Phase III Randomized Trial of Standard Systemic Therapy (SST) Versus Standard Systemic Therapy Plus Definitive Treatment (Surgery or Radiation) of the Primary Tumor in Metastatic Prostate Cancer
Summary
This phase III trial studies how well standard systemic therapy with or without definitive treatment (prostate removal surgery or radiation therapy) works in treating participants with prostate cancer that has spread to other places in the body. Addition of prostate removal surgery or radiation therapy to standard systemic therapy for prostate cancer may lower the chance of the cancer growing or spreading.
Detailed description
PRIMARY OBJECTIVES: I. To compare overall survival in metastatic prostate cancer patients who are randomized to standard systemic therapy (SST) plus definitive treatment of the primary tumor versus standard systemic therapy alone. SECONDARY OBJECTIVES: I. To compare overall survival in metastatic prostate cancer patients who received SST plus surgical excision of the primary tumor versus SST alone in the subset who specify the surgical intent stratification factor. II. To compare the rate of symptomatic local progression between the treatment arms. III. To compare progression-free survival (PFS) between the two treatment arms. IV. To compare rates of progression-free survival between arms for the subsets of patients with and without metastasis directed therapy (MDT) to oligometastatic sites. QUALITY OF LIFE OBJECTIVES: I. To compare between arms patient-reported urinary function and urinary bother over time (after initiation of SST at 6 months, 1, 2, and 3 years) using the Expanded Prostate Cancer Index Composite (EPIC) and patient-reported pain and physical functioning using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) between patients receiving standard systemic therapy and those receiving systemic therapy and definitive management of the primary prostate cancer. OTHER OBJECTIVES: I. To bank tissue and whole blood specimens for future use. OUTLINE: INDUCTION: Participants receive 1 of 6 acceptable forms of SST for 22-28 weeks. I. Participants undergo a bilateral orchiectomy. II. Participants receive goserelin acetate subcutaneously (SC) every 28 days or 12 weeks, histrelin acetate SC every 12 months, leuprolide acetate SC or intramuscularly (IM) every 1, 3, 4, or 6 months, and triptorelin every 1, 3, or 6 months. III. Participants receive goserelin acetate SC every 28 days or 12 weeks, histrelin acetate SC every 12 months, leuprolide acetate SC or IM every 1, 3, 4, or 6 months, and triptorelin every 1, 3, or 6 months. Participants also receive nilutamide orally (PO) daily, flutamide PO every 8 hours, and bicalutamide PO daily. IV. Participants receive degarelix via injection for 2 doses and then every 28 days. V. Participants receive nilutamide PO daily, flutamide PO every 8 hours, and bicalutamide PO daily. Participants also receive docetaxel over 1 hour every 3 weeks with or without prednisone PO every 12 hours. VI. Participants receive nilutamide PO daily, flutamide PO every 8 hours, and bicalutamide PO daily. Participants also receive abiraterone PO daily or prednisone PO every 12 hours. After completion of 22-28 weeks of SST, participants are then randomized to 1 of 2 arms. ARM I: Participants receive 1 acceptable form of SST as in Induction except for treatment with docetaxel and prednisone. ARM II: Participants receive 1 acceptable form of SST as in Induction except for treatment with docetaxel and prednisone. Participants undergo prostatectomy within 8 weeks after randomization or radiation therapy within 4 weeks of randomization. After completion of study treatment, participants are followed up for 8 years.
Arms & interventions
- DrugAbiraterone
Given PO
- DrugBicalutamide
Given PO
- DrugDegarelix
Given via injection
- DrugDocetaxel
intravenous
- DrugFlutamide
Given PO
- DrugGoserelin Acetate
Given SC
- DrugHistrelin Acetate
Receive SC
- DrugLeuprolide Acetate
Receive SC or IM
- DrugNilutamide
Given PO
- ProcedureOrchiectomy
Undergo bilateral orchiectomy
- DrugPrednisone
Given PO
- OtherQuality-of-Life Assessment
Ancillary studies
- RadiationRadiation Therapy
Standard radiation
- ProcedureRadical Prostatectomy
Standard surgery
- DrugTriptorelin
injection
Outcome measures
Primary
Overall survival (OS)
Time frame: From date of randomization to date of death due to any cause, assessed up to 8 years
Secondary
Media OS
Time frame: From date of randomization to date of death due to any cause, assessed up to 8 years
Rate of symptomatic local progression
Time frame: Up to 8 years
Progression-free survival (PFS)
Time frame: From date of randomization to date of first documentation of progression, or death due to any cause, assessed up to 8 years
Eligibility criteria
Study locations (334)
Banner MD Anderson Cancer Center
Gilbert, Arizona, 85234
Cancer Center at Saint Joseph's
Phoenix, Arizona, 85004
Mayo Clinic Hospital in Arizona
Phoenix, Arizona, 85054
Mayo Clinic in Arizona
Scottsdale, Arizona, 85259
University of Arizona Cancer Center-Orange Grove Campus
Tucson, Arizona, 85704
University of Arizona Cancer Center-North Campus
Tucson, Arizona, 85719
University of Arkansas for Medical Sciences
Little Rock, Arkansas, 72205
Kaiser Permanente-Deer Valley Medical Center
Antioch, California, 94531
Community Cancer Institute
Clovis, California, 93611
University Oncology Associates
Clovis, California, 93611
City of Hope Comprehensive Cancer Center
Duarte, California, 91010
Kaiser Permanente Dublin
Dublin, California, 94568
Kaiser Permanente-Fremont
Fremont, California, 94538
Fresno Cancer Center
Fresno, California, 93720
Kaiser Permanente-Fresno
Fresno, California, 93720
UC San Diego Moores Cancer Center
La Jolla, California, 92093
Tibor Rubin VA Medical Center
Long Beach, California, 90822
Los Angeles County-USC Medical Center
Los Angeles, California, 90033
USC / Norris Comprehensive Cancer Center
Los Angeles, California, 90033
Fremont - Rideout Cancer Center
Marysville, California, 95901
Kaiser Permanente-Modesto
Modesto, California, 95356
Kaiser Permanente Oakland-Broadway
Oakland, California, 94611
Kaiser Permanente-Oakland
Oakland, California, 94611
Desert Regional Medical Center
Palm Springs, California, 92262
Stanford Cancer Institute Palo Alto
Palo Alto, California, 94304
Kaiser Permanente-Rancho Cordova Cancer Center
Rancho Cordova, California, 95670
Kaiser Permanente-Redwood City
Redwood City, California, 94063
Kaiser Permanente-Richmond
Richmond, California, 94801
Rohnert Park Cancer Center
Rohnert Park, California, 94928
Kaiser Permanente-Roseville
Roseville, California, 95661
The Permanente Medical Group-Roseville Radiation Oncology
Roseville, California, 95678
Kaiser Permanente Downtown Commons
Sacramento, California, 95814
Mercy Cancer Center - Sacramento
Sacramento, California, 95816
University of California Davis Comprehensive Cancer Center
Sacramento, California, 95817
Kaiser Permanente-South Sacramento
Sacramento, California, 95823
South Sacramento Cancer Center
Sacramento, California, 95823
Kaiser Permanente-San Francisco
San Francisco, California, 94115
Kaiser Permanente-Santa Teresa-San Jose
San Jose, California, 95119
Kaiser Permanente San Leandro
San Leandro, California, 94577
Pacific Central Coast Health Center-San Luis Obispo
San Luis Obispo, California, 93401
Kaiser San Rafael-Gallinas
San Rafael, California, 94903
Kaiser Permanente Medical Center - Santa Clara
Santa Clara, California, 95051
Kaiser Permanente-Santa Rosa
Santa Rosa, California, 95403
Kaiser Permanente Cancer Treatment Center
South San Francisco, California, 94080
Kaiser Permanente-South San Francisco
South San Francisco, California, 94080
Kaiser Permanente-Stockton
Stockton, California, 95210
Gene Upshaw Memorial Tahoe Forest Cancer Center
Truckee, California, 96161
Kaiser Permanente Medical Center-Vacaville
Vacaville, California, 95688
Kaiser Permanente-Vallejo
Vallejo, California, 94589
Kaiser Permanente-Walnut Creek
Walnut Creek, California, 94596
University of Colorado Hospital
Aurora, Colorado, 80045
Rocky Mountain Cancer Centers-Boulder
Boulder, Colorado, 80304
UCHealth Memorial Hospital Central
Colorado Springs, Colorado, 80909
Memorial Hospital North
Colorado Springs, Colorado, 80920
Porter Adventist Hospital
Denver, Colorado, 80210
Shaw Cancer Center
Edwards, Colorado, 81632
Poudre Valley Hospital
Fort Collins, Colorado, 80524
North Colorado Medical Center
Greeley, Colorado, 80631
Littleton Adventist Hospital
Littleton, Colorado, 80122
McKee Medical Center
Loveland, Colorado, 80539
Parker Adventist Hospital
Parker, Colorado, 80138
Smilow Cancer Hospital Care Center - Guilford
Guilford, Connecticut, 06437
Yale University
New Haven, Connecticut, 06520
Stamford Hospital/Bennett Cancer Center
Stamford, Connecticut, 06904
Smilow Cancer Hospital Care Center-Trumbull
Trumbull, Connecticut, 06611
Smilow Cancer Hospital Care Center - Waterford
Waterford, Connecticut, 06385
Veterans Affairs Connecticut Healthcare System-West Haven Campus
West Haven, Connecticut, 06516
Helen F Graham Cancer Center
Newark, Delaware, 19713
Christiana Care Health System-Christiana Hospital
Newark, Delaware, 19718
MedStar Georgetown University Hospital
Washington D.C., District of Columbia, 20007
MedStar Washington Hospital Center
Washington D.C., District of Columbia, 20010
George Washington University Medical Center
Washington D.C., District of Columbia, 20037
Mount Sinai Comprehensive Cancer Center at Aventura
Aventura, Florida, 33180
UM Sylvester Comprehensive Cancer Center at Coral Gables
Coral Gables, Florida, 33146
UM Sylvester Comprehensive Cancer Center at Deerfield Beach
Deerfield Beach, Florida, 33442
Baptist MD Anderson Cancer Center
Jacksonville, Florida, 32207
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami, Florida, 33136
UM Sylvester Comprehensive Cancer Center at Kendall
Miami, Florida, 33176
Mount Sinai Medical Center
Miami Beach, Florida, 33140
Orlando Health Cancer Institute
Orlando, Florida, 32806
UM Sylvester Comprehensive Cancer Center at Plantation
Plantation, Florida, 33324
Grady Health System
Atlanta, Georgia, 30303
Emory University Hospital Midtown
Atlanta, Georgia, 30308
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia, 30322
Emory Saint Joseph's Hospital
Atlanta, Georgia, 30342
Augusta University Medical Center
Augusta, Georgia, 30912
Atlanta VA Medical Center
Decatur, Georgia, 30033
Saint Alphonsus Cancer Care Center-Caldwell
Caldwell, Idaho, 83605
Saint Alphonsus Cancer Care Center-Nampa
Nampa, Idaho, 83687
Kootenai Clinic Cancer Services - Post Falls
Post Falls, Idaho, 83854
Rush - Copley Medical Center
Aurora, Illinois, 60504
Illinois CancerCare-Bloomington
Bloomington, Illinois, 61704
Illinois CancerCare-Canton
Canton, Illinois, 61520
Illinois CancerCare-Carthage
Carthage, Illinois, 62321
Northwestern University
Chicago, Illinois, 60611
Rush University Medical Center
Chicago, Illinois, 60612
University of Illinois
Chicago, Illinois, 60612
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
Decatur Memorial Hospital
Decatur, Illinois, 62526
Crossroads Cancer Center
Effingham, Illinois, 62401
Illinois CancerCare-Eureka
Eureka, Illinois, 61530
Illinois CancerCare-Galesburg
Galesburg, Illinois, 61401
Illinois CancerCare-Kewanee Clinic
Kewanee, Illinois, 61443
Illinois CancerCare-Macomb
Macomb, Illinois, 61455
Loyola University Medical Center
Maywood, Illinois, 60153
Illinois CancerCare-Ottawa Clinic
Ottawa, Illinois, 61350
Illinois CancerCare-Pekin
Pekin, Illinois, 61554
Illinois CancerCare-Peoria
Peoria, Illinois, 61615
Methodist Medical Center of Illinois
Peoria, Illinois, 61636
OSF Saint Francis Medical Center
Peoria, Illinois, 61637
Illinois CancerCare-Peru
Peru, Illinois, 61354
Illinois CancerCare-Princeton
Princeton, Illinois, 61356
Southwest Illinois Health Services LLP
Swansea, Illinois, 62226
Carle Cancer Center
Urbana, Illinois, 61801
Indiana University/Melvin and Bren Simon Cancer Center
Indianapolis, Indiana, 46202
Reid Health
Richmond, Indiana, 47374
McFarland Clinic - Ames
Ames, Iowa, 50010
Iowa Methodist Medical Center
Des Moines, Iowa, 50309
University of Iowa/Holden Comprehensive Cancer Center
Iowa City, Iowa, 52242
University of Kansas Cancer Center
Kansas City, Kansas, 66160
Olathe Health Cancer Center
Olathe, Kansas, 66061
University of Kansas Cancer Center-Overland Park
Overland Park, Kansas, 66210
University of Kansas Hospital-Westwood Cancer Center
Westwood, Kansas, 66205
Saint Joseph Radiation Oncology Resource Center
Lexington, Kentucky, 40504
Saint Joseph Hospital East
Lexington, Kentucky, 40509
University of Kentucky/Markey Cancer Center
Lexington, Kentucky, 40536
The James Graham Brown Cancer Center at University of Louisville
Louisville, Kentucky, 40202
East Jefferson General Hospital
Metairie, Louisiana, 70006
LSU Healthcare Network / Metairie Multi-Specialty Clinic
Metairie, Louisiana, 70006
MaineHealth Coastal Cancer Treatment Center
Bath, Maine, 04530
Lafayette Family Cancer Center-EMMC
Brewer, Maine, 04412
Maine Medical Center-Bramhall Campus
Portland, Maine, 04102
MaineHealth Cancer Care Center of York County
Sanford, Maine, 04073
MaineHealth/SMHC Cancer Care and Blood Disorders-Sanford
Sanford, Maine, 04073
Maine Medical Center- Scarborough Campus
Scarborough, Maine, 04074
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore, Maryland, 21287
Lahey Hospital and Medical Center
Burlington, Massachusetts, 01805
Saint Joseph Mercy Hospital
Ann Arbor, Michigan, 48106
University of Michigan Comprehensive Cancer Center
Ann Arbor, Michigan, 48109
Saint Joseph Mercy Brighton
Brighton, Michigan, 48114
Henry Ford Cancer Institute-Downriver
Brownstown, Michigan, 48183
Saint Joseph Mercy Canton
Canton, Michigan, 48188
Saint Joseph Mercy Chelsea
Chelsea, Michigan, 48118
GenesisCare USA - Clarkston
Clarkston, Michigan, 48346
Henry Ford Macomb Hospital-Clinton Township
Clinton Township, Michigan, 48038
Wayne State University/Karmanos Cancer Institute
Detroit, Michigan, 48201
Henry Ford Hospital
Detroit, Michigan, 48202
GenesisCare USA - Farmington Hills
Farmington Hills, Michigan, 48334
Spectrum Health at Butterworth Campus
Grand Rapids, Michigan, 49503
West Michigan Cancer Center
Kalamazoo, Michigan, 49007
Sparrow Hospital
Lansing, Michigan, 48912
GenesisCare USA - Macomb
Macomb, Michigan, 48044
GenesisCare USA - Madison Heights
Madison Heights, Michigan, 48071
21st Century Oncology-Pontiac
Pontiac, Michigan, 48341
Ascension Saint Mary's Hospital
Saginaw, Michigan, 48601
Munson Medical Center
Traverse City, Michigan, 49684
GenesisCare USA - Troy
Troy, Michigan, 48098
Henry Ford West Bloomfield Hospital
West Bloomfield, Michigan, 48322
Mercy Hospital
Coon Rapids, Minnesota, 55433
Fairview Southdale Hospital
Edina, Minnesota, 55435
Unity Hospital
Fridley, Minnesota, 55432
Hennepin County Medical Center
Minneapolis, Minnesota, 55415
Health Partners Inc
Minneapolis, Minnesota, 55454
North Memorial Medical Health Center
Robbinsdale, Minnesota, 55422
Mayo Clinic in Rochester
Rochester, Minnesota, 55905
Park Nicollet Clinic - Saint Louis Park
Saint Louis Park, Minnesota, 55416
Regions Hospital
Saint Paul, Minnesota, 55101
Saint Francis Regional Medical Center
Shakopee, Minnesota, 55379
University of Mississippi Medical Center
Jackson, Mississippi, 39216
Saint Francis Medical Center
Cape Girardeau, Missouri, 63703
Southeast Cancer Center
Cape Girardeau, Missouri, 63703
Siteman Cancer Center at Saint Peters Hospital
City of Saint Peters, Missouri, 63376
University of Missouri - Ellis Fischel
Columbia, Missouri, 65212
Siteman Cancer Center at West County Hospital
Creve Coeur, Missouri, 63141
Freeman Health System
Joplin, Missouri, 64804
University of Kansas Cancer Center - North
Kansas City, Missouri, 64154
Delbert Day Cancer Institute at PCRMC
Rolla, Missouri, 65401
Sainte Genevieve County Memorial Hospital
Sainte Genevieve, Missouri, 63670
Mercy Hospital Springfield
Springfield, Missouri, 65804
CoxHealth South Hospital
Springfield, Missouri, 65807
Washington University School of Medicine
St Louis, Missouri, 63110
Siteman Cancer Center-South County
St Louis, Missouri, 63129
Missouri Baptist Medical Center
St Louis, Missouri, 63131
Siteman Cancer Center at Christian Hospital
St Louis, Missouri, 63136
Mercy Hospital Saint Louis
St Louis, Missouri, 63141
Billings Clinic Cancer Center
Billings, Montana, 59101
Bozeman Deaconess Hospital
Bozeman, Montana, 59715
Saint James Community Hospital and Cancer Treatment Center
Butte, Montana, 59701
Benefis Healthcare- Sletten Cancer Institute
Great Falls, Montana, 59405
Kalispell Regional Medical Center
Kalispell, Montana, 59901
Nebraska Medicine-Bellevue
Bellevue, Nebraska, 68123
Nebraska Methodist Hospital
Omaha, Nebraska, 68114
Nebraska Medicine-Village Pointe
Omaha, Nebraska, 68118
University of Nebraska Medical Center
Omaha, Nebraska, 68198
Comprehensive Cancer Centers of Nevada - Henderson
Henderson, Nevada, 89052
Radiation Oncology Centers of Nevada Central
Las Vegas, Nevada, 89106
Comprehensive Cancer Centers of Nevada - Northwest
Las Vegas, Nevada, 89128
Comprehensive Cancer Centers of Nevada-Summerlin
Las Vegas, Nevada, 89144
Comprehensive Cancer Centers of Nevada
Las Vegas, Nevada, 89148
Comprehensive Cancer Centers of Nevada - Central Valley
Las Vegas, Nevada, 89169
New Hampshire Oncology Hematology PA-Concord
Concord, New Hampshire, 03301
Wentworth-Douglass Hospital
Dover, New Hampshire, 03820
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon, New Hampshire, 03756
Elliot Hospital
Manchester, New Hampshire, 03103
Solinsky Center for Cancer Care
Manchester, New Hampshire, 03103
Hackensack University Medical Center
Hackensack, New Jersey, 07601
Holy Name Hospital
Teaneck, New Jersey, 07666
Albany Medical Center
Albany, New York, 12208
Roswell Park Cancer Institute
Buffalo, New York, 14263
Noyes Memorial Hospital/Myers Cancer Center
Dansville, New York, 14437
Glens Falls Hospital
Glens Falls, New York, 12801
Northwell Health/Center for Advanced Medicine
Lake Success, New York, 11042
NYP/Weill Cornell Medical Center
New York, New York, 10065
Upstate Cancer Center Radiation Oncology at Oneida
Oneida, New York, 13421
Upstate Cancer Center Radiation Oncology at Oswego
Oswego, New York, 13126
Highland Hospital
Rochester, New York, 14620
University of Rochester
Rochester, New York, 14642
Stony Brook University Medical Center
Stony Brook, New York, 11794
State University of New York Upstate Medical University
Syracuse, New York, 13210
Montefiore Medical Center-Einstein Campus
The Bronx, New York, 10461
Montefiore Medical Center - Moses Campus
The Bronx, New York, 10467
James J Peters VA Medical Center
The Bronx, New York, 10468
Atrium Health Stanly/LCI-Albemarle
Albemarle, North Carolina, 28002
Mission Hospital
Asheville, North Carolina, 28801
Carolinas Medical Center/Levine Cancer Institute
Charlotte, North Carolina, 28203
Atrium Health Pineville/LCI-Pineville
Charlotte, North Carolina, 28210
Atrium Health University City/LCI-University
Charlotte, North Carolina, 28262
Levine Cancer Institute-Ballantyne
Charlotte, North Carolina, 28277
Atrium Health Cabarrus/LCI-Concord
Concord, North Carolina, 28025
Levine Cancer Institute-Gaston
Gastonia, North Carolina, 28054
Margaret R Pardee Memorial Hospital
Hendersonville, North Carolina, 28791
Atrium Health Union/LCI-Union
Monroe, North Carolina, 28112
CarolinaEast Medical Center
New Bern, North Carolina, 28561
Cleveland Clinic Mercy Hospital
Canton, Ohio, 44708
Miami Valley Hospital South
Centerville, Ohio, 45459
University of Cincinnati Cancer Center-UC Medical Center
Cincinnati, Ohio, 45219
MetroHealth Medical Center
Cleveland, Ohio, 44109
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210
Miami Valley Hospital North
Dayton, Ohio, 45415
Greater Dayton Cancer Center
Kettering, Ohio, 45409
Kettering Medical Center
Kettering, Ohio, 45429
ProMedica Flower Hospital
Sylvania, Ohio, 43560
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
Toledo, Ohio, 43606
University of Toledo
Toledo, Ohio, 43614
University of Cincinnati Cancer Center-West Chester
West Chester, Ohio, 45069
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Legacy Mount Hood Medical Center
Gresham, Oregon, 97030
Legacy Good Samaritan Hospital and Medical Center
Portland, Oregon, 97210
Oregon Health and Science University
Portland, Oregon, 97239
Chambersburg Hospital
Chambersburg, Pennsylvania, 17201
Geisinger Medical Center
Danville, Pennsylvania, 17822
Ephrata Cancer Center
Ephrata, Pennsylvania, 17522
Adams Cancer Center
Gettysburg, Pennsylvania, 17325
Sechler Family Cancer Center
Lebanon, Pennsylvania, 17042
Geisinger Medical Oncology-Lewisburg
Lewisburg, Pennsylvania, 17837
Temple University Hospital
Philadelphia, Pennsylvania, 19140
University of Pittsburgh Cancer Institute (UPCI)
Pittsburgh, Pennsylvania, 15232
UPMC-Shadyside Hospital
Pittsburgh, Pennsylvania, 15232
Geisinger Wyoming Valley/Henry Cancer Center
Wilkes-Barre, Pennsylvania, 18711
WellSpan Health-York Cancer Center
York, Pennsylvania, 17403
Prisma Health Cancer Institute - Spartanburg
Boiling Springs, South Carolina, 29316
Medical University of South Carolina
Charleston, South Carolina, 29425
Prisma Health Cancer Institute - Faris
Greenville, South Carolina, 29605
Saint Francis Cancer Center
Greenville, South Carolina, 29607
Prisma Health Cancer Institute - Eastside
Greenville, South Carolina, 29615
Prisma Health Cancer Institute - Greer
Greer, South Carolina, 29650
Carolina Regional Cancer Center
Myrtle Beach, South Carolina, 29577
Rock Hill Radiation Therapy Center
Rock Hill, South Carolina, 29730
Levine Cancer Institute-Rock Hill
Rock Hill, South Carolina, 29732
Prisma Health Cancer Institute - Seneca
Seneca, South Carolina, 29672
Vanderbilt University/Ingram Cancer Center
Nashville, Tennessee, 37232
MD Anderson in The Woodlands
Conroe, Texas, 77384
Parkland Memorial Hospital
Dallas, Texas, 75235
UT Southwestern Simmons Cancer Center - RedBird
Dallas, Texas, 75237
UT Southwestern/Simmons Cancer Center-Dallas
Dallas, Texas, 75390
UT Southwestern/Simmons Cancer Center-Fort Worth
Fort Worth, Texas, 76104
Lyndon Baines Johnson General Hospital
Houston, Texas, 77026-1967
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
Houston, Texas, 77030
Ben Taub General Hospital
Houston, Texas, 77030
Houston Methodist Hospital
Houston, Texas, 77030
M D Anderson Cancer Center
Houston, Texas, 77030
Michael E DeBakey VA Medical Center
Houston, Texas, 77030
MD Anderson West Houston
Houston, Texas, 77079
MD Anderson League City
League City, Texas, 77573
UT Southwestern Clinical Center at Richardson/Plano
Richardson, Texas, 75080
Audie L Murphy VA Hospital
San Antonio, Texas, 78229
University of Texas Health Science Center at San Antonio
San Antonio, Texas, 78229
MD Anderson in Sugar Land
Sugar Land, Texas, 77478
Scott and White Memorial Hospital
Temple, Texas, 76508
American Fork Hospital / Huntsman Intermountain Cancer Center
American Fork, Utah, 84003
Sandra L Maxwell Cancer Center
Cedar City, Utah, 84720
Logan Regional Hospital
Logan, Utah, 84321
Intermountain Medical Center
Murray, Utah, 84107
McKay-Dee Hospital Center
Ogden, Utah, 84403
Utah Valley Regional Medical Center
Provo, Utah, 84604
Riverton Hospital
Riverton, Utah, 84065
University of Utah Sugarhouse Health Center
Salt Lake City, Utah, 84106
Utah Cancer Specialists-Salt Lake City
Salt Lake City, Utah, 84106
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, 84112
LDS Hospital
Salt Lake City, Utah, 84143
George E Wahlen Department of Veterans Affairs Medical Center
Salt Lake City, Utah, 84148
Saint George Regional Medical Center
St. George, Utah, 84770
Central Vermont Medical Center/National Life Cancer Treatment
Berlin Corners, Vermont, 05602
University of Vermont Medical Center
Burlington, Vermont, 05401
Bon Secours Saint Francis Medical Center
Midlothian, Virginia, 23114
Bon Secours Cancer Institute at Reynolds Crossing
Richmond, Virginia, 23230
VCU Massey Cancer Center at Stony Point
Richmond, Virginia, 23235
Virginia Commonwealth University/Massey Cancer Center
Richmond, Virginia, 23298
VCU Community Memorial Health Center
South Hill, Virginia, 23970
FHCC Overlake
Bellevue, Washington, 98004
Seattle Cancer Care Alliance at EvergreenHealth
Kirkland, Washington, 98034
FHCC South Lake Union
Seattle, Washington, 98109
FHCC at Northwest Hospital
Seattle, Washington, 98133
University of Washington Medical Center - Montlake
Seattle, Washington, 98195
Legacy Salmon Creek Hospital
Vancouver, Washington, 98686
West Virginia University Healthcare
Morgantown, West Virginia, 26506
Langlade Hospital and Cancer Center
Antigo, Wisconsin, 54409
Marshfield Medical Center-EC Cancer Center
Eau Claire, Wisconsin, 54701
Mayo Clinic Health System-Franciscan Healthcare
La Crosse, Wisconsin, 54601
Marshfield Medical Center-Marshfield
Marshfield, Wisconsin, 54449
Froedtert Menomonee Falls Hospital
Menomonee Falls, Wisconsin, 53051
Medical College of Wisconsin
Milwaukee, Wisconsin, 53226
Zablocki Veterans Administration Medical Center
Milwaukee, Wisconsin, 53295
Marshfield Clinic-Minocqua Center
Minocqua, Wisconsin, 54548
Cancer Center of Western Wisconsin
New Richmond, Wisconsin, 54017
Drexel Town Square Health Center
Oak Creek, Wisconsin, 53154
Marshfield Medical Center-Rice Lake
Rice Lake, Wisconsin, 54868
Ascension Saint Michael's Hospital
Stevens Point, Wisconsin, 54481
Marshfield Medical Center-River Region at Stevens Point
Stevens Point, Wisconsin, 54482
Aspirus Regional Cancer Center
Wausau, Wisconsin, 54401
Froedtert West Bend Hospital/Kraemer Cancer Center
West Bend, Wisconsin, 53095
Diagnostic and Treatment Center
Weston, Wisconsin, 54476
Marshfield Medical Center - Weston
Weston, Wisconsin, 54476
Aspirus Cancer Care - Wisconsin Rapids
Wisconsin Rapids, Wisconsin, 54494