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A Randomized Phase III Trial of Maintenance Chemotherapy Comparing 12 Monthly Cycles of Single Agent Paclitaxel or Xyotax (CT-2103) (IND# 70177), Versus No Treatment Until Documented Relapse in Women With Advanced Ovarian or Primary Peritoneal or Fallopian Tube Cancer Who Achieve a Complete Clinical Response to Primary Platinum/Taxane Chemotherapy


Phase 3
N/A
N/A
Open (Enrolling)
Female
Fallopian Tube Cancer, Ovarian Cancer, Primary Peritoneal Cavity Cancer

Thank you

Trial Information

A Randomized Phase III Trial of Maintenance Chemotherapy Comparing 12 Monthly Cycles of Single Agent Paclitaxel or Xyotax (CT-2103) (IND# 70177), Versus No Treatment Until Documented Relapse in Women With Advanced Ovarian or Primary Peritoneal or Fallopian Tube Cancer Who Achieve a Complete Clinical Response to Primary Platinum/Taxane Chemotherapy


OBJECTIVES:

Primary

- Compare overall survival of patients with stage III or IV ovarian epithelial or primary
peritoneal cancer or fallopian tube cancer in clinical complete response after prior
primary platinum and taxane-based chemotherapy treated with paclitaxel vs polyglutamate
paclitaxel as consolidation/maintenance therapy vs no further anticancer therapy until
documented disease progression.

Secondary

- Compare progression-free survival of patients treated with these drugs.

- Compare the toxicity profile of these drugs, particularly peripheral neuropathy, in
these patients.

- Compare the quality of life of patients treated with these drugs.

Tertiary

- Correlate angiogenic marker expression with overall or progression-free survival of
patients treated with these drugs.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to
disease stage at diagnosis (stage III vs stage IV); presence of macroscopic disease after
initial debulking surgery (yes vs no); type of prior taxane-based therapy (docetaxel vs
paclitaxel); and route of prior platinum therapy (intraperitoneal vs IV). Patients are
randomized to 1 of 3 treatment arms.

- Arm I: Patients receive polyglutamate paclitaxel IV over 10-20 minutes on day 1.

- Arm II: Patients receive paclitaxel IV over 3 hours on day 1.

- Arm III: Patients receive no further anticancer treatment until evidence of disease
progression.

In arms I and II, treatment repeats every 28 days for up to 12 courses in the absence of
disease progression or unacceptable toxicity.

Quality of life is assessed at baseline, before courses 3, 5, and 7 of study treatment, at
completion of study treatment, and then at 1 year after completion of study treatment.

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

PROJECTED ACCRUAL: A total of 1,110 patients (555 per treatment arm) will be accrued for
this study within 8.5 years.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed stage III or IV ovarian epithelial or primary peritoneal
cancer or fallopian tube cancer

- The following histologic epithelial cell types are allowed:

- Serous adenocarcinoma

- Endometrioid adenocarcinoma

- Mucinous adenocarcinoma

- Undifferentiated carcinoma

- Clear cell adenocarcinoma

- Mixed epithelial carcinoma

- Transitional cell carcinoma

- Malignant Brenner tumor

- Adenocarcinoma not otherwise specified

- The following histologic cell types are not allowed:

- Germ cell tumor

- Sex cord-stromal tumor

- Carcinosarcoma

- Mixed müllerian tumor or carcinosarcoma

- Metastatic carcinoma from other sites to the ovary

- Low malignant potential (LMP) tumor (borderline carcinoma), including
micropapillary serous carcinoma

- Patients with a prior diagnosis of LMP tumor that was surgically resected
and who subsequently developed invasive adenocarcinoma are eligible
provided patient did not receive prior chemotherapy for the ovarian LMP
tumor

- Must have undergone surgery for ovarian epithelial or primary peritoneal cancer AND
have tissue available for histologic evaluation

- Optimal (≤ 1 cm) residual disease OR suboptimal residual disease after initial
surgery

- Must have completed at least 5, but no more that 8 courses of primary therapy
comprising carboplatin (IV or intraperitoneal) AND paclitaxel or docetaxel-based
combination chemotherapy within the past 12 weeks AND have no symptoms of persistent
cancer after completion of therapy

- CT scan of the abdomen and/or pelvis normal

- CA 125 normal

- Patients treated with neo-adjuvant platinum-taxane chemotherapy for a presumptive
diagnosis of stage III or IV primary peritoneal carcinoma or epithelial ovarian
carcinoma (by paracentesis, percutaneous biopsy or open biopsy) are eligible provided
the following criteria is met:

- Must have undergone interval abdominal surgery after at least one but no more
than 6 courses of standard chemotherapy

- Surgery must meet the same criteria as the up front surgery, including
tissue diagnosis for confirmation of primary tumor site and stage III or IV
disease

- Patients must have received at least 2 courses after interval abdominal
surgery

- No synchronous primary endometrial cancer or history of primary endometrial cancer,
unless all of the following criteria are met:

- Stage ≤ IB

- Less than 3 mm invasion without vascular or lymphatic invasion

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

PATIENT CHARACTERISTICS:

Age

- Not specified

Performance status

- GOG 0-2

Life expectancy

- Not specified

Hematopoietic

- Absolute neutrophil count ≥ 1,500/mm^3

- Platelet count ≥ 100,000/mm^3

- No active bleeding

Hepatic

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

- SGOT ≤ 2.5 times ULN

- Alkaline phosphatase ≤ 2.5 times ULN

- PT or PTT normal

- No acute or chronic hepatitis

Renal

- Creatinine ≤ 1.5 times ULN

Cardiovascular

- Abnormal cardiac conduction (e.g., bundle branch block or heart block) allowed
provided the disease has remained stable within the past 6 months

- No unstable angina

- No myocardial infarction within the past 6 months

Other

- No neuropathy (sensory and motor) ≥ grade 2

- No active infection requiring antibiotics

- No ongoing gastrointestinal bleeding requiring blood product support

- No circumstance that would preclude study participation

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

- Not pregnant or nursing

- Fertile patients must agree to use an effective contraception method

- Negative pregnancy test

PRIOR CONCURRENT THERAPY:

Biologic therapy

- No prior biologic therapy (e.g., bevacizumab or erlotinib) for any other abdominal or
pelvic tumor

Chemotherapy

- See Disease Characteristics

- No prior polyglutamate paclitaxel

- No prior chemotherapy for any other abdominal or pelvic tumor

- More than 3 years since prior adjuvant chemotherapy for localized breast cancer AND
no recurrent or metastatic disease

Endocrine therapy

- Not specified

Radiotherapy

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

- More than 3 years since prior radiotherapy for localized cancer of the breast, head
and neck, or skin AND no recurrent or metastatic disease

Surgery

- See Disease Characteristics

Other

- No prior investigational therapy for any other abdominal or pelvic tumor

- No prior anticancer therapy that would preclude study therapy

- No concurrent amifostine or other protective agents

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Primary Purpose: Treatment

Outcome Measure:

Overall survival

Safety Issue:

No

Principal Investigator

Larry J. Copeland, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Ohio State University Comprehensive Cancer Center

Authority:

United States: Food and Drug Administration

Study ID:

GOG-0212

NCT ID:

NCT00108745

Start Date:

March 2005

Completion Date:

Related Keywords:

  • Fallopian Tube Cancer
  • Ovarian Cancer
  • Primary Peritoneal Cavity Cancer
  • stage IV ovarian epithelial cancer
  • ovarian clear cell cystadenocarcinoma
  • ovarian endometrioid adenocarcinoma
  • ovarian mixed epithelial carcinoma
  • ovarian mucinous cystadenocarcinoma
  • ovarian serous cystadenocarcinoma
  • Brenner tumor
  • ovarian undifferentiated adenocarcinoma
  • stage IIIA fallopian tube cancer
  • stage IIIB fallopian tube cancer
  • stage IIIC fallopian tube cancer
  • stage IIIA primary peritoneal cavity cancer
  • stage IIIB primary peritoneal cavity cancer
  • stage IIIC primary peritoneal cavity cancer
  • stage IV primary peritoneal cavity cancer
  • stage IIIA ovarian epithelial cancer
  • stage IIIB ovarian epithelial cancer
  • stage IIIC ovarian epithelial cancer
  • stage IV fallopian tube cancer
  • Ovarian Neoplasms
  • Peritoneal Neoplasms
  • Fallopian Tube Neoplasms

Name

Location

Louisiana State University New Orleans, Louisiana  70112-2282
Memorial Sloan Kettering Cancer Center New York, New York  10021
Cleveland Clinic Foundation Cleveland, Ohio  44195
Roswell Park Cancer Institute Buffalo, New York  14263
Mayo Clinic Rochester, Minnesota  55905
H. Lee Moffitt Cancer Center and Research Institute Tampa, Florida  33612
University of Iowa Hospitals and Clinics Iowa City, Iowa  52242
University of Mississippi Medical Center Jackson, Mississippi  39216-4505
Washington University School of Medicine Saint Louis, Missouri  63110
Abington Memorial Hospital Abington, Pennsylvania  19001
Medical University of South Carolina Charleston, South Carolina  29425-0721
University of Washington Medical Center Seattle, Washington  98195-6043
Tacoma General Hospital Tacoma, Washington  98405
Pennsylvania Hospital Philadelphia, Pennsylvania  19107
Boulder Community Hospital Boulder, Colorado  80301-9019
Porter Adventist Hospital Denver, Colorado  80210
Rose Medical Center Denver, Colorado  80220
Bronson Methodist Hospital Kalamazoo, Michigan  49007
West Michigan Cancer Center Kalamazoo, Michigan  49007-3731
Borgess Medical Center Kalamazooaa, Michigan  49001
Fairview Ridges Hospital Burnsville, Minnesota  55337
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
Geisinger Medical Center Danville, Pennsylvania  17822-0001
Abramson Cancer Center of the University of Pennsylvania Philadelphia, Pennsylvania  19104-4283
Avera Cancer Institute Sioux Falls, South Dakota  57105
Massachusetts General Hospital Cancer Center Boston, Massachusetts  02114
Morristown Memorial Hospital Morristown, New Jersey  07962-1956
Henry Ford Hospital Detroit, Michigan  48202
Memorial Hospital of South Bend South Bend, Indiana  46601
Akron General Medical Center Akron, Ohio  44302
Western Pennsylvania Hospital Pittsburgh, Pennsylvania  15224
Reading Hospital and Medical Center Reading, Pennsylvania  19612-6052
University of Texas Medical Branch Galveston, Texas  77555-1329
LDS Hospital Salt Lake City, Utah  84143
Waukesha Memorial Hospital Waukesha, Wisconsin  53188
Rush University Medical Center Chicago, Illinois  60612-3824
Cedars-Sinai Medical Center Los Angeles, California  90048
North Shore University Hospital Manhasset, New York  11030
University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
University of Kansas Medical Center Kansas City, Kansas  66160-7353
Brooke Army Medical Center Fort Sam Houston, Texas  78234-6200
Hartford Hospital Hartford, Connecticut  06102-5037
Sarasota Memorial Hospital Sarasota, Florida  34239
Franklin Square Hospital Center Baltimore, Maryland  21237
Baystate Medical Center Springfield, Massachusetts  01199
William Beaumont Hospital Royal Oak, Michigan  48073
University of Nebraska Medical Center Omaha, Nebraska  68198-3330
Via Christi Regional Medical Center Wichita, Kansas  67214
University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma  73104
Iowa Methodist Medical Center Des Moines, Iowa  50309
Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
New Hanover Regional Medical Center Wilmington, North Carolina  28402-9025
University of Wisconsin Hospital and Clinics Madison, Wisconsin  53792-0001
Winthrop University Hospital Mineola, New York  11501
MetroHealth Medical Center Cleveland, Ohio  44109
Central Baptist Hospital Lexington, Kentucky  40503
Long Island Jewish Medical Center New Hyde Park, New York  11040
Mount Sinai Medical Center New York, New York  10029
Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium Seattle, Washington  98109
Sibley Memorial Hospital Washington, District of Columbia  20016
North Colorado Medical Center Greeley, Colorado  80631
Cancer Center of Kansas - Chanute Chanute, Kansas  66720
Cancer Center of Kansas - Dodge City Dodge City, Kansas  67801
Cancer Center of Kansas - Newton Newton, Kansas  67114
Cancer Center of Kansas - Salina Salina, Kansas  67042
Cancer Center of Kansas - Wellington Wellington, Kansas  67152
Associates in Womens Health Wichita, Kansas  67203
Cancer Center of Kansas - Winfield Winfield, Kansas  67156
Munson Medical Center Traverse City, Michigan  49684
Cancer Care Northwest - Spokane South Spokane, Washington  99202
University of New Mexico Cancer Center Albuquerque, New Mexico  87131-5636
Methodist Estabrook Cancer Center Omaha, Nebraska  68114-4199
Elkhart General Hospital Elkhart, Indiana  46515
Gynecologic Oncology of Indiana Indianapolis, Indiana  46237
South Bend Clinic South Bend, Indiana  46617
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center Columbus, Ohio  43210-1240
Beebe Medical Center Lewes, Delaware  19958
Mecosta County Medical Center Big Rapids, Michigan  49307
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
Mercy Hospital Coon Rapids, Minnesota  55433
Medical Oncology and Hematology Associates Des Moines, Iowa  50309
Saint Joseph Mercy Hospital Ann Arbor, Michigan  48106
Fairview-Southdale Hospital Edina, Minnesota  55435
Abbott-Northwestern Hospital Minneapolis, Minnesota  55407
Regions Hospital Saint Paul, Minnesota  55101
Geisinger Medical Group State College, Pennsylvania  16801
Northeast Georgia Medical Center Gainesville, Georgia  30501
Miami Valley Hospital Dayton, Ohio  45409
Eastern Connecticut Hematology and Oncology Associates Norwich, Connecticut  06360
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Research Medical Center Kansas City, Missouri  64132
Saint Luke's East - Lee's Summit Lee's Summit, Missouri  64086
Woman's Hospital Baton Rouge, Louisiana  70815
Seattle Cancer Care Alliance Seattle, Washington  98109
Morton Plant Hospital Clearwater, Florida  33756
Singing River Hospital Pascagoula, Mississippi  39581
Methodist Hospital Houston, Texas  77030
Greater Baltimore Medical Center Baltimore, Maryland  21204
Rutherford Hospital Rutherfordton, North Carolina  28139
AnMed Health Cancer Center Anderson, South Carolina  29621
Union Hospital of Cecil County Elkton MD, Maryland  21921
Presbyterian Hospital Charlotte, North Carolina  28233-3549
Mayo Clinic in Arizona Scottsdale, Arizona  85259-5404
Mayo Clinic in Florida Jacksonville, Florida  32224
Pacific Gynecology Specialists Seattle, Washington  98104
Washington Hospital Center Washington, District of Columbia  20010
Memorial Medical Center Springfield, Illinois  62781
Metro Health Hospital Grand Rapids, Michigan  49506
University of Virginia Charlottesville, Virginia  22908
University of Pittsburgh Pittsburgh, Pennsylvania  15261
New York Hospital Medical Center of Queens Fresh Meadows, New York  11365
University of Alabama at Birmingham Birmingham, Alabama  35294-3300
Vanderbilt University Nashville, Tennessee  37232-6305
University of North Carolina Chapel Hill, North Carolina  27599
Duke University Medical Center Durham, North Carolina  27710
Northwestern University Chicago, Illinois  60611
Queens Hospital Center Jamaica, New York  11432
Saint Louis University Hospital St. Louis, Missouri  63110-0250
University of Connecticut Farmington, Connecticut  06032
Saint Alphonsus Regional Medical Center Boise, Idaho  83706
University of California at San Diego La Jolla, California  92093
Case Western Reserve University Cleveland, Ohio  44106
Yale University New Haven, Connecticut  06520
Wayne State University Detroit, Michigan  48202
Riverside Methodist Hospital Columbus, Ohio  43214
Dartmouth Hitchcock Medical Center Lebanon, New Hampshire  03756
Indiana University Medical Center Indianapolis, Indiana  46202
University of Texas Southwestern Medical Center Dallas, Texas  
University of Kentucky Lexington, Kentucky  40536-0098
Wichita CCOP Wichita, Kansas  67214-3882
Northwest Hospital Seattle, Washington  98133
Virginia Mason CCOP Seattle, Washington  98101
Metro-Minnesota CCOP St. Louis Park, Minnesota  
UC Davis Comprehensive Cancer Center Sacramento, California  95817
Tufts Medical Center Boston, Massachusetts  02111
Oregon Health and Science University Portland, Oregon  97201
Florida Gynecologic Oncology Fort Myers, Florida  33901
Jersey Shore Medical Center Neptune, New Jersey  07754
Decatur Memorial Hospital Decatur, Illinois  62526
Westchester County Medical Center Valhalla, New York  10595
Tulane University Health Sciences Center New Orleans, Louisiana  70112
Virginia Commonwealth University Richmond, Virginia  
Central Georgia Gynecologic Oncology Macon, Georgia  31201
Providence Saint Joseph Medical Center Burbank, California  91505-4866
Florida Hospital Orlando, Florida  32803
Memorial Health University Medical Center Savannah, Georgia  31404
Hillcrest Hospital Cancer Center Mayfield Heights, Ohio  44124
University of Chicago Comprehensive Cancer Center Chicago, Illinois  60637-1470
M D Anderson Cancer Center Houston, Texas  77030
Northern Indiana Cancer Research Consortium South Bend, Indiana  
Chattanooga's Program in Women's Oncology Chattanooga, Tennessee  37403
Northern Virginia Pelvic Surgery Associates Annandale, Virginia  22003
Virginia Oncology Associates - Lake Wright Norfolk, Virginia  23502
University of Cincinnati Cincinnati, Ohio  45267-0502
Penn State Milton S Hershey Medical Center Hershey, Pennsylvania  17033
The Community Hospital Munster, Indiana  46321
Littleton Adventist Hospital Littleton, Colorado  80122
Parker Adventist Hospital Parker, Colorado  80138
Froedtert and the Medical College of Wisconsin Milwaukee, Wisconsin  53226
Wake Forest University Health Sciences Winston-Salem, North Carolina  27157
Sutter General Hospital Sacramento, California  95816
University of California San Francisco Medical Center-Mount Zion San Francisco, California  94115
Penrose-Saint Francis Healthcare Colorado Springs, Colorado  80907
Exempla Saint Joseph Hospital Denver, Colorado  80218
Colorado Cancer Research Program CCOP Denver, Colorado  80224-2522
Saint Mary's Hospital and Regional Medical Center Grand Junction, Colorado  81502
Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
The Hospital of Central Connecticut New Britain, Connecticut  06050
M D Anderson Cancer Center- Orlando Orlando, Florida  32806
John B Amos Cancer Center Columbus, Georgia  31904
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
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
Cancer Center of Kansas-Wichita Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas - Main Office Wichita, Kansas  67214
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
Mercy Health Partners-Mercy Campus Muskegon, Michigan  49443
Lakeland Hospital St. Joseph, Michigan  49085
Saint Luke's Hospital of Duluth Duluth, Minnesota  55805
Unity Hospital Fridley, Minnesota  55432
Minnesota Oncology Hematology PA-Maplewood Maplewood, Minnesota  55109
North Memorial Medical Health Center Robbinsdale, Minnesota  55422
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
Saint John's Mercy Medical Center Saint Louis, Missouri  63141
Saint John's Hospital Springfield, Missouri  65804
Cox Medical Center Springfield, Missouri  65807
Cooper Hospital University Medical Center Camden, New Jersey  08103
Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington County Mount Holly, New Jersey  08060
Memorial Medical Center - Las Cruces Las Cruces, New Mexico  88011
New York University Langone Medical Center New York, New York  10016
Columbia University Medical Center New York, New York  10032
State University of New York Upstate Medical University Syracuse, New York  13210
Alamance Regional Medical Center Burlington, North Carolina  27216
Aultman Health Foundation Canton, Ohio  44710
Kettering Medical Center Kettering, Ohio  45429
Northwest Cancer Specialists-Rose Quarter Cancer Center Portland, Oregon  97227
Saint Luke's Hospital Bethlehem, Pennsylvania  18015
Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania  18711
Upstate Carolina CCOP Spartanburg, South Carolina  29303
The Don and Sybil Harrington Cancer Center Amarillo, Texas  79106
Harrison Bremerton Hematology and Oncology Bremerton, Washington  98310
Swedish Medical Center-First Hill Seattle, Washington  98122-4307
Saint Vincent Hospital Green Bay, Wisconsin  54301
Green Bay Oncology Limited at Saint Mary's Hospital Green Bay, Wisconsin  54303
Green Bay Oncology at Saint Vincent Hospital Green Bay, Wisconsin  54301-3526
Bay Area Medical Center Marinette, Wisconsin  54143
University of California Medical Center At Irvine-Orange Campus Orange, California  92868
Cancer Care Associates-Yale Tulsa, Oklahoma  74136-1929
Women and Infants Hospital Providence, Rhode Island  02905
University of Maryland Greenebaum Cancer Center Baltimore, Maryland  21201
Lake University Ireland Cancer Center Mentor, Ohio  44060
Lyndon Baines Johnson General Hospital Houston, Texas  77030
Women's Cancer Associates Saint Petersburg, Florida  33701
University of Illinois Chicago, Illinois  60612
Stony Brook University Medical Center Stony Brook, New York  11794
University of Colorado Cancer Center - Anschutz Cancer Pavilion Aurora, Colorado  80045
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
University of Michigan University Hospital Ann Arbor, Michigan  48109
Michiana Hematology Oncology PC-Niles Niles, Michigan  49120
University of Missouri - Ellis Fischel Columbia, Missouri  65203
Moses Cone Health System-Regional Cancer Center Greensboro, North Carolina  27403
Holy Family Memorial Hospital Manitowoc, Wisconsin  54221
Vince Lombardi Cancer Clinic-Sheboygan Sheboygan, Wisconsin  53081
Vince Lombardi Cancer Clinic - Slinger Slinger, Wisconsin  53086
Advocate Lutheran General Hospital Park Ridge, Illinois  60068
Gynecologic Oncology of West Michigan PLLC Grand Rapids, Michigan  49546
Center of Hope at Renown Medical Center Reno, Nevada  89502
State University of New York Downstate Medical Center Brooklyn, New York  11203
Monter Cancer Center Lake Success, New York  11042
Hope, A Women's Cancer Center Asheville, North Carolina  28816
Magee-Womens Hospital - University of Pittsburgh Medical Center Pittsburgh, Pennsylvania  15213
Black Hills Obstetrics and Gynecology Rapid City, South Dakota  57701
Chattanooga Gynecological Oncology Chattanooga, Tennessee  37403
Carilion Clinic Gynecological Oncology Roanoke, Virginia  24016
Aurora Women's Pavilion of Aurora West Allis Medical Center West Allis, Wisconsin  53227
Long Beach Memorial Medical Center-Todd Cancer Institute Long Beach, California  90806
Kaiser Permanente Los Angeles Medical Center Los Angeles, California  90027
Rocky Mountain Gynecologic Oncology PC Englewood, Colorado  80110
Norton Health Care Pavilion - Downtown Louisville, Kentucky  40202
Christus Schumpert Saint Mary's Place Shreveport, Louisiana  71101
University of Minnesota Medical Center-Fairview Minneapolis, Minnesota  55455
Saint Dominic-Jackson Memorial Hospital Jackson, Mississippi  39216
Southwest Gynecologic Oncology Associates Inc Albuquerque, New Mexico  87106
Knoxville Gynecologic Cancer Specialists PC Knoxville, Tennessee  37920
Women's Cancer Center of Nevada Las Vegas, Nevada  89109
Central DuPage Hospital Cancer Center Warrenville, Illinois  60555
Saint Luke's South Hospital Overland Park, Kansas  66213
Kansas City CCOP Prairie Village, Kansas  66208
Spectrum Health Reed City Hospital Reed City, Michigan  49677
Gundersen Lutheran La Crosse, Wisconsin  54601
Walter Reed National Military Medical Center Bethesda, Maryland  20889
Palo Alto Medical Foundation-Gynecologic Oncology Mountain View, California  94040
Sudarshan K Sharma MD Limted-Gynecologic Oncology Hinsdale, Illinois  60521
University of Massachusetts Memorial Health Care Worcester, Massachusetts  01605
University Medical Center Brackenridge Austin, Texas  78701
Skagit Valley Hospital Regional Cancer Care Center Mount Vernon, Washington  98274
Providence Saint Mary Regional Cancer Center Walla Walla, Washington  99362
Aurora Saint Luke's Medical Center Milwaukee, Wisconsin  53215
Jonsson Comprehensive Cancer Center Los Angeles, California  90095
Carle Foundation - Carle Cancer Center Urbana, Illinois  61801
Michiana Hematology Oncology PC-Mishawaka Mishawaka, Indiana  46545-1470
Summa Akron City Hospital Akron, Ohio  44304
Sanford USD Medical Center - Sioux Falls Sioux Falls, South Dakota  57117-5134
Geisinger Medical Center-Cancer Center Hazelton Hazleton, Pennsylvania  18201
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
Christiana Care Health System-Christiana Hospital Newark, Delaware  19718
Bronson Battle Creek Battle Creek, Michigan  49017
Cleveland Clinic Cancer Center/Fairview Hospital Cleveland, Ohio  44111
Saint Joseph's Hospital and Medical Center Phoenix, Arizona  85013
Kaiser Permanente Medical Care Program - Los Angeles Medical Center & Sunset Hospital Los Angeles, California  90027
Southeast Gynecologic Oncology Associates Jacksonville, Florida  32204
The James Graham Brown Cancer Center at University of Louisville Louisville, Kentucky  40202
Women's Cancer Care Associates LLC Albany, New York  12208
Island Gynecologic Oncology Brightwaters, New York  11718
Fletcher Allen Health Care-Medical Center Burlington, Vermont  05401
Aurora Cancer Care-Grafton Grafton, Wisconsin  53024