Risk-Based Therapy in Treating Younger Patients With Newly Diagnosed Liver Cancer



Status:Active, not recruiting
Conditions:Liver Cancer, Cancer, Cancer, Brain Cancer
Therapuetic Areas:Oncology
Healthy:No
Age Range:Any - 21
Updated:3/9/2019
Start Date:September 14, 2009
End Date:July 31, 2020

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Treatment of Children With All Stages of Hepatoblastoma With Temsirolimus (NSC#683864) Added to High Risk Stratum Treatment

This phase III trial studies the side effects and how well risk-based therapy works in
treating younger patients with newly diagnosed liver cancer. Surgery, chemotherapy drugs
(cancer fighting medicines), and when necessary, liver transplant, are the main current
treatments for hepatoblastoma. The stage of the cancer is one factor used to decide the best
treatment. Treating patients according to the risk group they are in may help get rid of the
cancer, keep it from coming back, and decrease the side effects of chemotherapy.

PRIMARY OBJECTIVES:

I. To estimate the event-free survival (EFS) in children with stage I (non-pure fetal
histology [PFH], non-small cell undifferentiated [SCU]) and stage II (non-SCU) hepatoblastoma
treated with surgical resection followed by 2 cycles of cisplatin, fluorouracil, and
vincristine sulfate (C5V).

II. To determine the feasibility and toxicity of adding doxorubicin (doxorubicin
hydrochloride) to the chemotherapy regimen of C5V for children with intermediate-risk
hepatoblastoma.

III. To estimate the response rate to vincristine (vincristine sulfate), irinotecan
(irinotecan hydrochloride), and temsirolimus in previously untreated children with high-risk,
metastatic hepatoblastoma.

IV. To determine whether timely (between diagnosis and end of second cycle of chemotherapy)
consultation with a treatment center with surgical expertise in major pediatric liver
resection and transplant can be achieved in 70% of patients with potentially unresectable
hepatoblastoma.

V. To foster the collection of tumor tissue and biologic samples to facilitate translational
research and to provide data that may aid in risk-adapted approaches for subsequent clinical
trials.

SECONDARY OBJECTIVES:

I. To estimate the EFS of patients with stage I PFH treated with surgery alone. II. To
determine whether orthotopic liver transplantation (OLT) can be accomplished after successful
referral and completion of 4 cycles of initial chemotherapy.

III. To estimate the 2-year EFS for patients once identified as candidates for possible OLT,
the 2-year EFS for patients referred to a transplant center that are resected without OLT,
and the 2-year EFS for patients referred to a transplant center who receive OLT.

IV. To register children with hepatoblastoma who receive OLT with PLUTO (Pediatric Liver
Unresectable Tumor Observatory), an international cooperative registry for children
transplanted for liver tumors.

V. To determine if pretreatment extent of disease (PRETEXT) grouping can predict tumor
resectability.

VI. To monitor the concordance between institutional assessment of PRETEXT grouping and
PRETEXT grouping as performed by expert panel review.

VII. To estimate the proportion of stage IV patients who have surgical resection of
metastatic pulmonary lesions.

VIII. To determine the proportion and estimate the EFS of patients with potentially poor
prognostic factors including alpha fetoprotein (AFP) < 100 ng/mL at diagnosis, microscopic
positive surgical margins, surgical complications, multifocal tumors, microscopic vascular
invasion, macrotrabecular histologic subtype, and SCU histologic subtype.

OUTLINE: Patients are assigned to 1 of 4 treatment groups according to risk group.

VERY LOW-RISK GROUP: Patients undergo surgery and receive no further treatment.

LOW-RISK GROUP: (regimen T) Patients undergo surgery and then receive adjuvant cisplatin
intravenously (IV) over 6 hours on day 1, fluorouracil IV over 2-4 minutes on day 2, and
vincristine sulfate IV over 1 minute on days 2, 9, and 16. Treatment repeats every 21 days
for 2 courses in the absence of disease progression or unacceptable toxicity.

INTERMEDIATE-RISK GROUP: (regimen F) (closed to accrual as of 3/12/2012) Patients receive
C5VD chemotherapy comprising cisplatin IV over 6 hours on day 1, fluorouracil IV over 2-4
minutes on day 2, vincristine sulfate IV over 1 minute on days 2, 9, and 16, and doxorubicin
hydrochloride IV over 15 minutes on days 1-2. Treatment repeats every 21 days for 6 courses
in the absence of disease progression or unacceptable toxicity. Patients also undergo
surgical resection after course 2 OR surgical resection or liver transplantation after course
4 of C5VD. Patients may also receive dexrazoxane IV over 5-15 minutes on days 1-2 of courses
5 and 6.

HIGH-RISK GROUP: (regimen H) Patients receive up front VIT chemotherapy comprising
vincristine sulfate IV over 1 minute on days 1 and 8 and irinotecan hydrochloride IV over 90
minutes on days 1-5, and temsirolimus IV over 30 minutes on days 1 and 8. Treatment with VIT
repeats every 21 days for 2 courses in the absence of disease progression or unacceptable
toxicity. Patients with disease response then receive 6 courses of C5VD with 4 courses of VIT
in between each 2-course block. Patients with no disease response receive 6 courses of C5VD
in the absence of disease progression or unacceptable toxicity. Patients undergo tumor
resection or liver transplant after course 4 of C5VD followed by 2 courses of adjuvant C5VD.
Patients may also receive dexrazoxane IV over 5-15 minutes on days 1-2 of courses 5 and 6.

After completion of study therapy, patients who receive chemotherapy are followed up
periodically for at least 4 years.

Inclusion Criteria:

- Patients must be newly diagnosed with histologically-proven hepatoblastoma

- In emergency situations when a patient meets all other eligibility criteria and has
had baseline required observations, but is too ill to undergo a biopsy safely, the
patient may be enrolled on AHEP0731 without a biopsy

- Clinical situations in which such emergent treatment may be indicated include,
but are not limited to, the following circumstances:

- Anatomic or mechanical compromise of critical organ function by tumor (e.g.,
respiratory distress/failure, abdominal compartment syndrome, urinary
obstruction, etc)

- Uncorrectable coagulopathy

- For a patient to maintain eligibility for AHEP0731 when emergent treatment is
given, the following must occur:

- The patient must have a clinical diagnosis of hepatoblastoma, including an
elevated alpha fetoprotein, and must meet all AHEP0731 eligibility criteria
at the time of emergent treatment

- Patient must be enrolled on AHEP0731 prior to initiating protocol therapy; a
patient will be ineligible if any chemotherapy is administered prior to
AHEP0731 enrollment

- If the patient receives AHEP0731 chemotherapy PRIOR to undergoing a
diagnostic biopsy, pathologic review of material obtained in the future
during either biopsy or surgical resection must either confirm the diagnosis
of hepatoblastoma or not reveal another pathological diagnosis to be
included in the analysis of the study aims

- Patients will be staged for risk classification and treatment at diagnosis using
Children's Oncology Group (COG) staging guidelines

- At the time of study enrollment, the patient's treatment regimen must be identified;
if the patient's primary tumor was resected prior to the day of enrollment and a blood
specimen for the determination of serum alpha fetoprotein was not obtained prior to
that surgery, the patient will be considered to have alpha fetoprotein of greater than
100 ng/mL for the purpose of treatment assignment; if tumor samples obtained prior to
the date of enrollment were not sufficient to determine whether small cell
undifferentiated (SCU) histology was present, treatment assignment will be made
assuming SCU is not present in the tumor

- For patients with stage I or II disease, specimens for rapid central review have been
submitted and the rapid central review diagnosis and staging must be available to be
provided on the AHEP0731 eligibility case report form (CRF)

- Patients must have a performance status corresponding to Eastern Cooperative Oncology
Group (ECOG) scores 0, 1, or 2; use Karnofsky for patients > 16 years of age and
Lansky for patients =< 16 years of age

- Patients may have had surgical resection of some or all sites of hepatoblastoma prior
to enrollment

- Organ function requirements are not required for enrolled patients who are stage I,
PFH and will not be receiving chemotherapy

- Creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70
mL/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) or 1.4 mg/dL (female)

- >= 16 years: 1.7 mg/dL (male) or 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]) < 10 x
ULN for age

- Absolute neutrophil count (ANC) > 750/uL

- Platelet count > 75,000/uL

- Shortening fraction >= 27% by echocardiogram

- Ejection fraction >= 47% by radionuclide angiogram (multi gated acquisition scan
[MUGA]); Note: the echocardiogram (or MUGA) may be done within 28 days prior to
enrollment

- Serum triglyceride level =< 300 mg/dL (=< 3.42 mmol/L)

- Serum cholesterol level =< 300 mg/dL (7.75 mmol/L)

- Random or fasting blood glucose within the upper normal limits for age; if the initial
blood glucose is a random sample that is outside of the normal limits, then a
follow-up fasting blood glucose can be obtained and must be within the upper normal
limits for age

- Normal pulmonary function tests (including diffusing capacity of the lungs for carbon
monoxide [DLCO]) if there is clinical indication for determination (e.g. dyspnea at
rest, known requirement for supplemental oxygen); Note: for patients who do not have
respiratory symptoms or requirement for supplemental oxygen, pulmonary function tests
(PFTs) are NOT required

- Patients with seizure disorder may be enrolled if on non-enzyme inducing
anticonvulsants and if seizures are well controlled

- Prothrombin time (PT) < 1.2 x ULN

- All patients and/or their parents or legal guardians must sign a written informed
consent

- All institutional, Food and Drug Administration (FDA), and National Cancer Institute
(NCI) requirements for human studies must be met

Exclusion Criteria:

- Patients with stage I or II disease who do not have specimens submitted for rapid
central pathology review by day 14 after initial surgical resection

- Patients that have been previously treated with chemotherapy for hepatoblastoma or
other hepatoblastoma-directed therapy (e.g., radiation therapy, biologic agents, local
therapy [embolization, radiofrequency ablation, laser]) are not eligible

- Patients who have received any prior chemotherapy are not eligible

- Patients who are currently receiving another investigational drug are not eligible

- Patients who are currently receiving other anticancer agents are not eligible

- Patients who have previously received a solid organ transplant are not eligible

- Patients who have an uncontrolled infection are not eligible

- Females who are pregnant or breast feeding are not eligible for this study

- Female patients of childbearing potential are not eligible unless a negative pregnancy
test result has been obtained

- Males and females of reproductive potential are not eligible unless they have agreed
to use an effective contraceptive method

- Patients receiving corticosteroids are not eligible; patients must have been off
corticosteroids for 7 days prior to start of chemotherapy

- Patients who are currently receiving enzyme inducing anticonvulsants are not eligible

- Patients must not be receiving any of the following potent cytochrome P450, family 3,
subfamily A, polypeptide 4 (CYP3A4) inducers or inhibitors: erythromycin,
clarithromycin, azithromycin, ketoconazole, itraconazole, voriconazole, posaconazole,
grapefruit juice or St. John's wort

- Patients who are currently receiving therapeutic anticoagulants (including aspirin,
low molecular weight heparin, warfarin and others) are not eligible

- Patients who are currently receiving angiotensin-converting enzymes (ACE) inhibitors
are not eligible

- Patients must not have had major surgery within 6 weeks prior to enrollment on the
high risk stratum; patients with history of recent minor surgical procedures (vascular
catheter placement, bone marrow evaluation, laparoscopic surgery, liver tumor biopsy)
will be eligible
We found this trial at
185
sites
1200 Pleasant Street
Des Moines, Iowa 50309
(515) 241-KIDS
Principal Investigator: Wendy L. Woods-Swafford
Phone: 515-241-3305
Blank Children's Hospital Blank Children's Hospital is completely dedicated to meeting the unique health care...
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1201 Camino de Salud Northeast
Albuquerque, New Mexico 87131
(505) 272-4946
Principal Investigator: Koh B. Boayue
Phone: 505-925-0366
University of New Mexico Cancer Center It’s been 40 years since the New Mexico State...
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4900 Mueller Boulevard
Austin, Texas 78723
(512) 324-0000
Principal Investigator: Amy C. Fowler
Phone: 214-648-7097
Dell Children's Medical Center of Central Texas Welcome to Dell Children
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1600 7th Avenue
Birmingham, Alabama 35233
(205) 638-9100
Principal Investigator: Alyssa T. Reddy
Phone: 205-638-9285
Children's Hospital of Alabama Children
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666 Elm Street
Buffalo, New York 14263
(716) 845-2300
Principal Investigator: Denise A. Rokitka
Phone: 877-275-7724
Roswell Park Cancer Institute Welcome to Roswell Park Cancer Institute (RPCI), America's first cancer center...
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1300 Jefferson Park Avenue
Charlottesville, Virginia 22908
434-243-6784
Principal Investigator: William C. Petersen
Phone: 434-243-6322
University of Virginia Cancer Center We are fortunate in having state of the art clinical...
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3333 Burnet Avenue # Mlc3008
Cincinnati, Ohio 45229
 1-513-636-4200 
Principal Investigator: James I. Geller
Phone: 513-636-2799
Cincinnati Children's Hospital Medical Center Patients and families from across the region and around the...
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11100 Euclid Avenue
Cleveland, Ohio 44106
(216) 844-1000
Principal Investigator: John J. Letterio
Phone: 216-844-5437
Rainbow Babies and Children's Hospital UH Rainbow Babies & Children’s Hospital is a 244-bed, full-service...
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700 Childrens Drive
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Nationwide Children's Hospital At Nationwide Children’s, we are creating the future of pediatric health care....
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3533 South Alameda Street
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7777 Forest Ln # C840
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3300 Gallows Road
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Principal Investigator: Marshall A. Schorin
Phone: 703-208-6650
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1 Hurley Plaza
Flint, Michigan 48503
(810) 262-9000
Principal Investigator: Nkechi Onwuzurike
Phone: 734-712-3671
Hurley Medical Center From its founding in 1908, Hurley Medical Center has devoted itself to...
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9981 S Healthpark Dr # 465
Fort Myers, Florida 33908
239-343-5000
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3551 Roger Brooke Dr
Fort Sam Houston, Texas 78234
(210) 916-4141
Brooke Army Medical Center Brooke Army Medical Center (BAMC) is the Flagship of Army Medicine!...
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100 Michigan Street Northeast
Grand Rapids, Michigan 49503
616.391.9000
Principal Investigator: David S. Dickens
Phone: 616-391-1230
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Phone: 800-579-7822
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2500 N State St
Jackson, Mississippi 39216
(601) 984-1000
Principal Investigator: Gail C. Megason
Phone: 601-815-6700
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524 South Park Street
Kalamazoo, Michigan 49007
(269) 341-7654
Principal Investigator: Katharina E. Elliott
Phone: 616-391-1230
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1800 West Charleston Boulevard
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(702) 383-2000
Principal Investigator: Alan K. Ikeda
Phone: 702-384-0013
University Medical Center of Southern Nevada University Medical Center is dedicated to providing the highest...
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529 West Markham Street
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(501) 686-7000
University of Arkansas for Medical Sciences The University of Arkansas for Medical Sciences (UAMS) in...
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4650 Sunset Blvd
Los Angeles, California 90027
 (323) 660-2450
Principal Investigator: Leo Mascarenhas
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8700 Beverly Blvd # 8211
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(1-800-233-2771)
Principal Investigator: Fataneh (Fae) Majlessipour
Phone: 310-423-8965
Cedars Sinai Med Ctr Cedars-Sinai is known for providing the highest quality patient care. Our...
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262 Danny Thomas Pl
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(901) 495-3300
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Phone: 866-278-5833
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601 Children's Lane
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(757) 668-7000
Principal Investigator: Eric J. Lowe
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747 52nd St
Oakland, California 94609
(510) 428-3000
Principal Investigator: Carla B. Golden
Phone: 510-450-7600
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1201 W La Veta Ave
Orange, California 92868
(714) 997-3000
Principal Investigator: Elyssa M. Rubin
Phone: 714-997-3000
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(407) 650-7000
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5153 North 9th Avenue
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(850) 505-4700
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530 Northeast Glen Oak Avenue
Peoria, Illinois 61603
(309) 624-4945
Principal Investigator: Pedro A. De Alarcon
Phone: 888-226-4343
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South 34th Street
Philadelphia, Pennsylvania 19104
 215-590-1000
Principal Investigator: Elizabeth Fox
Phone: 800-411-1222
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4401 Penn Avenue
Pittsburgh, Pennsylvania 15224
412-692-5325
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3181 Southwest Sam Jackson Park Road
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503 494-8311
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593 Eddy Street
Providence, Rhode Island 02903
401-444-4000
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Phone: 401-444-1488
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401 College Street
Richmond, Virginia 23298
(804) 828-0450
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Phone: 804-628-1939
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60 Crittenden Blvd # 70
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(585) 275-2121
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Phone: 585-275-5830
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7700 Floyd Curl Dr
San Antonio, Texas 78229
(210) 575-7000
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Phone: 210-575-7000
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4502 Medical Drive
San Antonio, Texas 78284
(210) 567-7000
Principal Investigator: Anne-Marie R. Langevin
Phone: 210-450-3800
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3020 Childrens way
San Diego, California 92123
(858) 576-1700
Principal Investigator: William D. Roberts
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34800 Bob Wilson Dr,
San Diego, California 92134
(619) 532-6400
Principal Investigator: Shelton A. Viola
Phone: 619-532-8712
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40 Sunshine Cottage Road
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(914) 594-4000
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Phone: 914-594-3794
New York Medical College The College was founded in 1860 by a group of New...
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1600 Rockland Road
Wilmington, Delaware 19803
(302) 651-4200
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Phone: 302-651-5755
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Akron, Ohio 44308
Principal Investigator: Steven J. Kuerbitz
Phone: 330-543-3193
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Albany, New York 12208
Principal Investigator: Kenneth G. Lucas
Phone: 518-262-5513
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1540 East Hospital Drive
Ann Arbor, Michigan 48109
(877) 475-6688
Principal Investigator: Rama Jasty
Phone: 800-865-1125
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Asheville, North Carolina 28801
Principal Investigator: Douglas J. Scothorn
Phone: 828-213-4150
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Atlanta, Georgia 30322
Principal Investigator: Muna Qayed
Phone: 404-785-1112
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13123 E 16th Ave
Aurora, Colorado 80045
(720) 777-1234
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2401 W Belvedere Ave
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(410) 601-9000
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489 State St
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(207) 973-7000
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8901 Rockville Pike
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(301) 295-4000
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100 E Idaho St
Boise, Idaho 83712
(208) 381-2711
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Saint Luke's Mountain States Tumor Institute For more than 100 years, St. Luke
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55 Fruit St
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Chapel Hill, North Carolina 27599
Principal Investigator: Stuart H. Gold
Phone: 877-668-0683
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171 Ashley Avenue
Charleston, South Carolina 29425
843-792-1414
Principal Investigator: Jacqueline M. Kraveka
Phone: 843-792-9321
Medical University of South Carolina The Medical University of South Carolina (MUSC) has grown from...
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3110 MacCorkle Avenue Southeast
Charleston, West Virginia 25304
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Charleston, WV
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Charlotte, North Carolina 28204
Principal Investigator: Joel A. Kaplan
Phone: 704-355-2884
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Charlotte, NC
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Charlotte, North Carolina 28204
Principal Investigator: Jessica A. Bell
Phone: 704-384-5369
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Charlotte, NC
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Chattanooga, Tennessee 37403
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Chicago, Illinois 60614
Principal Investigator: Amy L. Walz
Phone: 773-880-4562
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Chicago, IL
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1200 West Harrison Stree
Chicago, Illinois 60607
(312) 996-4350
Principal Investigator: Mary L. Schmidt
Phone: 312-355-3046
Univ of Illinois A major research university in the heart of one of the world's...
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5841 S Maryland Ave
Chicago, Illinois 60637
1-773-702-6180
Principal Investigator: Susan L. Cohn
Phone: 773-834-7424
University of Chicago Comprehensive Cancer Center The University of Chicago Comprehensive Cancer Center (UCCCC) is...
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2049 E 100th St
Cleveland, Ohio 44106
(216) 444-2200
Principal Investigator: Aron Flagg
Phone: 866-223-8100
Cleveland Clinic Foundation The Cleveland Clinic (formally known as The Cleveland Clinic Foundation) is a...
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Cleveland, OH
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Columbia, Missouri 65201
Principal Investigator: Barbara A. Gruner
Phone: 573-882-7440
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5 Richland Medical Park Dr
Columbia, South Carolina 29203
(803) 434-7000
Principal Investigator: Stuart L. Cramer
Phone: 803-434-3680
Palmetto Health Richland Palmetto Health Richland, originally founded in 1892 as Columbia Hospital, has a...
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Dallas, Texas 75390
Principal Investigator: Jonathan E. Wickiser
Phone: 214-648-7097
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Dallas, TX
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Dayton, Ohio 45404
Principal Investigator: Ayman A. El-Sheikh
Phone: 800-228-4055
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Dayton, OH
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Denver, Colorado 80218
Principal Investigator: Jennifer J. Clark
Phone: 866-775-6246
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Denver, CO
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4160 John R St #2122
Detroit, Michigan 48201
(313) 833-1785
Principal Investigator: Jeffrey W. Taub
Phone: 313-576-9363
Wayne State University/Karmanos Cancer Institute Karmanos is based in southeast Michigan, in midtown Detroit, and...
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Detroit, Michigan 48236
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9333 Imperial Highway
Downey, California 90242
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Downey, CA
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2301 Erwin Rd
Durham, North Carolina 27710
919-684-8111
Principal Investigator: Susan G. Kreissman
Phone: 888-275-3853
Duke Univ Med Ctr As a world-class academic and health care system, Duke Medicine strives...
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Durham, NC
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East Lansing, Michigan 48824
Principal Investigator: Renuka Gera
Phone: 517-975-9547
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East Lansing, MI
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El Paso, Texas 79905
Principal Investigator: Lisa L. Hartman
Phone: 915-298-5444
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1600 S Andrews Ave
Fort Lauderdale, Florida 33316
(954) 355-4400
Principal Investigator: Hector M. Rodriguez-Cortes
Phone: 954-355-5346
Broward Health Medical Center Broward Health, providing service for more than 75 years, is a...
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Fort Myers, Florida 33908
Principal Investigator: Emad K. Salman
Phone: 877-680-0008
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801 7th Avenue
Fort Worth, Texas 76104
(682) 885-4000
Principal Investigator: Lauren J. Akers
Phone: 682-885-2103
Cook Children's Medical Center Cook Children's Health Care System is a not-for-profit, nationally recognized pediatric...
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1600 Southwest Archer Road
Gainesville, Florida 32610
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1001 E 5th St
Greenville, North Carolina 27858
(252) 328-6131
Principal Investigator: Andrea R. Whitfield
Phone: 252-744-2391
East Carolina University Whether it's meeting the demand for more teachers and healthcare professionals or...
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Greenville, NC
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900 West Faris Rd.
Greenville, South Carolina 29605
(864)455-8898
Principal Investigator: Nichole L. Bryant
Phone: 864-241-6251
BI-LO Charities Children's Cancer Center The BI-LO Charities Children
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Greenville, SC
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Greenville, South Carolina 29605
Principal Investigator: Cary E. Stroud
Phone: 864-241-6251
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30 Prospect Ave
Hackensack, New Jersey 07601
(201) 996-2000
Principal Investigator: Katharine Offer
Phone: 201-996-2879
Hackensack University Medical Center Hackensack University Medical Center, part of the Hackensack University Health Network,...
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Hershey, Pennsylvania 17033
Principal Investigator: Lisa M. McGregor
Phone: 717-531-6012
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Hollywood, Florida 33021
Principal Investigator: Iftikhar Hanif
Phone: 954-265-2234
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Honolulu, Hawaii 96813
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1319 Punahou St
Honolulu, Hawaii 96826
(808) 983-6000
Principal Investigator: Wade T. Kyono
Phone: 808-983-6090
Kapiolani Medical Center for Women and Children Hawai‘i Pacific Health is an integrated health care...
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1 Jarrett White Rd
Honolulu, Hawaii 96859
(808) 433-6661
Tripler Army Medical Center The attack of Pearl Harbor led to the construction of Tripler...
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Honolulu, HI
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Houston, Texas 77030
Principal Investigator: Patrick A. Thompson
Phone: 713-798-1354
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Hunter Regional Mail Centre, New South Wales
Principal Investigator: Bhavna Padhye
Phone: (02) 9845 8183
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Hunter Regional Mail Centre,
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705 Riley Hospital Dr
Indianapolis, Indiana 46202
(317) 944-5000
Principal Investigator: Kamnesh R. Pradhan
Phone: 800-248-1199
Riley Hospital for Children Riley Hospital for Children at IU Health is a place of...
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Indianapolis, IN
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Indianapolis, Indiana 46260
Principal Investigator: Bassem I. Razzouk
Phone: 317-338-2194
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Iowa City, Iowa 52242
Principal Investigator: Mariko Sato
Phone: 800-237-1225
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Iowa City, IA
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Jacksonville, Florida 32207
Principal Investigator: Ramamoorthy Nagasubramanian
Phone: 407-650-7150
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Kalamazoo, Michigan 49008
Principal Investigator: Jeffrey S. Lobel
Phone: 800-227-2345
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Kalamazoo, MI
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Kansas City, Missouri 64108
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2018 W Clinch Ave
Knoxville, Tennessee 37916
(865) 541-8000
Principal Investigator: Ray C. Pais
Phone: 865-541-8266
East Tennessee Children's Hospital East Tennessee Children's Hospital is a not-for-profit, private, independent pediatric medical...
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Knoxville, TN
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Las Vegas, Nevada 89109
Principal Investigator: Alan K. Ikeda
Phone: 702-384-0013
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Las Vegas, NV
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Las Vegas, Nevada 89144
Principal Investigator: Alan K. Ikeda
Phone: 702-384-0013
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Las Vegas, NV
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