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Brief Title: Chemotherapy Plus Radiation Therapy in Treating Patients With Stage II or Stage III Anal Cancer
Official Title: A Phase III Randomized Study of 5-Fluorouracil, Mitomycin-C, and Radiotherapy Versus 5-Fluorouracil, Cisplatin, and Radiotherapy in Carcinoma of the Anal Canal
Study ID: NCT00003596
Brief Summary: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug or combining radiation therapy with chemotherapy may kill more tumor cells. It is not yet known whether fluorouracil and mitomycin plus radiation therapy is more effective than fluorouracil and cisplatin plus radiation therapy for anal cancer. PURPOSE: This randomized phase III trial is studying fluorouracil and mitomycin plus radiation therapy to see how well it works compared to fluorouracil and cisplatin plus radiation therapy in treating patients with stage II or stage III anal cancer.
Detailed Description: OBJECTIVES: * Compare the initial and total local and distant failure rates in patients with anal canal cancer treated with either fluorouracil (5-FU) plus mitomycin concurrently with radiotherapy or 5-FU plus cisplatin followed by 5-FU plus cisplatin concurrently with radiotherapy. * Identify any differences in local control and colostomy rates at 2 years in patients treated with these regimens. * Determine any difference in colostomy free, disease free, or overall survival in patients treated with these regimens. * Compare the toxic effects of these regimens in these patients. * Evaluate the prognostic effects of tumor markers P53 overexpression, human papilloma virus status, and enzyme HAP1 in patients treated with these regimens. OUTLINE: This is a randomized study. Patients are stratified according to gender, nodal status (positive vs negative), and primary tumor size (greater than 2 cm to 5 cm vs greater than 5 cm). Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients receive fluorouracil (5-FU) IV continuously over 96 hours beginning on days 1 and 29 and mitomycin IV on days 1 and 29 with concurrent radiotherapy. * Arm II: Patients receive induction chemotherapy comprising 5-FU IV continuously over 96 hours beginning on days 1, 29, 57, and 85 and cisplatin IV over 1 hour on days 1, 29, 57, and 85. Beginning on day 57, patients receive concurrent radiotherapy. In both arms, radiotherapy is administered daily, 5 days a week, for 5-6.5 weeks. Patients with T3, T4, or N+ lesions or T2 lesions with residual disease receive additional radiotherapy to a reduced field. Patients are followed every 3 months for 1 year, every 6 months for 1 year, and then annually thereafter. PROJECTED ACCRUAL: A total of 650 patients will be accrued for this study within 5 years.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Comprehensive Cancer Center at University of Alabama at Birmingham, Birmingham, Alabama, United States
Mobile Infirmary Medical Center, Mobile, Alabama, United States
Alaska Regional Hospital, Anchorage, Alaska, United States
Providence Alaska Medical Center, Anchorage, Alaska, United States
Foundation for Cancer Research and Education, Phoenix, Arizona, United States
CCOP - Mayo Clinic Scottsdale Oncology Program, Scottsdale, Arizona, United States
Hembree Mercy Cancer Center at St. Edward Mercy Medical Center, Ft. Smith, Arkansas, United States
Alta Bates Comprehensive Cancer Center, Berkeley, California, United States
Providence Saint Joseph Medical Center - Burbank, Burbank, California, United States
Mills-Peninsula Health Services, Burlingame, California, United States
Mount Diablo Regional Cancer Center, Concord, California, United States
City of Hope Comprehensive Cancer Center, Duarte, California, United States
California Cancer Center - Woodward Park Office, Fresno, California, United States
Marin Cancer Institute at Marin General Hospital, Greenbrae, California, United States
Sutter Health Western Division Cancer Research Group, Greenbrae, California, United States
Saint Rose Hospital, Hayward, California, United States
Valley Memorial Hospital, Livermore, California, United States
Loma Linda University Cancer Institute at Loma Linda University Medical Center, Loma Linda, California, United States
USC/Norris Comprehensive Cancer Center and Hospital, Los Angeles, California, United States
Providence Holy Cross Cancer Center, Mission Hills, California, United States
Memorial Medical Center Cancer Services, Modesto, California, United States
Leavey Cancer Center at Northridge Hospital Medical Center, Northridge, California, United States
Highland General Hospital, Oakland, California, United States
CCOP - Bay Area Tumor Institute, Oakland, California, United States
Summit Medical Center, Oakland, California, United States
Palo Alto Medical Foundation, Palo Alto, California, United States
Pomona Valley Hospital Medical Center, Pomona, California, United States
Radiological Associates of Sacramento Medical Group, Inc., Sacramento, California, United States
University of California Davis Cancer Center, Sacramento, California, United States
Naval Medical Center - San Diego, San Diego, California, United States
California Pacific Medical Center - California Campus, San Francisco, California, United States
J.C. Robinson, M.D. Regional Cancer Center, San Pablo, California, United States
CCOP - Santa Rosa Memorial Hospital, Sana Rosa, California, United States
Torrance Memorial Medical Center, Torrance, California, United States
Sutter Solano Medical Center, Vallejo, California, United States
Aurora Presbyterian Hospital, Aurora, Colorado, United States
Boulder Community Hospital, Boulder, Colorado, United States
Memorial Hospital Cancer Center, Colorado Springs, Colorado, United States
Penrose Cancer Center at Penrose Hospital, Colorado Springs, Colorado, United States
Porter Adventist Hospital, Denver, Colorado, United States
Presbyterian - St. Luke's Medical Center, Denver, Colorado, United States
St. Joseph Hospital, Denver, Colorado, United States
Rose Medical Center, Denver, Colorado, United States
CCOP - Colorado Cancer Research Program, Incorporated, Denver, Colorado, United States
Swedish Medical Center, Englewood, Colorado, United States
Front Range Cancer Specialists, Fort Collins, Colorado, United States
St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center, Grand Junction, Colorado, United States
Sky Ridge Medical Center, Lone Tree, Colorado, United States
Hope Cancer Care Center at Longmont United Hospital, Longmont, Colorado, United States
St. Mary-Corwin Regional Medical Center, Pueblo, Colorado, United States
North Suburban Medical Center, Thorton, Colorado, United States
Middlesex Hospital Cancer Center, Middletown, Connecticut, United States
Beebe Medical Center, Lewes, Delaware, United States
CCOP - Christiana Care Health Services, Newark, Delaware, United States
St. Francis Hospital, Wilmington, Delaware, United States
Lombardi Cancer Center at Georgetown University Medical Center, Washington, District of Columbia, United States
Michael & Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital, Fort Lauderdale, Florida, United States
21st Century Oncology - Fort Myers, Fort Myers, Florida, United States
Memorial Cancer Institute at Memorial Regional Hospital, Hollywood, Florida, United States
Baptist Cancer Institute - Jacksonville, Jacksonville, Florida, United States
Mayo Clinic - Jacksonville, Jacksonville, Florida, United States
Ella Milbank Foshay Cancer Center at Jupiter Medical Center, Jupiter, Florida, United States
CCOP - Mount Sinai Medical Center, Miami Beach, Florida, United States
University of Miami Sylvester Comprehensive Cancer Center, Miami, Florida, United States
Baptist-South Miami Regional Cancer Program, Miami, Florida, United States
Gulf Coast Cancer Treatment Center, Panama City, Florida, United States
Tallahassee Memorial Hospital, Tallahassee, Florida, United States
H. Lee Moffitt Cancer Center and Research Institute at University of South Florida, Tampa, Florida, United States
Emory University Hospital - Atlanta, Altanta, Georgia, United States
Northeast Georgia Medical Center, Gainesville, Georgia, United States
Pearlman Comprehensive Cancer Center at South Georgia Medical Center, Valdosta, Georgia, United States
Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical Center, Boise, Idaho, United States
Mountain States Tumor Institute - Boise, Boise, Idaho, United States
Saint Anthony's Hospital at Saint Anthony's Health Center, Alton, Illinois, United States
Northwest Community Hospital, Arlington Heights, Illinois, United States
Rush-Copley Cancer Care Center, Aurora, Illinois, United States
Good Shepherd Hospital, Barrington, Illinois, United States
St. Joseph Medical Center, Bloomington, Illinois, United States
Graham Hospital, Canton, Illinois, United States
Memorial Hospital, Carthage, Illinois, United States
Robert H. Lurie Comprehensive Cancer Center at Northwestern University, Chicago, Illinois, United States
Creticos Cancer Center at Advocate Illinois Masonic Medical Center, Chicago, Illinois, United States
Cancer Care Center at Advocate Good Samaritan Hospital, Downers Grove, Illinois, United States
St. Anthony's Memorial Hospital, Effingham, Illinois, United States
Eureka Hospital, Eureka, Illinois, United States
Evanston Northwestern Health Care - Evanston Hospital, Evanston, Illinois, United States
Galesburg Clinic, Galesburg, Illinois, United States
Galesburg Cottage Hospital, Galesburg, Illinois, United States
InterCommunity Cancer Center of Western Illinois, Galesburg, Illinois, United States
Mason District Hospital, Havana, Illinois, United States
Hinsdale Hematology Oncology Associates, Hinsdale, Illinois, United States
Hopedale Medical Complex, Hopedale, Illinois, United States
Joliet Oncology Hematology Associates, Limited - West, Joliet, Illinois, United States
Kewanee Hospital, Kewanee, Illinois, United States
McDonough District Hospital, Macomb, Illinois, United States
Edward Hospital Cancer Center, Naperville, Illinois, United States
BroMenn Regional Medical Center, Normal, Illinois, United States
Community Cancer Center, Normal, Illinois, United States
Community Hospital of Ottawa, Ottawa, Illinois, United States
Oncology Hematology Associates of Central Illinois - Ottawa, Ottawa, Illinois, United States
Lutheran General Cancer Care Center, Park Ridge, Illinois, United States
Cancer Treatment Center at Pekin Hospital, Pekin, Illinois, United States
Methodist Medical Center of Illinois, Peoria, Illinois, United States
Proctor Hospital, Peoria, Illinois, United States
CCOP - Illinois Oncology Research Association, Peoria, Illinois, United States
Oncology/Hematology Associates of Central Illinois, P.C., Peoria, Illinois, United States
OSF St. Francis Medical Center, Peoria, Illinois, United States
Illinois Valley Community Hospital, Peru, Illinois, United States
Perry Memorial Hospital, Princeton, Illinois, United States
Swedish American Hospital, Rockford, Illinois, United States
St. Margaret's Hospital, Spring Valley, Illinois, United States
Valley Cancer Center, Spring Valley, Illinois, United States
Carle Cancer Center at Carle Foundation Hospital, Urbana, Illinois, United States
CCOP - Carle Cancer Center, Urbana, Illinois, United States
St. Francis Hospital and Health Centers, Beech Grove, Indiana, United States
Bloomington Hospital, Bloomington, Indiana, United States
Elkhart General Hospital, Elkhart, Indiana, United States
Center for Cancer Therapy at LaPorte Hospital and Health Services, La Porte, Indiana, United States
Saint Anthony Memorial Health Centers, Michigan City, Indiana, United States
Cancer Center at Ball Memorial Hospital, Muncie, Indiana, United States
Saint Joseph Regional Medical Center - Plymouth Campus, Plymouth, Indiana, United States
CCOP - Northern Indiana CR Consortium, South Bend, Indiana, United States
Memorial Hospital of South Bend, South Bend, Indiana, United States
Union Hospital, Terre Haute, Indiana, United States
McFarland Clinic, P.C., Ames, Iowa, United States
Saint Anthony Regional Hospital, Carroll, Iowa, United States
St. Luke's Hospital, Cedar Rapids, Iowa, United States
Cedar Rapids Oncology Associates, Cedar Rapids, Iowa, United States
Mercy Cancer Center at Mercy Medical Center, Cedar Rapids, Iowa, United States
Alegent Health Mercy Hospital, Council Bluffs, Iowa, United States
Genesis Regional Cancer Center at Genesis Medical Center, Davenport, Iowa, United States
Genesis Medical Center - West Campus, Davenport, Iowa, United States
Mercy Capitol Hospital, Des Moines, Iowa, United States
CCOP - Iowa Oncology Research Association, Des Moines, Iowa, United States
John Stoddard Cancer Center at Iowa Methodist Medical Center, Des Moines, Iowa, United States
Medical Oncology and Hematology Associates at John Stoddard Cancer Center, Des Moines, Iowa, United States
Medical Oncology and Hematology Associates at Mercy Cancer Center, Des Moines, Iowa, United States
Mercy Cancer Center at Mercy Medical Center - Des Moines, Des Moines, Iowa, United States
John Stoddard Cancer Center at Iowa Lutheran Hospital, Des Moines, Iowa, United States
Wendt Regional Cancer Center at Finley Hospital, Dubuque, Iowa, United States
Holden Comprehensive Cancer Center at University of Iowa, Iowa City, Iowa, United States
Mercy Cancer Center at Mercy Medical Center - North Iowa, Mason City, Iowa, United States
Alegent Health Community Memorial Hospital, Missouri Valley, Iowa, United States
Burgess Health Center, Onawa, Iowa, United States
Siouxland Hematology-Oncology Associates, Sioux City, Iowa, United States
Mercy Medical Center - Sioux City, Sioux City, Iowa, United States
St. Luke's Regional Medical Center, Sioux City, Iowa, United States
Medical Oncology and Hematology Associates - West Des Moines, West Des Moines, Iowa, United States
South Central Kansas Regional Medical Center, Arkansas City, Kansas, United States
Cancer Center of Kansas - Chanute, Chanute, Kansas, United States
Cancer Center of Kansas - Dodge City, Dodge City, Kansas, United States
Cancer Center of Kansas, P.A. - El Dorado, El Dorado, Kansas, United States
Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center, Kansas City, Kansas, United States
Cancer Center of Kansas - Kingman, Kingman, Kansas, United States
Southwest Medical Center, Liberal, Kansas, United States
Cancer Center of Kansas - Newton, Newton, Kansas, United States
Cancer Center of Kansas - Ottawa, Ottawa, Kansas, United States
Cancer Center of Kansas, P.A. - Parsons, Parsons, Kansas, United States
Pratt Cancer Center of Kansas, Pratt, Kansas, United States
Cancer Center of Kansas - Salina, Salina, Kansas, United States
Cancer Center of Kansas - Wellington, Wellington, Kansas, United States
Associates in Womens Health, Wichita, Kansas, United States
Cancer Center of Kansas, P.A., Wichita, Kansas, United States
Cancer Center of Kansas, P.A. - Wichita, Wichita, Kansas, United States
CCOP - Wichita, Wichita, Kansas, United States
Via Christi Cancer Center at Via Christi Regional Medical Center, Wichita, Kansas, United States
Wesley Medical Center, Wichita, Kansas, United States
Cancer Center of Kansas - Winfield, Winfield, Kansas, United States
Cancer Treatment Center at the Medical Center - Bowling Green, Bowling Green, Kentucky, United States
Central Baptist Hospital, Lexington, Kentucky, United States
Markey Cancer Center at University of Kentucky Chandler Medical Center, Lexington, Kentucky, United States
Merle M. Mahr Cancer Center at Regional Medical Center of Hopkins County, Madisonville, Kentucky, United States
Louisiana State University Health Sciences Center - Monroe, Monroe, Louisiana, United States
Tulane Cancer Center, New Orleans, Louisiana, United States
Veterans Affairs Medical Center - Shreveport, Shreveport, Louisiana, United States
Feist-Weiller Cancer Center at Louisiana State University Health Sciences, Shreveport, Louisiana, United States
CancerCare of Maine at Eastern Maine Medial Center, Bangor, Maine, United States
Central Maine Medical Center, Lewiston, Maine, United States
Maine General Medical Center - Waterville, Waterville, Maine, United States
DeCesaris Cancer Institute at Anne Arundel Medical Center, Annapolis, Maryland, United States
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, United States
Union Hospital Cancer Center at Union Hospital, Elkton MD, Maryland, United States
Massachusetts General Hospital Cancer Center, Boston, Massachusetts, United States
Brigham and Women's Hospital, Boston, Massachusetts, United States
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute, Boston, Massachusetts, United States
Cancer Research Center at Boston Medical Center, Boston, Massachusetts, United States
Bethke Cancer Center at Emerson Hospital, Concord, Massachusetts, United States
Hudner Oncology Center at Saint Anne's Hospital, Fall River, Massachusetts, United States
Cape Cod Hospital, Hyannis, Massachusetts, United States
Newton - Wellesley Hospital, Newton, Massachusetts, United States
South Suburban Oncology Center, Quincy, Massachusetts, United States
Hickman Cancer Center at Bixby Medical Center, Adrian, Michigan, United States
CCOP - Michigan Cancer Research Consortium, Ann Arbor, Michigan, United States
St. Joseph Mercy Cancer Center at St. Joseph Mercy Hospital, Ann Arbor, Michigan, United States
University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan, United States
Battle Creek Health System, Battle Creek, Michigan, United States
Mecosta County General Hospital, Big Rapids, Michigan, United States
Josephine Ford Cancer Center at Henry Ford Health System, Detroit, Michigan, United States
Hurley Medical Center, Flint, Michigan, United States
Genesys Hurley Cancer Institute, Flint, Michigan, United States
Great Lakes Cancer Institute at McLaren Regional Medical Center, Flint, Michigan, United States
CCOP - Grand Rapids, Grand Rapids, Michigan, United States
Lacks Cancer Center at Saint Mary's Mercy Medical Center, Grand Rapids, Michigan, United States
Spectrum Health Cancer Care - Butterworth Campus, Grand Rapids, Michigan, United States
Metropolitan Hospital, Grand Rapids, Michigan, United States
Spectrum Health Hospital - Blodgett Campus, Grand Rapids, Michigan, United States
Holland Community Hospital, Holland, Michigan, United States
Borgess Medical Center, Kalamazooaa, Michigan, United States
Bronson Methodist Hospital, Kalamazoo, Michigan, United States
West Michigan Cancer Center, Kalamazoo, Michigan, United States
Upper Michigan Cancer Center at Marquette General Hospital, Marquette, Michigan, United States
Hackley Hospital, Muskegon, Michigan, United States
Northern Michigan Hospital, Petoskey, Michigan, United States
Mercy Hospital, Port Huron, Michigan, United States
Seton Cancer Institute - Saginaw, Saginaw, Michigan, United States
Oncology Care Associates, P.L.L.C., Saint Joseph, Michigan, United States
Providence Cancer Institute at Providence Hospital - Southfield Campus, Southfield, Michigan, United States
Munson Medical Center, Traverse City, Michigan, United States
St. John Macomb Hospital, Warren, Michigan, United States
MeritCare Clinic - Bemidji, Bemidji, Minnesota, United States
Brainerd Medical Center, Brainerd, Minnesota, United States
Fairview Ridges Hospital, Burnsville, Minnesota, United States
Mercy Hospital, Coon Rapids, Minnesota, United States
Cancer Care Center at St. Luke's Hospital, Duluth, Minnesota, United States
CCOP - Duluth, Duluth, Minnesota, United States
Miller-Dwan Medical Center, Duluth, Minnesota, United States
St. Mary's - Duluth Clinic Cancer Center, Duluth, Minnesota, United States
Fairview Southdale Hospital, Edina, Minnesota, United States
Mercy and Unity Cancer Center at Mercy and Unity Hospitals, Fridley, Minnesota, United States
Hutchinson Area Health Care, Hutchinson, Minnesota, United States
Meeker County Memorial Hospital, Litchfield, Minnesota, United States
St. John's Hospital, Maplewood, Minnesota, United States
Virginia Piper Cancer Institute at Abbott-Northwestern Hospital, Minneapolis, Minnesota, United States
Hennepin County Medical Center - Minneapolis, Minneapolis, Minnesota, United States
Fairview University Medical Center - University Campus, Minneapolis, Minnesota, United States
Chippewa County - Montevideo Hospital, Montevideo, Minnesota, United States
Hubert H. Humphrey Cancer Center at North Memorial Medical Center, Robbinsdale, Minnesota, United States
Mayo Clinic Cancer Center, Rochester, Minnesota, United States
CCOP - Metro-Minnesota, Saint Louis Park, Minnesota, United States
Cancer Care Center at Regions Hospital, Saint Paul, Minnesota, United States
Saint Francis Cancer Center, Shakopee, Minnesota, United States
St. Joseph's Hospital, St Paul, Minnesota, United States
Adult and Pediatric Urology, P.L.L.P., St. Cloud, Minnesota, United States
CentraCare Clinic - River Campus, St. Cloud, Minnesota, United States
Park Nicollet Clinic, St. Louis Park, Minnesota, United States
United Hospital, St. Paul, Minnesota, United States
Ridgeview Medical Center, Waconia, Minnesota, United States
Rice Memorial Hospital, Willmar, Minnesota, United States
Woodwinds Hospital, Woodbury, Minnesota, United States
University of Mississippi Medical Center, Jackson, Mississippi, United States
Veterans Affairs Medical Center - Jackson, Jackson, Mississippi, United States
Regional Cancer Center at Singing River Hospital, Pascagoula, Mississippi, United States
St. Francis Medical Center, Cape Girardeau, Missouri, United States
Saint Luke's Hospital, Chesterfield, Missouri, United States
Missouri Cancer Associates, Columbia, Missouri, United States
Ellis Fischel Cancer Center at University of Missouri - Columbia, Columbia, Missouri, United States
Southeast Missouri Regional Cancer Center at Southeast Missouri Hospital, Gape Girardeau, Missouri, United States
CCOP - Kansas City, Kansas City, Missouri, United States
St. John's Regional Health Center, Springfield, Missouri, United States
Hulston Cancer Center at Cox Medical Center South, Springfield, Missouri, United States
Siteman Cancer Center at Barnes-Jewish Hospital, St Louis, Missouri, United States
Missouri Baptist Cancer Center, St. Louis, Missouri, United States
CCOP - St. Louis-Cape Girardeau, St. Louis, Missouri, United States
Center for Cancer Care and Research, St. Louis, Missouri, United States
David C. Pratt Cancer Center at St. John's Mercy, St. Louis, Missouri, United States
CCOP - Montana Cancer Consortium, Billings, Montana, United States
Great Falls Clinic, Great Falls, Montana, United States
Sletten Regional Cancer Institute, Great Falls, Montana, United States
Fremont Area Medical Center, Fremont, Nebraska, United States
Cancer Center at the Good Samaritan Health Systems, Kearney, Nebraska, United States
Bryan LGH Medical Center West, Lincoln, Nebraska, United States
Cancer Resource Center - Lincoln, Lincoln, Nebraska, United States
St. Elizabeth Regional Medical Center, Lincoln, Nebraska, United States
CCOP - Missouri Valley Cancer Consortium, Omaha, Nebraska, United States
Methodist Hospital Cancer Center at Nebraska Methodist Hospital - Omaha, Omaha, Nebraska, United States
Alegent Health - Immanuel Medical Center, Omaha, Nebraska, United States
Bergan Mercy Medical Center, Omaha, Nebraska, United States
Cancer Center at Creighton University Medical Center, Omaha, Nebraska, United States
Midlands Cancer Center at Midlands Community Hospital, Papillion, Nebraska, United States
University Medical Center of Southern Nevada, Las Vegas, Nevada, United States
CCOP - Southern Nevada Cancer Research Foundation, Las Vegas, Nevada, United States
Sunrise Hospital and Medical Center, Las Vegas, Nevada, United States
Washoe Cancer Services at Washoe Medical Center - Reno, Reno, Nevada, United States
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, United States
Cancer Institute of New Jersey at the Cooper University Hospital, Camden, New Jersey, United States
CCOP - Northern New Jersey, Hackensack, New Jersey, United States
Monmouth Medical Center, Long Branch, New Jersey, United States
South Jersey Healthcare Regional Cancer Center, Millville, New Jersey, United States
Cancer Center at the Mountainside Hospital, Montclair, New Jersey, United States
Fox Chase Virtua Health Cancer Program - Marlton, Mount Holly, New Jersey, United States
Newark Beth Israel Medical Center, Newark, New Jersey, United States
Atlantic City Medical Center - Mainland Division, Pomona, New Jersey, United States
Booker Cancer Center at Riverview Medical Center, Red Bank, New Jersey, United States
Community Medical Center, Toms River, New Jersey, United States
Fox Chase Cancer Center at St. Francis Medical Center, Trenton, New Jersey, United States
Capital Health System Regional Cancer Center, Trenton, New Jersey, United States
Hematology-Oncology Associates, PC, Albuquerque, New Mexico, United States
University of New Mexico Cancer Research and Treatment Center, Albuquerque, New Mexico, United States
Lovelace Medical Center at Lovelace Sandia Health System, Albuquerque, New Mexico, United States
SUNY Downstate Medical Center, Brooklyn, New York, United States
New York Methodist Hospital, Brooklyn, New York, United States
Finger Lakes Hematology and Oncology, Clifton Springs, New York, United States
Louis Busch Hager Cancer Center at Mary Imogene Bassett Hospital, Cooperstown, New York, United States
Catskill Regional Medical Center, Harris, New York, United States
CCOP - North Shore University Hospital, Manhasset, New York, United States
New York Weill Cornell Cancer Center at Cornell University, New York, New York, United States
Highland Hospital of Rochester, Rochester, New York, United States
James P. Wilmot Cancer Center at University of Rochester Medical Center, Rochester, New York, United States
CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C., Syracuse, New York, United States
Crouse Hospital, Syracuse, New York, United States
Veterans Affairs Medical Center - Syracuse, Syracuse, New York, United States
Community General Hospital of Greater Syracuse, Syracuse, New York, United States
Randolph Hospital, Asheboro, North Carolina, United States
Blumenthal Cancer Center at Carolinas Medical Center, Charlotte, North Carolina, United States
Presbyterian Cancer Center at Presbyterian Hospital, Charlotte, North Carolina, United States
John Smith, Jr./Dalton McMichael Cancer Center at Morehead Memorial Hospital, Eden, North Carolina, United States
Wayne Memorial Hospital, Incorporated, Goldsboro, North Carolina, United States
Wayne Radiation Oncology, Goldsboro, North Carolina, United States
Moses Cone Regional Cancer Center at Wesley Long Community Hospital, Greensboro, North Carolina, United States
Lenoir Memorial Cancer Center, Kinston, North Carolina, United States
Annie Penn Cancer Center, Reidsville, North Carolina, United States
Zimmer Cancer Center at New Hanover Regional Medical Center, Wilmington, North Carolina, United States
Wilson Medical Center, Wilson, North Carolina, United States
Forsyth Regional Cancer Center at Forsyth Medical Center, Winston-Salem, North Carolina, United States
Bismarck Cancer Center, Bismarck, North Dakota, United States
Medcenter One Health System, Bismarck, North Dakota, United States
Mid Dakota Clinic, P.C., Bismarck, North Dakota, United States
St. Alexius Medical Center, Bismarck, North Dakota, United States
CCOP - MeritCare Hospital, Fargo, North Dakota, United States
MeritCare Medical Group, Fargo, North Dakota, United States
Altru Cancer Center at Altru Hospital, Grand Forks, North Dakota, United States
Trinity Cancer Care Center, Minot, North Dakota, United States
Akron City Hospital at Summa Health System, Akron, Ohio, United States
McDowell Cancer Center at Akron General Medical Center, Akron, Ohio, United States
University Hospitals Ireland Cancer Center at Mercy Medical Center, Canton, Ohio, United States
Adena Regional Medical Center, Chillicothe, Ohio, United States
Ireland Cancer Center at University Hospitals of Cleveland and Case Western Reserve University, Cleveland, Ohio, United States
MetroHealth's Cancer Care Center at MetroHealth Medical Center, Cleveland, Ohio, United States
Huron Hospital Cancer Care Center, Cleveland, Ohio, United States
Euclid Hospital, Cleveland, Ohio, United States
Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio, United States
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University, Columbus, Ohio, United States
Riverside Methodist Hospital Cancer Care, Columbus, Ohio, United States
CCOP - Columbus, Columbus, Ohio, United States
Grant Riverside Cancer Services, Columbus, Ohio, United States
Mount Carmel West Hospital, Columbus, Ohio, United States
Doctors Hospital at Ohio Health, Columbus, Ohio, United States
Grandview Hospital, Dayton, Ohio, United States
Good Samaritan Hospital, Dayton, Ohio, United States
Miami Valley Hospital, Dayton, Ohio, United States
Samaritan North Cancer Care Center, Dayton, Ohio, United States
Veterans Affairs Medical Center - Dayton, Dayton, Ohio, United States
CCOP - Dayton, Dayton, Ohio, United States
Grady Memorial Hospital, Delaware, Ohio, United States
Charles F. Kettering Memorial Hospital, Kettering, Ohio, United States
Fairfield Medical Center, Lancaster, Ohio, United States
St. Rita's Medical Center, Lima, Ohio, United States
Lima Memorial Hospital, Lima, Ohio, United States
Strecker Cancer Center at Marietta Memorial Hospital, Marietta, Ohio, United States
St. Luke's Hospital, Maumee, Ohio, United States
Hillcrest Cancer Center at Hillcrest Hospital, Mayfield Heights, Ohio, United States
Middletown Regional Hospital, Middletown, Ohio, United States
Licking Memorial Cancer Care Program at Licking Memorial Hospital, Newark, Ohio, United States
St. Charles Mercy Hospital, Oregon, Ohio, United States
Cancer Research UK Medical Oncology Unit at Churchill Hospital & Weatherall Institute of Molecular Medicine - Oxford, Salem, Ohio, United States
Firelands Regional Medical Center, Sandusky, Ohio, United States
Mercy Medical Center Oncology Unit, Springfield, Ohio, United States
Community Hospital of Springfield and Clark County, Springfield, Ohio, United States
Promedica Cancer Center at Flower Hospital, Sylvania, Ohio, United States
Mercy Hospital of Tiffin, Tiffin, Ohio, United States
Toledo Hospital, Toledo, Ohio, United States
St. Vincent Mercy Medical Center, Toledo, Ohio, United States
Medical College of Ohio Cancer Institute, Toledo, Ohio, United States
CCOP - Toledo Community Hospital, Toledo, Ohio, United States
Toledo Clinic, Incorporated, Toledo, Ohio, United States
UVMC Cancer Care Center at Upper Valley Medical Center, Troy, Ohio, United States
South Pointe Hospital Cancer Care Center, Warrensville Heights, Ohio, United States
Mount Carmel Cancer Services at Mount Carmel St. Ann's Hospital, Westerville, Ohio, United States
Cancer Treatment Center, Wooster, Ohio, United States
Ruth G. McMillan Cancer Center at Greene Memorial Hospital, Xenia, Ohio, United States
Genesis - Good Samaritan Hospital, Zanesville, Ohio, United States
LaFortune Cancer Center at St. John Health System, Tulsa, Oklahoma, United States
Natalie Warren Bryant Cancer Center at St. Francis Hospital, Tulsa, Oklahoma, United States
Legacy Mount Hood Medical Center, Glesham, Oregon, United States
Providence Milwaukie Hospital, Milwaukie, Oregon, United States
Comprehensive Cancer Center at Legacy Good Samaritan Hospital & Medical Center, Portland, Oregon, United States
Providence Cancer Center at Providence Portland Medical Center, Portland, Oregon, United States
CCOP - Columbia River Oncology Program, Portland, Oregon, United States
Providence St. Vincent Medical Center, Portland, Oregon, United States
Institute of Oncology at Vilnius University, Portland, Oregon, United States
Kaiser Permanente Health Care - Portland, Portland, Oregon, United States
Cancer Institute at Oregon Health and Science University, Portland, Oregon, United States
Salem Hospital Regional Cancer Center, Salem, Oregon, United States
Legacy Meridian Park Hospital, Tualatin, Oregon, United States
John and Dorothy Morgan Cancer Center at Lehigh Valley Hospital, Allentown, Pennsylvania, United States
St. Luke's Hospital Cancer Center, Bethlehem, Pennsylvania, United States
Bryn Mawr Hospital, Bryn Mawr, Pennsylvania, United States
Geisinger Medical Center, Danville, Pennsylvania, United States
Delaware County Regional Cancer Center at Delaware County Memorial Hospital, Drexel Hill, Pennsylvania, United States
Penn State Cancer Institute at Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
St. Mary Regional Cancer Center, Langhorne, Pennsylvania, United States
Lewistown Hospital, Lewistown, Pennsylvania, United States
Cancer Center at Paoli Memorial Hospital, Paoli, Pennsylvania, United States
Joan Karnell Cancer Center at Pennsylvania Hospital, Philadelphia, Pennsylvania, United States
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia, Philadelphia, Pennsylvania, United States
Fox Chase Cancer Center, Philadelphia, Pennsylvania, United States
Albert Einstein Cancer Center, Philadelphia, Pennsylvania, United States
Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, Pennsylvania, United States
Mercy Hospital of Pittsburgh, Pittsburgh, Pennsylvania, United States
Western Pennsylvania Cancer Institute at Western Pennsylvania Hospital, Pittsburgh, Pennsylvania, United States
Pottstown Memorial Regional Cancer Center, Pottstown, Pennsylvania, United States
St. Joseph Medical Center, Reading, Pennsylvania, United States
Guthrie Medical Center - Sayre, Sayre, Pennsylvania, United States
Mercy Hospital Cancer Center - Scranton, Scranton, Pennsylvania, United States
Geisinger Medical Group, State College, Pennsylvania, United States
Mount Nittany Medical Center, State College, Pennsylvania, United States
Reading Hospital and Medical Center, West Reading, Pennsylvania, United States
Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, United States
CCOP - MainLine Health, Wynnewood, Pennsylvania, United States
Lankenau Cancer Center at Lankenau Hospital, Wynnewood, Pennsylvania, United States
Bon Secours St. Francis Health System, Greenville, South Carolina, United States
Greenville Hospital System Cancer Center, Greenville, South Carolina, United States
CCOP - Greenville, Greenville, South Carolina, United States
Rapid City Regional Hospital, Rapid City, South Dakota, United States
Sioux Valley Hospital and University of South Dakota Medical Center, Sioux Falls, South Dakota, United States
Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota, United States
Medical X-Ray Center, Sioux Falls, South Dakota, United States
Baptist Centers for Cancer Care, Memphis, Tennessee, United States
Harrington Cancer Center, Amarillo, Texas, United States
St. Joseph Regional Cancer Center, Bryan, Texas, United States
Brooke Army Medical Center, Fort Sam Houston, Texas, United States
M.D. Anderson Cancer Center at University of Texas, Houston, Texas, United States
Wilford Hall Medical Center, Lackland AFB, Texas, United States
Joe Arrington Cancer Research and Treatment Center, Lubbock, Texas, United States
Veterans Affairs Medical Center - San Antonio (Murphy), San Antonio, Texas, United States
Cancer Therapy and Research Center, San Antonio, Texas, United States
University Hospital - San Antonio, San Antonio, Texas, United States
University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
Cottonwood Hospital Medical Center, Murray, Utah, United States
McKay-Dee Hospital Center, Ogden, Utah, United States
Utah Valley Regional Medical Center - Provo, Provo, Utah, United States
Utah Cancer Specialists at UCS Cancer Center, Salt Lake City, Utah, United States
Huntsman Cancer Institute at University of Utah, Salt Lake City, Utah, United States
LDS Hospital, Salt Lake City, Utah, United States
Dixie Regional Medical Center, St. George, Utah, United States
Mountainview Medical, Berlin, Vermont, United States
Fletcher Allen Health Care - University Health Center Campus, Burlington, Vermont, United States
Danville Regional Medical Center, Danville, Virginia, United States
Virginia Oncology Associates - Hampton, Hampton, Virginia, United States
Bon Secours Cancer Care at St. Mary's Hospital, Richmond, Virginia, United States
St. Joseph Hospital Community Cancer Center, Bellingham, Washington, United States
Olympic Hematology and Oncology, Bremerton, Washington, United States
Providence Cancer Institute at Providence Everett Medical Center - Pacific Campus, Everett, Washington, United States
Cancer Care Center at Skagit Valley Hospital, Mt. Vernon, Washington, United States
CCOP - Virginia Mason Research Center, Seattle, Washington, United States
Fred Hutchinson Cancer Research Center, Seattle, Washington, United States
Group Health Central Hospital, Seattle, Washington, United States
Harborview Medical Center, Seattle, Washington, United States
Swedish Cancer Institute at Swedish Medical Center - First Hill Campus, Seattle, Washington, United States
University Cancer Center at University of Washington Medical Center, Seattle, Washington, United States
Cancer Care Northwest - Spokane South, Spokane, Washington, United States
Madigan Army Medical Center, Tacoma, Washington, United States
Cancer Center at Southwest Washington Medical Center, Vancouver, Washington, United States
Central Washington Hospital, Wenatchee, Washington, United States
Wenatchee Valley Clinic, Wenatchee, Washington, United States
Mary Babb Randolph Cancer Center at West Virginia University Hospitals, Morgantown, West Virginia, United States
Camden-Clark Memorial Hospital, Parkersburg, West Virginia, United States
Luther Mildelfort Hospital, Eau Claire, Wisconsin, United States
Midelfort Clinic - Luther, Eau Claire, Wisconsin, United States
Central Wisconsin Cancer Program at Agnesian Health Care, Fond Du Lac, Wisconsin, United States
Green Bay Oncology, Limited at St. Vincent Hospital, Green Bay, Wisconsin, United States
St. Vincent Hospital, Green Bay, Wisconsin, United States
Green Bay Oncology, Limited at St. Mary's Hospital, Green Bay, Wisconsin, United States
St. Mary's Hospital Medical Center, Green Bay, Wisconsin, United States
Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical Center, La Crosse, Wisconsin, United States
University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin, United States
Bay Area Cancer Care Center at Bay Area Medical Center, Marinette, Wisconsin, United States
Marshfield Clinic - Marshfield Center, Marshfield, Wisconsin, United States
Community Memorial Hospital, Menomonee Falls, Wisconsin, United States
Vince Lombardi Cancer Clinic at St. Luke's Medical Center, Milwaukee, Wisconsin, United States
Medical College of Wisconsin Cancer Center, Milwaukee, Wisconsin, United States
Veterans Affairs Medical Center - Milwaukee (Zablocki), Milwaukee, Wisconsin, United States
All Saints Cancer Center at All Saints Healthcare, Racine, Wisconsin, United States
West Allis Memorial Hospital, West Allis, Wisconsin, United States
Pretoria Academic Hospital, Pretoria, 0001, , South Africa
Name: Jaffer A. Ajani, MD
Affiliation: M.D. Anderson Cancer Center
Role: STUDY_CHAIR
Name: Al B. Benson, MD, FACP
Affiliation: Robert H. Lurie Cancer Center
Role: STUDY_CHAIR
Name: Joel E. Tepper, MD
Affiliation: UNC Lineberger Comprehensive Cancer Center
Role: STUDY_CHAIR
Name: John S. MacDonald, MD
Affiliation: Beth Israel Comprehensive Cancer Center - West Side Campus
Role: STUDY_CHAIR
Name: Michael G. Haddock, MD
Affiliation: Mayo Clinic
Role: STUDY_CHAIR