Study Description

PRIMARY OBJECTIVES:

I. To compare progression-free survival (PFS) in patients with newly diagnosed myeloma treated with lenalidomide plus low dose dexamethasone versus bortezomib plus lenalidomide and low dose dexamethasone.

SECONDARY OBJECTIVES:

I. Assess response using the new international response criteria. II. To bank specimens for future translational medicine research. III. Follow patients to assess overall survival and other long-term outcomes stratified by intent to transplant at progression.

TERTIARY OBJECTIVES:

I. To evaluate custom and genome-wide single nucleotide polymorphisms in correlation with biology, prognosis and outcome for both treatment regimens combined; to verify the findings recently obtained with the custom Bank on a Cure program (BOAC) single nucleotide polymorphism (SNP) chip on Total Therapy 2 (TT2) data with respect to bone disease in the cooperative group setting.

II. To use baseline gene expression profiling as a tool to evaluate the biology, prognostic and risk factors, and response to therapy for both treatment regimens combined. To validate John Shaughnessy's 70 gene risk model developed for Total Therapy 2 (TT2) in the cooperative group setting.

OUTLINE:

INDUCTION THERAPY: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive dexamethasone orally (PO) once daily (QD) on days 1, 8, 15, and 22 and lenalidomide PO QD on days 1-21. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.

ARM II: Patients receive dexamethasone PO QD on days 1, 2, 4, 5, 8, 9, 11, and 12; lenalidomide PO QD on days 1-14; and bortezomib intravenously (IV) over 3-5 seconds on days 1, 4, 8, and 11. Treatment repeats every 21 days for 8 courses in the absence of disease progression or unacceptable toxicity.

In both arms, patients who intend to undergo transplantation at relapse undergo peripheral blood stem cell collection, preferably after course 2.

MAINTENANCE THERAPY: After the completion of at least 4 courses (Arm I) or at least 6 courses (Arm II) of induction therapy, patients receive maintenance therapy comprising dexamethasone PO QD on days 1, 8, 15, and 22 and lenalidomide PO QD on days 1-21. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up periodically for up to 6 years.

Condition or Disease	Intervention/Treatment
DS Stage I Multiple Myeloma DS Stage II Multiple Myeloma DS Stage III Multiple Myeloma	Drug: Bortezomib Drug: Dexamethasone Other: Laboratory Biomarker Analysis Drug: Lenalidomide

Study Design

Study Type	Interventional
Actual Enrollment	525 participants
Design Allocation	Randomized
Interventional Model	Parallel Assignment
Masking	None (Open Label)
Primary Purpose	Treatment
Official Title	A Randomized Phase III Trial of CC-5013 (Lenalidomide, NSC-703813) and Low Dose Dexamethasone (LLD) Versus Bortezomib (PS-341, NSC-681239), Lenalidomide And Low Dose Dexamethasone (BLLD) for Induction, in Patients With Previously Untreated Multiple Myeloma Without an Intent for Immediate Autologous Stem Cell Transplant
Study Start Date	July 28, 2008
Actual Primary Completion Date	November 5, 2015
Anticipated Study Completion Date	September 18, 2025

Groups and Cohorts

Group/ Cohort	Intervention/ Treatment
Arm I (dexamethasone and lenalidomide) Patients receive dexamethasone PO QD on days 1, 8, 15, and 22 and lenalidomide PO QD on days 1-21. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.	Drug: Dexamethasone Other: Laboratory Biomarker Analysis Drug: Lenalidomide
Arm II (dexamethasone, lenalidomide, bortezomib) Patients receive dexamethasone PO QD on days 1, 2, 4, 5, 8, 9, 11, and 12; lenalidomide PO QD on days 1-14; and bortezomib IV over 3-5 seconds on days 1, 4, 8, and 11. Treatment repeats every 21 days for 8 courses in the absence of disease progression or unacceptable toxicity.	Drug: Bortezomib Given IV Drug: Dexamethasone Other: Laboratory Biomarker Analysis Drug: Lenalidomide

Outcome Measures

Primary Outcome Measures

1. Progression-free Survival [From date of registration to date of first documentation of progression or symptomatic deterioration, or death due to any cause, assessed up to 6 years]
   Unstratified median progression-free survival in months.

Secondary Outcome Measures

1. Overall Survival [Up to 6 years]
   Unstratified median overall survival in months.
2. Response Rates () [Up to 6 years]
   The response rate was calculated as the number of patients with documented confirmed partial response (PR) or better, which includes confirmed/unconfirmed stringent complete response (sCR), confirmed/unconfirmed complete response (CR), confirmed/unconfirmed very good partial response (VGPR), or confirmed partial response (PR), as best response divided by the total number of evaluable patients, in each arm. Patients with measurable disease, as defined in the protocol, are evaluable. Response rates were compared between the two treatment arms using a stratified Cochran-Mantel-Haenszel test. Response designations were based on the International Uniform Response Criteria for Multiple Myeloma. Due to the complexity of these criteria, the details of these criteria have been omitted.

Eligibility Criteria

Ages Eligible for Study	18 Years and Older (Adult, Older Adult)
Sexes Eligible for Study	All
Accepts Healthy Volunteers	No
Inclusion Criteria	Patients must have newly diagnosed multiple myeloma with measurable disease; patients with non-secretory multiple myeloma (MM) based upon standard M-component criteria (i.e., measurable serum/urine M-component) are not eligible for this study; exception: patients with non-secretory MM will be eligible only if the baseline serum Freelite is elevated (Note that serum Freelite must be drawn; serum light chains are not acceptable); all tests for establishing baseline disease status must be completed within 28 days prior to registration and documented on the baseline and follow-up tumor assessment form for multiple myeloma Patients must have received no prior chemotherapy for this disease; patients must have received no prior radiotherapy to a large area of the pelvis (more than half of the pelvis); prior steroid treatment is allowed provided treatment was not more than 2 weeks in duration; patients must not have received any prior treatment with bortezomib or lenalidomide Patients must have a Zubrod performance status (PS) of 0 - 3; NOTE: patients with PS 3 are eligible only if it is documented by the treating physician that the patient's multiple myeloma is the central cause of his/her disability; patients who have a PS of 3 due to other concurrent medical conditions are not eligible for this trial Platelet count >= 80 x 10^3/mcL; must be obtained within 28 days prior to registration; exception: patients with biopsy-proven heavy-marrow involvement, as defined by having at least 30% marrow cellularity, with > 50% of the cells being malignant plasma cells (documented marrow results required); in this case, although there are no required lower limits of normal for the blood counts, the treating physician must use his/her medical judgment as to the appropriateness of this study therapy for these patients Absolute neutrophil count (ANC) >= 1 x 10^3/mcL; must be obtained within 28 days prior to registration; exception: patients with biopsy-proven heavy-marrow involvement, as defined by having at least 30% marrow cellularity, with > 50% of the cells being malignant plasma cells (documented marrow results required); in this case, although there are no required lower limits of normal for the blood counts, the treating physician must use his/her medical judgment as to the appropriateness of this study therapy for these patients Hemoglobin (including patients who have been either transfused or treated with erythropoietin [EPO]) >= 9 g/dL; must be obtained within 28 days prior to registration; exception: patients with biopsy-proven heavy-marrow involvement, as defined by having at least 30% marrow cellularity, with > 50% of the cells being malignant plasma cells (documented marrow results required); in this case, although there are no required lower limits of normal for the blood counts, the treating physician must use his/her medical judgment as to the appropriateness of this study therapy for these patients Patients must be offered participation in the Myeloma Specimen Repository for banking and future research; with the patient's consent, bone marrow aspirates and serum specimens will be submitted to the Myeloma Specimen Repository for additional testing and banking (including SNP testing); patient consent must be obtained before specimens may be submitted Patients must have baseline skeletal survey to include lateral skull, anterior-posterior (AP) pelvis and posterior-anterior (PA) chest within 28 days prior to registration Institutions must submit a local cytogenetics report and fluorescence in situ hybridization (FISH) analysis report obtained prior to enrollment to S0777; for FISH analysis two probes will be utilized: LSI 13 (RBI) 13q14 SpectrumOrange Probe for detection of chromosome 13 deletion and LSI p53 (17p13.1) SpectrumOrange probe for detection of tumor protein (p)53 locus on chromosome 17; if these exact probes are not available locally, it is acceptable to submit results using local protocol; this must be noted on the prestudy form; NOTE: it is not required that the results of the FISH analysis be known prior to registration, only that pre-registration specimens be drawn and sent for analysis prior to registration, and the FISH analysis report be submitted Patients with pathologic fractures, pneumonia at diagnosis or symptomatic hyperviscosity must have these conditions attended to prior to registration (i.e., intramedullary rod, I.V. antibiotics, plasmapheresis) Patients must have a calculated or measured creatinine clearance > 30 cc/min; measured creatinine clearance or serum creatinine used in calculation must be obtained within 28 days prior to registration Patients must not have uncontrolled, active infection requiring intravenous antibiotics, New York Heart Association (NYHA) class III or class IV heart failure, myocardial infarction within the last 6 months, history of treatment for clinically significant ventricular cardiac arrhythmias, poorly controlled hypertension, or poorly controlled diabetes mellitus; patients must have undergone an electrocardiogram (EKG) within 28 days prior to registration Patients must not have any psychiatric illness that could potentially interfere with the completion of treatment according to this protocol Patients must not be hepatitis B, hepatitis C or human immunodeficiency virus (HIV) positive; patients must have a negative hepatitis B and HIV test performed within 28 days prior to registration; exception: treatment-sensitive HIV infection patients will be eligible provided that immunological and virologic indices are indicative of favorable long-term survival prospects on the basis of HIV infection, but whose life expectancy is limited predominantly by multiple myeloma rather than HIV infection in the judgment of the treating physician Patients must not have a history of cerebral vascular accident with persistent neurologic deficits Patients must be able to take aspirin 325 mg daily (or enoxaparin 40 mg subcutaneously [SQ] daily if patient is unable to take aspirin) as prophylactic anticoagulation; exception: patients receiving anticoagulation therapy such as Coumadin or heparin will NOT receive aspirin, and therefore need not be able to take it Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 25 mIU/mL within 10 - 14 days and again within 24 hours prior to starting cycle 1 of lenalidomide; further, they must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control: one highly effective method and one additional effective method AT THE SAME TIME, at least 28 days before starting lenalidomide; FCBP must also agree to ongoing pregnancy testing; men must agree to use a latex condom during sexual contact with a FCBP, even if they have had a successful vasectomy; a FCBP is a sexually mature woman who: has not undergone a hysterectomy or bilateral oophorectomy; or has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months); all patients must be counseled by a trained counselor every 28 days about pregnancy precautions and risks of fetal exposure No prior malignancy is allowed except for adequately treated basal cell (or squamous cell) skin cancer, in situ cervical cancer or other cancer for which the patient has been disease-free for five years Patients must be offered participation in gene expression profiling (GEP) molecular studies for the evaluation of genetic polymorphisms All patients must be informed of the investigational nature of this study and must sign and give written consent in accordance with institutional federal guidelines At the time of patient registration, the treating institution's name and identification (ID) number must be provided to the statistical center in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been enter
Exclusion Criteria	Patients must have newly diagnosed multiple myeloma with measurable disease; patients with non-secretory multiple myeloma (MM) based upon standard M-component criteria (i.e., measurable serum/urine M-component) are not eligible for this study; exception: patients with non-secretory MM will be eligible only if the baseline serum Freelite is elevated (Note that serum Freelite must be drawn; serum light chains are not acceptable); all tests for establishing baseline disease status must be completed within 28 days prior to registration and documented on the baseline and follow-up tumor assessment form for multiple myeloma Patients must have received no prior chemotherapy for this disease; patients must have received no prior radiotherapy to a large area of the pelvis (more than half of the pelvis); prior steroid treatment is allowed provided treatment was not more than 2 weeks in duration; patients must not have received any prior treatment with bortezomib or lenalidomide Patients must have a Zubrod performance status (PS) of 0 - 3; NOTE: patients with PS 3 are eligible only if it is documented by the treating physician that the patient's multiple myeloma is the central cause of his/her disability; patients who have a PS of 3 due to other concurrent medical conditions are not eligible for this trial Platelet count >= 80 x 10^3/mcL; must be obtained within 28 days prior to registration; exception: patients with biopsy-proven heavy-marrow involvement, as defined by having at least 30% marrow cellularity, with > 50% of the cells being malignant plasma cells (documented marrow results required); in this case, although there are no required lower limits of normal for the blood counts, the treating physician must use his/her medical judgment as to the appropriateness of this study therapy for these patients Absolute neutrophil count (ANC) >= 1 x 10^3/mcL; must be obtained within 28 days prior to registration; exception: patients with biopsy-proven heavy-marrow involvement, as defined by having at least 30% marrow cellularity, with > 50% of the cells being malignant plasma cells (documented marrow results required); in this case, although there are no required lower limits of normal for the blood counts, the treating physician must use his/her medical judgment as to the appropriateness of this study therapy for these patients Hemoglobin (including patients who have been either transfused or treated with erythropoietin [EPO]) >= 9 g/dL; must be obtained within 28 days prior to registration; exception: patients with biopsy-proven heavy-marrow involvement, as defined by having at least 30% marrow cellularity, with > 50% of the cells being malignant plasma cells (documented marrow results required); in this case, although there are no required lower limits of normal for the blood counts, the treating physician must use his/her medical judgment as to the appropriateness of this study therapy for these patients Patients must be offered participation in the Myeloma Specimen Repository for banking and future research; with the patient's consent, bone marrow aspirates and serum specimens will be submitted to the Myeloma Specimen Repository for additional testing and banking (including SNP testing); patient consent must be obtained before specimens may be submitted Patients must have baseline skeletal survey to include lateral skull, anterior-posterior (AP) pelvis and posterior-anterior (PA) chest within 28 days prior to registration Institutions must submit a local cytogenetics report and fluorescence in situ hybridization (FISH) analysis report obtained prior to enrollment to S0777; for FISH analysis two probes will be utilized: LSI 13 (RBI) 13q14 SpectrumOrange Probe for detection of chromosome 13 deletion and LSI p53 (17p13.1) SpectrumOrange probe for detection of tumor protein (p)53 locus on chromosome 17; if these exact probes are not available locally, it is acceptable to submit results using local protocol; this must be noted on the prestudy form; NOTE: it is not required that the results of the FISH analysis be known prior to registration, only that pre-registration specimens be drawn and sent for analysis prior to registration, and the FISH analysis report be submitted Patients with pathologic fractures, pneumonia at diagnosis or symptomatic hyperviscosity must have these conditions attended to prior to registration (i.e., intramedullary rod, I.V. antibiotics, plasmapheresis) Patients must have a calculated or measured creatinine clearance > 30 cc/min; measured creatinine clearance or serum creatinine used in calculation must be obtained within 28 days prior to registration Patients must not have uncontrolled, active infection requiring intravenous antibiotics, New York Heart Association (NYHA) class III or class IV heart failure, myocardial infarction within the last 6 months, history of treatment for clinically significant ventricular cardiac arrhythmias, poorly controlled hypertension, or poorly controlled diabetes mellitus; patients must have undergone an electrocardiogram (EKG) within 28 days prior to registration Patients must not have any psychiatric illness that could potentially interfere with the completion of treatment according to this protocol Patients must not be hepatitis B, hepatitis C or human immunodeficiency virus (HIV) positive; patients must have a negative hepatitis B and HIV test performed within 28 days prior to registration; exception: treatment-sensitive HIV infection patients will be eligible provided that immunological and virologic indices are indicative of favorable long-term survival prospects on the basis of HIV infection, but whose life expectancy is limited predominantly by multiple myeloma rather than HIV infection in the judgment of the treating physician Patients must not have a history of cerebral vascular accident with persistent neurologic deficits Patients must be able to take aspirin 325 mg daily (or enoxaparin 40 mg subcutaneously [SQ] daily if patient is unable to take aspirin) as prophylactic anticoagulation; exception: patients receiving anticoagulation therapy such as Coumadin or heparin will NOT receive aspirin, and therefore need not be able to take it Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 25 mIU/mL within 10 - 14 days and again within 24 hours prior to starting cycle 1 of lenalidomide; further, they must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control: one highly effective method and one additional effective method AT THE SAME TIME, at least 28 days before starting lenalidomide; FCBP must also agree to ongoing pregnancy testing; men must agree to use a latex condom during sexual contact with a FCBP, even if they have had a successful vasectomy; a FCBP is a sexually mature woman who: has not undergone a hysterectomy or bilateral oophorectomy; or has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months); all patients must be counseled by a trained counselor every 28 days about pregnancy precautions and risks of fetal exposure No prior malignancy is allowed except for adequately treated basal cell (or squamous cell) skin cancer, in situ cervical cancer or other cancer for which the patient has been disease-free for five years Patients must be offered participation in gene expression profiling (GEP) molecular studies for the evaluation of genetic polymorphisms All patients must be informed of the investigational nature of this study and must sign and give written consent in accordance with institutional federal guidelines At the time of patient registration, the treating institution's name and identification (ID) number must be provided to the statistical center in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered into the data base

Contacts and Locations

Sponsors and Collaborators	National Cancer Institute (NCI)
Locations	Providence Alaska Medical Center | Anchorage, Alaska, United States, 99508 Mayo Clinic in Arizona | Scottsdale, Arizona, United States, 85259 University of Arizona Cancer Center-Orange Grove Campus | Tucson, Arizona, United States, 85704 Banner University Medical Center - Tucson | Tucson, Arizona, United States, 85719 University of Arizona Cancer Center-North Campus | Tucson, Arizona, United States, 85719 University of Arkansas for Medical Sciences | Little Rock, Arkansas, United States, 72205 Kaiser Permanente-Deer Valley Medical Center | Antioch, California, United States, 94531 PCR Oncology | Arroyo Grande, California, United States, 93420 Alta Bates Summit Medical Center-Herrick Campus | Berkeley, California, United States, 94704 Providence Saint Joseph Medical Center/Disney Family Cancer Center | Burbank, California, United States, 91505 Mills-Peninsula Medical Center | Burlingame, California, United States, 94010 Kaiser Permanente-Fremont | Fremont, California, United States, 94538 Kaiser Permanente-Fresno | Fresno, California, United States, 93720 Saint Jude Medical Center | Fullerton, California, United States, 92835 Marin General Hospital | Greenbrae, California, United States, 94904 Fremont - Rideout Cancer Center | Marysville, California, United States, 95901 Providence Holy Cross Medical Center | Mission Hills, California, United States, 91346-9600 Palo Alto Medical Foundation-Camino Division | Mountain View, California, United States, 94040 Sutter Cancer Research Consortium | Novato, California, United States, 94945 Kaiser Permanente-Oakland | Oakland, California, United States, 94611 Saint Joseph Hospital - Orange | Orange, California, United States, 92868 Desert Regional Medical Center | Palm Springs, California, United States, 92262 Palo Alto Medical Foundation Health Care | Palo Alto, California, United States, 94301 Valley Medical Oncology Consultants | Pleasanton, California, United States, 94588 Eisenhower Medical Center | Rancho Mirage, California, United States, 92270 Kaiser Permanente-Redwood City | Redwood City, California, United States, 94063 Kaiser Permanente-Richmond | Richmond, California, United States, 94801 Kaiser Permanente-Roseville | Roseville, California, United States, 95661 University of California Davis Comprehensive Cancer Center | Sacramento, California, United States, 95817 Kaiser Permanente-South Sacramento | Sacramento, California, United States, 95823 Kaiser Permanente Sacramento Medical Center | Sacramento, California, United States, 95825 California Pacific Medical Center-Pacific Campus | San Francisco, California, United States, 94115 Kaiser Permanente-San Francisco | San Francisco, California, United States, 94115 Kaiser Permanente-Santa Teresa-San Jose | San Jose, California, United States, 95119 Kaiser Permanente San Leandro | San Leandro, California, United States, 94577 Kaiser Permanente-San Rafael | San Rafael, California, United States, 94903 Kaiser Permanente Medical Center - Santa Clara | Santa Clara, California, United States, 95051 Kaiser Permanente-Santa Rosa | Santa Rosa, California, United States, 95403 Kaiser Permanente-South San Francisco | South San Francisco, California, United States, 94080 Kaiser Permanente-Stockton | Stockton, California, United States, 95210 Gene Upshaw Memorial Tahoe Forest Cancer Center | Truckee, California, United States, 96161 Kaiser Permanente Medical Center-Vacaville | Vacaville, California, United States, 95688 Kaiser Permanente-Vallejo | Vallejo, California, United States, 94589 Sutter Solano Medical Center/Cancer Center | Vallejo, California, United States, 94589 Kaiser Permanente-Walnut Creek | Walnut Creek, California, United States, 94596 The Medical Center of Aurora | Aurora, Colorado, United States, 80012 UCHealth University of Colorado Hospital | Aurora, Colorado, United States, 80045 Boulder Community Hospital | Boulder, Colorado, United States, 80301 Penrose-Saint Francis Healthcare | Colorado Springs, Colorado, United States, 80907 Denver Health Medical Center | Denver, Colorado, United States, 80204 Kaiser Permanente-Franklin | Denver, Colorado, United States, 80205 Porter Adventist Hospital | Denver, Colorado, United States, 80210 University of Colorado | Denver, Colorado, United States, 80217-3364 Presbyterian - Saint Lukes Medical Center - Health One | Denver, Colorado, United States, 80218 SCL Health Saint Joseph Hospital | Denver, Colorado, United States, 80218 Rose Medical Center | Denver, Colorado, United States, 80220 Western States Cancer Research NCORP | Denver, Colorado, United States, 80222 Swedish Medical Center | Englewood, Colorado, United States, 80113 Poudre Valley Hospital | Fort Collins, Colorado, United States, 80524 Saint Mary's Hospital and Regional Medical Center | Grand Junction, Colorado, United States, 81501 Banner North Colorado Medical Center | Greeley, Colorado, United States, 80631 Kaiser Permanente-Rock Creek | Lafayette, Colorado, United States, 80026 Saint Anthony Hospital | Lakewood, Colorado, United States, 80228 Sky Ridge Medical Center | Lone Tree, Colorado, United States, 80124 Longmont United Hospital | Longmont, Colorado, United States, 80501 Banner McKee Medical Center | Loveland, Colorado, United States, 80539 Parker Adventist Hospital | Parker, Colorado, United States, 80138 Saint Mary Corwin Medical Center | Pueblo, Colorado, United States, 81004 North Suburban Medical Center | Thornton, Colorado, United States, 80229 Intermountain Health Lutheran Hospital | Wheat Ridge, Colorado, United States, 80401 Danbury Hospital | Danbury, Connecticut, United States, 06810 Smilow Cancer Hospital Care Center at Saint Francis | Hartford, Connecticut, United States, 06105 The Hospital of Central Connecticut | New Britain, Connecticut, United States, 06050 Norwalk Hospital | Norwalk, Connecticut, United States, 06856 Beebe Medical Center | Lewes, Delaware, United States, 19958 Christiana Care Health System-Christiana Hospital | Newark, Delaware, United States, 19718 Mayo Clinic in Florida | Jacksonville, Florida, United States, 32224-9980 AdventHealth Orlando | Orlando, Florida, United States, 32803 Orlando Health Cancer Institute | Orlando, Florida, United States, 32806 Martin Medical Center | Stuart, Florida, United States, 34994 Robert and Carol Weissman Cancer Center at Martin Health | Stuart, Florida, United States, 34994 Martin Hospital South | Stuart, Florida, United States, 34997 Piedmont Hospital | Atlanta, Georgia, United States, 30309 Atlanta Regional CCOP | Atlanta, Georgia, United States, 30342 Emory Saint Joseph's Hospital | Atlanta, Georgia, United States, 30342 Northside Hospital | Atlanta, Georgia, United States, 30342 WellStar Cobb Hospital | Austell, Georgia, United States, 30106 John B Amos Cancer Center | Columbus, Georgia, United States, 31904 Dekalb Medical Center | Decatur, Georgia, United States, 30033 Piedmont Fayette Hospital | Fayetteville, Georgia, United States, 30214 Northside Hospital - Gwinnett | Lawrenceville, Georgia, United States, 30046 Wellstar Kennestone Hospital | Marietta, Georgia, United States, 30060 Southern Regional Medical Center | Riverdale, Georgia, United States, 30274 Harbin Clinic Medical Oncology and Clinical Research | Rome, Georgia, United States, 30165 Pali Momi Medical Center | 'Aiea, Hawaii, United States, 96701 Hawaii Cancer Care Inc - Waterfront Plaza | Honolulu, Hawaii, United States, 96813 Queen's Medical Center | Honolulu, Hawaii, United States, 96813 Straub Clinic and Hospital | Honolulu, Hawaii, United States, 96813 University of Hawaii Cancer Center | Honolulu, Hawaii, United States, 96813 Queen's Cancer Center - Kuakini | Honolulu, Hawaii, United States, 96817 The Cancer Center of Hawaii-Liliha | Honolulu, Hawaii, United States, 96817 Kaiser Permanente Moanalua Medical Center | Honolulu, Hawaii, United States, 96819 Kapiolani Medical Center for Women and Children | Honolulu, Hawaii, United States, 96826 Castle Medical Center | Kailua, Hawaii, United States, 96734 Wilcox Memorial Hospital and Kauai Medical Clinic | Lihue, Hawaii, United States, 96766 Maui Memorial Medical Center | Wailuku, Hawaii, United States, 96793 Pacific Cancer Institute of Maui | Wailuku, Hawaii, United States, 96793 OSF Saint Anthony's Health Center | Alton, Illinois, United States, 62002 Rush - Copley Medical Center | Aurora, Illinois, United States, 60504 MacNeal Hospital and Cancer Center | Berwyn, Illinois, United States, 60402 OSF Saint Joseph Medical Center | Bloomington, Illinois, United States, 61701 Illinois CancerCare-Bloomington | Bloomington, Illinois, United States, 61704 Graham Hospital Association | Canton, Illinois, United States, 61520 Illinois CancerCare-Canton | Canton, Illinois, United States, 61520 Illinois CancerCare-Carthage | Carthage, Illinois, United States, 62321 Memorial Hospital | Carthage, Illinois, United States, 62321 Hematology and Oncology Associates | Chicago, Illinois, United States, 60611 Northwestern University | Chicago, Illinois, United States, 60611 University of Illinois | Chicago, Illinois, United States, 60612 Decatur Memorial Hospital | Decatur, Illinois, United States, 62526 Heartland Cancer Research NCORP | Decatur, Illinois, United States, 62526 Advocate Good Samaritan Hospital | Downers Grove, Illinois, United States, 60515 Eureka Hospital | Eureka, Illinois, United States, 61530 Illinois CancerCare-Eureka | Eureka, Illinois, United States, 61530 NorthShore University HealthSystem-Evanston Hospital | Evanston, Illinois, United States, 60201 Galesburg Cottage Hospital | Galesburg, Illinois, United States, 61401 Illinois CancerCare-Galesburg | Galesburg, Illinois, United States, 61401 Illinois CancerCare-Havana | Havana, Illinois, United States, 62644 Mason District Hospital | Havana, Illinois, United States, 62644 Hematology Oncology Associates of Illinois-Highland Park | Highland Park, Illinois, United States, 60035 Hopedale Medical Complex - Hospital | Hopedale, Illinois, United States, 61747 Midwest Center for Hematology Oncology | Joliet, Illinois, United States, 60432 Duly Health and Care Joliet | Joliet, Illinois, United States, 60435 Presence Saint Mary's Hospital | Kankakee, Illinois, United States, 60901 Illinois CancerCare-Kewanee Clinic | Kewanee, Illinois, United States, 61443 AMG Libertyville - Oncology | Libertyville, Illinois, United States, 60048 Illinois CancerCare-Macomb | Macomb, Illinois, United States, 61455 Mcdonough District Hospital | Macomb, Illinois, United States, 61455 Loyola University Medical Center | Maywood, Illinois, United States, 60153 Holy Family Medical Center | Monmouth, Illinois, United States, 61462 Illinois CancerCare-Monmouth | Monmouth, Illinois, United States, 61462 Good Samaritan Regional Health Center | Mount Vernon, Illinois, United States, 62864 DuPage Medical Group-Ogden | Naperville, Illinois, United States, 60563 Illinois Cancer Specialists-Niles | Niles, Illinois, United States, 60714 Carle BroMenn Medical Center | Normal, Illinois, United States, 61761 Carle Cancer Institute Normal | Normal, Illinois, United States, 61761 Illinois CancerCare-Community Cancer Center | Normal, Illinois, United States, 61761 Illinois CancerCare-Ottawa Clinic | Ottawa, Illinois, United States, 61350 Ottawa Regional Hospital and Healthcare Center | Ottawa, Illinois, United States, 61350 Illinois CancerCare-Pekin | Pekin, Illinois, United States, 61554 OSF Saint Francis Radiation Oncology at Pekin | Pekin, Illinois, United States, 61554 Pekin Hospital | Pekin, Illinois, United States, 61554 Proctor Hospital | Peoria, Illinois, United States, 61614 Illinois CancerCare-Peoria | Peoria, Illinois, United States, 61615 Methodist Medical Center of Illinois | Peoria, Illinois, United States, 61636 OSF Saint Francis Medical Center | Peoria, Illinois, United States, 61637 Illinois CancerCare-Peru | Peru, Illinois, United States, 61354 Illinois Valley Hospital | Peru, Illinois, United States, 61354 Illinois CancerCare-Princeton | Princeton, Illinois, United States, 61356 Perry Memorial Hospital | Princeton, Illinois, United States, 61356 Hematology Oncology Associates of Illinois - Skokie | Skokie, Illinois, United States, 60076 Illinois CancerCare-Spring Valley | Spring Valley, Illinois, United States, 61362 Saint Margaret's Hospital | Spring Valley, Illinois, United States, 61362 Springfield Memorial Hospital | Springfield, Illinois, United States, 62781 Carle Cancer Center | Urbana, Illinois, United States, 61801 Northwestern Medicine Cancer Center Warrenville | Warrenville, Illinois, United States, 60555 Northwestern Medicine Central DuPage Hospital | Winfield, Illinois, United States, 60190 Franciscan Saint Francis Health-Beech Grove | Beech Grove, Indiana, United States, 46107 Elkhart Clinic | Elkhart, Indiana, United States, 46514-2098 Michiana Hematology Oncology PC-Elkhart | Elkhart, Indiana, United States, 46514 Elkhart General Hospital | Elkhart, Indiana, United States, 46515 Fort Wayne Medical Oncology and Hematology Inc-Parkview | Fort Wayne, Indiana, United States, 46845 Goshen Center for Cancer Care | Goshen, Indiana, United States, 46526 Community Howard Regional Health | Kokomo, Indiana, United States, 46904 IU Health La Porte Hospital | La Porte, Indiana, United States, 46350 Franciscan Saint Anthony Health-Michigan City | Michigan City, Indiana, United States, 46360 Michiana Hematology Oncology PC-Mishawaka | Mishawaka, Indiana, United States, 46545 Saint Joseph Regional Medical Center-Mishawaka | Mishawaka, Indiana, United States, 46545 The Community Hospital | Munster, Indiana, United States, 46321 Michiana Hematology Oncology PC-Plymouth | Plymouth, Indiana, United States, 46563 Reid Health | Richmond, Indiana, United States, 47374 Memorial Hospital of South Bend | South Bend, Indiana, United States, 46601 Northern Indiana Cancer Research Consortium | South Bend, Indiana, United States, 46628 Michiana Hematology Oncology PC-Westville | Westville, Indiana, United States, 46391 Mercy Hospital | Cedar Rapids, Iowa, United States, 52403 Oncology Associates at Mercy Medical Center | Cedar Rapids, Iowa, United States, 52403 Iowa-Wide Oncology Research Coalition NCORP | Des Moines, Iowa, United States, 50309 Mercy Medical Center - North Iowa | Mason City, Iowa, United States, 50401 Ottumwa Regional Health Center | Ottumwa, Iowa, United States, 52501 Siouxland Regional Cancer Center | Sioux City, Iowa, United States, 51101 Mercy Medical Center-Sioux City | Sioux City, Iowa, United States, 51102 Saint Luke's Regional Medical Center | Sioux City, Iowa, United States, 51104 Lawrence Memorial Hospital | Lawrence, Kansas, United States, 66044 Menorah Medical Center | Overland Park, Kansas, United States, 66209 Saint Luke's South Hospital | Overland Park, Kansas, United States, 66213 Kansas City NCI Community Oncology Research Program | Prairie Village, Kansas, United States, 66208 Salina Regional Health Center | Salina, Kansas, United States, 67401 Advent Health - Shawnee Mission Medical Center | Shawnee Mission, Kansas, United States, 66204 Cotton O'Neil Cancer Center / Stormont Vail Health | Topeka, Kansas, United States, 66606 Wesley Medical Center | Wichita, Kansas, United States, 67214 Wichita NCI Community Oncology Research Program | Wichita, Kansas, United States, 67214 Mary Bird Perkins Cancer Center | Baton Rouge, Louisiana, United States, 70809 Louisiana State University Health Science Center | New Orleans, Louisiana, United States, 70112 University Medical Center New Orleans | New Orleans, Louisiana, United States, 70112 Harold Alfond Center for Cancer Care | Augusta, Maine, United States, 04330 Eastern Maine Medical Center | Bangor, Maine, United States, 04401 York Hospital | York, Maine, United States, 03909 Greater Baltimore Medical Center | Baltimore, Maryland, United States, 21204 Sinai Hospital of Baltimore | Baltimore, Maryland, United States, 21215 Christiana Care - Union Hospital | Elkton, Maryland, United States, 21921 Boston Medical Center | Boston, Massachusetts, United States, 02118 Beth Israel Deaconess Medical Center | Boston, Massachusetts, United States, 02215 Commonwealth Hematology Oncology PC-Concord | Concord, Massachusetts, United States, 01742 Dana Farber Community Cancer Care-Haverhill | Haverhill, Massachusetts, United States, 01830 Dana Farber-Merrimack Valley | Methuen, Massachusetts, United States, 01844 Dana Farber Community Cancer Care-Quincy | Quincy, Massachusetts, United States, 02169 Baystate Medical Center | Springfield, Massachusetts, United States, 01199 Dana Farber Community Cancer Care-Stoneham | Stoneham, Massachusetts, United States, 02180 Dana Farber Community Cancer Care-Weymouth | Weymouth, Massachusetts, United States, 02189 Commonwealth Hematology Oncology PC-Worcester | Worcester, Massachusetts, United States, 01605 Bixby Medical Center | Adrian, Michigan, United States, 49221 Hickman Cancer Center | Adrian, Michigan, United States, 49221 Michigan Cancer Research Consortium NCORP | Ann Arbor, Michigan, United States, 48106 Trinity Health Saint Joseph Mercy Hospital Ann Arbor | Ann Arbor, Michigan, United States, 48106 University of Michigan Comprehensive Cancer Center | Ann Arbor, Michigan, United States, 48109 Bronson Battle Creek | Battle Creek, Michigan, United States, 49017 Spectrum Health Big Rapids Hospital | Big Rapids, Michigan, United States, 49307 Corewell Health Dearborn Hospital | Dearborn, Michigan, United States, 48124 Wayne State University/Karmanos Cancer Institute | Detroit, Michigan, United States, 48201 Henry Ford Health Saint John Hospital | Detroit, Michigan, United States, 48236 OSF Saint Francis Hospital and Medical Group | Escanaba, Michigan, United States, 49829 Hurley Medical Center | Flint, Michigan, United States, 48503 Genesys Regional Medical Center-West Flint Campus | Flint, Michigan, United States, 48532 Cancer Research Consortium of West Michigan NCORP | Grand Rapids, Michigan, United States, 49503 Corewell Health Grand Rapids Hospitals - Butterworth Hospital | Grand Rapids, Michigan, United States, 49503 Trinity Health Grand Rapids Hospital | Grand Rapids, Michigan, United States, 49503 Holland Community Hospital | Holland, Michigan, United States, 49423 Allegiance Health | Jackson, Michigan, United States, 49201 Bronson Methodist Hospital | Kalamazoo, Michigan, United States, 49007 West Michigan Cancer Center | Kalamazoo, Michigan, United States, 49007 Ascension Borgess Hospital | Kalamazoo, Michigan, United States, 49048 University of Michigan Health - Sparrow Lansing | Lansing, Michigan, United States, 48912 Trinity Health Saint Mary Mercy Livonia Hospital | Livonia, Michigan, United States, 48154 UP Health System Marquette | Marquette, Michigan, United States, 49855 Mercy Memorial Hospital | Monroe, Michigan, United States, 48162 Toledo Clinic Cancer Centers-Monroe | Monroe, Michigan, United States, 48162 McLaren Cancer Institute-Macomb | Mount Clemens, Michigan, United States, 48043 Mercy Health Partners-Hackley Campus | Muskegon, Michigan, United States, 49442 Trinity Health Muskegon Hospital | Muskegon, Michigan, United States, 49444 Corewell Health Lakeland Hospitals - Niles Hospital | Niles, Michigan, United States, 49120 Trinity Health Saint Joseph Mercy Oakland Hospital | Pontiac, Michigan, United States, 48341 Lake Huron Medical Center | Port Huron, Michigan, United States, 48060 Corewell Health William Beaumont University Hospital | Royal Oak, Michigan, United States, 48073 MyMichigan Medical Center Saginaw | Saginaw, Michigan, United States, 48601 Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center | Saint Joseph, Michigan, United States, 49085 Corewell Health Lakeland Hospitals - Saint Joseph Hospital | Saint Joseph, Michigan, United States, 49085 Henry Ford Health Providence Southfield Hospital | Southfield, Michigan, United States, 48075 Munson Medical Center | Traverse City, Michigan, United States, 49684 Henry Ford Health Warren Hospital | Warren, Michigan, United States, 48093 University of Michigan Health - West | Wyoming, Michigan, United States, 49519 Medini, Eitan MD (UIA Investigator) | Alexandria, Minnesota, United States, 56308 Essentia Health Saint Joseph's Medical Center | Brainerd, Minnesota, United States, 56401 Fairview Ridges Hospital | Burnsville, Minnesota, United States, 55337 Mercy Hospital | Coon Rapids, Minnesota, United States, 55433 Essentia Health Cancer Center | Duluth, Minnesota, United States, 55805 Essentia Health Saint Mary's Medical Center | Duluth, Minnesota, United States, 55805 Miller-Dwan Hospital | Duluth, Minnesota, United States, 55805 Fairview Southdale Hospital | Edina, Minnesota, United States, 55435 Etzell, Paul S MD (UIA Investigator) | Fergus Falls, Minnesota, United States, 56537 Swenson, Wade II, MD (UIA Investigator) | Fergus Falls, Minnesota, United States, 56537 Unity Hospital | Fridley, Minnesota, United States, 55432 Hutchinson Area Health Care | Hutchinson, Minnesota, United States, 55350 Meeker County Memorial Hospital | Litchfield, Minnesota, United States, 55355 Minnesota Oncology Hematology PA-Maplewood | Maplewood, Minnesota, United States, 55109 Saint John's Hospital - Healtheast | Maplewood, Minnesota, United States, 55109 Abbott-Northwestern Hospital | Minneapolis, Minnesota, United States, 55407 Virginia Piper Cancer Institute | Minneapolis, Minnesota, United States, 55407 Hennepin County Medical Center | Minneapolis, Minnesota, United States, 55415 North Memorial Medical Health Center | Robbinsdale, Minnesota, United States, 55422 Mayo Clinic in Rochester | Rochester, Minnesota, United States, 55905 Coborn Cancer Center at Saint Cloud Hospital | Saint Cloud, Minnesota, United States, 56303 Saint Cloud Hospital | Saint Cloud, Minnesota, United States, 56303 Metro Minnesota Community Oncology Research Consortium | Saint Louis Park, Minnesota, United States, 55416 Park Nicollet Clinic - Saint Louis Park | Saint Louis Park, Minnesota, United States, 55416 Regions Hospital | Saint Paul, Minnesota, United States, 55101 Saint Joseph's Hospital - Healtheast | Saint Paul, Minnesota, United States, 55102 United Hospital | Saint Paul, Minnesota, United States, 55102 Saint Francis Regional Medical Center | Shakopee, Minnesota, United States, 55379 Lakeview Hospital | Stillwater, Minnesota, United States, 55082 Ridgeview Medical Center | Waconia, Minnesota, United States, 55387 Rice Memorial Hospital | Willmar, Minnesota, United States, 56201 Minnesota Oncology Hematology PA-Woodbury | Woodbury, Minnesota, United States, 55125 Woodwinds Health Campus | Woodbury, Minnesota, United States, 55125 University of Mississippi Medical Center | Jackson, Mississippi, United States, 39216 Keesler Medical Center | Keesler Air Force Base, Mississippi, United States, 39534 Singing River Hospital | Pascagoula, Mississippi, United States, 39581 Southeast Missouri Hospital | Cape Girardeau, Missouri, United States, 63701 Saint Francis Medical Center | Cape Girardeau, Missouri, United States, 63703 Freeman Health System | Joplin, Missouri, United States, 64804 University Health Truman Medical Center | Kansas City, Missouri, United States, 64108 Saint Luke's Hospital of Kansas City | Kansas City, Missouri, United States, 64111 Saint Joseph Health Center | Kansas City, Missouri, United States, 64114 North Kansas City Hospital | Kansas City, Missouri, United States, 64116 Heartland Hematology and Oncology Associates Incorporated | Kansas City, Missouri, United States, 64118 Research Medical Center | Kansas City, Missouri, United States, 64132 Saint Luke's East - Lee's Summit | Lee's Summit, Missouri, United States, 64086 Liberty Radiation Oncology Center | Liberty, Missouri, United States, 64068 Heartland Regional Medical Center | Saint Joseph, Missouri, United States, 64506 Saint Louis Cancer and Breast Institute-South City | Saint Louis, Missouri, United States, 63109 Mercy Hospital Saint Louis | Saint Louis, Missouri, United States, 63141 Saint Louis-Cape Girardeau CCOP | Saint Louis, Missouri, United States, 63141 Billings Clinic Cancer Center | Billings, Montana, United States, 59101 Northern Rockies Radiation Oncology Center | Billings, Montana, United States, 59101 Saint Vincent Healthcare | Billings, Montana, United States, 59101 Montana Cancer Consortium NCORP | Billings, Montana, United States, 59102 Saint Vincent Frontier Cancer Center | Billings, Montana, United States, 59102 Bozeman Health Deaconess Hospital | Bozeman, Montana, United States, 59715 Saint James Community Hospital and Cancer Treatment Center | Butte, Montana, United States, 59701 Benefis Sletten Cancer Institute | Great Falls, Montana, United States, 59405 Berdeaux, Donald MD (UIA Investigator) | Great Falls, Montana, United States, 59405 Great Falls Clinic | Great Falls, Montana, United States, 59405 Northern Montana Hospital | Havre, Montana, United States, 59501 Saint Peter's Community Hospital | Helena, Montana, United States, 59601 Glacier Oncology PLLC | Kalispell, Montana, United States, 59901 Kalispell Medical Oncology | Kalispell, Montana, United States, 59901 Logan Health Medical Center | Kalispell, Montana, United States, 59901 Montana Cancer Specialists | Missoula, Montana, United States, 59802 Saint Patrick Hospital - Community Hospital | Missoula, Montana, United States, 59802 Community Medical Center | Missoula, Montana, United States, 59804 Guardian Oncology and Center for Wellness | Missoula, Montana, United States, 59804 University Medical Center of Southern Nevada | Las Vegas, Nevada, United States, 89102 Nevada Cancer Research Foundation NCORP | Las Vegas, Nevada, United States, 89169 Cooper Hospital University Medical Center | Camden, New Jersey, United States, 08103 CentraState Medical Center | Freehold, New Jersey, United States, 07728 Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital | New Brunswick, New Jersey, United States, 08903 Rutgers Cancer Institute of New Jersey | New Brunswick, New Jersey, United States, 08903 Rutgers New Jersey Medical School | Newark, New Jersey, United States, 07101 Lovelace Medical Center-Saint Joseph Square | Albuquerque, New Mexico, United States, 87102 University of New Mexico Cancer Center | Albuquerque, New Mexico, United States, 87106 Memorial Medical Center - Las Cruces | Las Cruces, New Mexico, United States, 88011 San Juan Regional Medical Center | San Juan, New Mexico, United States, 87401 Montefiore Medical Center-Wakefield Campus | Bronx, New York, United States, 10466 Adirondack Cancer Center | Glens Falls, New York, United States, 12801 Garnet Health Medical Center | Middletown, New York, United States, 10940 NYU Langone Hospital - Long Island | Mineola, New York, United States, 11501 Mount Sinai Union Square | New York, New York, United States, 10003 Mount Sinai West | New York, New York, United States, 10019 Highland Hospital | Rochester, New York, United States, 14620 University of Rochester | Rochester, New York, United States, 14642 Mission Hospital | Asheville, North Carolina, United States, 28801 Novant Health Presbyterian Medical Center | Charlotte, North Carolina, United States, 28204 Wayne Memorial Hospital | Goldsboro, North Carolina, United States, 27534 Margaret R Pardee Memorial Hospital | Hendersonville, North Carolina, United States, 28791 ECU Health Oncology Kinston | Kinston, North Carolina, United States, 28501 Rutherford Hospital | Rutherfordton, North Carolina, United States, 28139 Southeast Clinical Oncology Research Consortium NCORP | Winston-Salem, North Carolina, United States, 27104 Mid Dakota Clinic | Bismarck, North Dakota, United States, 58501 Saint Alexius Medical Center | Bismarck, North Dakota, United States, 58501 Sanford Bismarck Medical Center | Bismarck, North Dakota, United States, 58501 Cleveland Clinic Cancer Center Beachwood | Beachwood, Ohio, United States, 44122 Toledo Clinic Cancer Centers-Bowling Green | Bowling Green, Ohio, United States, 43402 Case Western Reserve University | Cleveland, Ohio, United States, 44106 MetroHealth Medical Center | Cleveland, Ohio, United States, 44109 Cleveland Clinic Cancer Center/Fairview Hospital | Cleveland, Ohio, United States, 44111 Cleveland Clinic Foundation | Cleveland, Ohio, United States, 44195 North Coast Cancer Care-Clyde | Clyde, Ohio, United States, 43410 Grandview Hospital | Dayton, Ohio, United States, 45405 Good Samaritan Hospital - Dayton | Dayton, Ohio, United States, 45406 Miami Valley Hospital | Dayton, Ohio, United States, 45409 Miami Valley Hospital North | Dayton, Ohio, United States, 45415 Dayton Veterans Affairs Medical Center | Dayton, Ohio, United States, 45428 Dayton NCI Community Oncology Research Program | Dayton, Ohio, United States, 45459 Hematology Oncology Center Incorporated | Elyria, Ohio, United States, 44035 Mercy Cancer Center-Elyria | Elyria, Ohio, United States, 44035 Blanchard Valley Hospital | Findlay, Ohio, United States, 45840 Atrium Medical Center-Middletown Regional Hospital | Franklin, Ohio, United States, 45005-1066 Wayne Hospital | Greenville, Ohio, United States, 45331 Cleveland Clinic Cancer Center Independence | Independence, Ohio, United States, 44131 Kettering Medical Center | Kettering, Ohio, United States, 45429 Saint Rita's Medical Center | Lima, Ohio, United States, 45801 Lima Memorial Hospital | Lima, Ohio, United States, 45804 Saint Luke's Hospital | Maumee, Ohio, United States, 43537 Toledo Clinic Cancer Centers-Maumee | Maumee, Ohio, United States, 43537 Toledo Radiation Oncology at Northwest Ohio Onocolgy Center | Maumee, Ohio, United States, 43537 Hillcrest Hospital Cancer Center | Mayfield Heights, Ohio, United States, 44124 Fisher-Titus Medical Center | Norwalk, Ohio, United States, 44857 Saint Charles Hospital | Oregon, Ohio, United States, 43616 Toledo Clinic Cancer Centers-Oregon | Oregon, Ohio, United States, 43616 University Hospitals Parma Medical Center | Parma, Ohio, United States, 44129 North Coast Cancer Care | Sandusky, Ohio, United States, 44870 ProMedica Flower Hospital | Sylvania, Ohio, United States, 43560 Mercy Hospital of Tiffin | Tiffin, Ohio, United States, 44883 ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital | Toledo, Ohio, United States, 43606 Mercy Health - Saint Vincent Hospital | Toledo, Ohio, United States, 43608 University of Toledo | Toledo, Ohio, United States, 43614 Toledo Community Hospital Oncology Program CCOP | Toledo, Ohio, United States, 43617 Mercy Health - Saint Anne Hospital | Toledo, Ohio, United States, 43623 Toledo Clinic Cancer Centers-Toledo | Toledo, Ohio, United States, 43623 Upper Valley Medical Center | Troy, Ohio, United States, 45373 Fulton County Health Center | Wauseon, Ohio, United States, 43567 Clinton Memorial Hospital/Foster J Boyd Regional Cancer Center | Wilmington, Ohio, United States, 45177 Cleveland Clinic Wooster Family Health and Surgery Center | Wooster, Ohio, United States, 44691 Greene Memorial Hospital | Xenia, Ohio, United States, 45385 Clackamas Radiation Oncology Center | Clackamas, Oregon, United States, 97015 Legacy Mount Hood Medical Center | Gresham, Oregon, United States, 97030 Providence Milwaukie Hospital | Milwaukie, Oregon, United States, 97222 Providence Newberg Medical Center | Newberg, Oregon, United States, 97132 Providence Willamette Falls Medical Center | Oregon City, Oregon, United States, 97045 Legacy Good Samaritan Hospital and Medical Center | Portland, Oregon, United States, 97210 Providence Portland Medical Center | Portland, Oregon, United States, 97213 Adventist Medical Center | Portland, Oregon, United States, 97216 Providence Saint Vincent Medical Center | Portland, Oregon, United States, 97225 Compass Oncology Rose Quarter | Portland, Oregon, United States, 97227 Legacy Emanuel Hospital and Health Center | Portland, Oregon, United States, 97227 Legacy Meridian Park Hospital | Tualatin, Oregon, United States, 97062 Lehigh Valley Hospital-Cedar Crest | Allentown, Pennsylvania, United States, 18103 Butler Memorial Hospital | Butler, Pennsylvania, United States, 16001 Geisinger Medical Center | Danville, Pennsylvania, United States, 17822 Oncology Hematology Associates of Northern Pennsylvania | DuBois, Pennsylvania, United States, 15801 Geisinger Medical Center-Cancer Center Hazleton | Hazleton, Pennsylvania, United States, 18201 Penn State Milton S Hershey Medical Center | Hershey, Pennsylvania, United States, 17033-0850 Lancaster General Hospital | Lancaster, Pennsylvania, United States, 17602 Pennsylvania Hospital | Philadelphia, Pennsylvania, United States, 19107 Geisinger Medical Group | State College, Pennsylvania, United States, 16801 Mount Nittany Medical Center | State College, Pennsylvania, United States, 16803 Associates In Hematology Oncology PC-Upland | Upland, Pennsylvania, United States, 19013 Jennersville Regional Hospital | West Grove, Pennsylvania, United States, 19390 Reading Hospital | West Reading, Pennsylvania, United States, 19611 Geisinger Wyoming Valley/Henry Cancer Center | Wilkes-Barre, Pennsylvania, United States, 18711 Geisinger South Wilkes-Barre | Wilkes-Barre, Pennsylvania, United States, 18765 Hematology and Oncology Associates of Rhode Island Inc | Cranston, Rhode Island, United States, 02920 Memorial Hospital of Rhode Island | Pawtucket, Rhode Island, United States, 02860 Kent Hospital | Warwick, Rhode Island, United States, 02886 AnMed Health Hospital | Anderson, South Carolina, United States, 29621 Spartanburg Medical Center | Spartanburg, South Carolina, United States, 29303 Rapid City Regional Hospital | Rapid City, South Dakota, United States, 57701 Sanford Cancer Center Oncology Clinic | Sioux Falls, South Dakota, United States, 57104 Avera Cancer Institute | Sioux Falls, South Dakota, United States, 57105 Medical X-Ray Center | Sioux Falls, South Dakota, United States, 57105 Avera McKennan Hospital and University Health Center | Sioux Falls, South Dakota, United States, 57117-5045 Sanford USD Medical Center - Sioux Falls | Sioux Falls, South Dakota, United States, 57117-5134 Erlanger Medical Center | Chattanooga, Tennessee, United States, 37403 Jackson-Madison County General Hospital | Jackson, Tennessee, United States, 38301 The Jackson Clinic PA | Jackson, Tennessee, United States, 38301 Wellmont Holston Valley Hospital and Medical Center | Kingsport, Tennessee, United States, 37660 University of Tennessee Health Science Center | Memphis, Tennessee, United States, 38163 The Don and Sybil Harrington Cancer Center | Amarillo, Texas, United States, 79106 Brooke Army Medical Center | Fort Sam Houston, Texas, United States, 78234 Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center | Houston, Texas, United States, 77030 Baylor Saint Luke's Medical Center | Houston, Texas, United States, 77030 Ben Taub General Hospital | Houston, Texas, United States, 77030 Houston Methodist Hospital | Houston, Texas, United States, 77030 M D Anderson Cancer Center | Houston, Texas, United States, 77030 Michael E DeBakey VA Medical Center | Houston, Texas, United States, 77030 Wilford Hall Medical Center | Lackland Air Force Base, Texas, United States, 78236 Danville Regional Medical Center | Danville, Virginia, United States, 24541 Fredericksburg Oncology Inc | Fredericksburg, Virginia, United States, 22401 Sovah Health Martinsville | Martinsville, Virginia, United States, 24112 Ballad Health Cancer Care - Norton | Norton, Virginia, United States, 24273 Virginia Mason Medical Center | Seattle, Washington, United States, 98101 PeaceHealth Southwest Medical Center | Vancouver, Washington, United States, 98664 Compass Oncology Vancouver | Vancouver, Washington, United States, 98684 Legacy Salmon Creek Hospital | Vancouver, Washington, United States, 98686 Wheeling Hospital/Schiffler Cancer Center | Wheeling, West Virginia, United States, 26003 Aurora Cancer Care-Southern Lakes VLCC | Burlington, Wisconsin, United States, 53105 Marshfield Clinic-Chippewa Center | Chippewa Falls, Wisconsin, United States, 54729 HSHS Sacred Heart Hospital | Eau Claire, Wisconsin, United States, 54701 Marshfield Clinic Cancer Center at Sacred Heart | Eau Claire, Wisconsin, United States, 54701 Green Bay Oncology at Saint Vincent Hospital | Green Bay, Wisconsin, United States, 54301-3526 Saint Vincent Hospital Cancer Center Green Bay | Green Bay, Wisconsin, United States, 54301 Saint Vincent Hospital Cancer Center at Saint Mary's | Green Bay, Wisconsin, United States, 54303 Aurora BayCare Medical Center | Green Bay, Wisconsin, United States, 54311 University of Wisconsin Carbone Cancer Center - Johnson Creek | Johnson Creek, Wisconsin, United States, 53038 Gundersen Lutheran Medical Center | La Crosse, Wisconsin, United States, 54601 Mayo Clinic Health System-Franciscan Healthcare | La Crosse, Wisconsin, United States, 54601 Marshfield Medical Center - Ladysmith | Ladysmith, Wisconsin, United States, 54848 University of Wisconsin Carbone Cancer Center - University Hospital | Madison, Wisconsin, United States, 53792 Holy Family Memorial Hospital | Manitowoc, Wisconsin, United States, 54221 Aurora Bay Area Medical Group-Marinette | Marinette, Wisconsin, United States, 54143 Bay Area Medical Center | Marinette, Wisconsin, United States, 54143 Marshfield Medical Center-Marshfield | Marshfield, Wisconsin, United States, 54449 Marshfield Medical Center | Marshfield, Wisconsin, United States, 54449 Ascension Southeast Wisconsin Hospital - Saint Joseph Campus | Milwaukee, Wisconsin, United States, 53210 Marshfield Medical Center - Minocqua | Minocqua, Wisconsin, United States, 54548 Saint Vincent Hospital Cancer Center at Oconto Falls | Oconto Falls, Wisconsin, United States, 54154 Aspirus Cancer Care - James Beck Cancer Center | Rhinelander, Wisconsin, United States, 54501 Marshfield Medical Center-Rice Lake | Rice Lake, Wisconsin, United States, 54868 HSHS Saint Nicholas Hospital | Sheboygan, Wisconsin, United States, 53081 Vince Lombardi Cancer Clinic-Sheboygan | Sheboygan, Wisconsin, United States, 53081 Aspirus Cancer Care - Stevens Point | Stevens Point, Wisconsin, United States, 54481 Saint Vincent Hospital Cancer Center at Sturgeon Bay | Sturgeon Bay, Wisconsin, United States, 54235-1495 Aurora Medical Center in Summit | Summit, Wisconsin, United States, 53066 Vince Lombardi Cancer Clinic-Two Rivers | Two Rivers, Wisconsin, United States, 54241 Ascension Saint Clare's Hospital | Weston, Wisconsin, United States, 54476 Marshfield Medical Center - Weston | Weston, Wisconsin, United States, 54476 Marshfield Clinic - Wisconsin Rapids Center | Wisconsin Rapids, Wisconsin, United States, 54494 Rocky Mountain Oncology | Casper, Wyoming, United States, 82609 Welch Cancer Center | Sheridan, Wyoming, United States, 82801 San Juan City Hospital | San Juan, Puerto Rico, 00936 King Faisal Specialist Hospital and Research Centre | Riyadh, Saudi Arabia, 11211
Investigators	Principal Investigator: Brian M Durie, SWOG Cancer Research Network

More Information

Additional Information

• Data Available: Select individual patient-level data from this trial can be requested from the NCTN/NCORP Data Archive.

Publications

• Unger JM, LeBlanc M, Blanke CD. The Effect of Positive SWOG Treatment Trials on Survival of Patients With Cancer in the US Population. JAMA Oncol. 2017 Oct 1;3(10):1345-1351. doi: 10.1001/jamaoncol.2017.0762.

• Durie BGM, Hoering A, Abidi MH, Rajkumar SV, Epstein J, Kahanic SP, Thakuri M, Reu F, Reynolds CM, Sexton R, Orlowski RZ, Barlogie B, Dispenzieri A. Bortezomib with lenalidomide and dexamethasone versus lenalidomide and dexamethasone alone in patients with newly diagnosed myeloma without intent for immediate autologous stem-cell transplant (SWOG S0777): a randomised, open-label, phase 3 trial. Lancet. 2017 Feb 4;389(10068):519-527. doi: 10.1016/S0140-6736(16)31594-X. Epub 2016 Dec 23.

• Usmani SZ, Heuck C, Mitchell A, Szymonifka J, Nair B, Hoering A, Alsayed Y, Waheed S, Haider S, Restrepo A, Van Rhee F, Crowley J, Barlogie B. Extramedullary disease portends poor prognosis in multiple myeloma and is over-represented in high-risk disease even in the era of novel agents. Haematologica. 2012 Nov;97(11):1761-7. doi: 10.3324/haematol.2012.065698. Epub 2012 Jun 11.

Additional Relevant MeSH Terms

• Multiple Myeloma
• Neoplasms, Plasma Cell
• Neoplasms by Histologic Type
• Neoplasms
• Hemostatic Disorders
• Vascular Diseases
• Cardiovascular Diseases
• Paraproteinemias
• Blood Protein Disorders
• Hematologic Diseases
• Hemorrhagic Disorders
• Lymphoproliferative Disorders
• Immunoproliferative Disorders
• Immune System Diseases