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A Phase III Clinical Trial of Bevacizumab With IV Versus IP Chemotherapy in Ovarian, Fallopian Tube, and Primary Peritoneal Carcinoma NCI-Supplied Agent(s): Bevacizumab (NSC #704865, IND #7921)


Phase 3
18 Years
N/A
Open (Enrolling)
Female
Brenner Tumor, Ovarian Clear Cell Cystadenocarcinoma, Ovarian Endometrioid Adenocarcinoma, Ovarian Mixed Epithelial Carcinoma, Ovarian Mucinous Cystadenocarcinoma, Ovarian Serous Cystadenocarcinoma, Ovarian Undifferentiated Adenocarcinoma, Stage IIA Fallopian Tube Cancer, Stage IIA Ovarian Epithelial Cancer, Stage IIA Primary Peritoneal Cavity Cancer, Stage IIB Fallopian Tube Cancer, Stage IIB Ovarian Epithelial Cancer, Stage IIB Primary Peritoneal Cavity Cancer, Stage IIC Fallopian Tube Cancer, Stage IIC Ovarian Epithelial Cancer, Stage IIC Primary Peritoneal Cavity Cancer, Stage IIIA Fallopian Tube Cancer, Stage IIIA Ovarian Epithelial Cancer, Stage IIIA Primary Peritoneal Cavity Cancer, Stage IIIB Fallopian Tube Cancer, Stage IIIB Ovarian Epithelial Cancer, Stage IIIB Primary Peritoneal Cavity Cancer, Stage IIIC Fallopian Tube Cancer, Stage IIIC Ovarian Epithelial Cancer, Stage IIIC Primary Peritoneal Cavity Cancer, Stage IV Fallopian Tube Cancer, Stage IV Ovarian Epithelial Cancer, Stage IV Primary Peritoneal Cavity Cancer

Thank you

Trial Information

A Phase III Clinical Trial of Bevacizumab With IV Versus IP Chemotherapy in Ovarian, Fallopian Tube, and Primary Peritoneal Carcinoma NCI-Supplied Agent(s): Bevacizumab (NSC #704865, IND #7921)


PRIMARY OBJECTIVES:

I. To determine if one or both of the proposed intraperitoneal chemotherapy regimens
improves the progression-free survival (PFS) event rate compared to standard intravenous
chemotherapy for first-line treatment of patients diagnosed with advanced stage ovarian,
peritoneal or fallopian tube cancer.

II. If both IP regimens significantly improve the PFS event rate compared to the standard
regimen, then a second study objective is to determine whether IP cisplatin and IV
paclitaxel on day one plus IP paclitaxel on day eight improves the PFS event rate when
compared to the IP carboplatin and IV paclitaxel.

SECONDARY OBJECTIVES:

I. To determine if intraperitoneal chemotherapy reduces the overall death rate compared to
standard intravenous chemotherapy.

II. To assess the frequency and severity of adverse events as defined by CTCAE version 3.0.

III. To compare the patient-reported outcomes on: Quality of Life (FACT-O-TOI), Neuropathy
(FACT-GOG/NTX4 scale), Abdominal discomfort (FACT-GOG/AD scale), Fatigue (FACIT-Fatigue
scale), and Nausea (item from FACT-O-TOI).

IV. To assess the frequency and the reasons for early discontinuation of the study
treatments.

TERTIARY OBJECTIVES:

I. To bank DNA from whole blood for research and examine the association between single
nucleotide polymorphisms (SNPs) and measures of clinical outcome including overall survival,
progression-free survival and adverse events.

II. To bank archival tumor for research and examine the association between tumor markers
and measures of clinical outcome including overall survival, progression-free survival and
adverse events.

III. Patients will be encouraged to enroll on the companion translational research protocol
(CEM0703 under development).

OUTLINE: This is a multicenter study. Patients are stratified according to disease stage
(FIGO stage II vs stage III vs stage IV) and size of residual disease after initial
staging/debulking surgery (no gross residual disease vs gross residual disease with lesion ≤
1 cm vs any gross residual disease with lesion > 1 cm). Patients are randomized to 1 of 3
treatment arms.

ARM I: Patients receive paclitaxel IV over 1 hour on days 1, 8, and 15 and carboplatin IV
over 30 minutes on day 1. Patients also receive bevacizumab IV over 30-90 minutes on day 1
in courses 2-6. Treatment repeats every 21 days for 6 courses in the absence of disease
progression or unacceptable toxicity. Patients then receive bevacizumab alone in courses
7-22 in the absence of disease progression or unacceptable toxicity.

ARM II: Patients receive paclitaxel as in arm I and carboplatin intraperitoneally (IP) on
day 1. Patients also receive bevacizumab as in arm I. Treatment repeats every 21 days for 6
courses in the absence of disease progression or unacceptable toxicity. Patients then
receive bevacizumab alone as in arm I.

ARM III: Patients receive paclitaxel IV over 3 hours on day 1, cisplatin IP on day 2, and
paclitaxel IP on day 8. Patients also receive bevacizumab as in arm I. Treatment repeats
every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity.
Patients then receive bevacizumab alone as in arm I.

Patients complete quality-of-life questionnaires at baseline and at weeks 9, 18, 36, 60, and
84. Blood and tissue samples may be collected for further laboratory analysis.

After completion of study treatment, patients are followed up every 3 months for 2 years,
every 6 months for 3 years, and then annually for 5 years.


Inclusion Criteria:



- Histologically confirmed ovarian epithelial, fallopian tube, or primary peritoneal
carcinoma, including any of the following epithelial cell types*:

- Serous adenocarcinoma

- Endometrioid adenocarcinoma

- Mucinous**adenocarcinoma

- Undifferentiated carcinoma

- Clear** cell adenocarcinoma

- Mixed epithelial carcinoma

- Transitional cell carcinoma

- Malignant Brenner tumor

- Adenocarcinoma not otherwise specified

- Stage II, III, or IV disease with either optimal (≤ 1 cm residual disease) or
suboptimal residual disease

- Must have undergone surgery for diagnosis, staging, and/or cytoreduction within the
past 12 weeks

- Prior or concurrent primary endometrial cancer allowed provided the primary origin of
the invasive tumor is ovarian or peritoneal and all of the following criteria are
met:

- Stage of endometrial cancer is ≤ IB

- No more than superficial myometrial invasion, without vascular or lymphatic
invasion

- No poorly differentiated subtypes, including papillary serous, clear cell, or
other FIGO grade 3 lesions

- No borderline ovarian epithelial tumor ("tumors of low malignant potential") (e.g.,
stage IA or IB disease with low-grade lesions)

- Patients with a prior diagnosis of a borderline tumor that was surgically
resected and who subsequently develop an unrelated, new invasive ovarian
epithelial or primary peritoneal cancer are eligible provided they have not
received prior chemotherapy for any ovarian tumor

- No recurrent invasive ovarian epithelial cancer treated with surgery only

- No history or evidence of major CNS disease by physical examination (e.g., primary
brain tumor, metastatic cancer in the brain, seizures not controlled with standard
medical therapy, or any brain metastases within the past 6 months

- No metastatic tumor in the parenchyma of the liver or lungs with proximity to large
vessels

- GOG performance status 0-2

- ANC ≥ 1,500/mm³ (without granulocyte colony-stimulating factor support)

- Platelet count ≥ 100,000/mm³

- Bilirubin ≤ 1.5 times upper limit of normal (ULN)

- AST and ALT ≤ 2.5 times ULN

- Alkaline phosphatase ≤ 2.5 times ULN

- Creatinine normal

- Urine protein:creatinine ratio < 1.0

- PTT <1.5 times ULN

- Concurrent heparin, lovenox or alternative anticoagulants allowed

- PT/INR ≤ 1.5 times ULN (or an in-range INR, usually between 2 and 3, if patient is on
a stable dose of therapeutic warfarin)

- Not pregnant or nursing

- Negative pregnancy test

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

- No sensory or motor neuropathy > CTCAE grade 1

- No seizures not controlled with standard medical therapy

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

- No acute hepatitis or active infection requiring parenteral antibiotics

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

- Granulating incisions healing by secondary intention allowed provided there is
no evidence of fascial dehiscence or infection AND the wound is examined weekly
during study

- No clinical symptoms or signs of gastrointestinal obstruction and/or those who
require parenteral hydration and/or nutrition

- Patients with a history or current diagnosis of inflammatory bowel disease are
not eligible

- No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within
the past 28 days

- 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 cerebrovascular accident (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 mmHg or diastolic BP >
90 mmHg

- Myocardial infarction or unstable angina within the past 6 months

- NYHA class II-IV congestive heart failure

- Serious cardiac arrhythmia requiring medication

- Asymptomatic atrial fibrillation with controlled ventricular rate or
history of supraventricular tachycardia controlled with medications and
asymptomatic allowed

- Peripheral vascular disease ≥ CTCAE grade 2 (at least brief [< 24 hrs] episodes
of ischemia managed non-surgically and without permanent deficit)

- No history or evidence of cerebrovascular accident (CVA, stroke), transient ischemic
attack, or subarachnoid hemorrhage within the past 6 months

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

- No known allergy to Cremophor or polysorbate 80

- No significant traumatic injury within the past 28 days

- No other medical history or condition (e.g., persistent gastrointestinal symptoms
resulting from clostridia difficile enterocolitis or bowl surgery; or hearing loss or
neuropathy) that, in the opinion of the investigator, would preclude study
participation

- Concurrent ovarian estrogen (with or without progestin) replacement therapy for
control of menopausal symptoms allowed provided the lowest effective dose(s) is (are)
given

- No concurrent high-dose of progestins as an appetite stimulant

- No prior radiotherapy to any portion of the abdominal cavity or pelvis

- Prior radiotherapy for localized cancer of the breast, head and neck, or skin
allowed provided it was completed > 3 years ago AND patient remains free of
recurrent or metastatic disease

- No prior chemotherapy for any abdominal or pelvic tumor, including neoadjuvant
chemotherapy for ovarian or primary peritoneal cancer

- Prior adjuvant chemotherapy for localized breast cancer allowed provided it was
completed > 3 years ago AND patient remains free of recurrent or metastatic
disease

- No prior targeted therapy (including vaccines, antibodies, or tyrosine kinase
inhibitors) or hormonal therapy for management of ovarian epithelial or primary
peritoneal cancer

- No prior anti-VEGF therapy, including bevacizumab

- No prior cancer treatment that would contraindicate study treatment

- More than 7 days since prior core biopsy

- More than 28 days since prior major surgical procedure or open biopsy

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

- No other concurrent anti-neoplastic therapy, including cytotoxic therapy, biologic
therapy, hormonal therapy, or radiotherapy

- No concurrent amifostine or other protective reagents

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Progression-free survival

Outcome Time Frame:

From date that each patient is enrolled onto the study to the date of the patient's first failure event, assessed up to 10 years

Safety Issue:

No

Principal Investigator

Joan Walker

Investigator Role:

Principal Investigator

Investigator Affiliation:

Gynecologic Oncology Group

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2011-01956

NCT ID:

NCT00951496

Start Date:

July 2009

Completion Date:

Related Keywords:

  • Brenner Tumor
  • Ovarian Clear Cell Cystadenocarcinoma
  • Ovarian Endometrioid Adenocarcinoma
  • Ovarian Mixed Epithelial Carcinoma
  • Ovarian Mucinous Cystadenocarcinoma
  • Ovarian Serous Cystadenocarcinoma
  • Ovarian Undifferentiated Adenocarcinoma
  • Stage IIA Fallopian Tube Cancer
  • Stage IIA Ovarian Epithelial Cancer
  • Stage IIA Primary Peritoneal Cavity Cancer
  • Stage IIB Fallopian Tube Cancer
  • Stage IIB Ovarian Epithelial Cancer
  • Stage IIB Primary Peritoneal Cavity Cancer
  • Stage IIC Fallopian Tube Cancer
  • Stage IIC Ovarian Epithelial Cancer
  • Stage IIC Primary Peritoneal Cavity Cancer
  • Stage IIIA Fallopian Tube Cancer
  • Stage IIIA Ovarian Epithelial Cancer
  • Stage IIIA Primary Peritoneal Cavity Cancer
  • Stage IIIB Fallopian Tube Cancer
  • Stage IIIB Ovarian Epithelial Cancer
  • Stage IIIB Primary Peritoneal Cavity Cancer
  • Stage IIIC Fallopian Tube Cancer
  • Stage IIIC Ovarian Epithelial Cancer
  • Stage IIIC Primary Peritoneal Cavity Cancer
  • Stage IV Fallopian Tube Cancer
  • Stage IV Ovarian Epithelial Cancer
  • Stage IV Primary Peritoneal Cavity Cancer
  • Adenocarcinoma
  • Adenocarcinoma, Mucinous
  • Brenner Tumor
  • Carcinoma
  • Cystadenocarcinoma
  • Peritoneal Neoplasms
  • Fallopian Tube Neoplasms
  • Carcinoma, Endometrioid
  • Cystadenocarcinoma, Mucinous
  • Cystadenocarcinoma, Serous
  • Neoplasms, Glandular and Epithelial
  • Ovarian Neoplasms

Name

Location

Johns Hopkins UniversityBaltimore, Maryland  21205
Memorial Sloan Kettering Cancer CenterNew York, New York  10021
Cleveland Clinic FoundationCleveland, Ohio  44195
Roswell Park Cancer InstituteBuffalo, New York  14263
Mayo ClinicRochester, Minnesota  55905
University of Iowa Hospitals and ClinicsIowa City, Iowa  52242
University of Mississippi Medical CenterJackson, Mississippi  39216-4505
Washington University School of MedicineSaint Louis, Missouri  63110
Abington Memorial HospitalAbington, Pennsylvania  19001
Fox Chase Cancer CenterPhiladelphia, Pennsylvania  19111
Medical University of South CarolinaCharleston, South Carolina  29425-0721
University of Washington Medical CenterSeattle, Washington  98195-6043
Tacoma General HospitalTacoma, Washington  98405
Hurley Medical CenterFlint, Michigan  48503
Pennsylvania HospitalPhiladelphia, Pennsylvania  19107
Sinai Hospital of BaltimoreBaltimore, Maryland  21225
Beth Israel Deaconess Medical CenterBoston, Massachusetts  02215
Bronson Methodist HospitalKalamazoo, Michigan  49007
West Michigan Cancer CenterKalamazoo, Michigan  49007-3731
Borgess Medical CenterKalamazooaa, Michigan  49001
Fairview Ridges HospitalBurnsville, Minnesota  55337
Hutchinson Area Health CareHutchinson, Minnesota  55350
United HospitalSt. Paul, Minnesota  55102
Ridgeview Medical CenterWaconia, Minnesota  55387
Geisinger Medical CenterDanville, Pennsylvania  17822-0001
Abramson Cancer Center of the University of PennsylvaniaPhiladelphia, Pennsylvania  19104-4283
Avera Cancer InstituteSioux Falls, South Dakota  57105
Loyola University Medical CenterMaywood, Illinois  60153
Massachusetts General Hospital Cancer CenterBoston, Massachusetts  02114
CentraCare ClinicSaint Cloud, Minnesota  56303
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
Lehigh Valley HospitalAllentown, Pennsylvania  18103
Western Pennsylvania HospitalPittsburgh, Pennsylvania  15224
LDS HospitalSalt Lake City, Utah  84143
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
Eastern Maine Medical CenterBangor, Maine  04401
Franklin Square Hospital CenterBaltimore, Maryland  21237
Baystate Medical CenterSpringfield, Massachusetts  01199
Providence Alaska Medical CenterAnchorage, Alaska  99508
William Beaumont HospitalRoyal Oak, Michigan  48073
Hackensack University Medical CenterHackensack, New Jersey  07601
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
New Hanover Regional Medical CenterWilmington, North Carolina  28402-9025
Group Health CooperativeSeattle, Washington  98112
University of Wisconsin Hospital and ClinicsMadison, Wisconsin  53792-0001
Great Falls ClinicGreat Falls, Montana  59405
Overlook HospitalSummit, New Jersey  07902-0220
Winthrop University HospitalMineola, New York  11501
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
Mount Sinai Medical CenterNew York, New York  10029
Fred Hutchinson Cancer Research Center/University of Washington Cancer ConsortiumSeattle, Washington  98109
Chester County HospitalWest Chester, Pennsylvania  19380
Sibley Memorial HospitalWashington, District of Columbia  20016
Cancer Center of Kansas - ChanuteChanute, Kansas  66720
Cancer Center of Kansas - Dodge CityDodge City, Kansas  67801
Cancer Center of Kansas - NewtonNewton, Kansas  67114
Cancer Center of Kansas - SalinaSalina, Kansas  67042
Cancer Center of Kansas - WellingtonWellington, Kansas  67152
Associates in Womens HealthWichita, Kansas  67203
Cancer Center of Kansas - WinfieldWinfield, Kansas  67156
Munson Medical CenterTraverse City, Michigan  49684
Northern Rockies Radiation Oncology CenterBillings, Montana  59101
Bozeman Deaconess HospitalBozeman, Montana  59715
Big Sky OncologyGreat Falls, Montana  59405
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
McKay-Dee Hospital CenterOgden, Utah  84403
Cancer Care Northwest - Spokane SouthSpokane, Washington  99202
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
Elkhart General HospitalElkhart, Indiana  46515
South Bend ClinicSouth Bend, Indiana  46617
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical CenterColumbus, Ohio  43210-1240
Parkland Memorial HospitalDallas, Texas  75235
Sutter Solano Medical CenterVallejo, California  94589
Beebe Medical CenterLewes, Delaware  19958
Memorial HospitalCarthage, Illinois  62321
Galesburg Cottage HospitalGalesburg, Illinois  61401
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
Grandview HospitalDayton, Ohio  45405
Mercy Medical CenterSpringfield, Ohio  45504
Danville Regional Medical CenterDanville, Virginia  24541
North Star Lodge Cancer Center at Yakima Valley Memorial HospitalYakima, Washington  98902
Eureka HospitalEureka, Illinois  61530
Mercy HospitalCoon Rapids, Minnesota  55433
Graham Hospital AssociationCanton, Illinois  61520
Holy Family Medical CenterDes Plaines, Illinois  60016
Saint Joseph Medical CenterJoliet, Illinois  60435
Pekin HospitalPekin, Illinois  61554
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
Geisinger Medical GroupState College, Pennsylvania  16801
Northeast Georgia Medical CenterGainesville, Georgia  30501
Randolph HospitalAsheboro, North Carolina  27203
Miami Valley HospitalDayton, Ohio  45409
Eastern Connecticut Hematology and Oncology AssociatesNorwich, Connecticut  06360
Cancer Center of Kansas - Fort ScottFort Scott, Kansas  66701
Cancer Center of Kansas-IndependenceIndependence, Kansas  67301
Lawrence Memorial HospitalLawrence, Kansas  66044
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
Wenatchee Valley Medical CenterWenatchee, Washington  98801-2028
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
Seattle Cancer Care AllianceSeattle, Washington  98109
Morton Plant HospitalClearwater, Florida  33756
Temple University HospitalPhiladelphia, Pennsylvania  19140
Zale Lipshy University HospitalDallas, Texas  75235-7786
Methodist HospitalHouston, Texas  77030
Aurora Sinai Medical CenterMilwaukee, Wisconsin  53201-0342
Greene Memorial HospitalXenia, Ohio  45385
Greater Baltimore Medical CenterBaltimore, Maryland  21204
AnMed Health Cancer CenterAnderson, South Carolina  29621
Harold Alfond Center for Cancer CareAugusta, Maine  04330
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
Mayo Clinic in ArizonaScottsdale, Arizona  85259-5404
Mayo Clinic in FloridaJacksonville, Florida  32224
Pacific Gynecology SpecialistsSeattle, Washington  98104
Sutter Roseville Medical CenterRoseville, California  95661
Washington Hospital CenterWashington, District of Columbia  20010
Memorial Medical CenterSpringfield, Illinois  62781
Phelps County Regional Medical CenterRolla, Missouri  65401
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
New York Hospital Medical Center of QueensFresh Meadows, New York  11365
University of Alabama at BirminghamBirmingham, Alabama  35294-3300
Vanderbilt UniversityNashville, Tennessee  37232-6305
University of North CarolinaChapel Hill, North Carolina  27599
Duke University Medical CenterDurham, North Carolina  27710
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
University of California at San DiegoLa Jolla, California  92093
Case Western Reserve UniversityCleveland, Ohio  44106
Wayne State UniversityDetroit, Michigan  48202
Straub Clinic and HospitalHonolulu, Hawaii  96813
University of Massachusetts Medical SchoolWorcester, Massachusetts  01605
Riverside Methodist HospitalColumbus, Ohio  43214
Licking Memorial HospitalNewark, Ohio  43055-2899
California Pacific Medical CenterSan Francisco, California  94115
Dartmouth Hitchcock Medical CenterLebanon, New Hampshire  03756
Columbus CCOPColumbus, Ohio  43206
Indiana University Medical CenterIndianapolis, Indiana  46202
University of Texas Southwestern Medical CenterDallas, Texas  
University of KentuckyLexington, Kentucky  40536-0098
Wichita CCOPWichita, Kansas  67214-3882
Montana Cancer Consortium CCOPBillings, Montana  59101
Northwest HospitalSeattle, Washington  98133
Huntsman Cancer Institute/University of UtahSalt Lake City, Utah  84112
Columbia Saint Mary's Hospital - OzaukeeMequon, Wisconsin  53097
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
Thomas Jefferson University HospitalPhiladelphia, Pennsylvania  19131
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  
Holy Cross HospitalSilver Spring, Maryland  20910
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
Harrison Medical CenterBremerton, Washington  98310
Phoenixville HospitalPhoenixville, Pennsylvania  19460
University of Chicago Comprehensive Cancer CenterChicago, Illinois  60637-1470
M D Anderson Cancer CenterHouston, Texas  77030
Northern Indiana Cancer Research ConsortiumSouth Bend, Indiana  
Northern Virginia Pelvic Surgery AssociatesAnnandale, Virginia  22003
University of CincinnatiCincinnati, Ohio  45267-0502
Hawaii Medical Center EastHonolulu, Hawaii  96817
Vince Lombardi Cancer Clinic - OshkoshOshkosh, Wisconsin  54904
Penn State Milton S Hershey Medical CenterHershey, Pennsylvania  17033
The Community HospitalMunster, Indiana  46321
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
Saint Joseph HospitalOrange, California  92868
Sutter General HospitalSacramento, California  95816
University of California San Francisco Medical Center-Mount ZionSan Francisco, California  94115
Danbury HospitalDanbury, Connecticut  06810
Saint Francis Hospital and Medical CenterHartford, Connecticut  06105
The Hospital of Central ConnecticutNew Britain, Connecticut  06050
Stamford HospitalStamford, Connecticut  06904
The Watson ClinicLakeland, Florida  33805
M D Anderson Cancer Center- OrlandoOrlando, Florida  32806
John B Amos Cancer CenterColumbus, Georgia  31904
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
Resurrection HealthcareChicago, Illinois  60631
Evanston CCOP-NorthShore University HealthSystemEvanston, Illinois  60201
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 Margaret's HospitalSpring Valley, Illinois  61362
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
Cancer Center of Kansas - El DoradoEl Dorado, Kansas  67042
Cancer Center of Kansas-KingmanKingman, Kansas  67068
Cancer Center of Kansas - ParsonsParsons, Kansas  67357
Cancer Center of Kansas - PrattPratt, Kansas  67124
Stormont-Vail Regional Health CenterTopeka, Kansas  66604
Cancer Center of Kansas-Wichita Medical Arts TowerWichita, Kansas  67208
Cancer Center of Kansas - Main OfficeWichita, Kansas  67214
Associates in Oncology Hematology PC -KensingtonKensington, Maryland  20895
Associates In Oncology Hematology PC-RockvilleRockville, Maryland  20878
Michigan Cancer Research Consortium Community Clinical Oncology ProgramAnn Arbor, Michigan  48106
Oakwood HospitalDearborn, Michigan  48123
Saint John Hospital and Medical CenterDetroit, Michigan  48236
Grand Rapids Clinical Oncology ProgramGrand Rapids, Michigan  49503
Saint Mary's Health CareGrand Rapids, Michigan  49503
Spectrum Health at Butterworth CampusGrand Rapids, Michigan  49503
Allegiance HealthJackson, Michigan  49201
Sparrow HospitalLansing, Michigan  48912
Saint Mary Mercy HospitalLivonia, Michigan  48154
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
Medini, Eitan MD (UIA Investigator)Alexandria, Minnesota  56308
Miller-Dwan HospitalDuluth, Minnesota  55805
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
Saint Cloud HospitalSaint Cloud, Minnesota  56303
Park Nicollet Clinic - Saint Louis ParkSaint Louis Park, Minnesota  55416
Minnesota Oncology and Hematology PA-WoodburyWoodbury, Minnesota  55125
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
Community Medical HospitalMissoula, Montana  59801
Saint Patrick Hospital - Community HospitalMissoula, Montana  59802
Good Samaritan HospitalKearney, Nebraska  68847
Cooper Hospital University Medical CenterCamden, New Jersey  08103
Hunterdon Medical CenterFlemington, New Jersey  08822
Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington CountyMount Holly, New Jersey  08060
Virtua West Jersey Hospital VoorheesVoorhees, New Jersey  08043
New York University Langone Medical CenterNew York, New York  10016
State University of New York Upstate Medical UniversitySyracuse, New York  13210
Alamance Regional Medical CenterBurlington, North Carolina  27216
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
Marietta Memorial HospitalMarietta, Ohio  45750
University of ToledoToledo, Ohio  43614
Upper Valley Medical CenterTroy, Ohio  45373
Saint Ann's HospitalWesterville, Ohio  43081
Wright-Patterson Medical CenterWright-Patterson Afb, Ohio  45433-5529
Genesis HealthCare SystemZanesville, Ohio  43701
Legacy Good Samaritan Hospital and Medical CenterPortland, Oregon  97210
Northwest Cancer Specialists-Rose Quarter Cancer CenterPortland, Oregon  97227
Scranton Hematology OncologyScranton, Pennsylvania  18510
Mercy HospitalScranton, Pennsylvania  18501
Geisinger Wyoming ValleyWilkes-Barre, Pennsylvania  18711
Greenville CCOPGreenville, South Carolina  29615
Greenville Memorial HospitalGreenville, South Carolina  29605
Sanford Cancer Center-Oncology ClinicSioux Falls, South Dakota  57104
Peninsula Cancer Institute-Newport NewsNewport News, Virginia  23601
Harrison Bremerton Hematology and OncologyBremerton, Washington  98310
Swedish Medical Center-First HillSeattle, Washington  98122-4307
Saint Joseph Medical CenterTacoma, Washington  98405
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
Aurora BayCare Medical CenterGreen Bay, Wisconsin  54311-6519
Marshfield Clinic-Minocqua CenterMinocqua, Wisconsin  54548
Marshfield Clinic at James Beck Cancer CenterRhinelander, Wisconsin  54501
Marshfield Clinic-Rice Lake CenterRice Lake, Wisconsin  54868
Saint Michael's HospitalStevens Point, Wisconsin  54481
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
Colorado Gynecologic Oncology GroupAurora, Colorado  80010
Lake University Ireland Cancer CenterMentor, Ohio  44060
Lyndon Baines Johnson General HospitalHouston, Texas  77030
Women's Cancer AssociatesSaint Petersburg, Florida  33701
Stony Brook University Medical CenterStony Brook, New York  11794
Lahey Clinic Medical CenterBurlington, Massachusetts  01805
Elkhart ClinicElkhart, Indiana  46515
John Muir Medical Center-Concord CampusConcord, California  94520
Marin General HospitalGreenbrae, California  94904
University of Colorado Cancer Center - Anschutz Cancer PavilionAurora, Colorado  80045
Kootenai Cancer CenterPost Falls, Idaho  83854
Illinois CancerCare-BloomingtonBloomington%, Illinois  61701
Illinois CancerCare-CantonCanton, Illinois  61520
Illinois CancerCare-CarthageCarthage, Illinois  62321
Illinois CancerCare-EurekaEureka, Illinois  61530
Illinois CancerCare-CottageGalesburg, Illinois  61401
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
Commonwealth Hematology Oncology PC-WorcesterWorcester, Massachusetts  01605
Michiana Hematology Oncology PC-NilesNiles, Michigan  49120
University of Missouri - Ellis FischelColumbia, Missouri  65203
Hackensack University Medical CCOPHackensack, New Jersey  07601
Moses Cone Health System-Regional Cancer CenterGreensboro, North Carolina  27403
Duke Raleigh HospitalRaleigh, North Carolina  27609
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
Saint Paul HospitalDallas, Texas  75235
Utah Valley Regional Medical CenterProvo, Utah  84603
Dixie Medical Center Regional Cancer CenterSaint George, Utah  84770
Intermountain Health CareSalt Lake City, Utah  84103
Marshfield Clinic-Chippewa CenterChippewa Falls, Wisconsin  54729
Marshfield Clinic Cancer Care at Saint Michael's HospitalStevens Point, Wisconsin  54481
Aurora Medical Center in SummitSummit, Wisconsin  53066
Vince Lombardi Cancer ClinicTwo Rivers, Wisconsin  54241
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
Gynecologic Oncology of West Michigan PLLCGrand Rapids, Michigan  49546
Center of Hope at Renown Medical CenterReno, Nevada  89502
Montefiore Medical Center-Weiler DivisionBronx, New York  10461
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
Saint Vincent's Medical CenterJacksonville, Florida  32204
University of Miami Miller School of Medicine-Sylvester Cancer CenterMiami, Florida  33136
Bayfront Outpatient Health ClinicSaint Petersburg, Florida  33701
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
Arizona Cancer Center at University Medical Center NorthTucson, Arizona  85719
Palchak David MDPismo Beach, California  93449
Wilcox Memorial Hospital and Kauai Medical ClinicLihue, Hawaii  96766-1099
Central DuPage Hospital Cancer CenterWarrenville, Illinois  60555
Hematology and Oncology ClinicBaton Rouge, Louisiana  70809
Southern Ohio Medical CenterPortsmouth, Ohio  45662
Providence Regional Cancer PartnershipEverett, Washington  98201
Gundersen LutheranLa Crosse, Wisconsin  54601
Columbia Saint Mary's Water Tower Medical CommonsMilwaukee, Wisconsin  53211
Stanford University Hospitals and ClinicsStanford, California  94305
Walter Reed National Military Medical CenterBethesda, Maryland  20889
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
PeaceHealth Medical Group PCBellingham, Washington  98226
Skagit Valley Hospital Regional Cancer Care CenterMount Vernon, Washington  98274
Olympic Medical Cancer Care CenterSequim, Washington  98384
Rockwood Cancer Treatment CenterSpokane, Washington  99204
Providence Saint Mary Regional Cancer CenterWalla Walla, Washington  99362
Cancer Institutes of Washington PLLCYakima, Washington  98902
Aurora Saint Luke's Medical CenterMilwaukee, Wisconsin  53215
Norris Cotton Cancer Center-ManchesterManchester, New Hampshire  03104
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
Summa Akron City HospitalAkron, Ohio  44304
Park Nicollet Frauenshuh Cancer CenterMinneapolis, Minnesota  55416
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
Essentia Health Saint Joseph's Medical CenterBrainerd, Minnesota  56401
Essentia Health Duluth Clinic CCOPDuluth, Minnesota  55805
Essentia Health Saint Mary's Medical CenterDuluth, Minnesota  55805
Geisinger Medical Center-Cancer Center HazeltonHazleton, Pennsylvania  18201
Community Howard Regional HealthKokomo, Indiana  46904
Indiana University Health La Porte HospitalLa Porte, Indiana  46350
Saint Joseph Regional Medical Center-MishawakaMishawaka, Indiana  46545-1470
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
Southeast Gynecologic Oncology AssociatesJacksonville, Florida  32204
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
Harrison Poulsbo Hematology and OncologyPoulsbo, Washington  98370
Baylor All Saints Medical Center at Fort WorthFort Worth, Texas  76104
The Women's Oncology CenterSaint Louis, Missouri  63141