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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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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
The Hospital of Central ConnecticutNew Britain, Connecticut  06050
Bayhealth Medical Center at Kent GeneralDover, Delaware  19901
Lombardi Comprehensive Cancer Center at Georgetown UniversityWashington, District of Columbia  20057
Edna Williams Cancer Center at the Baptist Cancer InstituteJacksonville, Florida  32207
Sacred Heart Medical Oncology Group - Davis HighwayPensacola, Florida  32514
Atlanta Regional CCOPAtlanta, Georgia  30342
Well Star Cobb HospitalAustell, Georgia  30106
John B Amos Cancer CenterColumbus, Georgia  31904
Veterans Administration Medical CenterDecatur, Georgia  30033
Wellstar Kennestone HospitalMarietta, Georgia  30060
Oncare Hawaii Inc-POB IIHonolulu, Hawaii  96813
Oncare Hawaii Inc-KuakiniHonolulu, Hawaii  96817
University of HawaiiHonolulu, Hawaii  96813
Pacific Cancer Institute of MauiWailuku, Hawaii  96793
Saint Luke's Mountain States Tumor InstituteBoise, Idaho  83712
Rush - Copley Medical CenterAurora, Illinois  60504
John H Stroger Jr Hospital of Cook CountyChicago, Illinois  60612-3785
Resurrection HealthcareChicago, Illinois  60631
Evanston CCOP-NorthShore University HealthSystemEvanston, Illinois  60201
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
Hematology Oncology Consultants LimitedNaperville, Illinois  60540
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
West Suburban Cancer CenterRiver Forest, Illinois  60305
Hematology Oncology Associates of Illinois - SkokieSkokie, Illinois  60076
Saint Margaret's HospitalSpring Valley, Illinois  61362
Carle Clinic-Urbana MainUrbana, Illinois  61801
Fort Wayne Medical Oncology and Hematology Inc - State BoulevardFort Wayne, Indiana  46845
Wishard HospitalIndianapolis, Indiana  46202
Saint Vincent Hospital and Health ServicesIndianapolis, Indiana  46260
Saint Anthony Memorial Health CenterMichigan City, Indiana  46360
McFarland ClinicAmes, Iowa  50010
Constantinou, Costas L MD (UIA Investigator)Bettendorf, Iowa  52722
Cedar Rapids Oncology AssociationCedar Rapids, Iowa  52403
Mercy HospitalCedar Rapids, Iowa  52403
Medical Oncology and Hematology Associates-West Des MoinesClive, Iowa  50325
Iowa Oncology Research Association CCOPDes Moines, Iowa  50309
Mercy CapitolDes Moines, Iowa  50307
Mercy Medical Center - Des MoinesDes Moines, Iowa  50314
Medical Oncology and Hematology Associates-Des MoinesDes Moines, Iowa  50309
Mercy Medical Center - North IowaMason City, Iowa  50401
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
Cancer Center of Kansas-Wichita Medical Arts TowerWichita, Kansas  67208
Cancer Center of Kansas - Main OfficeWichita, Kansas  67214
Our Lady Bellefonte HospitalAshland, Kentucky  41101
Louisiana State University Sciences Center- MonroeMonroe, Louisiana  71210
Medical Center of LouisianaNew Orleans, Louisiana  70112
Highland ClinicShreveport, Louisiana  71105
Holy Family HospitalMethuen, Massachusetts  01844
Berkshire Hematology Oncology PCPittsfield, Massachusetts  01201
Michigan Cancer Research Consortium Community Clinical Oncology ProgramAnn Arbor, Michigan  48106
Oakwood HospitalDearborn, Michigan  48123
Saint John Hospital and Medical CenterDetroit, Michigan  48236
Green Bay Oncology - EscanabaEscanaba, Michigan  49431
Grand Rapids Clinical Oncology ProgramGrand Rapids, Michigan  49503
Saint Mary's Health CareGrand Rapids, Michigan  49503
Spectrum Health at Butterworth CampusGrand Rapids, Michigan  49503
Green Bay Oncology - Iron MountainIron Mountain, Michigan  49801
Allegiance HealthJackson, Michigan  49201
Sparrow HospitalLansing, Michigan  48912
Saint Mary Mercy HospitalLivonia, Michigan  48154
Mercy Health Partners-Mercy CampusMuskegon, Michigan  49443
Mercy Health Partners-Hackley CampusMuskegon, Michigan  49442
Saint Joseph Mercy OaklandPontiac, Michigan  48341-2985
Saint Joseph Mercy Port HuronPort Huron, Michigan  48060
Saint Mary's of MichiganSaginaw, Michigan  48601
Lakeland HospitalSt. Joseph, Michigan  49085
Saint John Macomb-Oakland HospitalWarren, Michigan  48093
Medini, Eitan MD (UIA Investigator)Alexandria, Minnesota  56308
Miller-Dwan HospitalDuluth, Minnesota  55805
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
Southeast Missouri HospitalCape Girardeau, Missouri  63701
Saint Luke's Cancer InstituteKansas City, Missouri  64111
Saint Luke's Hospital of Kansas CityKansas City, Missouri  64111
Saint Joseph Health CenterKansas City, Missouri  64114
Liberty Radiation Oncology ClinicKansas City, Missouri  64116
Truman Medical CenterKansas City, Missouri  64108
Missouri Baptist Medical CenterSaint Louis, Missouri  63131
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
Veterans Adminstration New Jersey Health Care SystemEast Orange, New Jersey  07018-1095
Memorial Medical Center - Las CrucesLas Cruces, New Mexico  88011
Veterans Affairs Western New York Health Care System-BuffaloBuffalo, New York  14215
Orange Regional Medical CenterMiddletown, New York  10940
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
Samaritan North Health CenterDayton, Ohio  45415
Veteran Affairs Medical CenterDayton, Ohio  45428
Saint Rita's Medical CenterLima, Ohio  45801
Marietta Memorial HospitalMarietta, Ohio  45750
Upper Valley Medical CenterTroy, Ohio  45373
Saint Ann's HospitalWesterville, Ohio  43081
Genesis HealthCare SystemZanesville, Ohio  43701
Salem HospitalSalem, Oregon  97309
Saint Luke's HospitalBethlehem, Pennsylvania  18015
Pocono Medical CenterEast Stroudsburg, Pennsylvania  18301
Riddle HospitalMedia, Pennsylvania  19063
Saint Joseph Medical CenterReading, Pennsylvania  19605
Hematology and Oncology Associates of North East PennsylvaniaScranton, Pennsylvania  18508
Scranton Hematology OncologyScranton, Pennsylvania  18510
Mercy HospitalScranton, Pennsylvania  18501
Associates In Hematology Oncology PC-UplandUpland, Pennsylvania  19013
Geisinger Wyoming ValleyWilkes-Barre, Pennsylvania  18711
Greenville Memorial HospitalGreenville, South Carolina  29605
Sanford Cancer Center-Oncology ClinicSioux Falls, South Dakota  57104
Veterans Administration Medical CenterHouston, Texas  77030
Saint Luke's Episcopal HospitalHouston, Texas  77030
Audie L Murphy Veterans Affairs HospitalSan Antonio, Texas  78209
University HospitalSan Antonio, Texas  78229
Saint Francis HospitalFederal Way, Washington  98003
Evergreen Hospital Medical CenterKirkland, Washington  98033
Swedish Medical Center-First HillSeattle, Washington  98122-4307
Edwards Comprehensive Cancer CenterHuntington, West Virginia  25701
West Virginia UniversityMorgantown, West Virginia  26506
Langlade Hospital and Cancer CenterAntigo, Wisconsin  54409
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
Aurora BayCare Medical CenterGreen Bay, Wisconsin  54311-6519
Vince Lombardi Cancer Clinic-MarinetteMarinette, Wisconsin  54143
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
Aspirus Regional Cancer CenterWausau, Wisconsin  54401
Lake University Ireland Cancer CenterMentor, Ohio  44060
Jupiter Medical CenterJupiter, Florida  33458
Gainesville Hematology Oncology AssociatesGainesville, Florida  32605
University of IllinoisChicago, Illinois  60612
Elkhart ClinicElkhart, Indiana  46515
Memorial Healthcare System - Joe DiMaggio Children's HospitalHollywood, Florida  33021
Mount Sinai Medical Center CCOPMiami Beach, Florida  33140
Harbin Clinic Medical Oncology and Clinical ResearchRome, Georgia  30165
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
Michiana Hematology Oncology PC-NilesNiles, Michigan  49120
Central Care Cancer Center-Carrie J Babb Cancer CenterBolivar, Missouri  65613
Skaggs Cancer CenterBranson, Missouri  65616
University of Missouri - Ellis FischelColumbia, Missouri  65203
Veterans AdministrationColumbia, Missouri  65201
Renown Regional Medical CenterReno, Nevada  89502
Hackensack University Medical CCOPHackensack, New Jersey  07601
UMDNJ - New Jersey Medical SchoolNewark, New Jersey  07103
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
Vanderbilt-Ingram Cancer Center Cool SpringsFranklin, Tennessee  37067
University of Tennessee - KnoxvilleKnoxville, Tennessee  37920
Nashville Oncology Associates PCNashville, Tennessee  37203
Sandra L Maxwell Cancer CenterCedar City, Utah  84720
Intermountain Medical CenterMurray, Utah  84157
Utah Valley Regional Medical CenterProvo, Utah  84603
Dixie Medical Center Regional Cancer CenterSaint George, Utah  84770
Utah Cancer Specialists-Salt Lake CitySalt Lake City, Utah  84106
West Virginia University CharlestonCharleston, West Virginia  25304
Marshfield Clinic-Chippewa CenterChippewa Falls, Wisconsin  54729
Holy Family Memorial HospitalManitowoc, Wisconsin  54221
Wheaton Franciscan Cancer Care - All SaintsRacine, Wisconsin  53405
Vince Lombardi Cancer Clinic-SheboyganSheboygan, Wisconsin  53081
Marshfield Clinic Cancer Care at Saint Michael's HospitalStevens Point, Wisconsin  54481
Aurora Medical Center in SummitSummit, Wisconsin  53066
Vince Lombardi Cancer ClinicTwo Rivers, Wisconsin  54241
Riverview HospitalWisconsin Rapids, Wisconsin  54494
VA Pittsburgh Healthcare SystemPittsburgh, Pennsylvania  15240
State University of New York Downstate Medical CenterBrooklyn, New York  11203
Texas Tech University Health Sciences CenterLubbock, Texas  79430
Kaiser Permanente Los Angeles Medical CenterLos Angeles, California  90027
University of Miami Miller School of Medicine-Sylvester Cancer CenterMiami, Florida  33136
Saint Luke's Mountain States Tumor Institute - FruitlandFruitland, Idaho  83619
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
Epic Care-OaklandOakland, California  94612
Kaiser Permanente - Panorama CityPanorama City, California  91402
Kaiser Permanente at San DiegoSan Diego, California  92120
Kaiser Permanente Health CareSan Marcos, California  92069
Kaiser Permanente-Rock CreekLafayette, Colorado  80026
Saint Luke's Mountain States Tumor Institute - MeridianMeridian, Idaho  83642
Saint Luke's Mountain States Tumor Institute - NampaNampa, Idaho  83686
Hinsdale Hematology Oncology Associates IncorporatedHinsdale, Illinois  60521
Spector, David MD (UIA Investigator)Moline, Illinois  61265
Saint Luke's South HospitalOverland Park, Kansas  66213
Kansas City CCOPPrairie Village, Kansas  66208
Hematology and Oncology ClinicBaton Rouge, Louisiana  70809
Spectrum Health Reed City HospitalReed City, Michigan  49677
Capital Region Medical Center-Goldschmidt Cancer CenterJefferson City, Missouri  65109
Heartland Hematology and Oncology Associates IncorporatedKansas City, Missouri  64118
Saint John's Clinic-Rolla-Cancer and HematologyRolla, Missouri  65401
Saint Joseph Oncology IncSaint Joseph, Missouri  64507
Comprehensive Cancer Care PCSaint Louis, Missouri  63141
Veteran Affairs New York Harbor Healthcare System-Brooklyn CampusBrooklyn, New York  11209
Kings County HospitalBrooklyn, New York  11203
The Mark H Zangmeister CenterColumbus, Ohio  43219
UHHS-Chagrin Highlands Medical CenterOrange Village, Ohio  44122
Southern Ohio Medical CenterPortsmouth, Ohio  45662
UHHS-Westlake Medical CenterWestlake, Ohio  44145
Susquehanna Cancer CenterWilliamsport, Pennsylvania  17701
Pacific Medical Center-First HillSeattle, Washington  98104
Gundersen LutheranLa Crosse, Wisconsin  54601
Saint Nicholas HospitalMadison, Wisconsin  53715
Columbia Saint Mary's Water Tower Medical CommonsMilwaukee, Wisconsin  53211
Fairbanks Memorial HospitalFairbanks, Alaska  99701
Alegent Health Lakeside HospitalOmaha, Nebraska  68130
Southlake ClinicRenton, Washington  98055
Stanford University Hospitals and ClinicsStanford, California  94305
Kaiser Permanente-FranklinDenver, Colorado  80205
Siouxland Hematology Oncology AssociatesSioux City, Iowa  51101
Space Coast Cancer Centers-TitusvilleTitusville, Florida  32796
Gulfport Memorial HospitalGulfport, Mississippi  39502
INTEGRIS Cancer Institute of OklahomaOklahoma City, Oklahoma  73142
Roger Williams HospitalProvidence, Rhode Island  02908
Swedish Cancer Institute-IssaquahIssaquah, Washington  98029
IU Health ArnettLafayette, Indiana  
Alta Bates Summit Medical Center-Herrick CampusBerkeley, California  94704
Boca Raton Regional HospitalBoca Raton, Florida  33486
Carle Foundation - Carle Cancer CenterUrbana, Illinois  61801
Michiana Hematology Oncology PC-MishawakaMishawaka, Indiana  46545-1470
Oncology Associates at Mercy Medical CenterCedar Rapids, Iowa  52403
Marie Yeager Cancer CenterSaint Joseph, Michigan  49085
Hematology Oncology Associates of Central New York PCEast Syracuse, New York  13057
Summa Akron City HospitalAkron, Ohio  44304
Sanford USD Medical Center - Sioux FallsSioux Falls, South Dakota  57117-5134
Genesys Regional Medical Center-West Flint CampusFlint, Michigan  48532
Essentia Health Saint Joseph's Medical CenterBrainerd, Minnesota  56401
Essentia Health Duluth Clinic CCOPDuluth, Minnesota  55805
Essentia Health Saint Mary's Medical CenterDuluth, Minnesota  55805
Sanford Bismarck Medical CenterBismarck, North Dakota  58501
Geisinger Medical Center-Cancer Center HazeltonHazleton, Pennsylvania  18201
Veterans Administration-San Diego Medical CenterSan Diego, California  92161
Community Howard Regional HealthKokomo, Indiana  46904
Indiana University Health La Porte HospitalLa Porte, Indiana  46350
Saint Joseph Regional Medical Center-MishawakaMishawaka, Indiana  46545-1470
Christiana Care Health System-Christiana HospitalNewark, Delaware  19718
Illinois Cancer Specialists-NilesNiles, Illinois  60714
Bronson Battle CreekBattle Creek, Michigan  49017
Springfield Regional Medical CenterSpringfield, Ohio  45505
Guthrie Clinic-Robert Packer HospitalSayre, Pennsylvania  18840
Self Regional HealthcareGreenwood, South Carolina  29646
Aurora Cancer Care-Southern LakesElkhorn, Wisconsin  53121
IU Health Ball Memorial HospitalMuncie, Indiana  47303
Sutter Pacific Medical FoundationSanta Rosa, California  95403
Saint Luke's Mountain States Tumor Institute-Twin FallsTwin Falls, Idaho  83301
Ireland Cancer Center at Firelands Regional Medical CenterSandusky, Ohio  44870