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Randomized, Phase III, Double-Blind Placebo-Controlled Trial of Sunitinib (NSC #736511, IND #74019) as Maintenance Therapy in Non-Progressing Patients Following an Initial Four Cycles of Platinum-Based Combination Chemotherapy in Advanced, Stage IIIB / IV Non-Small Cell Lung Cancer


Phase 3
18 Years
N/A
Open (Enrolling)
Both
Stage IIIB Non-small Cell Lung Cancer, Stage IV Non-small Cell Lung Cancer

Thank you

Trial Information

Randomized, Phase III, Double-Blind Placebo-Controlled Trial of Sunitinib (NSC #736511, IND #74019) as Maintenance Therapy in Non-Progressing Patients Following an Initial Four Cycles of Platinum-Based Combination Chemotherapy in Advanced, Stage IIIB / IV Non-Small Cell Lung Cancer


PRIMARY OBJECTIVES:

I. To evaluate the effect of sunitinib (sunitinib malate) compared to placebo on PFS in
advanced NSCLC patients who have had either stable or responding disease over the course of
their initial 4 cycles of platinum-based therapy.

SECONDARY OBJECTIVES:

I. To evaluate the toxicity of sunitinib compared to placebo in the maintenance setting.

II. To evaluate the additional response rate as a result of sunitinib in this setting.

III. To assess the impact of sunitinib on overall survival compared to the placebo arm.

IV. To assess the impact of sunitinib on delaying the time to deterioration in quality of
life and symptom progression compared to placebo using the EORTC QLQ-C30 and LC13.

V. To assess VEGF haplotypes in advanced non-small cell lung cancer and sunitinib
maintenance.

OUTLINE: This is a multicenter study. Patients are stratified according to ECOG performance
status (0 vs 1), disease stage (IIIB vs IV), prior treatment with bevacizumab (yes vs no),
and gender. Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive sunitinib malate orally (PO) once daily on days 1-21. Courses repeat
every 21 days in the absence of disease progression or unacceptable toxicity.

ARM II: Patients receive placebo PO once daily on days 1-21. Courses repeat every 21 days in
the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed every 3 months for 1 year, every
6 months for 1 year, and periodically for 3 years.


Inclusion Criteria:



- Histologic or cytologic documentation of primary non-small cell lung cancer

- Stage IIIB or IV disease patients who are not candidates for combined modality
therapy (chemoradiotherapy)

- No evidence of symptomatic or untreated brain metastases, spinal cord compression, or
carcinomatous meningitis; patients with central nervous system (CNS) metastases must
be asymptomatic, must have received definitive therapy (>= 6 weeks since resection or
>= 2 weeks since radiotherapy) for brain metastases, and be off steroids or on a
stable dose for 2 weeks prior to registration

- No cavitary lesions

- Patients must have received one chemotherapy regimen for stage IIIB or IV NSCLC; the
regimen must include four cycles of platinum-based doublet chemotherapy with or
without bevacizumab (bevacizumab may not be given beyond the fourth cycle of
chemotherapy); patients must have achieved a complete response, partial response, or
stable disease to first-line chemotherapy and have no evidence of disease
progression; patients will be registered 3-5 weeks following day 1 of cycle 4 of
prior therapy

- No prior adjuvant chemotherapy for stage I-III resected NSCLC or combined modality
therapy for stage III NSCLC

- No other primary therapy (including experimental therapy) for NSCLC; palliative
radiation therapy must have been completed at least one week before planned start of
protocol therapy

- Patients must have measurable or non-measurable disease

- Measurable disease: lesions that can be accurately measured in at least one
dimension (longest diameter to be recorded) as >= 2 cm with conventional
techniques or as >= 1 cm with spiral CT scan

- Non-measurable disease: all other lesions, including small lesions (longest
diameter < 20 mm with conventional techniques or < 10 mm with spiral computed
tomography [CT] scan) and truly non-measurable lesions; lesions that are
considered non-measurable include the following:

- Bone lesions

- Leptomeningeal disease

- Ascites

- Pleural/pericardial effusion

- Lymphangitis cutis/pulmonis

- Abdominal masses that are not confirmed and followed by imaging techniques

- Cystic lesions

- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1

- Non-pregnant and non-nursing

- No ongoing cardiac dysrhythmias, atrial fibrillation, or history of corrected QT
(QTc) interval >= 500 msec (within 2 years prior to registration); the use of agents
with proarrhythmic potential (e.g., quinidine, procainamide, disopyramide, sotalol,
probucol, haloperidol, risperidone, indapamide, flecainide) is not recommended while
on protocol therapy

- Patients with class I New York Heart Association (NYHA) heart failure are eligible;
patients with a history of class II NYHA heart failure are eligible, provided they
meet at least one of the following criteria:

- Patients with a history of class II heart failure who are asymptomatic on
treatment

- Patients with prior anthracycline exposure

- Patients who have received central thoracic radiation that included the heart in
the radiotherapy port

- Patients with a history of class III or IV NYHA heart failure within 12 months prior
to registration are not eligible

- No myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass
graft or stenting, cerebrovascular accident or transient ischemic attack within the
last year

- Patients with hypertension that cannot be controlled by medications (> 150/100 mmHg
despite optimal medical therapy) are not eligible

- Patients who require use of therapeutic anticoagulation for thromboembolic disease
are not eligible; Note: low doses of coumadin (up to 2 mg daily) are permitted for
prophylaxis of thrombosis

- No history of venous thrombosis, pulmonary embolism, or hypercoagulopathy syndrome

- No history of pulmonary hemorrhage, bleeding diathesis, or evidence of hemoptysis;
patients with blood-tinged or blood-streaked sputum will be permitted on study if the
hemoptysis amounts to less than 5 ml of blood per episode and less than 10 ml of
blood per 24-hour period in the best estimate of the investigator

- Patients with a history of hypothyroidism are eligible, provided they are currently
euthyroid

- None of the following within 28 days of beginning treatment: abdominal fistula,
gastrointestinal perforation, intra-abdominal abscess, serious or non-healing wound,
ulcer, or bone fracture

- The following inhibitors of cytochrome P450 3A4 (CYP3A4) are prohibited within 7 days
before beginning and during treatment with sunitinib: azole antifungals
(ketoconazole, itraconozole), diltiazem, clarithromycin, erythromycin, verapamil,
delavirdine, and HIV protease inhibitors (indinavir, saquinavir, ritonavir,
atazanavir, nelfinavir); the following inducers of CYP3A4 are prohibited within 12
days before beginning and during treatment with sunitinib: rifampin, rifabutin,
carbamazepine, phenobarbital, phenytoin, St. John's Wort, efavirenz, tipranavir;
other inhibitors and inducers of CYP3A4 may be used if necessary, but their use is
discouraged

- Patients unable to take oral medication are not eligible

- Granulocytes >= 1,500/mcl

- Platelet count >= 100,000/mcl

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

- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)=< 2.5 x ULN;
patients with liver metastases may have AST and ALT =< 5 x ULN; all other patients
will have AST and ALT =< 2.5 x ULN

- Creatinine =< 1.5 mg/dl

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment

Outcome Measure:

Progression-free survival (PFS)

Outcome Description:

PFS will be characterized by the Kaplan-Meier method. PFS will be performed using the intent-to-treat principle, which included all randomized patients. The comparisons of treatment arms on PFS will be done using the stratified log ranked.

Outcome Time Frame:

Time from the date of randomization of non-progressing patients following the first-line therapy to the date of disease progression or death of any cause, whichever comes first, assessed up to 5 years

Safety Issue:

No

Principal Investigator

Mark Socinski

Investigator Role:

Principal Investigator

Investigator Affiliation:

Cancer and Leukemia Group B

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2009-00469

NCT ID:

NCT00693992

Start Date:

June 2008

Completion Date:

Related Keywords:

  • Stage IIIB Non-Small Cell Lung Cancer
  • Stage IV Non-Small Cell Lung Cancer
  • Carcinoma, Non-Small-Cell Lung
  • Lung Neoplasms

Name

Location

Baylor College of Medicine Houston, Texas  77030
Howard University Hospital Washington, District of Columbia  20060
University of Iowa Hospitals and Clinics Iowa City, Iowa  52242
Washington University School of Medicine Saint Louis, Missouri  63110
Rhode Island Hospital Providence, Rhode Island  02903
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
Hutchinson Area Health Care Hutchinson, Minnesota  55350
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
Marshfield Clinic Marshfield, Wisconsin  54449
Memorial Hospital of South Bend South Bend, Indiana  46601
Mary Bird Perkins Cancer Center Baton Rouge, Louisiana  70809
Harbor Hospital Center Baltimore, Maryland  21225
Newark Beth Israel Medical Center Newark, New Jersey  07112
Community Medical Center Toms River, New Jersey  08755
Akron General Medical Center Akron, Ohio  44302
Waukesha Memorial Hospital Waukesha, Wisconsin  53188
University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
Hartford Hospital Hartford, Connecticut  06102-5037
Illinois Masonic Medical Center Chicago, Illinois  60657
Eastern Maine Medical Center Bangor, Maine  04401
Franklin Square Hospital Center Baltimore, Maryland  21237
Camden-Clark Memorial Hospital Parkersburg, West Virginia  26102
William Beaumont Hospital Royal Oak, Michigan  48073
University of Nebraska Medical Center Omaha, Nebraska  68198-3330
Broward General Medical Center Fort Lauderdale, Florida  33316
Via Christi Regional Medical Center Wichita, Kansas  67214
University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma  73104
Scott and White Memorial Hospital Temple, Texas  76508
Northeast Alabama Regional Medical Center Anniston, Alabama  36207
Saint Anthony Medical Center Rockford, Illinois  61108
Iowa Methodist Medical Center Des Moines, Iowa  50309
Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
Weill Medical College of Cornell University New York, New York  10021
Southern California Permanente Medical Group Downey, California  90242
Great Falls Clinic Great Falls, Montana  59405
MetroHealth Medical Center Cleveland, Ohio  44109
Chester County Hospital West Chester, Pennsylvania  19380
Sibley Memorial Hospital Washington, District of Columbia  20016
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
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
Medical X-Ray Center Sioux Falls, South Dakota  57105
Welch Cancer Center Sheridan, Wyoming  82801
Methodist Estabrook Cancer Center Omaha, Nebraska  68114-4199
Cancer Centers of the Carolinas Greenville, South Carolina  29605
Mercy Health System Janesville, Wisconsin  53545
Elkhart General Hospital Elkhart, Indiana  46515
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
Front Range Cancer Specialists Fort Collins, Colorado  80528
University Medical Center of Southern Nevada Las Vegas, Nevada  89102
Alta Bates Summit Medical Center - Summit Campus Oakland, California  94609
Poudre Valley Hospital Fort Collins, Colorado  80524
Beebe Medical Center Lewes, Delaware  19958
Swedish Covenant Hospital Chicago, Illinois  60625
Hematology and Oncology Associates Chicago, Illinois  60611
Sturdy Memorial Hospital Attleboro, Massachusetts  02703
Community Cancer Center of Monroe Monroe, Michigan  48162
Saint Francis Medical Center Cape Girardeau, Missouri  63701
Great Plains Regional Medical Center North Platte, Nebraska  69101-6598
Creighton University Medical Center Omaha, Nebraska  68131-2197
Bismarck Cancer Center Bismarck, North Dakota  58501
Lima Memorial Hospital Lima, Ohio  45804
Mercy Medical Center Springfield, Ohio  45504
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Fulton County Health Center Wauseon, Ohio  43567
Providence Milwaukie Hospital Milwaukie, Oregon  97222
Mountainview Medical Berlin, Vermont  05602
Danville Regional Medical Center Danville, Virginia  24541
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital Yakima, Washington  98902
Mercy Hospital Coon Rapids, Minnesota  55433
Trinity Medical Center Moline, Illinois  61265-1291
Medical Oncology and Hematology Associates Des Moines, Iowa  50309
Bixby Medical Center Adrian, Michigan  49221
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
Mary Imogene Bassett Hospital Cooperstown, New York  13326
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
Swedish American Hospital Rockford, Illinois  61104
Saint Luke's Hospital Chesterfield, Missouri  63017
Center for Cancer Care and Research St. Louis, Missouri  63141
Saint Joseph Hospital Chicago, Illinois  60657
Hospital District Sixth of Harper County Anthony, Kansas  67003
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Lawrence Memorial Hospital Lawrence, Kansas  66044
Menorah Medical Center Overland Park, Kansas  66209
Shawnee Mission Medical Center Shawnee Mission, Kansas  66204
North Kansas City Hospital Kansas City, Missouri  64116
Research Medical Center Kansas City, Missouri  64132
Saint Luke's East - Lee's Summit Lee's Summit, Missouri  64086
Liberty Hospital Liberty, Missouri  64068
Heartland Regional Medical Center Saint Joseph, Missouri  64506
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
Marshfield Clinic Cancer Care at Regional Cancer Center Eau Claire, Wisconsin  54701
Saint Joseph's Hospital Marshfield, Wisconsin  54449
Marshfield Clinic - Weston Center Weston, Wisconsin  54476
Marshfield Clinic - Wisconsin Rapids Center Wisconsin Rapids, Wisconsin  54494
Rocky Mountain Oncology Casper, Wyoming  82609
Memorial Hospital of Rhode Island Pawtucket, Rhode Island  02860
Temple University Hospital Philadelphia, Pennsylvania  19140
Baton Rouge General Medical Center Baton Rouge, Louisiana  70821-2511
Singing River Hospital Pascagoula, Mississippi  39581
Ben Taub General Hospital Houston, Texas  77030
Methodist Hospital Houston, Texas  77030
Union Hospital of Cecil County Elkton MD, Maryland  21921
Miriam Hospital Providence, Rhode Island  02906
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
Memorial Medical Center Springfield, Illinois  62781
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
University of Virginia Charlottesville, Virginia  22908
University of Pittsburgh Pittsburgh, Pennsylvania  15261
Providence Hospital Mobile, Alabama  36608
University of North Carolina Chapel Hill, North Carolina  27599
Duke University Medical Center Durham, North Carolina  27710
Meharry Medical College Nashville, Tennessee  37208-3599
Providence Medical Center Kansas City, Kansas  66112
Independence Regional Health Center Independence, Missouri  64050
Lynchburg Hematology-Oncology Clinic Lynchburg, Virginia  24501
East Bay Radiation Oncology Center Castro Valley, California  94546
Contra Costa Regional Medical Center Martinez, California  94553-3156
Memorial Medical Center Modesto, California  95355
Larry G Strieff MD Medical Corporation Oakland, California  94609
Elmhurst Memorial Hospital Elmhurst, Illinois  60126
Bay Area Hospital Coos Bay, Oregon  97420
Hennepin County Medical Center Minneapolis, Minnesota  
University of Rochester Rochester, New York  14642
Glens Falls Hospital Glens Falls, New York  12801
Holy Cross Hospital Fort Lauderdale, Florida  33308
El Camino Hospital Mountain View, California  94040
Kaiser Permanente Medical Center Vallejo, California  94589
New Hampshire Oncology-Hematology PA Hooksett, New Hampshire  03106
Riverside Methodist Hospital Columbus, Ohio  43214
Licking Memorial Hospital Newark, Ohio  43055-2899
Cancer Center of Kansas - McPherson McPherson, Kansas  67460
Providence Portland Medical Center Portland, Oregon  97213-3635
Mid Dakota Clinic Bismarck, North Dakota  58501
Columbus CCOP Columbus, Ohio  43206
University Of Vermont Burlington,, Vermont  05403
Kaiser Permanente Sacramento, California  
Wichita CCOP Wichita, Kansas  67214-3882
Montana Cancer Consortium CCOP Billings, Montana  59101
Alegent Health Immanuel Medical Center Omaha, Nebraska  68122
Alegent Health Bergan Mercy Medical Center Omaha, Nebraska  68124
Flower Hospital Sylvania, Ohio  43560-2197
Mount Sinai Hospital Medical Center Chicago, Illinois  60608
Addison Gilbert Hospital Gloucester, Massachusetts  01930
Southeastern Regional Medical Center Lumberton, North Carolina  28359
Granville Medical Center Oxford, North Carolina  27565
Person Memorial Hospital Roxboro, North Carolina  27573
Columbia Saint Mary's Hospital - Ozaukee Mequon, Wisconsin  53097
Metro-Minnesota CCOP St. Louis Park, Minnesota  
Providence Hospital Southfield, Michigan  48075
Community Memorial Health Center South Hill, Virginia  23970-0090
Cancer Centers of the Carolinas - Easley Easley, South Carolina  29640
Lakeview Hospital Stillwater, Minnesota  55082
Decatur Memorial Hospital Decatur, Illinois  62526
Tulane University Health Sciences Center New Orleans, Louisiana  70112
Louisiana State University Health Science Center New Orleans, Louisiana  70112
Virginia Commonwealth University Richmond, Virginia  
Montana Cancer Specialists Missoula, Montana  59807-7877
Boca Raton Comprehensive Cancer Center Boca Raton, Florida  33486
Florida Hospital Orlando, Florida  32803
Memorial Health University Medical Center Savannah, Georgia  31404
University of Chicago Comprehensive Cancer Center Chicago, Illinois  60637-1470
Northern Indiana Cancer Research Consortium South Bend, Indiana  
Florida Hospital Memorial Medical Center Daytona Beach, Florida  32117
Southeast Cancer Center Cape Girardeau, Missouri  63703
Clackamas Radiation Oncology Center Clackamas, Oregon  97015
Providence Newberg Medical Center Newberg, Oregon  97132
Butler Memorial Hospital Butler, Pennsylvania  16001
New Ulm Medical Center New Ulm, Minnesota  56073
Wake Forest University Health Sciences Winston-Salem, North Carolina  27157
Upper Chesapeake Medical Center Bel Air, Maryland  21014
Saint Helena Hospital Saint Helena, California  94574
Veteran's Administration Medical Center Little Rock, Arkansas  72205
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
Palo Alto Medical Foundation-Camino Division Mountain View, California  94040
Bay Area Breast Surgeons Inc Oakland, California  94609
Bay Area Tumor Institution CCOP Oakland, California  94609
Tom K Lee Inc Oakland, California  94609
Palo Alto Medical Foundation Heath Care Palo Alto, California  94301
Valley Medical Oncology Consultants Pleasanton, California  94588
Valley Care Health System - Pleasanton Pleasanton, California  94588
Naval Medical Center -San Diego San Diego, California  92134
Doctors Medical Center- JC Robinson Regional Cancer Center San Pablo, California  94806
Middlesex Hospital Middletown, Connecticut  06457
The Hospital of Central Connecticut New Britain, Connecticut  06050
Lombardi Comprehensive Cancer Center at Georgetown University Washington, District of Columbia  20057
John B Amos Cancer Center Columbus, Georgia  31904
Saint Joseph's-Candler Health System Savannah, Georgia  31405
Saint Anthony's Health Alton, Illinois  62002
Rush - Copley Medical Center Aurora, Illinois  60504
Cancer Institute at Alexian Brothers Elk Grove Village, Illinois  60007
Saint Francis Hospital Evanston, Illinois  60202
Evanston CCOP-NorthShore University HealthSystem Evanston, Illinois  60201
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
West Suburban Cancer Center River Forest, Illinois  60305
Hematology Oncology Associates of Illinois - Skokie Skokie, Illinois  60076
Carle Clinic-Urbana Main Urbana, Illinois  61801
Fort Wayne Medical Oncology and Hematology Inc - State Boulevard Fort Wayne, Indiana  46845
Saint Vincent Hospital and Health Services Indianapolis, Indiana  46260
Saint Anthony Memorial Health Center Michigan City, Indiana  46360
Constantinou, Costas L MD (UIA Investigator) 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 - 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
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
Cancer Center of Kansas-Wichita Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas - Main Office Wichita, Kansas  67214
Medical Center of Louisiana New Orleans, Louisiana  70112
Hickman Cancer Center Adrian, Michigan  49221
Green Bay Oncology - Escanaba Escanaba, Michigan  49431
Green Bay Oncology - Iron Mountain Iron Mountain, Michigan  49801
Mercy Memorial Hospital Monroe, Michigan  48162
Lakeland Hospital St. Joseph, Michigan  49085
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
Minneapolis Veterans Medical Center Minneapolis, Minnesota  55417
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
Southeast Missouri Hospital Cape Girardeau, Missouri  63701
Saint Luke's Cancer Institute Kansas City, Missouri  64111
Saint Luke's Hospital of Kansas City Kansas City, Missouri  64111
Saint Joseph Health Center Kansas City, Missouri  64114
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
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
Berdeaux, Donald MD (UIA Investigator) 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
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
Exeter Hospital Exeter, New Hampshire  03833
New Hampshire Oncology Hematology Associates Hooksett, New Hampshire  03106
LRGHealthcare-Lakes Region General Hospital Laconia, New Hampshire  03246
Cooper Hospital University Medical Center Camden, New Jersey  08103
Veterans Adminstration New Jersey Health Care System East Orange, New Jersey  07018-1095
South Jersey Healthcare Vineland, New Jersey  08360
Orange Regional Medical Center Middletown, New York  10940
Interlakes Foundation Inc-Rochester Rochester, New York  14623
Highland Hospital Rochester, New York  14620
State University of New York Upstate Medical University Syracuse, New York  13210
Alamance Regional Medical Center Burlington, North Carolina  27216
Wayne Memorial Hospital Goldsboro, North Carolina  27534
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
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
Saint Rita's Medical Center Lima, Ohio  45801
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
Providence Saint Vincent Medical Center Portland, Oregon  97225
Columbia River Oncology Program Portland, Oregon  97225
Salem Hospital Salem, Oregon  97309
Scranton Hematology Oncology Scranton, Pennsylvania  18510
Mercy Hospital Scranton, Pennsylvania  18501
Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania  18711
Greenville CCOP Greenville, South Carolina  29615
Greenville Memorial Hospital Greenville, South Carolina  29605
Sanford Cancer Center-Oncology Clinic Sioux Falls, South Dakota  57104
Veterans Administration Medical Center Houston, Texas  77030
Saint Luke's Episcopal Hospital Houston, Texas  77030
Southwestern Oncology Research Department Bennington, Vermont  05201
Fredericksburg Oncology Inc Fredericksburg, Virginia  22401
Edwards Comprehensive Cancer Center Huntington, West Virginia  25701
West Virginia University Morgantown, West Virginia  26506
Wheeling Hospital Wheeling, West Virginia  26003
Central Wisconsin Cancer Program Fond Du Lac, Wisconsin  54935
Saint Vincent Hospital Green Bay, Wisconsin  54301
Green Bay Oncology Limited at Saint Mary's Hospital Green Bay, Wisconsin  54303
Saint Mary's Hospital Green Bay, Wisconsin  54303
Green Bay Oncology at Saint Vincent Hospital Green Bay, Wisconsin  54301-3526
Dean Hematology and Oncology Clinic Madison, Wisconsin  53717
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
University of Maryland Greenebaum Cancer Center Baltimore, Maryland  21201
Jupiter Medical Center Jupiter, Florida  33458
Elkhart Clinic Elkhart, Indiana  46515
Mount Sinai Medical Center CCOP Miami Beach, Florida  33140
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 Mary's Regional Medical Center Lewiston, Maine  04240
Michiana Hematology Oncology PC-Niles Niles, Michigan  49120
University of Missouri - Ellis Fischel Columbia, Missouri  65203
Veterans Administration Columbia, Missouri  65201
Syracuse Veterans Administration Medical Center Syracuse, New York  13210
East Carolina University Greenville, North Carolina  27858
Duke Raleigh Hospital Raleigh, North Carolina  27609
North Coast Cancer Care-Clyde Clyde, Ohio  43410
Community Health Partners Regional Medical Center Elyria, Ohio  44035
Roper Hospital Charleston, South Carolina  29401
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
Nashville Oncology Associates PC Nashville, Tennessee  37203
Marshfield Clinic-Chippewa Center Chippewa Falls, Wisconsin  54729
Holy Family Memorial Hospital Manitowoc, Wisconsin  54221
Wheaton Franciscan Cancer Care - All Saints Racine, Wisconsin  53405
Marshfield Clinic Cancer Care at Saint Michael's Hospital Stevens Point, Wisconsin  54481
Riverview Hospital Wisconsin Rapids, Wisconsin  54494
Long Beach Memorial Medical Center-Todd Cancer Institute Long Beach, California  90806
Kaiser Permanente Los Angeles Medical Center Los Angeles, California  90027
Cancer Centers of Southwest Oklahoma Research Lawton, Oklahoma  
Kaiser Anaheim Medical Center Anaheim, California  92807
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
Palchak David MD Pismo Beach, California  93449
Kaiser Permanente at San Diego San Diego, California  92120
Kaiser Permanente Health Care San Marcos, California  92069
Spector, David MD (UIA Investigator) Moline, Illinois  61265
Saint Luke's South Hospital Overland Park, Kansas  66213
Kansas City CCOP Prairie Village, Kansas  66208
Doctors Carrol, Sheth, Raghavan Louisville, Kentucky  40215
Hematology and Oncology Clinic Baton Rouge, Louisiana  70809
Veterans Administration Medical Center Baltimore, Maryland  21201
Capital Region Medical Center-Goldschmidt Cancer Center Jefferson City, Missouri  65109
Heartland Hematology and Oncology Associates Incorporated Kansas City, Missouri  64118
Saint Joseph Oncology Inc Saint Joseph, Missouri  64507
Comprehensive Cancer Care PC Saint Louis, Missouri  63141
Arnot Ogden Medical Center Elmira, New York  14905
Durham Veterans Affairs Medical Center Durham, North Carolina  27705
Mount Carmel East Hospital Columbus, Ohio  43213
The Mark H Zangmeister Center Columbus, Ohio  43219
Southern Ohio Medical Center Portsmouth, Ohio  45662
Cancer Care Associates-Mercy Oklahoma City, Oklahoma  73120
Dallas VA Medical Center Dallas, Texas  75216
Memorial Hospital Of Martinsville Martinsville, Virginia  24115
Saint Mary's Medical Center Huntington, West Virginia  25702
Gundersen Lutheran La Crosse, Wisconsin  54601
Saint Nicholas Hospital Madison, Wisconsin  53715
Columbia Saint Mary's Water Tower Medical Commons Milwaukee, Wisconsin  53211
Alegent Health Lakeside Hospital Omaha, Nebraska  68130
Beaufort Memorial Hospital Beaufort, South Carolina  29902
Siouxland Hematology Oncology Associates Sioux City, Iowa  51101
Walter Reed National Military Medical Center Bethesda, Maryland  20889
Kaiser Permanente-Mission San Diego, California  92108
Hunter Holmes McGuire Veterans Administration Medical Center Richmond, Virginia  23249
Gulfport Memorial Hospital Gulfport, Mississippi  39502
VA Medical Center - University of Iowa Iowa City, Iowa  52246
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
The Toledo Hospital/Toledo Children's Hospital Toledo, Ohio  43606
Sanford USD Medical Center - Sioux Falls Sioux Falls, South Dakota  57117-5134
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
Essentia Health Cancer Center-South University Clinic Fargo, North Dakota  58103
Christiana Care Health System-Christiana Hospital Newark, Delaware  19718
Springfield Regional Medical Center Springfield, Ohio  45505
Edward Hospital/Cancer Center Naperville, Illinois  60540
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
Self Regional Healthcare Greenwood, South Carolina  29646
PeaceHealth Southwest Medical Center Vancouver, Washington  98664
Aurora Cancer Care-Southern Lakes Elkhorn, Wisconsin  53121
Cancer Care Associates-Norman Norman, Oklahoma  73071
Mercy Physicians of Oklahoma-Lakeside Oklahoma City, Oklahoma  73120
Providence Willamette Falls Medical Center Oregon City, Oregon  97045
Cancer Center of Western Wisconsin New Richmond, Wisconsin  54017
Feather River Cancer Center Paradise, California  95969
Nash General Hospital Rocky Mount, North Carolina  27804
Trinity's Tony Teramana Cancer Center Steubenville, Ohio  43952
Associated Medical Specialists PA dba Coastal Cancer Center Myrtle Beach, South Carolina  29572