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Cyclophosphamide And Doxorubicin (CA) (4 VS 6 Cycles) Versus Paclitaxel (4 VS 6 Cycles) As Adjuvant Therapy For Breast Cancer in Women With 0-3 Positive Axillary Lymph Nodes:A 2X2 Factorial Phase III Randomized Study

Phase 3
18 Years
Open (Enrolling)
Breast Cancer

Thank you

Trial Information

Cyclophosphamide And Doxorubicin (CA) (4 VS 6 Cycles) Versus Paclitaxel (4 VS 6 Cycles) As Adjuvant Therapy For Breast Cancer in Women With 0-3 Positive Axillary Lymph Nodes:A 2X2 Factorial Phase III Randomized Study



- Compare the disease-free survival of women with operable breast cancer and 0-3 positive
axillary lymph nodes treated with two different schedules (4 vs 6 courses) of adjuvant
cyclophosphamide and doxorubicin vs paclitaxel. (Arms II and IV closed to accrual as of

- Compare the disease-free survival of patients treated with these regimens.


- Compare overall survival, local control, and time to distant metastasis in patients
treated with these regimens.

- Compare the toxic effects of these regimens in these patients.

- Compare the effect of these regimens on the induction of menopause in premenopausal

- Determine the discrepancy of myelosuppression in patients with MDR1 haplotypes on the
CA treatment arm.

- Compare the disease-free survival of patients with MDR1 haplotypes treated with these

- Correlate CYP3A5, CYP2C8, and CYP2B6 polymorphisms with disease-free survival and
toxicity in patients treated with these regimens.

OUTLINE: This is a randomized study. Patients are stratified according to menopausal status
(premenopausal vs postmenopausal), estrogen receptor (ER)/progesterone receptor (PR) status
(ER and/or PR positive or unknown vs ER and PR negative), and HER2/neu status (negative vs
unknown vs positive [by immunohistochemistry 3+ staining or gene amplification by
fluorescence in situ hybridization]). Patients are randomized to 1 of 4 treatment arms (arms
II and IV closed to accrual as of 1/30/2008).

- Arm I: Patients receive doxorubicin IV and cyclophosphamide IV on day 1. Treatment
repeats every 14 days for 4 courses.

- Arm II (closed to accrual as of 1/30/2008): Patients receive doxorubicin and
cyclophosphamide as in arm I. Treatment repeats every 14 days for 6 courses.

- Arm III: Patients receive paclitaxel IV over 1 hour on day 1. Treatment repeats every
14 days for 4 courses.

- Arm IV (closed to accrual as of 1/30/2008): Patients receive paclitaxel as in arm III.
Treatment repeats every 14 days for 6 courses.

Treatment in all arms continues in the absence of disease progression or unacceptable

Lumpectomy patients must then undergo radiotherapy. Mastectomy patients undergo radiotherapy
at the discretion of the treating physician.

Patients are followed every 6 months for 2 years and then annually for 15 years.

PROJECTED ACCRUAL: A total of 4,646 patients will be accrued for this study within 29

Inclusion Criteria


- Histologically confirmed invasive carcinoma of the breast with 0-3 positive axillary
lymph nodes

- Meets 1 of the following criteria for node-negative disease:

- Negative sentinel lymph node biopsy

- At least 6 negative axillary lymph nodes removed and determined to be
negative by axillary dissection

- Meets 1 of the following criteria for node-positive disease (1-3 positive
axillary lymph nodes):

- At least 1 positive lymph node by sentinel lymph node biopsy AND at least 6
axillary lymph nodes removed by axillary dissection; of all the nodes
removed from both the sentinel lymph node biopsy and the axillary
dissection, 1-3 must be positive

- At least 6 lymph nodes removed by axillary dissection; 1-3 nodes from the
axillary dissection must be positive

- "High-risk" disease that warrants chemotherapy (ultimately determined by the treating

- Modified radical mastectomy or lumpectomy within the past 84 days required

- Negative tumor margins for invasive cancer and ductal carcinoma in situ (DCIS)

- Lobular carcinoma in situ (LCIS) at the margin allowed

- Multicentric disease allowed provided margins and axillary nodes are negative after

- Bilateral synchronous disease allowed

- Invasive cancer on one side and DCIS or LCIS on the contralateral side is allowed
provided all other eligibility criteria are met

- No locally advanced, inflammatory, or metastatic breast cancer

- No dermal lymphatics involvement, even if there are no clinical signs of inflammatory

- HER2/neu positive, negative, or unknown

- Hormone receptor status:

- Any estrogen and/or progesterone receptor status



- 18 and over


- Female

Menopausal status:

- Premenopausal or postmenopausal

Performance status:

- CTC 0-1

Life expectancy:

- Not specified


- Absolute neutrophil count at least 1,000/mm^3

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


- Bilirubin no greater than 1.5 times upper limit of normal


- Creatinine no greater than 2.0 mg/dL


- No active congestive heart failure

- No myocardial infarction within the past 6 months


- Not pregnant or nursing

- Fertile patients must use effective nonhormonal contraception during and for at least
2 months after study participation

- No other malignancy within the past 5 years except curatively treated basal cell or
squamous cell skin cancer or carcinoma in situ of the cervix


Biologic therapy:

- No prior trastuzumab (Herceptin^®) for this malignancy


- See Disease Characteristics

- No prior chemotherapy for this malignancy

- No other concurrent chemotherapy

Endocrine therapy:

- No prior hormonal therapy for this malignancy except tamoxifen given for up to 4

- Prior tamoxifen or other selective estrogen receptor modulators (SERMs) for
prevention or other indications (e.g., osteoporosis) allowed

- No concurrent exogenous hormonal therapy (including oral contraceptives,
postmenopausal hormone replacement therapy, or raloxifene) except:

- Steroids for adrenal failure

- Hormonal agents for nondisease-related conditions (e.g., insulin for diabetes or
synthroid for hypothyroidism)

- Intermittent dexamethasone as an antiemetic and premedication for paclitaxel

- No concurrent tamoxifen or other SERMs


- See Disease Characteristics


- No concurrent dexrazoxane

- No concurrent raloxifene

- Concurrent bisphosphonates for osteoporosis allowed

- Concurrent trastuzumab (Herceptin^®) allowed for patients with HER2-positive disease

- Concurrent enrollment on adjuvant bisphosphonate studies allowed

- Concurrent enrollment on adjuvant hormonal studies allowed provided hormonal therapy
does not commence until completion of study chemotherapy

Type of Study:


Study Design:

Allocation: Randomized, Primary Purpose: Treatment

Outcome Measure:

Disease-free survival

Safety Issue:


Principal Investigator

Lawrence N. Shulman, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Dana-Farber Cancer Institute


United States: Federal Government

Study ID:




Start Date:

May 2002

Completion Date:

Related Keywords:

  • Breast Cancer
  • stage IB breast cancer
  • stage II breast cancer
  • Breast Neoplasms



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Virginia Piper Cancer Institute at Abbott - Northwestern Hospital Minneapolis, Minnesota  55407
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Sanford Cancer Center at Sanford USD Medical Center Sioux Falls, South Dakota  57117-5039
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Dean Medical Center - Madison Madison, Wisconsin  53717
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Memorial Hospital of South Bend South Bend, Indiana  46601
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Harrington Cancer Center Amarillo, Texas  79106
CCOP - Northern Indiana CR Consortium South Bend, Indiana  46601
Saint Joseph Regional Medical Center South Bend, Indiana  46617
Holden Comprehensive Cancer Center at University of Iowa Iowa City, Iowa  52242-1002
UMASS Memorial Cancer Center - University Campus Worcester, Massachusetts  01605-2982
Ellis Fischel Cancer Center at University of Missouri - Columbia Columbia, Missouri  65203
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center Lebanon, New Hampshire  03756-0002
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill Chapel Hill, North Carolina  27599-7570
CCOP - Columbia River Oncology Program Portland, Oregon  97225
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia Philadelphia, Pennsylvania  19107
MultiCare Regional Cancer Center at Tacoma General Hospital Tacoma, Washington  98405
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Baltimore, Maryland  21231-2410
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MBCCOP - LSU Health Sciences Center New Orleans, Louisiana  70112
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Rebecca and John Moores UCSD Cancer Center La Jolla, California  92093-0658
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John Stoddard Cancer Center at Iowa Methodist Medical Center Des Moines, Iowa  50309
Medical Center of Central Georgia Macon, Georgia  31201
St. Vincent Mercy Medical Center Toledo, Ohio  43608
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Swedish Cancer Institute at Swedish Medical Center - First Hill Campus Seattle, Washington  98104
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Maine Center for Cancer Medicine and Blood Disorders - Scarborough Scarborough, Maine  04074
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Hulston Cancer Center at Cox Medical Center South Springfield, Missouri  65807
St. John's Regional Health Center Springfield, Missouri  65804
Carol G. Simon Cancer Center at Morristown Memorial Hospital Morristown, New Jersey  07962
UMDNJ University Hospital Newark, New Jersey  07103
CCOP - Toledo Community Hospital Toledo, Ohio  43623-3456
Waukesha Memorial Hospital Regional Cancer Center Waukesha, Wisconsin  53188
University of Florida Shands Cancer Center Gainesville, Florida  32610-0232
Florida Hospital Cancer Institute at Florida Hospital Orlando Orlando, Florida  32803-1273
Via Christi Cancer Center at Via Christi Regional Medical Center Wichita, Kansas  67214
Ochsner Cancer Institute at Ochsner Clinic Foundation New Orleans, Louisiana  70121
Albert Einstein Cancer Center at Albert Einstein College of Medicine Bronx, New York  10461
Mount Sinai Medical Center New York, New York  10029
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SUNY Upstate Medical University Hospital Syracuse, New York  13210
Wake Forest University Comprehensive Cancer Center Winston-Salem, North Carolina  27157-1096
Medical University of Ohio Cancer Center Toledo, Ohio  43614
Toledo Hospital Toledo, Ohio  43606
Rhode Island Hospital Comprehensive Cancer Center Providence, Rhode Island  02903
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Carilion Cancer Center of Western Virginia Roanoke, Virginia  24029
Providence Cancer Center at Sacred Heart Medical Center Spokane, Washington  99220-2555
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Lahey Clinic Medical Center - Burlington Burlington, Massachusetts  01805
James P. Wilmot Cancer Center at University of Rochester Medical Center Rochester, New York  14642
Our Lady of Mercy Medical Center Comprehensive Cancer Center Bronx, New York  10466
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Lewistown Hospital Lewistown, Pennsylvania  17044
Mount Nittany Medical Center State College, Pennsylvania  16803
Sibley Memorial Hospital Washington, District of Columbia  20016
Hematology Oncology Associates of the Quad Cities Bettendorf, Iowa  52722
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Batte Cancer Center at Northeast Medical Center Concord, North Carolina  28025
North Colorado Medical Center Greeley, Colorado  80631
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Strecker Cancer Center at Marietta Memorial Hospital Marietta, Ohio  45750
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Community Hospital of Springfield and Clark County Springfield, Ohio  45505
Olympic Hematology and Oncology Bremerton, Washington  98310
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Mercy Capitol Hospital Des Moines, Iowa  50307
Medical Oncology and Hematology Associates at John Stoddard Cancer Center Des Moines, Iowa  50309
Medical Oncology and Hematology Associates at Mercy Cancer Center Des Moines, Iowa  50314
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Cancer Center of Kansas, PA - Dodge City Dodge City, Kansas  67801
St. Francis Comprehensive Cancer Center Topeka, Kansas  66606
Pennington Cancer Center at Baton Rouge General Baton Rouge, Louisiana  70806
Mary Bird Perkins Cancer Center - Baton Rouge Baton Rouge, Louisiana  70809
Medical Center of Louisiana - New Orleans New Orleans, Louisiana  70112
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Community Cancer Center of Monroe Monroe, Michigan  48162
CentraCare Clinic - River Campus St. Cloud, Minnesota  56303
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Saint Francis Cancer Treatment Center at Saint Francis Memorial Health Center Grand Island, Nebraska  68803
Immanuel Medical Center Omaha, Nebraska  68122
Creighton University Medical Center Omaha, Nebraska  68131-2197
Kingsbury Center for Cancer Care at Cheshire Medical Center Keene, New Hampshire  03431
Cancer Institute of New Jersey at Cooper - Voorhees Voorhees, New Jersey  08043
Highland Hospital of Rochester Rochester, New York  14620
Iredell Memorial Hospital Statesville, North Carolina  28677
Bismarck Cancer Center Bismarck, North Dakota  58501
Wood County Oncology Center Bowling Green, Ohio  43402
Samaritan North Cancer Care Center Dayton, Ohio  45415
Grandview Hospital Dayton, Ohio  45405
David L. Rike Cancer Center at Miami Valley Hospital Dayton, Ohio  45409
Good Samaritan Hospital Dayton, Ohio  45406
Blanchard Valley Medical Associates Findlay, Ohio  45840
Charles F. Kettering Memorial Hospital Kettering, Ohio  45429
Lima Memorial Hospital Lima, Ohio  45804
St. Luke's Hospital Maumee, Ohio  43537
Northwest Ohio Oncology Center Maumee, Ohio  43537
Middletown Regional Hospital Middletown, Ohio  45044
Toledo Clinic - Oregon Oregon, Ohio  43616
St. Charles Mercy Hospital Oregon, Ohio  43616
North Coast Cancer Care, Incorporated Sandusky, Ohio  44870
Mercy Medical Center Springfield, Ohio  45504
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Toledo Clinic, Incorporated - Main Clinic Toledo, Ohio  43623
UVMC Cancer Care Center at Upper Valley Medical Center Troy, Ohio  45373-1300
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Cleveland Clinic - Wooster Wooster, Ohio  44691
Ruth G. McMillan Cancer Center at Greene Memorial Hospital Xenia, Ohio  45385
Legacy Mount Hood Medical Center Gresham, Oregon  97030
Providence Milwaukie Hospital Milwaukie, Oregon  97222
Kaiser Permanente Health Care - Portland Portland, Oregon  97232
Providence Cancer Center at Providence Portland Medical Center Portland, Oregon  97213-2967
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Legacy Meridian Park Hospital Tualatin, Oregon  97062
Oncology Services of Aberdeen Aberdeen, South Dakota  57401
Virginia Oncology Associates - Hampton Hampton, Virginia  23666
Minor and James Medical, PLLC Seattle, Washington  98104
Polyclinic First Hill Seattle, Washington  98122
Providence Cancer Center at Holy Family Hospital Spokane, Washington  99207
Southwest Washington Medical Center Cancer Center Vancouver, Washington  98668
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital Yakima, Washington  98902
Holy Family Memorial Medical Center Cancer Care Center Manitowoc, Wisconsin  54221-1450
Welch Cancer Center at Sheridan Memorial Hospital Sheridan, Wyoming  82801
Massachusetts General Hospital Boston, Massachusetts  02114-2617
Fairbanks Cancer Treatment Center at Fairbanks Memorial Hospital Fairbanks, Alaska  99701
St. Anthony Central Hospital Denver, Colorado  80204-1335
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
St. Francis Hospital Federal Way, Washington  98003
Cascade Cancer Center at Evergreen Hospital Medical Center Kirkland, Washington  98034-3013
St. Clare Hospital Lakewood, Washington  98499-0998
Providence St. Peter Hospital Regional Cancer Center Olympia, Washington  98506
Good Samaritan Cancer Center Puyallup, Washington  98371
Valley Medical Center Renton, Washington  98055
Allenmore Hospital Tacoma, Washington  98411-0414
Lancaster General Hospital Lancaster, Pennsylvania  17604-3555
Hembree Mercy Cancer Center at St. Edward Mercy Medical Center Ft. Smith, Arkansas  72903
California Cancer Center - Woodward Park Office Fresno, California  93720
Highland General Hospital Oakland, California  94602
Northeast Georgia Medical Center Gainesville, Georgia  30501
Creticos Cancer Center at Advocate Illinois Masonic Medical Center Chicago, Illinois  60657
Regional Cancer Center at Singing River Hospital Pascagoula, Mississippi  39581
Saint Luke's Hospital Chesterfield, Missouri  63017
Missouri Baptist Cancer Center St. Louis, Missouri  63131
Cancer Resource Center - Lincoln Lincoln, Nebraska  68510
Randolph Hospital Asheboro, North Carolina  27203
Moses Cone Regional Cancer Center at Wesley Long Community Hospital Greensboro, North Carolina  27401
Annie Penn Cancer Center Reidsville, North Carolina  27320
Altru Cancer Center at Altru Hospital Grand Forks, North Dakota  58201
Allegheny Cancer Center at Allegheny General Hospital Pittsburgh, Pennsylvania  15212
St. Joseph Medical Center Reading, Pennsylvania  19604
Midelfort Clinic - Luther Eau Claire, Wisconsin  54702
UAB Comprehensive Cancer Center Birmingham, Alabama  35294
Alta Bates Summit Comprehensive Cancer Center Berkeley, California  94704
Eastern Connecticut Hematology and Oncology Associates Norwich, Connecticut  06360
Tunnell Cancer Center at Beebe Medical Center Lewes, Delaware  19958
Herbert D. Kerman Regional Oncology Center - Daytona Beach Daytona Beach, Florida  32114
Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital Fort Lauderdale, Florida  33308
John B. Amos Cancer Center Columbus, Georgia  31904
Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/Candler Savannah, Georgia  31405
Elkhart Clinic, LLC Elkhart, Indiana  46514-2098
Michiana Hematology-Oncology, PC - South Bend Mishawaka, Indiana  46545-1470
Reid Hospital & Health Care Services Richmond, Indiana  47374
McFarland Clinic, PC Ames, Iowa  50010
Cancer Center of Kansas, PA - Chanute Chanute, Kansas  66720
Cancer Center of Kansas, PA - El Dorado El Dorado, Kansas  67042
Cancer Center of Kansas-Independence Independence, Kansas  67301
Cancer Center of Kansas, PA - Kingman Kingman, Kansas  67068
Lawrence Memorial Hospital Lawrence, Kansas  66044
Cancer Center of Kansas, PA - Newton Newton, Kansas  67114
Menorah Medical Center Overland Park, Kansas  66209
Cancer Center of Kansas, PA - Parsons Parsons, Kansas  67357
Cancer Center of Kansas, PA - Pratt Pratt, Kansas  67124
Cancer Center of Kansas, PA - Salina Salina, Kansas  67401
Shawnee Mission Medical Center Shawnee Mission, Kansas  66204
Cotton-O'Neil Cancer Center Topeka, Kansas  66606
Cancer Center of Kansas, PA - Wellington Wellington, Kansas  67152
Cancer Center of Kansas, PA - Wichita Wichita, Kansas  67214
Associates in Womens Health, PA - North Review Wichita, Kansas  67208
Cancer Center of Kansas, PA - Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas, PA - Winfield Winfield, Kansas  67156
Ochsner Health Center - Bluebonnet Baton Rouge, Louisiana  70809
Union Hospital Cancer Program at Union Hospital Elkton MD, Maryland  21921
Foote Memorial Hospital Jackson, Michigan  49201
Haematology-Oncology Associates of Ohio and Michigan, PC Lambertville, Michigan  48144
St. Mary Mercy Hospital Livonia, Michigan  48154
Mercy Memorial Hospital - Monroe Monroe, Michigan  48162
St. Joseph Mercy Oakland Pontiac, Michigan  48341-2985
Mercy Regional Cancer Center at Mercy Hospital Port Huron, Michigan  48060
Seton Cancer Institute at Saint Mary's - Saginaw Saginaw, Michigan  48601
Lakeside Cancer Specialists, PLLC Saint Joseph, Michigan  49085
St. Luke's Hospital Cancer Care Center Duluth, Minnesota  55805
Fergus Falls Medical Group, PA Fergus Falls, Minnesota  56537
Truman Medical Center - Hospital Hill Kansas City, Missouri  64108
St. Joseph Medical Center Kansas City, Missouri  64114
Heartland Hematology Oncology Associates, Incorporated Kansas City, Missouri  64118
North Kansas City Hospital Kansas City, Missouri  64116
Saint Luke's Cancer Institute at Saint Luke's Hospital Kansas City, Missouri  64111
Research Medical Center Kansas City, Missouri  64132
Heartland Regional Medical Center Saint Joseph, Missouri  64506
Arch Medical Services, Incorporated at Center for Cancer Care and Research Saint Louis, Missouri  63141
Billings Clinic - Downtown Billings, Montana  59107-7000
Bozeman Deaconess Cancer Center Bozeman, Montana  59715
St. James Healthcare Cancer Care Butte, Montana  59701
Great Falls Clinic - Main Facility Great Falls, Montana  59405
Sletten Cancer Institute at Benefis Healthcare Great Falls, Montana  59405
Kalispell Medical Oncology at KRMC Kalispell, Montana  59901
Alegant Health Cancer Center at Bergan Mercy Medical Center Omaha, Nebraska  68124
Leo W. Jenkins Cancer Center at ECU Medical School Greenville, North Carolina  27834
Summa Center for Cancer Care at Akron City Hospital Akron, Ohio  44309-2090
Barberton Citizens Hospital Barberton, Ohio  44203
North Coast Cancer Care - Clyde Clyde, Ohio  43410
Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at Ohio State University Comprehensive Cancer Center Columbus, Ohio  43210-1240
Grant Medical Center Cancer Care Columbus, Ohio  43215
Wayne Hospital Greenville, Ohio  45331
Fisher-Titus Medical Center Norwalk, Ohio  44857
Flower Hospital Cancer Center Sylvania, Ohio  43560
St. Anne Mercy Hospital Toledo, Ohio  43623
Mount Carmel St. Ann's Cancer Center Westerville, Ohio  43081
Clinton Memorial Hospital Wilmington, Ohio  45177
Cleo Craig Cancer Research Clinic Lawton, Oklahoma  73505
Cancer Care Associates - Mercy Campus Oklahoma City, Oklahoma  73120
Adventist Medical Center Portland, Oregon  97216
Legacy Good Samaritan Hospital & Comprehensive Cancer Center Portland, Oregon  97210
Hematology and Oncology Associates of Northeastern Pennsylvania Scranton, Pennsylvania  18510
Fredericksburg Oncology, Incorporated Fredericksburg, Virginia  22401
St. Joseph Cancer Center Bellingham, Washington  98225
Providence Centralia Hospital Centralia, Washington  98531-9027
Columbia Basin Hematology Kennewick, Washington  99336
Harrison Poulsbo Hematology and Onocology Poulsbo, Washington  98370
Evergreen Hematology and Oncology, PS Spokane, Washington  99218
Franciscan Cancer Center at St. Joseph Medical Center Tacoma, Washington  98405-3004
Wenatchee Valley Medical Center Wenatchee, Washington  98801-2028
Marshfield Clinic - Chippewa Center Chippewa Falls, Wisconsin  54729
Marshfield Clinic Cancer Care at Regional Cancer Center Eau Claire, Wisconsin  54701
Vince Lombardi Cancer Center at Aurora Lakeland Medical Center - Elkhorn Elkhorn, Wisconsin  53121
Vince Lombardi Cancer Clinic - Green Bay at Aurora BayCare Medical Center Green Bay, Wisconsin  54311
UW Cancer Center Johnson Creek Johnson Creek, Wisconsin  53038
Vince Lombardi Cancer Clinic - Marinette Marinette, Wisconsin  54143
Saint Joseph's Hospital Marshfield, Wisconsin  54449
Medical Consultants, Limited Milwaukee, Wisconsin  53215
Marshfield Clinic - Lakeland Center Minocqua, Wisconsin  54548
Ministry Medical Group at Saint Mary's Hospital Rhinelander, Wisconsin  54501
Vince Lombardi Cancer Clinic - Sheboygan Sheboygan, Wisconsin  53081
Saint Michael's Hospital Cancer Center Stevens Point, Wisconsin  54481
Aurora Medical Center Summit, Wisconsin  53066
Vince Lombardi Cancer Clinic - Two Rivers Two Rivers, Wisconsin  54241
Marshfield Clinic - Wausau Center Wausau, Wisconsin  54401
Marshfield Clinic - Wisconsin Rapids Center Wisconsin Rapids, Wisconsin  54494
Cancer Resource Center at King's Daughters Medical Center Ashland, Kentucky  41101
Mid Dakota Clinic, PC Bismarck, North Dakota  58501
Regional Cancer Center at Memorial Medical Center Springfield, Illinois  62781-0001
Auburn Regional Center for Cancer Care Auburn, Washington  98002
Memorial Hospital of Rhode Island Pawtucket, Rhode Island  02860
Aurora Sinai Medical Center Milwaukee, Wisconsin  53201-0342
Washington Township Hospital Fremont, California  94538
Lowell General Hospital Lowell, Massachusetts  01854
Caritas Norwood Hospital Norwood, Massachusetts  02062
Good Samaritan Cancer Center at Good Samaritan Hospital Kearney, Nebraska  68848-1990
Elliot Regional Cancer Center at Elliot Hospital Manchester, New Hampshire  03103
Pardee Memorial Hospital Hendersonville, North Carolina  28791
Three Rivers Community Hospital Grants Pass, Oregon  97527
Dubs Cancer Center at Rogue Valley Medical Center Medford, Oregon  97504
Martha Jefferson Hospital Cancer Care Center Charlottesville, Virginia  22901
Regional Cancer Center at Oconomowoc Memorial Hospital Oconomowoc, Wisconsin  53066
Harold Alfond Center for Cancer Care Augusta, Maine  04330
Dana-Farber/Brigham and Women's Cancer Center Boston, Massachusetts  02115
Kinston Medical Specialists Kinston, North Carolina  28501
Miriam Hospital Providence, Rhode Island  02906
St. Francis Hospital Evanston, Illinois  60202
Frederick Memorial Hospital Regional Cancer Therapy Center Frederick, Maryland  21701
St. John's Regional Medical Center Joplin, Missouri  64804
McLeod Regional Medical Center Florence, South Carolina  29501
MBCCOP - Meharry Medical College - Nashville Nashville, Tennessee  37208-3599
Palm Beach Cancer Institute - West Palm Beach West Palm Beach, Florida  33401
Great Falls, Montana  59405
Lakes Region General Hospital Laconia, New Hampshire  03246
Roper St. Francis Cancer Center at Roper Hospital Charleston, South Carolina  29401
Rockwood Clinic Cancer Treatment Center Spokane, Washington  99204-2967
Franklin & Edith Scarpa Regional Cancer Center at South Jersey Healthcare Vineland, New Jersey  08360
Lipson Cancer and Blood Center at Rochester General Hospital Rochester, New York  14621
Center for Cancer Care at OSF Saint Anthony Medical Center Rockford, Illinois  61108
Doctors Medical Center - San Pablo Campus San Pablo, California  94806
St. Vincent Healthcare Cancer Care Services Billings, Montana  59101
Center for Cancer Care and Research at Watson Clinic, LLP Lakeland, Florida  33805
Berkshire Hematology Oncology, PC Pittsfield, Massachusetts  01201
Parvin Radiation Oncology Kansas City, Missouri  64116
Midwest Hematology Oncology Group, Incorporated Saint Louis, Missouri  63109
Lynchburg Hematology-Oncology Clinic Lynchburg, Virginia  24501
Providence Cancer Center at Providence Hospital Mobile, Alabama  36608
East Bay Radiation Oncology Center Castro Valley, California  94546
Contra Costa Regional Medical Center Martinez, California  94553-3156
Tibotec Therapeutics - Division of Ortho Biotech Products, LP Marysville, California  95901
Memorial Medical Center Modesto, California  95355
Tom K Lee, Incorporated Oakland, California  94609
Bay Area Breast Surgeons, Incorporated Oakland, California  94609
Valley Medical Oncology Consultants - Pleasanton Pleasanton, California  94588
Tahoe Forest Cancer Center Truckee, California  96161
Alexian Brothers Radiation Oncology Elk Grove Village, Illinois  60007
Trinity Cancer Center at Trinity Medical Center - 7th Street Campus Moline, Illinois  61265
Iowa Blood and Cancer Care Cedar Rapids, Iowa  52402
Caritas St. Elizabeth's Medical Center Brighton, Massachusetts  02135-2997
Hattiesburg Clinic, PA at Forrest General Hattiesburg, Mississippi  39401
New Hampshire Oncology - Hematology, PA at Payson Center for Cancer Care Concord, New Hampshire  03301
Center for Cancer Care at Exeter Hospital Exeter, New Hampshire  03833
New Hampshire Oncology - Hematology, PA - Hooksett Hooksett, New Hampshire  03106
Faxton Regional Cancer Center Utica, New York  13502
Trinity CancerCare Center Minot, North Dakota  58701
United States Air Force Medical Center - Wright-Patterson Wright-Patterson AFB, Ohio  45433-5529
Franciscan Skemp Healthcare - La Crosse Campus La Crosse, Wisconsin  54601
Saint James Hospital and Health Centers Comprehensive Cancer Institute - Olympia Fields Olympia Fields, Illinois  60461
Medcenter One Hospital Cancer Care Center Bismarck, North Dakota  58501
St. Alexius Medical Center Cancer Center Bismarck, North Dakota  58502
Providence Cancer Center at PMCC Medford, Oregon  97504
Callahan Cancer Center at Great Plains Regional Medical Center North Platte, Nebraska  69103
Regional Medical Center Anniston, Alabama  36202
Valley Medical Oncology Consultants - Castro Valley Castro Valley, California  94546
Valley Medical Oncology Fremont, California  94538
Cancer Care Associates Fresno, California  93720
Mercy Regional Cancer Center at Mercy Medical Center Redding, California  96049
Memorial Hospital Cancer Center - Colorado Springs Colorado Springs, Colorado  80909
Integrated Community Oncology Network - Orange Park Orange Park, Florida  32073
Mount Sinai Hospital Medical Center Chicago, Illinois  60608
Provena St. Mary's Regional Cancer Center - Kankakee Kankakee, Illinois  60901
Heartland Oncology and Hematology Council Bluffs, Iowa  51503
Ochsner Health Center - Covington Covington, Louisiana  70433
Hudner Oncology Center at Saint Anne's Hospital - Fall River Fall River, Massachusetts  02721
Addison Gilbert Hospital Gloucester, Massachusetts  01930
NSMC Cancer Center - Peabody Peabody, Massachusetts  01960
Noble Hospital Westfield, Massachusetts  01085
Immanuel St. Joseph's Mankato, Minnesota  56002
Hematology & Oncology Clinic Hattiesburg, Mississippi  39402
Skaggs Cancer Center at Skaggs Regional Medical Center Branson, Missouri  65616
Dana-Farber Cancer Institute at Londonderry Londonderry, New Hampshire  03053
Fitzpatrick Cancer Center at Champlain Valley Physicians Hospital Medical Center Plattsburgh, New York  12901
Alamance Cancer Center at Alamance Regional Medical Center Burlington, North Carolina  27216
Cape Fear Valley Medical Center Cancer Center Fayetteville, North Carolina  28302-2000
Maria Parham Medical Center Henderson, North Carolina  27536
Southeastern Regional Medical Center Lumberton, North Carolina  28359
Granville Medical Center Oxford, North Carolina  27565
Duke Health Raleigh Hospital Raleigh, North Carolina  27609
Person Memorial Hospital Roxboro, North Carolina  27573
Marion L. Shepard Cancer Center at Beaufort County Hospital Washington, North Carolina  27889
Nashville Oncology Associates, PC Nashville, Tennessee  37203
Virginia Cancer Institute - West End Richmond, Virginia  23230
Luther Midlelfort Hospital Eau Claire, Wisconsin  54702
Mercy Regional Cancer Center Janesville, Wisconsin  53547
Columbia Saint Mary's Hospital - Ozaukee Mequon, Wisconsin  53097
Columbia-Saint Mary's Cancer Care Center Milwaukee, Wisconsin  53211