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A Phase III Clinical Trial Comparing the Combination of Docetaxel Plus Cyclophosphamide to Anthracycline-Based Chemotherapy Regimens for Women With Node-Positive or High-Risk Node-Negative, HER2-Negative Breast Cancer

Phase 3
18 Years
Open (Enrolling)
Breast Cancer

Thank you

Trial Information

A Phase III Clinical Trial Comparing the Combination of Docetaxel Plus Cyclophosphamide to Anthracycline-Based Chemotherapy Regimens for Women With Node-Positive or High-Risk Node-Negative, HER2-Negative Breast Cancer



- To determine if the docetaxel and cyclophosphamide (TC) regimen is non-inferior to the
anthracycline-based chemotherapy regimens in terms of invasive disease-free survival
(DFS) by combining B-49 data with the docetaxel, doxorubicin, and cyclophosphamide
(TAC) and TC arms of NSABP B-46-I/US Oncology Research, Inc.(USOR) 07132 and the data
from USOR 06-090.


- To determine rates of DFS-ductal carcinoma in situ (DCIS) for the TC and
anthracycline-based chemotherapy regimens.

- To determine rates of overall survival (OS) for the TC and anthracycline-based
chemotherapy regimens.

- To determine rates of recurrence-free interval (RFI) for the TC and anthracycline-based
chemotherapy regimens.

- To evaluate the toxicity associated with each of the regimens.

- To determine the role of TOP2A in prognosis and prediction of degree of benefit from
anthracycline-based chemotherapy over TC. (exploratory)

- To develop predictive markers for benefit from doxorubicin. (exploratory)

OUTLINE: This is a multicenter randomized study. Patients are stratified according to number
of positive nodes (0 vs 1-3 vs 4-9 vs 10+) and hormone-receptor status (estrogen receptor
[ER] and/or progesterone receptor [PgR] positive vs ER and PgR negative). Patients are
randomized to 1 of 2 treatment arms.

Inclusion Criteria:

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

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

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

- All of the following staging criteria must be met according to American Joint
Committee on Cancer (AJCC) criteria:

- By pathologic evaluation, primary tumor must be pT1-3;

- By pathologic evaluation, ipsilateral nodes must be pN0, pN1 (pN1mi, pN1a, pN1b,
pN1c), pN2a, pN3a, or pN3b.

- If pN0, at least one of the following criteria must be met:

- ER negative and PgR negative; or

- Pathologic tumor size greater than 2.0 cm; or

- T1c (pathologic tumor size greater than 1.0 cm but less than or equal to 2.0 cm)
and ER positive (PgR status may be positive or negative) and either grade 3
histology or Oncotype DX® Recurrence Score of greater than or equal to 25.

- Patients must have undergone either a total mastectomy or breast-conserving surgery

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

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

- Patients must have completed one of the following procedures for evaluation of
pathologic nodal status:

- Sentinel lymphadenectomy alone if pathologic nodal staging based on sentinel
lymphadenectomy is pN0, pN1mi, or pN1b;

- Sentinel lymphadenectomy alone if pathologic nodal staging based on sentinel
lymphadenectomy is pN1a limited to 1 or 2 positive nodes and primary tumor is T1
or T2 by pathologic evaluation;

- Sentinel lymphadenectomy followed by removal of additional non-sentinel lymph
nodes if the sentinel node (SN) is positive; or

- Axillary lymphadenectomy with or without SN isolation procedure.

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

- Patients must have ER analysis performed on the primary tumor prior to randomization.
Breast cancer must be assessed for ER status by current ASCO/CAP Guideline
Recommendations for hormone receptor testing. If negative for ER, assessment of PgR
must also be performed according to current ASCO/CAP Guideline Recommendations for
hormone receptor testing. (Either a core biopsy or surgical resection specimen can
be used for ER/PgR testing.)

- The most recent postoperative blood counts, performed within 6 weeks prior to
randomization, must meet the following criteria:

- absolute neutrophil count (ANC) must be greater than or equal to 1200/mm3;

- platelet count must be greater than or equal to 100,000/mm3; and

- hemoglobin must be greater than or equal to 10 g/dL.

- The following criteria for evidence of adequate hepatic function must be met based on
the results of the most recent postoperative tests performed within 6 weeks prior to

- total bilirubin must be less than or equal to upper limit of normal (ULN) for
the lab unless the patient has a bilirubin elevation greater than ULN to 1.5 x
ULN due to Gilbert's disease or similar syndrome involving slow conjugation of
bilirubin; and

- alkaline phosphatase must be less than or equal to 2.5 x ULN for the lab; and

- aspartate transaminase (AST) must be less than or equal to 1.5 x ULN for the

- Alkaline phosphatase and AST may not both be greater than the ULN. For example,
if the alkaline phosphatase is greater than the ULN but less than or equal to
2.5 x ULN, then the AST must be less than or equal to the ULN. If the AST is
greater than the ULN but less than or equal to 1.5 x ULN, then the alkaline
phosphatase must be less than or equal to ULN.

- Note: If alanine aminotransferase (ALT) is performed instead of AST (per
institution's standard practice), the ALT value must be less than or equal to
1.5 x ULN; if both were performed, the AST must be less than or equal to 1.5 x

- Patients with AST or alkaline phosphatase greater than ULN are eligible for inclusion
in the study if liver imaging (CT, MRI, PET-CT, or PET scan performed within 90 days
prior to randomization) does not demonstrate metastatic disease and the requirements
for adequate hepatic function as described above are met.

- Patients with alkaline phosphatase that is greater than ULN but less than or equal to
2.5 x ULN are eligible for inclusion in the study if a bone scan, PET-CT scan, or PET
scan performed within 90 days prior to randomization does not demonstrate metastatic

- The most recent postoperative serum creatinine performed within 6 weeks prior to
randomization must be less than or equal to ULN for the lab.

- Left ventricular ejection fraction (LVEF) assessment by 2-D echocardiogram or
multigated acquisition (MUGA) scan must be performed within 90 days prior to
randomization. The LVEF must be greater than or equal to 50% regardless of the
facility's lower limit of normal (LLN). (If the facility performing the assessment
has not reported the LVEF as a whole number, decimals reported as greater than or
equal to 5 should be rounded up and decimals reported as less than 5 should be
rounded down.)

Exclusion criteria:

Patients with one or more of the following conditions are ineligible for this study.

- T4 tumors including inflammatory breast cancer.

- Definitive clinical or radiologic evidence of metastatic disease. (Chest imaging
[mandatory for all patients] and other imaging [if required] must have been performed
within 90 days prior to randomization.)

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

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

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

- Previous therapy with anthracyclines or taxanes for any malignancy.

- Chemotherapy administered for the currently diagnosed breast cancer prior to

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

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

- Known active hepatitis B or hepatitis C with abnormal liver function tests.

- Cardiac disease (history of and/or active disease) that would preclude the use of the
drugs included in the treatment regimens. This includes but is not confined to:

- Active cardiac disease

- angina pectoris that requires the use of anti-anginal medication;

- ventricular arrhythmias except for benign premature ventricular contractions;

- supraventricular and nodal arrhythmias requiring a pacemaker or not controlled
with medication;

- conduction abnormality requiring a pacemaker;

- valvular disease with documented compromise in cardiac function;

- symptomatic pericarditis.

- History of cardiac disease

- myocardial infarction documented by elevated cardiac enzymes or persistent
regional wall abnormalities on assessment of left ventricular function;

- history of documented congestive heart failure (CHF);

- documented cardiomyopathy.

- Whole breast radiation therapy (RT) prior to randomization or partial breast RT that
cannot be completed on or before the date of randomization.

- Intrinsic lung disease resulting in dyspnea.

- Unstable diabetes mellitus.

- Active infection or chronic infection requiring suppressive antibiotics.

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

- Nervous system disorder (paresthesia, peripheral motor neuropathy, or peripheral
sensory neuropathy) greater than or equal to grade 2, per the NCI CTCAE v4.0.

- Conditions that would prohibit administration of corticosteroids.

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

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

- Pregnancy or lactation at the time of study entry. (Note: Pregnancy testing must be
performed within 2 weeks prior to randomization according to institutional standards
for women of childbearing potential.)

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

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

- Use of any investigational product within 30 days prior to randomization.

Type of Study:


Study Design:

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

Outcome Measure:

Invasive disease-free survival (IDFS)

Outcome Description:

The time to local recurrence following mastectomy, invasive local recurrence in the ipsilateral breast following lumpectomy, regional recurrence, distant recurrence, invasive contralateral breast cancer, second primary cancer (other than squamous or basal cell carcinoma of the skin, melanoma in situ, carcinoma in situ of the cervix, colorectal carcinoma in situ, or lobular carcinoma in situ of the breast), or death from any cause prior to recurrence or second primary cancer.

Outcome Time Frame:

Assessed before each cycle of chemotherapy, 3-4 weeks after completion of chemotherapy, every 6 months through 5 years and yearly years 6-10.

Safety Issue:


Principal Investigator

Norman Wolmark, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

NSABP Foundation, Inc.


United States: Food and Drug Administration

Study ID:




Start Date:

April 2012

Completion Date:

May 2019

Related Keywords:

  • Breast Cancer
  • estrogen receptor-negative breast cancer
  • estrogen receptor-positive breast cancer
  • HER2-negative breast cancer
  • progesterone receptor-negative breast cancer
  • progesterone receptor-positive breast cancer
  • stage IA breast cancer
  • stage IB breast cancer
  • stage II breast cancer
  • stage IIIA breast cancer
  • stage IIIC breast cancer
  • Breast Neoplasms



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New Ulm Medical Center New Ulm, Minnesota  56073
Mercy Hospital Portland, Maine  04101
Wake Forest University Health Sciences Winston-Salem, North Carolina  27157
OSF Saint Francis Medical Center Peoria, Illinois  61637
Saint Helena Hospital Saint Helena, California  94574
Valley Medical Oncology Consultants-Castro Valley Castro Valley, California  94546
Northbay Cancer Center Fairfield, California  94533
Valley Medical Oncology Consultants-Fremont Fremont, California  94538
Kaiser Permanente, Fremont Fremont, California  94538
California Cancer Center - North Fresno Fresno, California  93720
Kaiser Permanente, Hayward Hayward, California  94545
Community Hospital of Monterey Peninsula Monterey, California  93940
Bay Area Breast Surgeons Inc Oakland, California  94609
Bay Area Tumor Institution CCOP Oakland, California  94609
Tom K Lee Inc Oakland, California  94609
Kaiser Permanente-Oakland Oakland, California  94611
Kaiser Permanente-Redwood City Redwood City, California  94063
Kaiser Permanente-Richmond Richmond, California  94801
Kaiser Permanente-Roseville Roseville, California  95661
Kaiser Permanente-South Sacramento Sacramento, California  95823
Kaiser Permanente - Sacramento Sacramento, California  95825
Naval Medical Center -San Diego San Diego, California  92134
Kaiser Permanente-San Francisco San Francisco, California  94115
Kaiser Permanente-Santa Teresa-San Jose San Jose, California  95119
Doctors Medical Center- JC Robinson Regional Cancer Center San Pablo, California  94806
Kaiser Permanente-San Rafael San Rafael, California  94903
Kaiser Permanente-Santa Rosa Santa Rosa, California  95403
Kaiser Permanente-South San Francisco South San Francisco, California  94080
Kaiser Permanente-Stockton Stockton, California  95210
Kaiser Permanente-Vallejo Vallejo, California  94589
Kaiser Permanente-Walnut Creek Walnut Creek, California  94596
The Medical Center of Aurora Aurora, Colorado  80012
Penrose-Saint Francis Healthcare Colorado Springs, Colorado  80907
Saint Anthony Central Hospital Denver, Colorado  80204
Exempla Saint Joseph Hospital Denver, Colorado  80218
Colorado Cancer Research Program CCOP Denver, Colorado  80224-2522
Saint Mary Corwin Medical Center Pueblo, Colorado  81004
Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
Middlesex Hospital Middletown, Connecticut  06457
The Hospital of Central Connecticut New Britain, Connecticut  06050
Stamford Hospital Stamford, Connecticut  06904
Bayhealth Medical Center at Kent General Dover, Delaware  19901
Lombardi Comprehensive Cancer Center at Georgetown University Washington, District of Columbia  20057
Edna Williams Cancer Center at the Baptist Cancer Institute Jacksonville, Florida  32207
The Watson Clinic Lakeland, Florida  33805
M D Anderson Cancer Center- Orlando Orlando, Florida  32806
Sacred Heart Medical Oncology Group - Davis Highway Pensacola, Florida  32514
Saint Joseph's-Candler Health System Savannah, Georgia  31405
Oncare Hawaii Inc-POB II Honolulu, Hawaii  96813
Oncare Hawaii Inc-Kuakini Honolulu, Hawaii  96817
University of Hawaii Honolulu, Hawaii  96813
Saint Luke's Mountain States Tumor Institute Boise, Idaho  83712
Rush - Copley Medical Center Aurora, Illinois  60504
John H Stroger Jr Hospital of Cook County Chicago, Illinois  60612-3785
Evanston CCOP-NorthShore University HealthSystem Evanston, Illinois  60201
Joliet Oncology-Hematology Associates Limited Joliet, Illinois  60435
Provena Saint Mary's Hospital Kankakee, Illinois  60901
Garneau, Stewart C MD (UIA Investigator) Moline, Illinois  61265
Porubcin, Michael MD (UIA Investigator) Moline, Illinois  61265
Good Samaritan Regional Medical Center Mt. Vernon, Illinois  62864
Hematology Oncology Consultants Limited Naperville, Illinois  60540
Community Cancer Center Foundation Normal, Illinois  61761
Illinois CancerCare-Ottawa Clinic Ottawa, Illinois  61350
Ottawa Regional Hospital and Healthcare Center Ottawa, Illinois  61350
Pekin Cancer Treatment Center Pekin, Illinois  61554
Illinois Oncology Research Association CCOP Peoria, Illinois  61615
Illinois CancerCare-Peoria Peoria, Illinois  61615
Illinois Valley Hospital Peru, Illinois  61354
West Suburban Cancer Center River Forest, Illinois  60305
Saint Francis Hospital and Health Centers Beech Grove, Indiana  46107
Fort Wayne Medical Oncology and Hematology Inc - State Boulevard Fort Wayne, Indiana  46845
Saint Anthony Memorial Health Center Michigan City, Indiana  46360
Reid Hospital and Health Care Services Richmond, Indiana  47374
McFarland Clinic Ames, Iowa  50010
Hematology Oncology Associates-Quad Cities Bettendorf, Iowa  52722
Constantinou, Costas L MD (UIA Investigator) Bettendorf, Iowa  52722
Cedar Rapids Oncology Association Cedar Rapids, Iowa  52403
Iowa Blood and Cancer Care PLC Cedar Rapids, Iowa  52402
Mercy Hospital Cedar Rapids, Iowa  52403
Saint Luke's Hospital Cedar Rapids, Iowa  52402
Medical Oncology and Hematology Associates-West Des Moines Clive, Iowa  50325
Genesis Medical Center - East Campus Davenport, Iowa  52803
Iowa Oncology Research Association CCOP Des Moines, Iowa  50309
Mercy Medical Center - Des Moines Des Moines, Iowa  50314
Medical Oncology and Hematology Associates-Des Moines Des Moines, Iowa  50309
Mercy Medical Center - North Iowa Mason City, Iowa  50401
Mercy Medical Center-Sioux City Sioux City, Iowa  51104
Saint Luke's Regional Medical Center Sioux City, Iowa  51104
Covenant Medical Center Waterloo, Iowa  50702
Cancer Center of Kansas - El Dorado El Dorado, Kansas  67042
Cancer Center of Kansas-Kingman Kingman, Kansas  67068
Cancer Center of Kansas - Parsons Parsons, Kansas  67357
Cancer Center of Kansas - Pratt Pratt, Kansas  67124
Stormont-Vail Regional Health Center Topeka, Kansas  66604
Saint Francis Hospital and Medical Center - Topeka Topeka, Kansas  66606
Cancer Center of Kansas-Wichita Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas - Main Office Wichita, Kansas  67214
Ochsner Clinic Foundation-Baton Rouge Baton Rouge, Louisiana  70809
Ochsner Clinic CCOP New Orleans, Louisiana  70121
The Union Memorial Hospital Baltimore, Maryland  21218
Holy Family Hospital Methuen, Massachusetts  01844
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
Saint John Hospital and Medical Center Detroit, Michigan  48236
Michigan State University - Breslin Cancer Center East Lansing, Michigan  48824-1313
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
Northern Michigan Regional Hospital Petoskey, Michigan  49770
Saint Joseph Mercy Oakland Pontiac, Michigan  48341-2985
Saint Joseph Mercy Port Huron Port Huron, Michigan  48060
Saint Mary's of Michigan Saginaw, Michigan  48601
Lakeland Hospital St. Joseph, Michigan  49085
Saint John Macomb-Oakland Hospital Warren, Michigan  48093
Miller-Dwan Hospital Duluth, Minnesota  55805
Saint Luke's Hospital of Duluth Duluth, Minnesota  55805
Unity Hospital Fridley, Minnesota  55432
Immanuel-Saint Joseph Hospital-Mayo Health System Mankato, Minnesota  56002
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
Saint John's Regional Medical Center Joplin, Missouri  64804
Freeman Health System Joplin, Missouri  64804
Saint Luke's Cancer Institute Kansas City, Missouri  64111
Saint Luke's Hospital of Kansas City Kansas City, Missouri  64111
Liberty Radiation Oncology Clinic Kansas City, Missouri  64116
Truman Medical Center Kansas City, Missouri  64108
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
Hematology-Oncology Centers of the Northern Rockies PC Billings, Montana  59101
Saint Vincent Healthcare Billings, Montana  59101
Billings Clinic Billings, Montana  59107-7000
Saint James Community Hospital and Cancer Treatment Center Butte, Montana  59701
Benefis Healthcare- Sletten Cancer Institute Great Falls, Montana  59405
Saint Peter's Community Hospital Helena, Montana  59601
Glacier Oncology PLLC Kalispell, Montana  59901
Saint Patrick Hospital - Community Hospital Missoula, Montana  59802
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
Portsmouth Regional Hospital Portsmouth, New Hampshire  03802
Cooper Hospital University Medical Center Camden, New Jersey  08103
Hunterdon Medical Center Flemington, New Jersey  08822
Sparta Cancer Treatment Center Sparta, New Jersey  07871
University of New Mexico at Lovelace Medical Center Albuquerque, New Mexico  87102
Presbyterian Kaseman Hospital Albuquerque, New Mexico  87110
Memorial Medical Center - Las Cruces Las Cruces, New Mexico  88011
Columbia University Medical Center New York, New York  10032
Mission Hospitals Inc Asheville, North Carolina  28801
Alamance Regional Medical Center Burlington, North Carolina  27216
Gaston Memorial Hospital Gastonia, North Carolina  28054
Wayne Memorial Hospital Goldsboro, North Carolina  27534
Margaret R Pardee Memorial Hospital Hendersonville, North Carolina  28791
Kinston Medical Specialists PA Kinston, North Carolina  28501
Marion L Shepard Cancer Center Washington, North Carolina  27889
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
Hematology Oncology Center Incorporated Elyria, Ohio  44035
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
Saint Rita's Medical Center Lima, Ohio  45801
Mansfield General Hospital-MedCentral Health System Mansfield, Ohio  44903
Marietta Memorial Hospital Marietta, Ohio  45750
Toledo Radiation Oncology at Northwest Ohio Onocolgy Center Maumee, Ohio  43537
Saint Charles Hospital Oregon, Ohio  43616
North Coast Cancer Care Sandusky, Ohio  44870
Toledo Community Hospital Oncology Program CCOP Toledo, Ohio  43617
Mercy Cancer Center at Saint Anne Mercy Hospital Toledo, Ohio  43623
University of Toledo Toledo, Ohio  43614
Saint Vincent Mercy Medical Center Toledo, Ohio  43608
Upper Valley Medical Center Troy, Ohio  45373
Saint Ann's Hospital Westerville, Ohio  43081
Cleveland Clinic Wooster Specialty Center Wooster, Ohio  44691
Wright-Patterson Medical Center Wright-Patterson Afb, Ohio  45433-5529
Genesis HealthCare System Zanesville, Ohio  43701
Natalie W Bryant Cancer Center Tulsa, Oklahoma  74136
Legacy Good Samaritan Hospital and Medical Center Portland, Oregon  97210
Providence Saint Vincent Medical Center Portland, Oregon  97225
Columbia River Oncology Program Portland, Oregon  97225
Ephrata Cancer Center Ephrata, Pennsylvania  17522
Riddle Hospital Media, Pennsylvania  19063
Pottstown Memorial Medical Center Pottstown, Pennsylvania  19464
Saint Joseph Medical Center Reading, Pennsylvania  19605
Hematology and Oncology Associates of North East Pennsylvania Scranton, Pennsylvania  18508
Scranton Hematology Oncology Scranton, Pennsylvania  18510
Mercy Hospital Scranton, Pennsylvania  18501
Associates In Hematology Oncology PC-Upland Upland, Pennsylvania  19013
Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania  18711
Mainline Health CCOP Wynnewood, Pennsylvania  19096
Kent County Hospital Warwick, Rhode Island  02886
AnMed Health Hospital Anderson, South Carolina  29621
Greenville CCOP Greenville, South Carolina  29615
Greenville Memorial Hospital Greenville, South Carolina  29605
Upstate Carolina CCOP Spartanburg, South Carolina  29303
Conklin Regional Cancer Center Aberdeen, South Dakota  57401
Sanford Cancer Center-Oncology Clinic Sioux Falls, South Dakota  57104
Texas Health Presbyterian Hospital Dallas Dallas, Texas  75231
Fredericksburg Oncology Inc Fredericksburg, Virginia  22401
Southwest VA Regional Cancer Center Norton, Virginia  24273
Auburn Regional Medical Center Auburn, Washington  98002
Harrison Bremerton Hematology and Oncology Bremerton, Washington  98310
Saint Francis Hospital Federal Way, Washington  98003
Columbia Basin Hematology and Oncology PLLC Kennewick, Washington  99336
Providence - Saint Peter Hospital Olympia, Washington  98506-5166
Good Samaritan Community Hospital Puyallup, Washington  98372
Swedish Medical Center-First Hill Seattle, Washington  98122-4307
Northwest CCOP Tacoma, Washington  98405
Multicare Health System Tacoma, Washington  98415
Saint Clare Hospital Tacoma, Washington  98499
Saint Joseph Medical Center Tacoma, Washington  98405
Edwards Comprehensive Cancer Center Huntington, West Virginia  25701
West Virginia University Morgantown, West Virginia  26506
Langlade Hospital and Cancer Center Antigo, Wisconsin  54409
Saint Vincent Hospital Green Bay, Wisconsin  54301
Green Bay Oncology Limited at Saint Mary's Hospital Green Bay, Wisconsin  54303
Saint Mary's Hospital Green Bay, Wisconsin  54303
Green Bay Oncology at Saint Vincent Hospital Green Bay, Wisconsin  54301-3526
Aurora BayCare Medical Center Green Bay, Wisconsin  54311-6519
Vince Lombardi Cancer Clinic-Marinette Marinette, Wisconsin  54143
Bay Area Medical Center Marinette, Wisconsin  54143
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
Marshfield Clinic-Rice Lake Center Rice Lake, Wisconsin  54868
Green Bay Oncology - Sturgeon Bay Sturgeon Bay, Wisconsin  54235
Marshfield Clinic-Wausau Center Wausau, Wisconsin  54401
Aspirus Regional Cancer Center Wausau, Wisconsin  54401
Women and Infants Hospital Providence, Rhode Island  02905
Jupiter Medical Center Jupiter, Florida  33458
Puget Sound Cancer Center Edmonds, Washington  98026
Kansas City Cancer Centers - North Kansas City, Missouri  64154
University of Illinois Chicago, Illinois  60612
Stony Brook University Medical Center Stony Brook, New York  11794
Alle-Kiski Medical Center Natrona Heights, Pennsylvania  15065
Roger Maris Cancer Center Fargo, North Dakota  58122
Great Lakes Cancer Institute Lansing, Michigan  48910
Lahey Clinic Medical Center Burlington, Massachusetts  01805
Baptist Hospital East Louisville, Kentucky  40207
Elkhart Clinic Elkhart, Indiana  46515
Washington Hospital Fremont, California  94538
Mount Sinai Medical Center CCOP Miami Beach, Florida  33140
Kootenai Cancer Center Post Falls, Idaho  83854
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
The Memorial Hospital at Easton Easton, Maryland  21601
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
Carolinas Medical Center - Northeast Concord, North Carolina  28025
Moses Cone Health System-Regional Cancer Center Greensboro, North Carolina  27403
Annie Penn Memorial Hospital Reidsville, North Carolina  27320
Community Health Partners Regional Medical Center Elyria, Ohio  44035
The Regional Cancer Center Erie, Pennsylvania  16505
Armstrong Center for Medicine and Health Kittanning, Pennsylvania  16201
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
University of Tennessee - Knoxville Knoxville, Tennessee  37920
Texas Oncology - Round Rock Cancer Center Round Rock, Texas  78681
Sandra L Maxwell Cancer Center Cedar City, Utah  84720
Intermountain Medical Center Murray, Utah  84157
Utah Valley Regional Medical Center Provo, Utah  84603
Dixie Medical Center Regional Cancer Center Saint George, Utah  84770
Utah Cancer Specialists-Salt Lake City Salt Lake City, Utah  84106
Virginia Oncology Associates-Hampton Hampton, Virginia  23666
Skagit Valley Hospital Mt. Vernon, Washington  98273
Evergreen Hematology and Oncology PS Spokane, Washington  99218
West Virginia University Charleston Charleston, West Virginia  25304
Marshfield Clinic-Chippewa Center Chippewa Falls, Wisconsin  54729
Holy Family Memorial Hospital Manitowoc, Wisconsin  54221
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
Texas Oncology PA Dallas, Texas  75231
Texas Cancer Center-Sherman Sherman, Texas  75090
Premiere Oncology of Arizona Scottsdale, Arizona  85260
Kansas City Cancer Centers-Southwest Overland Park, Kansas  66210
Monter Cancer Center Lake Success, New York  11042
Hope, A Women's Cancer Center Asheville, North Carolina  28816
Texas Tech University Health Sciences Center Lubbock, Texas  79430
Kaiser Permanente Los Angeles Medical Center Los Angeles, California  90027
Saint Vincent's Medical Center Jacksonville, Florida  32204
University of Miami Miller School of Medicine-Sylvester Cancer Center Miami, Florida  33136
Christus Schumpert Saint Mary's Place Shreveport, Louisiana  71101
Kaiser Permanente - Largo Medical Center Largo, Maryland  20774
FirstHealth of the Carolinas-Moore Regional Hosiptal Pinehurst, North Carolina  28374
Kaiser Permanente - Fair Oaks Medical Center Fairfax, Virginia  22033
Waverly Hematology Oncology Cary, North Carolina  27518
Cancer Centers of Southwest Oklahoma Research Lawton, Oklahoma  
Kuakini Medical Center Honolulu, Hawaii  96817
Saint Luke's Mountain States Tumor Institute - Fruitland Fruitland, Idaho  83619
Adams Cancer Center Gettysburg, Pennsylvania  17325
Cherry Tree Cancer Center Hanover, Pennsylvania  17331
Kaiser Anaheim Medical Center Anaheim, California  92807
Kaiser Permanente-Deer Valley Medical Center Antioch, California  94531
Kaiser Permanente Medical Group - Baldwin Park Baldwin Park, California  91706
Kaiser Foundation Hospital Bellflower, California  90706
Kaiser Permanente Hospital Fontana, California  92335
Kaiser Permanente - Harbor City Harbor City, California  90710
Kaiser Permanente-West Los Angeles Los Angeles, California  90034
Epic Care-Oakland Oakland, California  94612
Kaiser Permanente - Panorama City Panorama City, California  91402
Kaiser Permanente at San Diego San Diego, California  92120
Kaiser Permanente Health Care San Marcos, California  92069
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 Joseph Regional Medical Center Lewiston, Idaho  83501
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 Cancer Center-West Kansas City, Kansas  66112
Saint Luke's South Hospital Overland Park, Kansas  66213
Kansas City CCOP Prairie Village, Kansas  66208
Kansas City Cancer Center-Shawnee Mission Shawnee Mission, Kansas  66204
Hematology and Oncology Clinic Baton Rouge, Louisiana  70809
Ochsner North Shore Medical Center Covington, Louisiana  70433
Singh and Arora Hematology Oncology PC Flint, Michigan  48532
Great Lakes Cancer Institute-Lapeer Campus Lapeer, Michigan  48446
Mount Clemens Regional Medical Center Mount Clemens, Michigan  48043
Spectrum Health Reed City Hospital Reed City, Michigan  49677
Capital Region Medical Center-Goldschmidt Cancer Center Jefferson City, Missouri  65109
Kansas City Cancer Center - South Kansas City, Missouri  64131
Heartland Hematology and Oncology Associates Incorporated Kansas City, Missouri  64118
Kansas City Cancer Center-Lee's Summit Lee's Summit, Missouri  64064
Saint John's Clinic-Rolla-Cancer and Hematology Rolla, Missouri  65401
Saint Joseph Oncology Inc Saint Joseph, Missouri  64507
Comprehensive Cancer Care PC Saint Louis, Missouri  63141
Saint Joseph Hospital Nashua, New Hampshire  03060
Saint Francis Poughkeepsie, New York  12601
Forsyth Memorial Hospital Winston-Salem, North Carolina  27103
Cleveland Clinic Cancer Center Beachwood Beachwood, Ohio  44122
The Mark H Zangmeister Center Columbus, Ohio  43219
Southern Ohio Medical Center Portsmouth, Ohio  45662
Cancer Care Associates-Mercy Oklahoma City, Oklahoma  73120
Asante Health System Medford, Oregon  97504
Rogue Valley Medical Center Medford, Oregon  97504
Susquehanna Cancer Center Williamsport, Pennsylvania  17701
Saint Francis Hospital Greenville, South Carolina  29601
Hematology Oncology Associates of Fredericksburg Inc Fredericksburg, Virginia  22401
Cancer Care Center at Island Hospital Anacortes, Washington  98221
Overlake Hospital Medical Center Bellevue, Washington  98004
Highline Medical Center-Main Campus Burien, Washington  98166
Providence Regional Cancer Partnership Everett, Washington  98201
United General Hospital Sedro-Woolley, Washington  98284
Legacy Salmon Creek Hospital Vancouver, Washington  98686
Gundersen Lutheran La Crosse, Wisconsin  54601
Saint Nicholas Hospital Madison, Wisconsin  53715
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
Central Indiana Cancer Centers - Indianapolis Indianapolis, Indiana  46227
Stanford University Hospitals and Clinics Stanford, California  94305
Kaiser Permanente-Franklin Denver, Colorado  80205
Beaufort Memorial Hospital Beaufort, South Carolina  29902
Siouxland Hematology Oncology Associates Sioux City, Iowa  51101
Swedish Cancer Institute-Issaquah Issaquah, Washington  98029
Mid-Illinois Hematology Oncology Associates Normal, Illinois  
Forbes Regional Hospital Monroeville, Pennsylvania  15146
Methodist West Hospital West Des Moines, Iowa  50266-7700
IU Health Arnett Lafayette, Indiana  
Texas Oncology PA - Amarillo Amarillo, Texas  79106
Texas Oncology - Lewisville Lewisville, Texas  75067
Carle Foundation - Carle Cancer Center Urbana, Illinois  61801
Michiana Hematology Oncology PC-Mishawaka Mishawaka, Indiana  46545-1470
Oncology Associates at Mercy Medical Center Cedar Rapids, Iowa  52403
Marie Yeager Cancer Center Saint Joseph, Michigan  49085
Hematology Oncology Associates of Central New York PC East Syracuse, New York  13057
Sanford Clinic North-Fargo Fargo, North Dakota  58102
Sanford Medical Center-Fargo Fargo, North Dakota  58122
Summa Akron City Hospital Akron, Ohio  44304
Oncology and Hematology Associates of Southwest Virginia Roanoke, Virginia  24014
Texas Oncology-Arlington South Arlington, Texas  76014
Franciscan St. Francis Health Indianapolis, Indiana  46237
Texas Oncology-Paris Paris, Texas  75460
Texas Oncology-Denton South Denton, Texas  76210
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
Sanford Clinic North-Bemidgi Bemidji, Minnesota  56601
Essentia Health Saint Joseph's Medical Center Brainerd, Minnesota  56401
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
Essentia Health Cancer Center-South University Clinic Fargo, North Dakota  58103
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
Bronson Battle Creek Battle Creek, Michigan  49017
Springfield Regional Medical Center Springfield, Ohio  45505
Cleveland Clinic Cancer Center/Fairview Hospital Cleveland, Ohio  44111
The James Graham Brown Cancer Center at University of Louisville Louisville, Kentucky  40202
Augusta Oncology Associates PC-Saint Sebastian Augusta, Georgia  30901
Edward Hospital/Cancer Center Naperville, Illinois  60540
Promise Regional Medical Center-Hutchinson Hutchinson, Kansas  65702
Saint Louis Cancer and Breast Institute-South City Saint Louis, Missouri  63109
Toledo Clinic Cancer Centers-Bowling Green Bowling Green, Ohio  43402
Toledo Clinic Cancer Centers-Maumee Maumee, Ohio  43537-1839
Toledo Clinic Cancer Centers-Toledo Toledo, Ohio  43623
PinnacleHealth Fox Chase Regional Cancer Center at Polyclinic Hospital Harrisburg, Pennsylvania  17110
Guthrie Clinic-Robert Packer Hospital Sayre, Pennsylvania  18840
Self Regional Healthcare Greenwood, South Carolina  29646
Harrison Poulsbo Hematology and Oncology Poulsbo, Washington  98370
PeaceHealth Southwest Medical Center Vancouver, Washington  98664
Christus Saint Frances Cabrini Hospital Alexandria, Louisiana  71301
Maine Center for Cancer Medicine and Blood Disorders-Scarborough Scarborough, Maine  04074
Park Ridge Hospital Breast Health Center Hendersonville, North Carolina  28792
Blue Ridge Medical Specialists PC Bristol, Tennessee  37620
Saint Joseph Regional Cancer Center Bryan, Texas  77802
Covenant Medical Center-Lakeside Lubbock, Texas  79410
NEA Baptist Clinic-Matthews Jonesboro, Arkansas  72401
OnCare Hawaii-Liliha Honolulu, Hawaii  96817-3169
Saint Luke's Mountain States Tumor Institute-Twin Falls Twin Falls, Idaho  83301
Saint Rose Ambulatory and Surgery Center Great Bend, Kansas  67530
Ochsner Baptist Medical Center New Orleans, Louisiana  70115
Carolinas Medical Center-Union Monroe, North Carolina  28112
Cleveland Regional Medical Center Shelby, North Carolina  28150
Cleveland Clinic Cancer Center-Strongsville Strongsville, Ohio  44136
Cancer Care Associates-Norman Norman, Oklahoma  73071
Providence Willamette Falls Medical Center Oregon City, Oregon  97045
Kaiser Permanente Tysons Corner Medical Center McLean, Virginia  22102
Mercy Cancer Center-West Lakes Clive, Iowa  50325
Mercy Medical Center-West Lakes West Des Moines, Iowa  50266
East Bay Medical Oncology Hematology Medical Associates Inc-Pleasant Hill Pleasant Hill, California  94523
LC Ferguson Cancer Center Freeport, Illinois  61032
Feather River Cancer Center Paradise, California  95969
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
Texas Oncology PA - Bedford Bedford, Texas  76022
Texas Oncology Methodist Charlton Cancer Center Dallas, Texas  75237
Idaho Urologic Institute PA Meridian, Idaho  83642
Cancer Care Centers of South Texas- Northeast San Antonio, Texas  78217
Epic Care-Dublin Dublin, California  94568
Kaiser Permanente-Capitol Hill Medical Center Washington, District of Columbia  20002
Kaiser Permanente-Woodlawn Medical Center Baltimore, Maryland  21244
Kaiser Permanente-Gaithersburg Medical Center Gaithersburg, Maryland  20879
Texas Cancer Center - Medical City Dallas Dallas, Texas  75230
Texas Oncology-El Paso El Paso, Texas  79915
Texas Oncology Fort Worth at 12th Avenue Fort Worth, Texas  76104
Texas Oncology-McAllen McAllen, Texas  78503
US Oncology Research LLC-The Woodlands The Woodlands, Texas  77380
Kaiser Permanente-Burke Medical Center Burke, Virginia  22015
Sedona Medical Center Sedona, Arizona  86336
Advanced Medical Specialties -North Miami, Florida  33176
Jordan Hospital Plymouth, Massachusetts  02360
Texas Oncology PA Beaumont Beaumont, Texas  77702
Memorial Hospital-Memorial City Houston, Texas  77024
Texas Cancer Center - Mesquite Mesquite, Texas  75150
Scott and White Healthcare Round Rock Round Rock, Texas  78665
Virginia Cancer Specialists-Fairfax Fairfax, Virginia  22031
Shenandoah Oncology Associates PC Winchester, Virginia  22601