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Brief Title: Testing the Addition of a New Anti-Cancer Drug, Triapine, to the Usual Chemotherapy Treatment (Cisplatin) During Radiation Therapy for Advanced-stage Cervical and Vaginal Cancers
Official Title: A Randomized Phase III Trial of Radiation Therapy and Cisplatin Alone or in Combination With Intravenous Triapine in Women With Newly Diagnosed Bulky Stage IB2, Stage II, IIIB, or IVA Cancer of the Uterine Cervix or Stage II-IVA Vaginal Cancer
Study ID: NCT02466971
Brief Summary: This randomized phase III trial studies radiation therapy and cisplatin with triapine to see how well they work compared to the standard radiation therapy and cisplatin alone in treating patients with newly diagnosed stage IB2, II, or IIIB-IVA cervical cancer or stage II-IVA vaginal cancer. Radiation therapy uses high energy protons to kill tumor cells and shrink tumors. Drugs used in chemotherapy, such as cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Triapine may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known whether radiation therapy and cisplatin are more effective with triapine in treating cervical or vaginal cancer.
Detailed Description: PRIMARY OBJECTIVE: I. To evaluate the efficacy of the experimental regimen of triapine (3AP), cisplatin, and radiation to increase overall survival relative to the standard/control regimen of cisplatin and radiation in women with uterine cervix or vaginal cancer. SECONDARY OBJECTIVE: I. To determine the relative progression-free survival impact of triapine-cisplatin radio-chemotherapy and cisplatin radio-chemotherapy. TERTIARY OBJECTIVES: I. To evaluate incidence and severity of hematologic and gastrointestinal (GI) adverse events by radiation modality; image guided intensity modulated radiation therapy (IG-IMRT) versus conventional pelvic radiotherapy. (05/30/2017) II. To summarize and compare differences in acute adverse events (Common Terminology Criteria for Adverse Events \[CTCAE\], version \[v\]4.0) by treatment arm and by radiation modality. (05/30/2017) III. To summarize and compare differences in chronic or late (\>= 30-days from off study treatment date) adverse events (CTCAE, v4.0) by treatment arm and by radiation modality. (05/30/2017) IV. To determine peripheral blood methemoglobin proportion before and after triapine infusion (optional for Arm 2 patients). V. To explore whether knowledge-based planning (KBP) can improve IG-IMRT plans compared to plans that would have been delivered without KBP, estimate the resulting toxicity reduction using normal tissue complication probability (NTCP) models, and determine whether KBP should be a requirement for future IG-IMRT protocols. VI. To determine the post-therapy 3-month fludeoxyglucose F-18 (18F-FDG) PET/CT metabolic complete response rate by treatment arm VII. To compare acute toxicity and chemotherapy delivery for atlas-based IG-IMRT vs. positron emission tomography (PET)/computed tomography (CT)-based IG-IMRT vs. conventional radiation therapy (RT), and assess the impact of treatment on changes in hematopoietic compensatory response. VIII. To develop and validate machine learning and radiomics techniques for dose accumulation, automated treatment planning, and prediction of treatment response. OUTLINE: Patients are randomized to 1 of 2 treatment arms. ARM I: Patients receive cisplatin intravenously (IV) over 90 minutes on days 2, 9, 16, 23, 30, (and day 36 or 37 at the treating physician's discretion). Patients then undergo external beam radiation therapy (EBRT) (either conventional RT or intensity modulated radiation therapy \[IMRT\]) once daily (QD) 5 days a week for 25 fractions followed by low dose rate (LDR) or high dose rate (HDR) brachytherapy according to institution's standards. Treatment continues in the absence of disease progression or unacceptable toxicity. ARM II: Patients receive cisplatin and undergo EBRT followed by brachytherapy as in Arm I. Patients also receive triapine IV over 2 hours on days 1, 3, 5, 8, 10, 12, 15, 17, 19, 22, 24, 26, 29, 31, and 33. Treatment continues in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 1 and 3 months, every 3 months for 2 years, and then every 6 months for 3 years. The patient data from NCI #9434 will be merged with NRG-GY006 per the Protocol Analysis Plan.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: FEMALE
Healthy Volunteers: No
University of Alabama at Birmingham Cancer Center, Birmingham, Alabama, United States
Anchorage Associates in Radiation Medicine, Anchorage, Alaska, United States
Alaska Breast Care and Surgery LLC, Anchorage, Alaska, United States
Alaska Oncology and Hematology LLC, 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
Banner University Medical Center - Tucson, Tucson, Arizona, United States
University of Arizona Cancer Center-North Campus, Tucson, Arizona, United States
CHI Saint Vincent Cancer Center Hot Springs, Hot Springs, Arkansas, United States
University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
Kaiser Permanente-Deer Valley Medical Center, Antioch, California, United States
Providence Saint Joseph Medical Center/Disney Family Cancer Center, Burbank, California, United States
Kaiser Permanente-Fremont, Fremont, California, United States
Kaiser Permanente-Fresno, Fresno, California, United States
UC San Diego Moores Cancer Center, La Jolla, California, United States
Los Angeles General Medical Center, Los Angeles, California, United States
Kaiser Permanente-Modesto, Modesto, California, United States
Kaiser Permanente Oakland-Broadway, Oakland, California, United States
Kaiser Permanente-Oakland, Oakland, California, United States
UC Irvine Health/Chao Family Comprehensive Cancer Center, Orange, California, United States
Kaiser Permanente-Rancho Cordova Cancer Center, Rancho Cordova, California, United States
Kaiser Permanente-Redwood City, Redwood City, California, United States
Kaiser Permanente-Richmond, Richmond, California, United States
Rohnert Park Cancer Center, Rohnert Park, California, United States
Kaiser Permanente-Roseville, Roseville, California, United States
The Permanente Medical Group-Roseville Radiation Oncology, Roseville, California, United States
University of California Davis Comprehensive Cancer Center, Sacramento, California, United States
Kaiser Permanente-South Sacramento, Sacramento, California, United States
South Sacramento Cancer Center, Sacramento, California, United States
Kaiser Permanente - Sacramento, Sacramento, California, United States
Kaiser Permanente-San Francisco, San Francisco, California, United States
Kaiser Permanente-Santa Teresa-San Jose, San Jose, California, United States
Kaiser Permanente San Leandro, San Leandro, California, United States
Kaiser Permanente-San Rafael, San Rafael, California, United States
Kaiser San Rafael-Gallinas, San Rafael, California, United States
Kaiser Permanente Medical Center - Santa Clara, Santa Clara, California, United States
Kaiser Permanente-Santa Rosa, Santa Rosa, California, United States
Kaiser Permanente Cancer Treatment Center, South San Francisco, California, United States
Kaiser Permanente-South San Francisco, South San Francisco, California, United States
Kaiser Permanente-Stockton, Stockton, California, United States
Gene Upshaw Memorial Tahoe Forest Cancer Center, Truckee, California, United States
Kaiser Permanente Medical Center-Vacaville, Vacaville, California, United States
Kaiser Permanente-Vallejo, Vallejo, California, United States
Kaiser Permanente-Walnut Creek, Walnut Creek, California, United States
UCHealth University of Colorado Hospital, Aurora, Colorado, United States
Penrose-Saint Francis Healthcare, Colorado Springs, Colorado, United States
Rocky Mountain Cancer Centers-Penrose, Colorado Springs, Colorado, United States
Porter Adventist Hospital, Denver, Colorado, United States
Saint Anthony Hospital, Lakewood, Colorado, United States
Littleton Adventist Hospital, Littleton, Colorado, United States
Longmont United Hospital, Longmont, Colorado, United States
Saint Mary Corwin Medical Center, Pueblo, Colorado, United States
Rocky Mountain Cancer Centers-Thornton, Thornton, Colorado, United States
Hartford Hospital, Hartford, Connecticut, United States
Beebe Medical Center, Lewes, Delaware, United States
Christiana Gynecologic Oncology LLC, Newark, Delaware, United States
Delaware Clinical and Laboratory Physicians PA, Newark, 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
University of Florida Health Science Center - Gainesville, Gainesville, Florida, United States
Mayo Clinic in Florida, Jacksonville, Florida, United States
Lakeland Regional Health Hollis Cancer Center, Lakeland, Florida, United States
Moffitt Cancer Center, Tampa, Florida, 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
Augusta University Medical Center, Augusta, Georgia, United States
Memorial Health University Medical Center, Savannah, Georgia, United States
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler, Savannah, Georgia, United States
Pali Momi Medical Center, 'Aiea, Hawaii, United States
Queen's Cancer Center - Pearlridge, 'Aiea, Hawaii, United States
The Cancer Center of Hawaii-Pali Momi, 'Aiea, Hawaii, United States
Hawaii Cancer Care Inc - Waterfront Plaza, Honolulu, Hawaii, United States
Island Urology, 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
Kuakini Medical Center, Honolulu, Hawaii, United States
Queen's Cancer Center - Kuakini, Honolulu, Hawaii, United States
The Cancer Center of Hawaii-Liliha, Honolulu, Hawaii, United States
Kaiser Permanente Moanalua Medical Center, Honolulu, Hawaii, United States
Kapiolani Medical Center for Women and Children, Honolulu, Hawaii, United States
Wilcox Memorial Hospital and Kauai Medical Clinic, Lihue, Hawaii, 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
Saint Luke's Cancer Institute - Fruitland, Fruitland, Idaho, United States
Saint Luke's Cancer Institute - Meridian, Meridian, Idaho, United States
Saint Luke's Cancer Institute - Nampa, Nampa, Idaho, United States
Kootenai Clinic Cancer Services - Post Falls, Post Falls, Idaho, United States
Saint Luke's Cancer Institute - Twin Falls, Twin Falls, Idaho, United States
OSF Saint Joseph Medical Center, Bloomington, Illinois, United States
Memorial Hospital of Carbondale, Carbondale, Illinois, United States
Northwestern University, Chicago, Illinois, United States
John H Stroger Jr Hospital of Cook County, Chicago, Illinois, United States
Rush University Medical Center, Chicago, Illinois, United States
Cancer Care Specialists of Illinois - Decatur, Decatur, Illinois, United States
Decatur Memorial Hospital, Decatur, Illinois, United States
Crossroads Cancer Center, Effingham, Illinois, United States
Western Illinois Cancer Treatment Center, Galesburg, Illinois, United States
Northwestern Medicine Cancer Center Delnor, Geneva, Illinois, United States
Loyola University Medical Center, Maywood, Illinois, United States
Good Samaritan Regional Health Center, Mount Vernon, 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
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
Illinois CancerCare-Princeton, Princeton, 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
Carle Cancer Center, Urbana, Illinois, United States
Northwestern Medicine Cancer Center Warrenville, Warrenville, Illinois, United States
Parkview Hospital Randallia, Fort Wayne, Indiana, United States
Parkview Regional Medical Center, Fort Wayne, Indiana, United States
Indiana University/Melvin and Bren Simon Cancer Center, Indianapolis, Indiana, United States
Sidney and Lois Eskenazi Hospital, Indianapolis, Indiana, United States
Ascension Saint Vincent Indianapolis Hospital, Indianapolis, Indiana, United States
Reid Health, Richmond, Indiana, 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
Mission Cancer and Blood - West Des Moines, Clive, Iowa, United States
Iowa Methodist Medical Center, Des Moines, Iowa, United States
Mission Cancer and Blood - Des Moines, Des Moines, Iowa, United States
Mercy Medical Center - Des Moines, Des Moines, Iowa, United States
Mission Cancer and Blood - Laurel, Des Moines, Iowa, United States
Iowa Lutheran Hospital, Des Moines, Iowa, United States
Methodist West Hospital, West Des Moines, Iowa, United States
Mercy Medical Center-West Lakes, West Des Moines, Iowa, United States
Saint Catherine Hospital, Garden City, Kansas, United States
Saint Rose Ambulatory and Surgery Center, Great Bend, Kansas, United States
HaysMed, Hays, Kansas, United States
University of Kansas Cancer Center, Kansas City, Kansas, United States
Olathe Health Cancer Center, Olathe, Kansas, United States
University of Kansas Cancer Center-Overland Park, Overland Park, Kansas, United States
Ascension Via Christi - Pittsburg, Pittsburg, Kansas, United States
Salina Regional Health Center, Salina, Kansas, United States
University of Kansas Health System Saint Francis Campus, Topeka, Kansas, 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
The James Graham Brown Cancer Center at University of Louisville, Louisville, Kentucky, United States
UofL Health Medical Center Northeast, Louisville, Kentucky, United States
East Jefferson General Hospital, Metairie, Louisiana, United States
University Medical Center New Orleans, New Orleans, Louisiana, United States
Ochsner Medical Center Jefferson, New Orleans, Louisiana, United States
Greater Baltimore Medical Center, Baltimore, Maryland, United States
Walter Reed National Military Medical Center, Bethesda, Maryland, United States
Henry Ford Cancer Institute-Downriver, Brownstown, Michigan, United States
Henry Ford Macomb Hospital-Clinton Township, Clinton Township, Michigan, United States
Wayne State University/Karmanos Cancer Institute, Detroit, Michigan, United States
Henry Ford Hospital, Detroit, Michigan, United States
Weisberg Cancer Treatment Center, Farmington Hills, Michigan, United States
Corewell Health Grand Rapids Hospitals - Butterworth Hospital, Grand Rapids, Michigan, United States
Trinity Health Grand Rapids Hospital, Grand Rapids, 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
Trinity Health Muskegon Hospital, Muskegon, Michigan, United States
Corewell Health Reed City Hospital, Reed City, Michigan, United States
Corewell Health Lakeland Hospitals - Saint Joseph Hospital, Saint Joseph, Michigan, United States
Munson Medical Center, Traverse City, Michigan, United States
Henry Ford West Bloomfield Hospital, West Bloomfield, Michigan, United States
University of Michigan Health - West, Wyoming, Michigan, United States
University of Minnesota/Masonic Cancer Center, Minneapolis, Minnesota, United States
Mayo Clinic in Rochester, Rochester, Minnesota, United States
University of Mississippi Medical Center, Jackson, Mississippi, United States
Saint Louis Cancer and Breast Institute-Ballwin, Ballwin, Missouri, United States
Saint Francis Medical Center, Cape Girardeau, Missouri, United States
Southeast Cancer Center, Cape Girardeau, Missouri, United States
MU Health Care Goldschmidt Cancer Center, Jefferson City, Missouri, United States
Freeman Health System, Joplin, Missouri, United States
North Kansas City Hospital, Kansas City, Missouri, United States
The University of Kansas Cancer Center-South, 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
Delbert Day Cancer Institute at PCRMC, Rolla, Missouri, United States
Mercy Clinic-Rolla-Cancer and Hematology, Rolla, Missouri, United States
Missouri Baptist Medical Center, Saint Louis, Missouri, United States
Mercy Hospital Saint Louis, Saint Louis, Missouri, United States
Mercy Hospital Springfield, Springfield, Missouri, United States
CoxHealth South Hospital, Springfield, Missouri, United States
Billings Clinic Cancer Center, Billings, Montana, 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
Great Falls Clinic, Great Falls, Montana, United States
Kalispell Regional Medical Center, Kalispell, Montana, United States
Community Medical Center, Missoula, Montana, United States
Nebraska Cancer Specialists/Oncology Hematology West PC, Grand Island, Nebraska, United States
CHI Health Good Samaritan, Kearney, Nebraska, United States
Nebraska Methodist Hospital, Omaha, 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
University of Nebraska Medical Center, Omaha, Nebraska, United States
Midlands Community Hospital, Papillion, Nebraska, United States
Radiation Oncology Centers of Nevada Central, Las Vegas, Nevada, United States
Women's Cancer Center of Nevada, Las Vegas, Nevada, United States
Center of Hope at Renown Medical Center, Reno, Nevada, United States
Renown Regional Medical Center, Reno, Nevada, United States
Cooper Hospital University Medical Center, Camden, New Jersey, United States
Virtua Memorial, Mount Holly, New Jersey, United States
Cooper CyberKnife Center, Mount Laurel, New Jersey, United States
Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, United States
Rutgers New Jersey Medical School, Newark, New Jersey, United States
Robert Wood Johnson University Hospital Somerset, Somerville, New Jersey, United States
MD Anderson Cancer Center at Cooper-Voorhees, Voorhees, New Jersey, United States
Virtua Voorhees, Voorhees, New Jersey, United States
Southwest Gynecologic Oncology Associates Inc, Albuquerque, New Mexico, United States
University of New Mexico Cancer Center, Albuquerque, New Mexico, United States
Memorial Medical Center - Las Cruces, Las Cruces, New Mexico, United States
Saint Peter's Health Partners, Albany, New York, United States
Women's Cancer Care Associates LLC, Albany, New York, United States
Maimonides Medical Center, Brooklyn, New York, United States
Roswell Park Cancer Institute, Buffalo, New York, United States
Mount Sinai Chelsea, New York, New York, United States
Laura and Isaac Perlmutter Cancer Center at NYU Langone, New York, New York, United States
Highland Hospital, Rochester, New York, United States
University of Rochester, Rochester, New York, United States
State University of New York Upstate Medical University, Syracuse, New York, United States
Novant Health Presbyterian Medical Center, Charlotte, North Carolina, United States
Wake Forest University Health Sciences, Winston-Salem, North Carolina, United States
Summa Health System - Akron Campus, Akron, Ohio, United States
UHHS-Chagrin Highlands Medical Center, Beachwood, Ohio, United States
Aultman Health Foundation, Canton, Ohio, United States
Miami Valley Hospital South, Centerville, Ohio, United States
Geauga Hospital, Chardon, Ohio, United States
Adena Regional Medical Center, Chillicothe, Ohio, United States
University of Cincinnati Cancer Center-UC Medical Center, Cincinnati, Ohio, United States
Good Samaritan Hospital - Cincinnati, Cincinnati, Ohio, United States
Bethesda North Hospital, Cincinnati, Ohio, United States
Oncology Hematology Care Inc-Blue Ash, Cincinnati, Ohio, United States
Case Western Reserve University, Cleveland, Ohio, United States
MetroHealth Medical Center, Cleveland, Ohio, United States
Cleveland Clinic Cancer Center/Fairview Hospital, Cleveland, Ohio, United States
Cleveland Clinic Foundation, Cleveland, Ohio, United States
Mount Carmel East Hospital, Columbus, Ohio, United States
Riverside Methodist Hospital, Columbus, Ohio, United States
Grant Medical Center, Columbus, Ohio, United States
The Mark H Zangmeister Center, Columbus, Ohio, United States
Mount Carmel Health Center West, Columbus, Ohio, United States
Doctors Hospital, Columbus, Ohio, United States
Good Samaritan Hospital - Dayton, Dayton, Ohio, United States
Miami Valley Hospital, Dayton, Ohio, United States
Dayton Physician LLC - Englewood, Dayton, Ohio, United States
Miami Valley Hospital North, Dayton, Ohio, United States
Delaware Radiation Oncology, Delaware, Ohio, United States
Grady Memorial Hospital, Delaware, Ohio, United States
Blanchard Valley Hospital, Findlay, Ohio, United States
Atrium Medical Center-Middletown Regional Hospital, Franklin, Ohio, United States
Wayne Hospital, Greenville, Ohio, United States
Kettering Medical Center, Kettering, Ohio, United States
OhioHealth Mansfield Hospital, Mansfield, Ohio, United States
Marietta Memorial Hospital, Marietta, Ohio, United States
Hillcrest Hospital Cancer Center, Mayfield Heights, Ohio, United States
UH Seidman Cancer Center at Lake Health Mentor Campus, Mentor, Ohio, United States
Licking Memorial Hospital, Newark, Ohio, United States
Newark Radiation Oncology, Newark, Ohio, United States
Southern Ohio Medical Center, Portsmouth, Ohio, United States
Springfield Regional Medical Center, Springfield, Ohio, United States
ProMedica Flower Hospital, Sylvania, Ohio, United States
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital, Toledo, Ohio, United States
Upper Valley Medical Center, Troy, Ohio, United States
University Hospitals Sharon Health Center, Wadsworth, Ohio, United States
University of Cincinnati Cancer Center-West Chester, West Chester, Ohio, United States
Saint Ann's Hospital, Westerville, Ohio, United States
UH Seidman Cancer Center at Saint John Medical Center, Westlake, Ohio, United States
UHHS-Westlake Medical Center, Westlake, Ohio, United States
Genesis Healthcare System Cancer Care Center, Zanesville, Ohio, United States
University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
Oklahoma Cancer Specialists and Research Institute-Tulsa, Tulsa, Oklahoma, United States
Saint Charles Health System, Bend, Oregon, United States
Clackamas Radiation Oncology Center, Clackamas, Oregon, United States
Bay Area Hospital, Coos Bay, Oregon, United States
Legacy Mount Hood Medical Center, Gresham, Oregon, United States
Legacy Good Samaritan Hospital and Medical Center, Portland, Oregon, United States
Providence Portland Medical Center, Portland, Oregon, United States
Providence Saint Vincent Medical Center, Portland, Oregon, United States
Oregon Health and Science University, Portland, Oregon, United States
Legacy Meridian Park Hospital, Tualatin, Oregon, United States
Jefferson Abington Hospital, Abington, Pennsylvania, United States
UPMC-Heritage Valley Health System Beaver, Beaver, Pennsylvania, United States
Christiana Care Health System-Concord Health Center, Chadds Ford, Pennsylvania, United States
Northeast Radiation Oncology Center, Dunmore, Pennsylvania, United States
Ephrata Cancer Center, Ephrata, Pennsylvania, United States
Adams Cancer Center, Gettysburg, Pennsylvania, United States
UPMC Cancer Centers - Arnold Palmer Pavilion, Greensburg, Pennsylvania, United States
WellSpan Medical Oncology and Hematology, Hanover, Pennsylvania, United States
UPMC Hillman Cancer Center in Coraopolis, Moon, Pennsylvania, United States
Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
UPMC-Magee Womens Hospital, Pittsburgh, Pennsylvania, United States
University of Pittsburgh Cancer Institute (UPCI), Pittsburgh, Pennsylvania, United States
UPMC-Shadyside Hospital, Pittsburgh, Pennsylvania, United States
Reading Hospital, West Reading, Pennsylvania, United States
Asplundh Cancer Pavilion, Willow Grove, Pennsylvania, United States
Lankenau Medical Center, Wynnewood, Pennsylvania, United States
WellSpan Health-York Cancer Center, York, Pennsylvania, United States
WellSpan Health-York Hospital, York, Pennsylvania, United States
Women and Infants Hospital, Providence, Rhode Island, United States
Saint Francis Hospital, Greenville, South Carolina, United States
Prisma Health Cancer Institute - Faris, Greenville, South Carolina, United States
Saint Francis Cancer Center, Greenville, South Carolina, United States
Spartanburg Medical Center, Spartanburg, South Carolina, United States
Rapid City Regional Hospital, Rapid City, South Dakota, United States
Memorial Hospital, Chattanooga, Tennessee, United States
Vanderbilt University/Ingram Cancer Center, Nashville, Tennessee, United States
Saint Joseph Regional Cancer Center, Bryan, Texas, United States
Parkland Memorial Hospital, Dallas, Texas, United States
UT Southwestern/Simmons Cancer Center-Dallas, Dallas, Texas, United States
Houston Methodist Hospital, Houston, Texas, United States
Memorial Hermann Texas Medical Center, Houston, Texas, United States
Methodist Willowbrook Hospital, Houston, Texas, United States
Houston Methodist Sugar Land Hospital, Sugar Land, Texas, United States
Houston Methodist The Woodlands Hospital, The Woodlands, Texas, United States
Sandra L Maxwell Cancer Center, Cedar City, 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
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
Providence Regional Cancer System-Aberdeen, Aberdeen, Washington, United States
MultiCare Auburn Medical Center, Auburn, Washington, United States
Overlake Medical Center, Bellevue, Washington, United States
PeaceHealth Saint Joseph Medical Center, Bellingham, Washington, United States
Harrison HealthPartners Hematology and Oncology-Bremerton, Bremerton, Washington, United States
Highline Medical Center-Main Campus, Burien, Washington, United States
Providence Regional Cancer System-Centralia, Centralia, Washington, United States
Providence Regional Cancer Partnership, Everett, Washington, United States
Virginia Mason Federal Way Medical Center, Federal Way, Washington, United States
Tacoma/Valley Radiation Oncology Centers-Gig Harbor, Gig Harbor, Washington, United States
MultiCare Gig Harbor Medical Park, Gig Harbor, Washington, United States
Swedish Cancer Institute-Issaquah, Issaquah, Washington, United States
Providence Regional Cancer System-Lacey, Lacey, Washington, United States
PeaceHealth Saint John Medical Center, Longview, Washington, United States
MultiCare Good Samaritan Hospital, Puyallup, Washington, United States
Tacoma/Valley Radiation Oncology Centers-Puyallup, Puyallup, Washington, United States
Virginia Mason Medical Center, Seattle, Washington, United States
FHCC South Lake Union, Seattle, Washington, United States
Kaiser Permanente Washington, Seattle, Washington, United States
Swedish Medical Center-First Hill, Seattle, Washington, United States
Saint Michael Cancer Center, Silverdale, Washington, United States
MultiCare Tacoma General Hospital, Tacoma, Washington, United States
Northwest Medical Specialties PLLC, Tacoma, Washington, United States
Tacoma/Valley Radiation Oncology Centers-Saint Joe's, Tacoma, Washington, United States
PeaceHealth Southwest Medical Center, Vancouver, Washington, United States
Legacy Salmon Creek Hospital, 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
Edwards Comprehensive Cancer Center, Huntington, West Virginia, United States
West Virginia University Healthcare, Morgantown, West Virginia, United States
Wheeling Hospital/Schiffler Cancer Center, Wheeling, West Virginia, United States
Marshfield Medical Center-EC Cancer Center, Eau Claire, Wisconsin, United States
University of Wisconsin Carbone Cancer Center - University Hospital, Madison, Wisconsin, United States
Marshfield Medical Center-Marshfield, Marshfield, Wisconsin, United States
Medical College of Wisconsin, Milwaukee, Wisconsin, United States
Marshfield Clinic-Minocqua Center, Minocqua, Wisconsin, United States
Marshfield Medical Center-River Region at Stevens Point, Stevens Point, Wisconsin, United States
Marshfield Medical Center - Weston, Weston, Wisconsin, United States
Odette Cancer Centre- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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: Charles A Leath
Affiliation: NRG Oncology
Role: PRINCIPAL_INVESTIGATOR