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Randomized Phase III Trial of Cisplatin (NSC-119875) and Irinotecan (NSC-616348) Versus Cisplatin and Etoposide (NSC-141540) in Patients With Extensive Stage Small Cell Lung Cancer (E-SCLC)


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

Thank you

Trial Information

Randomized Phase III Trial of Cisplatin (NSC-119875) and Irinotecan (NSC-616348) Versus Cisplatin and Etoposide (NSC-141540) in Patients With Extensive Stage Small Cell Lung Cancer (E-SCLC)


OBJECTIVES:

- Compare the survival of patients with extensive stage small cell lung cancer treated
with cisplatin and irinotecan vs cisplatin and etoposide.

- Compare the objective response rate and progression-free survival of patients treated
with these regimens.

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

- Determine the association between UGT1A1 polymorphisms and irinotecan-associated toxic
effects in these patients.

- Determine the association between ERCC-1 and XRCC-1 polymorphisms and non-response of
patients treated with these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to
number of metastatic sites (single vs multiple), lactic dehydrogenase (no greater than upper
limit of normal (ULN) vs greater than ULN), and weight loss in the past 6 months (5% or less
vs more than 5%). Patients are randomized to 1 of 2 treatment arms.

- Arm I: Patients receive irinotecan IV over 90 minutes on days 1, 8, and 15 and
cisplatin IV over 30-60 minutes on day 1. Courses repeat every 4 weeks.

- Arm II: Patients receive etoposide IV over 30-60 minutes on days 1-3 and cisplatin IV
over 30-60 minutes on day 1. Courses repeat every 3 weeks.

Treatment in both arms continues for 4 courses in the absence of disease progression or
unacceptable toxicity.

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

PROJECTED ACCRUAL: A total of 620 patients (310 per treatment arm) will be accrued for this
study within 4 years.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed extensive stage small cell lung cancer
(SCLC)

- Measurable or evaluable disease by CT scan, MRI, x-ray, physical exam, or nuclear
exam

- Brain metastases allowed if previously treated with radiotherapy and/or surgery and
are neurologically stable (i.e., no progressing symptoms and off steroids and
anticonvulsants)

PATIENT CHARACTERISTICS:

Age

- 18 and over

Performance status

- Zubrod 0-1

Life expectancy

- Not specified

Hematopoietic

- WBC at least 3,000/mm^3

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

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

Hepatic

- Bilirubin no greater than 1.5 times upper limit of normal (ULN)

- AST or ALT no greater than 2.5 times ULN

Renal

- Creatinine normal

- Creatinine clearance at least 50 mL/min

Other

- Not pregnant or nursing

- Fertile patients must use effective contraception

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

- HIV negative

- No concurrent AIDS-related illness

PRIOR CONCURRENT THERAPY:

Biologic therapy

- No prior biologic therapy for SCLC

- No filgrastim (G-CSF) within 24 hours of chemotherapy

Chemotherapy

- No prior systemic chemotherapy for SCLC

Endocrine therapy

- See Disease Characteristics

Radiotherapy

- See Disease Characteristics

- At least 21 days since prior brain radiotherapy and recovered

- No other prior radiotherapy for SCLC

Surgery

- See Disease Characteristics

- At least 21 days since prior thoracic or other major surgery and recovered

Other

- No concurrent enzyme inducing antiepileptic drugs (phenytoin, phenobarbital,
oxcarboxepine, or carbamazepine)

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Survival

Outcome Description:

To compare the survival of patients with extensive stage small cell lung cancer (E-SCLC) treated with cisplatin and irinotecan versus cisplatin and etoposide.

Outcome Time Frame:

0-3 years or until death

Safety Issue:

No

Principal Investigator

Ronald B. Natale, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Cedars-Sinai Medical Center

Authority:

United States: Federal Government

Study ID:

CDR0000256908

NCT ID:

NCT00045162

Start Date:

November 2002

Completion Date:

December 2009

Related Keywords:

  • Lung Cancer
  • extensive stage small cell lung cancer
  • Lung Neoplasms
  • Small Cell Lung Carcinoma

Name

Location

Fred Hutchinson Cancer Research CenterSeattle, Washington  98109
Mayo Clinic ScottsdaleScottsdale, Arizona  85259
Mayo Clinic Cancer CenterRochester, Minnesota  55905
Cardinal Bernardin Cancer Center at Loyola University Medical CenterMaywood, Illinois  60153-5500
University of Mississippi Medical CenterJackson, Mississippi  39216-4505
CCOP - Upstate CarolinaSpartanburg, South Carolina  29303
Tripler Army Medical CenterHonolulu, Hawaii  96859-5000
CCOP - WichitaWichita, Kansas  67214-3882
Hurley Medical CenterFlint, Michigan  48503
Medical City Dallas HospitalDallas, Texas  75230
University of Texas Health Science Center at San AntonioSan Antonio, Texas  78284-7811
CCOP - Atlanta RegionalAtlanta, Georgia  30342-1701
CCOP - Kansas CityKansas City, Missouri  64131
CCOP - Missouri Valley Cancer ConsortiumOmaha, Nebraska  68131
CCOP - North Shore University HospitalManhasset, New York  11030
CCOP - Carle Cancer CenterUrbana, Illinois  61801
CCOP - Iowa Oncology Research AssociationDes Moines, Iowa  50309-1016
CCOP - Metro-MinnesotaSaint Louis Park, Minnesota  55416
Rush-Copley Cancer Care CenterAurora, Illinois  60507
Joliet Oncology-Hematology Associates, Limited - WestJoliet, Illinois  60435
Carle Cancer Center at Carle Foundation HospitalUrbana, Illinois  61801
Saint Anthony Memorial Health CentersMichigan City, Indiana  46360
Cedar Rapids Oncology AssociatesCedar Rapids, Iowa  52403
Mercy Medical Center - Sioux CitySioux City, Iowa  51104
Siouxland Hematology-Oncology Associates, LLPSioux City, Iowa  51101
St. Luke's Regional Medical CenterSioux City, Iowa  51104
CCOP - Michigan Cancer Research ConsortiumAnn Arbor, Michigan  48106
Saint Joseph Mercy Cancer CenterAnn Arbor, Michigan  48106-0995
Genesys Hurley Cancer InstituteFlint, Michigan  48503
Van Elslander Cancer Center at St. John Hospital and Medical CenterGrosse Pointe Woods, Michigan  48236
Foote HospitalJackson, Michigan  49201
Bronson Methodist HospitalKalamazoo, Michigan  49007
West Michigan Cancer CenterKalamazoo, Michigan  49007-3731
Borgess Medical CenterKalamazooaa, Michigan  49001
Sparrow Regional Cancer CenterLansing, Michigan  48912-1811
Seton Cancer Institute - SaginawSaginaw, Michigan  48601
St. John Macomb HospitalWarren, Michigan  48093
Fairview Ridges HospitalBurnsville, Minnesota  55337
Mercy and Unity Cancer Center at Mercy HospitalCoon Rapids, Minnesota  55433
CCOP - DuluthDuluth, Minnesota  55805
Fairview Southdale HospitalEdina, Minnesota  55435
Mercy and Unity Cancer Center at Unity HospitalFridley, Minnesota  55432
Hutchinson Area Health CareHutchinson, Minnesota  55350
Meeker County Memorial HospitalLichfield, Minnesota  55355
HealthEast Cancer Care at St. John's HospitalMaplewood, Minnesota  55109
Hennepin County Medical Center - MinneapolisMinneapolis, Minnesota  55415
Regions Hospital Cancer Care CenterSt. Paul, Minnesota  55101
United HospitalSt. Paul, Minnesota  55102
Ridgeview Medical CenterWaconia, Minnesota  55387
Minnesota Oncology Hematology, PA - WoodburyWoodbury, Minnesota  55125
MeritCare BroadwayFargo, North Dakota  58122
CCOP - MeritCare HospitalFargo, North Dakota  58122
Mercy Cancer Center at Mercy Medical CenterCanton, Ohio  44708
St. Rita's Medical CenterLima, Ohio  45801
Geisinger Medical CenterDanville, Pennsylvania  17822-0001
Geisinger Medical Group - Scenery ParkState College, Pennsylvania  16801
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical CenterWilkes-Barre, Pennsylvania  18711
Medical X-Ray Center, PCSioux Falls, South Dakota  57105
Avera Cancer InstituteSioux Falls, South Dakota  57105
Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical CenterLa Crosse, Wisconsin  54601
Marshfield Clinic - Marshfield CenterMarshfield, Wisconsin  54449
Marshfield Clinic - Indianhead CenterRice Lake, Wisconsin  54868
Rapid City Regional HospitalRapid City, South Dakota  57709
Providence Saint Joseph Medical Center - BurbankBurbank, California  91505
CCOP - Santa Rosa Memorial HospitalSanta Rosa, California  95403
Memorial Hospital of South BendSouth Bend, Indiana  46601
CCOP - Cancer Research for the OzarksSpringfield, Missouri  65807
CCOP - Montana Cancer ConsortiumBillings, Montana  59101
CCOP - ColumbusColumbus, Ohio  43206
Veterans Affairs Medical Center - DaytonDayton, Ohio  45428
CCOP - DaytonKettering, Ohio  45429
Mercy Hospital Cancer Center - ScrantonScranton, Pennsylvania  18501
CCOP - GreenvilleGreenville, South Carolina  29615
Hinsdale, Illinois  60521
CCOP - Northern Indiana CR ConsortiumSouth Bend, Indiana  46601
Saint Joseph Regional Medical CenterSouth Bend, Indiana  46617
UMASS Memorial Cancer Center - University CampusWorcester, Massachusetts  01605-2982
CCOP - Grand RapidsGrand Rapids, Michigan  49503
Ellis Fischel Cancer Center at University of Missouri - ColumbiaColumbia, Missouri  65203
Charles M. Barrett Cancer Center at University HospitalCincinnati, Ohio  45267-0526
MetroHealth's Cancer Care Center at MetroHealth Medical CenterCleveland, Ohio  44106
CCOP - Scott and White HospitalTemple, Texas  76508
MultiCare Regional Cancer Center at Tacoma General HospitalTacoma, Washington  98405
Cleveland Clinic Taussig Cancer CenterCleveland, Ohio  44195
USC/Norris Comprehensive Cancer Center and HospitalLos Angeles, California  90033-0804
Veterans Affairs Medical Center - ShreveportShreveport, Louisiana  71130
CCOP - St. Louis-Cape GirardeauSaint Louis, Missouri  63141
Veterans Affairs Medical Center - PortlandPortland, Oregon  97207
Brooke Army Medical CenterFort Sam Houston, Texas  78234-6200
Veterans Affairs Medical Center - HoustonHouston, Texas  77030
Veterans Affairs Medical Center - San Antonio (Murphy)San Antonio, Texas  78284
CCOP - NorthwestTacoma, Washington  98405-0986
Sutter Cancer CenterSacramento, California  95816
Utah Valley Regional Medical Center - ProvoProvo, Utah  84604
Veterans Affairs Medical Center - RichmondRichmond, Virginia  23249
MidMichigan Medical Center - MidlandMidland, Michigan  48670
Veterans Affairs Medical Center - Columbia (Truman Memorial)Columbia, Missouri  65201
Veterans Affairs Medical Center - BuffaloBuffalo, New York  14215
University of California Davis Cancer CenterSacramento, California  95817
Northeast Alabama Regional Medical CenterAnniston, Alabama  36207
West Suburban Center for Cancer CareRiver Forest, Illinois  60305
Mobile Infirmary Medical CenterMobile, Alabama  36640-0460
John Stoddard Cancer Center at Iowa Methodist Medical CenterDes Moines, Iowa  50309
St. Vincent Mercy Medical CenterToledo, Ohio  43608
Great Falls ClinicGreat Falls, Montana  59405
Arizona Cancer Center at University of Arizona Health Sciences CenterTucson, Arizona  85724
Arkansas Cancer Research Center at University of Arkansas for Medical SciencesLittle Rock, Arkansas  72205
Cancer Research Center at Boston Medical CenterBoston, Massachusetts  02118
Josephine Ford Cancer Center at Henry Ford HospitalDetroit, Michigan  48202
Swedish Cancer Institute at Swedish Medical Center - First Hill CampusSeattle, Washington  98104
Thompson Cancer Survival CenterKnoxville, Tennessee  37916
Overlook HospitalSummit, New Jersey  07902-0220
Northside Hospital Cancer CenterAtlanta, Georgia  30342-1611
Hulston Cancer Center at Cox Medical Center SouthSpringfield, Missouri  65807
St. John's Regional Health CenterSpringfield, Missouri  65804
Carol G. Simon Cancer Center at Morristown Memorial HospitalMorristown, New Jersey  07962
Winthrop University HospitalMineola, New York  11501
McDowell Cancer Center at Akron General Medical CenterAkron, Ohio  44307
Sioux Valley Hospital and University of South Dakota Medical CenterSioux Falls, South Dakota  57117-5134
CCOP - Toledo Community HospitalToledo, Ohio  43623-3456
Wilford Hall Medical CenterLackland Air Force Base, Texas  78236-5300
Latter Day Saints HospitalSalt Lake City, Utah  84143
Long Island Jewish Medical CenterNew Hyde Park, New York  11040
Broward General Medical Center Cancer CenterFt. Lauderdale, Florida  33316
Curtis & Elizabeth Anderson Cancer Institute at Memorial Health University Medical CenterSavannah, Georgia  31403-3089
Via Christi Cancer Center at Via Christi Regional Medical CenterWichita, Kansas  67214
CancerCare of Maine at Eastern Maine Medial CenterBangor, Maine  04401
Albert Einstein Cancer Center at Albert Einstein College of MedicineBronx, New York  10461
SUNY Upstate Medical University HospitalSyracuse, New York  13210
Medical University of Ohio Cancer CenterToledo, Ohio  43614
Toledo HospitalToledo, Ohio  43606
Tod Children's Hospital - Forum HealthYoungstown, Ohio  44501
Hollings Cancer Center at Medical University of South CarolinaCharleston, South Carolina  29425
Baylor University Medical Center - HoustonHouston, Texas  77030-2399
Providence Cancer Center at Sacred Heart Medical CenterSpokane, Washington  99220-2555
St. Vincent Hospital Regional Cancer CenterGreen Bay, Wisconsin  54307-3508
Interlakes Oncology/Hematology PCRochester, New York  14623
St. Mary's - Duluth Clinic Cancer CenterDuluth, Minnesota  55805
James P. Wilmot Cancer Center at University of Rochester Medical CenterRochester, New York  14642
McCreery Cancer Center at Ottumwa RegionalOttumwa, Iowa  52501
Green Bay Oncology, Limited - EscanabaEscanaba, Michigan  49431
Hunterdon Regional Cancer Center at Hunterdon Medical CenterFlemington, New Jersey  08822
St. Mary's Hospital Medical Center - Green BayGreen Bay, Wisconsin  54303
Green Bay Oncology, Limited at St. Mary's HospitalGreen Bay, Wisconsin  54303
Bay Area Cancer Care Center at Bay Area Medical CenterMarinette, Wisconsin  54143
Green Bay Oncology, Limited - Oconto FallsOconto Falls, Wisconsin  54154
Green Bay Oncology, Limited - Sturgeon BaySturgeon Bay, Wisconsin  54235
Hematology Oncology Associates of the Quad CitiesBettendorf, Iowa  52722
Alaska Regional Hospital Cancer CenterAnchorage, Alaska  99508
Saint Anthony's Hospital at Saint Anthony's Health CenterAlton, Illinois  62002
Good Samaritan Regional Health CenterMt. Vernon, Illinois  62864
Siouxland Regional Cancer CenterSioux City, Iowa  51101-1733
Veterans Affairs Medical Center - Kansas CityKansas City, Kansas  64128
Southwest Medical CenterLiberal, Kansas  67901
Battle Creek Health System Cancer Care CenterBattle Creek, Michigan  49017
Holland Community HospitalHolland, Michigan  49423
Hackley HospitalMuskegon, Michigan  49443
Northern Michigan HospitalPetoskey, Michigan  49770
Munson Medical CenterTraverse City, Michigan  49684
Southeast Missouri Regional Cancer Center at Southeast Missouri HospitalGape Girardeau, Missouri  63701
David C. Pratt Cancer Center at St. John's MercySt. Louis, Missouri  63141
Northern Rockies Radiation Oncology CenterBillings, Montana  59101
Hematology-Oncology Centers of the Northern Rockies - BillingsBillings, Montana  59101
St. Vincent HealthcareBillings, Montana  59101
Deaconess Billings Clinic - DowntownBillings, Montana  59101
St. James Community HospitalButte, Montana  59701
Big Sky OncologyGreat Falls, Montana  59405
St. Peter's HospitalHelena, Montana  59601
Kalispell Medical OncologyKalispell, Montana  59901
Kalispell Regional Medical CenterKalispell, Montana  59901
Glacier Oncology, PLLCKalispell, Montana  59901
Montana Cancer Center at St. Patrick Hospital and Health Sciences CenterMissoula, Montana  59802
Montana Cancer Specialists at Montana Cancer CenterMissoula, Montana  59802
Community Medical CenterMissoula, Montana  59801
Wayne Memorial Hospital, IncorporatedGoldsboro, North Carolina  27534
Adena Regional Medical CenterChillicothe, Ohio  54601
Doctors Hospital at Ohio HealthColumbus, Ohio  43228
Riverside Methodist Hospital Cancer CareColumbus, Ohio  43214
Grant Riverside Cancer ServicesColumbus, Ohio  43215
Grady Memorial HospitalDelaware, Ohio  43015
Fairfield Medical CenterLancaster, Ohio  43130
Strecker Cancer Center at Marietta Memorial HospitalMarietta, Ohio  45750
Licking Memorial Cancer Care Program at Licking Memorial HospitalNewark, Ohio  43055
Community Hospital of Springfield and Clark CountySpringfield, Ohio  45505
Mount Carmel Cancer Services at Mount Carmel St. Ann's HospitalWesterville, Ohio  43081
Genesis - Good Samaritan HospitalZanesville, Ohio  43701
American Fork HospitalAmerican Fork, Utah  84003
Logan Regional HospitalLogan, Utah  84321
Cottonwood Hospital Medical CenterMurray, Utah  84107
McKay-Dee Hospital CenterOgden, Utah  84403
Utah Cancer Specialists at UCS Cancer CenterSalt Lake City, Utah  84106
Olympic Hematology and OncologyBremerton, Washington  98310
Skagit Valley Hospital Cancer Care CenterMt. Vernon, Washington  98273
University Cancer Center at University of Washington Medical CenterSeattle, Washington  98195
Harborview Medical CenterSeattle, Washington  98104
Group Health Central HospitalSeattle, Washington  98104
Cancer Care Northwest - Spokane SouthSpokane, Washington  99202
Veterans Affairs Medical Center - HinesHines, Illinois  60141
Lakeland Cancer Care Center at Lakeland Hospital - St. JosephSaint Joseph, Michigan  49085
Lenoir Memorial Cancer CenterKinston, North Carolina  28503-1678
Zimmer Cancer Center at New Hanover Regional Medical CenterWilmington, North Carolina  28402-9025
Swedish-American Regional Cancer CenterRockford, Illinois  61104-2315
CCOP - Nevada Cancer Research FoundationLas Vegas, Nevada  89109-2306
Don Monti Comprehensive Cancer Center at North Shore University HospitalManhasset, New York  11030
Dakota Cancer Institute at Dakota Clinic - South UniversityFargo, North Dakota  58103-4940
Spectrum Health Hospital - Butterworth CampusGrand Rapids, Michigan  49503
Huntsman Cancer Institute at University of UtahSalt Lake City, Utah  84112
Decatur Memorial Hospital Cancer Care InstituteDecatur, Illinois  62526
Elkhart General HospitalElkhart, Indiana  46515
Mount Carmel Health - West HospitalColumbus, Ohio  43222
Morgan Cancer Center at Lehigh Valley Hospital - Cedar CrestAllentown, Pennsylvania  18105
University Medical Center of Southern NevadaLas Vegas, Nevada  89102
Finger Lakes Hematology and OncologyClifton Springs, New York  14432
Fox Valley Hematology and Oncology - East Grant StreetAppleton, Wisconsin  54911-3496
All Saints Cancer Center at Wheaton Franciscan HealthcareRacine, Wisconsin  53405
Sutter Cancer Center at Roseville Medical CenterRoseville, California  95661
John Muir/Mt. Diablo Comprehensive Cancer CenterWalnut Creek, California  94598
Memorial HospitalColorado Springs, Colorado  80909
Saint Joseph's Hospital of AtlantaAtlanta, Georgia  30342-1701
Piedmont HospitalAtlanta, Georgia  30309
WellStar Cobb HospitalAustell, Georgia  30106
Charles B. Eberhart Cancer Center at DeKalb Medical CenterDecatur, Georgia  30033
Gwinnett Medical CenterLawrenceville, Georgia  30045
Kennestone Cancer Center at Wellstar Kennestone HospitalMarietta, Georgia  30060
Southern Regional Medical CenterRiverdale, Georgia  30274-2600
Trinity Medical Center - EastMoline, Illinois  61265
St. Francis Hospital and Health Centers - Beech Grove CampusBeech Grove, Indiana  46107
Howard Community Hospital at Howard Regional Health SystemKokomo, Indiana  46904
Center for Cancer Therapy at LaPorte Hospital and Health ServicesLa Porte, Indiana  46350
Reid Hospital & Health Care Services, IncorporatedRichmond, Indiana  47374
Bettendorf, Iowa  52722
St. Luke's HospitalCedar Rapids, Iowa  52402
Mercy Regional Cancer Center at Mercy Medical CenterCedar Rapids, Iowa  52403
Genesis Medical Center - West CampusDavenport, Iowa  52804
Genesis Regional Cancer Center at Genesis Medical CenterDavenport, Iowa  52803
John Stoddard Cancer Center at Iowa Lutheran HospitalDes Moines, Iowa  50316-2301
Mercy Capitol HospitalDes Moines, Iowa  50307
Medical Oncology and Hematology Associates at John Stoddard Cancer CenterDes Moines, Iowa  50309
Medical Oncology and Hematology Associates at Mercy Cancer CenterDes Moines, Iowa  50314
Mercy Cancer Center at Mercy Medical Center - Des MoinesDes Moines, Iowa  50314
Cancer Center of Kansas, PA - Dodge CityDodge City, Kansas  67801
Stormont-Vail Cancer CenterTopeka, Kansas  66604
Louisiana State University Health Sciences Center - MonroeMonroe, Louisiana  71210
Feist-Weiller Cancer Center at Louisiana State University Health SciencesShreveport, Louisiana  71130-3932
Sturdy Memorial HospitalAttleboro, Massachusetts  02703
Hickman Cancer Center at Bixby Medical CenterAdrian, Michigan  49221
Mecosta County Medical CenterBig Rapids, Michigan  49307
Green Bay Oncology, Limited - Iron MountainIron Mountain, Michigan  49801
Upper Michigan Cancer Center at Marquette General HospitalMarquette, Michigan  49855
Community Cancer Center of MonroeMonroe, Michigan  48162
Mercy Memorial Hospital SystemMonroe, Michigan  48162
Alexandria, Minnesota  56308
MeritCare Clinic - BemidjiBemidji, Minnesota  56601
Virginia Piper Cancer Institute at Abbott-Northwestern HospitalMinneapolis, Minnesota  55407
Chippewa County - Montevideo HospitalMontevideo, Minnesota  56265
Hubert H. Humphrey Cancer Center at North Memorial Medical CenterRobbinsdale, Minnesota  55422-2900
Coborn Cancer CenterSaint Cloud, Minnesota  56303
CentraCare Clinic - River CampusSt. Cloud, Minnesota  56303
Park Nicollet Health ServicesSt. Louis Park, Minnesota  55416
Saint Francis Medical CenterCape Girardeau, Missouri  63701
Immanuel Medical CenterOmaha, Nebraska  68122
Creighton University Medical CenterOmaha, Nebraska  68131-2197
Adirondack Cancer Care - Glens FallsGlens Falls, New York  12801
Bismarck Cancer CenterBismarck, North Dakota  58501
Wood County Oncology CenterBowling Green, Ohio  43402
Samaritan North Cancer Care CenterDayton, Ohio  45415
Grandview HospitalDayton, Ohio  45405
Good Samaritan HospitalDayton, Ohio  45406
Blanchard Valley Medical AssociatesFindlay, Ohio  45840
Fremont Memorial HospitalFremont, Ohio  43420
Community Oncology Group at Cleveland Clinic Cancer CenterIndependence, Ohio  44131
Kenton Oncology, IncorporatedKenton, Ohio  43326
Charles F. Kettering Memorial HospitalKettering, Ohio  45429
Lima Memorial HospitalLima, Ohio  45804
St. Luke's HospitalMaumee, Ohio  43537
Northwest Ohio Oncology CenterMaumee, Ohio  43537
Middletown Regional HospitalMiddletown, Ohio  45044
Toledo Clinic - OregonOregon, Ohio  43616
St. Charles Mercy HospitalOregon, Ohio  43616
North Coast Cancer Care, IncorporatedSandusky, Ohio  44870
Firelands Regional Medical CenterSandusky, Ohio  44870
Mercy Medical CenterSpringfield, Ohio  45504
Toledo Clinic, Incorporated - Main ClinicToledo, Ohio  43623
UVMC Cancer Care Center at Upper Valley Medical CenterTroy, Ohio  45373-1300
Fulton County Health CenterWauseon, Ohio  43567
Cleveland Clinic - WoosterWooster, Ohio  44691
Ruth G. McMillan Cancer Center at Greene Memorial HospitalXenia, Ohio  45385
Kaiser Permanente Health Care - PortlandPortland, Oregon  97232
St. Mary Regional Cancer CenterLanghorne, Pennsylvania  19047
Bon Secours St. Francis Health SystemGreenville, South Carolina  29601
UMC Southwest Cancer and Research CenterLubbock, Texas  79415-3364
Cancer Therapy and Research CenterSan Antonio, Texas  78229
University Hospital - San AntonioSan Antonio, Texas  78229
Dixie Regional Medical Center - East CampusSaint George, Utah  84770
Danville Regional Medical CenterDanville, Virginia  24541
Minor and James Medical, PLLCSeattle, Washington  98104
Polyclinic First HillSeattle, Washington  98122
Providence Cancer Center at Holy Family HospitalSpokane, Washington  99207
Green Bay Oncology, Limited at St. Vincent HospitalGreen Bay, Wisconsin  54301-3526
Holy Family Memorial Medical Center Cancer Care CenterManitowoc, Wisconsin  54221-1450
Welch Cancer Center at Sheridan Memorial HospitalSheridan, Wyoming  82801
St. Francis HospitalFederal Way, Washington  98003
St. Clare HospitalLakewood, Washington  98499-0998
Providence St. Peter Hospital Regional Cancer CenterOlympia, Washington  98506
Good Samaritan Cancer CenterPuyallup, Washington  98371
St. Joseph Medical Center at Franciscan Health SystemTacoma, Washington  98405-3004
Allenmore HospitalTacoma, Washington  98411-0414
Miller-Dwan Medical CenterDuluth, Minnesota  55805
Lancaster General HospitalLancaster, Pennsylvania  17604-3555
Hembree Mercy Cancer Center at St. Edward Mercy Medical CenterFt. Smith, Arkansas  72903
California Cancer Center - Woodward Park OfficeFresno, California  93720
Pearlman Comprehensive Cancer Center at South Georgia Medical CenterValdosta, Georgia  31603
Mercy Cancer Center at Mercy Medical Center - North IowaMason City, Iowa  50401
Merle M. Mahr Cancer Center at Regional Medical Center of Hopkins CountyMadisonville, Kentucky  42431
Tulane Cancer CenterNew Orleans, Louisiana  70112
Cancer Care Center at St. Luke's HospitalDuluth, Minnesota  55805
Saint Francis Cancer CenterShakopee, Minnesota  55379
St. Joseph's HospitalSt Paul, Minnesota  55102
Missouri Baptist Cancer CenterSt. Louis, Missouri  63131
Cancer Resource Center - LincolnLincoln, Nebraska  68510
Allegheny Cancer Center at Allegheny General HospitalPittsburgh, Pennsylvania  15212
Eastern Connecticut Hematology and Oncology AssociatesNorwich, Connecticut  06360
West Florida Cancer Institute at West Florida Hospital - PensacolaPensacola, Florida  32514
Covenant Cancer Treatment CenterWaterloo, Iowa  50702
Cancer Center of Kansas, PA - ChanuteChanute, Kansas  66720
Cancer Center of Kansas, PA - El DoradoEl Dorado, Kansas  67042
Cancer Center of Kansas, PA - KingmanKingman, Kansas  67068
Cancer Center of Kansas, PA - NewtonNewton, Kansas  67114
Cancer Center of Kansas, PA - ParsonsParsons, Kansas  67357
Cancer Center of Kansas, PA - PrattPratt, Kansas  67124
Tammy Walker Cancer Center at Salina Regional Health CenterSalina, Kansas  67401
Cancer Center of Kansas, PA - SalinaSalina, Kansas  67401
Cancer Center of Kansas, PA - WellingtonWellington, Kansas  67152
Cancer Center of Kansas, PA - WichitaWichita, Kansas  67214
Associates in Womens Health, PA - North ReviewWichita, Kansas  67208
Cancer Center of Kansas, PA - Medical Arts TowerWichita, Kansas  67208
Cancer Center of Kansas, PA - WinfieldWinfield, Kansas  67156
Mercy Regional Cancer Center at Mercy HospitalPort Huron, Michigan  48060
Willmar Cancer Center at Rice Memorial HospitalWillmar, Minnesota  56201
Bozeman Deaconess Cancer CenterBozeman, Montana  59715
Alegant Health Cancer Center at Bergan Mercy Medical CenterOmaha, Nebraska  68124
Flower Hospital Cancer CenterSylvania, Ohio  43560
Salem Hospital Regional Cancer Care ServicesSalem, Oregon  97309-5014
Hematology and Oncology Associates of Northeastern PennsylvaniaScranton, Pennsylvania  18510
St. Joseph Cancer CenterBellingham, Washington  98225
Wenatchee Valley Medical CenterWenatchee, Washington  98801-2028
Methodist Cancer Center at Methodist Hospital - OmahaOmaha, Nebraska  68114
Mid Dakota Clinic, PCBismarck, North Dakota  58501
Oregon Health & Science University Cancer InstitutePortland, Oregon  97239-3098
Regional Cancer Center at Memorial Medical CenterSpringfield, Illinois  62781-0001
Auburn Regional Center for Cancer CareAuburn, Washington  98002
Ben Taub General HospitalHouston, Texas  77030
Methodist HospitalHouston, Texas  77030
Shasta Regional Medical CenterRedding, California  96001-0853
Washington Township HospitalFremont, California  94538
Hematology Oncology Associates of Eastern IdahoIdaho Falls, Idaho  83404
Immanuel St. Joseph's ClinicMankato, Minnesota  56002
Good Samaritan Cancer Center at Good Samaritan HospitalKearney, Nebraska  68848-1990
Tucker Center for Cancer Care at Orange Regional Medical CenterMiddletown, New York  10940-4199
Rutherford HospitalRutherfordton, North Carolina  28139
Easton Regional Cancer Center at Easton HospitalEaston, Pennsylvania  18042
Gibbs Regional Cancer Center at Spartanburg Regional Medical CenterSpartanburg, South Carolina  29303
Martha Jefferson Hospital Cancer Care CenterCharlottesville, Virginia  22901
MedCentral - Mansfield HospitalMansfield, Ohio  44903
Freeman Cancer Institute at Freeman Health SystemJoplin, Missouri  64803-2644
U.T. Cancer Institute at University of Tennessee Medical CenterKnoxville, Tennessee  37920-2911
Huntsville HospitalHuntsville, Alabama  35807
La Grange Memorial HospitalLa Grange, Illinois  60525
Cedar Valley Medical Specialists, PC - West Ridgeway AvenueWaterloo, Iowa  50702
Lacks Cancer Center at Saint Mary's Health CareGrand Rapids, Michigan  49503
Metro Health HospitalGrand Rapids, Michigan  49506
Arch Medical Services, Incorporated at Center for Cancer Care ResearchSaint Louis, Missouri  63141
Billings Clinic Cancer CenterBillings, Montana  59107-5100
Great Falls, Montana  59405
Sletten Regional Cancer Institute at Benefis HealthcareGreat Falls, Montana  59405
Guardian Oncology and Center for WellnessMissoula, Montana  59804
PinnacleHealth Regional Cancer Center at Polyclinic HospitalHarrisburg, Pennsylvania  17105
Rockwood Clinic Cancer Treatment CenterSpokane, Washington  99204-2967
University of Wisconcin Cancer Center at Aspirus Wausau HospitalWausau, Wisconsin  54401
Halifax Medical Center - Daytona BeachDaytona Beach, Florida  32115
Woodwinds Health CampusWoodbury, Minnesota  55125
Oncology Hematology Associates of Northern Pennsylvania, PC at Hahne Regional Cancer CenterDubois, Pennsylvania  15801
Desert Regional Medical Center Comprehensive Cancer CenterPalm Springs, California  92262
Lynchburg Hematology-Oncology ClinicLynchburg, Virginia  24501
Elmhurst Memorial HospitalElmhurst, Illinois  60126
AnMed Cancer CenterAnderson, South Carolina  29621
Ted B. Wahby Cancer Center at Mount Clemens General HospitalMount Clemens, Michigan  48043
Providence Centralia Hospital Regional Cancer CenterCentralia, Washington  98531
Minnesota Oncology Hematology, PA at Maplewood Cancer CenterMaplewood, Minnesota  55109
Medcenter One Hospital Cancer Care CenterBismarck, North Dakota  58501
St. Alexius Medical Center Cancer CenterBismarck, North Dakota  58502
Augusta Oncology Associates - Walton WayAugusta, Georgia  30901
Heartland Oncology & HematologyCouncil Bluffs, Iowa  51503
Christus Schumpert Cancer Treatment CenterShreveport, Louisiana  71101
MaineGeneral Medical Center - Waterville CampusWaterville, Maine  04901
Jersey Shore Cancer Center at Jersey Shore University Medical CenterNeptune, New Jersey  07754-0397
Addison Gilbert HospitalGloucester, Massachusetts  01930
Mercy Regional Cancer CenterJanesville, Wisconsin  53547
East Alabama Medical CenterOpelika, Alabama  36801-5452
Cancer Care Center at John Muir Health - Concord CampusConcord, California  94524-4110
Capital Region Cancer CenterJefferson City, Missouri  65101
Merle West Medical Center Cancer Treatment CenterKlamath Falls, Oregon  97601
University of Tennessee Cancer Institute - Medical CenterMemphis, Tennessee  38104
St. Luke's Texas Cancer Institute at St. Luke's Episcopal HospitalHouston, Texas  77030
Peninsula Cancer Institute - Newport News OfficeNewport News, Virginia  23601