Know Cancer

or
forgot password

A Randomized Phase III Trial of Three Different Regimens of CPT-11 Plus 5-Fluorouracil and Leucovorin Compared to 5-Fluorouracil and Leucovorin in Patients With Advanced Adenocarcinoma of the Colon and Rectum


Phase 3
18 Years
N/A
Not Enrolling
Both
Colorectal Cancer

Thank you

Trial Information

A Randomized Phase III Trial of Three Different Regimens of CPT-11 Plus 5-Fluorouracil and Leucovorin Compared to 5-Fluorouracil and Leucovorin in Patients With Advanced Adenocarcinoma of the Colon and Rectum


OBJECTIVES:

- Compare the time to progression in patients with locally advanced, locally recurrent,
or metastatic colorectal adenocarcinoma treated with combinations of oxaliplatin,
fluorouracil, leucovorin calcium, and irinotecan.

- Compare the quality of life, response rate, time to treatment failure, and overall
survival in patients treated with these regimens.

- Compare the toxicity of these regimens in these patients.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to ECOG
performance status (0-1 vs 2), prior adjuvant chemotherapy (yes vs no), prior immunotherapy
(yes vs no), and age (under 65 vs 65 and over). Patients are randomized to one of three
treatment arms.

Only arm II remains open to accrual.

- Arm I (Saltz regimen): Patients receive irinotecan IV over 90 minutes followed by
leucovorin calcium IV over 15 minutes and fluorouracil IV once a week for 4 weeks
followed by 2 weeks of rest. Courses repeat every 6 weeks. (Arm I closed to accrual as
of March 15, 2002.)

- Arm II (FOLFOX4 regimen): Patients receive oxaliplatin IV over 2 hours on day 1 and
leucovorin calcium IV over 2 hours plus fluorouracil IV over 22 hours on days 1 and 2.
Courses repeat every 2 weeks.

- Arm III (oxaliplatin plus irinotecan): Patients receive oxaliplatin IV over 2 hours and
irinotecan IV over 30 minutes on day 1. Courses repeat every 3 weeks. (Arm III closed
to accrual as of March 15, 2002.) Treatment continues in the absence of disease
progression or unacceptable toxicity.

Quality of life is assessed before treatment, during treatment (arm specific), and after
completion of treatment.

Patients are followed every 3 months for 1 year, every 6 months for 2 years, and then
annually thereafter.

PROJECTED ACCRUAL: A total of 825 patients (275 per arm) have been accrued for this study
thus far. Additional patients are being accrued on arm II. (Arms I and III closed to accrual
as of March 15, 2002.)

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed locally advanced, locally recurrent, or
metastatic colorectal adenocarcinoma not curable by surgery or radiotherapy

- Histological or cytological requirement waived in patients who developed
radiological or clinical evidence of metastatic cancer after a prior surgical
resection unless:

- More than 5 years has elapsed since primary surgery OR

- Primary cancer was stage I or II

- Site of primary lesion must be or have been confirmed endoscopically, radiologically,
or surgically to be or have been in the large bowel

- Measurable or evaluable disease

- No CNS metastases or carcinomatous meningitis

PATIENT CHARACTERISTICS:

Age:

- 18 and over

Performance status:

- ECOG 0-2

Life expectancy:

- At least 12 weeks

Hematopoietic:

- Absolute granulocyte count at least 1,500/mm^3

- Platelet count at least 100,000/mm^3

- Hemoglobin at least 9.0 g/dL (transfusion allowed)

Hepatic:

- Bilirubin no greater than 1.5 mg/dL

- AST no greater than 5 times upper limit of normal (ULN)

- Alkaline phosphatase no greater than 5 times ULN

Renal:

- Creatinine no greater than 1.5 times ULN

Cardiovascular:

- No uncontrolled hypertension

- No unstable angina

- No symptomatic congestive heart failure

- No myocardial infarction within the past 6 months

- No serious uncontrolled arrhythmia

- No New York Heart Association class III or IV cardiac disease

Pulmonary:

- No interstitial pneumonia or extensive and symptomatic interstitial fibrosis of the
lung

- No pleural effusion or ascites that cause respiratory compromise (grade 2 or worse
dyspnea)

Other:

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- No active or uncontrolled infection

- No symptomatic sensory peripheral neuropathy

- No known allergy to platinum compounds

- No history of gastrointestinal bleeding unless it is determined to be acceptable by
the enrolling physician

- No other prior or concurrent malignancy within the past 3 years except nonmelanoma
skin cancer, carcinoma in situ of the uterine cervix, or other resected malignant
tumor with less than a 10% probability of tumor relapse within 3 years of diagnosis

- No medical or psychiatric conditions that would preclude study

- No colonic or small bowel disorders with uncontrolled symptoms of more than 3 loose
stools per day

- Colostomy or ileostomy allowed at investigator's discretion

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- Prior adjuvant immunotherapy for resected stage II-IV disease allowed if adjuvant
therapy concluded at least 1 year before documentation of recurrent disease

- No concurrent sargramostim (GM-CSF)

Chemotherapy:

- No prior chemotherapy for advanced colorectal cancer

- No prior standard adjuvant chemotherapy for rectal cancer

- Prior adjuvant fluorouracil for resected stage II-IV disease allowed if adjuvant
therapy concluded at least 1 year before documentation of recurrent disease

Endocrine therapy:

- Not specified

Radiotherapy:

- See Disease Characteristics

- At least 4 weeks since prior major radiotherapy (e.g., chest or bone palliative
radiotherapy)

- No prior radiotherapy to more than 15% of bone marrow

- No prior standard adjuvant radiotherapy for rectal cancer

Surgery:

- See Disease Characteristics

- At least 4 weeks since prior major surgery (e.g., laparotomy) (2 weeks for minor
surgery) and recovered

- Insertion of a vascular access device not considered major or minor surgery

Other:

- No other concurrent investigational agents

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Primary Purpose: Treatment

Principal Investigator

Henry C. Pitot, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Mayo Clinic

Authority:

United States: Federal Government

Study ID:

CDR0000066665

NCT ID:

NCT00003594

Start Date:

October 1998

Completion Date:

Related Keywords:

  • Colorectal Cancer
  • stage III colon cancer
  • stage IV colon cancer
  • stage III rectal cancer
  • stage IV rectal cancer
  • recurrent colon cancer
  • recurrent rectal cancer
  • adenocarcinoma of the colon
  • adenocarcinoma of the rectum
  • Adenocarcinoma
  • Colorectal Neoplasms
  • Colonic Neoplasms

Name

Location

Akron City HospitalAkron, Ohio  44304
Arizona Cancer CenterTucson, Arizona  85724
Memorial Sloan-Kettering Cancer CenterNew York, New York  10021
Albert Einstein Comprehensive Cancer CenterBronx, New York  10461
University of Michigan Comprehensive Cancer CenterAnn Arbor, Michigan  48109-0752
Mayo Clinic ScottsdaleScottsdale, Arizona  85259
Mayo Clinic Cancer CenterRochester, Minnesota  55905
Jonsson Comprehensive Cancer Center, UCLALos Angeles, California  90095-1781
Chao Family Comprehensive Cancer CenterOrange, California  92868
Stanford University Medical CenterStanford, California  94305-5408
University of Colorado Cancer CenterDenver, Colorado  80262
Walter Reed Army Medical CenterWashington, District of Columbia  20307-5000
H. Lee Moffitt Cancer Center and Research InstituteTampa, Florida  33612
Emory University Hospital - AtlantaAtlanta, Georgia  30322
University of Chicago Cancer Research CenterChicago, Illinois  60637
Albert B. Chandler Medical Center, University of KentuckyLexington, Kentucky  40536-0084
University of Massachusetts Memorial Medical CenterWorcester, Massachusetts  01655
Barbara Ann Karmanos Cancer InstituteDetroit, Michigan  48201
University of Minnesota Cancer CenterMinneapolis, Minnesota  55455
University of Mississippi Medical CenterJackson, Mississippi  39216-4505
Lineberger Comprehensive Cancer Center, UNCChapel Hill, North Carolina  27599-7295
Duke Comprehensive Cancer CenterDurham, North Carolina  27710
Barrett Cancer Center, The University HospitalCincinnati, Ohio  45219
Ireland Cancer CenterCleveland, Ohio  44106-5065
Arthur G. James Cancer Hospital - Ohio State UniversityColumbus, Ohio  43210
University of Pennsylvania Cancer CenterPhiladelphia, Pennsylvania  19104
CCOP - Upstate CarolinaSpartanburg, South Carolina  29303
Robert H. Lurie Comprehensive Cancer Center, Northwestern UniversityChicago, Illinois  60611
University of California Davis Medical CenterSacramento, California  95817
CCOP - WichitaWichita, Kansas  67214-3882
Rhode Island HospitalProvidence, Rhode Island  02903
University of Texas Health Science Center at San AntonioSan Antonio, Texas  78284-7811
Vermont Cancer CenterBurlington, Vermont  05401-3498
CCOP - Greater PhoenixPhoenix, Arizona  85006-2726
CCOP - Atlanta RegionalAtlanta, Georgia  30342-1701
CCOP - Kansas CityKansas City, Missouri  64131
CCOP - Southern Nevada Cancer Research FoundationLas Vegas, Nevada  89106
University of California San Diego Cancer CenterLa Jolla, California  92093-0658
UCSF Cancer Center and Cancer Research InstituteSan Francisco, California  94115-0128
CCOP - Christiana Care Health ServicesWilmington, Delaware  19899
CCOP - Mount Sinai Medical CenterMiami Beach, Florida  33140
Ellis Fischel Cancer Center - ColumbiaColumbia, Missouri  65203
Barnes-Jewish HospitalSaint Louis, Missouri  63110
Norris Cotton Cancer CenterLebanon, New Hampshire  03756
CCOP - North Shore University HospitalManhasset, New York  11030
State University of New York - Upstate Medical UniversitySyracuse, New York  13210
CCOP - Southeast Cancer Control ConsortiumWinston-Salem, North Carolina  27104-4241
University of Tennessee, Memphis Cancer CenterMemphis, Tennessee  38103
MBCCOP - Massey Cancer CenterRichmond, Virginia  23298-0037
Mount Sinai Medical Center, NYNew York, New York  10029
CCOP - Colorado Cancer Research Program, Inc.Denver, Colorado  80209-5031
Veterans Affairs Medical Center - Atlanta (Decatur)Decatur, Georgia  30033
New England Medical Center HospitalBoston, Massachusetts  02111
CCOP - Metro-MinnesotaSaint Louis Park, Minnesota  55416
Hahnemann University HospitalPhiladelphia, Pennsylvania  19102-1192
Bergan Mercy Medical CenterOmaha, Nebraska  68124
Porter Adventist HospitalDenver, Colorado  80210
St. Joseph HospitalDenver, Colorado  80218
Swedish Medical CenterEnglewood, Colorado  80110
Hinsdale Hematology Oncology AssociatesHinsdale, Illinois  60521
Cedar Rapids Oncology AssociatesCedar Rapids, Iowa  52403
Mercy Medical Center - Sioux CitySioux City, Iowa  51104
St. Luke's Regional Medical CenterSioux City, Iowa  51104
Bronson Methodist HospitalKalamazoo, Michigan  49007
West Michigan Cancer CenterKalamazoo, Michigan  49007-3731
Borgess Medical CenterKalamazooaa, Michigan  49001
Sparrow Regional Cancer CenterLansing, Michigan  48912-1811
St. John Macomb HospitalWarren, Michigan  48093
Fairview Ridges HospitalBurnsville, Minnesota  55337
Hutchinson Area Health CareHutchinson, Minnesota  55350
Meeker County Memorial HospitalLichfield, Minnesota  55355
Hennepin County Medical Center - MinneapolisMinneapolis, Minnesota  55415
United HospitalSt. Paul, Minnesota  55102
Ridgeview Medical CenterWaconia, Minnesota  55387
St. Rita's Medical CenterLima, Ohio  45801
Geisinger Medical CenterDanville, Pennsylvania  17822-0001
Avera Cancer InstituteSioux Falls, South Dakota  57105
Loyola University Medical CenterMaywood, Illinois  60153
Siouxland Hematology-OncologySioux City, Iowa  51101-1733
New York Presbyterian Hospital - Cornell CampusNew York, New York  10021
CCOP - Merit Care HospitalFargo, North Dakota  58122
Altru Health SystemsGrand Forks, North Dakota  58201
Rapid City Regional HospitalRapid City, South Dakota  57709
Holden Comprehensive Cancer Center at The University of IowaIowa City, Iowa  52242-1009
Comprehensive Cancer Center at Wake Forest UniversityWinston-Salem, North Carolina  27157-1082
NYU School of Medicine's Kaplan Comprehensive Cancer CenterNew York, New York  10016
Henry Ford HospitalDetroit, Michigan  48202
Huntsman Cancer InstituteSalt Lake City, Utah  84112
Medical College of WisconsinMilwaukee, Wisconsin  53226
Veterans Affairs Medical Center - BirminghamBirmingham, Alabama  35233
Veterans Affairs Medical Center - Long BeachLong Beach, California  90822
Veterans Affairs Outpatient Clinic - MartinezMartinez, California  94553
CCOP - Bay Area Tumor InstituteOakland, California  94609-3305
CCOP - Santa Rosa Memorial HospitalSanta Rosa, California  95403
David Grant Medical CenterTravis Air Force Base, California  94535
Ingalls Memorial HospitalHarvey, Illinois  60426
Methodist Medical Center of IllinoisPeoria, Illinois  61636
CCOP - Central IllinoisSpringfield, Illinois  62526
Veterans Affairs Medical Center - LexingtonLexington, Kentucky  40511-1093
Tulane University School of MedicineNew Orleans, Louisiana  70112
Veterans Affairs Medical Center - Boston (Jamaica Plain)Jamaica Plain, Massachusetts  02130
Veterans Affairs Medical Center - Ann ArborAnn Arbor, Michigan  48105
St. Mary's Medical CenterSaginaw, Michigan  48601
St. Louis University Health Sciences CenterSaint Louis, Missouri  63110-0250
CCOP - Cancer Research for the OzarksSpringfield, Missouri  65807
CCOP - Montana Cancer ConsortiumBillings, Montana  59101
St. Francis Medical CenterTrenton, New Jersey  08629
Meritcare Roger Maris Cancer CenterFargo, North Dakota  58122
CCOP - ColumbusColumbus, Ohio  43206
Veterans Affairs Medical Center - DaytonDayton, Ohio  45428
CCOP - DaytonKettering, Ohio  45429
CCOP - Columbia River ProgramPortland, Oregon  97213
Lehigh Valley HospitalAllentown, Pennsylvania  18103
Delaware County Memorial HospitalDrexel Hill, Pennsylvania  19026
Albert Einstein Cancer CenterPhiladelphia, Pennsylvania  19141
Reading Hospital and Medical CenterReading, Pennsylvania  19612-6052
Mercy Hospital Cancer Center - ScrantonScranton, Pennsylvania  18501
CCOP - GreenvilleGreenville, South Carolina  29615
University of Texas Medical BranchGalveston, Texas  77555-1329
Veterans Affairs Medical Center - White River JunctionWhite River Junction, Vermont  05009
Swedish Cancer InstituteSeattle, Washington  98104
St. Vincent HospitalGreen Bay, Wisconsin  54307-3508
Veterans Affairs Medical Center - MadisonMadison, Wisconsin  53705
University of Wisconsin Comprehensive Cancer CenterMadison, Wisconsin  53792
Veterans Affairs Medical Center - Milwaukee (Zablocki)Milwaukee, Wisconsin  53295
Waukesha Memorial HospitalWaukesha, Wisconsin  53188
CCOP - EvanstonEvanston, Illinois  60201
MBCCOP - University of New Mexico HSCAlbuquerque, New Mexico  87131
CCOP - Scott and White HospitalTemple, Texas  76508
Veterans Affairs Medical Center - Lakeside ChicagoChicago, Illinois  60611
Veterans Affairs Medical Center - New YorkNew York, New York  10010
CCOP - Marshfield Medical Research and Education FoundationMarshfield, Wisconsin  54449
Dana-Farber Cancer InstituteBoston, Massachusetts  02115
Baptist Regional Cancer Institute - JacksonvilleJacksonville, Florida  32207
Cancer Research Center of HawaiiHonolulu, Hawaii  96813
Virginia Piper Cancer InstituteMinneapolis, Minnesota  55407
Cleveland Clinic Taussig Cancer CenterCleveland, Ohio  44195
MBCCOP - Gulf CoastMobile, Alabama  36688
Veterans Affairs Medical Center - TucsonTucson, Arizona  85723
University of Arkansas for Medical SciencesLittle Rock, Arkansas  72205
Veterans Affairs Medical Center - Little Rock (McClellan)Little Rock, Arkansas  72205
Cancer Center and Beckman Research Institute, City of HopeDuarte, California  91010-3000
Veterans Affairs Medical Center - West Los AngelesLos Angeles, California  90073
USC/Norris Comprehensive Cancer Center and HospitalLos Angeles, California  90033-0804
Veterans Affairs Medical Center - DenverDenver, Colorado  80220
Dwight David Eisenhower Army Medical CenterFort Gordon, Georgia  30905-5650
Veterans Affairs Medical Center - Chicago (Westside Hospital)Chicago, Illinois  60612
Veterans Affairs Medical Center - Hines (Hines Junior VA Hospital)Hines, Illinois  60141
University of Kansas Medical CenterKansas City, Kansas  66160-7353
Veterans Affairs Medical Center - WichitaWichita, Kansas  67218
MBCCOP - LSU Health Sciences CenterNew Orleans, Louisiana  70112
Louisiana State University Health Sciences Center - ShreveportShreveport, Louisiana  71130-3932
Veterans Affairs Medical Center - ShreveportShreveport, Louisiana  71130
Boston Medical CenterBoston, Massachusetts  02118
Veterans Affairs Medical Center - DetroitDetroit, Michigan  48201-1932
Providence Hospital - SouthfieldSouthfield, Michigan  48075-9975
Veterans Affairs Medical Center - BiloxiBiloxi, Mississippi  39531-2410
Veterans Affairs Medical Center - JacksonJackson, Mississippi  39216
Keesler Medical Center - Keesler AFBKeesler AFB, Mississippi  39534-2576
Veterans Affairs Medical Center - Kansas CityKansas City, Missouri  64128
CCOP - St. Louis-Cape GirardeauSaint Louis, Missouri  63141
Veterans Affairs Medical Center - AlbuquerqueAlbuquerque, New Mexico  87108-5138
Herbert Irving Comprehensive Cancer CenterNew York, New York  10032
Veterans Affairs Medical Center - CincinnatiCincinnati, Ohio  45220-2288
Oklahoma Medical Research FoundationOklahoma City, Oklahoma  73104
Veterans Affairs Medical Center - Oklahoma CityOklahoma City, Oklahoma  73104
Veterans Affairs Medical Center - PortlandPortland, Oregon  97207
Brooke Army Medical CenterFort Sam Houston, Texas  78234-6200
Veterans Affairs Medical Center - San Antonio (Murphy)San Antonio, Texas  78284
Veterans Affairs Medical Center - TempleTemple, Texas  76504
Veterans Affairs Medical Center - Salt Lake CitySalt Lake City, Utah  84148
CCOP - Virginia Mason Research CenterSeattle, Washington  98101
Veterans Affairs Medical Center - SeattleSeattle, Washington  98108
CCOP - NorthwestTacoma, Washington  98405-0986
Madigan Army Medical CenterTacoma, Washington  98431-5048
Veterans Affairs Medical Center - Phoenix (Hayden)Phoenix, Arizona  85012
CCOP - Grand Rapids Clinical Oncology ProgramGrand Rapids, Michigan  49503
Veterans Affairs Medical Center - San FranciscoSan Francisco, California  94121
CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C.Syracuse, New York  13217
Aultman Cancer CenterCanton, Ohio  44710
CCOP - OklahomaTulsa, Oklahoma  74136
Oregon Cancer CenterPortland, Oregon  97201-3098
Veterans Affairs Medical Center - MemphisMemphis, Tennessee  38104
Veterans Affairs Medical Center - RichmondRichmond, Virginia  23249
Trinitas Hospital - Jersey Street CampusElizabeth, New Jersey  07201
South Jersey Regional Cancer CenterMillville, New Jersey  08332
Fox Chase Cancer Center at Virtua Memorial Hospital Burlington CountyMount Holly, New Jersey  08060
Cancer Institute of New JerseyNew Brunswick, New Jersey  08901
Veterans Affairs Medical Center - TogusTogus, Maine  04330
Veterans Affairs Medical Center - MinneapolisMinneapolis, Minnesota  55417
Veterans Affairs Medical Center - Columbia (Truman Memorial)Columbia, Missouri  65201
University of Nebraska Medical CenterOmaha, Nebraska  68198-3330
Hunterdon Regional Cancer CenterFlemington, New Jersey  08822
Veterans Affairs Medical Center - BuffaloBuffalo, New York  14215
Veterans Affairs Medical Center - SyracuseSyracuse, New York  13210
Veterans Affairs Medical Center - DurhamDurham, North Carolina  27705
Veterans Affairs Medical Center - Palo AltoPalo Alto, California  94304
Via Christi Regional Medical CenterWichita, Kansas  67214
St. John Hospital and Medical CenterDetroit, Michigan  48236
Iowa Methodist Medical CenterDes Moines, Iowa  50309
Mercy Medical CenterDes Moines, Iowa  50314
Iowa Lutheran HospitalDes Moines, Iowa  50316-2301
Alegent Health-Midlands Community HospitalPapillion, Nebraska  68128-4157
Presbyterian-St Luke's Medical CenterDenver, Colorado  80218
University of Connecticut Health CenterFarmington, Connecticut  06360-7106
St. Vincent Mercy Medical CenterToledo, Ohio  43608
Sioux Valley HospitalSioux Falls, South Dakota  57117
Gundersen Lutheran Medical CenterLa Crosse, Wisconsin  54601
Creighton University Cancer CenterOmaha, Nebraska  68131-2197
St. Mary's/Duluth Clinic Health SystemDuluth, Minnesota  55805
New Britain General HospitalNew Britain, Connecticut  06050
Toledo HospitalToledo, Ohio  43606
Chester County HospitalWest Chester, Pennsylvania  19380
Oncology Institute of Greater LafayetteLafayette, Indiana  47904
Hematology Oncology Associates of the Quad CitiesBettendorf, Iowa  52722
Cancer Center of Kansas - ChanuteChanute, Kansas  66720
Cancer Center of Kansas - Dodge CityDodge City, Kansas  67801
Cancer Center of Kansas - KingmanKingman, Kansas  67068
Cancer Center of Kansas - NewtonNewton, Kansas  67114
Pratt Cancer Center of KansasPratt, Kansas  67124
Cancer Center of Kansas - SalinaSalina, Kansas  67042
Cancer Center of Kansas - WellingtonWellington, Kansas  67152
Cancer Center of Kansas - WinfieldWinfield, Kansas  67156
Avera McKennan Hospital and University Health CenterSioux Falls, South Dakota  57105
Duluth ClinicDuluth, Minnesota  55805
Riverview Medical Center - Booker Cancer CenterRed Bank, New Jersey  07701
Schneider Children's Hospital at North ShoreManhasset, New York  11030
Mayo ClinicJacksonville, Florida  32224
Medcenter One Health SystemBismarck, North Dakota  58501
Oncology/Hematology Associates of Central Illinois, P.C.Peoria, Illinois  61602
Meriter HospitalMadison, Wisconsin  53715
Saint Mary Regional CenterLanghorne, Pennsylvania  19047
CentraCare Health PlazaSaint Cloud, Minnesota  56303
St. Francis Hospital and Medical CenterHartford, Connecticut  06105
Rochester General HospitalRochester, New York  14621
Hematology Oncology Associates - SkokieSkokie, Illinois  60076
Poudre Valley HospitalFort Collins, Colorado  80524
St. Mary-Corwin Regional Medical CenterPueblo, Colorado  81004
Memorial HospitalCarthage, Illinois  62321
Mercy Hospital and Medical CenterChicago, Illinois  60616
Galesburg Cottage HospitalGalesburg, Illinois  61401
Galesburg ClinicGalesburg, Illinois  61401
InterCommunity Cancer Center of Western IllinoisGalesburg, Illinois  61401
Mason District HospitalHavana, Illinois  62644
Kewanee HospitalKewanee, Illinois  61443
McDonough District HospitalMacomb, Illinois  61455
BroMenn Regional Medical CenterNormal, Illinois  61761
Community Cancer CenterNormal, Illinois  61761
Community Hospital of OttawaOttawa, Illinois  61350
Proctor HospitalPeoria, Illinois  61614
Illinois Valley Community HospitalPeru, Illinois  61354
Perry Memorial HospitalPrinceton, Illinois  61356
St. Margaret's HospitalSpring Valley, Illinois  61362
Valley Cancer CenterSpring Valley, Illinois  61362
St. Luke's HospitalCedar Rapids, Iowa  52402
Burgess Health CenterOnawa, Iowa  51040
Community Cancer Center of MonroeMonroe, Michigan  48162
Brainerd Medical CenterBrainerd, Minnesota  56401
St. Joseph's Medical CenterBrainerd, Minnesota  56401
St. Elizabeth Regional Medical CenterLincoln, Nebraska  68510
Bismarck Cancer CenterBismarck, North Dakota  58501
St. Alexius Medical CenterBismarck, North Dakota  58502
Wood County Oncology CenterBowling Green, Ohio  43402
Fremont Memorial HospitalFremont, Ohio  43420
Lima Memorial HospitalLima, Ohio  45804
Firelands Regional Medical CenterSandusky, Ohio  44870
Fulton County Health CenterWauseon, Ohio  43567
Veterans Affairs Medical Center - OmahaOmaha, Nebraska  68105
Illinois Oncology Research AssociationPeoria, Illinois  61602
North Memorial Research CenterMinneapolis, Minnesota  55442-2900
University of Florida - GainesvilleGainesville, Florida  32610-0277
Eureka HospitalEureka, Illinois  61530
Mercy HospitalCoon Rapids, Minnesota  55433
Park Nicollet ClinicSt. Louis Park, Minnesota  55416
Mayo Clinic HospitalPhoenix, Arizona  85054-4502
Community Hospital of the Monterey PeninsulaMonterey, California  93940
Columbia Medical Center of Aurora North CampusAurora, Colorado  80011
Penrose Cancer CenterColorado Springs, Colorado  80933
HealthOne Rose Medical CenterDenver, Colorado  80220
Rocky Mountain Cancer Centers - Northern ColoradoFort Collins, Colorado  80524-4038
Poudre Valley Radiation OncologyFort Collins, Colorado  80528
Bristol HospitalBristol, Connecticut  06011-0977
Lawrence and Memorial HospitalNew London, Connecticut  06320
William W. Backus HospitalNorwich, Connecticut  06360
Northwestern Connecticut Oncology-Hematology AssociatesTorrington, Connecticut  06790
University of Florida Health Science Center - JacksonvilleJacksonville, Florida  32209
Grady Memorial HospitalAtlanta, Georgia  30335
BroMenn Lifecare CenterBloomington, Illinois  61701-3081
St. Joseph's Hospital Medical CenterBloomington, Illinois  61701
Graham Hospital AssociationCanton, Illinois  61520
Hematology-Oncology Associates of IllinoisChicago, Illinois  60611-2998
Hematology Oncology Associates of Illinois - Lake Shore DrChicago, Illinois  60611
Holy Family Medical CenterDes Plaines, Illinois  60016
St. Anthony's Memorial HospitalEffingham, Illinois  62401
Northwest Oncology and Hematology, S.C.Elk Grove Village, Illinois  60007
Glenbrook HospitalGlenview, Illinois  60025
Hematology Oncology Associates of Illinois-Highland ParkHighland Park, Illinois  60035
Hopedale Medical Complex HospitalHopedale, Illinois  61747
Joliet Oncology/Hematology Associates, Ltd.Joliet, Illinois  60435
Silver Cross HospitalJoliet, Illinois  60432
Saint Joseph Medical CenterJoliet, Illinois  60435
Deerpath Medical AssociatesLake Forest, Illinois  60045
North Shore Oncology Hematology AssociatesLibertyville, Illinois  60048
Hematology/Oncology Associates of Illinois, LLCMelrose Park, Illinois  60160
Mendota Community HospitalMendota, Illinois  61342
Trinity Medical CenterMoline, Illinois  61265-1291
Morris HospitalMorris, Illinois  60450
Hematology Oncology Associates of Illinois, LLCOak Park, Illinois  60304
Pekin HospitalPekin, Illinois  61554
Midwest Radiation Oncology PhysiciansPeoria, Illinois  61636
Peoria Urological AssociatesPeoria, Illinois  61614
Midwest Urological GroupPeoria, Illinois  61603
Affiliated Urology SpecialistsPeoria, Illinois  61603
St. Francis Medical CenterPeoria, Illinois  61637
St. James HospitalPontiac, Illinois  61764
Swedish-American Health SystemRockford, Illinois  61104-2315
Sarah D. Culbertson Memorial HospitalRushville, Illinois  62681
Midwest Cancer Research Group, Inc.Skokie, Illinois  60077
Edward H. Kaplan MD and AssociatesSkokie, Illinois  60076
Carle Foundation HospitalUrbana, Illinois  61801
Carle Cancer CenterUrbana, Illinois  61801
Therapy Associates Hematology/OncologyEvansville, Indiana  47715
William R. Bliss Cancer CenterAmes, Iowa  50010
McFarland Clinic, P.C.Ames, Iowa  50010
Saint Anthony Regional HospitalCarroll, Iowa  51401
Alegent Health Southwest Iowa Medical CenterCouncil Bluffs, Iowa  51503
Medical Oncology and Hematology AssociatesDes Moines, Iowa  50309
Mercy Hospital Medical CenterDes Moines, Iowa  50314
Des Moines General HospitalDes Moines, Iowa  50309
Mercy Cancer CenterMason City, Iowa  50401
Community Memorial HospitalMissouri Valley, Iowa  51555-1199
Ottumwa Regional Health CenterOttumwa, Iowa  52501
Oncology & Hematology of Ottumwa, PCOttumwa, Iowa  52501
Cancer Center of Kansas - Arkansas CityArkansas City, Kansas  67005
Radiation Oncology CenterDodge City, Kansas  67801
Halstead Cancer Center of KansasHalstead, Kansas  67056
Liberal Cancer Center of KansasLiberal, Kansas  67901
Wichita Clinic Cancer Medicine Associates, P.A.Wichita, Kansas  67208
Associates in Women's Health - WichitaWichita, Kansas  67208
Cancer Center of Kansas - WichitaWichita, Kansas  67214
Anne Arundel Medical CenterAnnapolis, Maryland  21401
Faulkner HospitalJamaica Plain, Massachusetts  02130
Lawrence Memorial Hospital of Medford/Hallmark Health SystemsMedford, Massachusetts  02155
Morton Hospital & Medical CenterTaunton, Massachusetts  02780
Bixby Medical CenterAdrian, Michigan  49221
Saint Joseph Mercy HospitalAnn Arbor, Michigan  48106
Genesee Regional Medical CenterFlint, Michigan  48503
Office of E. Michael LodishMadison Heights, Michigan  48071-3457
Balcueva ClinicSaginaw, Michigan  48602
Alexandria ClinicAlexandria, Minnesota  56308
Alexandria Radiation OncologyAlexandria, Minnesota  56308
Miller-Dwan Medical CenterDuluth, Minnesota  55805
Fairview-Southdale HospitalEdina, Minnesota  55435
Fergus Falls Medical GroupFergus Falls, Minnesota  56537
Mercy/Unity HospitalsFridley, Minnesota  55432
Duluth Clinic - HibbingHibbing, Minnesota  55746
Central Mesabi Medical CenterHibbing, Minnesota  55746
Radiation Therapy CenterHibbing, Minnesota  55746
St. John's HospitalMaplewood, Minnesota  55109
Fairview University Medical Center - Riverside CampusMinneapolis, Minnesota  55454-1395
Abbott-Northwestern HospitalMinneapolis, Minnesota  55407
St. Cloud HospitalSaint Cloud, Minnesota  56303
Regions HospitalSaint Paul, Minnesota  55101
Healtheast Cancer CareSaint Paul, Minnesota  55102
Saint Francis Regional Medical CenterShakopee, Minnesota  55379
Rice Memorial HospitalWillmar, Minnesota  56201
Fremont Area Medical CenterFremont, Nebraska  68025-2387
Williamsburg Radiation Oncology CenterLincoln, Nebraska  68516
Bryan LGH Medical CenterLincoln, Nebraska  68502-3780
Bryan LGH Medical Center EastLincoln, Nebraska  68506
Office of Susan Hansen, M.D.Lincoln, Nebraska  68506
Prairie View ClinicLincoln, Nebraska  68506-5247
Southeast Nebraska HematologyLincoln, Nebraska  68516
Southeast Nebreska Hematology-Oncology Consultants, PCLincoln, Nebraska  68516
Wedgewood Medical CenterLincoln, Nebraska  68510
Alegent Health - Immanuel Medical CenterOmaha, Nebraska  68122
St. Joseph HospitalOmaha, Nebraska  68131-2197
Oncology Hematology West, P.C.Omaha, Nebraska  68114
Center for Cancer And Hematologic DiseaseCherry Hill, New Jersey  08046
Southern Oncology-Hematology Associates, P.A.Vineland, New Jersey  08360
Comprehensive Cancer and Hematology AssociatesVoorhees, New Jersey  08043
Burlington County Hematology Oncology Association, P.A.Willingboro, New Jersey  08046
Mary Imogene Bassett HospitalCooperstown, New York  13326
Mid Dakota Clinic, P.C.Bismarck, North Dakota  58501
Altru Cancer CenterGrand Forks, North Dakota  58206
Mercy Ireland Cancer CenterCanton, Ohio  44708
Woman Wise Blanchard Valley Regional Health CenterFindlay, Ohio  45840
Office of Sharon Cole, M.D.Kenton, Ohio  43326
Saint Luke's HospitalMaumee, Ohio  43537
North West Ohio Oncology CenterMaumee, Ohio  43537
St. Charles HospitalOregon, Ohio  43616
North Coast Cancer Care, Inc.Sandusky, Ohio  44870
Flower Hospital - Pro Medica Health SystemSylvania, Ohio  43560
Haematology-Oncology Associates, Inc.Toledo, Ohio  43623-4474
Riverside HospitalToledo, Ohio  43604
Toledo Clinic, Inc.Toledo, Ohio  43623
MCO Cancer InstituteToledo, Ohio  43614
Medical College of Ohio HospitalToledo, Ohio  43614-0008
Muhlenberg Hospital CenterBethlehem, Pennsylvania  18017
Marion Community HospitalCarbondale, Pennsylvania  18407
DuBois Regional Medical CenterDuBois, Pennsylvania  15801-0447
UPMC HorizonGreenville, Pennsylvania  16125
Pinnacle Health HospitalsHarrisburg, Pennsylvania  17105-8700
Wayne Memorial HospitalHonesdale, Pennsylvania  18431-1498
Conemaugh Memorial HospitalJohnstown, Pennsylvania  15905
UPCI @ UPMC Lee HospitalJohnstown, Pennsylvania  15901
Armstrong County Memorial HospitalKittanning, Pennsylvania  16201-8808
Lancaster General HospitalLancaster, Pennsylvania  17604-3555
Latrobe Area HospitalLatrobe, Pennsylvania  15650
Central Pennsylvania Hematology and Medical Oncology AssociatesLemoyne, Pennsylvania  17043
Magee-Womens HospitalPittsburgh, Pennsylvania  15213-3180
UPMC/Passavant HospitalPittsburgh, Pennsylvania  15237
University of Pittsburgh Medical CenterPittsburgh, Pennsylvania  15213
Pottstown Memorial Regional Cancer CenterPottstown, Pennsylvania  19464
Scranton Hematology-OncologyScranton, Pennsylvania  18510
Moses Taylor HospitalScranton, Pennsylvania  18510
Geisinger Medical GroupState College, Pennsylvania  16801
Geisinger Wyoming Valley Medical CenterWilkes-Barre, Pennsylvania  18711
Sioux Valley ClinicSioux Falls, South Dakota  57104
Fox Valley Hematology and OncologyAppleton, Wisconsin  54911
Memorial Medical CenterAshland, Wisconsin  54806
Luther HospitalEau Claire, Wisconsin  54703
Midelfort ClinicEau Claire, Wisconsin  54703
Franciscan Skemp HealthcareLa Crosse, Wisconsin  54601-4796
Dean Medical CenterMadison, Wisconsin  53715
Aurora Sinai Samaritan Medical CenterMilwaukee, Wisconsin  53201-0342
Oconomowoc Memorial HospitalOconomowoc, Wisconsin  53066
UW Cancer Center Wausau HospitalWausau, Wisconsin  54401