American Ginseng in Treating Patients With Fatigue Caused by Cancer

Last updated: December 19, 2016
Sponsor: Alliance for Clinical Trials in Oncology
Overall Status: Completed

Phase

3

Condition

Multiple Myeloma

Neoplasms

Myelodysplastic Syndromes (Mds)

Treatment

N/A

Clinical Study ID

NCT00719563
NCCTG-N07C2
CDR0000597665
NCI-2009-00872
  • Ages > 18
  • All Genders

Study Summary

RATIONALE: American ginseng may reduce fatigue in patients with cancer. It is not yet known whether American ginseng is more effective than a placebo in treating cancer-related fatigue.

PURPOSE: This randomized phase III trial is studying American ginseng to see how well it works in treating patients with fatigue caused by cancer.

Eligibility Criteria

Inclusion

  1. Required characteristics

  • ≥ 18 years of age

  • Men or women with a history of cancer-related fatigue as defined by an average score ≥ 4 over the past 30 days on the numeric analogue scale (1 - 10)

  • The presence of fatigue ≥ 1 month prior to randomization

  • ECOG performance score 0, 1, or 2

  • Histologic or cytologic proven cancer other than brain cancer or CNS lymphoma, undergoing curative intent therapy (including anti-hormonal therapies such as tamoxifen or leuprolide) or those having completed curative intent therapy who were diagnosed within the past 2 years

  • Note: If a patient is receiving treatment for their disease such as chemotherapy, targeted therapies, immunotherapy or radiation therapy then, the patient must have completed ≥ 1 cycle of chemotherapy, targeted therapy, or ≥ 1 week of radiation treatment.

  • Laboratory values obtained prior to randomization:

  • Hgb ≥ 11 (must be obtained ≤ 30 days; patients must not be transfused ≤ 30 days to meet this criterion)

  • Creatinine ≤ 1.2 x UNL (must be obtained ≤ 180 days prior to randomization)

  • AST (SGOT) or ALT (SGPT) ≤ 1.5 x UNL (must be obtained ≤ 180 days prior to randomization)

  • Negative pregnancy test done ≤ 7 days prior to registration, for women of childbearing potential only

  • Ability to complete patient questionnaires alone or with assistance

  • Controlled:

  • Pain (≤ 4 on Linear Analogue Scale)

  • Insomnia (≤ 4 on Linear Analogue Scale)

  • Willingness to provide blood/saliva samples for correlative studies.

  • Note: These samples are only required for those not receiving active treatment for their disease. Active treatment is defined as chemotherapy, radiation therapy, or immunotherapy, not anti-hormone therapy such as tamoxifen, aromatase inhibitors or leuprolide.

  1. Contraindications

  • Hypersensitivity to ginseng

  • Prior use of ginseng capsules for fatigue in the past year

  • Note: Prior use of teas or drinks containing ginseng is allowed, however, patients will be asked to avoid these beverages while on the study.

  • Uncontrolled hypertension on more than one occasion (diastolic blood pressure > 100, systolic > 160) measured ≤ 90 days prior to randomization

  • Currently using any other pharmacologic agents or nonpharmacologic interventions to specifically treat fatigue including psychostimulants, antidepressants, acupuncture, etc.

  • Note: Antidepressants used to treat items other than fatigue (such as hot flashes) are allowed if the patient has been on a stable dose for ≥ 1 month and plans to continue for ≥ 1 month. Erythropoietin agents to treat anemia are allowed. Exercise is allowed.

  • Known brain metastasis or primary CNS malignancy

  • Chronic systemic steroid use (including CHOP therapy or as part of any regular cancer treatment, however, steroids used as prophylaxis for nausea and vomiting are allowed) to prevent rash with Alimta, low dose dexamethasone will be allowed.

  • Diabetes Type I or II (defined by being on oral hypoglycemics or insulin).

  • Psychiatric disorder such as severe depression, manic depressive disorder, obsessive compulsive disorder or schizophrenia. (Defined per medical history).

  • ≤ 4 weeks from major surgery to randomization, including any procedure that requires general anesthetic

  • Any of the following:

  • Pregnant women

  • Nursing women

  • Women of childbearing potential who are unwilling to employ adequate contraception

  • Pain requiring opioid pain medication, however, over the counter analgesics such as Tylenol or ibuprofen are allowed.

  • Use of full dose of anticoagulant therapy (Exception: 1 mg/day of Coumadin for preventing catheter clots is allowed).

  • Use of MAO inhibitors.

  • Planning to start or complete any type of cancer therapy during the 8 week, double blind, course of the study, once randomized on the study. Note: If not currently getting treatment, no chemotherapy agents ≤ 21 days prior to randomization. Combination treatment regimens that have components ending at different times are allowed, as long as any part of the initially started treatment continues through the double blind portion of the study.

  • Malnutrition, active infection, significant pulmonary disease and cardiovascular disease as determined by the physician, as they could impact fatigue.

  • Use of any over the counter herbal/dietary supplement marketed for fatigue or energy (for example, products containing any type of ginseng, rhodiola rosea, high doses of caffeine, guarana, or anything called an "adaptogen").

  • Uncontrolled nausea or vomiting or any symptom that would prevent the ability to comply with daily oral ginseng/placebo treatment.

  • Uncontrolled thyroid disorder.

  • Currently receiving single agent on blinded placebo controlled treatment trials.

Study Design

Total Participants: 364
Study Start date:
October 01, 2008
Estimated Completion Date:
August 31, 2013

Study Description

OBJECTIVES:

Primary

  • To evaluate the efficacy of American ginseng (Panax quinquefolius) as therapy for cancer-related fatigue as measured by the general subscale of the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF).

Secondary

  • To evaluate toxicities and tolerability of American ginseng when used for cancer-related fatigue.

  • To examine stress as a mediating variable on the effects of American ginseng on cancer-related fatigue.

  • To explore the impact of American ginseng on various dimensions of fatigue as measured by the other subscales of the MFSI-SF, functional interference as measured by the Brief Fatigue Inventory (BFI), stress as measured by the Perceived Stress Scale, and well being as measured by the Profile of Mood States (POMS), as well as the single measure of fatigue.

  • To determine clinically significant changes in fatigue scores using the global impression of change.

  • To evaluate whether there are differences in the efficacy of American ginseng for fatigue based on minority populations.

Tertiary

  • To describe cortisol and cytokine values in fatigued cancer survivors and to evaluate the relationship of cortisol and cytokines to fatigue severity as well as to patterns of alterations previously documented in fatigued breast cancer survivors.

  • To evaluate whether Wisconsin Ginseng impacts the expression of cortisol and cytokine in fatigued cancer survivors.

  • To evaluate the role of cortisol and cytokine changes as the mechanism by which Wisconsin Ginseng can ameliorate cancer related fatigue.

  • To evaluate the relationships between cytokine and cortisol levels with secondary outcomes such as mood and stress.

OUTLINE: This is a multicenter study. Patients are stratified according to baseline fatigue score (4-7 vs 8-10), disease status of current cancer (initial diagnosis vs recurrent disease), current treatment (chemotherapy, radiation, endocrine therapy [i.e., tamoxifen or aromatase inhibitors], or other targeted therapy) ( yes vs no), duration of all prior cancer treatment in patient's lifetime (none vs ≤ 180 days vs > 180 days), and current tumor type (hematologic vs solid tumor malignancy). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive oral American ginseng twice daily for 14 days. Treatment repeats every 2 weeks for 4 courses until disease progression or unacceptable toxicity.

  • Arm II: Patients receive oral placebo twice daily for 14 days. Treatment repeats every 2 weeks for 4 courses.

Patients are instructed to complete the Ginseng Symptom Experience Diary and the Linear Analogue Scale weekly. Patients also complete the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF), the Profile of Mood States (POMS), and the Brief Fatigue Inventory (BFI) questionnaires at baseline and periodically during study therapy.

Patients who are not actively receiving chemotherapy or radiation therapy undergo blood and saliva sample collection at baseline and periodically during study therapy for correlative studies.

Connect with a study center

  • Mayo Clinic Scottsdale

    Scottsdale, Arizona 85259-5499
    United States

    Site Not Available

  • Aurora Presbyterian Hospital

    Aurora, Colorado 80012
    United States

    Site Not Available

  • Boulder Community Hospital

    Boulder, Colorado 80301-9019
    United States

    Site Not Available

  • Penrose Cancer Center at Penrose Hospital

    Colorado Springs, Colorado 80933
    United States

    Site Not Available

  • CCOP - Colorado Cancer Research Program

    Denver, Colorado 80224-2522
    United States

    Site Not Available

  • Porter Adventist Hospital

    Denver, Colorado 80210
    United States

    Site Not Available

  • Presbyterian - St. Luke's Medical Center

    Denver, Colorado 80218
    United States

    Site Not Available

  • Rose Medical Center

    Denver, Colorado 80220
    United States

    Site Not Available

  • St. Anthony Central Hospital

    Denver, Colorado 80204
    United States

    Site Not Available

  • St. Joseph Hospital

    Denver, Colorado 80218
    United States

    Site Not Available

  • Swedish Medical Center

    Englewood, Colorado 80110
    United States

    Site Not Available

  • Front Range Cancer Specialists

    Fort Collins, Colorado 80528
    United States

    Site Not Available

  • Poudre Valley Hospital

    Fort Collins, Colorado 80524
    United States

    Site Not Available

  • St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center

    Grand Junction, Colorado 81502
    United States

    Site Not Available

  • Sky Ridge Medical Center

    Lone Tree, Colorado 80124
    United States

    Site Not Available

  • Hope Cancer Care Center at Longmont United Hospital

    Longmont, Colorado 80501
    United States

    Site Not Available

  • St. Mary - Corwin Regional Medical Center

    Pueblo, Colorado 81004
    United States

    Site Not Available

  • North Suburban Medical Center

    Thornton, Colorado 80229
    United States

    Site Not Available

  • Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical Center

    Hartford, Connecticut 06105
    United States

    Site Not Available

  • University of Florida Shands Cancer Center

    Gainesville, Florida 32610-0232
    United States

    Site Not Available

  • Mayo Clinic - Jacksonville

    Jacksonville, Florida 32224
    United States

    Site Not Available

  • MBCCOP - Medical College of Georgia Cancer Center

    Augusta, Georgia 30912
    United States

    Site Not Available

  • Kapiolani Medical Center at Pali Momi

    Aiea, Hawaii 96701
    United States

    Site Not Available

  • Cancer Research Center of Hawaii

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • Hawaii Medical Center - East

    Honolulu, Hawaii 96817
    United States

    Site Not Available

  • Kapiolani Medical Center for Women and Children

    Honolulu, Hawaii 96826
    United States

    Site Not Available

  • MBCCOP - Hawaii

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • OnCare Hawaii, Incorporated - Kuakini

    Honolulu, Hawaii 96817
    United States

    Site Not Available

  • OnCare Hawaii, Incorporated - Lusitana

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • Queen's Cancer Institute at Queen's Medical Center

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • Straub Clinic and Hospital, Incorporated

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • Tripler Army Medical Center

    Honolulu, Hawaii 96859
    United States

    Site Not Available

  • Kauai Medical Clinic

    Lihue, Hawaii 96766
    United States

    Site Not Available

  • Maui Memorial Medical Center

    Wailuku, Hawaii 96793
    United States

    Site Not Available

  • Pacific Cancer Institute - Maui

    Wailuku, Hawaii 96793
    United States

    Site Not Available

  • Rush-Copley Cancer Care Center

    Aurora, Illinois 60504
    United States

    Site Not Available

  • St. Joseph Medical Center

    Bloomington, Illinois 61701
    United States

    Site Not Available

  • Illinois CancerCare - Bloomington

    Bloomington%, Illinois 61701
    United States

    Site Not Available

  • Graham Hospital

    Canton, Illinois 61520
    United States

    Site Not Available

  • Illinois CancerCare - Canton

    Canton, Illinois 61520
    United States

    Site Not Available

  • Illinois CancerCare - Carthage

    Carthage, Illinois 62321
    United States

    Site Not Available

  • Memorial Hospital

    Carthage, Illinois 62321
    United States

    Site Not Available

  • Eureka Community Hospital

    Eureka, Illinois 61530
    United States

    Site Not Available

  • Illinois CancerCare - Eureka

    Eureka, Illinois 61530
    United States

    Site Not Available

  • Galesburg Clinic, PC

    Galesburg, Illinois 61401
    United States

    Site Not Available

  • Galesburg Cottage Hospital

    Galesburg, Illinois 61401
    United States

    Site Not Available

  • Illinois CancerCare - Galesburg

    Galesburg, Illinois 61401
    United States

    Site Not Available

  • Illinois CancerCare - Havana

    Havana, Illinois 62644
    United States

    Site Not Available

  • Mason District Hospital

    Havana, Illinois 62644
    United States

    Site Not Available

  • Illinois CancerCare - Kewanee Clinic

    Kewanee, Illinois 61443
    United States

    Site Not Available

  • Illinois CancerCare - Macomb

    Macomb, Illinois 61455
    United States

    Site Not Available

  • McDonough District Hospital

    Macomb, Illinois 61455
    United States

    Site Not Available

  • Trinity Cancer Center at Trinity Medical Center - 7th Street Campus

    Moline, Illinois 61265
    United States

    Site Not Available

  • Moline, Illinois 61265
    United States

    Site Not Available

  • Illinois CancerCare - Monmouth

    Monmouth, Illinois 61462
    United States

    Site Not Available

  • OSF Holy Family Medical Center

    Monmouth, Illinois 61462
    United States

    Site Not Available

  • BroMenn Regional Medical Center

    Normal, Illinois 61761
    United States

    Site Not Available

  • Community Cancer Center

    Normal, Illinois 61761
    United States

    Site Not Available

  • Illinois CancerCare - Community Cancer Center

    Normal, Illinois 61761
    United States

    Site Not Available

  • Community Hospital of Ottawa

    Ottawa, Illinois 61350
    United States

    Site Not Available

  • Oncology Hematology Associates of Central Illinois, PC - Ottawa

    Ottawa, Illinois 61350
    United States

    Site Not Available

  • Cancer Treatment Center at Pekin Hospital

    Pekin, Illinois 61554
    United States

    Site Not Available

  • Illinois CancerCare - Pekin

    Pekin, Illinois 61603
    United States

    Site Not Available

  • CCOP - Illinois Oncology Research Association

    Peoria, Illinois 61615
    United States

    Site Not Available

  • Methodist Medical Center of Illinois

    Peoria, Illinois 61636
    United States

    Site Not Available

  • OSF St. Francis Medical Center

    Peoria, Illinois 61637
    United States

    Site Not Available

  • Oncology Hematology Associates of Central Illinois, PC - Peoria

    Peoria, Illinois 61615
    United States

    Site Not Available

  • Proctor Hospital

    Peoria, Illinois 61614
    United States

    Site Not Available

  • Illinois CancerCare - Peru

    Peru, Illinois 61354
    United States

    Site Not Available

  • Illinois Valley Community Hospital

    Peru, Illinois 61354
    United States

    Site Not Available

  • Illinois CancerCare - Princeton

    Princeton, Illinois 61356
    United States

    Site Not Available

  • Perry Memorial Hospital

    Princeton, Illinois 61356
    United States

    Site Not Available

  • Illinois CancerCare - Spring Valley

    Spring Valley, Illinois 61362
    United States

    Site Not Available

  • CCOP - Carle Cancer Center

    Urbana, Illinois 61801
    United States

    Site Not Available

  • St. Francis Hospital and Health Centers - Beech Grove Campus

    Beech Grove, Indiana 46107
    United States

    Site Not Available

  • Elkhart Clinic, LLC

    Elkhart, Indiana 46514-2098
    United States

    Site Not Available

  • Elkhart General Hospital

    Elkhart, Indiana 46515
    United States

    Site Not Available

  • Michiana Hematology-Oncology, PC - Elkhart

    Elkhart, Indiana 46514
    United States

    Site Not Available

  • Howard Community Hospital

    Kokomo, Indiana 46904
    United States

    Site Not Available

  • Center for Cancer Therapy at LaPorte Hospital and Health Services

    La Porte, Indiana 46350
    United States

    Site Not Available

  • Michiana Hematology-Oncology, PC - South Bend

    Mishawaka, Indiana 46545-1470
    United States

    Site Not Available

  • Saint Joseph Regional Medical Center

    Mishawaka, Indiana 46545-1470
    United States

    Site Not Available

  • Michiana Hematology Oncology PC - Plymouth

    Plymouth, Indiana 46563
    United States

    Site Not Available

  • Reid Hospital & Health Care Services

    Richmond, Indiana 47374
    United States

    Site Not Available

  • CCOP - Northern Indiana CR Consortium

    South Bend, Indiana 46601
    United States

    Site Not Available

  • Memorial Hospital of South Bend

    South Bend, Indiana 46601
    United States

    Site Not Available

  • South Bend Clinic

    South Bend, Indiana 46617
    United States

    Site Not Available

  • Michiana Hematology Oncology PC - La Porte

    Westville, Indiana 46391
    United States

    Site Not Available

  • McFarland Clinic, PC

    Ames, Iowa 50010
    United States

    Site Not Available

  • Bettendorf, Iowa 52722
    United States

    Site Not Available

  • Cedar Rapids Oncology Associates

    Cedar Rapids, Iowa 52403
    United States

    Site Not Available

  • Mercy Regional Cancer Center at Mercy Medical Center

    Cedar Rapids, Iowa 52403
    United States

    Site Not Available

  • Medical Oncology and Hematology Associates - West Des Moines

    Clive, Iowa 50325
    United States

    Site Not Available

  • CCOP - Iowa Oncology Research Association

    Des Moines, Iowa 50309
    United States

    Site Not Available

  • John Stoddard Cancer Center at Iowa Lutheran Hospital

    Des Moines, Iowa 50316
    United States

    Site Not Available

  • John Stoddard Cancer Center at Iowa Methodist Medical Center

    Des Moines, Iowa 50309
    United States

    Site Not Available

  • Medical Oncology and Hematology Associates at John Stoddard Cancer Center

    Des Moines, Iowa 50309
    United States

    Site Not Available

  • Medical Oncology and Hematology Associates at Mercy Cancer Center

    Des Moines, Iowa 50314
    United States

    Site Not Available

  • Mercy Cancer Center at Mercy Medical Center - Des Moines

    Des Moines, Iowa 50314
    United States

    Site Not Available

  • McCreery Cancer Center at Ottumwa Regional

    Ottumwa, Iowa 52501
    United States

    Site Not Available

  • Mercy Medical Center - Sioux City

    Sioux City, Iowa 51104
    United States

    Site Not Available

  • Siouxland Hematology-Oncology Associates, LLP

    Sioux City, Iowa 51101
    United States

    Site Not Available

  • St. Luke's Regional Medical Center

    Sioux City, Iowa 51104
    United States

    Site Not Available

  • Hospital District Sixth of Harper County

    Anthony, Kansas 67003
    United States

    Site Not Available

  • Cancer Center of Kansas, PA - Chanute

    Chanute, Kansas 66720
    United States

    Site Not Available

  • Cancer Center of Kansas, PA - Dodge City

    Dodge City, Kansas 67801
    United States

    Site Not Available

  • Cancer Center of Kansas, PA - El Dorado

    El Dorado, Kansas 67042
    United States

    Site Not Available

  • Cancer Center of Kansas - Fort Scott

    Fort Scott, Kansas 66701
    United States

    Site Not Available

  • Cancer Center of Kansas-Independence

    Independence, Kansas 67301
    United States

    Site Not Available

  • Cancer Center of Kansas, PA - Kingman

    Kingman, Kansas 67068
    United States

    Site Not Available

  • Lawrence Memorial Hospital

    Lawrence, Kansas 66044
    United States

    Site Not Available

  • Cancer Center of Kansas, PA - Liberal

    Liberal, Kansas 67905
    United States

    Site Not Available

  • Cancer Center of Kansas, PA - Newton

    Newton, Kansas 67114
    United States

    Site Not Available

  • Cancer Center of Kansas, PA - Parsons

    Parsons, Kansas 67357
    United States

    Site Not Available

  • Cancer Center of Kansas, PA - Pratt

    Pratt, Kansas 67124
    United States

    Site Not Available

  • Cancer Center of Kansas, PA - Salina

    Salina, Kansas 67401
    United States

    Site Not Available

  • Cancer Center of Kansas, PA - Wellington

    Wellington, Kansas 67152
    United States

    Site Not Available

  • Associates in Womens Health, PA - North Review

    Wichita, Kansas 67208
    United States

    Site Not Available

  • CCOP - Wichita

    Wichita, Kansas 67214
    United States

    Site Not Available

  • Cancer Center of Kansas, PA - Medical Arts Tower

    Wichita, Kansas 67208
    United States

    Site Not Available

  • Cancer Center of Kansas, PA - Wichita

    Wichita, Kansas 67214
    United States

    Site Not Available

  • Via Christi Cancer Center at Via Christi Regional Medical Center

    Wichita, Kansas 67214
    United States

    Site Not Available

  • Wesley Medical Center

    Wichita, Kansas 67214
    United States

    Site Not Available

  • Cancer Center of Kansas, PA - Winfield

    Winfield, Kansas 67156
    United States

    Site Not Available

  • Ochsner Health Center - Bluebonnet

    Baton Rouge, Louisiana 70809
    United States

    Site Not Available

  • Ochsner Health Center - Covington

    Covington, Louisiana 70433
    United States

    Site Not Available

  • CCOP - Ochsner

    New Orleans, Louisiana 70121
    United States

    Site Not Available

  • Ochsner Cancer Institute at Ochsner Clinic Foundation

    New Orleans, Louisiana 70121
    United States

    Site Not Available

  • Hickman Cancer Center at Bixby Medical Center

    Adrian, Michigan 49221
    United States

    Site Not Available

  • CCOP - Michigan Cancer Research Consortium

    Ann Arbor, Michigan 48106
    United States

    Site Not Available

  • Saint Joseph Mercy Cancer Center

    Ann Arbor, Michigan 48106-0995
    United States

    Site Not Available

  • Battle Creek Health System Cancer Care Center

    Battle Creek, Michigan 49017
    United States

    Site Not Available

  • Mecosta County Medical Center

    Big Rapids, Michigan 49307
    United States

    Site Not Available

  • Oakwood Cancer Center at Oakwood Hospital and Medical Center

    Dearborn, Michigan 48123-2500
    United States

    Site Not Available

  • Green Bay Oncology, Limited - Escanaba

    Escanaba, Michigan 49431
    United States

    Site Not Available

  • Genesys Hurley Cancer Institute

    Flint, Michigan 48503
    United States

    Site Not Available

  • Hurley Medical Center

    Flint, Michigan 48503
    United States

    Site Not Available

  • Butterworth Hospital at Spectrum Health

    Grand Rapids, Michigan 49503
    United States

    Site Not Available

  • CCOP - Grand Rapids

    Grand Rapids, Michigan 49503
    United States

    Site Not Available

  • Lacks Cancer Center at Saint Mary's Health Care

    Grand Rapids, Michigan 49503
    United States

    Site Not Available

  • Van Elslander Cancer Center at St. John Hospital and Medical Center

    Grosse Pointe Woods, Michigan 48236
    United States

    Site Not Available

  • Dickinson County Healthcare System

    Iron Mountain, Michigan 49801
    United States

    Site Not Available

  • Foote Memorial Hospital

    Jackson, Michigan 49201
    United States

    Site Not Available

  • Sparrow Regional Cancer Center

    Lansing, Michigan 48912-1811
    United States

    Site Not Available

  • St. Mary Mercy Hospital

    Livonia, Michigan 48154
    United States

    Site Not Available

  • Community Cancer Center of Monroe

    Monroe, Michigan 48162
    United States

    Site Not Available

  • Mercy Memorial Hospital - Monroe

    Monroe, Michigan 48162
    United States

    Site Not Available

  • Mercy General Health Partners

    Muskegon, Michigan 49443
    United States

    Site Not Available

  • Michiana Hematology Oncology PC - Niles

    Niles, Michigan 49120
    United States

    Site Not Available

  • St. Joseph Mercy Oakland

    Pontiac, Michigan 48341-2985
    United States

    Site Not Available

  • Mercy Regional Cancer Center at Mercy Hospital

    Port Huron, Michigan 48060
    United States

    Site Not Available

  • Seton Cancer Institute at Saint Mary's - Saginaw

    Saginaw, Michigan 48601
    United States

    Site Not Available

  • Lakeside Cancer Specialists, PLLC

    Saint Joseph, Michigan 49085
    United States

    Site Not Available

  • Lakeland Regional Cancer Care Center - St. Joseph

    St. Joseph, Michigan 49085
    United States

    Site Not Available

  • Munson Medical Center

    Traverse City, Michigan 49684
    United States

    Site Not Available

  • St. John Macomb Hospital

    Warren, Michigan 48093
    United States

    Site Not Available

  • Metro Health Hospital

    Wyoming, Michigan 49519
    United States

    Site Not Available

  • Alexandria, Minnesota 56308
    United States

    Site Not Available

  • MeritCare Bemidji

    Bemidji, Minnesota 56601
    United States

    Site Not Available

  • St. Joseph's Medical Center

    Brainerd, Minnesota 56401
    United States

    Site Not Available

  • Fairview Ridges Hospital

    Burnsville, Minnesota 55337
    United States

    Site Not Available

  • Mercy and Unity Cancer Center at Mercy Hospital

    Coon Rapids, Minnesota 55433
    United States

    Site Not Available

  • CCOP - Duluth

    Duluth, Minnesota 55805
    United States

    Site Not Available

  • Duluth Clinic Cancer Center - Duluth

    Duluth, Minnesota 55805-1983
    United States

    Site Not Available

  • Miller - Dwan Medical Center

    Duluth, Minnesota 55805
    United States

    Site Not Available

  • Fairview Southdale Hospital

    Edina, Minnesota 55435
    United States

    Site Not Available

  • Fergus Falls Medical Group, PA

    Fergus Falls, Minnesota 56537
    United States

    Site Not Available

  • Mercy and Unity Cancer Center at Unity Hospital

    Fridley, Minnesota 55432
    United States

    Site Not Available

  • Hutchinson Area Health Care

    Hutchinson, Minnesota 55350
    United States

    Site Not Available

  • Immanuel St. Joseph's

    Mankato, Minnesota 56002
    United States

    Site Not Available

  • HealthEast Cancer Care at St. John's Hospital

    Maplewood, Minnesota 55109
    United States

    Site Not Available

  • Minnesota Oncology Hematology, PA - Maplewood

    Maplewood, Minnesota 55109
    United States

    Site Not Available

  • Hennepin County Medical Center - Minneapolis

    Minneapolis, Minnesota 55415
    United States

    Site Not Available

  • Virginia Piper Cancer Institute at Abbott - Northwestern Hospital

    Minneapolis, Minnesota 55407
    United States

    Site Not Available

  • Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center

    Robbinsdale, Minnesota 55422-2900
    United States

    Site Not Available

  • Mayo Clinic Cancer Center

    Rochester, Minnesota 55905
    United States

    Site Not Available

  • CentraCare Clinic - River Campus

    Saint Cloud, Minnesota 56303
    United States

    Site Not Available

  • Coborn Cancer Center

    Saint Cloud, Minnesota 56303
    United States

    Site Not Available

  • CCOP - Metro-Minnesota

    Saint Louis Park, Minnesota 55416
    United States

    Site Not Available

  • Park Nicollet Cancer Center

    Saint Louis Park, Minnesota 55416
    United States

    Site Not Available

  • United Hospital

    Saint Paul, Minnesota 55102
    United States

    Site Not Available

  • St. Francis Cancer Center at St. Francis Medical Center

    Shakopee, Minnesota 55379
    United States

    Site Not Available

  • Regions Hospital Cancer Care Center

    St. Paul, Minnesota 55101
    United States

    Site Not Available

  • Lakeview Hospital

    Stillwater, Minnesota 55082
    United States

    Site Not Available

  • Ridgeview Medical Center

    Waconia, Minnesota 55387
    United States

    Site Not Available

  • Willmar Cancer Center at Rice Memorial Hospital

    Willmar, Minnesota 56201
    United States

    Site Not Available

  • Minnesota Oncology Hematology, PA - Woodbury

    Woodbury, Minnesota 55125
    United States

    Site Not Available

  • Goldschmidt Cancer Center

    Jefferson City, Missouri 65109
    United States

    Site Not Available

  • Comprehensive Cancer Care, PC

    Saint Louis, Missouri 63141
    United States

    Site Not Available

  • Missouri Baptist Cancer Center

    Saint Louis, Missouri 63131
    United States

    Site Not Available

  • CCOP - Cancer Research for the Ozarks

    Springfield, Missouri 65802
    United States

    Site Not Available

  • Hulston Cancer Center at Cox Medical Center South

    Springfield, Missouri 65807
    United States

    Site Not Available

  • St. John's Regional Health Center

    Springfield, Missouri 65804
    United States

    Site Not Available

  • Billings Clinic - Downtown

    Billings, Montana 59107-7000
    United States

    Site Not Available

  • CCOP - Montana Cancer Consortium

    Billings, Montana 59101
    United States

    Site Not Available

  • Hematology-Oncology Centers of the Northern Rockies - Billings

    Billings, Montana 59102
    United States

    Site Not Available

  • Northern Rockies Radiation Oncology Center

    Billings, Montana 59101
    United States

    Site Not Available

  • St. Vincent Healthcare Cancer Care Services

    Billings, Montana 59101
    United States

    Site Not Available

  • Bozeman Deaconess Cancer Center

    Bozeman, Montana 59715
    United States

    Site Not Available

  • St. James Healthcare Cancer Care

    Butte, Montana 59701
    United States

    Site Not Available

  • Big Sky Oncology

    Great Falls, Montana 59405-5309
    United States

    Site Not Available

  • Great Falls Clinic - Main Facility

    Great Falls, Montana 59405
    United States

    Site Not Available

  • Sletten Cancer Institute at Benefis Healthcare

    Great Falls, Montana 59405
    United States

    Site Not Available

  • Northern Montana Hospital

    Havre, Montana 59501
    United States

    Site Not Available

  • St. Peter's Hospital

    Helena, Montana 59601
    United States

    Site Not Available

  • Glacier Oncology, PLLC

    Kalispell, Montana 59901
    United States

    Site Not Available

  • Kalispell Medical Oncology at KRMC

    Kalispell, Montana 59901
    United States

    Site Not Available

  • Kalispell Regional Medical Center

    Kalispell, Montana 59901
    United States

    Site Not Available

  • Montana Cancer Center at St. Patrick Hospital and Health Sciences Center

    Missoula, Montana 59807
    United States

    Site Not Available

  • Montana Cancer Specialists at Montana Cancer Center

    Missoula, Montana 59807-7877
    United States

    Site Not Available

  • Cancer Resource Center - Lincoln

    Lincoln, Nebraska 68510
    United States

    Site Not Available

  • Alegant Health Cancer Center at Bergan Mercy Medical Center

    Omaha, Nebraska 68124
    United States

    Site Not Available

  • CCOP - Missouri Valley Cancer Consortium

    Omaha, Nebraska 68106
    United States

    Site Not Available

  • Creighton University Medical Center

    Omaha, Nebraska 68131-2197
    United States

    Site Not Available

  • Immanuel Medical Center

    Omaha, Nebraska 68122
    United States

    Site Not Available

  • Hematology Oncology Associates, PC

    Albuquerque, New Mexico 87106
    United States

    Site Not Available

  • Lovelace Medical Center - Downtown

    Albuquerque, New Mexico 87102
    United States

    Site Not Available

  • University of New Mexico Cancer Center

    Albuquerque, New Mexico 87131-5636
    United States

    Site Not Available

  • Rutherford Hospital

    Rutherfordton, North Carolina 28139
    United States

    Site Not Available

  • Bismarck Cancer Center

    Bismarck, North Dakota 58501
    United States

    Site Not Available

  • Medcenter One Hospital Cancer Care Center

    Bismarck, North Dakota 58501
    United States

    Site Not Available

  • Mid Dakota Clinic, PC

    Bismarck, North Dakota 58501
    United States

    Site Not Available

  • St. Alexius Medical Center Cancer Center

    Bismarck, North Dakota 58502
    United States

    Site Not Available

  • CCOP - MeritCare Hospital

    Fargo, North Dakota 58122
    United States

    Site Not Available

  • MeritCare Broadway

    Fargo, North Dakota 58122
    United States

    Site Not Available

  • Altru Cancer Center at Altru Hospital

    Grand Forks, North Dakota 58201
    United States

    Site Not Available

  • Mary Rutan Hospital

    Bellefontaine, Ohio 43311
    United States

    Site Not Available

  • Wood County Oncology Center

    Bowling Green, Ohio 43402
    United States

    Site Not Available

  • Adena Regional Medical Center

    Chillicothe, Ohio 45601
    United States

    Site Not Available

  • North Coast Cancer Care - Clyde

    Clyde, Ohio 43410
    United States

    Site Not Available

  • CCOP - Columbus

    Columbus, Ohio 43215
    United States

    Site Not Available

  • Doctors Hospital at Ohio Health

    Columbus, Ohio 43228
    United States

    Site Not Available

  • Grant Medical Center Cancer Care

    Columbus, Ohio 43215
    United States

    Site Not Available

  • Mount Carmel Health - West Hospital

    Columbus, Ohio 43222
    United States

    Site Not Available

  • Riverside Methodist Hospital Cancer Care

    Columbus, Ohio 43214-3998
    United States

    Site Not Available

  • CCOP - Dayton

    Dayton, Ohio 45420
    United States

    Site Not Available

  • David L. Rike Cancer Center at Miami Valley Hospital

    Dayton, Ohio 45409
    United States

    Site Not Available

  • Good Samaritan Hospital

    Dayton, Ohio 45406
    United States

    Site Not Available

  • Grandview Hospital

    Dayton, Ohio 45405
    United States

    Site Not Available

  • Samaritan North Cancer Care Center

    Dayton, Ohio 45415
    United States

    Site Not Available

  • Grady Memorial Hospital

    Delaware, Ohio 43015
    United States

    Site Not Available

  • Community Cancer Center

    Elyria, Ohio 44035
    United States

    Site Not Available

  • Hematology Oncology Center

    Elyria, Ohio 44035
    United States

    Site Not Available

  • Blanchard Valley Medical Associates

    Findlay, Ohio 45840
    United States

    Site Not Available

  • Middletown Regional Hospital

    Franklin, Ohio 45005-1066
    United States

    Site Not Available

  • Wayne Hospital

    Greenville, Ohio 45331
    United States

    Site Not Available

  • Charles F. Kettering Memorial Hospital

    Kettering, Ohio 45429
    United States

    Site Not Available

  • Fairfield Medical Center

    Lancaster, Ohio 43130
    United States

    Site Not Available

  • Lima Memorial Hospital

    Lima, Ohio 45804
    United States

    Site Not Available

  • Strecker Cancer Center at Marietta Memorial Hospital

    Marietta, Ohio 45750
    United States

    Site Not Available

  • Northwest Ohio Oncology Center

    Maumee, Ohio 43537-1839
    United States

    Site Not Available

  • St. Luke's Hospital

    Maumee, Ohio 43537
    United States

    Site Not Available

  • Knox Community Hospital

    Mount Vernon, Ohio 43050
    United States

    Site Not Available

  • Licking Memorial Cancer Care Program at Licking Memorial Hospital

    Newark, Ohio 43055
    United States

    Site Not Available

  • Fisher-Titus Medical Center

    Norwalk, Ohio 44857
    United States

    Site Not Available

  • St. Charles Mercy Hospital

    Oregon, Ohio 43616
    United States

    Site Not Available

  • Toledo Clinic - Oregon

    Oregon, Ohio 43616
    United States

    Site Not Available

  • North Coast Cancer Care, Incorporated

    Sandusky, Ohio 44870
    United States

    Site Not Available

  • Community Hospital of Springfield and Clark County

    Springfield, Ohio 45505
    United States

    Site Not Available

  • Flower Hospital Cancer Center

    Sylvania, Ohio 43560
    United States

    Site Not Available

  • Mercy Hospital of Tiffin

    Tiffin, Ohio 44883
    United States

    Site Not Available

  • CCOP - Toledo Community Hospital

    Toledo, Ohio 43617
    United States

    Site Not Available

  • Medical University of Ohio Cancer Center

    Toledo, Ohio 43614
    United States

    Site Not Available

  • St. Anne Mercy Hospital

    Toledo, Ohio 43623
    United States

    Site Not Available

  • St. Vincent Mercy Medical Center

    Toledo, Ohio 43608
    United States

    Site Not Available

  • Toledo Clinic, Incorporated - Main Clinic

    Toledo, Ohio 43623
    United States

    Site Not Available

  • Toledo Hospital

    Toledo, Ohio 43606
    United States

    Site Not Available

  • UVMC Cancer Care Center at Upper Valley Medical Center

    Troy, Ohio 45373-1300
    United States

    Site Not Available

  • Fulton County Health Center

    Wauseon, Ohio 43567
    United States

    Site Not Available

  • Mount Carmel St. Ann's Cancer Center

    Westerville, Ohio 43081
    United States

    Site Not Available

  • Clinton Memorial Hospital

    Wilmington, Ohio 45177
    United States

    Site Not Available

  • United States Air Force Medical Center - Wright-Patterson

    Wright-Patterson Afb, Ohio 45433-5529
    United States

    Site Not Available

  • Ruth G. McMillan Cancer Center at Greene Memorial Hospital

    Xenia, Ohio 45385
    United States

    Site Not Available

  • Genesis - Good Samaritan Hospital

    Zanesville, Ohio 43701
    United States

    Site Not Available

  • Natalie Warren Bryant Cancer Center at St. Francis Hospital

    Tulsa, Oklahoma 74136
    United States

    Site Not Available

  • Clackamas Radiation Oncology Center

    Clackamas, Oregon 97015
    United States

    Site Not Available

  • Providence Milwaukie Hospital

    Milwaukie, Oregon 97222
    United States

    Site Not Available

  • Providence Newberg Medical Center

    Newberg, Oregon 97132
    United States

    Site Not Available

  • Willamette Falls Hospital

    Oregon City, Oregon 97045
    United States

    Site Not Available

  • Adventist Medical Center

    Portland, Oregon 97216
    United States

    Site Not Available

  • CCOP - Columbia River Oncology Program

    Portland, Oregon 97225
    United States

    Site Not Available

  • Providence Cancer Center at Providence Portland Medical Center

    Portland, Oregon 97213-2967
    United States

    Site Not Available

  • Providence St. Vincent Medical Center

    Portland, Oregon 97225
    United States

    Site Not Available

  • Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest

    Allentown, Pennsylvania 18105
    United States

    Site Not Available

  • Geisinger Cancer Institute at Geisinger Health

    Danville, Pennsylvania 17822-0001
    United States

    Site Not Available

  • Geisinger Hazleton Cancer Center

    Hazleton, Pennsylvania 18201
    United States

    Site Not Available

  • Geisinger Medical Group - Scenery Park

    State College, Pennsylvania 16801
    United States

    Site Not Available

  • Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center

    Wilkes-Barre, Pennsylvania 18711
    United States

    Site Not Available

  • AnMed Cancer Center

    Anderson, South Carolina 29621
    United States

    Site Not Available

  • CCOP - Upstate Carolina

    Spartanburg, South Carolina 29303
    United States

    Site Not Available

  • Gibbs Regional Cancer Center at Spartanburg Regional Medical Center

    Spartanburg, South Carolina 29303
    United States

    Site Not Available

  • Rapid City Regional Hospital

    Rapid City, South Dakota 57701
    United States

    Site Not Available

  • Avera Cancer Institute

    Sioux Falls, South Dakota 57105
    United States

    Site Not Available

  • Fredericksburg Oncology, Incorporated

    Fredericksburg, Virginia 22401
    United States

    Site Not Available

  • St. Joseph Cancer Center

    Bellingham, Washington 98225
    United States

    Site Not Available

  • Cascade Cancer Center at Evergreen Hospital Medical Center

    Kirkland, Washington 98033
    United States

    Site Not Available

  • Valley Medical Center

    Renton, Washington 98055
    United States

    Site Not Available

  • CCOP - Virginia Mason Research Center

    Seattle, Washington 98101
    United States

    Site Not Available

  • Pacific Medical Center

    Seattle, Washington 98104
    United States

    Site Not Available

  • Southwest Washington Medical Center Cancer Center

    Vancouver, Washington 98668
    United States

    Site Not Available

  • Edwards Comprehensive Cancer Center at Cabell Huntington Hospital

    Huntington, West Virginia 25701
    United States

    Site Not Available

  • Marshfield Clinic - Chippewa Center

    Chippewa Falls, Wisconsin 54729
    United States

    Site Not Available

  • Luther Midlelfort Hospital

    Eau Claire, Wisconsin 54702
    United States

    Site Not Available

  • Marshfield Clinic Cancer Care at Regional Cancer Center

    Eau Claire, Wisconsin 54701
    United States

    Site Not Available

  • Midelfort Clinic - Luther

    Eau Claire, Wisconsin 54703-1510
    United States

    Site Not Available

  • Central Wisconsin Cancer Program at Agnesian HealthCare

    Fond du Lac, Wisconsin 54935
    United States

    Site Not Available

  • Green Bay Oncology, Limited at St. Mary's Hospital

    Green Bay, Wisconsin 54303
    United States

    Site Not Available

  • Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center

    Green Bay, Wisconsin 54301-3526
    United States

    Site Not Available

  • St. Mary's Hospital Medical Center - Green Bay

    Green Bay, Wisconsin 54303
    United States

    Site Not Available

  • St. Vincent Hospital Regional Cancer Center

    Green Bay, Wisconsin 54307-3508
    United States

    Site Not Available

  • Franciscan Skemp Healthcare - La Crosse Campus

    La Crosse, Wisconsin 54601
    United States

    Site Not Available

  • Holy Family Memorial Medical Center Cancer Care Center

    Manitowoc, Wisconsin 54221-1450
    United States

    Site Not Available

  • Bay Area Cancer Care Center at Bay Area Medical Center

    Marinette, Wisconsin 54143
    United States

    Site Not Available

  • Marshfield Clinic - Marshfield Center

    Marshfield, Wisconsin 54449
    United States

    Site Not Available

  • Marshfield Clinic - Lakeland Center

    Minocqua, Wisconsin 54548
    United States

    Site Not Available

  • Green Bay Oncology, Limited - Oconto Falls

    Oconto Falls, Wisconsin 54154
    United States

    Site Not Available

  • Ministry Medical Group at Saint Mary's Hospital

    Rhinelander, Wisconsin 54501
    United States

    Site Not Available

  • Marshfield Clinic - Indianhead Center

    Rice Lake, Wisconsin 54868
    United States

    Site Not Available

  • St. Nicholas Hospital

    Sheboygan, Wisconsin 53081
    United States

    Site Not Available

  • Marshfield Clinic at Saint Michael's Hospital

    Stevens Point, Wisconsin 54481
    United States

    Site Not Available

  • Door County Cancer Center at Door County Memorial Hospital

    Sturgeon Bay, Wisconsin 54235-1495
    United States

    Site Not Available

  • Green Bay Oncology, Limited - Sturgeon Bay

    Sturgeon Bay, Wisconsin 54235
    United States

    Site Not Available

  • Marshfield Clinic - Weston Center

    Weston, Wisconsin 54476
    United States

    Site Not Available

  • Marshfield Clinic - Wisconsin Rapids Center

    Wisconsin Rapids, Wisconsin 54494
    United States

    Site Not Available

  • Rocky Mountain Oncology

    Casper, Wyoming 82609
    United States

    Site Not Available

  • Welch Cancer Center at Sheridan Memorial Hospital

    Sheridan, Wyoming 82801
    United States

    Site Not Available

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