Combination Chemotherapy in Treating Patients With Non-Metastatic Extracranial Ewing Sarcoma
Study Purpose
This trial examined the outcome benefit to patients of adding a new chemotherapy drug combination to the established treatment approach for patients with extracranial Ewing sarcoma, that had not spread from the primary site to other places in the body. The trial randomly assigned patients at the time of study entry to receive established standard treatment with the following 5-drugs: vincristine sulfate, doxorubicin hydrochloride, cyclophosphamide, ifosfamide and etoposide. The outcome for patients receiving the standard 5-drug combination was compared to the outcome for patients who received the same 5-drugs with an additional drug, topotecan hydrochloride delivered in a novel combination with vincristine sulfate and cyclophosphamide.
Recruitment Criteria
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Accepts Healthy Volunteers
Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms |
No |
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Study Type
An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes. An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes. Searching Both is inclusive of interventional and observational studies. |
Interventional |
| Eligible Ages | N/A - 50 Years |
| Gender | All |
Inclusion Criteria:
- - Patients with newly diagnosed, biopsy confirmed, extracranial, non-metastatic Ewing sarcoma or primitive neuroectodermal tumor (PNET) of bone or soft tissue are eligible for this study; note: - For the purpose of this study, chest wall tumors with ipsilateral pleural effusions, ipsilateral positive pleural fluid cytology or ipsilateral pleural based secondary tumor nodules will be considered localized disease.
- - Patients with regional node involvement, based on clinical suspicion confirmed by pathologic documentation are considered to be non-metastatic.
- - Patients with discontinuous osseous lesions within the same bone are considered to be non-metastatic.
- - Tumors arising in the bony skull (extra-dural) are considered to be extracranial.
- - Patient eligibility will be based on a diagnosis of Ewing sarcoma or PNET by institutional pathologist.
- - No prior chemotherapy or radiation therapy is allowed; patients should only have had a biopsy of the primary tumor without an attempt at complete or partial resection; patients will still be eligible if unplanned excision was attempted or accomplished as long as adequate imaging was obtained prior to surgery.
- - Creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70mL/min/1.73 m^2 or serum creatinine based on age/gender as follows: - 1 month to < 6 months: 0.4 mg/dL.
- - 6 months to < 1 year: 0.5 mg/dL.
- - 1 to < 2 years: 0.6 mg/dL.
- - 2 to < 6 years: 0.8 mg/dL.
- - 6 to < 10 years: 1 mg/dL.
- - 10 to < 13 years: 1.2 mg/dL.
- - 13 to < 16 years: 1.5 mg/dL (male), 1.4 mg/dL (female) - >= 16 years: 1.7 mg/dL (male), 1.4 mg/dL (female) - Total bilirubin < 1.5 x upper limit of normal (ULN) for age.
- - Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) or serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) < 2.5 x upper limit of normal (ULN) for age.
- - Shortening fraction of >= 27% by echocardiogram, or ejection fraction of >= 50% by radionuclide angiogram.
Exclusion Criteria:
- - Patients must have no evidence of metastatic disease; metastatic disease are lesions which are discontinuous from the primary tumor, are not regional lymph nodes and do not share a body cavity with the primary tumor; if there is any doubt whether lesions are metastatic, a biopsy of those lesions should be taken.
- - Skeletal lesions in adjacent bones (trans-articular) - Contralateral pleural effusion and contralateral pleural nodules.
- - Distant lymph node involvement.
- - Patients with pulmonary nodules are considered to have metastatic disease if the patient has: - Solitary nodule > 0.5 cm or multiple nodules of > 0.3 cm unless biopsied and negative for Ewing's.
- - Biopsies of solitary nodule =< 0.5 cm or multiple nodules =< 0.3 cm are not required but if performed and positive indicate metastatic disease.
- - Patients whose tumors arise in the dural and intra-dural soft tissues of the cranium and spine are not eligible.
- - Patients with pathologic diagnoses other than Ewing sarcoma will be excluded.
- - Patients diagnosed with Ewing Sarcoma as a second malignant neoplasm are not eligible if they have received chemotherapy or radiation for the treatment of their primary malignancy.
- - Pregnant women will not be entered on this study; pregnancy tests must be obtained in female patients who are post-menarchal; lactating females may not participate unless they have agreed not to breastfeed their infants; males or females of reproductive potential may not participate unless they have agreed to use an effective contraceptive method for the duration of the study treatment.
- - All patients and/or their parents or legal guardians must sign a written informed consent.
Trial Details
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Trial ID:
This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries. |
NCT01231906 |
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Phase
Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans. Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data. Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs. Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use. |
Phase 3 |
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Lead Sponsor
The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data. |
Children's Oncology Group |
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Principal Investigator
The person who is responsible for the scientific and technical direction of the entire clinical study. |
Patrick J Leavey |
| Principal Investigator Affiliation | Children's Oncology Group |
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Agency Class
Category of organization(s) involved as sponsor (and collaborator) supporting the trial. |
Other, NIH |
| Overall Status | Active, not recruiting |
| Countries | Australia, Canada, New Zealand, Puerto Rico, Saudi Arabia, United States |
|
Conditions
The disease, disorder, syndrome, illness, or injury that is being studied. |
Localized Extraskeletal Ewing Sarcoma, Peripheral Primitive Neuroectodermal Tumor of Bone, Peripheral Primitive Neuroectodermal Tumor of Soft Tissues |
| Study Website: | View Trial Website |
PRIMARY OBJECTIVES: l. Test the effect of the combination of vincristine (vincristine sulfate), cyclophosphamide, and topotecan (topotecan hydrochloride) (VTC) added to the standard 5-drug interval-compressed chemotherapy backbone on event-free and overall survival of children and young adults with Ewing sarcoma. CORRELATIVE SCIENCE OBJECTIVES:
- I. To evaluate initial volumetric tumor size as a prognostic factor for event free survival (EFS) in patients with localized Ewing tumors.
- II. To evaluate histologic response as a prognostic factor for EFS in patients with localized Ewing tumors.
- III. To continue evaluation of biologic markers both as related to prognosis and as eventual therapeutic targets via encouraging concurrent enrollment on a Ewing sarcoma specimen-collection study.
- IV. To evaluate imaging response by fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) as a prognostic factor for EFS.
- V. To evaluate the effects of the type of local therapy on EFS and overall survival.
- VI. To evaluate the effect of local surgical margins in conjunction with histologic response on EFS in patients with localized Ewing tumors.
- VII. To evaluate the effect of local therapy modality (surgery, radiotherapy, or a combination) as well as the type of surgical reconstruction on musculoskeletal complications.
Arms
Experimental: Arm A (combination chemotherapy)
INDUCTION THERAPY: Patients receive vincristine sulfate IV on day 1 in weeks 1, 2, 5, 6, 9, and 10; doxorubicin hydrochloride IV over 1-15 minutes (or as per institutional policies up to 60-minutes) on days 1 and 2 and cyclophosphamide IV over 30-60 minutes on day 1 in weeks 1, 5, and 9; and ifosfamide IV over 1 hour and etoposide IV over 1-2 hours on days 1-5 in weeks 3, 7, and 11. CONSOLIDATION THERAPY: Patients receive vincristine sulfate IV on day 1 in weeks 1, 2, 7, 8, 9, 10, 13, 14, 17, 18, 21, and 22; doxorubicin hydrochloride IV on days 1 and 2 in weeks 1 and 9; cyclophosphamide IV over 30-60 minutes on day 1 in weeks 1, 7, 9, 13, 17, and 21; and ifosfamide IV over 1 hour and etoposide IV over 1-2 hours on days 1-5 in weeks 3, 5, 11, 15, and 19. Patients received Dexrazoxane with doxorubicin hydrochloride in weeks 1 and 9.
Experimental: Arm B (combination chemotherapy, topotecan hydrochloride)
INDUCTION THERAPY: Patients receive vincristine sulfate IV on day 1 in weeks 1, 2, 5, 6, 9, 10, 11 and 12; topotecan hydrochloride IV over 30 minutes on days 1-5 in weeks 1 and 9; cyclophosphamide IV over 15-30 minutes on days 1-5 in weeks 1 and 9, and over 30-60 minutes on day 1 of weeks 5 and 11; ifosfamide and etoposide as in arm A; and doxorubicin hydrochloride IV on days 1 and 2 in weeks 5 and 11. CONSOLIDATION THERAPY: Patients receive vincristine sulfate IV on day 1 in weeks 1, 2, 7-10, 13-16, 19, and 20; topotecan hydrochloride IV over 30 minutes on days 1-5 in weeks 1, 7, and 15; cyclophosphamide IV over 15-60 minutes on days 1-5 in weeks 1, 7, and 15, and over 30-60 minutes on day 1 in weeks 9, 13, and 19; ifosfamide IV over 1 hour and etoposide IV over 1- 2 hours on days 1-5 in weeks 3, 5, 11, 17, and 21; and doxorubicin hydrochloride IV on days 1 and 2 in weeks 9,13, and 19. Patients received Dexrazoxane with doxorubicin hydrochloride in weeks 13 and 19.
Interventions
Drug: - Cyclophosphamide
Given IV
Drug: - Dexrazoxane
Drug: - Doxorubicin Hydrochloride
Given IV
Drug: - Etoposide
Given IV
Drug: - Ifosfamide
Given IV
Other: - Laboratory Biomarker Analysis
Correlative studies
Drug: - Topotecan Hydrochloride
Given IV
Drug: - Vincristine Sulfate
Given IV
Contact a Trial Team
If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.
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Children's Hospital of Alabama
Birmingham, Alabama, 35233
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University of Alabama at Birmingham Cancer Center
Birmingham, Alabama, 35233
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USA Health Strada Patient Care Center
Mobile, Alabama, 36604
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Providence Alaska Medical Center
Anchorage, Alaska, 99508
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Phoenix Childrens Hospital
Phoenix, Arizona, 85016
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Banner University Medical Center - Tucson
Tucson, Arizona, 85719
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Arkansas Children's Hospital
Little Rock, Arkansas, 72202-3591
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University of Arkansas for Medical Sciences
Little Rock, Arkansas, 72205
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Kaiser Permanente Downey Medical Center
Downey, California, 90242
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City of Hope Comprehensive Cancer Center
Duarte, California, 91010
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Loma Linda University Medical Center
Loma Linda, California, 92354
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Miller Children's and Women's Hospital Long Beach
Long Beach, California, 90806
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Children's Hospital Los Angeles
Los Angeles, California, 90027
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Los Angeles County-USC Medical Center
Los Angeles, California, 90033
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USC / Norris Comprehensive Cancer Center
Los Angeles, California, 90033
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Cedars Sinai Medical Center
Los Angeles, California, 90048
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Mattel Children's Hospital UCLA
Los Angeles, California, 90095
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UCLA / Jonsson Comprehensive Cancer Center
Los Angeles, California, 90095
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Valley Children's Hospital
Madera, California, 93636
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UCSF Benioff Children's Hospital Oakland
Oakland, California, 94609
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Kaiser Permanente-Oakland
Oakland, California, 94611
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Children's Hospital of Orange County
Orange, California, 92868
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UC Irvine Health/Chao Family Comprehensive Cancer Center
Orange, California, 92868
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Lucile Packard Children's Hospital Stanford University
Palo Alto, California, 94304
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Sutter Medical Center Sacramento
Sacramento, California, 95816
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University of California Davis Comprehensive Cancer Center
Sacramento, California, 95817
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Rady Children's Hospital - San Diego
San Diego, California, 92123
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UCSF Medical Center-Parnassus
San Francisco, California, 94143
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UCSF Medical Center-Mission Bay
San Francisco, California, 94158
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Children's Hospital Colorado
Aurora, Colorado, 80045
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Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center
Denver, Colorado, 80218
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Connecticut Children's Medical Center
Hartford, Connecticut, 06106
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Yale University
New Haven, Connecticut, 06520
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Alfred I duPont Hospital for Children
Wilmington, Delaware, 19803
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MedStar Georgetown University Hospital
Washington, District of Columbia, 20007
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Children's National Medical Center
Washington, District of Columbia, 20010
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Broward Health Medical Center
Fort Lauderdale, Florida, 33316
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Lee Memorial Health System
Fort Myers, Florida, 33901
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Golisano Children's Hospital of Southwest Florida
Fort Myers, Florida, 33908
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University of Florida Health Science Center - Gainesville
Gainesville, Florida, 32610
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Memorial Regional Hospital/Joe DiMaggio Children's Hospital
Hollywood, Florida, 33021
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Nemours Children's Clinic-Jacksonville
Jacksonville, Florida, 32207
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University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami, Florida, 33136
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Miami Cancer Institute
Miami, Florida, 33176
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AdventHealth Orlando
Orlando, Florida, 32803
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Arnold Palmer Hospital for Children
Orlando, Florida, 32806
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Nemours Children's Clinic - Orlando
Orlando, Florida, 32806
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Orlando Health Cancer Institute
Orlando, Florida, 32806
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Nemours Children's Hospital
Orlando, Florida, 32827
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Nemours Children's Clinic - Pensacola
Pensacola, Florida, 32504
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Johns Hopkins All Children's Hospital
Saint Petersburg, Florida, 33701
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Saint Joseph's Hospital/Children's Hospital-Tampa
Tampa, Florida, 33607
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Saint Mary's Hospital
West Palm Beach, Florida, 33407
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Children's Healthcare of Atlanta - Egleston
Atlanta, Georgia, 30322
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Augusta University Medical Center
Augusta, Georgia, 30912
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Memorial Health University Medical Center
Savannah, Georgia, 31404
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Straub Clinic and Hospital
Honolulu, Hawaii, 96813
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University of Hawaii Cancer Center
Honolulu, Hawaii, 96813
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Kapiolani Medical Center for Women and Children
Honolulu, Hawaii, 96826
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Tripler Army Medical Center
Honolulu, Hawaii, 96859
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Saint Luke's Cancer Institute - Boise
Boise, Idaho, 83712
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Lurie Children's Hospital-Chicago
Chicago, Illinois, 60611
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Address
Northwestern University
Chicago, Illinois, 60611
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University of Illinois
Chicago, Illinois, 60612
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University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
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Loyola University Medical Center
Maywood, Illinois, 60153
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Advocate Children's Hospital-Oak Lawn
Oak Lawn, Illinois, 60453
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Address
Advocate Children's Hospital-Park Ridge
Park Ridge, Illinois, 60068
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Advocate Lutheran General Hospital
Park Ridge, Illinois, 60068
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Saint Jude Midwest Affiliate
Peoria, Illinois, 61637
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Saint John's Hospital
Springfield, Illinois, 62702
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Address
Southern Illinois University School of Medicine
Springfield, Illinois, 62702
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Address
Memorial Medical Center
Springfield, Illinois, 62781
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Address
Indiana University/Melvin and Bren Simon Cancer Center
Indianapolis, Indiana, 46202
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Address
Riley Hospital for Children
Indianapolis, Indiana, 46202
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Address
Ascension Saint Vincent Indianapolis Hospital
Indianapolis, Indiana, 46260
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Address
Blank Children's Hospital
Des Moines, Iowa, 50309
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University of Iowa/Holden Comprehensive Cancer Center
Iowa City, Iowa, 52242
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Siouxland Regional Cancer Center
Sioux City, Iowa, 51101
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Mercy Medical Center-Sioux City
Sioux City, Iowa, 51102
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Saint Luke's Regional Medical Center
Sioux City, Iowa, 51104
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University of Kentucky/Markey Cancer Center
Lexington, Kentucky, 40536
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Norton Children's Hospital
Louisville, Kentucky, 40202
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Tulane University Health Sciences Center
New Orleans, Louisiana, 70112
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Children's Hospital New Orleans
New Orleans, Louisiana, 70118
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Ochsner Medical Center Jefferson
New Orleans, Louisiana, 70121
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Eastern Maine Medical Center
Bangor, Maine, 04401
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Maine Children's Cancer Program
Scarborough, Maine, 04074
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University of Maryland/Greenebaum Cancer Center
Baltimore, Maryland, 21201
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Sinai Hospital of Baltimore
Baltimore, Maryland, 21215
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Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore, Maryland, 21287
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Walter Reed National Military Medical Center
Bethesda, Maryland, 20889-5600
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Massachusetts General Hospital Cancer Center
Boston, Massachusetts, 02114
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Dana-Farber Cancer Institute
Boston, Massachusetts, 02215
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Address
Baystate Medical Center
Springfield, Massachusetts, 01199
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UMass Memorial Medical Center - University Campus
Worcester, Massachusetts, 01655
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Address
C S Mott Children's Hospital
Ann Arbor, Michigan, 48109
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Wayne State University/Karmanos Cancer Institute
Detroit, Michigan, 48201
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Ascension Saint John Hospital
Detroit, Michigan, 48236
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Michigan State University Clinical Center
East Lansing, Michigan, 48824-7016
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Hurley Medical Center
Flint, Michigan, 48503
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Helen DeVos Children's Hospital at Spectrum Health
Grand Rapids, Michigan, 49503
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Bronson Methodist Hospital
Kalamazoo, Michigan, 49007
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Beaumont Children's Hospital-Royal Oak
Royal Oak, Michigan, 48073
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Children's Hospitals and Clinics of Minnesota - Minneapolis
Minneapolis, Minnesota, 55404
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University of Minnesota/Masonic Cancer Center
Minneapolis, Minnesota, 55455
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Mayo Clinic in Rochester
Rochester, Minnesota, 55905
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University of Mississippi Medical Center
Jackson, Mississippi, 39216
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Columbia Regional
Columbia, Missouri, 65201
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Children's Mercy Hospitals and Clinics
Kansas City, Missouri, 64108
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Washington University School of Medicine
Saint Louis, Missouri, 63110
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Mercy Hospital Saint Louis
Saint Louis, Missouri, 63141
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Children's Hospital and Medical Center of Omaha
Omaha, Nebraska, 68114
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University of Nebraska Medical Center
Omaha, Nebraska, 68198
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University Medical Center of Southern Nevada
Las Vegas, Nevada, 89102
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Sunrise Hospital and Medical Center
Las Vegas, Nevada, 89109
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Alliance for Childhood Diseases/Cure 4 the Kids Foundation
Las Vegas, Nevada, 89135
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Summerlin Hospital Medical Center
Las Vegas, Nevada, 89144
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Nevada Cancer Research Foundation NCORP
Las Vegas, Nevada, 89169
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Saint Mary's Regional Medical Center
Reno, Nevada, 89503
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Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon, New Hampshire, 03756
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Hackensack University Medical Center
Hackensack, New Jersey, 07601
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Saint Barnabas Medical Center
Livingston, New Jersey, 07039
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Morristown Medical Center
Morristown, New Jersey, 07960
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Saint Peter's University Hospital
New Brunswick, New Jersey, 08901
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Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
New Brunswick, New Jersey, 08903
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Newark Beth Israel Medical Center
Newark, New Jersey, 07112
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Saint Joseph's Regional Medical Center
Paterson, New Jersey, 07503
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Overlook Hospital
Summit, New Jersey, 07902
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University of New Mexico Cancer Center
Albuquerque, New Mexico, 87102
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Albany Medical Center
Albany, New York, 12208
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Montefiore Medical Center - Moses Campus
Bronx, New York, 10467
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Roswell Park Cancer Institute
Buffalo, New York, 14263
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Address
The Steven and Alexandra Cohen Children's Medical Center of New York
New Hyde Park, New York, 11040
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Laura and Isaac Perlmutter Cancer Center at NYU Langone
New York, New York, 10016
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Address
Mount Sinai Hospital
New York, New York, 10029
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Address
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
New York, New York, 10032
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Address
University of Rochester
Rochester, New York, 14642
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Address
Stony Brook University Medical Center
Stony Brook, New York, 11794
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Address
State University of New York Upstate Medical University
Syracuse, New York, 13210
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Address
New York Medical College
Valhalla, New York, 10595
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Address
Mission Hospital
Asheville, North Carolina, 28801
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Address
UNC Lineberger Comprehensive Cancer Center
Chapel Hill, North Carolina, 27599
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Carolinas Medical Center/Levine Cancer Institute
Charlotte, North Carolina, 28203
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Novant Health Presbyterian Medical Center
Charlotte, North Carolina, 28204
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Duke University Medical Center
Durham, North Carolina, 27710
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Address
Wake Forest University Health Sciences
Winston-Salem, North Carolina, 27157
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Sanford Broadway Medical Center
Fargo, North Dakota, 58122
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Address
Children's Hospital Medical Center of Akron
Akron, Ohio, 44308
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Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, 45229
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Rainbow Babies and Childrens Hospital
Cleveland, Ohio, 44106
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Cleveland Clinic Foundation
Cleveland, Ohio, 44195
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Nationwide Children's Hospital
Columbus, Ohio, 43205
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Address
Dayton Children's Hospital
Dayton, Ohio, 45404
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Address
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
Toledo, Ohio, 43606
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Address
Mercy Children's Hospital
Toledo, Ohio, 43608
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Address
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
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Address
Natalie Warren Bryant Cancer Center at Saint Francis
Tulsa, Oklahoma, 74136
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Address
Providence Saint Vincent Medical Center
Portland, Oregon, 97225
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Address
Legacy Emanuel Children's Hospital
Portland, Oregon, 97227
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Address
Legacy Emanuel Hospital and Health Center
Portland, Oregon, 97227
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Address
Oregon Health and Science University
Portland, Oregon, 97239
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Address
Lehigh Valley Hospital - Muhlenberg
Bethlehem, Pennsylvania, 18017
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Address
Geisinger Medical Center
Danville, Pennsylvania, 17822
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Address
Penn State Children's Hospital
Hershey, Pennsylvania, 17033
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Address
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, 19104
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Address
Fox Chase Cancer Center
Philadelphia, Pennsylvania, 19111
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Address
Saint Christopher's Hospital for Children
Philadelphia, Pennsylvania, 19134
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Address
Children's Hospital of Pittsburgh of UPMC
Pittsburgh, Pennsylvania, 15224
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Address
Rhode Island Hospital
Providence, Rhode Island, 02903
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Address
Medical University of South Carolina
Charleston, South Carolina, 29425
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Address
Prisma Health Richland Hospital
Columbia, South Carolina, 29203
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Address
BI-LO Charities Children's Cancer Center
Greenville, South Carolina, 29605
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Address
Greenville Cancer Treatment Center
Greenville, South Carolina, 29605
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Address
Sanford USD Medical Center - Sioux Falls
Sioux Falls, South Dakota, 57117-5134
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Address
T C Thompson Children's Hospital
Chattanooga, Tennessee, 37403
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East Tennessee Childrens Hospital
Knoxville, Tennessee, 37916
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Address
Saint Jude Children's Research Hospital
Memphis, Tennessee, 38105
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Address
Vanderbilt University/Ingram Cancer Center
Nashville, Tennessee, 37232
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Address
Dell Children's Medical Center of Central Texas
Austin, Texas, 78723
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Address
Driscoll Children's Hospital
Corpus Christi, Texas, 78411
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Address
Medical City Dallas Hospital
Dallas, Texas, 75230
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Address
UT Southwestern/Simmons Cancer Center-Dallas
Dallas, Texas, 75390
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Address
El Paso Children's Hospital
El Paso, Texas, 79905
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Address
Brooke Army Medical Center
Fort Sam Houston, Texas, 78234
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Address
Cook Children's Medical Center
Fort Worth, Texas, 76104
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Address
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
Houston, Texas, 77030
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Address
M D Anderson Cancer Center
Houston, Texas, 77030
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Address
Covenant Children's Hospital
Lubbock, Texas, 79410
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Address
Children's Hospital of San Antonio
San Antonio, Texas, 78207
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Address
Methodist Children's Hospital of South Texas
San Antonio, Texas, 78229
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Address
University of Texas Health Science Center at San Antonio
San Antonio, Texas, 78229
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Address
Scott and White Memorial Hospital
Temple, Texas, 76508
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Address
Primary Children's Hospital
Salt Lake City, Utah, 84113
Status
Address
University of Vermont and State Agricultural College
Burlington, Vermont, 05405
Status
Address
University of Virginia Cancer Center
Charlottesville, Virginia, 22908
Status
Address
Inova Fairfax Hospital
Falls Church, Virginia, 22042
Status
Address
Children's Hospital of The King's Daughters
Norfolk, Virginia, 23507
Status
Address
Naval Medical Center - Portsmouth
Portsmouth, Virginia, 23708-2197
Status
Address
Virginia Commonwealth University/Massey Cancer Center
Richmond, Virginia, 23298
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Address
Carilion Children's
Roanoke, Virginia, 24014
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Address
Seattle Children's Hospital
Seattle, Washington, 98105
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Address
University of Washington Medical Center - Montlake
Seattle, Washington, 98195
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Address
Providence Sacred Heart Medical Center and Children's Hospital
Spokane, Washington, 99204
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Address
Mary Bridge Children's Hospital and Health Center
Tacoma, Washington, 98405
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Address
Madigan Army Medical Center
Tacoma, Washington, 98431
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Address
United Hospital Center
Bridgeport, West Virginia, 26330
Status
Address
West Virginia University Charleston Division
Charleston, West Virginia, 25304
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Address
West Virginia University Healthcare
Morgantown, West Virginia, 26506
Status
Address
Camden Clark Medical Center
Parkersburg, West Virginia, 26101
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Address
Saint Vincent Hospital Cancer Center Green Bay
Green Bay, Wisconsin, 54301
Status
Address
University of Wisconsin Carbone Cancer Center
Madison, Wisconsin, 53792
Status
Address
Marshfield Medical Center-Marshfield
Marshfield, Wisconsin, 54449
Status
Address
Children's Hospital of Wisconsin
Milwaukee, Wisconsin, 53226
Status
Address
Medical College of Wisconsin
Milwaukee, Wisconsin, 53226
International Sites
Status
Address
John Hunter Children's Hospital
Hunter Regional Mail Centre, New South Wales, 2310
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Address
Sydney Children's Hospital
Randwick, New South Wales, 2031
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Address
The Children's Hospital at Westmead
Westmead, New South Wales, 2145
Status
Address
Royal Brisbane and Women's Hospital
Herston, Queensland, 4029
Status
Address
Royal Children's Hospital-Brisbane
Herston, Queensland, 4029
Status
Address
Queensland Children's Hospital
South Brisbane, Queensland, 4101
Status
Address
Women's and Children's Hospital-Adelaide
North Adelaide, South Australia, 5006
Status
Address
Princess Margaret Hospital for Children
Perth, Western Australia, 6008
Status
Address
Alberta Children's Hospital
Calgary, Alberta, T3B 6A8
Status
Address
University of Alberta Hospital
Edmonton, Alberta, T6G 2B7
Status
Address
British Columbia Children's Hospital
Vancouver, British Columbia, V6H 3V4
Status
Address
CancerCare Manitoba
Winnipeg, Manitoba, R3E 0V9
Status
Address
Janeway Child Health Centre
Saint John's, Newfoundland and Labrador, A1B 3V6
Status
Address
IWK Health Centre
Halifax, Nova Scotia, B3K 6R8
Status
Address
McMaster Children's Hospital at Hamilton Health Sciences
Hamilton, Ontario, L8N 3Z5
Status
Address
Kingston Health Sciences Centre
Kingston, Ontario, K7L 2V7
Status
Address
Children's Hospital
London, Ontario, N6A 5W9
Status
Address
Children's Hospital of Eastern Ontario
Ottawa, Ontario, K1H 8L1
Status
Address
Hospital for Sick Children
Toronto, Ontario, M5G 1X8
Status
Address
The Montreal Children's Hospital of the MUHC
Montreal, Quebec, H3H 1P3
Status
Address
Centre Hospitalier Universitaire Sainte-Justine
Montreal, Quebec, H3T 1C5
Status
Address
Allan Blair Cancer Centre
Regina, Saskatchewan, S4T 7T1
Status
Address
Saskatoon Cancer Centre
Saskatoon, Saskatchewan, S7N 4H4
Status
Address
Centre Hospitalier Universitaire de Quebec
Quebec, , G1V 4G2
Status
Address
Starship Children's Hospital
Grafton, Auckland, 1145
Status
Address
Christchurch Hospital
Christchurch, , 8011
Status
Address
San Jorge Children's Hospital
San Juan, , 00912
Status
Address
King Faisal Specialist Hospital and Research Centre
Riyadh, , 11211
