Comparison of Combination Chemotherapy Regimens in Treating Older Women Who Have Undergone Surgery for Breast Cancer
- Registration Number
- NCT00024102
- Lead Sponsor
- Alliance for Clinical Trials in Oncology
- Brief Summary
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug and giving them in different ways after surgery may kill more tumor cells. It is not yet known which chemotherapy regimen is more effective in treating older women with breast cancer.
PURPOSE: This randomized phase III trial is studying different combination chemotherapy regimens to see how well they work in treating older women who have undergone surgery for breast cancer.
- Detailed Description
OBJECTIVES:
* Compare the effectiveness of adjuvant chemotherapy comprising standard cyclophosphamide, methotrexate, and fluorouracil (CMF) or doxorubicin and cyclophosphamide (AC) vs oral capecitabine, in terms of disease-free and overall survival, in elderly women with operable adenocarcinoma of the breast.
* Compare the quality of life and physical functioning of patients treated with these regimens.
* Compare the toxicity of these regimens in these patients.
* Evaluate the adherence of older patients to an oral chemotherapy regimen.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to age (65 to 69 vs 70 to 80 vs over 80), performance status (0-1 vs 2), and HER2 status (positive vs negative vs unknown). Patients are randomized to 1 of 2 treatment arms.
* Arm I: Patients with insufficient left ventricular ejection fraction (LVEF) are assigned to group A. Patients with normal LVEF are assigned to group A or B based on physician/patient choice.
* Group A (CMF): Patients receive oral cyclophosphamide (CTX) daily on days 1-14 and methotrexate IV and fluorouracil IV on days 1 and 8. Treatment repeats every 4 weeks for 6 courses in the absence of disease progression or unacceptable toxicity.
* Group B (AC): Patients receive doxorubicin IV and CTX IV on day 1. Treatment repeats every 3 weeks for 4 courses in the absence of disease progression or unacceptable toxicity.
* Arm II: Patients receive oral capecitabine twice daily on days 1-14. Treatment repeats every 3 weeks for 6 courses in the absence of disease progression or unacceptable toxicity.
Beginning within 12 weeks after treatment in arm I or II, patients with estrogen or progesterone receptor-positive disease receive oral tamoxifen or an aromatase inhibitor daily for 5 years.
Beginning 4-6 weeks after treatment in arm I or II, eligible patients who previously underwent breast conservation surgery undergo radiotherapy.
Quality of life is assessed at baseline; at 6 weeks (group B), 9 weeks (arm II), or 12 weeks (group A); and then at 1, 12, 18, and 24 months after study.
Drug adherence is assessed at 9 weeks during study (arm II).
Patients are followed at 1 month, every 6 months for 2 years, and then annually for 15 years.
PROJECTED ACCRUAL: A total of 600-1,800 patients (300-900 per treatment arm) will be accrued for this study within 2-6 years.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 633
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Standard Chemotherapy Standard Treatment Patient/Physician choice of cyclophosphamide + MTX + 5-FU OR Cyclophosphamide + doxorubicin Capecitabine capecitabine Treatment with capecitabine
- Primary Outcome Measures
Name Time Method Relapse-free Survival Rates at 2.4 Years randomization until date of first event, or date last known to be event free if no event was reported (up to 5 years) Percentage of participants who were alive and relapse-free at time of analysis were counted as "Alive without relapse" at 2.4 years. Participants who had a first local recurrence, first distant metastasis or death from any cause were counted as "relapse, first occurrence". These rates were estimated using the Kaplan Meier method
- Secondary Outcome Measures
Name Time Method Overall Survival Rate at 2.4 Years Time from registration to death (up to 15 years) Percentage of patients who were alive at 2.4 years. This rate was estimated using the Kaplan Meier method.
Number of Participants With Grade 3, 4 or 5 Adverse Event at Least Possibly Related to Treatment. Reported during protocol treatment after each cycle The National Cancer Institute (NCI) Common Toxicity Criteria (CTC) Version 2.0 was used to evaluate toxicity.
Grade 1: Mild; Grade 2: Moderate; Grade 3: Severe; Grade 4: Life Threatening; Grade 5: Death.
Trial Locations
- Locations (329)
Mount Sinai Hospital - Toronto
🇨🇦Toronto, Ontario, Canada
USC/Norris Comprehensive Cancer Center and Hospital
🇺🇸Los Angeles, California, United States
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia
🇺🇸Philadelphia, Pennsylvania, United States
Great Falls Clinic
🇺🇸Great Falls, Montana, United States
Robert H. Lurie Comprehensive Cancer Center at Northwestern University
🇺🇸Chicago, Illinois, United States
University of Illinois Cancer Center
🇺🇸Chicago, Illinois, United States
Mercy Hospital and Medical Center
🇺🇸Chicago, Illinois, United States
University of Chicago Cancer Research Center
🇺🇸Chicago, Illinois, United States
Tufts-NEMC Cancer Center
🇺🇸Boston, Massachusetts, United States
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
🇺🇸Boston, Massachusetts, United States
MetroHealth's Cancer Care Center at MetroHealth Medical Center
🇺🇸Cleveland, Ohio, United States
University Cancer Center at University of Washington Medical Center
🇺🇸Seattle, Washington, United States
University Medical Center of Southern Nevada
🇺🇸Las Vegas, Nevada, United States
CCOP - Nevada Cancer Research Foundation
🇺🇸Las Vegas, Nevada, United States
Kaiser Permanente Medical Office -Vandever Medical Office
🇺🇸San Diego, California, United States
Virginia Piper Cancer Institute at Abbott-Northwestern Hospital
🇺🇸Minneapolis, Minnesota, United States
Hennepin County Medical Center - Minneapolis
🇺🇸Minneapolis, Minnesota, United States
Duke Comprehensive Cancer Center
🇺🇸Durham, North Carolina, United States
Charles M. Barrett Cancer Center at University Hospital
🇺🇸Cincinnati, Ohio, United States
Stormont-Vail Cancer Center
🇺🇸Topeka, Kansas, United States
St. Francis Comprehensive Cancer Center
🇺🇸Topeka, Kansas, United States
Huntsman Cancer Institute at University of Utah
🇺🇸Salt Lake City, Utah, United States
University of Alabama at Birmingham Comprehensive Cancer Center
🇺🇸Birmingham, Alabama, United States
Oklahoma University Medical Center
🇺🇸Oklahoma City, Oklahoma, United States
Cancer Care Associates - Mercy Campus
🇺🇸Oklahoma City, Oklahoma, United States
Cross Cancer Institute at University of Alberta
🇨🇦Edmonton, Alberta, Canada
Mayo Clinic Cancer Center
🇺🇸Rochester, Minnesota, United States
CCOP - Missouri Valley Cancer Consortium
🇺🇸Omaha, Nebraska, United States
Creighton University Medical Center
🇺🇸Omaha, Nebraska, United States
Aurora Sinai Medical Center
🇺🇸Milwaukee, Wisconsin, United States
Pacific Cancer Institute - Maui
🇺🇸Wailuku, Maui, Hawaii, United States
Stony Brook University Cancer Center
🇺🇸Stony Brook, New York, United States
Winthrop University Hospital
🇺🇸Mineola, New York, United States
Nashville Oncology Associates, P.C.
🇺🇸Nashville, Tennessee, United States
University of Minnesota Medical Center & Children's Hospital - Fairview
🇺🇸Minneapolis, Minnesota, United States
Alegant Health Cancer Center at Bergan Mercy Medical Center
🇺🇸Omaha, Nebraska, United States
Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton
🇺🇸Marlton, New Jersey, United States
Wayne Memorial Hospital, Incorporated
🇺🇸Goldsboro, North Carolina, United States
UNMC Eppley Cancer Center at the University of Nebraska Medical Center
🇺🇸Omaha, Nebraska, United States
Park Nicollet Health Services
🇺🇸St. Louis Park, Minnesota, United States
Carol G. Simon Cancer Center at Morristown Memorial Hospital
🇺🇸Morristown, New Jersey, United States
Regions Hospital Cancer Care Center
🇺🇸St. Paul, Minnesota, United States
Highland Hospital of Rochester
🇺🇸Rochester, New York, United States
Proctor Hospital
🇺🇸Peoria, Illinois, United States
CCOP - Illinois Oncology Research Association
🇺🇸Peoria, Illinois, United States
Cancer Treatment Center at Pekin Hospital
🇺🇸Pekin, Illinois, United States
St. Margaret's Hospital
🇺🇸Spring Valley, Illinois, United States
CCOP - Grand Rapids
🇺🇸Grand Rapids, Michigan, United States
CCOP - Montana Cancer Consortium
🇺🇸Billings, Montana, United States
St. John's Regional Health Center
🇺🇸Springfield, Missouri, United States
Minnesota Oncology Hematology, PA - Woodbury
🇺🇸Woodbury, Minnesota, United States
Swedish-American Regional Cancer Center
🇺🇸Rockford, Illinois, United States
MeritCare Medical Group
🇺🇸Fargo, North Dakota, United States
Community Cancer Center of Monroe
🇺🇸Monroe, Michigan, United States
West Michigan Cancer Center
🇺🇸Kalamazoo, Michigan, United States
Cancer Care Center at Medcenter One Hospital
🇺🇸Bismarck, North Dakota, United States
Altru Cancer Center at Altru Hospital
🇺🇸Grand Forks, North Dakota, United States
Oncology Hematology Associates of Central Illinois, PC - Peoria
🇺🇸Peoria, Illinois, United States
Mercy and Unity Cancer Center at Mercy Hospital
🇺🇸Coon Rapids, Minnesota, United States
Haematology-Oncology Associates of Ohio and Michigan, PC
🇺🇸Lambertville, Michigan, United States
Mayo Clinic Scottsdale
🇺🇸Scottsdale, Arizona, United States
OSF St. Francis Medical Center
🇺🇸Peoria, Illinois, United States
Community Hospital of Ottawa
🇺🇸Ottawa, Illinois, United States
Northern Michigan Hospital
🇺🇸Petoskey, Michigan, United States
Highland General Hospital at St. George's University School of Medicine
🇺🇸Oakland, California, United States
McCreery Cancer Center at Ottumwa Regional
🇺🇸Ottumwa, Iowa, United States
Maine Center for Cancer Medicine and Blood Disorders - Scarborough
🇺🇸Scarborough, Maine, United States
Illinois Valley Community Hospital
🇺🇸Peru, Illinois, United States
Saint Anthony Memorial Health Centers
🇺🇸Michigan City, Indiana, United States
Frederick Memorial Hospital Regional Cancer Therapy Center
🇺🇸Frederick, Maryland, United States
MeritCare Clinic - Bemidji
🇺🇸Bemidji, Minnesota, United States
Cancer Care Center at St. Luke's Hospital
🇺🇸Duluth, Minnesota, United States
Mid Dakota Clinic, PC
🇺🇸Bismarck, North Dakota, United States
Siteman Cancer Center at Barnes-Jewish Hospital
🇺🇸St Louis, Missouri, United States
Missouri Baptist Cancer Center
🇺🇸St. Louis, Missouri, United States
New Hampshire Oncology-Hematology, PA - Hooksett
🇺🇸Hooksett, New Hampshire, United States
J. Phillip Citta Regional Cancer Center at Community Medical Center
🇺🇸Toms River, New Jersey, United States
McFarland Clinic, PC
🇺🇸Ames, Iowa, United States
Cedar Rapids Oncology Associates
🇺🇸Cedar Rapids, Iowa, United States
Regional Cancer Institute at Bloomington Hospital
🇺🇸Bloomington, Indiana, United States
MaineGeneral Medical Center - Waterville Campus
🇺🇸Waterville, Maine, United States
Fairview Southdale Hospital
🇺🇸Edina, Minnesota, United States
HealthEast Cancer Care at St. John's Hospital
🇺🇸Maplewood, Minnesota, United States
CCOP - Hematology-Oncology Associates of Central New York
🇺🇸Syracuse, New York, United States
Hutchinson Area Health Care
🇺🇸Hutchinson, Minnesota, United States
Immanuel Medical Center
🇺🇸Omaha, Nebraska, United States
Doctors Medical Center - San Pablo Campus
🇺🇸San Pablo, California, United States
Genesis Regional Cancer Center at Genesis Medical Center
🇺🇸Davenport, Iowa, United States
Christus Schumpert Cancer Treatment Center
🇺🇸Shreveport, Louisiana, United States
Meeker County Memorial Hospital
🇺🇸Lichfield, Minnesota, United States
Hematology Oncology Associates of the Quad Cities
🇺🇸Bettendorf, Iowa, United States
Cedar Valley Medical Specialists, PC - West Ridgeway Avenue
🇺🇸Waterloo, Iowa, United States
Lakes Region General Hospital
🇺🇸Laconia, New Hampshire, United States
CentraCare Clinic - River Campus
🇺🇸St. Cloud, Minnesota, United States
OnCare Hawaii, Incorporated - Lusitana
🇺🇸Honolulu, Hawaii, United States
Augusta Oncology Associates - Walton Way
🇺🇸Augusta, Georgia, United States
St. Francis Medical Center
🇺🇸Honolulu, Hawaii, United States
Gwinnett Medical Center
🇺🇸Lawrenceville, Georgia, United States
Minnesota Oncology Hematology, PA at Maplewood Cancer Center
🇺🇸Maplewood, Minnesota, United States
SUNY Upstate Medical University Hospital
🇺🇸Syracuse, New York, United States
Adirondack Cancer Care - Glens Falls
🇺🇸Glens Falls, New York, United States
Lawrence Memorial Hospital of Medford
🇺🇸Medford, Massachusetts, United States
Ridgeview Medical Center
🇺🇸Waconia, Minnesota, United States
Chippewa County - Montevideo Hospital
🇺🇸Montevideo, Minnesota, United States
United Hospital
🇺🇸St. Paul, Minnesota, United States
St. Joseph Medical Center
🇺🇸Reading, Pennsylvania, United States
Rush-Copley Cancer Care Center
🇺🇸Aurora, Illinois, United States
Galesburg Cottage Hospital
🇺🇸Galesburg, Illinois, United States
Trinity Cancer Care Center
🇺🇸Minot, North Dakota, United States
Graham Hospital
🇺🇸Canton, Illinois, United States
Central Maine Medical Center
🇺🇸Lewiston, Maine, United States
Cape Cod Hospital
🇺🇸Hyannis, Massachusetts, United States
Greenebaum Cancer Center at University of Maryland Medical Center
🇺🇸Baltimore, Maryland, United States
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
🇺🇸Baltimore, Maryland, United States
Grandview Hospital
🇺🇸Dayton, Ohio, United States
Fremont Memorial Hospital
🇺🇸Fremont, Ohio, United States
Case Comprehensive Cancer Center
🇺🇸Cleveland, Ohio, United States
Toledo Clinic, Incorporated - Main Clinic
🇺🇸Toledo, Ohio, United States
Lima Memorial Hospital
🇺🇸Lima, Ohio, United States
Toledo Clinic - Oregon
🇺🇸Oregon, Ohio, United States
Cleo Craig Cancer Research Clinic
🇺🇸Lawton, Oklahoma, United States
Medical University of Ohio Cancer Center
🇺🇸Toledo, Ohio, United States
St. Rita's Medical Center
🇺🇸Lima, Ohio, United States
MBCCOP - Meharry Medical College - Nashville
🇺🇸Nashville, Tennessee, United States
Medical X-Ray Center, PC
🇺🇸Sioux Falls, South Dakota, United States
Sioux Valley Hospital and University of South Dakota Medical Center
🇺🇸Sioux Falls, South Dakota, United States
Penn State Cancer Institute at Milton S. Hershey Medical Center
🇺🇸Hershey, Pennsylvania, United States
St. Luke's Hospital Cancer Center
🇺🇸Bethlehem, Pennsylvania, United States
Geisinger Medical Center
🇺🇸Danville, Pennsylvania, United States
Bryn Mawr Hospital
🇺🇸Bryn Mawr, Pennsylvania, United States
Lewistown Hospital
🇺🇸Lewistown, Pennsylvania, United States
Avera Cancer Institute
🇺🇸Sioux Falls, South Dakota, United States
East Tennessee State University Cancer Center at Johnson City Medical Center
🇺🇸Johnson City, Tennessee, United States
Memorial Hospital of Rhode Island
🇺🇸Pawtucket, Rhode Island, United States
Oncology Services of Aberdeen
🇺🇸Aberdeen, South Dakota, United States
Fletcher Allen Health Care - University Health Center Campus
🇺🇸Burlington, Vermont, United States
Providence Cancer Center at Holy Family Hospital
🇺🇸Spokane, Washington, United States
Madigan Army Medical Center - Tacoma
🇺🇸Tacoma, Washington, United States
Medical Consultants, Limited
🇺🇸Milwaukee, Wisconsin, United States
Allan Blair Cancer Centre at Pasqua Hospital
🇨🇦Regina, Saskatchewan, Canada
St. Joseph Medical Center at Franciscan Health System
🇺🇸Tacoma, Washington, United States
Veterans Affairs Medical Center - Dayton
🇺🇸Dayton, Ohio, United States
St. Charles Mercy Hospital
🇺🇸Oregon, Ohio, United States
Fulton County Health Center
🇺🇸Wauseon, Ohio, United States
UVMC Cancer Care Center at Upper Valley Medical Center
🇺🇸Troy, Ohio, United States
Cancer Center of Paoli Memorial Hospital
🇺🇸Paoli, Pennsylvania, United States
Geisinger Medical Group - Scenery Park
🇺🇸State College, Pennsylvania, United States
Eureka Community Hospital
🇺🇸Eureka, Illinois, United States
Hopedale Medical Complex
🇺🇸Hopedale, Illinois, United States
Community Cancer Center
🇺🇸Normal, Illinois, United States
Hematology/Oncology of the North Shore at Gross Point Medical Center
🇺🇸Skokie, Illinois, United States
Hematology Oncology Associates - Skokie
🇺🇸Skokie, Illinois, United States
Carson-Tahoe Cancer Services at Carson Tahoe Regional Healthcare
🇺🇸Carson City, Nevada, United States
Martha Jefferson Hospital Cancer Care Center
🇺🇸Charlottesville, Virginia, United States
Regional Cancer Center at Singing River Hospital
🇺🇸Pascagoula, Mississippi, United States
South Shore Hospital
🇺🇸South Weymouth, Massachusetts, United States
CaroMont Cancer Center at Gaston Memorial Hospital
🇺🇸Gastonia, North Carolina, United States
Randolph Hospital
🇺🇸Asheboro, North Carolina, United States
Annie Penn Cancer Center
🇺🇸Reidsville, North Carolina, United States
Moses Cone Regional Cancer Center at Wesley Long Community Hospital
🇺🇸Greensboro, North Carolina, United States
Zimmer Cancer Center at New Hanover Regional Medical Center
🇺🇸Wilmington, North Carolina, United States
Faulkner Hospital
🇺🇸Boston, Massachusetts, United States
Methodist Medical Center of Illinois
🇺🇸Peoria, Illinois, United States
Willmar Cancer Center at Rice Memorial Hospital
🇺🇸Willmar, Minnesota, United States
Mobile Infirmary Medical Center
🇺🇸Mobile, Alabama, United States
Arizona Cancer Center at University of Arizona Health Sciences Center
🇺🇸Tucson, Arizona, United States
St. Joseph's Mercy Cancer Center
🇺🇸Hot Springs, Arkansas, United States
Glendale Memorial Hospital Comprehensive Cancer Center
🇺🇸Glendale, California, United States
Saint Rose Hospital
🇺🇸Hayward, California, United States
Moores UCSD Cancer Center
🇺🇸La Jolla, California, United States
Leavey Cancer Center at Northridge Hospital Medical Center
🇺🇸Northridge, California, United States
Alta Bates Summit Medical Center - Summit Campus
🇺🇸Oakland, California, United States
CCOP - Bay Area Tumor Institute
🇺🇸Oakland, California, United States
Valley Care Medical Center
🇺🇸Pleasanton, California, United States
Salinas Valley Memorial Hospital
🇺🇸Salinas, California, United States
Memorial Hospital
🇺🇸Carthage, Illinois, United States
Kent General Hospital at Bayhealth Medical Center
🇺🇸Dover, Delaware, United States
Eastern Connecticut Hematology and Oncology Associates
🇺🇸Norwich, Connecticut, United States
CCOP - Christiana Care Health Services
🇺🇸Newark, Delaware, United States
Walter Reed Army Medical Center
🇺🇸Washington, District of Columbia, United States
Mayo Clinic - Jacksonville
🇺🇸Jacksonville, Florida, United States
Halifax Medical Center - Daytona Beach
🇺🇸Daytona Beach, Florida, United States
Sibley Memorial Hospital
🇺🇸Washington, District of Columbia, United States
Michael & Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital
🇺🇸Fort Lauderdale, Florida, United States
Ella Milbank Foshay Cancer Center at Jupiter Medical Center
🇺🇸Jupiter, Florida, United States
Lakeland Regional Cancer Center at Lakeland Regional Medical Center
🇺🇸Lakeland, Florida, United States
Palm Beach Cancer Institute - West Palm Beach
🇺🇸West Palm Beach, Florida, United States
University of Miami Sylvester Comprehensive Cancer Center
🇺🇸Miami, Florida, United States
CCOP - Mount Sinai Medical Center
🇺🇸Miami Beach, Florida, United States
CCOP - Atlanta Regional
🇺🇸Atlanta, Georgia, United States
Kapiolani Medical Center at Pali Momi
🇺🇸Aiea, Hawaii, United States
Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/Candler
🇺🇸Savannah, Georgia, United States
Queen's Cancer Institute at Queen's Medical Center
🇺🇸Honolulu, Hawaii, United States
Cancer Research Center of Hawaii
🇺🇸Honolula, Hawaii, United States
Straub Clinic and Hospital, Incorporated
🇺🇸Honolulu, Hawaii, United States
OnCare Hawaii, Incorporated - Kuakini
🇺🇸Honolulu, Hawaii, United States
Kapiolani Medical Center for Women and Children
🇺🇸Honolulu, Hawaii, United States
Hematology Oncology Associates of Eastern Idaho
🇺🇸Idaho Falls, Idaho, United States
Hematology and Oncology Associates
🇺🇸Scranton, Pennsylvania, United States
Veterans Affairs Medical Center - Chicago Westside Hospital
🇺🇸Chicago, Illinois, United States
Swedish Covenant Hospital
🇺🇸Chicago, Illinois, United States
Evanston Northwestern Healthcare - Evanston Hospital
🇺🇸Evanston, Illinois, United States
Decatur Memorial Hospital Cancer Care Institute
🇺🇸Decatur, Illinois, United States
St. Francis Hospital
🇺🇸Federal Way, Washington, United States
Galesburg Clinic
🇺🇸Galesburg, Illinois, United States
Mason District Hospital
🇺🇸Havana, Illinois, United States
Midwest Center for Hematology/Oncology
🇺🇸Joliet, Illinois, United States
Joliet Oncology-Hematology Associates, Limited - West
🇺🇸Joliet, Illinois, United States
Provena St. Mary's Wasser Regional Cancer Center - Kankakee
🇺🇸Kankakee, Illinois, United States
McDonough District Hospital
🇺🇸Macomb, Illinois, United States
Cancer Care and Hematology Specialists of Chicagoland - Niles
🇺🇸Niles, Illinois, United States
North Shore Oncology and Hematology Associates, Limited - Libertyville
🇺🇸Libertyville, Illinois, United States
BroMenn Regional Medical Center
🇺🇸Normal, Illinois, United States
Saint James Hospital and Health Centers Comprehensive Cancer Institute - Olympia Fields
🇺🇸Olympia Fields, Illinois, United States
Perry Memorial Hospital
🇺🇸Princeton, Illinois, United States
Center for Cancer Care at OSF Saint Anthony Medical Center
🇺🇸Rockford, Illinois, United States
Regional Cancer Center at Memorial Medical Center
🇺🇸Springfield, Illinois, United States
Carle Cancer Center at Carle Foundation Hospital
🇺🇸Urbana, Illinois, United States
CCOP - Carle Cancer Center
🇺🇸Urbana, Illinois, United States
St. Francis Hospital and Health Centers - Beech Grove Campus
🇺🇸Beech Grove, Indiana, United States
CCOP - Northern Indiana CR Consortium
🇺🇸South Bend, Indiana, United States
Fort Wayne Medical Oncology and Hematology
🇺🇸Fort Wayne, Indiana, United States
St. Luke's Hospital
🇺🇸Maumee, Ohio, United States
Mercy Regional Cancer Center at Mercy Medical Center
🇺🇸Cedar Rapids, Iowa, United States
Mercy Hospital of Portland
🇺🇸Portland, Maine, United States
Cancer Research Center at Boston Medical Center
🇺🇸Boston, Massachusetts, United States
Saints Memorial Cancer Center at Saints Memorial Medical Center
🇺🇸Lowell, Massachusetts, United States
Hickman Cancer Center at Bixby Medical Center
🇺🇸Adrian, Michigan, United States
Josephine Ford Cancer Center at Henry Ford Hospital
🇺🇸Detroit, Michigan, United States
Mercy Memorial Hospital System
🇺🇸Monroe, Michigan, United States
Lakeland Cancer Care Center at Lakeland Hospital - St. Joseph
🇺🇸St. Joseph, Michigan, United States
Providence Cancer Institute at Providence Hospital - Southfield Campus
🇺🇸Southfield, Michigan, United States
William Beaumont Hospital - Royal Oak Campus
🇺🇸Royal Oak, Michigan, United States
Albert Lea Cancer Center at Albert Lea Medical Center
🇺🇸Albert Lea, Minnesota, United States
Fairview Ridges Hospital
🇺🇸Burnsville, Minnesota, United States
CCOP - Duluth
🇺🇸Duluth, Minnesota, United States
Mercy and Unity Cancer Center at Unity Hospital
🇺🇸Fridley, Minnesota, United States
Immanuel St. Joseph's Clinic
🇺🇸Mankato, Minnesota, United States
Hubert H. Humphrey Cancer Center at North Memorial Medical Center
🇺🇸Robbinsdale, Minnesota, United States
St. Joseph's Hospital
🇺🇸St Paul, Minnesota, United States
CCOP - Metro-Minnesota
🇺🇸Saint Louis Park, Minnesota, United States
Saint Francis Cancer Center
🇺🇸Shakopee, Minnesota, United States
Ellis Fischel Cancer Center at University of Missouri - Columbia
🇺🇸Columbia, Missouri, United States
Hulston Cancer Center at Cox Medical Center South
🇺🇸Springfield, Missouri, United States
Good Samaritan Cancer Center at Good Samaritan Hospital
🇺🇸Kearney, Nebraska, United States
Saint Francis Cancer Treatment Center at Saint Francis Memorial Health Center
🇺🇸Grand Island, Nebraska, United States
Parkland Oncology-Hematology Clinic at Parkland Medical Center
🇺🇸Derry, New Hampshire, United States
Elliot Regional Cancer Center at Elliot Hospital
🇺🇸Manchester, New Hampshire, United States
Ocean Medical Center at Meridian Health
🇺🇸Brick, New Jersey, United States
Booker Cancer Center at Riverview Medical Center
🇺🇸Red Bank, New Jersey, United States
Overlook Hospital
🇺🇸Summit, New Jersey, United States
Fox Chase Virtua Health Cancer Program at Virtua West Jersey
🇺🇸Voorhees, New Jersey, United States
Memorial Sloan-Kettering Cancer Center
🇺🇸New York, New York, United States
Mission Hospitals - Memorial Campus
🇺🇸Asheville, North Carolina, United States
FirstHealth Moore Regional Community Hospital Comprehensive Cancer Center
🇺🇸Pinehurst, North Carolina, United States
Aultman Hospital Cancer Center at Aultman Health Foundation
🇺🇸Canton, Ohio, United States
Rutherford Hospital
🇺🇸Rutherfordton, North Carolina, United States
Wood County Oncology Center
🇺🇸Bowling Green, Ohio, United States
Akron City Hospital
🇺🇸Akron, Ohio, United States
Samaritan North Cancer Care Center
🇺🇸Dayton, Ohio, United States
Good Samaritan Hospital
🇺🇸Dayton, Ohio, United States
Charles F. Kettering Memorial Hospital
🇺🇸Kettering, Ohio, United States
Northwest Ohio Oncology Center
🇺🇸Maumee, Ohio, United States
Firelands Regional Medical Center
🇺🇸Sandusky, Ohio, United States
Middletown Regional Hospital
🇺🇸Middletown, Ohio, United States
North Coast Cancer Care, Incorporated
🇺🇸Sandusky, Ohio, United States
Flower Hospital Cancer Center
🇺🇸Sylvania, Ohio, United States
St. Vincent Mercy Medical Center
🇺🇸Toledo, Ohio, United States
CCOP - Toledo Community Hospital
🇺🇸Toledo, Ohio, United States
Toledo Hospital
🇺🇸Toledo, Ohio, United States
Ruth G. McMillan Cancer Center at Greene Memorial Hospital
🇺🇸Xenia, Ohio, United States
LaFortune Cancer Center at St. John Medical Center
🇺🇸Tulsa, Oklahoma, United States
Dale and Frances Hughes Cancer Center at Pocono Medical Center
🇺🇸East Stroudsburg, Pennsylvania, United States
Meadville Medical Center
🇺🇸Meadville, Pennsylvania, United States
Jennersville Regional Hospital
🇺🇸West Grove, Pennsylvania, United States
Mount Nittany Medical Center
🇺🇸State College, Pennsylvania, United States
CCOP - MainLine Health
🇺🇸Wynnewood, Pennsylvania, United States
Associates in Hematology-Oncology, PC at Crozer Regional Cancer Center
🇺🇸Upland, Pennsylvania, United States
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center
🇺🇸Wilkes-Barre, Pennsylvania, United States
CCOP - Upstate Carolina
🇺🇸Spartanburg, South Carolina, United States
Lankenau Cancer Center at Lankenau Hospital
🇺🇸Wynnewood, Pennsylvania, United States
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center
🇺🇸Spartanburg, South Carolina, United States
Kent County Memorial Hospital
🇺🇸Warwick, Rhode Island, United States
AnMed Health Cancer Center
🇺🇸Anderson, South Carolina, United States
Thompson Cancer Survival Center
🇺🇸Knoxville, Tennessee, United States
Brooke Army Medical Center
🇺🇸Fort Sam Houston, Texas, United States
Wilford Hall Medical Center
🇺🇸Lackland AFB, Texas, United States
Mountainview Medical
🇺🇸Berlin, Vermont, United States
Auburn Regional Center for Cancer Care
🇺🇸Auburn, Washington, United States
St. Joseph Cancer Center
🇺🇸Bellingham, Washington, United States
Providence St. Peter Hospital Regional Cancer Center
🇺🇸Olympia, Washington, United States
Capital Medical Center
🇺🇸Olympia, Washington, United States
Good Samaritan Cancer Center
🇺🇸Puyallup, Washington, United States
Group Health Central Hospital
🇺🇸Seattle, Washington, United States
Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
🇺🇸Seattle, Washington, United States
CCOP - Northwest
🇺🇸Tacoma, Washington, United States
Cancer Care Northwest - Spokane South
🇺🇸Spokane, Washington, United States
St. Clare Hospital
🇺🇸Tacoma, Washington, United States
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
🇺🇸Yakima, Washington, United States
Marshall University Medical Center
🇺🇸Huntington, West Virginia, United States
Vince Lombardi Cancer Clinic - Green Bay at Aurora BayCare Medical Center
🇺🇸Green Bay, Wisconsin, United States
Dean Medical Center - Madison
🇺🇸Madison, Wisconsin, United States
University of Wisconsin Comprehensive Cancer Center
🇺🇸Madison, Wisconsin, United States
Vince Lombardi Cancer Center at Aurora Lakeland Medical Center - Elkhorn
🇺🇸Elkhorn, Wisconsin, United States
Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical Center
🇺🇸La Crosse, Wisconsin, United States
Holy Family Memorial Medical Center Cancer Care Center
🇺🇸Manitowoc, Wisconsin, United States
University of Wisconcin Cancer Center at Aspirus Wausau Hospital
🇺🇸Wausau, Wisconsin, United States
Tom Baker Cancer Centre - Calgary
🇨🇦Calgary, Alberta, Canada
CancerCare Manitoba
🇨🇦Winnipeg, Manitoba, Canada
Windsor Regional Cancer Centre at Windsor Regional Hospital
🇨🇦Windsor, Ontario, Canada
Instituto Nacional de Enfermedades Neoplasicas
🇵🇪Lima, Peru
Prince Edward Island Cancer Centre at Queen Elizabeth Hospital
🇨🇦Charlottetown, Prince Edward Island, Canada
James P. Wilmot Cancer Center at University of Rochester Medical Center
🇺🇸Rochester, New York, United States
CCOP - MeritCare Hospital
🇺🇸Fargo, North Dakota, United States
Caritas Norwood Hospital
🇺🇸Norwood, Massachusetts, United States
Western Pennsylvania Cancer Institute at Western Pennsylvania Hospital
🇺🇸Pittsburgh, Pennsylvania, United States
Bethke Cancer Center at Emerson Hospital
🇺🇸Concord, Massachusetts, United States
David L. Rike Cancer Center at Miami Valley Hospital
🇺🇸Dayton, Ohio, United States
Reading Hospital and Medical Center
🇺🇸Reading, Pennsylvania, United States
Providence Cancer Center at Sacred Heart Medical Center
🇺🇸Spokane, Washington, United States
Sletten Regional Cancer Institute at Benefis Healthcare
🇺🇸Great Falls, Montana, United States
Woodwinds Health Campus
🇺🇸Woodbury, Minnesota, United States
Hollings Cancer Center at Medical University of South Carolina
🇺🇸Charleston, South Carolina, United States
MBCCOP - LSU Health Sciences Center
🇺🇸New Orleans, Louisiana, United States
Bronx-Lebanon Hospital Center & BronxCare Adult Medical Practice
🇺🇸Bronx, New York, United States
Roswell Park Cancer Institute
🇺🇸Buffalo, New York, United States
Community Hospital
🇺🇸Munster, Indiana, United States
Charles R. Wood Cancer Center at Glens Falls Hospital
🇺🇸Glens Falls, New York, United States
Heartland Oncology & Hematology
🇺🇸Council Bluffs, Iowa, United States