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Endocrine Therapy With or Without Anti-VEGF Therapy: A Randomized, Phase III Trial of Endocrine Therapy Alone or Endocrine Therapy Plus Bevacizumab (NSC 704865; IND 7921) for Women With Hormone Receptor-Positive Advanced Breast Cancer


Phase 3
18 Years
N/A
Open (Enrolling)
Female
Recurrent Breast Cancer, Stage IIIB Breast Cancer, Stage IV Breast Cancer

Thank you

Trial Information

Endocrine Therapy With or Without Anti-VEGF Therapy: A Randomized, Phase III Trial of Endocrine Therapy Alone or Endocrine Therapy Plus Bevacizumab (NSC 704865; IND 7921) for Women With Hormone Receptor-Positive Advanced Breast Cancer


PRIMARY OBJECTIVES:

I. To compare the progression-free survival of women with estrogen- and/or
progesterone-receptor-positive stage IIIB-IV breast cancer treated with letrozole with vs
without bevacizumab as first-line treatment.

SECONDARY OBJECTIVES:

I. To compare the proportion of patients receiving letrozole with or without bevacizumab who
remain progression-free at 6 and 12 months.

II. To compare the incidence of objective response (complete response [CR] + partial
response [PR]) in patients receiving letrozole with or without bevacizumab, as determined by
RECIST criteria, excluding patients with non-measurable disease.

III. To compare the incidence of clinical benefit (CR + PR + stable disease >= 6 months) in
patients receiving letrozole with or without bevacizumab.

IV. To compare the duration of objective response in patients receiving letrozole with or
without bevacizumab.

V. To compare the time to treatment failure, defined as the interval from randomization
until progression, toxicity, withdrawn consent, or going onto non protocol therapy, in
patients receiving letrozole with or without bevacizumab.

VI. To compare the overall survival of patients receiving letrozole with or without
bevacizumab, including the probability of survival until 36 months.

V. To compare toxicity levels of bevacizumab in both the letrozole-treated patients and in
the tamoxifen-treated* patients.

VI. To compare progression-free survival and overall survival of all patients receiving
endocrine therapy with and without bevacizumab (by combining both letrozole and tamoxifen*
patient subgroups). NOTE: *As of 5/15/2011, patients only receive letrozole.

OUTLINE: This is a multicenter study. Patients are stratified according to planned endocrine
therapy* (letrozole vs tamoxifen*), disease measurability (no vs yes), and disease-free
interval from initial diagnosis to first progression (≤ 24 months vs > 24 months). Patients
are randomized to 1 of 2 treatment arms.

NOTE: The placebo-controlled portion of the study was canceled on 5-15-10

ARM I: Patients receive oral endocrine therapy* (tamoxifen citrate or letrozole) once daily
on days 1-21 and bevacizumab IV on day 1. Treatment repeats every 21 days in the absence of
disease progression or unacceptable toxicity.

ARM II: Patients receive oral endocrine therapy* (tamoxifen citrate or letrozole) once daily
on days 1-21. Treatment repeats every 21 days in the absence of disease progression or
unacceptable toxicity.

After completion of study therapy, patients are followed up every 6 months for the first 2
years and then annually for up to 3 years.

NOTE: As of 5/15/2011, patients only receive letrozole.


Inclusion Criteria:



- Histologic confirmation of invasive cancer of the female breast in either the primary
or metastatic setting

- Stage IIIB disease not amenable to local therapy or stage IV disease

- Must have measurable or nonmeasurable disease by RECIST criteria, with radiologic
scans (CT scan of the chest/abdomen)

- Measurable disease is defined as lesions that can be accurately measured in at
least one dimension (longest diameter to be recorded) as ≥ 2.0 cm with
conventional techniques or as ≥ 1.0 cm with spiral CT scan

- Nonmeasurable disease is defined as all other lesions, including small lesions
(longest diameter < 2.0 cm with conventional techniques or < 1.0 cm with spiral
CT scan) and truly nonmeasurable lesions, including any of the following:

- Bone lesions

- Leptomeningeal disease

- Ascites

- Pleural/pericardial effusion

- Inflammatory breast disease

- Abdominal masses that are not confirmed and followed by imaging techniques

- Cystic lesions

- Baseline bone scans required for all patients for determination of metastatic bone
disease

- CT scan with bone windows required only for patients with bone metastases as the
only site of disease

- No known CNS metastases or leptomeningeal disease(screening with brain imaging is not
required for asymptomatic patients)

- Hormone receptor status: tumors (from either primary or metastatic sites) must
express estrogen receptor (ER)and/or progesterone receptor (PgR) in ≥ 1% of cells

- Menopausal status: pre- or postmenopausal, meeting 1 of the following criteria:

- Age ≥ 55 years and one year or more of amenorrhea

- Age < 55 years and one year or more of amenorrhea, with an estradiol assay <
20pg/ml

- Age < 55 with prior hysterectomy but intact ovaries, with an estradiol assay <
20 pg/ml

- Surgical menopause with bilateral oophorectomy

- Ovarian suppression on a luteinizing hormone-releasing hormone agonist
(goserelin acetate or leuprolide acetate)

- Premenopausal women must undergo ovarian suppression prior to beginning
protocol therapy

- Ovarian radiation is not permitted for induction of ovarian
suppression

- ECOG (Zubrod) performance status 0-1

- Life expectancy ≥ 12 weeks

- Granulocytes ≥ 1,000/μl

- Platelet count ≥ 100,000/μl

- Creatinine ≤ 2.0 mg/dL

- Bilirubin ≤ 1.5 times upper limit of normal (ULN) unless due to Gilbert's syndrome

- Transaminases (ALT, AST) ≤ 2.5 times ULN

- INR ≤ 1.6 unless on full dose warfarin

- Urinalysis ≤ 1+ protein

- Proteinuria ≥ 2 + at baseline must demonstrate < 1 g of protein/24 hr or
protein:creatinine ratio < 1 on 24-hoururine collection

- No "currently active" second malignancy other than nonmelanoma skin cancers

- Patients are not considered to have a "currently active" malignancy if they have
completed therapy and are considered by their physician to be at less than 30%
risk of relapse

- Taxane-related neurotoxicity must have resolved to sensory grade < 2

- No motor neuropathy of any grade

- No significant traumatic injury within 28 days prior to study registration

- No history of abdominal fistula, or intra-abdominal abscess within the past 6 months

- No history of GI perforation within the past 12 months

- No history of significant bleeding episodes (e.g., hemoptysis, upper or lower GI
bleeding) within the past 6 months

- No clinically significant cardiovascular disease, including any of the following:

- Uncontrolled hypertension, defined as systolic blood pressure (BP) > 150 mm Hg
and/or diastolic BP > 90 mm Hg on antihypertensive medications

- Prior history of hypertensive crisis or hypertensive encephalopathy

- Myocardial infarction or unstable angina within past 6 months

- New York Heart Association class II-IV congestive heart failure

- Symptomatic peripheral vascular disease

- Significant vascular disease (e.g., aortic aneurysm, aortic dissection)

- Significant arterial thrombotic events

- No history of stroke or transient ischemic attack within the past 6 months

- History of seizures must be well controlled with standard medication

- No known allergies to imidazole drugs, (e.g., clotrimazole, ketoconazole, miconazole,
econazole, sulconazole, ticonazole, or terconazole) or compounds structurally similar
to bevacizumab (for patients treated with aromatase inhibitors)

- No known allergies to selective estrogen receptor modulators (e.g., tamoxifen,
raloxifene, or toremifene) or compounds structurally similar to bevacizumab (for
patients treated with tamoxifen) NOTE: As of 5/15/2011, patients only receive
letrozole.

- No serious, non-healing wound, ulcer, or bone fracture

- Not pregnant or nursing

- Negative pregnancy test

- No prior endocrine therapy in the metastatic setting unless tamoxifen or an aromatase
inhibitor was initiated within 4 weeks prior to registration

- If prior endocrine therapy was initiated within the past 4 weeks, the patients
should remain on that chosen hormonal therapy (tamoxifen or aromatase inhibitor)
as the study therapy. NOTE: As of 5/15/2011, patients only receive letrozole.

- Patients who began therapy with tamoxifen (after 5/15/2011), anastrozole or
exemestane must switch to letrozole

- Prior endocrine therapy in the adjuvant setting allowed

- Prior treatment with ovarian suppression is allowed in either the adjuvant or
metastatic setting

- If medical ovarian suppression is being administered it can be initiated any
time prior to or at the start of protocol therapy, and continued throughout the
duration of the trial

- At least 28 days since surgical castration with bilateral oophorectomy

- At least 2 weeks since prior radiotherapy and all toxicities resolved

- At least 12 months since the completion of prior adjuvant or neoadjuvant chemotherapy
and all toxicities must have resolved

- No prior anti-VEGF or VEGFR tyrosine kinase inhibitor therapy

- May have received 1 prior chemotherapy regimen for metastatic disease

- More than 28 days since prior major surgical procedure or open biopsy and fully
recovered from any such procedure

- No core biopsy or other minor surgical procedure (except placement of a vascular
access device) within 7 days prior to study registration

- Prior palliative irradiation of a symptomatic lesion, or one that may produce
disability (e.g., unstable femur) prior to study initiation, provided other
measurable or non-measurable disease is present, is allowed

- Palliative radiotherapy may not be administered during protocol therapy

- Must not have anticipation of need for major surgical procedure during the course of
the study

- Concurrent full-dose anticoagulation therapy is allowed for the treatment of prior
conditions such as venous thromboses or atrial fibrillation, but not for the
treatment of prior arterial thrombotic events

- Patients on full-dose anticoagulants must be on a stable dose of warfarin and
have an in-range INR (usually between 2 and 3) or be on a stable dose flow
molecular weight heparin

- Concurrent antiplatelet agents, daily prophylactic aspirin, or anticoagulation for
atrial fibrillation allowed

- Concurrent treatment with bisphosphonates is allowed and recommended

- No concurrent hormones or other chemotherapeutic agents except for steroids given for
adrenal failure or chronic non-cancer related diseases, hormones administered for
non-disease-related conditions (e.g., insulin for diabetes), and intermittent use of
dexamethasone as an antiemetic in solid tumor protocols

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Progression-free survival

Outcome Time Frame:

From randomization until disease progression or death, assessed up to 3 years

Safety Issue:

No

Principal Investigator

Maura Dickler

Investigator Role:

Principal Investigator

Investigator Affiliation:

Cancer and Leukemia Group B

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2009-00477

NCT ID:

NCT00601900

Start Date:

May 2008

Completion Date:

Related Keywords:

  • Recurrent Breast Cancer
  • Stage IIIB Breast Cancer
  • Stage IV Breast Cancer
  • Breast Neoplasms

Name

Location

Albert Einstein College of MedicineBronx, New York  10461
Memorial Sloan Kettering Cancer CenterNew York, New York  10021
University of Iowa Hospitals and ClinicsIowa City, Iowa  52242
University of Mississippi Medical CenterJackson, Mississippi  39216-4505
Washington University School of MedicineSaint Louis, Missouri  63110
Abington Memorial HospitalAbington, Pennsylvania  19001
Hurley Medical CenterFlint, Michigan  48503
Sinai Hospital of BaltimoreBaltimore, Maryland  21225
Beth Israel Deaconess Medical CenterBoston, Massachusetts  02215
Boulder Community HospitalBoulder, Colorado  80301-9019
Porter Adventist HospitalDenver, Colorado  80210
Rose Medical CenterDenver, Colorado  80220
Swedish Medical CenterEnglewood, Colorado  80110
Sky Ridge Medical CenterLone Tree, Colorado  80124
North Suburban Medical CenterThornton, Colorado  80229
Bronson Methodist HospitalKalamazoo, Michigan  49007
West Michigan Cancer CenterKalamazoo, Michigan  49007-3731
Borgess Medical CenterKalamazooaa, Michigan  49001
Avera Cancer InstituteSioux Falls, South Dakota  57105
CentraCare ClinicSaint Cloud, Minnesota  56303
Rapid City Regional HospitalRapid City, South Dakota  57709
Morristown Memorial HospitalMorristown, New Jersey  07962-1956
Marshfield ClinicMarshfield, Wisconsin  54449
Sutter Health Western Division Cancer Research GroupGreenbrae, California  94904
Ingalls Memorial HospitalHarvey, Illinois  60426
Methodist Medical Center of IllinoisPeoria, Illinois  61636
Memorial Hospital of South BendSouth Bend, Indiana  46601
Mary Bird Perkins Cancer CenterBaton Rouge, Louisiana  70809
Cape Cod HospitalHyannis, Massachusetts  02601
Marquette General HospitalMarquette, Michigan  49855
Newark Beth Israel Medical CenterNewark, New Jersey  07112
Beth Israel Medical CenterNew York, New York  10003
Lehigh Valley HospitalAllentown, Pennsylvania  18103
Reading Hospital and Medical CenterReading, Pennsylvania  19612-6052
Grand View HospitalSellersville, Pennsylvania  18960
Waukesha Memorial HospitalWaukesha, Wisconsin  53188
Dana-Farber Cancer InstituteBoston, Massachusetts  02115
University of Kansas Medical CenterKansas City, Kansas  66160-7353
Hartford HospitalHartford, Connecticut  06102-5037
Illinois Masonic Medical CenterChicago, Illinois  60657
Eastern Maine Medical CenterBangor, Maine  04401
Staten Island University HospitalStaten Island, New York  10305
University of Nebraska Medical CenterOmaha, Nebraska  68198-3330
Ochsner Clinic FoundationNew Orleans, Louisiana  70121
Carolinas Medical CenterCharlotte, North Carolina  28232-2861
Iowa Methodist Medical CenterDes Moines, Iowa  50309
Iowa Lutheran HospitalDes Moines, Iowa  50316-2301
Elmhurst Hospital CenterElmhurst, New York  11373
Weill Medical College of Cornell UniversityNew York, New York  10021
Medical Center of Central GeorgiaMacon, Georgia  31201
Bellin Memorial HospitalGreen Bay, Wisconsin  54301
Great Falls ClinicGreat Falls, Montana  59405
Overlook HospitalSummit, New Jersey  07902-0220
MetroHealth Medical CenterCleveland, Ohio  44109
Trinity Cancer Care CenterMinot, North Dakota  58701
Montefiore Medical CenterBronx, New York  10467-2490
Chester County HospitalWest Chester, Pennsylvania  19380
Sibley Memorial HospitalWashington, District of Columbia  20016
North Colorado Medical CenterGreeley, Colorado  80631
McKee Medical CenterLoveland, Colorado  80539
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
Adena Regional Medical CenterChillicothe, Ohio  54601
Grady Memorial HospitalDelaware, Ohio  43015
Fairfield Medical CenterLancaster, Ohio  43130
Avera McKennan Hospital and University Health CenterSioux Falls, South Dakota  57105
Medical X-Ray CenterSioux Falls, South Dakota  57105
Welch Cancer CenterSheridan, Wyoming  82801
Brigham and Women's HospitalBoston, Massachusetts  02115
Mercy Health SystemJanesville, Wisconsin  53545
Elkhart General HospitalElkhart, Indiana  46515
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
Alta Bates Summit Medical Center - Summit CampusOakland, California  94609
Sutter Solano Medical CenterVallejo, California  94589
Poudre Valley HospitalFort Collins, Colorado  80524
Beebe Medical CenterLewes, Delaware  19958
Saint Joseph's Hospital of AtlantaAtlanta, Georgia  30342-1701
Piedmont HospitalAtlanta, Georgia  30309
Gwinnett Medical CenterLawrenceville, Georgia  30045
Southern Regional Medical CenterRiverdale, Georgia  30274-2600
Memorial HospitalCarthage, Illinois  62321
Mercy Hospital and Medical CenterChicago, Illinois  60616
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
Bay Regional Medical CenterBay City, Michigan  48708
Great Plains Regional Medical CenterNorth Platte, Nebraska  69101-6598
Creighton University Medical CenterOmaha, Nebraska  68131-2197
Bismarck Cancer CenterBismarck, North Dakota  58501
Providence Milwaukie HospitalMilwaukie, Oregon  97222
Doctor's Hospital of LaredoLaredo, Texas  78041
Danville Regional Medical CenterDanville, Virginia  24541
Exempla Lutheran Medical CenterWheat Ridge, Colorado  80033
Eureka HospitalEureka, Illinois  61530
Graham Hospital AssociationCanton, Illinois  61520
Holy Family Medical CenterDes Plaines, Illinois  60016
Saint Joseph Medical CenterJoliet, Illinois  60435
Trinity Medical CenterMoline, Illinois  61265-1291
Medical Oncology and Hematology AssociatesDes Moines, Iowa  50309
Saint Joseph Mercy HospitalAnn Arbor, Michigan  48106
Rice Memorial HospitalWillmar, Minnesota  56201
Altru Cancer CenterGrand Forks, North Dakota  58206
Highland General HospitalOakland, California  94602
Pomona Valley Hospital Medical CenterPomona, California  91767
Northeast Georgia Medical CenterGainesville, Georgia  30501
Randolph HospitalAsheboro, North Carolina  27203
Spartanburg Regional Medical CenterSpartanburg, South Carolina  29303
Bozeman Deaconess Cancer CenterBozeman, Montana  59715
Northern Montana HospitalHavre, Montana  59501
Mary Rutan HospitalBellefontaine, Ohio  43311
Knox Community HospitalMount Vernon, Ohio  43050
Adventist Medical CenterPortland, Oregon  97216
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
Singing River HospitalPascagoula, Mississippi  39581
Greater Baltimore Medical CenterBaltimore, Maryland  21204
Lowell General HospitalLowell, Massachusetts  01854
Rutherford HospitalRutherfordton, North Carolina  28139
AnMed Health Cancer CenterAnderson, South Carolina  29621
Harold Alfond Center for Cancer CareAugusta, Maine  04330
Union Hospital of Cecil CountyElkton MD, Maryland  21921
Memorial Medical CenterSpringfield, Illinois  62781
Phelps County Regional Medical CenterRolla, Missouri  65401
Saint Francis Medical CenterGrand Island, Nebraska  68802
Doylestown HospitalDoylestown, Pennsylvania  18901
McLeod Regional Medical CenterFlorence, South Carolina  29501
Guardian Oncology and Center for WellnessMissoula, Montana  59804
University of PittsburghPittsburgh, Pennsylvania  15261
Newton-Wellesley HospitalNewton, Massachusetts  02462
Providence HospitalMobile, Alabama  36608
University of North CarolinaChapel Hill, North Carolina  27599
East Bay Radiation Oncology CenterCastro Valley, California  94546
Contra Costa Regional Medical CenterMartinez, California  94553-3156
Larry G Strieff MD Medical CorporationOakland, California  94609
Tahoe Forest Cancer CenterTruckee, California  96161
Elmhurst Memorial HospitalElmhurst, Illinois  60126
Queens Hospital CenterJamaica, New York  11432
Holy Cross HospitalFort Lauderdale, Florida  33308
El Camino HospitalMountain View, California  94040
Yale UniversityNew Haven, Connecticut  06520
Wayne State UniversityDetroit, Michigan  48202
New Hampshire Oncology-Hematology PAHooksett, New Hampshire  03106
Riverside Methodist HospitalColumbus, Ohio  43214
Licking Memorial HospitalNewark, Ohio  43055-2899
Providence Portland Medical CenterPortland, Oregon  97213-3635
California Pacific Medical CenterSan Francisco, California  94115
Dartmouth Hitchcock Medical CenterLebanon, New Hampshire  03756
Mid Dakota ClinicBismarck, North Dakota  58501
Columbus CCOPColumbus, Ohio  43206
Presbyterian - Saint Lukes Medical Center - Health OneDenver, Colorado  80218
Montana Cancer Consortium CCOPBillings, Montana  59101
Alegent Health Immanuel Medical CenterOmaha, Nebraska  68122
Alegent Health Bergan Mercy Medical CenterOmaha, Nebraska  68124
Mount Sinai Hospital Medical CenterChicago, Illinois  60608
UC Davis Comprehensive Cancer CenterSacramento, California  95817
Providence HospitalSouthfield, Michigan  48075
Decatur Memorial HospitalDecatur, Illinois  62526
Tulane University Health Sciences CenterNew Orleans, Louisiana  70112
Kaiser PermanentePortland, Oregon  97227
Frederick Memorial HospitalFrederick, Maryland  21701
CentraState Medical CenterFreehold, New Jersey  07728
Holy Cross HospitalSilver Spring, Maryland  20910
Montana Cancer SpecialistsMissoula, Montana  59807-7877
Providence Saint Joseph Medical CenterBurbank, California  91505-4866
University of Chicago Comprehensive Cancer CenterChicago, Illinois  60637-1470
University of Southern CaliforniaLos Angeles, California  90033
DeKalb Medical CenterDecatur, Georgia  30033
Northern Indiana Cancer Research ConsortiumSouth Bend, Indiana  
Rockwood ClinicSpokane, Washington  99220
Vince Lombardi Cancer Clinic - OshkoshOshkosh, Wisconsin  54904
Piedmont Fayette HospitalFayetteville, Georgia  30214
Hays Medical CenterHays, Kansas  67601
Southeast Cancer CenterCape Girardeau, Missouri  63703
Clackamas Radiation Oncology CenterClackamas, Oregon  97015
Providence Newberg Medical CenterNewberg, Oregon  97132
Littleton Adventist HospitalLittleton, Colorado  80122
Froedtert and the Medical College of WisconsinMilwaukee, Wisconsin  53226
Wake Forest University Health SciencesWinston-Salem, North Carolina  27157
OSF Saint Francis Medical CenterPeoria, Illinois  61637
Northside HospitalAtlanta, Georgia  30342
Saint Helena HospitalSaint Helena, California  94574
Mills - Peninsula HospitalsBurlingame, California  94010
Valley Medical Oncology Consultants-Castro ValleyCastro Valley, California  94546
Eden Hospital Medical CenterCastro Valley, California  94546
Northbay Cancer CenterFairfield, California  94533
Valley Medical Oncology Consultants-FremontFremont, California  94538
California Cancer Center - North FresnoFresno, California  93720
Fremont - Rideout Cancer CenterMarysville, California  95901
Bay Area Breast Surgeons IncOakland, California  94609
Bay Area Tumor Institution CCOPOakland, California  94609
Tom K Lee IncOakland, California  94609
Valley Medical Oncology ConsultantsPleasanton, California  94588
Valley Care Health System - PleasantonPleasanton, California  94588
University of California San Francisco Medical Center-Mount ZionSan Francisco, California  94115
Doctors Medical Center- JC Robinson Regional Cancer CenterSan Pablo, California  94806
The Medical Center of AuroraAurora, Colorado  80012
Penrose-Saint Francis HealthcareColorado Springs, Colorado  80907
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
Middlesex HospitalMiddletown, Connecticut  06457
The Hospital of Central ConnecticutNew Britain, Connecticut  06050
Stamford HospitalStamford, Connecticut  06904
Atlanta Regional CCOPAtlanta, Georgia  30342
Well Star Cobb HospitalAustell, Georgia  30106
John B Amos Cancer CenterColumbus, Georgia  31904
Wellstar Kennestone HospitalMarietta, Georgia  30060
Rush - Copley Medical CenterAurora, Illinois  60504
John H Stroger Jr Hospital of Cook CountyChicago, Illinois  60612-3785
Resurrection HealthcareChicago, Illinois  60631
Cancer Institute at Alexian BrothersElk Grove Village, Illinois  60007
Joliet Oncology-Hematology Associates LimitedJoliet, Illinois  60435
Provena Saint Mary's HospitalKankakee, Illinois  60901
Stoffel, Thomas J MD (UIA Investigator)Moline, Illinois  61265
Garneau, Stewart C MD (UIA Investigator)Moline, Illinois  61265
Sharis, Christine M 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
Carle Clinic-Urbana MainUrbana, Illinois  61801
Fort Wayne Medical Oncology and Hematology Inc - State BoulevardFort Wayne, Indiana  46845
Saint Vincent Hospital and Health ServicesIndianapolis, Indiana  46260
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
Medical Oncology and Hematology Associates-West Des MoinesClive, Iowa  50325
Iowa Oncology Research Association CCOPDes Moines, Iowa  50309
Mercy CapitolDes Moines, Iowa  50307
Mercy Medical Center - Des MoinesDes Moines, Iowa  50314
Medical Oncology and Hematology Associates-Des MoinesDes Moines, Iowa  50309
Mercy Medical Center-Sioux CitySioux City, Iowa  51104
Saint Luke's Regional Medical CenterSioux City, Iowa  51104
Stormont-Vail Regional Health CenterTopeka, Kansas  66604
Saint Francis Hospital and Medical Center - TopekaTopeka, Kansas  66606
Our Lady Bellefonte HospitalAshland, Kentucky  41101
Ochsner Clinic Foundation-Baton RougeBaton Rouge, Louisiana  70809
Ochsner Clinic CCOPNew Orleans, Louisiana  70121
Holy Family HospitalMethuen, Massachusetts  01844
Michigan Cancer Research Consortium Community Clinical Oncology ProgramAnn Arbor, Michigan  48106
Oakwood HospitalDearborn, Michigan  48123
Saint John Hospital and Medical CenterDetroit, Michigan  48236
Michigan State University - Breslin Cancer CenterEast Lansing, Michigan  48824-1313
Green Bay Oncology - EscanabaEscanaba, Michigan  49431
McLaren Regional Medical CenterFlint, Michigan  48532
Grand Rapids Clinical Oncology ProgramGrand Rapids, Michigan  49503
Green Bay Oncology - Iron MountainIron Mountain, Michigan  49801
Allegiance HealthJackson, Michigan  49201
Ingham Regional Medical CenterLansing, Michigan  48910
Sparrow HospitalLansing, Michigan  48912
Saint Mary Mercy HospitalLivonia, Michigan  48154
Mid-Michigan Medical Center - MidlandMidland, Michigan  48670
Mercy Health Partners-Hackley CampusMuskegon, Michigan  49442
Northern Michigan Regional HospitalPetoskey, Michigan  49770
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
Etzell, Paul S MD (UIA Investigator)Fergus Falls, Minnesota  56537
Swenson, Wade II, MD (UIA Investigator)Fergus Falls, Minnesota  56537
Immanuel-Saint Joseph Hospital-Mayo Health SystemMankato, Minnesota  56002
Saint Cloud HospitalSaint Cloud, Minnesota  56303
Southeast Missouri HospitalCape Girardeau, Missouri  63701
Freeman Health SystemJoplin, Missouri  64804
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
Community Medical HospitalMissoula, Montana  59801
Saint Patrick Hospital - Community HospitalMissoula, Montana  59802
Lincoln Medical Education Foundation Cancer Resource CenterLincoln, Nebraska  68510
Missouri Valley Cancer Consortium CCOPOmaha, Nebraska  68106
New Hampshire Oncology Hematology AssociatesHooksett, New Hampshire  03106
Cheshire Medical Center-Dartmouth-Hitchcock KeeneKeene, New Hampshire  03431
LRGHealthcare-Lakes Region General HospitalLaconia, New Hampshire  03246
Cooper Hospital University Medical CenterCamden, New Jersey  08103
South Jersey HealthcareVineland, New Jersey  08360
Adirondack Cancer CenterGlens Falls, New York  12801
Saint Luke's Roosevelt Hospital Center - Saint Luke's DivisionNew York, New York  10025
Columbia University Medical CenterNew York, New York  10032
Faxton-Saint Luke's HealthcareUtica, New York  13502
Wayne Memorial HospitalGoldsboro, North Carolina  27534
Kinston Medical Specialists PAKinston, North Carolina  28501
Saint Alexius Medical CenterBismarck, North Dakota  58501
Aultman Health FoundationCanton, Ohio  44710
Doctors HospitalColumbus, Ohio  43228
Grant Medical CenterColumbus, Ohio  43215
Mount Carmel Health Center WestColumbus, Ohio  43222
Saint Rita's Medical CenterLima, Ohio  45801
Marietta Memorial HospitalMarietta, Ohio  45750
Saint Ann's HospitalWesterville, Ohio  43081
Genesis HealthCare SystemZanesville, Ohio  43701
Providence Saint Vincent Medical CenterPortland, Oregon  97225
Columbia River Oncology ProgramPortland, Oregon  97225
Scranton Hematology OncologyScranton, Pennsylvania  18510
Mercy HospitalScranton, Pennsylvania  18501
Hematology and Oncology Associates of Rhode Island IncCranston, Rhode Island  02920
Kent County HospitalWarwick, Rhode Island  02886
AnMed Health HospitalAnderson, South Carolina  29621
Upstate Carolina CCOPSpartanburg, South Carolina  29303
Conklin Regional Cancer CenterAberdeen, South Dakota  57401
Sanford Cancer Center-Oncology ClinicSioux Falls, South Dakota  57104
Wheeling HospitalWheeling, West Virginia  26003
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
Dean Hematology and Oncology ClinicMadison, Wisconsin  53717
Vince Lombardi Cancer Clinic-MarinetteMarinette, Wisconsin  54143
Bay Area Medical CenterMarinette, Wisconsin  54143
Marshfield Clinic-Minocqua CenterMinocqua, Wisconsin  54548
Oconomowoc Memorial Hospital-ProHealth Care IncOconomowoc, Wisconsin  53066-3896
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
Green Bay Oncology - Sturgeon BaySturgeon Bay, Wisconsin  54235
University of California Medical Center At Irvine-Orange CampusOrange, California  92868
University of Maryland Greenebaum Cancer CenterBaltimore, Maryland  21201
Olathe Cancer CenterOlathe, Kansas  66061
Jupiter Medical CenterJupiter, Florida  33458
Gainesville Hematology Oncology AssociatesGainesville, Florida  32605
Elkhart ClinicElkhart, Indiana  46515
Marin General HospitalGreenbrae, California  94904
Mount Sinai Medical Center CCOPMiami Beach, Florida  33140
Northeast Georgia Cancer Care LLCAthens, Georgia  30607
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
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
Hackensack University Medical CCOPHackensack, New Jersey  07601
Moses Cone Health System-Regional Cancer CenterGreensboro, North Carolina  27403
Annie Penn Memorial HospitalReidsville, North Carolina  27320
Erlanger Medical CenterChattanooga, Tennessee  37403
West Virginia University CharlestonCharleston, West Virginia  25304
Marshfield Clinic-Chippewa CenterChippewa Falls, Wisconsin  54729
Holy Family Memorial HospitalManitowoc, Wisconsin  54221
Aurora Advanced Healthcare Inc-MequonMequon, Wisconsin  53092
Medical Consultants LimitedMilwaukee, Wisconsin  53215
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
Kaiser Permanente - Largo Medical CenterLargo, Maryland  20774
Kaiser Permanente - Towson Medical CenterLutherville, Maryland  21093
Kaiser Permanente - Fair Oaks Medical CenterFairfax, Virginia  22033
Spector, David MD (UIA Investigator)Moline, Illinois  61265
Doctors Carrol, Sheth, RaghavanLouisville, Kentucky  40215
Hematology and Oncology ClinicBaton Rouge, Louisiana  70809
Ochsner North Shore Medical CenterCovington, Louisiana  70433
Veterans Administration Medical CenterBaltimore, Maryland  21201
Capital Region Medical Center-Goldschmidt Cancer CenterJefferson City, Missouri  65109
Comprehensive Cancer Care PCSaint Louis, Missouri  63141
Saint Joseph HospitalNashua, New Hampshire  03060
Arnot Ogden Medical CenterElmira, New York  14905
Southern Ohio Medical CenterPortsmouth, Ohio  45662
Saint Charles Medical Center-BendBend, Oregon  97701
Saint Francis HospitalGreenville, South Carolina  29601
Gundersen LutheranLa Crosse, Wisconsin  54601
Saint Nicholas HospitalMadison, Wisconsin  53715
Sparks Regional Medical CenterFort Smith, Arkansas  72901
Los Angeles County-USC Medical CenterLos Angeles, California  90033
San Francisco General HospitalSan Francisco, California  94110
Eisenhower Army Medical CenterFort Gordon, Georgia  30509
Siouxland Hematology Oncology AssociatesSioux City, Iowa  51101
The Schiffler Cancer Center of Wheeling HospitalWheeling, West Virginia  26003
Dublin Hematology Oncology Care PCDublin, Georgia  31021
IU Health ArnettLafayette, Indiana  
Georgia Health Sciences UniversityAugusta, Georgia  30912
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
Marie Yeager Cancer CenterSaint Joseph, Michigan  49085
Hematology Oncology Associates of Central New York PCEast Syracuse, New York  13057
Roy and Patricia Disney Family Cancer CenterBurbank, California  91505
Sanford USD Medical Center - Sioux FallsSioux Falls, South Dakota  57117-5134
Providence Sacred Heart Medical Center and Children's HospitalSpokane, Washington  99204
Genesys Regional Medical Center-West Flint CampusFlint, Michigan  48532
Essentia Health Duluth Clinic CCOPDuluth, Minnesota  55805
Essentia Health Saint Mary's Medical CenterDuluth, Minnesota  55805
Sanford Bismarck Medical CenterBismarck, North Dakota  58501
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
Aurora Cancer Care-BurlingtonBurlington, Wisconsin  53105
Aurora Cancer Care-FranklinFranklin, Wisconsin  53132
Aurora Cancer Care-GlendaleGlendale, Wisconsin  53212
Aurora Cancer Care-Kenosha SouthKenosha, Wisconsin  53142
Aurora Cancer Care-Milwaukee SouthMilwaukee, Wisconsin  53215
Aurora Cancer Care-RacineRacine, Wisconsin  53406-5661
Aurora Cancer Care-WaukeshaWaukesha, Wisconsin  53188
Aurora Cancer Care-Milwaukee WestWauwatosa, Wisconsin  53226
Christiana Care Health System-Christiana HospitalNewark, Delaware  19718
Springfield Regional Medical CenterSpringfield, Ohio  45505
Promise Regional Medical Center-HutchinsonHutchinson, Kansas  65702
Guthrie Clinic-Robert Packer HospitalSayre, Pennsylvania  18840
Providence Holy Family HospitalSpokane, Washington  99208
PeaceHealth Southwest Medical CenterVancouver, Washington  98664
Aurora Cancer Care-Southern LakesElkhorn, Wisconsin  53121
Maine Center for Cancer Medicine and Blood Disorders-ScarboroughScarborough, Maine  04074
Saint Vincent's Hospital and Medical Center of New YorkNew York, New York  10011
Ochsner Baptist Medical CenterNew Orleans, Louisiana  70115
Providence Willamette Falls Medical CenterOregon City, Oregon  97045
East Bay Medical Oncology Hematology Medical Associates-AntiochAntioch, California  94531
Diablo Valley Oncology and Hematology Medical Group-Pleasant HillPleasant Hill, California  94523
East Bay Medical Oncology Hematology Medical Associates Inc-Pleasant HillPleasant Hill, California  94523
East Bay Medical Oncology Hematology Associates IncSan Leandro, California  94578
LC Ferguson Cancer CenterFreeport, Illinois  61032
Dana-Farber/Brigham and Women's Cancer Center at Milford RegionalMilford, Massachusetts  01757