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Randomized, Phase III, Double-Blind Placebo-Controlled Trial of Sunitinib (NSC #736511, IND #74019) as Maintenance Therapy in Non-Progressing Patients Following an Initial Four Cycles of Platinum-Based Combination Chemotherapy in Advanced, Stage IIIB / IV Non-Small Cell Lung Cancer


Phase 3
18 Years
N/A
Open (Enrolling)
Both
Stage IIIB Non-small Cell Lung Cancer, Stage IV Non-small Cell Lung Cancer

Thank you

Trial Information

Randomized, Phase III, Double-Blind Placebo-Controlled Trial of Sunitinib (NSC #736511, IND #74019) as Maintenance Therapy in Non-Progressing Patients Following an Initial Four Cycles of Platinum-Based Combination Chemotherapy in Advanced, Stage IIIB / IV Non-Small Cell Lung Cancer


PRIMARY OBJECTIVES:

I. To evaluate the effect of sunitinib (sunitinib malate) compared to placebo on PFS in
advanced NSCLC patients who have had either stable or responding disease over the course of
their initial 4 cycles of platinum-based therapy.

SECONDARY OBJECTIVES:

I. To evaluate the toxicity of sunitinib compared to placebo in the maintenance setting.

II. To evaluate the additional response rate as a result of sunitinib in this setting.

III. To assess the impact of sunitinib on overall survival compared to the placebo arm.

IV. To assess the impact of sunitinib on delaying the time to deterioration in quality of
life and symptom progression compared to placebo using the EORTC QLQ-C30 and LC13.

V. To assess VEGF haplotypes in advanced non-small cell lung cancer and sunitinib
maintenance.

OUTLINE: This is a multicenter study. Patients are stratified according to ECOG performance
status (0 vs 1), disease stage (IIIB vs IV), prior treatment with bevacizumab (yes vs no),
and gender. Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive sunitinib malate orally (PO) once daily on days 1-21. Courses repeat
every 21 days in the absence of disease progression or unacceptable toxicity.

ARM II: Patients receive placebo PO once daily on days 1-21. Courses repeat every 21 days in
the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed every 3 months for 1 year, every
6 months for 1 year, and periodically for 3 years.


Inclusion Criteria:



- Histologic or cytologic documentation of primary non-small cell lung cancer

- Stage IIIB or IV disease patients who are not candidates for combined modality
therapy (chemoradiotherapy)

- No evidence of symptomatic or untreated brain metastases, spinal cord compression, or
carcinomatous meningitis; patients with central nervous system (CNS) metastases must
be asymptomatic, must have received definitive therapy (>= 6 weeks since resection or
>= 2 weeks since radiotherapy) for brain metastases, and be off steroids or on a
stable dose for 2 weeks prior to registration

- No cavitary lesions

- Patients must have received one chemotherapy regimen for stage IIIB or IV NSCLC; the
regimen must include four cycles of platinum-based doublet chemotherapy with or
without bevacizumab (bevacizumab may not be given beyond the fourth cycle of
chemotherapy); patients must have achieved a complete response, partial response, or
stable disease to first-line chemotherapy and have no evidence of disease
progression; patients will be registered 3-5 weeks following day 1 of cycle 4 of
prior therapy

- No prior adjuvant chemotherapy for stage I-III resected NSCLC or combined modality
therapy for stage III NSCLC

- No other primary therapy (including experimental therapy) for NSCLC; palliative
radiation therapy must have been completed at least one week before planned start of
protocol therapy

- Patients must have measurable or non-measurable disease

- Measurable disease: lesions that can be accurately measured in at least one
dimension (longest diameter to be recorded) as >= 2 cm with conventional
techniques or as >= 1 cm with spiral CT scan

- Non-measurable disease: all other lesions, including small lesions (longest
diameter < 20 mm with conventional techniques or < 10 mm with spiral computed
tomography [CT] scan) and truly non-measurable lesions; lesions that are
considered non-measurable include the following:

- Bone lesions

- Leptomeningeal disease

- Ascites

- Pleural/pericardial effusion

- Lymphangitis cutis/pulmonis

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

- Cystic lesions

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

- Non-pregnant and non-nursing

- No ongoing cardiac dysrhythmias, atrial fibrillation, or history of corrected QT
(QTc) interval >= 500 msec (within 2 years prior to registration); the use of agents
with proarrhythmic potential (e.g., quinidine, procainamide, disopyramide, sotalol,
probucol, haloperidol, risperidone, indapamide, flecainide) is not recommended while
on protocol therapy

- Patients with class I New York Heart Association (NYHA) heart failure are eligible;
patients with a history of class II NYHA heart failure are eligible, provided they
meet at least one of the following criteria:

- Patients with a history of class II heart failure who are asymptomatic on
treatment

- Patients with prior anthracycline exposure

- Patients who have received central thoracic radiation that included the heart in
the radiotherapy port

- Patients with a history of class III or IV NYHA heart failure within 12 months prior
to registration are not eligible

- No myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass
graft or stenting, cerebrovascular accident or transient ischemic attack within the
last year

- Patients with hypertension that cannot be controlled by medications (> 150/100 mmHg
despite optimal medical therapy) are not eligible

- Patients who require use of therapeutic anticoagulation for thromboembolic disease
are not eligible; Note: low doses of coumadin (up to 2 mg daily) are permitted for
prophylaxis of thrombosis

- No history of venous thrombosis, pulmonary embolism, or hypercoagulopathy syndrome

- No history of pulmonary hemorrhage, bleeding diathesis, or evidence of hemoptysis;
patients with blood-tinged or blood-streaked sputum will be permitted on study if the
hemoptysis amounts to less than 5 ml of blood per episode and less than 10 ml of
blood per 24-hour period in the best estimate of the investigator

- Patients with a history of hypothyroidism are eligible, provided they are currently
euthyroid

- None of the following within 28 days of beginning treatment: abdominal fistula,
gastrointestinal perforation, intra-abdominal abscess, serious or non-healing wound,
ulcer, or bone fracture

- The following inhibitors of cytochrome P450 3A4 (CYP3A4) are prohibited within 7 days
before beginning and during treatment with sunitinib: azole antifungals
(ketoconazole, itraconozole), diltiazem, clarithromycin, erythromycin, verapamil,
delavirdine, and HIV protease inhibitors (indinavir, saquinavir, ritonavir,
atazanavir, nelfinavir); the following inducers of CYP3A4 are prohibited within 12
days before beginning and during treatment with sunitinib: rifampin, rifabutin,
carbamazepine, phenobarbital, phenytoin, St. John's Wort, efavirenz, tipranavir;
other inhibitors and inducers of CYP3A4 may be used if necessary, but their use is
discouraged

- Patients unable to take oral medication are not eligible

- Granulocytes >= 1,500/mcl

- Platelet count >= 100,000/mcl

- Total bilirubin =< 1.5 x upper limit of normal (ULN)

- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)=< 2.5 x ULN;
patients with liver metastases may have AST and ALT =< 5 x ULN; all other patients
will have AST and ALT =< 2.5 x ULN

- Creatinine =< 1.5 mg/dl

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment

Outcome Measure:

Progression-free survival (PFS)

Outcome Description:

PFS will be characterized by the Kaplan-Meier method. PFS will be performed using the intent-to-treat principle, which included all randomized patients. The comparisons of treatment arms on PFS will be done using the stratified log ranked.

Outcome Time Frame:

Time from the date of randomization of non-progressing patients following the first-line therapy to the date of disease progression or death of any cause, whichever comes first, assessed up to 5 years

Safety Issue:

No

Principal Investigator

Mark Socinski

Investigator Role:

Principal Investigator

Investigator Affiliation:

Cancer and Leukemia Group B

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2009-00469

NCT ID:

NCT00693992

Start Date:

June 2008

Completion Date:

Related Keywords:

  • Stage IIIB Non-Small Cell Lung Cancer
  • Stage IV Non-Small Cell Lung Cancer
  • Carcinoma, Non-Small-Cell Lung
  • Lung Neoplasms

Name

Location

Baylor College of MedicineHouston, Texas  77030
Howard University HospitalWashington, District of Columbia  20060
University of Iowa Hospitals and ClinicsIowa City, Iowa  52242
Washington University School of MedicineSaint Louis, Missouri  63110
Rhode Island HospitalProvidence, Rhode Island  02903
Bronson Methodist HospitalKalamazoo, Michigan  49007
West Michigan Cancer CenterKalamazoo, Michigan  49007-3731
Borgess Medical CenterKalamazooaa, Michigan  49001
Fairview Ridges HospitalBurnsville, Minnesota  55337
Hutchinson Area Health CareHutchinson, Minnesota  55350
United HospitalSt. Paul, Minnesota  55102
Ridgeview Medical CenterWaconia, Minnesota  55387
Geisinger Medical CenterDanville, Pennsylvania  17822-0001
Rapid City Regional HospitalRapid City, South Dakota  57709
Marshfield ClinicMarshfield, Wisconsin  54449
Memorial Hospital of South BendSouth Bend, Indiana  46601
Mary Bird Perkins Cancer CenterBaton Rouge, Louisiana  70809
Harbor Hospital CenterBaltimore, Maryland  21225
Newark Beth Israel Medical CenterNewark, New Jersey  07112
Community Medical CenterToms River, New Jersey  08755
Akron General Medical CenterAkron, Ohio  44302
Waukesha Memorial HospitalWaukesha, Wisconsin  53188
University of Arkansas for Medical SciencesLittle Rock, Arkansas  72205
Hartford HospitalHartford, Connecticut  06102-5037
Illinois Masonic Medical CenterChicago, Illinois  60657
Eastern Maine Medical CenterBangor, Maine  04401
Franklin Square Hospital CenterBaltimore, Maryland  21237
Camden-Clark Memorial HospitalParkersburg, West Virginia  26102
William Beaumont HospitalRoyal Oak, Michigan  48073
University of Nebraska Medical CenterOmaha, Nebraska  68198-3330
Broward General Medical CenterFort Lauderdale, Florida  33316
Via Christi Regional Medical CenterWichita, Kansas  67214
University of Oklahoma Health Sciences CenterOklahoma City, Oklahoma  73104
Scott and White Memorial HospitalTemple, Texas  76508
Northeast Alabama Regional Medical CenterAnniston, Alabama  36207
Saint Anthony Medical CenterRockford, Illinois  61108
Iowa Methodist Medical CenterDes Moines, Iowa  50309
Iowa Lutheran HospitalDes Moines, Iowa  50316-2301
Weill Medical College of Cornell UniversityNew York, New York  10021
Southern California Permanente Medical GroupDowney, California  90242
Great Falls ClinicGreat Falls, Montana  59405
MetroHealth Medical CenterCleveland, Ohio  44109
Chester County HospitalWest Chester, Pennsylvania  19380
Sibley Memorial HospitalWashington, District of Columbia  20016
Cancer Center of Kansas - ChanuteChanute, Kansas  66720
Cancer Center of Kansas - Dodge CityDodge City, Kansas  67801
Cancer Center of Kansas - NewtonNewton, Kansas  67114
Cancer Center of Kansas - SalinaSalina, Kansas  67042
Cancer Center of Kansas - WellingtonWellington, Kansas  67152
Associates in Womens HealthWichita, Kansas  67203
Cancer Center of Kansas - WinfieldWinfield, Kansas  67156
Northern Rockies Radiation Oncology CenterBillings, Montana  59101
Bozeman Deaconess HospitalBozeman, Montana  59715
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
Medical X-Ray CenterSioux Falls, South Dakota  57105
Welch Cancer CenterSheridan, Wyoming  82801
Methodist Estabrook Cancer CenterOmaha, Nebraska  68114-4199
Cancer Centers of the CarolinasGreenville, South Carolina  29605
Mercy Health SystemJanesville, Wisconsin  53545
Elkhart General HospitalElkhart, Indiana  46515
South Bend ClinicSouth Bend, Indiana  46617
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical CenterColumbus, Ohio  43210-1240
Front Range Cancer SpecialistsFort Collins, Colorado  80528
University Medical Center of Southern NevadaLas Vegas, Nevada  89102
Alta Bates Summit Medical Center - Summit CampusOakland, California  94609
Poudre Valley HospitalFort Collins, Colorado  80524
Beebe Medical CenterLewes, Delaware  19958
Swedish Covenant HospitalChicago, Illinois  60625
Hematology and Oncology AssociatesChicago, Illinois  60611
Sturdy Memorial HospitalAttleboro, Massachusetts  02703
Community Cancer Center of MonroeMonroe, Michigan  48162
Saint Francis Medical CenterCape Girardeau, Missouri  63701
Great Plains Regional Medical CenterNorth Platte, Nebraska  69101-6598
Creighton University Medical CenterOmaha, Nebraska  68131-2197
Bismarck Cancer CenterBismarck, North Dakota  58501
Lima Memorial HospitalLima, Ohio  45804
Mercy Medical CenterSpringfield, Ohio  45504
Mercy Hospital of TiffinTiffin, Ohio  44883
Fulton County Health CenterWauseon, Ohio  43567
Providence Milwaukie HospitalMilwaukie, Oregon  97222
Mountainview MedicalBerlin, Vermont  05602
Danville Regional Medical CenterDanville, Virginia  24541
North Star Lodge Cancer Center at Yakima Valley Memorial HospitalYakima, Washington  98902
Mercy HospitalCoon Rapids, Minnesota  55433
Trinity Medical CenterMoline, Illinois  61265-1291
Medical Oncology and Hematology AssociatesDes Moines, Iowa  50309
Bixby Medical CenterAdrian, Michigan  49221
Fairview-Southdale HospitalEdina, Minnesota  55435
Abbott-Northwestern HospitalMinneapolis, Minnesota  55407
Regions HospitalSaint Paul, Minnesota  55101
Saint Francis Regional Medical CenterShakopee, Minnesota  55379
Rice Memorial HospitalWillmar, Minnesota  56201
Mary Imogene Bassett HospitalCooperstown, New York  13326
Altru Cancer CenterGrand Forks, North Dakota  58206
Saint Luke's HospitalMaumee, Ohio  43537
Geisinger Medical GroupState College, Pennsylvania  16801
Highland General HospitalOakland, California  94602
Swedish American HospitalRockford, Illinois  61104
Saint Luke's HospitalChesterfield, Missouri  63017
Center for Cancer Care and ResearchSt. Louis, Missouri  63141
Saint Joseph HospitalChicago, Illinois  60657
Hospital District Sixth of Harper CountyAnthony, Kansas  67003
Cancer Center of Kansas - Fort ScottFort Scott, Kansas  66701
Cancer Center of Kansas-IndependenceIndependence, Kansas  67301
Lawrence Memorial HospitalLawrence, Kansas  66044
Menorah Medical CenterOverland Park, Kansas  66209
Shawnee Mission Medical CenterShawnee Mission, Kansas  66204
North Kansas City HospitalKansas City, Missouri  64116
Research Medical CenterKansas City, Missouri  64132
Saint Luke's East - Lee's SummitLee's Summit, Missouri  64086
Liberty HospitalLiberty, Missouri  64068
Heartland Regional Medical CenterSaint Joseph, Missouri  64506
Bozeman Deaconess Cancer CenterBozeman, Montana  59715
Northern Montana HospitalHavre, Montana  59501
Mary Rutan HospitalBellefontaine, Ohio  43311
Knox Community HospitalMount Vernon, Ohio  43050
Fisher-Titus Medical CenterNorwalk, Ohio  44857
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
Memorial Hospital of Rhode IslandPawtucket, Rhode Island  02860
Temple University HospitalPhiladelphia, Pennsylvania  19140
Baton Rouge General Medical CenterBaton Rouge, Louisiana  70821-2511
Singing River HospitalPascagoula, Mississippi  39581
Ben Taub General HospitalHouston, Texas  77030
Methodist HospitalHouston, Texas  77030
Union Hospital of Cecil CountyElkton MD, Maryland  21921
Miriam HospitalProvidence, Rhode Island  02906
Cancer Centers of the Carolinas - Grove CommonsGreenville, South Carolina  29605
Cancer Centers of the Carolinas - SenecaSeneca, South Carolina  29672
Cancer Centers of the Carolinas - SpartanburgSpartanburg, South Carolina  29307
Memorial Medical CenterSpringfield, Illinois  62781
McLeod Regional Medical CenterFlorence, South Carolina  29501
La Grange Memorial HospitalLa Grange, Illinois  60525
Guardian Oncology and Center for WellnessMissoula, Montana  59804
University of VirginiaCharlottesville, Virginia  22908
University of PittsburghPittsburgh, Pennsylvania  15261
Providence HospitalMobile, Alabama  36608
University of North CarolinaChapel Hill, North Carolina  27599
Duke University Medical CenterDurham, North Carolina  27710
Meharry Medical CollegeNashville, Tennessee  37208-3599
Providence Medical CenterKansas City, Kansas  66112
Independence Regional Health CenterIndependence, Missouri  64050
Lynchburg Hematology-Oncology ClinicLynchburg, Virginia  24501
East Bay Radiation Oncology CenterCastro Valley, California  94546
Contra Costa Regional Medical CenterMartinez, California  94553-3156
Memorial Medical CenterModesto, California  95355
Larry G Strieff MD Medical CorporationOakland, California  94609
Elmhurst Memorial HospitalElmhurst, Illinois  60126
Bay Area HospitalCoos Bay, Oregon  97420
Hennepin County Medical CenterMinneapolis, Minnesota  
University of RochesterRochester, New York  14642
Glens Falls HospitalGlens Falls, New York  12801
Holy Cross HospitalFort Lauderdale, Florida  33308
El Camino HospitalMountain View, California  94040
Kaiser Permanente Medical CenterVallejo, California  94589
New Hampshire Oncology-Hematology PAHooksett, New Hampshire  03106
Riverside Methodist HospitalColumbus, Ohio  43214
Licking Memorial HospitalNewark, Ohio  43055-2899
Cancer Center of Kansas - McPhersonMcPherson, Kansas  67460
Providence Portland Medical CenterPortland, Oregon  97213-3635
Mid Dakota ClinicBismarck, North Dakota  58501
Columbus CCOPColumbus, Ohio  43206
University Of VermontBurlington,, Vermont  05403
Kaiser PermanenteSacramento, California  
Wichita CCOPWichita, Kansas  67214-3882
Montana Cancer Consortium CCOPBillings, Montana  59101
Alegent Health Immanuel Medical CenterOmaha, Nebraska  68122
Alegent Health Bergan Mercy Medical CenterOmaha, Nebraska  68124
Flower HospitalSylvania, Ohio  43560-2197
Mount Sinai Hospital Medical CenterChicago, Illinois  60608
Addison Gilbert HospitalGloucester, Massachusetts  01930
Southeastern Regional Medical CenterLumberton, North Carolina  28359
Granville Medical CenterOxford, North Carolina  27565
Person Memorial HospitalRoxboro, North Carolina  27573
Columbia Saint Mary's Hospital - OzaukeeMequon, Wisconsin  53097
Metro-Minnesota CCOPSt. Louis Park, Minnesota  
Providence HospitalSouthfield, Michigan  48075
Community Memorial Health CenterSouth Hill, Virginia  23970-0090
Cancer Centers of the Carolinas - EasleyEasley, South Carolina  29640
Lakeview HospitalStillwater, Minnesota  55082
Decatur Memorial HospitalDecatur, Illinois  62526
Tulane University Health Sciences CenterNew Orleans, Louisiana  70112
Louisiana State University Health Science CenterNew Orleans, Louisiana  70112
Virginia Commonwealth UniversityRichmond, Virginia  
Montana Cancer SpecialistsMissoula, Montana  59807-7877
Boca Raton Comprehensive Cancer CenterBoca Raton, Florida  33486
Florida HospitalOrlando, Florida  32803
Memorial Health University Medical CenterSavannah, Georgia  31404
University of Chicago Comprehensive Cancer CenterChicago, Illinois  60637-1470
Northern Indiana Cancer Research ConsortiumSouth Bend, Indiana  
Florida Hospital Memorial Medical CenterDaytona Beach, Florida  32117
Southeast Cancer CenterCape Girardeau, Missouri  63703
Clackamas Radiation Oncology CenterClackamas, Oregon  97015
Providence Newberg Medical CenterNewberg, Oregon  97132
Butler Memorial HospitalButler, Pennsylvania  16001
New Ulm Medical CenterNew Ulm, Minnesota  56073
Wake Forest University Health SciencesWinston-Salem, North Carolina  27157
Upper Chesapeake Medical CenterBel Air, Maryland  21014
Saint Helena HospitalSaint Helena, California  94574
Veteran's Administration Medical CenterLittle Rock, Arkansas  72205
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
Palo Alto Medical Foundation-Camino DivisionMountain View, California  94040
Bay Area Breast Surgeons IncOakland, California  94609
Bay Area Tumor Institution CCOPOakland, California  94609
Tom K Lee IncOakland, California  94609
Palo Alto Medical Foundation Heath CarePalo Alto, California  94301
Valley Medical Oncology ConsultantsPleasanton, California  94588
Valley Care Health System - PleasantonPleasanton, California  94588
Naval Medical Center -San DiegoSan Diego, California  92134
Doctors Medical Center- JC Robinson Regional Cancer CenterSan Pablo, California  94806
Middlesex HospitalMiddletown, Connecticut  06457
The Hospital of Central ConnecticutNew Britain, Connecticut  06050
Lombardi Comprehensive Cancer Center at Georgetown UniversityWashington, District of Columbia  20057
John B Amos Cancer CenterColumbus, Georgia  31904
Saint Joseph's-Candler Health SystemSavannah, Georgia  31405
Saint Anthony's HealthAlton, Illinois  62002
Rush - Copley Medical CenterAurora, Illinois  60504
Cancer Institute at Alexian BrothersElk Grove Village, Illinois  60007
Saint Francis HospitalEvanston, Illinois  60202
Evanston CCOP-NorthShore University HealthSystemEvanston, Illinois  60201
Provena Saint Mary's HospitalKankakee, Illinois  60901
Garneau, Stewart C MD (UIA Investigator)Moline, Illinois  61265
Porubcin, Michael MD (UIA Investigator)Moline, Illinois  61265
Good Samaritan Regional Medical CenterMt. Vernon, Illinois  62864
Hematology Oncology Consultants LimitedNaperville, Illinois  60540
West Suburban Cancer CenterRiver Forest, Illinois  60305
Hematology Oncology Associates of Illinois - SkokieSkokie, Illinois  60076
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
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
Stormont-Vail Regional Health CenterTopeka, Kansas  66604
Cancer Center of Kansas-Wichita Medical Arts TowerWichita, Kansas  67208
Cancer Center of Kansas - Main OfficeWichita, Kansas  67214
Medical Center of LouisianaNew Orleans, Louisiana  70112
Hickman Cancer CenterAdrian, Michigan  49221
Green Bay Oncology - EscanabaEscanaba, Michigan  49431
Green Bay Oncology - Iron MountainIron Mountain, Michigan  49801
Mercy Memorial HospitalMonroe, Michigan  48162
Lakeland HospitalSt. Joseph, Michigan  49085
Miller-Dwan HospitalDuluth, Minnesota  55805
Saint Luke's Hospital of DuluthDuluth, Minnesota  55805
Unity HospitalFridley, Minnesota  55432
Immanuel-Saint Joseph Hospital-Mayo Health SystemMankato, Minnesota  56002
Saint John's Hospital - HealtheastMaplewood, Minnesota  55109
Minnesota Oncology Hematology PA-MaplewoodMaplewood, Minnesota  55109
Minneapolis Veterans Medical CenterMinneapolis, Minnesota  55417
North Memorial Medical Health CenterRobbinsdale, Minnesota  55422
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
Saint Louis-Cape Girardeau CCOPSaint Louis, Missouri  63141
Missouri Baptist Medical CenterSaint Louis, Missouri  63131
Saint John's Mercy Medical CenterSaint Louis, Missouri  63141
Ozark Health Ventures LLC dba Cancer Research for The Ozarks SpringfieldSpringfield, Missouri  65802
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
Lincoln Medical Education Foundation Cancer Resource CenterLincoln, Nebraska  68510
Missouri Valley Cancer Consortium CCOPOmaha, Nebraska  68106
Nevada Cancer Research Foundation CCOPLas Vegas, Nevada  89106
Exeter HospitalExeter, New Hampshire  03833
New Hampshire Oncology Hematology AssociatesHooksett, New Hampshire  03106
LRGHealthcare-Lakes Region General HospitalLaconia, New Hampshire  03246
Cooper Hospital University Medical CenterCamden, New Jersey  08103
Veterans Adminstration New Jersey Health Care SystemEast Orange, New Jersey  07018-1095
South Jersey HealthcareVineland, New Jersey  08360
Orange Regional Medical CenterMiddletown, New York  10940
Interlakes Foundation Inc-RochesterRochester, New York  14623
Highland HospitalRochester, New York  14620
State University of New York Upstate Medical UniversitySyracuse, New York  13210
Alamance Regional Medical CenterBurlington, North Carolina  27216
Wayne Memorial HospitalGoldsboro, North Carolina  27534
Margaret R Pardee Memorial HospitalHendersonville, North Carolina  28791
Kinston Medical Specialists PAKinston, North Carolina  28501
Saint Alexius Medical CenterBismarck, North Dakota  58501
Doctors HospitalColumbus, Ohio  43228
Grant Medical CenterColumbus, Ohio  43215
Mount Carmel Health Center WestColumbus, Ohio  43222
Hematology Oncology Center IncorporatedElyria, Ohio  44035
Saint Rita's Medical CenterLima, Ohio  45801
Marietta Memorial HospitalMarietta, Ohio  45750
Toledo Radiation Oncology at Northwest Ohio Onocolgy CenterMaumee, Ohio  43537
Saint Charles HospitalOregon, Ohio  43616
North Coast Cancer CareSandusky, Ohio  44870
Toledo Community Hospital Oncology Program CCOPToledo, Ohio  43617
Mercy Cancer Center at Saint Anne Mercy HospitalToledo, Ohio  43623
University of ToledoToledo, Ohio  43614
Saint Vincent Mercy Medical CenterToledo, Ohio  43608
Saint Ann's HospitalWesterville, Ohio  43081
Genesis HealthCare SystemZanesville, Ohio  43701
Providence Saint Vincent Medical CenterPortland, Oregon  97225
Columbia River Oncology ProgramPortland, Oregon  97225
Salem HospitalSalem, Oregon  97309
Scranton Hematology OncologyScranton, Pennsylvania  18510
Mercy HospitalScranton, Pennsylvania  18501
Geisinger Wyoming ValleyWilkes-Barre, Pennsylvania  18711
Greenville CCOPGreenville, South Carolina  29615
Greenville Memorial HospitalGreenville, South Carolina  29605
Sanford Cancer Center-Oncology ClinicSioux Falls, South Dakota  57104
Veterans Administration Medical CenterHouston, Texas  77030
Saint Luke's Episcopal HospitalHouston, Texas  77030
Southwestern Oncology Research DepartmentBennington, Vermont  05201
Fredericksburg Oncology IncFredericksburg, Virginia  22401
Edwards Comprehensive Cancer CenterHuntington, West Virginia  25701
West Virginia UniversityMorgantown, West Virginia  26506
Wheeling HospitalWheeling, West Virginia  26003
Central Wisconsin Cancer ProgramFond Du Lac, Wisconsin  54935
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
Dean Hematology and Oncology ClinicMadison, Wisconsin  53717
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 Maryland Greenebaum Cancer CenterBaltimore, Maryland  21201
Jupiter Medical CenterJupiter, Florida  33458
Elkhart ClinicElkhart, Indiana  46515
Mount Sinai Medical Center CCOPMiami Beach, Florida  33140
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
Saint Mary's Regional Medical CenterLewiston, Maine  04240
Michiana Hematology Oncology PC-NilesNiles, Michigan  49120
University of Missouri - Ellis FischelColumbia, Missouri  65203
Veterans AdministrationColumbia, Missouri  65201
Syracuse Veterans Administration Medical CenterSyracuse, New York  13210
East Carolina UniversityGreenville, North Carolina  27858
Duke Raleigh HospitalRaleigh, North Carolina  27609
North Coast Cancer Care-ClydeClyde, Ohio  43410
Community Health Partners Regional Medical CenterElyria, Ohio  44035
Roper HospitalCharleston, South Carolina  29401
Cancer Centers of the Carolinas - FarisGreenville, South Carolina  29605
Cancer Centers of the Carolinas-Greer Radiation OncologyGreer, South Carolina  29650
Cancer Centers of the Carolinas-Greer Medical OncologyGreer, South Carolina  29650
Nashville Oncology Associates PCNashville, Tennessee  37203
Marshfield Clinic-Chippewa CenterChippewa Falls, Wisconsin  54729
Holy Family Memorial HospitalManitowoc, Wisconsin  54221
Wheaton Franciscan Cancer Care - All SaintsRacine, Wisconsin  53405
Marshfield Clinic Cancer Care at Saint Michael's HospitalStevens Point, Wisconsin  54481
Riverview HospitalWisconsin Rapids, Wisconsin  54494
Long Beach Memorial Medical Center-Todd Cancer InstituteLong Beach, California  90806
Kaiser Permanente Los Angeles Medical CenterLos Angeles, California  90027
Cancer Centers of Southwest Oklahoma ResearchLawton, Oklahoma  
Kaiser Anaheim Medical CenterAnaheim, California  92807
Kaiser Permanente Medical Group - Baldwin ParkBaldwin Park, California  91706
Kaiser Foundation HospitalBellflower, California  90706
Kaiser Permanente HospitalFontana, California  92335
Kaiser Permanente - Harbor CityHarbor City, California  90710
Kaiser Permanente-West Los AngelesLos Angeles, California  90034
Epic Care-OaklandOakland, California  94612
Kaiser Permanente - Panorama CityPanorama City, California  91402
Palchak David MDPismo Beach, California  93449
Kaiser Permanente at San DiegoSan Diego, California  92120
Kaiser Permanente Health CareSan Marcos, California  92069
Spector, David MD (UIA Investigator)Moline, Illinois  61265
Saint Luke's South HospitalOverland Park, Kansas  66213
Kansas City CCOPPrairie Village, Kansas  66208
Doctors Carrol, Sheth, RaghavanLouisville, Kentucky  40215
Hematology and Oncology ClinicBaton Rouge, Louisiana  70809
Veterans Administration Medical CenterBaltimore, Maryland  21201
Capital Region Medical Center-Goldschmidt Cancer CenterJefferson City, Missouri  65109
Heartland Hematology and Oncology Associates IncorporatedKansas City, Missouri  64118
Saint Joseph Oncology IncSaint Joseph, Missouri  64507
Comprehensive Cancer Care PCSaint Louis, Missouri  63141
Arnot Ogden Medical CenterElmira, New York  14905
Durham Veterans Affairs Medical CenterDurham, North Carolina  27705
Mount Carmel East HospitalColumbus, Ohio  43213
The Mark H Zangmeister CenterColumbus, Ohio  43219
Southern Ohio Medical CenterPortsmouth, Ohio  45662
Cancer Care Associates-MercyOklahoma City, Oklahoma  73120
Dallas VA Medical CenterDallas, Texas  75216
Memorial Hospital Of MartinsvilleMartinsville, Virginia  24115
Saint Mary's Medical CenterHuntington, West Virginia  25702
Gundersen LutheranLa Crosse, Wisconsin  54601
Saint Nicholas HospitalMadison, Wisconsin  53715
Columbia Saint Mary's Water Tower Medical CommonsMilwaukee, Wisconsin  53211
Alegent Health Lakeside HospitalOmaha, Nebraska  68130
Beaufort Memorial HospitalBeaufort, South Carolina  29902
Siouxland Hematology Oncology AssociatesSioux City, Iowa  51101
Walter Reed National Military Medical CenterBethesda, Maryland  20889
Kaiser Permanente-MissionSan Diego, California  92108
Hunter Holmes McGuire Veterans Administration Medical CenterRichmond, Virginia  23249
Gulfport Memorial HospitalGulfport, Mississippi  39502
VA Medical Center - University of IowaIowa City, Iowa  52246
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
The Toledo Hospital/Toledo Children's HospitalToledo, Ohio  43606
Sanford USD Medical Center - Sioux FallsSioux Falls, South Dakota  57117-5134
Essentia Health Duluth Clinic CCOPDuluth, Minnesota  55805
Essentia Health Saint Mary's Medical CenterDuluth, Minnesota  55805
Sanford Bismarck Medical CenterBismarck, North Dakota  58501
Toledo Clinic Cancer Centers-OregonOregon, Ohio  43616
Geisinger Medical Center-Cancer Center HazeltonHazleton, Pennsylvania  18201
Community Howard Regional HealthKokomo, Indiana  46904
Indiana University Health La Porte HospitalLa Porte, Indiana  46350
Saint Joseph Regional Medical Center-MishawakaMishawaka, Indiana  46545-1470
Essentia Health Cancer Center-South University ClinicFargo, North Dakota  58103
Christiana Care Health System-Christiana HospitalNewark, Delaware  19718
Springfield Regional Medical CenterSpringfield, Ohio  45505
Edward Hospital/Cancer CenterNaperville, Illinois  60540
Saint Louis Cancer and Breast Institute-South CitySaint Louis, Missouri  63109
Toledo Clinic Cancer Centers-Bowling GreenBowling Green, Ohio  43402
Toledo Clinic Cancer Centers-MaumeeMaumee, Ohio  43537-1839
Toledo Clinic Cancer Centers-ToledoToledo, Ohio  43623
Self Regional HealthcareGreenwood, South Carolina  29646
PeaceHealth Southwest Medical CenterVancouver, Washington  98664
Aurora Cancer Care-Southern LakesElkhorn, Wisconsin  53121
Cancer Care Associates-NormanNorman, Oklahoma  73071
Mercy Physicians of Oklahoma-LakesideOklahoma City, Oklahoma  73120
Providence Willamette Falls Medical CenterOregon City, Oregon  97045
Cancer Center of Western WisconsinNew Richmond, Wisconsin  54017
Feather River Cancer CenterParadise, California  95969
Nash General HospitalRocky Mount, North Carolina  27804
Trinity's Tony Teramana Cancer CenterSteubenville, Ohio  43952
Associated Medical Specialists PA dba Coastal Cancer CenterMyrtle Beach, South Carolina  29572