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S1703 Serum Tumor Marker Directed Disease Monitoring in Patients With Hormone Receptor Positive Her2 Negative Metastatic Breast Cancer

Sponsor
Southwest Oncology Group (Other)
Overall Status
Recruiting
CT.gov ID
NCT03723928
Collaborator
National Cancer Institute (NCI) (NIH)
1,320
Enrollment
676
Locations
2
Arms
233.6
Anticipated Duration (Months)
2
Patients Per Site
0
Patients Per Site Per Month

Study Details

Study Description

Brief Summary

This randomized research trial studies how well serum tumor marker directed disease monitoring works in monitoring patients with hormone receptor positive Her2 negative breast cancer that has spread to other places in the body. Using markers to prompt when scans should be ordered may be as good as the usual approach to monitoring disease.

Condition or Disease Intervention/Treatment Phase
  • Other: Usual care disease monitoring
  • Other: Serum Tumor Marker directed disease monitoring
  • Other: Quality-of-Life Assessment
  • Other: Anxiety Questionnaire Administration
 N/A

Detailed Description

PRIMARY OBJECTIVES:
  1. To assess whether patients with HER-2 negative, hormone receptor positive, metastatic breast cancer who are monitored with serum tumor marker directed disease monitoring (STMDDM) have non-inferior overall survival compared to patients monitored with usual care.
SECONDARY OBJECTIVES:

  1. To compare cumulative direct healthcare costs through 48 weeks among patients monitored with STMDDM versus those monitored with usual care in this patient population.

  2. To assess whether the patient-reported outcomes (PROs) of anxiety and quality of life (QOL) are different among patients who are monitored with STMDDM compared with patients who are monitored with usual care in this patient population.

TERTIARY OBJECTIVES:

  1. To assess modality and frequency of disease monitoring testing in the usual care cohort.

  2. To assess the association of PROs and patient preferences for disease monitoring testing.

  3. To evaluate predictors of physician preferences for disease monitoring testing.

OUTLINE: Patients are randomized into 1 of 2 arms.

ARM I: Patients undergo imaging studies at a minimum frequency of every 12 weeks and continue with usual care disease monitoring for up to 312 weeks in the absence of disease progression.

ARM II: Patients undergo disease specific serum tumor marker (STM) evaluation every 4-8 weeks. Patients with elevated STM, undergo imaging evaluation. Patients continue with STMDDM for up to 312 weeks in the absence of disease progression.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
1320 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Health Services Research
Official Title:
Randomized Non-Inferiority Trial Comparing Overall Survival of Patients Monitored With Serum Tumor Marker Directed Disease Monitoring (STMDDM) Versus Usual Care in Patients With Metastatic Hormone Receptor Positive Breast Cancer
Actual Study Start Date :
Jul 16, 2018
Anticipated Primary Completion Date :
Jan 1, 2035
Anticipated Study Completion Date :
Jan 1, 2038

Arms and Interventions

Arm Intervention/Treatment
Active Comparator: Arm I (usual care)

Patients will have imaging studies (modality and frequency per treating physician, however at a minimum frequency of every 12 weeks) alone or in conjunction with STMs (frequency determined by treating physician). Patients will continue with usual care disease monitoring for up to 312 weeks in the absence of disease progression.

Other: Usual care disease monitoring
Imaging and serum tumor markers are at the discretion of the treating physician (however imaging must be performed at least every 12 weeks).

Other: Quality-of-Life Assessment
Ancillary studies
Other Names:
  • Quality of Life Assessment

    • Other: Anxiety Questionnaire Administration
    Ancillary studies
    Experimental: Arm II (serum tumor directed disease monitoring)

    Patients undergo disease specific serum tumor marker evaluation (CEA and either CA 15-3 or CA 27.29, whichever were tested at Step 1 Registration and Step 2 Registration) every 4-8 weeks (starting from randomization) without imaging until an elevation of at least one disease specific STM. In the event of an elevated STM, the patient will have imaging within 4 weeks to evaluate for disease progression. Patients continue with STMDDM for up to 312 weeks in the absence of disease progression.

    Other: Serum Tumor Marker directed disease monitoring
    Serum tumor markers every 4-8 weeks without imaging
    Other Names:
  • STMDDM

    • Other: Quality-of-Life Assessment
    Ancillary studies
    Other Names:
  • Quality of Life Assessment

    • Other: Anxiety Questionnaire Administration
    Ancillary studies

    Outcome Measures

    Primary Outcome Measures

    1. Assessment of whether patients monitored with STMDDM have non-inferior overall survival compared with patients monitored with usual care [Up to 312 weeks after randomization]

      The assessment of whether patients monitored with STMDDM have non-inferior overall survival compared with patients monitored with usual care will be based on multivariable Cox regression, adjusting for intervention assignment (intention-to-treat) and the stratification factor (bone only versus visceral disease). If at the time of final analysis the study shows notably fewer events than anticipated, extended follow-up will be examined for its potential to allow examination of the primary endpoint with full power.

    Secondary Outcome Measures

    1. Cumulative direct healthcare costs (in the United States) of patients monitored with STMDDM versus usual care [Up to 48 weeks after randomization]

      The comparison of direct healthcare costs (in the US) by arm will be based on a multivariable linear regression, adjusting for patient and tumor characteristics.

    2. Assessment of anxiety of patients monitored with STMDDM compared to patients monitored with usual care [Up to 102 weeks after randomization]

      Patient anxiety will be measured at baseline and at 12, 24, 36, 48, and 102 after randomization using the State-Trait Anxiety inventory Scale (STAI-S). Differences in anxiety by arm will be evaluated using a mixed-effects model for repeated measures controlling for the baseline score and stratification factor as covariates. No direction of effect will be assumed, implying two-sided testing.

    3. Assessment of quality of life of patients monitored with STMDDM versus patients monitored with usual care [Up to 102 weeks after randomization]

      Patient quality of life (QOL) will be measured at baseline and at weeks 12, 24, 36, 48, and 102 after randomization using the PROMIS-29. Differences in QOL by arm will be evaluated using a mixed-effects model for repeated measures, controlling for the baseline score and stratification factor as covariates. No direction of effect will be assumed, implying two-sided testing.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:

    • STEP 1 REGISTRATION

    • Patients must have a diagnosis of hormone receptor positive (estrogen receptor positive [ER+] and/or progesterone receptor positive [PR+]), HER-2 negative, metastatic (M1) breast cancer and must be receiving or plan to receive first-line systemic treatment for metastatic disease. (Systemic treatment is any treatment meant to treat the whole body such as endocrine therapy +/- targeted therapy +/- chemotherapy).

    • NOTE: Participants are eligible if they have either de-novo metastatic breast cancer and/or recurrent breast cancer from an earlier stage that is now metastatic

    • Patients must be registered to step 1 between 14 days prior to and 60 days after start of first-line systemic treatment for metastatic disease

    • Patients must have been tested for the following breast cancer specific STMs after diagnosis of metastatic disease and within +/-14 days of initiation of first-line systemic treatment for metastatic disease:

    • CEA (must be tested)

    • CA 15-3 or CA 27.29 (at least one of these must be tested)

    • At least one of the tested STMs must have been >= 2 x the institutional upper limit of normal at this time.

    Testing all three STMs is encouraged but only two are required. Patients must plan to have the same two STMs tested for the duration that the patient is on protocol-specified disease monitoring.

    • Patients must have systemic radiographic imaging prior to initiation of systemic therapy or within 30 days of initiation of treatment for metastatic breast cancer and prior to step 1 registration. Modality of imaging is at the discretion of the treating physician.

    • Note: the treating physician can order additional imaging tests at any point prior to randomization at their discretion

    • Patients must be willing to obtain disease monitoring (imaging and/or serum tumor markers) from a consistent facility in which the registering site has access to the results for the duration of the study intervention (312 weeks after step 2 randomization). Imaging and STMs do not need to be completed at the same facility.

    • Patients with known cirrhosis, untreated B12 deficiency, thalassemia, or sickle cell anemia are not eligible as these could cause falsely elevated STM levels

    • Patients with known brain leptomeningeal metastases are not eligible as they may require regular radiographic monitoring to assess treatment response

    • Patients must not be currently enrolled or plan to participate in a first-line treatment trial for metastatic breast cancer with a defined monitoring schedule

    • Patients who are able to complete questionnaires in English or Spanish must participate in patient-reported outcome (PRO) assessments

    • Patients must not be pregnant due to the potential harm to the fetus from radiation exposure from radiographic imaging

    • Except for breast cancer (and previous history of breast cancer), no other prior malignancy is allowed except for adequately treated basal (or squamous cell) skin cancer, in situ cervical cancer or other cancer for which the patient has been disease free for five years

    • Patients must not have received prior systemic therapy for metastatic breast cancer, except for their current line of therapy.

    • Patients must have decision making capacity and be able to provide informed consent

    • Patients must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines; use of legally-authorized representative is not permissible for this study

    • As a part of the Oncology Patient Enrollment Network (OPEN) registration process the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the system

    • STEP 2 RANDOMIZATION

    • Patients must be tested for the breast cancer specific STMs that were tested prior to STEP 1 Registration between 56 and 140 days after initiation of first-line systemic therapy for metastatic disease:

    • CEA (must be tested)

    • CA 15-3 or CA 27.29 (whichever was tested prior to Step 1)

    Testing all three STMs is encouraged but only two are required. Patients must plan to have the same two STMs tested for the duration that the patient is on protocol-specified disease monitoring.

    • At least one of the STMs that was previously elevated must have decreased from the assessment at step 1 by >= 10% at this time.

    • Patients must not have known progression since registration to step 1

    • Patients must be registered to step 2 randomization between 56 days and 140 days after the initiation of first-line systemic therapy for metastatic disease; This window is inclusive; patients may be registered to Step 2 on day 56 or Day 140. Patients must have been eligible for Step 1 in order to be eligible for Step 2 Randomization

    • Baseline questionnaires must be completed within 28 days prior to step 2 randomization; (Note: Those patients who cannot complete the PRO questionnaires in English or Spanish can be registered to step 2 without contributing to PRO research)

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Anchorage Associates in Radiation Medicine Anchorage Alaska United States 98508
    2 Anchorage Radiation Therapy Center Anchorage Alaska United States 99504
    3 Alaska Breast Care and Surgery LLC Anchorage Alaska United States 99508
    4 Alaska Oncology and Hematology LLC Anchorage Alaska United States 99508
    5 Alaska Women's Cancer Care Anchorage Alaska United States 99508
    6 Anchorage Oncology Centre Anchorage Alaska United States 99508
    7 Katmai Oncology Group Anchorage Alaska United States 99508
    8 Providence Alaska Medical Center Anchorage Alaska United States 99508
    9 Fairbanks Memorial Hospital Fairbanks Alaska United States 99701
    10 Kingman Regional Medical Center Kingman Arizona United States 86401
    11 Cancer Center at Saint Joseph's Phoenix Arizona United States 85004
    12 University of Arizona Cancer Center-Orange Grove Campus Tucson Arizona United States 85704
    13 Banner University Medical Center - Tucson Tucson Arizona United States 85719
    14 University of Arizona Cancer Center-North Campus Tucson Arizona United States 85719
    15 Mercy Hospital Fort Smith Fort Smith Arkansas United States 72903
    16 CHI Saint Vincent Cancer Center Hot Springs Hot Springs Arkansas United States 71913
    17 Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro Jonesboro Arkansas United States 72401
    18 Kaiser Permanente-Anaheim Anaheim California United States 92806
    19 Mission Hope Medical Oncology - Arroyo Grande Arroyo Grande California United States 93420
    20 PCR Oncology Arroyo Grande California United States 93420
    21 Kaiser Permanente-Baldwin Park Baldwin Park California United States 91706
    22 Kaiser Permanente-Bellflower Bellflower California United States 90706
    23 Providence Saint Joseph Medical Center/Disney Family Cancer Center Burbank California United States 91505
    24 Kaiser Permanente-Fontana Fontana California United States 92335
    25 Kaiser Permanente-Irvine Irvine California United States 92618
    26 Kaiser Permanente Los Angeles Medical Center Los Angeles California United States 90027
    27 Los Angeles County-USC Medical Center Los Angeles California United States 90033
    28 USC / Norris Comprehensive Cancer Center Los Angeles California United States 90033
    29 Kaiser Permanente West Los Angeles Los Angeles California United States 90034
    30 Providence Queen of The Valley Napa California United States 94558
    31 USC Norris Oncology/Hematology-Newport Beach Newport Beach California United States 92663
    32 Kaiser Permanente-Ontario Ontario California United States 91761
    33 Desert Regional Medical Center Palm Springs California United States 92262
    34 Kaiser Permanente - Panorama City Panorama City California United States 91402
    35 Keck Medical Center of USC Pasadena Pasadena California United States 91105
    36 Kaiser Permanente-Riverside Riverside California United States 92505
    37 Kaiser Permanente-San Diego Mission San Diego California United States 92108
    38 Kaiser Permanente-San Diego Zion San Diego California United States 92120
    39 Pacific Central Coast Health Center-San Luis Obispo San Luis Obispo California United States 93401
    40 Kaiser Permanente-San Marcos San Marcos California United States 92078
    41 Mission Hope Medical Oncology - Santa Maria Santa Maria California United States 93444
    42 Providence Medical Foundation - Santa Rosa Santa Rosa California United States 95403
    43 Providence Santa Rosa Memorial Hospital Santa Rosa California United States 95405
    44 Kaiser Permanente-Woodland Hills Woodland Hills California United States 91367
    45 Rocky Mountain Cancer Centers-Aurora Aurora Colorado United States 80012
    46 The Medical Center of Aurora Aurora Colorado United States 80012
    47 Boulder Community Hospital Boulder Colorado United States 80301
    48 Boulder Community Foothills Hospital Boulder Colorado United States 80303
    49 Rocky Mountain Cancer Centers-Boulder Boulder Colorado United States 80304
    50 Rocky Mountain Cancer Centers - Centennial Centennial Colorado United States 80112
    51 Penrose-Saint Francis Healthcare Colorado Springs Colorado United States 80907
    52 Rocky Mountain Cancer Centers-Penrose Colorado Springs Colorado United States 80907
    53 Saint Francis Cancer Center Colorado Springs Colorado United States 80923
    54 Cancer Center of Colorado at Sloan's Lake Denver Colorado United States 80204
    55 Denver Health Medical Center Denver Colorado United States 80204
    56 National Jewish Health-Main Campus Denver Colorado United States 80206
    57 The Women's Imaging Center Denver Colorado United States 80209
    58 Porter Adventist Hospital Denver Colorado United States 80210
    59 Colorado Blood Cancer Institute Denver Colorado United States 80218
    60 Presbyterian - Saint Lukes Medical Center - Health One Denver Colorado United States 80218
    61 Rocky Mountain Cancer Centers-Midtown Denver Colorado United States 80218
    62 SCL Health Saint Joseph Hospital Denver Colorado United States 80218
    63 Rocky Mountain Cancer Centers-Rose Denver Colorado United States 80220
    64 Rose Medical Center Denver Colorado United States 80220
    65 Western Surgical Care Denver Colorado United States 80220
    66 Mercy Medical Center Durango Colorado United States 81301
    67 Southwest Oncology PC Durango Colorado United States 81301
    68 Mountain Blue Cancer Care Center - Swedish Englewood Colorado United States 80113
    69 Rocky Mountain Cancer Centers - Swedish Englewood Colorado United States 80113
    70 Swedish Medical Center Englewood Colorado United States 80113
    71 The Melanoma and Skin Cancer Institute Englewood Colorado United States 80113
    72 Mountain Blue Cancer Care Center Golden Colorado United States 80401
    73 National Jewish Health-Western Hematology Oncology Golden Colorado United States 80401
    74 Saint Mary's Hospital and Regional Medical Center Grand Junction Colorado United States 81501
    75 North Colorado Medical Center Greeley Colorado United States 80631
    76 Good Samaritan Medical Center Lafayette Colorado United States 80026
    77 Rocky Mountain Cancer Centers-Lakewood Lakewood Colorado United States 80228
    78 Saint Anthony Hospital Lakewood Colorado United States 80228
    79 Rocky Mountain Cancer Centers-Littleton Littleton Colorado United States 80120
    80 Littleton Adventist Hospital Littleton Colorado United States 80122
    81 Rocky Mountain Cancer Centers-Sky Ridge Lone Tree Colorado United States 80124
    82 Sky Ridge Medical Center Lone Tree Colorado United States 80124
    83 Longmont United Hospital Longmont Colorado United States 80501
    84 Rocky Mountain Cancer Centers-Longmont Longmont Colorado United States 80501
    85 McKee Medical Center Loveland Colorado United States 80539
    86 Parker Adventist Hospital Parker Colorado United States 80138
    87 Rocky Mountain Cancer Centers-Parker Parker Colorado United States 80138
    88 Saint Mary Corwin Medical Center Pueblo Colorado United States 81004
    89 Rocky Mountain Cancer Centers - Pueblo Pueblo Colorado United States 81008
    90 National Jewish Health-Northern Hematology Oncology Thornton Colorado United States 80260
    91 Rocky Mountain Cancer Centers-Thornton Thornton Colorado United States 80260
    92 SCL Health Lutheran Medical Center Wheat Ridge Colorado United States 80033
    93 Smilow Cancer Hospital-Derby Care Center Derby Connecticut United States 06418
    94 Smilow Cancer Hospital Care Center-Fairfield Fairfield Connecticut United States 06824
    95 Smilow Cancer Hospital Care Center at Glastonbury Glastonbury Connecticut United States 06033
    96 Smilow Cancer Hospital Care Center - Guiford Guilford Connecticut United States 06437
    97 Smilow Cancer Hospital Care Center at Saint Francis Hartford Connecticut United States 06105
    98 Smilow Cancer Center/Yale-New Haven Hospital New Haven Connecticut United States 06510
    99 Yale University New Haven Connecticut United States 06520
    100 Yale-New Haven Hospital North Haven Medical Center North Haven Connecticut United States 06473
    101 Smilow Cancer Hospital-Orange Care Center Orange Connecticut United States 06477
    102 Smilow Cancer Hospital-Torrington Care Center Torrington Connecticut United States 06790
    103 Smilow Cancer Hospital Care Center-Trumbull Trumbull Connecticut United States 06611
    104 Smilow Cancer Hospital-Waterbury Care Center Waterbury Connecticut United States 06708
    105 Smilow Cancer Hospital Care Center - Waterford Waterford Connecticut United States 06385
    106 Mount Sinai Comprehensive Cancer Center at Aventura Aventura Florida United States 33180
    107 Broward Health North Deerfield Beach Florida United States 33064
    108 Holy Cross Hospital Fort Lauderdale Florida United States 33308
    109 Broward Health Medical Center Fort Lauderdale Florida United States 33316
    110 The Watson Clinic Lakeland Florida United States 33805
    111 Mount Sinai Medical Center Miami Beach Florida United States 33140
    112 Sacred Heart Hospital Pensacola Florida United States 32504
    113 Cleveland Clinic-Weston Weston Florida United States 33331
    114 Grady Health System Atlanta Georgia United States 30303
    115 Emory University Hospital Midtown Atlanta Georgia United States 30308
    116 Emory University Hospital/Winship Cancer Institute Atlanta Georgia United States 30322
    117 Emory Saint Joseph's Hospital Atlanta Georgia United States 30342
    118 Lewis Cancer and Research Pavilion at Saint Joseph's/Candler Savannah Georgia United States 31405
    119 Summit Cancer Care-Candler Savannah Georgia United States 31405
    120 Hawaii Cancer Care - Savio 'Aiea Hawaii United States 96701
    121 Pali Momi Medical Center 'Aiea Hawaii United States 96701
    122 Queen's Cancer Center - Pearlridge 'Aiea Hawaii United States 96701
    123 Straub Pearlridge Clinic 'Aiea Hawaii United States 96701
    124 The Cancer Center of Hawaii-Pali Momi 'Aiea Hawaii United States 96701
    125 The Queen's Medical Center - West Oahu 'Ewa Beach Hawaii United States 96706
    126 Hawaii Cancer Care Inc - Waterfront Plaza Honolulu Hawaii United States 96813
    127 Island Urology Honolulu Hawaii United States 96813
    128 Queen's Cancer Cenrer - POB I Honolulu Hawaii United States 96813
    129 Queen's Medical Center Honolulu Hawaii United States 96813
    130 Straub Clinic and Hospital Honolulu Hawaii United States 96813
    131 University of Hawaii Cancer Center Honolulu Hawaii United States 96813
    132 Hawaii Cancer Care Inc-Liliha Honolulu Hawaii United States 96817
    133 Hawaii Diagnostic Radiology Services LLC Honolulu Hawaii United States 96817
    134 Kuakini Medical Center Honolulu Hawaii United States 96817
    135 Queen's Cancer Center - Kuakini Honolulu Hawaii United States 96817
    136 The Cancer Center of Hawaii-Liliha Honolulu Hawaii United States 96817
    137 Kapiolani Medical Center for Women and Children Honolulu Hawaii United States 96826
    138 Straub Medical Center - Kahului Clinic Kahului Hawaii United States 96732
    139 Castle Medical Center Kailua Hawaii United States 96734
    140 Wilcox Memorial Hospital and Kauai Medical Clinic Lihue Hawaii United States 96766
    141 Saint Alphonsus Cancer Care Center-Boise Boise Idaho United States 83706
    142 Saint Luke's Cancer Institute - Boise Boise Idaho United States 83712
    143 Saint Alphonsus Cancer Care Center-Caldwell Caldwell Idaho United States 83605
    144 Kootenai Health - Coeur d'Alene Coeur d'Alene Idaho United States 83814
    145 Walter Knox Memorial Hospital Emmett Idaho United States 83617
    146 Saint Luke's Cancer Institute - Fruitland Fruitland Idaho United States 83619
    147 Idaho Urologic Institute-Meridian Meridian Idaho United States 83642
    148 Saint Luke's Cancer Institute - Meridian Meridian Idaho United States 83642
    149 Saint Alphonsus Medical Center-Nampa Nampa Idaho United States 83686
    150 Saint Luke's Cancer Institute - Nampa Nampa Idaho United States 83686
    151 Kootenai Clinic Cancer Services - Post Falls Post Falls Idaho United States 83854
    152 Kootenai Cancer Clinic Sandpoint Idaho United States 83864
    153 Saint Luke's Cancer Institute - Twin Falls Twin Falls Idaho United States 83301
    154 Saint Anthony's Health Alton Illinois United States 62002
    155 Rush - Copley Medical Center Aurora Illinois United States 60504
    156 Illinois CancerCare-Bloomington Bloomington Illinois United States 61704
    157 Loyola Center for Health at Burr Ridge Burr Ridge Illinois United States 60527
    158 Illinois CancerCare-Canton Canton Illinois United States 61520
    159 Memorial Hospital of Carbondale Carbondale Illinois United States 62902
    160 SIH Cancer Institute Carterville Illinois United States 62918
    161 Illinois CancerCare-Carthage Carthage Illinois United States 62321
    162 Centralia Oncology Clinic Centralia Illinois United States 62801
    163 Carle on Vermilion Danville Illinois United States 61832
    164 Cancer Care Specialists of Illinois - Decatur Decatur Illinois United States 62526
    165 Decatur Memorial Hospital Decatur Illinois United States 62526
    166 Illinois CancerCare-Dixon Dixon Illinois United States 61021
    167 Carle Physician Group-Effingham Effingham Illinois United States 62401
    168 Crossroads Cancer Center Effingham Illinois United States 62401
    169 Illinois CancerCare-Eureka Eureka Illinois United States 61530
    170 Illinois CancerCare-Galesburg Galesburg Illinois United States 61401
    171 Western Illinois Cancer Treatment Center Galesburg Illinois United States 61401
    172 Loyola Medicine Homer Glen Homer Glen Illinois United States 60491
    173 Illinois CancerCare-Kewanee Clinic Kewanee Illinois United States 61443
    174 Illinois CancerCare-Macomb Macomb Illinois United States 61455
    175 Carle Physician Group-Mattoon/Charleston Mattoon Illinois United States 61938
    176 Loyola University Medical Center Maywood Illinois United States 60153
    177 Marjorie Weinberg Cancer Center at Loyola-Gottlieb Melrose Park Illinois United States 60160
    178 Trinity Medical Center Moline Illinois United States 61265
    179 Good Samaritan Regional Health Center Mount Vernon Illinois United States 62864
    180 Cancer Care Center of O'Fallon O'Fallon Illinois United States 62269
    181 Illinois CancerCare-Ottawa Clinic Ottawa Illinois United States 61350
    182 Illinois CancerCare-Pekin Pekin Illinois United States 61554
    183 Illinois CancerCare-Peoria Peoria Illinois United States 61615
    184 Methodist Medical Center of Illinois Peoria Illinois United States 61636
    185 Illinois CancerCare-Peru Peru Illinois United States 61354
    186 Valley Radiation Oncology Peru Illinois United States 61354
    187 Illinois CancerCare-Princeton Princeton Illinois United States 61356
    188 West Suburban Medical Center River Forest Illinois United States 60305
    189 Southern Illinois University School of Medicine Springfield Illinois United States 62702
    190 Springfield Clinic Springfield Illinois United States 62702
    191 Memorial Medical Center Springfield Illinois United States 62781
    192 Southwest Illinois Health Services LLP Swansea Illinois United States 62226
    193 Carle Cancer Center Urbana Illinois United States 61801
    194 The Carle Foundation Hospital Urbana Illinois United States 61801
    195 Illinois CancerCare - Washington Washington Illinois United States 61571
    196 Rush-Copley Healthcare Center Yorkville Illinois United States 60560
    197 IU Health Ball Memorial Hospital Muncie Indiana United States 47303
    198 Reid Health Richmond Indiana United States 47374
    199 Mary Greeley Medical Center Ames Iowa United States 50010
    200 McFarland Clinic PC - Ames Ames Iowa United States 50010
    201 McFarland Clinic PC-Boone Boone Iowa United States 50036
    202 Medical Oncology and Hematology Associates-West Des Moines Clive Iowa United States 50325
    203 Mercy Cancer Center-West Lakes Clive Iowa United States 50325
    204 Alegent Health Mercy Hospital Council Bluffs Iowa United States 51503
    205 Greater Regional Medical Center Creston Iowa United States 50801
    206 Medical Oncology and Hematology Associates-Laurel Des Moines Iowa United States 50314
    207 Mercy Medical Center - Des Moines Des Moines Iowa United States 50314
    208 McFarland Clinic PC-Trinity Cancer Center Fort Dodge Iowa United States 50501
    209 McFarland Clinic PC-Jefferson Jefferson Iowa United States 50129
    210 McFarland Clinic PC-Marshalltown Marshalltown Iowa United States 50158
    211 MercyOne Waterloo Medical Center Waterloo Iowa United States 50702
    212 Mercy Medical Center-West Lakes West Des Moines Iowa United States 50266
    213 Central Care Cancer Center - Garden City Garden City Kansas United States 67846
    214 Central Care Cancer Center - Great Bend Great Bend Kansas United States 67530
    215 HaysMed University of Kansas Health System Hays Kansas United States 67601
    216 Lawrence Memorial Hospital Lawrence Kansas United States 66044
    217 Kansas Institute of Medicine Cancer and Blood Center Lenexa Kansas United States 66219
    218 Minimally Invasive Surgery Hospital Lenexa Kansas United States 66219
    219 Olathe Health Cancer Center Olathe Kansas United States 66061
    220 Menorah Medical Center Overland Park Kansas United States 66209
    221 Ascension Via Christi - Pittsburg Pittsburg Kansas United States 66762
    222 Salina Regional Health Center Salina Kansas United States 67401
    223 Cotton O'Neil Cancer Center / Stormont Vail Health Topeka Kansas United States 66606
    224 University of Kansas Health System Saint Francis Campus Topeka Kansas United States 66606
    225 Cancer Center of Kansas-Wichita Medical Arts Tower Wichita Kansas United States 67208
    226 Cancer Center of Kansas - Wichita Wichita Kansas United States 67214
    227 Flaget Memorial Hospital Bardstown Kentucky United States 40004
    228 Commonwealth Cancer Center-Corbin Corbin Kentucky United States 40701
    229 Saint Joseph Radiation Oncology Resource Center Lexington Kentucky United States 40504
    230 Saint Joseph Hospital East Lexington Kentucky United States 40509
    231 Saint Joseph London London Kentucky United States 40741
    232 Jewish Hospital Louisville Kentucky United States 40202
    233 Saints Mary and Elizabeth Hospital Louisville Kentucky United States 40215
    234 UofL Health Medical Center Northeast Louisville Kentucky United States 40245
    235 Jewish Hospital Medical Center South Shepherdsville Kentucky United States 40165
    236 Ochsner LSU Health Monroe Medical Center Monroe Louisiana United States 71202
    237 Louisiana State University Health Science Center New Orleans Louisiana United States 70112
    238 University Medical Center New Orleans New Orleans Louisiana United States 70112
    239 Ochsner LSU Health Saint Mary's Medical Center Shreveport Louisiana United States 71101
    240 LSU Health Sciences Center at Shreveport Shreveport Louisiana United States 71103
    241 Holy Cross Hospital Silver Spring Maryland United States 20910
    242 Lahey Hospital and Medical Center Burlington Massachusetts United States 01805
    243 Lahey Medical Center-Peabody Peabody Massachusetts United States 01960
    244 Mercy Medical Center Springfield Massachusetts United States 01104
    245 Winchester Hospital Winchester Massachusetts United States 01890
    246 Hickman Cancer Center Adrian Michigan United States 49221
    247 Saint Joseph Mercy Hospital Ann Arbor Michigan United States 48106
    248 Bronson Battle Creek Battle Creek Michigan United States 49017
    249 IHA Hematology Oncology Consultants-Brighton Brighton Michigan United States 48114
    250 Saint Joseph Mercy Brighton Brighton Michigan United States 48114
    251 IHA Hematology Oncology Consultants-Canton Canton Michigan United States 48188
    252 Saint Joseph Mercy Canton Canton Michigan United States 48188
    253 Caro Cancer Center Caro Michigan United States 48723
    254 IHA Hematology Oncology Consultants-Chelsea Chelsea Michigan United States 48118
    255 Saint Joseph Mercy Chelsea Chelsea Michigan United States 48118
    256 Hematology Oncology Consultants-Clarkston Clarkston Michigan United States 48346
    257 Newland Medical Associates-Clarkston Clarkston Michigan United States 48346
    258 Ascension Saint John Hospital Detroit Michigan United States 48236
    259 Great Lakes Cancer Management Specialists-Doctors Park East China Township Michigan United States 48054
    260 Green Bay Oncology - Escanaba Escanaba Michigan United States 49829
    261 Genesee Cancer and Blood Disease Treatment Center Flint Michigan United States 48503
    262 Genesee Hematology Oncology PC Flint Michigan United States 48503
    263 Genesys Hurley Cancer Institute Flint Michigan United States 48503
    264 Hurley Medical Center Flint Michigan United States 48503
    265 Helen DeVos Children's Hospital at Spectrum Health Grand Rapids Michigan United States 49503
    266 Mercy Health Saint Mary's Grand Rapids Michigan United States 49503
    267 Spectrum Health at Butterworth Campus Grand Rapids Michigan United States 49503
    268 Academic Hematology Oncology Specialists Grosse Pointe Woods Michigan United States 48236
    269 Great Lakes Cancer Management Specialists-Van Elslander Cancer Center Grosse Pointe Woods Michigan United States 48236
    270 Michigan Breast Specialists-Grosse Pointe Woods Grosse Pointe Woods Michigan United States 48236
    271 Bronson Methodist Hospital Kalamazoo Michigan United States 49007
    272 West Michigan Cancer Center Kalamazoo Michigan United States 49007
    273 Ascension Borgess Cancer Center Kalamazoo Michigan United States 49009
    274 Borgess Medical Center Kalamazoo Michigan United States 49048
    275 Sparrow Hospital Lansing Michigan United States 48912
    276 Hope Cancer Clinic Livonia Michigan United States 48154
    277 Saint Mary Mercy Hospital Livonia Michigan United States 48154
    278 Great Lakes Cancer Management Specialists-Macomb Medical Campus Macomb Michigan United States 48044
    279 Michigan Breast Specialists-Macomb Township Macomb Michigan United States 48044
    280 Saint Mary's Oncology/Hematology Associates of Marlette Marlette Michigan United States 48453
    281 Toledo Clinic Cancer Centers-Monroe Monroe Michigan United States 48162
    282 Mercy Health Mercy Campus Muskegon Michigan United States 49444
    283 Lakeland Hospital Niles Niles Michigan United States 49120
    284 Cancer and Hematology Centers of Western Michigan - Norton Shores Norton Shores Michigan United States 49444
    285 21st Century Oncology-Pontiac Pontiac Michigan United States 48341
    286 Hope Cancer Center Pontiac Michigan United States 48341
    287 Newland Medical Associates-Pontiac Pontiac Michigan United States 48341
    288 Saint Joseph Mercy Oakland Pontiac Michigan United States 48341
    289 Spectrum Health Reed City Hospital Reed City Michigan United States 49677
    290 Great Lakes Cancer Management Specialists-Rochester Hills Rochester Hills Michigan United States 48309
    291 Ascension Saint Mary's Hospital Saginaw Michigan United States 48601
    292 Oncology Hematology Associates of Saginaw Valley PC Saginaw Michigan United States 48604
    293 Lakeland Medical Center Saint Joseph Saint Joseph Michigan United States 49085
    294 Marie Yeager Cancer Center Saint Joseph Michigan United States 49085
    295 Bhadresh Nayak MD PC-Sterling Heights Sterling Heights Michigan United States 48312
    296 Ascension Saint Joseph Hospital Tawas City Michigan United States 48764
    297 Munson Medical Center Traverse City Michigan United States 49684
    298 Advanced Breast Care Center PLLC Warren Michigan United States 48088
    299 Great Lakes Cancer Management Specialists-Macomb Professional Building Warren Michigan United States 48093
    300 Macomb Hematology Oncology PC Warren Michigan United States 48093
    301 Michigan Breast Specialists-Warren Warren Michigan United States 48093
    302 Saint John Macomb-Oakland Hospital Warren Michigan United States 48093
    303 Saint Mary's Oncology/Hematology Associates of West Branch West Branch Michigan United States 48661
    304 Metro Health Hospital Wyoming Michigan United States 49519
    305 Huron Gastroenterology PC Ypsilanti Michigan United States 48106
    306 IHA Hematology Oncology Consultants-Ann Arbor Ypsilanti Michigan United States 48197
    307 Sanford Joe Lueken Cancer Center Bemidji Minnesota United States 56601
    308 Fairview Ridges Hospital Burnsville Minnesota United States 55337
    309 Minnesota Oncology - Burnsville Burnsville Minnesota United States 55337
    310 Cambridge Medical Center Cambridge Minnesota United States 55008
    311 Mercy Hospital Coon Rapids Minnesota United States 55433
    312 Fairview Southdale Hospital Edina Minnesota United States 55435
    313 Unity Hospital Fridley Minnesota United States 55432
    314 Fairview Clinics and Surgery Center Maple Grove Maple Grove Minnesota United States 55369
    315 Minnesota Oncology Hematology PA-Maplewood Maplewood Minnesota United States 55109
    316 Saint John's Hospital - Healtheast Maplewood Minnesota United States 55109
    317 Abbott-Northwestern Hospital Minneapolis Minnesota United States 55407
    318 Hennepin County Medical Center Minneapolis Minnesota United States 55415
    319 Health Partners Inc Minneapolis Minnesota United States 55454
    320 Monticello Cancer Center Monticello Minnesota United States 55362
    321 New Ulm Medical Center New Ulm Minnesota United States 56073
    322 Fairview Northland Medical Center Princeton Minnesota United States 55371
    323 North Memorial Medical Health Center Robbinsdale Minnesota United States 55422
    324 Park Nicollet Clinic - Saint Louis Park Saint Louis Park Minnesota United States 55416
    325 Regions Hospital Saint Paul Minnesota United States 55101
    326 United Hospital Saint Paul Minnesota United States 55102
    327 Saint Francis Regional Medical Center Shakopee Minnesota United States 55379
    328 Lakeview Hospital Stillwater Minnesota United States 55082
    329 Sanford Thief River Falls Medical Center Thief River Falls Minnesota United States 56701
    330 Ridgeview Medical Center Waconia Minnesota United States 55387
    331 Rice Memorial Hospital Willmar Minnesota United States 56201
    332 Minnesota Oncology Hematology PA-Woodbury Woodbury Minnesota United States 55125
    333 Sanford Cancer Center Worthington Worthington Minnesota United States 56187
    334 Fairview Lakes Medical Center Wyoming Minnesota United States 55092
    335 Baptist Memorial Hospital and Cancer Center-Golden Triangle Columbus Mississippi United States 39705
    336 Baptist Cancer Center-Grenada Grenada Mississippi United States 38901
    337 Gulfport Memorial Hospital Gulfport Mississippi United States 39502
    338 Baptist Memorial Hospital and Cancer Center-Union County New Albany Mississippi United States 38652
    339 Baptist Memorial Hospital and Cancer Center-Oxford Oxford Mississippi United States 38655
    340 Singing River Hospital Pascagoula Mississippi United States 39581
    341 Baptist Memorial Hospital and Cancer Center-Desoto Southhaven Mississippi United States 38671
    342 Saint Louis Cancer and Breast Institute-Ballwin Ballwin Missouri United States 63011
    343 Central Care Cancer Center - Bolivar Bolivar Missouri United States 65613
    344 Parkland Health Center-Bonne Terre Bonne Terre Missouri United States 63628
    345 Cox Cancer Center Branson Branson Missouri United States 65616
    346 Saint Francis Medical Center Cape Girardeau Missouri United States 63703
    347 Southeast Cancer Center Cape Girardeau Missouri United States 63703
    348 University of Missouri - Ellis Fischel Columbia Missouri United States 65212
    349 Parkland Health Center - Farmington Farmington Missouri United States 63640
    350 Centerpoint Medical Center LLC Independence Missouri United States 64057
    351 Capital Region Southwest Campus Jefferson City Missouri United States 65109
    352 Freeman Health System Joplin Missouri United States 64804
    353 Mercy Hospital Joplin Joplin Missouri United States 64804
    354 Truman Medical Centers Kansas City Missouri United States 64108
    355 Research Medical Center Kansas City Missouri United States 64132
    356 Delbert Day Cancer Institute at PCRMC Rolla Missouri United States 65401
    357 Mercy Clinic-Rolla-Cancer and Hematology Rolla Missouri United States 65401
    358 Heartland Regional Medical Center Saint Joseph Missouri United States 64506
    359 Saint Louis Cancer and Breast Institute-South City Saint Louis Missouri United States 63109
    360 Mercy Hospital South Saint Louis Missouri United States 63128
    361 Missouri Baptist Medical Center Saint Louis Missouri United States 63131
    362 Mercy Hospital Saint Louis Saint Louis Missouri United States 63141
    363 Sainte Genevieve County Memorial Hospital Sainte Genevieve Missouri United States 63670
    364 Mercy Hospital Springfield Springfield Missouri United States 65804
    365 CoxHealth South Hospital Springfield Missouri United States 65807
    366 Missouri Baptist Sullivan Hospital Sullivan Missouri United States 63080
    367 Missouri Baptist Outpatient Center-Sunset Hills Sunset Hills Missouri United States 63127
    368 Mercy Hospital Washington Washington Missouri United States 63090
    369 Community Hospital of Anaconda Anaconda Montana United States 59711
    370 Billings Clinic Cancer Center Billings Montana United States 59101
    371 Saint Vincent Healthcare Billings Montana United States 59101
    372 Saint Vincent Frontier Cancer Center Billings Montana United States 59102
    373 Bozeman Deaconess Hospital Bozeman Montana United States 59715
    374 Saint James Community Hospital and Cancer Treatment Center Butte Montana United States 59701
    375 Benefis Healthcare- Sletten Cancer Institute Great Falls Montana United States 59405
    376 Great Falls Clinic Great Falls Montana United States 59405
    377 Saint Peter's Community Hospital Helena Montana United States 59601
    378 Kalispell Regional Medical Center Kalispell Montana United States 59901
    379 Saint Patrick Hospital - Community Hospital Missoula Montana United States 59802
    380 Community Medical Hospital Missoula Montana United States 59804
    381 CHI Health Saint Francis Grand Island Nebraska United States 68803
    382 Heartland Hematology and Oncology Kearney Nebraska United States 68845
    383 CHI Health Good Samaritan Kearney Nebraska United States 68847
    384 Saint Elizabeth Regional Medical Center Lincoln Nebraska United States 68510
    385 Alegent Health Immanuel Medical Center Omaha Nebraska United States 68122
    386 Hematology and Oncology Consultants PC Omaha Nebraska United States 68122
    387 Alegent Health Bergan Mercy Medical Center Omaha Nebraska United States 68124
    388 Alegent Health Lakeside Hospital Omaha Nebraska United States 68130
    389 Creighton University Medical Center Omaha Nebraska United States 68131
    390 Midlands Community Hospital Papillion Nebraska United States 68046
    391 Carson Tahoe Regional Medical Center Carson City Nevada United States 89703
    392 Cancer and Blood Specialists-Henderson Henderson Nevada United States 89052
    393 Comprehensive Cancer Centers of Nevada - Henderson Henderson Nevada United States 89052
    394 Comprehensive Cancer Centers of Nevada-Horizon Ridge Henderson Nevada United States 89052
    395 Las Vegas Cancer Center-Henderson Henderson Nevada United States 89052
    396 OptumCare Cancer Care at Seven Hills Henderson Nevada United States 89052
    397 21st Century Oncology-Henderson Henderson Nevada United States 89074
    398 Comprehensive Cancer Centers of Nevada-Southeast Henderson Henderson Nevada United States 89074
    399 Las Vegas Urology - Green Valley Henderson Nevada United States 89074
    400 Las Vegas Urology - Pebble Henderson Nevada United States 89074
    401 Urology Specialists of Nevada - Green Valley Henderson Nevada United States 89074
    402 Las Vegas Urology - Pecos Las Vegas Nevada United States 89074
    403 Desert West Surgery Las Vegas Nevada United States 89102
    404 OptumCare Cancer Care at Charleston Las Vegas Nevada United States 89102
    405 University Medical Center of Southern Nevada Las Vegas Nevada United States 89102
    406 Hope Cancer Care of Nevada Las Vegas Nevada United States 89103
    407 Radiation Oncology Centers of Nevada Central Las Vegas Nevada United States 89106
    408 Urology Specialists of Nevada - Central Las Vegas Nevada United States 89106
    409 21st Century Oncology Las Vegas Nevada United States 89109
    410 Sunrise Hospital and Medical Center Las Vegas Nevada United States 89109
    411 Las Vegas Prostate Cancer Center Las Vegas Nevada United States 89113
    412 Las Vegas Urology - Sunset Las Vegas Nevada United States 89113
    413 Urology Specialists of Nevada - Southwest Las Vegas Nevada United States 89113
    414 Radiation Oncology Centers of Nevada Southeast Las Vegas Nevada United States 89119
    415 21st Century Oncology-Vegas Tenaya Las Vegas Nevada United States 89128
    416 Ann M Wierman MD LTD Las Vegas Nevada United States 89128
    417 Comprehensive Cancer Centers of Nevada - Northwest Las Vegas Nevada United States 89128
    418 Las Vegas Urology - Cathedral Rock Las Vegas Nevada United States 89128
    419 Las Vegas Urology - Smoke Ranch Las Vegas Nevada United States 89128
    420 OptumCare Cancer Care at MountainView Las Vegas Nevada United States 89128
    421 Urology Specialists of Nevada - Northwest Las Vegas Nevada United States 89128
    422 Alliance for Childhood Diseases/Cure 4 the Kids Foundation Las Vegas Nevada United States 89135
    423 Comprehensive Cancer Centers of Nevada - Town Center Las Vegas Nevada United States 89144
    424 Comprehensive Cancer Centers of Nevada-Summerlin Las Vegas Nevada United States 89144
    425 Summerlin Hospital Medical Center Las Vegas Nevada United States 89144
    426 Las Vegas Cancer Center-Medical Center Las Vegas Nevada United States 89148-2405
    427 21st Century Oncology-Fort Apache Las Vegas Nevada United States 89148
    428 Comprehensive Cancer Centers of Nevada Las Vegas Nevada United States 89148
    429 OptumCare Cancer Care at Fort Apache Las Vegas Nevada United States 89148
    430 Comprehensive Cancer Centers of Nevada - Central Valley Las Vegas Nevada United States 89169
    431 University Cancer Center Las Vegas Nevada United States 89169
    432 Hope Cancer Care of Nevada-Pahrump Pahrump Nevada United States 89048
    433 Renown Regional Medical Center Reno Nevada United States 89502
    434 Saint Mary's Regional Medical Center Reno Nevada United States 89503
    435 Radiation Oncology Associates Reno Nevada United States 89509
    436 New Hampshire Oncology Hematology PA-Concord Concord New Hampshire United States 03301
    437 Elliot Hospital Manchester New Hampshire United States 03103
    438 Solinsky Center for Cancer Care Manchester New Hampshire United States 03103
    439 AtlantiCare Health Park-Cape May Court House Cape May Court House New Jersey United States 08210
    440 AtlantiCare Surgery Center Egg Harbor Township New Jersey United States 08234
    441 Morristown Medical Center Morristown New Jersey United States 07960
    442 Sidney Kimmel Cancer Center Washington Township Sewell New Jersey United States 08080
    443 Overlook Hospital Summit New Jersey United States 07902
    444 University of New Mexico Cancer Center Albuquerque New Mexico United States 87102
    445 Presbyterian Kaseman Hospital Albuquerque New Mexico United States 87110
    446 Memorial Medical Center - Las Cruces Las Cruces New Mexico United States 88011
    447 Presbyterian Rust Medical Center/Jorgensen Cancer Center Rio Rancho New Mexico United States 87124
    448 Montefiore Medical Center-Einstein Campus Bronx New York United States 10461
    449 Montefiore Medical Center-Weiler Hospital Bronx New York United States 10461
    450 Montefiore Medical Center - Moses Campus Bronx New York United States 10467
    451 Mary Imogene Bassett Hospital Cooperstown New York United States 13326
    452 Arnot Ogden Medical Center/Falck Cancer Center Elmira New York United States 14905
    453 Mount Sinai Chelsea New York New York United States 10011
    454 Mount Sinai West New York New York United States 10019
    455 Mount Sinai Hospital New York New York United States 10029
    456 NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center New York New York United States 10032
    457 University of Rochester Rochester New York United States 14642
    458 Southeastern Medical Oncology Center-Clinton Clinton North Carolina United States 28328
    459 CaroMont Regional Medical Center Gastonia North Carolina United States 28054
    460 Southeastern Medical Oncology Center-Goldsboro Goldsboro North Carolina United States 27534
    461 Wayne Memorial Hospital Goldsboro North Carolina United States 27534
    462 Onslow Memorial Hospital Jacksonville North Carolina United States 28546
    463 Southeastern Medical Oncology Center-Jacksonville Jacksonville North Carolina United States 28546
    464 Sanford Bismarck Medical Center Bismarck North Dakota United States 58501
    465 Sanford South University Medical Center Fargo North Dakota United States 58103
    466 Southpointe-Sanford Medical Center Fargo Fargo North Dakota United States 58103
    467 Sanford Medical Center Fargo Fargo North Dakota United States 58104
    468 Sanford Broadway Medical Center Fargo North Dakota United States 58122
    469 Sanford Roger Maris Cancer Center Fargo North Dakota United States 58122
    470 Altru Cancer Center Grand Forks North Dakota United States 58201
    471 Indu and Raj Soin Medical Center Beavercreek Ohio United States 45431
    472 Strecker Cancer Center-Belpre Belpre Ohio United States 45714
    473 Saint Elizabeth Boardman Hospital Boardman Ohio United States 44512
    474 Dayton Physicians LLC-Miami Valley South Centerville Ohio United States 45459
    475 Miami Valley Hospital South Centerville Ohio United States 45459
    476 Adena Regional Medical Center Chillicothe Ohio United States 45601
    477 Good Samaritan Hospital - Cincinnati Cincinnati Ohio United States 45220
    478 Oncology Hematology Care Inc-Kenwood Cincinnati Ohio United States 45236
    479 Bethesda North Hospital Cincinnati Ohio United States 45242
    480 TriHealth Cancer Institute-Westside Cincinnati Ohio United States 45247
    481 TriHealth Cancer Institute-Anderson Cincinnati Ohio United States 45255
    482 Cleveland Clinic Cancer Center/Fairview Hospital Cleveland Ohio United States 44111
    483 Mount Carmel East Hospital Columbus Ohio United States 43213
    484 Columbus Oncology and Hematology Associates Inc Columbus Ohio United States 43214
    485 Riverside Methodist Hospital Columbus Ohio United States 43214
    486 Grant Medical Center Columbus Ohio United States 43215
    487 The Mark H Zangmeister Center Columbus Ohio United States 43219
    488 Mount Carmel Health Center West Columbus Ohio United States 43222
    489 Doctors Hospital Columbus Ohio United States 43228
    490 Good Samaritan Hospital - Dayton Dayton Ohio United States 45406
    491 Miami Valley Hospital Dayton Ohio United States 45409
    492 Dayton Physician LLC-Miami Valley Hospital North Dayton Ohio United States 45415
    493 Miami Valley Hospital North Dayton Ohio United States 45415
    494 Delaware Health Center-Grady Cancer Center Delaware Ohio United States 43015
    495 Delaware Radiation Oncology Delaware Ohio United States 43015
    496 Grady Memorial Hospital Delaware Ohio United States 43015
    497 Dublin Methodist Hospital Dublin Ohio United States 43016
    498 Armes Family Cancer Center Findlay Ohio United States 45840
    499 Blanchard Valley Hospital Findlay Ohio United States 45840
    500 Orion Cancer Care Findlay Ohio United States 45840
    501 Atrium Medical Center-Middletown Regional Hospital Franklin Ohio United States 45005-1066
    502 Dayton Physicians LLC-Atrium Franklin Ohio United States 45005
    503 Dayton Physicians LLC-Wayne Greenville Ohio United States 45331
    504 Wayne Hospital Greenville Ohio United States 45331
    505 Mount Carmel Grove City Hospital Grove City Ohio United States 43123
    506 Cleveland Clinic Cancer Center Independence Independence Ohio United States 44131
    507 Greater Dayton Cancer Center Kettering Ohio United States 45409
    508 First Dayton Cancer Care Kettering Ohio United States 45420
    509 Kettering Medical Center Kettering Ohio United States 45429
    510 Fairfield Medical Center Lancaster Ohio United States 43130
    511 Saint Rita's Medical Center Lima Ohio United States 45801
    512 OhioHealth Mansfield Hospital Mansfield Ohio United States 44903
    513 Cleveland Clinic Cancer Center Mansfield Mansfield Ohio United States 44906
    514 Marietta Memorial Hospital Marietta Ohio United States 45750
    515 OhioHealth Marion General Hospital Marion Ohio United States 43302
    516 Toledo Clinic Cancer Centers-Maumee Maumee Ohio United States 43537
    517 Toledo Radiation Oncology at Northwest Ohio Onocolgy Center Maumee Ohio United States 43537
    518 Hillcrest Hospital Cancer Center Mayfield Heights Ohio United States 44124
    519 Knox Community Hospital Mount Vernon Ohio United States 43050
    520 Licking Memorial Hospital Newark Ohio United States 43055
    521 Newark Radiation Oncology Newark Ohio United States 43055
    522 Mercy Health Perrysburg Cancer Center Perrysburg Ohio United States 43551
    523 Southern Ohio Medical Center Portsmouth Ohio United States 45662
    524 North Coast Cancer Care Sandusky Ohio United States 44870
    525 Springfield Regional Cancer Center Springfield Ohio United States 45504
    526 Springfield Regional Medical Center Springfield Ohio United States 45505
    527 Cleveland Clinic Cancer Center Strongsville Strongsville Ohio United States 44136
    528 Saint Vincent Mercy Medical Center Toledo Ohio United States 43608
    529 Mercy Health - Saint Anne Hospital Toledo Ohio United States 43623
    530 Toledo Clinic Cancer Centers-Toledo Toledo Ohio United States 43623
    531 Dayton Physicians LLC-Upper Valley Troy Ohio United States 45373
    532 Upper Valley Medical Center Troy Ohio United States 45373
    533 South Pointe Hospital Warrensville Heights Ohio United States 44122
    534 Saint Joseph Warren Hospital Warren Ohio United States 44484
    535 Saint Ann's Hospital Westerville Ohio United States 43081
    536 Cleveland Clinic Wooster Family Health and Surgery Center Wooster Ohio United States 44691
    537 Saint Elizabeth Youngstown Hospital Youngstown Ohio United States 44501
    538 Genesis Healthcare System Cancer Care Center Zanesville Ohio United States 43701
    539 Mercy Hospital Oklahoma City Oklahoma City Oklahoma United States 73120
    540 Saint Alphonsus Medical Center-Baker City Baker City Oregon United States 97814
    541 Saint Charles Health System Bend Oregon United States 97701
    542 Clackamas Radiation Oncology Center Clackamas Oregon United States 97015
    543 Providence Cancer Institute Clackamas Clinic Clackamas Oregon United States 97015
    544 Bay Area Hospital Coos Bay Oregon United States 97420
    545 Providence Newberg Medical Center Newberg Oregon United States 97132
    546 Saint Alphonsus Medical Center-Ontario Ontario Oregon United States 97914
    547 Providence Portland Medical Center Portland Oregon United States 97213
    548 Providence Saint Vincent Medical Center Portland Oregon United States 97225
    549 Saint Charles Health System-Redmond Redmond Oregon United States 97756
    550 Salem Hospital Salem Oregon United States 97301
    551 Lehigh Valley Hospital-Cedar Crest Allentown Pennsylvania United States 18103
    552 Lehigh Valley Hospital - Muhlenberg Bethlehem Pennsylvania United States 18017
    553 Geisinger Medical Center Danville Pennsylvania United States 17822
    554 Doylestown Hospital Doylestown Pennsylvania United States 18901
    555 Pocono Medical Center East Stroudsburg Pennsylvania United States 18301
    556 UPMC Pinnacle Harrisburg Harrisburg Pennsylvania United States 17101
    557 UPMC Pinnacle Cancer Center/Community Osteopathic Campus Harrisburg Pennsylvania United States 17109
    558 Geisinger Medical Center-Cancer Center Hazleton Hazleton Pennsylvania United States 18201
    559 Lehigh Valley Hospital-Hazleton Hazleton Pennsylvania United States 18201
    560 Geisinger Medical Oncology-Lewisburg Lewisburg Pennsylvania United States 17837
    561 Thomas Jefferson University Hospital Philadelphia Pennsylvania United States 19107
    562 University of Pittsburgh Cancer Institute (UPCI) Pittsburgh Pennsylvania United States 15232
    563 Geisinger Cancer Services-Pottsville Pottsville Pennsylvania United States 17901
    564 Community Medical Center Scranton Pennsylvania United States 18510
    565 Geisinger Medical Oncology-Selinsgrove Selinsgrove Pennsylvania United States 17870
    566 Geisinger Medical Group State College Pennsylvania United States 16801
    567 Geisinger Wyoming Valley/Henry Cancer Center Wilkes-Barre Pennsylvania United States 18711
    568 UPMC Susquehanna Williamsport Pennsylvania United States 17701
    569 Smilow Cancer Hospital Care Center - Westerly Westerly Rhode Island United States 02891
    570 Saint Joseph's/Candler - Bluffton Campus Bluffton South Carolina United States 29910
    571 Prisma Health Cancer Institute - Spartanburg Boiling Springs South Carolina United States 29316
    572 Prisma Health Cancer Institute - Laurens Clinton South Carolina United States 29325
    573 Prisma Health Cancer Institute - Easley Easley South Carolina United States 29640
    574 Prisma Health Cancer Institute - Butternut Greenville South Carolina United States 29605
    575 Prisma Health Cancer Institute - Faris Greenville South Carolina United States 29605
    576 Prisma Health Greenville Memorial Hospital Greenville South Carolina United States 29605
    577 Prisma Health Cancer Institute - Eastside Greenville South Carolina United States 29615
    578 Prisma Health Cancer Institute - Greer Greer South Carolina United States 29650
    579 South Carolina Cancer Specialists PC Hilton Head Island South Carolina United States 29926-3827
    580 Prisma Health Cancer Institute - Seneca Seneca South Carolina United States 29672
    581 Rapid City Regional Hospital Rapid City South Dakota United States 57701
    582 Sanford Cancer Center Oncology Clinic Sioux Falls South Dakota United States 57104
    583 Sanford USD Medical Center - Sioux Falls Sioux Falls South Dakota United States 57117-5134
    584 Memorial Hospital Chattanooga Tennessee United States 37404
    585 Baptist Memorial Hospital and Cancer Center-Collierville Collierville Tennessee United States 38017
    586 Cookeville Regional Medical Center Cookeville Tennessee United States 38501
    587 Pulmonary Medicine Center of Chattanooga-Hixson Hixson Tennessee United States 37343
    588 Baptist Memorial Hospital and Cancer Center-Memphis Memphis Tennessee United States 38120
    589 Memorial GYN Plus Ooltewah Tennessee United States 37363
    590 Saint Joseph Regional Cancer Center Bryan Texas United States 77802
    591 American Fork Hospital / Huntsman Intermountain Cancer Center American Fork Utah United States 84003
    592 Sandra L Maxwell Cancer Center Cedar City Utah United States 84720
    593 Logan Regional Hospital Logan Utah United States 84321
    594 Intermountain Medical Center Murray Utah United States 84107
    595 McKay-Dee Hospital Center Ogden Utah United States 84403
    596 Utah Valley Regional Medical Center Provo Utah United States 84604
    597 Riverton Hospital Riverton Utah United States 84065
    598 Dixie Medical Center Regional Cancer Center Saint George Utah United States 84770
    599 Utah Cancer Specialists-Salt Lake City Salt Lake City Utah United States 84106
    600 LDS Hospital Salt Lake City Utah United States 84143
    601 Sovah Health Martinsville Martinsville Virginia United States 24115
    602 Providence Regional Cancer System-Aberdeen Aberdeen Washington United States 98520
    603 MultiCare Auburn Medical Center Auburn Washington United States 98001
    604 Kaiser Permanente Bellevue Medical Center Bellevue Washington United States 98004
    605 Overlake Medical Center Bellevue Washington United States 98004
    606 PeaceHealth Saint Joseph Medical Center Bellingham Washington United States 98225
    607 Harrison HealthPartners Hematology and Oncology-Bremerton Bremerton Washington United States 98310
    608 Harrison Medical Center Bremerton Washington United States 98310
    609 Highline Medical Center-Main Campus Burien Washington United States 98166
    610 Providence Regional Cancer System-Centralia Centralia Washington United States 98531
    611 Swedish Cancer Institute-Edmonds Edmonds Washington United States 98026
    612 Saint Elizabeth Hospital Enumclaw Washington United States 98022
    613 Providence Regional Cancer Partnership Everett Washington United States 98201
    614 Saint Francis Hospital Federal Way Washington United States 98003
    615 MultiCare Gig Harbor Medical Park Gig Harbor Washington United States 98335
    616 Swedish Cancer Institute-Issaquah Issaquah Washington United States 98029
    617 Kadlec Clinic Hematology and Oncology Kennewick Washington United States 99336
    618 Providence Regional Cancer System-Lacey Lacey Washington United States 98503
    619 Saint Clare Hospital Lakewood Washington United States 98499
    620 PeaceHealth Saint John Medical Center Longview Washington United States 98632
    621 Jefferson Healthcare Port Townsend Washington United States 98368
    622 Harrison HealthPartners Hematology and Oncology-Poulsbo Poulsbo Washington United States 98370
    623 MultiCare Good Samaritan Hospital Puyallup Washington United States 98372
    624 Valley Medical Center Renton Washington United States 98055
    625 Pacific Gynecology Specialists Seattle Washington United States 98104
    626 Swedish Medical Center-Ballard Campus Seattle Washington United States 98107
    627 Kaiser Permanente Washington Seattle Washington United States 98112
    628 Swedish Medical Center-First Hill Seattle Washington United States 98122-4307
    629 Swedish Medical Center-Cherry Hill Seattle Washington United States 98122-5711
    630 PeaceHealth United General Medical Center Sedro-Woolley Washington United States 98284
    631 Providence Regional Cancer System-Shelton Shelton Washington United States 98584
    632 MultiCare Deaconess Cancer and Blood Specialty Center - Valley Spokane Valley Washington United States 99216
    633 MultiCare Deaconess Cancer and Blood Specialty Center - Downtown Spokane Washington United States 99204
    634 MultiCare Deaconess Cancer and Blood Specialty Center - North Spokane Washington United States 99218
    635 Franciscan Research Center-Northwest Medical Plaza Tacoma Washington United States 98405
    636 Mary Bridge Children's Hospital and Health Center Tacoma Washington United States 98405
    637 MultiCare Tacoma General Hospital Tacoma Washington United States 98405
    638 Northwest Medical Specialties PLLC Tacoma Washington United States 98405
    639 PeaceHealth Southwest Medical Center Vancouver Washington United States 98664
    640 Providence Saint Mary Regional Cancer Center Walla Walla Washington United States 99362
    641 North Star Lodge Cancer Center at Yakima Valley Memorial Hospital Yakima Washington United States 98902
    642 Providence Regional Cancer System-Yelm Yelm Washington United States 98597
    643 Marshfield Clinic-Chippewa Center Chippewa Falls Wisconsin United States 54729
    644 HSHS Sacred Heart Hospital Eau Claire Wisconsin United States 54701
    645 Marshfield Medical Center-EC Cancer Center Eau Claire Wisconsin United States 54701
    646 Saint Vincent Hospital Cancer Center Green Bay Green Bay Wisconsin United States 54301
    647 Saint Vincent Hospital Cancer Center at Saint Mary's Green Bay Wisconsin United States 54303
    648 Mercyhealth Hospital and Cancer Center - Janesville Janesville Wisconsin United States 53548
    649 Marshfield Clinic - Ladysmith Center Ladysmith Wisconsin United States 54848
    650 Marshfield Medical Center-Marshfield Marshfield Wisconsin United States 54449
    651 Marshfield Clinic-Minocqua Center Minocqua Wisconsin United States 54548
    652 Cancer Center of Western Wisconsin New Richmond Wisconsin United States 54017
    653 Saint Vincent Hospital Cancer Center at Oconto Falls Oconto Falls Wisconsin United States 54154
    654 Marshfield Medical Center-Rice Lake Rice Lake Wisconsin United States 54868
    655 HSHS Saint Nicholas Hospital Sheboygan Wisconsin United States 53081
    656 Marshfield Clinic Stevens Point Center Stevens Point Wisconsin United States 54482
    657 Saint Vincent Hospital Cancer Center at Sturgeon Bay Sturgeon Bay Wisconsin United States 54235-1495
    658 Marshfield Clinic-Wausau Center Wausau Wisconsin United States 54401
    659 Marshfield Medical Center - Weston Weston Wisconsin United States 54476
    660 Marshfield Clinic - Wisconsin Rapids Center Wisconsin Rapids Wisconsin United States 54494
    661 Cheyenne Regional Medical Center-West Cheyenne Wyoming United States 82001
    662 Billings Clinic-Cody Cody Wyoming United States 82414
    663 Welch Cancer Center Sheridan Wyoming United States 82801
    664 FHP Health Center-Guam Tamuning Guam 96913
    665 Advance Oncology Center Aguadilla Puerto Rico 00603
    666 Doctor's Cancer Center-Arecibo Arecibo Puerto Rico 00614
    667 Cancer Center-Metro Medical Center Bayamon Bayamon Puerto Rico 00959-5060
    668 Hematologia Oncologia San Pablo Bayamon Puerto Rico 00961
    669 HIMA San Pablo Oncologic Hospital Caguas Puerto Rico 00726
    670 Doctors Cancer Center Manati Puerto Rico 00674
    671 Instituto Oncologia Moderna Ponce Ponce Puerto Rico 00716
    672 San Juan Community Oncology Group San Juan Puerto Rico 00917
    673 Primary Care Physician Group San Juan Puerto Rico 00920
    674 Centro Comprensivo de Cancer de UPR San Juan Puerto Rico 00927
    675 San Juan City Hospital San Juan Puerto Rico 00936
    676 Centro de Hematologia y Oncologia del Sur Santa Isabel Puerto Rico 00757

    Sponsors and Collaborators

    • Southwest Oncology Group
    • National Cancer Institute (NCI)

    Investigators

    • Principal Investigator: Melissa Accordino, Southwest Oncology Group

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Southwest Oncology Group
    ClinicalTrials.gov Identifier:
    NCT03723928
    Other Study ID Numbers:
    • S1703
    • NCI-2018-00090
    • S1703
    • SWOG-S1703
    • S1703
    • UG1CA189974
    First Posted:
    Oct 30, 2018
    Last Update Posted:
    Mar 10, 2022
    Last Verified:
    Mar 1, 2022
    Studies a U.S. FDA-regulated Drug Product:
    No
    Studies a U.S. FDA-regulated Device Product:
    No
    Product Manufactured in and Exported from the U.S.:
    No
    Additional relevant MeSH terms:
    Breast Neoplasms

    Study Results

    No Results Posted as of Mar 10, 2022