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A Randomized Phase III Trial of Three Different Regimens of CPT-11 Plus 5-Fluorouracil and Leucovorin Compared to 5-Fluorouracil and Leucovorin in Patients With Advanced Adenocarcinoma of the Colon and Rectum


Phase 3
18 Years
N/A
Not Enrolling
Both
Colorectal Cancer

Thank you

Trial Information

A Randomized Phase III Trial of Three Different Regimens of CPT-11 Plus 5-Fluorouracil and Leucovorin Compared to 5-Fluorouracil and Leucovorin in Patients With Advanced Adenocarcinoma of the Colon and Rectum


OBJECTIVES:

- Compare the time to progression in patients with locally advanced, locally recurrent,
or metastatic colorectal adenocarcinoma treated with combinations of oxaliplatin,
fluorouracil, leucovorin calcium, and irinotecan.

- Compare the quality of life, response rate, time to treatment failure, and overall
survival in patients treated with these regimens.

- Compare the toxicity of these regimens in these patients.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to ECOG
performance status (0-1 vs 2), prior adjuvant chemotherapy (yes vs no), prior immunotherapy
(yes vs no), and age (under 65 vs 65 and over). Patients are randomized to one of three
treatment arms.

Only arm II remains open to accrual.

- Arm I (Saltz regimen): Patients receive irinotecan IV over 90 minutes followed by
leucovorin calcium IV over 15 minutes and fluorouracil IV once a week for 4 weeks
followed by 2 weeks of rest. Courses repeat every 6 weeks. (Arm I closed to accrual as
of March 15, 2002.)

- Arm II (FOLFOX4 regimen): Patients receive oxaliplatin IV over 2 hours on day 1 and
leucovorin calcium IV over 2 hours plus fluorouracil IV over 22 hours on days 1 and 2.
Courses repeat every 2 weeks.

- Arm III (oxaliplatin plus irinotecan): Patients receive oxaliplatin IV over 2 hours and
irinotecan IV over 30 minutes on day 1. Courses repeat every 3 weeks. (Arm III closed
to accrual as of March 15, 2002.) Treatment continues in the absence of disease
progression or unacceptable toxicity.

Quality of life is assessed before treatment, during treatment (arm specific), and after
completion of treatment.

Patients are followed every 3 months for 1 year, every 6 months for 2 years, and then
annually thereafter.

PROJECTED ACCRUAL: A total of 825 patients (275 per arm) have been accrued for this study
thus far. Additional patients are being accrued on arm II. (Arms I and III closed to accrual
as of March 15, 2002.)

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed locally advanced, locally recurrent, or
metastatic colorectal adenocarcinoma not curable by surgery or radiotherapy

- Histological or cytological requirement waived in patients who developed
radiological or clinical evidence of metastatic cancer after a prior surgical
resection unless:

- More than 5 years has elapsed since primary surgery OR

- Primary cancer was stage I or II

- Site of primary lesion must be or have been confirmed endoscopically, radiologically,
or surgically to be or have been in the large bowel

- Measurable or evaluable disease

- No CNS metastases or carcinomatous meningitis

PATIENT CHARACTERISTICS:

Age:

- 18 and over

Performance status:

- ECOG 0-2

Life expectancy:

- At least 12 weeks

Hematopoietic:

- Absolute granulocyte count at least 1,500/mm^3

- Platelet count at least 100,000/mm^3

- Hemoglobin at least 9.0 g/dL (transfusion allowed)

Hepatic:

- Bilirubin no greater than 1.5 mg/dL

- AST no greater than 5 times upper limit of normal (ULN)

- Alkaline phosphatase no greater than 5 times ULN

Renal:

- Creatinine no greater than 1.5 times ULN

Cardiovascular:

- No uncontrolled hypertension

- No unstable angina

- No symptomatic congestive heart failure

- No myocardial infarction within the past 6 months

- No serious uncontrolled arrhythmia

- No New York Heart Association class III or IV cardiac disease

Pulmonary:

- No interstitial pneumonia or extensive and symptomatic interstitial fibrosis of the
lung

- No pleural effusion or ascites that cause respiratory compromise (grade 2 or worse
dyspnea)

Other:

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- No active or uncontrolled infection

- No symptomatic sensory peripheral neuropathy

- No known allergy to platinum compounds

- No history of gastrointestinal bleeding unless it is determined to be acceptable by
the enrolling physician

- No other prior or concurrent malignancy within the past 3 years except nonmelanoma
skin cancer, carcinoma in situ of the uterine cervix, or other resected malignant
tumor with less than a 10% probability of tumor relapse within 3 years of diagnosis

- No medical or psychiatric conditions that would preclude study

- No colonic or small bowel disorders with uncontrolled symptoms of more than 3 loose
stools per day

- Colostomy or ileostomy allowed at investigator's discretion

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- Prior adjuvant immunotherapy for resected stage II-IV disease allowed if adjuvant
therapy concluded at least 1 year before documentation of recurrent disease

- No concurrent sargramostim (GM-CSF)

Chemotherapy:

- No prior chemotherapy for advanced colorectal cancer

- No prior standard adjuvant chemotherapy for rectal cancer

- Prior adjuvant fluorouracil for resected stage II-IV disease allowed if adjuvant
therapy concluded at least 1 year before documentation of recurrent disease

Endocrine therapy:

- Not specified

Radiotherapy:

- See Disease Characteristics

- At least 4 weeks since prior major radiotherapy (e.g., chest or bone palliative
radiotherapy)

- No prior radiotherapy to more than 15% of bone marrow

- No prior standard adjuvant radiotherapy for rectal cancer

Surgery:

- See Disease Characteristics

- At least 4 weeks since prior major surgery (e.g., laparotomy) (2 weeks for minor
surgery) and recovered

- Insertion of a vascular access device not considered major or minor surgery

Other:

- No other concurrent investigational agents

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Primary Purpose: Treatment

Principal Investigator

Henry C. Pitot, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Mayo Clinic

Authority:

United States: Federal Government

Study ID:

CDR0000066665

NCT ID:

NCT00003594

Start Date:

October 1998

Completion Date:

Related Keywords:

  • Colorectal Cancer
  • stage III colon cancer
  • stage IV colon cancer
  • stage III rectal cancer
  • stage IV rectal cancer
  • recurrent colon cancer
  • recurrent rectal cancer
  • adenocarcinoma of the colon
  • adenocarcinoma of the rectum
  • Adenocarcinoma
  • Colorectal Neoplasms
  • Colonic Neoplasms

Name

Location

Akron City Hospital Akron, Ohio  44304
Arizona Cancer Center Tucson, Arizona  85724
Memorial Sloan-Kettering Cancer Center New York, New York  10021
Albert Einstein Comprehensive Cancer Center Bronx, New York  10461
University of Michigan Comprehensive Cancer Center Ann Arbor, Michigan  48109-0752
Mayo Clinic Scottsdale Scottsdale, Arizona  85259
Mayo Clinic Cancer Center Rochester, Minnesota  55905
Jonsson Comprehensive Cancer Center, UCLA Los Angeles, California  90095-1781
Chao Family Comprehensive Cancer Center Orange, California  92868
Stanford University Medical Center Stanford, California  94305-5408
University of Colorado Cancer Center Denver, Colorado  80262
Walter Reed Army Medical Center Washington, District of Columbia  20307-5000
H. Lee Moffitt Cancer Center and Research Institute Tampa, Florida  33612
Emory University Hospital - Atlanta Atlanta, Georgia  30322
University of Chicago Cancer Research Center Chicago, Illinois  60637
Albert B. Chandler Medical Center, University of Kentucky Lexington, Kentucky  40536-0084
University of Massachusetts Memorial Medical Center Worcester, Massachusetts  01655
Barbara Ann Karmanos Cancer Institute Detroit, Michigan  48201
University of Minnesota Cancer Center Minneapolis, Minnesota  55455
University of Mississippi Medical Center Jackson, Mississippi  39216-4505
Lineberger Comprehensive Cancer Center, UNC Chapel Hill, North Carolina  27599-7295
Duke Comprehensive Cancer Center Durham, North Carolina  27710
Barrett Cancer Center, The University Hospital Cincinnati, Ohio  45219
Ireland Cancer Center Cleveland, Ohio  44106-5065
Arthur G. James Cancer Hospital - Ohio State University Columbus, Ohio  43210
University of Pennsylvania Cancer Center Philadelphia, Pennsylvania  19104
CCOP - Upstate Carolina Spartanburg, South Carolina  29303
Robert H. Lurie Comprehensive Cancer Center, Northwestern University Chicago, Illinois  60611
University of California Davis Medical Center Sacramento, California  95817
CCOP - Wichita Wichita, Kansas  67214-3882
Rhode Island Hospital Providence, Rhode Island  02903
University of Texas Health Science Center at San Antonio San Antonio, Texas  78284-7811
Vermont Cancer Center Burlington, Vermont  05401-3498
CCOP - Greater Phoenix Phoenix, Arizona  85006-2726
CCOP - Atlanta Regional Atlanta, Georgia  30342-1701
CCOP - Kansas City Kansas City, Missouri  64131
CCOP - Southern Nevada Cancer Research Foundation Las Vegas, Nevada  89106
University of California San Diego Cancer Center La Jolla, California  92093-0658
UCSF Cancer Center and Cancer Research Institute San Francisco, California  94115-0128
CCOP - Christiana Care Health Services Wilmington, Delaware  19899
CCOP - Mount Sinai Medical Center Miami Beach, Florida  33140
Ellis Fischel Cancer Center - Columbia Columbia, Missouri  65203
Barnes-Jewish Hospital Saint Louis, Missouri  63110
Norris Cotton Cancer Center Lebanon, New Hampshire  03756
CCOP - North Shore University Hospital Manhasset, New York  11030
State University of New York - Upstate Medical University Syracuse, New York  13210
CCOP - Southeast Cancer Control Consortium Winston-Salem, North Carolina  27104-4241
University of Tennessee, Memphis Cancer Center Memphis, Tennessee  38103
MBCCOP - Massey Cancer Center Richmond, Virginia  23298-0037
Mount Sinai Medical Center, NY New York, New York  10029
CCOP - Colorado Cancer Research Program, Inc. Denver, Colorado  80209-5031
Veterans Affairs Medical Center - Atlanta (Decatur) Decatur, Georgia  30033
New England Medical Center Hospital Boston, Massachusetts  02111
CCOP - Metro-Minnesota Saint Louis Park, Minnesota  55416
Hahnemann University Hospital Philadelphia, Pennsylvania  19102-1192
Bergan Mercy Medical Center Omaha, Nebraska  68124
Porter Adventist Hospital Denver, Colorado  80210
St. Joseph Hospital Denver, Colorado  80218
Swedish Medical Center Englewood, Colorado  80110
Hinsdale Hematology Oncology Associates Hinsdale, Illinois  60521
Cedar Rapids Oncology Associates Cedar Rapids, Iowa  52403
Mercy Medical Center - Sioux City Sioux City, Iowa  51104
St. Luke's Regional Medical Center Sioux City, Iowa  51104
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
Fairview Ridges Hospital Burnsville, Minnesota  55337
Hutchinson Area Health Care Hutchinson, Minnesota  55350
Meeker County Memorial Hospital Lichfield, Minnesota  55355
Hennepin County Medical Center - Minneapolis Minneapolis, Minnesota  55415
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
St. Rita's Medical Center Lima, Ohio  45801
Geisinger Medical Center Danville, Pennsylvania  17822-0001
Avera Cancer Institute Sioux Falls, South Dakota  57105
Loyola University Medical Center Maywood, Illinois  60153
Siouxland Hematology-Oncology Sioux City, Iowa  51101-1733
New York Presbyterian Hospital - Cornell Campus New York, New York  10021
CCOP - Merit Care Hospital Fargo, North Dakota  58122
Altru Health Systems Grand Forks, North Dakota  58201
Rapid City Regional Hospital Rapid City, South Dakota  57709
Holden Comprehensive Cancer Center at The University of Iowa Iowa City, Iowa  52242-1009
Comprehensive Cancer Center at Wake Forest University Winston-Salem, North Carolina  27157-1082
NYU School of Medicine's Kaplan Comprehensive Cancer Center New York, New York  10016
Henry Ford Hospital Detroit, Michigan  48202
Huntsman Cancer Institute Salt Lake City, Utah  84112
Medical College of Wisconsin Milwaukee, Wisconsin  53226
Veterans Affairs Medical Center - Birmingham Birmingham, Alabama  35233
Veterans Affairs Medical Center - Long Beach Long Beach, California  90822
Veterans Affairs Outpatient Clinic - Martinez Martinez, California  94553
CCOP - Bay Area Tumor Institute Oakland, California  94609-3305
CCOP - Santa Rosa Memorial Hospital Santa Rosa, California  95403
David Grant Medical Center Travis Air Force Base, California  94535
Ingalls Memorial Hospital Harvey, Illinois  60426
Methodist Medical Center of Illinois Peoria, Illinois  61636
CCOP - Central Illinois Springfield, Illinois  62526
Veterans Affairs Medical Center - Lexington Lexington, Kentucky  40511-1093
Tulane University School of Medicine New Orleans, Louisiana  70112
Veterans Affairs Medical Center - Boston (Jamaica Plain) Jamaica Plain, Massachusetts  02130
Veterans Affairs Medical Center - Ann Arbor Ann Arbor, Michigan  48105
St. Mary's Medical Center Saginaw, Michigan  48601
St. Louis University Health Sciences Center Saint Louis, Missouri  63110-0250
CCOP - Cancer Research for the Ozarks Springfield, Missouri  65807
CCOP - Montana Cancer Consortium Billings, Montana  59101
St. Francis Medical Center Trenton, New Jersey  08629
Meritcare Roger Maris Cancer Center Fargo, North Dakota  58122
CCOP - Columbus Columbus, Ohio  43206
Veterans Affairs Medical Center - Dayton Dayton, Ohio  45428
CCOP - Dayton Kettering, Ohio  45429
CCOP - Columbia River Program Portland, Oregon  97213
Lehigh Valley Hospital Allentown, Pennsylvania  18103
Delaware County Memorial Hospital Drexel Hill, Pennsylvania  19026
Albert Einstein Cancer Center Philadelphia, Pennsylvania  19141
Reading Hospital and Medical Center Reading, Pennsylvania  19612-6052
Mercy Hospital Cancer Center - Scranton Scranton, Pennsylvania  18501
CCOP - Greenville Greenville, South Carolina  29615
University of Texas Medical Branch Galveston, Texas  77555-1329
Veterans Affairs Medical Center - White River Junction White River Junction, Vermont  05009
Swedish Cancer Institute Seattle, Washington  98104
St. Vincent Hospital Green Bay, Wisconsin  54307-3508
Veterans Affairs Medical Center - Madison Madison, Wisconsin  53705
University of Wisconsin Comprehensive Cancer Center Madison, Wisconsin  53792
Veterans Affairs Medical Center - Milwaukee (Zablocki) Milwaukee, Wisconsin  53295
Waukesha Memorial Hospital Waukesha, Wisconsin  53188
CCOP - Evanston Evanston, Illinois  60201
MBCCOP - University of New Mexico HSC Albuquerque, New Mexico  87131
CCOP - Scott and White Hospital Temple, Texas  76508
Veterans Affairs Medical Center - Lakeside Chicago Chicago, Illinois  60611
Veterans Affairs Medical Center - New York New York, New York  10010
CCOP - Marshfield Medical Research and Education Foundation Marshfield, Wisconsin  54449
Dana-Farber Cancer Institute Boston, Massachusetts  02115
Baptist Regional Cancer Institute - Jacksonville Jacksonville, Florida  32207
Cancer Research Center of Hawaii Honolulu, Hawaii  96813
Virginia Piper Cancer Institute Minneapolis, Minnesota  55407
Cleveland Clinic Taussig Cancer Center Cleveland, Ohio  44195
MBCCOP - Gulf Coast Mobile, Alabama  36688
Veterans Affairs Medical Center - Tucson Tucson, Arizona  85723
University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
Veterans Affairs Medical Center - Little Rock (McClellan) Little Rock, Arkansas  72205
Cancer Center and Beckman Research Institute, City of Hope Duarte, California  91010-3000
Veterans Affairs Medical Center - West Los Angeles Los Angeles, California  90073
USC/Norris Comprehensive Cancer Center and Hospital Los Angeles, California  90033-0804
Veterans Affairs Medical Center - Denver Denver, Colorado  80220
Dwight David Eisenhower Army Medical Center Fort Gordon, Georgia  30905-5650
Veterans Affairs Medical Center - Chicago (Westside Hospital) Chicago, Illinois  60612
Veterans Affairs Medical Center - Hines (Hines Junior VA Hospital) Hines, Illinois  60141
University of Kansas Medical Center Kansas City, Kansas  66160-7353
Veterans Affairs Medical Center - Wichita Wichita, Kansas  67218
MBCCOP - LSU Health Sciences Center New Orleans, Louisiana  70112
Louisiana State University Health Sciences Center - Shreveport Shreveport, Louisiana  71130-3932
Veterans Affairs Medical Center - Shreveport Shreveport, Louisiana  71130
Boston Medical Center Boston, Massachusetts  02118
Veterans Affairs Medical Center - Detroit Detroit, Michigan  48201-1932
Providence Hospital - Southfield Southfield, Michigan  48075-9975
Veterans Affairs Medical Center - Biloxi Biloxi, Mississippi  39531-2410
Veterans Affairs Medical Center - Jackson Jackson, Mississippi  39216
Keesler Medical Center - Keesler AFB Keesler AFB, Mississippi  39534-2576
Veterans Affairs Medical Center - Kansas City Kansas City, Missouri  64128
CCOP - St. Louis-Cape Girardeau Saint Louis, Missouri  63141
Veterans Affairs Medical Center - Albuquerque Albuquerque, New Mexico  87108-5138
Herbert Irving Comprehensive Cancer Center New York, New York  10032
Veterans Affairs Medical Center - Cincinnati Cincinnati, Ohio  45220-2288
Oklahoma Medical Research Foundation Oklahoma City, Oklahoma  73104
Veterans Affairs Medical Center - Oklahoma City Oklahoma City, Oklahoma  73104
Veterans Affairs Medical Center - Portland Portland, Oregon  97207
Brooke Army Medical Center Fort Sam Houston, Texas  78234-6200
Veterans Affairs Medical Center - San Antonio (Murphy) San Antonio, Texas  78284
Veterans Affairs Medical Center - Temple Temple, Texas  76504
Veterans Affairs Medical Center - Salt Lake City Salt Lake City, Utah  84148
CCOP - Virginia Mason Research Center Seattle, Washington  98101
Veterans Affairs Medical Center - Seattle Seattle, Washington  98108
CCOP - Northwest Tacoma, Washington  98405-0986
Madigan Army Medical Center Tacoma, Washington  98431-5048
Veterans Affairs Medical Center - Phoenix (Hayden) Phoenix, Arizona  85012
CCOP - Grand Rapids Clinical Oncology Program Grand Rapids, Michigan  49503
Veterans Affairs Medical Center - San Francisco San Francisco, California  94121
CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C. Syracuse, New York  13217
Aultman Cancer Center Canton, Ohio  44710
CCOP - Oklahoma Tulsa, Oklahoma  74136
Oregon Cancer Center Portland, Oregon  97201-3098
Veterans Affairs Medical Center - Memphis Memphis, Tennessee  38104
Veterans Affairs Medical Center - Richmond Richmond, Virginia  23249
Trinitas Hospital - Jersey Street Campus Elizabeth, New Jersey  07201
South Jersey Regional Cancer Center Millville, New Jersey  08332
Fox Chase Cancer Center at Virtua Memorial Hospital Burlington County Mount Holly, New Jersey  08060
Cancer Institute of New Jersey New Brunswick, New Jersey  08901
Veterans Affairs Medical Center - Togus Togus, Maine  04330
Veterans Affairs Medical Center - Minneapolis Minneapolis, Minnesota  55417
Veterans Affairs Medical Center - Columbia (Truman Memorial) Columbia, Missouri  65201
University of Nebraska Medical Center Omaha, Nebraska  68198-3330
Hunterdon Regional Cancer Center Flemington, New Jersey  08822
Veterans Affairs Medical Center - Buffalo Buffalo, New York  14215
Veterans Affairs Medical Center - Syracuse Syracuse, New York  13210
Veterans Affairs Medical Center - Durham Durham, North Carolina  27705
Veterans Affairs Medical Center - Palo Alto Palo Alto, California  94304
Via Christi Regional Medical Center Wichita, Kansas  67214
St. John Hospital and Medical Center Detroit, Michigan  48236
Iowa Methodist Medical Center Des Moines, Iowa  50309
Mercy Medical Center Des Moines, Iowa  50314
Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
Alegent Health-Midlands Community Hospital Papillion, Nebraska  68128-4157
Presbyterian-St Luke's Medical Center Denver, Colorado  80218
University of Connecticut Health Center Farmington, Connecticut  06360-7106
St. Vincent Mercy Medical Center Toledo, Ohio  43608
Sioux Valley Hospital Sioux Falls, South Dakota  57117
Gundersen Lutheran Medical Center La Crosse, Wisconsin  54601
Creighton University Cancer Center Omaha, Nebraska  68131-2197
St. Mary's/Duluth Clinic Health System Duluth, Minnesota  55805
New Britain General Hospital New Britain, Connecticut  06050
Toledo Hospital Toledo, Ohio  43606
Chester County Hospital West Chester, Pennsylvania  19380
Oncology Institute of Greater Lafayette Lafayette, Indiana  47904
Hematology Oncology Associates of the Quad Cities Bettendorf, Iowa  52722
Cancer Center of Kansas - Chanute Chanute, Kansas  66720
Cancer Center of Kansas - Dodge City Dodge City, Kansas  67801
Cancer Center of Kansas - Kingman Kingman, Kansas  67068
Cancer Center of Kansas - Newton Newton, Kansas  67114
Pratt Cancer Center of Kansas Pratt, Kansas  67124
Cancer Center of Kansas - Salina Salina, Kansas  67042
Cancer Center of Kansas - Wellington Wellington, Kansas  67152
Cancer Center of Kansas - Winfield Winfield, Kansas  67156
Avera McKennan Hospital and University Health Center Sioux Falls, South Dakota  57105
Duluth Clinic Duluth, Minnesota  55805
Riverview Medical Center - Booker Cancer Center Red Bank, New Jersey  07701
Schneider Children's Hospital at North Shore Manhasset, New York  11030
Mayo Clinic Jacksonville, Florida  32224
Medcenter One Health System Bismarck, North Dakota  58501
Oncology/Hematology Associates of Central Illinois, P.C. Peoria, Illinois  61602
Meriter Hospital Madison, Wisconsin  53715
Saint Mary Regional Center Langhorne, Pennsylvania  19047
CentraCare Health Plaza Saint Cloud, Minnesota  56303
St. Francis Hospital and Medical Center Hartford, Connecticut  06105
Rochester General Hospital Rochester, New York  14621
Hematology Oncology Associates - Skokie Skokie, Illinois  60076
Poudre Valley Hospital Fort Collins, Colorado  80524
St. Mary-Corwin Regional Medical Center Pueblo, Colorado  81004
Memorial Hospital Carthage, Illinois  62321
Mercy Hospital and Medical Center Chicago, Illinois  60616
Galesburg Cottage Hospital Galesburg, Illinois  61401
Galesburg Clinic Galesburg, Illinois  61401
InterCommunity Cancer Center of Western Illinois Galesburg, Illinois  61401
Mason District Hospital Havana, Illinois  62644
Kewanee Hospital Kewanee, Illinois  61443
McDonough District Hospital Macomb, Illinois  61455
BroMenn Regional Medical Center Normal, Illinois  61761
Community Cancer Center Normal, Illinois  61761
Community Hospital of Ottawa Ottawa, Illinois  61350
Proctor Hospital Peoria, Illinois  61614
Illinois Valley Community Hospital Peru, Illinois  61354
Perry Memorial Hospital Princeton, Illinois  61356
St. Margaret's Hospital Spring Valley, Illinois  61362
Valley Cancer Center Spring Valley, Illinois  61362
St. Luke's Hospital Cedar Rapids, Iowa  52402
Burgess Health Center Onawa, Iowa  51040
Community Cancer Center of Monroe Monroe, Michigan  48162
Brainerd Medical Center Brainerd, Minnesota  56401
St. Joseph's Medical Center Brainerd, Minnesota  56401
St. Elizabeth Regional Medical Center Lincoln, Nebraska  68510
Bismarck Cancer Center Bismarck, North Dakota  58501
St. Alexius Medical Center Bismarck, North Dakota  58502
Wood County Oncology Center Bowling Green, Ohio  43402
Fremont Memorial Hospital Fremont, Ohio  43420
Lima Memorial Hospital Lima, Ohio  45804
Firelands Regional Medical Center Sandusky, Ohio  44870
Fulton County Health Center Wauseon, Ohio  43567
Veterans Affairs Medical Center - Omaha Omaha, Nebraska  68105
Illinois Oncology Research Association Peoria, Illinois  61602
North Memorial Research Center Minneapolis, Minnesota  55442-2900
University of Florida - Gainesville Gainesville, Florida  32610-0277
Eureka Hospital Eureka, Illinois  61530
Mercy Hospital Coon Rapids, Minnesota  55433
Park Nicollet Clinic St. Louis Park, Minnesota  55416
Mayo Clinic Hospital Phoenix, Arizona  85054-4502
Community Hospital of the Monterey Peninsula Monterey, California  93940
Columbia Medical Center of Aurora North Campus Aurora, Colorado  80011
Penrose Cancer Center Colorado Springs, Colorado  80933
HealthOne Rose Medical Center Denver, Colorado  80220
Rocky Mountain Cancer Centers - Northern Colorado Fort Collins, Colorado  80524-4038
Poudre Valley Radiation Oncology Fort Collins, Colorado  80528
Bristol Hospital Bristol, Connecticut  06011-0977
Lawrence and Memorial Hospital New London, Connecticut  06320
William W. Backus Hospital Norwich, Connecticut  06360
Northwestern Connecticut Oncology-Hematology Associates Torrington, Connecticut  06790
University of Florida Health Science Center - Jacksonville Jacksonville, Florida  32209
Grady Memorial Hospital Atlanta, Georgia  30335
BroMenn Lifecare Center Bloomington, Illinois  61701-3081
St. Joseph's Hospital Medical Center Bloomington, Illinois  61701
Graham Hospital Association Canton, Illinois  61520
Hematology-Oncology Associates of Illinois Chicago, Illinois  60611-2998
Hematology Oncology Associates of Illinois - Lake Shore Dr Chicago, Illinois  60611
Holy Family Medical Center Des Plaines, Illinois  60016
St. Anthony's Memorial Hospital Effingham, Illinois  62401
Northwest Oncology and Hematology, S.C. Elk Grove Village, Illinois  60007
Glenbrook Hospital Glenview, Illinois  60025
Hematology Oncology Associates of Illinois-Highland Park Highland Park, Illinois  60035
Hopedale Medical Complex Hospital Hopedale, Illinois  61747
Joliet Oncology/Hematology Associates, Ltd. Joliet, Illinois  60435
Silver Cross Hospital Joliet, Illinois  60432
Saint Joseph Medical Center Joliet, Illinois  60435
Deerpath Medical Associates Lake Forest, Illinois  60045
North Shore Oncology Hematology Associates Libertyville, Illinois  60048
Hematology/Oncology Associates of Illinois, LLC Melrose Park, Illinois  60160
Mendota Community Hospital Mendota, Illinois  61342
Trinity Medical Center Moline, Illinois  61265-1291
Morris Hospital Morris, Illinois  60450
Hematology Oncology Associates of Illinois, LLC Oak Park, Illinois  60304
Pekin Hospital Pekin, Illinois  61554
Midwest Radiation Oncology Physicians Peoria, Illinois  61636
Peoria Urological Associates Peoria, Illinois  61614
Midwest Urological Group Peoria, Illinois  61603
Affiliated Urology Specialists Peoria, Illinois  61603
St. Francis Medical Center Peoria, Illinois  61637
St. James Hospital Pontiac, Illinois  61764
Swedish-American Health System Rockford, Illinois  61104-2315
Sarah D. Culbertson Memorial Hospital Rushville, Illinois  62681
Midwest Cancer Research Group, Inc. Skokie, Illinois  60077
Edward H. Kaplan MD and Associates Skokie, Illinois  60076
Carle Foundation Hospital Urbana, Illinois  61801
Carle Cancer Center Urbana, Illinois  61801
Therapy Associates Hematology/Oncology Evansville, Indiana  47715
William R. Bliss Cancer Center Ames, Iowa  50010
McFarland Clinic, P.C. Ames, Iowa  50010
Saint Anthony Regional Hospital Carroll, Iowa  51401
Alegent Health Southwest Iowa Medical Center Council Bluffs, Iowa  51503
Medical Oncology and Hematology Associates Des Moines, Iowa  50309
Mercy Hospital Medical Center Des Moines, Iowa  50314
Des Moines General Hospital Des Moines, Iowa  50309
Mercy Cancer Center Mason City, Iowa  50401
Community Memorial Hospital Missouri Valley, Iowa  51555-1199
Ottumwa Regional Health Center Ottumwa, Iowa  52501
Oncology & Hematology of Ottumwa, PC Ottumwa, Iowa  52501
Cancer Center of Kansas - Arkansas City Arkansas City, Kansas  67005
Radiation Oncology Center Dodge City, Kansas  67801
Halstead Cancer Center of Kansas Halstead, Kansas  67056
Liberal Cancer Center of Kansas Liberal, Kansas  67901
Wichita Clinic Cancer Medicine Associates, P.A. Wichita, Kansas  67208
Associates in Women's Health - Wichita Wichita, Kansas  67208
Cancer Center of Kansas - Wichita Wichita, Kansas  67214
Anne Arundel Medical Center Annapolis, Maryland  21401
Faulkner Hospital Jamaica Plain, Massachusetts  02130
Lawrence Memorial Hospital of Medford/Hallmark Health Systems Medford, Massachusetts  02155
Morton Hospital & Medical Center Taunton, Massachusetts  02780
Bixby Medical Center Adrian, Michigan  49221
Saint Joseph Mercy Hospital Ann Arbor, Michigan  48106
Genesee Regional Medical Center Flint, Michigan  48503
Office of E. Michael Lodish Madison Heights, Michigan  48071-3457
Balcueva Clinic Saginaw, Michigan  48602
Alexandria Clinic Alexandria, Minnesota  56308
Alexandria Radiation Oncology Alexandria, Minnesota  56308
Miller-Dwan Medical Center Duluth, Minnesota  55805
Fairview-Southdale Hospital Edina, Minnesota  55435
Fergus Falls Medical Group Fergus Falls, Minnesota  56537
Mercy/Unity Hospitals Fridley, Minnesota  55432
Duluth Clinic - Hibbing Hibbing, Minnesota  55746
Central Mesabi Medical Center Hibbing, Minnesota  55746
Radiation Therapy Center Hibbing, Minnesota  55746
St. John's Hospital Maplewood, Minnesota  55109
Fairview University Medical Center - Riverside Campus Minneapolis, Minnesota  55454-1395
Abbott-Northwestern Hospital Minneapolis, Minnesota  55407
St. Cloud Hospital Saint Cloud, Minnesota  56303
Regions Hospital Saint Paul, Minnesota  55101
Healtheast Cancer Care Saint Paul, Minnesota  55102
Saint Francis Regional Medical Center Shakopee, Minnesota  55379
Rice Memorial Hospital Willmar, Minnesota  56201
Fremont Area Medical Center Fremont, Nebraska  68025-2387
Williamsburg Radiation Oncology Center Lincoln, Nebraska  68516
Bryan LGH Medical Center Lincoln, Nebraska  68502-3780
Bryan LGH Medical Center East Lincoln, Nebraska  68506
Office of Susan Hansen, M.D. Lincoln, Nebraska  68506
Prairie View Clinic Lincoln, Nebraska  68506-5247
Southeast Nebraska Hematology Lincoln, Nebraska  68516
Southeast Nebreska Hematology-Oncology Consultants, PC Lincoln, Nebraska  68516
Wedgewood Medical Center Lincoln, Nebraska  68510
Alegent Health - Immanuel Medical Center Omaha, Nebraska  68122
St. Joseph Hospital Omaha, Nebraska  68131-2197
Oncology Hematology West, P.C. Omaha, Nebraska  68114
Center for Cancer And Hematologic Disease Cherry Hill, New Jersey  08046
Southern Oncology-Hematology Associates, P.A. Vineland, New Jersey  08360
Comprehensive Cancer and Hematology Associates Voorhees, New Jersey  08043
Burlington County Hematology Oncology Association, P.A. Willingboro, New Jersey  08046
Mary Imogene Bassett Hospital Cooperstown, New York  13326
Mid Dakota Clinic, P.C. Bismarck, North Dakota  58501
Altru Cancer Center Grand Forks, North Dakota  58206
Mercy Ireland Cancer Center Canton, Ohio  44708
Woman Wise Blanchard Valley Regional Health Center Findlay, Ohio  45840
Office of Sharon Cole, M.D. Kenton, Ohio  43326
Saint Luke's Hospital Maumee, Ohio  43537
North West Ohio Oncology Center Maumee, Ohio  43537
St. Charles Hospital Oregon, Ohio  43616
North Coast Cancer Care, Inc. Sandusky, Ohio  44870
Flower Hospital - Pro Medica Health System Sylvania, Ohio  43560
Haematology-Oncology Associates, Inc. Toledo, Ohio  43623-4474
Riverside Hospital Toledo, Ohio  43604
Toledo Clinic, Inc. Toledo, Ohio  43623
MCO Cancer Institute Toledo, Ohio  43614
Medical College of Ohio Hospital Toledo, Ohio  43614-0008
Muhlenberg Hospital Center Bethlehem, Pennsylvania  18017
Marion Community Hospital Carbondale, Pennsylvania  18407
DuBois Regional Medical Center DuBois, Pennsylvania  15801-0447
UPMC Horizon Greenville, Pennsylvania  16125
Pinnacle Health Hospitals Harrisburg, Pennsylvania  17105-8700
Wayne Memorial Hospital Honesdale, Pennsylvania  18431-1498
Conemaugh Memorial Hospital Johnstown, Pennsylvania  15905
UPCI @ UPMC Lee Hospital Johnstown, Pennsylvania  15901
Armstrong County Memorial Hospital Kittanning, Pennsylvania  16201-8808
Lancaster General Hospital Lancaster, Pennsylvania  17604-3555
Latrobe Area Hospital Latrobe, Pennsylvania  15650
Central Pennsylvania Hematology and Medical Oncology Associates Lemoyne, Pennsylvania  17043
Magee-Womens Hospital Pittsburgh, Pennsylvania  15213-3180
UPMC/Passavant Hospital Pittsburgh, Pennsylvania  15237
University of Pittsburgh Medical Center Pittsburgh, Pennsylvania  15213
Pottstown Memorial Regional Cancer Center Pottstown, Pennsylvania  19464
Scranton Hematology-Oncology Scranton, Pennsylvania  18510
Moses Taylor Hospital Scranton, Pennsylvania  18510
Geisinger Medical Group State College, Pennsylvania  16801
Geisinger Wyoming Valley Medical Center Wilkes-Barre, Pennsylvania  18711
Sioux Valley Clinic Sioux Falls, South Dakota  57104
Fox Valley Hematology and Oncology Appleton, Wisconsin  54911
Memorial Medical Center Ashland, Wisconsin  54806
Luther Hospital Eau Claire, Wisconsin  54703
Midelfort Clinic Eau Claire, Wisconsin  54703
Franciscan Skemp Healthcare La Crosse, Wisconsin  54601-4796
Dean Medical Center Madison, Wisconsin  53715
Aurora Sinai Samaritan Medical Center Milwaukee, Wisconsin  53201-0342
Oconomowoc Memorial Hospital Oconomowoc, Wisconsin  53066
UW Cancer Center Wausau Hospital Wausau, Wisconsin  54401