RECRUITING

Active Surveillance, Bleomycin, Etoposide, Carboplatin or Cisplatin in Treating Pediatric and Adult Patients With Germ Cell Tumors

Conditions

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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 III trial studies how well active surveillance help doctors to monitor subjects with low risk germ cell tumors for recurrence after their tumor is removed. When the germ cell tumor has spread outside of the organ in which it developed, it is considered metastatic. Chemotherapy drugs, such as bleomycin, carboplatin, etoposide, and cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. The trial studies whether carboplatin or cisplatin is the preferred chemotherapy to use in treating metastatic standard risk germ cell tumors.

Official Title

A Phase 3 Study of Active Surveillance for Low Risk and a Randomized Trial of Carboplatin vs. Cisplatin for Standard Risk Pediatric and Adult Patients With Germ Cell Tumors

Quick Facts

Study Start:2017-05-25

Study Completion:2027-06-30

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT03067181

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:Not specified

Sexes Eligible for Study:ALL

Accepts Healthy Volunteers:No

Standard Ages:CHILD, ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
* There is no age limit for the low risk stratum (stage I ovarian immature teratoma and stage I non-seminoma or seminoma malignant GCT \[all sites\]) * Standard risk 1: Patients must be \< 11 years of age at enrollment * Standard risk 2: Patients must be \>= 11 and \< 25 years of age at enrollment * Patients enrolling on one of the low risk arms must be newly diagnosed with a stage I germ cell tumor; for the standard risk arms, patients must be newly diagnosed with malignant germ cell tumor (stage II or higher). * Histologic confirmation of a primary extracranial germ cell tumor in any of the categories outlined below is required of all patients at enrollment , with the following exceptions: * Among patients were initially diagnosed with completely resected non-seminoma malignant GCT and later recur during observation post surgery, a diagnostic biopsy is not required for enrollment if elevated tumor markers rise to \> 5 x upper limit of normal (ULN) on at least 2 measurements taken at least 1 week apart. The pathology report of initial surgery should be provided * Patients may be enrolled without histologic or cytologic confirmation in the rare case where there are exceptionally raised tumor markers (alpha fetoprotein \[AFP- ≥ 500 ng/mL or HCG ≥ 500 IU/L) and radiologic features consistent with GCT. In addition, the treating clinician must deem that the patient's tumor is not suitable for upfront resection and that a biopsy is not in the patient's best interest; or that there is a need to start therapy urgently * Low risk immature teratoma (IT); site: ovarian; stage: any; grade: any; histology: pure immature teratoma, mixed immature and mature teratoma, (may contain microscopic foci of yolk sac tumor \[\< 3 mm\], but no other pathological evidence of MGCT); tumor markers: alpha-FP =\< 1,000 ng/mL, beta-HCG institutional normal; all ages * Low risk stage I non-seminoma MGCT; site: ovarian, testicular, or extragonadal; stage: COG stage I, FIGO stage IA and IB, American Joint Committee on Cancer (AJCC) testicular stage IA, IB and IS; histology: must contain at least one of the following: yolk sac tumor, embryonal carcinoma, or choriocarcinoma (pure or mixed); all ages * Low risk stage I seminoma-MGCT; site: testicular; stage: COG stage I; AJCC testicular stage IA IB, and IS; histology: must contain only seminoma; may contain immature/mature teratoma; may NOT contain yolk sac tumor, embryonal carcinoma, or choriocarcinoma; all ages * Standard risk 1 (SR1); site: ovarian, testicular, or extragonadal; stage: COG stage II-IV, FIGO stage IC-IV, (International Germ Cell Consensus Classification \[IGCCC\] criteria DO NOT apply); histology: must contain at least one of the following: yolk sac tumor, embryonal carcinoma, or choriocarcinoma; age (years) \< 11 * Standard risk 2 (SR2) * Site: ovarian; stage: COG stage II, III, and III-X, FIGO stage IC, II and III; histology: must contain at least one of the following: yolk sac tumor, embryonal carcinoma, or choriocarcinoma; age (years) \>= 11 and \< 25 * Site: testicular; stage: COG stage II-IV, AJCC stage II, III, IGCCC good risk; histology: must contain at least one of the following: yolk sac tumor, embryonal carcinoma, or choriocarcinoma: must be IGCCC good risk; post op: alpha-FP \< 1,000 ng/mL, beta-HCG \< 5,000 IU/mL and lactate dehydrogenase (LDH) \< 3.0 x normal; age (years) \>= 11 and \< 25 * Notes: * IGCCC criteria only apply to SR2 patients with a testicular primary tumor * Use post-op tumor marker levels to determine IGCCC risk group * Pure seminoma patients are not eligible for the standard risk arms of the study * For the low risk stage I non-seminoma MGCT and the standard risk arms, components of yolk sac tumor, embryonal carcinoma, or choriocarcinoma can be mixed with other forms of GCT, such as seminoma or mature or immature teratoma; if yolk sac tumor is the only malignant component present, then it must be deemed by the pathologist to be greater than a "microscopic component" of yolk sac tumor * Patients must have a performance status corresponding to Eastern Cooperative Oncology Group (ECOG) scores of 0, 1, 2 or 3; use Karnofsky for patients \> 16 years of age and Lansky for patients =\< 16 years of age * Organ function requirements apply ONLY to patients who will receive chemotherapy (SR1 and SR2 patients) * Adequate renal function defined as: * Creatinine clearance or radioisotope glomerular filtration rate (GFR) \>= 70 mL/min/1.73 m\^2 (within 7 days prior to enrollment) OR * A serum creatinine based on age/sex as follows (within 7 days prior to enrollment): (mg/dL) * 1 month to \< 6 months male: 0.4 female: 0.4 * 6 months to \< 1 year male: 0.5 female: 0.5 * 1 to \< 2 years male: 0.6 female: 0.6 * 2 to \< 6 years male: 0.8 female: 0.8 * 6 to \< 10 years male: 1 female: 1 * 10 to \< 13 years male: 1.2 female: 1.2 * 13 to \< 16 years: male: 1.5 female: 1.4 * \>= 16 years male: 1.7 female: 1.4 * Total bilirubin =\< 2 x upper limit of normal (ULN) for age (within 7 days prior to enrollment) * Unless due to Gilbert's disease, malignant involvement of liver or vanishing bile duct syndrome * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) \< 3 x upper limit of normal (ULN) (within 7 days prior to enrollment) * Unless due to Gilbert's disease, malignant involvement of liver or vanishing bile duct syndrome * Peripheral absolute neutrophil count (ANC) \>= 750/mm\^3 (within 7 days prior to enrollment) AND * Platelet count \>= 75,000/mm\^3 (within 7 days prior to enrollment) * Patients enrolling on the standard risk arms must be medically fit to receive protocol treatment and with no contraindications to protocol treatment * Eligibility criteria to participate in the pilot study of the AYA-Hears instrument (patient reported outcomes \[PROs\] of ototoxicity) Note: participants in group 1 will not receive AGCT1531 protocol-directed therapy; all other AYA-HEARS patients must be enrolled on the AGCT1531 SR2 arm in order to participate * \>= 11 and \< 25 years old at enrollment * Able to fluently speak and read English * Has received prior cisplatin- or carboplatin-based chemotherapy regimen for malignancy including diagnoses other than germ cell tumor * Followed for cancer or survivorship care at one of the following institutions: * Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center * Dana Farber/Harvard Cancer Center * Hospital for Sick Children * Children's Hospital of Eastern Ontario * Oregon Health and Science University * Seattle Children's Hospital * Yale University	* Patients with any diagnoses not listed including: * Stage I testicular cancer patients who have undergone primary RPLND (retroperitoneal lymph node dissection) * Pure ovarian or extragonadal dysgerminoma/seminoma * Pure mature teratoma * Pure immature teratoma with alpha-fetoprotein (AFP) \>= 1000 ng/mL * "Poor risk" GCT (age \>= 11 years old and COG stage IV ovarian, COG stage II- IV extragonadal, or IGCCC intermediate or poor risk testicular), or * Primary central nervous system (CNS) germ cell tumor * Germ cell tumor with somatic malignant transformation * Spermatocytic seminoma * Patients must have had no prior systemic therapy for the current cancer diagnosis * Patients must have had no prior radiation therapy with the exception of CNS irradiation of brain metastases; (this exception only applies to SR1 patients; any patients over age 11 with distant metastases to brain \[stage IV disease\] would be considered poor risk and therefore not eligible for this trial) * Patients with significant, pre-existing co-morbid respiratory disease that contraindicate the use of bleomycin are ineligible for the standard risk arms of the trial * Female patients who are pregnant since fetal toxicities and teratogenic effects have been noted for several of the study drugs; a pregnancy test is required for female patients of childbearing potential; (this criteria applies ONLY to patients who will receive chemotherapy \[SR1 and SR2 patients\]) * Lactating females who plan to breastfeed their infants; (this criteria applies ONLY to patients who will receive chemotherapy \[SR1 and SR2 patients\]) * Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method for the duration of their study participation; (this criteria applies ONLY to patients who will receive chemotherapy \[SR1 and SR2 patients\])

Inclusion Criteria

Exclusion Criteria

* There is no age limit for the low risk stratum (stage I ovarian immature teratoma and stage I non-seminoma or seminoma malignant GCT \[all sites\])
* Standard risk 1: Patients must be \< 11 years of age at enrollment
* Standard risk 2: Patients must be \>= 11 and \< 25 years of age at enrollment
* Patients enrolling on one of the low risk arms must be newly diagnosed with a stage I germ cell tumor; for the standard risk arms, patients must be newly diagnosed with malignant germ cell tumor (stage II or higher).
* Histologic confirmation of a primary extracranial germ cell tumor in any of the categories outlined below is required of all patients at enrollment , with the following exceptions:
* Among patients were initially diagnosed with completely resected non-seminoma malignant GCT and later recur during observation post surgery, a diagnostic biopsy is not required for enrollment if elevated tumor markers rise to \> 5 x upper limit of normal (ULN) on at least 2 measurements taken at least 1 week apart. The pathology report of initial surgery should be provided
* Patients may be enrolled without histologic or cytologic confirmation in the rare case where there are exceptionally raised tumor markers (alpha fetoprotein \[AFP- ≥ 500 ng/mL or HCG ≥ 500 IU/L) and radiologic features consistent with GCT. In addition, the treating clinician must deem that the patient's tumor is not suitable for upfront resection and that a biopsy is not in the patient's best interest; or that there is a need to start therapy urgently
* Low risk immature teratoma (IT); site: ovarian; stage: any; grade: any; histology: pure immature teratoma, mixed immature and mature teratoma, (may contain microscopic foci of yolk sac tumor \[\< 3 mm\], but no other pathological evidence of MGCT); tumor markers: alpha-FP =\< 1,000 ng/mL, beta-HCG institutional normal; all ages
* Low risk stage I non-seminoma MGCT; site: ovarian, testicular, or extragonadal; stage: COG stage I, FIGO stage IA and IB, American Joint Committee on Cancer (AJCC) testicular stage IA, IB and IS; histology: must contain at least one of the following: yolk sac tumor, embryonal carcinoma, or choriocarcinoma (pure or mixed); all ages
* Low risk stage I seminoma-MGCT; site: testicular; stage: COG stage I; AJCC testicular stage IA IB, and IS; histology: must contain only seminoma; may contain immature/mature teratoma; may NOT contain yolk sac tumor, embryonal carcinoma, or choriocarcinoma; all ages
* Standard risk 1 (SR1); site: ovarian, testicular, or extragonadal; stage: COG stage II-IV, FIGO stage IC-IV, (International Germ Cell Consensus Classification \[IGCCC\] criteria DO NOT apply); histology: must contain at least one of the following: yolk sac tumor, embryonal carcinoma, or choriocarcinoma; age (years) \< 11
* Standard risk 2 (SR2)
* Site: ovarian; stage: COG stage II, III, and III-X, FIGO stage IC, II and III; histology: must contain at least one of the following: yolk sac tumor, embryonal carcinoma, or choriocarcinoma; age (years) \>= 11 and \< 25
* Site: testicular; stage: COG stage II-IV, AJCC stage II, III, IGCCC good risk; histology: must contain at least one of the following: yolk sac tumor, embryonal carcinoma, or choriocarcinoma: must be IGCCC good risk; post op: alpha-FP \< 1,000 ng/mL, beta-HCG \< 5,000 IU/mL and lactate dehydrogenase (LDH) \< 3.0 x normal; age (years) \>= 11 and \< 25
* Notes:
* IGCCC criteria only apply to SR2 patients with a testicular primary tumor
* Use post-op tumor marker levels to determine IGCCC risk group
* Pure seminoma patients are not eligible for the standard risk arms of the study
* For the low risk stage I non-seminoma MGCT and the standard risk arms, components of yolk sac tumor, embryonal carcinoma, or choriocarcinoma can be mixed with other forms of GCT, such as seminoma or mature or immature teratoma; if yolk sac tumor is the only malignant component present, then it must be deemed by the pathologist to be greater than a "microscopic component" of yolk sac tumor
* Patients must have a performance status corresponding to Eastern Cooperative Oncology Group (ECOG) scores of 0, 1, 2 or 3; use Karnofsky for patients \> 16 years of age and Lansky for patients =\< 16 years of age
* Organ function requirements apply ONLY to patients who will receive chemotherapy (SR1 and SR2 patients)
* Adequate renal function defined as:
* Creatinine clearance or radioisotope glomerular filtration rate (GFR) \>= 70 mL/min/1.73 m\^2 (within 7 days prior to enrollment) OR
* A serum creatinine based on age/sex as follows (within 7 days prior to enrollment): (mg/dL)
* 1 month to \< 6 months male: 0.4 female: 0.4
* 6 months to \< 1 year male: 0.5 female: 0.5
* 1 to \< 2 years male: 0.6 female: 0.6
* 2 to \< 6 years male: 0.8 female: 0.8
* 6 to \< 10 years male: 1 female: 1
* 10 to \< 13 years male: 1.2 female: 1.2
* 13 to \< 16 years: male: 1.5 female: 1.4
* \>= 16 years male: 1.7 female: 1.4
* Total bilirubin =\< 2 x upper limit of normal (ULN) for age (within 7 days prior to enrollment)
* Unless due to Gilbert's disease, malignant involvement of liver or vanishing bile duct syndrome
* Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) \< 3 x upper limit of normal (ULN) (within 7 days prior to enrollment)
* Unless due to Gilbert's disease, malignant involvement of liver or vanishing bile duct syndrome
* Peripheral absolute neutrophil count (ANC) \>= 750/mm\^3 (within 7 days prior to enrollment) AND
* Platelet count \>= 75,000/mm\^3 (within 7 days prior to enrollment)
* Patients enrolling on the standard risk arms must be medically fit to receive protocol treatment and with no contraindications to protocol treatment
* Eligibility criteria to participate in the pilot study of the AYA-Hears instrument (patient reported outcomes \[PROs\] of ototoxicity) Note: participants in group 1 will not receive AGCT1531 protocol-directed therapy; all other AYA-HEARS patients must be enrolled on the AGCT1531 SR2 arm in order to participate
* \>= 11 and \< 25 years old at enrollment
* Able to fluently speak and read English
* Has received prior cisplatin- or carboplatin-based chemotherapy regimen for malignancy including diagnoses other than germ cell tumor
* Followed for cancer or survivorship care at one of the following institutions:
* Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
* Dana Farber/Harvard Cancer Center
* Hospital for Sick Children
* Children's Hospital of Eastern Ontario
* Oregon Health and Science University
* Seattle Children's Hospital
* Yale University

* Patients with any diagnoses not listed including:
* Stage I testicular cancer patients who have undergone primary RPLND (retroperitoneal lymph node dissection)
* Pure ovarian or extragonadal dysgerminoma/seminoma
* Pure mature teratoma
* Pure immature teratoma with alpha-fetoprotein (AFP) \>= 1000 ng/mL
* "Poor risk" GCT (age \>= 11 years old and COG stage IV ovarian, COG stage II- IV extragonadal, or IGCCC intermediate or poor risk testicular), or
* Primary central nervous system (CNS) germ cell tumor
* Germ cell tumor with somatic malignant transformation
* Spermatocytic seminoma
* Patients must have had no prior systemic therapy for the current cancer diagnosis
* Patients must have had no prior radiation therapy with the exception of CNS irradiation of brain metastases; (this exception only applies to SR1 patients; any patients over age 11 with distant metastases to brain \[stage IV disease\] would be considered poor risk and therefore not eligible for this trial)
* Patients with significant, pre-existing co-morbid respiratory disease that contraindicate the use of bleomycin are ineligible for the standard risk arms of the trial
* Female patients who are pregnant since fetal toxicities and teratogenic effects have been noted for several of the study drugs; a pregnancy test is required for female patients of childbearing potential; (this criteria applies ONLY to patients who will receive chemotherapy \[SR1 and SR2 patients\])
* Lactating females who plan to breastfeed their infants; (this criteria applies ONLY to patients who will receive chemotherapy \[SR1 and SR2 patients\])
* Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method for the duration of their study participation; (this criteria applies ONLY to patients who will receive chemotherapy \[SR1 and SR2 patients\])

Contacts and Locations

Principal Investigator

A. L Frazier

PRINCIPAL_INVESTIGATOR

Children's Oncology Group

Study Locations (Sites)

Children's Hospital of Alabama

Birmingham, Alabama, 35233

United States

USA Health Strada Patient Care Center

Mobile, Alabama, 36604

United States

Anchorage Associates in Radiation Medicine

Anchorage, Alaska, 98508

United States

Anchorage Radiation Therapy Center

Anchorage, Alaska, 99504

United States

Alaska Breast Care and Surgery LLC

Anchorage, Alaska, 99508

United States

Alaska Oncology and Hematology LLC

Anchorage, Alaska, 99508

United States

Alaska Women's Cancer Care

Anchorage, Alaska, 99508

United States

Anchorage Oncology Centre

Anchorage, Alaska, 99508

United States

Katmai Oncology Group

Anchorage, Alaska, 99508

United States

Providence Alaska Medical Center

Anchorage, Alaska, 99508

United States

Kingman Regional Medical Center

Kingman, Arizona, 86401

United States

Banner Children's at Desert

Mesa, Arizona, 85202

United States

Cancer Center at Saint Joseph's

Phoenix, Arizona, 85004

United States

Phoenix Childrens Hospital

Phoenix, Arizona, 85016

United States

Banner University Medical Center - Tucson

Tucson, Arizona, 85719

United States

University of Arizona Cancer Center-North Campus

Tucson, Arizona, 85719

United States

CHI Saint Vincent Cancer Center Hot Springs

Hot Springs, Arkansas, 71913

United States

Arkansas Children's Hospital

Little Rock, Arkansas, 72202-3591

United States

CARTI Cancer Center

Little Rock, Arkansas, 72205

United States

University of Arkansas for Medical Sciences

Little Rock, Arkansas, 72205

United States

Kaiser Permanente-Anaheim

Anaheim, California, 92806

United States

Mission Hope Medical Oncology - Arroyo Grande

Arroyo Grande, California, 93420

United States

PCR Oncology

Arroyo Grande, California, 93420

United States

Kaiser Permanente-Bellflower

Bellflower, California, 90706

United States

Providence Saint Joseph Medical Center/Disney Family Cancer Center

Burbank, California, 91505

United States

Mercy Cancer Center - Carmichael

Carmichael, California, 95608

United States

Mercy San Juan Medical Center

Carmichael, California, 95608

United States

Kaiser Permanente Downey Medical Center

Downey, California, 90242

United States

City of Hope Comprehensive Cancer Center

Duarte, California, 91010

United States

Mercy Cancer Center - Elk Grove

Elk Grove, California, 95758

United States

Kaiser Permanente-Fontana

Fontana, California, 92335

United States

UC San Diego Moores Cancer Center

La Jolla, California, 92093

United States

Loma Linda University Medical Center

Loma Linda, California, 92354

United States

Miller Children's and Women's Hospital Long Beach

Long Beach, California, 90806

United States

Children's Hospital Los Angeles

Los Angeles, California, 90027

United States

Kaiser Permanente Los Angeles Medical Center

Los Angeles, California, 90027

United States

Los Angeles General Medical Center

Los Angeles, California, 90033

United States

USC / Norris Comprehensive Cancer Center

Los Angeles, California, 90033

United States

Cedars Sinai Medical Center

Los Angeles, California, 90048

United States

Mattel Children's Hospital UCLA

Los Angeles, California, 90095

United States

UCLA / Jonsson Comprehensive Cancer Center

Los Angeles, California, 90095

United States

Valley Children's Hospital

Madera, California, 93636

United States

Providence Queen of The Valley

Napa, California, 94558

United States

USC Norris Oncology/Hematology-Newport Beach

Newport Beach, California, 92663

United States

UCSF Benioff Children's Hospital Oakland

Oakland, California, 94609

United States

Kaiser Permanente-Oakland

Oakland, California, 94611

United States

Children's Hospital of Orange County

Orange, California, 92868

United States

Lucile Packard Children's Hospital Stanford University

Palo Alto, California, 94304

United States

Stanford Cancer Institute Palo Alto

Palo Alto, California, 94304

United States

Mercy Cancer Center - Rocklin

Rocklin, California, 95765

United States

Kaiser Permanente-Roseville

Roseville, California, 95661

United States

Mercy Cancer Center - Sacramento

Sacramento, California, 95816

United States

Sutter Medical Center Sacramento

Sacramento, California, 95816

United States

University of California Davis Comprehensive Cancer Center

Sacramento, California, 95817

United States

Kaiser Permanente-San Diego Mission

San Diego, California, 92108

United States

Rady Children's Hospital - San Diego

San Diego, California, 92123

United States

Naval Medical Center -San Diego

San Diego, California, 92134

United States

UCSF Medical Center-Mission Bay

San Francisco, California, 94158

United States

Pacific Central Coast Health Center-San Luis Obispo

San Luis Obispo, California, 93401

United States

Kaiser Permanente Medical Center - Santa Clara

Santa Clara, California, 95051

United States

Mission Hope Medical Oncology - Santa Maria

Santa Maria, California, 93444

United States

Providence Medical Foundation - Santa Rosa

Santa Rosa, California, 95403

United States

Providence Santa Rosa Memorial Hospital

Santa Rosa, California, 95405

United States

Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center

Torrance, California, 90502

United States

Woodland Memorial Hospital

Woodland, California, 95695

United States

Children's Hospital Colorado

Aurora, Colorado, 80045

United States

UCHealth University of Colorado Hospital

Aurora, Colorado, 80045

United States

Penrose-Saint Francis Healthcare

Colorado Springs, Colorado, 80907

United States

Rocky Mountain Cancer Centers-Penrose

Colorado Springs, Colorado, 80907

United States

UCHealth Memorial Hospital Central

Colorado Springs, Colorado, 80909

United States

Memorial Hospital North

Colorado Springs, Colorado, 80920

United States

Saint Francis Cancer Center

Colorado Springs, Colorado, 80923

United States

AdventHealth Porter

Denver, Colorado, 80210

United States

Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center

Denver, Colorado, 80218

United States

Mercy Medical Center

Durango, Colorado, 81301

United States

Southwest Oncology PC

Durango, Colorado, 81301

United States

Poudre Valley Hospital

Fort Collins, Colorado, 80524

United States

Cancer Care and Hematology-Fort Collins

Fort Collins, Colorado, 80528

United States

Mountain Blue Cancer Care Center

Golden, Colorado, 80401

United States

UCHealth Greeley Hospital

Greeley, Colorado, 80631

United States

Rocky Mountain Cancer Centers-Lakewood

Lakewood, Colorado, 80228

United States

Saint Anthony Hospital

Lakewood, Colorado, 80228

United States

AdventHealth Littleton

Littleton, Colorado, 80122

United States

UCHealth Lone Tree Health Center

Lone Tree, Colorado, 80124

United States

Longmont United Hospital

Longmont, Colorado, 80501

United States

Rocky Mountain Cancer Centers-Longmont

Longmont, Colorado, 80501

United States

Medical Center of the Rockies

Loveland, Colorado, 80538

United States

AdventHealth Parker

Parker, Colorado, 80138

United States

Rocky Mountain Cancer Centers-Parker

Parker, Colorado, 80138

United States

Saint Mary Corwin Medical Center

Pueblo, Colorado, 81004

United States

Rocky Mountain Cancer Centers - Pueblo

Pueblo, Colorado, 81008

United States

Rocky Mountain Cancer Centers-Thornton

Thornton, Colorado, 80260

United States

Connecticut Children's Medical Center

Hartford, Connecticut, 06106

United States

Yale University

New Haven, Connecticut, 06520

United States

Alfred I duPont Hospital for Children

Wilmington, Delaware, 19803

United States

Kaiser Permanente-Capitol Hill Medical Center

Washington, District of Columbia, 20002

United States

MedStar Georgetown University Hospital

Washington, District of Columbia, 20007

United States

Children's National Medical Center

Washington, District of Columbia, 20010

United States

Broward Health Medical Center

Fort Lauderdale, Florida, 33316

United States

Golisano Children's Hospital of Southwest Florida

Fort Myers, Florida, 33908

United States

University of Florida Health Science Center - Gainesville

Gainesville, Florida, 32610

United States

Memorial Regional Hospital/Joe DiMaggio Children's Hospital

Hollywood, Florida, 33021

United States

Nemours Children's Clinic-Jacksonville

Jacksonville, Florida, 32207

United States

University of Miami Miller School of Medicine-Sylvester Cancer Center

Miami, Florida, 33136

United States

Nicklaus Children's Hospital

Miami, Florida, 33155

United States

Miami Cancer Institute

Miami, Florida, 33176

United States

AdventHealth Orlando

Orlando, Florida, 32803

United States

Arnold Palmer Hospital for Children

Orlando, Florida, 32806

United States

Nemours Children's Hospital

Orlando, Florida, 32827

United States

Nemours Children's Clinic - Pensacola

Pensacola, Florida, 32504

United States

Sacred Heart Hospital

Pensacola, Florida, 32504

United States

Johns Hopkins All Children's Hospital

Saint Petersburg, Florida, 33701

United States

Tampa General Hospital

Tampa, Florida, 33606

United States

Saint Joseph's Hospital/Children's Hospital-Tampa

Tampa, Florida, 33607

United States

Saint Mary's Medical Center

West Palm Beach, Florida, 33407

United States

Children's Healthcare of Atlanta - Arthur M Blank Hospital

Atlanta, Georgia, 30329

United States

Augusta University Medical Center

Augusta, Georgia, 30912

United States

Atrium Health Navicent

Macon, Georgia, 31201

United States

Memorial Health University Medical Center

Savannah, Georgia, 31404

United States

Straub Clinic and Hospital

Honolulu, Hawaii, 96813

United States

Kaiser Permanente Moanalua Medical Center

Honolulu, Hawaii, 96819

United States

Kapiolani Medical Center for Women and Children

Honolulu, Hawaii, 96826

United States

Tripler Army Medical Center

Honolulu, Hawaii, 96859

United States

Saint Luke's Cancer Institute - Boise

Boise, Idaho, 83712

United States

Saint Luke's Cancer Institute - Fruitland

Fruitland, Idaho, 83619

United States

Saint Luke's Cancer Institute - Meridian

Meridian, Idaho, 83642

United States

Saint Luke's Cancer Institute - Nampa

Nampa, Idaho, 83687

United States

Saint Luke's Cancer Institute - Twin Falls

Twin Falls, Idaho, 83301

United States

Rush - Copley Medical Center

Aurora, Illinois, 60504

United States

Illinois CancerCare-Bloomington

Bloomington, Illinois, 61704

United States

Illinois CancerCare-Canton

Canton, Illinois, 61520

United States

Memorial Hospital of Carbondale

Carbondale, Illinois, 62902

United States

SIH Cancer Institute

Carterville, Illinois, 62918

United States

Illinois CancerCare-Carthage

Carthage, Illinois, 62321

United States

Centralia Oncology Clinic

Centralia, Illinois, 62801

United States

Lurie Children's Hospital-Chicago

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

University of Chicago Comprehensive Cancer Center

Chicago, Illinois, 60637

United States

Carle at The Riverfront

Danville, Illinois, 61832

United States

Cancer Care Specialists of Illinois - Decatur

Decatur, Illinois, 62526

United States

Decatur Memorial Hospital

Decatur, Illinois, 62526

United States

Illinois CancerCare-Dixon

Dixon, Illinois, 61021

United States

Carle Physician Group-Effingham

Effingham, Illinois, 62401

United States

Crossroads Cancer Center

Effingham, Illinois, 62401

United States

Illinois CancerCare-Eureka

Eureka, Illinois, 61530

United States

NorthShore University HealthSystem-Evanston Hospital

Evanston, Illinois, 60201

United States

Illinois CancerCare-Galesburg

Galesburg, Illinois, 61401

United States

Western Illinois Cancer Treatment Center

Galesburg, Illinois, 61401

United States

NorthShore University HealthSystem-Glenbrook Hospital

Glenview, Illinois, 60026

United States

NorthShore University HealthSystem-Highland Park Hospital

Highland Park, Illinois, 60035

United States

Illinois CancerCare-Kewanee Clinic

Kewanee, Illinois, 61443

United States

Illinois CancerCare-Macomb

Macomb, Illinois, 61455

United States

Carle Physician Group-Mattoon/Charleston

Mattoon, Illinois, 61938

United States

Loyola University Medical Center

Maywood, Illinois, 60153

United States

Cancer Care Center of O'Fallon

O'Fallon, Illinois, 62269

United States

HSHS Saint Elizabeth's Hospital

O'Fallon, Illinois, 62269

United States

Advocate Children's Hospital-Oak Lawn

Oak Lawn, Illinois, 60453

United States

Illinois CancerCare-Ottawa Clinic

Ottawa, Illinois, 61350

United States

Advocate Children's Hospital-Park Ridge

Park Ridge, Illinois, 60068

United States

Illinois CancerCare-Pekin

Pekin, Illinois, 61554

United States

OSF Saint Francis Radiation Oncology at Pekin

Pekin, Illinois, 61554

United States

Illinois CancerCare-Peoria

Peoria, Illinois, 61615

United States

OSF Saint Francis Radiation Oncology at Peoria Cancer Center

Peoria, Illinois, 61615

United States

Methodist Medical Center of Illinois

Peoria, Illinois, 61636

United States

OSF Saint Francis Medical Center

Peoria, Illinois, 61637

United States

Saint Jude Midwest Affiliate

Peoria, Illinois, 61637

United States

Illinois CancerCare-Peru

Peru, Illinois, 61354

United States

Valley Radiation Oncology

Peru, Illinois, 61354

United States

Illinois CancerCare-Princeton

Princeton, Illinois, 61356

United States

North Shore Medical Center

Skokie, Illinois, 60076

United States

Saint John's Hospital

Springfield, Illinois, 62702

United States

Southern Illinois University School of Medicine

Springfield, Illinois, 62702

United States

Springfield Clinic

Springfield, Illinois, 62702

United States

Springfield Memorial Hospital

Springfield, Illinois, 62781

United States

Southwest Illinois Health Services LLP

Swansea, Illinois, 62226

United States

Carle Cancer Center

Urbana, Illinois, 61801

United States

The Carle Foundation Hospital

Urbana, Illinois, 61801

United States

Illinois CancerCare - Washington

Washington, Illinois, 61571

United States

Rush-Copley Healthcare Center

Yorkville, Illinois, 60560

United States

IU Health North Hospital

Carmel, Indiana, 46032

United States

Deaconess Clinic Downtown

Evansville, Indiana, 47713

United States

Indiana University/Melvin and Bren Simon Cancer Center

Indianapolis, Indiana, 46202

United States

Riley Hospital for Children

Indianapolis, Indiana, 46202

United States

Ascension Saint Vincent Indianapolis Hospital

Indianapolis, Indiana, 46260

United States

Chancellor Center for Oncology

Newburgh, Indiana, 47630

United States

Memorial Hospital of South Bend

South Bend, Indiana, 46601

United States

UI Health Care Mission Cancer and Blood - Ankeny Clinic

Ankeny, Iowa, 50023

United States

Mercy Cancer Center-West Lakes

Clive, Iowa, 50325

United States

UI Health Care Mission Cancer and Blood - West Des Moines Clinic

Clive, Iowa, 50325

United States

Alegent Health Mercy Hospital

Council Bluffs, Iowa, 51503

United States

Greater Regional Medical Center

Creston, Iowa, 50801

United States

Blank Children's Hospital

Des Moines, Iowa, 50309

United States

Iowa Methodist Medical Center

Des Moines, Iowa, 50309

United States

Mercy Medical Center - Des Moines

Des Moines, Iowa, 50314

United States

UI Health Care Mission Cancer and Blood - Laurel Clinic

Des Moines, Iowa, 50314

United States

Iowa Lutheran Hospital

Des Moines, Iowa, 50316

United States

University of Iowa/Holden Comprehensive Cancer Center

Iowa City, Iowa, 52242

United States

Mercy Medical Center-West Lakes

West Des Moines, Iowa, 50266

United States

Wesley Medical Center

Wichita, Kansas, 67214

United States

Flaget Memorial Hospital

Bardstown, Kentucky, 40004

United States

Commonwealth Cancer Center-Corbin

Corbin, Kentucky, 40701

United States

Saint Joseph Hospital

Lexington, Kentucky, 40504

United States

Saint Joseph Radiation Oncology Resource Center

Lexington, Kentucky, 40504

United States

Saint Joseph Hospital East

Lexington, Kentucky, 40509

United States

University of Kentucky/Markey Cancer Center

Lexington, Kentucky, 40536

United States

Saint Joseph London

London, Kentucky, 40741

United States

Jewish Hospital

Louisville, Kentucky, 40202

United States

Norton Children's Hospital

Louisville, Kentucky, 40202

United States

Saints Mary and Elizabeth Hospital

Louisville, Kentucky, 40215

United States

UofL Health Medical Center Northeast

Louisville, Kentucky, 40245

United States

Saint Joseph Mount Sterling

Mount Sterling, Kentucky, 40353

United States

Jewish Hospital Medical Center South

Shepherdsville, Kentucky, 40165

United States

Children's Hospital New Orleans

New Orleans, Louisiana, 70118

United States

Ochsner Medical Center Jefferson

New Orleans, Louisiana, 70121

United States

Eastern Maine Medical Center

Bangor, Maine, 04401

United States

Lafayette Family Cancer Center-EMMC

Brewer, Maine, 04412

United States

MaineHealth Maine Medical Center - Portland

Portland, Maine, 04102

United States

Maine Children's Cancer Program

Scarborough, Maine, 04074

United States

MaineHealth Maine Medical Center- Scarborough

Scarborough, Maine, 04074

United States

University of Maryland/Greenebaum Cancer Center

Baltimore, Maryland, 21201

United States

Sinai Hospital of Baltimore

Baltimore, Maryland, 21215

United States

Johns Hopkins University/Sidney Kimmel Cancer Center

Baltimore, Maryland, 21287

United States

Walter Reed National Military Medical Center

Bethesda, Maryland, 20889-5600

United States

Tufts Children's Hospital

Boston, Massachusetts, 02111

United States

Tufts Medical Center

Boston, Massachusetts, 02111

United States

Massachusetts General Hospital Cancer Center

Boston, Massachusetts, 02114

United States

Dana-Farber Cancer Institute

Boston, Massachusetts, 02215

United States

Baystate Medical Center

Springfield, Massachusetts, 01199

United States

UMass Memorial Medical Center - University Campus

Worcester, Massachusetts, 01655

United States

C S Mott Children's Hospital

Ann Arbor, Michigan, 48109

United States

University of Michigan Comprehensive Cancer Center

Ann Arbor, Michigan, 48109

United States

Bronson Battle Creek

Battle Creek, Michigan, 49017

United States

Children's Hospital of Michigan

Detroit, Michigan, 48201

United States

Henry Ford Health Saint John Hospital

Detroit, Michigan, 48236

United States

Michigan State University

East Lansing, Michigan, 48823

United States

OSF Saint Francis Hospital and Medical Group

Escanaba, Michigan, 49829

United States

Hurley Medical Center

Flint, Michigan, 48503

United States

Corewell Health Grand Rapids Hospitals - Butterworth Hospital

Grand Rapids, Michigan, 49503

United States

Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital

Grand Rapids, Michigan, 49503

United States

Trinity Health Grand Rapids Hospital

Grand Rapids, Michigan, 49503

United States

Bronson Methodist Hospital

Kalamazoo, Michigan, 49007

United States

West Michigan Cancer Center

Kalamazoo, Michigan, 49007

United States

Ascension Borgess Hospital

Kalamazoo, Michigan, 49048

United States

Trinity Health Muskegon Hospital

Muskegon, Michigan, 49444

United States

Corewell Health Lakeland Hospitals - Niles Hospital

Niles, Michigan, 49120

United States

Lake Huron Medical Center

Port Huron, Michigan, 48060

United States

Corewell Health Reed City Hospital

Reed City, Michigan, 49677

United States

Corewell Health Children's

Royal Oak, Michigan, 48073

United States

Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center

Saint Joseph, Michigan, 49085

United States

Corewell Health Lakeland Hospitals - Saint Joseph Hospital

Saint Joseph, Michigan, 49085

United States

Munson Medical Center

Traverse City, Michigan, 49684

United States

University of Michigan Health - West

Wyoming, Michigan, 49519

United States

Essentia Health Cancer Center

Duluth, Minnesota, 55805

United States

Children's Hospitals and Clinics of Minnesota - Minneapolis

Minneapolis, Minnesota, 55404

United States

University of Minnesota/Masonic Cancer Center

Minneapolis, Minnesota, 55455

United States

Mayo Clinic in Rochester

Rochester, Minnesota, 55905

United States

University of Mississippi Medical Center

Jackson, Mississippi, 39216

United States

Parkland Health Center-Bonne Terre

Bonne Terre, Missouri, 63628

United States

Mercy Cancer Center - Cape Girardeau

Cape Girardeau, Missouri, 63703

United States

Saint Francis Medical Center

Cape Girardeau, Missouri, 63703

United States

University of Missouri Children's Hospital

Columbia, Missouri, 65212

United States

Parkland Health Center - Farmington

Farmington, Missouri, 63640

United States

MU Health Care Goldschmidt Cancer Center

Jefferson City, Missouri, 65109

United States

Children's Mercy Hospitals and Clinics

Kansas City, Missouri, 64108

United States

Lake Regional Hospital

Osage Beach, Missouri, 65065

United States

Washington University School of Medicine

Saint Louis, Missouri, 63110

United States

Missouri Baptist Medical Center

Saint Louis, Missouri, 63131

United States

Mercy Hospital Saint Louis

Saint Louis, Missouri, 63141

United States

Sainte Genevieve County Memorial Hospital

Sainte Genevieve, Missouri, 63670

United States

Missouri Baptist Sullivan Hospital

Sullivan, Missouri, 63080

United States

BJC Outpatient Center at Sunset Hills

Sunset Hills, Missouri, 63127

United States

Saint Patrick Hospital - Community Hospital

Missoula, Montana, 59802

United States

Nebraska Cancer Specialists/Oncology Hematology West PC

Grand Island, Nebraska, 68803

United States

Fred and Pamela Buffett Cancer Center - Kearney

Kearney, Nebraska, 68845

United States

CHI Health Good Samaritan

Kearney, Nebraska, 68847

United States

Saint Elizabeth Regional Medical Center

Lincoln, Nebraska, 68510

United States

Children's Hospital and Medical Center of Omaha

Omaha, Nebraska, 68114

United States

Alegent Health Immanuel Medical Center

Omaha, Nebraska, 68122

United States

Hematology and Oncology Consultants PC

Omaha, Nebraska, 68122

United States

Alegent Health Bergan Mercy Medical Center

Omaha, Nebraska, 68124

United States

Alegent Health Lakeside Hospital

Omaha, Nebraska, 68130

United States

Creighton University Medical Center

Omaha, Nebraska, 68131

United States

University of Nebraska Medical Center

Omaha, Nebraska, 68198

United States

Midlands Community Hospital

Papillion, Nebraska, 68046

United States

Carson Tahoe Regional Medical Center

Carson City, Nevada, 89703

United States

Cancer and Blood Specialists-Henderson

Henderson, Nevada, 89052

United States

Comprehensive Cancer Centers of Nevada - Henderson

Henderson, Nevada, 89052

United States

Comprehensive Cancer Centers of Nevada-Horizon Ridge

Henderson, Nevada, 89052

United States

Las Vegas Cancer Center-Henderson

Henderson, Nevada, 89052

United States

OptumCare Cancer Care at Seven Hills

Henderson, Nevada, 89052

United States

Comprehensive Cancer Centers of Nevada-Southeast Henderson

Henderson, Nevada, 89074

United States

Las Vegas Urology - Green Valley

Henderson, Nevada, 89074

United States

Las Vegas Urology - Pebble

Henderson, Nevada, 89074

United States

Urology Specialists of Nevada - Green Valley

Henderson, Nevada, 89074

United States

Las Vegas Urology - Pecos

Las Vegas, Nevada, 89074

United States

Desert West Surgery

Las Vegas, Nevada, 89102

United States

OptumCare Cancer Care at Charleston

Las Vegas, Nevada, 89102

United States

University Medical Center of Southern Nevada

Las Vegas, Nevada, 89102

United States

Hope Cancer Care of Nevada

Las Vegas, Nevada, 89103

United States

Cancer and Blood Specialists-Shadow

Las Vegas, Nevada, 89106

United States

Radiation Oncology Centers of Nevada Central

Las Vegas, Nevada, 89106

United States

Urology Specialists of Nevada - Central

Las Vegas, Nevada, 89106

United States

Women's Cancer Center of Nevada

Las Vegas, Nevada, 89106

United States

Sunrise Hospital and Medical Center

Las Vegas, Nevada, 89109

United States

Las Vegas Urology - Sunset

Las Vegas, Nevada, 89113

United States

Urology Specialists of Nevada - Southwest

Las Vegas, Nevada, 89113

United States

Radiation Oncology Centers of Nevada Southeast

Las Vegas, Nevada, 89119

United States

Cancer Therapy and Integrative Medicine

Las Vegas, Nevada, 89121

United States

Ann M Wierman MD LTD

Las Vegas, Nevada, 89128

United States

Cancer and Blood Specialists-Tenaya

Las Vegas, Nevada, 89128

United States

Comprehensive Cancer Centers of Nevada - Northwest

Las Vegas, Nevada, 89128

United States

Las Vegas Urology - Cathedral Rock

Las Vegas, Nevada, 89128

United States

Las Vegas Urology - Smoke Ranch

Las Vegas, Nevada, 89128

United States

OptumCare Cancer Care at MountainView

Las Vegas, Nevada, 89128

United States

Urology Specialists of Nevada - Northwest

Las Vegas, Nevada, 89128

United States

Alliance for Childhood Diseases/Cure 4 the Kids Foundation

Las Vegas, Nevada, 89135

United States

Comprehensive Cancer Centers of Nevada - Town Center

Las Vegas, Nevada, 89144

United States

Comprehensive Cancer Centers of Nevada-Summerlin

Las Vegas, Nevada, 89144

United States

Summerlin Hospital Medical Center

Las Vegas, Nevada, 89144

United States

Las Vegas Cancer Center-Medical Center

Las Vegas, Nevada, 89148-2405

United States

Comprehensive Cancer Centers of Nevada

Las Vegas, Nevada, 89148

United States

OptumCare Cancer Care at Fort Apache

Las Vegas, Nevada, 89148

United States

Comprehensive Cancer Centers of Nevada - Central Valley

Las Vegas, Nevada, 89169

United States

University Cancer Center

Las Vegas, Nevada, 89169

United States

Hope Cancer Care of Nevada-Pahrump

Pahrump, Nevada, 89048

United States

Renown Regional Medical Center

Reno, Nevada, 89502

United States

Saint Mary's Regional Medical Center

Reno, Nevada, 89503

United States

Radiation Oncology Associates

Reno, Nevada, 89509

United States

Cancer Care Specialists - Reno

Reno, Nevada, 89511

United States

Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center

Lebanon, New Hampshire, 03756

United States

Hackensack University Medical Center

Hackensack, New Jersey, 07601

United States

Morristown Medical Center

Morristown, New Jersey, 07960

United States

Jersey Shore Medical Center

Neptune, New Jersey, 07753

United States

Saint Peter's University Hospital

New Brunswick, New Jersey, 08901

United States

Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital

New Brunswick, New Jersey, 08903

United States

Newark Beth Israel Medical Center

Newark, New Jersey, 07112

United States

Saint Joseph's Regional Medical Center

Paterson, New Jersey, 07503

United States

Presbyterian Hospital

Albuquerque, New Mexico, 87106

United States

University of New Mexico Cancer Center

Albuquerque, New Mexico, 87106

United States

Albany Medical Center

Albany, New York, 12208

United States

Montefiore Medical Center-Einstein Campus

Bronx, New York, 10461

United States

Montefiore Medical Center-Weiler Hospital

Bronx, New York, 10461

United States

Children's Hospital at Montefiore

Bronx, New York, 10467

United States

Montefiore Medical Center - Moses Campus

Bronx, New York, 10467

United States

Maimonides Medical Center

Brooklyn, New York, 11219

United States

Roswell Park Cancer Institute

Buffalo, New York, 14263

United States

Glens Falls Hospital

Glens Falls, New York, 12801

United States

NYU Langone Hospital - Long Island

Mineola, New York, 11501

United States

The Steven and Alexandra Cohen Children's Medical Center of New York

New Hyde Park, New York, 11040

United States

Laura and Isaac Perlmutter Cancer Center at NYU Langone

New York, New York, 10016

United States

Mount Sinai Hospital

New York, New York, 10029

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

University of Rochester

Rochester, New York, 14642

United States

Stony Brook University Medical Center

Stony Brook, New York, 11794

United States

State University of New York Upstate Medical University

Syracuse, New York, 13210

United States

New York Medical College

Valhalla, New York, 10595

United States

Westchester Medical Center

Valhalla, New York, 10595

United States

Mission Hospital

Asheville, North Carolina, 28801

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

Novant Health Presbyterian Medical Center

Charlotte, North Carolina, 28204

United States

Oncology Specialists of Charlotte

Charlotte, North Carolina, 28207

United States

Southern Oncology Specialists-Charlotte

Charlotte, North Carolina, 28262

United States

Southeastern Medical Oncology Center-Clinton

Clinton, North Carolina, 28328

United States

Duke University Medical Center

Durham, North Carolina, 27710

United States

Southeastern Medical Oncology Center-Goldsboro

Goldsboro, North Carolina, 27534

United States

Wayne Memorial Hospital

Goldsboro, North Carolina, 27534

United States

East Carolina University

Greenville, North Carolina, 27834

United States

Novant Health Cancer Institute - Huntersville

Huntersville, North Carolina, 28078

United States

Southern Oncology Specialists-Huntersville

Huntersville, North Carolina, 28078

United States

Southeastern Medical Oncology Center-Jacksonville

Jacksonville, North Carolina, 28546

United States

Matthews Radiation Oncology Center

Matthews, North Carolina, 28105

United States

Novant Health Cancer Institute - Matthews

Matthews, North Carolina, 28105

United States

Novant Health Cancer Institute - Mooresville

Mooresville, North Carolina, 28117

United States

Novant Health Cancer Institute - Rowan

Salisbury, North Carolina, 28144

United States

Rowan Regional Medical Center

Salisbury, North Carolina, 28144

United States

Wake Forest University Health Sciences

Winston-Salem, North Carolina, 27157

United States

Sanford Broadway Medical Center

Fargo, North Dakota, 58122

United States

Children's Hospital Medical Center of Akron

Akron, Ohio, 44308

United States

OhioHealth O'Bleness Hospital

Athens, Ohio, 45701

United States

Strecker Cancer Center-Belpre

Belpre, Ohio, 45714

United States

Adena Regional Medical Center

Chillicothe, Ohio, 45601

United States

Good Samaritan Hospital - Cincinnati

Cincinnati, Ohio, 45220

United States

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, 45229

United States

Bethesda North Hospital

Cincinnati, Ohio, 45242

United States

TriHealth Cancer Institute-Westside

Cincinnati, Ohio, 45247

United States

TriHealth Cancer Institute-Anderson

Cincinnati, Ohio, 45255

United States

Case Western Reserve University

Cleveland, Ohio, 44106

United States

Rainbow Babies and Childrens Hospital

Cleveland, Ohio, 44106

United States

Cleveland Clinic Foundation

Cleveland, Ohio, 44195

United States

Nationwide Children's Hospital

Columbus, Ohio, 43205

United States

Ohio State University Comprehensive Cancer Center

Columbus, Ohio, 43210

United States

Mount Carmel East Hospital

Columbus, Ohio, 43213

United States

Columbus Oncology and Hematology Associates Inc

Columbus, Ohio, 43214

United States

Riverside Methodist Hospital

Columbus, Ohio, 43214

United States

Grant Medical Center

Columbus, Ohio, 43215

United States

The Mark H Zangmeister Center

Columbus, Ohio, 43219

United States

Mount Carmel Health Center West

Columbus, Ohio, 43222

United States

Doctors Hospital

Columbus, Ohio, 43228

United States

Dayton Children's Hospital

Dayton, Ohio, 45404

United States

Delaware Health Center-Grady Cancer Center

Delaware, Ohio, 43015

United States

Grady Memorial Hospital

Delaware, Ohio, 43015

United States

Columbus Oncology and Hematology Associates

Dublin, Ohio, 43016

United States

Dublin Methodist Hospital

Dublin, Ohio, 43016

United States

Mount Carmel Grove City Hospital

Grove City, Ohio, 43123

United States

Saint Rita's Medical Center

Lima, Ohio, 45801

United States

OhioHealth Mansfield Hospital

Mansfield, Ohio, 44903

United States

Marietta Memorial Hospital

Marietta, Ohio, 45750

United States

OhioHealth Marion General Hospital

Marion, Ohio, 43302

United States

Memorial Hospital

Marysville, Ohio, 43040

United States

Knox Community Hospital

Mount Vernon, Ohio, 43050

United States

Licking Memorial Hospital

Newark, Ohio, 43055

United States

Mercy Health - Perrysburg Hospital

Perrysburg, Ohio, 43551

United States

OhioHealth Pickerington Methodist Hospital

Pickerington, Ohio, 43147

United States

Southern Ohio Medical Center

Portsmouth, Ohio, 45662

United States

ProMedica Flower Hospital

Sylvania, Ohio, 43560

United States

ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital

Toledo, Ohio, 43606

United States

Mercy Health - Saint Vincent Hospital

Toledo, Ohio, 43608

United States

Mercy Health - Saint Anne Hospital

Toledo, Ohio, 43623

United States

Saint Ann's Hospital

Westerville, Ohio, 43081

United States

OhioHealth Westerville Medical Campus/Westerville Cancer Center

Westerville, Ohio, 43082

United States

Clinton Memorial Hospital/Foster J Boyd Regional Cancer Center

Wilmington, Ohio, 45177

United States

Genesis Healthcare System Cancer Care Center

Zanesville, Ohio, 43701

United States

Cancer Centers of Southwest Oklahoma Research

Lawton, Oklahoma, 73505

United States

University of Oklahoma Health Sciences Center

Oklahoma City, Oklahoma, 73104

United States

Saint Charles Health System

Bend, Oregon, 97701

United States

Clackamas Radiation Oncology Center

Clackamas, Oregon, 97015

United States

Providence Cancer Institute Clackamas Clinic

Clackamas, Oregon, 97015

United States

Bay Area Hospital

Coos Bay, Oregon, 97420

United States

Asante Rogue Regional Medical Center

Medford, Oregon, 97504

United States

Providence Newberg Medical Center

Newberg, Oregon, 97132

United States

Providence Willamette Falls Medical Center

Oregon City, Oregon, 97045

United States

Providence Portland Medical Center

Portland, Oregon, 97213

United States

Providence Saint Vincent Medical Center

Portland, Oregon, 97225

United States

Legacy Emanuel Children's Hospital

Portland, Oregon, 97227

United States

Oregon Health and Science University

Portland, Oregon, 97239

United States

Jefferson Abington Hospital

Abington, Pennsylvania, 19001

United States

Lehigh Valley Hospital-Cedar Crest

Allentown, Pennsylvania, 18103

United States

Lehigh Valley Hospital - Muhlenberg

Bethlehem, Pennsylvania, 18017

United States

Geisinger Medical Center

Danville, Pennsylvania, 17822

United States

Penn State Children's Hospital

Hershey, Pennsylvania, 17033

United States

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, 19104

United States

University of Pennsylvania/Abramson Cancer Center

Philadelphia, Pennsylvania, 19104

United States

Saint Christopher's Hospital for Children

Philadelphia, Pennsylvania, 19134

United States

UPMC-Magee Womens Hospital

Pittsburgh, Pennsylvania, 15213

United States

Children's Hospital of Pittsburgh of UPMC

Pittsburgh, Pennsylvania, 15224

United States

University of Pittsburgh Cancer Institute (UPCI)

Pittsburgh, Pennsylvania, 15232

United States

UPMC-Passavant Hospital

Pittsburgh, Pennsylvania, 15237

United States

Asplundh Cancer Pavilion

Willow Grove, Pennsylvania, 19090

United States

Rhode Island Hospital

Providence, Rhode Island, 02903

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 Richland Hospital

Columbia, South Carolina, 29203

United States

Gibbs Cancer Center-Gaffney

Gaffney, South Carolina, 29341

United States

Saint Francis Hospital

Greenville, South Carolina, 29601

United States

BI-LO Charities Children's Cancer Center

Greenville, South Carolina, 29605

United States

Prisma Health Cancer Institute - Butternut

Greenville, South Carolina, 29605

United States

Prisma Health Cancer Institute - Faris

Greenville, South Carolina, 29605

United States

Prisma Health Greenville Memorial Hospital

Greenville, South Carolina, 29605

United States

Saint Francis Cancer Center

Greenville, South Carolina, 29607

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

Prisma Health Cancer Institute - Seneca

Seneca, South Carolina, 29672

United States

North Grove Medical Park

Spartanburg, South Carolina, 29303

United States

Spartanburg Medical Center

Spartanburg, South Carolina, 29303

United States

Spartanburg Medical Center - Mary Black Campus

Spartanburg, South Carolina, 29307

United States

SMC Center for Hematology Oncology Union

Union, South Carolina, 29379

United States

Sanford USD Medical Center - Sioux Falls

Sioux Falls, South Dakota, 57117-5134

United States

T C Thompson Children's Hospital

Chattanooga, Tennessee, 37403

United States

Memorial Hospital

Chattanooga, Tennessee, 37404

United States

Pulmonary Medicine Center of Chattanooga-Hixson

Hixson, Tennessee, 37343

United States

East Tennessee Childrens Hospital

Knoxville, Tennessee, 37916

United States

Saint Jude Children's Research Hospital

Memphis, Tennessee, 38105

United States

The Children's Hospital at TriStar Centennial

Nashville, Tennessee, 37203

United States

Vanderbilt University/Ingram Cancer Center

Nashville, Tennessee, 37232

United States

Memorial GYN Plus

Ooltewah, Tennessee, 37363

United States

Texas Tech University Health Sciences Center-Amarillo

Amarillo, Texas, 79106

United States

The Don and Sybil Harrington Cancer Center

Amarillo, Texas, 79106

United States

Dell Children's Medical Center of Central Texas

Austin, Texas, 78723

United States

Saint Joseph Regional Cancer Center

Bryan, Texas, 77802

United States

Driscoll Children's Hospital

Corpus Christi, Texas, 78411

United States

Medical City Dallas Hospital

Dallas, Texas, 75230

United States

Parkland Memorial Hospital

Dallas, Texas, 75235

United States

UT Southwestern/Simmons Cancer Center-Dallas

Dallas, Texas, 75390

United States

El Paso Children's Hospital

El Paso, Texas, 79905

United States

Texas Tech University Health Sciences Center-El Paso

El Paso, Texas, 79905

United States

Cook Children's Medical Center

Fort Worth, Texas, 76104

United States

Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center

Houston, Texas, 77030

United States

M D Anderson Cancer Center

Houston, Texas, 77030

United States

Covenant Children's Hospital

Lubbock, Texas, 79410

United States

UMC Cancer Center / UMC Health System

Lubbock, Texas, 79415

United States

Texas Tech University Health Sciences Center-Lubbock

Lubbock, Texas, 79430

United States

Children's Hospital of San Antonio

San Antonio, Texas, 78207

United States

Methodist Children's Hospital of South Texas

San Antonio, Texas, 78229

United States

University Hospital

San Antonio, Texas, 78229

United States

University of Texas Health Science Center at San Antonio

San Antonio, Texas, 78229

United States

Scott and White Memorial Hospital

Temple, Texas, 76508

United States

Primary Children's Hospital

Salt Lake City, Utah, 84113

United States

Central Vermont Medical Center/National Life Cancer Treatment

Berlin, Vermont, 05602

United States

University of Vermont Medical Center

Burlington, Vermont, 05401

United States

University of Vermont and State Agricultural College

Burlington, Vermont, 05405

United States

University of Virginia Cancer Center

Charlottesville, Virginia, 22908

United States

Children's Hospital of The King's Daughters

Norfolk, Virginia, 23507

United States

Naval Medical Center - Portsmouth

Portsmouth, Virginia, 23708-2197

United States

Virginia Commonwealth University/Massey Cancer Center

Richmond, Virginia, 23298

United States

Carilion Children's

Roanoke, Virginia, 24014

United States

Providence Regional Cancer System-Aberdeen

Aberdeen, Washington, 98520

United States

Overlake Medical Center

Bellevue, Washington, 98004

United States

PeaceHealth Saint Joseph Medical Center

Bellingham, Washington, 98225

United States

Highline Medical Center-Main Campus

Burien, Washington, 98166

United States

Providence Regional Cancer System-Centralia

Centralia, Washington, 98531

United States

Swedish Cancer Institute-Edmonds

Edmonds, Washington, 98026

United States

Saint Elizabeth Hospital

Enumclaw, Washington, 98022

United States

Providence Regional Cancer Partnership

Everett, Washington, 98201

United States

Saint Francis Hospital

Federal Way, Washington, 98003

United States

Swedish Cancer Institute-Issaquah

Issaquah, Washington, 98029

United States

Kadlec Clinic Hematology and Oncology

Kennewick, Washington, 99336

United States

Providence Regional Cancer System-Lacey

Lacey, Washington, 98503

United States

Saint Clare Hospital

Lakewood, Washington, 98499

United States

PeaceHealth Saint John Medical Center

Longview, Washington, 98632

United States

Harrison HealthPartners Hematology and Oncology-Poulsbo

Poulsbo, Washington, 98370

United States

Pacific Gynecology Specialists

Seattle, Washington, 98104

United States

Seattle Children's Hospital

Seattle, Washington, 98105

United States

Swedish Medical Center-Ballard Campus

Seattle, Washington, 98107

United States

Kaiser Permanente Washington

Seattle, Washington, 98112

United States

Swedish Medical Center-Cherry Hill

Seattle, Washington, 98122-5711

United States

Swedish Medical Center-First Hill

Seattle, Washington, 98122

United States

Providence Regional Cancer System-Shelton

Shelton, Washington, 98584

United States

Saint Michael Cancer Center

Silverdale, Washington, 98383

United States

MultiCare Deaconess Cancer and Blood Specialty Center - Valley

Spokane Valley, Washington, 99216

United States

MultiCare Deaconess Cancer and Blood Specialty Center - Downtown

Spokane, Washington, 99204

United States

Providence Sacred Heart Medical Center and Children's Hospital

Spokane, Washington, 99204

United States

MultiCare Deaconess Cancer and Blood Specialty Center - North

Spokane, Washington, 99218

United States

Franciscan Research Center-Northwest Medical Plaza

Tacoma, Washington, 98405

United States

Mary Bridge Children's Hospital and Health Center

Tacoma, Washington, 98405

United States

Northwest Medical Specialties PLLC

Tacoma, Washington, 98405

United States

Madigan Army Medical Center

Tacoma, Washington, 98431

United States

PeaceHealth Southwest Medical Center

Vancouver, Washington, 98664

United States

Providence Saint Mary Regional Cancer Center

Walla Walla, Washington, 99362

United States

North Star Lodge Cancer Center at Yakima Valley Memorial Hospital

Yakima, Washington, 98902

United States

Providence Regional Cancer System-Yelm

Yelm, Washington, 98597

United States

United Hospital Center

Bridgeport, West Virginia, 26330

United States

West Virginia University Charleston Division

Charleston, West Virginia, 25304

United States

Edwards Comprehensive Cancer Center

Huntington, West Virginia, 25701

United States

WVUH-Berkely Medical Center

Martinsburg, West Virginia, 25401

United States

West Virginia University Healthcare

Morgantown, West Virginia, 26506

United States

Camden Clark Medical Center

Parkersburg, West Virginia, 26101

United States

Green Bay Oncology at Saint Vincent Hospital

Green Bay, Wisconsin, 54301-3526

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

University of Wisconsin Carbone Cancer Center - University Hospital

Madison, Wisconsin, 53792

United States

Holy Family Memorial Hospital

Manitowoc, Wisconsin, 54221

United States

Saint Vincent Hospital Cancer Center at Marinette

Marinette, Wisconsin, 54143

United States

Marshfield Medical Center-Marshfield

Marshfield, Wisconsin, 54449

United States

Children's Hospital of Wisconsin

Milwaukee, Wisconsin, 53226

United States

Saint Vincent Hospital Cancer Center at Oconto Falls

Oconto Falls, Wisconsin, 54154

United States

HSHS Saint Nicholas Hospital

Sheboygan, Wisconsin, 53081

United States

Saint Vincent Hospital Cancer Center at Sturgeon Bay

Sturgeon Bay, Wisconsin, 54235-1495

United States

Collaborators and Investigators

Sponsor: Children's Oncology Group

A. L Frazier, PRINCIPAL_INVESTIGATOR, Children's Oncology Group

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 Date2017-05-25

Study Completion Date2027-06-30

Study Record Updates

Study Start Date2017-05-25

Study Completion Date2027-06-30

Terms related to this study

Additional Relevant MeSH Terms

Childhood Extracranial Germ Cell Tumor
Extragonadal Embryonal Carcinoma
Germ Cell Tumor
Malignant Germ Cell Tumor
Malignant Ovarian Teratoma
Stage I Ovarian Choriocarcinoma
Stage I Ovarian Embryonal Carcinoma AJCC v6 and v7
Stage I Ovarian Yolk Sac Tumor AJCC v6 and v7
Stage I Testicular Choriocarcinoma AJCC v6 and v7
Stage I Testicular Embryonal Carcinoma AJCC v6 and v7
Stage I Testicular Seminoma AJCC v6 and v7
Stage I Testicular Yolk Sac Tumor AJCC v6 and v7
Stage II Ovarian Choriocarcinoma
Stage II Ovarian Embryonal Carcinoma AJCC v6 and v7
Stage II Ovarian Yolk Sac Tumor AJCC v6 and v7
Stage II Testicular Choriocarcinoma AJCC v6 and v7
Stage II Testicular Embryonal Carcinoma AJCC v6 and v7
Stage II Testicular Yolk Sac Tumor AJCC v6 and v7
Stage III Ovarian Choriocarcinoma
Stage III Ovarian Embryonal Carcinoma AJCC v6 and v7
Stage III Ovarian Yolk Sac Tumor AJCC v6 and v7
Stage III Testicular Choriocarcinoma AJCC v6 and v7
Stage III Testicular Embryonal Carcinoma AJCC v6 and v7
Stage III Testicular Yolk Sac Tumor AJCC v6 and v7
Stage IV Ovarian Choriocarcinoma
Stage IV Ovarian Embryonal Carcinoma AJCC v6 and v7
Stage IV Ovarian Yolk Sac Tumor AJCC v6 and v7
Testicular Mixed Choriocarcinoma and Embryonal Carcinoma
Testicular Mixed Choriocarcinoma and Teratoma
Testicular Mixed Choriocarcinoma and Yolk Sac Tumor