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A Randomized Phase III Trial of Maintenance Chemotherapy Comparing 12 Monthly Cycles of Single Agent Paclitaxel or Xyotax (CT-2103) (IND# 70177), Versus No Treatment Until Documented Relapse in Women With Advanced Ovarian or Primary Peritoneal or Fallopian Tube Cancer Who Achieve a Complete Clinical Response to Primary Platinum/Taxane Chemotherapy


Phase 3
N/A
N/A
Open (Enrolling)
Female
Fallopian Tube Cancer, Ovarian Cancer, Primary Peritoneal Cavity Cancer

Thank you

Trial Information

A Randomized Phase III Trial of Maintenance Chemotherapy Comparing 12 Monthly Cycles of Single Agent Paclitaxel or Xyotax (CT-2103) (IND# 70177), Versus No Treatment Until Documented Relapse in Women With Advanced Ovarian or Primary Peritoneal or Fallopian Tube Cancer Who Achieve a Complete Clinical Response to Primary Platinum/Taxane Chemotherapy


OBJECTIVES:

Primary

- Compare overall survival of patients with stage III or IV ovarian epithelial or primary
peritoneal cancer or fallopian tube cancer in clinical complete response after prior
primary platinum and taxane-based chemotherapy treated with paclitaxel vs polyglutamate
paclitaxel as consolidation/maintenance therapy vs no further anticancer therapy until
documented disease progression.

Secondary

- Compare progression-free survival of patients treated with these drugs.

- Compare the toxicity profile of these drugs, particularly peripheral neuropathy, in
these patients.

- Compare the quality of life of patients treated with these drugs.

Tertiary

- Correlate angiogenic marker expression with overall or progression-free survival of
patients treated with these drugs.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to
disease stage at diagnosis (stage III vs stage IV); presence of macroscopic disease after
initial debulking surgery (yes vs no); type of prior taxane-based therapy (docetaxel vs
paclitaxel); and route of prior platinum therapy (intraperitoneal vs IV). Patients are
randomized to 1 of 3 treatment arms.

- Arm I: Patients receive polyglutamate paclitaxel IV over 10-20 minutes on day 1.

- Arm II: Patients receive paclitaxel IV over 3 hours on day 1.

- Arm III: Patients receive no further anticancer treatment until evidence of disease
progression.

In arms I and II, treatment repeats every 28 days for up to 12 courses in the absence of
disease progression or unacceptable toxicity.

Quality of life is assessed at baseline, before courses 3, 5, and 7 of study treatment, at
completion of study treatment, and then at 1 year after completion of study treatment.

After completion of study treatment, patients are followed every 3 months for 2 years and
then every 6 months for 3 years.

PROJECTED ACCRUAL: A total of 1,110 patients (555 per treatment arm) will be accrued for
this study within 8.5 years.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed stage III or IV ovarian epithelial or primary peritoneal
cancer or fallopian tube cancer

- The following histologic epithelial cell types are allowed:

- Serous adenocarcinoma

- Endometrioid adenocarcinoma

- Mucinous adenocarcinoma

- Undifferentiated carcinoma

- Clear cell adenocarcinoma

- Mixed epithelial carcinoma

- Transitional cell carcinoma

- Malignant Brenner tumor

- Adenocarcinoma not otherwise specified

- The following histologic cell types are not allowed:

- Germ cell tumor

- Sex cord-stromal tumor

- Carcinosarcoma

- Mixed müllerian tumor or carcinosarcoma

- Metastatic carcinoma from other sites to the ovary

- Low malignant potential (LMP) tumor (borderline carcinoma), including
micropapillary serous carcinoma

- Patients with a prior diagnosis of LMP tumor that was surgically resected
and who subsequently developed invasive adenocarcinoma are eligible
provided patient did not receive prior chemotherapy for the ovarian LMP
tumor

- Must have undergone surgery for ovarian epithelial or primary peritoneal cancer AND
have tissue available for histologic evaluation

- Optimal (≤ 1 cm) residual disease OR suboptimal residual disease after initial
surgery

- Must have completed at least 5, but no more that 8 courses of primary therapy
comprising carboplatin (IV or intraperitoneal) AND paclitaxel or docetaxel-based
combination chemotherapy within the past 12 weeks AND have no symptoms of persistent
cancer after completion of therapy

- CT scan of the abdomen and/or pelvis normal

- CA 125 normal

- Patients treated with neo-adjuvant platinum-taxane chemotherapy for a presumptive
diagnosis of stage III or IV primary peritoneal carcinoma or epithelial ovarian
carcinoma (by paracentesis, percutaneous biopsy or open biopsy) are eligible provided
the following criteria is met:

- Must have undergone interval abdominal surgery after at least one but no more
than 6 courses of standard chemotherapy

- Surgery must meet the same criteria as the up front surgery, including
tissue diagnosis for confirmation of primary tumor site and stage III or IV
disease

- Patients must have received at least 2 courses after interval abdominal
surgery

- No synchronous primary endometrial cancer or history of primary endometrial cancer,
unless all of the following criteria are met:

- Stage ≤ IB

- Less than 3 mm invasion without vascular or lymphatic invasion

- No poorly differentiated subtypes, including papillary serous, clear cell, or
other FIGO grade 3 lesion

PATIENT CHARACTERISTICS:

Age

- Not specified

Performance status

- GOG 0-2

Life expectancy

- Not specified

Hematopoietic

- Absolute neutrophil count ≥ 1,500/mm^3

- Platelet count ≥ 100,000/mm^3

- No active bleeding

Hepatic

- Bilirubin ≤ 1.5 times upper limit of normal (ULN)

- SGOT ≤ 2.5 times ULN

- Alkaline phosphatase ≤ 2.5 times ULN

- PT or PTT normal

- No acute or chronic hepatitis

Renal

- Creatinine ≤ 1.5 times ULN

Cardiovascular

- Abnormal cardiac conduction (e.g., bundle branch block or heart block) allowed
provided the disease has remained stable within the past 6 months

- No unstable angina

- No myocardial infarction within the past 6 months

Other

- No neuropathy (sensory and motor) ≥ grade 2

- No active infection requiring antibiotics

- No ongoing gastrointestinal bleeding requiring blood product support

- No circumstance that would preclude study participation

- No other invasive malignancy within the past 5 years except nonmelanoma skin cancer

- Not pregnant or nursing

- Fertile patients must agree to use an effective contraception method

- Negative pregnancy test

PRIOR CONCURRENT THERAPY:

Biologic therapy

- No prior biologic therapy (e.g., bevacizumab or erlotinib) for any other abdominal or
pelvic tumor

Chemotherapy

- See Disease Characteristics

- No prior polyglutamate paclitaxel

- No prior chemotherapy for any other abdominal or pelvic tumor

- More than 3 years since prior adjuvant chemotherapy for localized breast cancer AND
no recurrent or metastatic disease

Endocrine therapy

- Not specified

Radiotherapy

- No prior radiotherapy to any portion of the abdominal cavity or pelvis

- More than 3 years since prior radiotherapy for localized cancer of the breast, head
and neck, or skin AND no recurrent or metastatic disease

Surgery

- See Disease Characteristics

Other

- No prior investigational therapy for any other abdominal or pelvic tumor

- No prior anticancer therapy that would preclude study therapy

- No concurrent amifostine or other protective agents

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Primary Purpose: Treatment

Outcome Measure:

Overall survival

Safety Issue:

No

Principal Investigator

Larry J. Copeland, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Ohio State University Comprehensive Cancer Center

Authority:

United States: Food and Drug Administration

Study ID:

GOG-0212

NCT ID:

NCT00108745

Start Date:

March 2005

Completion Date:

Related Keywords:

  • Fallopian Tube Cancer
  • Ovarian Cancer
  • Primary Peritoneal Cavity Cancer
  • stage IV ovarian epithelial cancer
  • ovarian clear cell cystadenocarcinoma
  • ovarian endometrioid adenocarcinoma
  • ovarian mixed epithelial carcinoma
  • ovarian mucinous cystadenocarcinoma
  • ovarian serous cystadenocarcinoma
  • Brenner tumor
  • ovarian undifferentiated adenocarcinoma
  • stage IIIA fallopian tube cancer
  • stage IIIB fallopian tube cancer
  • stage IIIC fallopian tube cancer
  • stage IIIA primary peritoneal cavity cancer
  • stage IIIB primary peritoneal cavity cancer
  • stage IIIC primary peritoneal cavity cancer
  • stage IV primary peritoneal cavity cancer
  • stage IIIA ovarian epithelial cancer
  • stage IIIB ovarian epithelial cancer
  • stage IIIC ovarian epithelial cancer
  • stage IV fallopian tube cancer
  • Ovarian Neoplasms
  • Peritoneal Neoplasms
  • Fallopian Tube Neoplasms

Name

Location

Louisiana State UniversityNew Orleans, Louisiana  70112-2282
Memorial Sloan Kettering Cancer CenterNew York, New York  10021
Cleveland Clinic FoundationCleveland, Ohio  44195
Roswell Park Cancer InstituteBuffalo, New York  14263
Mayo ClinicRochester, Minnesota  55905
H. Lee Moffitt Cancer Center and Research InstituteTampa, Florida  33612
University of Iowa Hospitals and ClinicsIowa City, Iowa  52242
University of Mississippi Medical CenterJackson, Mississippi  39216-4505
Washington University School of MedicineSaint Louis, Missouri  63110
Abington Memorial HospitalAbington, Pennsylvania  19001
Medical University of South CarolinaCharleston, South Carolina  29425-0721
University of Washington Medical CenterSeattle, Washington  98195-6043
Tacoma General HospitalTacoma, Washington  98405
Pennsylvania HospitalPhiladelphia, Pennsylvania  19107
Boulder Community HospitalBoulder, Colorado  80301-9019
Porter Adventist HospitalDenver, Colorado  80210
Rose Medical CenterDenver, Colorado  80220
Bronson Methodist HospitalKalamazoo, Michigan  49007
West Michigan Cancer CenterKalamazoo, Michigan  49007-3731
Borgess Medical CenterKalamazooaa, Michigan  49001
Fairview Ridges HospitalBurnsville, Minnesota  55337
United HospitalSt. Paul, Minnesota  55102
Ridgeview Medical CenterWaconia, Minnesota  55387
Geisinger Medical CenterDanville, Pennsylvania  17822-0001
Abramson Cancer Center of the University of PennsylvaniaPhiladelphia, Pennsylvania  19104-4283
Avera Cancer InstituteSioux Falls, South Dakota  57105
Massachusetts General Hospital Cancer CenterBoston, Massachusetts  02114
Morristown Memorial HospitalMorristown, New Jersey  07962-1956
Henry Ford HospitalDetroit, Michigan  48202
Memorial Hospital of South BendSouth Bend, Indiana  46601
Akron General Medical CenterAkron, Ohio  44302
Western Pennsylvania HospitalPittsburgh, Pennsylvania  15224
Reading Hospital and Medical CenterReading, Pennsylvania  19612-6052
University of Texas Medical BranchGalveston, Texas  77555-1329
LDS HospitalSalt Lake City, Utah  84143
Waukesha Memorial HospitalWaukesha, Wisconsin  53188
Rush University Medical CenterChicago, Illinois  60612-3824
Cedars-Sinai Medical CenterLos Angeles, California  90048
North Shore University HospitalManhasset, New York  11030
University of Arkansas for Medical SciencesLittle Rock, Arkansas  72205
University of Kansas Medical CenterKansas City, Kansas  66160-7353
Brooke Army Medical CenterFort Sam Houston, Texas  78234-6200
Hartford HospitalHartford, Connecticut  06102-5037
Sarasota Memorial HospitalSarasota, Florida  34239
Franklin Square Hospital CenterBaltimore, Maryland  21237
Baystate Medical CenterSpringfield, Massachusetts  01199
William Beaumont HospitalRoyal Oak, Michigan  48073
University of Nebraska Medical CenterOmaha, Nebraska  68198-3330
Via Christi Regional Medical CenterWichita, Kansas  67214
University of Oklahoma Health Sciences CenterOklahoma City, Oklahoma  73104
Iowa Methodist Medical CenterDes Moines, Iowa  50309
Iowa Lutheran HospitalDes Moines, Iowa  50316-2301
New Hanover Regional Medical CenterWilmington, North Carolina  28402-9025
University of Wisconsin Hospital and ClinicsMadison, Wisconsin  53792-0001
Winthrop University HospitalMineola, New York  11501
MetroHealth Medical CenterCleveland, Ohio  44109
Central Baptist HospitalLexington, Kentucky  40503
Long Island Jewish Medical CenterNew Hyde Park, New York  11040
Mount Sinai Medical CenterNew York, New York  10029
Fred Hutchinson Cancer Research Center/University of Washington Cancer ConsortiumSeattle, Washington  98109
Sibley Memorial HospitalWashington, District of Columbia  20016
North Colorado Medical CenterGreeley, Colorado  80631
Cancer Center of Kansas - ChanuteChanute, Kansas  66720
Cancer Center of Kansas - Dodge CityDodge City, Kansas  67801
Cancer Center of Kansas - NewtonNewton, Kansas  67114
Cancer Center of Kansas - SalinaSalina, Kansas  67042
Cancer Center of Kansas - WellingtonWellington, Kansas  67152
Associates in Womens HealthWichita, Kansas  67203
Cancer Center of Kansas - WinfieldWinfield, Kansas  67156
Munson Medical CenterTraverse City, Michigan  49684
Cancer Care Northwest - Spokane SouthSpokane, Washington  99202
University of New Mexico Cancer CenterAlbuquerque, New Mexico  87131-5636
Methodist Estabrook Cancer CenterOmaha, Nebraska  68114-4199
Elkhart General HospitalElkhart, Indiana  46515
Gynecologic Oncology of IndianaIndianapolis, Indiana  46237
South Bend ClinicSouth Bend, Indiana  46617
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical CenterColumbus, Ohio  43210-1240
Beebe Medical CenterLewes, Delaware  19958
Mecosta County Medical CenterBig Rapids, Michigan  49307
Exempla Lutheran Medical CenterWheat Ridge, Colorado  80033
Mercy HospitalCoon Rapids, Minnesota  55433
Medical Oncology and Hematology AssociatesDes Moines, Iowa  50309
Saint Joseph Mercy HospitalAnn Arbor, Michigan  48106
Fairview-Southdale HospitalEdina, Minnesota  55435
Abbott-Northwestern HospitalMinneapolis, Minnesota  55407
Regions HospitalSaint Paul, Minnesota  55101
Geisinger Medical GroupState College, Pennsylvania  16801
Northeast Georgia Medical CenterGainesville, Georgia  30501
Miami Valley HospitalDayton, Ohio  45409
Eastern Connecticut Hematology and Oncology AssociatesNorwich, Connecticut  06360
Cancer Center of Kansas - Fort ScottFort Scott, Kansas  66701
Cancer Center of Kansas-IndependenceIndependence, Kansas  67301
Research Medical CenterKansas City, Missouri  64132
Saint Luke's East - Lee's SummitLee's Summit, Missouri  64086
Woman's HospitalBaton Rouge, Louisiana  70815
Seattle Cancer Care AllianceSeattle, Washington  98109
Morton Plant HospitalClearwater, Florida  33756
Singing River HospitalPascagoula, Mississippi  39581
Methodist HospitalHouston, Texas  77030
Greater Baltimore Medical CenterBaltimore, Maryland  21204
Rutherford HospitalRutherfordton, North Carolina  28139
AnMed Health Cancer CenterAnderson, South Carolina  29621
Union Hospital of Cecil CountyElkton MD, Maryland  21921
Presbyterian HospitalCharlotte, North Carolina  28233-3549
Mayo Clinic in ArizonaScottsdale, Arizona  85259-5404
Mayo Clinic in FloridaJacksonville, Florida  32224
Pacific Gynecology SpecialistsSeattle, Washington  98104
Washington Hospital CenterWashington, District of Columbia  20010
Memorial Medical CenterSpringfield, Illinois  62781
Metro Health HospitalGrand Rapids, Michigan  49506
University of VirginiaCharlottesville, Virginia  22908
University of PittsburghPittsburgh, Pennsylvania  15261
New York Hospital Medical Center of QueensFresh Meadows, New York  11365
University of Alabama at BirminghamBirmingham, Alabama  35294-3300
Vanderbilt UniversityNashville, Tennessee  37232-6305
University of North CarolinaChapel Hill, North Carolina  27599
Duke University Medical CenterDurham, North Carolina  27710
Northwestern UniversityChicago, Illinois  60611
Queens Hospital CenterJamaica, New York  11432
Saint Louis University HospitalSt. Louis, Missouri  63110-0250
University of ConnecticutFarmington, Connecticut  06032
Saint Alphonsus Regional Medical CenterBoise, Idaho  83706
University of California at San DiegoLa Jolla, California  92093
Case Western Reserve UniversityCleveland, Ohio  44106
Yale UniversityNew Haven, Connecticut  06520
Wayne State UniversityDetroit, Michigan  48202
Riverside Methodist HospitalColumbus, Ohio  43214
Dartmouth Hitchcock Medical CenterLebanon, New Hampshire  03756
Indiana University Medical CenterIndianapolis, Indiana  46202
University of Texas Southwestern Medical CenterDallas, Texas  
University of KentuckyLexington, Kentucky  40536-0098
Wichita CCOPWichita, Kansas  67214-3882
Northwest HospitalSeattle, Washington  98133
Virginia Mason CCOPSeattle, Washington  98101
Metro-Minnesota CCOPSt. Louis Park, Minnesota  
UC Davis Comprehensive Cancer CenterSacramento, California  95817
Tufts Medical CenterBoston, Massachusetts  02111
Oregon Health and Science UniversityPortland, Oregon  97201
Florida Gynecologic OncologyFort Myers, Florida  33901
Jersey Shore Medical CenterNeptune, New Jersey  07754
Decatur Memorial HospitalDecatur, Illinois  62526
Westchester County Medical CenterValhalla, New York  10595
Tulane University Health Sciences CenterNew Orleans, Louisiana  70112
Virginia Commonwealth UniversityRichmond, Virginia  
Central Georgia Gynecologic OncologyMacon, Georgia  31201
Providence Saint Joseph Medical CenterBurbank, California  91505-4866
Florida HospitalOrlando, Florida  32803
Memorial Health University Medical CenterSavannah, Georgia  31404
Hillcrest Hospital Cancer CenterMayfield Heights, Ohio  44124
University of Chicago Comprehensive Cancer CenterChicago, Illinois  60637-1470
M D Anderson Cancer CenterHouston, Texas  77030
Northern Indiana Cancer Research ConsortiumSouth Bend, Indiana  
Chattanooga's Program in Women's OncologyChattanooga, Tennessee  37403
Northern Virginia Pelvic Surgery AssociatesAnnandale, Virginia  22003
Virginia Oncology Associates - Lake WrightNorfolk, Virginia  23502
University of CincinnatiCincinnati, Ohio  45267-0502
Penn State Milton S Hershey Medical CenterHershey, Pennsylvania  17033
The Community HospitalMunster, Indiana  46321
Littleton Adventist HospitalLittleton, Colorado  80122
Parker Adventist HospitalParker, Colorado  80138
Froedtert and the Medical College of WisconsinMilwaukee, Wisconsin  53226
Wake Forest University Health SciencesWinston-Salem, North Carolina  27157
Sutter General HospitalSacramento, California  95816
University of California San Francisco Medical Center-Mount ZionSan Francisco, California  94115
Penrose-Saint Francis HealthcareColorado Springs, Colorado  80907
Exempla Saint Joseph HospitalDenver, Colorado  80218
Colorado Cancer Research Program CCOPDenver, Colorado  80224-2522
Saint Mary's Hospital and Regional Medical CenterGrand Junction, Colorado  81502
Saint Francis Hospital and Medical CenterHartford, Connecticut  06105
The Hospital of Central ConnecticutNew Britain, Connecticut  06050
M D Anderson Cancer Center- OrlandoOrlando, Florida  32806
John B Amos Cancer CenterColumbus, Georgia  31904
Iowa Oncology Research Association CCOPDes Moines, Iowa  50309
Mercy Medical Center - Des MoinesDes Moines, Iowa  50314
Medical Oncology and Hematology Associates-Des MoinesDes Moines, Iowa  50309
Cancer Center of Kansas - El DoradoEl Dorado, Kansas  67042
Cancer Center of Kansas-KingmanKingman, Kansas  67068
Cancer Center of Kansas - ParsonsParsons, Kansas  67357
Cancer Center of Kansas - PrattPratt, Kansas  67124
Cancer Center of Kansas-Wichita Medical Arts TowerWichita, Kansas  67208
Cancer Center of Kansas - Main OfficeWichita, Kansas  67214
Grand Rapids Clinical Oncology ProgramGrand Rapids, Michigan  49503
Saint Mary's Health CareGrand Rapids, Michigan  49503
Spectrum Health at Butterworth CampusGrand Rapids, Michigan  49503
Mercy Health Partners-Mercy CampusMuskegon, Michigan  49443
Lakeland HospitalSt. Joseph, Michigan  49085
Saint Luke's Hospital of DuluthDuluth, Minnesota  55805
Unity HospitalFridley, Minnesota  55432
Minnesota Oncology Hematology PA-MaplewoodMaplewood, Minnesota  55109
North Memorial Medical Health CenterRobbinsdale, Minnesota  55422
Park Nicollet Clinic - Saint Louis ParkSaint Louis Park, Minnesota  55416
Minnesota Oncology and Hematology PA-WoodburyWoodbury, Minnesota  55125
Saint John's Regional Medical CenterJoplin, Missouri  64804
Freeman Health SystemJoplin, Missouri  64804
Saint Luke's Cancer InstituteKansas City, Missouri  64111
Saint Luke's Hospital of Kansas CityKansas City, Missouri  64111
Saint John's Mercy Medical CenterSaint Louis, Missouri  63141
Saint John's HospitalSpringfield, Missouri  65804
Cox Medical CenterSpringfield, Missouri  65807
Cooper Hospital University Medical CenterCamden, New Jersey  08103
Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington CountyMount Holly, New Jersey  08060
Memorial Medical Center - Las CrucesLas Cruces, New Mexico  88011
New York University Langone Medical CenterNew York, New York  10016
Columbia University Medical CenterNew York, New York  10032
State University of New York Upstate Medical UniversitySyracuse, New York  13210
Alamance Regional Medical CenterBurlington, North Carolina  27216
Aultman Health FoundationCanton, Ohio  44710
Kettering Medical CenterKettering, Ohio  45429
Northwest Cancer Specialists-Rose Quarter Cancer CenterPortland, Oregon  97227
Saint Luke's HospitalBethlehem, Pennsylvania  18015
Geisinger Wyoming ValleyWilkes-Barre, Pennsylvania  18711
Upstate Carolina CCOPSpartanburg, South Carolina  29303
The Don and Sybil Harrington Cancer CenterAmarillo, Texas  79106
Harrison Bremerton Hematology and OncologyBremerton, Washington  98310
Swedish Medical Center-First HillSeattle, Washington  98122-4307
Saint Vincent HospitalGreen Bay, Wisconsin  54301
Green Bay Oncology Limited at Saint Mary's HospitalGreen Bay, Wisconsin  54303
Green Bay Oncology at Saint Vincent HospitalGreen Bay, Wisconsin  54301-3526
Bay Area Medical CenterMarinette, Wisconsin  54143
University of California Medical Center At Irvine-Orange CampusOrange, California  92868
Cancer Care Associates-YaleTulsa, Oklahoma  74136-1929
Women and Infants HospitalProvidence, Rhode Island  02905
University of Maryland Greenebaum Cancer CenterBaltimore, Maryland  21201
Lake University Ireland Cancer CenterMentor, Ohio  44060
Lyndon Baines Johnson General HospitalHouston, Texas  77030
Women's Cancer AssociatesSaint Petersburg, Florida  33701
University of IllinoisChicago, Illinois  60612
Stony Brook University Medical CenterStony Brook, New York  11794
University of Colorado Cancer Center - Anschutz Cancer PavilionAurora, Colorado  80045
Michiana Hematology Oncology PC-ElkhartElkhart, Indiana  46514
Michiana Hematology Oncology PC-PlymouthPlymouth, Indiana  46563
Michiana Hematology Oncology PC-South BendSouth Bend, Indiana  46601
Michiana Hematology Oncology-PC WestvilleWestville, Indiana  46391
University of Michigan University HospitalAnn Arbor, Michigan  48109
Michiana Hematology Oncology PC-NilesNiles, Michigan  49120
University of Missouri - Ellis FischelColumbia, Missouri  65203
Moses Cone Health System-Regional Cancer CenterGreensboro, North Carolina  27403
Holy Family Memorial HospitalManitowoc, Wisconsin  54221
Vince Lombardi Cancer Clinic-SheboyganSheboygan, Wisconsin  53081
Vince Lombardi Cancer Clinic - SlingerSlinger, Wisconsin  53086
Advocate Lutheran General HospitalPark Ridge, Illinois  60068
Gynecologic Oncology of West Michigan PLLCGrand Rapids, Michigan  49546
Center of Hope at Renown Medical CenterReno, Nevada  89502
State University of New York Downstate Medical CenterBrooklyn, New York  11203
Monter Cancer CenterLake Success, New York  11042
Hope, A Women's Cancer CenterAsheville, North Carolina  28816
Magee-Womens Hospital - University of Pittsburgh Medical CenterPittsburgh, Pennsylvania  15213
Black Hills Obstetrics and GynecologyRapid City, South Dakota  57701
Chattanooga Gynecological OncologyChattanooga, Tennessee  37403
Carilion Clinic Gynecological OncologyRoanoke, Virginia  24016
Aurora Women's Pavilion of Aurora West Allis Medical CenterWest Allis, Wisconsin  53227
Long Beach Memorial Medical Center-Todd Cancer InstituteLong Beach, California  90806
Kaiser Permanente Los Angeles Medical CenterLos Angeles, California  90027
Rocky Mountain Gynecologic Oncology PCEnglewood, Colorado  80110
Norton Health Care Pavilion - DowntownLouisville, Kentucky  40202
Christus Schumpert Saint Mary's PlaceShreveport, Louisiana  71101
University of Minnesota Medical Center-FairviewMinneapolis, Minnesota  55455
Saint Dominic-Jackson Memorial HospitalJackson, Mississippi  39216
Southwest Gynecologic Oncology Associates IncAlbuquerque, New Mexico  87106
Knoxville Gynecologic Cancer Specialists PCKnoxville, Tennessee  37920
Women's Cancer Center of NevadaLas Vegas, Nevada  89109
Central DuPage Hospital Cancer CenterWarrenville, Illinois  60555
Saint Luke's South HospitalOverland Park, Kansas  66213
Kansas City CCOPPrairie Village, Kansas  66208
Spectrum Health Reed City HospitalReed City, Michigan  49677
Gundersen LutheranLa Crosse, Wisconsin  54601
Walter Reed National Military Medical CenterBethesda, Maryland  20889
Palo Alto Medical Foundation-Gynecologic OncologyMountain View, California  94040
Sudarshan K Sharma MD Limted-Gynecologic OncologyHinsdale, Illinois  60521
University of Massachusetts Memorial Health CareWorcester, Massachusetts  01605
University Medical Center BrackenridgeAustin, Texas  78701
Skagit Valley Hospital Regional Cancer Care CenterMount Vernon, Washington  98274
Providence Saint Mary Regional Cancer CenterWalla Walla, Washington  99362
Aurora Saint Luke's Medical CenterMilwaukee, Wisconsin  53215
Jonsson Comprehensive Cancer CenterLos Angeles, California  90095
Carle Foundation - Carle Cancer CenterUrbana, Illinois  61801
Michiana Hematology Oncology PC-MishawakaMishawaka, Indiana  46545-1470
Summa Akron City HospitalAkron, Ohio  44304
Sanford USD Medical Center - Sioux FallsSioux Falls, South Dakota  57117-5134
Geisinger Medical Center-Cancer Center HazeltonHazleton, Pennsylvania  18201
Community Howard Regional HealthKokomo, Indiana  46904
Indiana University Health La Porte HospitalLa Porte, Indiana  46350
Saint Joseph Regional Medical Center-MishawakaMishawaka, Indiana  46545-1470
Christiana Care Health System-Christiana HospitalNewark, Delaware  19718
Bronson Battle CreekBattle Creek, Michigan  49017
Cleveland Clinic Cancer Center/Fairview HospitalCleveland, Ohio  44111
Saint Joseph's Hospital and Medical CenterPhoenix, Arizona  85013
Kaiser Permanente Medical Care Program - Los Angeles Medical Center & Sunset HospitalLos Angeles, California  90027
Southeast Gynecologic Oncology AssociatesJacksonville, Florida  32204
The James Graham Brown Cancer Center at University of LouisvilleLouisville, Kentucky  40202
Women's Cancer Care Associates LLCAlbany, New York  12208
Island Gynecologic OncologyBrightwaters, New York  11718
Fletcher Allen Health Care-Medical CenterBurlington, Vermont  05401
Aurora Cancer Care-GraftonGrafton, Wisconsin  53024