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Phase III Prospective Randomized Comparison of Depot Octreotide Plus Interferon Alpha Versus Depot Octreotide Plus Bevacizumab (NSC #704865) in Advanced, Poor Prognosis Carcinoid Patients


Phase 3
N/A
N/A
Open (Enrolling)
Both
Neuroendocrine Carcinoma

Thank you

Trial Information

Phase III Prospective Randomized Comparison of Depot Octreotide Plus Interferon Alpha Versus Depot Octreotide Plus Bevacizumab (NSC #704865) in Advanced, Poor Prognosis Carcinoid Patients


PRIMARY OBJECTIVES:

I. To compare central review-based progression-free survival in poor prognosis carcinoid
patients treated with either depot octreotide (octreotide acetate) plus bevacizumab, or
depot octreotide plus interferon (recombinant interferon alfa-2b).

II. To compare overall survival, time to treatment failure and traditionally reported
progression-free survival in poor prognosis carcinoid patients treated with either depot
octreotide plus bevacizumab, or depot octreotide plus interferon.

III. To compare objective response (confirmed and unconfirmed CR and PR) in poor prognosis
carcinoid patients treated with either depot octreotide plus bevacizumab, or depot
octreotide plus interferon.

IV. To compare the toxicity profile of patients treated with these two regimens.

V. To assess the prognostic and predictive value of VEGF expression in relation to
progression-free survival and treatment effect.

VI. To compare response of 5HIAA, chromogranin A and neuronspecific enolase among patients
with elevated levels at baseline between patients treated with octreotide plus interferon
versus octreotide plus bevacizumab.

VII. To assess and compare the prognostic and predictive value of the combination of In-111
pentetreotide somatostatin-receptor scintigraphy (SRS) and CT vs. CT in relation to
progression-free survival (PFS).

VIII. To assess and compare the prognostic and predictive value of the combination of SRS
and CT vs. CT in relation to overall survival (OS) and time to treatment failure (TTF).

OUTLINE: This is a multicenter study. Patients are stratified according to site of disease
(small bowel vs cecum vs appendix vs other site), disease progression after initial
diagnosis (yes or no), histologic grade (low vs intermediate [atypical]), and prior
octreotide acetate therapy within the past 2 months (yes vs no). Patients are randomized to
1 of 2 treatment arms.

ARM I: Patients receive depot octreotide acetate intramuscularly (IM) and bevacizumab
intravenously (IV) over 30-90 minutes on day 1.

ARM II: Patients receive octreotide acetate IM as in arm I on day 1 and recombinant
interferon alfa-2b subcutaneously (SC) on days 1, 3, 5, 8, 10, 12, 15, 17, and 19.

Treatment in both arms repeats every 21 days in the absence of disease progression or
unacceptable toxicity.

After completion of study treatment, patients are followed every 2-6 months for up to 3
years.


Inclusion Criteria:



- Diagnosis of unresectable metastatic or locally advanced, low- or intermediate-grade
neuroendocrine carcinoma, including the following subtypes:

- Carcinoid tumor, low-grade or well differentiated neuroendocrine carcinoma

- Atypical carcinoid tumor, intermediate-grade or moderately differentiated
neuroendocrine carcinoma

- High-risk disease as defined by at least one of the following:

- Progressive disease

- Refractory carcinoid syndrome while receiving octreotide acetate (i.e., defined
by > 2 flushing episodes/day or > 4 bowel movements/day)

- Atypical histology and more than 6 lesions

- Metastatic colorectal carcinoid tumor

- Patients with metastatic cecal or appendiceal carcinoid tumor are not
eligible unless they fit other mentioned high-risk features

- Metastatic gastric carcinoid tumor

- Measurable disease

- Patients with poorly differentiated neuroendocrine carcinoma, high-grade
neuroendocrine carcinoma, adenocarcinoid tumor, or goblet cell carcinoid tumor are
not eligible

- Osseous metastasis as only site of disease

- Medullary thyroid carcinoma or islet cell carcinoma

- History of primary brain tumor or metastatic cancer to the brain

- Zubrod performance status 0-2

- Platelet count > 100,000/mm³

- ANC > 1,500/mm³

- Hemoglobin > 8 g/dL

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

- SGOT and SGPT ≤ 2.5 times ULN

- Serum creatinine < 1.5 mg/dL

- 24-hour urine protein < 1,000 mg if urine protein:creatinine ratio > 0.5

- PT and PTT ≤ 1.1 times ULN

- History of hypertension must be well controlled (i.e., blood pressure < 150/90 mm Hg)
on a stable regimen of antihypertensive therapy

- Not pregnant or nursing

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

- History or evidence of clinically significant peripheral vascular disease (e.g.,
non-healing peripheral ulcers or claudication)

- Abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within
the past 28 days

- Bleeding diathesis or coagulopathy that results in spontaneous bleeding (in the
absence of trauma) requiring red blood cell transfusion within the past 5 years

- Serious (i.e., requiring active medical therapy with medication or medical device
under the supervision of a physician) non-healing wound, ulcer, or bone fracture

- Recent history (i.e., within the past 6 months) of any of the following arterial
thromboembolic events:

- Transient ischemic attack

- Cerebrovascular accident

- Unstable angina

- Myocardial infarction

- New York Heart Association class II or higher congestive heart failure

- Hemoglobinopathies (e.g., Thalassemia) or any other cause of hemolytic anemia

- Pregnant or nursing

- Any other prior malignancy within the past 5 years except for adequately treated
basal cell or squamous cell skin cancer, or other adequately treated in situ cancer

- Any immunologically mediated disease, including any of the following:

- Inflammatory bowel disease (Crohn disease, ulcerative colitis)

- Rheumatoid arthritis

- Idiopathic thrombocytopenia purpura

- Systemic lupus erythematosus

- Autoimmune hemolytic anemia

- Scleroderma

- Severe psoriasis

- Any serious intercurrent infections or nonmalignant medical illnesses that are
uncontrolled or whose control may be jeopardized by the complications of this
treatment

- Psychiatric disorders rendering patient incapable of complying with the requirements
of the protocol

- Recovered from all prior therapy

- At least 28 days since and no more than 1 prior regimen of cytotoxic chemotherapy

- At least 28 days since prior hepatic artery embolization provided there is residual
measurable disease

- Chemoembolization is considered as 1 prior chemotherapy regimen

- No prior interferon, bevacizumab, or any other therapy targeting VEGF or VEGF
receptors (e.g., SU11248, PTK/ZK, sorafenib tosylate, or pazopanib hydrochloride)

- Prior therapy targeting c-kit, abl, PDGFR, mTOR, and somatostatin receptors allowed

- At least 28 days since prior radiotherapy

- Target lesions must have shown disease progression if therapy included peptide
receptor radiotherapy

- At least 1 week since prior minor surgery

- At least 4 weeks since prior major surgery

- At least 21 days since prior octreotide acetate therapy

- Concurrent full-dose anticoagulation (warfarin or low molecular weight heparin)
allowed provided the following criteria are met:

- In-range INR (e.g., between 2 and 3) on a stable dose of oral anticoagulant or
on a stable dose of low molecular weight heparin

- No active bleeding or pathological condition that carries a high risk of
bleeding (e.g., varices)

- No concurrent interferon to control carcinoid syndrome for patients receiving
bevacizumab

- Other supportive care medication (e.g., short acting octreotide acetate) allowed

- No other concurrent chemotherapy, immunotherapy, radiotherapy, hepatic artery
embolization, hepatic artery chemoembolization, radiofrequency ablation, or other
tumor ablative procedure

- No other investigational or commercial agents

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:

Central-review based progression-free survival

Outcome Description:

Analyzed using the stratified log rank test (which is the score test from the stratified Cox-model).

Outcome Time Frame:

Up to 3 years

Safety Issue:

No

Principal Investigator

James Yao

Investigator Role:

Principal Investigator

Investigator Affiliation:

Southwest Oncology Group

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2009-00778

NCT ID:

NCT00569127

Start Date:

December 2007

Completion Date:

Related Keywords:

  • Neuroendocrine Carcinoma
  • Carcinoma
  • Carcinoma, Neuroendocrine
  • Neuroendocrine Tumors

Name

Location

Roswell Park Cancer Institute Buffalo, New York  14263
Mayo Clinic Rochester, Minnesota  55905
H. Lee Moffitt Cancer Center and Research Institute Tampa, Florida  33612
University of Mississippi Medical Center Jackson, Mississippi  39216-4505
University of Washington Medical Center Seattle, Washington  98195-6043
Hurley Medical Center Flint, Michigan  48503
University of Texas Health Science Center at San Antonio San Antonio, Texas  78284-7811
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
Bronson Methodist Hospital Kalamazoo, Michigan  49007
West Michigan Cancer Center Kalamazoo, Michigan  49007-3731
Borgess Medical Center Kalamazooaa, Michigan  49001
Fairview Ridges Hospital Burnsville, Minnesota  55337
Hutchinson Area Health Care Hutchinson, Minnesota  55350
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
Geisinger Medical Center Danville, Pennsylvania  17822-0001
Abramson Cancer Center of the University of Pennsylvania Philadelphia, Pennsylvania  19104-4283
Avera Cancer Institute Sioux Falls, South Dakota  57105
Massachusetts General Hospital Cancer Center Boston, Massachusetts  02114
CentraCare Clinic Saint Cloud, Minnesota  56303
Marshfield Clinic Marshfield, Wisconsin  54449
Sutter Health Western Division Cancer Research Group Greenbrae, California  94904
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 Mason Medical Center Seattle, Washington  98111
Dana-Farber Cancer Institute Boston, Massachusetts  02115
Cedars-Sinai Medical Center Los Angeles, California  90048
University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
University of Kansas Medical Center Kansas City, Kansas  66160-7353
Boston Medical Center Boston, Massachusetts  02118
University of Nebraska Medical Center Omaha, Nebraska  68198-3330
Via Christi Regional Medical Center Wichita, Kansas  67214
Ochsner Clinic Foundation New Orleans, Louisiana  70121
Carolinas Medical Center Charlotte, North Carolina  28232-2861
Southern California Permanente Medical Group Downey, California  90242
Group Health Cooperative Seattle, Washington  98112
Great Falls Clinic Great Falls, Montana  59405
MetroHealth Medical Center Cleveland, Ohio  44109
Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium Seattle, Washington  98109
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
Northern Rockies Radiation Oncology Center Billings, Montana  59101
Bozeman Deaconess Hospital Bozeman, Montana  59715
Big Sky Oncology Great Falls, Montana  59405
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
Avera McKennan Hospital and University Health Center Sioux Falls, South Dakota  57105
Medical X-Ray Center Sioux Falls, South Dakota  57105
Harborview Medical Center Seattle, Washington  98104
Cancer Care Northwest - Spokane South Spokane, Washington  99202
Welch Cancer Center Sheridan, Wyoming  82801
University of New Mexico Cancer Center Albuquerque, New Mexico  87131-5636
Brigham and Women's Hospital Boston, Massachusetts  02115
Cancer Centers of the Carolinas Greenville, South Carolina  29605
Elkhart General Hospital Elkhart, Indiana  46515
South Bend Clinic South Bend, Indiana  46617
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center Columbus, Ohio  43210-1240
Front Range Cancer Specialists Fort Collins, Colorado  80528
University Medical Center of Southern Nevada Las Vegas, Nevada  89102
Jennersville Regional Hospital West Grove, Pennsylvania  19390-9499
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
McDonough District Hospital Macomb, Illinois  61455
BroMenn Regional Medical Center Normal, Illinois  61761
Proctor Hospital Peoria, Illinois  61614
Perry Memorial Hospital Princeton, Illinois  61356
Salina Regional Health Center Salina, Kansas  67401
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
Creighton University Medical Center Omaha, Nebraska  68131-2197
Iredell Memorial Hospital Statesville, North Carolina  28677
Bismarck Cancer Center Bismarck, North Dakota  58501
Lima Memorial Hospital Lima, Ohio  45804
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Fulton County Health Center Wauseon, Ohio  43567
Providence Milwaukie Hospital Milwaukie, Oregon  97222
Danville Regional Medical Center Danville, Virginia  24541
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
Eureka Hospital Eureka, Illinois  61530
Mercy Hospital Coon Rapids, Minnesota  55433
Olympic Medical Center Port Angeles, Washington  98362
Valley Medical Center Renton, Washington  98055
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
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
Geisinger Medical Group State College, Pennsylvania  16801
Northeast Georgia Medical Center Gainesville, Georgia  30501
Swedish American Hospital Rockford, Illinois  61104
Center for Cancer Care and Research St. Louis, Missouri  63141
Eastern Connecticut Hematology and Oncology Associates Norwich, Connecticut  06360
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Lawrence Memorial Hospital Lawrence, Kansas  66044
Bozeman Deaconess Cancer Center Bozeman, Montana  59715
Northern Montana Hospital Havre, Montana  59501
Mary Rutan Hospital Bellefontaine, Ohio  43311
Knox Community Hospital Mount Vernon, Ohio  43050
Fisher-Titus Medical Center Norwalk, Ohio  44857
Wenatchee Valley Medical Center Wenatchee, Washington  98801-2028
Marshfield Clinic Cancer Care at Regional Cancer Center Eau Claire, Wisconsin  54701
Saint Joseph's Hospital Marshfield, Wisconsin  54449
Marshfield Clinic - Weston 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
Baton Rouge General Medical Center Baton Rouge, Louisiana  70821-2511
Genesys Regional Medical Center Grand Blanc, Michigan  48439-8066
Union Hospital of Cecil County Elkton MD, Maryland  21921
Cancer Centers of the Carolinas - Grove Commons Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Seneca Seneca, South Carolina  29672
Cancer Centers of the Carolinas - Spartanburg Spartanburg, South Carolina  29307
Mayo Clinic in Florida Jacksonville, Florida  32224
Manchester Memorial Hospital Manchester, Connecticut  06040-4188
Memorial Medical Center Springfield, Illinois  62781
Phelps County Regional Medical Center Rolla, Missouri  65401
Saint Francis Medical Center Grand Island, Nebraska  68802
Wellmont Holston Valley Hospital and Medical Center Kingsport, Tennessee  37662
La Grange Memorial Hospital La Grange, Illinois  60525
Guardian Oncology and Center for Wellness Missoula, Montana  59804
Providence Hospital Mobile, Alabama  36608
Vanderbilt University Nashville, Tennessee  37232-6305
Northwestern University Chicago, Illinois  60611
Northwest Cancer Specialists Vancouver, Washington  98664
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
Saint Alphonsus Regional Medical Center Boise, Idaho  83706
Kaiser Permanente Medical Center Vallejo, California  94589
Riverside Methodist Hospital Columbus, Ohio  43214
Licking Memorial Hospital Newark, Ohio  43055-2899
Cancer Center of Kansas - McPherson McPherson, Kansas  67460
Providence Portland Medical Center Portland, Oregon  97213-3635
California Pacific Medical Center San Francisco, California  94115
Mid Dakota Clinic Bismarck, North Dakota  58501
Columbus CCOP Columbus, Ohio  43206
Presbyterian - Saint Lukes Medical Center - Health One Denver, Colorado  80218
Kaiser Permanente Sacramento, California  
Wichita CCOP Wichita, Kansas  67214-3882
Montana Cancer Consortium CCOP Billings, Montana  59101
Alegent Health Immanuel Medical Center Omaha, Nebraska  68122
Alegent Health Bergan Mercy Medical Center Omaha, Nebraska  68124
Flower Hospital Sylvania, Ohio  43560-2197
Virginia Mason CCOP Seattle, Washington  98101
Metro-Minnesota CCOP St. Louis Park, Minnesota  
Cancer Centers of the Carolinas - Easley Easley, South Carolina  29640
Lakeview Hospital Stillwater, Minnesota  55082
Thomas Jefferson University Hospital Philadelphia, Pennsylvania  19131
Decatur Memorial Hospital Decatur, Illinois  62526
Tulane University Health Sciences Center New Orleans, Louisiana  70112
Louisiana State University Health Science Center New Orleans, Louisiana  70112
Kaiser Permanente Portland, Oregon  97227
Princeton Community Hospital Princeton, West Virginia  24740
Montana Cancer Specialists Missoula, Montana  59807-7877
M D Anderson Cancer Center Houston, Texas  77030
University of Southern California Los Angeles, California  90033
Northern Indiana Cancer Research Consortium South Bend, Indiana  
University of Cincinnati Cincinnati, Ohio  45267-0502
San Luis Valley Regional Medical Center Alamosa, Colorado  81101
Valley View Hospital Cancer Center Glenwood Springs, Colorado  81601
Hays Medical Center Hays, Kansas  67601
Southeast Cancer Center Cape Girardeau, Missouri  63703
Clackamas Radiation Oncology Center Clackamas, Oregon  97015
Providence Newberg Medical Center Newberg, Oregon  97132
Butler Memorial Hospital Butler, Pennsylvania  16001
Littleton Adventist Hospital Littleton, Colorado  80122
Parker Adventist Hospital Parker, Colorado  80138
New Ulm Medical Center New Ulm, Minnesota  56073
OSF Saint Francis Medical Center Peoria, Illinois  61637
Highlands Oncology Group-Bentonville Bentonville, Arkansas  72712
Saint Edward Mercy Medical Center Ft. Smith, Arkansas  72903
Mills - Peninsula Hospitals Burlingame, California  94010
The Medical Center of Aurora Aurora, Colorado  80012
Penrose-Saint Francis Healthcare Colorado Springs, Colorado  80907
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
Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
Lombardi Comprehensive Cancer Center at Georgetown University Washington, District of Columbia  20057
Edna Williams Cancer Center at the Baptist Cancer Institute Jacksonville, Florida  32207
M D Anderson Cancer Center- Orlando Orlando, Florida  32806
Saint Joseph's-Candler Health System Savannah, Georgia  31405
Saint Anthony's Health Alton, Illinois  62002
Rush - Copley Medical Center Aurora, Illinois  60504
Saint Anthony Memorial Hospital Effingham, Illinois  62401
Hopedale Medical Complex - Hospital Hopedale, Illinois  61747
Joliet Oncology-Hematology Associates Limited Joliet, Illinois  60435
Midwest Center for Hematology Oncology Joliet, Illinois  60432
Provena Saint Mary's Hospital Kankakee, Illinois  60901
North Shore Hematology Oncology Libertyville, Illinois  60048
Garneau, Stewart C MD (UIA Investigator) Moline, Illinois  61265
Porubcin, Michael MD (UIA Investigator) Moline, Illinois  61265
Good Samaritan Regional Medical Center Mt. Vernon, Illinois  62864
Community Cancer Center Foundation Normal, Illinois  61761
Illinois CancerCare-Ottawa Clinic Ottawa, Illinois  61350
Ottawa Regional Hospital and Healthcare Center Ottawa, Illinois  61350
Pekin Cancer Treatment Center Pekin, Illinois  61554
Illinois Oncology Research Association CCOP Peoria, Illinois  61615
Illinois CancerCare-Peoria Peoria, Illinois  61615
Illinois Valley Hospital Peru, Illinois  61354
Hematology Oncology Associates of Illinois - Skokie Skokie, Illinois  60076
Saint Margaret's Hospital Spring Valley, Illinois  61362
Carle Clinic-Urbana Main Urbana, Illinois  61801
Saint Anthony Memorial Health Center Michigan City, Indiana  46360
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
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
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
Our Lady Bellefonte Hospital Ashland, Kentucky  41101
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
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
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
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
Minnesota Oncology and Hematology PA-Woodbury Woodbury, Minnesota  55125
Veterans Affairs Medical Center Jackson, Mississippi  39216
Southeast Missouri Hospital Cape Girardeau, Missouri  63701
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
Ozark Health Ventures LLC dba Cancer Research for The Ozarks Springfield Springfield, Missouri  65802
Saint John's Hospital Springfield, Missouri  65804
Cox Medical Center Springfield, Missouri  65807
Hematology-Oncology Centers of the Northern Rockies PC Billings, Montana  59101
Saint Vincent Healthcare Billings, Montana  59101
Billings Clinic Billings, Montana  59107-7000
Saint James Community Hospital and Cancer Treatment Center Butte, Montana  59701
Benefis Healthcare- Sletten Cancer Institute Great Falls, Montana  59405
Berdeaux, Donald MD (UIA Investigator) Great Falls, Montana  59405
Saint Peter's Community Hospital Helena, Montana  59601
Glacier Oncology PLLC Kalispell, Montana  59901
Saint Patrick Hospital - Community Hospital Missoula, Montana  59802
Good Samaritan Hospital Kearney, Nebraska  68847
Lincoln Medical Education Foundation Cancer Resource Center Lincoln, Nebraska  68510
Missouri Valley Cancer Consortium CCOP Omaha, Nebraska  68106
Nevada Cancer Research Foundation CCOP Las Vegas, Nevada  89106
Cooper Hospital University Medical Center Camden, New Jersey  08103
Hunterdon Medical Center Flemington, New Jersey  08822
Memorial Medical Center - Las Cruces Las Cruces, New Mexico  88011
Orange Regional Medical Center Middletown, New York  10940
Interlakes Foundation Inc-Rochester Rochester, New York  14623
Highland Hospital Rochester, New York  14620
Wayne Memorial Hospital Goldsboro, North Carolina  27534
Kinston Medical Specialists PA Kinston, North Carolina  28501
Saint Alexius Medical Center Bismarck, North Dakota  58501
Summa Barberton Hospital Barberton, Ohio  44203
Aultman Health Foundation Canton, Ohio  44710
Doctors Hospital Columbus, Ohio  43228
Grant Medical Center Columbus, Ohio  43215
Mount Carmel Health Center West Columbus, Ohio  43222
Hematology Oncology Center Incorporated Elyria, Ohio  44035
Saint Rita's Medical Center Lima, Ohio  45801
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
Saint Ann's Hospital Westerville, Ohio  43081
Genesis HealthCare System Zanesville, Ohio  43701
Providence Saint Vincent Medical Center Portland, Oregon  97225
Columbia River Oncology Program Portland, Oregon  97225
Pocono Medical Center East Stroudsburg, Pennsylvania  18301
Scranton Hematology Oncology Scranton, Pennsylvania  18510
Mercy Hospital Scranton, Pennsylvania  18501
Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania  18711
Greenville CCOP Greenville, South Carolina  29615
Greenville Memorial Hospital Greenville, South Carolina  29605
Sanford Cancer Center-Oncology Clinic Sioux Falls, South Dakota  57104
The Don and Sybil Harrington Cancer Center Amarillo, Texas  79106
Audie L Murphy Veterans Affairs Hospital San Antonio, Texas  78209
University Hospital San Antonio, Texas  78229
Fredericksburg Oncology Inc Fredericksburg, Virginia  22401
Southwest VA Regional Cancer Center Norton, Virginia  24273
Harrison Bremerton Hematology and Oncology Bremerton, Washington  98310
Columbia Basin Hematology and Oncology PLLC Kennewick, Washington  99336
Evergreen Hospital Medical Center Kirkland, Washington  98033
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
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
Olathe Cancer Center Olathe, Kansas  66061
Kansas City Cancer Centers - North Kansas City, Missouri  64154
Elkhart Clinic Elkhart, Indiana  46515
Marin General Hospital Greenbrae, California  94904
University of Colorado Cancer Center - Anschutz Cancer Pavilion Aurora, Colorado  80045
Denver Veterans Administration Medical Center Denver, Colorado  80220
The Shaw Regional Cancer Center Edwards, Colorado  81632
Montrose Memorial Hospital Montrose, Colorado  81401
Illinois CancerCare-Bloomington Bloomington%, Illinois  61701
Illinois CancerCare-Canton Canton, Illinois  61520
Illinois CancerCare-Carthage Carthage, Illinois  62321
Illinois CancerCare-Eureka Eureka, Illinois  61530
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
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
Cancer Center of Kansas-Liberal Liberal, Kansas  67901
University of Michigan University Hospital Ann Arbor, Michigan  48109
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
Roper Hospital Charleston, South Carolina  29401
Cancer Centers of the Carolinas - Faris Greenville, South Carolina  29605
Cancer Centers of the Carolinas-Greer Radiation Oncology Greer, South Carolina  29650
Cancer Centers of the Carolinas-Greer Medical Oncology Greer, South Carolina  29650
Erlanger Medical Center Chattanooga, Tennessee  37403
The Center for Biomedical Research Knoxville, Tennessee  37909
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
Marshfield Clinic Cancer Care at Saint Michael's Hospital Stevens Point, Wisconsin  54481
Kansas City Cancer Centers-Southwest Overland Park, Kansas  66210
Kaiser Permanente Los Angeles Medical Center Los Angeles, California  90027
Cancer Centers of Southwest Oklahoma Research Lawton, Oklahoma  
Kaiser Anaheim Medical Center Anaheim, California  92807
Kaiser Permanente Medical Group - Baldwin Park Baldwin Park, California  91706
Kaiser Foundation Hospital Bellflower, California  90706
Kaiser Permanente Hospital Fontana, California  92335
Kaiser Permanente - Harbor City Harbor City, California  90710
Kaiser Permanente-West Los Angeles Los Angeles, California  90034
Kaiser Permanente - Panorama City Panorama City, California  91402
Palchak David MD Pismo Beach, California  93449
Kaiser Permanente at San Diego San Diego, California  92120
Kaiser Permanente Health Care San Marcos, California  92069
Spector, David MD (UIA Investigator) Moline, Illinois  61265
Kansas City Cancer Center-West Kansas City, Kansas  66112
Kansas City Cancer Center-Shawnee Mission Shawnee Mission, Kansas  66204
Hematology and Oncology Clinic Baton Rouge, Louisiana  70809
Ochsner North Shore Medical Center Covington, Louisiana  70433
Capital Region Medical Center-Goldschmidt Cancer Center Jefferson City, Missouri  65109
Kansas City Cancer Center - South Kansas City, Missouri  64131
Kansas City Cancer Center-Lee's Summit Lee's Summit, Missouri  64064
Saint John's Clinic-Rolla-Cancer and Hematology Rolla, Missouri  65401
Comprehensive Cancer Care PC Saint Louis, Missouri  63141
The Mark H Zangmeister Center Columbus, Ohio  43219
Southern Ohio Medical Center Portsmouth, Ohio  45662
Cancer Care Center at Island Hospital Anacortes, Washington  98221
Highline Medical Center-Main Campus Burien, Washington  98166
Pacific Medical Center-First Hill Seattle, Washington  98104
United General Hospital Sedro-Woolley, Washington  98284
Saint Nicholas Hospital Madison, Wisconsin  53715
Fairbanks Memorial Hospital Fairbanks, Alaska  99701
Alegent Health Lakeside Hospital Omaha, Nebraska  68130
Los Angeles County-USC Medical Center Los Angeles, California  90033
Stanford University Hospitals and Clinics Stanford, California  94305
Siouxland Hematology Oncology Associates Sioux City, Iowa  51101
Swedish Cancer Institute-Issaquah Issaquah, Washington  98029
Alta Bates Summit Medical Center-Herrick Campus Berkeley, California  94704
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
Summa Akron City Hospital Akron, Ohio  44304
The Toledo Hospital/Toledo Children's Hospital Toledo, Ohio  43606
Sanford USD Medical Center - Sioux Falls Sioux Falls, South Dakota  57117-5134
Genesys Regional Medical Center-West Flint Campus Flint, Michigan  48532
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
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
Via Christi Hospital-Pittsburg Pittsburg, Kansas  66762
PeaceHealth Saint Joseph Medical Center Bellingham, Washington  98225
Christiana Care Health System-Christiana Hospital Newark, Delaware  19718
Illinois Cancer Specialists-Niles Niles, Illinois  60714
Springfield Regional Medical Center Springfield, Ohio  45505
Promise Regional Medical Center-Hutchinson Hutchinson, Kansas  65702
Saint Louis Cancer and Breast Institute-South City Saint Louis, Missouri  63109
Toledo Clinic Cancer Centers-Bowling Green Bowling Green, Ohio  43402
Toledo Clinic Cancer Centers-Maumee Maumee, Ohio  43537-1839
Toledo Clinic Cancer Centers-Toledo Toledo, Ohio  43623
Guthrie Clinic-Robert Packer Hospital Sayre, Pennsylvania  18840
Self Regional Healthcare Greenwood, South Carolina  29646
Harrison Poulsbo Hematology and Oncology Poulsbo, Washington  98370
PeaceHealth Southwest Medical Center Vancouver, Washington  98664
Sutter Pacific Medical Foundation Santa Rosa, California  95403
NEA Baptist Clinic-Matthews Jonesboro, Arkansas  72401
Saint Rose Ambulatory and Surgery Center Great Bend, Kansas  67530
Ochsner Baptist Medical Center New Orleans, Louisiana  70115
Providence Willamette Falls Medical Center Oregon City, Oregon  97045
Geisinger South Wilkes-Barre Wilkes-Barre, Pennsylvania  18765