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Randomized Phase III Trial Comparing Two Different Rituximab Dosing Regimens For Patients With Low Tumor Burden Indolent Non-Hodgkin's Lymphoma


Phase 3
18 Years
N/A
Open (Enrolling)
Both
Lymphoma

Thank you

Trial Information

Randomized Phase III Trial Comparing Two Different Rituximab Dosing Regimens For Patients With Low Tumor Burden Indolent Non-Hodgkin's Lymphoma


OBJECTIVES:

Primary

- Compare the time to rituximab failure in patients with low tumor burden indolent
non-Hodgkin's lymphoma treated with rituximab scheduled vs rituximab retreatment.

Secondary

- Compare the time to first cytotoxic therapy in patients treated with these regimens.

- Determine the rationale for beginning cytotoxic therapy, defined as chemotherapy,
radiotherapy, or radioimmunotherapy, in patients treated with these regimens.

- Compare the toxic effects associated with these regimens in these patients.

- Correlate response and duration of response in these patients with rituximab
pharmacokinetics.

- Compare the health-related quality of life, distress, psychological functioning,
physical well-being, and functional well-being of patients treated with these regimens.

- Compare the impact of differential treatment response (delayed time to rituximab
failure and/or time to first cytotoxic therapy) on quality of life, distress, and
psychological functioning in patients treated with these regimens.

- Determine, prospectively, the physical and functional well-being of patients during
treatment with these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to
histologic subtype (follicular vs other), age (under 60 vs 60 and over), and the time from
diagnosis (less than 1 year vs at least 1 year).

- Induction rituximab: Patients receive rituximab IV once a week for 4 weeks. Patients
are re-evaluated 9 weeks after the completion of induction rituximab. Patients with a
partial or complete response to induction rituximab are randomized to 1 of 2 treatment
arms.

- Arm I (retreatment rituximab): Patients receive rituximab IV once a week for 4 weeks
upon disease progression provided time to progression is more than 6 months.

- Arm II (scheduled rituximab): Patients receive a single dose of rituximab IV once every
13 weeks until disease progression and in the absence of unacceptable toxicity.

Quality of life is assessed after induction rituximab treatment and at 26, 39, 65, 117, 169,
and 221 weeks after randomization.

Patients are followed at least annually for 15 years from study entry.

PROJECTED ACCRUAL: A total of 389 patients will be accrued for this study within 45 months.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed non-Hodgkin's lymphoma, including 1 of the following:

- Follicular grade 1 or 2

- Small lymphocytic

- Marginal zone (nodal)

- Marginal zone (splenic)

- Mucosa-associated lymphoid tissue (MALT)

- No evidence of transformation to a large cell histology

- Stage III or IV disease

- Must meet the following criteria for low tumor burden:

- No nodal or extranodal mass at least 7 cm

- Less than 3 nodal masses greater than 3 cm in diameter

- No systemic symptoms or B symptoms

- No splenomegaly greater than 16 cm by CT scan

- No evidence of risk of compression of a vital organ (i.e., ureteral or epidural)

- No leukemic phase with greater than 5,000/mm^3 circulating lymphocytes

- No cytopenias, defined as any of the following:

- Platelet count less than 100,000/mm^3

- Hemoglobin less than 10 g/dL

- Absolute neutrophil count less than 1,500/mm^3

- At least 1 objective measurable disease parameter

- Abnormal PET scans will not constitute evaluable disease unless verified by CT
scan or other appropriate imaging

PATIENT CHARACTERISTICS:

Age

- 18 and over

Performance status

- ECOG 0-1

Life expectancy

- Not specified

Hematopoietic

- See Disease Characteristics

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

- Hemoglobin at least 10 g/dL*

- Platelet count at least 100,000/mm^3* NOTE: *Without growth factor and/or transfusion
support

Hepatic

- Bilirubin no greater than 2 times upper limit of normal (ULN) OR direct bilirubin
normal for patients with Gilbert's Syndrome

- AST/ALT no greater than 5 times ULN

- Hepatitis B surface antigen negative

Renal

- Creatinine no greater than 2 times ULN

Other

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- HIV negative

- No uncontrolled active infection

- Afebrile for at least 48 hours off antibiotics

- No other malignancy within the past 2 years except adequately treated basal cell or
squamous cell skin cancer or carcinoma in situ of the cervix

PRIOR CONCURRENT THERAPY:

Biologic therapy

- See Radiotherapy

- No prior immunotherapy for lymphoma

Chemotherapy

- No prior chemotherapy for lymphoma

- No concurrent chemotherapy

Endocrine therapy

- Not specified

Radiotherapy

- No prior radiotherapy for lymphoma

- No concurrent radiotherapy

- No concurrent radioimmunotherapy

Surgery

- Not specified

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Primary Purpose: Treatment

Outcome Measure:

Time to treatment failure

Safety Issue:

No

Principal Investigator

Brad S. Kahl, MD

Investigator Role:

Study Chair

Investigator Affiliation:

University of Wisconsin, Madison

Authority:

United States: Federal Government

Study ID:

CDR0000346359

NCT ID:

NCT00075946

Start Date:

November 2003

Completion Date:

Related Keywords:

  • Lymphoma
  • stage III grade 1 follicular lymphoma
  • stage III grade 2 follicular lymphoma
  • stage IV grade 1 follicular lymphoma
  • stage IV grade 2 follicular lymphoma
  • stage III small lymphocytic lymphoma
  • stage III marginal zone lymphoma
  • stage IV small lymphocytic lymphoma
  • stage IV marginal zone lymphoma
  • extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue
  • nodal marginal zone B-cell lymphoma
  • splenic marginal zone lymphoma
  • Lymphoma
  • Lymphoma, Non-Hodgkin

Name

Location

Mayo Clinic ScottsdaleScottsdale, Arizona  85259
Mayo Clinic - JacksonvilleJacksonville, Florida  32224
Mayo Clinic Cancer CenterRochester, Minnesota  55905
Walter Reed Army Medical CenterWashington, District of Columbia  20307-5000
CCOP - Upstate CarolinaSpartanburg, South Carolina  29303
CCOP - WichitaWichita, Kansas  67214-3882
Hurley Medical CenterFlint, Michigan  48503
CCOP - Kansas CityKansas City, Missouri  64131
CCOP - Missouri Valley Cancer ConsortiumOmaha, Nebraska  68131
CCOP - Christiana Care Health ServicesWilmington, Delaware  19899
CCOP - Mount Sinai Medical CenterMiami Beach, Florida  33140
CCOP - Illinois Oncology Research AssociationPeoria, Illinois  61602
CCOP - Carle Cancer CenterUrbana, Illinois  61801
CCOP - Iowa Oncology Research AssociationDes Moines, Iowa  50309-1016
CCOP - Metro-MinnesotaSaint Louis Park, Minnesota  55416
Veterans Affairs Medical Center - East OrangeEast Orange, New Jersey  07018-1095
Aurora Presbyterian HospitalAurora, Colorado  80012
Boulder Community HospitalBoulder, Colorado  80301-9019
Penrose Cancer Center at Penrose HospitalColorado Springs, Colorado  80933
CCOP - Colorado Cancer Research ProgramDenver, Colorado  80224-2522
Porter Adventist HospitalDenver, Colorado  80210
Presbyterian - St. Luke's Medical CenterDenver, Colorado  80218
St. Joseph HospitalDenver, Colorado  80218
Rose Medical CenterDenver, Colorado  80220
Swedish Medical CenterEnglewood, Colorado  80110
St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical CenterGrand Junction, Colorado  81502
Sky Ridge Medical CenterLone Tree, Colorado  80124
Hope Cancer Care Center at Longmont United HospitalLongmont, Colorado  80502
St. Mary - Corwin Regional Medical CenterPueblo, Colorado  81004
North Suburban Medical CenterThornton, Colorado  80229
Rush-Copley Cancer Care CenterAurora, Illinois  60507
Evanston Northwestern Healthcare - Evanston HospitalEvanston, Illinois  60201-1781
Hinsdale Hematology Oncology AssociatesHinsdale, Illinois  60521
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
Tufts-NEMC Cancer CenterBoston, Massachusetts  02111
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
Bronson Methodist HospitalKalamazoo, Michigan  49007
West Michigan Cancer CenterKalamazoo, Michigan  49007-3731
Borgess Medical CenterKalamazooaa, Michigan  49001
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
Hutchinson Area Health CareHutchinson, Minnesota  55350
Meeker County Memorial HospitalLichfield, Minnesota  55355
Minnesota Oncology Hematology, PA - MaplewoodMaplewood, Minnesota  55109
HealthEast Cancer Care at St. John's HospitalMaplewood, Minnesota  55109
Hennepin County Medical Center - MinneapolisMinneapolis, Minnesota  55415
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
HealthEast Cancer Care at St. Joseph's HospitalSt Paul, Minnesota  55102
Park Nicollet Cancer CenterSt. Louis Park, Minnesota  55416
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
HealthEast Cancer Care at Woodwinds Health CampusWoodbury, Minnesota  55125
MeritCare BroadwayFargo, North Dakota  58122
CCOP - MeritCare HospitalFargo, North Dakota  58122
Aultman Cancer Center at Aultman HospitalCanton, Ohio  44710-1799
Mercy Cancer Center at Mercy Medical CenterCanton, Ohio  44708
Case Comprehensive Cancer CenterCleveland, Ohio  44106-5065
MetroHealth Cancer Care Center at MetroHealth Medical CenterCleveland, Ohio  44109
St. Rita's Medical CenterLima, Ohio  45801
Natalie Warren Bryant Cancer Center at St. Francis HospitalTulsa, Oklahoma  74136
Penn State Cancer Institute at Milton S. Hershey Medical CenterHershey, Pennsylvania  17033-0850
Abramson Cancer Center of the University of PennsylvaniaPhiladelphia, Pennsylvania  19104-4283
Geisinger Medical Group - Scenery ParkState College, Pennsylvania  16801
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical CenterWilkes-Barre, Pennsylvania  18711
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
Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical CenterLa Crosse, Wisconsin  54601
Dean Medical Center - MadisonMadison, Wisconsin  53717
University of Wisconsin Paul P. Carbone Comprehensive Cancer CenterMadison, Wisconsin  53792-6164
Marshfield Clinic - Marshfield CenterMarshfield, Wisconsin  54449
Medical College of Wisconsin Cancer CenterMilwaukee, Wisconsin  53226
Froedtert Hospital and Medical College of WisconsinMilwaukee, Wisconsin  53226-3596
Marshfield Clinic - Indianhead CenterRice Lake, Wisconsin  54868
CCOP - OchsnerNew Orleans, Louisiana  70121
Rapid City Regional HospitalRapid City, South Dakota  57709
Providence Saint Joseph Medical Center - BurbankBurbank, California  91505
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
Veterans Affairs Medical Center - DaytonDayton, Ohio  45428
CCOP - DaytonKettering, Ohio  45429
Albert Einstein Cancer CenterPhiladelphia, Pennsylvania  19141
Mercy Hospital Cancer Center - ScrantonScranton, Pennsylvania  18501
Grand View HospitalSellersville, Pennsylvania  18960
CCOP - GreenvilleGreenville, South Carolina  29615
Green Mountain Oncology GroupRutland, Vermont  05701
CCOP - Northern Indiana CR ConsortiumSouth Bend, Indiana  46601
Saint Joseph Regional Medical CenterSouth Bend, Indiana  46617
Kimmel Cancer Center at Thomas Jefferson University - PhiladelphiaPhiladelphia, Pennsylvania  19107
MultiCare Regional Cancer Center at Tacoma General HospitalTacoma, Washington  98405
Sidney Kimmel Comprehensive Cancer Center at Johns HopkinsBaltimore, Maryland  21231-2410
Cleveland Clinic Taussig Cancer CenterCleveland, Ohio  44195
MBCCOP - LSU Health Sciences CenterNew Orleans, Louisiana  70112
CCOP - St. Louis-Cape GirardeauSaint Louis, Missouri  63141
CCOP - NorthwestTacoma, Washington  98405-0986
Kaiser Permanente Medical Center - VallejoVallejo, California  94589
Veterans Affairs Medical Center - RichmondRichmond, Virginia  23249
St. Joseph's Hospital and Medical CenterPaterson, New Jersey  07503
Veterans Affairs Medical Center - Palo AltoPalo Alto, California  94304
Louis A. Weiss Memorial HospitalChicago, Illinois  60640
John Stoddard Cancer Center at Iowa Methodist Medical CenterDes Moines, Iowa  50309
Kaiser Permanente Medical Center - San Francisco Geary CampusSan Francisco, California  94115
Medical Center of Central GeorgiaMacon, Georgia  31201
St. Vincent Mercy Medical CenterToledo, Ohio  43608
Arkansas Cancer Research Center at University of Arkansas for Medical SciencesLittle Rock, Arkansas  72205
Blumenthal Cancer Center at Carolinas Medical CenterCharlotte, North Carolina  28232-2861
Hulston Cancer Center at Cox Medical Center SouthSpringfield, Missouri  65807
St. John's Regional Health CenterSpringfield, Missouri  65804
McDowell Cancer Center at Akron General Medical CenterAkron, Ohio  44307
CCOP - Toledo Community HospitalToledo, Ohio  43623-3456
Mercy Fitzgerald HospitalDarby, Pennsylvania  19023
Kaiser Permanente Medical Center - OaklandSacramento, California  95825
University of Florida Shands Cancer CenterGainesville, Florida  32610-0232
Via Christi Cancer Center at Via Christi Regional Medical CenterWichita, Kansas  67214
Ochsner Cancer Institute at Ochsner Clinic FoundationNew Orleans, Louisiana  70121
Albert Einstein Cancer Center at Albert Einstein College of MedicineBronx, New York  10461
SUNY Upstate Medical University HospitalSyracuse, New York  13210
Mission Hospitals - Memorial CampusAsheville, North Carolina  28801
Presbyterian Cancer Center at Presbyterian HospitalCharlotte, North Carolina  28233-3549
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
McCreery Cancer Center at Ottumwa RegionalOttumwa, Iowa  52501
Green Bay Oncology, Limited - EscanabaEscanaba, Michigan  49431
Dickinson County Healthcare SystemIron Mountain, Michigan  49801
Our Lady of Mercy Medical Center Comprehensive Cancer CenterBronx, New York  10466
Lewistown HospitalLewistown, Pennsylvania  17044
Mount Nittany Medical CenterState College, Pennsylvania  16803
Chester County HospitalWest Chester, Pennsylvania  19380
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
Somerset Medical CenterSomerville, New Jersey  08876
Batte Cancer Center at Northeast Medical CenterConcord, North Carolina  28025
North Colorado Medical CenterGreeley, Colorado  80631
McKee Medical CenterLoveland, Colorado  80539
Baptist Cancer Institute - JacksonvilleJacksonville, Florida  32207
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
Northern Michigan HospitalPetoskey, Michigan  49770
William Beaumont Hospital - Royal Oak CampusRoyal Oak, Michigan  48073
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
St. Peter's HospitalHelena, Montana  59601
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
Memorial Cancer Institute at Memorial Regional HospitalHollywood, Florida  33021
Kaiser Permanente Medical Center - Santa Clara Kiely CampusSanta Clara, California  95051-5386
Mountain States Tumor Institute at St. Luke's Regional Medical CenterBoise, Idaho  83712-6297
Swedish-American Regional Cancer CenterRockford, Illinois  61104-2315
Indiana University Melvin and Bren Simon Cancer CenterIndianapolis, Indiana  46202-5289
CancerCare of Maine at Eastern Maine Medical CenterBangor, Maine  04401
CCOP - Nevada Cancer Research FoundationLas Vegas, Nevada  89109-2306
Geisinger Cancer Institute at Geisinger HealthDanville, Pennsylvania  17822-0001
Virginia Commonwealth University Massey Cancer CenterRichmond, Virginia  23298-0037
Kaiser Permanente Medical Center - SacramentoSacramento, California  95825
Methodist Estabrook Cancer CenterOmaha, Nebraska  68114-4199
University of Virginia Cancer CenterCharlottesville, Virginia  22908
Robert H. Lurie Comprehensive Cancer Center at Northwestern UniversityChicago, Illinois  60611
Decatur Memorial Hospital Cancer Care InstituteDecatur, Illinois  62526
Elkhart General HospitalElkhart, Indiana  46515
Howard Community HospitalKokomo, Indiana  46904
Lakeland Regional Cancer Care Center - St. JosephSt. Joseph, Michigan  49085
Cleveland Clinic Cancer Center at Fairview HospitalCleveland, Ohio  44111
Mount Carmel Health - West HospitalColumbus, Ohio  43222
Rosenfeld Cancer Center at Abington Memorial HospitalAbington, Pennsylvania  19001
Morgan Cancer Center at Lehigh Valley Hospital - Cedar CrestAllentown, Pennsylvania  18105
Fox Chase Cancer Center - PhiladelphiaPhiladelphia, Pennsylvania  19111-2497
Front Range Cancer SpecialistsFort Collins, Colorado  80528
University Medical Center of Southern NevadaLas Vegas, Nevada  89102
Finger Lakes Hematology and OncologyClifton Springs, New York  14432
Joan Karnell Cancer Center at Pennsylvania HospitalPhiladelphia, Pennsylvania  19107
UPMC Cancer CentersPittsburgh, Pennsylvania  15232
Fox Valley Hematology and Oncology - East Grant StreetAppleton, Wisconsin  54911-3496
North Bay Cancer CenterFairfield, California  94533
Kaiser Permanente - FremontFremont, California  94538
Kaiser Permanente Medical Center - HaywardHayward, California  94545
Kaiser Permanente Medical Center - Redwood CityRedwood City, California  94063
Kaiser Permanente Medical Center - RichmondRichmond, California  94801
Kaiser Permanente Medical Center - RosevilleRoseville, California  95661
South Sacramento Kaiser-Permanente Medical CenterSacramento, California  95823
Kaiser Permanente Medical Office -Vandever Medical OfficeSan Diego, California  92120
Kaiser Permanente Medical Center - Santa TeresaSan Jose, California  95119
Kaiser Foundation Hospital - San RafaelSan Rafael, California  94903
Kaiser Permanente Medical Center - Santa RosaSanta Rosa, California  95403
Kaiser Permanente Medical Center - South San FranciscoSouth San Francisco, California  94080
Kaiser Permanente Medical Facility - StocktonStockton, California  95210
Kaiser Permanente Medical Center - Walnut CreekWalnut Creek, California  94596
Poudre Valley HospitalFort Collins, Colorado  80524
Ella Milbank Foshay Cancer Center at Jupiter Medical CenterJupiter, Florida  33458
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
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
St. Francis Hospital and Health Centers - Beech Grove CampusBeech Grove, Indiana  46107
Fort Wayne Medical Oncology and HematologyFort Wayne, Indiana  46815
Center for Cancer Therapy at LaPorte Hospital and Health ServicesLa Porte, Indiana  46350
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
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
Terrebonne General Medical CenterHouma, Louisiana  70360
Medical Center of Louisiana - New OrleansNew Orleans, Louisiana  70112
Hickman Cancer Center at Bixby Medical CenterAdrian, Michigan  49221
Community Cancer Center of MonroeMonroe, Michigan  48162
Alexandria, Minnesota  56308
Coborn Cancer CenterSaint Cloud, Minnesota  56303
CentraCare Clinic - River CampusSt. Cloud, Minnesota  56303
Saint Francis Medical CenterCape Girardeau, Missouri  63701
Immanuel Medical CenterOmaha, Nebraska  68122
Creighton University Medical CenterOmaha, Nebraska  68131-2197
Cancer Institute of New Jersey at Cooper - VoorheesVoorhees, New Jersey  08043
Bismarck Cancer CenterBismarck, North Dakota  58501
Wood County Oncology CenterBowling Green, Ohio  43402
Samaritan North Cancer Care CenterDayton, Ohio  45415
Grandview HospitalDayton, Ohio  45405
David L. Rike Cancer Center at Miami Valley HospitalDayton, Ohio  45409
Good Samaritan HospitalDayton, Ohio  45406
Blanchard Valley Medical AssociatesFindlay, Ohio  45840
Community Oncology Group at Cleveland Clinic Cancer CenterIndependence, Ohio  44131
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
Mercy Hospital of TiffinTiffin, Ohio  44883
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
Bryn Mawr HospitalBryn Mawr, Pennsylvania  19010
Delaware County Regional Cancer Center at Delaware County Memorial HospitalDrexel Hill, Pennsylvania  19026
Lankenau Cancer Center at Lankenau HospitalWynnewood, Pennsylvania  19096
Oncology Services of AberdeenAberdeen, South Dakota  57401
Danville Regional Medical CenterDanville, Virginia  24541
Holy Family Memorial Medical Center Cancer Care CenterManitowoc, Wisconsin  54221-1450
Welch Cancer Center at Sheridan Memorial HospitalSheridan, Wyoming  82801
St. Anthony Central HospitalDenver, Colorado  80204-1335
Exempla Lutheran Medical CenterWheat Ridge, Colorado  80033
St. Francis HospitalFederal Way, Washington  98003
St. Clare HospitalLakewood, Washington  98499-0998
Good Samaritan Cancer CenterPuyallup, Washington  98371
Allenmore HospitalTacoma, Washington  98411-0414
Morton Hospital & Medical CenterTaunton, Massachusetts  02780
Lancaster General HospitalLancaster, Pennsylvania  17604-3555
Pottstown Memorial Regional Cancer CenterPottstown, Pennsylvania  19464
Hembree Mercy Cancer Center at St. Edward Mercy Medical CenterFt. Smith, Arkansas  72903
Northeast Georgia Medical CenterGainesville, Georgia  30501
Creticos Cancer Center at Advocate Illinois Masonic Medical CenterChicago, Illinois  60657
Mercy Cancer Center at Mercy Medical Center - North IowaMason City, Iowa  50401
Missouri Baptist Cancer CenterSt. Louis, Missouri  63131
Cancer Resource Center - LincolnLincoln, Nebraska  68510
Altru Cancer Center at Altru HospitalGrand Forks, North Dakota  58201
Stanford Cancer CenterStanford, California  94305-5824
Eastern Connecticut Hematology and Oncology AssociatesNorwich, Connecticut  06360
Tunnell Cancer Center at Beebe Medical CenterLewes, Delaware  19958
Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross HospitalFort Lauderdale, Florida  33308
Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/CandlerSavannah, Georgia  31405
William N. Wishard Memorial HospitalIndianapolis, Indiana  46202
Reid Hospital & Health Care ServicesRichmond, Indiana  47374
McFarland Clinic, PCAmes, Iowa  50010
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-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
Ochsner Health Center - BluebonnetBaton Rouge, Louisiana  70809
Union Hospital Cancer Program at Union HospitalElkton MD, Maryland  21921
Foote Memorial HospitalJackson, Michigan  49201
Haematology-Oncology Associates of Ohio and Michigan, PCLambertville, Michigan  48144
Mercy Memorial Hospital - MonroeMonroe, Michigan  48162
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
Heartland Regional Medical CenterSaint Joseph, Missouri  64506
Arch Medical Services, Incorporated at Center for Cancer Care and ResearchSaint Louis, Missouri  63141
Billings Clinic - DowntownBillings, Montana  59107-7000
Bozeman Deaconess Cancer CenterBozeman, Montana  59715
St. James Healthcare Cancer CareButte, Montana  59701
Great Falls Clinic - Main FacilityGreat Falls, Montana  59405
Sletten Cancer Institute at Benefis HealthcareGreat Falls, Montana  59405
Kalispell Medical Oncology at KRMCKalispell, Montana  59901
Alegant Health Cancer Center at Bergan Mercy Medical CenterOmaha, Nebraska  68124
Frederick R. and Betty M. Smith Cancer Treatment CenterSparta, New Jersey  07871
Leo W. Jenkins Cancer Center at ECU Medical SchoolGreenville, North Carolina  27834
Mary Rutan HospitalBellefontaine, Ohio  43311
Christ Hospital Cancer CenterCincinnati, Ohio  45219
Grant Medical Center Cancer CareColumbus, Ohio  43215
Flower Hospital Cancer CenterSylvania, Ohio  43560
Mount Carmel St. Ann's Cancer CenterWesterville, Ohio  43081
Clinton Memorial HospitalWilmington, Ohio  45177
St. Luke's Cancer Network at St. Luke's HospitalBethlehem, Pennsylvania  18015
McGlinn Family Regional Cancer Center at Reading Hospital and Medical CenterReading, Pennsylvania  19612-6052
Guthrie Cancer Center at Guthrie Clinic SayreSayre, Pennsylvania  18840
Hematology and Oncology Associates of Northeastern PennsylvaniaScranton, Pennsylvania  18510
Susquehanna Cancer Center at Divine Providence HospitalWilliamsport, Pennsylvania  17701
York Cancer Center at Apple Hill Medical CenterYork, Pennsylvania  17405
Fredericksburg Oncology, IncorporatedFredericksburg, Virginia  22401
Franciscan Cancer Center at St. Joseph Medical CenterTacoma, Washington  98405-3004
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
Vince Lombardi Cancer Clinic - Green Bay at Aurora BayCare Medical CenterGreen Bay, Wisconsin  54311
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
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
Mid Dakota Clinic, PCBismarck, North Dakota  58501
Regional Cancer Center at Memorial Medical CenterSpringfield, Illinois  62781-0001
John H. Stroger, Jr. Hospital of Cook CountyChicago, Illinois  60612-9985
Aurora Sinai Medical CenterMilwaukee, Wisconsin  53201-0342
Good Samaritan Cancer Center at Good Samaritan HospitalKearney, Nebraska  68848-1990
Dizzy Gillespie Cancer Institute at Englewood Hospital and Medical CenterEnglewood, New Jersey  07631
Pardee Memorial HospitalHendersonville, North Carolina  28791
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
Kinston Medical SpecialistsKinston, North Carolina  28501
Resurrection Medical CenterChicago, Illinois  60631
St. Francis HospitalEvanston, Illinois  60202
Frederick Memorial Hospital Regional Cancer Therapy CenterFrederick, Maryland  21701
Underwood Memorial HospitalWoodbury, New Jersey  08096
McLeod Regional Medical CenterFlorence, South Carolina  29501
Central Pennsylvania Hematology and Medical Oncology Associates, PCLemoyne, Pennsylvania  17043
La Grange Memorial HospitalLa Grange, Illinois  60525
Cedar Valley Medical Specialists, PC - West Ridgeway AvenueWaterloo, Iowa  50702
Great Falls, Montana  59405
Guardian Oncology and Center for WellnessMissoula, Montana  59804
Rockwood Clinic Cancer Treatment CenterSpokane, Washington  99204-2967
University of Wisconcin Cancer Center at Aspirus Wausau HospitalWausau, Wisconsin  54401
Jacobi Medical CenterBronx, New York  10461
Franklin & Edith Scarpa Regional Cancer Center at South Jersey HealthcareVineland, New Jersey  08360
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
Desert Regional Medical Center Comprehensive Cancer CenterPalm Springs, California  92262
Providence Medical CenterKansas City, Kansas  66112
Johnson County Radiation TherapyOverland Park, Kansas  66210
Berkshire Hematology Oncology, PCPittsfield, Massachusetts  01201
Oncology Care Associates, PLLCSaint Joseph, Michigan  49085
Independence Regional Health CenterIndependence, Missouri  64050
Kansas City Cancer Center at St. Joseph's Medical MallKansas City, Missouri  64114
Parvin Radiation OncologyKansas City, Missouri  64116
Radiation Oncology Associates of Kansas City at Northland Radiation Oncology CenterKansas City, Missouri  64154
Midwest Hematology Oncology Group, IncorporatedSaint Louis, Missouri  63109
Memorial Medical CenterModesto, California  95355
Elmhurst Memorial HospitalElmhurst, Illinois  60126
Veterans Affairs Medical Center - IndianapolisIndianapolis, Indiana  46202
Hattiesburg Clinic, PA at Forrest GeneralHattiesburg, Mississippi  39401
Valley Hospital - RidgewoodRidgewood, New Jersey  07450
Trinity CancerCare CenterMinot, North Dakota  58701
United States Air Force Medical Center - Wright-PattersonWright-Patterson AFB, Ohio  45433-5529
Riddle Memorial Hospital Cancer CenterMedia, Pennsylvania  19063
Cancer Center of Paoli Memorial HospitalPaoli, Pennsylvania  19301-1792
CCOP - Main Line HealthWynnewood, Pennsylvania  19096
AnMed Cancer CenterAnderson, South Carolina  29621
Dale and Frances Hughes Cancer Center at Pocono Medical CenterEast Stroudsburg, Pennsylvania  18301
Associates in Hematology-Oncology, PC at Crozer Regional Cancer CenterUpland, Pennsylvania  19013
Saint James Hospital and Health Centers Comprehensive Cancer Institute - Olympia FieldsOlympia Fields, Illinois  60461
Medcenter One Hospital Cancer Care CenterBismarck, North Dakota  58501
St. Alexius Medical Center Cancer CenterBismarck, North Dakota  58502
Center for Cancer Care at Goshen General HospitalGoshen, Indiana  46526
Augusta Oncology Associates - Walton WayAugusta, Georgia  30901
Provena St. Mary's Regional Cancer Center - KankakeeKankakee, Illinois  60901
Hematology & Oncology ClinicHattiesburg, Mississippi  39402
Frankford Hospital Cancer Center - Torresdale CampusPhiladelphia, Pennsylvania  19114
Eugene M. and Christine E. Lynn Cancer Institute at Boca Raton Community Hospital - Main CampusBoca Raton, Florida  33486
Camino Medical Group - Treatment CenterMountain View, California  94040
Delnor Community Hospital - GenevaGeneva, Illinois  60134
Kaiser Permanente Capital Area Medical Group - Shady Grove FacilityRockville, Maryland  20850
Ephrata Cancer Center at Ephrata Community HospitalEphrata, Pennsylvania  17522
Central Wisconsin Cancer Program at Agnesian HealthCareFond du Lac, Wisconsin  54935
Richard G. Laube Cancer Center at ACMHKittanning, Pennsylvania  16201
Clarian Arnett Cancer CareLafayette, Indiana  47904
St. Agnes Hospital Cancer CenterBaltimore, Maryland  21229
Kaiser Permanente Mid-Atlantic Medical Group-Largo Medical FacilityLargo, Maryland  20774
Kaiser Permanente - TowsonLutherville, Maryland  21093
Kaiser Permanente Medical Center - Fair OaksFairfax, Virginia  22033
Langlade Memorial HospitalAntigo, Wisconsin  54409
MaineGeneral Medical Center - WatervilleWaterville, Maine  04901
Upper Chesapeake Medical CenterBel Air, Maryland  21014
Carson Tahoe Cancer Center at Carson Tahoe Regional Medical CenterCarson City, Nevada  89703
AtlantiCare Cancer Care Institute at AtlantiCare Regional Medical Center - Mainland CampusPomona, New Jersey  08240