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CHAARTED: ChemoHormonal Therapy Versus Androgen Ablation Randomized Trial for Extensive Disease in Prostate Cancer [CHAARTED]


Phase 3
18 Years
N/A
Open (Enrolling)
Male
Prostate Cancer

Thank you

Trial Information

CHAARTED: ChemoHormonal Therapy Versus Androgen Ablation Randomized Trial for Extensive Disease in Prostate Cancer [CHAARTED]


OBJECTIVES:

Primary

- Evaluate the ability of early chemotherapy to improve overall survival of patients
commencing androgen deprivation for metastatic prostate cancer.

Secondary

- Determine whether early chemotherapy can increase the time to clinical progression
(radiographic or symptomatic deterioration due to disease) over hormonal therapy alone.

- Determine whether early chemotherapy can increase the time to development of
hormone-refractory disease over hormonal therapy alone.

- Determine whether early chemotherapy can increase the time to serological progression
over hormonal therapy alone.

- Determine rates of biochemical response at 6 months and 12 months in the chemohormonal
arm versus the hormonal therapy alone arm.

- Determine the frequency of adverse events and the tolerability of chemotherapy combined
with hormonal therapy versus hormonal therapy alone.

- Determine whether the postulated clinically meaningful increase in disease control is
associated with an alteration in overall quality of life using the Functional
Assessment of Cancer Therapy-Prostate questionnaire.

- Determine the ability of prostate-specific antigen changes to be a surrogate for
clinical benefit from therapy and overall survival.

Tertiary

- Determine whether there are proteins differentially translated from the genome in
hormone-sensitive prostate cancer, prostate cancer that has responded to hormonal
therapy, and hormone-refractory prostate cancer.

- Determine the frequency of constitutive polymorphisms of enzymes involved in steroid
metabolism and other carcinogenic processes.

- Determine whether the amount and frequency of certain carcinogenic proteins in prostate
cancer tissue such as CXCR4 and manganese superoxide dismutase can be correlated with a
poor prognosis.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to age
(≥ 70 vs < 70), ECOG performance status (0-1 vs 2), combined androgen blockade for > 30 days
(yes vs no), duration of prior adjuvant hormonal therapy (> 12 months vs ≤ 12 months),
concurrent bisphosphonate use (yes vs no), and volume of disease (low vs high). Patients are
randomized to 1 of 2 treatment arms.

- Arm A: Patients receive androgen-deprivation therapy (including luteinizing
hormone-releasing hormone [LHRH] agonist therapy, LHRH antagonist therapy, or surgical
castration). Patients also receive docetaxel IV over 1 hour on day 1. Treatment with
docetaxel repeats every 21 days for up to 6 courses in the absence of disease
progression or unacceptable toxicity.

- Arm B: Patients receive androgen-deprivation therapy (as in arm A) alone. Quality of
life is assessed at baseline and at weeks 12, 24, 36, and 48.

After completion of study treatment, patients are followed up periodically for up to 10
years.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed prostate cancer

- High-volume metastatic disease meeting any of the following criteria:

- Visceral metastases (extranodal)

- Bone metastases

- At least 4 bone lesions

- At least 1 bone lesion must be outside of the vertebral column or
pelvis

- On androgen-deprivation therapy for < 120 days

- Prostate-specific antigen (PSA) level may not have risen and met criteria for
progression from its lowest point between the start of androgen-deprivation
therapy and randomization

PATIENT CHARACTERISTICS:

- ECOG performance status (PS) 0-2

- PS 2 eligible only if decline in PS is due to metastatic prostate cancer

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

- Platelet count ≥ 100,000/mm^3

- Bilirubin ≤ upper limit of normal (ULN)

- ALT ≤ 2.5 times ULN

- Creatinine clearance ≥ 30 mL/min

- PT and INR ≤ 1.5 times ULN (unless on therapeutic anticoagulation)

- PTT ≤ 1.5 times ULN (unless on therapeutic anticoagulation)

- No prior malignancy in the past 5 years except for basal cell or squamous cell
carcinoma of the skin

- Other malignancies that are considered to have low potential to progress (e.g.,
grade 2, T1a transitional cell carcinoma) may be allowed if approved by study
chair

- No peripheral neuropathy > grade 1

- No history of severe hypersensitivity reaction to docetaxel or other drugs formulated
with polysorbate 80

- No active cardiac disease, including the following:

- Active angina

- Symptomatic congestive heart failure

- Myocardial infarction within the past 6 months

- Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- At least 4 weeks since prior major surgery and recovered from all toxicity prior to
randomization

- Prior adjuvant or neoadjuvant hormonal therapy allowed provided the following are
true:

- Therapy was discontinued ≥ 12 months ago AND there is no evidence of disease, as
defined by 1 of the following:

- PSA < 0.1 ng/dL after prostatectomy plus hormonal therapy

- PSA < 0.5 ng/dL and has not doubled above nadir after radiotherapy plus
hormonal therapy

- Therapy lasted no more than 24 months

- Last depot injection must have expired by the 24-month mark

- Prior palliative radiotherapy allowed if commenced within 30 days before starting
androgen deprivation

- Anti-androgen therapy allowed as single-agent therapy ≤ 7 days before medial
castration to prevent flare

- No prior chemotherapy in adjuvant or neoadjuvant setting

- No prior hormone therapy in the metastatic setting

- More than 30 days (or 6 half-lives) (whichever is longer) since prior participation
in another clinical trial

- Patients can not simultaneously enroll on CALGB 90202

- Concurrent participation in nontherapeutic trials allowed

- Concurrent antiandrogen therapy (e.g., bicalutamide or flutamide) allowed, but not as
sole hormonal therapy

- No concurrent 5-alpha reductase inhibitors

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Overall survival

Safety Issue:

No

Principal Investigator

Christopher Sweeney, MBBS

Investigator Role:

Study Chair

Investigator Affiliation:

Royal Adelaide Hospital Cancer Centre

Authority:

Unspecified

Study ID:

CDR0000462099

NCT ID:

NCT00309985

Start Date:

July 2006

Completion Date:

Related Keywords:

  • Prostate Cancer
  • recurrent prostate cancer
  • stage IV prostate cancer
  • Prostatic Neoplasms

Name

Location

Roswell Park Cancer InstituteBuffalo, New York  14263
George Washington University Medical CenterWashington, District of Columbia  20037
University of Michigan Comprehensive Cancer CenterAnn Arbor, Michigan  48109-0752
Mayo Clinic ScottsdaleScottsdale, Arizona  85259
Mayo Clinic - JacksonvilleJacksonville, Florida  32224
Mayo Clinic Cancer CenterRochester, Minnesota  55905
Cardinal Bernardin Cancer Center at Loyola University Medical CenterMaywood, Illinois  60153-5500
Cleveland Clinic Cancer CenterCleveland, Ohio  44195
Hurley Medical CenterFlint, Michigan  48503
University of Texas Health Science Center at San AntonioSan Antonio, Texas  78284-7811
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
St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical CenterGrand Junction, Colorado  81502
Rush-Copley Cancer Care CenterAurora, Illinois  60507
Hinsdale Hematology Oncology AssociatesHinsdale, Illinois  60521
Joliet Oncology-Hematology Associates, Limited - WestJoliet, Illinois  60435
Saint Anthony Memorial Health CentersMichigan City, Indiana  46360
Mercy Medical Center - Sioux CitySioux City, Iowa  51104
Siouxland Hematology-Oncology Associates, LLPSioux City, Iowa  51101
St. Luke's Regional Medical CenterSioux City, Iowa  51104
CCOP - Michigan Cancer Research ConsortiumAnn Arbor, Michigan  48106
Saint Joseph Mercy Cancer CenterAnn Arbor, Michigan  48106-0995
Oakwood Cancer Center at Oakwood Hospital and Medical CenterDearborn, Michigan  48123-2500
Genesys Hurley Cancer InstituteFlint, Michigan  48503
Van Elslander Cancer Center at St. John Hospital and Medical CenterGrosse Pointe Woods, Michigan  48236
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
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
St. Francis Cancer Center at St. Francis Medical CenterShakopee, Minnesota  55379
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
MeritCare BroadwayFargo, North Dakota  58122
CCOP - MeritCare HospitalFargo, North Dakota  58122
Aultman Cancer Center at Aultman HospitalCanton, Ohio  44710-1799
Case Comprehensive Cancer CenterCleveland, Ohio  44106-5065
MetroHealth Cancer Care Center at MetroHealth Medical CenterCleveland, Ohio  44109
St. Rita's Medical CenterLima, Ohio  45801
Geisinger Medical Group - Scenery ParkState College, Pennsylvania  16801
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical CenterWilkes-Barre, Pennsylvania  18711
Avera Cancer InstituteSioux Falls, South Dakota  57105
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
Marshfield Clinic - Indianhead CenterRice Lake, Wisconsin  54868
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
Virginia Mason Medical CenterSeattle, Washington  98111
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
Sidney Kimmel Comprehensive Cancer Center at Johns HopkinsBaltimore, Maryland  21231-2410
Cleveland Clinic Taussig Cancer CenterCleveland, Ohio  44195
USC/Norris Comprehensive Cancer Center and HospitalLos Angeles, California  90033-0804
Veterans Affairs Medical Center - DenverDenver, Colorado  80220
MBCCOP - LSU Health Sciences CenterNew Orleans, Louisiana  70112
CCOP - St. Louis-Cape GirardeauSaint Louis, Missouri  63141
Veterans Affairs Medical Center - San Antonio (Murphy)San Antonio, Texas  78284
CCOP - Virginia Mason Research CenterSeattle, Washington  98101
University of California Davis Cancer CenterSacramento, California  95817
Veterans Affairs Medical Center - BaltimoreBaltimore, Maryland  21201
John Stoddard Cancer Center at Iowa Methodist Medical CenterDes Moines, Iowa  50309
Arkansas Cancer Research Center at University of Arkansas for Medical SciencesLittle Rock, Arkansas  72205
Kansas Masonic Cancer Research Institute at the University of Kansas Medical CenterKansas City, Kansas  66160-7353
Overlook HospitalSummit, New Jersey  07902-0220
Hulston Cancer Center at Cox Medical Center SouthSpringfield, Missouri  65807
St. John's Regional Health CenterSpringfield, Missouri  65804
Carol G. Simon Cancer Center at Morristown Memorial HospitalMorristown, New Jersey  07962
SUNY Downstate Medical CenterBrooklyn, New York  11203
Cancer Institute of New Jersey at HamiltonHamilton, New Jersey  08690
Yale Cancer CenterNew Haven, Connecticut  06520-8028
University of Florida Shands Cancer CenterGainesville, Florida  32610-0232
NYU Cancer Institute at New York University Medical CenterNew York, New York  10016
SUNY Upstate Medical University HospitalSyracuse, New York  13210
St. Vincent Hospital Regional Cancer CenterGreen Bay, Wisconsin  54307-3508
Lahey Clinic Medical Center - BurlingtonBurlington, Massachusetts  01805
McCreery Cancer Center at Ottumwa RegionalOttumwa, Iowa  52501
Green Bay Oncology, Limited - EscanabaEscanaba, Michigan  49431
Dickinson County Healthcare SystemIron Mountain, Michigan  49801
Hunterdon Regional Cancer Center at Hunterdon Medical CenterFlemington, New Jersey  08822
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
Parma Community General HospitalParma, Ohio  44129
Good Samaritan Regional Health CenterMt. Vernon, Illinois  62864
David C. Pratt Cancer Center at St. John's MercySt. Louis, Missouri  63141
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
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
Veterans Affairs Medical Center - HinesHines, Illinois  60141
Greenebaum Cancer Center at University of Maryland Medical CenterBaltimore, Maryland  21201
Lombardi Comprehensive Cancer Center at Georgetown University Medical CenterWashington, District of Columbia  20007
Mountain States Tumor Institute at St. Luke's Regional Medical CenterBoise, Idaho  83712-6297
Indiana University Melvin and Bren Simon Cancer CenterIndianapolis, Indiana  46202-5289
Lucille P. Markey Cancer Center at University of KentuckyLexington, Kentucky  40536-0093
Dana-Farber/Harvard Cancer Center at Dana-Farber Cancer InstituteBoston, Massachusetts  02115
University of Mississippi Cancer ClinicJackson, Mississippi  39216-4505
Siteman Cancer Center at Barnes-Jewish Hospital - Saint LouisSt. Louis, Missouri  63110
CCOP - Nevada Cancer Research FoundationLas Vegas, Nevada  89109-2306
Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical SchoolNew Brunswick, New Jersey  08903
Oklahoma University Cancer InstituteOklahoma City, Oklahoma  73104
Geisinger Cancer Institute at Geisinger HealthDanville, Pennsylvania  17822-0001
West Virginia University Health Sciences Center - CharlestonCharleston, West Virginia  25302
Gundersen Lutheran Center for Cancer and BloodLa Crosse, Wisconsin  54601
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
Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical CenterHartford, Connecticut  06105
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
Hillcrest Cancer Center at Hillcrest HospitalMayfield Heights, Ohio  44124
Fox Chase Cancer Center - PhiladelphiaPhiladelphia, Pennsylvania  19111-2497
Front Range Cancer SpecialistsFort Collins, Colorado  80528
Hematology Oncology Associates - SkokieSkokie, Illinois  60076
Peninsula Medical CenterBurlingame, California  94010
Sutter Health - Western Division Cancer Research GroupGreenbrae, California  94904
California Pacific Medical Center - California CampusSan Francisco, California  94118
Sutter Solano Medical CenterVallejo, California  94589
Poudre Valley HospitalFort Collins, Colorado  80524
Ella Milbank Foshay Cancer Center at Jupiter Medical CenterJupiter, Florida  33458
Graham HospitalCanton, Illinois  61520
Memorial HospitalCarthage, Illinois  62321
Hematology and Oncology AssociatesChicago, Illinois  60611
Eureka Community HospitalEureka, Illinois  61530
North Shore Oncology and Hematology Associates, Limited - LibertyvilleLibertyville, Illinois  60048
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
Proctor HospitalPeoria, Illinois  61614
Illinois Valley Community HospitalPeru, Illinois  61354
Fort Wayne Medical Oncology and HematologyFort Wayne, Indiana  46815
Center for Cancer Therapy at LaPorte Hospital and Health ServicesLa Porte, Indiana  46350
John Stoddard Cancer Center at Iowa Lutheran HospitalDes Moines, Iowa  50316-2301
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
Medical Oncology and Hematology Associates - West Des MoinesWest Des Moines, Iowa  50266
St. Francis Comprehensive Cancer CenterTopeka, Kansas  66606
Mary Bird Perkins Cancer Center - Baton RougeBaton Rouge, Louisiana  70809
Medical Center of Louisiana - New OrleansNew Orleans, Louisiana  70112
St. Joseph's Medical CenterBrainerd, Minnesota  56401
Coborn Cancer CenterSaint Cloud, Minnesota  56303
CentraCare Clinic - River CampusSt. Cloud, Minnesota  56303
Saint Francis Medical CenterCape Girardeau, Missouri  63701
North Coast Cancer Care, IncorporatedSandusky, Ohio  44870
Cleveland Clinic - WoosterWooster, Ohio  44691
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
Cancer Therapy and Research CenterSan Antonio, Texas  78229
University Hospital - San AntonioSan Antonio, Texas  78229
Holy Family Memorial Medical Center Cancer Care CenterManitowoc, Wisconsin  54221-1450
Fairbanks Cancer Treatment Center at Fairbanks Memorial HospitalFairbanks, Alaska  99701
Montrose Memorial Hospital Cancer CenterMontrose, Colorado  81401
DeCesaris Cancer Institute at Anne Arundel Medical CenterAnnapolis, Maryland  21401
Cascade Cancer Center at Evergreen Hospital Medical CenterKirkland, Washington  98034-3013
Mayo Clinic HospitalPhoenix, Arizona  85054-4502
Hembree Mercy Cancer Center at St. Edward Mercy Medical CenterFt. Smith, Arkansas  72903
Northeast Georgia Medical CenterGainesville, Georgia  30501
Regional Cancer Center at Singing River HospitalPascagoula, Mississippi  39581
St. Joseph Medical CenterReading, Pennsylvania  19604
Alta Bates Summit Comprehensive Cancer CenterBerkeley, California  94704
Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross HospitalFort Lauderdale, Florida  33308
Evanston HospitalEvanston, Illinois  60201-1781
Kellogg Cancer Care CenterHighland Park, Illinois  60035
Cancer Care and Hematology Specialists of Chicagoland - NilesNiles, Illinois  60714
Michiana Hematology-Oncology, PC - ElkhartElkhart, Indiana  46514
Elkhart Clinic, LLCElkhart, Indiana  46514-2098
William N. Wishard Memorial HospitalIndianapolis, Indiana  46202
Michiana Hematology Oncology PC - La PorteLa Porte, Indiana  46350
Michiana Hematology-Oncology, PC - South BendMishawaka, Indiana  46545-1470
Michiana Hematology Oncology PC - PlymouthPlymouth, Indiana  46563
Greater Baltimore Medical Center Cancer CenterBaltimore, Maryland  21204
Foote Memorial HospitalJackson, Michigan  49201
St. Mary Mercy HospitalLivonia, Michigan  48154
St. Joseph Mercy OaklandPontiac, Michigan  48341-2985
Mercy Regional Cancer Center at Mercy HospitalPort Huron, Michigan  48060
Seton Cancer Institute at Saint Mary's - SaginawSaginaw, Michigan  48601
Lakeside Cancer Specialists, PLLCSaint Joseph, Michigan  49085
Willmar Cancer Center at Rice Memorial HospitalWillmar, Minnesota  56201
Truman Medical Center - Hospital HillKansas City, Missouri  64108
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
Frederick R. and Betty M. Smith Cancer Treatment CenterSparta, New Jersey  07871
Summa Center for Cancer Care at Akron City HospitalAkron, Ohio  44309-2090
Barberton Citizens HospitalBarberton, Ohio  44203
Grant Medical Center Cancer CareColumbus, Ohio  43215
Knox Community HospitalMount Vernon, Ohio  43050
Mount Carmel St. Ann's Cancer CenterWesterville, Ohio  43081
Geisinger Hazleton Cancer CenterHazleton, Pennsylvania  18201
McGlinn Family Regional Cancer Center at Reading Hospital and Medical CenterReading, Pennsylvania  19612-6052
York Cancer Center at Apple Hill Medical CenterYork, Pennsylvania  17405
Marshfield Clinic - Chippewa CenterChippewa Falls, Wisconsin  54729
Marshfield Clinic Cancer Care at Regional Cancer CenterEau Claire, Wisconsin  54701
Vince Lombardi Cancer Clinic - Green Bay at Aurora BayCare Medical CenterGreen Bay, Wisconsin  54311
UW Cancer Center Johnson CreekJohnson Creek, Wisconsin  53038
Vince Lombardi Cancer Clinic - MarinetteMarinette, Wisconsin  54143
Saint Joseph's HospitalMarshfield, Wisconsin  54449
Marshfield Clinic - Lakeland CenterMinocqua, Wisconsin  54548
Ministry Medical Group at Saint Mary's HospitalRhinelander, Wisconsin  54501
Vince Lombardi Cancer Clinic - SheboyganSheboygan, Wisconsin  53081
Marshfield Clinic at Saint Michael's HospitalStevens Point, Wisconsin  54481
Saint Michael's Hospital Cancer CenterStevens Point, Wisconsin  54481
Aurora Medical CenterSummit, Wisconsin  53066
Vince Lombardi Cancer Clinic - Two RiversTwo Rivers, Wisconsin  54241
Marshfield Clinic - Wausau CenterWausau, Wisconsin  54401
Oncology Alliance, SC - Milwaukee - WestWauwatosa, Wisconsin  53226
Marshfield Clinic - Weston CenterWeston, Wisconsin  54476
Diagnostic and Treatment CenterWeston, Wisconsin  54476
Marshfield Clinic - Wisconsin Rapids CenterWisconsin Rapids, Wisconsin  54494
Rocky Mountain OncologyCasper, Wyoming  82609
Mid Dakota Clinic, PCBismarck, North Dakota  58501
Regional Cancer Center at Memorial Medical CenterSpringfield, Illinois  62781-0001
Genesys Regional Medical CenterGrand Blanc, Michigan  48439-8066
Tucker Center for Cancer Care at Orange Regional Medical CenterMiddletown, New York  10940-4199
Pardee Memorial HospitalHendersonville, North Carolina  28791
Kinston Medical SpecialistsKinston, North Carolina  28501
St. Francis HospitalEvanston, Illinois  60202
Jordan Hospital Club Cancer CenterPlymouth, Massachusetts  02360
MBCCOP - Meharry Medical College - NashvilleNashville, Tennessee  37208-3599
Providence Cancer CenterAnchorage, Alaska  99508
La Grange Memorial HospitalLa Grange, Illinois  60525
Mid-Illinois Hematology-Oncology Associates at Community Cancer CenterNormal, Illinois  61761
University of Wisconcin Cancer Center at Aspirus Wausau HospitalWausau, Wisconsin  54401
Veterans Affairs Medical Center - Iowa CityIowa City, Iowa  52246-2208
Newton-Wellesley HospitalNewton, Massachusetts  02462
Galesburg Clinic, PCGalesburg, Illinois  61401
Boston University Cancer Research CenterBoston, Massachusetts  02118
St. Vincent Healthcare Cancer Care ServicesBillings, Montana  59101
Midwest Hematology Oncology Group, IncorporatedSaint Louis, Missouri  63109
Lynchburg Hematology-Oncology ClinicLynchburg, Virginia  24501
Tibotec Therapeutics - Division of Ortho Biotech Products, LPMarysville, California  95901
Memorial Medical CenterModesto, California  95355
Tahoe Forest Cancer CenterTruckee, California  96161
Illinois CancerCare - BloomingtonBloomington%, Illinois  61701
Illinois CancerCare - CantonCanton, Illinois  61520
Illinois CancerCare - CarthageCarthage, Illinois  62321
Illinois CancerCare - EurekaEureka, Illinois  61530
Illinois CancerCare - HavanaHavana, Illinois  62644
Illinois CancerCare - Kewanee ClinicKewanee, Illinois  61443
Illinois CancerCare - MacombMacomb, Illinois  61455
Illinois CancerCare - MonmouthMonmouth, Illinois  61462
Illinois CancerCare - Community Cancer CenterNormal, Illinois  61761
Illinois CancerCare - PekinPekin, Illinois  61603
Illinois CancerCare - PeruPeru, Illinois  61354
Illinois CancerCare - PrincetonPrinceton, Illinois  61356
Illinois CancerCare - Spring ValleySpring Valley, Illinois  61362
Veterans Affairs Medical Center - IndianapolisIndianapolis, Indiana  46202
Cancer Center of Paoli Memorial HospitalPaoli, Pennsylvania  19301-1792
CCOP - Main Line HealthWynnewood, Pennsylvania  19096
Medcenter One Hospital Cancer Care CenterBismarck, North Dakota  58501
St. Alexius Medical Center Cancer CenterBismarck, North Dakota  58502
University of Colorado Cancer Center at UC Health Sciences CenterAurora, Colorado  80045
Provena St. Mary's Regional Cancer Center - KankakeeKankakee, Illinois  60901
Skaggs Cancer Center at Skaggs Regional Medical CenterBranson, Missouri  65616
Minnesota Oncology - MaplewoodMaplewood, Minnesota  55109
Humphrey Cancer Center at North Memorial Outpatient CenterRobbinsdale, Minnesota  55422-2900
Lakeview HospitalStillwater, Minnesota  55082
Minnesota Oncology - WoodburyWoodbury, Minnesota  55125
Kings County Hospital CenterBrooklyn, New York  11203
Mount Carmel Regional Cancer CenterPittsburg, Kansas  66762
St. Agnes Hospital Cancer CenterBaltimore, Maryland  21229
Nevada Cancer InstituteLas Vegas, Nevada  89135
California Cancer Care, Incorporated - GreenbraeGreenbrae, California  94904
Shaw Regional Cancer CenterEdwards, Colorado  81632
Langlade Memorial HospitalAntigo, Wisconsin  54409
Hays Medical CenterHays, Kansas  67601
Hutchinson Hospital CorporationHutchinson, Kansas  67502
Cleveland Clinic Beachwood Family Health and Surgery CenterBeachwood, Ohio  44122
Cleveland Clinic Foundation - StrongsvilleStrongsville, Ohio  44136
New Ulm Medical CenterNew Ulm, Minnesota  56073
Roger Maris Cancer Center at MeritCare HospitalFargo, North Dakota  58122
St. Nicholas HospitalSheboygan, Wisconsin  53081
Saint Helena HospitalSaint Helena, California  94574
Pacific Medical CenterSeattle, Washington  98104
Saint Luke's Mountain States Tumor InstituteBoise, Idaho  83712
Commonwealth Hematology-Oncology, PC - QuincyQuincy, Massachusetts  02169
Southern Ohio Medical Center Cancer CenterPortsmouth, Ohio  45662
Illinois CancerCare - CottageGalesburg, Illinois  61401
Mather Veteran Affairs Medical CenterMather, California  95655
Saint Luke's Mountain States Tumor Institute - FruitlandFruitland, Idaho  83619
Mountain States Tumor Institute - MeridianMeridian, Idaho  83642
Mountain States Tumor Institute at St. Luke'sTwin Falls, Idaho  83301
Central Care Cancer Center at Carrie J. Babb Cancer CenterBolivar, Missouri  65613
Adams Cancer CenterGettysburg, Pennsylvania  17325
Cherry Tree Cancer CenterHanover, Pennsylvania  17331
Dickstein Cancer Treatment Center at White Plains Hospital CenterWhite Plains, New York  10601
Idaho Urologic Institute, PAMeridian, Idaho  83642
Zangmeister CenterColumbus, Ohio  43219
Mercy Cancer Center at Mercy Medical CenterMerced, California  95340
Sutter Pacific Medical FoundationSanta Rosa, California  95403