Randomized Phase III Trial of Cisplatin (NSC-119875) and Irinotecan (NSC-616348) Versus Cisplatin and Etoposide (NSC-141540) in Patients With Extensive Stage Small Cell Lung Cancer (E-SCLC)
Phase 3
18 Years
N/A
18 Years
N/A
Not Enrolling
Both
Lung Cancer
Both
Lung Cancer
Trial Information
Randomized Phase III Trial of Cisplatin (NSC-119875) and Irinotecan (NSC-616348) Versus Cisplatin and Etoposide (NSC-141540) in Patients With Extensive Stage Small Cell Lung Cancer (E-SCLC)
OBJECTIVES:
- Compare the survival of patients with extensive stage small cell lung cancer treated
with cisplatin and irinotecan vs cisplatin and etoposide.
- Compare the objective response rate and progression-free survival of patients treated
with these regimens.
- Compare the toxic effects of these regimens in these patients.
- Determine the association between UGT1A1 polymorphisms and irinotecan-associated toxic
effects in these patients.
- Determine the association between ERCC-1 and XRCC-1 polymorphisms and non-response of
patients treated with these regimens.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to
number of metastatic sites (single vs multiple), lactic dehydrogenase (no greater than upper
limit of normal (ULN) vs greater than ULN), and weight loss in the past 6 months (5% or less
vs more than 5%). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive irinotecan IV over 90 minutes on days 1, 8, and 15 and
cisplatin IV over 30-60 minutes on day 1. Courses repeat every 4 weeks.
- Arm II: Patients receive etoposide IV over 30-60 minutes on days 1-3 and cisplatin IV
over 30-60 minutes on day 1. Courses repeat every 3 weeks.
Treatment in both arms continues for 4 courses in the absence of disease progression or
unacceptable toxicity.
Patients are followed every 3 months for 1 year and then every 6 months for 2 years.
PROJECTED ACCRUAL: A total of 620 patients (310 per treatment arm) will be accrued for this
study within 4 years.
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed extensive stage small cell lung cancer
(SCLC)
- Measurable or evaluable disease by CT scan, MRI, x-ray, physical exam, or nuclear
exam
- Brain metastases allowed if previously treated with radiotherapy and/or surgery and
are neurologically stable (i.e., no progressing symptoms and off steroids and
anticonvulsants)
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- Zubrod 0-1
Life expectancy
- Not specified
Hematopoietic
- WBC at least 3,000/mm^3
- Absolute granulocyte count at least 1,500/mm^3
- Platelet count at least 100,000/mm^3
Hepatic
- Bilirubin no greater than 1.5 times upper limit of normal (ULN)
- AST or ALT no greater than 2.5 times ULN
Renal
- Creatinine normal
- Creatinine clearance at least 50 mL/min
Other
- Not pregnant or nursing
- Fertile patients must use effective contraception
- 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
- No concurrent AIDS-related illness
PRIOR CONCURRENT THERAPY:
Biologic therapy
- No prior biologic therapy for SCLC
- No filgrastim (G-CSF) within 24 hours of chemotherapy
Chemotherapy
- No prior systemic chemotherapy for SCLC
Endocrine therapy
- See Disease Characteristics
Radiotherapy
- See Disease Characteristics
- At least 21 days since prior brain radiotherapy and recovered
- No other prior radiotherapy for SCLC
Surgery
- See Disease Characteristics
- At least 21 days since prior thoracic or other major surgery and recovered
Other
- No concurrent enzyme inducing antiepileptic drugs (phenytoin, phenobarbital,
oxcarboxepine, or carbamazepine)
Type of Study:
Interventional
Study Design:
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Outcome Measure:
Survival
Outcome Description:
To compare the survival of patients with extensive stage small cell lung cancer (E-SCLC) treated with cisplatin and irinotecan versus cisplatin and etoposide.
Outcome Time Frame:
0-3 years or until death
Safety Issue:
No
Principal Investigator
Ronald B. Natale, MD
Investigator Role:
Principal Investigator
Investigator Affiliation:
Cedars-Sinai Medical Center
Authority:
United States: Federal Government
Study ID:
CDR0000256908
NCT ID:
NCT00045162
Start Date:
November 2002
Completion Date:
December 2009
Related Keywords:
- Lung Cancer
- extensive stage small cell lung cancer
- Lung Neoplasms
- Small Cell Lung Carcinoma
Name | Location |
|---|---|
| Fred Hutchinson Cancer Research Center | Seattle, Washington 98109 |
| Mayo Clinic Scottsdale | Scottsdale, Arizona 85259 |
| Mayo Clinic Cancer Center | Rochester, Minnesota 55905 |
| Cardinal Bernardin Cancer Center at Loyola University Medical Center | Maywood, Illinois 60153-5500 |
| 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 |
| Hurley Medical Center | Flint, Michigan 48503 |
| Medical City Dallas Hospital | Dallas, Texas 75230 |
| University of Texas Health Science Center at San Antonio | San Antonio, Texas 78284-7811 |
| CCOP - Atlanta Regional | Atlanta, Georgia 30342-1701 |
| CCOP - Kansas City | Kansas City, Missouri 64131 |
| CCOP - Missouri Valley Cancer Consortium | Omaha, Nebraska 68131 |
| CCOP - North Shore University Hospital | Manhasset, New York 11030 |
| 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 |
| Rush-Copley Cancer Care Center | Aurora, Illinois 60507 |
| Joliet Oncology-Hematology Associates, Limited - West | Joliet, Illinois 60435 |
| 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 |
| Siouxland Hematology-Oncology Associates, LLP | Sioux City, Iowa 51101 |
| St. Luke's Regional Medical Center | Sioux City, Iowa 51104 |
| CCOP - Michigan Cancer Research Consortium | Ann Arbor, Michigan 48106 |
| Saint Joseph Mercy Cancer Center | Ann Arbor, Michigan 48106-0995 |
| Genesys Hurley Cancer Institute | Flint, Michigan 48503 |
| Van Elslander Cancer Center at St. John Hospital and Medical Center | Grosse Pointe Woods, Michigan 48236 |
| Foote Hospital | Jackson, Michigan 49201 |
| 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 |
| Seton Cancer Institute - Saginaw | Saginaw, Michigan 48601 |
| St. John Macomb Hospital | Warren, Michigan 48093 |
| 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 |
| HealthEast Cancer Care at St. John's Hospital | Maplewood, Minnesota 55109 |
| 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 |
| Minnesota Oncology Hematology, PA - Woodbury | Woodbury, Minnesota 55125 |
| MeritCare Broadway | Fargo, North Dakota 58122 |
| CCOP - MeritCare Hospital | Fargo, North Dakota 58122 |
| Mercy Cancer Center at Mercy Medical Center | Canton, Ohio 44708 |
| St. Rita's Medical Center | Lima, Ohio 45801 |
| Geisinger Medical Center | Danville, Pennsylvania 17822-0001 |
| 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 |
| Medical X-Ray Center, PC | Sioux Falls, South Dakota 57105 |
| Avera Cancer Institute | Sioux Falls, South Dakota 57105 |
| Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical Center | La Crosse, Wisconsin 54601 |
| Marshfield Clinic - Marshfield Center | Marshfield, Wisconsin 54449 |
| Marshfield Clinic - Indianhead Center | Rice Lake, Wisconsin 54868 |
| Rapid City Regional Hospital | Rapid City, South Dakota 57709 |
| Providence Saint Joseph Medical Center - Burbank | Burbank, California 91505 |
| CCOP - Santa Rosa Memorial Hospital | Santa Rosa, California 95403 |
| Memorial Hospital of South Bend | South Bend, Indiana 46601 |
| CCOP - Cancer Research for the Ozarks | Springfield, Missouri 65807 |
| CCOP - Montana Cancer Consortium | Billings, Montana 59101 |
| CCOP - Columbus | Columbus, Ohio 43206 |
| Veterans Affairs Medical Center - Dayton | Dayton, Ohio 45428 |
| CCOP - Dayton | Kettering, Ohio 45429 |
| Mercy Hospital Cancer Center - Scranton | Scranton, Pennsylvania 18501 |
| CCOP - Greenville | Greenville, South Carolina 29615 |
| Hinsdale, Illinois 60521 | |
| CCOP - Northern Indiana CR Consortium | South Bend, Indiana 46601 |
| Saint Joseph Regional Medical Center | South Bend, Indiana 46617 |
| UMASS Memorial Cancer Center - University Campus | Worcester, Massachusetts 01605-2982 |
| CCOP - Grand Rapids | Grand Rapids, Michigan 49503 |
| Ellis Fischel Cancer Center at University of Missouri - Columbia | Columbia, Missouri 65203 |
| Charles M. Barrett Cancer Center at University Hospital | Cincinnati, Ohio 45267-0526 |
| MetroHealth's Cancer Care Center at MetroHealth Medical Center | Cleveland, Ohio 44106 |
| CCOP - Scott and White Hospital | Temple, Texas 76508 |
| MultiCare Regional Cancer Center at Tacoma General Hospital | Tacoma, Washington 98405 |
| Cleveland Clinic Taussig Cancer Center | Cleveland, Ohio 44195 |
| USC/Norris Comprehensive Cancer Center and Hospital | Los Angeles, California 90033-0804 |
| Veterans Affairs Medical Center - Shreveport | Shreveport, Louisiana 71130 |
| CCOP - St. Louis-Cape Girardeau | Saint Louis, Missouri 63141 |
| Veterans Affairs Medical Center - Portland | Portland, Oregon 97207 |
| Brooke Army Medical Center | Fort Sam Houston, Texas 78234-6200 |
| Veterans Affairs Medical Center - Houston | Houston, Texas 77030 |
| Veterans Affairs Medical Center - San Antonio (Murphy) | San Antonio, Texas 78284 |
| CCOP - Northwest | Tacoma, Washington 98405-0986 |
| Sutter Cancer Center | Sacramento, California 95816 |
| Utah Valley Regional Medical Center - Provo | Provo, Utah 84604 |
| Veterans Affairs Medical Center - Richmond | Richmond, Virginia 23249 |
| MidMichigan Medical Center - Midland | Midland, Michigan 48670 |
| Veterans Affairs Medical Center - Columbia (Truman Memorial) | Columbia, Missouri 65201 |
| Veterans Affairs Medical Center - Buffalo | Buffalo, New York 14215 |
| University of California Davis Cancer Center | Sacramento, California 95817 |
| Northeast Alabama Regional Medical Center | Anniston, Alabama 36207 |
| West Suburban Center for Cancer Care | River Forest, Illinois 60305 |
| Mobile Infirmary Medical Center | Mobile, Alabama 36640-0460 |
| John Stoddard Cancer Center at Iowa Methodist Medical Center | Des Moines, Iowa 50309 |
| St. Vincent Mercy Medical Center | Toledo, Ohio 43608 |
| Great Falls Clinic | Great Falls, Montana 59405 |
| Arizona Cancer Center at University of Arizona Health Sciences Center | Tucson, Arizona 85724 |
| Arkansas Cancer Research Center at University of Arkansas for Medical Sciences | Little Rock, Arkansas 72205 |
| Cancer Research Center at Boston Medical Center | Boston, Massachusetts 02118 |
| Josephine Ford Cancer Center at Henry Ford Hospital | Detroit, Michigan 48202 |
| Swedish Cancer Institute at Swedish Medical Center - First Hill Campus | Seattle, Washington 98104 |
| Thompson Cancer Survival Center | Knoxville, Tennessee 37916 |
| Overlook Hospital | Summit, New Jersey 07902-0220 |
| Northside Hospital Cancer Center | Atlanta, Georgia 30342-1611 |
| 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 |
| Winthrop University Hospital | Mineola, New York 11501 |
| McDowell Cancer Center at Akron General Medical Center | Akron, Ohio 44307 |
| Sioux Valley Hospital and University of South Dakota Medical Center | Sioux Falls, South Dakota 57117-5134 |
| CCOP - Toledo Community Hospital | Toledo, Ohio 43623-3456 |
| Wilford Hall Medical Center | Lackland Air Force Base, Texas 78236-5300 |
| Latter Day Saints Hospital | Salt Lake City, Utah 84143 |
| Long Island Jewish Medical Center | New Hyde Park, New York 11040 |
| Broward General Medical Center Cancer Center | Ft. Lauderdale, Florida 33316 |
| Curtis & Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center | Savannah, Georgia 31403-3089 |
| Via Christi Cancer Center at Via Christi Regional Medical Center | Wichita, Kansas 67214 |
| CancerCare of Maine at Eastern Maine Medial Center | Bangor, Maine 04401 |
| Albert Einstein Cancer Center at Albert Einstein College of Medicine | Bronx, New York 10461 |
| SUNY Upstate Medical University Hospital | Syracuse, New York 13210 |
| Medical University of Ohio Cancer Center | Toledo, Ohio 43614 |
| Toledo Hospital | Toledo, Ohio 43606 |
| Tod Children's Hospital - Forum Health | Youngstown, Ohio 44501 |
| Hollings Cancer Center at Medical University of South Carolina | Charleston, South Carolina 29425 |
| Baylor University Medical Center - Houston | Houston, Texas 77030-2399 |
| Providence Cancer Center at Sacred Heart Medical Center | Spokane, Washington 99220-2555 |
| St. Vincent Hospital Regional Cancer Center | Green Bay, Wisconsin 54307-3508 |
| Interlakes Oncology/Hematology PC | Rochester, New York 14623 |
| 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 |
| McCreery Cancer Center at Ottumwa Regional | Ottumwa, Iowa 52501 |
| Green Bay Oncology, Limited - Escanaba | Escanaba, Michigan 49431 |
| Hunterdon Regional Cancer Center at Hunterdon Medical Center | Flemington, New Jersey 08822 |
| St. Mary's Hospital Medical Center - Green Bay | Green Bay, Wisconsin 54303 |
| 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 |
| 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 |
| Veterans Affairs Medical Center - Kansas City | Kansas City, Kansas 64128 |
| Southwest Medical Center | Liberal, Kansas 67901 |
| Battle Creek Health System Cancer Care Center | Battle Creek, Michigan 49017 |
| Holland Community Hospital | Holland, Michigan 49423 |
| Hackley Hospital | Muskegon, Michigan 49443 |
| Northern Michigan Hospital | Petoskey, Michigan 49770 |
| Munson Medical Center | Traverse City, Michigan 49684 |
| 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 |
| St. James Community Hospital | Butte, Montana 59701 |
| Big Sky Oncology | 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 |
| 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 |
| Adena Regional Medical Center | Chillicothe, Ohio 54601 |
| Doctors Hospital at Ohio Health | Columbus, Ohio 43228 |
| Riverside Methodist Hospital Cancer Care | Columbus, Ohio 43214 |
| Grant Riverside Cancer Services | Columbus, Ohio 43215 |
| Grady Memorial Hospital | Delaware, Ohio 43015 |
| Fairfield Medical Center | Lancaster, Ohio 43130 |
| Strecker Cancer Center at Marietta Memorial Hospital | Marietta, Ohio 45750 |
| Licking Memorial Cancer Care Program at Licking Memorial Hospital | Newark, Ohio 43055 |
| Community Hospital of Springfield and Clark County | Springfield, Ohio 45505 |
| Mount Carmel Cancer Services at Mount Carmel St. Ann's Hospital | Westerville, Ohio 43081 |
| Genesis - Good Samaritan Hospital | Zanesville, Ohio 43701 |
| 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 |
| 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 |
| Cancer Care Northwest - Spokane South | Spokane, Washington 99202 |
| Veterans Affairs Medical Center - Hines | Hines, Illinois 60141 |
| Lakeland Cancer Care Center at Lakeland Hospital - St. Joseph | Saint Joseph, Michigan 49085 |
| Lenoir Memorial Cancer Center | Kinston, North Carolina 28503-1678 |
| Zimmer Cancer Center at New Hanover Regional Medical Center | Wilmington, North Carolina 28402-9025 |
| Swedish-American Regional Cancer Center | Rockford, Illinois 61104-2315 |
| CCOP - Nevada Cancer Research Foundation | Las Vegas, Nevada 89109-2306 |
| Don Monti Comprehensive Cancer Center at North Shore University Hospital | Manhasset, New York 11030 |
| Dakota Cancer Institute at Dakota Clinic - South University | Fargo, North Dakota 58103-4940 |
| Spectrum Health Hospital - Butterworth Campus | Grand Rapids, Michigan 49503 |
| Huntsman Cancer Institute at University of Utah | Salt Lake City, Utah 84112 |
| Decatur Memorial Hospital Cancer Care Institute | Decatur, Illinois 62526 |
| Elkhart General Hospital | Elkhart, Indiana 46515 |
| Mount Carmel Health - West Hospital | Columbus, Ohio 43222 |
| Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest | Allentown, Pennsylvania 18105 |
| University Medical Center of Southern Nevada | Las Vegas, Nevada 89102 |
| Finger Lakes Hematology and Oncology | Clifton Springs, New York 14432 |
| Fox Valley Hematology and Oncology - East Grant Street | Appleton, Wisconsin 54911-3496 |
| All Saints Cancer Center at Wheaton Franciscan Healthcare | Racine, Wisconsin 53405 |
| Sutter Cancer Center at Roseville Medical Center | Roseville, California 95661 |
| John Muir/Mt. Diablo Comprehensive Cancer Center | Walnut Creek, California 94598 |
| Memorial Hospital | Colorado Springs, Colorado 80909 |
| Saint Joseph's Hospital of Atlanta | Atlanta, Georgia 30342-1701 |
| Piedmont Hospital | Atlanta, Georgia 30309 |
| WellStar Cobb Hospital | Austell, Georgia 30106 |
| Charles B. Eberhart Cancer Center at DeKalb Medical Center | Decatur, Georgia 30033 |
| Gwinnett Medical Center | Lawrenceville, Georgia 30045 |
| Kennestone Cancer Center at Wellstar Kennestone Hospital | Marietta, Georgia 30060 |
| Southern Regional Medical Center | Riverdale, Georgia 30274-2600 |
| Trinity Medical Center - East | Moline, Illinois 61265 |
| St. Francis Hospital and Health Centers - Beech Grove Campus | Beech Grove, Indiana 46107 |
| Howard Community Hospital at Howard Regional Health System | Kokomo, Indiana 46904 |
| Center for Cancer Therapy at LaPorte Hospital and Health Services | La Porte, Indiana 46350 |
| Reid Hospital & Health Care Services, Incorporated | Richmond, Indiana 47374 |
| Bettendorf, Iowa 52722 | |
| 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 |
| Cancer Center of Kansas, PA - Dodge City | Dodge City, Kansas 67801 |
| Stormont-Vail Cancer Center | Topeka, Kansas 66604 |
| Louisiana State University Health Sciences Center - Monroe | Monroe, Louisiana 71210 |
| 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 |
| Mecosta County Medical Center | Big Rapids, Michigan 49307 |
| Green Bay Oncology, Limited - Iron Mountain | Iron Mountain, Michigan 49801 |
| Upper Michigan Cancer Center at Marquette General Hospital | Marquette, Michigan 49855 |
| Community Cancer Center of Monroe | Monroe, Michigan 48162 |
| Mercy Memorial Hospital System | Monroe, Michigan 48162 |
| Alexandria, Minnesota 56308 | |
| MeritCare Clinic - Bemidji | Bemidji, Minnesota 56601 |
| Virginia Piper Cancer Institute at Abbott-Northwestern Hospital | Minneapolis, Minnesota 55407 |
| Chippewa County - Montevideo Hospital | Montevideo, Minnesota 56265 |
| Hubert H. Humphrey Cancer Center at North Memorial Medical Center | Robbinsdale, Minnesota 55422-2900 |
| Coborn Cancer Center | Saint Cloud, Minnesota 56303 |
| CentraCare Clinic - River Campus | St. Cloud, Minnesota 56303 |
| Park Nicollet Health Services | St. Louis Park, Minnesota 55416 |
| Saint Francis Medical Center | Cape Girardeau, Missouri 63701 |
| Immanuel Medical Center | Omaha, Nebraska 68122 |
| Creighton University Medical Center | Omaha, Nebraska 68131-2197 |
| Adirondack Cancer Care - Glens Falls | Glens Falls, New York 12801 |
| Bismarck Cancer Center | 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 |
| Good Samaritan Hospital | Dayton, Ohio 45406 |
| Blanchard Valley Medical Associates | Findlay, Ohio 45840 |
| Fremont Memorial Hospital | Fremont, Ohio 43420 |
| Community Oncology Group at Cleveland Clinic Cancer Center | Independence, Ohio 44131 |
| 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 |
| Mercy Medical Center | Springfield, Ohio 45504 |
| 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 |
| Kaiser Permanente Health Care - Portland | Portland, Oregon 97232 |
| St. Mary Regional Cancer Center | Langhorne, Pennsylvania 19047 |
| Bon Secours St. Francis Health System | Greenville, South Carolina 29601 |
| 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 |
| Dixie Regional Medical Center - East Campus | Saint George, Utah 84770 |
| Danville Regional Medical Center | Danville, Virginia 24541 |
| Minor and James Medical, PLLC | Seattle, Washington 98104 |
| Polyclinic First Hill | Seattle, Washington 98122 |
| Providence Cancer Center at Holy Family Hospital | Spokane, Washington 99207 |
| Green Bay Oncology, Limited at St. Vincent Hospital | Green Bay, Wisconsin 54301-3526 |
| Holy Family Memorial Medical Center Cancer Care Center | Manitowoc, Wisconsin 54221-1450 |
| Welch Cancer Center at Sheridan Memorial Hospital | Sheridan, Wyoming 82801 |
| St. Francis Hospital | Federal Way, Washington 98003 |
| St. Clare Hospital | Lakewood, Washington 98499-0998 |
| Providence St. Peter Hospital Regional Cancer Center | Olympia, Washington 98506 |
| Good Samaritan Cancer Center | Puyallup, Washington 98371 |
| St. Joseph Medical Center at Franciscan Health System | Tacoma, Washington 98405-3004 |
| Allenmore Hospital | Tacoma, Washington 98411-0414 |
| Miller-Dwan Medical Center | Duluth, Minnesota 55805 |
| Lancaster General Hospital | Lancaster, Pennsylvania 17604-3555 |
| Hembree Mercy Cancer Center at St. Edward Mercy Medical Center | Ft. Smith, Arkansas 72903 |
| California Cancer Center - Woodward Park Office | Fresno, California 93720 |
| 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 |
| Merle M. Mahr Cancer Center at Regional Medical Center of Hopkins County | Madisonville, Kentucky 42431 |
| Tulane Cancer Center | New Orleans, Louisiana 70112 |
| 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 |
| Missouri Baptist Cancer Center | St. Louis, Missouri 63131 |
| Cancer Resource Center - Lincoln | Lincoln, Nebraska 68510 |
| Allegheny Cancer Center at Allegheny General Hospital | Pittsburgh, Pennsylvania 15212 |
| Eastern Connecticut Hematology and Oncology Associates | Norwich, Connecticut 06360 |
| West Florida Cancer Institute at West Florida Hospital - Pensacola | Pensacola, Florida 32514 |
| Covenant Cancer Treatment Center | Waterloo, Iowa 50702 |
| Cancer Center of Kansas, PA - Chanute | Chanute, Kansas 66720 |
| Cancer Center of Kansas, PA - El Dorado | El Dorado, Kansas 67042 |
| Cancer Center of Kansas, PA - Kingman | Kingman, Kansas 67068 |
| Cancer Center of Kansas, PA - Newton | Newton, Kansas 67114 |
| Cancer Center of Kansas, PA - Parsons | Parsons, Kansas 67357 |
| Cancer Center of Kansas, PA - Pratt | Pratt, Kansas 67124 |
| Tammy Walker Cancer Center at Salina Regional Health Center | Salina, Kansas 67401 |
| Cancer Center of Kansas, PA - Salina | Salina, Kansas 67401 |
| Cancer Center of Kansas, PA - Wellington | Wellington, Kansas 67152 |
| Cancer Center of Kansas, PA - Wichita | Wichita, Kansas 67214 |
| Associates in Womens Health, PA - North Review | Wichita, Kansas 67208 |
| Cancer Center of Kansas, PA - Medical Arts Tower | Wichita, Kansas 67208 |
| Cancer Center of Kansas, PA - Winfield | Winfield, Kansas 67156 |
| Mercy Regional Cancer Center at Mercy Hospital | Port Huron, Michigan 48060 |
| Willmar Cancer Center at Rice Memorial Hospital | Willmar, Minnesota 56201 |
| Bozeman Deaconess Cancer Center | Bozeman, Montana 59715 |
| Alegant Health Cancer Center at Bergan Mercy Medical Center | Omaha, Nebraska 68124 |
| Flower Hospital Cancer Center | Sylvania, Ohio 43560 |
| Salem Hospital Regional Cancer Care Services | Salem, Oregon 97309-5014 |
| Hematology and Oncology Associates of Northeastern Pennsylvania | Scranton, Pennsylvania 18510 |
| St. Joseph Cancer Center | Bellingham, Washington 98225 |
| Wenatchee Valley Medical Center | Wenatchee, Washington 98801-2028 |
| Methodist Cancer Center at Methodist Hospital - Omaha | Omaha, Nebraska 68114 |
| Mid Dakota Clinic, PC | Bismarck, North Dakota 58501 |
| Oregon Health & Science University Cancer Institute | Portland, Oregon 97239-3098 |
| Regional Cancer Center at Memorial Medical Center | Springfield, Illinois 62781-0001 |
| Auburn Regional Center for Cancer Care | Auburn, Washington 98002 |
| Ben Taub General Hospital | Houston, Texas 77030 |
| Methodist Hospital | Houston, Texas 77030 |
| Shasta Regional Medical Center | Redding, California 96001-0853 |
| Washington Township Hospital | Fremont, California 94538 |
| Hematology Oncology Associates of Eastern Idaho | Idaho Falls, Idaho 83404 |
| Immanuel St. Joseph's Clinic | Mankato, Minnesota 56002 |
| Good Samaritan Cancer Center at Good Samaritan Hospital | Kearney, Nebraska 68848-1990 |
| Tucker Center for Cancer Care at Orange Regional Medical Center | Middletown, New York 10940-4199 |
| Rutherford Hospital | Rutherfordton, North Carolina 28139 |
| Easton Regional Cancer Center at Easton Hospital | Easton, Pennsylvania 18042 |
| Gibbs Regional Cancer Center at Spartanburg Regional Medical Center | Spartanburg, South Carolina 29303 |
| Martha Jefferson Hospital Cancer Care Center | Charlottesville, Virginia 22901 |
| MedCentral - Mansfield Hospital | Mansfield, Ohio 44903 |
| Freeman Cancer Institute at Freeman Health System | Joplin, Missouri 64803-2644 |
| U.T. Cancer Institute at University of Tennessee Medical Center | Knoxville, Tennessee 37920-2911 |
| Huntsville Hospital | Huntsville, Alabama 35807 |
| La Grange Memorial Hospital | La Grange, Illinois 60525 |
| Cedar Valley Medical Specialists, PC - West Ridgeway Avenue | Waterloo, Iowa 50702 |
| Lacks Cancer Center at Saint Mary's Health Care | Grand Rapids, Michigan 49503 |
| Metro Health Hospital | Grand Rapids, Michigan 49506 |
| Arch Medical Services, Incorporated at Center for Cancer Care Research | Saint Louis, Missouri 63141 |
| Billings Clinic Cancer Center | Billings, Montana 59107-5100 |
| Great Falls, Montana 59405 | |
| Sletten Regional Cancer Institute at Benefis Healthcare | Great Falls, Montana 59405 |
| Guardian Oncology and Center for Wellness | Missoula, Montana 59804 |
| 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 |
| Halifax Medical Center - Daytona Beach | Daytona Beach, Florida 32115 |
| Woodwinds Health Campus | Woodbury, Minnesota 55125 |
| Oncology Hematology Associates of Northern Pennsylvania, PC at Hahne Regional Cancer Center | Dubois, Pennsylvania 15801 |
| Desert Regional Medical Center Comprehensive Cancer Center | Palm Springs, California 92262 |
| Lynchburg Hematology-Oncology Clinic | Lynchburg, Virginia 24501 |
| Elmhurst Memorial Hospital | Elmhurst, Illinois 60126 |
| AnMed Cancer Center | Anderson, South Carolina 29621 |
| Ted B. Wahby Cancer Center at Mount Clemens General Hospital | Mount Clemens, Michigan 48043 |
| Providence Centralia Hospital Regional Cancer Center | Centralia, Washington 98531 |
| Minnesota Oncology Hematology, PA at Maplewood Cancer Center | Maplewood, Minnesota 55109 |
| Medcenter One Hospital Cancer Care Center | Bismarck, North Dakota 58501 |
| St. Alexius Medical Center Cancer Center | Bismarck, North Dakota 58502 |
| Augusta Oncology Associates - Walton Way | Augusta, Georgia 30901 |
| Heartland Oncology & Hematology | Council Bluffs, Iowa 51503 |
| Christus Schumpert Cancer Treatment Center | Shreveport, Louisiana 71101 |
| MaineGeneral Medical Center - Waterville Campus | Waterville, Maine 04901 |
| Jersey Shore Cancer Center at Jersey Shore University Medical Center | Neptune, New Jersey 07754-0397 |
| Addison Gilbert Hospital | Gloucester, Massachusetts 01930 |
| Mercy Regional Cancer Center | Janesville, Wisconsin 53547 |
| East Alabama Medical Center | Opelika, Alabama 36801-5452 |
| Cancer Care Center at John Muir Health - Concord Campus | Concord, California 94524-4110 |
| Capital Region Cancer Center | Jefferson City, Missouri 65101 |
| Merle West Medical Center Cancer Treatment Center | Klamath Falls, Oregon 97601 |
| University of Tennessee Cancer Institute - Medical Center | Memphis, Tennessee 38104 |
| St. Luke's Texas Cancer Institute at St. Luke's Episcopal Hospital | Houston, Texas 77030 |
| Peninsula Cancer Institute - Newport News Office | Newport News, Virginia 23601 |
