NCT05624996ClinicalTrials.gov
Testing the Addition of High Dose, Targeted Radiation to the Usual Treatment for Locally-Advanced Inoperable Non-Small Cell Lung Cancer
Phase III Prospective Randomized Trial of Primary Lung Tumor Stereotactic Body Radiation Therapy Followed by Concurrent Mediastinal Chemoradiation for Locally-Advanced Non-Small Cell Lung Cancer
باختصار
This phase III trial compares the effect of adding stereotactic body radiation therapy (SBRT) to the usual treatment (conventional image guided radiation therapy \[IGRT\] and chemotherapy followed by immunotherapy with durvalumab or targeted therapy with osimertinib) versus the usual treatment…
المرحلة 3مطلوب 474 مشاركاً477 موقعاًدولتان
الفئات
مسجَّلة في سجل واحد
- ClinicalTrials.govNCT05624996فتح هذا السجل في ClinicalTrials.govتمت المزامنة الشهر الماضي
يمكن أن تُسجَّل دراسة واحدة في عدة سجلات. نعرضها مرة واحدة ونربط بكل سجل نحتفظ به.
تُعرض معلومات التجربة كما نشرها السجل، بلغتها الأصلية.
هل أنت مهتم بهذه الدراسة؟
تسجيل الدخول أو أنشئ حسابًا لتسجيل اهتمامك ومتابعة هذه الدراسة.
How this study is set up
The points below are drawn from the public registry record for this study. Each one cites the field or sentence it came from. A dash (—) means the record does not state something — not that it is missing or wrong. Many well-run studies, especially small ones, leave some of these blank.
- Present: Registered before enrolment beganFirst posted 2022-11-22; recorded start 2023-07-12
- Present: Has a defined primary outcomeA primary outcome measure is listed in the record
- Present: The primary outcome states a time frameThe primary outcome measure records a time frame
- Present: Participants are randomly assignedAllocation is recorded as randomised
- Present: Has a comparison groupThe record lists a placebo or comparator arm, or more than one study arm
- Not stated: Open label (no blinding)Masking is recorded as none (open label)
- Not stated: An ethics committee is not stated in the registry recordThis registry's ingested record has no ethics-committee field
- Not stated: Regulatory oversight (such as an IND or IDE) is not stated in the registry recordThis registry's ingested record has no regulatory-authorisation field
- Not stated: A data monitoring committee is not stated in the registry recordThis registry's ingested record has no data-monitoring-committee fieldA data monitoring committee is not required for many smaller studies, and its absence here is not unusual.
- Present: No cost to participants is mentioned in the recordChecked the summary, description and eligibility text; no cost-to-participant phrase found
- Present: Sponsor has 49 other studies in this databaseCounted from the lead sponsor named in the record (NRG Oncology)
- Present: Sponsor has posted results for at least one studyBased on the sponsor’s studies in this database
- The record lists 3 conditions.
- Lead sponsor type recorded as: other.
- Intervention regulatory context: investigational, within a phased regulatory pathway.
Trial stature
Three independent measures of this study, described from its registry record — not a recommendation about it. A rigorous study by investigators nobody has heard of is better evidence than a weak study led by a famous one. How these are scored.
A strong methodological design for a phase 3 study, judged from its ClinicalTrials.gov record.
How this score is built
- Randomised allocation20/20
Participants are randomly allocated between arms
- Blinding0/20
Open-label
- Control arm15/15
Active-comparator control arm
- Primary-outcome specificity10/10
Named primary outcome with a defined time frame
- Endpoint type10/10
Mortality / MACE endpoint (hard clinical outcome)
- Multi-centre8/8
Multi-centre: 477 sites
- Data monitoring committee0/7
No data monitoring committee stated
- Prospective registration5/5
Registered before the study start date
- Protocol / SAP posted0/5
No protocol or SAP posted to the registry
A medium-sized study, international in scope: 474 participants (target), run at 477 sites, across 2 countries.
How this score is built
- Enrolment26/40
474 participants (target)
- Site count25/25
477 sites
- Country count7/15
2 countries
- Planned duration10/10
Planned over about 101 months
- Sponsor scale6/10
NRG Oncology has led 49 trials in our corpus
We have no verifiable track record for the investigator named on this trial. That is common for early-career investigators and for records held outside ClinicalTrials.gov — it is not a negative signal.
How this score is built
- Investigator standing0/100
No investigator recorded in the registry for this trial
These describe the registry record only, and today we hold ClinicalTrials.gov data. Absent fields lower a score, and absence often reflects registration practice rather than study quality. A high-stature trial is not necessarily safer or a better choice for you — enrolling in a large definitive trial can mean a higher chance of receiving placebo, while a small early-phase study may be the only route to a new therapy.
ملخص
This phase III trial compares the effect of adding stereotactic body radiation therapy (SBRT) to the usual treatment (conventional image guided radiation therapy \[IGRT\] and chemotherapy followed by immunotherapy with durvalumab or targeted therapy with osimertinib) versus the usual treatment alone in treating patients with non-small cell lung cancer that has spread to nearby tissue or lymph nodes (locally advanced) and cannot be treated by surgery (inoperable). SBRT uses special equipment to position a patient and deliver radiation therapy to tumors with high precision. This method may kill tumor cells with fewer doses over a shorter period and cause less damage to normal tissue. IGRT is a type of radiation therapy that creates a picture of the tumor to help guide the radiation beam during therapy, making it more accurate and causing less damage to healthy tissue. Usual chemotherapy used in this trial consists of combinations of the following drugs: cisplatin, carboplatin, paclitaxel, nab-paclitaxel, pemetrexed, and etoposide. Cisplatin and carboplatin are in a class of medications known as platinum-containing compounds. Cisplatin works by killing, stopping, or slowing the growth of tumor cells. Carboplatin works in a way similar to the anticancer drug cisplatin but may be better tolerated than cisplatin. Carboplatin works by killing, stopping, or slowing the growth of tumor cells as well. Paclitaxel is in a class of medications called antimicrotubule agents. It works by stopping the growth and spread of tumor cells. Nab-paclitaxel is an albumin-stabilized nanoparticle formulation of paclitaxel which may have fewer side effects and work better than other forms of paclitaxel. Pemetrexed is in a class of medications called antifolate antineoplastic agents. It works by blocking the action of a certain substance in the body that may help tumor cells multiply. Etoposide is in a class of medications known as podophyllotoxin derivatives. It blocks a certain enzyme needed for cell division and deoxyribonucleic acid (DNA) repair and may kill tumor cells. Immunotherapy with durvalumab can induce changes in the body's immune system and can interfere with the ability of tumor cells to grow and spread. Osimertinib is in a class of medications called kinase inhibitors. It works by blocking the action of a protein called EGFR that signals cancer cells to multiply. This helps slow or stop the spread of tumor cells. Adding SBRT to the usual treatment of IGRT with chemotherapy and immunotherapy may be more effective at treating patients with locally-advanced non-small cell lung cancer than giving the usual treatment alone.
الحالات
- Locally Advanced Lung Non-Small Cell Carcinoma
- Stage IIB Lung Cancer AJCC v8
- Stage III Lung Cancer AJCC v8
الأهلية
| الجنس | الجميع |
|---|---|
| الأعمار | 18 Years – لا حد أقصى |
| المتطوعون الأصحّاء | لا |
الأهلية كما كُتبت في السجل
الأهلية في عبارات بسيطة
لم تُقسَّم معايير هذا السجل إلى عبارات منفصلة بعد. نص السجل أعلاه كامل وهو النسخة المُعتمَدة.
تصميم الدراسة
| نوع الدراسة | تدخّلية |
|---|---|
| المرحلة | المرحلة 3 |
| التخصيص | معشّاة |
| نموذج التدخّل | PARALLEL |
| الغرض الأساسي | TREATMENT |
| التعمية | NONE (0) |
| التجنيد | مطلوب 474 مشاركاً |
الجهة الراعية والمتعاونون
- NRG Oncology الجهة الراعية
الأذرع والتدخلات
- Arm I (image guided RT, chemotherapy, immunotherapy)ACTIVE_COMPARATOR
Patients undergo conventional IGRT and receive usual care chemotherapy consisting of paclitaxel IV followed by carboplatin IV Q7D during radiotherapy or pemetrexed IV followed by carboplatin IV every 21 days during radiotherapy or etoposide IV on days 1 to 5 and days 29 to 33 followed by cisplatin IV on days 1, 8, 29, and 36 or pemetrexed IV followed by cisplatin IV every 21 days during radiotherapy. Patients then receive consolidation durvalumab IV every 2 or 4 weeks for up to one year or osimertinib PO QD in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and/or PET/CT during follow-up.
- Arm II (SBRT, image guided RT, chemotherapy, immunotherapy)EXPERIMENTAL
Patients undergo SBRT and conventional IGRT and then receive standard-of-care chemotherapy consisting of paclitaxel IV followed by carboplatin IV Q7D during radiotherapy or pemetrexed IV followed by carboplatin IV every 21 days during radiotherapy or etoposide IV on days 1 to 5 and days 29 to 33 followed by cisplatin IV on days 1, 8, 29, and 36 or pemetrexed IV followed by cisplatin IV every 21 days during radiotherapy. Patients then receive consolidation durvalumab IV every 2 or 4 weeks for up to one year or osimertinib PO QD in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and/or PET/CT during follow-up.
التدخلات
- دواء Carboplatin
Given IV
- دواء Cisplatin
Given IV
- إجراء Computed Tomography
Undergo CT and/or PET/CT
- منتج بيولوجي Durvalumab
Given IV
- دواء Etoposide
Given IV
- إشعاع Image Guided Radiation Therapy
Undergo IGRT
- دواء Nab-paclitaxel
Given IV
- دواء Osimertinib
Given PO
- دواء Paclitaxel
Given IV
- دواء Pemetrexed
Given IV
- إجراء Positron Emission Tomography
Undergo PET/CT
- أخرى Questionnaire Administration
Ancillary studies
- إشعاع Stereotactic Body Radiation Therapy
Undergo SBRT
مقاييس النتائج
مقياس النتيجة الأولي
Overall survival (OS)
Non-inferiority (NI) between arm 2 and arm 1 (reference level) will be evaluated by comparing the upper bound of the 95% confidence interval for the hazard ratio to the pre-specified NI margin. NI of arm 2 will be concluded if the upper bound of the confidence interval is equal to, or falls below, the pre-specified margin at the final analysis. When evaluating the NI of arm 2 in OS, a Cox proportional hazards (PH) model stratified by stratification factors will be used to compute the hazard ratio and associated 95% confidence interval (CI). OS rates will be estimated using the Kaplan-Meier method. If the NI of arm 2 in OS is demonstrated, the superiority of arm 1 in OS will be tested at 1-sided significance level of 0.025 using a stratified log-rank test by adjusting for stratification factors.
الإطار الزمني Time between date of randomization and date of death due to any cause, assessed up to 8 years
مقياس النتيجة الأولي
Progression-free survival (PFS)
The PFS analysis will be conducted using the same methods and stratification factors as the OS analysis. The superiority of arm 2 in PFS will be tested at 1-sided significance level of 0.025 using a stratified log-rank test by adjusting for stratification factors. In the event that the NI of OS is not established, statistical inference of PFS will be considered exploratory in nature only. A Cox PH model stratified by stratification factors will be used to compute the hazard ratio and associated 95% CI.
الإطار الزمني Time between date of randomization and first date of documented progression or death due to any cause, assessed up to 8 years
مقياس النتيجة الثانوي
Objective response rate (ORR)
ORR (per Response Evaluation Criteria in Solid Tumors \[RECIST\] 1.1) is defined as the number (%) of patients with at least 1 visit response of complete response (CR) or partial response (PR) and will be based on all randomized patients who have measurable disease. Therefore, data obtained up until progression, or the last evaluable assessment in the absence of progression, will be included in the assessment of ORR. The ORR will be compared between arm 2 versus arm 1 using a Fisher's exact test. A binary response variable for ORR will be used for the analysis with the categories of CR and PR versus stable disease, progressive disease and inevaluable.
الإطار الزمني Up to 8 years
مقياس النتيجة الثانوي
Time to progression
Local control also known as time to progression will be defined as freedom from local progression, in which a failure is defined as intrathoracic tumor progression (failure in the lobe of the primary tumor or mediastinal lymph nodes) by RECIST 1.1 criteria. Local control will be analyzed as competing risks data based on cause-specific hazards approaches, where deaths without local failure will be considered as a competing event and analyzed as "censoring" of local failure. The rates at various timepoints (e.g., every 6 months after randomization) and medians of PFS for each arm will be estimated using the Kaplan-Meier method. The associated 95% CI will be calculated using Greenwood's formula and based on a log-log transformation applied on the survival function. Results from an unstratified analysis will also be provided.
الإطار الزمني Up to 8 years
مقياس النتيجة الثانوي
Time to primary, locoregional, or distant failure
Competing risks analysis will be used to analyze times to primary failure, locoregional failure and distant failure as the first failure. Competing events include primary failure, locoregional failure, distant failure and deaths without any failures. Rates at various timepoints (i.e., every 6 months after randomization) for each arm will be estimated using the cumulative incidence function. The associated 95% CI will be calculated using the Delta method and based on a log-log transformation applied on the estimated cumulative incidence functions. Statistical inferences of the development of each failure between arms will be based on cause-specific hazards using the log-rank test and Cox proportional hazard model. In addition, Gray's test and the Fine-Gray model will also be used to provide statistical inferences between arms based on cumulative incidence functions and subdistribution hazards.
الإطار الزمني Up to 8 years
مقياس النتيجة الثانوي
Changes in pulmonary function
Includes forced expiratory volume in 1 second (FEV1) and diffusion capacity of the lung for carbon monoxide (DLCO). Changes in pulmonary function (FEV1 and DLCO) will be summarized with descriptive statistics, and compared with Wilcoxon rank-sum test. The descriptive statistics of changes in FEV1 and diffusion capacity before and after treatment will be reported by treatment arm and by response categories (complete response; partial response; stable disease; progressive disease). Linear regression will be used to model changes with adjustment for treatment arms and possibly other baseline covariates, if applicable. The grade 3-5 NRG Oncology Pulmonary Toxicity Scale for changes will be reported with the frequency and grade by arm. Logistic regression will be used to model the distribution of the NRG Oncology Pulmonary Toxicity Scale by arms with and without adjustment for covariates.
الإطار الزمني From randomization to 6 months or 12 months
مقياس النتيجة الثانوي
Patient reported outcomes-Common Terminology Criteria for Adverse Events (PRO-CTCAE)
Adverse events will also be assessed using PRO-CTCAE items. The PRO-CTCAE is a patient-reported outcome measurement system developed to characterize the frequency, severity, and interference of symptomatic treatment toxicities. Items are scored on a Likert scale. For each symptom and each domain (i.e., frequency, severity, and interference), counts and frequencies will be summarized for the worst score experienced by the patient by the treatment arm. In addition, a composite grading algorithm (Basch 2021) will be used to derive a single numerical grade for each adverse event scored using PRO-CTCAE. PRO-CTCAE, the frequency of acute grade \>= 3 patient-reported toxicity will be compared to the corresponding rate of clinician-scored toxicity using a chi-square test or Fisher exact test, as appropriate. Distributions of clinician-reported and patient-reported adverse events will also be compared across study arms.
الإطار الزمني At 3, 12, and 24 months
مقياس النتيجة الثانوي
Functional Assessment of Cancer Therapy Lung (FACT-L) and Trial Outcome Index (TOI)
FACT-L and TOI is a measure that sums the functional well-being (FWB - 7 items), physical well-being (PWB - 7), and the lung cancer subscale (LCS - 9 items) of FACT-L. Questionnaire trial outcome index deterioration rates at 3 months and associated 95% confidence interval will be calculated for each treatment group, based on all randomized subjects. In addition, to explore if higher QOL scores will be maintained at 12 and 24 months from the end of radiotherapy as well, longitudinal data analysis will also be performed to characterize the trend of scores over time across the two treatment groups using hierarchical formulation of the linear mixed model. The Clopper-Pearson method will be used for calculating 95% CI. The deterioration rates of each arm will also be compared using Cochran-Mantel-Haenszel Test, stratified by PD-L1 expression and T-stage.
الإطار الزمني At 3, 12, and 24 months
مقياس النتيجة الثانوي
European Quality of Life Five Dimension (EQ-5D) scale
Subjects' overall health state on a visual analog scale (EQ-VAS) at each assessment time point will be summarized using descriptive statistics by treatment group, as randomized. Proportion of subjects reporting problems for the five EQ-5D dimensions at each assessment time point will be summarized by level of problem and by treatment group, as randomized. Percentages will be based on number subjects assessed at assessment time point.
الإطار الزمني At 3, 12, and 24 months
مقياس النتيجة الثانوي
Incidence of adverse events
For each patient, the maximum severity reported will be used in the summaries. Adverse events will be summarized regardless of relationship to protocol treatment as assessed by the investigator. Treatment-related adverse events using National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) will be presented in statistical analysis reports/publications in CTCAE version 5. Adverse event rates will be reported with the frequency and severity (e.g., type, grade, and attribution) by arm.
الإطار الزمني Up to 8 years
مقياس نتيجة آخر
Clinical outcomes
Descriptive analyses will be reported, based on corresponding analysis plans within patients who actually receive proton and photon radiotherapy (e.g., per-protocol population), respectively.
الإطار الزمني Up to 8 years
مقياس نتيجة آخر
Functional mean lung dose
Collection of 4-dimensional (4D) computed tomography (CT) planning CTs and calculation of radiation dose to regional lung ventilation will be performed among randomized patients with 4D CT planning CTs. To evaluate functional dose metrics, ventilation maps will be registered to the average 4DCT reference frame. Functional dose metrics and standard dose metrics will be calculated and evaluated. Functional mean lung dose will be defined as the mean dose delivered to functional lung. Dose to total lung and dose to functional lung will then be correlated with pulmonary toxicity including grade 2 or higher radiation pneumonitis or any grade 3 or higher cough, dyspnea, hypoxia or respiratory failure. Logistic regression models will be used to explore the correlation between pulmonary toxicity and functional mean lung dose.
الإطار الزمني Up to 8 years
مقياس نتيجة آخر
Incidence of toxicities
Descriptive analyses will be reported, based on corresponding analysis plans within patients who actually receive proton and photon radiotherapy (e.g., per-protocol population), respectively.
الإطار الزمني Up to 8 years
مقياس نتيجة آخر
Changes in pulmonary function
Descriptive analyses will be reported, based on corresponding analysis plans within patients who actually receive proton and photon radiotherapy (e.g., per-protocol population), respectively.
الإطار الزمني Up to 8 years
مقياس نتيجة آخر
Changes in quality of life
Descriptive analyses will be reported, based on corresponding analysis plans within patients who actually receive proton and photon radiotherapy (e.g., per-protocol population), respectively.
الإطار الزمني Up to 8 years
مقياس نتيجة آخر
Development and characterization of a machine learning/artificial intelligence (AI) algorithm for radiotherapy planning and/or quality assurance
Assessment will focus on four key areas: tumor volume contouring score, organs-at-risk contouring score, tumor volume dose-volume analysis score, and organs-at-risk dose-volume analysis score. Each area will be scored as per protocol: acceptable variation, unacceptable variation, or not evaluable. Cases deemed not evaluable will be considered as such, regardless of the reviewer. The scores generated by the AI algorithm will be compared with those from radiation oncologists, ensuring the AI algorithm adheres to the contours. The sensitivity of the AI algorithm, indicating its ability to detect deviations from the protocol, will be calculated. The AI algorithm will be refined until its sensitivity exceeds 95%. Inter-rater reliability between the AI algorithm and the radiation oncologists will be assessed using Cohen's κ. Concordance and discordance frequencies will also be recorded.
الإطار الزمني Up to 8 years
مقياس نتيجة آخر
Treatment effect and confidence intervals by sex
الإطار الزمني Up to 8 years
مقياس نتيجة آخر
Treatment effect and confidence intervals by race
الإطار الزمني Up to 8 years
مقياس نتيجة آخر
Treatment effect and confidence intervals by ethnicity
الإطار الزمني Up to 8 years
التواريخ
| تاريخ البدء | 12 يوليو 2023 (فعلي) |
|---|---|
| الإتمام الأولي | 15 أكتوبر 2031 (تقديري) |
| الإتمام | 15 أكتوبر 2036 (تقديري) |
| أول نشر | 22 نوفمبر 2022 (فعلي) |
| آخر تحديث | 17 أغسطس 2026 |
| النتائج منشورة | غير مذكور في سجل السجل |
| آخر تأكيد للحالة | أغسطس 2026 |
فعلي يعني أن الحدث وقع. تقديري يعني أن الجهة الراعية تتوقعه. للكلمتين معنيان مختلفان.
المواقع
446 موقعاً قيد التجنيد
Canada
| المنشأة | المدينة | الولاية أو المنطقة | الحالة |
|---|---|---|---|
| Ottawa Hospital and Cancer Center-General Campus | Ottawa | Ontario | مُعلَّق |
United States
| المنشأة | المدينة | الولاية أو المنطقة | الحالة |
|---|---|---|---|
| Cleveland Clinic Akron General | Akron | Ohio | قيد التجنيد |
| Atrium Health Stanly/LCI-Albemarle | Albemarle | North Carolina | قيد التجنيد |
| Presbyterian Kaseman Hospital | Albuquerque | New Mexico | نشط، دون تجنيد |
| University of New Mexico Cancer Center | Albuquerque | New Mexico | قيد التجنيد |
| Alton Memorial Hospital | Alton | Illinois | نشط، دون تجنيد |
| Mary Greeley Medical Center | Ames | Iowa | قيد التجنيد |
| McFarland Clinic - Ames | Ames | Iowa | قيد التجنيد |
| UI Health Care Mission Cancer and Blood - Ankeny Clinic | Ankeny | Iowa | قيد التجنيد |
| Trinity Health Saint Joseph Mercy Hospital Ann Arbor | Ann Arbor | Michigan | قيد التجنيد |
| Luminis Health Anne Arundel Medical Center | Annapolis | Maryland | نشط، دون تجنيد |
| Langlade Hospital and Cancer Center | Antigo | Wisconsin | قيد التجنيد |
| Northwest Wisconsin Cancer Center | Ashland | Wisconsin | قيد التجنيد |
| Duluth Clinic Ashland | Ashland | Wisconsin | قيد التجنيد |
| Emory Saint Joseph's Hospital | Atlanta | Georgia | قيد التجنيد |
| Grady Health System | Atlanta | Georgia | قيد التجنيد |
| Emory Proton Therapy Center | Atlanta | Georgia | قيد التجنيد |
| Emory University Hospital Midtown | Atlanta | Georgia | قيد التجنيد |
| Emory University Hospital/Winship Cancer Institute | Atlanta | Georgia | قيد التجنيد |
| Augusta University Medical Center | Augusta | Georgia | قيد التجنيد |
| UCHealth University of Colorado Hospital | Aurora | Colorado | قيد التجنيد |
| Rush-Copley Medical Center | Aurora | Illinois | قيد التجنيد |
| Advocate Outpatient Center - Aurora | Aurora | Illinois | قيد التجنيد |
| WellStar Cobb Hospital | Austell | Georgia | قيد التجنيد |
| UH Seidman Cancer Center at UH Avon Health Center | Avon | Ohio | قيد التجنيد |
| AIS Cancer Center at San Joaquin Community Hospital | Bakersfield | California | قيد التجنيد |
| Sinai Hospital of Baltimore | Baltimore | Maryland | قيد التجنيد |
| Greater Baltimore Medical Center | Baltimore | Maryland | قيد التجنيد |
| Advocate Good Shepherd Hospital | Barrington | Illinois | قيد التجنيد |
| Memorial Sloan Kettering Basking Ridge | Basking Ridge | New Jersey | قيد التجنيد |
| Wilmot Cancer Center at Batavia | Batavia | New York | مُعلَّق |
| McLaren Cancer Institute-Bay City | Bay City | Michigan | قيد التجنيد |
| Bay Pines VA Healthcare System | Bay Pines | Florida | قيد التجنيد |
| Northwell Health Imbert Cancer Center | Bay Shore | New York | قيد التجنيد |
| UHHS-Chagrin Highlands Medical Center | Beachwood | Ohio | قيد التجنيد |
| Sanford Joe Lueken Cancer Center | Bemidji | Minnesota | قيد التجنيد |
| Central Vermont Medical Center/National Life Cancer Treatment | Berlin Corners | Vermont | قيد التجنيد |
| Billings Clinic Cancer Center | Billings | Montana | قيد التجنيد |
| The Kirklin Clinic at Acton Road | Birmingham | Alabama | قيد التجنيد |
| University of Alabama at Birmingham Cancer Center | Birmingham | Alabama | قيد التجنيد |
| Sanford Bismarck Medical Center | Bismarck | North Dakota | قيد التجنيد |
| OSF Saint Joseph Medical Center | Bloomington | Illinois | قيد التجنيد |
| Illinois CancerCare-Bloomington | Bloomington | Illinois | قيد التجنيد |
| Saint Joseph's/Candler - Bluffton Campus | Bluffton | South Carolina | قيد التجنيد |
| Bozeman Health Deaconess Hospital | Bozeman | Montana | قيد التجنيد |
| Essentia Health Saint Joseph's Medical Center | Brainerd | Minnesota | قيد التجنيد |
| Trinity Health IHA Medical Group Hematology Oncology - Brighton | Brighton | Michigan | قيد التجنيد |
| Trinity Health Medical Center - Brighton | Brighton | Michigan | قيد التجنيد |
| Henry Ford Cancer Institute-Downriver | Brownstown | Michigan | قيد التجنيد |
| Mills-Peninsula Medical Center | Burlingame | California | قيد التجنيد |
يُدرَج 427 موقعاً إضافياً في سجل السجل.
مستندات الدراسة
لا تُرتبط أي مستندات في سجل السجل هذا.
التغيّرات عبر الزمن
لم تُسجَّل أي تغييرات منذ أن أدرجنا هذا السجل لأول مرة.
يُسجَّل تغيير في كل مرة تحدّث فيها الجهة الراعية سجل السجل. تظهر هنا الحالة والتواريخ والتجنيد والمواقع كلما تغيّرت.