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Phase III Intergroup Trial of Adjuvant Chemoradiation After Resection of Gastric or Gastroesophageal Adenocarcinoma

Phase 3
18 Years
Open (Enrolling)
Esophageal Cancer, Gastric Cancer

Thank you

Trial Information

Phase III Intergroup Trial of Adjuvant Chemoradiation After Resection of Gastric or Gastroesophageal Adenocarcinoma


- Compare overall survival in patients with resected gastric adenocarcinoma treated with
epirubicin, cisplatin, and infusional fluorouracil (5-FU) vs 5-FU bolus and leucovorin
calcium before and after 5-FU plus radiotherapy.

- Compare disease-free survival and local and distant recurrence rates in these patients
treated with these regimens.

- Correlate the expression of putative prognostic markers (including TS, ERCC-1, MSI,
E-cadherin, EGFR, p27, COX-2, and c-erbB-2) with overall survival of patients treated
with these regimens.

- Correlate specific germline polymorphisms related to chemotherapy metabolism and
resistance (including UGT2B7 [epirubicin], GST [cisplatin], ERCCI [cisplatin], XRCC1
[cisplatin], TS [5-FU], DPD [5-FU], and EGFR polymorphisms) with treatment-related
toxicity and overall survival of these patients.

- Correlate serum levels of insulin-like growth factor-1 (IGF-1), IGF-2, and IGF-binding
protein 3 with overall survival of patients treated with these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to depth
of tumor penetration (T1 or T2 vs T3 vs T4), lymph node involvement (0 vs 1-3), and extent
of lymphadenectomy (D1 or D2 vs D0 or unknown). Patients are randomized to 1 of 2 treatment

- Arm I: Patients receive leucovorin calcium IV and fluorouracil (5-FU) IV on days 1-5 of
courses 1, 3, and 4. Courses repeat every 28 days. During course 2, patients undergo
radiotherapy 5 days a week and receive 5-FU IV continuously for 5 weeks. Patients rest
for 28-35 days between course 2 and 3.

- Arm II: Patients receive epirubicin IV over 3-15 minutes and cisplatin IV over 1 hour
on day 1 and 5-FU IV continuously on days 1-21 during course 1. Beginning 1 week later,
patients undergo radiotherapy 5 days a week and receive 5-FU IV continuously for 5
weeks. Patients rest for 28-35 days before beginning course 2 of chemotherapy. Patients
then receive epirubicin, cisplatin, and 5-FU as in course 1. Treatment repeats every 21
days for 2 courses.

Patients are followed every 3 months for 2 years, every 4 months for 2 years, and then
annually for 3 years.

PROJECTED ACCRUAL: A total of 824 patients will be accrued for this study.

Inclusion Criteria


- Histologically confirmed adenocarcinoma of the stomach or gastroesophageal junction
(adenocarcinoma of the esophagus must involve the gastroesophageal junction) meeting
the following criteria:

- Tumor extension beyond muscularis propria and/or nodal involvement without
evidence of M1 disease

- Stage II, IIIA, IIIB, or IV (T2, N2, M0)

- Stage IB (T1, N1, M0; T2, N0, M0 allowed if extension beyond muscularis propia)

- Prior en bloc resection, with curative intent, of all known tumor

- No microscopic evidence of tumor at the line of resection

- No noncontiguous resection

- No known unresected or recurrent disease at the distal or proximal line of stomach

- No metastatic disease



- 18 and over

Performance status

- ECOG 0-2

Life expectancy

- Not specified


- Granulocyte count at least 1,500/mm^3

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


- Bilirubin no greater than 2.0 mg/dL

- AST no greater than 3 times upper limit of normal


- Creatinine no greater than 1.5 mg/dL

- No unilateral renal function


- No myocardial infarction within the past 6 months

- No uncontrolled high blood pressure

- No unstable angina

- No symptomatic congestive heart failure

- No serious uncontrolled cardiac arrhythmia

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

- No cardiac disease resulting in marked limitation or inability of physical activity


- Stable weight for at least one week before study

- 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 fully resected noninvasive carcinoma in situ

- No other uncontrolled serious medical condition or psychiatric illness that would
preclude study entry

- No active infection

- No peripheral neuropathy grade 2 or greater

- All patients must be evaluated by a radiation oncologist prior to enrollment to
ensure patient is appropriate for radiotherapy


Biologic therapy

- Prior biologic therapy allowed


- No prior chemotherapy

- No other concurrent chemotherapy

Endocrine therapy

- Prior hormonal therapy allowed

- No concurrent hormonal therapy except the following:

- Steroids for adrenal failure

- Hormones for non-disease-related conditions (e.g., insulin for diabetes)

- Intermittent dexamethasone as an antiemetic


- No prior radiotherapy


- See Disease Characteristics

- At least 3 weeks since prior surgery

- No more than 12 weeks since prior surgery

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Overall survival

Outcome Time Frame:

3 years

Safety Issue:


Principal Investigator

Charles S. Fuchs, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Dana-Farber Cancer Institute


United States: Federal Government

Study ID:




Start Date:

December 2002

Completion Date:

June 2017

Related Keywords:

  • Esophageal Cancer
  • Gastric Cancer
  • stage I gastric cancer
  • stage II gastric cancer
  • stage III gastric cancer
  • adenocarcinoma of the stomach
  • adenocarcinoma of the esophagus
  • stage I esophageal cancer
  • stage II esophageal cancer
  • stage III esophageal cancer
  • Adenocarcinoma
  • Adenocarcinoma, Mucinous
  • Esophageal Diseases
  • Esophageal Neoplasms
  • Stomach Neoplasms



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Meeker County Memorial Hospital Lichfield, Minnesota  55355
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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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Albert Einstein Cancer Center Philadelphia, Pennsylvania  19141
Mercy Hospital Cancer Center - Scranton Scranton, Pennsylvania  18501
Grand View Hospital Sellersville, Pennsylvania  18960
CCOP - Greenville Greenville, South Carolina  29615
LDS Hospital Salt Lake City, Utah  84143
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
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Ellis Fischel Cancer Center at University of Missouri - Columbia Columbia, Missouri  65203
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill Chapel Hill, North Carolina  27599-7570
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia Philadelphia, Pennsylvania  19107
CCOP - Scott and White Hospital Temple, Texas  76508
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Baltimore, Maryland  21231-2410
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Brooke Army Medical Center Fort Sam Houston, Texas  78234-6200
Kaiser Permanente Medical Center - Vallejo Vallejo, California  94589
Kent County Memorial Hospital Warwick, Rhode Island  02886
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Wesley Medical Center Wichita, Kansas  67214
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City of Hope Comprehensive Cancer Center Duarte, California  91010
West Suburban Center for Cancer Care River Forest, Illinois  60305
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Medical Center of Central Georgia Macon, Georgia  31201
St. Vincent Mercy Medical Center Toledo, Ohio  43608
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Arkansas Cancer Research Center at University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
Swedish Cancer Institute at Swedish Medical Center - First Hill Campus Seattle, Washington  98104
Thompson Cancer Survival Center Knoxville, Tennessee  37916
Blumenthal Cancer Center at Carolinas Medical Center Charlotte, North Carolina  28232-2861
Overlook Hospital Summit, New Jersey  07902-0220
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
SUNY Downstate Medical Center Brooklyn, New York  11203
McDowell Cancer Center at Akron General Medical Center Akron, Ohio  44307
CCOP - Toledo Community Hospital Toledo, Ohio  43623-3456
Wilford Hall Medical Center Lackland Air Force Base, Texas  78236-5300
Waukesha Memorial Hospital Regional Cancer Center Waukesha, Wisconsin  53188
Kaiser Permanente Medical Center - Oakland Sacramento, California  95825
Broward General Medical Center Cancer Center Ft. Lauderdale, Florida  33316
Sacred Heart Cancer Center at Sacred Heart Hospital Pensacola, Florida  32504
Winship Cancer Institute of Emory University Atlanta, Georgia  30322
Advocate Christ Medical Center Oak Lawn, Illinois  60453
Via Christi Cancer Center at Via Christi Regional Medical Center Wichita, Kansas  67214
Ochsner Cancer Institute at Ochsner Clinic Foundation New Orleans, Louisiana  70121
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Presbyterian Cancer Center at Presbyterian Hospital Charlotte, North Carolina  28233-3549
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Medical University of Ohio Cancer Center Toledo, Ohio  43614
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Edwards Comprehensive Cancer Center at Cabell Huntington Hospital Huntington, West Virginia  25701
St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54307-3508
Lahey Clinic Medical Center - Burlington Burlington, Massachusetts  01805
James P. Wilmot Cancer Center at University of Rochester Medical Center Rochester, New York  14642
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Green Bay Oncology, Limited - Escanaba Escanaba, Michigan  49431
Dickinson County Healthcare System Iron Mountain, Michigan  49801
Our Lady of Mercy Medical Center Comprehensive Cancer Center Bronx, New York  10466
CCOP - Hematology-Oncology Associates of Central New York East Syracuse, New York  13057
Lewistown Hospital Lewistown, Pennsylvania  17044
Mount Nittany Medical Center State College, Pennsylvania  16803
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Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54301-3526
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Hematology Oncology Associates of the Quad Cities Bettendorf, Iowa  52722
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Community Hospital of Springfield and Clark County Springfield, Ohio  45505
Genesis - Good Samaritan Hospital Zanesville, Ohio  43701
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Utah Cancer Specialists at UCS Cancer Center Salt Lake City, Utah  84106
Olympic Hematology and Oncology Bremerton, Washington  98310
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Hematology Oncology Associates - Skokie Skokie, Illinois  60076
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Joan Karnell Cancer Center at Pennsylvania Hospital Philadelphia, Pennsylvania  19107
UPMC Cancer Centers Pittsburgh, Pennsylvania  15232
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Kaiser Permanente - Fremont Fremont, California  94538
Kaiser Permanente Medical Center - Hayward Hayward, California  94545
Alta Bates Summit Medical Center - Summit Campus Oakland, California  94609
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Kaiser Permanente Medical Center - Santa Teresa San Jose, California  95119
Kaiser Foundation Hospital - San Rafael San Rafael, California  94903
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Ella Milbank Foshay Cancer Center at Jupiter Medical Center Jupiter, Florida  33458
Hematology and Oncology Associates Chicago, Illinois  60611
Ingalls Cancer Care Center at Ingalls Memorial Hospital Harvey, Illinois  60426
Midwest Center for Hematology/Oncology Joliet, Illinois  60432
North Shore Oncology and Hematology Associates, Limited - Libertyville Libertyville, Illinois  60048
Edward Hospital Cancer Center Naperville, Illinois  60540
Hematology Oncology Consultants - Naperville Naperville, Illinois  60540
St. Francis Hospital and Health Centers - Beech Grove Campus Beech Grove, Indiana  46107
Fort Wayne Medical Oncology and Hematology Fort Wayne, Indiana  46815
Center for Cancer Therapy at LaPorte Hospital and Health Services La Porte, Indiana  46350
St. Luke's Hospital Cedar Rapids, Iowa  52402
Mercy Regional Cancer Center at Mercy Medical Center Cedar Rapids, Iowa  52403
John Stoddard Cancer Center at Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
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
Mercy Cancer Center at Mercy Medical Center - Des Moines Des Moines, Iowa  50314
Medical Oncology and Hematology Associates - West Des Moines West Des Moines, Iowa  50266
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
Terrebonne General Medical Center Houma, Louisiana  70360
Medical Center of Louisiana - New Orleans New Orleans, Louisiana  70112
Hickman Cancer Center at Bixby Medical Center Adrian, Michigan  49221
Bay Regional Medical Center Bay City, Michigan  48708
Mecosta County Medical Center Big Rapids, Michigan  49307
Community Cancer Center of Monroe Monroe, Michigan  48162
Alexandria, Minnesota  56308
Coborn Cancer Center Saint Cloud, Minnesota  56303
CentraCare Clinic - River Campus St. Cloud, Minnesota  56303
Immanuel Medical Center Omaha, Nebraska  68122
Creighton University Medical Center Omaha, Nebraska  68131-2197
Cancer Institute of New Jersey at Cooper - Voorhees Voorhees, New Jersey  08043
Bismarck Cancer Center Bismarck, North Dakota  58501
Wood County Oncology Center Bowling Green, Ohio  43402
Grandview Hospital Dayton, Ohio  45405
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
Fulton County Health Center Wauseon, Ohio  43567
Ruth G. McMillan Cancer Center at Greene Memorial Hospital Xenia, Ohio  45385
Kaiser Permanente Health Care - Portland Portland, Oregon  97232
Bryn Mawr Hospital Bryn Mawr, Pennsylvania  19010
St. Mary Regional Cancer Center Langhorne, Pennsylvania  19047
Lankenau Cancer Center at Lankenau Hospital Wynnewood, Pennsylvania  19096
Christine LaGuardia Phillips Cancer Center at Wellmont Holston Valley Medical Center Kingsport, Tennessee  37662
Doctor's Hospital of Laredo Laredo, Texas  78041
Dixie Regional Medical Center - East Campus Saint George, Utah  84770
Danville Regional Medical Center Danville, Virginia  24541
Virginia Oncology Associates - Hampton Hampton, Virginia  23666
Minor and James Medical, PLLC Seattle, Washington  98104
Polyclinic First Hill Seattle, Washington  98122
San Francisco General Hospital Medical Center San Francisco, California  94110
Massachusetts General Hospital Boston, Massachusetts  02114-2617
St. Anthony Central Hospital Denver, Colorado  80204-1335
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
St. Anthony's Memorial Hospital Effingham, Illinois  62401
Morton Hospital & Medical Center Taunton, Massachusetts  02780
Hembree Mercy Cancer Center at St. Edward Mercy Medical Center Ft. Smith, Arkansas  72903
Highland General Hospital Oakland, California  94602
Creticos Cancer Center at Advocate Illinois Masonic Medical Center Chicago, Illinois  60657
Cancer Center at Ball Memorial Hospital Muncie, Indiana  47303
Regional Cancer Center at Singing River Hospital Pascagoula, Mississippi  39581
Missouri Baptist Cancer Center St. Louis, Missouri  63131
Cancer Resource Center - Lincoln Lincoln, Nebraska  68510
Altru Cancer Center at Altru Hospital Grand Forks, North Dakota  58201
Cancer Research UK Medical Oncology Unit at Churchill Hospital & Weatherall Institute of Molecular Medicine - Oxford Salem, Ohio  44460
Cancer Treatment Center Wooster, Ohio  44691
Kaiser Permanente - Deer Valley Antioch, California  94531
Praxair Cancer Center at Danbury Hospital Danbury, Connecticut  06810
Tunnell Cancer Center at Beebe Medical Center Lewes, Delaware  19958
Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital Fort Lauderdale, Florida  33308
West Florida Cancer Institute at West Florida Hospital - Pensacola Pensacola, Florida  32514
Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/Candler Savannah, Georgia  31405
Hematology Oncology Associates of Illinois - Berwyn Berwyn, Illinois  60402
La Grange Oncology Associates - Geneva Naperville, Illinois  60563
Cancer Care and Hematology Specialists of Chicagoland - Niles Niles, Illinois  60714
William N. Wishard Memorial Hospital Indianapolis, Indiana  46202
Medical Consultants, PC at Ball Memorial Cancer Center Muncie, Indiana  47303
Reid Hospital & Health Care Services Richmond, Indiana  47374
McFarland Clinic, PC Ames, Iowa  50010
Covenant Cancer Treatment Center Waterloo, Iowa  50702
Cancer Center of Kansas, PA - Chanute Chanute, Kansas  66720
Cancer Center of Kansas, PA - El Dorado El Dorado, Kansas  67042
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
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
Tammy Walker Cancer Center at Salina Regional Health Center Salina, Kansas  67401
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
Willmar Cancer Center at Rice Memorial Hospital Willmar, Minnesota  56201
Truman Medical Center - Hospital Hill Kansas City, Missouri  64108
St. Joseph Medical Center Kansas City, Missouri  64114
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
Liberty Hospital Liberty, Missouri  64068
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
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
Northern Montana Hospital Havre, Montana  59501
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
Mary Rutan Hospital Bellefontaine, Ohio  43311
North Coast Cancer Care - Clyde Clyde, Ohio  43410
Grant Medical Center Cancer Care Columbus, Ohio  43215
Hematology Oncology Center Elyria, Ohio  44035
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
Salem Hospital Regional Cancer Care Services Salem, Oregon  97309-5014
St. Luke's Cancer Network at St. Luke's Hospital Bethlehem, Pennsylvania  18015
Guthrie Cancer Center at Guthrie Clinic Sayre Sayre, Pennsylvania  18840
Hematology and Oncology Associates of Northeastern Pennsylvania Scranton, Pennsylvania  18510
Sandra L. Maxwell Cancer Center Cedar City, Utah  84720
Jon and Karen Huntsman Cancer Center at Intermountain Medical Center Murray, Utah  84157
Val and Ann Browning Cancer Center at McKay-Dee Hospital Center Ogden, Utah  84403
Fredericksburg Oncology, Incorporated Fredericksburg, Virginia  22401
Southwest Virginia Regional Cancer Center at Wellmonth Health Norton, Virginia  24273
St. Joseph Cancer Center Bellingham, Washington  98225
Columbia Basin Hematology Kennewick, Washington  99336
Community Comprehensive Cancer Center at Camden-Clark Memorial Hospital Parkersburg, West Virginia  26102
Marshfield Clinic Cancer Care at Regional Cancer Center Eau Claire, Wisconsin  54701
Marshfield Clinic - Lakeland Center Minocqua, Wisconsin  54548
Ministry Medical Group at Saint Mary's Hospital Rhinelander, Wisconsin  54501
Marshfield Clinic - Weston Center Weston, Wisconsin  54476
Marshfield Clinic - Wisconsin Rapids Center Wisconsin Rapids, Wisconsin  54494
FirstHealth Moore Regional Community Hospital Comprehensive Cancer Center Pinehurst, North Carolina  28374
Mid Dakota Clinic, PC Bismarck, North Dakota  58501
Regional Cancer Center at Memorial Medical Center Springfield, Illinois  62781-0001
Community Hospital Munster, Indiana  46321
Memorial Hospital of Rhode Island Pawtucket, Rhode Island  02860
Phoebe Cancer Center at Phoebe Putney Memorial Hospital Albany, Georgia  31702
Lowell General Hospital Lowell, Massachusetts  01854
Good Samaritan Cancer Center at Good Samaritan Hospital Kearney, Nebraska  68848-1990
Elliot Regional Cancer Center at Elliot Hospital Manchester, New Hampshire  03103
Rutherford Hospital Rutherfordton, North Carolina  28139
Easton Regional Cancer Center at Easton Hospital Easton, Pennsylvania  18042
Mercy Cancer Institute at Mercy Hospital Pittsburgh, Pennsylvania  15219
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center Spartanburg, South Carolina  29303
Regional Cancer Center at Oconomowoc Memorial Hospital Oconomowoc, Wisconsin  53066
Dana-Farber/Brigham and Women's Cancer Center Boston, Massachusetts  02115
Kinston Medical Specialists Kinston, North Carolina  28501
Glendale Memorial Hospital Comprehensive Cancer Center Glendale, California  91204
Resurrection Medical Center Chicago, Illinois  60631
Nalitt Cancer Institute at Staten Island University Hospital Staten Island, New York  10305
La Grange Memorial Hospital La Grange, Illinois  60525
Cedar Valley Medical Specialists, PC - West Ridgeway Avenue Waterloo, Iowa  50702
Lacks Cancer Center at Saint Mary's Health Care Grand Rapids, Michigan  49503
Metro Health Hospital Grand Rapids, Michigan  49506
Great Falls, Montana  59405
Guardian Oncology and Center for Wellness Missoula, Montana  59804
Roper St. Francis Cancer Center at Roper Hospital Charleston, South Carolina  29401
Franklin & Edith Scarpa Regional Cancer Center at South Jersey Healthcare Vineland, New Jersey  08360
Oncology Hematology Associates of Northern Pennsylvania, PC at Hahne Regional Cancer Center Dubois, Pennsylvania  15801
Associates in Oncology and Hematology Rockville, Maryland  20850
Doctors Medical Center - San Pablo Campus San Pablo, California  94806
Boston University Cancer Research Center Boston, Massachusetts  02118
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
Oncology Care Associates, PLLC Saint Joseph, Michigan  49085
Independence Regional Health Center Independence, Missouri  64050
Parvin Radiation Oncology Kansas City, Missouri  64116
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
Memorial Medical Center Modesto, California  95355
El Camino Hospital Cancer Center Mountain View, California  94040
Larry G Strieff MD Medical Corporation Oakland, California  94609
Tom K Lee, Incorporated Oakland, California  94609
Bay Area Breast Surgeons, Incorporated Oakland, California  94609
Valley Medical Oncology Consultants - Pleasanton Pleasanton, California  94588
Elmhurst Memorial Hospital Elmhurst, Illinois  60126
Iowa Blood and Cancer Care Cedar Rapids, Iowa  52402
Caritas St. Elizabeth's Medical Center Brighton, Massachusetts  02135-2997
Mercy General Health Partners Muskegon, Michigan  49443
Hattiesburg Clinic, PA at Forrest General Hattiesburg, Mississippi  39401
Christian Hospital Northeast Cancer Care Center Saint Louis, Missouri  63136
Riddle Memorial Hospital Cancer Center Media, Pennsylvania  19063
Cancer Center of Paoli Memorial Hospital Paoli, Pennsylvania  19301-1792
CCOP - Main Line Health Wynnewood, Pennsylvania  19096
AnMed Cancer Center Anderson, South Carolina  29621
Dale and Frances Hughes Cancer Center at Pocono Medical Center East Stroudsburg, Pennsylvania  18301
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
Cleveland Clinic Florida - Weston Weston, Florida  33331
South Shore Hospital South Weymouth, Massachusetts  02190
Ben E. Owens Cancer Treatment Center at St. Bernard's Medical Center Jonesboro, Arkansas  72401-9320
Regional Medical Center Anniston, Alabama  36202
Valley Medical Oncology Consultants - Castro Valley Castro Valley, California  94546
Valley Medical Oncology Fremont, California  94538
Memorial Hospital Cancer Center - Colorado Springs Colorado Springs, Colorado  80909
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
Hematology & Oncology Clinic Hattiesburg, Mississippi  39402
Frankford Hospital Cancer Center - Torresdale Campus Philadelphia, Pennsylvania  19114
Shore Regional Cancer Center at Memorial Hospital - Easton Easton, Maryland  21601
Eugene M. and Christine E. Lynn Cancer Institute at Boca Raton Community Hospital - Main Campus Boca Raton, Florida  33486
Community Hospital of the Monterey Peninsula Comprehensive Cancer Center Monterey, California  93940
Camino Medical Group - Treatment Center Mountain View, California  94040
Associates in Oncology and Hematology - Medical Center Drive Rockville, Maryland  20878
CentraState Medical Center Freehold, New Jersey  07728
Kings County Hospital Center Brooklyn, New York  11203
Ralph Lauren Center for Cancer Care and Prevention New York, New York  10035
UPMC Cancer Center at Beaver Medical Center Beaver, Pennsylvania  15009
UPMC Cancer Center at Jefferson Regional Medical Center Clairton, Pennsylvania  15025
UPMC Cancer Center - Arnold Palmer Pavilion Greensburg, Pennsylvania  15601
UPMC Cancer Center at the John P. Murtha Pavilion Johnstown, Pennsylvania  15901
UPMC - Moon Moon Township, Pennsylvania  15108
UPMC Cancer Center - Natrona Heights Natrona Heights, Pennsylvania  15065
Jameson Memorial Hospital - North Campus New Castle, Pennsylvania  16105
UPMC - Shadyside Pittsburgh, Pennsylvania  15213-2582
UPMC Cancer Center at UPMC St. Margaret Pittsburgh, Pennsylvania  15215
St. Clair Memorial Hospital Cancer Center Pittsburgh, Pennsylvania  15243
UPMC Cancer Center at UPMC Passavant Pittsburgh, Pennsylvania  15237
UPMC Cancer Center at UPMC Northwest Seneca, Pennsylvania  16346
Washington Hospital Cancer Center Washington, Pennsylvania  15301
Hematology and Oncology Associates of Rhode Island Cranston, Rhode Island  02920
Blue Ridge Medical Specialists, PC Bristol, Tennessee  37620
Princeton Community Hospital Princeton, West Virginia  24740