Lung cancer hope: can targeted local therapy boost chemo for advanced disease?

NCT ID NCT03137771

Disease control Sponsor: NRG Oncology Source: ClinicalTrials.gov ↗

First seen Jun 26, 2026 · Last updated Jun 27, 2026 · Updated 1 time

Summary

This study looks at whether adding local treatments like radiation or surgery to ongoing chemotherapy can help people with stage IV non-small cell lung cancer that has spread to a limited number of spots. About 218 participants are randomly assigned to get either maintenance chemo alone or chemo plus local therapy. The goal is to see if the combination delays cancer progression and improves survival.

What this could mean

Our plain-language read of the trial. This is informational only, not medical advice or a prediction.

Active substance: chemotherapy (docetaxel, pemetrexed, erlotinib, gemcitabine) plus radiation or surgery
What this could lead to: If it works, this could show that adding targeted radiation or surgery to standard maintenance chemo helps people with limited metastatic lung cancer live longer without the disease getting worse.
What could go wrong: This is a mid-stage trial with only 218 participants, so results may not apply to everyone. Adding local therapy also carries risks like radiation side effects or surgical complications.

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

218 people

The number who actually took part.

Started

Apr 2017

Expected to finish

Dec 2028

An estimate. End dates often move.

Lead sponsor

Other sponsor

The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.

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: * Patients must have the psychological ability and general health that permits completion of the study requirements and required follow up * Women of childbearing potential and men who are sexually active should be willing and able to use medically acceptable forms of contraception during the trial and for up to 180 days after completion of all treatment to prevent pregnancy or fathering a child. * Pathologically proven diagnosis of NSCLC, with metastases (stage IV disease) present prior to registration; this includes patients newly diagnosed with metastatic disease or those initially diagnosed and treated for stage I-III NSCLC who ultimately develop limited metastases. Limited metastases is defined as 3 or fewer sites of metastatic disease * Appropriate stage for study entry based on the following diagnostic workup: * History/physical examination by a radiation oncologist (and a surgeon if surgery is planned) within 30 days prior to registration * Imaging proof of limited metastatic disease and response to therapy/stable disease, by at least diagnostic quality CT chest through the adrenals or positron emission tomography (PET)/CT within 30 days prior to registration * Zubrod performance status 0, 1, or 2 within 30 days prior to registration * Adequate organ and hematologic/bone marrow function within 14 days prior to registration, defined as follows: * Aspartate transaminase (AST) and alanine transaminase (ALT) ≤ 2.5 × upper limit of normal (ULN) or ≤ 5 × ULN with metastatic liver disease * Total bilirubin ≤ 1.5 × ULN * Absolute neutrophil count (ANC) ≥ 500 cells/mm3 * Platelets ≥ 50,000 cells/mm3 * Renal: * Creatinine ≤ 1.5 x ULN; or * Creatinine Clearance (CrCl) \> 45 mL/min if creatinine \> 1.5 x ULN (calculated CrCl based on Cockcroft-Gault equation) * HIV-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial. * For patients who will undergo resection of disease (if randomized to Arm 2 and dispositioned to receive surgery), adequate pre-surgical work-up for anticipated surgery, as defined by institutional guidelines. * Negative serum pregnancy test within one week prior to registration for females of childbearing potential * Patients must have received first-line/induction systemic therapy comprising of immunotherapy and/or platinum-based chemotherapy (at least 4 cycles or courses but less than 6, i.e. 4-5 cycles/courses), and achieved stable disease or a partial response. Though the intention is for every course/cycle to be identical in an induction regimen, Some but not all of the 4-5 cycles may omit an immunotherapy or platinum compound if the treating physician determines it is in the patient's best interest secondary to toxicity or other institutional parameter. * For patients treated with nivolumab, ipilimumab and 2 cycles of chemotherapy, the 4-5 cycles requirement will be met by 4-5 total doses of nivolumab. * For patients treated with nivolumab and ipilimumab, this requirement will be met by 2 doses of ipilimumab and 4-5 doses of nivolumab. * After induction systemic therapy, patients must have a minimum of one site of disease, primary or metastasis, present for potential consolidation with local therapy. All sites of disease present after induction systemic therapy, primary and metastases (up to 3) are able to be consolidated with local therapy; * Prior systemic therapy as part of concurrent treatment approach for previously diagnosed stage I-III NSCLC, adjuvant or neo-adjuvant therapy for stage I-III NSCLC, as adjuvant therapy for previously resected or irradiated NSCLC, or for other previous cancers is permitted * For de novo stage IV NSCLC patients (patients with metastatic disease at first presentation), primary disease must be treatable with local therapy in the form of SBRT or hypofractionated radiation. If the primary disease is found in the peripheral or central lung parenchyma without nodal disease, for instance, SBRT may be employed at the discretion of the treating institution. If primary disease is more advanced with involvement of the mediastinum (T4 tumor, N1-N3 disease, etc.), these volumes should be technically treatable with hypofractionated radiation; surgery should only be used for metastatic tumors that can be completely resected by lobectomy, segmentectomy, or wide wedge resection. * If primary disease in the thoracic cavity was previously treated with local therapy in the form of surgery or radiation, any new local/regional disease recurrence should be technically treatable with SBRT or hypofractionated radiation after induction systemic therapy. * The patient or a legally authorized representative must provide study-specific informed consent prior to registration. * Radiotherapy for patients with brain metastases prior to registration is acceptable. * Patients with brain metastases are eligible if these lesions have been previously treated or resolved and the patients have no clinical or radiographic evidence of progression prior to registration. * Subjects may receive palliative radiotherapy for symptomatic metastases or primary disease prior to registration provided that there is at least one other non-irradiated lesion amenable to LCT at the time of registration. Exclusion Criteria: * Clinical or radiologic evidence of untreated and/or progressive brain metastases prior to registration after induction systemic therapy * Cutaneous metastasis of NSCLC * Metastatic disease invading the esophagus, stomach, intestines, or mesenteric lymph nodes if not a candidate for surgery for these lesions * Prior invasive malignancy (except non-melanomatous skin cancer, low or intermediate risk prostate cancer, or in situ carcinoma of breast, oral cavity, skin, or cervix) unless disease free for a minimum of one year * Metastases located within 3 cm of previously irradiated (\< 3 Gy per fraction) structures if if not a candidate for surgery for these lesions and if: * Spinal cord previously irradiated to \> 40 Gy * Brachial plexus previously irradiated to \> 50 Gy * Small intestine, large intestine, or stomach previously irradiated to \> 45 Gy * Brainstem previously irradiated to \> 50 Gy * Lung previously irradiated with prior V20 Gy \> 35% * Patients receiving targeted therapy (non-cytotoxic systemic therapy) for NSCLC in the first-line setting * Patients with NSCLC who have driver mutations for which targeted therapies (non-cytotoxic, non-immunotherapy based systemic therapy including but not limited to tyrosine-kinase inhibitors) are available. Such designations would include but not be limited to treatments targeting epidermal growth factor receptor (EGFR) mutant or anaplastic lymphoma kinase (ALK) positive NSCLC. * If a patient has progressed in previous areas of primary disease that received definitive doses of radiation, these patients would require re-irradiation in previous high dose anatomic areas and are not eligible for this study. * Patients with malignant pleural effusions that do not resolve after first-line systemic therapy; patients with pleural effusions that have become too small for thoracentesis at the time of registration would be permitted on study, indicating a significant response to first-line systemic therapy * Patients with more than 3 discrete locations of extra-cranial metastatic disease after first-line systemic therapy requiring more than 3 radiation/surgery plans to cover these distinct metastatic disease entities * Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration * Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception during treatment and for 180 days after the completion of all treatment. This exclusion is necessary because the treatment involved in this study may be significantly teratogenic. Women who are breastfeeding (and unwilling to discontinue) are also excluded * Participation in any investigational drug study for the treatment of cancer within 4 weeks prior to registration. * For patients who received immunotherapy during induction, patients on chronic steroids or who have active autoimmune disease for which they received systemic treatment in the previous 2 years with corticosteroids, disease modifying agents, or immunosuppressive drugs are not eligible. Replacement therapy (thyroxine, insulin or physiological corticosteroid replacement for adrenal or pituitary insufficiency) is allowed. Patients with active interstitial lung disease or who have a history of pneumonitis for which they had received glucocorticoids are not eligible * Use of bevacizumab or other antiangiogenic therapy in first-line or planned maintenance therapy (due to potential for increased complications from local therapy

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Conditions

The condition(s) this trial relates to.

non-small cell lung carcinoma

As listed by the trial registrant

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

Recurrent non-small cell lung carcinoma Stage IV non-small cell lung cancer

Contacts and locations

Locations

Adena Regional Medical Center

Chillicothe, Ohio, 45601, United States
Advocate Lutheran General Hospital

Park Ridge, Illinois, 60068, United States
Alegent Health Bergan Mercy Medical Center

Omaha, Nebraska, 68124, United States
Allegiance Health

Jackson, Michigan, 49201, United States
Alta Bates Summit Medical Center-Herrick Campus

Berkeley, California, 94704, United States
Altru Cancer Center

Grand Forks, North Dakota, 58201, United States
Arizona Center for Cancer Care - Gilbert

Gilbert, Arizona, 85297, United States
Arizona Center for Cancer Care - Scottsdale

Scottsdale, Arizona, 85258, United States
Arizona Center for Cancer Care-Peoria

Peoria, Arizona, 85381, United States
Ascension Mercy Hospital

Oshkosh, Wisconsin, 54904, United States
Ascension Saint Elizabeth Hospital

Appleton, Wisconsin, 54915, United States
Ascension Via Christi Hospitals Wichita

Wichita, Kansas, 67214, United States
Aspirus Cancer Care - Wisconsin Rapids

Wisconsin Rapids, Wisconsin, 54494, United States
Aspirus Regional Cancer Center

Wausau, Wisconsin, 54401, United States
Asplundh Cancer Pavilion

Willow Grove, Pennsylvania, 19090, United States
Atrium Health Cabarrus/LCI-Concord

Concord, North Carolina, 28025, United States
Atrium Health Pineville/LCI-Pineville

Charlotte, North Carolina, 28210, United States
Atrium Health Union/LCI-Union

Monroe, North Carolina, 28112, United States
Atrium Health University City/LCI-University

Charlotte, North Carolina, 28262, United States
Augusta University Medical Center

Augusta, Georgia, 30912, United States
Aurora Bay Area Medical Group-Marinette

Marinette, Wisconsin, 54143, United States
Aurora BayCare Medical Center

Green Bay, Wisconsin, 54311, United States
Aurora Cancer Care-Grafton

Grafton, Wisconsin, 53024, United States
Aurora Cancer Care-Kenosha South

Kenosha, Wisconsin, 53142, United States
Aurora Cancer Care-Milwaukee

Milwaukee, Wisconsin, 53209, United States
Aurora Cancer Care-Milwaukee West

Wauwatosa, Wisconsin, 53226, United States
Aurora Cancer Care-Racine

Racine, Wisconsin, 53406, United States
Aurora Cancer Care-Southern Lakes VLCC

Burlington, Wisconsin, 53105, United States
Aurora Health Care Germantown Health Center

Germantown, Wisconsin, 53022, United States
Aurora Health Center-Fond du Lac

Fond du Lac, Wisconsin, 54937, United States
Aurora Medical Center in Summit

Summit, Wisconsin, 53066, United States
Aurora Saint Luke's Medical Center

Milwaukee, Wisconsin, 53215, United States
Aurora Sinai Medical Center

Milwaukee, Wisconsin, 53233, United States
Aurora West Allis Medical Center

West Allis, Wisconsin, 53227, United States
Banner University Medical Center - Tucson

Tucson, Arizona, 85719, United States
Baptist Memorial Hospital and Cancer Center-Memphis

Memphis, Tennessee, 38120, United States
Beebe Health Campus

Rehoboth Beach, Delaware, 19971, United States
Benefis Sletten Cancer Institute

Great Falls, Montana, 59405, United States
Boston Medical Center

Boston, Massachusetts, 02118, United States
Bozeman Health Deaconess Hospital

Bozeman, Montana, 59715, United States
Brigham and Women's Hospital

Boston, Massachusetts, 02115, United States
Bryn Mawr Hospital

Bryn Mawr, Pennsylvania, 19010, United States
Carle Cancer Center

Urbana, Illinois, 61801, United States
CarolinaEast Medical Center

New Bern, North Carolina, 28561, United States
Carolinas Medical Center/Levine Cancer Institute

Charlotte, North Carolina, 28203, United States
Case Western Reserve University

Cleveland, Ohio, 44106, United States
Central Maryland Radiation Oncology in Howard County

Columbia, Maryland, 21044, United States
Chaim Sheba Medical Center

Tel Litwinsky, 52621, Israel
Christus Saint Vincent Regional Cancer Center

Santa Fe, New Mexico, 87505, United States
City of Hope Comprehensive Cancer Center

Duarte, California, 91010, United States
City of Hope South Pasadena

South Pasadena, California, 91030, United States
Cleveland Clinic Akron General

Akron, Ohio, 44307, United States
Cleveland Clinic Cancer Center Mansfield

Mansfield, Ohio, 44906, United States
Cleveland Clinic Cancer Center/Fairview Hospital

Cleveland, Ohio, 44111, United States
Cleveland Clinic Foundation

Cleveland, Ohio, 44195, United States
Cleveland Clinic Wooster Family Health and Surgery Center

Wooster, Ohio, 44691, United States
Cleveland Clinic-Weston

Weston, Florida, 33331, United States
Coborn Cancer Center at Saint Cloud Hospital

Saint Cloud, Minnesota, 56303, United States
Community Cancer Center East

Indianapolis, Indiana, 46219, United States
Community Cancer Center North

Indianapolis, Indiana, 46256, United States
Community Cancer Center South

Indianapolis, Indiana, 46227, United States
Community Medical Center

Toms River, New Jersey, 08755, United States
Condell Memorial Hospital

Libertyville, Illinois, 60048, United States
Corewell Health Beaumont Troy Hospital

Troy, Michigan, 48085, United States
Corewell Health William Beaumont University Hospital

Royal Oak, Michigan, 48073, United States
Covenant Medical Center-Lakeside

Lubbock, Texas, 79410, United States
Cross Cancer Institute

Edmonton, Alberta, T6G 1Z2, Canada
Crossroads Cancer Center

Effingham, Illinois, 62401, United States
Dartmouth Cancer Center - North

Saint Johnsbury, Vermont, 05819, United States
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center

Lebanon, New Hampshire, 03756, United States
Decatur Memorial Hospital

Decatur, Illinois, 62526, United States
Delaware County Memorial Hospital

Drexel Hill, Pennsylvania, 19026, United States
Delbert Day Cancer Institute at PCRMC

Rolla, Missouri, 65401, United States
Dickstein Cancer Treatment Center

White Plains, New York, 10601, United States
Duke University Medical Center

Durham, North Carolina, 27710, United States
Edward Hines Jr VA Hospital

Hines, Illinois, 60141, United States
Emory Saint Joseph's Hospital

Atlanta, Georgia, 30342, United States
Emory University Hospital Midtown

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

Atlanta, Georgia, 30322, United States
Fox Chase Cancer Center

Philadelphia, Pennsylvania, 19111, United States
Franciscan Health Indianapolis

Indianapolis, Indiana, 46237, United States
Franciscan Health Mooresville

Mooresville, Indiana, 46158, United States
Froedtert Menomonee Falls Hospital

Menomonee Falls, Wisconsin, 53051, United States
Froedtert West Bend Hospital/Kraemer Cancer Center

West Bend, Wisconsin, 53095, United States
Geauga Hospital

Chardon, Ohio, 44024, United States
Geisinger Cancer Services-Pottsville

Pottsville, Pennsylvania, 17901, United States
Geisinger Medical Center

Danville, Pennsylvania, 17822, United States
Geisinger Medical Oncology-Lewisburg

Lewisburg, Pennsylvania, 17837, United States
Geisinger Wyoming Valley/Henry Cancer Center

Wilkes-Barre, Pennsylvania, 18711, United States
Gene Upshaw Memorial Tahoe Forest Cancer Center

Truckee, California, 96161, United States
Genesis Healthcare System Cancer Care Center

Zanesville, Ohio, 43701, United States
George E Wahlen Department of Veterans Affairs Medical Center

Salt Lake City, Utah, 84148, United States
Gibbs Cancer Center-Pelham

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

Corvallis, Oregon, 97330, United States
Goshen Center for Cancer Care

Goshen, Indiana, 46526, United States
Grady Health System

Atlanta, Georgia, 30303, United States
Gundersen Lutheran Medical Center

La Crosse, Wisconsin, 54601, United States
Guthrie Medical Group PC-Robert Packer Hospital

Sayre, Pennsylvania, 18840, United States
Helen F Graham Cancer Center

Newark, Delaware, 19713, United States
Hennepin County Medical Center

Minneapolis, Minnesota, 55415, United States
Henry Ford Health Saint John Hospital

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

Warren, Michigan, 48093, United States
Henry Ford Hospital

Detroit, Michigan, 48202, United States
Henry Ford Macomb Hospital-Clinton Township

Clinton Township, Michigan, 48038, United States
Hillcrest Hospital Cancer Center

Mayfield Heights, Ohio, 44124, United States
Huntsman Cancer Institute/University of Utah

Salt Lake City, Utah, 84112, United States
Iowa Methodist Medical Center

Des Moines, Iowa, 50309, United States
Jefferson Torresdale Hospital

Philadelphia, Pennsylvania, 19114, United States
Kaiser Permanente Cancer Treatment Center

South San Francisco, California, 94080, United States
Kansas City Veterans Affairs Medical Center

Kansas City, Missouri, 64128, United States
Karmanos Cancer Institute at McLaren Greater Lansing

Lansing, Michigan, 48910, United States
King Faisal Specialist Hospital and Research Centre

Riyadh, 11211, Saudi Arabia
LSU Health Baton Rouge-North Clinic

Baton Rouge, Louisiana, 70805, United States
Lahey Hospital and Medical Center

Burlington, Massachusetts, 01805, United States
Lancaster General Ann B Barshinger Cancer Institute

Lancaster, Pennsylvania, 17601, United States
Lancaster General Hospital

Lancaster, Pennsylvania, 17602, United States
Langlade Hospital and Cancer Center

Antigo, Wisconsin, 54409, United States
Lankenau Medical Center

Wynnewood, Pennsylvania, 19096, United States
Lawrence Memorial Hospital

Lawrence, Kansas, 66044, United States
Legacy Good Samaritan Hospital and Medical Center

Portland, Oregon, 97210, United States
Legacy Mount Hood Medical Center

Gresham, Oregon, 97030, United States
Legacy Salmon Creek Hospital

Vancouver, Washington, 98686, United States
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler

Savannah, Georgia, 31405, United States
Lewistown Hospital

Lewistown, Pennsylvania, 17044, United States
Logan Health Medical Center

Kalispell, Montana, 59901, United States
London Regional Cancer Program

London, Ontario, N6A 4L6, Canada
Los Angeles General Medical Center

Los Angeles, California, 90033, United States
Louisiana Hematology Oncology Associates LLC

Baton Rouge, Louisiana, 70809, United States
Lovelace Medical Center-Saint Joseph Square

Albuquerque, New Mexico, 87102, United States
Lovelace Radiation Oncology

Albuquerque, New Mexico, 87109, United States
Loyola University Medical Center

Maywood, Illinois, 60153, United States
M D Anderson Cancer Center

Houston, Texas, 77030, 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-River Region at Stevens Point

Stevens Point, Wisconsin, 54482, United States
Mary Bird Perkins Cancer Center

Baton Rouge, Louisiana, 70809, United States
Massachusetts General Hospital Cancer Center

Boston, Massachusetts, 02114, United States
Mayo Clinic Hospital in Arizona

Phoenix, Arizona, 85054, United States
Mayo Clinic in Arizona

Scottsdale, Arizona, 85259, United States
Mayo Clinic in Florida

Jacksonville, Florida, 32224-9980, United States
McLaren Cancer Institute-Bay City

Bay City, Michigan, 48706, United States
McLaren Cancer Institute-Clarkston

Clarkston, Michigan, 48346, United States
McLaren Cancer Institute-Flint

Flint, Michigan, 48532, United States
McLaren Cancer Institute-Lapeer Region

Lapeer, Michigan, 48446, United States
McLaren Cancer Institute-Macomb

Mount Clemens, Michigan, 48043, United States
McLaren Cancer Institute-Northern Michigan

Petoskey, Michigan, 49770, United States
McLaren-Port Huron

Port Huron, Michigan, 48060, United States
Medical College of Wisconsin

Milwaukee, Wisconsin, 53226, United States
Memorial Medical Center

Modesto, California, 95355, United States
Memorial Sloan Kettering Basking Ridge

Basking Ridge, New Jersey, 07920, United States
Memorial Sloan Kettering Bergen

Montvale, New Jersey, 07645, United States
Memorial Sloan Kettering Cancer Center

New York, New York, 10065, United States
Memorial Sloan Kettering Commack

Commack, New York, 11725, United States
Memorial Sloan Kettering Monmouth

Middletown, New Jersey, 07748, United States
Memorial Sloan Kettering Nassau

Uniondale, New York, 11553, United States
Memorial Sloan Kettering Westchester

Harrison, New York, 10604, United States
Mercy Cancer Center-West Lakes

Clive, Iowa, 50325, United States
Mercy Hospital Oklahoma City

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

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

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

Des Moines, Iowa, 50314, United States
Methodist Medical Center of Illinois

Peoria, Illinois, 61636, United States
Miami Cancer Institute

Miami, Florida, 33176, United States
Michigan Healthcare Professionals Pontiac

Pontiac, Michigan, 48341, United States
Mid-Michigan Physicians-Lansing

Lansing, Michigan, 48912, United States
Missouri Baptist Medical Center

St Louis, Missouri, 63131, United States
Moffitt Cancer Center

Tampa, Florida, 33612, United States
Montefiore Medical Center - Moses Campus

The Bronx, New York, 10467, United States
Montefiore Medical Center-Einstein Campus

The Bronx, New York, 10461, United States
Mount Sinai Hospital

New York, New York, 10029, United States
Mount Sinai West

New York, New York, 10019, United States
MyMichigan Medical Center Saginaw

Saginaw, Michigan, 48601, United States
Nebraska Methodist Hospital

Omaha, Nebraska, 68114, United States
New York-Presbyterian/Brooklyn Methodist Hospital

Brooklyn, New York, 11215, United States
North Coast Cancer Care

Sandusky, Ohio, 44870, United States
Northeast Radiation Oncology Center

Dunmore, Pennsylvania, 18512, United States
Northwestern University

Chicago, Illinois, 60611, United States
Norton Brownsboro Hospital and Medical Campus

Louisville, Kentucky, 40241, United States
Norton Hospital Pavilion and Medical Campus

Louisville, Kentucky, 40202, United States
Novant Cancer Institute Radiation Oncology - Supply

Supply, North Carolina, 28462, United States
Novant Health Cancer Institute Radiation Oncology - Wilmington

Wilmington, North Carolina, 28401, United States
Novant Health New Hanover Regional Medical Center

Wilmington, North Carolina, 28401, United States
OSF Saint Francis Medical Center

Peoria, Illinois, 61637, United States
Ohio State University Comprehensive Cancer Center

Columbus, Ohio, 43210, United States
Orlando Health Cancer Institute

Orlando, Florida, 32806, United States
Ottawa Hospital and Cancer Center-General Campus

Ottawa, Ontario, K1H 8L6, Canada
Our Lady of the Lake Physician Group

Baton Rouge, Louisiana, 70808, United States
Paoli Memorial Hospital

Paoli, Pennsylvania, 19301, United States
Parkview Hospital Randallia

Fort Wayne, Indiana, 46805, United States
Parkview Regional Medical Center

Fort Wayne, Indiana, 46845, 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
Porter Adventist Hospital

Denver, Colorado, 80210, United States
Poudre Valley Hospital

Fort Collins, Colorado, 80524, United States
Prisma Health Cancer Institute - Eastside

Greenville, South Carolina, 29615, United States
Prisma Health Cancer Institute - Faris

Greenville, South Carolina, 29605, United States
Prisma Health Cancer Institute - Greer

Greer, South Carolina, 29650, United States
Prisma Health Cancer Institute - Seneca

Seneca, South Carolina, 29672, United States
Prisma Health Cancer Institute - Spartanburg

Boiling Springs, South Carolina, 29316, United States
ProMedica Flower Hospital

Sylvania, Ohio, 43560, United States
Providence Portland Medical Center

Portland, Oregon, 97213, United States
Providence Saint Vincent Medical Center

Portland, Oregon, 97225, United States
Queen's Medical Center

Honolulu, Hawaii, 96813, United States
Reading Hospital

West Reading, Pennsylvania, 19611, United States
Regions Hospital

Saint Paul, Minnesota, 55101, United States
Renown Regional Medical Center

Reno, Nevada, 89502, United States
Rush University Medical Center

Chicago, Illinois, 60612, United States
Saint Alphonsus Cancer Care Center-Nampa

Nampa, Idaho, 83687, United States
Saint Elizabeth Healthcare Edgewood

Edgewood, Kentucky, 41017, United States
Saint Francis Cancer Center

Greenville, South Carolina, 29607, United States
Saint Francis Medical Center

Cape Girardeau, Missouri, 63703, United States
Saint Helena Hospital

St. Helena, California, 94574, United States
Saint James Community Hospital and Cancer Treatment Center

Butte, Montana, 59701, United States
Saint Joseph Hospital - Orange

Orange, California, 92868, United States
Saint Luke's Hospital of Duluth

Duluth, Minnesota, 55805, United States
Saint Vincent Hospital

Erie, Pennsylvania, 16544, United States
Saint Vincent Hospital Cancer Center Green Bay

Green Bay, Wisconsin, 54301, United States
Saint Vincent Hospital Cancer Center at Saint Mary's

Green Bay, Wisconsin, 54303, United States
Salinas Valley Memorial

Salinas, California, 93901, United States
Sanford Bismarck Medical Center

Bismarck, North Dakota, 58501, United States
Sanford Joe Lueken Cancer Center

Bemidji, Minnesota, 56601, United States
Sanford Roger Maris Cancer Center

Fargo, North Dakota, 58122, United States
Sanford USD Medical Center - Sioux Falls

Sioux Falls, South Dakota, 57117-5134, United States
Self Regional Healthcare

Greenwood, South Carolina, 29646, United States
Singh and Arora Hematology Oncology PC

Flint, Michigan, 48532, United States
Siteman Cancer Center at West County Hospital

Creve Coeur, Missouri, 63141, United States
Southwest Illinois Health Services LLP

Swansea, Illinois, 62226, United States
Spartanburg Medical Center

Spartanburg, South Carolina, 29303, United States
Springfield Memorial Hospital

Springfield, Illinois, 62781, United States
State University of New York Upstate Medical University

Syracuse, New York, 13210, United States
Stony Brook University Medical Center

Stony Brook, New York, 11794, United States
Sutter Medical Center Sacramento

Sacramento, California, 95816, United States
Tallahassee Memorial HealthCare

Tallahassee, Florida, 32308, United States
The Cancer Center of Hawaii-Liliha

Honolulu, Hawaii, 96817, United States
The James Graham Brown Cancer Center at University of Louisville

Louisville, Kentucky, 40202, United States
The Mark H Zangmeister Center

Columbus, Ohio, 43219, United States
The Permanente Medical Group-Roseville Radiation Oncology

Roseville, California, 95678, United States
The Radiation Oncology Center-Hilton Head/Bluffton

Hilton Head Island, South Carolina, 29926, United States
Thomas Jefferson University Hospital

Philadelphia, Pennsylvania, 19107, United States
TidalHealth Peninsula Regional

Salisbury, Maryland, 21801, United States
TidalHealth Richard A Henson Cancer Institute

Ocean Pines, Maryland, 21811, United States
Trinity Health Saint Mary Mercy Livonia Hospital

Livonia, Michigan, 48154, United States
UC San Diego Moores Cancer Center

La Jolla, California, 92093, United States
UCHealth Memorial Hospital Central

Colorado Springs, Colorado, 80909, United States
UH Seidman Cancer Center at Firelands Regional Medical Center

Sandusky, Ohio, 44870, United States
UH Seidman Cancer Center at Lake Health Mentor Campus

Mentor, Ohio, 44060, United States
UH Seidman Cancer Center at Saint John Medical Center

Westlake, Ohio, 44145, United States
UH Seidman Cancer Center at Southwest General Hospital

Middleburg Heights, Ohio, 44130, United States
UHHS-Chagrin Highlands Medical Center

Beachwood, Ohio, 44122, United States
UHHS-Westlake Medical Center

Westlake, Ohio, 44145, United States
UM Baltimore Washington Medical Center/Tate Cancer Center

Glen Burnie, Maryland, 21061, United States
UM Sylvester Comprehensive Cancer Center at Coral Gables

Coral Gables, Florida, 33146, United States
UM Sylvester Comprehensive Cancer Center at Deerfield Beach

Deerfield Beach, Florida, 33442, United States
UM Sylvester Comprehensive Cancer Center at Kendall

Miami, Florida, 33176, United States
UM Sylvester Comprehensive Cancer Center at Plantation

Plantation, Florida, 33324, United States
UPMC Pinnacle Cancer Center/Community Osteopathic Campus

Harrisburg, Pennsylvania, 17109, United States
USC / Norris Comprehensive Cancer Center

Los Angeles, California, 90033, United States
UT Southwestern/Simmons Cancer Center-Dallas

Dallas, Texas, 75390, United States
UT Southwestern/Simmons Cancer Center-Fort Worth

Fort Worth, Texas, 76104, United States
UW Health Carbone Cancer Center Rockford

Rockford, Illinois, 61114, United States
University Hospitals Parma Medical Center

Parma, Ohio, 44129, United States
University Hospitals Portage Medical Center

Ravenna, Ohio, 44266, United States
University of Alabama at Birmingham Cancer Center

Birmingham, Alabama, 35233, United States
University of Arizona Cancer Center-North Campus

Tucson, Arizona, 85719, United States
University of Arizona Cancer Center-Orange Grove Campus

Tucson, Arizona, 85704, United States
University of Arkansas for Medical Sciences

Little Rock, Arkansas, 72205, United States
University of California Davis Comprehensive Cancer Center

Sacramento, California, 95817, United States
University of Cincinnati Cancer Center-UC Medical Center

Cincinnati, Ohio, 45219, United States
University of Cincinnati Cancer Center-West Chester

West Chester, Ohio, 45069, United States
University of Florida Health Science Center - Gainesville

Gainesville, Florida, 32610, United States
University of Illinois

Chicago, Illinois, 60612, United States
University of Kansas Cancer Center

Kansas City, Kansas, 66160, United States
University of Kansas Cancer Center-Overland Park

Overland Park, Kansas, 66210, United States
University of Kentucky/Markey Cancer Center

Lexington, Kentucky, 40536, United States
University of Maryland/Greenebaum Cancer Center

Baltimore, Maryland, 21201, United States
University of Miami Miller School of Medicine-Sylvester Cancer Center

Miami, Florida, 33136, United States
University of Michigan Health - Sparrow Lansing

Lansing, Michigan, 48912, United States
University of Michigan Health - West

Wyoming, Michigan, 49519, 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 Rochester

Rochester, New York, 14642, United States
University of Texas Health Science Center at San Antonio

San Antonio, Texas, 78229, United States
University of Texas Medical Branch

Galveston, Texas, 77555-0565, United States
VCU Massey Cancer Center at Stony Point

Richmond, Virginia, 23235, United States
Vince Lombardi Cancer Clinic - Oshkosh

Oshkosh, Wisconsin, 54904, United States
Vince Lombardi Cancer Clinic-Sheboygan

Sheboygan, Wisconsin, 53081, United States
Vince Lombardi Cancer Clinic-Two Rivers

Two Rivers, Wisconsin, 54241, United States
Virginia Commonwealth University/Massey Cancer Center

Richmond, Virginia, 23298, United States
Virtua Memorial

Mount Holly, New Jersey, 08060, United States
Virtua Samson Cancer Center

Moorestown, New Jersey, 08057, United States
Virtua Voorhees

Voorhees Township, New Jersey, 08043, United States
Washington University School of Medicine

St Louis, Missouri, 63110, United States
Wayne State University/Karmanos Cancer Institute

Detroit, Michigan, 48201, United States
Weisberg Cancer Treatment Center

Farmington Hills, Michigan, 48334, United States
Wentworth-Douglass Hospital

Dover, New Hampshire, 03820, United States
West Michigan Cancer Center

Kalamazoo, Michigan, 49007, United States
West Virginia University Healthcare

Morgantown, West Virginia, 26506, United States
Western Illinois Cancer Treatment Center

Galesburg, Illinois, 61401, United States
Yale University

New Haven, Connecticut, 06520, United States

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