Cycle length: Every 21 days, for a maximum of six cycles. | |||
Drug | Dose and route | Administration | Given on days |
Carboplatin | AUC* = 6 mg/mL × min IV | Dilute in 250 mL NS¶ and administer over 30 minutes. Carboplatin should be administered after the completion of docetaxel infusion. | Day 1 |
Docetaxel | 75 mg/m2 IV | Dilute in 250 mL NS¶ to a final concentration of 0.3 to 0.74 mg/mL and administer over 60 minutes. Docetaxel should be infused prior to carboplatin. | Day 1 |
Pretreatment considerations: | |||
Emesis risk |
| ||
Prophylaxis for infusion reactions |
| ||
Vesicant/irritant properties |
| ||
Infection prophylaxis |
| ||
Dose adjustment for baseline liver or kidney dysfunction |
| ||
Dose adjustment for known drug interactions |
| ||
Monitoring parameters: | |||
| |||
| |||
| |||
Suggested dose modifications for toxicity: | |||
Myelotoxicity |
| ||
Nonhematologic toxicity |
| ||
Cutaneous, mucosal, and neurologic toxicity |
| ||
If there is a change in body weight of at least 10%, doses should be recalculated. |
ANC: absolute neutrophil count; AUC: area under the concentration × time curve; CBC: complete blood count; CYP3A4: cytochrome P450 3A4; GFR: glomerular filtration rate; IV: intravenous; NCCN: National Comprehensive Cancer Network; NS: normal saline; TLS: tumor lysis syndrome; ULN: upper limit of normal.
* AUC is converted to a patient-specific carboplatin dose (in mg) according to renal function by using the Calvert formula. The Calvert formula is total dose (mg) = (target AUC) × (GFR + 25). If using measured serum creatinine, limit the maximal GFR for the calculation to 125 mL/min. Refer to UpToDate topics on dosing of anticancer agents in adults.
¶ Diluent solutions should not be modified without consulting a detailed reference due to potential incompatibility(ies).
Δ Consensus-based guidelines from the NCCN classify higher carboplatin doses (AUC ≥4) as highly emetogenic; by contrast, the American Society of Clinical Oncology and the Multinational Association for Supportive Care in Cancer guidelines consider all carboplatin doses to be moderately emetogenic. Although many institutions classify carboplatin-containing regimens as moderately emetogenic, a benefit for adding a neurokinin 1 receptor antagonist on day 1 has been shown in many studies; additional prophylaxis beyond day 1 for delayed emesis is not needed for most patients. Refer to UpToDate topics on prevention and treatment of chemotherapy-induced nausea and vomiting in adults.
◊ A list of strong and moderate CYP3A4 inhibitors is available as a separate table in UpToDate. Specific interactions may be determined by use of the Lexicomp drug interactions program included within UpToDate.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟