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A Randomized Phase III Trial of CC-5013 (Lenalidomide, NSC-703813) and Low Dose Dexamethasone (LLD) Versus Bortezomib (PS-341, NSC-681239), Lenalidomide and Low Dose Dexamethasone (BLLD) for Induction, in Patients With Previously Untreated Multiple Myeloma Without an Intent for Immediate Autologous Stem Cell Transplant


Phase 3
18 Years
N/A
Open (Enrolling)
Both
Stage I Multiple Myeloma, Stage II Multiple Myeloma, Stage III Multiple Myeloma

Thank you

Trial Information

A Randomized Phase III Trial of CC-5013 (Lenalidomide, NSC-703813) and Low Dose Dexamethasone (LLD) Versus Bortezomib (PS-341, NSC-681239), Lenalidomide and Low Dose Dexamethasone (BLLD) for Induction, in Patients With Previously Untreated Multiple Myeloma Without an Intent for Immediate Autologous Stem Cell Transplant


PRIMARY OBJECTIVES:

I. To compare progression-free survival of patients with newly diagnosed multiple myeloma
treated with lenalidomide and low-dose dexamethasone with or without bortezomib.

SECONDARY OBJECTIVES:

I. To assess response using the new international response criteria. II. To bank specimens
for future research. III. To assess overall survival and other long-term outcomes stratified
by intent to undergo transplantation at progression.

IV. To verify the reported benefit of bortezomib in promoting bone repair/healing by
comparing and contrasting the bone healing as determined by achievement of MRI-CR (closed as
of 10/15/10).

V. To utilize MRI for accurate baseline staging plus evaluation of response and progression
(closed as of 10/15/10).

VI. To compare achievement of MRI-CR with achievement of x-ray-CR (closed as of 10/15/10).

VII. To evaluate custom and genome-wide single nucleotide polymorphisms (SNPs) in
correlation with biology, prognosis and outcome for both treatment regimens combined.

VIII. To verify the findings recently obtained with the custom BOAC SNP chip on TT2 data
with respect to bone disease in the cooperative group setting.

IX. To use baseline gene expression profiling as a tool to evaluate the biology, prognostic
and risk factors, and response to therapy for both treatment regimens combined.

X. To validate John Shaughnessy's 70 gene risk model developed for Total Therapy 2 (TT2) in
the cooperative group setting.

OUTLINE: Patients are stratified according to the International Staging System (I vs II vs
III) and intent to undergo transplantation at relapse (yes vs no).

INDUCTION THERAPY: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive oral dexamethasone once daily on days 1, 8, 15, and 22 and oral
lenalidomide once daily on days 1-21. Treatment repeats every 28 days for 6 courses in the
absence of disease progression or unacceptable toxicity.

ARM II: Patients receive oral dexamethasone once daily on days 1, 2, 4, 5, 8, 9, 11, and 12;
oral lenalidomide once daily on days 1-14; and bortezomib IV over 3-5 seconds on days 1, 4,
8, and 11. Treatment repeats every 21 days for 8 courses in the absence of disease
progression or unacceptable toxicity.

In both arms, patients who intend to undergo transplantation at relapse undergo peripheral
blood stem cell collection, preferably after course 2.

MAINTENANCE THERAPY: After the completion of at least 4 courses (arm I) or at least 6
courses (arm II) of induction therapy, patients receive maintenance therapy comprising oral
dexamethasone once daily on days 1, 8, 15, and 22 and oral lenalidomide once daily on days
1-21. Treatment repeats every 28 days in the absence of disease progression or unacceptable
toxicity.

Patients undergo bone marrow biopsy at baseline and periodically during study for
correlative studies. Patients may also undergo blood sample collection.

After completion of study treatment, patients are followed periodically for up to 6 years.


Inclusion Criteria:



- Newly diagnosed multiple myeloma (MM)

- Stage I, II, or III disease by the New International Staging System

- Measurable disease

- Nonsecretory MM based upon standard M-component criteria (i.e., measurable
serum/urine M-component) is not allowed unless the baseline serum free light chain
level (Freelite™) is elevated

- Serum Freelite must be drawn

- No freelite chains

- Must be offered participation in the Myeloma Specimen Repository for banking and
future research, and in the Gene Expression Profiling (GEP) molecular studies for the
evaluation of genetic polymorphisms

- Must have baseline skeletal survey, including lateral skull, anteroposterior (AP)
pelvis and posteroanterior (PA) chest within 28 days prior to study entry

- Institutions must submit a local cytogenetics report and FISH analysis prior to study
entry

- Zubrod performance status 0-3

- Platelet count ≥ 80,000/mm³*

- ANC ≥ 1,000/mm³*

- Hemoglobin ≥ 9.0 g/dL* (including patients who have been transfused or treated with
epoetin)

- Creatinine clearance > 30 cc/min

- FEV_1 and FVC ≥ 50% of predicted**

- DLCO ≥ 50% of predicted**

- No uncontrolled, active infection requiring IV antibiotics

- No NYHA class III-IV heart failure

- No myocardial infarction within the past 6 months

- No history of treatment for clinically significant ventricular cardiac arrhythmias

- No poorly controlled hypertension

- No poorly controlled diabetes mellitus

- No chronic obstructive or chronic restrictive pulmonary disease

- Must have undergone an EKG within the past month

- No psychiatric illness that could potentially interfere with the completion of study
treatment

- No history of cerebral vascular accident with persistent neurologic deficits

- No other prior malignancy except adequately treated basal cell or squamous cell skin
cancer, in situ cervical cancer, or other cancer for which the patient has been
disease-free for 5 years

- No hepatitis B or C positivity

- HIV negative***

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception for 4 weeks before, during, and for
4 weeks after study treatment

- Female patients must use 2 reliable forms of contraception simultaneously

- Male patients must use effective barrier contraception

- Patients with pathologic fractures, pneumonia at diagnosis, or symptomatic
hyperviscosity syndrome must have these conditions attended to prior to study entry
(i.e., intramedullary rod, IV antibiotics, or plasmapheresis)

- Patients must have baseline skeletal survey that include lateral skull,
anteroposterior (AP) pelvis, and posteroanterior (PA) chest within the past 28 days

- No prior chemotherapy for this disease

- No prior radiotherapy to a large area of the pelvis (i.e., more than half of the
pelvis)

- No prior bortezomib or lenalidomide

- Prior steroid treatment allowed provided treatment was no more than 2 weeks in
duration

- Must be able to take concurrent aspirin 325 mg daily (or enoxaparin 40 mg
subcutaneously daily if allergic to aspirin) as prophylactic coagulation

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Progression-free survival

Outcome Description:

Evaluated by a one-sided stratified log-rank test.

Outcome Time Frame:

From date of registration to date of first documentation of progression or symptomatic deterioration, or death due to any cause, assessed up to 6 years

Safety Issue:

No

Principal Investigator

Brian G. Durie

Investigator Role:

Principal Investigator

Investigator Affiliation:

Southwest Oncology Group (SWOG) Research Base

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2009-00798

NCT ID:

NCT00644228

Start Date:

April 2008

Completion Date:

Related Keywords:

  • Stage I Multiple Myeloma
  • Stage II Multiple Myeloma
  • Stage III Multiple Myeloma
  • Multiple Myeloma
  • Neoplasms, Plasma Cell

Name

Location

Baylor College of Medicine Houston, Texas  77030
Cleveland Clinic Foundation Cleveland, Ohio  44195
Mayo Clinic Rochester, Minnesota  55905
University of Mississippi Medical Center Jackson, Mississippi  39216-4505
Hurley Medical Center Flint, Michigan  48503
Pennsylvania Hospital Philadelphia, Pennsylvania  19107
Sinai Hospital of Baltimore Baltimore, Maryland  21225
Beth Israel Deaconess Medical Center Boston, Massachusetts  02215
Boulder Community Hospital Boulder, Colorado  80301-9019
Porter Adventist Hospital Denver, Colorado  80210
Rose Medical Center Denver, Colorado  80220
Swedish Medical Center Englewood, Colorado  80110
Sky Ridge Medical Center Lone Tree, Colorado  80124
North Suburban Medical Center Thornton, Colorado  80229
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
Hutchinson Area Health Care Hutchinson, Minnesota  55350
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
Geisinger Medical Center Danville, Pennsylvania  17822-0001
Loyola University Medical Center Maywood, Illinois  60153
CentraCare Clinic Saint Cloud, Minnesota  56303
Rapid City Regional Hospital Rapid City, South Dakota  57709
Marshfield Clinic Marshfield, Wisconsin  54449
Methodist Medical Center of Illinois Peoria, Illinois  61636
Memorial Hospital of South Bend South Bend, Indiana  46601
Mary Bird Perkins Cancer Center Baton Rouge, Louisiana  70809
Marquette General Hospital Marquette, Michigan  49855
Beth Israel Medical Center New York, New York  10003
Lehigh Valley Hospital Allentown, Pennsylvania  18103
Reading Hospital and Medical Center Reading, Pennsylvania  19612-6052
Jackson-Madison County General Hospital Jackson, Tennessee  38301
University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
Boston Medical Center Boston, Massachusetts  02118
Brooke Army Medical Center Fort Sam Houston, Texas  78234-6200
Eastern Maine Medical Center Bangor, Maine  04401
Baystate Medical Center Springfield, Massachusetts  01199
Providence Alaska Medical Center Anchorage, Alaska  99508
William Beaumont Hospital Royal Oak, Michigan  48073
Cancer Institute of New Jersey New Brunswick, New Jersey  08901
Kaiser Permanente Medical Center - Santa Clara Santa Clara, California  95051-5386
Wesley Medical Center Wichita, Kansas  67214
Legacy Emanuel Hospital and Health Center Portland, Oregon  97227
University of Wisconsin Hospital and Clinics Madison, Wisconsin  53792-0001
Great Falls Clinic Great Falls, Montana  59405
Winthrop University Hospital Mineola, New York  11501
MetroHealth Medical Center Cleveland, Ohio  44109
Wilford Hall Medical Center Lackland Air Force Base, Texas  78236-5300
Eisenhower Medical Center Rancho Mirage, California  92270
Mount Nittany Medical Center State College, Pennsylvania  16803
Parma Community General Hospital Parma, Ohio  44129
North Colorado Medical Center Greeley, Colorado  80631
McKee Medical Center Loveland, Colorado  80539
Munson Medical Center Traverse City, Michigan  49684
Northern Rockies Radiation Oncology Center Billings, Montana  59101
Bozeman Deaconess Hospital Bozeman, Montana  59715
Kalispell Medical Oncology Kalispell, Montana  59901
Kalispell Regional Medical Center Kalispell, Montana  59901
Medical X-Ray Center Sioux Falls, South Dakota  57105
Welch Cancer Center Sheridan, Wyoming  82801
University of New Mexico Cancer Center Albuquerque, New Mexico  87131-5636
Elkhart General Hospital Elkhart, Indiana  46515
University Medical Center of Southern Nevada Las Vegas, Nevada  89102
Jennersville Regional Hospital West Grove, Pennsylvania  19390-9499
Poudre Valley Hospital Fort Collins, Colorado  80524
Beebe Medical Center Lewes, Delaware  19958
Saint Joseph's Hospital of Atlanta Atlanta, Georgia  30342-1701
Piedmont Hospital Atlanta, Georgia  30309
Gwinnett Medical Center Lawrenceville, Georgia  30045
Southern Regional Medical Center Riverdale, Georgia  30274-2600
Memorial Hospital Carthage, Illinois  62321
Hematology and Oncology Associates Chicago, Illinois  60611
Galesburg Cottage Hospital Galesburg, Illinois  61401
Galesburg Clinic Galesburg, Illinois  61401
Mason District Hospital Havana, Illinois  62644
McDonough District Hospital Macomb, Illinois  61455
BroMenn Regional Medical Center Normal, Illinois  61761
Proctor Hospital Peoria, Illinois  61614
Perry Memorial Hospital Princeton, Illinois  61356
Mecosta County Medical Center Big Rapids, Michigan  49307
Community Cancer Center of Monroe Monroe, Michigan  48162
Saint Francis Medical Center Cape Girardeau, Missouri  63701
Bismarck Cancer Center Bismarck, North Dakota  58501
Wood County Oncology Center Bowling Green, Ohio  43402
Grandview Hospital Dayton, Ohio  45405
Lima Memorial Hospital Lima, Ohio  45804
Northwest Ohio Oncology Center Maumee, Ohio  43537
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Fulton County Health Center Wauseon, Ohio  43567
Legacy Mount Hood Medical Center Gresham, Oregon  97030
Providence Milwaukie Hospital Milwaukie, Oregon  97222
Legacy Meridian Park Hospital Tualatin, Oregon  97062
Danville Regional Medical Center Danville, Virginia  24541
Denver Health Medical Center Denver, Colorado  80204-4507
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
Eureka Hospital Eureka, Illinois  61530
Mercy Hospital Coon Rapids, Minnesota  55433
Graham Hospital Association Canton, Illinois  61520
Holy Family Medical Center Des Plaines, Illinois  60016
Hematology Oncology Associates of Illinois-Highland Park Highland Park, Illinois  60035
Saint Joseph Medical Center Joliet, Illinois  60435
Pekin Hospital Pekin, Illinois  61554
Ottumwa Regional Health Center Ottumwa, Iowa  52501
Bixby Medical Center Adrian, Michigan  49221
Saint Joseph Mercy Hospital Ann Arbor, Michigan  48106
Fairview-Southdale Hospital Edina, Minnesota  55435
Abbott-Northwestern Hospital Minneapolis, Minnesota  55407
Regions Hospital Saint Paul, Minnesota  55101
Saint Francis Regional Medical Center Shakopee, Minnesota  55379
Rice Memorial Hospital Willmar, Minnesota  56201
Saint Luke's Hospital Maumee, Ohio  43537
Geisinger Medical Group State College, Pennsylvania  16801
Miami Valley Hospital Dayton, Ohio  45409
Spartanburg Regional Medical Center Spartanburg, South Carolina  29303
Lawrence Memorial Hospital Lawrence, Kansas  66044
Menorah Medical Center Overland Park, Kansas  66209
Shawnee Mission Medical Center Shawnee Mission, Kansas  66204
North Kansas City Hospital Kansas City, Missouri  64116
Research Medical Center Kansas City, Missouri  64132
Saint Luke's East - Lee's Summit Lee's Summit, Missouri  64086
Liberty Hospital Liberty, Missouri  64068
Heartland Regional Medical Center Saint Joseph, Missouri  64506
Bozeman Deaconess Cancer Center Bozeman, Montana  59715
Northern Montana Hospital Havre, Montana  59501
Wayne Hospital Greenville, Ohio  45331
Fisher-Titus Medical Center Norwalk, Ohio  44857
Clinton Memorial Hospital Wilmington, Ohio  45177
Marshfield Clinic Cancer Care at Regional Cancer Center Eau Claire, Wisconsin  54701
UW Cancer Center Johnson Creek Johnson Creek, Wisconsin  53038
Saint Joseph's Hospital Marshfield, Wisconsin  54449
Marshfield Clinic - Weston Center Weston, Wisconsin  54476
Marshfield Clinic - Wisconsin Rapids Center Wisconsin Rapids, Wisconsin  54494
Rocky Mountain Oncology Casper, Wyoming  82609
Longmont United Hospital Longmont, Colorado  80501
Memorial Hospital of Rhode Island Pawtucket, Rhode Island  02860
Singing River Hospital Pascagoula, Mississippi  39581
Ben Taub General Hospital Houston, Texas  77030
Methodist Hospital Houston, Texas  77030
Martin Memorial Cancer Center Stuart, Florida  34995-9010
Greene Memorial Hospital Xenia, Ohio  45385
Greater Baltimore Medical Center Baltimore, Maryland  21204
Rutherford Hospital Rutherfordton, North Carolina  28139
Harold Alfond Center for Cancer Care Augusta, Maine  04330
Union Hospital of Cecil County Elkton MD, Maryland  21921
Presbyterian Hospital Charlotte, North Carolina  28233-3549
Mayo Clinic in Arizona Scottsdale, Arizona  85259-5404
Memorial Medical Center Springfield, Illinois  62781
Metro Health Hospital Grand Rapids, Michigan  49506
Guardian Oncology and Center for Wellness Missoula, Montana  59804
Queen's Medical Center Honolulu, Hawaii  96813
LaPorte Hospital LaPorte, Indiana  46350-0250
Northwestern University Chicago, Illinois  60611
Northwest Cancer Specialists Vancouver, Washington  98664
Tahoe Forest Cancer Center Truckee, California  96161
Kapiolani Medical Center at Pali Momi Aiea, Hawaii  96701
Kapiolani Medical Center for Women and Children Honolulu, Hawaii  96826
Maui Memorial Medical Center Wailuku, Hawaii  96793
Hennepin County Medical Center Minneapolis, Minnesota  
University of Rochester Rochester, New York  14642
Southwest Washington Medical Center Vancouver, Washington  98664
Case Western Reserve University Cleveland, Ohio  44106
Wayne State University Detroit, Michigan  48202
University of Arizona Health Sciences Center Tucson, Arizona  85724
Straub Clinic and Hospital Honolulu, Hawaii  96813
Toledo Clinic Oregon, Ohio  43616
Providence Portland Medical Center Portland, Oregon  97213-3635
Mid Dakota Clinic Bismarck, North Dakota  58501
Presbyterian - Saint Lukes Medical Center - Health One Denver, Colorado  80218
Kaiser Permanente Sacramento, California  
Montana Cancer Consortium CCOP Billings, Montana  59101
Flower Hospital Sylvania, Ohio  43560-2197
Providence Holy Cross Medical Center Mission Hills, California  91345
Metro-Minnesota CCOP St. Louis Park, Minnesota  
UC Davis Comprehensive Cancer Center Sacramento, California  95817
Providence Hospital Southfield, Michigan  48075
Lakeview Hospital Stillwater, Minnesota  55082
Decatur Memorial Hospital Decatur, Illinois  62526
Oncology Associates Cedar Rapids, Iowa  52403
Louisiana State University Health Science Center New Orleans, Louisiana  70112
CentraState Medical Center Freehold, New Jersey  07728
Montana Cancer Specialists Missoula, Montana  59807-7877
Providence Saint Joseph Medical Center Burbank, California  91505-4866
Hillcrest Hospital Cancer Center Mayfield Heights, Ohio  44124
M D Anderson Cancer Center Houston, Texas  77030
DeKalb Medical Center Decatur, Georgia  30033
Northern Indiana Cancer Research Consortium South Bend, Indiana  
Hawaii Medical Center East Honolulu, Hawaii  96817
Penn State Milton S Hershey Medical Center Hershey, Pennsylvania  17033
Piedmont Fayette Hospital Fayetteville, Georgia  30214
Castle Medical Center Kailua, Hawaii  96734
Clackamas Radiation Oncology Center Clackamas, Oregon  97015
Providence Newberg Medical Center Newberg, Oregon  97132
Butler Memorial Hospital Butler, Pennsylvania  16001
Parker Adventist Hospital Parker, Colorado  80138
OSF Saint Francis Medical Center Peoria, Illinois  61637
Northside Hospital Atlanta, Georgia  30342
Kaiser Permanente, Fremont Fremont, California  94538
Kaiser Permanente, Hayward Hayward, California  94545
Fremont - Rideout Cancer Center Marysville, California  95901
Palo Alto Medical Foundation-Camino Division Mountain View, California  94040
Kaiser Permanente-Oakland Oakland, California  94611
Saint Joseph Hospital Orange, California  92868
Palo Alto Medical Foundation Heath Care Palo Alto, California  94301
Valley Medical Oncology Consultants Pleasanton, California  94588
Kaiser Permanente-Redwood City Redwood City, California  94063
Kaiser Permanente-Richmond Richmond, California  94801
Kaiser Permanente-Roseville Roseville, California  95661
Kaiser Permanente-South Sacramento Sacramento, California  95823
Kaiser Permanente - Sacramento Sacramento, California  95825
Kaiser Permanente-San Francisco San Francisco, California  94115
Kaiser Permanente-Santa Teresa-San Jose San Jose, California  95119
Kaiser Permanente-San Rafael San Rafael, California  94903
Kaiser Permanente-Santa Rosa Santa Rosa, California  95403
Kaiser Permanente-South San Francisco South San Francisco, California  94080
Kaiser Permanente-Stockton Stockton, California  95210
Kaiser Permanente-Vallejo Vallejo, California  94589
Kaiser Permanente-Walnut Creek Walnut Creek, California  94596
The Medical Center of Aurora Aurora, Colorado  80012
Penrose-Saint Francis Healthcare Colorado Springs, Colorado  80907
Saint Anthony Central Hospital Denver, Colorado  80204
Exempla Saint Joseph Hospital Denver, Colorado  80218
Colorado Cancer Research Program CCOP Denver, Colorado  80224-2522
Saint Mary's Hospital and Regional Medical Center Grand Junction, Colorado  81502
Saint Mary Corwin Medical Center Pueblo, Colorado  81004
Danbury Hospital Danbury, Connecticut  06810
Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
The Hospital of Central Connecticut New Britain, Connecticut  06050
M D Anderson Cancer Center- Orlando Orlando, Florida  32806
Martin Memorial Hospital - South Stuart, Florida  34997
Martin Memorial Medical Center - North Stuart, Florida  34994
Atlanta Regional CCOP Atlanta, Georgia  30342
Well Star Cobb Hospital Austell, Georgia  30106
John B Amos Cancer Center Columbus, Georgia  31904
Wellstar Kennestone Hospital Marietta, Georgia  30060
Oncare Hawaii Inc-POB II Honolulu, Hawaii  96813
Oncare Hawaii Inc-Kuakini Honolulu, Hawaii  96817
University of Hawaii Honolulu, Hawaii  96813
Pacific Cancer Institute of Maui Wailuku, Hawaii  96793
Saint Anthony's Health Alton, Illinois  62002
Evanston CCOP-NorthShore University HealthSystem Evanston, Illinois  60201
Hopedale Medical Complex - Hospital Hopedale, Illinois  61747
Joliet Oncology-Hematology Associates Limited Joliet, Illinois  60435
Midwest Center for Hematology Oncology Joliet, Illinois  60432
Provena Saint Mary's Hospital Kankakee, Illinois  60901
North Shore Hematology Oncology Libertyville, Illinois  60048
Good Samaritan Regional Medical Center Mt. Vernon, Illinois  62864
Hematology Oncology Consultants Limited Naperville, Illinois  60540
Community Cancer Center Foundation Normal, Illinois  61761
Illinois CancerCare-Ottawa Clinic Ottawa, Illinois  61350
Ottawa Regional Hospital and Healthcare Center Ottawa, Illinois  61350
Pekin Cancer Treatment Center Pekin, Illinois  61554
Illinois Oncology Research Association CCOP Peoria, Illinois  61615
Illinois CancerCare-Peoria Peoria, Illinois  61615
Illinois Valley Hospital Peru, Illinois  61354
Hematology Oncology Associates of Illinois - Skokie Skokie, Illinois  60076
Saint Margaret's Hospital Spring Valley, Illinois  61362
Carle Clinic-Urbana Main Urbana, Illinois  61801
Saint Francis Hospital and Health Centers Beech Grove, Indiana  46107
Fort Wayne Medical Oncology and Hematology Inc - State Boulevard Fort Wayne, Indiana  46845
Reid Hospital and Health Care Services Richmond, Indiana  47374
Saint Joseph's Medical Center South Bend, Indiana  46617
Cedar Rapids Oncology Association Cedar Rapids, Iowa  52403
Mercy Hospital Cedar Rapids, Iowa  52403
Mercy Medical Center - North Iowa Mason City, Iowa  50401
Mercy Medical Center-Sioux City Sioux City, Iowa  51104
Saint Luke's Regional Medical Center Sioux City, Iowa  51104
Siouxland Hematology - Oncology Associates Sioux City, Iowa  51101
Stormont-Vail Regional Health Center Topeka, Kansas  66604
Medical Center of Louisiana New Orleans, Louisiana  70112
Hickman Cancer Center Adrian, Michigan  49221
Michigan Cancer Research Consortium Community Clinical Oncology Program Ann Arbor, Michigan  48106
Oakwood Hospital Dearborn, Michigan  48123
Saint John Hospital and Medical Center Detroit, Michigan  48236
Green Bay Oncology - Escanaba Escanaba, Michigan  49431
Grand Rapids Clinical Oncology Program Grand Rapids, Michigan  49503
Saint Mary's Health Care Grand Rapids, Michigan  49503
Spectrum Health at Butterworth Campus Grand Rapids, Michigan  49503
Green Bay Oncology - Iron Mountain Iron Mountain, Michigan  49801
Allegiance Health Jackson, Michigan  49201
Sparrow Hospital Lansing, Michigan  48912
Saint Mary Mercy Hospital Livonia, Michigan  48154
Mercy Memorial Hospital Monroe, Michigan  48162
Mercy Health Partners-Mercy Campus Muskegon, Michigan  49443
Mercy Health Partners-Hackley Campus Muskegon, Michigan  49442
Saint Joseph Mercy Oakland Pontiac, Michigan  48341-2985
Saint Joseph Mercy Port Huron Port Huron, Michigan  48060
Saint Mary's of Michigan Saginaw, Michigan  48601
Lakeland Hospital St. Joseph, Michigan  49085
Saint John Macomb-Oakland Hospital Warren, Michigan  48093
Medini, Eitan MD (UIA Investigator) Alexandria, Minnesota  56308
Saint Joseph's Medical Center Brainerd, Minnesota  56401
Saint Mary's Medical Center Duluth, Minnesota  55805
Miller-Dwan Hospital Duluth, Minnesota  55805
Unity Hospital Fridley, Minnesota  55432
Saint John's Hospital - Healtheast Maplewood, Minnesota  55109
Minnesota Oncology Hematology PA-Maplewood Maplewood, Minnesota  55109
North Memorial Medical Health Center Robbinsdale, Minnesota  55422
Saint Cloud Hospital Saint Cloud, Minnesota  56303
Park Nicollet Clinic - Saint Louis Park Saint Louis Park, Minnesota  55416
Minnesota Oncology and Hematology PA-Woodbury Woodbury, Minnesota  55125
Keesler Medical Center Kessler AFB, Mississippi  39534
Southeast Missouri Hospital Cape Girardeau, Missouri  63701
Saint Luke's Cancer Institute Kansas City, Missouri  64111
Saint Luke's Hospital of Kansas City Kansas City, Missouri  64111
Saint Joseph Health Center Kansas City, Missouri  64114
Liberty Radiation Oncology Clinic Kansas City, Missouri  64116
Truman Medical Center Kansas City, Missouri  64108
Saint Louis-Cape Girardeau CCOP Saint Louis, Missouri  63141
Saint John's Mercy Medical Center Saint Louis, Missouri  63141
Saint Louis Cancer and Breast Institute Saint Louis, Missouri  63109
Hematology-Oncology Centers of the Northern Rockies PC Billings, Montana  59101
Saint Vincent Healthcare Billings, Montana  59101
Billings Clinic Billings, Montana  59107-7000
Saint James Community Hospital and Cancer Treatment Center Butte, Montana  59701
Benefis Healthcare- Sletten Cancer Institute Great Falls, Montana  59405
Berdeaux, Donald MD (UIA Investigator) Great Falls, Montana  59405
Saint Peter's Community Hospital Helena, Montana  59601
Glacier Oncology PLLC Kalispell, Montana  59901
Saint Patrick Hospital - Community Hospital Missoula, Montana  59802
Nevada Cancer Research Foundation CCOP Las Vegas, Nevada  89106
Cooper Hospital University Medical Center Camden, New Jersey  08103
Memorial Medical Center - Las Cruces Las Cruces, New Mexico  88011
Orange Regional Medical Center Middletown, New York  10940
Saint Luke's Roosevelt Hospital Center - Saint Luke's Division New York, New York  10025
Highland Hospital Rochester, New York  14620
Mission Hospitals Inc Asheville, North Carolina  28801
Wayne Memorial Hospital Goldsboro, North Carolina  27534
Margaret R Pardee Memorial Hospital Hendersonville, North Carolina  28791
Kinston Medical Specialists PA Kinston, North Carolina  28501
Saint Alexius Medical Center Bismarck, North Dakota  58501
Medcenter One Health Systems Bismarck, North Dakota  58501
Good Samaritan Hospital - Dayton Dayton, Ohio  45406
Dayton CCOP Dayton, Ohio  45429
Samaritan North Health Center Dayton, Ohio  45415
Veteran Affairs Medical Center Dayton, Ohio  45428
Hematology Oncology Center Incorporated Elyria, Ohio  44035
Blanchard Valley Hospital Findlay, Ohio  45840
Atrium Medical Center-Middletown Regional Hospital Franklin, Ohio  45005-1066
Cleveland Clinic Cancer Center Independence Independence, Ohio  44131
Kettering Medical Center Kettering, Ohio  45429
Saint Rita's Medical Center Lima, Ohio  45801
Toledo Radiation Oncology at Northwest Ohio Onocolgy Center Maumee, Ohio  43537
Saint Charles Hospital Oregon, Ohio  43616
North Coast Cancer Care Sandusky, Ohio  44870
Toledo Community Hospital Oncology Program CCOP Toledo, Ohio  43617
Mercy Cancer Center at Saint Anne Mercy Hospital Toledo, Ohio  43623
University of Toledo Toledo, Ohio  43614
The Toledo Hospital Toledo, Ohio  43606
Saint Vincent Mercy Medical Center Toledo, Ohio  43608
Upper Valley Medical Center Troy, Ohio  45373
Cleveland Clinic Wooster Specialty Center Wooster, Ohio  44691
Legacy Good Samaritan Hospital and Medical Center Portland, Oregon  97210
Northwest Cancer Specialists-Rose Quarter Cancer Center Portland, Oregon  97227
Providence Saint Vincent Medical Center Portland, Oregon  97225
Columbia River Oncology Program Portland, Oregon  97225
Associates In Hematology Oncology PC-Upland Upland, Pennsylvania  19013
Geisinger Wyoming Valley Wilkes-Barre, Pennsylvania  18711
Kent County Hospital Warwick, Rhode Island  02886
AnMed Health Hospital Anderson, South Carolina  29621
Upstate Carolina CCOP Spartanburg, South Carolina  29303
Sanford Cancer Center-Oncology Clinic Sioux Falls, South Dakota  57104
Sanford University of South Dakota Medical Center Sioux Falls, South Dakota  57117-5134
The Don and Sybil Harrington Cancer Center Amarillo, Texas  79106
Veterans Administration Medical Center Houston, Texas  77030
Saint Luke's Episcopal Hospital Houston, Texas  77030
Fredericksburg Oncology Inc Fredericksburg, Virginia  22401
Wheeling Hospital Wheeling, West Virginia  26003
Sacred Heart Hospital Eau Claire, Wisconsin  54701
Saint Vincent Hospital Green Bay, Wisconsin  54301
Green Bay Oncology Limited at Saint Mary's Hospital Green Bay, Wisconsin  54303
Saint Mary's Hospital Green Bay, Wisconsin  54303
Green Bay Oncology at Saint Vincent Hospital Green Bay, Wisconsin  54301-3526
Aurora BayCare Medical Center Green Bay, Wisconsin  54311-6519
Vince Lombardi Cancer Clinic-Marinette Marinette, Wisconsin  54143
Bay Area Medical Center Marinette, Wisconsin  54143
Marshfield Clinic-Minocqua Center Minocqua, Wisconsin  54548
Green Bay Oncology - Oconto Falls Oconto Falls, Wisconsin  54154
Marshfield Clinic at James Beck Cancer Center Rhinelander, Wisconsin  54501
Marshfield Clinic-Rice Lake Center Rice Lake, Wisconsin  54868
Saint Michael's Hospital Stevens Point, Wisconsin  54481
Green Bay Oncology - Sturgeon Bay Sturgeon Bay, Wisconsin  54235
University of Illinois Chicago, Illinois  60612
York Hospital York, Maine  03909
Elkhart Clinic Elkhart, Indiana  46515
Saint Jude Medical Center Fullerton, California  92835
Marin General Hospital Greenbrae, California  94904
University of Colorado Cancer Center - Anschutz Cancer Pavilion Aurora, Colorado  80045
Harbin Clinic Medical Oncology and Clinical Research Rome, Georgia  30165
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
Michiana Hematology Oncology PC-Elkhart Elkhart, Indiana  46514
Michiana Hematology Oncology Professional Corporation Indianapolis, Indiana  46601
Michiana Hematology Oncology PC-Plymouth Plymouth, Indiana  46563
Michiana Hematology Oncology PC-South Bend South Bend, Indiana  46601
Michiana Hematology Oncology-PC Westville Westville, Indiana  46391
University of Michigan University Hospital Ann Arbor, Michigan  48109
Michiana Hematology Oncology PC-Niles Niles, Michigan  49120
Lakeside Cancer Specialists PLLC Saint Joseph, Michigan  49085
UMDNJ - New Jersey Medical School Newark, New Jersey  07103
North Coast Cancer Care-Clyde Clyde, Ohio  43410
Community Health Partners Regional Medical Center Elyria, Ohio  44035
Oncology Hematology Associates of Northern Pennsylvania Dubois, Pennsylvania  15801
Marshfield Clinic-Chippewa Center Chippewa Falls, Wisconsin  54729
Holy Family Memorial Hospital Manitowoc, Wisconsin  54221
Wheaton Franciscan Healthcare - Saint Joseph Milwaukee, Wisconsin  53210
Vince Lombardi Cancer Clinic-Sheboygan Sheboygan, Wisconsin  53081
Marshfield Clinic Cancer Care at Saint Michael's Hospital Stevens Point, Wisconsin  54481
Aurora Medical Center in Summit Summit, Wisconsin  53066
Vince Lombardi Cancer Clinic Two Rivers, Wisconsin  54241
Arizona Cancer Center at UMC Orange Grove Tucson, Arizona  85704
Kaiser Permanente-Deer Valley Medical Center Antioch, California  94531
Palchak David MD Pismo Beach, California  93449
Kaiser Permanente Medical Center-Vacaville Vacaville, California  95688
Kaiser Permanente-Rock Creek Lafayette, Colorado  80026
Kaiser Permanente Moanalua Medical Center Honolulu, Hawaii  96819
Wilcox Memorial Hospital and Kauai Medical Clinic Lihue, Hawaii  96766-1099
Central DuPage Hospital Cancer Center Warrenville, Illinois  60555
Saint Luke's South Hospital Overland Park, Kansas  66213
Kansas City CCOP Prairie Village, Kansas  66208
Salina Regional Health Center. Salina, Kansas  67401
Heartland Hematology and Oncology Associates Incorporated Kansas City, Missouri  64118
Saint Joseph Oncology Inc Saint Joseph, Missouri  64507
Cleveland Clinic Cancer Center Beachwood Beachwood, Ohio  44122
Willamette Falls Community Hospital Oregon City, Oregon  97045
University of Tennessee - Memphis Memphis, Tennessee  38163
Memorial Hospital Of Martinsville Martinsville, Virginia  24115
Legacy Salmon Creek Hospital Vancouver, Washington  98686
Gundersen Lutheran La Crosse, Wisconsin  54601
Saint Nicholas Hospital Madison, Wisconsin  53715
Kaiser Permanente-Franklin Denver, Colorado  80205
UMDNJ - Robert Wood Johnson University Hospital New Brunswick, New Jersey  08903
Marshfield Clinic - Ladysmith Center Ladysmith, Wisconsin  54848
Roy and Patricia Disney Family Cancer Center Burbank, California  91505
Indiana University Health Goshen Center For Cancer Care Goshen, Indiana  46526
Southwest Oncology Group (SWOG) Research Base San Antonio, Texas  78245
Genesys Regional Medical Center-West Flint Campus Flint, Michigan  48532
Essentia Health Duluth Clinic CCOP Duluth, Minnesota  55805
Toledo Clinic Cancer Centers-Oregon Oregon, Ohio  43616
Geisinger Medical Center-Cancer Center Hazelton Hazleton, Pennsylvania  18201
Community Howard Regional Health Kokomo, Indiana  46904
Christiana Care Health System-Christiana Hospital Newark, Delaware  19718
Illinois Cancer Specialists-Niles Niles, Illinois  60714
Bronson Battle Creek Battle Creek, Michigan  49017
Cleveland Clinic Cancer Center/Fairview Hospital Cleveland, Ohio  44111
Aurora Cancer Care-Southern Lakes Elkhorn, Wisconsin  53121
Mayo Clinic Health System-Franciscan Healthcare La Crosse, Wisconsin  54601
San Juan Regional Medical Center San Juan, New Mexico  87401
Saint Clare's Hospital Weston, Wisconsin  54476