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A Phase III Double Blind Trial of Oral Duloxetine for Treatment of Pain Associated With Chemotherapy-Induced Peripheral Neuropathy


Phase 3
25 Years
N/A
Open (Enrolling)
Both
Neurotoxicity Syndromes, Pain, Peripheral Neuropathy, Unspecified Adult Solid Tumor, Protocol Specific

Thank you

Trial Information

A Phase III Double Blind Trial of Oral Duloxetine for Treatment of Pain Associated With Chemotherapy-Induced Peripheral Neuropathy


OBJECTIVES:

Primary

- Determine the efficacy of duloxetine hydrochloride in cancer patients with painful
chemotherapy-induced (taxane or platinum agent) peripheral neuropathy.

Secondary

- Determine the influence of this drug on peripheral neuropathy-related functional status
and quality of life of these patients.

- Describe the differences in duloxetine hydrochloride efficacy when used to treat pain
caused by chemotherapy-induced peripheral neuropathy based on the neurotoxic drug and
class.

OUTLINE: This is a randomized, double-blind, placebo-controlled, crossover study. Patients
are stratified according to prior neurotoxic agent (paclitaxel vs oxaliplatin vs other
taxane agents without paclitaxel vs platinum agents [cisplatin] without oxaliplatin) and
high risk for developing painful chemotherapy-induced peripheral neuropathy (no vs yes).
Patients are randomized to 1 of 2 treatment arms.

- Arm I: Patients receive oral duloxetine hydrochloride once or twice daily in weeks 1-6.
After a 1-week rest period, patients cross over to receive an oral placebo once or
twice daily in weeks 8-13.

- Arm II: Patients receive an oral placebo once or twice daily in weeks 1-6. After a
1-week rest period, patients cross over to receive oral duloxetine hydrochloride once
or twice daily in weeks 8-13.

Patients complete pain and quality of life questionnaires, including the BPI-SF once weekly
and FACT/GOG-NTX and EORTC QLQ-C30 questionnaires, in weeks 1, 6, 8, and 13.

After completion of study treatment, patients are followed for 2 weeks.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Diagnosis of cancer

- CNS malignancy allowed with the exception of leptomeningeal carcinomatosis

- Must have painful sensory chemotherapy-induced peripheral neuropathy (CIPN) resulting
from prior treatment with single-agent taxane or platinum agents (paclitaxel,
docetaxel, nab-paclitaxel, oxaliplatin, cisplatin) (may not have received drugs from
both classes)

- CIPN > grade 1 as measured by NCI-CTCAE v 4.0

- Average neuropathic pain score ≥ 4

- Patients with the following illnesses known to cause peripheral neuropathy are
eligible, provided they have no evidence of neuropathy from these illnesses:

- Diabetes mellitus

- Peripheral vascular disease

- HIV infection

- Significant degenerative or familial neurologic disorder known to cause
peripheral neuropathy

- No clinical or subclinical neuropathy from nerve compression injuries (i.e., carpal
tunnel syndrome, brachial plexopathy, spinal stenosis, or spinal nerve root
compression)

PATIENT CHARACTERISTICS:

- AST ≤ 3 times upper limit of normal

- Total bilirubin ≤ normal

- Creatinine clearance > 30 mL/min

- Not pregnant or nursing

- Able to take oral or enteral medication

- No history of seizure disorder

- No diagnosis of ethanol addiction or dependence within the past 10 years

- No history of narrow-angle glaucoma

- None of the following:

- History of suicidal thoughts

- Symptoms of or history of schizophrenia, bipolar disease, or a major depression

- Serious eating disorder such as bulimia or anorexia where electrolyte imbalance
is likely

PRIOR CONCURRENT THERAPY:

- At least 3 months since prior and no concurrent taxane or platinum agent

- At least 14 days since prior and no concurrent monoamine oxidase inhibitors or other
antidepressants

- No other prior or concurrent neurotoxic drugs (e.g., vincristine, vinblastine,
cytarabine, thalidomide, bortezomib, carboplatin, or procarbazine)

- No concurrent anticonvulsants

- No concurrent B or E vitamin supplementation in doses greater than the recommended
daily allowance (RDA)

- Centrum (standard formula) and One-A-Day "essential" formula which contain 100%
RDA for vitamins B6, E, and B12 allowed

- Other multivitamins allowed provided they contain no more than 100% RDA of B
vitamins and vitamin E

- No concurrent treatment (pharmacologic) for depression

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Masking: Double-Blind, Primary Purpose: Supportive Care

Outcome Measure:

Average pain as measured by the BPI-SF

Principal Investigator

Ellen L. Smith, PhD, ARNP, AOCN

Investigator Role:

Study Chair

Investigator Affiliation:

University of Michigan

Authority:

United States: Federal Government

Study ID:

CDR0000553389

NCT ID:

NCT00489411

Start Date:

April 2008

Completion Date:

Related Keywords:

  • Neurotoxicity Syndromes
  • Pain
  • Peripheral Neuropathy
  • Unspecified Adult Solid Tumor, Protocol Specific
  • unspecified adult solid tumor, protocol specific
  • neurotoxicity
  • pain
  • peripheral neuropathy
  • Peripheral Nervous System Diseases
  • Neurotoxicity Syndromes
  • Demyelinating Diseases
  • Polyneuropathies
  • Nerve Compression Syndromes
  • Neurologic Manifestations

Name

Location

Cardinal Bernardin Cancer Center at Loyola University Medical Center Maywood, Illinois  60153-5500
Walter Reed Army Medical Center Washington, District of Columbia  20307-5000
University of Chicago Cancer Research Center Chicago, Illinois  60637
CCOP - Wichita Wichita, Kansas  67214-3882
Hurley Medical Center Flint, Michigan  48503
CCOP - Atlanta Regional Atlanta, Georgia  30342-1701
CCOP - Missouri Valley Cancer Consortium Omaha, Nebraska  68131
CCOP - Christiana Care Health Services Wilmington, Delaware  19899
CCOP - Mount Sinai Medical Center Miami Beach, Florida  33140
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
Aurora Presbyterian Hospital Aurora, Colorado  80012
Boulder Community Hospital Boulder, Colorado  80301-9019
Penrose Cancer Center at Penrose Hospital Colorado Springs, Colorado  80933
CCOP - Colorado Cancer Research Program Denver, Colorado  80224-2522
Porter Adventist Hospital Denver, Colorado  80210
Presbyterian - St. Luke's Medical Center Denver, Colorado  80218
St. Joseph Hospital Denver, Colorado  80218
Rose Medical Center Denver, Colorado  80220
Swedish Medical Center Englewood, Colorado  80110
St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center Grand Junction, Colorado  81502
Sky Ridge Medical Center Lone Tree, Colorado  80124
Hope Cancer Care Center at Longmont United Hospital Longmont, Colorado  80502
St. Mary - Corwin Regional Medical Center Pueblo, Colorado  81004
North Suburban Medical Center Thornton, Colorado  80229
Rush-Copley Cancer Care Center Aurora, Illinois  60507
Joliet Oncology-Hematology Associates, Limited - West Joliet, Illinois  60435
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
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
MeritCare Bemidji Bemidji, Minnesota  56601
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
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
MeritCare Broadway Fargo, North Dakota  58122
CCOP - MeritCare Hospital Fargo, North Dakota  58122
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
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
Dean Medical Center - Madison Madison, Wisconsin  53717
Marshfield Clinic - Marshfield Center Marshfield, Wisconsin  54449
Marshfield Clinic - Indianhead Center Rice Lake, Wisconsin  54868
Rapid City Regional Hospital Rapid City, South Dakota  57709
CCOP - Bay Area Tumor Institute Oakland, California  94609-3305
Methodist Medical Center of Illinois Peoria, Illinois  61636
Memorial Hospital of South Bend South Bend, Indiana  46601
CCOP - Cancer Research for the Ozarks Springfield, Missouri  65807
CCOP - Montana Cancer Consortium Billings, Montana  59101
CCOP - Columbus Columbus, Ohio  43206
CCOP - Dayton Kettering, Ohio  45429
CCOP - Greenville Greenville, South Carolina  29615
Hinsdale, Illinois  60521
CCOP - Northern Indiana CR Consortium South Bend, Indiana  46601
Saint Joseph Regional Medical Center South Bend, Indiana  46617
Ellis Fischel Cancer Center at University of Missouri - Columbia Columbia, Missouri  65203
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
USC/Norris Comprehensive Cancer Center and Hospital Los Angeles, California  90033-0804
CCOP - St. Louis-Cape Girardeau Saint Louis, Missouri  63141
Brooke Army Medical Center Fort Sam Houston, Texas  78234-6200
Sutter Cancer Center Sacramento, California  95816
Kaiser Permanente Medical Center - Vallejo Vallejo, California  94589
Veterans Affairs Medical Center - Syracuse Syracuse, New York  13210
Rebecca and John Moores UCSD Cancer Center La Jolla, California  92093-0658
Queens Cancer Center of Queens Hospital Jamaica, New York  11432
John Stoddard Cancer Center at Iowa Methodist Medical Center Des Moines, Iowa  50309
Kaiser Permanente Medical Center - San Francisco Geary Campus San Francisco, California  94115
St. Vincent Mercy Medical Center Toledo, Ohio  43608
Veterans Affairs Medical Center - Brooklyn Brooklyn, New York  11209
Northside Hospital Cancer Center Atlanta, Georgia  30342-1611
Hulston Cancer Center at Cox Medical Center South Springfield, Missouri  65807
St. John's Regional Health Center Springfield, Missouri  65804
McDowell Cancer Center at Akron General Medical Center Akron, Ohio  44307
Central Baptist Hospital Lexington, Kentucky  40503
CCOP - Toledo Community Hospital Toledo, Ohio  43623-3456
Waukesha Memorial Hospital Regional Cancer Center Waukesha, Wisconsin  53188
Kaiser Permanente Medical Center - Oakland Sacramento, California  95825
Florida Hospital Cancer Institute at Florida Hospital Orlando Orlando, Florida  32803-1273
Via Christi Cancer Center at Via Christi Regional Medical Center Wichita, Kansas  67214
Breslin Cancer Center at Ingham Regional Medical Center Lansing, Michigan  48910
Mount Sinai Medical Center New York, New York  10029
Wake Forest University Comprehensive Cancer Center Winston-Salem, North Carolina  27157-1096
Medical University of Ohio Cancer Center Toledo, Ohio  43614
Toledo Hospital Toledo, Ohio  43606
St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54307-3508
Saint Peter's University Hospital New Brunswick, New Jersey  08901-1780
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
Hunterdon Regional Cancer Center at Hunterdon Medical Center Flemington, New Jersey  08822
CCOP - Hematology-Oncology Associates of Central New York East Syracuse, New York  13057
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
Somerset Medical Center Somerville, New Jersey  08876
Batte Cancer Center at Northeast Medical Center Concord, North Carolina  28025
North Colorado Medical Center Greeley, Colorado  80631
McKee Medical Center Loveland, Colorado  80539
Saint Anthony's Hospital at Saint Anthony's Health Center Alton, Illinois  62002
Good Samaritan Regional Health Center Mt. Vernon, Illinois  62864
William Beaumont Hospital - Royal Oak Campus Royal Oak, Michigan  48073
David C. Pratt Cancer Center at St. John's Mercy St. Louis, Missouri  63141
Northern Rockies Radiation Oncology Center Billings, Montana  59101
Hematology-Oncology Centers of the Northern Rockies - Billings Billings, Montana  59101
Big Sky Oncology Great Falls, Montana  59405
St. Peter's Hospital Helena, Montana  59601
Kalispell Regional Medical Center Kalispell, Montana  59901
Glacier Oncology, PLLC Kalispell, Montana  59901
Montana Cancer Center at St. Patrick Hospital and Health Sciences Center Missoula, Montana  59802
Montana Cancer Specialists at Montana Cancer Center Missoula, Montana  59802
Wayne Memorial Hospital, Incorporated Goldsboro, North Carolina  27534
Adena Regional Medical Center Chillicothe, Ohio  54601
Doctors Hospital at Ohio Health Columbus, Ohio  43228
Riverside Methodist Hospital Cancer Care Columbus, Ohio  43214
Grady Memorial Hospital Delaware, Ohio  43015
Fairfield Medical Center Lancaster, Ohio  43130
Strecker Cancer Center at Marietta Memorial Hospital Marietta, Ohio  45750
Licking Memorial Cancer Care Program at Licking Memorial Hospital Newark, Ohio  43055
Community Hospital of Springfield and Clark County Springfield, Ohio  45505
Genesis - Good Samaritan Hospital Zanesville, Ohio  43701
Greenebaum Cancer Center at University of Maryland Medical Center Baltimore, Maryland  21201
Memorial Cancer Institute at Memorial Regional Hospital Hollywood, Florida  33021
New York Weill Cornell Cancer Center at Cornell University New York, New York  10021
Kaiser Permanente Medical Center - Santa Clara Kiely Campus Santa Clara, California  95051-5386
Lombardi Comprehensive Cancer Center at Georgetown University Medical Center Washington, District of Columbia  20007
Swedish-American Regional Cancer Center Rockford, Illinois  61104-2315
CCOP - Nevada Cancer Research Foundation Las Vegas, Nevada  89109-2306
Geisinger Cancer Institute at Geisinger Health Danville, Pennsylvania  17822-0001
Virginia Commonwealth University Massey Cancer Center Richmond, Virginia  23298-0037
Gundersen Lutheran Center for Cancer and Blood La Crosse, Wisconsin  54601
Kaiser Permanente Medical Center - Sacramento Sacramento, California  95825
Decatur Memorial Hospital Cancer Care Institute Decatur, Illinois  62526
Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
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
Mount Carmel Health - West Hospital Columbus, Ohio  43222
Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest Allentown, Pennsylvania  18105
Front Range Cancer Specialists Fort Collins, Colorado  80528
Lakeland Regional Cancer Center at Lakeland Regional Medical Center Lakeland, Florida  33805
University Medical Center of Southern Nevada Las Vegas, Nevada  89102
Peninsula Medical Center Burlingame, California  94010
Kaiser Permanente - Fremont Fremont, California  94538
Sutter Health - Western Division Cancer Research Group Greenbrae, California  94904
Kaiser Permanente Medical Center - Hayward Hayward, California  94545
Alta Bates Summit Medical Center - Summit Campus Oakland, California  94609
Kaiser Permanente Medical Center - Redwood City Redwood City, California  94063
Kaiser Permanente Medical Center - Richmond Richmond, California  94801
Kaiser Permanente Medical Center - Roseville Roseville, California  95661
Sutter Cancer Center at Roseville Medical Center Roseville, California  95661
South Sacramento Kaiser-Permanente Medical Center Sacramento, California  95823
Kaiser Permanente Medical Office -Vandever Medical Office San Diego, California  92120
California Pacific Medical Center - California Campus San Francisco, California  94118
Kaiser Permanente Medical Center - Santa Teresa San Jose, California  95119
Kaiser Foundation Hospital - San Rafael San Rafael, California  94903
Kaiser Permanente Medical Center - Santa Rosa Santa Rosa, California  95403
Kaiser Permanente Medical Center - South San Francisco South San Francisco, California  94080
Kaiser Permanente Medical Facility - Stockton Stockton, California  95210
Sutter Solano Medical Center Vallejo, California  94589
Kaiser Permanente Medical Center - Walnut Creek Walnut Creek, California  94596
John Muir/Mt. Diablo Comprehensive Cancer Center Walnut Creek, California  94598
Poudre Valley Hospital Fort Collins, Colorado  80524
Ella Milbank Foshay Cancer Center at Jupiter Medical Center Jupiter, Florida  33458
Saint Joseph's Hospital of Atlanta Atlanta, Georgia  30342-1701
Piedmont Hospital Atlanta, Georgia  30309
WellStar Cobb Hospital Austell, Georgia  30106
Charles B. Eberhart Cancer Center at DeKalb Medical Center Decatur, Georgia  30033
Gwinnett Medical Center Lawrenceville, Georgia  30045
Kennestone Cancer Center at Wellstar Kennestone Hospital Marietta, Georgia  30060
Southern Regional Medical Center Riverdale, Georgia  30274-2600
St. Joseph Medical Center Bloomington, Illinois  61701
Graham Hospital Canton, Illinois  61520
Memorial Hospital Carthage, Illinois  62321
Eureka Community Hospital Eureka, Illinois  61530
Mason District Hospital Havana, Illinois  62644
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. Francis Hospital and Health Centers - Beech Grove Campus Beech Grove, Indiana  46107
Center for Cancer Therapy at LaPorte Hospital and Health Services La Porte, Indiana  46350
Bettendorf, Iowa  52722
St. Luke's Hospital Cedar Rapids, Iowa  52402
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
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
Sturdy Memorial Hospital Attleboro, Massachusetts  02703
Hickman Cancer Center at Bixby Medical Center Adrian, Michigan  49221
Community Cancer Center of Monroe Monroe, Michigan  48162
Saint Francis Medical Center Cape Girardeau, Missouri  63701
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
Iredell Memorial Hospital Statesville, North Carolina  28677
Bismarck Cancer Center Bismarck, North Dakota  58501
Wood County Oncology Center Bowling Green, Ohio  43402
Samaritan North Cancer Care Center Dayton, Ohio  45415
Grandview Hospital Dayton, Ohio  45405
David L. Rike Cancer Center at Miami Valley Hospital Dayton, Ohio  45409
Good Samaritan Hospital Dayton, Ohio  45406
Blanchard Valley Medical Associates Findlay, Ohio  45840
Charles F. Kettering Memorial Hospital Kettering, Ohio  45429
Lima Memorial Hospital Lima, Ohio  45804
St. Luke's Hospital Maumee, Ohio  43537
Northwest Ohio Oncology Center Maumee, Ohio  43537
Middletown Regional Hospital Middletown, Ohio  45044
Toledo Clinic - Oregon Oregon, Ohio  43616
St. Charles Mercy Hospital Oregon, Ohio  43616
North Coast Cancer Care, Incorporated Sandusky, Ohio  44870
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Toledo Clinic, Incorporated - Main Clinic Toledo, Ohio  43623
UVMC Cancer Care Center at Upper Valley Medical Center Troy, Ohio  45373-1300
Fulton County Health Center Wauseon, Ohio  43567
Ruth G. McMillan Cancer Center at Greene Memorial Hospital Xenia, Ohio  45385
Bryn Mawr Hospital Bryn Mawr, Pennsylvania  19010
Delaware County Regional Cancer Center at Delaware County Memorial Hospital Drexel Hill, Pennsylvania  19026
Lankenau Cancer Center at Lankenau Hospital Wynnewood, Pennsylvania  19096
Bon Secours St. Francis Health System Greenville, South Carolina  29601
Danville Regional Medical Center Danville, Virginia  24541
Holy Family Memorial Medical Center Cancer Care Center Manitowoc, Wisconsin  54221-1450
Welch Cancer Center at Sheridan Memorial Hospital Sheridan, Wyoming  82801
St. Anthony Central Hospital Denver, Colorado  80204-1335
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
Pottstown Memorial Regional Cancer Center Pottstown, Pennsylvania  19464
Highland General Hospital Oakland, California  94602
Palo Alto Medical Foundation Palo Alto, California  94301
Northeast Georgia Medical Center Gainesville, Georgia  30501
Great Lakes Cancer Institute at McLaren Regional Medical Center Flint, Michigan  48532
Saint Luke's Hospital Chesterfield, Missouri  63017
Missouri Baptist Cancer Center St. Louis, Missouri  63131
Cancer Resource Center - Lincoln Lincoln, Nebraska  68510
Kaiser Permanente - Deer Valley Antioch, California  94531
Alta Bates Summit Comprehensive Cancer Center Berkeley, California  94704
Kaiser Permanente - Denver Denver, Colorado  80205
Kaiser Permanente - Lafayette Lafayette, Colorado  80026
Tunnell Cancer Center at Beebe Medical Center Lewes, Delaware  19958
Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital Fort Lauderdale, Florida  33308
John B. Amos Cancer Center Columbus, Georgia  31904
Harbin Clinic Cancer Center - Medical Oncology Rome, Georgia  30165
Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/Candler Savannah, Georgia  31405
Kaiser Permanente - Moanalua Medical Center and Clinic Honolulu, Hawaii  96819
Michiana Hematology-Oncology, PC - Elkhart Elkhart, Indiana  46514
Elkhart Clinic, LLC Elkhart, Indiana  46514-2098
Michiana Hematology Oncology PC - La Porte La Porte, Indiana  46350
Michiana Hematology-Oncology, PC - South Bend Mishawaka, Indiana  46545-1470
Michiana Hematology Oncology PC - Plymouth Plymouth, Indiana  46563
Reid Hospital & Health Care Services Richmond, Indiana  47374
McFarland Clinic, PC Ames, Iowa  50010
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 - Liberal Liberal, Kansas  67905
Cancer Center of Kansas, PA - Newton Newton, Kansas  67114
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
Cotton-O'Neil Cancer Center Topeka, Kansas  66606
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
Union Hospital Cancer Program at Union Hospital Elkton MD, Maryland  21921
Foote Memorial Hospital Jackson, Michigan  49201
Haematology-Oncology Associates of Ohio and Michigan, PC Lambertville, Michigan  48144
St. Mary Mercy Hospital Livonia, Michigan  48154
Mercy Memorial Hospital - Monroe Monroe, Michigan  48162
Michiana Hematology Oncology PC - Niles Niles, Michigan  49120
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
Lakeside Cancer Specialists, PLLC Saint Joseph, Michigan  49085
St. Luke's Hospital Cancer Care Center Duluth, Minnesota  55805
Fergus Falls Medical Group, PA Fergus Falls, Minnesota  56537
Willmar Cancer Center at Rice Memorial Hospital Willmar, Minnesota  56201
Arch Medical Services, Incorporated at Center for Cancer Care and Research Saint Louis, Missouri  63141
Billings Clinic - Downtown Billings, Montana  59107-7000
Bozeman Deaconess Cancer Center Bozeman, Montana  59715
St. James Healthcare Cancer Care Butte, Montana  59701
Great Falls Clinic - Main Facility Great Falls, Montana  59405
Sletten Cancer Institute at Benefis Healthcare Great Falls, Montana  59405
Northern Montana Hospital Havre, Montana  59501
Kalispell Medical Oncology at KRMC Kalispell, Montana  59901
Alegant Health Cancer Center at Bergan Mercy Medical Center Omaha, Nebraska  68124
Norris Cotton Cancer Center at Catholic Medical Center Manchester, New Hampshire  03102
Summa Center for Cancer Care at Akron City Hospital Akron, Ohio  44309-2090
Barberton Citizens Hospital Barberton, Ohio  44203
Mary Rutan Hospital Bellefontaine, Ohio  43311
North Coast Cancer Care - Clyde Clyde, Ohio  43410
Grant Medical Center Cancer Care Columbus, Ohio  43215
Hematology Oncology Center Elyria, Ohio  44035
Community Cancer Center Elyria, Ohio  44035
Wayne Hospital Greenville, Ohio  45331
Knox Community Hospital Mount Vernon, Ohio  43050
Fisher-Titus Medical Center Norwalk, Ohio  44857
Flower Hospital Cancer Center Sylvania, Ohio  43560
St. Anne Mercy Hospital Toledo, Ohio  43623
Mount Carmel St. Ann's Cancer Center Westerville, Ohio  43081
Geisinger Hazleton Cancer Center Hazleton, Pennsylvania  18201
Fredericksburg Oncology, Incorporated Fredericksburg, Virginia  22401
Schiffler Cancer Center at Wheeling Hospital Wheeling, West Virginia  26003
Aurora Memorial Hospital of Burlington Burlington, Wisconsin  53105
Marshfield Clinic - Chippewa Center Chippewa Falls, Wisconsin  54729
Marshfield Clinic Cancer Care at Regional Cancer Center Eau Claire, Wisconsin  54701
Vince Lombardi Cancer Center at Aurora Lakeland Medical Center - Elkhorn Elkhorn, Wisconsin  53121
Oncology Alliance - Franklin Franklin, Wisconsin  53132
Oncology Alliance, SC - Milwaukee - East Glendale, Wisconsin  53212-1038
Vince Lombardi Cancer Clinic - Green Bay at Aurora BayCare Medical Center Green Bay, Wisconsin  54311
Oncology Alliance - Kenosha South Kenosha, Wisconsin  53143
Vince Lombardi Cancer Clinic - Marinette Marinette, Wisconsin  54143
Aurora Advanced Healthcare East Mequon Clinic Mequon, Wisconsin  53092
Oncology Alliance, SC - Milwaukee - South Milwaukee, Wisconsin  53215
Medical Consultants, Limited Milwaukee, Wisconsin  53215
Marshfield Clinic - Lakeland Center Minocqua, Wisconsin  54548
Aurora Health Center - Racine Racine, Wisconsin  53406-5661
Ministry Medical Group at Saint Mary's Hospital Rhinelander, Wisconsin  54501
Vince Lombardi Cancer Clinic - Sheboygan Sheboygan, Wisconsin  53081
Marshfield Clinic at Saint Michael's Hospital Stevens Point, Wisconsin  54481
Aurora Medical Center Summit, Wisconsin  53066
Vince Lombardi Cancer Clinic - Two Rivers Two Rivers, Wisconsin  54241
Aurora Health Center - Waukesha Waukesha, Wisconsin  53188
Marshfield Clinic - Wausau Center Wausau, Wisconsin  54401
Oncology Alliance, SC - Milwaukee - West Wauwatosa, Wisconsin  53226
Marshfield Clinic - Weston Center Weston, Wisconsin  54476
Marshfield Clinic - Wisconsin Rapids Center Wisconsin Rapids, Wisconsin  54494
Rocky Mountain Oncology Casper, Wyoming  82609
Cancer Resource Center at King's Daughters Medical Center Ashland, Kentucky  41101
Mid Dakota Clinic, PC Bismarck, North Dakota  58501
Regional Cancer Center at Memorial Medical Center Springfield, Illinois  62781-0001
John H. Stroger, Jr. Hospital of Cook County Chicago, Illinois  60612-9985
Aurora Sinai Medical Center Milwaukee, Wisconsin  53201-0342
Pardee Memorial Hospital Hendersonville, North Carolina  28791
Martha Jefferson Hospital Cancer Care Center Charlottesville, Virginia  22901
Regional Cancer Center at Oconomowoc Memorial Hospital Oconomowoc, Wisconsin  53066
Harold Alfond Center for Cancer Care Augusta, Maine  04330
Kinston Medical Specialists Kinston, North Carolina  28501
Greenville Hospital Cancer Center Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Grove Commons Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Faris Road Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Greer Medical Oncology Greer, South Carolina  29650
Cancer Centers of the Carolinas - Seneca Seneca, South Carolina  29672
Cancer Centers of the Carolinas - Spartanburg Spartanburg, South Carolina  29307
Glendale Memorial Hospital Comprehensive Cancer Center Glendale, California  91204
Resurrection Medical Center Chicago, Illinois  60631
McLeod Regional Medical Center Florence, South Carolina  29501
Nalitt Cancer Institute at Staten Island University Hospital Staten Island, New York  10305
La Grange Memorial Hospital La Grange, Illinois  60525
Lakes Region General Hospital Laconia, New Hampshire  03246
Roper St. Francis Cancer Center at Roper Hospital Charleston, South Carolina  29401
Franklin & Edith Scarpa Regional Cancer Center at South Jersey Healthcare Vineland, New Jersey  08360
Cancer Center at Phoenixville Hospital Phoenixville, Pennsylvania  19460
Doctors Medical Center - San Pablo Campus San Pablo, California  94806
Galesburg Clinic, PC Galesburg, Illinois  61401
St. Vincent Healthcare Cancer Care Services Billings, Montana  59101
Midwest Hematology Oncology Group, Incorporated Saint Louis, Missouri  63109
East Bay Radiation Oncology Center Castro Valley, California  94546
Contra Costa Regional Medical Center Martinez, California  94553-3156
El Camino Hospital Cancer Center Mountain View, California  94040
Larry G Strieff MD Medical Corporation Oakland, California  94609
Tom K Lee, Incorporated Oakland, California  94609
Bay Area Breast Surgeons, Incorporated Oakland, California  94609
Illinois CancerCare - Bloomington Bloomington%, Illinois  61701
Illinois CancerCare - Canton Canton, Illinois  61520
Illinois CancerCare - Carthage Carthage, Illinois  62321
Elmhurst Memorial Hospital Elmhurst, Illinois  60126
Illinois CancerCare - Eureka Eureka, Illinois  61530
Illinois CancerCare - Galesburg Galesburg, Illinois  61401
Illinois CancerCare - Havana Havana, Illinois  62644
Illinois CancerCare - Kewanee Clinic Kewanee, Illinois  61443
Illinois CancerCare - Macomb Macomb, Illinois  61455
Trinity Cancer Center at Trinity Medical Center - 7th Street Campus Moline, Illinois  61265
OSF Holy Family Medical Center Monmouth, Illinois  61462
Illinois CancerCare - Monmouth Monmouth, Illinois  61462
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
Iowa Blood and Cancer Care Cedar Rapids, Iowa  52402
New Hampshire Oncology - Hematology, PA at Payson Center for Cancer Care Concord, New Hampshire  03301
Center for Cancer Care at Exeter Hospital Exeter, New Hampshire  03833
New Hampshire Oncology - Hematology, PA - Hooksett Hooksett, New Hampshire  03106
Trinity CancerCare Center Minot, North Dakota  58701
United States Air Force Medical Center - Wright-Patterson Wright-Patterson AFB, Ohio  45433-5529
Bay Area Hospital Coos Bay, Oregon  97420
Cancer Center of Paoli Memorial Hospital Paoli, Pennsylvania  19301-1792
CCOP - Main Line Health Wynnewood, Pennsylvania  19096
Fountain Valley, California  92708
St. Anthony's Cancer Center St. Louis, Missouri  63128
Medcenter One Hospital Cancer Care Center Bismarck, North Dakota  58501
St. Alexius Medical Center Cancer Center Bismarck, North Dakota  58502
Cleveland Clinic Florida - Weston Weston, Florida  33331
High Point Regional Hospital High Point, North Carolina  27261
CaroMont Cancer Center at Gaston Memorial Hospital Gastonia, North Carolina  28053
Valley Medical Oncology Consultants - Castro Valley Castro Valley, California  94546
Valley Medical Oncology Fremont, California  94538
Mercy Regional Cancer Center Janesville, Wisconsin  53547
Cancer Care Center at John Muir Health - Concord Campus Concord, California  94524-4110
Self Regional Cancer Center at Self Regional Medical Center Greenwood, South Carolina  29646
Shore Regional Cancer Center at Memorial Hospital - Easton Easton, Maryland  21601
Camino Medical Group - Treatment Center Mountain View, California  94040
New York Oncology Hematology, PC at Albany Regional Cancer Care Albany, New York  12208
Amsterdam Community Cancer Program Amsterdam, New York  12010
Riverview Cancer Care Medical Associates, PC Rexford, New York  12148
Samaritan Hospital at Northeast Health Troy, New York  12180
Ravenel Oncology Center at Memorial Hospital of Martinsville and Henry County Martinsville, Virginia  24115
Kaiser Permanente - Division of Research - Oakland Oakland, California  94611
Kaiser Permanente Medical Center - Rancho Cordova Rancho Cordova, California  95670
Rohnert Park Cancer Center Rohnert Park, California  94928
South Sacramento Cancer Center Sacramento, California  95823
Aurora Women's Pavilion of West Allis Memorial Hospital West Allis, Wisconsin  53227
New York Oncology Hematology, PC at Albany Medical Center Albany, New York  12208
New York Oncology Hematology, PC - Hudson Hudson, New York  12534
Bendheim Cancer Center at Greenwich Hospital Greenwich, Connecticut  06830
Vince Lombardi Cancer Clinic - Oshkosh Oshkosh, Wisconsin  54904
Central Dupage Cancer Center Warrenville, Illinois  60555
Comprehensive Cancer Care, PC Saint Louis, Missouri  63141
New York Oncology Hematology, PC - Latham Latham, New York  12110
Doylestown Hospital Cancer Center Doylestown, Pennsylvania  18901
Waverly Hematology Oncology Cary, North Carolina  27518
Dickstein Cancer Treatment Center at White Plains Hospital Center White Plains, New York  10601
Kaiser Permanente Medical Center - Vacaville Vacaville, California  95688
Emerywood Hematology/Oncology High Point, North Carolina  27262