S0012 Doxorubicin, Cyclophosphamide, and Paclitaxel With or Without Filgrastim in Treating Women With Inflammatory or Locally Advanced Breast Cancer
- Conditions
- Breast Cancer
- Interventions
- Registration Number
- NCT00016406
- Lead Sponsor
- SWOG Cancer Research Network
- Brief Summary
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known whether combination chemotherapy is more effective with or without filgrastim in treating breast cancer.
PURPOSE: Randomized phase III trial to compare the effectiveness of combining doxorubicin, cyclophosphamide, and paclitaxel with or without filgrastim in treating women who have inflammatory or locally advanced breast cancer.
- Detailed Description
OBJECTIVES:
* Compare the microscopic pathologic response rates in women with inflammatory or locally advanced breast cancer treated with standard neoadjuvant doxorubicin and cyclophosphamide followed by weekly paclitaxel vs weekly doxorubicin and daily oral cyclophosphamide with filgrastim (G-CSF) followed by weekly paclitaxel.
* Compare the toxic effects of these regimens in this patient population.
* Compare the delivered dose intensity of these regimens in this patient population.
* Evaluate the association between microscopic pathologic complete response and clinical complete response at the primary tumor site in these patients.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to disease status (inflammatory vs other). Patients are randomized to one of two treatment arms.
* Arm I: Patients receive doxorubicin IV followed by cyclophosphamide IV on day 1. Treatment repeats every 21 days for a total of 5 courses in the absence of disease progression or unacceptable toxicity. Three weeks after completion of doxorubicin and cyclophosphamide, patients receive paclitaxel IV over 1 hour weekly on day 1 for a total of 12 weeks.
* Arm II: Patients receive doxorubicin IV on day 1, oral cyclophosphamide on days 1-7, and filgrastim (G-CSF) subcutaneously on days 2-7. Treatment repeats weekly for a total of 15 courses of doxorubicin and cyclophosphamide and 16 courses of G-CSF in the absence of disease progression or unacceptable toxicity. One week after completion of G-CSF, patients receive paclitaxel as in arm I.
Within 3-6 weeks after completion of chemotherapy, patients with stable or responsive disease undergo surgical resection of tumor and affected nodes.
After surgery, patients may receive radiotherapy or additional chemotherapy and/or hormonal therapy at the discretion of the treating physician.
Patients are followed every 6 months for 1 year and then annually for 4 years.
PROJECTED ACCRUAL: A total of 350 patients (175 per treatment arm) will be accrued for this study within 3 years.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 399
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description AC followed by P cyclophosphamide doxorubicin and cyclophosphamide followed by paclitaxel followed by surgery AC followed by P doxorubicin doxorubicin and cyclophosphamide followed by paclitaxel followed by surgery AC followed by P paclitaxel doxorubicin and cyclophosphamide followed by paclitaxel followed by surgery AC followed by P surgery doxorubicin and cyclophosphamide followed by paclitaxel followed by surgery AC+G followed by P filgrastim weekly doxorubicin and daily cyclophosphamide with filgrastim followed by paclitaxel followed by surgery AC+G followed by P cyclophosphamide weekly doxorubicin and daily cyclophosphamide with filgrastim followed by paclitaxel followed by surgery AC+G followed by P doxorubicin weekly doxorubicin and daily cyclophosphamide with filgrastim followed by paclitaxel followed by surgery AC+G followed by P surgery weekly doxorubicin and daily cyclophosphamide with filgrastim followed by paclitaxel followed by surgery AC+G followed by P paclitaxel weekly doxorubicin and daily cyclophosphamide with filgrastim followed by paclitaxel followed by surgery
- Primary Outcome Measures
Name Time Method Comparison of microscopic pathologic response rates no sooner than 21 days after chemo Toxicity during chemo and at surgery Comparison of delivered dose intensity after chemo Correlation of microscopic pathologic complete response with clinical complete response at the primary tumor site no sooner than 21 days after chemo
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (312)
Lenoir Memorial Cancer Center
🇺🇸Kinston, North Carolina, United States
Holland Community Hospital
🇺🇸Holland, Michigan, United States
Good Samaritan Cancer Center
🇺🇸Puyallup, Washington, United States
Hembree Mercy Cancer Center at St. Edward Mercy Medical Center
🇺🇸Ft. Smith, Arkansas, United States
Alaska Regional Hospital Cancer Center
🇺🇸Anchorage, Alaska, United States
Fairbanks Cancer Treatment Center at Fairbanks Memorial Hospital
🇺🇸Fairbanks, Alaska, United States
Salem Hospital Regional Cancer Center
🇺🇸Salem, Oregon, United States
Rose Ramer Cancer Clinic at Anderson Area Medical Center
🇺🇸Anderson, South Carolina, United States
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center
🇺🇸Spartanburg, South Carolina, United States
CCOP - Upstate Carolina
🇺🇸Spartanburg, South Carolina, United States
Oncology Services of Aberdeen
🇺🇸Aberdeen, South Dakota, United States
Rapid City Regional Hospital
🇺🇸Rapid City, South Dakota, United States
CCOP - Virginia Mason Research Center
🇺🇸Seattle, Washington, United States
Group Health Central Hospital
🇺🇸Seattle, Washington, United States
Harborview Medical Center
🇺🇸Seattle, Washington, United States
Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
🇺🇸Seattle, Washington, United States
University Cancer Center at University of Washington Medical Center
🇺🇸Seattle, Washington, United States
Michael & Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital
🇺🇸Fort Lauderdale, Florida, United States
Memorial Cancer Institute at Memorial Regional Hospital
🇺🇸Hollywood, Florida, United States
Comprehensive Cancer Center at Desert Regional Medical Center
🇺🇸Palm Springs, California, United States
Mobile Infirmary Medical Center
🇺🇸Mobile, Alabama, United States
Cancer Research Center of Hawaii
🇺🇸Honolula, Hawaii, United States
Highland General Hospital at St. George's University School of Medicine
🇺🇸Oakland, California, United States
CCOP - Mount Sinai Medical Center
🇺🇸Miami Beach, Florida, United States
Summit Medical Center
🇺🇸Oakland, California, United States
Valley Memorial Hospital
🇺🇸Livermore, California, United States
Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
🇺🇸Little Rock, Arkansas, United States
Glendale Memorial Hospital Comprehensive Cancer Center
🇺🇸Glendale, California, United States
St. Francis Medical Center
🇺🇸Cape Girardeau, Missouri, United States
Rush-Copley Cancer Care Center
🇺🇸Aurora, Illinois, United States
Halifax Medical Center
🇺🇸Daytona Beach, Florida, United States
Saint Rose Hospital
🇺🇸Hayward, California, United States
Mayo Clinic - Jacksonville
🇺🇸Jacksonville, Florida, United States
Saint Anthony's Hospital at Saint Anthony's Health Center
🇺🇸Alton, Illinois, United States
Ella Milbank Foshay Cancer Center at Jupiter Medical Center
🇺🇸Jupiter, Florida, United States
Swedish American Hospital
🇺🇸Rockford, Illinois, United States
St. Francis Hospital and Health Centers
🇺🇸Beech Grove, Indiana, United States
Saint James Hospital and Health Centers Comprehensive Cancer Institute - Olympia Fields
🇺🇸Olympia Fields, Illinois, United States
Good Samaritan Regional Health Center
🇺🇸Mt. Vernon, Illinois, United States
Miller-Dwan Medical Center
🇺🇸Duluth, Minnesota, United States
St. John's Hospital
🇺🇸Maplewood, Minnesota, United States
St. John's Regional Health Center
🇺🇸Springfield, Missouri, United States
Missouri Baptist Cancer Center
🇺🇸St. Louis, Missouri, United States
Mercy and Unity Cancer Center at Mercy Hospital
🇺🇸Coon Rapids, Minnesota, United States
Munson Medical Center
🇺🇸Traverse City, Michigan, United States
St. Mary's - Duluth Clinic Cancer Center
🇺🇸Duluth, Minnesota, United States
CCOP - Metro-Minnesota
🇺🇸Saint Louis Park, Minnesota, United States
Fairview Ridges Hospital
🇺🇸Burnsville, Minnesota, United States
CCOP - Duluth
🇺🇸Duluth, Minnesota, United States
Hulston Cancer Center at Cox Medical Center South
🇺🇸Springfield, Missouri, United States
Park Nicollet Health Services
🇺🇸St. Louis Park, Minnesota, United States
Glacier Oncology, PLLC
🇺🇸Kalispell, Montana, United States
Eastern Montana Cancer Center
🇺🇸Miles City, Montana, United States
Hutchinson Area Health Care
🇺🇸Hutchinson, Minnesota, United States
Fairview Southdale Hospital
🇺🇸Edina, Minnesota, United States
Meeker County Memorial Hospital
🇺🇸Litchfield, Minnesota, United States
Mercy and Unity Cancer Center at Unity Hospital
🇺🇸Fridley, Minnesota, United States
Medical City Dallas Hospital
🇺🇸Dallas, Texas, United States
CCOP - Dayton
🇺🇸Dayton, Ohio, United States
Community Medical Center
🇺🇸Missoula, Montana, United States
Montana Cancer Specialists at Montana Cancer Center
🇺🇸Missoula, Montana, United States
Seton Shivers Cancer Program at Brackenridge Hospital
🇺🇸Austin, Texas, United States
Utah Valley Regional Medical Center - Provo
🇺🇸Provo, Utah, United States
Midlands Cancer Center at Midlands Community Hospital
🇺🇸Papillion, Nebraska, United States
Jennersville Regional Hospital
🇺🇸West Grove, Pennsylvania, United States
Harrington Cancer Center
🇺🇸Amarillo, Texas, United States
Legacy Meridian Park Hospital
🇺🇸Tualatin, Oregon, United States
American Fork Hospital
🇺🇸American Fork, Utah, United States
Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest
🇺🇸Allentown, Pennsylvania, United States
Wilford Hall Medical Center
🇺🇸Lackland AFB, Texas, United States
CCOP - Scott and White Hospital
🇺🇸Temple, Texas, United States
Skagit Valley Hospital Cancer Care Center
🇺🇸Mt. Vernon, Washington, United States
Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical Center
🇺🇸La Crosse, Wisconsin, United States
St. Joseph Hospital Community Cancer Center
🇺🇸Bellingham, Washington, United States
St. Joseph Medical Center at Franciscan Health System
🇺🇸Tacoma, Washington, United States
Providence St. Peter Hospital Regional Cancer Center
🇺🇸Olympia, Washington, United States
Auburn Regional Center for Cancer Care
🇺🇸Auburn, Washington, United States
Cottonwood Hospital Medical Center
🇺🇸Murray, Utah, United States
Olympic Medical Center
🇺🇸Port Angeles, Washington, United States
Welch Cancer Center
🇺🇸Sheridan, Wyoming, United States
Allenmore Hospital
🇺🇸Tacoma, Washington, United States
Capital Medical Center
🇺🇸Olympia, Washington, United States
Olympic Hematology and Oncology
🇺🇸Bremerton, Washington, United States
Wenatchee Valley Clinic
🇺🇸Wenatchee, Washington, United States
Washington Hematology - Oncology Specialists
🇺🇸Yakima, Washington, United States
Madigan Army Medical Center
🇺🇸Tacoma, Washington, United States
University Medical Center of Southern Nevada
🇺🇸Las Vegas, Nevada, United States
CCOP - Nevada Cancer Research Foundation
🇺🇸Las Vegas, Nevada, United States
Charles M. Barrett Cancer Center at University Hospital
🇺🇸Cincinnati, Ohio, United States
Virginia Piper Cancer Institute at Abbott-Northwestern Hospital
🇺🇸Minneapolis, Minnesota, United States
Hennepin County Medical Center - Minneapolis
🇺🇸Minneapolis, Minnesota, United States
University Hospital - San Antonio
🇺🇸San Antonio, Texas, United States
MBCCOP - Meharry Medical College - Nashville
🇺🇸Nashville, Tennessee, United States
University of Texas Health Science Center at San Antonio
🇺🇸San Antonio, Texas, United States
Veterans Affairs Medical Center - San Antonio (Murphy)
🇺🇸San Antonio, Texas, United States
Utah Cancer Specialists at UCS Cancer Center
🇺🇸Salt Lake City, Utah, United States
Huntsman Cancer Institute at University of Utah
🇺🇸Salt Lake City, Utah, United States
LDS Hospital
🇺🇸Salt Lake City, Utah, United States
University of Mississippi Medical Center
🇺🇸Jackson, Mississippi, United States
Kapiolani Medical Center for Women and Children
🇺🇸Honolulu, Hawaii, United States
Via Christi Cancer Center at Via Christi Regional Medical Center
🇺🇸Wichita, Kansas, United States
Southwest Medical Center
🇺🇸Liberal, Kansas, United States
Stormont-Vail Cancer Center
🇺🇸Topeka, Kansas, United States
Salina Regional Health Center
🇺🇸Salina, Kansas, United States
Cancer Center of Kansas, P.A. - Wellington
🇺🇸Wellington, Kansas, United States
Tripler Army Medical Center
🇺🇸Honolulu, Hawaii, United States
St. Alexius Medical Center
🇺🇸Bismarck, North Dakota, United States
Cancer Center of Kansas, P.A. - El Dorado
🇺🇸El Dorado, Kansas, United States
Cancer Center of Kansas, P.A. - Kingman
🇺🇸Kingman, Kansas, United States
Cancer Care Center at Medcenter One Hospital
🇺🇸Bismarck, North Dakota, United States
Queen's Cancer Institute at Queen's Medical Center
🇺🇸Honolulu, Hawaii, United States
Memorial Hospital Cancer Center
🇺🇸Colorado Springs, Colorado, United States
Cancer Center of Kansas, P.A. - Dodge City
🇺🇸Dodge City, Kansas, United States
Englewood Hospital and Medical Center
🇺🇸Englewood, New Jersey, United States
OnCare Hawaii, Incorporated - Kuakini
🇺🇸Honolulu, Hawaii, United States
Kapiolani Medical Center at Pali Momi
🇺🇸Aiea, Hawaii, United States
Associates in Womens Health, P.A. - North Review
🇺🇸Wichita, Kansas, United States
Cancer Center of Kansas, P.A. - Pratt
🇺🇸Pratt, Kansas, United States
Cancer Center of Kansas, P.A. - Wichita
🇺🇸Wichita, Kansas, United States
Cancer Center of Kansas, P.A. - Newton
🇺🇸Newton, Kansas, United States
Barbara Ann Karmanos Cancer Institute
🇺🇸Detroit, Michigan, United States
Legacy Good Samaritan Hospital & Medical Center Comprehensive Cancer Center
🇺🇸Portland, Oregon, United States
Providence Cancer Center at Providence Portland Medical Center
🇺🇸Portland, Oregon, United States
Cancer Institute at Oregon Health and Science University
🇺🇸Portland, Oregon, United States
Providence St. Vincent Medical Center
🇺🇸Portland, Oregon, United States
Institute of Oncology at Vilnius University
🇺🇸Portland, Oregon, United States
Dixie Regional Medical Center
🇺🇸St. George, Utah, United States
Hubert H. Humphrey Cancer Center at North Memorial Medical Center
🇺🇸Robbinsdale, Minnesota, United States
Saint Francis Cancer Center
🇺🇸Shakopee, Minnesota, United States
St. Joseph's Hospital
🇺🇸St Paul, Minnesota, United States
United Hospital
🇺🇸St. Paul, Minnesota, United States
Regions Hospital Cancer Care Center
🇺🇸Saint Paul, Minnesota, United States
Ridgeview Medical Center
🇺🇸Waconia, Minnesota, United States
Hematology Oncology Consultants Ltd.
🇺🇸Naperville, Illinois, United States
Fort Wayne Medical Oncology and Hematology
🇺🇸Fort Wayne, Indiana, United States
St. Luke's Hospital
🇺🇸Maumee, Ohio, United States
Edward Hospital Cancer Center
🇺🇸Naperville, Illinois, United States
Hematology Oncology Associates of the Quad Cities
🇺🇸Bettendorf, Iowa, United States
Center for Cancer Care at Goshen Health System
🇺🇸Goshen, Indiana, United States
Saint Anthony Memorial Health Centers
🇺🇸Michigan City, Indiana, United States
Cedar Rapids Oncology Associates
🇺🇸Cedar Rapids, Iowa, United States
Genesis Medical Center - West Campus
🇺🇸Davenport, Iowa, United States
United States Air Force Medical Center Wright-Patterson
🇺🇸Wright-Patterson Afb, Ohio, United States
Firelands Regional Medical Center
🇺🇸Sandusky, Ohio, United States
Cancer Therapy and Research Center
🇺🇸San Antonio, Texas, United States
North Puget Oncology at United General Hospital
🇺🇸Sedro-Wooley, Washington, United States
CCOP - Northwest
🇺🇸Tacoma, Washington, United States
St. Clare Hospital
🇺🇸Tacoma, Washington, United States
North Star Lodge Cancer Center
🇺🇸Yakima, Washington, United States
CCOP - Missouri Valley Cancer Consortium
🇺🇸Omaha, Nebraska, United States
Bergan Mercy Medical Center
🇺🇸Omaha, Nebraska, United States
Creighton University Medical Center
🇺🇸Omaha, Nebraska, United States
Forsyth Regional Cancer Center at Forsyth Medical Center
🇺🇸Winston-Salem, North Carolina, United States
Fred Hutchinson Cancer Research Center
🇺🇸Seattle, Washington, United States
CCOP - Carle Cancer Center
🇺🇸Urbana, Illinois, United States
USC/Norris Comprehensive Cancer Center and Hospital
🇺🇸Los Angeles, California, United States
J.C. Robinson, M.D. Regional Cancer Center
🇺🇸San Pablo, California, United States
CCOP - Bay Area Tumor Institute
🇺🇸Oakland, California, United States
Straub Clinic and Hospital, Incorporated
🇺🇸Honolulu, Hawaii, United States
OnCare Hawaii, Incorporated - Lusitana
🇺🇸Honolulu, Hawaii, United States
Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical Center
🇺🇸Boise, Idaho, United States
Joliet Oncology Hematology Associates, Limited - West
🇺🇸Joliet, Illinois, United States
North Idaho Cancer Center
🇺🇸Coeur D'Alene, Idaho, United States
Trinity Medical Center - East
🇺🇸Moline, Illinois, United States
St. Luke's Mountain States Tumor Institute - Boise
🇺🇸Boise, Idaho, United States
Medical and Surgical Specialists, L L C
🇺🇸Galesburg, Illinois, United States
Mercy Regional Cancer Center at Mercy Medical Center
🇺🇸Cedar Rapids, Iowa, United States
Cardinal Bernardin Cancer Center at Loyola University Medical Center
🇺🇸Maywood, Illinois, United States
Saint Anthony Regional Hospital
🇺🇸Carroll, Iowa, United States
Carle Cancer Center at Carle Foundation Hospital
🇺🇸Urbana, Illinois, United States
Genesis Regional Cancer Center at Genesis Medical Center
🇺🇸Davenport, Iowa, United States
Alegent Health Mercy Hospital
🇺🇸Council Bluffs, Iowa, United States
John Stoddard Cancer Center at Iowa Methodist Medical Center
🇺🇸Des Moines, Iowa, United States
Medical Oncology and Hematology Associates at John Stoddard Cancer Center
🇺🇸Des Moines, Iowa, United States
Mercy Capitol Hospital
🇺🇸Des Moines, 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
Medical Oncology and Hematology Associates at Mercy Cancer Center
🇺🇸Des Moines, Iowa, United States
Alegent Health Community Memorial Hospital
🇺🇸Missouri Valley, Iowa, United States
Siouxland Hematology-Oncology Associates at June E. Nylen Cancer Center
🇺🇸Sioux City, Iowa, United States
John Stoddard Cancer Center at Iowa Lutheran Hospital
🇺🇸Des Moines, Iowa, United States
Burgess Health Center
🇺🇸Onawa, Iowa, United States
Mercy Medical Center - Sioux City
🇺🇸Sioux City, Iowa, United States
St. Luke's Regional Medical Center
🇺🇸Sioux City, Iowa, United States
Cancer Center of Kansas, P.A. - Chanute
🇺🇸Chanute, Kansas, United States
Medical Oncology and Hematology Associates - West Des Moines
🇺🇸West Des Moines, Iowa, United States
Siouxland Regional Cancer Center
🇺🇸Sioux City, Iowa, United States
Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center
🇺🇸Kansas City, Kansas, United States
Cancer Center of Kansas, P.A. - Parsons
🇺🇸Parsons, Kansas, United States
Cancer Center of Kansas, P.A. - Salina
🇺🇸Salina, Kansas, United States
St. Francis Comprehensive Cancer Center
🇺🇸Topeka, Kansas, United States
Cancer Center of Kansas, P.A. - Medical Arts Tower
🇺🇸Wichita, Kansas, United States
CCOP - Wichita
🇺🇸Wichita, Kansas, United States
Cancer Center of Kansas, P.A. - Winfield
🇺🇸Winfield, Kansas, United States
Markey Cancer Center at University of Kentucky Chandler Medical Center
🇺🇸Lexington, Kentucky, United States
Baton Rouge General Regional Cancer Center
🇺🇸Baton Rouge, Louisiana, United States
Mary Bird Perkins Cancer Center - Baton Rouge
🇺🇸Baton Rouge, Louisiana, United States
Medical Center of Louisiana - New Orleans
🇺🇸New Orleans, Louisiana, United States
Cancer Treatment Center at Christus Schumpert St. Mary Place
🇺🇸Shreveport, Louisiana, United States
MBCCOP - LSU Health Sciences Center
🇺🇸New Orleans, Louisiana, United States
CancerCare of Maine at Eastern Maine Medial Center
🇺🇸Bangor, Maine, United States
Tufts - New England Medical Center
🇺🇸Boston, Massachusetts, United States
Cancer Research Center at Boston Medical Center
🇺🇸Boston, Massachusetts, United States
Hickman Cancer Center at Bixby Medical Center
🇺🇸Adrian, Michigan, United States
Battle Creek Health System Cancer Care Center
🇺🇸Battle Creek, Michigan, United States
Commonwealth Hematology-Oncology P. C. - Quincy
🇺🇸Quincy, Massachusetts, United States
CCOP - Grand Rapids
🇺🇸Grand Rapids, Michigan, United States
Spectrum Health Cancer Care - Butterworth Campus
🇺🇸Grand Rapids, Michigan, United States
Metropolitan Hospital
🇺🇸Grand Rapids, Michigan, United States
Lacks Cancer Center at Saint Mary's Mercy Medical Center
🇺🇸Grand Rapids, Michigan, United States
Spectrum Health Hospital - Blodgett Campus
🇺🇸Grand Rapids, Michigan, United States
Borgess Medical Center
🇺🇸Kalamazooaa, Michigan, United States
Haematology-Oncology Associates of Ohio and Michigan, P.C.
🇺🇸Lambertville, Michigan, United States
Bronson Methodist Hospital
🇺🇸Kalamazoo, Michigan, United States
West Michigan Cancer Center
🇺🇸Kalamazoo, Michigan, United States
Ted B. Wahby Cancer Center at Mount Clemens General Hospital
🇺🇸Mount Clemens, Michigan, United States
Northern Michigan Hospital
🇺🇸Petoskey, Michigan, United States
Providence Cancer Institute at Providence Hospital - Southfield Campus
🇺🇸Southfield, Michigan, United States
Community Cancer Center of Monroe
🇺🇸Monroe, Michigan, United States
Mercy Memorial Hospital System
🇺🇸Monroe, Michigan, United States
Hackley Hospital
🇺🇸Muskegon, Michigan, United States
William Beaumont Hospital - Royal Oak Campus
🇺🇸Royal Oak, Michigan, United States
Cancer Care Center at St. Luke's Hospital
🇺🇸Duluth, Minnesota, United States
Woodwinds Hospital
🇺🇸Woodbury, Minnesota, United States
CCOP - Cancer Research for the Ozarks
🇺🇸Springfield, Missouri, United States
Southeast Missouri Regional Cancer Center at Southeast Missouri Hospital
🇺🇸Gape Girardeau, Missouri, United States
CCOP - St. Louis-Cape Girardeau
🇺🇸St. Louis, Missouri, United States
CCOP - Montana Cancer Consortium
🇺🇸Billings, Montana, United States
David C. Pratt Cancer Center at St. John's Mercy
🇺🇸St. Louis, Missouri, United States
Deaconess Billings Clinic - Downtown
🇺🇸Billings, Montana, United States
Northern Rockies Radiation Oncology Center
🇺🇸Billings, Montana, United States
Hematology-Oncology Centers of the Northern Rockies - Billings
🇺🇸Billings, Montana, United States
St. Vincent Healthcare
🇺🇸Billings, Montana, United States
Deaconess Billings Clinic Cancer Center
🇺🇸Billings, Montana, United States
Bozeman Deaconess Hospital
🇺🇸Bozeman, Montana, United States
Internal Medicine Associates of Bozeman
🇺🇸Bozeman, Montana, United States
Great Falls Clinic
🇺🇸Great Falls, Montana, United States
St. James Community Hospital
🇺🇸Butte, Montana, United States
Sletten Regional Cancer Institute
🇺🇸Great Falls, Montana, United States
Kalispell Medical Oncology
🇺🇸Kalispell, Montana, United States
St. Peter's Hospital
🇺🇸Helena, Montana, United States
Kalispell Regional Medical Center
🇺🇸Kalispell, Montana, United States
Montana Cancer Center at St. Patrick Hospital and Health Sciences Center
🇺🇸Missoula, Montana, United States
Fremont Area Medical Center
🇺🇸Fremont, Nebraska, United States
Good Samaritan Health Systems
🇺🇸Kearney, Nebraska, United States
Immanuel Medical Center
🇺🇸Omaha, Nebraska, United States
New Mexico Cancer Care Associates
🇺🇸Santa Fe, New Mexico, United States
University of New Mexico Cancer Research and Treatment Center
🇺🇸Albuquerque, New Mexico, United States
Lovelace Medical Center
🇺🇸Albuquerque, New Mexico, United States
Roswell Park Cancer Institute
🇺🇸Buffalo, New York, United States
Cancer Care Center at Catskill Regional Medical Center
🇺🇸Harris, New York, United States
Hope A Women's Cancer Center
🇺🇸Asheville, North Carolina, United States
Mission Hospitals - Memorial Campus
🇺🇸Asheville, North Carolina, United States
James P. Wilmot Cancer Center at University of Rochester Medical Center
🇺🇸Rochester, New York, United States
St. Vincent's Comprehensive Cancer Center - Manhattan
🇺🇸New York, New York, United States
Highland Hospital of Rochester
🇺🇸Rochester, New York, United States
Wayne Memorial Hospital, Incorporated
🇺🇸Goldsboro, North Carolina, United States
Leo W. Jenkins Cancer Center at Pitt County Memorial Hospital
🇺🇸Greenville, North Carolina, United States
Rutherford Hospital
🇺🇸Rutherfordton, North Carolina, United States
Bismarck Cancer Center
🇺🇸Bismarck, North Dakota, United States
Altru Cancer Center at Altru Hospital
🇺🇸Grand Forks, North Dakota, United States
Wood County Oncology Center
🇺🇸Bowling Green, Ohio, United States
Grandview Hospital
🇺🇸Dayton, Ohio, United States
Good Samaritan Hospital
🇺🇸Dayton, Ohio, United States
Blanchard Valley Medical Associates
🇺🇸Findlay, Ohio, United States
David L. Rike Cancer Center at Miami Valley Hospital
🇺🇸Dayton, Ohio, United States
Lima Memorial Hospital
🇺🇸Lima, Ohio, United States
Charles F. Kettering Memorial Hospital
🇺🇸Kettering, Ohio, United States
Samaritan North Cancer Care Center
🇺🇸Dayton, Ohio, United States
Veterans Affairs Medical Center - Dayton
🇺🇸Dayton, Ohio, United States
Kenton Oncology, Incorporated
🇺🇸Kenton, Ohio, United States
Fremont Memorial Hospital
🇺🇸Fremont, Ohio, United States
St. Rita's Medical Center
🇺🇸Lima, Ohio, United States
MedCentral - Mansfield Hospital
🇺🇸Mansfield, Ohio, United States
North Coast Cancer Care, Incorporated
🇺🇸Sandusky, Ohio, United States
Northwest Ohio Oncology Center
🇺🇸Maumee, Ohio, United States
St. Charles Mercy Hospital
🇺🇸Oregon, Ohio, United States
Middletown Regional Hospital
🇺🇸Middletown, Ohio, United States
Toledo Clinic - Oregon
🇺🇸Oregon, Ohio, United States
Promedica Cancer Center at Flower Hospital
🇺🇸Sylvania, Ohio, United States
Toledo Hospital
🇺🇸Toledo, Ohio, United States
St. Vincent Mercy Medical Center
🇺🇸Toledo, Ohio, United States
Medical College of Ohio Cancer Institute
🇺🇸Toledo, Ohio, United States
Mercy Hospital of Tiffin
🇺🇸Tiffin, Ohio, United States
Toledo Clinic, Incorporated - Main Clinic
🇺🇸Toledo, Ohio, United States
Toledo Surgical Specialists
🇺🇸Toledo, Ohio, United States
Fulton County Health Center
🇺🇸Wauseon, Ohio, United States
CCOP - Toledo Community Hospital
🇺🇸Toledo, Ohio, United States
Ruth G. McMillan Cancer Center at Greene Memorial Hospital
🇺🇸Xenia, Ohio, United States
Natalie Warren Bryant Cancer Center at St. Francis Hospital
🇺🇸Tulsa, Oklahoma, United States
UVMC Cancer Care Center at Upper Valley Medical Center
🇺🇸Troy, Ohio, United States
Legacy Mount Hood Medical Center
🇺🇸Glesham, Oregon, United States
Providence Milwaukie Hospital
🇺🇸Milwaukie, Oregon, United States
CCOP - Columbia River Oncology Program
🇺🇸Portland, Oregon, United States
UMC Southwest Cancer and Research Center
🇺🇸Lubbock, Texas, United States
Brooke Army Medical Center
🇺🇸Fort Sam Houston, Texas, United States
McKay-Dee Hospital Center
🇺🇸Ogden, Utah, United States
Logan Regional Hospital
🇺🇸Logan, Utah, United States
Danville Regional Medical Center
🇺🇸Danville, Virginia, United States
Providence Centralia Hospital Regional Cancer Center
🇺🇸Centralia, Washington, United States
St. Francis Hospital
🇺🇸Federal Way, Washington, United States
Valley Medical Center
🇺🇸Renton, Washington, United States
All Saints Cancer Center at All Saints Healthcare
🇺🇸Racine, Wisconsin, United States
Central Washington Hospital
🇺🇸Wenatchee, Washington, United States
Southwest Washington Medical Center Cancer Center
🇺🇸Vancouver, Washington, United States
Cancer Care Northwest - Spokane South
🇺🇸Spokane, Washington, United States
Mid Dakota Clinic, P. C.
🇺🇸Bismarck, North Dakota, United States
CCOP - Kansas City
🇺🇸Kansas City, Missouri, United States
Roper St. Francis Cancer Center at Roper Hospital
🇺🇸Charleston, South Carolina, United States
Mayo Clinic Scottsdale
🇺🇸Scottsdale, Arizona, United States
Highlands Oncology Group - Springdale
🇺🇸Springdale, Arkansas, United States
Mecosta County General Hospital
🇺🇸Big Rapids, Michigan, United States