S0012 Doxorubicin, Cyclophosphamide, and Paclitaxel With or Without Filgrastim in Treating Women With Inflammatory or Locally Advanced Breast Cancer
Overview[ - collapse ][ - ]
| Purpose | RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known whether combination chemotherapy is more effective with or without filgrastim in treating breast cancer. PURPOSE: Randomized phase III trial to compare the effectiveness of combining doxorubicin, cyclophosphamide, and paclitaxel with or without filgrastim in treating women who have inflammatory or locally advanced breast cancer. |
|---|---|
| Condition | Breast Cancer |
| Intervention | Biological: filgrastim Drug: cyclophosphamide Drug: doxorubicin Drug: paclitaxel Procedure: surgery |
| Phase | Phase 3 |
| Sponsor | Southwest Oncology Group |
| Responsible Party | Southwest Oncology Group |
| ClinicalTrials.gov Identifier | NCT00016406 |
| First Received | May 6, 2001 |
| Last Updated | January 23, 2013 |
| Last verified | January 2013 |
Tracking Information[ + expand ][ + ]
| First Received Date | May 6, 2001 |
|---|---|
| Last Updated Date | January 23, 2013 |
| Start Date | May 2001 |
| Estimated Primary Completion Date | February 2012 |
| Current Primary Outcome Measures |
|
| Current Secondary Outcome Measures | Not Provided |
Descriptive Information[ + expand ][ + ]
| Brief Title | S0012 Doxorubicin, Cyclophosphamide, and Paclitaxel With or Without Filgrastim in Treating Women With Inflammatory or Locally Advanced Breast Cancer |
|---|---|
| Official Title | A Comparative Randomized Study of Standard Doxorubicin and Cyclophosphamide Followed by Weekly Paclitaxel Vs. Weekly Doxorubicin and Daily Oral Cyclophosphamide Plus G-CSF Followed by Weekly Paclitaxel As Neoadjuvant Therapy For Inflammatory and Locally Advanced Breast Cancer |
| Brief Summary | RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known whether combination chemotherapy is more effective with or without filgrastim in treating breast cancer. PURPOSE: Randomized phase III trial to compare the effectiveness of combining doxorubicin, cyclophosphamide, and paclitaxel with or without filgrastim in treating women who have inflammatory or locally advanced breast cancer. |
| Detailed Description | OBJECTIVES: - Compare the microscopic pathologic response rates in women with inflammatory or locally advanced breast cancer treated with standard neoadjuvant doxorubicin and cyclophosphamide followed by weekly paclitaxel vs weekly doxorubicin and daily oral cyclophosphamide with filgrastim (G-CSF) followed by weekly paclitaxel. - Compare the toxic effects of these regimens in this patient population. - Compare the delivered dose intensity of these regimens in this patient population. - Evaluate the association between microscopic pathologic complete response and clinical complete response at the primary tumor site in these patients. OUTLINE: This is a randomized, multicenter study. Patients are stratified according to disease status (inflammatory vs other). Patients are randomized to one of two treatment arms. - Arm I: Patients receive doxorubicin IV followed by cyclophosphamide IV on day 1. Treatment repeats every 21 days for a total of 5 courses in the absence of disease progression or unacceptable toxicity. Three weeks after completion of doxorubicin and cyclophosphamide, patients receive paclitaxel IV over 1 hour weekly on day 1 for a total of 12 weeks. - Arm II: Patients receive doxorubicin IV on day 1, oral cyclophosphamide on days 1-7, and filgrastim (G-CSF) subcutaneously on days 2-7. Treatment repeats weekly for a total of 15 courses of doxorubicin and cyclophosphamide and 16 courses of G-CSF in the absence of disease progression or unacceptable toxicity. One week after completion of G-CSF, patients receive paclitaxel as in arm I. Within 3-6 weeks after completion of chemotherapy, patients with stable or responsive disease undergo surgical resection of tumor and affected nodes. After surgery, patients may receive radiotherapy or additional chemotherapy and/or hormonal therapy at the discretion of the treating physician. Patients are followed every 6 months for 1 year and then annually for 4 years. PROJECTED ACCRUAL: A total of 350 patients (175 per treatment arm) will be accrued for this study within 3 years. |
| Study Type | Interventional |
| Study Phase | Phase 3 |
| Study Design | Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment |
| Condition | Breast Cancer |
| Intervention | Biological: filgrastim Other Names: G-CSFDrug: cyclophosphamide Other Names: cytoxanDrug: doxorubicin Other Names: AdriamycinDrug: paclitaxel Procedure: surgery |
| Study Arm (s) |
|
Recruitment Information[ + expand ][ + ]
| Recruitment Status | Completed |
|---|---|
| Estimated Enrollment | 399 |
| Estimated Completion Date | February 2012 |
| Estimated Primary Completion Date | September 2006 |
| Eligibility Criteria | DISEASE CHARACTERISTICS: - Histologically confirmed inflammatory or locally advanced breast cancer - Stage IIB (T3, N0, M0), IIIA (T3, N1-2, M0 or T0-2, N2, M0), or IIIB (T4, any N, M0 or any T, N3, M0) - Unresectable or otherwise appropriate for neoadjuvant therapy - Confirmed by core needle or incisional biopsy - Punch biopsy allowed if invasive disease is documented - No distant metastases - Hormone receptor status: - Not specified PATIENT CHARACTERISTICS: Age: - Not specified Sex: - Female Menopausal status: - Not specified Performance status: - Zubrod 0-2 Life expectancy: - Not specified Hematopoietic: - Absolute neutrophil count at least 1,500/mm^3 - Platelet count at least 100,000/mm^3 Hepatic: - Bilirubin no greater than upper limit of normal (ULN) - SGOT or SGPT no greater than 2 times ULN Renal: - Creatinine no greater than ULN Cardiovascular: - No congestive heart failure or angina pectoris - LVEF greater than lower limit of normal Other: - No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix - HIV negative - Not pregnant or nursing - Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy: - Not specified Chemotherapy: - No prior chemotherapy for breast cancer Endocrine therapy: - No prior hormonal therapy for breast cancer Radiotherapy: - No prior radiotherapy for breast cancer Surgery: - No prior definitive surgery for breast cancer Other: - No other concurrent anticancer therapy |
| Gender | Female |
| Ages | 18 Years |
| Accepts Healthy Volunteers | No |
| Contacts | Not Provided |
| Location Countries | United States |
Administrative Information[ + expand ][ + ]
| NCT Number | NCT00016406 |
|---|---|
| Other Study ID Numbers | CDR0000068630 |
| Has Data Monitoring Committee | Yes |
| Information Provided By | Southwest Oncology Group |
| Study Sponsor | Southwest Oncology Group |
| Collaborators | National Cancer Institute (NCI) |
| Investigators | Study Chair: Georgiana K. Ellis, MD Seattle Cancer Care Alliance |
| Verification Date | January 2013 |
Locations[ + expand ][ + ]
| Mobile Infirmary Medical Center | Mobile, Alabama, United States, 36607 |
|---|---|
| Alaska Regional Hospital Cancer Center | Anchorage, Alaska, United States, 99508 |
| Fairbanks Cancer Treatment Center at Fairbanks Memorial Hospital | Fairbanks, Alaska, United States, 99701 |
| Mayo Clinic Scottsdale | Scottsdale, Arizona, United States, 85259 |
| Hembree Mercy Cancer Center at St. Edward Mercy Medical Center | Ft. Smith, Arkansas, United States, 72903 |
| Arkansas Cancer Research Center at University of Arkansas for Medical Sciences | Little Rock, Arkansas, United States, 72205 |
| Highlands Oncology Group - Springdale | Springdale, Arkansas, United States, 72764 |
| Glendale Memorial Hospital Comprehensive Cancer Center | Glendale, California, United States, 91204 |
| Saint Rose Hospital | Hayward, California, United States, 94545 |
| Valley Memorial Hospital | Livermore, California, United States, 94550 |
| USC/Norris Comprehensive Cancer Center and Hospital | Los Angeles, California, United States, 90033-0804 |
| CCOP - Bay Area Tumor Institute | Oakland, California, United States, 94609 |
| Highland General Hospital at St. George's University School of Medicine | Oakland, California, United States, 94602 |
| Summit Medical Center | Oakland, California, United States, 94609 |
| Comprehensive Cancer Center at Desert Regional Medical Center | Palm Springs, California, United States, 92262 |
| J.C. Robinson, M.D. Regional Cancer Center | San Pablo, California, United States, 94806 |
| Memorial Hospital Cancer Center | Colorado Springs, Colorado, United States, 80909 |
| Halifax Medical Center | Daytona Beach, Florida, United States, 32115 |
| Michael & Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital | Fort Lauderdale, Florida, United States, 33308 |
| Memorial Cancer Institute at Memorial Regional Hospital | Hollywood, Florida, United States, 33021 |
| Mayo Clinic - Jacksonville | Jacksonville, Florida, United States, 32224-9980 |
| Ella Milbank Foshay Cancer Center at Jupiter Medical Center | Jupiter, Florida, United States, 33458 |
| CCOP - Mount Sinai Medical Center | Miami Beach, Florida, United States, 33140 |
| Kapiolani Medical Center at Pali Momi | Aiea, Hawaii, United States, 96701 |
| Cancer Research Center of Hawaii | Honolula, Hawaii, United States, 96813 |
| Kapiolani Medical Center for Women and Children | Honolulu, Hawaii, United States, 96826 |
| OnCare Hawaii, Incorporated - Kuakini | Honolulu, Hawaii, United States, 96817 |
| OnCare Hawaii, Incorporated - Lusitana | Honolulu, Hawaii, United States, 96813 |
| Queen's Cancer Institute at Queen's Medical Center | Honolulu, Hawaii, United States, 96813 |
| St. Francis Medical Center | Honolulu, Hawaii, United States, 96817 |
| Straub Clinic and Hospital, Incorporated | Honolulu, Hawaii, United States, 96813 |
| Tripler Army Medical Center | Honolulu, Hawaii, United States, 96859 |
| St. Luke's Mountain States Tumor Institute - Boise | Boise, Idaho, United States, 83712 |
| Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical Center | Boise, Idaho, United States, 83706 |
| North Idaho Cancer Center | Coeur D'Alene, Idaho, United States, 83814 |
| Saint Anthony's Hospital at Saint Anthony's Health Center | Alton, Illinois, United States, 62002 |
| Rush-Copley Cancer Care Center | Aurora, Illinois, United States, 60507 |
| Medical and Surgical Specialists, L L C | Galesburg, Illinois, United States, 61401 |
| Joliet Oncology Hematology Associates, Limited - West | Joliet, Illinois, United States, 60435 |
| Cardinal Bernardin Cancer Center at Loyola University Medical Center | Maywood, Illinois, United States, 60153 |
| Trinity Medical Center - East | Moline, Illinois, United States, 61265 |
| Good Samaritan Regional Health Center | Mt. Vernon, Illinois, United States, 62864 |
| Hematology Oncology Consultants Ltd. | Naperville, Illinois, United States, 60540 |
| Edward Hospital Cancer Center | Naperville, Illinois, United States, 60566 |
| Saint James Hospital and Health Centers Comprehensive Cancer Institute - Olympia Fields | Olympia Fields, Illinois, United States, 60461 |
| Swedish American Hospital | Rockford, Illinois, United States, 61104 |
| Carle Cancer Center at Carle Foundation Hospital | Urbana, Illinois, United States, 61801 |
| CCOP - Carle Cancer Center | Urbana, Illinois, United States, 61801 |
| St. Francis Hospital and Health Centers | Beech Grove, Indiana, United States, 46107 |
| Fort Wayne Medical Oncology and Hematology | Fort Wayne, Indiana, United States, 46815 |
| Center for Cancer Care at Goshen Health System | Goshen, Indiana, United States, 46527 |
| Saint Anthony Memorial Health Centers | Michigan City, Indiana, United States, 46360 |
| Hematology Oncology Associates of the Quad Cities | Bettendorf, Iowa, United States, 52722 |
| Saint Anthony Regional Hospital | Carroll, Iowa, United States, 51401 |
| St. Luke's Hospital | Cedar Rapids, Iowa, United States, 52402 |
| Mercy Regional Cancer Center at Mercy Medical Center | Cedar Rapids, Iowa, United States, 52403 |
| Cedar Rapids Oncology Associates | Cedar Rapids, Iowa, United States, 52403 |
| Alegent Health Mercy Hospital | Council Bluffs, Iowa, United States, 51503 |
| Genesis Regional Cancer Center at Genesis Medical Center | Davenport, Iowa, United States, 52803 |
| Genesis Medical Center - West Campus | Davenport, Iowa, United States, 52804 |
| John Stoddard Cancer Center at Iowa Lutheran Hospital | Des Moines, Iowa, United States, 50316 |
| CCOP - Iowa Oncology Research Association | Des Moines, Iowa, United States, 50309 |
| John Stoddard Cancer Center at Iowa Methodist Medical Center | Des Moines, Iowa, United States, 50309 |
| Medical Oncology and Hematology Associates at John Stoddard Cancer Center | Des Moines, Iowa, United States, 50309 |
| Medical Oncology and Hematology Associates at Mercy Cancer Center | Des Moines, Iowa, United States, 50314 |
| Mercy Cancer Center at Mercy Medical Center - Des Moines | Des Moines, Iowa, United States, 50314 |
| Mercy Capitol Hospital | Des Moines, Iowa, United States, 50307 |
| Alegent Health Community Memorial Hospital | Missouri Valley, Iowa, United States, 51555 |
| Burgess Health Center | Onawa, Iowa, United States, 51040 |
| Mercy Medical Center - Sioux City | Sioux City, Iowa, United States, 51104 |
| Siouxland Hematology-Oncology Associates at June E. Nylen Cancer Center | Sioux City, Iowa, United States, 51101 |
| Siouxland Regional Cancer Center | Sioux City, Iowa, United States, 51101-1733 |
| St. Luke's Regional Medical Center | Sioux City, Iowa, United States, 51104 |
| Medical Oncology and Hematology Associates - West Des Moines | West Des Moines, Iowa, United States, 50266 |
| Cancer Center of Kansas, P.A. - Chanute | Chanute, Kansas, United States, 66720 |
| Cancer Center of Kansas, P.A. - Dodge City | Dodge City, Kansas, United States, 67801 |
| Cancer Center of Kansas, P.A. - El Dorado | El Dorado, Kansas, United States, 67042 |
| Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center | Kansas City, Kansas, United States, 66160 |
| Cancer Center of Kansas, P.A. - Kingman | Kingman, Kansas, United States, 67068 |
| Southwest Medical Center | Liberal, Kansas, United States, 67901 |
| Cancer Center of Kansas, P.A. - Newton | Newton, Kansas, United States, 67114 |
| Cancer Center of Kansas, P.A. - Parsons | Parsons, Kansas, United States, 67357 |
| Cancer Center of Kansas, P.A. - Pratt | Pratt, Kansas, United States, 67124 |
| Salina Regional Health Center | Salina, Kansas, United States, 67401 |
| Cancer Center of Kansas, P.A. - Salina | Salina, Kansas, United States, 67042 |
| St. Francis Comprehensive Cancer Center | Topeka, Kansas, United States, 66606 |
| Stormont-Vail Cancer Center | Topeka, Kansas, United States, 66604 |
| Cancer Center of Kansas, P.A. - Wellington | Wellington, Kansas, United States, 67152 |
| CCOP - Wichita | Wichita, Kansas, United States, 67214 |
| Cancer Center of Kansas, P.A. - Medical Arts Tower | Wichita, Kansas, United States, 67208 |
| Cancer Center of Kansas, P.A. - Wichita | Wichita, Kansas, United States, 67214 |
| Associates in Womens Health, P.A. - North Review | Wichita, Kansas, United States, 67203 |
| Via Christi Cancer Center at Via Christi Regional Medical Center | Wichita, Kansas, United States, 67214 |
| Cancer Center of Kansas, P.A. - Winfield | Winfield, Kansas, United States, 67156 |
| Markey Cancer Center at University of Kentucky Chandler Medical Center | Lexington, Kentucky, United States, 40536 |
| Baton Rouge General Regional Cancer Center | Baton Rouge, Louisiana, United States, 70806 |
| Mary Bird Perkins Cancer Center - Baton Rouge | Baton Rouge, Louisiana, United States, 70809 |
| Medical Center of Louisiana - New Orleans | New Orleans, Louisiana, United States, 70112 |
| MBCCOP - LSU Health Sciences Center | New Orleans, Louisiana, United States, 70112 |
| Cancer Treatment Center at Christus Schumpert St. Mary Place | Shreveport, Louisiana, United States, 71101 |
| CancerCare of Maine at Eastern Maine Medial Center | Bangor, Maine, United States, 04401 |
| Cancer Research Center at Boston Medical Center | Boston, Massachusetts, United States, 02118 |
| Tufts - New England Medical Center | Boston, Massachusetts, United States, 02111 |
| Commonwealth Hematology-Oncology P. C. - Quincy | Quincy, Massachusetts, United States, 02169 |
| Hickman Cancer Center at Bixby Medical Center | Adrian, Michigan, United States, 49221 |
| Battle Creek Health System Cancer Care Center | Battle Creek, Michigan, United States, 49017 |
| Mecosta County General Hospital | Big Rapids, Michigan, United States, 49307 |
| Barbara Ann Karmanos Cancer Institute | Detroit, Michigan, United States, 48202 |
| CCOP - Grand Rapids | Grand Rapids, Michigan, United States, 49503 |
| Lacks Cancer Center at Saint Mary's Mercy Medical Center | Grand Rapids, Michigan, United States, 49503 |
| Spectrum Health Hospital - Blodgett Campus | Grand Rapids, Michigan, United States, 49506 |
| Spectrum Health Cancer Care - Butterworth Campus | Grand Rapids, Michigan, United States, 49503 |
| Metropolitan Hospital | Grand Rapids, Michigan, United States, 49506 |
| Holland Community Hospital | Holland, Michigan, United States, 49423 |
| Bronson Methodist Hospital | Kalamazoo, Michigan, United States, 49007 |
| West Michigan Cancer Center | Kalamazoo, Michigan, United States, 49007 |
| Borgess Medical Center | Kalamazooaa, Michigan, United States, 49001 |
| Haematology-Oncology Associates of Ohio and Michigan, P.C. | Lambertville, Michigan, United States, 48144 |
| Community Cancer Center of Monroe | Monroe, Michigan, United States, 48162 |
| Mercy Memorial Hospital System | Monroe, Michigan, United States, 48162 |
| Ted B. Wahby Cancer Center at Mount Clemens General Hospital | Mount Clemens, Michigan, United States, 48043 |
| Hackley Hospital | Muskegon, Michigan, United States, 49443 |
| Northern Michigan Hospital | Petoskey, Michigan, United States, 49770 |
| William Beaumont Hospital - Royal Oak Campus | Royal Oak, Michigan, United States, 48073 |
| Providence Cancer Institute at Providence Hospital - Southfield Campus | Southfield, Michigan, United States, 48075 |
| Munson Medical Center | Traverse City, Michigan, United States, 49684 |
| Fairview Ridges Hospital | Burnsville, Minnesota, United States, 55337 |
| Mercy and Unity Cancer Center at Mercy Hospital | Coon Rapids, Minnesota, United States, 55433 |
| Miller-Dwan Medical Center | Duluth, Minnesota, United States, 55805 |
| Cancer Care Center at St. Luke's Hospital | Duluth, Minnesota, United States, 55805 |
| St. Mary's - Duluth Clinic Cancer Center | Duluth, Minnesota, United States, 55805 |
| CCOP - Duluth | Duluth, Minnesota, United States, 55805 |
| Fairview Southdale Hospital | Edina, Minnesota, United States, 55435 |
| Mercy and Unity Cancer Center at Unity Hospital | Fridley, Minnesota, United States, 55432 |
| Hutchinson Area Health Care | Hutchinson, Minnesota, United States, 55350 |
| Meeker County Memorial Hospital | Litchfield, Minnesota, United States, 55355 |
| St. John's Hospital | Maplewood, Minnesota, United States, 55109 |
| Hennepin County Medical Center - Minneapolis | Minneapolis, Minnesota, United States, 55415 |
| Virginia Piper Cancer Institute at Abbott-Northwestern Hospital | Minneapolis, Minnesota, United States, 55407 |
| Hubert H. Humphrey Cancer Center at North Memorial Medical Center | Robbinsdale, Minnesota, United States, 55422 |
| CCOP - Metro-Minnesota | Saint Louis Park, Minnesota, United States, 55416 |
| Regions Hospital Cancer Care Center | Saint Paul, Minnesota, United States, 55101 |
| Saint Francis Cancer Center | Shakopee, Minnesota, United States, 55379 |
| St. Joseph's Hospital | St Paul, Minnesota, United States, 55102 |
| Park Nicollet Health Services | St. Louis Park, Minnesota, United States, 55416 |
| United Hospital | St. Paul, Minnesota, United States, 55102 |
| Ridgeview Medical Center | Waconia, Minnesota, United States, 55387 |
| Woodwinds Hospital | Woodbury, Minnesota, United States, 55125 |
| University of Mississippi Medical Center | Jackson, Mississippi, United States, 39216 |
| St. Francis Medical Center | Cape Girardeau, Missouri, United States, 63701 |
| Southeast Missouri Regional Cancer Center at Southeast Missouri Hospital | Gape Girardeau, Missouri, United States, 63701 |
| CCOP - Kansas City | Kansas City, Missouri, United States, 64131 |
| Hulston Cancer Center at Cox Medical Center South | Springfield, Missouri, United States, 65807 |
| CCOP - Cancer Research for the Ozarks | Springfield, Missouri, United States, 65802 |
| St. John's Regional Health Center | Springfield, Missouri, United States, 65804 |
| David C. Pratt Cancer Center at St. John's Mercy | St. Louis, Missouri, United States, 63141 |
| CCOP - St. Louis-Cape Girardeau | St. Louis, Missouri, United States, 63141 |
| Missouri Baptist Cancer Center | St. Louis, Missouri, United States, 63131 |
| Deaconess Billings Clinic - Downtown | Billings, Montana, United States, 59101 |
| CCOP - Montana Cancer Consortium | Billings, Montana, United States, 59101 |
| St. Vincent Healthcare | Billings, Montana, United States, 59101 |
| Deaconess Billings Clinic Cancer Center | Billings, Montana, United States, 59107 |
| Hematology-Oncology Centers of the Northern Rockies - Billings | Billings, Montana, United States, 59101 |
| Northern Rockies Radiation Oncology Center | Billings, Montana, United States, 59101 |
| Bozeman Deaconess Hospital | Bozeman, Montana, United States, 59715 |
| Internal Medicine Associates of Bozeman | Bozeman, Montana, United States, 59715 |
| St. James Community Hospital | Butte, Montana, United States, 59701 |
| Great Falls Clinic | Great Falls, Montana, United States, 59405 |
| Sletten Regional Cancer Institute | Great Falls, Montana, United States, 59405 |
| St. Peter's Hospital | Helena, Montana, United States, 59601 |
| Kalispell Regional Medical Center | Kalispell, Montana, United States, 59901 |
| Kalispell Medical Oncology | Kalispell, Montana, United States, 59901 |
| Glacier Oncology, PLLC | Kalispell, Montana, United States, 59901 |
| Eastern Montana Cancer Center | Miles City, Montana, United States, 59301 |
| Community Medical Center | Missoula, Montana, United States, 59801 |
| Montana Cancer Center at St. Patrick Hospital and Health Sciences Center | Missoula, Montana, United States, 59802 |
| Montana Cancer Specialists at Montana Cancer Center | Missoula, Montana, United States, 59802 |
| Fremont Area Medical Center | Fremont, Nebraska, United States, 68025 |
| Good Samaritan Health Systems | Kearney, Nebraska, United States, 68847 |
| CCOP - Missouri Valley Cancer Consortium | Omaha, Nebraska, United States, 68106 |
| Creighton University Medical Center | Omaha, Nebraska, United States, 68131 |
| Bergan Mercy Medical Center | Omaha, Nebraska, United States, 68124 |
| Immanuel Medical Center | Omaha, Nebraska, United States, 68122 |
| Midlands Cancer Center at Midlands Community Hospital | Papillion, Nebraska, United States, 68046 |
| CCOP - Nevada Cancer Research Foundation | Las Vegas, Nevada, United States, 89106 |
| University Medical Center of Southern Nevada | Las Vegas, Nevada, United States, 89102 |
| Englewood Hospital and Medical Center | Englewood, New Jersey, United States, 07631 |
| Lovelace Medical Center | Albuquerque, New Mexico, United States, 87108 |
| University of New Mexico Cancer Research and Treatment Center | Albuquerque, New Mexico, United States, 87106 |
| New Mexico Cancer Care Associates | Santa Fe, New Mexico, United States, 87505 |
| Roswell Park Cancer Institute | Buffalo, New York, United States, 14263 |
| Cancer Care Center at Catskill Regional Medical Center | Harris, New York, United States, 12742 |
| St. Vincent's Comprehensive Cancer Center - Manhattan | New York, New York, United States, 10011 |
| Highland Hospital of Rochester | Rochester, New York, United States, 14620 |
| James P. Wilmot Cancer Center at University of Rochester Medical Center | Rochester, New York, United States, 14642 |
| Mission Hospitals - Memorial Campus | Asheville, North Carolina, United States, 28801 |
| Hope A Women's Cancer Center | Asheville, North Carolina, United States, 28801 |
| Wayne Memorial Hospital, Incorporated | Goldsboro, North Carolina, United States, 27534 |
| Leo W. Jenkins Cancer Center at Pitt County Memorial Hospital | Greenville, North Carolina, United States, 27858 |
| Lenoir Memorial Cancer Center | Kinston, North Carolina, United States, 28501 |
| Rutherford Hospital | Rutherfordton, North Carolina, United States, 28139 |
| Forsyth Regional Cancer Center at Forsyth Medical Center | Winston-Salem, North Carolina, United States, 27103 |
| Mid Dakota Clinic, P. C. | Bismarck, North Dakota, United States, 58501 |
| Bismarck Cancer Center | Bismarck, North Dakota, United States, 58501 |
| Cancer Care Center at Medcenter One Hospital | Bismarck, North Dakota, United States, 58501 |
| St. Alexius Medical Center | Bismarck, North Dakota, United States, 58501 |
| Altru Cancer Center at Altru Hospital | Grand Forks, North Dakota, United States, 58201 |
| Wood County Oncology Center | Bowling Green, Ohio, United States, 43402 |
| Charles M. Barrett Cancer Center at University Hospital | Cincinnati, Ohio, United States, 45267 |
| Grandview Hospital | Dayton, Ohio, United States, 45405 |
| David L. Rike Cancer Center at Miami Valley Hospital | Dayton, Ohio, United States, 45409 |
| CCOP - Dayton | Dayton, Ohio, United States, 45429 |
| Veterans Affairs Medical Center - Dayton | Dayton, Ohio, United States, 45428 |
| Good Samaritan Hospital | Dayton, Ohio, United States, 45406 |
| Samaritan North Cancer Care Center | Dayton, Ohio, United States, 45415 |
| Blanchard Valley Medical Associates | Findlay, Ohio, United States, 45840 |
| Fremont Memorial Hospital | Fremont, Ohio, United States, 43420 |
| Kenton Oncology, Incorporated | Kenton, Ohio, United States, 43326 |
| Charles F. Kettering Memorial Hospital | Kettering, Ohio, United States, 45429 |
| Lima Memorial Hospital | Lima, Ohio, United States, 45804 |
| St. Rita's Medical Center | Lima, Ohio, United States, 45801 |
| MedCentral - Mansfield Hospital | Mansfield, Ohio, United States, 44903 |
| St. Luke's Hospital | Maumee, Ohio, United States, 43537 |
| Northwest Ohio Oncology Center | Maumee, Ohio, United States, 43537 |
| Middletown Regional Hospital | Middletown, Ohio, United States, 45044 |
| St. Charles Mercy Hospital | Oregon, Ohio, United States, 43616 |
| Toledo Clinic - Oregon | Oregon, Ohio, United States, 43616 |
| North Coast Cancer Care, Incorporated | Sandusky, Ohio, United States, 44870 |
| Firelands Regional Medical Center | Sandusky, Ohio, United States, 44870 |
| Promedica Cancer Center at Flower Hospital | Sylvania, Ohio, United States, 43560 |
| Mercy Hospital of Tiffin | Tiffin, Ohio, United States, 44883 |
| Medical College of Ohio Cancer Institute | Toledo, Ohio, United States, 43614 |
| CCOP - Toledo Community Hospital | Toledo, Ohio, United States, 43623 |
| St. Vincent Mercy Medical Center | Toledo, Ohio, United States, 43608 |
| Toledo Clinic, Incorporated - Main Clinic | Toledo, Ohio, United States, 43623 |
| Toledo Hospital | Toledo, Ohio, United States, 43606 |
| Toledo Surgical Specialists | Toledo, Ohio, United States, 43623 |
| UVMC Cancer Care Center at Upper Valley Medical Center | Troy, Ohio, United States, 45373 |
| Fulton County Health Center | Wauseon, Ohio, United States, 43567 |
| United States Air Force Medical Center Wright-Patterson | Wright-Patterson Afb, Ohio, United States, 45433-5529 |
| Ruth G. McMillan Cancer Center at Greene Memorial Hospital | Xenia, Ohio, United States, 45385 |
| Natalie Warren Bryant Cancer Center at St. Francis Hospital | Tulsa, Oklahoma, United States, 74136 |
| Legacy Mount Hood Medical Center | Glesham, Oregon, United States, 97030 |
| Providence Milwaukie Hospital | Milwaukie, Oregon, United States, 97222 |
| Institute of Oncology at Vilnius University | Portland, Oregon, United States, 97227 |
| CCOP - Columbia River Oncology Program | Portland, Oregon, United States, 97225 |
| Cancer Institute at Oregon Health and Science University | Portland, Oregon, United States, 97239 |
| Legacy Good Samaritan Hospital & Medical Center Comprehensive Cancer Center | Portland, Oregon, United States, 97210 |
| Providence Cancer Center at Providence Portland Medical Center | Portland, Oregon, United States, 97213 |
| Providence St. Vincent Medical Center | Portland, Oregon, United States, 97225 |
| Salem Hospital Regional Cancer Center | Salem, Oregon, United States, 97309 |
| Legacy Meridian Park Hospital | Tualatin, Oregon, United States, 97062 |
| Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest | Allentown, Pennsylvania, United States, 18105 |
| Jennersville Regional Hospital | West Grove, Pennsylvania, United States, 19390 |
| Rose Ramer Cancer Clinic at Anderson Area Medical Center | Anderson, South Carolina, United States, 29621 |
| Roper St. Francis Cancer Center at Roper Hospital | Charleston, South Carolina, United States, 29401 |
| Gibbs Regional Cancer Center at Spartanburg Regional Medical Center | Spartanburg, South Carolina, United States, 29303 |
| CCOP - Upstate Carolina | Spartanburg, South Carolina, United States, 29304 |
| Oncology Services of Aberdeen | Aberdeen, South Dakota, United States, 57401 |
| Rapid City Regional Hospital | Rapid City, South Dakota, United States, 57701 |
| MBCCOP - Meharry Medical College - Nashville | Nashville, Tennessee, United States, 37208-3599 |
| Harrington Cancer Center | Amarillo, Texas, United States, 79106 |
| Seton Shivers Cancer Program at Brackenridge Hospital | Austin, Texas, United States, 78701 |
| Medical City Dallas Hospital | Dallas, Texas, United States, 75230 |
| Brooke Army Medical Center | Fort Sam Houston, Texas, United States, 78234 |
| Wilford Hall Medical Center | Lackland AFB, Texas, United States, 78236 |
| UMC Southwest Cancer and Research Center | Lubbock, Texas, United States, 79415 |
| Veterans Affairs Medical Center - San Antonio (Murphy) | San Antonio, Texas, United States, 78209 |
| University Hospital - San Antonio | San Antonio, Texas, United States, 78229 |
| University of Texas Health Science Center at San Antonio | San Antonio, Texas, United States, 78229-3900 |
| Cancer Therapy and Research Center | San Antonio, Texas, United States, 78229 |
| CCOP - Scott and White Hospital | Temple, Texas, United States, 76508 |
| American Fork Hospital | American Fork, Utah, United States, 84003 |
| Logan Regional Hospital | Logan, Utah, United States, 84321 |
| Cottonwood Hospital Medical Center | Murray, Utah, United States, 84107 |
| McKay-Dee Hospital Center | Ogden, Utah, United States, 84403 |
| Utah Valley Regional Medical Center - Provo | Provo, Utah, United States, 84603 |
| LDS Hospital | Salt Lake City, Utah, United States, 84143 |
| Huntsman Cancer Institute at University of Utah | Salt Lake City, Utah, United States, 84112 |
| Utah Cancer Specialists at UCS Cancer Center | Salt Lake City, Utah, United States, 84106 |
| Dixie Regional Medical Center | St. George, Utah, United States, 84770 |
| Danville Regional Medical Center | Danville, Virginia, United States, 24541 |
| Auburn Regional Center for Cancer Care | Auburn, Washington, United States, 98002 |
| St. Joseph Hospital Community Cancer Center | Bellingham, Washington, United States, 98225 |
| Olympic Hematology and Oncology | Bremerton, Washington, United States, 98310 |
| Providence Centralia Hospital Regional Cancer Center | Centralia, Washington, United States, 98531 |
| St. Francis Hospital | Federal Way, Washington, United States, 98003 |
| Skagit Valley Hospital Cancer Care Center | Mt. Vernon, Washington, United States, 98273 |
| Providence St. Peter Hospital Regional Cancer Center | Olympia, Washington, United States, 95806 |
| Capital Medical Center | Olympia, Washington, United States, 98507 |
| Olympic Medical Center | Port Angeles, Washington, United States, 98362 |
| Good Samaritan Cancer Center | Puyallup, Washington, United States, 98372 |
| Valley Medical Center | Renton, Washington, United States, 98055 |
| Group Health Central Hospital | Seattle, Washington, United States, 98104 |
| Harborview Medical Center | Seattle, Washington, United States, 98104 |
| University Cancer Center at University of Washington Medical Center | Seattle, Washington, United States, 98195 |
| Fred Hutchinson Cancer Research Center | Seattle, Washington, United States, 98104 |
| Swedish Cancer Institute at Swedish Medical Center - First Hill Campus | Seattle, Washington, United States, 98114 |
| CCOP - Virginia Mason Research Center | Seattle, Washington, United States, 98101 |
| North Puget Oncology at United General Hospital | Sedro-Wooley, Washington, United States, 98284 |
| Cancer Care Northwest - Spokane South | Spokane, Washington, United States, 99202 |
| Allenmore Hospital | Tacoma, Washington, United States, 98405 |
| Madigan Army Medical Center | Tacoma, Washington, United States, 98431 |
| CCOP - Northwest | Tacoma, Washington, United States, 98405 |
| St. Clare Hospital | Tacoma, Washington, United States, 98499 |
| St. Joseph Medical Center at Franciscan Health System | Tacoma, Washington, United States, 98405 |
| Southwest Washington Medical Center Cancer Center | Vancouver, Washington, United States, 98668 |
| Central Washington Hospital | Wenatchee, Washington, United States, 98801 |
| Wenatchee Valley Clinic | Wenatchee, Washington, United States, 98801 |
| Washington Hematology - Oncology Specialists | Yakima, Washington, United States, 98902 |
| North Star Lodge Cancer Center | Yakima, Washington, United States, 98902 |
| Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical Center | La Crosse, Wisconsin, United States, 54601 |
| All Saints Cancer Center at All Saints Healthcare | Racine, Wisconsin, United States, 53405 |
| Welch Cancer Center | Sheridan, Wyoming, United States, 82801 |