MedPath

Triptorelin With Either Exemestane or Tamoxifen in Treating Premenopausal Women With Hormone-Responsive Breast Cancer

Phase 3
Completed
Conditions
Breast Cancer
Interventions
Registration Number
NCT00066703
Lead Sponsor
ETOP IBCSG Partners Foundation
Brief Summary

RATIONALE: Estrogen can stimulate the growth of breast cancer cells. Hormone therapy using triptorelin, exemestane, and tamoxifen may fight breast cancer by blocking the use of estrogen. It is not yet known whether giving triptorelin together with exemestane is more effective than triptorelin and tamoxifen in treating hormone-responsive breast cancer.

PURPOSE: This randomized phase III trial is studying triptorelin and exemestane to see how well they work compared to triptorelin and tamoxifen in treating premenopausal women with hormone-responsive breast cancer.

Detailed Description

OBJECTIVES:

* Compare the disease-free survival, breast cancer-free interval, distant recurrence-free interval and overall survival of premenopausal women with endocrine-responsive breast cancer when treated with triptorelin and exemestane vs triptorelin and tamoxifen.

* Compare the quality of life, including late side effects of early menopause, of patients treated with these regimens.

OUTLINE: This is a randomized, international, multicenter study. Patients are stratified according to planned use of concurrent adjuvant chemotherapy (yes vs no), and number of positive lymph nodes (0 vs 1 or more). Treatment duration is 5 years. Patients are followed every 3 months for 1 year, every 6 months for 5 years, and then annually thereafter. Quality of life is assessed at baseline, every 6 months for 2 years, and annually for 3 years.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
2672
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
E+OFStriptorelinOvarian function suppression (OFS) by triptorelin (GnRH analogue) 3.75mg by im injection q28 days for 5 years plus exemestane 25mg orally daily for 5 years. Exemestane (E) begins after the completion of adjuvant chemotherapy if given, or approximately 6-8 weeks after the initiation of triptorelin. Bilateral oophorectomy or ovarian irradiation was allowed after at least 6 months of triptorelin.
T+OFStamoxifenOvarian function suppression (OFS) by triptorelin (GnRH analogue) 3.75mg by im injection q28 days for 5 years plus tamoxifen 20mg orally daily for 5 years. Tamoxifen (T) begins after the completion of adjuvant chemotherapy if given, or approximately 6-8 weeks after the initiation of triptorelin. Bilateral oophorectomy or ovarian irradiation was allowed after at least 6 months of triptorelin.
E+OFSexemestaneOvarian function suppression (OFS) by triptorelin (GnRH analogue) 3.75mg by im injection q28 days for 5 years plus exemestane 25mg orally daily for 5 years. Exemestane (E) begins after the completion of adjuvant chemotherapy if given, or approximately 6-8 weeks after the initiation of triptorelin. Bilateral oophorectomy or ovarian irradiation was allowed after at least 6 months of triptorelin.
T+OFStriptorelinOvarian function suppression (OFS) by triptorelin (GnRH analogue) 3.75mg by im injection q28 days for 5 years plus tamoxifen 20mg orally daily for 5 years. Tamoxifen (T) begins after the completion of adjuvant chemotherapy if given, or approximately 6-8 weeks after the initiation of triptorelin. Bilateral oophorectomy or ovarian irradiation was allowed after at least 6 months of triptorelin.
Primary Outcome Measures
NameTimeMethod
Disease-free Survival5-year estimate reported at a median follow-up of 72 months

Estimated percentage of patients alive and disease-free at 5 years from randomization, where disease-free survival is defined as the time from randomization to the first appearance of one of the following: invasive breast cancer recurrence at local, regional, or distant site, invasive contralateral breast cancer, second (non-breast) invasive cancer, or death without cancer event; or censored at date of last follow up.

Secondary Outcome Measures
NameTimeMethod
Breast Cancer-free Interval5-year estimate reported at a median follow-up of 72 months

Estimated percentage of patients alive and disease-free at 5 years from randomization, where breast cancer-free interval is defined as the time from randomization to the invasive breast cancer recurrence at local, regional, or distant site, or invasive contralateral breast cancer; or censored at date of last follow up.

Distant Recurrence-free Interval5-year estimates reported at a median follow-up of 72 months

Estimated percentage of patients alive and disease-free at 5 years from randomization, where distant recurrence-free interval is defined as the time from randomization to breast cancer recurrence at a distant site; or censored at date of last follow-up

Overall Survival8-year estimates, reported at a median follow-up of 9 years

Estimated percentage of patients alive at 8 years from randomization, where overall survival is defined as the time from randomization to death from any cause; or censored at date last known alive.

Trial Locations

Locations (228)

Elkhart General Hospital

🇺🇸

Elkhart, Indiana, United States

Memorial Hospital of South Bend

🇺🇸

South Bend, Indiana, United States

Greenebaum Cancer Center at University of Maryland Medical Center

🇺🇸

Baltimore, Maryland, United States

United Hospital

🇺🇸

Saint Paul, Minnesota, United States

Istituto Clinico Humanitas

🇮🇹

Rozzano, Italy

Policlinico Universitario Udine

🇮🇹

Udine, Italy

University Hospital of Linkoping

🇸🇪

Linkoping, Sweden

Resurrection Medical Center

🇺🇸

Chicago, Illinois, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Via Christi Cancer Center at Via Christi Regional Medical Center

🇺🇸

Wichita, Kansas, United States

Cancer Center of Kansas-Independence

🇺🇸

Independence, Kansas, United States

Royal Perth Hospital

🇦🇺

Perth, Western Australia, Australia

Cancer Center of Kansas, PA - Pratt

🇺🇸

Pratt, Kansas, United States

Kootenai Cancer Center - Coeur d'Alene

🇺🇸

Coeur d'Alene, Idaho, United States

Fox Chase Virtua Health Cancer Program at Virtua West Jersey

🇺🇸

Voorhees, New Jersey, United States

Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton

🇺🇸

Marlton, New Jersey, United States

Launceston General Hospital

🇦🇺

Launceston, Tasmania, Australia

Mary Babb Randolph Cancer Center at West Virginia University Hospitals

🇺🇸

Morgantown, West Virginia, United States

Onkologie-Praxis ZeTup Chur

🇨🇭

Chur, Switzerland

Centre Hospitalier Universitaire Vaudois

🇨🇭

Lausanne, Switzerland

Regionalspital

🇨🇭

Thun, Switzerland

CCOP - Greenville

🇺🇸

Greenville, South Carolina, United States

Tom Baker Cancer Centre - Calgary

🇨🇦

Calgary, Alberta, Canada

Medical X-Ray Center, PC

🇺🇸

Sioux Falls, South Dakota, United States

Inselspital Bern

🇨🇭

Bern, Switzerland

West Tennessee Cancer Center at Jackson-Madison County General Hospital

🇺🇸

Jackson, Tennessee, United States

Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center

🇺🇸

Farmington, Connecticut, United States

Peter MacCallum Cancer Centre

🇦🇺

East Melbourne, Victoria, Australia

Erlanger Cancer Center at Erlanger Hospital - Baroness

🇺🇸

Chattanooga, Tennessee, United States

Oncology Institute of Southern Switzerland

🇨🇭

Bellinzona, Switzerland

Sanford Cancer Center at Sanford USD Medical Center

🇺🇸

Sioux Falls, South Dakota, United States

Fletcher Allen Health Care - University Health Center Campus

🇺🇸

Burlington, Vermont, United States

Franklin & Edith Scarpa Regional Cancer Center at South Jersey Healthcare

🇺🇸

Vineland, New Jersey, United States

Royal Hobart Hospital

🇦🇺

Hobart, Tasmania, Australia

Peterborough Hospitals Trust

🇬🇧

Peterborough, England, United Kingdom

South Tyneside District Hospital

🇬🇧

South Shields, England, United Kingdom

Ospedale Civico

🇨🇭

Lugano, Switzerland

Centre Hospitalier Hutois

🇧🇪

Huy, Belgium

Institute of Oncology - Ljubljana

🇸🇮

Ljubljana, Slovenia

Universitaetsspital-Basel

🇨🇭

Basel, Switzerland

Oncocare Sonnenhof-Klinik Engeriedspital

🇨🇭

Bern, Switzerland

St. Vincent's Hospital - Melbourne

🇦🇺

Fitzroy, Victoria, Australia

Sutter Cancer Center at Roseville Medical Center

🇺🇸

Roseville, California, United States

Mountain States Tumor Institute at St. Luke's Regional Medical Center

🇺🇸

Boise, Idaho, United States

University of Chicago Cancer Research Center

🇺🇸

Chicago, Illinois, United States

Providence Holy Cross Cancer Center

🇺🇸

Mission Hills, California, United States

Shaw Regional Cancer Center

🇺🇸

Edwards, Colorado, United States

Sibley Memorial Hospital

🇺🇸

Washington, District of Columbia, United States

Desert Regional Medical Center Comprehensive Cancer Center

🇺🇸

Palm Springs, California, United States

Ruby L. Golleher Cancer Program at Presbyterian Intercommunity Hospital

🇺🇸

Whittier, California, United States

Evanston Hospital

🇺🇸

Evanston, Illinois, United States

CCOP - Carle Cancer Center

🇺🇸

Urbana, Illinois, United States

Shawnee Mission Medical Center

🇺🇸

Shawnee Mission, Kansas, United States

Siouxland Hematology-Oncology Associates, LLP

🇺🇸

Sioux City, Iowa, United States

CCOP - Wichita

🇺🇸

Wichita, Kansas, United States

Lawrence Memorial Hospital

🇺🇸

Lawrence, Kansas, United States

Cotton-O'Neil Cancer Center

🇺🇸

Topeka, Kansas, United States

Cancer Center of Kansas, PA - Newton

🇺🇸

Newton, Kansas, United States

CCOP - Northern Indiana CR Consortium

🇺🇸

South Bend, Indiana, United States

Menorah Medical Center

🇺🇸

Overland Park, Kansas, United States

Center for Cancer Therapy at LaPorte Hospital and Health Services

🇺🇸

La Porte, Indiana, United States

Cancer Center of Kansas, PA - Chanute

🇺🇸

Chanute, Kansas, United States

Cancer Center of Kansas, PA - Dodge City

🇺🇸

Dodge City, Kansas, United States

Cancer Center of Kansas, PA - Winfield

🇺🇸

Winfield, Kansas, United States

Cancer Center of Kansas, PA - Medical Arts Tower

🇺🇸

Wichita, Kansas, United States

Associates in Womens Health, PA - North Review

🇺🇸

Wichita, Kansas, United States

Cancer Center of Kansas, PA - Wellington

🇺🇸

Wellington, Kansas, United States

Mercy Medical Center

🇺🇸

Baltimore, Maryland, United States

Fairview Southdale Hospital

🇺🇸

Edina, Minnesota, United States

William Beaumont Hospital - Royal Oak Campus

🇺🇸

Royal Oak, Michigan, United States

Dana-Farber/Harvard Cancer Center at Dana-Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Bethke Cancer Center at Emerson Hospital

🇺🇸

Concord, Massachusetts, United States

NSMC Cancer Center - Peabody

🇺🇸

Peabody, Massachusetts, United States

CCOP - Kansas City

🇺🇸

Kansas City, Missouri, United States

Saint Francis Cancer Treatment Center at Saint Francis Memorial Health Center

🇺🇸

Grand Island, Nebraska, United States

Regions Hospital Cancer Care Center

🇺🇸

Saint Paul, Minnesota, United States

Oncology Alliance, SC - Milwaukee - East

🇺🇸

Glendale, Wisconsin, United States

MetroHealth Cancer Care Center at MetroHealth Medical Center

🇺🇸

Cleveland, Ohio, United States

Columbia Saint Mary's Water Tower Medical Commons Milwaukee

🇺🇸

Mequon, Wisconsin, United States

Randolph Hospital

🇺🇸

Asheboro, North Carolina, United States

Geisinger Hazleton Cancer Center

🇺🇸

Hazleton, Pennsylvania, United States

Aurora Memorial Hospital of Burlington

🇺🇸

Burlington, Wisconsin, United States

Geisinger Cancer Institute at Geisinger Health

🇺🇸

Danville, Pennsylvania, United States

Oncology Alliance - Kenosha South

🇺🇸

Kenosha, Wisconsin, United States

U.Z. Gasthuisberg

🇧🇪

Leuven, Belgium

Coffs Harbour Health Campus

🇦🇺

Coffs Harbour, New South Wales, Australia

Hospital de Clinicas de Porto Alegre

🇧🇷

Porto Alegre, Rio Grande Do Sul, Brazil

Langlade Memorial Hospital

🇺🇸

Antigo, Wisconsin, United States

Maroondah Hospital

🇦🇺

Ringwood East, Victoria, Australia

Geisinger Medical Group - Scenery Park

🇺🇸

State College, Pennsylvania, United States

Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center

🇺🇸

Wilkes-Barre, Pennsylvania, United States

Oncology Alliance - Franklin

🇺🇸

Franklin, Wisconsin, United States

Oncology Alliance, SC - Milwaukee - West

🇺🇸

Wauwatosa, Wisconsin, United States

Breast Unit Mercy Private

🇦🇺

East Melbourne, Victoria, Australia

Tweed Heads Hospital

🇦🇺

Tweed Heads, New South Wales, Australia

Universitatsklinik Mainz

🇩🇪

Mainz, Germany

Universitaetsfrauenklinik Frankfurt

🇩🇪

Frankfurt, Germany

Universitaetsklinikum Schleswig-Holstein - Campus Luebeck

🇩🇪

Luebeck, Germany

Alfred Hospital

🇦🇺

Melbourne, Victoria, Australia

Brustzentrum Klinikum Mittelbaden

🇩🇪

Baden-Baden, Germany

Box Hill Hospital

🇦🇺

Box Hill, Victoria, Australia

CHU Liege - Domaine Universitaire du Sart Tilman

🇧🇪

Liege, Belgium

Centre Hospitalier Peltzer-La Tourelle

🇧🇪

Verviers, Belgium

Austin Hospital

🇦🇺

Heidelberg, Victoria, Australia

Manning Base Hospital

🇦🇺

Taree, New South Wales, Australia

Universitaets-Frauenklinik Goettingen

🇩🇪

Göttingen, Germany

National Cancer Institute of Egypt

🇪🇬

Cairo, Egypt

Doctor Leon Richard Oncology Centre

🇨🇦

Moncton, New Brunswick, Canada

Allan Blair Cancer Centre at Pasqua Hospital

🇨🇦

Regina, Saskatchewan, Canada

Cairo Oncology Center

🇪🇬

Cairo, Egypt

Hopital Charles Lemoyne

🇨🇦

Greenfield Park, Quebec, Canada

Frauenklinik des Universitaetsklinikum Erlangen

🇩🇪

Erlangen, Germany

National Institute of Oncology

🇭🇺

Budapest, Hungary

Tata Memorial Hospital

🇮🇳

Mumbai, India

UniversitaetsSpital Zuerich

🇨🇭

Zurich, Switzerland

Klinikum Obergoeltzsch Rodewisch

🇩🇪

Rodewisch, Germany

Klinikum Landkreis Tuttlingen

🇩🇪

Tuttlingen, Germany

Addenbrooke's Hospital

🇬🇧

Cambridge, England, United Kingdom

Centro di Riferimento Oncologico - Aviano

🇮🇹

Aviano, Italy

Instituto Nacional de Enfermedades Neoplasicas

🇵🇪

Lima, Peru

Ospedale "la Carita", Locarno

🇨🇭

Locarno, Switzerland

Ospedale Beata Vergine

🇨🇭

Mendrisio, Switzerland

Kantonsspital - St. Gallen

🇨🇭

St. Gallen, Switzerland

Windsor Regional Cancer Centre at Windsor Regional Hospital

🇨🇦

Windsor, Ontario, Canada

Heartland Regional Medical Center

🇺🇸

Saint Joseph, Missouri, United States

Universitaetsfrauenklinik Mannheim

🇩🇪

Mannheim, Germany

CCOP - Metro-Minnesota

🇺🇸

Saint Louis Park, Minnesota, United States

University of Colorado Cancer Center at UC Health Sciences Center

🇺🇸

Aurora, Colorado, United States

Suburban Hospital

🇺🇸

Bethesda, Maryland, United States

UNMC Eppley Cancer Center at the University of Nebraska Medical Center

🇺🇸

Omaha, Nebraska, United States

Aurora Advanced Healthcare East Mequon Clinic

🇺🇸

Mequon, Wisconsin, United States

Sutter Cancer Center

🇺🇸

Sacramento, California, United States

Mercy General Hospital

🇺🇸

Sacramento, California, United States

Roy and Patricia Disney Family Cancer Center at Providence Saint Joseph Medical Center

🇺🇸

Burbank, California, United States

Rebecca and John Moores UCSD Cancer Center

🇺🇸

La Jolla, California, United States

Poudre Valley Hospital

🇺🇸

Fort Collins, Colorado, United States

Front Range Cancer Specialists

🇺🇸

Fort Collins, Colorado, United States

Decatur Memorial Hospital Cancer Care Institute

🇺🇸

Decatur, Illinois, United States

UCSF Helen Diller Family Comprehensive Cancer Center

🇺🇸

San Francisco, California, United States

Saint Joseph Regional Medical Center

🇺🇸

Mishawaka, Indiana, United States

Elkhart Clinic, LLC

🇺🇸

Elkhart, Indiana, United States

Fort Wayne Medical Oncology and Hematology

🇺🇸

Fort Wayne, Indiana, United States

Howard Community Hospital

🇺🇸

Kokomo, Indiana, United States

Michiana Hematology-Oncology, PC - South Bend

🇺🇸

South Bend, Indiana, United States

South Bend Clinic

🇺🇸

South Bend, Indiana, United States

Cancer Center of Kansas, PA - Wichita

🇺🇸

Wichita, Kansas, United States

Cancer Center of Kansas, PA - Salina

🇺🇸

Salina, Kansas, United States

Frederick Memorial Hospital Regional Cancer Therapy Center

🇺🇸

Frederick, Maryland, United States

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

Tufts Medical Center Cancer Center

🇺🇸

Boston, Massachusetts, United States

Addison Gilbert Hospital

🇺🇸

Gloucester, Massachusetts, United States

Lowell General Hospital

🇺🇸

Lowell, Massachusetts, United States

Lakeland Regional Cancer Care Center - St. Joseph

🇺🇸

Saint Joseph, Michigan, United States

HealthEast Cancer Care at St. John's Hospital

🇺🇸

Maplewood, Minnesota, United States

Mercy and Unity Cancer Center at Mercy Hospital

🇺🇸

Coon Rapids, Minnesota, United States

Fairview Ridges Hospital

🇺🇸

Burnsville, Minnesota, United States

Mercy and Unity Cancer Center at Unity Hospital

🇺🇸

Fridley, Minnesota, United States

Lakeside Cancer Specialists, PLLC

🇺🇸

Saint Joseph, Michigan, United States

Ridgeview Medical Center

🇺🇸

Waconia, Minnesota, United States

Hennepin County Medical Center - Minneapolis

🇺🇸

Minneapolis, Minnesota, United States

Mayo Clinic Cancer Center

🇺🇸

Rochester, Minnesota, United States

Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center

🇺🇸

Robbinsdale, Minnesota, United States

Park Nicollet Cancer Center

🇺🇸

Saint Louis Park, Minnesota, United States

Virginia Piper Cancer Institute at Abbott - Northwestern Hospital

🇺🇸

Minneapolis, Minnesota, United States

Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis

🇺🇸

Saint Louis, Missouri, United States

Saint Louis University Cancer Center

🇺🇸

Saint Louis, Missouri, United States

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

Hope A Women's Cancer Center

🇺🇸

Asheville, North Carolina, United States

NYU Cancer Institute at New York University Medical Center

🇺🇸

New York, New York, United States

Mission Hospitals - Memorial Campus

🇺🇸

Asheville, North Carolina, United States

Moses Cone Regional Cancer Center at Wesley Long Community Hospital

🇺🇸

Greensboro, North Carolina, United States

Pardee Memorial Hospital

🇺🇸

Hendersonville, North Carolina, United States

Annie Penn Cancer Center

🇺🇸

Reidsville, North Carolina, United States

Kinston Medical Specialists

🇺🇸

Kinston, North Carolina, United States

Aultman Cancer Center at Aultman Hospital

🇺🇸

Canton, Ohio, United States

Mountainview Medical

🇺🇸

Berlin, Vermont, United States

Madigan Army Medical Center - Tacoma

🇺🇸

Tacoma, Washington, United States

Doctor's Hospital of Laredo

🇺🇸

Laredo, Texas, United States

Columbia-Saint Mary's Hospital-Ozaukee

🇺🇸

Mequon, Wisconsin, United States

Aurora Health Center - Waukesha

🇺🇸

Waukesha, Wisconsin, United States

Oncology Alliance, SC - Milwaukee - South

🇺🇸

Milwaukee, Wisconsin, United States

University of Wisconcin Cancer Center at Aspirus Wausau Hospital

🇺🇸

Wausau, Wisconsin, United States

Lismore Base Hospital

🇦🇺

Lismore, New South Wales, Australia

Tamworth Base Hospital

🇦🇺

Tamworth, New South Wales, Australia

Cancer Therapy Centre at Campbelltown Hospital

🇦🇺

Campbelltown, New South Wales, Australia

Newcastle Mater Misericordiae Hospital

🇦🇺

Waratah, New South Wales, Australia

Cancer Therapy Centre at Liverpool Hospital

🇦🇺

Liverpool, New South Wales, Australia

Flinders Medical Centre

🇦🇺

Bedford Park, South Australia, Australia

Royal Brisbane and Women's Hospital

🇦🇺

Brisbane, Queensland, Australia

Institut Jules Bordet

🇧🇪

Brussels, Belgium

Trillium Health Centre - Mississauga Site

🇨🇦

Toronto, Ontario, Canada

Cross Cancer Institute at University of Alberta

🇨🇦

Edmonton, Alberta, Canada

Margaret and Charles Juravinski Cancer Centre

🇨🇦

Hamilton, Ontario, Canada

Klinikum Deggendorf

🇩🇪

Deggendorf, Germany

Saskatoon Cancer Centre at the University of Saskatchewan

🇨🇦

Saskatoon, Saskatchewan, Canada

St. Vincentius - Kliniken

🇩🇪

Karlsruhe, Germany

Klinikum Schwaebisch Gmuend Stauferklinik

🇩🇪

Mutlangen, Germany

Klinikum Nuernberg - Klinikum Nord

🇩🇪

Nuremberg, Germany

Caritas - Krankenhaus Saint Josef

🇩🇪

Regensburg, Germany

Klinikum Rosenheim

🇩🇪

Rosenheim, Germany

Ospedali Riuniti di Bergamo

🇮🇹

Bergamo, Italy

Ospedale Civile Ramazzini

🇮🇹

Carpi, Italy

Spedali Civili di Brescia

🇮🇹

Brescia, Italy

European Institute of Oncology

🇮🇹

Milan, Italy

Azienda Sanitaria di Bolzano

🇮🇹

Bolzano, Italy

Fondazione Salvatore Maugeri

🇮🇹

Pavia, Italy

Misericordia e Dolce Hospital

🇮🇹

Prato, Italy

Ospedale Civile Rimini

🇮🇹

Rimini, Italy

Waikato Hospital

🇳🇿

Hamilton, New Zealand

Ospedale di Circolo e Fondazione Macchi

🇮🇹

Varese, Italy

Sandton Oncology Centre

🇿🇦

Johannesburg, South Africa

Sahlgrenska University Hospital

🇸🇪

Gothenburg, Sweden

Skaraborgs Hospital

🇸🇪

Skovde, Sweden

Kantonsspital Graubuenden

🇨🇭

Chur, Switzerland

Truman Medical Center - Hospital Hill

🇺🇸

Kansas City, Missouri, United States

Saint Luke's Cancer Institute at Saint Luke's Hospital

🇺🇸

Kansas City, Missouri, United States

St. Joseph Medical Center

🇺🇸

Kansas City, Missouri, United States

North Kansas City Hospital

🇺🇸

Kansas City, Missouri, United States

Research Medical Center

🇺🇸

Kansas City, Missouri, United States

Our Lady of Mercy Medical Center Comprehensive Cancer Center

🇺🇸

Bronx, New York, United States

Mayo Clinic - Jacksonville

🇺🇸

Jacksonville, Florida, United States

Cancer Center of Kansas, PA - Parsons

🇺🇸

Parsons, Kansas, United States

Northeast Georgia Medical Center

🇺🇸

Gainesville, Georgia, United States

Cancer Center of Kansas, PA - El Dorado

🇺🇸

El Dorado, Kansas, United States

Aurora Health Center - Racine

🇺🇸

Racine, Wisconsin, United States

Cancer Center of Kansas, PA - Kingman

🇺🇸

Kingman, Kansas, United States

MidMichigan Medical Center - Midland

🇺🇸

Midland, Michigan, United States

Walter Reed Army Medical Center

🇺🇸

Washington, District of Columbia, United States

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