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Statin Polyp Prevention Trial in Patients With Resected Colon Cancer


Phase 3
18 Years
N/A
Open (Enrolling)
Both
Colorectal Cancer, Precancerous Condition

Thank you

Trial Information

Statin Polyp Prevention Trial in Patients With Resected Colon Cancer


OBJECTIVES:

Primary

- To compare the effect of rosuvastatin vs placebo on the 5-year occurrence of
adenomatous polyps of the colon or rectum, metachronous colorectal carcinoma, or colon
cancer recurrence (APMC+R) in patients with resected stage I or II colon cancer.

Secondary

- To determine whether the effect of rosuvastatin vs placebo is of the same magnitude in
patients taking aspirin (regardless of dose) compared to patients not taking aspirin.

- To determine whether taking aspirin (regardless of dose) vs no aspirin will decrease
the occurrence or APMC+R and, if there is an effect, to explore the relationship to
dose.

- To determine the effect of rosuvastatin in patients with familial colorectal cancer.

- To determine the effect of rosuvastatin in patients with microsatellite unstable tumors
(i.e., tumors displaying loss of MLH1 or MSH2 expression by IHC).

- To determine the relationship between rosuvastatin therapy and features of colorectal
adenomas as well as the size and number of colorectal adenomas.

- To compare the time to APMC+R in patients treated with rosuvastatin vs placebo.

- To compare the disease-free survival of patients treated with rosuvastatin vs placebo.

- To compare the overall survival of patients treated with rosuvastatin vs placebo.

- To compare the rate of recurrence of colon cancer in patients treated with rosuvastatin
vs placebo.

- To compare the rate of second non-colorectal primary cancers in patients treated with
rosuvastatin vs placebo.

- To determine the effect of rosuvastatin on health-related quality of life, global
quality of life, and self-reported symptoms.

- To compare the incidence and severity of adverse events associated with rosuvastatin vs
placebo.

- To assess relevant tumor and blood markers that may affect the metabolism, activity, or
effect of the study drugs, such as HMG-CoA reductase, UGT1A6, P450-2C9, PTGS2 (COX-2),
and other possible markers.

OUTLINE: This is a multicenter study. Patients are stratified according to family history of
a first-degree relative with colorectal cancer (yes vs no), intended aspirin dose (none vs
81 mg vs 325 mg), and adjuvant therapy for colon cancer (yes vs no). Patients are randomized
to 1 of 2 treatment arms.

- Arm I: Patients receive oral rosuvastatin once daily for 5 years.

- Arm II: Patients receive oral placebo once daily for 5 years. Patients may complete a
quality-of-life questionnaire at baseline and at 6, 12, 36, 60, and 84 months.

Tumor tissue, serum, and blood samples may be collected periodically for biomarker and other
analyses.

After completion of study treatment, patients are followed up periodically for up to 2
years.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Has undergone complete resection of stage I or II adenocarcinoma of the colon with
curative intent within the past year

- Laparoscopically-assisted colectomy is allowed

- Completed adjuvant therapy (if indicated)

- Has undergone either a preoperative or postoperative colonoscopy to the cecum (or
small bowel anastomosis) with adequate bowel preparation within the past 180 days

- All observed polyps must have been removed

- Polyps can be removed during colonoscopy or surgery performed prior to
randomization

- Distal border of the tumor located ≥ 12 cm from the anal verge

- No classic familial adenomatous polyposis, attenuated familial adenomatous polyposis
(i.e., ≥ 20 adenomas, either synchronous or metachronous), or hereditary nonpolyposis
colorectal cancer (Lynch syndrome)

PATIENT CHARACTERISTICS:

- ECOG performance status 0-1

- Postoperative serum creatinine ≤ 1.5 times upper limit of normal (ULN)

- AST and/or ALT ≤ 3.0 times ULN

- Total bilirubin ≤ 1.5 times ULN

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception during and for ≥ 3 months after
completion of study treatment

- Able to swallow oral medication

- No malabsorption syndrome, ulcerative colitis, inflammatory bowel disease, resection
of the stomach or small bowel, or other disease significantly affecting
gastrointestinal (GI) function

- No history of documented upper GI bleeding or upper GI ulcerative disease

- No hyperlipidemia with clinical indication for statin therapy or other prescribed
medication (determination of acceptable fasting lipid values should be in accordance
with current dyslipidemia management guidelines)

- No inadequately treated hypothyroidism, as determined by the investigator

- No history of myopathy or rhabdomyolysis

- No other malignancy within the past 5 years except for in situ cancers or basal cell
or squamous cell carcinoma of the skin

- Deemed by the physician to be at low risk for recurrence

- No hypersensitivity or intolerance to statins

- No other non-malignant systemic disease that would preclude rosuvastatin
administration or prolonged follow-up

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- More than 30 days since prior statins

- More than 30 days since prior investigational agents

- No prior total colectomy or total proctocolectomy

- No concurrent chronic use of NSAIDs

- Concurrent cardioprotective low-dose aspirin allowed provided there is no
clinically significant toxicity, as determined by the investigator, that would
preclude continuation of aspirin AND patient is willing to continue the same
dose (81 mg or 325 mg) throughout study therapy

- No concurrent chronic drug therapy with cyclosporine, coumarin anticoagulants,
gemfibrozil, other lipid-lowering therapies (e.g., fibrates or niacin),
lopinavir/ritonavir, or drugs (e.g., ketoconazole, spironolactone, or cimetidine)
that lower levels or activity of steroid hormones

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Masking: Double-Blind, Primary Purpose: Treatment

Outcome Measure:

Occurrence of ≥ 1 adenomatous polyp of the colon or rectum, metachronous colorectal carcinoma, or colon cancer recurrence (APMC+R) during a 5-year follow-up period

Safety Issue:

No

Principal Investigator

Bruce M. Boman, MD, PhD

Investigator Role:

Study Chair

Investigator Affiliation:

National Surgical Adjuvant Breast and Bowel Project (NSABP)

Authority:

Unspecified

Study ID:

CDR0000658554

NCT ID:

NCT01011478

Start Date:

March 2010

Completion Date:

Related Keywords:

  • Colorectal Cancer
  • Precancerous Condition
  • adenomatous polyp
  • stage I colon cancer
  • stage II colon cancer
  • adenocarcinoma of the colon
  • Colonic Neoplasms
  • Colorectal Neoplasms
  • Precancerous Conditions

Name

Location

Fred Hutchinson Cancer Research Center Seattle, Washington  98109
CCOP - Upstate Carolina Spartanburg, South Carolina  29303
Tripler Army Medical Center Honolulu, Hawaii  96859-5000
CCOP - Wichita Wichita, Kansas  67214-3882
Hurley Medical Center Flint, Michigan  48503
CCOP - Atlanta Regional Atlanta, Georgia  30342-1701
CCOP - Missouri Valley Cancer Consortium Omaha, Nebraska  68131
CCOP - Christiana Care Health Services Wilmington, Delaware  19899
CCOP - Mount Sinai Medical Center Miami Beach, Florida  33140
CCOP - North Shore University Hospital Manhasset, New York  11030
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
Aurora Presbyterian Hospital Aurora, Colorado  80012
Boulder Community Hospital Boulder, Colorado  80301-9019
Penrose Cancer Center at Penrose Hospital Colorado Springs, Colorado  80933
CCOP - Colorado Cancer Research Program Denver, Colorado  80224-2522
Porter Adventist Hospital Denver, Colorado  80210
Presbyterian - St. Luke's Medical Center Denver, Colorado  80218
St. Joseph Hospital Denver, Colorado  80218
Rose Medical Center Denver, Colorado  80220
Swedish Medical Center Englewood, Colorado  80110
St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center Grand Junction, Colorado  81502
Sky Ridge Medical Center Lone Tree, Colorado  80124
Hope Cancer Care Center at Longmont United Hospital Longmont, Colorado  80502
St. Mary - Corwin Regional Medical Center Pueblo, Colorado  81004
North Suburban Medical Center Thornton, Colorado  80229
Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center Farmington, Connecticut  06360-2875
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
Cedar Rapids Oncology Associates Cedar Rapids, Iowa  52403
Mercy Medical Center - Sioux City Sioux City, Iowa  51104
Siouxland Hematology-Oncology Associates, LLP Sioux City, Iowa  51101
St. Luke's Regional Medical Center Sioux City, Iowa  51104
CCOP - Michigan Cancer Research Consortium Ann Arbor, Michigan  48106
Saint Joseph Mercy Cancer Center Ann Arbor, Michigan  48106-0995
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
Minnesota Oncology Hematology, PA - Maplewood Maplewood, Minnesota  55109
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
Minnesota Oncology Hematology, PA - Woodbury Woodbury, Minnesota  55125
MeritCare Broadway Fargo, North Dakota  58122
CCOP - MeritCare Hospital Fargo, North Dakota  58122
Aultman Cancer Center at Aultman Hospital Canton, Ohio  44710-1799
Mercy Cancer Center at Mercy Medical Center Canton, Ohio  44708
Natalie Warren Bryant Cancer Center at St. Francis Hospital Tulsa, Oklahoma  74136
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
Sanford Cancer Center at Sanford USD Medical Center Sioux Falls, South Dakota  57117-5039
Medical X-Ray Center, PC Sioux Falls, South Dakota  57105
Avera Cancer Institute Sioux Falls, South Dakota  57105
Marshfield Clinic - Marshfield Center Marshfield, Wisconsin  54449
Marshfield Clinic - Indianhead Center Rice Lake, Wisconsin  54868
CCOP - Ochsner New Orleans, Louisiana  70121
Rapid City Regional Hospital Rapid City, South Dakota  57709
CCOP - Bay Area Tumor Institute Oakland, California  94609-3305
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
Newark Beth Israel Medical Center Newark, New Jersey  07112
CCOP - Columbus Columbus, Ohio  43206
CCOP - Dayton Kettering, Ohio  45429
Albert Einstein Cancer Center Philadelphia, Pennsylvania  19141
Mercy Hospital Cancer Center - Scranton Scranton, Pennsylvania  18501
CCOP - Greenville Greenville, South Carolina  29615
Joe Arrington Cancer Research and Treatment Center Lubbock, Texas  79410-1894
LDS Hospital Salt Lake City, Utah  84143
Hinsdale, Illinois  60521
CCOP - Northern Indiana CR Consortium South Bend, Indiana  46601
Saint Joseph Regional Medical Center South Bend, Indiana  46617
Holden Comprehensive Cancer Center at University of Iowa Iowa City, Iowa  52242-1002
CCOP - Grand Rapids Grand Rapids, Michigan  49503
Charles M. Barrett Cancer Center at University Hospital Cincinnati, Ohio  45267-0526
CCOP - Columbia River Oncology Program Portland, Oregon  97225
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia Philadelphia, Pennsylvania  19107
MultiCare Regional Cancer Center at Tacoma General Hospital Tacoma, Washington  98405
MBCCOP - LSU Health Sciences Center New Orleans, Louisiana  70112
CCOP - St. Louis-Cape Girardeau Saint Louis, Missouri  63141
CCOP - Northwest Tacoma, Washington  98405-0986
Sutter Cancer Center Sacramento, California  95816
Kaiser Permanente Medical Center - Vallejo Vallejo, California  94589
Utah Valley Regional Medical Center - Provo Provo, Utah  84604
Peninsula Regional Medical Center Salisbury, Maryland  21801
Monmouth Medical Center Long Branch, New Jersey  07740-6395
Veterans Affairs Medical Center - Buffalo Buffalo, New York  14215
City of Hope Comprehensive Cancer Center Duarte, California  91010
John Stoddard Cancer Center at Iowa Methodist Medical Center Des Moines, Iowa  50309
Kaiser Permanente Medical Center - San Francisco Geary Campus San Francisco, California  94115
Bellin Memorial Hospital Green Bay, Wisconsin  54301
Arkansas Cancer Research Center at University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
Josephine Ford Cancer Center at Henry Ford Hospital Detroit, Michigan  48202
Swedish Cancer Institute at Swedish Medical Center - First Hill Campus Seattle, Washington  98104
Blumenthal Cancer Center at Carolinas Medical Center Charlotte, North Carolina  28232-2861
Northside Hospital Cancer Center Atlanta, Georgia  30342-1611
Harry and Jeanette Weinberg Cancer Institute at Franklin Square Hospital Center Baltimore, Maryland  21237
Hulston Cancer Center at Cox Medical Center South Springfield, Missouri  65807
St. John's Regional Health Center Springfield, Missouri  65804
McDowell Cancer Center at Akron General Medical Center Akron, Ohio  44307
Central Baptist Hospital Lexington, Kentucky  40503
Waukesha Memorial Hospital Regional Cancer Center Waukesha, Wisconsin  53188
Long Island Jewish Medical Center New Hyde Park, New York  11040
Kaiser Permanente Medical Center - Oakland Sacramento, California  95825
University of Florida Shands Cancer Center Gainesville, Florida  32610-0232
Florida Hospital Cancer Institute at Florida Hospital Orlando Orlando, Florida  32803-1273
Advocate Christ Medical Center Oak Lawn, Illinois  60453
Via Christi Cancer Center at Via Christi Regional Medical Center Wichita, Kansas  67214
Ochsner Cancer Institute at Ochsner Clinic Foundation New Orleans, Louisiana  70121
Breslin Cancer Center at Ingham Regional Medical Center Lansing, Michigan  48910
SUNY Upstate Medical University Hospital Syracuse, New York  13210
Mission Hospitals - Memorial Campus Asheville, North Carolina  28801
Wake Forest University Comprehensive Cancer Center Winston-Salem, North Carolina  27157-1096
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
CCOP - Hematology-Oncology Associates of Central New York East Syracuse, New York  13057
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
Somerset Medical Center Somerville, New Jersey  08876
North Colorado Medical Center Greeley, Colorado  80631
McKee Medical Center Loveland, Colorado  80539
Saint Anthony's Hospital at Saint Anthony's Health Center Alton, Illinois  62002
Good Samaritan Regional Health Center Mt. Vernon, Illinois  62864
Battle Creek Health System Cancer Care Center Battle Creek, Michigan  49017
William Beaumont Hospital - Royal Oak Campus Royal Oak, Michigan  48073
Munson Medical Center Traverse City, Michigan  49684
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
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
American Fork Hospital American Fork, Utah  84003
Logan Regional Hospital Logan, Utah  84321
Utah Cancer Specialists at UCS Cancer Center Salt Lake City, Utah  84106
Olympic Hematology and Oncology Bremerton, Washington  98310
Skagit Valley Hospital Cancer Care Center Mt. Vernon, Washington  98273
Group Health Central Hospital Seattle, Washington  98104
Kaiser Permanente Medical Center - Santa Clara Kiely Campus Santa Clara, California  95051-5386
MBCCOP - Medical College of Georgia Cancer Center Augusta, Georgia  30912-3730
Advocate Lutheran General Cancer Care Center Park Ridge, Illinois  60068-1174
Swedish-American Regional Cancer Center Rockford, Illinois  61104-2315
Tulane Cancer Center Office of Clinical Research Alexandria, Louisiana  71315-3198
CancerCare of Maine at Eastern Maine Medical Center Bangor, Maine  04401
Butterworth Hospital at Spectrum Health Grand Rapids, Michigan  49503-2560
CCOP - Nevada Cancer Research Foundation Las Vegas, Nevada  89109-2306
University of New Mexico Cancer Center Albuquerque, New Mexico  87131-5636
Don Monti Comprehensive Cancer Center at North Shore University Hospital Manhasset, New York  11030
Dakota Cancer Institute at Dakota Clinic - South University Fargo, North Dakota  58103-4940
Geisinger Cancer Institute at Geisinger Health Danville, Pennsylvania  17822-0001
M. D. Anderson Cancer Center at University of Texas Houston, Texas  77030-4009
Virginia Commonwealth University Massey Cancer Center Richmond, Virginia  23298-0037
West Virginia University Health Sciences Center - Charleston Charleston, West Virginia  25302
Kaiser Permanente Medical Center - Sacramento Sacramento, California  95825
Methodist Estabrook Cancer Center Omaha, Nebraska  68114-4199
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
Helen and Harry Gray Cancer Center at Hartford Hospital Hartford, Connecticut  06102-5037
Elkhart General Hospital Elkhart, Indiana  46515
Howard Community Hospital Kokomo, Indiana  46904
Lakeland Regional Cancer Care Center - St. Joseph St. Joseph, Michigan  49085
Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton Marlton, New Jersey  08053
Fox Chase Virtua Health Cancer Program at Virtua West Jersey Voorhees, New Jersey  08043
Mount Carmel Health - West Hospital Columbus, Ohio  43222
Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest Allentown, Pennsylvania  18105
Lucy Curci Cancer Center at Eisenhower Memorial Hospital and Medical Center Rancho Mirage, California  92270
Front Range Cancer Specialists Fort Collins, Colorado  80528
University Medical Center of Southern Nevada Las Vegas, Nevada  89102
Jennersville Regional Hospital West Grove, Pennsylvania  19390-9499
North Bay Cancer Center Fairfield, California  94533
Kaiser Permanente - Fremont Fremont, California  94538
Kaiser Permanente Medical Center - Hayward Hayward, California  94545
Alta Bates Summit Medical Center - Summit Campus Oakland, California  94609
Kaiser Permanente Medical Center - Redwood City Redwood City, California  94063
Kaiser Permanente Medical Center - Richmond Richmond, California  94801
Kaiser Permanente Medical Center - Roseville Roseville, California  95661
Sutter Cancer Center at Roseville Medical Center Roseville, California  95661
South Sacramento Kaiser-Permanente Medical Center Sacramento, California  95823
Salinas Valley Memorial Hospital Salinas, California  93901
Kaiser Permanente Medical Office -Vandever Medical Office San Diego, California  92120
Kaiser Permanente Medical Center - Santa Teresa San Jose, California  95119
Kaiser Foundation Hospital - San Rafael San Rafael, California  94903
Kaiser Permanente Medical Center - Santa Rosa Santa Rosa, California  95403
Kaiser Permanente Medical Center - South San Francisco South San Francisco, California  94080
Kaiser Permanente Medical Facility - Stockton Stockton, California  95210
Kaiser Permanente Medical Center - Walnut Creek Walnut Creek, California  94596
John Muir/Mt. Diablo Comprehensive Cancer Center Walnut Creek, California  94598
Poudre Valley Hospital Fort Collins, Colorado  80524
Ella Milbank Foshay Cancer Center at Jupiter Medical Center Jupiter, Florida  33458
Saint Joseph's Hospital of Atlanta Atlanta, Georgia  30342-1701
Piedmont Hospital Atlanta, Georgia  30309
WellStar Cobb Hospital Austell, Georgia  30106
Charles B. Eberhart Cancer Center at DeKalb Medical Center Decatur, Georgia  30033
Gwinnett Medical Center Lawrenceville, Georgia  30045
Kennestone Cancer Center at Wellstar Kennestone Hospital Marietta, Georgia  30060
Southern Regional Medical Center Riverdale, Georgia  30274-2600
Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical Center Boise, Idaho  83706
St. Joseph Medical Center Bloomington, Illinois  61701
Graham Hospital Canton, Illinois  61520
Memorial Hospital Carthage, Illinois  62321
Eureka Community Hospital Eureka, Illinois  61530
Ingalls Cancer Care Center at Ingalls Memorial Hospital Harvey, Illinois  60426
Mason District Hospital Havana, Illinois  62644
McDonough District Hospital Macomb, Illinois  61455
Edward Hospital Cancer Center 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
OSF St. Francis Medical Center Peoria, Illinois  61637
Proctor Hospital Peoria, Illinois  61614
Illinois Valley Community Hospital Peru, Illinois  61354
Perry Memorial Hospital Princeton, Illinois  61356
St. Francis Hospital and Health Centers - Beech Grove Campus Beech Grove, Indiana  46107
Center for Cancer Therapy at LaPorte Hospital and Health Services La Porte, Indiana  46350
Bettendorf, Iowa  52722
Mercy Regional Cancer Center at Mercy Medical Center Cedar Rapids, Iowa  52403
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
Cancer Center of Kansas, PA - Dodge City Dodge City, Kansas  67801
Mary Bird Perkins Cancer Center - Baton Rouge Baton Rouge, Louisiana  70809
Louisiana State University Health Sciences Center - Monroe Monroe, Louisiana  71210
Medical Center of Louisiana - New Orleans New Orleans, Louisiana  70112
Feist-Weiller Cancer Center at Louisiana State University Health Sciences Shreveport, Louisiana  71130-3932
Mecosta County Medical Center Big Rapids, Michigan  49307
Upper Michigan Cancer Center at Marquette General Hospital Marquette, Michigan  49855
St. Joseph's Medical Center Brainerd, Minnesota  56401
Saint Francis Medical Center Cape Girardeau, Missouri  63701
Immanuel Medical Center Omaha, Nebraska  68122
Creighton University Medical Center Omaha, Nebraska  68131-2197
Cancer Institute of New Jersey at Cooper - Voorhees Voorhees, New Jersey  08043
Charles R. Wood Cancer Center at Glens Falls Hospital Glens Falls, New York  12801
Iredell Memorial Hospital Statesville, North Carolina  28677
Forsyth Regional Cancer Center at Forsyth Medical Center Winston-Salem, North Carolina  27103
Bismarck Cancer Center Bismarck, North Dakota  58501
Samaritan North Cancer Care Center Dayton, Ohio  45415
Grandview Hospital Dayton, Ohio  45405
David L. Rike Cancer Center at Miami Valley Hospital Dayton, Ohio  45409
Good Samaritan Hospital Dayton, Ohio  45406
Blanchard Valley Medical Associates Findlay, Ohio  45840
Charles F. Kettering Memorial Hospital Kettering, Ohio  45429
Middletown Regional Hospital Middletown, Ohio  45044
UVMC Cancer Care Center at Upper Valley Medical Center Troy, Ohio  45373-1300
Ruth G. McMillan Cancer Center at Greene Memorial Hospital Xenia, Ohio  45385
Providence Milwaukie Hospital Milwaukie, Oregon  97222
Kaiser Permanente Health Care - Portland Portland, Oregon  97232
Providence Cancer Center at Providence Portland Medical Center Portland, Oregon  97213-2967
Providence St. Vincent Medical Center Portland, Oregon  97225
Delaware County Regional Cancer Center at Delaware County Memorial Hospital Drexel Hill, Pennsylvania  19026
Bon Secours St. Francis Health System Greenville, South Carolina  29601
Oncology Services of Aberdeen Aberdeen, South Dakota  57401
Christine LaGuardia Phillips Cancer Center at Wellmont Holston Valley Medical Center Kingsport, Tennessee  37662
Doctor's Hospital of Laredo Laredo, Texas  78041
Dixie Regional Medical Center - East Campus Saint George, Utah  84770
Southwest Washington Medical Center Cancer Center Vancouver, Washington  98668
Holy Family Memorial Medical Center Cancer Care Center Manitowoc, Wisconsin  54221-1450
Welch Cancer Center at Sheridan Memorial Hospital Sheridan, Wyoming  82801
St. Anthony Central Hospital Denver, Colorado  80204-1335
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
St. Francis Hospital Federal Way, Washington  98003
St. Clare Hospital Lakewood, Washington  98499-0998
Providence St. Peter Hospital Regional Cancer Center Olympia, Washington  98506
Good Samaritan Cancer Center Puyallup, Washington  98371
Allenmore Hospital Tacoma, Washington  98411-0414
Pottstown Memorial Regional Cancer Center Pottstown, Pennsylvania  19464
Highland General Hospital Oakland, California  94602
Palo Alto Medical Foundation Palo Alto, California  94301
Middlesex Hospital Cancer Center Middletown, Connecticut  06457
Mercy Cancer Center at Mercy Medical Center - North Iowa Mason City, Iowa  50401
Saint Luke's Hospital Chesterfield, Missouri  63017
Missouri Baptist Cancer Center St. Louis, Missouri  63131
Cancer Resource Center - Lincoln Lincoln, Nebraska  68510
Randolph Hospital Asheboro, North Carolina  27203
Moses Cone Regional Cancer Center at Wesley Long Community Hospital Greensboro, North Carolina  27401
Annie Penn Cancer Center Reidsville, North Carolina  27320
Allegheny Cancer Center at Allegheny General Hospital Pittsburgh, Pennsylvania  15212
Kaiser Permanente - Deer Valley Antioch, California  94531
Kaiser Permanente - Denver Denver, Colorado  80205
Kaiser Permanente - Lafayette Lafayette, Colorado  80026
Carl and Dorothy Bennett Cancer Center at Stamford Hospital Stamford, Connecticut  06904
Tunnell Cancer Center at Beebe Medical Center Lewes, Delaware  19958
Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital Fort Lauderdale, Florida  33308
Florida Cancer Specialists - Sarasota Downtown Sarasota, Florida  34236
John B. Amos Cancer Center Columbus, Georgia  31904
Harbin Clinic Cancer Center - Medical Oncology Rome, Georgia  30165
Kaiser Permanente - Moanalua Medical Center and Clinic Honolulu, Hawaii  96819
Evanston Hospital Evanston, Illinois  60201-1781
Michiana Hematology-Oncology, PC - Elkhart Elkhart, Indiana  46514
Elkhart Clinic, LLC Elkhart, Indiana  46514-2098
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
Reid Hospital & Health Care Services Richmond, Indiana  47374
McFarland Clinic, PC Ames, Iowa  50010
Covenant Cancer Treatment Center Waterloo, Iowa  50702
Cancer Center of Kansas, PA - Chanute Chanute, Kansas  66720
Cancer Center of Kansas, PA - El Dorado El Dorado, Kansas  67042
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Cancer Center of Kansas, PA - Kingman Kingman, Kansas  67068
Lawrence Memorial Hospital Lawrence, Kansas  66044
Cancer Center of Kansas, PA - Liberal Liberal, Kansas  67905
Cancer Center of Kansas, PA - Newton Newton, Kansas  67114
Menorah Medical Center Overland Park, Kansas  66209
Saint Luke's Hospital - South Overland Park, Kansas  66213
Cancer Center of Kansas, PA - Parsons Parsons, Kansas  67357
Cancer Center of Kansas, PA - Pratt Pratt, Kansas  67124
Cancer Center of Kansas, PA - Salina Salina, Kansas  67401
Cancer Center of Kansas, PA - Wellington Wellington, Kansas  67152
Cancer Center of Kansas, PA - Wichita Wichita, Kansas  67214
Associates in Womens Health, PA - North Review Wichita, Kansas  67208
Cancer Center of Kansas, PA - Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas, PA - Winfield Winfield, Kansas  67156
Foote Memorial Hospital Jackson, Michigan  49201
St. Mary Mercy Hospital Livonia, Michigan  48154
Michiana Hematology Oncology PC - Niles Niles, Michigan  49120
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
St. Luke's Hospital Cancer Care Center Duluth, Minnesota  55805
Willmar Cancer Center at Rice Memorial Hospital Willmar, Minnesota  56201
St. Joseph Medical Center Kansas City, Missouri  64114
Heartland Hematology Oncology Associates, Incorporated Kansas City, Missouri  64118
North Kansas City Hospital Kansas City, Missouri  64116
Saint Luke's Cancer Institute at Saint Luke's Hospital Kansas City, Missouri  64111
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
Saint Joseph Oncology, Incorporated Saint Joseph, Missouri  64507
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
Northern Montana Hospital Havre, Montana  59501
Kalispell Medical Oncology at KRMC Kalispell, Montana  59901
Alegant Health Cancer Center at Bergan Mercy Medical Center Omaha, Nebraska  68124
Frederick R. and Betty M. Smith Cancer Treatment Center Sparta, New Jersey  07871
Monter Cancer Center of the North Shore-LIJ Health System Lake Success, New York  11042
Summa Center for Cancer Care at Akron City Hospital Akron, Ohio  44309-2090
Christ Hospital Cancer Center Cincinnati, Ohio  45219
Grant Medical Center Cancer Care Columbus, Ohio  43215
Wayne Hospital Greenville, Ohio  45331
Knox Community Hospital Mount Vernon, Ohio  43050
Mount Carmel St. Ann's Cancer Center Westerville, Ohio  43081
Cancer Care Associates - Mercy Campus Oklahoma City, Oklahoma  73120
Geisinger Hazleton Cancer Center Hazleton, Pennsylvania  18201
Hematology and Oncology Associates of Northeastern Pennsylvania Scranton, Pennsylvania  18510
Susquehanna Cancer Center at Divine Providence Hospital Williamsport, Pennsylvania  17701
York Cancer Center at Apple Hill Medical Center York, Pennsylvania  17405
Sandra L. Maxwell Cancer Center Cedar City, Utah  84720
Jon and Karen Huntsman Cancer Center at Intermountain Medical Center Murray, Utah  84157
Val and Ann Browning Cancer Center at McKay-Dee Hospital Center Ogden, Utah  84403
Southwest Virginia Regional Cancer Center at Wellmonth Health Norton, Virginia  24273
St. Joseph Cancer Center Bellingham, Washington  98225
Providence Centralia Hospital Centralia, Washington  98531-9027
Franciscan Cancer Center at St. Joseph Medical Center Tacoma, Washington  98405-3004
Wenatchee Valley Medical Center Wenatchee, Washington  98801-2028
Community Comprehensive Cancer Center at Camden-Clark Memorial Hospital Parkersburg, West Virginia  26102
Marshfield Clinic Cancer Care at Regional Cancer Center Eau Claire, Wisconsin  54701
Marshfield Clinic - Lakeland Center Minocqua, Wisconsin  54548
Ministry Medical Group at Saint Mary's Hospital Rhinelander, Wisconsin  54501
Marshfield Clinic at Saint Michael's Hospital Stevens Point, Wisconsin  54481
Marshfield Clinic - Weston Center Weston, Wisconsin  54476
FirstHealth Moore Regional Community Hospital Comprehensive Cancer Center Pinehurst, North Carolina  28374
Mid Dakota Clinic, PC Bismarck, North Dakota  58501
Regional Cancer Center at Memorial Medical Center Springfield, Illinois  62781-0001
John H. Stroger, Jr. Hospital of Cook County Chicago, Illinois  60612-9985
Community Hospital Munster, Indiana  46321
St. Joseph Hospital Regional Cancer Center - Orange Orange, California  92868-3849
Phoebe Cancer Center at Phoebe Putney Memorial Hospital Albany, Georgia  31702
Seton Shivers Cancer Program at Brackenridge Hospital Austin, Texas  78701
Good Samaritan Cancer Center at Good Samaritan Hospital Kearney, Nebraska  68848-1990
Tucker Center for Cancer Care at Orange Regional Medical Center Middletown, New York  10940-4199
Pardee Memorial Hospital Hendersonville, North Carolina  28791
Rutherford Hospital Rutherfordton, North Carolina  28139
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center Spartanburg, South Carolina  29303
Regional Cancer Center at Oconomowoc Memorial Hospital Oconomowoc, Wisconsin  53066
Union Hospital of Cecil County Elkton MD, Maryland  21921
Kinston Medical Specialists Kinston, North Carolina  28501
Greenville Hospital Cancer Center Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Grove Commons Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Faris Road Greenville, South Carolina  29605
Cancer Centers of the Carolinas - Greer Medical Oncology Greer, South Carolina  29650
Cancer Centers of the Carolinas - Seneca Seneca, South Carolina  29672
Cancer Centers of the Carolinas - Spartanburg Spartanburg, South Carolina  29307
Glendale Memorial Hospital Comprehensive Cancer Center Glendale, California  91204
St. Vincent's Medical Center Jacksonville, Florida  32203
Resurrection Medical Center Chicago, Illinois  60631
Sherman Hospital Elgin, Illinois  60120-2198
Frederick Memorial Hospital Regional Cancer Therapy Center Frederick, Maryland  21701
Memorial Healthcare Owosso, Michigan  48867
Phelps County Regional Medical Center Rolla, Missouri  65401
McLeod Regional Medical Center Florence, South Carolina  29501
Lacks Cancer Center at Saint Mary's Health Care Grand Rapids, Michigan  49503
Lakes Region General Hospital Laconia, New Hampshire  03246
PinnacleHealth Regional Cancer Center at Polyclinic Hospital Harrisburg, Pennsylvania  17105
Roper St. Francis Cancer Center at Roper Hospital Charleston, South Carolina  29401
Rockwood Clinic Cancer Treatment Center Spokane, Washington  99204-2967
University of Wisconcin Cancer Center at Aspirus Wausau Hospital Wausau, Wisconsin  54401
Franklin & Edith Scarpa Regional Cancer Center at South Jersey Healthcare Vineland, New Jersey  08360
Oncology Hematology Associates of Northern Pennsylvania, PC at Hahne Regional Cancer Center Dubois, Pennsylvania  15801
Louisville Oncology at Norton Cancer Institute - Louisville Louisville, Kentucky  40202
Galesburg Clinic, PC Galesburg, Illinois  61401
Boston University Cancer Research Center Boston, Massachusetts  02118
St. Vincent Healthcare Cancer Care Services Billings, Montana  59101
Berkshire Hematology Oncology, PC Pittsfield, Massachusetts  01201
Parvin Radiation Oncology Kansas City, Missouri  64116
Midwest Hematology Oncology Group, Incorporated Saint Louis, Missouri  63109
Providence Cancer Center at Providence Hospital Mobile, Alabama  36608
East Bay Radiation Oncology Center Castro Valley, California  94546
Contra Costa Regional Medical Center Martinez, California  94553-3156
El Camino Hospital Cancer Center Mountain View, California  94040
Larry G Strieff MD Medical Corporation Oakland, California  94609
Tom K Lee, Incorporated Oakland, California  94609
Bay Area Breast Surgeons, Incorporated Oakland, California  94609
Illinois CancerCare - Bloomington Bloomington%, Illinois  61701
Illinois CancerCare - Canton Canton, Illinois  61520
Illinois CancerCare - Carthage Carthage, Illinois  62321
Alexian Brothers Radiation Oncology Elk Grove Village, Illinois  60007
Illinois CancerCare - Eureka Eureka, Illinois  61530
Illinois CancerCare - Galesburg Galesburg, Illinois  61401
Illinois CancerCare - Havana Havana, Illinois  62644
Illinois CancerCare - Kewanee Clinic Kewanee, Illinois  61443
Illinois CancerCare - Macomb Macomb, Illinois  61455
Trinity Cancer Center at Trinity Medical Center - 7th Street Campus Moline, Illinois  61265
OSF Holy Family Medical Center Monmouth, Illinois  61462
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
Mercy General Health Partners Muskegon, Michigan  49443
New Hampshire Oncology - Hematology, PA at Payson Center for Cancer Care Concord, New Hampshire  03301
Center for Cancer Care at Exeter Hospital Exeter, New Hampshire  03833
New Hampshire Oncology - Hematology, PA - Hooksett Hooksett, New Hampshire  03106
Trinity CancerCare Center Minot, North Dakota  58701
Riddle Memorial Hospital Cancer Center Media, Pennsylvania  19063
AnMed Cancer Center Anderson, South Carolina  29621
Fountain Valley, California  92708
Medcenter One Hospital Cancer Care Center Bismarck, North Dakota  58501
St. Alexius Medical Center Cancer Center Bismarck, North Dakota  58502
Cleveland Clinic Florida - Weston Weston, Florida  33331
St. Mary's Regional Cancer Center at St. Mary's Medical Center Huntington, West Virginia  25702
J. Phillip Citta Regional Cancer Center at Community Medical Center Toms River, New Jersey  08755
Saint Mary's Regional Medical Center Reno, Nevada  89503
Lovelace Medical Center - Downtown Albuquerque, New Mexico  87102
Hematology Oncology Associates, PC Albuquerque, New Mexico  87106
Valley Medical Oncology Consultants - Castro Valley Castro Valley, California  94546
Valley Medical Oncology Fremont, California  94538
Hudner Oncology Center at Saint Anne's Hospital - Fall River Fall River, Massachusetts  02721
Immanuel St. Joseph's Mankato, Minnesota  56002
Mercy Regional Cancer Center Janesville, Wisconsin  53547
Cancer Care Center at John Muir Health - Concord Campus Concord, California  94524-4110
Self Regional Cancer Center at Self Regional Medical Center Greenwood, South Carolina  29646
Humphrey Cancer Center at North Memorial Outpatient Center Robbinsdale, Minnesota  55422-2900
Lakeview Hospital Stillwater, Minnesota  55082
Camino Medical Group - Treatment Center Mountain View, California  94040
Princeton Community Hospital Princeton, West Virginia  24740
Virginia K. Crosson Cancer Center at St. Jude Medical Center Fullerton, California  92835
Kaiser Permanente Capital Area Medical Group - Shady Grove Facility Rockville, Maryland  20850
Ephrata Cancer Center at Ephrata Community Hospital Ephrata, Pennsylvania  17522
St. Mary Regional Cancer Center at St. Mary Medical Center Walla Walla, Washington  99362
Richard G. Laube Cancer Center at ACMH Kittanning, Pennsylvania  16201
Radiation Oncology Associates - Reno Reno, Nevada  89509
Kaiser Permanente - Division of Research - Oakland Oakland, California  94611
Kaiser Permanente Medical Center - Rancho Cordova Rancho Cordova, California  95670
Rohnert Park Cancer Center Rohnert Park, California  94928
South Sacramento Cancer Center Sacramento, California  95823
CCOP - Kansas City Prairie Village, Kansas  66208
Renown Institute for Cancer at Renown Regional Medical Center Reno, Nevada  89502
Kaiser Permanente Mid-Atlantic Medical Group-Largo Medical Facility Largo, Maryland  20774
Kaiser Permanente Medical Center - Fair Oaks Fairfax, Virginia  22033
Langlade Memorial Hospital Antigo, Wisconsin  54409
Piedmont Fayette Hospital Fayetteville, Georgia  30214
Southeast Cancer Center Cape Girardeau, Missouri  63703
Goldschmidt Cancer Center Jefferson City, Missouri  65109
Comprehensive Cancer Care, PC Saint Louis, Missouri  63141
Cancer Care Associates - Norman Norman, Oklahoma  73071
Clackamas Radiation Oncology Center Clackamas, Oregon  97015
Providence Newberg Medical Center Newberg, Oregon  97132
Willamette Falls Hospital Oregon City, Oregon  97045
Roger Maris Cancer Center at MeritCare Hospital Fargo, North Dakota  58122
St. Nicholas Hospital Sheboygan, Wisconsin  53081
Mercy Hospital Portland, Maine  04101
United Hospital Center Clarksburg, West Virginia  26301
Highland Clinic Shreveport, Louisiana  71105
Drs Gurtler Brinz and Russo APMC-Metairie Oncologists Metairie, Louisiana  70006
Overlake Cancer Center at Overlake Hospital Medical Center Bellevue, Washington  98004
Southern Ohio Medical Center Cancer Center Portsmouth, Ohio  45662
Celilo Cancer Center at Mid-Columbia Medical Center The Dalles, Oregon  97058
Adams Cancer Center Gettysburg, Pennsylvania  17325
Cherry Tree Cancer Center Hanover, Pennsylvania  17331
Kaiser Permanente at Capitol Hill Medical Center Washington, District of Columbia  20002
Kaiser Permanente at Woodlawn Medical Center Baltimore, Maryland  21244
Kaiser Permanente Medical Center - Vacaville Vacaville, California  95688
D.N. Greenwald Center Mukwonago, Wisconsin  53149
Mercy Cancer Center - West Lakes Clive, Iowa  50325
Methodist West Hospital West Des Moines, Iowa  50266-7700
Kaiser Permanente Fresno Medical Center Fresno, California  93720
Olympic Medical Cancer Center Sequim, Washington  98382
CHRISTUS Cabrini Cancer Center Alexandria, Louisiana  71301