The Cancer Research Department at the Coborn Cancer Center opens new clinical trials on a regular basis. Please contact the research staff at (320) 229-4907 for information on these or additional studies that may be open and available to treat, control or prevent cancer. A sample of cancer research trials currently open to enrollment at the Coborn Cancer Center is listed below.

Treatment Trials

Breast	Esophagus or Gastric	Lung	Ovarian
Bladder	Head and Neck	Lymphoma	Pancreatic
Carcinoid	Hematology	Melanoma	Prostate
Central Nervous System	Leukemia	Myeloma	Renal
Colon and Rectal

Breast

B-47 / A Randomized Phase III Trial of Adjuvant Therapy Comparing Chemotherapy Alone (Six Cycles of Docetaxel Plus Cyclophosphamide or Four Cycles of Doxorubicin Plus Cyclophosphamide Followed by Weekly Paclitaxel) to Chemotherapy Plus Trastuzumab in Women with Node-Positive or High-Risk Node-Negative HER2-Low Invasive Breast Cancer

The main purpose of this study is to learn if adding a targeted therapy, trastuzumab (Herceptin®), to standard treatment with chemotherapy for early stage, HER2-low breast cancer, will prevent breast cancer from returning.

N0937 / Phase II Trial of Brostallicin and Cisplatin in Patients with Metastatic Triple Negative Breast Cancer

This purpose of this research study is to:
• Find out what effects the study treatment has on cancer
• Look at the safety of chemotherapy treatment with cisplatin in combination with brostallicin

MA. 32 / A Phase III Randomized Trial of Metformin Versus Placebo on Recurrence and Survival in Early Stage Breast Cancer

This study is looking at whether Metformin, an agent that is commonly used to treat diabetes, can decrease or affect the ability of breast cancer cells to grow and whether Metformin will work with other therapy to keep cancer from recurring. Health Canada has not approved the sale or use of Metformin to treat breast cancer, although they have approved its use in this clinical trial. Although Metformin is approved by the FDA for the treatment of diabetes, its use in breast cancer is considered investigational.

S1007 / A Phase III Randomized Clinical Trial of Standard Adjuvant Endocrine Therapy +/ Chemotherapy in Patients with 1-3 Positive Nodes, Hormone Receptor-Positive and
HER2-Negative Breast Cancer with Recurrence Score of 25 or Less.

We are using the Oncotype DX® to determine whether patients are eligible to continue to the treatment part of this clinical trial. We are asking that you give permission for your breast cancer tissue to be tested.

If the recurrence score is higher than 25, the risk that the cancer may come back is higher than the limit we will be testing in the treatment part of this study. In this case, we ask that you discuss other treatment studies with your study doctor.

If the recurrence score is 25 or lower, we ask that you discuss participation in this study with your study doctor and consider joining the study. If you choose not to join the study, we will also ask you to let us know what kind of treatment you have chosen.

S0221 / Phase III Trial of Continuous Schedule AC + G Vs. Q 2 Week Schedule AC, Followed by Paclitaxel Given Either Every 2 Weeks or Weekly for 12 Weeks as Post-Operative Adjuvant Therapy in Node-Positive or High-Risk Node-Negative Breast Cancer

The main purpose of this study is to compare the effects (good and bad) of two different treatments (or “regimens”) for breast cancer.  These two treatments include essentially the same drugs given in different ways and on different schedules.  All of the treatments use standard, commercially available medicines that are known to be effective for treating breast cancer. 

B-43 / A Phase III Clinical Trial Comparing Trastuzumab Given Concurrently with Radiation Therapy and Radiation Therapy Alone for Women with HER-2 Positive Ductal Carcinoma in Situ Resected by Lumpectomy

This study is being done to compare the effects, good and/or bad, of adding the drug trastuzumab (also called Herceptin®) to breast radiation therapy. Radiation therapy is the standard treatment for patients with DCIS.

This study will find out if adding trastuzumab to breast radiation therapy is more effective than radiation therapy without trastuzumab in preventing occurrence of breast cancer in the same breast, in the other breast, or in other parts of the body in patients with HER2-positive DCIS.

N0733 / Randomized Phase II Trial of Capecitabine and Lapatinib with or without IMC-A12 in Patients with HER2 Positive Breast Cancer Previously Treated with Trastuzumab and an Anthracycline and/or Taxane

Capecitabine (Xeloda®) plus lapatinib (Tykerb®) is a standard treatment for HER2 positive metastatic breast cancer. The purpose of this research study is to find out if a new drug, IMC-A12, can make the treatment with capecitabine and lapatinib work better. The purpose is also to see what effects IMC-A12 has when combined with this capecitabine plus lapatinib.

S0500 / A Randomized Phase III Trial to Test the Strategy of Changing Therapy Versus Maintaining Therapy for Metastatic Breast Cancer Patients Who Have Elevated Circulating Tumor Cell Levels at First Follow-up Assessment

The purpose of this experimental study is to find out if the CellSearch™ blood test, which identifies tumor cells in the blood, can predict survival outcome in patients with metastatic breast cancer. These tumor cells are called circulating tumor cells (CTCs). The CellSearch™ blood test may allow doctors to tell if current chemotherapy is not working before the patient shows signs that that the cancer is getting worse. This is based upon a prior study that showed that most women with high numbers of CTCs had worsening of their breast cancer within 1-3 months. In this prior study, increase in the size of a tumor or spread of cancer in the body was determined by standard clinical tests such as physical examinations, x-rays and scans, and not by the CellSearch™ blood test. This study will test whether switching to another form of treatment based upon the results of the CellSearch™ blood test helps people live longer. In addition, this study will be used to further confirm results of the prior study, which showed that patients with < 5 CTCs before they begin treatment are more likely to live longer than those with ≥ 5 CTCs.

B-39/RTOG 0413 / A Randomized Phase III Study of Conventional Whole Breast
Irradiation (WBI) Versus Partial Breast Irradiation (PBI) for Women with Stage 0, I, or II Breast Cancer

The purpose of this study is to see if partial breast irradiation (PBI) is as good as or better than whole breast irradiation (WBI) in keeping cancer from coming back in the breast.

Bladder

C90601 / A Randomized Double-Blind Phase III Comparing Gemcitabine, Cisplatin and Bevacizumab to Gemcitabine, Cisplatin and Placebo in Advanced Transitional Cell Carcinoma

The purpose of this study is to compare the effects of the combination of the chemotherapy drugs gemcitabine and cisplatin (chemotherapy) with the combination of gemcitabine, cisplatin, and the experimental drug bevacizumab on transitional cell cancer to find out which is better. Bevacizumab is an antibody that we think can block a protein called VEGF and inhibit the growth of new blood vessels. Bevacizumab has been approved by the FDA for the treatment of metastatic colorectal, lung, and breast cancer, but for transitional cell carcinoma, it is not FDA-approved and should be considered experimental.

Carcinoid

S0518 / "Phase III Prospective Randomized Comparison of Depot Octreotide Plus Interferon Alpha Versus Depot Octreotide Plus Bevacizumab in Advanced, Poor Prognosis Carcinoid Patients"

The purpose of this study is to compare the effects, good and/or bad, of octreotide plus bevacizumab with octreotide plus interferon on carcinoid tumors to find out which is better. In this study, you will get either the bevacizumab or the interferon. You will not get both. Interferon is considered an accepted treatment for carcinoid tumors. Octreotide is an accepted treatment for carcinoid tumor and is a standard treatment for carcinoid syndrome. The combination of octreotide and interferon is considered a standard option even for patients who have progressed on octreotide alone. Bevacizumab is considered experimental for treating patients with carcinoid tumors.

Central Nervous System (Brain)

N0874 / Phase I/II Study of Varinostat (Suberoylanilide Hydroxamic Acid [SAHA]), Temozolomide, and Radiation Therapy in Patients with Newly Diagnosed Glioblastoma

The purpose of this research study is to see how well vorinostat works against glioblastoma and gliosarcoma when it is given in combination with temozolomide and radiation therapy. Temozolomide and radiation therapy are standard treatments for glioblastomas and gliosarcomas.  Vorinostat is a drug that may stop cancer cells from growing abnormally and may help temozolomide and radiation therapy to work against the tumor. This drug has been used in treatment for other cancers, and it has been used with temozolomide against brain tumors.  Information from those other research studies suggests that vorinostat may help to slow or stop the growth of brain tumors in this research study.

N0872 / Phase I/Randomized Phase II Double Blind Study of Either Dasatinib or Placebo Combined with Bevacizumab in Recurrent Glioblastoma

The purpose of this research study is to: 

• Find out what effects, good and/or bad, the combination of dasatinib and bevacizumab have on cancer.
• Find out if the combination of dasatinib and bevacizumab can help you get better.
• Find out if there are individual differences and/or tumor characteristics that will affect response to treatment.
  
  The use of dasatinib and bevacizumab in this study is considered investigational.

N0572 / Phase I/II Trial of Sorafenib and CCI-779 in Patients with Recurrent Glioblastoma

This study is being done:
• To find out what effects sorafenib and CCI-779 have on brain tumors
• To compare the response to sorafenib and CCI-779 with laboratory studies of the patients blood cells and tumor tissues
• To look at sorafenib and CCI-779’s ability to slow down the growth of brain tumors.

Sorafenib and CCI-779 are experimental drugs not yet approved by the Food and Drug Administration.

Esophagus or Gastric (Stomach)

There are no current esophagus/gastric studies.

Colon and Rectal

RC0948 / The Oncotype DX® Colon Cancer Assay for Stage II Colon Carcinoma: Does it Impact Physician Adjuvant Treatment Decision Making and Patient Satisfaction?

The purpose of this study is to determine whether a test called Oncotype DX® Colon Cancer Assay helps physicians and patients decide whether you might need chemotherapy.  Some patients with stage II colon cancer receive chemotherapy after the cancer has been surgically removed.  These decisions may be based on an overall assessment of risks of colon cancer recurrence, age of the patient, anticipated tolerance of chemotherapy, and other factors. However, in general, only a small minority of patients with stage II colon cancer benefit from chemotherapy.

N0949 / Randomized Phase III Trial of mFOLFOX or XELOX plus Bevacizumab versus 5-FU/Leucovorin or Capecitabine plus Bevacizumab as First Line Treatment in Elderly Patients with Metastatic Colorectal Cancer

In general, clinical trials usually enroll significantly more younger patients (<70 years old) than older patients (≥70 years old), so it’s not clear if the current day therapies for metastatic colorectal cancer need to include oxaliplatin in the treatment of older patients. This is of particular importance since oxaliplatin can affect the nerve system with loss of sensation in hands and feet which can affect activities of daily living, in particular, in elderly patients. The purpose of this research study is to compare the length of time during and after treatment that metastatic colorectal cancer does not get worse in older patients treated with bevacizumab plus either 5-fluorouracil/leucovorin or capecitabine without oxaliplatin or in patients treated with bevacizumab plus 5-fluorouracil/leucovorin or capecitabine with oxaliplatin.

C80702 / A Phase III Trial of 6 Versus 12 Treatments of Adjuvant FOLFOX plus Celecoxib or Placebo for Patients with Resected Stage III Colon Cancer

This study is being done to evaluate the effects of different chemotherapy treatments. One of the common combinations of chemotherapy drugs used to treat your type of cancer includes 5-fluorouracil (also called 5-FU), leucovorin and oxaliplatin, and is also called “FOLFOX”. At the present time, the Food and Drug Administration (FDA) has approved each of these drugs as treatment for colon cancer. FOLFOX is a standard treatment used to prevent colon cancer from coming back (recurrence).

C80405 / Phase III Trial of Inrinotecan/5-FU/Leucovorin or Oxaliplatin/5-FU/Leucovorin with Bevacizumab or Cetuximab (C225) for Patients with Untreated Metastatic Adenocarcinoma of the Colon or Rectum

This study is being done to evaluate the effects of different regimens of chemotherapy. There are two common combinations of chemotherapy drugs: One uses 5-fluorouracil (also called 5-FU), leucovorin and oxaliplatin, and is also called “FOLFOX;”the other combination uses 5-FU, leucovorin, and irinotecan, this combination is also called “FOLFIRI.” At the present time, the Food and Drug Administration (FDA) has approved each of these as treatment for colon or rectal cancer.

The FDA has also approved the use of a drug called bevacizumab (or Avastin) in combination with these chemotherapy regimens. Bevacizumab plus either of these chemotherapy regimens is considered the standard of care for most patients.

Cetuximab is approved by the FDA for the treatment of colorectal cancer in patients who have developed progressive cancer following the use of irinotecan. Recent studies, however, have shown that people who have a mutation (an abnormality) in a gene in their tumor tissue called K-ras do not appear to benefit from treatment with cetuximab or other similar drugs. Another recent study has shown that adding cetuximab to a regimen of bevacizumab and chemotherapy does not appear to help patients with colorectal cancer, however, that study included patients who had K-ras mutations in their tumors.

The purpose of this study is to determine whether cetuximab plus chemotherapy is better than bevacizumab with chemotherapy in patients who do not have K-ras mutations in their tumor tissue.

Prostate

C70807 / The Men’s Eating and Living (MEAL) Study: A Randomized Trial of Diet to Alter Disease Progression in Prostate Cancer Patients on Active Surveillance

The purpose of the study is to find out more about how diet may prevent prostate cancer from getting worse.

E3805 / CHAARTED: ChemoHormonal Therapy versus Androgen Ablation Randomized Trial for Extensive Disease in Prostate Cancer

The purpose of this study is to evaluate a new way of treating patients with prostate cancer. In Arm A, the patient will receive docetaxel chemotherapy both at the time of starting hormonal therapy and later when/if the hormonal therapy is no longer working per the doctor’s decision. In Arm B, patients only get chemotherapy when/if the hormonal therapy is no longer working per the doctor’s decision. We are doing the study to see if there is a benefit to giving chemotherapy at the beginning.

RTOG 0534 / Phase III Trial of Short Term Androgen Deprivation with Pelvic Lymph Node or Prostate Bed Only Radiotherapy (SPORT) in Prostatic Cancer Patients with a Rising PSA After Radical Prostatectomy

The purpose of this study is to compare the effects of three treatment methods on participants and their cancer. 

There are 3 treatment groups in this study:
1)   Patients who receive radiation therapy to the prostate bed only;
2)   Patients who receive hormone therapy for 4 to 6 months plus radiation therapy to the prostate bed;
3)   Patients who receive hormone therapy for 4 to 6 months plus radiation therapy to the prostate bed and to the pelvic lymph nodes.

CALBG 90203 / Randomized Phase III Study of Neo-Adjuvant Docetaxel and Androgen Deprivation Prior to Radical Prostatectomy versus Immediate Radical Prostatectomy in Patients with High-Risk, Clinically Localized Prostate Cancer

The purpose of this study is to compare the effects (good and bad) of the combination of chemotherapy and hormone therapy followed by radical prostatectomy (surgery to remove your prostate) with radical prostatectomy alone to see which is better.

Renal (Kidney)

S0931/ "EVEREST:  EVErolimus for Renal Cancer Ensuing Surgical Therapy, a Phase III Study"

The purpose of this study is to see whether treatment with everolimus after surgery for kidney cancer will increase the time without cancer returning.  The current standard treatment after surgery is careful monitoring with no immediate treatment.  Studies suggest that one way kidney cancer may grow is through chemical signaling through a protein named “mTOR”.  Everolimus is a drug that stops signaling through mTOR and may therefore stop the growth of kidney cancer.  Everolimus is a drug currently approved for the treatment of patients with advanced or metastatic kidney cancer.  It is considered investigational for use after surgery.  In this study, you will get either everolimus or placebo (a pill with no medication). 

C90802 / Randomized Phase III Trail Comparing Everolimus Plus Placebo Versus Everolimus Plus Bevacizumab for Advanced Renal Cell Carcimona Progressing After Treatment with Tyrosine Kinase Inhibitors.

The purpose of this study is to compare the effects of a drug called everolimus alone with those of the combination of everolimus and a drug called bevacizumab for advanced kidney cancer to find out which is better. In this study, you will get either the combination of everolimus and a placebo or the combination of everolimus and bevacizumab.

Lymphoma

There are no current lymphoma studies.

Lung

Non Small Cell Lung

H3E-US-S130 / A Randomized, Open Label, Phase 3 Study of Pemetrexed plus Carboplatin followed by Maintenance Pemetrexed plus vs Paclitaxel plus Carboplatin and Bevacizumab followed by Maintenance Bevacizumab in Patients with Advanced Non-Small Cell Lung Cancer of Non-squamous Histology

The primary purpose of this study is to help answer the following research question:
• How treatment with pemetrexed plus carboplatin followed by additional pemetrexed compares to treatment with paclitaxel plus carboplatin plus bevacizumab followed by additional bevacizumab.

Small Cell Lung

N0923 / A Randomized, Double-Blinded Phase II Study of NTX-010, a Replication-Competent Picornvirus, After Standard Platinum-Containing Cytoreductive Induction Chemotherapy in Patients with Extensive Stage Small Cell Lung Cancer

The purpose of this research study is to:
• Find out if NTX010 will help improve survival.
• Find out what effects NTX-010 has on small cell lung cancer.
• Find out if there are individual differences and/or tumor characteristics that will affect response to treatment.

The agent, NTX-010, a live virus, used in this study is considered investigational, which means it has either not been approved by the Food and Drug Administration (FDA) for routine clinical use or for the use described in this study. However, the National Cancer Institute and the FDA have approved the use of this agent for this study.

Melanoma

E1609 / A Phase III Randomized Study of Adjuvant Ipilimumab Anti-CTLA4 Therapy Versus High-Dose Interferon α-2b for Resected High-risk Melanoma

The purpose of this study is to compare the effects, good and/or bad, of ipilimumab with interferon alfa-2b on melanoma to find out which is better. In this study, you will get either ipilimumab or the interferon alfa-2b. You will not get both. We plan to determine whether ipilimumab stops or delays your cancer from returning in comparison to interferon alfa-2b

N0879 / A Randomized Phase II Trial of Carboplatin, Paclitaxel, Bevacizumab with or without Everolimus for Therapy of Metastatic Malignant Melanoma

This research study is being done to:
• Find out what effects the combination of study drugs has on melanoma
Group A: Carboplatin, paclitaxel, and bevacizumab
Group B: Carboplatin, paclitaxel, bevacizumab, and everolimus.
• Find out what effects the combination of study drugs has on the immune system and the way the tumor grows

Paclitaxel, carboplatin, bevacizumab, and everolimus are chemotherapy drugs that are FDA approved to treat certain types of cancer. However, the drugs and combinations listed above have not been approved for the treatment of melanoma; so their use in this study is considered investigational.

Head and Neck

E1305 / A Phase III Randomized Trial of Chemotherapy with or without Bevacizumab In Patients with Recurrent Or Metastatic Head and Neck Cancer

The purpose of this study is to compare the effects of the addition of a drug called bevacizumab to the standard chemotherapy to see which works better. We will determine if the combination of standard chemotherapy (cisplatin and docetaxel or cisplatin and 5-FU) and bevacizumab can increase the effectiveness of treatment for head and neck cancer. This combination is experimental. We will determine if the adding bevacizumab to standard therapy produces results that are better than those we would ordinarily expect. Currently, we do not know whether using bevacizumab will be effective. This is a subject of this study. Bevacizumab is approved by the Food and Drug Administration (FDA) for another type of cancer, colorectal cancer, but is not approved for head and neck cancer.

Hematology

E2905 / Randomized Phase III Trial Comparing the Frequency of Major Erythroid Response (MER) to Treatment with Lenalidomide (Revlimid) Alone and in Combination with Epoetin Alfa (Procrit) in Subjects with Low or Intermediate-1 Risk MDS and Symptomatic Anemia.

This study is being done to determine if the combination of treatment with epoetin alfa and lenalidomide is better than lenalidomide alone in improving red blood cell production and in relieving the need for red blood cell transfusions in patients with MDS (myelodysplastic syndrome).

Leukemia

RC0783 / Randomized Phase II Trial of Pentostatin, Cyclophosphamide, and Rituximab With or Without Concurrent Avastin® for Previously Untreated B-Chronic Lymphocytic Leukemia (CLL)

The purpose of this research study is to learn about the effectiveness and side effects of Pentostatin, Cyclophosphamide, and Rituximab (PCR) with or without a fourth medicine, Avastin®, for previously untreated B-chronic lymphocytic leukemia.

Myeloma

S0777A / Randomized Phase III Trial of Lenalidomide and Low Dose Dexamethasone (LLD) Versus Bortezomib, Lenalidomide and Low Dose Dexamethasone (BLLD) for Induction, in Patients with Previously Untreated Multiple Myeloma Without an Intent for Immediate Autologous Stem Cell Transplant

The purpose of this study is to compare the effectsof a two-drug combination (CC-5013 [lenalidomide] and low dose dexamethasone, also called "LLD") with a three-drug combination (CC-5013 [lenalidomide], low dose dexamethasone, and a new drug called bortezomib ([Velcade], also called "BLLD"). CC-5013 (lenalidomide) and bortezomib are both experimental drugs. We are comparing these two different combinations of drugs to evaluate whether they can stop or slow down the progression of cancer, and if so, which one is more effective.

Ovarian

There are no current ovarian studies.

Pancreatic

There are no current pancreatic studies.

Control Trials

N107C / A Phase III Trial of Post-Surgical Stereotactic Radiosurgery (SRS) Compared with Whole Brain Radiotherapy (WBRT) for Resected Metastatic Brain Disease

The purpose of this research study is to compare overall survival and to compare the effects (good and bad) of stereotactic radiosurgery (SRS) to whole brain radiation therapy (WBRT) on you and your brain metastases.

N10C1 / Vaginal DHEA for Vaginal Symptoms: A Phase III Randomized, Double Blind, Placebo-Controlled Trial

The purpose of this research study is to determine the effectiveness of daily vaginal DHEA gel over 12 weeks to improve vaginal symptoms of dryness or pain with intercourse. Two different doses of DHEA will be tested, in addition to a placebo, as part of this study. DHEA is a substance made naturally by the adrenal gland. It is a substance that is sold as a dietary supplement and is not regulated by the Food and Drug Administration (FDA) like other drugs. For this study, the FDA has been notified and has given permission to study it in this way. DHEA can be changed into estrogen or testosterone in various body tissues. Previous studies in postmenopausal women without a history of cancer have shown that DHEA gel inserted into the vagina can help make vaginal tissue less dry and the cells more mature, like they were when estrogen was present. These studies have shown that DHEA gel in the vagina can do this without increasing levels of hormones in the blood. The placebo will be a gel without any active ingredients in it, such as DHEA.

N07C4 / A Phase II trial evaluating two non-pharmacologic interventions in cancer survivors for the treatment of sleep-wake disturbances

The purpose of this research study is to:
• Look at the effect of two types of behavioral interventions to improve sleep.

Behavioral interventions are things people can do by themselves to try and improve a symptom, such as sleep.  Exercise is an example of a behavioral intervention that is used to improve fatigue.  The two types of behavioral interventions being tested in this study is the use of two types of pre-recorded mp3 device as well as following some rules related to sleep. 

N09C6 / Randomized Double-Blind Study of Doxepin Rinse versus Placebo in the Treatment of Acute Oral Mucositis Pain in Patients Receiving Radiotherapy with or without Chemotherapy

The purpose of this research study is to:
• Learn if taking the study drug, doxepin, which is a mouth rinse, is effective in reducing mouth pain in patients undergoing radiation therapy to the head and neck.
• Compare the effects, good and/or bad, of taking doxepin compared to a placebo (inactive agent) while receiving radiation therapy to the head and neck.

C70604 / A Randomized, Phase III Study of Standard Dosing versus Longer Dosing Interval of Zoledronic Acid in Metastatic Cancer

The purpose of this study is to compare the effects of less frequent treatment (every 12 weeks) with zoledronic acid (Zometa) compared to standard treatment (every 4 weeks) with zoledronic acid.

RTOG 0433 / A Phase III International Randomized Trial of Single Versus Multiple Fractions For Re-Irradiation of Painful Bone Metastases

The purpose of this study is to examine the effects of re-irradiation given in a single dose compared to re-irradiation given in multiple smaller doses on people with painful bone metastases.

N0574 / Phase III Randomized Trial of the Role of Whole Brain Radiation Therapy in Addition to Radiosurgery in Patients with One to Three Cerebral Metastases

The purpose of this research study is to compare overall survival and to compare the effects of radiosurgery (SRS) to radiosurgery plus whole brain radiation therapy (WBRT) on brain metastases.

Prevention Trials

There are no current prevention trials.

Registry Trials

AIMMS / Adults in MN with Myelodysplastic Syndrome

This study is being done to learn more about myelodysplastic syndrome. Myelodysplastic syndrome (MDS) is a blood cancer that affects about 10,000 people in the United States each year. Little is known about why MDS happens or why some people with MDS eventually develop leukemia. We are proposing one of the largest epidemiological studies of MDS ever conducted, with the goal of being able to identify risk factors that could lead to prevention.  This case-control epidemiology study was designed to investigate the causes of MDS in Minnesota.