtained within 14 days prior to step 1 randomization. Actual body weight, not ideal body weight, must be used in the calculation. * Patients with human immunodeficiency virus (HIV) on effective anti-retroviral therapy with undetectable viral load within 6 months of step 1 randomization are eligible for this trial. * For patients with autoimmune conditions, patient must not have history of prior documented autoimmune disease within 2 years prior to step 1 randomization. * NOTE: Patient with vitiligo, Grave's disease, eczema or psoriasis (not requiring systemic treatment within 2 years prior to step 1 randomization) are not excluded. Patients with history of completely resolved childhood asthma or atopy are not excluded. Patients with asthma not requiring more than 10 mg/d or equivalent of prednisone are not excluded. Patients with well-controlled hypothyroidism on thyroxine replacement will be eligible as well. Patients with known history of hypoadrenalism on maintenance steroids will be eligible. Patients with type I diabetes mellitus will be eligible, provided their disease is well controlled. History of autoimmune related alopecia is also not an exclusion criteria. * Patient with active or prior documented inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis) are not eligible. * Patient with a history of and/or confirmed pneumonitis are not eligible. * Patient with a history of primary immunodeficiency are not eligible. * Patient with history of allogeneic organ transplant are not eligible. * Patient must not have an active infection, including: * Tuberculosis (based on clinical evaluation that includes clinical history, physical examination, and radiographic findings, and tuberculosis testing in line with local practice). * Hepatitis B (known positive hepatitis B virus \[HBV\] surface antigen \[HBsAg\] result). Past or resolved HBV infection (defined as the presence of hepatitis b core antibody \[anti-HBc\] and absence of HBsAg) are eligible. * Hepatitis C. Patients positive for hepatitis C (HCV) antibody are eligible only if polymerase chain reaction test is negative for HCV ribonucleic acid (RNA). * Patient must not have clinically significant liver disease that precludes patient from treatment regimens prescribed on the study (including, but not limited to, active viral, alcoholic or other autoimmune hepatitis, cirrhosis or inherited liver disease). * Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial. Site is encouraged to discuss with the study chair if needed prior to enrollment. * 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 IIB or better. * Patient must not have received live attenuated vaccine within 30 days prior to the first dose of durvalumab * NOTE: Patient, if enrolled, must not receive live vaccine whilst receiving durvalumab and up to 30 days after the last dose of durvalumab. * NOTE: Patient is permitted to receive inactivated vaccines and any non-live vaccines including those for the seasonal influenza and coronavirus disease 2019 (COVID-19) (Note: intranasal influenza vaccines, such as Flu-Mist (registered trademark) are live attenuated vaccines and are not allowed). If possible, it is recommended to separate study drug administration from vaccine administration by about a week (primarily in order to minimize an overlap of adverse events). * Patient must not have current or prior use of immunosuppressive medication within 14 days before the first dose of durvalumab. The following are exceptions to this criterion: * Intranasal, inhaled, topical steroids, or local steroid injections (e.g., intra articular injection). * Systemic corticosteroids at physiologic doses not to exceed 10 mg/day of prednisone or its equivalent. * Steroids as premedication for hypersensitivity reactions (e.g., CT scan premedication). * Patient must not have any unresolved toxicity (National Cancer Institute \[NCI\] CTCAE grade \>= 2) from previous anti-cancer therapy with the exception of alopecia, vitiligo, and the laboratory values. * NOTE: Patients with grade \>= 2 neuropathy will be evaluated on a case-by-case basis after consultation with the study chair. * NOTE: Patients with irreversible toxicity not reasonably expected to be exacerbated by treatment with durvalumab may be included only after consultation with the study chair. Documentation of correspondences with the study chair must be kept on file. * STEP 2 (REGISTRACTION: ADJUVANT DURVALUMAB VERSUS \[VS\] OBSERVATION) ELIGIBILITY CRITERIA: * Patient must have evaluation to determine clinical outcome post step 1 treatment (chemoRT+/- durvalumab) with imaging (CT chest, abdomen, and pelvis) (preferably contrast with urogram, if not contraindicated) and cystoscopy with biopsy confirmation to ensure no progression and absence of \>= T2 disease in the bladder. Patient should be registered to step 2 within 28 days from the determination of primary response to step 1 treatment. However, for patients previously on Arm C, an additional 4 week delay to step 2 registration is allowed. * Patient on the chemoRT+ durvalumab (Arm C) must meet the following: * Patient must have achieved either complete clinical response OR have demonstrated clinical benefit prior to continuing onto adjuvant durvalumab. * Patients who are to go on the adjuvant durvalumab (Arm E) must have recovered to at least grade 2 or less immune related adverse event (AE) prior to starting treatment except for immune related alopecia, clinically asymptomatic endocrinopathies. For patients who may have gotten immune related AEs during chemoRT+ durvalumab (Arm C), step 2 registration could be delayed up to additional 4 weeks to ensure recovery to at least grade 2 or lower prior to starting adjuvant therapy. However patients with durvalumab related AEs that require permanent discontinuation of durvalumab will not continue on the adjuvant treatment regardless of the response. * Patient must not have experienced immune related neurological disorder described as Guillain-Barré syndrome, myasthenic syndrome or myasthenia gravis, or meningoencephalitis during chemoRT+ durvalumab treatment. * Patient must not have experienced immune related myocarditis or immune related pericarditis during chemoRT+ durvalumab treatment. * ANC \>= 1,000 mcL (must be obtained \< 28 days prior to step 2 registration). * Hemoglobin \>= 8g/dL (must be obtained \< 28 days prior to step 2 registration). * Platelets \>= 70,000 mcL (must be obtained \< 28 days prior to step 2 registration). * NOTE: If recovery is not achieved, blood counts could be repeated weekly and step 2 registration could be delayed up to additional 4 weeks. * Patient on the chemoRT arm (Arm D) must have achieved either complete clinical response OR have demonstrated clinical benefit prior to be placed on the observation alone arm (Arm F).

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Conditions

The condition(s) this trial relates to.

bladder transitional cell carcinoma Urinary Bladder Neoplasms

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

Bladder urothelial carcinoma Stage III bladder cancer ajcc V8

Contacts and locations

Locations

AdventHealth Littleton

Littleton, Colorado, 80122, United States
AdventHealth Parker

Parker, Colorado, 80138, United States
AdventHealth Porter

Denver, Colorado, 80210, United States
Alaska Breast Care and Surgery LLC

Anchorage, Alaska, 99508, United States
Alaska Oncology and Hematology LLC

Anchorage, Alaska, 99508, United States
Alaska Women's Cancer Care

Anchorage, Alaska, 99508, United States
Alegent Health Bergan Mercy Medical Center

Omaha, Nebraska, 68124, United States
Alegent Health Immanuel Medical Center

Omaha, Nebraska, 68122, United States
Alegent Health Lakeside Hospital

Omaha, Nebraska, 68130, United States
Anchorage Associates in Radiation Medicine

Anchorage, Alaska, 98508, United States
Anchorage Oncology Centre

Anchorage, Alaska, 99508, United States
BJC Outpatient Center at Sunset Hills

Sunset Hills, Missouri, 63127, United States
Baptist Health Louisville

Louisville, Kentucky, 40207, United States
Bay Area Hospital

Coos Bay, Oregon, 97420, United States
Beebe Health Campus

Rehoboth Beach, Delaware, 19971, United States
Beebe South Coastal Health Campus

Millville, Delaware, 19967, United States
Benefis Sletten Cancer Institute

Great Falls, Montana, 59405, United States
Bethesda North Hospital

Cincinnati, Ohio, 45242, United States
Billings Clinic Cancer Center

Billings, Montana, 59101, United States
Bozeman Health Deaconess Hospital

Bozeman, Montana, 59715, United States
Broadlawns Medical Center

Des Moines, Iowa, 50314, United States
CHI Health Good Samaritan

Kearney, Nebraska, 68847, United States
CHI Saint Vincent Cancer Center Hot Springs

Hot Springs, Arkansas, 71913, United States
Cancer Care Center of O'Fallon

O'Fallon, Illinois, 62269, United States
Cancer Care Specialists of Illinois - Decatur

Decatur, Illinois, 62526, United States
Carle Cancer Center

Urbana, Illinois, 61801, United States
Carle Physician Group-Effingham

Effingham, Illinois, 62401, United States
Carle Physician Group-Mattoon/Charleston

Mattoon, Illinois, 61938, United States
Carle at The Riverfront

Danville, Illinois, 61832, United States
Centralia Oncology Clinic

Centralia, Illinois, 62801, United States
Chelsea Hospital

Chelsea, Michigan, 48118, United States
Christiana Care Health System-Concord Health Center

Chadds Ford, Pennsylvania, 19317, United States
Clackamas Radiation Oncology Center

Clackamas, Oregon, 97015, United States
Community Medical Center

Missoula, Montana, 59804, United States
CoxHealth South Hospital

Springfield, Missouri, 65807, United States
Creighton University Medical Center

Omaha, Nebraska, 68131, United States
Crossroads Cancer Center

Effingham, Illinois, 62401, United States
Decatur Memorial Hospital

Decatur, Illinois, 62526, United States
Duluth Clinic Ashland

Ashland, Wisconsin, 54806, United States
East Jefferson General Hospital

Metairie, Louisiana, 70006, United States
Eastern Maine Medical Center

Bangor, Maine, 04401, United States
Edward Hines Jr VA Hospital

Hines, Illinois, 60141, United States
Emory University Hospital Midtown

Atlanta, Georgia, 30308, United States
Emory University Hospital/Winship Cancer Institute

Atlanta, Georgia, 30322, United States
Essentia Health - Deer River Clinic

Deer River, Minnesota, 56636, United States
Essentia Health Cancer Center

Duluth, Minnesota, 55805, United States
Essentia Health Hibbing Clinic

Hibbing, Minnesota, 55746, United States
Essentia Health Saint Joseph's Medical Center

Brainerd, Minnesota, 56401, United States
Essentia Health Saint Mary's Medical Center

Duluth, Minnesota, 55805, United States
Essentia Health Sandstone

Sandstone, Minnesota, 55072, United States
Essentia Health Virginia Clinic

Virginia, Minnesota, 55792, United States
Genesys Hurley Cancer Institute

Flint, Michigan, 48503, United States
Gibbs Cancer Center-Gaffney

Gaffney, South Carolina, 29341, United States
Gibbs Cancer Center-Pelham

Greer, South Carolina, 29651, United States
Good Samaritan Hospital - Cincinnati

Cincinnati, Ohio, 45220, United States
Great Falls Clinic

Great Falls, Montana, 59405, United States
Greater Regional Medical Center

Creston, Iowa, 50801, United States
Heartland Regional Medical Center

Saint Joseph, Missouri, 64506, United States
Helen F Graham Cancer Center

Newark, Delaware, 19713, United States
Henry Ford Health Saint John Hospital

Detroit, Michigan, 48236, United States
Henry Ford Health Warren Hospital

Warren, Michigan, 48093, United States
Highline Medical Center-Main Campus

Burien, Washington, 98166, United States
Holy Cross Hospital

Fort Lauderdale, Florida, 33308, United States
Hurley Medical Center

Flint, Michigan, 48503, United States
Idaho Urologic Institute-Meridian

Meridian, Idaho, 83642, United States
Illinois CancerCare-Bloomington

Bloomington, Illinois, 61704, United States
Illinois CancerCare-Canton

Canton, Illinois, 61520, United States
Illinois CancerCare-Carthage

Carthage, Illinois, 62321, United States
Illinois CancerCare-Eureka

Eureka, Illinois, 61530, United States
Illinois CancerCare-Galesburg

Galesburg, Illinois, 61401, United States
Illinois CancerCare-Kewanee Clinic

Kewanee, Illinois, 61443, United States
Illinois CancerCare-Macomb

Macomb, Illinois, 61455, United States
Illinois CancerCare-Ottawa Clinic

Ottawa, Illinois, 61350, United States
Illinois CancerCare-Pekin

Pekin, Illinois, 61554, United States
Illinois CancerCare-Peoria

Peoria, Illinois, 61615, United States
Illinois CancerCare-Peru

Peru, Illinois, 61354, United States
Illinois CancerCare-Princeton

Princeton, Illinois, 61356, United States
Iowa Lutheran Hospital

Des Moines, Iowa, 50316, United States
Iowa Methodist Medical Center

Des Moines, Iowa, 50309, United States
Jewish Hospital

Louisville, Kentucky, 40202, United States
Johns Hopkins University/Sidney Kimmel Cancer Center

Baltimore, Maryland, 21287, United States
Katmai Oncology Group

Anchorage, Alaska, 99508, United States
Kootenai Clinic Cancer Services - Post Falls

Post Falls, Idaho, 83854, United States
Kootenai Health - Coeur d'Alene

Coeur d'Alene, Idaho, 83814, United States
LSU Healthcare Network / Metairie Multi-Specialty Clinic

Metairie, Louisiana, 70006, United States
Lafayette Family Cancer Center-EMMC

Brewer, Maine, 04412, United States
Lehigh Valley Hospital - Muhlenberg

Bethlehem, Pennsylvania, 18017, United States
Lehigh Valley Hospital-Cedar Crest

Allentown, Pennsylvania, 18103, United States
Logan Health Medical Center

Kalispell, Montana, 59901, United States
Longmont United Hospital

Longmont, Colorado, 80501, United States
Louisiana State University Health Science Center

New Orleans, Louisiana, 70112, United States
Loyola University Medical Center

Maywood, Illinois, 60153, United States
MU Health Care Goldschmidt Cancer Center

Jefferson City, Missouri, 65109, United States
Marshfield Medical Center - Minocqua

Minocqua, Wisconsin, 54548, United States
Marshfield Medical Center - Weston

Weston, Wisconsin, 54476, United States
Marshfield Medical Center-EC Cancer Center

Eau Claire, Wisconsin, 54701, United States
Marshfield Medical Center-Marshfield

Marshfield, Wisconsin, 54449, United States
Marshfield Medical Center-Rice Lake

Rice Lake, Wisconsin, 54868, United States
Marshfield Medical Center-River Region at Stevens Point

Stevens Point, Wisconsin, 54482, United States
Mary Greeley Medical Center

Ames, Iowa, 50010, United States
Massachusetts General Hospital Cancer Center

Boston, Massachusetts, 02114, United States
McFarland Clinic - Ames

Ames, Iowa, 50010, United States
Medical Oncology Hematology Consultants PA

Newark, Delaware, 19713, United States
Memorial Hospital of Carbondale

Carbondale, Illinois, 62902, United States
Mercy Cancer Center - Cape Girardeau

Cape Girardeau, Missouri, 63703, United States
Mercy Cancer Center-West Lakes

Clive, Iowa, 50325, United States
Mercy Clinic-Rolla-Cancer and Hematology

Rolla, Missouri, 65401, United States
Mercy Hospital

Coon Rapids, Minnesota, 55433, United States
Mercy Hospital Fort Smith

Fort Smith, Arkansas, 72903, United States
Mercy Hospital Joplin

Joplin, Missouri, 64804, United States
Mercy Hospital Oklahoma City

Oklahoma City, Oklahoma, 73120, United States
Mercy Hospital Saint Louis

St Louis, Missouri, 63141, United States
Mercy Hospital South

St Louis, Missouri, 63128, United States
Mercy Hospital Springfield

Springfield, Missouri, 65804, United States
Mercy Medical Center - Des Moines

Des Moines, Iowa, 50314, United States
Mercy Medical Center-West Lakes

West Des Moines, Iowa, 50266, United States
Mercy Oncology and Hematology - Clayton-Clarkson

Ballwin, Missouri, 63011, United States
Methodist Medical Center of Illinois

Peoria, Illinois, 61636, United States
Methodist West Hospital

West Des Moines, Iowa, 50266-7700, United States
Michigan Healthcare Professionals Pontiac

Pontiac, Michigan, 48341, United States
Miller-Dwan Hospital

Duluth, Minnesota, 55805, United States
Missouri Baptist Medical Center

St Louis, Missouri, 63131, United States
Missouri Baptist Sullivan Hospital

Sullivan, Missouri, 63080, United States
Mount Sinai Medical Center

Miami Beach, Florida, 33140, United States
MyMichigan Medical Center Saginaw

Saginaw, Michigan, 48601, United States
Nebraska Cancer Specialists/Oncology Hematology West PC

Grand Island, Nebraska, 68803, United States
Northwest Wisconsin Cancer Center

Ashland, Wisconsin, 54806, United States
Northwestern Medicine Cancer Center Delnor

Geneva, Illinois, 60134, United States
Northwestern Medicine Cancer Center Kishwaukee

DeKalb, Illinois, 60115, United States
Northwestern Medicine Cancer Center Warrenville

Warrenville, Illinois, 60555, United States
Northwestern Medicine Lake Forest Hospital

Lake Forest, Illinois, 60045, United States
Northwestern University

Chicago, Illinois, 60611, United States
OSF Saint Francis Medical Center

Peoria, Illinois, 61637, United States
OSF Saint Francis Radiation Oncology at Pekin

Pekin, Illinois, 61554, United States
OSF Saint Francis Radiation Oncology at Peoria Cancer Center

Peoria, Illinois, 61615, United States
Parkland Health Center - Farmington

Farmington, Missouri, 63640, United States
PeaceHealth Saint John Medical Center

Longview, Washington, 98632, United States
PeaceHealth Saint Joseph Medical Center

Bellingham, Washington, 98225, United States
PeaceHealth Southwest Medical Center

Vancouver, Washington, 98664, United States
PeaceHealth United General Medical Center

Sedro-Woolley, Washington, 98284, United States
Penn State Milton S Hershey Medical Center

Hershey, Pennsylvania, 17033-0850, United States
Penrose-Saint Francis Healthcare

Colorado Springs, Colorado, 80907, United States
Phelps Health Delbert Day Cancer Institute

Rolla, Missouri, 65401, United States
Pocono Medical Center

East Stroudsburg, Pennsylvania, 18301, United States
Providence Alaska Medical Center

Anchorage, Alaska, 99508, United States
Providence Cancer Institute Clackamas Clinic

Clackamas, Oregon, 97015, United States
Providence Newberg Medical Center

Newberg, Oregon, 97132, United States
Providence Portland Medical Center

Portland, Oregon, 97213, United States
Providence Regional Cancer Partnership

Everett, Washington, 98201, United States
Providence Regional Cancer System-Aberdeen

Aberdeen, Washington, 98520, United States
Providence Regional Cancer System-Centralia

Centralia, Washington, 98531, United States
Providence Regional Cancer System-Lacey

Lacey, Washington, 98503, United States
Providence Saint Joseph Medical Center/Disney Family Cancer Center

Burbank, California, 91505, United States
Providence Saint Mary Regional Cancer Center

Walla Walla, Washington, 99362, United States
Providence Saint Vincent Medical Center

Portland, Oregon, 97225, United States
Rocky Mountain Cancer Centers-Penrose

Colorado Springs, Colorado, 80907, United States
Rush-Copley Medical Center

Aurora, Illinois, 60504, United States
SIH Cancer Institute

Carterville, Illinois, 62918, United States
SMC Center for Hematology Oncology Union

Union, South Carolina, 29379, United States
SSM Health Good Samaritan

Mount Vernon, Illinois, 62864, United States
Saint Alphonsus Cancer Care Center-Boise

Boise, Idaho, 83706, United States
Saint Alphonsus Cancer Care Center-Caldwell

Caldwell, Idaho, 83605, United States
Saint Alphonsus Cancer Care Center-Nampa

Nampa, Idaho, 83687, United States
Saint Anthony Hospital

Lakewood, Colorado, 80228, United States
Saint Charles Health System

Bend, Oregon, 97701, United States
Saint Francis Medical Center

Cape Girardeau, Missouri, 63703, United States
Saint Joseph Hospital East

Lexington, Kentucky, 40509, United States
Saint Joseph Radiation Oncology Resource Center

Lexington, Kentucky, 40504, United States
Saint Joseph Regional Cancer Center

Bryan, Texas, 77802, United States
Saint Luke's Cancer Institute - Boise

Boise, Idaho, 83712, United States
Saint Luke's Cancer Institute - Fruitland

Fruitland, Idaho, 83619, United States
Saint Luke's Cancer Institute - Meridian

Meridian, Idaho, 83642, United States
Saint Luke's Cancer Institute - Nampa

Nampa, Idaho, 83687, United States
Saint Luke's Cancer Institute - Twin Falls

Twin Falls, Idaho, 83301, United States
Saint Mary Corwin Medical Center

Pueblo, Colorado, 81004, United States
Saint Michael Cancer Center

Silverdale, Washington, 98383, United States
Sainte Genevieve County Memorial Hospital

Sainte Genevieve, Missouri, 63670, United States
Sibley Memorial Hospital

Washington D.C., District of Columbia, 20016, United States
Siteman Cancer Center at Christian Hospital

St Louis, Missouri, 63136, United States
Siteman Cancer Center at Saint Peters Hospital

City of Saint Peters, Missouri, 63376, United States
Siteman Cancer Center at West County Hospital

Creve Coeur, Missouri, 63141, United States
Siteman Cancer Center-South County

St Louis, Missouri, 63129, United States
Southern Illinois University School of Medicine

Springfield, Illinois, 62702, United States
Sovah Health Martinsville

Martinsville, Virginia, 24112, United States
Spartanburg Medical Center

Spartanburg, South Carolina, 29303, United States
Springfield Clinic

Springfield, Illinois, 62702, United States
Springfield Memorial Hospital

Springfield, Illinois, 62781, United States
Swedish Cancer Institute-Edmonds

Edmonds, Washington, 98026, United States
Swedish Cancer Institute-Issaquah

Issaquah, Washington, 98029, United States
Swedish Medical Center-Ballard Campus

Seattle, Washington, 98107, United States
Swedish Medical Center-First Hill

Seattle, Washington, 98122, United States
The Carle Foundation Hospital

Urbana, Illinois, 61801, United States
Trinity Health IHA Medical Group Hematology Oncology - Brighton

Brighton, Michigan, 48114, United States
Trinity Health IHA Medical Group Hematology Oncology - Canton

Canton, Michigan, 48188, United States
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus

Ypsilanti, Michigan, 48197, United States
Trinity Health Medical Center - Brighton

Brighton, Michigan, 48114, United States
Trinity Health Medical Center - Canton

Canton, Michigan, 48188, United States
Trinity Health Saint Joseph Mercy Hospital Ann Arbor

Ann Arbor, Michigan, 48106, United States
Trinity Health Saint Joseph Mercy Oakland Hospital

Pontiac, Michigan, 48341, United States
Trinity Health Saint Mary Mercy Livonia Hospital

Livonia, Michigan, 48154, United States
UI Health Care Mission Cancer and Blood - Des Moines Clinic

Des Moines, Iowa, 50309, United States
UI Health Care Mission Cancer and Blood - Laurel Clinic

Des Moines, Iowa, 50314, United States
UI Health Care Mission Cancer and Blood - West Des Moines Clinic

Clive, Iowa, 50325, United States
Unity Hospital

Fridley, Minnesota, 55432, United States
University Medical Center New Orleans

New Orleans, Louisiana, 70112, United States
University of Iowa/Holden Comprehensive Cancer Center

Iowa City, Iowa, 52242, United States
University of Michigan Health - Sparrow Lansing

Lansing, Michigan, 48912, United States
University of New Mexico Cancer Center

Albuquerque, New Mexico, 87106, United States
University of Oklahoma Health Sciences Center

Oklahoma City, Oklahoma, 73104, United States
University of Tennessee - Knoxville

Knoxville, Tennessee, 37920, United States
UofL Health Medical Center Northeast

Louisville, Kentucky, 40245, United States
VA Palo Alto Health Care System

Palo Alto, California, 94304, United States
Valley Radiation Oncology

Peru, Illinois, 61354, United States
Washington University School of Medicine

St Louis, Missouri, 63110, United States
Welch Cancer Center

Sheridan, Wyoming, 82801, United States
Western Illinois Cancer Treatment Center

Galesburg, Illinois, 61401, United States

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