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ASSURE: Adjuvant Sorafenib or Sunitinib for Unfavorable Renal Carcinoma

Phase 3
18 Years
Open (Enrolling)
Clear Cell Renal Cell Carcinoma, Papillary Renal Cell Carcinoma, Stage I Renal Cell Cancer, Stage II Renal Cell Cancer, Stage III Renal Cell Cancer, Stage IV Renal Cell Cancer

Thank you

Trial Information

ASSURE: Adjuvant Sorafenib or Sunitinib for Unfavorable Renal Carcinoma


I. To demonstrate an improvement in disease-free survival in locally advanced renal cell
carcinoma patients randomly assigned to adjuvant sunitinib (sunitinib malate) (Arm A) or
sorafenib (sorafenib tosylate) (Arm B) versus placebo (Arm C) after radical or partial


I. To compare overall survival of patients randomized to each of the two regimens with

II. To further define the toxicity of prolonged administration of sunitinib or sorafenib in
this patient population.

III. To prospectively collect tumor and biological specimens to assess their characteristics
and associations:

IV. Novel approaches to assess angiogenesis markers in tissue, blood and urine as predictors
of disease-free survival and of therapeutic benefit.

V. The frequency of oncogene and tumor suppressor gene mutations as predictors of
disease-free survival and therapeutic benefit.

VI. Tumor and genetic polymorphisms as predictors of disease-free survival and therapeutic

VII. Deoxyribonucleic acid (DNA) methylation profiles as predictors of outcome and of
therapeutic benefit.

VIII. The relationship of polymorphisms in drug metabolizing enzymes with steady state
concentrations of sorafenib and sunitinib in selected patients.

IX. To study the effect of vascular endothelial growth factor (VEGF) targeted therapy on
circulating endothelial cells and circulating endothelial progenitors.

X. To prospectively assess patient-reported fatigue in order to compare the magnitude and
trajectory of fatigue among renal cell carcinoma (RCC) patients randomized to adjuvant
sunitinib (Arm A) or sorafenib (Arm B) to placebo (Arm C).

XI. To evaluate the Patient-Reported Outcomes Measurement Information System (PROMIS)
Fatigue-Short Form (SF)1, a newly developed state-of-the-science PROMIS measure for fatigue
and to calibrate the PROMIS Fatigue-SF1 with the established, validated Functional
Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale.

OUTLINE: This is a randomized, double-blind, multicenter study. Patients who have not had
surgical resection undergo radical or partial nephrectomy first. Patients are then
randomized to 1 of 3 treatment arms.

ARM A: Patients receive oral sunitinib malate once daily for 4 weeks followed by rest for 2
weeks and oral placebo for sorafenib tosylate twice daily for 6 weeks.

ARM B: Patients receive oral sorafenib tosylate twice daily for 6 weeks and oral placebo for
sunitinib malate once daily for 4 weeks followed by rest for 2 weeks.

ARM C: Patients receive oral placebo for sorafenib tosylate as in arm A and oral placebo for
sunitinib malate as in arm B.

In all arms, treatment repeats every 6 weeks for up to 9 courses in the absence of disease
progression or unacceptable toxicity.

Tumor tissue is collected prior to or during nephrectomy. Blood and urine samples are
collected at baseline and periodically during study for biomarker correlative studies.

Patients complete quality of life questionnaires, the FACIT-fatigue scale and the PROMIS
fatigue form, at baseline, and after courses 2 and 4 of treatment.

After completion of study treatment, patients are followed periodically for 9 years.

Inclusion Criteria:

- Histologically or cytologically confirmed renal cell carcinoma, including any of the
following subtypes:

- Clear cell carcinoma

- Nonclear cell carcinoma

- No collecting duct or medullary carcinomas

- Meets 1 of the following risk categories:

- Intermediate high-risk disease

- pT1b, G3-4 N0 (or pNX where clinically N0) M0

- pT2, G1-2 N0 (or pNX where clinically N0) M0

- pT2, G3-4 N0 (or pNX where clinically N0) M0

- pT3a, G1-2 (as long as pT3a is not due to adrenal involvement) N0 (or pNX
where clinically N0) M0

- Patients with microvascular invasion of the renal vein of pT1a-pT3a (as
long as pT3a is not due to adrenal involvement and grade 1-2) N0 (or pNX
where clinically N0) M0

- Very high-risk disease

- pT3a, G3-4 (or any grade pT3a if due to adrenal involvement) N0 (or pNX
where clinically N0) M0

- pT3b-c G any N0 (or pNX where clinically N0) M0

- pT4 G N0 (or pNX where clinically N0) M0 any

- pT any G any N+

- Patients with microvascular invasion of the renal vein with above other

- Planning to start study treatment between 4-12 weeks after radical or partial

- Underwent full surgical resection (i.e., radical or partial nephrectomy) by
either open or laparoscopic technique within the past 3-10 weeks

- Clinical evidence of lymph node positivity requires complete regional

- All surgical specimens must have negative margins

- Planning to undergo the above surgical resection AND meets all of the following

- Primary intact renal cell carcinoma, eligible for nephrectomy with curative

- pT1b-4, N0 or any fully resectable N (i.e., N1-2), M0 disease by radiologic
criteria, meeting any of the following criteria:

- Tumors ≥ 4 cm

- Macroscopic fully resectable nodes

- Surgically resectable renal vein thrombus

- Surgically resectable inferior vena caval thrombus by radiologic

- Multifocal ipsilateral renal cell carcinoma allowed provided fully
resectable and does not exceed inclusion criteria

- No evidence of residual or metastatic renal cell cancer by chest, abdomen, and pelvic
CT scan with oral and IV contrast (or MRI scan of the abdomen and pelvis with
gadolinium and a CT scan of the chest with or without IV contrast) within 4 weeks of
randomization (after radical or partial nephrectomy)

- Patients unable to tolerate either gadolinium or IV contrast should not
participate in this study

- No history of distant metastases

- Eastern Cooperative Oncology Group (ECOG) performance status 0-1

- Absolute granulocyte count ≥ 1,500/mm³

- Platelet count ≥ 100,000/mm³

- Creatinine ≤ 2.0 times upper limit of normal (ULN) OR creatinine clearance ≥ 30

- Bilirubin ≤ 1.5 times ULN

- SGOT and SGPT ≤ 2.5 times ULN

- Absolute baseline LVEF ≥ 50% by MUGA within 4 weeks of randomization

- No other malignancy within the past 5 years except basal cell or squamous cell skin
cancer, in situ cervical cancer, or ductal or lobular carcinoma in situ of the breast

- No serious intercurrent illness, including, but not limited to, any of the following:

- Clinically significant cardiovascular disease(e.g., uncontrolled hypertension,
myocardial infraction, or unstable angina)

- New York Heart Association class II-IV congestive heart failure

- Peripheral vascular disease ≥ grade 2

- Psychiatric illness or social situation that would preclude study compliance

- At least 6 months since any of the following:

- Myocardial infarction

- Severe or unstable angina

- Coronary or peripheral artery bypass graft

- Symptomatic congestive heart failure

- Cerebrovascular accident

- Transient ischemic attack

- Pulmonary embolism

- No ongoing ventricular cardiac dysrhythmias ≥ grade 2

- No ongoing atrial fibrillation

- No history of serious ventricular arrhythmia (i.e., ventricular tachycardia or
ventricular fibrillation ≥ 3 beats in a row)

- QTc interval < 500 msec by baseline EKG

- No uncontrolled hypertension (i.e., diastolic blood pressure ≥ 100 mm Hg despite
optimal medical therapy)

- No pre-existing thyroid abnormality with thyroid stimulating hormone that cannot be
maintained in the normal range with medication

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- No known HIV infection

- Able to swallow pills

- Recovered from prior surgery

- No prior anticancer therapy for renal cell carcinoma in either the adjuvant or
neoadjuvant setting, including any of the following:

- Metastectomy

- Radiotherapy to the renal bed

- At least 2 weeks since prior and no concurrent treatment with any of the following*:

- Cytochrome P450 enzyme-inducing antiepileptic drugs (phenytoin, carbamazepine,
or phenobarbital)

- Hypericum perforatum (St. John's wort)

- Ketoconazole

- Dexamethasone

- Dysrhythmic drugs (i.e., terfenadine, quinidine, procainamide, sotalol,
probucol, bepridil, indapamide, or flecainide)

- Haloperidol

- Risperidone

- Rifampin

- Grapefruit juice or grapefruit

- Concurrent participation in protocol ECOG-E1Y03 allowed

- No other concurrent investigational anticancer agents

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment

Outcome Measure:

Disease-free survival (DFS)

Outcome Description:

A weighted mixture of the log hazard rates was used to estimate the effective (increased) hazard rate on the experimental arm. Using this adjusted alternative hazard rate, the target is instead a reduction in the hazard rate of 20% for DFS events when comparing each experimental arm to placebo.

Outcome Time Frame:

Time from randomization to recurrence, development of second primary cancer, or death from any cause, assessed up to 6.5 years

Safety Issue:


Principal Investigator

Naomi Balzer-Haas

Investigator Role:

Principal Investigator

Investigator Affiliation:

Eastern Cooperative Oncology Group


United States: Food and Drug Administration

Study ID:




Start Date:

April 2006

Completion Date:

Related Keywords:

  • Clear Cell Renal Cell Carcinoma
  • Papillary Renal Cell Carcinoma
  • Stage I Renal Cell Cancer
  • Stage II Renal Cell Cancer
  • Stage III Renal Cell Cancer
  • Stage IV Renal Cell Cancer
  • Carcinoma
  • Carcinoma, Renal Cell



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Dartmouth Hitchcock Medical CenterLebanon, New Hampshire  03756
Mid Dakota ClinicBismarck, North Dakota  58501
Columbus CCOPColumbus, Ohio  43206
Indiana University Medical CenterIndianapolis, Indiana  46202
Nyack HospitalNyack, New York  10960
University Of VermontBurlington,, Vermont  05403
Presbyterian - Saint Lukes Medical Center - Health OneDenver, Colorado  80218
Sacred Heart HospitalPensacola, Florida  32503
Kaiser PermanenteSacramento, California  
University of Texas Southwestern Medical CenterDallas, Texas  
University of KentuckyLexington, Kentucky  40536-0098
Wichita CCOPWichita, Kansas  67214-3882
Montana Cancer Consortium CCOPBillings, Montana  59101
Alegent Health Immanuel Medical CenterOmaha, Nebraska  68122
Alegent Health Bergan Mercy Medical CenterOmaha, Nebraska  68124
Flower HospitalSylvania, Ohio  43560-2197
Virginia Mason CCOPSeattle, Washington  98101
Huntsman Cancer Institute/University of UtahSalt Lake City, Utah  84112
Mount Sinai Hospital Medical CenterChicago, Illinois  60608
Addison Gilbert HospitalGloucester, Massachusetts  01930
Metro-Minnesota CCOPSt. Louis Park, Minnesota  
UC Davis Comprehensive Cancer CenterSacramento, California  95817
Providence HospitalSouthfield, Michigan  48075
Lagrange Oncology AssociatesLa Grange, Illinois  60525
Cancer Centers of the Carolinas - EasleyEasley, South Carolina  29640
Oregon Health and Science UniversityPortland, Oregon  97201
Thomas Jefferson University HospitalPhiladelphia, Pennsylvania  19131
Decatur Memorial HospitalDecatur, Illinois  62526
Louisiana State University Health Science CenterNew Orleans, Louisiana  70112
Virginia Commonwealth UniversityRichmond, Virginia  
Kaiser PermanentePortland, Oregon  97227
Frederick Memorial HospitalFrederick, Maryland  21701
Lankenau HospitalWynnewood, Pennsylvania  19096
Montana Cancer SpecialistsMissoula, Montana  59807-7877
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
University of Southern CaliforniaLos Angeles, California  90033
DeKalb Medical CenterDecatur, Georgia  30033
Northern Indiana Cancer Research ConsortiumSouth Bend, Indiana  
Rockwood ClinicSpokane, Washington  99220
Clearview Cancer InstituteHuntsville, Alabama  35805
University of CincinnatiCincinnati, Ohio  45267-0502
Hawaii Medical Center EastHonolulu, Hawaii  96817
Hematology Oncology AssociatesAlbuquerque, New Mexico  87106
Valley View Hospital Cancer CenterGlenwood Springs, Colorado  81601
Hays Medical CenterHays, Kansas  67601
The Community HospitalMunster, Indiana  46321
Froedtert and the Medical College of WisconsinMilwaukee, Wisconsin  53226
OSF Saint Francis Medical CenterPeoria, Illinois  61637
Northside HospitalAtlanta, Georgia  30342
Western Regional CCOPPhoenix, Arizona  85006
Highlands Oncology Group-BentonvilleBentonville, Arkansas  72712
Mills - Peninsula HospitalsBurlingame, California  94010
Valley Medical Oncology Consultants-Castro ValleyCastro Valley, California  94546
Eden Hospital Medical CenterCastro Valley, California  94546
Northbay Cancer CenterFairfield, California  94533
Valley Medical Oncology Consultants-FremontFremont, California  94538
Kaiser Permanente, FremontFremont, California  94538
Kaiser Permanente, HaywardHayward, California  94545
Fremont - Rideout Cancer CenterMarysville, California  95901
Community Hospital of Monterey PeninsulaMonterey, California  93940
Palo Alto Medical Foundation-Camino DivisionMountain View, California  94040
Bay Area Breast Surgeons IncOakland, California  94609
Bay Area Tumor Institution CCOPOakland, California  94609
Tom K Lee IncOakland, California  94609
Kaiser Permanente-OaklandOakland, California  94611
Saint Joseph HospitalOrange, California  92868
Palo Alto Medical Foundation Heath CarePalo Alto, California  94301
Valley Medical Oncology ConsultantsPleasanton, California  94588
Valley Care Health System - PleasantonPleasanton, California  94588
Kaiser Permanente-Redwood CityRedwood City, California  94063
Kaiser Permanente-RichmondRichmond, California  94801
Kaiser Permanente-RosevilleRoseville, California  95661
Sutter General HospitalSacramento, California  95816
Kaiser Permanente-South SacramentoSacramento, California  95823
Kaiser Permanente - SacramentoSacramento, California  95825
Kaiser Permanente-San FranciscoSan Francisco, California  94115
University of California San Francisco Medical Center-Mount ZionSan Francisco, California  94115
Kaiser Permanente-Santa Teresa-San JoseSan Jose, California  95119
Doctors Medical Center- JC Robinson Regional Cancer CenterSan Pablo, California  94806
Kaiser Permanente-San RafaelSan Rafael, California  94903
Kaiser Permanente-Santa RosaSanta Rosa, California  95403
Kaiser Permanente-South San FranciscoSouth San Francisco, California  94080
Kaiser Permanente-StocktonStockton, California  95210
Kaiser Permanente-VallejoVallejo, California  94589
Kaiser Permanente-Walnut CreekWalnut Creek, California  94596
The Medical Center of AuroraAurora, Colorado  80012
Penrose-Saint Francis HealthcareColorado Springs, Colorado  80907
Memorial Hospital Colorado SpringsColorado Springs, Colorado  80909
Saint Anthony Central HospitalDenver, Colorado  80204
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 Mary Corwin Medical CenterPueblo, Colorado  81004
Danbury HospitalDanbury, Connecticut  06810
Saint Francis Hospital and Medical CenterHartford, Connecticut  06105
Bayhealth Medical Center at Kent GeneralDover, Delaware  19901
Lombardi Comprehensive Cancer Center at Georgetown UniversityWashington, District of Columbia  20057
Edna Williams Cancer Center at the Baptist Cancer InstituteJacksonville, Florida  32207
Cancer Centers of Central Florida PALeesburg, Florida  34788
M D Anderson Cancer Center- OrlandoOrlando, Florida  32806
Sacred Heart Medical Oncology Group - Davis HighwayPensacola, Florida  32514
Phoebe Putney Memorial HospitalAlbany, Georgia  31703
Atlanta Regional CCOPAtlanta, Georgia  30342
Well Star Cobb HospitalAustell, Georgia  30106
John B Amos Cancer CenterColumbus, Georgia  31904
Veterans Administration Medical CenterDecatur, Georgia  30033
Wellstar Kennestone HospitalMarietta, Georgia  30060
Saint Joseph's-Candler Health SystemSavannah, Georgia  31405
Oncare Hawaii Inc-POB IIHonolulu, Hawaii  96813
Oncare Hawaii Inc-KuakiniHonolulu, Hawaii  96817
University of HawaiiHonolulu, Hawaii  96813
Pacific Cancer Institute of MauiWailuku, Hawaii  96793
Saint Anthony's HealthAlton, Illinois  62002
John H Stroger Jr Hospital of Cook CountyChicago, Illinois  60612-3785
Resurrection HealthcareChicago, Illinois  60631
Cancer Institute at Alexian BrothersElk Grove Village, Illinois  60007
Saint Francis HospitalEvanston, Illinois  60202
Evanston CCOP-NorthShore University HealthSystemEvanston, Illinois  60201
Hopedale Medical Complex - HospitalHopedale, Illinois  61747
Joliet Oncology-Hematology Associates LimitedJoliet, Illinois  60435
Midwest Center for Hematology OncologyJoliet, Illinois  60432
Provena Saint Mary's HospitalKankakee, Illinois  60901
North Shore Hematology OncologyLibertyville, 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 CenterMt. Vernon, Illinois  62864
Community Cancer Center FoundationNormal, Illinois  61761
Illinois CancerCare-Ottawa ClinicOttawa, Illinois  61350
Ottawa Regional Hospital and Healthcare CenterOttawa, Illinois  61350
Pekin Cancer Treatment CenterPekin, Illinois  61554
Illinois Oncology Research Association CCOPPeoria, Illinois  61615
Illinois CancerCare-PeoriaPeoria, Illinois  61615
Illinois Valley HospitalPeru, Illinois  61354
Hematology Oncology Associates of Illinois - SkokieSkokie, Illinois  60076
Edward H Kaplan MD and AssociatesSkokie, Illinois  60076
Saint Margaret's HospitalSpring Valley, Illinois  61362
Carle Clinic-Urbana MainUrbana, Illinois  61801
Saint Francis Hospital and Health CentersBeech Grove, Indiana  46107
Fort Wayne Medical Oncology and Hematology Inc - State BoulevardFort Wayne, Indiana  46845
Richard L. Roudebush Veterans Affairs Medical CenterIndianapolis, Indiana  46202
Wishard HospitalIndianapolis, Indiana  46202
Saint Vincent Hospital and Health ServicesIndianapolis, Indiana  46260
Premier Oncology Hematology AssociatesMerrillville, Indiana  46410
Reid Hospital and Health Care ServicesRichmond, Indiana  47374
McFarland ClinicAmes, Iowa  50010
Hematology Oncology Associates-Quad CitiesBettendorf, Iowa  52722
Constantinou, Costas L MD (UIA Investigator)Bettendorf, Iowa  52722
Cedar Rapids Oncology AssociationCedar Rapids, Iowa  52403
Mercy HospitalCedar Rapids, Iowa  52403
Saint Luke's HospitalCedar Rapids, Iowa  52402
Medical Oncology and Hematology Associates-West Des MoinesClive, Iowa  50325
Genesis Medical Center - East CampusDavenport, Iowa  52803
Iowa Oncology Research Association CCOPDes Moines, Iowa  50309
Mercy CapitolDes Moines, Iowa  50307
Mercy Medical Center - Des MoinesDes Moines, Iowa  50314
Medical Oncology and Hematology Associates-Des MoinesDes Moines, Iowa  50309
Mercy Medical Center-Sioux CitySioux City, Iowa  51104
Saint Luke's Regional Medical CenterSioux City, Iowa  51104
Covenant Medical CenterWaterloo, Iowa  50702
Cancer Center of Kansas - El DoradoEl Dorado, Kansas  67042
Cancer Center of Kansas-KingmanKingman, Kansas  67068
Radiation Oncology Practice Corporation SouthwestOverland Park, Kansas  66210
Cancer Center of Kansas - ParsonsParsons, Kansas  67357
Cancer Center of Kansas - PrattPratt, Kansas  67124
Stormont-Vail Regional Health CenterTopeka, Kansas  66604
Saint Francis Hospital and Medical Center - TopekaTopeka, Kansas  66606
Cancer Center of Kansas-Wichita Medical Arts TowerWichita, Kansas  67208
Cancer Center of Kansas - Main OfficeWichita, Kansas  67214
Ochsner Clinic Foundation-Baton RougeBaton Rouge, Louisiana  70809
Medical Center of LouisianaNew Orleans, Louisiana  70112
Highland ClinicShreveport, Louisiana  71105
Holy Family HospitalMethuen, Massachusetts  01844
Hickman Cancer CenterAdrian, Michigan  49221
Michigan Cancer Research Consortium Community Clinical Oncology ProgramAnn Arbor, Michigan  48106
Oakwood HospitalDearborn, Michigan  48123
Saint John Hospital and Medical CenterDetroit, Michigan  48236
Green Bay Oncology - EscanabaEscanaba, Michigan  49431
McLaren Regional Medical CenterFlint, Michigan  48532
Grand Rapids Clinical Oncology ProgramGrand Rapids, Michigan  49503
Saint Mary's Health CareGrand Rapids, Michigan  49503
Spectrum Health at Butterworth CampusGrand Rapids, Michigan  49503
Green Bay Oncology - Iron MountainIron Mountain, Michigan  49801
Allegiance HealthJackson, Michigan  49201
Sparrow HospitalLansing, Michigan  48912
Saint Mary Mercy HospitalLivonia, Michigan  48154
Mercy Memorial HospitalMonroe, Michigan  48162
Mercy Health Partners-Mercy CampusMuskegon, Michigan  49443
Mercy Health Partners-Hackley CampusMuskegon, Michigan  49442
Saint Joseph Mercy OaklandPontiac, Michigan  48341-2985
Saint Joseph Mercy Port HuronPort Huron, Michigan  48060
Saint Mary's of MichiganSaginaw, Michigan  48601
Lakeland HospitalSt. Joseph, Michigan  49085
Saint John Macomb-Oakland HospitalWarren, Michigan  48093
Harris, John Gilbert MD (UIA Investigator)Alexandria, Minnesota  56308
Medini, Eitan MD (UIA Investigator)Alexandria, Minnesota  56308
Brainerd Medical Center IncBrainerd, Minnesota  56401
Miller-Dwan HospitalDuluth, Minnesota  55805
Etzell, Paul S MD (UIA Investigator)Fergus Falls, Minnesota  56537
Swenson, Wade II, MD (UIA Investigator)Fergus Falls, Minnesota  56537
Unity HospitalFridley, Minnesota  55432
Saint John's Hospital - HealtheastMaplewood, Minnesota  55109
Minnesota Oncology Hematology PA-MaplewoodMaplewood, Minnesota  55109
Minneapolis Veterans Medical CenterMinneapolis, Minnesota  55417
North Memorial Medical Health CenterRobbinsdale, Minnesota  55422
Saint Cloud HospitalSaint Cloud, Minnesota  56303
Park Nicollet Clinic - Saint Louis ParkSaint Louis Park, Minnesota  55416
Saint Joseph's Hospital - HealtheastSaint Paul, Minnesota  55102
Adult and Pediatric Urology PLLPSartell, Minnesota  56377
Minnesota Oncology and Hematology PA-WoodburyWoodbury, Minnesota  55125
Southeast Missouri HospitalCape Girardeau, Missouri  63701
Freeman Health SystemJoplin, Missouri  64804
Radiation Oncology Practice Corporation - NorthKansas City, Missouri  64154
Saint Luke's Cancer InstituteKansas City, Missouri  64111
Radiation Oncology Practice Corporation SouthKansas City, Missouri  64114
Saint Luke's Hospital of Kansas CityKansas City, Missouri  64111
Saint Joseph Health CenterKansas City, Missouri  64114
Liberty Radiation Oncology ClinicKansas City, Missouri  64116
Truman Medical CenterKansas City, Missouri  64108
Saint Anthony's Medical CenterSaint Louis, Missouri  63128
Saint Louis-Cape Girardeau CCOPSaint Louis, Missouri  63141
Christian Hospital Northeast - NorthwestSaint Louis, Missouri  63136
Missouri Baptist Medical CenterSaint Louis, Missouri  63131
Saint John's Mercy Medical CenterSaint Louis, Missouri  63141
Ozark Health Ventures LLC dba Cancer Research for The Ozarks SpringfieldSpringfield, Missouri  65802
Saint John's HospitalSpringfield, Missouri  65804
Cox Medical CenterSpringfield, Missouri  65807
Hematology-Oncology Centers of the Northern Rockies PCBillings, Montana  59101
Saint Vincent HealthcareBillings, Montana  59101
Deaconess Medical CenterBillings, Montana  59107
Billings ClinicBillings, Montana  59107-7000
Saint James Community Hospital and Cancer Treatment CenterButte, Montana  59701
Benefis Healthcare- Sletten Cancer InstituteGreat Falls, Montana  59405
Berdeaux, Donald MD (UIA Investigator)Great Falls, Montana  59405
Saint Peter's Community HospitalHelena, Montana  59601
Glacier Oncology PLLCKalispell, Montana  59901
Community Medical HospitalMissoula, Montana  59801
Saint Patrick Hospital - Community HospitalMissoula, Montana  59802
Good Samaritan HospitalKearney, Nebraska  68847
Lincoln Medical Education Foundation Cancer Resource CenterLincoln, Nebraska  68510
Missouri Valley Cancer Consortium CCOPOmaha, Nebraska  68106
Midlands Community HospitalPapillion, Nebraska  68046
Nevada Cancer Research Foundation CCOPLas Vegas, Nevada  89106
Cheshire Medical Center-Dartmouth-Hitchcock KeeneKeene, New Hampshire  03431
Cooper Hospital University Medical CenterCamden, New Jersey  08103
Hunterdon Medical CenterFlemington, New Jersey  08822
Mountainside HospitalMontclair, New Jersey  07042
Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington CountyMount Holly, New Jersey  08060
South Jersey HealthcareVineland, New Jersey  08360
Virtua West Jersey Hospital VoorheesVoorhees, New Jersey  08043
Presbyterian Kaseman HospitalAlbuquerque, New Mexico  87110
Memorial Medical Center - Las CrucesLas Cruces, New Mexico  88011
The North Division of Montefiore Medical CenterBronx, New York  10466
Veterans Affairs Western New York Health Care System-BuffaloBuffalo, New York  14215
Adirondack Cancer CenterGlens Falls, New York  12801
Orange Regional Medical CenterMiddletown, New York  10940
Saint Luke's Roosevelt Hospital Center - Saint Luke's DivisionNew York, New York  10025
Columbia University Medical CenterNew York, New York  10032
Interlakes Foundation Inc-RochesterRochester, New York  14623
State University of New York Upstate Medical UniversitySyracuse, New York  13210
Faxton-Saint Luke's HealthcareUtica, New York  13502
Mission Hospitals IncAsheville, North Carolina  28801
Alamance Regional Medical CenterBurlington, North Carolina  27216
Gaston Memorial HospitalGastonia, North Carolina  28054
Wayne Memorial HospitalGoldsboro, North Carolina  27534
Margaret R Pardee Memorial HospitalHendersonville, North Carolina  28791
Kinston Medical Specialists PAKinston, North Carolina  28501
Saint Alexius Medical CenterBismarck, North Dakota  58501
Aultman Health FoundationCanton, Ohio  44710
Doctors HospitalColumbus, Ohio  43228
Grant Medical CenterColumbus, Ohio  43215
Mount Carmel Health Center WestColumbus, Ohio  43222
Good Samaritan Hospital - DaytonDayton, Ohio  45406
Dayton CCOPDayton, Ohio  45429
Samaritan North Health CenterDayton, Ohio  45415
Veteran Affairs Medical CenterDayton, Ohio  45428
Hematology Oncology Center IncorporatedElyria, Ohio  44035
Blanchard Valley HospitalFindlay, Ohio  45840
Atrium Medical Center-Middletown Regional HospitalFranklin, Ohio  45005-1066
Cleveland Clinic Cancer Center IndependenceIndependence, Ohio  44131
Kettering Medical CenterKettering, Ohio  45429
Saint Rita's Medical CenterLima, Ohio  45801
Mansfield General Hospital-MedCentral Health SystemMansfield, Ohio  44903
Marietta Memorial HospitalMarietta, Ohio  45750
Toledo Radiation Oncology at Northwest Ohio Onocolgy CenterMaumee, Ohio  43537
Saint Charles HospitalOregon, Ohio  43616
North Coast Cancer CareSandusky, Ohio  44870
Toledo Community Hospital Oncology Program CCOPToledo, Ohio  43617
Mercy Cancer Center at Saint Anne Mercy HospitalToledo, Ohio  43623
University of ToledoToledo, Ohio  43614
Saint Vincent Mercy Medical CenterToledo, Ohio  43608
Upper Valley Medical CenterTroy, Ohio  45373
Saint Ann's HospitalWesterville, Ohio  43081
Cleveland Clinic Wooster Specialty CenterWooster, Ohio  44691
Genesis HealthCare SystemZanesville, Ohio  43701
Natalie W Bryant Cancer CenterTulsa, Oklahoma  74136
Legacy Good Samaritan Hospital and Medical CenterPortland, Oregon  97210
Northwest Cancer Specialists-Rose Quarter Cancer CenterPortland, Oregon  97227
Providence Saint Vincent Medical CenterPortland, Oregon  97225
Columbia River Oncology ProgramPortland, Oregon  97225
Salem HospitalSalem, Oregon  97309
Saint Luke's HospitalBethlehem, Pennsylvania  18015
Pocono Medical CenterEast Stroudsburg, Pennsylvania  18301
Ephrata Cancer CenterEphrata, Pennsylvania  17522
Central PA Hematology-Medical Oncology Associates PCLemoyne, Pennsylvania  17043
Riddle HospitalMedia, Pennsylvania  19063
Aria Health-Torresdale CampusPhiladelphia, Pennsylvania  19114
Pottstown Memorial Medical CenterPottstown, Pennsylvania  19464
Saint Joseph Medical CenterReading, Pennsylvania  19605
Hematology and Oncology Associates of North East PennsylvaniaScranton, Pennsylvania  18508
Scranton Hematology OncologyScranton, Pennsylvania  18510
Mercy HospitalScranton, Pennsylvania  18501
Associates In Hematology Oncology PC-UplandUpland, Pennsylvania  19013
Geisinger Wyoming ValleyWilkes-Barre, Pennsylvania  18711
Mainline Health CCOPWynnewood, Pennsylvania  19096
Hematology and Oncology Associates of Rhode Island IncCranston, Rhode Island  02920
Kent County HospitalWarwick, Rhode Island  02886
AnMed Health HospitalAnderson, South Carolina  29621
Greenville CCOPGreenville, South Carolina  29615
Greenville Memorial HospitalGreenville, South Carolina  29605
Upstate Carolina CCOPSpartanburg, South Carolina  29303
Conklin Regional Cancer CenterAberdeen, South Dakota  57401
Sanford Cancer Center-Oncology ClinicSioux Falls, South Dakota  57104
The Don and Sybil Harrington Cancer CenterAmarillo, Texas  79106
Texas Health Presbyterian Hospital DallasDallas, Texas  75231
The Center for Integrative Cancer MedicineEl Paso, Texas  79902
Veterans Administration Medical CenterHouston, Texas  77030
Saint Luke's Episcopal HospitalHouston, Texas  77030
Cancer Therapy and Research Center at The UT Health Science Center at San AntonioSan Antonio, Texas  78229
Audie L Murphy Veterans Affairs HospitalSan Antonio, Texas  78209
University HospitalSan Antonio, Texas  78229
Southwestern Oncology Research DepartmentBennington, Vermont  05201
Fredericksburg Oncology IncFredericksburg, Virginia  22401
Southwest VA Regional Cancer CenterNorton, Virginia  24273
Auburn Regional Medical CenterAuburn, Washington  98002
Harrison Bremerton Hematology and OncologyBremerton, Washington  98310
Saint Francis HospitalFederal Way, Washington  98003
Columbia Basin Hematology and Oncology PLLCKennewick, Washington  99336
Evergreen Hospital Medical CenterKirkland, Washington  98033
Providence - Saint Peter HospitalOlympia, Washington  98506-5166
Good Samaritan Community HospitalPuyallup, Washington  98372
Minor and James Medical PLLCSeattle, Washington  98104
The PolyclinicSeattle, Washington  98122
Swedish Medical Center-First HillSeattle, Washington  98122-4307
Northwest CCOPTacoma, Washington  98405
Multicare Health SystemTacoma, Washington  98415
Saint Clare HospitalTacoma, Washington  98499
Saint Joseph Medical CenterTacoma, Washington  98405
West Virginia UniversityMorgantown, West Virginia  26506
Langlade Hospital and Cancer CenterAntigo, Wisconsin  54409
Saint Vincent HospitalGreen Bay, Wisconsin  54301
Green Bay Oncology Limited at Saint Mary's HospitalGreen Bay, Wisconsin  54303
Saint Mary's HospitalGreen Bay, Wisconsin  54303
Green Bay Oncology at Saint Vincent HospitalGreen Bay, Wisconsin  54301-3526
Aurora BayCare Medical CenterGreen Bay, Wisconsin  54311-6519
Dean Hematology and Oncology ClinicMadison, Wisconsin  53717
UW Health Oncology - 1 South ParkMadison, Wisconsin  53715
Vince Lombardi Cancer Clinic-MarinetteMarinette, Wisconsin  54143
Bay Area Medical CenterMarinette, Wisconsin  54143
Marshfield Clinic-Minocqua CenterMinocqua, Wisconsin  54548
Green Bay Oncology - Oconto FallsOconto Falls, Wisconsin  54154
Marshfield Clinic at James Beck Cancer CenterRhinelander, Wisconsin  54501
Marshfield Clinic-Rice Lake CenterRice Lake, Wisconsin  54868
Saint Michael's HospitalStevens Point, Wisconsin  54481
Green Bay Oncology - Sturgeon BaySturgeon Bay, Wisconsin  54235
Aspirus Regional Cancer CenterWausau, Wisconsin  54401
University of Maryland Greenebaum Cancer CenterBaltimore, Maryland  21201
Olathe Cancer CenterOlathe, Kansas  66061
Jupiter Medical CenterJupiter, Florida  33458
Gainesville Hematology Oncology AssociatesGainesville, Florida  32605
Horizon Oncology CenterLafayette, Indiana  47905
Baptist Hospital EastLouisville, Kentucky  40207
Elkhart ClinicElkhart, Indiana  46515
John Muir Medical Center-Concord CampusConcord, California  94520
Washington HospitalFremont, California  94538
Saint Jude Medical CenterFullerton, California  92835
Marin General HospitalGreenbrae, California  94904
Denver Veterans Administration Medical CenterDenver, Colorado  80220
The Shaw Regional Cancer CenterEdwards, Colorado  81632
Montrose Memorial HospitalMontrose, Colorado  81401
Memorial Healthcare System - Joe DiMaggio Children's HospitalHollywood, Florida  33021
Mount Sinai Medical Center CCOPMiami Beach, Florida  33140
Northeast Georgia Cancer Care LLCAthens, Georgia  30607
Harbin Clinic Medical Oncology and Clinical ResearchRome, Georgia  30165
Portneuf Medical CenterPocatello, Idaho  83201
Illinois CancerCare-BloomingtonBloomington%, Illinois  61701
Illinois CancerCare-CantonCanton, Illinois  61520
Illinois CancerCare-CarthageCarthage, Illinois  62321
Jesse Brown Veterans Affairs Medical CenterChicago, Illinois  60612
Illinois CancerCare-EurekaEureka, Illinois  61530
Illinois CancerCare-CottageGalesburg, Illinois  61401
Delnor Community HospitalGeneva, Illinois  60134
Illinois CancerCare-HavanaHavana, Illinois  62644
Illinois CancerCare-Kewanee ClinicKewanee, Illinois  61443
Illinois CancerCare-MacombMacomb, Illinois  61455
Illinois CancerCare-MonmouthMonmouth, Illinois  61462
DuPage Medical Group-OgdenNaperville, Illinois  60563
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
Michiana Hematology Oncology PC-South BendSouth Bend, Indiana  46601
Maine Medical Center- Scarborough CampusScarborough, Maine  04074
Saint Agnes HospitalBaltimore, Maryland  21229
The Memorial Hospital at EastonEaston, Maryland  21601
Memorial Hospital at Easton - Shore Regional Cancer CenterEaston, Maryland  21601
Commonwealth Hematology Oncology PC-WorcesterWorcester, Massachusetts  01605
University of Michigan University HospitalAnn Arbor, Michigan  48109
University of Missouri - Ellis FischelColumbia, Missouri  65203
Veterans AdministrationColumbia, Missouri  65201
Hackensack University Medical CCOPHackensack, New Jersey  07601
Carolinas Medical Center - NortheastConcord, North Carolina  28025
North Coast Cancer Care-ClydeClyde, Ohio  43410
Community Health Partners Regional Medical CenterElyria, Ohio  44035
Oncology Hematology Associates of Northern PennsylvaniaDubois, Pennsylvania  15801
Armstrong Center for Medicine and HealthKittanning, Pennsylvania  16201
Roper HospitalCharleston, South Carolina  29401
Cancer Centers of the Carolinas - FarisGreenville, South Carolina  29605
Cancer Centers of the Carolinas-Greer Radiation OncologyGreer, South Carolina  29650
Cancer Centers of the Carolinas-Greer Medical OncologyGreer, South Carolina  29650
Vanderbilt-Ingram Cancer Center Cool SpringsFranklin, Tennessee  37067
University of Tennessee - KnoxvilleKnoxville, Tennessee  37920
Texas Oncology-Austin NorthAustin, Texas  78759
Texas Oncology-Austin MidtownAustin, Texas  78705
Texas Oncology - Central Austin Cancer CenterAustin, Texas  78731
Texas Oncology - South Austin Cancer CenterAustin, Texas  78745
Saint Paul HospitalDallas, Texas  75235
Texas Oncology-Seton WilliamsonRound Rock, Texas  78665
Texas Oncology - Round Rock Cancer CenterRound Rock, Texas  78681
Texas Oncology- San MarcosSan Marcos, Texas  78666
Sandra L Maxwell Cancer CenterCedar City, Utah  84720
Intermountain Medical CenterMurray, Utah  84157
Utah Valley Regional Medical CenterProvo, Utah  84603
Dixie Medical Center Regional Cancer CenterSaint George, Utah  84770
Intermountain Health CareSalt Lake City, Utah  84103
Utah Cancer Specialists-Salt Lake CitySalt Lake City, Utah  84106
Skagit Valley HospitalMt. Vernon, Washington  98273
West Virginia University CharlestonCharleston, West Virginia  25304
Marshfield Clinic-Chippewa CenterChippewa Falls, Wisconsin  54729
Holy Family Memorial HospitalManitowoc, Wisconsin  54221
Aurora Advanced Healthcare Inc-MequonMequon, Wisconsin  53092
Medical Consultants LimitedMilwaukee, Wisconsin  53215
Vince Lombardi Cancer Clinic-SheboyganSheboygan, Wisconsin  53081
Marshfield Clinic Cancer Care at Saint Michael's HospitalStevens Point, Wisconsin  54481
Aurora Medical Center in SummitSummit, Wisconsin  53066
Vince Lombardi Cancer ClinicTwo Rivers, Wisconsin  54241
Riverview HospitalWisconsin Rapids, Wisconsin  54494
State University of New York Downstate Medical CenterBrooklyn, New York  11203
Texas Tech University Health Sciences CenterLubbock, Texas  79430
University of Miami Miller School of Medicine-Sylvester Cancer CenterMiami, Florida  33136
University of Minnesota Medical Center-FairviewMinneapolis, Minnesota  55455
Frisbie HospitalRochester, New Hampshire  03867
FirstHealth of the Carolinas-Moore Regional HosiptalPinehurst, North Carolina  28374
Waverly Hematology OncologyCary, North Carolina  27518
Cancer Centers of Southwest Oklahoma ResearchLawton, Oklahoma  
Adams Cancer CenterGettysburg, Pennsylvania  17325
Saint Vincent's Medical CenterBridgeport, Connecticut  06606
Kaiser Permanente Moanalua Medical CenterHonolulu, Hawaii  96819
Hinsdale Hematology Oncology Associates IncorporatedHinsdale, Illinois  60521
Spector, David MD (UIA Investigator)Moline, Illinois  61265
Saint Luke's South HospitalOverland Park, Kansas  66213
Doctors Carrol, Sheth, RaghavanLouisville, Kentucky  40215
Saint Joseph Medical CenterTowson, Maryland  21204
Heartland Hematology and Oncology Associates IncorporatedKansas City, Missouri  64118
Saint Joseph Oncology IncSaint Joseph, Missouri  64507
Kings County HospitalBrooklyn, New York  11203
Forsyth Memorial HospitalWinston-Salem, North Carolina  27103
Cleveland Clinic Cancer Center BeachwoodBeachwood, Ohio  44122
The Christ HospitalCincinnati, Ohio  45219
Saint Charles Medical Center-BendBend, Oregon  97701
Mid-Columbia Medical CenterThe Dalles, Oregon  97058
University of Tennessee - MemphisMemphis, Tennessee  38163
Pacific Medical Center-First HillSeattle, Washington  98104
Legacy Salmon Creek HospitalVancouver, Washington  98686
Saint Mary's Medical CenterHuntington, West Virginia  25702
Gundersen LutheranLa Crosse, Wisconsin  54601
Fairbanks Memorial HospitalFairbanks, Alaska  99701
Sparks Regional Medical CenterFort Smith, Arkansas  72901
Heartland Oncology and Hematology LLPCouncil Bluffs, Iowa  51503
Milford Regional Medical CenterMilford, Massachusetts  01757
Alegent Health Lakeside HospitalOmaha, Nebraska  68130
Carson-Tahoe Specialty Medical CenterCarson City, Nevada  89703
New York Oncology Hematology PC -Albany Medical CenterAlbany, New York  12208
New York Oncology Hematology PC - AlbanyAlbany, New York  12206
New York Oncology Hematology PC - AmsterdamAmsterdam, New York  12010
University Hospital of BrooklynBrooklyn, New York  11203
New York Oncology Hematology PC-HudsonHudson, New York  12534
New York Oncology Hematology PC - LathamLatham, New York  12110
New York Oncology Hematology PC - RexfordRexford, New York  12148
New York Oncology Hematology PC - TroyTroy, New York  12180
Oncology and Hematology Care Inc - Blue AshCincinnati, Ohio  45242
Texas Oncology Seton NorthwestAustin, Texas  78759
Dallas Oncology Consultants PADuncanville, Texas  75137
Stanford University Hospitals and ClinicsStanford, California  94305
Siouxland Hematology Oncology AssociatesSioux City, Iowa  51101
IU Health ArnettLafayette, Indiana  
Georgia Health Sciences UniversityAugusta, Georgia  30912
Alta Bates Summit Medical Center-Herrick CampusBerkeley, California  94704
Oncology Associates at Mercy Medical CenterCedar Rapids, Iowa  52403
Marie Yeager Cancer CenterSaint Joseph, Michigan  49085
Hematology Oncology Associates of Central New York PCEast Syracuse, New York  13057
Sanford Clinic North-FargoFargo, North Dakota  58102
Sanford Medical Center-FargoFargo, North Dakota  58122
Emory University Hospital MidtownAtlanta, Georgia  30308
Summa Akron City HospitalAkron, Ohio  44304
Indiana University Health Goshen Center For Cancer CareGoshen, Indiana  46526
The Toledo Hospital/Toledo Children's HospitalToledo, Ohio  43606
Sanford USD Medical Center - Sioux FallsSioux Falls, South Dakota  57117-5134
Providence Sacred Heart Medical Center and Children's HospitalSpokane, Washington  99204
North Shore-LIJ Health System CCOPManhasset, New York  11030
Genesys Regional Medical Center-West Flint CampusFlint, Michigan  48532
Sanford Clinic North-BemidgiBemidji, Minnesota  56601
Essentia Health Saint Joseph's Medical CenterBrainerd, Minnesota  56401
Essentia Health Duluth Clinic CCOPDuluth, Minnesota  55805
Essentia Health Saint Mary's Medical CenterDuluth, Minnesota  55805
Sanford Bismarck Medical CenterBismarck, North Dakota  58501
Toledo Clinic Cancer Centers-OregonOregon, Ohio  43616
Geisinger Medical Center-Cancer Center HazeltonHazleton, Pennsylvania  18201
Veterans Administration-San Diego Medical CenterSan Diego, California  92161
Community Howard Regional HealthKokomo, Indiana  46904
Indiana University Health La Porte HospitalLa Porte, Indiana  46350
Saint Joseph Regional Medical Center-MishawakaMishawaka, Indiana  46545-1470
Essentia Health Cancer Center-South University ClinicFargo, North Dakota  58103
PeaceHealth Saint Joseph Medical CenterBellingham, Washington  98225
Aurora Cancer Care-BurlingtonBurlington, Wisconsin  53105
Aurora Cancer Care-FranklinFranklin, Wisconsin  53132
Aurora Cancer Care-GlendaleGlendale, Wisconsin  53212
Aurora Cancer Care-Kenosha SouthKenosha, Wisconsin  53142
Aurora Cancer Care-Milwaukee SouthMilwaukee, Wisconsin  53215
Aurora Cancer Care-RacineRacine, Wisconsin  53406-5661
Aurora Cancer Care-WaukeshaWaukesha, Wisconsin  53188
Aurora Cancer Care-Milwaukee WestWauwatosa, Wisconsin  53226
Christiana Care Health System-Christiana HospitalNewark, Delaware  19718
Illinois Cancer Specialists-NilesNiles, Illinois  60714
Bronson Battle CreekBattle Creek, Michigan  49017
Riverview Medical Center/Booker Cancer CenterRed Bank, New Jersey  07701
Springfield Regional Medical CenterSpringfield, Ohio  45505
Cleveland Clinic Cancer Center/Fairview HospitalCleveland, Ohio  44111
The James Graham Brown Cancer Center at University of LouisvilleLouisville, Kentucky  40202
Marin Cancer Care IncGreenbrae, California  94904
Edward Hospital/Cancer CenterNaperville, Illinois  60540
Promise Regional Medical Center-HutchinsonHutchinson, Kansas  65702
Saint Louis Cancer and Breast Institute-South CitySaint Louis, Missouri  63109
Toledo Clinic Cancer Centers-Bowling GreenBowling Green, Ohio  43402
Toledo Clinic Cancer Centers-MaumeeMaumee, Ohio  43537-1839
Toledo Clinic Cancer Centers-ToledoToledo, Ohio  43623
PinnacleHealth Fox Chase Regional Cancer Center at Polyclinic HospitalHarrisburg, Pennsylvania  17110
Guthrie Clinic-Robert Packer HospitalSayre, Pennsylvania  18840
Self Regional HealthcareGreenwood, South Carolina  29646
Harrison Poulsbo Hematology and OncologyPoulsbo, Washington  98370
Providence Holy Family HospitalSpokane, Washington  99208
PeaceHealth Southwest Medical CenterVancouver, Washington  98664
Aurora Cancer Care-Southern LakesElkhorn, Wisconsin  53121
Mayo Clinic Health System-Franciscan HealthcareLa Crosse, Wisconsin  54601
Maine Center for Cancer Medicine and Blood Disorders-ScarboroughScarborough, Maine  04074
Peninsula Cancer Center-GloucesterGloucester, Virginia  23061
Peninsula Cancer Institute-WilliamsburgWilliamsburg, Virginia  23185
Capital Health Medical Center-HopewellPennington, New Jersey  08534