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Phase III Trial of Irinotecan-Based Chemotherapy Plus Cetuximab (NSC-714692) or Bevacizumab (NSC-704865) As Second-Line Therapy for Patients With Metastatic Colorectal Cancer Who Have Progressed on Bevacizumab With Either FOLFOX, OPTIMOX or XELOX


Phase 3
18 Years
N/A
Open (Enrolling)
Both
Recurrent Colon Cancer, Recurrent Rectal Cancer, Stage IVA Colon Cancer, Stage IVA Rectal Cancer, Stage IVB Colon Cancer, Stage IVB Rectal Cancer

Thank you

Trial Information

Phase III Trial of Irinotecan-Based Chemotherapy Plus Cetuximab (NSC-714692) or Bevacizumab (NSC-704865) As Second-Line Therapy for Patients With Metastatic Colorectal Cancer Who Have Progressed on Bevacizumab With Either FOLFOX, OPTIMOX or XELOX


PRIMARY OBJECTIVES:

I. Compare progression-free survival of patients with metastatic colorectal cancer that
progressed on first-line therapy comprising bevacizumab and FOLFOX, OPTIMOX, or XELOX
treated with irinotecan hydrochloride-based chemotherapy and cetuximab with vs without
bevacizumab.

II. Compare overall survival of patients treated with these regimens. III. Compare objective
tumor response (confirmed and unconfirmed, complete and partial response) in patients with
measurable disease treated with these regimens.

IV. Compare the tolerability and safety profile of these regimens in these patients.

OUTLINE: This is a multicenter, randomized study. Patients are stratified according to
Zubrod performance status (0 vs 1 or 2), discontinuation of oxaliplatin during first-line
therapy (yes vs no), planned concurrent chemotherapy (FOLFIRI vs single-agent irinotecan
hydrochloride), and time from last dose of bevacizumab (14-42 days vs >= 43 days).

All patients receive 1 of the following chemotherapy regimens:

SINGLE AGENT IRINOTECAN HYDROCHLORIDE: Patients receive irinotecan hydrochloride
intravenously (IV) over 90 minutes on day 1. Treatment repeats every 21 days in the absence
of disease progression or unacceptable toxicity.

FOLFIRI: Patients receive irinotecan hydrochloride IV over 90 minutes and 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 are then randomized to 1 of 3 treatment arms.

ARM I: Patients receive single-agent irinotecan hydrochloride or FOLFIRI as outlined above
and cetuximab IV over 1-2 hours on day 1. Courses repeat every 14-21 days (depending upon
chemotherapy regimen) in the absence of disease progression or unacceptable toxicity.

ARM II: Patients receive single-agent irinotecan hydrochloride or FOLFIRI as outlined above
and cetuximab as in arm I. Patients also receive bevacizumab IV over 30 minutes on day 1.
Courses repeat every 14-21 days (depending upon chemotherapy regimen) in the absence of
disease progression or unacceptable toxicity.

ARM III (closed to accrual as of 4/20/2009): Patients receive single-agent irinotecan
hydrochloride or FOLFIRI as outlined above and cetuximab as in arm I. Patients also receive
a higher dose of bevacizumab (higher than in arm II) IV over 30 minutes on day 1. Courses
repeat every 14-21 days (depending upon chemotherapy regimen) in the absence of disease
progression or unacceptable toxicity.

After completion of study treatment, patients are followed every 6 months for 2 years and
then once a year for 3 years.


Inclusion Criteria:



- Patients must have metastatic colorectal cancer that has been histologically or
cytologically confirmed; confirmation may be from either the primary tumor or a
metastasis; patients must have wild type KRAS

- Patients must be registered within 28 days of documented disease progression on first
line chemotherapy with bevacizumab plus either FOLFOX, OPTIMOX, or XELOX; this
progression must have occurred within 90 days after the last dose of bevacizumab;
patients who discontinued oxaliplatin, continued with 5-FU/LV or capecitabine and
bevacizumab and then had subsequent progression while on fluoropyrimidine and
bevacizumab are eligible; patients who discontinued bevacizumab due to adverse events
in the first-line setting are not eligible

- Measurable or nonmeasurable disease

- At least 14 days must have elapsed since the last dose of first line chemotherapy and
bevacizumab

- Patients must not have received prior treatment with irinotecan (either as adjuvant
or metastatic treatment)

- Patients must have no history of prior treatment with cetuximab or other agents
targeting VEGF or EGFR (except for bevacizumab)

- Prior radiotherapy is allowed, provided at least 28 days have elapsed since the last
treatment; all adverse events related to radiation therapy must be resolved

- Prior surgery is allowed, provided at least 28 days have elapsed since any major
surgery and patient has recovered from all effects

- Zubrod performance status 0-2

- Absolute neutrophil count (ANC) >= 1,500/mm^3

- Platelet count >= 100,000/mm^3

- Hemoglobin >= 9 g/dL

- Total bilirubin =< 1.5 times upper limit of normal (ULN)

- Serum glutamic oxaloacetic transaminase (SGOT) or serum glutamic pyruvate
transaminase (SGPT) =< 2.5 x IULN; if there are known liver metastases, SGOT or SGPT
must be =< 5 x IULN; these results must be obtained within 28 days prior to
registration

- Serum creatinine =< IULN or measured or estimated creatinine clearance >= 60 mL/min

- Patients must not have a history or known presence of brain metastasis

- Patients may be on full dose anticoagulation with warfarin provided that the patient
has an acceptable International Normalized Ratio (INR) (between 2 and 3), obtained
within 28 days prior to registration

- No clinically relevant bleeding diathesis or coagulopathy

- Patients must not have experienced nephrotic range proteinuria from prior bevacizumab
therapy; urine protein must be screened by urine analysis for Urine Protein
Creatinine (UPC) ratio; for UPC ratio > 0.5, 24-hour urine protein must be obtained
and the level must be < 1,000 mg for patient enrollment; urine protein and creatinine
used in calculating the UPC ratio must be obtained within 28 days prior to
registration

- No uncontrolled high blood pressure (BP) (i.e., systolic BP > 150 mm Hg and
diastolic BP > 90 mm Hg)

- No cardiovascular event within the past 6 months, including any of the following:

- Arterial thrombosis

- Unstable angina

- Myocardial infarction

- Cerebrovascular accident

- Patients must not have New York Heart Association (NYHA) >= Grade 2 congestive heart
failure

- Patients must not have unstable symptomatic arrhythmia requiring medication;
(patients with chronic, controlled arrhythmias such as atrial fibrillation or
paroxysmal supraventricular tachycardia [PSVT] are eligible)

- No clinically significant peripheral vascular disease

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

- No history of gastrointestinal (GI) perforation while on prior bevacizumab

- No significant bleeding episodes (e.g., hemoptysis or upper or lower GI bleeding)
within the past 6 months unless the source of bleeding has been resected

- No known hypersensitivity to bevacizumab or known potential hypersensitivity to
cetuximab

- No other concurrent chemotherapy, hormonal therapy, radiotherapy, immunotherapy, or
any other type of anticancer treatment

- Due to the possibility of harm to a fetus or nursing infant from this treatment
regimen, patients must not be pregnant or nursing; women and men of reproductive
potential must have agreed to use an effective contraceptive method

- No other malignancy within the past 5 years except for adequately treated basal or
squamous cell skin cancer or cervical cancer in situ

- All patients must be informed of the investigational nature of this study and must
sign and give written informed consent in accordance with institutional and federal
guidelines

- At the time of patient registration, the treating institution's name and
identification (ID) number must be provided to the Data Operations Center in Seattle
in order to ensure that the current (within 365 days) date of institutional review
board approval for this study has been entered into the data base

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Progression-free survival

Outcome Description:

Evaluated by the stratified log-rank test.

Outcome Time Frame:

Up to 5 years

Safety Issue:

No

Principal Investigator

Philip Gold

Investigator Role:

Principal Investigator

Investigator Affiliation:

Southwest Oncology Group

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2009-00784

NCT ID:

NCT00499369

Start Date:

June 2007

Completion Date:

Related Keywords:

  • Recurrent Colon Cancer
  • Recurrent Rectal Cancer
  • Stage IVA Colon Cancer
  • Stage IVA Rectal Cancer
  • Stage IVB Colon Cancer
  • Stage IVB Rectal Cancer
  • Colonic Neoplasms
  • Rectal Neoplasms
  • Colorectal Neoplasms

Name

Location

Mayo ClinicRochester, Minnesota  55905
University of Washington Medical CenterSeattle, Washington  98195-6043
Hurley Medical CenterFlint, Michigan  48503
Boulder Community HospitalBoulder, Colorado  80301-9019
Porter Adventist HospitalDenver, Colorado  80210
Rose Medical CenterDenver, Colorado  80220
Swedish Medical CenterEnglewood, Colorado  80110
Sky Ridge Medical CenterLone Tree, Colorado  80124
North Suburban Medical CenterThornton, Colorado  80229
Fairview Ridges HospitalBurnsville, Minnesota  55337
Hutchinson Area Health CareHutchinson, Minnesota  55350
Meeker County Memorial HospitalLichfield, Minnesota  55355
United HospitalSt. Paul, Minnesota  55102
Ridgeview Medical CenterWaconia, Minnesota  55387
Geisinger Medical CenterDanville, Pennsylvania  17822-0001
Rapid City Regional HospitalRapid City, South Dakota  57709
Henry Ford HospitalDetroit, Michigan  48202
Glendale Memorial Hospital and Health CenterGlendale, California  91204
South Georgia Medical CenterValdosta, Georgia  31603
Methodist Medical Center of IllinoisPeoria, Illinois  61636
Memorial Hospital of South BendSouth Bend, Indiana  46601
Akron General Medical CenterAkron, Ohio  44302
Virginia Piper Cancer InstituteMinneapolis, Minnesota  55407
University of Kansas Medical CenterKansas City, Kansas  66160-7353
Boston Medical CenterBoston, Massachusetts  02118
Eastern Maine Medical CenterBangor, Maine  04401
Camden-Clark Memorial HospitalParkersburg, West Virginia  26102
William Beaumont HospitalRoyal Oak, Michigan  48073
Via Christi Regional Medical CenterWichita, Kansas  67214
Scott and White Memorial HospitalTemple, Texas  76508
Iowa Methodist Medical CenterDes Moines, Iowa  50309
Iowa Lutheran HospitalDes Moines, Iowa  50316-2301
Group Health CooperativeSeattle, Washington  98112
Great Falls ClinicGreat Falls, Montana  59405
Mercy Fitzgerald HospitalDarby, Pennsylvania  19023
Fred Hutchinson Cancer Research Center/University of Washington Cancer ConsortiumSeattle, Washington  98109
Montefiore Medical CenterBronx, New York  10467-2490
North Colorado Medical CenterGreeley, Colorado  80631
McKee Medical CenterLoveland, Colorado  80539
Cancer Center of Kansas - ChanuteChanute, Kansas  66720
Cancer Center of Kansas - Dodge CityDodge City, Kansas  67801
Cancer Center of Kansas - NewtonNewton, Kansas  67114
Cancer Center of Kansas - SalinaSalina, Kansas  67042
Cancer Center of Kansas - WellingtonWellington, Kansas  67152
Associates in Womens HealthWichita, Kansas  67203
Cancer Center of Kansas - WinfieldWinfield, Kansas  67156
Holland Community HospitalHolland, Michigan  49423
Northern Rockies Radiation Oncology CenterBillings, Montana  59101
Bozeman Deaconess HospitalBozeman, Montana  59715
Kalispell Medical OncologyKalispell, Montana  59901
Kalispell Regional Medical CenterKalispell, Montana  59901
Adena Regional Medical CenterChillicothe, Ohio  54601
Grady Memorial HospitalDelaware, Ohio  43015
Fairfield Medical CenterLancaster, Ohio  43130
Harborview Medical CenterSeattle, Washington  98104
Cancer Care Northwest - Spokane SouthSpokane, Washington  99202
Welch Cancer CenterSheridan, Wyoming  82801
Cancer Centers of the CarolinasGreenville, South Carolina  29605
City of Hope Medical CenterDuarte, California  91010
Mercy Health SystemJanesville, Wisconsin  53545
Elkhart General HospitalElkhart, Indiana  46515
South Bend ClinicSouth Bend, Indiana  46617
Finger Lakes Hematology and OncologyClifton Springs, New York  14432
Saint Rose HospitalHayward, California  94545
Alta Bates Summit Medical Center - Summit CampusOakland, California  94609
Saint Joseph's Hospital of AtlantaAtlanta, Georgia  30342-1701
Piedmont HospitalAtlanta, Georgia  30309
Gwinnett Medical CenterLawrenceville, Georgia  30045
Southern Regional Medical CenterRiverdale, Georgia  30274-2600
Memorial HospitalCarthage, Illinois  62321
Galesburg Cottage HospitalGalesburg, Illinois  61401
Galesburg ClinicGalesburg, Illinois  61401
Mason District HospitalHavana, Illinois  62644
McDonough District HospitalMacomb, Illinois  61455
BroMenn Regional Medical CenterNormal, Illinois  61761
Proctor HospitalPeoria, Illinois  61614
Perry Memorial HospitalPrinceton, Illinois  61356
Salina Regional Health CenterSalina, Kansas  67401
Sturdy Memorial HospitalAttleboro, Massachusetts  02703
Community Cancer Center of MonroeMonroe, Michigan  48162
Bismarck Cancer CenterBismarck, North Dakota  58501
Fremont Memorial HospitalFremont, Ohio  43420
Lima Memorial HospitalLima, Ohio  45804
Firelands Regional Medical CenterSandusky, Ohio  44870
Mercy Medical CenterSpringfield, Ohio  45504
Mercy Hospital of TiffinTiffin, Ohio  44883
Fulton County Health CenterWauseon, Ohio  43567
Exempla Lutheran Medical CenterWheat Ridge, Colorado  80033
Eureka HospitalEureka, Illinois  61530
Mercy HospitalCoon Rapids, Minnesota  55433
Graham Hospital AssociationCanton, Illinois  61520
Saint Joseph Medical CenterJoliet, Illinois  60435
Pekin HospitalPekin, Illinois  61554
Medical Oncology and Hematology AssociatesDes Moines, Iowa  50309
Bixby Medical CenterAdrian, Michigan  49221
Saint Joseph Mercy HospitalAnn Arbor, Michigan  48106
Fairview-Southdale HospitalEdina, Minnesota  55435
Abbott-Northwestern HospitalMinneapolis, Minnesota  55407
Regions HospitalSaint Paul, Minnesota  55101
Saint Francis Regional Medical CenterShakopee, Minnesota  55379
Rice Memorial HospitalWillmar, Minnesota  56201
Altru Cancer CenterGrand Forks, North Dakota  58206
Saint Luke's HospitalMaumee, Ohio  43537
Geisinger Medical GroupState College, Pennsylvania  16801
Highland General HospitalOakland, California  94602
Center for Cancer Care and ResearchSt. Louis, Missouri  63141
Allegheny Cancer Center at Allegheny General HospitalPittsburgh, Pennsylvania  15212
Spartanburg Regional Medical CenterSpartanburg, South Carolina  29303
Crossroads Cancer CenterEffingham, Illinois  62401
Cancer Center of Kansas - Fort ScottFort Scott, Kansas  66701
Cancer Center of Kansas-IndependenceIndependence, Kansas  67301
Lawrence Memorial HospitalLawrence, Kansas  66044
Bozeman Deaconess Cancer CenterBozeman, Montana  59715
Northern Montana HospitalHavre, Montana  59501
Mary Rutan HospitalBellefontaine, Ohio  43311
Knox Community HospitalMount Vernon, Ohio  43050
Fisher-Titus Medical CenterNorwalk, Ohio  44857
Adventist Medical CenterPortland, Oregon  97216
Wenatchee Valley Medical CenterWenatchee, Washington  98801-2028
Rocky Mountain OncologyCasper, Wyoming  82609
Longmont United HospitalLongmont, Colorado  80501
Baton Rouge General Medical CenterBaton Rouge, Louisiana  70821-2511
Singing River HospitalPascagoula, Mississippi  39581
Rutherford HospitalRutherfordton, North Carolina  28139
Harold Alfond Center for Cancer CareAugusta, Maine  04330
Cancer Centers of the Carolinas - Grove CommonsGreenville, South Carolina  29605
Cancer Centers of the Carolinas - SenecaSeneca, South Carolina  29672
Cancer Centers of the Carolinas - SpartanburgSpartanburg, South Carolina  29307
Mayo Clinic in FloridaJacksonville, Florida  32224
Sutter Roseville Medical CenterRoseville, California  95661
Memorial Medical CenterSpringfield, Illinois  62781
Southeastern Medical Oncology CenterGoldsboro, North Carolina  27534
McLeod Regional Medical CenterFlorence, South Carolina  29501
La Grange Memorial HospitalLa Grange, Illinois  60525
Guardian Oncology and Center for WellnessMissoula, Montana  59804
Woodwinds Health CampusWoodbury, Minnesota  55125
East Bay Radiation Oncology CenterCastro Valley, California  94546
Larry G Strieff MD Medical CorporationOakland, California  94609
Tahoe Forest Cancer CenterTruckee, California  96161
Bay Area HospitalCoos Bay, Oregon  97420
Hennepin County Medical CenterMinneapolis, Minnesota  
Saint Louis University HospitalSt. Louis, Missouri  63110-0250
Glens Falls HospitalGlens Falls, New York  12801
Riverside Methodist HospitalColumbus, Ohio  43214
Licking Memorial HospitalNewark, Ohio  43055-2899
Mid Dakota ClinicBismarck, North Dakota  58501
Columbus CCOPColumbus, Ohio  43206
Presbyterian - Saint Lukes Medical Center - Health OneDenver, Colorado  80218
Wichita CCOPWichita, Kansas  67214-3882
Montana Cancer Consortium CCOPBillings, Montana  59101
Flower HospitalSylvania, Ohio  43560-2197
Columbia Saint Mary's Hospital - OzaukeeMequon, Wisconsin  53097
Metro-Minnesota CCOPSt. Louis Park, Minnesota  
UC Davis Comprehensive Cancer CenterSacramento, California  95817
Cancer Centers of the Carolinas - EasleyEasley, South Carolina  29640
Thomas Jefferson University HospitalPhiladelphia, Pennsylvania  19131
Decatur Memorial HospitalDecatur, Illinois  62526
Frederick Memorial HospitalFrederick, Maryland  21701
Montana Cancer SpecialistsMissoula, Montana  59807-7877
Providence Saint Joseph Medical CenterBurbank, California  91505-4866
University of Southern CaliforniaLos Angeles, California  90033
DeKalb Medical CenterDecatur, Georgia  30033
Northern Indiana Cancer Research ConsortiumSouth Bend, Indiana  
Hays Medical CenterHays, Kansas  67601
OSF Saint Francis Medical CenterPeoria, Illinois  61637
Northside HospitalAtlanta, Georgia  30342
Saint Edward Mercy Medical CenterFt. Smith, Arkansas  72903
Valley Medical Oncology Consultants-Castro ValleyCastro Valley, California  94546
Eden Hospital Medical CenterCastro Valley, California  94546
Northbay Cancer CenterFairfield, California  94533
Valley Medical Oncology Consultants-FremontFremont, California  94538
Fremont - Rideout Cancer CenterMarysville, California  95901
Bay Area Breast Surgeons IncOakland, California  94609
Bay Area Tumor Institution CCOPOakland, California  94609
Tom K Lee IncOakland, California  94609
Valley Medical Oncology ConsultantsPleasanton, California  94588
Valley Care Health System - PleasantonPleasanton, California  94588
Doctors Medical Center- JC Robinson Regional Cancer CenterSan Pablo, California  94806
The Medical Center of AuroraAurora, Colorado  80012
Penrose-Saint Francis HealthcareColorado Springs, Colorado  80907
Memorial Hospital Colorado SpringsColorado Springs, Colorado  80909
Saint Anthony Central HospitalDenver, Colorado  80204
Exempla Saint Joseph HospitalDenver, Colorado  80218
Colorado Cancer Research Program CCOPDenver, Colorado  80224-2522
Saint Mary's Hospital and Regional Medical CenterGrand Junction, Colorado  81502
Saint Mary Corwin Medical CenterPueblo, Colorado  81004
The Hospital of Central ConnecticutNew Britain, Connecticut  06050
Bayhealth Medical Center at Kent GeneralDover, Delaware  19901
Lombardi Comprehensive Cancer Center at Georgetown UniversityWashington, District of Columbia  20057
Edna Williams Cancer Center at the Baptist Cancer InstituteJacksonville, Florida  32207
Atlanta Regional CCOPAtlanta, Georgia  30342
Well Star Cobb HospitalAustell, Georgia  30106
John B Amos Cancer CenterColumbus, Georgia  31904
Veterans Administration Medical CenterDecatur, Georgia  30033
Wellstar Kennestone HospitalMarietta, Georgia  30060
Rush - Copley Medical CenterAurora, Illinois  60504
John H Stroger Jr Hospital of Cook CountyChicago, Illinois  60612-3785
Resurrection HealthcareChicago, Illinois  60631
Saint Anthony Memorial HospitalEffingham, Illinois  62401
Hopedale Medical Complex - HospitalHopedale, Illinois  61747
Joliet Oncology-Hematology Associates LimitedJoliet, Illinois  60435
Community Cancer Center FoundationNormal, Illinois  61761
Illinois CancerCare-Ottawa ClinicOttawa, Illinois  61350
Ottawa Regional Hospital and Healthcare CenterOttawa, Illinois  61350
Pekin Cancer Treatment CenterPekin, Illinois  61554
Illinois Oncology Research Association CCOPPeoria, Illinois  61615
Illinois CancerCare-PeoriaPeoria, Illinois  61615
Illinois Valley HospitalPeru, Illinois  61354
Saint Margaret's HospitalSpring Valley, Illinois  61362
Carle Clinic-Urbana MainUrbana, Illinois  61801
Fort Wayne Medical Oncology and Hematology Inc - State BoulevardFort Wayne, Indiana  46845
Saint Anthony Memorial Health CenterMichigan City, Indiana  46360
McFarland ClinicAmes, Iowa  50010
Hematology Oncology Associates-Quad CitiesBettendorf, Iowa  52722
Cedar Rapids Oncology AssociationCedar Rapids, Iowa  52403
Mercy HospitalCedar Rapids, Iowa  52403
Medical Oncology and Hematology Associates-West Des MoinesClive, Iowa  50325
Iowa Oncology Research Association CCOPDes Moines, Iowa  50309
Mercy CapitolDes Moines, Iowa  50307
Mercy Medical Center - Des MoinesDes Moines, Iowa  50314
Medical Oncology and Hematology Associates-Des MoinesDes Moines, Iowa  50309
Mercy Medical Center-Sioux CitySioux City, Iowa  51104
Saint Luke's Regional Medical CenterSioux City, Iowa  51104
Covenant Medical CenterWaterloo, Iowa  50702
Cancer Center of Kansas - El DoradoEl Dorado, Kansas  67042
Cancer Center of Kansas-KingmanKingman, Kansas  67068
Cancer Center of Kansas - ParsonsParsons, Kansas  67357
Cancer Center of Kansas - PrattPratt, Kansas  67124
Stormont-Vail Regional Health CenterTopeka, Kansas  66604
Saint Francis Hospital and Medical Center - TopekaTopeka, Kansas  66606
Cancer Center of Kansas-Wichita Medical Arts TowerWichita, Kansas  67208
Cancer Center of Kansas - Main OfficeWichita, Kansas  67214
Hickman Cancer CenterAdrian, Michigan  49221
Michigan Cancer Research Consortium Community Clinical Oncology ProgramAnn Arbor, Michigan  48106
Oakwood HospitalDearborn, Michigan  48123
Saint John Hospital and Medical CenterDetroit, Michigan  48236
Green Bay Oncology - EscanabaEscanaba, Michigan  49431
Grand Rapids Clinical Oncology ProgramGrand Rapids, Michigan  49503
Green Bay Oncology - Iron MountainIron Mountain, Michigan  49801
Allegiance HealthJackson, Michigan  49201
Sparrow HospitalLansing, Michigan  48912
Saint Mary Mercy HospitalLivonia, Michigan  48154
Mercy Memorial HospitalMonroe, Michigan  48162
Mercy Health Partners-Hackley CampusMuskegon, Michigan  49442
Saint Joseph Mercy OaklandPontiac, Michigan  48341-2985
Saint Joseph Mercy Port HuronPort Huron, Michigan  48060
Saint Mary's of MichiganSaginaw, Michigan  48601
Lakeland HospitalSt. Joseph, Michigan  49085
Saint John Macomb-Oakland HospitalWarren, Michigan  48093
Miller-Dwan HospitalDuluth, Minnesota  55805
Etzell, Paul S MD (UIA Investigator)Fergus Falls, Minnesota  56537
Swenson, Wade II, MD (UIA Investigator)Fergus Falls, Minnesota  56537
Unity HospitalFridley, Minnesota  55432
Immanuel-Saint Joseph Hospital-Mayo Health SystemMankato, Minnesota  56002
Saint John's Hospital - HealtheastMaplewood, Minnesota  55109
Minnesota Oncology Hematology PA-MaplewoodMaplewood, Minnesota  55109
North Memorial Medical Health CenterRobbinsdale, Minnesota  55422
Park Nicollet Clinic - Saint Louis ParkSaint Louis Park, Minnesota  55416
Saint Joseph's Hospital - HealtheastSaint Paul, Minnesota  55102
Minnesota Oncology and Hematology PA-WoodburyWoodbury, Minnesota  55125
Southeast Missouri HospitalCape Girardeau, Missouri  63701
Missouri Baptist Medical CenterSaint Louis, Missouri  63131
Saint John's HospitalSpringfield, Missouri  65804
Hematology-Oncology Centers of the Northern Rockies PCBillings, Montana  59101
Saint Vincent HealthcareBillings, Montana  59101
Billings ClinicBillings, Montana  59107-7000
Saint James Community Hospital and Cancer Treatment CenterButte, Montana  59701
Benefis Healthcare- Sletten Cancer InstituteGreat Falls, Montana  59405
Berdeaux, Donald MD (UIA Investigator)Great Falls, Montana  59405
Saint Peter's Community HospitalHelena, Montana  59601
Glacier Oncology PLLCKalispell, Montana  59901
Community Medical HospitalMissoula, Montana  59801
Saint Patrick Hospital - Community HospitalMissoula, Montana  59802
Good Samaritan HospitalKearney, Nebraska  68847
Lincoln Medical Education Foundation Cancer Resource CenterLincoln, Nebraska  68510
Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington CountyMount Holly, New Jersey  08060
Sparta Cancer Treatment CenterSparta, New Jersey  07871
Virtua West Jersey Hospital VoorheesVoorhees, New Jersey  08043
Veterans Affairs Western New York Health Care System-BuffaloBuffalo, New York  14215
Adirondack Cancer CenterGlens Falls, New York  12801
Orange Regional Medical CenterMiddletown, New York  10940
Margaret R Pardee Memorial HospitalHendersonville, North Carolina  28791
Kinston Medical Specialists PAKinston, North Carolina  28501
Saint Alexius Medical CenterBismarck, North Dakota  58501
Aultman Health FoundationCanton, Ohio  44710
Doctors HospitalColumbus, Ohio  43228
Grant Medical CenterColumbus, Ohio  43215
Mount Carmel Health Center WestColumbus, Ohio  43222
Hematology Oncology Center IncorporatedElyria, Ohio  44035
Mansfield General Hospital-MedCentral Health SystemMansfield, Ohio  44903
Marietta Memorial HospitalMarietta, Ohio  45750
Toledo Radiation Oncology at Northwest Ohio Onocolgy CenterMaumee, Ohio  43537
Saint Charles HospitalOregon, Ohio  43616
North Coast Cancer CareSandusky, Ohio  44870
Toledo Community Hospital Oncology Program CCOPToledo, Ohio  43617
Mercy Cancer Center at Saint Anne Mercy HospitalToledo, Ohio  43623
University of ToledoToledo, Ohio  43614
Saint Vincent Mercy Medical CenterToledo, Ohio  43608
Saint Ann's HospitalWesterville, Ohio  43081
Genesis HealthCare SystemZanesville, Ohio  43701
Central PA Hematology-Medical Oncology Associates PCLemoyne, Pennsylvania  17043
Riddle HospitalMedia, Pennsylvania  19063
Hematology and Oncology Associates of North East PennsylvaniaScranton, Pennsylvania  18508
Associates In Hematology Oncology PC-UplandUpland, Pennsylvania  19013
Geisinger Wyoming ValleyWilkes-Barre, Pennsylvania  18711
AnMed Health HospitalAnderson, South Carolina  29621
Greenville CCOPGreenville, South Carolina  29615
Greenville Memorial HospitalGreenville, South Carolina  29605
Upstate Carolina CCOPSpartanburg, South Carolina  29303
The Don and Sybil Harrington Cancer CenterAmarillo, Texas  79106
Fredericksburg Oncology IncFredericksburg, Virginia  22401
Harrison Bremerton Hematology and OncologyBremerton, Washington  98310
Columbia Basin Hematology and Oncology PLLCKennewick, Washington  99336
Minor and James Medical PLLCSeattle, Washington  98104
The PolyclinicSeattle, Washington  98122
Swedish Medical Center-First HillSeattle, Washington  98122-4307
Mayo Clinic Health System Eau Claire Hospital - Luther CampusEau Claire, Wisconsin  54703
Midelfort Clinic-Clairemont CampusEau Claire, Wisconsin  54702
Saint Vincent HospitalGreen Bay, Wisconsin  54301
Green Bay Oncology Limited at Saint Mary's HospitalGreen Bay, Wisconsin  54303
Saint Mary's HospitalGreen Bay, Wisconsin  54303
Green Bay Oncology at Saint Vincent HospitalGreen Bay, Wisconsin  54301-3526
Bay Area Medical CenterMarinette, Wisconsin  54143
Green Bay Oncology - Oconto FallsOconto Falls, Wisconsin  54154
Green Bay Oncology - Sturgeon BaySturgeon Bay, Wisconsin  54235
Olathe Cancer CenterOlathe, Kansas  66061
Elkhart ClinicElkhart, Indiana  46515
Marin General HospitalGreenbrae, California  94904
Harbin Clinic Medical Oncology and Clinical ResearchRome, Georgia  30165
Michiana Hematology Oncology PC-ElkhartElkhart, Indiana  46514
Michiana Hematology Oncology PC-PlymouthPlymouth, Indiana  46563
Michiana Hematology Oncology PC-South BendSouth Bend, Indiana  46601
Michiana Hematology Oncology-PC WestvilleWestville, Indiana  46391
Cancer Center of Kansas-LiberalLiberal, Kansas  67901
Memorial Hospital at Easton - Shore Regional Cancer CenterEaston, Maryland  21601
Michiana Hematology Oncology PC-NilesNiles, Michigan  49120
University of Missouri - Ellis FischelColumbia, Missouri  65203
Veterans AdministrationColumbia, Missouri  65201
North Coast Cancer Care-ClydeClyde, Ohio  43410
Community Health Partners Regional Medical CenterElyria, Ohio  44035
Cancer Centers of the Carolinas - FarisGreenville, South Carolina  29605
Cancer Centers of the Carolinas-Greer Radiation OncologyGreer, South Carolina  29650
Cancer Centers of the Carolinas-Greer Medical OncologyGreer, South Carolina  29650
Skagit Valley HospitalMt. Vernon, Washington  98273
Evergreen Hematology and Oncology PSSpokane, Washington  99218
West Virginia University CharlestonCharleston, West Virginia  25304
Holy Family Memorial HospitalManitowoc, Wisconsin  54221
Medical Consultants LimitedMilwaukee, Wisconsin  53215
University of Miami Miller School of Medicine-Sylvester Cancer CenterMiami, Florida  33136
FirstHealth of the Carolinas-Moore Regional HosiptalPinehurst, North Carolina  28374
Palchak David MDPismo Beach, California  93449
Doctors Carrol, Sheth, RaghavanLouisville, Kentucky  40215
University of Tennessee - MemphisMemphis, Tennessee  38163
United General HospitalSedro-Woolley, Washington  98284
Columbia Saint Mary's Water Tower Medical CommonsMilwaukee, Wisconsin  53211
Siouxland Hematology Oncology AssociatesSioux City, Iowa  51101
Space Coast Cancer Centers-TitusvilleTitusville, Florida  32796
Carle Foundation - Carle Cancer CenterUrbana, Illinois  61801
Michiana Hematology Oncology PC-MishawakaMishawaka, Indiana  46545-1470
Oncology Associates at Mercy Medical CenterCedar Rapids, Iowa  52403
Marie Yeager Cancer CenterSaint Joseph, Michigan  49085
The Toledo Hospital/Toledo Children's HospitalToledo, Ohio  43606
Genesys Regional Medical Center-West Flint CampusFlint, Michigan  48532
Essentia Health Duluth Clinic CCOPDuluth, Minnesota  55805
Essentia Health Saint Mary's Medical CenterDuluth, Minnesota  55805
Sanford Bismarck Medical CenterBismarck, North Dakota  58501
Toledo Clinic Cancer Centers-OregonOregon, Ohio  43616
Geisinger Medical Center-Cancer Center HazeltonHazleton, Pennsylvania  18201
Community Howard Regional HealthKokomo, Indiana  46904
Indiana University Health La Porte HospitalLa Porte, Indiana  46350
Saint Joseph Regional Medical Center-MishawakaMishawaka, Indiana  46545-1470
Via Christi Hospital-PittsburgPittsburg, Kansas  66762
PeaceHealth Saint Joseph Medical CenterBellingham, Washington  98225
Springfield Regional Medical CenterSpringfield, Ohio  45505
Promise Regional Medical Center-HutchinsonHutchinson, Kansas  65702
Toledo Clinic Cancer Centers-Bowling GreenBowling Green, Ohio  43402
Toledo Clinic Cancer Centers-MaumeeMaumee, Ohio  43537-1839
Toledo Clinic Cancer Centers-ToledoToledo, Ohio  43623
Self Regional HealthcareGreenwood, South Carolina  29646
Harrison Poulsbo Hematology and OncologyPoulsbo, Washington  98370
Aurora Cancer Care-Southern LakesElkhorn, Wisconsin  53121
South Carolina Oncology Associates PAColumbia, South Carolina  29210