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BiCaZO: A Study Combining Two Immunotherapies (Cabozantinib and Nivolumab) to Treat Patients With Advanced Melanoma or Squamous Cell Head and Neck Cancer, an immunoMATCH Pilot Study
NCT05136196 · National Cancer Institute (NCI)
In plain English
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Official title
Biomarker Stratified CaboZantinib (NSC#761968) and NivOlumab (NSC#748726) (BiCaZO) - A Phase II Study of Combining Cabozantinib and Nivolumab in Participants With Advanced Solid Tumors (IO Refractory Melanoma or HNSCC) Stratified by Tumor Biomarkers - an immunoMATCH Pilot Study
About this study
PRIMARY OBJECTIVES:
I. To evaluate the feasibility of molecular characterization based on tumor mutation burden (TMB) for participant stratification, as assessed by the proportion of participants with less than or equal to a 21-day turnaround time for biopsy results in Stage I of the study.
II. To evaluate the feasibility of molecular characterization based on TMB and gene expression profiling (GEP) (for Tumor Inflammation Score \[TIS\]) for stratification, as assessed by the proportion of participants with less than or equal to a 21-day turnaround time for biopsy results in Stage II of the study.
III. To evaluate the efficacy by overall response rate (ORR - defined as confirmed and unconfirmed partial responses plus complete responses) of cabozantinib S-malate (cabozantinib) plus nivolumab in each disease cohort, both across and within tumor biomarker subgroups.
SECONDARY OBJECTIVES:
I. To assess the difference in ORR in each disease cohort between tumor marker subgroups separately for each disease cohort.
II. To assess safety and tolerability of this treatment in these populations. III. To estimate disease control rate (DCR) in participants receiving cabozantinib plus nivolumab in each disease cohort, stratified by tumor biomarkers.
IV. To estimate progression-free survival (PFS) in participants receiving cabozantinib plus nivolumab in each disease cohort, stratified by tumor biomarkers.
V. To estimate overall survival (OS) in participants receiving cabozantinib plus nivolumab in each disease cohort, stratified by tumor biomarkers.
VI. To assess the proportion of patients with assay failure, and the time from the date of tissue collection to molecular group determination at the end of Stage I.
ADDITIONAL OBJECTIVE:
I. To identify candidate biomarkers predictive of response and toxicity to the cabozantinib and nivolumab combination.
BANKING OBJECTIVE:
I. To bank specimens for future correlative studies.
OUTLINE:
Patients receive nivolumab intravenously (IV) over 30 minutes on day 1 of each cycle and cabozantinib orally (PO) daily. Cycles repeat every 28 days for 2 years in the absence of disease progression or unacceptable toxicity. Patients also undergo computed tomography (CT) or magnetic resonance imaging (MRI) scans and collection of blood samples throughout the trial. Patients undergo a tumor biopsy during screening and optionally during follow-up.
After completion of study treatment, patients are followed up every 12 weeks for 1 year and then every 6 months until 3 years after step 2 registration.
Eligibility criteria
Inclusion Criteria:
* STEP 1 - SPECIMEN SUBMISSION
* Participants must have histologically confirmed melanoma that is stage III or IV, unresectable, recurrent, or metastatic non-uveal melanoma OR Participants must have histologically confirmed squamous cell carcinoma of the head and neck (HNSCC) that is either locally recurrent and non-amendable to curative therapy (e.g., radiation, surgery) or metastatic. The primary tumor location must be the oropharynx, oral cavity, hypopharynx, or larynx. Primary tumor site of nasopharynx (any histology) or unknown primary tumor are not eligible
* Note: For participants with primary oropharyngeal cancer, human papillomavirus (HPV) or p16 status must be known prior to step 1 registration
* Participants must have disease presentation consistent with measurable disease. Note: Current disease measurements will not be required until step 2 registration
* Participants must have had documented progression during or within 12 weeks after the last dose of PD-1 checkpoint inhibition-based therapy. Participants must have been receiving checkpoint inhibition for a minimum of 6 weeks. Participants who recur during adjuvant anti-PD1 treatment or within 12 weeks of completion of adjuvant anti-PD1 treatment are eligible if they have measurable disease and are considered unresectable
* Participants with known human immunodeficiency virus (HIV)-infection must be receiving anti-retroviral therapy and have an undetectable viral load test within 6 months prior to step 1 registration
* Participants with evidence of chronic hepatitis B virus (HBV) infection must have undetectable HBV viral load within 28 days prior to step 1 registration
* Participants with a history of hepatitis C virus (HCV) infection must have no detectable viral load within 28 days prior to step 1 registration
* Participants must not have an active infection requiring systemic therapy (except HBV, HCV or HIV as mentioned above)
* Participants must not have experienced myocardial infarction or thromboembolic event requiring anticoagulation within 90 days prior to step 1 registration, unless clinically stable with ongoing medical management
* Participants must have recovered to baseline or =\< grade 1 Common Terminology Criteria for Adverse Events (CTCAE) version (v) 5 toxicities related to any prior treatments, unless adverse events are deemed clinically nonsignificant by the treating investigator or stable on supportive therapy
* Participants must not have received more than one prior primary radiotherapy regimen, curative or adjuvant, to the mucosal surfaces of the head and neck, with the additional following criteria:
* If the primary radiation is combined with chemotherapy, a minimum of 16 weeks will be required to have elapsed between the end of radiotherapy and step 1 registration. If the radiation is given alone, a minimum of 8 weeks will be required to have elapsed between the end of radiotherapy and step 1 registration
* Additional palliative radiotherapy regimens are permitted but cannot have been administered to previously treated tissue (i.e., overlapping fields are excluded) with the exception of central nervous system (CNS) radiation and must be completed at least 4 weeks prior to step 1 registration
* Treatment areas should be healed with no sequelae from radiation therapy (RT) that would predispose to fistula formation
* Participants must not have received prior treatment with anti-VEGF therapies for any reason
* Participants must be \>= 18 years of age
* Participants must have a Zubrod Performance Status 0 or 1
* Participants must have adequate cardiac function. Participants with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, must have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification and must be class 2B or better to be eligible for this trial
* Participants must not have any known significant organ disfunction that, in the opinion of the treating investigator, may impact suitability for receiving combination nivolumab/cabozantinib treatment
* Participants must be able to take oral medication without breaking, opening, crushing, dissolving or chewing capsules
* Participants must not have malabsorption syndrome
* Participants must not have active autoimmune disease requiring systemic steroids (equivalent of \> 10mg of prednisone) or other immune suppression. Exceptions:
* Type 1 diabetes mellitus
* Endocrinopathy only requiring hormone replacement
* Skin disorders (e.g., vitiligo, psoriasis, or alopecia) not requiring systemic treatment
* Conditions not expected to recur in the absence of an external trigger
* Participants must not have received an organ allograft
* Participants must not have a history of hemoptysis (defined as \>= 1/2 tsp of bright red blood per day) or tumor bleeding within 90 days prior to step 1 registration
* Participants must not have any of the following criteria due to the possibility of increased risk for tumor bleeding with cabozantinib therapy:
* Prior carotid bleeding
* Tumors that invade major vessels (e.g., the carotid) as shown unequivocally by imaging studies
* Central (e.g., within 2 cm from the hilum) lung metastases that are cavitary as shown unequivocally by imaging studies
* Any prior history of bleeding related to the current head and neck cancer
* History of gross hemoptysis (bright red blood of 1/2 teaspoon or more per episode of coughing) within 3 months
* Participants must not require concomitant anticoagulation with coumarin agents (e.g., warfarin), direct thrombin inhibitors (e.g., dabigatran), direct factor Xa inhibitor betrixaban, or platelet inhibitors (e.g., clopidogrel)
* Participants must not require anticoagulants except for the following:
* Prophylactic use of low-dose aspirin for cardio-protection (per local applicable guidelines) and low-dose low molecular weight heparins (LMWH).
* Therapeutic doses of LMWH or anticoagulation with direct factor Xa inhibitors, rivaroxaban, edoxaban, or apixaban in participants without known brain metastases who are on a stable dose of the anticoagulant for at least 1 week prior to step 1 registration without clinically significant hemorrhagic complications from the anticoagulation regimen or the tumor
* Participants must not have evidence of preexisting uncontrolled hypertension 28 days prior to step 1 registration as documented by baseline blood pressure reading with systolic blood pressure \> 150 mmHg and/or diastolic blood pressure \> 90 mmHg. Participants on antihypertensive therapies with controlled blood pressure are eligible
* Participants must not have a prior or concurrent malignancy whose natural history or treatment (in the opinion of the treating physician) has the potential to interfere with the safety or efficacy assessment of the investigational regimen
* Participants must not be pregnant or nursing due to the known safety profiles of the drugs in this study. Individuals who are of reproductive potential must have agreed to use an effective contraceptive method with details provided as a part of the consent process. A person who has had menses at any time in the preceding 12 consecutive months or who has semen likely to contain sperm is considered to be of "reproductive potential". In addition to routine contraceptive methods, "effective contraception" also includes refraining from sexual activity that might result in pregnancy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) including hysterectomy, bilateral oophorectomy, bilateral tubal ligation/occlusion and vasectomy with testing showing no sperm in the semen
* Have an adequate archival tissue specimen verified by the local pathologist and documented on the Pathology Review Form from a procedure obtained after the development of resistance to anti-PD-1/L1 therapy. Archival tissue must consist of tumor block or at least 1 hematoxylin and eosin (H\&E)-stained 4-5 micron slide and 20 freshly cut serially sectioned and numbered 4-5 micron unstained, uncharged slides OR
Be willing to undergo research biopsy AND have tumor accessible for biopsy based on the following criteria:
* Mediastinal, laparoscopic, gastrointestinal, or bronchial endoscopic biopsies can be obtained incidentally to a clinically necessary procedure and NOT for the sole purpose of the clinical trial
* Acceptable biopsy procedures are:
* Percutaneous biopsy with local anesthetic and/or sedation with an expected risk of severe complications \< 2%
* Direct transoral biopsy (with or without local anesthetic and/or sedation) with an expected risk of severe complications \< 2%
* Excisional cutaneous biopsy with local anesthetic and/or sedation with an expected risk of severe complications \< 2%
* Biopsy with removal of additional tumor tissue during a medically necessary mediastinoscopy, laparoscopy, gastrointestinal endoscopy, bronchoscopy or craniotomy. No open surgical, laparoscopic or endoscopic procedure should be performed solely to obtain a biopsy for this protocol
* Removal of additional tumor tissue during a medically necessary surgical procedure
* Participants must submit whole blood for germline genomic analysis
* Participants must have been offered the opportunity to participate in specimen banking
* Note: 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
* Participants must be informed of the investigational nature of this study and must sign and give informed consent in accordance with institutional and federal guidelines
* Participants with impaired decision-making capacity are eligible as long as their neurological or psychological condition does not preclude their safe participation in the study (e.g., tracking pill consumption and reporting adverse events to the investigator)
* STEP 2 TREATMENT REGISTRATION
* Note: No tests or exams are required to be repeated for step 2 registration (Treatment). However, participants who are known to have a change in eligibility status after step 1 registration are not eligible for step 2 registration
* Participants must continue to meet eligibility for step 1 registration prior to step 2 registration
* Participants must have had their tumor tissue submitted via the Southwest Oncology Group (SWOG) Specimen Tracking System prior to step 2 registration
* Participants registered during stage II of the protocol must have received assignment to an open cohort from the SWOG Statistics and Data Management Center based on their biomarker screening profile (not applicable for patients registered during stage I of the protocol)
* Participants must have measurable disease. All measurable disease must be assessed within 28 days prior to step 2 registration. All non-measurable disease must be assessed within 42 days prior to step 2 registration. Note: All disease must be assessed and documented on the Baseline Tumor Assessment Form (Response Evaluation Criteria in Solid Tumors \[RECIST\] 1.1)
* For melanoma participants, CT chest, abdomen and pelvis must be obtained. For HNSCC participants, CT neck and chest must be obtained. Further imaging (i.e., MR brain, CT abdomen/pelvis or extremities, bone scan) will be performed as deemed appropriate by the treating physician
* Participants with treated brain metastases must have no evidence of progression on the follow-up brain imaging after central nervous system (CNS)-directed therapy
* Participants must not have experienced any significant health changes that, in the opinion of the treating investigator, may impact continued suitability for receiving combination nivolumab/cabozantinib treatment
* Participants with treated brain metastases must have discontinued steroid treatment at least 14 days prior to step 2 registration
* Participants must not have received investigational agents or monoclonal antibodies (except Food and Drug Administration \[FDA\] approved supportive care antibodies, such as denosumab) within 28 days prior to step 2 registration
* Participants must not have received surgery, chemotherapy, radiation therapy, biologic agents, or steroids within 14 days prior to step 2 registration
* Participants must not have received administration of a live, attenuated vaccine within 30 days prior to step 2 registration. Note: Participants may have received a messenger ribonucleic acid (mRNA) or viral vector-based coronavirus disease 2019 (COVID-19) vaccine within 30 days prior to step 2 registration
* Participants must not have received administration of any strong CYP3A4 inducers, such as but not limited to rifampin, carbamazepine, enzalutamide, mitotane, phenytoin and St. John's wort, within 14 days prior to step 2 registration
* Participants must not have received administration of any strong CYP3A4 inhibitors, such as but not limited to clarithromycin, itraconazole, ketoconazole, grapefruit juice, indinavir, nelfinavir, ritonavir, nefazodone, saquinavir, and telithromycin, within 5 times the half-life of the CYP3A inhibitor prior to step 2 registration
* Participants must have a history and physical examination performed within 28 days prior to step 2 registration
* Leukocytes \>= 3,000/uL (within 28 days prior to step 2 registration)
* Absolute neutrophil count \>= 1,500/uL (within 28 days prior to step 2 registration)
* Platelets \>= 100,000/uL (within 28 days prior to step 2 registration)
* Total bilirubin =\< 1.5 x institutional upper limit of normal (ULN) or =\< 3 x ULN for participants with Gilbert's disease (within 28 days prior to step 2 registration)
* Aspartate aminotransferase (AST) =\< 3 x institutional ULN (within 28 days prior to step 2 registration)
* Alanine aminotransferase (ALT) =\< 3 x institutional ULN (within 28 days prior to step 2 registration)
* Urinalysis: For baseline value (no required value for eligibility)
* Measured (OR calculated) creatinine clearance \>= 30 mL/min using the following Cockcroft-Gault Formula. This specimen must have been drawn and processed within 28 days prior to step 2 registration
Study design
Enrollment target: 150 participants
Allocation: na
Masking: none
Age groups: adult, older_adult
Timeline
Starts: 2022-12-06
Estimated completion: 2027-01-01
Last updated: 2026-04-13
Interventions
Procedure: Biopsy ProcedureProcedure: Biospecimen CollectionDrug: Cabozantinib S-malateProcedure: Computed TomographyProcedure: Magnetic Resonance ImagingBiological: Nivolumab
Primary outcomes
- • Biomarker results turnaround time (Within 21 days)
- • Objective response rate (At the end of stage I)
Sponsor
National Cancer Institute (NCI) · nih
Contacts & investigators
InvestigatorSiwen Hu-Lieskovan · principal_investigator, SWOG Cancer Research Network
All locations (221)
Mayo Clinic Hospital in ArizonaRecruiting
Phoenix, Arizona, United States
University of Arkansas for Medical SciencesRecruiting
Little Rock, Arkansas, United States
Tower Cancer Research FoundationRecruiting
Beverly Hills, California, United States
UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory CareRecruiting
Irvine, California, United States
The Angeles Clinic and Research Institute - West Los Angeles OfficeRecruiting
Los Angeles, California, United States
Cedars Sinai Medical CenterRecruiting
Los Angeles, California, United States
UC Irvine Health/Chao Family Comprehensive Cancer CenterRecruiting
Orange, California, United States
Rocky Mountain Regional VA Medical CenterActive Not Recruiting
Aurora, Colorado, United States
UCHealth Memorial Hospital CentralRecruiting
Colorado Springs, Colorado, United States
Memorial Hospital NorthRecruiting
Colorado Springs, Colorado, United States
Poudre Valley HospitalRecruiting
Fort Collins, Colorado, United States
Cancer Care and Hematology-Fort CollinsRecruiting
Fort Collins, Colorado, United States
UCHealth Greeley HospitalRecruiting
Greeley, Colorado, United States
Medical Center of the RockiesRecruiting
Loveland, Colorado, United States
Helen F Graham Cancer CenterRecruiting
Newark, Delaware, United States
Medical Oncology Hematology Consultants PARecruiting
Newark, Delaware, United States
Mayo Clinic in FloridaRecruiting
Jacksonville, Florida, United States
Hawaii Cancer Care Inc - Waterfront PlazaActive Not Recruiting
Honolulu, Hawaii, United States
Queen's Cancer Cenrer - POB IActive Not Recruiting
Honolulu, Hawaii, United States
Queen's Medical CenterActive Not Recruiting
Honolulu, Hawaii, United States
Queen's Cancer Center - KuakiniActive Not Recruiting
Honolulu, Hawaii, United States
Hawaii Cancer Care - WestridgeActive Not Recruiting
‘Aiea, Hawaii, United States
Saint Alphonsus Cancer Care Center-BoiseRecruiting
Boise, Idaho, United States
Saint Luke's Cancer Institute - BoiseRecruiting
Boise, Idaho, United States
Saint Alphonsus Cancer Care Center-CaldwellRecruiting
Caldwell, Idaho, United States
Kootenai Health - Coeur d'AleneRecruiting
Coeur d'Alene, Idaho, United States
Saint Luke's Cancer Institute - FruitlandRecruiting
Fruitland, Idaho, United States
Saint Luke's Cancer Institute - MeridianRecruiting
Meridian, Idaho, United States
Saint Alphonsus Cancer Care Center-NampaRecruiting
Nampa, Idaho, United States
Saint Luke's Cancer Institute - NampaRecruiting
Nampa, Idaho, United States
Kootenai Clinic Cancer Services - Post FallsRecruiting
Post Falls, Idaho, United States
Kootenai Clinic Cancer Services - SandpointRecruiting
Sandpoint, Idaho, United States
Saint Luke's Cancer Institute - Twin FallsRecruiting
Twin Falls, Idaho, United States
Rush-Copley Medical CenterRecruiting
Aurora, Illinois, United States
Illinois CancerCare-BloomingtonRecruiting
Bloomington, Illinois, United States
Illinois CancerCare-CantonRecruiting
Canton, Illinois, United States
Illinois CancerCare-CarthageRecruiting
Carthage, Illinois, United States
Centralia Oncology ClinicRecruiting
Centralia, Illinois, United States
Northwestern UniversityRecruiting
Chicago, Illinois, United States
University of IllinoisRecruiting
Chicago, Illinois, United States
Carle at The RiverfrontRecruiting
Danville, Illinois, United States
Cancer Care Specialists of Illinois - DecaturRecruiting
Decatur, Illinois, United States
Decatur Memorial HospitalRecruiting
Decatur, Illinois, United States
Northwestern Medicine Cancer Center KishwaukeeRecruiting
DeKalb, Illinois, United States
Illinois CancerCare-DixonRecruiting
Dixon, Illinois, United States
Carle Physician Group-EffinghamRecruiting
Effingham, Illinois, United States
Crossroads Cancer CenterRecruiting
Effingham, Illinois, United States
Illinois CancerCare-EurekaRecruiting
Eureka, Illinois, United States
Illinois CancerCare-GalesburgRecruiting
Galesburg, Illinois, United States
Northwestern Medicine Cancer Center DelnorRecruiting
Geneva, Illinois, United States
Illinois CancerCare-Kewanee ClinicRecruiting
Kewanee, Illinois, United States
Northwestern Medicine Lake Forest HospitalRecruiting
Lake Forest, Illinois, United States
Illinois CancerCare-MacombRecruiting
Macomb, Illinois, United States
Carle Physician Group-Mattoon/CharlestonRecruiting
Mattoon, Illinois, United States
Cancer Care Center of O'FallonRecruiting
O'Fallon, Illinois, United States
Northwestern Medicine Orland ParkRecruiting
Orland Park, Illinois, United States
Illinois CancerCare-Ottawa ClinicRecruiting
Ottawa, Illinois, United States
Illinois CancerCare-PekinRecruiting
Pekin, Illinois, United States
Illinois CancerCare-PeoriaRecruiting
Peoria, Illinois, United States
Illinois CancerCare-PeruRecruiting
Peru, Illinois, United States
Illinois CancerCare-PrincetonRecruiting
Princeton, Illinois, United States
Memorial Hospital EastRecruiting
Shiloh, Illinois, United States
Southern Illinois University School of MedicineRecruiting
Springfield, Illinois, United States
Springfield ClinicRecruiting
Springfield, Illinois, United States
Springfield Memorial HospitalRecruiting
Springfield, Illinois, United States
Carle Cancer CenterRecruiting
Urbana, Illinois, United States
Northwestern Medicine Cancer Center WarrenvilleRecruiting
Warrenville, Illinois, United States
Illinois CancerCare - WashingtonRecruiting
Washington, Illinois, United States
Rush-Copley Healthcare CenterRecruiting
Yorkville, Illinois, United States
Mary Greeley Medical CenterRecruiting
Ames, Iowa, United States
McFarland Clinic - AmesRecruiting
Ames, Iowa, United States
UI Health Care Mission Cancer and Blood - Ankeny ClinicRecruiting
Ankeny, Iowa, United States
McFarland Clinic - BooneSuspended
Boone, Iowa, United States
Mercy HospitalRecruiting
Cedar Rapids, Iowa, United States
Oncology Associates at Mercy Medical CenterRecruiting
Cedar Rapids, Iowa, United States
Mercy Cancer Center-West LakesRecruiting
Clive, Iowa, United States
UI Health Care Mission Cancer and Blood - West Des Moines ClinicRecruiting
Clive, Iowa, United States
UI Health Care Mission Cancer and Blood - Des Moines ClinicRecruiting
Des Moines, Iowa, United States
Mercy Medical Center - Des MoinesRecruiting
Des Moines, Iowa, United States
UI Health Care Mission Cancer and Blood - Laurel ClinicRecruiting
Des Moines, Iowa, United States
McFarland Clinic - Trinity Cancer CenterRecruiting
Fort Dodge, Iowa, United States
McFarland Clinic - JeffersonSuspended
Jefferson, Iowa, United States
McFarland Clinic - MarshalltownRecruiting
Marshalltown, Iowa, United States
UI Health Care Mission Cancer and Blood - Waukee ClinicRecruiting
Waukee, Iowa, United States
Tufts Medical CenterRecruiting
Boston, Massachusetts, United States
Baystate Medical CenterRecruiting
Springfield, Massachusetts, United States
Tufts Medical Center Cancer Center StonehamRecruiting
Stoneham, Massachusetts, United States
Trinity Health Saint Joseph Mercy Hospital Ann ArborRecruiting
Ann Arbor, Michigan, United States
University of Michigan Rogel Cancer CenterRecruiting
Ann Arbor, Michigan, United States
Bronson Battle CreekRecruiting
Battle Creek, Michigan, United States
Trinity Health IHA Medical Group Hematology Oncology - BrightonRecruiting
Brighton, Michigan, United States
Trinity Health Medical Center - BrightonRecruiting
Brighton, Michigan, United States
Trinity Health IHA Medical Group Hematology Oncology - CantonRecruiting
Canton, Michigan, United States
Trinity Health Medical Center - CantonRecruiting
Canton, Michigan, United States
Chelsea HospitalRecruiting
Chelsea, Michigan, United States
Trinity Health IHA Medical Group Hematology Oncology - Chelsea HospitalRecruiting
Chelsea, Michigan, United States
Wayne State University/Karmanos Cancer InstituteActive Not Recruiting
Detroit, Michigan, United States
OSF Saint Francis Hospital and Medical GroupRecruiting
Escanaba, Michigan, United States
Weisberg Cancer Treatment CenterActive Not Recruiting
Farmington Hills, Michigan, United States
Cancer Hematology Centers - FlintRecruiting
Flint, Michigan, United States
Genesee Hematology Oncology PCSuspended
Flint, Michigan, United States
Genesys Hurley Cancer InstituteRecruiting
Flint, Michigan, United States
Hurley Medical CenterRecruiting
Flint, Michigan, United States
Corewell Health Grand Rapids Hospitals - Butterworth 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
University of Michigan Health - Sparrow LansingRecruiting
Lansing, Michigan, United States
Trinity Health Saint Mary Mercy Livonia HospitalRecruiting
Livonia, 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
Trinity Health Saint Joseph Mercy Oakland HospitalRecruiting
Pontiac, 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
Munson Medical CenterRecruiting
Traverse City, Michigan, United States
University of Michigan Health - WestRecruiting
Wyoming, Michigan, United States
Huron Gastroenterology PCRecruiting
Ypsilanti, Michigan, United States
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor CampusRecruiting
Ypsilanti, Michigan, United States
Sanford Joe Lueken Cancer CenterRecruiting
Bemidji, Minnesota, United States
Essentia Health Saint Joseph's Medical CenterRecruiting
Brainerd, Minnesota, United States
Mercy HospitalRecruiting
Coon Rapids, Minnesota, United States
Essentia Health - Deer River ClinicRecruiting
Deer River, Minnesota, United States
Essentia Health Saint Mary's - Detroit Lakes ClinicRecruiting
Detroit Lakes, Minnesota, United States
Essentia Health Cancer CenterRecruiting
Duluth, Minnesota, United States
Fairview Southdale HospitalRecruiting
Edina, Minnesota, United States
Essentia Health - FosstonRecruiting
Fosston, Minnesota, United States
Unity HospitalActive Not Recruiting
Fridley, Minnesota, United States
Essentia Health Hibbing ClinicRecruiting
Hibbing, Minnesota, United States
Saint John's Hospital - HealtheastRecruiting
Maplewood, Minnesota, United States
Abbott-Northwestern HospitalRecruiting
Minneapolis, Minnesota, United States
Essentia Health - Park RapidsRecruiting
Park Rapids, Minnesota, United States
Mayo Clinic in RochesterRecruiting
Rochester, Minnesota, United States
Park Nicollet Clinic - Saint Louis ParkRecruiting
Saint Louis Park, Minnesota, United States
Regions HospitalRecruiting
Saint Paul, Minnesota, United States
United HospitalRecruiting
Saint Paul, Minnesota, United States
Essentia Health SandstoneRecruiting
Sandstone, Minnesota, United States
Essentia Health Virginia ClinicRecruiting
Virginia, Minnesota, United States
Ridgeview Medical CenterRecruiting
Waconia, Minnesota, United States
Minnesota Oncology Hematology PA-WoodburyRecruiting
Woodbury, Minnesota, United States
Saint Francis Medical CenterRecruiting
Cape Girardeau, Missouri, United States
Siteman Cancer Center at Saint Peters HospitalRecruiting
City of Saint Peters, Missouri, United States
Siteman Cancer Center at West County HospitalRecruiting
Creve Coeur, Missouri, United States
Washington University School of MedicineRecruiting
St Louis, Missouri, United States
Mercy Hospital SouthRecruiting
St Louis, Missouri, United States
Siteman Cancer Center-South CountyRecruiting
St Louis, Missouri, United States
Siteman Cancer Center at Christian HospitalRecruiting
St Louis, Missouri, United States
Community Hospital of AnacondaRecruiting
Anaconda, Montana, United States
Billings Clinic Cancer CenterRecruiting
Billings, Montana, United States
Bozeman Health Deaconess HospitalRecruiting
Bozeman, Montana, United States
Benefis Sletten Cancer InstituteRecruiting
Great Falls, Montana, United States
Logan Health Medical CenterRecruiting
Kalispell, Montana, United States
Community Medical CenterRecruiting
Missoula, Montana, United States
Nebraska Medicine-BellevueRecruiting
Bellevue, Nebraska, United States
Nebraska Medicine-Village PointeRecruiting
Omaha, Nebraska, United States
University of Nebraska Medical CenterRecruiting
Omaha, Nebraska, United States
Dartmouth Hitchcock Medical Center/Dartmouth Cancer CenterRecruiting
Lebanon, New Hampshire, United States
University of New Mexico Cancer CenterRecruiting
Albuquerque, New Mexico, United States
Northwell Health/Center for Advanced MedicineActive Not Recruiting
Lake Success, New York, United States
NYU Langone Hospital - Long IslandRecruiting
Mineola, New York, United States
Laura and Isaac Perlmutter Cancer Center at NYU LangoneRecruiting
New York, New York, United States
Southeastern Medical Oncology Center-ClintonRecruiting
Clinton, North Carolina, United States
Southeastern Medical Oncology Center-GoldsboroRecruiting
Goldsboro, North Carolina, United States
Southeastern Medical Oncology Center-JacksonvilleRecruiting
Jacksonville, North Carolina, United States
Sanford Bismarck Medical CenterRecruiting
Bismarck, North Dakota, United States
Essentia Health Cancer Center-South University ClinicRecruiting
Fargo, North Dakota, United States
Sanford Broadway Medical CenterRecruiting
Fargo, North Dakota, United States
Sanford Roger Maris Cancer CenterRecruiting
Fargo, North Dakota, United States
Essentia Health - Jamestown ClinicRecruiting
Jamestown, North Dakota, United States
Miami Valley Hospital SouthRecruiting
Centerville, Ohio, United States
Premier Blood and Cancer CenterRecruiting
Dayton, Ohio, United States
Miami Valley Hospital NorthRecruiting
Dayton, Ohio, United States
Atrium Medical Center-Middletown Regional HospitalRecruiting
Franklin, Ohio, United States
Miami Valley Cancer Care and InfusionRecruiting
Greenville, Ohio, United States
Upper Valley Medical CenterRecruiting
Troy, Ohio, United States
University of Oklahoma Health Sciences CenterRecruiting
Oklahoma City, Oklahoma, United States
Saint Charles Health SystemRecruiting
Bend, Oregon, United States
Clackamas Radiation Oncology CenterRecruiting
Clackamas, Oregon, United States
Providence Newberg Medical CenterRecruiting
Newberg, Oregon, United States
Saint Alphonsus Cancer Care Center-OntarioRecruiting
Ontario, Oregon, United States
Providence Willamette Falls Medical CenterRecruiting
Oregon City, Oregon, United States
Providence Portland Medical CenterRecruiting
Portland, Oregon, United States
Providence Saint Vincent Medical CenterRecruiting
Portland, Oregon, United States
Thomas Jefferson University HospitalRecruiting
Philadelphia, Pennsylvania, United States
Jefferson Torresdale HospitalActive Not Recruiting
Philadelphia, Pennsylvania, United States
Asplundh Cancer PavilionActive Not Recruiting
Willow Grove, Pennsylvania, United States
Rapid City Regional HospitalRecruiting
Rapid City, South Dakota, United States
Sanford Cancer Center Oncology ClinicRecruiting
Sioux Falls, South Dakota, United States
Sanford USD Medical Center - Sioux FallsRecruiting
Sioux Falls, South Dakota, United States
Huntsman Cancer Institute/University of UtahRecruiting
Salt Lake City, Utah, United States
Dartmouth Cancer Center - NorthRecruiting
Saint Johnsbury, Vermont, United States
Inova Alexandria HospitalRecruiting
Alexandria, Virginia, United States
Inova Schar Cancer InstituteRecruiting
Fairfax, Virginia, United States
Inova Fair Oaks HospitalRecruiting
Fairfax, Virginia, United States
Inova Fairfax HospitalRecruiting
Falls Church, Virginia, United States
Centra Alan B Pearson Regional Cancer CenterRecruiting
Lynchburg, Virginia, United States
Virginia Cancer InstituteRecruiting
Richmond, Virginia, United States
VCU Massey Cancer Center at Stony PointRecruiting
Richmond, Virginia, United States
VCU Massey Comprehensive Cancer CenterRecruiting
Richmond, Virginia, United States
VCU Health Tappahannock HospitalRecruiting
Tappahannock, Virginia, United States
Duluth Clinic AshlandRecruiting
Ashland, Wisconsin, United States
Marshfield Medical Center-EC Cancer CenterRecruiting
Eau Claire, Wisconsin, United States
Saint Vincent Hospital Cancer Center Green BayRecruiting
Green Bay, Wisconsin, United States
Saint Vincent Hospital Cancer Center at Saint Mary'sRecruiting
Green Bay, Wisconsin, United States
Gundersen Lutheran Medical CenterRecruiting
La Crosse, Wisconsin, United States
Marshfield Medical Center-MarshfieldRecruiting
Marshfield, Wisconsin, United States
Medical College of WisconsinRecruiting
Milwaukee, Wisconsin, United States
Marshfield Medical Center - MinocquaRecruiting
Minocqua, Wisconsin, United States
ProHealth D N Greenwald CenterRecruiting
Mukwonago, Wisconsin, United States
Cancer Center of Western WisconsinRecruiting
New Richmond, Wisconsin, United States
ProHealth Oconomowoc Memorial HospitalRecruiting
Oconomowoc, Wisconsin, United States
Saint Vincent Hospital Cancer Center at Oconto FallsRecruiting
Oconto Falls, Wisconsin, United States
Marshfield Medical Center-Rice LakeRecruiting
Rice Lake, Wisconsin, United States
Saint Vincent Hospital Cancer Center at SheboyganRecruiting
Sheboygan, Wisconsin, United States
Marshfield Medical Center-River Region at Stevens PointRecruiting
Stevens Point, Wisconsin, United States
Saint Vincent Hospital Cancer Center at Sturgeon BayRecruiting
Sturgeon Bay, Wisconsin, United States
Essentia Health Saint Mary's Hospital - SuperiorRecruiting
Superior, Wisconsin, United States
ProHealth Waukesha Memorial HospitalRecruiting
Waukesha, Wisconsin, United States
UW Cancer Center at ProHealth CareRecruiting
Waukesha, Wisconsin, United States
Marshfield Medical Center - WestonRecruiting
Weston, Wisconsin, United States