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A Randomized Phase III Trial of Cisplatin Plus Paclitaxel With and Without NCI-Supplied Bevacizumab (NSC #704865, IND #113912) Versus the Non-Platinum Doublet, Topotecan Plus Paclitaxel, With and Without NCI-Supplied Bevacizumab, In Stage IVB, Recurrent or Persistent Carcinoma of the Cervix


Phase 3
18 Years
N/A
Open (Enrolling)
Female
Cervical Adenocarcinoma, Cervical Adenosquamous Cell Carcinoma, Cervical Squamous Cell Carcinoma, Recurrent Cervical Cancer, Stage IVB Cervical Cancer

Thank you

Trial Information

A Randomized Phase III Trial of Cisplatin Plus Paclitaxel With and Without NCI-Supplied Bevacizumab (NSC #704865, IND #113912) Versus the Non-Platinum Doublet, Topotecan Plus Paclitaxel, With and Without NCI-Supplied Bevacizumab, In Stage IVB, Recurrent or Persistent Carcinoma of the Cervix


PRIMARY OBJECTIVES:

I. To determine whether the addition of bevacizumab to chemotherapy improves overall
survival. Also to determine if a regimen involving paclitaxel and topotecan improves overall
survival in comparison to a regimen involving cisplatin and paclitaxel. These regimens are
to be evaluated in patients with stage IVB, recurrent, or persistent carcinoma of the
cervix.

II. To determine and compare the frequency and severity of adverse events as assessed by
CTCAE version 3.0 for the regimens administered on this study.

SECONDARY OBJECTIVES:

I. To estimate and compare the progression-free survival of patients treated by the regimens
investigated on this study.

II. To estimate and compare the proportion of patients with tumor responses by the regimens
investigated on this study.

TERTIARY OBJECTIVES:

I. To determine whether the addition of bevacizumab to chemotherapy, or the substitution of
cisplatin with topotecan improve the health related quality of life (QOL) as measured by the
FACT-Cx TOI and produce favorable toxicity profiles (with a particular focus on peripheral
neuropathy as measured by the FACT/GOG-Ntx4 subscale and pain as measured by BPI single
item).

II. To evaluate the impact of age, race, performance status, stage, histology, grade,
disease site, prior chemotherapy with primary radiation, and time to recurrence on response
rate, progression-free survival and overall survival of patients with
metastatic/recurrent/persistent carcinoma of the cervix.

III. To determine the prevalence of active smoking in this cohort of recurrent cervical
cancer patients.

IV. To estimate the extent of tobacco/nicotine dependence in the cohort. V. To determine if
smoking is an independent risk factor for progression-free survival and overall survival in
this population.

VI. To isolate, enumerate and characterize circulating tumor cells (CTC) recovered from
blood drawn pre-cycle 1, pre-cycle 2 and pre-cycle 3 using the CTC-chip developed by the
Massachusetts General Hospital (MGH) BioMEMS Resource Center and the MGH Cancer Center.

VII. To determine the association between CTC counts or characteristics and measures of
clinical outcome.

VIII. To examine the association between angiogenesis markers in plasma (recovered from
blood drawn pre-cycle 1, pre-cycle 2 and pre-cycle 3) and measures of clinical outcome.

IX. To evaluate the association between tumor markers of angiogenesis and hypoxia (using
archival formalin-fixed and paraffin-embedded tumor tissue) and measures of clinical
outcome.

X. To evaluate the association between single nucleotide polymorphisms (using DNA extracted
from whole blood) and measures of clinical outcome as well as measures of quality of life
such as chemotherapy toxicity.

XI. To examine the relationship(s) among the various biomarkers. XII. To develop an optimal
prognostic model for progression-free survival and overall survival using clinical
covariates, smoking status and the various biomarkers.

OUTLINE: This is a multicenter study. Patients are stratified according to disease status
(recurrent/persistent disease vs primary stage IVB disease), GOG performance status (0 vs
1), and prior platinum therapy as a radiosensitizer (yes vs no). Patients are randomized to
1 of 4 treatment arms.

ARM I: Patients receive paclitaxel IV over 3 hours or 24 hours on day 1 and cisplatin IV on
day 1 or 2.

ARM II: Patients receive paclitaxel IV over 3 hours or 24 hours on day 1 and cisplatin IV
and bevacizumab IV over 30-90 minutes on day 1 or 2.

ARM III: Patients receive paclitaxel IV over 3 hours on day 1 and topotecan hydrochloride IV
over 30 minutes on days 1-3.

ARM IV: Patients receive paclitaxel IV over 3 hours and bevacizumab IV over 30-90 minutes on
day 1 and topotecan hydrochloride IV over 30 minutes on days 1-3.

In all arms, courses repeat every 21 days in the absence of disease progression or
unacceptable toxicity. Patients complete quality-of-life questionnaires, including the
FACT-Cx TOI, FACT/GOG-Ntx4, and Brief Pain Inventory, at baseline, before courses 2 and 5,
and at 6 and 9 months after course 1. Patients also complete a smoking questionnaire at
baseline. After completion of study therapy, patients are followed every 3 months for 2
years and then every 6 months for 3 years.


Inclusion Criteria:



- Histologically confirmed carcinoma of the cervix, including any of the following
subtypes:

- Squamous cell carcinoma

- Adenosquamous cell carcinoma

- Adenocarcinoma

- Primary stage IVB, recurrent, or persistent disease not amenable to curative
treatment with surgery and/or radiotherapy

- Measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm by
conventional techniques or ≥ 10 mm by spiral CT scan

- Biopsy confirmation required if target lesion(s) measures < 30 mm or if the
treating physician determines it is clinically indicated

- Has ≥ 1 "target lesion" that can be used to assess response

- Tumors within a previously irradiated field are designated as "non-target"
lesions unless progression is documented or a biopsy is obtained to confirm
persistence ≥ 90 days following completion of radiotherapy

- No history or evidence of CNS disease, including primary brain tumor, brain
metastases, or craniospinal metastases

- GOG performance status 0-1

- ANC ≥ 1,500/mm³

- Platelet count ≥ 100,000/mm³

- Bilirubin ≤ 1.5 times normal

- SGOT ≤ 2.5 times normal

- Alkaline phosphatase ≤ 2.5 times normal

- PT/INR ≤ 1.5 (or in-range INR, if patient is on a stable dose of therapeutic warfarin
for management of venous thrombosis, including pulmonary thromboembolus)

- PTT < 1.2 times upper limit of normal

- Serum creatinine normal OR creatinine clearance ≥ 60 mL/min

- Urine protein:creatinine ratio 1.0 mg/dL

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception during and for ≥ 6 months after
completion of study treatment

- No active infection requiring antibiotics

- No significant traumatic injury within the past 28 days

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

- Patients with granulating incisions healing by secondary intention are eligible
provided there is no evidence of fascial dehiscence or infection AND the wound
is examined weekly

- No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within
the past 3-6 months

- Patients must have undergone correction (or spontaneous healing) of the
perforation/fistula and/or the underlying process causing the
fistula/perforation

- No clinical symptoms or signs of gastrointestinal obstruction requiring parenteral
hydration and/or nutrition

- No active bleeding or pathologic condition that carries a high risk of bleeding
(e.g., known bleeding disorder, coagulopathy, or tumor involving major vessels)

- No seizures not controlled with standard medical therapy

- No cerebrovascular accident (i.e., stroke), transient ischemic attack, or
subarachnoid hemorrhage within the past 6 months

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

- Uncontrolled hypertension, defined as systolic BP > 150 mm Hg or diastolic BP >
90 mm Hg

- Myocardial infarction or unstable angina within the past 6 months

- NYHA class II-IV congestive heart failure

- Serious cardiac arrhythmia requiring medication

- Atrial fibrillation allowed provided it is asymptomatic and ventricular
rate is controlled

- Significant peripheral vascular disease (i.e., ≥ grade 2 peripheral vascular
disease, as defined by NCI CTCAE v3.0 criteria)

- No bilateral hydronephrosis that cannot be alleviated by ureteral stents or
percutaneous drainage

- No known hypersensitivity to Chinese hamster ovary cell products or other recombinant
human or humanized antibodies

- No other invasive malignancy within the past 5 years, except nonmelanoma skin cancer

- No other medical history or condition that, in the opinion of the investigator, would
preclude study participation

- No peripheral neuropathy ≥ grade 2

- Recovered from all prior therapy

- No prior anti-cancer therapy that would preclude study therapy

- No prior anti-VEGF drugs, including bevacizumab

- No prior chemotherapy unless given concurrently with radiotherapy

- Prior paclitaxel and/or topotecan with radiotherapy not allowed

- At least 6 weeks since prior chemoradiotherapy

- At least 3 weeks since prior radiotherapy alone

- More than 28 days since prior major surgery or open biopsy

- More than 7 days since prior core biopsy

- No concurrent major surgery including, but not limited to, abdominal surgery prior to
disease progression (e.g., colostomy or enterostomy reversal, interval or secondary
cytoreductive surgery, or second-look surgery via laparotomy or laparoscopy)

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Overall survival

Outcome Time Frame:

From entry into the study to death or the date of last contact, assessed up to 5 years

Safety Issue:

No

Principal Investigator

Krishnansu Tewari

Investigator Role:

Principal Investigator

Investigator Affiliation:

Gynecologic Oncology Group

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2009-01084

NCT ID:

NCT00803062

Start Date:

April 2009

Completion Date:

Related Keywords:

  • Cervical Adenocarcinoma
  • Cervical Adenosquamous Cell Carcinoma
  • Cervical Squamous Cell Carcinoma
  • Recurrent Cervical Cancer
  • Stage IVB Cervical Cancer
  • Adenocarcinoma
  • Adenocarcinoma, Mucinous
  • Carcinoma
  • Carcinoma, Squamous Cell
  • Uterine Cervical Neoplasms
  • Carcinoma, Adenosquamous

Name

Location

Baylor College of MedicineHouston, Texas  77030
Louisiana State UniversityNew Orleans, Louisiana  70112-2282
Memorial Sloan Kettering Cancer CenterNew York, New York  10021
Cleveland Clinic FoundationCleveland, Ohio  44195
Mayo ClinicRochester, Minnesota  55905
H. Lee Moffitt Cancer Center and Research InstituteTampa, Florida  33612
University of Iowa Hospitals and ClinicsIowa City, Iowa  52242
University of Mississippi Medical CenterJackson, Mississippi  39216-4505
Abington Memorial HospitalAbington, Pennsylvania  19001
Fox Chase Cancer CenterPhiladelphia, Pennsylvania  19111
Medical University of South CarolinaCharleston, South Carolina  29425-0721
Hurley Medical CenterFlint, Michigan  48503
Pennsylvania HospitalPhiladelphia, Pennsylvania  19107
Sinai Hospital of BaltimoreBaltimore, Maryland  21225
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
Fairview Ridges HospitalBurnsville, Minnesota  55337
Hutchinson Area Health CareHutchinson, Minnesota  55350
United HospitalSt. Paul, Minnesota  55102
Ridgeview Medical CenterWaconia, Minnesota  55387
Avera Cancer InstituteSioux Falls, South Dakota  57105
Loyola University Medical CenterMaywood, Illinois  60153
Massachusetts General Hospital Cancer CenterBoston, Massachusetts  02114
Morristown Memorial HospitalMorristown, New Jersey  07962-1956
Henry Ford HospitalDetroit, Michigan  48202
Marshfield ClinicMarshfield, Wisconsin  54449
Sutter Health Western Division Cancer Research GroupGreenbrae, California  94904
Methodist Medical Center of IllinoisPeoria, Illinois  61636
Memorial Hospital of South BendSouth Bend, Indiana  46601
Beth Israel Medical CenterNew York, New York  10003
Akron General Medical CenterAkron, Ohio  44302
Lehigh Valley HospitalAllentown, Pennsylvania  18103
Western Pennsylvania HospitalPittsburgh, Pennsylvania  15224
Reading Hospital and Medical CenterReading, Pennsylvania  19612-6052
University of Texas Medical BranchGalveston, Texas  77555-1329
LDS HospitalSalt Lake City, Utah  84143
Waukesha Memorial HospitalWaukesha, Wisconsin  53188
Rush University Medical CenterChicago, Illinois  60612-3824
Dana-Farber Cancer InstituteBoston, Massachusetts  02115
North Shore University HospitalManhasset, New York  11030
University of Arkansas for Medical SciencesLittle Rock, Arkansas  72205
University of Kansas Medical CenterKansas City, Kansas  66160-7353
Brooke Army Medical CenterFort Sam Houston, Texas  78234-6200
Hartford HospitalHartford, Connecticut  06102-5037
Sarasota Memorial HospitalSarasota, Florida  34239
Franklin Square Hospital CenterBaltimore, Maryland  21237
Baystate Medical CenterSpringfield, Massachusetts  01199
William Beaumont HospitalRoyal Oak, Michigan  48073
Cancer Institute of New JerseyNew Brunswick, New Jersey  08901
University of Nebraska Medical CenterOmaha, Nebraska  68198-3330
Broward General Medical CenterFort Lauderdale, Florida  33316
Via Christi Regional Medical CenterWichita, Kansas  67214
Ochsner Clinic FoundationNew Orleans, Louisiana  70121
Carolinas Medical CenterCharlotte, North Carolina  28232-2861
University of Oklahoma Health Sciences CenterOklahoma City, Oklahoma  73104
Scott and White Memorial HospitalTemple, Texas  76508
John Muir Medical CenterWalnut Creek, California  94598
Iowa Methodist Medical CenterDes Moines, Iowa  50309
Iowa Lutheran HospitalDes Moines, Iowa  50316-2301
Weill Medical College of Cornell UniversityNew York, New York  10021
University of Wisconsin Hospital and ClinicsMadison, Wisconsin  53792-0001
Great Falls ClinicGreat Falls, Montana  59405
Overlook HospitalSummit, New Jersey  07902-0220
MetroHealth Medical CenterCleveland, Ohio  44109
Central Baptist HospitalLexington, Kentucky  40503
Valley HospitalRidgewood, New Jersey  07450
Wilford Hall Medical CenterLackland Air Force Base, Texas  78236-5300
Long Island Jewish Medical CenterNew Hyde Park, New York  11040
Advocate Christ Medical CenterOak Lawn, Illinois  60453
North Colorado Medical CenterGreeley, Colorado  80631
McKee Medical CenterLoveland, Colorado  80539
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
Munson Medical CenterTraverse City, Michigan  49684
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
American Fork HospitalAmerican Fork, Utah  84003
Logan Regional HospitalLogan, Utah  84321
McKay-Dee Hospital CenterOgden, Utah  84403
Welch Cancer CenterSheridan, Wyoming  82801
University of South Alabama Mitchell Cancer InstituteMobile, Alabama  36604
University of New Mexico Cancer CenterAlbuquerque, New Mexico  87131-5636
Good Samaritan Hospital - CincinnatiCincinnati, Ohio  45220
Brigham and Women's HospitalBoston, Massachusetts  02115
Methodist Estabrook Cancer CenterOmaha, Nebraska  68114-4199
Cancer Centers of the CarolinasGreenville, South Carolina  29605
City of Hope Medical CenterDuarte, California  91010
Paoli Memorial HospitalPaoli, Pennsylvania  19301-1792
Elkhart General HospitalElkhart, Indiana  46515
Gynecologic Oncology of IndianaIndianapolis, Indiana  46237
South Bend ClinicSouth Bend, Indiana  46617
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical CenterColumbus, Ohio  43210-1240
Parkland Memorial HospitalDallas, Texas  75235
Front Range Cancer SpecialistsFort Collins, Colorado  80528
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
Swedish Covenant HospitalChicago, Illinois  60625
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
Mecosta County Medical CenterBig Rapids, Michigan  49307
Bismarck Cancer CenterBismarck, North Dakota  58501
Grandview HospitalDayton, Ohio  45405
Bryn Mawr HospitalBryn Mawr, Pennsylvania  19010
Exempla Lutheran Medical CenterWheat Ridge, Colorado  80033
Eureka HospitalEureka, Illinois  61530
Mercy HospitalCoon Rapids, Minnesota  55433
Allenmore HospitalTacoma, Washington  98411-0414
Graham Hospital AssociationCanton, Illinois  61520
Holy Family Medical CenterDes Plaines, Illinois  60016
Saint Joseph Medical CenterJoliet, Illinois  60435
Medical Oncology and Hematology AssociatesDes Moines, Iowa  50309
Saint Joseph Mercy HospitalAnn Arbor, Michigan  48106
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
Northeast Georgia Medical CenterGainesville, Georgia  30501
Randolph HospitalAsheboro, North Carolina  27203
Miami Valley HospitalDayton, Ohio  45409
Spartanburg Regional Medical CenterSpartanburg, South Carolina  29303
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
Wayne HospitalGreenville, Ohio  45331
Knox Community HospitalMount Vernon, Ohio  43050
Clinton Memorial HospitalWilmington, Ohio  45177
Providence Centralia HospitalCentralia, Washington  98531-9027
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
Woman's HospitalBaton Rouge, Louisiana  70815
Longmont United HospitalLongmont, Colorado  80501
Temple University HospitalPhiladelphia, Pennsylvania  19140
Singing River HospitalPascagoula, Mississippi  39581
Ben Taub General HospitalHouston, Texas  77030
Methodist HospitalHouston, Texas  77030
Aurora Sinai Medical CenterMilwaukee, Wisconsin  53201-0342
Greene Memorial HospitalXenia, Ohio  45385
Greater Baltimore Medical CenterBaltimore, Maryland  21204
Rutherford HospitalRutherfordton, North Carolina  28139
AnMed Health Cancer CenterAnderson, South Carolina  29621
Union Hospital of Cecil CountyElkton MD, Maryland  21921
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
Presbyterian HospitalCharlotte, North Carolina  28233-3549
Mayo Clinic in FloridaJacksonville, Florida  32224
Washington Hospital CenterWashington, District of Columbia  20010
Memorial Medical CenterSpringfield, Illinois  62781
Phelps County Regional Medical CenterRolla, Missouri  65401
McLeod Regional Medical CenterFlorence, South Carolina  29501
Wellmont Holston Valley Hospital and Medical CenterKingsport, Tennessee  37662
Metro Health HospitalGrand Rapids, Michigan  49506
Guardian Oncology and Center for WellnessMissoula, Montana  59804
Queen's Medical CenterHonolulu, Hawaii  96813
University of VirginiaCharlottesville, Virginia  22908
University of Alabama at BirminghamBirmingham, Alabama  35294-3300
Vanderbilt UniversityNashville, Tennessee  37232-6305
University of North CarolinaChapel Hill, North Carolina  27599
Meharry Medical CollegeNashville, Tennessee  37208-3599
Northwestern UniversityChicago, Illinois  60611
Kapiolani Medical Center at Pali MomiAiea, Hawaii  96701
Kapiolani Medical Center for Women and ChildrenHonolulu, Hawaii  96826
Maui Memorial Medical CenterWailuku, Hawaii  96793
Hennepin County Medical CenterMinneapolis, Minnesota  
Queens Hospital CenterJamaica, New York  11432
Saint Louis University HospitalSt. Louis, Missouri  63110-0250
Saint Alphonsus Regional Medical CenterBoise, Idaho  83706
University of California at San DiegoLa Jolla, California  92093
Emory UniversityAtlanta, Georgia  30322
Wayne State UniversityDetroit, Michigan  48202
Straub Clinic and HospitalHonolulu, Hawaii  96813
Lakeland Regional Cancer CenterLakeland, Florida  33805
Riverside Methodist HospitalColumbus, Ohio  43214
Licking Memorial HospitalNewark, Ohio  43055-2899
Cancer Center of Kansas - McPhersonMcPherson, Kansas  67460
California Pacific Medical CenterSan Francisco, California  94115
Dartmouth Hitchcock Medical CenterLebanon, New Hampshire  03756
Mid Dakota ClinicBismarck, North Dakota  58501
Columbus CCOPColumbus, Ohio  43206
Indiana University Medical CenterIndianapolis, Indiana  46202
Presbyterian - Saint Lukes Medical Center - Health OneDenver, Colorado  80218
University of Texas Southwestern Medical CenterDallas, Texas  
University of KentuckyLexington, Kentucky  40536-0098
Wichita CCOPWichita, Kansas  67214-3882
Montana Cancer Consortium CCOPBillings, Montana  59101
Huntsman Cancer Institute/University of UtahSalt Lake City, Utah  84112
Mount Sinai Hospital Medical CenterChicago, Illinois  60608
Metro-Minnesota CCOPSt. Louis Park, Minnesota  
UC Davis Comprehensive Cancer CenterSacramento, California  95817
Providence HospitalSouthfield, Michigan  48075
Tufts Medical CenterBoston, Massachusetts  02111
Cancer Centers of the Carolinas - EasleyEasley, South Carolina  29640
Lakeview HospitalStillwater, Minnesota  55082
Florida Gynecologic OncologyFort Myers, Florida  33901
Jersey Shore Medical CenterNeptune, New Jersey  07754
Decatur Memorial HospitalDecatur, Illinois  62526
Tulane University Health Sciences CenterNew Orleans, Louisiana  70112
Virginia Commonwealth UniversityRichmond, Virginia  
Lankenau HospitalWynnewood, Pennsylvania  19096
Central Georgia Gynecologic OncologyMacon, Georgia  31201
Montana Cancer SpecialistsMissoula, Montana  59807-7877
Providence Saint Joseph Medical CenterBurbank, California  91505-4866
Florida HospitalOrlando, Florida  32803
Memorial Health University Medical CenterSavannah, Georgia  31404
Hillcrest Hospital Cancer CenterMayfield Heights, Ohio  44124
University of Chicago Comprehensive Cancer CenterChicago, Illinois  60637-1470
M D Anderson Cancer CenterHouston, Texas  77030
University of Southern CaliforniaLos Angeles, California  90033
DeKalb Medical CenterDecatur, Georgia  30033
Northern Indiana Cancer Research ConsortiumSouth Bend, Indiana  
University of CincinnatiCincinnati, Ohio  45267-0502
Hawaii Medical Center EastHonolulu, Hawaii  96817
Penn State Milton S Hershey Medical CenterHershey, Pennsylvania  17033
Piedmont Fayette HospitalFayetteville, Georgia  30214
The Community HospitalMunster, Indiana  46321
Littleton Adventist HospitalLittleton, Colorado  80122
Parker Adventist HospitalParker, Colorado  80138
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
Mills - Peninsula HospitalsBurlingame, California  94010
California Cancer Center - North FresnoFresno, California  93720
Saint Joseph HospitalOrange, California  92868
University of California San Francisco Medical Center-Mount ZionSan Francisco, California  94115
The Medical Center of AuroraAurora, Colorado  80012
Penrose-Saint Francis HealthcareColorado Springs, Colorado  80907
Saint Anthony Central HospitalDenver, Colorado  80204
Exempla Saint Joseph HospitalDenver, Colorado  80218
Colorado Cancer Research Program CCOPDenver, Colorado  80224-2522
Saint Mary's Hospital and Regional Medical CenterGrand Junction, Colorado  81502
Saint Mary Corwin Medical CenterPueblo, Colorado  81004
Saint Francis Hospital and Medical CenterHartford, Connecticut  06105
The Hospital of Central ConnecticutNew Britain, Connecticut  06050
M D Anderson Cancer Center- OrlandoOrlando, Florida  32806
Atlanta Regional CCOPAtlanta, Georgia  30342
Well Star Cobb HospitalAustell, Georgia  30106
John B Amos Cancer CenterColumbus, Georgia  31904
Wellstar Kennestone HospitalMarietta, Georgia  30060
Oncare Hawaii Inc-POB IIHonolulu, Hawaii  96813
Oncare Hawaii Inc-KuakiniHonolulu, Hawaii  96817
University of HawaiiHonolulu, Hawaii  96813
Pacific Cancer Institute of MauiWailuku, Hawaii  96793
John H Stroger Jr Hospital of Cook CountyChicago, Illinois  60612-3785
Saint Francis HospitalEvanston, Illinois  60202
Joliet Oncology-Hematology Associates LimitedJoliet, Illinois  60435
Provena Saint Mary's HospitalKankakee, Illinois  60901
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
Saint Francis Hospital and Health CentersBeech Grove, Indiana  46107
Fort Wayne Medical Oncology and Hematology Inc - State BoulevardFort Wayne, Indiana  46845
Saint Vincent Hospital and Health ServicesIndianapolis, Indiana  46260
Reid Hospital and Health Care ServicesRichmond, Indiana  47374
McFarland ClinicAmes, Iowa  50010
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
Cancer Center of Kansas - El DoradoEl Dorado, Kansas  67042
Cancer Center of Kansas-KingmanKingman, Kansas  67068
Cancer Center of Kansas - ParsonsParsons, Kansas  67357
Cancer Center of Kansas - PrattPratt, Kansas  67124
Cancer Center of Kansas-Wichita Medical Arts TowerWichita, Kansas  67208
Cancer Center of Kansas - Main OfficeWichita, Kansas  67214
Ochsner Clinic CCOPNew Orleans, Louisiana  70121
Highland ClinicShreveport, Louisiana  71105
Michigan Cancer Research Consortium Community Clinical Oncology ProgramAnn Arbor, Michigan  48106
Oakwood HospitalDearborn, Michigan  48123
Saint John Hospital and Medical CenterDetroit, Michigan  48236
Green Bay Oncology - EscanabaEscanaba, Michigan  49431
Grand Rapids Clinical Oncology ProgramGrand Rapids, Michigan  49503
Saint Mary's Health CareGrand Rapids, Michigan  49503
Spectrum Health at Butterworth CampusGrand Rapids, Michigan  49503
Green Bay Oncology - Iron MountainIron Mountain, Michigan  49801
Allegiance HealthJackson, Michigan  49201
Sparrow HospitalLansing, Michigan  48912
Saint Mary Mercy HospitalLivonia, Michigan  48154
Mid-Michigan Medical Center - MidlandMidland, Michigan  48670
Mercy Health Partners-Mercy CampusMuskegon, Michigan  49443
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
Unity HospitalFridley, Minnesota  55432
Saint John's Hospital - HealtheastMaplewood, Minnesota  55109
Minnesota Oncology Hematology PA-MaplewoodMaplewood, Minnesota  55109
North Memorial Medical Health CenterRobbinsdale, Minnesota  55422
Park Nicollet Clinic - Saint Louis ParkSaint Louis Park, Minnesota  55416
Minnesota Oncology and Hematology PA-WoodburyWoodbury, Minnesota  55125
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
Ozark Health Ventures LLC dba Cancer Research for The Ozarks SpringfieldSpringfield, Missouri  65802
Saint John's HospitalSpringfield, Missouri  65804
Cox Medical CenterSpringfield, Missouri  65807
Hematology-Oncology Centers of the Northern Rockies PCBillings, Montana  59101
Saint Vincent HealthcareBillings, Montana  59101
Billings ClinicBillings, Montana  59107-7000
Saint James Community Hospital and Cancer Treatment CenterButte, Montana  59701
Benefis Healthcare- Sletten Cancer InstituteGreat Falls, Montana  59405
Berdeaux, Donald MD (UIA Investigator)Great Falls, Montana  59405
Saint Peter's Community HospitalHelena, Montana  59601
Glacier Oncology PLLCKalispell, Montana  59901
Saint Patrick Hospital - Community HospitalMissoula, Montana  59802
Cooper Hospital University Medical CenterCamden, New Jersey  08103
Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington CountyMount Holly, New Jersey  08060
South Jersey HealthcareVineland, New Jersey  08360
Virtua West Jersey Hospital VoorheesVoorhees, New Jersey  08043
Orange Regional Medical CenterMiddletown, New York  10940
New York University Langone Medical CenterNew York, New York  10016
Saint Luke's Roosevelt Hospital Center - Saint Luke's DivisionNew York, New York  10025
Columbia University Medical CenterNew York, New York  10032
State University of New York Upstate Medical UniversitySyracuse, New York  13210
Alamance Regional Medical CenterBurlington, North Carolina  27216
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
Good Samaritan Hospital - DaytonDayton, Ohio  45406
Dayton CCOPDayton, Ohio  45429
Samaritan North Health CenterDayton, Ohio  45415
Blanchard Valley HospitalFindlay, Ohio  45840
Atrium Medical Center-Middletown Regional HospitalFranklin, Ohio  45005-1066
Kettering Medical CenterKettering, Ohio  45429
Saint Rita's Medical CenterLima, Ohio  45801
Marietta Memorial HospitalMarietta, Ohio  45750
Upper Valley Medical CenterTroy, Ohio  45373
Saint Ann's HospitalWesterville, Ohio  43081
Genesis HealthCare SystemZanesville, Ohio  43701
Saint Luke's HospitalBethlehem, Pennsylvania  18015
Mainline Health CCOPWynnewood, Pennsylvania  19096
AnMed Health HospitalAnderson, South Carolina  29621
Greenville CCOPGreenville, South Carolina  29615
Greenville Memorial HospitalGreenville, South Carolina  29605
Upstate Carolina CCOPSpartanburg, South Carolina  29303
Sanford Cancer Center-Oncology ClinicSioux Falls, South Dakota  57104
Tennessee Oncology PLLC- Centennial Medical CenterNashville, Tennessee  37203
Veterans Administration Medical CenterHouston, Texas  77030
Saint Luke's Episcopal HospitalHouston, Texas  77030
Southwest VA Regional Cancer CenterNorton, Virginia  24273
Saint Francis HospitalFederal Way, Washington  98003
Providence - Saint Peter HospitalOlympia, Washington  98506-5166
Good Samaritan Community HospitalPuyallup, Washington  98372
Northwest CCOPTacoma, Washington  98405
Multicare Health SystemTacoma, Washington  98415
Saint Clare HospitalTacoma, Washington  98499
Saint Joseph Medical CenterTacoma, Washington  98405
Langlade Hospital and Cancer CenterAntigo, Wisconsin  54409
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
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
Saint Michael's HospitalStevens Point, Wisconsin  54481
Green Bay Oncology - Sturgeon BaySturgeon Bay, Wisconsin  54235
Aspirus Regional Cancer CenterWausau, Wisconsin  54401
University of California Medical Center At Irvine-Orange CampusOrange, California  92868
Cancer Care Associates-YaleTulsa, Oklahoma  74136-1929
Women and Infants HospitalProvidence, Rhode Island  02905
University of Maryland Greenebaum Cancer CenterBaltimore, Maryland  21201
Lyndon Baines Johnson General HospitalHouston, Texas  77030
Stony Brook University Medical CenterStony Brook, New York  11794
Elkhart ClinicElkhart, Indiana  46515
John Muir Medical Center-Concord CampusConcord, California  94520
University of Colorado Cancer Center - Anschutz Cancer PavilionAurora, Colorado  80045
Memorial Healthcare System - Joe DiMaggio Children's HospitalHollywood, Florida  33021
Harbin Clinic Medical Oncology and Clinical ResearchRome, Georgia  30165
Illinois CancerCare-BloomingtonBloomington%, Illinois  61701
Illinois CancerCare-CantonCanton, Illinois  61520
Illinois CancerCare-CarthageCarthage, Illinois  62321
Illinois CancerCare-EurekaEureka, Illinois  61530
Illinois CancerCare-HavanaHavana, Illinois  62644
Illinois CancerCare-Kewanee ClinicKewanee, Illinois  61443
Illinois CancerCare-MacombMacomb, Illinois  61455
Illinois CancerCare-MonmouthMonmouth, Illinois  61462
Illinois CancerCare-Community Cancer CenterNormal, Illinois  61761
Illinois CancerCare-PekinPekin, Illinois  61603
Illinois CancerCare-PeruPeru, Illinois  61354
Illinois CancerCare-PrincetonPrinceton, Illinois  61356
Illinois CancerCare-Spring ValleySpring Valley, Illinois  61362
Michiana Hematology Oncology PC-ElkhartElkhart, Indiana  46514
Michiana Hematology Oncology PC-PlymouthPlymouth, Indiana  46563
Michiana Hematology Oncology PC-South BendSouth Bend, Indiana  46601
Michiana Hematology Oncology-PC WestvilleWestville, Indiana  46391
Cancer Center of Kansas-LiberalLiberal, Kansas  67901
Michiana Hematology Oncology PC-NilesNiles, Michigan  49120
Renown Regional Medical CenterReno, Nevada  89502
UMDNJ - New Jersey Medical SchoolNewark, New Jersey  07103
Moses Cone Health System-Regional Cancer CenterGreensboro, North Carolina  27403
Annie Penn Memorial HospitalReidsville, North Carolina  27320
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
University of Tennessee - KnoxvilleKnoxville, Tennessee  37920
Sandra L Maxwell Cancer CenterCedar City, Utah  84720
Intermountain Medical CenterMurray, Utah  84157
Utah Valley Regional Medical CenterProvo, Utah  84603
Dixie Medical Center Regional Cancer CenterSaint George, Utah  84770
Utah Cancer Specialists-Salt Lake CitySalt Lake City, Utah  84106
Marshfield Clinic-Chippewa CenterChippewa Falls, Wisconsin  54729
Holy Family Memorial HospitalManitowoc, Wisconsin  54221
Marshfield Clinic Cancer Care at Saint Michael's HospitalStevens Point, Wisconsin  54481
Vince Lombardi Cancer ClinicTwo Rivers, Wisconsin  54241
Washington Regional Medical Center - FayettevilleFayetteville, Arkansas  72703
Olive View-University of California Los Angeles Medical CenterSylmar, California  91342
Hawaii Minority Based CCOPHonolulu, Hawaii  96813
Advocate Lutheran General HospitalPark Ridge, Illinois  60068
Saint Elizabeth Medical Center SouthEdgewood, Kentucky  41017
Maine Medical Center-Bramhall CampusPortland, Maine  04102
Center of Hope at Renown Medical CenterReno, Nevada  89502
Montefiore Medical Center-Weiler DivisionBronx, New York  10461
State University of New York Downstate Medical CenterBrooklyn, New York  11203
Monter Cancer CenterLake Success, New York  11042
Hope, A Women's Cancer CenterAsheville, North Carolina  28816
Magee-Womens Hospital - University of Pittsburgh Medical CenterPittsburgh, Pennsylvania  15213
Black Hills Obstetrics and GynecologyRapid City, South Dakota  57701
Carilion Clinic Gynecological OncologyRoanoke, Virginia  24016
Aurora Women's Pavilion of Aurora West Allis Medical CenterWest Allis, Wisconsin  53227
Long Beach Memorial Medical Center-Todd Cancer InstituteLong Beach, California  90806
Kaiser Permanente Medical Care Program - Los Angeles Medical Center & Sunset HospitalLos Angeles, California  90027
Rocky Mountain Gynecologic Oncology PCEnglewood, Colorado  80110
Grady Health SystemAtlanta, Georgia  30303
Norton Health Care Pavilion - DowntownLouisville, Kentucky  40202
University of Minnesota Medical Center-FairviewMinneapolis, Minnesota  55455
Southwest Gynecologic Oncology Associates IncAlbuquerque, New Mexico  87106
Women's Cancer Center of NevadaLas Vegas, Nevada  89109
Wilcox Memorial Hospital and Kauai Medical ClinicLihue, Hawaii  96766-1099
Central DuPage Hospital Cancer CenterWarrenville, Illinois  60555
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
Heartland Hematology and Oncology Associates IncorporatedKansas City, Missouri  64118
Saint Joseph Oncology IncSaint Joseph, Missouri  64507
Southern Ohio Medical CenterPortsmouth, Ohio  45662
Saint Francis HospitalGreenville, South Carolina  29601
Gundersen LutheranLa Crosse, Wisconsin  54601
Los Angeles County-USC Medical CenterLos Angeles, California  90033
Stanford University Hospitals and ClinicsStanford, California  94305
Palo Alto Medical Foundation-Gynecologic OncologyMountain View, California  94040
Sudarshan K Sharma MD Limted-Gynecologic OncologyHinsdale, Illinois  60521
Saint Vincent Oncology CenterIndianapolis, Indiana  46260
University of Massachusetts Memorial Health CareWorcester, Massachusetts  01605
The Women's Institute for Gynecologic Cancer and Special Pelvic SurgeryPhillipsburg, New Jersey  08865
University Medical Center BrackenridgeAustin, Texas  78701
Aurora Saint Luke's Medical CenterMilwaukee, Wisconsin  53215
Georgia Health Sciences UniversityAugusta, Georgia  30912
Jonsson Comprehensive Cancer CenterLos Angeles, California  90095
Alta Bates Summit Medical Center-Herrick CampusBerkeley, California  94704
Michiana Hematology Oncology PC-MishawakaMishawaka, Indiana  46545-1470
Marie Yeager Cancer CenterSaint Joseph, Michigan  49085
Emory University Hospital MidtownAtlanta, Georgia  30308
Summa Akron City HospitalAkron, Ohio  44304
Roy and Patricia Disney Family Cancer CenterBurbank, California  91505
Sanford USD Medical Center - Sioux FallsSioux Falls, South Dakota  57117-5134
North Shore-LIJ Health System CCOPManhasset, New York  11030
Genesys Regional Medical Center-West Flint CampusFlint, Michigan  48532
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
Christiana Care Health System-Christiana HospitalNewark, Delaware  19718
Bronson Battle CreekBattle Creek, Michigan  49017
Springfield Regional Medical CenterSpringfield, Ohio  45505
Cleveland Clinic Cancer Center/Fairview HospitalCleveland, Ohio  44111
Saint Joseph's Hospital and Medical CenterPhoenix, Arizona  85013
Women's Cancer Care Associates LLCAlbany, New York  12208
Island Gynecologic OncologyBrightwaters, New York  11718
Fletcher Allen Health Care-Medical CenterBurlington, Vermont  05401
Self Regional HealthcareGreenwood, South Carolina  29646
South Carolina Oncology Associates PAColumbia, South Carolina  29210
D N Greenwald CenterMukwonago, Wisconsin  53149
Pikeville Medical CenterPikeville, Kentucky  41501
Baylor All Saints Medical Center at Fort WorthFort Worth, Texas  76104