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Brief Title: Combination Chemotherapy With or Without Blinatumomab in Treating Patients With Newly Diagnosed BCR-ABL-Negative B Lineage Acute Lymphoblastic Leukemia
Official Title: A Phase III Randomized Trial of Blinatumomab for Newly Diagnosed BCR-ABL-Negative B Lineage Acute Lymphoblastic Leukemia in Adults
Study ID: NCT02003222
Brief Summary: This randomized phase III trial studies combination chemotherapy with blinatumomab to see how well it works compared to induction chemotherapy alone in treating patients with newly diagnosed breakpoint cluster region (BCR)-c-abl oncogene 1, non-receptor tyrosine kinase (ABL)-negative B lineage acute lymphoblastic leukemia. Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Immunotherapy with monoclonal antibodies, such as blinatumomab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. It is not yet known whether combination chemotherapy is more effective with or without blinatumomab in treating newly diagnosed acute lymphoblastic leukemia.
Detailed Description: PRIMARY OBJECTIVE: I. To compare the overall survival (OS) of blinatumomab in conjunction with chemotherapy to chemotherapy alone in patients with BCR-ABL-negative B cell precursor acute lymphoblastic leukemia (ALL) who are minimal residual disease (MRD) negative after induction and intensification chemotherapy, based on multiparameter flow cytometric (MFC) assessment of residual blasts. SECONDARY OBJECTIVES: I. To compare the relapse-free survival (RFS) of blinatumomab in conjunction with chemotherapy to chemotherapy alone in MRD negative patients after induction and intensification chemotherapy. II. To compare the OS and RFS of those patients who are MRD positive (+) at step 3 randomization/registration and then convert to MRD negative (-) after 2 cycles of blinatumomab to those patients who are MRD- at randomization and remain MRD- after 2 cycles of blinatumomab or consolidation chemotherapy. III. To assess the toxicities of blinatumomab in this patient population. IV. To assess the toxicities of the modified E2993 chemotherapy regimen in this patient population. V. To describe the outcome of patients who proceed to allogeneic blood or marrow transplant after treatment with or without blinatumomab. LABORATORY OBJECTIVES: I. To determine differences in MRD kinetics among patients with the BCR/ABL1-like B-lineage ALL, and to compare the OS (and RFS) of patients with BCR-ABL-like phenotype with those without BCR-ABL-like phenotype. II. To evaluate the incidence of anti-blinatumomab antibody formation. OUTLINE: INDUCTION CHEMOTHERAPY: Patients receive cytarabine intrathecally (IT) on day 1; daunorubicin hydrochloride intravenously (IV) over 10-15 minutes on days 1, 8, 15, and 22; vincristine sulfate IV on days 1, 8, 15, and 22; dexamethasone orally (PO) daily on days 1-7 (and 15-21 for patients age \< 55 years only); methotrexate IT on day 14; pegaspargase intramuscularly (IM) or IV on day 18 (patients age \< 55 years); and CD20 positive patients may optionally receive rituximab IV on day 8 and 15. Beginning on day 29, patients with absolute neutrophil count (ANC) \>= 0.75 x 10\^9/L and platelets \> 75 x 10\^9/L (patients with delayed hematologic recovery) (patients with residual disease that is delaying count begin treatment immediately) receive cyclophosphamide IV over 30 minutes on days 1 and 29, cytarabine IV over 30 minutes or subcutaneously (SC) on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO on days 1-14, 29-42, pegaspargase IM or IV on day 15 (patients age \< 55 years), patients receiving treatment for central nervous system (CNS) 2 or 3 leukemia in cycle 1 receive methotrexate IT on days 1, 8, 15, and 22, and CD20 positive patients may optionally receive rituximab IV on days 8 and 15. INTENSIFICATION THERAPY: Beginning 4 weeks after the completion of cycle 2 of induction therapy, patients receive intensification therapy comprising high-dose methotrexate IV over 2 hours on days 1 and 8, and pegaspargase IM or IV on day 9. Patients are then randomized to 1 of 2 treatment arms. Patients randomized to the blinatumomab group receive blinatumomab IV continuously on days 1-28. Treatment repeats every 6 weeks for 2 cycles in the absence of disease progression or unacceptable toxicity. Patients may then undergo allogeneic stem cell transplant (SCT) or proceed to consolidation therapy per investigator discretion. CONSOLIDATION THERAPY: Beginning after the second cycle of blinatumomab (patients randomized to the blinatumomab group) or after intensification therapy (patients not randomized to blinatumomab), patients receive cytarabine IV over 30 minutes or SC on days 1-5, etoposide IV over 1 hour on days 1-5, methotrexate IT on day 1, and pegaspargase IM or IV on day 5, and CD20 positive patients may optionally receive rituximab IV on day 5. Beginning 4 weeks from day 1 of cycle 1, patients receive cytarabine, etoposide, methotrexate, and CD20 positive patients may receive rituximab as in cycle 1. Beginning 4 weeks from day 1 of cycle 2, patients receive daunorubicin hydrochloride IV over 10-15 minutes on day 1, 8, 15, and 22; vincristine sulfate IV on days 1, 8, 15, and 22; dexamethasone PO daily on days 1-7 (and 15-21 for patients age \< 55 years); methotrexate IT on day 2; cyclophosphamide IV over 30 minutes on day 29; cytarabine IV over 30 minutes or SC on days 30-33 and 37-40; mercaptopurine PO on days 29-42 and CD20 positive patients may receive rituximab on day 8. Beginning 8 weeks from day 1 of cycle 3, patients receive cytarabine, etoposide, methotrexate, and CD20 positive patients may optionally receive rituximab as in cycle 1. Patients randomized to blinatumomab repeat cycle 4 and then receive blinatumomab IV continuously on days 1-28. MAINTENANCE THERAPY: Within 6 weeks after beginning last cycle of consolidation therapy, patients receive mercaptopurine PO daily, methotrexate PO or IV over 2 hours once weekly for 2.5 years, vincristine sulfate IV on day 1 every 3 months, prednisone PO on days 1-5 every 3 months, and methotrexate IT on day 1 every 3 months. Treatment continues for up to 2.5 years in the absence of disease progression or unacceptable toxicity. Patients undergo x-ray imaging during screening, lumbar puncture while on study, and bone marrow aspiration, bone marrow biopsy, and blood sample collection throughout the study. After completion of study treatment, patients are followed up every 3 months for 2 years, every 6 months for 3 years, and then every 12 months for 5 years.
Minimum Age: 30 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: Yes
University of Alabama at Birmingham Cancer Center, Birmingham, Alabama, United States
Anchorage Associates in Radiation Medicine, Anchorage, Alaska, United States
Anchorage Radiation Therapy Center, Anchorage, Alaska, United States
Alaska Breast Care and Surgery LLC, Anchorage, Alaska, United States
Alaska Oncology and Hematology LLC, Anchorage, Alaska, United States
Alaska Regional Hospital, Anchorage, Alaska, United States
Alaska Women's Cancer Care, Anchorage, Alaska, United States
Anchorage Oncology Centre, Anchorage, Alaska, United States
Katmai Oncology Group, Anchorage, Alaska, United States
Providence Alaska Medical Center, Anchorage, Alaska, United States
Fairbanks Memorial Hospital, Fairbanks, Alaska, United States
Kingman Regional Medical Center, Kingman, Arizona, United States
Banner University Medical Center - Tucson, Tucson, Arizona, United States
University of Arizona Cancer Center-North Campus, Tucson, Arizona, United States
Mercy Hospital Fort Smith, Fort Smith, Arkansas, United States
University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
PCR Oncology, Arroyo Grande, California, United States
Providence Saint Joseph Medical Center/Disney Family Cancer Center, Burbank, California, United States
Community Cancer Institute, Clovis, California, United States
University Oncology Associates, Clovis, California, United States
UC San Diego Moores Cancer Center, La Jolla, California, United States
UC Irvine Health/Chao Family Comprehensive Cancer Center, Orange, California, United States
Stanford Cancer Institute Palo Alto, Palo Alto, California, United States
Rocky Mountain Cancer Centers-Aurora, Aurora, Colorado, United States
The Medical Center of Aurora, Aurora, Colorado, United States
Boulder Community Hospital, Boulder, Colorado, United States
Rocky Mountain Cancer Centers-Boulder, Boulder, Colorado, United States
Cancer Center of Colorado at Sloan's Lake, Denver, Colorado, United States
National Jewish Health-Main Campus, Denver, Colorado, United States
The Women's Imaging Center, 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
SCL Health Saint Joseph Hospital, Denver, Colorado, United States
Rocky Mountain Cancer Centers-Rose, Denver, Colorado, United States
Rose Medical Center, Denver, Colorado, United States
Western Surgical Care, Denver, Colorado, United States
Mountain Blue Cancer Care Center - Swedish, Englewood, Colorado, United States
Swedish Medical Center, Englewood, Colorado, United States
National Jewish Health-Western Hematology Oncology, Golden, Colorado, United States
Saint Mary's Hospital and Regional Medical Center, Grand Junction, Colorado, United States
Grand Valley Oncology, Grand Junction, Colorado, United States
North Colorado Medical Center, Greeley, Colorado, United States
Good Samaritan Medical Center, Lafayette, Colorado, United States
Rocky Mountain Cancer Centers-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
McKee Medical Center, Loveland, Colorado, United States
National Jewish Health-Northern Hematology Oncology, Thornton, Colorado, United States
SCL Health Lutheran Medical Center, Wheat Ridge, Colorado, United States
Smilow Cancer Hospital Care Center at Saint Francis, Hartford, Connecticut, United States
Yale University, New Haven, Connecticut, United States
Smilow Cancer Hospital-Torrington Care Center, Torrington, Connecticut, United States
Sibley Memorial Hospital, Washington, District of Columbia, United States
UM Sylvester Comprehensive Cancer Center at Coral Springs, Coral Springs, Florida, United States
UM Sylvester Comprehensive Cancer Center at Deerfield Beach, Deerfield Beach, Florida, United States
UM Sylvester Comprehensive Cancer Center at Hollywood, Hollywood, Florida, United States
Baptist MD Anderson Cancer Center, Jacksonville, 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
Emory University Hospital/Winship Cancer Institute, Atlanta, Georgia, United States
Northside Hospital, Atlanta, Georgia, United States
Saint Alphonsus Cancer Care Center-Boise, Boise, Idaho, United States
Saint Luke's Cancer Institute - Boise, Boise, Idaho, United States
Saint Alphonsus Cancer Care Center-Caldwell, Caldwell, Idaho, United States
Kootenai Health - Coeur d'Alene, Coeur d'Alene, Idaho, United States
Walter Knox Memorial Hospital, Emmett, Idaho, United States
Saint Luke's Cancer Institute - Fruitland, Fruitland, Idaho, United States
Idaho Urologic Institute-Meridian, Meridian, Idaho, United States
Saint Luke's Cancer Institute - Meridian, Meridian, Idaho, United States
Saint Luke's Cancer Institute - Nampa, Nampa, Idaho, United States
Saint Alphonsus Cancer Care Center-Nampa, Nampa, Idaho, United States
Kootenai Clinic Cancer Services - Post Falls, Post Falls, Idaho, United States
Kootenai Cancer Clinic, Sandpoint, Idaho, United States
Saint Luke's Cancer Institute - Twin Falls, Twin Falls, Idaho, United States
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
SIH Cancer Institute, Carterville, Illinois, United States
Illinois CancerCare-Carthage, Carthage, Illinois, United States
Centralia Oncology Clinic, Centralia, Illinois, United States
Mount Sinai Hospital Medical Center, Chicago, Illinois, United States
Northwestern University, Chicago, Illinois, United States
University of Illinois, Chicago, Illinois, United States
University of Chicago Comprehensive Cancer Center, Chicago, Illinois, United States
Cancer Care Specialists of Illinois - Decatur, Decatur, Illinois, United States
Decatur Memorial Hospital, Decatur, Illinois, United States
Illinois CancerCare-Dixon, Dixon, Illinois, United States
Crossroads Cancer Center, Effingham, Illinois, United States
Illinois CancerCare-Eureka, Eureka, Illinois, United States
NorthShore University HealthSystem-Evanston Hospital, Evanston, Illinois, United States
Illinois CancerCare-Galesburg, Galesburg, Illinois, United States
Western Illinois Cancer Treatment Center, Galesburg, Illinois, United States
NorthShore University HealthSystem-Glenbrook Hospital, Glenview, Illinois, United States
Hematology Oncology Associates of Illinois-Highland Park, Highland Park, Illinois, United States
NorthShore University HealthSystem-Highland Park Hospital, Highland Park, Illinois, United States
Presence Saint Mary's Hospital, Kankakee, Illinois, United States
Illinois CancerCare-Kewanee Clinic, Kewanee, Illinois, United States
AMG Libertyville - Oncology, Libertyville, Illinois, United States
Illinois CancerCare-Macomb, Macomb, Illinois, United States
Loyola University Medical Center, Maywood, Illinois, United States
Good Samaritan Regional Health Center, Mount Vernon, Illinois, United States
Illinois Cancer Specialists-Niles, Niles, Illinois, United States
Cancer Care Center of O'Fallon, O'Fallon, 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 Cancer Treatment Center, 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
Illinois CancerCare-Princeton, Princeton, Illinois, United States
Hematology Oncology Associates of Illinois - Skokie, Skokie, Illinois, United States
North Shore Medical Center, Skokie, 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
Memorial Medical Center, Springfield, Illinois, United States
Southwest Illinois Health Services LLP, Swansea, Illinois, United States
Parkview Hospital Randallia, Fort Wayne, Indiana, United States
Parkview Regional Medical Center, Fort Wayne, Indiana, United States
Franciscan Health Indianapolis, Indianapolis, Indiana, United States
Franciscan Health Mooresville, Mooresville, Indiana, United States
Reid Health, Richmond, Indiana, United States
Mary Greeley Medical Center, Ames, Iowa, United States
McFarland Clinic - Ames, Ames, Iowa, United States
McFarland Clinic - Boone, Boone, Iowa, United States
McFarland Clinic - Trinity Cancer Center, Fort Dodge, Iowa, United States
McFarland Clinic - Jefferson, Jefferson, Iowa, United States
McFarland Clinic - Marshalltown, Marshalltown, 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
Central Care Cancer Center - Garden City, Garden City, Kansas, United States
Central Care Cancer Center - Great Bend, Great Bend, Kansas, United States
Cancer Center of Kansas-Independence, Independence, Kansas, United States
University of Kansas Cancer Center, 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
Olathe Health Cancer Center, Olathe, Kansas, United States
Menorah Medical Center, Overland Park, Kansas, United States
Saint Luke's South Hospital, 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
Cancer Center of Kansas - Wellington, Wellington, Kansas, United States
University of Kansas Hospital-Westwood Cancer Center, Westwood, 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
Wesley Medical Center, Wichita, Kansas, United States
Cancer Center of Kansas - Winfield, Winfield, Kansas, United States
Oncology Hematology Care Inc-Crestview, Crestview Hills, Kentucky, United States
The James Graham Brown Cancer Center at University of Louisville, Louisville, Kentucky, United States
Ochsner Health Center-Summa, Baton Rouge, Louisiana, United States
Medical Center of Baton Rouge, Baton Rouge, Louisiana, United States
Ochsner High Grove, Baton Rouge, Louisiana, United States
Ochsner LSU Health Monroe Medical Center, Monroe, Louisiana, United States
Ochsner Medical Center Jefferson, New Orleans, Louisiana, United States
LSU Health Sciences Center at Shreveport, Shreveport, Louisiana, United States
Eastern Maine Medical Center, Bangor, Maine, United States
Lafayette Family Cancer Center-EMMC, Brewer, Maine, United States
University of Maryland/Greenebaum Cancer Center, Baltimore, Maryland, United States
Johns Hopkins University/Sidney Kimmel Cancer Center, Baltimore, Maryland, United States
Walter Reed National Military Medical Center, Bethesda, Maryland, United States
Massachusetts General Hospital Cancer Center, Boston, Massachusetts, United States
Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
Dana-Farber Cancer Institute, Boston, Massachusetts, United States
Bixby Medical Center, Adrian, Michigan, United States
Hickman Cancer Center, Adrian, Michigan, United States
Saint Joseph Mercy Hospital, Ann Arbor, Michigan, United States
Bronson Battle Creek, Battle Creek, Michigan, United States
Henry Ford Cancer Institute-Downriver, Brownstown, Michigan, United States
Henry Ford Macomb Hospital-Clinton Township, Clinton Township, Michigan, United States
Beaumont Hospital - Dearborn, 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
Ascension Saint John Hospital, Detroit, Michigan, United States
Green Bay Oncology - Escanaba, Escanaba, Michigan, United States
Weisberg Cancer Treatment Center, Farmington Hills, Michigan, United States
Beaumont Hospital - Farmington Hills, Farmington Hills, Michigan, United States
Genesys Hurley Cancer Institute, Flint, Michigan, United States
Hurley Medical Center, Flint, Michigan, United States
Helen DeVos Children's Hospital at Spectrum Health, Grand Rapids, Michigan, United States
Spectrum Health at Butterworth Campus, Grand Rapids, Michigan, United States
Trinity Health Grand Rapids Hospital, Grand Rapids, Michigan, United States
William Beaumont Hospital-Grosse Pointe, Grosse Pointe, Michigan, United States
Allegiance Health, Jackson, Michigan, United States
Bronson Methodist Hospital, Kalamazoo, Michigan, United States
West Michigan Cancer Center, Kalamazoo, Michigan, United States
Borgess Medical Center, Kalamazoo, Michigan, United States
Sparrow Hospital, Lansing, Michigan, United States
Trinity Health Saint Mary Mercy Livonia Hospital, Livonia, Michigan, United States
Mercy Memorial Hospital, Monroe, Michigan, United States
Toledo Clinic Cancer Centers-Monroe, Monroe, Michigan, United States
Trinity Health Muskegon Hospital, Muskegon, Michigan, United States
Lakeland Hospital Niles, Niles, Michigan, United States
Cancer and Hematology Centers of Western Michigan - Norton Shores, Norton Shores, Michigan, United States
Henry Ford Medical Center-Columbus, Novi, Michigan, United States
Saint Joseph Mercy Oakland, Pontiac, Michigan, United States
Huron Medical Center PC, Port Huron, Michigan, United States
Lake Huron Medical Center, Port Huron, Michigan, United States
Spectrum Health Reed City Hospital, Reed City, Michigan, United States
Michigan Cancer Specialists, Roseville, Michigan, United States
Oakland Colon Rectal Associates, Royal Oak, Michigan, United States
Cancer Care Associates PC, Royal Oak, Michigan, United States
Comprehensive Medical Center PLLC, Royal Oak, Michigan, United States
Hematology Oncology Consultants PC, Royal Oak, Michigan, United States
Oakland Medical Group, Royal Oak, Michigan, United States
William Beaumont Hospital-Royal Oak, Royal Oak, Michigan, United States
Ascension Saint Mary's Hospital, Saginaw, Michigan, United States
Lakeland Medical Center Saint Joseph, Saint Joseph, Michigan, United States
Marie Yeager Cancer Center, Saint Joseph, Michigan, United States
Premier Hematology Oncology Care, Sterling Heights, Michigan, United States
Mitchell Folbe MD PC, Sterling Heights, Michigan, United States
Munson Medical Center, Traverse City, Michigan, United States
Michigan Institute of Urology-Town Center, Troy, Michigan, United States
Claudia BR Herke MD PC, Troy, Michigan, United States
William Beaumont Hospital - Troy, Troy, Michigan, United States
Hematology Oncology Consultants PC-Troy, Troy, Michigan, United States
Saint John Macomb-Oakland Hospital, Warren, Michigan, United States
Henry Ford West Bloomfield Hospital, West Bloomfield, Michigan, United States
University of Michigan Health - West, Wyoming, Michigan, United States
Mayo Clinic in Rochester, Rochester, Minnesota, United States
Saint Louis Cancer and Breast Institute-Ballwin, Ballwin, Missouri, United States
Central Care Cancer Center - Bolivar, Bolivar, Missouri, United States
Parkland Health Center-Bonne Terre, Bonne Terre, Missouri, United States
Cox Cancer Center Branson, Branson, Missouri, United States
Saint Francis Medical Center, Cape Girardeau, Missouri, United States
Southeast Cancer Center, Cape Girardeau, Missouri, United States
Siteman Cancer Center at West County Hospital, Creve Coeur, Missouri, United States
Parkland Health Center - Farmington, Farmington, Missouri, United States
Centerpoint Medical Center LLC, Independence, Missouri, United States
Capital Region Southwest Campus, Jefferson City, Missouri, United States
Freeman Health System, Joplin, Missouri, United States
Mercy Hospital Joplin, Joplin, Missouri, United States
Saint Luke's Hospital of Kansas City, Kansas City, Missouri, United States
Heartland Hematology and Oncology Associates Incorporated, Kansas City, Missouri, United States
Research Medical Center, Kansas City, Missouri, United States
Saint Luke's East - Lee's Summit, Lee's Summit, Missouri, United States
Liberty Radiation Oncology Center, Liberty, Missouri, United States
Delbert Day Cancer Institute at PCRMC, Rolla, Missouri, United States
Mercy Clinic-Rolla-Cancer and Hematology, Rolla, Missouri, United States
Heartland Regional Medical Center, Saint Joseph, Missouri, United States
Saint Louis Cancer and Breast Institute-South City, Saint Louis, Missouri, United States
Washington University School of Medicine, Saint Louis, Missouri, United States
Mercy Hospital South, Saint Louis, Missouri, United States
Siteman Cancer Center-South County, Saint Louis, Missouri, United States
Missouri Baptist Medical Center, Saint Louis, Missouri, United States
Mercy Hospital Saint Louis, Saint Louis, Missouri, United States
Siteman Cancer Center at Saint Peters Hospital, Saint Peters, 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
Missouri Baptist Sullivan Hospital, Sullivan, Missouri, United States
BJC Outpatient Center at Sunset Hills, Sunset Hills, Missouri, United States
Mercy Hospital Washington, Washington, Missouri, United States
Community Hospital of Anaconda, Anaconda, Montana, United States
Billings Clinic Cancer Center, Billings, Montana, United States
Saint Vincent Healthcare, Billings, Montana, United States
Saint Vincent Frontier Cancer Center, Billings, Montana, United States
Bozeman Deaconess Hospital, Bozeman, Montana, United States
Saint James Community Hospital and Cancer Treatment Center, Butte, Montana, United States
Benefis Healthcare- Sletten Cancer Institute, Great Falls, Montana, United States
Great Falls Clinic, Great Falls, Montana, United States
Saint Peter's Community Hospital, Helena, Montana, United States
Kalispell Regional Medical Center, Kalispell, Montana, United States
Saint Patrick Hospital - Community Hospital, Missoula, Montana, United States
Community Medical Hospital, Missoula, Montana, United States
Nebraska Medicine-Bellevue, Bellevue, Nebraska, United States
Nebraska Medicine-Village Pointe, Omaha, Nebraska, United States
University of Nebraska Medical Center, Omaha, Nebraska, United States
Carson Tahoe Regional Medical Center, Carson City, Nevada, United States
Cancer and Blood Specialists-Henderson, Henderson, Nevada, United States
Comprehensive Cancer Centers of Nevada - Henderson, Henderson, Nevada, United States
Comprehensive Cancer Centers of Nevada-Horizon Ridge, Henderson, Nevada, United States
Las Vegas Cancer Center-Henderson, Henderson, Nevada, United States
OptumCare Cancer Care at Seven Hills, Henderson, Nevada, United States
Comprehensive Cancer Centers of Nevada-Southeast Henderson, Henderson, Nevada, United States
GenesisCare USA - Henderson, Henderson, Nevada, United States
Las Vegas Urology - Green Valley, Henderson, Nevada, United States
Las Vegas Urology - Pebble, Henderson, Nevada, United States
Urology Specialists of Nevada - Green Valley, Henderson, Nevada, United States
Las Vegas Urology - Pecos, Las Vegas, Nevada, United States
Desert West Surgery, Las Vegas, Nevada, United States
OptumCare Cancer Care at Charleston, Las Vegas, Nevada, United States
University Medical Center of Southern Nevada, Las Vegas, Nevada, United States
Hope Cancer Care of Nevada, Las Vegas, Nevada, United States
Cancer and Blood Specialists-Shadow, Las Vegas, Nevada, United States
Radiation Oncology Centers of Nevada Central, Las Vegas, Nevada, United States
Urology Specialists of Nevada - Central, Las Vegas, Nevada, United States
GenesisCare USA - Las Vegas, Las Vegas, Nevada, United States
HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway, Las Vegas, Nevada, United States
Sunrise Hospital and Medical Center, Las Vegas, Nevada, United States
HealthCare Partners Medical Group Oncology/Hematology-San Martin, Las Vegas, Nevada, United States
Las Vegas Prostate Cancer Center, Las Vegas, Nevada, United States
Las Vegas Urology - Sunset, Las Vegas, Nevada, United States
Urology Specialists of Nevada - Southwest, Las Vegas, Nevada, United States
Radiation Oncology Centers of Nevada Southeast, Las Vegas, Nevada, United States
Cancer Therapy and Integrative Medicine, Las Vegas, Nevada, United States
Ann M Wierman MD LTD, Las Vegas, Nevada, United States
Cancer and Blood Specialists-Tenaya, Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada - Northwest, Las Vegas, Nevada, United States
GenesisCare USA - Vegas Tenaya, Las Vegas, Nevada, United States
HealthCare Partners Medical Group Oncology/Hematology-Tenaya, Las Vegas, Nevada, United States
Las Vegas Urology - Cathedral Rock, Las Vegas, Nevada, United States
Las Vegas Urology - Smoke Ranch, Las Vegas, Nevada, United States
OptumCare Cancer Care at MountainView, Las Vegas, Nevada, United States
Urology Specialists of Nevada - Northwest, Las Vegas, Nevada, United States
Alliance for Childhood Diseases/Cure 4 the Kids Foundation, Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada - Town Center, Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada-Summerlin, Las Vegas, Nevada, United States
Summerlin Hospital Medical Center, Las Vegas, Nevada, United States
Las Vegas Cancer Center-Medical Center, Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada, Las Vegas, Nevada, United States
GenesisCare USA - Fort Apache, Las Vegas, Nevada, United States
OptumCare Cancer Care at Fort Apache, Las Vegas, Nevada, United States
HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills, Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada - Central Valley, Las Vegas, Nevada, United States
University Cancer Center, Las Vegas, Nevada, United States
Hope Cancer Care of Nevada-Pahrump, Pahrump, Nevada, United States
Renown Regional Medical Center, Reno, Nevada, United States
Saint Mary's Regional Medical Center, Reno, Nevada, United States
Radiation Oncology Associates, Reno, Nevada, United States
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center, Lebanon, New Hampshire, United States
Memorial Sloan Kettering Basking Ridge, Basking Ridge, New Jersey, United States
Memorial Sloan Kettering Monmouth, Middletown, New Jersey, United States
Memorial Sloan Kettering Bergen, Montvale, New Jersey, United States
Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, United States
Montefiore Medical Center-Einstein Campus, Bronx, New York, United States
Montefiore Medical Center-Weiler Hospital, Bronx, New York, United States
Montefiore Medical Center - Moses Campus, Bronx, New York, United States
Roswell Park Cancer Institute, Buffalo, New York, United States
Memorial Sloan Kettering Commack, Commack, New York, United States
Memorial Sloan Kettering Westchester, Harrison, New York, United States
Northwell Health/Center for Advanced Medicine, Lake Success, New York, United States
North Shore University Hospital, Manhasset, New York, United States
Long Island Jewish Medical Center, New Hyde Park, New York, United States
Memorial Sloan Kettering Cancer Center, New York, New York, United States
University of Rochester, Rochester, New York, United States
Stony Brook University Medical Center, Stony Brook, New York, United States
Memorial Sloan Kettering Nassau, Uniondale, New York, United States
AdventHealth Infusion Center Asheville, Asheville, North Carolina, United States
UNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, United States
AdventHealth Infusion Center Haywood, Clyde, North Carolina, United States
AdventHealth Hendersonville, Hendersonville, North Carolina, United States
Wake Forest University Health Sciences, Winston-Salem, North Carolina, United States
Indu and Raj Soin Medical Center, Beavercreek, Ohio, United States
Saint Elizabeth Boardman Hospital, Boardman, Ohio, United States
Toledo Clinic Cancer Centers-Bowling Green, Bowling Green, Ohio, United States
Dayton Physicians LLC-Miami Valley South, Centerville, Ohio, United States
Miami Valley Hospital South, Centerville, Ohio, United States
Oncology Hematology Care Inc-Eden Park, Cincinnati, Ohio, United States
Oncology Hematology Care Inc-Mercy West, Cincinnati, Ohio, United States
University of Cincinnati Cancer Center-UC Medical Center, Cincinnati, Ohio, United States
Oncology Hematology Care Inc-Anderson, Cincinnati, Ohio, United States
Oncology Hematology Care Inc-Kenwood, Cincinnati, Ohio, United States
Oncology Hematology Care Inc-Blue Ash, Cincinnati, Ohio, United States
Case Western Reserve University, Cleveland, Ohio, United States
Cleveland Clinic Foundation, Cleveland, Ohio, United States
Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States
Good Samaritan Hospital - Dayton, Dayton, Ohio, United States
Miami Valley Hospital, Dayton, Ohio, United States
Dayton Physician LLC-Miami Valley Hospital North, Dayton, Ohio, United States
Miami Valley Hospital North, Dayton, Ohio, United States
Oncology Hematology Care Inc-Healthplex, Fairfield, Ohio, United States
Armes Family Cancer Center, Findlay, Ohio, United States
Blanchard Valley Hospital, Findlay, Ohio, United States
Orion Cancer Care, Findlay, Ohio, United States
Atrium Medical Center-Middletown Regional Hospital, Franklin, Ohio, United States
Dayton Physicians LLC-Atrium, Franklin, Ohio, United States
Dayton Physicians LLC-Wayne, Greenville, Ohio, United States
Wayne Hospital, Greenville, Ohio, United States
Greater Dayton Cancer Center, Kettering, Ohio, United States
First Dayton Cancer Care, Kettering, Ohio, United States
Kettering Medical Center, Kettering, Ohio, United States
Lima Memorial Hospital, Lima, Ohio, United States
Toledo Clinic Cancer Centers-Maumee, Maumee, Ohio, United States
Toledo Radiation Oncology at Northwest Ohio Onocolgy Center, Maumee, Ohio, United States
Dayton Physicians LLC-Signal Point, Middletown, Ohio, United States
Saint Charles Hospital, Oregon, Ohio, United States
Toledo Clinic Cancer Centers-Oregon, Oregon, Ohio, United States
Dayton Physicians LLC-Wilson, Sidney, Ohio, United States
Springfield Regional Cancer Center, Springfield, Ohio, United States
Springfield Regional Medical Center, Springfield, Ohio, United States
ProMedica Flower Hospital, Sylvania, Ohio, United States
Mercy Hospital of Tiffin, Tiffin, Ohio, United States
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital, Toledo, Ohio, United States
Saint Vincent Mercy Medical Center, Toledo, Ohio, United States
University of Toledo, Toledo, Ohio, United States
Toledo Community Hospital Oncology Program CCOP, Toledo, Ohio, United States
Mercy Health - Saint Anne Hospital, Toledo, Ohio, United States
Toledo Clinic Cancer Centers-Toledo, Toledo, Ohio, United States
Dayton Physicians LLC - Troy, Troy, Ohio, United States
Upper Valley Medical Center, Troy, Ohio, United States
Saint Joseph Warren Hospital, Warren, Ohio, United States
Fulton County Health Center, Wauseon, Ohio, United States
University of Cincinnati Cancer Center-West Chester, West Chester, Ohio, United States
Wright-Patterson Medical Center, Wright-Patterson Air Force Base, Ohio, United States
Saint Elizabeth Youngstown Hospital, Youngstown, Ohio, United States
University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
Mercy Hospital Oklahoma City, Oklahoma City, Oklahoma, United States
Saint Alphonsus Medical Center-Baker City, Baker City, Oregon, United States
Saint Charles Health System, Bend, Oregon, United States
Clackamas Radiation Oncology Center, Clackamas, Oregon, United States
Providence Cancer Institute Clackamas Clinic, Clackamas, Oregon, United States
Bay Area Hospital, Coos Bay, Oregon, United States
Providence Newberg Medical Center, Newberg, Oregon, United States
Saint Alphonsus Medical Center-Ontario, Ontario, Oregon, United States
Providence Willamette Falls Medical Center, Oregon City, Oregon, United States
Providence Portland Medical Center, Portland, Oregon, United States
Providence Saint Vincent Medical Center, Portland, Oregon, United States
Saint Charles Health System-Redmond, Redmond, Oregon, United States
Geisinger Medical Center, Danville, Pennsylvania, United States
Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, United States
University of Pennsylvania/Abramson Cancer Center, Philadelphia, Pennsylvania, United States
Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
Fox Chase Cancer Center, Philadelphia, Pennsylvania, United States
University of Pittsburgh Cancer Institute (UPCI), Pittsburgh, Pennsylvania, United States
Community Medical Center, Scranton, Pennsylvania, United States
AnMed Health Cancer Center, Anderson, South Carolina, United States
Prisma Health Cancer Institute - Spartanburg, Boiling Springs, South Carolina, United States
Prisma Health Cancer Institute - Easley, Easley, South Carolina, United States
Gibbs Cancer Center-Gaffney, Gaffney, South Carolina, United States
Greenville Health System Cancer Institute-Andrews, Greenville, South Carolina, United States
Saint Francis Hospital, Greenville, South Carolina, United States
Prisma Health Cancer Institute - Butternut, Greenville, South Carolina, United States
Prisma Health Cancer Institute - Faris, Greenville, South Carolina, United States
Prisma Health Greenville Memorial Hospital, Greenville, South Carolina, United States
Saint Francis Cancer Center, Greenville, South Carolina, United States
Prisma Health Cancer Institute - Eastside, Greenville, South Carolina, United States
Prisma Health Cancer Institute - Greer, Greer, South Carolina, United States
Gibbs Cancer Center-Pelham, Greer, South Carolina, United States
Carolina Blood and Cancer Care Associates PA-Lancaster, Lancaster, South Carolina, United States
Carolina Blood and Cancer Care Associates PA, Rock Hill, South Carolina, United States
Prisma Health Cancer Institute - Seneca, Seneca, South Carolina, United States
Spartanburg Medical Center, Spartanburg, South Carolina, United States
Vanderbilt-Ingram Cancer Center Cool Springs, Franklin, Tennessee, United States
Vanderbilt Breast Center at One Hundred Oaks, Nashville, Tennessee, United States
Vanderbilt University/Ingram Cancer Center, Nashville, Tennessee, United States
Parkland Memorial Hospital, Dallas, Texas, United States
UT Southwestern/Simmons Cancer Center-Dallas, Dallas, Texas, United States
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center, Houston, Texas, United States
Ben Taub General Hospital, Houston, Texas, United States
Houston Methodist Hospital, Houston, Texas, United States
American Fork Hospital / Huntsman Intermountain Cancer Center, American Fork, Utah, United States
Sandra L Maxwell Cancer Center, Cedar City, Utah, United States
Farmington Health Center, Farmington, Utah, United States
Logan Regional Hospital, Logan, Utah, United States
Intermountain Medical Center, Murray, Utah, United States
McKay-Dee Hospital Center, Ogden, Utah, United States
Utah Valley Regional Medical Center, Provo, Utah, United States
Riverton Hospital, Riverton, Utah, United States
Saint George Regional Medical Center, Saint George, Utah, United States
Utah Cancer Specialists-Salt Lake City, Salt Lake City, Utah, United States
Huntsman Cancer Institute/University of Utah, Salt Lake City, Utah, United States
LDS Hospital, Salt Lake City, Utah, United States
South Jordan Health Center, South Jordan, Utah, United States
Fredericksburg Oncology Inc, Fredericksburg, Virginia, United States
VCU Massey Cancer Center at Stony Point, Richmond, Virginia, United States
Virginia Commonwealth University/Massey Cancer Center, Richmond, Virginia, United States
Providence Regional Cancer System-Aberdeen, Aberdeen, Washington, United States
Cancer Care Center at Island Hospital, Anacortes, Washington, United States
MultiCare Auburn Medical Center, Auburn, Washington, United States
Overlake Medical Center, Bellevue, Washington, United States
Swedish Cancer Institute-Eastside Oncology Hematology, Bellevue, Washington, United States
PeaceHealth Saint Joseph Medical Center, Bellingham, Washington, United States
Providence Regional Cancer System-Centralia, Centralia, Washington, United States
Swedish Cancer Institute-Edmonds, Edmonds, Washington, United States
Providence Regional Cancer Partnership, Everett, Washington, United States
MultiCare Gig Harbor Medical Park, Gig Harbor, Washington, United States
Swedish Cancer Institute-Issaquah, Issaquah, Washington, United States
Kadlec Clinic Hematology and Oncology, Kennewick, Washington, United States
Providence Regional Cancer System-Lacey, Lacey, Washington, United States
PeaceHealth Saint John Medical Center, Longview, Washington, United States
Jefferson Healthcare, Port Townsend, Washington, United States
MultiCare Good Samaritan Hospital, Puyallup, Washington, United States
Valley Medical Center, Renton, Washington, United States
Minor and James Medical PLLC, Seattle, Washington, United States
Pacific Gynecology Specialists, Seattle, Washington, United States
Swedish Medical Center-Ballard Campus, Seattle, Washington, United States
Kaiser Permanente Washington, Seattle, Washington, United States
Swedish Medical Center-Cherry Hill, Seattle, Washington, United States
Swedish Medical Center-First Hill, Seattle, Washington, United States
PeaceHealth United General Medical Center, Sedro-Woolley, Washington, United States
Providence Regional Cancer System-Shelton, Shelton, Washington, United States
MultiCare Deaconess Cancer and Blood Specialty Center - Valley, Spokane Valley, Washington, United States
MultiCare Deaconess Cancer and Blood Specialty Center - Downtown, Spokane, Washington, United States
Evergreen Hematology and Oncology PS, Spokane, Washington, United States
MultiCare Deaconess Cancer and Blood Specialty Center - North, Spokane, Washington, United States
Mary Bridge Children's Hospital and Health Center, Tacoma, Washington, United States
MultiCare Tacoma General Hospital, Tacoma, Washington, United States
PeaceHealth Southwest Medical Center, Vancouver, Washington, United States
Providence Saint Mary Regional Cancer Center, Walla Walla, Washington, United States
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital, Yakima, Washington, United States
Providence Regional Cancer System-Yelm, Yelm, Washington, United States
Marshfield Clinic Cancer Center at Sacred Heart, Eau Claire, Wisconsin, United States
Marshfield Medical Center-EC Cancer Center, Eau Claire, Wisconsin, United States
Green Bay Oncology at Saint Vincent Hospital, Green Bay, Wisconsin, United States
Saint Vincent Hospital Cancer Center Green Bay, Green Bay, Wisconsin, United States
Green Bay Oncology Limited at Saint Mary's Hospital, Green Bay, Wisconsin, United States
Saint Vincent Hospital Cancer Center at Saint Mary's, Green Bay, Wisconsin, United States
Gundersen Lutheran Medical Center, La Crosse, Wisconsin, United States
University of Wisconsin Carbone Cancer Center, Madison, Wisconsin, United States
Holy Family Memorial Hospital, Manitowoc, Wisconsin, United States
Saint Vincent Hospital Cancer Center at Marinette, Marinette, Wisconsin, United States
Marshfield Medical Center-Marshfield, Marshfield, Wisconsin, United States
Marshfield Medical Center, Marshfield, Wisconsin, United States
Medical College of Wisconsin, Milwaukee, Wisconsin, United States
Marshfield Clinic-Minocqua Center, Minocqua, Wisconsin, United States
Saint Vincent Hospital Cancer Center at Oconto Falls, Oconto Falls, Wisconsin, United States
Marshfield Medical Center-Rice Lake, Rice Lake, Wisconsin, United States
HSHS Saint Nicholas Hospital, Sheboygan, Wisconsin, United States
Marshfield Medical Center-River Region at Stevens Point, Stevens Point, Wisconsin, United States
Saint Vincent Hospital Cancer Center at Sturgeon Bay, Sturgeon Bay, Wisconsin, United States
Green Bay Oncology - Sturgeon Bay, Sturgeon Bay, Wisconsin, United States
Marshfield Clinic-Wausau Center, Wausau, Wisconsin, United States
Marshfield Medical Center - Weston, Weston, Wisconsin, United States
Rocky Mountain Oncology, Casper, Wyoming, United States
Cheyenne Regional Medical Center-West, Cheyenne, Wyoming, United States
Big Horn Basin Cancer Center, Cody, Wyoming, United States
Billings Clinic-Cody, Cody, Wyoming, United States
Welch Cancer Center, Sheridan, Wyoming, United States
Tom Baker Cancer Centre, Calgary, Alberta, Canada
Clinical Research Unit at Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada
QEII Health Sciences Centre/Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
Kingston Health Sciences Centre, Kingston, Ontario, Canada
CIUSSSEMTL-Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada
Allan Blair Cancer Centre, Regina, Saskatchewan, Canada
Rambam Medical Center, Haifa, , Israel
Shaare Zedek Medical Center, Jerusalem, , Israel
Cancer Center-Metro Medical Center Bayamon, Bayamon, , Puerto Rico
Doctors Cancer Center, Manati, , Puerto Rico
San Juan Community Oncology Group, San Juan, , Puerto Rico
Centro Comprensivo de Cancer de UPR, San Juan, , Puerto Rico
San Juan City Hospital, San Juan, , Puerto Rico
Name: Mark R Litzow
Affiliation: ECOG-ACRIN Cancer Research Group
Role: PRINCIPAL_INVESTIGATOR