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ACTIVE NOT RECRUITING

NCT02115282

PHASE3

Exemestane With or Without Entinostat in Treating Patients With Recurrent Hormone Receptor-Positive Breast Cancer That is Locally Advanced or Metastatic

Sponsor: National Cancer Institute (NCI)

View on ClinicalTrials.gov

Summary

This randomized phase III trial studies exemestane and entinostat to see how well they work compared to exemestane alone in treating patients with hormone receptor-positive breast cancer that has spread to nearby tissue or lymph nodes (locally advanced) or another place in the body (metastatic). Estrogen can cause the growth of breast cancer cells. Endocrine therapy using exemestane may fight breast cancer by lowering the amount of estrogen the body makes. Entinostat may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known whether exemestane is more effective with or without entinostat in treating breast cancer.

Official title: A Randomized Phase III Trial of Endocrine Therapy Plus Entinostat/Placebo in Patients With Hormone Receptor-Positive Advanced Breast Cancer

Key Details

Gender

All

Age Range

18 Years - Any

Study Type

INTERVENTIONAL

Enrollment

608

Start Date

2014-03-29

Completion Date

2026-06-02

Last Updated

2025-12-18

Healthy Volunteers

Conditions

Anatomic Stage III Breast Cancer AJCC v8 Anatomic Stage IV Breast Cancer AJCC v8 Breast Adenocarcinoma HER2/Neu Negative Locally Advanced Breast Carcinoma Metastatic Breast Carcinoma Recurrent Breast Carcinoma

Interventions

PROCEDURE

Biospecimen Collection

Undergo collection of blood and archived tissue samples

PROCEDURE

Computed Tomography

Undergo CT

DRUG

Entinostat

Given PO

DRUG

Exemestane

Given PO

DRUG

Goserelin

Given PO

DRUG

Goserelin Acetate

Given SC

PROCEDURE

Magnetic Resonance Imaging

Undergo MRI

OTHER

Placebo Administration

Given PO

OTHER

Quality-of-Life Assessment

Ancillary studies

Inclusion Criteria: * Estrogen receptor (ER) and/or progesterone receptor (PR) positive histologically confirmed adenocarcinoma of the breast with staining of \>= 1% cells will be considered positive; receptor status may be based on any time during treatment prior to study randomization, and from any site (i.e. primary, recurrent, or metastatic) * Patients whose tumors have HER2 immunohistochemistry (IHC) 3+, in situ hybridization (ISH) \>= 2.0, or average HER2 copy number \>= 6.0 signals per cell are not eligible; receptor status may be based on any time during treatment prior to study randomization, and from any site (i.e. primary, recurrent, or metastatic) * Patients must have measurable or non-measurable stage III/locally advanced or metastatic carcinoma of the breast where local therapy with curative intent is not possible; lesions must be evaluated =\< 4 weeks prior to study randomization; diagnostic-quality computed tomography (CT) scans with both oral and intravenous (IV) contrast are the expected radiologic method, unless an alternative is approved * NOTE: Where baseline imaging has already been performed =\< 6 weeks prior to study randomization, repeat imaging may not be required * NOTE: As of October 16, 2016, accrual of new patients having non-measurable disease has stopped; the planned accrual for this target population has been reached * Pre/peri- and postmenopausal women and all men are eligible for this trial; postmenopausal is defined as: * Age \>= 55 years and one year or more of amenorrhea * Age \< 55 years and one year or more of amenorrhea, with estradiol \< 20 pg/ml * Age \< 55 with prior hysterectomy but intact ovaries, with estradiol \< 20 pg/ml * Prior bilateral oophorectomy * NOTE: Women who do not fit the criteria for being postmenopausal as above are deemed pre-or peri-menopausal; pre/perimenopausal women and all men can enroll provided they agree to receive concomitant luteinizing hormone-releasing hormone (LHRH) agonist; pre/perimenopausal women must have commenced treatment with LHRH agonist at least 4 weeks prior to randomization; if patients have received alternative LHRH agonist prior to study entry, they must switch to goserelin for the duration of the trial * Sexually active males and pre/perimenopausal women must agree to use an accepted and effective method of contraception or to abstain from sexual intercourse for the duration of their participation in the study and for 3 months after discontinuation of therapy * Women must not be pregnant or breast-feeding; all females of childbearing potential must have a blood test or urine study =\< 2 weeks prior to randomization * A female of childbearing potential is any woman, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months) * Patients must not have known central nervous system metastasis or a history of central nervous system (CNS) metastases; patients with leptomeningeal disease are not eligible * Patients must be disease-free of prior invasive malignancies for \> 5 years with the exception of curatively-treated basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix * NOTE: If there is a history of prior malignancy, patients must not be receiving other specific treatment for that cancer * Patients must meet at least one of the following criteria: * Disease progression any time after non-steroidal AI use in the advanced disease setting * Relapse while on or within =\< 12 months of end of adjuvant non-steroidal AI therapy with or without prior endocrine therapy for advanced disease * NOTE: In either setting, treatment with any prior endocrine therapy must be completed \>= 2 weeks prior to cycle 1 day 1 (C1D1) of study treatment with the exception of exemestane which is permitted in the advanced disease setting within =\< 4 weeks immediately prior to C1D1; prior adjuvant exemestane is allowed if the disease free interval is \> 12 months from the discontinuation of exemestane; prior faslodex, everolimus, palbociclib or other cyclin-dependent kinase (CDK) inhibitor (e.g. ribociclib, abemaciclib) use are allowed and must have been completed \>= 2 weeks prior to C1D1; failure to adhere to this washout guideline will result in a protocol violation * Patients may have received only one prior chemotherapy regimen for metastatic disease provided treatment was completed \>= 3 weeks prior to randomization * Patients may be treated with bone modifying agents such as bisphosphonates or RANK-ligand agents (e.g. denosumab) per American Society of Clinical Oncology (ASCO) guidelines; whenever possible, patients requiring bone modifying agents should start treatment \>= 7 days prior to study therapy and should continue the same agent throughout study unless clinically compelled to change * Prior radiotherapy must in general have been completed \>= 2 weeks prior to randomization and patients must have recovered from the toxicity of the radiation * NOTE: Patients may receive concurrent radiation therapy to painful sites of bony disease or areas of impending fracture as long as sites of measurable or non-measurable disease outside the radiation therapy port are available to follow * Patients must NOT receive concurrent anti-cancer therapy or investigational agent unless specified in protocol * Patients must NOT be receiving valproic acid, an histone deacetylase (HDAC) inhibitor, and may not have previously received any HDAC inhibitor prior to enrollment (e.g. valproic acid, entinostat, vorinostat) unless discussed with the study chair; patients must not have received prior HDAC therapy for the treatment of their malignancy * Patients must have no known allergies to exemestane, entinostat, or medications that have a benzamide structure (e.g., tiapride, remoxipride, clebropride) * Patients must NOT suffer from medical or psychiatric conditions that would interfere with protocol compliance, the ability to provide informed consent, or assessment of response or anticipated toxicities; this includes uncontrolled intercurrent illness including, but not limited to ongoing or active infection * Patients must have recovered from all clinically relevant adverse events to grade 1 or baseline due to previous agents administered (except alopecia) * Patients must have adequate hematologic, liver and renal function =\< 28 days prior to randomization * NOTE: It is preferred that laboratory values for eligibility be assessed after the last dose of prior treatment, especially in cases where most-recent treatment prior to study entry is chemotherapy * Hemoglobin (HgB) \>= 9.0 g/dL (=\< 28 days prior to randomization) * Platelet count \>= 100,000/mcL (=\< 28 days prior to randomization) * Absolute neutrophil count \>= 1,500/mcL (=\< 28 days prior to randomization) * Creatinine =\< 2.0 mg/dL (=\< 28 days prior to randomization) * Total bilirubin \< 1.5 x institutional upper limit of normal (=\< 3 mg/dL in case of Gilbert's syndrome) (=\< 28 days prior to randomization) * Transaminases (alanine aminotransferase \[ALT\], aspartate aminotransferase \[AST\]) =\< 2.5 x institutional upper limit normal (=\< 28 days prior to randomization) * Known human immunodeficiency virus (HIV)-positive patients should have a cluster of differentiation (CD)4 count \> 250/mm\^3 * Patients must have Eastern Cooperative Oncology Group (ECOG) performance status 0-1 * Patients must have a life expectancy \>= 12 weeks * Patients must be able to swallow tablets

Locations (655)

University of Alabama at Birmingham Cancer Center

Birmingham, Alabama, United States

NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro

Jonesboro, Arkansas, United States

Mercy San Juan Medical Center

Carmichael, California, United States

Enloe Medical Center

Chico, California, United States

Adventist Health Cancer Care Center Chico

Chico, California, United States

Community Cancer Institute

Clovis, California, United States

University Oncology Associates

Clovis, California, United States

Eisenhower Medical Center

Rancho Mirage, California, United States

Mercy Cancer Center - Sacramento

Sacramento, California, United States

Saint Helena Hospital

St. Helena, California, United States

Presbyterian Intercommunity Hospital

Whittier, California, United States

Woodland Memorial Hospital

Woodland, California, United States

Rocky Mountain Cancer Centers-Aurora

Aurora, Colorado, United States

The Medical Center of Aurora

Aurora, Colorado, United States

Boulder Community Foothills Hospital

Boulder, Colorado, United States

Rocky Mountain Cancer Centers-Boulder

Boulder, Colorado, United States

Penrose-Saint Francis Healthcare

Colorado Springs, Colorado, United States

Rocky Mountain Cancer Centers-Penrose

Colorado Springs, Colorado, United States

UCHealth Memorial Hospital Central

Colorado Springs, Colorado, United States

AdventHealth Porter

Denver, Colorado, United States

Colorado Blood Cancer Institute

Denver, Colorado, United States

Presbyterian - Saint Lukes Medical Center - Health One

Denver, Colorado, United States

Rocky Mountain Cancer Centers-Midtown

Denver, Colorado, United States

Saint Joseph Hospital - Cancer Centers of Colorado

Denver, Colorado, United States

Rocky Mountain Cancer Centers-Rose

Denver, Colorado, United States

Rose Medical Center

Denver, Colorado, United States

CommonSpirit Cancer Center Mercy

Durango, Colorado, United States

Mercy Medical Center

Durango, Colorado, United States

Mountain Blue Cancer Care Center - Swedish

Englewood, Colorado, United States

Swedish Medical Center

Englewood, Colorado, United States

Mountain Blue Cancer Care Center

Golden, Colorado, United States

Banner North Colorado Medical Center

Greeley, Colorado, United States

Rocky Mountain Cancer Centers-Greenwood Village

Greenwood Village, Colorado, United States

Rocky Mountain Cancer Centers-Lakewood

Lakewood, Colorado, United States

Saint Anthony Hospital

Lakewood, Colorado, United States

Rocky Mountain Cancer Centers-Littleton

Littleton, Colorado, United States

AdventHealth Littleton

Littleton, Colorado, United States

Rocky Mountain Cancer Centers-Sky Ridge

Lone Tree, Colorado, United States

Sky Ridge Medical Center

Lone Tree, Colorado, United States

Longmont United Hospital

Longmont, Colorado, United States

Rocky Mountain Cancer Centers-Longmont

Longmont, Colorado, United States

Banner North Colorado Medical Center - Loveland Campus

Loveland, Colorado, United States

AdventHealth Parker

Parker, Colorado, United States

Rocky Mountain Cancer Centers-Parker

Parker, Colorado, United States

Saint Mary Corwin Medical Center

Pueblo, Colorado, United States

Rocky Mountain Cancer Centers - Pueblo

Pueblo, Colorado, United States

Rocky Mountain Cancer Centers-Thornton

Thornton, Colorado, United States

Intermountain Health Lutheran Hospital

Wheat Ridge, Colorado, United States

Smilow Cancer Hospital Care Center - Guilford

Guilford, Connecticut, United States

Smilow Cancer Hospital Care Center at Saint Francis

Hartford, Connecticut, United States

Manchester Memorial Hospital

Manchester, Connecticut, United States

Middlesex Hospital

Middletown, Connecticut, United States

The Hospital of Central Connecticut

New Britain, Connecticut, United States

Yale University

New Haven, Connecticut, United States

Smilow Cancer Hospital-Orange Care Center

Orange, Connecticut, United States

Smilow Cancer Hospital-Torrington Care Center

Torrington, Connecticut, United States

Smilow Cancer Hospital Care Center - Waterford

Waterford, Connecticut, United States

Bayhealth Hospital Kent Campus

Dover, Delaware, United States

Beebe Medical Center

Lewes, Delaware, United States

Helen F Graham Cancer Center

Newark, Delaware, United States

Medical Oncology Hematology Consultants PA

Newark, Delaware, United States

Christiana Care Health System-Christiana Hospital

Newark, Delaware, United States

Beebe Health Campus

Rehoboth Beach, Delaware, United States

TidalHealth Nanticoke / Allen Cancer Center

Seaford, Delaware, United States

Christiana Care Health System-Wilmington Hospital

Wilmington, Delaware, United States

MedStar Georgetown University Hospital

Washington D.C., District of Columbia, United States

MedStar Washington Hospital Center

Washington D.C., District of Columbia, United States

Sibley Memorial Hospital

Washington D.C., District of Columbia, United States

UM Sylvester Comprehensive Cancer Center at Deerfield Beach

Deerfield Beach, Florida, United States

UF Health Cancer Institute - Gainesville

Gainesville, Florida, United States

Baptist MD Anderson Cancer Center

Jacksonville, Florida, United States

Lakeland Regional Health Hollis Cancer Center

Lakeland, Florida, United States

University of Miami Miller School of Medicine-Sylvester Cancer Center

Miami, Florida, United States

UM Sylvester Comprehensive Cancer Center at Kendall

Miami, Florida, United States

UM Sylvester Comprehensive Cancer Center at Plantation

Plantation, Florida, United States

Cleveland Clinic-Weston

Weston, Florida, United States

Grady Health System

Atlanta, Georgia, United States

Emory University Hospital Midtown

Atlanta, Georgia, United States

Emory University Hospital/Winship Cancer Institute

Atlanta, Georgia, United States

Emory Saint Joseph's Hospital

Atlanta, Georgia, United States

John B Amos Cancer Center

Columbus, Georgia, United States

Atrium Health Navicent

Macon, Georgia, United States

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

Savannah, Georgia, United States

Hawaii Cancer Care Inc - Waterfront Plaza

Honolulu, Hawaii, United States

Queen's Cancer Cenrer - POB I

Honolulu, Hawaii, United States

Queen's Medical Center

Honolulu, Hawaii, United States

Straub Clinic and Hospital

Honolulu, Hawaii, United States

University of Hawaii Cancer Center

Honolulu, Hawaii, United States

Hawaii Cancer Care Inc-Liliha

Honolulu, Hawaii, United States

Queen's Cancer Center - Kuakini

Honolulu, Hawaii, United States

Pali Momi Medical Center

‘Aiea, Hawaii, United States

Queen's Cancer Center - Pearlridge

‘Aiea, Hawaii, United States

Saint Alphonsus Cancer Care Center-Boise

Boise, Idaho, United States

Saint Luke's Cancer Institute - Boise

Boise, Idaho, United States

Kootenai Health - Coeur d'Alene

Coeur d'Alene, Idaho, United States

Saint Luke's Cancer Institute - Fruitland

Fruitland, Idaho, United States

Kootenai Clinic Cancer Services - Post Falls

Post Falls, Idaho, United States

Kootenai Clinic Cancer Services - Sandpoint

Sandpoint, Idaho, United States

Saint Luke's Cancer Institute - Twin Falls

Twin Falls, Idaho, United States

Rush-Copley Medical Center

Aurora, Illinois, United States

OSF Saint Joseph Medical Center

Bloomington, Illinois, United States

Illinois CancerCare-Bloomington

Bloomington, Illinois, United States

Illinois CancerCare-Canton

Canton, Illinois, United States

Memorial Hospital of Carbondale

Carbondale, Illinois, United States

Illinois CancerCare-Carthage

Carthage, Illinois, United States

Centralia Oncology Clinic

Centralia, Illinois, United States

Northwestern University

Chicago, Illinois, United States

John H Stroger Jr Hospital of Cook County

Chicago, Illinois, United States

Swedish Covenant Hospital

Chicago, Illinois, United States

University of Chicago Comprehensive Cancer Center

Chicago, Illinois, United States

Weiss Memorial Hospital

Chicago, Illinois, United States

UChicago Medicine Comprehensive Cancer Center - Saint Joseph Hospital

Chicago, Illinois, United States

Carle at The Riverfront

Danville, Illinois, United States

Cancer Care Specialists of Illinois - Decatur

Decatur, Illinois, United States

Decatur Memorial Hospital

Decatur, Illinois, United States

Carle Physician Group-Effingham

Effingham, Illinois, United States

Crossroads Cancer Center

Effingham, Illinois, United States

Ascension Alexian Brothers - Elk Grove Village

Elk Grove Village, Illinois, United States

Elmhurst Memorial Hospital

Elmhurst, Illinois, United States

Illinois CancerCare-Eureka

Eureka, Illinois, United States

Saint Francis Hospital

Evanston, Illinois, United States

Freeport Memorial Hospital/Leonard C Ferguson Cancer Center

Freeport, Illinois, United States

Illinois CancerCare-Galesburg

Galesburg, Illinois, United States

Western Illinois Cancer Treatment Center

Galesburg, Illinois, United States

Northwestern Medicine Cancer Center Delnor

Geneva, Illinois, United States

Ingalls Memorial Hospital

Harvey, Illinois, United States

Duly Health and Care Joliet

Joliet, Illinois, United States

Presence Saint Mary's Hospital

Kankakee, Illinois, United States

Illinois CancerCare-Kewanee Clinic

Kewanee, Illinois, United States

Illinois CancerCare-Macomb

Macomb, Illinois, United States

Carle Physician Group-Mattoon/Charleston

Mattoon, Illinois, United States

Loyola University Medical Center

Maywood, Illinois, United States

SSM Health Good Samaritan

Mount Vernon, Illinois, United States

Edward Hospital/Cancer Center

Naperville, Illinois, United States

Carle Cancer Institute Normal

Normal, Illinois, United States

Advocate Christ Medical Center

Oak Lawn, Illinois, United States

Illinois CancerCare-Ottawa Clinic

Ottawa, Illinois, United States

Radiation Oncology of Northern Illinois

Ottawa, Illinois, United States

Illinois CancerCare-Pekin

Pekin, Illinois, United States

OSF Saint Francis Radiation Oncology at Pekin

Pekin, Illinois, United States

Illinois CancerCare-Peoria

Peoria, Illinois, United States

OSF Saint Francis Radiation Oncology at Peoria Cancer Center

Peoria, Illinois, United States

Methodist Medical Center of Illinois

Peoria, Illinois, United States

OSF Saint Francis Medical Center

Peoria, Illinois, United States

Illinois CancerCare-Peru

Peru, Illinois, United States

Valley Radiation Oncology

Peru, Illinois, United States

Edward Hospital/Cancer Center?Plainfield

Plainfield, Illinois, United States

Illinois CancerCare-Princeton

Princeton, Illinois, United States

West Suburban Medical Center

River Forest, Illinois, United States

UW Health Carbone Cancer Center Rockford

Rockford, Illinois, United States

Central Illinois Hematology Oncology Center

Springfield, Illinois, United States

Southern Illinois University School of Medicine

Springfield, Illinois, United States

Springfield Clinic

Springfield, Illinois, United States

Springfield Memorial Hospital

Springfield, Illinois, United States

Carle Cancer Center

Urbana, Illinois, United States

The Carle Foundation Hospital

Urbana, Illinois, United States

Northwestern Medicine Cancer Center Warrenville

Warrenville, Illinois, United States

Rush-Copley Healthcare Center

Yorkville, Illinois, United States

IU Health North Hospital

Carmel, Indiana, United States

IU Health Central Indiana Cancer Centers-Fishers

Fishers, Indiana, United States

Fort Wayne Medical Oncology and Hematology Inc-Parkview

Fort Wayne, Indiana, United States

Indiana University/Melvin and Bren Simon Cancer Center

Indianapolis, Indiana, United States

IU Health Methodist Hospital

Indianapolis, Indiana, United States

Sidney and Lois Eskenazi Hospital

Indianapolis, Indiana, United States

IU Health Central Indiana Cancer Centers-East

Indianapolis, Indiana, United States

Franciscan Health Indianapolis

Indianapolis, Indiana, United States

Springmill Medical Center

Indianapolis, Indiana, United States

IU Health Arnett Cancer Care

Lafayette, Indiana, United States

Woodland Cancer Care Center

Michigan City, Indiana, United States

Franciscan Health Mooresville

Mooresville, Indiana, United States

IU Health Ball Memorial Hospital

Muncie, Indiana, United States

Reid Health

Richmond, Indiana, United States

Union Hospital

Terre Haute, Indiana, United States

Mary Greeley Medical Center

Ames, Iowa, United States

McFarland Clinic - Ames

Ames, Iowa, United States

University of Iowa Healthcare Cancer Services Quad Cities

Bettendorf, Iowa, United States

McFarland Clinic - Boone

Boone, Iowa, United States

Mercy Hospital

Cedar Rapids, Iowa, United States

Oncology Associates at Mercy Medical Center

Cedar Rapids, Iowa, United States

Mercy Cancer Center-West Lakes

Clive, Iowa, United States

UI Health Care Mission Cancer and Blood - West Des Moines Clinic

Clive, Iowa, United States

Alegent Health Mercy Hospital

Council Bluffs, Iowa, United States

MercyOne Genesis Davenport Medical Center

Davenport, Iowa, United States

Iowa Methodist Medical Center

Des Moines, Iowa, United States

UI Health Care Mission Cancer and Blood - Des Moines Clinic

Des Moines, Iowa, United States

Broadlawns Medical Center

Des Moines, Iowa, United States

Mercy Medical Center - Des Moines

Des Moines, Iowa, United States

UI Health Care Mission Cancer and Blood - Laurel Clinic

Des Moines, Iowa, United States

McFarland Clinic - Trinity Cancer Center

Fort Dodge, Iowa, United States

UI Healthcare Mission Cancer and Blood - Fort Dodge

Fort Dodge, Iowa, United States

University of Iowa/Holden Comprehensive Cancer Center

Iowa City, Iowa, United States

McFarland Clinic - Jefferson

Jefferson, Iowa, United States

McFarland Clinic - Marshalltown

Marshalltown, Iowa, United States

Mercy Medical Center - North Iowa

Mason City, Iowa, United States

Siouxland Regional Cancer Center

Sioux City, Iowa, United States

Mercy Medical Center-West Lakes

West Des Moines, Iowa, United States

Cancer Center of Kansas - Chanute

Chanute, Kansas, United States

Cancer Center of Kansas - Dodge City

Dodge City, Kansas, United States

Cancer Center of Kansas - El Dorado

El Dorado, Kansas, United States

Cancer Center of Kansas - Fort Scott

Fort Scott, Kansas, United States

Saint Catherine Hospital

Garden City, Kansas, United States

Central Care Cancer Center - Great Bend

Great Bend, Kansas, United States

Saint Rose Ambulatory and Surgery Center

Great Bend, Kansas, United States

HaysMed

Hays, Kansas, United States

Cancer Center of Kansas-Independence

Independence, Kansas, United States

University of Kansas Cancer Center-West

Kansas City, Kansas, United States

Cancer Center of Kansas-Kingman

Kingman, Kansas, United States

Lawrence Memorial Hospital

Lawrence, Kansas, United States

Kansas Institute of Medicine Cancer and Blood Center

Lenexa, Kansas, United States

Minimally Invasive Surgery Hospital

Lenexa, Kansas, United States

Cancer Center of Kansas-Liberal

Liberal, Kansas, United States

Cancer Center of Kansas-Manhattan

Manhattan, Kansas, United States

Cancer Center of Kansas - McPherson

McPherson, Kansas, United States

Cancer Center of Kansas - Newton

Newton, Kansas, United States

The University of Kansas Cancer Center - Olathe

Olathe, Kansas, United States

Menorah Medical Center

Overland Park, Kansas, United States

University of Kansas Cancer Center-Overland Park

Overland Park, Kansas, United States

Cancer Center of Kansas - Parsons

Parsons, Kansas, United States

Cancer Center of Kansas - Pratt

Pratt, Kansas, United States

Cancer Center of Kansas - Salina

Salina, Kansas, United States

Salina Regional Health Center

Salina, Kansas, United States

University of Kansas Health System Saint Francis Campus

Topeka, Kansas, United States

Cancer Center of Kansas - Wellington

Wellington, Kansas, United States

Associates In Womens Health

Wichita, Kansas, United States

Cancer Center of Kansas-Wichita Medical Arts Tower

Wichita, Kansas, United States

Ascension Via Christi Hospitals Wichita

Wichita, Kansas, United States

Cancer Center of Kansas - Wichita

Wichita, Kansas, United States

Cancer Center of Kansas - Winfield

Winfield, Kansas, United States

Flaget Memorial Hospital

Bardstown, Kentucky, United States

Baptist Health Corbin

Corbin, Kentucky, United States

Oncology Hematology Care Inc-Crestview

Crestview Hills, Kentucky, United States

Saint Elizabeth Healthcare Edgewood

Edgewood, Kentucky, United States

Baptist Health Hardin

Elizabethtown, Kentucky, United States

Saint Elizabeth Healthcare Fort Thomas

Fort Thomas, Kentucky, United States

Baptist Health Lexington

Lexington, Kentucky, United States

Saint Joseph Radiation Oncology Resource Center

Lexington, Kentucky, United States

Saint Joseph Hospital East

Lexington, Kentucky, United States

University of Kentucky/Markey Cancer Center

Lexington, Kentucky, United States

Jewish Hospital

Louisville, Kentucky, United States

Baptist Health Louisville

Louisville, Kentucky, United States

UofL Health Medical Center Northeast

Louisville, Kentucky, United States

Baptist Health Madisonville/Merle Mahr Cancer Center

Madisonville, Kentucky, United States

Baptist Health Paducah

Paducah, Kentucky, United States

LSU Health Baton Rouge-North Clinic

Baton Rouge, Louisiana, United States

Our Lady of the Lake Physician Group

Baton Rouge, Louisiana, United States

Hematology/Oncology Clinic PLLC

Baton Rouge, Louisiana, United States

Louisiana Hematology Oncology Associates LLC

Baton Rouge, Louisiana, United States

Mary Bird Perkins Cancer Center

Baton Rouge, Louisiana, United States

Ochsner Health Center-Summa

Baton Rouge, Louisiana, United States

Medical Center of Baton Rouge

Baton Rouge, Louisiana, United States

Mary Bird Perkins Cancer Center - Covington

Covington, Louisiana, United States

Northshore Oncology Associates-Covington

Covington, Louisiana, United States

Mary Bird Perkins Cancer Center - Houma

Houma, Louisiana, United States

Oncology Center of The South Incorporated

Houma, Louisiana, United States

Louisiana State University Health Science Center

New Orleans, Louisiana, United States

University Medical Center New Orleans

New Orleans, Louisiana, United States

Ochsner Medical Center Jefferson

New Orleans, Louisiana, United States

Harold Alfond Center for Cancer Care

Augusta, Maine, United States

Eastern Maine Medical Center

Bangor, Maine, United States

Lafayette Family Cancer Center-EMMC

Brewer, Maine, United States

Penobscot Bay Medical Center

Rockport, Maine, United States

York Hospital

York Village, Maine, United States

Luminis Health Anne Arundel Medical Center

Annapolis, Maryland, United States

University of Maryland/Greenebaum Cancer Center

Baltimore, Maryland, United States

Greater Baltimore Medical Center

Baltimore, Maryland, United States

Sinai Hospital of Baltimore

Baltimore, Maryland, United States

MedStar Franklin Square Medical Center/Weinberg Cancer Institute

Baltimore, Maryland, United States

Johns Hopkins University/Sidney Kimmel Cancer Center

Baltimore, Maryland, United States

UM Upper Chesapeake Medical Center

Bel Air, Maryland, United States

UPMC Western Maryland

Cumberland, Maryland, United States

University of Maryland Shore Medical Center at Easton

Easton, Maryland, United States

MedStar Montgomery Medical Center

Olney, Maryland, United States

Northwest Hospital Center

Randallstown, Maryland, United States

Beverly Hospital

Beverly, Massachusetts, United States

Lahey Hospital and Medical Center

Burlington, Massachusetts, United States

Saint Anne's Hospital

Fall River, Massachusetts, United States

Addison Gilbert Hospital

Gloucester, Massachusetts, United States

Newton-Wellesley Hospital

Newton, Massachusetts, United States

Berkshire Medical Center - Cancer Center

Pittsfield, Massachusetts, United States

Beth Israel Deaconess Medical Center/Winchester Center for Cancer Care

Winchester, Massachusetts, United States

UMass Memorial Medical Center - University Campus

Worcester, Massachusetts, United States

Hickman Cancer Center

Adrian, Michigan, United States

Trinity Health Saint Joseph Mercy Hospital Ann Arbor

Ann Arbor, Michigan, United States

Henry Ford Cancer Institute-Downriver

Brownstown, Michigan, United States

Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital

Chelsea, Michigan, United States

Henry Ford Macomb Hospital-Clinton Township

Clinton Township, Michigan, United States

Corewell Health Dearborn Hospital

Dearborn, Michigan, United States

Henry Ford Medical Center-Fairlane

Dearborn, Michigan, United States

Wayne State University/Karmanos Cancer Institute

Detroit, Michigan, United States

Henry Ford Hospital

Detroit, Michigan, United States

Henry Ford Health Saint John Hospital

Detroit, Michigan, United States

OSF Saint Francis Hospital and Medical Group

Escanaba, Michigan, United States

Weisberg Cancer Treatment Center

Farmington Hills, Michigan, United States

Genesys Hurley Cancer Institute

Flint, Michigan, United States

Hurley Medical Center

Flint, Michigan, United States

Corewell Health Grand Rapids Hospitals - Butterworth Hospital

Grand Rapids, Michigan, United States

William Beaumont Hospital-Grosse Pointe

Grosse Pointe, Michigan, United States

Allegiance Health

Jackson, Michigan, United States

West Michigan Cancer Center

Kalamazoo, Michigan, United States

Beacon Kalamazoo

Kalamazoo, Michigan, United States

Trinity Health Saint Mary Mercy Livonia Hospital

Livonia, Michigan, United States

Henry Ford Medical Center-Columbus

Novi, Michigan, United States

Trinity Health Saint Joseph Mercy Oakland Hospital

Pontiac, Michigan, United States

Lake Huron Medical Center

Port Huron, Michigan, United States

Corewell Health William Beaumont University Hospital

Royal Oak, Michigan, United States

MyMichigan Medical Center Saginaw

Saginaw, Michigan, United States

Corewell Health Beaumont Troy Hospital

Troy, Michigan, United States

Henry Ford Health Warren Hospital

Warren, Michigan, United States

Henry Ford West Bloomfield Hospital

West Bloomfield, Michigan, United States

Sanford Joe Lueken Cancer Center

Bemidji, Minnesota, United States

Essentia Health Saint Joseph's Medical Center

Brainerd, Minnesota, United States

Mercy Hospital

Coon Rapids, Minnesota, United States

Essentia Health Cancer Center

Duluth, Minnesota, United States

Lake Region Healthcare Corporation-Cancer Care

Fergus Falls, Minnesota, United States

Minnesota Oncology Hematology PA-Maplewood

Maplewood, Minnesota, United States

Saint John's Hospital - Healtheast

Maplewood, Minnesota, United States

Abbott-Northwestern Hospital

Minneapolis, Minnesota, United States

Health Partners Inc

Minneapolis, Minnesota, United States

New Ulm Medical Center

New Ulm, Minnesota, United States

Coborn Cancer Center at Saint Cloud Hospital

Saint Cloud, Minnesota, United States

Regions Hospital

Saint Paul, Minnesota, United States

Lakeview Hospital

Stillwater, Minnesota, United States

Rice Memorial Hospital

Willmar, Minnesota, United States

Baptist Memorial Hospital and Cancer Center-Golden Triangle

Columbus, Mississippi, United States

Baptist Cancer Center-Grenada

Grenada, Mississippi, United States

Hattiesburg Clinic - Hematology/Oncology Clinic

Hattiesburg, Mississippi, United States

Forrest General Hospital / Cancer Center

Hattiesburg, Mississippi, United States

University of Mississippi Medical Center

Jackson, Mississippi, United States

Baptist Memorial Hospital and Cancer Center-Union County

New Albany, Mississippi, United States

Baptist Memorial Hospital and Cancer Center-Oxford

Oxford, Mississippi, United States

Singing River Hospital

Pascagoula, Mississippi, United States

Baptist Memorial Hospital and Cancer Center-Desoto

Southhaven, Mississippi, United States

Mercy Oncology and Hematology - Clayton-Clarkson

Ballwin, Missouri, United States

Parkland Health Center-Bonne Terre

Bonne Terre, Missouri, United States

Cox Cancer Center Branson

Branson, Missouri, United States

Mercy Cancer Center - Cape Girardeau

Cape Girardeau, Missouri, United States

Saint Francis Medical Center

Cape Girardeau, Missouri, United States

Saint Luke's Hospital

Chesterfield, Missouri, United States

Siteman Cancer Center at Saint Peters Hospital

City of Saint Peters, Missouri, United States

MU Health - University Hospital/Ellis Fischel Cancer Center

Columbia, Missouri, United States

Siteman Cancer Center at West County Hospital

Creve Coeur, Missouri, United States

Centerpoint Medical Center LLC

Independence, Missouri, United States

MU Health Care Goldschmidt Cancer Center

Jefferson City, Missouri, United States

University Health Truman Medical Center

Kansas City, Missouri, United States

The University of Kansas Cancer Center-South

Kansas City, Missouri, United States

Research Medical Center

Kansas City, Missouri, United States

University of Kansas Cancer Center - North

Kansas City, Missouri, United States

University of Kansas Cancer Center - Lee's Summit

Lee's Summit, Missouri, United States

Sainte Genevieve County Memorial Hospital

Sainte Genevieve, Missouri, United States

Mercy Hospital Springfield

Springfield, Missouri, United States

CoxHealth South Hospital

Springfield, Missouri, United States

Mercy Infusion Center - Chippewa

St Louis, Missouri, United States

Washington University School of Medicine

St Louis, Missouri, United States

Missouri Baptist Medical Center

St Louis, Missouri, United States

Mercy Hospital Saint Louis

St Louis, Missouri, United States

Missouri Baptist Sullivan Hospital

Sullivan, Missouri, United States

BJC Outpatient Center at Sunset Hills

Sunset Hills, Missouri, United States

Saint Vincent Healthcare

Billings, Montana, United States

Bozeman Health Deaconess Hospital

Bozeman, Montana, United States

Saint James Community Hospital and Cancer Treatment Center

Butte, Montana, United States

Benefis Sletten Cancer Institute

Great Falls, Montana, United States

Saint Peter's Community Hospital

Helena, Montana, United States

Logan Health Medical Center

Kalispell, Montana, United States

Saint Patrick Hospital - Community Hospital

Missoula, Montana, United States

Nebraska Cancer Specialists/Oncology Hematology West PC

Grand Island, Nebraska, United States

CHI Health Good Samaritan

Kearney, Nebraska, United States

Alegent Health Immanuel Medical Center

Omaha, Nebraska, United States

Alegent Health Bergan Mercy Medical Center

Omaha, Nebraska, United States

Alegent Health Lakeside Hospital

Omaha, Nebraska, United States

Creighton University Medical Center

Omaha, Nebraska, United States

Wentworth-Douglass Hospital

Dover, New Hampshire, United States

Cheshire Medical Center-Dartmouth-Hitchcock Keene

Keene, New Hampshire, United States

Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center

Lebanon, New Hampshire, United States

Dartmouth Cancer Center - Manchester

Manchester, New Hampshire, United States

Saint Joseph Hospital

Nashua, New Hampshire, United States

Dartmouth Cancer Center - Nashua

Nashua, New Hampshire, United States

AtlantiCare Health Park-Cape May Court House

Cape May Court House, New Jersey, United States

AtlantiCare Surgery Center

Egg Harbor, New Jersey, United States

Englewood Hospital and Medical Center

Englewood, New Jersey, United States

Hackensack University Medical Center

Hackensack, New Jersey, United States

The Cancer Institute of New Jersey Hamilton

Hamilton, New Jersey, United States

Monmouth Medical Center

Long Branch, New Jersey, United States

Virtua Memorial

Mount Holly, New Jersey, United States

Inspira Medical Center Mullica Hill

Mullica Hill, New Jersey, United States

Jersey Shore Medical Center

Neptune City, New Jersey, United States

Robert Wood Johnson University Hospital Somerset

Somerville, New Jersey, United States

Inspira Medical Center Vineland

Vineland, New Jersey, United States

Virtua Voorhees

Voorhees Township, New Jersey, United States

University of New Mexico Cancer Center

Albuquerque, New Mexico, United States

New Mexico Oncology Hematology Consultants

Albuquerque, New Mexico, United States

Presbyterian Kaseman Hospital

Albuquerque, New Mexico, United States

Memorial Medical Center-Las Cruces

Las Cruces, New Mexico, United States

Christus Saint Vincent Regional Cancer Center

Santa Fe, New Mexico, United States

Hematology Oncology Associates of Central New York-Auburn

Auburn, New York, United States

Kings County Hospital

Brooklyn, New York, United States

State University of New York Downstate Medical Center

Brooklyn, New York, United States

Roswell Park Cancer Institute

Buffalo, New York, United States

Hematology Oncology Associates of CNY at Camillus

Camillus, New York, United States

Hematology Oncology Associates of Central New York-East Syracuse

East Syracuse, New York, United States

Arnot Ogden Medical Center/Falck Cancer Center

Elmira, New York, United States

Mount Sinai Union Square

New York, New York, United States

Mount Sinai West

New York, New York, United States

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

New York, New York, United States

NYP/Weill Cornell Medical Center

New York, New York, United States

University of Rochester

Rochester, New York, United States

Staten Island University Hospital

Staten Island, New York, United States

Montefiore Medical Center-Einstein Campus

The Bronx, New York, United States

Montefiore Medical Center-Weiler Hospital

The Bronx, New York, United States

Montefiore Medical Center - Moses Campus

The Bronx, New York, United States

Dickstein Cancer Treatment Center

White Plains, New York, United States

Randolph Hospital

Asheboro, North Carolina, United States

Mission Hospital

Asheville, North Carolina, United States

Messino Cancer Centers

Asheville, North Carolina, United States

Hope Women's Cancer Centers-Asheville

Asheville, North Carolina, United States

Cone Health Cancer Center at Alamance Regional

Burlington, North Carolina, United States

UNC Lineberger Comprehensive Cancer Center

Chapel Hill, North Carolina, United States

Southeastern Medical Oncology Center-Clinton

Clinton, North Carolina, United States

Southeastern Medical Oncology Center-Goldsboro

Goldsboro, North Carolina, United States

Wayne Memorial Hospital

Goldsboro, North Carolina, United States

Cone Health Cancer Center

Greensboro, North Carolina, United States

Margaret R Pardee Memorial Hospital

Hendersonville, North Carolina, United States

Southeastern Medical Oncology Center-Jacksonville

Jacksonville, North Carolina, United States

ECU Health Oncology Kinston

Kinston, North Carolina, United States

Cone Heath Cancer Center at Mebane

Mebane, North Carolina, United States

Annie Penn Memorial Hospital

Reidsville, North Carolina, United States

Marion L Shepard Cancer Center - ECU Health Beaufort Hospital

Washington, North Carolina, United States

Wake Forest University Health Sciences

Winston-Salem, North Carolina, United States

Sanford Bismarck Medical Center

Bismarck, North Dakota, United States

Essentia Health Cancer Center-South University Clinic

Fargo, North Dakota, United States

Sanford Broadway Medical Center

Fargo, North Dakota, United States

Sanford Roger Maris Cancer Center

Fargo, North Dakota, United States

Altru Cancer Center

Grand Forks, North Dakota, United States

Trinity Cancer Care Center

Minot, North Dakota, United States

Summa Health System - Akron Campus

Akron, Ohio, United States

Cleveland Clinic Akron General

Akron, Ohio, United States

Strecker Cancer Center-Belpre

Belpre, Ohio, United States

Toledo Clinic Cancer Centers-Bowling Green

Bowling Green, Ohio, United States

Adena Regional Medical Center

Chillicothe, Ohio, United States

Oncology Hematology Care Inc-Eden Park