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EVEREST: EVErolimus for Renal Cancer Ensuing Surgical Therapy, A Phase III Study

Phase 3
18 Years
Open (Enrolling)
Kidney Cancer

Thank you

Trial Information

EVEREST: EVErolimus for Renal Cancer Ensuing Surgical Therapy, A Phase III Study



- to compare recurrence-free survival in renal carcinoma patients randomly assigned to 54
weeks of everolimus versus 54 weeks of placebo after nephrectomy or partial


- To compare the overall survival of patients treated with everolimus vs placebo.

- To compare qualitative and quantitative toxicity between the two study arms.

- To bank tissue and biologic specimens for future study of molecular biomarkers relevant
to the AKT/mTOR and other pathways implicated in the pathogenesis of renal carcinoma
and to investigate their potential predictive and prognostic value.

- To bank blood specimens for the future study of the relationship between steady-state
trough levels of everolimus and relevant side effects (lymphopenia, infection,
hyperglycemia, hypercholesterolemia, hypertriglyceridemia) in patients treated on this
study with everolimus.

OUTLINE: This is a multicenter study.

Patients are stratified according to pathologic stage (intermediate high-risk vs very
high-risk), histologic subtype (clear cell vs non-clear cell), and performance status (0 vs
1). Patients are randomized to 1 of 2 treatment arms.

- Arm I: Patients receive oral everolimus once daily on days 1-42. Treatment repeats
every 6 weeks for 9 courses in the absence of disease progression or unacceptable

- Arm II: Patients receive oral placebo once daily on days 1-42. Treatment repeats every
6 weeks for 9 courses in the absence of disease progression or unacceptable toxicity.

Archived tumor tissue, plasma, and whole blood samples may be collected periodically for
biomarker analysis and other translational studies.

After completion of study treatment, patients are followed up every 6 months for 2 years and
then annually for 8 years.

Inclusion Criteria


- Histologically or cytologically confirmed renal cell carcinoma

- Clear cell or non-clear cell allowed

- No disease of the collecting duct or medullary carcinoma

- Considered pathologically either intermediate high-risk or very high-risk

- No history of distant metastases

- Patients with microvascular invasion of the renal vein of any grade or stage (as
long as M0) are eligible

- Have undergone a full surgical resection (radical nephrectomy or partial nephrectomy)
including removal of all clinically positive nodes

- Surgical margins must be negative

- Patients with positive renal vein margins are eligible unless there is
invasion of the renal vein wall at the margin (provided no other margins
are positive)

- Patients must be registered within 84 days after the date of the first surgical
resection of the first tumor

- No evidence of residual or metastatic renal cell cancer on CT scan of the chest,
abdomen, and pelvis (all with oral and IV contrast) performed after nephrectomy and
within 28 days before registration

- MRI scans of the abdomen and pelvis with gadolinium and a non-contrast CT scan
of the chest may be substituted if the patient is not able to have CT scans with
IV contrast


- Zubrod performance status 0-1

- ANC ≥ 1,500/mm^3

- Platelet count ≥ 100,000/mm^3

- Serum creatinine ≤ 2.0 times upper limit of normal (ULN) OR calculated creatinine
clearance ≥ 30 mL/min

- Bilirubin ≤ 1.5 times ULN

- SGOT and SGPT ≤ 2.5 times ULN

- Not pregnant or nursing

- Fertile patients must use effective contraception during and for up to 8 weeks after
completion of study treatment

- Able to take oral medications

- Patients must not have any of the following:

- NYHA class III-IV cardiac disease (i.e., patients with cardiac disease resulting
in marked limitation of physical activity or resulting in inability to carry on
any physical activity without discomfort)

- Unstable angina pectoris

- Myocardial infarction within the past 6 months

- Serious uncontrolled cardiac arrhythmia

- Patients must NOT have liver disease such as cirrhosis or severe hepatic impairment
(Child-Pugh Class C)

- HBV and HCV testing are required at screening for all patients with a positive
medical history based on risk factors and/or confirmation of prior HBV/HCV infection

- Must be able to take oral medications

- No impairment of gastrointestinal function or gastrointestinal disease that may
significantly alter the absorption of everolimus (e.g., ulcerative disease,
uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel

- No known history of HIV seropositivity

- No known uncontrolled, underlying pulmonary disease (spirometry and DLCO ≤ 50% of
predicted OR oxygen saturation ≤ 88% at rest on room air)

- No uncontrolled hyperlipidemia (fasting serum cholesterol > 300 mg/dL AND fasting
triglycerides > 2.5 times ULN) obtained within 28 days prior to registration

- Optimal lipid control must be achieved before registration and monitored during
protocol treatment

- No uncontrolled diabetes mellitus (defined by fasting serum glucose > 1.5 times ULN)
obtained within 28 days prior to registration.

- Optimal glucose control must be achieved before registration and monitored
during protocol treatment

- No prior malignancies except for any of the following:

- Adequately treated basal cell or squamous cell skin cancer

- In situ cervical cancer

- Adequately treated stage I or stage II cancer from which the patient is
currently in complete remission

- Any other cancer from which the patient has been disease-free for 5 years

- No known hypersensitivity to everolimus or other rapamycins (sirolimus, temsirolimus)
or to their excipients

- No contraindications to receiving either IV iodine-based contrast or gadolinium


- See Disease Characteristics

- Patients must have recovered from any surgery-related complications

- No prior anticancer therapy for renal cell carcinoma including systemic therapy in
the adjuvant or neoadjuvant setting, immunotherapy, investigational therapy, surgical
metastasectomy, or radiotherapy

- More than 14 days since prior and no concurrent strong CYP3A4 inhibitors (i.e.,
ketoconazole, itraconazole, voriconazole, posaconazole, fluvoxamine, nefazodone,
nelfinavir, or ritonavir) or strong CYP3A4 inducers (i.e., phenytoin, rifampin, or

- More than 7 days since prior and no concurrent live vaccines

- No other concurrent anticancer agents including investigational agents

- No concurrent chronic treatment with systemic steroids or another immunosuppressive

- Topical or inhaled corticosteroids are allowed

Type of Study:


Study Design:

Allocation: Randomized, Masking: Double-Blind, Primary Purpose: Treatment

Outcome Measure:

Recurrence-free survival

Safety Issue:


Principal Investigator

Christopher W. Ryan, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

OHSU Knight Cancer Institute



Study ID:




Start Date:

April 2011

Completion Date:

Related Keywords:

  • Kidney Cancer
  • stage I renal cell cancer
  • stage II renal cell cancer
  • stage III renal cell cancer
  • clear cell renal cell carcinoma
  • papillary renal cell carcinoma
  • Carcinoma, Renal Cell
  • Kidney Neoplasms



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Veterans Affairs Medical Center - Minneapolis Minneapolis, Minnesota  55417
University of California Davis Cancer Center Sacramento, California  95817
Veterans Affairs Medical Center - Baltimore Baltimore, Maryland  21201
John Stoddard Cancer Center at Iowa Methodist Medical Center Des Moines, Iowa  50309
Sunrise Hospital and Medical Center Las Vegas, Nevada  89109-2306
St. Vincent Mercy Medical Center Toledo, Ohio  43608
Arkansas Cancer Research Center at University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center Kansas City, Kansas  66160-7353
Josephine Ford Cancer Center at Henry Ford Hospital Detroit, Michigan  48202
Swedish Cancer Institute at Swedish Medical Center - First Hill Campus Seattle, Washington  98104
Overlook Hospital Summit, New Jersey  07902-0220
Northside Hospital Cancer Center Atlanta, Georgia  30342-1611
Hulston Cancer Center at Cox Medical Center South Springfield, Missouri  65807
St. John's Regional Health Center Springfield, Missouri  65804
Carol G. Simon Cancer Center at Morristown Memorial Hospital Morristown, New Jersey  07962
Winthrop University Hospital Mineola, New York  11501
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Florida Hospital Cancer Institute at Florida Hospital Orlando Orlando, Florida  32803-1273
Via Christi Cancer Center at Via Christi Regional Medical Center Wichita, Kansas  67214
Wake Forest University Comprehensive Cancer Center Winston-Salem, North Carolina  27157-1096
Medical University of Ohio Cancer Center Toledo, Ohio  43614
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Baylor University Medical Center - Houston Houston, Texas  77030-2399
St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54307-3508
Saint Peter's University Hospital New Brunswick, New Jersey  08901-1780
James P. Wilmot Cancer Center at University of Rochester Medical Center Rochester, New York  14642
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Bay Area Cancer Care Center at Bay Area Medical Center Marinette, Wisconsin  54143
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David C. Pratt Cancer Center at St. John's Mercy St. Louis, Missouri  63141
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Cancer Institute of New Jersey at Cooper - Voorhees Voorhees, New Jersey  08043
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Grandview Hospital Dayton, Ohio  45405
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Charles F. Kettering Memorial Hospital Kettering, Ohio  45429
Lima Memorial Hospital Lima, Ohio  45804
Northwest Ohio Oncology Center Maumee, Ohio  43537
Middletown Regional Hospital Middletown, Ohio  45044
St. Charles Mercy Hospital Oregon, Ohio  43616
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Toledo Clinic, Incorporated - Main Clinic Toledo, Ohio  43623
UVMC Cancer Care Center at Upper Valley Medical Center Troy, Ohio  45373-1300
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Ruth G. McMillan Cancer Center at Greene Memorial Hospital Xenia, Ohio  45385
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Cancer Therapy and Research Center San Antonio, Texas  78229
University Hospital - San Antonio San Antonio, Texas  78229
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Fairbanks Cancer Treatment Center at Fairbanks Memorial Hospital Fairbanks, Alaska  99701
St. Anthony Central Hospital Denver, Colorado  80204-1335
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
St. Francis Hospital Federal Way, Washington  98003
Cascade Cancer Center at Evergreen Hospital Medical Center Kirkland, Washington  98034-3013
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Providence St. Peter Hospital Regional Cancer Center Olympia, Washington  98506
Good Samaritan Cancer Center Puyallup, Washington  98371
Allenmore Hospital Tacoma, Washington  98411-0414
Lancaster General Hospital Lancaster, Pennsylvania  17604-3555
Pottstown Memorial Regional Cancer Center Pottstown, Pennsylvania  19464
Highland General Hospital Oakland, California  94602
Pearlman Comprehensive Cancer Center at South Georgia Medical Center Valdosta, Georgia  31603
Saint Luke's Hospital Chesterfield, Missouri  63017
Missouri Baptist Cancer Center St. Louis, Missouri  63131
Randolph Hospital Asheboro, North Carolina  27203
Moses Cone Regional Cancer Center at Wesley Long Community Hospital Greensboro, North Carolina  27401
Annie Penn Cancer Center Reidsville, North Carolina  27320
Altru Cancer Center at Altru Hospital Grand Forks, North Dakota  58201
UAB Comprehensive Cancer Center Birmingham, Alabama  35294
Alta Bates Summit Comprehensive Cancer Center Berkeley, California  94704
Tunnell Cancer Center at Beebe Medical Center Lewes, Delaware  19958
Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital Fort Lauderdale, Florida  33308
John B. Amos Cancer Center Columbus, Georgia  31904
Harbin Clinic Cancer Center - Medical Oncology Rome, Georgia  30165
Reid Hospital & Health Care Services Richmond, Indiana  47374
McFarland Clinic, PC Ames, Iowa  50010
Cancer Center of Kansas, PA - Chanute Chanute, Kansas  66720
Cancer Center of Kansas, PA - El Dorado El Dorado, Kansas  67042
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Cancer Center of Kansas, PA - Kingman Kingman, Kansas  67068
Lawrence Memorial Hospital Lawrence, Kansas  66044
Cancer Center of Kansas, PA - Liberal Liberal, Kansas  67905
Cancer Center of Kansas, PA - Newton Newton, Kansas  67114
Menorah Medical Center Overland Park, Kansas  66209
Saint Luke's Hospital - South Overland Park, Kansas  66213
Cancer Center of Kansas, PA - Parsons Parsons, Kansas  67357
Cancer Center of Kansas, PA - Pratt Pratt, Kansas  67124
Tammy Walker Cancer Center at Salina Regional Health Center Salina, Kansas  67401
Cancer Center of Kansas, PA - Salina Salina, Kansas  67401
Cancer Center of Kansas, PA - Wellington Wellington, Kansas  67152
Cancer Center of Kansas, PA - Wichita Wichita, Kansas  67214
Associates in Womens Health, PA - North Review Wichita, Kansas  67208
Cancer Center of Kansas, PA - Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas, PA - Winfield Winfield, Kansas  67156
Greater Baltimore Medical Center Cancer Center Baltimore, Maryland  21204
Foote Memorial Hospital Jackson, Michigan  49201
St. Mary Mercy Hospital Livonia, Michigan  48154
Mercy Memorial Hospital - Monroe Monroe, Michigan  48162
St. Joseph Mercy Oakland Pontiac, Michigan  48341-2985
Mercy Regional Cancer Center at Mercy Hospital Port Huron, Michigan  48060
Seton Cancer Institute at Saint Mary's - Saginaw Saginaw, Michigan  48601
Willmar Cancer Center at Rice Memorial Hospital Willmar, Minnesota  56201
Truman Medical Center - Hospital Hill Kansas City, Missouri  64108
Heartland Hematology Oncology Associates, Incorporated Kansas City, Missouri  64118
Saint Luke's Cancer Institute at Saint Luke's Hospital Kansas City, Missouri  64111
Research Medical Center Kansas City, Missouri  64132
Saint Luke's East - Lee's Summit Lee's Summit, Missouri  64086
Heartland Regional Medical Center Saint Joseph, Missouri  64506
Saint Joseph Oncology, Incorporated Saint Joseph, Missouri  64507
Billings Clinic - Downtown Billings, Montana  59107-7000
Bozeman Deaconess Cancer Center Bozeman, Montana  59715
St. James Healthcare Cancer Care Butte, Montana  59701
Great Falls Clinic - Main Facility Great Falls, Montana  59405
Sletten Cancer Institute at Benefis Healthcare Great Falls, Montana  59405
Kalispell Medical Oncology at KRMC Kalispell, Montana  59901
Summa Center for Cancer Care at Akron City Hospital Akron, Ohio  44309-2090
Barberton Citizens Hospital Barberton, Ohio  44203
Grant Medical Center Cancer Care Columbus, Ohio  43215
Hematology Oncology Center Elyria, Ohio  44035
Community Cancer Center Elyria, Ohio  44035
Wayne Hospital Greenville, Ohio  45331
Knox Community Hospital Mount Vernon, Ohio  43050
Flower Hospital Cancer Center Sylvania, Ohio  43560
St. Anne Mercy Hospital Toledo, Ohio  43623
Mount Carmel St. Ann's Cancer Center Westerville, Ohio  43081
Cancer Care Associates - Mercy Campus Oklahoma City, Oklahoma  73120
Legacy Good Samaritan Hospital & Comprehensive Cancer Center Portland, Oregon  97210
Salem Hospital Regional Cancer Care Services Salem, Oregon  97309-5014
Geisinger Hazleton Cancer Center Hazleton, Pennsylvania  18201
McGlinn Family Regional Cancer Center at Reading Hospital and Medical Center Reading, Pennsylvania  19612-6052
Guthrie Cancer Center at Guthrie Clinic Sayre Sayre, Pennsylvania  18840
Fredericksburg Oncology, Incorporated Fredericksburg, Virginia  22401
Southwest Virginia Regional Cancer Center at Wellmonth Health Norton, Virginia  24273
St. Joseph Cancer Center Bellingham, Washington  98225
Providence Centralia Hospital Centralia, Washington  98531-9027
Columbia Basin Hematology Kennewick, Washington  99336
Harrison Poulsbo Hematology and Onocology Poulsbo, Washington  98370
Evergreen Hematology and Oncology, PS Spokane, Washington  99218
Franciscan Cancer Center at St. Joseph Medical Center Tacoma, Washington  98405-3004
Legacy Salmon Creek Medical Center Vancouver, Washington  98686
Wenatchee Valley Medical Center Wenatchee, Washington  98801-2028
Center for Cancer Treatment & Prevention at Sacred Heart Hospital Eau Claire, Wisconsin  54701
Marshfield Clinic Cancer Care at Regional Cancer Center Eau Claire, Wisconsin  54701
Vince Lombardi Cancer Clinic - Green Bay at Aurora BayCare Medical Center Green Bay, Wisconsin  54311
UW Cancer Center Johnson Creek Johnson Creek, Wisconsin  53038
Vince Lombardi Cancer Clinic - Marinette Marinette, Wisconsin  54143
Saint Joseph's Hospital Marshfield, Wisconsin  54449
Marshfield Clinic - Lakeland Center Minocqua, Wisconsin  54548
Ministry Medical Group at Saint Mary's Hospital Rhinelander, Wisconsin  54501
Vince Lombardi Cancer Clinic - Sheboygan Sheboygan, Wisconsin  53081
Marshfield Clinic at Saint Michael's Hospital Stevens Point, Wisconsin  54481
Saint Michael's Hospital Cancer Center Stevens Point, Wisconsin  54481
Aurora Medical Center Summit, Wisconsin  53066
Vince Lombardi Cancer Clinic - Two Rivers Two Rivers, Wisconsin  54241
Oncology Alliance, SC - Milwaukee - West Wauwatosa, Wisconsin  53226
Marshfield Clinic - Weston Center Weston, Wisconsin  54476
Diagnostic and Treatment Center Weston, Wisconsin  54476
Marshfield Clinic - Wisconsin Rapids Center Wisconsin Rapids, Wisconsin  54494
Rocky Mountain Oncology Casper, Wyoming  82609
FirstHealth Moore Regional Community Hospital Comprehensive Cancer Center Pinehurst, North Carolina  28374
Mid Dakota Clinic, PC Bismarck, North Dakota  58501
Regional Cancer Center at Memorial Medical Center Springfield, Illinois  62781-0001
Saint Louis University Cancer Center Saint Louis, Missouri  63110
Genesys Regional Medical Center Grand Blanc, Michigan  48439-8066
Ben Taub General Hospital Houston, Texas  77030
Methodist Hospital Houston, Texas  77030
Phoebe Cancer Center at Phoebe Putney Memorial Hospital Albany, Georgia  31702
Washington Township Hospital Fremont, California  94538
Ruby L. Golleher Cancer Program at Presbyterian Intercommunity Hospital Whittier, California  90602
Queen's Cancer Institute at Queen's Medical Center Honolulu, Hawaii  96813
Lowell General Hospital Lowell, Massachusetts  01854
Dizzy Gillespie Cancer Institute at Englewood Hospital and Medical Center Englewood, New Jersey  07631
Pardee Memorial Hospital Hendersonville, North Carolina  28791
Three Rivers Community Hospital Grants Pass, Oregon  97527
Dubs Cancer Center at Rogue Valley Medical Center Medford, Oregon  97504
Harold Alfond Center for Cancer Care Augusta, Maine  04330
Union Hospital of Cecil County Elkton MD, Maryland  21921
Kinston Medical Specialists Kinston, North Carolina  28501
Greenville Hospital Cancer Center Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Grove Commons Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Faris Road Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Greer Medical Oncology Greer, South Carolina  29650
Cancer Centers of the Carolinas - Seneca Seneca, South Carolina  29672
Cancer Centers of the Carolinas - Spartanburg Spartanburg, South Carolina  29307
Kaiser Permanente Medical Center - Anaheim/Orange County Anaheim, California  92805
Kaiser Permanente Medical Center - Baldwin Park Baldwin Park, California  91706
Kaiser Permanente Medical Center - Bellflower Bellflower, California  90706
Kaiser Permanente Medical Center - Fontana Fontana, California  92335
Glendale Memorial Hospital Comprehensive Cancer Center Glendale, California  91204
Kaiser Permanente Medical Center - Harbor City Harbor City, California  90710
Kaiser Foundation Hospital - West Los Angeles Los Angeles, California  90034
Kaiser Permanente Medical Center - Riverside Riverside, California  92505
Kaiser Permanente Medical Cener - Woodland Hills Woodland Hills, California  91365-4084
Resurrection Medical Center Chicago, Illinois  60631
Freeman Cancer Institute at Freeman Health System Joplin, Missouri  64803-2644
Phelps County Regional Medical Center Rolla, Missouri  65401
McLeod Regional Medical Center Florence, South Carolina  29501
La Grange Memorial Hospital La Grange, Illinois  60525
Mid-Illinois Hematology-Oncology Associates at Community Cancer Center Normal, Illinois  61761
Lacks Cancer Center at Saint Mary's Health Care Grand Rapids, Michigan  49503
Lakes Region General Hospital Laconia, New Hampshire  03246
St. Charles Medical Center - Bend Bend, Oregon  97701
Roper St. Francis Cancer Center at Roper Hospital Charleston, South Carolina  29401
Doctors Medical Center - San Pablo Campus San Pablo, California  94806
Galesburg Clinic, PC Galesburg, Illinois  61401
Boston University Cancer Research Center Boston, Massachusetts  02118
St. Vincent Healthcare Cancer Care Services Billings, Montana  59101
Center for Cancer Care and Research at Watson Clinic, LLP Lakeland, Florida  33805
Parvin Radiation Oncology Kansas City, Missouri  64116
Midwest Hematology Oncology Group, Incorporated Saint Louis, Missouri  63109
Lynchburg Hematology-Oncology Clinic Lynchburg, Virginia  24501
East Bay Radiation Oncology Center Castro Valley, California  94546
Contra Costa Regional Medical Center Martinez, California  94553-3156
Tibotec Therapeutics - Division of Ortho Biotech Products, LP Marysville, California  95901
Memorial Medical Center Modesto, California  95355
El Camino Hospital Cancer Center Mountain View, California  94040
Larry G Strieff MD Medical Corporation Oakland, California  94609
Tom K Lee, Incorporated Oakland, California  94609
Bay Area Breast Surgeons, Incorporated Oakland, California  94609
Valley Medical Oncology Consultants - Pleasanton Pleasanton, California  94588
Tahoe Forest Cancer Center Truckee, California  96161
Kapiolani Medical Center at Pali Momi Aiea, Hawaii  96701
Kapiolani Medical Center for Women and Children Honolulu, Hawaii  96826
Straub Clinic and Hospital, Incorporated Honolulu, Hawaii  96813
OnCare Hawaii, Incorporated - Kuakini Honolulu, Hawaii  96817
OnCare Hawaii, Incorporated - Lusitana Honolulu, Hawaii  96813
Illinois CancerCare - Bloomington Bloomington%, Illinois  61701
Illinois CancerCare - Canton Canton, Illinois  61520
Illinois CancerCare - Carthage Carthage, Illinois  62321
Illinois CancerCare - Eureka Eureka, Illinois  61530
Illinois CancerCare - Galesburg Galesburg, Illinois  61401
Illinois CancerCare - Havana Havana, Illinois  62644
Illinois CancerCare - Kewanee Clinic Kewanee, Illinois  61443
Illinois CancerCare - Macomb Macomb, Illinois  61455
OSF Holy Family Medical Center Monmouth, Illinois  61462
Illinois CancerCare - Monmouth Monmouth, Illinois  61462
Illinois CancerCare - Community Cancer Center Normal, Illinois  61761
Illinois CancerCare - Pekin Pekin, Illinois  61603
Illinois CancerCare - Peru Peru, Illinois  61354
Illinois CancerCare - Princeton Princeton, Illinois  61356
Illinois CancerCare - Spring Valley Spring Valley, Illinois  61362
Veterans Affairs Medical Center - Indianapolis Indianapolis, Indiana  46202
Iowa Blood and Cancer Care Cedar Rapids, Iowa  52402
York Hospital's Oncology Treatment Center York, Maine  03909
Mercy General Health Partners Muskegon, Michigan  49443
New Hampshire Oncology - Hematology, PA at Payson Center for Cancer Care Concord, New Hampshire  03301
New Hampshire Oncology - Hematology, PA - Hooksett Hooksett, New Hampshire  03106
United States Air Force Medical Center - Wright-Patterson Wright-Patterson AFB, Ohio  45433-5529
Bay Area Hospital Coos Bay, Oregon  97420
Cancer Center of Paoli Memorial Hospital Paoli, Pennsylvania  19301-1792
CCOP - Main Line Health Wynnewood, Pennsylvania  19096
U.T. Medical Center Cancer Institute Knoxville, Tennessee  37920-6999
Medcenter One Hospital Cancer Care Center Bismarck, North Dakota  58501
St. Alexius Medical Center Cancer Center Bismarck, North Dakota  58502
Suniti Medical Corporation Merrillville, Indiana  46410
Providence Cancer Center at PMCC Medford, Oregon  97504
Precision Radiotherapy at University Pointe West Chester, Ohio  45069
Hematology Oncology Associates, PC Albuquerque, New Mexico  87106
Valley Medical Oncology Consultants - Castro Valley Castro Valley, California  94546
Valley Medical Oncology Fremont, California  94538
Memorial Hospital Cancer Center - Colorado Springs Colorado Springs, Colorado  80909
Provena St. Mary's Regional Cancer Center - Kankakee Kankakee, Illinois  60901
Addison Gilbert Hospital Gloucester, Massachusetts  01930
St. Luke's Texas Cancer Institute at St. Luke's Episcopal Hospital Houston, Texas  77030
Minnesota Oncology - Maplewood Maplewood, Minnesota  55109
Humphrey Cancer Center at North Memorial Outpatient Center Robbinsdale, Minnesota  55422-2900
Lakeview Hospital Stillwater, Minnesota  55082
Minnesota Oncology - Woodbury Woodbury, Minnesota  55125
Associates in Oncology and Hematology - Medical Center Drive Rockville, Maryland  20878
CentraState Medical Center Freehold, New Jersey  07728
Mount Carmel Regional Cancer Center Pittsburg, Kansas  66762
Bassett Healthcare Regional Cancer Program at Mary Imogene Bassett Hospital Cooperstown, New York  13326
CCOP - Kansas City Prairie Village, Kansas  66208
Renown Institute for Cancer at Renown Regional Medical Center Reno, Nevada  89502
Erlanger Cancer Center at Erlanger Hospital - Baroness Chattanooga, Tennessee  37403
Kansas City Cancer Centers - Southwest Overland Park, Kansas  66210
Piedmont Fayette Hospital Fayetteville, Georgia  30214
Castle Medical Center Kailua, Hawaii  96734
Kauai Medical Clinic Lihue, Hawaii  96766
Central Dupage Cancer Center Warrenville, Illinois  60555
Hays Medical Center Hays, Kansas  67601
Hutchinson Hospital Corporation Hutchinson, Kansas  67502
Southeast Cancer Center Cape Girardeau, Missouri  63703
Goldschmidt Cancer Center Jefferson City, Missouri  65109
Comprehensive Cancer Care, PC Saint Louis, Missouri  63141
Presbyterian Cancer Treatment Center at Presbyterian Kaseman Hospital Albuquerque, New Mexico  87110
Cancer Care Associates - Norman Norman, Oklahoma  73071
Island Hospital Cancer Care Center at Island Hospital Anacortes, Washington  98221
Highline Medical Center Cancer Center Burien, Washington  98166
Riverview UW Cancer Center at Riverview Hospital Wisconsin Rapids, Wisconsin  54494
Littleton Adventist Hospital Littleton, Colorado  80122
Parker Adventist Hospital Parker, Colorado  80138
New Ulm Medical Center New Ulm, Minnesota  56073
Roger Maris Cancer Center at MeritCare Hospital Fargo, North Dakota  58122
St. Nicholas Hospital Sheboygan, Wisconsin  53081
Capital Health Regional Cancer Center Trenton, New Jersey  08618
Pacific Medical Center Seattle, Washington  98104
Wheaton Franciscan Cancer Care - St. Joseph Milwaukee, Wisconsin  53210
Highland Clinic Shreveport, Louisiana  71105
Overlake Cancer Center at Overlake Hospital Medical Center Bellevue, Washington  98004
Southern Ohio Medical Center Cancer Center Portsmouth, Ohio  45662
Kansas City Cancer Centers - North Kansas City, Missouri  64154
Kansas City Cancer Centers - South Kansas City, Missouri  64131
Kuakini Medical Center Honolulu, Hawaii  96817
St. Rose Ambulatory and Surgery Center Great Bend, Kansas  67530
Kansas City Cancer Centers - West Kansas City, Kansas  66112
Kansas City Cancer Center - Shawnee Mission Shawnee Mission, Kansas  66204
Kansas City Cancer Centers - East Lee's Summit, Missouri  64064
Cancer Centers of Southwest Oklahoma, LLC - Lawton Lawton, Oklahoma  73505
Kaiser Permanente Health Care San Marcos, California  92069
Spectrum Health Reed City Hospital Reed City, Michigan  49677
Providence Regional Cancer Partnership Everett, Washington  98201
Cancer Center of Kansas, PA - McPherson McPherson, Kansas  67460
Dickstein Cancer Treatment Center at White Plains Hospital Center White Plains, New York  10601
St. Joseph Regional Medical Center Lewiston, Idaho  83501
Mercy Clinic Cancer and Hematology - Rolla Rolla, Missouri  65401
Swedish Medical Center - Issaquah Campus Issaquah, Washington  98029
Kaiser Permanente - Irvine Irvine, California  92618
Oncare Hawaii, Incorporated - Pali Momi Aiea, Hawaii  96701
Mercy Cancer Center - West Lakes Clive, Iowa  50325
Methodist West Hospital West Des Moines, Iowa  50266-7700
Zangmeister Center Columbus, Ohio  43219
Epic Care - Oakland Oakland, California  94612
Delnor Hospital - Geneva Geneva, Illinois  60134
Sutter Pacific Medical Foundation Santa Rosa, California  95403