Know Cancer

or
forgot password

Phase III Randomized Trial of Anastrozole Versus Anastrozole and Fulvestrant as First Line Therapy for Post Menopausal Women With Metastatic Breast Cancer


Phase 3
18 Years
N/A
Open (Enrolling)
Female
Breast Cancer

Thank you

Trial Information

Phase III Randomized Trial of Anastrozole Versus Anastrozole and Fulvestrant as First Line Therapy for Post Menopausal Women With Metastatic Breast Cancer


OBJECTIVES:

- Compare the time to tumor progression in postmenopausal women with metastatic breast
cancer treated with anastrozole with or without fulvestrant as first-line therapy.

- Compare the clinical benefit (complete or partial response, confirmed or unconfirmed,
or stable disease ≥ 24 weeks) and overall survival of patients treated with these
regimens.

- Compare adverse events in patients treated with these regimens.

- Determine the prognostic significance of estrogen receptor positivity and HER2/neu
status in patients treated with these regimens.

- Determine parameters of estrogen and clinical pharmacology and estrogen levels in
patients treated with these regimens.

- Compare anastrozole plasma levels at 8, 16, and 24 weeks in patients treated with these
regimens (closed as of 4/16/2009).

- Compare estradiol serum levels at 8, 16, and 24 weeks in patients treated with these
regimens (closed as of 4/16/2009).

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to prior
adjuvant tamoxifen therapy (yes vs no). Patients are randomized to 1 of 2 treatment arms.

- Arm I: Patients receive oral anastrozole once daily on days 1-28.

- Arm II: Patients receive oral anastrozole as in arm I. Patients also receive
fulvestrant intramuscularly on days 1, 14, and 28 during course 1 and then on day 28 of
the subsequent courses.

In both arms, courses repeat every 28 days in the absence of disease progression or
unacceptable toxicity.

Patients are followed for up to 4 years.

PROJECTED ACCRUAL: A total of 690 patients (345 per treatment arm) will be accrued for this
study within 3 years.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed breast cancer meeting 1 of the following criteria:

- Metastatic disease (M1)

- Multiple sites of new disease that is clinically obvious metastatic disease
(e.g., multiple sites of new osseous disease)

- Measurable or nonmeasurable disease

- No known brain or CNS metastases

- Hormone receptor status:

- Estrogen-receptor positive* AND/OR

- Progesterone-receptor positive* NOTE: *Positivity defined as estrogen binding of
> 10 fmol/mg cytosol protein by ligand binding assay or positive by
immunohistochemistry

PATIENT CHARACTERISTICS:

Age

- Not specified

Sex

- Female

Menopausal status

- Postmenopausal, as defined by 1 of the following:

- Prior bilateral oophorectomy

- More than 12 months since last menstrual period with no prior hysterectomy

- At least 55 years of age with prior hysterectomy

- Under 55 years of age with a prior hysterectomy without oophorectomy and with
estradiol and follicle-stimulating hormone levels consistent with menopause

Performance status

- Zubrod 0-2

Life expectancy

- Not specified

Hematopoietic

- No bleeding diathesis (e.g., disseminated intravascular coagulation or clotting
factor deficiency)

Hepatic

- INR ≤ 1.6

Renal

- Not specified

Other

- HIV negative

- No other malignancy within the past 5 years except adequately treated basal cell or
squamous cell skin cancer, carcinoma in situ of the cervix, or adequately treated
stage I or II cancer currently in complete remission

PRIOR CONCURRENT THERAPY:

Biologic therapy

- No prior immunotherapy for recurrent or metastatic disease

Chemotherapy

- No prior chemotherapy for recurrent or metastatic disease

- More than 12 months since prior adjuvant or neoadjuvant chemotherapy

- No concurrent chemotherapy for malignancy

Endocrine therapy

- Prior adjuvant hormonal therapy allowed

- At least 12 months since prior adjuvant luteinizing hormone-releasing hormone (LHRH)
analogues

- Menstrual periods must not have resumed since LHRH therapy

- More than 12 months since prior adjuvant or neoadjuvant aromatase inhibitors (e.g.,
anastrozole, letrozole, or exemestane)

- More than 12 months since prior fulvestrant

- No prior hormonal therapy for recurrent or metastatic disease

- No other concurrent hormonal therapy for malignancy

- No concurrent hormone replacement therapy

Radiotherapy

- Not specified

Surgery

- Not specified

Other

- No long-term anticoagulant therapy (except antiplatelet therapy)

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Time to tumor progression

Outcome Time Frame:

13 months

Safety Issue:

No

Principal Investigator

Rita S. Mehta, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Chao Family Comprehensive Cancer Center

Authority:

United States: Federal Government

Study ID:

CDR0000349337

NCT ID:

NCT00075764

Start Date:

April 2004

Completion Date:

October 2013

Related Keywords:

  • Breast Cancer
  • stage IV breast cancer
  • recurrent breast cancer
  • Breast Neoplasms

Name

Location

Roswell Park Cancer InstituteBuffalo, New York  14263
Fred Hutchinson Cancer Research CenterSeattle, Washington  98109
University of Michigan Comprehensive Cancer CenterAnn Arbor, Michigan  48109-0752
Cardinal Bernardin Cancer Center at Loyola University Medical CenterMaywood, Illinois  60153-5500
Walter Reed Army Medical CenterWashington, District of Columbia  20307-5000
Barbara Ann Karmanos Cancer InstituteDetroit, Michigan  48201
Cleveland Clinic Cancer CenterCleveland, Ohio  44195
CCOP - Upstate CarolinaSpartanburg, South Carolina  29303
CCOP - WichitaWichita, Kansas  67214-3882
Hurley Medical CenterFlint, Michigan  48503
CCOP - Atlanta RegionalAtlanta, Georgia  30342-1701
CCOP - Kansas CityKansas City, Missouri  64131
CCOP - Illinois Oncology Research AssociationPeoria, Illinois  61602
CCOP - Metro-MinnesotaSaint Louis Park, Minnesota  55416
Carle Cancer Center at Carle Foundation HospitalUrbana, Illinois  61801
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
Oakwood Cancer Center at Oakwood Hospital and Medical CenterDearborn, Michigan  48123-2500
Genesys Hurley Cancer InstituteFlint, Michigan  48503
Van Elslander Cancer Center at St. John Hospital and Medical CenterGrosse Pointe Woods, Michigan  48236
Sparrow Regional Cancer CenterLansing, Michigan  48912-1811
St. John Macomb HospitalWarren, Michigan  48093
MeritCare BemidjiBemidji, Minnesota  56601
Fairview Ridges HospitalBurnsville, Minnesota  55337
Mercy and Unity Cancer Center at Mercy HospitalCoon Rapids, Minnesota  55433
Duluth Clinic Cancer Center - DuluthDuluth, Minnesota  55805-1983
CCOP - DuluthDuluth, Minnesota  55805
Miller - Dwan Medical CenterDuluth, Minnesota  55805
Fairview Southdale HospitalEdina, Minnesota  55435
Mercy and Unity Cancer Center at Unity HospitalFridley, Minnesota  55432
Minnesota Oncology Hematology, PA - MaplewoodMaplewood, Minnesota  55109
Virginia Piper Cancer Institute at Abbott - Northwestern HospitalMinneapolis, Minnesota  55407
Hubert H. Humphrey Cancer Center at North Memorial Outpatient CenterRobbinsdale, Minnesota  55422-2900
St. Francis Cancer Center at St. Francis Medical CenterShakopee, Minnesota  55379
Park Nicollet Cancer CenterSt. Louis Park, Minnesota  55416
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
Aultman Cancer Center at Aultman HospitalCanton, Ohio  44710-1799
Sanford Cancer Center at Sanford USD Medical CenterSioux Falls, South Dakota  57117-5039
Medical X-Ray Center, PCSioux Falls, South Dakota  57105
Avera Cancer InstituteSioux Falls, South Dakota  57105
Marshfield Clinic - Marshfield CenterMarshfield, Wisconsin  54449
Marshfield Clinic - Indianhead CenterRice Lake, Wisconsin  54868
Rapid City Regional HospitalRapid City, South Dakota  57709
CCOP - Santa Rosa Memorial HospitalSanta Rosa, California  95403
Methodist Medical Center of IllinoisPeoria, Illinois  61636
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
Mercy Hospital Cancer Center - ScrantonScranton, Pennsylvania  18501
LDS HospitalSalt Lake City, Utah  84143
CCOP - Northern Indiana CR ConsortiumSouth Bend, Indiana  46601
Saint Joseph Regional Medical CenterSouth Bend, Indiana  46617
CCOP - Grand RapidsGrand Rapids, Michigan  49503
CCOP - Columbia River Oncology ProgramPortland, Oregon  97225
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 - DenverDenver, Colorado  80220
MBCCOP - LSU Health Sciences CenterNew Orleans, Louisiana  70112
CCOP - St. Louis-Cape GirardeauSaint Louis, Missouri  63141
CCOP - NorthwestTacoma, Washington  98405-0986
Utah Valley Regional Medical Center - ProvoProvo, Utah  84604
Monmouth Medical CenterLong Branch, New Jersey  07740-6395
St. Joseph's Hospital and Medical CenterPaterson, New Jersey  07503
University of California Davis Cancer CenterSacramento, California  95817
City of Hope Comprehensive Cancer CenterDuarte, California  91010
St. Vincent Mercy Medical CenterToledo, Ohio  43608
Arizona Cancer Center at University of Arizona Health Sciences CenterTucson, Arizona  85724
Josephine Ford Cancer Center at Henry Ford HospitalDetroit, Michigan  48202
Swedish Cancer Institute at Swedish Medical Center - First Hill CampusSeattle, Washington  98104
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
McDowell Cancer Center at Akron General Medical CenterAkron, Ohio  44307
CCOP - Toledo Community HospitalToledo, Ohio  43623-3456
Loma Linda University Cancer Institute at Loma Linda University Medical CenterLoma Linda, California  92354
Sacred Heart Cancer Center at Sacred Heart HospitalPensacola, Florida  32504
St. Vincent Indianapolis HospitalIndianapolis, Indiana  46260
Via Christi Cancer Center at Via Christi Regional Medical CenterWichita, Kansas  67214
Alvin and Lois Lapidus Cancer Institute at Sinai HospitalBaltimore, Maryland  21215
Mission Hospitals - Memorial CampusAsheville, North Carolina  28801
Medical University of Ohio Cancer CenterToledo, Ohio  43614
Toledo HospitalToledo, Ohio  43606
Edwards Comprehensive Cancer Center at Cabell Huntington HospitalHuntington, West Virginia  25701
St. Vincent Hospital Regional Cancer CenterGreen Bay, Wisconsin  54307-3508
Interlakes Oncology/Hematology PCRochester, New York  14623
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
Dickinson County Healthcare SystemIron Mountain, Michigan  49801
Mount Nittany Medical CenterState College, Pennsylvania  16803
St. Mary's Hospital Medical Center - Green BayGreen Bay, Wisconsin  54303
Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer CenterGreen Bay, Wisconsin  54301-3526
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
Southwest Medical CenterLiberal, Kansas  67901
Battle Creek Health System Cancer Care CenterBattle Creek, Michigan  49017
Northern Michigan HospitalPetoskey, Michigan  49770
William Beaumont Hospital - Royal Oak CampusRoyal Oak, Michigan  48073
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
Big Sky OncologyGreat Falls, Montana  59405
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
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
Genesis - Good Samaritan HospitalZanesville, Ohio  43701
American Fork HospitalAmerican Fork, Utah  84003
Logan Regional HospitalLogan, Utah  84321
Utah Cancer Specialists at UCS Cancer CenterSalt Lake City, Utah  84106
Olympic Hematology and OncologyBremerton, Washington  98310
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
Zimmer Cancer Center at New Hanover Regional Medical CenterWilmington, North Carolina  28402-9025
MBCCOP - Medical College of Georgia Cancer CenterAugusta, Georgia  30912-3730
Mountain States Tumor Institute at St. Luke's Regional Medical CenterBoise, Idaho  83712-6297
University of Illinois Cancer CenterChicago, Illinois  60612-7243
Advocate Lutheran General Cancer Care CenterPark Ridge, Illinois  60068-1174
Butterworth Hospital at Spectrum HealthGrand Rapids, Michigan  49503-2560
Keesler Air Force Base Medical CenterKeesler AFB, Mississippi  39534-2511
Siteman Cancer Center at Barnes-Jewish Hospital - Saint LouisSt. Louis, Missouri  63110
CCOP - Nevada Cancer Research FoundationLas Vegas, Nevada  89109-2306
Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical SchoolNew Brunswick, New Jersey  08903
University of New Mexico Cancer CenterAlbuquerque, New Mexico  87131-5636
Tod Children's HospitalYoungstown, Ohio  44501
Legacy Emanuel Hospital and Health Center and Children's HospitalPortland, Oregon  97227
Virginia Commonwealth University Massey Cancer CenterRichmond, Virginia  23298-0037
Madigan Army Medical Center - TacomaTacoma, Washington  98431
Gundersen Lutheran Center for Cancer and BloodLa Crosse, Wisconsin  54601
Methodist Estabrook Cancer CenterOmaha, Nebraska  68114-4199
Huntsman Cancer Institute at University of UtahSalt Lake City, Utah  84112
Decatur Memorial Hospital Cancer Care InstituteDecatur, Illinois  62526
Elkhart General HospitalElkhart, Indiana  46515
Howard Community HospitalKokomo, Indiana  46904
South Bend ClinicSouth Bend, Indiana  46617
Lakeland Regional Cancer Care Center - St. JosephSt. Joseph, Michigan  49085
Hope A Women's Cancer CenterAsheville, North Carolina  28801
Cleveland Clinic Cancer Center at Fairview HospitalCleveland, Ohio  44111
Mount Carmel Health - West HospitalColumbus, Ohio  43222
Hillcrest Cancer Center at Hillcrest HospitalMayfield Heights, Ohio  44124
University Medical Center of Southern NevadaLas Vegas, Nevada  89102
Finger Lakes Hematology and OncologyClifton Springs, New York  14432
UPMC Cancer CentersPittsburgh, Pennsylvania  15232
All Saints Cancer Center at Wheaton Franciscan HealthcareRacine, Wisconsin  53405
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
Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical CenterBoise, Idaho  83706
St. Joseph Medical CenterBloomington, Illinois  61701
Graham HospitalCanton, Illinois  61520
Memorial HospitalCarthage, Illinois  62321
Eureka Community HospitalEureka, Illinois  61530
Galesburg Cottage HospitalGalesburg, Illinois  61401
Ingalls Cancer Care Center at Ingalls Memorial HospitalHarvey, Illinois  60426
Mason District HospitalHavana, Illinois  62644
Hopedale Medical ComplexHopedale, Illinois  61747
McDonough District HospitalMacomb, Illinois  61455
Edward Hospital Cancer CenterNaperville, Illinois  60540
Hematology Oncology Consultants - NapervilleNaperville, Illinois  60540
BroMenn Regional Medical CenterNormal, Illinois  61761
Community Cancer CenterNormal, Illinois  61761
Community Hospital of OttawaOttawa, Illinois  61350
Oncology Hematology Associates of Central Illinois, PC - OttawaOttawa, Illinois  61350
Cancer Treatment Center at Pekin HospitalPekin, Illinois  61554
Oncology Hematology Associates of Central Illinois, PC - PeoriaPeoria, Illinois  61615
OSF St. Francis Medical CenterPeoria, Illinois  61637
Proctor HospitalPeoria, Illinois  61614
Illinois Valley Community HospitalPeru, Illinois  61354
Perry Memorial HospitalPrinceton, Illinois  61356
St. Margaret's HospitalSpring Valley, Illinois  61362
Center for Cancer Therapy at LaPorte Hospital and Health ServicesLa Porte, Indiana  46350
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
Cancer Center of Kansas, PA - Dodge CityDodge City, Kansas  67801
St. Francis Comprehensive Cancer CenterTopeka, Kansas  66606
Pennington Cancer Center at Baton Rouge GeneralBaton Rouge, Louisiana  70806
Mary Bird Perkins Cancer Center - Baton RougeBaton Rouge, Louisiana  70809
Medical Center of Louisiana - New OrleansNew Orleans, Louisiana  70112
Hickman Cancer Center at Bixby Medical CenterAdrian, Michigan  49221
Mecosta County Medical CenterBig Rapids, Michigan  49307
Upper Michigan Cancer Center at Marquette General HospitalMarquette, Michigan  49855
Community Cancer Center of MonroeMonroe, Michigan  48162
Providence Cancer Institute at Providence Hospital - Southfield CampusSouthfield, Michigan  48075
Saint Francis Medical CenterCape Girardeau, Missouri  63701
Adirondack Cancer Care - Glens FallsGlens Falls, New York  12801
Highland Hospital of RochesterRochester, New York  14620
Bismarck Cancer CenterBismarck, North Dakota  58501
Wood County Oncology CenterBowling Green, Ohio  43402
Lima Memorial HospitalLima, Ohio  45804
St. Luke's HospitalMaumee, Ohio  43537
Northwest Ohio Oncology CenterMaumee, Ohio  43537
Toledo Clinic - OregonOregon, Ohio  43616
St. Charles Mercy HospitalOregon, Ohio  43616
North Coast Cancer Care, IncorporatedSandusky, Ohio  44870
Mercy Medical CenterSpringfield, Ohio  45504
Mercy Hospital of TiffinTiffin, Ohio  44883
Toledo Clinic, Incorporated - Main ClinicToledo, Ohio  43623
Fulton County Health CenterWauseon, Ohio  43567
Legacy Mount Hood Medical CenterGresham, Oregon  97030
Providence Milwaukie HospitalMilwaukie, Oregon  97222
Kaiser Permanente Health Care - PortlandPortland, Oregon  97232
Providence Cancer Center at Providence Portland Medical CenterPortland, Oregon  97213-2967
Providence St. Vincent Medical CenterPortland, Oregon  97225
Legacy Meridian Park HospitalTualatin, Oregon  97062
Delaware County Regional Cancer Center at Delaware County Memorial HospitalDrexel Hill, Pennsylvania  19026
Dixie Regional Medical Center - East CampusSaint George, Utah  84770
Minor and James Medical, PLLCSeattle, Washington  98104
Polyclinic First HillSeattle, Washington  98122
Southwest Washington Medical Center Cancer CenterVancouver, Washington  98668
North Star Lodge Cancer Center at Yakima Valley Memorial HospitalYakima, Washington  98902
San Francisco General Hospital Medical CenterSan Francisco, California  94110
Denver Health Medical CenterDenver, Colorado  80204-4507
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
Allenmore HospitalTacoma, Washington  98411-0414
Lancaster General HospitalLancaster, Pennsylvania  17604-3555
Hembree Mercy Cancer Center at St. Edward Mercy Medical CenterFt. Smith, Arkansas  72903
Middlesex Hospital Cancer CenterMiddletown, Connecticut  06457
Regional Cancer Center at Singing River HospitalPascagoula, Mississippi  39581
Cancer Resource Center - LincolnLincoln, Nebraska  68510
Altru Cancer Center at Altru HospitalGrand Forks, North Dakota  58201
West Florida Cancer Institute at West Florida Hospital - PensacolaPensacola, Florida  32514
Harbin Clinic Cancer Center - Medical OncologyRome, Georgia  30165
Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/CandlerSavannah, Georgia  31405
McFarland Clinic, PCAmes, Iowa  50010
Cancer Center of Kansas, PA - ChanuteChanute, Kansas  66720
Cancer Center of Kansas, PA - El DoradoEl Dorado, Kansas  67042
Cancer Center of Kansas-IndependenceIndependence, Kansas  67301
Cancer Center of Kansas, PA - KingmanKingman, Kansas  67068
Lawrence Memorial HospitalLawrence, Kansas  66044
Cancer Center of Kansas, PA - NewtonNewton, Kansas  67114
Menorah Medical CenterOverland Park, Kansas  66209
Cancer Center of Kansas, PA - ParsonsParsons, Kansas  67357
Cancer Center of Kansas, PA - PrattPratt, Kansas  67124
Cancer Center of Kansas, PA - SalinaSalina, Kansas  67401
Shawnee Mission Medical CenterShawnee Mission, Kansas  66204
Cotton-O'Neil Cancer CenterTopeka, Kansas  66606
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
Foote Memorial HospitalJackson, Michigan  49201
Haematology-Oncology Associates of Ohio and Michigan, PCLambertville, Michigan  48144
St. Mary Mercy HospitalLivonia, Michigan  48154
Mercy Memorial Hospital - MonroeMonroe, Michigan  48162
St. Joseph Mercy OaklandPontiac, Michigan  48341-2985
Mercy Regional Cancer Center at Mercy HospitalPort Huron, Michigan  48060
Seton Cancer Institute at Saint Mary's - SaginawSaginaw, Michigan  48601
St. Luke's Hospital Cancer Care CenterDuluth, Minnesota  55805
Willmar Cancer Center at Rice Memorial HospitalWillmar, Minnesota  56201
Truman Medical Center - Hospital HillKansas City, Missouri  64108
St. Joseph Medical CenterKansas City, Missouri  64114
North Kansas City HospitalKansas City, Missouri  64116
Saint Luke's Cancer Institute at Saint Luke's HospitalKansas City, Missouri  64111
Research Medical CenterKansas City, Missouri  64132
Saint Luke's East - Lee's SummitLee's Summit, Missouri  64086
Liberty HospitalLiberty, Missouri  64068
Heartland Regional Medical CenterSaint Joseph, Missouri  64506
Billings Clinic - DowntownBillings, Montana  59107-7000
St. James Healthcare Cancer CareButte, Montana  59701
Great Falls Clinic - Main FacilityGreat Falls, Montana  59405
Sletten Cancer Institute at Benefis HealthcareGreat Falls, Montana  59405
Northern Montana HospitalHavre, Montana  59501
Kalispell Medical Oncology at KRMCKalispell, Montana  59901
Mary Rutan HospitalBellefontaine, Ohio  43311
Grant Medical Center Cancer CareColumbus, Ohio  43215
Hematology Oncology CenterElyria, Ohio  44035
Flower Hospital Cancer CenterSylvania, Ohio  43560
St. Anne Mercy HospitalToledo, Ohio  43623
Mount Carmel St. Ann's Cancer CenterWesterville, Ohio  43081
Adventist Medical CenterPortland, Oregon  97216
Legacy Good Samaritan Hospital & Comprehensive Cancer CenterPortland, Oregon  97210
St. Luke's Cancer Network at St. Luke's HospitalBethlehem, Pennsylvania  18015
Guthrie Cancer Center at Guthrie Clinic SayreSayre, Pennsylvania  18840
Hematology and Oncology Associates of Northeastern PennsylvaniaScranton, Pennsylvania  18510
Sandra L. Maxwell Cancer CenterCedar City, Utah  84720
Jon and Karen Huntsman Cancer Center at Intermountain Medical CenterMurray, Utah  84157
Val and Ann Browning Cancer Center at McKay-Dee Hospital CenterOgden, Utah  84403
Fredericksburg Oncology, IncorporatedFredericksburg, Virginia  22401
St. Joseph Cancer CenterBellingham, Washington  98225
Providence Centralia HospitalCentralia, Washington  98531-9027
Columbia Basin HematologyKennewick, Washington  99336
Franciscan Cancer Center at St. Joseph Medical CenterTacoma, Washington  98405-3004
Community Comprehensive Cancer Center at Camden-Clark Memorial HospitalParkersburg, West Virginia  26102
Center for Cancer Treatment & Prevention at Sacred Heart HospitalEau Claire, Wisconsin  54701
Marshfield Clinic Cancer Care at Regional Cancer CenterEau Claire, Wisconsin  54701
Vince Lombardi Cancer Center at Aurora Lakeland Medical Center - ElkhornElkhorn, Wisconsin  53121
Saint Joseph's HospitalMarshfield, Wisconsin  54449
Medical Consultants, LimitedMilwaukee, Wisconsin  53215
Marshfield Clinic - Lakeland CenterMinocqua, Wisconsin  54548
Ministry Medical Group at Saint Mary's HospitalRhinelander, Wisconsin  54501
Vince Lombardi Cancer Clinic - SheboyganSheboygan, Wisconsin  53081
Saint Michael's Hospital Cancer CenterStevens Point, Wisconsin  54481
Marshfield Clinic - Wausau CenterWausau, Wisconsin  54401
Marshfield Clinic - Weston CenterWeston, Wisconsin  54476
Marshfield Clinic - Wisconsin Rapids CenterWisconsin Rapids, Wisconsin  54494
FirstHealth Moore Regional Community Hospital Comprehensive Cancer CenterPinehurst, North Carolina  28374
Mid Dakota Clinic, PCBismarck, North Dakota  58501
Regional Cancer Center at Memorial Medical CenterSpringfield, Illinois  62781-0001
Saint Louis University Cancer CenterSaint Louis, Missouri  63110
Auburn Regional Center for Cancer CareAuburn, Washington  98002
Good Samaritan Cancer Center at Good Samaritan HospitalKearney, Nebraska  68848-1990
Elliot Regional Cancer Center at Elliot HospitalManchester, New Hampshire  03103
Rutherford HospitalRutherfordton, North Carolina  28139
Three Rivers Community HospitalGrants Pass, Oregon  97527
Dubs Cancer Center at Rogue Valley Medical CenterMedford, Oregon  97504
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
Kinston Medical SpecialistsKinston, North Carolina  28501
Glendale Memorial Hospital Comprehensive Cancer CenterGlendale, California  91204
Resurrection Medical CenterChicago, Illinois  60631
Sherman HospitalElgin, Illinois  60120-2198
Freeman Cancer Institute at Freeman Health SystemJoplin, Missouri  64803-2644
New Mexico Cancer Care AssociatesSanta Fe, New Mexico  87505-7670
McLeod Regional Medical CenterFlorence, South Carolina  29501
Providence Cancer CenterAnchorage, Alaska  99508
Highlands Oncology Group - SpringdaleSpringdale, Arkansas  72764
La Grange Memorial HospitalLa Grange, Illinois  60525
Lacks Cancer Center at Saint Mary's Health CareGrand Rapids, Michigan  49503
Metro Health HospitalGrand Rapids, Michigan  49506
Great Falls, Montana  59405
Guardian Oncology and Center for WellnessMissoula, Montana  59804
Lakes Region General HospitalLaconia, New Hampshire  03246
St. Charles Medical Center - BendBend, Oregon  97701
Rockwood Clinic Cancer Treatment CenterSpokane, Washington  99204-2967
Oncology Hematology Associates of Northern Pennsylvania, PC at Hahne Regional Cancer CenterDubois, Pennsylvania  15801
Galesburg Clinic, PCGalesburg, Illinois  61401
St. Vincent Healthcare Cancer Care ServicesBillings, Montana  59101
University of Tennessee Cancer Institute - MemphisMemphis, Tennessee  38104
Independence Regional Health CenterIndependence, Missouri  64050
Parvin Radiation OncologyKansas City, Missouri  64116
Midwest Hematology Oncology Group, IncorporatedSaint Louis, Missouri  63109
Providence Cancer Center at Providence HospitalMobile, Alabama  36608
Tibotec Therapeutics - Division of Ortho Biotech Products, LPMarysville, California  95901
Tahoe Forest Cancer CenterTruckee, California  96161
York Hospital's Oncology Treatment CenterYork, Maine  03909
Caritas St. Elizabeth's Medical CenterBrighton, Massachusetts  02135-2997
Mercy General Health PartnersMuskegon, Michigan  49443
New Hampshire Oncology - Hematology, PA at Payson Center for Cancer CareConcord, New Hampshire  03301
Center for Cancer Care at Exeter HospitalExeter, New Hampshire  03833
New Hampshire Oncology - Hematology, PA - HooksettHooksett, New Hampshire  03106
Trinity CancerCare CenterMinot, North Dakota  58701
Bay Area HospitalCoos Bay, Oregon  97420
AnMed Cancer CenterAnderson, South Carolina  29621
Franciscan Skemp Healthcare - La Crosse CampusLa Crosse, Wisconsin  54601
Medcenter One Hospital Cancer Care CenterBismarck, North Dakota  58501
St. Alexius Medical Center Cancer CenterBismarck, North Dakota  58502
University of Colorado Cancer Center at UC Health Sciences CenterAurora, Colorado  80045
Providence Cancer Center at PMCCMedford, Oregon  97504
Lovelace Medical Center - DowntownAlbuquerque, New Mexico  87102
Hematology Oncology Associates, PCAlbuquerque, New Mexico  87106
Regional Medical CenterAnniston, Alabama  36202
Memorial Hospital Cancer Center - Colorado SpringsColorado Springs, Colorado  80909
Provena St. Mary's Regional Cancer Center - KankakeeKankakee, Illinois  60901
Heartland Oncology and HematologyCouncil Bluffs, Iowa  51503
Mercy Regional Cancer CenterJanesville, Wisconsin  53547
Central Maine Comprehensive Cancer Center at Central Maine Medical CenterLewiston, Maine  04240
Eugene M. and Christine E. Lynn Cancer Institute at Boca Raton Community Hospital - Main CampusBoca Raton, Florida  33486
Portneuf Cancer Center at Portneuf Medical CenterPocatello, Idaho  83201
Caritas Holy Family HospitalMethuen, Massachusetts  01844
Union State Bank Cancer Center at Nyack HospitalNyack, New York  10960-1998
Hudson Valley Oncology AssociatesPoughkeepsie, New York  12601
Clarian Arnett Cancer CareLafayette, Indiana  47904
Bassett Healthcare Regional Cancer Program at Mary Imogene Bassett HospitalCooperstown, New York  13326
Shaw Regional Cancer CenterEdwards, Colorado  81632
Valley View Hospital Cancer CenterGlenwood Springs, Colorado  81601
Presbyterian Cancer Treatment Center at Presbyterian Kaseman HospitalAlbuquerque, New Mexico  87110
Cleveland Clinic Beachwood Family Health and Surgery CenterBeachwood, Ohio  44122
Riverview UW Cancer Center at Riverview HospitalWisconsin Rapids, Wisconsin  54494
North Broward Medical CenterDearfield Beach, Florida  33064-3596
Northeast Georgia Cancer Care, LLC - Medical OncologyAthens, Georgia  30607
St. Francis Regional Cancer CenterTrenton, New Jersey  08629
Capital Health Regional Cancer CenterTrenton, New Jersey  08618
St. Vincent Cancer Center at St. Vincent Regional Medical CenterSanta Fe, New Mexico  87505
Cancer Center of PoughkeepsiePoughkeepsie, New York  12601
Dyson Center for Cancer Care at Vassar Brothers Medical CenterPoughkeepsie, New York  12601-3990
Mabry Center for Cancer Care at Regional Medical CenterOrangeburg, South Carolina  29118