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A Phase III Clinical Trial of Bevacizumab With IV Versus IP Chemotherapy in Ovarian, Fallopian Tube, and Primary Peritoneal Carcinoma NCI-Supplied Agent(s): Bevacizumab (NSC #704865, IND #7921)


Phase 3
18 Years
N/A
Open (Enrolling)
Female
Brenner Tumor, Ovarian Clear Cell Cystadenocarcinoma, Ovarian Endometrioid Adenocarcinoma, Ovarian Mixed Epithelial Carcinoma, Ovarian Mucinous Cystadenocarcinoma, Ovarian Serous Cystadenocarcinoma, Ovarian Undifferentiated Adenocarcinoma, Stage IIA Fallopian Tube Cancer, Stage IIA Ovarian Epithelial Cancer, Stage IIA Primary Peritoneal Cavity Cancer, Stage IIB Fallopian Tube Cancer, Stage IIB Ovarian Epithelial Cancer, Stage IIB Primary Peritoneal Cavity Cancer, Stage IIC Fallopian Tube Cancer, Stage IIC Ovarian Epithelial Cancer, Stage IIC Primary Peritoneal Cavity Cancer, Stage IIIA Fallopian Tube Cancer, Stage IIIA Ovarian Epithelial Cancer, Stage IIIA Primary Peritoneal Cavity Cancer, Stage IIIB Fallopian Tube Cancer, Stage IIIB Ovarian Epithelial Cancer, Stage IIIB Primary Peritoneal Cavity Cancer, Stage IIIC Fallopian Tube Cancer, Stage IIIC Ovarian Epithelial Cancer, Stage IIIC Primary Peritoneal Cavity Cancer, Stage IV Fallopian Tube Cancer, Stage IV Ovarian Epithelial Cancer, Stage IV Primary Peritoneal Cavity Cancer

Thank you

Trial Information

A Phase III Clinical Trial of Bevacizumab With IV Versus IP Chemotherapy in Ovarian, Fallopian Tube, and Primary Peritoneal Carcinoma NCI-Supplied Agent(s): Bevacizumab (NSC #704865, IND #7921)


PRIMARY OBJECTIVES:

I. To determine if one or both of the proposed intraperitoneal chemotherapy regimens
improves the progression-free survival (PFS) event rate compared to standard intravenous
chemotherapy for first-line treatment of patients diagnosed with advanced stage ovarian,
peritoneal or fallopian tube cancer.

II. If both IP regimens significantly improve the PFS event rate compared to the standard
regimen, then a second study objective is to determine whether IP cisplatin and IV
paclitaxel on day one plus IP paclitaxel on day eight improves the PFS event rate when
compared to the IP carboplatin and IV paclitaxel.

SECONDARY OBJECTIVES:

I. To determine if intraperitoneal chemotherapy reduces the overall death rate compared to
standard intravenous chemotherapy.

II. To assess the frequency and severity of adverse events as defined by CTCAE version 3.0.

III. To compare the patient-reported outcomes on: Quality of Life (FACT-O-TOI), Neuropathy
(FACT-GOG/NTX4 scale), Abdominal discomfort (FACT-GOG/AD scale), Fatigue (FACIT-Fatigue
scale), and Nausea (item from FACT-O-TOI).

IV. To assess the frequency and the reasons for early discontinuation of the study
treatments.

TERTIARY OBJECTIVES:

I. To bank DNA from whole blood for research and examine the association between single
nucleotide polymorphisms (SNPs) and measures of clinical outcome including overall survival,
progression-free survival and adverse events.

II. To bank archival tumor for research and examine the association between tumor markers
and measures of clinical outcome including overall survival, progression-free survival and
adverse events.

III. Patients will be encouraged to enroll on the companion translational research protocol
(CEM0703 under development).

OUTLINE: This is a multicenter study. Patients are stratified according to disease stage
(FIGO stage II vs stage III vs stage IV) and size of residual disease after initial
staging/debulking surgery (no gross residual disease vs gross residual disease with lesion ≤
1 cm vs any gross residual disease with lesion > 1 cm). Patients are randomized to 1 of 3
treatment arms.

ARM I: Patients receive paclitaxel IV over 1 hour on days 1, 8, and 15 and carboplatin IV
over 30 minutes on day 1. Patients also receive bevacizumab IV over 30-90 minutes on day 1
in courses 2-6. Treatment repeats every 21 days for 6 courses in the absence of disease
progression or unacceptable toxicity. Patients then receive bevacizumab alone in courses
7-22 in the absence of disease progression or unacceptable toxicity.

ARM II: Patients receive paclitaxel as in arm I and carboplatin intraperitoneally (IP) on
day 1. Patients also receive bevacizumab as in arm I. Treatment repeats every 21 days for 6
courses in the absence of disease progression or unacceptable toxicity. Patients then
receive bevacizumab alone as in arm I.

ARM III: Patients receive paclitaxel IV over 3 hours on day 1, cisplatin IP on day 2, and
paclitaxel IP on day 8. Patients also receive bevacizumab as in arm I. Treatment repeats
every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity.
Patients then receive bevacizumab alone as in arm I.

Patients complete quality-of-life questionnaires at baseline and at weeks 9, 18, 36, 60, and
84. Blood and tissue samples may be collected for further laboratory analysis.

After completion of study treatment, patients are followed up every 3 months for 2 years,
every 6 months for 3 years, and then annually for 5 years.


Inclusion Criteria:



- Histologically confirmed ovarian epithelial, fallopian tube, or primary peritoneal
carcinoma, including any of the following epithelial cell types*:

- Serous adenocarcinoma

- Endometrioid adenocarcinoma

- Mucinous**adenocarcinoma

- Undifferentiated carcinoma

- Clear** cell adenocarcinoma

- Mixed epithelial carcinoma

- Transitional cell carcinoma

- Malignant Brenner tumor

- Adenocarcinoma not otherwise specified

- Stage II, III, or IV disease with either optimal (≤ 1 cm residual disease) or
suboptimal residual disease

- Must have undergone surgery for diagnosis, staging, and/or cytoreduction within the
past 12 weeks

- Prior or concurrent primary endometrial cancer allowed provided the primary origin of
the invasive tumor is ovarian or peritoneal and all of the following criteria are
met:

- Stage of endometrial cancer is ≤ IB

- No more than superficial myometrial invasion, without vascular or lymphatic
invasion

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

- No borderline ovarian epithelial tumor ("tumors of low malignant potential") (e.g.,
stage IA or IB disease with low-grade lesions)

- Patients with a prior diagnosis of a borderline tumor that was surgically
resected and who subsequently develop an unrelated, new invasive ovarian
epithelial or primary peritoneal cancer are eligible provided they have not
received prior chemotherapy for any ovarian tumor

- No recurrent invasive ovarian epithelial cancer treated with surgery only

- No history or evidence of major CNS disease by physical examination (e.g., primary
brain tumor, metastatic cancer in the brain, seizures not controlled with standard
medical therapy, or any brain metastases within the past 6 months

- No metastatic tumor in the parenchyma of the liver or lungs with proximity to large
vessels

- GOG performance status 0-2

- ANC ≥ 1,500/mm³ (without granulocyte colony-stimulating factor support)

- Platelet count ≥ 100,000/mm³

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

- AST and ALT ≤ 2.5 times ULN

- Alkaline phosphatase ≤ 2.5 times ULN

- Creatinine normal

- Urine protein:creatinine ratio < 1.0

- PTT <1.5 times ULN

- Concurrent heparin, lovenox or alternative anticoagulants allowed

- PT/INR ≤ 1.5 times ULN (or an in-range INR, usually between 2 and 3, if patient is on
a stable dose of therapeutic warfarin)

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception during and for ≥ 6 months after
completion of study treatment

- No sensory or motor neuropathy > CTCAE grade 1

- No seizures not controlled with standard medical therapy

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

- No acute hepatitis or active infection requiring parenteral antibiotics

- No serious non-healing wound, ulcer, or bone fracture

- Granulating incisions healing by secondary intention allowed provided there is
no evidence of fascial dehiscence or infection AND the wound is examined weekly
during study

- No clinical symptoms or signs of gastrointestinal obstruction and/or those who
require parenteral hydration and/or nutrition

- Patients with a history or current diagnosis of inflammatory bowel disease are
not eligible

- No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within
the past 28 days

- No active bleeding or pathologic condition that carries a high risk of bleeding
(e.g., known bleeding disorder, coagulopathy, or tumor involving major vessels)

- No cerebrovascular accident (stroke), transient ischemic attack, or subarachnoid
hemorrhage within the past 6 months

- No clinically significant cardiovascular disease, including any of the following:

- Uncontrolled hypertension, defined as systolic BP > 150 mmHg or diastolic BP >
90 mmHg

- Myocardial infarction or unstable angina within the past 6 months

- NYHA class II-IV congestive heart failure

- Serious cardiac arrhythmia requiring medication

- Asymptomatic atrial fibrillation with controlled ventricular rate or
history of supraventricular tachycardia controlled with medications and
asymptomatic allowed

- Peripheral vascular disease ≥ CTCAE grade 2 (at least brief [< 24 hrs] episodes
of ischemia managed non-surgically and without permanent deficit)

- No history or evidence of cerebrovascular accident (CVA, stroke), transient ischemic
attack, or subarachnoid hemorrhage within the past 6 months

- No known hypersensitivity to Chinese hamster ovary cell products or other recombinant
human or humanized antibodies

- No known allergy to Cremophor or polysorbate 80

- No significant traumatic injury within the past 28 days

- No other medical history or condition (e.g., persistent gastrointestinal symptoms
resulting from clostridia difficile enterocolitis or bowl surgery; or hearing loss or
neuropathy) that, in the opinion of the investigator, would preclude study
participation

- Concurrent ovarian estrogen (with or without progestin) replacement therapy for
control of menopausal symptoms allowed provided the lowest effective dose(s) is (are)
given

- No concurrent high-dose of progestins as an appetite stimulant

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

- Prior radiotherapy for localized cancer of the breast, head and neck, or skin
allowed provided it was completed > 3 years ago AND patient remains free of
recurrent or metastatic disease

- No prior chemotherapy for any abdominal or pelvic tumor, including neoadjuvant
chemotherapy for ovarian or primary peritoneal cancer

- Prior adjuvant chemotherapy for localized breast cancer allowed provided it was
completed > 3 years ago AND patient remains free of recurrent or metastatic
disease

- No prior targeted therapy (including vaccines, antibodies, or tyrosine kinase
inhibitors) or hormonal therapy for management of ovarian epithelial or primary
peritoneal cancer

- No prior anti-VEGF therapy, including bevacizumab

- No prior cancer treatment that would contraindicate study treatment

- More than 7 days since prior core biopsy

- More than 28 days since prior major surgical procedure or open biopsy

- No concurrent major surgical procedure, including, but not limited to, abdominal
surgery (laparotomy or laparoscopy) before disease progression (e.g., colostomy or
enterostomy reversal, secondary cytoreductive surgery, or second-look surgery)

- No other concurrent anti-neoplastic therapy, including cytotoxic therapy, biologic
therapy, hormonal therapy, or radiotherapy

- No concurrent amifostine or other protective reagents

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Progression-free survival

Outcome Time Frame:

From date that each patient is enrolled onto the study to the date of the patient's first failure event, assessed up to 10 years

Safety Issue:

No

Principal Investigator

Joan Walker

Investigator Role:

Principal Investigator

Investigator Affiliation:

Gynecologic Oncology Group

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2011-01956

NCT ID:

NCT00951496

Start Date:

July 2009

Completion Date:

Related Keywords:

  • Brenner Tumor
  • Ovarian Clear Cell Cystadenocarcinoma
  • Ovarian Endometrioid Adenocarcinoma
  • Ovarian Mixed Epithelial Carcinoma
  • Ovarian Mucinous Cystadenocarcinoma
  • Ovarian Serous Cystadenocarcinoma
  • Ovarian Undifferentiated Adenocarcinoma
  • Stage IIA Fallopian Tube Cancer
  • Stage IIA Ovarian Epithelial Cancer
  • Stage IIA Primary Peritoneal Cavity Cancer
  • Stage IIB Fallopian Tube Cancer
  • Stage IIB Ovarian Epithelial Cancer
  • Stage IIB Primary Peritoneal Cavity Cancer
  • Stage IIC Fallopian Tube Cancer
  • Stage IIC Ovarian Epithelial Cancer
  • Stage IIC Primary Peritoneal Cavity Cancer
  • Stage IIIA Fallopian Tube Cancer
  • Stage IIIA Ovarian Epithelial Cancer
  • Stage IIIA Primary Peritoneal Cavity Cancer
  • Stage IIIB Fallopian Tube Cancer
  • Stage IIIB Ovarian Epithelial Cancer
  • Stage IIIB Primary Peritoneal Cavity Cancer
  • Stage IIIC Fallopian Tube Cancer
  • Stage IIIC Ovarian Epithelial Cancer
  • Stage IIIC Primary Peritoneal Cavity Cancer
  • Stage IV Fallopian Tube Cancer
  • Stage IV Ovarian Epithelial Cancer
  • Stage IV Primary Peritoneal Cavity Cancer
  • Adenocarcinoma
  • Adenocarcinoma, Mucinous
  • Brenner Tumor
  • Carcinoma
  • Cystadenocarcinoma
  • Peritoneal Neoplasms
  • Fallopian Tube Neoplasms
  • Carcinoma, Endometrioid
  • Cystadenocarcinoma, Mucinous
  • Cystadenocarcinoma, Serous
  • Neoplasms, Glandular and Epithelial
  • Ovarian Neoplasms

Name

Location

Johns Hopkins University Baltimore, Maryland  21205
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
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
Fox Chase Cancer Center Philadelphia, Pennsylvania  19111
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
Hurley Medical Center Flint, Michigan  48503
Pennsylvania Hospital Philadelphia, Pennsylvania  19107
Sinai Hospital of Baltimore Baltimore, Maryland  21225
Beth Israel Deaconess Medical Center Boston, Massachusetts  02215
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
Abramson Cancer Center of the University of Pennsylvania Philadelphia, Pennsylvania  19104-4283
Avera Cancer Institute Sioux Falls, South Dakota  57105
Loyola University Medical Center Maywood, Illinois  60153
Massachusetts General Hospital Cancer Center Boston, Massachusetts  02114
CentraCare Clinic Saint Cloud, Minnesota  56303
Morristown Memorial Hospital Morristown, New Jersey  07962-1956
Henry Ford Hospital Detroit, Michigan  48202
Marshfield Clinic Marshfield, Wisconsin  54449
Sutter Health Western Division Cancer Research Group Greenbrae, California  94904
Methodist Medical Center of Illinois Peoria, Illinois  61636
Memorial Hospital of South Bend South Bend, Indiana  46601
Lehigh Valley Hospital Allentown, Pennsylvania  18103
Western Pennsylvania Hospital Pittsburgh, Pennsylvania  15224
LDS Hospital Salt Lake City, Utah  84143
Rush University Medical Center Chicago, Illinois  60612-3824
Dana-Farber Cancer Institute Boston, Massachusetts  02115
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
Eastern Maine Medical Center Bangor, Maine  04401
Franklin Square Hospital Center Baltimore, Maryland  21237
Baystate Medical Center Springfield, Massachusetts  01199
Providence Alaska Medical Center Anchorage, Alaska  99508
William Beaumont Hospital Royal Oak, Michigan  48073
Hackensack University Medical Center Hackensack, New Jersey  07601
Via Christi Regional Medical Center Wichita, Kansas  67214
Ochsner Clinic Foundation New Orleans, Louisiana  70121
Carolinas Medical Center Charlotte, North Carolina  28232-2861
University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma  73104
Scott and White Memorial Hospital Temple, Texas  76508
John Muir Medical Center Walnut Creek, California  94598
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
New Hanover Regional Medical Center Wilmington, North Carolina  28402-9025
Group Health Cooperative Seattle, Washington  98112
University of Wisconsin Hospital and Clinics Madison, Wisconsin  53792-0001
Great Falls Clinic Great Falls, Montana  59405
Overlook Hospital Summit, New Jersey  07902-0220
Winthrop University Hospital Mineola, New York  11501
MetroHealth Medical Center Cleveland, Ohio  44109
Central Baptist Hospital Lexington, Kentucky  40503
Valley Hospital Ridgewood, New Jersey  07450
Wilford Hall Medical Center Lackland Air Force Base, Texas  78236-5300
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
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
Munson Medical Center Traverse City, Michigan  49684
Northern Rockies Radiation Oncology Center Billings, Montana  59101
Bozeman Deaconess Hospital Bozeman, Montana  59715
Big Sky Oncology Great Falls, Montana  59405
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
McKay-Dee Hospital Center Ogden, Utah  84403
Cancer Care Northwest - Spokane South Spokane, Washington  99202
Welch Cancer Center Sheridan, Wyoming  82801
University of South Alabama Mitchell Cancer Institute Mobile, Alabama  36604
University of New Mexico Cancer Center Albuquerque, New Mexico  87131-5636
Good Samaritan Hospital - Cincinnati Cincinnati, Ohio  45220
Brigham and Women's Hospital Boston, Massachusetts  02115
Methodist Estabrook Cancer Center Omaha, Nebraska  68114-4199
Cancer Centers of the Carolinas Greenville, South Carolina  29605
City of Hope Medical Center Duarte, California  91010
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
Parkland Memorial Hospital Dallas, Texas  75235
Sutter Solano Medical Center Vallejo, California  94589
Beebe Medical Center Lewes, Delaware  19958
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
Mecosta County Medical Center Big Rapids, Michigan  49307
Grandview Hospital Dayton, Ohio  45405
Mercy Medical Center Springfield, Ohio  45504
Danville Regional Medical Center Danville, Virginia  24541
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital Yakima, Washington  98902
Eureka Hospital Eureka, Illinois  61530
Mercy Hospital Coon Rapids, Minnesota  55433
Graham Hospital Association Canton, Illinois  61520
Holy Family Medical Center Des Plaines, Illinois  60016
Saint Joseph Medical Center Joliet, Illinois  60435
Pekin Hospital Pekin, Illinois  61554
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
Saint Francis Regional Medical Center Shakopee, Minnesota  55379
Rice Memorial Hospital Willmar, Minnesota  56201
Geisinger Medical Group State College, Pennsylvania  16801
Northeast Georgia Medical Center Gainesville, Georgia  30501
Randolph Hospital Asheboro, North Carolina  27203
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
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
Wayne Hospital Greenville, Ohio  45331
Knox Community Hospital Mount Vernon, Ohio  43050
Clinton Memorial Hospital Wilmington, Ohio  45177
Wenatchee Valley Medical Center Wenatchee, Washington  98801-2028
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
Woman's Hospital Baton Rouge, Louisiana  70815
Seattle Cancer Care Alliance Seattle, Washington  98109
Morton Plant Hospital Clearwater, Florida  33756
Temple University Hospital Philadelphia, Pennsylvania  19140
Zale Lipshy University Hospital Dallas, Texas  75235-7786
Methodist Hospital Houston, Texas  77030
Aurora Sinai Medical Center Milwaukee, Wisconsin  53201-0342
Greene Memorial Hospital Xenia, Ohio  45385
Greater Baltimore Medical Center Baltimore, Maryland  21204
AnMed Health Cancer Center Anderson, South Carolina  29621
Harold Alfond Center for Cancer Care Augusta, Maine  04330
Union Hospital of Cecil County Elkton MD, Maryland  21921
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 Arizona Scottsdale, Arizona  85259-5404
Mayo Clinic in Florida Jacksonville, Florida  32224
Pacific Gynecology Specialists Seattle, Washington  98104
Sutter Roseville Medical Center Roseville, California  95661
Washington Hospital Center Washington, District of Columbia  20010
Memorial Medical Center Springfield, Illinois  62781
Phelps County Regional Medical Center Rolla, Missouri  65401
Metro Health Hospital Grand Rapids, Michigan  49506
Guardian Oncology and Center for Wellness Missoula, Montana  59804
Queen's Medical Center Honolulu, Hawaii  96813
University of Virginia Charlottesville, Virginia  22908
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
Kapiolani Medical Center at Pali Momi Aiea, Hawaii  96701
Kapiolani Medical Center for Women and Children Honolulu, Hawaii  96826
Maui Memorial Medical Center Wailuku, Hawaii  96793
Hennepin County Medical Center Minneapolis, Minnesota  
Queens Hospital Center Jamaica, New York  11432
Saint Louis University Hospital St. Louis, Missouri  63110-0250
University of California at San Diego La Jolla, California  92093
Case Western Reserve University Cleveland, Ohio  44106
Wayne State University Detroit, Michigan  48202
Straub Clinic and Hospital Honolulu, Hawaii  96813
University of Massachusetts Medical School Worcester, Massachusetts  01605
Riverside Methodist Hospital Columbus, Ohio  43214
Licking Memorial Hospital Newark, Ohio  43055-2899
California Pacific Medical Center San Francisco, California  94115
Dartmouth Hitchcock Medical Center Lebanon, New Hampshire  03756
Columbus CCOP Columbus, Ohio  43206
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
Montana Cancer Consortium CCOP Billings, Montana  59101
Northwest Hospital Seattle, Washington  98133
Huntsman Cancer Institute/University of Utah Salt Lake City, Utah  84112
Columbia Saint Mary's Hospital - Ozaukee Mequon, Wisconsin  53097
Metro-Minnesota CCOP St. Louis Park, Minnesota  
UC Davis Comprehensive Cancer Center Sacramento, California  95817
Providence Hospital Southfield, Michigan  48075
Tufts Medical Center Boston, Massachusetts  02111
Cancer Centers of the Carolinas - Easley Easley, South Carolina  29640
Lakeview Hospital Stillwater, Minnesota  55082
Thomas Jefferson University Hospital Philadelphia, Pennsylvania  19131
Florida Gynecologic Oncology Fort Myers, Florida  33901
Jersey Shore Medical Center Neptune, New Jersey  07754
Decatur Memorial Hospital Decatur, Illinois  62526
Tulane University Health Sciences Center New Orleans, Louisiana  70112
Virginia Commonwealth University Richmond, Virginia  
Holy Cross Hospital Silver Spring, Maryland  20910
Montana Cancer Specialists Missoula, Montana  59807-7877
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
Harrison Medical Center Bremerton, Washington  98310
Phoenixville Hospital Phoenixville, Pennsylvania  19460
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  
Northern Virginia Pelvic Surgery Associates Annandale, Virginia  22003
University of Cincinnati Cincinnati, Ohio  45267-0502
Hawaii Medical Center East Honolulu, Hawaii  96817
Vince Lombardi Cancer Clinic - Oshkosh Oshkosh, Wisconsin  54904
Penn State Milton S Hershey Medical Center Hershey, Pennsylvania  17033
The Community Hospital Munster, Indiana  46321
Froedtert and the Medical College of Wisconsin Milwaukee, Wisconsin  53226
Wake Forest University Health Sciences Winston-Salem, North Carolina  27157
OSF Saint Francis Medical Center Peoria, Illinois  61637
Northside Hospital Atlanta, Georgia  30342
Mills - Peninsula Hospitals Burlingame, California  94010
Saint Joseph Hospital Orange, California  92868
Sutter General Hospital Sacramento, California  95816
University of California San Francisco Medical Center-Mount Zion San Francisco, California  94115
Danbury Hospital Danbury, Connecticut  06810
Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
The Hospital of Central Connecticut New Britain, Connecticut  06050
Stamford Hospital Stamford, Connecticut  06904
The Watson Clinic Lakeland, Florida  33805
M D Anderson Cancer Center- Orlando Orlando, Florida  32806
John B Amos Cancer Center Columbus, Georgia  31904
Oncare Hawaii Inc-POB II Honolulu, Hawaii  96813
Oncare Hawaii Inc-Kuakini Honolulu, Hawaii  96817
University of Hawaii Honolulu, Hawaii  96813
Pacific Cancer Institute of Maui Wailuku, Hawaii  96793
Resurrection Healthcare Chicago, Illinois  60631
Evanston CCOP-NorthShore University HealthSystem Evanston, Illinois  60201
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
Saint Vincent Hospital and Health Services Indianapolis, Indiana  46260
Reid Hospital and Health Care Services Richmond, Indiana  47374
McFarland Clinic Ames, Iowa  50010
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
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
Associates in Oncology Hematology PC -Kensington Kensington, Maryland  20895
Associates In Oncology Hematology PC-Rockville Rockville, Maryland  20878
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
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
Allegiance Health Jackson, Michigan  49201
Sparrow Hospital Lansing, Michigan  48912
Saint Mary Mercy Hospital Livonia, Michigan  48154
Mercy Health Partners-Mercy Campus Muskegon, Michigan  49443
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
Medini, Eitan MD (UIA Investigator) Alexandria, Minnesota  56308
Miller-Dwan Hospital Duluth, Minnesota  55805
Unity Hospital Fridley, Minnesota  55432
Saint John's Hospital - Healtheast Maplewood, Minnesota  55109
Minnesota Oncology Hematology PA-Maplewood Maplewood, Minnesota  55109
North Memorial Medical Health Center Robbinsdale, Minnesota  55422
Saint Cloud Hospital Saint Cloud, Minnesota  56303
Park Nicollet Clinic - Saint Louis Park Saint Louis Park, Minnesota  55416
Minnesota Oncology and Hematology PA-Woodbury Woodbury, Minnesota  55125
Ozark Health Ventures LLC dba Cancer Research for The Ozarks Springfield Springfield, Missouri  65802
Saint John's Hospital Springfield, Missouri  65804
Cox Medical Center Springfield, Missouri  65807
Hematology-Oncology Centers of the Northern Rockies PC Billings, Montana  59101
Saint Vincent Healthcare Billings, Montana  59101
Billings Clinic Billings, Montana  59107-7000
Saint James Community Hospital and Cancer Treatment Center Butte, Montana  59701
Benefis Healthcare- Sletten Cancer Institute Great Falls, Montana  59405
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
Cooper Hospital University Medical Center Camden, New Jersey  08103
Hunterdon Medical Center Flemington, New Jersey  08822
Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington County Mount Holly, New Jersey  08060
Virtua West Jersey Hospital Voorhees Voorhees, New Jersey  08043
New York University Langone Medical Center New York, New York  10016
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
Doctors Hospital Columbus, Ohio  43228
Grant Medical Center Columbus, Ohio  43215
Mount Carmel Health Center West Columbus, Ohio  43222
Good Samaritan Hospital - Dayton Dayton, Ohio  45406
Dayton CCOP Dayton, Ohio  45429
Samaritan North Health Center Dayton, Ohio  45415
Blanchard Valley Hospital Findlay, Ohio  45840
Atrium Medical Center-Middletown Regional Hospital Franklin, Ohio  45005-1066
Kettering Medical Center Kettering, Ohio  45429
Marietta Memorial Hospital Marietta, Ohio  45750
University of Toledo Toledo, Ohio  43614
Upper Valley Medical Center Troy, Ohio  45373
Saint Ann's Hospital Westerville, Ohio  43081
Wright-Patterson Medical Center Wright-Patterson Afb, Ohio  45433-5529
Genesis HealthCare System Zanesville, Ohio  43701
Legacy Good Samaritan Hospital and Medical Center Portland, Oregon  97210
Northwest Cancer Specialists-Rose Quarter Cancer Center Portland, Oregon  97227
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
Peninsula Cancer Institute-Newport News Newport News, Virginia  23601
Harrison Bremerton Hematology and Oncology Bremerton, Washington  98310
Swedish Medical Center-First Hill Seattle, Washington  98122-4307
Saint Joseph Medical Center Tacoma, Washington  98405
Saint Vincent Hospital Green Bay, Wisconsin  54301
Green Bay Oncology Limited at Saint Mary's Hospital Green Bay, Wisconsin  54303
Saint Mary's Hospital Green Bay, Wisconsin  54303
Green Bay Oncology at Saint Vincent Hospital Green Bay, Wisconsin  54301-3526
Aurora BayCare Medical Center Green Bay, Wisconsin  54311-6519
Marshfield Clinic-Minocqua Center Minocqua, Wisconsin  54548
Marshfield Clinic at James Beck Cancer Center Rhinelander, Wisconsin  54501
Marshfield Clinic-Rice Lake Center Rice Lake, Wisconsin  54868
Saint Michael's Hospital Stevens Point, Wisconsin  54481
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
Colorado Gynecologic Oncology Group Aurora, Colorado  80010
Lake University Ireland Cancer Center Mentor, Ohio  44060
Lyndon Baines Johnson General Hospital Houston, Texas  77030
Women's Cancer Associates Saint Petersburg, Florida  33701
Stony Brook University Medical Center Stony Brook, New York  11794
Lahey Clinic Medical Center Burlington, Massachusetts  01805
Elkhart Clinic Elkhart, Indiana  46515
John Muir Medical Center-Concord Campus Concord, California  94520
Marin General Hospital Greenbrae, California  94904
University of Colorado Cancer Center - Anschutz Cancer Pavilion Aurora, Colorado  80045
Kootenai Cancer Center Post Falls, Idaho  83854
Illinois CancerCare-Bloomington Bloomington%, Illinois  61701
Illinois CancerCare-Canton Canton, Illinois  61520
Illinois CancerCare-Carthage Carthage, Illinois  62321
Illinois CancerCare-Eureka Eureka, Illinois  61530
Illinois CancerCare-Cottage Galesburg, Illinois  61401
Illinois CancerCare-Havana Havana, Illinois  62644
Illinois CancerCare-Kewanee Clinic Kewanee, Illinois  61443
Illinois CancerCare-Macomb Macomb, Illinois  61455
Illinois CancerCare-Monmouth Monmouth, Illinois  61462
Illinois CancerCare-Community Cancer Center Normal, Illinois  61761
Illinois CancerCare-Pekin Pekin, Illinois  61603
Illinois CancerCare-Peru Peru, Illinois  61354
Illinois CancerCare-Princeton Princeton, Illinois  61356
Illinois CancerCare-Spring Valley Spring Valley, Illinois  61362
Michiana Hematology Oncology PC-Elkhart Elkhart, Indiana  46514
Michiana Hematology Oncology PC-Plymouth Plymouth, Indiana  46563
Michiana Hematology Oncology PC-South Bend South Bend, Indiana  46601
Michiana Hematology Oncology-PC Westville Westville, Indiana  46391
Cancer Center of Kansas-Liberal Liberal, Kansas  67901
Commonwealth Hematology Oncology PC-Worcester Worcester, Massachusetts  01605
Michiana Hematology Oncology PC-Niles Niles, Michigan  49120
University of Missouri - Ellis Fischel Columbia, Missouri  65203
Hackensack University Medical CCOP Hackensack, New Jersey  07601
Moses Cone Health System-Regional Cancer Center Greensboro, North Carolina  27403
Duke Raleigh Hospital Raleigh, North Carolina  27609
Annie Penn Memorial Hospital Reidsville, North Carolina  27320
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
University of Tennessee - Knoxville Knoxville, Tennessee  37920
Saint Paul Hospital Dallas, Texas  75235
Utah Valley Regional Medical Center Provo, Utah  84603
Dixie Medical Center Regional Cancer Center Saint George, Utah  84770
Intermountain Health Care Salt Lake City, Utah  84103
Marshfield Clinic-Chippewa Center Chippewa Falls, Wisconsin  54729
Marshfield Clinic Cancer Care at Saint Michael's Hospital Stevens Point, Wisconsin  54481
Aurora Medical Center in Summit Summit, Wisconsin  53066
Vince Lombardi Cancer Clinic Two Rivers, Wisconsin  54241
Hawaii Minority Based CCOP Honolulu, Hawaii  96813
Advocate Lutheran General Hospital Park Ridge, Illinois  60068
Saint Elizabeth Medical Center South Edgewood, Kentucky  41017
Maine Medical Center-Bramhall Campus Portland, Maine  04102
Gynecologic Oncology of West Michigan PLLC Grand Rapids, Michigan  49546
Center of Hope at Renown Medical Center Reno, Nevada  89502
Montefiore Medical Center-Weiler Division Bronx, New York  10461
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
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 Medical Care Program - Los Angeles Medical Center & Sunset Hospital Los Angeles, California  90027
Rocky Mountain Gynecologic Oncology PC Englewood, Colorado  80110
Saint Vincent's Medical Center Jacksonville, Florida  32204
University of Miami Miller School of Medicine-Sylvester Cancer Center Miami, Florida  33136
Bayfront Outpatient Health Clinic Saint Petersburg, Florida  33701
Norton Health Care Pavilion - Downtown Louisville, Kentucky  40202
University of Minnesota Medical Center-Fairview Minneapolis, Minnesota  55455
Southwest Gynecologic Oncology Associates Inc Albuquerque, New Mexico  87106
Women's Cancer Center of Nevada Las Vegas, Nevada  89109
Arizona Cancer Center at University Medical Center North Tucson, Arizona  85719
Palchak David MD Pismo Beach, California  93449
Wilcox Memorial Hospital and Kauai Medical Clinic Lihue, Hawaii  96766-1099
Central DuPage Hospital Cancer Center Warrenville, Illinois  60555
Hematology and Oncology Clinic Baton Rouge, Louisiana  70809
Southern Ohio Medical Center Portsmouth, Ohio  45662
Providence Regional Cancer Partnership Everett, Washington  98201
Gundersen Lutheran La Crosse, Wisconsin  54601
Columbia Saint Mary's Water Tower Medical Commons Milwaukee, Wisconsin  53211
Stanford University Hospitals and Clinics Stanford, California  94305
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
Saint Vincent Oncology Center Indianapolis, Indiana  46260
University of Massachusetts Memorial Health Care Worcester, Massachusetts  01605
PeaceHealth Medical Group PC Bellingham, Washington  98226
Skagit Valley Hospital Regional Cancer Care Center Mount Vernon, Washington  98274
Olympic Medical Cancer Care Center Sequim, Washington  98384
Rockwood Cancer Treatment Center Spokane, Washington  99204
Providence Saint Mary Regional Cancer Center Walla Walla, Washington  99362
Cancer Institutes of Washington PLLC Yakima, Washington  98902
Aurora Saint Luke's Medical Center Milwaukee, Wisconsin  53215
Norris Cotton Cancer Center-Manchester Manchester, New Hampshire  03104
Jonsson Comprehensive Cancer Center Los Angeles, California  90095
Alta Bates Summit Medical Center-Herrick Campus Berkeley, California  94704
Michiana Hematology Oncology PC-Mishawaka Mishawaka, Indiana  46545-1470
Marie Yeager Cancer Center Saint Joseph, Michigan  49085
Summa Akron City Hospital Akron, Ohio  44304
Park Nicollet Frauenshuh Cancer Center Minneapolis, Minnesota  55416
Sanford USD Medical Center - Sioux Falls Sioux Falls, South Dakota  57117-5134
North Shore-LIJ Health System CCOP Manhasset, New York  11030
Genesys Regional Medical Center-West Flint Campus Flint, Michigan  48532
Essentia Health Saint Joseph's Medical Center Brainerd, Minnesota  56401
Essentia Health Duluth Clinic CCOP Duluth, Minnesota  55805
Essentia Health Saint Mary's Medical Center Duluth, Minnesota  55805
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
Springfield Regional Medical Center Springfield, Ohio  45505
Cleveland Clinic Cancer Center/Fairview Hospital Cleveland, Ohio  44111
Saint Joseph's Hospital and Medical Center Phoenix, Arizona  85013
Southeast Gynecologic Oncology Associates Jacksonville, Florida  32204
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
Self Regional Healthcare Greenwood, South Carolina  29646
Harrison Poulsbo Hematology and Oncology Poulsbo, Washington  98370
Baylor All Saints Medical Center at Fort Worth Fort Worth, Texas  76104
The Women's Oncology Center Saint Louis, Missouri  63141