Taxane and Taxane-Induced Peripheral Neuropathy in African American Patients With Stage I-III Breast Cancer
Фаза 2 – изследване на ефективността и дозировката
Заболявания:
Anatomic Stage I Breast Cancer AJCC v8
Anatomic Stage IA Breast Cancer AJCC v8
Anatomic Stage IB Breast Cancer AJCC v8
Anatomic Stage II Breast Cancer AJCC v8
Anatomic Stage IIA Breast Cancer AJCC v8
Anatomic Stage IIB Breast Cancer AJCC v8
Anatomic Stage III Breast Cancer AJCC v8
Anatomic Stage IIIA Breast Cancer AJCC v8
Anatomic Stage IIIB Breast Cancer AJCC v8
Anatomic Stage IIIC Breast Cancer AJCC v8
Invasive Breast Carcinoma
Prognostic Stage I Breast Cancer AJCC v8
Prognostic Stage IA Breast Cancer AJCC v8
Prognostic Stage IB Breast Cancer AJCC v8
Prognostic Stage II Breast Cancer AJCC v8
Prognostic Stage IIA Breast Cancer AJCC v8
Prognostic Stage IIB Breast Cancer AJCC v8
Prognostic Stage III Breast Cancer AJCC v8
Prognostic Stage IIIA Breast Cancer AJCC v8
Prognostic Stage IIIB Breast Cancer AJCC v8
Prognostic Stage IIIC Breast Cancer AJCC v8
Спонсор: ECOG-ACRIN Cancer Research Group
Налично на:
БГ
Обобщение
This phase II trial studies whether a prior germline predictor of taxane-induced peripheral neuropathy (TIPN) can help identify a subgroup of patients who are at higher risk of chemotherapy-induced peripheral neuropathy in African American patients with stages I-III breast cancer. The study also investigates whether docetaxel maybe work better than paclitaxel with regard to TIPN rate/severity and dose reductions.
Описание
PRIMARY OBJECTIVES:
I. Prospectively validate a prior germline predictor of TIPN using the Common Terminology Criteria for Adverse Events (CTCAE). Specifically, this study will demonstrate that patients with a high-risk TIPN genotype have significantly more grade 2-4 TIPN than patients with a low risk genotype.
SECONDARY OBJECTIVES:
I. Validate a prior germline predictor of TIPN using the Functional Assessment of Cancer Therapy (FACT)/Gynecologic Oncology Group (GOG)-Neurotoxicity (NTX) neurotoxicity subscale in Arm A.
II. Compare grade 2-4 TIPN based on CTCAE between weekly paclitaxel (Arm A) versus (vs.) every three-week docetaxel (Arm B).
III. Prospectively confirm dose reductions due to TIPN are lower for every three-week docetaxel compared with weekly paclitaxel in a prospective cohort of patients of African ancestry.
IV. Prospectively confirm dose reductions due to any cause are lower for every three-week docetaxel compared with weekly paclitaxel in a prospective cohort of patients of African ancestry.
V. Assess the ability of the high-risk genotype to predict TIPN risk for docetaxel.
EXPLORATORY OBJECTIVES:
Correlative Study Objectives:
I. Identify novel markers of TIPN and elucidate the mechanism. II. Whole genome sequencing of germline blood to evaluate for additional predictors of TIPN.
III. Create induced pluripotent stem cell (iPSC) derived neurons from patient samples.
IIIa. Evaluate whether clinical findings can be mimicked in vitro. IIIb. Evaluate gene expression (ribonucleic acid \[RNA\] sequencing \[seq\]) and the epigenome at baseline versus after exposure in those prone to TIPN versus those not.
IV. Create a biorepository of patient derived samples for future translational research.
Patient-Reported Outcome Objectives:
I. Compare Grade 2-4 TIPN (moderate to life threatening) based on Patient Reported Outcomes (PRO)-CTCAE items between weekly paclitaxel (Arm A) vs. every three-week docetaxel (Arm B).
II. Prospectively compare FACT/GOG-NTX Health-Related Quality of Life (HRQoL) subscale, Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function version (v.)2 Short Form (SF) 10a, scores between every three-week docetaxel and weekly paclitaxel and between high risk and low risk genotypes (Arm A) in a cohort of African ancestry.
III. Compare the impact on financial toxicity (Comprehensive Score for Financial Toxicity \[COST\] scores) for every three-week docetaxel compared with weekly paclitaxel.
IV. Examine associations between social determinants of health (zip code, marital status, education, income \& insurance status) and dose reductions and treatment discontinuation.
OUTLINE: Patients are assigned to 1 of 2 arms.
ARM A: Patients receive paclitaxel intravenously (IV) over 3 hours once weekly. Treatment repeats every 21 days for 4 cycles in the absence of disease progression or unacceptable toxicity. Patients may also receive trastuzumab and/or pertuzumab per institution routine care
Кой може да участва
Inclusion Criteria:
* Patients must be women with a known stage I-III invasive breast cancer diagnosis. Registration must occur within 84 days from the date of diagnosis
* Patients must be capable and willing to provide informed consent
* Patients must have plans to receive either neoadjuvant or adjuvant:
* Every 3-week docetaxel x 4-6 cycles OR
* Weekly paclitaxel x 4 cycles
* NOTE: Recommended therapies for various therapy regimens are outlined based on estrogen receptor (ER)/progesterone receptor (PR)/HER2 and nodal status. Where there are options, the treating physician will choose a regimen best fitted for that patient. If the physician does not feel any of the regimens are the best fit for the patient, the patient should not be enrolled. Physicians will also document why a regimen was felt to be inappropriate when an option
* Patients must self-identify their race as black, African American, or of African descent; patients may be of any ethnicity
* Patients with a history of other cancers are eligible if they have not received prior taxane or platinum or vinca alkaloid therapy
* Eastern Cooperative Oncology Group (ECOG) performance status 0-1
* Patients must not be pregnant or lactating
* All females of childbearing potential must have a blood test or urine study within 2 weeks prior to registration to rule out pregnancy
* A female of childbearing potential is any woman, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy, or 3) has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)
* Women of childbearing potential must be strongly advised to use an accepted and effective method of contraception or to abstain from sexual intercourse for the duration of their participation in the study
Exclusion Criteria:
* Patients have received prior taxane or prior/concurrent platinum therapy
* Patients have pre-existing peripheral neuropathy
* Patients have a total bilirubin \> upper limit of normal (ULN)
* Patients have aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) above 1.5 times the ULN concomitant with alkaline phosphatase above 2.5 times the ULN
Интервенции
Docetaxel
DRUG
Paclitaxel
DRUG
Quality-of-Life Assessment
OTHER
Questionnaire Administration
OTHER
Места на провеждане
485
САЩ (485)
Providence Regional Cancer System-Aberdeen
Aberdeen , Washington
Cleveland Clinic Akron General
Akron , Ohio
Lehigh Valley Hospital-Cedar Crest
Allentown , Pennsylvania
Saint Anthony's Health
Alton , Illinois
American Fork Hospital / Huntsman Intermountain Cancer Center
American Fork , Utah
Anchorage Associates in Radiation Medicine
Anchorage , Alaska
Anchorage Radiation Therapy Center
Anchorage , Alaska
Alaska Breast Care and Surgery LLC
Anchorage , Alaska
Alaska Oncology and Hematology LLC
Anchorage , Alaska
Alaska Women's Cancer Care
Anchorage , Alaska
Anchorage Oncology Centre
Anchorage , Alaska
Katmai Oncology Group
Anchorage , Alaska
Providence Alaska Medical Center
Anchorage , Alaska
Saint Joseph Mercy Hospital
Ann Arbor , Michigan
PCR Oncology
Arroyo Grande , California
Grady Health System
Atlanta , Georgia
Emory University Hospital Midtown
Atlanta , Georgia
Emory University Hospital/Winship Cancer Institute
Atlanta , Georgia
Emory Saint Joseph's Hospital
Atlanta , Georgia
Northside Hospital
Atlanta , Georgia
MultiCare Auburn Medical Center
Auburn , Washington
Rocky Mountain Cancer Centers-Aurora
Aurora , Colorado
The Medical Center of Aurora
Aurora , Colorado
Rush - Copley Medical Center
Aurora , Illinois
IU Health West Hospital
Avon , Indiana
Saint Louis Cancer and Breast Institute-Ballwin
Ballwin , Missouri
Sinai Hospital of Baltimore
Baltimore , Maryland
Saint Agnes Hospital
Baltimore , Maryland
MedStar Good Samaritan Hospital
Baltimore , Maryland
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore , Maryland
LSU Health Baton Rouge-North Clinic
Baton Rouge , Louisiana
Our Lady of The Lake
Baton Rouge , Louisiana
Louisiana Hematology Oncology Associates LLC
Baton Rouge , Louisiana
Mary Bird Perkins Cancer Center
Baton Rouge , Louisiana
Our Lady of the Lake Physicians Group - Medical Oncology
Baton Rouge , Louisiana
Louisiana Hematology Oncology Associates
Baton Rouge , Louisiana
Our Lady of the Lake Medical Oncology
Baton Rouge , Louisiana
Woman's Hospital
Baton Rouge , Louisiana
Bronson Battle Creek
Battle Creek , Michigan
UHHS-Chagrin Highlands Medical Center
Beachwood , Ohio
Baptist Hospitals of Southeast Texas Cancer Center
Beaumont , Texas
Overlake Medical Center
Bellevue , Washington
Nebraska Medicine-Bellevue
Bellevue , Nebraska
PeaceHealth Saint Joseph Medical Center
Bellingham , Washington
Strecker Cancer Center-Belpre
Belpre , Ohio
Saint Charles Health System
Bend , Oregon
Lehigh Valley Hospital - Muhlenberg
Bethlehem , Pennsylvania
Saint Vincent Healthcare
Billings , Montana
Saint Vincent Frontier Cancer Center
Billings , Montana
University of Alabama at Birmingham Cancer Center
Birmingham , Alabama
Illinois CancerCare-Bloomington
Bloomington , Illinois
Saint Joseph's/Candler - Bluffton Campus
Bluffton , South Carolina
Saint Luke's Cancer Institute - Boise
Boise , Idaho
Central Care Cancer Center - Bolivar
Bolivar , Missouri
Parkland Health Center-Bonne Terre
Bonne Terre , Missouri
Boulder Community Hospital
Boulder , Colorado
Boulder Community Foothills Hospital
Boulder , Colorado
Rocky Mountain Cancer Centers-Boulder
Boulder , Colorado
Cox Cancer Center Branson
Branson , Missouri
IHA Hematology Oncology Consultants-Brighton
Brighton , Michigan
Saint Joseph Mercy Brighton
Brighton , Michigan
Bryn Mawr Hospital
Bryn Mawr , Pennsylvania
Providence Saint Joseph Medical Center/Disney Family Cancer Center
Burbank , California
Aurora Cancer Care-Southern Lakes VLCC
Burlington , Wisconsin
Fairview Ridges Hospital
Burnsville , Minnesota
Minnesota Oncology - Burnsville
Burnsville , Minnesota
Saint James Community Hospital and Cancer Treatment Center
Butte , Montana
Cambridge Medical Center
Cambridge , Minnesota
IHA Hematology Oncology Consultants-Canton
Canton , Michigan
Saint Joseph Mercy Canton
Canton , Michigan
Illinois CancerCare-Canton
Canton , Illinois
Saint Francis Medical Center
Cape Girardeau , Missouri
Southeast Cancer Center
Cape Girardeau , Missouri
Memorial Hospital of Carbondale
Carbondale , Illinois
IU Health North Hospital
Carmel , Indiana
Caro Cancer Center
Caro , Michigan
Carson Tahoe Regional Medical Center
Carson City , Nevada
SIH Cancer Institute
Carterville , Illinois
Illinois CancerCare-Carthage
Carthage , Illinois
Sandra L Maxwell Cancer Center
Cedar City , Utah
Rocky Mountain Cancer Centers - Centennial
Centennial , Colorado
Providence Regional Cancer System-Centralia
Centralia , Washington
Centralia Oncology Clinic
Centralia , Illinois
Christiana Care Health System-Concord Health Center
Chadds Ford , Pennsylvania
Geauga Hospital
Chardon , Ohio
Medical University of South Carolina
Charleston , South Carolina
IHA Hematology Oncology Consultants-Chelsea
Chelsea , Michigan
Saint Joseph Mercy Chelsea
Chelsea , Michigan
Cheyenne Regional Medical Center-West
Cheyenne , Wyoming
Northwestern University
Chicago , Illinois
John H Stroger Jr Hospital of Cook County
Chicago , Illinois
Adena Regional Medical Center
Chillicothe , Ohio
Siteman Cancer Center at Saint Peters Hospital
City of Saint Peters , Missouri
Clackamas Radiation Oncology Center
Clackamas , Oregon
Providence Cancer Institute Clackamas Clinic
Clackamas , Oregon
Hematology Oncology Consultants-Clarkston
Clarkston , Michigan
Newland Medical Associates-Clarkston
Clarkston , Michigan
Case Western Reserve University
Cleveland , Ohio
MetroHealth Medical Center
Cleveland , Ohio
Main Line Health Center-Collegeville
Collegeville , Pennsylvania
Baptist Memorial Hospital and Cancer Center-Collierville
Collierville , Tennessee
Baptist Memorial Hospital and Cancer Center-Golden Triangle
Columbus , Mississippi
John B Amos Cancer Center
Columbus , Georgia
Mount Carmel East Hospital
Columbus , Ohio
Columbus Oncology and Hematology Associates Inc
Columbus , Ohio
Riverside Methodist Hospital
Columbus , Ohio
Grant Medical Center
Columbus , Ohio
The Mark H Zangmeister Center
Columbus , Ohio
Mount Carmel Health Center West
Columbus , Ohio
Doctors Hospital
Columbus , Ohio
Mercy Hospital
Coon Rapids , Minnesota
Bay Area Hospital
Coos Bay , Oregon
Northshore Oncology Associates-Covington
Covington , Louisiana
Siteman Cancer Center at West County Hospital
Creve Coeur , Missouri
Northwest Cancer Center - Main Campus
Crown Point , Indiana
Aurora Saint Luke's South Shore
Cudahy , Wisconsin
Carle on Vermilion
Danville , Illinois
Cancer Care Specialists of Illinois - Decatur
Decatur , Illinois
Decatur Memorial Hospital
Decatur , Illinois
Delaware Health Center-Grady Cancer Center
Delaware , Ohio
Grady Memorial Hospital
Delaware , Ohio
Cancer Center of Colorado at Sloan's Lake
Denver , Colorado
National Jewish Health-Main Campus
Denver , Colorado
The Women's Imaging Center
Denver , Colorado
Colorado Blood Cancer Institute
Denver , Colorado
Presbyterian - Saint Lukes Medical Center - Health One
Denver , Colorado
Rocky Mountain Cancer Centers-Midtown
Denver , Colorado
SCL Health Saint Joseph Hospital
Denver , Colorado
Rocky Mountain Cancer Centers-Rose
Denver , Colorado
Rose Medical Center
Denver , Colorado
Western Surgical Care
Denver , Colorado
Ascension Saint John Hospital
Detroit , Michigan
Illinois CancerCare-Dixon
Dixon , Illinois
Epic Care-Dublin
Dublin , California
Dublin Methodist Hospital
Dublin , Ohio
Northside Hospital - Duluth
Duluth , Georgia
Northwest Oncology LLC
Dyer , Indiana
Great Lakes Cancer Management Specialists-Doctors Park
East China , Michigan
Fox Chase Cancer Center - East Norriton Hospital Outpatient Center
East Norriton , Pennsylvania
Pocono Medical Center
East Stroudsburg , Pennsylvania
University of Maryland Shore Medical Center at Easton
Easton , Maryland
Fairview Southdale Hospital
Edina , Minnesota
Swedish Cancer Institute-Edmonds
Edmonds , Washington
Carle Physician Group-Effingham
Effingham , Illinois
Crossroads Cancer Center
Effingham , Illinois
Bay Area Breast Surgeons Inc
Emeryville , California
Epic Care Partners in Cancer Care
Emeryville , California
Mountain Blue Cancer Care Center - Swedish
Englewood , Colorado
Rocky Mountain Cancer Centers - Swedish
Englewood , Colorado
Swedish Medical Center
Englewood , Colorado
The Melanoma and Skin Cancer Institute
Englewood , Colorado
Englewood Hospital and Medical Center
Englewood , New Jersey
Illinois CancerCare-Eureka
Eureka , Illinois
Providence Regional Cancer Partnership
Everett , Washington
Main Line Health Center-Exton
Exton , Pennsylvania
Fairbanks Memorial Hospital
Fairbanks , Alaska
Parkland Health Center - Farmington
Farmington , Missouri
Augusta Health Center for Cancer and Blood Disorders
Fishersville , Virginia
Genesee Cancer and Blood Disease Treatment Center
Flint , Michigan
Genesee Hematology Oncology PC
Flint , Michigan
Genesys Hurley Cancer Institute
Flint , Michigan
Hurley Medical Center
Flint , Michigan
Aurora Health Center-Fond du Lac
Fond du Lac , Wisconsin
Holy Cross Hospital
Fort Lauderdale , Florida
Mercy Hospital Fort Smith
Fort Smith , Arkansas
Beebe South Coastal Health Campus
Frankford , Delaware
Unity Hospital
Fridley , Minnesota
Saint Luke's Cancer Institute - Fruitland
Fruitland , Idaho
Central Ohio Breast and Endocrine Surgery
Gahanna , Ohio
University of Florida Health Science Center - Gainesville
Gainesville , Florida
Illinois CancerCare-Galesburg
Galesburg , Illinois
Western Illinois Cancer Treatment Center
Galesburg , Illinois
Central Care Cancer Center - Garden City
Garden City , Kansas
Tidelands Georgetown Memorial Hospital
Georgetown , South Carolina
Aurora Health Care Germantown Health Center
Germantown , Wisconsin
MultiCare Gig Harbor Medical Park
Gig Harbor , Washington
National Jewish Health-Western Hematology Oncology
Golden , Colorado
Aurora Cancer Care-Grafton
Grafton , Wisconsin
Saint Mary's Hospital and Regional Medical Center
Grand Junction , Colorado
Helen DeVos Children's Hospital at Spectrum Health
Grand Rapids , Michigan
Mercy Health Saint Mary's
Grand Rapids , Michigan
Spectrum Health at Butterworth Campus
Grand Rapids , Michigan
Central Care Cancer Center - Great Bend
Great Bend , Kansas
North Colorado Medical Center
Greeley , Colorado
Aurora BayCare Medical Center
Green Bay , Wisconsin
Self Regional Healthcare
Greenwood , South Carolina
Baptist Cancer Center-Grenada
Grenada , Mississippi
Academic Hematology Oncology Specialists
Grosse Pointe Woods , Michigan
Great Lakes Cancer Management Specialists-Van Elslander Cancer Center
Grosse Pointe Woods , Michigan
Michigan Breast Specialists-Grosse Pointe Woods
Grosse Pointe Woods , Michigan
Mount Carmel Grove City Hospital
Grove City , Ohio
The Cancer Institute of New Jersey Hamilton
Hamilton , New Jersey
Lehigh Valley Hospital-Hazleton
Hazleton , Pennsylvania
Cancer and Blood Specialists-Henderson
Henderson , Nevada
Comprehensive Cancer Centers of Nevada - Henderson
Henderson , Nevada
Comprehensive Cancer Centers of Nevada-Horizon Ridge
Henderson , Nevada
Las Vegas Cancer Center-Henderson
Henderson , Nevada
OptumCare Cancer Care at Seven Hills
Henderson , Nevada
21st Century Oncology-Henderson
Henderson , Nevada
Comprehensive Cancer Centers of Nevada-Southeast Henderson
Henderson , Nevada
Las Vegas Urology - Green Valley
Henderson , Nevada
Las Vegas Urology - Pebble
Henderson , Nevada
Urology Specialists of Nevada - Green Valley
Henderson , Nevada
South Carolina Cancer Specialists PC
Hilton Head Island , South Carolina
Northwest Cancer Center - Hobart
Hobart , Indiana
Saint Mary Medical Center
Hobart , Indiana
Terrebonne General Medical Center
Houma , Louisiana
Indiana University/Melvin and Bren Simon Cancer Center
Indianapolis , Indiana
IU Health Methodist Hospital
Indianapolis , Indiana
Sidney and Lois Eskenazi Hospital
Indianapolis , Indiana
Springmill Medical Center
Indianapolis , Indiana
Saint Catherine Hospital
Indianapolis , Indiana
Swedish Cancer Institute-Issaquah
Issaquah , Washington
Capital Region Southwest Campus
Jefferson City , Missouri
Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
Jonesboro , Arkansas
Freeman Health System
Joplin , Missouri
Mercy Hospital Joplin
Joplin , Missouri
Bronson Methodist Hospital
Kalamazoo , Michigan
West Michigan Cancer Center
Kalamazoo , Michigan
Ascension Borgess Cancer Center
Kalamazoo , Michigan
Borgess Medical Center
Kalamazoo , Michigan
Kadlec Clinic Hematology and Oncology
Kennewick , Washington
Aurora Cancer Care-Kenosha South
Kenosha , Wisconsin
Illinois CancerCare-Kewanee Clinic
Kewanee , Illinois
Kingman Regional Medical Center
Kingman , Arizona
Providence Regional Cancer System-Lacey
Lacey , Washington
Good Samaritan Medical Center
Lafayette , Colorado
Rocky Mountain Cancer Centers-Lakewood
Lakewood , Colorado
Fairfield Medical Center
Lancaster , Ohio
Sparrow Hospital
Lansing , Michigan
Las Vegas Urology - Pecos
Las Vegas , Nevada
Desert West Surgery
Las Vegas , Nevada
OptumCare Cancer Care at Charleston
Las Vegas , Nevada
University Medical Center of Southern Nevada
Las Vegas , Nevada
Hope Cancer Care of Nevada
Las Vegas , Nevada
Radiation Oncology Centers of Nevada Central
Las Vegas , Nevada
Urology Specialists of Nevada - Central
Las Vegas , Nevada
21st Century Oncology
Las Vegas , Nevada
Sunrise Hospital and Medical Center
Las Vegas , Nevada
Las Vegas Prostate Cancer Center
Las Vegas , Nevada
Las Vegas Urology - Sunset
Las Vegas , Nevada
Urology Specialists of Nevada - Southwest
Las Vegas , Nevada
Radiation Oncology Centers of Nevada Southeast
Las Vegas , Nevada
21st Century Oncology-Vegas Tenaya
Las Vegas , Nevada
Ann M Wierman MD LTD
Las Vegas , Nevada
Comprehensive Cancer Centers of Nevada - Northwest
Las Vegas , Nevada
Las Vegas Urology - Cathedral Rock
Las Vegas , Nevada
Las Vegas Urology - Smoke Ranch
Las Vegas , Nevada
OptumCare Cancer Care at MountainView
Las Vegas , Nevada
Urology Specialists of Nevada - Northwest
Las Vegas , Nevada
Alliance for Childhood Diseases/Cure 4 the Kids Foundation
Las Vegas , Nevada
Comprehensive Cancer Centers of Nevada - Town Center
Las Vegas , Nevada
Comprehensive Cancer Centers of Nevada-Summerlin
Las Vegas , Nevada
Summerlin Hospital Medical Center
Las Vegas , Nevada
Las Vegas Cancer Center-Medical Center
Las Vegas , Nevada
21st Century Oncology-Fort Apache
Las Vegas , Nevada
Comprehensive Cancer Centers of Nevada
Las Vegas , Nevada
OptumCare Cancer Care at Fort Apache
Las Vegas , Nevada
Comprehensive Cancer Centers of Nevada - Central Valley
Las Vegas , Nevada
University Cancer Center
Las Vegas , Nevada
Northside Hospital - Gwinnett
Lawrenceville , Georgia
Beebe Medical Center
Lewes , Delaware
Saint Rita's Medical Center
Lima , Ohio
Rocky Mountain Cancer Centers-Littleton
Littleton , Colorado
Hope Cancer Clinic
Livonia , Michigan
Saint Mary Mercy Hospital
Livonia , Michigan
Logan Regional Hospital
Logan , Utah
Rocky Mountain Cancer Centers-Sky Ridge
Lone Tree , Colorado
Sky Ridge Medical Center
Lone Tree , Colorado
PeaceHealth Saint John Medical Center
Longview , Washington
McKee Medical Center
Loveland , Colorado
Illinois CancerCare-Macomb
Macomb , Illinois
Great Lakes Cancer Management Specialists-Macomb Medical Campus
Macomb , Michigan
Michigan Breast Specialists-Macomb Township
Macomb , Michigan
OhioHealth Mansfield Hospital
Mansfield , Ohio
Fairview Clinics and Surgery Center Maple Grove
Maple Grove , Minnesota
Minnesota Oncology Hematology PA-Maplewood
Maplewood , Minnesota
Saint John's Hospital - Healtheast
Maplewood , Minnesota
Marietta Memorial Hospital
Marietta , Ohio
Aurora Bay Area Medical Group-Marinette
Marinette , Wisconsin
OhioHealth Marion General Hospital
Marion , Ohio
Saint Mary's Oncology/Hematology Associates of Marlette
Marlette , Michigan
Contra Costa Regional Medical Center
Martinez , California
Carle Physician Group-Mattoon/Charleston
Mattoon , Illinois
Bon Secours Memorial Regional Medical Center
Mechanicsville , Virginia
Riddle Memorial Hospital
Media , Pennsylvania
Baptist Memorial Hospital and Cancer Center-Memphis
Memphis , Tennessee
Baptist Memorial Hospital for Women
Memphis , Tennessee
UH Seidman Cancer Center at Lake Health Mentor Campus
Mentor , Ohio
Saint Luke's Cancer Institute - Meridian
Meridian , Idaho
UH Seidman Cancer Center at Southwest General Hospital
Middleburg Heights , Ohio
Bon Secours Westchester Emergency Center
Midlothian , Virginia
Bon Secours Saint Francis Medical Center
Midlothian , Virginia
Aurora Cancer Care-Milwaukee
Milwaukee , Wisconsin
Aurora Saint Luke's Medical Center
Milwaukee , Wisconsin
Aurora Sinai Medical Center
Milwaukee , Wisconsin
Abbott-Northwestern Hospital
Minneapolis , Minnesota
Hennepin County Medical Center
Minneapolis , Minnesota
Health Partners Inc
Minneapolis , Minnesota
Saint Patrick Hospital - Community Hospital
Missoula , Montana
Monticello Cancer Center
Monticello , Minnesota
Morristown Medical Center
Morristown , New Jersey
Good Samaritan Regional Health Center
Mount Vernon , Illinois
Knox Community Hospital
Mount Vernon , Ohio
Inspira Medical Center Mullica Hill
Mullica Hill , New Jersey
The Community Hospital
Munster , Indiana
Women's Diagnostic Center - Munster
Munster , Indiana
Intermountain Medical Center
Murray , Utah
Mercy Health Mercy Campus
Muskegon , Michigan
Saint Luke's Cancer Institute - Nampa
Nampa , Idaho
Baptist Memorial Hospital and Cancer Center-Union County
New Albany , Mississippi
Rutgers Cancer Institute of New Jersey
New Brunswick , New Jersey
Louisiana State University Health Science Center
New Orleans , Louisiana
University Medical Center New Orleans
New Orleans , Louisiana
Cancer Center of Western Wisconsin
New Richmond , Wisconsin
New Ulm Medical Center
New Ulm , Minnesota
Licking Memorial Hospital
Newark , Ohio
Newark Radiation Oncology
Newark , Ohio
Delaware Clinical and Laboratory Physicians PA
Newark , Delaware
Helen F Graham Cancer Center
Newark , Delaware
Medical Oncology Hematology Consultants PA
Newark , Delaware
Christiana Care Health System-Christiana Hospital
Newark , Delaware
Providence Newberg Medical Center
Newberg , Oregon
Lakeland Hospital Niles
Niles , Michigan
Bon Secours DePaul Medical Center
Norfolk , Virginia
Cancer and Hematology Centers of Western Michigan - Norton Shores
Norton Shores , Michigan
Cancer Care Center of O'Fallon
O'Fallon , Illinois
Alta Bates Summit Medical Center - Summit Campus
Oakland , California
Bay Area Tumor Institute
Oakland , California
McKay-Dee Hospital Center
Ogden , Utah
Mercy Hospital Oklahoma City
Oklahoma City , Oklahoma
Nebraska Medicine-Village Pointe
Omaha , Nebraska
University of Nebraska Medical Center
Omaha , Nebraska
Vince Lombardi Cancer Clinic - Oshkosh
Oshkosh , Wisconsin
Illinois CancerCare-Ottawa Clinic
Ottawa , Illinois
Baptist Memorial Hospital and Cancer Center-Oxford
Oxford , Mississippi
Hope Cancer Care of Nevada-Pahrump
Pahrump , Nevada
Paoli Memorial Hospital
Paoli , Pennsylvania
University Hospitals Parma Medical Center
Parma , Ohio
Illinois CancerCare-Pekin
Pekin , Illinois
Illinois CancerCare-Peoria
Peoria , Illinois
Methodist Medical Center of Illinois
Peoria , Illinois
Mercy Health Perrysburg Cancer Center
Perrysburg , Ohio
Illinois CancerCare-Peru
Peru , Illinois
Valley Radiation Oncology
Peru , Illinois
Thomas Jefferson University Hospital
Philadelphia , Pennsylvania
Fox Chase Cancer Center
Philadelphia , Pennsylvania
Jefferson Torresdale Hospital
Philadelphia , Pennsylvania
Temple University Hospital
Philadelphia , Pennsylvania
21st Century Oncology-Pontiac
Pontiac , Michigan
Hope Cancer Center
Pontiac , Michigan
Newland Medical Associates-Pontiac
Pontiac , Michigan
Saint Joseph Mercy Oakland
Pontiac , Michigan
Baptist Regional Cancer Network-Cancer Center of Southeast Texas
Port Arthur , Texas
Jefferson Healthcare
Port Townsend , Washington
Providence Portland Medical Center
Portland , Oregon
Providence Saint Vincent Medical Center
Portland , Oregon
Southern Ohio Medical Center
Portsmouth , Ohio
Bon Secours Maryview Medical Center
Portsmouth , Virginia
Illinois CancerCare-Princeton
Princeton , Illinois
Fairview Northland Medical Center
Princeton , Minnesota
Utah Valley Regional Medical Center
Provo , Utah
MultiCare Good Samaritan Hospital
Puyallup , Washington
Aurora Cancer Care-Racine
Racine , Wisconsin
Northwest Hospital Center
Randallstown , Maryland
University Hospitals Portage Medical Center
Ravenna , Ohio
Saint Charles Health System-Redmond
Redmond , Oregon
Spectrum Health Reed City Hospital
Reed City , Michigan
Beebe Health Campus
Rehoboth Beach , Delaware
Renown Regional Medical Center
Reno , Nevada
Saint Mary's Regional Medical Center
Reno , Nevada
Radiation Oncology Associates
Reno , Nevada
Valley Medical Center
Renton , Washington
Bon Secours Saint Mary's Hospital
Richmond , Virginia
Bon Secours Cancer Institute at Reynolds Crossing
Richmond , Virginia
Riverton Hospital
Riverton , Utah
North Memorial Medical Health Center
Robbinsdale , Minnesota
University of Rochester
Rochester , New York
Great Lakes Cancer Management Specialists-Rochester Hills
Rochester Hills , Michigan
Delbert Day Cancer Institute at PCRMC
Rolla , Missouri
Mercy Clinic-Rolla-Cancer and Hematology
Rolla , Missouri
Ascension Saint Mary's Hospital
Saginaw , Michigan
Oncology Hematology Associates of Saginaw Valley PC
Saginaw , Michigan
Lakeland Medical Center Saint Joseph
Saint Joseph , Michigan
Marie Yeager Cancer Center
Saint Joseph , Michigan
Heartland Regional Medical Center
Saint Joseph , Missouri
Park Nicollet Clinic - Saint Louis Park
Saint Louis Park , Minnesota
Regions Hospital
Saint Paul , Minnesota
United Hospital
Saint Paul , Minnesota
Sainte Genevieve County Memorial Hospital
Sainte Genevieve , Missouri
Utah Cancer Specialists-Salt Lake City
Salt Lake City , Utah
LDS Hospital
Salt Lake City , Utah
UH Seidman Cancer Center at Firelands Regional Medical Center
Sandusky , Ohio
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
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