Know Cancer

forgot password

The BeST Trial: A Randomized Phase II Study of VEGF, RAF Kinase, and mTOR Combination Targeted Therapy (CTT) With Bevacizumab, Sorafenib and Temsirolimus in Advanced Renal Cell Carcinoma

Phase 2
18 Years
Open (Enrolling)
Clear Cell Renal Cell Carcinoma, Recurrent Renal Cell Cancer, Stage IV Renal Cell Cancer

Thank you

Trial Information

The BeST Trial: A Randomized Phase II Study of VEGF, RAF Kinase, and mTOR Combination Targeted Therapy (CTT) With Bevacizumab, Sorafenib and Temsirolimus in Advanced Renal Cell Carcinoma


I. To assess progression-free survival on each arm of combination targeted therapy (CTT)
compared to that of bevacizumab alone.


I. To assess the significance of changes in tumor size over early time points as a predictor
of PFS.

II. To quantify the number and percent of patients who have stable disease at 6 months of
therapy (failure to progress) in each treatment arm of CTT in patients with metastatic RCC.

III. To evaluate the safety of each treatment arm of combination targeted therapy (CTT) in
patients with metastatic RCC.

IV. To assess overall survival in each arm of the study. V. To assess the objective response
rate in each treatment arm of CTT in patients with metastatic RCC.

VI. To assess pathology, angiogenesis histology and to assess activation status of MAP
kinase and VEGFR2 pathways and relate to clinical outcome.


I. To analyze the pharmacokinetic and pharmacogenetic properties of sorafenib including
angiogenesis, monooxygenases polymorphisms and MDR.

II. To relate changes in tumor perfusion and vascular permeability on serial dynamic
contrast-enhanced MRI to clinical outcome and radiologic regression detected by other
standard methods.

III. To assess the potential of DCE MRI imaging as a biomarker for response to therapy
and/or as a prognostic indicator of disease progression.

IV. To assess site readiness and ability in acquiring DCE-MRI data. V. To determine the
relationship between tumor and blood biomarkers and clinical outcomes of patients treated
with the combination of targeted agents.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to prior
cytokine or vaccine therapy (no vs yes) and Motzer risk category (low vs intermediate vs
high). Patients are randomized to 1 of 4 treatment arms.

ARM A: Patients receive bevacizumab intravenously (IV) over 30-90 minutes on days 1 and 15.

ARM B: Patients receive temsirolimus IV over 30 minutes on days 1, 8, 15, and 22 and
bevacizumab as in arm A.

ARM C: Patients receive bevacizumab as in arm A and sorafenib tosylate orally (PO) twice
daily on days 1-28.

ARM D: Patients receive temsirolimus as in arm B and sorafenib tosylate as in arm C.

In all arms treatment repeats every 28 days in the absence of disease progression or
unacceptable toxicity.

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

Inclusion Criteria:

- Histologically confirmed clear cell renal cell carcinoma

- Primary or metastatic lesion

- Less than 25% of any other histology (papillary, chromophobe, or oncocytic)

- Sufficient pathology material available for diagnostic review

- Core-needle biopsy allowed

- No fine-needle aspirations as only source for diagnosis

- Measurable metastatic disease

- Lesions that can be accurately measured in ≥ 1 dimension(longest diameter to be
recorded) as > 20 mm (2.0 cm) with conventional techniques or as ≥ 10 mm (1.0
cm) with spiral CT scan

- Not curable by standard radiotherapy or surgery

- Prior nephrectomy required, with the following exceptions:

- Primary tumor ≤ 5 cm

- Extensive liver metastases (> 30% of liver parenchymal) or multiple (> 5) bone

- Unresectable primary tumor due to invasion into adjacent organs or encasing the
aorta or vena cava

- No history or clinical evidence of CNS disease, including primary brain tumor or
brain metastases

- ECOG performance status 0-1

- Life expectancy > 3 months

- WBC ≥ 3,000/mm³

- Absolute granulocyte count ≥ 1,200/mm³

- Platelet count ≥ 100,000/mm³

- Hemoglobin ≥ 9.0 g/dL (transfusions allowed)

- Creatinine ≤ 1.5 times upper limit of normal (ULN) OR creatinine clearance ≥ 55

- Bilirubin ≤ 1.5 times ULN

- AST/ALT ≤ 2.5 times ULN (5.0 times ULN in the presence of liver metastases)

- INR ≤ 1.5 and aPTT normal

- Fasting cholesterol < 350 mg/dL

- Fasting triglycerides < 400 mg/dL

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception during and for 6 months after
completion of study treatment

- No seizures not controlled with standard medical therapy

- No stroke within the past 12 months

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

- No history of allergic reactions attributed to Chinese hamster ovary cell products,
other recombinant human antibodies, or compounds of similar chemical or biologic
composition to sorafenib tosylate, temsirolimus, or bevacizumab

- No history of bleeding diathesis or coagulopathy

- No condition that impairs ability to swallow pills

- No significant traumatic injury within the past 28 days

- No clinically significant cardiovascular disease, including any of the following:

- Uncontrolled hypertension

- Blood pressure must be ≤ 150/100 mm Hg on a stable antihypertensive regimen

- Myocardial infarction or unstable angina within the past 6 months

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

- Serious cardiac arrhythmia requiring medication

- Unstable angina pectoris

- Peripheral vascular disease ≥ grade 2

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

- No significant proteinuria

- If urine protein: creatinine ratio > 0.5, 24-hour urine protein must be < 1,000

- No uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection requiring parental antibiotics on day 0 or psychiatric illness or social
situations that would preclude compliance with study requirements

- No concurrent prophylactic hematopoietic colony-stimulating factors

- No prior cytotoxic chemotherapy

- No prior antiangiogenic therapy including, but not limited to, sunitinib malate,
ZD6474, or VEGF Trap

- No prior bevacizumab, mTOR inhibitors (including, but not limited to, temsirolimus),
or sorafenib tosylate

- Prior thalidomide or interferon alfa allowed as adjuvant therapy or for metastatic

- More than 4 weeks since prior immunotherapy and recovered

- No more than 1 prior vaccine or cytokine-based immunotherapy regimen for
metastatic disease

- More than 2 weeks since prior radiotherapy and recovered

- More than 4 weeks since prior major surgery or open biopsy

- No concurrent major surgery

- No concurrent or recent full-dose anticoagulants or thrombolytic agents (unless
required to maintain patency of pre-existing or permanent indwelling IV catheters)

- No concurrent cytochrome P450 enzyme-inducing drugs including any of the following:

- Phenytoin

- Carbamazepine

- Phenobarbital

- Rifampin

- No concurrent combination antiretroviral therapy for HIV-positive patients

- No other concurrent anticancer therapies or investigational agents

Type of Study:


Study Design:

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

Outcome Measure:

Progression-free survival (PFS) as defined by Response Evaluation Criteria in Solid Tumors (RECIST)

Outcome Description:

Each combination therapy will also be evaluated in comparison to a historical control rate of 9 months using a one-sample exponential test with one-sided Type I error of 10%.

Outcome Time Frame:

Time from randomization to clinical evidence of disease progression or death without progression, assessed up to 2 years

Safety Issue:


Principal Investigator

Keith Flaherty

Investigator Role:

Principal Investigator

Investigator Affiliation:

Eastern Cooperative Oncology Group


United States: Food and Drug Administration

Study ID:




Start Date:

September 2007

Completion Date:

Related Keywords:

  • Clear Cell Renal Cell Carcinoma
  • Recurrent Renal Cell Cancer
  • Stage IV Renal Cell Cancer
  • Carcinoma
  • Carcinoma, Renal Cell



Baylor College of Medicine Houston, Texas  77030
Mayo Clinic Rochester, Minnesota  55905
University of Mississippi Medical Center Jackson, Mississippi  39216-4505
Washington University School of Medicine Saint Louis, Missouri  63110
University of Washington Medical Center Seattle, Washington  98195-6043
Hurley Medical Center Flint, Michigan  48503
Pennsylvania Hospital Philadelphia, Pennsylvania  19107
Sinai Hospital of Baltimore Baltimore, Maryland  21225
Beth Israel Deaconess Medical Center Boston, Massachusetts  02215
Boulder Community Hospital Boulder, Colorado  80301-9019
Porter Adventist Hospital Denver, Colorado  80210
Rose Medical Center Denver, Colorado  80220
Swedish Medical Center Englewood, Colorado  80110
Sky Ridge Medical Center Lone Tree, Colorado  80124
North Suburban Medical Center Thornton, Colorado  80229
Fairview Ridges Hospital Burnsville, Minnesota  55337
Hutchinson Area Health Care Hutchinson, Minnesota  55350
Meeker County Memorial Hospital Lichfield, Minnesota  55355
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
Geisinger Medical Center Danville, Pennsylvania  17822-0001
CentraCare Clinic Saint Cloud, Minnesota  56303
Rapid City Regional Hospital Rapid City, South Dakota  57709
Marshfield Clinic Marshfield, Wisconsin  54449
Glendale Memorial Hospital and Health Center Glendale, California  91204
Methodist Medical Center of Illinois Peoria, Illinois  61636
Memorial Hospital of South Bend South Bend, Indiana  46601
Mary Bird Perkins Cancer Center Baton Rouge, Louisiana  70809
Akron General Medical Center Akron, Ohio  44302
Lehigh Valley Hospital Allentown, Pennsylvania  18103
Virginia Piper Cancer Institute Minneapolis, Minnesota  55407
North Shore University Hospital Manhasset, New York  11030
University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
Hartford Hospital Hartford, Connecticut  06102-5037
Eastern Maine Medical Center Bangor, Maine  04401
University of Nebraska Medical Center Omaha, Nebraska  68198-3330
Via Christi Regional Medical Center Wichita, Kansas  67214
Ochsner Clinic Foundation New Orleans, Louisiana  70121
University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma  73104
Iowa Methodist Medical Center Des Moines, Iowa  50309
Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
Medical Center of Central Georgia Macon, Georgia  31201
Group Health Cooperative Seattle, Washington  98112
University of Wisconsin Hospital and Clinics Madison, Wisconsin  53792-0001
Great Falls Clinic Great Falls, Montana  59405
Thompson Cancer Survival Center Knoxville, Tennessee  37916
Long Island Jewish Medical Center New Hyde Park, New York  11040
Montefiore Medical Center Bronx, New York  10467-2490
North Colorado Medical Center Greeley, Colorado  80631
McKee Medical Center Loveland, Colorado  80539
Cancer Center of Kansas - Chanute Chanute, Kansas  66720
Cancer Center of Kansas - Dodge City Dodge City, Kansas  67801
Cancer Center of Kansas - Newton Newton, Kansas  67114
Cancer Center of Kansas - Salina Salina, Kansas  67042
Cancer Center of Kansas - Wellington Wellington, Kansas  67152
Associates in Womens Health Wichita, Kansas  67203
Cancer Center of Kansas - Winfield Winfield, Kansas  67156
Munson Medical Center Traverse City, Michigan  49684
Northern Rockies Radiation Oncology Center Billings, Montana  59101
Bozeman Deaconess Hospital Bozeman, Montana  59715
Kalispell Medical Oncology Kalispell, Montana  59901
Kalispell Regional Medical Center Kalispell, Montana  59901
Adena Regional Medical Center Chillicothe, Ohio  54601
Grady Memorial Hospital Delaware, Ohio  43015
Fairfield Medical Center Lancaster, Ohio  43130
Medical X-Ray Center Sioux Falls, South Dakota  57105
Cancer Care Northwest - Spokane South Spokane, Washington  99202
Welch Cancer Center Sheridan, Wyoming  82801
Elkhart General Hospital Elkhart, Indiana  46515
South Bend Clinic South Bend, Indiana  46617
Front Range Cancer Specialists Fort Collins, Colorado  80528
University Medical Center of Southern Nevada Las Vegas, Nevada  89102
Alta Bates Summit Medical Center - Summit Campus Oakland, California  94609
Sutter Solano Medical Center Vallejo, California  94589
Poudre Valley Hospital Fort Collins, Colorado  80524
Beebe Medical Center Lewes, Delaware  19958
Memorial Hospital Carthage, Illinois  62321
Hematology and Oncology Associates Chicago, Illinois  60611
Galesburg Cottage Hospital Galesburg, Illinois  61401
Galesburg Clinic Galesburg, Illinois  61401
Mason District Hospital Havana, Illinois  62644
Kewanee Hospital Kewanee, Illinois  61443
McDonough District Hospital Macomb, Illinois  61455
BroMenn Regional Medical Center Normal, Illinois  61761
Proctor Hospital Peoria, Illinois  61614
Perry Memorial Hospital Princeton, Illinois  61356
Genesis Medical Center - West Campus Davenport, Iowa  52804
Mecosta County Medical Center Big Rapids, Michigan  49307
Community Cancer Center of Monroe Monroe, Michigan  48162
Saint Francis Medical Center Cape Girardeau, Missouri  63701
Great Plains Regional Medical Center North Platte, Nebraska  69101-6598
Bismarck Cancer Center Bismarck, North Dakota  58501
Grandview Hospital Dayton, Ohio  45405
Fremont Memorial Hospital Fremont, Ohio  43420
Lima Memorial Hospital Lima, Ohio  45804
Firelands Regional Medical Center Sandusky, Ohio  44870
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Fulton County Health Center Wauseon, Ohio  43567
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
Eureka Hospital Eureka, Illinois  61530
Mercy Hospital Coon Rapids, Minnesota  55433
Graham Hospital Association Canton, Illinois  61520
Holy Family Medical Center Des Plaines, Illinois  60016
Hematology Oncology Associates of Illinois-Highland Park Highland Park, Illinois  60035
Saint Joseph Medical Center Joliet, Illinois  60435
Trinity Medical Center Moline, Illinois  61265-1291
Pekin Hospital Pekin, Illinois  61554
Medical Oncology and Hematology Associates Des Moines, Iowa  50309
Ottumwa Regional Health Center Ottumwa, Iowa  52501
Bixby Medical Center Adrian, Michigan  49221
Saint Joseph Mercy Hospital Ann Arbor, Michigan  48106
Fairview-Southdale Hospital Edina, Minnesota  55435
Abbott-Northwestern Hospital Minneapolis, Minnesota  55407
Regions Hospital Saint Paul, Minnesota  55101
Saint Francis Regional Medical Center Shakopee, Minnesota  55379
Rice Memorial Hospital Willmar, Minnesota  56201
Mary Imogene Bassett Hospital Cooperstown, New York  13326
Saint Luke's Hospital Maumee, Ohio  43537
Lancaster General Hospital Lancaster, Pennsylvania  17604-3555
Geisinger Medical Group State College, Pennsylvania  16801
Fox Valley Hematology and Oncology Appleton, Wisconsin  54911
Highland General Hospital Oakland, California  94602
Northeast Georgia Medical Center Gainesville, Georgia  30501
Swedish American Hospital Rockford, Illinois  61104
Center for Cancer Care and Research St. Louis, Missouri  63141
Miami Valley Hospital Dayton, Ohio  45409
Spartanburg Regional Medical Center Spartanburg, South Carolina  29303
Hospital District Sixth of Harper County Anthony, Kansas  67003
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Lawrence Memorial Hospital Lawrence, Kansas  66044
Menorah Medical Center Overland Park, Kansas  66209
Shawnee Mission Medical Center Shawnee Mission, Kansas  66204
North Kansas City Hospital Kansas City, Missouri  64116
Research Medical Center Kansas City, Missouri  64132
Saint Luke's East - Lee's Summit Lee's Summit, Missouri  64086
Liberty Hospital Liberty, Missouri  64068
Heartland Regional Medical Center Saint Joseph, Missouri  64506
Bozeman Deaconess Cancer Center Bozeman, Montana  59715
Northern Montana Hospital Havre, Montana  59501
Mary Rutan Hospital Bellefontaine, Ohio  43311
Wayne Hospital Greenville, Ohio  45331
Knox Community Hospital Mount Vernon, Ohio  43050
Fisher-Titus Medical Center Norwalk, Ohio  44857
Clinton Memorial Hospital Wilmington, Ohio  45177
Wenatchee Valley Medical Center Wenatchee, Washington  98801-2028
Marshfield Clinic Cancer Care at Regional Cancer Center Eau Claire, Wisconsin  54701
UW Cancer Center Johnson Creek Johnson Creek, Wisconsin  53038
Saint Joseph's Hospital Marshfield, Wisconsin  54449
Marshfield Clinic - Weston Center Weston, Wisconsin  54476
Diagnostic and Treatment Center Weston, Wisconsin  54476
Marshfield Clinic - Wisconsin Rapids Center Wisconsin Rapids, Wisconsin  54494
Rocky Mountain Oncology Casper, Wyoming  82609
Longmont United Hospital Longmont, Colorado  80501
Memorial Hospital of Rhode Island Pawtucket, Rhode Island  02860
Baton Rouge General Medical Center Baton Rouge, Louisiana  70821-2511
Ben Taub General Hospital Houston, Texas  77030
Methodist Hospital Houston, Texas  77030
Greene Memorial Hospital Xenia, Ohio  45385
Greater Baltimore Medical Center Baltimore, Maryland  21204
Rutherford Hospital Rutherfordton, North Carolina  28139
Union Hospital of Cecil County Elkton MD, Maryland  21921
Presbyterian Hospital Charlotte, North Carolina  28233-3549
Mayo Clinic in Arizona Scottsdale, Arizona  85259-5404
Mayo Clinic in Florida Jacksonville, Florida  32224
Sherman Hospital Elgin, Illinois  60120-2198
Memorial Medical Center Springfield, Illinois  62781
Saint Francis Medical Center Grand Island, Nebraska  68802
Southeastern Medical Oncology Center Goldsboro, North Carolina  27534
Metro Health Hospital Grand Rapids, Michigan  49506
Guardian Oncology and Center for Wellness Missoula, Montana  59804
University of Pittsburgh Pittsburgh, Pennsylvania  15261
Woodwinds Health Campus Woodbury, Minnesota  55125
University of Alabama at Birmingham Birmingham, Alabama  35294-3300
Vanderbilt University Nashville, Tennessee  37232-6305
Independence Regional Health Center Independence, Missouri  64050
Northwestern University Chicago, Illinois  60611
East Bay Radiation Oncology Center Castro Valley, California  94546
Contra Costa Regional Medical Center Martinez, California  94553-3156
Larry G Strieff MD Medical Corporation Oakland, California  94609
Tahoe Forest Cancer Center Truckee, California  96161
Bay Area Hospital Coos Bay, Oregon  97420
Hennepin County Medical Center Minneapolis, Minnesota  
Saint Louis University Hospital St. Louis, Missouri  63110-0250
University of Rochester Rochester, New York  14642
Glens Falls Hospital Glens Falls, New York  12801
El Camino Hospital Mountain View, California  94040
University of California at San Diego La Jolla, California  92093
University of Arizona Health Sciences Center Tucson, Arizona  85724
Riverside Methodist Hospital Columbus, Ohio  43214
Licking Memorial Hospital Newark, Ohio  43055-2899
Mid Dakota Clinic Bismarck, North Dakota  58501
Columbus CCOP Columbus, Ohio  43206
Indiana University Medical Center Indianapolis, Indiana  46202
Presbyterian - Saint Lukes Medical Center - Health One Denver, Colorado  80218
Wichita CCOP Wichita, Kansas  67214-3882
Montana Cancer Consortium CCOP Billings, Montana  59101
Flower Hospital Sylvania, Ohio  43560-2197
Metro-Minnesota CCOP St. Louis Park, Minnesota  
UC Davis Comprehensive Cancer Center Sacramento, California  95817
Providence Hospital Southfield, Michigan  48075
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
Montana Cancer Specialists Missoula, Montana  59807-7877
Providence Saint Joseph Medical Center Burbank, California  91505-4866
University of Chicago Comprehensive Cancer Center Chicago, Illinois  60637-1470
University of Southern California Los Angeles, California  90033
Northern Indiana Cancer Research Consortium South Bend, Indiana  
Rockwood Clinic Spokane, Washington  99220
Valley View Hospital Cancer Center Glenwood Springs, Colorado  81601
Froedtert and the Medical College of Wisconsin Milwaukee, Wisconsin  53226
Wake Forest University Health Sciences Winston-Salem, North Carolina  27157
OSF Saint Francis Medical Center Peoria, Illinois  61637
Saint Edward Mercy Medical Center Ft. Smith, Arkansas  72903
Valley Medical Oncology Consultants-Castro Valley Castro Valley, California  94546
Eden Hospital Medical Center Castro Valley, California  94546
Valley Medical Oncology Consultants-Fremont Fremont, California  94538
Fremont - Rideout Cancer Center Marysville, California  95901
Bay Area Breast Surgeons Inc Oakland, California  94609
Bay Area Tumor Institution CCOP Oakland, California  94609
Tom K Lee Inc Oakland, California  94609
Valley Medical Oncology Consultants Pleasanton, California  94588
Valley Care Health System - Pleasanton Pleasanton, California  94588
Doctors Medical Center- JC Robinson Regional Cancer Center San Pablo, California  94806
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
M D Anderson Cancer Center- Orlando Orlando, Florida  32806
John B Amos Cancer Center Columbus, Georgia  31904
Saint Anthony's Health Alton, Illinois  62002
Rush - Copley Medical Center Aurora, Illinois  60504
Resurrection Healthcare Chicago, Illinois  60631
Hopedale Medical Complex - Hospital Hopedale, Illinois  61747
Joliet Oncology-Hematology Associates Limited Joliet, Illinois  60435
Midwest Center for Hematology Oncology Joliet, Illinois  60432
North Shore Hematology Oncology Libertyville, Illinois  60048
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
Hematology Oncology Consultants Limited Naperville, Illinois  60540
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
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 Anthony Memorial Health Center Michigan City, Indiana  46360
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
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
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
Ochsner Clinic CCOP New Orleans, Louisiana  70121
Hickman Cancer Center Adrian, Michigan  49221
Michigan Cancer Research Consortium Community Clinical Oncology Program Ann Arbor, Michigan  48106
Oakwood Hospital Dearborn, Michigan  48123
Saint John Hospital and Medical Center Detroit, Michigan  48236
Green Bay Oncology - Escanaba Escanaba, Michigan  49431
Grand Rapids Clinical Oncology Program Grand Rapids, Michigan  49503
Saint Mary's Health Care Grand Rapids, Michigan  49503
Spectrum Health at Butterworth Campus Grand Rapids, Michigan  49503
Green Bay Oncology - Iron Mountain Iron Mountain, Michigan  49801
Allegiance Health Jackson, Michigan  49201
Sparrow Hospital Lansing, Michigan  48912
Saint Mary Mercy Hospital Livonia, Michigan  48154
Mercy Memorial Hospital Monroe, Michigan  48162
Mercy Health Partners-Mercy Campus Muskegon, Michigan  49443
Mercy Health Partners-Hackley Campus Muskegon, Michigan  49442
Saint Joseph Mercy Oakland Pontiac, Michigan  48341-2985
Saint Joseph Mercy Port Huron Port Huron, Michigan  48060
Saint Mary's of Michigan Saginaw, Michigan  48601
Lakeland Hospital St. Joseph, Michigan  49085
Saint John Macomb-Oakland Hospital Warren, Michigan  48093
Medini, Eitan MD (UIA Investigator) Alexandria, Minnesota  56308
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
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
Minnesota Oncology and Hematology PA-Woodbury Woodbury, Minnesota  55125
Southeast Missouri Hospital Cape Girardeau, Missouri  63701
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 Louis-Cape Girardeau CCOP Saint Louis, Missouri  63141
Missouri Baptist Medical Center Saint Louis, Missouri  63131
Saint John's Mercy Medical Center Saint Louis, Missouri  63141
Saint John's Hospital Springfield, Missouri  65804
Hematology-Oncology Centers of the Northern Rockies PC Billings, Montana  59101
Saint Vincent Healthcare Billings, Montana  59101
Billings Clinic Billings, Montana  59107-7000
Saint James Community Hospital and Cancer Treatment Center Butte, Montana  59701
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
Nevada Cancer Research Foundation CCOP Las Vegas, Nevada  89106
Portsmouth Regional Hospital Portsmouth, New Hampshire  03802
Cooper Hospital University Medical Center Camden, New Jersey  08103
Veterans Adminstration New Jersey Health Care System East Orange, New Jersey  07018-1095
South Jersey Healthcare Vineland, New Jersey  08360
The North Division of Montefiore Medical Center Bronx, New York  10466
Orange Regional Medical Center Middletown, New York  10940
Columbia University Medical Center New York, New York  10032
Mission Hospitals Inc Asheville, North Carolina  28801
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
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
Kettering Medical Center Kettering, Ohio  45429
Marietta Memorial Hospital Marietta, Ohio  45750
Toledo Radiation Oncology at Northwest Ohio Onocolgy Center Maumee, Ohio  43537
Saint Charles Hospital Oregon, Ohio  43616
North Coast Cancer Care Sandusky, Ohio  44870
Toledo Community Hospital Oncology Program CCOP Toledo, Ohio  43617
Mercy Cancer Center at Saint Anne Mercy Hospital Toledo, Ohio  43623
University of Toledo Toledo, Ohio  43614
Saint Vincent Mercy Medical Center Toledo, Ohio  43608
Upper Valley Medical Center Troy, Ohio  45373
Saint Ann's Hospital Westerville, Ohio  43081
Genesis HealthCare System Zanesville, Ohio  43701
Natalie W Bryant Cancer Center Tulsa, Oklahoma  74136
Saint Luke's Hospital Bethlehem, Pennsylvania  18015
Central PA Hematology-Medical Oncology Associates PC Lemoyne, Pennsylvania  17043
Riddle Hospital Media, Pennsylvania  19063
Hematology and Oncology Associates of North East Pennsylvania Scranton, Pennsylvania  18508
Scranton Hematology Oncology Scranton, Pennsylvania  18510
Mercy Hospital Scranton, Pennsylvania  18501
Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania  18711
AnMed Health Hospital Anderson, South Carolina  29621
Upstate Carolina CCOP Spartanburg, South Carolina  29303
Sanford Cancer Center-Oncology Clinic Sioux Falls, South Dakota  57104
The Don and Sybil Harrington Cancer Center Amarillo, Texas  79106
Veterans Administration Medical Center Houston, Texas  77030
Saint Luke's Episcopal Hospital Houston, Texas  77030
Fredericksburg Oncology Inc Fredericksburg, Virginia  22401
Harrison Bremerton Hematology and Oncology Bremerton, Washington  98310
Columbia Basin Hematology and Oncology PLLC Kennewick, Washington  99336
Minor and James Medical PLLC Seattle, Washington  98104
The Polyclinic Seattle, Washington  98122
Swedish Medical Center-First Hill Seattle, Washington  98122-4307
Sacred Heart Hospital Eau Claire, Wisconsin  54701
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
Dean Hematology and Oncology Clinic Madison, Wisconsin  53717
UW Health Oncology - 1 South Park Madison, Wisconsin  53715
Bay Area Medical Center Marinette, Wisconsin  54143
Marshfield Clinic-Minocqua Center Minocqua, Wisconsin  54548
Green Bay Oncology - Oconto Falls Oconto Falls, Wisconsin  54154
Marshfield Clinic at James Beck Cancer Center Rhinelander, Wisconsin  54501
Marshfield Clinic-Rice Lake Center Rice Lake, Wisconsin  54868
Saint Michael's Hospital Stevens Point, Wisconsin  54481
Green Bay Oncology - Sturgeon Bay Sturgeon Bay, Wisconsin  54235
Marshfield Clinic-Wausau Center Wausau, Wisconsin  54401
University of Illinois Chicago, Illinois  60612
Elkhart Clinic Elkhart, Indiana  46515
Marin General Hospital Greenbrae, California  94904
University of Colorado Cancer Center - Anschutz Cancer Pavilion Aurora, Colorado  80045
The Shaw Regional Cancer Center Edwards, Colorado  81632
Montrose Memorial Hospital Montrose, Colorado  81401
Kootenai Cancer Center Post Falls, Idaho  83854
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
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-Elkhart Elkhart, Indiana  46514
Michiana Hematology Oncology PC-Plymouth Plymouth, Indiana  46563
Michiana Hematology Oncology PC-South Bend South Bend, Indiana  46601
Michiana Hematology Oncology-PC Westville Westville, Indiana  46391
Saint Mary's Regional Medical Center Lewiston, Maine  04240
Michiana Hematology Oncology PC-Niles Niles, Michigan  49120
North Coast Cancer Care-Clyde Clyde, Ohio  43410
Community Health Partners Regional Medical Center Elyria, Ohio  44035
Vanderbilt-Ingram Cancer Center Cool Springs Franklin, Tennessee  37067
The Center for Biomedical Research Knoxville, Tennessee  37909
East Tennessee Baptist Hospital-Mercy Health Partners Knoxville, Tennessee  37920
University of Tennessee - Knoxville Knoxville, Tennessee  37920
Skagit Valley Hospital Mt. Vernon, Washington  98273
Evergreen Hematology and Oncology PS Spokane, Washington  99218
West Virginia University Charleston Charleston, West Virginia  25304
Marshfield Clinic-Chippewa Center Chippewa Falls, Wisconsin  54729
Holy Family Memorial Hospital Manitowoc, Wisconsin  54221
Riverview Hospital Wisconsin Rapids, Wisconsin  54494
State University of New York Downstate Medical Center Brooklyn, New York  11203
FirstHealth of the Carolinas-Moore Regional Hosiptal Pinehurst, North Carolina  28374
Hematology Oncology Associates-Berwyn Berwyn, Illinois  60402
Spector, David MD (UIA Investigator) Moline, Illinois  61265
Saint Luke's South Hospital Overland Park, Kansas  66213
Doctors Carrol, Sheth, Raghavan Louisville, Kentucky  40215
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
University of Tennessee - Memphis Memphis, Tennessee  38163
Memorial Hospital Of Martinsville Martinsville, Virginia  24115
Gundersen Lutheran La Crosse, Wisconsin  54601
University Hospital of Brooklyn Brooklyn, New York  11203
The Center for Cancer and Blood Disorders-Burleson Burleson, Texas  76115
The Center for Cancer and Blood Disorders-Cleburne Cleburne, Texas  76033
The Center for Cancer and Blood Disorders-Fort Worth Fort Worth, Texas  76104
The Center for Cancer and Blood Disorders-Mineral Wells Mineral Wells, Texas  76067
The Center for Cancer and Blood Disorders-Weatherford Weatherford, Texas  76086
Siouxland Hematology Oncology Associates Sioux City, Iowa  51101
Carle Foundation - Carle Cancer Center Urbana, Illinois  61801
Michiana Hematology Oncology PC-Mishawaka Mishawaka, Indiana  46545-1470
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
The Toledo Hospital/Toledo Children's Hospital Toledo, Ohio  43606
Sanford USD Medical Center - Sioux Falls Sioux Falls, South Dakota  57117-5134
North Shore-LIJ Health System CCOP Manhasset, New York  11030
Genesys Regional Medical Center-West Flint Campus Flint, Michigan  48532
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
PeaceHealth Saint Joseph Medical Center Bellingham, Washington  98225
Christiana Care Health System-Christiana Hospital Newark, Delaware  19718
Illinois Cancer Specialists-Niles Niles, Illinois  60714
Bronson Battle Creek Battle Creek, Michigan  49017
Springfield Regional Medical Center Springfield, Ohio  45505
NEA Baptist Memorial Hospital Jonesboro, Arkansas  72401
Marin Cancer Care Inc Greenbrae, California  94904
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
Harrison Poulsbo Hematology and Oncology Poulsbo, Washington  98370