RecruitingRecruiting
Study to Test OBI-3424 in Patients With T-Cell Acute Lymphoblastic Leukemia (T-ALL) or T-Cell Lymphoblastic Lymphoma (T-LBL)
NCT04315324 · SWOG Cancer Research Network
In plain English
Click the button to translate this study into plain language — what it is, who qualifies, and what participation looks like.
Official title
A Phase I/II Study of AKR1C3-Activated Prodrug OBI-3424 (OBI-3424) In Patients With Relapsed/Refractory T-Cell Acute Lymphoblastic Leukemia (T-ALL)/T-Cell Lymphoblastic Lymphoma (T-LBL)
About this study
PRIMARY OBJECTIVES:
I. To assess the safety of AKR1C3-activated prodrug OBI-3424 (OBI-3424) and to determine the maximum tolerated dose (MTD) of OBI-3424 in this regimen for patients with relapsed/refractory T-cell acute lymphoblastic leukemia (T-ALL)/T-cell lymphoblastic lymphoma (T-LBL). (Phase I) II. To assess the response rate (complete remission \[CR\] or CR with incomplete count recovery \[CRi\]) of patients treated with OBI-3424 at the maximum tolerated dose (MTD) determined in the Phase I portion of the trial in this patient population. (Phase II)
SECONDARY OBJECTIVES:
I. To estimate the frequency and severity of toxicities of OBI-3424 in this patient population.
II. To estimate event-free survival (EFS), relapse-free survival (RFS) and overall survival (OS) in this patient population.
TRANSLATIONAL MEDICINE OBJECTIVES:
I. To estimate minimal/measurable residual disease (MRD) negativity (among patients who achieve CR or CRi).
II. To assess AKR1C3 expression levels in this patient population. III. To evaluate associations between AKR1C3 expression and response to OBI-3424, achievement of MRD-negative remission, and relapse from remission.
IV. To bank specimens for future research.
OUTLINE: This is a phase I, dose-escalation study followed by a phase II study.
Patients receive AKR1C3-activated prodrug OBI-3424 intravenously (IV) over 30 minutes on days 1 and 8. Treatment repeats every 21 days for up to 17 cycles in the absence of disease progression or unacceptable toxicity. Patients who have not achieved a partial remission (PR) by the 4th cycle of treatment are removed from the study (unless clinically benefiting in the opinion of the treating investigator). Patients undergo blood sample collection during screening and cerebrospinal fluid (CSF) sample collection on study. Patients also undergo bone marrow aspirate or core biopsy and may undergo computed tomography (CT) scan throughout the study.
After completion of study treatment, patients are followed up every month for 1 year, every 2 months for 1 year, every 3 months for 1 year, and then every 6 months for up to 5 years from registration.
Eligibility criteria
Inclusion Criteria:
* Patients must have a diagnosis of relapsed or refractory T-cell acute lymphoblastic leukemia (T-ALL) based on World Health Organization (WHO) classification. Patients with relapsed/refractory T-cell lymphoblastic lymphoma are eligible if lymphoblasts are \>= 5% in the bone marrow or in the peripheral blood by morphology or flow cytometry
* Patients must have evidence of acute leukemia in their peripheral blood or bone marrow. Patients must have \>= 5% lymphoblasts in the peripheral blood or bone marrow within 14 days prior to registration. Patients with only extramedullary disease are not eligible
* Patients ≥ 18 years of age must be refractory to or have relapsed following a standard induction chemotherapy. Patients \< 18 years of age must have relapsed or must be refractory after 2 or more chemotherapy cycles (example: induction and consolidation)
* A standard chemotherapy induction regimen is defined as any program of treatment that includes:
* Vincristine and corticosteroids plus at least one more chemotherapy agent
* Cytarabine and anthracycline, or
* High dose cytarabine (defined as at least 1 gr/m\^2 per individual dose unless adjustments were required for renal/liver function)
* Patients must have no evidence of central nervous system disease within 28 days prior to registration based on cerebrospinal fluid (CSF) studies. Patients with clinical signs or symptoms consistent with central nervous system (CNS) involvement must have a lumbar puncture which is negative for CNS involvement; the lumbar puncture must be completed within 28 days prior to registration. Patients with CNS1 or CNS2 are eligible; however patients with CNS3 are not eligible
* Note that the patients may receive intrathecal chemotherapy with the initial lumbar puncture. This may count as the first dose of intrathecal therapy required as part of the study
* Prior nelarabine therapy is not required. In addition, for patients ≥ 18 years of age who received nelarabine during initial induction or post-remission treatment are eligible only if the physician does not feel they would benefit from other, multi-agent chemotherapy
* Patients must not have had chemotherapy or investigational agents within 14 days prior to registration except for corticosteroids, oral 6-mercaptopurine, oral methotrexate, vincristine, intrathecal chemotherapy, or hydroxyurea. For participants who have received radiation therapy, at least 7 days must have elapsed from the end of radiation prior to registration and participants must not currently be experiencing toxicities from radiation therapy
* Patients must not have undergone allogeneic hematopoietic transplant within 90 days prior to registration
* Patients must have no evidence of active \>= grade 2 acute graft versus host disease (GVHD) or moderate or severe limited chronic GVHD. Patients must have no history of extensive GVHD of any severity within 90 days prior to registration. Patients who are post-transplant must be off calcineurin inhibitors for at least 21 days to be eligible. Extensive GVHD is defined as 1) generalized skin involvement or 2) localized skin involvement and/or hepatic dysfunction plus liver histology or cirrhosis or involvement of eye or minor salivary organ or oral mucosa or any other target organ
* Patients must be \>= 12 years of age
* Patients ≥ 16 years of age must have a Zubrod Performance Status of 0-3. Patients \< 16 years of age must have a Lansky score of ≥ 50
* Patients must not have systemic fungal, bacterial, viral or other infection that is not controlled (defined as exhibiting ongoing signs/symptoms related to the infection and without improvement, despite appropriate antibiotics or other treatment) within 14 days prior to registration
* Patients ≥ 18 years of age must have creatinine clearance \> 30 mL/min within 14 days prior to registration according to the Cockcroft Gault equation
* Patients 12-17 years of age must have adequate renal function within 14 days prior to registration defined as serum creatinine ≤ 1.5 x institutional upper limit of normal (ULN) according to age or a calculated estimated glomerular filtration rate (eGFR) (based on Schwartz formula) or radioisotope glomerular filtration rate (GFR) ≥ 50ml/min/1.73 m\^2
* Patients must have direct bilirubin =\< 1.5 x institutional upper limit of normal (ULN) within 14 days prior to registration
* Patients must have alanine aminotransferase (ALT) =\< 3.0 x institutional upper limit of normal (ULN) or =\< 5.0 x ULN (if thought to be related to leukemic involvement) within 14 days prior to registration
* Prothrombin time (PT)/partial thromboplastin time (PTT)/ fibrinogen (as clinically indicated for example but not limited to history of bleeding or active bleeding, concern for disseminated intravascular coagulation) (within 14 days prior to registration to obtain baseline measurements)
* From metabolic panel (comprehensive or basic): sodium, potassium, chloride, carbon dioxide (CO2), and blood urea nitrogen (BUN) (within 14 days prior to registration to obtain baseline measurements)
* Patients must be able to safely discontinue use of strong inhibitors/inducers of CYP3A4 or PgP-g-p and must be able to safely discontinue use of naproxen for 48 hours before and after each dose of OBI-3424
* Patients with known human immunodeficiency virus (HIV)-infection are eligible providing they are on effective anti-retroviral therapy and have undetectable viral load at their most recent viral load test within 6 months prior to registration. (HIV viral load testing is required only for patients with known HIV infection). Patients must not be receiving antiviral therapies that are known strong inhibitors or inducers of CYP3A4
* Patients with evidence of chronic hepatitis B virus (HBV) infection may be eligible provided that they have an undetectable HBV viral load within 28 days prior to registration. Patients may be currently receiving HBV treatment. (HBV viral load testing is required only for patients with known HBV infection). Patients must not be receiving antiviral therapies that are known strong inhibitors or inducers of CYP3A4
* Patients with known history of hepatitis C virus (HCV) infection may be eligible provided that they have an undetectable HCV viral load within in 28 days prior to registration. Patients may be currently receiving treatment. (HCV viral load testing is required only for patients with known HCV infection). Patients must not be receiving antiviral therapies that are known strong inhibitors or inducers of CYP3A4
* Patients must not have a known history of prolonged QT interval by Fridericia (QTcF) (interval \> 450 msec for males; \> 470 msec for females). Patients that had transient prolongation of QTc secondary to medications or electrolyte abnormalities are not excluded if the QTc normalized and remain within acceptable QTcF range (interval \> 450 msec for males; \> 470 msec for females). Additionally, suspected medications should be no longer required or used, and electrolyte abnormalities must have normalized
* Patients must not be pregnant or nursing due to the teratogenic potential of the drug used on this study. Females of reproductive potential must have a negative serum pregnancy test within 14 days prior to registration. Women/men of reproductive potential must have agreed to use an effective contraceptive method during and up to 6 months after treatment. A woman is considered to be of "reproductive potential" if she has had menses at any time in the preceding 12 consecutive months. In addition to routine contraceptive methods, "effective contraception" also includes heterosexual celibacy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) defined as a hysterectomy, bilateral oophorectomy or bilateral tubal ligation. However, if at any point a previously celibate patient chooses to become heterosexually active during the time period for use of contraceptive measures outlined in the protocol, he/she is responsible for beginning contraceptive measures
* Patients must not have other active malignancies for which they have received treatments within 6 months prior to registration excluding localized malignancies that do not require systemic treatment
* Patients must agree to have bone marrow and blood specimens submitted for MRD testing
* Patients must be offered the opportunity to participate in specimen banking. With patient consent, residuals from specimens submitted will be retained and banked for future research
* Patients must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with fedral, local, institutional and Central Institutional Review Board (CIRB) guidelines unless they are unable to provide consent based on age (\< 18 years) or based on impaired decision-making capabilities. For patients \< 18 years of age or with impaired decision making capabilities, parents or other legally authorized representatives must sign and give informed consent on behalf of study participants in accordance with applicable federal, local, institutional and CIRB regulations
* As a part of the Oncology Patient Enrollment Network (OPEN) registration process the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the system
* This trial will use a slot reservation system to enroll the Phase I portion of the study. Patients planning to enroll at this phase of the study must first have a slot reserved in advance of the registration. All site staff will use OPEN to create a slot reservation
Study design
Enrollment target: 67 participants
Allocation: na
Masking: none
Age groups: child, adult, older_adult
Timeline
Starts: 2021-02-08
Estimated completion: 2028-08-01
Last updated: 2025-08-15
Interventions
Drug: AKR1C3-activated Prodrug AST-3424Procedure: Biopsy ProcedureProcedure: Biospecimen CollectionProcedure: Bone Marrow AspirationProcedure: Computed Tomography
Primary outcomes
- • Maximum tolerated dose (MTD) (Phase I) (Up to 21 days)
- • Response rate (complete remission [CR] or CR with incomplete count recovery [CRi]) (Phase II) (Up to 5 years)
Sponsor
SWOG Cancer Research Network · network
With: National Cancer Institute (NCI)
Contacts & investigators
InvestigatorAnjali S Advani · principal_investigator, SWOG Cancer Research Network
All locations (163)
University of Alabama at Birmingham Cancer CenterActive Not Recruiting
Birmingham, Alabama, United States
Kingman Regional Medical CenterRecruiting
Kingman, Arizona, United States
Arkansas Children's HospitalRecruiting
Little Rock, Arkansas, United States
PCR OncologyRecruiting
Arroyo Grande, California, United States
City of Hope Comprehensive Cancer CenterRecruiting
Duarte, California, United States
Loma Linda University Medical CenterRecruiting
Loma Linda, California, United States
Children's Hospital of Orange CountyRecruiting
Orange, California, United States
Children's Hospital ColoradoRecruiting
Aurora, Colorado, United States
Alfred I duPont Hospital for ChildrenRecruiting
Wilmington, Delaware, United States
Golisano Children's Hospital of Southwest FloridaRecruiting
Fort Myers, Florida, United States
Memorial Regional Hospital/Joe DiMaggio Children's HospitalRecruiting
Hollywood, Florida, United States
Johns Hopkins All Children's HospitalRecruiting
St. Petersburg, Florida, United States
Emory University Hospital/Winship Cancer InstituteRecruiting
Atlanta, Georgia, United States
Children's Healthcare of Atlanta - Arthur M Blank HospitalRecruiting
Atlanta, Georgia, United States
Augusta University Medical CenterRecruiting
Augusta, Georgia, United States
Loyola Center for Health at Burr RidgeActive Not Recruiting
Burr Ridge, Illinois, United States
Lurie Children's Hospital-ChicagoRecruiting
Chicago, Illinois, United States
Northwestern UniversityRecruiting
Chicago, Illinois, United States
University of IllinoisRecruiting
Chicago, Illinois, United States
University of Chicago Comprehensive Cancer CenterActive Not Recruiting
Chicago, Illinois, United States
Loyola Medicine Homer GlenActive Not Recruiting
Homer Glen, Illinois, United States
Northwestern Medicine Lake Forest HospitalActive Not Recruiting
Lake Forest, Illinois, United States
Loyola University Medical CenterActive Not Recruiting
Maywood, Illinois, United States
Marjorie Weinberg Cancer Center at Loyola-GottliebActive Not Recruiting
Melrose Park, Illinois, United States
UC Comprehensive Cancer Center at Silver CrossActive Not Recruiting
New Lenox, Illinois, United States
University of Chicago Medicine-Orland ParkActive Not Recruiting
Orland Park, Illinois, United States
Southern Illinois University School of MedicineRecruiting
Springfield, Illinois, United States
Mary Greeley Medical CenterRecruiting
Ames, Iowa, United States
McFarland Clinic - AmesRecruiting
Ames, Iowa, United States
McFarland Clinic - BooneRecruiting
Boone, Iowa, United States
McFarland Clinic - Trinity Cancer CenterRecruiting
Fort Dodge, Iowa, United States
McFarland Clinic - JeffersonRecruiting
Jefferson, Iowa, United States
McFarland Clinic - MarshalltownRecruiting
Marshalltown, Iowa, United States
Norton Children's HospitalRecruiting
Louisville, Kentucky, United States
LSU Health Baton Rouge-North ClinicRecruiting
Baton Rouge, Louisiana, United States
Our Lady of the Lake Physician GroupRecruiting
Baton Rouge, Louisiana, United States
Johns Hopkins University/Sidney Kimmel Cancer CenterRecruiting
Baltimore, Maryland, United States
Bronson Battle CreekRecruiting
Battle Creek, Michigan, United States
Wayne State University/Karmanos Cancer InstituteActive Not Recruiting
Detroit, Michigan, United States
Weisberg Cancer Treatment CenterActive Not Recruiting
Farmington Hills, Michigan, United States
Corewell Health Grand Rapids Hospitals - Butterworth HospitalRecruiting
Grand Rapids, Michigan, United States
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's HospitalRecruiting
Grand Rapids, Michigan, United States
Trinity Health Grand Rapids HospitalRecruiting
Grand Rapids, Michigan, United States
Bronson Methodist HospitalRecruiting
Kalamazoo, Michigan, United States
West Michigan Cancer CenterRecruiting
Kalamazoo, Michigan, United States
Beacon Kalamazoo Cancer CenterRecruiting
Kalamazoo, Michigan, United States
Beacon KalamazooRecruiting
Kalamazoo, Michigan, United States
Trinity Health Muskegon HospitalRecruiting
Muskegon, Michigan, United States
Corewell Health Lakeland Hospitals - Niles HospitalRecruiting
Niles, Michigan, United States
Cancer and Hematology Centers of Western Michigan - Norton ShoresRecruiting
Norton Shores, Michigan, United States
Corewell Health Reed City HospitalRecruiting
Reed City, Michigan, United States
Corewell Health Lakeland Hospitals - Marie Yeager Cancer CenterRecruiting
Saint Joseph, Michigan, United States
Corewell Health Lakeland Hospitals - Saint Joseph HospitalRecruiting
Saint Joseph, Michigan, United States
Munson Medical CenterRecruiting
Traverse City, Michigan, United States
University of Michigan Health - WestRecruiting
Wyoming, Michigan, United States
Fairview Ridges HospitalActive Not Recruiting
Burnsville, Minnesota, United States
Minnesota Oncology - BurnsvilleActive Not Recruiting
Burnsville, Minnesota, United States
Cambridge Medical CenterActive Not Recruiting
Cambridge, Minnesota, United States
Mercy HospitalActive Not Recruiting
Coon Rapids, Minnesota, United States
Fairview Southdale HospitalActive Not Recruiting
Edina, Minnesota, United States
Unity HospitalActive Not Recruiting
Fridley, Minnesota, United States
Fairview Clinics and Surgery Center Maple GroveActive Not Recruiting
Maple Grove, Minnesota, United States
Minnesota Oncology Hematology PA-MaplewoodActive Not Recruiting
Maplewood, Minnesota, United States
Saint John's Hospital - HealtheastActive Not Recruiting
Maplewood, Minnesota, United States
Abbott-Northwestern HospitalActive Not Recruiting
Minneapolis, Minnesota, United States
Hennepin County Medical CenterActive Not Recruiting
Minneapolis, Minnesota, United States
Health Partners IncActive Not Recruiting
Minneapolis, Minnesota, United States
University of Minnesota/Masonic Cancer CenterRecruiting
Minneapolis, Minnesota, United States
Monticello Cancer CenterActive Not Recruiting
Monticello, Minnesota, United States
New Ulm Medical CenterActive Not Recruiting
New Ulm, Minnesota, United States
Fairview Northland Medical CenterActive Not Recruiting
Princeton, Minnesota, United States
North Memorial Medical Health CenterActive Not Recruiting
Robbinsdale, Minnesota, United States
Park Nicollet Clinic - Saint Louis ParkActive Not Recruiting
Saint Louis Park, Minnesota, United States
Regions HospitalActive Not Recruiting
Saint Paul, Minnesota, United States
United HospitalActive Not Recruiting
Saint Paul, Minnesota, United States
Saint Francis Regional Medical CenterActive Not Recruiting
Shakopee, Minnesota, United States
Lakeview HospitalActive Not Recruiting
Stillwater, Minnesota, United States
Ridgeview Medical CenterActive Not Recruiting
Waconia, Minnesota, United States
Rice Memorial HospitalActive Not Recruiting
Willmar, Minnesota, United States
Minnesota Oncology Hematology PA-WoodburyActive Not Recruiting
Woodbury, Minnesota, United States
Fairview Lakes Medical CenterActive Not Recruiting
Wyoming, Minnesota, United States
Children's Mercy Hospitals and ClinicsRecruiting
Kansas City, Missouri, United States
Children's Hospital and Medical Center of OmahaRecruiting
Omaha, Nebraska, United States
University of Nebraska Medical CenterRecruiting
Omaha, Nebraska, United States
Carson Tahoe Regional Medical CenterRecruiting
Carson City, Nevada, United States
Cancer and Blood Specialists-HendersonRecruiting
Henderson, Nevada, United States
Comprehensive Cancer Centers of Nevada - HendersonRecruiting
Henderson, Nevada, United States
Comprehensive Cancer Centers of Nevada-Horizon RidgeRecruiting
Henderson, Nevada, United States
Las Vegas Cancer Center-HendersonSuspended
Henderson, Nevada, United States
OptumCare Cancer Care at Seven HillsRecruiting
Henderson, Nevada, United States
Comprehensive Cancer Centers of Nevada-Southeast HendersonRecruiting
Henderson, Nevada, United States
GenesisCare USA - HendersonRecruiting
Henderson, Nevada, United States
Las Vegas Urology - Green ValleyRecruiting
Henderson, Nevada, United States
Las Vegas Urology - PebbleRecruiting
Henderson, Nevada, United States
Urology Specialists of Nevada - Green ValleyRecruiting
Henderson, Nevada, United States
Las Vegas Urology - PecosRecruiting
Las Vegas, Nevada, United States
Desert West SurgerySuspended
Las Vegas, Nevada, United States
OptumCare Cancer Care at CharlestonRecruiting
Las Vegas, Nevada, United States
University Medical Center of Southern NevadaRecruiting
Las Vegas, Nevada, United States
Hope Cancer Care of NevadaRecruiting
Las Vegas, Nevada, United States
Radiation Oncology Centers of Nevada CentralRecruiting
Las Vegas, Nevada, United States
Urology Specialists of Nevada - CentralRecruiting
Las Vegas, Nevada, United States
GenesisCare USA - Las VegasRecruiting
Las Vegas, Nevada, United States
HealthCare Partners Medical Group Oncology/Hematology-Maryland ParkwaySuspended
Las Vegas, Nevada, United States
Sunrise Hospital and Medical CenterRecruiting
Las Vegas, Nevada, United States
HealthCare Partners Medical Group Oncology/Hematology-San MartinSuspended
Las Vegas, Nevada, United States
Las Vegas Prostate Cancer CenterRecruiting
Las Vegas, Nevada, United States
Las Vegas Urology - SunsetRecruiting
Las Vegas, Nevada, United States
Urology Specialists of Nevada - SouthwestRecruiting
Las Vegas, Nevada, United States
Radiation Oncology Centers of Nevada SoutheastRecruiting
Las Vegas, Nevada, United States
Ann M Wierman MD LTDRecruiting
Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada - NorthwestRecruiting
Las Vegas, Nevada, United States
GenesisCare USA - Vegas TenayaRecruiting
Las Vegas, Nevada, United States
HealthCare Partners Medical Group Oncology/Hematology-TenayaSuspended
Las Vegas, Nevada, United States
Las Vegas Urology - Cathedral RockRecruiting
Las Vegas, Nevada, United States
Las Vegas Urology - Smoke RanchRecruiting
Las Vegas, Nevada, United States
OptumCare Cancer Care at MountainViewRecruiting
Las Vegas, Nevada, United States
Urology Specialists of Nevada - NorthwestRecruiting
Las Vegas, Nevada, United States
Alliance for Childhood Diseases/Cure 4 the Kids FoundationRecruiting
Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada - Town CenterRecruiting
Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada-SummerlinRecruiting
Las Vegas, Nevada, United States
Summerlin Hospital Medical CenterRecruiting
Las Vegas, Nevada, United States
Las Vegas Cancer Center-Medical CenterSuspended
Las Vegas, Nevada, United States
Comprehensive Cancer Centers of NevadaRecruiting
Las Vegas, Nevada, United States
GenesisCare USA - Fort ApacheRecruiting
Las Vegas, Nevada, United States
OptumCare Cancer Care at Fort ApacheRecruiting
Las Vegas, Nevada, United States
HealthCare Partners Medical Group Oncology/Hematology-Centennial HillsSuspended
Las Vegas, Nevada, United States
Comprehensive Cancer Centers of Nevada - Central ValleyRecruiting
Las Vegas, Nevada, United States
University Cancer CenterRecruiting
Las Vegas, Nevada, United States
Hope Cancer Care of Nevada-PahrumpRecruiting
Pahrump, Nevada, United States
Renown Regional Medical CenterRecruiting
Reno, Nevada, United States
Saint Mary's Regional Medical CenterRecruiting
Reno, Nevada, United States
Radiation Oncology AssociatesRecruiting
Reno, Nevada, United States
University of New Mexico Cancer CenterRecruiting
Albuquerque, New Mexico, United States
Roswell Park Cancer InstituteActive Not Recruiting
Buffalo, New York, United States
University of RochesterRecruiting
Rochester, New York, United States
Duke University Medical CenterRecruiting
Durham, North Carolina, United States
University of Cincinnati Cancer Center-UC Medical CenterRecruiting
Cincinnati, Ohio, United States
Cincinnati Children's Hospital Medical CenterRecruiting
Cincinnati, Ohio, United States
Cleveland Clinic FoundationRecruiting
Cleveland, Ohio, United States
University of Cincinnati Cancer Center-West ChesterSuspended
West Chester, Ohio, United States
Oregon Health and Science UniversityActive Not Recruiting
Portland, Oregon, United States
Children's Hospital of PhiladelphiaRecruiting
Philadelphia, Pennsylvania, United States
Children's Hospital of Pittsburgh of UPMCRecruiting
Pittsburgh, Pennsylvania, United States
Rhode Island HospitalRecruiting
Providence, Rhode Island, United States
Prisma Health Richland HospitalRecruiting
Columbia, South Carolina, United States
The Children's Hospital at TriStar CentennialRecruiting
Nashville, Tennessee, United States
Dell Children's Medical Center of Central TexasRecruiting
Austin, Texas, United States
El Paso Children's HospitalRecruiting
El Paso, Texas, United States
Methodist Children's Hospital of South TexasRecruiting
San Antonio, Texas, United States
University of Texas Health Science Center at San AntonioRecruiting
San Antonio, Texas, United States
Huntsman Cancer Institute/University of UtahRecruiting
Salt Lake City, Utah, United States
University of Virginia Cancer CenterRecruiting
Charlottesville, Virginia, United States
Children's Hospital of The King's DaughtersRecruiting
Norfolk, Virginia, United States
VCU Massey Comprehensive Cancer CenterRecruiting
Richmond, Virginia, United States
Overlake Medical CenterSuspended
Bellevue, Washington, United States
Valley Medical CenterRecruiting
Renton, Washington, United States
Fred Hutchinson Cancer CenterRecruiting
Seattle, Washington, United States
University of Washington Medical Center - MontlakeRecruiting
Seattle, Washington, United States
North Star Lodge Cancer Center at Yakima Valley Memorial HospitalRecruiting
Yakima, Washington, United States
West Virginia University HealthcareRecruiting
Morgantown, West Virginia, United States
Gundersen Lutheran Medical CenterActive Not Recruiting
La Crosse, Wisconsin, United States
Cancer Center of Western WisconsinActive Not Recruiting
New Richmond, Wisconsin, United States