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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 InstituteBuffalo, New York  14263
Mayo ClinicRochester, Minnesota  55905
H. Lee Moffitt Cancer Center and Research InstituteTampa, Florida  33612
University of Mississippi Medical CenterJackson, Mississippi  39216-4505
University of Washington Medical CenterSeattle, Washington  98195-6043
Hurley Medical CenterFlint, Michigan  48503
University of Texas Health Science Center at San AntonioSan Antonio, Texas  78284-7811
Beth Israel Deaconess Medical CenterBoston, Massachusetts  02215
Boulder Community HospitalBoulder, Colorado  80301-9019
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Rose Medical CenterDenver, Colorado  80220
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Sky Ridge Medical CenterLone Tree, Colorado  80124
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Bronson Methodist HospitalKalamazoo, Michigan  49007
West Michigan Cancer CenterKalamazoo, Michigan  49007-3731
Borgess Medical CenterKalamazooaa, Michigan  49001
Fairview Ridges HospitalBurnsville, Minnesota  55337
Hutchinson Area Health CareHutchinson, Minnesota  55350
United HospitalSt. Paul, Minnesota  55102
Ridgeview Medical CenterWaconia, Minnesota  55387
Geisinger Medical CenterDanville, Pennsylvania  17822-0001
Abramson Cancer Center of the University of PennsylvaniaPhiladelphia, Pennsylvania  19104-4283
Avera Cancer InstituteSioux Falls, South Dakota  57105
Massachusetts General Hospital Cancer CenterBoston, Massachusetts  02114
CentraCare ClinicSaint Cloud, Minnesota  56303
Marshfield ClinicMarshfield, Wisconsin  54449
Sutter Health Western Division Cancer Research GroupGreenbrae, California  94904
Methodist Medical Center of IllinoisPeoria, Illinois  61636
Memorial Hospital of South BendSouth Bend, Indiana  46601
Mary Bird Perkins Cancer CenterBaton Rouge, Louisiana  70809
Akron General Medical CenterAkron, Ohio  44302
Lehigh Valley HospitalAllentown, Pennsylvania  18103
Virginia Mason Medical CenterSeattle, Washington  98111
Dana-Farber Cancer InstituteBoston, Massachusetts  02115
Cedars-Sinai Medical CenterLos Angeles, California  90048
University of Arkansas for Medical SciencesLittle Rock, Arkansas  72205
University of Kansas Medical CenterKansas City, Kansas  66160-7353
Boston Medical CenterBoston, Massachusetts  02118
University of Nebraska Medical CenterOmaha, Nebraska  68198-3330
Via Christi Regional Medical CenterWichita, Kansas  67214
Ochsner Clinic FoundationNew Orleans, Louisiana  70121
Carolinas Medical CenterCharlotte, North Carolina  28232-2861
Southern California Permanente Medical GroupDowney, California  90242
Group Health CooperativeSeattle, Washington  98112
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Fred Hutchinson Cancer Research Center/University of Washington Cancer ConsortiumSeattle, Washington  98109
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Cancer Center of Kansas - ChanuteChanute, Kansas  66720
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Cancer Center of Kansas - WellingtonWellington, Kansas  67152
Associates in Womens HealthWichita, Kansas  67203
Cancer Center of Kansas - WinfieldWinfield, Kansas  67156
Northern Rockies Radiation Oncology CenterBillings, Montana  59101
Bozeman Deaconess HospitalBozeman, Montana  59715
Big Sky OncologyGreat Falls, Montana  59405
Kalispell Medical OncologyKalispell, Montana  59901
Kalispell Regional Medical CenterKalispell, Montana  59901
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Grady Memorial HospitalDelaware, Ohio  43015
Fairfield Medical CenterLancaster, Ohio  43130
Avera McKennan Hospital and University Health CenterSioux Falls, South Dakota  57105
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Harborview Medical CenterSeattle, Washington  98104
Cancer Care Northwest - Spokane SouthSpokane, Washington  99202
Welch Cancer CenterSheridan, Wyoming  82801
University of New Mexico Cancer CenterAlbuquerque, New Mexico  87131-5636
Brigham and Women's HospitalBoston, Massachusetts  02115
Cancer Centers of the CarolinasGreenville, South Carolina  29605
Elkhart General HospitalElkhart, Indiana  46515
South Bend ClinicSouth Bend, Indiana  46617
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical CenterColumbus, Ohio  43210-1240
Front Range Cancer SpecialistsFort Collins, Colorado  80528
University Medical Center of Southern NevadaLas Vegas, Nevada  89102
Jennersville Regional HospitalWest Grove, Pennsylvania  19390-9499
Sutter Solano Medical CenterVallejo, California  94589
Poudre Valley HospitalFort Collins, Colorado  80524
Beebe Medical CenterLewes, Delaware  19958
Memorial HospitalCarthage, Illinois  62321
Hematology and Oncology AssociatesChicago, Illinois  60611
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
Community Cancer Center of MonroeMonroe, Michigan  48162
Saint Francis Medical CenterCape Girardeau, Missouri  63701
Great Plains Regional Medical CenterNorth Platte, Nebraska  69101-6598
Creighton University Medical CenterOmaha, Nebraska  68131-2197
Iredell Memorial HospitalStatesville, North Carolina  28677
Bismarck Cancer CenterBismarck, North Dakota  58501
Lima Memorial HospitalLima, Ohio  45804
Mercy Hospital of TiffinTiffin, Ohio  44883
Fulton County Health CenterWauseon, Ohio  43567
Providence Milwaukie HospitalMilwaukie, Oregon  97222
Danville Regional Medical CenterDanville, Virginia  24541
Exempla Lutheran Medical CenterWheat Ridge, Colorado  80033
Eureka HospitalEureka, Illinois  61530
Mercy HospitalCoon Rapids, Minnesota  55433
Olympic Medical CenterPort Angeles, Washington  98362
Valley Medical CenterRenton, Washington  98055
Graham Hospital AssociationCanton, Illinois  61520
Holy Family Medical CenterDes Plaines, Illinois  60016
Hematology Oncology Associates of Illinois-Highland ParkHighland Park, Illinois  60035
Saint Joseph Medical CenterJoliet, Illinois  60435
Trinity Medical CenterMoline, Illinois  61265-1291
Pekin HospitalPekin, Illinois  61554
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
Geisinger Medical GroupState College, Pennsylvania  16801
Northeast Georgia Medical CenterGainesville, Georgia  30501
Swedish American HospitalRockford, Illinois  61104
Center for Cancer Care and ResearchSt. Louis, Missouri  63141
Eastern Connecticut Hematology and Oncology AssociatesNorwich, Connecticut  06360
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
Wenatchee Valley Medical CenterWenatchee, Washington  98801-2028
Marshfield Clinic Cancer Care at Regional Cancer CenterEau Claire, Wisconsin  54701
Saint Joseph's HospitalMarshfield, Wisconsin  54449
Marshfield Clinic - Weston CenterWeston, Wisconsin  54476
Marshfield Clinic - Wisconsin Rapids CenterWisconsin Rapids, Wisconsin  54494
Rocky Mountain OncologyCasper, Wyoming  82609
Longmont United HospitalLongmont, Colorado  80501
Baton Rouge General Medical CenterBaton Rouge, Louisiana  70821-2511
Genesys Regional Medical CenterGrand Blanc, Michigan  48439-8066
Union Hospital of Cecil CountyElkton MD, Maryland  21921
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
Manchester Memorial HospitalManchester, Connecticut  06040-4188
Memorial Medical CenterSpringfield, Illinois  62781
Phelps County Regional Medical CenterRolla, Missouri  65401
Saint Francis Medical CenterGrand Island, Nebraska  68802
Wellmont Holston Valley Hospital and Medical CenterKingsport, Tennessee  37662
La Grange Memorial HospitalLa Grange, Illinois  60525
Guardian Oncology and Center for WellnessMissoula, Montana  59804
Providence HospitalMobile, Alabama  36608
Vanderbilt UniversityNashville, Tennessee  37232-6305
Northwestern UniversityChicago, Illinois  60611
Northwest Cancer SpecialistsVancouver, Washington  98664
Bay Area HospitalCoos Bay, Oregon  97420
Hennepin County Medical CenterMinneapolis, Minnesota  
Saint Louis University HospitalSt. Louis, Missouri  63110-0250
University of RochesterRochester, New York  14642
Saint Alphonsus Regional Medical CenterBoise, Idaho  83706
Kaiser Permanente Medical CenterVallejo, California  94589
Riverside Methodist HospitalColumbus, Ohio  43214
Licking Memorial HospitalNewark, Ohio  43055-2899
Cancer Center of Kansas - McPhersonMcPherson, Kansas  67460
Providence Portland Medical CenterPortland, Oregon  97213-3635
California Pacific Medical CenterSan Francisco, California  94115
Mid Dakota ClinicBismarck, North Dakota  58501
Columbus CCOPColumbus, Ohio  43206
Presbyterian - Saint Lukes Medical Center - Health OneDenver, Colorado  80218
Kaiser PermanenteSacramento, California  
Wichita CCOPWichita, Kansas  67214-3882
Montana Cancer Consortium CCOPBillings, Montana  59101
Alegent Health Immanuel Medical CenterOmaha, Nebraska  68122
Alegent Health Bergan Mercy Medical CenterOmaha, Nebraska  68124
Flower HospitalSylvania, Ohio  43560-2197
Virginia Mason CCOPSeattle, Washington  98101
Metro-Minnesota CCOPSt. Louis Park, Minnesota  
Cancer Centers of the Carolinas - EasleyEasley, South Carolina  29640
Lakeview HospitalStillwater, Minnesota  55082
Thomas Jefferson University HospitalPhiladelphia, Pennsylvania  19131
Decatur Memorial HospitalDecatur, Illinois  62526
Tulane University Health Sciences CenterNew Orleans, Louisiana  70112
Louisiana State University Health Science CenterNew Orleans, Louisiana  70112
Kaiser PermanentePortland, Oregon  97227
Princeton Community HospitalPrinceton, West Virginia  24740
Montana Cancer SpecialistsMissoula, Montana  59807-7877
M D Anderson Cancer CenterHouston, Texas  77030
University of Southern CaliforniaLos Angeles, California  90033
Northern Indiana Cancer Research ConsortiumSouth Bend, Indiana  
University of CincinnatiCincinnati, Ohio  45267-0502
San Luis Valley Regional Medical CenterAlamosa, Colorado  81101
Valley View Hospital Cancer CenterGlenwood Springs, Colorado  81601
Hays Medical CenterHays, Kansas  67601
Southeast Cancer CenterCape Girardeau, Missouri  63703
Clackamas Radiation Oncology CenterClackamas, Oregon  97015
Providence Newberg Medical CenterNewberg, Oregon  97132
Butler Memorial HospitalButler, Pennsylvania  16001
Littleton Adventist HospitalLittleton, Colorado  80122
Parker Adventist HospitalParker, Colorado  80138
New Ulm Medical CenterNew Ulm, Minnesota  56073
OSF Saint Francis Medical CenterPeoria, Illinois  61637
Highlands Oncology Group-BentonvilleBentonville, Arkansas  72712
Saint Edward Mercy Medical CenterFt. Smith, Arkansas  72903
Mills - Peninsula HospitalsBurlingame, California  94010
The Medical Center of AuroraAurora, Colorado  80012
Penrose-Saint Francis HealthcareColorado Springs, Colorado  80907
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
Saint Francis Hospital and Medical CenterHartford, Connecticut  06105
Lombardi Comprehensive Cancer Center at Georgetown UniversityWashington, District of Columbia  20057
Edna Williams Cancer Center at the Baptist Cancer InstituteJacksonville, Florida  32207
M D Anderson Cancer Center- OrlandoOrlando, Florida  32806
Saint Joseph's-Candler Health SystemSavannah, Georgia  31405
Saint Anthony's HealthAlton, Illinois  62002
Rush - Copley Medical CenterAurora, Illinois  60504
Saint Anthony Memorial HospitalEffingham, Illinois  62401
Hopedale Medical Complex - HospitalHopedale, Illinois  61747
Joliet Oncology-Hematology Associates LimitedJoliet, Illinois  60435
Midwest Center for Hematology OncologyJoliet, Illinois  60432
Provena Saint Mary's HospitalKankakee, Illinois  60901
North Shore Hematology OncologyLibertyville, Illinois  60048
Garneau, Stewart C MD (UIA Investigator)Moline, Illinois  61265
Porubcin, Michael MD (UIA Investigator)Moline, Illinois  61265
Good Samaritan Regional Medical CenterMt. Vernon, Illinois  62864
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
Hematology Oncology Associates of Illinois - SkokieSkokie, Illinois  60076
Saint Margaret's HospitalSpring Valley, Illinois  61362
Carle Clinic-Urbana MainUrbana, Illinois  61801
Saint Anthony Memorial Health CenterMichigan City, Indiana  46360
McFarland ClinicAmes, Iowa  50010
Hematology Oncology Associates-Quad CitiesBettendorf, Iowa  52722
Constantinou, Costas L MD (UIA Investigator)Bettendorf, Iowa  52722
Cedar Rapids Oncology AssociationCedar Rapids, Iowa  52403
Mercy HospitalCedar Rapids, Iowa  52403
Genesis Medical Center - East CampusDavenport, Iowa  52803
Mercy Medical Center-Sioux CitySioux City, Iowa  51104
Saint Luke's Regional Medical CenterSioux City, Iowa  51104
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
Our Lady Bellefonte HospitalAshland, Kentucky  41101
Ochsner Clinic Foundation-Baton RougeBaton Rouge, Louisiana  70809
Medical Center of LouisianaNew Orleans, Louisiana  70112
Ochsner Clinic CCOPNew Orleans, Louisiana  70121
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
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
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
Medini, Eitan MD (UIA Investigator)Alexandria, Minnesota  56308
Unity HospitalFridley, Minnesota  55432
Saint John's Hospital - HealtheastMaplewood, Minnesota  55109
Minnesota Oncology Hematology PA-MaplewoodMaplewood, Minnesota  55109
North Memorial Medical Health CenterRobbinsdale, Minnesota  55422
Saint Cloud HospitalSaint Cloud, Minnesota  56303
Park Nicollet Clinic - Saint Louis ParkSaint Louis Park, Minnesota  55416
Minnesota Oncology and Hematology PA-WoodburyWoodbury, Minnesota  55125
Veterans Affairs Medical CenterJackson, Mississippi  39216
Southeast Missouri HospitalCape Girardeau, Missouri  63701
Truman Medical CenterKansas City, Missouri  64108
Saint Louis-Cape Girardeau CCOPSaint Louis, Missouri  63141
Missouri Baptist Medical CenterSaint Louis, Missouri  63131
Saint John's Mercy Medical CenterSaint Louis, Missouri  63141
Ozark Health Ventures LLC dba Cancer Research for The Ozarks SpringfieldSpringfield, Missouri  65802
Saint John's HospitalSpringfield, Missouri  65804
Cox Medical CenterSpringfield, Missouri  65807
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
Saint Patrick Hospital - Community HospitalMissoula, Montana  59802
Good Samaritan HospitalKearney, Nebraska  68847
Lincoln Medical Education Foundation Cancer Resource CenterLincoln, Nebraska  68510
Missouri Valley Cancer Consortium CCOPOmaha, Nebraska  68106
Nevada Cancer Research Foundation CCOPLas Vegas, Nevada  89106
Cooper Hospital University Medical CenterCamden, New Jersey  08103
Hunterdon Medical CenterFlemington, New Jersey  08822
Memorial Medical Center - Las CrucesLas Cruces, New Mexico  88011
Orange Regional Medical CenterMiddletown, New York  10940
Interlakes Foundation Inc-RochesterRochester, New York  14623
Highland HospitalRochester, New York  14620
Wayne Memorial HospitalGoldsboro, North Carolina  27534
Kinston Medical Specialists PAKinston, North Carolina  28501
Saint Alexius Medical CenterBismarck, North Dakota  58501
Summa Barberton HospitalBarberton, Ohio  44203
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
Saint Rita's Medical CenterLima, Ohio  45801
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
Providence Saint Vincent Medical CenterPortland, Oregon  97225
Columbia River Oncology ProgramPortland, Oregon  97225
Pocono Medical CenterEast Stroudsburg, Pennsylvania  18301
Scranton Hematology OncologyScranton, Pennsylvania  18510
Mercy HospitalScranton, Pennsylvania  18501
Geisinger Wyoming ValleyWilkes-Barre, Pennsylvania  18711
Greenville CCOPGreenville, South Carolina  29615
Greenville Memorial HospitalGreenville, South Carolina  29605
Sanford Cancer Center-Oncology ClinicSioux Falls, South Dakota  57104
The Don and Sybil Harrington Cancer CenterAmarillo, Texas  79106
Audie L Murphy Veterans Affairs HospitalSan Antonio, Texas  78209
University HospitalSan Antonio, Texas  78229
Fredericksburg Oncology IncFredericksburg, Virginia  22401
Southwest VA Regional Cancer CenterNorton, Virginia  24273
Harrison Bremerton Hematology and OncologyBremerton, Washington  98310
Columbia Basin Hematology and Oncology PLLCKennewick, Washington  99336
Evergreen Hospital Medical CenterKirkland, Washington  98033
Minor and James Medical PLLCSeattle, Washington  98104
The PolyclinicSeattle, Washington  98122
Swedish Medical Center-First HillSeattle, Washington  98122-4307
Sacred Heart HospitalEau Claire, Wisconsin  54701
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
Marshfield Clinic-Minocqua CenterMinocqua, Wisconsin  54548
Green Bay Oncology - Oconto FallsOconto Falls, Wisconsin  54154
Marshfield Clinic at James Beck Cancer CenterRhinelander, Wisconsin  54501
Marshfield Clinic-Rice Lake CenterRice Lake, Wisconsin  54868
Saint Michael's HospitalStevens Point, Wisconsin  54481
Green Bay Oncology - Sturgeon BaySturgeon Bay, Wisconsin  54235
Marshfield Clinic-Wausau CenterWausau, Wisconsin  54401
Olathe Cancer CenterOlathe, Kansas  66061
Kansas City Cancer Centers - NorthKansas City, Missouri  64154
Elkhart ClinicElkhart, Indiana  46515
Marin General HospitalGreenbrae, California  94904
University of Colorado Cancer Center - Anschutz Cancer PavilionAurora, Colorado  80045
Denver Veterans Administration Medical CenterDenver, Colorado  80220
The Shaw Regional Cancer CenterEdwards, Colorado  81632
Montrose Memorial HospitalMontrose, Colorado  81401
Illinois CancerCare-BloomingtonBloomington%, Illinois  61701
Illinois CancerCare-CantonCanton, Illinois  61520
Illinois CancerCare-CarthageCarthage, Illinois  62321
Illinois CancerCare-EurekaEureka, Illinois  61530
Illinois CancerCare-HavanaHavana, Illinois  62644
Illinois CancerCare-Kewanee ClinicKewanee, Illinois  61443
Illinois CancerCare-MacombMacomb, Illinois  61455
Illinois CancerCare-MonmouthMonmouth, Illinois  61462
Illinois CancerCare-Community Cancer CenterNormal, Illinois  61761
Illinois CancerCare-PekinPekin, Illinois  61603
Illinois CancerCare-PeruPeru, Illinois  61354
Illinois CancerCare-PrincetonPrinceton, Illinois  61356
Illinois CancerCare-Spring ValleySpring Valley, Illinois  61362
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
University of Michigan University HospitalAnn Arbor, Michigan  48109
Michiana Hematology Oncology PC-NilesNiles, Michigan  49120
North Coast Cancer Care-ClydeClyde, Ohio  43410
Community Health Partners Regional Medical CenterElyria, Ohio  44035
Roper HospitalCharleston, South Carolina  29401
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
Erlanger Medical CenterChattanooga, Tennessee  37403
The Center for Biomedical ResearchKnoxville, Tennessee  37909
University of Tennessee - KnoxvilleKnoxville, Tennessee  37920
Skagit Valley HospitalMt. Vernon, Washington  98273
Evergreen Hematology and Oncology PSSpokane, Washington  99218
West Virginia University CharlestonCharleston, West Virginia  25304
Marshfield Clinic-Chippewa CenterChippewa Falls, Wisconsin  54729
Holy Family Memorial HospitalManitowoc, Wisconsin  54221
Marshfield Clinic Cancer Care at Saint Michael's HospitalStevens Point, Wisconsin  54481
Kansas City Cancer Centers-SouthwestOverland Park, Kansas  66210
Kaiser Permanente Los Angeles Medical CenterLos Angeles, California  90027
Cancer Centers of Southwest Oklahoma ResearchLawton, Oklahoma  
Kaiser Anaheim Medical CenterAnaheim, California  92807
Kaiser Permanente Medical Group - Baldwin ParkBaldwin Park, California  91706
Kaiser Foundation HospitalBellflower, California  90706
Kaiser Permanente HospitalFontana, California  92335
Kaiser Permanente - Harbor CityHarbor City, California  90710
Kaiser Permanente-West Los AngelesLos Angeles, California  90034
Kaiser Permanente - Panorama CityPanorama City, California  91402
Palchak David MDPismo Beach, California  93449
Kaiser Permanente at San DiegoSan Diego, California  92120
Kaiser Permanente Health CareSan Marcos, California  92069
Spector, David MD (UIA Investigator)Moline, Illinois  61265
Kansas City Cancer Center-WestKansas City, Kansas  66112
Kansas City Cancer Center-Shawnee MissionShawnee Mission, Kansas  66204
Hematology and Oncology ClinicBaton Rouge, Louisiana  70809
Ochsner North Shore Medical CenterCovington, Louisiana  70433
Capital Region Medical Center-Goldschmidt Cancer CenterJefferson City, Missouri  65109
Kansas City Cancer Center - SouthKansas City, Missouri  64131
Kansas City Cancer Center-Lee's SummitLee's Summit, Missouri  64064
Saint John's Clinic-Rolla-Cancer and HematologyRolla, Missouri  65401
Comprehensive Cancer Care PCSaint Louis, Missouri  63141
The Mark H Zangmeister CenterColumbus, Ohio  43219
Southern Ohio Medical CenterPortsmouth, Ohio  45662
Cancer Care Center at Island HospitalAnacortes, Washington  98221
Highline Medical Center-Main CampusBurien, Washington  98166
Pacific Medical Center-First HillSeattle, Washington  98104
United General HospitalSedro-Woolley, Washington  98284
Saint Nicholas HospitalMadison, Wisconsin  53715
Fairbanks Memorial HospitalFairbanks, Alaska  99701
Alegent Health Lakeside HospitalOmaha, Nebraska  68130
Los Angeles County-USC Medical CenterLos Angeles, California  90033
Stanford University Hospitals and ClinicsStanford, California  94305
Siouxland Hematology Oncology AssociatesSioux City, Iowa  51101
Swedish Cancer Institute-IssaquahIssaquah, Washington  98029
Alta Bates Summit Medical Center-Herrick CampusBerkeley, California  94704
Michiana Hematology Oncology PC-MishawakaMishawaka, Indiana  46545-1470
Oncology Associates at Mercy Medical CenterCedar Rapids, Iowa  52403
Marie Yeager Cancer CenterSaint Joseph, Michigan  49085
Summa Akron City HospitalAkron, Ohio  44304
The Toledo Hospital/Toledo Children's HospitalToledo, Ohio  43606
Sanford USD Medical Center - Sioux FallsSioux Falls, South Dakota  57117-5134
Genesys Regional Medical Center-West Flint CampusFlint, Michigan  48532
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
Christiana Care Health System-Christiana HospitalNewark, Delaware  19718
Illinois Cancer Specialists-NilesNiles, Illinois  60714
Springfield Regional Medical CenterSpringfield, Ohio  45505
Promise Regional Medical Center-HutchinsonHutchinson, Kansas  65702
Saint Louis Cancer and Breast Institute-South CitySaint Louis, Missouri  63109
Toledo Clinic Cancer Centers-Bowling GreenBowling Green, Ohio  43402
Toledo Clinic Cancer Centers-MaumeeMaumee, Ohio  43537-1839
Toledo Clinic Cancer Centers-ToledoToledo, Ohio  43623
Guthrie Clinic-Robert Packer HospitalSayre, Pennsylvania  18840
Self Regional HealthcareGreenwood, South Carolina  29646
Harrison Poulsbo Hematology and OncologyPoulsbo, Washington  98370
PeaceHealth Southwest Medical CenterVancouver, Washington  98664
Sutter Pacific Medical FoundationSanta Rosa, California  95403
NEA Baptist Clinic-MatthewsJonesboro, Arkansas  72401
Saint Rose Ambulatory and Surgery CenterGreat Bend, Kansas  67530
Ochsner Baptist Medical CenterNew Orleans, Louisiana  70115
Providence Willamette Falls Medical CenterOregon City, Oregon  97045
Geisinger South Wilkes-BarreWilkes-Barre, Pennsylvania  18765