Ignite Creation Date:
2025-12-24 @ 3:51 PM
Ignite Modification Date:
2025-12-26 @ 9:00 AM
Study NCT ID:
NCT04553692
Status:
TERMINATED
Last Update Posted:
2025-03-28
First Post:
2020-09-04
Is NOT Gene Therapy:
True
Has Adverse Events:
False
Brief Title:
Phase 1a/1b Study of Aplitabart (IGM-8444) Alone or in Combination in Participants with Relapsed, Refractory, or Newly Diagnosed Cancers
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'conditionBrowseModule': {'meshes': [{'id': 'D015179', 'term': 'Colorectal Neoplasms'}, {'id': 'D008228', 'term': 'Lymphoma, Non-Hodgkin'}, {'id': 'D012509', 'term': 'Sarcoma'}, {'id': 'D002813', 'term': 'Chondrosarcoma'}, {'id': 'D015451', 'term': 'Leukemia, Lymphocytic, Chronic, B-Cell'}, {'id': 'D015470', 'term': 'Leukemia, Myeloid, Acute'}, {'id': 'D009362', 'term': 'Neoplasm Metastasis'}], 'ancestors': [{'id': 'D007414', 'term': 'Intestinal Neoplasms'}, {'id': 'D005770', 'term': 'Gastrointestinal Neoplasms'}, {'id': 'D004067', 'term': 'Digestive System Neoplasms'}, {'id': 'D009371', 'term': 'Neoplasms by Site'}, {'id': 'D009369', 'term': 'Neoplasms'}, {'id': 'D004066', 'term': 'Digestive System Diseases'}, {'id': 'D005767', 'term': 'Gastrointestinal Diseases'}, {'id': 'D003108', 'term': 'Colonic Diseases'}, {'id': 'D007410', 'term': 'Intestinal Diseases'}, {'id': 'D012002', 'term': 'Rectal Diseases'}, {'id': 'D008223', 'term': 'Lymphoma'}, {'id': 'D009370', 'term': 'Neoplasms by Histologic Type'}, {'id': 'D008232', 'term': 'Lymphoproliferative Disorders'}, {'id': 'D008206', 'term': 'Lymphatic Diseases'}, {'id': 'D006425', 'term': 'Hemic and Lymphatic Diseases'}, {'id': 'D007160', 'term': 'Immunoproliferative Disorders'}, {'id': 'D007154', 'term': 'Immune System Diseases'}, {'id': 'D018204', 'term': 'Neoplasms, Connective and Soft Tissue'}, {'id': 'D009372', 'term': 'Neoplasms, Connective Tissue'}, {'id': 'D015448', 'term': 'Leukemia, B-Cell'}, {'id': 'D007945', 'term': 'Leukemia, Lymphoid'}, {'id': 'D007938', 'term': 'Leukemia'}, {'id': 'D006402', 'term': 'Hematologic Diseases'}, {'id': 'D002908', 'term': 'Chronic Disease'}, {'id': 'D020969', 'term': 'Disease Attributes'}, {'id': 'D010335', 'term': 'Pathologic Processes'}, {'id': 'D013568', 'term': 'Pathological Conditions, Signs and Symptoms'}, {'id': 'D007951', 'term': 'Leukemia, Myeloid'}, {'id': 'D009385', 'term': 'Neoplastic Processes'}]}, 'interventionBrowseModule': {'meshes': [{'id': 'C480833', 'term': 'IFL protocol'}, {'id': 'D005472', 'term': 'Fluorouracil'}, {'id': 'D002955', 'term': 'Leucovorin'}, {'id': 'D000077146', 'term': 'Irinotecan'}, {'id': 'D000068258', 'term': 'Bevacizumab'}, {'id': 'C582429', 'term': 'birinapant'}, {'id': 'C579720', 'term': 'venetoclax'}, {'id': 'D000093542', 'term': 'Gemcitabine'}, {'id': 'D000077143', 'term': 'Docetaxel'}, {'id': 'D001374', 'term': 'Azacitidine'}], 'ancestors': [{'id': 'D014498', 'term': 'Uracil'}, {'id': 'D011744', 'term': 'Pyrimidinones'}, {'id': 'D011743', 'term': 'Pyrimidines'}, {'id': 'D006573', 'term': 'Heterocyclic Compounds, 1-Ring'}, {'id': 'D006571', 'term': 'Heterocyclic Compounds'}, {'id': 'D005575', 'term': 'Formyltetrahydrofolates'}, {'id': 'D013763', 'term': 'Tetrahydrofolates'}, {'id': 'D005492', 'term': 'Folic Acid'}, {'id': 'D011622', 'term': 'Pterins'}, {'id': 'D011621', 'term': 'Pteridines'}, {'id': 'D006574', 'term': 'Heterocyclic Compounds, 2-Ring'}, {'id': 'D000072471', 'term': 'Heterocyclic Compounds, Fused-Ring'}, {'id': 'D003067', 'term': 'Coenzymes'}, {'id': 'D045762', 'term': 'Enzymes and Coenzymes'}, {'id': 'D002166', 'term': 'Camptothecin'}, {'id': 'D000470', 'term': 'Alkaloids'}, {'id': 'D061067', 'term': 'Antibodies, Monoclonal, Humanized'}, {'id': 'D000911', 'term': 'Antibodies, Monoclonal'}, {'id': 'D000906', 'term': 'Antibodies'}, {'id': 'D007136', 'term': 'Immunoglobulins'}, {'id': 'D007162', 'term': 'Immunoproteins'}, {'id': 'D001798', 'term': 'Blood Proteins'}, {'id': 'D011506', 'term': 'Proteins'}, {'id': 'D000602', 'term': 'Amino Acids, Peptides, and Proteins'}, {'id': 'D012712', 'term': 'Serum Globulins'}, {'id': 'D005916', 'term': 'Globulins'}, {'id': 'D003841', 'term': 'Deoxycytidine'}, {'id': 'D003562', 'term': 'Cytidine'}, {'id': 'D011741', 'term': 'Pyrimidine Nucleosides'}, {'id': 'D043823', 'term': 'Taxoids'}, {'id': 'D043822', 'term': 'Cyclodecanes'}, {'id': 'D003516', 'term': 'Cycloparaffins'}, {'id': 'D006840', 'term': 'Hydrocarbons, Alicyclic'}, {'id': 'D006844', 'term': 'Hydrocarbons, Cyclic'}, {'id': 'D006838', 'term': 'Hydrocarbons'}, {'id': 'D009930', 'term': 'Organic Chemicals'}, {'id': 'D004224', 'term': 'Diterpenes'}, {'id': 'D013729', 'term': 'Terpenes'}, {'id': 'D001372', 'term': 'Aza Compounds'}, {'id': 'D009705', 'term': 'Nucleosides'}, {'id': 'D009706', 'term': 'Nucleic Acids, Nucleotides, and Nucleosides'}, {'id': 'D012263', 'term': 'Ribonucleosides'}]}}, 'protocolSection': {'designModule': {'phases': ['PHASE1'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'RANDOMIZED', 'maskingInfo': {'masking': 'NONE', 'maskingDescription': 'Phase 1a is non-randomized; Ph1b is randomized'}, 'primaryPurpose': 'TREATMENT', 'interventionModel': 'SEQUENTIAL'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 272}}, 'statusModule': {'whyStopped': 'Study terminated due strategic corporate pivot to focus on auto-immune indications', 'overallStatus': 'TERMINATED', 'startDateStruct': {'date': '2020-09-23', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2025-03', 'completionDateStruct': {'date': '2025-01-20', 'type': 'ACTUAL'}, 'lastUpdateSubmitDate': '2025-03-25', 'studyFirstSubmitDate': '2020-09-04', 'studyFirstSubmitQcDate': '2020-09-11', 'lastUpdatePostDateStruct': {'date': '2025-03-28', 'type': 'ACTUAL'}, 'studyFirstPostDateStruct': {'date': '2020-09-17', 'type': 'ACTUAL'}, 'primaryCompletionDateStruct': {'date': '2025-01-20', 'type': 'ACTUAL'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Ph1a: Adverse Events of aplitabart as single agent and with FOLFIRI ± bevacizumab, aplitibart with birinapant, aplitibart with venetoclax, aplitibart with venetoclax and azacitadine, and aplitibart with gemcitabine and docetaxel', 'timeFrame': 'From Cycle 1 Day 1 through 28 days after the final dose of study drug', 'description': 'Incidence of treatment-related AEs graded according to the NCI Common Technology Criteria for Adverse Events (CTCAE) v5.0'}, {'measure': 'Ph1a: To identify the recommended expansion dose for aplitabart as single agent, with FOLFIRI ± bevacizumab, aplitibart with birinapant, aplitibart with venetoclax, aplitibart with venetoclax and azacitadine, and aplitibart with gemcitabine and docetaxel', 'timeFrame': '4 weeks', 'description': 'Relationship between aplitabart dose and safety, PK, activity, and endpoints.'}, {'measure': 'Ph1b: Progression-Free Survival (PFS)', 'timeFrame': 'Study duration of approximately 36 months', 'description': 'PFS is defined as the time from randomization to the first documented disease progression per RECIST 1.1 by investigator or death, whichever occurs first.'}], 'secondaryOutcomes': [{'measure': 'Ph1a and Ph1b: Area Under the Curve (AUC) of aplitabart', 'timeFrame': 'At pre-defined intervals from Cycle 1 Day 1 through end of treatment at approximately 6 months', 'description': 'Area Under the Curve (AUC) of aplitabart as a single agent and in combination with the anticancer agents listed above.'}, {'measure': 'Ph1a and Ph1b: Clearance (CL) of aplitabart', 'timeFrame': 'At pre-defined intervals from Cycle 1 Day 1 through end of treatment at approximately 6 months', 'description': 'Clearance (CL) of aplitabart as a single agent and in combination with the anticancer agents listed above.'}, {'measure': 'Ph1a and Ph1b: Volume of distribution (V) of aplitabart', 'timeFrame': 'At pre-defined intervals from Cycle 1 Day 1 through end of treatment at approximately 6 months', 'description': 'Volume of distribution (V) of aplitabart as a single agent and in combination with the anticancer agents listed above.'}, {'measure': 'Ph1a and Ph1b: Maximum Concentration (c-max) of aplitabart', 'timeFrame': 'At pre-defined intervals from Cycle 1 Day 1 through end of treatment at approximately 6 months', 'description': 'Maximum Concentration of aplitabart as a single agent and in combination with the anticancer agents listed above.'}, {'measure': 'Ph1a and Ph1b: Immunogenicity', 'timeFrame': 'through end of treatment at approximately 6 months', 'description': 'Immunogenicity as assessed by detection of anti-drug antibodies (ADAs) to aplitabart'}, {'measure': 'Ph1a and Ph1b: Objective Response Rate (ORR)', 'timeFrame': 'Study duration of approximately 36 months', 'description': 'Preliminary efficacy of objective response rate (ORR)'}, {'measure': 'Ph1a and Ph1b: Duration of Response (DoR)', 'timeFrame': 'Study duration of approximately 36 months', 'description': 'Preliminary efficacy of duration of response (DoR)'}, {'measure': 'Ph1a: Progression-Free Survival (PFS)', 'timeFrame': 'Study duration of approximately 36 months', 'description': 'PFS is defined as the time from first dose (Ph1a) to the first documented disease progression per RECIST 1.1 by investigator or death, whichever occurs first.'}, {'measure': 'Ph1a and Ph1b: Overall Survival (OS)', 'timeFrame': 'Study duration of approximately 36 months', 'description': 'OS is defined as the time from first dose (Ph1a) or randomization (Ph1b) to death due to any cause'}, {'measure': 'Ph1b: Adverse events of aplitabart + FOLFIRI + bevacizumab', 'timeFrame': 'From Cycle 1 Day 1 through 28 days after the final dose of study drug', 'description': 'Incidence of treatment-related AEs graded according to the NCI Common Technology Criteria for Adverse Events (CTCAE) v5.0'}]}, 'oversightModule': {'isUsExport': False, 'oversightHasDmc': True, 'isFdaRegulatedDrug': True, 'isFdaRegulatedDevice': False}, 'conditionsModule': {'keywords': ['Relapsed and/or Refractory', 'Metastatic Cancer', 'Advanced Tumors', 'Hematological cancer', 'Newly diagnosed'], 'conditions': ['Solid Tumor', 'Colorectal Cancer', 'Non Hodgkin Lymphoma', 'Sarcoma', 'Chondrosarcoma', 'Small Lymphocytic Lymphoma', 'Chronic Lymphocytic Leukemia', 'Acute Myeloid Leukemia']}, 'descriptionModule': {'briefSummary': 'This study is a first-in-human, Phase 1a/1b, multicenter, open-label study to determine the safety, tolerability, and pharmacokinetics of aplitabart as a single agent and in combination in participants with relapsed and/or refractory solid or hematologic cancers, as well as newly diagnosed cancers, and an open-label, randomized study of aplitabart+FOLFIRI+bevacizumab.', 'detailedDescription': "Participants will be enrolled in Phase 1a, which consists of two stages: a dose-escalation stage and an expansion stage. Aplitabart will be used as a single agent and in combination with numerous other agents where standard therapeutic regimens do not exist, have proven to be ineffective or intolerable, or are considered inappropriate.\n\nColorectal participants may be enrolled in Phase 1b, an open-label, randomized study of aplitabart+FOLFIRI+ bevacizumab.\n\nAplitabart will be investigated in numerous tumor types including all-comers solid tumors, colorectal carcinoma (CRC), sarcoma, non-Hodgkin's lymphoma (NHL), acute myeloid leukemia (AML), and chronic lymphocytic leukemia (CLL).\n\nAplitabart will be administered intravenously (IV).\n\nAn alternative dosing schedule may be evaluated."}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'minimumAge': '18 Years', 'healthyVolunteers': False, 'eligibilityCriteria': 'Key Inclusion Criteria:\n\n* Age ≥ 18 years at time of signing ICF\n* ECOG Performance Status of 0 or 1\n* Histologic documentation of incurable, locally advanced or metastatic tumor of the type being evaluated in individual cohorts.\n* Adequate hepatic and renal function and adequate bone marrow reserve function.\n* For combination cohorts, participants must be eligible to receive the chemotherapy or targeted agent.\n* Ph1a only: No more than three prior therapeutic regimens.\n* Ph1b only: Must be FOLFIRI naïve participants and must have received only 1 prior therapeutic regimen administered for the treatment of cancer in the advanced/metastatic setting - OR - FOLFIRI naïve participants that only received adjuvant therapy who progressed within six months after completing adjuvant therapy, and are confirmed to have locally advanced/metastatic disease\n\nKey Exclusion Criteria:\n\n* Inability to comply with study and follow-up procedures.\n* Prior DR5 agonist therapy.\n* Concomitant use of agents well-known to cause liver toxicity.\n* Concomitant use of anti-cancer agents\n* Palliative radiation to bone metastases within 2 weeks prior to Day 1.\n* Major surgical procedure within 4 weeks prior to Day 1.\n* Untreated or active central nervous system (CNS) metastases (progressing or requiring anticonvulsants or corticosteroids for symptomatic control). Participants with a history of treated CNS metastases are eligible.\n* Prior use of any chemotherapeutic agent or small molecule inhibitors (SMI) within 2 weeks or 5 half-lives, prior to the first dose of study treatment\n* Treatment with a monoclonal antibody, or any other anticancer agent (including biologic, experimental, or hormonal therapy) investigational or otherwise, that is not chemotherapy or a SMI, within 4 weeks or five half-lives prior to first dose of study treatment.\n* Ph1b: Participants who have previously received FOLFIRI treatment in the adjuvant, advanced, or metastatic disease setting'}, 'identificationModule': {'nctId': 'NCT04553692', 'briefTitle': 'Phase 1a/1b Study of Aplitabart (IGM-8444) Alone or in Combination in Participants with Relapsed, Refractory, or Newly Diagnosed Cancers', 'organization': {'class': 'INDUSTRY', 'fullName': 'IGM Biosciences, Inc.'}, 'officialTitle': 'An Open-label, Multicenter, Phase 1a/1b Study of Aplitibart (IGM-8444) As a Single Agent and in Combination in Participants with Relapsed, Refractory, or Newly Diagnosed Cancers', 'orgStudyIdInfo': {'id': 'IGM-8444-001'}}, 'armsInterventionsModule': {'armGroups': [{'type': 'EXPERIMENTAL', 'label': 'Ph1a: Aplitabart Single Agent Alternate Dosing Escalation', 'description': 'Aplitabart will be administered intravenously as a single agent on an alternate dosing schedule.', 'interventionNames': ['Drug: Aplitabart (IGM-8444)']}, {'type': 'EXPERIMENTAL', 'label': 'Ph1a: Aplitabart + FOLFIRI ± bevacizumab Escalation and Expansion', 'description': 'Aplitabart will be administered intravenously in combination with FOLFIRI± bevacizumab.', 'interventionNames': ['Drug: Aplitabart (IGM-8444)', 'Drug: FOLFIRI', 'Drug: Bevacizumab (and approved biosimilars)']}, {'type': 'EXPERIMENTAL', 'label': 'Ph1a: Aplitabart + Birinapant Escalation and Expansion', 'description': 'Aplitabart will be administered intravenously in combination with Birinapant which will also be administered intravenously.', 'interventionNames': ['Drug: Aplitabart (IGM-8444)', 'Drug: Birinapant']}, {'type': 'EXPERIMENTAL', 'label': 'Ph1a: Aplitabart + Venetoclax Escalation and Expansion', 'description': 'Aplitabart will be administered intravenously in combination with Venetoclax.', 'interventionNames': ['Drug: Aplitabart (IGM-8444)', 'Drug: Venetoclax']}, {'type': 'EXPERIMENTAL', 'label': 'Ph1a: Aplitabart + Docetaxel + Gemcitabine Escalation and Expansion', 'description': 'Aplitabart will be administered intravenously in combination with Docetaxel and Gemcitabine.', 'interventionNames': ['Drug: Aplitabart (IGM-8444)', 'Drug: Gemcitabine', 'Drug: Docetaxel']}, {'type': 'EXPERIMENTAL', 'label': 'Ph1a: Aplitabart + Venetoclax + Azacitidine Escalation and Expansion', 'description': 'Aplitabart will be administered intravenously in combination with Venetoclax and Azacitidine.', 'interventionNames': ['Drug: Aplitabart (IGM-8444)', 'Drug: Venetoclax', 'Drug: Azacitidine']}, {'type': 'EXPERIMENTAL', 'label': 'Ph1b: Aplitabart + FOLFIRI + Bevacizumab', 'description': 'Aplitabart will be administered intravenously in combination with FOLFIRI + bevacizumab', 'interventionNames': ['Drug: Aplitabart (IGM-8444)', 'Drug: FOLFIRI', 'Drug: Bevacizumab (and approved biosimilars)']}, {'type': 'EXPERIMENTAL', 'label': 'Ph1b: FOLFIRI + Bevacizumab', 'description': 'Standard of Care FOLFIRI + bevacizumab will be administered intravenously', 'interventionNames': ['Drug: FOLFIRI', 'Drug: Bevacizumab (and approved biosimilars)']}], 'interventions': [{'name': 'Aplitabart (IGM-8444)', 'type': 'DRUG', 'description': 'DR5 Agonist Investigational Drug', 'armGroupLabels': ['Ph1a: Aplitabart + Birinapant Escalation and Expansion', 'Ph1a: Aplitabart + Docetaxel + Gemcitabine Escalation and Expansion', 'Ph1a: Aplitabart + FOLFIRI ± bevacizumab Escalation and Expansion', 'Ph1a: Aplitabart + Venetoclax + Azacitidine Escalation and Expansion', 'Ph1a: Aplitabart + Venetoclax Escalation and Expansion', 'Ph1a: Aplitabart Single Agent Alternate Dosing Escalation', 'Ph1b: Aplitabart + FOLFIRI + Bevacizumab']}, {'name': 'FOLFIRI', 'type': 'DRUG', 'otherNames': ['Fluorouracil or 5-FU', 'Leucovorin', 'Irinotecan'], 'description': 'Chemotherapy Regimen', 'armGroupLabels': ['Ph1a: Aplitabart + FOLFIRI ± bevacizumab Escalation and Expansion', 'Ph1b: Aplitabart + FOLFIRI + Bevacizumab', 'Ph1b: FOLFIRI + Bevacizumab']}, {'name': 'Bevacizumab (and approved biosimilars)', 'type': 'DRUG', 'otherNames': ['Avastin'], 'description': 'Targeted Therapy', 'armGroupLabels': ['Ph1a: Aplitabart + FOLFIRI ± bevacizumab Escalation and Expansion', 'Ph1b: Aplitabart + FOLFIRI + Bevacizumab', 'Ph1b: FOLFIRI + Bevacizumab']}, {'name': 'Birinapant', 'type': 'DRUG', 'description': 'SMAC-mimetic Investigational Drug', 'armGroupLabels': ['Ph1a: Aplitabart + Birinapant Escalation and Expansion']}, {'name': 'Venetoclax', 'type': 'DRUG', 'otherNames': ['Venclexta'], 'description': 'Targeted Therapy', 'armGroupLabels': ['Ph1a: Aplitabart + Venetoclax + Azacitidine Escalation and Expansion', 'Ph1a: Aplitabart + Venetoclax Escalation and Expansion']}, {'name': 'Gemcitabine', 'type': 'DRUG', 'otherNames': ['Gemzar'], 'description': 'Chemotherapy', 'armGroupLabels': ['Ph1a: Aplitabart + Docetaxel + Gemcitabine Escalation and Expansion']}, {'name': 'Docetaxel', 'type': 'DRUG', 'otherNames': ['Taxotere', 'Docefrez'], 'description': 'Chemotherapy', 'armGroupLabels': ['Ph1a: Aplitabart + Docetaxel + Gemcitabine Escalation and Expansion']}, {'name': 'Azacitidine', 'type': 'DRUG', 'otherNames': ['VIDAZA'], 'description': 'Chemotherapy', 'armGroupLabels': ['Ph1a: Aplitabart + Venetoclax + Azacitidine Escalation and Expansion']}]}, 'contactsLocationsModule': {'locations': [{'zip': '85054', 'city': 'Phoenix', 'state': 'Arizona', 'country': 'United States', 'facility': 'Mayo Clinic', 'geoPoint': {'lat': 33.44838, 'lon': -112.07404}}, {'zip': '91010', 'city': 'Duarte', 'state': 'California', 'country': 'United States', 'facility': 'City of Hope Comprehensive Cancer Center', 'geoPoint': {'lat': 34.13945, 'lon': -117.97729}}, {'zip': '90720', 'city': 'Los Alamitos', 'state': 'California', 'country': 'United States', 'facility': 'Cancer and Blood Specialty Clinic (CBSC)', 'geoPoint': {'lat': 33.80307, 'lon': -118.07256}}, {'zip': '90033', 'city': 'Los Angeles', 'state': 'California', 'country': 'United States', 'facility': 'USC Norris', 'geoPoint': {'lat': 34.05223, 'lon': -118.24368}}, {'zip': '90404', 'city': 'Los Angeles', 'state': 'California', 'country': 'United States', 'facility': 'UCLA', 'geoPoint': {'lat': 34.05223, 'lon': -118.24368}}, {'zip': '92868', 'city': 'Orange', 'state': 'California', 'country': 'United States', 'facility': 'UC Irvine Manchester Pavilion', 'geoPoint': {'lat': 33.78779, 'lon': -117.85311}}, {'zip': '94143', 'city': 'San Francisco', 'state': 'California', 'country': 'United States', 'facility': 'UCSF', 'geoPoint': {'lat': 37.77493, 'lon': -122.41942}}, {'zip': '80218', 'city': 'Denver', 'state': 'Colorado', 'country': 'United States', 'facility': 'Rocky Mountain Cancer Centers', 'geoPoint': {'lat': 39.73915, 'lon': -104.9847}}, {'zip': '80218', 'city': 'Denver', 'state': 'Colorado', 'country': 'United States', 'facility': 'SCRI at Healthone', 'geoPoint': {'lat': 39.73915, 'lon': -104.9847}}, {'zip': '06510', 'city': 'New Haven', 'state': 'Connecticut', 'country': 'United States', 'facility': 'Yale Cancer Center', 'geoPoint': {'lat': 41.30815, 'lon': -72.92816}}, {'zip': '32224', 'city': 'Jacksonville', 'state': 'Florida', 'country': 'United States', 'facility': 'Mayo Clinic', 'geoPoint': {'lat': 30.33218, 'lon': -81.65565}}, {'zip': '32746', 'city': 'Lake Mary', 'state': 'Florida', 'country': 'United States', 'facility': 'FL Cancer Specialists - Lake Mary', 'geoPoint': {'lat': 28.75888, 'lon': -81.31784}}, {'zip': '33028', 'city': 'Pembroke Pines', 'state': 'Florida', 'country': 'United States', 'facility': 'Memorial Cancer Institute', 'geoPoint': {'lat': 26.00315, 'lon': -80.22394}}, {'zip': '34232', 'city': 'Sarasota', 'state': 'Florida', 'country': 'United States', 'facility': 'Florida Cancer Specialists', 'geoPoint': {'lat': 27.33643, 'lon': -82.53065}}, {'zip': '46804', 'city': 'Fort Wayne', 'state': 'Indiana', 'country': 'United States', 'facility': 'Fort Wayne Medical Oncology and Hematology', 'geoPoint': {'lat': 41.1306, 'lon': -85.12886}}, {'zip': '40241', 'city': 'Louisville', 'state': 'Kentucky', 'country': 'United States', 'facility': 'Norton Cancer Institute', 'geoPoint': {'lat': 38.25424, 'lon': -85.75941}}, {'zip': '70121', 'city': 'Jefferson', 'state': 'Louisiana', 'country': 'United States', 'facility': 'Ochsner Cancer', 'geoPoint': {'lat': 29.96604, 'lon': -90.15313}}, {'zip': '21044', 'city': 'Columbia', 'state': 'Maryland', 'country': 'United States', 'facility': 'Maryland Oncology Hematology, PA - Columbia', 'geoPoint': {'lat': 39.24038, 'lon': -76.83942}}, {'zip': '49546', 'city': 'Grand Rapids', 'state': 'Michigan', 'country': 'United States', 'facility': 'START Midwest', 'geoPoint': {'lat': 42.96336, 'lon': -85.66809}}, {'zip': '55404', 'city': 'Minneapolis', 'state': 'Minnesota', 'country': 'United States', 'facility': 'Minnesota Oncology - Minneapolis Clinic', 'geoPoint': {'lat': 44.97997, 'lon': -93.26384}}, {'zip': '55905', 'city': 'Minneapolis', 'state': 'Minnesota', 'country': 'United States', 'facility': 'Mayo Clinic', 'geoPoint': {'lat': 44.97997, 'lon': -93.26384}}, {'zip': '63110', 'city': 'St Louis', 'state': 'Missouri', 'country': 'United States', 'facility': 'Washington University School of Medicine', 'geoPoint': {'lat': 38.62727, 'lon': -90.19789}}, {'zip': '44718', 'city': 'Canton', 'state': 'Ohio', 'country': 'United States', 'facility': 'Gabrail Cancer Research', 'geoPoint': {'lat': 40.79895, 'lon': -81.37845}}, {'zip': '73104', 'city': 'Oklahoma City', 'state': 'Oklahoma', 'country': 'United States', 'facility': 'Stephenson Cancer 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