A Phase III Study Evaluating the Role of Perioperative Chemotherapy in Patients With Potentially Resectable Hepatic Colorectal Metastases
OBJECTIVES:
Primary
- To evaluate the difference in recurrence-free survival (RFS) of patients with
potentially resectable hepatic colorectal metastases receiving perioperative
(preoperative plus postoperative) adjuvant chemotherapy vs only postoperative adjuvant
chemotherapy following liver resection for colorectal metastases.
Secondary
- To compare the proportion of patients between study arms who are R0 or R1 resected,
alive, and free of recurrence at 6 months.
- To compare RFS between study arms in the cohort of patients event-free at 6 months.
- To compare overall survival between study arms.
- To evaluate the difference in R0 and combined R0 + R1 resection rates in patients
receiving neoadjuvant therapy and those undergoing initial surgical resection.
- To compare the postoperative morbidity profile between study arms.
- To evaluate the safety and toxicity profile of postoperative and perioperative
administration of chemotherapy and bevacizumab.
Tertiary
- To evaluate the relationship of baseline circulating tumor cells (CTC) to RFS.
- To evaluate the relationship of baseline CTC to R0 resection.
- To evaluate the relationship of pre-resection CTC in the preoperative therapy group
only with RFS and R0 resection.
OUTLINE: This is a multicenter study. Patients are stratified by number of liver metastases
(1-3 vs 4+), chemotherapy regimen* (mFOLFOX6 vs FOLFIRI), and synchronous** primary
colorectal cancer (yes vs no). Patients are randomized to 1 of 2 treatment arms.
NOTE: *Patients who have not received previous oxaliplatin receive mFOLFOX6 chemotherapy
comprising oxaliplatin IV over 2 hours, leucovorin calcium IV over 2 hours, and fluorouracil
IV over 46 hours on day 1. Patients who have received previous oxaliplatin receive FOLFIRI
chemotherapy comprising irinotecan hydrochloride IV over 2 hours, leucovorin calcium IV over
2 hours, and fluorouracil IV over 46 hours on day 1.
NOTE: **Synchronous is defined as the detection (by imaging) of suspicious liver metastases
within 90 days before or after the date of histologic diagnosis of the primary colon or
rectal cancer.
- Arm 1 (postoperative): Patients undergo hepatic resection. Beginning 31-56 days after
surgery, patients receive mFOLFOX6 or FOLFIRI chemotherapy IV on day 1 over 3 hours.
Patients receive an additional dose of fluorouracil over 46 hours using a portable
pump. Treatment repeats every 2 weeks for 12 courses.
- Arm 2 (perioperative): Patients receive mFOLFOX6 or FOLFIRI chemotherapy IV over 3
hours on day 1. Patients receive an additional dose of fluorouracil over 46 hours using
a portable pump. Treatment repeats for every 2 weeks for 6 courses. Patients then
undergo hepatic resection. Beginning 31-56 days after surgery, patients receive an
additional 6 courses of mFOLFOX6 or FOLFIRI chemotherapy.
Blood and tumor tissue samples may be collected periodically for correlative studies.
After completion of study treatment, patients are followed up every 3 months for 2 years and
then every 6 months for 3 years.
Interventional
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Recurrence-free Survival (RFS)
Time to recurrence or death
From study entry until the date of recurrence or death or for a maximum of 5 years.
No
Norman Wolmark, MD
Principal Investigator
NSABP Foundation, Inc.
United States: Federal Government
NSABP C-11
NCT01189227
August 2010
December 2011
Name | Location |
---|---|
Roswell Park Cancer Institute | Buffalo, New York 14263 |
Fred Hutchinson Cancer Research Center | Seattle, Washington 98109 |
CCOP - Wichita | Wichita, Kansas 67214-3882 |
Hurley Medical Center | Flint, Michigan 48503 |
CCOP - Missouri Valley Cancer Consortium | Omaha, Nebraska 68131 |
CCOP - Christiana Care Health Services | Wilmington, Delaware 19899 |
Veterans Affairs Medical Center - Atlanta (Decatur) | Decatur, Georgia 30033 |
CCOP - Illinois Oncology Research Association | Peoria, Illinois 61602 |
CCOP - Iowa Oncology Research Association | Des Moines, Iowa 50309-1016 |
CCOP - Metro-Minnesota | Saint Louis Park, Minnesota 55416 |
Hinsdale Hematology Oncology Associates | Hinsdale, Illinois 60521 |
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 |
Fairview Ridges Hospital | Burnsville, Minnesota 55337 |
Mercy and Unity Cancer Center at Mercy Hospital | Coon Rapids, Minnesota 55433 |
CCOP - Duluth | Duluth, Minnesota 55805 |
Fairview Southdale Hospital | Edina, Minnesota 55435 |
Mercy and Unity Cancer Center at Unity Hospital | Fridley, Minnesota 55432 |
Hutchinson Area Health Care | Hutchinson, Minnesota 55350 |
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 |
CCOP - MeritCare Hospital | Fargo, North Dakota 58122 |
Case Comprehensive Cancer Center | Cleveland, Ohio 44106-5065 |
Natalie Warren Bryant Cancer Center at St. Francis Hospital | Tulsa, Oklahoma 74136 |
Sanford Cancer Center at Sanford USD Medical Center | Sioux Falls, South Dakota 57117-5039 |
Medical X-Ray Center, PC | Sioux Falls, South Dakota 57105 |
Marshfield Clinic - Marshfield Center | Marshfield, Wisconsin 54449 |
Medical College of Wisconsin Cancer Center | Milwaukee, Wisconsin 53226 |
Marshfield Clinic - Indianhead Center | Rice Lake, Wisconsin 54868 |
CCOP - Ochsner | New Orleans, Louisiana 70121 |
Methodist Medical Center of Illinois | Peoria, Illinois 61636 |
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 |
CCOP - Greenville | Greenville, South Carolina 29615 |
Joe Arrington Cancer Research and Treatment Center | Lubbock, Texas 79410-1894 |
LDS Hospital | Salt Lake City, Utah 84143 |
CCOP - Northern Indiana CR Consortium | South Bend, Indiana 46601 |
Holden Comprehensive Cancer Center at University of Iowa | Iowa City, Iowa 52242-1002 |
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia | Philadelphia, Pennsylvania 19107 |
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | Baltimore, Maryland 21231-2410 |
Kaiser Permanente Medical Center - Vallejo | Vallejo, California 94589 |
Utah Valley Regional Medical Center - Provo | Provo, Utah 84604 |
Peninsula Regional Medical Center | Salisbury, Maryland 21801 |
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 |
St. Vincent Mercy Medical Center | Toledo, Ohio 43608 |
Swedish Cancer Institute at Swedish Medical Center - First Hill Campus | Seattle, Washington 98104 |
Thompson Cancer Survival Center | Knoxville, Tennessee 37916 |
Washington Cancer Institute at Washington Hospital Center | Washington, District of Columbia 20010 |
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 |
Central Baptist Hospital | Lexington, Kentucky 40503 |
CCOP - Toledo Community Hospital | Toledo, Ohio 43623-3456 |
Kaiser Permanente Medical Center - Oakland | Sacramento, California 95825 |
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 |
Breslin Cancer Center at Ingham Regional Medical Center | Lansing, Michigan 48910 |
NYU Cancer Institute at New York University Medical Center | New York, New York 10016 |
Presbyterian Cancer Center at Presbyterian Hospital | Charlotte, North Carolina 28233-3549 |
Wake Forest University Comprehensive Cancer Center | Winston-Salem, North Carolina 27157-1096 |
Medical University of Ohio Cancer Center | Toledo, Ohio 43614 |
Toledo Hospital | Toledo, Ohio 43606 |
Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas | Dallas, Texas 75390 |
McCreery Cancer Center at Ottumwa Regional | Ottumwa, Iowa 52501 |
Baptist Cancer Institute - Jacksonville | Jacksonville, Florida 32207 |
Hematology-Oncology Centers of the Northern Rockies - Billings | Billings, Montana 59101 |
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 |
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 |
Logan Regional Hospital | Logan, Utah 84321 |
Group Health Central Hospital | Seattle, Washington 98104 |
Kaiser Permanente Medical Center - Santa Clara Kiely Campus | Santa Clara, California 95051-5386 |
Lucille P. Markey Cancer Center at University of Kentucky | Lexington, Kentucky 40536-0093 |
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis | St. Louis, Missouri 63110 |
University of New Mexico Cancer Center | Albuquerque, New Mexico 87131-5636 |
Oklahoma University Cancer Institute | Oklahoma City, Oklahoma 73104 |
Kaiser Permanente Medical Center - Sacramento | Sacramento, California 95825 |
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 |
Howard Community Hospital | Kokomo, Indiana 46904 |
Mount Carmel Health - West Hospital | Columbus, Ohio 43222 |
Parkland Memorial Hospital | Dallas, Texas 75235 |
Lakeland Regional Cancer Center at Lakeland Regional Medical Center | Lakeland, Florida 33805 |
UPMC Cancer Centers | Pittsburgh, Pennsylvania 15232 |
Kaiser Permanente - Fremont | Fremont, California 94538 |
Kaiser Permanente Medical Center - Hayward | Hayward, California 94545 |
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 |
South Sacramento Kaiser-Permanente Medical Center | Sacramento, California 95823 |
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 |
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 |
Mason District Hospital | Havana, Illinois 62644 |
McDonough District Hospital | Macomb, Illinois 61455 |
BroMenn Regional Medical Center | Normal, Illinois 61761 |
Community Cancer Center | Normal, Illinois 61761 |
Community Hospital of 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 |
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 |
Hickman Cancer Center at Bixby Medical Center | Adrian, Michigan 49221 |
Providence Cancer Institute at Providence Hospital - Southfield Campus | Southfield, Michigan 48075 |
St. Joseph's Medical Center | Brainerd, Minnesota 56401 |
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 |
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 |
Lima Memorial Hospital | Lima, Ohio 45804 |
Middletown Regional Hospital | Middletown, Ohio 45044 |
St. Charles Mercy Hospital | Oregon, Ohio 43616 |
North Coast Cancer Care, Incorporated | Sandusky, Ohio 44870 |
Mercy Hospital of Tiffin | Tiffin, Ohio 44883 |
Toledo Clinic, Incorporated - Main Clinic | Toledo, Ohio 43623 |
UVMC Cancer Care Center at Upper Valley Medical Center | Troy, Ohio 45373-1300 |
Fulton County Health Center | Wauseon, Ohio 43567 |
Ruth G. McMillan Cancer Center at Greene Memorial Hospital | Xenia, Ohio 45385 |
Bon Secours St. Francis Health System | Greenville, South Carolina 29601 |
Dixie Regional Medical Center - East Campus | Saint George, Utah 84770 |
Danville Regional Medical Center | Danville, Virginia 24541 |
Welch Cancer Center at Sheridan Memorial Hospital | Sheridan, Wyoming 82801 |
Missouri Baptist Cancer Center | St. Louis, Missouri 63131 |
Cancer Resource Center - Lincoln | Lincoln, Nebraska 68510 |
Allegheny Cancer Center at Allegheny General Hospital | Pittsburgh, Pennsylvania 15212 |
Kaiser Permanente - Deer Valley | Antioch, California 94531 |
Tunnell Cancer Center at Beebe Medical Center | Lewes, Delaware 19958 |
Kaiser Permanente - Moanalua Medical Center and Clinic | Honolulu, Hawaii 96819 |
Elkhart Clinic, LLC | Elkhart, Indiana 46514-2098 |
Michiana Hematology-Oncology, PC - South Bend | Mishawaka, Indiana 46545-1470 |
Reid Hospital & Health Care Services | Richmond, Indiana 47374 |
McFarland Clinic, PC | Ames, Iowa 50010 |
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 |
Ochsner Health Center - Bluebonnet | Baton Rouge, Louisiana 70809 |
Foote Memorial Hospital | Jackson, Michigan 49201 |
St. Mary Mercy Hospital | Livonia, Michigan 48154 |
Mercy Memorial Hospital - Monroe | Monroe, Michigan 48162 |
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 |
Fergus Falls Medical Group, PA | Fergus Falls, Minnesota 56537 |
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 |
Billings Clinic - Downtown | Billings, Montana 59107-7000 |
Bozeman Deaconess Cancer Center | Bozeman, Montana 59715 |
St. James Healthcare Cancer Care | Butte, Montana 59701 |
Great Falls Clinic - Main Facility | Great Falls, Montana 59405 |
Sletten Cancer Institute at Benefis Healthcare | Great Falls, Montana 59405 |
Kalispell Medical Oncology at KRMC | Kalispell, Montana 59901 |
Alegant Health Cancer Center at Bergan Mercy Medical Center | Omaha, Nebraska 68124 |
Leo W. Jenkins Cancer Center at ECU Medical School | Greenville, North Carolina 27834 |
Mary Rutan Hospital | Bellefontaine, Ohio 43311 |
Grant Medical Center Cancer Care | Columbus, Ohio 43215 |
Hematology Oncology Center | Elyria, Ohio 44035 |
Community Cancer Center | Elyria, Ohio 44035 |
Wayne Hospital | Greenville, Ohio 45331 |
Knox Community Hospital | Mount Vernon, Ohio 43050 |
Fisher-Titus Medical Center | Norwalk, Ohio 44857 |
Flower Hospital Cancer Center | Sylvania, Ohio 43560 |
St. Anne Mercy Hospital | Toledo, Ohio 43623 |
Mount Carmel St. Ann's Cancer Center | Westerville, Ohio 43081 |
McGlinn Family Regional Cancer Center at Reading Hospital and Medical Center | Reading, Pennsylvania 19612-6052 |
Sandra L. Maxwell Cancer Center | Cedar City, Utah 84720 |
Val and Ann Browning Cancer Center at McKay-Dee Hospital Center | Ogden, Utah 84403 |
Fredericksburg Oncology, Incorporated | Fredericksburg, Virginia 22401 |
Community Comprehensive Cancer Center at Camden-Clark Memorial Hospital | Parkersburg, West Virginia 26102 |
Marshfield Clinic - Chippewa Center | Chippewa Falls, Wisconsin 54729 |
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 |
Marshfield Clinic - Wisconsin Rapids Center | Wisconsin Rapids, Wisconsin 54494 |
Regional Cancer Center at Memorial Medical Center | Springfield, Illinois 62781-0001 |
Saint Louis University Cancer Center | Saint Louis, Missouri 63110 |
St. Joseph Hospital Regional Cancer Center - Orange | Orange, California 92868-3849 |
Union Hospital of Cecil County | Elkton MD, Maryland 21921 |
Kinston Medical Specialists | Kinston, North Carolina 28501 |
Manchester Memorial Hospital | Manchester, Connecticut 06040-4188 |
Nalitt Cancer Institute at Staten Island University Hospital | Staten Island, New York 10305 |
Galesburg Clinic, PC | Galesburg, Illinois 61401 |
St. Vincent Healthcare Cancer Care Services | Billings, Montana 59101 |
Berkshire Hematology Oncology, PC | Pittsfield, Massachusetts 01201 |
Parvin Radiation Oncology | Kansas City, Missouri 64116 |
Riddle Memorial Hospital Cancer Center | Media, Pennsylvania 19063 |
Associates in Hematology-Oncology, PC at Crozer Regional Cancer Center | Upland, Pennsylvania 19013 |
University of Colorado Cancer Center at UC Health Sciences Center | Aurora, Colorado 80045 |
Ochsner Health Center - Covington | Covington, Louisiana 70433 |
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 |
CCOP - Kansas City | Prairie Village, Kansas 66208 |
Goldschmidt Cancer Center | Jefferson City, Missouri 65109 |
Comprehensive Cancer Care, PC | Saint Louis, Missouri 63141 |
Butler Memorial Hospital | Butler, Pennsylvania 16001 |
Overlake Cancer Center at Overlake Hospital Medical Center | Bellevue, Washington 98004 |
Kaiser Permanente Medical Center - Vacaville | Vacaville, California 95688 |
Mercy Cancer Center - West Lakes | Clive, Iowa 50325 |