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A Phase III Clinical Trial Comparing the Combination of TC Plus Bevacizumab to TC Alone and to TAC for Women With Node-Positive or High-Risk Node-Negative, HER2-Negative Breast Cancer


Phase 3
18 Years
70 Years
Open (Enrolling)
Female
Breast Cancer

Thank you

Trial Information

A Phase III Clinical Trial Comparing the Combination of TC Plus Bevacizumab to TC Alone and to TAC for Women With Node-Positive or High-Risk Node-Negative, HER2-Negative Breast Cancer


The B-46-I/07132 study, a multicenter, open-label, randomized Phase III, adjuvant therapy
trial, will compare the value of adding bevacizumab to a non-anthracycline-based
chemotherapy regimen relative to the same chemotherapy without bevacizumab and relative to
an anthracycline-based chemotherapy regimen in women with resected node-positive or
high-risk node-negative, HER2-negative breast cancer. This trial will determine whether the
addition of bevacizumab to a regimen of docetaxel and cyclophosphamide (TCB) improves
invasive disease-free survival relative to docetaxel and cyclophosphamide alone (TC). A
secondary aim will be to determine whether the addition of bevacizumab to TC improves
invasive disease-free survival compared to a regimen of docetaxel, doxorubicin, and
cyclophosphamide (TAC). Other secondary aims include whether TCB improves disease-free
survival, overall survival, and recurrence-free interval relative to TC alone and to TAC.
The toxicities of the three regimens will also be compared.

Patients in the B-46-I/07132 study will be randomized to one of three treatment regimens:
Group 1 patients will receive 6 cycles of TAC administered every 21 days (docetaxel 75
mg/m2, doxorubicin 50 mg/m2, and cyclophosphamide 500 mg/m2); Group 2 patients will receive
6 cycles of TC administered every 21 days (docetaxel 75 mg/m2, cyclophosphamide 600 mg/m2);
and Group 3 patients will receive 6 cycles of TCB every 21 days with bevacizumab therapy
continuing every 21 days after completion of chemotherapy until 1 year following the first
dose (docetaxel 75 mg/m2, cyclophosphamide 600 mg/m2, and bevacizumab 15 mg/kg). Primary
prophylaxis with pegfilgrastim or filgrastim is required for Group 1 patients (optional for
patients in Groups 2 and 3). Patients will also receive adjuvant radiation therapy as
clinically indicated and endocrine therapy for hormone receptor-positive tumors.

Tumor samples will be submitted for correlative science studies to evaluate predictors of
study therapy benefit. Submission of a tumor sample is a study requirement for all
patients.


Inclusion Criteria:



- Patients must be female.

- The patient must be greater than or equal to 18 years of age and less than or equal
to 70 years of age.

- The patient must have an Eastern Cooperative Oncology Group (ECOG) performance status
of 0 or 1.

- The tumor must be unilateral invasive adenocarcinoma of the breast on histologic
examination.

- The breast cancer must be HER2-negative based on current American Society of Clinical
Oncology (ASCO)/College of American Pathologists (CAP) Guideline Recommendations for
Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer. If the result of
the in situ hybridization testing (FISH, chromagen in situ hybridization (CISH), or
other) is equivocal, the patient is eligible if there is no plan to administer
HER2-targeted therapy.

- All of the following staging criteria (according to the 6th edition of the American
Joint Committee on Cancer (AJCC) Cancer Staging Manual) must be met: By pathologic
evaluation, primary tumor must be pT1-3; By pathologic evaluation, ipsilateral nodes
must be pN0, pN1 (pN1mi, pN1a, pN1b, pN1c), pN2a, pN3a, or pN3b. If pN0, at least one
of the following criteria must be met: ER negative and PgR negative; or Pathologic
tumor size greater than 2.0 cm; or T1c (pathologic tumor size greater than 1.0 cm but
less than or equal to 2.0 cm) and ER positive (PgR status may be positive or
negative) and either Oncotype DX® Recurrence Score of greater than or equal to 25 or
grade 3 histology.

- Patients must have undergone either a total mastectomy or breast-conserving surgery
(lumpectomy).

- For patients who undergo lumpectomy, the margins of the resected specimen must be
histologically free of invasive tumor and DCIS as determined by the local
pathologist. If pathologic examination demonstrates tumor at the line of resection,
additional operative procedures must be performed to obtain clear margins. If tumor
is still present at the resected margin after re-excision(s), the patient must
undergo total mastectomy to be eligible. (Patients with margins positive for lobular
carcinoma in situ [LCIS] are eligible without additional resection.)

- For patients who undergo mastectomy, margins must be histologically free of invasive
tumor and DCIS.

- Patients must have completed one of the following procedures for evaluation of
pathologic nodal status: Sentinel lymphadenectomy alone if pathologic nodal staging
based on sentinel lymphadenectomy is pN0, pN1mi, or pN1b; Sentinel lymphadenectomy
followed by removal of additional non-sentinel lymph nodes if the sentinel node (SN)
is positive; or Axillary lymphadenectomy without SN isolation procedure.

- The interval between the last surgery for breast cancer (treatment or staging) and
randomization must be at least 28 days but no more than 84 days.

- Patients must have ER analysis performed on the primary tumor prior to randomization.
If ER analysis is negative, then PgR analysis must also be performed. (Either a
core biopsy or surgical resection specimen can be used for ER/PgR testing.)

- The most recent postoperative blood counts must meet the following criteria: Absolute
neutrophil count (ANC) must be greater than or equal to 1200/mm3; platelet count must
be greater than or equal to 100,000/mm3; and hemoglobin must be greater than or equal
to 10 g/dL.

- The following criteria for evidence of adequate hepatic function must be met based on
the results of the most recent postoperative tests: total bilirubin must be less than
or equal to upper limits of normal (ULN)for the lab unless the patient has a
bilirubin elevation less than ULN to 1.5 x ULN due to Gilbert's disease or similar
syndrome involving slow conjugation of bilirubin; and alkaline phosphatase must be
less than or equal to 2.5 x ULN for the lab; and AST must be less than or equal to
1.5 x ULN for the lab. Alkaline phosphatase and aspartate transaminase (AST) may not
both be greater than the ULN. For example, if the alkaline phosphatase is greater
than the ULN but less than or equal to 2.5 x ULN, then the AST must be less than or
equal to the ULN. If the AST is greater than the ULN but less than or equal to 1.5 x
ULN, then the alkaline phosphatase must be less than or equal to ULN.

- Patients with AST or alkaline phosphatase greater than ULN are eligible for inclusion
in the study if liver imaging (CT, MRI, PET-CT, or PET scan) does not demonstrate
metastatic disease and the requirements for adequate hepatic function are met.

- Patients with alkaline phosphatase that is greater than ULN but less than or equal to
2.5 x ULN are eligible for inclusion in the study if a bone scan, PET-CT, or PET scan
does not demonstrate metastatic disease.

- The most recent postoperative serum creatinine must be less than or equal to ULN for
the lab.

- A urine sample must be tested for proteinuria by the dipstick method. Eligibility
must be based on the most recent postoperative test result(s) performed within 6
weeks prior to randomization. Urine dipstick must indicate 0-1+ protein. If
dipstick reading is greater than or equal to 2+, a 24-hour urine specimen must be
collected and must demonstrate less than 1 gram of protein.

- Left ventricular ejection fraction (LVEF) assessment by 2-D echocardiogram or
multigated acquisition (MUGA) scan must be performed within 90 days prior to
randomization. The LVEF must be greater than or equal to 50% regardless of the
facility's lower limits of normal (LLN).

Exclusion Criteria:

- T4 tumors including inflammatory breast cancer.

- Definitive clinical or radiologic evidence of metastatic disease.

- Synchronous or metachronous contralateral invasive breast cancer. (Patients with
synchronous and/or metachronous contralateral DCIS are eligible.)

- Any history of ipsilateral invasive breast cancer or ipsilateral DCIS.

- History of non-breast malignancies within 5 years prior to randomization, except for
the following: carcinoma in situ of the cervix, colorectal carcinoma in situ,
melanoma in situ, and basal cell and squamous cell carcinomas of the skin.

- Previous therapy with anthracyclines, taxanes, or bevacizumab for any malignancy.

- Chemotherapy administered for the currently diagnosed breast cancer prior to
randomization.

- Continued therapy with any hormonal agent such as raloxifene or tamoxifen (or other
SERM) or an aromatase inhibitor. (Patients are eligible if these medications are
discontinued prior to randomization.)

- Any sex hormonal therapy, e.g., birth control pills, ovarian hormone replacement
therapy. Patients are eligible if these medications are discontinued prior to
randomization.

- Active hepatitis B or hepatitis C with abnormal liver function tests.

- Cardiac disease (history of and/or active disease) that would preclude the use of the
drugs included in the treatment regimens. This includes but is not confined to 1)
Active cardiac disease: angina pectoris that requires the use of anti-anginal
medication; ventricular arrhythmias except for benign premature ventricular
contractions; supraventricular and nodal arrhythmias requiring a pacemaker or not
controlled with medication; conduction abnormality requiring a pacemaker; valvular
disease with documented compromise in cardiac function; and symptomatic pericarditis,
2) History of cardiac disease: myocardial infarction documented by elevated cardiac
enzymes or persistent regional wall abnormalities on assessment of left ventricular
(LV) function; history of documented congestive heart failure (CHF); and documented
cardiomyopathy.

- Uncontrolled hypertension defined as systolic BP greater than 150 mmHg or diastolic
BP greater than 90 mmHg, with or without anti-hypertensive medication. Patients with
initial BP elevations are eligible if initiation or adjustment of BP medication
lowers pressure to meet entry criteria.

- History of hypertensive crisis or hypertensive encephalopathy.

- History of transient ischemic attack (TIA) or cerebrovascular accident (CVA).

- History of any arterial thrombotic event within 12 months prior to randomization.

- Symptomatic peripheral vascular disease.

- Intrinsic lung disease resulting in dyspnea.

- Unstable diabetes mellitus.

- Active infection or chronic infection requiring suppressive antibiotics.

- History of a major organ allograft or condition requiring chronic immunosuppression,
e.g., kidney, liver, lung, heart, bone marrow transplant, or autoimmune diseases.
(Patients who have received corneal transplants, cadaver skin, or bone transplants
are eligible.)

- Any significant bleeding within 180 days prior to randomization, exclusive of
menorrhagia in premenopausal women.

- Non-healing wound, skin ulcers, or incompletely healed bone fracture.

- Major surgical procedure, open biopsy, or significant traumatic injury within 28 days
prior to the planned start of study therapy.

- Anticipation of need for major surgical procedures during study therapy and for at
least 3 months following completion of bevacizumab.

- Gastroduodenal ulcer(s) documented by endoscopy to be active within 6 months before
randomization.

- History of GI perforation, abdominal fistulae, or intra-abdominal abscess.

- Known bleeding diathesis or coagulopathy.

- Requirement for therapeutic doses of coumadin or equivalent.

- Sensory/motor neuropathy greater than or equal to grade 2, as defined by the NCI
Common Terminology Criteria for Adverse Events (CTCAE) v3.0.

- Conditions that would prohibit administration of corticosteroids.

- Chronic daily treatment with corticosteroids (dose of greater than or equal to 10
mg/day methylprednisolone equivalent) (excluding inhaled steroids).

- History of hypersensitivity reaction to drugs formulated with polysorbate 80.

- Pregnancy or lactation at the time of study entry.

- Other non-malignant systemic disease that would preclude the patient from receiving
study treatment or would prevent required follow-up.

- Psychiatric or addictive disorders or other conditions that, in the opinion of the
investigator, would preclude the patient from meeting the study requirements.

- Use of any investigational product within 4 weeks prior to randomization.

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:

Invasive disease-free survival(IDFS)relative to the TAC chemotherapy regimen alone

Outcome Time Frame:

Every 12 months until recurrence

Safety Issue:

No

Principal Investigator

Norman Wolmark, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

NSABP Foundation, Inc.

Authority:

United States: Food and Drug Administration

Study ID:

NSABP B-46-I

NCT ID:

NCT00887536

Start Date:

May 2009

Completion Date:

January 2022

Related Keywords:

  • Breast Cancer
  • National Surgical Adjuvant Breast and Bowel Project (NSABP)
  • Taxotere
  • Docetaxel
  • Doxorubicin
  • Cyclophosphamide
  • Bevacizumab
  • Breast Neoplasms
  • Adenocarcinoma
  • Breast Diseases
  • Carcinoma
  • HER2 negative
  • Node negative
  • High risk node positive
  • Adjuvant Therapy
  • Breast Neoplasms

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Akron City HospitalAkron, Ohio  44304
Suburban HospitalBethesda, Maryland  20814
University of IowaIowa City, Iowa  52242
MD Anderson Cancer CenterHouston, Texas  77030-4096
Fred Hutchinson Cancer Research CenterSeattle, Washington  98109
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Medical University of South CarolinaCharleston, South Carolina  29425-0721
CCOP - Kansas CityKansas City, Missouri  64131
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CCOP - North Shore University HospitalManhasset, New York  11030
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Porter Adventist HospitalDenver, Colorado  80210
Swedish Medical CenterEnglewood, Colorado  80110
St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical CenterGrand Junction, Colorado  81502
Hinsdale Hematology Oncology AssociatesHinsdale, Illinois  60521
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Bronson Methodist HospitalKalamazoo, Michigan  49007
West Michigan Cancer CenterKalamazoo, Michigan  49007-3731
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Mercy and Unity Cancer Center at Mercy HospitalCoon Rapids, Minnesota  55433
Fairview Southdale HospitalEdina, Minnesota  55435
Hennepin County Medical Center - MinneapolisMinneapolis, Minnesota  55415
Regions Hospital Cancer Care CenterSt. Paul, Minnesota  55101
Geisinger Medical Group - Scenery ParkState College, Pennsylvania  16801
Avera Cancer InstituteSioux Falls, South Dakota  57105
Medical College of WisconsinMilwaukee, Wisconsin  53226
Ingalls Memorial HospitalHarvey, Illinois  60426
Marquette General HospitalMarquette, Michigan  49855
St. Louis University Health Sciences CenterSaint Louis, Missouri  63110-0250
Newark Beth Israel Medical CenterNewark, New Jersey  07112
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Michigan State UniversityEast Lansing, Michigan  48824
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Cancer Institute of New JerseyNew Brunswick, New Jersey  08901
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Kaiser Permanente Medical Center - San Francisco Geary CampusSan Francisco, California  94115
Creighton University Cancer CenterOmaha, Nebraska  68131-2197
Cancer Institute of New Jersey at HamiltonHamilton, New Jersey  08690
Virginia Oncology AssociatesNewport News, Virginia  23606
University of Florida Shands Cancer CenterGainesville, Florida  32610-0232
CCOP - Marshfield Clinic Research FoundationMarshfield, Wisconsin  54449
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Siouxland Hematology-Oncology AssociatesSioux City, Iowa  51101
Wayne Memorial Hospital, IncorporatedGoldsboro, North Carolina  27534
McKay-Dee Hospital CenterOgden, Utah  84403
Rocky Mountain Cancer CenterDenver, Colorado  80218
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University of ColoradoDenver, Colorado  80217
Decatur Memorial Hospital Cancer Care InstituteDecatur, Illinois  62526
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Carle Foundation HospitalUrbana, Illinois  61801
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Missouri Cancer AssociatesColumbia, Missouri  65201
Covenant Cancer Treatment CenterWaterloo, Iowa  50702
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Wayne HospitalGreenville, Ohio  45331
Clinton Memorial HospitalWilmington, Ohio  45177
Geisinger Hazleton Cancer CenterHazleton, Pennsylvania  18201
Sandra L. Maxwell Cancer CenterCedar City, Utah  84720
North Memorial Health CareRobbinsdale, Minnesota  55422
Pacific Shores Medical GroupLong Beach, California  90813
Rocky Mountain Cancer CentersThornton, Colorado  80260
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Community HospitalMunster, Indiana  46321
Consultants in Blood Disorders and CancerLouisville, Kentucky  40207
Tulane University Medical CenterNew Orleans, Louisiana  70112
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Baton Rouge General Medical CenterBaton Rouge, Louisiana  70821-2511
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AnMed Health Cancer CenterAnderson, South Carolina  29621
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Presbyterian HospitalCharlotte, North Carolina  28233-3549
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Lapeer Regional HospitalLapeer, Michigan  48446
Memorial HealthcareOwosso, Michigan  48867
New Mexico Cancer Care AssociatesSanta Fe, New Mexico  87505-7670
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Spartanburg Regional Healthcare SystemSpartanburg, South Carolina  29303
St. Charles Medical Center - BendBend, Oregon  97701
Rockwood Clinic Cancer Treatment CenterSpokane, Washington  99204-2967
University of PittsburghPittsburgh, Pennsylvania  15261
Tyler Cancer CenterTyler, Texas  75702
Rittenhouse Hematology/OncologyPhiladelphia, Pennsylvania  19146
San Antonio Tumor and Blood ClinicSan Antonio, Texas  78217
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University of ConnecticutFarmington, Connecticut  06032
Henry Ford Health SystemDetroit, Michigan  48202
Holy Cross HospitalFort Lauderdale, Florida  33308
High Point Regional HospitalHigh Point, North Carolina  27261
Cancer Center at Glens Falls HospitalGlens Falls, New York  12801
University of Texas Health Science CenterSan Antonio, Texas  78284
Albert Einstein Healthcare NetworkPhiladelphia, Pennsylvania  19141
New York University School of MedicineNew York, New York  10016
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Central Indiana Cancer CentersIndianapolis, Indiana  46227
Mercy Medical CenterBaltimore, Maryland  21202
South Austin Cancer CenterAustin, Texas  78745
Texas Cancer Center at Medical CityDallas, Texas  75230
Allison Cancer CenterMidland, Texas  79701
Texoma Cancer CenterWichita Falls, Texas  76310
Arlington Fairfax Hematology OncologyArlington, Virginia  22205
Frederick Memorial HospitalFrederick, Maryland  21701
Holy Cross HospitalSilver Spring, Maryland  20910
Amsterdam Community Cancer ProgramAmsterdam, New York  12010
New York Oncology Hematology, P.C. at Cavell Cancer Treatment ProgramHudson, New York  12534
Highline Medical OncologyBurien, Washington  98166
Florida HospitalOrlando, Florida  32803
Suburban Hematology-Oncology AssociatesLawrenceville, Georgia  30045
Memorial Health University Medical CenterSavannah, Georgia  31404
Southwest Fort Worth Cancer CenterFort Worth, Texas  76132
Clarian Arnett Cancer CareLafayette, Indiana  47904
Hematology Oncology AssociatesPhoenix, Arizona  85012
New York Oncology Hematology, PC at Albany Medical CenterAlbany, New York  12208
Virginia Oncology Associates - Lake WrightNorfolk, Virginia  23502
Northwest Georgia Oncology CentersMarietta, Georgia  30060
Greater Dayton Cancer CenterKettering, Ohio  45409
Vince Lombardi Cancer Clinic - OshkoshOshkosh, Wisconsin  54904
Shaw Regional Cancer CenterEdwards, Colorado  81632
Birmingham Hematology and OncologyBirmingham, Alabama  35235
Rocky Mountain Cancer Center - MidtownDenver, Colorado  80218
Texas Cancer CenterAbilene, Texas  79606
Mamie McFaddin Ward Cancer CenterBeaumont, Texas  77702
Lake Vista Cancer CenterLewisville, Texas  75067
Longview Cancer CenterLongview, Texas  75601
Texas Cancer Center of MesquiteMesquite, Texas  75150
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Phoebe Putney Memorial HospitalAlbany, Georgia  31703
University of HawaiiHonolulu, Hawaii  96813
Edward HospitalNaperville, Illinois  60566
Finley HospitalDubuque, Iowa  52001
McLaren Regional Medical CenterFlint, Michigan  48532
Unity HospitalFridley, Minnesota  55432
Alamance Regional Medical CenterBurlington, North Carolina  27216
Kettering Medical CenterKettering, Ohio  45429
Upper Valley Medical CenterTroy, Ohio  45373
Pocono Medical CenterEast Stroudsburg, Pennsylvania  18301
Scranton Hematology OncologyScranton, Pennsylvania  18510
Wheeling HospitalWheeling, West Virginia  26003
Marshfield Clinic at James Beck Cancer CenterRhinelander, Wisconsin  54501
Aspirus Regional Cancer CenterWausau, Wisconsin  54401
Northern Arizona Hematology & Oncology AssociatesSedona, Arizona  86336
New York Oncology Hematology, PCAlbany, New York  12208
Breastlink Medical Group, Incorporated at Long Beach Memorial Medical CenterLong Beach, California  90806
Minnesota Oncology HematologyMinneapolis, Minnesota  55404
South Texas Cancer Center - McAllenMcAllen, Texas  78503-1298
Paris Regional Cancer CenterParis, Texas  75460
University of North Carolina at Chapel HillChapel Hill, North Carolina  27599
Antelope Valley Cancer CenterLancaster, California  93534
Central Coast Medical Oncology CorporationSanta Maria, California  93454
Tennessee OncologyNashville, Tennessee  37203
Aultman HospitalCanton, Ohio  44710
Cancer Care & Hematology Specialists of ChicagolandNiles, Illinois  60714
US OncologyHouston, Texas  77060
Renown Regional Medical CenterReno, Nevada  89502
East Carolina UniversityGreenville, North Carolina  27858
Texas Oncology - Round Rock Cancer CenterRound Rock, Texas  78681
Texas Oncology PADallas, Texas  75231
HOAST - New BraunfelsNew Braunfels, Texas  78131
Cancer Care Northwest-SouthSpokane, Washington  99202
Hematology-Oncology Associates of NNJ, PAMorristown, New Jersey  07960
Alliance Hematology Oncology PAWestminster, Maryland  21157
Kaiser Permanente Santa TeresaSan Jose, California  95119
Aurora Women's Pavilion of Aurora West Allis Medical CenterWest Allis, Wisconsin  53227
Texas Oncology Cancer Care and Research CenterWaco, Texas  76712
Geisinger ClinicDanville, Pennsylvania  17822
MD Anderson Cancer CenterOrlando, Florida  32806
Fairfax-Northern Virginia Hematology-Oncology PCFairfax, Virginia  22031
Kansas City Cancer Centers - EastLee's Summit, Missouri  64064
Cancer Centers of North CarolinaRaleigh, North Carolina  27607
Mount Clemens Regional Medical CenterMount Clemens, Michigan  48043
Kansas City Cancer Center - SouthKansas City, Missouri  64131
Florida Cancer Institute - New HopeNew Port Richey, Florida  34655
Texas Oncology, PA - Cedar ParkCedar Park, Texas  78613
Willamette Valley Cancer Institute and Research CenterSpringfield, Oregon  97477
Clearview Cancer Institute- HuntsvilleHuntsville, Alabama  35801
Kaiser Permanente-San DiegoSan Diego, California  92120
NortonHealtcare Inc.Louisville, Kentucky  40202
Allegheny General Hospital/Allegheny-Singer Research InstitutePittsburgh, Pennsylvania  15212
Joe Arrington Cancer Research & Treatment CenterLubbock, Texas  79410
MBCCOP, Virginia Commonwealth UniversityRichmond, Virginia  23298
St. Joseph HospitalOrange, California  92868
Sutter Medical CenterSacramento, California  95816
Kaiser Permanente-FranklinDenver, Colorado  80205
Kaiser Permanente Rock CreekLafayette, Colorado  80026
Kaiser Permanente Hawaii - Moanalua Med CenterHonolulu, Hawaii  96819
CCOP, William Beaumont HospitalRoyal Oak, Michigan  48073
University of Missouri-Ellis FischelColumbia, Missouri  65203
New York Oncology Hematology PC-AlbanyAlbany, New York  12206
West Virginia University Hospitals Inc.Morgantown, West Virginia  26506-9162
Columbia Basin Hematology and OncologyKennewick, Washington  99336
Raleigh Regional Cancer CenterBeckley, West Virginia  25801
Trivalley Oncology HematologyWestlake Village, California  91361
Cancer Care and Hematology Specialists of ChicagolandNiles, Illinois  60714
Sparta Cancer CenterSparta, New Jersey  07871
Texas Oncology - OdessaOdessa, Texas  79761
St. Jude Heritage HealthcareFullerton, California  92835
Puget Sound Cancer Center - SeattleSeattle, Washington  98133
Texas Oncology Cancer Center - Sugar LandSugar Land, Texas  77479
Northern Arizona Hematology & Onclogy AssociatesFlagstaff, Arizona  86001
Central Hematology/Oncology Medical Group, Inc.Alhambra, California  91801
CCOP, St. Joseph Mercy HospitalAnn Arbor, Michigan  48106
CCOP, Sparrow Health SystemLansing, Michigan  48909
CCOP, St. Mary's Medical CenterSaginaw, Michigan  48601
CCOP, St. John Macomb HospitalWarren, Michigan  48093
Minnesota Oncology Hematology-BurnsvilleBurnsville, Minnesota  55337
Minnesota Oncology Hematology-EdinaEdina, Minnesota  55435
Minnesota Oncology Hematology PA - MaplewoodMaplewood, Minnesota  55109
Minnesota Oncology Hematology-MinneapolisMinneapolis, Minnesota  55407
Minnesota Hematology Oncology-St. PaulSt. Paul, Minnesota  55102
Comprehensive Cancer Centers of Nevada (Siena)Henderson, Nevada  89052
Troy Cancer Treatment ProgramTroy, New York  12180
Northwest Cancer Specialists-PortlandPortland, Oregon  97213
Texas Oncology- Sammons CCDallas, Texas  75246
Northwest Cancer Specialists-136th AveVancouver, Washington  98684
Northwest Cancer Specialists-134th St.Vancouver, Washington  98686
New York Oncology Hematology PCAlbany, New York  12206
Providence Medical CenterPortland, Oregon  97213
Methodist Charlton Cancer CenterDallas, Texas  75237
El Paso Cancer Treatment Center - EastEl Paso, Texas  79915
Birmingham Hematology and Oncology - PilotBirmingham, Alabama  35235
Birmingham Hematology and Oncology - PrincetonBirmingham, Alabama  35211
Birmingham Hematology and Oncology - MontclairBirmingham, Alabama  35213
Birmingham Hematology and Oncology - BrookwoodBirmingham, Alabama  35209
Arizona Oncolocy (CASA-Green Valley)Green Valley, Arizona  85614
Arizona Oncology (CASA- Oro Valley)Oro Valley, Arizona  85737
Arizona Oncology (CASA-Safford)Safford, Arizona  85546
Arizona Oncology Associates - CarondeletTucson, Arizona  85710
Arizona Oncology - CASA St. Mary'sTucson, Arizona  85745
Arizona Oncology (CASA-Office Only)Tucson, Arizona  85715
Arizona Oncology Associates - RudasillTucson, Arizona  85704
Arizona Oncology (CASA-Craycroft)Tucson, Arizona  85712
Kaiser Permanente Deer Valley Med CenterAntioch, California  94531
Comp Blook and Cancer CenterBakersfield, California  93309
Southwest Cancer Care (E. Grand)Escondido, California  92025
Kaiser Permanente FremontFremont, California  94538
Wilshire Oncology Medical Group (Business Office)La Verne, California  91750
Todd Cancer Institute at Long Beach Memorial Med CentLong Beach, California  90806
TORI- N Valley Hematology Oncology Med GroupMission Hills, California  91345
TORI - Oncology Care Medical Assoc.Montebello, California  90640
Southwest Cancer Care (Medical Center)Murrieta, California  92562
NValley Hematology/Oncology Medical GroupNorthridge, California  91325
Kaiser Permanente RosevilleRoseville, California  95678
TORI - Oncology Care Med AssocSan Gabriel, California  91776
Kaiser Permanente San RafaelSan Rafael, California  94903
Santa Barbara II (Samsum Clinic) - TORISanta Barbara, California  93105
Santa Barbara Hematology/Oncology Medical Group, IncSolvang, California  93463
Kaiser Permanente, South SacramentoSouth Sacramento, California  95823
Olive View/UCLA Medical CenterSylmar, California  91342
Kaiser Permanente Medical Center VacavilleVacaville, California  95688
Westlake Infusion CenterWestlake Village, California  91361
Medical Center of AuroraAurora, Colorado  80012
Rocky Mountain Cancer Centers - BoulderBoulder, Colorado  80303
Rocky Mountain Cancer Center - CO SpringsColorado Springs, Colorado  80909
Rocky Mountain Cancer Center at the Pivillion- FontaneroColorado Springs, Colorado  80907
Penrose/St. Francis Healthcare SystemColorado Springs, Colorado  80907
Rocky Mountain Cancer Center - 9th AvenueDenver, Colorado  80220
Rocky Mountain Cancer Center - RoseDenver, Colorado  80220
Exempla St. Joseph HospitalDenver, Colorado  80218
St. Mary's Hospital and Medical CenterGrand Junction, Colorado  81502-1628
Rocky Mountain Cancer Center - Dry CreekLittleton, Colorado  80120-4413
Rocky Mountain Cancer Center- Sky RidgeLone Tree, Colorado  80124
Rocky Mountain Cancer Center - LongmontLongmont, Colorado  80501
Washington Regional Cancer CenterWashington, District of Columbia  20010
SCRI - Florida Cancer Specialists- Bonita SpringsBonita Springs, Florida  34135
SCRI - Florida Cancer Specialists - BradentonBradenton, Florida  34209
SCRI Florida Cancer Specialists - Cape Coral (811)Cape Coral, Florida  33990
SCRI Florida Cancer Specialists - Cape Coral (1708)Cape Coral, Florida  33914
SCRI Florida Cancer Specialists - EnglewoodEnglewood, Florida  33990
SCRI Florida Cancer Specialists- Fort Myers (Veronica)Fort Myers, Florida  33916
SCRI Florida Cancer Specialists - Ft. Myers (Broadway)Fort Myers, Florida  33908
SCRI Florida Cancer Specialists - Fort Myers (Hampshire)Fort Myers, Florida  33908
Integrated Community Oncology Network (ICON)Jacksonville, Florida  32207
TORI-ICON St.AugJacksonville, Florida  32258
TORI-ICON - ShirclJacksonville, Florida  32204
CCOP, Jupiter Medical CenerJupiter, Florida  33458
Ocala Oncology Center - Lady LakeLady Lake, Florida  32159
Melbourne International Medicine AssociatesMelbourne, Florida  32901
Advanced Medical Specialties - N. Kendall (STE 905E)Miami, Florida  33176
Advanced Medical Specialties - AMSMiami, Florida  33133
Advanced Medical Specialists- SunsetMiami, Florida  33143
Advanced Medical Specialties - N Kendall (STE 300E)Miami, Florida  33176
SCRI Florida Cancer Specialists - Naples (Goodlette)Naples, Florida  34102
SCRI Florida Cancer Specialists - Naples (Pine)Naples, Florida  34119
Tori-IconOrange Park, Florida  32073
SCRI - Florida Cancer Specialists - Port CharlottePort Charlotte, Florida  33980
SCRI Florida Cancer Specialists - Sarasota (Cattleman)Sarasota, Florida  34232
SCRI- Florida Cancer Specialists - SarasotaSarasota, Florida  34236
SCRI - Florida Cancer Specialists - ArmeniaTampa, Florida  33603
SCRI - Florida Cancer Specialists - TampaTampa, Florida  33607
SCRI Florida Cancer Specilaists - VeniceVenice, Florida  34292
SCRI Florida Cancer Specialists - Venice (Tamiami)Venice, Florida  34285
Dublin Hematology/OncologyDublin, Georgia  31021
SCRI Chattanooga Oncol & Hematol Assoc, PC - RinggoldRinggold, Georgia  30736
CCOP NorthShore University HealthSystemEvanston, Illinois  60201
Carle Cancer Center, CCOPUrbana, Illinois  61801
Central Indiana Cancer Centers (E. County)Indianapolis, Indiana  46227
Kansas Cty Cancer Center - WestKansas City, Kansas  66112
Kansas City Cancer Center (CBO)Overland Park, Kansas  66210
Kansas CityCancer Centers - SouthwestOverland Park, Kansas  66210
Kansas City Cancer Center, Shawnee MissionShawnee Mission, Kansas  66204
SCRI Oncology Hematology Care, Inc. Crestview Hills (CVH)Crestview Hills, Kentucky  41017
Christus St. Frances Cabrini HospitalAlexandria, Louisiana  71301
St. Joseph's Medical CenterBaltimore, Maryland  21204-7582
SCRI - Center for Cancer and Blood DisordersBethesda, Maryland  20817
Chevy Chase Healthcare Management, LLCChevy Chase, Maryland  20815
Maryland Oncology Hematology PAColumbia, Maryland  21044
Penisula Regional Medical CenterSalisbury, Maryland  21801
CCOP - Oakwood Hospital and Medical CenterDearborn, Michigan  48123-2500
CCOP - St. John Hospital and Medical CenterDetroit, Michigan  48236-2172
CCOP - Hurley Medical CenterFlint, Michigan  48503
CCOP - Genesys Regional HospitalFlint, Michigan  48503
CCOP - Allegiance HealthJackson, Michigan  49201
Ingham Regional Medical Center - LansingLansing, Michigan  48910-0817
CCOP - St. Mary Mercy Hospital - LivoniaLivonia, Michigan  48154
CCOP - St. Joseph Mercy Hospital - OaklandPontiac, Michigan  48341
CCOP - St. Joseph Mercy Port HuronPort Huron, Michigan  48060
St. John's Hospital Northeast/HealthEast, Inc.Maplewood, Minnesota  55109
Kansas City Cancer Center - CentralKansas City, Missouri  64111
Kansas City Cancer Center - NorthKansas City, Missouri  64154
St. Elizabeth Community Health CenterLincoln, Nebraska  68510
Nebraska Cancer Research CenterLincoln, Nebraska  68510
CCOP, Missouri Valley Cance ConsortiumOmaha, Nebraska  68131
Alegent Health Midlands HospitalPapillion, Nebraska  68046
Comprehensive Cancer Centers of Nevada (Wigwam)Henderson, Nevada  89074
US Oncology West Region Office (Horizon Ridge)Henderson, Nevada  89052
Comprehensive Cancer Centers of Nevada (Twain)Las Vegas, Nevada  89169
Comprehensive Cancer Centers of Nevada (Peak Dr.)Las Vegas, Nevada  89128
Comprehensive Cancer Centers of Nevada (Southern Hills)Las Vegas, Nevada  89148
Saint Clare's Center at Parsippany CommonsParsippany, New Jersey  07054
Interlakes Oncology Hematology PCBrockport, New York  14420
CCOP, Long Island Jewish Medical CenterNew Hyde Park, New York  11040
Interlakes Oncology Hematology PC- Long PondRochester, New York  14626
Interlakes Oncology Hematology PC - White SpruceRochester, New York  14623
University Hospital and Medical Center - SUNY Stony BrookStonybrook, New York  11794
CCOP Carolinas HealthCare SystemCharlotte, North Carolina  28232-2861
Regional Cancer Care, PADurham, North Carolina  27704
Virginia Oncology AssociatesElizabeth City, North Carolina  27909
CCOP, Moses Cone Health System-Regional CA CntrGreensboro, North Carolina  27401
Margaret R. Pardee Memorial HospitalHendersonville, North Carolina  28791
Cancer Centers of North Carolina- North RaleighRaleigh, North Carolina  27614
CCOP Forsyth Memorial HospitalWinston-Salem, North Carolina  27103
Innovis HealthFargo, North Dakota  58103
SCRI Oncology Hematology Care, Inc. Cincinnati (WST)Cincinnati, Ohio  45248
SCRI Oncology Hematology Care, Inc. - Cincinnati (TFT)Cincinnati, Ohio  45219
SCRI Oncology Hematology Care, Inc - Cincinnati (BAM)Cincinnati, Ohio  45242
SCRI Oncology Hematlogy Care, Inc. - Cincinnati (RPR)Cincinnati, Ohio  45238
SCRI Oncology Hematology Care, Inc. - Cincinnati (KWD)Cincinnati, Ohio  45236
SCRI Oncology Hematology Care, Inc - Cincinnati (AND)Cincinnati, Ohio  45230
HemOnc Care, Inc.Fairfield, Ohio  45014
Atrium Medical Center - Middletown Regional HospFranklin, Ohio  45005-1066
SCRI Oncology Hematology Care, Inc. - Hamilton (HAM)Hamilton, Ohio  45013
SCRI Oncology Hematology Care, Inc. - Wilmington (WLM)Wilmington, Ohio  45177
Northwest Cancer Specialists- Rose QtrPortland, Oregon  97227
Northwest Cancer Specialists- St. VincentPortland, Oregon  97225
Williamette Valley Cancer Institute and Research CenterSpringfield, Oregon  97477
Celilo Center for Cancer CareThe Dalles, Oregon  97058
Northwest Cancer Specialists-TualatinTualatin, Oregon  97062
Oncology Hematology Associates of Northern PADubois, Pennsylvania  15801
Hematology and Oncology Associates of NEPAScranton, Pennsylvania  18501
Roper Hosp & Med Asso (Care Alliance Health)Charleston, South Carolina  29401
SCRI - South Carolina Oncology Associates - StoneridgeColumbia, South Carolina  29210
Cancer Centers of the Carolinas Easley, SCEasley, South Carolina  29640
Georgetown Hospital SystemGeorgetown, South Carolina  29440
Cancer Centers of the Carolinas-W. Faris RoadGreenville, South Carolina  29605
Cancer Centers of the Carolinas (International)Greenville, South Carolina  29615
Cancer Centers of the Carolinas (Butternut)Greenville, South Carolina  29605
Avera McKenna HospitalSioux Falls, South Dakota  57101
CCOP, Sanford Cancer Center - Oncology ClinicSioux Falls, South Dakota  57105
SCRI Chattanooga Oncol & Hematol Assoc, PC - ChattanoogaChattanooga, Tennessee  37404
SCRI Tennessee Oncology - PLLC FranklinFranklin, Tennessee  37067
SCRI Tennessee Oncology- GallatinGallatin, Tennessee  37066
SCRI Tennessee Oncology, PLLC HermitageHermitage, Tennessee  37076
SCRI Chattanooga Oncol & Hematol Assoc, PC HixsonHixson, Tennessee  37404
CCOP Holston Valley Medical CenterKingsport, Tennessee  37662
SCRI Tennessee Oncology LebanonLebanon, Tennessee  37087
SCRI Tennessee Oncology MurfreesboroMurfreesboro, Tennessee  37130
SCRI Tennessee Oncology, PLLC (Harding)Nashville, Tennessee  37205
SCRI - Tennessee Oncology PLLCNashville, Tennessee  37203
SCRI Tennessee Onclogy, PLLC (Dickerson)Nashville, Tennessee  37207
SCRI Tennessee Oncology, PLLC (Wallace)Nashville, Tennessee  37211
SCRI Tennessee Oncology, PLLC SmyrnaSmyrna, Tennessee  37167
Texas Cancer Center - Abilene SouthAbilene, Texas  79606-5208
Texas Oncology PA - AmarilloAmarillo, Texas  79106
Texas Onclogy - Arlington SouthArlington, Texas  76014
Texas Oncology PA - Arlington NorthArlington, Texas  76012
Southwest Regional Cancer Center- NorthAustin, Texas  78759
Texas Oncology Cancer Center - BalconesAustin, Texas  78731
Texas Oncology Central AustinAustin, Texas  78705
Texas Oncology North Austin- RenfertAustin, Texas  78759
Edwards Cancer Center - BedfordBedford, Texas  76022
Texas Oncology PA - Harris HEBBedford, Texas  76022
Texas Oncology PA- PresbyterianDallas, Texas  75231-4400
El Paso Cancer Treatment Center - WestEl Paso, Texas  79902
Texas Oncology at KlabzubaFort Worth, Texas  76104
Texas Oncology - 8th AvenueFort Worth, Texas  76104
Texas Oncology PA - 12th AvenueFort Worth, Texas  76104
Texas Oncology PA - FrostwoodHouston, Texas  77024
Texas Oncology PA Las CrucesLas Cruces, Texas  88011
Texas Oncology Plano West Cancer CenterPlano, Texas  75093
Texas Oncology Seton WilliamsonRound Rock, Texas  78665
San Antonio Tumor and Blood Clinic - M.OakSan Antonio, Texas  78258-3912
HOAST - Medical DriveSan Antonio, Texas  78229
Cancer Care Centers of South Texas- BrooklynSan Antonio, Texas  78212
Cancer Care Centers of South Texas - Loop 410San Antonio, Texas  78217
Texas Oncology - San MarcosSan Marcos, Texas  78666
Texas Oncology - Clear LakeWebster, Texas  77598
South Texas Cancer ClinicWeslaco, Texas  78596
Huntsman Cancer Inst. at the University of Utah- Salt Lake CitySalt Lake City, Utah  84132
Southwestern Regional Cancer Center (SWORD)Bennington, Vermont  05201
Virginia Oncology Associates - Medical PkwyChesapeake, Virginia  23320
Oncology and Hematology Associates of SW VA, IncChristiansburg, Virginia  24073
Fair Oaks OfficeFairfax, Virginia  22033
Fairfax Northern VA Hematology-Oncology PCFairfax, Virginia  22031
SCRI Virginia Cancer Institute (Flank)Mechanicsville, Virginia  23116
SCRI Virginia Cancer InstituteMidlothian, Virginia  23114
SCRI Virginia Cancer Institute (6605)Richmond, Virginia  23226
SCRI Virginia Cancer Institute (1401)Richmond, Virginia  23235
Fairfax Northern Virginia Hematology-Oncology - WinchesterWinchester, Virginia  22601
Puget Sound Cancer Center- EdmondsEdmonds, Washington  98026
Cancer Care Northwest- Valley - MissionSpokane, Washington  99216
Evergreen Hematology & Oncology (Farwell)Spokane, Washington  99218
Cancer Care Northwest-North - HollandSpokane, Washington  99218
Cancer Care Northwest-Radiation Therapy (XRT)Spokane, Washington  99204
Yakima Valley Memorial Hospital - North Star LodgeYakima, Washington  98902
CAMC Health Education & Research Institute, Inc.Charleston, West Virginia  25304
Marshfield Clinic Chippewa Falls CenterChippewa, Wisconsin  54729
Marshfield Clinic Regional CA Cntr - Sacred Heart HospitalEau Claire, Wisconsin  54701
CCOP, St. Mary's Hospital Medical CenterGreen Bay, Wisconsin  54303
CCOP, St. Vincent HospitalGreen Bay, Wisconsin  54301
Marshfield Clinic Minocqua CenterMinocqua, Wisconsin  54548
Marshfield Clinic Rice Lake CenterRice Lake, Wisconsin  54868
Marshfield Clinic Cancer Care at St. Michael's HospitalStevens Point, Wisconsin  54481
CCOP Marshfield Clinic - Weston CenterWeston, Wisconsin  54476
Marshfield Clinic Wisconsin Rapids CenterWisconsin Rapids, Wisconsin  54494