Doxorubicin Hydrochloride and Cyclophosphamide Followed by Paclitaxel With or Without Carboplatin in Treating Patients With Triple-Negative Breast Cancer
Purpose
This randomized phase III trial studies how well doxorubicin hydrochloride and cyclophosphamide followed by paclitaxel with or without carboplatin work in treating patients with triple-negative breast cancer. Drugs used in chemotherapy, such as doxorubicin hydrochloride, cyclophosphamide, paclitaxel, and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. It is not yet known whether doxorubicin hydrochloride and cyclophosphamide is more effective when followed by paclitaxel alone or paclitaxel and carboplatin in treating triple-negative breast cancer.
Conditions
- Breast Adenocarcinoma
- Estrogen Receptor Negative
- HER2/Neu Negative
- Progesterone Receptor Negative
- Stage IB Breast Cancer
- Stage IIA Breast Cancer
- Stage IIB Breast Cancer
- Stage IIIA Breast Cancer
- Stage IIIC Breast Cancer
- Triple-Negative Breast Carcinoma
Eligibility
- Eligible Ages
- Over 18 Years
- Eligible Genders
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- The patient must have signed and dated an institutional review board (IRB)-approved consent form that conforms to federal and institutional guidelines - Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 - The tumor must be unilateral invasive adenocarcinoma of the breast on histologic examination - All of the following staging criteria (according to the 7th edition of the American Joint Committee on Cancer [AJCC] Cancer Staging Manual) must be met: - By pathologic evaluation, primary tumor must be pT1-3 - By pathologic evaluation, ipsilateral nodes must be pN0, pN1 (pN1mi, pN1a, pN1b, pN1c), pN2a, pN2b, pN3a, or pN3b - If pN0, pathological tumor must be greater than or equal to 3.0 cm - The tumor must have been determined to be human epidermal growth factor receptor 2 (HER2)-negative as follows: - Immunohistochemistry (IHC) 0-1+; or - IHC 2+ and in situ hybridization (ISH) non-amplified with a ratio of HER2 to centromere enumerator probe 17 (CEP17) less than 2.0, and if reported, average HER2 gene copy number less than 4 signals/cells; or - ISH non-amplified with a ratio of HER2 to CEP17 less than 2.0, and if reported, average HER2 gene copy number less than 4 signals/cells - The tumor must have estrogen receptor (ER)-and progesterone receptor (PgR)-status assessed using current American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines; patients are eligible if the tumor staining meets one of the following criteria: - ER-negative and PgR-negative by ASCO/CAP guidelines, OR - ER or PgR stains are positive in 1-9% of cells and neither is positive in greater than or equal to 10% of cells. - The patient must have undergone either a mastectomy (total, skin-sparing, or nipple-sparing) or lumpectomy - For patients who undergo lumpectomy, the margins of the resected specimen must be histologically free of invasive tumor and ductal carcinoma in situ (DCIS) as determined by the local pathologist; if pathologic examination demonstrates tumor at the line of resection, additional excisions may be performed to obtain clear margins; if tumor is still present at the resected margin after re-excision(s), the patient must undergo mastectomy to be eligible; (patients with margins positive for lobular carcinoma in situ [LCIS] are eligible without additional resection) - For patients who undergo mastectomy, the margins must be free of residual gross tumor; (patients with microscopic positive margins are eligible as long as post-mastectomy radiation therapy [RT] of the chest wall will be administered) - The patient must have completed one of the procedures for evaluation of pathologic nodal status listed below. - Sentinel lymphadenectomy alone: - If pathologic nodal staging based on sentinel lymphadenectomy is pN0 or pN1b; - If pathologic nodal staging based on sentinel lymphadenectomy is pN1mi or pN1a and the patient has undergone breast conserving surgery (with planned breast radiotherapy), the primary tumor must be T1 or T2 by pathologic evaluation and the nodal involvement must be limited to 1 or 2 positive nodes - Sentinel lymphadenectomy followed by removal of additional non-sentinel lymph nodes if the sentinel node (SN) is positive; or - Axillary lymphadenectomy with or without SN isolation procedure - The interval between the last surgery for breast cancer (including re-excision of margins) and randomization must be no more than 60 days - Absolute neutrophil count (ANC) must be greater than or equal to1200/mm^3 - Platelet count must be greater than or equal 100,000/mm^3 - Hemoglobin must be greater than or equal to 10 g/dL - Adequate hepatic function must be met based on the results of the most recent postoperative tests performed with 6 weeks prior to randomization. - Total bilirubin must be less than or equal to upper limit of normal (ULN) for the laboratory (lab) unless the patient has a bilirubin elevation greater than ULN to 1.5 x ULN due to Gilbert's disease or similar syndrome involving slow conjugation of bilirubin - Alkaline phosphatase must be less than or equal to 2.5 x ULN for the lab - Aspartate aminotransferase (AST) must be less than or equal to 1.5 x ULN for the lab - Note: If alanine aminotransferase (ALT) is performed instead of AST (per institution's standard practice), the ALT value must be less than or equal to 1.5 x ULN; if both were performed, the AST must be less than or equal to 1.5 x ULN. - Patients with AST or alkaline phosphatase greater than ULN are eligible for inclusion in the study if liver imaging (computed tomography [CT], magnetic resonance imaging [MRI], positron emission tomography [PET]-CT, or PET scan) performed within 90 days prior to randomization does not demonstrate metastatic disease and the requirements above are met - Patients with alkaline phosphatase that is greater than ULN but less than or equal to 2.5 x ULN or unexplained bone pain are eligible for inclusion in the study if a bone scan, PET-CT scan, or PET scan performed within 90 days prior to randomization does not demonstrate metastatic disease - Adequate renal function determined within 6 weeks prior to randomization defined as the most recent serum creatinine less than or equal to ULN or measured or calculated creatinine clearance greater than 60 mL/min - Left ventricular ejection fraction (LVEF) assessment must be performed within 90 days prior to randomization; (LVEF assessment performed by 2-dimensional [D] echocardiogram is preferred; however, multi gated acquisition [MUGA] scan may be substituted based on institutional preferences;) the LVEF must be greater than or equal to 50% regardless of the cardiac imaging facility's lower limit of normal.
Exclusion Criteria
- T4 tumors including inflammatory breast cancer - Definitive clinical or radiologic evidence of metastatic disease; required imaging studies must have been performed within 90 days prior to randomization - Synchronous or previous contralateral invasive breast cancer; (patients with synchronous and/or previous contralateral DCIS or LCIS are eligible) - Any previous history of ipsilateral invasive breast cancer or ipsilateral DCIS; (patients with synchronous or previous ipsilateral LCIS are eligible) - History of non-breast malignancies (except for in situ cancers treated only by local excision and basal cell and squamous cell carcinomas of the skin) within 5 years prior to randomization - Previous therapy with anthracyclines or taxanes for any malignancy - Chemotherapy administered for the currently diagnosed breast cancer prior to randomization - Any continued use of sex hormonal therapy, e.g., birth control pills, ovarian hormone replacement therapy; patients are eligible if these medications are discontinued prior to randomization - Cardiac disease (history of and/or active disease) that would preclude the use of the drugs included in the treatment regimens; this includes but is not confined to: - Active cardiac disease - Angina pectoris that requires the current use of anti-anginal medication; - Ventricular arrhythmias except for benign premature ventricular contractions; - Supraventricular and nodal arrhythmias requiring a pacemaker or not controlled with medication; - Conduction abnormality requiring a pacemaker; - Valvular disease with documented compromise in cardiac function; or - Symptomatic pericarditis - History of cardiac disease - Myocardial infarction documented by elevated cardiac enzymes or persistent regional wall abnormalities on assessment of left ventricle (LV) function; - History of documented congestive heart failure (CHF); or - Documented cardiomyopathy - Uncontrolled hypertension defined as sustained systolic blood pressure (BP) greater than 150 mmHg or diastolic BP greater than 90 mmHg; (patients with initial BP elevations are eligible if initiation or adjustment of BP medication lowers pressure to meet entry criteria) - Active hepatitis B or hepatitis C with abnormal liver function tests - Patients known to be human immunodeficiency virus (HIV) positive with a baseline cluster of differentiation (CD)4 count of less than 250 cells/mm^3 or have a history of acquired immune deficiency syndrome (AIDS) indicator conditions - Intrinsic lung disease resulting in dyspnea - History of hospitalization in past 12 months for diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic nonketotic syndrome (HHNS) - Active infection or chronic infection requiring chronic suppressive antibiotics - Nervous system disorder (paresthesia, peripheral motor neuropathy, or peripheral sensory neuropathy) greater than or equal to grade 2, per the Common Terminology Criteria for Adverse Events (CTCAE) version (v)4.0 - Conditions that would prohibit administration of corticosteroids - Chronic daily treatment with corticosteroids with a dose of greater than or equal to 10 mg/day methylprednisolone equivalent (excluding inhaled steroids) - Known hypersensitivity to any of the study drugs or excipients, e.g., polysorbate 80 and Cremophor® EL - Other non-malignant systemic disease that would preclude the patient from receiving study treatment or would prevent required follow-up - Psychiatric or addictive disorders or other conditions that, in the opinion of the investigator, would preclude the patient from meeting the study requirements - Pregnancy or lactation at the time of study entry; (note: pregnancy testing according to institutional standards for women of childbearing potential must be performed within 2 weeks prior to randomization) - Use of any investigational product within 4 weeks prior to randomization
Study Design
- Phase
- Phase 3
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel Assignment
- Primary Purpose
- Treatment
- Masking
- None (Open Label)
Arm Groups
Arm | Description | Assigned Intervention |
---|---|---|
Active Comparator Arm I (AC-->WP) |
Patients receive doxorubicin hydrochloride IV over 15 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 2 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. Patients then receive paclitaxel IV over 60 minutes on day 1. Treatment repeats weekly for 12 courses in the absence of disease progression or unacceptable toxicity. |
|
Experimental Arm II (AC-->WP + carboplatin) |
Patients receive doxorubicin hydrochloride and cyclophosphamide as in Arm I. Patients then receive paclitaxel IV over 60 minutes on days 1, 8, and 15 and carboplatin IV over 30-60 minutes on day 1. Treatment repeats every 3 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. |
|
Recruiting Locations
Anchorage, Alaska 98508
Anchorage, Alaska 99504
Anchorage, Alaska 99508
Anchorage, Alaska 99508
Anchorage, Alaska 99508
Anchorage, Alaska 99508
Anchorage, Alaska 99508
Anchorage, Alaska 99508
Fairbanks, Alaska 99701
Goodyear, Arizona 85338
Site Public Contact
623-207-3000
Phoenix, Arizona 85016
Site Public Contact
602-277-4868
Scottsdale, Arizona 85258
Fort Smith, Arkansas 72903
Site Public Contact
800-378-9373
Hot Springs, Arkansas 71913
Jonesboro, Arkansas 72401
Little Rock, Arkansas 72205
Site Public Contact
501-686-8274
Anaheim, California 92806
Antioch, California 94531
Arroyo Grande, California 93420
Auburn, California 95602
Auburn, California 95603
Baldwin Park, California 91706
Bellflower, California 90706
Berkeley, California 94704
Burbank, California 91505
Cameron Park, California 95682
Carmichael, California 95608
Castro Valley, California 94546
Clovis, California 93611
Site Public Contact
559-387-1827
Clovis, California 93611
Site Public Contact
559-256-9680
Davis, California 95616
Dublin, California 94568
Site Public Contact
925-875-1677
Emeryville, California 94608
Site Public Contact
510-835-9900
Emeryville, California 94608
Site Public Contact
510-629-6682
Fontana, California 92335
Fremont, California 94538
Fresno, California 93720
Fullerton, California 92835
Site Public Contact
714-446-5642
Greenbrae, California 94904
Harbor City, California 90710
Irvine, California 92618
La Jolla, California 92093
Los Angeles, California 90027
Los Angeles, California 90033
Site Public Contact
323-865-0451
Los Angeles, California 90033
Site Public Contact
323-865-0451
Los Angeles, California 90034
Martinez, California 94553-3156
Site Public Contact
925-957-5400
Modesto, California 95355
Modesto, California 95356
Mountain View, California 94040
Mountain View, California 94040
Newport Beach, California 92663
Site Public Contact
323-865-0451
Oakland, California 94609
Site Public Contact
510-204-1414
Oakland, California 94609
Oakland, California 94611
Palm Springs, California 92262
Site Public Contact
760-416-4730
Palo Alto, California 94301
Palo Alto, California 94304
Panorama City, California 91402
Pasadena, California 91105
Site Public Contact
323-865-0451
Pomona, California 91767
Site Public Contact
909-865-9555
Rancho Mirage, California 92270
Site Public Contact
760-834-3798
Redwood City, California 94063
Richmond, California 94801
Riverside, California 92505
Roseville, California 95661
Roseville, California 95661
Roseville, California 95661
Sacramento, California 95814
Sacramento, California 95816
Sacramento, California 95816
Sacramento, California 95823
Sacramento, California 95825
Salinas, California 93901
San Diego, California 92108
San Diego, California 92120
San Francisco, California 94115
San Francisco, California 94115
San Jose, California 95119
San Jose, California 95124
San Leandro, California 94577
San Marcos, California 92078
San Rafael, California 94903
San Rafael, California 94903
Santa Clara, California 95051
Santa Cruz, California 95065
Site Public Contact
831-462-7770
Santa Cruz, California 95065
Santa Rosa, California 95403
Santa Rosa, California 95403
South San Francisco, California 94080
Stockton, California 95210
Sunnyvale, California 94086
Vacaville, California 95687
Vacaville, California 95688
Vallejo, California 94589
Vallejo, California 94589
Walnut Creek, California 94596
Walnut Creek, California 94597
Woodland Hills, California 91367
Woodland, California 95695
Aurora, Colorado 80012
Boulder, Colorado 80301
Boulder, Colorado 80304
Colorado Springs, Colorado 80907
Colorado Springs, Colorado 80907
Denver, Colorado 80205
Denver, Colorado 80206
Denver, Colorado 80209
Denver, Colorado 80210
Denver, Colorado 80218
Denver, Colorado 80218
Denver, Colorado 80218
Denver, Colorado 80218
Denver, Colorado 80220
Durango, Colorado 81301
Durango, Colorado 81301
Englewood, Colorado 80113
Englewood, Colorado 80113
Golden, Colorado 80401
Grand Junction, Colorado 81501
Greeley, Colorado 80631
Lafayette, Colorado 80026
Lakewood, Colorado 80228
Littleton, Colorado 80120
Littleton, Colorado 80122
Lone Tree, Colorado 80124
Lone Tree, Colorado 80124
Longmont, Colorado 80501
Longmont, Colorado 80501
Loveland, Colorado 80539
Parker, Colorado 80138
Pueblo, Colorado 81004
Thornton, Colorado 80260
Wheat Ridge, Colorado 80033
Derby, Connecticut 06418
Fairfield, Connecticut 06824
Greenwich, Connecticut 06830
Site Public Contact
203-863-3698
Guilford, Connecticut 06437
Hartford, Connecticut 06105
New Haven, Connecticut 06510
New Haven, Connecticut 06520
North Haven, Connecticut 06473
Orange, Connecticut 06477
Torrington, Connecticut 06790
Trumbull, Connecticut 06611
Waterbury, Connecticut 06708
Waterford, Connecticut 06385
Dover, Delaware 19901
Lewes, Delaware 19958
Milford, Delaware 19963
Newark, Delaware 19713
Newark, Delaware 19713
Newark, Delaware 19713
Newark, Delaware 19718
Rehoboth Beach, Delaware 19971
Seaford, Delaware 19973
Wilmington, Delaware 19801
Washington, District of Columbia 20002
Site Public Contact
301-548-5743
Washington, District of Columbia 20016
Aventura, Florida 33180
Clearwater, Florida 33756
Site Public Contact
855-314-8646
Coral Gables, Florida 33146
Site Public Contact
305-243-2647
Daytona Beach, Florida 32114
Site Public Contact
386-254-4211
Deerfield Beach, Florida 33442
Site Public Contact
305-243-2647
Fort Lauderdale, Florida 33308
Site Public Contact
954-267-7750
Fort Myers, Florida 33905
Miami Beach, Florida 33140
Miami, Florida 33136
Site Public Contact
305-243-2647
Miami, Florida 33176
Site Public Contact
305-243-2647
Orlando, Florida 32806
Plantation, Florida 33324
Site Public Contact
305-243-2647
Tallahassee, Florida 32308
Site Public Contact
850-431-0673
Tampa, Florida 33607
Weston, Florida 33331
Albany, Georgia 31701
Athens, Georgia 30607
Atlanta, Georgia 30342
Augusta, Georgia 30912
Decatur, Georgia 30033
Rome, Georgia 30165
Savannah, Georgia 31404
Savannah, Georgia 31404
Savannah, Georgia 31405
Valdosta, Georgia 31602
'Aiea, Hawaii 96701
Site Public Contact
808-487-7447
'Aiea, Hawaii 96701
Site Public Contact
808-486-6000
'Aiea, Hawaii 96701
Site Public Contact
808-678-9000
Honolulu, Hawaii 96813
Site Public Contact
808-524-6115
Honolulu, Hawaii 96813
Site Public Contact
808-532-0315
Honolulu, Hawaii 96813
Honolulu, Hawaii 96813
Site Public Contact
808-545-8548
Honolulu, Hawaii 96813
Site Public Contact
808-522-4333
Honolulu, Hawaii 96813
Site Public Contact
808-586-2979
Honolulu, Hawaii 96817
Site Public Contact
808-536-4888
Honolulu, Hawaii 96817
Site Public Contact
808-531-8521
Honolulu, Hawaii 96817
Site Public Contact
808-547-9816
Honolulu, Hawaii 96817
Site Public Contact
808-547-6881
Honolulu, Hawaii 96819
Honolulu, Hawaii 96826
Site Public Contact
808-983-6090
Lihue, Hawaii 96766
Site Public Contact
808-535-7960
Boise, Idaho 83706
Boise, Idaho 83712
Caldwell, Idaho 83605
Coeur d'Alene, Idaho 83814
Emmett, Idaho 83617
Fruitland, Idaho 83619
Meridian, Idaho 83642
Meridian, Idaho 83642
Nampa, Idaho 83686
Nampa, Idaho 83686
Post Falls, Idaho 83854
Sandpoint, Idaho 83864
Twin Falls, Idaho 83301
Arlington Heights, Illinois 60005
Site Public Contact
847-618-4968
Aurora, Illinois 60504
Bloomington, Illinois 61704
Canton, Illinois 61520
Carbondale, Illinois 62902
Carterville, Illinois 62918
Carthage, Illinois 62321
Centralia, Illinois 62801
Chicago, Illinois 60611
Chicago, Illinois 60612
Site Public Contact
312-864-5204
Chicago, Illinois 60612
Site Public Contact
312-355-3046
Chicago, Illinois 60640
Site Public Contact
773-564-5032
Danville, Illinois 61832
Decatur, Illinois 62526
Decatur, Illinois 62526
Effingham, Illinois 62401
Effingham, Illinois 62401
Elmhurst, Illinois 60126
Eureka, Illinois 61530
Galesburg, Illinois 61401
Galesburg, Illinois 61401
Site Public Contact
309-344-2831
Harvey, Illinois 60426
Joliet, Illinois 60435
Kewanee, Illinois 61443
Lake Forest, Illinois 60045
Macomb, Illinois 61455
Mattoon, Illinois 61938
Maywood, Illinois 60153
Site Public Contact
708-226-4357
Mount Vernon, Illinois 62864
Site Public Contact
618-242-4600
Naperville, Illinois 60540
Site Public Contact
630-646-6075
Ottawa, Illinois 61350
Park Ridge, Illinois 60068
Site Public Contact
847-384-3621
Pekin, Illinois 61554
Pekin, Illinois 61554
Peoria, Illinois 61615
Peoria, Illinois 61615
Peoria, Illinois 61636
Peoria, Illinois 61637
Peru, Illinois 61354
Peru, Illinois 61354
Site Public Contact
815-664-4141
Plainfield, Illinois 60585
Princeton, Illinois 61356
River Forest, Illinois 60305
Site Public Contact
708-763-2707
Silvis, Illinois 61282
Springfield, Illinois 62702
Site Public Contact
217-545-7929
Springfield, Illinois 62702
Site Public Contact
800-444-7541
Springfield, Illinois 62781
Site Public Contact
217-788-3528
Swansea, Illinois 62226
Swansea, Illinois 62226
Urbana, Illinois 61801
Urbana, Illinois 61801
Yorkville, Illinois 60560
Zion, Illinois 60099
Evansville, Indiana 47713
Goshen, Indiana 46526
Indianapolis, Indiana 46237
Site Public Contact
317-528-7060
Michigan City, Indiana 46360
Mooresville, Indiana 46158
Site Public Contact
317-834-3603
Munster, Indiana 46321
Site Public Contact
219-836-3349
Newburgh, Indiana 47630
South Bend, Indiana 46601
Site Public Contact
800-284-7370
Terre Haute, Indiana 47804
Site Public Contact
812-238-7394
Ames, Iowa 50010
Site Public Contact
515-956-4132
Ames, Iowa 50010
Site Public Contact
515-956-4132
Bettendorf, Iowa 52722
Boone, Iowa 50036
Site Public Contact
515-956-4132
Cedar Rapids, Iowa 52403
Site Public Contact
319-365-4673
Cedar Rapids, Iowa 52403
Site Public Contact
319-363-2690
Clive, Iowa 50325
Clive, Iowa 50325
Council Bluffs, Iowa 51503
Davenport, Iowa 52803
Davenport, Iowa 52804
Davenport, Iowa 52807
Des Moines, Iowa 50309
Site Public Contact
515-241-6727
Des Moines, Iowa 50309
Site Public Contact
515-282-2921
Des Moines, Iowa 50314
Site Public Contact
515-282-2200
Des Moines, Iowa 50314
Des Moines, Iowa 50314
Des Moines, Iowa 50316
Site Public Contact
515-241-8704
Fairfield, Iowa 52556
Site Public Contact
641-469-4144
Fort Dodge, Iowa 50501
Site Public Contact
515-956-4132
Iowa City, Iowa 52242
Site Public Contact
800-237-1225
Jefferson, Iowa 50129
Site Public Contact
515-956-4132
Marshalltown, Iowa 50158
Site Public Contact
515-956-4132
Ottumwa, Iowa 52501
Site Public Contact
641-684-2742
Sioux City, Iowa 51101
West Des Moines, Iowa 50266-7700
Site Public Contact
515-343-1000
West Des Moines, Iowa 50266
Chanute, Kansas 66720
Dodge City, Kansas 67801
El Dorado, Kansas 67042
Garden City, Kansas 67846
Great Bend, Kansas 67530
Independence, Kansas 67301
Kingman, Kansas 67068
Lawrence, Kansas 66044
Lenexa, Kansas 66219
Lenexa, Kansas 66219
Liberal, Kansas 67905
Manhattan, Kansas 66502
McPherson, Kansas 67460
Newton, Kansas 67114
Overland Park, Kansas 66209
Parsons, Kansas 67357
Pratt, Kansas 67124
Salina, Kansas 67401
Topeka, Kansas 66606
Site Public Contact
785-270-4939
Wellington, Kansas 67152
Wichita, Kansas 67208
Wichita, Kansas 67208
Wichita, Kansas 67214
Wichita, Kansas 67214
Winfield, Kansas 67156
Bardstown, Kentucky 40004
Corbin, Kentucky 40701
Site Public Contact
859-523-1934
Corbin, Kentucky 40701
Edgewood, Kentucky 41017
Fort Thomas, Kentucky 41075
Site Public Contact
859-301-9418
Lexington, Kentucky 40503
Site Public Contact
859-260-6425
Lexington, Kentucky 40504
Lexington, Kentucky 40509
Lexington, Kentucky 40536
Site Public Contact
859-257-3379
Louisville, Kentucky 40202
Louisville, Kentucky 40202
Site Public Contact
502-629-2500
Louisville, Kentucky 40207
Louisville, Kentucky 40207
Site Public Contact
502-629-3465
Louisville, Kentucky 40215
Louisville, Kentucky 40217
Site Public Contact
502-629-3465
Louisville, Kentucky 40241
Louisville, Kentucky 40245
Paducah, Kentucky 42003
Site Public Contact
270-575-2928
Shepherdsville, Kentucky 40165
Baton Rouge, Louisiana 70805
Baton Rouge, Louisiana 70809
Site Public Contact
225-767-0822
Baton Rouge, Louisiana 70809
Baton Rouge, Louisiana 70809
Baton Rouge, Louisiana 70809
Baton Rouge, Louisiana 70809
Baton Rouge, Louisiana 70816
Baton Rouge, Louisiana 70817
Baton Rouge, Louisiana 70836
Covington, Louisiana 70433
Kenner, Louisiana 70065
Lake Charles, Louisiana 70601
Monroe, Louisiana 71202
New Orleans, Louisiana 70112
Site Public Contact
504-988-6121
New Orleans, Louisiana 70121
Shreveport, Louisiana 71103
Shreveport, Louisiana 71105
Bangor, Maine 04401
Site Public Contact
207-973-4274
Belfast, Maine 04915
Site Public Contact
207-338-2500
Biddeford, Maine 04005
Brewer, Maine 04412
Site Public Contact
800-987-3005
Norway, Maine 04268
Sanford, Maine 04073
Scarborough, Maine 04074
South Portland, Maine 04106
Baltimore, Maryland 21201
Site Public Contact
800-888-8823
Baltimore, Maryland 21202
Baltimore, Maryland 21229
Site Public Contact
410-368-2910
Baltimore, Maryland 21237
Site Public Contact
443-777-7364
Baltimore, Maryland 21239
Baltimore, Maryland 21244
Site Public Contact
301-816-7218
Baltimore, Maryland 21287
Bel Air, Maryland 21014
Site Public Contact
443-643-3010
Easton, Maryland 21601
Frederick, Maryland 21701
Gaithersburg, Maryland 20879
Site Public Contact
301-816-7218
Kensington, Maryland 20895
Site Public Contact
301-816-7218
Largo, Maryland 20774
Site Public Contact
301-816-7446
Rockville, Maryland 20850
Boston, Massachusetts 02111
Boston, Massachusetts 02215
Site Public Contact
617-667-9925
Boston, Massachusetts 02215
Site Public Contact
877-442-3324
Milford, Massachusetts 01757
Site Public Contact
877-332-4294
Pittsfield, Massachusetts 01201
South Weymouth, Massachusetts 02190
Site Public Contact
781-624-5000
Adrian, Michigan 49221
Site Public Contact
517-265-0116
Ann Arbor, Michigan 48106
Ann Arbor, Michigan 48109
Site Public Contact
800-865-1125
Battle Creek, Michigan 49017
Bay City, Michigan 48706
Bloomfield, Michigan 48302
Brighton, Michigan 48114
Brighton, Michigan 48114
Brownstown, Michigan 48183
Canton, Michigan 48188
Canton, Michigan 48188
Caro, Michigan 48723
Chelsea, Michigan 48118
Chelsea, Michigan 48118
Clarkston, Michigan 48346
Clarkston, Michigan 48346
Clarkston, Michigan 48346
Clinton Township, Michigan 48038
Dearborn, Michigan 48126
Detroit, Michigan 48201
Detroit, Michigan 48202
Detroit, Michigan 48236
East China Township, Michigan 48054
Escanaba, Michigan 49829
Farmington Hills, Michigan 48334
Flint, Michigan 48503
Flint, Michigan 48532
Grand Rapids, Michigan 49503
Grand Rapids, Michigan 49503
Grand Rapids, Michigan 49503
Grosse Pointe Woods, Michigan 48236
Grosse Pointe Woods, Michigan 48236
Grosse Pointe Woods, Michigan 48236
Jackson, Michigan 49201
Kalamazoo, Michigan 49007
Kalamazoo, Michigan 49007
Kalamazoo, Michigan 49048
Lansing, Michigan 48910
Lansing, Michigan 48912
Lansing, Michigan 48912
Lapeer, Michigan 48446
Livonia, Michigan 48154
Livonia, Michigan 48154
Macomb, Michigan 48044
Macomb, Michigan 48044
Marlette, Michigan 48453
Monroe, Michigan 48162
Mount Clemens, Michigan 48043
Mount Pleasant, Michigan 48858
Muskegon, Michigan 49444
Niles, Michigan 49120
Site Public Contact
616-391-1230
Novi, Michigan 48374
Novi, Michigan 48377
Petoskey, Michigan 49770
Pontiac, Michigan 48341
Pontiac, Michigan 48341
Pontiac, Michigan 48341
Pontiac, Michigan 48341
Port Huron, Michigan 48060
Reed City, Michigan 49677
Rochester Hills, Michigan 48309
Saginaw, Michigan 48601
Saginaw, Michigan 48604
Saint Joseph, Michigan 49085
Saint Joseph, Michigan 49085
Southfield, Michigan 48075
Sterling Heights, Michigan 48312
Traverse City, Michigan 49684
Warren, Michigan 48088
Warren, Michigan 48093
Warren, Michigan 48093
Warren, Michigan 48093
Warren, Michigan 48093
West Bloomfield, Michigan 48322
West Branch, Michigan 48661
Wyoming, Michigan 49519
Ypsilanti, Michigan 48106
Ypsilanti, Michigan 48197
Brainerd, Minnesota 56401
Burnsville, Minnesota 55337
Coon Rapids, Minnesota 55433
Deer River, Minnesota 56636
Detroit Lakes, Minnesota 56501
Duluth, Minnesota 55805
Duluth, Minnesota 55805
Duluth, Minnesota 55805
Edina, Minnesota 55435
Fergus Falls, Minnesota 56537
Fosston, Minnesota 56542
Fridley, Minnesota 55432
Hibbing, Minnesota 55746
Maple Grove, Minnesota 55369
Maplewood, Minnesota 55109
Maplewood, Minnesota 55109
Minneapolis, Minnesota 55407
Minneapolis, Minnesota 55415
Minneapolis, Minnesota 55454
Monticello, Minnesota 55362
New Ulm, Minnesota 56073
Park Rapids, Minnesota 56470
Robbinsdale, Minnesota 55422
Saint Cloud, Minnesota 56303
Saint Louis Park, Minnesota 55416
Saint Paul, Minnesota 55101
Saint Paul, Minnesota 55102
Sandstone, Minnesota 55072
Shakopee, Minnesota 55379
Stillwater, Minnesota 55082
Virginia, Minnesota 55792
Waconia, Minnesota 55387
Willmar, Minnesota 56201
Woodbury, Minnesota 55125
Wyoming, Minnesota 55092
Gulfport, Mississippi 39502
Jackson, Mississippi 39216
Site Public Contact
601-815-6700
Pascagoula, Mississippi 39581
Site Public Contact
228-809-5292
Ballwin, Missouri 63011
Site Public Contact
314-251-7058
Bolivar, Missouri 65613
Bonne Terre, Missouri 63628
Site Public Contact
314-996-5569
Branson, Missouri 65616
Site Public Contact
417-269-4520
Cape Girardeau, Missouri 63703
Cape Girardeau, Missouri 63703
Site Public Contact
573-651-5550
Chesterfield, Missouri 63017
Site Public Contact
314-205-6936
Jefferson City, Missouri 65109
Joplin, Missouri 64804
Joplin, Missouri 64804
Rolla, Missouri 65401
Rolla, Missouri 65401
Saint Joseph, Missouri 64507
Saint Louis, Missouri 63109
Site Public Contact
314-353-1870
Saint Louis, Missouri 63131
Site Public Contact
314-996-5569
Saint Louis, Missouri 63141
Site Public Contact
314-251-7066
Sainte Genevieve, Missouri 63670
Site Public Contact
314-996-5569
Springfield, Missouri 65804
Site Public Contact
417-269-4520
Springfield, Missouri 65807
Site Public Contact
417-269-4520
Sullivan, Missouri 63080
Site Public Contact
314-996-5569
Sunset Hills, Missouri 63127
Site Public Contact
314-996-5569
Anaconda, Montana 59711
Billings, Montana 59101
Bozeman, Montana 59715
Butte, Montana 59701
Site Public Contact
406-723-2621
Great Falls, Montana 59405
Great Falls, Montana 59405
Helena, Montana 59601
Kalispell, Montana 59901
Missoula, Montana 59802
Missoula, Montana 59804
Grand Island, Nebraska 68803
Kearney, Nebraska 68847
Lincoln, Nebraska 68506
Site Public Contact
402-484-4911
Lincoln, Nebraska 68510
Lincoln, Nebraska 68510
Site Public Contact
402-327-7363
Norfolk, Nebraska 68701
North Platte, Nebraska 69101
Omaha, Nebraska 68114
Site Public Contact
402-354-5144
Omaha, Nebraska 68122
Omaha, Nebraska 68124
Omaha, Nebraska 68124
Omaha, Nebraska 68130
Omaha, Nebraska 68130
Site Public Contact
402-334-4773
Omaha, Nebraska 68131
Papillion, Nebraska 68046
Scottsbluff, Nebraska 69361
Carson City, Nevada 89703
Henderson, Nevada 89052
Henderson, Nevada 89052
Henderson, Nevada 89052
Henderson, Nevada 89052
Henderson, Nevada 89074
Henderson, Nevada 89074
Las Vegas, Nevada 89102
Las Vegas, Nevada 89106
Las Vegas, Nevada 89106
Las Vegas, Nevada 89106
Las Vegas, Nevada 89109
Las Vegas, Nevada 89109
Las Vegas, Nevada 89113
Las Vegas, Nevada 89119
Las Vegas, Nevada 89128
Las Vegas, Nevada 89128
Las Vegas, Nevada 89128
Las Vegas, Nevada 89128
Las Vegas, Nevada 89128
Las Vegas, Nevada 89128
Las Vegas, Nevada 89135
Las Vegas, Nevada 89144
Las Vegas, Nevada 89144
Las Vegas, Nevada 89148-2405
Las Vegas, Nevada 89148
Las Vegas, Nevada 89148
Las Vegas, Nevada 89148
Las Vegas, Nevada 89149
Las Vegas, Nevada 89169
Las Vegas, Nevada 89169
Reno, Nevada 89502
Reno, Nevada 89503
Reno, Nevada 89509
Exeter, New Hampshire 03833
Site Public Contact
800-439-3837
Nashua, New Hampshire 03060
Cape May Court House, New Jersey 08210
Site Public Contact
888-369-2427
Egg Harbor Township, New Jersey 08234
Site Public Contact
609-748-7200
Elizabeth, New Jersey 07207
Site Public Contact
908-994-8000
Hackensack, New Jersey 07601
Site Public Contact
201-996-2879
Hamilton, New Jersey 08690
Site Public Contact
609-631-6946
Lakewood, New Jersey 08701
Livingston, New Jersey 07039
Long Branch, New Jersey 07740
Site Public Contact
732-923-7689
Mount Holly, New Jersey 08060
Site Public Contact
609-914-6762
New Brunswick, New Jersey 08901
New Brunswick, New Jersey 08903
Site Public Contact
732-235-8675
Newark, New Jersey 07112
Site Public Contact
973-926-7230
Pennington, New Jersey 08534
Site Public Contact
800-255-3440
Somerville, New Jersey 08876
Site Public Contact
908-685-2481
Sparta, New Jersey 07871
Site Public Contact
973-729-7001
Teaneck, New Jersey 07666
Site Public Contact
201-833-6312
Vineland, New Jersey 08360
Site Public Contact
856-641-7933
Voorhees, New Jersey 08043
Site Public Contact
856-247-7395
Woodbury, New Jersey 08096
Bronx, New York 10461
Bronx, New York 10461
Bronx, New York 10467
Buffalo, New York 14263
Cooperstown, New York 13326
East Syracuse, New York 13057
Site Public Contact
315-472-7504
Glens Falls, New York 12801
Site Public Contact
518-926-6700
Mineola, New York 11501
Site Public Contact
516-663-3115
New York, New York 10003
New York, New York 10029
Plattsburgh, New York 12901
Site Public Contact
518-561-2000
Rochester, New York 14642
Site Public Contact
585-275-5830
Stony Brook, New York 11794
Site Public Contact
800-862-2215
Syracuse, New York 13210
Site Public Contact
315-464-5476
Syracuse, New York 13215
White Plains, New York 10601
Albemarle, North Carolina 28002
Site Public Contact
800-804-9376
Asheboro, North Carolina 27203
Asheville, North Carolina 28801
Asheville, North Carolina 28801
Asheville, North Carolina 28803
Asheville, North Carolina 28816
Burlington, North Carolina 27215
Cary, North Carolina 27518
Site Public Contact
919-784-7209
Chapel Hill, North Carolina 27599
Charlotte, North Carolina 28203
Site Public Contact
800-804-9376
Charlotte, North Carolina 28204
Charlotte, North Carolina 28207
Charlotte, North Carolina 28210
Site Public Contact
980-442-2000
Charlotte, North Carolina 28211
Site Public Contact
980-442-2000
Charlotte, North Carolina 28262
Site Public Contact
800-804-9376
Charlotte, North Carolina 28262
Charlotte, North Carolina 28277
Site Public Contact
800-804-9376
Clinton, North Carolina 28328
Concord, North Carolina 28025
Site Public Contact
800-804-9376
Forest City, North Carolina 28043
Site Public Contact
800-804-9376
Garner, North Carolina 27529
Site Public Contact
919-784-7209
Goldsboro, North Carolina 27534
Goldsboro, North Carolina 27534
Greensboro, North Carolina 27403
Greenville, North Carolina 27834
Hendersonville, North Carolina 28791
James E. Radford
828-696-4716
Hendersonville, North Carolina 28791
Hendersonville, North Carolina 28792
Huntersville, North Carolina 28078
Huntersville, North Carolina 28078
Jacksonville, North Carolina 28546
Kenansville, North Carolina 28349
Kinston, North Carolina 28501
Matthews, North Carolina 28105
Matthews, North Carolina 28105
Mebane, North Carolina 27302
Monroe, North Carolina 28112
Site Public Contact
980-442-2000
Mooresville, North Carolina 28117
Pinehurst, North Carolina 28374
Raleigh, North Carolina 27607
Site Public Contact
919-784-7209
Raleigh, North Carolina 27607
Site Public Contact
919-784-7209
Raleigh, North Carolina 27614
Site Public Contact
919-784-7209
Reidsville, North Carolina 27320
Richlands, North Carolina 28574
Shelby, North Carolina 28150
Site Public Contact
800-804-9376
Washington, North Carolina 27889
Site Public Contact
252-975-4308
Winston-Salem, North Carolina 27157
Site Public Contact
336-713-6771
Fargo, North Dakota 58103
Grand Forks, North Dakota 58201
Site Public Contact
701-780-6520
Jamestown, North Dakota 58401
Minot, North Dakota 58701
Site Public Contact
800-862-0005
Akron, Ohio 44307
Beachwood, Ohio 44122
Beachwood, Ohio 44122
Beavercreek, Ohio 45431
Belpre, Ohio 45714
Canton, Ohio 44708
Site Public Contact
888-293-4673
Canton, Ohio 44710
Centerville, Ohio 45459
Centerville, Ohio 45459
Chardon, Ohio 44024
Chillicothe, Ohio 45601
Cincinnati, Ohio 45219
Site Public Contact
513-585-0844
Cincinnati, Ohio 45220
Cincinnati, Ohio 45236
Cincinnati, Ohio 45242
Cincinnati, Ohio 45247
Cincinnati, Ohio 45255
Cleveland, Ohio 44106
Cleveland, Ohio 44109
Cleveland, Ohio 44111
Cleveland, Ohio 44195
Columbus, Ohio 43210
Columbus, Ohio 43213
Columbus, Ohio 43214
Columbus, Ohio 43214
Columbus, Ohio 43215
Columbus, Ohio 43219
Columbus, Ohio 43222
Columbus, Ohio 43228
Dayton, Ohio 45406
Dayton, Ohio 45409
Dayton, Ohio 45415
Dayton, Ohio 45415
Delaware, Ohio 43015
Delaware, Ohio 43015
Dublin, Ohio 43016
Elyria, Ohio 44035
Findlay, Ohio 45840
Findlay, Ohio 45840
Franklin, Ohio 45005-1066
Franklin, Ohio 45005
Greenville, Ohio 45331
Independence, Ohio 44131
Kettering, Ohio 45409
Kettering, Ohio 45420
Kettering, Ohio 45429
Lancaster, Ohio 43130
Mansfield, Ohio 44903
Mansfield, Ohio 44906
Marietta, Ohio 45750
Marion, Ohio 43302
Mayfield Heights, Ohio 44124
Mayfield Heights, Ohio 44124
Mentor, Ohio 44060
Middleburg Heights, Ohio 44130
Mount Vernon, Ohio 43050
Newark, Ohio 43055
Newark, Ohio 43055
Parma, Ohio 44129
Portsmouth, Ohio 45662
Ravenna, Ohio 44266
Sandusky, Ohio 44870
Sandusky, Ohio 44870
Springfield, Ohio 45504
Springfield, Ohio 45505
Strongsville, Ohio 44136
Sylvania, Ohio 43560
Site Public Contact
419-824-1842
Toledo, Ohio 43606
Site Public Contact
419-824-1842
Toledo, Ohio 43623
Site Public Contact
419-407-1160
Toledo, Ohio 43623
Site Public Contact
800-444-3561
Troy, Ohio 45373
Troy, Ohio 45373
Wadsworth, Ohio 44281
Warrensville Heights, Ohio 44122
Westerville, Ohio 43081
Westlake, Ohio 44145
Westlake, Ohio 44145
Wooster, Ohio 44691
Zanesville, Ohio 43701
Lawton, Oklahoma 73505
Site Public Contact
877-231-4440
Oklahoma City, Oklahoma 73104
Oklahoma City, Oklahoma 73120
Site Public Contact
405-752-3402
Tulsa, Oklahoma 74146
Site Public Contact
918-505-3200
Baker City, Oregon 97814
Bend, Oregon 97701
Clackamas, Oregon 97015
Clackamas, Oregon 97015
Coos Bay, Oregon 97420
Corvallis, Oregon 97330
Eugene, Oregon 97401
Medford, Oregon 97504
Site Public Contact
541-789-6176
Newberg, Oregon 97132
Ontario, Oregon 97914
Portland, Oregon 97213
Portland, Oregon 97213
Portland, Oregon 97225
Site Public Contact
503-291-6233
Portland, Oregon 97225
Portland, Oregon 97227
Site Public Contact
503-280-1223
Tualatin, Oregon 97062
Site Public Contact
503-692-2032
Allentown, Pennsylvania 18103
Bethlehem, Pennsylvania 18017
Bryn Mawr, Pennsylvania 19010
Chadds Ford, Pennsylvania 19317
Danville, Pennsylvania 17822
Darby, Pennsylvania 19023-1291
Site Public Contact
610-237-4982
Doylestown, Pennsylvania 18901
East Stroudsburg, Pennsylvania 18301
Ephrata, Pennsylvania 17522
Site Public Contact
717-721-4840
Gettysburg, Pennsylvania 17325
Site Public Contact
877-441-7957
Hanover, Pennsylvania 17331
Site Public Contact
877-441-7957
Harrisburg, Pennsylvania 17109
Hazleton, Pennsylvania 18201
Hershey, Pennsylvania 17033-0850
Jefferson Hills, Pennsylvania 15025
Kittanning, Pennsylvania 16201
Site Public Contact
724-543-8682
Lebanon, Pennsylvania 17042
Lewisburg, Pennsylvania 17837
Lewistown, Pennsylvania 17044
Media, Pennsylvania 19063
Monroeville, Pennsylvania 15146
Site Public Contact
412-858-7746
Natrona Heights, Pennsylvania 15065
Site Public Contact
724-226-7380
Paoli, Pennsylvania 19301
Philadelphia, Pennsylvania 19107
Site Public Contact
215-955-6084
Philadelphia, Pennsylvania 19111
Site Public Contact
215-728-4790
Philadelphia, Pennsylvania 19114
Site Public Contact
215-612-5296
Philadelphia, Pennsylvania 19124
Philadelphia, Pennsylvania 19140
Site Public Contact
215-728-2983
Philadelphia, Pennsylvania 19141
Site Public Contact
215-456-3880
Pittsburgh, Pennsylvania 15212
Site Public Contact
877-284-2000
Pittsburgh, Pennsylvania 15224
Site Public Contact
412-578-5000
Pittsburgh, Pennsylvania 15232
Site Public Contact
412-647-8073
Pottsville, Pennsylvania 17901
Reading, Pennsylvania 19605
Sayre, Pennsylvania 18840
Site Public Contact
800-836-0388
Scranton, Pennsylvania 18508
Site Public Contact
570-342-3675
Scranton, Pennsylvania 18510
Selinsgrove, Pennsylvania 17870
State College, Pennsylvania 16801
State College, Pennsylvania 16803
West Chester, Pennsylvania 19380
Site Public Contact
610-431-5297
West Reading, Pennsylvania 19611
Site Public Contact
610-988-9323
Wexford, Pennsylvania 15090
Wilkes-Barre, Pennsylvania 18711
Wynnewood, Pennsylvania 19096
York, Pennsylvania 17403
Site Public Contact
877-441-7957
York, Pennsylvania 17403
Site Public Contact
877-441-7957
Anderson, South Carolina 29621
Easley, South Carolina 29640
Florence, South Carolina 29506
Gaffney, South Carolina 29341
Georgetown, South Carolina 29440
Greenville, South Carolina 29601
Greenville, South Carolina 29605
Greenville, South Carolina 29605
Greenville, South Carolina 29605
Greenville, South Carolina 29607
Greenville, South Carolina 29615
Greenwood, South Carolina 29646
Greer, South Carolina 29650
Greer, South Carolina 29651
Hilton Head Island, South Carolina 29926-3827
Rock Hill, South Carolina 29732
Site Public Contact
800-804-9376
Seneca, South Carolina 29672
Spartanburg, South Carolina 29303
Spartanburg, South Carolina 29307
Union, South Carolina 29379
Rapid City, South Dakota 57701
Bristol, Tennessee 37620
Kingsport, Tennessee 37660
Kingsport, Tennessee 37660
Nashville, Tennessee 37208
Abilene, Texas 79601
Site Public Contact
325-670-6340
Abilene, Texas 79606
Amarillo, Texas 79106
Austin, Texas 78705
Site Public Contact
512-421-4163
Austin, Texas 78731
Site Public Contact
512-427-9400
Austin, Texas 78745
Site Public Contact
512-447-2202
Bedford, Texas 76022
Site Public Contact
817-359-9000
Bryan, Texas 77802
Dallas, Texas 75230
Site Public Contact
972-566-7790
Denton, Texas 76210
Site Public Contact
940-382-1022
El Paso, Texas 79915
Flower Mound, Texas 75028
Site Public Contact
972-537-4100
Grapevine, Texas 76053
Houston, Texas 77030
Houston, Texas 77094
Longview, Texas 75601
Site Public Contact
903-757-2122
Lubbock, Texas 79410
McAllen, Texas 78503
McKinney, Texas 75071
Site Public Contact
972-542-8609
Midland, Texas 79701
Nassau Bay, Texas 77058
Odessa, Texas 79761
Site Public Contact
800-360-5045
Paris, Texas 75460
Plano, Texas 75075
Site Public Contact
972-867-3577
Plano, Texas 75093
Round Rock, Texas 78681
Site Public Contact
512-341-8724
San Antonio, Texas 78229
Sherman, Texas 75090
Site Public Contact
903-868-4700
Sugar Land, Texas 77478
Sugar Land, Texas 77479
Site Public Contact
281-277-5200
The Woodlands, Texas 77380
Site Public Contact
888-864-4226
The Woodlands, Texas 77384
Tyler, Texas 75702
Site Public Contact
903-579-9800
Waco, Texas 76712
Webster, Texas 77598
Wichita Falls, Texas 76310
Site Public Contact
940-691-8271
American Fork, Utah 84003
Cedar City, Utah 84720
Farmington, Utah 84025
Logan, Utah 84321
Murray, Utah 84107
Ogden, Utah 84403
Provo, Utah 84604
Riverton, Utah 84065
Saint George, Utah 84770
Salt Lake City, Utah 84106
Salt Lake City, Utah 84112
Salt Lake City, Utah 84143
South Jordan, Utah 84009
Berlin, Vermont 05602
Site Public Contact
802-225-5400
Burlington, Vermont 05401
Burlington, Vermont 05405
Bristol, Virginia 24201
Burke, Virginia 22015
Fishersville, Virginia 22939
Site Public Contact
540-332-5960
Fredericksburg, Virginia 22408
Gloucester, Virginia 23061
McLean, Virginia 22102
Site Public Contact
240-632-4284
Mechanicsville, Virginia 23116
Midlothian, Virginia 23114
Newport News, Virginia 23601
Norton, Virginia 24273
Richmond, Virginia 23226
Richmond, Virginia 23230
Richmond, Virginia 23298
South Hill, Virginia 23970
Virginia Beach, Virginia 23454
Williamsburg, Virginia 23185
Winchester, Virginia 22601
Aberdeen, Washington 98520
Auburn, Washington 98001
Bainbridge Island, Washington 98110
Bellevue, Washington 98004
Bellingham, Washington 98225
Bremerton, Washington 98310
Bremerton, Washington 98310
Burien, Washington 98166
Centralia, Washington 98531
Edmonds, Washington 98026
Enumclaw, Washington 98022
Everett, Washington 98201
Federal Way, Washington 98002
Federal Way, Washington 98003
Gig Harbor, Washington 98335
Issaquah, Washington 98029
Kennewick, Washington 99336
Lacey, Washington 98503
Lakewood, Washington 98499
Longview, Washington 98632
Lynnwood, Washington 98036
Port Townsend, Washington 98368
Site Public Contact
360-344-3091
Poulsbo, Washington 98370
Puyallup, Washington 98372
Renton, Washington 98055
Seattle, Washington 98101
Seattle, Washington 98104
Seattle, Washington 98107
Seattle, Washington 98122-4307
Seattle, Washington 98122-5711
Shelton, Washington 98584
Spokane Valley, Washington 99216
Spokane, Washington 99204
Spokane, Washington 99218
Tacoma, Washington 98405
Tacoma, Washington 98405
Vancouver, Washington 98664
Vancouver, Washington 98684
Walla Walla, Washington 99362
Yakima, Washington 98902
Yelm, Washington 98597
Bridgeport, West Virginia 26330
Charleston, West Virginia 25304
Site Public Contact
304-388-9944
Huntington, West Virginia 25701
Site Public Contact
304-399-6617
Martinsburg, West Virginia 25401
Morgantown, West Virginia 26506
Parkersburg, West Virginia 26101
Princeton, West Virginia 24740
Site Public Contact
304-487-7515
Antigo, Wisconsin 54409
Ashland, Wisconsin 54806
Ashland, Wisconsin 54806
Brookfield, Wisconsin 53045
Burlington, Wisconsin 53105
Chippewa Falls, Wisconsin 54729
Eau Claire, Wisconsin 54701
Fond Du Lac, Wisconsin 54937
Franklin, Wisconsin 53132
Germantown, Wisconsin 53022
Grafton, Wisconsin 53024
Green Bay, Wisconsin 54301-3526
Matthew L. Ryan
920-433-8889
Green Bay, Wisconsin 54301
Green Bay, Wisconsin 54303
Matthew L. Ryan
920-433-8889
Green Bay, Wisconsin 54303
Green Bay, Wisconsin 54311
Janesville, Wisconsin 53547
Site Public Contact
800-928-1103
Kenosha, Wisconsin 53142
La Crosse, Wisconsin 54601
Ladysmith, Wisconsin 54848
Manitowoc, Wisconsin 54221
Site Public Contact
920-320-2749
Marinette, Wisconsin 54143
Marshfield, Wisconsin 54449
Mequon, Wisconsin 53097
Milwaukee, Wisconsin 53209
Milwaukee, Wisconsin 53211
Milwaukee, Wisconsin 53215
Milwaukee, Wisconsin 53233
Minocqua, Wisconsin 54548
Mukwonago, Wisconsin 53149
New Richmond, Wisconsin 54017
Oconomowoc, Wisconsin 53066
Site Public Contact
262-928-7878
Oconto Falls, Wisconsin 54154
Oshkosh, Wisconsin 54904
Racine, Wisconsin 53405
Racine, Wisconsin 53406
Rice Lake, Wisconsin 54868
Sheboygan, Wisconsin 53081
Sheboygan, Wisconsin 53081
Stevens Point, Wisconsin 54482
Sturgeon Bay, Wisconsin 54235-1495
Sturgeon Bay, Wisconsin 54235
Matthew L. Ryan
920-433-8889
Summit, Wisconsin 53066
Two Rivers, Wisconsin 54241
Waukesha, Wisconsin 53188
Site Public Contact
262-928-7632
Waukesha, Wisconsin 53188
Wausau, Wisconsin 54401
Site Public Contact
877-405-6866
Wausau, Wisconsin 54401
Wauwatosa, Wisconsin 53226
Wauwatosa, Wisconsin 53226
West Allis, Wisconsin 53227
Weston, Wisconsin 54476
Wisconsin Rapids, Wisconsin 54494
Site Public Contact
715-422-7718
Wisconsin Rapids, Wisconsin 54494
Cheyenne, Wyoming 82001
Cody, Wyoming 82414
Sheridan, Wyoming 82801
More Details
- NCT ID
- NCT02488967
- Status
- Recruiting
- Sponsor
- NRG Oncology
Detailed Description
PRIMARY OBJECTIVES: I. To determine whether the addition of carboplatin to an adjuvant chemotherapy regimen of doxorubicin (doxorubicin hydrochloride)/cyclophosphamide followed by paclitaxel will improve the invasive disease-free survival (IDFS) compared to doxorubicin/cyclophosphamide followed by paclitaxel when administered to patients with operable node-positive or high-risk node-negative triple-negative breast cancer. SECONDARY OBJECTIVES: I. To determine whether the addition of carboplatin to an adjuvant chemotherapy regimen of doxorubicin/cyclophosphamide followed by paclitaxel will improve the overall survival (OS) compared to doxorubicin/cyclophosphamide followed by paclitaxel when administered to patients with operable node-positive or high-risk node-negative triple-negative breast cancer. II. To determine whether the addition of carboplatin to an adjuvant chemotherapy regimen of doxorubicin/cyclophosphamide followed by paclitaxel will improve the breast cancer-free survival (BCFS) compared to doxorubicin/cyclophosphamide followed by paclitaxel when administered to patients with operable node-positive or high-risk node-negative triple-negative breast cancer. III. To determine whether the addition of carboplatin to an adjuvant chemotherapy regimen of doxorubicin/cyclophosphamide followed by paclitaxel will improve the recurrence-free interval (RFI) compared to doxorubicin/cyclophosphamide followed by paclitaxel when administered to patients with operable node-positive or high-risk node-negative triple-negative breast cancer. IV. To determine whether the addition of carboplatin to an adjuvant chemotherapy regimen of doxorubicin/cyclophosphamide followed by paclitaxel will improve the distant recurrence-free interval (DRFI) compared to doxorubicin/cyclophosphamide followed by paclitaxel when administered to patients with operable node-positive or high-risk node-negative triple-negative breast cancer. V. To determine the toxicity of doxorubicin/cyclophosphamide followed by paclitaxel administered concurrently with carboplatin compared to the toxicity of doxorubicin/cyclophosphamide followed by paclitaxel alone. VI. To determine if germline breast cancer (BRCA) status is associated with benefit in IDFS or OS from the addition of carboplatin to an adjuvant chemotherapy regimen of doxorubicin/cyclophosphamide followed by paclitaxel in patients with operable node-positive or high-risk node-negative triple-negative breast cancer. VII. To determine if the addition of carboplatin will improve the RFI among the homologous recombination (HR) deficient patients as determined by the homologous recombination deficiency (HRD) score. VIII. To determine whether the efficacy of carboplatin on RFI in HR-deficient patients differs from that in patients who are not HR-deficient. IX. To collect tissue and blood samples at several occasions for future biomarkers development in predicting risk of breast cancer recurrence in patients with operable node-positive or high-risk node-negative triple-negative breast cancer treated with doxorubicin/cyclophosphamide followed by paclitaxel with or without carboplatin and predicting benefit from the addition of carboplatin among these patients. OUTLINE: Patients are randomized to 1 of 2 treatment arms. ARM I (DOXORUBICIN HYDROCHLORIDE [A] CYCLOPHOSPHAMIDE [C]-->WEEKLY PACLITAXEL [WP]): Patients receive doxorubicin hydrochloride intravenously (IV) over 15 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 2 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. Patients then receive paclitaxel IV over 60 minutes on day 1. Treatment repeats weekly for 12 courses in the absence of disease progression or unacceptable toxicity. ARM II (AC-->WP + CARBOPLATIN): Patients receive doxorubicin hydrochloride and cyclophosphamide as in Arm I. Patients then receive paclitaxel IV over 60 minutes on days 1, 8, and 15 and carboplatin IV over 30-60 minutes on day 1. Treatment repeats every 3 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 6 months for 5 years and then every 12 months for 5 years.