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Phase III Trial of Irinotecan-Based Chemotherapy Plus Cetuximab (NSC-714692) or Bevacizumab (NSC-704865) As Second-Line Therapy for Patients With Metastatic Colorectal Cancer Who Have Progressed on Bevacizumab With Either FOLFOX, OPTIMOX or XELOX


Phase 3
18 Years
N/A
Open (Enrolling)
Both
Recurrent Colon Cancer, Recurrent Rectal Cancer, Stage IVA Colon Cancer, Stage IVA Rectal Cancer, Stage IVB Colon Cancer, Stage IVB Rectal Cancer

Thank you

Trial Information

Phase III Trial of Irinotecan-Based Chemotherapy Plus Cetuximab (NSC-714692) or Bevacizumab (NSC-704865) As Second-Line Therapy for Patients With Metastatic Colorectal Cancer Who Have Progressed on Bevacizumab With Either FOLFOX, OPTIMOX or XELOX


PRIMARY OBJECTIVES:

I. Compare progression-free survival of patients with metastatic colorectal cancer that
progressed on first-line therapy comprising bevacizumab and FOLFOX, OPTIMOX, or XELOX
treated with irinotecan hydrochloride-based chemotherapy and cetuximab with vs without
bevacizumab.

II. Compare overall survival of patients treated with these regimens. III. Compare objective
tumor response (confirmed and unconfirmed, complete and partial response) in patients with
measurable disease treated with these regimens.

IV. Compare the tolerability and safety profile of these regimens in these patients.

OUTLINE: This is a multicenter, randomized study. Patients are stratified according to
Zubrod performance status (0 vs 1 or 2), discontinuation of oxaliplatin during first-line
therapy (yes vs no), planned concurrent chemotherapy (FOLFIRI vs single-agent irinotecan
hydrochloride), and time from last dose of bevacizumab (14-42 days vs >= 43 days).

All patients receive 1 of the following chemotherapy regimens:

SINGLE AGENT IRINOTECAN HYDROCHLORIDE: Patients receive irinotecan hydrochloride
intravenously (IV) over 90 minutes on day 1. Treatment repeats every 21 days in the absence
of disease progression or unacceptable toxicity.

FOLFIRI: Patients receive irinotecan hydrochloride IV over 90 minutes and leucovorin calcium
IV over 2 hours on day 1 and fluorouracil IV continuously over 46-48 hours on days 1 and 2.
Treatment repeats every 14 days in the absence of disease progression or unacceptable
toxicity.

Patients are then randomized to 1 of 3 treatment arms.

ARM I: Patients receive single-agent irinotecan hydrochloride or FOLFIRI as outlined above
and cetuximab IV over 1-2 hours on day 1. Courses repeat every 14-21 days (depending upon
chemotherapy regimen) in the absence of disease progression or unacceptable toxicity.

ARM II: Patients receive single-agent irinotecan hydrochloride or FOLFIRI as outlined above
and cetuximab as in arm I. Patients also receive bevacizumab IV over 30 minutes on day 1.
Courses repeat every 14-21 days (depending upon chemotherapy regimen) in the absence of
disease progression or unacceptable toxicity.

ARM III (closed to accrual as of 4/20/2009): Patients receive single-agent irinotecan
hydrochloride or FOLFIRI as outlined above and cetuximab as in arm I. Patients also receive
a higher dose of bevacizumab (higher than in arm II) IV over 30 minutes on day 1. Courses
repeat every 14-21 days (depending upon chemotherapy regimen) in the absence of disease
progression or unacceptable toxicity.

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


Inclusion Criteria:



- Patients must have metastatic colorectal cancer that has been histologically or
cytologically confirmed; confirmation may be from either the primary tumor or a
metastasis; patients must have wild type KRAS

- Patients must be registered within 28 days of documented disease progression on first
line chemotherapy with bevacizumab plus either FOLFOX, OPTIMOX, or XELOX; this
progression must have occurred within 90 days after the last dose of bevacizumab;
patients who discontinued oxaliplatin, continued with 5-FU/LV or capecitabine and
bevacizumab and then had subsequent progression while on fluoropyrimidine and
bevacizumab are eligible; patients who discontinued bevacizumab due to adverse events
in the first-line setting are not eligible

- Measurable or nonmeasurable disease

- At least 14 days must have elapsed since the last dose of first line chemotherapy and
bevacizumab

- Patients must not have received prior treatment with irinotecan (either as adjuvant
or metastatic treatment)

- Patients must have no history of prior treatment with cetuximab or other agents
targeting VEGF or EGFR (except for bevacizumab)

- Prior radiotherapy is allowed, provided at least 28 days have elapsed since the last
treatment; all adverse events related to radiation therapy must be resolved

- Prior surgery is allowed, provided at least 28 days have elapsed since any major
surgery and patient has recovered from all effects

- Zubrod performance status 0-2

- Absolute neutrophil count (ANC) >= 1,500/mm^3

- Platelet count >= 100,000/mm^3

- Hemoglobin >= 9 g/dL

- Total bilirubin =< 1.5 times upper limit of normal (ULN)

- Serum glutamic oxaloacetic transaminase (SGOT) or serum glutamic pyruvate
transaminase (SGPT) =< 2.5 x IULN; if there are known liver metastases, SGOT or SGPT
must be =< 5 x IULN; these results must be obtained within 28 days prior to
registration

- Serum creatinine =< IULN or measured or estimated creatinine clearance >= 60 mL/min

- Patients must not have a history or known presence of brain metastasis

- Patients may be on full dose anticoagulation with warfarin provided that the patient
has an acceptable International Normalized Ratio (INR) (between 2 and 3), obtained
within 28 days prior to registration

- No clinically relevant bleeding diathesis or coagulopathy

- Patients must not have experienced nephrotic range proteinuria from prior bevacizumab
therapy; urine protein must be screened by urine analysis for Urine Protein
Creatinine (UPC) ratio; for UPC ratio > 0.5, 24-hour urine protein must be obtained
and the level must be < 1,000 mg for patient enrollment; urine protein and creatinine
used in calculating the UPC ratio must be obtained within 28 days prior to
registration

- No uncontrolled high blood pressure (BP) (i.e., systolic BP > 150 mm Hg and
diastolic BP > 90 mm Hg)

- No cardiovascular event within the past 6 months, including any of the following:

- Arterial thrombosis

- Unstable angina

- Myocardial infarction

- Cerebrovascular accident

- Patients must not have New York Heart Association (NYHA) >= Grade 2 congestive heart
failure

- Patients must not have unstable symptomatic arrhythmia requiring medication;
(patients with chronic, controlled arrhythmias such as atrial fibrillation or
paroxysmal supraventricular tachycardia [PSVT] are eligible)

- No clinically significant peripheral vascular disease

- No serious or nonhealing active wound, ulcer, or bone fracture

- No history of gastrointestinal (GI) perforation while on prior bevacizumab

- No significant bleeding episodes (e.g., hemoptysis or upper or lower GI bleeding)
within the past 6 months unless the source of bleeding has been resected

- No known hypersensitivity to bevacizumab or known potential hypersensitivity to
cetuximab

- No other concurrent chemotherapy, hormonal therapy, radiotherapy, immunotherapy, or
any other type of anticancer treatment

- Due to the possibility of harm to a fetus or nursing infant from this treatment
regimen, patients must not be pregnant or nursing; women and men of reproductive
potential must have agreed to use an effective contraceptive method

- No other malignancy within the past 5 years except for adequately treated basal or
squamous cell skin cancer or cervical cancer in situ

- All patients must be informed of the investigational nature of this study and must
sign and give written informed consent in accordance with institutional and federal
guidelines

- At the time of patient registration, the treating institution's name and
identification (ID) number must be provided to the Data Operations Center in Seattle
in order to ensure that the current (within 365 days) date of institutional review
board approval for this study has been entered into the data base

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Progression-free survival

Outcome Description:

Evaluated by the stratified log-rank test.

Outcome Time Frame:

Up to 5 years

Safety Issue:

No

Principal Investigator

Philip Gold

Investigator Role:

Principal Investigator

Investigator Affiliation:

Southwest Oncology Group

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2009-00784

NCT ID:

NCT00499369

Start Date:

June 2007

Completion Date:

Related Keywords:

  • Recurrent Colon Cancer
  • Recurrent Rectal Cancer
  • Stage IVA Colon Cancer
  • Stage IVA Rectal Cancer
  • Stage IVB Colon Cancer
  • Stage IVB Rectal Cancer
  • Colonic Neoplasms
  • Rectal Neoplasms
  • Colorectal Neoplasms

Name

Location

Mayo Clinic Rochester, Minnesota  55905
University of Washington Medical Center Seattle, Washington  98195-6043
Hurley Medical Center Flint, Michigan  48503
Boulder Community Hospital Boulder, Colorado  80301-9019
Porter Adventist Hospital Denver, Colorado  80210
Rose Medical Center Denver, Colorado  80220
Swedish Medical Center Englewood, Colorado  80110
Sky Ridge Medical Center Lone Tree, Colorado  80124
North Suburban Medical Center Thornton, Colorado  80229
Fairview Ridges Hospital Burnsville, Minnesota  55337
Hutchinson Area Health Care Hutchinson, Minnesota  55350
Meeker County Memorial Hospital Lichfield, Minnesota  55355
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
Geisinger Medical Center Danville, Pennsylvania  17822-0001
Rapid City Regional Hospital Rapid City, South Dakota  57709
Henry Ford Hospital Detroit, Michigan  48202
Glendale Memorial Hospital and Health Center Glendale, California  91204
South Georgia Medical Center Valdosta, Georgia  31603
Methodist Medical Center of Illinois Peoria, Illinois  61636
Memorial Hospital of South Bend South Bend, Indiana  46601
Akron General Medical Center Akron, Ohio  44302
Virginia Piper Cancer Institute Minneapolis, Minnesota  55407
University of Kansas Medical Center Kansas City, Kansas  66160-7353
Boston Medical Center Boston, Massachusetts  02118
Eastern Maine Medical Center Bangor, Maine  04401
Camden-Clark Memorial Hospital Parkersburg, West Virginia  26102
William Beaumont Hospital Royal Oak, Michigan  48073
Via Christi Regional Medical Center Wichita, Kansas  67214
Scott and White Memorial Hospital Temple, Texas  76508
Iowa Methodist Medical Center Des Moines, Iowa  50309
Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
Group Health Cooperative Seattle, Washington  98112
Great Falls Clinic Great Falls, Montana  59405
Mercy Fitzgerald Hospital Darby, Pennsylvania  19023
Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium Seattle, Washington  98109
Montefiore Medical Center Bronx, New York  10467-2490
North Colorado Medical Center Greeley, Colorado  80631
McKee Medical Center Loveland, Colorado  80539
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
Holland Community Hospital Holland, Michigan  49423
Northern Rockies Radiation Oncology Center Billings, Montana  59101
Bozeman Deaconess Hospital Bozeman, Montana  59715
Kalispell Medical Oncology Kalispell, Montana  59901
Kalispell Regional Medical Center Kalispell, Montana  59901
Adena Regional Medical Center Chillicothe, Ohio  54601
Grady Memorial Hospital Delaware, Ohio  43015
Fairfield Medical Center Lancaster, Ohio  43130
Harborview Medical Center Seattle, Washington  98104
Cancer Care Northwest - Spokane South Spokane, Washington  99202
Welch Cancer Center Sheridan, Wyoming  82801
Cancer Centers of the Carolinas Greenville, South Carolina  29605
City of Hope Medical Center Duarte, California  91010
Mercy Health System Janesville, Wisconsin  53545
Elkhart General Hospital Elkhart, Indiana  46515
South Bend Clinic South Bend, Indiana  46617
Finger Lakes Hematology and Oncology Clifton Springs, New York  14432
Saint Rose Hospital Hayward, California  94545
Alta Bates Summit Medical Center - Summit Campus Oakland, California  94609
Saint Joseph's Hospital of Atlanta Atlanta, Georgia  30342-1701
Piedmont Hospital Atlanta, Georgia  30309
Gwinnett Medical Center Lawrenceville, Georgia  30045
Southern Regional Medical Center Riverdale, Georgia  30274-2600
Memorial Hospital Carthage, Illinois  62321
Galesburg Cottage Hospital Galesburg, Illinois  61401
Galesburg Clinic Galesburg, Illinois  61401
Mason District Hospital Havana, Illinois  62644
McDonough District Hospital Macomb, Illinois  61455
BroMenn Regional Medical Center Normal, Illinois  61761
Proctor Hospital Peoria, Illinois  61614
Perry Memorial Hospital Princeton, Illinois  61356
Salina Regional Health Center Salina, Kansas  67401
Sturdy Memorial Hospital Attleboro, Massachusetts  02703
Community Cancer Center of Monroe Monroe, Michigan  48162
Bismarck Cancer Center Bismarck, North Dakota  58501
Fremont Memorial Hospital Fremont, Ohio  43420
Lima Memorial Hospital Lima, Ohio  45804
Firelands Regional Medical Center Sandusky, Ohio  44870
Mercy Medical Center Springfield, Ohio  45504
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Fulton County Health Center Wauseon, Ohio  43567
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
Eureka Hospital Eureka, Illinois  61530
Mercy Hospital Coon Rapids, Minnesota  55433
Graham Hospital Association Canton, Illinois  61520
Saint Joseph Medical Center Joliet, Illinois  60435
Pekin Hospital Pekin, Illinois  61554
Medical Oncology and Hematology Associates Des Moines, Iowa  50309
Bixby Medical Center Adrian, Michigan  49221
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
Saint Francis Regional Medical Center Shakopee, Minnesota  55379
Rice Memorial Hospital Willmar, Minnesota  56201
Altru Cancer Center Grand Forks, North Dakota  58206
Saint Luke's Hospital Maumee, Ohio  43537
Geisinger Medical Group State College, Pennsylvania  16801
Highland General Hospital Oakland, California  94602
Center for Cancer Care and Research St. Louis, Missouri  63141
Allegheny Cancer Center at Allegheny General Hospital Pittsburgh, Pennsylvania  15212
Spartanburg Regional Medical Center Spartanburg, South Carolina  29303
Crossroads Cancer Center Effingham, Illinois  62401
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Lawrence Memorial Hospital Lawrence, Kansas  66044
Bozeman Deaconess Cancer Center Bozeman, Montana  59715
Northern Montana Hospital Havre, Montana  59501
Mary Rutan Hospital Bellefontaine, Ohio  43311
Knox Community Hospital Mount Vernon, Ohio  43050
Fisher-Titus Medical Center Norwalk, Ohio  44857
Adventist Medical Center Portland, Oregon  97216
Wenatchee Valley Medical Center Wenatchee, Washington  98801-2028
Rocky Mountain Oncology Casper, Wyoming  82609
Longmont United Hospital Longmont, Colorado  80501
Baton Rouge General Medical Center Baton Rouge, Louisiana  70821-2511
Singing River Hospital Pascagoula, Mississippi  39581
Rutherford Hospital Rutherfordton, North Carolina  28139
Harold Alfond Center for Cancer Care Augusta, Maine  04330
Cancer Centers of the Carolinas - Grove Commons Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Seneca Seneca, South Carolina  29672
Cancer Centers of the Carolinas - Spartanburg Spartanburg, South Carolina  29307
Mayo Clinic in Florida Jacksonville, Florida  32224
Sutter Roseville Medical Center Roseville, California  95661
Memorial Medical Center Springfield, Illinois  62781
Southeastern Medical Oncology Center Goldsboro, North Carolina  27534
McLeod Regional Medical Center Florence, South Carolina  29501
La Grange Memorial Hospital La Grange, Illinois  60525
Guardian Oncology and Center for Wellness Missoula, Montana  59804
Woodwinds Health Campus Woodbury, Minnesota  55125
East Bay Radiation Oncology Center Castro Valley, California  94546
Larry G Strieff MD Medical Corporation Oakland, California  94609
Tahoe Forest Cancer Center Truckee, California  96161
Bay Area Hospital Coos Bay, Oregon  97420
Hennepin County Medical Center Minneapolis, Minnesota  
Saint Louis University Hospital St. Louis, Missouri  63110-0250
Glens Falls Hospital Glens Falls, New York  12801
Riverside Methodist Hospital Columbus, Ohio  43214
Licking Memorial Hospital Newark, Ohio  43055-2899
Mid Dakota Clinic Bismarck, North Dakota  58501
Columbus CCOP Columbus, Ohio  43206
Presbyterian - Saint Lukes Medical Center - Health One Denver, Colorado  80218
Wichita CCOP Wichita, Kansas  67214-3882
Montana Cancer Consortium CCOP Billings, Montana  59101
Flower Hospital Sylvania, Ohio  43560-2197
Columbia Saint Mary's Hospital - Ozaukee Mequon, Wisconsin  53097
Metro-Minnesota CCOP St. Louis Park, Minnesota  
UC Davis Comprehensive Cancer Center Sacramento, California  95817
Cancer Centers of the Carolinas - Easley Easley, South Carolina  29640
Thomas Jefferson University Hospital Philadelphia, Pennsylvania  19131
Decatur Memorial Hospital Decatur, Illinois  62526
Frederick Memorial Hospital Frederick, Maryland  21701
Montana Cancer Specialists Missoula, Montana  59807-7877
Providence Saint Joseph Medical Center Burbank, California  91505-4866
University of Southern California Los Angeles, California  90033
DeKalb Medical Center Decatur, Georgia  30033
Northern Indiana Cancer Research Consortium South Bend, Indiana  
Hays Medical Center Hays, Kansas  67601
OSF Saint Francis Medical Center Peoria, Illinois  61637
Northside Hospital Atlanta, Georgia  30342
Saint Edward Mercy Medical Center Ft. Smith, Arkansas  72903
Valley Medical Oncology Consultants-Castro Valley Castro Valley, California  94546
Eden Hospital Medical Center Castro Valley, California  94546
Northbay Cancer Center Fairfield, California  94533
Valley Medical Oncology Consultants-Fremont Fremont, California  94538
Fremont - Rideout Cancer Center Marysville, California  95901
Bay Area Breast Surgeons Inc Oakland, California  94609
Bay Area Tumor Institution CCOP Oakland, California  94609
Tom K Lee Inc Oakland, California  94609
Valley Medical Oncology Consultants Pleasanton, California  94588
Valley Care Health System - Pleasanton Pleasanton, California  94588
Doctors Medical Center- JC Robinson Regional Cancer Center San Pablo, California  94806
The Medical Center of Aurora Aurora, Colorado  80012
Penrose-Saint Francis Healthcare Colorado Springs, Colorado  80907
Memorial Hospital Colorado Springs Colorado Springs, Colorado  80909
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's Hospital and Regional Medical Center Grand Junction, Colorado  81502
Saint Mary Corwin Medical Center Pueblo, Colorado  81004
The Hospital of Central Connecticut New Britain, Connecticut  06050
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
Atlanta Regional CCOP Atlanta, Georgia  30342
Well Star Cobb Hospital Austell, Georgia  30106
John B Amos Cancer Center Columbus, Georgia  31904
Veterans Administration Medical Center Decatur, Georgia  30033
Wellstar Kennestone Hospital Marietta, Georgia  30060
Rush - Copley Medical Center Aurora, Illinois  60504
John H Stroger Jr Hospital of Cook County Chicago, Illinois  60612-3785
Resurrection Healthcare Chicago, Illinois  60631
Saint Anthony Memorial Hospital Effingham, Illinois  62401
Hopedale Medical Complex - Hospital Hopedale, Illinois  61747
Joliet Oncology-Hematology Associates Limited Joliet, Illinois  60435
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
Saint Margaret's Hospital Spring Valley, Illinois  61362
Carle Clinic-Urbana Main Urbana, Illinois  61801
Fort Wayne Medical Oncology and Hematology Inc - State Boulevard Fort Wayne, Indiana  46845
Saint Anthony Memorial Health Center Michigan City, Indiana  46360
McFarland Clinic Ames, Iowa  50010
Hematology Oncology Associates-Quad Cities Bettendorf, Iowa  52722
Cedar Rapids Oncology Association Cedar Rapids, Iowa  52403
Mercy Hospital Cedar Rapids, Iowa  52403
Medical Oncology and Hematology Associates-West Des Moines Clive, Iowa  50325
Iowa Oncology Research Association CCOP Des Moines, Iowa  50309
Mercy Capitol Des Moines, Iowa  50307
Mercy Medical Center - Des Moines Des Moines, Iowa  50314
Medical Oncology and Hematology Associates-Des Moines Des Moines, Iowa  50309
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
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
Green Bay Oncology - Escanaba Escanaba, Michigan  49431
Grand Rapids Clinical Oncology Program 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-Hackley Campus Muskegon, Michigan  49442
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
Etzell, Paul S MD (UIA Investigator) Fergus Falls, Minnesota  56537
Swenson, Wade II, MD (UIA Investigator) Fergus Falls, Minnesota  56537
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
Park Nicollet Clinic - Saint Louis Park Saint Louis Park, Minnesota  55416
Saint Joseph's Hospital - Healtheast Saint Paul, Minnesota  55102
Minnesota Oncology and Hematology PA-Woodbury Woodbury, Minnesota  55125
Southeast Missouri Hospital Cape Girardeau, Missouri  63701
Missouri Baptist Medical Center Saint Louis, Missouri  63131
Saint John's Hospital Springfield, Missouri  65804
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
Berdeaux, Donald MD (UIA Investigator) Great Falls, Montana  59405
Saint Peter's Community Hospital Helena, Montana  59601
Glacier Oncology PLLC Kalispell, Montana  59901
Community Medical Hospital Missoula, Montana  59801
Saint Patrick Hospital - Community Hospital Missoula, Montana  59802
Good Samaritan Hospital Kearney, Nebraska  68847
Lincoln Medical Education Foundation Cancer Resource Center Lincoln, Nebraska  68510
Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington County Mount Holly, New Jersey  08060
Sparta Cancer Treatment Center Sparta, New Jersey  07871
Virtua West Jersey Hospital Voorhees Voorhees, New Jersey  08043
Veterans Affairs Western New York Health Care System-Buffalo Buffalo, New York  14215
Adirondack Cancer Center Glens Falls, New York  12801
Orange Regional Medical Center Middletown, New York  10940
Margaret R Pardee Memorial Hospital Hendersonville, North Carolina  28791
Kinston Medical Specialists PA Kinston, North Carolina  28501
Saint Alexius Medical Center Bismarck, North Dakota  58501
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
Hematology Oncology Center Incorporated Elyria, Ohio  44035
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
Saint Ann's Hospital Westerville, Ohio  43081
Genesis HealthCare System Zanesville, Ohio  43701
Central PA Hematology-Medical Oncology Associates PC Lemoyne, Pennsylvania  17043
Riddle Hospital Media, Pennsylvania  19063
Hematology and Oncology Associates of North East Pennsylvania Scranton, Pennsylvania  18508
Associates In Hematology Oncology PC-Upland Upland, Pennsylvania  19013
Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania  18711
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
The Don and Sybil Harrington Cancer Center Amarillo, Texas  79106
Fredericksburg Oncology Inc Fredericksburg, Virginia  22401
Harrison Bremerton Hematology and Oncology Bremerton, Washington  98310
Columbia Basin Hematology and Oncology PLLC Kennewick, Washington  99336
Minor and James Medical PLLC Seattle, Washington  98104
The Polyclinic Seattle, Washington  98122
Swedish Medical Center-First Hill Seattle, Washington  98122-4307
Mayo Clinic Health System Eau Claire Hospital - Luther Campus Eau Claire, Wisconsin  54703
Midelfort Clinic-Clairemont Campus Eau Claire, Wisconsin  54702
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
Bay Area Medical Center Marinette, Wisconsin  54143
Green Bay Oncology - Oconto Falls Oconto Falls, Wisconsin  54154
Green Bay Oncology - Sturgeon Bay Sturgeon Bay, Wisconsin  54235
Olathe Cancer Center Olathe, Kansas  66061
Elkhart Clinic Elkhart, Indiana  46515
Marin General Hospital Greenbrae, California  94904
Harbin Clinic Medical Oncology and Clinical Research Rome, Georgia  30165
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
Memorial Hospital at Easton - Shore Regional Cancer Center Easton, Maryland  21601
Michiana Hematology Oncology PC-Niles Niles, Michigan  49120
University of Missouri - Ellis Fischel Columbia, Missouri  65203
Veterans Administration Columbia, Missouri  65201
North Coast Cancer Care-Clyde Clyde, Ohio  43410
Community Health Partners Regional Medical Center Elyria, Ohio  44035
Cancer Centers of the Carolinas - Faris Greenville, South Carolina  29605
Cancer Centers of the Carolinas-Greer Radiation Oncology Greer, South Carolina  29650
Cancer Centers of the Carolinas-Greer Medical Oncology Greer, South Carolina  29650
Skagit Valley Hospital Mt. Vernon, Washington  98273
Evergreen Hematology and Oncology PS Spokane, Washington  99218
West Virginia University Charleston Charleston, West Virginia  25304
Holy Family Memorial Hospital Manitowoc, Wisconsin  54221
Medical Consultants Limited Milwaukee, Wisconsin  53215
University of Miami Miller School of Medicine-Sylvester Cancer Center Miami, Florida  33136
FirstHealth of the Carolinas-Moore Regional Hosiptal Pinehurst, North Carolina  28374
Palchak David MD Pismo Beach, California  93449
Doctors Carrol, Sheth, Raghavan Louisville, Kentucky  40215
University of Tennessee - Memphis Memphis, Tennessee  38163
United General Hospital Sedro-Woolley, Washington  98284
Columbia Saint Mary's Water Tower Medical Commons Milwaukee, Wisconsin  53211
Siouxland Hematology Oncology Associates Sioux City, Iowa  51101
Space Coast Cancer Centers-Titusville Titusville, Florida  32796
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
The Toledo Hospital/Toledo Children's Hospital Toledo, Ohio  43606
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
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
Springfield Regional Medical Center Springfield, Ohio  45505
Promise Regional Medical Center-Hutchinson Hutchinson, Kansas  65702
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
Self Regional Healthcare Greenwood, South Carolina  29646
Harrison Poulsbo Hematology and Oncology Poulsbo, Washington  98370
Aurora Cancer Care-Southern Lakes Elkhorn, Wisconsin  53121
South Carolina Oncology Associates PA Columbia, South Carolina  29210