Doxorubicin Hydrochloride, Cyclophosphamide, and Pacltaxel With or Without Trastuzumab in Treating Women With HER2-Positive Node-Positive or High-Risk Node-Negative Breast Cancer
Status: | Active, not recruiting |
---|---|
Conditions: | Breast Cancer, Cancer, Cancer, Cancer |
Therapuetic Areas: | Oncology |
Healthy: | No |
Age Range: | 18 - Any |
Updated: | 3/27/2019 |
Start Date: | May 19, 2000 |
Phase III Trial of Doxorubicin and Cyclophosphamide (AC) Followed by Weekly Paclitaxel With or Without Trastuzumab as Adjuvant Treatment for Women With HER-2 Over-Expressing or Amplified Node Positive or High-Risk Node Negative Breast Cancer
This randomized phase III trial studies doxorubicin hydrochloride, cyclophosphamide,
paclitaxel, and trastuzumab to see how well they work compared to combination chemotherapy
alone in treating women with breast cancer that is human epidermal growth factor receptor 2
(HER2)-positive and has spread to the lymph nodes or high-risk and has not spread to the
lymph nodes. Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. Monoclonal antibodies such as trastuzumab can locate tumor cells
and either kill them or deliver tumor-killing substances to them without harming normal
cells. It is not yet known whether combination chemotherapy is more effective with or without
trastuzumab in treating breast cancer.
paclitaxel, and trastuzumab to see how well they work compared to combination chemotherapy
alone in treating women with breast cancer that is human epidermal growth factor receptor 2
(HER2)-positive and has spread to the lymph nodes or high-risk and has not spread to the
lymph nodes. Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. Monoclonal antibodies such as trastuzumab can locate tumor cells
and either kill them or deliver tumor-killing substances to them without harming normal
cells. It is not yet known whether combination chemotherapy is more effective with or without
trastuzumab in treating breast cancer.
PRIMARY OBJECTIVES:
I. To compare the combination of doxorubicin hydrochloride and cyclophosphamide (AC) followed
by weekly paclitaxel with the combination of AC followed by the combination of weekly
paclitaxel and trastuzumab in terms of disease free survival (DFS). (Stage I) II. To compare
the combination of AC followed by weekly paclitaxel with the combination of AC followed by
the combination of weekly paclitaxel and trastuzumab in terms of the rate of cardiac events.
(Stage I) III. To compare the combination AC followed by weekly paclitaxel with the
sequential schedule of the combination of AC, weekly paclitaxel, and trastuzumab in terms of
DFS. (Stage II) IV. To compare the sequential schedule of the combination of AC, weekly
paclitaxel, and trastuzumab with the combination of AC followed by the combination of weekly
paclitaxel and trastuzumab in terms of DFS. (Stage II) V. To compare the combination AC
followed by weekly paclitaxel with the sequential schedule of the combination of AC, weekly
paclitaxel, and trastuzumab in terms of the rate of cardiac events. (Stage II)
SECONDARY OBJECTIVES:
I. To compare the combination of AC followed by weekly paclitaxel with the sequential
schedule of the combination of AC, weekly paclitaxel, and trastuzumab in terms of overall
survival (OS).
II. To compare the combination AC followed by weekly paclitaxel with the combination of AC
followed by the combination of weekly paclitaxel and trastuzumab in terms of OS.
III. To compare the sequential schedule of the combination AC, weekly paclitaxel, and
trastuzumab with the combination of AC followed by the combination of weekly paclitaxel and
trastuzumab in terms of OS.
TERTIARY OBJECTIVES:
I. To determine whether higher levels of shed ECD (extracellular domain) or autoantibodies to
human epidermal growth factor receptor (HER)-2 and HER-1 measured in the serum prior to
treatment are prognostic for DFS and survival.
II. To determine the concordance of central review of HER-2 overexpression as measured by the
HercepTest (DAKO) and Vysis fluorescence in situ hybridization (FISH).
III. For each treatment arm, levels of brain natriuretic peptide (BNP), troponin-T (TnT),
troponin-I (cTnI), tumor necrosis factor alpha (TNF-alpha), interleukin-1 beta (IL-1beta) and
interleukin-6 (IL-6), CD40 ligand, and troponin levels will be compared and contrasted.
IV. To determine whether genetic markers are prognostic for cardiac adverse events associated
with treatment.
OUTLINE: Patients are randomized to 1 of 3 treatment arms.
ARM I*: Patients receive doxorubicin hydrochloride intravenously (IV) and cyclophosphamide IV
over 20-30 minutes on day 1. Treatment repeats every 3 weeks for 4 courses. Patients then
receive paclitaxel IV over 1 hour beginning on day 1 of week 13 and continuing weekly for 12
courses in the absence of disease progression or unacceptable toxicity. NOTE: *Patients who
completed paclitaxel on or after October 25, 2004 may receive trastuzumab for a maximum of 52
weeks either concurrently with paclitaxel or following completion of paclitaxel treatment.
ARM II*: Patients receive doxorubicin hydrochloride, cyclophosphamide, and paclitaxel as in
arm I. Patients then receive trastuzumab IV over 30-90 minutes beginning on day 1 of week 25
and continuing weekly for 52 courses in the absence of disease progression or unacceptable
toxicity. NOTE: *Patients who completed paclitaxel on or after October 25, 2004 may receive
trastuzumab for a maximum of 52 weeks either concurrently with paclitaxel or following
completion of paclitaxel treatment.
ARM III: Patients receive doxorubicin hydrochloride and cyclophosphamide as in arm I.
Patients then receive paclitaxel IV over 1 hour and trastuzumab IV over 30-90 minutes
beginning on day 1 of week 13 and continuing weekly for 12 courses. Patients then receive
trastuzumab IV over 30 minutes beginning on day 1 of week 25 and continuing weekly for 40
courses in the absence of disease progression or unacceptable toxicity.
Within 5 weeks after completion of paclitaxel, patients may undergo radiotherapy. All
postmenopausal estrogen receptor (ER)- or progesterone receptor (PR)-positive patients
receive oral tamoxifen or an aromatase inhibitor once daily for 5 years beginning no later
than 5 weeks after the last dose of paclitaxel. Patients may also receive an aromatase
inhibitor once daily for 5 years after 5 years of daily tamoxifen. Patients who receive
tamoxifen once daily for less than 4.5 years may receive an aromatase inhibitor daily until
they have received a total of 5 years of adjuvant hormonal therapy.
After completion of study treatment, patients are followed up every 3 months for 1 year,
every 6 months for 4 years, and then annually for 15 years or until disease progression.
I. To compare the combination of doxorubicin hydrochloride and cyclophosphamide (AC) followed
by weekly paclitaxel with the combination of AC followed by the combination of weekly
paclitaxel and trastuzumab in terms of disease free survival (DFS). (Stage I) II. To compare
the combination of AC followed by weekly paclitaxel with the combination of AC followed by
the combination of weekly paclitaxel and trastuzumab in terms of the rate of cardiac events.
(Stage I) III. To compare the combination AC followed by weekly paclitaxel with the
sequential schedule of the combination of AC, weekly paclitaxel, and trastuzumab in terms of
DFS. (Stage II) IV. To compare the sequential schedule of the combination of AC, weekly
paclitaxel, and trastuzumab with the combination of AC followed by the combination of weekly
paclitaxel and trastuzumab in terms of DFS. (Stage II) V. To compare the combination AC
followed by weekly paclitaxel with the sequential schedule of the combination of AC, weekly
paclitaxel, and trastuzumab in terms of the rate of cardiac events. (Stage II)
SECONDARY OBJECTIVES:
I. To compare the combination of AC followed by weekly paclitaxel with the sequential
schedule of the combination of AC, weekly paclitaxel, and trastuzumab in terms of overall
survival (OS).
II. To compare the combination AC followed by weekly paclitaxel with the combination of AC
followed by the combination of weekly paclitaxel and trastuzumab in terms of OS.
III. To compare the sequential schedule of the combination AC, weekly paclitaxel, and
trastuzumab with the combination of AC followed by the combination of weekly paclitaxel and
trastuzumab in terms of OS.
TERTIARY OBJECTIVES:
I. To determine whether higher levels of shed ECD (extracellular domain) or autoantibodies to
human epidermal growth factor receptor (HER)-2 and HER-1 measured in the serum prior to
treatment are prognostic for DFS and survival.
II. To determine the concordance of central review of HER-2 overexpression as measured by the
HercepTest (DAKO) and Vysis fluorescence in situ hybridization (FISH).
III. For each treatment arm, levels of brain natriuretic peptide (BNP), troponin-T (TnT),
troponin-I (cTnI), tumor necrosis factor alpha (TNF-alpha), interleukin-1 beta (IL-1beta) and
interleukin-6 (IL-6), CD40 ligand, and troponin levels will be compared and contrasted.
IV. To determine whether genetic markers are prognostic for cardiac adverse events associated
with treatment.
OUTLINE: Patients are randomized to 1 of 3 treatment arms.
ARM I*: Patients receive doxorubicin hydrochloride intravenously (IV) and cyclophosphamide IV
over 20-30 minutes on day 1. Treatment repeats every 3 weeks for 4 courses. Patients then
receive paclitaxel IV over 1 hour beginning on day 1 of week 13 and continuing weekly for 12
courses in the absence of disease progression or unacceptable toxicity. NOTE: *Patients who
completed paclitaxel on or after October 25, 2004 may receive trastuzumab for a maximum of 52
weeks either concurrently with paclitaxel or following completion of paclitaxel treatment.
ARM II*: Patients receive doxorubicin hydrochloride, cyclophosphamide, and paclitaxel as in
arm I. Patients then receive trastuzumab IV over 30-90 minutes beginning on day 1 of week 25
and continuing weekly for 52 courses in the absence of disease progression or unacceptable
toxicity. NOTE: *Patients who completed paclitaxel on or after October 25, 2004 may receive
trastuzumab for a maximum of 52 weeks either concurrently with paclitaxel or following
completion of paclitaxel treatment.
ARM III: Patients receive doxorubicin hydrochloride and cyclophosphamide as in arm I.
Patients then receive paclitaxel IV over 1 hour and trastuzumab IV over 30-90 minutes
beginning on day 1 of week 13 and continuing weekly for 12 courses. Patients then receive
trastuzumab IV over 30 minutes beginning on day 1 of week 25 and continuing weekly for 40
courses in the absence of disease progression or unacceptable toxicity.
Within 5 weeks after completion of paclitaxel, patients may undergo radiotherapy. All
postmenopausal estrogen receptor (ER)- or progesterone receptor (PR)-positive patients
receive oral tamoxifen or an aromatase inhibitor once daily for 5 years beginning no later
than 5 weeks after the last dose of paclitaxel. Patients may also receive an aromatase
inhibitor once daily for 5 years after 5 years of daily tamoxifen. Patients who receive
tamoxifen once daily for less than 4.5 years may receive an aromatase inhibitor daily until
they have received a total of 5 years of adjuvant hormonal therapy.
After completion of study treatment, patients are followed up every 3 months for 1 year,
every 6 months for 4 years, and then annually for 15 years or until disease progression.
Inclusion Criteria:
- Required tumor parameters for node positive disease: NOTE: This study will continue to
use the American Joint Committee on Cancer (AJCC) 5th edition for TNM classification
and staging
- Operable, histologically confirmed adenocarcinoma of the female breast and
positive lymph nodes
- Node positivity may be determined by either an axillary node dissection or a
positive sentinel node finding by hematoxylin and eosin (H&E)
- NOTE: Positive nodes refers to H&E visible nodal metastases;
immunohistochemistry (IHC) positive only cells in lymph nodes will not
be considered positive nodes
- One or more positive lymph nodes whose tumors are T1-3, pN1-2, M0 are
eligible
- cN2 disease is not eligible
- pN2 disease is eligible
- One positive lymph node by sentinel node biopsy or at least 6 axillary nodes
must be examined on axillary node dissection with at least one positive
lymph node
- Metaplastic carcinoma is eligible
- ER/PgR determination
- HER-2 positive (pre-entry requirement for registration)
- FISH must show gene amplification OR
- IHC assay must show a strong positive (3+) staining score
- NOTE: ductal carcinoma in situ (DCIS) components should not be counted
in the determination of degree of IHC staining or FISH amplification
- Required tumor parameters for high-risk node-negative disease; NOTE: This study will
continue to use the AJCC 5th edition for TNM classification and staging
- Operable, histologically confirmed adenocarcinoma of the female breast and
negative lymph nodes
- Node status may be determined by either axillary node dissection or sentinel
node biopsy with H&E staining; to be considered node negative, either of the
following must be true: 1) negative sentinel node biopsy or 2) no positive
lymph nodes found among at least 6 axillary nodes examined on axillary node
dissection
- NOTE: IHC positive only cells in lymph nodes will not be considered positive
nodes
- Tumors > 2.0 cm (irrespective of hormonal receptor status) or > 1.0 cm if
ER-negative and PR-negative disease
- ER/PgR determination
- HER-2 positive (pre-entry requirement for registration)
- FISH must show gene amplification OR
- IHC assay must show a strong positive (3+) staining score
- NOTE: DCIS components should not be counted in the determination of
degree of IHC staining or FISH amplification
- =< 84 days from mastectomy or =< 84 days from axillary dissection or sentinel node
detection if the patient's most extensive breast surgery was a breast sparing
procedure; (This timing is per a decision by the Breast Intergroup)
- Surgical resection margins. All tumor should be removed by either a modified radical
mastectomy or a segmental mastectomy with axillary node dissection
- Mastectomy: There will be no evidence of gross or microscopic tumor (invasive or
DCIS) at the surgical resection margins noted in the final surgery or pathology
reports; patients with close margins are eligible
- Segmental mastectomy (lumpectomy): Margins must be clear of invasive cancer and
DCIS
- Axillary dissection or sentinel node dissection: There will be no gross residual
adenopathy
- TAM therapy
- May have received up to four weeks of TAM therapy, or any other hormonal agent,
for this malignancy
- May have received TAM or raloxifene for purposes of chemoprevention (e.g., Breast
Cancer Prevention Trial) or for other indications (including previous breast
cancer if lobular carcinoma in situ [LCIS]) but must be discontinued before
registration on this study
- May never have received TAM, raloxifene, or any other hormonal agent
- Absolute neutrophil count (ANC) >= 1500/mm^3
- Platelets (PLT) >= 100,000/mm^3
- Total bilirubin =< 1.5 x upper normal limit (UNL)
- Aspartate aminotransferase (AST) =< 2.0 x UNL
- Left ventricular ejection fraction (LVEF) within institutional normal range; if LVEF
is > 75%, the investigator should consider performing a second review of the
multigated acquisition (MUGA)/echocardiogram or performing a repeat
MUGA/echocardiogram prior to registration; such re-reviews or repeat
MUGA/echocardiogram are not permitted after registration
- Willingness to discontinue sex hormonal therapy, e.g., birth control pills, ovarian
hormonal replacement therapy, etc., prior to registration and while on study
- Willingness to discontinue any hormonal agent such as raloxifene (Evista) prior to
registration and while on study
- Non-breast malignancies that have not recurred within the last 5 years and are deemed
to be at low risk for recurrence
EXCEPTIONS: These non-breast malignancies are eligible even if diagnosed =< 5 years prior
to registration:
- Squamous or basal cell carcinoma of the skin that has been effectively treated
- Carcinoma in situ of the cervix that has been treated by surgery only
- Lobular carcinoma in situ (LCIS) of the ipsilateral or contralateral breast treated by
surgery and/or tamoxifen only
- Patients undergoing breast conservation therapy (i.e., lumpectomy and axillary
dissection) must have plans to receive radiation therapy to the breast +/-
regional lymphatics following completion of the chemotherapy; for patients
treated with mastectomy, the use of radiation therapy is required for 4 or more
positive lymph nodes and must be started after completion of chemotherapy; the
use of radiation therapy is at the discretion of the investigator for 0-3
positive lymph nodes but, if used, must be started after the completion of
chemotherapy
- Prior to registration, the physician must designate if it is planned for the
patient to receive radiation therapy (for adjuvant radiation therapy
post-mastectomy or, less commonly, post-conservative therapy but not primary
breast radiation as part of breast conserving treatment)
- Willing and able to sign an informed consent
- Gene amplified by FISH or strong positivity (3+) by HercepTest on central review;
Note: The patient registers based on community HER-2 testing using FISH or IHC,
AC chemotherapy is initiated; the tumor block or slides must be received =< 2
weeks from time of registration to the North Central Cancer Treatment Group
(NCCTG) Operations Office for central HER-2 testing
Exclusion Criteria:
- Any of the following:
- Pregnant women
- Nursing women
- Women of childbearing potential or their sexual partners who are unwilling to
employ adequate contraception (condoms, diaphragm, intrauterine device [IUD],
surgical sterilization, or abstinence, etc.); hormonal birth control methods are
not permitted
- Locally advanced tumors (classification T4) at diagnosis including tumors fixed to
chest wall, peau d'orange, skin ulcerations/nodules, or clinical inflammatory changes
(diffuse brawny cutaneous induration with an erysipeloid edge)
- Prior history of breast cancer, except LCIS
- Bilateral invasive carcinoma, either metachronous or synchronous (EXCEPTION: Patients
diagnosed with unilateral invasive carcinoma and metachronous or synchronous DCIS of
the contralateral breast treated with mastectomy are eligible)
- Prior chemotherapy, radiation therapy, immunotherapy, or biotherapy for breast cancer
- Active, unresolved infection
- Active cardiac disease
- Any prior myocardial infarction
- History of documented congestive heart failure (CHF)
- Current use of digitalis or beta-blockers for CHF
- Any prior history of arrhythmia or cardiac valvular disease requiring medications
or clinically significant
- Current use of medications for treatment of arrhythmias or angina pectoris
- Current uncontrolled hypertension (diastolic > 100 mmHg or systolic > 200 mmHg)
- Clinically significant pericardial effusion
- Prior anthracycline or taxane therapy for any malignancy
- Sensitivity to benzyl alcohol
- Neurology/Neuropathy-Sensory >= grade 2 per the National Cancer Institute's (NCI's)
Common Toxicity Criteria Version 2.0; EXCEPTION: Any chronic neurologic disorder will
be looked at on a case-by-case basis by the study chair
We found this trial at
155
sites
615 N Michigan Street
South Bend, Indiana 46601
South Bend, Indiana 46601
(574) 647-7370
Northern Indiana Cancer Research Consortium The Northern Indiana Cancer Research Consortium (NICRC) is comprised of...
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Beth Israel Deaconess Medical Center Beth Israel Deaconess Medical Center (BIDMC) is one of the...
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Tufts Medical Center Tufts Medical Center is an internationally-respected academic medical center – a teaching...
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Roswell Park Cancer Institute Welcome to Roswell Park Cancer Institute (RPCI), America's first cancer center...
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1 South Prospect Street
Burlington, Vermont 05401
Burlington, Vermont 05401
802-656-8990
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City of Hope Comprehensive Cancer Center City of Hope is a leading research and treatment...
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Brooke Army Medical Center Brooke Army Medical Center (BAMC) is the Flagship of Army Medicine!...
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University of Texas Medical Branch Established in 1891 as the University of Texas Medical Department,...
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University of Mississippi Medical Center The University of Mississippi Medical Center, located in Jackson, is...
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1800 West Charleston Boulevard
Las Vegas, Nevada 89102
Las Vegas, Nevada 89102
(702) 383-2000
University Medical Center of Southern Nevada University Medical Center is dedicated to providing the highest...
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529 West Markham Street
Little Rock, Arkansas 72205
Little Rock, Arkansas 72205
(501) 686-7000
University of Arkansas for Medical Sciences The University of Arkansas for Medical Sciences (UAMS) in...
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North Shore University Hospital North Shore-LIJ Health System includes 16 award-winning hospitals and nearly 400...
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4805 Northeast Glisan Street
Portland, Oregon 97213
Portland, Oregon 97213
(503) 215-1111
Providence Portland Medical Center We strive to give those we serve exceptional, compassionate health care...
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Rhode Island Hospital Founded in 1863, Rhode Island Hospital in Providence, RI, is a private,...
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University of Rochester The University of Rochester is one of the country's top-tier research universities....
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4502 Medical Drive
San Antonio, Texas 78284
San Antonio, Texas 78284
(210) 567-7000
University of Texas Health Science Center at San Antonio The University of Texas Health Science...
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Naval Medical Center - San Diego We are the largest and most comprehensive military healthcare...
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1500 East Medical Center Drive
Ann Arbor, Michigan 48109
Ann Arbor, Michigan 48109
800-865-1125
University of Michigan Comprehensive Cancer Center The U-M Comprehensive Cancer Center's mission is the conquest...
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University of Colorado Hospital, Site Top medical professionals, superior medicine and progressive change make University...
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22 South Greene Street
Baltimore, Maryland 21201
Baltimore, Maryland 21201
410-328-7904
University of Maryland Greenebaum Cancer Center The University of Maryland Marlene and Stewart Greenebaum Cancer...
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401 North Broadway
Baltimore, Maryland 21287
Baltimore, Maryland 21287
410-955-5000
Johns Hopkins University-Sidney Kimmel Cancer Center The name Johns Hopkins has become synonymous with excellence...
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8901 Rockville Pike
Bethesda, Maryland 20889
Bethesda, Maryland 20889
(301) 295-4000
Walter Reed National Military Medical Center The Walter Reed National Military Medical Center is one...
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Sanford Bismarck Medical Center Whether your stay in our hospital is one day for same...
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Dana-Farber Cancer Institute Since it’s founding in 1947, Dana-Farber has been committed to providing adults...
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Massachusetts General Hospital Cancer Center An integral part of one of the world
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171 Ashley Avenue
Charleston, South Carolina 29425
Charleston, South Carolina 29425
843-792-1414
Medical University of South Carolina The Medical University of South Carolina (MUSC) has grown from...
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Rush University Medical Center Rush University Medical Center encompasses a 664-bed hospital serving adults and...
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Univ of Illinois A major research university in the heart of one of the world's...
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5841 S Maryland Ave
Chicago, Illinois 60637
Chicago, Illinois 60637
1-773-702-6180
University of Chicago Comprehensive Cancer Center The University of Chicago Comprehensive Cancer Center (UCCCC) is...
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Cleveland Clinic Foundation The Cleveland Clinic (formally known as The Cleveland Clinic Foundation) is a...
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Case Western Reserve Univ Continually ranked among America's best colleges, Case Western Reserve University has...
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University of Missouri-Ellis Fischel Ellis Fischel Cancer Center's team of physician specialists and other trained...
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Geisinger Medical Center Since 1915, Geisinger Medical Center has been known as the region’s resource...
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Henry Ford Hospital Founded in 1915 by auto pioneer Henry Ford and now one of...
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4160 John R St #2122
Detroit, Michigan 48201
Detroit, Michigan 48201
(313) 833-1785
Wayne State University/Karmanos Cancer Institute Karmanos is based in southeast Michigan, in midtown Detroit, and...
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Duke Univ Med Ctr As a world-class academic and health care system, Duke Medicine strives...
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Englewood Hospital and Medical Center Englewood Hospital was incorporated in 1888 as a non-profit, non-sectarian...
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Cone Health Cancer Center Located adjacent to Wesley Long Hospital, our Cone Health Cancer Center...
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Hackensack University Medical Center Hackensack University Medical Center, part of the Hackensack University Health Network,...
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500 University Dr
Hershey, Pennsylvania 17033
Hershey, Pennsylvania 17033
(717) 531-6955
Penn State Milton S. Hershey Medical Center Penn State Milton S. Hershey Medical Center, Penn...
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200 Technology Drive
Hooksett, New Hampshire 03106
Hooksett, New Hampshire 03106
603-622-6484
New Hampshire Oncology - Hematology, PA - Hooksett New Hampshire Oncology-Hematology, PA (NHOH) was founded...
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535 Barnhill Dr
Indianapolis, Indiana 46202
Indianapolis, Indiana 46202
(888) 600-4822
Indiana University Melvin and Bren Simon Cancer Center At the IU Simon Cancer Center, more...
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Mayo Clinic Florida Thousands of people come to Mayo Clinic in Jacksonville, Fla., annually for...
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Thompson Cancer Survival Center The Thompson Cancer Survival Center Downtown facility has pioneered many advances...
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Dartmouth Hitchcock Medical Center Dartmouth-Hitchcock is a national leader in patient-centered health care and building...
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1441 Eastlake Ave
Los Angeles, California 90033
Los Angeles, California 90033
(323) 865-3000
U.S.C./Norris Comprehensive Cancer Center The USC Norris Comprehensive Cancer Center, located in Los Angeles, is...
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600 Highland Ave
Madison, Wisconsin 53792
Madison, Wisconsin 53792
(608) 263-6400
University of Wisconsin Hospital and Clinics UW Health strives to meet the health needs of...
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Loyola University Medical Center Loyola University Health System is committed to excellence in patient care...
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9200 W Wisconsin Ave
Milwaukee, Wisconsin 53226
Milwaukee, Wisconsin 53226
(414) 805-3666
Froedtert and the Medical College of Wisconsin Froedtert Health combines with the Medical College of...
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Memorial Medical Center Memorial is affiliated with Sutter Health, a family of not-for-profit hospitals, physician...
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Long Island Jewish Medical Center Serving North Shore LIJ Health System employees and their families....
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1430 Tulane Ave Suite SL32
New Orleans, Louisiana 70112
New Orleans, Louisiana 70112
(504) 588-5912
Tulane University Health Sciences Center One of the nation's most recognized centers for medical education,...
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Memorial Sloan Kettering Cancer Center Memorial Sloan Kettering Cancer Center — the world's oldest and...
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New York, New York 10032
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940 NE 13th St
Oklahoma City, Oklahoma 73190
Oklahoma City, Oklahoma 73190
(405) 271-6458
University of Oklahoma Health Sciences Center The OU Health Sciences Center is composed of seven...
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Univ of Nebraska Med Ctr A vital enterprise in the nation’s heartland, the University of...
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