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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

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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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University of Texas Southwestern Medical Center Dallas, Texas  
University of Kentucky Lexington, Kentucky  40536-0098
Wichita CCOP Wichita, Kansas  67214-3882
Montana Cancer Consortium CCOP Billings, Montana  59101
Alegent Health Immanuel Medical Center Omaha, Nebraska  68122
Alegent Health Bergan Mercy Medical Center Omaha, Nebraska  68124
Flower Hospital Sylvania, Ohio  43560-2197
Virginia Mason CCOP Seattle, Washington  98101
Huntsman Cancer Institute/University of Utah Salt Lake City, Utah  84112
Mount Sinai Hospital Medical Center Chicago, Illinois  60608
Addison Gilbert Hospital Gloucester, Massachusetts  01930
Metro-Minnesota CCOP St. Louis Park, Minnesota  
UC Davis Comprehensive Cancer Center Sacramento, California  95817
Providence Hospital Southfield, Michigan  48075
Lagrange Oncology Associates La Grange, Illinois  60525
Cancer Centers of the Carolinas - Easley Easley, South Carolina  29640
Oregon Health and Science University Portland, Oregon  97201
Thomas Jefferson University Hospital Philadelphia, Pennsylvania  19131
Decatur Memorial Hospital Decatur, Illinois  62526
Louisiana State University Health Science Center New Orleans, Louisiana  70112
Virginia Commonwealth University Richmond, Virginia  
Kaiser Permanente Portland, Oregon  97227
Frederick Memorial Hospital Frederick, Maryland  21701
Lankenau Hospital Wynnewood, Pennsylvania  19096
Montana Cancer Specialists Missoula, Montana  59807-7877
Providence Saint Joseph Medical Center Burbank, California  91505-4866
Florida Hospital Orlando, Florida  32803
Memorial Health University Medical Center Savannah, Georgia  31404
Hillcrest Hospital Cancer Center Mayfield Heights, Ohio  44124
University of Chicago Comprehensive Cancer Center Chicago, Illinois  60637-1470
M D Anderson Cancer Center Houston, Texas  77030
University of Southern California Los Angeles, California  90033
DeKalb Medical Center Decatur, Georgia  30033
Northern Indiana Cancer Research Consortium South Bend, Indiana  
Rockwood Clinic Spokane, Washington  99220
Clearview Cancer Institute Huntsville, Alabama  35805
University of Cincinnati Cincinnati, Ohio  45267-0502
Hawaii Medical Center East Honolulu, Hawaii  96817
Hematology Oncology Associates Albuquerque, New Mexico  87106
Valley View Hospital Cancer Center Glenwood Springs, Colorado  81601
Hays Medical Center Hays, Kansas  67601
The Community Hospital Munster, Indiana  46321
Froedtert and the Medical College of Wisconsin Milwaukee, Wisconsin  53226
OSF Saint Francis Medical Center Peoria, Illinois  61637
Northside Hospital Atlanta, Georgia  30342
Western Regional CCOP Phoenix, Arizona  85006
Highlands Oncology Group-Bentonville Bentonville, Arkansas  72712
Mills - Peninsula Hospitals Burlingame, California  94010
Valley Medical Oncology Consultants-Castro Valley Castro Valley, California  94546
Eden Hospital Medical Center Castro Valley, California  94546
Northbay Cancer Center Fairfield, California  94533
Valley Medical Oncology Consultants-Fremont Fremont, California  94538
Kaiser Permanente, Fremont Fremont, California  94538
Kaiser Permanente, Hayward Hayward, California  94545
Fremont - Rideout Cancer Center Marysville, California  95901
Community Hospital of Monterey Peninsula Monterey, California  93940
Palo Alto Medical Foundation-Camino Division Mountain View, California  94040
Bay Area Breast Surgeons Inc Oakland, California  94609
Bay Area Tumor Institution CCOP Oakland, California  94609
Tom K Lee Inc Oakland, California  94609
Kaiser Permanente-Oakland Oakland, California  94611
Saint Joseph Hospital Orange, California  92868
Palo Alto Medical Foundation Heath Care Palo Alto, California  94301
Valley Medical Oncology Consultants Pleasanton, California  94588
Valley Care Health System - Pleasanton Pleasanton, California  94588
Kaiser Permanente-Redwood City Redwood City, California  94063
Kaiser Permanente-Richmond Richmond, California  94801
Kaiser Permanente-Roseville Roseville, California  95661
Sutter General Hospital Sacramento, California  95816
Kaiser Permanente-South Sacramento Sacramento, California  95823
Kaiser Permanente - Sacramento Sacramento, California  95825
Kaiser Permanente-San Francisco San Francisco, California  94115
University of California San Francisco Medical Center-Mount Zion San Francisco, California  94115
Kaiser Permanente-Santa Teresa-San Jose San Jose, California  95119
Doctors Medical Center- JC Robinson Regional Cancer Center San Pablo, California  94806
Kaiser Permanente-San Rafael San Rafael, California  94903
Kaiser Permanente-Santa Rosa Santa Rosa, California  95403
Kaiser Permanente-South San Francisco South San Francisco, California  94080
Kaiser Permanente-Stockton Stockton, California  95210
Kaiser Permanente-Vallejo Vallejo, California  94589
Kaiser Permanente-Walnut Creek Walnut Creek, California  94596
The Medical Center of Aurora Aurora, Colorado  80012
Penrose-Saint Francis Healthcare Colorado Springs, Colorado  80907
Memorial Hospital Colorado Springs Colorado Springs, Colorado  80909
Saint Anthony Central Hospital Denver, Colorado  80204
Exempla Saint Joseph Hospital Denver, Colorado  80218
Colorado Cancer Research Program CCOP Denver, Colorado  80224-2522
Saint Mary's Hospital and Regional Medical Center Grand Junction, Colorado  81502
Saint Mary Corwin Medical Center Pueblo, Colorado  81004
Danbury Hospital Danbury, Connecticut  06810
Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
Bayhealth Medical Center at Kent General Dover, Delaware  19901
Lombardi Comprehensive Cancer Center at Georgetown University Washington, District of Columbia  20057
Edna Williams Cancer Center at the Baptist Cancer Institute Jacksonville, Florida  32207
Cancer Centers of Central Florida PA Leesburg, Florida  34788
M D Anderson Cancer Center- Orlando Orlando, Florida  32806
Sacred Heart Medical Oncology Group - Davis Highway Pensacola, Florida  32514
Phoebe Putney Memorial Hospital Albany, Georgia  31703
Atlanta Regional CCOP Atlanta, Georgia  30342
Well Star Cobb Hospital Austell, Georgia  30106
John B Amos Cancer Center Columbus, Georgia  31904
Veterans Administration Medical Center Decatur, Georgia  30033
Wellstar Kennestone Hospital Marietta, Georgia  30060
Saint Joseph's-Candler Health System Savannah, Georgia  31405
Oncare Hawaii Inc-POB II Honolulu, Hawaii  96813
Oncare Hawaii Inc-Kuakini Honolulu, Hawaii  96817
University of Hawaii Honolulu, Hawaii  96813
Pacific Cancer Institute of Maui Wailuku, Hawaii  96793
Saint Anthony's Health Alton, Illinois  62002
John H Stroger Jr Hospital of Cook County Chicago, Illinois  60612-3785
Resurrection Healthcare Chicago, Illinois  60631
Cancer Institute at Alexian Brothers Elk Grove Village, Illinois  60007
Saint Francis Hospital Evanston, Illinois  60202
Evanston CCOP-NorthShore University HealthSystem Evanston, Illinois  60201
Hopedale Medical Complex - Hospital Hopedale, Illinois  61747
Joliet Oncology-Hematology Associates Limited Joliet, Illinois  60435
Midwest Center for Hematology Oncology Joliet, Illinois  60432
Provena Saint Mary's Hospital Kankakee, Illinois  60901
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
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
Richard L. Roudebush Veterans Affairs Medical Center Indianapolis, Indiana  46202
Wishard Hospital Indianapolis, Indiana  46202
Saint Vincent Hospital and Health Services Indianapolis, Indiana  46260
Premier Oncology Hematology Associates Merrillville, Indiana  46410
Reid Hospital and Health Care Services Richmond, Indiana  47374
McFarland Clinic Ames, Iowa  50010
Hematology Oncology Associates-Quad Cities Bettendorf, Iowa  52722
Constantinou, Costas L MD (UIA Investigator) Bettendorf, Iowa  52722
Cedar Rapids Oncology Association Cedar Rapids, Iowa  52403
Mercy Hospital Cedar Rapids, Iowa  52403
Saint Luke's Hospital Cedar Rapids, Iowa  52402
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-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
Radiation Oncology Practice Corporation Southwest Overland Park, Kansas  66210
Cancer Center of Kansas - Parsons Parsons, Kansas  67357
Cancer Center of Kansas - Pratt Pratt, Kansas  67124
Stormont-Vail Regional Health Center Topeka, Kansas  66604
Saint Francis Hospital and Medical Center - Topeka Topeka, Kansas  66606
Cancer Center of Kansas-Wichita Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas - Main Office Wichita, Kansas  67214
Ochsner Clinic Foundation-Baton Rouge Baton Rouge, Louisiana  70809
Medical Center of Louisiana New Orleans, Louisiana  70112
Highland Clinic Shreveport, Louisiana  71105
Holy Family Hospital Methuen, Massachusetts  01844
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
McLaren Regional Medical Center Flint, Michigan  48532
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
Harris, John Gilbert MD (UIA Investigator) Alexandria, Minnesota  56308
Medini, Eitan MD (UIA Investigator) Alexandria, Minnesota  56308
Brainerd Medical Center Inc Brainerd, Minnesota  56401
Miller-Dwan Hospital Duluth, Minnesota  55805
Etzell, Paul S MD (UIA Investigator) Fergus Falls, Minnesota  56537
Swenson, Wade II, MD (UIA Investigator) Fergus Falls, Minnesota  56537
Unity Hospital Fridley, Minnesota  55432
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
Saint Cloud Hospital Saint Cloud, Minnesota  56303
Park Nicollet Clinic - Saint Louis Park Saint Louis Park, Minnesota  55416
Saint Joseph's Hospital - Healtheast Saint Paul, Minnesota  55102
Adult and Pediatric Urology PLLP Sartell, Minnesota  56377
Minnesota Oncology and Hematology PA-Woodbury Woodbury, Minnesota  55125
Southeast Missouri Hospital Cape Girardeau, Missouri  63701
Freeman Health System Joplin, Missouri  64804
Radiation Oncology Practice Corporation - North Kansas City, Missouri  64154
Saint Luke's Cancer Institute Kansas City, Missouri  64111
Radiation Oncology Practice Corporation South Kansas City, Missouri  64114
Saint Luke's Hospital of Kansas City Kansas City, Missouri  64111
Saint Joseph Health Center Kansas City, Missouri  64114
Liberty Radiation Oncology Clinic Kansas City, Missouri  64116
Truman Medical Center Kansas City, Missouri  64108
Saint Anthony's Medical Center Saint Louis, Missouri  63128
Saint Louis-Cape Girardeau CCOP Saint Louis, Missouri  63141
Christian Hospital Northeast - Northwest Saint Louis, Missouri  63136
Missouri Baptist Medical Center Saint Louis, Missouri  63131
Saint John's Mercy Medical Center Saint Louis, Missouri  63141
Ozark Health Ventures LLC dba Cancer Research for The Ozarks Springfield Springfield, Missouri  65802
Saint John's Hospital Springfield, Missouri  65804
Cox Medical Center Springfield, Missouri  65807
Hematology-Oncology Centers of the Northern Rockies PC Billings, Montana  59101
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
Good Samaritan Hospital Kearney, Nebraska  68847
Lincoln Medical Education Foundation Cancer Resource Center Lincoln, Nebraska  68510
Missouri Valley Cancer Consortium CCOP Omaha, Nebraska  68106
Midlands Community Hospital Papillion, Nebraska  68046
Nevada Cancer Research Foundation CCOP Las Vegas, Nevada  89106
Cheshire Medical Center-Dartmouth-Hitchcock Keene Keene, New Hampshire  03431
Cooper Hospital University Medical Center Camden, New Jersey  08103
Hunterdon Medical Center Flemington, New Jersey  08822
Mountainside Hospital Montclair, New Jersey  07042
Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington County Mount Holly, New Jersey  08060
South Jersey Healthcare Vineland, New Jersey  08360
Virtua West Jersey Hospital Voorhees Voorhees, New Jersey  08043
Presbyterian Kaseman Hospital Albuquerque, New Mexico  87110
Memorial Medical Center - Las Cruces Las Cruces, New Mexico  88011
The North Division of Montefiore Medical Center Bronx, New York  10466
Veterans Affairs Western New York Health Care System-Buffalo Buffalo, New York  14215
Adirondack Cancer Center Glens Falls, New York  12801
Orange Regional Medical Center Middletown, New York  10940
Saint Luke's Roosevelt Hospital Center - Saint Luke's Division New York, New York  10025
Columbia University Medical Center New York, New York  10032
Interlakes Foundation Inc-Rochester Rochester, New York  14623
State University of New York Upstate Medical University Syracuse, New York  13210
Faxton-Saint Luke's Healthcare Utica, New York  13502
Mission Hospitals Inc Asheville, North Carolina  28801
Alamance Regional Medical Center Burlington, North Carolina  27216
Gaston Memorial Hospital Gastonia, North Carolina  28054
Wayne Memorial Hospital Goldsboro, North Carolina  27534
Margaret R Pardee Memorial Hospital Hendersonville, North Carolina  28791
Kinston Medical Specialists PA Kinston, North Carolina  28501
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
Kettering Medical Center Kettering, Ohio  45429
Saint Rita's Medical Center Lima, Ohio  45801
Mansfield General Hospital-MedCentral Health System Mansfield, Ohio  44903
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
Legacy Good Samaritan Hospital and Medical Center Portland, Oregon  97210
Northwest Cancer Specialists-Rose Quarter Cancer Center Portland, Oregon  97227
Providence Saint Vincent Medical Center Portland, Oregon  97225
Columbia River Oncology Program Portland, Oregon  97225
Salem Hospital Salem, Oregon  97309
Saint Luke's Hospital Bethlehem, Pennsylvania  18015
Pocono Medical Center East Stroudsburg, Pennsylvania  18301
Ephrata Cancer Center Ephrata, Pennsylvania  17522
Central PA Hematology-Medical Oncology Associates PC Lemoyne, Pennsylvania  17043
Riddle Hospital Media, Pennsylvania  19063
Aria Health-Torresdale Campus Philadelphia, Pennsylvania  19114
Pottstown Memorial Medical Center Pottstown, Pennsylvania  19464
Saint Joseph Medical Center Reading, Pennsylvania  19605
Hematology and Oncology Associates of North East Pennsylvania Scranton, Pennsylvania  18508
Scranton Hematology Oncology Scranton, Pennsylvania  18510
Mercy Hospital Scranton, Pennsylvania  18501
Associates In Hematology Oncology PC-Upland Upland, Pennsylvania  19013
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
Greenville Memorial Hospital Greenville, South Carolina  29605
Upstate Carolina CCOP Spartanburg, South Carolina  29303
Conklin Regional Cancer Center Aberdeen, South Dakota  57401
Sanford Cancer Center-Oncology Clinic Sioux Falls, South Dakota  57104
The Don and Sybil Harrington Cancer Center Amarillo, Texas  79106
Texas Health Presbyterian Hospital Dallas Dallas, Texas  75231
The Center for Integrative Cancer Medicine El Paso, Texas  79902
Veterans Administration Medical Center Houston, Texas  77030
Saint Luke's Episcopal Hospital Houston, Texas  77030
Cancer Therapy and Research Center at The UT Health Science Center at San Antonio San Antonio, Texas  78229
Audie L Murphy Veterans Affairs Hospital San Antonio, Texas  78209
University Hospital San Antonio, Texas  78229
Southwestern Oncology Research Department Bennington, Vermont  05201
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
Evergreen Hospital Medical Center Kirkland, Washington  98033
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
West Virginia University Morgantown, West Virginia  26506
Langlade Hospital and Cancer Center Antigo, Wisconsin  54409
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
Aurora BayCare Medical Center Green Bay, Wisconsin  54311-6519
Dean Hematology and Oncology Clinic Madison, Wisconsin  53717
UW Health Oncology - 1 South Park Madison, Wisconsin  53715
Vince Lombardi Cancer Clinic-Marinette Marinette, Wisconsin  54143
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
Aspirus Regional Cancer Center Wausau, Wisconsin  54401
University of Maryland Greenebaum Cancer Center Baltimore, Maryland  21201
Olathe Cancer Center Olathe, Kansas  66061
Jupiter Medical Center Jupiter, Florida  33458
Gainesville Hematology Oncology Associates Gainesville, Florida  32605
Horizon Oncology Center Lafayette, Indiana  47905
Baptist Hospital East Louisville, Kentucky  40207
Elkhart Clinic Elkhart, Indiana  46515
John Muir Medical Center-Concord Campus Concord, California  94520
Washington Hospital Fremont, California  94538
Saint Jude Medical Center Fullerton, California  92835
Marin General Hospital Greenbrae, California  94904
Denver Veterans Administration Medical Center Denver, Colorado  80220
The Shaw Regional Cancer Center Edwards, Colorado  81632
Montrose Memorial Hospital Montrose, Colorado  81401
Memorial Healthcare System - Joe DiMaggio Children's Hospital Hollywood, Florida  33021
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
Illinois CancerCare-Bloomington Bloomington%, Illinois  61701
Illinois CancerCare-Canton Canton, Illinois  61520
Illinois CancerCare-Carthage Carthage, Illinois  62321
Jesse Brown Veterans Affairs Medical Center Chicago, Illinois  60612
Illinois CancerCare-Eureka Eureka, Illinois  61530
Illinois CancerCare-Cottage Galesburg, Illinois  61401
Delnor Community Hospital Geneva, Illinois  60134
Illinois CancerCare-Havana Havana, Illinois  62644
Illinois CancerCare-Kewanee Clinic Kewanee, Illinois  61443
Illinois CancerCare-Macomb Macomb, Illinois  61455
Illinois CancerCare-Monmouth Monmouth, Illinois  61462
DuPage Medical Group-Ogden Naperville, Illinois  60563
Illinois CancerCare-Community Cancer Center Normal, Illinois  61761
Illinois CancerCare-Pekin Pekin, Illinois  61603
Illinois CancerCare-Peru Peru, Illinois  61354
Illinois CancerCare-Princeton Princeton, Illinois  61356
Illinois CancerCare-Spring Valley Spring Valley, Illinois  61362
Michiana Hematology Oncology PC-South Bend South Bend, Indiana  46601
Maine Medical Center- Scarborough Campus Scarborough, Maine  04074
Saint Agnes Hospital Baltimore, Maryland  21229
The Memorial Hospital at Easton Easton, Maryland  21601
Memorial Hospital at Easton - Shore Regional Cancer Center Easton, Maryland  21601
Commonwealth Hematology Oncology PC-Worcester Worcester, Massachusetts  01605
University of Michigan University Hospital Ann Arbor, Michigan  48109
University of Missouri - Ellis Fischel Columbia, Missouri  65203
Veterans Administration Columbia, Missouri  65201
Hackensack University Medical CCOP Hackensack, New Jersey  07601
Carolinas Medical Center - Northeast Concord, North Carolina  28025
North Coast Cancer Care-Clyde Clyde, Ohio  43410
Community Health Partners Regional Medical Center Elyria, Ohio  44035
Oncology Hematology Associates of Northern Pennsylvania Dubois, Pennsylvania  15801
Armstrong Center for Medicine and Health Kittanning, Pennsylvania  16201
Roper Hospital Charleston, South Carolina  29401
Cancer Centers of the Carolinas - Faris Greenville, South Carolina  29605
Cancer Centers of the Carolinas-Greer Radiation Oncology Greer, South Carolina  29650
Cancer Centers of the Carolinas-Greer Medical Oncology Greer, South Carolina  29650
Vanderbilt-Ingram Cancer Center Cool Springs Franklin, Tennessee  37067
University of Tennessee - Knoxville Knoxville, Tennessee  37920
Texas Oncology-Austin North Austin, Texas  78759
Texas Oncology-Austin Midtown Austin, Texas  78705
Texas Oncology - Central Austin Cancer Center Austin, Texas  78731
Texas Oncology - South Austin Cancer Center Austin, Texas  78745
Saint Paul Hospital Dallas, Texas  75235
Texas Oncology-Seton Williamson Round Rock, Texas  78665
Texas Oncology - Round Rock Cancer Center Round Rock, Texas  78681
Texas Oncology- San Marcos San Marcos, Texas  78666
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
Skagit Valley Hospital Mt. Vernon, Washington  98273
West Virginia University Charleston Charleston, West Virginia  25304
Marshfield Clinic-Chippewa Center Chippewa Falls, Wisconsin  54729
Holy Family Memorial Hospital Manitowoc, Wisconsin  54221
Aurora Advanced Healthcare Inc-Mequon Mequon, Wisconsin  53092
Medical Consultants Limited Milwaukee, Wisconsin  53215
Vince Lombardi Cancer Clinic-Sheboygan Sheboygan, Wisconsin  53081
Marshfield Clinic Cancer Care at Saint Michael's Hospital Stevens Point, Wisconsin  54481
Aurora Medical Center in Summit Summit, Wisconsin  53066
Vince Lombardi Cancer Clinic Two Rivers, Wisconsin  54241
Riverview Hospital Wisconsin Rapids, Wisconsin  54494
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
University of Minnesota Medical Center-Fairview Minneapolis, Minnesota  55455
Frisbie Hospital Rochester, New Hampshire  03867
FirstHealth of the Carolinas-Moore Regional Hosiptal Pinehurst, North Carolina  28374
Waverly Hematology Oncology Cary, North Carolina  27518
Cancer Centers of Southwest Oklahoma Research Lawton, Oklahoma  
Adams Cancer Center Gettysburg, Pennsylvania  17325
Saint Vincent's Medical Center Bridgeport, Connecticut  06606
Kaiser Permanente Moanalua Medical Center Honolulu, Hawaii  96819
Hinsdale Hematology Oncology Associates Incorporated Hinsdale, Illinois  60521
Spector, David MD (UIA Investigator) Moline, Illinois  61265
Saint Luke's South Hospital Overland Park, Kansas  66213
Doctors Carrol, Sheth, Raghavan Louisville, Kentucky  40215
Saint Joseph Medical Center Towson, Maryland  21204
Heartland Hematology and Oncology Associates Incorporated Kansas City, Missouri  64118
Saint Joseph Oncology Inc Saint Joseph, Missouri  64507
Kings County Hospital Brooklyn, New York  11203
Forsyth Memorial Hospital Winston-Salem, North Carolina  27103
Cleveland Clinic Cancer Center Beachwood Beachwood, Ohio  44122
The Christ Hospital Cincinnati, Ohio  45219
Saint Charles Medical Center-Bend Bend, Oregon  97701
Mid-Columbia Medical Center The Dalles, Oregon  97058
University of Tennessee - Memphis Memphis, Tennessee  38163
Pacific Medical Center-First Hill Seattle, Washington  98104
Legacy Salmon Creek Hospital Vancouver, Washington  98686
Saint Mary's Medical Center Huntington, West Virginia  25702
Gundersen Lutheran La Crosse, Wisconsin  54601
Fairbanks Memorial Hospital Fairbanks, Alaska  99701
Sparks Regional Medical Center Fort Smith, Arkansas  72901
Heartland Oncology and Hematology LLP Council Bluffs, Iowa  51503
Milford Regional Medical Center Milford, Massachusetts  01757
Alegent Health Lakeside Hospital Omaha, Nebraska  68130
Carson-Tahoe Specialty Medical Center Carson City, Nevada  89703
New York Oncology Hematology PC -Albany Medical Center Albany, New York  12208
New York Oncology Hematology PC - Albany Albany, New York  12206
New York Oncology Hematology PC - Amsterdam Amsterdam, New York  12010
University Hospital of Brooklyn Brooklyn, New York  11203
New York Oncology Hematology PC-Hudson Hudson, New York  12534
New York Oncology Hematology PC - Latham Latham, New York  12110
New York Oncology Hematology PC - Rexford Rexford, New York  12148
New York Oncology Hematology PC - Troy Troy, New York  12180
Oncology and Hematology Care Inc - Blue Ash Cincinnati, Ohio  45242
Texas Oncology Seton Northwest Austin, Texas  78759
Dallas Oncology Consultants PA Duncanville, Texas  75137
Stanford University Hospitals and Clinics Stanford, California  94305
Siouxland Hematology Oncology Associates Sioux City, Iowa  51101
IU Health Arnett Lafayette, Indiana  
Georgia Health Sciences University Augusta, Georgia  30912
Alta Bates Summit Medical Center-Herrick Campus Berkeley, California  94704
Oncology Associates at Mercy Medical Center Cedar Rapids, Iowa  52403
Marie Yeager Cancer Center Saint Joseph, Michigan  49085
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
Emory University Hospital Midtown Atlanta, Georgia  30308
Summa Akron City Hospital Akron, Ohio  44304
Indiana University Health Goshen Center For Cancer Care Goshen, Indiana  46526
The Toledo Hospital/Toledo Children's Hospital Toledo, Ohio  43606
Sanford USD Medical Center - Sioux Falls Sioux Falls, South Dakota  57117-5134
Providence Sacred Heart Medical Center and Children's Hospital Spokane, Washington  99204
North Shore-LIJ Health System CCOP Manhasset, New York  11030
Genesys Regional Medical Center-West Flint Campus Flint, Michigan  48532
Sanford Clinic North-Bemidgi Bemidji, Minnesota  56601
Essentia Health Saint Joseph's Medical Center Brainerd, Minnesota  56401
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
Geisinger Medical Center-Cancer Center Hazelton Hazleton, Pennsylvania  18201
Veterans Administration-San Diego Medical Center San Diego, California  92161
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
Essentia Health Cancer Center-South University Clinic Fargo, North Dakota  58103
PeaceHealth Saint Joseph Medical Center Bellingham, Washington  98225
Aurora Cancer Care-Burlington Burlington, Wisconsin  53105
Aurora Cancer Care-Franklin Franklin, Wisconsin  53132
Aurora Cancer Care-Glendale Glendale, Wisconsin  53212
Aurora Cancer Care-Kenosha South Kenosha, Wisconsin  53142
Aurora Cancer Care-Milwaukee South Milwaukee, Wisconsin  53215
Aurora Cancer Care-Racine Racine, Wisconsin  53406-5661
Aurora Cancer Care-Waukesha Waukesha, Wisconsin  53188
Aurora Cancer Care-Milwaukee West Wauwatosa, Wisconsin  53226
Christiana Care Health System-Christiana Hospital Newark, Delaware  19718
Illinois Cancer Specialists-Niles Niles, Illinois  60714
Bronson Battle Creek Battle Creek, Michigan  49017
Riverview Medical Center/Booker Cancer Center Red Bank, New Jersey  07701
Springfield Regional Medical Center Springfield, Ohio  45505
Cleveland Clinic Cancer Center/Fairview Hospital Cleveland, Ohio  44111
The James Graham Brown Cancer Center at University of Louisville Louisville, Kentucky  40202
Marin Cancer Care Inc Greenbrae, California  94904
Edward Hospital/Cancer Center Naperville, Illinois  60540
Promise Regional Medical Center-Hutchinson Hutchinson, Kansas  65702
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
PinnacleHealth Fox Chase Regional Cancer Center at Polyclinic Hospital Harrisburg, Pennsylvania  17110
Guthrie Clinic-Robert Packer Hospital Sayre, Pennsylvania  18840
Self Regional Healthcare Greenwood, South Carolina  29646
Harrison Poulsbo Hematology and Oncology Poulsbo, Washington  98370
Providence Holy Family Hospital Spokane, Washington  99208
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
Maine Center for Cancer Medicine and Blood Disorders-Scarborough Scarborough, Maine  04074
Peninsula Cancer Center-Gloucester Gloucester, Virginia  23061
Peninsula Cancer Institute-Williamsburg Williamsburg, Virginia  23185
Capital Health Medical Center-Hopewell Pennington, New Jersey  08534