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Randomized Phase II 2 x 2 Factorial Trial of the Addition of Carboplatin +/- Bevacizumab to Neoadjuvant Weekly Paclitaxel Followed by Dose-Dense AC in Hormone Receptor-Poor/HER2-Negative Resectable Breast Cancer

Phase 2
18 Years
Open (Enrolling)
Estrogen Receptor-negative Breast Cancer, HER2-negative Breast Cancer, Male Breast Cancer, Progesterone Receptor-negative Breast Cancer, Stage II Breast Cancer, Stage IIIA Breast Cancer, Triple-negative Breast Cancer

Thank you

Trial Information

Randomized Phase II 2 x 2 Factorial Trial of the Addition of Carboplatin +/- Bevacizumab to Neoadjuvant Weekly Paclitaxel Followed by Dose-Dense AC in Hormone Receptor-Poor/HER2-Negative Resectable Breast Cancer


I. To determine whether adding bevacizumab to neoadjuvant weekly paclitaxel (+/-
carboplatin) and subsequent dose-dense doxorubicin and cyclophosphamide (ddAC) significantly
raises the rate of pathologic complete response (pCR) in the breast in patients with
HR-poor/HER2 (-), resectable breast cancer.

II. To determine whether adding carboplatin every 3 weeks to neoadjuvant weekly paclitaxel
followed by ddAC (+/- bevacizumab) significantly raises the rate of pCR in the breast in
patients with HR-poor/HER2(-), resectable breast cancer.

III. To determine whether adding bevacizumab every 2 weeks to neoadjuvant weekly paclitaxel
(+/- carboplatin) and subsequent ddAC significantly raises the rate of pCR in the breast in
patients with basal-like breast cancers, as defined by gene expression array.

IV. To determine whether adding carboplatin every 3 weeks to neoadjuvant weekly paclitaxel
followed by ddAC (+/- bevacizumab) significantly raises the rate of pCR in the breast in
patients with basal-like breast cancers, as defined by gene expression array.


I. To determine the pCR rates in the breast and axilla, using AJCC TNM criteria (Version 6),
to neoadjuvant weekly paclitaxel, with or without carboplatin, followed by ddAC, with or
without bevacizumab, given concurrently with the weekly paclitaxel and ddAC, in (a) patients
with HR-poor/HER2(-), resectable breast cancer and (b) the subset of patients with
basal-like breast cancers, as defined by gene expression array.

II. To assess whether there is an interaction between the addition of carboplatin and
bevacizumab to neoadjuvant chemotherapy (NAC) with weekly paclitaxel followed by ddAC as
regards the path pCR rates in (a) patients with HR-poor/HER2(-), resectable breast cancer
and (b) the subset of patients with basal-like breast cancers, as defined by gene expression

III. To assess the toxicity of the control regimen (weekly paclitaxel followed by ddAC) and
any incremental toxicities associated with the addition of carboplatin and/or bevacizumab in
this patient population, including the incidence of febrile neutropenia, grade > 3
thrombocytopenia, grade > 2 neurotoxicity, grade > 3 hypertension, and clinically
significant bleeding or thrombotic (including cardiovascular and cerebrovascular) events.

IV. To determine the recurrence-free survival (RFS) measured from definitive surgery to
first event, and time to first failure (TFF) measured from study entry to first event (see
Sec 16.2).

V. To determine overall survival (OS), defined as time from registration to death from any

VI. To assess the impact of NAC with weekly paclitaxel followed by ddAC, with or without
carboplatin and/or bevacizumab, on axillary lymph node involvement at surgery, particularly
in patients with clinically or histologically positive axillary lymph nodes prior to
initiation of NAC.

VII. To assess the impact of the addition of bevacizumab to NAC on the incidence and
severity of post-op complications, especially excessive bleeding, delayed wound healing, and
thrombotic complications.

VIII. To evaluate residual cancer burden (RCB) as a predictor of RFS, TFF and OS.

IX. To determine the correlation between clinical, radiographic, and pathologic response.

X. Given the prevalence of the triple-negative phenotype in young African-American women,
the study team, the CALGB Committee on Advocacy, Research Communications and Ethics (CARE)
and the CARE Disparities Subcommittee will collaborate to develop a plan intended to enhance
accrual of this patient subgroup.


I. To assess whether the impact of the addition of carboplatin and/or bevacizumab to NAC
with weekly paclitaxel followed by ddAC on achievement of pathologic CRs in patients with
HR-poor/HER2(-), resectable breast cancer is influenced by molecular subtype, as defined by
gene expression array.

II. To obtain blood, fresh frozen and fixed tumor tissue to test specific hypotheses for
which biomarker data exist and to evaluate biomarkers in tissue, blood, and serum that may
influence response to and toxicity of weekly paclitaxel, ddAC, carboplatin, and/or

III. To obtain blood samples to test specific hypotheses for which biomarker data exist and
to evaluate biomarkers in blood that may influence response to and toxicity of weekly
paclitaxel, ddAC, carboplatin and/or bevacizumab.

IV. To determine the surgical practice patterns for breast conservation and sentinel
lymphadenectomy in patients undergoing neoadjuvant chemotherapy.

V. To examine the practice patterns and use of sentinel lymphadenectomy (pre-chemotherapy or
post-chemotherapy) in patients with T2 or T3 breast cancer.

VI. To examine the proportion of patients who presented with T2 or T3 cancers who undergo
mastectomy despite cytoreduction adequate for breast conservation.

VII. To determine the radiotherapy practice patterns for post-mastectomy and regional nodal
irradiation in patients undergoing neoadjuvant chemotherapy.

OUTLINE: This is a multicenter study. Patients are stratified according to clinical stage of
disease (II vs III). Patients are randomized to 1 of 4 treatment arms.

ARM I: Patients receive paclitaxel IV over 60 minutes once weekly in weeks 1-12. Patients
then receive dose-dense doxorubicin hydrochloride IV over 3-10 minutes and cyclophosphamide
IV over 5-60 minutes (ddAC) once in weeks 13, 15, 17, and 19.

ARM II: Patients receive paclitaxel and ddAC as in arm I. Patients also receive bevacizumab
IV over 30-90 minutes once in weeks 1, 3, 5, 7, 9, 11, 13, 15, and 17.

ARM III: Patients receive paclitaxel and ddAC as in arm I. Patients also receive carboplatin
IV over 30 minutes once in weeks 1, 4, 7, and 10.

ARM IV: Patients receive paclitaxel and ddAC as in arm I, bevacizumab as in arm II, and
carboplatin as in arm III. Patients in all arms undergo definitive surgery (i.e., modified
radical mastectomy or breast-conserving surgery with appropriate management of the axilla)
between 4-8 weeks after completion of neoadjuvant therapy. Patients undergo core tissue
biopsies at baseline for correlative biomarker studies.

After completion of study treatment, patients are followed periodically for up to 10 years.

Inclusion Criteria:

- Histologically confirmed invasive breast cancer by core needle or incisional biopsy
(excisional biopsy is not allowed)

- Clinical stage II-III disease

- No inflammatory breast cancer

- Resectable disease

- Intent to undergo surgery after completion of neoadjuvant therapy

- Hormone receptor status poor, defined as estrogen receptor-negative and progesterone
receptor-negative tumor OR staining present in ≤ 10% of invasive cancer cells by IHC

- HER2-negative disease, defined as IHC0-1+ OR FISH ratio (HER2 gene copy/chromosome
17) of < 2.0

- Measurable disease, defined as clinically orradiographically measurable target lesion
in the breast that is ≥ 1 cm

- No axillary disease only (i.e., no identifiable tumor in the breast that is ≥ 1
cm onphysical exam or radiographic study)

- Multicentric or bilateral disease allowed provided the target lesion meets the above
eligibility criteria

- Concurrent registration on CALGB-150709 required

- Menopausal status not specified

- Zubrod performance status 0-1

- Granulocytes ≥ 1,000/μL

- Platelets ≥ 100,000/μL

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

- ALT ≤ 2.5 times ULN

- Creatinine clearance> 30 mL/min

- Urine protein ≤ 1+ by urinalysis OR urine protein:creatinine ratio < 1 OR 24-hour
urine protein < 1 g

- PT/INR ≤ 1.5 times ULN (INR ≤ 3 times ULN if patient is on stable, therapeutic doses
of warfarin and has no active bleeding or pathologic condition that is associated
with a high risk of bleeding)

- LVEF > lower limit of normal by MUGA scan or echocardiogram

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective, non-hormonal contraception during the entire
period of study treatment

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

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

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

- No baseline neuropathy ≥ grade 2

- No congestive heart failure

- No myocardial infarction, unstable angina pectoris, arterial thrombotic event,
stroke, or transient ischemia attack within the past 12 months

- No uncontrolled hypertension (systolic blood pressure [BP] > 160 mm Hg or diastolic
BP > 90 mm Hg), uncontrolled or symptomatic arrhythmia, or peripheral vascular
disease ≥ grade 2

- More than 28 days since prior and no concurrent major surgical procedure; the
following are NOT considered to be major surgical procedures:

- Obtaining the required research needle biopsies

- Placement of a radiopaque clip to localize a tumor or tumors for subsequent
surgical resection

- Placement of a port for central venous access

- Fine needle aspiration of a prominent or suspicious axillary lymph node

- Needle biopsy of a clinically or radiographically detected lesion to rule out
metastatic disease

- Pretreatment sentinel lymph node sampling

- No prior chemotherapy, hormonal therapy, or radiotherapy with therapeutic intent for
this cancer

- No other concurrent chemotherapy

- No concurrent hormonal therapy, except steroids for adrenal failure or hormones for
non-disease-related conditions (e.g., insulin for diabetes, dexamethasone as
pre-treatment for paclitaxel, or dexamethasone as an antiemetic)

Type of Study:


Study Design:

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

Outcome Measure:

Pathologic complete response (pCR), defined as the absence of residual invasive carcinoma in the breast

Outcome Description:

Will use two separate chi-square tests, one for each factor, to assess the difference in proportion of pCR in the breast between the control and experimental groups. Will use exact binomial methods to construct 95% confidence intervals around the pCR incidence by factor.

Outcome Time Frame:

At the time of definitive surgical removal

Safety Issue:


Principal Investigator

William Sikov

Investigator Role:

Principal Investigator

Investigator Affiliation:

Cancer and Leukemia Group B


United States: Food and Drug Administration

Study ID:




Start Date:

May 2009

Completion Date:

Related Keywords:

  • Estrogen Receptor-negative Breast Cancer
  • HER2-negative Breast Cancer
  • Male Breast Cancer
  • Progesterone Receptor-negative Breast Cancer
  • Stage II Breast Cancer
  • Stage IIIA Breast Cancer
  • Triple-negative Breast Cancer
  • Breast Neoplasms
  • Breast Neoplasms, Male



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Group Health Cooperative Seattle, Washington  98112
Great Falls Clinic Great Falls, Montana  59405
Thompson Cancer Survival Center Knoxville, Tennessee  37916
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Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium Seattle, Washington  98109
Lewistown Hospital Lewistown, Pennsylvania  17044
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Sibley Memorial Hospital Washington, District of Columbia  20016
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Avera McKennan Hospital and University Health Center Sioux Falls, South Dakota  57105
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Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center Columbus, Ohio  43210-1240
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Sutter Solano Medical Center Vallejo, California  94589
Poudre Valley Hospital Fort Collins, Colorado  80524
Beebe Medical Center Lewes, Delaware  19958
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Southern Regional Medical Center Riverdale, Georgia  30274-2600
Salina Regional Health Center Salina, Kansas  67401
Community Cancer Center of Monroe Monroe, Michigan  48162
Iredell Memorial Hospital Statesville, North Carolina  28677
Grandview Hospital Dayton, Ohio  45405
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Mercy Hospital of Tiffin Tiffin, Ohio  44883
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Doctor's Hospital of Laredo Laredo, Texas  78041
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Mercy Hospital Coon Rapids, Minnesota  55433
Allenmore Hospital Tacoma, Washington  98411-0414
Bixby Medical Center Adrian, Michigan  49221
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
Highland General Hospital Oakland, California  94602
Northeast Georgia Medical Center Gainesville, Georgia  30501
Swedish American Hospital Rockford, Illinois  61104
Center for Cancer Care and Research St. Louis, Missouri  63141
Miami Valley Hospital Dayton, Ohio  45409
Spartanburg Regional Medical Center Spartanburg, South Carolina  29303
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Lawrence Memorial Hospital Lawrence, Kansas  66044
Menorah Medical Center Overland Park, Kansas  66209
Shawnee Mission Medical Center Shawnee Mission, Kansas  66204
North Kansas City Hospital Kansas City, Missouri  64116
Research Medical Center Kansas City, Missouri  64132
Saint Luke's East - Lee's Summit Lee's Summit, Missouri  64086
Liberty Hospital Liberty, Missouri  64068
Heartland Regional Medical Center Saint Joseph, Missouri  64506
Bozeman Deaconess Cancer Center Bozeman, Montana  59715
Northern Montana Hospital Havre, Montana  59501
Wayne Hospital Greenville, Ohio  45331
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
Greene Memorial Hospital Xenia, Ohio  45385
Greater Baltimore Medical Center Baltimore, Maryland  21204
Rutherford Hospital Rutherfordton, North Carolina  28139
AnMed Health Cancer Center Anderson, South Carolina  29621
Union Hospital of Cecil County Elkton MD, Maryland  21921
Miriam Hospital Providence, Rhode Island  02906
Cancer Centers of the Carolinas - Grove Commons Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Seneca Seneca, South Carolina  29672
Cancer Centers of the Carolinas - Spartanburg Spartanburg, South Carolina  29307
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Manchester Memorial Hospital Manchester, Connecticut  06040-4188
Phelps County Regional Medical Center Rolla, Missouri  65401
La Grange Memorial Hospital La Grange, Illinois  60525
Queen's Medical Center Honolulu, Hawaii  96813
Newton-Wellesley Hospital Newton, Massachusetts  02462
University of North Carolina Chapel Hill, North Carolina  27599
Meharry Medical College Nashville, Tennessee  37208-3599
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
Kapiolani Medical Center at Pali Momi Aiea, Hawaii  96701
Kapiolani Medical Center for Women and Children Honolulu, Hawaii  96826
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Queens Hospital Center Jamaica, New York  11432
Saint Louis University Hospital St. Louis, Missouri  63110-0250
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Holy Cross Hospital Fort Lauderdale, Florida  33308
El Camino Hospital Mountain View, California  94040
New Hampshire Oncology-Hematology PA Hooksett, New Hampshire  03106
Albert Einstein Medical Center Philadelphia, Pennsylvania  19141
Straub Clinic and Hospital Honolulu, Hawaii  96813
Cancer Center of Kansas - McPherson McPherson, Kansas  67460
California Pacific Medical Center San Francisco, California  94115
Dartmouth Hitchcock Medical Center Lebanon, New Hampshire  03756
Weiss Memorial Hospital Chicago,, Illinois  60640
Presbyterian - Saint Lukes Medical Center - Health One Denver, Colorado  80218
Wichita CCOP Wichita, Kansas  67214-3882
Montana Cancer Consortium CCOP Billings, Montana  59101
Flower Hospital Sylvania, Ohio  43560-2197
Mount Sinai Hospital Medical Center Chicago, Illinois  60608
Addison Gilbert Hospital Gloucester, Massachusetts  01930
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Frederick Memorial Hospital Frederick, Maryland  21701
Princeton Community Hospital Princeton, West Virginia  24740
Montana Cancer Specialists Missoula, Montana  59807-7877
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Memorial Health University Medical Center Savannah, Georgia  31404
University of Chicago Comprehensive Cancer Center Chicago, Illinois  60637-1470
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Bay Area Breast Surgeons Inc Oakland, California  94609
Bay Area Tumor Institution CCOP Oakland, California  94609
Tom K Lee Inc Oakland, California  94609
Saint Joseph Hospital Orange, California  92868
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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
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Lombardi Comprehensive Cancer Center at Georgetown University Washington, District of Columbia  20057
Phoebe Putney Memorial Hospital Albany, Georgia  31703
Atlanta Regional CCOP Atlanta, Georgia  30342
Well Star Cobb Hospital Austell, Georgia  30106
John B Amos Cancer Center Columbus, Georgia  31904
Wellstar Kennestone Hospital Marietta, Georgia  30060
Oncare Hawaii Inc-POB II Honolulu, Hawaii  96813
Oncare Hawaii Inc-Kuakini Honolulu, Hawaii  96817
University of Hawaii Honolulu, Hawaii  96813
Pacific Cancer Institute of Maui Wailuku, Hawaii  96793
John H Stroger Jr Hospital of Cook County Chicago, Illinois  60612-3785
Resurrection Healthcare Chicago, Illinois  60631
Hematology Oncology Consultants Limited Naperville, Illinois  60540
West Suburban Cancer Center River Forest, Illinois  60305
Saint Francis Hospital and Health Centers Beech Grove, Indiana  46107
Fort Wayne Medical Oncology and Hematology Inc - State Boulevard Fort Wayne, Indiana  46845
Reid Hospital and Health Care Services Richmond, Indiana  47374
Iowa Blood and Cancer Care PLC Cedar Rapids, Iowa  52402
Mercy Hospital Cedar Rapids, Iowa  52403
Saint Luke's Hospital Cedar Rapids, Iowa  52402
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
Saint Francis Hospital and Medical Center - Topeka Topeka, Kansas  66606
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Mid-Michigan Medical Center - Midland Midland, Michigan  48670
Mercy Memorial Hospital Monroe, Michigan  48162
Lakeland Hospital St. Joseph, Michigan  49085
Miller-Dwan Hospital Duluth, Minnesota  55805
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
Park Nicollet Clinic - Saint Louis Park Saint Louis Park, Minnesota  55416
Minnesota Oncology and Hematology PA-Woodbury Woodbury, Minnesota  55125
Saint Luke's Cancer Institute Kansas City, Missouri  64111
Saint Luke's Hospital of Kansas City Kansas City, Missouri  64111
Saint Joseph Health Center Kansas City, Missouri  64114
Liberty Radiation Oncology Clinic Kansas City, Missouri  64116
Truman Medical Center Kansas City, Missouri  64108
Missouri Baptist Medical Center Saint Louis, Missouri  63131
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
Saint Peter's Community Hospital Helena, Montana  59601
Glacier Oncology PLLC Kalispell, Montana  59901
Saint Patrick Hospital - Community Hospital Missoula, Montana  59802
Exeter Hospital Exeter, New Hampshire  03833
New Hampshire Oncology Hematology Associates Hooksett, New Hampshire  03106
LRGHealthcare-Lakes Region General Hospital Laconia, New Hampshire  03246
Cooper Hospital University Medical Center Camden, New Jersey  08103
Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington County Mount Holly, New Jersey  08060
Virtua West Jersey Hospital Voorhees Voorhees, New Jersey  08043
Orange Regional Medical Center Middletown, New York  10940
Saint Luke's Roosevelt Hospital Center - Saint Luke's Division New York, New York  10025
State University of New York Upstate Medical University Syracuse, New York  13210
Mission Hospitals Inc Asheville, North Carolina  28801
Wayne Memorial Hospital Goldsboro, North Carolina  27534
Kinston Medical Specialists PA Kinston, North Carolina  28501
Summa Barberton Hospital Barberton, Ohio  44203
Aultman Health Foundation Canton, Ohio  44710
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
Mansfield General Hospital-MedCentral Health System Mansfield, Ohio  44903
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 Luke's Hospital Bethlehem, Pennsylvania  18015
Aria Health-Torresdale Campus Philadelphia, Pennsylvania  19114
Kent County Hospital Warwick, Rhode Island  02886
AnMed Health Hospital Anderson, South Carolina  29621
Greenville CCOP Greenville, South Carolina  29615
Greenville Memorial Hospital Greenville, South Carolina  29605
Upstate Carolina CCOP Spartanburg, South Carolina  29303
Sanford Cancer Center-Oncology Clinic Sioux Falls, South Dakota  57104
Fredericksburg Oncology Inc Fredericksburg, Virginia  22401
Auburn Regional Medical Center Auburn, Washington  98002
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
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
Aurora BayCare Medical Center Green Bay, Wisconsin  54311-6519
Vince Lombardi Cancer Clinic-Marinette Marinette, Wisconsin  54143
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
Women and Infants Hospital Providence, Rhode Island  02905
University of Maryland Greenebaum Cancer Center Baltimore, Maryland  21201
Jupiter Medical Center Jupiter, Florida  33458
Lahey Clinic Medical Center Burlington, Massachusetts  01805
Elkhart Clinic Elkhart, Indiana  46515
Mount Sinai Medical Center CCOP Miami Beach, Florida  33140
Harbin Clinic Medical Oncology and Clinical Research Rome, Georgia  30165
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
University of Missouri - Ellis Fischel Columbia, Missouri  65203
UMDNJ - New Jersey Medical School Newark, New Jersey  07103
Rex Cancer Center Raleigh, North Carolina  27607
North Coast Cancer Care-Clyde Clyde, Ohio  43410
Community Health Partners Regional Medical Center Elyria, Ohio  44035
Roper Hospital Charleston, South Carolina  29401
Cancer Centers of the Carolinas - Faris Greenville, South Carolina  29605
Cancer Centers of the Carolinas-Greer Medical Oncology Greer, South Carolina  29650
Erlanger Medical Center Chattanooga, Tennessee  37403
Nashville Oncology Associates PC Nashville, Tennessee  37203
Sandra L Maxwell Cancer Center Cedar City, Utah  84720
Intermountain Medical Center Murray, Utah  84157
Utah Valley Regional Medical Center Provo, Utah  84603
Dixie Medical Center Regional Cancer Center Saint George, Utah  84770
Utah Cancer Specialists-Salt Lake City Salt Lake City, Utah  84106
Virginia Oncology Associates-Hampton Hampton, Virginia  23666
Skagit Valley Hospital Mt. Vernon, Washington  98273
Evergreen Hematology and Oncology PS Spokane, Washington  99218
Holy Family Memorial Hospital Manitowoc, Wisconsin  54221
Aurora Medical Center in Summit Summit, Wisconsin  53066
Texas Tech University Health Sciences Center Lubbock, Texas  79430
FirstHealth of the Carolinas-Moore Regional Hosiptal Pinehurst, North Carolina  28374
Adams Cancer Center Gettysburg, Pennsylvania  17325
Cherry Tree Cancer Center Hanover, Pennsylvania  17331
Epic Care-Oakland Oakland, California  94612
Salinas Valley Memorial Salinas, California  93901
Saint Vincent's Medical Center Bridgeport, Connecticut  06606
Greenwich Hospital Greenwich, Connecticut  06830
Wilcox Memorial Hospital and Kauai Medical Clinic Lihue, Hawaii  96766-1099
Saint Luke's South Hospital Overland Park, Kansas  66213
Kansas City CCOP Prairie Village, Kansas  66208
Capital Region Medical Center-Goldschmidt Cancer Center Jefferson City, Missouri  65109
Heartland Hematology and Oncology Associates Incorporated Kansas City, Missouri  64118
Saint John's Clinic-Rolla-Cancer and Hematology Rolla, Missouri  65401
Saint Joseph Oncology Inc Saint Joseph, Missouri  64507
Comprehensive Cancer Care PC Saint Louis, Missouri  63141
Coney Island Hospital Brooklyn, New York  11235
Forsyth Memorial Hospital Winston-Salem, North Carolina  27103
Saint Francis Hospital Greenville, South Carolina  29601
Hematology Oncology Associates of Fredericksburg Inc Fredericksburg, Virginia  22401
Cancer Care Center at Island Hospital Anacortes, Washington  98221
Highline Medical Center-Main Campus Burien, Washington  98166
United General Hospital Sedro-Woolley, Washington  98284
Gundersen Lutheran La Crosse, Wisconsin  54601
Saint Nicholas Hospital Madison, Wisconsin  53715
Siouxland Hematology Oncology Associates Sioux City, Iowa  51101
Walter Reed National Military Medical Center Bethesda, Maryland  20889
Providence Saint Mary Regional Cancer Center Walla Walla, Washington  99362
Swedish Cancer Institute-Issaquah Issaquah, Washington  98029
Norris Cotton Cancer Center-Manchester Manchester, New Hampshire  03104
Aurora West Allis Medical Center West Allis, Wisconsin  53227
Alta Bates Summit Medical Center-Herrick Campus Berkeley, California  94704
Michiana Hematology Oncology PC-Mishawaka Mishawaka, Indiana  46545-1470
Marie Yeager Cancer Center Saint Joseph, Michigan  49085
Hematology Oncology Associates of Central New York PC East Syracuse, New York  13057
Summa Akron City Hospital Akron, Ohio  44304
Roy and Patricia Disney Family Cancer Center Burbank, California  91505
The Toledo Hospital/Toledo Children's Hospital Toledo, Ohio  43606
Sanford USD Medical Center - Sioux Falls Sioux Falls, South Dakota  57117-5134
Essentia Health Duluth Clinic CCOP Duluth, Minnesota  55805
Essentia Health Saint Mary's Medical Center Duluth, Minnesota  55805
Toledo Clinic Cancer Centers-Oregon Oregon, Ohio  43616
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
Via Christi Hospital-Pittsburg Pittsburg, Kansas  66762
PeaceHealth Saint Joseph Medical Center Bellingham, Washington  98225
Aurora Cancer Care-Milwaukee West Wauwatosa, Wisconsin  53226
Christiana Care Health System-Christiana Hospital Newark, Delaware  19718
NEA Baptist Memorial Hospital Jonesboro, Arkansas  72401
Promise Regional Medical Center-Hutchinson Hutchinson, Kansas  65702
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
Guthrie Clinic-Robert Packer Hospital Sayre, Pennsylvania  18840
Self Regional Healthcare Greenwood, South Carolina  29646
Harrison Poulsbo Hematology and Oncology Poulsbo, Washington  98370
Sutter Pacific Medical Foundation Santa Rosa, California  95403
Maine Center for Cancer Medicine and Blood Disorders-Scarborough Scarborough, Maine  04074
Fox Valley Surgical Associates Limited Appleton, Wisconsin  54911
NEA Baptist Clinic-Matthews Jonesboro, Arkansas  72401
OnCare Hawaii-Liliha Honolulu, Hawaii  96817-3169
Dana-Farber/Brigham and Women's Cancer Center at Milford Regional Milford, Massachusetts  01757
Nash General Hospital Rocky Mount, North Carolina  27804
Breastlink Medical Group Inc Long Beach, California  90806
Cancer Center of South Florida Foundation Inc-Lake Worth Lake Worth, Florida  33461