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A Randomized Phase III Trial of Cisplatin Plus Paclitaxel With and Without NCI-Supplied Bevacizumab (NSC #704865, IND #113912) Versus the Non-Platinum Doublet, Topotecan Plus Paclitaxel, With and Without NCI-Supplied Bevacizumab, In Stage IVB, Recurrent or Persistent Carcinoma of the Cervix


Phase 3
18 Years
N/A
Open (Enrolling)
Female
Cervical Adenocarcinoma, Cervical Adenosquamous Cell Carcinoma, Cervical Squamous Cell Carcinoma, Recurrent Cervical Cancer, Stage IVB Cervical Cancer

Thank you

Trial Information

A Randomized Phase III Trial of Cisplatin Plus Paclitaxel With and Without NCI-Supplied Bevacizumab (NSC #704865, IND #113912) Versus the Non-Platinum Doublet, Topotecan Plus Paclitaxel, With and Without NCI-Supplied Bevacizumab, In Stage IVB, Recurrent or Persistent Carcinoma of the Cervix


PRIMARY OBJECTIVES:

I. To determine whether the addition of bevacizumab to chemotherapy improves overall
survival. Also to determine if a regimen involving paclitaxel and topotecan improves overall
survival in comparison to a regimen involving cisplatin and paclitaxel. These regimens are
to be evaluated in patients with stage IVB, recurrent, or persistent carcinoma of the
cervix.

II. To determine and compare the frequency and severity of adverse events as assessed by
CTCAE version 3.0 for the regimens administered on this study.

SECONDARY OBJECTIVES:

I. To estimate and compare the progression-free survival of patients treated by the regimens
investigated on this study.

II. To estimate and compare the proportion of patients with tumor responses by the regimens
investigated on this study.

TERTIARY OBJECTIVES:

I. To determine whether the addition of bevacizumab to chemotherapy, or the substitution of
cisplatin with topotecan improve the health related quality of life (QOL) as measured by the
FACT-Cx TOI and produce favorable toxicity profiles (with a particular focus on peripheral
neuropathy as measured by the FACT/GOG-Ntx4 subscale and pain as measured by BPI single
item).

II. To evaluate the impact of age, race, performance status, stage, histology, grade,
disease site, prior chemotherapy with primary radiation, and time to recurrence on response
rate, progression-free survival and overall survival of patients with
metastatic/recurrent/persistent carcinoma of the cervix.

III. To determine the prevalence of active smoking in this cohort of recurrent cervical
cancer patients.

IV. To estimate the extent of tobacco/nicotine dependence in the cohort. V. To determine if
smoking is an independent risk factor for progression-free survival and overall survival in
this population.

VI. To isolate, enumerate and characterize circulating tumor cells (CTC) recovered from
blood drawn pre-cycle 1, pre-cycle 2 and pre-cycle 3 using the CTC-chip developed by the
Massachusetts General Hospital (MGH) BioMEMS Resource Center and the MGH Cancer Center.

VII. To determine the association between CTC counts or characteristics and measures of
clinical outcome.

VIII. To examine the association between angiogenesis markers in plasma (recovered from
blood drawn pre-cycle 1, pre-cycle 2 and pre-cycle 3) and measures of clinical outcome.

IX. To evaluate the association between tumor markers of angiogenesis and hypoxia (using
archival formalin-fixed and paraffin-embedded tumor tissue) and measures of clinical
outcome.

X. To evaluate the association between single nucleotide polymorphisms (using DNA extracted
from whole blood) and measures of clinical outcome as well as measures of quality of life
such as chemotherapy toxicity.

XI. To examine the relationship(s) among the various biomarkers. XII. To develop an optimal
prognostic model for progression-free survival and overall survival using clinical
covariates, smoking status and the various biomarkers.

OUTLINE: This is a multicenter study. Patients are stratified according to disease status
(recurrent/persistent disease vs primary stage IVB disease), GOG performance status (0 vs
1), and prior platinum therapy as a radiosensitizer (yes vs no). Patients are randomized to
1 of 4 treatment arms.

ARM I: Patients receive paclitaxel IV over 3 hours or 24 hours on day 1 and cisplatin IV on
day 1 or 2.

ARM II: Patients receive paclitaxel IV over 3 hours or 24 hours on day 1 and cisplatin IV
and bevacizumab IV over 30-90 minutes on day 1 or 2.

ARM III: Patients receive paclitaxel IV over 3 hours on day 1 and topotecan hydrochloride IV
over 30 minutes on days 1-3.

ARM IV: Patients receive paclitaxel IV over 3 hours and bevacizumab IV over 30-90 minutes on
day 1 and topotecan hydrochloride IV over 30 minutes on days 1-3.

In all arms, courses repeat every 21 days in the absence of disease progression or
unacceptable toxicity. Patients complete quality-of-life questionnaires, including the
FACT-Cx TOI, FACT/GOG-Ntx4, and Brief Pain Inventory, at baseline, before courses 2 and 5,
and at 6 and 9 months after course 1. Patients also complete a smoking questionnaire at
baseline. After completion of study therapy, patients are followed every 3 months for 2
years and then every 6 months for 3 years.


Inclusion Criteria:



- Histologically confirmed carcinoma of the cervix, including any of the following
subtypes:

- Squamous cell carcinoma

- Adenosquamous cell carcinoma

- Adenocarcinoma

- Primary stage IVB, recurrent, or persistent disease not amenable to curative
treatment with surgery and/or radiotherapy

- Measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm by
conventional techniques or ≥ 10 mm by spiral CT scan

- Biopsy confirmation required if target lesion(s) measures < 30 mm or if the
treating physician determines it is clinically indicated

- Has ≥ 1 "target lesion" that can be used to assess response

- Tumors within a previously irradiated field are designated as "non-target"
lesions unless progression is documented or a biopsy is obtained to confirm
persistence ≥ 90 days following completion of radiotherapy

- No history or evidence of CNS disease, including primary brain tumor, brain
metastases, or craniospinal metastases

- GOG performance status 0-1

- ANC ≥ 1,500/mm³

- Platelet count ≥ 100,000/mm³

- Bilirubin ≤ 1.5 times normal

- SGOT ≤ 2.5 times normal

- Alkaline phosphatase ≤ 2.5 times normal

- PT/INR ≤ 1.5 (or in-range INR, if patient is on a stable dose of therapeutic warfarin
for management of venous thrombosis, including pulmonary thromboembolus)

- PTT < 1.2 times upper limit of normal

- Serum creatinine normal OR creatinine clearance ≥ 60 mL/min

- Urine protein:creatinine ratio 1.0 mg/dL

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception during and for ≥ 6 months after
completion of study treatment

- No active infection requiring antibiotics

- No significant traumatic injury within the past 28 days

- No serious non-healing wound, ulcer, or bone fracture

- Patients with granulating incisions healing by secondary intention are eligible
provided there is no evidence of fascial dehiscence or infection AND the wound
is examined weekly

- No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within
the past 3-6 months

- Patients must have undergone correction (or spontaneous healing) of the
perforation/fistula and/or the underlying process causing the
fistula/perforation

- No clinical symptoms or signs of gastrointestinal obstruction requiring parenteral
hydration and/or nutrition

- No active bleeding or pathologic condition that carries a high risk of bleeding
(e.g., known bleeding disorder, coagulopathy, or tumor involving major vessels)

- No seizures not controlled with standard medical therapy

- No cerebrovascular accident (i.e., stroke), transient ischemic attack, or
subarachnoid hemorrhage within the past 6 months

- No clinically significant cardiovascular disease, including any of the following:

- Uncontrolled hypertension, defined as systolic BP > 150 mm Hg or diastolic BP >
90 mm Hg

- Myocardial infarction or unstable angina within the past 6 months

- NYHA class II-IV congestive heart failure

- Serious cardiac arrhythmia requiring medication

- Atrial fibrillation allowed provided it is asymptomatic and ventricular
rate is controlled

- Significant peripheral vascular disease (i.e., ≥ grade 2 peripheral vascular
disease, as defined by NCI CTCAE v3.0 criteria)

- No bilateral hydronephrosis that cannot be alleviated by ureteral stents or
percutaneous drainage

- No known hypersensitivity to Chinese hamster ovary cell products or other recombinant
human or humanized antibodies

- No other invasive malignancy within the past 5 years, except nonmelanoma skin cancer

- No other medical history or condition that, in the opinion of the investigator, would
preclude study participation

- No peripheral neuropathy ≥ grade 2

- Recovered from all prior therapy

- No prior anti-cancer therapy that would preclude study therapy

- No prior anti-VEGF drugs, including bevacizumab

- No prior chemotherapy unless given concurrently with radiotherapy

- Prior paclitaxel and/or topotecan with radiotherapy not allowed

- At least 6 weeks since prior chemoradiotherapy

- At least 3 weeks since prior radiotherapy alone

- More than 28 days since prior major surgery or open biopsy

- More than 7 days since prior core biopsy

- No concurrent major surgery including, but not limited to, abdominal surgery prior to
disease progression (e.g., colostomy or enterostomy reversal, interval or secondary
cytoreductive surgery, or second-look surgery via laparotomy or laparoscopy)

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Overall survival

Outcome Time Frame:

From entry into the study to death or the date of last contact, assessed up to 5 years

Safety Issue:

No

Principal Investigator

Krishnansu Tewari

Investigator Role:

Principal Investigator

Investigator Affiliation:

Gynecologic Oncology Group

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2009-01084

NCT ID:

NCT00803062

Start Date:

April 2009

Completion Date:

Related Keywords:

  • Cervical Adenocarcinoma
  • Cervical Adenosquamous Cell Carcinoma
  • Cervical Squamous Cell Carcinoma
  • Recurrent Cervical Cancer
  • Stage IVB Cervical Cancer
  • Adenocarcinoma
  • Adenocarcinoma, Mucinous
  • Carcinoma
  • Carcinoma, Squamous Cell
  • Uterine Cervical Neoplasms
  • Carcinoma, Adenosquamous

Name

Location

Baylor College of Medicine Houston, Texas  77030
Louisiana State University New Orleans, Louisiana  70112-2282
Memorial Sloan Kettering Cancer Center New York, New York  10021
Cleveland Clinic Foundation Cleveland, Ohio  44195
Mayo Clinic Rochester, Minnesota  55905
H. Lee Moffitt Cancer Center and Research Institute Tampa, Florida  33612
University of Iowa Hospitals and Clinics Iowa City, Iowa  52242
University of Mississippi Medical Center Jackson, Mississippi  39216-4505
Abington Memorial Hospital Abington, Pennsylvania  19001
Fox Chase Cancer Center Philadelphia, Pennsylvania  19111
Medical University of South Carolina Charleston, South Carolina  29425-0721
Hurley Medical Center Flint, Michigan  48503
Pennsylvania Hospital Philadelphia, Pennsylvania  19107
Sinai Hospital of Baltimore Baltimore, Maryland  21225
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
Avera Cancer Institute Sioux Falls, South Dakota  57105
Loyola University Medical Center Maywood, Illinois  60153
Massachusetts General Hospital Cancer Center Boston, Massachusetts  02114
Morristown Memorial Hospital Morristown, New Jersey  07962-1956
Henry Ford Hospital Detroit, Michigan  48202
Marshfield Clinic Marshfield, Wisconsin  54449
Sutter Health Western Division Cancer Research Group Greenbrae, California  94904
Methodist Medical Center of Illinois Peoria, Illinois  61636
Memorial Hospital of South Bend South Bend, Indiana  46601
Beth Israel Medical Center New York, New York  10003
Akron General Medical Center Akron, Ohio  44302
Lehigh Valley Hospital Allentown, Pennsylvania  18103
Western Pennsylvania Hospital Pittsburgh, Pennsylvania  15224
Reading Hospital and Medical Center Reading, Pennsylvania  19612-6052
University of Texas Medical Branch Galveston, Texas  77555-1329
LDS Hospital Salt Lake City, Utah  84143
Waukesha Memorial Hospital Waukesha, Wisconsin  53188
Rush University Medical Center Chicago, Illinois  60612-3824
Dana-Farber Cancer Institute Boston, Massachusetts  02115
North Shore University Hospital Manhasset, New York  11030
University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
University of Kansas Medical Center Kansas City, Kansas  66160-7353
Brooke Army Medical Center Fort Sam Houston, Texas  78234-6200
Hartford Hospital Hartford, Connecticut  06102-5037
Sarasota Memorial Hospital Sarasota, Florida  34239
Franklin Square Hospital Center Baltimore, Maryland  21237
Baystate Medical Center Springfield, Massachusetts  01199
William Beaumont Hospital Royal Oak, Michigan  48073
Cancer Institute of New Jersey New Brunswick, New Jersey  08901
University of Nebraska Medical Center Omaha, Nebraska  68198-3330
Broward General Medical Center Fort Lauderdale, Florida  33316
Via Christi Regional Medical Center Wichita, Kansas  67214
Ochsner Clinic Foundation New Orleans, Louisiana  70121
Carolinas Medical Center Charlotte, North Carolina  28232-2861
University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma  73104
Scott and White Memorial Hospital Temple, Texas  76508
John Muir Medical Center Walnut Creek, California  94598
Iowa Methodist Medical Center Des Moines, Iowa  50309
Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
Weill Medical College of Cornell University New York, New York  10021
University of Wisconsin Hospital and Clinics Madison, Wisconsin  53792-0001
Great Falls Clinic Great Falls, Montana  59405
Overlook Hospital Summit, New Jersey  07902-0220
MetroHealth Medical Center Cleveland, Ohio  44109
Central Baptist Hospital Lexington, Kentucky  40503
Valley Hospital Ridgewood, New Jersey  07450
Wilford Hall Medical Center Lackland Air Force Base, Texas  78236-5300
Long Island Jewish Medical Center New Hyde Park, New York  11040
Advocate Christ Medical Center Oak Lawn, Illinois  60453
North Colorado Medical Center Greeley, Colorado  80631
McKee Medical Center Loveland, Colorado  80539
Cancer Center of Kansas - Chanute Chanute, Kansas  66720
Cancer Center of Kansas - Dodge City Dodge City, Kansas  67801
Cancer Center of Kansas - Newton Newton, Kansas  67114
Cancer Center of Kansas - Salina Salina, Kansas  67042
Cancer Center of Kansas - Wellington Wellington, Kansas  67152
Associates in Womens Health Wichita, Kansas  67203
Cancer Center of Kansas - Winfield Winfield, Kansas  67156
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
Adena Regional Medical Center Chillicothe, Ohio  54601
Grady Memorial Hospital Delaware, Ohio  43015
Fairfield Medical Center Lancaster, Ohio  43130
Medical X-Ray Center Sioux Falls, South Dakota  57105
American Fork Hospital American Fork, Utah  84003
Logan Regional Hospital Logan, Utah  84321
McKay-Dee Hospital Center Ogden, Utah  84403
Welch Cancer Center Sheridan, Wyoming  82801
University of South Alabama Mitchell Cancer Institute Mobile, Alabama  36604
University of New Mexico Cancer Center Albuquerque, New Mexico  87131-5636
Good Samaritan Hospital - Cincinnati Cincinnati, Ohio  45220
Brigham and Women's Hospital Boston, Massachusetts  02115
Methodist Estabrook Cancer Center Omaha, Nebraska  68114-4199
Cancer Centers of the Carolinas Greenville, South Carolina  29605
City of Hope Medical Center Duarte, California  91010
Paoli Memorial Hospital Paoli, Pennsylvania  19301-1792
Elkhart General Hospital Elkhart, Indiana  46515
Gynecologic Oncology of Indiana Indianapolis, Indiana  46237
South Bend Clinic South Bend, Indiana  46617
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center Columbus, Ohio  43210-1240
Parkland Memorial Hospital Dallas, Texas  75235
Front Range Cancer Specialists Fort Collins, Colorado  80528
Sutter Solano Medical Center Vallejo, California  94589
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
Swedish Covenant Hospital Chicago, Illinois  60625
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
Bismarck Cancer Center Bismarck, North Dakota  58501
Grandview Hospital Dayton, Ohio  45405
Bryn Mawr Hospital Bryn Mawr, Pennsylvania  19010
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
Eureka Hospital Eureka, Illinois  61530
Mercy Hospital Coon Rapids, Minnesota  55433
Allenmore Hospital Tacoma, Washington  98411-0414
Graham Hospital Association Canton, Illinois  61520
Holy Family Medical Center Des Plaines, Illinois  60016
Saint Joseph Medical Center Joliet, Illinois  60435
Medical Oncology and Hematology Associates Des Moines, Iowa  50309
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
Northeast Georgia Medical Center Gainesville, Georgia  30501
Randolph Hospital Asheboro, North Carolina  27203
Miami Valley Hospital Dayton, Ohio  45409
Spartanburg Regional Medical Center Spartanburg, South Carolina  29303
Hospital District Sixth of Harper County Anthony, Kansas  67003
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
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
Mary Rutan Hospital Bellefontaine, Ohio  43311
Wayne Hospital Greenville, Ohio  45331
Knox Community Hospital Mount Vernon, Ohio  43050
Clinton Memorial Hospital Wilmington, Ohio  45177
Providence Centralia Hospital Centralia, Washington  98531-9027
Marshfield Clinic Cancer Care at Regional Cancer Center Eau Claire, Wisconsin  54701
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
Woman's Hospital Baton Rouge, Louisiana  70815
Longmont United Hospital Longmont, Colorado  80501
Temple University Hospital Philadelphia, Pennsylvania  19140
Singing River Hospital Pascagoula, Mississippi  39581
Ben Taub General Hospital Houston, Texas  77030
Methodist Hospital Houston, Texas  77030
Aurora Sinai Medical Center Milwaukee, Wisconsin  53201-0342
Greene Memorial Hospital Xenia, Ohio  45385
Greater Baltimore Medical Center Baltimore, Maryland  21204
Rutherford Hospital Rutherfordton, North Carolina  28139
AnMed Health Cancer Center Anderson, South Carolina  29621
Union Hospital of Cecil County Elkton MD, Maryland  21921
Cancer Centers of the Carolinas - Grove Commons Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Seneca Seneca, South Carolina  29672
Cancer Centers of the Carolinas - Spartanburg Spartanburg, South Carolina  29307
Presbyterian Hospital Charlotte, North Carolina  28233-3549
Mayo Clinic in Florida Jacksonville, Florida  32224
Washington Hospital Center Washington, District of Columbia  20010
Memorial Medical Center Springfield, Illinois  62781
Phelps County Regional Medical Center Rolla, Missouri  65401
McLeod Regional Medical Center Florence, South Carolina  29501
Wellmont Holston Valley Hospital and Medical Center Kingsport, Tennessee  37662
Metro Health Hospital Grand Rapids, Michigan  49506
Guardian Oncology and Center for Wellness Missoula, Montana  59804
Queen's Medical Center Honolulu, Hawaii  96813
University of Virginia Charlottesville, Virginia  22908
University of Alabama at Birmingham Birmingham, Alabama  35294-3300
Vanderbilt University Nashville, Tennessee  37232-6305
University of North Carolina Chapel Hill, North Carolina  27599
Meharry Medical College Nashville, Tennessee  37208-3599
Northwestern University Chicago, Illinois  60611
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  
Queens Hospital Center Jamaica, New York  11432
Saint Louis University Hospital St. Louis, Missouri  63110-0250
Saint Alphonsus Regional Medical Center Boise, Idaho  83706
University of California at San Diego La Jolla, California  92093
Emory University Atlanta, Georgia  30322
Wayne State University Detroit, Michigan  48202
Straub Clinic and Hospital Honolulu, Hawaii  96813
Lakeland Regional Cancer Center Lakeland, Florida  33805
Riverside Methodist Hospital Columbus, Ohio  43214
Licking Memorial Hospital Newark, Ohio  43055-2899
Cancer Center of Kansas - McPherson McPherson, Kansas  67460
California Pacific Medical Center San Francisco, California  94115
Dartmouth Hitchcock Medical Center Lebanon, New Hampshire  03756
Mid Dakota Clinic Bismarck, North Dakota  58501
Columbus CCOP Columbus, Ohio  43206
Indiana University Medical Center Indianapolis, Indiana  46202
Presbyterian - Saint Lukes Medical Center - Health One Denver, Colorado  80218
University of Texas Southwestern Medical Center Dallas, Texas  
University of Kentucky Lexington, Kentucky  40536-0098
Wichita CCOP Wichita, Kansas  67214-3882
Montana Cancer Consortium CCOP Billings, Montana  59101
Huntsman Cancer Institute/University of Utah Salt Lake City, Utah  84112
Mount Sinai Hospital Medical Center Chicago, Illinois  60608
Metro-Minnesota CCOP St. Louis Park, Minnesota  
UC Davis Comprehensive Cancer Center Sacramento, California  95817
Providence Hospital Southfield, Michigan  48075
Tufts Medical Center Boston, Massachusetts  02111
Cancer Centers of the Carolinas - Easley Easley, South Carolina  29640
Lakeview Hospital Stillwater, Minnesota  55082
Florida Gynecologic Oncology Fort Myers, Florida  33901
Jersey Shore Medical Center Neptune, New Jersey  07754
Decatur Memorial Hospital Decatur, Illinois  62526
Tulane University Health Sciences Center New Orleans, Louisiana  70112
Virginia Commonwealth University Richmond, Virginia  
Lankenau Hospital Wynnewood, Pennsylvania  19096
Central Georgia Gynecologic Oncology Macon, Georgia  31201
Montana Cancer Specialists Missoula, Montana  59807-7877
Providence Saint Joseph Medical Center Burbank, California  91505-4866
Florida Hospital Orlando, Florida  32803
Memorial Health University Medical Center Savannah, Georgia  31404
Hillcrest Hospital Cancer Center Mayfield Heights, Ohio  44124
University of Chicago Comprehensive Cancer Center Chicago, Illinois  60637-1470
M D Anderson Cancer Center Houston, Texas  77030
University of Southern California Los Angeles, California  90033
DeKalb Medical Center Decatur, Georgia  30033
Northern Indiana Cancer Research Consortium South Bend, Indiana  
University of Cincinnati Cincinnati, Ohio  45267-0502
Hawaii Medical Center East Honolulu, Hawaii  96817
Penn State Milton S Hershey Medical Center Hershey, Pennsylvania  17033
Piedmont Fayette Hospital Fayetteville, Georgia  30214
The Community Hospital Munster, Indiana  46321
Littleton Adventist Hospital Littleton, Colorado  80122
Parker Adventist Hospital Parker, Colorado  80138
Froedtert and the Medical College of Wisconsin Milwaukee, Wisconsin  53226
Wake Forest University Health Sciences Winston-Salem, North Carolina  27157
OSF Saint Francis Medical Center Peoria, Illinois  61637
Northside Hospital Atlanta, Georgia  30342
Mills - Peninsula Hospitals Burlingame, California  94010
California Cancer Center - North Fresno Fresno, California  93720
Saint Joseph Hospital Orange, California  92868
University of California San Francisco Medical Center-Mount Zion San Francisco, California  94115
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
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
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
John H Stroger Jr Hospital of Cook County Chicago, Illinois  60612-3785
Saint Francis Hospital Evanston, Illinois  60202
Joliet Oncology-Hematology Associates Limited Joliet, Illinois  60435
Provena Saint Mary's Hospital Kankakee, Illinois  60901
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
Saint Francis Hospital and Health Centers Beech Grove, Indiana  46107
Fort Wayne Medical Oncology and Hematology Inc - State Boulevard Fort Wayne, Indiana  46845
Saint Vincent Hospital and Health Services Indianapolis, Indiana  46260
Reid Hospital and Health Care Services Richmond, Indiana  47374
McFarland Clinic Ames, Iowa  50010
Medical Oncology and Hematology Associates-West Des Moines Clive, Iowa  50325
Iowa Oncology Research Association CCOP Des Moines, Iowa  50309
Mercy Capitol Des Moines, Iowa  50307
Mercy Medical Center - Des Moines Des Moines, Iowa  50314
Medical Oncology and Hematology Associates-Des Moines Des Moines, Iowa  50309
Mercy Medical Center-Sioux City Sioux City, Iowa  51104
Saint Luke's Regional Medical Center Sioux City, Iowa  51104
Cancer Center of Kansas - El Dorado El Dorado, Kansas  67042
Cancer Center of Kansas-Kingman Kingman, Kansas  67068
Cancer Center of Kansas - Parsons Parsons, Kansas  67357
Cancer Center of Kansas - Pratt Pratt, Kansas  67124
Cancer Center of Kansas-Wichita Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas - Main Office Wichita, Kansas  67214
Ochsner Clinic CCOP New Orleans, Louisiana  70121
Highland Clinic Shreveport, Louisiana  71105
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
Mid-Michigan Medical Center - Midland Midland, Michigan  48670
Mercy Health Partners-Mercy Campus Muskegon, Michigan  49443
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
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
Park Nicollet Clinic - Saint Louis Park Saint Louis Park, Minnesota  55416
Minnesota Oncology and Hematology PA-Woodbury Woodbury, Minnesota  55125
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
Ozark Health Ventures LLC dba Cancer Research for The Ozarks Springfield Springfield, Missouri  65802
Saint John's Hospital Springfield, Missouri  65804
Cox Medical Center Springfield, Missouri  65807
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
Cooper Hospital University Medical Center Camden, New Jersey  08103
Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington County Mount Holly, New Jersey  08060
South Jersey Healthcare Vineland, New Jersey  08360
Virtua West Jersey Hospital Voorhees Voorhees, New Jersey  08043
Orange Regional Medical Center Middletown, New York  10940
New York University Langone Medical Center New York, New York  10016
Saint Luke's Roosevelt Hospital Center - Saint Luke's Division New York, New York  10025
Columbia University Medical Center New York, New York  10032
State University of New York Upstate Medical University Syracuse, New York  13210
Alamance Regional Medical Center Burlington, North Carolina  27216
Wayne Memorial Hospital Goldsboro, North Carolina  27534
Kinston Medical Specialists PA Kinston, North Carolina  28501
Saint Alexius Medical Center Bismarck, North Dakota  58501
Aultman Health Foundation Canton, Ohio  44710
Doctors Hospital Columbus, Ohio  43228
Grant Medical Center Columbus, Ohio  43215
Mount Carmel Health Center West Columbus, Ohio  43222
Good Samaritan Hospital - Dayton Dayton, Ohio  45406
Dayton CCOP Dayton, Ohio  45429
Samaritan North Health Center Dayton, Ohio  45415
Blanchard Valley Hospital Findlay, Ohio  45840
Atrium Medical Center-Middletown Regional Hospital Franklin, Ohio  45005-1066
Kettering Medical Center Kettering, Ohio  45429
Saint Rita's Medical Center Lima, Ohio  45801
Marietta Memorial Hospital Marietta, Ohio  45750
Upper Valley Medical Center Troy, Ohio  45373
Saint Ann's Hospital Westerville, Ohio  43081
Genesis HealthCare System Zanesville, Ohio  43701
Saint Luke's Hospital Bethlehem, Pennsylvania  18015
Mainline Health CCOP Wynnewood, Pennsylvania  19096
AnMed Health Hospital Anderson, South Carolina  29621
Greenville CCOP Greenville, South Carolina  29615
Greenville Memorial Hospital Greenville, South Carolina  29605
Upstate Carolina CCOP Spartanburg, South Carolina  29303
Sanford Cancer Center-Oncology Clinic Sioux Falls, South Dakota  57104
Tennessee Oncology PLLC- Centennial Medical Center Nashville, Tennessee  37203
Veterans Administration Medical Center Houston, Texas  77030
Saint Luke's Episcopal Hospital Houston, Texas  77030
Southwest VA Regional Cancer Center Norton, Virginia  24273
Saint Francis Hospital Federal Way, Washington  98003
Providence - Saint Peter Hospital Olympia, Washington  98506-5166
Good Samaritan Community Hospital Puyallup, Washington  98372
Northwest CCOP Tacoma, Washington  98405
Multicare Health System Tacoma, Washington  98415
Saint Clare Hospital Tacoma, Washington  98499
Saint Joseph Medical Center Tacoma, Washington  98405
Langlade Hospital and Cancer Center Antigo, Wisconsin  54409
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
Bay Area Medical Center Marinette, Wisconsin  54143
Marshfield Clinic-Minocqua Center Minocqua, Wisconsin  54548
Oconomowoc Memorial Hospital-ProHealth Care Inc Oconomowoc, Wisconsin  53066-3896
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
Aspirus Regional Cancer Center Wausau, Wisconsin  54401
University of California Medical Center At Irvine-Orange Campus Orange, California  92868
Cancer Care Associates-Yale Tulsa, Oklahoma  74136-1929
Women and Infants Hospital Providence, Rhode Island  02905
University of Maryland Greenebaum Cancer Center Baltimore, Maryland  21201
Lyndon Baines Johnson General Hospital Houston, Texas  77030
Stony Brook University Medical Center Stony Brook, New York  11794
Elkhart Clinic Elkhart, Indiana  46515
John Muir Medical Center-Concord Campus Concord, California  94520
University of Colorado Cancer Center - Anschutz Cancer Pavilion Aurora, Colorado  80045
Memorial Healthcare System - Joe DiMaggio Children's Hospital Hollywood, Florida  33021
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 PC-Plymouth Plymouth, Indiana  46563
Michiana Hematology Oncology PC-South Bend South Bend, Indiana  46601
Michiana Hematology Oncology-PC Westville Westville, Indiana  46391
Cancer Center of Kansas-Liberal Liberal, Kansas  67901
Michiana Hematology Oncology PC-Niles Niles, Michigan  49120
Renown Regional Medical Center Reno, Nevada  89502
UMDNJ - New Jersey Medical School Newark, New Jersey  07103
Moses Cone Health System-Regional Cancer Center Greensboro, North Carolina  27403
Annie Penn Memorial Hospital Reidsville, North Carolina  27320
Cancer Centers of the Carolinas - Faris Greenville, South Carolina  29605
Cancer Centers of the Carolinas-Greer Radiation Oncology Greer, South Carolina  29650
Cancer Centers of the Carolinas-Greer Medical Oncology Greer, South Carolina  29650
University of Tennessee - Knoxville Knoxville, Tennessee  37920
Sandra L Maxwell Cancer Center Cedar City, Utah  84720
Intermountain Medical Center Murray, Utah  84157
Utah Valley Regional Medical Center Provo, Utah  84603
Dixie Medical Center Regional Cancer Center Saint George, Utah  84770
Utah Cancer Specialists-Salt Lake City Salt Lake City, Utah  84106
Marshfield Clinic-Chippewa Center Chippewa Falls, Wisconsin  54729
Holy Family Memorial Hospital Manitowoc, Wisconsin  54221
Marshfield Clinic Cancer Care at Saint Michael's Hospital Stevens Point, Wisconsin  54481
Vince Lombardi Cancer Clinic Two Rivers, Wisconsin  54241
Washington Regional Medical Center - Fayetteville Fayetteville, Arkansas  72703
Olive View-University of California Los Angeles Medical Center Sylmar, California  91342
Hawaii Minority Based CCOP Honolulu, Hawaii  96813
Advocate Lutheran General Hospital Park Ridge, Illinois  60068
Saint Elizabeth Medical Center South Edgewood, Kentucky  41017
Maine Medical Center-Bramhall Campus Portland, Maine  04102
Center of Hope at Renown Medical Center Reno, Nevada  89502
Montefiore Medical Center-Weiler Division Bronx, New York  10461
State University of New York Downstate Medical Center Brooklyn, New York  11203
Monter Cancer Center Lake Success, New York  11042
Hope, A Women's Cancer Center Asheville, North Carolina  28816
Magee-Womens Hospital - University of Pittsburgh Medical Center Pittsburgh, Pennsylvania  15213
Black Hills Obstetrics and Gynecology Rapid City, South Dakota  57701
Carilion Clinic Gynecological Oncology Roanoke, Virginia  24016
Aurora Women's Pavilion of Aurora West Allis Medical Center West Allis, Wisconsin  53227
Long Beach Memorial Medical Center-Todd Cancer Institute Long Beach, California  90806
Kaiser Permanente Medical Care Program - Los Angeles Medical Center & Sunset Hospital Los Angeles, California  90027
Rocky Mountain Gynecologic Oncology PC Englewood, Colorado  80110
Grady Health System Atlanta, Georgia  30303
Norton Health Care Pavilion - Downtown Louisville, Kentucky  40202
University of Minnesota Medical Center-Fairview Minneapolis, Minnesota  55455
Southwest Gynecologic Oncology Associates Inc Albuquerque, New Mexico  87106
Women's Cancer Center of Nevada Las Vegas, Nevada  89109
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
Doctors Carrol, Sheth, Raghavan Louisville, Kentucky  40215
Hematology and Oncology Clinic Baton Rouge, Louisiana  70809
Heartland Hematology and Oncology Associates Incorporated Kansas City, Missouri  64118
Saint Joseph Oncology Inc Saint Joseph, Missouri  64507
Southern Ohio Medical Center Portsmouth, Ohio  45662
Saint Francis Hospital Greenville, South Carolina  29601
Gundersen Lutheran La Crosse, Wisconsin  54601
Los Angeles County-USC Medical Center Los Angeles, California  90033
Stanford University Hospitals and Clinics Stanford, California  94305
Palo Alto Medical Foundation-Gynecologic Oncology Mountain View, California  94040
Sudarshan K Sharma MD Limted-Gynecologic Oncology Hinsdale, Illinois  60521
Saint Vincent Oncology Center Indianapolis, Indiana  46260
University of Massachusetts Memorial Health Care Worcester, Massachusetts  01605
The Women's Institute for Gynecologic Cancer and Special Pelvic Surgery Phillipsburg, New Jersey  08865
University Medical Center Brackenridge Austin, Texas  78701
Aurora Saint Luke's Medical Center Milwaukee, Wisconsin  53215
Georgia Health Sciences University Augusta, Georgia  30912
Jonsson Comprehensive Cancer Center Los Angeles, California  90095
Alta Bates Summit Medical Center-Herrick Campus Berkeley, California  94704
Michiana Hematology Oncology PC-Mishawaka Mishawaka, Indiana  46545-1470
Marie Yeager Cancer Center Saint Joseph, Michigan  49085
Emory University Hospital Midtown Atlanta, Georgia  30308
Summa Akron City Hospital Akron, Ohio  44304
Roy and Patricia Disney Family Cancer Center Burbank, California  91505
Sanford USD Medical Center - Sioux Falls Sioux Falls, South Dakota  57117-5134
North Shore-LIJ Health System CCOP Manhasset, New York  11030
Genesys Regional Medical Center-West Flint Campus Flint, Michigan  48532
Sanford Bismarck Medical Center Bismarck, North Dakota  58501
Community Howard Regional Health Kokomo, Indiana  46904
Indiana University Health La Porte Hospital La Porte, Indiana  46350
Saint Joseph Regional Medical Center-Mishawaka Mishawaka, Indiana  46545-1470
Christiana Care Health System-Christiana Hospital Newark, Delaware  19718
Bronson Battle Creek Battle Creek, Michigan  49017
Springfield Regional Medical Center Springfield, Ohio  45505
Cleveland Clinic Cancer Center/Fairview Hospital Cleveland, Ohio  44111
Saint Joseph's Hospital and Medical Center Phoenix, Arizona  85013
Women's Cancer Care Associates LLC Albany, New York  12208
Island Gynecologic Oncology Brightwaters, New York  11718
Fletcher Allen Health Care-Medical Center Burlington, Vermont  05401
Self Regional Healthcare Greenwood, South Carolina  29646
South Carolina Oncology Associates PA Columbia, South Carolina  29210
D N Greenwald Center Mukwonago, Wisconsin  53149
Pikeville Medical Center Pikeville, Kentucky  41501
Baylor All Saints Medical Center at Fort Worth Fort Worth, Texas  76104