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A Phase III Randomized Study of Adjuvant Ipilimumab Anti-CTLA4 Therapy Versus High-Dose Interferon Alpha-2b for Resected High-Risk Melanoma

Phase 3
18 Years
Open (Enrolling)
Recurrent Melanoma, Stage IIIB Melanoma, Stage IIIC Melanoma, Stage IV Melanoma

Thank you

Trial Information

A Phase III Randomized Study of Adjuvant Ipilimumab Anti-CTLA4 Therapy Versus High-Dose Interferon Alpha-2b for Resected High-Risk Melanoma


I. To evaluate recurrence-free survival (RFS) between patients randomized to receive
post-operative adjuvant ipilimumab given at either 10 mg/kg (high dose ipilimumab; HIP) or 3
mg/kg (low dose ipilimumab: LIP) versus those randomized to receive HDI utilizing a
hierarchical design assessing HIP versus HDI first and LIP versus HDI second (if the first
comparison is significant).

II. To evaluate overall survival (OS) between patients randomized to receive post-operative
adjuvant ipilimumab given at either 10 mg/kg (HIP) or 3 mg/kg (LIP) versus those randomized
to receive HDI utilizing a hierarchical design assessing HIP versus HDI first and LIP versus
HDI second (if the first comparison is significant).


I. To evaluate safety and tolerability of post-operative adjuvant ipilimumab therapy given
at either 10 mg/kg (HIP) or 3 mg/kg (LIP).

II. Among patients enrolled by CCOPs, to compare the global QOL between the ipilimumab arms
versus HDI using FACT-G form and to evaluate the effect of treatment-related side effects
that may have an impact on the health-related domains of QOL using FACIT-D and FACT-BRM.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive induction ipilimumab IV over 90 minutes on day 1. Treatment repeats
every 21 days for a total of 4 courses in the absence of disease progression or unacceptable
toxicity. Beginning on week 24, patients receive maintenance ipilimumab IV over 90 minutes
on day 1. Treatment repeats every 90 days for a maximum of 4 courses in the absence of
disease progression or unacceptable toxicity.

ARM II: Patients receive induction high-dose recombinant interferon alfa-2b IV on days 1-5,
8-12, 15-19, and 22-26 in the absence of disease progression or unacceptable toxicity.
Patients then receive maintenance high-dose recombinant interferon alfa-2b subcutaneously on
days 1, 3, and 5. Treatment repeats every week for 48 weeks in the absence of disease
progression or unacceptable toxicity.

After completion of study therapy, patients are followed up every 3 months for 2 years,
every 6 months for 3 years, and then yearly for 15 years.

Inclusion Criteria:

- Diagnosis of melanoma of a cutaneous origin or unknown primary

- No ocular melanoma or melanoma of mucosal origin

- Stage IIIB, IIIC, or IV (M1a or M1b) disease

- Patients with stage IV melanoma must have normal LDH and distant skin,
subcutaneous, lymph node, or lung metastases

- No other visceral metastases allowed

- Disease that has been completely resected with negative margins on resected specimens
within the past 12 weeks

- Disease-free status documented by a complete physical examination and imaging
studies within 4 weeks prior to randomization

- Imaging studies must include a total body PET-CT scan (with or without
brain) and brain MRI or CT (if MRI is contraindicated) (if PET-CT cannot be
done, CT scan of neck, chest, abdomen, and pelvis should be done)

- Patients rendered free of disease by non-surgical means not allowed

- Disease recurrence after adequate surgical excision of original primary cutaneous
melanoma allowed provided one of the following criteria are met:

- Recurrence in a regional lymph node basin after a prior complete lymph node

- Relapsed disease must be completely surgically resected with free margins

- Recurrence in the form of in-transit or satellite metastases or distant
skin/subcutaneous, nodal, or lung metastases that are completely surgically
resected with free margins

- Recurrence in a regional lymph node basin

- Relapsed disease must be completely surgically resected with free margins

- Patients must be randomized within 84 days (12 weeks) of surgical resection; if more
than one surgical procedure is required to render the patient disease-free, the
patient must be randomized within 12 weeks of the last surgery

- NOTE: patients with clinically positive lymph nodes for melanoma involvement or
those with positive lymph nodes identified through lymphoscintigraphic and/or
dye lymphographic techniques in the groin, axilla, or neck should have
additional lymphadenectomy in those sites; the complete lymph node dissection
procedure would be considered as the last surgery in counting the 84 days unless
a subsequent surgical procedure(s) was clinically required to ensure the disease
free status

- ECOG performance status 0-1

- WBC ≥ 3,000/μL

- ANC ≥ 1,500/μL

- Platelet count ≥ 100,000/μL

- Hemoglobin ≥ 10 g/dL

- Serum creatinine ≤ 1.8 mg/dL

- AST and ALT ≤ 2.5 times upper limit of normal (ULN)

- Serum bilirubin < 2 times ULN (< 3 mg/dL in case of Gilbert syndrome)

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use adequate method of contraception throughout the study and
for up to 26 weeks after the last dose of high-dose recombinant interferon alpha-2b

- No active infection requiring concurrent treatment with parenteral antibiotics

- None of the following:

- Other significant medical, surgical, or psychiatric conditions

- Requirement for any medication or treatment that, in the opinion of the
investigator, may interfere with compliance, make the administration of
ipilimumab or HDI hazardous, or obscure the interpretation of adverse events,
such as a condition associated with frequent diarrhea

- Patients should be carefully screened for depression at baseline and if there are
indications or a history of depression it is strongly recommended that these patients
be closely followed together with behavioral health or psychiatric medical support;
patients with an established diagnosis of depression that, in the assessment of the
investigator may make the administration of IFNα or ipilimumab hazardous, should not
be enrolled on this protocol; the risks and benefits of being treated with standard
adjuvant IFNα should be weighed very carefully in consultation with behavioral health
or psychiatry

- No documented history of inflammatory bowel disease, including ulcerative colitis and
Crohn disease, or diverticulitis

- History of diverticulosis allowed

- No autoimmune disorders or conditions of immunosuppression that require current
ongoing treatment with systemic corticosteroids (or other systemic
immunosuppressants), including oral steroids or continuous use of topical steroid
creams or ointments or ophthalmologic steroids

- History of occasional (but not continuous) use of steroid inhalers allowed

- None of the following:

- History of symptomatic autoimmune disease

- Rheumatoid arthritis

- Systemic progressive sclerosis (scleroderma)

- Systemic lupus erythematosus

- Sjögren syndrome

- Autoimmune vasculitis (e.g., Wegener granulomatosis)

- Motor neuropathy considered of autoimmune origin (e.g., Guillain-Barre syndrome
and myasthenia gravis)

- Other CNS autoimmune disease (e.g., poliomyelitis, multiple sclerosis)

- Autoimmune hypothyroid disease or type 1 diabetes allowed provided replacement
therapy is administered

- Not incarcerated or compulsorily detained (involuntarily incarcerated) for treatment
of either a psychiatric or physical (e.g., infectious) illness

- No other current malignancies except any prior in situ cancer, lobular carcinoma of
the breast in situ, cervical cancer in situ, atypical melanocytic hyperplasia or
melanoma in situ, multiple primary melanomas, basal or squamous skin cancer, or other
malignancies for which the patient has been disease free for > 5 years

- No active or chronic infection with HIV, hepatitis B virus (HBV), or hepatitis C
virus (HCV)

- Patients must have negative testing for HIV, hepatitis B antigen, and HCV within
the past 4 weeks

- No other concurrent anticancer or investigational agent

- No prior adjuvant treatment (chemotherapy, biotherapy, or limb perfusion) after

- At least 30 days since prior radiotherapy, including after surgical resection

- No prior or concurrent anti-CTLA4 monoclonal antibodies, CTLA-4 inhibitor or agonist,
CD137 agonist, or prior interferon-α

- At least 4 weeks since prior aldesleukin (IL-2), anti-tumor vaccine, or chemotherapy
given before randomization

- No infectious disease vaccination (e.g., standard influenza, H1N1 influenza,
pneumococcal, meningococcal, or tetanus toxoid) within the past 4 weeks

- No concurrent systemic corticosteroids (or other systemic immunosuppressants),
including oral steroids (i.e., prednisone, dexamethasone), continuous use of topical
steroid creams or ointments, or ophthalmologic steroids

- Occasional but not continuous use of steroid inhalers allowed

- Systemic corticosteroids (or other systemic immunosuppressants), including oral
steroids (i.e., prednisone, dexamethasone), continuous use of topical steroid
creams or ointments, or ophthalmologic steroids within the past 2 weeks allowed
provided, in judgment of the treating physician investigator, that the patient
is not likely to require resumption of treatment with these classes of drugs
during the study

- Replacement doses of steroids for patients with adrenal insufficiency allowed

- No concurrent chemotherapy or radiotherapy

Type of Study:


Study Design:

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

Outcome Measure:

Recurrence-free survival

Outcome Time Frame:

Time from randomization to the time of disease recurrence or death from any cause, assessed up to 20 years

Safety Issue:


Principal Investigator

Ahmad Tarhini

Investigator Role:

Principal Investigator

Investigator Affiliation:

Eastern Cooperative Oncology Group


United States: Food and Drug Administration

Study ID:




Start Date:

May 2011

Completion Date:

Related Keywords:

  • Recurrent Melanoma
  • Stage IIIB Melanoma
  • Stage IIIC Melanoma
  • Stage IV Melanoma
  • Melanoma



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Cancer Center of Kansas - Main Office Wichita, Kansas  67214
Ochsner Clinic Foundation-Baton Rouge Baton Rouge, Louisiana  70809
Associates In Oncology Hematology PC-Rockville Rockville, Maryland  20878
North Shore Medical Center Cancer Center Peabody, Massachusetts  01960
Berkshire Hematology Oncology PC Pittsfield, Massachusetts  01201
Hickman Cancer Center Adrian, Michigan  49221
Michigan Cancer Research Consortium Community Clinical Oncology Program Ann Arbor, Michigan  48106
Oakwood Hospital Dearborn, Michigan  48123
Green Bay Oncology - Escanaba Escanaba, Michigan  49431
Grand Rapids Clinical Oncology Program Grand Rapids, Michigan  49503
Saint Mary's Health Care Grand Rapids, Michigan  49503
Spectrum Health at Butterworth Campus Grand Rapids, Michigan  49503
Green Bay Oncology - Iron Mountain Iron Mountain, Michigan  49801
Allegiance Health Jackson, Michigan  49201
Sparrow Hospital Lansing, Michigan  48912
Saint Mary Mercy Hospital Livonia, Michigan  48154
Mercy Memorial Hospital Monroe, Michigan  48162
Mercy Health Partners-Mercy Campus Muskegon, Michigan  49443
Saint Joseph Mercy Port Huron Port Huron, Michigan  48060
Saint Mary's of Michigan Saginaw, Michigan  48601
Lakeland Hospital St. Joseph, Michigan  49085
Miller-Dwan Hospital Duluth, Minnesota  55805
Unity Hospital Fridley, Minnesota  55432
Saint John's Hospital - Healtheast Maplewood, Minnesota  55109
Minnesota Oncology Hematology PA-Maplewood Maplewood, Minnesota  55109
North Memorial Medical Health Center Robbinsdale, Minnesota  55422
Saint Cloud Hospital Saint Cloud, Minnesota  56303
Park Nicollet Clinic - Saint Louis Park Saint Louis Park, Minnesota  55416
Minnesota Oncology and Hematology PA-Woodbury Woodbury, Minnesota  55125
Freeman Health System Joplin, Missouri  64804
Saint Louis-Cape Girardeau CCOP Saint Louis, Missouri  63141
Missouri Baptist Medical Center Saint Louis, Missouri  63131
Saint John's Mercy Medical Center Saint Louis, Missouri  63141
Ozark Health Ventures LLC dba Cancer Research for The Ozarks Springfield Springfield, Missouri  65802
Saint John's Hospital Springfield, Missouri  65804
Cox Medical Center Springfield, Missouri  65807
Saint Vincent Healthcare Billings, Montana  59101
Billings Clinic Billings, Montana  59107-7000
Benefis Healthcare- Sletten Cancer Institute Great Falls, Montana  59405
Good Samaritan Hospital Kearney, Nebraska  68847
Lincoln Medical Education Foundation Cancer Resource Center Lincoln, Nebraska  68510
Missouri Valley Cancer Consortium CCOP Omaha, Nebraska  68106
Nevada Cancer Research Foundation CCOP Las Vegas, Nevada  89106
Cooper Hospital University Medical Center Camden, New Jersey  08103
Hunterdon Medical Center Flemington, New Jersey  08822
Saint Barnabas Medical Center Livingston, New Jersey  07039
Presbyterian Kaseman Hospital Albuquerque, New Mexico  87110
Orange Regional Medical Center Middletown, New York  10940
Saint Luke's Roosevelt Hospital Center - Saint Luke's Division New York, New York  10025
Columbia University Medical Center New York, New York  10032
State University of New York Upstate Medical University Syracuse, New York  13210
Mission Hospitals Inc Asheville, North Carolina  28801
Kinston Medical Specialists PA Kinston, North Carolina  28501
Saint Alexius Medical Center Bismarck, North Dakota  58501
Summa Barberton Hospital Barberton, Ohio  44203
Aultman Health Foundation Canton, Ohio  44710
Doctors Hospital Columbus, Ohio  43228
Grant Medical Center Columbus, Ohio  43215
Mount Carmel Health Center West Columbus, Ohio  43222
Good Samaritan Hospital - Dayton Dayton, Ohio  45406
Dayton CCOP Dayton, Ohio  45429
Samaritan North Health Center Dayton, Ohio  45415
Blanchard Valley Hospital Findlay, Ohio  45840
Atrium Medical Center-Middletown Regional Hospital Franklin, Ohio  45005-1066
Cleveland Clinic Cancer Center Independence Independence, Ohio  44131
Kettering Medical Center Kettering, Ohio  45429
Marietta Memorial Hospital Marietta, Ohio  45750
Saint Charles Hospital Oregon, Ohio  43616
North Coast Cancer Care Sandusky, Ohio  44870
Toledo Community Hospital Oncology Program CCOP Toledo, Ohio  43617
University of Toledo Toledo, Ohio  43614
Saint Vincent Mercy Medical Center Toledo, Ohio  43608
Upper Valley Medical Center Troy, Ohio  45373
Saint Ann's Hospital Westerville, Ohio  43081
Cleveland Clinic Wooster Specialty Center Wooster, Ohio  44691
Genesis HealthCare System Zanesville, Ohio  43701
Providence Saint Vincent Medical Center Portland, Oregon  97225
Columbia River Oncology Program Portland, Oregon  97225
Saint Luke's Hospital Bethlehem, Pennsylvania  18015
Pocono Medical Center East Stroudsburg, Pennsylvania  18301
Scranton Hematology Oncology Scranton, Pennsylvania  18510
Mercy Hospital Scranton, Pennsylvania  18501
Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania  18711
Mainline Health CCOP Wynnewood, Pennsylvania  19096
AnMed Health Hospital Anderson, South Carolina  29621
Greenville CCOP Greenville, South Carolina  29615
Greenville Memorial Hospital Greenville, South Carolina  29605
Upstate Carolina CCOP Spartanburg, South Carolina  29303
Sanford Cancer Center-Oncology Clinic Sioux Falls, South Dakota  57104
Harrison Bremerton Hematology and Oncology Bremerton, Washington  98310
Columbia Basin Hematology and Oncology PLLC Kennewick, Washington  99336
Good Samaritan Community Hospital Puyallup, Washington  98372
Swedish Medical Center-First Hill Seattle, Washington  98122-4307
Northwest CCOP Tacoma, Washington  98405
Edwards Comprehensive Cancer Center Huntington, West Virginia  25701
West Virginia University Morgantown, West Virginia  26506
Wheeling Hospital Wheeling, West Virginia  26003
Langlade Hospital and Cancer Center Antigo, Wisconsin  54409
Sacred Heart Hospital Eau Claire, Wisconsin  54701
Central Wisconsin Cancer Program Fond Du Lac, Wisconsin  54935
Saint Vincent Hospital Green Bay, Wisconsin  54301
Green Bay Oncology Limited at Saint Mary's Hospital Green Bay, Wisconsin  54303
Saint Mary's Hospital Green Bay, Wisconsin  54303
Green Bay Oncology at Saint Vincent Hospital Green Bay, Wisconsin  54301-3526
Aurora BayCare Medical Center Green Bay, Wisconsin  54311-6519
Dean Hematology and Oncology Clinic Madison, Wisconsin  53717
Vince Lombardi Cancer Clinic-Marinette Marinette, Wisconsin  54143
Marshfield Clinic-Minocqua Center Minocqua, Wisconsin  54548
Oconomowoc Memorial Hospital-ProHealth Care Inc Oconomowoc, Wisconsin  53066-3896
Green Bay Oncology - Oconto Falls Oconto Falls, Wisconsin  54154
Marshfield Clinic at James Beck Cancer Center Rhinelander, Wisconsin  54501
Saint Michael's Hospital Stevens Point, Wisconsin  54481
Green Bay Oncology - Sturgeon Bay Sturgeon Bay, Wisconsin  54235
Aspirus Regional Cancer Center Wausau, Wisconsin  54401
Jupiter Medical Center Jupiter, Florida  33458
University of Illinois Chicago, Illinois  60612
Stony Brook University Medical Center Stony Brook, New York  11794
York Hospital York, Maine  03909
Lahey Clinic Medical Center Burlington, Massachusetts  01805
Elkhart Clinic Elkhart, Indiana  46515
Saint Jude Medical Center Fullerton, California  92835
Moores University of California San Diego Cancer Center LA Jolla, California  92093
University of Colorado Cancer Center - Anschutz Cancer Pavilion Aurora, Colorado  80045
Memorial Healthcare System - Joe DiMaggio Children's Hospital Hollywood, Florida  33021
Mount Sinai Medical Center CCOP Miami Beach, Florida  33140
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-Havana Havana, Illinois  62644
Illinois CancerCare-Kewanee Clinic Kewanee, Illinois  61443
Illinois CancerCare-Macomb Macomb, Illinois  61455
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
Michiana Hematology Oncology PC-Elkhart Elkhart, Indiana  46514
Michiana Hematology Oncology PC-Plymouth Plymouth, Indiana  46563
Michiana Hematology Oncology PC-South Bend South Bend, Indiana  46601
Michiana Hematology Oncology-PC Westville Westville, Indiana  46391
Cancer Center of Kansas-Liberal Liberal, Kansas  67901
Saint Agnes Hospital Baltimore, Maryland  21229
University of Michigan University Hospital Ann Arbor, Michigan  48109
Central Care Cancer Center-Carrie J Babb Cancer Center Bolivar, Missouri  65613
University of Missouri - Ellis Fischel Columbia, Missouri  65203
Veterans Administration Columbia, Missouri  65201
Renown Regional Medical Center Reno, Nevada  89502
Hackensack University Medical CCOP Hackensack, New Jersey  07601
Carolinas Medical Center - Northeast Concord, North Carolina  28025
Moses Cone Health System-Regional Cancer Center Greensboro, North Carolina  27403
Roper Hospital Charleston, South Carolina  29401
Cancer Centers of the Carolinas - Faris Greenville, South Carolina  29605
Cancer Centers of the Carolinas-Greer Medical Oncology Greer, South Carolina  29650
Erlanger Medical Center Chattanooga, Tennessee  37403
Sandra L Maxwell Cancer Center Cedar City, Utah  84720
Intermountain Medical Center Murray, Utah  84157
Utah Valley Regional Medical Center Provo, Utah  84603
Dixie Medical Center Regional Cancer Center Saint George, Utah  84770
Utah Cancer Specialists-Salt Lake City Salt Lake City, Utah  84106
West Virginia University Charleston Charleston, West Virginia  25304
Holy Family Memorial Hospital Manitowoc, Wisconsin  54221
Wheaton Franciscan Healthcare - Saint Joseph Milwaukee, Wisconsin  53210
Vince Lombardi Cancer Clinic-Sheboygan Sheboygan, Wisconsin  53081
Marshfield Clinic Cancer Care at Saint Michael's Hospital Stevens Point, Wisconsin  54481
Aurora Medical Center in Summit Summit, Wisconsin  53066
Vince Lombardi Cancer Clinic Two Rivers, Wisconsin  54241
Riverview Hospital Wisconsin Rapids, Wisconsin  54494
Kansas City Cancer Centers-Southwest Overland Park, Kansas  66210
University of California at Los Angeles (UCLA ) Los Angeles, California  90095
Monter Cancer Center Lake Success, New York  11042
Cancer Centers of Southwest Oklahoma Research Lawton, Oklahoma  
Arizona Cancer Center at University Medical Center North Tucson, Arizona  85719
Kuakini Medical Center Honolulu, Hawaii  96817
Saint Luke's Mountain States Tumor Institute - Fruitland Fruitland, Idaho  83619
Arizona Cancer Center at UMC Orange Grove Tucson, Arizona  85704
Kaiser Permanente-Deer Valley Medical Center Antioch, California  94531
Palchak David MD Pismo Beach, California  93449
Kaiser Permanente Medical Center-Vacaville Vacaville, California  95688
Kaiser Permanente-Rock Creek Lafayette, Colorado  80026
Kaiser Permanente Moanalua Medical Center Honolulu, Hawaii  96819
Wilcox Memorial Hospital and Kauai Medical Clinic Lihue, Hawaii  96766-1099
Saint Luke's Mountain States Tumor Institute - Meridian Meridian, Idaho  83642
Saint Luke's Mountain States Tumor Institute - Nampa Nampa, Idaho  83686
Hinsdale Hematology Oncology Associates Incorporated Hinsdale, Illinois  60521
Spector, David MD (UIA Investigator) Moline, Illinois  61265
Kansas City CCOP Prairie Village, Kansas  66208
Kansas City Cancer Center-Shawnee Mission Shawnee Mission, Kansas  66204
Owensboro Mercy Medical Center Owensboro, Kentucky  42303
Spectrum Health Reed City Hospital Reed City, Michigan  49677
Saint Francis Poughkeepsie, New York  12601
Cleveland Clinic Cancer Center Beachwood Beachwood, Ohio  44122
The Christ Hospital Cincinnati, Ohio  45219
The Mark H Zangmeister Center Columbus, Ohio  43219
Southern Ohio Medical Center Portsmouth, Ohio  45662
Cancer Care Associates-Mercy Oklahoma City, Oklahoma  73120
Saint Charles Medical Center-Bend Bend, Oregon  97701
Mid-Columbia Medical Center The Dalles, Oregon  97058
Susquehanna Cancer Center Williamsport, Pennsylvania  17701
Saint Francis Hospital Greenville, South Carolina  29601
Hematology Oncology Associates of Fredericksburg Inc Fredericksburg, Virginia  22401
Highline Medical Center-Main Campus Burien, Washington  98166
Providence Regional Cancer Partnership Everett, Washington  98201
Gundersen Lutheran La Crosse, Wisconsin  54601
Alegent Health Lakeside Hospital Omaha, Nebraska  68130
New York Oncology Hematology PC -Albany Medical Center Albany, New York  12208
New York Oncology Hematology PC - Albany Albany, New York  12206
New York Oncology Hematology PC - Amsterdam Amsterdam, New York  12010
New York Oncology Hematology PC-Hudson Hudson, New York  12534
New York Oncology Hematology PC - Latham Latham, New York  12110
New York Oncology Hematology PC - Rexford Rexford, New York  12148
New York Oncology Hematology PC - Troy Troy, New York  12180
Stanford University Hospitals and Clinics Stanford, California  94305
Kaiser Permanente-Franklin Denver, Colorado  80205
Siouxland Hematology Oncology Associates Sioux City, Iowa  51101
Roger Williams Hospital Providence, Rhode Island  02908
Mid-Illinois Hematology Oncology Associates Normal, Illinois  
Methodist West Hospital West Des Moines, Iowa  50266-7700
Georgia Health Sciences University Augusta, Georgia  30912
Boca Raton Regional Hospital Boca Raton, Florida  33486
Carle Foundation - Carle Cancer Center Urbana, Illinois  61801
Michiana Hematology Oncology PC-Mishawaka Mishawaka, Indiana  46545-1470
Marie Yeager Cancer Center Saint Joseph, Michigan  49085
Hematology Oncology Associates of Central New York PC East Syracuse, New York  13057
Summa Akron City Hospital Akron, Ohio  44304
Franciscan St. Francis Health Indianapolis, Indiana  46237
The Toledo Hospital/Toledo Children's Hospital Toledo, Ohio  43606
Sanford USD Medical Center - Sioux Falls Sioux Falls, South Dakota  57117-5134
North Shore-LIJ Health System CCOP Manhasset, New York  11030
Genesys Regional Medical Center-West Flint Campus Flint, Michigan  48532
Essentia Health Duluth Clinic CCOP Duluth, Minnesota  55805
Essentia Health Saint Mary's Medical Center Duluth, Minnesota  55805
Sanford Bismarck Medical Center Bismarck, North Dakota  58501
Toledo Clinic Cancer Centers-Oregon Oregon, Ohio  43616
Geisinger Medical Center-Cancer Center Hazelton Hazleton, Pennsylvania  18201
Presbyterian Intercommunity Hospital Whittier, California  90602
Community Howard Regional Health Kokomo, Indiana  46904
Indiana University Health La Porte Hospital La Porte, Indiana  46350
Saint Joseph Regional Medical Center-Mishawaka Mishawaka, Indiana  46545-1470
Via Christi Hospital-Pittsburg Pittsburg, Kansas  66762
PeaceHealth Saint Joseph Medical Center Bellingham, Washington  98225
Aurora Cancer Care-Milwaukee West Wauwatosa, Wisconsin  53226
Christiana Care Health System-Christiana Hospital Newark, Delaware  19718
Illinois Cancer Specialists-Niles Niles, Illinois  60714
Bronson Battle Creek Battle Creek, Michigan  49017
Springfield Regional Medical Center Springfield, Ohio  45505
Cleveland Clinic Cancer Center/Fairview Hospital Cleveland, Ohio  44111
Marin Cancer Care Inc Greenbrae, California  94904
Promise Regional Medical Center-Hutchinson Hutchinson, Kansas  65702
Saint Louis Cancer and Breast Institute-South City Saint Louis, Missouri  63109
Toledo Clinic Cancer Centers-Maumee Maumee, Ohio  43537-1839
Toledo Clinic Cancer Centers-Toledo Toledo, Ohio  43623
Guthrie Clinic-Robert Packer Hospital Sayre, Pennsylvania  18840
IU Health Ball Memorial Hospital Muncie, Indiana  47303
Sutter Pacific Medical Foundation Santa Rosa, California  95403
Maine Center for Cancer Medicine and Blood Disorders-Scarborough Scarborough, Maine  04074
Saint Luke's Mountain States Tumor Institute-Twin Falls Twin Falls, Idaho  83301
Ochsner Baptist Medical Center New Orleans, Louisiana  70115
Cancer Care Associates-Norman Norman, Oklahoma  73071
Mercy Physicians of Oklahoma-Lakeside Oklahoma City, Oklahoma  73120
Mercy Cancer Center-West Lakes Clive, Iowa  50325
Mercy Medical Center-West Lakes West Des Moines, Iowa  50266
Oncare Hawaii Inc - Kapiolani Medical Center at Pali Momi Aiea, Hawaii  96701
D N Greenwald Center Mukwonago, Wisconsin  53149
Swedish Medical Center-Edmonds Edmonds, Washington  98026
The Angeles Clinic and Research Institute - West Los Angeles Office Los Angeles, California  90025