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Phase III Trial of Continuous Schedule AC + G vs. Q 2 Week Schedule AC, Followed by Paclitaxel Given Either Every 2 Weeks or Weekly for 12 Weeks as Post-Operative Adjuvant Therapy in Node-Positive or High-Risk Node-Negative Breast Cancer

Phase 3
18 Years
Open (Enrolling)
Breast Cancer

Thank you

Trial Information

Phase III Trial of Continuous Schedule AC + G vs. Q 2 Week Schedule AC, Followed by Paclitaxel Given Either Every 2 Weeks or Weekly for 12 Weeks as Post-Operative Adjuvant Therapy in Node-Positive or High-Risk Node-Negative Breast Cancer


- Compare the disease-free survival of patients with node-positive or high-risk
node-negative breast cancer treated with 2 different schedules of adjuvant doxorubicin,
cyclophosphamide, and paclitaxel.

- Compare the overall survival of patients treated with these regimens.

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

- Correlate outcome with putative prognostic markers in patients treated with these

OUTLINE: This is a randomized, multicenter study. Patients are randomized to 1 of 2
treatment arms (arms V and VI) (arms I-IV closed 11/10/10).

- Arm I: (closed 11/10/10) Patients receive doxorubicin IV and cyclophosphamide IV on day
1 and pegfilgrastim subcutaneously (SC) on day 2 or filgrastim (G-CSF) SC on days 3-10.
Treatment repeats every 14 days for 6 courses.

Beginning 2 weeks after completion of doxorubicin and cyclophosphamide, patients receive
paclitaxel IV over 3 hours on day 1 and pegfilgrastim SC on day 2. Treatment repeats every
14 days for 6 courses.

- Arm II: (closed 11/10/10) Patients receive doxorubicin IV on day 1, oral
cyclophosphamide on days 1-7, and G-CSF SC on days 2-7. Treatment repeats every 7 days
for 15 courses.

Beginning 2 weeks after completion of cyclophosphamide, patients receive paclitaxel and
pegfilgrastim as in arm I.

- Arm III: (closed 11/10/10) Patients receive doxorubicin, cyclophosphamide, and
pegfilgrastim or G-CSF as in arm I.

Beginning 2 weeks after completion of doxorubicin and cyclophosphamide, patients receive
paclitaxel IV over 1 hour on day 1. Treatment repeats every 7 days for 12 courses.

- Arm IV: (closed 11/10/10) Patients receive doxorubicin, cyclophosphamide, and G-CSF as
in arm II.

Beginning 2 weeks after completion of cyclophosphamide, patients receive paclitaxel as in
arm III.

- Arm V: Patients receive doxorubicin IV and cyclophosphamide IV on day 1 and
pegfilgrastim SC on day 2. Treatment repeats every 14 days for 4 courses. Patients
receive doxorubicin IV and cyclophosphamide IV on day 1 and pegfilgrastim SC on day 2.
Treatment repeats every 14 days for 6 courses.

Beginning 2 weeks after completion of doxorubicin and cyclophosphamide, patients receive
paclitaxel IV over 3 hours on day 1 and pegfilgrastim SC on day 2. Treatment repeats every
14 days for 6 courses.

- Arm VI: Patients receive doxorubicin, cyclophosphamide, and pegfilgrastim as in arm V.

Beginning 2 weeks after completion of doxorubicin and cyclophosphamide, patients receive
paclitaxel IV over 1 hour on day 1. Treatment repeats every 7 days for 12 courses.

In all arms, treatment continues in the absence of disease progression or unacceptable

In all arms patients with HER2/neu-positive tumors also receive trastuzumab (Herceptin®)
weekly or every 3 weeks beginning concurrently with paclitaxel OR 3 months after the last
dose of paclitaxel and continuing for up to 52 weeks.

In all arms, patients with estrogen-receptor or progesterone-receptor positive tumors
receive hormonal therapy beginning within 28 days of the completion of adjuvant chemotherapy
or radiotherapy (if given).

After finishing study treatment patients are followed up every 6 months for 5 years and then
once a year for up to 15 years.

PROJECTED ACCRUAL: A total of 3,250 patients will be accrued for this study.

Inclusion Criteria


- Histologically confirmed stage I-III invasive breast cancer

- Operable disease

- Stage I, II, IIIA, and IIIC (T1-3, N3a only)

- No T4 tumors

- High-risk disease, defined by 1 of the following:

- Tumor ≥ 2 cm in greatest diameter (includes both invasive and intraductal

- Patients with nodal status of N0+ (i.e., no cluster of tumor cells in any
node greater than 0.2 mm) are considered to be node negative and must have
a primary tumor ≥ 2 cm in size or have a tumor ≥ 1 cm with high risk

- Patients who are node negative on the basis of a sentinel node procedure
and fewer than 6 axillary nodes are removed are eligible OR at least 6
axillary or intramammary nodes must be negative

- Tumor ≥ 1 cm in diameter and meeting 1 of the following criteria:

- ER-negative and PgR-negative

- ER-positive or PgR-positive with a Genomic Health Recurrence Score of ≥ 26

- One or more axillary or intramammary nodes are involved by metastatic breast

- If one or more nodes is involved, a minimum of 6 axillary or intramammary
nodes must have been examined histologically

- Patients with N0(I+) disease will be considered node negative

- HER2/neu-positive tumors (3+ by immunohistochemical staining or amplified by
fluorescence in-situ hybridization) allowed

- Bilateral synchronous breast cancer diagnosed within 1 month of each other allowed
provided the higher TNM stage primary tumor meets the eligibility criteria

- Prior modified radical mastectomy OR local excision of all tumors with axillary lymph
node dissection or sentinel node resection required

- No more than 84 days since prior surgery for the primary tumor and/or axilla

- Final resection margins for the primary tumor must be histologically negative
for invasive cancer and ductal carcinoma in situ

- Resection margins positive for lobular carcinoma in situ are allowed

- Hormone receptor status:

- Estrogen receptor status known

- Progesterone receptor status known



- 18 and over


- Male or female

Menopausal status

- Not specified

Performance status

- Zubrod 0-2

Life expectancy

- Not specified


- Absolute neutrophil count at least 1,200/mm^3

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


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

- Alkaline phosphatase no greater than 2 times ULN

- SGOT or SGPT no greater than 2 times ULN


- Creatinine no greater than ULN


- No congestive heart failure

- No active angina pectoris

- LVEF greater than or equal to the lower limit of normal* by MUGA or echocardiogram
NOTE: Patients age 60 and over OR with a history of hypertension


- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

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

- Prior invasive breast cancer or ductal carcinoma in situ allowed if disease-free
for 5 years

- HIV negative


Biologic therapy

- Not specified


- No prior cytotoxic chemotherapy for this breast cancer

- No prior chemotherapy with an anthracycline, anthracenedione, or taxane

Endocrine therapy

- Not specified


- No prior radiotherapy for this malignancy

- At least 2 weeks since prior radiotherapy for ductal carcinoma in situ


- See Disease Characteristics

Type of Study:


Study Design:

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

Outcome Measure:

Disease-free survival by medical history, physical exam, and mammograms every 6 months (annually for mammograms) for 5 years and then annually for 15 years or until death

Outcome Time Frame:

every 6 months (annually for mammograms) for 5 years and then annually for 15 years or until death

Safety Issue:


Principal Investigator

George Thomas Budd, MD

Investigator Role:

Study Chair

Investigator Affiliation:

The Cleveland Clinic


United States: Federal Government

Study ID:




Start Date:

November 2003

Completion Date:

February 2017

Related Keywords:

  • Breast Cancer
  • stage II breast cancer
  • stage IA breast cancer
  • stage IB breast cancer
  • stage IIIC breast cancer
  • male breast cancer
  • HER2-positive breast cancer
  • estrogen receptor-negative breast cancer
  • estrogen receptor-positive breast cancer
  • progesterone receptor-negative breast cancer
  • progesterone receptor-positive breast cancer
  • Breast Neoplasms



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BroMenn Regional Medical Center Normal, Illinois  61761
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Community Hospital of Ottawa Ottawa, Illinois  61350
Oncology Hematology Associates of Central Illinois, PC - Ottawa Ottawa, Illinois  61350
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OSF St. Francis Medical Center Peoria, Illinois  61637
Proctor Hospital Peoria, Illinois  61614
Illinois Valley Community Hospital Peru, Illinois  61354
Perry Memorial Hospital Princeton, Illinois  61356
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Fort Wayne Medical Oncology and Hematology Fort Wayne, Indiana  46815
Center for Cancer Therapy at LaPorte Hospital and Health Services La Porte, Indiana  46350
Mercy Regional Cancer Center at Mercy Medical Center Cedar Rapids, Iowa  52403
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Feist-Weiller Cancer Center at Louisiana State University Health Sciences Shreveport, Louisiana  71130-3932
Hickman Cancer Center at Bixby Medical Center Adrian, Michigan  49221
Bay Regional Medical Center Bay City, Michigan  48708
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Community Cancer Center of Monroe Monroe, Michigan  48162
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Coborn Cancer Center Saint Cloud, Minnesota  56303
CentraCare Clinic - River Campus St. Cloud, Minnesota  56303
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David L. Rike Cancer Center at Miami Valley Hospital Dayton, Ohio  45409
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Charles F. Kettering Memorial Hospital Kettering, Ohio  45429
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St. Charles Mercy Hospital Oregon, Ohio  43616
North Coast Cancer Care, Incorporated Sandusky, Ohio  44870
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Toledo Clinic, Incorporated - Main Clinic Toledo, Ohio  43623
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UMC Southwest Cancer and Research Center Lubbock, Texas  79415-3364
University Hospital - San Antonio San Antonio, Texas  78229
Dixie Regional Medical Center - East Campus Saint George, Utah  84770
Minor and James Medical, PLLC Seattle, Washington  98104
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Denver Health Medical Center Denver, Colorado  80204-4507
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Regional Cancer Center at Singing River Hospital Pascagoula, Mississippi  39581
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Altru Cancer Center at Altru Hospital Grand Forks, North Dakota  58201
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Saint Joseph Hospital Chicago, Illinois  60657
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Michiana Hematology-Oncology, PC - Elkhart Elkhart, Indiana  46514
Elkhart Clinic, LLC Elkhart, Indiana  46514-2098
Michiana Hematology Oncology PC - La Porte La Porte, Indiana  46350
Michiana Hematology-Oncology, PC - South Bend Mishawaka, Indiana  46545-1470
Michiana Hematology Oncology PC - Plymouth Plymouth, Indiana  46563
Reid Hospital & Health Care Services Richmond, Indiana  47374
McFarland Clinic, PC Ames, Iowa  50010
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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 - Liberal Liberal, Kansas  67905
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Menorah Medical Center Overland Park, Kansas  66209
Saint Luke's Hospital - South Overland Park, Kansas  66213
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
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
Foote Memorial Hospital Jackson, Michigan  49201
St. Mary Mercy Hospital Livonia, Michigan  48154
Mercy Memorial Hospital - Monroe Monroe, Michigan  48162
Michiana Hematology Oncology PC - Niles Niles, Michigan  49120
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
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
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
Saint Luke's East - Lee's Summit Lee's Summit, Missouri  64086
Liberty Hospital Liberty, Missouri  64068
Heartland Regional Medical Center Saint Joseph, Missouri  64506
Saint Joseph Oncology, Incorporated Saint Joseph, Missouri  64507
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
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
Summa Center for Cancer Care at Akron City Hospital Akron, Ohio  44309-2090
Barberton Citizens Hospital Barberton, Ohio  44203
Mary Rutan Hospital Bellefontaine, Ohio  43311
Grant Medical Center Cancer Care Columbus, Ohio  43215
Hematology Oncology Center Elyria, Ohio  44035
Community Cancer Center Elyria, Ohio  44035
Wayne Hospital Greenville, Ohio  45331
Knox Community Hospital Mount Vernon, Ohio  43050
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
Cleo Craig Cancer Research Clinic Lawton, Oklahoma  73505
Cancer Care Associates - Mercy Campus Oklahoma City, Oklahoma  73120
Legacy Good Samaritan Hospital & Comprehensive Cancer Center Portland, Oregon  97210
Penn State Hershey Cancer Institute at Milton S. Hershey Medical Center Hershey, Pennsylvania  17033-0850
Guthrie Cancer Center at Guthrie Clinic Sayre Sayre, Pennsylvania  18840
Hematology and Oncology Associates of Northeastern Pennsylvania Scranton, Pennsylvania  18510
Susquehanna Cancer Center at Divine Providence Hospital Williamsport, Pennsylvania  17701
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
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
Community Comprehensive Cancer Center at Camden-Clark Memorial Hospital Parkersburg, West Virginia  26102
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
Vince Lombardi Cancer Clinic - Sheboygan Sheboygan, Wisconsin  53081
Aurora Medical Center Summit, Wisconsin  53066
Vince Lombardi Cancer Clinic - Two Rivers Two Rivers, Wisconsin  54241
Oncology Alliance, SC - Milwaukee - West Wauwatosa, Wisconsin  53226
Mid Dakota Clinic, PC Bismarck, North Dakota  58501
Regional Cancer Center at Memorial Medical Center Springfield, Illinois  62781-0001
St. Joseph Hospital Regional Cancer Center - Orange Orange, California  92868-3849
Queen's Cancer Institute at Queen's Medical Center Honolulu, Hawaii  96813
Dizzy Gillespie Cancer Institute at Englewood Hospital and Medical Center Englewood, New Jersey  07631
Bethesda North Hospital Cincinnati, Ohio  45242
Kinston Medical Specialists Kinston, North Carolina  28501
Greenville Hospital Cancer Center Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Grove Commons Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Faris Road Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Greer Medical Oncology Greer, South Carolina  29650
Cancer Centers of the Carolinas - Seneca Seneca, South Carolina  29672
Cancer Centers of the Carolinas - Spartanburg Spartanburg, South Carolina  29307
MedCentral - Mansfield Hospital Mansfield, Ohio  44903
Resurrection Medical Center Chicago, Illinois  60631
Sherman Hospital Elgin, Illinois  60120-2198
St. Francis Hospital Evanston, Illinois  60202
Lapeer Regional Hospital Lapeer, Michigan  48446
St. John's Regional Medical Center Joplin, Missouri  64804
Freeman Cancer Institute at Freeman Health System Joplin, Missouri  64803-2644
McLeod Regional Medical Center Florence, South Carolina  29501
MBCCOP - Meharry Medical College - Nashville Nashville, Tennessee  37208-3599
Providence Cancer Center Anchorage, Alaska  99508
Lacks Cancer Center at Saint Mary's Health Care Grand Rapids, Michigan  49503
Metro Health Hospital Grand Rapids, Michigan  49506
PinnacleHealth Regional Cancer Center at Polyclinic Hospital Harrisburg, Pennsylvania  17105
University of Wisconcin Cancer Center at Aspirus Wausau Hospital Wausau, Wisconsin  54401
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
South Carolina Oncology Associates, PA Columbia, South Carolina  29210
Doctors Medical Center - San Pablo Campus San Pablo, California  94806
Galesburg Clinic, PC Galesburg, Illinois  61401
St. Vincent Healthcare Cancer Care Services Billings, Montana  59101
University of Tennessee Cancer Institute - Memphis Memphis, Tennessee  38104
Good Samaritan Hospital Cancer Treatment Center Cincinnati, Ohio  45220
Desert Regional Medical Center Comprehensive Cancer Center Palm Springs, California  92262
Parvin Radiation Oncology Kansas City, Missouri  64116
Midwest Hematology Oncology Group, Incorporated Saint Louis, Missouri  63109
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
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
Kapiolani Medical Center at Pali Momi Aiea, Hawaii  96701
Kapiolani Medical Center for Women and Children Honolulu, Hawaii  96826
Straub Clinic and Hospital, Incorporated Honolulu, Hawaii  96813
Hawaii Medical Center - East Honolulu, Hawaii  96817
OnCare Hawaii, Incorporated - Kuakini Honolulu, Hawaii  96817
OnCare Hawaii, Incorporated - Lusitana Honolulu, Hawaii  96813
Maui Memorial Medical Center Wailuku, Hawaii  96793
Pacific Cancer Institute - Maui Wailuku, Hawaii  96793
Illinois CancerCare - Bloomington Bloomington%, Illinois  61701
Illinois CancerCare - Canton Canton, Illinois  61520
Illinois CancerCare - Carthage Carthage, Illinois  62321
Elmhurst Memorial Hospital Elmhurst, Illinois  60126
Illinois CancerCare - Eureka Eureka, Illinois  61530
Illinois CancerCare - Galesburg Galesburg, Illinois  61401
Illinois CancerCare - Havana Havana, Illinois  62644
Illinois CancerCare - Kewanee Clinic Kewanee, Illinois  61443
Illinois CancerCare - Macomb Macomb, Illinois  61455
OSF Holy Family Medical Center Monmouth, Illinois  61462
Illinois CancerCare - Monmouth Monmouth, Illinois  61462
Illinois CancerCare - Community Cancer Center Normal, Illinois  61761
Illinois CancerCare - Pekin Pekin, Illinois  61603
Illinois CancerCare - Peru Peru, Illinois  61354
Illinois CancerCare - Princeton Princeton, Illinois  61356
Illinois CancerCare - Spring Valley Spring Valley, Illinois  61362
Caritas St. Elizabeth's Medical Center Brighton, Massachusetts  02135-2997
Mercy General Health Partners Muskegon, Michigan  49443
New Hampshire Oncology - Hematology, PA at Payson Center for Cancer Care Concord, New Hampshire  03301
New Hampshire Oncology - Hematology, PA - Hooksett Hooksett, New Hampshire  03106
Bay Area Hospital Coos Bay, Oregon  97420
Franciscan Skemp Healthcare - La Crosse Campus La Crosse, Wisconsin  54601
Dale and Frances Hughes Cancer Center at Pocono Medical Center East Stroudsburg, Pennsylvania  18301
Associates in Hematology-Oncology, PC at Crozer Regional Cancer Center Upland, Pennsylvania  19013
Medcenter One Hospital Cancer Care Center Bismarck, North Dakota  58501
St. Alexius Medical Center Cancer Center Bismarck, North Dakota  58502
Hematology-Oncology Associates of Fredericksburg, Incorporated Fredericksburg, Virginia  22401
University of Colorado Cancer Center at UC Health Sciences Center Aurora, Colorado  80045
Christus Schumpert Cancer Treatment Center Shreveport, Louisiana  71101
Hematology Oncology Associates, PC Albuquerque, New Mexico  87106
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
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
Addison Gilbert Hospital Gloucester, Massachusetts  01930
New Orleans Cancer Institute at Memorial Medical Center New Orleans, Louisiana  70115
Cancer Centers of the Carolinas - Easley Easley, South Carolina  29640
Self Regional Cancer Center at Self Regional Medical Center Greenwood, South Carolina  29646
Humphrey Cancer Center at North Memorial Outpatient Center Robbinsdale, Minnesota  55422-2900
Lakeview Hospital Stillwater, Minnesota  55082
Princeton Community Hospital Princeton, West Virginia  24740
Mount Carmel Regional Cancer Center Pittsburg, Kansas  66762
Union State Bank Cancer Center at Nyack Hospital Nyack, New York  10960-1998
Northwest Cancer Specialists at Vancouver Cancer Center Vancouver, Washington  98684
CCOP - Kansas City Prairie Village, Kansas  66208
St. Agnes Hospital Cancer Center Baltimore, Maryland  21229
Vince Lombardi Cancer Clinic - Oshkosh Oshkosh, Wisconsin  54904
Shaw Regional Cancer Center Edwards, Colorado  81632
Kootenai Cancer Center - Coeur d'Alene Coeur d'Alene, Idaho  83814
Langlade Memorial Hospital Antigo, Wisconsin  54409
San Luis Valley Regional Medical Center Alamosa, Colorado  81101
Valley View Hospital Cancer Center Glenwood Springs, Colorado  81601
Florida Hospital Memorial Medical Center Daytona Beach, Florida  32117
Piedmont Fayette Hospital Fayetteville, Georgia  30214
Castle Medical Center Kailua, Hawaii  96734
Kauai Medical Clinic Lihue, Hawaii  96766
Central Dupage Cancer Center Warrenville, Illinois  60555
Hays Medical Center Hays, Kansas  67601
Hutchinson Hospital Corporation Hutchinson, Kansas  67502
Regional Cancer Center at Western Maryland Health System - Sacred Heart Campus Cumberland, Maryland  21502
Clemens Regional Medical Center Mount Clemens, Michigan  48043
Southeast Cancer Center Cape Girardeau, Missouri  63703
Goldschmidt Cancer Center Jefferson City, Missouri  65109
Comprehensive Cancer Care, PC Saint Louis, Missouri  63141
Lakeside Hospital Omaha, Nebraska  68130
Presbyterian Cancer Treatment Center at Presbyterian Kaseman Hospital Albuquerque, New Mexico  87110
University of New Mexico Cancer Center - South Las Cruces, New Mexico  88011
Cleveland Clinic Beachwood Family Health and Surgery Center Beachwood, Ohio  44122
Cleveland Clinic Foundation - Strongsville Strongsville, Ohio  44136
Cancer Care Associates - Norman Norman, Oklahoma  73071
Cancer Care Associates at Troy and Dollie Smith Cancer Center Oklahoma City, Oklahoma  73120
Clackamas Radiation Oncology Center Clackamas, Oregon  97015
Providence Newberg Medical Center Newberg, Oregon  97132
Willamette Falls Hospital Oregon City, Oregon  97045
Butler Memorial Hospital Butler, Pennsylvania  16001
Texas Tech University Health Sciences Center School of Medicine - El Paso El Paso, Texas  79905
Island Hospital Cancer Care Center at Island Hospital Anacortes, Washington  98221
Highline Medical Center Cancer Center Burien, Washington  98166
Riverview UW Cancer Center at Riverview Hospital Wisconsin Rapids, Wisconsin  54494