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Intergroup Randomized Phase III Study of Postoperative Oxaliplatin, 5-Fluorouracil and Leucovorin vs Oxaliplatin, 5-Fluorouracil, Leucovorin and Bevacizumab for Patients With Stage II or III Rectal Cancer Receiving Pre-operative Chemoradiation

Phase 3
18 Years
Not Enrolling
Adenocarcinoma of the Rectum, Stage II Rectal Cancer, Stage III Rectal Cancer

Thank you

Trial Information

Intergroup Randomized Phase III Study of Postoperative Oxaliplatin, 5-Fluorouracil and Leucovorin vs Oxaliplatin, 5-Fluorouracil, Leucovorin and Bevacizumab for Patients With Stage II or III Rectal Cancer Receiving Pre-operative Chemoradiation


I. Compare the overall survival of patients who have undergone prior surgery and neoadjuvant
chemoradiotherapy for clinical stage II or III rectal cancer treated with adjuvant
oxaliplatin, leucovorin calcium, fluorouracil with vs without postoperative bevacizumab.


I. Evaluate tolerance of treatment, patterns of failure, and disease-free survival in
patients treated with these regimens.

II. Assess long-term rectal function using the Patient Bowel Function/Uniscale questionnaire
and the Functional Assessment of Cancer (FACT)-Diarrhea subscale in patients treated with
these regimens.

III. Validate the FACT-Diarrhea subscale. IV. Assess long-term symptoms of
oxaliplatin-related neurotoxicity using the FACT/GOG-Neurotoxicity subscale in patients
treated with these regimens.

V. Correlate TS, DPD and TP expression (key targets for fluorouracil); retention of
chromosome 18q alleles and microsatellite instability (MSI) with TGFβ1RII mutation (markers
for fluorouracil efficacy); ERCC1, ERCC2, and XPF expression (participants in repair of
adducts from oxaliplatin); and p53 gene mutation and possibly other molecular markers
pertinent to vascular endothelial growth factor in tumor tissue specimens with treatment
efficacy in these patients.

VI. Correlate tumor molecular prognostic markers (chromosome 18q allelic loss and MSI) with
survival in patients treated with this regimen.

OUTLINE: This is a randomized study. Patients are stratified according to ECOG performance
status (0 vs 1), clinical staging (high risk [T3, N+, M0 or T4, any N, M0] vs low risk
[T1-2, N+, M0 or T3, N0, M0]), prior pre-operative oxaliplatin (yes vs no), and prior
radiotherapy dose (40-50 Gy vs > 50-55.8 Gy pre-operatively). Patients are randomized to 1
of 2 treatment arms.

ARM I (closed to accrual as of 4/29/2009): Patients receive oxaliplatin IV over 2 hours,
leucovorin calcium IV over 2 hours, and fluorouracil IV on day 1 followed by fluorouracil IV
continuously over 46 hours on days 1 and 2. Treatment repeats every 2 weeks for up to 12
courses* in the absence of disease progression or unacceptable toxicity.

ARM II (closed to accrual as of 4/29/2009): Patients receive bevacizumab** IV over 30-90
minutes on day 1. Patients also receive oxaliplatin, leucovorin calcium, and fluorouracil as
in arm I*.

[Note: **Patients no longer receive bevacizumab as of 4/29/2009)]

[Note: *Patients who received prior neoadjuvant oxaliplatin including patients on protocol
NSABP-R-04 receive up to 9 courses of treatment followed by leucovorin calcium IV and
fluorouracil IV with (arm II) or without (arm I) bevacizumab for up to 3 courses.]

Patients complete 10-15 minute questionnaires about bowel function 4 times during study

After completion of study treatment, patients are followed periodically for approximately 10

Inclusion Criteria:

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception during and for at least 3 months
after study treatment

- No other previous or concurrent malignancy except nonmelanoma skin cancer, breast
cancer in situ, carcinoma in situ of the cervix, or previously treated nonpelvic
cancer that has been disease-free for > 5 years

- Patients with a history of breast cancer (without evidence of disease) who remain on
hormonal therapy for > 5 years are eligible

- No active bleeding not related to the primary rectal tumor within the past 6 months

- No active inflammatory bowel disease or other serious medical illness which might
limit the ability of the patient to receive protocol therapy

- No active gastroduodenal ulcer determined by endoscopy

- No serious or nonhealing wound, skin ulcer, or bone fracture

- No clinically significant peripheral sensory or motor neuropathy >= grade 2

- No nonmalignant systemic disease (e.g., cardiovascular, renal, or hepatic) that would
preclude study treatment including, but not limited to, any of the following:

- New York Heart Association class III or IV congestive heart failure

- Concurrent symptomatic arrhythmia

- No transient ischemic attack or cerebrovascular accident

- No arterial thromboembolic event, unstable angina, or myocardial infarction within
the past 12 months

- No significant peripheral vascular disease

- No psychiatric or addictive disorders or other conditions that, in the opinion of the
investigator, would preclude study requirements

- Patients with a history of hypertension must have blood pressure < 150/90 mm Hg AND
be on a stable regimen of antihypertensive therapy

- No significant traumatic injury within the past 28 days

- No known allergy to platinum compounds

- No other prior chemotherapy or pelvic radiotherapy except as neoadjuvant treatment
for current diagnosis of rectal cancer

- No prior invasive procedure, including either of the following:

- Major surgical procedure or open biopsy within the past 28 days

- Core biopsy or other minor procedure, except placement of a vascular access
device, within the past 7 days

- Concurrent participation on protocol NSABP-R-04 allowed

- Histologically confirmed adenocarcinoma of the rectum meeting 1 of the following
clinical (e.g., before neoadjuvant therapy) or pathologic staging criteria:

- T3, N+, M0

- T3, N0, M0

- T4, N0, M0

- Any T, N1-2, M0

- T4, N0-2, M0 disease must meet 1 of the following criteria:

- Clinically fixed tumor on rectal examination with tumor adherent to the pelvic
sidewall or sacrum

- Hydronephrosis on CT scan or IVP

- Ureteric or bladder invasion as documented by cystoscopy and cytology or biopsy

- Invasion into prostate

- Vaginal or uterine involvement

- Must have undergone complete tumor resection >= 28 days ago and able to begin
treatment by day 56

- No evidence of metastatic disease on the surgical/intraoperative examination

- Must have undergone concurrent neoadjuvant chemoradiotherapy*

- Must have undergone prior radiotherapy at 40-55.8 Gy** AND received 1 of the
following chemotherapy regimens:

- Continuous infusion of fluorouracil with or without oxaliplatin; fluorouracil
and leucovorin calcium

- Capecitabine with or without oxaliplatin; capecitabine with or without
oxaliplatin OR a continuous infusion of fluorouracil with or without oxaliplatin
received on protocol NSABP-R-04

- NOTE: *Neoadjuvant chemoradiotherapy received on protocol NSABP-R-04 allowed provided
it met these criteria

- NOTE: **Intensity-modulated radiotherapy allowed

- No evidence of metastatic disease confirmed by CT scan, MRI, or ultrasound of the
liver or chest CT scan or chest x-ray within the past 6 months

- No evidence of tumor outside of the pelvis, including liver metastases, peritoneal
seeding, or metastatic inguinal lymphadenopathy

- ECOG performance status 0-1

- Platelet count >= 100,000/mm^3

- Absolute granulocyte count >= 1,500/mm^3

- Bilirubin normal (unless chronic grade 1 bilirubin elevation due to Gilbert's disease
or similar syndrome due to slow conjugation of bilirubin)

- Alkaline phosphatase (AP) < 2.5 times upper limit of normal (ULN) and AST < 1.5 times

- Hepatitis B and C negative (for patients with AP > normal) unless previously

- Serum creatinine =< 1.5 times ULN

- Urine protein:creatinine (UPC) ratio < 1.0 OR urine protein < 1 g on 24-hour urine

- INR =< 1.5

- INR > 1.5 allowed provided patient is on full-dose anticoagulants AND meets all of
the following criteria:

- In-range INR (i.e., between 2 and 3) on a stable dose of warfarin or low
molecular weight heparin

- No active bleeding or pathological condition that is associated with a high risk
of bleeding

- No concurrent major surgery

Type of Study:


Study Design:

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

Outcome Measure:

Overall survival

Outcome Description:

Treatment arms compared by stratified log-rank test.

Outcome Time Frame:

Up to 10 years

Safety Issue:


Principal Investigator

Al Benson

Investigator Role:

Principal Investigator

Investigator Affiliation:

Eastern Cooperative Oncology Group


United States: Food and Drug Administration

Study ID:




Start Date:

February 2006

Completion Date:

Related Keywords:

  • Adenocarcinoma of the Rectum
  • Stage II Rectal Cancer
  • Stage III Rectal Cancer
  • Adenocarcinoma
  • Adenocarcinoma, Mucinous
  • Rectal Neoplasms



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Saint Anthony Central Hospital Denver, Colorado  80204
Exempla Saint Joseph Hospital Denver, Colorado  80218
Colorado Cancer Research Program CCOP Denver, Colorado  80224-2522
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Saint Mary Corwin Medical Center Pueblo, Colorado  81004
Lombardi Comprehensive Cancer Center at Georgetown University Washington, District of Columbia  20057
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Atlanta Regional CCOP Atlanta, Georgia  30342
Well Star Cobb Hospital Austell, Georgia  30106
Veterans Administration Medical Center Decatur, Georgia  30033
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University of Hawaii Honolulu, Hawaii  96813
Pacific Cancer Institute of Maui Wailuku, Hawaii  96793
Saint Luke's Mountain States Tumor Institute Boise, Idaho  83712
Saint Anthony's Health Alton, Illinois  62002
Rush - Copley Medical Center Aurora, Illinois  60504
John H Stroger Jr Hospital of Cook County Chicago, Illinois  60612-3785
Resurrection Healthcare Chicago, Illinois  60631
Saint Francis Hospital Evanston, Illinois  60202
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Joliet Oncology-Hematology Associates Limited Joliet, Illinois  60435
Midwest Center for Hematology Oncology Joliet, Illinois  60432
North Shore Hematology Oncology Libertyville, Illinois  60048
Vigliotti, Antonio, P.G. M.D. (UIA Investigator) Moline, Illinois  61265
Stoffel, Thomas J MD (UIA Investigator) Moline, Illinois  61265
Garneau, Stewart C MD (UIA Investigator) Moline, Illinois  61265
Sharis, Christine M MD (UIA Investigator) Moline, Illinois  61265
Porubcin, Michael MD (UIA Investigator) Moline, Illinois  61265
Good Samaritan Regional Medical Center Mt. Vernon, Illinois  62864
Community Cancer Center Foundation Normal, Illinois  61761
Illinois CancerCare-Ottawa Clinic Ottawa, Illinois  61350
Ottawa Regional Hospital and Healthcare Center Ottawa, Illinois  61350
Pekin Cancer Treatment Center Pekin, Illinois  61554
Illinois Oncology Research Association CCOP Peoria, Illinois  61615
Illinois CancerCare-Peoria Peoria, Illinois  61615
Illinois Valley Hospital Peru, Illinois  61354
Hematology Oncology Associates of Illinois - Skokie Skokie, Illinois  60076
Midwest Cancer Research Group Incorporated Skokie, Illinois  60077
Edward H Kaplan MD and Associates Skokie, Illinois  60076
Saint Margaret's Hospital Spring Valley, Illinois  61362
Carle Clinic-Urbana Main Urbana, Illinois  61801
Saint Francis Hospital and Health Centers Beech Grove, Indiana  46107
Fort Wayne Medical Oncology and Hematology Inc - State Boulevard Fort Wayne, Indiana  46845
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Saint Anthony Memorial Health Center Michigan City, Indiana  46360
Reid Hospital and Health Care Services Richmond, Indiana  47374
McFarland Clinic Ames, Iowa  50010
Constantinou, Costas L MD (UIA Investigator) Bettendorf, Iowa  52722
Cedar Rapids Oncology Association Cedar Rapids, Iowa  52403
Medical Oncology and Hematology Associates-West Des Moines Clive, Iowa  50325
Genesis Medical Center - East Campus Davenport, Iowa  52803
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
Mercy Medical Center - North Iowa Mason City, Iowa  50401
Mercy Medical Center-Sioux City Sioux City, Iowa  51104
Saint Luke's Regional Medical Center Sioux City, Iowa  51104
Covenant Medical Center Waterloo, Iowa  50702
Cancer Center of Kansas - El Dorado El Dorado, Kansas  67042
Cancer Center of Kansas-Kingman Kingman, Kansas  67068
Cancer Center of Kansas - Parsons Parsons, Kansas  67357
Cancer Center of Kansas - Pratt Pratt, Kansas  67124
Stormont-Vail Regional Health Center Topeka, Kansas  66604
Cancer Center of Kansas-Wichita Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas - Main Office Wichita, Kansas  67214
Caritas Saint Elizabeth's Medical Center Brighton, Massachusetts  02135-2997
Berkshire Hematology Oncology PC Pittsfield, Massachusetts  01201
Hickman Cancer Center Adrian, Michigan  49221
Michigan Cancer Research Consortium Community Clinical Oncology Program Ann Arbor, Michigan  48106
Oakwood Hospital Dearborn, Michigan  48123
Saint John Hospital and Medical Center Detroit, Michigan  48236
Green Bay Oncology - Escanaba Escanaba, Michigan  49431
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
Allegiance Health Jackson, Michigan  49201
Sparrow Hospital Lansing, Michigan  48912
Saint Mary Mercy Hospital Livonia, Michigan  48154
Mercy Memorial Hospital Monroe, Michigan  48162
Mercy Health Partners-Mercy Campus Muskegon, Michigan  49443
Mercy Health Partners-Hackley Campus Muskegon, Michigan  49442
Saint Joseph Mercy Oakland Pontiac, Michigan  48341-2985
Saint Joseph Mercy Port Huron Port Huron, Michigan  48060
Saint Mary's of Michigan Saginaw, Michigan  48601
Lakeland Hospital St. Joseph, Michigan  49085
Saint John Macomb-Oakland Hospital Warren, Michigan  48093
Miller-Dwan Hospital Duluth, Minnesota  55805
Unity Hospital Fridley, Minnesota  55432
Immanuel-Saint Joseph Hospital-Mayo Health System Mankato, Minnesota  56002
Saint John's Hospital - Healtheast Maplewood, Minnesota  55109
Minnesota Oncology Hematology PA-Maplewood Maplewood, Minnesota  55109
Minneapolis Veterans Medical Center Minneapolis, Minnesota  55417
North Memorial Medical Health Center Robbinsdale, Minnesota  55422
Park Nicollet Clinic - Saint Louis Park Saint Louis Park, Minnesota  55416
Saint Joseph's Hospital - Healtheast Saint Paul, Minnesota  55102
Minnesota Oncology and Hematology PA-Woodbury Woodbury, Minnesota  55125
Southeast Missouri Hospital Cape Girardeau, Missouri  63701
Saint John's Regional Medical Center Joplin, Missouri  64804
Freeman Health System Joplin, Missouri  64804
Saint Louis-Cape Girardeau CCOP Saint Louis, Missouri  63141
Missouri Baptist Medical Center Saint Louis, Missouri  63131
Saint John's Mercy Medical Center Saint Louis, Missouri  63141
Hematology-Oncology Centers of the Northern Rockies PC Billings, Montana  59101
Saint Vincent Healthcare Billings, Montana  59101
Deaconess Medical Center Billings, Montana  59107
Billings Clinic Billings, Montana  59107-7000
Saint James Community Hospital and Cancer Treatment Center Butte, Montana  59701
Benefis Healthcare- Sletten Cancer Institute Great Falls, Montana  59405
Berdeaux, Donald MD (UIA Investigator) Great Falls, Montana  59405
Saint Peter's Community Hospital Helena, Montana  59601
Glacier Oncology PLLC Kalispell, Montana  59901
Community Medical Hospital Missoula, Montana  59801
Saint Patrick Hospital - Community Hospital Missoula, Montana  59802
Lincoln Medical Education Foundation Cancer Resource Center Lincoln, Nebraska  68510
Missouri Valley Cancer Consortium CCOP Omaha, Nebraska  68106
Nevada Cancer Research Foundation CCOP Las Vegas, Nevada  89106
Exeter Hospital Exeter, New Hampshire  03833
Cheshire Medical Center-Dartmouth-Hitchcock Keene Keene, New Hampshire  03431
Elliot Hospital Manchester, New Hampshire  03103
Ocean Medical Center Brick, New Jersey  08724
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
Sparta Cancer Treatment Center Sparta, New Jersey  07871
Virtua West Jersey Hospital Voorhees Voorhees, New Jersey  08043
Presbyterian Kaseman Hospital Albuquerque, New Mexico  87110
Veterans Affairs Western New York Health Care System-Buffalo Buffalo, New York  14215
Orange Regional Medical Center Middletown, New York  10940
New York University Langone Medical Center New York, New York  10016
Columbia University Medical Center New York, New York  10032
Interlakes Foundation Inc-Rochester Rochester, New York  14623
Highland Hospital Rochester, New York  14620
State University of New York Upstate Medical University Syracuse, New York  13210
Mission Hospitals Inc Asheville, North Carolina  28801
Alamance Regional Medical Center Burlington, North Carolina  27216
Wayne Memorial Hospital Goldsboro, North Carolina  27534
Saint Alexius Medical Center Bismarck, North Dakota  58501
Aultman Health Foundation Canton, Ohio  44710
Doctors Hospital Columbus, Ohio  43228
Grant Medical Center Columbus, Ohio  43215
Mount Carmel Health Center West Columbus, Ohio  43222
Good Samaritan Hospital - Dayton Dayton, Ohio  45406
Dayton CCOP Dayton, Ohio  45429
Samaritan North Health Center Dayton, Ohio  45415
Veteran Affairs Medical Center Dayton, Ohio  45428
Hematology Oncology Center Incorporated Elyria, Ohio  44035
Blanchard Valley Hospital Findlay, Ohio  45840
Atrium Medical Center-Middletown Regional Hospital Franklin, Ohio  45005-1066
Cleveland Clinic Cancer Center Independence Independence, Ohio  44131
Cole, Sharon, K. M.D. (UIA Investigator) Kenton, Ohio  43326
Kettering Medical Center Kettering, Ohio  45429
Marietta Memorial Hospital Marietta, Ohio  45750
Toledo Radiation Oncology at Northwest Ohio Onocolgy Center Maumee, Ohio  43537
Saint Charles Hospital Oregon, Ohio  43616
North Coast Cancer Care Sandusky, Ohio  44870
Toledo Community Hospital Oncology Program CCOP Toledo, Ohio  43617
Mercy Cancer Center at Saint Anne Mercy Hospital Toledo, Ohio  43623
University of Toledo Toledo, Ohio  43614
Saint Vincent Mercy Medical Center Toledo, Ohio  43608
Upper Valley Medical Center Troy, Ohio  45373
Saint Ann's Hospital Westerville, Ohio  43081
Cleveland Clinic Wooster Specialty Center Wooster, Ohio  44691
Genesis HealthCare System Zanesville, Ohio  43701
Natalie W Bryant Cancer Center Tulsa, Oklahoma  74136
Providence Saint Vincent Medical Center Portland, Oregon  97225
Columbia River Oncology Program Portland, Oregon  97225
Saint Luke's Hospital Bethlehem, Pennsylvania  18015
Riddle Hospital Media, Pennsylvania  19063
Pottstown Memorial Medical Center Pottstown, Pennsylvania  19464
Hematology and Oncology Associates of North East Pennsylvania Scranton, Pennsylvania  18508
Scranton Hematology Oncology Scranton, Pennsylvania  18510
Mercy Hospital Scranton, Pennsylvania  18501
Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania  18711
Mainline Health CCOP Wynnewood, Pennsylvania  19096
Hematology and Oncology Associates of Rhode Island Inc Cranston, Rhode Island  02920
Kent County Hospital Warwick, Rhode Island  02886
AnMed Health Hospital Anderson, South Carolina  29621
Greenville CCOP Greenville, South Carolina  29615
Upstate Carolina CCOP Spartanburg, South Carolina  29303
Sanford Cancer Center-Oncology Clinic Sioux Falls, South Dakota  57104
Tennessee Oncology PLLC- Centennial Medical Center Nashville, Tennessee  37203
Fredericksburg Oncology Inc Fredericksburg, Virginia  22401
Southwest VA Regional Cancer Center Norton, Virginia  24273
Auburn Regional Medical Center Auburn, Washington  98002
Harrison Bremerton Hematology and Oncology Bremerton, Washington  98310
Saint Francis Hospital Federal Way, Washington  98003
Columbia Basin Hematology and Oncology PLLC Kennewick, Washington  99336
Providence - Saint Peter Hospital Olympia, Washington  98506-5166
Good Samaritan Community Hospital Puyallup, Washington  98372
Minor and James Medical PLLC Seattle, Washington  98104
The Polyclinic Seattle, Washington  98122
Swedish Medical Center-First Hill Seattle, Washington  98122-4307
Northwest CCOP Tacoma, Washington  98405
Multicare Health System Tacoma, Washington  98415
Saint Clare Hospital Tacoma, Washington  98499
Saint Joseph Medical Center Tacoma, Washington  98405
Sacred Heart Hospital Eau Claire, Wisconsin  54701
Central Wisconsin Cancer Program Fond Du Lac, Wisconsin  54935
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
Marshfield Clinic-Minocqua Center Minocqua, Wisconsin  54548
Green Bay Oncology - Oconto Falls Oconto Falls, Wisconsin  54154
Marshfield Clinic at James Beck Cancer Center Rhinelander, Wisconsin  54501
Marshfield Clinic-Rice Lake Center Rice Lake, Wisconsin  54868
Saint Michael's Hospital Stevens Point, Wisconsin  54481
Green Bay Oncology - Sturgeon Bay Sturgeon Bay, Wisconsin  54235
Marshfield Clinic-Wausau Center Wausau, Wisconsin  54401
Cedar Valley Medical Specialists Waterloo, Iowa  50702
Community General Hospital Syracuse, New York  13215
Olathe Cancer Center Olathe, Kansas  66061
Jupiter Medical Center Jupiter, Florida  33458
Lahey Clinic Medical Center Burlington, Massachusetts  01805
Saint Jude Medical Center Fullerton, California  92835
Marin General Hospital Greenbrae, California  94904
Mount Sinai Medical Center CCOP Miami Beach, Florida  33140
Northeast Georgia Cancer Care LLC Athens, Georgia  30607
Harbin Clinic Medical Oncology and Clinical Research Rome, Georgia  30165
Portneuf Medical Center Pocatello, Idaho  83201
Jesse Brown Veterans Affairs Medical Center Chicago, Illinois  60612
Saint Mary's Regional Medical Center Lewiston, Maine  04240
Maine Medical Center- Scarborough Campus Scarborough, Maine  04074
Memorial Hospital at Easton - Shore Regional Cancer Center Easton, Maryland  21601
Carolinas Medical Center - Northeast Concord, North Carolina  28025
North Coast Cancer Care-Clyde Clyde, Ohio  43410
Stark, Michael, Edward. M.D. (UIA Investigator) Toledo, Ohio  43623
Armstrong Center for Medicine and Health Kittanning, Pennsylvania  16201
Roper Hospital Charleston, South Carolina  29401
Nashville Oncology Associates PC Nashville, Tennessee  37203
Saint Paul Hospital Dallas, Texas  75235
Sandra L Maxwell Cancer Center Cedar City, Utah  84720
Intermountain Medical Center Murray, Utah  84157
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
Virginia Oncology Associates-Hampton Hampton, Virginia  23666
Medical Consultants Limited Milwaukee, Wisconsin  53215
Vince Lombardi Cancer Clinic-Sheboygan Sheboygan, Wisconsin  53081
State University of New York Downstate Medical Center Brooklyn, New York  11203
Texas Tech University Health Sciences Center Lubbock, Texas  79430
University of Miami Miller School of Medicine-Sylvester Cancer Center Miami, Florida  33136
Saint Bernards Regional Medical Center Jonesboro, Arkansas  72401
Salinas Valley Memorial Salinas, California  93901
Hinsdale Hematology Oncology Associates Incorporated Hinsdale, Illinois  60521
OSF Saint Francis Medical Center Radiation Oncology Service at the Central Illinois Comprehensive CC Peoria, Illinois  61615-7827
Kings County Hospital Brooklyn, New York  11203
The Christ Hospital Cincinnati, Ohio  45219
Saint Charles Medical Center-Bend Bend, Oregon  97701
University of Tennessee - Memphis Memphis, Tennessee  38163
University Hospital of Brooklyn Brooklyn, New York  11203
Siouxland Hematology Oncology Associates Sioux City, Iowa  51101
Georgia Health Sciences University Augusta, Georgia  30912
Alta Bates Summit Medical Center-Herrick Campus Berkeley, California  94704
Carle Foundation - Carle Cancer Center Urbana, Illinois  61801
Oncology Associates at Mercy Medical Center Cedar Rapids, Iowa  52403
Hematology Oncology Associates of Central New York PC East Syracuse, New York  13057
Sanford Clinic North-Fargo Fargo, North Dakota  58102
Sanford Medical Center-Fargo Fargo, North Dakota  58122
Cancer Care Associates of Fresno Medical Group Inc Fresno, California  93720
Eastern Cooperative Oncology Group Boston, Massachusetts  02215
The Toledo Hospital/Toledo Children's Hospital Toledo, Ohio  43606
Sanford USD Medical Center - Sioux Falls Sioux Falls, South Dakota  57117-5134
Genesys Regional Medical Center-West Flint Campus Flint, Michigan  48532
Sanford Clinic North-Bemidgi Bemidji, Minnesota  56601
Essentia Health Duluth Clinic CCOP Duluth, Minnesota  55805
Essentia Health Saint Mary's Medical Center Duluth, Minnesota  55805
Sanford Bismarck Medical Center Bismarck, North Dakota  58501
Toledo Clinic Cancer Centers-Oregon Oregon, Ohio  43616
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
PeaceHealth Saint Joseph Medical Center Bellingham, Washington  98225
Aurora Cancer Care-Glendale Glendale, Wisconsin  53212
Christiana Care Health System-Christiana Hospital Newark, Delaware  19718
Illinois Cancer Specialists-Niles Niles, Illinois  60714
Bronson Battle Creek Battle Creek, Michigan  49017
Springfield Regional Medical Center Springfield, Ohio  45505
Cancer Specialists of North Florida-Orange Park Orange Park, Florida  32073
The James Graham Brown Cancer Center at University of Louisville Louisville, Kentucky  40202
Edward Hospital/Cancer Center Naperville, Illinois  60540
Saint Louis Cancer and Breast Institute-South City Saint Louis, Missouri  63109
Toledo Clinic Cancer Centers-Bowling Green Bowling Green, Ohio  43402
Toledo Clinic Cancer Centers-Maumee Maumee, Ohio  43537-1839
Toledo Clinic Cancer Centers-Toledo Toledo, Ohio  43623
PeaceHealth Southwest Medical Center Vancouver, Washington  98664
Aurora Cancer Care-Southern Lakes Elkhorn, Wisconsin  53121
Mayo Clinic Health System-Franciscan Healthcare La Crosse, Wisconsin  54601
Good Samaritan Hospital Downers Grove, Illinois  60515
IU Health Ball Memorial Hospital Muncie, Indiana  47303
Oncology Hematology Associates of Southwest Indiana Newburgh, Indiana  47630
Simonds-Sinon Regional Cancer Center Fitchburg, Massachusetts  01420
Rockingham Memorial Hospital Hahn Cancer Center Harrisonburg, Virginia  22801