RECRUITING

Testing Docetaxel-Cetuximab or the Addition of an Immunotherapy Drug, Atezolizumab, to the Usual Chemotherapy and Radiation Therapy in High-Risk Head and Neck Cancer

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This phase II/III trial studies how well radiation therapy works when given together with cisplatin, docetaxel, cetuximab, and/or atezolizumab after surgery in treating patients with high-risk stage III-IV head and neck cancer the begins in the thin, flat cells (squamous cell). Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. Drugs used in chemotherapy, such as cisplatin and docetaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Cetuximab is a monoclonal antibody that may interfere with the ability of tumor cells to grow and spread. Immunotherapy with monoclonal antibodies, such as atezolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. The purpose of this study is to compare the usual treatment (radiation therapy with cisplatin chemotherapy) to using radiation therapy with docetaxel and cetuximab chemotherapy, and using the usual treatment plus an immunotherapy drug, atezolizumab.

Official Title

Randomized Phase II/III Trial of Adjuvant Radiation Therapy With Cisplatin, Docetaxel-Cetuximab, or Cisplatin-Atezolizumab in Pathologic High-Risk Squamous Cell Cancer of the Head and Neck

Quick Facts

Study Start:2013-03-22
Study Completion:2027-01-01
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT01810913

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * PHASE II INCLUSION CRITERIA (COMPLETE AS OF 20-MAR-2020)
  2. * Pathologically (histologically or cytologically) proven diagnosis of head and neck squamous cell carcinoma (HNSCC) involving the oral cavity (excluding lips), oropharynx (p16 negative), larynx, or hypopharynx
  3. * Patients must have undergone gross total surgical resection of high-risk oral cavity, oropharynx (p16 negative), larynx, or hypopharynx within 63 days prior to registration; Note: patients may have biopsy under general anesthesia in an operating room followed by definitive ablative cancer surgery representing gross total resection; the gross total resection has to be done within 63 days prior to registration; if, however, patients have ablative resection but shortly recur or are determined to have persisting disease requiring re-resection to achieve gross total resection, then the patient is not eligible
  4. * Patients must have at least 1 of the following high-risk pathologic features: extracapsular nodal extension or invasive cancer at the primary tumor resection margin (tumor on ink)
  5. * Pathologic stage III or IV HNSCC, including no distant metastases, based upon the following minimum diagnostic workup:
  6. * General history and physical examination by a radiation oncologist and/or medical oncologist within 84 days prior to registration;
  7. * Examination by an ear nose throat (ENT) or head \& neck surgeon prior to surgery; a laryngopharyngoscopy (mirror and/or fiber optic and/or direct procedure), if appropriate, is recommended but not required; intra-operative examination is acceptable documentation
  8. * Pre-operative (op) Imaging of the head and neck: A neck computed tomography (CT) (with contrast) or CT/positron emission tomography (PET) (with contrast) and/or an magnetic resonance imaging (MRI) of the neck (T1 with gadolinium and T2) within 84 days prior to surgery; Note: this imaging data (diagnostic pre-operative scan showing gross disease) is to be submitted in Digital Imaging and Communications in Medicine (DICOM) format via TRIAD; the report is to be uploaded into Rave
  9. * Chest CT scan (with or without contrast) or CT/PET that includes the chest (with or without contrast) either within 84 days prior to surgery or within 120 days prior to registration; Note: if the CT/PET with or without contrast is done within 84 days prior to surgery, it fulfills the chest imaging requirement
  10. * Zubrod performance status of 0-1 within 14 days prior to registration
  11. * Age \>= 18
  12. * Absolute granulocyte count (AGC) \>= 1,500 cells/mm\^3 (obtained within 14 days prior to registration on study)
  13. * Platelets \>= 100,000 cells/mm\^3 (obtained within 14 days prior to registration on study)
  14. * Hemoglobin \>= 8.0 g/dl (Note: the use of transfusion or other intervention to achieve hemoglobin \[Hgb\] \>= 8.0 g/dl is acceptable)
  15. * Total bilirubin \< 2 x institutional upper limit of normal (ULN) within 14 days prior to registration
  16. * Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) \< 3 x institutional ULN within 14 days prior to registration
  17. * Serum creatinine institutional ULN within 14 days prior to registration or; creatinine clearance (CC) \>= 50 ml/min within 14 days prior to registration determined by 24-hour collection or estimated by Cockcroft-Gault formula
  18. * Negative urine or serum pregnancy test within 14 days prior to registration for women of childbearing potential
  19. * The following assessments are required within 14 days prior to registration: sodium (Na), potassium (K), chloride (Cl), glucose, calcium (Ca), magnesium (Mg), and albumin; Note: patients with an initial magnesium \< 0.5 mmol/L (1.2 mg/dl) may receive corrective magnesium supplementation but should continue to receive either prophylactic weekly infusion of magnesium and/or oral magnesium supplementation (e.g., magnesium oxide) at the investigator's discretion
  20. * Patients with feeding tubes are eligible for the study
  21. * Women of childbearing potential and male participants who are sexually active must agree to use a medically effective means of birth control
  22. * Patient must provide study specific informed consent prior to study entry, including consent for mandatory tissue submission for epidermal growth factor receptor (EGFR) analysis and for oropharyngeal cancer patients, human papilloma virus (HPV) analysis
  23. * PHASE III: Pathologically (histologically or cytologically) proven diagnosis of head and neck squamous cell carcinoma (HNSCC) involving the oral cavity (excluding lips), oropharynx (p16 negative), larynx, or hypopharynx
  24. * PHASE III: Patients with oropharyngeal cancer must have p16-negative based on central review prior to Step 2 registration. All patients with oropharyngeal primary must consent for mandatory tissue submission for central p16 confirmation
  25. * PHASE III: Patients must have undergone gross total surgical resection of high-risk oral cavity, oropharynx (p16 negative), larynx, or hypopharynx within 63 days prior to registration
  26. * Note: Patients may have biopsy under general anesthesia in an operating room followed by definitive ablative cancer surgery representing gross total resection. The gross total resection has to be done within 63 days prior to registration. If, however, patients have ablative resection but shortly recur or are determined to have persisting disease requiring re-resection to achieve gross total resection, then the patient is not eligible
  27. * PHASE III: Patients must have at least 1 of the following high-risk pathologic features: extracapsular nodal extension or invasive cancer at the primary tumor resection margin (tumor on ink or tumor in a final separately submitted margin)
  28. * PHASE III: Pathologic stage III or IV HNSCC (American Joint Committee on Cancer \[AJCC\] 7th edition), including no distant metastases, based upon the following minimum diagnostic workup:
  29. * General history and physical examination by a radiation oncologist or medical oncologist within 84 days prior to registration;
  30. * Examination by an ENT or head \& neck surgeon prior to surgery; a laryngopharyngoscopy (mirror or fiberoptic or direct procedure), if appropriate, is recommended but not required. Intra-operative examination is acceptable documentation.
  31. * Pre-op Imaging of the head and neck: A neck CT (with contrast and of diagnostic quality) or PET/CT (with contrast and of diagnostic quality) and/or an MRI of the neck of diagnostic quality (T1 with gadolinium and T2) within 84 days prior to surgery; Note: this imaging data (diagnostic pre-operative scan showing gross disease) is to be submitted in DICOM format via TRIAD. The report is to be uploaded into Rave.
  32. * Chest CT scan (with or without contrast) or PET/CT that includes the chest (with or without contrast) either within 84 days prior to surgery or within 120 days prior to registration; Note: If the PET/CT with or without contrast is done within 84 days prior to surgery, it fulfills the chest imaging requirement
  33. * PHASE III: Zubrod performance status of 0-1 within 14 days prior to registration
  34. * PHASE III: Age \>= 18
  35. * PHASE III: Leukocytes \>= 2,500 cells/mm\^3 (obtained within 14 days prior to registration on study)
  36. * PHASE III: Absolute neutrophil count (ANC) \>= 1,500 cells/mm\^3 (obtained within 14 days prior to registration on study)
  37. * PHASE III: Platelets \>= 100,000 cells/mm\^3 (obtained within 14 days prior to registration on study)
  38. * PHASE III: Hemoglobin \>= 8.0 g/dL (Note: The use of transfusion or other intervention to achieve Hgb \>= 8.0 g/dL is acceptable) (obtained within 14 days prior to registration on study)
  39. * PHASE III: Total bilirubin =\< 1.5 x institutional upper limit of normal (ULN) (however, patients with known Gilbert disease who have serum bilirubin level =\< 3 x institutional ULN may be enrolled) (within 14 days prior to registration)
  40. * PHASE III: AST or ALT =\< 3 x institutional ULN (within 14 days prior to registration)
  41. * PHASE III: Alkaline phosphatase =\< 2.5 x institutional ULN (within 14 days prior to registration)
  42. * PHASE III: Creatinine clearance (CrCl) \>= 50 mL/min within 14 days prior to registration determined by 24-hour collection or estimated by Cockcroft-Gault formula
  43. * PHASE III: Patients with feeding tubes are eligible for the study
  44. * PHASE III: Negative urine or serum pregnancy test within 14 days prior to registration for women of childbearing potential
  45. * PHASE III: All patients must provide study specific informed consent prior to study entry
  46. * PHASE III: Patients positive for human immunodeficiency virus (HIV) are allowed on study, but HIV-positive patients must have:
  47. * A stable regimen of highly active anti-retroviral therapy (HAART);
  48. * No requirement for concurrent antibiotics or antifungal agents for the prevention of opportunistic infections;
  49. * A CD4 count above 250 cells/mcL and an undetectable HIV viral load on standard polymerase chain reaction (PCR)-based tests
  1. * PHASE II EXCLUSION CRITERIA (COMPLETE AS OF 20-MAR-2020)
  2. * Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 1095 days (3 years); noninvasive cancers (for example, carcinoma in situ of the breast, oral cavity, or cervix are all permissible) are permitted even if diagnosed and treated \< 3 years ago
  3. * Patients with simultaneous primaries or bilateral tumors are excluded, with the exception of patients with bilateral tonsil cancers or patients with T1-2, N0, M0 resected differentiated thyroid carcinoma, who are eligible
  4. * Prior systemic chemotherapy or anti-epidermal growth factor (EGF) therapy for the study cancer; note that prior chemotherapy for a different cancer is allowable
  5. * Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields
  6. * Severe, active co-morbidity, defined as follows:
  7. * Unstable angina and/or congestive heart failure requiring hospitalization within 6 months prior to registration
  8. * Transmural myocardial infarction within 6 months prior to registration
  9. * Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration
  10. * Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration
  11. * Idiopathic pulmonary fibrosis or other severe interstitial lung disease that requires oxygen therapy or is thought to require oxygen therapy within 1 year prior to registration
  12. * Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects; note, however, that laboratory tests for coagulation parameters are not required for entry into this protocol
  13. * Acquired immune deficiency syndrome (AIDS) based upon current Centers for Disease and Control and Prevention (CDC) definition; note: human immunodeficiency virus (HIV) testing is not required for entry into this protocol; the need to exclude patients with AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive; protocol-specific requirements may also exclude immuno-compromised patients.
  14. * Grade 3-4 electrolyte abnormalities (Common Terminology Criteria for Adverse Events \[CTCAE\], version \[v.\] 4):
  15. * Serum calcium (ionized or adjusted for albumin) \< 7 mg/dl (1.75 mmol/L) or \> 12.5 mg/dl (\> 3.1 mmol/L) despite intervention to normalize levels
  16. * Glucose \< 40 mg/dl (\< 2.2 mmol/L) or \> 250 mg/dl (\> 14 mmol/L)
  17. * Magnesium \< 0.9 mg/dl (\< 0.4 mmol/L) or \> 3 mg/dl (\> 1.23 mmol/L) despite intervention to normalize levels
  18. * Potassium \< 3.0 mmol/L or \> 6 mmol/L despite intervention to normalize levels
  19. * Sodium \< 130 mmol/L or \> 155 mmol/L despite intervention to normalize levels
  20. * Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception; this exclusion is necessary because the treatment involved in this study may be significantly teratogenic
  21. * Prior allergic reaction to cetuximab
  22. * PHASE III: Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 1095 days (3 years) with the following exceptions: T1-2, N0, M0 resected differentiated thyroid carcinoma; Note that noninvasive cancers (For example, carcinoma in situ of the breast, oral cavity, or cervix) are permitted even if diagnosed and treated \< 3 years ago
  23. * PHASE III: Patients with simultaneous primaries or bilateral tumors are excluded, with the exception of patients with bilateral tonsil cancers or patients with T1-2, N0, M0 resected differentiated thyroid carcinoma, who are eligible
  24. * PHASE III: Prior systemic therapy, including cytotoxic chemotherapy, biologic/targeted therapy (such as anti-EGF therapy), or immune therapy for the study cancer; note that prior chemotherapy for a different cancer is allowable, however, a prior anti-PD-1, anti-PD-L1, or anti-PD-L2 agent is not permitted
  25. * PHASE III: Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields
  26. * PHASE III: Severe, active co-morbidity, defined as follows:
  27. * Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification; to be eligible for this trial, patients should be class 2B or better within 6 months prior to registration
  28. * Transmural myocardial infarction within 6 months prior to registration;
  29. * Severe infections within 4 weeks prior to registration including, but not limited to, hospitalization for complications of infection, bacteremia, or severe pneumonia;
  30. * Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration; Note: Patients receiving prophylactic antibiotics (e.g., for prevention of a urinary tract infection or chronic obstructive pulmonary disease exacerbation) are eligible.
  31. * Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration;
  32. * History of idiopathic pulmonary fibrosis, pneumonitis (including drug induced), organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia, etc.), or evidence of active pneumonitis on screening chest computed tomography (CT) scan. History of radiation pneumonitis in a prior radiation field (fibrosis) is permitted, provided that field does not overlap with the planned radiation field for the study cancer;
  33. * Patients with active tuberculosis (TB) are excluded;
  34. * Known clinically significant liver disease, including active viral, alcoholic, or other hepatitis; cirrhosis; fatty liver; and inherited liver disease;
  35. * Patients with past or resolved hepatitis B infection (defined as having a negative hepatitis B surface antigen \[HBsAg\] test and a positive anti-HBc \[antibody to hepatitis B core antigen\] antibody test) are eligible.
  36. * Patients positive for hepatitis C virus (HCV) antibody are eligible only if polymerase chain reaction (PCR) is negative for HCV RNA.
  37. * History of allogeneic bone marrow transplantation or solid organ transplantation.
  38. * A diagnosis of immunodeficiency:
  39. * Acquired immune deficiency syndrome (AIDS) based upon current CDC definition; note: HIV testing is not required for entry into this protocol; the need to exclude patients with AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive.
  40. * Is receiving treatment with systemic immunosuppressive medications (including, but not limited to, prednisone, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor \[anti-TNF\] agents) within 2 weeks prior to registration.
  41. * Note: Patients who have received acute, low dose, systemic immunosuppressant medications (e.g., a one-time dose of dexamethasone for nausea) may be enrolled.
  42. * Note: The use of inhaled corticosteroids and mineralocorticoids (e.g., fludrocortisone) for patients with orthostatic hypotension or adrenocortical insufficiency is allowed.
  43. * History or risk of autoimmune disease, including, but not limited to, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with antiphospholipid syndrome, Wegener's granulomatosis, Sjogren's syndrome, Guillain-Barré syndrome, multiple sclerosis, vasculitis, or glomerulonephritis.
  44. * Patients with a history of autoimmune hypothyroidism who are asymptomatic and/or are on a stable dose of thyroid replacement hormone are eligible.
  45. * Patients with controlled Type 1 diabetes mellitus on a stable insulin regimen are eligible.
  46. * Patients with eczema, psoriasis, lichen simplex chronicus, or vitiligo with dermatologic manifestations only (e.g., patients with psoriatic arthritis would be excluded) are permitted provided that they meet the following conditions:
  47. * Patients with psoriasis must have a baseline ophthalmologic exam to rule out ocular manifestations
  48. * Rash must cover less than 10% of body surface area (BSA)
  49. * Disease is well controlled at baseline and only requiring low potency topical steroids (e.g., hydrocortisone 2.5%, hydrocortisone butyrate 0.1%, flucinolone 0.01%, desonide 0.05%, aclometasone dipropionate 0.05%)
  50. * No acute exacerbations of underlying condition within the last 12 months (not requiring psoralen plus ultraviolet A radiation \[PUVA\], methotrexate, retinoids, biologic agents, oral calcineurin inhibitors; high potency or oral steroids)
  51. * PHASE III: Grade 3-4 electrolyte abnormalities (CTCAE, v. 4) within 14 days prior to registration:
  52. * Serum calcium (ionized or adjusted for albumin) \< 7 mg/dL (1.75 mmol/L) or \> 12.5 mg/dL (\> 3.1 mmol/L) despite intervention to normalize levels;
  53. * Glucose \< 40 mg/dL (\< 2.2 mmol/L) or \> 250 mg/dL (\> 14 mmol/L);
  54. * Magnesium \< 0.9 mg/dL (\< 0.4 mmol/L) or \> 3 mg/dL (\> 1.23 mmol/L) despite intervention to normalize levels;
  55. * Potassium \< 3.0 mmol/L or \> 6 mmol/L despite intervention to normalize levels;
  56. * Sodium \< 130 mmol/L or \> 155 mmol/L despite intervention to normalize levels.
  57. * PHASE III: Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception for up to 5 months from last study treatment; this exclusion is necessary because the treatment involved in this study may be significantly teratogenic. Women who are breastfeeding and unwilling to discontinue are also excluded
  58. * PHASE III: History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins
  59. * PHASE III: Patients taking bisphosphonate therapy for symptomatic hypercalcemia. Use of bisphosphonate therapy for other non-oncologic reasons (e.g., osteoporosis) is allowed
  60. * PHASE III: Patients requiring treatment with a RANKL inhibitor (e.g. denosumab) for non-oncologic reasons who cannot discontinue it before registration
  61. * PHASE III: Patients with known distant metastatic disease are excluded
  62. * PHASE III: Known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies
  63. * PHASE III: Major surgical procedure within 28 days prior to registration or anticipation of need for a major surgical procedure during the course of the study
  64. * PHASE III: Administration of a live, attenuated vaccine within 4 weeks prior to registration or anticipation that such a live, attenuated vaccine will be required during the study and for patients receiving atezolizumab, up to 5 months after the last dose of atezolizumab.
  65. * Influenza vaccination should be given during influenza season only (approximately October to

Contacts and Locations

Principal Investigator

Paul M Harari
PRINCIPAL_INVESTIGATOR
NRG Oncology

Study Locations (Sites)

University of Alabama at Birmingham Cancer Center
Birmingham, Alabama, 35233
United States
The Kirklin Clinic at Acton Road
Birmingham, Alabama, 35243
United States
Banner University Medical Center - Tucson
Tucson, Arizona, 85719
United States
University of Arizona Cancer Center-North Campus
Tucson, Arizona, 85719
United States
University of Arkansas for Medical Sciences
Little Rock, Arkansas, 72205
United States
Sutter Cancer Centers Radiation Oncology Services-Auburn
Auburn, California, 95603
United States
Providence Saint Joseph Medical Center/Disney Family Cancer Center
Burbank, California, 91505
United States
Sutter Cancer Centers Radiation Oncology Services-Cameron Park
Cameron Park, California, 95682
United States
Mercy San Juan Medical Center
Carmichael, California, 95608
United States
UC San Diego Health System - Encinitas
Encinitas, California, 92024
United States
UC San Diego Moores Cancer Center
La Jolla, California, 92093
United States
Cedars Sinai Medical Center
Los Angeles, California, 90048
United States
Memorial Medical Center
Modesto, California, 95355
United States
UC Irvine Health/Chao Family Comprehensive Cancer Center
Orange, California, 92868
United States
Stanford Cancer Institute Palo Alto
Palo Alto, California, 94304
United States
Sutter Cancer Centers Radiation Oncology Services-Roseville
Roseville, California, 95661
United States
Sutter Medical Center Sacramento
Sacramento, California, 95816
United States
University of California Davis Comprehensive Cancer Center
Sacramento, California, 95817
United States
Saint Helena Hospital
Saint Helena, California, 94574
United States
UCSF Medical Center-Mount Zion
San Francisco, California, 94115
United States
UCSF Medical Center-Mission Bay
San Francisco, California, 94158
United States
Mills Health Center
San Mateo, California, 94401
United States
Sutter Cancer Centers Radiation Oncology Services-Vacaville
Vacaville, California, 95687
United States
UCHealth University of Colorado Hospital
Aurora, Colorado, 80045
United States
Rocky Mountain Cancer Centers-Boulder
Boulder, Colorado, 80304
United States
Penrose-Saint Francis Healthcare
Colorado Springs, Colorado, 80907
United States
Porter Adventist Hospital
Denver, Colorado, 80210
United States
Shaw Cancer Center
Edwards, Colorado, 81632
United States
Banner North Colorado Medical Center
Greeley, Colorado, 80631
United States
Rocky Mountain Cancer Centers-Littleton
Littleton, Colorado, 80120
United States
Longmont United Hospital
Longmont, Colorado, 80501
United States
Banner McKee Medical Center
Loveland, Colorado, 80539
United States
Parker Adventist Hospital
Parker, Colorado, 80138
United States
University of Connecticut
Farmington, Connecticut, 06030
United States
Yale University
New Haven, Connecticut, 06520
United States
Smilow Cancer Hospital Care Center - Waterford
Waterford, Connecticut, 06385
United States
Helen F Graham Cancer Center
Newark, Delaware, 19713
United States
Christiana Care Health System-Christiana Hospital
Newark, Delaware, 19718
United States
George Washington University Medical Center
Washington, District of Columbia, 20037
United States
UM Sylvester Comprehensive Cancer Center at Deerfield Beach
Deerfield Beach, Florida, 33442
United States
Holy Cross Hospital
Fort Lauderdale, Florida, 33308
United States
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami, Florida, 33136
United States
AdventHealth Orlando
Orlando, Florida, 32803
United States
Orlando Health Cancer Institute
Orlando, Florida, 32806
United States
Moffitt Cancer Center
Tampa, Florida, 33612
United States
Emory University Hospital Midtown
Atlanta, Georgia, 30308
United States
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia, 30322
United States
Augusta University Medical Center
Augusta, Georgia, 30912
United States
Memorial Health University Medical Center
Savannah, Georgia, 31404
United States
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
Savannah, Georgia, 31405
United States
Queen's Medical Center
Honolulu, Hawaii, 96813
United States
The Cancer Center of Hawaii-Liliha
Honolulu, Hawaii, 96817
United States
Saint Alphonsus Cancer Care Center-Nampa
Nampa, Idaho, 83687
United States
Northwestern University
Chicago, Illinois, 60611
United States
John H Stroger Jr Hospital of Cook County
Chicago, Illinois, 60612
United States
Rush University Medical Center
Chicago, Illinois, 60612
United States
University of Illinois
Chicago, Illinois, 60612
United States
Decatur Memorial Hospital
Decatur, Illinois, 62526
United States
Crossroads Cancer Center
Effingham, Illinois, 62401
United States
NorthShore University HealthSystem-Evanston Hospital
Evanston, Illinois, 60201
United States
NorthShore University HealthSystem-Glenbrook Hospital
Glenview, Illinois, 60026
United States
NorthShore University HealthSystem-Highland Park Hospital
Highland Park, Illinois, 60035
United States
HSHS Saint Elizabeth's Hospital
O'Fallon, Illinois, 62269
United States
Advocate Christ Medical Center
Oak Lawn, Illinois, 60453-2699
United States
OSF Saint Francis Radiation Oncology at Peoria Cancer Center
Peoria, Illinois, 61615
United States
OSF Saint Francis Medical Center
Peoria, Illinois, 61637
United States
UW Health Carbone Cancer Center Rockford
Rockford, Illinois, 61114
United States
Springfield Memorial Hospital
Springfield, Illinois, 62781
United States
Carle Cancer Center
Urbana, Illinois, 61801
United States
Ascension Saint Vincent Anderson
Anderson, Indiana, 46016
United States
Elkhart General Hospital
Elkhart, Indiana, 46515
United States
Radiation Oncology Associates PC
Fort Wayne, Indiana, 46804
United States
Parkview Hospital Randallia
Fort Wayne, Indiana, 46805
United States
Parkview Regional Medical Center
Fort Wayne, Indiana, 46845
United States
Goshen Center for Cancer Care
Goshen, Indiana, 46526
United States
Indiana University/Melvin and Bren Simon Cancer Center
Indianapolis, Indiana, 46202
United States
IU Health Methodist Hospital
Indianapolis, Indiana, 46202
United States
IU Health Central Indiana Cancer Centers-East
Indianapolis, Indiana, 46219
United States
Michiana Hematology Oncology PC-Mishawaka
Mishawaka, Indiana, 46545
United States
Memorial Hospital of South Bend
South Bend, Indiana, 46601
United States
McFarland Clinic - Ames
Ames, Iowa, 50010
United States
Iowa Methodist Medical Center
Des Moines, Iowa, 50309
United States
University of Kansas Cancer Center
Kansas City, Kansas, 66160
United States
Olathe Health Cancer Center
Olathe, Kansas, 66061
United States
University of Kansas Cancer Center-Overland Park
Overland Park, Kansas, 66210
United States
Salina Regional Health Center
Salina, Kansas, 67401
United States
University of Kentucky/Markey Cancer Center
Lexington, Kentucky, 40536
United States
The James Graham Brown Cancer Center at University of Louisville
Louisville, Kentucky, 40202
United States
UofL Health Medical Center Northeast
Louisville, Kentucky, 40245
United States
Tulane University School of Medicine
New Orleans, Louisiana, 70112
United States
University Medical Center New Orleans
New Orleans, Louisiana, 70112
United States
Ochsner Medical Center Jefferson
New Orleans, Louisiana, 70121
United States
University of Maryland/Greenebaum Cancer Center
Baltimore, Maryland, 21201
United States
Greater Baltimore Medical Center
Baltimore, Maryland, 21204
United States
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore, Maryland, 21287
United States
UM Upper Chesapeake Medical Center
Bel Air, Maryland, 21014
United States
Central Maryland Radiation Oncology in Howard County
Columbia, Maryland, 21044
United States
UM Baltimore Washington Medical Center/Tate Cancer Center
Glen Burnie, Maryland, 21061
United States
Holy Cross Hospital
Silver Spring, Maryland, 20910
United States
Boston Medical Center
Boston, Massachusetts, 02118
United States
Trinity Health Saint Joseph Mercy Hospital Ann Arbor
Ann Arbor, Michigan, 48106
United States
University of Michigan Comprehensive Cancer Center
Ann Arbor, Michigan, 48109
United States
Trinity Health Medical Center - Brighton
Brighton, Michigan, 48114
United States
University of Michigan - Brighton Center for Specialty Care
Brighton, Michigan, 48116
United States
Henry Ford Cancer Institute-Downriver
Brownstown, Michigan, 48183
United States
Henry Ford Macomb Hospital-Clinton Township
Clinton Township, Michigan, 48038
United States
Henry Ford Hospital
Detroit, Michigan, 48202
United States
Corewell Health Grand Rapids Hospitals - Butterworth Hospital
Grand Rapids, Michigan, 49503
United States
Allegiance Health
Jackson, Michigan, 49201
United States
West Michigan Cancer Center
Kalamazoo, Michigan, 49007
United States
University of Michigan Health - Sparrow Lansing
Lansing, Michigan, 48912
United States
Trinity Health Saint Mary Mercy Livonia Hospital
Livonia, Michigan, 48154
United States
Henry Ford Medical Center-Columbus
Novi, Michigan, 48377
United States
Corewell Health William Beaumont University Hospital
Royal Oak, Michigan, 48073
United States
MyMichigan Medical Center Saginaw
Saginaw, Michigan, 48601
United States
Corewell Health Beaumont Troy Hospital
Troy, Michigan, 48085
United States
Henry Ford West Bloomfield Hospital
West Bloomfield, Michigan, 48322
United States
University of Michigan Health - West
Wyoming, Michigan, 49519
United States
Sanford Joe Lueken Cancer Center
Bemidji, Minnesota, 56601
United States
Minnesota Oncology - Burnsville
Burnsville, Minnesota, 55337
United States
Miller-Dwan Hospital
Duluth, Minnesota, 55805
United States
Hennepin County Medical Center
Minneapolis, Minnesota, 55415
United States
Mayo Clinic in Rochester
Rochester, Minnesota, 55905
United States
Coborn Cancer Center at Saint Cloud Hospital
Saint Cloud, Minnesota, 56303
United States
University of Mississippi Medical Center
Jackson, Mississippi, 39216
United States
Saint Francis Medical Center
Cape Girardeau, Missouri, 63703
United States
MU Health - University Hospital/Ellis Fischel Cancer Center
Columbia, Missouri, 65212
United States
Siteman Cancer Center at West County Hospital
Creve Coeur, Missouri, 63141
United States
North Kansas City Hospital
Kansas City, Missouri, 64116
United States
The University of Kansas Cancer Center-South
Kansas City, Missouri, 64131
United States
University of Kansas Cancer Center - North
Kansas City, Missouri, 64154
United States
University of Kansas Cancer Center - Lee's Summit
Lee's Summit, Missouri, 64064
United States
Delbert Day Cancer Institute at PCRMC
Rolla, Missouri, 65401
United States
Washington University School of Medicine
Saint Louis, Missouri, 63110
United States
Siteman Cancer Center-South County
Saint Louis, Missouri, 63129
United States
Missouri Baptist Medical Center
Saint Louis, Missouri, 63131
United States
Mercy Hospital Saint Louis
Saint Louis, Missouri, 63141
United States
Siteman Cancer Center at Saint Peters Hospital
Saint Peters, Missouri, 63376
United States
Mercy Hospital Springfield
Springfield, Missouri, 65804
United States
CoxHealth South Hospital
Springfield, Missouri, 65807
United States
CHI Health Good Samaritan
Kearney, Nebraska, 68847
United States
Nebraska Methodist Hospital
Omaha, Nebraska, 68114
United States
Alegent Health Bergan Mercy Medical Center
Omaha, Nebraska, 68124
United States
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon, New Hampshire, 03756
United States
Memorial Sloan Kettering Basking Ridge
Basking Ridge, New Jersey, 07920
United States
The Cancer Institute of New Jersey Hamilton
Hamilton, New Jersey, 08690
United States
Saint Barnabas Medical Center
Livingston, New Jersey, 07039
United States
Monmouth Medical Center
Long Branch, New Jersey, 07740
United States
Memorial Sloan Kettering Monmouth
Middletown, New Jersey, 07748
United States
Memorial Sloan Kettering Bergen
Montvale, New Jersey, 07645
United States
Virtua Memorial
Mount Holly, New Jersey, 08060
United States
Rutgers Cancer Institute of New Jersey
New Brunswick, New Jersey, 08903
United States
Rutgers New Jersey Medical School
Newark, New Jersey, 07101
United States
Sparta Cancer Treatment Center
Sparta, New Jersey, 07871
United States
Community Medical Center
Toms River, New Jersey, 08755
United States
Virtua Voorhees
Voorhees, New Jersey, 08043
United States
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87106
United States
New Mexico Oncology Hematology Consultants
Albuquerque, New Mexico, 87109
United States
South Shore University Hospital
Bay Shore, New York, 11706
United States
Montefiore Medical Center-Einstein Campus
Bronx, New York, 10461
United States
Montefiore Medical Center - Moses Campus
Bronx, New York, 10467
United States
New York-Presbyterian/Brooklyn Methodist Hospital
Brooklyn, New York, 11215
United States
NYU Langone Hospital - Brooklyn
Brooklyn, New York, 11220
United States
Roswell Park Cancer Institute
Buffalo, New York, 14263
United States
Sands Cancer Center
Canandaigua, New York, 14424
United States
Memorial Sloan Kettering Commack
Commack, New York, 11725
United States
Arnot Ogden Medical Center/Falck Cancer Center
Elmira, New York, 14905
United States
Memorial Sloan Kettering Westchester
Harrison, New York, 10604
United States
Northwell Health/Center for Advanced Medicine
Lake Success, New York, 11042
United States
NYU Langone Hospital - Long Island
Mineola, New York, 11501
United States
Mount Sinai Union Square
New York, New York, 10003
United States
Laura and Isaac Perlmutter Cancer Center at NYU Langone
New York, New York, 10016
United States
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
New York, New York, 10032
United States
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
United States
Wilmot Cancer Institute Radiation Oncology at Greece
Rochester, New York, 14606
United States
Highland Hospital
Rochester, New York, 14620
United States
University of Rochester
Rochester, New York, 14642
United States
Memorial Sloan Kettering Sleepy Hollow
Sleepy Hollow, New York, 10591
United States
State University of New York Upstate Medical University
Syracuse, New York, 13210
United States
Memorial Sloan Kettering Nassau
Uniondale, New York, 11553
United States
Atrium Health Stanly/LCI-Albemarle
Albemarle, North Carolina, 28002
United States
UNC Lineberger Comprehensive Cancer Center
Chapel Hill, North Carolina, 27599
United States
Carolinas Medical Center/Levine Cancer Institute
Charlotte, North Carolina, 28203
United States
Atrium Health Pineville/LCI-Pineville
Charlotte, North Carolina, 28210
United States
Atrium Health University City/LCI-University
Charlotte, North Carolina, 28262
United States
Atrium Health Cabarrus/LCI-Concord
Concord, North Carolina, 28025
United States
East Carolina University
Greenville, North Carolina, 27834
United States
ECU Health Oncology Kinston
Kinston, North Carolina, 28501
United States
Atrium Health Union/LCI-Union
Monroe, North Carolina, 28112
United States
Wake Forest University Health Sciences
Winston-Salem, North Carolina, 27157
United States
Sanford Bismarck Medical Center
Bismarck, North Dakota, 58501
United States
Sanford Roger Maris Cancer Center
Fargo, North Dakota, 58122
United States
Summa Health System - Akron Campus
Akron, Ohio, 44304
United States
Cleveland Clinic Akron General
Akron, Ohio, 44307
United States
UH Seidman Cancer Center at UH Avon Health Center
Avon, Ohio, 44011
United States
Summa Health System - Barberton Campus
Barberton, Ohio, 44203
United States
UHHS-Chagrin Highlands Medical Center
Beachwood, Ohio, 44122
United States
Geauga Hospital
Chardon, Ohio, 44024
United States
Adena Regional Medical Center
Chillicothe, Ohio, 45601
United States
University of Cincinnati Cancer Center-UC Medical Center
Cincinnati, Ohio, 45219
United States
Case Western Reserve University
Cleveland, Ohio, 44106
United States
MetroHealth Medical Center
Cleveland, Ohio, 44109
United States
Cleveland Clinic Cancer Center/Fairview Hospital
Cleveland, Ohio, 44111
United States
Cleveland Clinic Foundation
Cleveland, Ohio, 44195
United States
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210
United States
Mercy Cancer Center-Elyria
Elyria, Ohio, 44035
United States
Cleveland Clinic Cancer Center Independence
Independence, Ohio, 44131
United States
OhioHealth Mansfield Hospital
Mansfield, Ohio, 44903
United States
Hillcrest Hospital Cancer Center
Mayfield Heights, Ohio, 44124
United States
Summa Health Medina Medical Center
Medina, Ohio, 44256
United States
UH Seidman Cancer Center at Lake Health Mentor Campus
Mentor, Ohio, 44060
United States
UH Seidman Cancer Center at Southwest General Hospital
Middleburg Heights, Ohio, 44130
United States
University Hospitals Parma Medical Center
Parma, Ohio, 44129
United States
Southern Ohio Medical Center
Portsmouth, Ohio, 45662
United States
University Hospitals Portage Medical Center
Ravenna, Ohio, 44266
United States
North Coast Cancer Care
Sandusky, Ohio, 44870
United States
UH Seidman Cancer Center at Firelands Regional Medical Center
Sandusky, Ohio, 44870
United States
Cleveland Clinic Cancer Center Strongsville
Strongsville, Ohio, 44136
United States
University of Cincinnati Cancer Center-West Chester
West Chester, Ohio, 45069
United States
UHHS-Westlake Medical Center
Westlake, Ohio, 44145
United States
Cleveland Clinic Wooster Family Health and Surgery Center
Wooster, Ohio, 44691
United States
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
United States
Clackamas Radiation Oncology Center
Clackamas, Oregon, 97015
United States
Providence Portland Medical Center
Portland, Oregon, 97213
United States
Providence Saint Vincent Medical Center
Portland, Oregon, 97225
United States
UPMC Altoona
Altoona, Pennsylvania, 16601
United States
UPMC-Heritage Valley Health System Beaver
Beaver, Pennsylvania, 15009
United States
Carlisle Regional Cancer Center
Carlisle, Pennsylvania, 17015
United States
UPMC Hillman Cancer Center Erie
Erie, Pennsylvania, 16505
United States
UPMC Cancer Center at UPMC Horizon
Farrell, Pennsylvania, 16121
United States
UPMC Cancer Centers - Arnold Palmer Pavilion
Greensburg, Pennsylvania, 15601
United States
UPMC Pinnacle Cancer Center/Community Osteopathic Campus
Harrisburg, Pennsylvania, 17109
United States
Penn State Milton S Hershey Medical Center
Hershey, Pennsylvania, 17033-0850
United States
IRMC Cancer Center
Indiana, Pennsylvania, 15701
United States
UPMC-Johnstown/John P. Murtha Regional Cancer Center
Johnstown, Pennsylvania, 15901
United States
UPMC Cancer Center at UPMC McKeesport
McKeesport, Pennsylvania, 15132
United States
UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion
Mechanicsburg, Pennsylvania, 17050
United States
UPMC Cancer Center - Monroeville
Monroeville, Pennsylvania, 15146
United States
UPMC Hillman Cancer Center in Coraopolis
Moon, Pennsylvania, 15108
United States
UPMC Cancer Center-Natrona Heights
Natrona Heights, Pennsylvania, 15065
United States
UPMC Jameson
New Castle, Pennsylvania, 16105
United States
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, 19107
United States
Fox Chase Cancer Center
Philadelphia, Pennsylvania, 19111
United States
Temple University Hospital
Philadelphia, Pennsylvania, 19140
United States
Allegheny General Hospital
Pittsburgh, Pennsylvania, 15212
United States
UPMC-Magee Womens Hospital
Pittsburgh, Pennsylvania, 15213
United States
UPMC-Saint Margaret
Pittsburgh, Pennsylvania, 15215
United States
UPMC-Shadyside Hospital
Pittsburgh, Pennsylvania, 15232
United States
UPMC Jefferson Regional Radiation Oncology
Pittsburgh, Pennsylvania, 15236
United States
UPMC-Passavant Hospital
Pittsburgh, Pennsylvania, 15237
United States
UPMC-Saint Clair Hospital Cancer Center
Pittsburgh, Pennsylvania, 15243
United States
UPMC Cancer Center at UPMC Northwest
Seneca, Pennsylvania, 16346
United States
UPMC Uniontown Hospital Radiation Oncology
Uniontown, Pennsylvania, 15401
United States
UPMC Washington Hospital Radiation Oncology
Washington, Pennsylvania, 15301
United States
Reading Hospital
West Reading, Pennsylvania, 19611
United States
Wexford Health and Wellness Pavilion
Wexford, Pennsylvania, 15090
United States
AnMed Health Cancer Center
Anderson, South Carolina, 29621
United States
Saint Joseph's/Candler - Bluffton Campus
Bluffton, South Carolina, 29910
United States
Prisma Health Cancer Institute - Spartanburg
Boiling Springs, South Carolina, 29316
United States
Medical University of South Carolina
Charleston, South Carolina, 29425
United States
Prisma Health Cancer Institute - Faris
Greenville, South Carolina, 29605
United States
Prisma Health Cancer Institute - Eastside
Greenville, South Carolina, 29615
United States
Prisma Health Cancer Institute - Greer
Greer, South Carolina, 29650
United States
Gibbs Cancer Center-Pelham
Greer, South Carolina, 29651
United States
Rock Hill Radiation Therapy Center
Rock Hill, South Carolina, 29730
United States
Prisma Health Cancer Institute - Seneca
Seneca, South Carolina, 29672
United States
Spartanburg Medical Center
Spartanburg, South Carolina, 29303
United States
Rapid City Regional Hospital
Rapid City, South Dakota, 57701
United States
Sanford USD Medical Center - Sioux Falls
Sioux Falls, South Dakota, 57117-5134
United States
Vanderbilt University/Ingram Cancer Center
Nashville, Tennessee, 37232
United States
MD Anderson in The Woodlands
Conroe, Texas, 77384
United States
UT Southwestern/Simmons Cancer Center-Dallas
Dallas, Texas, 75390
United States
University of Texas Medical Branch
Galveston, Texas, 77555-0565
United States
M D Anderson Cancer Center
Houston, Texas, 77030
United States
MD Anderson West Houston
Houston, Texas, 77079
United States
MD Anderson League City
League City, Texas, 77573
United States
UTMB Cancer Center at Victory Lakes
League City, Texas, 77573
United States
Covenant Medical Center-Lakeside
Lubbock, Texas, 79410
United States
MD Anderson in Sugar Land
Sugar Land, Texas, 77478
United States
Intermountain Medical Center
Murray, Utah, 84107
United States
Saint George Regional Medical Center
Saint George, Utah, 84770
United States
Utah Cancer Specialists-Salt Lake City
Salt Lake City, Utah, 84106
United States
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, 84112
United States
Dartmouth Cancer Center - North
Saint Johnsbury, Vermont, 05819
United States
Inova Fairfax Hospital
Falls Church, Virginia, 22042
United States
Sentara Cancer Institute at Sentara CarePlex Hospital
Hampton, Virginia, 23666
United States
Sentara Norfolk General Hospital
Norfolk, Virginia, 23507
United States
Virginia Commonwealth University/Massey Cancer Center
Richmond, Virginia, 23298
United States
Sentara Virginia Beach General Hospital
Virginia Beach, Virginia, 23454
United States
Saint Francis Hospital
Federal Way, Washington, 98003
United States
Tri-Cities Cancer Center
Kennewick, Washington, 99336
United States
PeaceHealth Saint John Medical Center
Longview, Washington, 98632
United States
Skagit Regional Health Cancer Care Center
Mount Vernon, Washington, 98274
United States
University of Washington Medical Center - Montlake
Seattle, Washington, 98195
United States
Spokane Valley Cancer Center-Mayfair
Spokane, Washington, 99208
United States
Spokane Valley Cancer Center-Mission
Spokane, Washington, 99216
United States
Wenatchee Valley Hospital and Clinics
Wenatchee, Washington, 98801
United States
West Virginia University Healthcare
Morgantown, West Virginia, 26506
United States
Camden Clark Medical Center
Parkersburg, West Virginia, 26101
United States
Wheeling Hospital/Schiffler Cancer Center
Wheeling, West Virginia, 26003
United States
Langlade Hospital and Cancer Center
Antigo, Wisconsin, 54409
United States
Saint Vincent Hospital Cancer Center Green Bay
Green Bay, Wisconsin, 54301
United States
Saint Vincent Hospital Cancer Center at Saint Mary's
Green Bay, Wisconsin, 54303
United States
University of Wisconsin Carbone Cancer Center - Johnson Creek
Johnson Creek, Wisconsin, 53038
United States
Gundersen Lutheran Medical Center
La Crosse, Wisconsin, 54601
United States
Mayo Clinic Health System-Franciscan Healthcare
La Crosse, Wisconsin, 54601
United States
University of Wisconsin Carbone Cancer Center - University Hospital
Madison, Wisconsin, 53792
United States
Bay Area Medical Center
Marinette, Wisconsin, 54143
United States
Marshfield Medical Center
Marshfield, Wisconsin, 54449
United States
Froedtert Menomonee Falls Hospital
Menomonee Falls, Wisconsin, 53051
United States
Medical College of Wisconsin
Milwaukee, Wisconsin, 53226
United States
Marshfield Medical Center - Minocqua
Minocqua, Wisconsin, 54548
United States
Cancer Center of Western Wisconsin
New Richmond, Wisconsin, 54017
United States
Drexel Town Square Health Center
Oak Creek, Wisconsin, 53154
United States
Aspirus Cancer Care - James Beck Cancer Center
Rhinelander, Wisconsin, 54501
United States
Aspirus Cancer Care - Stevens Point
Stevens Point, Wisconsin, 54481
United States
Saint Vincent Hospital Cancer Center at Sturgeon Bay
Sturgeon Bay, Wisconsin, 54235-1495
United States
Aspirus Regional Cancer Center
Wausau, Wisconsin, 54401
United States
Froedtert West Bend Hospital/Kraemer Cancer Center
West Bend, Wisconsin, 53095
United States
Aspirus Cancer Care - Wisconsin Rapids
Wisconsin Rapids, Wisconsin, 54494
United States

Collaborators and Investigators

Sponsor: National Cancer Institute (NCI)

  • Paul M Harari, PRINCIPAL_INVESTIGATOR, NRG Oncology

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2013-03-22
Study Completion Date2027-01-01

Study Record Updates

Study Start Date2013-03-22
Study Completion Date2027-01-01

Terms related to this study

Additional Relevant MeSH Terms

  • Oropharyngeal p16INK4a-Negative Squamous Cell Carcinoma
  • Stage III Hypopharyngeal Squamous Cell Carcinoma AJCC v7
  • Stage III Laryngeal Squamous Cell Carcinoma AJCC v6 and v7
  • Stage III Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7
  • Stage III Oropharyngeal Squamous Cell Carcinoma AJCC v7
  • Stage IV Hypopharyngeal Squamous Cell Carcinoma AJCC v7
  • Stage IV Laryngeal Squamous Cell Carcinoma AJCC v7
  • Stage IV Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7
  • Stage IV Oropharyngeal Squamous Cell Carcinoma AJCC v7