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A Phase III, Randomized Trial of Weekly Cisplatin and Radiation Versus Cisplatin and Tirapazamine (IND #46525) and Radiation in Stage IB2, IIA, IIIB and IVA Cervical Carcinoma Limited to the Pelvis

Phase 3
18 Years
Open (Enrolling)
Cervical Adenocarcinoma, Cervical Adenosquamous Cell Carcinoma, Cervical Squamous Cell Carcinoma, Stage IB Cervical Cancer, Stage IIA Cervical Cancer, Stage IIB Cervical Cancer, Stage III Cervical Cancer, Stage IVA Cervical Cancer

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Trial Information

A Phase III, Randomized Trial of Weekly Cisplatin and Radiation Versus Cisplatin and Tirapazamine (IND #46525) and Radiation in Stage IB2, IIA, IIIB and IVA Cervical Carcinoma Limited to the Pelvis


I. Compare the progression-free survival of patients with stage IB, IIA, IIB, IIIB, or IVA
carcinoma of the cervix treated with cisplatin and radiotherapy with vs without


I. Compare overall survival of patients treated with these regimens. II. Compare the
toxicity of these regimens in these patients.


I. Correlate study treatment with tumor expression of carbonic anhydrase IX (CA-IX) and
recurrence-free survival, overall survival, or metastasis in patients treated with these

II. Correlate expression of CA-IX, hypoxia inducible factor-1α, CD-31, thrombospondin-1,
CD-105, or vascular endothelial growth factor (VEGF) in primary tumor tissue with
recurrence-free survival, overall survival, or metastasis in patients treated with these

III. Correlate pre-treatment and/or post-treatment serum concentrations of angiogenic
markers including angiogenin or VEGF with recurrence-free survival, overall survival, or
metastasis in patients treated with these regimens.

IV. Correlate various combinations of biological markers of hypoxia and angiogenesis with
recurrence-free survival, overall survival, or metastasis in patients treated with these

V. Correlate levels of individual biological markers of hypoxia or angiogenesis with
clinicopathological characteristics including tumor size, histologic subtype, FIGO stage,
depth of invasion, pelvic node status, site of recurrence, and hemoglobin level as well as
patient, age, race and performance status in patients treated with these regimens.

OUTLINE: This is a randomized, controlled, multicenter study. Patients are stratified
according to FIGO stage of disease (IB2 vs IIA vs IIB vs IIIB vs IVA), brachytherapy method
(low-dose rate vs high-dose rate), surgical staging of para-aortic nodes (yes vs no).
Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive cisplatin IV over 30-60 minutes once weekly on days 1, 8, 15, 22,
29, and 36 (weeks 1-6). Patients also undergo external beam radiotherapy to the pelvis once
daily on days 1-5, 8-12, 15-19, 22-26, and 29-33 (weeks 1-5). Patients then receive either 1
or 2 applications of low-dose rate brachytherapy in weeks 6-8 OR 5 applications of high-dose
rate (HDR)* brachytherapy once weekly in weeks 4-8 and 3-5 days of parametrial boost
radiotherapy** beginning after the first brachytherapy implant. Treatment continues in the
absence of disease progression or unacceptable toxicity.

ARM II: Patients receive tirapazamine IV over 2 hours on days 1, 8, 10, 12, 15, 22, 24, 26,
and 29 and cisplatin IV over 1 hour on days 1, 15, and 29. Patients also undergo
radiotherapy and brachytherapy as in arm I. Treatment continues in the absence of disease
progression or unacceptable toxicity.

NOTE: *No external beam radiotherapy is administered on the day of HDR brachytherapy. If the
majority of external beam radiotherapy has been administered, HDR brachytherapy may be
administered in 2 applications per week (separated by at least 72 hours) in order to
complete all treatment within 8 weeks.

NOTE: ** Patients may receive a parametrial boost at the discretion of the treating
radiation oncologist.

After completion of study treatment, patients are followed for at least 5 years.

Inclusion Criteria:

- Histologically confirmed invasive squamous cell carcinoma, adenocarcinoma, or
adenosquamous cell carcinoma of the uterine cervix

- Stage IB2, IIA, IIB, IIIB, or IVA disease

- Stage IIA tumors must be > 4 cm

- Primary, untreated disease

- Negative, non-suspicious para-aortic nodes by lymphangiogram, CT scan, MRI, or

- Must have been adequately clinically staged

- Suitable for treatment with radical intent using concurrent chemotherapy and pelvic

- No disease involvement of the lower third of the vagina regardless of stage (all
stage IIIA, IIIB and IVA with lower one-third involvement)

- No carcinoma of the cervical stump

- Performance status - GOG 0-3

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

- Platelet count ≥ 100,000/mm^3

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

- SGOT ≤ 3 times ULN

- Alkaline phosphatase ≤ 3 times ULN

- Creatinine ≤ ULN or calculated creatinine clearance ≥ 60mL/min

- No New York Heart Association class III-IV heart failure

- No history of myocardial infarction

- No unstable angina

- No uncontrolled hypertension

- No pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- No septicemia or severe infection

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

- No prior hysterectomy or planned hysterectomy as part of initial cervix cancer

- No prior coronary artery bypass surgery

- No prior cancer therapy that would preclude study treatment

- No concurrent angina medication

- No concurrent intensity-modulated radiotherapy

Type of Study:


Study Design:

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

Outcome Measure:

Progression-free survival

Outcome Time Frame:

Up to 5 years

Safety Issue:


Principal Investigator

Paul DiSilvestro

Investigator Role:

Principal Investigator

Investigator Affiliation:

Gynecologic Oncology Group


United States: Food and Drug Administration

Study ID:




Start Date:

February 2006

Completion Date:

Related Keywords:

  • Cervical Adenocarcinoma
  • Cervical Adenosquamous Cell Carcinoma
  • Cervical Squamous Cell Carcinoma
  • Stage IB Cervical Cancer
  • Stage IIA Cervical Cancer
  • Stage IIB Cervical Cancer
  • Stage III Cervical Cancer
  • Stage IVA Cervical Cancer
  • Adenocarcinoma
  • Adenocarcinoma, Mucinous
  • Carcinoma
  • Carcinoma, Squamous Cell
  • Uterine Cervical Neoplasms
  • Carcinoma, Adenosquamous



Louisiana State University New Orleans, Louisiana  70112-2282
Memorial Sloan Kettering Cancer Center New York, New York  10021
Cleveland Clinic Foundation Cleveland, Ohio  44195
Roswell Park Cancer Institute Buffalo, New York  14263
Mayo Clinic Rochester, Minnesota  55905
University of Iowa Hospitals and Clinics Iowa City, Iowa  52242
University of Mississippi Medical Center Jackson, Mississippi  39216-4505
Abington Memorial Hospital Abington, Pennsylvania  19001
Medical University of South Carolina Charleston, South Carolina  29425-0721
University of Washington Medical Center Seattle, Washington  98195-6043
Tacoma General Hospital Tacoma, Washington  98405
Tripler Army Medical Center Honolulu, Hawaii  96859-5000
Memorial Hospital of South Bend South Bend, Indiana  46601
Community Medical Center Toms River, New Jersey  08755
Akron General Medical Center Akron, Ohio  44302
Lehigh Valley Hospital Allentown, Pennsylvania  18103
Western Pennsylvania Hospital Pittsburgh, Pennsylvania  15224
Reading Hospital and Medical Center Reading, Pennsylvania  19612-6052
University of Texas Medical Branch Galveston, Texas  77555-1329
LDS Hospital Salt Lake City, Utah  84143
Rush University Medical Center Chicago, Illinois  60612-3824
North Shore University Hospital Manhasset, New York  11030
University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
University of Kansas Medical Center Kansas City, Kansas  66160-7353
Brooke Army Medical Center Fort Sam Houston, Texas  78234-6200
Hartford Hospital Hartford, Connecticut  06102-5037
Eastern Maine Medical Center Bangor, Maine  04401
Providence Alaska Medical Center Anchorage, Alaska  99508
William Beaumont Hospital Royal Oak, Michigan  48073
Cancer Institute of New Jersey New Brunswick, New Jersey  08901
University of Nebraska Medical Center Omaha, Nebraska  68198-3330
Via Christi Regional Medical Center Wichita, Kansas  67214
Wesley Medical Center Wichita, Kansas  67214
University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma  73104
Iowa Methodist Medical Center Des Moines, Iowa  50309
Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
New Hanover Regional Medical Center Wilmington, North Carolina  28402-9025
Mobile Infirmary Medical Center Mobile, Alabama  36640-0460
Great Falls Clinic Great Falls, Montana  59405
MetroHealth Medical Center Cleveland, Ohio  44109
Long Island Jewish Medical Center New Hyde Park, New York  11040
Banner Good Samaritan Medical Center Phoenix, Arizona  85006
North Colorado Medical Center Greeley, Colorado  80631
McKee Medical Center Loveland, Colorado  80539
Cancer Center of Kansas - Chanute Chanute, Kansas  66720
Cancer Center of Kansas - Dodge City Dodge City, Kansas  67801
Cancer Center of Kansas - Newton Newton, Kansas  67114
Cancer Center of Kansas - Salina Salina, Kansas  67042
Cancer Center of Kansas - Wellington Wellington, Kansas  67152
Associates in Womens Health Wichita, Kansas  67203
Cancer Center of Kansas - Winfield Winfield, Kansas  67156
Munson Medical Center Traverse City, Michigan  49684
Northern Rockies Radiation Oncology Center Billings, Montana  59101
American Fork Hospital American Fork, Utah  84003
Logan Regional Hospital Logan, Utah  84321
Cottonwood Hospital Medical Center Murray, Utah  84107
McKay-Dee Hospital Center Ogden, Utah  84403
University of New Mexico Cancer Center Albuquerque, New Mexico  87131-5636
Good Samaritan Hospital - Cincinnati Cincinnati, Ohio  45220
Methodist Estabrook Cancer Center Omaha, Nebraska  68114-4199
City of Hope Medical Center Duarte, California  91010
Elkhart General Hospital Elkhart, Indiana  46515
Gynecologic Oncology of Indiana Indianapolis, Indiana  46237
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center Columbus, Ohio  43210-1240
Beebe Medical Center Lewes, Delaware  19958
Saint Joseph's Hospital of Atlanta Atlanta, Georgia  30342-1701
Piedmont Hospital Atlanta, Georgia  30309
BroMenn Regional Medical Center Normal, Illinois  61761
Valley Cancer Center Spring Valley, Illinois  61362
Mecosta County Medical Center Big Rapids, Michigan  49307
Wilson Medical Center Wilson, North Carolina  27893-3428
Bismarck Cancer Center Bismarck, North Dakota  58501
Doctor's Hospital of Laredo Laredo, Texas  78041
Graham Hospital Association Canton, Illinois  61520
Saint Joseph Medical Center Joliet, Illinois  60435
Medical Oncology and Hematology Associates Des Moines, Iowa  50309
Saint Francis Regional Medical Center Shakopee, Minnesota  55379
Lancaster General Hospital Lancaster, Pennsylvania  17604-3555
Pomona Valley Hospital Medical Center Pomona, California  91767
Center for Cancer Care and Research St. Louis, Missouri  63141
Miami Valley Hospital Dayton, Ohio  45409
Hospital District Sixth of Harper County Anthony, Kansas  67003
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Lawrence Memorial Hospital Lawrence, Kansas  66044
Bethesda North Hospital Cincinnati, Ohio  45242
Union Hospital of Cecil County Elkton MD, Maryland  21921
Mayo Clinic in Florida Jacksonville, Florida  32224
Washington Hospital Center Washington, District of Columbia  20010
Memorial Medical Center Springfield, Illinois  62781
Metro Health Hospital Grand Rapids, Michigan  49506
Queen's Medical Center Honolulu, Hawaii  96813
University of Virginia Charlottesville, Virginia  22908
University of Alabama at Birmingham Birmingham, Alabama  35294-3300
Vanderbilt University Nashville, Tennessee  37232-6305
University of North Carolina Chapel Hill, North Carolina  27599
Duke University Medical Center Durham, North Carolina  27710
Meharry Medical College Nashville, Tennessee  37208-3599
Providence Medical Center Kansas City, Kansas  66112
Independence Regional Health Center Independence, Missouri  64050
East Bay Radiation Oncology Center Castro Valley, California  94546
Kapiolani Medical Center at Pali Momi Aiea, Hawaii  96701
Maui Memorial Medical Center Wailuku, Hawaii  96793
Queens Hospital Center Jamaica, New York  11432
Saint Louis University Hospital St. Louis, Missouri  63110-0250
Case Western Reserve University Cleveland, Ohio  44106
Yale University New Haven, Connecticut  06520
Wayne State University Detroit, Michigan  48202
Straub Clinic and Hospital Honolulu, Hawaii  96813
University of Massachusetts Medical School Worcester, Massachusetts  01605
Riverside Methodist Hospital Columbus, Ohio  43214
Mid Dakota Clinic Bismarck, North Dakota  58501
Indiana University Medical Center Indianapolis, Indiana  46202
University of Texas Southwestern Medical Center Dallas, Texas  
Wichita CCOP Wichita, Kansas  67214-3882
Montana Cancer Consortium CCOP Billings, Montana  59101
Providence Hospital Southfield, Michigan  48075
Thomas Jefferson University Hospital Philadelphia, Pennsylvania  19131
Florida Gynecologic Oncology Fort Myers, Florida  33901
Jersey Shore Medical Center Neptune, New Jersey  07754
Tulane University Health Sciences Center New Orleans, Louisiana  70112
Virginia Commonwealth University Richmond, Virginia  
Memorial Health University Medical Center Savannah, Georgia  31404
Good Samaritan Hospital Medical Center West Islip, New York  11795
Hillcrest Hospital Cancer Center Mayfield Heights, Ohio  44124
University of Chicago Comprehensive Cancer Center Chicago, Illinois  60637-1470
M D Anderson Cancer Center Houston, Texas  77030
DeKalb Medical Center Decatur, Georgia  30033
Northern Indiana Cancer Research Consortium South Bend, Indiana  
Chattanooga's Program in Women's Oncology Chattanooga, Tennessee  37403
Northern Virginia Pelvic Surgery Associates Annandale, Virginia  22003
University of Cincinnati Cincinnati, Ohio  45267-0502
Hawaii Medical Center East Honolulu, Hawaii  96817
Froedtert and the Medical College of Wisconsin Milwaukee, Wisconsin  53226
Wake Forest University Health Sciences Winston-Salem, North Carolina  27157
OSF Saint Francis Medical Center Peoria, Illinois  61637
Northside Hospital Atlanta, Georgia  30342
Western Regional CCOP Phoenix, Arizona  85006
Bay Area Tumor Institution CCOP Oakland, California  94609
Memorial Hospital Colorado Springs Colorado Springs, Colorado  80909
The Hospital of Central Connecticut New Britain, Connecticut  06050
M D Anderson Cancer Center- Orlando Orlando, Florida  32806
John B Amos Cancer Center Columbus, Georgia  31904
Wellstar Kennestone Hospital Marietta, Georgia  30060
University of Hawaii Honolulu, Hawaii  96813
Rush - Copley Medical Center Aurora, Illinois  60504
Saint Francis Hospital Evanston, Illinois  60202
Intercommunity Cancer Center Galesburg, Illinois  61401
Joliet Oncology-Hematology Associates Limited Joliet, Illinois  60435
Community Cancer Center Foundation Normal, Illinois  61761
Illinois CancerCare-Peoria Peoria, Illinois  61615
Saint Margaret's Hospital Spring Valley, Illinois  61362
Carle Clinic-Urbana Main Urbana, Illinois  61801
Saint Anthony Memorial Health Center Michigan City, Indiana  46360
McFarland Clinic Ames, Iowa  50010
Medical Oncology and Hematology Associates-West Des Moines Clive, Iowa  50325
Iowa Oncology Research Association CCOP Des Moines, Iowa  50309
Mercy Capitol Des Moines, Iowa  50307
Mercy Medical Center - Des Moines Des Moines, Iowa  50314
Medical Oncology and Hematology Associates-Des Moines Des Moines, Iowa  50309
Cancer Center of Kansas - El Dorado El Dorado, Kansas  67042
Cancer Center of Kansas-Kingman Kingman, Kansas  67068
Radiation Oncology Practice Corporation Southwest Overland Park, Kansas  66210
Cancer Center of Kansas - Parsons Parsons, Kansas  67357
Cancer Center of Kansas - Pratt Pratt, Kansas  67124
Cancer Center of Kansas-Wichita Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas - Main Office Wichita, Kansas  67214
Green Bay Oncology - Escanaba Escanaba, Michigan  49431
Spectrum Health-Blodgett Campus Grand Rapids, Michigan  49506
Grand Rapids Clinical Oncology Program Grand Rapids, Michigan  49503
Saint Mary's Health Care Grand Rapids, Michigan  49503
Spectrum Health at Butterworth Campus Grand Rapids, Michigan  49503
Green Bay Oncology - Iron Mountain Iron Mountain, Michigan  49801
Mercy Health Partners-Mercy Campus Muskegon, Michigan  49443
Mercy Health Partners-Hackley Campus Muskegon, Michigan  49442
Lakeland Hospital St. Joseph, Michigan  49085
Radiation Oncology Practice Corporation - North Kansas City, Missouri  64154
Radiation Oncology Practice Corporation South Kansas City, Missouri  64114
Missouri Baptist Medical Center Saint Louis, Missouri  63131
Saint John's Mercy Medical Center Saint Louis, Missouri  63141
Ozark Health Ventures LLC dba Cancer Research for The Ozarks Springfield Springfield, Missouri  65802
Saint John's Hospital Springfield, Missouri  65804
Cox Medical Center Springfield, Missouri  65807
Hematology-Oncology Centers of the Northern Rockies PC Billings, Montana  59101
Billings Clinic Billings, Montana  59107-7000
Berdeaux, Donald MD (UIA Investigator) Great Falls, Montana  59405
Good Samaritan Hospital Kearney, Nebraska  68847
Cooper Hospital University Medical Center Camden, New Jersey  08103
Mountainside Hospital Montclair, New Jersey  07042
Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington County Mount Holly, New Jersey  08060
Virtua West Jersey Hospital Voorhees Voorhees, New Jersey  08043
Orange Regional Medical Center Middletown, New York  10940
New York University Langone Medical Center New York, New York  10016
State University of New York Upstate Medical University Syracuse, New York  13210
Saint Alexius Medical Center Bismarck, North Dakota  58501
Aultman Health Foundation Canton, Ohio  44710
Mount Carmel Health Center West Columbus, Ohio  43222
Good Samaritan Hospital - Dayton Dayton, Ohio  45406
Samaritan North Health Center Dayton, Ohio  45415
Wright-Patterson Medical Center Wright-Patterson Afb, Ohio  45433-5529
Salem Hospital Salem, Oregon  97309
Saint Luke's Hospital Bethlehem, Pennsylvania  18015
Hematology and Oncology Associates of North East Pennsylvania Scranton, Pennsylvania  18508
Scranton Hematology Oncology Scranton, Pennsylvania  18510
Mercy Hospital Scranton, Pennsylvania  18501
The Don and Sybil Harrington Cancer Center Amarillo, Texas  79106
Southwest VA Regional Cancer Center Norton, Virginia  24273
Good Samaritan Community Hospital Puyallup, Washington  98372
Northwest CCOP Tacoma, Washington  98405
Multicare Health System Tacoma, Washington  98415
Saint Joseph Medical Center Tacoma, Washington  98405
Wheeling Hospital Wheeling, West Virginia  26003
Saint Vincent Hospital Green Bay, Wisconsin  54301
Green Bay Oncology Limited at Saint Mary's Hospital Green Bay, Wisconsin  54303
Saint Mary's Hospital Green Bay, Wisconsin  54303
Green Bay Oncology at Saint Vincent Hospital Green Bay, Wisconsin  54301-3526
Bay Area Medical Center Marinette, Wisconsin  54143
Green Bay Oncology - Oconto Falls Oconto Falls, Wisconsin  54154
Green Bay Oncology - Sturgeon Bay Sturgeon Bay, Wisconsin  54235
University of California Medical Center At Irvine-Orange Campus Orange, California  92868
Cancer Care Associates-Yale Tulsa, Oklahoma  74136-1929
Cancer Care Associates-Midtown Tulsa, Oklahoma  74104
Women and Infants Hospital Providence, Rhode Island  02905
Colorado Gynecologic Oncology Group Aurora, Colorado  80010
Lake University Ireland Cancer Center Mentor, Ohio  44060
University of Illinois Chicago, Illinois  60612
Stony Brook University Medical Center Stony Brook, New York  11794
University of Missouri - Ellis Fischel Columbia, Missouri  65203
Renown Regional Medical Center Reno, Nevada  89502
UMDNJ - New Jersey Medical School Newark, New Jersey  07103
Utah Valley Regional Medical Center Provo, Utah  84603
Dixie Medical Center Regional Cancer Center Saint George, Utah  84770
Intermountain Health Care Salt Lake City, Utah  84103
Utah Cancer Specialists-Salt Lake City Salt Lake City, Utah  84106
Washington Regional Medical Center - Fayetteville Fayetteville, Arkansas  72703
Highlands Oncology Group PA - Fayetteville Fayetteville, Arkansas  72703
Olive View-University of California Los Angeles Medical Center Sylmar, California  91342
Hawaii Minority Based CCOP Honolulu, Hawaii  96813
Advocate Lutheran General Hospital Park Ridge, Illinois  60068
Saint Elizabeth Medical Center South Edgewood, Kentucky  41017
Maine Medical Center-Bramhall Campus Portland, Maine  04102
Gynecologic Oncology of West Michigan PLLC Grand Rapids, Michigan  49546
Center of Hope at Renown Medical Center Reno, Nevada  89502
Montefiore Medical Center-Weiler Division Bronx, New York  10461
State University of New York Downstate Medical Center Brooklyn, New York  11203
Monter Cancer Center Lake Success, New York  11042
Hope, A Women's Cancer Center Asheville, North Carolina  28816
Magee-Womens Hospital - University of Pittsburgh Medical Center Pittsburgh, Pennsylvania  15213
Black Hills Obstetrics and Gynecology Rapid City, South Dakota  57701
Chattanooga Gynecological Oncology Chattanooga, Tennessee  37403
East Tennessee State University Johnson City, Tennessee  37614-0054
Texas Tech University Health Sciences Center Lubbock, Texas  79430
Bon Secours Commonwealth Gynecologic Oncology Richmond, Virginia  23226
Carilion Clinic Gynecological Oncology Roanoke, Virginia  24016
Northwest Medical Specialties PLLC Tacoma, Washington  98405
Aurora Women's Pavilion of Aurora West Allis Medical Center West Allis, Wisconsin  53227
Stanford University Hospitals and Clinics Stanford, California  94305
Siouxland Hematology Oncology Associates Sioux City, Iowa  51101
Georgia Health Sciences University Augusta, Georgia  30912
Jonsson Comprehensive Cancer Center Los Angeles, California  90095
Carle Foundation - Carle Cancer Center Urbana, Illinois  61801
North Shore-LIJ Health System CCOP Manhasset, New York  11030
Sanford Bismarck Medical Center Bismarck, North Dakota  58501
Community Howard Regional Health Kokomo, Indiana  46904
Indiana University Health La Porte Hospital La Porte, Indiana  46350
Saint Joseph Regional Medical Center-Mishawaka Mishawaka, Indiana  46545-1470
Christiana Care Health System-Christiana Hospital Newark, Delaware  19718
Bronson Battle Creek Battle Creek, Michigan  49017
Cleveland Clinic Cancer Center/Fairview Hospital Cleveland, Ohio  44111
The James Graham Brown Cancer Center at University of Louisville Louisville, Kentucky  40202
Women's Cancer Care Associates LLC Albany, New York  12208
Island Gynecologic Oncology Brightwaters, New York  11718
Fletcher Allen Health Care-Medical Center Burlington, Vermont  05401