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Clinical Trials and Studies

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A Double Blind Placebo-Controlled Trial of Eflornithine and Sulindac to Prevent Recurrence of High Risk Adenomas and Second Primary Colorectal Cancers in Patients With Stage 0-III Colon or Rectal Cancer, Phase III - Preventing Adenomas of the Colon With Eflornithine and Sulindac (PACES)

Description

Brief Summary
The investigators hypothesize that the combination of eflornithine and sulindac will be effective in reducing a three-year event rate of adenomas and second primary colorectal cancers in patients previously treated for Stages 0 through III colon or rectal cancer.


Detailed Description
The purpose of this study is to assess whether the combination of eflornithine 500 mg and sulindac 150 mg (compared to corresponding placebos) has efficacy against colorectal lesions with respect to high-grade dysplasia, adenomas with villous features, adenomas 1 cm or greater, multiple adenomas, any adenomas >/= 0.3 cm, total advanced colorectal events, or total colorectal events.

Phase

Phase 3 - a treatment has shown activity against a particular disease, where it is either added to existing treatment or compared to the standard treatment.

Inclusion and Exclusion Criteria

  • History of Stage 0-III colon or rectal cancer with primary resection 1 year previously
  • Post-operative colonoscopy and CT scans of chest, abdomen & pelvis showing no evidence of disease
  • Must not have cardiovascular risk factors including unstable angina, history of myocardial infarction, or cerebrovascular accident, coronary artery bypass surgery, or NY Heart Assoc Class III or IV heart failure.
  • Patients must not have known uncontrolled hyperlipidemia (defined as LDL-C >/= 190 mg/dL or triglycerides >/= 500 mg/dL within the past 3 years or uncontrolled high blood pressure (systolic blood pressure > 150 mm Hg) within 28 days prior to registration
  • At least 30 days from completion of adjuvant chemo and RT.
  • Presence of gastroesophageal reflux disease acceptable if controlled with medications
  • Not receiving or planning to receive concomitant intravenous corticosteroids on a regular basis,nonsteroidal anti-inflammatory drugs (NSAIDs), nor anticoagulants on a regular predictable intermittent basis. NSAID use must not exceed 10 days per month; Maximum aspirin dose
  • 100 mg per day or ≤ two 325 mg tablets per week. Inhaled steroids (i.e. for asthma or related conditions) are allowed.
  • Able to swallow oral medications
  • Laboratory: WBC ≥ 4.0 x 1000/mcL, platelets ≥ 100,000/mcL and hemoglobin > 11.0 g/dL. (A total WBC ≥ 3.1 x 1000/mcL is allowed for non-Hispanic black males and total WBC ≥ 3.4 x 1000/mcL for non-Hispanic black females. Serum bilirubin ≤ 2.0 mg/dL and AST (SGOT) or ALT(SGPT) ≤ 2 x IULN. Serum creatinine ≤ 1.5 x IULN
  • Zubrod PS 0-1, 18 years of age or older
  • Will not participate in any other clinical trial for the treatment or prevention of cancer unless off protocol treatment, on follow-up phase only
  • Offered opportunity to participate in blood specimen banking

  • History of colon resection > 40 cm
  • Mid-low rectal cancer
  • Recurrent or metastatic disease
  • High cardiovascular risk; Uncontrolled hypertension
  • Planned radiation therapy or additional chemotherapy
  • Documented history of gastric/duodenal ulcer within last 12 months and/or current treatment or active symptoms of gastric/duodenal ulcer
  • Known history of familial adenomatous polyposis, hereditary nonpolyposis colorectal cancer, or inflammatory bowel disease
  • ≥ 30 dB uncorrectable hearing loss for age of any of the five tested frequencies on prestudy audiogram
  • Known hypersensitivity to sulindac or excipient byproducts. Previous asthma, urticaria, or allergic-type reaction to aspirin or other NSAIDs
  • Significant medical or psychiatric condition that would preclude study completion (8 years)
  • No other prior malignancy except adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the patient has been disease-free for > 5 years
  • Pregnant or nursing women. Women/men of reproductive potential must agree to use effective contraception

Sites

  • California

    • Los Angeles County-USC Medical Center, Los Angeles, California, 90033
    • University of Southern California/Norris Cancer Center, Los Angeles, California, 90033
    • Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, 90027
    • Keck Medical Center of USC Pasadena, Pasadena, California, 91105
    • Cedars-Sinai Medical Center, Los Angeles, California, 90048
    • Kaiser Permanente-West Los Angeles, Los Angeles, California, 90034
    • Presbyterian Intercommunity Hospital, Whittier, California, 90602
    • Kaiser Foundation Hospital, Bellflower, California, 90706
    • Kaiser Permanente Medical Group - Baldwin Park, Baldwin Park, California, 91706
    • City of Hope, Duarte, California, 91010
    • Kaiser Permanente - Panorama City, Panorama City, California, 91402
    • Kaiser Permanente - Harbor City, Harbor City, California, 90710
    • Kaiser Permanente, Woodland Hills, California, 91367
    • Saint Joseph Hospital - Orange, Orange, California, 92868
    • University of California Medical Center At Irvine-Orange Campus, Orange, California, 92868
    • Kaiser Anaheim Medical Center, Anaheim, California, 92807
    • Southern California Permanente Medical Group, Irvine, California, 92618
    • Kaiser Permanente Medical Center, Riverside, California, 92505
    • Kaiser Permanente Hospital, Fontana, California, 92335
    • Loma Linda University Medical Center, Loma Linda, California, 92354
    • Kaiser Permanente Health Care, San Marcos, California, 92069
    • Kaiser Permanente at San Diego, San Diego, California, 92120
    • Kaiser Permanente, San Diego, California, 92120
    • Kaiser Permanente, Fresno, California, 93720
    • Kaiser Permanente-Modesto, Modesto, California, 95356
    • Kaiser Permanente-Santa Teresa-San Jose, San Jose, California, 95119
    • Kaiser Permanente Medical Center - Santa Clara, Santa Clara, California, 95051
    • El Camino Hospital, Mountain View, California, 94040
    • Valley Medical Oncology Consultants-Fremont, Fremont, California, 94538
    • Kaiser Permanente, Fremont, Fremont, California, 94538
    • Kaiser Permanente-Stockton, Stockton, California, 95210
    • Valley Medical Oncology Consultants, Pleasanton, California, 94588
    • Kaiser Permanente-Redwood City, Redwood City, California, 94063
    • Epic Care-Dublin, Dublin, California, 94568
    • Kaiser Permanente-Deer Valley Medical Center, Antioch, California, 94531
    • Valley Medical Oncology Consultants-Castro Valley, Castro Valley, California, 94546
    • East Bay Radiation Oncology Center, Castro Valley, California, 94546
    • Kaiser Permanente San Leandro, San Leandro, California, 94577
    • Mills - Peninsula Hospitals, Burlingame, California, 94010
    • Highland General Hospital, Oakland, California, 94602
    • Kaiser Permanente-Walnut Creek, Walnut Creek, California, 94596
    • Kaiser Permanente-South San Francisco, South San Francisco, California, 94080
    • Kaiser Permanente-Oakland, Oakland, California, 94611
    • Epic Care-Oakland, Oakland, California, 94612
    • East Bay Medical Oncology Hematology Medical Associates Inc-Pleasant Hill, Pleasant Hill, California, 94523
    • Tom K Lee Inc, Oakland, California, 94609
    • Alta Bates Summit Medical Center - Summit Campus, Oakland, California, 94609
    • Larry G Strieff MD Medical Corporation, Oakland, California, 94609
    • Bay Area Tumor Institute CCOP, Oakland, California, 94609
    • Bay Area Breast Surgeons Inc, Oakland, California, 94609
    • Alta Bates Summit Medical Center-Herrick Campus, Berkeley, California, 94704
    • Kaiser Permanente-San Francisco, San Francisco, California, 94115
    • California Pacific Medical Center, San Francisco, California, 94118
    • Kaiser Permanente-South Sacramento, Sacramento, California, 95823
    • Kaiser Permanente-Richmond, Richmond, California, 94801
    • Doctors Medical Center- JC Robinson Regional Cancer Center, San Pablo, California, 94806
    • Kaiser Permanente - Sacramento, Sacramento, California, 95825
    • Sutter Solano Medical Center, Vallejo, California, 94589
    • Kaiser Permanente-Vallejo, Vallejo, California, 94589
    • Kaiser Permanente-Roseville, Roseville, California, 95661
    • Kaiser Permanente-San Rafael, San Rafael, California, 94903
    • Kaiser Permanente Medical Center-Vacaville, Vacaville, California, 95688
    • Sutter Cancer Research Consortium, Novato, California, 94945
    • Kaiser Permanente-Santa Rosa, Santa Rosa, California, 95403
    • Sutter Pacific Medical Foundation, Santa Rosa, California, 95403
  • Nevada

    • 21st Century Oncology - Fort Apache, Las Vegas, Nevada, 89148
    • Cancer and Blood Specialists-Fort Apache, Las Vegas, Nevada, 89148
    • Comprehensive Cancer Centers of Nevada, Las Vegas, Nevada, 89148
    • HealthCare Partners Medical Group Oncology/Hematology-San Martin, Las Vegas, Nevada, 89113
    • Comprehensive Cancer Centers of Nevada-Summerlin, Las Vegas, Nevada, 89144
    • Comprehensive Cancer Centers of Nevada - Henderson, Henderson, Nevada, 89052
    • Cancer and Blood Specialists-Henderson, Henderson, Nevada, 89052
    • Las Vegas Cancer Center-Henderson, Henderson, Nevada, 89052
    • Cancer and Blood Specialists-Tenaya, Las Vegas, Nevada, 89128
    • HealthCare Partners Medical Group Oncology/Hematology-Tenaya, Las Vegas, Nevada, 89128
    • Comprehensive Cancer Centers of Nevada - Northwest, Las Vegas, Nevada, 89128
    • Radiation Oncology Centers of Nevada Southeast, Las Vegas, Nevada, 89119
    • Comprehensive Cancer Centers of Nevada-Southeast Henderson, Henderson, Nevada, 89074
    • 21st Century Oncology - Henderson, Henderson, Nevada, 89074
    • University Medical Center of Southern Nevada, Las Vegas, Nevada, 89102
    • HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway, Las Vegas, Nevada, 89109
    • 21st Century Oncology - Vegas Sunrise, Las Vegas, Nevada, 89109
    • HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills, Las Vegas, Nevada, 89149
    • Cancer and Blood Specialists-Shadow, Las Vegas, Nevada, 89106
    • Radiation Oncology Centers of Nevada Central, Las Vegas, Nevada, 89106
    • Nevada Cancer Research Foundation CCOP, Las Vegas, Nevada, 89106
    • Cancer Therapy and Integrative Medicine, Las Vegas, Nevada, 89121
  • Arizona

    • Arizona Cancer Center at UMC Orange Grove, Tucson, Arizona, 85704
    • Arizona Cancer Center at University Medical Center North, Tucson, Arizona, 85719
    • University of Arizona Health Sciences Center, Tucson, Arizona, 85724
  • Colorado

    • Mercy Medical Center, Durango, Colorado, 81301
    • Saint Mary Corwin Medical Center, Pueblo, Colorado, 81004
    • Rocky Mountain Cancer Centers - Pueblo, Pueblo, Colorado, 81008
    • Rocky Mountain Cancer Centers-Penrose, Colorado Springs, Colorado, 80907
    • Penrose-Saint Francis Healthcare, Colorado Springs, Colorado, 80907
    • Colorado Blood Cancer Institute, Denver, Colorado, 80907
    • Mountain Blue Cancer Care Center, Golden, Colorado, 80401
    • Rocky Mountain Cancer Centers-Lakewood, Lakewood, Colorado, 80228
    • Saint Anthony Hospital, Lakewood, Colorado, 80228
    • Rocky Mountain Cancer Centers-Boulder, Boulder, Colorado, 80304
    • Exempla Lutheran Medical Center, Wheat Ridge, Colorado, 80033
    • Littleton Adventist Hospital, Littleton, Colorado, 80122
    • Boulder Community Hospital, Boulder, Colorado, 80301
    • Rocky Mountain Cancer Centers-Sky Ridge, Lone Tree, Colorado, 80124
    • Sky Ridge Medical Center, Lone Tree, Colorado, 80124
    • Porter Adventist Hospital, Denver, Colorado, 80210
    • Rocky Mountain Cancer Centers-Midtown, Denver, Colorado, 80218
    • Presbyterian - Saint Lukes Medical Center - Health One, Denver, Colorado, 80218
    • Exempla Saint Joseph Hospital, Denver, Colorado, 80218
    • Breast Cancer Care Consultants, Greenwood Village, Colorado, 80111
    • Rocky Mountain Cancer Centers-Rose, Denver, Colorado, 80220
    • Rose Medical Center, Denver, Colorado, 80220
    • Denver Veterans Administration Medical Center, Denver, Colorado, 80220
    • The Medical Center of Aurora, Aurora, Colorado, 80012
    • Rocky Mountain Cancer Centers-Longmont, Longmont, Colorado, 80501
    • Longmont United Hospital, Longmont, Colorado, 80501
    • University of Colorado Cancer Center - Anschutz Cancer Pavilion, Aurora, Colorado, 80045
    • Rocky Mountain Cancer Centers-Parker, Parker, Colorado, 80138
    • Parker Adventist Hospital, Parker, Colorado, 80138
    • McKee Medical Center, Loveland, Colorado, 80539
    • Front Range Cancer Specialists, Fort Collins, Colorado, 80528
    • Poudre Valley Hospital, Fort Collins, Colorado, 80524
    • North Colorado Medical Center, Greeley, Colorado, 80631
  • Idaho

    • Saint Alphonsus Regional Medical Center, Boise, Idaho, 83706
    • Saint Joseph Regional Medical Center, Lewiston, Idaho, 83501
    • Kootenai Cancer Center, Post Falls, Idaho, 83854
  • Oregon

    • Kaiser Permanente, Portland, Oregon, 97227
  • Washington

    • Columbia Basin Hematology and Oncology PLLC, Kennewick, Washington, 99336
    • Providence Regional Cancer System-Centralia, Centralia, Washington, 98531
    • Multicare Health System, Tacoma, Washington, 98415
    • Capital Medical Center, Olympia, Washington, 98507
    • Providence Regional Cancer System-Lacey, Lacey, Washington, 98503
    • Wenatchee Valley Medical Center, Wenatchee, Washington, 98801
    • Good Samaritan Community Hospital, Puyallup, Washington, 98372
    • Saint Clare Hospital, Lakewood, Washington, 98499
    • Saint Joseph Medical Center, Tacoma, Washington, 98405
    • Allenmore Hospital, Tacoma, Washington, 98405
    • Northwest Medical Specialties PLLC, Tacoma, Washington, 98405
    • Northwest CCOP, Tacoma, Washington, 98405
    • Auburn Regional Medical Center, Auburn, Washington, 98001
    • Saint Francis Hospital, Federal Way, Washington, 98003
    • Rockwood Clinic, Spokane, Washington, 99220
    • Cancer Care Northwest - Spokane South, Spokane, Washington, 99202
    • University of Washington Medical Center, Seattle, Washington, 98195
    • Evergreen Hematology and Oncology PS, Spokane, Washington, 99218
    • Highline Medical Center-Main Campus, Burien, Washington, 98166
    • Swedish Cancer Institute-Issaquah, Issaquah, Washington, 98029
    • Overlake Hospital Medical Center, Bellevue, Washington, 98004
    • Minor and James Medical PLLC, Seattle, Washington, 98104
    • Harborview Medical Center, Seattle, Washington, 98104
    • Pacific Medical Center-First Hill, Seattle, Washington, 98104
    • Virginia Mason CCOP, Seattle, Washington, 98101
    • Virginia Mason Medical Center, Seattle, Washington, 98101
    • Group Health Cooperative-Seattle, Seattle, Washington, 98112
    • Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium, Seattle, Washington, 98109
    • Harrison HealthPartners Hematology and Oncology-Bremerton, Bremerton, Washington, 98310
    • Swedish Medical Center-Ballard Campus, Seattle, Washington, 98107
    • Cascade Cancer Center, Kirkland, Washington, 98034
    • Harrison HealthPartners Hematology and Oncology-Poulsbo, Poulsbo, Washington, 98370
    • Swedish Medical Center-Edmonds, Edmonds, Washington, 98026
    • Providence Regional Cancer Partnership, Everett, Washington, 98201
    • Skagit Valley Hospital, Mount Vernon, Washington, 98274
    • United General Hospital, Sedro-Woolley, Washington, 98284
    • Cancer Care Center at Island Hospital, Anacortes, Washington, 98221
    • PeaceHealth Saint Joseph Medical Center, Bellingham, Washington, 98225
  • Montana

    • Saint James Community Hospital and Cancer Treatment Center, Butte, Montana, 59701
    • Bozeman Deaconess Cancer Center, Bozeman, Montana, 59715
    • Bozeman Deaconess Hospital, Bozeman, Montana, 59715
    • Saint Patrick Hospital - Community Hospital, Missoula, Montana, 59802
    • Montana Cancer Specialists, Missoula, Montana, 59802
    • Saint Peter's Community Hospital, Helena, Montana, 59601
    • Hematology-Oncology Centers of the Northern Rockies PC, Billings, Montana, 59102
    • Saint Vincent Healthcare, Billings, Montana, 59101
    • Montana Cancer Consortium CCOP, Billings, Montana, 59101
    • Benefis Healthcare- Sletten Cancer Institute, Great Falls, Montana, 59405
    • Kalispell Regional Medical Center, Kalispell, Montana, 59901
  • Wyoming

    • Rocky Mountain Oncology, Casper, Wyoming, 82609
    • Welch Cancer Center, Sheridan, Wyoming, 82801
  • Kansas

    • Cancer Center of Kansas-Liberal, Liberal, Kansas, 67901
    • Saint Catherine Hospital, Garden City, Kansas, 67846
    • Cancer Center of Kansas - Dodge City, Dodge City, Kansas, 67801
    • Hays Medical Center, Hays, Kansas, 67601
    • Cancer Center of Kansas - Pratt, Pratt, Kansas, 67124
    • Saint Rose Ambulatory and Surgery Center, Great Bend, Kansas, 67530
    • Cancer Center of Kansas-Kingman, Kingman, Kansas, 67068
    • Cancer Center of Kansas - McPherson, McPherson, Kansas, 67460
    • Cancer Center of Kansas - Wellington, Wellington, Kansas, 67152
    • Cancer Center of Kansas - Salina, Salina, Kansas, 67401
    • Salina Regional Health Center, Salina, Kansas, 67401
    • Cancer Center of Kansas - Main Office, Wichita, Kansas, 67214
    • Wichita CCOP, Wichita, Kansas, 67214
    • Via Christi Regional Medical Center, Wichita, Kansas, 67214
    • Cancer Center of Kansas-Wichita Medical Arts Tower, Wichita, Kansas, 67208
    • Associates In Womens Health, Wichita, Kansas, 67208
    • Cancer Center of Kansas - Newton, Newton, Kansas, 67114
    • Cancer Center of Kansas - Winfield, Winfield, Kansas, 67156
    • Cancer Center of Kansas - El Dorado, El Dorado, Kansas, 67042
    • Cancer Center of Kansas-Manhattan, Manhattan, Kansas, 66502
    • Newman Regional Health, Emporia, Kansas, 66801
    • Cancer Center of Kansas-Independence, Independence, Kansas, 67301
    • Stormont-Vail Regional Health Center, Topeka, Kansas, 66604
    • Saint Francis Hospital and Medical Center - Topeka, Topeka, Kansas, 66606
    • Cancer Center of Kansas - Chanute, Chanute, Kansas, 66720
    • Cancer Center of Kansas - Parsons, Parsons, Kansas, 67357
    • Lawrence Memorial Hospital, Lawrence, Kansas, 66044
    • Via Christi Hospital-Pittsburg, Pittsburg, Kansas, 66762
    • Cancer Center of Kansas - Fort Scott, Fort Scott, Kansas, 66701
    • Providence Medical Center, Kansas City, Kansas, 66112
    • Kansas City Cancer Center-West, Kansas City, Kansas, 66112
    • University of Kansas Medical Center, Kansas City, Kansas, 66160
    • Saint Luke's South Hospital, Overland Park, Kansas, 66213
    • Kansas City Cancer Centers-Southwest, Overland Park, Kansas, 66210
    • Kansas City Cancer Center-Shawnee Mission, Shawnee Mission, Kansas, 66204
    • Menorah Medical Center, Overland Park, Kansas, 66209
    • Kansas City CCOP, Prairie Village, Kansas, 66208
    • Promise Regional Medical Center-Hutchinson, Hutchinson, Kansas, 65702
  • Oklahoma

    • Cancer Centers of Southwest Oklahoma Research, Lawton, Oklahoma, 73505
    • University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104
  • Nebraska

    • Good Samaritan Hospital, Kearney, Nebraska, 68847
    • Nebraska Cancer Research Center, Lincoln, Nebraska, 68510
    • Alegent Health Lakeside Hospital, Omaha, Nebraska, 68130
    • Alegent Health Bergan Mercy Medical Center, Omaha, Nebraska, 68124
    • Alegent Health Immanuel Medical Center, Omaha, Nebraska, 68122
    • Missouri Valley Cancer Consortium CCOP, Omaha, Nebraska, 68106
    • Creighton University Medical Center, Omaha, Nebraska, 68131
  • Texas

    • University Hospital, San Antonio, Texas, 78229
    • University of Texas Health Science Center at San Antonio, San Antonio, Texas, 78229
    • Cancer Therapy and Research Center at The UT Health Science Center at San Antonio, San Antonio, Texas, 78229
    • Audie L Murphy Veterans Affairs Hospital, San Antonio, Texas, 78209
    • M D Anderson Cancer Center, Houston, Texas, 77030
  • North Dakota

    • Sanford Bismarck Medical Center, Bismarck, North Dakota, 58501
    • Trinity Cancer Care Center, Minot, North Dakota, 58701
    • Sanford Clinic North-Fargo, Fargo, North Dakota, 58122
    • Roger Maris Cancer Center, Fargo, North Dakota, 58122
    • Sanford Medical Center-Fargo, Fargo, North Dakota, 58122
  • Iowa

    • Siouxland Hematology Oncology Associates, Sioux City, Iowa, 51101
    • Saint Luke's Regional Medical Center, Sioux City, Iowa, 51104
    • Mercy Medical Center-Sioux City, Sioux City, Iowa, 51104
    • Mercy Medical Center-West Lakes, West Des Moines, Iowa, 50266
    • Medical Oncology and Hematology Associates-West Des Moines, Clive, Iowa, 50325
    • Mercy Cancer Center-West Lakes, Clive, Iowa, 50325
    • Mercy Medical Center - Des Moines, Des Moines, Iowa, 50314
    • Medical Oncology and Hematology Associates-Laurel, Des Moines, Iowa, 50314
    • Iowa Methodist Medical Center, Des Moines, Iowa, 50309
    • Iowa Oncology Research Association CCOP, Des Moines, Iowa, 50309
    • Medical Oncology and Hematology Associates-Des Moines, Des Moines, Iowa, 50309
    • Iowa Lutheran Hospital, Des Moines, Iowa, 50316
    • Mercy Medical Center - North Iowa, Mason City, Iowa, 50401
    • Covenant Medical Center, Waterloo, Iowa, 50702
    • Mercy Hospital, Cedar Rapids, Iowa, 52403
    • Oncology Associates at Mercy Medical Center, Cedar Rapids, Iowa, 52403
    • Cedar Rapids Oncology Association, Cedar Rapids, Iowa, 52403
  • South Dakota

    • Avera Cancer Institute, Sioux Falls, South Dakota, 57105
    • Sanford Cancer Center-Oncology Clinic, Sioux Falls, South Dakota, 57104
  • Missouri

    • Saint Joseph Oncology Inc, Saint Joseph, Missouri, 64507
    • Heartland Regional Medical Center, Saint Joseph, Missouri, 64506
    • Kansas City Cancer Centers - North, Kansas City, Missouri, 64154
    • Saint Luke's Hospital of Kansas City, Kansas City, Missouri, 64111
    • Kansas City Cancer Center - South, Kansas City, Missouri, 64131
    • Truman Medical Center, Kansas City, Missouri, 64108
    • Research Medical Center, Kansas City, Missouri, 64132
    • North Kansas City Hospital, Kansas City, Missouri, 64116
    • Heartland Hematology and Oncology Associates Incorporated, Kansas City, Missouri, 64118
    • Liberty Hospital, Liberty, Missouri, 64068
    • Kansas City Cancer Center-Lee's Summit, Lee's Summit, Missouri, 64064
    • Centerpoint Medical Center LLC, Independence, Missouri, 64057
    • Saint Luke's East - Lee's Summit, Lee's Summit, Missouri, 64086
    • CoxHealth South Hospital, Springfield, Missouri, 65807
    • Mercy Hospital Springfield, Springfield, Missouri, 65804
    • Ozark Health Ventures LLC-Cancer Research for The Ozarks Springfield, Springfield, Missouri, 65804
    • Saint Francis Medical Center, Cape Girardeau, Missouri, 63703
  • Arkansas

    • Highlands Oncology Group-Rogers, Rogers, Arkansas, 72758
    • University of Arkansas for Medical Sciences, Little Rock, Arkansas, 72205
  • Louisiana

    • Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, 71130
    • Highland Clinic, Shreveport, Louisiana, 71105
    • Louisiana State University Sciences Center- Monroe, Monroe, Louisiana, 71202
    • Mary Bird Perkins Cancer Center, Baton Rouge, Louisiana, 70809
    • Louisiana State University Health Science Center, New Orleans, Louisiana, 70112
  • Minnesota

    • Lake Region Healthcare Corporation-Cancer Care, Fergus Falls, Minnesota, 56537
    • Rice Memorial Hospital, Willmar, Minnesota, 56201
    • New Ulm Medical Center, New Ulm, Minnesota, 56073
    • Hutchinson Area Health Care, Hutchinson, Minnesota, 55350
    • Ridgeview Medical Center, Waconia, Minnesota, 55387
    • Saint Cloud Hospital, Saint Cloud, Minnesota, 56303
    • Coborn Cancer Center at Saint Cloud Hospital, Saint Cloud, Minnesota, 56303
    • Saint Francis Regional Medical Center, Shakopee, Minnesota, 55379
    • Fairview-Southdale Hospital, Edina, Minnesota, 55435
    • Fairview Ridges Hospital, Burnsville, Minnesota, 55337
    • Park Nicollet Clinic - Saint Louis Park, Saint Louis Park, Minnesota, 55416
    • Metro-Minnesota CCOP, Saint Louis Park, Minnesota, 55416
    • North Memorial Medical Health Center, Robbinsdale, Minnesota, 55422
    • Abbott-Northwestern Hospital, Minneapolis, Minnesota, 55407
    • Hennepin County Medical Center, Minneapolis, Minnesota, 55415
    • Mercy Hospital, Coon Rapids, Minnesota, 55433
    • Unity Hospital, Fridley, Minnesota, 55432
    • Sanford Clinic North-Bemidgi, Bemidji, Minnesota, 56601
    • United Hospital, Saint Paul, Minnesota, 55102
    • Regions Hospital, Saint Paul, Minnesota, 55101
    • Saint John's Hospital - Healtheast, Maplewood, Minnesota, 55109
    • Minnesota Oncology Hematology PA-Maplewood, Maplewood, Minnesota, 55109
    • Minnesota Oncology and Hematology PA-Woodbury, Woodbury, Minnesota, 55125
    • Mayo Clinic, Rochester, Minnesota, 55905
    • Lakeview Hospital, Stillwater, Minnesota, 55082
    • Essentia Health Duluth Clinic CCOP, Duluth, Minnesota, 55805
    • Miller-Dwan Hospital, Duluth, Minnesota, 55805
    • Essentia Health Saint Mary's Medical Center, Duluth, Minnesota, 55805
  • Illinois

    • Illinois CancerCare-Carthage, Carthage, Illinois, 62321
    • Illinois CancerCare-Macomb, Macomb, Illinois, 61455
    • Holy Family Medical Center, Monmouth, Illinois, 61462
    • Illinois CancerCare-Monmouth, Monmouth, Illinois, 61462
    • Illinois CancerCare Galesburg, Galesburg, Illinois, 61401
    • Illinois CancerCare-Galesburg Cottage Plaza Office, Galesburg, Illinois, 61401
    • Illinois CancerCare-Canton, Canton, Illinois, 61520
    • Illinois CancerCare-Kewanee Clinic, Kewanee, Illinois, 61443
    • Memorial Hospital of Carbondale, Carbondale, Illinois, 62902
    • Illinois CancerCare-Pekin, Pekin, Illinois, 61554
    • Pekin Cancer Treatment Center, Pekin, Illinois, 61554
    • Illinois Oncology Research Association CCOP, Peoria, Illinois, 61615
    • Illinois CancerCare-Peoria, Peoria, Illinois, 61615
    • OSF Saint Francis Medical Center, Peoria, Illinois, 61637
    • Proctor Hospital, Peoria, Illinois, 61614
    • Methodist Medical Center of Illinois, Peoria, Illinois, 61603
    • Centralia Oncology Clinic, Centralia, Illinois, 62801
    • Illinois CancerCare-Princeton, Princeton, Illinois, 61356
    • Illinois CancerCare-Eureka, Eureka, Illinois, 61530
    • Good Samaritan Regional Health Center, Mount Vernon, Illinois, 62864
    • Decatur Memorial Hospital, Decatur, Illinois, 62526
    • Saint Joseph Medical Center, Bloomington, Illinois, 61701
    • Illinois CancerCare-Bloomington, Bloomington, Illinois, 61701
    • Illinois CancerCare-Peru, Peru, Illinois, 61354
    • Illinois Valley Hospital, Peru, Illinois, 61354
    • Community Cancer Center Foundation, Normal, Illinois, 61761
    • Illinois CancerCare-Ottawa Clinic, Ottawa, Illinois, 61350
    • Ottawa Regional Hospital and Healthcare Center, Ottawa, Illinois, 61350
    • Crossroads Cancer Center, Effingham, Illinois, 62401
    • Carle Cancer Center, Urbana, Illinois, 61801
    • Cadence Cancer Center at Delnor, Geneva, Illinois, 60134
    • Cadence Cancer Center in Warrenville, Warrenville, Illinois, 60555
    • Loyola University Medical Center, Maywood, Illinois, 60153
    • Hines Veterans Administration Hospital, Hines, Illinois, 60141
    • West Suburban Medical Center, River Forest, Illinois, 60305
    • Mac Neal Hospital, Berwyn, Illinois, 60402
    • Weiss Memorial Hospital, Chicago, Illinois, 60640
  • Wisconsin

    • Cancer Center of Western Wisconsin, New Richmond, Wisconsin, 54017
    • Gundersen Lutheran, La Crosse, Wisconsin, 54601
    • Marshfield Clinic Cancer Center at Sacred Heart, Eau Claire, Wisconsin, 54701
    • Marshfield Clinic-Rice Lake Center, Rice Lake, Wisconsin, 54868
    • Marshfield Clinic-Chippewa Center, Chippewa Falls, Wisconsin, 54729
    • Marshfield Clinic, Marshfield, Wisconsin, 54449
    • Marshfield Clinic - Wisconsin Rapids Center, Wisconsin Rapids, Wisconsin, 54494
    • Marshfield Clinic Cancer Care at Saint Michael's Hospital, Stevens Point, Wisconsin, 54481
    • Marshfield Clinic-Wausau Center, Wausau, Wisconsin, 54401
    • Marshfield Clinic - Weston Center, Weston, Wisconsin, 54476
    • Marshfield Clinic-Minocqua Center, Minocqua, Wisconsin, 54548
    • Marshfield Clinic at James Beck Cancer Center, Rhinelander, Wisconsin, 54501
    • Green Bay Oncology Limited at Saint Mary's Hospital, Green Bay, Wisconsin, 54303
    • Saint Mary's Hospital, Green Bay, Wisconsin, 54303
    • Green Bay Oncology - Oconto Falls, Oconto Falls, Wisconsin, 54154
    • Saint Vincent Hospital, Green Bay, Wisconsin, 54301
    • Bellin Memorial Hospital, Green Bay, Wisconsin, 54301
    • Saint Nicholas Hospital, Sheboygan, Wisconsin, 53081
    • Holy Family Memorial Hospital, Manitowoc, Wisconsin, 54221
    • Bay Area Medical Center, Marinette, Wisconsin, 54143
    • Green Bay Oncology - Sturgeon Bay, Sturgeon Bay, Wisconsin, 54235
  • Mississippi

    • University of Mississippi Medical Center, Jackson, Mississippi, 39216
    • Singing River Hospital, Pascagoula, Mississippi, 39581
  • Indiana

    • Premier Oncology Hematology Associates, Merrillville, Indiana, 46410
    • Michiana Hematology Oncology-PC Westville, Westville, Indiana, 46391
    • Franciscan Saint Anthony Health-Michigan City, Michigan City, Indiana, 46360
    • IU Health La Porte Hospital, La Porte, Indiana, 46350
    • Michiana Hematology Oncology PC-Plymouth, Plymouth, Indiana, 46563
    • Northern Indiana Cancer Research Consortium, South Bend, Indiana, 46628
    • Franciscan Saint Francis Health-Indianapolis, Indianapolis, Indiana, 46237
    • Community Howard Regional Health, Kokomo, Indiana, 46904
    • Michiana Hematology Oncology PC-South Bend, South Bend, Indiana, 46601
    • Memorial Hospital of South Bend, South Bend, Indiana, 46601
    • Michiana Hematology Oncology PC-Elkhart, Elkhart, Indiana, 46514
    • Elkhart General Hospital, Elkhart, Indiana, 46515
    • Reid Hospital and Health Care Services, Richmond, Indiana, 47374
  • Tennessee

    • Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, 37232
  • Michigan

    • Green Bay Oncology - Iron Mountain, Iron Mountain, Michigan, 49801
    • Marie Yeager Cancer Center, Saint Joseph, Michigan, 49085
    • Lakeland Hospital, St. Joseph, Michigan, 49085
    • Green Bay Oncology - Escanaba, Escanaba, Michigan, 49431
    • Mercy Health Mercy Campus, Muskegon, Michigan, 49444
    • West Michigan Cancer Center, Kalamazoo, Michigan, 49007
    • Bronson Methodist Hospital, Kalamazoo, Michigan, 49007
    • Borgess Medical Center, Kalamazoo, Michigan, 49001
    • Grand Rapids Clinical Oncology Program, Grand Rapids, Michigan, 49503
    • Mercy Health Saint Mary's, Grand Rapids, Michigan, 49503
    • Spectrum Health at Butterworth Campus, Grand Rapids, Michigan, 49503
    • Spectrum Health Big Rapids Hospital, Big Rapids, Michigan, 49307
    • Bronson Battle Creek, Battle Creek, Michigan, 49017
    • Spectrum Health Reed City Hospital, Reed City, Michigan, 49677
    • Munson Medical Center, Traverse City, Michigan, 49684
    • McLaren-Central Michigan, Mount Pleasant, Michigan, 48858
    • McLaren-Greater Lansing, Lansing, Michigan, 48910
    • Sparrow Hospital, Lansing, Michigan, 48912
    • Allegiance Health, Jackson, Michigan, 49201
    • Northern Michigan Regional Hospital, Petoskey, Michigan, 49770
  • Ohio

    • Oncology Hematology Care Inc - Western Hills, Cincinnati, Ohio, 45248
    • Wayne Hospital, Greenville, Ohio, 45331
    • Oncology Hematology Care Inc, Fairfield, Ohio, 45014
    • Oncology and Hematology Care Incorporated, Cincinnati, Ohio, 45219
    • Oncology Hematology Care Inc - Kenwood, Cincinnati, Ohio, 45236
    • Oncology Hematology Care Inc - Anderson, Cincinnati, Ohio, 45230
    • Oncology and Hematology Care Inc - Blue Ash, Cincinnati, Ohio, 45242
    • Samaritan North Health Center, Dayton, Ohio, 45415
    • Good Samaritan Hospital - Dayton, Dayton, Ohio, 45406
    • Grandview Hospital, Dayton, Ohio, 45405
    • Upper Valley Medical Center, Troy, Ohio, 45373
    • Miami Valley Hospital, Dayton, Ohio, 45409
    • Kettering Medical Center, Kettering, Ohio, 45429
    • Fulton County Health Center, Wauseon, Ohio, 43567
  • Kentucky

    • Oncology Hematology Care Incorporated, Crestview Hills, Kentucky, 41017
    • University of Kentucky, Lexington, Kentucky, 40536
  • Georgia

    • John B Amos Cancer Center, Columbus, Georgia, 31904
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