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A Phase III Randomized Trial of Chemotherapy With or Without Bevacizumab In Patients With Recurrent Or Metastatic Head and Neck Cancer

Phase 3
18 Years
Open (Enrolling)
Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma, Recurrent Metastatic Squamous Neck Cancer With Occult Primary, Recurrent Salivary Gland Cancer, Recurrent Squamous Cell Carcinoma of the Hypopharynx, Recurrent Squamous Cell Carcinoma of the Larynx, Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity, Recurrent Squamous Cell Carcinoma of the Nasopharynx, Recurrent Squamous Cell Carcinoma of the Oropharynx, Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity, Recurrent Verrucous Carcinoma of the Larynx, Recurrent Verrucous Carcinoma of the Oral Cavity, Salivary Gland Squamous Cell Carcinoma, Stage IV Salivary Gland Cancer, Stage IV Squamous Cell Carcinoma of the Hypopharynx, Stage IV Squamous Cell Carcinoma of the Larynx, Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity, Stage IV Squamous Cell Carcinoma of the Nasopharynx, Stage IV Squamous Cell Carcinoma of the Oropharynx, Stage IV Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity, Stage IV Verrucous Carcinoma of the Larynx, Stage IV Verrucous Carcinoma of the Oral Cavity, Tongue Cancer, Untreated Metastatic Squamous Neck Cancer With Occult Primary

Thank you

Trial Information

A Phase III Randomized Trial of Chemotherapy With or Without Bevacizumab In Patients With Recurrent Or Metastatic Head and Neck Cancer


I. To compare the overall survival of patients with recurrent or metastatic squamous cell
carcinoma of the head and neck treated with standard platinum-based chemotherapy with or
without bevacizumab.


I. To assess toxicities with the addition of bevacizumab to each platinum-doublet
(cisplatin/docetaxel, carboplatin/docetaxel, cisplatin/fluorouracil,

II. To compare the objective response rates and the progression-free survival achieved with
the above therapies.

III. To collect blood samples before and after therapy for future correlative studies.

IV. To collect tumor tissue samples available at baseline from prior diagnostic procedures
for future correlative studies.

OUTLINE: After the physician decides which chemotherapy doublet to use, patients are
randomized to1 of 2 treatment arms for that chemotherapy combination.

ARM IA: Patients receive chemotherapy comprising docetaxel intravenously (IV) over 1 hour
and cisplatin IV over 1-2 hours on day 1. Treatment repeats every 21 days in the absence of
disease progression or unacceptable toxicity.

ARM IB: Patients receive bevacizumab IV over 30-90 minutes on day 1 and docetaxel and
cisplatin as in arm IA.

ARM IIA: Patients receive docetaxel IV over 1 hour and carboplatin IV over 30 minutes on day
1. Treatment repeats every 21 days in the absence of disease progression or unacceptable

ARM IIB: Patients receive bevacizumab as in arm IB and docetaxel and carboplatin as in arm

ARM IIIA: Patients receive cisplatin IV over 1-2 hours on day 1 and fluorouracil IV
continuously over days 1-4. Treatment repeats every 21 days in the absence of disease
progression or unacceptable toxicity.

ARM IIIB: Patients receive bevacizumab as in arm IB and cisplatin and fluorouracil as in arm

ARM IVA: Patients receive carboplatin IV over 30 minutes on day 1 and fluorouracil IV
continuously over days 1-4. Treatment repeats every 21 days in the absence of disease
progression or unacceptable toxicity.

ARM IVB: Patients receive bevacizumab as in arm IB and carboplatin and fluorouracil as in
arm IVA.

After completion of study treatment, patients are followed up every 3-6 months for 5 years.

Inclusion Criteria:

- Histologically or cytologically confirmed squamous cell carcinoma of the head and
neck (SCCHN) from any primary site, including unknown primary cancers of the head and

- No nasopharyngeal carcinoma of histologic types World Health Organization (WHO)
2 or 3

- No squamous cell carcinoma that originated in the skin

- Recurrent disease, incurable disease as determined by surgery or radiation, or
metastatic disease

- A second primary SCCHN allowed if eligibility is based on a recurrent or
metastatic first primary SCCHN

- Patients who refuse radical resection for recurrent disease are eligible

- Patients must have measurable disease based on Response Evaluation Criteria in Solid
Tumors (RECIST)

- Disease in previously irradiated sites is considered measurable if there has
been unequivocal disease progression or biopsy-proven residual carcinoma after

- Persistent disease after radiotherapy must be biopsy proven at least 8 weeks
after completion of radiotherapy (radiographic findings are acceptable providing
that clear cut measurements can be made)

- Patients must be progression-free for at least 6 months after completion of
chemotherapy or chemoradiotherapy or radiotherapy plus cetuximab given as part of
initial potential curative therapy (if received such prior therapy)

- At least 6 months since completion of prior concurrent radiotherapy plus
cetuximab (8 weeks for cetuximab given as part of adjuvant regimen post

- Patients having progression after 2 courses of induction chemotherapy are not

- No tumors that invade major vessels (e.g., the carotid) as shown unequivocally by
imaging studies

- No known brain metastases

- Eastern Cooperative Oncology Group (ECOG) performance status 0-1

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

- Hemoglobin >= 8.0 g/dL

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

- Creatinine clearance >= 60 mL/min

- Total bilirubin normal

- Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) and alkaline
phosphatase must meet one of the following criteria:

- Alkaline phosphatase normal AND AST or ALT =< 5 x upper limit of normal (ULN)

- Alkaline phosphatase > 1 but =< 2.5 x ULN AND AST or ALT > 1 but =< 1.5 x ULN

- Alkaline phosphatase > 2.5 but =< 5 x ULN AND AST or ALT normal

- Urine dipstick must be < 0-1+ within 2 weeks (14 days) of randomization; if urine
dipstick result is > 1+, a calculation of Urine Protein Creatinine (UPC) ratio is
required; patients must have a UPC ratio < 1.0 to participate in the study

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- Patients who meet the following criteria will be excluded due to the possibility of
increased risk for tumor bleeding with bevacizumab therapy:

- Tumors that invade major vessels (e.g. the carotid) as shown unequivocally by
imaging studies

- Central (i.e. within 2 cm from the hilum) lung metastases that are cavitary as
shown unequivocally by imaging studies

- Any prior history of bleeding related to the current head and neck cancer

- History of gross hemoptysis (bright red blood of 0.5 teaspoon or more per
episode of coughing) =< 3 months prior to enrollment

- No history of coagulopathy or hemorrhagic disorders

- No history of thrombosis (e.g., pulmonary embolism or deep venous thrombosis)
currently requiring therapeutic anticoagulation (prophylactic use of warfarin 1
mg/day is allowed)

- International normalized ratio (INR) < 1.5 at registration

- No hypercalcemia related to head and neck cancer

- Patients with a prior history of squamous cell or basal cell carcinoma of the skin or
in situ carcinoma of the cervix must have been curatively treated

- Patients with a history of other prior malignancy must have been treated with
curative intent and must have remained disease free for 5 years post diagnosis

- No current peripheral neuropathy >= grade 2

- Patients must not have any co-existing condition that would preclude full compliance
with the study

- No history of severe hypersensitivity reaction to docetaxel or other drugs formulated
with polysorbate 80 (if the physician's choice of chemotherapy is docetaxel)

- Patients must have a blood pressure (BP) =< 150/90 mm Hg within 2 weeks prior to

- Patients with a history of hypertension must be well-controlled upon study entry
(BP =< 150/90 mm Hg) on a stable regimen of anti-hypertensive therapy

- No history of abdominal fistula, gastrointestinal perforation, or intra-abdominal
abscess within 6 months prior to registration

- No significant traumatic injury within the past 28 days

- No serious nonhealing wound, ulcer, or bone fracture

- No unstable angina or myocardial infarction within the past 6 months

- No symptomatic congestive heart failure or New York Heart Association (NYHA) class
II-IV heart disease

- No history of aortic dissection or presence of aneurysm > 6 cm (or at high risk for

- No serious cardiac arrhythmia requiring medication (history of chronic atrial
fibrillation or other atrial arrhythmia with controlled rate on medication is

- No clinically significant peripheral vascular disease manifested by intermittent
claudication or need for vascular intervention

- No history of any central nervous system (CNS) cerebrovascular ischemia or stroke
within the past 6 months

- No active serious infection

- No history of a serious human anti-human antibody (HAHA) reaction

- Patients with known hypersensitivity to Chinese hamster ovary cell products or other
recombinant human antibodies are not eligible

- Chronic latex xerostomia, speech and swallowing abnormalities, resulting from prior
radiation or surgery, allowed provided nutritional status is stable

- No other prior malignancy except curatively treated squamous cell or basal carcinoma
of the skin, in situ cervical cancer, or malignancy for which the patient has been
curatively treated and remains disease-free for the past 3 years

- No concurrent bisphosphonates for bone metastasis unless initiated > 3 months before
study entry

- Patients must have recovered to grade 1 or better from the effects of any prior
surgery, chemotherapy, or radiotherapy AND > 4 weeks post-surgery

- A maximum of one prior radiotherapy regimen, curative or palliative, to the head and
neck is allowed; if the radiation is combined with chemotherapy and/or cetuximab, a
minimum of 4 months must elapse between the end of radiotherapy and registration; if
the radiation is given alone, a minimum of 8 weeks must elapse between the end of
radiotherapy and registration; a minimum of 3 weeks must elapse between prior
radiation to other areas and registration

- No prior bevacizumab

- No prior chemotherapy or biologic/molecular-targeted therapy for recurrent or
metastatic SCCHN

- Patients may have received one regimen of induction, concurrent
chemoradiotherapy, and/or adjuvant chemotherapy as part of initial potential
curative therapy

- A minimum of 6 months is required between last dose of chemotherapy or
chemoradiotherapy and study treatment

- No major surgical procedure or open biopsy within 28 days prior to study enrollment,
or anticipation of need for major surgical procedure during the course of the study

- More than 4 weeks since prior surgery

- No other concurrent investigational agent

- Patients must not be receiving chronic daily treatment with aspirin (> 325 mg/day) or
nonsteroidal anti-inflammatory agents (NSAIDs) known to inhibit platelet function

- The use of anti-platelet agents (e.g., dipyridamole [Persantine], ticlopidine
[Ticlid], or clopidogrel [Plavix]) is allowed only if patient is not receiving
aspirin or NSAIDs known to inhibit platelet function

- No human immunodeficiency virus (HIV)-positive patients on combination antiretroviral

- No other concurrent chemotherapy, immunotherapy, antitumor hormonal therapy
(excluding contraceptives and replacement steroids), radiotherapy, or experimental

- No concurrent amifostine

Type of Study:


Study Design:

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

Outcome Measure:

Overall survival

Outcome Description:

Interim analyses comparing overall survival between the two arms using log-rank tests will be performed. The trial will be monitored according to principles of group-sequential methods using a one-sided O'Brien-Fleming upper boundary in order to preserve the overall type I error rate of 0.025. At each analysis, critical values for the log-rank test will be calculated using a truncated Lan-Demets error spending rate function corresponding to the O'Brien-Fleming boundary.

Outcome Time Frame:

Time from randomization to date of death from any cause, censored at date of last contact, assessed up to 5 years

Safety Issue:


Principal Investigator

Athanassios Argiris

Investigator Role:

Principal Investigator

Investigator Affiliation:

Eastern Cooperative Oncology Group


United States: Food and Drug Administration

Study ID:




Start Date:

August 2008

Completion Date:

Related Keywords:

  • Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma
  • Recurrent Metastatic Squamous Neck Cancer With Occult Primary
  • Recurrent Salivary Gland Cancer
  • Recurrent Squamous Cell Carcinoma of the Hypopharynx
  • Recurrent Squamous Cell Carcinoma of the Larynx
  • Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity
  • Recurrent Squamous Cell Carcinoma of the Nasopharynx
  • Recurrent Squamous Cell Carcinoma of the Oropharynx
  • Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity
  • Recurrent Verrucous Carcinoma of the Larynx
  • Recurrent Verrucous Carcinoma of the Oral Cavity
  • Salivary Gland Squamous Cell Carcinoma
  • Stage IV Salivary Gland Cancer
  • Stage IV Squamous Cell Carcinoma of the Hypopharynx
  • Stage IV Squamous Cell Carcinoma of the Larynx
  • Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity
  • Stage IV Squamous Cell Carcinoma of the Nasopharynx
  • Stage IV Squamous Cell Carcinoma of the Oropharynx
  • Stage IV Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity
  • Stage IV Verrucous Carcinoma of the Larynx
  • Stage IV Verrucous Carcinoma of the Oral Cavity
  • Tongue Cancer
  • Untreated Metastatic Squamous Neck Cancer With Occult Primary
  • Carcinoma
  • Carcinoma, Squamous Cell
  • Head and Neck Neoplasms
  • Laryngeal Diseases
  • Tongue Neoplasms
  • Carcinoma, Verrucous
  • Neoplasms, Unknown Primary
  • Salivary Gland Neoplasms
  • Hypopharyngeal Neoplasms
  • Laryngeal Neoplasms
  • Paranasal Sinus Neoplasms
  • Oropharyngeal Neoplasms
  • Nasopharyngeal Neoplasms



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Hematology and Oncology Associates Chicago, Illinois  60611
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Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
Eureka Hospital Eureka, Illinois  61530
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Olympic Medical Center Port Angeles, Washington  98362
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Saint Luke's East - Lee's Summit Lee's Summit, Missouri  64086
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Columbus CCOP Columbus, Ohio  43206
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Montana Cancer Consortium CCOP Billings, Montana  59101
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Alegent Health Bergan Mercy Medical Center Omaha, Nebraska  68124
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Mount Sinai Hospital Medical Center Chicago, Illinois  60608
Addison Gilbert Hospital Gloucester, Massachusetts  01930
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Decatur Memorial Hospital Decatur, Illinois  62526
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Montana Cancer Specialists Missoula, Montana  59807-7877
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Hawaii Medical Center East Honolulu, Hawaii  96817
Vince Lombardi Cancer Clinic - Oshkosh Oshkosh, Wisconsin  54904
Piedmont Fayette Hospital Fayetteville, Georgia  30214
Southeast Cancer Center Cape Girardeau, Missouri  63703
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
Northside Hospital Atlanta, Georgia  30342
Saint Helena Hospital Saint Helena, California  94574
Saint Edward Mercy Medical Center Ft. Smith, Arkansas  72903
Mills - Peninsula Hospitals Burlingame, California  94010
Valley Medical Oncology Consultants-Castro Valley Castro Valley, California  94546
Eden Hospital Medical Center Castro Valley, California  94546
Valley Medical Oncology Consultants-Fremont Fremont, California  94538
Bay Area Breast Surgeons Inc Oakland, California  94609
Bay Area Tumor Institution CCOP Oakland, California  94609
Tom K Lee Inc Oakland, California  94609
Valley Medical Oncology Consultants Pleasanton, California  94588
Valley Care Health System - Pleasanton Pleasanton, California  94588
Doctors Medical Center- JC Robinson Regional Cancer Center San Pablo, California  94806
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
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Saint Mary Corwin Medical Center Pueblo, Colorado  81004
Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
The Hospital of Central Connecticut New Britain, Connecticut  06050
Bayhealth Medical Center at Kent General Dover, Delaware  19901
Lombardi Comprehensive Cancer Center at Georgetown University Washington, District of Columbia  20057
Edna Williams Cancer Center at the Baptist Cancer Institute Jacksonville, Florida  32207
Sacred Heart Medical Oncology Group - Davis Highway Pensacola, Florida  32514
Atlanta Regional CCOP Atlanta, Georgia  30342
Well Star Cobb Hospital Austell, Georgia  30106
John B Amos Cancer Center Columbus, Georgia  31904
Veterans Administration Medical Center Decatur, Georgia  30033
Wellstar Kennestone Hospital Marietta, Georgia  30060
Oncare Hawaii Inc-POB II Honolulu, Hawaii  96813
Oncare Hawaii Inc-Kuakini Honolulu, Hawaii  96817
University of Hawaii Honolulu, Hawaii  96813
Pacific Cancer Institute of Maui Wailuku, Hawaii  96793
Saint Luke's Mountain States Tumor Institute Boise, Idaho  83712
Rush - Copley Medical Center Aurora, Illinois  60504
John H Stroger Jr Hospital of Cook County Chicago, Illinois  60612-3785
Resurrection Healthcare Chicago, Illinois  60631
Evanston CCOP-NorthShore University HealthSystem Evanston, Illinois  60201
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
Hematology Oncology Consultants Limited Naperville, Illinois  60540
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
West Suburban Cancer Center River Forest, Illinois  60305
Hematology Oncology Associates of Illinois - Skokie Skokie, Illinois  60076
Saint Margaret's Hospital Spring Valley, Illinois  61362
Carle Clinic-Urbana Main Urbana, Illinois  61801
Fort Wayne Medical Oncology and Hematology Inc - State Boulevard Fort Wayne, Indiana  46845
Wishard Hospital Indianapolis, Indiana  46202
Saint Vincent Hospital and Health Services Indianapolis, Indiana  46260
Saint Anthony Memorial Health Center Michigan City, Indiana  46360
McFarland Clinic Ames, Iowa  50010
Constantinou, Costas L MD (UIA Investigator) Bettendorf, Iowa  52722
Cedar Rapids Oncology Association Cedar Rapids, Iowa  52403
Mercy Hospital Cedar Rapids, Iowa  52403
Medical Oncology and Hematology Associates-West Des Moines Clive, Iowa  50325
Iowa Oncology Research Association CCOP Des Moines, Iowa  50309
Mercy Capitol Des Moines, Iowa  50307
Mercy Medical Center - Des Moines Des Moines, Iowa  50314
Medical Oncology and Hematology Associates-Des Moines Des Moines, Iowa  50309
Mercy Medical Center - North Iowa Mason City, Iowa  50401
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
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
Louisiana State University Sciences Center- Monroe Monroe, Louisiana  71210
Medical Center of Louisiana New Orleans, Louisiana  70112
Highland Clinic Shreveport, Louisiana  71105
Holy Family Hospital Methuen, Massachusetts  01844
Berkshire Hematology Oncology PC Pittsfield, Massachusetts  01201
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
Grand Rapids Clinical Oncology Program Grand Rapids, Michigan  49503
Saint Mary's Health Care Grand Rapids, Michigan  49503
Spectrum Health at Butterworth Campus Grand Rapids, Michigan  49503
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 Health Partners-Mercy Campus Muskegon, Michigan  49443
Mercy Health Partners-Hackley Campus Muskegon, Michigan  49442
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
Miller-Dwan Hospital Duluth, Minnesota  55805
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
Southeast Missouri Hospital Cape Girardeau, Missouri  63701
Saint Luke's Cancer Institute Kansas City, Missouri  64111
Saint Luke's Hospital of Kansas City Kansas City, Missouri  64111
Saint Joseph Health Center Kansas City, Missouri  64114
Liberty Radiation Oncology Clinic Kansas City, Missouri  64116
Truman Medical Center Kansas City, Missouri  64108
Missouri Baptist Medical Center Saint Louis, Missouri  63131
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
Veterans Adminstration New Jersey Health Care System East Orange, New Jersey  07018-1095
Memorial Medical Center - Las Cruces Las Cruces, New Mexico  88011
Veterans Affairs Western New York Health Care System-Buffalo Buffalo, New York  14215
Orange Regional Medical Center Middletown, New York  10940
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
Samaritan North Health Center Dayton, Ohio  45415
Veteran Affairs Medical Center Dayton, Ohio  45428
Saint Rita's Medical Center Lima, Ohio  45801
Marietta Memorial Hospital Marietta, Ohio  45750
Upper Valley Medical Center Troy, Ohio  45373
Saint Ann's Hospital Westerville, Ohio  43081
Genesis HealthCare System Zanesville, Ohio  43701
Salem Hospital Salem, Oregon  97309
Saint Luke's Hospital Bethlehem, Pennsylvania  18015
Pocono Medical Center East Stroudsburg, Pennsylvania  18301
Riddle Hospital Media, Pennsylvania  19063
Saint Joseph Medical Center Reading, Pennsylvania  19605
Hematology and Oncology Associates of North East Pennsylvania Scranton, Pennsylvania  18508
Scranton Hematology Oncology Scranton, Pennsylvania  18510
Mercy Hospital Scranton, Pennsylvania  18501
Associates In Hematology Oncology PC-Upland Upland, Pennsylvania  19013
Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania  18711
Greenville Memorial Hospital Greenville, South Carolina  29605
Sanford Cancer Center-Oncology Clinic Sioux Falls, South Dakota  57104
Veterans Administration Medical Center Houston, Texas  77030
Saint Luke's Episcopal Hospital Houston, Texas  77030
Audie L Murphy Veterans Affairs Hospital San Antonio, Texas  78209
University Hospital San Antonio, Texas  78229
Saint Francis Hospital Federal Way, Washington  98003
Evergreen Hospital Medical Center Kirkland, Washington  98033
Swedish Medical Center-First Hill Seattle, Washington  98122-4307
Edwards Comprehensive Cancer Center Huntington, West Virginia  25701
West Virginia University Morgantown, West Virginia  26506
Langlade Hospital and Cancer Center Antigo, Wisconsin  54409
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
Aurora BayCare Medical Center Green Bay, Wisconsin  54311-6519
Vince Lombardi Cancer Clinic-Marinette Marinette, Wisconsin  54143
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
Aspirus Regional Cancer Center Wausau, Wisconsin  54401
Lake University Ireland Cancer Center Mentor, Ohio  44060
Jupiter Medical Center Jupiter, Florida  33458
Gainesville Hematology Oncology Associates Gainesville, Florida  32605
University of Illinois Chicago, Illinois  60612
Elkhart Clinic Elkhart, Indiana  46515
Memorial Healthcare System - Joe DiMaggio Children's Hospital Hollywood, Florida  33021
Mount Sinai Medical Center CCOP Miami Beach, Florida  33140
Harbin Clinic Medical Oncology and Clinical Research Rome, Georgia  30165
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
Michiana Hematology Oncology PC-Niles Niles, Michigan  49120
Central Care Cancer Center-Carrie J Babb Cancer Center Bolivar, Missouri  65613
Skaggs Cancer Center Branson, Missouri  65616
University of Missouri - Ellis Fischel Columbia, Missouri  65203
Veterans Administration Columbia, Missouri  65201
Renown Regional Medical Center Reno, Nevada  89502
Hackensack University Medical CCOP Hackensack, New Jersey  07601
UMDNJ - New Jersey Medical School Newark, New Jersey  07103
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
Vanderbilt-Ingram Cancer Center Cool Springs Franklin, Tennessee  37067
University of Tennessee - Knoxville Knoxville, Tennessee  37920
Nashville Oncology Associates PC Nashville, Tennessee  37203
Sandra L Maxwell Cancer Center Cedar City, Utah  84720
Intermountain Medical Center Murray, Utah  84157
Utah Valley Regional Medical Center Provo, Utah  84603
Dixie Medical Center Regional Cancer Center Saint George, Utah  84770
Utah Cancer Specialists-Salt Lake City Salt Lake City, Utah  84106
West Virginia University Charleston Charleston, West Virginia  25304
Marshfield Clinic-Chippewa Center Chippewa Falls, Wisconsin  54729
Holy Family Memorial Hospital Manitowoc, Wisconsin  54221
Wheaton Franciscan Cancer Care - All Saints Racine, Wisconsin  53405
Vince Lombardi Cancer Clinic-Sheboygan Sheboygan, Wisconsin  53081
Marshfield Clinic Cancer Care at Saint Michael's Hospital Stevens Point, Wisconsin  54481
Aurora Medical Center in Summit Summit, Wisconsin  53066
Vince Lombardi Cancer Clinic Two Rivers, Wisconsin  54241
Riverview Hospital Wisconsin Rapids, Wisconsin  54494
VA Pittsburgh Healthcare System Pittsburgh, Pennsylvania  15240
State University of New York Downstate Medical Center Brooklyn, New York  11203
Texas Tech University Health Sciences Center Lubbock, Texas  79430
Kaiser Permanente Los Angeles Medical Center Los Angeles, California  90027
University of Miami Miller School of Medicine-Sylvester Cancer Center Miami, Florida  33136
Saint Luke's Mountain States Tumor Institute - Fruitland Fruitland, Idaho  83619
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
Epic Care-Oakland Oakland, California  94612
Kaiser Permanente - Panorama City Panorama City, California  91402
Kaiser Permanente at San Diego San Diego, California  92120
Kaiser Permanente Health Care San Marcos, California  92069
Kaiser Permanente-Rock Creek Lafayette, Colorado  80026
Saint Luke's Mountain States Tumor Institute - Meridian Meridian, Idaho  83642
Saint Luke's Mountain States Tumor Institute - Nampa Nampa, Idaho  83686
Hinsdale Hematology Oncology Associates Incorporated Hinsdale, Illinois  60521
Spector, David MD (UIA Investigator) Moline, Illinois  61265
Saint Luke's South Hospital Overland Park, Kansas  66213
Kansas City CCOP Prairie Village, Kansas  66208
Hematology and Oncology Clinic Baton Rouge, Louisiana  70809
Spectrum Health Reed City Hospital Reed City, Michigan  49677
Capital Region Medical Center-Goldschmidt Cancer Center Jefferson City, Missouri  65109
Heartland Hematology and Oncology Associates Incorporated Kansas City, Missouri  64118
Saint John's Clinic-Rolla-Cancer and Hematology Rolla, Missouri  65401
Saint Joseph Oncology Inc Saint Joseph, Missouri  64507
Comprehensive Cancer Care PC Saint Louis, Missouri  63141
Veteran Affairs New York Harbor Healthcare System-Brooklyn Campus Brooklyn, New York  11209
Kings County Hospital Brooklyn, New York  11203
The Mark H Zangmeister Center Columbus, Ohio  43219
UHHS-Chagrin Highlands Medical Center Orange Village, Ohio  44122
Southern Ohio Medical Center Portsmouth, Ohio  45662
UHHS-Westlake Medical Center Westlake, Ohio  44145
Susquehanna Cancer Center Williamsport, Pennsylvania  17701
Pacific Medical Center-First Hill Seattle, Washington  98104
Gundersen Lutheran La Crosse, Wisconsin  54601
Saint Nicholas Hospital Madison, Wisconsin  53715
Columbia Saint Mary's Water Tower Medical Commons Milwaukee, Wisconsin  53211
Fairbanks Memorial Hospital Fairbanks, Alaska  99701
Alegent Health Lakeside Hospital Omaha, Nebraska  68130
Southlake Clinic Renton, Washington  98055
Stanford University Hospitals and Clinics Stanford, California  94305
Kaiser Permanente-Franklin Denver, Colorado  80205
Siouxland Hematology Oncology Associates Sioux City, Iowa  51101
Space Coast Cancer Centers-Titusville Titusville, Florida  32796
Gulfport Memorial Hospital Gulfport, Mississippi  39502
INTEGRIS Cancer Institute of Oklahoma Oklahoma City, Oklahoma  73142
Roger Williams Hospital Providence, Rhode Island  02908
Swedish Cancer Institute-Issaquah Issaquah, Washington  98029
IU Health Arnett Lafayette, Indiana  
Alta Bates Summit Medical Center-Herrick Campus Berkeley, California  94704
Boca Raton Regional Hospital Boca Raton, Florida  33486
Carle Foundation - Carle Cancer Center Urbana, Illinois  61801
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
Hematology Oncology Associates of Central New York PC East Syracuse, New York  13057
Summa Akron City Hospital Akron, Ohio  44304
Sanford USD Medical Center - Sioux Falls Sioux Falls, South Dakota  57117-5134
Genesys Regional Medical Center-West Flint Campus Flint, Michigan  48532
Essentia Health Saint Joseph's Medical Center Brainerd, Minnesota  56401
Essentia Health Duluth Clinic CCOP Duluth, Minnesota  55805
Essentia Health Saint Mary's Medical Center Duluth, Minnesota  55805
Sanford Bismarck Medical Center Bismarck, North Dakota  58501
Geisinger Medical Center-Cancer Center Hazelton Hazleton, Pennsylvania  18201
Veterans Administration-San Diego Medical Center San Diego, California  92161
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
Christiana Care Health System-Christiana Hospital Newark, Delaware  19718
Illinois Cancer Specialists-Niles Niles, Illinois  60714
Bronson Battle Creek Battle Creek, Michigan  49017
Springfield Regional Medical Center Springfield, Ohio  45505
Guthrie Clinic-Robert Packer Hospital Sayre, Pennsylvania  18840
Self Regional Healthcare Greenwood, South Carolina  29646
Aurora Cancer Care-Southern Lakes Elkhorn, Wisconsin  53121
IU Health Ball Memorial Hospital Muncie, Indiana  47303
Sutter Pacific Medical Foundation Santa Rosa, California  95403
Saint Luke's Mountain States Tumor Institute-Twin Falls Twin Falls, Idaho  83301
Ireland Cancer Center at Firelands Regional Medical Center Sandusky, Ohio  44870