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CHAARTED: ChemoHormonal Therapy Versus Androgen Ablation Randomized Trial for Extensive Disease in Prostate Cancer [CHAARTED]


Phase 3
18 Years
N/A
Open (Enrolling)
Male
Prostate Cancer

Thank you

Trial Information

CHAARTED: ChemoHormonal Therapy Versus Androgen Ablation Randomized Trial for Extensive Disease in Prostate Cancer [CHAARTED]


OBJECTIVES:

Primary

- Evaluate the ability of early chemotherapy to improve overall survival of patients
commencing androgen deprivation for metastatic prostate cancer.

Secondary

- Determine whether early chemotherapy can increase the time to clinical progression
(radiographic or symptomatic deterioration due to disease) over hormonal therapy alone.

- Determine whether early chemotherapy can increase the time to development of
hormone-refractory disease over hormonal therapy alone.

- Determine whether early chemotherapy can increase the time to serological progression
over hormonal therapy alone.

- Determine rates of biochemical response at 6 months and 12 months in the chemohormonal
arm versus the hormonal therapy alone arm.

- Determine the frequency of adverse events and the tolerability of chemotherapy combined
with hormonal therapy versus hormonal therapy alone.

- Determine whether the postulated clinically meaningful increase in disease control is
associated with an alteration in overall quality of life using the Functional
Assessment of Cancer Therapy-Prostate questionnaire.

- Determine the ability of prostate-specific antigen changes to be a surrogate for
clinical benefit from therapy and overall survival.

Tertiary

- Determine whether there are proteins differentially translated from the genome in
hormone-sensitive prostate cancer, prostate cancer that has responded to hormonal
therapy, and hormone-refractory prostate cancer.

- Determine the frequency of constitutive polymorphisms of enzymes involved in steroid
metabolism and other carcinogenic processes.

- Determine whether the amount and frequency of certain carcinogenic proteins in prostate
cancer tissue such as CXCR4 and manganese superoxide dismutase can be correlated with a
poor prognosis.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to age
(≥ 70 vs < 70), ECOG performance status (0-1 vs 2), combined androgen blockade for > 30 days
(yes vs no), duration of prior adjuvant hormonal therapy (> 12 months vs ≤ 12 months),
concurrent bisphosphonate use (yes vs no), and volume of disease (low vs high). Patients are
randomized to 1 of 2 treatment arms.

- Arm A: Patients receive androgen-deprivation therapy (including luteinizing
hormone-releasing hormone [LHRH] agonist therapy, LHRH antagonist therapy, or surgical
castration). Patients also receive docetaxel IV over 1 hour on day 1. Treatment with
docetaxel repeats every 21 days for up to 6 courses in the absence of disease
progression or unacceptable toxicity.

- Arm B: Patients receive androgen-deprivation therapy (as in arm A) alone. Quality of
life is assessed at baseline and at weeks 12, 24, 36, and 48.

After completion of study treatment, patients are followed up periodically for up to 10
years.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed prostate cancer

- High-volume metastatic disease meeting any of the following criteria:

- Visceral metastases (extranodal)

- Bone metastases

- At least 4 bone lesions

- At least 1 bone lesion must be outside of the vertebral column or
pelvis

- On androgen-deprivation therapy for < 120 days

- Prostate-specific antigen (PSA) level may not have risen and met criteria for
progression from its lowest point between the start of androgen-deprivation
therapy and randomization

PATIENT CHARACTERISTICS:

- ECOG performance status (PS) 0-2

- PS 2 eligible only if decline in PS is due to metastatic prostate cancer

- Absolute neutrophil count ≥ 1,500/mm^3

- Platelet count ≥ 100,000/mm^3

- Bilirubin ≤ upper limit of normal (ULN)

- ALT ≤ 2.5 times ULN

- Creatinine clearance ≥ 30 mL/min

- PT and INR ≤ 1.5 times ULN (unless on therapeutic anticoagulation)

- PTT ≤ 1.5 times ULN (unless on therapeutic anticoagulation)

- No prior malignancy in the past 5 years except for basal cell or squamous cell
carcinoma of the skin

- Other malignancies that are considered to have low potential to progress (e.g.,
grade 2, T1a transitional cell carcinoma) may be allowed if approved by study
chair

- No peripheral neuropathy > grade 1

- No history of severe hypersensitivity reaction to docetaxel or other drugs formulated
with polysorbate 80

- No active cardiac disease, including the following:

- Active angina

- Symptomatic congestive heart failure

- Myocardial infarction within the past 6 months

- Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- At least 4 weeks since prior major surgery and recovered from all toxicity prior to
randomization

- Prior adjuvant or neoadjuvant hormonal therapy allowed provided the following are
true:

- Therapy was discontinued ≥ 12 months ago AND there is no evidence of disease, as
defined by 1 of the following:

- PSA < 0.1 ng/dL after prostatectomy plus hormonal therapy

- PSA < 0.5 ng/dL and has not doubled above nadir after radiotherapy plus
hormonal therapy

- Therapy lasted no more than 24 months

- Last depot injection must have expired by the 24-month mark

- Prior palliative radiotherapy allowed if commenced within 30 days before starting
androgen deprivation

- Anti-androgen therapy allowed as single-agent therapy ≤ 7 days before medial
castration to prevent flare

- No prior chemotherapy in adjuvant or neoadjuvant setting

- No prior hormone therapy in the metastatic setting

- More than 30 days (or 6 half-lives) (whichever is longer) since prior participation
in another clinical trial

- Patients can not simultaneously enroll on CALGB 90202

- Concurrent participation in nontherapeutic trials allowed

- Concurrent antiandrogen therapy (e.g., bicalutamide or flutamide) allowed, but not as
sole hormonal therapy

- No concurrent 5-alpha reductase inhibitors

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Overall survival

Safety Issue:

No

Principal Investigator

Christopher Sweeney, MBBS

Investigator Role:

Study Chair

Investigator Affiliation:

Royal Adelaide Hospital Cancer Centre

Authority:

Unspecified

Study ID:

CDR0000462099

NCT ID:

NCT00309985

Start Date:

July 2006

Completion Date:

Related Keywords:

  • Prostate Cancer
  • recurrent prostate cancer
  • stage IV prostate cancer
  • Prostatic Neoplasms

Name

Location

Roswell Park Cancer Institute Buffalo, New York  14263
George Washington University Medical Center Washington, District of Columbia  20037
University of Michigan Comprehensive Cancer Center Ann Arbor, Michigan  48109-0752
Mayo Clinic Scottsdale Scottsdale, Arizona  85259
Mayo Clinic - Jacksonville Jacksonville, Florida  32224
Mayo Clinic Cancer Center Rochester, Minnesota  55905
Cardinal Bernardin Cancer Center at Loyola University Medical Center Maywood, Illinois  60153-5500
Cleveland Clinic Cancer Center Cleveland, Ohio  44195
Hurley Medical Center Flint, Michigan  48503
University of Texas Health Science Center at San Antonio San Antonio, Texas  78284-7811
CCOP - Mount Sinai Medical Center Miami Beach, Florida  33140
CCOP - Illinois Oncology Research Association Peoria, Illinois  61602
CCOP - Carle Cancer Center Urbana, Illinois  61801
CCOP - Iowa Oncology Research Association Des Moines, Iowa  50309-1016
CCOP - Metro-Minnesota Saint Louis Park, Minnesota  55416
Veterans Affairs Medical Center - East Orange East Orange, New Jersey  07018-1095
St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center Grand Junction, Colorado  81502
Rush-Copley Cancer Care Center Aurora, Illinois  60507
Hinsdale Hematology Oncology Associates Hinsdale, Illinois  60521
Joliet Oncology-Hematology Associates, Limited - West Joliet, Illinois  60435
Saint Anthony Memorial Health Centers Michigan City, Indiana  46360
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
Oakwood Cancer Center at Oakwood Hospital and Medical Center Dearborn, Michigan  48123-2500
Genesys Hurley Cancer Institute Flint, Michigan  48503
Van Elslander Cancer Center at St. John Hospital and Medical Center Grosse Pointe Woods, Michigan  48236
Bronson Methodist Hospital Kalamazoo, Michigan  49007
West Michigan Cancer Center Kalamazoo, Michigan  49007-3731
Borgess Medical Center Kalamazooaa, Michigan  49001
Sparrow Regional Cancer Center Lansing, Michigan  48912-1811
St. John Macomb Hospital Warren, Michigan  48093
MeritCare Bemidji Bemidji, Minnesota  56601
Fairview Ridges Hospital Burnsville, Minnesota  55337
Mercy and Unity Cancer Center at Mercy Hospital Coon Rapids, Minnesota  55433
Duluth Clinic Cancer Center - Duluth Duluth, Minnesota  55805-1983
CCOP - Duluth Duluth, Minnesota  55805
Miller - Dwan Medical Center Duluth, Minnesota  55805
Fairview Southdale Hospital Edina, Minnesota  55435
Mercy and Unity Cancer Center at Unity Hospital Fridley, Minnesota  55432
Hutchinson Area Health Care Hutchinson, Minnesota  55350
HealthEast Cancer Care at St. John's Hospital Maplewood, Minnesota  55109
Hennepin County Medical Center - Minneapolis Minneapolis, Minnesota  55415
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital Minneapolis, Minnesota  55407
St. Francis Cancer Center at St. Francis Medical Center Shakopee, Minnesota  55379
Park Nicollet Cancer Center St. Louis Park, Minnesota  55416
Regions Hospital Cancer Care Center St. Paul, Minnesota  55101
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
MeritCare Broadway Fargo, North Dakota  58122
CCOP - MeritCare Hospital Fargo, North Dakota  58122
Aultman Cancer Center at Aultman Hospital Canton, Ohio  44710-1799
Case Comprehensive Cancer Center Cleveland, Ohio  44106-5065
MetroHealth Cancer Care Center at MetroHealth Medical Center Cleveland, Ohio  44109
St. Rita's Medical Center Lima, Ohio  45801
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
Avera Cancer Institute Sioux Falls, South Dakota  57105
Dean Medical Center - Madison Madison, Wisconsin  53717
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center Madison, Wisconsin  53792-6164
Marshfield Clinic - Marshfield Center Marshfield, Wisconsin  54449
Medical College of Wisconsin Cancer Center Milwaukee, Wisconsin  53226
Marshfield Clinic - Indianhead Center Rice Lake, Wisconsin  54868
Methodist Medical Center of Illinois Peoria, Illinois  61636
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
Virginia Mason Medical Center Seattle, Washington  98111
CCOP - Northern Indiana CR Consortium South Bend, Indiana  46601
Saint Joseph Regional Medical Center South Bend, Indiana  46617
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia Philadelphia, Pennsylvania  19107
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Baltimore, Maryland  21231-2410
Cleveland Clinic Taussig Cancer Center Cleveland, Ohio  44195
USC/Norris Comprehensive Cancer Center and Hospital Los Angeles, California  90033-0804
Veterans Affairs Medical Center - Denver Denver, Colorado  80220
MBCCOP - LSU Health Sciences Center New Orleans, Louisiana  70112
CCOP - St. Louis-Cape Girardeau Saint Louis, Missouri  63141
Veterans Affairs Medical Center - San Antonio (Murphy) San Antonio, Texas  78284
CCOP - Virginia Mason Research Center Seattle, Washington  98101
University of California Davis Cancer Center Sacramento, California  95817
Veterans Affairs Medical Center - Baltimore Baltimore, Maryland  21201
John Stoddard Cancer Center at Iowa Methodist Medical Center Des Moines, Iowa  50309
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
Overlook Hospital Summit, New Jersey  07902-0220
Hulston Cancer Center at Cox Medical Center South Springfield, Missouri  65807
St. John's Regional Health Center Springfield, Missouri  65804
Carol G. Simon Cancer Center at Morristown Memorial Hospital Morristown, New Jersey  07962
SUNY Downstate Medical Center Brooklyn, New York  11203
Cancer Institute of New Jersey at Hamilton Hamilton, New Jersey  08690
Yale Cancer Center New Haven, Connecticut  06520-8028
University of Florida Shands Cancer Center Gainesville, Florida  32610-0232
NYU Cancer Institute at New York University Medical Center New York, New York  10016
SUNY Upstate Medical University Hospital Syracuse, New York  13210
St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54307-3508
Lahey Clinic Medical Center - Burlington Burlington, Massachusetts  01805
McCreery Cancer Center at Ottumwa Regional Ottumwa, Iowa  52501
Green Bay Oncology, Limited - Escanaba Escanaba, Michigan  49431
Dickinson County Healthcare System Iron Mountain, Michigan  49801
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. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54301-3526
Green Bay Oncology, Limited at St. Mary's Hospital Green Bay, Wisconsin  54303
Bay Area Cancer Care Center at Bay Area Medical Center Marinette, Wisconsin  54143
Green Bay Oncology, Limited - Oconto Falls Oconto Falls, Wisconsin  54154
Green Bay Oncology, Limited - Sturgeon Bay Sturgeon Bay, Wisconsin  54235
Parma Community General Hospital Parma, Ohio  44129
Good Samaritan Regional Health Center Mt. Vernon, Illinois  62864
David C. Pratt Cancer Center at St. John's Mercy St. Louis, Missouri  63141
Hematology-Oncology Centers of the Northern Rockies - Billings Billings, Montana  59101
Big Sky Oncology Great Falls, Montana  59405
St. Peter's Hospital Helena, Montana  59601
Kalispell Regional Medical Center Kalispell, Montana  59901
Glacier Oncology, PLLC Kalispell, Montana  59901
Montana Cancer Center at St. Patrick Hospital and Health Sciences Center Missoula, Montana  59802
Montana Cancer Specialists at Montana Cancer Center Missoula, Montana  59802
Wayne Memorial Hospital, Incorporated Goldsboro, North Carolina  27534
Adena Regional Medical Center Chillicothe, Ohio  54601
Doctors Hospital at Ohio Health Columbus, Ohio  43228
Riverside Methodist Hospital Cancer Care Columbus, Ohio  43214
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
Genesis - Good Samaritan Hospital Zanesville, Ohio  43701
Veterans Affairs Medical Center - Hines Hines, Illinois  60141
Greenebaum Cancer Center at University of Maryland Medical Center Baltimore, Maryland  21201
Lombardi Comprehensive Cancer Center at Georgetown University Medical Center Washington, District of Columbia  20007
Mountain States Tumor Institute at St. Luke's Regional Medical Center Boise, Idaho  83712-6297
Indiana University Melvin and Bren Simon Cancer Center Indianapolis, Indiana  46202-5289
Lucille P. Markey Cancer Center at University of Kentucky Lexington, Kentucky  40536-0093
Dana-Farber/Harvard Cancer Center at Dana-Farber Cancer Institute Boston, Massachusetts  02115
University of Mississippi Cancer Clinic Jackson, Mississippi  39216-4505
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis St. Louis, Missouri  63110
CCOP - Nevada Cancer Research Foundation Las Vegas, Nevada  89109-2306
Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School New Brunswick, New Jersey  08903
Oklahoma University Cancer Institute Oklahoma City, Oklahoma  73104
Geisinger Cancer Institute at Geisinger Health Danville, Pennsylvania  17822-0001
West Virginia University Health Sciences Center - Charleston Charleston, West Virginia  25302
Gundersen Lutheran Center for Cancer and Blood La Crosse, Wisconsin  54601
University of Virginia Cancer Center Charlottesville, Virginia  22908
Robert H. Lurie Comprehensive Cancer Center at Northwestern University Chicago, Illinois  60611
Decatur Memorial Hospital Cancer Care Institute Decatur, Illinois  62526
Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
Elkhart General Hospital Elkhart, Indiana  46515
Howard Community Hospital Kokomo, Indiana  46904
Lakeland Regional Cancer Care Center - St. Joseph St. Joseph, Michigan  49085
Cleveland Clinic Cancer Center at Fairview Hospital Cleveland, Ohio  44111
Mount Carmel Health - West Hospital Columbus, Ohio  43222
Hillcrest Cancer Center at Hillcrest Hospital Mayfield Heights, Ohio  44124
Fox Chase Cancer Center - Philadelphia Philadelphia, Pennsylvania  19111-2497
Front Range Cancer Specialists Fort Collins, Colorado  80528
Hematology Oncology Associates - Skokie Skokie, Illinois  60076
Peninsula Medical Center Burlingame, California  94010
Sutter Health - Western Division Cancer Research Group Greenbrae, California  94904
California Pacific Medical Center - California Campus San Francisco, California  94118
Sutter Solano Medical Center Vallejo, California  94589
Poudre Valley Hospital Fort Collins, Colorado  80524
Ella Milbank Foshay Cancer Center at Jupiter Medical Center Jupiter, Florida  33458
Graham Hospital Canton, Illinois  61520
Memorial Hospital Carthage, Illinois  62321
Hematology and Oncology Associates Chicago, Illinois  60611
Eureka Community Hospital Eureka, Illinois  61530
North Shore Oncology and Hematology Associates, Limited - Libertyville Libertyville, Illinois  60048
McDonough District Hospital Macomb, Illinois  61455
Hematology Oncology Consultants - Naperville Naperville, Illinois  60540
BroMenn Regional Medical Center Normal, Illinois  61761
Community Cancer Center Normal, Illinois  61761
Community Hospital of Ottawa Ottawa, Illinois  61350
Oncology Hematology Associates of Central Illinois, PC - Ottawa Ottawa, Illinois  61350
Cancer Treatment Center at Pekin Hospital Pekin, Illinois  61554
Oncology Hematology Associates of Central Illinois, PC - Peoria Peoria, Illinois  61615
Proctor Hospital Peoria, Illinois  61614
Illinois Valley Community Hospital Peru, Illinois  61354
Fort Wayne Medical Oncology and Hematology Fort Wayne, Indiana  46815
Center for Cancer Therapy at LaPorte Hospital and Health Services La Porte, Indiana  46350
John Stoddard Cancer Center at Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
Medical Oncology and Hematology Associates at John Stoddard Cancer Center Des Moines, Iowa  50309
Medical Oncology and Hematology Associates at Mercy Cancer Center Des Moines, Iowa  50314
Mercy Cancer Center at Mercy Medical Center - Des Moines Des Moines, Iowa  50314
Medical Oncology and Hematology Associates - West Des Moines West Des Moines, Iowa  50266
St. Francis Comprehensive Cancer Center Topeka, Kansas  66606
Mary Bird Perkins Cancer Center - Baton Rouge Baton Rouge, Louisiana  70809
Medical Center of Louisiana - New Orleans New Orleans, Louisiana  70112
St. Joseph's Medical Center Brainerd, Minnesota  56401
Coborn Cancer Center Saint Cloud, Minnesota  56303
CentraCare Clinic - River Campus St. Cloud, Minnesota  56303
Saint Francis Medical Center Cape Girardeau, Missouri  63701
North Coast Cancer Care, Incorporated Sandusky, Ohio  44870
Cleveland Clinic - Wooster Wooster, Ohio  44691
Bryn Mawr Hospital Bryn Mawr, Pennsylvania  19010
Delaware County Regional Cancer Center at Delaware County Memorial Hospital Drexel Hill, Pennsylvania  19026
Lankenau Cancer Center at Lankenau Hospital Wynnewood, Pennsylvania  19096
Cancer Therapy and Research Center San Antonio, Texas  78229
University Hospital - San Antonio San Antonio, Texas  78229
Holy Family Memorial Medical Center Cancer Care Center Manitowoc, Wisconsin  54221-1450
Fairbanks Cancer Treatment Center at Fairbanks Memorial Hospital Fairbanks, Alaska  99701
Montrose Memorial Hospital Cancer Center Montrose, Colorado  81401
DeCesaris Cancer Institute at Anne Arundel Medical Center Annapolis, Maryland  21401
Cascade Cancer Center at Evergreen Hospital Medical Center Kirkland, Washington  98034-3013
Mayo Clinic Hospital Phoenix, Arizona  85054-4502
Hembree Mercy Cancer Center at St. Edward Mercy Medical Center Ft. Smith, Arkansas  72903
Northeast Georgia Medical Center Gainesville, Georgia  30501
Regional Cancer Center at Singing River Hospital Pascagoula, Mississippi  39581
St. Joseph Medical Center Reading, Pennsylvania  19604
Alta Bates Summit Comprehensive Cancer Center Berkeley, California  94704
Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital Fort Lauderdale, Florida  33308
Evanston Hospital Evanston, Illinois  60201-1781
Kellogg Cancer Care Center Highland Park, Illinois  60035
Cancer Care and Hematology Specialists of Chicagoland - Niles Niles, Illinois  60714
Michiana Hematology-Oncology, PC - Elkhart Elkhart, Indiana  46514
Elkhart Clinic, LLC Elkhart, Indiana  46514-2098
William N. Wishard Memorial Hospital Indianapolis, Indiana  46202
Michiana Hematology Oncology PC - La Porte La Porte, Indiana  46350
Michiana Hematology-Oncology, PC - South Bend Mishawaka, Indiana  46545-1470
Michiana Hematology Oncology PC - Plymouth Plymouth, Indiana  46563
Greater Baltimore Medical Center Cancer Center Baltimore, Maryland  21204
Foote Memorial Hospital Jackson, Michigan  49201
St. Mary Mercy Hospital Livonia, Michigan  48154
St. Joseph Mercy Oakland Pontiac, Michigan  48341-2985
Mercy Regional Cancer Center at Mercy Hospital Port Huron, Michigan  48060
Seton Cancer Institute at Saint Mary's - Saginaw Saginaw, Michigan  48601
Lakeside Cancer Specialists, PLLC Saint Joseph, Michigan  49085
Willmar Cancer Center at Rice Memorial Hospital Willmar, Minnesota  56201
Truman Medical Center - Hospital Hill Kansas City, Missouri  64108
Billings Clinic - Downtown Billings, Montana  59107-7000
Bozeman Deaconess Cancer Center Bozeman, Montana  59715
St. James Healthcare Cancer Care Butte, Montana  59701
Great Falls Clinic - Main Facility Great Falls, Montana  59405
Sletten Cancer Institute at Benefis Healthcare Great Falls, Montana  59405
Kalispell Medical Oncology at KRMC Kalispell, Montana  59901
Frederick R. and Betty M. Smith Cancer Treatment Center Sparta, New Jersey  07871
Summa Center for Cancer Care at Akron City Hospital Akron, Ohio  44309-2090
Barberton Citizens Hospital Barberton, Ohio  44203
Grant Medical Center Cancer Care Columbus, Ohio  43215
Knox Community Hospital Mount Vernon, Ohio  43050
Mount Carmel St. Ann's Cancer Center Westerville, Ohio  43081
Geisinger Hazleton Cancer Center Hazleton, Pennsylvania  18201
McGlinn Family Regional Cancer Center at Reading Hospital and Medical Center Reading, Pennsylvania  19612-6052
York Cancer Center at Apple Hill Medical Center York, Pennsylvania  17405
Marshfield Clinic - Chippewa Center Chippewa Falls, Wisconsin  54729
Marshfield Clinic Cancer Care at Regional Cancer Center Eau Claire, Wisconsin  54701
Vince Lombardi Cancer Clinic - Green Bay at Aurora BayCare Medical Center Green Bay, Wisconsin  54311
UW Cancer Center Johnson Creek Johnson Creek, Wisconsin  53038
Vince Lombardi Cancer Clinic - Marinette Marinette, Wisconsin  54143
Saint Joseph's Hospital Marshfield, Wisconsin  54449
Marshfield Clinic - Lakeland Center Minocqua, Wisconsin  54548
Ministry Medical Group at Saint Mary's Hospital Rhinelander, Wisconsin  54501
Vince Lombardi Cancer Clinic - Sheboygan Sheboygan, Wisconsin  53081
Marshfield Clinic at Saint Michael's Hospital Stevens Point, Wisconsin  54481
Saint Michael's Hospital Cancer Center Stevens Point, Wisconsin  54481
Aurora Medical Center Summit, Wisconsin  53066
Vince Lombardi Cancer Clinic - Two Rivers Two Rivers, Wisconsin  54241
Marshfield Clinic - Wausau Center Wausau, Wisconsin  54401
Oncology Alliance, SC - Milwaukee - West Wauwatosa, Wisconsin  53226
Marshfield Clinic - Weston Center Weston, Wisconsin  54476
Diagnostic and Treatment Center Weston, Wisconsin  54476
Marshfield Clinic - Wisconsin Rapids Center Wisconsin Rapids, Wisconsin  54494
Rocky Mountain Oncology Casper, Wyoming  82609
Mid Dakota Clinic, PC Bismarck, North Dakota  58501
Regional Cancer Center at Memorial Medical Center Springfield, Illinois  62781-0001
Genesys Regional Medical Center Grand Blanc, Michigan  48439-8066
Tucker Center for Cancer Care at Orange Regional Medical Center Middletown, New York  10940-4199
Pardee Memorial Hospital Hendersonville, North Carolina  28791
Kinston Medical Specialists Kinston, North Carolina  28501
St. Francis Hospital Evanston, Illinois  60202
Jordan Hospital Club Cancer Center Plymouth, Massachusetts  02360
MBCCOP - Meharry Medical College - Nashville Nashville, Tennessee  37208-3599
Providence Cancer Center Anchorage, Alaska  99508
La Grange Memorial Hospital La Grange, Illinois  60525
Mid-Illinois Hematology-Oncology Associates at Community Cancer Center Normal, Illinois  61761
University of Wisconcin Cancer Center at Aspirus Wausau Hospital Wausau, Wisconsin  54401
Veterans Affairs Medical Center - Iowa City Iowa City, Iowa  52246-2208
Newton-Wellesley Hospital Newton, Massachusetts  02462
Galesburg Clinic, PC Galesburg, Illinois  61401
Boston University Cancer Research Center Boston, Massachusetts  02118
St. Vincent Healthcare Cancer Care Services Billings, Montana  59101
Midwest Hematology Oncology Group, Incorporated Saint Louis, Missouri  63109
Lynchburg Hematology-Oncology Clinic Lynchburg, Virginia  24501
Tibotec Therapeutics - Division of Ortho Biotech Products, LP Marysville, California  95901
Memorial Medical Center Modesto, California  95355
Tahoe Forest Cancer Center Truckee, California  96161
Illinois CancerCare - Bloomington Bloomington%, Illinois  61701
Illinois CancerCare - Canton Canton, Illinois  61520
Illinois CancerCare - Carthage Carthage, Illinois  62321
Illinois CancerCare - Eureka Eureka, Illinois  61530
Illinois CancerCare - Havana Havana, Illinois  62644
Illinois CancerCare - Kewanee Clinic Kewanee, Illinois  61443
Illinois CancerCare - Macomb Macomb, Illinois  61455
Illinois CancerCare - Monmouth Monmouth, Illinois  61462
Illinois CancerCare - Community Cancer Center Normal, Illinois  61761
Illinois CancerCare - Pekin Pekin, Illinois  61603
Illinois CancerCare - Peru Peru, Illinois  61354
Illinois CancerCare - Princeton Princeton, Illinois  61356
Illinois CancerCare - Spring Valley Spring Valley, Illinois  61362
Veterans Affairs Medical Center - Indianapolis Indianapolis, Indiana  46202
Cancer Center of Paoli Memorial Hospital Paoli, Pennsylvania  19301-1792
CCOP - Main Line Health Wynnewood, Pennsylvania  19096
Medcenter One Hospital Cancer Care Center Bismarck, North Dakota  58501
St. Alexius Medical Center Cancer Center Bismarck, North Dakota  58502
University of Colorado Cancer Center at UC Health Sciences Center Aurora, Colorado  80045
Provena St. Mary's Regional Cancer Center - Kankakee Kankakee, Illinois  60901
Skaggs Cancer Center at Skaggs Regional Medical Center Branson, Missouri  65616
Minnesota Oncology - Maplewood Maplewood, Minnesota  55109
Humphrey Cancer Center at North Memorial Outpatient Center Robbinsdale, Minnesota  55422-2900
Lakeview Hospital Stillwater, Minnesota  55082
Minnesota Oncology - Woodbury Woodbury, Minnesota  55125
Kings County Hospital Center Brooklyn, New York  11203
Mount Carmel Regional Cancer Center Pittsburg, Kansas  66762
St. Agnes Hospital Cancer Center Baltimore, Maryland  21229
Nevada Cancer Institute Las Vegas, Nevada  89135
California Cancer Care, Incorporated - Greenbrae Greenbrae, California  94904
Shaw Regional Cancer Center Edwards, Colorado  81632
Langlade Memorial Hospital Antigo, Wisconsin  54409
Hays Medical Center Hays, Kansas  67601
Hutchinson Hospital Corporation Hutchinson, Kansas  67502
Cleveland Clinic Beachwood Family Health and Surgery Center Beachwood, Ohio  44122
Cleveland Clinic Foundation - Strongsville Strongsville, Ohio  44136
New Ulm Medical Center New Ulm, Minnesota  56073
Roger Maris Cancer Center at MeritCare Hospital Fargo, North Dakota  58122
St. Nicholas Hospital Sheboygan, Wisconsin  53081
Saint Helena Hospital Saint Helena, California  94574
Pacific Medical Center Seattle, Washington  98104
Saint Luke's Mountain States Tumor Institute Boise, Idaho  83712
Commonwealth Hematology-Oncology, PC - Quincy Quincy, Massachusetts  02169
Southern Ohio Medical Center Cancer Center Portsmouth, Ohio  45662
Illinois CancerCare - Cottage Galesburg, Illinois  61401
Mather Veteran Affairs Medical Center Mather, California  95655
Saint Luke's Mountain States Tumor Institute - Fruitland Fruitland, Idaho  83619
Mountain States Tumor Institute - Meridian Meridian, Idaho  83642
Mountain States Tumor Institute at St. Luke's Twin Falls, Idaho  83301
Central Care Cancer Center at Carrie J. Babb Cancer Center Bolivar, Missouri  65613
Adams Cancer Center Gettysburg, Pennsylvania  17325
Cherry Tree Cancer Center Hanover, Pennsylvania  17331
Dickstein Cancer Treatment Center at White Plains Hospital Center White Plains, New York  10601
Idaho Urologic Institute, PA Meridian, Idaho  83642
Zangmeister Center Columbus, Ohio  43219
Mercy Cancer Center at Mercy Medical Center Merced, California  95340
Sutter Pacific Medical Foundation Santa Rosa, California  95403