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A Comparative Randomized Study of Standard Doxorubicin and Cyclophosphamide Followed by Weekly Paclitaxel Vs. Weekly Doxorubicin and Daily Oral Cyclophosphamide Plus G-CSF Followed by Weekly Paclitaxel As Neoadjuvant Therapy For Inflammatory and Locally Advanced Breast Cancer


Phase 3
18 Years
N/A
Not Enrolling
Female
Breast Cancer

Thank you

Trial Information

A Comparative Randomized Study of Standard Doxorubicin and Cyclophosphamide Followed by Weekly Paclitaxel Vs. Weekly Doxorubicin and Daily Oral Cyclophosphamide Plus G-CSF Followed by Weekly Paclitaxel As Neoadjuvant Therapy For Inflammatory and Locally Advanced Breast Cancer


OBJECTIVES:

- Compare the microscopic pathologic response rates in women with inflammatory or locally
advanced breast cancer treated with standard neoadjuvant doxorubicin and
cyclophosphamide followed by weekly paclitaxel vs weekly doxorubicin and daily oral
cyclophosphamide with filgrastim (G-CSF) followed by weekly paclitaxel.

- Compare the toxic effects of these regimens in this patient population.

- Compare the delivered dose intensity of these regimens in this patient population.

- Evaluate the association between microscopic pathologic complete response and clinical
complete response at the primary tumor site in these patients.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to
disease status (inflammatory vs other). Patients are randomized to one of two treatment
arms.

- Arm I: Patients receive doxorubicin IV followed by cyclophosphamide IV on day 1.
Treatment repeats every 21 days for a total of 5 courses in the absence of disease
progression or unacceptable toxicity. Three weeks after completion of doxorubicin and
cyclophosphamide, patients receive paclitaxel IV over 1 hour weekly on day 1 for a
total of 12 weeks.

- Arm II: Patients receive doxorubicin IV on day 1, oral cyclophosphamide on days 1-7,
and filgrastim (G-CSF) subcutaneously on days 2-7. Treatment repeats weekly for a total
of 15 courses of doxorubicin and cyclophosphamide and 16 courses of G-CSF in the
absence of disease progression or unacceptable toxicity. One week after completion of
G-CSF, patients receive paclitaxel as in arm I.

Within 3-6 weeks after completion of chemotherapy, patients with stable or responsive
disease undergo surgical resection of tumor and affected nodes.

After surgery, patients may receive radiotherapy or additional chemotherapy and/or hormonal
therapy at the discretion of the treating physician.

Patients are followed every 6 months for 1 year and then annually for 4 years.

PROJECTED ACCRUAL: A total of 350 patients (175 per treatment arm) will be accrued for this
study within 3 years.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed inflammatory or locally advanced breast cancer

- Stage IIB (T3, N0, M0), IIIA (T3, N1-2, M0 or T0-2, N2, M0), or IIIB (T4, any N,
M0 or any T, N3, M0)

- Unresectable or otherwise appropriate for neoadjuvant therapy

- Confirmed by core needle or incisional biopsy

- Punch biopsy allowed if invasive disease is documented

- No distant metastases

- Hormone receptor status:

- Not specified

PATIENT CHARACTERISTICS:

Age:

- Not specified

Sex:

- Female

Menopausal status:

- Not specified

Performance status:

- Zubrod 0-2

Life expectancy:

- Not specified

Hematopoietic:

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

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

Hepatic:

- Bilirubin no greater than upper limit of normal (ULN)

- SGOT or SGPT no greater than 2 times ULN

Renal:

- Creatinine no greater than ULN

Cardiovascular:

- No congestive heart failure or angina pectoris

- LVEF greater than lower limit of normal

Other:

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

- HIV negative

- Not pregnant or nursing

- Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- Not specified

Chemotherapy:

- No prior chemotherapy for breast cancer

Endocrine therapy:

- No prior hormonal therapy for breast cancer

Radiotherapy:

- No prior radiotherapy for breast cancer

Surgery:

- No prior definitive surgery for breast cancer

Other:

- No other concurrent anticancer therapy

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Comparison of microscopic pathologic response rates

Outcome Time Frame:

no sooner than 21 days after chemo

Safety Issue:

No

Principal Investigator

Georgiana K. Ellis, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Seattle Cancer Care Alliance

Authority:

United States: Federal Government

Study ID:

CDR0000068630

NCT ID:

NCT00016406

Start Date:

May 2001

Completion Date:

February 2012

Related Keywords:

  • Breast Cancer
  • stage II breast cancer
  • stage IIIA breast cancer
  • stage IIIB breast cancer
  • stage IIIC breast cancer
  • inflammatory breast cancer
  • Breast Neoplasms

Name

Location

Roswell Park Cancer Institute Buffalo, New York  14263
Fred Hutchinson Cancer Research Center Seattle, Washington  98109
Mayo Clinic Scottsdale Scottsdale, Arizona  85259
Mayo Clinic - Jacksonville Jacksonville, Florida  32224
Cardinal Bernardin Cancer Center at Loyola University Medical Center Maywood, Illinois  60153-5500
Barbara Ann Karmanos Cancer Institute Detroit, Michigan  48201
University of Mississippi Medical Center Jackson, Mississippi  39216-4505
CCOP - Upstate Carolina Spartanburg, South Carolina  29303
Tripler Army Medical Center Honolulu, Hawaii  96859-5000
CCOP - Wichita Wichita, Kansas  67214-3882
Medical City Dallas Hospital Dallas, Texas  75230
University of Texas Health Science Center at San Antonio San Antonio, Texas  78284-7811
CCOP - Kansas City Kansas City, Missouri  64131
CCOP - Missouri Valley Cancer Consortium Omaha, Nebraska  68131
CCOP - Mount Sinai Medical Center Miami Beach, Florida  33140
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
Bergan Mercy Medical Center Omaha, Nebraska  68124
Rush-Copley Cancer Care Center Aurora, Illinois  60507
Carle Cancer Center at Carle Foundation Hospital Urbana, Illinois  61801
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
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
Fairview Ridges Hospital Burnsville, Minnesota  55337
Mercy and Unity Cancer Center at Mercy Hospital Coon Rapids, Minnesota  55433
CCOP - Duluth 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
Meeker County Memorial Hospital Lichfield, Minnesota  55355
Hennepin County Medical Center - Minneapolis Minneapolis, Minnesota  55415
Regions Hospital Cancer Care Center St. Paul, Minnesota  55101
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
St. Rita's Medical Center Lima, Ohio  45801
Natalie Warren Bryant Cancer Center at St. Francis Hospital Tulsa, Oklahoma  74136
Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical Center La Crosse, Wisconsin  54601
Rapid City Regional Hospital Rapid City, South Dakota  57709
CCOP - Bay Area Tumor Institute Oakland, California  94609-3305
Memorial Hospital Cancer Center Colorado Springs, Colorado  80909
Halifax Medical Center Daytona Beach, Florida  32114
CCOP - Cancer Research for the Ozarks Springfield, Missouri  65807
CCOP - Montana Cancer Consortium Billings, Montana  59101
Veterans Affairs Medical Center - Dayton Dayton, Ohio  45428
CCOP - Dayton Kettering, Ohio  45429
Harrington Cancer Center Amarillo, Texas  79106
Dixie Regional Medical Center Saint George, Utah  84770
LDS Hospital Salt Lake City, Utah  84143
CCOP - Grand Rapids Grand Rapids, Michigan  49503
Charles M. Barrett Cancer Center at University Hospital Cincinnati, Ohio  45267-0526
CCOP - Columbia River Oncology Program Portland, Oregon  97225
CCOP - Scott and White Hospital Temple, Texas  76508
Cancer Research Center of Hawaii Honolulu, Hawaii  96813
USC/Norris Comprehensive Cancer Center and Hospital Los Angeles, California  90033-0804
MBCCOP - LSU Health Sciences Center New Orleans, Louisiana  70112
CCOP - St. Louis-Cape Girardeau Saint Louis, Missouri  63141
Brooke Army Medical Center Fort Sam Houston, Texas  78234-6200
Veterans Affairs Medical Center - San Antonio (Murphy) San Antonio, Texas  78284
CCOP - Virginia Mason Research Center Seattle, Washington  98101
CCOP - Northwest Tacoma, Washington  98405-0986
Madigan Army Medical Center Tacoma, Washington  98431-5048
Utah Valley Regional Medical Center - Provo Provo, Utah  84604
University of New Mexico Cancer Research and Treatment Center Albuquerque, New Mexico  87131
Mobile Infirmary Medical Center Mobile, Alabama  36640-0460
John Stoddard Cancer Center at Iowa Methodist Medical Center Des Moines, Iowa  50309
Midlands Cancer Center at Midlands Community Hospital Papillion, Nebraska  68128-4157
St. Vincent Mercy Medical Center Toledo, Ohio  43608
Great Falls Clinic Great Falls, Montana  59405
Arkansas Cancer Research Center at University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center Kansas City, Kansas  66160-7353
Markey Cancer Center at University of Kentucky Chandler Medical Center Lexington, Kentucky  40536-0084
Cancer Research Center at Boston Medical Center Boston, Massachusetts  02118
Cancer Institute at Oregon Health and Science University Portland, Oregon  97201-3098
Swedish Cancer Institute at Swedish Medical Center - First Hill Campus Seattle, Washington  98104
Tufts - New England Medical Center Boston, Massachusetts  02111
Hulston Cancer Center at Cox Medical Center South Springfield, Missouri  65807
St. John's Regional Health Center Springfield, Missouri  65804
North Idaho Cancer Center Coeur d'Alene, Idaho  83814
CCOP - Toledo Community Hospital Toledo, Ohio  43623-3456
Wilford Hall Medical Center Lackland Air Force Base, Texas  78236-5300
St. Luke's Mountain States Tumor Institute - Boise Boise, Idaho  83712-6297
Via Christi Cancer Center at Via Christi Regional Medical Center Wichita, Kansas  67214
CancerCare of Maine at Eastern Maine Medial Center Bangor, Maine  04401
Spectrum Health Cancer Care - Butterworth Campus Grand Rapids, Michigan  49503-2560
Mission Hospitals - Memorial Campus Asheville, North Carolina  28801
Toledo Hospital Toledo, Ohio  43606
St. Mary's - Duluth Clinic Cancer Center Duluth, Minnesota  55805
James P. Wilmot Cancer Center at University of Rochester Medical Center Rochester, New York  14642
St. Vincent's Comprehensive Cancer Center - Manhattan New York, New York  10011
Hematology Oncology Associates of the Quad Cities Bettendorf, Iowa  52722
Alaska Regional Hospital Cancer Center Anchorage, Alaska  99508
Saint Anthony's Hospital at Saint Anthony's Health Center Alton, Illinois  62002
Good Samaritan Regional Health Center Mt. Vernon, Illinois  62864
Siouxland Regional Cancer Center Sioux City, Iowa  51101-1733
Cancer Center of Kansas, P.A. - El Dorado El Dorado, Kansas  67042
Southwest Medical Center Liberal, Kansas  67901
Cancer Center of Kansas, P.A. - Parsons Parsons, Kansas  67357
Cancer Center of Kansas, P.A. - Wichita Wichita, Kansas  67214
Battle Creek Health System Cancer Care Center Battle Creek, Michigan  49017
Mecosta County General Hospital Big Rapids, Michigan  49307
Metropolitan Hospital Grand Rapids, Michigan  49506
Lacks Cancer Center at Saint Mary's Mercy Medical Center Grand Rapids, Michigan  49503
Holland Community Hospital Holland, Michigan  49423
Hackley Hospital Muskegon, Michigan  49443
Northern Michigan Hospital Petoskey, Michigan  49770
William Beaumont Hospital - Royal Oak Campus Royal Oak, Michigan  48073
Munson Medical Center Traverse City, Michigan  49684
St. Francis Medical Center Cape Girardeau, Missouri  63701
Southeast Missouri Regional Cancer Center at Southeast Missouri Hospital Gape Girardeau, Missouri  63701
David C. Pratt Cancer Center at St. John's Mercy St. Louis, Missouri  63141
Northern Rockies Radiation Oncology Center Billings, Montana  59101
Hematology-Oncology Centers of the Northern Rockies - Billings Billings, Montana  59101
St. Vincent Healthcare Billings, Montana  59101
Deaconess Billings Clinic - Downtown Billings, Montana  59101
Deaconess Billings Clinic Cancer Center Billings, Montana  59107
Internal Medicine Associates of Bozeman Bozeman, Montana  59715
Bozeman Deaconess Hospital Bozeman, Montana  59715
St. James Community Hospital Butte, Montana  59701
Sletten Regional Cancer Institute Great Falls, Montana  59405
St. Peter's Hospital Helena, Montana  59601
Kalispell Medical Oncology Kalispell, Montana  59901
Kalispell Regional Medical Center Kalispell, Montana  59901
Glacier Oncology, PLLC Kalispell, Montana  59901
Eastern Montana Cancer Center Miles City, Montana  59301
Montana Cancer Center at St. Patrick Hospital and Health Sciences Center Missoula, Montana  59802
Montana Cancer Specialists at Montana Cancer Center Missoula, Montana  59802
Community Medical Center Missoula, Montana  59801
Wayne Memorial Hospital, Incorporated Goldsboro, North Carolina  27534
American Fork Hospital American Fork, Utah  84003
Logan Regional Hospital Logan, Utah  84321
Cottonwood Hospital Medical Center Murray, Utah  84107
McKay-Dee Hospital Center Ogden, Utah  84403
Utah Cancer Specialists at UCS Cancer Center Salt Lake City, Utah  84106
St. Joseph Hospital Community Cancer Center Bellingham, Washington  98225
Olympic Hematology and Oncology Bremerton, Washington  98310
Skagit Valley Hospital Cancer Care Center Mt. Vernon, Washington  98273
University Cancer Center at University of Washington Medical Center Seattle, Washington  98195
Harborview Medical Center Seattle, Washington  98104
Group Health Central Hospital Seattle, Washington  98104
North Puget Oncology at United General Hospital Sedro-Wooley, Washington  98284
Cancer Care Northwest - Spokane South Spokane, Washington  99202
Central Washington Hospital Wenatchee, Washington  98801
Wenatchee Valley Clinic Wenatchee, Washington  98801
Welch Cancer Center Sheridan, Wyoming  82801
Memorial Cancer Institute at Memorial Regional Hospital Hollywood, Florida  33021
Lenoir Memorial Cancer Center Kinston, North Carolina  28503-1678
CCOP - Nevada Cancer Research Foundation Las Vegas, Nevada  89109-2306
Leo W. Jenkins Cancer Center at Pitt County Memorial Hospital Greenville, North Carolina  27858-4354
Huntsman Cancer Institute at University of Utah Salt Lake City, Utah  84112
Summit Medical Center Oakland, California  94609
Hope A Women's Cancer Center Asheville, North Carolina  28801
Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest Allentown, Pennsylvania  18105
University Medical Center of Southern Nevada Las Vegas, Nevada  89102
Jennersville Regional Hospital West Grove, Pennsylvania  19390-9499
Saint Rose Hospital Hayward, California  94545
Highland General Hospital at St. George's University School of Medicine Oakland, California  94602
J.C. Robinson, M.D. Regional Cancer Center San Pablo, California  94806
Michael & Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital Fort Lauderdale, Florida  33308
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
Trinity Medical Center - East Moline, Illinois  61265
Edward Hospital Cancer Center Naperville, Illinois  60540
Fort Wayne Medical Oncology and Hematology Fort Wayne, Indiana  46815
St. Luke's Hospital Cedar Rapids, Iowa  52402
Mercy Regional Cancer Center at Mercy Medical Center Cedar Rapids, Iowa  52403
Genesis Medical Center - West Campus Davenport, Iowa  52804
Genesis Regional Cancer Center at Genesis Medical Center Davenport, Iowa  52803
John Stoddard Cancer Center at Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
Mercy Capitol Hospital Des Moines, Iowa  50307
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
Burgess Health Center Onawa, Iowa  51040
Medical Oncology and Hematology Associates - West Des Moines West Des Moines, Iowa  50266
Cancer Center of Kansas, P.A. - Chanute Chanute, Kansas  66720
Cancer Center of Kansas, P.A. - Kingman Kingman, Kansas  67068
Cancer Center of Kansas, P.A. - Newton Newton, Kansas  67114
Cancer Center of Kansas, P.A. - Pratt Pratt, Kansas  67124
Cancer Center of Kansas, P.A. - Salina Salina, Kansas  67042
Salina Regional Health Center Salina, Kansas  67401
Stormont-Vail Cancer Center Topeka, Kansas  66604
St. Francis Comprehensive Cancer Center Topeka, Kansas  66606
Cancer Center of Kansas, P.A. - Wellington Wellington, Kansas  67152
Cancer Center of Kansas, P.A. - Medical Arts Tower Wichita, Kansas  67208
Associates in Womens Health, P.A. - North Review Wichita, Kansas  67203
Cancer Center of Kansas, P.A. - Winfield Winfield, Kansas  67156
Mary Bird Perkins Cancer Center - Baton Rouge Baton Rouge, Louisiana  70809
Medical Center of Louisiana - New Orleans New Orleans, Louisiana  70112
Hickman Cancer Center at Bixby Medical Center Adrian, Michigan  49221
Haematology-Oncology Associates of Ohio and Michigan, P.C. Lambertville, Michigan  48144
Community Cancer Center of Monroe Monroe, Michigan  48162
Mercy Memorial Hospital System Monroe, Michigan  48162
Providence Cancer Institute at Providence Hospital - Southfield Campus Southfield, Michigan  48075
Virginia Piper Cancer Institute at Abbott-Northwestern Hospital Minneapolis, Minnesota  55407
Hubert H. Humphrey Cancer Center at North Memorial Medical Center Robbinsdale, Minnesota  55422-2900
Park Nicollet Health Services St. Louis Park, Minnesota  55416
Immanuel Medical Center Omaha, Nebraska  68122
Creighton University Medical Center Omaha, Nebraska  68131-2197
Highland Hospital of Rochester Rochester, New York  14620
Forsyth Regional Cancer Center at Forsyth Medical Center Winston-Salem, North Carolina  27103
Cancer Care Center at Medcenter One Hospital Bismarck, North Dakota  58501
Bismarck Cancer Center Bismarck, North Dakota  58501
St. Alexius Medical Center Bismarck, North Dakota  58502
Mid Dakota Clinic, P. C. Bismarck, North Dakota  58501
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
Fremont Memorial Hospital Fremont, Ohio  43420
Kenton Oncology, Incorporated Kenton, Ohio  43326
Charles F. Kettering Memorial Hospital Kettering, Ohio  45429
Lima Memorial Hospital Lima, Ohio  45804
St. Luke's Hospital Maumee, Ohio  43537
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
Firelands Regional Medical Center Sandusky, Ohio  44870
Promedica Cancer Center at Flower Hospital Sylvania, Ohio  43560
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Toledo Clinic, Incorporated - Main Clinic Toledo, Ohio  43623
Toledo Surgical Specialists Toledo, Ohio  43623
UVMC Cancer Care Center at Upper Valley Medical Center Troy, Ohio  45373-1300
Fulton County Health Center Wauseon, Ohio  43567
Ruth G. McMillan Cancer Center at Greene Memorial Hospital Xenia, Ohio  45385
Legacy Mount Hood Medical Center Gresham, Oregon  97030
Providence Milwaukie Hospital Milwaukie, Oregon  97222
Legacy Good Samaritan Hospital & Medical Center Comprehensive Cancer Center Portland, Oregon  97210
Providence Cancer Center at Providence Portland Medical Center Portland, Oregon  97213-2967
Providence St. Vincent Medical Center Portland, Oregon  97225
Legacy Meridian Park Hospital Tualatin, Oregon  97062
Oncology Services of Aberdeen Aberdeen, South Dakota  57401
UMC Southwest Cancer and Research Center Lubbock, Texas  79415-3364
Cancer Therapy and Research Center San Antonio, Texas  78229
University Hospital - San Antonio San Antonio, Texas  78229
Danville Regional Medical Center Danville, Virginia  24541
Southwest Washington Medical Center Cancer Center Vancouver, Washington  98668
Fairbanks Cancer Treatment Center at Fairbanks Memorial Hospital Fairbanks, Alaska  99701
Joliet Oncology Hematology Associates, Limited - West Joliet, Illinois  60435
Baton Rouge General Regional Cancer Center Baton Rouge, Louisiana  70821
Rose Ramer Cancer Clinic at Anderson Area Medical Center Anderson, South Carolina  29621
St. Francis Hospital Federal Way, Washington  98003
St. Clare Hospital Lakewood, Washington  98499-0998
Capital Medical Center Olympia, Washington  98502
Providence St. Peter Hospital Regional Cancer Center Olympia, Washington  98506
Olympic Medical Center Port Angeles, Washington  98362
Good Samaritan Cancer Center Puyallup, Washington  98371
Valley Medical Center Renton, Washington  98055
St. Joseph Medical Center at Franciscan Health System Tacoma, Washington  98405-3004
Allenmore Hospital Tacoma, Washington  98411-0414
Saint Anthony Regional Hospital Carroll, Iowa  51401
Miller-Dwan Medical Center Duluth, Minnesota  55805
St. John's Hospital Maplewood, Minnesota  55109
Fremont Area Medical Center Fremont, Nebraska  68025-2387
Hembree Mercy Cancer Center at St. Edward Mercy Medical Center Ft. Smith, Arkansas  72903
Valley Memorial Hospital Livermore, California  94550
Swedish American Hospital Rockford, Illinois  61104
St. Francis Hospital and Health Centers Beech Grove, Indiana  46107
Alegent Health Mercy Hospital Council Bluffs, Iowa  51503
Alegent Health Community Memorial Hospital Missouri Valley, Iowa  51555
Spectrum Health Hospital - Blodgett Campus Grand Rapids, Michigan  49506
Cancer Care Center at St. Luke's Hospital Duluth, Minnesota  55805
Saint Francis Cancer Center Shakopee, Minnesota  55379
St. Joseph's Hospital St Paul, Minnesota  55102
Woodwinds Hospital Woodbury, Minnesota  55125
Missouri Baptist Cancer Center St. Louis, Missouri  63131
Altru Cancer Center at Altru Hospital Grand Forks, North Dakota  58201
Medical College of Ohio Cancer Institute Toledo, Ohio  43614
Institute of Oncology at Vilnius University Portland, Oregon  97227
Salem Hospital Regional Cancer Center Salem, Oregon  97309
All Saints Cancer Center at All Saints Healthcare Racine, Wisconsin  53405
St. Francis Medical Center Honolulu, Hawaii  96817
Auburn Regional Center for Cancer Care Auburn, Washington  98002
Seton Shivers Cancer Program at Brackenridge Hospital Austin, Texas  78701
Queen's Cancer Institute at Queen's Medical Center Honolulu, Hawaii  96813
Rutherford Hospital Rutherfordton, North Carolina  28139
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center Spartanburg, South Carolina  29303
Good Samaritan Health Systems Kearney, Nebraska  68847
MedCentral - Mansfield Hospital Mansfield, Ohio  44903
Glendale Memorial Hospital Comprehensive Cancer Center Glendale, California  91204
Center for Cancer Care at Goshen Health System Goshen, Indiana  46526
Cancer Treatment Center at Christus Schumpert St. Mary Place Shreveport, Louisiana  71101
Englewood Hospital and Medical Center Englewood, New Jersey  07631
New Mexico Cancer Care Associates Santa Fe, New Mexico  87505-7670
MBCCOP - Meharry Medical College - Nashville Nashville, Tennessee  37208-3599
Comprehensive Cancer Center at Desert Regional Medical Center Palm Springs, California  92262
Highlands Oncology Group - Springdale Springdale, Arkansas  72764
Roper St. Francis Cancer Center at Roper Hospital Charleston, South Carolina  29401
Cancer Center of Kansas, P.A. - Dodge City Dodge City, Kansas  67801
Kapiolani Medical Center at Pali Momi Aiea, Hawaii  96701
Kapiolani Medical Center for Women and Children Honolulu, Hawaii  96826
Straub Clinic and Hospital, Incorporated Honolulu, Hawaii  96813
OnCare Hawaii, Incorporated - Kuakini Honolulu, Hawaii  96817
OnCare Hawaii, Incorporated - Lusitana Honolulu, Hawaii  96813
Medical and Surgical Specialists, L L C Galesburg, Illinois  61401
Hematology Oncology Consultants Ltd. Naperville, Illinois  60540
Saint James Hospital and Health Centers Comprehensive Cancer Institute - Olympia Fields Olympia Fields, Illinois  60461
Siouxland Hematology-Oncology Associates at June E. Nylen Cancer Center Sioux City, Iowa  51101
Commonwealth Hematology-Oncology P. C. - Quincy Quincy, Massachusetts  02169
Ted B. Wahby Cancer Center at Mount Clemens General Hospital Mount Clemens, Michigan  48043
Lovelace Medical Center Albuquerque, New Mexico  87108
Cancer Care Center at Catskill Regional Medical Center Harris, New York  12742
United States Air Force Medical Center Wright-Patterson Wright-Patterson Afb, Ohio  45433-5529
Providence Centralia Hospital Regional Cancer Center Centralia, Washington  98531
Washington Hematology - Oncology Specialists Yakima, Washington  98902
North Star Lodge Cancer Center Yakima, Washington  98902