Testing Higher Dose Radiation Therapy for Locally Advanced Pancreatic Cancer

Recruitment Status
RECRUITING
(See Contacts and Locations)Verified March 2026 by NRG Oncology
Sponsor
NRG Oncology
Information Provided by (Responsible Party)
NRG Oncology
Clinicaltrials.gov Identifier
NCT06958328
Other Study ID Numbers:
NRG-GI011
First Submitted
April 24, 2025
First Posted
May 5, 2025
Last Update Posted
May 3, 2026
Last Verified
March 2026

ClinicalTrials.gov processed this data on April 2026. Link to the current ClinicalTrials.gov record .

History of Changes

Study Details

Study Description

PRIMARY OBJECTIVE:

I. To evaluate whether dose-escalated radiation therapy (RT) improves 3-year overall survival (OS) compared to standard treatments without dose-escalated RT, in locally advanced pancreatic cancer patients without radiographic progression and with biochemical response after an initial interval of chemotherapy.

SECONDARY OBJECTIVES:

I. To evaluate and compare local progression between the two treatment arms. II. To evaluate and compare progression-free survival (PFS) between the two treatment arms.

III. To evaluate and compare chemotherapy-free interval between the two treatment arms.

IV. To evaluate and compare toxicity within and between the two treatment arms.

HEALTH-RELATED QUALITY-OF-LIFE (HRQOL) OBJECTIVES:

I. Primary: To compare Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) Total Score at 6 months between the two treatment arms.

II. Secondary: To compare nadir of HRQoL scores over course of study participation between the two treatment arms.

III. Secondary: To evaluate HRQoL scores over time between the two treatment arms.

EXPLORATORY OBJECTIVE:

I. Biospecimen collection for future correlative analyses.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I (STANDARD OF CARE): Patients are assigned to 1 of 3 treatment options per physician's decision.

OPTION 1: Patients continue to receive fluorouracil, irinotecan hydrochloride, leucovorin calcium, and oxaliplatin (FOLFIRINOX or modified FOLFIRINOX \[mFOLFIRINOX\]) or fluorouracil, liposomal irinotecan, leucovorin calcium, and oxaliplatin (NALIRIFOX) or gemcitabine/nab-paclitaxel per standard of care for a total of 6 months of treatment. Patients may continue treatment beyond 6 months at physician's discretion.

OPTION 2: Patients undergo standard dose radiation therapy once daily for 28 or 30 fractions and receive concurrent fluorouracil or capecitabine per standard of care during radiation therapy. After completing concurrent chemoradiation, patients who received less than 6 months of chemotherapy at study entry are encouraged to receive the remaining chemotherapy to total 6 months of chemotherapy. Patients may continue chemotherapy treatment beyond 6 months at physician's discretion.

OPTION 3: Patients undergo observation per standard of care. (It is recommended \[but not required\] that this option only be for patients that have already completed total 6 months chemotherapy pre-randomization.)

Additionally, patients undergo blood sample collection, computed tomography (CT), magnetic resonance imaging (MRI) and tumor tissue biopsy throughout the study. Patients may optionally undergo positron emission tomography (PET)/CT prior to treatment.

ARM II (DOSE-ESCALATED RADIATION THERAPY): Patients undergo dose-escalated RT daily, every other day, or twice weekly for 5 fractions or daily for 25 fractions (with or without concurrent fluorouracil or capecitabine for 25 fractions only). The 5-fraction regimen is preferred when feasible. After completing dose-escalated RT, patients who received less than 6 months of chemotherapy at study entry are encouraged to receive the remaining chemotherapy to total 6 months of chemotherapy. Patients may continue chemotherapy treatment beyond 6 months at physician's discretion. Additionally, patients undergo blood sample collection, CT, MRI and tumor tissue biopsy throughout the study. Patients may optionally undergo PET/CT prior to treatment.

Patients are followed every 3 months from study entry for 2 years then annually for 3 years.

Condition or DiseaseIntervention/Treatment
Locally Advanced Unresectable Pancreatic Ductal AdenocarcinomaStage II Pancreatic Cancer AJCC v8Stage III Pancreatic Cancer AJCC v8Stage IV Pancreatic Cancer AJCC v8
Procedure: Biopsy ProcedureProcedure: Biopsy Procedure

Study Design

Study TypeInterventional
Actual Enrollment356 participants
Design AllocationRandomized
Interventional ModelParallel Assignment
MaskingNone (Open Label)
Primary PurposeTreatment
Official TitleA Phase III Randomized Trial of Dose Escalated Radiation in Locally Advanced Pancreas Cancer (LAPC) Patients (LAP100)
Study Start DateAugust 20, 2025
Actual Primary Completion Date4yrs 4mos from now
Actual Study Completion Date4yrs 4mos from now

Groups and Cohorts

Group/CohortIntervention/Treatment
Arm I (Options 1, 2, or 3)
See Detailed Description.
Procedure: Biopsy Procedure
Undergo tumor tissue biopsy
Arm II (dose-escalated RT)
Patients undergo dose-escalated RT daily, every other day, or twice weekly for 5 fractions or daily for 25 fractions (with or without concurrent fluorouracil or capecitabine for 25 fractions only). The 5-fraction regimen is preferred when feasible. After completing dose-escalated RT, patients who received less than 6 months of chemotherapy at study entry are encouraged to receive the remaining chemotherapy to total 6 months of chemotherapy. Patients may continue chemotherapy treatment beyond 6 months at physician's discretion. Additionally, patients undergo blood sample collection, CT, MRI and tumor tissue biopsy throughout the study. Patients may optionally undergo PET/CT prior to treatment.
Procedure: Biopsy Procedure
Undergo tumor tissue biopsy

Outcome Measures

Primary Outcome Measures
  1. Overall survival (OS)
    OS will be estimated by the Kaplan-Meier method (Kaplan 1958). The 3-year OS estimates between the two arms will be compared using a Z-test. A logistic regression model will be used to analyze the effects of factors, in addition to treatment, including, but not limited to the stratification factor, which may be associated with 3-year OS. The primary hypothesis of improved 3-year OS will be tested with a 1-sided significance level of 0.023 (level based on not having stopped at either of the 2 planned interim analyses).
Secondary Outcome Measures
  1. Local progression (LP)
    Defined as progression of the primary tumor/nodes as determined by Response Evaluation Criteria in Solid Tumors criteria. LP will be estimated by the cumulative incidence method (Kalbfleish 1980), with death as a competing risk, and compared between treatment arms using Gray's test (Gray 1988). The Fine-Gray regression model will be used to analyze the effects of factors, in addition to treatment, which may be associated with LP (Fine 1999).
  2. Progression-free survival (PFS)
    Defined as local progression, distant failure, or death due to any cause. PFS will be estimated by the Kaplan-Meier method (Kaplan 1958) and estimates between treatment arms will be compared using the log-rank test (Mantel 1966). The Cox proportional hazard regression model will be used to analyze the effects of factors, in addition to treatment, which may be associated with PFS (Cox 1972).
  3. Chemotherapy-free interval (CFI)
    Defined as the time in months without chemotherapy for locally advanced pancreatic cancer post the initial chemotherapy treatment. Mean CFI will be compared between treatment arms using a Z-test. Regression modeling will be used to analyze the effects of factors, in addition to treatment, which may be associated with CFI.
  4. Long-term radiation-related ≥ grade 3 adverse events
    The percentage of patients on the dose-escalated radiation therapy arm will be reported.
  5. Incidence of ≥ grade 3 adverse events
    The percentage of patients will be compared between the treatment arms using a Z-test.

Eligibility Criteria

Ages Eligible for Study(Adult, Older Adult)
Sexes Eligible for StudyAll
Accepts Healthy VolunteersNo
Inclusion Criteria
At time of enrollment, the patient must have received 4-6 months of active chemotherapy with FOLFIRINOX or NALIRIFOX or gemcitabine/nab-paclitaxel. Patients are permitted to receive more than 1 type of chemotherapy for toxicity reasons, but not for disease progression. "Active chemotherapy" refers to time on chemotherapy not counting treatment breaks (i.e. if a patient had 1 month of chemotherapy followed by 1 month break, this would count as 1 month chemotherapy). Study registration must occur within 45 days of last day of chemotherapy cycle
BASELINE PRE-ENTRY CHEMOTHERAPY REQUIREMENTS:
Pathologically (histologically or cytologically) proven diagnosis of pancreatic ductal adenocarcinoma
Locally advanced unresectable disease (as defined per the National Comprehensive Cancer Network \[NCCN\] guidelines and institutional tumor board review)
Patients must have baseline pre-chemotherapy scans for staging. Options include: CT chest/abdomen/pelvis, CT chest/MRI abdomen/pelvis, CT chest/CT pelvis/MRI abdomen, or PET/CT performed prior to enrollment
Age ≥ 18 years
Performance status Eastern Cooperative Oncology Group (ECOG) 0-2
Required initial laboratory values: All laboratory values must be obtained any time prior to initiation of chemotherapy up to 30 days post initiation of chemotherapy
Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3 x upper limit of normal (ULN)
BASELINE CA19-9 AND BILIRUBIN REQUIREMENTS: The purpose is to obtain a baseline CA19-9 in the setting of a normal (or close to normal) bilirubin, since serologic response by serial CA19-9 measurements is part of post-chemotherapy eligibility criteria
If baseline CA19-9 \> 37 U/mL the concurrent bilirubin must be ≤ 1.5 x ULN. (Note: if the bilirubin is not ≤ 1.5 x ULN both the CA19-9 and concurrent bilirubin can be repeated until bilirubin is ≤ 1.5 x ULN, as long as done within specified timeframe \[up to 30 days post chemotherapy initiation\])
If baseline CA19-9 U/mL ≤ 37, there are no restrictions on the required concurrent bilirubin level, and this can be the accepted baseline value
Prior radiation treatment
Has the patient had prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields
Prior non-overlapping radiation (e.g., breast, head and neck, extremity) is permitted
If uncertain about prior overlap, please contact the study principal investigator, Dr. Nina Sanford
POST PRE-ENTRY CHEMOTHERAPY REQUIREMENTS:
If baseline CA19-9 is elevated (defined as \> 37 u/mL) the post-pre-entry chemotherapy CA19-9 must be less than 37 u/mL or a 50% decline from pre-chemotherapy level with absolute value less than 100u/mL
If baseline CA19-9 is not elevated (defined as ≤ 37 u/mL) the post-pre-entry chemotherapy CA19-9 must remain ≤ 37 u/mL
No active duodenal or gastric ulcers
No direct tumor invasion of the bowel or stomach
Restaging scans showing at least stable disease (no progression). Options for scans include: CT chest/abdomen/pelvis, CT chest/MRI abdomen/pelvis, or CT chest/CT pelvis/MRI abdomen, or PET/CT performed prior to enrollment, with restaging CT showing at least stable disease
Not pregnant and not nursing
No cardiac condition that was the primary reason for hospitalization in the last 6 months
New York Heart Association Functional Classification II or better (NYHA Functional Classification III/IV are not eligible) (Note: Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification.)
HIV-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial
Exclusion Criteria
Inclusion Criteria:
At time of enrollment, the patient must have received 4-6 months of active chemotherapy with FOLFIRINOX or NALIRIFOX or gemcitabine/nab-paclitaxel. Patients are permitted to receive more than 1 type of chemotherapy for toxicity reasons, but not for disease progression. "Active chemotherapy" refers to time on chemotherapy not counting treatment breaks (i.e. if a patient had 1 month of chemotherapy followed by 1 month break, this would count as 1 month chemotherapy). Study registration must occur within 45 days of last day of chemotherapy cycle
BASELINE PRE-ENTRY CHEMOTHERAPY REQUIREMENTS:
Pathologically (histologically or cytologically) proven diagnosis of pancreatic ductal adenocarcinoma
Locally advanced unresectable disease (as defined per the National Comprehensive Cancer Network \[NCCN\] guidelines and institutional tumor board review)
Patients must have baseline pre-chemotherapy scans for staging. Options include: CT chest/abdomen/pelvis, CT chest/MRI abdomen/pelvis, CT chest/CT pelvis/MRI abdomen, or PET/CT performed prior to enrollment
Age ≥ 18 years
Performance status Eastern Cooperative Oncology Group (ECOG) 0-2
Required initial laboratory values: All laboratory values must be obtained any time prior to initiation of chemotherapy up to 30 days post initiation of chemotherapy
Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3 x upper limit of normal (ULN)
BASELINE CA19-9 AND BILIRUBIN REQUIREMENTS: The purpose is to obtain a baseline CA19-9 in the setting of a normal (or close to normal) bilirubin, since serologic response by serial CA19-9 measurements is part of post-chemotherapy eligibility criteria
If baseline CA19-9 \> 37 U/mL the concurrent bilirubin must be ≤ 1.5 x ULN. (Note: if the bilirubin is not ≤ 1.5 x ULN both the CA19-9 and concurrent bilirubin can be repeated until bilirubin is ≤ 1.5 x ULN, as long as done within specified timeframe \[up to 30 days post chemotherapy initiation\])
If baseline CA19-9 U/mL ≤ 37, there are no restrictions on the required concurrent bilirubin level, and this can be the accepted baseline value
Prior radiation treatment
Has the patient had prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields
Prior non-overlapping radiation (e.g., breast, head and neck, extremity) is permitted
If uncertain about prior overlap, please contact the study principal investigator, Dr. Nina Sanford
POST PRE-ENTRY CHEMOTHERAPY REQUIREMENTS:
If baseline CA19-9 is elevated (defined as \> 37 u/mL) the post-pre-entry chemotherapy CA19-9 must be less than 37 u/mL or a 50% decline from pre-chemotherapy level with absolute value less than 100u/mL
If baseline CA19-9 is not elevated (defined as ≤ 37 u/mL) the post-pre-entry chemotherapy CA19-9 must remain ≤ 37 u/mL
No active duodenal or gastric ulcers
No direct tumor invasion of the bowel or stomach
Restaging scans showing at least stable disease (no progression). Options for scans include: CT chest/abdomen/pelvis, CT chest/MRI abdomen/pelvis, or CT chest/CT pelvis/MRI abdomen, or PET/CT performed prior to enrollment, with restaging CT showing at least stable disease
Not pregnant and not nursing
No cardiac condition that was the primary reason for hospitalization in the last 6 months
New York Heart Association Functional Classification II or better (NYHA Functional Classification III/IV are not eligible) (Note: Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification.)
HIV-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial

Contacts and Locations

Sponsors and CollaboratorsNRG Oncology
Locations
Banner MD Anderson Cancer Center | Gilbert Arizona, United States, 85234Arizona Center for Cancer Care - Gilbert | Gilbert Arizona, United States, 85297Arizona Center for Cancer Care-Peoria | Peoria Arizona, United States, 85381Arizona Center for Cancer Care - Phoenix | Phoenix Arizona, United States, 85027Arizona Center for Cancer Care - Scottsdale | Scottsdale Arizona, United States, 85258Arizona Center for Cancer Care-Surprise | Surprise Arizona, United States, 85374Arizona Center for Cancer Care | Tempe Arizona, United States, 85284NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro | Jonesboro Arkansas, United States, 72401AIS Cancer Center at San Joaquin Community Hospital | Bakersfield California, United States, 93301Alta Bates Summit Medical Center-Herrick Campus | Berkeley California, United States, 94704Mills-Peninsula Medical Center | Burlingame California, United States, 94010Sutter Cancer Centers Radiation Oncology Services-Cameron Park | Cameron Park California, United States, 95682Palo Alto Medical Foundation-Fremont | Fremont California, United States, 94538UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care | Irvine California, United States, 92612UC San Diego Moores Cancer Center | La Jolla California, United States, 92093Memorial Medical Center | Modesto California, United States, 95355Palo Alto Medical Foundation-Camino Division | Mountain View California, United States, 94040UC Irvine Health/Chao Family Comprehensive Cancer Center | Orange California, United States, 92868Palo Alto Medical Foundation Health Care | Palo Alto California, United States, 94301Stanford Cancer Institute Palo Alto | Palo Alto California, United States, 94304Sutter Cancer Centers Radiation Oncology Services-Roseville | Roseville California, United States, 95661Sutter Roseville Medical Center | Roseville California, United States, 95661Sutter Medical Center Sacramento | Sacramento California, United States, 95816California Pacific Medical Center-Pacific Campus | San Francisco California, United States, 94115Mills Health Center | San Mateo California, United States, 94401Ridley-Tree Cancer Center | Santa Barbara California, United States, 93105Sutter Pacific Medical Foundation | Santa Rosa California, United States, 95403Palo Alto Medical Foundation-Sunnyvale | Sunnyvale California, United States, 94086Sutter Solano Medical Center/Cancer Center | Vallejo California, United States, 94589BASS Medical Group - Lennon | Walnut Creek California, United States, 94598Rocky Mountain Cancer Centers-Boulder | Boulder Colorado, United States, 80304Rocky Mountain Cancer Centers-Penrose | Colorado Springs Colorado, United States, 80907UCHealth Memorial Hospital Central | Colorado Springs Colorado, United States, 80909Memorial Hospital North | Colorado Springs Colorado, United States, 80920AdventHealth Porter | Denver Colorado, United States, 80210AdventHealth Littleton | Littleton Colorado, United States, 80122AdventHealth Parker | Parker Colorado, United States, 80138Danbury Hospital | Danbury Connecticut, United States, 06810Smilow Cancer Hospital-Derby Care Center | Derby Connecticut, United States, 06418Smilow Cancer Hospital Care Center-Fairfield | Fairfield Connecticut, United States, 06824Smilow Cancer Hospital Care Center at Glastonbury | Glastonbury Connecticut, United States, 06033Smilow Cancer Hospital Care Center at Greenwich | Greenwich Connecticut, United States, 06830Smilow Cancer Hospital Care Center - Guilford | Guilford Connecticut, United States, 06437Smilow Cancer Hospital-Hamden Care Center | Hamden Connecticut, United States, 06518Smilow Cancer Hospital Care Center at Saint Francis | Hartford Connecticut, United States, 06105Smilow Cancer Center/Yale-New Haven Hospital | New Haven Connecticut, United States, 06510Yale University | New Haven Connecticut, United States, 06520Yale-New Haven Hospital North Haven Medical Center | North Haven Connecticut, United States, 06473Norwalk Hospital | Norwalk Connecticut, United States, 06856Smilow Cancer Hospital-Torrington Care Center | Torrington Connecticut, United States, 06790Smilow Cancer Hospital Care Center-Trumbull | Trumbull Connecticut, United States, 06611Smilow Cancer Hospital-Waterbury Care Center | Waterbury Connecticut, United States, 06708Smilow Cancer Hospital Care Center - Waterford | Waterford Connecticut, United States, 06385Helen F Graham Cancer Center | Newark Delaware, United States, 19713Medical Oncology Hematology Consultants PA | Newark Delaware, United States, 19713Christiana Care Health System-Christiana Hospital | Newark Delaware, United States, 19718Christiana Care Health System-Wilmington Hospital | Wilmington Delaware, United States, 19801MedStar Washington Hospital Center | Washington D.C. District of Columbia, United States, 20010UF Health Cancer Institute - Gainesville | Gainesville Florida, United States, 32610Grady Health System | Atlanta Georgia, United States, 30303Emory University Hospital Midtown | Atlanta Georgia, United States, 30308Piedmont Hospital | Atlanta Georgia, United States, 30309Emory University Hospital/Winship Cancer Institute | Atlanta Georgia, United States, 30322Emory Saint Joseph's Hospital | Atlanta Georgia, United States, 30342Memorial Health University Medical Center | Savannah Georgia, United States, 31404Hawaii Cancer Care Inc - Waterfront Plaza | Honolulu Hawaii, United States, 96813Queen's Cancer Cenrer - POB I | Honolulu Hawaii, United States, 96813Queen's Medical Center | Honolulu Hawaii, United States, 96813Straub Clinic and Hospital | Honolulu Hawaii, United States, 96813University of Hawaii Cancer Center | Honolulu Hawaii, United States, 96813Kuakini Medical Center | Honolulu Hawaii, United States, 96817Queen's Cancer Center - Kuakini | Honolulu Hawaii, United States, 96817The Cancer Center of Hawaii-Liliha | Honolulu Hawaii, United States, 96817Kapiolani Medical Center for Women and Children | Honolulu Hawaii, United States, 96826Wilcox Memorial Hospital and Kauai Medical Clinic | Lihue Hawaii, United States, 96766Hawaii Cancer Care - Westridge | ‘Aiea Hawaii, United States, 96701Pali Momi Medical Center | ‘Aiea Hawaii, United States, 96701Queen's Cancer Center - Pearlridge | ‘Aiea Hawaii, United States, 96701The Cancer Center of Hawaii-Pali Momi | ‘Aiea Hawaii, United States, 96701The Queen's Medical Center - West Oahu | ‘Ewa Beach Hawaii, United States, 96706Rush-Copley Medical Center | Aurora Illinois, United States, 60504Illinois CancerCare-Bloomington | Bloomington Illinois, United States, 61704Illinois CancerCare-Canton | Canton Illinois, United States, 61520Illinois CancerCare-Carthage | Carthage Illinois, United States, 62321Centralia Oncology Clinic | Centralia Illinois, United States, 62801Northwestern University | Chicago Illinois, United States, 60611University of Illinois | Chicago Illinois, United States, 60612Carle at The Riverfront | Danville Illinois, United States, 61832Cancer Care Specialists of Illinois - Decatur | Decatur Illinois, United States, 62526Decatur Memorial Hospital | Decatur Illinois, United States, 62526Northwestern Medicine Cancer Center Kishwaukee | DeKalb Illinois, United States, 60115Carle Physician Group-Effingham | Effingham Illinois, United States, 62401Crossroads Cancer Center | Effingham Illinois, United States, 62401Illinois CancerCare-Eureka | Eureka Illinois, United States, 61530Illinois CancerCare-Galesburg | Galesburg Illinois, United States, 61401Northwestern Medicine Cancer Center Delnor | Geneva Illinois, United States, 60134Northwestern Medicine Glenview Outpatient Center | Glenview Illinois, United States, 60026Northwestern Medicine Grayslake Outpatient Center | Grayslake Illinois, United States, 60030Illinois CancerCare-Kewanee Clinic | Kewanee Illinois, United States, 61443Northwestern Medicine Lake Forest Hospital | Lake Forest Illinois, United States, 60045Illinois CancerCare-Macomb | Macomb Illinois, United States, 61455Carle Physician Group-Mattoon/Charleston | Mattoon Illinois, United States, 61938Cancer Care Center of O'Fallon | O'Fallon Illinois, United States, 62269HSHS Saint Elizabeth's Hospital | O'Fallon Illinois, United States, 62269Northwestern Medicine Oak Brook | Oak Brook Illinois, United States, 60523Illinois CancerCare-Ottawa Clinic | Ottawa Illinois, United States, 61350Illinois CancerCare-Pekin | Pekin Illinois, United States, 61554Illinois CancerCare-Peoria | Peoria Illinois, United States, 61615OSF Saint Francis Medical Center | Peoria Illinois, United States, 61637Illinois CancerCare-Peru | Peru Illinois, United States, 61354Illinois CancerCare-Princeton | Princeton Illinois, United States, 61356Southern Illinois University School of Medicine | Springfield Illinois, United States, 62702Springfield Clinic | Springfield Illinois, United States, 62702Springfield Memorial Hospital | Springfield Illinois, United States, 62781Carle Cancer Center | Urbana Illinois, United States, 61801Northwestern Medicine Cancer Center Warrenville | Warrenville Illinois, United States, 60555Illinois CancerCare - Washington | Washington Illinois, United States, 61571Goshen Center for Cancer Care | Goshen Indiana, United States, 46526UI Health Care Mission Cancer and Blood - Ankeny Clinic | Ankeny Iowa, United States, 50023UI Health Care Mission Cancer and Blood - West Des Moines Clinic | Clive Iowa, United States, 50325Iowa Methodist Medical Center | Des Moines Iowa, United States, 50309UI Health Care Mission Cancer and Blood - Des Moines Clinic | Des Moines Iowa, United States, 50309UI Health Care Mission Cancer and Blood - Laurel Clinic | Des Moines Iowa, United States, 50314UI Health Care Mission Cancer and Blood - Waukee Clinic | Waukee Iowa, United States, 50263University of Kansas Cancer Center | Kansas City Kansas, United States, 66160Lawrence Memorial Hospital | Lawrence Kansas, United States, 66044The University of Kansas Cancer Center - Olathe | Olathe Kansas, United States, 66061University of Kansas Cancer Center-Overland Park | Overland Park Kansas, United States, 66210Salina Regional Health Center | Salina Kansas, United States, 67401University of Kansas Health System Saint Francis Campus | Topeka Kansas, United States, 66606University of Kansas Hospital-Westwood Cancer Center | Westwood Kansas, United States, 66205University of Kentucky/Markey Cancer Center | Lexington Kentucky, United States, 40536MaineHealth Coastal Cancer Treatment Center | Bath Maine, United States, 04530MaineHealth Maine Medical Center - Portland | Portland Maine, United States, 04102MaineHealth Cancer Care Center of York County | Sanford Maine, United States, 04073MaineHealth Maine Medical Center- Scarborough | Scarborough Maine, United States, 04074MaineHealth Cancer Care and IV Therapy - South Portland | South Portland Maine, United States, 04106Sinai Hospital of Baltimore | Baltimore Maryland, United States, 21215William E Kahlert Regional Cancer Center/Sinai Hospital | Westminster Maryland, United States, 21157Trinity Health Saint Joseph Mercy Hospital Ann Arbor | Ann Arbor Michigan, United States, 48106University of Michigan Rogel Cancer Center | Ann Arbor Michigan, United States, 48109Trinity Health IHA Medical Group Hematology Oncology - Brighton | Brighton Michigan, United States, 48114Trinity Health Medical Center - Brighton | Brighton Michigan, United States, 48114University of Michigan - Brighton Center for Specialty Care | Brighton Michigan, United States, 48116Henry Ford Cancer Institute-Downriver | Brownstown Michigan, United States, 48183Trinity Health IHA Medical Group Hematology Oncology - Canton | Canton Michigan, United States, 48188Trinity Health Medical Center - Canton | Canton Michigan, United States, 48188Chelsea Hospital | Chelsea Michigan, United States, 48118Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital | Chelsea Michigan, United States, 48118Henry Ford Macomb Hospital-Clinton Township | Clinton Township Michigan, United States, 48038Henry Ford Medical Center-Fairlane | Dearborn Michigan, United States, 48126Henry Ford Hospital | Detroit Michigan, United States, 48202Corewell Health Grand Rapids Hospitals - Butterworth Hospital | Grand Rapids Michigan, United States, 49503Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital | Grand Rapids Michigan, United States, 49503Trinity Health Grand Rapids Hospital | Grand Rapids Michigan, United States, 49503Allegiance Health | Jackson Michigan, United States, 49201Bronson Methodist Hospital | Kalamazoo Michigan, United States, 49007West Michigan Cancer Center | Kalamazoo Michigan, United States, 49007Beacon Kalamazoo | Kalamazoo Michigan, United States, 49048University of Michigan Health - Sparrow Lansing | Lansing Michigan, United States, 48912Trinity Health Saint Mary Mercy Livonia Hospital | Livonia Michigan, United States, 48154Henry Ford Medical Center-Columbus | Novi Michigan, United States, 48377Michigan Healthcare Professionals Pontiac | Pontiac Michigan, United States, 48341Trinity Health Saint Joseph Mercy Oakland Hospital | Pontiac Michigan, United States, 48341MyMichigan Medical Center Saginaw | Saginaw Michigan, United States, 48601MyMichigan Medical Center Tawas | Tawas City Michigan, United States, 48764Henry Ford West Bloomfield Hospital | West Bloomfield Michigan, United States, 48322Henry Ford Wyandotte Hospital | Wyandotte Michigan, United States, 48192University of Michigan Health - West | Wyoming Michigan, United States, 49519Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus | Ypsilanti Michigan, United States, 48197Sanford Joe Lueken Cancer Center | Bemidji Minnesota, United States, 56601Baptist Memorial Hospital and Cancer Center-Golden Triangle | Columbus Mississippi, United States, 39705Baptist Cancer Center-Grenada | Grenada Mississippi, United States, 38901Baptist Memorial Hospital and Cancer Center-Union County | New Albany Mississippi, United States, 38652Baptist Memorial Hospital and Cancer Center-Oxford | Oxford Mississippi, United States, 38655Baptist Memorial Hospital and Cancer Center-Desoto | Southhaven Mississippi, United States, 38671University of Kansas Cancer Center - North | Kansas City Missouri, United States, 64154University of Kansas Cancer Center - Lee's Summit | Lee's Summit Missouri, United States, 64064Nebraska Medicine-Village Pointe | Omaha Nebraska, United States, 68118University of Nebraska Medical Center | Omaha Nebraska, United States, 68198Renown Regional Medical Center | Reno Nevada, United States, 89502Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center | Lebanon New Hampshire, United States, 03756Memorial Sloan Kettering Basking Ridge | Basking Ridge New Jersey, United States, 07920Cooper Hospital University Medical Center | Camden New Jersey, United States, 08103Jefferson Cherry Hill Hospital | Cherry Hill New Jersey, United States, 08002Memorial Sloan Kettering Monmouth | Middletown New Jersey, United States, 07748Memorial Sloan Kettering Bergen | Montvale New Jersey, United States, 07645New York-Presbyterian/Brooklyn Methodist Hospital | Brooklyn New York, United States, 11215Memorial Sloan Kettering Commack | Commack New York, United States, 11725Memorial Sloan Kettering Westchester | East White Plains New York, United States, 10604NYU Langone Hospital - Long Island | Mineola New York, United States, 11501Laura and Isaac Perlmutter Cancer Center at NYU Langone | New York New York, United States, 10016Mount Sinai West | New York New York, United States, 10019Mount Sinai Hospital | New York New York, United States, 10029NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center | New York New York, United States, 10032Memorial Sloan Kettering Cancer Center | New York New York, United States, 10065Montefiore Medical Center-Einstein Campus | The Bronx New York, United States, 10461Montefiore Medical Center - Moses Campus | The Bronx New York, United States, 10467Memorial Sloan Kettering Nassau | Uniondale New York, United States, 11553UNC Lineberger Comprehensive Cancer Center | Chapel Hill North Carolina, United States, 27599Sanford Bismarck Medical Center | Bismarck North Dakota, United States, 58501Sanford Broadway Medical Center | Fargo North Dakota, United States, 58122Sanford Roger Maris Cancer Center | Fargo North Dakota, United States, 58122Miami Valley Hospital South | Centerville Ohio, United States, 45459University of Cincinnati Cancer Center-UC Medical Center | Cincinnati Ohio, United States, 45219Ohio State University Comprehensive Cancer Center | Columbus Ohio, United States, 43210Miami Valley Hospital | Dayton Ohio, United States, 45409Premier Blood and Cancer Center | Dayton Ohio, United States, 45409Miami Valley Hospital North | Dayton Ohio, United States, 45415Dublin Methodist Hospital | Dublin Ohio, United States, 43016Atrium Medical Center-Middletown Regional Hospital | Franklin Ohio, United States, 45005-1066Miami Valley Cancer Care and Infusion | Greenville Ohio, United States, 45331ProMedica Flower Hospital | Sylvania Ohio, United States, 43560ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital | Toledo Ohio, United States, 43606Upper Valley Medical Center | Troy Ohio, United States, 45373University of Cincinnati Cancer Center-West Chester | West Chester Ohio, United States, 45069Oregon Health and Science University | Portland Oregon, United States, 97239Christiana Care Health System-Concord Health Center | Chadds Ford Pennsylvania, United States, 19317Geisinger Medical Center | Danville Pennsylvania, United States, 17822Jefferson Hospital | Jefferson Hills Pennsylvania, United States, 15025Geisinger Medical Oncology-Lewisburg | Lewisburg Pennsylvania, United States, 17837Forbes Hospital | Monroeville Pennsylvania, United States, 15146Paoli Memorial Hospital | Paoli Pennsylvania, United States, 19301Thomas Jefferson University Hospital | Philadelphia Pennsylvania, United States, 19107Jefferson Torresdale Hospital | Philadelphia Pennsylvania, United States, 19114Allegheny General Hospital | Pittsburgh Pennsylvania, United States, 15212West Penn Hospital | Pittsburgh Pennsylvania, United States, 15224Reading Hospital | West Reading Pennsylvania, United States, 19611Geisinger Wyoming Valley/Henry Cancer Center | Wilkes-Barre Pennsylvania, United States, 18711Medical University of South Carolina | Charleston South Carolina, United States, 29425Saint Francis Hospital | Greenville South Carolina, United States, 29601Saint Francis Cancer Center | Greenville South Carolina, United States, 29607Sanford Cancer Center Oncology Clinic | Sioux Falls South Dakota, United States, 57104Sanford USD Medical Center - Sioux Falls | Sioux Falls South Dakota, United States, 57117-5134Baptist Memorial Hospital and Cancer Center-Collierville | Collierville Tennessee, United States, 38017Baptist Memorial Hospital and Cancer Center-Memphis | Memphis Tennessee, United States, 38120Houston Methodist San Jacinto Hospital | Baytown Texas, United States, 77521MD Anderson in The Woodlands | Conroe Texas, United States, 77384Houston Methodist Cypress Hospital | Cypress Texas, United States, 77429Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center | Houston Texas, United States, 77030Ben Taub General Hospital | Houston Texas, United States, 77030Houston Methodist Hospital | Houston Texas, United States, 77030M D Anderson Cancer Center | Houston Texas, United States, 77030Methodist Willowbrook Hospital | Houston Texas, United States, 77070MD Anderson West Houston | Houston Texas, United States, 77079Houston Methodist West Hospital | Houston Texas, United States, 77094MD Anderson League City | League City Texas, United States, 77573Houston Methodist Saint John Hospital | Nassau Bay Texas, United States, 77058University of Texas Health Science Center at San Antonio | San Antonio Texas, United States, 78229MD Anderson in Sugar Land | Sugar Land Texas, United States, 77478Houston Methodist Sugar Land Hospital | Sugar Land Texas, United States, 77479Houston Methodist The Woodlands Hospital | The Woodlands Texas, United States, 77385Dartmouth Cancer Center - North | Saint Johnsbury Vermont, United States, 05819Inova Alexandria Hospital | Alexandria Virginia, United States, 22304Inova Schar Cancer Institute | Fairfax Virginia, United States, 22031Inova Fair Oaks Hospital | Fairfax Virginia, United States, 22033Inova Fairfax Hospital | Falls Church Virginia, United States, 22042Inova Loudoun Hospital | Leesburg Virginia, United States, 20176Bon Secours Memorial Regional Medical Center | Mechanicsville Virginia, United States, 23116Bon Secours Saint Francis Medical Center | Midlothian Virginia, United States, 23114Bon Secours Saint Mary's Hospital | Richmond Virginia, United States, 23226Bon Secours Cancer Institute at Reynolds Crossing | Richmond Virginia, United States, 23230Fred Hutchinson Cancer Center | Seattle Washington, United States, 98109University of Washington Medical Center - Montlake | Seattle Washington, United States, 98195Edwards Comprehensive Cancer Center | Huntington West Virginia, United States, 25701Langlade Hospital and Cancer Center | Antigo Wisconsin, United States, 54409Marshfield Medical Center-EC Cancer Center | Eau Claire Wisconsin, United States, 54701Marshfield Medical Center-Marshfield | Marshfield Wisconsin, United States, 54449Froedtert Menomonee Falls Hospital | Menomonee Falls Wisconsin, United States, 53051Medical College of Wisconsin | Milwaukee Wisconsin, United States, 53226Drexel Town Square Health Center | Oak Creek Wisconsin, United States, 53154Aspirus Cancer Care - James Beck Cancer Center | Rhinelander Wisconsin, United States, 54501Marshfield Medical Center-Rice Lake | Rice Lake Wisconsin, United States, 54868Aspirus Cancer Care - Stevens Point | Stevens Point Wisconsin, United States, 54481Marshfield Medical Center-River Region at Stevens Point | Stevens Point Wisconsin, United States, 54482Aspirus Regional Cancer Center | Wausau Wisconsin, United States, 54401Froedtert West Bend Hospital/Kraemer Cancer Center | West Bend Wisconsin, United States, 53095Marshfield Medical Center - Weston | Weston Wisconsin, United States, 54476Aspirus Cancer Care - Wisconsin Rapids | Wisconsin Rapids Wisconsin, United States, 54494
Investigators
Principal Investigator: Nina N Sanford, NRG Oncology