ABSTRACT
Cisplatin 100mg/M2 IV day 1 Gemcitabine 1000 mg/M2 IV days 1,8,15 REF: Byrne et al. J Clin Oncol 1999; 17:25-30 PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy on day 1 2. Dexamethasone 20 mg IV 30 minutes before chemo
therapy on day 1 3. Compazine 10 mg PO/IV 30 minutes before chemotherapy
on days 8 and 15 OTHER MEDICATIONS 1. Give cisplatin delayed-emesis prophylaxis Repeat every 28 days Cisplatin-vigorous hydration is required; can be nephrotoxic and
ototoxic; can cause peripheral neuropathy; hold or reduce for creatinine >1.5
Cisplatin/ mitomycin C
Cisplatin 75 mg/M2 IV day 1 Mitomycin C 10 mg/M2 IV day 1 REF: Chahinian et al. J Clin Oncol 1993; 11:1559-1565 PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy 2. Dexamethasone 20 mg IV 30 minutes before chemo
therapy OTHER MEDICATIONS 1. Give cisplatin delayed-emesis prophylaxis Repeat every 28 days
Cisplatin-vigorous hydration is required; can be nephrotoxic and ototoxic; can cause peripheral neuropathy; hold or reduce for creatinine > 1.5
Mitomycin C-myelosuppression occurs late (approximately 4 weeks); limit cumulative dose to 50 mg/M2 (vascular toxicity)
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Cyclophos phamide/ doxorubicin/ cisplatin
Cyclophosphamide 500 mg/M2 IV dayl Doxorubicin 50 mg/M2 IV day 1 Cisplatin 80 mg/M2 IV dayl -cisplatin dose reduced to 50 mg/M2 after 1st cycle REF: Shin et al. Cancer 1995; 76:2230-2236 PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy 2. Dexamethasone 20 mg IV 30 minutes before chemo
therapy OTHER MEDICATIONS 1. Give cisplatin delayed-emesis prophylaxis Repeat every 21 days Cisplatin-vigorous hydration is required; can be nephrotoxic and
ototoxic; can cause peripheral neuropathy; hold or reduce for creatinine >1.5
Doxorubicin-monitor cumulative dose for cardiac toxicity (not to exceed 550 mg/M2 or 450 mg/M2 with prior chest radiotherapy); vesicant-avoid extravasation; use 50% for bilirubin 1.5-3.0; use 25% for bilirubin > 3.0
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Non-Small-CeU Lung Cancer CP carboplatin/ paclitaxel
Paclitaxel 225 mg/M2 IV (over 3 h) day 1 -followed by Carboplatin AUC 6 IV (over 1 h) day 1 REF: Kelly et al. Proc Amer Soc Clin One 1999; abstract 1777 OR Paclitaxel 175 mg/M2 IV (over 3 h) dayl
-followed by Carboplatin AUC 7 IV (over 1 h) day 1 REF: Kosmidis et al. Ann Oncol 1997; 8:697-699 PREMEDICATIONS 1. Dexamethasone 20 mg IV 30 minutes before chemo
therapy OR Dexamethasone 20 mg PO 6 and 12 hours prior
2. Diphenhydramine 50 mg IV 30 minutes before chemo therapy
3. Cimetidine 300 mg IV 30 minutes before chemotherapy 4. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy OTHER MEDICATIONS
i 1. Give cisplatin delayed-emesis prophylaxis 2. Dexamethasone 4 mg PO BID for 6 doses after chemo
therapy (for myalgias) ! Repeat every 21 days
Cisplatin/ vinblastine
i -followed by XRT Vinblastine 5 mg/M2 IV days 1,8,15,22,29 Cisplatin 100 mg/M2 IV days 1,29 -radiotherapy is started on day 50, to 60 Gy over a 6 week period REF: Dillman et al. NEJM1990; 323:940-945 PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy on days 1 and 29 2. Dexamethasone 20 mg IV 30 minutes before chemo
therapy on days 1 and 29 3. Compazine 10 mg PO/IV 30 minutes before chemotherapy
on days 8,15, and 22
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1. Give cisplatin delayed-emesis prophylaxis Cisplatin-vigorous hydration is required; can be nephrotoxic and
ototoxic; can cause peripheral neuropathy; hold or reduce for creatinine > 1.5
Vinblastine-use 50% of dose for bilirubin > 3.0; vesicant-avoid extravasation
Docetaxel/ cisplatin
Docetaxel 75 mg/M2 IV day 1 cisplatin 75 mg/M2 IV day 1 REF: Schiller et al. Proc ASCO 2000:abstract 2 PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy on day 1 2. Dexamethasone 20 mg IV 30 minutes before chemo
therapy on day 1 3. Cemitidine 300 mg IV 30 minutes before chemotherapy 4. Diphenhydramine 25-50 mg IV 30 minutes before
chemotherapy OTHER MEDICATIONS 1. Give cisplatin delayed-emesis prophylaxis 2. Dexamethasone 8 mg PO BID for 8 doses-start day prior
to chemo (decreases lower extremity edema) Repeat every 21 days Cisplatin-vigorous hydration is required; can be nephrotoxic and
ototoxic; can cause peripheral neuropathy; hold or reduce for creatinine > 1.5
EP (PE) cisplatin/ etoposide
Etoposide 100 mg/M2 IV days 1-3 Cisplatin 100 mg/M2 IV day 1
REF: Cardenal etal. J Clin Oncol 1999; 17:12-18 -there are multiple variants of this regimen PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy on day 1 2. Dexamethasone 20 mg IV 30 minutes before chemo
therapy on day 1 3. Compazine 10 mg PO/IV 30 minutes before chemotherapy
on days 2 and 3 OTHER MEDICATIONS 1. Give cisplatin delayed-emesis prophylaxis Repeat every 21 -28 days
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Agent Dosage Cisplatin-vigorous hydration is required; can be nephrotoxic and
ototoxic; can cause peripheral neuropathy; hold or reduce for creatinine > 1.5
Gemcitabine/ cisplatin
Gemcitabine 1000 mg/M2 IV days 1,8,15 Cisplatin 100 mg/M2 IV dayl REF: Sandler et al. J Clin Oncol 2000; 18:122-130 PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy on day 1 2. Dexamethasone 20 mg IV 30 minutes before chemo
therapy on day 1 3. Compazine 10 mg PO/IV 30 minutes before chemotherapy
on days 8 and 15 OTHER MEDICATIONS 1. Give cisplatin delayed-emesis prophylaxis Repeat every 28 days Cisplatin-vigorous hydration is required; can be nephrotoxic and
ototoxic; can cause peripheral neuropathy; hold or reduce for creatinine > 1.5
Gemcitabine-dosage modifications are based on degree of thrombocytopenia or neutropenia
Gemcitabine/ vinorelbine
Gemcitabine 1200 mg/M2 IV days 1,8 Vinorelbine 30 mg/M2 IV days 1,8 REF: Lorusso et al. J Clin Oncol 2000; 405-411 PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy Repeat every 21 days Vinorelbine-vesicant; avoid extravasation; can cause peripheral
neuropathy MVP mitomycin C/ vinblastine/ cisplatin
Mitomycin C 8 mg/M2 IV day 1 (of every
other course) Vinblastine 6 mg/M2 IV day 1 -maximum dose is 10 mg Cisplatin 50 mg/M2 IV day 1 REF: Ellis et al. Br J Cancer 1995; 71:366-370
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PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy 2. Dexamethasone 20 mg IV 30 minutes before chemo
therapy OTHER MEDICATIONS 1. Give cisplatin delayed-emesis prophylaxis Repeat every 21 days Cisplatin-vigorous hydration is required; can be nephrotoxic and
ototoxic; can cause peripheral neuropathy; hold or reduce for creatinine >1.5
Vinblastine-use 50% of dose for bilirubin > 3.0; vesicant-avoid extravasation
Mitomycin C-myelosuppression occurs late (approximately 4 weeks); limit cumulative dose to 50 mg/M2 (vascular toxicity)
VC vinorelbine/ cisplatin
Vinorelbine 25 mg/M2 IV days 1,8,15,22 Cisplatin 100 mg/M2 IV day 1
REF: Kelly et al. Proc Amer Soc Clin One 1999; abstract 1777 PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy on day 1 2. Dexamethasone 20 mg IV 30 minutes before chemo
therapy on day 1 3. Compazine 10 mg PO/IV 30 minutes before chemotherapy
on days 8,15, and 22 ! OTHER MEDICATIONS 11. Give cisplatin delayed-emesis prophylaxis Repeat every 28 days Vinorelbine-vesicant; avoid extravasation; can cause peripheral
; neuropathy i Cisplatin-vigorous hydration is required; can be nephrotoxic and
ototoxic; can cause peripheral neuropathy; hold or reduce for ! creatinine > 1.5
Docetaxel I Docetaxel 100 mg/M2 IV(over 1 h) day 1 ; REF: Gandara et al. J Clin Oncol 2000; 18:131 -135 OR Docetaxel 75 mg/M2 IV(over 1 h) day 1 REF: Fossella et al. J Clin Oncol 2000; 18:2354-2362
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Agent Dosage PREMEDICATIONS 1. Dexamethasone 20 mg IV 30 minutes before chemo
therapy 2. Cimetidine 300 mg IV 30 minutes before chemotherapy 3. Diphenhydramine 25-50 mg IV 30 minutes before
chemotherapy 4. Compazine 10 mg PO/IV 30 minutes before chemotherapy OTHER MEDICATIONS 1. Dexamethasone 8 mg PO BID for 8 doses-start day prior
to chemo (decreases lower extremity edema) Repeat every 21 days
Etoposide (VP-16)—oral
Etoposide 100 mg PO days 1-7 Etoposide 100 mg POQOD days 8-14 REF: Kakolyris etal. Am J Clin Oncol 1998; 21:505-508 Repeat every 28 days
Gemcitabine Gemcitabine 1000 mg/M2 IV days 1,8,15 REF: Crino et al. J Clin Oncol 1999; 17:2081-2085 PREMEDICATIONS 1. Compazine 10 mg PO/IV 30 minutes before chemotherapy Repeat every 28 days
Topotecan Topotecan 1.5 mg/M2/d IV (over 30 min) days 1 -5 REF: Perez-Soler et al. J Clin Oncol 1996; 14:503-13 PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy on days 1 -5 2. Dexamethasone 20 mg IV 30 minutes before chemo
therapy on days 1-5 Repeat every 21 days Topotecan-hold for ANC < 1500 or platelets < 100,000; decrease
dose by 0.25 mg/M2/d for prior episode of severe neutropenia or administer G-CSF starting on day 6
Vinorelbine Vinorelbine 30 mg/M2 IV every 7 days -decrease dose to 15 mg/M2 when ANC 1000-1499 REF: Crawford et al. J Clin Oncol 1996; 14:2774-2784 PREMEDICATIONS 1. Compazine 10 mg PO/IV 30 minutes before chemotherapy Repeat every 7 days Vinorelbine-vesicant; avoid extravasation; can cause peripheral
neuropathy
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Small-Cell Lung Cancer Agent Dosage Carboplatin/ paclitaxel
Paclitaxel 175 mg/M2 IV (over 3 h) dayl -followed by Carboplatin AUC7 IV (over3 h) dayl REF: Groen et al. J Clin Oncol 1999; 17:927-932 PREMEDICATIONS 1. Dexamethasone 20 mg IV 30 minutes before chemo
therapy OR Dexamethasone 20 mg PO 6 and 12 hours prior
2. Diphenhydramine 50 mg IV 30 minutes before chemo therapy
3. Cimetidine 300 mg IV 30 minutes before chemotherapy 4. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy OTHER MEDICATIONS 1. Give non-cisplatin delayed-emesis prophylaxis 2. Dexamethasone 4 mg PO BID for 6 doses after paclitaxel
(for myalgias) Repeat every 21 days
CAE (ACE) cyclophos phamide/ doxorubicin/ etoposide
Cyclophosphamide 1000 mg/M2 IV dayl Doxorubicin 45 mg/M2 IV day 1 Etoposide (VP-16) 50 mg/M2 IV days 1-5
REF: Aisner et al. Semin Oncol 1986; 13:54-62
PREMEDICATIONS 1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after
chemotherapy on day 1 2. Dexamethasone 20 mg IV 30 minutes before chemo
therapy on day 1 3. Compazine 10 mg PO/IV 30 minutes before chemotherapy
on days 2-5 OTHER MEDICATIONS 1. May need to give non-cisplatin delayed-emesis prophy
laxis Repeat every 21 days Doxorubicin-monitor cumulative dose for cardiac toxicity (not
to exceed 550 mg/M2 or 450 mg/M2 with prior chest radio therapy); vesicant-avoid extravasation; use 50% for bilirubin 1.5-3.0; use 25% for bilirubin > 3.
