A Phase III Randomized Trial of Metformin vs Placebo in Early Stage Breast Cancer
- Registration Number
- NCT01101438
- Lead Sponsor
- Canadian Cancer Trials Group
- Brief Summary
This study is looking at whether Metformin, an agent that is commonly used to treat diabetes, can decrease or affect the ability of breast cancer cells to grow and whether Metformin will work with other therapies to keep cancer from recurring. Health Canada has not approved the sale or use of Metformin to treat breast cancer, although they have approved its use in this clinical trial. Although Metformin is approved by the FDA for the treatment of diabetes, its use in breast cancer is considered investigational.
- Detailed Description
This is a multicenter study. Patients are stratified according to hormone-receptor status (estrogen receptor- and/or progesterone receptor- positive vs both receptors negative), body mass index (≤ 30 vs \> 30 kg/m²), HER2 status (positive vs negative), and prior chemotherapy (any vs none). Patients are randomized to 1 of 2 treatment arms.
* Arm I: Patients receive oral metformin hydrochloride twice daily (once daily in weeks 1-4). Treatment continues for up to 5 years in the absence of disease progression or unacceptable toxicity.
* Arm II: Patients receive oral placebo twice daily (once daily in weeks 1-4). Treatment continues for up to 5 years in the absence of disease progression or unacceptable toxicity.
Blood and tumor samples are collected periodically for correlative studies.
Patients may complete quality-of-life, physical activity, and diet questionnaires at baseline and at 6, 12, 24, 36, 48, and 60 months. (Sub-set of patients).
After completion of study treatment, patients are followed annually.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 3649
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Arm I metformin hydrochloride Patients receive oral metformin hydrochloride twice daily (once daily in weeks 1-4). Treatment continues for up to 5 years in receptor positive (ER and/or PgR positive) subjects in the absence of disease progression or unacceptable toxicity. Arm II placebo Patients receive oral placebo twice daily (once daily in weeks 1-4). Treatment continues for up to 5 years in receptor positive (ER and/or PgR positive) subjects in the absence of disease progression or unacceptable toxicity.
- Primary Outcome Measures
Name Time Method Invasive Disease-free Survival in Hormone Receptor (ER and PgR) Positive Sub-groups 5 years Invasive disease-free survival (IDFS) is defined as percentage of patients without documented development of ipsilateral and contralateral invasive breast tumour, local/regional invasive recurrence, distant recurrence, death from any causes. If a subject has not had invasive disease or died at the time of data cut-off for this final analysis, IDFS was censored on the date of last follow-up.
Invasive Disease-free Survival 5 years Invasive disease-free survival (IDFS) is defined as the percent of patients without documented development of ipsilateral and contralateral invasive breast tumour, local/regional invasive recurrence, distant recurrence, death from any causes. If a subject has not had invasive disease or died at the time of data cut-off for this final analysis, IDFS was censored on the date of last follow-up.
- Secondary Outcome Measures
Name Time Method Breast Cancer-specific Mortality 10 years Patients who died from breast cancer
Overall Survival 10 years Number of patients who died from any causes.
Distant Relapse-free Survival 5 years Distant Relapse Free Survival (DRFS) is defined as the percentage of patients without any documented distant recurrence, death from breast cancer, death from a non breast cancer cause or death from an unknown cause. If a subject has not had distant DRFS event nor died at the time of data cut-off for this analysis, DRFS will be censored on the date of last disease assessment.
Trial Locations
- Locations (343)
Kaiser Permanente-San Rafael
🇺🇸San Rafael, California, United States
The Vitalite Health Network - Dr. Leon Richard
🇨🇦Moncton, New Brunswick, Canada
Kaiser Permanente-Vallejo
🇺🇸Vallejo, California, United States
Michiana Hematology Oncology PC-Elkhart
🇺🇸Elkhart, Indiana, United States
Munson Medical Center
🇺🇸Traverse City, Michigan, United States
Mount Nittany Medical Center
🇺🇸State College, Pennsylvania, United States
Siouxland Hematology Oncology Associates
🇺🇸Sioux City, Iowa, United States
AnMed Health Cancer Center
🇺🇸Anderson, South Carolina, United States
Fox Chase Cancer Center
🇺🇸Philadelphia, Pennsylvania, United States
University of California at Los Angeles (UCLA )
🇺🇸Los Angeles, California, United States
Mount Sinai Hospital Medical Center
🇺🇸Chicago, Illinois, United States
John H Stroger Jr Hospital of Cook County
🇺🇸Chicago, Illinois, United States
Resurrection Healthcare
🇺🇸Chicago, Illinois, United States
University of Chicago
🇺🇸Chicago, Illinois, United States
Ohio State University Medical Center
🇺🇸Columbus, Ohio, United States
Case Western Reserve University
🇺🇸Cleveland, Ohio, United States
Cleveland Clinic Foundation
🇺🇸Cleveland, Ohio, United States
Virginia Mason CCOP
🇺🇸Seattle, Washington, United States
Pacific Medical Center-First Hill
🇺🇸Seattle, Washington, United States
University of Washington Medical Center
🇺🇸Seattle, Washington, United States
Indiana University Hospital/Melvin and Bren Simon Cancer Center
🇺🇸Indianapolis, Indiana, United States
Kaiser Permanente-Mission
🇺🇸San Diego, California, United States
University of Texas Health Science Center
🇺🇸San Antonio, Texas, United States
Stamford Hospital
🇺🇸Stamford, Connecticut, United States
Illinois Oncology Research Association CCOP
🇺🇸Peoria, Illinois, United States
Washington Hospital Center
🇺🇸Washington, District of Columbia, United States
Evanston CCOP-NorthShore University HealthSystem
🇺🇸Evanston, Illinois, United States
Fairbanks Memorial Hospital
🇺🇸Fairbanks, Alaska, United States
Mayo Clinic in Florida
🇺🇸Jacksonville, Florida, United States
Michiana Hematology Oncology PC-Niles
🇺🇸Niles, Michigan, United States
Eastern Maine Medical Center
🇺🇸Bangor, Maine, United States
University of Maryland Greenebaum Cancer Center
🇺🇸Baltimore, Maryland, United States
Beth Israel Deaconess Medical Center
🇺🇸Boston, Massachusetts, United States
Trinity Medical Center
🇺🇸Moline, Illinois, United States
Georgetown University Hospital
🇺🇸Washington, District of Columbia, United States
Phoebe Putney Memorial Hospital
🇺🇸Albany, Georgia, United States
Illinois CancerCare-Peoria
🇺🇸Peoria, Illinois, United States
Boca Raton Regional Hospital
🇺🇸Boca Raton, Florida, United States
Michiana Hematology Oncology PC-Mishawaka
🇺🇸Mishawaka, Indiana, United States
Mary Bird Perkins Cancer Center
🇺🇸Baton Rouge, Louisiana, United States
Heartland Oncology and Hematology LLP
🇺🇸Council Bluffs, Iowa, United States
Sibley Memorial Hospital
🇺🇸Washington, District of Columbia, United States
Rush - Copley Medical Center
🇺🇸Aurora, Illinois, United States
Elkhart Clinic
🇺🇸Elkhart, Indiana, United States
McFarland Clinic
🇺🇸Ames, Iowa, United States
York Hospital
🇺🇸York, Maine, United States
Elmhurst Memorial Hospital
🇺🇸Elmhurst, Illinois, United States
Oncology Associates at Mercy Medical Center
🇺🇸Cedar Rapids, Iowa, United States
Saint Anthony Memorial Health Center
🇺🇸Michigan City, Indiana, United States
Saint Francis Hospital
🇺🇸Evanston, Illinois, United States
Mount Sinai Medical Center CCOP
🇺🇸Miami Beach, Florida, United States
Howard Regional Healthcare System
🇺🇸Kokomo, Indiana, United States
Loyola University Medical Center
🇺🇸Maywood, Illinois, United States
Carle Foundation - Carle Cancer Center
🇺🇸Urbana, Illinois, United States
Connecticut Oncology and Hematology LLP
🇺🇸Torrington, Connecticut, United States
Michiana Hematology Oncology PC-Plymouth
🇺🇸Plymouth, Indiana, United States
CentraCare Clinic
🇺🇸Saint Cloud, Minnesota, United States
Saint Luke's Hospital
🇺🇸Chesterfield, Missouri, United States
Spectrum Health at Butterworth Campus
🇺🇸Grand Rapids, Michigan, United States
State University of New York Upstate Medical University
🇺🇸Syracuse, New York, United States
Mercy Health Partners-Mercy Campus
🇺🇸Muskegon, Michigan, United States
Ottumwa Regional Health Center
🇺🇸Ottumwa, Iowa, United States
Minnesota Oncology and Hematology PA-Woodbury
🇺🇸Woodbury, Minnesota, United States
Johns Hopkins University
🇺🇸Baltimore, Maryland, United States
Cox Medical Center
🇺🇸Springfield, Missouri, United States
Grand Rapids Clinical Oncology Program
🇺🇸Grand Rapids, Michigan, United States
Lowell General Hospital
🇺🇸Lowell, Massachusetts, United States
Missouri Baptist Medical Center
🇺🇸Saint Louis, Missouri, United States
Singing River Hospital
🇺🇸Pascagoula, Mississippi, United States
Abbott-Northwestern Hospital
🇺🇸Minneapolis, Minnesota, United States
Good Samaritan Hospital
🇺🇸Kearney, Nebraska, United States
Presbyterian Kaseman Hospital
🇺🇸Albuquerque, New Mexico, United States
Maimonides Medical Center
🇺🇸Brooklyn, New York, United States
Lincoln Medical Education Foundation Cancer Resource Center
🇺🇸Lincoln, Nebraska, United States
Fairview-Southdale Hospital
🇺🇸Edina, Minnesota, United States
The Dana-Farber Cancer Institute at Londonderry
🇺🇸Londonderry, New Hampshire, United States
University of Mississippi Medical Center
🇺🇸Jackson, Mississippi, United States
Mount Sinai Medical Center
🇺🇸New York, New York, United States
Duluth Clinic CCOP
🇺🇸Duluth, Minnesota, United States
Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington County
🇺🇸Mount Holly, New Jersey, United States
Wayne Memorial Hospital
🇺🇸Goldsboro, North Carolina, United States
Mission Hospitals Inc
🇺🇸Asheville, North Carolina, United States
Avera Cancer Institute
🇺🇸Sioux Falls, South Dakota, United States
Long Island Jewish Medical Center
🇺🇸New Hyde Park, New York, United States
Akron City Hospital
🇺🇸Akron, Ohio, United States
High Point Regional Hospital
🇺🇸High Point, North Carolina, United States
Saint Joseph Medical Center
🇺🇸Reading, Pennsylvania, United States
LRGHealthcare-Lakes Region General Hospital
🇺🇸Laconia, New Hampshire, United States
Sanford Medical Center-Fargo
🇺🇸Fargo, North Dakota, United States
Kinston Medical Specialists PA
🇺🇸Kinston, North Carolina, United States
Mid Dakota Clinic
🇺🇸Bismarck, North Dakota, United States
State University of New York Downstate Medical Center
🇺🇸Brooklyn, New York, United States
Bryn Mawr Hospital
🇺🇸Bryn Mawr, Pennsylvania, United States
New Hampshire Oncology-Hematology PA
🇺🇸Concord, New Hampshire, United States
New Hampshire Oncology Hematology Associates
🇺🇸Hooksett, New Hampshire, United States
Mount Kisco Medical Group
🇺🇸Mount Kisco, New York, United States
Cross Cancer Institute
🇨🇦Edmonton, Alberta, Canada
FirstHealth of the Carolinas-Moore Regional Hosiptal
🇺🇸Pinehurst, North Carolina, United States
Spartanburg Regional Medical Center
🇺🇸Spartanburg, South Carolina, United States
Medcenter One Health Systems
🇺🇸Bismarck, North Dakota, United States
Martha Jefferson Hospital
🇺🇸Charlottesville, Virginia, United States
Doctor's Hospital of Laredo
🇺🇸Laredo, Texas, United States
Women and Infants Hospital
🇺🇸Providence, Rhode Island, United States
Lancaster General Hospital
🇺🇸Lancaster, Pennsylvania, United States
MetroHealth Medical Center
🇺🇸Cleveland, Ohio, United States
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
🇺🇸Yakima, Washington, United States
Group Health Cooperative
🇺🇸Seattle, Washington, United States
Phoenixville Hospital
🇺🇸Phoenixville, Pennsylvania, United States
Wenatchee Valley Medical Center
🇺🇸Wenatchee, Washington, United States
University of Vermont
🇺🇸Burlington, Vermont, United States
Sanford Clinic
🇺🇸Sioux Falls, South Dakota, United States
Rockwood Clinic
🇺🇸Spokane, Washington, United States
Trillium Health Centre - West Toronto
🇨🇦Toronto, Ontario, Canada
Hopital de la Cite-de-la-Sante
🇨🇦Laval, Quebec, Canada
Medway NHS Foundation Trust
🇬🇧Gillingham, Kent, United Kingdom
Wichita CCOP
🇺🇸Wichita, Kansas, United States
Kansas City CCOP
🇺🇸Prairie Village, Kansas, United States
Kaiser Permanente-San Francisco
🇺🇸San Francisco, California, United States
University of California San Francisco Medical Center-Mount Zion
🇺🇸San Francisco, California, United States
Vanderbilt Breast Center at One Hundred Oaks
🇺🇸Nashville, Tennessee, United States
Vanderbilt University
🇺🇸Nashville, Tennessee, United States
Huntsman Cancer Institute/University of Utah
🇺🇸Salt Lake City, Utah, United States
University of Southern California
🇺🇸Los Angeles, California, United States
Saint Barnabas Medical Center
🇺🇸Livingston, New Jersey, United States
North Shore University Hospital
🇺🇸Manhasset, New York, United States
Switzerland - Brust-Zentrum, Zurich
🇨ðŸ‡Zurich, Switzerland
University of New Mexico
🇺🇸Albuquerque, New Mexico, United States
Washington University School of Medicine
🇺🇸Saint Louis, Missouri, United States
University of Pittsburgh
🇺🇸Pittsburgh, Pennsylvania, United States
The Moncton Hospital
🇨🇦Moncton, New Brunswick, Canada
Switzerland-Chur (Ratisches Kantons- und Regionalspital)
🇨ðŸ‡Chur, Switzerland
Brustzentrum Thurgau, Spital Thurgau AG
🇨ðŸ‡Frauenfeld, Switzerland
Rochester General Hospital
🇺🇸Rochester, New York, United States
BCCA - Cancer Centre for the Southern Interior
🇨🇦Kelowna, British Columbia, Canada
BCCA - Vancouver Island Cancer Centre
🇨🇦Victoria, British Columbia, Canada
Atlantic Health Sciences Corporation
🇨🇦Saint John, New Brunswick, Canada
BCCA - Abbotsford Centre
🇨🇦Abbotsford, British Columbia, Canada
Switzerland - Olten (Kantonsspital) affiliate-3101
🇨ðŸ‡Olten, Switzerland
Brighton and Sussex University Hospitals NHS Trust
🇬🇧Brighton, East Sussex, United Kingdom
Withybush General Hospital
🇬🇧Haverfordwest, Pembrokeshire, United Kingdom
Kaiser Permanente
🇺🇸Portland, Oregon, United States
Wayne State University
🇺🇸Detroit, Michigan, United States
Legacy Good Samaritan Hospital and Medical Center
🇺🇸Portland, Oregon, United States
Columbia River Oncology Program
🇺🇸Portland, Oregon, United States
Oregon Health and Science University
🇺🇸Portland, Oregon, United States
McGill University - Dept. Oncology
🇨🇦Montreal, Quebec, Canada
CHUM - Hotel Dieu du Montreal
🇨🇦Montreal, Quebec, Canada
Mayo Clinic
🇺🇸Rochester, Minnesota, United States
Missouri Valley Cancer Consortium CCOP
🇺🇸Omaha, Nebraska, United States
Methodist Estabrook Cancer Center
🇺🇸Omaha, Nebraska, United States
Wheaton Franciscan Healthcare - Saint Joseph
🇺🇸Milwaukee, Wisconsin, United States
Columbia Saint Mary's Water Tower Medical Commons
🇺🇸Milwaukee, Wisconsin, United States
Saint John's Mercy Medical Center
🇺🇸Saint Louis, Missouri, United States
Trinity Cancer Care Center
🇺🇸Minot, North Dakota, United States
North Shore University Hospital CCOP
🇺🇸Manhasset, New York, United States
Monter Cancer Center
🇺🇸Lake Success, New York, United States
Mount Kisco Medical Group at Northern Westchester Hospital
🇺🇸Mount Kisco, New York, United States
Beth Israel Medical Center
🇺🇸New York, New York, United States
Columbia University Medical Center
🇺🇸New York, New York, United States
Stony Brook University Medical Center
🇺🇸Stony Brook, New York, United States
Metro-Minnesota CCOP
🇺🇸Saint Louis Park, Minnesota, United States
Park Nicollet Clinic - Saint Louis Park
🇺🇸Saint Louis Park, Minnesota, United States
University of Colorado Cancer Center - Anschutz Cancer Pavilion
🇺🇸Aurora, Colorado, United States
Moffitt Cancer Center and Research Institute
🇺🇸Tampa, Florida, United States
Suburban Hospital
🇺🇸Bethesda, Maryland, United States
Memorial Medical Center
🇺🇸Springfield, Illinois, United States
Chester County Hospital
🇺🇸West Chester, Pennsylvania, United States
Geisinger Medical Center
🇺🇸Danville, Pennsylvania, United States
McLeod Regional Medical Center
🇺🇸Florence, South Carolina, United States
Saint Vincent Hospital - Fallon Clinic
🇺🇸Worcester, Massachusetts, United States
Metro Health Hospital
🇺🇸Wyoming, Michigan, United States
Providence Alaska Medical Center
🇺🇸Anchorage, Alaska, United States
Mayo Clinic in Arizona
🇺🇸Scottsdale, Arizona, United States
Pinnacle Oncology Associates
🇺🇸Scottsdale, Arizona, United States
Alta Bates Summit Medical Center-Herrick Campus
🇺🇸Berkeley, California, United States
Kaiser Permanente-Deer Valley Medical Center
🇺🇸Antioch, California, United States
Glendale Memorial Hospital and Health Center
🇺🇸Glendale, California, United States
Enloe Medical Center
🇺🇸Chico, California, United States
Moores University of California San Diego Cancer Center
🇺🇸La Jolla, California, United States
Long Beach Memorial Medical Center-Todd Cancer Institute
🇺🇸Long Beach, California, United States
Kaiser Permanente, Hayward
🇺🇸Hayward, California, United States
Bay Area Tumor Institution CCOP
🇺🇸Oakland, California, United States
Fremont - Rideout Cancer Center
🇺🇸Marysville, California, United States
University of California Medical Center At Irvine-Orange Campus
🇺🇸Orange, California, United States
Kaiser Permanente-Oakland
🇺🇸Oakland, California, United States
Pomona Valley Hospital Medical Center
🇺🇸Pomona, California, United States
Kaiser Permanente-Redwood City
🇺🇸Redwood City, California, United States
Kaiser Permanente-Roseville
🇺🇸Roseville, California, United States
University of Arizona Health Sciences Center
🇺🇸Tucson, Arizona, United States
Kaiser Permanente-Santa Teresa-San Jose
🇺🇸San Jose, California, United States
Mercy Hospital
🇺🇸Coon Rapids, Minnesota, United States
Kaiser Permanente-Santa Rosa
🇺🇸Santa Rosa, California, United States
Kaiser Permanente-Richmond
🇺🇸Richmond, California, United States
Kaiser Permanente Medical Center - Santa Clara
🇺🇸Santa Clara, California, United States
Kaiser Permanente-South San Francisco
🇺🇸South San Francisco, California, United States
Tahoe Forest Cancer Center
🇺🇸Truckee, California, United States
Stanford University
🇺🇸Stanford, California, United States
Kaiser Permanente-Stockton
🇺🇸Stockton, California, United States
Kaiser Permanente Medical Center-Vacaville
🇺🇸Vacaville, California, United States
John Muir Medical Center
🇺🇸Walnut Creek, California, United States
Kaiser Permanente-Walnut Creek
🇺🇸Walnut Creek, California, United States
Memorial Hospital Colorado Springs
🇺🇸Colorado Springs, Colorado, United States
Arizona Cancer Center at University Medical Center North
🇺🇸Tucson, Arizona, United States
Saint John Medical Center
🇺🇸Longview, Washington, United States
Pennsylvania Hospital
🇺🇸Philadelphia, Pennsylvania, United States
Kaiser Permanente-Franklin
🇺🇸Denver, Colorado, United States
Poudre Valley Hospital
🇺🇸Fort Collins, Colorado, United States
Front Range Cancer Specialists
🇺🇸Fort Collins, Colorado, United States
University of Connecticut
🇺🇸Farmington, Connecticut, United States
Greenwich Hospital
🇺🇸Greenwich, Connecticut, United States
Hartford Hospital
🇺🇸Hartford, Connecticut, United States
Albert Einstein Medical Center
🇺🇸Philadelphia, Pennsylvania, United States
Northwest CCOP
🇺🇸Tacoma, Washington, United States
Lynchburg Hematology-Oncology Clinic
🇺🇸Lynchburg, Virginia, United States
Providence Saint Mary Regional Cancer Center
🇺🇸Walla Walla, Washington, United States
The Watson Clinic
🇺🇸Lakeland, Florida, United States
Northeast Georgia Medical Center
🇺🇸Gainesville, Georgia, United States
South Georgia Medical Center
🇺🇸Valdosta, Georgia, United States
Swedish Covenant Hospital
🇺🇸Chicago, Illinois, United States
Decatur Memorial Hospital
🇺🇸Decatur, Illinois, United States
Ingalls Memorial Hospital
🇺🇸Harvey, Illinois, United States
Michiana Hematology Oncology PC-South Bend
🇺🇸South Bend, Indiana, United States
Michiana Hematology Oncology-PC Westville
🇺🇸Westville, Indiana, United States
Owensboro Mercy Medical Center
🇺🇸Owensboro, Kentucky, United States
Central Baptist Hospital
🇺🇸Lexington, Kentucky, United States
Dana-Farber Cancer Institute
🇺🇸Boston, Massachusetts, United States
Frederick Memorial Hospital
🇺🇸Frederick, Maryland, United States
Mercy Medical Center
🇺🇸Baltimore, Maryland, United States
Addison Gilbert Hospital
🇺🇸Gloucester, Massachusetts, United States
Lahey Clinic Medical Center
🇺🇸Burlington, Massachusetts, United States
Saint Mary's Health Care
🇺🇸Grand Rapids, Michigan, United States
West Michigan Cancer Center
🇺🇸Kalamazoo, Michigan, United States
Battle Creek Health System
🇺🇸Battle Creek, Michigan, United States
Marie Yeager Cancer Center
🇺🇸Saint Joseph, Michigan, United States
Unity Hospital
🇺🇸Fridley, Minnesota, United States
Saint John's Hospital - Healtheast
🇺🇸Maplewood, Minnesota, United States
North Memorial Medical Health Center
🇺🇸Robbinsdale, Minnesota, United States
Minnesota Oncology Hematology PA-Maplewood
🇺🇸Maplewood, Minnesota, United States
Rice Memorial Hospital
🇺🇸Willmar, Minnesota, United States
Regions Hospital
🇺🇸Saint Paul, Minnesota, United States
United Hospital
🇺🇸Saint Paul, Minnesota, United States
Saint Louis-Cape Girardeau CCOP
🇺🇸Saint Louis, Missouri, United States
Saint John's Hospital
🇺🇸Springfield, Missouri, United States
Dartmouth Hitchcock Medical Center
🇺🇸Lebanon, New Hampshire, United States
Valley Hospital
🇺🇸Ridgewood, New Jersey, United States
Roswell Park Cancer Institute
🇺🇸Buffalo, New York, United States
Coney Island Hospital
🇺🇸Brooklyn, New York, United States
Hematology Oncology Associates of Central New York PC
🇺🇸East Syracuse, New York, United States
Saint Luke's Roosevelt Hospital Center - Saint Luke's Division
🇺🇸New York, New York, United States
New York University Langone Medical Center
🇺🇸New York, New York, United States
Margaret R Pardee Memorial Hospital
🇺🇸Hendersonville, North Carolina, United States
Rex Cancer Center
🇺🇸Raleigh, North Carolina, United States
Sanford Clinic North-Fargo
🇺🇸Fargo, North Dakota, United States
Altru Cancer Center
🇺🇸Grand Forks, North Dakota, United States
Akron General Medical Center
🇺🇸Akron, Ohio, United States
Aultman Health Foundation
🇺🇸Canton, Ohio, United States
Kettering Medical Center
🇺🇸Kettering, Ohio, United States
Penn State Milton S Hershey Medical Center
🇺🇸Hershey, Pennsylvania, United States
Paoli Memorial Hospital
🇺🇸Paoli, Pennsylvania, United States
Memorial Hospital of Rhode Island
🇺🇸Pawtucket, Rhode Island, United States
Lankenau Hospital
🇺🇸Wynnewood, Pennsylvania, United States
Rapid City Regional Hospital
🇺🇸Rapid City, South Dakota, United States
University of Tennessee - Knoxville
🇺🇸Knoxville, Tennessee, United States
Mountainview Medical
🇺🇸Berlin, Vermont, United States
Swedish Medical Center-First Hill
🇺🇸Seattle, Washington, United States
Wheeling Hospital
🇺🇸Wheeling, West Virginia, United States
Edwards Comprehensive Cancer Center
🇺🇸Huntington, West Virginia, United States
West Virginia University
🇺🇸Morgantown, West Virginia, United States
Central Wisconsin Cancer Program
🇺🇸Fond Du Lac, Wisconsin, United States
Saint Vincent Hospital
🇺🇸Green Bay, Wisconsin, United States
Aurora BayCare Medical Center
🇺🇸Green Bay, Wisconsin, United States
Marshfield Clinic Cancer Care at Regional Cancer Center
🇺🇸Eau Claire, Wisconsin, United States
Gundersen Lutheran Health System/CCOP
🇺🇸La Crosse, Wisconsin, United States
University of Wisconsin Hospital and Clinics
🇺🇸Madison, Wisconsin, United States
Columbia Saint Mary's Hospital - Ozaukee
🇺🇸Mequon, Wisconsin, United States
Marshfield Clinic
🇺🇸Marshfield, Wisconsin, United States
Marshfield Clinic - Weston Center
🇺🇸Weston, Wisconsin, United States
Aurora Medical Center in Summit
🇺🇸Summit, Wisconsin, United States
Marshfield Clinic-Minocqua Center
🇺🇸Minocqua, Wisconsin, United States
BCCA - Vancouver Cancer Centre
🇨🇦Vancouver, British Columbia, Canada
CancerCare Manitoba
🇨🇦Winnipeg, Manitoba, Canada
Dr. H. Bliss Murphy Cancer Centre
🇨🇦St. John's, Newfoundland and Labrador, Canada
Cambridge Memorial Hospital
🇨🇦Cambridge, Ontario, Canada
Juravinski Cancer Centre at Hamilton Health Sciences
🇨🇦Hamilton, Ontario, Canada
Cancer Centre of Southeastern Ontario at Kingston
🇨🇦Kingston, Ontario, Canada
Credit Valley Hospital
🇨🇦Mississauga, Ontario, Canada
Stronach Regional Health Centre at Southlake
🇨🇦Newmarket, Ontario, Canada
London Regional Cancer Program
🇨🇦London, Ontario, Canada
Grand River Regional Cancer Centre
🇨🇦Kitchener, Ontario, Canada
Ottawa Health Research Institute - General Division
🇨🇦Ottawa, Ontario, Canada
Lakeridge Health Oshawa
🇨🇦Oshawa, Ontario, Canada
Northeast Cancer Center Health Sciences
🇨🇦Sudbury, Ontario, Canada
Algoma District Cancer Program
🇨🇦Sault Ste. Marie, Ontario, Canada
Toronto East General Hospital
🇨🇦Toronto, Ontario, Canada
Niagara Health System
🇨🇦St. Catharines, Ontario, Canada
Thunder Bay Regional Health Science Centre
🇨🇦Thunder Bay, Ontario, Canada
Odette Cancer Centre
🇨🇦Toronto, Ontario, Canada
St. Michael's Hospital
🇨🇦Toronto, Ontario, Canada
Mount Sinai Hospital
🇨🇦Toronto, Ontario, Canada
Univ. Health Network-Princess Margaret Hospital
🇨🇦Toronto, Ontario, Canada
Switzerland - ZeTup St.Gallen
🇨ðŸ‡St. Gallen, Switzerland
PEI Cancer Treatment Centre,Queen Elizabeth Hospital
🇨🇦Charlottetown, Prince Edward Island, Canada
Hopital Maisonneuve-Rosemont
🇨🇦Montreal, Quebec, Canada
Windsor Regional Cancer Centre
🇨🇦Windsor, Ontario, Canada
Hopital Charles LeMoyne
🇨🇦Greenfield Park, Quebec, Canada
Allan Blair Cancer Centre
🇨🇦Regina, Saskatchewan, Canada
Saskatoon Cancer Centre
🇨🇦Saskatoon, Saskatchewan, Canada
CHUQ-Pavillon Hotel-Dieu de Quebec
🇨🇦Quebec City, Quebec, Canada
CHA-Hopital Du St-Sacrement
🇨🇦Quebec City, Quebec, Canada
Fondazione Oncologia Lago Maggiore, FOLM
🇨ðŸ‡Locarno, Switzerland
University Hospital Birmingham NHS Foundation Trust
🇬🇧Edgbaston, Birmingham, United Kingdom
Switzerland - Oncology Institute of Southern Switzerland (IOSI)
🇨ðŸ‡Mendrisio, Switzerland
Switzerland-Luzern (Kantonsspital Luzern)
🇨ðŸ‡Luzern 16, Switzerland
Edinburgh Cancer Centre, Western General Hospital
🇬🇧Edinburgh, Crewe Road South, United Kingdom
Kent Centre for Oncology
🇬🇧Maidstone, Kent, United Kingdom
South Tees Hospitals NHS Foundation Trust
🇬🇧Middlesborough, Marton Road, United Kingdom
East and North Hertfordshire NHS Trust
🇬🇧Middlesex, Rickmansworth Road, United Kingdom
Singleton Hospital
🇬🇧Swansea, Sketty Lane, United Kingdom
North Bristol NHS Trust
🇬🇧Bristol, Southmead, United Kingdom
The Christie NHS Foundation Trust
🇬🇧Manchester, Withington, United Kingdom
St George's Healthcare NHS Trust
🇬🇧London, Tooting, United Kingdom
Ninewells Hospital
🇬🇧Dundee, University Of Dundee, United Kingdom
Velindre Cancer Centre
🇬🇧Cardiff, Whitchurch, United Kingdom
Sandwell and West Birmingham Hospitals NHS Trust
🇬🇧Birmingham, United Kingdom
University of California Davis-Cancer Center
🇺🇸Sacramento, California, United States
Kaiser Permanente-South Sacramento
🇺🇸Sacramento, California, United States
Kaiser Permanente - Sacramento
🇺🇸Sacramento, California, United States
Forsyth Memorial Hospital
🇺🇸Winston-Salem, North Carolina, United States
University of Michigan Health System-Cancer Center
🇺🇸Ann Arbor, Michigan, United States
Wake Forest University Health Sciences
🇺🇸Winston-Salem, North Carolina, United States
Florida Hospital
🇺🇸Orlando, Florida, United States
William Beaumont Hospital
🇺🇸Royal Oak, Michigan, United States
Yale University
🇺🇸New Haven, Connecticut, United States
Medical University of South Carolina
🇺🇸Charleston, South Carolina, United States
University Medical Center Brackenridge
🇺🇸Austin, Texas, United States
University of Hawaii
🇺🇸Honolulu, Hawaii, United States
Kaiser Permanente Moanalua Medical Center
🇺🇸Honolulu, Hawaii, United States
Albert Einstein College of Medicine
🇺🇸Bronx, New York, United States
The North Division of Montefiore Medical Center
🇺🇸Bronx, New York, United States
Presbyterian Hospital
🇺🇸Charlotte, North Carolina, United States
BCCA - Fraser Valley Cancer Centre
🇨🇦Surrey, British Columbia, Canada
Montefiore Medical Center
🇺🇸Bronx, New York, United States
Rhode Island Hospital
🇺🇸Providence, Rhode Island, United States