Could adding radiation to immunotherapy keep lung cancer at bay?

NCT ID NCT04402788

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

First seen Jun 27, 2026 · Last updated Sep 15, 2026 · Updated 26 times

Summary

This study tests whether adding radiation therapy to the usual maintenance drug atezolizumab helps people with extensive-stage small cell lung cancer live longer without their cancer growing. About 138 participants who have already responded to initial chemo-immunotherapy will be randomly assigned to receive either atezolizumab alone or atezolizumab plus radiation. The goal is to see if the combination delays 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: Atezolizumab (immunotherapy drug) and radiation therapy
What this could lead to: If successful, this could offer a new standard treatment that delays cancer progression for patients with extensive-stage small cell lung cancer.
What could go wrong: This is a mid-stage trial with only 138 participants, so results may not apply to all patients. Adding radiation may increase side effects without improving survival.

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 2/3

Runs two stages together: whether the treatment works, then large-scale confirmation.

Participants

About 138 people

The number the study aims to enrol. It can still change while the study runs.

Started

Jan 2021

Expected to finish

Apr 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: * Any confirmation (cytologic, histologic, or pathologic) of extensive stage small cell lung cancer at any site, either primary or metastases * Partial response (PR) or stable disease (SD) after 4-6 cycles of etoposide/platinum (E/P) doublet plus atezolizumab by re-staging scans (positron emission tomography \[PET\]/computed tomography \[CT\] scan, diagnostic CT scan, magnetic resonance imaging \[MRI\] optional per treating physician); atezolizumab should continue through randomization. Patients must be randomized within 9 weeks of last dose of etoposide/platinum (if not receiving PCI) or 6 weeks from completion of prophylactic cranial irradiation (PCI) * NOTE: Patients must have at least 3 cycles of E/P plus atezolizumab. They can have one cycle of induction E/P without concurrent atezolizumab if unable to receive concurrent E/P combined with atezolizumab for all cycles of induction therapy * Patients must have measurable disease (per Response Evaluation Criteria in Solid Tumors \[RECIST\]) and 3 or fewer observable liver metastases and no evidence of progressive disease (per RECIST) at time of enrollment * At time of enrollment after induction E/P chemotherapy and atezolizumab, if there is a pleural effusion, patients will be eligible if thoracentesis is cytologically negative or if pleural fluid is too small a volume to effectively sample by thoracentesis and does not show increased metabolic activity on CT/PET imaging * Appropriate stage for study entry based on the following diagnostic workup: * History/physical examination within 14 days prior to registration; * Imaging within 42 days prior to registration to include: * MRI brain with contrast or CT brain with contrast * CT chest, abdomen and pelvis or whole body PET/CT scan any time after the fourth cycle of chemotherapy and prior to registration * Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 within 14 days prior to registration * Absolute neutrophil count (ANC) \>= 1,000/cells/mm\^3 (within 14 days prior to registration) * Platelets \>= 75,000 cells/mm\^3 (within 14 days prior to registration) * Hemoglobin \>= 8 g/dL (within 14 days prior to registration) * Total bilirubin =\< 1.5 x upper limit of normal (ULN) (within 14 days prior to registration) * Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase \[SGOT\]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 3.0 x ULN (AST and/or ALT =\< 5 ULN for patients with liver involvement) (within 14 days prior to registration) * Alkaline phosphatase =\< 2.5 x ULN (=\< 5 ULN for patients with documented liver involvement or bone metastases) (within 14 days prior to registration) * Adequate renal function = Creatinine clearance \>=40 mL/min by the Cockcroft-Gault (C-G) equation: (within 14 days prior to registration) * Upfront radiation therapy of symptomatic metastatic site is permissible if causing symptoms such as pain or impending fracture * Patients with brain metastases are eligible after receiving whole brain radiation before enrollment (anytime during induction systemic therapy). Whole brain radiation can be delivered with hippocampal sparing or 3-D conformal technique. Patients with irradiated brain metastases are eligible if they are clinically stable from a neurological standpoint after completing radiotherapy (e.g. not having uncontrolled seizures) and do not require use of steroids above a dose of 10 mg of prednisone daily * For women of childbearing potential, a negative serum or urine pregnancy test within 14 days prior to registration. * Note: Women will be considered post-menopausal if they have been amenorrheic for 12 months without an alternative medical cause. The following age-specific requirements apply: * Women \< 50 years of age would be considered post-menopausal if they have been amenorrheic for 12 months or more following cessation of exogenous hormonal treatments and if they have luteinizing hormone and follicle-stimulating hormone levels in the post-menopausal range for the institution or underwent surgical sterilization (bilateral oophorectomy or hysterectomy) * Women \>= 50 years of age would be considered post-menopausal if they have been amenorrheic for 12 months or more following cessation of all exogenous hormonal treatments, had radiation-induced menopause with last menses \> 1 year ago, had chemotherapy-induced menopause with last menses \> 1 year ago, or underwent surgical sterilization (bilateral oophorectomy, bilateral salpingectomy or hysterectomy) * Patients positive for human immunodeficiency virus (HIV) on effective anti-retroviral therapy with undetectable viral load within 6 months and a stable regimen of highly active anti-retroviral (HAART) HIV-positive patients must have no requirement for concurrent antibiotics or antifungal agents for the prevention of opportunistic infections * The patient or a legally authorized representative must provide study-specific informed consent prior to study entry Exclusion Criteria: * Metastatic disease invading the liver (\> 3 metastases), heart or \> 10 metastatic sites detectable after induction systemic therapy. Each visible bone metastasis on radiographic scan counts as one site * Patients with a concurrent malignancy whose natural history or treatment has the potential to interfere with the safety or efficacy assessment of the investigational regimen with atezolizumab or radiation * Prior radiotherapy in the thorax that would result in overlapping RT fields, unless the overlapping fields meet acceptable dose constraints for normal tissue * Active autoimmune disease, including, but not limited to: systemic lupus erythematosus; rheumatoid arthritis; inflammatory bowel disease (e.g. Crohn's, ulcerative colitis); vascular thrombosis associated with antiphospholipid syndrome; Wegener's granulomatosis; Sjogren's syndrome; Guillain-Barre syndrome; multiple sclerosis; vasculitis; or glomerulonephritis. * If the autoimmune disease is not active for over 3 years and the patient is not receiving immunosuppressive treatment such as methotrexate or steroids above a dose equivalent to 10 mg prednisone daily, the patient is eligible. * Patients with a history of autoimmune hypothyroidism on a stable dose of thyroid replacement hormone are eligible * Patients with controlled type 1 diabetes mellitus on a stable insulin regimen are eligible * Patients with eczema, psoriasis, lichen simplex chronicus or vitiligo with dermatologic manifestations are excluded only if they have active disease with acute exacerbation and on immunosuppressive medications within the 12 months prior to enrollment. They are eligible otherwise. * Severe, active co-morbidity defined as follows: * Any other diseases, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that may affect the interpretation of the results or render the patient at high risk from treatment complications; * Active tuberculosis; * Known clinically significant liver disease, including active viral, alcoholic, or other hepatitis; cirrhosis; fatty liver; and inherited liver disease * Patients with past or resolved hepatitis B infection (defined as having a negative hepatitis B surface antigen \[HBsAg\] test and a positive anti-HBc \[antibody to hepatitis B core antigen\] antibody test) are eligible * Patients positive for hepatitis C virus (HCV) antibody are eligible only if polymerase chain reaction (PCR) is negative for HCV ribonucleic acid (RNA). (The HCV RNA test must be performed for patients who have a positive HCV antibody test) * Known immunosuppressive disease, for example history of bone marrow transplant or chronic lymphocytic leukemia (CLL); * Chronic obstructive pulmonary disease (COPD) requiring chronic oral steroid therapy of \> 10 mg prednisone daily or equivalent at the time of registration. Inhaled corticosteroids are not exclusionary; * Unstable angina and/or congestive heart failure requiring hospitalization within the last 3 months; * History of recent myocardial infarction within 6 months prior to registration. * Clinically significant interstitial lung disease * Pregnancy: Administration of atezolizumab may have an adverse effect on pregnancy and poses a risk to the human fetus, including embryo-lethality. Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study treatment, and for 5 months (150 days) after the last dose of study agent. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately * Women who are breastfeeding and unwilling to discontinue * History of allogeneic organ transplant * Patients who have had immunotherapy-induced pneumonitis

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Conditions

The condition(s) this trial relates to.

small cell lung carcinoma

As listed by the trial registrant

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

Extensive stage lung small cell carcinoma

How to take part

Only the study team decides who joins. These are the ways to reach them.

The places running it

411 sites. The list below names each one and where it is.
The official record

The full official record for this study. This one lists no contact details, but it is the first place any would appear.

Open the record ↗
A doctor treating you

A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.

Contacts and locations

Locations

Abbott-Northwestern Hospital

Minneapolis, Minnesota, 55407, United States
Adams Cancer Center

Gettysburg, Pennsylvania, 17325, United States
Allegheny General Hospital

Pittsburgh, Pennsylvania, 15212, United States
Allegheny Valley Hospital

Natrona Heights, Pennsylvania, 15065, United States
Ascension Via Christi Hospitals Wichita

Wichita, Kansas, 67214, United States
Aspirus Cancer Care - Stevens Point

Stevens Point, Wisconsin, 54481, United States
Aspirus Cancer Care - Wisconsin Rapids

Wisconsin Rapids, Wisconsin, 54494, United States
Aspirus Cancer Care-Antigo-Volm Cancer Center

Antigo, Wisconsin, 54409, United States
Aspirus Cancer Care-Rhinelander-James Beck Cancer Center

Rhinelander, Wisconsin, 54501, United States
Aspirus Cancer Care-Wausau

Wausau, Wisconsin, 54401, United States
Atrium Health Cabarrus/LCI-Concord

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

Shelby, North Carolina, 28150, United States
Atrium Health Lincoln/LCI-Lincolnton

Lincolnton, North Carolina, 28092, United States
Atrium Health Pineville/LCI-Pineville

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

Albemarle, North Carolina, 28002, 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
Atrium Medical Center-Middletown Regional Hospital

Franklin, Ohio, 45005-1066, United States
Aultman Health Foundation

Canton, Ohio, 44710, United States
Avera Cancer Institute

Sioux Falls, South Dakota, 57105, United States
Avera Cancer Institute at Pierre

Pierre, South Dakota, 57501, United States
Avera Cancer Institute at Yankton

Yankton, South Dakota, 57078, United States
Banner University Medical Center - Tucson

Tucson, Arizona, 85719, United States
Baptist Health Floyd

New Albany, Indiana, 47150, United States
Baptist Health Louisville

Louisville, Kentucky, 40207, United States
Baptist Memorial Hospital and Cancer Center-Desoto

Southhaven, Mississippi, 38671, United States
Baptist Memorial Hospital and Cancer Center-Memphis

Memphis, Tennessee, 38120, United States
Beacon Kalamazoo

Kalamazoo, Michigan, 49048, 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
Boston Medical Center

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

Bozeman, Montana, 59715, United States
Broadlawns Medical Center

Des Moines, Iowa, 50314, United States
Bronson Methodist Hospital

Kalamazoo, Michigan, 49007, United States
Bryn Mawr Hospital

Bryn Mawr, Pennsylvania, 19010, United States
CTCA at Southeastern Regional Medical Center

Newnan, Georgia, 30265, United States
California Pacific Medical Center-Pacific Campus

San Francisco, California, 94115, 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
Cancer Care and Hematology-Fort Collins

Fort Collins, Colorado, 80528, United States
Cancer Center at Saint Joseph's

Phoenix, Arizona, 85004, United States
Cancer Centers of Southwest Oklahoma Research

Lawton, Oklahoma, 73505, United States
Capital Health Medical Center-Hopewell

Pennington, New Jersey, 08534, 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
Carlisle Regional Cancer Center

Carlisle, Pennsylvania, 17015, United States
Carolinas Medical Center/Levine Cancer Institute

Charlotte, North Carolina, 28203, United States
Central Maryland Radiation Oncology in Howard County

Columbia, Maryland, 21044, United States
Central Vermont Medical Center/National Life Cancer Treatment

Berlin Corners, Vermont, 05602, United States
Centralia Oncology Clinic

Centralia, Illinois, 62801, United States
Chambersburg Hospital

Chambersburg, Pennsylvania, 17201, 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
Cleveland Clinic Akron General

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

Independence, Ohio, 44131, United States
Cleveland Clinic Cancer Center Mansfield

Mansfield, Ohio, 44906, United States
Cleveland Clinic Cancer Center Strongsville

Strongsville, Ohio, 44136, 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
CommonSpirit Saint Joseph Medical Center - East Lexington

Lexington, Kentucky, 40509, United States
Cooper Hospital University Medical Center

Camden, New Jersey, 08103, United States
Corewell Health Beaumont Troy Hospital

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

Royal Oak, Michigan, 48073, United States
Crossroads Cancer Center

Effingham, Illinois, 62401, United States
Crozer Regional Cancer Center at Brinton Lake

Glen Mills, Pennsylvania, 19342, United States
Crozer-Keystone Regional Cancer Center at Broomall

Broomall, Pennsylvania, 19008, 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
Dayton Physician LLC - Englewood

Dayton, Ohio, 45415, United States
Decatur Memorial Hospital

Decatur, Illinois, 62526, United States
Divine Providence Hospital

Williamsport, Pennsylvania, 17754, United States
Drexel Town Square Health Center

Oak Creek, Wisconsin, 53154, United States
Edward Hospital/Cancer Center

Naperville, Illinois, 60540, United States
Edward Hospital/Cancer Center?Plainfield

Plainfield, Illinois, 60585, United States
Elmhurst Memorial Hospital

Elmhurst, Illinois, 60126, 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
Englewood Hospital and Medical Center

Englewood, New Jersey, 07631, United States
Ephrata Cancer Center

Ephrata, Pennsylvania, 17522, United States
Farmington Health Center

Farmington, Utah, 84025, United States
Forbes Hospital

Monroeville, Pennsylvania, 15146, 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
Geisinger Cancer Center Dickson City

Dickson City, Pennsylvania, 18519, 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
Genesis Healthcare System Cancer Care Center

Zanesville, Ohio, 43701, 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
Grady Health System

Atlanta, Georgia, 30303, United States
Greater Regional Medical Center

Creston, Iowa, 50801, United States
Gundersen Lutheran Medical Center

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

Sayre, Pennsylvania, 18840, United States
HSHS Saint Elizabeth's Hospital

O'Fallon, Illinois, 62269, United States
Hawaii Cancer Care - Westridge

‘Aiea, Hawaii, 96701, United States
Hawaii Cancer Care Inc - Waterfront Plaza

Honolulu, Hawaii, 96813, United States
Hawaii Cancer Care Inc-Liliha

Honolulu, Hawaii, 96817, United States
Heartland Oncology and Hematology LLP

Council Bluffs, Iowa, 51503, United States
Helen F Graham Cancer Center

Newark, Delaware, 19713, United States
Hematology Oncology Associates of CNY at Camillus

Camillus, New York, 13031, United States
Hematology Oncology Associates of Central New York-East Syracuse

East Syracuse, New York, 13057, United States
Henry Ford Health Providence Novi Hospital

Novi, Michigan, 48374, United States
Henry Ford Health Providence Southfield Hospital

Southfield, Michigan, 48075, 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
Hurley Medical Center

Flint, Michigan, 48503, United States
IRMC Cancer Center

Indiana, Pennsylvania, 15701, United States
Illinois CancerCare - Washington

Washington, Illinois, 61571, 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
Inova Schar Cancer Institute

Fairfax, Virginia, 22031, United States
Iowa Lutheran Hospital

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

Des Moines, Iowa, 50309, United States
Jefferson Hospital

Jefferson Hills, Pennsylvania, 15025, United States
Jefferson Torresdale Hospital

Philadelphia, Pennsylvania, 19114, United States
Kapiolani Medical Center for Women and Children

Honolulu, Hawaii, 96826, United States
Karmanos Cancer Institute at McLaren Greater Lansing

Lansing, Michigan, 48910, United States
Katmai Oncology Group

Anchorage, Alaska, 99508, United States
Lankenau Medical Center

Wynnewood, Pennsylvania, 19096, United States
Legacy Cancer Institute Medical Oncology and Day Treatment

Vancouver, Washington, 98684, United States
Legacy Good Samaritan Hospital and Medical Center

Portland, Oregon, 97210, United States
Legacy Meridian Park Hospital

Tualatin, Oregon, 97062, United States
Legacy Mount Hood Medical Center

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

Vancouver, Washington, 98686, United States
Lehigh Valley Hospital - Muhlenberg

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

Allentown, Pennsylvania, 18103, United States
Levine Cancer Institute - Rutherford

Forest City, North Carolina, 28043, United States
Levine Cancer Institute - Union West

Matthews, North Carolina, 28104, United States
Levine Cancer Institute-Ballantyne

Charlotte, North Carolina, 28277, United States
Levine Cancer Institute-Gaston

Gastonia, North Carolina, 28054, United States
Levine Cancer Institute-Rock Hill

Rock Hill, South Carolina, 29732, United States
Levine Cancer Institute-SouthPark

Charlotte, North Carolina, 28211, United States
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler

Savannah, Georgia, 31405, United States
Lovelace Medical Center-Saint Joseph Square

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

Albuquerque, New Mexico, 87109, United States
Lowell General Hospital

Lowell, Massachusetts, 01854, United States
MD Anderson Cancer Center at Cooper-Voorhees

Voorhees Township, New Jersey, 08043, United States
MU Health - University Hospital/Ellis Fischel Cancer Center

Columbia, Missouri, 65212, United States
MaineHealth Cancer Care Center of York County

Sanford, Maine, 04073, United States
MaineHealth Cancer Care and IV Therapy - South Portland

South Portland, Maine, 04106, United States
MaineHealth Coastal Cancer Treatment Center

Bath, Maine, 04530, United States
MaineHealth Maine Medical Center - Portland

Portland, Maine, 04102, United States
MaineHealth Maine Medical Center- Scarborough

Scarborough, Maine, 04074, United States
Margaret R Pardee Memorial Hospital

Hendersonville, North Carolina, 28791, 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
Mayo Clinic Hospital in Arizona

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

Scottsdale, Arizona, 85259, 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 Center of the Rockies

Loveland, Colorado, 80538, United States
Medical College of Wisconsin

Milwaukee, Wisconsin, 53226, United States
Medical Oncology Hematology Consultants PA

Newark, Delaware, 19713, United States
Medical University of South Carolina

Charleston, South Carolina, 29425, United States
Memorial Health University Medical Center

Savannah, Georgia, 31404, United States
Memorial Hospital North

Colorado Springs, Colorado, 80920, United States
Mercy Cancer Center-West Lakes

Clive, Iowa, 50325, United States
Mercy Hospital

Coon Rapids, Minnesota, 55433, United States
Mercy Hospital Oklahoma City

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

St Louis, Missouri, 63141, 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
Methodist Jennie Edmundson Hospital

Council Bluffs, Iowa, 51503, United States
Methodist Medical Center of Illinois

Peoria, Illinois, 61636, United States
Methodist West Hospital

West Des Moines, Iowa, 50266-7700, United States
MetroHealth Medical Center

Cleveland, Ohio, 44109, United States
Miami Valley Cancer Care and Infusion

Greenville, Ohio, 45331, United States
Miami Valley Hospital

Dayton, Ohio, 45409, United States
Miami Valley Hospital North

Dayton, Ohio, 45415, United States
Miami Valley Hospital South

Centerville, Ohio, 45459, United States
Missouri Baptist Medical Center

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

Sullivan, Missouri, 63080, 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
Montefiore Medical Center-Weiler Hospital

The Bronx, New York, 10461, United States
Mount Carmel East Hospital

Columbus, Ohio, 43213, United States
Mount Carmel Health Center West

Columbus, Ohio, 43222, United States
Mount Sinai Chelsea

New York, New York, 10011, United States
Mount Sinai Comprehensive Cancer Center at Aventura

Aventura, Florida, 33180, United States
Mount Sinai Hospital

New York, New York, 10029, United States
Mount Sinai Medical Center

Miami Beach, Florida, 33140, United States
Mount Sinai West

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

Midland, Michigan, 48670, United States
MyMichigan Medical Center Saginaw

Saginaw, Michigan, 48601, United States
MyMichigan Medical Center Tawas

Tawas City, Michigan, 48764, United States
NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro

Jonesboro, Arkansas, 72401, United States
Nebraska Cancer Specialists/Oncology Hematology West PC - MECC

Omaha, Nebraska, 68114, United States
Nebraska Methodist Hospital

Omaha, Nebraska, 68114, United States
North Coast Cancer Care

Sandusky, Ohio, 44870, United States
Northwest Cancer Center - Crown Point

Crown Point, Indiana, 46307, United States
Northwest Cancer Center - Hobart

Hobart, Indiana, 46342, United States
Northwest Cancer Center - Valparaiso

Valparaiso, Indiana, 46383, United States
Northwest Oncology LLC

Dyer, Indiana, 46311, United States
Norton Audubon Hospital and Medical Campus

Louisville, Kentucky, 40217, United States
Norton Brownsboro Hospital and Medical Campus

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

Louisville, Kentucky, 40202, United States
OSF Saint Francis Medical Center

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

Columbus, Ohio, 43210, United States
Oncology Hematology Associates of Saginaw Valley PC

Saginaw, Michigan, 48604, United States
Oncology and Hematology Associates of Southwest Virginia

Roanoke, Virginia, 24014, United States
Orlando Health Cancer Institute

Orlando, Florida, 32806, United States
Pali Momi Medical Center

‘Aiea, Hawaii, 96701, United States
Palo Alto Medical Foundation Health Care

Palo Alto, California, 94301, United States
Palo Alto Medical Foundation-Sunnyvale

Sunnyvale, California, 94086, United States
Paoli Memorial Hospital

Paoli, Pennsylvania, 19301, United States
Park Nicollet Clinic - Saint Louis Park

Saint Louis Park, Minnesota, 55416, United States
Parkland Health Center - Farmington

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

Bellingham, Washington, 98225, 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
Physicians' Clinic of Iowa PC

Cedar Rapids, Iowa, 52402, United States
Poudre Valley Hospital

Fort Collins, Colorado, 80524, United States
Premier Blood and Cancer Center

Dayton, Ohio, 45409, 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
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 Saint Vincent Medical Center

Portland, Oregon, 97225, United States
Queen's Cancer Cenrer - POB I

Honolulu, Hawaii, 96813, United States
Queen's Cancer Center - Kuakini

Honolulu, Hawaii, 96817, United States
Queen's Medical Center

Honolulu, Hawaii, 96813, United States
Regions Hospital

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

Reno, Nevada, 89502, United States
Riddle Memorial Hospital

Media, Pennsylvania, 19063, United States
Rock Hill Radiation Therapy Center

Rock Hill, South Carolina, 29730, United States
Rocky Mountain Cancer Centers-Penrose

Colorado Springs, Colorado, 80907, United States
SMC Center for Hematology Oncology Union

Union, South Carolina, 29379, 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 Ann's Hospital

Westerville, Ohio, 43081, United States
Saint Francis Cancer Center

Greenville, South Carolina, 29607, United States
Saint Francis Hospital

Greenville, South Carolina, 29601, United States
Saint Francis Medical Center

Cape Girardeau, Missouri, 63703, United States
Saint John's Hospital - Healtheast

Maplewood, Minnesota, 55109, United States
Saint Joseph Medical Center Hematology and Oncology - Silverdale

Silverdale, Washington, 98383, United States
Saint Joseph's/Candler - Bluffton Campus

Bluffton, South Carolina, 29910, United States
Saint Luke's Cancer Center - Allentown

Allentown, Pennsylvania, 18104, 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 Luke's Hospital - Monroe Campus

Stroudsburg, Pennsylvania, 18360, United States
Saint Luke's Hospital - Upper Bucks Campus

Quakertown, Pennsylvania, 18951, United States
Saint Luke's Hospital of Duluth

Duluth, Minnesota, 55805, United States
Saint Luke's Hospital-Anderson Campus

Easton, Pennsylvania, 18045, United States
Saint Luke's University Hospital-Bethlehem Campus

Bethlehem, Pennsylvania, 18015, United States
Saint Mary Medical Center

Hobart, Indiana, 46342, United States
Saint Mary's Oncology/Hematology Associates of West Branch

West Branch, Michigan, 48661, 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 Sheboygan

Sheboygan, Wisconsin, 53081, United States
Saint Vincent Hospital Cancer Center at Sturgeon Bay

Sturgeon Bay, Wisconsin, 54235-1495, United States
Sainte Genevieve County Memorial Hospital

Sainte Genevieve, Missouri, 63670, United States
Sands Cancer Center

Canandaigua, New York, 14424, United States
Sanford Bismarck Medical Center

Bismarck, North Dakota, 58501, United States
Sanford Broadway Medical Center

Fargo, North Dakota, 58122, United States
Sanford Cancer Center Oncology Clinic

Sioux Falls, South Dakota, 57104, 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
Sechler Family Cancer Center

Lebanon, Pennsylvania, 17042, United States
Self Regional Healthcare

Greenwood, South Carolina, 29646, United States
Smilow Cancer Hospital Care Center - Guilford

Guilford, Connecticut, 06437, United States
Smilow Cancer Hospital Care Center - Waterford

Waterford, Connecticut, 06385, United States
Smilow Cancer Hospital Care Center - Westerly

Westerly, Rhode Island, 02891, United States
Smilow Cancer Hospital Care Center at Greenwich

Greenwich, Connecticut, 06830, United States
Smilow Cancer Hospital Care Center at Long Ridge

Stamford, Connecticut, 06902, United States
Smilow Cancer Hospital Care Center-Fairfield

Fairfield, Connecticut, 06824, United States
Smilow Cancer Hospital Care Center-Trumbull

Trumbull, Connecticut, 06611, United States
Smilow Cancer Hospital-Hamden Care Center

Hamden, Connecticut, 06518, United States
Smilow Cancer Hospital-Torrington Care Center

Torrington, Connecticut, 06790, United States
Smilow Cancer Hospital-Waterbury Care Center

Waterbury, Connecticut, 06708, United States
Southern Illinois University School of Medicine

Springfield, Illinois, 62702, 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
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
Straub Clinic and Hospital

Honolulu, Hawaii, 96813, United States
Sutter Cancer Centers Radiation Oncology Services-Roseville

Roseville, California, 95661, United States
Sutter Medical Center Sacramento

Sacramento, California, 95816, United States
Texas Oncology - Fort Worth Cancer Center

Fort Worth, Texas, 76104, United States
Texas Oncology Cancer Center Sugar Land

Sugar Land, Texas, 77479, United States
Texas Oncology-Flower Mound

Flower Mound, Texas, 75028, United States
Texas Oncology-McKinney

McKinney, Texas, 75071, United States
Texas Oncology-Plano West

Plano, Texas, 75093, United States
Texas Oncology-The Woodlands

The Woodlands, Texas, 77380, United States
The Cancer Center of Hawaii-Liliha

Honolulu, Hawaii, 96817, United States
The Carle Foundation Hospital

Urbana, Illinois, 61801, United States
The Community Hospital

Munster, Indiana, 46321, 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
Thomas Jefferson University Hospital

Philadelphia, Pennsylvania, 19107, 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 - Chelsea Hospital

Chelsea, Michigan, 48118, 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 Mary Mercy Livonia Hospital

Livonia, Michigan, 48154, United States
UC Irvine Health/Chao Family Comprehensive Cancer Center

Orange, California, 92868, United States
UCHealth Greeley Hospital

Greeley, Colorado, 80631, United States
UCHealth Memorial Hospital Central

Colorado Springs, Colorado, 80909, United States
UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care

Irvine, California, 92612, United States
UI Health Care Mission Cancer and Blood - Ankeny Clinic

Ankeny, Iowa, 50023, 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 - Waukee Clinic

Waukee, Iowa, 50263, United States
UI Health Care Mission Cancer and Blood - West Des Moines Clinic

Clive, Iowa, 50325, 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 Upper Chesapeake Medical Center

Bel Air, Maryland, 21014, United States
UMass Memorial Medical Center - University Campus

Worcester, Massachusetts, 01655, United States
UPMC Cancer Center - Monroeville

Monroeville, Pennsylvania, 15146, United States
UPMC Cancer Center at UPMC Horizon

Farrell, Pennsylvania, 16121, United States
UPMC Cancer Center-Washington

Washington, Pennsylvania, 15301, United States
UPMC Cancer Centers - Arnold Palmer Pavilion

Greensburg, Pennsylvania, 15601, United States
UPMC Hillman Cancer Center

Pittsburgh, Pennsylvania, 15232, United States
UPMC Hillman Cancer Center - Monroeville

Monroeville, Pennsylvania, 15146, United States
UPMC Hillman Cancer Center - New Castle

New Castle, Pennsylvania, 16105, United States
UPMC Hillman Cancer Center Erie

Erie, Pennsylvania, 16505, United States
UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion

Mechanicsburg, Pennsylvania, 17050, United States
UPMC Hillman Cancer Center in Greenville/UPMC Horizon

Greenville, Pennsylvania, 16125, United States
UPMC Memorial

York, Pennsylvania, 17408, United States
UPMC Pinnacle Cancer Center/Community Osteopathic Campus

Harrisburg, Pennsylvania, 17109, United States
UPMC Washington Hospital Radiation Oncology

Washington, Pennsylvania, 15301, United States
UPMC-Heritage Valley Health System Beaver

Beaver, Pennsylvania, 15009, United States
UPMC-Passavant Hospital

Pittsburgh, Pennsylvania, 15237, United States
UPMC-Saint Clair Hospital Cancer Center

Pittsburgh, Pennsylvania, 15243, United States
UPMC-Saint Margaret

Pittsburgh, Pennsylvania, 15215, United States
UPMC-Shadyside Hospital

Pittsburgh, Pennsylvania, 15232, United States
UT MD Anderson - League City

League City, Texas, 77573, United States
UT MD Anderson - Sugar Land

Sugar Land, Texas, 77478, United States
UT MD Anderson - The Woodlands

Conroe, Texas, 77384, United States
UT MD Anderson - West Houston

Houston, Texas, 77079, United States
UT MD Anderson Cancer Center

Houston, Texas, 77030, United States
UW Health Carbone Cancer Center Rockford

Rockford, Illinois, 61114, United States
Unity Hospital

Fridley, Minnesota, 55432, 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 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 Hawaii Cancer Center

Honolulu, Hawaii, 96813, United States
University of Illinois

Chicago, Illinois, 60612, 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 Nebraska Medical Center

Omaha, Nebraska, 68198, 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 Pennsylvania/Abramson Cancer Center

Philadelphia, Pennsylvania, 19104, United States
University of Rochester

Rochester, New York, 14642, United States
University of Utah Sugarhouse Health Center

Salt Lake City, Utah, 84106, United States
University of Vermont Medical Center

Burlington, Vermont, 05401, United States
University of Vermont and State Agricultural College

Burlington, Vermont, 05405, United States
UofL Health Medical Center Northeast

Louisville, Kentucky, 40245, United States
Upper Valley Medical Center

Troy, Ohio, 45373, United States
VCU Massey Cancer Center at Stony Point

Richmond, Virginia, 23235, United States
VCU Massey Comprehensive Cancer Center

Richmond, Virginia, 23298, United States
Wake Forest Baptist Health - Hematology Oncology - Statesville

Statesville, North Carolina, 28677, United States
Wake Forest University Health Sciences

Winston-Salem, North Carolina, 27157, United States
Wayne State University/Karmanos Cancer Institute

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

Farmington Hills, Michigan, 48334, United States
WellSpan Health-York Cancer Center

York, Pennsylvania, 17403, United States
WellSpan Health-York Hospital

York, Pennsylvania, 17403, United States
West Michigan Cancer Center

Kalamazoo, Michigan, 49007, United States
West Penn Hospital

Pittsburgh, Pennsylvania, 15224, United States
West Virginia University Charleston Division

Charleston, West Virginia, 25304, United States
West Virginia University Healthcare

Morgantown, West Virginia, 26506, United States
Westchester Medical Center

Valhalla, New York, 10595, United States
Western Illinois Cancer Treatment Center

Galesburg, Illinois, 61401, United States
Wexford Health and Wellness Pavilion

Wexford, Pennsylvania, 15090, United States
Wheeling Hospital/Schiffler Cancer Center

Wheeling, West Virginia, 26003, United States
Wilcox Memorial Hospital and Kauai Medical Clinic

Lihue, Hawaii, 96766, United States
Wilmot Cancer Institute Radiation Oncology at Greece

Rochester, New York, 14606, United States
Women's Diagnostic Center - Munster

Munster, Indiana, 46321, United States
Yale University

New Haven, Connecticut, 06520, United States
Yale-New Haven Hospital North Haven Medical Center

North Haven, Connecticut, 06473, United States

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