Chemotherapy With or Without Trastuzumab After Surgery in Treating Women With Invasive Breast Cancer

• Sponsor: National Cancer Institute (NCI) (NIH)
• Overall Status: Active, not recruiting
• CT.gov ID: NCT01275677
• Collaborator: NRG Oncology (Other)
• Enrollment: 3,270
• Locations: 1292
• Arms: 2
• Patients Per Site: 2.5

Study Details

Study Description

Brief Summary

This randomized phase III clinical trial studies chemotherapy with or without trastuzumab after surgery to see how well they work in treating women with invasive breast cancer. 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 more than one drug (combination chemotherapy) and giving chemotherapy after surgery may kill more tumor cells. Monoclonal antibodies, such as trastuzumab, can block cancer growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. It is not yet known whether combination chemotherapy is more effective with trastuzumab in treating breast cancer.

Condition or Disease	Intervention/Treatment	Phase
HER2/Neu Positive; Progesterone Receptor Positive; Recurrent Breast Carcinoma; Stage IA Breast Cancer AJCC v7; Stage IB Breast Cancer AJCC v7; Stage IIA Breast Cancer AJCC v6 and v7; Stage IIB Breast Cancer AJCC v6 and v7; Stage IIIA Breast Cancer AJCC v7; Stage IIIC Breast Cancer AJCC v7	Drug: Cyclophosphamide; Drug: Docetaxel; Drug: Doxorubicin; Drug: Doxorubicin Hydrochloride; Other: Laboratory Biomarker Analysis; Drug: Paclitaxel; Other: Quality-of-Life Assessment; Biological: Trastuzumab	Phase 3

Detailed Description

PRIMARY OBJECTIVES:

1. To determine whether the addition of trastuzumab to chemotherapy (TC or AC→WP) improves invasive disease-free survival (IDFS) in women with resected node-positive or high-risk node-negative breast cancer which is reported as human epidermal growth factor receptor (HER)2-low by all HER2 testing performed.

SECONDARY OBJECTIVES:

1. To determine whether the addition of trastuzumab to chemotherapy (TC or AC→WP) improves disease-free survival (DFS)-ductal carcinoma in situ (DCIS) in women with resected node-positive or high-risk node-negative breast cancer which is reported as HER2-low by all HER2 testing performed.

2. To determine whether the addition of trastuzumab to chemotherapy (TC or AC→WP) improves breast cancer-free survival (BCFS) in women with resected node-positive or high-risk node-negative breast cancer which is reported as HER2-low by all HER2 testing performed.

3. To determine whether the addition of trastuzumab to chemotherapy (TC or AC→WP) improves recurrence-free interval (RFI) in women with resected node-positive or high-risk node-negative breast cancer which is reported as HER2-low by all HER2 testing performed.

4. To determine whether the addition of trastuzumab to chemotherapy (TC or AC→WP) improves distant recurrence-free interval (DRFI) in women with resected node-positive or high-risk node-negative breast cancer which is reported as HER2-low by all HER2 testing performed.

5. To determine whether the addition of trastuzumab to chemotherapy (TC or AC→WP) improves overall survival (OS) in women with resected node-positive or high-risk node-negative breast cancer which is reported as HER2-low by all HER2 testing performed.

6. To evaluate the associations between amenorrhea and circulating reproductive hormone levels, and the associations between chemotherapy regimen, amenorrhea, and IDFS benefit in premenopausal women eligible at baseline for the menstrual history assessments.

7. To evaluate the toxicity associated with each of the regimens. VIII. To test the hypothesis that the HER2 messenger ribonucleic acid (mRNA) level is the predictor of the degree of benefit from trastuzumab and the threshold for benefit in the adjuvant setting is lower than defined by current American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) Guidelines for HER2 assays (immunohistochemistry [IHC] and fluorescent in situ hybridization [FISH]).

8. To identify and/or validate molecular predictors of the degree of benefit from the addition of trastuzumab to chemotherapy (TC or AC→WP).

9. To test the alternative hypothesis that the main determinant of trastuzumab response in the adjuvant setting of HER2-low breast cancer is through antibody-dependent cellular cytotoxicity (ADCC) by demonstrating that the polymorphism of the Fcgamma receptor gene is predictive of the degree of benefit from the addition of trastuzumab to chemotherapy (TC or AC→WP).

10. To examine the relationship between behavioral host factors (obesity, tobacco, alcohol) and comorbid conditions that may influence systemic inflammation and breast cancer outcomes, controlling for tumor/stage characteristics and treatment assignment.

11. To examine the relationship between medication exposures that may influence systemic inflammation and breast cancer outcomes, controlling for tumor/stage characteristics and treatment assignment.

12. To examine the relationship between comorbid conditions, medication exposures, and behavioral host factors together and breast cancer outcomes, controlling for tumor/stage characteristics and treatment assignment.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

NOTE: *Chemotherapy regimen is based on the investigator's preference.

ARM I:

GROUP IA: Patients receive docetaxel intravenously (IV) over 60 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity.

GROUP IB: Patients receive doxorubicin hydrochloride IV over 15 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 2 or 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. Beginning 2-3 weeks after last dose of doxorubicin hydrochloride and cyclophosphamide, patients also receive paclitaxel IV over 60 minutes once weekly for 12 doses in the absence of disease progression or unacceptable toxicity.

ARM II:

GROUP IIA: Patients receive docetaxel and cyclophosphamide as in Group IA. Patients also receive trastuzumab IV over 30-90 minutes on day 1. Courses repeat every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity.

GROUP IIB: Patients receive doxorubicin hydrochloride, cyclophosphamide, and paclitaxel as in Group IB. Patients also receive trastuzumab IV over 30-90 minutes weekly for 12 doses and then every 3 weeks for subsequent doses. Treatment repeats every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 6 months for 5 years and then every 12 months for 5 years.

Study Design

• Study Type: Interventional
• Actual Enrollment: 3270 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: A Randomized Phase III Trial of Adjuvant Therapy Comparing Chemotherapy Alone (Six Cycles of Docetaxel Plus Cyclophosphamide or Four Cycles of Doxorubicin Plus Cyclophosphamide Followed by Weekly Paclitaxel) to Chemotherapy Plus Trastuzumab in Women With Node-Positive or High-Risk Node-Negative HER2-Low Invasive Breast Cancer
• Actual Study Start Date: Jan 6, 2011
• Actual Primary Completion Date: Jul 31, 2017

Arms and Interventions

Arm	Intervention/Treatment
Active Comparator: Arm I (chemotherapy) GROUP IA: Patients receive docetaxel IV over 60 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. GROUP IB: Patients receive doxorubicin hydrochloride IV over 15 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 2 or 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. Beginning 2-3 weeks after last dose of doxorubicin hydrochloride and cyclophosphamide, patients also receive paclitaxel IV over 60 minutes once weekly for 12 doses in the absence of disease progression or unacceptable toxicity.	Drug: Cyclophosphamide; Given IV; Other Names: (-)-Cyclophosphamide 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate Carloxan Ciclofosfamida Ciclofosfamide Cicloxal Clafen Claphene CP monohydrate CTX CYCLO-cell Cycloblastin Cycloblastine Cyclophospham Cyclophosphamid monohydrate Cyclophosphamide Monohydrate Cyclophosphamidum Cyclophosphan Cyclophosphane Cyclophosphanum Cyclostin Cyclostine Cytophosphan Cytophosphane Cytoxan Fosfaseron Genoxal Genuxal Ledoxina Mitoxan Neosar Revimmune Syklofosfamid WR- 138719 ; Drug: Docetaxel; Given IV; Other Names: Docecad RP56976 Taxotere Taxotere Injection Concentrate ; Drug: Doxorubicin; Given IV; Other Names: Adriablastin Hydroxydaunomycin Hydroxyl Daunorubicin Hydroxyldaunorubicin ; Drug: Doxorubicin Hydrochloride; Given IV; Other Names: 5,12-Naphthacenedione, 10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8, 9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-, hydrochloride, (8S-cis)- (9CI) ADM Adriacin Adriamycin Adriamycin Hydrochloride Adriamycin PFS Adriamycin RDF ADRIAMYCIN, HYDROCHLORIDE Adriamycine Adriblastina Adriblastine Adrimedac Chloridrato de Doxorrubicina DOX DOXO-CELL Doxolem Doxorubicin HCl Doxorubicin.HCl Doxorubin Farmiblastina FI 106 FI-106 hydroxydaunorubicin Rubex ; Other: Laboratory Biomarker Analysis; Correlative studies; Drug: Paclitaxel; Given IV; Other Names: Anzatax Asotax Bristaxol Praxel Taxol Taxol Konzentrat ; Other: Quality-of-Life Assessment; Ancillary studies; Other Names: Quality of Life Assessment
Experimental: Arm II (chemotherapy, trastuzumab) GROUP IIA: Patients receive docetaxel and cyclophosphamide as in Group IA. Patients also receive trastuzumab IV over 30-90 minutes on day 1. Courses repeat every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. GROUP IIB: Patients receive doxorubicin hydrochloride, cyclophosphamide, and paclitaxel as in Group IB. Patients also receive trastuzumab IV over 30-90 minutes weekly for 12 doses and then every 3 weeks for subsequent doses. Treatment repeats every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity.	Drug: Cyclophosphamide; Given IV; Other Names: (-)-Cyclophosphamide 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate Carloxan Ciclofosfamida Ciclofosfamide Cicloxal Clafen Claphene CP monohydrate CTX CYCLO-cell Cycloblastin Cycloblastine Cyclophospham Cyclophosphamid monohydrate Cyclophosphamide Monohydrate Cyclophosphamidum Cyclophosphan Cyclophosphane Cyclophosphanum Cyclostin Cyclostine Cytophosphan Cytophosphane Cytoxan Fosfaseron Genoxal Genuxal Ledoxina Mitoxan Neosar Revimmune Syklofosfamid WR- 138719 ; Drug: Docetaxel; Given IV; Other Names: Docecad RP56976 Taxotere Taxotere Injection Concentrate ; Drug: Doxorubicin; Given IV; Other Names: Adriablastin Hydroxydaunomycin Hydroxyl Daunorubicin Hydroxyldaunorubicin ; Drug: Doxorubicin Hydrochloride; Given IV; Other Names: 5,12-Naphthacenedione, 10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8, 9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-, hydrochloride, (8S-cis)- (9CI) ADM Adriacin Adriamycin Adriamycin Hydrochloride Adriamycin PFS Adriamycin RDF ADRIAMYCIN, HYDROCHLORIDE Adriamycine Adriblastina Adriblastine Adrimedac Chloridrato de Doxorrubicina DOX DOXO-CELL Doxolem Doxorubicin HCl Doxorubicin.HCl Doxorubin Farmiblastina FI 106 FI-106 hydroxydaunorubicin Rubex ; Other: Laboratory Biomarker Analysis; Correlative studies; Drug: Paclitaxel; Given IV; Other Names: Anzatax Asotax Bristaxol Praxel Taxol Taxol Konzentrat ; Other: Quality-of-Life Assessment; Ancillary studies; Other Names: Quality of Life Assessment ; Biological: Trastuzumab; Given IV; Other Names: ABP 980 ALT02 Anti-c-ERB-2 Anti-c-erbB2 Monoclonal Antibody Anti-ERB-2 Anti-erbB-2 Anti-erbB2 Monoclonal Antibody Anti-HER2/c-erbB2 Monoclonal Antibody Anti-p185-HER2 c-erb-2 Monoclonal Antibody HER2 Monoclonal Antibody Herceptin Herceptin Biosimilar PF-05280014 Herceptin Trastuzumab Biosimilar PF-05280014 Herzuma Kanjinti MoAb HER2 Monoclonal Antibody c-erb-2 Monoclonal Antibody HER2 Ogivri Ontruzant PF-05280014 rhuMAb HER2 RO0452317 SB3 Trastuzumab Biosimilar ABP 980 Trastuzumab Biosimilar ALT02 trastuzumab biosimilar EG12014 Trastuzumab Biosimilar HLX02 Trastuzumab Biosimilar PF-05280014 Trastuzumab Biosimilar SB3 Trastuzumab Biosimilar SIBP-01 Trastuzumab-anns Trastuzumab-dkst Trastuzumab-dttb Trastuzumab-pkrb Trastuzumab-qyyp Trazimera

Outcome Measures

Primary Outcome Measures

1. Percentage of Patients Alive and Free From Invasive Disease (IDFS) [5 years]

   Percentage of patients free from an invasive disease-free survival event where events include any invasive recurrence, contralateral invasive breast cancer, second non-breast primary cancer (excluding squamous or basal cell carcinoma of the skin), or death from any cause.

Secondary Outcome Measures

1. Percentage of Patients Alive and Disease-Free (DFS-DCIS) [5 years]

   Percentage of patients free from a disease-free survival event where events include local recurrence (invasive or DCIS), regional or distant recurrence, contralateral breast cancer (invasive or DCIS), second primary cancer (excluding squamous or basal cell carcinoma of the skin), or death from any cause.

2. Percentage of Patients Alive and Free From Breast Cancer (BCFS) [5 years]

   Percentage of patients free from a breast cancer-free survival event where events include local recurrence (invasive or DCIS), regional or distant recurrence, contralateral breast cancer (invasive or DCIS), or death from any cause.

3. Percentage of Patients Alive and Recurrence-Free (RFI) [5 years]

   Percentage of patients free from a recurrence-free interval event where events include invasive local, regional, or distant recurrence, or death from breast cancer (censored for death from other causes).

4. Percentage of Patients Alive and Free From Distant Recurrence (DRFI) [5 years]

   Percentage of patients free from a distant recurrence-free interval event where events include distant recurrence or death from breast cancer (censored for deaths from other causes), regardless of occurrence of any intervening local or regional recurrences, contralateral breast cancers, or non-breast second primary cancer.

5. Percentage of Patients Alive (Overall Survival) [5 years]

   Percentage of patients alive.

6. Toxicity Assessed by Adverse Events [While on study therapy. Day 1 of first dose through 30 days after Day 1 of last dose.]

   Percentage of patients who ever experienced grade 2 or higher toxicites.

7. Change in HER2 mRNA Level [From baseline to 24 months]

   The interaction between treatment effect and HER2 mRNA level will be evaluated in the proportional hazards model, which would include an indicator for treatment group and the HER2 mRNA level as a continuous variable, and the corresponding interaction term. The log-hazard ratio plot for the interaction term with 95% confidence intervals will be used to determine the cut-off of the HER2 mRNA level that would determine a subset of the patients who would benefit from the adjuvant trastuzumab therapy.

8. Fcgamma Receptor Polymorphism [From baseline to up to 24 months]

   The polymorphism of the Fcgamma 158 receptor gene will be dichotomized as V/V (valine) vs. other genotypes and the polymorphism of the Fcgamma 131 receptor gene will be dichotomized as H/H (histidine) vs. other genotypes to evaluate an interaction between treatment group and Fcgamma polymorphism. The Kaplan-Meier method105 will be used to estimate the distribution of the primary endpoints stratified by the dichotomized subgroups, and the log-rank test106 will be used to statistically compare the time-to-event distributions.

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years and Older
• Sexes Eligible for Study: Female
• Accepts Healthy Volunteers: No

Inclusion Criteria:

• Patients should have a life expectancy of at least 10 years, excluding their diagnosis of breast cancer; (comorbid conditions should be taken into consideration, but not the diagnosis of breast cancer)

• Women of reproductive potential must agree to use an effective non-hormonal method of contraception (for example condoms, some intrauterine devices, diaphragms, tubal ligation, vasectomized partner, or abstinence) during therapy and for at least 6 months (Arm 1 patients) and for at least 7 months (Arm 2 patients) after the last dose of study therapy (chemotherapy or trastuzumab)

• Submission of tumor samples from the breast surgery is required for all patients; therefore, the local pathology department policy regarding release of tumor samples must be considered in the screening process; patients whose tumor samples are located in a pathology department that by policy will not submit any samples for research purposes should not be approached for participation in the B-47 trial

• The patient must have signed and dated an Institutional Review Board (IRB)-approved consent form that conforms to federal and institutional guidelines

• Eastern Cooperation Oncology Group (ECOG) performance status of 0 or 1

• The tumor must be unilateral invasive adenocarcinoma of the breast on histologic examination

• All of the following staging criteria (according to the 7th edition of the American

Joint Committee on Cancer [AJCC] Cancer Staging Manual) must be met:

• By pathologic evaluation, primary tumor must be pT1-3

• By pathologic evaluation, ipsilateral nodes must be pN0, pN1 (pN1mi, pN1a, pN1b, pN1c), pN2a, pN2b, pN3a, or pN3b

• If pN0, one of the following criteria must be met:

• pT2 and estrogen receptor (ER) negative and progesterone receptor (PgR) negative; or

• pT2 and ER positive (PgR status may be positive or negative) and either grade 3 histology or Oncotype DX Recurrence Score of >= 25; or

• pT3 regardless of hormone receptor status, histologic grade, and Oncotype DX Recurrence Score

• HER2 status of the primary tumor must be evaluated prior to randomization; all testing performed must indicate that the tumor is HER2-low as defined below

• IHC must be performed and the IHC staining results must indicate a score of 1+ (in situ hybridization [ISH] testing is not required) or 2+ (ISH must also be performed and must indicate that the tumor is HER2-low as described below)

• If ISH testing is performed, test results must be as follows and IHC must be 1+ or 2+: the ratio of HER2 to chromosome enumeration probe 17 (CEP17) must be < 2.0 or, if a ratio was not performed, the HER2 gene copy number must be < 4 per nucleus

• Note: If the IHC staining intensity is reported as a range, e.g., 0 to 1+ or 1+ to 2+, the higher intensity score in the range should be used to determine eligibility

• The patient must have undergone either a total mastectomy or breast-conserving surgery (lumpectomy); (patients who have had a nipple-sparing mastectomy are eligible)

• For patients who undergo lumpectomy, the margins of the resected specimen must be histologically free of invasive tumor and ductal carcinoma in situ (DCIS) as determined by the local pathologist; if pathologic examination demonstrates tumor at the line of resection, additional operative procedures may be performed to obtain clear margins; if tumor is still present at the resected margin after re-excision(s), the patient must undergo total mastectomy to be eligible; (patients with margins positive for lobular carcinoma in situ [LCIS] are eligible without additional resection)

• For patients who undergo mastectomy, margins must be free of gross residual tumor; (patients with microscopic positive margins are eligible as long as post-mastectomy radiation therapy [RT] of the chest wall will be administered)

• The patient must have completed one of the procedures for evaluation of pathologic nodal status listed below:

• Sentinel lymphadenectomy alone:

• If pathologic nodal staging based on sentinel lymphadenectomy is pN0 or pN1b

• If pathologic nodal staging based on sentinel lymphadenectomy is pN1mi or pN1a, the primary tumor must be T1 or T2 by pathologic evaluation and the nodal involvement must be limited to 1 or 2 positive nodes

• Sentinel lymphadenectomy followed by removal of additional non-sentinel lymph nodes if the sentinel node (SN) is positive; or

• Axillary lymphadenectomy with or without SN isolation procedures

• The interval between the last surgery for breast cancer (treatment or staging) and randomization must be no more than 84 days

• The patient must have ER analysis performed on the primary tumor prior to randomization; if ER analysis is negative, then PgR analysis must also be performed (either the core biopsy or surgical resection specimen can be used for ER/PgR testing); patients with a primary tumor that is hormone receptor-positive or receptor-negative are eligible

• Absolute neutrophil count (ANC) must be >= 1,200/mm^3

• Platelet count must be >= 100,000/mm^3

• Hemoglobin must be >= 10 g/dL

• Total bilirubin must be =< upper limit of normal (ULN) for the lab unless the patient has a bilirubin elevation > ULN to 1.5 x ULN due to Gilbert disease or similar syndrome involving slow conjugation of bilirubin

• Alkaline phosphatase must be =< 2.5 x ULN for the lab

• Aspartate aminotransferase (AST) must be =< 1.5 x ULN for the lab (if alanine aminotransferase [ALT] is performed instead of AST [per institution's standard practice], the alanine aminotransferase [ALT] value must be =< 1.5 x ULN; if both were performed, the AST must be =< 1.5 x ULN)

• Alkaline phosphatase and AST may not both be > the ULN

• Patients with AST or alkaline phosphatase > ULN are eligible for inclusion in the study if liver imaging (computed tomography [CT], magnetic resonance imaging [MRI], positron emission tomography [PET]-CT, or PET scan) performed within 90 days prior to randomization does not demonstrate metastatic disease and the above requirements are met

• Patients with alkaline phosphatase that is > ULN but =< 2.5 x ULN or unexplained bone pain are eligible for inclusion in the study if a bone scan, PET-CT scan, or PET scan performed within 90 days prior to randomization does not demonstrate metastatic disease

• The most recent postoperative serum creatinine performed within 6 weeks prior to randomization must be =< ULN for the lab

• Left ventricular ejection fraction (LVEF) assessment must be performed within 90 days prior to randomization; LVEF assessment performed by 2-dimensional (D) echocardiogram is preferred, however, multi-gated acquisition (MUGA) scan maybe substituted based on institutional preferences

• For patients who will receive the TC chemotherapy regimen, the LVEF must be >= 50% regardless of the cardiac imaging facility's lower limit of normal

• For patients who will receive the AC-->WP chemotherapy regimen, the LVEF must be

= 55% regardless of the cardiac imaging facility's lower limit of normal

• NOTE: Since the pre-entry LVEF serves as the baseline for comparing subsequent LVEF assessments, it is critical that this baseline study be an accurate assessment; if the baseline LVEF is > 70%, the investigator is encouraged to have the accuracy of the initial LVEF result confirmed and repeat the test if the accuracy is uncertain

Exclusion Criteria:

• Primary tumor with any of the following HER2 testing results:

• IHC staining intensity:

• 0 on all evaluations of specimens

• 3+ on evaluation of any specimen

• ISH with a ratio of HER2 to CEP17 >= 2.0 on evaluation of any specimen

• ISH result indicating HER2 gene copy number >= 4 per nucleus on evaluation of any specimen

• T4 tumors including inflammatory breast cancer

• Definitive clinical or radiologic evidence of metastatic disease

• NOTE: Chest imaging (mandatory for all patients) and other imaging (if required) must have been performed within 90 days prior to randomization

• Synchronous or previous contralateral invasive breast cancer (patients with synchronous and/or previous contralateral DCIS or LCIS are eligible)

• Any previous history of ipsilateral invasive breast cancer or ipsilateral DCIS; (patients with synchronous or previous ipsilateral LCIS are eligible)

• History of non-breast malignancies (except for in situ cancers treated only by local excision and basal cell and squamous cell carcinomas of the skin) within 5 years prior to randomization

• Previous therapy with anthracyclines, taxanes, or trastuzumab for any malignancy

• Chemotherapy or HER2-targeted therapy administered for the currently diagnosed breast cancer prior to randomization

• Whole-breast RT prior to randomization or partial-breast RT that cannot be completed on or before the date of randomization

• Continued endocrine therapy such as raloxifene or tamoxifen (or other selective estrogen receptor modulator [SERM]) or an aromatase inhibitor; patients are eligible if these medications are discontinued prior to randomization

• Any continued use of sex hormonal therapy, e.g., birth control pills, ovarian hormone replacement therapy; patients are eligible if these medications are discontinued prior to randomization

• Cardiac disease (history of and/or active disease) that would preclude the use of the drugs included in the treatment regimens; this includes but is not confined to:

• Active cardiac disease:

• Angina pectoris that requires the current use of anti-anginal medication

• Ventricular arrhythmias except for benign premature ventricular contractions

• Supraventricular and nodal arrhythmias requiring a pacemaker or not controlled with medication

• Conduction abnormality requiring a pacemaker

• Valvular disease with documented compromise in cardiac function

• Symptomatic pericarditis

• History of cardiac disease:

• Myocardial infarction documented by elevated cardiac enzymes or persistent regional wall abnormalities on assessment of left ventricle (LV) function

• History of documented congestive heart failure (CHF)

• Documented cardiomyopathy

• Hypertension defined according to the following ineligibility criteria:

• For patients who will receive TC (regardless of the patient's age): uncontrolled hypertension defined as sustained systolic blood pressure (BP) > 150 mm Hg or diastolic BP > 90 mm Hg; (patients with initial BP elevations are eligible if initiation or adjustment of BP medication lowers pressure to meet entry criteria)

• For patients < 50 years old who will receive AC-->WP: uncontrolled hypertension defined as sustained systolic BP > 150 mm Hg or diastolic BP > 90 mm Hg; patients with initial BP elevations are eligible if initiation or adjustment of BP medication lowers pressure to meet entry criteria

• For patients >= 50 years old who will receive AC-->WP:

• Uncontrolled hypertension defined as sustained systolic BP > 150 mm Hg or diastolic BP > 90 mm Hg

• Controlled hypertension (systolic BP =< 150 mm Hg and diastolic BP =< 90 mmHg), if anti-hypertensive medication(s) are needed

• NOTE: Patients who are not eligible based on the AC-WP regimen BP criteria but who meet the TC regimen BP criteria are eligible for B-47, if the intended chemotherapy regimen is changed to TC

• Active hepatitis B or hepatitis C with abnormal liver function tests

• Intrinsic lung disease resulting in dyspnea

• Poorly controlled diabetes mellitus

• Active infection or chronic infection requiring chronic suppressive antibiotics

• Nervous system disorder (paresthesia, peripheral motor neuropathy, or peripheral sensory neuropathy) >= grade 2, per the Common Terminology Criteria for Adverse Events (CTCAE) version (v)4.0

• Conditions that would prohibit administration of corticosteroids

• Chronic daily treatment with corticosteroids with a dose of >= 10 mg/day methylprednisol one equivalent (excluding inhaled steroids)

• Known hypersensitivity to any of the study drugs or excipients, e.g., polysorbate 80 and Cremophor EL

• Pregnancy or lactation at the time of study entry; (Note: pregnancy testing must be performed within 2 weeks prior to randomization according to institutional standards for women of childbearing potential)

• Other non-malignant systemic disease that would preclude the patient from receiving study treatment or would prevent required follow-up

• Psychiatric or addictive disorders or other conditions that, in the opinion of the investigator, would preclude the patient from meeting the study requirements

• Use of any investigational product within 30 days prior to randomization

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Northeast Alabama Regional Medical Center	Anniston	Alabama	United States	36202
2	Providence Hospital	Mobile	Alabama	United States	36608
3	University of South Alabama Mitchell Cancer Institute	Mobile	Alabama	United States	36688
4	Alaska Breast Care and Surgery LLC	Anchorage	Alaska	United States	99508
5	Alaska Women's Cancer Care	Anchorage	Alaska	United States	99508
6	Anchorage Oncology Centre	Anchorage	Alaska	United States	99508
7	Katmai Oncology Group	Anchorage	Alaska	United States	99508
8	Providence Alaska Medical Center	Anchorage	Alaska	United States	99508
9	Fairbanks Memorial Hospital	Fairbanks	Alaska	United States	99701
10	Arizona Oncology Associates-Biltmore Cancer Center	Phoenix	Arizona	United States	85016
11	Virginia G Piper Cancer Care-Del Camino	Scottsdale	Arizona	United States	85258
12	NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro	Jonesboro	Arkansas	United States	72401
13	NEA Baptist Memorial Hospital	Jonesboro	Arkansas	United States	72401
14	University of Arkansas for Medical Sciences	Little Rock	Arkansas	United States	72205
15	Kaiser Permanente-Anaheim	Anaheim	California	United States	92806
16	Kaiser Permanente-Deer Valley Medical Center	Antioch	California	United States	94531
17	PCR Oncology	Arroyo Grande	California	United States	93420
18	Sutter Auburn Faith Hospital	Auburn	California	United States	95602
19	Sutter Cancer Centers Radiation Oncology Services-Auburn	Auburn	California	United States	95603
20	Kaiser Permanente-Baldwin Park	Baldwin Park	California	United States	91706
21	Kaiser Permanente-Bellflower	Bellflower	California	United States	90706
22	Alta Bates Summit Medical Center-Herrick Campus	Berkeley	California	United States	94704
23	Providence Saint Joseph Medical Center/Disney Family Cancer Center	Burbank	California	United States	91505
24	Mills-Peninsula Medical Center	Burlingame	California	United States	94010
25	Sutter Cancer Centers Radiation Oncology Services-Cameron Park	Cameron Park	California	United States	95682
26	East Bay Radiation Oncology Center	Castro Valley	California	United States	94546
27	Valley Medical Oncology Consultants-Castro Valley	Castro Valley	California	United States	94546
28	John Muir Medical Center-Concord Campus	Concord	California	United States	94520
29	Sutter Davis Hospital	Davis	California	United States	95616
30	Epic Care-Dublin	Dublin	California	United States	94568
31	Bay Area Breast Surgeons Inc	Emeryville	California	United States	94608
32	Epic Care Partners in Cancer Care	Emeryville	California	United States	94608
33	Kaiser Permanente-Fontana	Fontana	California	United States	92335
34	Kaiser Permanente-Fremont	Fremont	California	United States	94538
35	Valley Medical Oncology Consultants-Fremont	Fremont	California	United States	94538
36	Kaiser Permanente-Fresno	Fresno	California	United States	93720
37	Glendale Memorial Hospital and Health Center	Glendale	California	United States	91204
38	Marin Cancer Care Inc	Greenbrae	California	United States	94904
39	Marin General Hospital	Greenbrae	California	United States	94904
40	Kaiser Permanente - Harbor City	Harbor City	California	United States	90710
41	Kaiser Permanente-Irvine	Irvine	California	United States	92618
42	Long Beach Memorial Medical Center-Todd Cancer Institute	Long Beach	California	United States	90806
43	Kaiser Permanente Los Angeles Medical Center	Los Angeles	California	United States	90027
44	Kaiser Permanente West Los Angeles	Los Angeles	California	United States	90034
45	Contra Costa Regional Medical Center	Martinez	California	United States	94553-3156
46	Memorial Medical Center	Modesto	California	United States	95355
47	Kaiser Permanente-Modesto	Modesto	California	United States	95356
48	Community Hospital of Monterey Peninsula	Monterey	California	United States	93940
49	El Camino Hospital	Mountain View	California	United States	94040
50	Palo Alto Medical Foundation-Camino Division	Mountain View	California	United States	94040
51	Palo Alto Medical Foundation-Gynecologic Oncology	Mountain View	California	United States	94040
52	Sutter Cancer Research Consortium	Novato	California	United States	94945
53	Highland General Hospital	Oakland	California	United States	94602
54	Alta Bates Summit Medical Center - Summit Campus	Oakland	California	United States	94609
55	Bay Area Tumor Institute	Oakland	California	United States	94609
56	Hematology and Oncology Associates-Oakland	Oakland	California	United States	94609
57	Tom K Lee Inc	Oakland	California	United States	94609
58	Kaiser Permanente Oakland-Broadway	Oakland	California	United States	94611
59	Kaiser Permanente-Oakland	Oakland	California	United States	94611
60	Saint Joseph Hospital - Orange	Orange	California	United States	92868
61	Ventura County Hematology Oncology Specialists	Oxnard	California	United States	93030
62	Desert Regional Medical Center	Palm Springs	California	United States	92262
63	Palo Alto Medical Foundation Health Care	Palo Alto	California	United States	94301
64	Stanford Cancer Institute Palo Alto	Palo Alto	California	United States	94304
65	Kaiser Permanente - Panorama City	Panorama City	California	United States	91402
66	Valley Medical Oncology Consultants	Pleasanton	California	United States	94588
67	Pomona Valley Hospital Medical Center	Pomona	California	United States	91767
68	Kaiser Permanente-Rancho Cordova Cancer Center	Rancho Cordova	California	United States	95670
69	Eisenhower Medical Center	Rancho Mirage	California	United States	92270
70	Kaiser Permanente-Redwood City	Redwood City	California	United States	94063
71	Kaiser Permanente-Richmond	Richmond	California	United States	94801
72	Kaiser Permanente-Riverside	Riverside	California	United States	92505
73	Rohnert Park Cancer Center	Rohnert Park	California	United States	94928
74	Kaiser Permanente-Roseville	Roseville	California	United States	95661
75	Sutter Cancer Centers Radiation Oncology Services-Roseville	Roseville	California	United States	95661
76	Sutter Roseville Medical Center	Roseville	California	United States	95661
77	The Permanente Medical Group-Roseville Radiation Oncology	Roseville	California	United States	95678
78	Sutter Medical Center Sacramento	Sacramento	California	United States	95816
79	Kaiser Permanente-South Sacramento	Sacramento	California	United States	95823
80	South Sacramento Cancer Center	Sacramento	California	United States	95823
81	Kaiser Permanente - Sacramento	Sacramento	California	United States	95825
82	Saint Helena Hospital	Saint Helena	California	United States	94574
83	Salinas Valley Memorial	Salinas	California	United States	93901
84	Kaiser Permanente-San Diego Mission	San Diego	California	United States	92108
85	Kaiser Permanente-San Diego Zion	San Diego	California	United States	92120
86	California Pacific Medical Center-Pacific Campus	San Francisco	California	United States	94115
87	Kaiser Permanente-San Francisco	San Francisco	California	United States	94115
88	Kaiser Permanente-Santa Teresa-San Jose	San Jose	California	United States	95119
89	Kaiser Permanente San Leandro	San Leandro	California	United States	94577
90	Pacific Central Coast Health Center-San Luis Obispo	San Luis Obispo	California	United States	93401
91	Kaiser Permanente-San Marcos	San Marcos	California	United States	92078
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	Kaiser Permanente Medical Center - Santa Clara	Santa Clara	California	United States	95051
96	Palo Alto Medical Foundation-Santa Cruz	Santa Cruz	California	United States	95065
97	Kaiser Permanente-Santa Rosa	Santa Rosa	California	United States	95403
98	Sutter Pacific Medical Foundation	Santa Rosa	California	United States	95403
99	Kaiser Permanente Cancer Treatment Center	South San Francisco	California	United States	94080
100	Kaiser Permanente-South San Francisco	South San Francisco	California	United States	94080
101	Kaiser Permanente-Stockton	Stockton	California	United States	95210
102	Palo Alto Medical Foundation-Sunnyvale	Sunnyvale	California	United States	94086
103	Northbay Cancer Center	Vacaville	California	United States	95687
104	Sutter Cancer Centers Radiation Oncology Services-Vacaville	Vacaville	California	United States	95687
105	Kaiser Permanente Medical Center-Vacaville	Vacaville	California	United States	95688
106	Kaiser Permanente-Vallejo	Vallejo	California	United States	94589
107	Sutter Solano Medical Center/Cancer Center	Vallejo	California	United States	94589
108	Kaiser Permanente-Walnut Creek	Walnut Creek	California	United States	94596
109	John Muir Medical Center-Walnut Creek	Walnut Creek	California	United States	94598
110	Kaiser Permanente-Woodland Hills	Woodland Hills	California	United States	91367
111	The Medical Center of Aurora	Aurora	Colorado	United States	80012
112	University of Colorado Hospital	Aurora	Colorado	United States	80045
113	Boulder Community Hospital	Boulder	Colorado	United States	80301
114	Rocky Mountain Cancer Centers-Boulder	Boulder	Colorado	United States	80304
115	Penrose-Saint Francis Healthcare	Colorado Springs	Colorado	United States	80907
116	Rocky Mountain Cancer Centers-Penrose	Colorado Springs	Colorado	United States	80907
117	UCHealth Memorial Hospital Central	Colorado Springs	Colorado	United States	80909
118	Kaiser Permanente-Franklin	Denver	Colorado	United States	80205
119	Porter Adventist Hospital	Denver	Colorado	United States	80210
120	Colorado Blood Cancer Institute	Denver	Colorado	United States	80218
121	Presbyterian - Saint Lukes Medical Center - Health One	Denver	Colorado	United States	80218
122	Rocky Mountain Cancer Centers-Midtown	Denver	Colorado	United States	80218
123	SCL Health Saint Joseph Hospital	Denver	Colorado	United States	80218
124	Rocky Mountain Cancer Centers-Rose	Denver	Colorado	United States	80220
125	Rose Medical Center	Denver	Colorado	United States	80220
126	Western States Cancer Research NCORP	Denver	Colorado	United States	80222
127	Mercy Medical Center	Durango	Colorado	United States	81301
128	Mountain Blue Cancer Care Center - Swedish	Englewood	Colorado	United States	80113
129	Swedish Medical Center	Englewood	Colorado	United States	80113
130	Poudre Valley Hospital	Fort Collins	Colorado	United States	80524
131	Mountain Blue Cancer Care Center	Golden	Colorado	United States	80401
132	Saint Mary's Hospital and Regional Medical Center	Grand Junction	Colorado	United States	81501
133	North Colorado Medical Center	Greeley	Colorado	United States	80631
134	Rocky Mountain Cancer Centers-Greenwood Village	Greenwood Village	Colorado	United States	80111
135	Kaiser Permanente-Rock Creek	Lafayette	Colorado	United States	80026
136	Rocky Mountain Cancer Centers-Lakewood	Lakewood	Colorado	United States	80228
137	Saint Anthony Hospital	Lakewood	Colorado	United States	80228
138	Littleton Adventist Hospital	Littleton	Colorado	United States	80122
139	Kaiser Permanente-Lone Tree	Lone Tree	Colorado	United States	80124
140	Rocky Mountain Cancer Centers-Sky Ridge	Lone Tree	Colorado	United States	80124
141	Sky Ridge Medical Center	Lone Tree	Colorado	United States	80124
142	Longmont United Hospital	Longmont	Colorado	United States	80501
143	Rocky Mountain Cancer Centers-Longmont	Longmont	Colorado	United States	80501
144	McKee Medical Center	Loveland	Colorado	United States	80539
145	Parker Adventist Hospital	Parker	Colorado	United States	80138
146	Rocky Mountain Cancer Centers-Parker	Parker	Colorado	United States	80138
147	Saint Mary Corwin Medical Center	Pueblo	Colorado	United States	81004
148	Rocky Mountain Cancer Centers - Pueblo	Pueblo	Colorado	United States	81008
149	North Suburban Medical Center	Thornton	Colorado	United States	80229
150	SCL Health Lutheran Medical Center	Wheat Ridge	Colorado	United States	80033
151	Hartford Hospital	Hartford	Connecticut	United States	06102
152	Smilow Cancer Hospital Care Center at Saint Francis	Hartford	Connecticut	United States	06105
153	Manchester Memorial Hospital	Manchester	Connecticut	United States	06040
154	Midstate Medical Center	Meriden	Connecticut	United States	06451
155	Middlesex Hospital	Middletown	Connecticut	United States	06457
156	The Hospital of Central Connecticut	New Britain	Connecticut	United States	06050
157	Yale University	New Haven	Connecticut	United States	06520
158	Eastern Connecticut Hematology and Oncology Associates	Norwich	Connecticut	United States	06360
159	Smilow Cancer Hospital Care Center - Waterford	Waterford	Connecticut	United States	06385
160	Bayhealth Hospital Kent Campus	Dover	Delaware	United States	19901
161	Beebe Medical Center	Lewes	Delaware	United States	19958
162	Christiana Gynecologic Oncology LLC	Newark	Delaware	United States	19713
163	Delaware Clinical and Laboratory Physicians PA	Newark	Delaware	United States	19713
164	Helen F Graham Cancer Center	Newark	Delaware	United States	19713
165	Medical Oncology Hematology Consultants PA	Newark	Delaware	United States	19713
166	Christiana Care Health System-Christiana Hospital	Newark	Delaware	United States	19718
167	Beebe Health Campus	Rehoboth Beach	Delaware	United States	19971
168	TidalHealth Nanticoke / Allen Cancer Center	Seaford	Delaware	United States	19973
169	Christiana Care Health System-Wilmington Hospital	Wilmington	Delaware	United States	19801
170	Kaiser Permanente-Capitol Hill Medical Center	Washington	District of Columbia	United States	20002
171	MedStar Georgetown University Hospital	Washington	District of Columbia	United States	20007
172	MedStar Washington Hospital Center	Washington	District of Columbia	United States	20010
173	Sibley Memorial Hospital	Washington	District of Columbia	United States	20016
174	AdventHealth Altamonte	Altamonte Springs	Florida	United States	32701
175	Halifax Health Medical Center-Centers for Oncology	Daytona Beach	Florida	United States	32114
176	UM Sylvester Comprehensive Cancer Center at Deerfield Beach	Deerfield Beach	Florida	United States	33442
177	Holy Cross Hospital	Fort Lauderdale	Florida	United States	33308
178	Broward Health Medical Center	Fort Lauderdale	Florida	United States	33316
179	University of Florida Health Science Center - Gainesville	Gainesville	Florida	United States	32610
180	Saint Vincent's Medical Center	Jacksonville	Florida	United States	32204
181	Baptist MD Anderson Cancer Center	Jacksonville	Florida	United States	32207
182	Jupiter Medical Center	Jupiter	Florida	United States	33458
183	AdventHealth Kissimmee	Kissimmee	Florida	United States	34744
184	Lakeland Regional Health Hollis Cancer Center	Lakeland	Florida	United States	33805
185	The Watson Clinic	Lakeland	Florida	United States	33805
186	Mount Sinai Medical Center	Miami Beach	Florida	United States	33140
187	University of Miami Miller School of Medicine-Sylvester Cancer Center	Miami	Florida	United States	33136
188	Ocala Oncology Center	Ocala	Florida	United States	34774
189	21st Century Oncology-Orange Park	Orange Park	Florida	United States	32073
190	AdventHealth Medical Group Urology at Orlando	Orlando	Florida	United States	32803
191	AdventHealth Orlando	Orlando	Florida	United States	32803
192	Orlando Health Cancer Institute	Orlando	Florida	United States	32806
193	AdventHealth East Orlando	Orlando	Florida	United States	32822
194	Florida Cancer Specialists - Sarasota Downtown	Sarasota	Florida	United States	34236
195	AdventHealth Winter Park	Winter Park	Florida	United States	32792
196	Phoebe Putney Memorial Hospital	Albany	Georgia	United States	31701
197	University Cancer and Blood Center LLC	Athens	Georgia	United States	30607
198	Grady Health System	Atlanta	Georgia	United States	30303
199	Emory University Hospital Midtown	Atlanta	Georgia	United States	30308
200	Piedmont Hospital	Atlanta	Georgia	United States	30309
201	Emory University Hospital/Winship Cancer Institute	Atlanta	Georgia	United States	30322
202	Atlanta Regional CCOP	Atlanta	Georgia	United States	30342
203	Emory Saint Joseph's Hospital	Atlanta	Georgia	United States	30342
204	Northside Hospital	Atlanta	Georgia	United States	30342
205	Augusta University Medical Center	Augusta	Georgia	United States	30912
206	WellStar Cobb Hospital	Austell	Georgia	United States	30106
207	John B Amos Cancer Center	Columbus	Georgia	United States	31904
208	Dekalb Medical Center	Decatur	Georgia	United States	30033
209	Dublin Hematology Oncology Care PC	Dublin	Georgia	United States	31021
210	Piedmont Fayette Hospital	Fayetteville	Georgia	United States	30214
211	Northside Hospital - Gwinnett	Lawrenceville	Georgia	United States	30046
212	Medical Center of Central Georgia	Macon	Georgia	United States	31201
213	Wellstar Kennestone Hospital	Marietta	Georgia	United States	30060
214	Southern Regional Medical Center	Riverdale	Georgia	United States	30274
215	Harbin Clinic Medical Oncology and Clinical Research	Rome	Georgia	United States	30165
216	Low Country Cancer Care	Savannah	Georgia	United States	31404
217	Memorial Health University Medical Center	Savannah	Georgia	United States	31404
218	Summit Cancer Care-Memorial	Savannah	Georgia	United States	31404
219	Lewis Cancer and Research Pavilion at Saint Joseph's/Candler	Savannah	Georgia	United States	31405
220	Pali Momi Medical Center	'Aiea	Hawaii	United States	96701
221	Hawaii Cancer Care Inc - Waterfront Plaza	Honolulu	Hawaii	United States	96813
222	Queen's Medical Center	Honolulu	Hawaii	United States	96813
223	Straub Clinic and Hospital	Honolulu	Hawaii	United States	96813
224	University of Hawaii Cancer Center	Honolulu	Hawaii	United States	96813
225	Queen's Cancer Center - Kuakini	Honolulu	Hawaii	United States	96817
226	The Cancer Center of Hawaii-Liliha	Honolulu	Hawaii	United States	96817
227	Kaiser Permanente Moanalua Medical Center	Honolulu	Hawaii	United States	96819
228	Kapiolani Medical Center for Women and Children	Honolulu	Hawaii	United States	96826
229	Tripler Army Medical Center	Honolulu	Hawaii	United States	96859
230	Wilcox Memorial Hospital and Kauai Medical Clinic	Lihue	Hawaii	United States	96766
231	Saint Alphonsus Cancer Care Center-Boise	Boise	Idaho	United States	83706
232	Saint Luke's Cancer Institute - Boise	Boise	Idaho	United States	83712
233	Saint Luke's Cancer Institute - Fruitland	Fruitland	Idaho	United States	83619
234	Saint Joseph Regional Medical Center	Lewiston	Idaho	United States	83501
235	Saint Luke's Cancer Institute - Meridian	Meridian	Idaho	United States	83642
236	Saint Luke's Cancer Institute - Nampa	Nampa	Idaho	United States	83686
237	Portneuf Medical Center	Pocatello	Idaho	United States	83201
238	Kootenai Clinic Cancer Services - Post Falls	Post Falls	Idaho	United States	83854
239	Saint Luke's Cancer Institute - Twin Falls	Twin Falls	Idaho	United States	83301
240	Saint Anthony's Health	Alton	Illinois	United States	62002
241	Rush - Copley Medical Center	Aurora	Illinois	United States	60504
242	Mac Neal Hospital	Berwyn	Illinois	United States	60402
243	Saint Joseph Medical Center	Bloomington	Illinois	United States	61701
244	Illinois CancerCare-Bloomington	Bloomington	Illinois	United States	61704
245	Graham Hospital Association	Canton	Illinois	United States	61520
246	Illinois CancerCare-Canton	Canton	Illinois	United States	61520
247	Memorial Hospital of Carbondale	Carbondale	Illinois	United States	62902
248	Illinois CancerCare-Carthage	Carthage	Illinois	United States	62321
249	Memorial Hospital	Carthage	Illinois	United States	62321
250	Centralia Oncology Clinic	Centralia	Illinois	United States	62801
251	Mount Sinai Hospital Medical Center	Chicago	Illinois	United States	60608
252	John H Stroger Jr Hospital of Cook County	Chicago	Illinois	United States	60612
253	Rush University Medical Center	Chicago	Illinois	United States	60612
254	University of Illinois	Chicago	Illinois	United States	60612
255	Swedish Covenant Hospital	Chicago	Illinois	United States	60625
256	Presence Resurrection Medical Center	Chicago	Illinois	United States	60631
257	Weiss Memorial Hospital	Chicago	Illinois	United States	60640
258	Carle on Vermilion	Danville	Illinois	United States	61832
259	Cancer Care Specialists of Illinois - Decatur	Decatur	Illinois	United States	62526
260	Decatur Memorial Hospital	Decatur	Illinois	United States	62526
261	Heartland Cancer Research NCORP	Decatur	Illinois	United States	62526
262	Advocate Good Samaritan Hospital	Downers Grove	Illinois	United States	60515
263	Carle Physician Group-Effingham	Effingham	Illinois	United States	62401
264	Crossroads Cancer Center	Effingham	Illinois	United States	62401
265	Advocate Sherman Hospital	Elgin	Illinois	United States	60123
266	AMITA Health Alexian Brothers Medical Center	Elk Grove Village	Illinois	United States	60007
267	Elmhurst Memorial Hospital	Elmhurst	Illinois	United States	60126
268	Eureka Hospital	Eureka	Illinois	United States	61530
269	Illinois CancerCare-Eureka	Eureka	Illinois	United States	61530
270	Saint Francis Hospital	Evanston	Illinois	United States	60202
271	Freeport Memorial Hospital/Leonard C Ferguson Cancer Center	Freeport	Illinois	United States	61032
272	Illinois CancerCare-Galesburg	Galesburg	Illinois	United States	61401
273	Western Illinois Cancer Treatment Center	Galesburg	Illinois	United States	61401
274	Northwestern Medicine Cancer Center Delnor	Geneva	Illinois	United States	60134
275	Ingalls Memorial Hospital	Harvey	Illinois	United States	60426
276	Illinois CancerCare-Havana	Havana	Illinois	United States	62644
277	Mason District Hospital	Havana	Illinois	United States	62644
278	Duly Health and Care Joliet	Joliet	Illinois	United States	60435
279	Presence Saint Mary's Hospital	Kankakee	Illinois	United States	60901
280	Illinois CancerCare-Kewanee Clinic	Kewanee	Illinois	United States	61443
281	Illinois CancerCare-Macomb	Macomb	Illinois	United States	61455
282	Mcdonough District Hospital	Macomb	Illinois	United States	61455
283	Carle Physician Group-Mattoon/Charleston	Mattoon	Illinois	United States	61938
284	Loyola University Medical Center	Maywood	Illinois	United States	60153
285	Holy Family Medical Center	Monmouth	Illinois	United States	61462
286	Illinois CancerCare-Monmouth	Monmouth	Illinois	United States	61462
287	Good Samaritan Regional Health Center	Mount Vernon	Illinois	United States	62864
288	Edward Hospital/Cancer Center	Naperville	Illinois	United States	60540
289	Bromenn Regional Medical Center	Normal	Illinois	United States	61761
290	Carle Cancer Institute Normal	Normal	Illinois	United States	61761
291	Illinois CancerCare-Community Cancer Center	Normal	Illinois	United States	61761
292	Advocate Christ Medical Center	Oak Lawn	Illinois	United States	60453-2699
293	Illinois CancerCare-Ottawa Clinic	Ottawa	Illinois	United States	61350
294	Ottawa Regional Hospital and Healthcare Center	Ottawa	Illinois	United States	61350
295	Radiation Oncology of Northern Illinois	Ottawa	Illinois	United States	61350
296	Advocate Lutheran General Hospital	Park Ridge	Illinois	United States	60068
297	Illinois CancerCare-Pekin	Pekin	Illinois	United States	61554
298	OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center	Pekin	Illinois	United States	61554
299	Proctor Hospital	Peoria	Illinois	United States	61614
300	Illinois CancerCare-Peoria	Peoria	Illinois	United States	61615
301	OSF Saint Francis Radiation Oncology at Peoria Cancer Center	Peoria	Illinois	United States	61615
302	Methodist Medical Center of Illinois	Peoria	Illinois	United States	61636
303	OSF Saint Francis Medical Center	Peoria	Illinois	United States	61637
304	Illinois CancerCare-Peru	Peru	Illinois	United States	61354
305	Illinois Valley Hospital	Peru	Illinois	United States	61354
306	Valley Radiation Oncology	Peru	Illinois	United States	61354
307	Illinois CancerCare-Princeton	Princeton	Illinois	United States	61356
308	Perry Memorial Hospital	Princeton	Illinois	United States	61356
309	West Suburban Medical Center	River Forest	Illinois	United States	60305
310	Swedish American Hospital	Rockford	Illinois	United States	61104
311	OSF Saint Anthony Medical Center	Rockford	Illinois	United States	61108
312	SwedishAmerican Regional Cancer Center/ACT	Rockford	Illinois	United States	61114
313	Illinois CancerCare-Spring Valley	Spring Valley	Illinois	United States	61362
314	Central Illinois Hematology Oncology Center	Springfield	Illinois	United States	62702
315	Memorial Medical Center	Springfield	Illinois	United States	62781
316	Carle Cancer Center	Urbana	Illinois	United States	61801
317	The Carle Foundation Hospital	Urbana	Illinois	United States	61801
318	Northwestern Medicine Cancer Center Warrenville	Warrenville	Illinois	United States	60555
319	Rush-Copley Healthcare Center	Yorkville	Illinois	United States	60560
320	Saint Vincent Anderson Regional Hospital/Cancer Center	Anderson	Indiana	United States	46016
321	Franciscan Saint Francis Health-Beech Grove	Beech Grove	Indiana	United States	46107
322	Elkhart Clinic	Elkhart	Indiana	United States	46514-2098
323	Michiana Hematology Oncology PC-Elkhart	Elkhart	Indiana	United States	46514
324	Elkhart General Hospital	Elkhart	Indiana	United States	46515
325	Fort Wayne Medical Oncology and Hematology Inc-Parkview	Fort Wayne	Indiana	United States	46845
326	Community Cancer Center East	Indianapolis	Indiana	United States	46219
327	Franciscan Health Indianapolis	Indianapolis	Indiana	United States	46237
328	Community Cancer Center North	Indianapolis	Indiana	United States	46256
329	Saint Vincent Hospital and Health Care Center	Indianapolis	Indiana	United States	46260
330	Community Howard Regional Health	Kokomo	Indiana	United States	46904
331	IU Health La Porte Hospital	La Porte	Indiana	United States	46350
332	Franciscan Saint Anthony Health-Michigan City	Michigan City	Indiana	United States	46360
333	Woodland Cancer Care Center	Michigan City	Indiana	United States	46360
334	Cancer Care Partners LLC	Mishawaka	Indiana	United States	46545
335	Memorial Regional Cancer Center Day Road	Mishawaka	Indiana	United States	46545
336	Michiana Hematology Oncology PC-Mishawaka	Mishawaka	Indiana	United States	46545
337	Saint Joseph Regional Medical Center-Mishawaka	Mishawaka	Indiana	United States	46545
338	IU Health Ball Memorial Hospital	Muncie	Indiana	United States	47303
339	The Community Hospital	Munster	Indiana	United States	46321
340	Michiana Hematology Oncology PC-Plymouth	Plymouth	Indiana	United States	46563
341	Reid Health	Richmond	Indiana	United States	47374
342	Memorial Hospital of South Bend	South Bend	Indiana	United States	46601
343	Michiana Hematology Oncology PC-South Bend	South Bend	Indiana	United States	46601
344	South Bend Clinic	South Bend	Indiana	United States	46617
345	Northern Indiana Cancer Research Consortium	South Bend	Indiana	United States	46628
346	Michiana Hematology Oncology PC-Westville	Westville	Indiana	United States	46391
347	Mary Greeley Medical Center	Ames	Iowa	United States	50010
348	McFarland Clinic PC - Ames	Ames	Iowa	United States	50010
349	McFarland Clinic PC-Boone	Boone	Iowa	United States	50036
350	Physicians' Clinic of Iowa PC	Cedar Rapids	Iowa	United States	52402
351	Saint Luke's Hospital	Cedar Rapids	Iowa	United States	52402
352	Mercy Hospital	Cedar Rapids	Iowa	United States	52403
353	Oncology Associates at Mercy Medical Center	Cedar Rapids	Iowa	United States	52403
354	Medical Oncology and Hematology Associates-West Des Moines	Clive	Iowa	United States	50325
355	Mercy Cancer Center-West Lakes	Clive	Iowa	United States	50325
356	Alegent Health Mercy Hospital	Council Bluffs	Iowa	United States	51503
357	Genesis Medical Center - East Campus	Davenport	Iowa	United States	52803
358	Iowa Methodist Medical Center	Des Moines	Iowa	United States	50309
359	Medical Oncology and Hematology Associates-Des Moines	Des Moines	Iowa	United States	50309
360	Medical Oncology and Hematology Associates-Laurel	Des Moines	Iowa	United States	50314
361	Mercy Medical Center - Des Moines	Des Moines	Iowa	United States	50314
362	Iowa Lutheran Hospital	Des Moines	Iowa	United States	50316
363	McFarland Clinic PC-Trinity Cancer Center	Fort Dodge	Iowa	United States	50501
364	University of Iowa/Holden Comprehensive Cancer Center	Iowa City	Iowa	United States	52242
365	McFarland Clinic PC-Jefferson	Jefferson	Iowa	United States	50129
366	McFarland Clinic PC-Marshalltown	Marshalltown	Iowa	United States	50158
367	Ottumwa Regional Health Center	Ottumwa	Iowa	United States	52501
368	Siouxland Regional Cancer Center	Sioux City	Iowa	United States	51101
369	Mercy Medical Center-Sioux City	Sioux City	Iowa	United States	51102
370	Saint Luke's Regional Medical Center	Sioux City	Iowa	United States	51104
371	MercyOne Waterloo Medical Center	Waterloo	Iowa	United States	50702
372	Methodist West Hospital	West Des Moines	Iowa	United States	50266-7700
373	Mercy Medical Center-West Lakes	West Des Moines	Iowa	United States	50266
374	Cancer Center of Kansas - Chanute	Chanute	Kansas	United States	66720
375	Cancer Center of Kansas - Dodge City	Dodge City	Kansas	United States	67801
376	Cancer Center of Kansas - El Dorado	El Dorado	Kansas	United States	67042
377	Cancer Center of Kansas - Fort Scott	Fort Scott	Kansas	United States	66701
378	Cancer Center of Kansas-Independence	Independence	Kansas	United States	67301
379	Cancer Center of Kansas-Kingman	Kingman	Kansas	United States	67068
380	Lawrence Memorial Hospital	Lawrence	Kansas	United States	66044
381	Cancer Center of Kansas-Liberal	Liberal	Kansas	United States	67905
382	Cancer Center of Kansas-Manhattan	Manhattan	Kansas	United States	66502
383	Cancer Center of Kansas - McPherson	McPherson	Kansas	United States	67460
384	Cancer Center of Kansas - Newton	Newton	Kansas	United States	67114
385	Menorah Medical Center	Overland Park	Kansas	United States	66209
386	Saint Luke's South Hospital	Overland Park	Kansas	United States	66213
387	Cancer Center of Kansas - Parsons	Parsons	Kansas	United States	67357
388	Kansas City NCI Community Oncology Research Program	Prairie Village	Kansas	United States	66208
389	Cancer Center of Kansas - Pratt	Pratt	Kansas	United States	67124
390	Cancer Center of Kansas - Salina	Salina	Kansas	United States	67401
391	Cotton O'Neil Cancer Center / Stormont Vail Health	Topeka	Kansas	United States	66606
392	Cancer Center of Kansas - Wellington	Wellington	Kansas	United States	67152
393	Associates In Womens Health	Wichita	Kansas	United States	67208
394	Cancer Center of Kansas-Wichita Medical Arts Tower	Wichita	Kansas	United States	67208
395	Ascension Via Christi Hospitals Wichita	Wichita	Kansas	United States	67214
396	Cancer Center of Kansas - Wichita	Wichita	Kansas	United States	67214
397	Wesley Medical Center	Wichita	Kansas	United States	67214
398	Wichita NCI Community Oncology Research Program	Wichita	Kansas	United States	67214
399	Cancer Center of Kansas - Winfield	Winfield	Kansas	United States	67156
400	Flaget Memorial Hospital	Bardstown	Kentucky	United States	40004
401	Baptist Health Corbin	Corbin	Kentucky	United States	40701
402	Commonwealth Cancer Center-Corbin	Corbin	Kentucky	United States	40701
403	Oncology Hematology Care Inc-Crestview	Crestview Hills	Kentucky	United States	41017
404	Baptist Health Hardin	Elizabethtown	Kentucky	United States	42701
405	Baptist Health Lexington	Lexington	Kentucky	United States	40503
406	Saint Joseph Radiation Oncology Resource Center	Lexington	Kentucky	United States	40504
407	Saint Joseph Hospital East	Lexington	Kentucky	United States	40509
408	University of Kentucky/Markey Cancer Center	Lexington	Kentucky	United States	40536
409	Jewish Hospital	Louisville	Kentucky	United States	40202
410	Norton Hospital Pavilion and Medical Campus	Louisville	Kentucky	United States	40202
411	The James Graham Brown Cancer Center at University of Louisville	Louisville	Kentucky	United States	40202
412	Baptist Health Louisville	Louisville	Kentucky	United States	40207
413	Saints Mary and Elizabeth Hospital	Louisville	Kentucky	United States	40215
414	UofL Health Medical Center Northeast	Louisville	Kentucky	United States	40245
415	Baptist Health Madisonville/Merle Mahr Cancer Center	Madisonville	Kentucky	United States	42431
416	Owensboro Health Mitchell Memorial Cancer Center	Owensboro	Kentucky	United States	42303
417	Jewish Hospital Medical Center South	Shepherdsville	Kentucky	United States	40165
418	Christus Saint Frances Cabrini Hospital	Alexandria	Louisiana	United States	71301
419	Baton Rouge General Medical Center	Baton Rouge	Louisiana	United States	70806
420	Hematology/Oncology Clinic PLLC	Baton Rouge	Louisiana	United States	70809
421	Mary Bird Perkins Cancer Center	Baton Rouge	Louisiana	United States	70809
422	Ochsner Health Center-Summa	Baton Rouge	Louisiana	United States	70809
423	Ochsner Health Center-Covington	Covington	Louisiana	United States	70433
424	West Jefferson Medical Center	Marrero	Louisiana	United States	70072
425	Robert Veith MD LLC	Metairie	Louisiana	United States	70006
426	Ochsner LSU Health Monroe Medical Center	Monroe	Louisiana	United States	71202
427	Louisiana State University Health Science Center	New Orleans	Louisiana	United States	70112
428	Tulane University Health Sciences Center	New Orleans	Louisiana	United States	70112
429	University Medical Center New Orleans	New Orleans	Louisiana	United States	70112
430	Ochsner Baptist Medical Center	New Orleans	Louisiana	United States	70115
431	Ochsner Medical Center Jefferson	New Orleans	Louisiana	United States	70121
432	LSU Health Sciences Center at Shreveport	Shreveport	Louisiana	United States	71103
433	Highland Clinic	Shreveport	Louisiana	United States	71105
434	Harold Alfond Center for Cancer Care	Augusta	Maine	United States	04330
435	Eastern Maine Medical Center	Bangor	Maine	United States	04401
436	Lafayette Family Cancer Center-EMMC	Brewer	Maine	United States	04412
437	Mercy Hospital	Portland	Maine	United States	04101
438	Penobscot Bay Medical Center	Rockport	Maine	United States	04856
439	Maine Center for Cancer Medicine-Scarborough	Scarborough	Maine	United States	04074
440	York Hospital	York	Maine	United States	03909
441	Anne Arundel Medical Center	Annapolis	Maryland	United States	21401
442	University of Maryland/Greenebaum Cancer Center	Baltimore	Maryland	United States	21201
443	Veterans Administration Medical Center-Baltimore	Baltimore	Maryland	United States	21201
444	Mercy Medical Center	Baltimore	Maryland	United States	21202
445	Greater Baltimore Medical Center	Baltimore	Maryland	United States	21204
446	Sinai Hospital of Baltimore	Baltimore	Maryland	United States	21215
447	MedStar Harbor Hospital	Baltimore	Maryland	United States	21225
448	Saint Agnes Hospital	Baltimore	Maryland	United States	21229
449	MedStar Franklin Square Medical Center/Weinberg Cancer Institute	Baltimore	Maryland	United States	21237
450	Kaiser Permanente-Woodlawn Medical Center	Baltimore	Maryland	United States	21244
451	Johns Hopkins University/Sidney Kimmel Cancer Center	Baltimore	Maryland	United States	21287
452	UM Upper Chesapeake Medical Center	Bel Air	Maryland	United States	21014
453	Suburban Hospital	Bethesda	Maryland	United States	20814
454	Walter Reed National Military Medical Center	Bethesda	Maryland	United States	20889-5600
455	Maryland Oncology Hematology PA-Columbia	Columbia	Maryland	United States	21044
456	Western Maryland Regional Medical Center	Cumberland	Maryland	United States	21502
457	University of Maryland Shore Medical Center at Easton	Easton	Maryland	United States	21601
458	Christiana Care - Union Hospital	Elkton	Maryland	United States	21921
459	Frederick Memorial Hospital	Frederick	Maryland	United States	21701
460	Kaiser Permanente-Gaithersburg Medical Center	Gaithersburg	Maryland	United States	20879
461	Meritus Medical Center	Hagerstown	Maryland	United States	21742
462	Kaiser Permanente - Largo Medical Center	Largo	Maryland	United States	20774
463	Northwest Hospital Center	Randallstown	Maryland	United States	21133
464	Kaiser Permanente - Shady Grove Medical Center	Rockville	Maryland	United States	20850
465	Maryland Oncology Hematology PA-Aquilino Cancer Center	Rockville	Maryland	United States	20850
466	TidalHealth Peninsula Regional	Salisbury	Maryland	United States	21801
467	Holy Cross Hospital	Silver Spring	Maryland	United States	20910
468	UM Saint Joseph Medical Center	Towson	Maryland	United States	21204
469	Sturdy Memorial Hospital	Attleboro	Massachusetts	United States	02703
470	Beverly Hospital	Beverly	Massachusetts	United States	01915
471	Tufts Medical Center	Boston	Massachusetts	United States	02111
472	Massachusetts General Hospital Cancer Center	Boston	Massachusetts	United States	02114
473	Boston Medical Center	Boston	Massachusetts	United States	02118
474	Dana-Farber Cancer Institute	Boston	Massachusetts	United States	02215
475	Lahey Hospital and Medical Center	Burlington	Massachusetts	United States	01805
476	Mount Auburn Hospital	Cambridge	Massachusetts	United States	02138
477	Mass General/North Shore Cancer Center	Danvers	Massachusetts	United States	01923
478	Southcoast Centers for Cancer Care-Fairhaven	Fairhaven	Massachusetts	United States	02719
479	Saint Anne's Hospital	Fall River	Massachusetts	United States	02721
480	MetroWest Medical Center-Framingham Union Hospital	Framingham	Massachusetts	United States	01702
481	Addison Gilbert Hospital	Gloucester	Massachusetts	United States	01930
482	Lowell General Hospital	Lowell	Massachusetts	United States	01854
483	Holy Family Hospital	Methuen	Massachusetts	United States	01844
484	Dana-Farber/Brigham and Women's Cancer Center at Milford Regional	Milford	Massachusetts	United States	01757
485	Newton-Wellesley Hospital	Newton	Massachusetts	United States	02462
486	Berkshire Medical Center - Cancer Center	Pittsfield	Massachusetts	United States	01201
487	Dana Farber Community Cancer Care-Quincy	Quincy	Massachusetts	United States	02169
488	Dana-Farber/Brigham and Women's Cancer Center at South Shore	South Weymouth	Massachusetts	United States	02190
489	Bixby Medical Center	Adrian	Michigan	United States	49221
490	Hickman Cancer Center	Adrian	Michigan	United States	49221
491	Michigan Cancer Research Consortium NCORP	Ann Arbor	Michigan	United States	48106
492	Saint Joseph Mercy Hospital	Ann Arbor	Michigan	United States	48106
493	University of Michigan Comprehensive Cancer Center	Ann Arbor	Michigan	United States	48109
494	Bronson Battle Creek	Battle Creek	Michigan	United States	49017
495	McLaren Cancer Institute-Bay City	Bay City	Michigan	United States	48706
496	Spectrum Health Big Rapids Hospital	Big Rapids	Michigan	United States	49307
497	McLaren Cancer Institute-Clarkston	Clarkston	Michigan	United States	48346
498	Henry Ford Macomb Hospital-Clinton Township	Clinton Township	Michigan	United States	48038
499	Huron Valley-Sinai Hospital	Commerce	Michigan	United States	48382
500	Beaumont Hospital - Dearborn	Dearborn	Michigan	United States	48124
501	Wayne State University/Karmanos Cancer Institute	Detroit	Michigan	United States	48201
502	Henry Ford Hospital	Detroit	Michigan	United States	48202
503	Ascension Saint John Hospital	Detroit	Michigan	United States	48236
504	Michigan State University Clinical Center	East Lansing	Michigan	United States	48824-7016
505	Green Bay Oncology - Escanaba	Escanaba	Michigan	United States	49829
506	Weisberg Cancer Treatment Center	Farmington Hills	Michigan	United States	48334
507	Beaumont Hospital - Farmington Hills	Farmington Hills	Michigan	United States	48336
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	Singh and Arora Hematology Oncology PC	Flint	Michigan	United States	48532
513	Genesys Regional Medical Center	Grand Blanc	Michigan	United States	48439
514	Cancer Research Consortium of West Michigan NCORP	Grand Rapids	Michigan	United States	49503
515	Mercy Health Saint Mary's	Grand Rapids	Michigan	United States	49503
516	Spectrum Health at Butterworth Campus	Grand Rapids	Michigan	United States	49503
517	Green Bay Oncology - Iron Mountain	Iron Mountain	Michigan	United States	49801
518	Allegiance Health	Jackson	Michigan	United States	49201
519	Bronson Methodist Hospital	Kalamazoo	Michigan	United States	49007
520	West Michigan Cancer Center	Kalamazoo	Michigan	United States	49007
521	Borgess Medical Center	Kalamazoo	Michigan	United States	49048
522	Karmanos Cancer Institute at McLaren Greater Lansing	Lansing	Michigan	United States	48910
523	Sparrow Hospital	Lansing	Michigan	United States	48912
524	Lapeer Regional Hospital	Lapeer	Michigan	United States	48446
525	McLaren Cancer Institute-Lapeer Region	Lapeer	Michigan	United States	48446
526	Trinity Health Saint Mary Mercy Livonia Hospital	Livonia	Michigan	United States	48154
527	MyMichigan Medical Center Midland	Midland	Michigan	United States	48670
528	Mercy Memorial Hospital	Monroe	Michigan	United States	48162
529	Toledo Clinic Cancer Centers-Monroe	Monroe	Michigan	United States	48162
530	McLaren Cancer Institute-Macomb	Mount Clemens	Michigan	United States	48043
531	McLaren Cancer Institute-Central Michigan	Mount Pleasant	Michigan	United States	48858
532	Mercy Health Mercy Campus	Muskegon	Michigan	United States	49444
533	Lakeland Hospital Niles	Niles	Michigan	United States	49120
534	McLaren Cancer Institute-Northern Michigan	Petoskey	Michigan	United States	49770
535	Saint Joseph Mercy Oakland	Pontiac	Michigan	United States	48341
536	Lake Huron Medical Center	Port Huron	Michigan	United States	48060
537	Spectrum Health Reed City Hospital	Reed City	Michigan	United States	49677
538	William Beaumont Hospital-Royal Oak	Royal Oak	Michigan	United States	48073
539	Ascension Saint Mary's Hospital	Saginaw	Michigan	United States	48601
540	Lakeland Medical Center Saint Joseph	Saint Joseph	Michigan	United States	49085
541	Marie Yeager Cancer Center	Saint Joseph	Michigan	United States	49085
542	Ascension Providence Hospitals - Southfield	Southfield	Michigan	United States	48075
543	Munson Medical Center	Traverse City	Michigan	United States	49684
544	William Beaumont Hospital - Troy	Troy	Michigan	United States	48085
545	Saint John Macomb-Oakland Hospital	Warren	Michigan	United States	48093
546	Metro Health Hospital	Wyoming	Michigan	United States	49519
547	Medini, Eitan MD (UIA Investigator)	Alexandria	Minnesota	United States	56308
548	Sanford Joe Lueken Cancer Center	Bemidji	Minnesota	United States	56601
549	Essentia Health Saint Joseph's Medical Center	Brainerd	Minnesota	United States	56401
550	Fairview Ridges Hospital	Burnsville	Minnesota	United States	55337
551	Mercy Hospital	Coon Rapids	Minnesota	United States	55433
552	Essentia Health Cancer Center	Duluth	Minnesota	United States	55805
553	Essentia Health Saint Mary's Medical Center	Duluth	Minnesota	United States	55805
554	Miller-Dwan Hospital	Duluth	Minnesota	United States	55805
555	Saint Luke's Hospital of Duluth	Duluth	Minnesota	United States	55805
556	Fairview Southdale Hospital	Edina	Minnesota	United States	55435
557	Lake Region Healthcare Corporation-Cancer Care	Fergus Falls	Minnesota	United States	56537
558	Unity Hospital	Fridley	Minnesota	United States	55432
559	Hutchinson Area Health Care	Hutchinson	Minnesota	United States	55350
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	Hennepin County Medical Center	Minneapolis	Minnesota	United States	55415
565	Health Partners Inc	Minneapolis	Minnesota	United States	55454
566	New Ulm Medical Center	New Ulm	Minnesota	United States	56073
567	North Memorial Medical Health Center	Robbinsdale	Minnesota	United States	55422
568	Coborn Cancer Center at Saint Cloud Hospital	Saint Cloud	Minnesota	United States	56303
569	Saint Cloud Hospital	Saint Cloud	Minnesota	United States	56303
570	Metro Minnesota Community Oncology Research Consortium	Saint Louis Park	Minnesota	United States	55416
571	Park Nicollet Clinic - Saint Louis Park	Saint Louis Park	Minnesota	United States	55416
572	Regions Hospital	Saint Paul	Minnesota	United States	55101
573	United Hospital	Saint Paul	Minnesota	United States	55102
574	Saint Francis Regional Medical Center	Shakopee	Minnesota	United States	55379
575	Lakeview Hospital	Stillwater	Minnesota	United States	55082
576	Ridgeview Medical Center	Waconia	Minnesota	United States	55387
577	Rice Memorial Hospital	Willmar	Minnesota	United States	56201
578	Minnesota Oncology Hematology PA-Woodbury	Woodbury	Minnesota	United States	55125
579	Gulfport Memorial Hospital	Gulfport	Mississippi	United States	39502
580	Hattiesburg Clinic - Hematology/Oncology Clinic	Hattiesburg	Mississippi	United States	39401
581	Forrest General Hospital / Cancer Center	Hattiesburg	Mississippi	United States	39404
582	University of Mississippi Medical Center	Jackson	Mississippi	United States	39216
583	Singing River Hospital	Pascagoula	Mississippi	United States	39581
584	Central Care Cancer Center - Bolivar	Bolivar	Missouri	United States	65613
585	Parkland Health Center-Bonne Terre	Bonne Terre	Missouri	United States	63628
586	Cox Cancer Center Branson	Branson	Missouri	United States	65616
587	Saint Francis Medical Center	Cape Girardeau	Missouri	United States	63703
588	Southeast Cancer Center	Cape Girardeau	Missouri	United States	63703
589	Saint Luke's Hospital	Chesterfield	Missouri	United States	63017
590	University of Missouri - Ellis Fischel	Columbia	Missouri	United States	65212
591	Centerpoint Medical Center LLC	Independence	Missouri	United States	64057
592	Capital Region Southwest Campus	Jefferson City	Missouri	United States	65109
593	Freeman Health System	Joplin	Missouri	United States	64804
594	Mercy Hospital Joplin	Joplin	Missouri	United States	64804
595	Saint Luke's Hospital of Kansas City	Kansas City	Missouri	United States	64111
596	Saint Joseph Health Center	Kansas City	Missouri	United States	64114
597	North Kansas City Hospital	Kansas City	Missouri	United States	64116
598	Heartland Hematology and Oncology Associates Incorporated	Kansas City	Missouri	United States	64118
599	Research Medical Center	Kansas City	Missouri	United States	64132
600	Saint Luke's East - Lee's Summit	Lee's Summit	Missouri	United States	64086
601	Liberty Radiation Oncology Center	Liberty	Missouri	United States	64068
602	Delbert Day Cancer Institute at PCRMC	Rolla	Missouri	United States	65401
603	Mercy Clinic-Rolla-Cancer and Hematology	Rolla	Missouri	United States	65401
604	Heartland Regional Medical Center	Saint Joseph	Missouri	United States	64506
605	Saint Joseph Oncology Inc	Saint Joseph	Missouri	United States	64507
606	Saint Louis Cancer and Breast Institute-South City	Saint Louis	Missouri	United States	63109
607	Washington University School of Medicine	Saint Louis	Missouri	United States	63110
608	Mercy Hospital South	Saint Louis	Missouri	United States	63128
609	Missouri Baptist Medical Center	Saint Louis	Missouri	United States	63131
610	Siteman Cancer Center at Christian Hospital	Saint Louis	Missouri	United States	63136
611	Comprehensive Cancer Care PC	Saint Louis	Missouri	United States	63141
612	Mercy Hospital Saint Louis	Saint Louis	Missouri	United States	63141
613	Saint Louis-Cape Girardeau CCOP	Saint Louis	Missouri	United States	63141
614	Sainte Genevieve County Memorial Hospital	Sainte Genevieve	Missouri	United States	63670
615	Cancer Research for the Ozarks NCORP	Springfield	Missouri	United States	65804
616	Mercy Hospital Springfield	Springfield	Missouri	United States	65804
617	CoxHealth South Hospital	Springfield	Missouri	United States	65807
618	Missouri Baptist Sullivan Hospital	Sullivan	Missouri	United States	63080
619	Missouri Baptist Outpatient Center-Sunset Hills	Sunset Hills	Missouri	United States	63127
620	Billings Clinic Cancer Center	Billings	Montana	United States	59101
621	Saint Vincent Healthcare	Billings	Montana	United States	59101
622	Montana Cancer Consortium NCORP	Billings	Montana	United States	59102
623	Saint Vincent Frontier Cancer Center	Billings	Montana	United States	59102
624	Bozeman Deaconess Hospital	Bozeman	Montana	United States	59715
625	Saint James Community Hospital and Cancer Treatment Center	Butte	Montana	United States	59701
626	Benefis Healthcare- Sletten Cancer Institute	Great Falls	Montana	United States	59405
627	Great Falls Clinic	Great Falls	Montana	United States	59405
628	Northern Montana Hospital	Havre	Montana	United States	59501
629	Saint Peter's Community Hospital	Helena	Montana	United States	59601
630	Glacier Oncology PLLC	Kalispell	Montana	United States	59901
631	Kalispell Medical Oncology	Kalispell	Montana	United States	59901
632	Kalispell Regional Medical Center	Kalispell	Montana	United States	59901
633	Montana Cancer Specialists	Missoula	Montana	United States	59802
634	Saint Patrick Hospital - Community Hospital	Missoula	Montana	United States	59802
635	CHI Health Saint Francis	Grand Island	Nebraska	United States	68803
636	Heartland Hematology and Oncology	Kearney	Nebraska	United States	68845
637	CHI Health Good Samaritan	Kearney	Nebraska	United States	68847
638	Nebraska Hematology and Oncology	Lincoln	Nebraska	United States	68506
639	Nebraska Cancer Research Center	Lincoln	Nebraska	United States	68510
640	Saint Elizabeth Regional Medical Center	Lincoln	Nebraska	United States	68510
641	Southeast Nebraska Cancer Center - 68th Street Place	Lincoln	Nebraska	United States	68516
642	Faith Regional Health Services Carson Cancer Center	Norfolk	Nebraska	United States	68701
643	Great Plains Health Callahan Cancer Center	North Platte	Nebraska	United States	69101
644	Cancer Alliance of Nebraska	Omaha	Nebraska	United States	68106
645	Missouri Valley Cancer Consortium	Omaha	Nebraska	United States	68106
646	Nebraska Methodist Hospital	Omaha	Nebraska	United States	68114
647	Alegent Health Immanuel Medical Center	Omaha	Nebraska	United States	68122
648	Hematology and Oncology Consultants PC	Omaha	Nebraska	United States	68122
649	Alegent Health Bergan Mercy Medical Center	Omaha	Nebraska	United States	68124
650	Nebraska Cancer Specialists - Omaha	Omaha	Nebraska	United States	68124
651	Alegent Health Lakeside Hospital	Omaha	Nebraska	United States	68130
652	Oncology Hematology West PC	Omaha	Nebraska	United States	68130
653	Creighton University Medical Center	Omaha	Nebraska	United States	68131
654	University of Nebraska Medical Center	Omaha	Nebraska	United States	68198
655	Midlands Community Hospital	Papillion	Nebraska	United States	68046
656	Regional West Medical Center Cancer Center	Scottsbluff	Nebraska	United States	69361
657	Cancer and Blood Specialists-Henderson	Henderson	Nevada	United States	89052
658	Comprehensive Cancer Centers of Nevada - Henderson	Henderson	Nevada	United States	89052
659	Las Vegas Cancer Center-Henderson	Henderson	Nevada	United States	89052
660	Comprehensive Cancer Centers of Nevada-Southeast Henderson	Henderson	Nevada	United States	89074
661	GenesisCare USA - Henderson	Henderson	Nevada	United States	89074
662	University Medical Center of Southern Nevada	Las Vegas	Nevada	United States	89102
663	Cancer and Blood Specialists-Shadow	Las Vegas	Nevada	United States	89106
664	Radiation Oncology Centers of Nevada Central	Las Vegas	Nevada	United States	89106
665	GenesisCare USA - Las Vegas	Las Vegas	Nevada	United States	89109
666	HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway	Las Vegas	Nevada	United States	89109
667	HealthCare Partners Medical Group Oncology/Hematology-San Martin	Las Vegas	Nevada	United States	89113
668	Radiation Oncology Centers of Nevada Southeast	Las Vegas	Nevada	United States	89119
669	Cancer Therapy and Integrative Medicine	Las Vegas	Nevada	United States	89121
670	Cancer and Blood Specialists-Tenaya	Las Vegas	Nevada	United States	89128
671	Comprehensive Cancer Centers of Nevada - Northwest	Las Vegas	Nevada	United States	89128
672	GenesisCare USA - Vegas Tenaya	Las Vegas	Nevada	United States	89128
673	HealthCare Partners Medical Group Oncology/Hematology-Tenaya	Las Vegas	Nevada	United States	89128
674	Comprehensive Cancer Centers of Nevada-Summerlin	Las Vegas	Nevada	United States	89144
675	Summerlin Hospital Medical Center	Las Vegas	Nevada	United States	89144
676	Las Vegas Cancer Center-Medical Center	Las Vegas	Nevada	United States	89148-2405
677	Comprehensive Cancer Centers of Nevada	Las Vegas	Nevada	United States	89148
678	GenesisCare USA - Fort Apache	Las Vegas	Nevada	United States	89148
679	OptumCare Cancer Care at Fort Apache	Las Vegas	Nevada	United States	89148
680	HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills	Las Vegas	Nevada	United States	89149
681	Comprehensive Cancer Centers of Nevada - Central Valley	Las Vegas	Nevada	United States	89169
682	Nevada Cancer Research Foundation NCORP	Las Vegas	Nevada	United States	89169
683	New Hampshire Oncology Hematology PA-Concord	Concord	New Hampshire	United States	03301
684	Exeter Hospital	Exeter	New Hampshire	United States	03833
685	Cheshire Medical Center-Dartmouth-Hitchcock Keene	Keene	New Hampshire	United States	03431
686	LRGHealthcare-Lakes Region General Hospital	Laconia	New Hampshire	United States	03246
687	Dartmouth Hitchcock Medical Center	Lebanon	New Hampshire	United States	03756
688	Norris Cotton Cancer Center-Manchester	Manchester	New Hampshire	United States	03102
689	Solinsky Center for Cancer Care	Manchester	New Hampshire	United States	03103
690	Norris Cotton Cancer Center-Nashua	Nashua	New Hampshire	United States	03063
691	Cooper Hospital University Medical Center	Camden	New Jersey	United States	08103
692	Hunterdon Medical Center	Flemington	New Jersey	United States	08822
693	Saint Barnabas Medical Center	Livingston	New Jersey	United States	07039
694	Monmouth Medical Center	Long Branch	New Jersey	United States	07740
695	Morristown Medical Center	Morristown	New Jersey	United States	07960
696	Virtua Memorial	Mount Holly	New Jersey	United States	08060
697	Inspira Medical Center Mullica Hill	Mullica Hill	New Jersey	United States	08062
698	Jersey Shore Medical Center	Neptune	New Jersey	United States	07753
699	Rutgers New Jersey Medical School	Newark	New Jersey	United States	07101
700	Newark Beth Israel Medical Center	Newark	New Jersey	United States	07112
701	Saint Joseph's Regional Medical Center	Paterson	New Jersey	United States	07503
702	Sidney Kimmel Cancer Center Washington Township	Sewell	New Jersey	United States	08080
703	Robert Wood Johnson University Hospital Somerset	Somerville	New Jersey	United States	08876
704	Sparta Cancer Treatment Center	Sparta	New Jersey	United States	07871
705	Overlook Hospital	Summit	New Jersey	United States	07902
706	Community Medical Center	Toms River	New Jersey	United States	08755
707	Inspira Medical Center Vineland	Vineland	New Jersey	United States	08360
708	MD Anderson Cancer Center at Cooper-Voorhees	Voorhees	New Jersey	United States	08043
709	Virtua Voorhees	Voorhees	New Jersey	United States	08043
710	Lovelace Medical Center-Saint Joseph Square	Albuquerque	New Mexico	United States	87102
711	University of New Mexico Cancer Center	Albuquerque	New Mexico	United States	87102
712	Hematology Oncology Associates	Albuquerque	New Mexico	United States	87106
713	Presbyterian Kaseman Hospital	Albuquerque	New Mexico	United States	87110
714	Memorial Medical Center - Las Cruces	Las Cruces	New Mexico	United States	88011
715	New York Oncology Hematology PC - Albany	Albany	New York	United States	12206
716	New York Oncology Hematology PC - Albany Medical Center	Albany	New York	United States	12208
717	Saint Peter's Health Partners	Albany	New York	United States	12208
718	New York Oncology Hematology PC - Amsterdam	Amsterdam	New York	United States	12010
719	Hematology Oncology Associates of Central New York-Auburn	Auburn	New York	United States	13021
720	Montefiore Medical Center-Weiler Hospital	Bronx	New York	United States	10461
721	Montefiore Medical Center - Moses Campus	Bronx	New York	United States	10467
722	Coney Island Hospital	Brooklyn	New York	United States	11235
723	Roswell Park Cancer Institute	Buffalo	New York	United States	14263
724	New York Oncology Hematology PC - Clifton Park	Clifton Park	New York	United States	12065
725	Mary Imogene Bassett Hospital	Cooperstown	New York	United States	13326
726	Hematology Oncology Associates of Central New York-East Syracuse	East Syracuse	New York	United States	13057
727	Elmhurst Hospital Center	Elmhurst	New York	United States	11373
728	Arnot Ogden Medical Center/Falck Cancer Center	Elmira	New York	United States	14905
729	Glens Falls Hospital	Glens Falls	New York	United States	12801
730	New York Oncology Hematology PC-Hudson	Hudson	New York	United States	12534
731	Queens Hospital Center	Jamaica	New York	United States	11432
732	Northwell Health NCORP	Lake Success	New York	United States	11042
733	Northwell Health/Center for Advanced Medicine	Lake Success	New York	United States	11042
734	North Shore University Hospital	Manhasset	New York	United States	11030
735	Garnet Health Medical Center	Middletown	New York	United States	10940
736	NYU Winthrop Hospital	Mineola	New York	United States	11501
737	Mount Kisco Medical Group at Northern Westchester Hospital	Mount Kisco	New York	United States	10549-3417
738	Long Island Jewish Medical Center	New Hyde Park	New York	United States	11040
739	Mount Sinai Union Square	New York	New York	United States	10003
740	Laura and Isaac Perlmutter Cancer Center at NYU Langone	New York	New York	United States	10016
741	Mount Sinai West	New York	New York	United States	10019
742	Mount Sinai Hospital	New York	New York	United States	10029
743	NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center	New York	New York	United States	10032
744	Champlain Valley Physicians Hospital Medical Center	Plattsburgh	New York	United States	12901
745	MidHudson Regional Hospital of Westchester Medical Center	Poughkeepsie	New York	United States	12601
746	Vassar Brothers Medical Center	Poughkeepsie	New York	United States	12601
747	Highland Hospital	Rochester	New York	United States	14620
748	Interlakes Foundation Inc-Rochester	Rochester	New York	United States	14623
749	University of Rochester	Rochester	New York	United States	14642
750	Staten Island University Hospital	Staten Island	New York	United States	10305
751	Stony Brook University Medical Center	Stony Brook	New York	United States	11794
752	State University of New York Upstate Medical University	Syracuse	New York	United States	13210
753	Hematology Oncology Associates of Central New York-Onondaga Hill	Syracuse	New York	United States	13215
754	New York Oncology Hematology PC - Troy	Troy	New York	United States	12180
755	Faxton-Saint Luke's Healthcare	Utica	New York	United States	13502
756	Dickstein Cancer Treatment Center	White Plains	New York	United States	10601
757	Randolph Hospital	Asheboro	North Carolina	United States	27203
758	Mission Hospital	Asheville	North Carolina	United States	28801
759	Mountain Radiation Oncology PA	Asheville	North Carolina	United States	28801
760	AdventHealth Infusion Center Asheville	Asheville	North Carolina	United States	28803
761	Messino Cancer Centers	Asheville	North Carolina	United States	28806
762	Hope Women's Cancer Centers-Asheville	Asheville	North Carolina	United States	28816
763	Transylvania Regional Hospital	Brevard	North Carolina	United States	28712
764	Cone Health Cancer Center at Alamance Regional	Burlington	North Carolina	United States	27215
765	UNC Lineberger Comprehensive Cancer Center	Chapel Hill	North Carolina	United States	27599
766	Carolinas Medical Center/Levine Cancer Institute	Charlotte	North Carolina	United States	28203
767	Novant Health Presbyterian Medical Center	Charlotte	North Carolina	United States	28204
768	Novant Health Carolina Surgical - Randolph	Charlotte	North Carolina	United States	28207
769	Oncology Specialists of Charlotte	Charlotte	North Carolina	United States	28207
770	Southern Oncology Specialists-Charlotte	Charlotte	North Carolina	United States	28262
771	Sampson Radiation Oncology	Clinton	North Carolina	United States	28328
772	Southeastern Medical Oncology Center-Clinton	Clinton	North Carolina	United States	28328
773	Atrium Health Cabarrus/LCI-Concord	Concord	North Carolina	United States	28025
774	Duke University Medical Center	Durham	North Carolina	United States	27710
775	Cape Fear Valley Health System	Fayetteville	North Carolina	United States	28304
776	Angel Medical Center	Franklin	North Carolina	United States	28734
777	CaroMont Regional Medical Center	Gastonia	North Carolina	United States	28054
778	Gaston Hematology and Oncology Associates	Gastonia	North Carolina	United States	28054
779	Southeastern Medical Oncology Center-Goldsboro	Goldsboro	North Carolina	United States	27534
780	Wayne Memorial Hospital	Goldsboro	North Carolina	United States	27534
781	Wayne Radiation Oncology	Goldsboro	North Carolina	United States	27534
782	Cone Health Cancer Center	Greensboro	North Carolina	United States	27403
783	Hendersonville Hematology and Oncology at Pardee	Hendersonville	North Carolina	United States	28791
784	Margaret R Pardee Memorial Hospital	Hendersonville	North Carolina	United States	28791
785	AdventHealth Hendersonville	Hendersonville	North Carolina	United States	28792
786	Maria Parham Hospital	Henderson	North Carolina	United States	27536
787	Novant Health Cancer Institute - Huntersville	Huntersville	North Carolina	United States	28078
788	Southern Oncology Specialists-Huntersville	Huntersville	North Carolina	United States	28078
789	Onslow Memorial Hospital	Jacksonville	North Carolina	United States	28546
790	Southeastern Medical Oncology Center-Jacksonville	Jacksonville	North Carolina	United States	28546
791	Novant Health Cancer Institute - Kernersville	Kernersville	North Carolina	United States	27284
792	Vidant Oncology-Kinston	Kinston	North Carolina	United States	28501
793	Scotland Memorial Hospital-Laurinburg Cancer Center	Laurinburg	North Carolina	United States	28352
794	Southeastern Regional Medical Center	Lumberton	North Carolina	United States	28358
795	Mission Hospital McDowell	Marion	North Carolina	United States	28752
796	Matthews Radiation Oncology Center	Matthews	North Carolina	United States	28105
797	Novant Health Cancer Institute - Matthews	Matthews	North Carolina	United States	28105
798	Cone Heath Cancer Center at Mebane	Mebane	North Carolina	United States	27302
799	Atrium Health Union/LCI-Union	Monroe	North Carolina	United States	28112
800	Novant Health Cancer Institute - Mooresville	Mooresville	North Carolina	United States	28117
801	Novant Health Cancer Institute - Mount Airy	Mount Airy	North Carolina	United States	27030
802	Granville Medical Center	Oxford	North Carolina	United States	27565
803	FirstHealth of the Carolinas-Moore Regional Hospital	Pinehurst	North Carolina	United States	28374
804	UNC Rex Cancer Center	Raleigh	North Carolina	United States	27607
805	Duke Raleigh Hospital	Raleigh	North Carolina	United States	27609
806	Rex Cancer Center of Wakefield	Raleigh	North Carolina	United States	27614
807	Annie Penn Memorial Hospital	Reidsville	North Carolina	United States	27320
808	Nash General Hospital	Rocky Mount	North Carolina	United States	27804
809	Person Memorial Hospital	Roxboro	North Carolina	United States	27573
810	Rutherford Hospital	Rutherfordton	North Carolina	United States	28139
811	Atrium Health Cleveland/LCI-Cleveland	Shelby	North Carolina	United States	28150
812	Cleveland Hematology and Oncology Associates PC	Shelby	North Carolina	United States	28150
813	Johnston Memorial Hospital	Smithfield	North Carolina	United States	27577
814	Blue Ridge Regional Hospital	Spruce Pine	North Carolina	United States	28777
815	Novant Health Cancer Institute - Statesville	Statesville	North Carolina	United States	28625
816	Iredell Memorial Hospital	Statesville	North Carolina	United States	28677
817	Novant Health Cancer Institute - Thomasville	Thomasville	North Carolina	United States	27360
818	Marion L Shepard Cancer Center at Vidant Beaufort Hospital	Washington	North Carolina	United States	27889
819	Novant Health Cancer Institute - Wilkesboro	Wilkesboro	North Carolina	United States	28659
820	Novant Health Forsyth Medical Center	Winston-Salem	North Carolina	United States	27103
821	Novant Health Oncology Specialists	Winston-Salem	North Carolina	United States	27103
822	Winston-Salem Health Care	Winston-Salem	North Carolina	United States	27103
823	Southeast Clinical Oncology Research Consortium NCORP	Winston-Salem	North Carolina	United States	27104
824	Mid Dakota Clinic	Bismarck	North Dakota	United States	58501
825	Saint Alexius Medical Center	Bismarck	North Dakota	United States	58501
826	Sanford Bismarck Medical Center	Bismarck	North Dakota	United States	58501
827	Essentia Health Cancer Center-South University Clinic	Fargo	North Dakota	United States	58103
828	Sanford Broadway Medical Center	Fargo	North Dakota	United States	58122
829	Sanford Clinic North-Fargo	Fargo	North Dakota	United States	58122
830	Sanford Roger Maris Cancer Center	Fargo	North Dakota	United States	58122
831	Altru Cancer Center	Grand Forks	North Dakota	United States	58201
832	Trinity Cancer Care Center	Minot	North Dakota	United States	58701
833	Summa Health System - Akron Campus	Akron	Ohio	United States	44304
834	Summa Health System - Barberton Campus	Barberton	Ohio	United States	44203
835	Cleveland Clinic Cancer Center Beachwood	Beachwood	Ohio	United States	44122
836	UHHS-Chagrin Highlands Medical Center	Beachwood	Ohio	United States	44122
837	Mary Rutan Hospital	Bellefontaine	Ohio	United States	43311
838	Strecker Cancer Center-Belpre	Belpre	Ohio	United States	45714
839	Toledo Clinic Cancer Centers-Bowling Green	Bowling Green	Ohio	United States	43402
840	Aultman Health Foundation	Canton	Ohio	United States	44710
841	Miami Valley Hospital South	Centerville	Ohio	United States	45459
842	Geauga Hospital	Chardon	Ohio	United States	44024
843	Adena Regional Medical Center	Chillicothe	Ohio	United States	45601
844	Oncology Hematology Care Inc-Eden Park	Cincinnati	Ohio	United States	45202
845	Oncology Hematology Care Inc-Mercy West	Cincinnati	Ohio	United States	45211
846	The Christ Hospital	Cincinnati	Ohio	United States	45219
847	University of Cincinnati Cancer Center-UC Medical Center	Cincinnati	Ohio	United States	45219
848	Good Samaritan Hospital - Cincinnati	Cincinnati	Ohio	United States	45220
849	Oncology Hematology Care Inc-Anderson	Cincinnati	Ohio	United States	45230
850	Oncology Hematology Care Inc-Kenwood	Cincinnati	Ohio	United States	45236
851	Bethesda North Hospital	Cincinnati	Ohio	United States	45242
852	Oncology Hematology Care Inc-Blue Ash	Cincinnati	Ohio	United States	45242
853	TriHealth Cancer Institute-Westside	Cincinnati	Ohio	United States	45247
854	TriHealth Cancer Institute-Anderson	Cincinnati	Ohio	United States	45255
855	Case Western Reserve University	Cleveland	Ohio	United States	44106
856	MetroHealth Medical Center	Cleveland	Ohio	United States	44109
857	Cleveland Clinic Cancer Center/Fairview Hospital	Cleveland	Ohio	United States	44111
858	Cleveland Clinic Foundation	Cleveland	Ohio	United States	44195
859	North Coast Cancer Care-Clyde	Clyde	Ohio	United States	43410
860	Ohio State University Comprehensive Cancer Center	Columbus	Ohio	United States	43210
861	Mount Carmel East Hospital	Columbus	Ohio	United States	43213
862	Columbus Oncology and Hematology Associates Inc	Columbus	Ohio	United States	43214
863	Riverside Methodist Hospital	Columbus	Ohio	United States	43214
864	Columbus NCI Community Oncology Research Program	Columbus	Ohio	United States	43215
865	Grant Medical Center	Columbus	Ohio	United States	43215
866	The Mark H Zangmeister Center	Columbus	Ohio	United States	43219
867	Mount Carmel Health Center West	Columbus	Ohio	United States	43222
868	Doctors Hospital	Columbus	Ohio	United States	43228
869	Grandview Hospital	Dayton	Ohio	United States	45405
870	Good Samaritan Hospital - Dayton	Dayton	Ohio	United States	45406
871	Miami Valley Hospital	Dayton	Ohio	United States	45409
872	Miami Valley Hospital North	Dayton	Ohio	United States	45415
873	Dayton NCI Community Oncology Research Program	Dayton	Ohio	United States	45459
874	Delaware Health Center-Grady Cancer Center	Delaware	Ohio	United States	43015
875	Delaware Radiation Oncology	Delaware	Ohio	United States	43015
876	Grady Memorial Hospital	Delaware	Ohio	United States	43015
877	Hematology Oncology Center Incorporated	Elyria	Ohio	United States	44035
878	Mercy Cancer Center-Elyria	Elyria	Ohio	United States	44035
879	Oncology Hematology Care Inc-Healthplex	Fairfield	Ohio	United States	45014
880	Blanchard Valley Hospital	Findlay	Ohio	United States	45840
881	Atrium Medical Center-Middletown Regional Hospital	Franklin	Ohio	United States	45005-1066
882	Wayne Hospital	Greenville	Ohio	United States	45331
883	Cleveland Clinic Cancer Center Independence	Independence	Ohio	United States	44131
884	Kettering Medical Center	Kettering	Ohio	United States	45429
885	Fairfield Medical Center	Lancaster	Ohio	United States	43130
886	Lancaster Radiation Oncology	Lancaster	Ohio	United States	43130
887	Saint Rita's Medical Center	Lima	Ohio	United States	45801
888	Lima Memorial Hospital	Lima	Ohio	United States	45804
889	OhioHealth Mansfield Hospital	Mansfield	Ohio	United States	44903
890	Cleveland Clinic Cancer Center Mansfield	Mansfield	Ohio	United States	44906
891	Marietta Memorial Hospital	Marietta	Ohio	United States	45750
892	Saint Luke's Hospital	Maumee	Ohio	United States	43537
893	Toledo Clinic Cancer Centers-Maumee	Maumee	Ohio	United States	43537
894	Toledo Radiation Oncology at Northwest Ohio Onocolgy Center	Maumee	Ohio	United States	43537
895	Hillcrest Hospital Cancer Center	Mayfield Heights	Ohio	United States	44124
896	UH Seidman Cancer Center at Landerbrook Health Center	Mayfield Heights	Ohio	United States	44124
897	UH Seidman Cancer Center at Lake Health Mentor Campus	Mentor	Ohio	United States	44060
898	UH Seidman Cancer Center at Southwest General Hospital	Middleburg Heights	Ohio	United States	44130
899	Knox Community Hospital	Mount Vernon	Ohio	United States	43050
900	Licking Memorial Hospital	Newark	Ohio	United States	43055
901	Newark Radiation Oncology	Newark	Ohio	United States	43055
902	Fisher-Titus Medical Center	Norwalk	Ohio	United States	44857
903	Saint Charles Hospital	Oregon	Ohio	United States	43616
904	Toledo Clinic Cancer Centers-Oregon	Oregon	Ohio	United States	43616
905	Southern Ohio Medical Center	Portsmouth	Ohio	United States	45662
906	North Coast Cancer Care	Sandusky	Ohio	United States	44870
907	UH Seidman Cancer Center at Firelands Regional Medical Center	Sandusky	Ohio	United States	44870
908	Springfield Regional Medical Center	Springfield	Ohio	United States	45505
909	Trinity's Tony Teramana Cancer Center	Steubenville	Ohio	United States	43952
910	Cleveland Clinic Cancer Center Strongsville	Strongsville	Ohio	United States	44136
911	ProMedica Flower Hospital	Sylvania	Ohio	United States	43560
912	Mercy Hospital of Tiffin	Tiffin	Ohio	United States	44883
913	ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital	Toledo	Ohio	United States	43606
914	Saint Vincent Mercy Medical Center	Toledo	Ohio	United States	43608
915	University of Toledo	Toledo	Ohio	United States	43614
916	Toledo Community Hospital Oncology Program CCOP	Toledo	Ohio	United States	43617
917	Mercy Health - Saint Anne Hospital	Toledo	Ohio	United States	43623
918	Toledo Clinic Cancer Centers-Toledo	Toledo	Ohio	United States	43623
919	Upper Valley Medical Center	Troy	Ohio	United States	45373
920	University Hospitals Sharon Health Center	Wadsworth	Ohio	United States	44281
921	South Pointe Hospital	Warrensville Heights	Ohio	United States	44122
922	Fulton County Health Center	Wauseon	Ohio	United States	43567
923	University of Cincinnati Cancer Center-West Chester	West Chester	Ohio	United States	45069
924	Saint Ann's Hospital	Westerville	Ohio	United States	43081
925	UH Seidman Cancer Center at Saint John Medical Center	Westlake	Ohio	United States	44145
926	Clinton Memorial Hospital	Wilmington	Ohio	United States	45177
927	Cleveland Clinic Wooster Family Health and Surgery Center	Wooster	Ohio	United States	44691
928	Wright-Patterson Medical Center	Wright-Patterson Air Force Base	Ohio	United States	45433
929	Greene Memorial Hospital	Xenia	Ohio	United States	45385
930	Genesis Healthcare System Cancer Care Center	Zanesville	Ohio	United States	43701
931	Cancer Centers of Southwest Oklahoma Research	Lawton	Oklahoma	United States	73505
932	University of Oklahoma Health Sciences Center	Oklahoma City	Oklahoma	United States	73104
933	Integris Southwest Medical Center	Oklahoma City	Oklahoma	United States	73109
934	Integris Cancer Institute of Oklahoma	Oklahoma City	Oklahoma	United States	73142
935	Natalie Warren Bryant Cancer Center at Saint Francis	Tulsa	Oklahoma	United States	74136
936	Surgical Associates Inc	Tulsa	Oklahoma	United States	74136
937	Oklahoma Cancer Specialists and Research Institute-Tulsa	Tulsa	Oklahoma	United States	74146
938	Warren Clinic Oncology-Tulsa	Tulsa	Oklahoma	United States	74146
939	Saint Charles Health System	Bend	Oregon	United States	97701
940	Clackamas Radiation Oncology Center	Clackamas	Oregon	United States	97015
941	Providence Cancer Institute Clackamas Clinic	Clackamas	Oregon	United States	97015
942	Three Rivers Community Hospital	Grants Pass	Oregon	United States	97527
943	Legacy Mount Hood Medical Center	Gresham	Oregon	United States	97030
944	Asante Health System	Medford	Oregon	United States	97504
945	Providence Medford Medical Center	Medford	Oregon	United States	97504
946	Rogue Valley Medical Center	Medford	Oregon	United States	97504
947	Providence Milwaukie Hospital	Milwaukie	Oregon	United States	97222
948	Providence Newberg Medical Center	Newberg	Oregon	United States	97132
949	Providence Willamette Falls Medical Center	Oregon City	Oregon	United States	97045
950	Legacy Good Samaritan Hospital and Medical Center	Portland	Oregon	United States	97210
951	Providence Portland Medical Center	Portland	Oregon	United States	97213
952	Providence Saint Vincent Medical Center	Portland	Oregon	United States	97225
953	Kaiser Permanente Northwest	Portland	Oregon	United States	97227
954	Legacy Emanuel Hospital and Health Center	Portland	Oregon	United States	97227
955	Salem Hospital	Salem	Oregon	United States	97301
956	Mid-Columbia Medical Center/Celilo Cancer Center	The Dalles	Oregon	United States	97058
957	Legacy Meridian Park Hospital	Tualatin	Oregon	United States	97062
958	Jefferson Abington Hospital	Abington	Pennsylvania	United States	19001
959	Lehigh Valley Hospital-Cedar Crest	Allentown	Pennsylvania	United States	18103
960	UPMC-Heritage Valley Health System Beaver	Beaver	Pennsylvania	United States	15009
961	Lehigh Valley Hospital - Muhlenberg	Bethlehem	Pennsylvania	United States	18017
962	Bryn Mawr Hospital	Bryn Mawr	Pennsylvania	United States	19010
963	Butler Memorial Hospital	Butler	Pennsylvania	United States	16001
964	Geisinger Medical Center	Danville	Pennsylvania	United States	17822
965	Mercy Fitzgerald Hospital	Darby	Pennsylvania	United States	19023-1291
966	Doylestown Hospital	Doylestown	Pennsylvania	United States	18901
967	Delaware County Memorial Hospital	Drexel Hill	Pennsylvania	United States	19026
968	Oncology Hematology Associates of Northern Pennsylvania	DuBois	Pennsylvania	United States	15801
969	Einstein Medical Center Montgomery	East Norriton	Pennsylvania	United States	19403
970	Pocono Medical Center	East Stroudsburg	Pennsylvania	United States	18301
971	Easton Hospital	Easton	Pennsylvania	United States	18042
972	Ephrata Cancer Center	Ephrata	Pennsylvania	United States	17522
973	Ephrata Community Hospital	Ephrata	Pennsylvania	United States	17522
974	Adams Cancer Center	Gettysburg	Pennsylvania	United States	17325
975	UPMC Cancer Centers - Arnold Palmer Pavilion	Greensburg	Pennsylvania	United States	15601
976	Cherry Tree Cancer Center	Hanover	Pennsylvania	United States	17331
977	UPMC Pinnacle Cancer Center/Community Osteopathic Campus	Harrisburg	Pennsylvania	United States	17109
978	Geisinger Medical Center-Cancer Center Hazleton	Hazleton	Pennsylvania	United States	18201
979	Penn State Milton S Hershey Medical Center	Hershey	Pennsylvania	United States	17033-0850
980	UPMC-Johnstown/John P. Murtha Regional Cancer Center	Johnstown	Pennsylvania	United States	15901
981	Saint Mary Medical and Regional Cancer Center	Langhorne	Pennsylvania	United States	19047
982	Geisinger Medical Oncology-Lewisburg	Lewisburg	Pennsylvania	United States	17837
983	Lewistown Hospital	Lewistown	Pennsylvania	United States	17044
984	UPMC Cancer Center at UPMC McKeesport	McKeesport	Pennsylvania	United States	15132
985	Holy Redeemer Hospital and Medical Center	Meadowbrook	Pennsylvania	United States	19046
986	Riddle Memorial Hospital	Media	Pennsylvania	United States	19063
987	Forbes Hospital	Monroeville	Pennsylvania	United States	15146
988	UPMC-Coraopolis/Heritage Valley Radiation Oncology	Moon	Pennsylvania	United States	15108
989	Allegheny Valley Hospital	Natrona Heights	Pennsylvania	United States	15065
990	Suburban Community Hospital and Cancer Center	Norristown	Pennsylvania	United States	19401
991	Paoli Memorial Hospital	Paoli	Pennsylvania	United States	19301
992	Thomas Jefferson University Hospital	Philadelphia	Pennsylvania	United States	19107
993	Temple University Hospital	Philadelphia	Pennsylvania	United States	19140
994	Einstein Medical Center Philadelphia	Philadelphia	Pennsylvania	United States	19141
995	Mercy Hospital of Philadelphia	Philadelphia	Pennsylvania	United States	19143
996	Phoenixville Hospital	Phoenixville	Pennsylvania	United States	19460
997	Allegheny General Hospital	Pittsburgh	Pennsylvania	United States	15212
998	UPMC-Magee Womens Hospital	Pittsburgh	Pennsylvania	United States	15213
999	UPMC-Presbyterian Hospital	Pittsburgh	Pennsylvania	United States	15213
1000	UPMC-Saint Margaret	Pittsburgh	Pennsylvania	United States	15215
1001	West Penn Hospital	Pittsburgh	Pennsylvania	United States	15224
1002	University of Pittsburgh Cancer Institute (UPCI)	Pittsburgh	Pennsylvania	United States	15232
1003	UPMC-Shadyside Hospital	Pittsburgh	Pennsylvania	United States	15232
1004	UPMC Jefferson Regional Radiation Oncology	Pittsburgh	Pennsylvania	United States	15236
1005	UPMC-Passavant Hospital	Pittsburgh	Pennsylvania	United States	15237
1006	UPMC-Saint Clair Hospital Cancer Center	Pittsburgh	Pennsylvania	United States	15243
1007	Pottstown Hospital	Pottstown	Pennsylvania	United States	19464
1008	Geisinger Cancer Services-Pottsville	Pottsville	Pennsylvania	United States	17901
1009	Penn State Health Saint Joseph Medical Center	Reading	Pennsylvania	United States	19605
1010	Guthrie Medical Group PC-Robert Packer Hospital	Sayre	Pennsylvania	United States	18840
1011	Mercy Hospital	Scranton	Pennsylvania	United States	18501
1012	Hematology and Oncology Associates of North East Pennsylvania	Scranton	Pennsylvania	United States	18508
1013	Scranton Hematology Oncology	Scranton	Pennsylvania	United States	18510
1014	Grand View Hospital	Sellersville	Pennsylvania	United States	18960
1015	UPMC Cancer Center at UPMC Northwest	Seneca	Pennsylvania	United States	16346
1016	Geisinger Medical Group	State College	Pennsylvania	United States	16801
1017	Mount Nittany Medical Center	State College	Pennsylvania	United States	16803
1018	UPMC Uniontown Hospital Radiation Oncology	Uniontown	Pennsylvania	United States	15401
1019	Associates In Hematology Oncology PC-Upland	Upland	Pennsylvania	United States	19013
1020	UPMC Washington Hospital Radiation Oncology	Washington	Pennsylvania	United States	15301
1021	Chester County Hospital	West Chester	Pennsylvania	United States	19380
1022	Reading Hospital	West Reading	Pennsylvania	United States	19611
1023	Geisinger Wyoming Valley/Henry Cancer Center	Wilkes-Barre	Pennsylvania	United States	18711
1024	UPMC Susquehanna	Williamsport	Pennsylvania	United States	17701
1025	Lankenau Medical Center	Wynnewood	Pennsylvania	United States	19096
1026	Main Line Health NCORP	Wynnewood	Pennsylvania	United States	19096
1027	WellSpan Health-York Hospital	York	Pennsylvania	United States	17403
1028	Rhode Island Hospital	Providence	Rhode Island	United States	02903
1029	Women and Infants Hospital	Providence	Rhode Island	United States	02905
1030	Miriam Hospital	Providence	Rhode Island	United States	02906
1031	Kent Hospital	Warwick	Rhode Island	United States	02886
1032	AnMed Health Cancer Center	Anderson	South Carolina	United States	29621
1033	AnMed Health Hospital	Anderson	South Carolina	United States	29621
1034	Beaufort Memorial Hospital	Beaufort	South Carolina	United States	29902
1035	Prisma Health Cancer Institute - Spartanburg	Boiling Springs	South Carolina	United States	29316
1036	Roper Hospital	Charleston	South Carolina	United States	29401
1037	Charleston Oncology - Roper	Charleston	South Carolina	United States	29403
1038	Lowcountry Hematology Oncology PA-North Charleston	Charleston	South Carolina	United States	29406
1039	Charleston Oncology - Saint Francis	Charleston	South Carolina	United States	29414
1040	Lowcountry Hematology Oncology PA-West Ashley	Charleston	South Carolina	United States	29414
1041	Medical University of South Carolina	Charleston	South Carolina	United States	29425
1042	Tidelands Georgetown Memorial Hospital	Georgetown	South Carolina	United States	29440
1043	Saint Francis Hospital	Greenville	South Carolina	United States	29601
1044	Prisma Health Cancer Institute - Butternut	Greenville	South Carolina	United States	29605
1045	Prisma Health Cancer Institute - Faris	Greenville	South Carolina	United States	29605
1046	Prisma Health Greenville Memorial Hospital	Greenville	South Carolina	United States	29605
1047	Saint Francis Cancer Center	Greenville	South Carolina	United States	29607
1048	Prisma Health Cancer Institute - Eastside	Greenville	South Carolina	United States	29615
1049	Self Regional Healthcare	Greenwood	South Carolina	United States	29646
1050	Prisma Health Cancer Institute - Greer	Greer	South Carolina	United States	29650
1051	Gibbs Cancer Center-Pelham	Greer	South Carolina	United States	29651
1052	Carolina Blood and Cancer Care Associates PA-Lancaster	Lancaster	South Carolina	United States	29720
1053	Lowcountry Hematology Oncology PA-Mount Pleasant	Mount Pleasant	South Carolina	United States	29464
1054	Carolina Blood and Cancer Care Associates PA	Rock Hill	South Carolina	United States	29732
1055	Levine Cancer Institute-Rock Hill	Rock Hill	South Carolina	United States	29732
1056	Prisma Health Cancer Institute - Seneca	Seneca	South Carolina	United States	29672
1057	Spartanburg Medical Center	Spartanburg	South Carolina	United States	29303
1058	Avera Cancer Institute-Aberdeen	Aberdeen	South Dakota	United States	57401
1059	Rapid City Regional Hospital	Rapid City	South Dakota	United States	57701
1060	Sanford Cancer Center Oncology Clinic	Sioux Falls	South Dakota	United States	57104
1061	Avera Cancer Institute	Sioux Falls	South Dakota	United States	57105
1062	Medical X-Ray Center	Sioux Falls	South Dakota	United States	57105
1063	Sanford USD Medical Center - Sioux Falls	Sioux Falls	South Dakota	United States	57117-5134
1064	Bristol Regional Medical Center	Bristol	Tennessee	United States	37620
1065	Wellmont Medical Associates Oncology and Hematology-Bristol	Bristol	Tennessee	United States	37620
1066	Memorial Hospital	Chattanooga	Tennessee	United States	37404
1067	Pulmonary Medicine Center of Chattanooga-Hixson	Hixson	Tennessee	United States	37343
1068	Wellmont Medical Associates Oncology and Hematology-Johnson City	Johnson City	Tennessee	United States	37604
1069	Ballad Health Cancer Care - Kingsport	Kingsport	Tennessee	United States	37660
1070	Wellmont Holston Valley Hospital and Medical Center	Kingsport	Tennessee	United States	37660
1071	Thompson Cancer Survival Center	Knoxville	Tennessee	United States	37916
1072	Meharry Medical College	Nashville	Tennessee	United States	37208
1073	Memorial GYN Plus	Ooltewah	Tennessee	United States	37363
1074	Hendrick Medical Center	Abilene	Texas	United States	79601
1075	Texas Oncology PA - Amarillo	Amarillo	Texas	United States	79106
1076	Dell Seton Medical Center at The University of Texas	Austin	Texas	United States	78701
1077	Texas Oncology-Austin Midtown	Austin	Texas	United States	78705
1078	Texas Oncology - Central Austin Cancer Center	Austin	Texas	United States	78731
1079	Texas Oncology - South Austin Cancer Center	Austin	Texas	United States	78745
1080	Texas Oncology-Austin North	Austin	Texas	United States	78758
1081	Texas Oncology PA Beaumont	Beaumont	Texas	United States	77702
1082	Texas Oncology Bedford	Bedford	Texas	United States	76022
1083	Texas Oncology-Cedar Park	Cedar Park	Texas	United States	78613
1084	Texas Cancer Center - Medical City Dallas	Dallas	Texas	United States	75230
1085	Texas Health Presbyterian Hospital Dallas	Dallas	Texas	United States	75231
1086	UT Southwestern/Simmons Cancer Center-Dallas	Dallas	Texas	United States	75390
1087	Texas Oncology - Denison Cancer Center	Denison	Texas	United States	75020
1088	Texas Oncology-Denton South	Denton	Texas	United States	76201
1089	Texas Oncology-El Paso	El Paso	Texas	United States	79915
1090	Texas Oncology-Flower Mound	Flower Mound	Texas	United States	75028
1091	Texas Oncology - Fort Worth Cancer Center	Fort Worth	Texas	United States	76104
1092	University of Texas Medical Branch	Galveston	Texas	United States	77555-0565
1093	Texas Oncology - Garland	Garland	Texas	United States	75042
1094	Texas Oncology-Grapevine	Grapevine	Texas	United States	76053
1095	Memorial Hermann Memorial City Medical Center	Houston	Texas	United States	77024
1096	Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center	Houston	Texas	United States	77030
1097	Houston Methodist Hospital	Houston	Texas	United States	77030
1098	Texas Oncology-Kyle Hays	Kyle	Texas	United States	78640
1099	Doctor's Hospital of Laredo	Laredo	Texas	United States	78041
1100	UTMB Cancer Center at Victory Lakes	League City	Texas	United States	77573
1101	Texas Oncology - Lewisville	Lewisville	Texas	United States	75067
1102	Texas Oncology-Longview Cancer Center	Longview	Texas	United States	75601
1103	Texas Oncology-McAllen	McAllen	Texas	United States	78503
1104	Texas Cancer Center - Mesquite	Mesquite	Texas	United States	75150
1105	North Texas Regional Cancer Center	Plano	Texas	United States	75075
1106	Texas Oncology-Plano West	Plano	Texas	United States	75093
1107	Texas Oncology - Round Rock Cancer Center	Round Rock	Texas	United States	78681
1108	Cancer Care Centers of South Texas- Northeast	San Antonio	Texas	United States	78217
1109	Cancer Care Centers of South Texas	San Antonio	Texas	United States	78229
1110	University of Texas Health Science Center at San Antonio	San Antonio	Texas	United States	78229
1111	Texas Oncology- San Marcos	San Marcos	Texas	United States	78666
1112	Scott and White Memorial Hospital	Temple	Texas	United States	76508
1113	Memorial Hermann The Woodlands Hospital	The Woodlands	Texas	United States	77380
1114	The US Oncology Network	The Woodlands	Texas	United States	77380
1115	Tyler Cancer Center	Tyler	Texas	United States	75702
1116	Texas Oncology-Waco Highway 6	Waco	Texas	United States	76712
1117	Texas Oncology-Wichita Falls Texoma Cancer Center	Wichita Falls	Texas	United States	76310
1118	American Fork Hospital / Huntsman Intermountain Cancer Center	American Fork	Utah	United States	84003
1119	Sandra L Maxwell Cancer Center	Cedar City	Utah	United States	84720
1120	Logan Regional Hospital	Logan	Utah	United States	84321
1121	Intermountain Medical Center	Murray	Utah	United States	84107
1122	McKay-Dee Hospital Center	Ogden	Utah	United States	84403
1123	Utah Valley Regional Medical Center	Provo	Utah	United States	84604
1124	Saint George Regional Medical Center	Saint George	Utah	United States	84770
1125	Utah Cancer Specialists-Salt Lake City	Salt Lake City	Utah	United States	84106
1126	LDS Hospital	Salt Lake City	Utah	United States	84143
1127	Southwestern Vermont Medical Center	Bennington	Vermont	United States	05201
1128	Central Vermont Medical Center/National Life Cancer Treatment	Berlin	Vermont	United States	05602
1129	University of Vermont and State Agricultural College	Burlington	Vermont	United States	05405
1130	Rutland Regional Medical Center	Rutland	Vermont	United States	05701
1131	Norris Cotton Cancer Center-North	Saint Johnsbury	Vermont	United States	05819
1132	Kaiser Permanente-Burke Medical Center	Burke	Virginia	United States	22015
1133	Sentara Martha Jefferson Hospital	Charlottesville	Virginia	United States	22901
1134	Danville Regional Medical Center	Danville	Virginia	United States	24541
1135	Kaiser Permanente - Fair Oaks Medical Center	Fairfax	Virginia	United States	22033
1136	Augusta Health Center for Cancer and Blood Disorders	Fishersville	Virginia	United States	22939
1137	Fredericksburg Oncology Inc	Fredericksburg	Virginia	United States	22401
1138	Hematology Oncology Associates of Fredericksburg Inc	Fredericksburg	Virginia	United States	22408
1139	Peninsula Cancer Institute-Gloucester	Gloucester	Virginia	United States	23061
1140	Virginia Oncology Associates-Hampton	Hampton	Virginia	United States	23666
1141	Centra Lynchburg Hematology-Oncology Clinic Inc	Lynchburg	Virginia	United States	24501
1142	Kaiser Permanente Tysons Corner Medical Center	McLean	Virginia	United States	22102
1143	Peninsula Cancer Institute-Newport News	Newport News	Virginia	United States	23601
1144	Southwest VA Regional Cancer Center	Norton	Virginia	United States	24273
1145	Virginia Cancer Institute	Richmond	Virginia	United States	23229
1146	Virginia Commonwealth University/Massey Cancer Center	Richmond	Virginia	United States	23298
1147	Peninsula Cancer Institute-Cancer Specialists of Tidewater	Virginia Beach	Virginia	United States	23454
1148	Peninsula Cancer Institute-Williamsburg	Williamsburg	Virginia	United States	23185
1149	Shenandoah Oncology PC	Winchester	Virginia	United States	22601
1150	Cancer Care Center at Island Hospital	Anacortes	Washington	United States	98221
1151	MultiCare Auburn Medical Center	Auburn	Washington	United States	98001
1152	Overlake Internal Medicine Associates	Bellevue	Washington	United States	98004
1153	Overlake Medical Center	Bellevue	Washington	United States	98004
1154	PeaceHealth Saint Joseph Medical Center	Bellingham	Washington	United States	98225
1155	Harrison HealthPartners Hematology and Oncology-Bremerton	Bremerton	Washington	United States	98310
1156	Highline Medical Center-Main Campus	Burien	Washington	United States	98166
1157	Providence Regional Cancer System-Centralia	Centralia	Washington	United States	98531
1158	Swedish Cancer Institute-Edmonds	Edmonds	Washington	United States	98026
1159	Saint Elizabeth Hospital	Enumclaw	Washington	United States	98022
1160	Providence Regional Cancer Partnership	Everett	Washington	United States	98201
1161	Saint Francis Hospital	Federal Way	Washington	United States	98003
1162	Swedish Cancer Institute-Issaquah	Issaquah	Washington	United States	98029
1163	Kadlec Clinic Hematology and Oncology	Kennewick	Washington	United States	99336
1164	EvergreenHealth Medical Center	Kirkland	Washington	United States	98033
1165	Seattle Cancer Care Alliance at EvergreenHealth	Kirkland	Washington	United States	98034
1166	Providence Regional Cancer System-Lacey	Lacey	Washington	United States	98503
1167	Saint Clare Hospital	Lakewood	Washington	United States	98499
1168	PeaceHealth Saint John Medical Center	Longview	Washington	United States	98632
1169	Skagit Regional Health Cancer Care Center	Mount Vernon	Washington	United States	98274
1170	Skagit Valley Hospital	Mount Vernon	Washington	United States	98274
1171	Providence - Saint Peter Hospital	Olympia	Washington	United States	98506-5166
1172	Capital Medical Center	Olympia	Washington	United States	98507
1173	Harrison HealthPartners Hematology and Oncology-Poulsbo	Poulsbo	Washington	United States	98370
1174	MultiCare Good Samaritan Hospital	Puyallup	Washington	United States	98372
1175	Virginia Mason Medical Center	Seattle	Washington	United States	98101
1176	Harborview Medical Center	Seattle	Washington	United States	98104
1177	Minor and James Medical PLLC	Seattle	Washington	United States	98104
1178	Pacific Medical Center-First Hill	Seattle	Washington	United States	98104
1179	Swedish Medical Center-Ballard Campus	Seattle	Washington	United States	98107
1180	Fred Hutchinson Cancer Research Center	Seattle	Washington	United States	98109
1181	Kaiser Permanente Washington	Seattle	Washington	United States	98112
1182	Swedish Medical Center-First Hill	Seattle	Washington	United States	98122-4307
1183	University of Washington Medical Center - Montlake	Seattle	Washington	United States	98195
1184	PeaceHealth United General Medical Center	Sedro-Woolley	Washington	United States	98284
1185	Olympic Medical Cancer Care Center	Sequim	Washington	United States	98384
1186	MultiCare Deaconess Cancer and Blood Specialty Center - Valley	Spokane Valley	Washington	United States	99216
1187	Cancer Care Northwest - Spokane South	Spokane	Washington	United States	99202
1188	MultiCare Deaconess Cancer and Blood Specialty Center - Downtown	Spokane	Washington	United States	99204
1189	Cancer Care Northwest-Valley	Spokane	Washington	United States	99216
1190	Cancer Care Northwest-North Spokane	Spokane	Washington	United States	99218
1191	Evergreen Hematology and Oncology PS	Spokane	Washington	United States	99218
1192	Rockwood Clinic	Spokane	Washington	United States	99220
1193	Franciscan Research Center-Northwest Medical Plaza	Tacoma	Washington	United States	98405
1194	MultiCare Allenmore Hospital	Tacoma	Washington	United States	98405
1195	MultiCare Tacoma General Hospital	Tacoma	Washington	United States	98405
1196	Northwest Medical Specialties PLLC	Tacoma	Washington	United States	98405
1197	Northwest NCI Community Oncology Research Program	Tacoma	Washington	United States	98405
1198	Saint Joseph Medical Center	Tacoma	Washington	United States	98405
1199	PeaceHealth Southwest Medical Center	Vancouver	Washington	United States	98664
1200	Compass Oncology Vancouver	Vancouver	Washington	United States	98684
1201	Legacy Salmon Creek Hospital	Vancouver	Washington	United States	98686
1202	Providence Saint Mary Regional Cancer Center	Walla Walla	Washington	United States	99362
1203	Wenatchee Valley Hospital and Clinics	Wenatchee	Washington	United States	98801
1204	North Star Lodge Cancer Center at Yakima Valley Memorial Hospital	Yakima	Washington	United States	98902
1205	United Hospital Center	Bridgeport	West Virginia	United States	26330
1206	West Virginia University Charleston Division	Charleston	West Virginia	United States	25304
1207	Fairmont Regional Cancer Center	Fairmont	West Virginia	United States	26554
1208	Edwards Comprehensive Cancer Center	Huntington	West Virginia	United States	25701
1209	Saint Mary's Medical Center	Huntington	West Virginia	United States	25702
1210	WVUH-Berkely Medical Center	Martinsburg	West Virginia	United States	25401
1211	West Virginia University Healthcare	Morgantown	West Virginia	United States	26506
1212	Camden Clark Medical Center	Parkersburg	West Virginia	United States	26101
1213	Princeton Community Hospital	Princeton	West Virginia	United States	24740
1214	Wheeling Hospital/Schiffler Cancer Center	Wheeling	West Virginia	United States	26003
1215	Langlade Hospital and Cancer Center	Antigo	Wisconsin	United States	54409
1216	ThedaCare Regional Cancer Center	Appleton	Wisconsin	United States	54911
1217	Aurora Cancer Care-Southern Lakes VLCC	Burlington	Wisconsin	United States	53105
1218	Marshfield Clinic-Chippewa Center	Chippewa Falls	Wisconsin	United States	54729
1219	HSHS Sacred Heart Hospital	Eau Claire	Wisconsin	United States	54701
1220	Marshfield Clinic Cancer Center at Sacred Heart	Eau Claire	Wisconsin	United States	54701
1221	Saint Agnes Hospital/Agnesian Cancer Center	Fond Du Lac	Wisconsin	United States	54935
1222	Aurora Health Center-Fond du Lac	Fond Du Lac	Wisconsin	United States	54937
1223	Green Bay Oncology at Saint Vincent Hospital	Green Bay	Wisconsin	United States	54301-3526
1224	Saint Vincent Hospital Cancer Center Green Bay	Green Bay	Wisconsin	United States	54301
1225	Green Bay Oncology Limited at Saint Mary's Hospital	Green Bay	Wisconsin	United States	54303
1226	Saint Vincent Hospital Cancer Center at Saint Mary's	Green Bay	Wisconsin	United States	54303
1227	Aurora BayCare Medical Center	Green Bay	Wisconsin	United States	54311
1228	Mercyhealth Hospital and Cancer Center - Janesville	Janesville	Wisconsin	United States	53548
1229	UW Cancer Center Johnson Creek	Johnson Creek	Wisconsin	United States	53038
1230	Gundersen Lutheran Medical Center	La Crosse	Wisconsin	United States	54601
1231	Dean Hematology and Oncology Clinic	Madison	Wisconsin	United States	53717
1232	University of Wisconsin Carbone Cancer Center	Madison	Wisconsin	United States	53792
1233	Holy Family Memorial Hospital	Manitowoc	Wisconsin	United States	54221
1234	Aurora Bay Area Medical Group-Marinette	Marinette	Wisconsin	United States	54143
1235	Bay Area Medical Center	Marinette	Wisconsin	United States	54143
1236	Marshfield Medical Center-Marshfield	Marshfield	Wisconsin	United States	54449
1237	Marshfield Medical Center	Marshfield	Wisconsin	United States	54449
1238	Ascension Columbia Saint Mary's Hospital Ozaukee	Mequon	Wisconsin	United States	53097
1239	Ascension Southeast Wisconsin Hospital - Saint Joseph Campus	Milwaukee	Wisconsin	United States	53210
1240	Ascension Columbia Saint Mary's Hospital - Milwaukee	Milwaukee	Wisconsin	United States	53211
1241	Medical College of Wisconsin	Milwaukee	Wisconsin	United States	53226
1242	Marshfield Clinic-Minocqua Center	Minocqua	Wisconsin	United States	54548
1243	ProHealth D N Greenwald Center	Mukwonago	Wisconsin	United States	53149
1244	Cancer Center of Western Wisconsin	New Richmond	Wisconsin	United States	54017
1245	ProHealth Oconomowoc Memorial Hospital	Oconomowoc	Wisconsin	United States	53066
1246	Saint Vincent Hospital Cancer Center at Oconto Falls	Oconto Falls	Wisconsin	United States	54154
1247	Vince Lombardi Cancer Clinic - Oshkosh	Oshkosh	Wisconsin	United States	54904
1248	Ascension All Saints Hospital	Racine	Wisconsin	United States	53405
1249	Ascension Saint Mary's Hospital	Rhinelander	Wisconsin	United States	54501
1250	Saint Mary's Hospital	Rhinelander	Wisconsin	United States	54501
1251	Marshfield Medical Center-Rice Lake	Rice Lake	Wisconsin	United States	54868
1252	HSHS Saint Nicholas Hospital	Sheboygan	Wisconsin	United States	53081
1253	Vince Lombardi Cancer Clinic-Sheboygan	Sheboygan	Wisconsin	United States	53081
1254	Ascension Saint Michael's Hospital	Stevens Point	Wisconsin	United States	54481
1255	Green Bay Oncology - Sturgeon Bay	Sturgeon Bay	Wisconsin	United States	54235
1256	Aurora Medical Center in Summit	Summit	Wisconsin	United States	53066
1257	Vince Lombardi Cancer Clinic-Two Rivers	Two Rivers	Wisconsin	United States	54241
1258	ProHealth Waukesha Memorial Hospital	Waukesha	Wisconsin	United States	53188
1259	Aspirus Regional Cancer Center	Wausau	Wisconsin	United States	54401
1260	Marshfield Clinic-Wausau Center	Wausau	Wisconsin	United States	54401
1261	Ascension Saint Clare's Hospital	Weston	Wisconsin	United States	54476
1262	Diagnostic and Treatment Center	Weston	Wisconsin	United States	54476
1263	Marshfield Medical Center - Weston	Weston	Wisconsin	United States	54476
1264	Aspirus Cancer Care - Wisconsin Rapids	Wisconsin Rapids	Wisconsin	United States	54494
1265	Marshfield Clinic - Wisconsin Rapids Center	Wisconsin Rapids	Wisconsin	United States	54494
1266	Rocky Mountain Oncology	Casper	Wyoming	United States	82609
1267	Cheyenne Regional Medical Center-West	Cheyenne	Wyoming	United States	82001
1268	Welch Cancer Center	Sheridan	Wyoming	United States	82801
1269	Tom Baker Cancer Centre	Calgary	Alberta	Canada	T2N 4N2
1270	CHUM - Hopital Notre-Dame	Montreal	Quebec	Canada	H2L 4M1
1271	CHUM-Hotel Dieu de Montreal	Montreal	Quebec	Canada	H2W 1T8
1272	CHUM - Centre Hospitalier de l'Universite de Montreal	Montreal	Quebec	Canada	H2X 3E4
1273	Montreal General Hospital	Montreal	Quebec	Canada	H3G 1A4
1274	The Research Institute of the McGill University Health Centre (MUHC)	Montreal	Quebec	Canada	H3H 2R9
1275	Jewish General Hospital	Montreal	Quebec	Canada	H3T 1E2
1276	Saint Mary's Hospital	Montreal	Quebec	Canada	H3T 1M5
1277	CHU de Quebec-Hopital du Saint-Sacrement (HSS)	Quebec City	Quebec	Canada	G1S 4L8
1278	Bon Secours Hospital	Cork	Co Cork	Ireland
1279	Tallaght University Hospital	Dublin	Co Dublin	Ireland	24
1280	Saint Vincent's University Hospital	Dublin	Co Dublin	Ireland	4
1281	Mater Misericordiae University Hospital	Dublin	Co Dublin	Ireland	7
1282	Mater Private Hospital	Dublin	Co Dublin	Ireland	7
1283	Beaumont Hospital	Dublin	Co Dublin	Ireland	9
1284	Saint Vincent's Private Hospital	Merrion	Co Dublin	Ireland	4
1285	University College Hospital Galway	Galway	Co Galway	Ireland
1286	Mid-Western Regional Hospital	Limerick	Co Limerick	Ireland	9
1287	Sligo University Hospital	Sligo	Co Sligo	Ireland
1288	University Hospital Waterford	Waterford	Co Waterford	Ireland	9
1289	Cork University Hospital	Cork		Ireland
1290	Saint James Hospital	Dublin		Ireland	8
1291	Letterkenny General Hospital	Letterkenny		Ireland	Co Donegal
1292	San Juan City Hospital	San Juan		Puerto Rico	00936

Sponsors and Collaborators

• National Cancer Institute (NCI)
• NRG Oncology

Investigators

• Principal Investigator: Louis Fehrenbacher, NRG Oncology

Study Documents (Full-Text)

• Study Protocol and Statistical Analysis Plan - Feb 8, 2018

More Information

Publications

None provided.

• Responsible Party: National Cancer Institute (NCI)
• ClinicalTrials.gov Identifier: NCT01275677
• Other Study ID Numbers: NCI-2011-02572; NCI-2011-02572; NSABP-B-47; S13-00177; CDR0000692574; NSABP-B-47; NSABP-B-47; U10CA012027; U10CA180868
• First Posted: Jan 12, 2011
• Last Update Posted: Aug 8, 2022
• Last Verified: Jun 1, 2022

• Additional relevant MeSH terms: Breast Neoplasms; Paclitaxel; Docetaxel; Cyclophosphamide; Doxorubicin; Liposomal doxorubicin; Trastuzumab; Albumin-Bound Paclitaxel; Daunorubicin; Trastuzumab biosimilar HLX02; Antineoplastic Agents, Immunological; Antibodies; Immunoglobulins; Antibodies, Monoclonal

Study Results

Participant Flow

Arm/Group Title	Arm I (Chemotherapy)	Arm II (Chemotherapy, Trastuzumab)
Arm/Group Description	GROUP IA: Patients receive docetaxel IV over 60 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. GROUP IB: Patients receive doxorubicin hydrochloride IV over 15 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 2 or 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. Beginning 2-3 weeks after last dose of doxorubicin hydrochloride and cyclophosphamide, patients also receive paclitaxel IV over 60 minutes once weekly for 12 doses in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies	GROUP IIA: Patients receive docetaxel and cyclophosphamide as in Group IA. Patients also receive trastuzumab IV over 30-90 minutes on day 1. Courses repeat every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. GROUP IIB: Patients receive doxorubicin hydrochloride, cyclophosphamide, and paclitaxel as in Group IB. Patients also receive trastuzumab IV over 30-90 minutes weekly for 12 doses and then every 3 weeks for subsequent doses. Treatment repeats every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies Trastuzumab: Given IV
Period Title: Overall Study
STARTED	1630	1640
COMPLETED	1602	1598
NOT COMPLETED	28	42

Baseline Characteristics

Arm/Group Title	Arm I (Chemotherapy)	Arm II (Chemotherapy, Trastuzumab)	Total
Arm/Group Description	Arm I (chemotherapy)	Arm II (chemotherapy, trastuzumab)	Total of all reporting groups
Overall Participants	1630	1640	3270
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]	52 (10.4)	52 (10.4)	52 (10.4)
Sex: Female, Male (Count of Participants)
Female	1630 100%	1640 100%	3270 100%
Male	0 0%	0 0%	0 0%
Race (NIH/OMB) (Count of Participants)
American Indian or Alaska Native	8 0.5%	6 0.4%	14 0.4%
Asian	63 3.9%	61 3.7%	124 3.8%
Native Hawaiian or Other Pacific Islander	4 0.2%	7 0.4%	11 0.3%
Black or African American	144 8.8%	175 10.7%	319 9.8%
White	1370 84%	1354 82.6%	2724 83.3%
More than one race	9 0.6%	10 0.6%	19 0.6%
Unknown or Not Reported	32 2%	27 1.6%	59 1.8%
Race/Ethnicity, Customized (Count of Participants)
Hispanic or Latino	102 6.3%	106 6.5%	208 6.4%
Not Hispanic or Latino	1488 91.3%	1513 92.3%	3001 91.8%
Unknown or Not Reported	40 2.5%	21 1.3%	61 1.9%

Outcome Measures

1. Primary Outcome

Title	Percentage of Patients Alive and Free From Invasive Disease (IDFS)
Description	Percentage of patients free from an invasive disease-free survival event where events include any invasive recurrence, contralateral invasive breast cancer, second non-breast primary cancer (excluding squamous or basal cell carcinoma of the skin), or death from any cause.
Time Frame	5 years

Outcome Measure Data

Analysis Population Description

Includes all at-risk patients with clinical follow up

Arm/Group Title	Arm I (Chemotherapy)	Arm II (Chemotherapy, Trastuzumab)
Arm/Group Description	GROUP IA: Patients receive docetaxel IV over 60 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. GROUP IB: Patients receive doxorubicin hydrochloride IV over 15 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 2 or 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. Beginning 2-3 weeks after last dose of doxorubicin hydrochloride and cyclophosphamide, patients also receive paclitaxel IV over 60 minutes once weekly for 12 doses in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies	GROUP IIA: Patients receive docetaxel and cyclophosphamide as in Group IA. Patients also receive trastuzumab IV over 30-90 minutes on day 1. Courses repeat every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. GROUP IIB: Patients receive doxorubicin hydrochloride, cyclophosphamide, and paclitaxel as in Group IB. Patients also receive trastuzumab IV over 30-90 minutes weekly for 12 doses and then every 3 weeks for subsequent doses. Treatment repeats every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies Trastuzumab: Given IV
Measure Participants	1602	1598
Number [percentage of patients]	89.2	89.8

2. Secondary Outcome

Title	Percentage of Patients Alive and Disease-Free (DFS-DCIS)
Description	Percentage of patients free from a disease-free survival event where events include local recurrence (invasive or DCIS), regional or distant recurrence, contralateral breast cancer (invasive or DCIS), second primary cancer (excluding squamous or basal cell carcinoma of the skin), or death from any cause.
Time Frame	5 years

Outcome Measure Data

Analysis Population Description

Includes all at-risk patients with clinical follow-up

Arm/Group Title	Arm I (Chemotherapy)	Arm II (Chemotherapy, Trastuzumab)
Arm/Group Description	GROUP IA: Patients receive docetaxel IV over 60 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. GROUP IB: Patients receive doxorubicin hydrochloride IV over 15 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 2 or 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. Beginning 2-3 weeks after last dose of doxorubicin hydrochloride and cyclophosphamide, patients also receive paclitaxel IV over 60 minutes once weekly for 12 doses in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies	GROUP IIA: Patients receive docetaxel and cyclophosphamide as in Group IA. Patients also receive trastuzumab IV over 30-90 minutes on day 1. Courses repeat every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. GROUP IIB: Patients receive doxorubicin hydrochloride, cyclophosphamide, and paclitaxel as in Group IB. Patients also receive trastuzumab IV over 30-90 minutes weekly for 12 doses and then every 3 weeks for subsequent doses. Treatment repeats every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies Trastuzumab: Given IV
Measure Participants	1602	1598
Number [percentage of patients]	89.1	89.6

3. Secondary Outcome

Title	Percentage of Patients Alive and Free From Breast Cancer (BCFS)
Description	Percentage of patients free from a breast cancer-free survival event where events include local recurrence (invasive or DCIS), regional or distant recurrence, contralateral breast cancer (invasive or DCIS), or death from any cause.
Time Frame	5 years

Outcome Measure Data

Analysis Population Description

Includes all at-risk patients with clinical follow up

Arm/Group Title	Arm I (Chemotherapy)	Arm II (Chemotherapy, Trastuzumab)
Arm/Group Description	GROUP IA: Patients receive docetaxel IV over 60 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. GROUP IB: Patients receive doxorubicin hydrochloride IV over 15 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 2 or 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. Beginning 2-3 weeks after last dose of doxorubicin hydrochloride and cyclophosphamide, patients also receive paclitaxel IV over 60 minutes once weekly for 12 doses in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies	GROUP IIA: Patients receive docetaxel and cyclophosphamide as in Group IA. Patients also receive trastuzumab IV over 30-90 minutes on day 1. Courses repeat every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. GROUP IIB: Patients receive doxorubicin hydrochloride, cyclophosphamide, and paclitaxel as in Group IB. Patients also receive trastuzumab IV over 30-90 minutes weekly for 12 doses and then every 3 weeks for subsequent doses. Treatment repeats every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies Trastuzumab: Given IV
Measure Participants	1602	1598
Number [percentage of patients]	91.0	90.7

4. Secondary Outcome

Title	Percentage of Patients Alive and Recurrence-Free (RFI)
Description	Percentage of patients free from a recurrence-free interval event where events include invasive local, regional, or distant recurrence, or death from breast cancer (censored for death from other causes).
Time Frame	5 years

Outcome Measure Data

Analysis Population Description

Includes all at-risk patients with clinical follow-up

Arm/Group Title	Arm I (Chemotherapy)	Arm II (Chemotherapy, Trastuzumab)
Arm/Group Description	GROUP IA: Patients receive docetaxel IV over 60 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. GROUP IB: Patients receive doxorubicin hydrochloride IV over 15 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 2 or 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. Beginning 2-3 weeks after last dose of doxorubicin hydrochloride and cyclophosphamide, patients also receive paclitaxel IV over 60 minutes once weekly for 12 doses in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies	GROUP IIA: Patients receive docetaxel and cyclophosphamide as in Group IA. Patients also receive trastuzumab IV over 30-90 minutes on day 1. Courses repeat every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. GROUP IIB: Patients receive doxorubicin hydrochloride, cyclophosphamide, and paclitaxel as in Group IB. Patients also receive trastuzumab IV over 30-90 minutes weekly for 12 doses and then every 3 weeks for subsequent doses. Treatment repeats every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies Trastuzumab: Given IV
Measure Participants	1602	1598
Number [percentage of patients]	92.3	92.0

5. Secondary Outcome

Title	Percentage of Patients Alive and Free From Distant Recurrence (DRFI)
Description	Percentage of patients free from a distant recurrence-free interval event where events include distant recurrence or death from breast cancer (censored for deaths from other causes), regardless of occurrence of any intervening local or regional recurrences, contralateral breast cancers, or non-breast second primary cancer.
Time Frame	5 years

Outcome Measure Data

Analysis Population Description

Includes all at-risk patients with clinical follow-up

Arm/Group Title	Arm I (Chemotherapy)	Arm II (Chemotherapy, Trastuzumab)
Arm/Group Description	GROUP IA: Patients receive docetaxel IV over 60 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. GROUP IB: Patients receive doxorubicin hydrochloride IV over 15 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 2 or 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. Beginning 2-3 weeks after last dose of doxorubicin hydrochloride and cyclophosphamide, patients also receive paclitaxel IV over 60 minutes once weekly for 12 doses in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies	GROUP IIA: Patients receive docetaxel and cyclophosphamide as in Group IA. Patients also receive trastuzumab IV over 30-90 minutes on day 1. Courses repeat every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. GROUP IIB: Patients receive doxorubicin hydrochloride, cyclophosphamide, and paclitaxel as in Group IB. Patients also receive trastuzumab IV over 30-90 minutes weekly for 12 doses and then every 3 weeks for subsequent doses. Treatment repeats every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies Trastuzumab: Given IV
Measure Participants	1602	1598
Number [percentage of patients]	93.6	92.7

6. Secondary Outcome

Title	Percentage of Patients Alive (Overall Survival)
Description	Percentage of patients alive.
Time Frame	5 years

Outcome Measure Data

Analysis Population Description

Includes all at-risk patients with follow-up

Arm/Group Title	Arm I (Chemotherapy)	Arm II (Chemotherapy, Trastuzumab)
Arm/Group Description	GROUP IA: Patients receive docetaxel IV over 60 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. GROUP IB: Patients receive doxorubicin hydrochloride IV over 15 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 2 or 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. Beginning 2-3 weeks after last dose of doxorubicin hydrochloride and cyclophosphamide, patients also receive paclitaxel IV over 60 minutes once weekly for 12 doses in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies	GROUP IIA: Patients receive docetaxel and cyclophosphamide as in Group IA. Patients also receive trastuzumab IV over 30-90 minutes on day 1. Courses repeat every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. GROUP IIB: Patients receive doxorubicin hydrochloride, cyclophosphamide, and paclitaxel as in Group IB. Patients also receive trastuzumab IV over 30-90 minutes weekly for 12 doses and then every 3 weeks for subsequent doses. Treatment repeats every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies Trastuzumab: Given IV
Measure Participants	1603	1602
Number [percentage of patients alive]	96.3	94.8

7. Secondary Outcome

Title	Toxicity Assessed by Adverse Events
Description	Percentage of patients who ever experienced grade 2 or higher toxicites.
Time Frame	While on study therapy. Day 1 of first dose through 30 days after Day 1 of last dose.

Outcome Measure Data

Analysis Population Description

Includes all at-risk patients with clinical follow-up.

Arm/Group Title	Arm I (Chemotherapy)	Arm II (Chemotherapy, Trastuzumab)
Arm/Group Description	GROUP IA: Patients receive docetaxel IV over 60 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 3 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. GROUP IB: Patients receive doxorubicin hydrochloride IV over 15 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 2 or 3 weeks for 4 cycles in the absence of disease progression or unacceptable toxicity. Beginning 2-3 weeks after last dose of doxorubicin hydrochloride and cyclophosphamide, patients also receive paclitaxel IV over 60 minutes once weekly for 12 doses in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies	GROUP IIA: Patients receive docetaxel and cyclophosphamide as in Group IA. Patients also receive trastuzumab IV over 30-90 minutes on day 1. Courses repeat every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. GROUP IIB: Patients receive doxorubicin hydrochloride, cyclophosphamide, and paclitaxel as in Group IB. Patients also receive trastuzumab IV over 30-90 minutes weekly for 12 doses and then every 3 weeks for subsequent doses. Treatment repeats every 3 weeks for 1 year in the absence of disease progression or unacceptable toxicity. Cyclophosphamide: Given IV Docetaxel: Given IV Doxorubicin: Given IV Doxorubicin Hydrochloride: Given IV Laboratory Biomarker Analysis: Correlative studies Paclitaxel: Given IV Quality-of-Life Assessment: Ancillary studies Trastuzumab: Given IV
Measure Participants	1615	1625
Number [percentage of patients]	90.9	94.1

8. Secondary Outcome

Title	Change in HER2 mRNA Level
Description	The interaction between treatment effect and HER2 mRNA level will be evaluated in the proportional hazards model, which would include an indicator for treatment group and the HER2 mRNA level as a continuous variable, and the corresponding interaction term. The log-hazard ratio plot for the interaction term with 95% confidence intervals will be used to determine the cut-off of the HER2 mRNA level that would determine a subset of the patients who would benefit from the adjuvant trastuzumab therapy.
Time Frame	From baseline to 24 months

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title

Arm/Group Description

9. Secondary Outcome

Title	Fcgamma Receptor Polymorphism
Description	The polymorphism of the Fcgamma 158 receptor gene will be dichotomized as V/V (valine) vs. other genotypes and the polymorphism of the Fcgamma 131 receptor gene will be dichotomized as H/H (histidine) vs. other genotypes to evaluate an interaction between treatment group and Fcgamma polymorphism. The Kaplan-Meier method105 will be used to estimate the distribution of the primary endpoints stratified by the dichotomized subgroups, and the log-rank test106 will be used to statistically compare the time-to-event distributions.
Time Frame	From baseline to up to 24 months

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title

Arm/Group Description

Adverse Events

Time Frame	All-Cause Mortality: 5 years; Adverse Events: While on study therapy. Day 1 of first dose through 30 days after Day 1 of last dose.
Adverse Event Reporting Description	B-47 used standard AE reporting based on the descriptions and grading scales found in the revised NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. The total at-risk patient groups for adverse events reflect the number of patients who had an AE form or an AdEERS report submitted. The at risk group for all-cause mortality reflects the number who submitted an AE form, an AdEERS report, or a follow-up form, (including follow-up by telephone only).
Arm/Group Title	Arm I (Chemotherapy)		Arm II (Chemotherapy, Trastuzumab)
Arm/Group Description	Arm I (chemotherapy)		Arm II (chemotherapy, trastuzumab)
All Cause Mortality
	Arm I (Chemotherapy)		Arm II (Chemotherapy, Trastuzumab)
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	48/1622 (3%)		61/1628 (3.7%)
Serious Adverse Events
	Arm I (Chemotherapy)		Arm II (Chemotherapy, Trastuzumab)
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	31/1615 (1.9%)		96/1625 (5.9%)
Blood and lymphatic system disorders
Blood and lymphatic system disorders - Other, specify	0/1615 (0%)		1/1625 (0.1%)
Disseminated intravascular coagulation	0/1615 (0%)		1/1625 (0.1%)
Cardiac disorders
Asystole	0/1615 (0%)		1/1625 (0.1%)
Heart failure	1/1615 (0.1%)		18/1625 (1.1%)
Myocardial infarction	2/1615 (0.1%)		2/1625 (0.1%)
Pericardial effusion	1/1615 (0.1%)		0/1625 (0%)
Supraventricular tachycardia	0/1615 (0%)		3/1625 (0.2%)
Ventricular tachycardia	0/1615 (0%)		1/1625 (0.1%)
Acute coronary syndrome	1/1615 (0.1%)		0/1625 (0%)
Tricuspid valve disease	0/1615 (0%)		1/1625 (0.1%)
Mitral valve disease	0/1615 (0%)		1/1625 (0.1%)
Aortic valve disease	0/1615 (0%)		1/1625 (0.1%)
Left ventricular systolic dysfunction	5/1615 (0.3%)		29/1625 (1.8%)
Gastrointestinal disorders
Colonic perforation	1/1615 (0.1%)		0/1625 (0%)
Diarrhea	0/1615 (0%)		1/1625 (0.1%)
Typhlitis	0/1615 (0%)		1/1625 (0.1%)
Upper gastrointestinal hemorrhage	0/1615 (0%)		1/1625 (0.1%)
General disorders
Multi-organ failure	1/1615 (0.1%)		1/1625 (0.1%)
Hepatobiliary disorders
Hepatic failure	0/1615 (0%)		1/1625 (0.1%)
Infections and infestations
Catheter related infection	0/1615 (0%)		1/1625 (0.1%)
Hepatitis viral	0/1615 (0%)		1/1625 (0.1%)
Sepsis	2/1615 (0.1%)		7/1625 (0.4%)
Enterocolitis infectious	0/1615 (0%)		2/1625 (0.1%)
Lung infection	1/1615 (0.1%)		1/1625 (0.1%)
Small intestine infection	1/1615 (0.1%)		0/1625 (0%)
Injury, poisoning and procedural complications
Injury, poisoning and procedural complications - Other, specify	0/1615 (0%)		1/1625 (0.1%)
Vascular access complication	1/1615 (0.1%)		0/1625 (0%)
Investigations
Alanine aminotransferase increased (ALT/SGPT)	0/1615 (0%)		1/1625 (0.1%)
Aspartate aminotransferase increased (AST/SGOT)	0/1615 (0%)		1/1625 (0.1%)
Lipase increased	1/1615 (0.1%)		0/1625 (0%)
Ejection fraction decreased	1/1615 (0.1%)		10/1625 (0.6%)
Metabolism and nutrition disorders
Hypercalcemia	1/1615 (0.1%)		0/1625 (0%)
Hyperglycemia	2/1615 (0.1%)		4/1625 (0.2%)
Hypertriglyceridemia	0/1615 (0%)		1/1625 (0.1%)
Hyperuricemia	1/1615 (0.1%)		0/1625 (0%)
Hypocalcemia	0/1615 (0%)		1/1625 (0.1%)
Hypokalemia	2/1615 (0.1%)		6/1625 (0.4%)
Hypomagnesemia	0/1615 (0%)		1/1625 (0.1%)
Hyponatremia	0/1615 (0%)		1/1625 (0.1%)
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Myelodysplastic syndrome	2/1615 (0.1%)		0/1625 (0%)
Leukemia secondary to oncology chemotherapy	1/1615 (0.1%)		1/1625 (0.1%)
Nervous system disorders
Intracranial hemorrhage	0/1615 (0%)		1/1625 (0.1%)
Stroke	0/1615 (0%)		1/1625 (0.1%)
Syncope	0/1615 (0%)		2/1625 (0.1%)
Pregnancy, puerperium and perinatal conditions
Pregnancy, puerperium and perinatal conditions - Other, specify	0/1615 (0%)		2/1625 (0.1%)
Psychiatric disorders
Delirium	1/1615 (0.1%)		1/1625 (0.1%)
Depression	3/1615 (0.2%)		4/1625 (0.2%)
Psychosis	0/1615 (0%)		1/1625 (0.1%)
Suicide attempt	0/1615 (0%)		1/1625 (0.1%)
Renal and urinary disorders
Acute kidney injury	0/1615 (0%)		1/1625 (0.1%)
Reproductive system and breast disorders
Vaginal dryness	0/1615 (0%)		1/1625 (0.1%)
Respiratory, thoracic and mediastinal disorders
Adult respiratory distress syndrome	0/1615 (0%)		1/1625 (0.1%)
Dyspnea	0/1615 (0%)		1/1625 (0.1%)
Hypoxia	1/1615 (0.1%)		0/1625 (0%)
Pneumonitis	7/1615 (0.4%)		5/1625 (0.3%)
Pneumothorax	0/1615 (0%)		1/1625 (0.1%)
Respiratory failure	1/1615 (0.1%)		0/1625 (0%)
Skin and subcutaneous tissue disorders
Erythema multiforme	0/1615 (0%)		1/1625 (0.1%)
Vascular disorders
Hypertension	0/1615 (0%)		2/1625 (0.1%)
Hypotension	0/1615 (0%)		1/1625 (0.1%)
Thromboembolic event	1/1615 (0.1%)		0/1625 (0%)
Other (Not Including Serious) Adverse Events
	Arm I (Chemotherapy)		Arm II (Chemotherapy, Trastuzumab)
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	1362/1615 (84.3%)		1418/1625 (87.3%)
Blood and lymphatic system disorders
Anemia	222/1615 (13.7%)		327/1625 (20.1%)
Gastrointestinal disorders
Constipation	135/1615 (8.4%)		124/1625 (7.6%)
Diarrhea	228/1615 (14.1%)		324/1625 (19.9%)
Mucositis oral	240/1615 (14.9%)		238/1625 (14.6%)
Nausea	408/1615 (25.3%)		377/1625 (23.2%)
Vomiting	141/1615 (8.7%)		129/1625 (7.9%)
General disorders
Fatigue	629/1615 (38.9%)		644/1625 (39.6%)
Infections and infestations
Upper respiratory infection	78/1615 (4.8%)		133/1625 (8.2%)
Investigations
Lymphocyte count decreased	131/1615 (8.1%)		152/1625 (9.4%)
Neutrophil count decreased	145/1615 (9%)		166/1625 (10.2%)
White blood cell decreased	119/1615 (7.4%)		151/1625 (9.3%)
Ejection fraction decreased	3/1615 (0.2%)		164/1625 (10.1%)
Musculoskeletal and connective tissue disorders
Arthralgia	161/1615 (10%)		233/1625 (14.3%)
Bone pain	228/1615 (14.1%)		221/1625 (13.6%)
Myalgia	196/1615 (12.1%)		222/1625 (13.7%)
Nervous system disorders
Headache	164/1615 (10.2%)		187/1625 (11.5%)
Peripheral sensory neuropathy	279/1615 (17.3%)		321/1625 (19.8%)
Psychiatric disorders
Insomnia	108/1615 (6.7%)		128/1625 (7.9%)
Respiratory, thoracic and mediastinal disorders
Cough	80/1615 (5%)		136/1625 (8.4%)
Skin and subcutaneous tissue disorders
Alopecia	633/1615 (39.2%)		653/1625 (40.2%)
Vascular disorders
Hypertension	103/1615 (6.4%)		196/1625 (12.1%)

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.