Know Cancer

or
forgot password

Randomized Phase II Trial of Capecitabine and Lapatinib With or Without IMC-A12 in Patients With HER2 Positive Breast Cancer Previously Treated With Trastuzumab and an Anthracycline and/or a Taxane


Phase 2
18 Years
N/A
Open (Enrolling)
Both
HER2-positive Breast Cancer, Male Breast Cancer, Recurrent Breast Cancer, Stage IIIB Breast Cancer, Stage IIIC Breast Cancer, Stage IV Breast Cancer

Thank you

Trial Information

Randomized Phase II Trial of Capecitabine and Lapatinib With or Without IMC-A12 in Patients With HER2 Positive Breast Cancer Previously Treated With Trastuzumab and an Anthracycline and/or a Taxane


PRIMARY OBJECTIVES:

I. To compare progression-free survival of HER2+ breast cancer patients randomized to
receive lapatinib and capecitabine +/- IMC-A12.

SECONDARY OBJECTIVES:

I. To assess the safety and tolerability of lapatinib and capecitabine +/- IMC-A12 in HER2+
breast cancer patients.

II. To compare the overall survival time, time to treatment failure, confirmed tumor
response rate, and duration of response of lapatinib and capecitabine +/- IMC-A12 in HER2+
breast cancer patients.

III. To assess patient compliance per treatment arm and to compare overall quality of life
and treatment side effects via patient-reported outcomes between treatment arms.

TERTIARY OBJECTIVES:

I. To determine the role of the following in predicting response to lapatinib and
capecitabine +/- IMC-A12:

II. Expression patterns and/or activation IGF- and ErbB family of receptors and signaling
molecules in formalin-fixed, paraffin-embedded breast tumor tissue.

III. Expression patterns and/or activation IGF- and ErbB receptors and signaling molecules
in circulating tumor cells from breast cancer patients.

IV. Changes in expression patterns and/or activation IGF- and ErbB receptors and signaling
molecules following treatment with lapatinib and capecitabine +/- IMC-A12 in circulating
tumor cells from breast cancer patients.

V. Expression patterns of IGF-1, IGF-II, insulin, growth hormone, and the IGF binding
proteins in the serum of breast cancer patients.

VI. Changes in expression patterns of IGF-1, IGF-II, insulin, growth hormone, and the IGF
binding proteins in the serum of breast cancer patients.

VII. As part of ongoing research for NCCTG breast studies, we are banking paraffin-embedded
tissue blocks/slides and blood products (i.e., serum, plasma, and buffy coat) for future
studies.

VIII. To assess the proportion of patients whose pathologic specimens were correctly
diagnosed as HER2 positive (according to 2007 ASCO CAP guidelines) metastatic breast cancer.

OUTLINE: This is a multicenter study. Patients are stratified according to hormone receptor
status (estrogen receptor- or progesterone receptor-positive vs other) and number of prior
chemotherapy regimens in the metastatic setting (2 vs 1 vs none). The first 10 patients
enrolled on this study are assigned to cohort 1 (safety analysis). All other patients are
assigned to cohort 2 (randomized treatment).

COHORT 1 (SAFETY ANALYSIS): Patients receive cixutumumab IV over 1-1½ hours on days 1, 8,
and 15. Patients also receive oral capecitabine twice daily on days 1-14 and oral lapatinib
ditosylate once daily on days 1-21. Courses repeat every 21 days in the absence of disease
progression or unacceptable toxicity.

COHORT 2 (RANDOMIZED TREATMENT): Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive oral capecitabine twice daily on days 1-14 and oral lapatinib
ditosylate once daily on days 1-21. Courses repeat every 21 days in the absence of disease
progression or unacceptable toxicity.

ARM II: Patients receive capecitabine and lapatinib ditosylate as in arm I. Patients also
receive cixutumumab IV over 1-1½ hours on days 1, 8, and 15. Courses repeat every 21 days in
the absence of disease progression or unacceptable toxicity.

Blood samples are collected at baseline and on day 8 of courses 1 and 2 for biomarker
laboratory studies. Serum and circulating tumor cell biomarkers are analyzed by
immunohistochemistry or immunofluorescence for changes in protein expression (total and
phosphorylated). Tumor tissue samples obtained at the time of original diagnosis are
analyzed by immunohistochemistry for protein biomarkers.

Patients complete quality of life questionnaires periodically. After completion of study
treatment, patients are followed every 3 months until disease progression and then every 6
months for up to 5 years.


Inclusion Criteria:



- Histologically confirmed breast cancer, meeting one of the following criteria:

- Locally advanced disease (i.e., stage IIIB or IIIC [T4 primary tumor] disease)

- Metastatic disease

- Disease progressed after treatment with regimens that included trastuzumab
(Herceptin®) in combination with an anthracycline and/or a taxane

- Must have received 1-2 prior chemotherapy regimens in the neoadjuvant, adjuvant,
or metastatic setting

- One regimen must have included treatment with an anthracyclineand/or a
taxane

- Prior treatment with trastuzumab required unless there is a contraindication for
trastuzumab treatment

- HER2-positive disease, defined by any of the following:

- Validated IHC assay score of 3+ (defined as uniform, intensestaining of > 30% of
invasive tumor cells)

- Average HER2 gene copy number > 6

- Gene amplified (HER2:D17Z1 ratio > 2.20)

- Measurable disease according to RECIST criteria

- No evidence of active brain metastases, including leptomeningeal involvement

- CNSmetastasis controlled* by prior surgery and/or radiotherapy is allowed

- Hormone receptor status not specified

- Menopausal status not specified

- ECOG performance status 0-2

- Life expectancy > 3 months

- WBC ≥ 3,000/mm³

- ANC ≥ 1,500/mm³

- Platelet count ≥ 75,000/mm³

- Hemoglobin > 9.0 g/dL

- Total bilirubin ≤ 1.5 times upper limit of normal (ULN)

- AST and ALT ≤ 2.5 times ULN (5 times ULN if elevations are due to liver metastases)

- Serum creatinine ≤ 1.5 times ULN

- Creatinine clearance ≥ 30 mL/min

- Fasting glucose < 120 mg/dL

- Diabetes allowed provided blood glucose level meets the above criterion

- INR ≤ 1.5 times ULN

- LVEF ≥ 50% by MUGA or ECHO

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- Willing to provide tissue and blood samples for research purposes

- Able to complete questionnaires by self or with assistance

- No other stage III or IV invasive cancer within the past 5 years

- No other malignancy requiring active treatment, except nonmelanoma skin canceror
carcinoma in situ of the cervix

- History of prior malignancy allowed providedpatient is not receiving other
specific treatment for their malignancy

- No current, active hepatic or biliary disease, except Gilbert syndrome's
orasymptomatic gallstones

- No New York Heart Association class III or IV cardiovascular disease

- No concurrent uncontrolled illness including, but not limited to, any of the
following:

- Poorly controlled diabetes

- Ongoing or active infection

- Symptomatic congestive heart failure

- Unstable angina pectoris

- Cardiac arrhythmia

- Psychiatric illness/social situation that would preclude compliance with
studyrequirements

- No co-morbid systemic illness or other severe concurrent disease that, in the
judgment of the investigator, would make the patient inappropriate for entry into
this study or interfere significantly with the proper assessment of the safety of the
prescribed study regimens

- Not immunocompromised (other than that related to the use of corticosteroids),
including known HIV-positivity with an AIDS-defining illness

- HIV-positive patients with a CD4 count within normal range and who have no
history of an AIDS-defining illness are eligible

- No other concurrent chemotherapeutic agents, biologic agents, or radiotherapy

- Prior hormonal therapy in the neoadjuvant, adjuvant, or metastatic setting allowed

- More than 6 weeks since prior major surgery, chemotherapy, or immunologic therapy

- More than 4 weeks since prior radiotherapy, except a single dose of palliative
radiotherapy or radiotherapy to a non-target lesion

- Prior radiotherapy to a target lesion is allowed only if there has been clear
progression of the lesion since completion of radiotherapy

- Recovered from prior radiotherapy

- No more than 2 prior chemotherapy regimens for metastatic disease

- No prior treatment with any therapy targeting IGF-I, IGF-II, or its receptors
(eithermonoclonal antibody or tyrosine kinase inhibitor) including, but not limited
to, anyof the following:

- Cixutumumab

- CP-751871

- AMG-479

- INSM-18

- MK-0646 (h7C10)

- 19D12

- R1507

- OSI-906

- BMS-536924

- PPP

- NVP-AEW541

- No other prior therapy targeting HER1 (EGFR) and/or HER2 (either monoclonal antibody
or tyrosine kinase inhibitor) including, but not limited to, any of the following:

- Lapatinib ditosylate

- Gefitinib

- Erlotinib hydrochloride

- Cetuximab

- Panitumumab

- No concurrent agents that would contraindicate study treatment, including any of the
following:

- CYP3A4 inhibitors and inducers, including grapefruit and grapefruit juice

- Warfarin, cimetidine,allopurinol, sorivudine or brivudine,ketoconazole,
itraconazole, ritonavir,amprenavir, or indinavir

- No concurrent treatment in another clinical study in which investigational procedures
are performed or investigational therapies are administered

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 (PFS)

Outcome Description:

Analysis of the primary endpoint, PFS, will be performed using Cox regression with treatment group as a single covariate. The distribution of PFS time will be estimated by the Kaplan-Meier (1958) method for each treatment group. Median PFS times will be estimated using Kaplan-Meier estimates with 95% confidence intervals. Supplementary analyses of PFS include a Cox regression with treatment group and the stratification factors as covariates; as well as estimation of the 6-month PFS rate within each treatment group and comparison between the treatment groups using χ² testing.

Outcome Time Frame:

From randomization to the earliest date of documentation of disease progression, up to 5 years

Safety Issue:

No

Principal Investigator

Paul Haluska

Investigator Role:

Principal Investigator

Investigator Affiliation:

North Central Cancer Treatment Group

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2009-00665

NCT ID:

NCT00684983

Start Date:

July 2008

Completion Date:

Related Keywords:

  • HER2-positive Breast Cancer
  • Male Breast Cancer
  • Recurrent Breast Cancer
  • Stage IIIB Breast Cancer
  • Stage IIIC Breast Cancer
  • Stage IV Breast Cancer
  • IGF-1R
  • IMC-A12
  • Breast Neoplasms
  • Breast Neoplasms, Male

Name

Location

Albert Einstein College of Medicine Bronx, New York  10461
Mayo Clinic Rochester, Minnesota  55905
University of Washington Medical Center Seattle, Washington  98195-6043
Hurley Medical Center Flint, Michigan  48503
Medical City Dallas Hospital Dallas, Texas  75230
Boulder Community Hospital Boulder, Colorado  80301-9019
Porter Adventist Hospital Denver, Colorado  80210
Rose Medical Center Denver, Colorado  80220
Swedish Medical Center Englewood, Colorado  80110
Sky Ridge Medical Center Lone Tree, Colorado  80124
North Suburban Medical Center Thornton, Colorado  80229
Bronson Methodist Hospital Kalamazoo, Michigan  49007
West Michigan Cancer Center Kalamazoo, Michigan  49007-3731
Borgess Medical Center Kalamazooaa, Michigan  49001
Fairview Ridges Hospital Burnsville, Minnesota  55337
Hutchinson Area Health Care Hutchinson, Minnesota  55350
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
Geisinger Medical Center Danville, Pennsylvania  17822-0001
CentraCare Clinic Saint Cloud, Minnesota  56303
Glendale Memorial Hospital and Health Center Glendale, California  91204
Sutter Health Western Division Cancer Research Group Greenbrae, California  94904
South Georgia Medical Center Valdosta, Georgia  31603
Memorial Hospital of South Bend South Bend, Indiana  46601
Marquette General Hospital Marquette, Michigan  49855
Akron General Medical Center Akron, Ohio  44302
Lehigh Valley Hospital Allentown, Pennsylvania  18103
Illinois Masonic Medical Center Chicago, Illinois  60657
Staten Island University Hospital Staten Island, New York  10305
Via Christi Regional Medical Center Wichita, Kansas  67214
Iowa Methodist Medical Center Des Moines, Iowa  50309
Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
Group Health Cooperative Seattle, Washington  98112
Great Falls Clinic Great Falls, Montana  59405
Thompson Cancer Survival Center Knoxville, Tennessee  37916
Trinity Cancer Care Center Minot, North Dakota  58701
Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium Seattle, Washington  98109
Montefiore Medical Center Bronx, New York  10467-2490
Mount Nittany Medical Center State College, Pennsylvania  16803
North Colorado Medical Center Greeley, Colorado  80631
McKee Medical Center Loveland, Colorado  80539
Cancer Center of Kansas - Chanute Chanute, Kansas  66720
Cancer Center of Kansas - Dodge City Dodge City, Kansas  67801
Cancer Center of Kansas - Newton Newton, Kansas  67114
Cancer Center of Kansas - Salina Salina, Kansas  67042
Cancer Center of Kansas - Wellington Wellington, Kansas  67152
Associates in Womens Health Wichita, Kansas  67203
Cancer Center of Kansas - Winfield Winfield, Kansas  67156
Northern Rockies Radiation Oncology Center Billings, Montana  59101
Bozeman Deaconess Hospital Bozeman, Montana  59715
Big Sky Oncology Great Falls, Montana  59405
Kalispell Medical Oncology Kalispell, Montana  59901
Kalispell Regional Medical Center Kalispell, Montana  59901
Adena Regional Medical Center Chillicothe, Ohio  54601
Grady Memorial Hospital Delaware, Ohio  43015
Fairfield Medical Center Lancaster, Ohio  43130
Harborview Medical Center Seattle, Washington  98104
Cancer Care Northwest - Spokane South Spokane, Washington  99202
Welch Cancer Center Sheridan, Wyoming  82801
University of New Mexico Cancer Center Albuquerque, New Mexico  87131-5636
Elkhart General Hospital Elkhart, Indiana  46515
South Bend Clinic South Bend, Indiana  46617
Front Range Cancer Specialists Fort Collins, Colorado  80528
University Medical Center of Southern Nevada Las Vegas, Nevada  89102
Alta Bates Summit Medical Center - Summit Campus Oakland, California  94609
Sutter Solano Medical Center Vallejo, California  94589
Poudre Valley Hospital Fort Collins, Colorado  80524
Community Cancer Center of Monroe Monroe, Michigan  48162
Iredell Memorial Hospital Statesville, North Carolina  28677
Bismarck Cancer Center Bismarck, North Dakota  58501
Grandview Hospital Dayton, Ohio  45405
Lima Memorial Hospital Lima, Ohio  45804
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Fulton County Health Center Wauseon, Ohio  43567
Providence Milwaukie Hospital Milwaukie, Oregon  97222
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
Mercy Hospital Coon Rapids, Minnesota  55433
Allenmore Hospital Tacoma, Washington  98411-0414
Medical Oncology and Hematology Associates Des Moines, Iowa  50309
Ottumwa Regional Health Center Ottumwa, Iowa  52501
Bixby Medical Center Adrian, Michigan  49221
Saint Joseph Mercy Hospital Ann Arbor, Michigan  48106
Fairview-Southdale Hospital Edina, Minnesota  55435
Abbott-Northwestern Hospital Minneapolis, Minnesota  55407
Regions Hospital Saint Paul, Minnesota  55101
Saint Francis Regional Medical Center Shakopee, Minnesota  55379
Rice Memorial Hospital Willmar, Minnesota  56201
Altru Cancer Center Grand Forks, North Dakota  58206
Saint Luke's Hospital Maumee, Ohio  43537
Geisinger Medical Group State College, Pennsylvania  16801
Highland General Hospital Oakland, California  94602
Miami Valley Hospital Dayton, Ohio  45409
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Lawrence Memorial Hospital Lawrence, Kansas  66044
Bozeman Deaconess Cancer Center Bozeman, Montana  59715
Northern Montana Hospital Havre, Montana  59501
Mary Rutan Hospital Bellefontaine, Ohio  43311
Wayne Hospital Greenville, Ohio  45331
Knox Community Hospital Mount Vernon, Ohio  43050
Fisher-Titus Medical Center Norwalk, Ohio  44857
Clinton Memorial Hospital Wilmington, Ohio  45177
Providence Centralia Hospital Centralia, Washington  98531-9027
Wenatchee Valley Medical Center Wenatchee, Washington  98801-2028
Rocky Mountain Oncology Casper, Wyoming  82609
Longmont United Hospital Longmont, Colorado  80501
Singing River Hospital Pascagoula, Mississippi  39581
Greene Memorial Hospital Xenia, Ohio  45385
Presbyterian Hospital Charlotte, North Carolina  28233-3549
Mayo Clinic in Arizona Scottsdale, Arizona  85259-5404
Mayo Clinic in Florida Jacksonville, Florida  32224
Memorial Medical Center Springfield, Illinois  62781
Phelps County Regional Medical Center Rolla, Missouri  65401
McLeod Regional Medical Center Florence, South Carolina  29501
Wellmont Holston Valley Hospital and Medical Center Kingsport, Tennessee  37662
Guardian Oncology and Center for Wellness Missoula, Montana  59804
Providence Hospital Mobile, Alabama  36608
Bay Area Tumor Institute Oakland, California  94609
East Bay Radiation Oncology Center Castro Valley, California  94546
Contra Costa Regional Medical Center Martinez, California  94553-3156
Larry G Strieff MD Medical Corporation Oakland, California  94609
Hennepin County Medical Center Minneapolis, Minnesota  
Glens Falls Hospital Glens Falls, New York  12801
Saint Alphonsus Regional Medical Center Boise, Idaho  83706
Holy Cross Hospital Fort Lauderdale, Florida  33308
El Camino Hospital Mountain View, California  94040
Riverside Methodist Hospital Columbus, Ohio  43214
Licking Memorial Hospital Newark, Ohio  43055-2899
Cancer Center of Kansas - McPherson McPherson, Kansas  67460
Providence Portland Medical Center Portland, Oregon  97213-3635
California Pacific Medical Center San Francisco, California  94115
Mid Dakota Clinic Bismarck, North Dakota  58501
Columbus CCOP Columbus, Ohio  43206
Presbyterian - Saint Lukes Medical Center - Health One Denver, Colorado  80218
Sacred Heart Hospital Pensacola, Florida  32503
Wichita CCOP Wichita, Kansas  67214-3882
Montana Cancer Consortium CCOP Billings, Montana  59101
Flower Hospital Sylvania, Ohio  43560-2197
Metro-Minnesota CCOP St. Louis Park, Minnesota  
Lakeview Hospital Stillwater, Minnesota  55082
Decatur Memorial Hospital Decatur, Illinois  62526
Tulane University Health Sciences Center New Orleans, Louisiana  70112
Holy Cross Hospital Silver Spring, Maryland  20910
Montana Cancer Specialists Missoula, Montana  59807-7877
Desert Regional Medical Center Palm Springs, California  92262
Florida Hospital Orlando, Florida  32803
Memorial Health University Medical Center Savannah, Georgia  31404
Northern Indiana Cancer Research Consortium South Bend, Indiana  
Clackamas Radiation Oncology Center Clackamas, Oregon  97015
Providence Newberg Medical Center Newberg, Oregon  97132
Butler Memorial Hospital Butler, Pennsylvania  16001
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
Palo Alto Medical Foundation-Camino Division Mountain View, California  94040
Bay Area Breast Surgeons Inc Oakland, California  94609
Tom K Lee Inc Oakland, California  94609
Palo Alto Medical Foundation Heath Care Palo Alto, California  94301
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
Saint Mary's Hospital and Regional Medical Center Grand Junction, Colorado  81502
Saint Mary Corwin Medical Center Pueblo, Colorado  81004
Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
Middlesex Hospital Middletown, Connecticut  06457
The Hospital of Central Connecticut New Britain, Connecticut  06050
Sacred Heart Medical Oncology Group - Davis Highway Pensacola, Florida  32514
John B Amos Cancer Center Columbus, Georgia  31904
Rush - Copley Medical Center Aurora, Illinois  60504
Joliet Oncology-Hematology Associates Limited Joliet, Illinois  60435
Carle Clinic-Urbana Main Urbana, Illinois  61801
Saint Francis Hospital and Health Centers Beech Grove, Indiana  46107
Fort Wayne Medical Oncology and Hematology Inc - State Boulevard Fort Wayne, Indiana  46845
Saint Anthony Memorial Health Center Michigan City, Indiana  46360
Reid Hospital and Health Care Services Richmond, Indiana  47374
McFarland Clinic Ames, Iowa  50010
Hematology Oncology Associates-Quad Cities 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
Genesis Medical Center - East Campus Davenport, Iowa  52803
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
Hickman Cancer Center Adrian, Michigan  49221
Michigan Cancer Research Consortium Community Clinical Oncology Program Ann Arbor, Michigan  48106
Oakwood Hospital Dearborn, Michigan  48123
Saint John Hospital and Medical Center Detroit, Michigan  48236
Green Bay Oncology - Escanaba Escanaba, Michigan  49431
Grand Rapids Clinical Oncology Program 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 Memorial Hospital Monroe, Michigan  48162
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
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
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
Nevada Cancer Research Foundation CCOP Las Vegas, Nevada  89106
Orange Regional Medical Center Middletown, New York  10940
Wayne Memorial Hospital Goldsboro, North Carolina  27534
Margaret R Pardee Memorial Hospital Hendersonville, North Carolina  28791
Kinston Medical Specialists PA Kinston, North Carolina  28501
Saint Alexius Medical Center Bismarck, North Dakota  58501
Doctors Hospital Columbus, Ohio  43228
Grant Medical Center Columbus, Ohio  43215
Mount Carmel Health Center West Columbus, Ohio  43222
Good Samaritan Hospital - Dayton Dayton, Ohio  45406
Dayton CCOP Dayton, Ohio  45429
Samaritan North Health Center Dayton, Ohio  45415
Hematology Oncology Center Incorporated Elyria, Ohio  44035
Blanchard Valley Hospital Findlay, Ohio  45840
Atrium Medical Center-Middletown Regional Hospital Franklin, Ohio  45005-1066
Kettering Medical Center Kettering, Ohio  45429
Saint Rita's Medical Center Lima, Ohio  45801
Marietta Memorial Hospital Marietta, Ohio  45750
Toledo Radiation Oncology at Northwest Ohio Onocolgy Center Maumee, Ohio  43537
Saint Charles Hospital Oregon, Ohio  43616
North Coast Cancer Care Sandusky, Ohio  44870
Toledo Community Hospital Oncology Program CCOP Toledo, Ohio  43617
Mercy Cancer Center at Saint Anne Mercy Hospital Toledo, Ohio  43623
University of Toledo Toledo, Ohio  43614
Saint Vincent Mercy Medical Center Toledo, Ohio  43608
Upper Valley Medical Center Troy, Ohio  45373
Saint Ann's Hospital Westerville, Ohio  43081
Genesis HealthCare System Zanesville, Ohio  43701
Providence Saint Vincent Medical Center Portland, Oregon  97225
Columbia River Oncology Program Portland, Oregon  97225
Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania  18711
Conklin Regional Cancer Center Aberdeen, South Dakota  57401
The Don and Sybil Harrington Cancer Center Amarillo, Texas  79106
Fredericksburg Oncology Inc Fredericksburg, Virginia  22401
Southwest VA Regional Cancer Center Norton, Virginia  24273
Harrison Bremerton Hematology and Oncology Bremerton, Washington  98310
Saint Francis Hospital Federal Way, Washington  98003
Columbia Basin Hematology and Oncology PLLC Kennewick, Washington  99336
Providence - Saint Peter Hospital Olympia, Washington  98506-5166
Good Samaritan Community Hospital Puyallup, Washington  98372
Minor and James Medical PLLC Seattle, Washington  98104
The Polyclinic Seattle, Washington  98122
Swedish Medical Center-First Hill Seattle, Washington  98122-4307
Northwest CCOP Tacoma, Washington  98405
Multicare Health System Tacoma, Washington  98415
Saint Clare Hospital Tacoma, Washington  98499
Saint Joseph Medical Center Tacoma, Washington  98405
Edwards Comprehensive Cancer Center Huntington, West Virginia  25701
Saint Vincent Hospital Green Bay, Wisconsin  54301
Green Bay Oncology Limited at Saint Mary's Hospital Green Bay, Wisconsin  54303
Saint Mary's Hospital Green Bay, Wisconsin  54303
Green Bay Oncology at Saint Vincent Hospital Green Bay, Wisconsin  54301-3526
Bay Area Medical Center Marinette, Wisconsin  54143
Green Bay Oncology - Oconto Falls Oconto Falls, Wisconsin  54154
Green Bay Oncology - Sturgeon Bay Sturgeon Bay, Wisconsin  54235
University of Maryland Greenebaum Cancer Center Baltimore, Maryland  21201
Jupiter Medical Center Jupiter, Florida  33458
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
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
North Coast Cancer Care-Clyde Clyde, Ohio  43410
Community Health Partners Regional Medical Center Elyria, Ohio  44035
University of Tennessee - Knoxville Knoxville, Tennessee  37920
Skagit Valley Hospital Mt. Vernon, Washington  98273
Evergreen Hematology and Oncology PS Spokane, Washington  99218
Holy Family Memorial Hospital Manitowoc, Wisconsin  54221
Salinas Valley Memorial Salinas, California  93901
Kaiser Permanente-Rock Creek Lafayette, Colorado  80026
Saint Joseph Regional Medical Center Lewiston, Idaho  83501
Mount Clemens Regional Medical Center Mount Clemens, Michigan  48043
Southern Ohio Medical Center Portsmouth, Ohio  45662
Memorial Hospital Of Martinsville Martinsville, Virginia  24115
Cancer Care Center at Island Hospital Anacortes, Washington  98221
Overlake Hospital Medical Center Bellevue, Washington  98004
Highline Medical Center-Main Campus Burien, Washington  98166
Providence Regional Cancer Partnership Everett, Washington  98201
United General Hospital Sedro-Woolley, Washington  98284
Gundersen Lutheran La Crosse, Wisconsin  54601
Saint Nicholas Hospital Madison, Wisconsin  53715
Kaiser Permanente-Franklin Denver, Colorado  80205
Siouxland Hematology Oncology Associates Sioux City, Iowa  51101
Alta Bates Summit Medical Center-Herrick Campus Berkeley, California  94704
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
The Toledo Hospital/Toledo Children's Hospital Toledo, Ohio  43606
Genesys Regional Medical Center-West Flint Campus Flint, Michigan  48532
Sanford Bismarck Medical Center Bismarck, North Dakota  58501
Toledo Clinic Cancer Centers-Oregon Oregon, Ohio  43616
Geisinger Medical Center-Cancer Center Hazelton Hazleton, Pennsylvania  18201
Community Howard Regional Health Kokomo, Indiana  46904
Indiana University Health La Porte Hospital La Porte, Indiana  46350
Saint Joseph Regional Medical Center-Mishawaka Mishawaka, Indiana  46545-1470
PeaceHealth Saint Joseph Medical Center Bellingham, Washington  98225
Aurora Cancer Care-Milwaukee West Wauwatosa, Wisconsin  53226
Springfield Regional Medical Center Springfield, Ohio  45505
Toledo Clinic Cancer Centers-Bowling Green Bowling Green, Ohio  43402
Toledo Clinic Cancer Centers-Maumee Maumee, Ohio  43537-1839
Toledo Clinic Cancer Centers-Toledo Toledo, Ohio  43623
Harrison Poulsbo Hematology and Oncology Poulsbo, Washington  98370
PeaceHealth Southwest Medical Center Vancouver, Washington  98664
Providence Willamette Falls Medical Center Oregon City, Oregon  97045