Alternate Title
Basic Trial Information
Objectives
Entry Criteria
Expected Enrollment
Outcomes
Outline
Trial Contact Information
Related Information
Registry Information

Alternate Title

Treatment Decision Making Based on Blood Levels of Tumor Cells in Women With Metastatic Breast Cancer Receiving Chemotherapy

Basic Trial Information

Special Category: CTSU trial, NCI Web site featured trial

Objectives

Primary

1. Determine whether women with metastatic breast cancer and elevated circulating tumor cells (CTCs) (≥ 5 per 7.5 mL of whole blood) after 3 weeks of first-line chemotherapy derive increased overall survival from changing to an alternative chemotherapy regimen at the next course rather than waiting for clinical evidence of progressive disease before changing to an alternative chemotherapy regimen.
2. Determine whether these patients derive increased progression-free survival (PFS) from changing to an alternative chemotherapy regimen at the next course rather than waiting for clinical evidence of progressive disease before changing to an alternative chemotherapy regimen.
3. Confirm previous findings that patients with < 5 CTCs per 7.5 mL of whole blood on initial screening have longer median OS and PFS than patients with ≥ 5 CTCs per 7.5 mL of whole blood.
4. Determine the prognostic value of sequentially collected CTC values in these patients.
5. Compare toxicity between patients with and without elevated CTCs after 3 weeks of first-line chemotherapy AND between the two randomized treatment arms.

Secondary

1. Compare the prognostic and predictive value of CTC number vs breast cancer tumor markers, including CA 15-3 and carcinoembryonic antigen.
2. Create a serum specimen bank for future biologic investigation.

Entry Criteria

Disease Characteristics:

• Histologically confirmed breast cancer
  • Clinical evidence of metastatic disease (stage IV disease)
  • Newly metastatic disease OR progressive metastatic disease while on hormonal therapy

• Meets 1 of the following criteria:
  • Measurable disease
  • Bone-only disease*

   [Note: *Patients with nonmeasurable disease that does not include bone are not eligible]

• HER-2 status determined by immunohistochemistry (IHC) or fluorescent in situ hybridization (FISH) assay
  • HER-2 positivity is defined as IHC 3+ or FISH+
  • If IHC is indeterminate (2+), FISH must be performed to classify disease

• Planning to undergo first-line chemotherapy for metastatic disease

• Patients with brain metastases must have stable disease for > 90 days after completion of prior radiotherapy to the brain

• No leptomeningeal disease

• Hormone receptor status not specified

Prior/Concurrent Therapy:

• See Disease Characteristics
• Prior hormonal therapy, bisphosphonate therapy, trastuzumab (Herceptin®), and/or bevacizumab for metastatic disease allowed
  • Any number of exogenous hormonal therapies for metastatic disease and/or as adjuvant therapy allowed
• At least 1 year since prior adjuvant chemotherapy
• At least 2 weeks since prior minor surgery and recovered
• At least 4 weeks since prior major surgery and recovered
• No prior chemotherapy for metastatic disease
• Concurrent hormonal therapy and/or bisphosphonate therapy allowed
• Concurrent trastuzumab and/or bevacizumab allowed

Patient Characteristics:

• Female
• Menopausal status not specified
• Zubrod performance status 0-2
• Not pregnant or nursing
• Negative pregnancy test
• No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or stage I or II cancer currently in complete remission

Expected Enrollment

A total of 500 patients will be accrued for this study.

Outcomes

Overall survival
Progression-free survival
Prognostic value of sequentially collected circulating tumor cell (CTC) values
Toxicity

Correlation of CTC levels with breast cancer tumor markers

Outline

This is a partially blinded, partially randomized, multicenter study. Patients are assigned to 1 of 3 groups based on circulating tumor cells (CTCs) after 1 course of chemotherapy.

All patients undergo blood collection before their first dose of first-line chemotherapy* to determine baseline CTC count. Patients with < 5 CTCs at baseline are assigned to group I. Patients with ≥ 5 CTCs at baseline undergo a second blood draw on day 22 (after completion of 1 course of chemotherapy). Patients with < 5 CTCs after completing 1 course of chemotherapy are assigned to group 2. Patients with ≥ 5 CTCs after completion of 1 course of chemotherapy are assigned to group 3.

 [Note: *Chemotherapy may be initiated while waiting for the baseline CTC result.]

• Group 1 (low risk of early progression): Patients continue to receive regular treatment without change at the discretion of the physician. Patients are eligible for other first-line chemotherapy trials. No further blood is collected.

• Group 2 (moderate risk of early progression): Patients continue to receive their current chemotherapy regimen without change.

• Group 3 (high risk of early progression): Patients are stratified according to HER-2 status (positive vs negative) and disease type (bone-only vs measurable disease). Patients are randomized to 1 of 2 treatment arms.
  • Arm I: Patients continue with their current chemotherapy regimen without change.

  • Arm II: Patients switch to a different chemotherapy regimen. Selection of a new chemotherapy regimen is made by the patient's doctor.

    Patients receiving hormonal therapy or biologic therapy and chemotherapy continue to receive the hormonal or biologic therapy unchanged regardless of CTC level.

In groups 2 and 3, blood is collected periodically during chemotherapy and then at the completion of chemotherapy. Samples are examined for CTCs via the CellSearch™ blood test. Blood is also tested for CA 15-3 and carcinoembryonic antigen (CEA).

After completion of study therapy, patients are followed for up to 5 years.

Trial Contact Information

Trial Lead Organizations

Southwest Oncology Group

Jeffrey Smerage, MD, PhD, Study coordinator		Ph: 734-936-0453; 800-865-1125 Email: smerage@umich.edu
Daniel Hayes, MD, Study coordinator		Ph: 734-615-6725; 800-865-1125 Email: hayesdf@umich.edu

Cancer and Leukemia Group B

Eric Winer, MD, Study coordinator		Ph: 617-632-3800; 866-790-4500

U.S.A.
Alabama
	Anniston
	Regional Medical Center
		Ellen Spremulli	Ph:  256-235-5877
Alaska
	Anchorage
	Alaska Regional Hospital Cancer Center
		Saul Rivkin, MD	Ph:  206-386-2441
	Providence Cancer Center
		Clinical Trials Office - Providence Cancer Center	Ph:  907-261-3109
Arkansas
	Jonesboro
	NEA Medical Center - Stadium Boulevard
		Carroll Scroggin, MD	Ph:  870-934-5343
California
	Glendale
	Glendale Memorial Hospital Comprehensive Cancer Center
		Clinical Trials Office - Glendale Memorial Hospital Comprehensive Cancer Center	Ph:  818-409-7653
	Greenbrae
	California Cancer Care, Incorporated - Greenbrae
		Peter Eisenberg, MD	Ph:  415-925-5000
	Loma Linda
	Loma Linda University Cancer Institute at Loma Linda University Medical Center
		Clinical Trials Office - Loma Linda University Cancer Institute	Ph:  909-558-3375
	Los Angeles
	USC/Norris Comprehensive Cancer Center and Hospital
		Clinical Trials Office - USC/Norris Comprehensive Cancer Center and Hospital	Ph:  323-865-0451
	Mountain View
	Camino Medical Group - Treatment Center
		Peter Yu, MD	Ph:  408-524-5814
	Palo Alto
	Palo Alto Medical Foundation
		David Leibowitz	Ph:  650-321-4121
	Salinas
	Salinas Valley Memorial Hospital
		Shehzad Aziz, MD	Ph:  831-755-1701
	Stanford
	Stanford Cancer Center
		Clinical Trials Office - Stanford Cancer Center	Ph:  650-498-7061
			Email: cctoffice@stanford.edu
Colorado
	Alamosa
	San Luis Valley Regional Medical Center
		Anthony Elias, MD	Ph:  720-848-1622
	Aurora
	University of Colorado Cancer Center at UC Health Sciences Center
		Clinical Trials Office - University of Colorado Cancer Center	Ph:  720-848-0650
	Denver
	Veterans Affairs Medical Center - Denver
		Anthony Elias, MD	Ph:  720-848-1622
	Edwards
	Shaw Regional Cancer Center
		Anthony Elias, MD	Ph:  720-848-1622
	Glenwood Springs
	Valley View Hospital Cancer Center
		Anthony Elias, MD	Ph:  720-848-1622
	Grand Junction
	St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center
		Anthony Elias, MD	Ph:  720-848-1622
	Montrose
	Montrose Memorial Hospital Cancer Center
		Clinical Trials Office - Montrose Memorial Hospital Cancer Center	Ph:  670-240-7267
Connecticut
	Hartford
	Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical Center
		Philip Stella, MD	Ph:  734-712-1000
	New Haven
	Yale Cancer Center
		Clinical Trials Office - Yale Cancer Center	Ph:  203-785-5702
Florida
	Orlando
	Florida Hospital Cancer Institute at Florida Hospital Orlando
		Clinical Trials Office - Florida Hospital Cancer Institute	Ph:  407-303-5623
Georgia
	Valdosta
	Pearlman Comprehensive Cancer Center at South Georgia Medical Center
		Jeffrey Hoy, MD	Ph:  229-259-4628
Hawaii
	Aiea
	Kapiolani Medical Center at Pali Momi
		Jeffrey Berenberg, MD	Ph:  808-433-4089
	Honolulu
	Cancer Research Center of Hawaii
		Clinical Trials Office - Cancer Research Center of Hawaii	Ph:  808-586-2979
	Hawaii Medical Center - East
		Jeffrey Berenberg, MD	Ph:  808-433-4089
	Kapiolani Medical Center for Women and Children
		Jeffrey Berenberg, MD	Ph:  808-433-4089
	OnCare Hawaii, Incorporated - Kuakini
		Jeffrey Berenberg, MD	Ph:  808-433-4089
	OnCare Hawaii, Incorporated - Lusitana
		Jeffrey Berenberg, MD	Ph:  808-433-4089
	Queen's Cancer Institute at Queen's Medical Center
		Jeffrey Berenberg, MD	Ph:  808-433-4089
	Straub Clinic and Hospital, Incorporated
		Jeffrey Berenberg, MD	Ph:  808-433-4089
	Tripler Army Medical Center
		Jeffrey Berenberg, MD	Ph:  808-433-4089
	Wailuku
	Maui Memorial Medical Center
		Jeffrey Berenberg, MD	Ph:  808-433-4089
	Pacific Cancer Institute - Maui
		Jeffrey Berenberg, MD	Ph:  808-433-4089
Idaho
	Boise
	Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical Center
		Clinical Trials Office - Saint Alphonsus Cancer Care Center	Ph:  208-367-7954
	Coeur d'Alene
	Kootenai Cancer Center - Coeur d'Alene
		Clinical Trials Office - North Idaho Cancer Center	Ph:  208-666-3764
Illinois
	Aurora
	Rush-Copley Cancer Care Center
		Patricia Johnson, MD, PhD	Ph:  217-383-3010
	Chicago
	Creticos Cancer Center at Advocate Illinois Masonic Medical Center
		Clinical Trials Office - Creticos Cancer Center at Advocate Illinois Masonic Medical Center	Ph:  773-296-5360
	Louis A. Weiss Memorial Hospital
		Clinical Trials Office - Louis A. Weiss Memorial Hospital	Ph:  773- 564-5044
	Resurrection Medical Center
		Christopher Rose, MD	Ph:  847-965-3200
	Elmhurst
	Elmhurst Memorial Hospital
		Robert Eisner	Ph:  630-833-1400
	Harvey
	Ingalls Cancer Care Center at Ingalls Memorial Hospital
		Clinical Trials Office - Ingalls Cancer Care Center at Ingalls Memorial Hospital	Ph:  708-915-4673
	Rockford
	Swedish-American Regional Cancer Center
		Clinical Trials Office - Swedish-American Regional Cancer Center	Ph:  815-489-4413
	Urbana
	CCOP - Carle Cancer Center
		Clinical Trials Office - CCOP - Carle Cancer Center	Ph:  800-446-5532
Indiana
	Elkhart
	Elkhart Clinic, LLC
		Rafat Ansari, MD, FACP	Ph:  574-234-5123
	Elkhart General Hospital
		Rafat Ansari, MD, FACP	Ph:  574-234-5123
	Michiana Hematology-Oncology, PC - Elkhart
		Rafat Ansari, MD, FACP	Ph:  574-234-5123
	Indianapolis
	Community Regional Cancer Care at Community Hospital North
		Pablo Bedano	Ph:  317-621-4300
	St. Vincent Indianapolis Hospital
		Clinical Trials Office - St. Vincent Indianapolis Hospital	Ph:  317-338-2194
	Kokomo
	Howard Community Hospital
		Rafat Ansari, MD, FACP	Ph:  574-234-5123
	La Porte
	Center for Cancer Therapy at LaPorte Hospital and Health Services
		Rafat Ansari, MD, FACP	Ph:  574-234-5123
	Michigan City
	Saint Anthony Memorial Health Centers
		Patricia Johnson, MD, PhD	Ph:  217-383-3010
	Mishawaka
	Michiana Hematology-Oncology, PC - South Bend
		Rafat Ansari, MD, FACP	Ph:  574-234-5123
	Saint Joseph Regional Medical Center
		Rafat Ansari, MD, FACP	Ph:  574-234-5123
	Muncie
	Cancer Center at Ball Memorial Hospital
		Clinical Trials Office - Cancer Center at Ball Memorial Hospital	Ph:  765-281-2107
	Plymouth
	Michiana Hematology Oncology PC - Plymouth
		Rafat Ansari, MD, FACP	Ph:  574-234-5123
	South Bend
	CCOP - Northern Indiana CR Consortium
		Rafat Ansari, MD, FACP	Ph:  574-234-5123
	Memorial Hospital of South Bend
		Clinical Trials Office - Memorial Hospital of South Bend	Ph:  800-284-7370
	Michiana Hematology-Oncology, PC - South Bend
		Rafat Ansari, MD, FACP	Ph:  574-234-5123
	Westville
	Michiana Hematology Oncology PC - La Porte
		Rafat Ansari, MD, FACP	Ph:  574-234-5123
Iowa
	Ames
	McFarland Clinic, PC
		Clinical Trials Office - McFarland Clinic, PC	Ph:  515-239-2621
	Sioux City
	Mercy Medical Center - Sioux City
		Donald Wender, MD, PhD	Ph:  712-252-0088
	Siouxland Hematology-Oncology Associates, LLP
		Donald Wender, MD, PhD	Ph:  712-252-0088
	St. Luke's Regional Medical Center
		Donald Wender, MD, PhD	Ph:  712-252-0088
	Waterloo
	Covenant Cancer Treatment Center
		Clinical Trials Office - Covenant Cancer Treatment Center	Ph:  319-272-2070
Kansas
	Salina
	Tammy Walker Cancer Center at Salina Regional Health Center
		William Cathcart-Rake, MD	Ph:  785-452-4860
	Topeka
	Cotton-O'Neil Cancer Center
		Clinical Trials Office - Cotton-O'Neil Cancer Center	Ph:  785-270-4963
Maine
	Portland
	Mercy Hospital
		Roger Inhorn, MD, PhD	Ph:  207-879-3030
Maryland
	Baltimore
	Alvin and Lois Lapidus Cancer Institute at Sinai Hospital
		Mayer Gorbaty	Ph:  410-601-4734
Massachusetts
	Worcester
	Saint Vincent Hospital at Worcester Medical Center
		Clinical Trials Office - Saint Vincent Hospital at Worcester Medical Center	Ph:  508-363-7018
Michigan
	Adrian
	Hickman Cancer Center at Bixby Medical Center
		Clinical Trials Office - Hickman Cancer Center at Bixby Medical Center	Ph:  517-265-0116
	Ann Arbor
	CCOP - Michigan Cancer Research Consortium
		Philip Stella, MD	Ph:  734-712-1000
	Saint Joseph Mercy Cancer Center
		Philip Stella, MD	Ph:  734-712-1000
	University of Michigan Comprehensive Cancer Center
		Clinical Trials Office - University of Michigan Comprehensive Cancer Center	Ph:  800-865-1125
	Battle Creek
	Battle Creek Health System Cancer Care Center
		Martin Bury	Ph:  616-966-8000
	Bay City
	Bay Regional Medical Center
		Clinical Trials Office - Bay Regional Medical Center	Ph:  989-667-6257
	Big Rapids
	Mecosta County Medical Center
		Martin Bury	Ph:  231-796-8691
	Dearborn
	Oakwood Cancer Center at Oakwood Hospital and Medical Center
		Clinical Trials Office - Oakwood Cancer Center at Oakwood Hospital and Medical Center	Ph:  313-593-8090
	Detroit
	Barbara Ann Karmanos Cancer Institute
		Clinical Trials Office - Barbara Ann Karmanos Cancer Institute	Ph:  313-576-9363
	Josephine Ford Cancer Center at Henry Ford Hospital
		Robert Chapman, MD	Ph:  313-916-1332
	Escanaba
	Green Bay Oncology, Limited - Escanaba
		Thomas Saphner, MD, FACP	Ph:  920-884-3135
	Flint
	Genesys Hurley Cancer Institute
		Clinical Trials Office - Genesys Hurley Cancer Institute	Ph:  810-762-8057
	Hurley Medical Center
		Clinical Trials Office - Hurley Medical Center	Ph:  810-762-8057
	Grand Rapids
	Butterworth Hospital at Spectrum Health
		Martin Bury	Ph:  616-391-2799
	CCOP - Grand Rapids
		Martin Bury	Ph:  616-391-1230
	Lacks Cancer Center at Saint Mary's Health Care
		Martin Bury	Ph:  616-752-5222
	Grosse Pointe Woods
	Van Elslander Cancer Center at St. John Hospital and Medical Center
		Clincial Trials Office - Van Elslander Cancer Center at St. John Hospital and Medical Center	Ph:  313-343-3166
	Iron Mountain
	Dickinson County Healthcare System
		Thomas Saphner, MD, FACP	Ph:  920-884-3135
	Jackson
	Foote Memorial Hospital
		Philip Stella, MD	Ph:  734-712-1000
	Kalamazoo
	Borgess Medical Center
		Raymond Lord, MD	Ph:  269-373-7458
	Bronson Methodist Hospital
		Raymond Lord, MD	Ph:  269-373-7458
	West Michigan Cancer Center
		Clinical Trials Office - West Michigan Cancer Center	Ph:  269-373-7458
	Lansing
	Breslin Cancer Center at Ingham Regional Medical Center
		Clinical Trials Office - Breslin Cancer Center at Ingham Regional Medical Center	Ph:  517-334-2765
	Sparrow Regional Cancer Center
		Clinical Trials Office - Sparrow Regional Cancer Center	Ph:  517-364-2890
	Livonia
	St. Mary Mercy Hospital
		Philip Stella, MD	Ph:  734-712-1000
	Monroe
	Community Cancer Center of Monroe
		Rex Mowat	Ph:  734-242-7902
	Mercy Memorial Hospital - Monroe
		Rex Mowat	Ph:  734-240-8400
	Mount Clemens
	Clemens Regional Medical Center
		Clinical Trials Office - Ted B. Wahby Cancer Center at Mount Clemens General Hospital	Ph:  586-493-3426
	Muskegon
	Mercy General Health Partners
		Martin Bury	Ph:  231-672-2000
	Pontiac
	St. Joseph Mercy Oakland
		Philip Stella, MD	Ph:  734-712-1000
	Port Huron
	Mercy Regional Cancer Center at Mercy Hospital
		Philip Stella, MD	Ph:  734-712-1000
	Royal Oak
	William Beaumont Hospital - Royal Oak Campus
		Clinical Trials Office - William Beaumont Hospital - Royal Oak Campus	Ph:  248-551-7695
	Saginaw
	Seton Cancer Institute at Saint Mary's - Saginaw
		Clinical Trials Office - Seton Cancer Institute - Saginaw	Ph:  989-776-8411
	Saint Joseph
	Lakeside Cancer Specialists, PLLC
		Rafat Ansari, MD, FACP	Ph:  574-234-5123
	Southfield
	Providence Cancer Institute at Providence Hospital - Southfield Campus
		Anibal Drelichman, MD, MPH, FACP	Ph:  313-552-0620
	St. Joseph
	Lakeland Regional Cancer Care Center - St. Joseph
		Rafat Ansari, MD, FACP	Ph:  574-234-5123
	Traverse City
	Munson Medical Center
		Martin Bury	Ph:  231-935-6202
	Warren
	St. John Macomb Hospital
		Philip Stella, MD	Ph:  734-712-1000
Minnesota
	Alexandria
		Donald Jurgens
	Burnsville
	Fairview Ridges Hospital
		Patrick Flynn, MD	Ph:  612-863-8585
	Coon Rapids
	Mercy and Unity Cancer Center at Mercy Hospital
		Patrick Flynn, MD	Ph:  612-863-8585
	Edina
	Fairview Southdale Hospital
		Clinical Trials Office - Fairview Southdale Hospital	Ph:  612-625-3650
	Fridley
	Mercy and Unity Cancer Center at Unity Hospital
		Patrick Flynn, MD	Ph:  612-863-8585
	Hutchinson
	Hutchinson Area Health Care
		Patrick Flynn, MD	Ph:  612-863-8585
	Maplewood
	HealthEast Cancer Care at St. John's Hospital
		Patrick Flynn, MD	Ph:  612-863-8585
	Minnesota Oncology Hematology, PA - Maplewood
		Patrick Flynn, MD	Ph:  612-863-8585
	Minneapolis
	Hennepin County Medical Center - Minneapolis
		Clinical Trials Office - Hennepin County Medical Center - Minneapolis	Ph:  612-873-5911
	Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
		Clinical Trials Office - Virginia Piper Cancer Institute	Ph:  612-863-5654
	Robbinsdale
	Humphrey Cancer Center at North Memorial Outpatient Center
		Clinical Trials Office - Humphrey Cancer Center at North Memorial Outpatient Center	Ph:  763-520-1893
	Saint Cloud
	CentraCare Clinic - River Campus
		Donald Jurgens	Ph:  320-252-5131
	Coborn Cancer Center
		Donald Jurgens	Ph:  320-229-4907 877-229-4907
	Saint Louis Park
	CCOP - Metro-Minnesota
		Patrick Flynn, MD	Ph:  612-863-8585
	Park Nicollet Cancer Center
		Patrick Flynn, MD	Ph:  612-863-8585
	Saint Paul
	United Hospital
		Patrick Flynn, MD	Ph:  612-863-8585
	Shakopee
	St. Francis Cancer Center at St. Francis Medical Center
		Patrick Flynn, MD	Ph:  612-863-8585
	St. Paul
	Regions Hospital Cancer Care Center
		Clinical Trials Office - Regions Hospital Cancer Care Center	Ph:  651-254-1517
	Stillwater
	Lakeview Hospital
		Patrick Flynn, MD	Ph:  612-863-8585
	Waconia
	Ridgeview Medical Center
		Patrick Flynn, MD	Ph:  612-863-8585
	Willmar
	Willmar Cancer Center at Rice Memorial Hospital
		Patrick Flynn, MD	Ph:  612-863-8585
	Woodbury
	Minnesota Oncology Hematology, PA - Woodbury
		Patrick Flynn, MD	Ph:  612-863-8585
Mississippi
	Jackson
	University of Mississippi Cancer Clinic
		Barbara Craft	Ph:  601-984-5590
	Pascagoula
	Regional Cancer Center at Singing River Hospital
		James Clarkson, MD	Ph:  228-374-6296
Missouri
	Cape Girardeau
	Southeast Cancer Center
		Alan Lyss, MD	Ph:  314-996-5514
	Jefferson City
	Goldschmidt Cancer Center
		Alan Lyss, MD	Ph:  314-996-5514
	Saint Louis
	Comprehensive Cancer Care, PC
		Alan Lyss, MD	Ph:  314-996-5514
	Missouri Baptist Cancer Center
		Alan Lyss, MD	Ph:  314-996-5514
	Springfield
	CCOP - Cancer Research for the Ozarks
		Robert Carolla	Ph:  417-269-4520
	Hulston Cancer Center at Cox Medical Center South
		Robert Carolla	Ph:  417-269-5257
Montana
	Billings
	Billings Clinic - Downtown
		Clinical Trials Office - Billings Clinic - Downtown	Ph:  800-996-2663
			Email: research@billingsclinic.org
	CCOP - Montana Cancer Consortium
		Benjamin Marchello, MD	Ph:  406-238-6290
	Hematology-Oncology Centers of the Northern Rockies - Billings
		Benjamin Marchello, MD	Ph:  406-238-6290
	St. Vincent Healthcare Cancer Care Services
		Benjamin Marchello, MD	Ph:  406-238-6290
	Bozeman
	Bozeman Deaconess Cancer Center
		Benjamin Marchello, MD	Ph:  406-238-6290
	Butte
	St. James Healthcare Cancer Care
		Benjamin Marchello, MD	Ph:  406-238-6290
	Great Falls
	Big Sky Oncology
		Clinical Trial Office - Big Sky Oncology	Ph:  406-731-8217
	Great Falls Clinic - Main Facility
		Benjamin Marchello, MD	Ph:  406-238-6290
	Sletten Cancer Institute at Benefis Healthcare
		Grant Harrer, MD, FACP, CCTI	Ph:  406-731-8100
	Havre
	Northern Montana Hospital
		Benjamin Marchello, MD	Ph:  406-238-6290
	Helena
	St. Peter's Hospital
		Benjamin Marchello, MD	Ph:  406-238-6290
	Kalispell
	Glacier Oncology, PLLC
		Benjamin Marchello, MD	Ph:  406-238-6290
	Kalispell Medical Oncology at KRMC
		Benjamin Marchello, MD	Ph:  406-238-6290
	Kalispell Regional Medical Center
		Benjamin Marchello, MD	Ph:  406-238-6290
	Missoula
	Montana Cancer Center at St. Patrick Hospital and Health Sciences Center
		Clinical Trials Office - Montana Cancer Center at St. Patrick Hospital and Health Sciences Center	Ph:  406-329-7029
Nebraska
	Kearney
	Good Samaritan Cancer Center at Good Samaritan Hospital
		Clinical Trials Office - Good Samaritan Cancer Center at Good Samaritan Hospital	Ph:  308-865-7963
New Hampshire
	Lebanon
	Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
		Clinical Trials Office - Norris Cotton Cancer Center	Ph:  603-650-7609
			Email: cancerhelp@dartmouth.edu
New Jersey
	Morristown
	Carol G. Simon Cancer Center at Morristown Memorial Hospital
		Bonni Guerin	Ph:  973-971-6100 800-247-9580
	New Brunswick
	Saint Peter's University Hospital
		Kathleen Toomey	Ph:  732-745-8600
	Newark
	Newark Beth Israel Medical Center
		Clinical Trials Office - Newark Beth Israel Medical Center	Ph:  973-926-3136
	UMDNJ University Hospital
		Robert Wieder	Ph:  973-972-4300
	Paterson
	St. Joseph's Hospital and Medical Center
		David Cornell, MD	Ph:  718-579-5000
	Summit
	Overlook Hospital
		Bonni Guerin	Ph:  908-522-2000
New Mexico
	Albuquerque
	Hematology Oncology Associates, PC
		Melanie Royce, MD, PhD	Ph:  505-272-6057
	Lovelace Medical Center - Downtown
		Melanie Royce, MD, PhD	Ph:  505-272-6057
	Presbyterian Cancer Treatment Center at Presbyterian Kaseman Hospital
		Melanie Royce, MD, PhD	Ph:  505-272-6057
	University of New Mexico Cancer Center
		Clinical Trials Office - University of New Mexico Cancer Center	Ph:  505-272-6972
	Las Cruces
	University of New Mexico Cancer Center - South
		Melanie Royce, MD, PhD	Ph:  505-272-6057
New York
	Bronx
	Albert Einstein Cancer Center at Albert Einstein College of Medicine
		Clinical Trials Office - Albert Einstein Cancer Center at Albert Einstein College of Medicine	Ph:  718-904-2730
			Email: aecc@aecom.yu.edu
	Buffalo
	Roswell Park Cancer Institute
		Clinical Trials Office - Roswell Park Cancer Institute	Ph:  877-275-7724
	East Syracuse
	CCOP - Hematology-Oncology Associates of Central New York
		Jeffrey Kirshner, MD	Ph:  315-472-7504
	Utica
	Faxton Regional Cancer Center
		Atul Butala, MD, FACP	Ph:  315-798-9300
	White Plains
	Dickstein Cancer Treatment Center at White Plains Hospital Center
		Clinical Trials Office - Dickstein Cancer Treatment Center	Ph:  914-681-2290
North Carolina
	Asheville
	Mission Hospitals - Memorial Campus
		Clinical Trials Office - Mission Hospitals - Memorial Campus	Ph:  828-213-4150
	Durham
	Duke Cancer Institute
		Clinical Trials Office - Duke Cancer Institute	Ph:  888-275-3853
	Goldsboro
	Wayne Memorial Hospital, Incorporated
		James Atkins, MD	Ph:  919-580-0000
	Hendersonville
	Pardee Memorial Hospital
		James Radford, MD	Ph:  828-692-8045
	Kinston
	Kinston Medical Specialists
		Peter Watson, MD	Ph:  252-559-2200ext.201
	Lumberton
	Southeastern Regional Medical Center
		Jeffrey Crawford, MD	Ph:  919-681-9509
	Oxford
	Granville Medical Center
		Jeffrey Crawford, MD	Ph:  919-681-9509
	Raleigh
	Duke Health Raleigh Hospital
		Jeffrey Crawford, MD	Ph:  919-681-9509
	Roxboro
	Person Memorial Hospital
		Jeffrey Crawford, MD	Ph:  919-681-9509
North Dakota
	Bismarck
	Bismarck Cancer Center
		Edward Wos, DO	Ph:  701-323-5741
	Medcenter One Hospital Cancer Care Center
		Edward Wos, DO	Ph:  701-323-5741
	Mid Dakota Clinic, PC
		Clinical Trials Office - Mid Dakota Clinic, PC	Ph:  701-530-6950
	St. Alexius Medical Center Cancer Center
		Clinical Trials Office - St. Alexius Medical Center Cancer Center	Ph:  701-530-6950
	Grand Forks
	Altru Cancer Center at Altru Hospital
		Clinical Trails Office - Altru Cancer Center at Altru Hospital	Ph:  701-780-6520
	Minot
	Trinity CancerCare Center
		Stephen Makoni	Ph:  701-857-3535 800-862-0005
Ohio
	Beachwood
	Cleveland Clinic Beachwood Family Health and Surgery Center
		Anjali Advani	Ph:  216-839-3200
	Bowling Green
	Wood County Oncology Center
		Rex Mowat	Ph:  419-352-9498
	Cincinnati
	Charles M. Barrett Cancer Center at University Hospital
		Leslie Oleksowicz	Ph:  513-584-3200 888-640-CARE
	Cleveland
	Case Comprehensive Cancer Center
		Clinical Trials Office - Case Comprehensive Cancer Center	Ph:  800-641-2422
	Cleveland Clinic Cancer Center at Fairview Hospital
		Clinical Trials Office - Cleveland Clinic Cancer Center at Fairview Hospital	Ph:  216-476-9362
	Cleveland Clinic Taussig Cancer Center
		Clinical Trials Office - Cleveland Clinic Taussig Cancer Center	Ph:  866-223-8100
	Elyria
	Community Cancer Center
		Rex Mowat	Ph:  440-324-0400
	Hematology Oncology Center
		Rex Mowat	Ph:  440-324-0401
	Independence
	Cleveland Clinic Cancer Center
		Anjali Advani	Ph:  216-524-7979
	Lima
	Lima Memorial Hospital
		Rex Mowat	Ph:  419-228-3335
	St. Rita's Medical Center
		Clinical Trials Office - St. Rita's Medical Center	Ph:  419-226-9617
	Maumee
		Rex Mowat	Ph:  419-891-5600
	Northwest Ohio Oncology Center
		Rex Mowat	Ph:  419-891-5600
	St. Luke's Hospital
		Rex Mowat	Ph:  419-893-5911
	Mayfield Heights
	Hillcrest Cancer Center at Hillcrest Hospital
		Anjali Advani	Ph:  440-312-4500
	Mentor
	Lake/University Ireland Cancer Center
		Joseph Baar	Ph:  440-205-5755
	Norwalk
	Fisher-Titus Medical Center
		Rex Mowat	Ph:  419-668-8101 800-589-3862
	Orange Village
	UHHS Chagrin Highlands Medical Center
		Joseph Baar	Ph:  216-292-1783
	Oregon
	St. Charles Mercy Hospital
		Rex Mowat	Ph:  419-696-7200
	Toledo Clinic - Oregon
		Rex Mowat	Ph:  419-691-4235
	Parma
	Parma Community General Hospital
		Clinical Trials Office - Parma Community General Hospital	Ph:  440-743-4747
	Sandusky
	North Coast Cancer Care, Incorporated
		Rex Mowat	Ph:  419-626-9090
	Strongsville
	Cleveland Clinic Foundation - Strongsville
		Anjali Advani	Ph:  440-878-2500 800-239-1098
	Sylvania
	Flower Hospital Cancer Center
		Clinical Trials Office - Flower Hospital Cancer Center	Ph:  419-824-1842
	Tiffin
	Mercy Hospital of Tiffin
		Rex Mowat	Ph:  419-447-3130
	Toledo
	CCOP - Toledo Community Hospital
		Rex Mowat	Ph:  419-843-6147
	Medical University of Ohio Cancer Center
		Clinical Trials Office - Medical University of Ohio Cancer Center	Ph:  419-383-6583
	St. Anne Mercy Hospital
		Rex Mowat	Ph:  419-407-2663
	St. Vincent Mercy Medical Center
		Rex Mowat	Ph:  419-251-4515
	Toledo Clinic, Incorporated - Main Clinic
		Rex Mowat	Ph:  419-479-5605
	Toledo Hospital
		Clinical Trials Office - Toledo Hospital	Ph:  419-824-1842
	Wauseon
	Fulton County Health Center
		Clinical Trials Office - Fulton County Health Center	Ph:  419-330-2708
	Westlake
	UHHS Westlake Medical Center
		Joseph Baar	Ph:  440-250-2001
	Wooster
	Cleveland Clinic - Wooster
		Clinical Trials Office - Cleveland Clinic - Wooster	Ph:  800-862-7798
Oklahoma
	Tulsa
	Natalie Warren Bryant Cancer Center at St. Francis Hospital
		Joseph Lynch, MD	Ph:  918-494-8275
Oregon
	Bend
	St. Charles Medical Center - Bend
		Robert Boone, MD	Ph:  541-317-4298
	Clackamas
	Clackamas Radiation Oncology Center
		Janet Ruzich	Ph:  503-513-3300
	Coos Bay
	Bay Area Hospital
		Bret Cook, MD	Ph:  541-267-5151
	Grants Pass
	Three Rivers Community Hospital
		Charles Dibb, MD	Ph:  541-774-5853
	Medford
	Dubs Cancer Center at Rogue Valley Medical Center
		Charles Dibb, MD	Ph:  541-774-5853
	Providence Cancer Center at PMCC
		Charles Dibb, MD	Ph:  541-774-5853
	Milwaukie
	Providence Milwaukie Hospital
		Janet Ruzich	Ph:  503-513-8300
	Newberg
	Providence Newberg Medical Center
		Janet Ruzich	Ph:  503-537-1555
	Oregon City
	Willamette Falls Hospital
		Janet Ruzich	Ph:  503-650-6758
	Portland
	CCOP - Columbia River Oncology Program
		Janet Ruzich	Ph:  503-216-6260
	Providence Cancer Center at Providence Portland Medical Center
		Clinical Trials Office - Providence Cancer Center at Providence Portland Medical Center	Ph:  503-215-6412
	Providence St. Vincent Medical Center
		Clinical Trials Office - Providence St. Vincent Medical Center	Ph:  503-215-6412
Pennsylvania
	Butler
	Butler Memorial Hospital
		Rex Mowat	Ph:  412-283-6666
	Ephrata
	Ephrata Cancer Center at Ephrata Community Hospital
		Allison Zibelli, MD	Ph:  215-923-5676
	Philadelphia
	Fox Chase Cancer Center - Philadelphia
		Clinical Trials Office - Fox Chase Cancer Center - Philadelphia	Ph:  215-728-4790
	Phoenixville
	Cancer Center at Phoenixville Hospital
		Carl Sharer, DO	Ph:  610-983-1800
	Pittsburgh
	UPMC Cancer Centers
		Clinical Trials Office - UPMC Cancer Centers	Ph:  412-647-8073
	Reading
	McGlinn Family Regional Cancer Center at Reading Hospital and Medical Center
		Clinical Trials Office - McGlinn Family Regional Cancer Center	Ph:  610-988-9323
	Sayre
	Guthrie Cancer Center at Guthrie Clinic Sayre
		Clinical Trials Office - Guthrie Cancer Center at Guthrie Clinic Sayre	Ph:  800-836-0388
	Scranton
	Hematology and Oncology Associates of Northeastern Pennsylvania
		Allison Zibelli, MD	Ph:  215-923-5676
South Carolina
	Charleston
	Roper St. Francis Cancer Center at Roper Hospital
		James Orcutt, MD	Ph:  843-577-2276
	Easley
	Cancer Centers of the Carolinas - Easley
		Clinical Trials Office - Cancer Centers of the Carolinas	Ph:  864-241-6251
	Greenville
	Cancer Centers of the Carolinas - Faris Road
		Jeffrey Giguere, MD, FACP	Ph:  864-987-7000
	Cancer Centers of the Carolinas - Grove Commons
		Clinical Trials Office - Cancer Centers of the Carolinas	Ph:  864-241-6251
	CCOP - Greenville
		Jeffrey Giguere, MD, FACP	Ph:  864-987-7000
	Greenville Hospital Cancer Center
		Clinical Trials Office - Greenville Hospital Cancer Center	Ph:  864-241-6251
	Greenwood
	Self Regional Cancer Center at Self Regional Medical Center
		Jeffrey Giguere, MD, FACP	Ph:  864-987-7000
	Greer
	Cancer Centers of the Carolinas - Greer Medical Oncology
		Jeffrey Giguere, MD, FACP	Ph:  864-987-7000
	Seneca
	Cancer Centers of the Carolinas - Seneca
		Jeffrey Giguere, MD, FACP	Ph:  864-987-7000
	Spartanburg
	Cancer Centers of the Carolinas - Spartanburg
		Jeffrey Giguere, MD, FACP	Ph:  864-987-7000
Tennessee
	Jackson
	West Tennessee Cancer Center at Jackson-Madison County General Hospital
		Clinical Trials Office - West Tennessee Cancer Center	Ph:  731-425-6865
	Nashville
	MBCCOP - Meharry Medical College - Nashville
		Steven Wolff, MD	Ph:  615-327-6277
Texas
	Houston
	M. D. Anderson Cancer Center at University of Texas
		Clinical Trials Office - M. D. Anderson Cancer Center at the University of Texas	Ph:  713-792-3245
	San Antonio
	Cancer Therapy and Research Center
		Clinical Trials Office - Cancer Therapy and Research Center	Ph:  210- 616-5798
	University Hospital - San Antonio
		Anand Karnad, MD	Ph:  210-567-4777
	University of Texas Health Science Center at San Antonio
		Anand Karnad, MD	Ph:  210-567-4777
	Veterans Affairs Medical Center - San Antonio (Murphy)
		Anand Karnad, MD	Ph:  210-567-4777
	Temple
	CCOP - Scott and White Hospital
		Lucas Wong, MD	Ph:  254-724-1053
Utah
	American Fork
	American Fork Hospital
		W. Harker, MD	Ph:  801-269-0231
	Cedar City
	Sandra L. Maxwell Cancer Center
		W. Harker, MD	Ph:  801-269-0231
	Logan
	Logan Regional Hospital
		W. Harker, MD	Ph:  801-269-0231
	Murray
	Jon and Karen Huntsman Cancer Center at Intermountain Medical Center
		W. Harker, MD	Ph:  801-269-0231
	Ogden
	Val and Ann Browning Cancer Center at McKay-Dee Hospital Center
		Clinical Trials Office - McKay-Dee Hospital Center	Ph:  801 387-7426
	Provo
	Utah Valley Regional Medical Center - Provo
		Clinical Trials Office - Utah Valley Regional Medical Center - Provo	Ph:  801-357-7965
	Saint George
	Dixie Regional Medical Center - East Campus
		Clinical Trials Office - Dixie Regional Medical Center - East Campus	Ph:  435-688-4167
	Salt Lake City
	LDS Hospital
		W. Harker, MD	Ph:  801-269-0231
	Utah Cancer Specialists at UCS Cancer Center
		W. Harker, MD	Ph:  801-269-0231
Virginia
	Danville
	Danville Regional Medical Center
		Clinical Trials Office - Danville Regional Medical Center	Ph:  434-799-3753
	Fredericksburg
	Fredericksburg Oncology, Incorporated
		Rex Mowat	Ph:  540-368-0500
	Richmond
	Virginia Cancer Institute - West End
		James May, MD, FACP	Ph:  804-330-7990
Washington
	Anacortes
	Island Hospital Cancer Care Center at Island Hospital
		Saul Rivkin, MD	Ph:  206-386-2441
	Bellingham
	St. Joseph Cancer Center
		Saul Rivkin, MD	Ph:  206-386-2441
	Bremerton
	Olympic Hematology and Oncology
		Saul Rivkin, MD	Ph:  206-386-2441
	Burien
	Highline Medical Center Cancer Center
		Saul Rivkin, MD	Ph:  206-386-2441
	Centralia
	Providence Centralia Hospital
		Clinical Trials Office - Providence Centralia Hospital	Ph:  360-493-4300
	Federal Way
	St. Francis Hospital
		Yoshio Inoue	Ph:  253-944-7997
	Kennewick
	Columbia Basin Hematology
		Saul Rivkin, MD	Ph:  206-386-2441
	Mount Vernon
	Skagit Valley Hospital Cancer Care Center
		Saul Rivkin, MD	Ph:  206-386-2441
	Olympia
	Providence St. Peter Hospital Regional Cancer Center
		Yoshio Inoue	Ph:  360-493-7514
	Poulsbo
	Harrison Poulsbo Hematology and Onocology
		Saul Rivkin, MD	Ph:  206-386-2441
	Puyallup
	Good Samaritan Cancer Center
		Yoshio Inoue	Ph:  253-697-4000
	Seattle
	Fred Hutchinson Cancer Research Center
		Saul Rivkin, MD	Ph:  206-386-2441
	Group Health Central Hospital
		Clinical Trials Office - Group Health Central Hospital	Ph:  206-287-2900
	Harborview Medical Center
		Saul Rivkin, MD	Ph:  206-386-2441
	Minor and James Medical, PLLC
		Saul Rivkin, MD	Ph:  206-386-2441
	Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
		Saul Rivkin, MD	Ph:  206-386-2441
	University Cancer Center at University of Washington Medical Center
		Saul Rivkin, MD	Ph:  206-386-2441
	Sedro-Woolley
	North Puget Oncology at United General Hospital
		Saul Rivkin, MD	Ph:  206-386-2441
	Spokane
	Cancer Care Northwest - Spokane South
		Clinical Trials Office - Cancer Care Northwest - Spokane South	Ph:  509-228-1083
	Evergreen Hematology and Oncology, PS
		Saul Rivkin, MD	Ph:  206-386-2441
	Tacoma
	Allenmore Hospital
		Yoshio Inoue	Ph:  253-459-6446
	CCOP - Northwest
		Yoshio Inoue	Ph:  253-403-1461
	Franciscan Cancer Center at St. Joseph Medical Center
		Clinical Trials Office - Franciscan Cancer Center	Ph:  253-426-6914
	MultiCare Regional Cancer Center at Tacoma General Hospital
		Clinical Trials Office - MultiCare Regional Cancer Center	Ph:  253-403-3229
	St. Clare Hospital
		Yoshio Inoue	Ph:  253-588-1711
	Vancouver
	Southwest Washington Medical Center Cancer Center
		Janet Ruzich	Ph:  360-514-2174
	Wenatchee
	Wenatchee Valley Medical Center
		Clinical Trials Office - Wenatchee Valley Medical Center	Ph:  509-665-5800
Wisconsin
	Green Bay
	Green Bay Oncology, Limited at St. Mary's Hospital
		Thomas Saphner, MD, FACP	Ph:  920-884-3135
	Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center
		Thomas Saphner, MD, FACP	Ph:  920-884-3135
	St. Mary's Hospital Medical Center - Green Bay
		Thomas Saphner, MD, FACP	Ph:  920-884-3135
	St. Vincent Hospital Regional Cancer Center
		Clinical Trials Office - St. Vincent Hospital Regional Cancer Center	Ph:  920-433-8889
	La Crosse
	Gundersen Lutheran Center for Cancer and Blood
		Clinical Trials Office - Gundersen Lutheran Cancer Center	Ph:  608-775-2385
			Email: cancerctr@gundluth.org
	Manitowoc
	Holy Family Memorial Medical Center Cancer Care Center
		Clinical Trials Office - Holy Family Memorial Medical Center Cancer Care Center	Ph:  920-320-2749
	Marinette
	Bay Area Cancer Care Center at Bay Area Medical Center
		Thomas Saphner, MD, FACP	Ph:  920-884-3135
	Oconto Falls
	Green Bay Oncology, Limited - Oconto Falls
		Thomas Saphner, MD, FACP	Ph:  920-884-3135
	Sheboygan
	St. Nicholas Hospital
		Thomas Saphner, MD, FACP	Ph:  920-884-3135
	Sturgeon Bay
	Green Bay Oncology, Limited - Sturgeon Bay
		Thomas Saphner, MD, FACP	Ph:  920-884-3135
	Wauwatosa
	Oncology Alliance, SC - Milwaukee - West
		Rubina Qamar	Ph:  414-476-8450
Wyoming
	Sheridan
	Welch Cancer Center at Sheridan Memorial Hospital
		Benjamin Marchello, MD	Ph:  406-238-6290