Know Cancer

forgot password

Randomized Phase II Study of ECF-C, IC-C, or FOLFOX-C in Metastatic Esophageal and GE Junction Cancer

Phase 2
18 Years
Open (Enrolling)
Esophageal Cancer

Thank you

Trial Information

Randomized Phase II Study of ECF-C, IC-C, or FOLFOX-C in Metastatic Esophageal and GE Junction Cancer



- Compare the tumor response rate in patients with metastatic esophageal or
gastroesophageal junction cancer treated with epirubicin hydrochloride, cisplatin,
fluorouracil, and cetuximab (ECF-C); irinotecan hydrochloride, cisplatin, and cetuximab
(IC-C); or fluorouracil, oxaliplatin, leucovorin calcium, and cetuximab (FOLFOX-C).


- Compare overall survival of patients treated with these regimens.

- Compare progression-free survival of patients treated with these regimens.

- Compare treatment failure in patients treated with these regimens.

- Determine the type and severity of toxicities associated with these regimens in the
multi-institutional phase II setting.

- Correlate quantitative immunohistochemistry results with objective response rate,
overall survival, and time to progression in these patients.

- Evaluate the cellular damage (i.e., apoptosis) as a result of oxaliplatin in these

- Determine if germline epidermal growth factor receptor (EGFR) variants correlate with
skin rash in patients treated with cetuximab.

- Correlate germline EGFR variants with tumor EGFR expression as measured by

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to
histology (squamous cell carcinoma vs adenocarcinoma) and ECOG performance status (0 or 1 vs
2). Patients are randomized to 1 of 3 treatment arms.

- Arm I (ECF + cetuximab): Patients receive cetuximab IV over 1-2 hours on days 1, 8, and
15; epirubicin hydrochloride IV followed by cisplatin IV over 1 hour on day 1; and
fluorouracil IV continuously on days 1-21. Treatment repeats every 21 days in the
absence of disease progression and unacceptable toxicity.

- Arm II (IC + cetuximab): Patients receive cetuximab IV over 1-2 hours on days 1, 8, and
15 and cisplatin IV over 30 minutes followed by irinotecan hydrochloride IV over 90
minutes on days 1 and 8. Treatment repeats every 21 days in the absence of disease
progression or unacceptable toxicity.

- ARM III (FOLFOX + cetuximab): Patients receive cetuximab IV over 1-2 hours on days 1
and 8; oxaliplatin IV over 2 hours followed by leucovorin calcium IV over 2 hours on
day 1; and fluorouracil IV continuously over 46-48 hours on days 1 and 2. Treatment
repeats every 14 days in the absence of disease progression or unacceptable toxicity.

Patients undergo tumor sample collection at baseline to examine quantitative
immunofluorescence with subcellular localization for epidermal growth factor receptor
(EGFR), phospho EGFR, HER-2, phospho-HER-2, HER-3, HER-4, FEF, AKT, phospho AKT, PTEN,
gastrin-releasing peptide (GRP), and GRP receptor levels. Tumor samples are collected at
baseline from patients randomized to arm III to evaluate molecular mechanisms for
correlative studies. Cellular damage (i.e., apoptosis) by oxaliplatin is determined by DNA
fragmentation by TUNEL assay.

After completion of study treatment, patients are followed periodically for up to 2 years.

PROJECTED ACCRUAL: A total of 270 patients will be accrued for this study.

Inclusion Criteria


- Histologically, cytologically, or radiologically confirmed esophageal cancer,
including any of the following types:

- Squamous cell carcinoma

- Adenocarcinoma* of the esophagus

- Adenocarcinoma* of the gastroesophageal (GE) junction according to Siewert

- Type I or II disease

- No type III disease NOTE: Undifferentiated adenocarcinoma and
adenosquamous tumor will be considered as adenocarcinoma

- Metastatic disease or locally recurrent or residual (post-resection) disease

- Resected esophageal or GE junction disease that develops radiological or
clinical evidence of metastatic disease does not require histological or
cytological confirmation of metastatic disease unless 1 of the following is

- More than 5 years since primary surgery and development of metastatic

- Primary cancer was stage I

- Measurable disease, defined as at least 1 unidimensionally measurable lesion (longest
diameter) as ≥ 20 mm by conventional techniques or ≥ 10 mm by spiral CT scan

- Must have ≥ 1 paraffin block (or ≥ 15 unstained slides) available for analysis of
tumor epidermal growth factor receptor (EGFR) status

- No known CNS metastases or carcinomatous meningitis


- ECOG performance status 0-2

- Platelet count ≥ 100,000/mm^3

- Granulocyte count ≥ 1,500/mm^3

- Creatinine ≤ 1.5 mg/dL

- AST ≤ 5.0 times upper limit of normal

- Bilirubin ≤ 1.5 mg/dL

- Albumin ≥ 2.5 g/dL

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- Must have a stable weight loss of (i.e., < 1 pound weight loss during the past week)

- No diarrhea ≥ grade 2 within the past 7 days

- No myocardial infarction within the past 6 months

- No New York Heart Association class III or IV congestive heart failure

- No interstitial pneumonia or symptomatic interstitial fibrosis of the lung

- No seizure disorder or active neurological disease requiring anti-epileptic

- No peripheral neuropathy ≥ grade 2

- No evidence of Gilbert's syndrome

- No prior allergic reaction to chimerized or murine monoclonal antibody therapy or
documented presence of human anti-mouse antibodies (HAMA)


- See Disease Characteristics

- No prior chemotherapy or radiotherapy

- No prior therapy that specifically and directly targets the EGFR pathway

- At least 4 weeks since prior major surgery* and recovered

- At least 2 weeks since prior minor surgery* and recovered

- No concurrent palliative radiotherapy

- No other concurrent investigational agent

- No other concurrent chemotherapy

- No concurrent hormonal therapy except for the following:

- Steroids given temporarily for adrenal failure

- Hormones for nondisease-related conditions (e.g., insulin for diabetes)

- Intermittent steroids (e.g., dexamethasone) as an antiemetic NOTE: *Insertion of
a vascular device is not considered major or minor surgery

Type of Study:


Study Design:

Allocation: Randomized, Primary Purpose: Treatment

Outcome Measure:

Tumor response rate (complete and partial) in patients with measurable esophageal or GE junction adenocarcinoma

Safety Issue:


Principal Investigator

Peter C. Enzinger, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Dana-Farber Cancer Institute



Study ID:




Start Date:

September 2006

Completion Date:

Related Keywords:

  • Esophageal Cancer
  • squamous cell carcinoma of the esophagus
  • adenocarcinoma of the esophagus
  • stage IV esophageal cancer
  • recurrent esophageal cancer
  • Esophageal Diseases
  • Esophageal Neoplasms



Memorial Sloan-Kettering Cancer Center New York, New York  10021
University of Chicago Cancer Research Center Chicago, Illinois  60637
CCOP - Wichita Wichita, Kansas  67214-3882
Hurley Medical Center Flint, Michigan  48503
CCOP - Kansas City Kansas City, Missouri  64131
CCOP - Missouri Valley Cancer Consortium Omaha, Nebraska  68131
CCOP - Christiana Care Health Services Wilmington, Delaware  19899
CCOP - Illinois Oncology Research Association Peoria, Illinois  61602
CCOP - Carle Cancer Center Urbana, Illinois  61801
CCOP - Iowa Oncology Research Association Des Moines, Iowa  50309-1016
CCOP - Metro-Minnesota Saint Louis Park, Minnesota  55416
Rush-Copley Cancer Care Center Aurora, Illinois  60507
Joliet Oncology-Hematology Associates, Limited - West Joliet, Illinois  60435
Carle Cancer Center at Carle Foundation Hospital Urbana, Illinois  61801
Saint Anthony Memorial Health Centers Michigan City, Indiana  46360
Cedar Rapids Oncology Associates Cedar Rapids, Iowa  52403
Mercy Medical Center - Sioux City Sioux City, Iowa  51104
Siouxland Hematology-Oncology Associates, LLP Sioux City, Iowa  51101
St. Luke's Regional Medical Center Sioux City, Iowa  51104
Baystate Regional Cancer Program at D'Amour Center for Cancer Care Springfield, Massachusetts  01199
CCOP - Michigan Cancer Research Consortium Ann Arbor, Michigan  48106
Saint Joseph Mercy Cancer Center Ann Arbor, Michigan  48106-0995
Oakwood Cancer Center at Oakwood Hospital and Medical Center Dearborn, Michigan  48123-2500
Genesys Hurley Cancer Institute Flint, Michigan  48503
Van Elslander Cancer Center at St. John Hospital and Medical Center Grosse Pointe Woods, Michigan  48236
Bronson Methodist Hospital Kalamazoo, Michigan  49007
West Michigan Cancer Center Kalamazoo, Michigan  49007-3731
Borgess Medical Center Kalamazooaa, Michigan  49001
Sparrow Regional Cancer Center Lansing, Michigan  48912-1811
St. John Macomb Hospital Warren, Michigan  48093
Fairview Ridges Hospital Burnsville, Minnesota  55337
Mercy and Unity Cancer Center at Mercy Hospital Coon Rapids, Minnesota  55433
Duluth Clinic Cancer Center - Duluth Duluth, Minnesota  55805-1983
CCOP - Duluth Duluth, Minnesota  55805
Miller - Dwan Medical Center Duluth, Minnesota  55805
Fairview Southdale Hospital Edina, Minnesota  55435
Mercy and Unity Cancer Center at Unity Hospital Fridley, Minnesota  55432
Hutchinson Area Health Care Hutchinson, Minnesota  55350
Meeker County Memorial Hospital Lichfield, Minnesota  55355
Minnesota Oncology Hematology, PA - Maplewood Maplewood, Minnesota  55109
HealthEast Cancer Care at St. John's Hospital Maplewood, Minnesota  55109
Hennepin County Medical Center - Minneapolis Minneapolis, Minnesota  55415
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital Minneapolis, Minnesota  55407
Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center Robbinsdale, Minnesota  55422-2900
St. Francis Cancer Center at St. Francis Medical Center Shakopee, Minnesota  55379
Park Nicollet Cancer Center St. Louis Park, Minnesota  55416
Regions Hospital Cancer Care Center St. Paul, Minnesota  55101
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
Minnesota Oncology Hematology, PA - Woodbury Woodbury, Minnesota  55125
Aultman Cancer Center at Aultman Hospital Canton, Ohio  44710-1799
MetroHealth Cancer Care Center at MetroHealth Medical Center Cleveland, Ohio  44109
St. Rita's Medical Center Lima, Ohio  45801
Abramson Cancer Center of the University of Pennsylvania Philadelphia, Pennsylvania  19104-4283
Geisinger Medical Group - Scenery Park State College, Pennsylvania  16801
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center Wilkes-Barre, Pennsylvania  18711
Sanford Cancer Center at Sanford USD Medical Center Sioux Falls, South Dakota  57117-5039
Medical X-Ray Center, PC Sioux Falls, South Dakota  57105
Avera Cancer Institute Sioux Falls, South Dakota  57105
Marshfield Clinic - Indianhead Center Rice Lake, Wisconsin  54868
Methodist Medical Center of Illinois Peoria, Illinois  61636
Memorial Hospital of South Bend South Bend, Indiana  46601
Newark Beth Israel Medical Center Newark, New Jersey  07112
CCOP - Northern Indiana CR Consortium South Bend, Indiana  46601
Saint Joseph Regional Medical Center South Bend, Indiana  46617
Holden Comprehensive Cancer Center at University of Iowa Iowa City, Iowa  52242-1002
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center Lebanon, New Hampshire  03756-0002
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill Chapel Hill, North Carolina  27599-7570
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia Philadelphia, Pennsylvania  19107
CCOP - Scott and White Hospital Temple, Texas  76508
Veterans Affairs Medical Center - Minneapolis Minneapolis, Minnesota  55417
Veterans Affairs Medical Center - Buffalo Buffalo, New York  14215
Fletcher Allen Health Care - University Health Center Campus Burlington, Vermont  05401
John Stoddard Cancer Center at Iowa Methodist Medical Center Des Moines, Iowa  50309
Blumenthal Cancer Center at Carolinas Medical Center Charlotte, North Carolina  28232-2861
Harry and Jeanette Weinberg Cancer Institute at Franklin Square Hospital Center Baltimore, Maryland  21237
Via Christi Cancer Center at Via Christi Regional Medical Center Wichita, Kansas  67214
St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54307-3508
Lahey Clinic Medical Center - Burlington Burlington, Massachusetts  01805
McCreery Cancer Center at Ottumwa Regional Ottumwa, Iowa  52501
Green Bay Oncology, Limited - Escanaba Escanaba, Michigan  49431
Dickinson County Healthcare System Iron Mountain, Michigan  49801
Our Lady of Mercy Medical Center Comprehensive Cancer Center Bronx, New York  10466
CCOP - Hematology-Oncology Associates of Central New York East Syracuse, New York  13057
Lewistown Hospital Lewistown, Pennsylvania  17044
Mount Nittany Medical Center State College, Pennsylvania  16803
St. Mary's Hospital Medical Center - Green Bay Green Bay, Wisconsin  54303
Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54301-3526
Green Bay Oncology, Limited at St. Mary's Hospital Green Bay, Wisconsin  54303
Bay Area Cancer Care Center at Bay Area Medical Center Marinette, Wisconsin  54143
Green Bay Oncology, Limited - Oconto Falls Oconto Falls, Wisconsin  54154
Green Bay Oncology, Limited - Sturgeon Bay Sturgeon Bay, Wisconsin  54235
Hematology Oncology Associates of the Quad Cities Bettendorf, Iowa  52722
Southwest Medical Center Liberal, Kansas  67901
Wayne Memorial Hospital, Incorporated Goldsboro, North Carolina  27534
Lombardi Comprehensive Cancer Center at Georgetown University Medical Center Washington, District of Columbia  20007
Swedish-American Regional Cancer Center Rockford, Illinois  61104-2315
Indiana University Melvin and Bren Simon Cancer Center Indianapolis, Indiana  46202-5289
CancerCare of Maine at Eastern Maine Medical Center Bangor, Maine  04401
Dana-Farber/Harvard Cancer Center at Dana-Farber Cancer Institute Boston, Massachusetts  02115
CCOP - Nevada Cancer Research Foundation Las Vegas, Nevada  89109-2306
Geisinger Cancer Institute at Geisinger Health Danville, Pennsylvania  17822-0001
Methodist Estabrook Cancer Center Omaha, Nebraska  68114-4199
Decatur Memorial Hospital Cancer Care Institute Decatur, Illinois  62526
Elkhart General Hospital Elkhart, Indiana  46515
Howard Community Hospital Kokomo, Indiana  46904
South Bend Clinic South Bend, Indiana  46617
Lakeland Regional Cancer Care Center - St. Joseph St. Joseph, Michigan  49085
Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton Marlton, New Jersey  08053
Fox Chase Virtua Health Cancer Program at Virtua West Jersey Voorhees, New Jersey  08043
Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest Allentown, Pennsylvania  18105
Fox Chase Cancer Center - Philadelphia Philadelphia, Pennsylvania  19111-2497
University Medical Center of Southern Nevada Las Vegas, Nevada  89102
Joan Karnell Cancer Center at Pennsylvania Hospital Philadelphia, Pennsylvania  19107
St. Joseph Medical Center Bloomington, Illinois  61701
Graham Hospital Canton, Illinois  61520
Memorial Hospital Carthage, Illinois  62321
Eureka Community Hospital Eureka, Illinois  61530
Galesburg Cottage Hospital Galesburg, Illinois  61401
Ingalls Cancer Care Center at Ingalls Memorial Hospital Harvey, Illinois  60426
Mason District Hospital Havana, Illinois  62644
Hopedale Medical Complex Hopedale, Illinois  61747
McDonough District Hospital Macomb, Illinois  61455
BroMenn Regional Medical Center Normal, Illinois  61761
Community Cancer Center Normal, Illinois  61761
Community Hospital of Ottawa Ottawa, Illinois  61350
Oncology Hematology Associates of Central Illinois, PC - Ottawa Ottawa, Illinois  61350
Cancer Treatment Center at Pekin Hospital Pekin, Illinois  61554
Oncology Hematology Associates of Central Illinois, PC - Peoria Peoria, Illinois  61615
OSF St. Francis Medical Center Peoria, Illinois  61637
Proctor Hospital Peoria, Illinois  61614
Illinois Valley Community Hospital Peru, Illinois  61354
Perry Memorial Hospital Princeton, Illinois  61356
St. Margaret's Hospital Spring Valley, Illinois  61362
Fort Wayne Medical Oncology and Hematology Fort Wayne, Indiana  46815
Center for Cancer Therapy at LaPorte Hospital and Health Services La Porte, Indiana  46350
Mercy Regional Cancer Center at Mercy Medical Center Cedar Rapids, Iowa  52403
John Stoddard Cancer Center at Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
Mercy Capitol Hospital Des Moines, Iowa  50307
Medical Oncology and Hematology Associates at John Stoddard Cancer Center Des Moines, Iowa  50309
Medical Oncology and Hematology Associates at Mercy Cancer Center Des Moines, Iowa  50314
Mercy Cancer Center at Mercy Medical Center - Des Moines Des Moines, Iowa  50314
Medical Oncology and Hematology Associates - West Des Moines West Des Moines, Iowa  50266
Cancer Center of Kansas, PA - Dodge City Dodge City, Kansas  67801
Immanuel Medical Center Omaha, Nebraska  68122
Creighton University Medical Center Omaha, Nebraska  68131-2197
Cancer Institute of New Jersey at Cooper - Voorhees Voorhees, New Jersey  08043
Charles R. Wood Cancer Center at Glens Falls Hospital Glens Falls, New York  12801
Christine LaGuardia Phillips Cancer Center at Wellmont Holston Valley Medical Center Kingsport, Tennessee  37662
Mountainview Medical Berlin, Vermont  05602
Danville Regional Medical Center Danville, Virginia  24541
Massachusetts General Hospital Boston, Massachusetts  02114-2617
Mercy Cancer Center at Mercy Medical Center - North Iowa Mason City, Iowa  50401
Missouri Baptist Cancer Center St. Louis, Missouri  63131
Tunnell Cancer Center at Beebe Medical Center Lewes, Delaware  19958
Evanston Hospital Evanston, Illinois  60201-1781
William N. Wishard Memorial Hospital Indianapolis, Indiana  46202
McFarland Clinic, PC Ames, Iowa  50010
Hospital District Sixth of Harper County Anthony, Kansas  67003
Cancer Center of Kansas, PA - Chanute Chanute, Kansas  66720
Cancer Center of Kansas, PA - El Dorado El Dorado, Kansas  67042
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Cancer Center of Kansas, PA - Kingman Kingman, Kansas  67068
Lawrence Memorial Hospital Lawrence, Kansas  66044
Cancer Center of Kansas, PA - Newton Newton, Kansas  67114
Menorah Medical Center Overland Park, Kansas  66209
Cancer Center of Kansas, PA - Parsons Parsons, Kansas  67357
Cancer Center of Kansas, PA - Pratt Pratt, Kansas  67124
Cancer Center of Kansas, PA - Salina Salina, Kansas  67401
Shawnee Mission Medical Center Shawnee Mission, Kansas  66204
Cancer Center of Kansas, PA - Wellington Wellington, Kansas  67152
Cancer Center of Kansas, PA - Wichita Wichita, Kansas  67214
Associates in Womens Health, PA - North Review Wichita, Kansas  67208
Cancer Center of Kansas, PA - Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas, PA - Winfield Winfield, Kansas  67156
Foote Memorial Hospital Jackson, Michigan  49201
St. Mary Mercy Hospital Livonia, Michigan  48154
St. Joseph Mercy Oakland Pontiac, Michigan  48341-2985
Mercy Regional Cancer Center at Mercy Hospital Port Huron, Michigan  48060
Seton Cancer Institute at Saint Mary's - Saginaw Saginaw, Michigan  48601
Truman Medical Center - Hospital Hill Kansas City, Missouri  64108
St. Joseph Medical Center Kansas City, Missouri  64114
North Kansas City Hospital Kansas City, Missouri  64116
Saint Luke's Cancer Institute at Saint Luke's Hospital Kansas City, Missouri  64111
Research Medical Center Kansas City, Missouri  64132
Liberty Hospital Liberty, Missouri  64068
Heartland Regional Medical Center Saint Joseph, Missouri  64506
Arch Medical Services, Incorporated at Center for Cancer Care and Research Saint Louis, Missouri  63141
Alegant Health Cancer Center at Bergan Mercy Medical Center Omaha, Nebraska  68124
Frederick R. and Betty M. Smith Cancer Treatment Center Sparta, New Jersey  07871
Summa Center for Cancer Care at Akron City Hospital Akron, Ohio  44309-2090
Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at Ohio State University Comprehensive Cancer Center Columbus, Ohio  43210-1240
St. Luke's Cancer Network at St. Luke's Hospital Bethlehem, Pennsylvania  18015
Geisinger Hazleton Cancer Center Hazleton, Pennsylvania  18201
Penn State Hershey Cancer Institute at Milton S. Hershey Medical Center Hershey, Pennsylvania  17033-0850
Hematology and Oncology Associates of Northeastern Pennsylvania Scranton, Pennsylvania  18510
Susquehanna Cancer Center at Divine Providence Hospital Williamsport, Pennsylvania  17701
Southwest Virginia Regional Cancer Center at Wellmonth Health Norton, Virginia  24273
Center for Cancer Treatment & Prevention at Sacred Heart Hospital Eau Claire, Wisconsin  54701
Marshfield Clinic Cancer Care at Regional Cancer Center Eau Claire, Wisconsin  54701
Saint Joseph's Hospital Marshfield, Wisconsin  54449
Medical Consultants, Limited Milwaukee, Wisconsin  53215
Marshfield Clinic - Lakeland Center Minocqua, Wisconsin  54548
Ministry Medical Group at Saint Mary's Hospital Rhinelander, Wisconsin  54501
Saint Michael's Hospital Cancer Center Stevens Point, Wisconsin  54481
Marshfield Clinic - Wausau Center Wausau, Wisconsin  54401
Marshfield Clinic - Weston Center Weston, Wisconsin  54476
Marshfield Clinic - Wisconsin Rapids Center Wisconsin Rapids, Wisconsin  54494
Regional Cancer Center at Memorial Medical Center Springfield, Illinois  62781-0001
Pardee Memorial Hospital Hendersonville, North Carolina  28791
Union Hospital of Cecil County Elkton MD, Maryland  21921
Dana-Farber/Brigham and Women's Cancer Center Boston, Massachusetts  02115
Kinston Medical Specialists Kinston, North Carolina  28501
McLeod Regional Medical Center Florence, South Carolina  29501
University of Wisconcin Cancer Center at Aspirus Wausau Hospital Wausau, Wisconsin  54401
Galesburg Clinic, PC Galesburg, Illinois  61401
Oncology Care Associates, PLLC Saint Joseph, Michigan  49085
Independence Regional Health Center Independence, Missouri  64050
Parvin Radiation Oncology Kansas City, Missouri  64116
Dale and Frances Hughes Cancer Center at Pocono Medical Center East Stroudsburg, Pennsylvania  18301
South Shore Hospital South Weymouth, Massachusetts  02190
Frankford Hospital Cancer Center - Torresdale Campus Philadelphia, Pennsylvania  19114
Shore Regional Cancer Center at Memorial Hospital - Easton Easton, Maryland  21601
Ralph Lauren Center for Cancer Care and Prevention New York, New York  10035
Norwalk Hospital Norwalk, Connecticut  06856
Mercy Hospital at Wilkes-Barre Wilkes-Barre, Pennsylvania  18765