Know Cancer

forgot password

Randomized Phase III Study of Maintenance Therapy With Bevacizumab, Pemetrexed, or a Combination of Bevacizumab and Pemetrexed Following Carboplatin, Paclitaxel and Bevacizumab for Advanced Non-Squamous NSCLC

Phase 3
18 Years
Open (Enrolling)
Lung Cancer

Thank you

Trial Information

Randomized Phase III Study of Maintenance Therapy With Bevacizumab, Pemetrexed, or a Combination of Bevacizumab and Pemetrexed Following Carboplatin, Paclitaxel and Bevacizumab for Advanced Non-Squamous NSCLC



- To compare the overall survival (OS) of patients with advanced non-squamous non-small
cell lung cancer (NSCLC) treated with maintenance therapy with bevacizumab vs
pemetrexed disodium vs bevacizumab and pemetrexed disodium following induction therapy.


- To determine the response rate in patients treated with these regimens.

- To evaluate the progression-free survival (PFS) of patients treated with these

- To define the toxicity of these regimens in these patients.

- To determine the frequency of polymorphisms in VEGF 3578 AA, 1154 AA, ABCB1 G2677TT/AA,
and ERCC-118 TT in patients treated with induction therapy comprising paclitaxel,
carboplatin and bevacizumab and determine the association between genotypes and
response rate.

- To determine the association between bevacizumab and pemetrexed disodium population
pharmacokinetics and patient-specific covariate with bevacizumab or pemetrexed disodium

- To determine the frequency of TSER*3 polymorphisms in NSCLC and the association between
TSER polymorphisms and benefit from pemetrexed disodium.

- To evaluate TS and ERCC1 expression by RT-PCR and MTAP mutations in existing tumor
specimens as a predictor of pemetrexed disodium response.

- To evaluate polymorphisms within CYPs 2C8, 3A4, 3A5 and/or the UGT1A1 collectively or
monogenically as markers for variation in efficacious and/or toxic response of
individuals to treatment with taxanes.

- To explore the association between proteomic profiles and ICAM, VEGF, and FGF-beta with
the clinical outcomes of the study (OS, PFS, and response) (Closed as of 04/01/2010).

- To evaluate the ability of FOX03a to predict first-line treatment outcome in
non-squamous NSCLC.(Closed as of 04/01/2010)

- To evaluate the ability of ADSS1 to predict outcome of pemetrexed maintenance treatment
in non-squamous NSCLC.(Closed as of 04/01/2010)

- To develop proteomic classifiers to identify patient populations that would benefit
from bevacizumab or pemetrexed therapy.(Closed as of 04/01/2010)

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to
gender (male vs female), stage of disease (IIIB-T4Nx [with nodule in ipsilateral lung lobe
and not candidate for combined chemotherapy and radiation] and IV M1a vs IV M1b vs
recurrent), best response to first-time therapy (complete response/partial response vs
stable disease), and smoking status (never vs smoker).

- Induction therapy: Patients receive paclitaxel IV over 3 hours, carboplatin IV over
15-30 minutes, and bevacizumab IV over 30-90 minutes on day 1. Courses repeat every 21
days for 4 courses in the absence of disease progression or unacceptable toxicity.

- Maintenance Therapy: Patients achieving complete response, partial response or stable
disease following induction therapy are randomized to 1 of 3 treatment arms. Treatment
begins within 6 weeks of the last day of induction chemotherapy administration.

- Arm I: Patients receive bevacizumab IV over 30-90 minutes on day 1.

- Arm II: Patients receive pemetrexed disodium IV over 10 minutes on day 1.

- Arm III: Patients receive bevacizumab as in arm I and pemetrexed as in arm II. In
all arms, courses repeat every 21 days in the absence of disease progression or
unacceptable toxicity.

Some patients undergo blood sample collection at baseline and periodically during study for
pharmacokinetics, protein biomarkers, proteomic profiling (closed as of 04/01/10), and other

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

Inclusion Criteria


- Cytologically or histologically confirmed non-small cell lung cancer (NSCLC)

- Predominant non-squamous histology

- NSCLC not otherwise specified allowed

- Mixed tumors are categorized by the predominant cell type

- Must meet 1 of the following criteria:

- Stage IV disease including M1a or M1b stages or recurrent disease

- Stage IIIB (T4NX) disease with ipsilateral lung lobe allowed provided patients
are not candidates for combined chemotherapy or radiotherapy

- Measurable or non-measurable disease as defined by RECIST criteria

- Patient must have an overall stable or better response after 4 courses of induction

- No cavitary lesions in the lungs

- Patients with brain metastasis must have received local therapy to the brain and have
no evidence of progression in the brain for at least 2 weeks from the time of
completion of local therapy, prior to registration


- ECOG performance status 0-1

- Leukocytes ≥ 3,000/mm^3

- ANC ≥ 1,500/mm^3

- Platelet count ≥ 100,000/mm^3

- Total bilirubin ≤ institutional upper limit of normal (ULN)

- AST and ALT ≤ 3 times ULN

- Creatinine ≤ institutional ULN OR creatinine clearance ≥ 60 mL/min

- Urine protein:urine dipstick ≤ 0-1+ (if > 1+, urine protein creatinine ratio must be
< 1)

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must agree to abstain from sexual intercourse or to use adequate
contraceptive methods during and for at least 6 months after completion of study

- No prior malignancy within the past 3 years except superficial melanoma, basal cell
carcinoma, or carcinoma in situ

- No major hemoptysis within the past 4 weeks

- No uncontrolled intercurrent illness including, but not limited to, any of the

- Ongoing or active infection

- Symptomatic congestive heart failure

- Unstable angina pectoris

- Serious cardiac arrhythmia

- Psychiatric illness and/or social situations that would limit compliance with
study requirements

- Patients with hypertension must be adequately controlled (BP < 150/100 mm Hg) with
appropriate anti-hypertensive therapy or diet

- No history of arterial thrombotic events or major bleeding within the past 12 months

- No significant vascular disease (e.g., aortic aneurysm requiring surgical repair or
recent peripheral arterial thrombosis) within the past 6 months

- No significant traumatic injury in the past 3 months

- No clinically significant cardiovascular disease

- No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within
the past 6 months

- No history of serious non-healing wounds, ulcers, or bone fractures


- See Disease Characteristics

- At least 12 months since prior adjuvant chemotherapy

- At least 2 weeks since prior radiotherapy

- Patients must not have had any major surgery such as thoracotomy, laparotomy,
craniotomy, or significant traumatic injury within 6 weeks prior to registration

- Biopsy procedures and chest tube insertion are not considered major surgery for
the purpose of this protocol

- More than 7 days since a core biopsy

- Concurrent therapeutic anti-coagulation allowed

- No prior systemic chemotherapy for advanced stage lung cancer

- No prior paclitaxel, pemetrexed disodium, or bevacizumab

- Prior carboplatin allowed provided it was given as part of adjuvant chemotherapy

- No concurrent anti-retroviral therapy in patients with HIV infection

Type of Study:


Study Design:

Allocation: Randomized, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Overall survival

Safety Issue:


Principal Investigator

Suresh Ramalingam, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Winship Cancer Institute of Emory University



Study ID:




Start Date:

August 2010

Completion Date:

Related Keywords:

  • Lung Cancer
  • recurrent non-small cell lung cancer
  • stage IIIB non-small cell lung cancer
  • stage IV non-small cell lung cancer
  • adenocarcinoma of the lung
  • bronchoalveolar cell lung cancer
  • large cell lung cancer
  • Carcinoma, Non-Small-Cell Lung
  • Lung Neoplasms



Cleveland Clinic Cancer Center Cleveland, Ohio  44195
CCOP - Upstate Carolina Spartanburg, South Carolina  29303
Hurley Medical Center Flint, Michigan  48503
CCOP - Missouri Valley Cancer Consortium Omaha, Nebraska  68131
CCOP - Mount Sinai Medical Center Miami Beach, Florida  33140
Veterans Affairs Medical Center - Atlanta (Decatur) Decatur, Georgia  30033
CCOP - Carle Cancer Center Urbana, Illinois  61801
CCOP - Iowa Oncology Research Association Des Moines, Iowa  50309-1016
CCOP - Metro-Minnesota Saint Louis Park, Minnesota  55416
Veterans Affairs Medical Center - East Orange East Orange, New Jersey  07018-1095
Aurora Presbyterian Hospital Aurora, Colorado  80012
Boulder Community Hospital Boulder, Colorado  80301-9019
Penrose Cancer Center at Penrose Hospital Colorado Springs, Colorado  80933
CCOP - Colorado Cancer Research Program Denver, Colorado  80224-2522
Porter Adventist Hospital Denver, Colorado  80210
Presbyterian - St. Luke's Medical Center Denver, Colorado  80218
St. Joseph Hospital Denver, Colorado  80218
Rose Medical Center Denver, Colorado  80220
Swedish Medical Center Englewood, Colorado  80110
Sky Ridge Medical Center Lone Tree, Colorado  80124
Hope Cancer Care Center at Longmont United Hospital Longmont, Colorado  80502
St. Mary - Corwin Regional Medical Center Pueblo, Colorado  81004
North Suburban Medical Center Thornton, Colorado  80229
George Bray Cancer Center at the Hospital of Central Connecticut - New Britain Campus New Britain, Connecticut  06050
Rush-Copley Cancer Care Center Aurora, Illinois  60507
Hinsdale Hematology Oncology Associates Hinsdale, Illinois  60521
Joliet Oncology-Hematology Associates, Limited - West Joliet, Illinois  60435
Saint Anthony Memorial Health Centers Michigan City, Indiana  46360
Cedar Rapids Oncology Associates Cedar Rapids, Iowa  52403
Mercy Medical Center - Sioux City Sioux City, Iowa  51104
Siouxland Hematology-Oncology Associates, LLP Sioux City, Iowa  51101
St. Luke's Regional Medical Center Sioux City, Iowa  51104
Baystate Regional Cancer Program at D'Amour Center for Cancer Care Springfield, Massachusetts  01199
CCOP - Michigan Cancer Research Consortium Ann Arbor, Michigan  48106
Saint Joseph Mercy Cancer Center Ann Arbor, Michigan  48106-0995
Oakwood Cancer Center at Oakwood Hospital and Medical Center Dearborn, Michigan  48123-2500
Genesys Hurley Cancer Institute Flint, Michigan  48503
Van Elslander Cancer Center at St. John Hospital and Medical Center Grosse Pointe Woods, Michigan  48236
Bronson Methodist Hospital Kalamazoo, Michigan  49007
West Michigan Cancer Center Kalamazoo, Michigan  49007-3731
Borgess Medical Center Kalamazooaa, Michigan  49001
Sparrow Regional Cancer Center Lansing, Michigan  48912-1811
St. John Macomb Hospital Warren, Michigan  48093
MeritCare Bemidji Bemidji, Minnesota  56601
Fairview Ridges Hospital Burnsville, Minnesota  55337
Mercy and Unity Cancer Center at Mercy Hospital Coon Rapids, Minnesota  55433
Duluth Clinic Cancer Center - Duluth Duluth, Minnesota  55805-1983
CCOP - Duluth Duluth, Minnesota  55805
Miller - Dwan Medical Center Duluth, Minnesota  55805
Fairview Southdale Hospital Edina, Minnesota  55435
Mercy and Unity Cancer Center at Unity Hospital Fridley, Minnesota  55432
Hutchinson Area Health Care Hutchinson, Minnesota  55350
HealthEast Cancer Care at St. John's Hospital Maplewood, Minnesota  55109
Hennepin County Medical Center - Minneapolis Minneapolis, Minnesota  55415
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital Minneapolis, Minnesota  55407
St. Francis Cancer Center at St. Francis Medical Center Shakopee, Minnesota  55379
Park Nicollet Cancer Center St. Louis Park, Minnesota  55416
Regions Hospital Cancer Care Center St. Paul, Minnesota  55101
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
MeritCare Broadway Fargo, North Dakota  58122
CCOP - MeritCare Hospital Fargo, North Dakota  58122
Aultman Cancer Center at Aultman Hospital Canton, Ohio  44710-1799
Mercy Cancer Center at Mercy Medical Center Canton, Ohio  44708
Case Comprehensive Cancer Center Cleveland, Ohio  44106-5065
MetroHealth Cancer Care Center at MetroHealth Medical Center Cleveland, Ohio  44109
St. Rita's Medical Center Lima, Ohio  45801
Natalie Warren Bryant Cancer Center at St. Francis Hospital Tulsa, Oklahoma  74136
Geisinger Medical Group - Scenery Park State College, Pennsylvania  16801
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center Wilkes-Barre, Pennsylvania  18711
Sanford Cancer Center at Sanford USD Medical Center Sioux Falls, South Dakota  57117-5039
Avera Cancer Institute Sioux Falls, South Dakota  57105
Vanderbilt-Ingram Cancer Center Nashville, Tennessee  37232-6838
CCOP - Ochsner New Orleans, Louisiana  70121
Rapid City Regional Hospital Rapid City, South Dakota  57709
CCOP - Cancer Research for the Ozarks Springfield, Missouri  65807
CCOP - Montana Cancer Consortium Billings, Montana  59101
Newark Beth Israel Medical Center Newark, New Jersey  07112
CCOP - Dayton Kettering, Ohio  45429
Albert Einstein Cancer Center Philadelphia, Pennsylvania  19141
Mercy Hospital Cancer Center - Scranton Scranton, Pennsylvania  18501
Grand View Hospital Sellersville, Pennsylvania  18960
CCOP - Greenville Greenville, South Carolina  29615
Harrington Cancer Center Amarillo, Texas  79106
Virginia Mason Medical Center Seattle, Washington  98111
UMASS Memorial Cancer Center - University Campus Worcester, Massachusetts  01605-2982
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill Chapel Hill, North Carolina  27599-7570
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia Philadelphia, Pennsylvania  19107
MultiCare Regional Cancer Center at Tacoma General Hospital Tacoma, Washington  98405
Cleveland Clinic Taussig Cancer Center Cleveland, Ohio  44195
MBCCOP - LSU Health Sciences Center New Orleans, Louisiana  70112
CCOP - Virginia Mason Research Center Seattle, Washington  98101
CCOP - Northwest Tacoma, Washington  98405-0986
Sutter Cancer Center Sacramento, California  95816
Peninsula Regional Medical Center Salisbury, Maryland  21801
Monmouth Medical Center Long Branch, New Jersey  07740-6395
Veterans Affairs Medical Center - Palo Alto Palo Alto, California  94304
Veterans Affairs Medical Center - Washington, DC Washington, District of Columbia  20422
Louis A. Weiss Memorial Hospital Chicago, Illinois  60640
West Suburban Center for Cancer Care River Forest, Illinois  60305
John Stoddard Cancer Center at Iowa Methodist Medical Center Des Moines, Iowa  50309
St. Vincent Mercy Medical Center Toledo, Ohio  43608
Bellin Memorial Hospital Green Bay, Wisconsin  54301
Overlook Hospital Summit, New Jersey  07902-0220
Hulston Cancer Center at Cox Medical Center South Springfield, Missouri  65807
St. John's Regional Health Center Springfield, Missouri  65804
Carol G. Simon Cancer Center at Morristown Memorial Hospital Morristown, New Jersey  07962
UMDNJ University Hospital Newark, New Jersey  07103
CCOP - Toledo Community Hospital Toledo, Ohio  43623-3456
Mercy Fitzgerald Hospital Darby, Pennsylvania  19023
Waukesha Memorial Hospital Regional Cancer Center Waukesha, Wisconsin  53188
Broward General Medical Center Cancer Center Ft. Lauderdale, Florida  33316
Florida Hospital Cancer Institute at Florida Hospital Orlando Orlando, Florida  32803-1273
Sacred Heart Cancer Center at Sacred Heart Hospital Pensacola, Florida  32504
Winship Cancer Institute of Emory University Atlanta, Georgia  30322
Ochsner Cancer Institute at Ochsner Clinic Foundation New Orleans, Louisiana  70121
Alvin and Lois Lapidus Cancer Institute at Sinai Hospital Baltimore, Maryland  21215
Albert Einstein Cancer Center at Albert Einstein College of Medicine Bronx, New York  10461
Stony Brook University Cancer Center Stony Brook, New York  11794-8174
Presbyterian Cancer Center at Presbyterian Hospital Charlotte, North Carolina  28233-3549
Medical University of Ohio Cancer Center Toledo, Ohio  43614
Toledo Hospital Toledo, Ohio  43606
Mary Babb Randolph Cancer Center at West Virginia University Hospitals Morgantown, West Virginia  26506
St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54307-3508
McCreery Cancer Center at Ottumwa Regional Ottumwa, Iowa  52501
Green Bay Oncology, Limited - Escanaba Escanaba, Michigan  49431
Dickinson County Healthcare System Iron Mountain, Michigan  49801
Lewistown Hospital Lewistown, Pennsylvania  17044
Mount Nittany Medical Center State College, Pennsylvania  16803
Chester County Hospital West Chester, Pennsylvania  19380
St. Mary's Hospital Medical Center - Green Bay Green Bay, Wisconsin  54303
Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54301-3526
Green Bay Oncology, Limited at St. Mary's Hospital Green Bay, Wisconsin  54303
Bay Area Cancer Care Center at Bay Area Medical Center Marinette, Wisconsin  54143
Green Bay Oncology, Limited - Oconto Falls Oconto Falls, Wisconsin  54154
Green Bay Oncology, Limited - Sturgeon Bay Sturgeon Bay, Wisconsin  54235
Sibley Memorial Hospital Washington, District of Columbia  20016
Hematology Oncology Associates of the Quad Cities Bettendorf, Iowa  52722
Parma Community General Hospital Parma, Ohio  44129
North Colorado Medical Center Greeley, Colorado  80631
McKee Medical Center Loveland, Colorado  80539
Hematology-Oncology Centers of the Northern Rockies - Billings Billings, Montana  59101
St. Peter's Hospital Helena, Montana  59601
Kalispell Regional Medical Center Kalispell, Montana  59901
Glacier Oncology, PLLC Kalispell, Montana  59901
Montana Cancer Center at St. Patrick Hospital and Health Sciences Center Missoula, Montana  59802
Montana Cancer Specialists at Montana Cancer Center Missoula, Montana  59802
Wayne Memorial Hospital, Incorporated Goldsboro, North Carolina  27534
Memorial Cancer Institute at Memorial Regional Hospital Hollywood, Florida  33021
Mountain States Tumor Institute at St. Luke's Regional Medical Center Boise, Idaho  83712-6297
University of Illinois Cancer Center Chicago, Illinois  60612-7243
Swedish-American Regional Cancer Center Rockford, Illinois  61104-2315
CancerCare of Maine at Eastern Maine Medical Center Bangor, Maine  04401
Maimonides Cancer Center at Maimonides Medical Center Brooklyn, New York  11219
Dakota Cancer Institute at Dakota Clinic - South University Fargo, North Dakota  58103-4940
Geisinger Cancer Institute at Geisinger Health Danville, Pennsylvania  17822-0001
M. D. Anderson Cancer Center at University of Texas Houston, Texas  77030-4009
Virginia Commonwealth University Massey Cancer Center Richmond, Virginia  23298-0037
West Virginia University Health Sciences Center - Charleston Charleston, West Virginia  25302
Gundersen Lutheran Center for Cancer and Blood La Crosse, Wisconsin  54601
Robert H. Lurie Comprehensive Cancer Center at Northwestern University Chicago, Illinois  60611
Leonard C. Ferguson Cancer Center Freeport, Illinois  61032
Todd Cancer Institute at Long Beach Memorial Medical Center Long Beach, California  90801
Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
Helen and Harry Gray Cancer Center at Hartford Hospital Hartford, Connecticut  06102-5037
Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton Marlton, New Jersey  08053
Fox Chase Virtua Health Cancer Program at Virtua West Jersey Voorhees, New Jersey  08043
Cleveland Clinic Cancer Center at Fairview Hospital Cleveland, Ohio  44111
Hillcrest Cancer Center at Hillcrest Hospital Mayfield Heights, Ohio  44124
Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest Allentown, Pennsylvania  18105
Fox Chase Cancer Center - Philadelphia Philadelphia, Pennsylvania  19111-2497
Front Range Cancer Specialists Fort Collins, Colorado  80528
Veterans Affairs Medical Center - Chicago Westside Hospital Chicago, Illinois  60612
Hematology Oncology Associates - Skokie Skokie, Illinois  60076
North Bay Cancer Center Fairfield, California  94533
Sutter Cancer Center at Roseville Medical Center Roseville, California  95661
Salinas Valley Memorial Hospital Salinas, California  93901
Poudre Valley Hospital Fort Collins, Colorado  80524
Ella Milbank Foshay Cancer Center at Jupiter Medical Center Jupiter, Florida  33458
Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical Center Boise, Idaho  83706
Swedish Covenant Hospital Chicago, Illinois  60625
Hematology and Oncology Associates Chicago, Illinois  60611
North Shore Oncology and Hematology Associates, Limited - Libertyville Libertyville, Illinois  60048
St. Francis Hospital and Health Centers - Beech Grove Campus Beech Grove, Indiana  46107
St. Luke's Hospital Cedar Rapids, Iowa  52402
Mercy Regional Cancer Center at Mercy Medical Center Cedar Rapids, Iowa  52403
John Stoddard Cancer Center at Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
Medical Oncology and Hematology Associates at John Stoddard Cancer Center Des Moines, Iowa  50309
Medical Oncology and Hematology Associates at Mercy Cancer Center Des Moines, Iowa  50314
Mercy Cancer Center at Mercy Medical Center - Des Moines Des Moines, Iowa  50314
Medical Oncology and Hematology Associates - West Des Moines West Des Moines, Iowa  50266
Mary Bird Perkins Cancer Center - Baton Rouge Baton Rouge, Louisiana  70809
Louisiana State University Health Sciences Center - Monroe Monroe, Louisiana  71210
Medical Center of Louisiana - New Orleans New Orleans, Louisiana  70112
Feist-Weiller Cancer Center at Louisiana State University Health Sciences Shreveport, Louisiana  71130-3932
Sturdy Memorial Hospital Attleboro, Massachusetts  02703
Hickman Cancer Center at Bixby Medical Center Adrian, Michigan  49221
Upper Michigan Cancer Center at Marquette General Hospital Marquette, Michigan  49855
Community Cancer Center of Monroe Monroe, Michigan  48162
St. Joseph's Medical Center Brainerd, Minnesota  56401
Immanuel Medical Center Omaha, Nebraska  68122
Creighton University Medical Center Omaha, Nebraska  68131-2197
Charles R. Wood Cancer Center at Glens Falls Hospital Glens Falls, New York  12801
Iredell Memorial Hospital Statesville, North Carolina  28677
Wood County Oncology Center Bowling Green, Ohio  43402
Samaritan North Cancer Care Center Dayton, Ohio  45415
Grandview Hospital Dayton, Ohio  45405
David L. Rike Cancer Center at Miami Valley Hospital Dayton, Ohio  45409
Good Samaritan Hospital Dayton, Ohio  45406
Blanchard Valley Medical Associates Findlay, Ohio  45840
Charles F. Kettering Memorial Hospital Kettering, Ohio  45429
Lima Memorial Hospital Lima, Ohio  45804
Northwest Ohio Oncology Center Maumee, Ohio  43537
Middletown Regional Hospital Middletown, Ohio  45044
Toledo Clinic - Oregon Oregon, Ohio  43616
St. Charles Mercy Hospital Oregon, Ohio  43616
North Coast Cancer Care, Incorporated Sandusky, Ohio  44870
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Toledo Clinic, Incorporated - Main Clinic Toledo, Ohio  43623
UVMC Cancer Care Center at Upper Valley Medical Center Troy, Ohio  45373-1300
Fulton County Health Center Wauseon, Ohio  43567
Cleveland Clinic - Wooster Wooster, Ohio  44691
Ruth G. McMillan Cancer Center at Greene Memorial Hospital Xenia, Ohio  45385
Bryn Mawr Hospital Bryn Mawr, Pennsylvania  19010
Lankenau Cancer Center at Lankenau Hospital Wynnewood, Pennsylvania  19096
Bon Secours St. Francis Health System Greenville, South Carolina  29601
Oncology Services of Aberdeen Aberdeen, South Dakota  57401
Christine LaGuardia Phillips Cancer Center at Wellmont Holston Valley Medical Center Kingsport, Tennessee  37662
Virginia Oncology Associates - Hampton Hampton, Virginia  23666
Holy Family Memorial Medical Center Cancer Care Center Manitowoc, Wisconsin  54221-1450
Fairbanks Cancer Treatment Center at Fairbanks Memorial Hospital Fairbanks, Alaska  99701
St. Anthony Central Hospital Denver, Colorado  80204-1335
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
St. Francis Hospital Federal Way, Washington  98003
Cascade Cancer Center at Evergreen Hospital Medical Center Kirkland, Washington  98034-3013
St. Clare Hospital Lakewood, Washington  98499-0998
Providence St. Peter Hospital Regional Cancer Center Olympia, Washington  98506
Good Samaritan Cancer Center Puyallup, Washington  98371
Allenmore Hospital Tacoma, Washington  98411-0414
Lancaster General Hospital Lancaster, Pennsylvania  17604-3555
Pearlman Comprehensive Cancer Center at South Georgia Medical Center Valdosta, Georgia  31603
Mercy Cancer Center at Mercy Medical Center - North Iowa Mason City, Iowa  50401
Regional Cancer Center at Singing River Hospital Pascagoula, Mississippi  39581
Missouri Baptist Cancer Center St. Louis, Missouri  63131
Cancer Resource Center - Lincoln Lincoln, Nebraska  68510
Randolph Hospital Asheboro, North Carolina  27203
Moses Cone Regional Cancer Center at Wesley Long Community Hospital Greensboro, North Carolina  27401
Annie Penn Cancer Center Reidsville, North Carolina  27320
Altru Cancer Center at Altru Hospital Grand Forks, North Dakota  58201
St. Joseph Medical Center Reading, Pennsylvania  19604
Stanford Cancer Center Stanford, California  94305-5824
Kaiser Permanente - Denver Denver, Colorado  80205
Kaiser Permanente - Lafayette Lafayette, Colorado  80026
Praxair Cancer Center at Danbury Hospital Danbury, Connecticut  06810
Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital Fort Lauderdale, Florida  33308
Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/Candler Savannah, Georgia  31405
Saint Joseph Hospital Chicago, Illinois  60657
Kellogg Cancer Care Center Highland Park, Illinois  60035
Cancer Care and Hematology Specialists of Chicagoland - Niles Niles, Illinois  60714
Reid Hospital & Health Care Services Richmond, Indiana  47374
McFarland Clinic, PC Ames, Iowa  50010
Covenant Cancer Treatment Center Waterloo, Iowa  50702
Menorah Medical Center Overland Park, Kansas  66209
Saint Luke's Hospital - South Overland Park, Kansas  66213
Ochsner Health Center - Bluebonnet Baton Rouge, Louisiana  70809
Foote Memorial Hospital Jackson, Michigan  49201
St. Mary Mercy Hospital Livonia, Michigan  48154
Mercy Memorial Hospital - Monroe Monroe, Michigan  48162
St. Joseph Mercy Oakland Pontiac, Michigan  48341-2985
Mercy Regional Cancer Center at Mercy Hospital Port Huron, Michigan  48060
Seton Cancer Institute at Saint Mary's - Saginaw Saginaw, Michigan  48601
Willmar Cancer Center at Rice Memorial Hospital Willmar, Minnesota  56201
Heartland Hematology Oncology Associates, Incorporated Kansas City, Missouri  64118
North Kansas City Hospital Kansas City, Missouri  64116
Saint Luke's Cancer Institute at Saint Luke's Hospital Kansas City, Missouri  64111
Research Medical Center Kansas City, Missouri  64132
Saint Luke's East - Lee's Summit Lee's Summit, Missouri  64086
Heartland Regional Medical Center Saint Joseph, Missouri  64506
Saint Joseph Oncology, Incorporated Saint Joseph, Missouri  64507
Billings Clinic - Downtown Billings, Montana  59107-7000
Bozeman Deaconess Cancer Center Bozeman, Montana  59715
St. James Healthcare Cancer Care Butte, Montana  59701
Great Falls Clinic - Main Facility Great Falls, Montana  59405
Sletten Cancer Institute at Benefis Healthcare Great Falls, Montana  59405
Kalispell Medical Oncology at KRMC Kalispell, Montana  59901
Alegant Health Cancer Center at Bergan Mercy Medical Center Omaha, Nebraska  68124
Frederick R. and Betty M. Smith Cancer Treatment Center Sparta, New Jersey  07871
Hematology Oncology Center Elyria, Ohio  44035
Community Cancer Center Elyria, Ohio  44035
Wayne Hospital Greenville, Ohio  45331
Flower Hospital Cancer Center Sylvania, Ohio  43560
St. Anne Mercy Hospital Toledo, Ohio  43623
Cancer Care Associates - Mercy Campus Oklahoma City, Oklahoma  73120
Geisinger Hazleton Cancer Center Hazleton, Pennsylvania  18201
Penn State Hershey Cancer Institute at Milton S. Hershey Medical Center Hershey, Pennsylvania  17033-0850
McGlinn Family Regional Cancer Center at Reading Hospital and Medical Center Reading, Pennsylvania  19612-6052
Guthrie Cancer Center at Guthrie Clinic Sayre Sayre, Pennsylvania  18840
Hematology and Oncology Associates of Northeastern Pennsylvania Scranton, Pennsylvania  18510
Susquehanna Cancer Center at Divine Providence Hospital Williamsport, Pennsylvania  17701
York Cancer Center at Apple Hill Medical Center York, Pennsylvania  17405
Fredericksburg Oncology, Incorporated Fredericksburg, Virginia  22401
Southwest Virginia Regional Cancer Center at Wellmonth Health Norton, Virginia  24273
Providence Centralia Hospital Centralia, Washington  98531-9027
Franciscan Cancer Center at St. Joseph Medical Center Tacoma, Washington  98405-3004
Vince Lombardi Cancer Clinic - Green Bay at Aurora BayCare Medical Center Green Bay, Wisconsin  54311
Vince Lombardi Cancer Clinic - Marinette Marinette, Wisconsin  54143
Vince Lombardi Cancer Clinic - Sheboygan Sheboygan, Wisconsin  53081
Aurora Medical Center Summit, Wisconsin  53066
Vince Lombardi Cancer Clinic - Two Rivers Two Rivers, Wisconsin  54241
Oncology Alliance, SC - Milwaukee - West Wauwatosa, Wisconsin  53226
Rocky Mountain Oncology Casper, Wyoming  82609
Mid Dakota Clinic, PC Bismarck, North Dakota  58501
Auburn Regional Center for Cancer Care Auburn, Washington  98002
Genesys Regional Medical Center Grand Blanc, Michigan  48439-8066
Phoebe Cancer Center at Phoebe Putney Memorial Hospital Albany, Georgia  31702
Good Samaritan Cancer Center at Good Samaritan Hospital Kearney, Nebraska  68848-1990
Pardee Memorial Hospital Hendersonville, North Carolina  28791
Rutherford Hospital Rutherfordton, North Carolina  28139
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center Spartanburg, South Carolina  29303
Community Cancer Center at Rutland Regional Medical Center Rutland, Vermont  05701
Regional Cancer Center at Oconomowoc Memorial Hospital Oconomowoc, Wisconsin  53066
Harold Alfond Center for Cancer Care Augusta, Maine  04330
Kinston Medical Specialists Kinston, North Carolina  28501
Greenville Hospital Cancer Center Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Grove Commons Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Faris Road Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Greer Medical Oncology Greer, South Carolina  29650
Cancer Centers of the Carolinas - Seneca Seneca, South Carolina  29672
Cancer Centers of the Carolinas - Spartanburg Spartanburg, South Carolina  29307
Regional Cancer Center - Erie Erie, Pennsylvania  16505
Resurrection Medical Center Chicago, Illinois  60631
St. Francis Hospital Evanston, Illinois  60202
Frederick Memorial Hospital Regional Cancer Therapy Center Frederick, Maryland  21701
Jordan Hospital Club Cancer Center Plymouth, Massachusetts  02360
St. John's Regional Medical Center Joplin, Missouri  64804
Phelps County Regional Medical Center Rolla, Missouri  65401
Hendrick Cancer Center Abilene, Texas  79601-2316
West Tennessee Cancer Center at Jackson-Madison County General Hospital Jackson, Tennessee  38301
Nalitt Cancer Institute at Staten Island University Hospital Staten Island, New York  10305
La Grange Memorial Hospital La Grange, Illinois  60525
PinnacleHealth Regional Cancer Center at Polyclinic Hospital Harrisburg, Pennsylvania  17105
Rockwood Clinic Cancer Treatment Center Spokane, Washington  99204-2967
University of Wisconcin Cancer Center at Aspirus Wausau Hospital Wausau, Wisconsin  54401
Franklin & Edith Scarpa Regional Cancer Center at South Jersey Healthcare Vineland, New Jersey  08360
Center for Cancer Care at OSF Saint Anthony Medical Center Rockford, Illinois  61108
St. Vincent Healthcare Cancer Care Services Billings, Montana  59101
Providence Medical Center Kansas City, Kansas  66112
Parvin Radiation Oncology Kansas City, Missouri  64116
Elmhurst Memorial Hospital Elmhurst, Illinois  60126
Iowa Blood and Cancer Care Cedar Rapids, Iowa  52402
Mitchell Memorial Cancer Center at Owensboro Medical Health System Owensboro, Kentucky  42303
Faxton Regional Cancer Center Utica, New York  13502
Trinity CancerCare Center Minot, North Dakota  58701
United States Air Force Medical Center - Wright-Patterson Wright-Patterson AFB, Ohio  45433-5529
Riddle Memorial Hospital Cancer Center Media, Pennsylvania  19063
Cancer Center of Paoli Memorial Hospital Paoli, Pennsylvania  19301-1792
CCOP - Main Line Health Wynnewood, Pennsylvania  19096
AnMed Cancer Center Anderson, South Carolina  29621
St. Anthony's Cancer Center St. Louis, Missouri  63128
Medcenter One Hospital Cancer Care Center Bismarck, North Dakota  58501
St. Alexius Medical Center Cancer Center Bismarck, North Dakota  58502
Cleveland Clinic Florida - Weston Weston, Florida  33331
Suniti Medical Corporation Merrillville, Indiana  46410
Oncology Center at St. Joseph Hospital Nashua, New Hampshire  03060
Regional Medical Center Anniston, Alabama  36202
Provena St. Mary's Regional Cancer Center - Kankakee Kankakee, Illinois  60901
Heartland Oncology and Hematology Council Bluffs, Iowa  51503
Ochsner Health Center - Covington Covington, Louisiana  70433
Addison Gilbert Hospital Gloucester, Massachusetts  01930
Immanuel St. Joseph's Mankato, Minnesota  56002
Skaggs Cancer Center at Skaggs Regional Medical Center Branson, Missouri  65616
Mercy Regional Cancer Center Janesville, Wisconsin  53547
Frankford Hospital Cancer Center - Torresdale Campus Philadelphia, Pennsylvania  19114
New Orleans Cancer Institute at Memorial Medical Center New Orleans, Louisiana  70115
Cancer Centers of the Carolinas - Easley Easley, South Carolina  29640
Minnesota Oncology - Maplewood Maplewood, Minnesota  55109
Humphrey Cancer Center at North Memorial Outpatient Center Robbinsdale, Minnesota  55422-2900
Lakeview Hospital Stillwater, Minnesota  55082
Minnesota Oncology - Woodbury Woodbury, Minnesota  55125
Community Hospital of the Monterey Peninsula Comprehensive Cancer Center Monterey, California  93940
Holy Cross Hospital Silver Spring, Maryland  20910
Ephrata Cancer Center at Ephrata Community Hospital Ephrata, Pennsylvania  17522
Clarian Arnett Cancer Care Lafayette, Indiana  47904
Bassett Healthcare Regional Cancer Program at Mary Imogene Bassett Hospital Cooperstown, New York  13326
CCOP - Kansas City Prairie Village, Kansas  66208
Renown Institute for Cancer at Renown Regional Medical Center Reno, Nevada  89502
Kaiser Permanente Mid-Atlantic Medical Group-Largo Medical Facility Largo, Maryland  20774
Vince Lombardi Cancer Clinic - Oshkosh Oshkosh, Wisconsin  54904
Langlade Memorial Hospital Antigo, Wisconsin  54409
Southwest General Health Center Middleburgh Heights, Ohio  44130
UHHS Chagrin Highlands Medical Center Orange Villager, Ohio  44122
UHHS Westlake Medical Center Westlaker, Ohio  44145
Central Dupage Cancer Center Warrenville, Illinois  60555
Regional Cancer Center at Western Maryland Health System - Sacred Heart Campus Cumberland, Maryland  21502
Southeast Cancer Center Cape Girardeau, Missouri  63703
Goldschmidt Cancer Center Jefferson City, Missouri  65109
Lakeside Hospital Omaha, Nebraska  68130
Cleveland Clinic Beachwood Family Health and Surgery Center Beachwood, Ohio  44122
Cleveland Clinic Foundation - Strongsville Strongsville, Ohio  44136
Cancer Care Associates - Norman Norman, Oklahoma  73071
Riverview UW Cancer Center at Riverview Hospital Wisconsin Rapids, Wisconsin  54494
Littleton Adventist Hospital Littleton, Colorado  80122
Parker Adventist Hospital Parker, Colorado  80138
New Ulm Medical Center New Ulm, Minnesota  56073
Roger Maris Cancer Center at MeritCare Hospital Fargo, North Dakota  58122
St. Nicholas Hospital Sheboygan, Wisconsin  53081
North Broward Medical Center Dearfield Beach, Florida  33064-3596
Pacific Medical Center Seattle, Washington  98104
Wheaton Franciscan Cancer Care - St. Joseph Milwaukee, Wisconsin  53210
Saint Luke's Mountain States Tumor Institute Boise, Idaho  83712
Overlake Cancer Center at Overlake Hospital Medical Center Bellevue, Washington  98004
Feather River Hospital Cancer Center Paradise, California  95969
Seacoast Cancer Center at Wentworth - Douglass Hospital Dover, New Hampshire  03820
Saint Luke's Mountain States Tumor Institute - Fruitland Fruitland, Idaho  83619
Mountain States Tumor Institute - Meridian Meridian, Idaho  83642
Mountain States Tumor Institute at St. Luke's Twin Falls, Idaho  83301
Central Care Cancer Center at Carrie J. Babb Cancer Center Bolivar, Missouri  65613
Adams Cancer Center Gettysburg, Pennsylvania  17325
Cherry Tree Cancer Center Hanover, Pennsylvania  17331
Providence Regional Cancer Partnership Everett, Washington  98201
Kaiser Permanente at Capitol Hill Medical Center Washington, District of Columbia  20002
Kaiser Permanente at Woodlawn Medical Center Baltimore, Maryland  21244
Kaiser Permanente - Gaithersburg Medical Center Gaithersburg, Maryland  20879
Dickstein Cancer Treatment Center at White Plains Hospital Center White Plains, New York  10601
St. Joseph Regional Medical Center Lewiston, Idaho  83501
Mercy Clinic Cancer and Hematology - Rolla Rolla, Missouri  65401
Fox Chase Cancer Center Buckingham Furlong, Pennsylvania  18925
D.N. Greenwald Center Mukwonago, Wisconsin  53149
Sacred Heart Medical Oncology Pensacola, Florida  32504
Mercy Cancer Center - West Lakes Clive, Iowa  50325
Methodist West Hospital West Des Moines, Iowa  50266-7700
Delnor Hospital - Geneva Geneva, Illinois  60134
Kaiser Permanente Tysons Corner Medical Center McLean, Virginia  22102
Iris V. Henderson Cancer Center at Mercy Hospital of Philadelphia Philadelphia, Pennsylvania  19143