Hormone Therapy With or Without Combination Chemotherapy in Treating Women Who Have Undergone Surgery for Node-Negative Breast Cancer (The TAILORx Trial)

Sponsor
National Cancer Institute (NCI) (NIH)
Overall Status
Active, not recruiting
CT.gov ID
NCT00310180
Collaborator
American College of Surgeons (Other), Cancer and Leukemia Group B (Other), NSABP Foundation Inc (Other), NCIC Clinical Trials Group (Other), North Central Cancer Treatment Group (Other), Southwest Oncology Group (Other)
10,273
1231
4
293.8
8.3
0

Study Details

Study Description

Brief Summary

This randomized phase III trial studies the best individual therapy for women who have node-negative, estrogen-receptor positive breast cancer by using a special test (Oncotype DX), and whether hormone therapy alone or hormone therapy together with combination chemotherapy is better for women who have an Oncotype DX recurrence score of 11-25. Estrogen can cause the growth of breast cancer cells. Hormone therapy may fight breast cancer by blocking the use of estrogen by the tumor cells or by lowering the amount of estrogen the body makes. Drugs used in chemotherapy work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving hormone therapy together with more than one chemotherapy drug (combination chemotherapy) has been shown to reduce the chance of breast cancer recurrence, but the benefit of adding chemotherapy to hormone therapy for women with node-negative, estrogen-receptor positive breast cancer is small. New tests may provide information about which patients are more likely to benefit from chemotherapy.

Condition or Disease Intervention/Treatment Phase
Phase 3

Detailed Description

PRIMARY OBJECTIVES:
  1. To determine whether adjuvant hormonal therapy is not inferior to adjuvant chemohormonal in women whose tumors meet established clinical guidelines for adjuvant chemotherapy and fall in the "primary study group" category (Oncotype DX Recurrence Score 11-25).

  2. To create a tissue and specimen bank for patients enrolled in this trial, including formalin fixed paraffin embedded tumor specimens, tissue microarrays, plasma, and deoxyribonucleic acid (DNA) obtained from peripheral blood.

SECONDARY OBJECTIVES:
  1. To determine whether adjuvant hormonal therapy is sufficient treatment (i.e. 10 year distant disease-free survival of at least 95%) for women whose tumors meet established clinical guidelines for adjuvant chemotherapy and who fall into the "Secondary Study Group-1" category (Oncotype DX Recurrence Score =< 10).

  2. To compare the outcomes projected at 10 years by Adjuvant (with outcomes projected using classical pathologic information including tumor size, hormone receptor status, and histologic grade) with those made by the Genomic Health Oncotype DX test. Classical pathologic information and outcome results will also be used to create and refine models that would use classical information instead of or in combination with genomic tests.

  3. To estimate failure rates as a function of recurrence score (RS) separately in the chemotherapy (arms C, D) and no chemotherapy (arms A, B) groups. The purpose of the analysis is to develop more precise estimates of the relationship between recurrence score and chemotherapy treatment effect, if any, at the upper range of the RS 11 - 25 group.

  4. To determine the prognostic significance of the Oncotype DX recurrence score and of the individual RS gene groups (proliferation gene group, human epidermal growth factor receptor [HER]2 gene group, estrogen receptor [ER] gene group, invasion gene group, and other genes).

TERTIARY OBJECTIVES:
  1. To evaluate the effects of chemotherapy and hormonal therapy vs hormonal therapy alone on perceived cognitive impairment, fatigue, fear of recurrence among pre-menopausal patients, endocrine symptoms and sexual dysfunction, and overall health-related quality of life (HRQL).

  2. To determine whether perceived cognitive impairment, fatigue, fear of recurrence, endocrine symptoms, and overall HRQL are similar for patients receiving chemotherapy plus hormonal therapy in secondary study group 2 as for those in the primary study group (arm D vs C).

  3. To determine whether perceived cognitive impairment, fatigue, fear of recurrence, endocrine symptoms, and overall HRQL are similar for patients receiving hormonal therapy alone in secondary study group 1 as for those in the primary study group (arms A vs B).

  4. To determine whether age will be inversely associated with a fear of recurrence, independent of treatment assignment.

  5. Among participants receiving hormonal treatment alone on arm A and arm B, to determine whether Oncotype DX Recurrence score will be inversely correlated with fear of recurrence.

  6. To create a biospecimen repository including plasma, serum and CellSearch cassettes containing circulating tumor cells (CTC) for evaluating determinants of late relapse, including candidate biomarkers reflecting occult tumor burden (e.g., CTCs and plasma tumor DNA) and host factors (e.g., estrogen, insulin growth factor-[IGF] axis, inflammation, etc).

  7. To create a biorepository of metastatic tumor samples in patients who have had a late relapse.

  8. To determine body mass index (BMI) and comorbidity burden in patients with operable breast cancer five or more years after diagnosis.

  9. To determine whether there is a relationship between late relapse and BMI at diagnosis and at 5 years after diagnosis, and whether BMI-associated inflammatory and/or metabolic biomarkers are associated with early and late recurrence.

OUTLINE: This is a partially randomized study. Patients are assigned to 1 of 3 treatment groups.

GROUP 1 (SECONDARY STUDY GROUP 1; ONCOTYPE DX RECURRENCE SCORE [ODRS] =< 10): Patients receive standard hormonal therapy (e.g., tamoxifen alone orally (PO), aromatase inhibitor [e.g., anastrozole, letrozole, or exemestane] alone PO, or tamoxifen PO followed by aromatase inhibitor PO) at the discretion of the treating physician for 5 or 10 years.

GROUP 2 (PRIMARY STUDY GROUP; ODRS 11-25): Patients are randomized to receive either hormonal therapy alone or combination chemotherapy and hormonal therapy.

ARM I (EXPERIMENTAL): Patients receive hormonal therapy as in Group 1 at the discretion of the treating physician.

ARM II (STANDARD): Patients receive standard combination chemotherapy at the discretion of the treating physician. Within 4 weeks after the last dose of chemotherapy, patients receive hormonal therapy as in Group 1 at the discretion of the treating physician.

GROUP 3 (SECONDARY STUDY GROUP 2; ODRS >= 26): Patients receive combination chemotherapy as in Group 2, Arm II followed by hormonal therapy as in Group 1.

Patients in all groups who have had breast-conservation surgery are also treated with radiotherapy. Radiotherapy should begin within 4 weeks of registration for patients receiving hormonal therapy alone or within 8 weeks after completion of chemotherapy. Patients participating in National Surgical Adjuvant Breast and Bowel Project (NSABP) and/or Radiation Therapy Oncology Group (RTOG) partial irradiation trial(s) may receive partial breast radiation.

After completion of study treatment, patients are followed up every 3-6 months for 5 years and then annually for 15 years.

Study Design

Study Type:
Interventional
Actual Enrollment :
10273 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
Program for the Assessment of Clinical Cancer Tests (PACCT-1): Trial Assigning Individualized Options for Treatment:The TAILORx Trial
Actual Study Start Date :
Apr 7, 2006
Actual Primary Completion Date :
Mar 2, 2018
Anticipated Study Completion Date :
Sep 30, 2030

Arms and Interventions

Arm Intervention/Treatment
Experimental: Group 1 (Oncotype DX recurrence score =< 10)

Patients in this group receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years.

Drug: Anastrozole
Given PO
Other Names:
  • Anastrazole
  • Arimidex
  • ICI D1033
  • ICI-D1033
  • ZD-1033
  • Drug: Exemestane
    Given PO
    Other Names:
  • Aromasin
  • FCE-24304
  • Other: Laboratory Biomarker Analysis
    Correlative studies

    Drug: Letrozole
    Given PO
    Other Names:
  • CGS 20267
  • Femara
  • Other: Quality-of-Life Assessment
    Ancillary studies
    Other Names:
  • Quality of Life Assessment
  • Radiation: Radiation Therapy
    Undergo radiation therapy or partial breast irradiation
    Other Names:
  • Cancer Radiotherapy
  • ENERGY_TYPE
  • Irradiate
  • Irradiated
  • Irradiation
  • Radiation
  • Radiation Therapy, NOS
  • Radiotherapeutics
  • Radiotherapy
  • RT
  • Therapy, Radiation
  • Drug: Tamoxifen Citrate
    Given PO
    Other Names:
  • Apo-Tamox
  • Clonoxifen
  • Dignotamoxi
  • Ebefen
  • Emblon
  • Estroxyn
  • Fentamox
  • Gen-Tamoxifen
  • Genox
  • ICI 46,474
  • ICI-46474
  • Jenoxifen
  • Kessar
  • Ledertam
  • Lesporene
  • Nolgen
  • Noltam
  • Nolvadex
  • Nolvadex-D
  • Nourytam
  • Novo-Tamoxifen
  • Novofen
  • Noxitem
  • Oestrifen
  • Oncotam
  • PMS-Tamoxifen
  • Soltamox
  • TAM
  • Tamax
  • Tamaxin
  • Tamifen
  • Tamizam
  • Tamofen
  • Tamoxasta
  • Tamoxifeni Citras
  • Zemide
  • Experimental: Group 2, Arm I (experimental)

    Patients receive hormonal therapy as in Group 1 at the discretion of the treating physician.

    Drug: Anastrozole
    Given PO
    Other Names:
  • Anastrazole
  • Arimidex
  • ICI D1033
  • ICI-D1033
  • ZD-1033
  • Drug: Exemestane
    Given PO
    Other Names:
  • Aromasin
  • FCE-24304
  • Other: Laboratory Biomarker Analysis
    Correlative studies

    Drug: Letrozole
    Given PO
    Other Names:
  • CGS 20267
  • Femara
  • Other: Quality-of-Life Assessment
    Ancillary studies
    Other Names:
  • Quality of Life Assessment
  • Drug: Tamoxifen Citrate
    Given PO
    Other Names:
  • Apo-Tamox
  • Clonoxifen
  • Dignotamoxi
  • Ebefen
  • Emblon
  • Estroxyn
  • Fentamox
  • Gen-Tamoxifen
  • Genox
  • ICI 46,474
  • ICI-46474
  • Jenoxifen
  • Kessar
  • Ledertam
  • Lesporene
  • Nolgen
  • Noltam
  • Nolvadex
  • Nolvadex-D
  • Nourytam
  • Novo-Tamoxifen
  • Novofen
  • Noxitem
  • Oestrifen
  • Oncotam
  • PMS-Tamoxifen
  • Soltamox
  • TAM
  • Tamax
  • Tamaxin
  • Tamifen
  • Tamizam
  • Tamofen
  • Tamoxasta
  • Tamoxifeni Citras
  • Zemide
  • Active Comparator: Group 2, Arm II (standard)

    Patients receive standard combination chemotherapy at the discretion of the treating physician. Within 4 weeks after the last dose of chemotherapy, patients receive hormonal therapy as in Group 1 at the discretion of the treating physician.

    Drug: Anastrozole
    Given PO
    Other Names:
  • Anastrazole
  • Arimidex
  • ICI D1033
  • ICI-D1033
  • ZD-1033
  • Drug: Exemestane
    Given PO
    Other Names:
  • Aromasin
  • FCE-24304
  • Other: Laboratory Biomarker Analysis
    Correlative studies

    Drug: Letrozole
    Given PO
    Other Names:
  • CGS 20267
  • Femara
  • Other: Quality-of-Life Assessment
    Ancillary studies
    Other Names:
  • Quality of Life Assessment
  • Radiation: Radiation Therapy
    Undergo radiation therapy or partial breast irradiation
    Other Names:
  • Cancer Radiotherapy
  • ENERGY_TYPE
  • Irradiate
  • Irradiated
  • Irradiation
  • Radiation
  • Radiation Therapy, NOS
  • Radiotherapeutics
  • Radiotherapy
  • RT
  • Therapy, Radiation
  • Drug: Tamoxifen Citrate
    Given PO
    Other Names:
  • Apo-Tamox
  • Clonoxifen
  • Dignotamoxi
  • Ebefen
  • Emblon
  • Estroxyn
  • Fentamox
  • Gen-Tamoxifen
  • Genox
  • ICI 46,474
  • ICI-46474
  • Jenoxifen
  • Kessar
  • Ledertam
  • Lesporene
  • Nolgen
  • Noltam
  • Nolvadex
  • Nolvadex-D
  • Nourytam
  • Novo-Tamoxifen
  • Novofen
  • Noxitem
  • Oestrifen
  • Oncotam
  • PMS-Tamoxifen
  • Soltamox
  • TAM
  • Tamax
  • Tamaxin
  • Tamifen
  • Tamizam
  • Tamofen
  • Tamoxasta
  • Tamoxifeni Citras
  • Zemide
  • Experimental: Group 3 (Oncotype DX recurrence score >= 26)

    Patients in this group receive combination chemotherapy followed by hormone therapy similar to the patients in group two who are assigned to receive both types of treatment.

    Drug: Anastrozole
    Given PO
    Other Names:
  • Anastrazole
  • Arimidex
  • ICI D1033
  • ICI-D1033
  • ZD-1033
  • Drug: Exemestane
    Given PO
    Other Names:
  • Aromasin
  • FCE-24304
  • Other: Laboratory Biomarker Analysis
    Correlative studies

    Drug: Letrozole
    Given PO
    Other Names:
  • CGS 20267
  • Femara
  • Other: Quality-of-Life Assessment
    Ancillary studies
    Other Names:
  • Quality of Life Assessment
  • Radiation: Radiation Therapy
    Undergo radiation therapy or partial breast irradiation
    Other Names:
  • Cancer Radiotherapy
  • ENERGY_TYPE
  • Irradiate
  • Irradiated
  • Irradiation
  • Radiation
  • Radiation Therapy, NOS
  • Radiotherapeutics
  • Radiotherapy
  • RT
  • Therapy, Radiation
  • Drug: Tamoxifen Citrate
    Given PO
    Other Names:
  • Apo-Tamox
  • Clonoxifen
  • Dignotamoxi
  • Ebefen
  • Emblon
  • Estroxyn
  • Fentamox
  • Gen-Tamoxifen
  • Genox
  • ICI 46,474
  • ICI-46474
  • Jenoxifen
  • Kessar
  • Ledertam
  • Lesporene
  • Nolgen
  • Noltam
  • Nolvadex
  • Nolvadex-D
  • Nourytam
  • Novo-Tamoxifen
  • Novofen
  • Noxitem
  • Oestrifen
  • Oncotam
  • PMS-Tamoxifen
  • Soltamox
  • TAM
  • Tamax
  • Tamaxin
  • Tamifen
  • Tamizam
  • Tamofen
  • Tamoxasta
  • Tamoxifeni Citras
  • Zemide
  • Outcome Measures

    Primary Outcome Measures

    1. 5-year Disease-free Survival [Assessed every 6 months within 5 years from registration and then annually up to 20 years, DFS rate estimated at 5 years]

      Disease-free survival (DFS) is defined to be time from randomization to first event, where the first event is any of ipsilateral breast tumor recurrence, local recurrence, regional recurrence, distant recurrence, contralateral second primary invasive cancer, second primary non-breast invasive cancer (excluding non-melanoma skin cancers), or death without evidence of recurrence. The distribution of DFS (eg, 5-year DFS rate) is estimated using Kaplan-Meier method, and compared between the two randomized arms (arm B vs. arm C) using stratified log rank test and stratified Cox proportional hazard model.

    Secondary Outcome Measures

    1. 5-year Distant Recurrence-free Interval [Assessed every 6 months within 5 years from registration and then annually up to 20 years, DRFI rate estimated at 5 years]

      Distant recurrence-free interval (DRFI) is defined as time from date of randomization or registration to the date of distant recurrence of breast cancer, or of death with distant recurrence, if death is the first manifestation of distant recurrence. The distribution of DRFI (eg, 5-year DRFI rate) is estimated using Kaplan-Meier method.

    2. 5-year Recurrence-free Interval [Assessed every 6 months within 5 years from registration and then annually up to 20 years, RFS rate estimated at 5 years]

      Recurrence-free interval (RFS) is defined as time from date of randomization or registration to the date of first recurrence of breast cancer (ipsilateral breast tumor recurrence, local/regional recurrence, distant recurrence) or to the date of death with recurrence, if death is the first manifestation of recurrence. The distribution of RFS (eg, 5-year RFS rate) is estimated using Kaplan-Meier method.

    3. 5-year Overall Survival [Assessed every 6 months within 5 years from registration and then annually up to 20 years, OS rate estimated at 5 years]

      Overall survival (OS) is defined as time from date of randomization or registration to date of death from any cause. The distribution of OS (eg, 5-year OS rate) is estimated using Kaplan-Meier method.

    4. 5-year Disease-free Survival by Age and Recurrence Score Groups [Assessed every 6 months within 5 years from registration and then annually up to 20 years, DFS rate estimated at 5 years]

      Disease-free survival (DFS) is defined to be time from randomization to first event, where the first event is any of ipsilateral breast tumor recurrence, local recurrence, regional recurrence, distant recurrence, contralateral second primary invasive cancer, second primary non-breast invasive cancer (excluding non-melanoma skin cancers), or death without evidence of recurrence. DFS is evaluated by recurrence score (0-10 vs. 11-15 vs. 16-20 vs. 21-25 vs. >25) and age groups (<=50 vs. 51-65 vs. 65-75). The distribution of DFS (eg, 5-year DFS rate) is estimated using Kaplan-Meier method.

    5. To Compare the Outcomes Projected at 10 Years by Adjuvant! With Those Made by the Genomic Health Oncotype DX Test [Assessed at 10 years after study entry]

      Adjuvant! is not currently available; additional work combining classical information with genomic tests will be reported separately.

    6. 5-year Disease-free Survival by Individual RS Gene Groups [Assessed every 6 months within 5 years from registration and then annually up to 20 years]

      Disease-free survival (DFS) is defined to be time from randomization to first event, where the first event is any of ipsilateral breast tumor recurrence, local recurrence, regional recurrence, distant recurrence, contralateral second primary invasive cancer, second primary non-breast invasive cancer (excluding non-melanoma skin cancers), or death without evidence of recurrence. The distribution of DFS (eg, 5-year DFS rate) is estimated using Kaplan-Meier method. 5-year DFS by individual RS gene groups (Proliferation Gene Group, HER2 Gene Group, ER Gene Group, Invasion Gene Group, and Other Genes) will be estimated in each arm.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 75 Years
    Sexes Eligible for Study:
    Female
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Patients with operable histologically confirmed adenocarcinoma of the female breast who have completed primary surgical treatment and meet the following criteria:

    • ER and/or progesterone receptor (PR)-positive: Estrogen and/or progesterone receptor positive disease (as defined by local pathology laboratory)

    • Negative axillary nodes: As assessed by a sentinel lymph node biopsy, an axillary dissection, or both, and as defined by the Sixth Edition of the American Joint Committee on Cancer (AJCC) staging criteria

    • Tumor size 1.1-5.0 cm (or 5 mm-1.0 cm plus unfavorable histological features):

    • Unfavorable features defined as intermediate or poor nuclear and/or histologic grade, or lymphovascular invasion

    • NOTE: Definition of tumor size: The tumor size used for determination of eligibility is the pathologic tumor size, which is usually determined by the size of the tumor as measured by inspection of the gross specimen; if the tumor size is measured microscopically and the tumor includes ductal carcinoma in-situ, the measurement should include only the invasive component of the tumor

    • The tumor must be human epidermal growth factor receptor 2 (Her2)/neu negative by either fluorescent in-situ hybridization (FISH) or immunohistochemistry (e.g. 0 or 1+ by DAKO Herceptest)

    • The patient and physician must be agreeable to initiate standard chemotherapy and hormonal therapy as adjuvant therapy

    • A tissue specimen from the primary breast cancer has been located and is ready to be shipped to the appropriate laboratory after consent is obtained and within 3 days following pre-registration; NOTE: For determination of the Oncotype Recurrence Score, tissue must be shipped to Genomic Health; if the Oncotype DX Recurrence Score was previously performed by Genomic Health (prior to pre-registration), tissue must be submitted to the Eastern Cooperative Oncology Group (ECOG)-American College of Radiology Imaging Network (ACRIN) Central Biorepository and Pathology Facility upon randomization

    • Leukocyte count >= 3500/mm^3

    • Platelets >= 100,000/mm^3

    • Serum creatinine =< 1.5 mg/dL

    • Serum aspartate transaminase (AST) that is =< 3-fold the upper institutional limits of normal

    • Patients must be disease-free of prior invasive malignancies for >= 5 years with the exception of curatively-treated basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix; patients with a previous ipsilateral or contralateral invasive breast cancer, or with bilateral synchronous cancers, are not eligible; patients with previous ipsilateral or contralateral ductal in situ carcinoma (DCIS) are not eligible

    • Prior treatment

    • Mandatory prior surgery criteria:

    • Patient must pre-register within 84 days from the final surgical procedure required to adequately treat the primary tumor (please note that if margins are not clear and a resection has to be conducted after pre-registration but before randomization, the patient will be deemed to be within the 84 day window allowed by protocol and therefore eligible)

    • All tumors should be removed by either a mastectomy or local excision plus an acceptable axillary procedure (i.e., sentinel lymph node biopsy, axillary dissection, or both); there must be adequate (at least 1 mm if margin width specified) tumor-free margins of resection (for invasive and ductal carcinoma in-situ) in order for the patients to be eligible; patients with lobular carcinoma in-situ involving the resection margins are eligible

    • Criteria re: other prior treatments:

    • No prior chemotherapy for this malignancy

    • No prior radiation therapy for this malignancy; this includes no prior MammoSite Brachytherapy radiation therapy (RT)

    • Hormonal therapy: Patients who develop breast cancer while receiving a selective estrogen-receptor modulator (SERM; e.g., tamoxifen, toremifene, raloxifene) or an aromatase inhibitor (e.g., anastrazole, letrozole, exemestane) for breast cancer prevention or a SERM for other indications (e.g., raloxifene for osteoporosis) are not eligible; however, patients may have received up to 8 weeks of a SERM or aromatase inhibitor for this malignancy and still be eligible for study entry

    • Patients must have an anticipated life expectancy of at least 10 years

    • Patients with the following medical conditions should not be enrolled on the study:

    • Chronic obstructive pulmonary disease requiring treatment

    • Chronic liver disease (e.g., cirrhosis, chronic active hepatitis)

    • Previous history of a cerebrovascular accident

    • History of congestive heart failure or other cardiac disease that would represent a contraindication to the use of an anthracycline (e.g., doxorubicin or epirubicin)

    • Chronic psychiatric condition or other condition that would impair compliance with the treatment regimen

    • Women must not be pregnant or breast-feeding; all females of childbearing potential must have a blood test or urine study within 2 weeks prior to pre-registration to rule out pregnancy

    • Women of childbearing potential must be strongly advised to utilize an accepted and effective form of non-hormonal contraception (e.g. intrauterine device, condoms, diaphragm, abstinence)

    • Patients must not have previously had the Oncotype DX Assay performed, with the exception of patients who have had the assay performed and have a recurrence score of 11-25

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Northeast Alabama Regional Medical Center Anniston Alabama United States 36202
    2 University of Alabama at Birmingham Cancer Center Birmingham Alabama United States 35233
    3 Mobile Infirmary Medical Center Mobile Alabama United States 36607
    4 Providence Hospital Mobile Alabama United States 36608
    5 University of South Alabama Mitchell Cancer Institute Mobile Alabama United States 36688
    6 Alaska Regional Hospital Anchorage Alaska United States 99508
    7 Providence Alaska Medical Center Anchorage Alaska United States 99508
    8 Fairbanks Memorial Hospital Fairbanks Alaska United States 99701
    9 Banner Thunderbird Medical Center Glendale Arizona United States 85306
    10 Banner Desert Medical Center Mesa Arizona United States 85202
    11 Banner Baywood Medical Center Mesa Arizona United States 85206
    12 Banner-University Medical Center Phoenix Phoenix Arizona United States 85006
    13 Western Regional CCOP Phoenix Arizona United States 85006
    14 Virginia G Piper Cancer Care-Del Camino Scottsdale Arizona United States 85258
    15 Banner University Medical Center - Tucson Tucson Arizona United States 85719
    16 Sparks Regional Medical Center Fort Smith Arkansas United States 72901
    17 Mercy Hospital Fort Smith Fort Smith Arkansas United States 72903
    18 CHI Saint Vincent Cancer Center Hot Springs Hot Springs Arkansas United States 71913
    19 NEA Baptist Memorial Hospital Jonesboro Arkansas United States 72401
    20 Saint Bernards Regional Medical Center Jonesboro Arkansas United States 72401
    21 University of Arkansas for Medical Sciences Little Rock Arkansas United States 72205
    22 Arroyo Grande Community Arroyo Grande California United States 93420
    23 PCR Oncology Arroyo Grande California United States 93420
    24 Alta Bates Summit Medical Center-Herrick Campus Berkeley California United States 94704
    25 Providence Saint Joseph Medical Center/Disney Family Cancer Center Burbank California United States 91505
    26 Mills-Peninsula Medical Center Burlingame California United States 94010
    27 East Bay Radiation Oncology Center Castro Valley California United States 94546
    28 Eden Hospital Medical Center Castro Valley California United States 94546
    29 Valley Medical Oncology Consultants-Castro Valley Castro Valley California United States 94546
    30 Enloe Medical Center Chico California United States 95926
    31 Community Cancer Institute Clovis California United States 93611
    32 John Muir Medical Center-Concord Campus Concord California United States 94520
    33 City of Hope Comprehensive Cancer Center Duarte California United States 91010
    34 Bay Area Breast Surgeons Inc Emeryville California United States 94608
    35 Kaiser Permanente-Fremont Fremont California United States 94538
    36 Valley Medical Oncology Consultants-Fremont Fremont California United States 94538
    37 Washington Hospital Fremont California United States 94538
    38 California Cancer Associates for Research and Excellence (cCare) Fresno California United States 93720
    39 Saint Jude Medical Center Fullerton California United States 92835
    40 Glendale Memorial Hospital and Health Center Glendale California United States 91204
    41 Marin Cancer Care Inc Greenbrae California United States 94904
    42 Marin General Hospital Greenbrae California United States 94904
    43 Saint Rose Hospital Hayward California United States 94545
    44 Scripps Green Hospital La Jolla California United States 92037
    45 UC San Diego Moores Cancer Center La Jolla California United States 92093
    46 Loma Linda University Medical Center Loma Linda California United States 92354
    47 Long Beach Memorial Medical Center-Todd Cancer Institute Long Beach California United States 90806
    48 USC / Norris Comprehensive Cancer Center Los Angeles California United States 90033
    49 UCLA / Jonsson Comprehensive Cancer Center Los Angeles California United States 90095
    50 Contra Costa Regional Medical Center Martinez California United States 94553-3156
    51 Fremont - Rideout Cancer Center Marysville California United States 95901
    52 Providence Holy Cross Medical Center Mission Hills California United States 91346-9600
    53 Memorial Medical Center Modesto California United States 95355
    54 Community Hospital of Monterey Peninsula Monterey California United States 93940
    55 Palo Alto Medical Foundation-Camino Division Mountain View California United States 94040
    56 Northridge Hospital Medical Center Northridge California United States 91325
    57 Sutter Cancer Research Consortium Novato California United States 94945
    58 Highland General Hospital Oakland California United States 94602
    59 Alta Bates Summit Medical Center - Summit Campus Oakland California United States 94609
    60 Bay Area Tumor Institute Oakland California United States 94609
    61 Hematology and Oncology Associates-Oakland Oakland California United States 94609
    62 Tom K Lee Inc Oakland California United States 94609
    63 Kaiser Permanente-Oakland Oakland California United States 94611
    64 Saint Joseph Hospital - Orange Orange California United States 92868
    65 UC Irvine Health/Chao Family Comprehensive Cancer Center Orange California United States 92868
    66 Desert Regional Medical Center Palm Springs California United States 92262
    67 Stanford Cancer Institute Palo Alto Palo Alto California United States 94304
    68 Valley Care Health System - Pleasanton Pleasanton California United States 94588
    69 Valley Medical Oncology Consultants Pleasanton California United States 94588
    70 Pomona Valley Hospital Medical Center Pomona California United States 91767
    71 Mercy Regional Cancer Center Redding California United States 96001
    72 Kaiser Permanente-Redwood City Redwood City California United States 94063
    73 Kaiser Permanente-Richmond Richmond California United States 94801
    74 Kaiser Permanente-Roseville Roseville California United States 95661
    75 Sutter Roseville Medical Center Roseville California United States 95661
    76 Sutter Medical Center Sacramento Sacramento California United States 95816
    77 University of California Davis Comprehensive Cancer Center Sacramento California United States 95817
    78 Mercy General Hospital Sacramento California United States 95819
    79 Kaiser Permanente-South Sacramento Sacramento California United States 95823
    80 Kaiser Permanente - Sacramento Sacramento California United States 95825
    81 Salinas Valley Memorial Salinas California United States 93901
    82 UC San Diego Medical Center - Hillcrest San Diego California United States 92103
    83 Kaiser Permanente-San Diego Mission San Diego California United States 92108
    84 Sharp Memorial Hospital San Diego California United States 92123
    85 Naval Medical Center -San Diego San Diego California United States 92134
    86 San Diego VA Medical Center San Diego California United States 92161
    87 Zuckerberg San Francisco General Hospital San Francisco California United States 94110
    88 California Pacific Medical Center-Pacific Campus San Francisco California United States 94115
    89 Kaiser Permanente-San Francisco San Francisco California United States 94115
    90 Kaiser Permanente-Santa Teresa-San Jose San Jose California United States 95119
    91 Kaiser Permanente San Leandro San Leandro California United States 94577
    92 Doctors Medical Center- JC Robinson Regional Cancer Center San Pablo California United States 94806
    93 Kaiser Permanente-San Rafael San Rafael California United States 94903
    94 Breastlink Medical Group Inc Santa Ana California United States 92705
    95 Cancer Center of Santa Barbara Santa Barbara California United States 93105
    96 Ridley-Tree Cancer Center Santa Barbara California United States 93105
    97 Sansum Clinic Inc Santa Barbara California United States 93105
    98 Ray, Margaret, Savage. M.D. (UIA Investigator) Santa Barbara California United States 93111
    99 Kaiser Permanente Medical Center - Santa Clara Santa Clara California United States 95051
    100 Kaiser Permanente-Santa Rosa Santa Rosa California United States 95403
    101 Providence Santa Rosa Memorial Hospital Santa Rosa California United States 95405
    102 Ridley-Tree Cancer Center-Solvang Solvang California United States 93463
    103 Kaiser Permanente-South San Francisco South San Francisco California United States 94080
    104 Kaiser Permanente-Stockton Stockton California United States 95210
    105 Olive View-University of California Los Angeles Medical Center Sylmar California United States 91342
    106 Torrance Memorial Medical Center Torrance California United States 90509
    107 Emanuel Medical Center Turlock California United States 95382
    108 Northbay Cancer Center Vacaville California United States 95687
    109 Kaiser Permanente Medical Center-Vacaville Vacaville California United States 95688
    110 Kaiser Permanente-Vallejo Vallejo California United States 94589
    111 Sutter Solano Medical Center/Cancer Center Vallejo California United States 94589
    112 Kaiser Permanente-Walnut Creek Walnut Creek California United States 94596
    113 John Muir Medical Center-Walnut Creek Walnut Creek California United States 94598
    114 Presbyterian Intercommunity Hospital Whittier California United States 90602
    115 The Medical Center of Aurora Aurora Colorado United States 80012
    116 Rocky Mountain Regional VA Medical Center Aurora Colorado United States 80045
    117 University of Colorado Hospital Aurora Colorado United States 80045
    118 Boulder Community Hospital Boulder Colorado United States 80301
    119 Penrose-Saint Francis Healthcare Colorado Springs Colorado United States 80907
    120 UCHealth Memorial Hospital Central Colorado Springs Colorado United States 80909
    121 Kaiser Permanente-Franklin Denver Colorado United States 80205
    122 Porter Adventist Hospital Denver Colorado United States 80210
    123 University of Colorado Denver Colorado United States 80217-3364
    124 Presbyterian - Saint Lukes Medical Center - Health One Denver Colorado United States 80218
    125 SCL Health Saint Joseph Hospital Denver Colorado United States 80218
    126 Rose Medical Center Denver Colorado United States 80220
    127 Western States Cancer Research NCORP Denver Colorado United States 80222
    128 Shaw Cancer Center Edwards Colorado United States 81632
    129 Swedish Medical Center Englewood Colorado United States 80113
    130 Poudre Valley Hospital Fort Collins Colorado United States 80524
    131 Saint Mary's Hospital and Regional Medical Center Grand Junction Colorado United States 81501
    132 North Colorado Medical Center Greeley Colorado United States 80631
    133 Kaiser Permanente-Rock Creek Lafayette Colorado United States 80026
    134 Saint Anthony Hospital Lakewood Colorado United States 80228
    135 Sky Ridge Medical Center Lone Tree Colorado United States 80124
    136 Longmont United Hospital Longmont Colorado United States 80501
    137 McKee Medical Center Loveland Colorado United States 80539
    138 Montrose Memorial Hospital Montrose Colorado United States 81401
    139 Saint Mary Corwin Medical Center Pueblo Colorado United States 81004
    140 North Suburban Medical Center Thornton Colorado United States 80229
    141 SCL Health Lutheran Medical Center Wheat Ridge Colorado United States 80033
    142 Hartford HealthCare - Saint Vincent's Medical Center Bridgeport Connecticut United States 06606
    143 Bridgeport Hospital Bridgeport Connecticut United States 06610
    144 Danbury Hospital Danbury Connecticut United States 06810
    145 University of Connecticut Farmington Connecticut United States 06030
    146 Greenwich Hospital Greenwich Connecticut United States 06830
    147 Hartford Hospital Hartford Connecticut United States 06102
    148 Smilow Cancer Hospital Care Center at Saint Francis Hartford Connecticut United States 06105
    149 Manchester Memorial Hospital Manchester Connecticut United States 06040
    150 Middlesex Hospital Middletown Connecticut United States 06457
    151 The Hospital of Central Connecticut New Britain Connecticut United States 06050
    152 Yale-New Haven Hospital Saint Raphael Campus New Haven Connecticut United States 06511
    153 Yale University New Haven Connecticut United States 06520
    154 Eastern Connecticut Hematology and Oncology Associates Norwich Connecticut United States 06360
    155 Stamford Hospital/Bennett Cancer Center Stamford Connecticut United States 06904
    156 Smilow Cancer Hospital-Torrington Care Center Torrington Connecticut United States 06790
    157 Harold Leever Regional Cancer Center Waterbury Connecticut United States 06708
    158 Bayhealth Hospital Kent Campus Dover Delaware United States 19901
    159 Beebe Medical Center Lewes Delaware United States 19958
    160 Christiana Care Health System-Christiana Hospital Newark Delaware United States 19718
    161 MedStar Georgetown University Hospital Washington District of Columbia United States 20007
    162 MedStar Washington Hospital Center Washington District of Columbia United States 20010
    163 Sibley Memorial Hospital Washington District of Columbia United States 20016
    164 George Washington University Medical Center Washington District of Columbia United States 20037
    165 Lynn Regional Cancer Center - West Boca Raton Florida United States 33428
    166 Boca Raton Comprehensive Cancer Center Boca Raton Florida United States 33486
    167 Boca Raton Regional Hospital Boca Raton Florida United States 33486
    168 Halifax Health Medical Center-Centers for Oncology Daytona Beach Florida United States 32114
    169 Broward Health North Deerfield Beach Florida United States 33064
    170 Holy Cross Hospital Fort Lauderdale Florida United States 33308
    171 Broward Health Medical Center Fort Lauderdale Florida United States 33316
    172 University of Florida Health Science Center - Gainesville Gainesville Florida United States 32610
    173 Memorial Regional Hospital/Joe DiMaggio Children's Hospital Hollywood Florida United States 33021
    174 Saint Vincent's Medical Center Jacksonville Florida United States 32204
    175 Baptist MD Anderson Cancer Center Jacksonville Florida United States 32207
    176 Mayo Clinic in Florida Jacksonville Florida United States 32224-9980
    177 Jupiter Medical Center Jupiter Florida United States 33458
    178 Lakeland Regional Health Hollis Cancer Center Lakeland Florida United States 33805
    179 The Watson Clinic Lakeland Florida United States 33805
    180 Cancer Centers of Central Florida PA Leesburg Florida United States 34788
    181 Mount Sinai Medical Center Miami Beach Florida United States 33140
    182 University of Miami Miller School of Medicine-Sylvester Cancer Center Miami Florida United States 33136
    183 Miami Cancer Institute Miami Florida United States 33176
    184 21st Century Oncology-Orange Park Orange Park Florida United States 32073
    185 AdventHealth Orlando Orlando Florida United States 32803
    186 Orlando Health Cancer Institute Orlando Florida United States 32806
    187 Sacred Heart Hospital Pensacola Florida United States 32504
    188 Florida Cancer Specialists - Sarasota Downtown Sarasota Florida United States 34236
    189 Martin Medical Center Stuart Florida United States 34994
    190 Robert and Carol Weissman Cancer Center at Martin Health Stuart Florida United States 34994
    191 Martin Hospital South Stuart Florida United States 34997
    192 Space Coast Cancer Centers-Titusville Titusville Florida United States 32796
    193 Cleveland Clinic-Weston Weston Florida United States 33331
    194 Phoebe Putney Memorial Hospital Albany Georgia United States 31701
    195 University Cancer and Blood Center LLC Athens Georgia United States 30607
    196 Grady Health System Atlanta Georgia United States 30303
    197 Piedmont Hospital Atlanta Georgia United States 30309
    198 Emory University Hospital/Winship Cancer Institute Atlanta Georgia United States 30322
    199 Atlanta Regional CCOP Atlanta Georgia United States 30342
    200 Emory Saint Joseph's Hospital Atlanta Georgia United States 30342
    201 Northside Hospital Atlanta Georgia United States 30342
    202 Augusta Oncology Associates PC-D'Antignac Augusta Georgia United States 30901
    203 Augusta University Medical Center Augusta Georgia United States 30912
    204 WellStar Cobb Hospital Austell Georgia United States 30106
    205 John B Amos Cancer Center Columbus Georgia United States 31904
    206 Dekalb Medical Center Decatur Georgia United States 30033
    207 Northeast Georgia Medical Center-Gainesville Gainesville Georgia United States 30501
    208 Northside Hospital - Gwinnett Lawrenceville Georgia United States 30046
    209 Medical Center of Central Georgia Macon Georgia United States 31201
    210 Wellstar Kennestone Hospital Marietta Georgia United States 30060
    211 Southern Regional Medical Center Riverdale Georgia United States 30274
    212 Harbin Clinic Medical Oncology and Clinical Research Rome Georgia United States 30165
    213 Memorial Health University Medical Center Savannah Georgia United States 31404
    214 Lewis Cancer and Research Pavilion at Saint Joseph's/Candler Savannah Georgia United States 31405
    215 South Georgia Medical Center/Pearlman Cancer Center Valdosta Georgia United States 31602
    216 Pali Momi Medical Center 'Aiea Hawaii United States 96701
    217 Hawaii Cancer Care Inc - Waterfront Plaza Honolulu Hawaii United States 96813
    218 Queen's Medical Center Honolulu Hawaii United States 96813
    219 Straub Clinic and Hospital Honolulu Hawaii United States 96813
    220 University of Hawaii Cancer Center Honolulu Hawaii United States 96813
    221 Queen's Cancer Center - Kuakini Honolulu Hawaii United States 96817
    222 The Cancer Center of Hawaii-Liliha Honolulu Hawaii United States 96817
    223 Kapiolani Medical Center for Women and Children Honolulu Hawaii United States 96826
    224 Tripler Army Medical Center Honolulu Hawaii United States 96859
    225 Maui Memorial Medical Center Wailuku Hawaii United States 96793
    226 Pacific Cancer Institute of Maui Wailuku Hawaii United States 96793
    227 Saint Alphonsus Cancer Care Center-Boise Boise Idaho United States 83706
    228 Saint Luke's Cancer Institute - Boise Boise Idaho United States 83712
    229 Portneuf Medical Center Pocatello Idaho United States 83201
    230 Kootenai Clinic Cancer Services - Post Falls Post Falls Idaho United States 83854
    231 Saint Anthony's Health Alton Illinois United States 62002
    232 Northwest Community Hospital Arlington Heights Illinois United States 60005
    233 Rush - Copley Medical Center Aurora Illinois United States 60504
    234 Saint Joseph Medical Center Bloomington Illinois United States 61701
    235 Illinois CancerCare-Bloomington Bloomington Illinois United States 61704
    236 Graham Hospital Association Canton Illinois United States 61520
    237 Illinois CancerCare-Canton Canton Illinois United States 61520
    238 Illinois CancerCare-Carthage Carthage Illinois United States 62321
    239 Memorial Hospital Carthage Illinois United States 62321
    240 Mount Sinai Hospital Medical Center Chicago Illinois United States 60608
    241 Hematology and Oncology Associates Chicago Illinois United States 60611
    242 Northwestern University Chicago Illinois United States 60611
    243 John H Stroger Jr Hospital of Cook County Chicago Illinois United States 60612
    244 Rush University Medical Center Chicago Illinois United States 60612
    245 University of Illinois Chicago Illinois United States 60612
    246 Mercy Hospital and Medical Center Chicago Illinois United States 60616
    247 Swedish Covenant Hospital Chicago Illinois United States 60625
    248 Presence Resurrection Medical Center Chicago Illinois United States 60631
    249 University of Chicago Comprehensive Cancer Center Chicago Illinois United States 60637
    250 Weiss Memorial Hospital Chicago Illinois United States 60640
    251 Advocate Illinois Masonic Medical Center Chicago Illinois United States 60657
    252 UChicago Medicine Comprehensive Cancer Center - Saint Joseph Hospital Chicago Illinois United States 60657
    253 Decatur Memorial Hospital Decatur Illinois United States 62526
    254 Heartland Cancer Research NCORP Decatur Illinois United States 62526
    255 AMITA Health Alexian Brothers Medical Center Elk Grove Village Illinois United States 60007
    256 Elmhurst Memorial Hospital Elmhurst Illinois United States 60126
    257 Eureka Hospital Eureka Illinois United States 61530
    258 Illinois CancerCare-Eureka Eureka Illinois United States 61530
    259 NorthShore University HealthSystem-Evanston Hospital Evanston Illinois United States 60201
    260 Saint Francis Hospital Evanston Illinois United States 60202
    261 Galesburg Cottage Hospital Galesburg Illinois United States 61401
    262 Illinois CancerCare-Cottage Galesburg Illinois United States 61401
    263 Illinois CancerCare-Galesburg Galesburg Illinois United States 61401
    264 LaGrange Oncology Associates Geneva Illinois United States 60134
    265 Northwestern Medicine Cancer Center Delnor Geneva Illinois United States 60134
    266 Ingalls Memorial Hospital Harvey Illinois United States 60426
    267 Illinois CancerCare-Havana Havana Illinois United States 62644
    268 Mason District Hospital Havana Illinois United States 62644
    269 Hinsdale Hematology Oncology Associates Incorporated Hinsdale Illinois United States 60521
    270 Hopedale Medical Complex - Hospital Hopedale Illinois United States 61747
    271 Midwest Center for Hematology Oncology Joliet Illinois United States 60432
    272 Duly Health and Care Joliet Joliet Illinois United States 60435
    273 Presence Saint Mary's Hospital Kankakee Illinois United States 60901
    274 Illinois CancerCare-Kewanee Clinic Kewanee Illinois United States 61443
    275 Kewanee Hospital Kewanee Illinois United States 61443
    276 AMITA Health Adventist Medical Center La Grange Illinois United States 60525
    277 AMG Libertyville - Oncology Libertyville Illinois United States 60048
    278 Illinois CancerCare-Macomb Macomb Illinois United States 61455
    279 Mcdonough District Hospital Macomb Illinois United States 61455
    280 Loyola University Medical Center Maywood Illinois United States 60153
    281 Garneau, Stewart C MD (UIA Investigator) Moline Illinois United States 61265
    282 Porubcin, Michael MD (UIA Investigator) Moline Illinois United States 61265
    283 Sharis, Christine M MD (UIA Investigator) Moline Illinois United States 61265
    284 Stoffel, Thomas J MD (UIA Investigator) Moline Illinois United States 61265
    285 Trinity Medical Center Moline Illinois United States 61265
    286 Vigliotti, Antonio, P.G. M.D. (UIA Investigator) Moline Illinois United States 61265
    287 Holy Family Medical Center Monmouth Illinois United States 61462
    288 Illinois CancerCare-Monmouth Monmouth Illinois United States 61462
    289 Good Samaritan Regional Health Center Mount Vernon Illinois United States 62864
    290 Edward Hospital/Cancer Center Naperville Illinois United States 60540
    291 Illinois Cancer Specialists-Niles Niles Illinois United States 60714
    292 Bromenn Regional Medical Center Normal Illinois United States 61761
    293 Carle Cancer Institute Normal Normal Illinois United States 61761
    294 Illinois CancerCare-Community Cancer Center Normal Illinois United States 61761
    295 Mid-Illinois Hematology Oncology Associates Limited Normal Illinois United States 61761
    296 Advocate Christ Medical Center Oak Lawn Illinois United States 60453-2699
    297 Franciscan St. James Health-Olympia Fields Campus Olympia Fields Illinois United States 60461
    298 Illinois CancerCare-Ottawa Clinic Ottawa Illinois United States 61350
    299 Ottawa Regional Hospital and Healthcare Center Ottawa Illinois United States 61350
    300 Advocate Lutheran General Hospital Park Ridge Illinois United States 60068
    301 Illinois CancerCare-Pekin Pekin Illinois United States 61554
    302 OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center Pekin Illinois United States 61554
    303 Pekin Hospital Pekin Illinois United States 61554
    304 Proctor Hospital Peoria Illinois United States 61614
    305 Illinois CancerCare-Peoria Peoria Illinois United States 61615
    306 Methodist Medical Center of Illinois Peoria Illinois United States 61636
    307 OSF Saint Francis Medical Center Peoria Illinois United States 61637
    308 Illinois CancerCare-Peru Peru Illinois United States 61354
    309 Illinois Valley Hospital Peru Illinois United States 61354
    310 Illinois CancerCare-Princeton Princeton Illinois United States 61356
    311 Perry Memorial Hospital Princeton Illinois United States 61356
    312 West Suburban Medical Center River Forest Illinois United States 60305
    313 Swedish American Hospital Rockford Illinois United States 61104
    314 OSF Saint Anthony Medical Center Rockford Illinois United States 61108
    315 Edward H Kaplan MD and Associates Skokie Illinois United States 60076
    316 Hematology Oncology Associates of Illinois - Skokie Skokie Illinois United States 60076
    317 Midwest Cancer Research Group Incorporated Skokie Illinois United States 60077
    318 Illinois CancerCare-Spring Valley Spring Valley Illinois United States 61362
    319 Saint Margaret's Hospital Spring Valley Illinois United States 61362
    320 Memorial Medical Center Springfield Illinois United States 62781
    321 Carle Cancer Center Urbana Illinois United States 61801
    322 Northwestern Medicine Central DuPage Hospital Winfield Illinois United States 60190
    323 Saint Vincent Anderson Regional Hospital/Cancer Center Anderson Indiana United States 46016
    324 Franciscan Saint Francis Health-Beech Grove Beech Grove Indiana United States 46107
    325 IU Health Bloomington Bloomington Indiana United States 47403
    326 Elkhart Clinic Elkhart Indiana United States 46514-2098
    327 Elkhart General Hospital Elkhart Indiana United States 46515
    328 Fort Wayne Medical Oncology and Hematology Inc-Parkview Fort Wayne Indiana United States 46845
    329 Goshen Center for Cancer Care Goshen Indiana United States 46526
    330 Indiana University/Melvin and Bren Simon Cancer Center Indianapolis Indiana United States 46202
    331 Sidney and Lois Eskenazi Hospital Indianapolis Indiana United States 46202
    332 Community Cancer Center East Indianapolis Indiana United States 46219
    333 Franciscan Health Indianapolis Indianapolis Indiana United States 46237
    334 Community Cancer Center North Indianapolis Indiana United States 46256
    335 Saint Vincent Hospital and Health Care Center Indianapolis Indiana United States 46260
    336 Community Howard Regional Health Kokomo Indiana United States 46904
    337 IU Health La Porte Hospital La Porte Indiana United States 46350
    338 IU Health Arnett Cancer Care Lafayette Indiana United States 47904
    339 Horizon Oncology Research LLC Lafayette Indiana United States 47905
    340 Premier Oncology Hematology Associates Merrillville Indiana United States 46410
    341 Franciscan Saint Anthony Health-Michigan City Michigan City Indiana United States 46360
    342 Saint Joseph Regional Medical Center-Mishawaka Mishawaka Indiana United States 46545
    343 IU Health Ball Memorial Hospital Muncie Indiana United States 47303
    344 The Community Hospital Munster Indiana United States 46321
    345 Reid Health Richmond Indiana United States 47374
    346 Memorial Hospital of South Bend South Bend Indiana United States 46601
    347 Michiana Hematology Oncology PC-South Bend South Bend Indiana United States 46601
    348 South Bend Clinic South Bend Indiana United States 46617
    349 Northern Indiana Cancer Research Consortium South Bend Indiana United States 46628
    350 McFarland Clinic PC - Ames Ames Iowa United States 50010
    351 Constantinou, Costas L MD (UIA Investigator) Bettendorf Iowa United States 52722
    352 University of Iowa Healthcare Cancer Services Quad Cities Bettendorf Iowa United States 52722
    353 Physicians' Clinic of Iowa PC Cedar Rapids Iowa United States 52402
    354 Saint Luke's Hospital Cedar Rapids Iowa United States 52402
    355 Mercy Hospital Cedar Rapids Iowa United States 52403
    356 Oncology Associates at Mercy Medical Center Cedar Rapids Iowa United States 52403
    357 Medical Oncology and Hematology Associates-West Des Moines Clive Iowa United States 50325
    358 Heartland Oncology and Hematology LLP Council Bluffs Iowa United States 51503
    359 Genesis Medical Center - East Campus Davenport Iowa United States 52803
    360 Genesis Cancer Care Institute Davenport Iowa United States 52804
    361 Mercy Capitol Des Moines Iowa United States 50307
    362 Iowa Methodist Medical Center Des Moines Iowa United States 50309
    363 Iowa-Wide Oncology Research Coalition NCORP Des Moines Iowa United States 50309
    364 Medical Oncology and Hematology Associates-Des Moines Des Moines Iowa United States 50309
    365 Medical Oncology and Hematology Associates-Laurel Des Moines Iowa United States 50314
    366 Mercy Medical Center - Des Moines Des Moines Iowa United States 50314
    367 Iowa Lutheran Hospital Des Moines Iowa United States 50316
    368 Finley Hospital Dubuque Iowa United States 52001
    369 Medical Associates Clinic PC Dubuque Iowa United States 52001
    370 Mercy Medical Center - North Iowa Mason City Iowa United States 50401
    371 Ottumwa Regional Health Center Ottumwa Iowa United States 52501
    372 Siouxland Regional Cancer Center Sioux City Iowa United States 51101
    373 Mercy Medical Center-Sioux City Sioux City Iowa United States 51102
    374 Saint Luke's Regional Medical Center Sioux City Iowa United States 51104
    375 Cedar Valley Medical Specialists Waterloo Iowa United States 50701
    376 MercyOne Waterloo Medical Center Waterloo Iowa United States 50702
    377 Cancer Center of Kansas - Chanute Chanute Kansas United States 66720
    378 Cancer Center of Kansas - Dodge City Dodge City Kansas United States 67801
    379 Cancer Center of Kansas - El Dorado El Dorado Kansas United States 67042
    380 Cancer Center of Kansas-Independence Independence Kansas United States 67301
    381 Providence Medical Center Kansas City Kansas United States 66112
    382 University of Kansas Cancer Center Kansas City Kansas United States 66160
    383 Cancer Center of Kansas-Kingman Kingman Kansas United States 67068
    384 Lawrence Memorial Hospital Lawrence Kansas United States 66044
    385 Southwest Medical Center Liberal Kansas United States 67901
    386 Cancer Center of Kansas-Liberal Liberal Kansas United States 67905
    387 Cancer Center of Kansas - Newton Newton Kansas United States 67114
    388 Olathe Cancer Center Olathe Kansas United States 66061
    389 Olathe Health Cancer Center Olathe Kansas United States 66061
    390 Menorah Medical Center Overland Park Kansas United States 66209
    391 Radiation Oncology Practice Corporation Southwest Overland Park Kansas United States 66210
    392 Saint Luke's South Hospital Overland Park Kansas United States 66213
    393 Cancer Center of Kansas - Parsons Parsons Kansas United States 67357
    394 Kansas City NCI Community Oncology Research Program Prairie Village Kansas United States 66208
    395 Cancer Center of Kansas - Pratt Pratt Kansas United States 67124
    396 Cancer Center of Kansas - Salina Salina Kansas United States 67401
    397 Salina Regional Health Center Salina Kansas United States 67401
    398 Advent Health - Shawnee Mission Medical Center Shawnee Mission Kansas United States 66204
    399 Cotton O'Neil Cancer Center / Stormont Vail Health Topeka Kansas United States 66606
    400 University of Kansas Health System Saint Francis Campus Topeka Kansas United States 66606
    401 Cancer Center of Kansas - Wellington Wellington Kansas United States 67152
    402 Associates In Womens Health Wichita Kansas United States 67208
    403 Cancer Center of Kansas-Wichita Medical Arts Tower Wichita Kansas United States 67208
    404 Ascension Via Christi Hospitals Wichita Wichita Kansas United States 67214
    405 Cancer Center of Kansas - Wichita Wichita Kansas United States 67214
    406 Wichita NCI Community Oncology Research Program Wichita Kansas United States 67214
    407 Cancer Center of Kansas - Winfield Winfield Kansas United States 67156
    408 King's Daughter's Medical Center Ashland Kentucky United States 41101
    409 Our Lady Bellefonte Hospital Ashland Kentucky United States 41101
    410 Baptist Health Lexington Lexington Kentucky United States 40503
    411 University of Kentucky/Markey Cancer Center Lexington Kentucky United States 40536
    412 The James Graham Brown Cancer Center at University of Louisville Louisville Kentucky United States 40202
    413 Baptist Health Louisville Louisville Kentucky United States 40207
    414 Baptist Health Madisonville/Merle Mahr Cancer Center Madisonville Kentucky United States 42431
    415 Owensboro Health Mitchell Memorial Cancer Center Owensboro Kentucky United States 42303
    416 Christus Saint Frances Cabrini Hospital Alexandria Louisiana United States 71301
    417 Baton Rouge General Medical Center Baton Rouge Louisiana United States 70806
    418 Mary Bird Perkins Cancer Center Baton Rouge Louisiana United States 70809
    419 Ochsner Health Center-Summa Baton Rouge Louisiana United States 70809
    420 Ochsner Health Center-Covington Covington Louisiana United States 70433
    421 Metairie Oncologists Metairie Louisiana United States 70006
    422 Ochsner LSU Health Monroe Medical Center Monroe Louisiana United States 71202
    423 Louisiana State University Health Science Center New Orleans Louisiana United States 70112
    424 Tulane University Health Sciences Center New Orleans Louisiana United States 70112
    425 University Medical Center New Orleans New Orleans Louisiana United States 70112
    426 Ochsner Medical Center Jefferson New Orleans Louisiana United States 70121
    427 Overton Brooks Veteran's Administration Medical Center Shreveport Louisiana United States 71101
    428 LSU Health Sciences Center at Shreveport Shreveport Louisiana United States 71103
    429 CHRISTUS Highland Medical Center Shreveport Louisiana United States 71105
    430 Highland Clinic Shreveport Louisiana United States 71105
    431 Harold Alfond Center for Cancer Care Augusta Maine United States 04330
    432 Eastern Maine Medical Center Bangor Maine United States 04401
    433 Central Maine Medical Center Lewiston Maine United States 04240
    434 Saint Mary's Regional Medical Center Lewiston Maine United States 04240
    435 Mercy Hospital Portland Maine United States 04101
    436 Maine Center for Cancer Medicine-Scarborough Scarborough Maine United States 04074
    437 Maine Medical Center- Scarborough Campus Scarborough Maine United States 04074
    438 Maine General Medical Center-Thayer Waterville Maine United States 04901
    439 York Hospital York Maine United States 03909
    440 Anne Arundel Medical Center Annapolis Maryland United States 21401
    441 Mercy Medical Center Baltimore Maryland United States 21202
    442 Greater Baltimore Medical Center Baltimore Maryland United States 21204
    443 Sinai Hospital of Baltimore Baltimore Maryland United States 21215
    444 MedStar Union Memorial Hospital Baltimore Maryland United States 21218
    445 Saint Agnes Hospital Baltimore Maryland United States 21229
    446 MedStar Franklin Square Medical Center/Weinberg Cancer Institute Baltimore Maryland United States 21237
    447 MedStar Good Samaritan Hospital Baltimore Maryland United States 21239
    448 Johns Hopkins University/Sidney Kimmel Cancer Center Baltimore Maryland United States 21287
    449 Suburban Hospital Bethesda Maryland United States 20814
    450 Walter Reed National Military Medical Center Bethesda Maryland United States 20889-5600
    451 Western Maryland Regional Medical Center Cumberland Maryland United States 21502
    452 University of Maryland Shore Medical Center at Easton Easton Maryland United States 21601
    453 Christiana Care - Union Hospital Elkton Maryland United States 21921
    454 Frederick Memorial Hospital Frederick Maryland United States 21701
    455 Associates in Oncology Hematology PC -Kensington Kensington Maryland United States 20895
    456 Maryland Oncology Hematology PA-Aquilino Cancer Center Rockville Maryland United States 20850
    457 TidalHealth Peninsula Regional Salisbury Maryland United States 21801
    458 Holy Cross Hospital Silver Spring Maryland United States 20910
    459 UM Saint Joseph Medical Center Towson Maryland United States 21204
    460 Sturdy Memorial Hospital Attleboro Massachusetts United States 02703
    461 Tufts Medical Center Boston Massachusetts United States 02111
    462 Massachusetts General Hospital Cancer Center Boston Massachusetts United States 02114
    463 Brigham and Women's Hospital Boston Massachusetts United States 02115
    464 Boston Medical Center Boston Massachusetts United States 02118
    465 Beth Israel Deaconess Medical Center Boston Massachusetts United States 02215
    466 Dana-Farber Cancer Institute Boston Massachusetts United States 02215
    467 Steward Saint Elizabeth's Medical Center Brighton Massachusetts United States 02135
    468 Lahey Hospital and Medical Center Burlington Massachusetts United States 01805
    469 Commonwealth Hematology Oncology PC-Concord Concord Massachusetts United States 01742
    470 Mass General/North Shore Cancer Center Danvers Massachusetts United States 01923
    471 Dana Farber Community Cancer Care-Dorchester Dorchester Massachusetts United States 02124
    472 Saint Anne's Hospital Fall River Massachusetts United States 02721
    473 Simonds-Sinon Regional Cancer Center Fitchburg Massachusetts United States 01420
    474 MetroWest Medical Center-Framingham Union Hospital Framingham Massachusetts United States 01702
    475 Addison Gilbert Hospital Gloucester Massachusetts United States 01930
    476 Dana Farber Community Cancer Care-Haverhill Haverhill Massachusetts United States 01830
    477 Cape Cod Hospital Hyannis Massachusetts United States 02601
    478 HealthAlliance Hospital - Leominster Leominster Massachusetts United States 01453
    479 Saints Memorial Medical Center Lowell Massachusetts United States 01852
    480 Lowell General Hospital Lowell Massachusetts United States 01854
    481 Dana Farber-Merrimack Valley Methuen Massachusetts United States 01844
    482 Holy Family Hospital Methuen Massachusetts United States 01844
    483 Norwood Hospital Norwood Massachusetts United States 02062
    484 Berkshire Medical Center - Cancer Center Pittsfield Massachusetts United States 01201
    485 Dana Farber Community Cancer Care-Quincy Quincy Massachusetts United States 02169
    486 South Shore Hospital South Weymouth Massachusetts United States 02190
    487 Baystate Medical Center Springfield Massachusetts United States 01199
    488 Dana Farber Community Cancer Care-Stoneham Stoneham Massachusetts United States 02180
    489 Morton Hospital and Medical Center Taunton Massachusetts United States 02780
    490 Dana Farber Community Cancer Care-Weymouth Weymouth Massachusetts United States 02189
    491 Commonwealth Hematology Oncology PC-Worcester Worcester Massachusetts United States 01605
    492 Reliant Medical Group Inc Worcester Massachusetts United States 01606
    493 UMass Memorial Medical Center - University Campus Worcester Massachusetts United States 01655
    494 Bixby Medical Center Adrian Michigan United States 49221
    495 Hickman Cancer Center Adrian Michigan United States 49221
    496 Michigan Cancer Research Consortium NCORP Ann Arbor Michigan United States 48106
    497 Saint Joseph Mercy Hospital Ann Arbor Michigan United States 48106
    498 University of Michigan Comprehensive Cancer Center Ann Arbor Michigan United States 48109
    499 Bronson Battle Creek Battle Creek Michigan United States 49017
    500 McLaren Cancer Institute-Bay City Bay City Michigan United States 48706
    501 Spectrum Health Big Rapids Hospital Big Rapids Michigan United States 49307
    502 Beaumont Hospital - Dearborn Dearborn Michigan United States 48124
    503 Wayne State University/Karmanos Cancer Institute Detroit Michigan United States 48201
    504 Henry Ford Hospital Detroit Michigan United States 48202
    505 Ascension Saint John Hospital Detroit Michigan United States 48236
    506 Michigan State University Clinical Center East Lansing Michigan United States 48824-7016
    507 Green Bay Oncology - Escanaba Escanaba Michigan United States 49829
    508 Genesys Hurley Cancer Institute Flint Michigan United States 48503
    509 Hurley Medical Center Flint Michigan United States 48503
    510 Genesys Regional Medical Center-West Flint Campus Flint Michigan United States 48532
    511 McLaren Cancer Institute-Flint Flint Michigan United States 48532
    512 Cancer Research Consortium of West Michigan NCORP Grand Rapids Michigan United States 49503
    513 Mercy Health Saint Mary's Grand Rapids Michigan United States 49503
    514 Spectrum Health at Butterworth Campus Grand Rapids Michigan United States 49503
    515 Holland Community Hospital Holland Michigan United States 49423
    516 Green Bay Oncology - Iron Mountain Iron Mountain Michigan United States 49801
    517 Allegiance Health Jackson Michigan United States 49201
    518 Bronson Methodist Hospital Kalamazoo Michigan United States 49007
    519 West Michigan Cancer Center Kalamazoo Michigan United States 49007
    520 Borgess Medical Center Kalamazoo Michigan United States 49048
    521 Karmanos Cancer Institute at McLaren Greater Lansing Lansing Michigan United States 48910
    522 Sparrow Hospital Lansing Michigan United States 48912
    523 Lapeer Regional Hospital Lapeer Michigan United States 48446
    524 Trinity Health Saint Mary Mercy Livonia Hospital Livonia Michigan United States 48154
    525 UP Health System Marquette Marquette Michigan United States 49855
    526 MyMichigan Medical Center Midland Midland Michigan United States 48670
    527 Mercy Memorial Hospital Monroe Michigan United States 48162
    528 Toledo Clinic Cancer Centers-Monroe Monroe Michigan United States 48162
    529 McLaren Cancer Institute-Macomb Mount Clemens Michigan United States 48043
    530 Mercy Health Partners-Hackley Campus Muskegon Michigan United States 49442
    531 Mercy Health Mercy Campus Muskegon Michigan United States 49444
    532 McLaren Cancer Institute-Northern Michigan Petoskey Michigan United States 49770
    533 Saint Joseph Mercy Oakland Pontiac Michigan United States 48341
    534 Lake Huron Medical Center Port Huron Michigan United States 48060
    535 Crittenton Hospital Rochester Michigan United States 48307
    536 William Beaumont Hospital-Royal Oak Royal Oak Michigan United States 48073
    537 Ascension Saint Mary's Hospital Saginaw Michigan United States 48601
    538 Lakeland Medical Center Saint Joseph Saint Joseph Michigan United States 49085
    539 Marie Yeager Cancer Center Saint Joseph Michigan United States 49085
    540 Oncology Care Associates PLLC Saint Joseph Michigan United States 49085
    541 Ascension Providence Hospitals - Southfield Southfield Michigan United States 48075
    542 Munson Medical Center Traverse City Michigan United States 49684
    543 Saint John Macomb-Oakland Hospital Warren Michigan United States 48093
    544 Metro Health Hospital Wyoming Michigan United States 49519
    545 Medini, Eitan MD (UIA Investigator) Alexandria Minnesota United States 56308
    546 Sanford Joe Lueken Cancer Center Bemidji Minnesota United States 56601
    547 Fairview Ridges Hospital Burnsville Minnesota United States 55337
    548 Mercy Hospital Coon Rapids Minnesota United States 55433
    549 Essentia Health Cancer Center Duluth Minnesota United States 55805
    550 Essentia Health Saint Mary's Medical Center Duluth Minnesota United States 55805
    551 Miller-Dwan Hospital Duluth Minnesota United States 55805
    552 Saint Luke's Hospital of Duluth Duluth Minnesota United States 55805
    553 Fairview Southdale Hospital Edina Minnesota United States 55435
    554 Etzell, Paul S MD (UIA Investigator) Fergus Falls Minnesota United States 56537
    555 Lake Region Healthcare Corporation-Cancer Care Fergus Falls Minnesota United States 56537
    556 Swenson, Wade II, MD (UIA Investigator) Fergus Falls Minnesota United States 56537
    557 Unity Hospital Fridley Minnesota United States 55432
    558 Hutchinson Area Health Care Hutchinson Minnesota United States 55350
    559 Meeker County Memorial Hospital Litchfield Minnesota United States 55355
    560 Mayo Clinic Health Systems-Mankato Mankato Minnesota United States 56001
    561 Minnesota Oncology Hematology PA-Maplewood Maplewood Minnesota United States 55109
    562 Saint John's Hospital - Healtheast Maplewood Minnesota United States 55109
    563 Abbott-Northwestern Hospital Minneapolis Minnesota United States 55407
    564 Virginia Piper Cancer Institute Minneapolis Minnesota United States 55407
    565 Hennepin County Medical Center Minneapolis Minnesota United States 55415
    566 University of Minnesota/Masonic Cancer Center Minneapolis Minnesota United States 55455
    567 Chippewa County - Montevideo Hospital Montevideo Minnesota United States 56265
    568 North Memorial Medical Health Center Robbinsdale Minnesota United States 55422
    569 Mayo Clinic in Rochester Rochester Minnesota United States 55905
    570 Coborn Cancer Center at Saint Cloud Hospital Saint Cloud Minnesota United States 56303
    571 Saint Cloud Hospital Saint Cloud Minnesota United States 56303
    572 Metro Minnesota Community Oncology Research Consortium Saint Louis Park Minnesota United States 55416
    573 Park Nicollet Clinic - Saint Louis Park Saint Louis Park Minnesota United States 55416
    574 Regions Hospital Saint Paul Minnesota United States 55101
    575 Saint Joseph's Hospital - Healtheast Saint Paul Minnesota United States 55102
    576 United Hospital Saint Paul Minnesota United States 55102
    577 Saint Francis Regional Medical Center Shakopee Minnesota United States 55379
    578 Ridgeview Medical Center Waconia Minnesota United States 55387
    579 Rice Memorial Hospital Willmar Minnesota United States 56201
    580 Minnesota Oncology Hematology PA-Woodbury Woodbury Minnesota United States 55125
    581 Woodwinds Health Campus Woodbury Minnesota United States 55125
    582 Hattiesburg Clinic - Hematology/Oncology Clinic Hattiesburg Mississippi United States 39401
    583 Hematology and Oncology Clinic Hattiesburg Mississippi United States 39402
    584 Jackson Oncology Associates PLLC Jackson Mississippi United States 39202
    585 University of Mississippi Medical Center Jackson Mississippi United States 39216
    586 Keesler Medical Center Keesler Air Force Base Mississippi United States 39534
    587 Singing River Hospital Pascagoula Mississippi United States 39581
    588 Southeast Missouri Hospital Cape Girardeau Missouri United States 63701
    589 Saint Francis Medical Center Cape Girardeau Missouri United States 63703
    590 Saint Luke's Hospital Chesterfield Missouri United States 63017
    591 Missouri Cancer Associates Columbia Missouri United States 65201
    592 Veterans Administration Columbia Missouri United States 65201
    593 University of Missouri - Ellis Fischel Columbia Missouri United States 65212
    594 Centerpoint Medical Center LLC Independence Missouri United States 64057
    595 Capital Region Medical Center Jefferson City Missouri United States 65101
    596 Capital Region Southwest Campus Jefferson City Missouri United States 65109
    597 Freeman Health System Joplin Missouri United States 64804
    598 Mercy Hospital Joplin Joplin Missouri United States 64804
    599 Truman Medical Centers Kansas City Missouri United States 64108
    600 Saint Luke's Hospital of Kansas City Kansas City Missouri United States 64111
    601 Radiation Oncology Practice Corporation South Kansas City Missouri United States 64114
    602 Saint Joseph Health Center Kansas City Missouri United States 64114
    603 North Kansas City Hospital Kansas City Missouri United States 64116
    604 Heartland Hematology and Oncology Associates Incorporated Kansas City Missouri United States 64118
    605 Research Medical Center Kansas City Missouri United States 64132
    606 Radiation Oncology Practice Corporation - North Kansas City Missouri United States 64154
    607 Saint Luke's East - Lee's Summit Lee's Summit Missouri United States 64086
    608 Liberty Radiation Oncology Center Liberty Missouri United States 64068
    609 Heartland Regional Medical Center Saint Joseph Missouri United States 64506
    610 SSM Health Saint Louis University Hospital Saint Louis Missouri United States 63104
    611 Saint Louis Cancer and Breast Institute-South City Saint Louis Missouri United States 63109
    612 Washington University School of Medicine Saint Louis Missouri United States 63110
    613 Mercy Hospital South Saint Louis Missouri United States 63128
    614 Missouri Baptist Medical Center Saint Louis Missouri United States 63131
    615 Siteman Cancer Center at Christian Hospital Saint Louis Missouri United States 63136
    616 Center for Cancer Care and Research Saint Louis Missouri United States 63141
    617 Mercy Hospital Saint Louis Saint Louis Missouri United States 63141
    618 Saint Louis-Cape Girardeau CCOP Saint Louis Missouri United States 63141
    619 Cancer Research for the Ozarks NCORP Springfield Missouri United States 65804
    620 Mercy Hospital Springfield Springfield Missouri United States 65804
    621 CoxHealth South Hospital Springfield Missouri United States 65807
    622 Billings Clinic Cancer Center Billings Montana United States 59101
    623 Northern Rockies Radiation Oncology Center Billings Montana United States 59101
    624 Saint Vincent Healthcare Billings Montana United States 59101
    625 Montana Cancer Consortium NCORP Billings Montana United States 59102
    626 Saint Vincent Frontier Cancer Center Billings Montana United States 59102
    627 Deaconess Medical Center Billings Montana United States 59107
    628 Bozeman Deaconess Hospital Bozeman Montana United States 59715
    629 Saint James Community Hospital and Cancer Treatment Center Butte Montana United States 59701
    630 Benefis Healthcare- Sletten Cancer Institute Great Falls Montana United States 59405
    631 Berdeaux, Donald MD (UIA Investigator) Great Falls Montana United States 59405
    632 Great Falls Clinic Great Falls Montana United States 59405
    633 Northern Montana Hospital Havre Montana United States 59501
    634 Saint Peter's Community Hospital Helena Montana United States 59601
    635 Glacier Oncology PLLC Kalispell Montana United States 59901
    636 Kalispell Medical Oncology Kalispell Montana United States 59901
    637 Kalispell Regional Medical Center Kalispell Montana United States 59901
    638 Montana Cancer Specialists Missoula Montana United States 59802
    639 Saint Patrick Hospital - Community Hospital Missoula Montana United States 59802
    640 Community Medical Hospital Missoula Montana United States 59804
    641 Guardian Oncology and Center for Wellness Missoula Montana United States 59804
    642 CHI Health Saint Francis Grand Island Nebraska United States 68803
    643 CHI Health Good Samaritan Kearney Nebraska United States 68847
    644 Nebraska Cancer Research Center Lincoln Nebraska United States 68510
    645 Cancer Alliance of Nebraska Omaha Nebraska United States 68106
    646 Missouri Valley Cancer Consortium Omaha Nebraska United States 68106
    647 Nebraska Methodist Hospital Omaha Nebraska United States 68114
    648 Alegent Health Immanuel Medical Center Omaha Nebraska United States 68122
    649 Alegent Health Bergan Mercy Medical Center Omaha Nebraska United States 68124
    650 Alegent Health Lakeside Hospital Omaha Nebraska United States 68130
    651 Creighton University Medical Center Omaha Nebraska United States 68131
    652 University of Nebraska Medical Center Omaha Nebraska United States 68198
    653 Midlands Community Hospital Papillion Nebraska United States 68046
    654 Carson-Tahoe Specialty Medical Center Carson City Nevada United States 89703
    655 University Medical Center of Southern Nevada Las Vegas Nevada United States 89102
    656 Nevada Cancer Research Foundation NCORP Las Vegas Nevada United States 89169
    657 Renown Regional Medical Center Reno Nevada United States 89502
    658 Saint Mary's Regional Medical Center Reno Nevada United States 89503
    659 New Hampshire Oncology Hematology PA-Concord Concord New Hampshire United States 03301
    660 Exeter Hospital Exeter New Hampshire United States 03833
    661 Cheshire Medical Center-Dartmouth-Hitchcock Keene Keene New Hampshire United States 03431
    662 LRGHealthcare-Lakes Region General Hospital Laconia New Hampshire United States 03246
    663 Dartmouth Hitchcock Medical Center Lebanon New Hampshire United States 03756
    664 Elliot Hospital Manchester New Hampshire United States 03103
    665 Solinsky Center for Cancer Care Manchester New Hampshire United States 03103
    666 Foundation Medical Partners Nashua New Hampshire United States 03060
    667 Saint Joseph Hospital Nashua New Hampshire United States 03060
    668 Portsmouth Regional Hospital Portsmouth New Hampshire United States 03802
    669 Ocean Medical Center Brick New Jersey United States 08724
    670 Cooper Hospital University Medical Center Camden New Jersey United States 08103
    671 John F Kennedy Medical Center Edison New Jersey United States 08818
    672 Englewood Hospital and Medical Center Englewood New Jersey United States 07631
    673 Hunterdon Medical Center Flemington New Jersey United States 08822
    674 CentraState Medical Center Freehold New Jersey United States 07728
    675 Hackensack University Medical Center Hackensack New Jersey United States 07601
    676 The Cancer Institute of New Jersey Hamilton Hamilton New Jersey United States 08690
    677 Saint Barnabas Medical Center Livingston New Jersey United States 07039
    678 Monmouth Medical Center Long Branch New Jersey United States 07740
    679 Mountainside Hospital Montclair New Jersey United States 07042
    680 Morristown Medical Center Morristown New Jersey United States 07960
    681 Virtua Memorial Mount Holly New Jersey United States 08060
    682 Jersey Shore Medical Center Neptune New Jersey United States 07753
    683 Saint Peter's University Hospital New Brunswick New Jersey United States 08901
    684 Rutgers Cancer Institute of New Jersey New Brunswick New Jersey United States 08903
    685 Rutgers New Jersey Medical School Newark New Jersey United States 07101
    686 Saint Michael's Medical Center Newark New Jersey United States 07102
    687 Newark Beth Israel Medical Center Newark New Jersey United States 07112
    688 Saint Joseph's Regional Medical Center Paterson New Jersey United States 07503
    689 Capital Health Medical Center-Hopewell Pennington New Jersey United States 08534
    690 Saint Luke's Hospital-Warren Campus Phillipsburg New Jersey United States 08865
    691 Penn Medicine Princeton Health Plainsboro New Jersey United States 08536
    692 AtlantiCare Regional Medical Center -Main Campus Pomona New Jersey United States 08240
    693 Riverview Medical Center/Booker Cancer Center Red Bank New Jersey United States 07701
    694 Valley Hospital Ridgewood New Jersey United States 07450
    695 Shore Memorial Hospital Somers Point New Jersey United States 08244
    696 Robert Wood Johnson University Hospital Somerset Somerville New Jersey United States 08876
    697 Sparta Cancer Treatment Center Sparta New Jersey United States 07871
    698 Overlook Hospital Summit New Jersey United States 07902
    699 Community Medical Center Toms River New Jersey United States 08755
    700 Inspira Medical Center Vineland Vineland New Jersey United States 08360
    701 Virtua Voorhees Voorhees New Jersey United States 08043
    702 Lovelace Medical Center-Downtown Albuquerque New Mexico United States 87102
    703 University of New Mexico Cancer Center Albuquerque New Mexico United States 87102
    704 Hematology Oncology Associates Albuquerque New Mexico United States 87106
    705 Presbyterian Kaseman Hospital Albuquerque New Mexico United States 87110
    706 Memorial Medical Center - Las Cruces Las Cruces New Mexico United States 88011
    707 San Juan Regional Medical Center San Juan New Mexico United States 87401
    708 Christus Saint Vincent Regional Cancer Center Santa Fe New Mexico United States 87505
    709 New York Oncology Hematology PC - Albany Albany New York United States 12206
    710 New York Oncology Hematology PC - Albany Medical Center Albany New York United States 12208
    711 New York Oncology Hematology PC - Amsterdam Amsterdam New York United States 12010
    712 Lincoln Medical and Mental Health Center Bronx New York United States 10451
    713 Bronx-Lebanon Hospital Center Bronx New York United States 10456
    714 Montefiore Medical Center-Weiler Hospital Bronx New York United States 10461
    715 Montefiore Medical Center-Wakefield Campus Bronx New York United States 10466
    716 Montefiore Medical Center - Moses Campus Bronx New York United States 10467
    717 Coney Island Hospital Brooklyn New York United States 11235
    718 Roswell Park Cancer Institute Buffalo New York United States 14263
    719 New York Oncology Hematology PC - Clifton Park Clifton Park New York United States 12065
    720 Finger Lakes Hematology and Oncology Clifton Springs New York United States 14432
    721 Mary Imogene Bassett Hospital Cooperstown New York United States 13326
    722 Hematology Oncology Associates of Central New York-East Syracuse East Syracuse New York United States 13057
    723 Adirondack Cancer Center Glens Falls New York United States 12801
    724 Glens Falls Hospital Glens Falls New York United States 12801
    725 Catskill Regional Medical Center Harris New York United States 12742
    726 New York Oncology Hematology PC-Hudson Hudson New York United States 12534
    727 Queens Hospital Center Jamaica New York United States 11432
    728 Benedictine Hospital Kingston New York United States 12401
    729 Northwell Health NCORP Lake Success New York United States 11042
    730 Northwell Health/Center for Advanced Medicine Lake Success New York United States 11042
    731 North Shore University Hospital Manhasset New York United States 11030
    732 Garnet Health Medical Center Middletown New York United States 10940
    733 NYU Winthrop Hospital Mineola New York United States 11501
    734 Long Island Jewish Medical Center New Hyde Park New York United States 11040
    735 Mount Sinai Union Square New York New York United States 10003
    736 Laura and Isaac Perlmutter Cancer Center at NYU Langone New York New York United States 10016
    737 Mount Sinai West New York New York United States 10019
    738 Mount Sinai Hospital New York New York United States 10029
    739 NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center New York New York United States 10032
    740 Ralph Lauren Center for Cancer Care and Prevention New York New York United States 10035
    741 Memorial Sloan Kettering Cancer Center New York New York United States 10065
    742 NYP/Weill Cornell Medical Center New York New York United States 10065
    743 Nyack Hospital Nyack New York United States 10960
    744 Champlain Valley Physicians Hospital Medical Center Plattsburgh New York United States 12901
    745 Hudson Valley Hematology Oncology Associates Poughkeepsie New York United States 12601
    746 MidHudson Regional Hospital of Westchester Medical Center Poughkeepsie New York United States 12601
    747 The Dyson Center for Cancer Care Poughkeepsie New York United States 12601
    748 Vassar Brothers Medical Center Poughkeepsie New York United States 12601
    749 Highland Hospital Rochester New York United States 14620
    750 Rochester General Hospital Rochester New York United States 14621
    751 Interlakes Foundation Inc-Rochester Rochester New York United States 14623
    752 University of Rochester Rochester New York United States 14642
    753 Staten Island University Hospital Staten Island New York United States 10305
    754 Richmond University Medical Center Staten Island New York United States 10310
    755 Stony Brook University Medical Center Stony Brook New York United States 11794
    756 State University of New York Upstate Medical University Syracuse New York United States 13210
    757 New York Oncology Hematology PC - Troy Troy New York United States 12180
    758 Faxton-Saint Luke's Healthcare Utica New York United States 13502
    759 Randolph Hospital Asheboro North Carolina United States 27203
    760 Mission Hospital Asheville North Carolina United States 28801
    761 Hope Women's Cancer Centers-Asheville Asheville North Carolina United States 28816
    762 Waverly Hematology Oncology Cary North Carolina United States 27518
    763 UNC Lineberger Comprehensive Cancer Center Chapel Hill North Carolina United States 27599
    764 Carolinas Medical Center/Levine Cancer Institute Charlotte North Carolina United States 28203
    765 Novant Health Presbyterian Medical Center Charlotte North Carolina United States 28204
    766 Atrium Health Cabarrus/LCI-Concord Concord North Carolina United States 28025
    767 Duke University Medical Center Durham North Carolina United States 27710
    768 Moorehead Memorial Hospital Eden North Carolina United States 27288
    769 Cape Fear Valley Health System Fayetteville North Carolina United States 28304
    770 CaroMont Regional Medical Center Gastonia North Carolina United States 28054
    771 Wayne Memorial Hospital Goldsboro North Carolina United States 27534
    772 Wayne Radiation Oncology Goldsboro North Carolina United States 27534
    773 Cone Health Cancer Center Greensboro North Carolina United States 27403
    774 East Carolina University Greenville North Carolina United States 27834
    775 AdventHealth Hendersonville Hendersonville North Carolina United States 28792
    776 Maria Parham Hospital Henderson North Carolina United States 27536
    777 High Point Regional Hospital High Point North Carolina United States 27262
    778 Vidant Oncology-Kinston Kinston North Carolina United States 28501
    779 Southeastern Regional Medical Center Lumberton North Carolina United States 28358
    780 Granville Medical Center Oxford North Carolina United States 27565
    781 FirstHealth of the Carolinas-Moore Regional Hospital Pinehurst North Carolina United States 28374
    782 UNC Rex Cancer Center Raleigh North Carolina United States 27607
    783 Duke Raleigh Hospital Raleigh North Carolina United States 27609
    784 Annie Penn Memorial Hospital Reidsville North Carolina United States 27320
    785 Person Memorial Hospital Roxboro North Carolina United States 27573
    786 Rutherford Hospital Rutherfordton North Carolina United States 28139
    787 Iredell Memorial Hospital Statesville North Carolina United States 28677
    788 Marion L Shepard Cancer Center at Vidant Beaufort Hospital Washington North Carolina United States 27889
    789 New Hanover Regional Medical Center/Zimmer Cancer Center Wilmington North Carolina United States 28401
    790 Wilson Medical Center Wilson North Carolina United States 27893
    791 Novant Health Forsyth Medical Center Winston-Salem North Carolina United States 27103
    792 Southeast Clinical Oncology Research Consortium NCORP Winston-Salem North Carolina United States 27104
    793 Wake Forest University Health Sciences Winston-Salem North Carolina United States 27157
    794 Mid Dakota Clinic Bismarck North Dakota United States 58501
    795 Saint Alexius Medical Center Bismarck North Dakota United States 58501
    796 Sanford Bismarck Medical Center Bismarck North Dakota United States 58501
    797 Sanford Broadway Medical Center Fargo North Dakota United States 58122
    798 Sanford Clinic North-Fargo Fargo North Dakota United States 58122
    799 Altru Cancer Center Grand Forks North Dakota United States 58201
    800 Trinity Cancer Care Center Minot North Dakota United States 58701
    801 Summa Health System - Akron Campus Akron Ohio United States 44304
    802 Cleveland Clinic Akron General Akron Ohio United States 44307
    803 Summa Health System - Barberton Campus Barberton Ohio United States 44203
    804 Mary Rutan Hospital Bellefontaine Ohio United States 43311
    805 Toledo Clinic Cancer Centers-Bowling Green Bowling Green Ohio United States 43402
    806 Community Hospital and Wellness Centers Bryan Ohio United States 43506
    807 Cleveland Clinic Mercy Hospital Canton Ohio United States 44708
    808 Aultman Health Foundation Canton Ohio United States 44710
    809 Adena Regional Medical Center Chillicothe Ohio United States 45601
    810 The Christ Hospital Cincinnati Ohio United States 45219
    811 University of Cincinnati Cancer Center-UC Medical Center Cincinnati Ohio United States 45219
    812 Good Samaritan Hospital - Cincinnati Cincinnati Ohio United States 45220
    813 Oncology Hematology Care Inc-Blue Ash Cincinnati Ohio United States 45242
    814 Case Western Reserve University Cleveland Ohio United States 44106
    815 MetroHealth Medical Center Cleveland Ohio United States 44109
    816 Cleveland Clinic Cancer Center/Fairview Hospital Cleveland Ohio United States 44111
    817 Cleveland Clinic Foundation Cleveland Ohio United States 44195
    818 North Coast Cancer Care-Clyde Clyde Ohio United States 43410
    819 Ohio State University Comprehensive Cancer Center Columbus Ohio United States 43210
    820 Riverside Methodist Hospital Columbus Ohio United States 43214
    821 Columbus NCI Community Oncology Research Program Columbus Ohio United States 43215
    822 Grant Medical Center Columbus Ohio United States 43215
    823 Mount Carmel Health Center West Columbus Ohio United States 43222
    824 Doctors Hospital Columbus Ohio United States 43228
    825 Grandview Hospital Dayton Ohio United States 45405
    826 Good Samaritan Hospital - Dayton Dayton Ohio United States 45406
    827 Miami Valley Hospital Dayton Ohio United States 45409
    828 Miami Valley Hospital North Dayton Ohio United States 45415
    829 Dayton Veterans Affairs Medical Center Dayton Ohio United States 45428
    830 Dayton NCI Community Oncology Research Program Dayton Ohio United States 45459
    831 Grady Memorial Hospital Delaware Ohio United States 43015
    832 Hematology Oncology Center Incorporated Elyria Ohio United States 44035
    833 Blanchard Valley Hospital Findlay Ohio United States 45840
    834 Atrium Medical Center-Middletown Regional Hospital Franklin Ohio United States 45005-1066
    835 Fremont Memorial Hospital Fremont Ohio United States 43420
    836 Wayne Hospital Greenville Ohio United States 45331
    837 Cleveland Clinic Cancer Center Independence Independence Ohio United States 44131
    838 Cole, Sharon, K. M.D. (UIA Investigator) Kenton Ohio United States 43326
    839 Kettering Medical Center Kettering Ohio United States 45429
    840 Fairfield Medical Center Lancaster Ohio United States 43130
    841 Saint Rita's Medical Center Lima Ohio United States 45801
    842 Lima Memorial Hospital Lima Ohio United States 45804
    843 OhioHealth Mansfield Hospital Mansfield Ohio United States 44903
    844 Marietta Memorial Hospital Marietta Ohio United States 45750
    845 Saint Luke's Hospital Maumee Ohio United States 43537
    846 Toledo Clinic Cancer Centers-Maumee Maumee Ohio United States 43537
    847 Toledo Radiation Oncology at Northwest Ohio Onocolgy Center Maumee Ohio United States 43537
    848 Hillcrest Hospital Cancer Center Mayfield Heights Ohio United States 44124
    849 Licking Memorial Hospital Newark Ohio United States 43055
    850 Fisher-Titus Medical Center Norwalk Ohio United States 44857
    851 Saint Charles Hospital Oregon Ohio United States 43616
    852 Toledo Clinic Cancer Centers-Oregon Oregon Ohio United States 43616
    853 UH Seidman Cancer Center at Salem Regional Medical Center Salem Ohio United States 44460
    854 Firelands Regional Medical Center Sandusky Ohio United States 44870
    855 North Coast Cancer Care Sandusky Ohio United States 44870
    856 Springfield Regional Medical Center Springfield Ohio United States 45505
    857 ProMedica Flower Hospital Sylvania Ohio United States 43560
    858 Mercy Hospital of Tiffin Tiffin Ohio United States 44883
    859 ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital Toledo Ohio United States 43606
    860 Saint Vincent Mercy Medical Center Toledo Ohio United States 43608
    861 University of Toledo Toledo Ohio United States 43614
    862 Toledo Community Hospital Oncology Program CCOP Toledo Ohio United States 43617
    863 Mercy Health - Saint Anne Hospital Toledo Ohio United States 43623
    864 Stark, Michael, Edward. M.D. (UIA Investigator) Toledo Ohio United States 43623
    865 Toledo Clinic Cancer Centers-Toledo Toledo Ohio United States 43623
    866 Upper Valley Medical Center Troy Ohio United States 45373
    867 Saint Joseph Warren Hospital Warren Ohio United States 44484
    868 Fulton County Health Center Wauseon Ohio United States 43567
    869 Saint Ann's Hospital Westerville Ohio United States 43081
    870 Clinton Memorial Hospital Wilmington Ohio United States 45177
    871 Cancer Treatment Center Wooster Ohio United States 44691
    872 Cleveland Clinic Wooster Family Health and Surgery Center Wooster Ohio United States 44691
    873 Wright-Patterson Medical Center Wright-Patterson Air Force Base Ohio United States 45433
    874 Greene Memorial Hospital Xenia Ohio United States 45385
    875 Tod Children's Hospital - Forum Health Youngstown Ohio United States 44501
    876 Genesis Healthcare System Cancer Care Center Zanesville Ohio United States 43701
    877 Cancer Centers of Southwest Oklahoma Research Lawton Oklahoma United States 73505
    878 University of Oklahoma Health Sciences Center Oklahoma City Oklahoma United States 73104
    879 Cancer Care Associates Oklahoma City Oklahoma United States 73120
    880 Mercy Hospital Oklahoma City Oklahoma City Oklahoma United States 73120
    881 Saint John Medical Center Tulsa Oklahoma United States 74104
    882 Natalie Warren Bryant Cancer Center at Saint Francis Tulsa Oklahoma United States 74136
    883 Bend Memorial Clinic Bend Oregon United States 97701
    884 Saint Charles Health System Bend Oregon United States 97701
    885 Bay Area Hospital Coos Bay Oregon United States 97420
    886 Three Rivers Community Hospital Grants Pass Oregon United States 97527
    887 Legacy Mount Hood Medical Center Gresham Oregon United States 97030
    888 Sky Lakes Medical Center - Cancer Treatment Center Klamath Falls Oregon United States 97601
    889 Asante Health System Medford Oregon United States 97504
    890 Providence Medford Medical Center Medford Oregon United States 97504
    891 Rogue Valley Medical Center Medford Oregon United States 97504
    892 Providence Milwaukie Hospital Milwaukie Oregon United States 97222
    893 Legacy Good Samaritan Hospital and Medical Center Portland Oregon United States 97210
    894 Providence Portland Medical Center Portland Oregon United States 97213
    895 Adventist Medical Center Portland Oregon United States 97216
    896 Providence Saint Vincent Medical Center Portland Oregon United States 97225
    897 Compass Oncology Rose Quarter Portland Oregon United States 97227
    898 Kaiser Permanente Northwest Portland Oregon United States 97227
    899 Legacy Emanuel Hospital and Health Center Portland Oregon United States 97227
    900 Oregon Health and Science University Portland Oregon United States 97239
    901 Salem Hospital Salem Oregon United States 97301
    902 Legacy Meridian Park Hospital Tualatin Oregon United States 97062
    903 Jefferson Abington Hospital Abington Pennsylvania United States 19001
    904 Sacred Heart Hospital Allentown Pennsylvania United States 18102
    905 Lehigh Valley Hospital-Cedar Crest Allentown Pennsylvania United States 18103
    906 Saint Luke's University Hospital-Bethlehem Campus Bethlehem Pennsylvania United States 18015
    907 Bryn Mawr Hospital Bryn Mawr Pennsylvania United States 19010
    908 Geisinger Medical Center Danville Pennsylvania United States 17822
    909 Mercy Fitzgerald Hospital Darby Pennsylvania United States 19023-1291
    910 Doylestown Hospital Doylestown Pennsylvania United States 18901
    911 Delaware County Memorial Hospital Drexel Hill Pennsylvania United States 19026
    912 Oncology Hematology Associates of Northern Pennsylvania DuBois Pennsylvania United States 15801
    913 Pocono Medical Center East Stroudsburg Pennsylvania United States 18301
    914 Easton Hospital Easton Pennsylvania United States 18042
    915 Ephrata Cancer Center Ephrata Pennsylvania United States 17522
    916 UPMC Hillman Cancer Center Erie Erie Pennsylvania United States 16505
    917 Saint Vincent Hospital Erie Pennsylvania United States 16544
    918 UPMC Pinnacle Cancer Center/Community Osteopathic Campus Harrisburg Pennsylvania United States 17109
    919 Geisinger Medical Center-Cancer Center Hazleton Hazleton Pennsylvania United States 18201
    920 Penn State Milton S Hershey Medical Center Hershey Pennsylvania United States 17033-0850
    921 Conemaugh Memorial Medical Center Johnstown Pennsylvania United States 15905-4398
    922 Lancaster General Hospital Lancaster Pennsylvania United States 17602
    923 Saint Mary Medical and Regional Cancer Center Langhorne Pennsylvania United States 19047
    924 Lewistown Hospital Lewistown Pennsylvania United States 17044
    925 Holy Redeemer Hospital and Medical Center Meadowbrook Pennsylvania United States 19046
    926 Riddle Memorial Hospital Media Pennsylvania United States 19063
    927 Paoli Memorial Hospital Paoli Pennsylvania United States 19301
    928 Drexel University School of Medicine Philadelphia Pennsylvania United States 19102
    929 University of Pennsylvania/Abramson Cancer Center Philadelphia Pennsylvania United States 19104
    930 Pennsylvania Hospital Philadelphia Pennsylvania United States 19107
    931 Thomas Jefferson University Hospital Philadelphia Pennsylvania United States 19107
    932 Fox Chase Cancer Center Philadelphia Pennsylvania United States 19111
    933 Jefferson Torresdale Hospital Philadelphia Pennsylvania United States 19114
    934 Chestnut Hill Health System Philadelphia Pennsylvania United States 19118
    935 Einstein Medical Center Philadelphia Philadelphia Pennsylvania United States 19141
    936 Phoenixville Hospital Phoenixville Pennsylvania United States 19460
    937 Allegheny General Hospital Pittsburgh Pennsylvania United States 15212
    938 UPMC-Magee Womens Hospital Pittsburgh Pennsylvania United States 15213
    939 West Penn Hospital Pittsburgh Pennsylvania United States 15224
    940 University of Pittsburgh Cancer Institute (UPCI) Pittsburgh Pennsylvania United States 15232
    941 Pottstown Hospital Pottstown Pennsylvania United States 19464
    942 Penn State Health Saint Joseph Medical Center Reading Pennsylvania United States 19605
    943 Guthrie Medical Group PC-Robert Packer Hospital Sayre Pennsylvania United States 18840
    944 Mercy Hospital Scranton Pennsylvania United States 18501
    945 Hematology and Oncology Associates of North East Pennsylvania Scranton Pennsylvania United States 18508
    946 Scranton Hematology Oncology Scranton Pennsylvania United States 18510
    947 Grand View Hospital Sellersville Pennsylvania United States 18960
    948 Geisinger Medical Group State College Pennsylvania United States 16801
    949 Mount Nittany Medical Center State College Pennsylvania United States 16803
    950 Associates In Hematology Oncology PC-Upland Upland Pennsylvania United States 19013
    951 Chester County Hospital West Chester Pennsylvania United States 19380
    952 Jennersville Regional Hospital West Grove Pennsylvania United States 19390
    953 Reading Hospital West Reading Pennsylvania United States 19611
    954 Geisinger Wyoming Valley/Henry Cancer Center Wilkes-Barre Pennsylvania United States 18711
    955 UPMC Susquehanna Williamsport Pennsylvania United States 17701
    956 Lankenau Medical Center Wynnewood Pennsylvania United States 19096
    957 Main Line Health NCORP Wynnewood Pennsylvania United States 19096
    958 WellSpan Health-York Hospital York Pennsylvania United States 17403
    959 Hematology and Oncology Associates of Rhode Island Inc Cranston Rhode Island United States 02920
    960 Memorial Hospital of Rhode Island Pawtucket Rhode Island United States 02860
    961 Rhode Island Hospital Providence Rhode Island United States 02903
    962 Women and Infants Hospital Providence Rhode Island United States 02905
    963 Miriam Hospital Providence Rhode Island United States 02906
    964 Roger Williams Medical Center Providence Rhode Island United States 02908
    965 Kent Hospital Warwick Rhode Island United States 02886
    966 AnMed Health Hospital Anderson South Carolina United States 29621
    967 Beaufort Memorial Hospital Beaufort South Carolina United States 29902
    968 Roper Hospital Charleston South Carolina United States 29401
    969 Medical University of South Carolina Charleston South Carolina United States 29425
    970 South Carolina Oncology Associates PA Columbia South Carolina United States 29210
    971 McLeod Regional Medical Center Florence South Carolina United States 29506
    972 Tidelands Georgetown Memorial Hospital Georgetown South Carolina United States 29440
    973 Saint Francis Hospital Greenville South Carolina United States 29601
    974 Prisma Health Cancer Institute - Eastside Greenville South Carolina United States 29615
    975 Spartanburg Medical Center Spartanburg South Carolina United States 29303
    976 Avera Cancer Institute-Aberdeen Aberdeen South Dakota United States 57401
    977 Sanford Cancer Center Oncology Clinic Sioux Falls South Dakota United States 57104
    978 Avera Cancer Institute Sioux Falls South Dakota United States 57105
    979 Medical X-Ray Center Sioux Falls South Dakota United States 57105
    980 Avera McKennan Hospital and University Health Center Sioux Falls South Dakota United States 57117-5045
    981 Sanford USD Medical Center - Sioux Falls Sioux Falls South Dakota United States 57117-5134
    982 Wellmont Medical Associates Oncology and Hematology-Bristol Bristol Tennessee United States 37620
    983 Erlanger Medical Center Chattanooga Tennessee United States 37403
    984 Cookeville Regional Medical Center Cookeville Tennessee United States 38501
    985 Vanderbilt-Ingram Cancer Center Cool Springs Franklin Tennessee United States 37067
    986 Jones Clinic Germantown Tennessee United States 38138
    987 Jackson-Madison County General Hospital Jackson Tennessee United States 38301
    988 The Jackson Clinic PA Jackson Tennessee United States 38301
    989 Wellmont Holston Valley Hospital and Medical Center Kingsport Tennessee United States 37660
    990 Tennessee Cancer Specialists-Dowell Springs Knoxville Tennessee United States 37909
    991 Thompson Cancer Survival Center Knoxville Tennessee United States 37916
    992 East Tennessee Baptist Hospital-Mercy Health Partners Knoxville Tennessee United States 37920
    993 University of Tennessee - Knoxville Knoxville Tennessee United States 37920
    994 University of Tennessee Health Science Center Memphis Tennessee United States 38163
    995 Nashville Breast Center Nashville Tennessee United States 37203
    996 Nashville Oncology Associates PC Nashville Tennessee United States 37203
    997 Tennessee Oncology PLLC- Centennial Medical Center Nashville Tennessee United States 37203
    998 Vanderbilt Breast Center at One Hundred Oaks Nashville Tennessee United States 37204
    999 Saint Thomas Hospital Nashville Tennessee United States 37205
    1000 Meharry Medical College Nashville Tennessee United States 37208
    1001 Vanderbilt University/Ingram Cancer Center Nashville Tennessee United States 37232
    1002 Saint Thomas Midtown Hospital Nashville Tennessee United States 37236
    1003 Saint Mary's North Cancer Center Powell Tennessee United States 37849
    1004 The Don and Sybil Harrington Cancer Center Amarillo Texas United States 79106
    1005 Dell Seton Medical Center at The University of Texas Austin Texas United States 78701
    1006 Texas Oncology-Austin Midtown Austin Texas United States 78705
    1007 Texas Oncology - Central Austin Cancer Center Austin Texas United States 78731
    1008 Texas Oncology - South Austin Cancer Center Austin Texas United States 78745
    1009 Texas Oncology-Austin North Austin Texas United States 78758
    1010 Texas Oncology Seton Northwest Austin Texas United States 78759
    1011 Saint Joseph Regional Cancer Center Bryan Texas United States 77802
    1012 The Center for Cancer and Blood Disorders-Burleson Burleson Texas United States 76115
    1013 Texas Oncology-Cedar Park Cedar Park Texas United States 78613
    1014 The Center for Cancer and Blood Disorders-Cleburne Cleburne Texas United States 76033
    1015 Medical City Dallas Hospital Dallas Texas United States 75230
    1016 Parkland Memorial Hospital Dallas Texas United States 75235
    1017 Clements University Hospital Dallas Texas United States 75390
    1018 UT Southwestern/Simmons Cancer Center-Dallas Dallas Texas United States 75390
    1019 Dallas Oncology Consultants PA Duncanville Texas United States 75137
    1020 The Center for Integrative Cancer Medicine El Paso Texas United States 79902
    1021 Brooke Army Medical Center Fort Sam Houston Texas United States 78234
    1022 The Center for Cancer and Blood Disorders-Fort Worth Fort Worth Texas United States 76104
    1023 Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center Houston Texas United States 77030
    1024 Ben Taub General Hospital Houston Texas United States 77030
    1025 Houston Methodist Hospital Houston Texas United States 77030
    1026 M D Anderson Cancer Center Houston Texas United States 77030
    1027 Wilford Hall Medical Center Lackland Air Force Base Texas United States 78236
    1028 Doctor's Hospital of Laredo Laredo Texas United States 78041
    1029 Covenant Medical Center-Lakeside Lubbock Texas United States 79410
    1030 Texas Tech University Health Sciences Center-Lubbock Lubbock Texas United States 79430
    1031 The Center for Cancer and Blood Disorders-Mineral Wells Mineral Wells Texas United States 76067
    1032 Texas Oncology-Seton Williamson Round Rock Texas United States 78665
    1033 Texas Oncology - Round Rock Cancer Center Round Rock Texas United States 78681
    1034 Cancer Therapy and Research Center at The UT Health Science Center at San Antonio San Antonio Texas United States 78229
    1035 University Hospital San Antonio Texas United States 78229
    1036 University of Texas Health Science Center at San Antonio San Antonio Texas United States 78229
    1037 Texas Oncology- San Marcos San Marcos Texas United States 78666
    1038 Scott and White Memorial Hospital Temple Texas United States 76508
    1039 The Center for Cancer and Blood Disorders-Weatherford Weatherford Texas United States 76086
    1040 American Fork Hospital / Huntsman Intermountain Cancer Center American Fork Utah United States 84003
    1041 Sandra L Maxwell Cancer Center Cedar City Utah United States 84720
    1042 Logan Regional Hospital Logan Utah United States 84321
    1043 Cottonwood Hospital Medical Center Murray Utah United States 84107
    1044 Intermountain Medical Center Murray Utah United States 84107
    1045 McKay-Dee Hospital Center Ogden Utah United States 84403
    1046 Utah Valley Regional Medical Center Provo Utah United States 84604
    1047 Saint George Regional Medical Center Saint George Utah United States 84770
    1048 Intermountain Health Care Salt Lake City Utah United States 84103
    1049 Utah Cancer Specialists-Salt Lake City Salt Lake City Utah United States 84106
    1050 LDS Hospital Salt Lake City Utah United States 84143
    1051 Southwestern Vermont Medical Center Bennington Vermont United States 05201
    1052 University of Vermont and State Agricultural College Burlington Vermont United States 05405
    1053 Rutland Regional Medical Center Rutland Vermont United States 05701
    1054 Mount Ascutney Hospital and Health Center Windsor Vermont United States 05089
    1055 Sentara Martha Jefferson Hospital Charlottesville Virginia United States 22901
    1056 University of Virginia Cancer Center Charlottesville Virginia United States 22908
    1057 Danville Regional Medical Center Danville Virginia United States 24541
    1058 Inova Fairfax Hospital Falls Church Virginia United States 22042
    1059 Fredericksburg Oncology Inc Fredericksburg Virginia United States 22401
    1060 Peninsula Cancer Institute-Gloucester Gloucester Virginia United States 23061
    1061 Virginia Oncology Associates-Hampton Hampton Virginia United States 23666
    1062 Centra Lynchburg Hematology-Oncology Clinic Inc Lynchburg Virginia United States 24501
    1063 Peninsula Cancer Institute-Newport News Newport News Virginia United States 23601
    1064 Sentara Port Warwick Newport News Virginia United States 23606
    1065 Eastern Virginia Medical School Norfolk Virginia United States 23507
    1066 Southwest VA Regional Cancer Center Norton Virginia United States 24273
    1067 Virginia Cancer Institute Richmond Virginia United States 23229
    1068 Virginia Commonwealth University/Massey Cancer Center Richmond Virginia United States 23298
    1069 Peninsula Cancer Institute-Williamsburg Williamsburg Virginia United States 23185
    1070 MultiCare Auburn Medical Center Auburn Washington United States 98001
    1071 PeaceHealth Saint Joseph Medical Center Bellingham Washington United States 98225
    1072 Harrison HealthPartners Hematology and Oncology-Bremerton Bremerton Washington United States 98310
    1073 Providence Regional Cancer System-Centralia Centralia Washington United States 98531
    1074 Saint Francis Hospital Federal Way Washington United States 98003
    1075 Kadlec Clinic Hematology and Oncology Kennewick Washington United States 99336
    1076 EvergreenHealth Medical Center Kirkland Washington United States 98033
    1077 Saint Clare Hospital Lakewood Washington United States 98499
    1078 PeaceHealth Saint John Medical Center Longview Washington United States 98632
    1079 Providence - Saint Peter Hospital Olympia Washington United States 98506-5166
    1080 Capital Medical Center Olympia Washington United States 98507
    1081 Olympic Medical Center Port Angeles Washington United States 98362
    1082 Harrison HealthPartners Hematology and Oncology-Poulsbo Poulsbo Washington United States 98370
    1083 MultiCare Good Samaritan Hospital Puyallup Washington United States 98372
    1084 Valley Medical Center Renton Washington United States 98055
    1085 Virginia Mason Medical Center Seattle Washington United States 98101
    1086 Minor and James Medical PLLC Seattle Washington United States 98104
    1087 Pacific Medical Center-First Hill Seattle Washington United States 98104
    1088 Kaiser Permanente Washington Seattle Washington United States 98112
    1089 Swedish Medical Center-First Hill Seattle Washington United States 98122-4307
    1090 University of Washington Medical Center - Montlake Seattle Washington United States 98195
    1091 Cancer Care Northwest - Spokane South Spokane Washington United States 99202
    1092 Providence Sacred Heart Medical Center and Children's Hospital Spokane Washington United States 99204
    1093 Providence Holy Family Hospital Spokane Washington United States 99208
    1094 Evergreen Hematology and Oncology PS Spokane Washington United States 99218
    1095 Rockwood Clinic Spokane Washington United States 99220
    1096 MultiCare Allenmore Hospital Tacoma Washington United States 98405
    1097 MultiCare Tacoma General Hospital Tacoma Washington United States 98405
    1098 Northwest NCI Community Oncology Research Program Tacoma Washington United States 98405
    1099 Saint Joseph Medical Center Tacoma Washington United States 98405
    1100 Madigan Army Medical Center Tacoma Washington United States 98431
    1101 PeaceHealth Southwest Medical Center Vancouver Washington United States 98664
    1102 Compass Oncology Vancouver Vancouver Washington United States 98684
    1103 Cancer Institutes of Washington PLLC Yakima Washington United States 98902
    1104 North Star Lodge Cancer Center at Yakima Valley Memorial Hospital Yakima Washington United States 98902
    1105 United Hospital Center Bridgeport West Virginia United States 26330
    1106 West Virginia University Charleston Division Charleston West Virginia United States 25304
    1107 Edwards Comprehensive Cancer Center Huntington West Virginia United States 25701
    1108 Marshall University Medical Center Huntington West Virginia United States 25701
    1109 Saint Mary's Medical Center Huntington West Virginia United States 25702
    1110 West Virginia University Healthcare Morgantown West Virginia United States 26506
    1111 Camden Clark Medical Center Parkersburg West Virginia United States 26101
    1112 Princeton Community Hospital Princeton West Virginia United States 24740
    1113 Wheeling Hospital/Schiffler Cancer Center Wheeling West Virginia United States 26003
    1114 Langlade Hospital and Cancer Center Antigo Wisconsin United States 54409
    1115 Fox Valley Surgical Associates Limited Appleton Wisconsin United States 54911
    1116 ThedaCare Regional Cancer Center Appleton Wisconsin United States 54911
    1117 Aurora Cancer Care-Southern Lakes VLCC Burlington Wisconsin United States 53105
    1118 Marshfield Clinic-Chippewa Center Chippewa Falls Wisconsin United States 54729
    1119 HSHS Sacred Heart Hospital Eau Claire Wisconsin United States 54701
    1120 Marshfield Clinic Cancer Center at Sacred Heart Eau Claire Wisconsin United States 54701
    1121 Saint Agnes Hospital/Agnesian Cancer Center Fond Du Lac Wisconsin United States 54935
    1122 Aurora Cancer Care-Franklin Franklin Wisconsin United States 53132
    1123 Aurora Cancer Care-Glendale Glendale Wisconsin United States 53212
    1124 Green Bay Oncology at Saint Vincent Hospital Green Bay Wisconsin United States 54301-3526
    1125 Saint Vincent Hospital Cancer Center Green Bay Green Bay Wisconsin United States 54301
    1126 Green Bay Oncology Limited at Saint Mary's Hospital Green Bay Wisconsin United States 54303
    1127 Saint Vincent Hospital Cancer Center at Saint Mary's Green Bay Wisconsin United States 54303
    1128 Aurora BayCare Medical Center Green Bay Wisconsin United States 54311
    1129 Mercyhealth Hospital and Cancer Center - Janesville Janesville Wisconsin United States 53548
    1130 UW Cancer Center Johnson Creek Johnson Creek Wisconsin United States 53038
    1131 Aurora Cancer Care-Kenosha South Kenosha Wisconsin United States 53142
    1132 Gundersen Lutheran Medical Center La Crosse Wisconsin United States 54601
    1133 Mayo Clinic Health System-Franciscan Healthcare La Crosse Wisconsin United States 54601
    1134 Dean Hematology and Oncology Clinic Madison Wisconsin United States 53717
    1135 University of Wisconsin Carbone Cancer Center Madison Wisconsin United States 53792
    1136 Holy Family Memorial Hospital Manitowoc Wisconsin United States 54221
    1137 Aurora Bay Area Medical Group-Marinette Marinette Wisconsin United States 54143
    1138 Bay Area Medical Center Marinette Wisconsin United States 54143
    1139 Marshfield Medical Center-Marshfield Marshfield Wisconsin United States 54449
    1140 Marshfield Medical Center Marshfield Wisconsin United States 54449
    1141 Ascension Columbia Saint Mary's Hospital Ozaukee Mequon Wisconsin United States 53097
    1142 Ascension Southeast Wisconsin Hospital - Saint Joseph Campus Milwaukee Wisconsin United States 53210
    1143 Ascension Columbia Saint Mary's Hospital - Milwaukee Milwaukee Wisconsin United States 53211
    1144 Aurora Saint Luke's Medical Center Milwaukee Wisconsin United States 53215
    1145 Medical College of Wisconsin Milwaukee Wisconsin United States 53226
    1146 Aurora Sinai Medical Center Milwaukee Wisconsin United States 53233
    1147 Marshfield Clinic-Minocqua Center Minocqua Wisconsin United States 54548
    1148 ProHealth Oconomowoc Memorial Hospital Oconomowoc Wisconsin United States 53066
    1149 Saint Vincent Hospital Cancer Center at Oconto Falls Oconto Falls Wisconsin United States 54154
    1150 Vince Lombardi Cancer Clinic - Oshkosh Oshkosh Wisconsin United States 54904
    1151 Ascension All Saints Hospital Racine Wisconsin United States 53405
    1152 Ascension Saint Mary's Hospital Rhinelander Wisconsin United States 54501
    1153 Marshfield Medical Center-Rice Lake Rice Lake Wisconsin United States 54868
    1154 Vince Lombardi Cancer Clinic-Sheboygan Sheboygan Wisconsin United States 53081
    1155 Ascension Saint Michael's Hospital Stevens Point Wisconsin United States 54481
    1156 Green Bay Oncology - Sturgeon Bay Sturgeon Bay Wisconsin United States 54235
    1157 Aurora Medical Center in Summit Summit Wisconsin United States 53066
    1158 Vince Lombardi Cancer Clinic-Two Rivers Two Rivers Wisconsin United States 54241
    1159 ProHealth Waukesha Memorial Hospital Waukesha Wisconsin United States 53188
    1160 Aspirus Regional Cancer Center Wausau Wisconsin United States 54401
    1161 Marshfield Clinic-Wausau Center Wausau Wisconsin United States 54401
    1162 Aurora Cancer Care-Milwaukee West Wauwatosa Wisconsin United States 53226
    1163 Aurora West Allis Medical Center West Allis Wisconsin United States 53227
    1164 Marshfield Medical Center - Weston Weston Wisconsin United States 54476
    1165 Aspirus Cancer Care - Wisconsin Rapids Wisconsin Rapids Wisconsin United States 54494
    1166 Marshfield Clinic - Wisconsin Rapids Center Wisconsin Rapids Wisconsin United States 54494
    1167 Rocky Mountain Oncology Casper Wyoming United States 82609
    1168 Welch Cancer Center Sheridan Wyoming United States 82801
    1169 Border Medical Oncology Albury New South Wales Australia 2640
    1170 Coffs Harbour Health Campus-North Coast Cancer Institute Coffs Harbour New South Wales Australia 2450
    1171 Concord Repatriation General Hospital Concord New South Wales Australia 2139
    1172 Lismore Base Hospital Lismore New South Wales Australia 2480
    1173 Lingard Private Hospital Merewether New South Wales Australia 2191
    1174 Royal Newcastle Hospital New Castle New South Wales Australia 2300
    1175 Calvary Mater Newcastle Hospital Waratah New South Wales Australia 2310
    1176 Royal Brisbane and Women's Hospital Herston Queensland Australia 4029
    1177 Nambour Hospital Nambour Queensland Australia 4560
    1178 Royal Hobart Hospital Saint Hobart Tasmania Australia 7000
    1179 Breast Unit-Mercy Private East Melbourne Victoria Australia 3002
    1180 Epworth Hospital Richmond Victoria Australia 3121
    1181 Saint John of God Hospital - Bunbury Bunbury Western Australia Australia 6230
    1182 Sir Charles Gairdner Hospital Nedlands Western Australia Australia 6009
    1183 Tom Baker Cancer Centre Calgary Alberta Canada T2N 4N2
    1184 BCCA-Cancer Centre for the Southern Interior Kelowna British Columbia Canada V1Y 5L3
    1185 Penticton Regional Hospital Penticton British Columbia Canada V2A 3G6
    1186 BCCA-Fraser Valley Cancer Centre Surrey British Columbia Canada V3V 1Z2
    1187 BCCA-Vancouver Cancer Centre Vancouver British Columbia Canada V5Z 4E6
    1188 BCCA-Vancouver Island Cancer Centre Victoria British Columbia Canada V8R 6V5
    1189 CancerCare Manitoba Winnipeg Manitoba Canada R3E 0V9
    1190 The Moncton Hospital Moncton New Brunswick Canada E1C 6Z8
    1191 Atlantic Health Sciences Corporation-Saint John Regional Hospital Saint John New Brunswick Canada E2L 4L2
    1192 Trillium Health Partners - Credit Valley Hospital Mississauga Ontario Canada L5M 2N1
    1193 Health Sciences North Sudbury Ontario Canada P3E 5J1
    1194 Thunder Bay Regional Health Science Centre Thunder Bay Ontario Canada P7B 6V4
    1195 Michael Garron Hospital Toronto Ontario Canada M4C 3E7
    1196 Odette Cancer Centre- Sunnybrook Health Sciences Centre Toronto Ontario Canada M4N 3M5
    1197 Saint Michael's Hospital Toronto Ontario Canada M5B 1W8
    1198 Trillium Health Partners - Queensway Health Centre Toronto Ontario Canada M9C 1A5
    1199 Windsor Regional Cancer Centre Windsor Ontario Canada N8W 2X3
    1200 CSSS Champlain-Charles Le Moyne Greenfield Park Quebec Canada J4V 2H1
    1201 CIUSSSEMTL-Hopital Maisonneuve-Rosemont Montreal Quebec Canada H1T 2M4
    1202 CHUM - Hopital Notre-Dame Montreal Quebec Canada H2L 4M1
    1203 McGill University Department of Oncology Montreal Quebec Canada H2W 1S6
    1204 CHUM-Hotel Dieu de Montreal Montreal Quebec Canada H2W 1T8
    1205 CHUM - Centre Hospitalier de l'Universite de Montreal Montreal Quebec Canada H2X 3E4
    1206 The Research Institute of the McGill University Health Centre (MUHC) Montreal Quebec Canada H3H 2R9
    1207 Jewish General Hospital Montreal Quebec Canada H3T 1E2
    1208 CHU de Quebec-Hopital du Saint-Sacrement (HSS) Quebec City Quebec Canada G1S 4L8
    1209 Allan Blair Cancer Centre Regina Saskatchewan Canada S4T 7T1
    1210 Saskatoon Cancer Centre Saskatoon Saskatchewan Canada S7N 4H4
    1211 Bon Secours Hospital Cork Co Cork Ireland
    1212 South Infirmary Victoria Hospital Cork Co Cork Ireland
    1213 Tallaght University Hospital Dublin Co Dublin Ireland 24
    1214 Saint Vincent's University Hospital Dublin Co Dublin Ireland 4
    1215 Mater Misericordiae University Hospital Dublin Co Dublin Ireland 7
    1216 Mater Private Hospital Dublin Co Dublin Ireland 7
    1217 Beaumont Hospital Dublin Co Dublin Ireland 9
    1218 Saint Vincent's Private Hospital Merrion Co Dublin Ireland 4
    1219 University College Hospital Galway Galway Co Galway Ireland
    1220 Mid-Western Regional Hospital Limerick Co Limerick Ireland 9
    1221 Sligo University Hospital Sligo Co Sligo Ireland
    1222 University Hospital Waterford Waterford Co Waterford Ireland 9
    1223 Cork University Hospital Cork Ireland
    1224 Saint James Hospital Dublin Ireland 8
    1225 Letterkenny General Hospital Letterkenny Ireland Co Donegal
    1226 Auckland City Hospital Grafton Auckland New Zealand 1010
    1227 Waikato Hospital Hamilton New Zealand 3204
    1228 Wellington Hospital Wellington New Zealand 6021
    1229 Instituto Nacional de Enfermedades Neoplasicas Lima Peru Lima 34
    1230 San Juan City Hospital San Juan Puerto Rico 00936
    1231 Belfast City Hospital Belfast Northern Ireland United Kingdom BT9 7AB

    Sponsors and Collaborators

    • National Cancer Institute (NCI)
    • American College of Surgeons
    • Cancer and Leukemia Group B
    • NSABP Foundation Inc
    • NCIC Clinical Trials Group
    • North Central Cancer Treatment Group
    • Southwest Oncology Group

    Investigators

    • Principal Investigator: Joseph A Sparano, ECOG-ACRIN Cancer Research Group

    Study Documents (Full-Text)

    More Information

    Additional Information:

    Publications

    None provided.
    Responsible Party:
    National Cancer Institute (NCI)
    ClinicalTrials.gov Identifier:
    NCT00310180
    Other Study ID Numbers:
    • NCI-2009-00707
    • NCI-2009-00707
    • ECOG-PACCT-1
    • 06-482
    • CDR0000472066
    • PACCT-1
    • PACCT-1
    • PACCT-1
    • U10CA180820
    • U10CA021115
    • NCT00554931
    First Posted:
    Apr 3, 2006
    Last Update Posted:
    Jul 28, 2022
    Last Verified:
    Mar 1, 2022
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details This study was activated on April 7, 2006 and closed to registrations on October 6, 2010. A total of 11,232 patients were preregistered for Recurrence Score evaluation and 10,273 proceeded to register on the study.
    Pre-assignment Detail Patients needed to be preregistered to the trial for ONCOTYPE recurrence score test, patients then were assigned or randomized to one of the four arms based on the recurrence score.
    Arm/Group Title Arm A Arm B Arm C Arm D
    Arm/Group Description Group 1 (Oncotype DX recurrence score =< 10): Patients in this group receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive standard combination chemotherapy at the discretion of the treating physician. Within 4 weeks after the last dose of chemotherapy, patients receive hormonal therapy as in Group 1 at the discretion of the treating physician. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials Group 3 (Oncotype DX recurrence score >= 26): Patients in this group receive combination chemotherapy followed by hormone therapy similar to the patients in Group 2 who are assigned to receive both types of treatment. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials
    Period Title: Overall Study
    STARTED 1629 3458 3449 1737
    No On-study Data 0 2 10 172
    Ineligible 3 4 6 7
    No Follow-up Data 7 55 131 245
    COMPLETED 1619 3399 3312 1389
    NOT COMPLETED 10 59 137 348

    Baseline Characteristics

    Arm/Group Title Arm A Arm B Arm C Arm D Total
    Arm/Group Description Group 1 (Oncotype DX recurrence score =< 10): Patients in this group receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive standard combination chemotherapy at the discretion of the treating physician. Within 4 weeks after the last dose of chemotherapy, patients receive hormonal therapy as in Group 1 at the discretion of the treating physician. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials Group 3 (Oncotype DX recurrence score >= 26): Patients in this group receive combination chemotherapy followed by hormone therapy similar to the patients in Group 2 who are assigned to receive both types of treatment. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials Total of all reporting groups
    Overall Participants 1619 3399 3312 1389 9719
    Age, Customized (Count of Participants)
    <=40 years
    58
    3.6%
    154
    4.5%
    157
    4.7%
    79
    5.7%
    448
    4.6%
    41-50 years
    371
    22.9%
    985
    29%
    920
    27.8%
    330
    23.8%
    2606
    26.8%
    51-60 years
    563
    34.8%
    1235
    36.3%
    1206
    36.4%
    512
    36.9%
    3516
    36.2%
    61-70 years
    518
    32%
    868
    25.5%
    895
    27%
    395
    28.4%
    2676
    27.5%
    71-75 years
    109
    6.7%
    157
    4.6%
    134
    4%
    73
    5.3%
    473
    4.9%
    Sex: Female, Male (Count of Participants)
    Female
    1619
    100%
    3399
    100%
    3312
    100%
    1389
    100%
    9719
    100%
    Male
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    8
    0.5%
    11
    0.3%
    16
    0.5%
    4
    0.3%
    39
    0.4%
    Asian
    82
    5.1%
    140
    4.1%
    132
    4%
    51
    3.7%
    405
    4.2%
    Native Hawaiian or Other Pacific Islander
    8
    0.5%
    7
    0.2%
    14
    0.4%
    1
    0.1%
    30
    0.3%
    Black or African American
    107
    6.6%
    236
    6.9%
    235
    7.1%
    115
    8.3%
    693
    7.1%
    White
    1361
    84.1%
    2883
    84.8%
    2783
    84%
    1162
    83.7%
    8189
    84.3%
    More than one race
    2
    0.1%
    5
    0.1%
    2
    0.1%
    1
    0.1%
    10
    0.1%
    Unknown or Not Reported
    51
    3.2%
    117
    3.4%
    130
    3.9%
    55
    4%
    353
    3.6%
    Recurrence score (Count of Participants)
    0-5
    432
    26.7%
    0
    0%
    0
    0%
    0
    0%
    432
    4.4%
    6-10
    1187
    73.3%
    0
    0%
    0
    0%
    0
    0%
    1187
    12.2%
    11-15
    0
    0%
    1214
    35.7%
    1159
    35%
    0
    0%
    2373
    24.4%
    16-20
    0
    0%
    1368
    40.2%
    1344
    40.6%
    0
    0%
    2712
    27.9%
    21-25
    0
    0%
    817
    24%
    809
    24.4%
    0
    0%
    1626
    16.7%
    26-30
    0
    0%
    0
    0%
    0
    0%
    598
    43.1%
    598
    6.2%
    31-35
    0
    0%
    0
    0%
    0
    0%
    315
    22.7%
    315
    3.2%
    36-40
    0
    0%
    0
    0%
    0
    0%
    158
    11.4%
    158
    1.6%
    41-50
    0
    0%
    0
    0%
    0
    0%
    202
    14.5%
    202
    2.1%
    >50
    0
    0%
    0
    0%
    0
    0%
    116
    8.4%
    116
    1.2%

    Outcome Measures

    1. Primary Outcome
    Title 5-year Disease-free Survival
    Description Disease-free survival (DFS) is defined to be time from randomization to first event, where the first event is any of ipsilateral breast tumor recurrence, local recurrence, regional recurrence, distant recurrence, contralateral second primary invasive cancer, second primary non-breast invasive cancer (excluding non-melanoma skin cancers), or death without evidence of recurrence. The distribution of DFS (eg, 5-year DFS rate) is estimated using Kaplan-Meier method, and compared between the two randomized arms (arm B vs. arm C) using stratified log rank test and stratified Cox proportional hazard model.
    Time Frame Assessed every 6 months within 5 years from registration and then annually up to 20 years, DFS rate estimated at 5 years

    Outcome Measure Data

    Analysis Population Description
    All eligible patients who had on-study data and follow-up data were included in the analysis
    Arm/Group Title Arm A Arm B Arm C Arm D
    Arm/Group Description Group 1 (Oncotype DX recurrence score =< 10): Patients in this group receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive standard combination chemotherapy at the discretion of the treating physician. Within 4 weeks after the last dose of chemotherapy, patients receive hormonal therapy as in Group 1 at the discretion of the treating physician. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials Group 3 (Oncotype DX recurrence score >= 26): Patients in this group receive combination chemotherapy followed by hormone therapy similar to the patients in Group 2 who are assigned to receive both types of treatment. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials
    Measure Participants 1619 3399 3312 1389
    Number (95% Confidence Interval) [percentage of participants]
    94.0
    5.8%
    92.8
    2.7%
    93.1
    2.8%
    87.6
    6.3%
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Arm B, Arm C
    Comments This study uses a noninferiority design, but the noninferiority question is formulated using the conventional superiority null hypothesis of equal DFS on the two arms (that is, the null hypothesis is that Arm B is not inferior to Arm C). The alternative hypothesis is that Arm B has substantially worse DFS than Arm C, specified by a hazard ratio for B vs. C of 1.322.
    Type of Statistical Test Superiority
    Comments Since the noninferiority comparison is formulated using a conventional superiority null hypothesis described as above, a type II error corresponds to concluding that Arm B is not inferior when in fact it is. The design therefore uses a one-sided type I error of 10% and is planned to have 95% power (5% type II error). If the null hypothesis is rejected (at the one-sided 10% level), then it will be concluded that endocrine therapy alone is inferior to chemoendocrine therapy.
    Statistical Test of Hypothesis p-Value 0.13
    Comments One-sided p value for stratified Cox proportional hazard analysis, stratified on recurrence score, tumor size and menopausal status.
    Method Regression, Cox
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.08
    Confidence Interval (2-Sided) 95%
    0.94 to 1.24
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    2. Secondary Outcome
    Title 5-year Distant Recurrence-free Interval
    Description Distant recurrence-free interval (DRFI) is defined as time from date of randomization or registration to the date of distant recurrence of breast cancer, or of death with distant recurrence, if death is the first manifestation of distant recurrence. The distribution of DRFI (eg, 5-year DRFI rate) is estimated using Kaplan-Meier method.
    Time Frame Assessed every 6 months within 5 years from registration and then annually up to 20 years, DRFI rate estimated at 5 years

    Outcome Measure Data

    Analysis Population Description
    All eligible patients who had on-study data and follow-up data
    Arm/Group Title Arm A Arm B Arm C Arm D
    Arm/Group Description Group 1 (Oncotype DX recurrence score =< 10): Patients in this group receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive standard combination chemotherapy at the discretion of the treating physician. Within 4 weeks after the last dose of chemotherapy, patients receive hormonal therapy as in Group 1 at the discretion of the treating physician. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials Group 3 (Oncotype DX recurrence score >= 26): Patients in this group receive combination chemotherapy followed by hormone therapy similar to the patients in Group 2 who are assigned to receive both types of treatment. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials
    Measure Participants 1619 3399 3312 1389
    Number (95% Confidence Interval) [percentage of participants]
    99.3
    6.1%
    98.0
    2.9%
    98.2
    3%
    93.0
    6.7%
    3. Secondary Outcome
    Title 5-year Recurrence-free Interval
    Description Recurrence-free interval (RFS) is defined as time from date of randomization or registration to the date of first recurrence of breast cancer (ipsilateral breast tumor recurrence, local/regional recurrence, distant recurrence) or to the date of death with recurrence, if death is the first manifestation of recurrence. The distribution of RFS (eg, 5-year RFS rate) is estimated using Kaplan-Meier method.
    Time Frame Assessed every 6 months within 5 years from registration and then annually up to 20 years, RFS rate estimated at 5 years

    Outcome Measure Data

    Analysis Population Description
    All eligible patients who had on-study data and follow-up data were included in the analysis
    Arm/Group Title Arm A Arm B Arm C Arm D
    Arm/Group Description Group 1 (Oncotype DX recurrence score =< 10): Patients in this group receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive standard combination chemotherapy at the discretion of the treating physician. Within 4 weeks after the last dose of chemotherapy, patients receive hormonal therapy as in Group 1 at the discretion of the treating physician. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials Group 3 (Oncotype DX recurrence score >= 26): Patients in this group receive combination chemotherapy followed by hormone therapy similar to the patients in Group 2 who are assigned to receive both types of treatment. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials
    Measure Participants 1619 3399 3312 1389
    Number (95% Confidence Interval) [percentage of participants]
    98.8
    6.1%
    96.9
    2.9%
    97.0
    2.9%
    91.0
    6.6%
    4. Secondary Outcome
    Title 5-year Overall Survival
    Description Overall survival (OS) is defined as time from date of randomization or registration to date of death from any cause. The distribution of OS (eg, 5-year OS rate) is estimated using Kaplan-Meier method.
    Time Frame Assessed every 6 months within 5 years from registration and then annually up to 20 years, OS rate estimated at 5 years

    Outcome Measure Data

    Analysis Population Description
    All eligible patients who had on-study data and follow-up data were included in the analysis
    Arm/Group Title Arm A Arm B Arm C Arm D
    Arm/Group Description Group 1 (Oncotype DX recurrence score =< 10): Patients in this group receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive standard combination chemotherapy at the discretion of the treating physician. Within 4 weeks after the last dose of chemotherapy, patients receive hormonal therapy as in Group 1 at the discretion of the treating physician. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials Group 3 (Oncotype DX recurrence score >= 26): Patients in this group receive combination chemotherapy followed by hormone therapy similar to the patients in Group 2 who are assigned to receive both types of treatment. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials
    Measure Participants 1619 3399 3312 1389
    Number (95% Confidence Interval) [percentage of participants]
    98.0
    6.1%
    98.0
    2.9%
    98.1
    3%
    95.9
    6.9%
    5. Secondary Outcome
    Title 5-year Disease-free Survival by Age and Recurrence Score Groups
    Description Disease-free survival (DFS) is defined to be time from randomization to first event, where the first event is any of ipsilateral breast tumor recurrence, local recurrence, regional recurrence, distant recurrence, contralateral second primary invasive cancer, second primary non-breast invasive cancer (excluding non-melanoma skin cancers), or death without evidence of recurrence. DFS is evaluated by recurrence score (0-10 vs. 11-15 vs. 16-20 vs. 21-25 vs. >25) and age groups (<=50 vs. 51-65 vs. 65-75). The distribution of DFS (eg, 5-year DFS rate) is estimated using Kaplan-Meier method.
    Time Frame Assessed every 6 months within 5 years from registration and then annually up to 20 years, DFS rate estimated at 5 years

    Outcome Measure Data

    Analysis Population Description
    All eligible patients who had on-study data and follow-up data were included in the analysis
    Arm/Group Title Arm A Arm B Arm C Arm D
    Arm/Group Description Group 1 (Oncotype DX recurrence score =< 10): Patients in this group receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive standard combination chemotherapy at the discretion of the treating physician. Within 4 weeks after the last dose of chemotherapy, patients receive hormonal therapy as in Group 1 at the discretion of the treating physician. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials Group 3 (Oncotype DX recurrence score >= 26): Patients in this group receive combination chemotherapy followed by hormone therapy similar to the patients in Group 2 who are assigned to receive both types of treatment. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials
    Measure Participants 1619 3399 3312 1389
    RS 0-10 & Age<=50
    95.1
    5.9%
    NA
    NaN
    NA
    NaN
    NA
    NaN
    RS 0-10 & Age 51-65
    94.7
    5.8%
    NA
    NaN
    NA
    NaN
    NA
    NaN
    RS 0-10 & Age 66-75
    90.5
    5.6%
    NA
    NaN
    NA
    NaN
    NA
    NaN
    RS 11-15 & Age <=50
    NA
    NaN
    95.1
    2.8%
    94.3
    2.8%
    NA
    NaN
    RS 11-15 & Age 51-65
    NA
    NaN
    95.5
    2.8%
    93.9
    2.8%
    NA
    NaN
    RS 11-15 & Age 66-75
    NA
    NaN
    87.1
    2.6%
    91.4
    2.8%
    NA
    NaN
    RS 16-20 & Age <=50
    NA
    NaN
    92.0
    2.7%
    94.7
    2.9%
    NA
    NaN
    RS 16-20 & Age 51-65
    NA
    NaN
    94.3
    2.8%
    92.2
    2.8%
    NA
    NaN
    RS 16-20 & Age 66-75
    NA
    NaN
    90.1
    2.7%
    90.2
    2.7%
    NA
    NaN
    RS 21-25 & Age <=50
    NA
    NaN
    86.3
    2.5%
    92.1
    2.8%
    NA
    NaN
    RS 21-25 & Age 51-65
    NA
    NaN
    91.6
    2.7%
    93.4
    2.8%
    NA
    NaN
    RS 21-25 & Age 66-75
    NA
    NaN
    93.8
    2.8%
    90.9
    2.7%
    NA
    NaN
    RS >25 & Age <=50
    NA
    NaN
    NA
    NaN
    NA
    NaN
    86.4
    6.2%
    RS >25 & Age 51-65
    NA
    NaN
    NA
    NaN
    NA
    NaN
    87.5
    6.3%
    RS >25 & Age 66-75
    NA
    NaN
    NA
    NaN
    NA
    NaN
    89.8
    6.5%
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Arm B, Arm C
    Comments Treatment interaction test was performed for the 9 age by RS subsets (3 groups for each, age groups <=50 vs. 51-65 vs. 66-75; RS groups 0-10 vs. 11-25 vs. >25) in patients randomized to arms B and C
    Type of Statistical Test Other
    Comments Treatment-by-Age and RS subset was performed via Cox proportional hazard analysis
    Statistical Test of Hypothesis p-Value 0.004
    Comments
    Method Regression, Cox
    Comments
    6. Secondary Outcome
    Title To Compare the Outcomes Projected at 10 Years by Adjuvant! With Those Made by the Genomic Health Oncotype DX Test
    Description Adjuvant! is not currently available; additional work combining classical information with genomic tests will be reported separately.
    Time Frame Assessed at 10 years after study entry

    Outcome Measure Data

    Analysis Population Description
    Outcome will never be analyzed.
    Arm/Group Title Arm A Arm B Arm C Arm D
    Arm/Group Description Group 1 (Oncotype DX recurrence score =< 10): Patients in this group receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive standard combination chemotherapy at the discretion of the treating physician. Within 4 weeks after the last dose of chemotherapy, patients receive hormonal therapy as in Group 1 at the discretion of the treating physician. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials Group 3 (Oncotype DX recurrence score >= 26): Patients in this group receive combination chemotherapy followed by hormone therapy similar to the patients in Group 2 who are assigned to receive both types of treatment. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials
    Measure Participants 0 0 0 0
    7. Secondary Outcome
    Title 5-year Disease-free Survival by Individual RS Gene Groups
    Description Disease-free survival (DFS) is defined to be time from randomization to first event, where the first event is any of ipsilateral breast tumor recurrence, local recurrence, regional recurrence, distant recurrence, contralateral second primary invasive cancer, second primary non-breast invasive cancer (excluding non-melanoma skin cancers), or death without evidence of recurrence. The distribution of DFS (eg, 5-year DFS rate) is estimated using Kaplan-Meier method. 5-year DFS by individual RS gene groups (Proliferation Gene Group, HER2 Gene Group, ER Gene Group, Invasion Gene Group, and Other Genes) will be estimated in each arm.
    Time Frame Assessed every 6 months within 5 years from registration and then annually up to 20 years

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title
    Arm/Group Description

    Adverse Events

    Time Frame Both the chemotherapy and endocrine therapy given on this study were standard therapies for this population. To simplify the effort required for participating sites, adverse event data were not collected.
    Adverse Event Reporting Description Both the chemotherapy and endocrine therapy given on this study were standard therapies for this population. To simplify the effort required for participating sites, adverse event data were not collected.
    Arm/Group Title Arm A Arm B Arm C Arm D
    Arm/Group Description Group 1 (Oncotype DX recurrence score =< 10): Patients in this group receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive hormone therapy with tamoxifen, anastrozole, letrozole, or exemestane PO for up to 5 years. Some patients then continue to receive hormone therapy for an additional 5 years. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Group 2 (Oncotype DX recurrence score 11-25): Patients receive standard combination chemotherapy at the discretion of the treating physician. Within 4 weeks after the last dose of chemotherapy, patients receive hormonal therapy as in Group 1 at the discretion of the treating physician. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials Group 3 (Oncotype DX recurrence score >= 26): Patients in this group receive combination chemotherapy followed by hormone therapy similar to the patients in Group 2 who are assigned to receive both types of treatment. Anastrozole: Given PO Exemestane: Given PO Letrozole: Given PO Tamoxifen: Given PO Combination chemotherapy: including oral CMF, IV CMF, standard AC, dose dense AC, standard AC-T, dose dense AC-T, FEC, TAC, TC, other protocol-specified regimens if participating in other CTSU trials including chemotherapy, and other regimens not protocol-specified if not participating in CTSU trials
    All Cause Mortality
    Arm A Arm B Arm C Arm D
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN)
    Serious Adverse Events
    Arm A Arm B Arm C Arm D
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN)
    Other (Not Including Serious) Adverse Events
    Arm A Arm B Arm C Arm D
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is less than or equal to 60 days. The sponsor cannot require changes to the communication and cannot extend the embargo.

    Results Point of Contact

    Name/Title ECOG-ACRIN statistician
    Organization ECOG-ACRIN Cancer Research Group
    Phone 617-632-3000
    Email eatrials@jimmy.harvard.edu
    Responsible Party:
    National Cancer Institute (NCI)
    ClinicalTrials.gov Identifier:
    NCT00310180
    Other Study ID Numbers:
    • NCI-2009-00707
    • NCI-2009-00707
    • ECOG-PACCT-1
    • 06-482
    • CDR0000472066
    • PACCT-1
    • PACCT-1
    • PACCT-1
    • U10CA180820
    • U10CA021115
    • NCT00554931
    First Posted:
    Apr 3, 2006
    Last Update Posted:
    Jul 28, 2022
    Last Verified:
    Mar 1, 2022