S0809: Capecitabine, Gemcitabine, and RT in Patients w/Cholangiocarcinoma of the Gallbladder or Bile Duct
- Conditions
- Gallbladder CancerExtrahepatic Bile Duct Cancer
- Interventions
- Drug: capecitabineDrug: gemcitabine hydrochlorideRadiation: 3-dimensional conformal radiation therapyRadiation: intensity-modulated radiation therapy
- Registration Number
- NCT00789958
- Lead Sponsor
- SWOG Cancer Research Network
- Brief Summary
RATIONALE: Drugs used in chemotherapy, such as capecitabine and gemcitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. Giving more than one drug (combination chemotherapy) together with radiation therapy may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving capecitabine together with gemcitabine followed by capecitabine and radiation therapy works in treating patients with cholangiocarcinoma of the gallbladder or bile duct.
- Detailed Description
OBJECTIVES:
* To estimate the stratum-specific (R0 and R1) and overall 2-year survival probabilities of patients with extrahepatic cholangiocarcinoma treated with adjuvant chemotherapy comprising capecitabine and gemcitabine hydrochloride, followed by capecitabine and radiotherapy. (R0 stratum closed as of 12-15-11)
* To estimate the 2-year stratum-specific and overall disease-free survival and local disease-free survival of patients treated with this regimen.
* To assess the frequency and severity of toxicity in patients treated with this regimen.
OUTLINE: This is a multicenter study. Patients are stratified according to margin of resection (negative \[R0\] vs microscopically positive \[R1\]). (R0 stratum closed as of 12-15-11)
* Adjuvant chemotherapy: Patients receive oral capecitabine every 12 hours on days 1-14 and gemcitabine hydrochloride IV over 30 minutes on days 1 and 8. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity.
* Chemoradiotherapy: Beginning in week 13, patients receive oral capecitabine every 12 hours on days 1-7. Patients also undergo concurrent three-dimensional or intensity-modulated radiotherapy on days 1-5. Treatment repeats weekly for 5-6 weeks in the absence of disease progression or unacceptable toxicity.
After completion of study therapy patients are followed periodically for up to 5 years.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 105
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Adjuvant Chemo+ Chemoradiotherapy 3-dimensional conformal radiation therapy Adjuvant Chemotherapy * Capecitabine, 1500 mg/m\^2/day, PO, Every 12 hrs on Days 1-14 of each cycle * Gemcitabine hydrochloride, 1000 mg/m\^2, IV, Days 1 \& 8 of each cycle Chemoradiotherapy -Capecitabine, 1330 mg/m\^2/day, PO, Every 12 hrs, 7 days per week beginning the first day of RT and finishing the last day of RT Radiation (RT): 3-dimensional conformal radiation therapy - 4,500 cGy over 5 weeks (5 days/week) in 180 cGy/fraction + 900 cGy during week 1 in 180 cGy fractions. intensity-modulated radiation therapy: 4,500 cGy over 5 weeks (5 days/week) in 180 cGy/fraction + 5,250 cGy in 210 cGy/fraction for a total of 25 fractions. Adjuvant Chemo+ Chemoradiotherapy gemcitabine hydrochloride Adjuvant Chemotherapy * Capecitabine, 1500 mg/m\^2/day, PO, Every 12 hrs on Days 1-14 of each cycle * Gemcitabine hydrochloride, 1000 mg/m\^2, IV, Days 1 \& 8 of each cycle Chemoradiotherapy -Capecitabine, 1330 mg/m\^2/day, PO, Every 12 hrs, 7 days per week beginning the first day of RT and finishing the last day of RT Radiation (RT): 3-dimensional conformal radiation therapy - 4,500 cGy over 5 weeks (5 days/week) in 180 cGy/fraction + 900 cGy during week 1 in 180 cGy fractions. intensity-modulated radiation therapy: 4,500 cGy over 5 weeks (5 days/week) in 180 cGy/fraction + 5,250 cGy in 210 cGy/fraction for a total of 25 fractions. Adjuvant Chemo+ Chemoradiotherapy intensity-modulated radiation therapy Adjuvant Chemotherapy * Capecitabine, 1500 mg/m\^2/day, PO, Every 12 hrs on Days 1-14 of each cycle * Gemcitabine hydrochloride, 1000 mg/m\^2, IV, Days 1 \& 8 of each cycle Chemoradiotherapy -Capecitabine, 1330 mg/m\^2/day, PO, Every 12 hrs, 7 days per week beginning the first day of RT and finishing the last day of RT Radiation (RT): 3-dimensional conformal radiation therapy - 4,500 cGy over 5 weeks (5 days/week) in 180 cGy/fraction + 900 cGy during week 1 in 180 cGy fractions. intensity-modulated radiation therapy: 4,500 cGy over 5 weeks (5 days/week) in 180 cGy/fraction + 5,250 cGy in 210 cGy/fraction for a total of 25 fractions. Adjuvant Chemo+ Chemoradiotherapy capecitabine Adjuvant Chemotherapy * Capecitabine, 1500 mg/m\^2/day, PO, Every 12 hrs on Days 1-14 of each cycle * Gemcitabine hydrochloride, 1000 mg/m\^2, IV, Days 1 \& 8 of each cycle Chemoradiotherapy -Capecitabine, 1330 mg/m\^2/day, PO, Every 12 hrs, 7 days per week beginning the first day of RT and finishing the last day of RT Radiation (RT): 3-dimensional conformal radiation therapy - 4,500 cGy over 5 weeks (5 days/week) in 180 cGy/fraction + 900 cGy during week 1 in 180 cGy fractions. intensity-modulated radiation therapy: 4,500 cGy over 5 weeks (5 days/week) in 180 cGy/fraction + 5,250 cGy in 210 cGy/fraction for a total of 25 fractions.
- Primary Outcome Measures
Name Time Method Stratum-specific (R0 and R1) 2-year Overall Survival Up to 2 years from registration Time to death is calculated from date of registration to date of death due to any cause. Patients last known to be alive are censored at date of last contact.
- Secondary Outcome Measures
Name Time Method 2-year Stratum-specific Local Relapse Rate Up to 2 years from registration Local relapse is any evidence of new disease within the primary tumor bed or the regional (retroperitoneal, celiac, and portal vein nodes) lymphatics (these areas are to be encompassed within the radiation fields).
2-year Overall Local Relapse Rate Up to 2 years from registration Local relapse is any evidence of new disease within the primary tumor bed or the regional (retroperitoneal, celiac, and portal vein nodes) lymphatics (these areas are to be encompassed within the radiation fields).
Number of Patients With Grade 3 Through Grade 5 Adverse Events That Are Related to Study Drug Up to 5 years Only adverse events that are possibly, probably or definitely related to study drug are reported.
2-year Overall Survival for All Patients Up to 2 years from registration Time to death is calculated from date of registration to date of death due to any cause. Patients last known to be alive are censored at date of last contact.
2-year Stratum-specific Disease-free Survival Up to 2 years from registration Disease-free survival is calculated from date of registration to date of first documentation of relapse or death due to any cause. Patients last known to be alive are censored at date of last contact.
2-year Disease-free Survival in All Patients Up to 2 years from registration Disease-free survival is calculated from date of registration to date of first documentation of relapse or death due to any cause. Patients last known to be alive are censored at date of last contact.
Trial Locations
- Locations (251)
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
🇺🇸Baltimore, Maryland, United States
Memorial Sloan-Kettering Cancer Center - Rockville Centre
🇺🇸Rockville Centre, New York, United States
Great Falls Clinic - Main Facility
🇺🇸Great Falls, Montana, United States
Kalispell Regional Medical Center
🇺🇸Kalispell, Montana, United States
Montana Cancer Specialists at Montana Cancer Center
🇺🇸Missoula, Montana, United States
Memorial Sloan-Kettering Cancer Center - Basking Ridge
🇺🇸Basking Ridge, New Jersey, United States
Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton
🇺🇸Marlton, New Jersey, United States
Cancer Institute of New Jersey at Cooper - Voorhees
🇺🇸Voorhees, New Jersey, United States
Fox Chase Virtua Health Cancer Program at Virtua West Jersey
🇺🇸Voorhees, New Jersey, United States
Memorial Sloan-Kettering Cancer Center
🇺🇸Commack, New York, United States
UPMC Cancer Centers
🇺🇸Pittsburgh, Pennsylvania, United States
M. D. Anderson Cancer Center at University of Texas
🇺🇸Houston, Texas, United States
Harborview Medical Center
🇺🇸Seattle, Washington, United States
Fred Hutchinson Cancer Research Center
🇺🇸Seattle, Washington, United States
Group Health Central Hospital
🇺🇸Seattle, Washington, United States
University Cancer Center at University of Washington Medical Center
🇺🇸Seattle, Washington, United States
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
🇺🇸Minneapolis, Minnesota, United States
Hennepin County Medical Center - Minneapolis
🇺🇸Minneapolis, Minnesota, United States
California Pacific Medical Center - California Campus
🇺🇸San Francisco, California, United States
Utah Cancer Specialists at UCS Cancer Center
🇺🇸Salt Lake City, Utah, United States
Rebecca and John Moores UCSD Cancer Center
🇺🇸La Jolla, California, United States
Alta Bates Summit Comprehensive Cancer Center
🇺🇸Berkeley, California, United States
Chao Family Comprehensive Cancer Center at University of California Irvine Medical Center
🇺🇸Orange, California, United States
Sutter Pacific Medical Foundation
🇺🇸Santa Rosa, California, United States
Penrose Cancer Center at Penrose Hospital
🇺🇸Colorado Springs, Colorado, United States
Swedish Medical Center
🇺🇸Englewood, Colorado, United States
Sky Ridge Medical Center
🇺🇸Lone Tree, Colorado, United States
Hope Cancer Care Center at Longmont United Hospital
🇺🇸Longmont, Colorado, United States
Parker Adventist Hospital
🇺🇸Parker, Colorado, United States
St. Mary - Corwin Regional Medical Center
🇺🇸Pueblo, Colorado, United States
Piedmont Hospital
🇺🇸Atlanta, Georgia, United States
Washington Cancer Institute at Washington Hospital Center
🇺🇸Washington, District of Columbia, United States
Gwinnett Medical Center
🇺🇸Lawrenceville, Georgia, United States
John B. Amos Cancer Center
🇺🇸Columbus, Georgia, United States
Piedmont Fayette Hospital
🇺🇸Fayetteville, Georgia, United States
Charles B. Eberhart Cancer Center at DeKalb Medical Center
🇺🇸Decatur, Georgia, United States
Harbin Clinic Cancer Center - Medical Oncology
🇺🇸Rome, Georgia, United States
University of Chicago Cancer Research Center
🇺🇸Chicago, Illinois, United States
Decatur Memorial Hospital Cancer Care Institute
🇺🇸Decatur, Illinois, United States
Kellogg Cancer Care Center
🇺🇸Highland Park, 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
Edward Hospital Cancer Center
🇺🇸Naperville, Illinois, United States
Hematology Oncology Associates - Skokie
🇺🇸Skokie, Illinois, United States
Reid Hospital & Health Care Services
🇺🇸Richmond, Indiana, United States
Medical Oncology and Hematology Associates at Mercy Cancer Center
🇺🇸Des Moines, Iowa, United States
Medical Oncology and Hematology Associates at John Stoddard Cancer Center
🇺🇸Des Moines, Iowa, United States
Siouxland Hematology-Oncology Associates, LLP
🇺🇸Sioux City, Iowa, United States
St. Luke's Regional Medical Center
🇺🇸Sioux City, Iowa, United States
Lawrence Memorial Hospital
🇺🇸Lawrence, Kansas, United States
Cancer Center of Kansas, PA - Parsons
🇺🇸Parsons, Kansas, United States
Lahey Clinic Medical Center - Burlington
🇺🇸Burlington, Massachusetts, United States
Boston University Cancer Research Center
🇺🇸Boston, Massachusetts, United States
Mercy Memorial Hospital - Monroe
🇺🇸Monroe, Michigan, United States
Bronson Methodist Hospital
🇺🇸Kalamazoo, Michigan, United States
HealthEast Cancer Care at St. John's Hospital
🇺🇸Maplewood, Minnesota, United States
Hutchinson Area Health Care
🇺🇸Hutchinson, Minnesota, United States
CCOP - Metro-Minnesota
🇺🇸Saint Louis Park, Minnesota, United States
St. Francis Cancer Center at St. Francis Medical Center
🇺🇸Shakopee, Minnesota, United States
Regions Hospital Cancer Care Center
🇺🇸Saint Paul, Minnesota, United States
United Hospital
🇺🇸Saint Paul, Minnesota, United States
Lakeview Hospital
🇺🇸Stillwater, Minnesota, United States
Ridgeview Medical Center
🇺🇸Waconia, Minnesota, United States
Willmar Cancer Center at Rice Memorial Hospital
🇺🇸Willmar, Minnesota, United States
Minnesota Oncology - Woodbury
🇺🇸Woodbury, Minnesota, United States
University of Mississippi Cancer Clinic
🇺🇸Jackson, Mississippi, United States
Truman Medical Center - Hospital Hill
🇺🇸Kansas City, Missouri, United States
Kansas City Cancer Centers - East
🇺🇸Lee's Summit, Missouri, United States
Kansas City Cancer Centers - North
🇺🇸Kansas City, Missouri, United States
St. Vincent Healthcare Cancer Care Services
🇺🇸Billings, Montana, United States
Billings Clinic - Downtown
🇺🇸Billings, Montana, United States
Hematology-Oncology Centers of the Northern Rockies - Billings
🇺🇸Billings, Montana, United States
Blumenthal Cancer Center at Carolinas Medical Center
🇺🇸Charlotte, North Carolina, United States
Wayne Hospital
🇺🇸Greenville, Ohio, United States
St. Anne Mercy Hospital
🇺🇸Toledo, Ohio, United States
Providence St. Vincent Medical Center
🇺🇸Portland, Oregon, United States
Jon and Karen Huntsman Cancer Center at Intermountain Medical Center
🇺🇸Murray, Utah, United States
AnMed Cancer Center
🇺🇸Anderson, South Carolina, United States
Hollings Cancer Center at Medical University of South Carolina
🇺🇸Charleston, South Carolina, United States
Highline Medical Center Cancer Center
🇺🇸Burien, Washington, United States
Olympic Hematology and Oncology
🇺🇸Bremerton, Washington, United States
Southwest Washington Medical Center Cancer Center
🇺🇸Vancouver, Washington, United States
Rocky Mountain Oncology
🇺🇸Casper, Wyoming, United States
St. Rose Ambulatory and Surgery Center
🇺🇸Great Bend, Kansas, United States
Cancer Center of Kansas, PA - Salina
🇺🇸Salina, Kansas, United States
Mount Carmel Regional Cancer Center
🇺🇸Pittsburg, Kansas, United States
Cancer Center of Kansas-Independence
🇺🇸Independence, Kansas, United States
Via Christi Cancer Center at Via Christi Regional Medical Center
🇺🇸Wichita, Kansas, United States
Cancer Center of Kansas, PA - Wellington
🇺🇸Wellington, Kansas, United States
Kansas City Cancer Centers - West
🇺🇸Kansas City, Kansas, United States
St. Francis Comprehensive Cancer Center
🇺🇸Topeka, Kansas, United States
Cancer Center of Kansas, PA - Kingman
🇺🇸Kingman, Kansas, United States
Cancer Center of Kansas, PA - Liberal
🇺🇸Liberal, Kansas, United States
Cancer Center of Kansas, PA - Winfield
🇺🇸Winfield, Kansas, United States
Cancer Center of Kansas, PA - McPherson
🇺🇸McPherson, Kansas, United States
Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center
🇺🇸Kansas City, Kansas, United States
Cancer Center of Kansas, PA - Newton
🇺🇸Newton, Kansas, United States
St. Anthony Central Hospital
🇺🇸Denver, Colorado, United States
Porter Adventist Hospital
🇺🇸Denver, Colorado, United States
Presbyterian - St. Luke's Medical Center
🇺🇸Denver, Colorado, United States
St. Joseph Hospital
🇺🇸Denver, Colorado, United States
Rose Medical Center
🇺🇸Denver, Colorado, United States
CCOP - Colorado Cancer Research Program
🇺🇸Denver, Colorado, United States
Barbara Ann Karmanos Cancer Institute
🇺🇸Detroit, Michigan, United States
University of Colorado Cancer Center at UC Health Sciences Center
🇺🇸Aurora, Colorado, United States
Aurora Presbyterian Hospital
🇺🇸Aurora, Colorado, United States
St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center
🇺🇸Grand Junction, Colorado, United States
Shaw Regional Cancer Center
🇺🇸Edwards, Colorado, United States
Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
🇺🇸Little Rock, Arkansas, United States
Sutter Solano Medical Center
🇺🇸Vallejo, California, United States
North Colorado Medical Center
🇺🇸Greeley, Colorado, United States
Littleton Adventist Hospital
🇺🇸Littleton, Colorado, United States
Kaiser Permanente Medical Center - Los Angeles
🇺🇸Los Angeles, California, United States
Sutter Health - Western Division Cancer Research Group
🇺🇸Novato, California, United States
USC/Norris Comprehensive Cancer Center and Hospital
🇺🇸Los Angeles, California, United States
Peninsula Medical Center
🇺🇸Burlingame, California, United States
Boulder Community Hospital
🇺🇸Boulder, Colorado, United States
WellStar Cobb Hospital
🇺🇸Austell, Georgia, United States
McKee Medical Center
🇺🇸Loveland, Colorado, United States
Tunnell Cancer Center at Beebe Medical Center
🇺🇸Lewes, Delaware, United States
CCOP - Atlanta Regional
🇺🇸Atlanta, Georgia, United States
CCOP - Christiana Care Health Services
🇺🇸Newark, Delaware, United States
Northside Hospital Cancer Center
🇺🇸Atlanta, Georgia, United States
Exempla Lutheran Medical Center
🇺🇸Wheat Ridge, Colorado, United States
Kennestone Cancer Center at Wellstar Kennestone Hospital
🇺🇸Marietta, Georgia, United States
Cancer Center of Kansas, PA - Dodge City
🇺🇸Dodge City, Kansas, United States
Cancer Center of Kansas - Fort Scott
🇺🇸Fort Scott, Kansas, United States
Provena St. Mary's Regional Cancer Center - Kankakee
🇺🇸Kankakee, Illinois, United States
Lombardi Comprehensive Cancer Center at Georgetown University Medical Center
🇺🇸Washington, District of Columbia, United States
Saint Joseph's Hospital of Atlanta
🇺🇸Atlanta, Georgia, United States
Medical Center of Central Georgia
🇺🇸Macon, Georgia, United States
Robert H. Lurie Comprehensive Cancer Center at Northwestern University
🇺🇸Chicago, Illinois, United States
Hematology and Oncology Associates
🇺🇸Chicago, Illinois, United States
Medical Oncology and Hematology Associates - West Des Moines
🇺🇸Clive, Iowa, United States
John Stoddard Cancer Center at Iowa Methodist Medical Center
🇺🇸Des Moines, Iowa, United States
Cancer Center of Kansas, PA - Chanute
🇺🇸Chanute, Kansas, United States
Cancer Center of Kansas, PA - El Dorado
🇺🇸El Dorado, Kansas, United States
Hays Medical Center
🇺🇸Hays, Kansas, United States
Hutchinson Hospital Corporation
🇺🇸Hutchinson, Kansas, United States
Kansas City Cancer Center - Shawnee Mission
🇺🇸Shawnee Mission, Kansas, United States
CCOP - Ochsner
🇺🇸New Orleans, Louisiana, United States
Ochsner Cancer Institute at Ochsner Clinic Foundation
🇺🇸New Orleans, Louisiana, United States
Fairview Ridges Hospital
🇺🇸Burnsville, Minnesota, United States
Mercy and Unity Cancer Center at Unity Hospital
🇺🇸Fridley, Minnesota, United States
Kansas City Cancer Centers - Southwest
🇺🇸Overland Park, Kansas, United States
Cancer Center of Kansas, PA - Pratt
🇺🇸Pratt, Kansas, United States
Tammy Walker Cancer Center at Salina Regional Health Center
🇺🇸Salina, Kansas, United States
Union Hospital of Cecil County
🇺🇸Elkton, Maryland, United States
CCOP - Wichita
🇺🇸Wichita, Kansas, United States
Associates in Womens Health, PA - North Review
🇺🇸Wichita, Kansas, United States
Cancer Center of Kansas, PA - Medical Arts Tower
🇺🇸Wichita, Kansas, United States
Cancer Center of Kansas, PA - Wichita
🇺🇸Wichita, Kansas, United States
Fairview Southdale Hospital
🇺🇸Edina, Minnesota, United States
Mercy and Unity Cancer Center at Mercy Hospital
🇺🇸Coon Rapids, Minnesota, United States
Humphrey Cancer Center at North Memorial Outpatient Center
🇺🇸Robbinsdale, Minnesota, United States
Mid Dakota Clinic, PC
🇺🇸Bismarck, North Dakota, United States
Mayo Clinic Cancer Center
🇺🇸Rochester, Minnesota, United States
New Ulm Medical Center
🇺🇸New Ulm, Minnesota, United States
Minnesota Oncology - Maplewood
🇺🇸Maplewood, Minnesota, United States
Park Nicollet Cancer Center
🇺🇸Saint Louis Park, Minnesota, United States
CCOP - Hematology-Oncology Associates of Central New York
🇺🇸East Syracuse, New York, United States
Kansas City Cancer Centers - South
🇺🇸Kansas City, Missouri, United States
CCOP - Montana Cancer Consortium
🇺🇸Billings, Montana, United States
Tucker Center for Cancer Care at Orange Regional Medical Center
🇺🇸Middletown, New York, United States
Montana Cancer Center at St. Patrick Hospital and Health Sciences Center
🇺🇸Missoula, Montana, United States
SUNY Upstate Medical University Hospital
🇺🇸Syracuse, New York, United States
Charles M. Barrett Cancer Center at University Hospital
🇺🇸Cincinnati, Ohio, United States
Presbyterian Cancer Center at Presbyterian Hospital
🇺🇸Charlotte, North Carolina, United States
Grandview Hospital
🇺🇸Dayton, Ohio, United States
Wayne Memorial Hospital, Incorporated
🇺🇸Goldsboro, North Carolina, United States
Kalispell Medical Oncology at KRMC
🇺🇸Kalispell, Montana, United States
Summa Center for Cancer Care at Akron City Hospital
🇺🇸Akron, Ohio, United States
Rutherford Hospital
🇺🇸Rutherfordton, North Carolina, United States
Glacier Oncology, PLLC
🇺🇸Kalispell, Montana, United States
St. Peter's Hospital
🇺🇸Helena, Montana, United States
St. James Healthcare Cancer Care
🇺🇸Butte, Montana, United States
Sletten Cancer Institute at Benefis Healthcare
🇺🇸Great Falls, Montana, United States
David L. Rike Cancer Center at Miami Valley Hospital
🇺🇸Dayton, Ohio, United States
Barberton Citizens Hospital
🇺🇸Barberton, Ohio, United States
Memorial Sloan-Kettering Cancer Center at Phelps Memorial Hospital Center
🇺🇸Sleepy Hollow, New York, United States
Medcenter One Hospital Cancer Care Center
🇺🇸Bismarck, North Dakota, United States
Good Samaritan Hospital
🇺🇸Dayton, Ohio, United States
Samaritan North Cancer Care Center
🇺🇸Dayton, Ohio, United States
CCOP - Dayton
🇺🇸Dayton, Ohio, United States
Community Cancer Center
🇺🇸Elyria, Ohio, United States
Fox Chase Cancer Center - Philadelphia
🇺🇸Philadelphia, Pennsylvania, United States
CCOP - Upstate Carolina
🇺🇸Spartanburg, South Carolina, United States
Providence Milwaukie Hospital
🇺🇸Milwaukie, Oregon, United States
Hematology Oncology Center
🇺🇸Elyria, Ohio, United States
Lima Memorial Hospital
🇺🇸Lima, Ohio, United States
Providence Newberg Medical Center
🇺🇸Newberg, Oregon, United States
CCOP - Columbia River Oncology Program
🇺🇸Portland, Oregon, United States
Blanchard Valley Medical Associates
🇺🇸Findlay, Ohio, United States
Clackamas Radiation Oncology Center
🇺🇸Clackamas, Oregon, United States
Middletown Regional Hospital
🇺🇸Franklin, Ohio, United States
LDS Hospital
🇺🇸Salt Lake City, Utah, United States
Providence Cancer Center at Providence Portland Medical Center
🇺🇸Portland, Oregon, United States
Willamette Falls Hospital
🇺🇸Oregon City, Oregon, United States
Natalie Warren Bryant Cancer Center at St. Francis Hospital
🇺🇸Tulsa, Oklahoma, United States
Wenatchee Valley Medical Center
🇺🇸Wenatchee, Washington, United States
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center
🇺🇸Spartanburg, South Carolina, United States
Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
🇺🇸Seattle, Washington, United States
Cancer Care Northwest - Spokane South
🇺🇸Spokane, Washington, United States
Dixie Regional Medical Center - East Campus
🇺🇸Saint George, Utah, United States
Columbia Basin Hematology
🇺🇸Kennewick, Washington, United States
Fredericksburg Oncology, Incorporated
🇺🇸Fredericksburg, Virginia, United States
Northwest Cancer Specialists at Vancouver Cancer Center
🇺🇸Vancouver, Washington, United States
Lynchburg Hematology-Oncology Clinic
🇺🇸Lynchburg, Virginia, United States
Island Hospital Cancer Care Center at Island Hospital
🇺🇸Anacortes, Washington, United States
American Fork Hospital
🇺🇸American Fork, Utah, United States
Sandra L. Maxwell Cancer Center
🇺🇸Cedar City, Utah, United States
Val and Ann Browning Cancer Center at McKay-Dee Hospital Center
🇺🇸Ogden, Utah, United States
Danville Regional Medical Center
🇺🇸Danville, Virginia, United States
Utah Valley Regional Medical Center - Provo
🇺🇸Provo, Utah, United States
Logan Regional Hospital
🇺🇸Logan, Utah, United States
Medical College of Wisconsin Cancer Center
🇺🇸Milwaukee, Wisconsin, United States
Hickman Cancer Center at Bixby Medical Center
🇺🇸Adrian, Michigan, United States
Borgess Medical Center
🇺🇸Kalamazoo, Michigan, United States
Mercy Medical Center - Sioux City
🇺🇸Sioux City, Iowa, United States
CCOP - Iowa Oncology Research Association
🇺🇸Des Moines, Iowa, United States
Mercy Cancer Center at Mercy Medical Center - Des Moines
🇺🇸Des Moines, Iowa, United States
John Stoddard Cancer Center at Iowa Lutheran Hospital
🇺🇸Des Moines, Iowa, United States
Cardinal Bernardin Cancer Center at Loyola University Medical Center
🇺🇸Maywood, Illinois, United States
Southern Regional Medical Center
🇺🇸Riverdale, Georgia, United States
Northwest Ohio Oncology Center
🇺🇸Maumee, Ohio, United States
Charles F. Kettering Memorial Hospital
🇺🇸Kettering, Ohio, United States
St. Charles Mercy Hospital
🇺🇸Oregon, Ohio, United States
Mercy Hospital of Tiffin
🇺🇸Tiffin, Ohio, United States
Flower Hospital Cancer Center
🇺🇸Sylvania, Ohio, United States
Toledo Hospital
🇺🇸Toledo, Ohio, United States
St. Vincent Mercy Medical Center
🇺🇸Toledo, Ohio, United States
Medical University of Ohio Cancer Center
🇺🇸Toledo, Ohio, United States
Toledo Clinic, Incorporated - Main Clinic
🇺🇸Toledo, Ohio, United States
Fulton County Health Center
🇺🇸Wauseon, Ohio, United States
Ruth G. McMillan Cancer Center at Greene Memorial Hospital
🇺🇸Xenia, Ohio, United States
Skagit Valley Hospital Cancer Care Center
🇺🇸Mount Vernon, Washington, United States
Harrison Poulsbo Hematology and Onocology
🇺🇸Poulsbo, Washington, United States
Evergreen Hematology and Oncology, PS
🇺🇸Spokane, Washington, United States
Polyclinic First Hill
🇺🇸Seattle, Washington, United States
St. Alexius Medical Center Cancer Center
🇺🇸Bismarck, North Dakota, United States
UVMC Cancer Care Center at Upper Valley Medical Center
🇺🇸Troy, Ohio, United States
West Michigan Cancer Center
🇺🇸Kalamazoo, Michigan, United States
CCOP - Toledo Community Hospital
🇺🇸Toledo, Ohio, United States
North Coast Cancer Care, Incorporated
🇺🇸Sandusky, Ohio, United States
North Puget Oncology at United General Hospital
🇺🇸Sedro-Woolley, Washington, United States
University of Michigan Comprehensive Cancer Center
🇺🇸Ann Arbor, Michigan, United States
Bozeman Deaconess Cancer Center
🇺🇸Bozeman, Montana, United States
St. Joseph Cancer Center
🇺🇸Bellingham, Washington, United States
Swedish Medical Center - Issaquah Campus
🇺🇸Issaquah, Washington, United States
Regional Medical Center
🇺🇸Anniston, Alabama, United States
St. Francis Hospital and Health Centers - Beech Grove Campus
🇺🇸Beech Grove, Indiana, United States