A Randomized Phase II Pilot Study Prospectively Evaluating Treatment for Patients Based on ERCC1(Excision Repair Cross-Complementing 1) for Advanced/Metastatic Esophageal, Gastric or Gastroesophageal Junction (GEJ) Cancer
Phase 2
18 Years
N/A
18 Years
N/A
Open (Enrolling)
Both
Adenocarcinoma of the Gastroesophageal Junction, Esophageal Cancer, Gastric Cancer
Both
Adenocarcinoma of the Gastroesophageal Junction, Esophageal Cancer, Gastric Cancer
Trial Information
A Randomized Phase II Pilot Study Prospectively Evaluating Treatment for Patients Based on ERCC1(Excision Repair Cross-Complementing 1) for Advanced/Metastatic Esophageal, Gastric or Gastroesophageal Junction (GEJ) Cancer
OBJECTIVES:
- To assess progression-free survival of high-excision repair cross-complementing
1(ERCC1) patients with advanced or metastatic cancer of the esophagus, stomach, or
gastroesophageal junction (GEJ) treated with FOLFOX comprising oxaliplatin, leucovorin
calcium, and fluorouracil compared to those treated with irinotecan hydrochloride plus
docetaxel.
- To assess progression-free survival of low-ERCC1 patients with advanced or metastatic
cancer of the esophagus, stomach, or GEJ treated with FOLFOX compared to those treated
with irinotecan hydrochloride plus docetaxel.
- To assess progression-free survival of low-ERCC1 patients with advanced or metastatic
cancer of the esophagus, stomach, or GEJ treated with FOLFOX compared to high-ERCC1
patients treated with FOLFOX.
- To assess overall survival of and toxicities in each of the two treatment arms in this
group of patients.
- To assess the response probability (confirmed and unconfirmed, complete and partial
responses) in the subset of patients with measurable disease in each of the two
treatment arms.
- To explore whether there is evidence of interaction between treatment arm and ERCC1
expression in this group of patients. (Exploratory)
- To bank tissue and blood for future translational medicine studies; a) To explore the
relationship of ERCC-1 and ERCC-2 single nucleotide polymorphism (SNP) genotypes with
clinical outcome in these patients; and b) To explore the association between germline
variations in these SNPs and ERCC-1 mRNA expression in these patients. (Exploratory)
OUTLINE: This is a multicenter study. Patients are stratified according to ERCC1 expression
(high [≥ 1.7] vs low [< 1.7]), and disease site (esophageal vs gastric/gastroesophageal
junction). Patients are randomized to 1 of 2 treatment arms.
- Arm I (FOLFOX): Patients receive oxaliplatin IV over 2 hours and leucovorin calcium IV
over 2 hours on day 1, and fluorouracil IV over 46-48 hours on days 1-2. Courses repeat
every 14 days in the absence of disease progression or unacceptable toxicity.
- Arm II: Patients receive irinotecan hydrochloride IV over 90 minutes and docetaxel IV
over 30-60 minutes on days 1 and 8. Courses repeat every 21 days in the absence of
disease progression or unacceptable toxicity.
Blood and tumor tissue samples may be collected for ERCC1 expression analysis and future
research studies.
After completion of study treatment, patients are followed up every 3 months for up to 3
years.
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Patients must have unresectable advanced or metastatic histologically or
cytologically confirmed adenocarcinoma of the esophagus, stomach, or gastroesophageal
junction (GEJ)
- Patients must not have received treatment for metastatic or unresectable disease
- Patients must not have brain metastases
- Patients must have measurable and/or non-measurable disease
- Patients who have had HER-2 expression testing prior to patient consent to this study
must be HER-2 negative; if HER-2 expression has not been tested prior to patient
consent to this study, a second specimen must be submitted for HER-2 expression; if
the specimen is HER-2 positive (or if HER-2 could not be evaluated), the patient will
not be randomized
- Patients must have completed any prior neoadjuvant and adjuvant therapy for
resectable disease at least 180 days prior to registration
PATIENT CHARACTERISTICS:
- Zubrod performance status of 0-1
- Hemoglobin ≥ 9 g/dL
- Absolute neutrophil count (ANC) ≥ 1,500/mcL
- Platelets ≥ 100,000/mcL
- Total bilirubin ≤ 1.5 mg/dL regardless of whether patients have liver involvement
secondary to tumor
- AST and ALT both ≤ 3 times institutional upper limit of normal (IULN) unless the
liver is involved with tumor, in which case both AST and ALT must be ≤ 5 times IULN
- Serum creatinine < 1.5 mg/dL within 28 days prior to registration AND/OR calculated
creatinine clearance > 60 mL/min
- Patients must not have motor or sensory neuropathy > Grade 1 using CTCAE version 4.0
- Patients must not be pregnant or nursing; women and men of reproductive potential
must have agreed to use an effective contraceptive method
- No other prior malignancy is allowed except for the following: adequately treated
basal cell or squamous cell skin cancer, in situ cervical cancer, adequately treated
stage I or II cancer from which the patient is currently in complete remission, or
any other cancer from which the patient has been disease-free for five years
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- All palliative radiation therapy alone must be completed at least 14 days prior to
registration
- Patient must have no plans to receive concurrent chemotherapy, hormonal therapy,
radiotherapy, immunotherapy, or any other type of therapy for treatment of cancer
while on this protocol treatment
Type of Study:
Interventional
Study Design:
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Outcome Measure:
Progression-free survival (PFS) between high-ERCC1 and low-ERCC1 patients treated with FOLFOX versus irinotecan hydrochloride plus docetaxel
Outcome Time Frame:
Up to 3 years
Safety Issue:
No
Principal Investigator
Syma Iqbal, MD
Investigator Role:
Principal Investigator
Investigator Affiliation:
USC/Norris Comprehensive Cancer Center
Authority:
United States: Federal Government
Study ID:
CDR0000720255
NCT ID:
NCT01498289
Start Date:
February 2012
Completion Date:
March 2019
Related Keywords:
- Adenocarcinoma of the Gastroesophageal Junction
- Esophageal Cancer
- Gastric Cancer
- recurrent esophageal cancer
- stage IV esophageal cancer
- recurrent gastric cancer
- stage IV gastric cancer
- adenocarcinoma of the gastroesophageal junction
- stage IIIB gastric cancer
- stage IIIC gastric cancer
- stage IIIB esophageal cancer
- stage IIIC esophageal cancer
- adenocarcinoma of the esophagus
- adenocarcinoma of the stomach
- Adenocarcinoma
- Adenocarcinoma, Mucinous
- Esophageal Diseases
- Esophageal Neoplasms
- Stomach Neoplasms
Name | Location |
|---|---|
| Fred Hutchinson Cancer Research Center | Seattle, Washington 98109 |
| CCOP - Upstate Carolina | Spartanburg, South Carolina 29303 |
| CCOP - Wichita | Wichita, Kansas 67214-3882 |
| Hurley Medical Center | Flint, Michigan 48503 |
| CCOP - Christiana Care Health Services | Wilmington, Delaware 19899 |
| CCOP - Mount Sinai Medical Center | Miami Beach, Florida 33140 |
| CCOP - Illinois Oncology Research Association | Peoria, Illinois 61602 |
| 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 |
| Sparrow Regional Cancer Center | Lansing, Michigan 48912-1811 |
| St. John Macomb Hospital | Warren, Michigan 48093 |
| MeritCare Broadway | Fargo, North Dakota 58122 |
| CCOP - MeritCare Hospital | Fargo, North Dakota 58122 |
| St. Rita's Medical Center | Lima, Ohio 45801 |
| 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 |
| Rapid City Regional Hospital | Rapid City, South Dakota 57709 |
| Methodist Medical Center of Illinois | Peoria, Illinois 61636 |
| CCOP - Cancer Research for the Ozarks | Springfield, Missouri 65807 |
| CCOP - Dayton | Kettering, Ohio 45429 |
| CCOP - Greenville | Greenville, South Carolina 29615 |
| MultiCare Regional Cancer Center at Tacoma General Hospital | Tacoma, Washington 98405 |
| Cancer Research Center of Hawaii | Honolulu, Hawaii 96813 |
| USC/Norris Comprehensive Cancer Center and Hospital | Los Angeles, California 90033-0804 |
| CCOP - St. Louis-Cape Girardeau | Saint Louis, Missouri 63141 |
| CCOP - Northwest | Tacoma, Washington 98405-0986 |
| Monmouth Medical Center | Long Branch, New Jersey 07740-6395 |
| University of California Davis Cancer Center | Sacramento, California 95817 |
| St. Vincent Mercy Medical Center | Toledo, Ohio 43608 |
| Arkansas Cancer Research Center at University of Arkansas for Medical Sciences | Little Rock, Arkansas 72205 |
| Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center | Kansas City, Kansas 66160-7353 |
| Josephine Ford Cancer Center at Henry Ford Hospital | Detroit, Michigan 48202 |
| Swedish Cancer Institute at Swedish Medical Center - First Hill Campus | Seattle, Washington 98104 |
| Hulston Cancer Center at Cox Medical Center South | Springfield, Missouri 65807 |
| St. John's Regional Health Center | Springfield, Missouri 65804 |
| UMDNJ University Hospital | Newark, New Jersey 07103 |
| McDowell Cancer Center at Akron General Medical Center | Akron, Ohio 44307 |
| CCOP - Toledo Community Hospital | Toledo, Ohio 43623-3456 |
| Florida Hospital Cancer Institute at Florida Hospital Orlando | Orlando, Florida 32803-1273 |
| Via Christi Cancer Center at Via Christi Regional Medical Center | Wichita, Kansas 67214 |
| Medical University of Ohio Cancer Center | Toledo, Ohio 43614 |
| Toledo Hospital | Toledo, Ohio 43606 |
| St. Vincent Hospital Regional Cancer Center | Green Bay, Wisconsin 54307-3508 |
| James P. Wilmot Cancer Center at University of Rochester Medical Center | Rochester, New York 14642 |
| Green Bay Oncology, Limited - Escanaba | Escanaba, Michigan 49431 |
| Dickinson County Healthcare System | Iron Mountain, Michigan 49801 |
| 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 |
| Good Samaritan Regional Health Center | Mt. Vernon, Illinois 62864 |
| David C. Pratt Cancer Center at St. John's Mercy | St. Louis, Missouri 63141 |
| Big Sky Oncology | Great Falls, Montana 59405 |
| Wayne Memorial Hospital, Incorporated | Goldsboro, North Carolina 27534 |
| Olympic Hematology and Oncology | Bremerton, Washington 98310 |
| Skagit Valley Hospital Cancer Care Center | Mt. Vernon, Washington 98273 |
| University Cancer Center at University of Washington Medical Center | Seattle, Washington 98195 |
| Harborview Medical Center | Seattle, Washington 98104 |
| Group Health Central Hospital | Seattle, Washington 98104 |
| North Puget Oncology at United General Hospital | Sedro-Wooley, Washington 98284 |
| Cancer Care Northwest - Spokane South | Spokane, Washington 99202 |
| University of South Alabama Mitchell Cancer Institute | Mobile, Alabama 36604 |
| University of Illinois Cancer Center | Chicago, Illinois 60612-7243 |
| Swedish-American Regional Cancer Center | Rockford, Illinois 61104-2315 |
| CancerCare of Maine at Eastern Maine Medical Center | Bangor, Maine 04401 |
| University of Mississippi Cancer Clinic | Jackson, Mississippi 39216-4505 |
| Virginia Commonwealth University Massey Cancer Center | Richmond, Virginia 23298-0037 |
| Chao Family Comprehensive Cancer Center at University of California Irvine Medical Center | Orange, California 92868 |
| 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 |
| Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest | Allentown, Pennsylvania 18105 |
| UPMC Cancer Centers | Pittsburgh, Pennsylvania 15232 |
| Ella Milbank Foshay Cancer Center at Jupiter Medical Center | Jupiter, Florida 33458 |
| 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 |
| McDonough District Hospital | Macomb, Illinois 61455 |
| Hematology Oncology Consultants - Naperville | Naperville, Illinois 60540 |
| BroMenn Regional Medical Center | Normal, Illinois 61761 |
| Community Cancer Center | Normal, Illinois 61761 |
| Community Hospital of Ottawa | Ottawa, Illinois 61350 |
| Oncology Hematology Associates of Central Illinois, PC - Ottawa | Ottawa, Illinois 61350 |
| Cancer Treatment Center at Pekin Hospital | Pekin, Illinois 61554 |
| Oncology Hematology Associates of Central Illinois, PC - Peoria | Peoria, Illinois 61615 |
| 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 |
| Fort Wayne Medical Oncology and Hematology | Fort Wayne, Indiana 46815 |
| Cancer Center of Kansas, PA - Dodge City | Dodge City, Kansas 67801 |
| St. Francis Comprehensive Cancer Center | Topeka, Kansas 66606 |
| Feist-Weiller Cancer Center at Louisiana State University Health Sciences | Shreveport, Louisiana 71130-3932 |
| Hickman Cancer Center at Bixby Medical Center | Adrian, Michigan 49221 |
| Community Cancer Center of Monroe | Monroe, Michigan 48162 |
| Saint Francis Medical Center | Cape Girardeau, Missouri 63701 |
| 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 |
| Wood County Oncology Center | Bowling Green, Ohio 43402 |
| 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 |
| Lima Memorial Hospital | Lima, Ohio 45804 |
| Northwest Ohio Oncology Center | Maumee, Ohio 43537 |
| Middletown Regional Hospital | Middletown, Ohio 45044 |
| Toledo Clinic - Oregon | Oregon, Ohio 43616 |
| St. Charles Mercy Hospital | Oregon, Ohio 43616 |
| 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 |
| Minor and James Medical, PLLC | Seattle, Washington 98104 |
| Polyclinic First Hill | Seattle, Washington 98122 |
| Holy Family Memorial Medical Center Cancer Care Center | Manitowoc, Wisconsin 54221-1450 |
| 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 |
| Regional Cancer Center at Singing River Hospital | Pascagoula, Mississippi 39581 |
| Missouri Baptist Cancer Center | St. Louis, Missouri 63131 |
| 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 |
| 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 |
| 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 |
| Tammy Walker Cancer Center at Salina Regional Health Center | Salina, Kansas 67401 |
| 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 |
| 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 |
| Truman Medical Center - Hospital Hill | Kansas City, Missouri 64108 |
| 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 |
| Heartland Regional Medical Center | Saint Joseph, Missouri 64506 |
| Saint Joseph Oncology, Incorporated | Saint Joseph, Missouri 64507 |
| Sletten Cancer Institute at Benefis Healthcare | Great Falls, Montana 59405 |
| Summa Center for Cancer Care at Akron City Hospital | Akron, Ohio 44309-2090 |
| Barberton Citizens Hospital | Barberton, Ohio 44203 |
| Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at Ohio State University Comprehensive Cancer Center | Columbus, Ohio 43210-1240 |
| Hematology Oncology Center | Elyria, Ohio 44035 |
| Community Cancer Center | Elyria, Ohio 44035 |
| Wayne Hospital | Greenville, Ohio 45331 |
| Flower Hospital Cancer Center | Sylvania, Ohio 43560 |
| St. Anne Mercy Hospital | Toledo, Ohio 43623 |
| York Cancer Center at Apple Hill Medical Center | York, Pennsylvania 17405 |
| Fredericksburg Oncology, Incorporated | Fredericksburg, Virginia 22401 |
| St. Joseph Cancer Center | Bellingham, Washington 98225 |
| Providence Centralia Hospital | Centralia, Washington 98531-9027 |
| Columbia Basin Hematology | Kennewick, Washington 99336 |
| Harrison Poulsbo Hematology and Onocology | Poulsbo, Washington 98370 |
| Evergreen Hematology and Oncology, PS | Spokane, Washington 99218 |
| Franciscan Cancer Center at St. Joseph Medical Center | Tacoma, Washington 98405-3004 |
| Wenatchee Valley Medical Center | Wenatchee, Washington 98801-2028 |
| FirstHealth Moore Regional Community Hospital Comprehensive Cancer Center | Pinehurst, North Carolina 28374 |
| Regional Cancer Center at Memorial Medical Center | Springfield, Illinois 62781-0001 |
| Genesys Regional Medical Center | Grand Blanc, Michigan 48439-8066 |
| Queen's Cancer Institute at Queen's Medical Center | Honolulu, Hawaii 96813 |
| Good Samaritan Cancer Center at Good Samaritan Hospital | Kearney, Nebraska 68848-1990 |
| 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 |
| Harold Alfond Center for Cancer Care | Augusta, Maine 04330 |
| 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 |
| Frederick Memorial Hospital Regional Cancer Therapy Center | Frederick, Maryland 21701 |
| Phelps County Regional Medical Center | Rolla, Missouri 65401 |
| La Grange Memorial Hospital | La Grange, Illinois 60525 |
| Rockwood Clinic Cancer Treatment Center | Spokane, Washington 99204-2967 |
| Galesburg Clinic, PC | Galesburg, Illinois 61401 |
| Parvin Radiation Oncology | Kansas City, Missouri 64116 |
| Midwest Hematology Oncology Group, Incorporated | Saint Louis, Missouri 63109 |
| Tibotec Therapeutics - Division of Ortho Biotech Products, LP | Marysville, California 95901 |
| Valley Medical Oncology Consultants - Pleasanton | Pleasanton, California 94588 |
| Tahoe Forest Cancer Center | Truckee, California 96161 |
| Kapiolani Medical Center at Pali Momi | Aiea, Hawaii 96701 |
| Kapiolani Medical Center for Women and Children | Honolulu, Hawaii 96826 |
| Straub Clinic and Hospital, Incorporated | Honolulu, Hawaii 96813 |
| OnCare Hawaii, Incorporated - Kuakini | Honolulu, Hawaii 96817 |
| OnCare Hawaii, Incorporated - Lusitana | Honolulu, Hawaii 96813 |
| 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 - 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 |
| AnMed Cancer Center | Anderson, South Carolina 29621 |
| Mount Carmel Regional Cancer Center | Pittsburg, Kansas 66762 |
| Falck Cancer Center at Arnot Ogden Medical Center | Elmira, New York 14905 |
| CCOP - Kansas City | Prairie Village, Kansas 66208 |
| Kansas City Cancer Centers - Southwest | Overland Park, Kansas 66210 |
| Castle Medical Center | Kailua, Hawaii 96734 |
| Kauai Medical Clinic | Lihue, Hawaii 96766 |
| Hays Medical Center | Hays, Kansas 67601 |
| Hutchinson Hospital Corporation | Hutchinson, Kansas 67502 |
| Southeast Cancer Center | Cape Girardeau, Missouri 63703 |
| Goldschmidt Cancer Center | Jefferson City, Missouri 65109 |
| Island Hospital Cancer Care Center at Island Hospital | Anacortes, Washington 98221 |
| Highline Medical Center Cancer Center | Burien, Washington 98166 |
| Roger Maris Cancer Center at MeritCare Hospital | Fargo, North Dakota 58122 |
| St. Nicholas Hospital | Sheboygan, Wisconsin 53081 |
| Overlake Cancer Center at Overlake Hospital Medical Center | Bellevue, Washington 98004 |
| Kansas City Cancer Centers - North | Kansas City, Missouri 64154 |
| Kansas City Cancer Centers - South | Kansas City, Missouri 64131 |
| Kuakini Medical Center | Honolulu, Hawaii 96817 |
| Kansas City Cancer Centers - West | Kansas City, Kansas 66112 |
| Kansas City Cancer Center - Shawnee Mission | Shawnee Mission, Kansas 66204 |
| Central Care Cancer Center at Carrie J. Babb Cancer Center | Bolivar, Missouri 65613 |
| Kansas City Cancer Centers - East | Lee's Summit, Missouri 64064 |
| Adams Cancer Center | Gettysburg, Pennsylvania 17325 |
| Cherry Tree Cancer Center | Hanover, Pennsylvania 17331 |
| Providence Regional Cancer Partnership | Everett, Washington 98201 |
| Cancer Center of Kansas, PA - McPherson | McPherson, Kansas 67460 |
| St. Joseph Regional Medical Center | Lewiston, Idaho 83501 |
| Mercy Clinic Cancer and Hematology - Rolla | Rolla, Missouri 65401 |
| Swedish Medical Center - Issaquah Campus | Issaquah, Washington 98029 |
| Idaho Urologic Institute, PA | Meridian, Idaho 83642 |
| Oncare Hawaii, Incorporated - Pali Momi | Aiea, Hawaii 96701 |
| Costas L. Constantinou MD | Moline, Illinois 61265 |
| Costas L. Constantinou MD | Bettendorf, Iowa 52722 |
