The Washington Manual of Oncology, 3 Ed.

Appendix II—Selected Chemotherapeutic Regimens

Leigh M. Boehmer • Sara K. Butler • Janelle Mann

This appendix, which can be accessed in the electronic version of this book, is a compilation of common chemotherapeutic regimens reported in the literature and national guidelines for the treatment of patients with cancer. It is not an all-inclusive list, and the regimens are sorted alphabetically by cancer. The chemotherapeutic regimens chosen are not meant to infer superiority or priority over other regimens, but rather to serve as a general reference and starting point for making treatment decisions. No liability will be assumed for the use of the appendix, nor for typographic errors. It is highly recommended to refer to the literature, practice guidelines, and package insert for information pertaining to the patient population participating in pertinent clinical trials, confirmation of dosing, administration rates, scheduling, duration of therapy, and need for supportive care medications (e.g., colony stimulating factors). Furthermore, evaluation of the literature and package inserts for dose modification recommendations based on hepatic dysfunction, renal dysfunction, and therapy-related toxicities is encouraged. Alteration in therapy may be necessary, based on good clinical judgment, for the individualization of therapy according to the patient’s response and tolerability.

Please register your electronic version of this book, using the instructions on the inside front cover of this book, to access Appendix II.

Regimen

Drug dose

References

AIDS-related malignancies

Kaposi sarcoma

ABV

Doxorubicin 20 mg/m2 i.v. on day 1

Northfelt DW. J Clin Oncol 1998;16:2445–2451.

Bleomycin 10 mg/m2 i.v. on day 1

Vincristine 1 mg i.v. on day 1

Repeat cycle every 14 d

BV

Bleomycin 15 IU/m2 i.v. on day 1

Stewart S. J Clin Oncol 1998;16:683–691.

Vincristine 2 mg i.v. on day 1

Repeat cycle every 3 wk

DaunoXome

Liposomal daunorubicin 40 mg/m2 i.v. on day 1

Gill PS. J Clin Oncol 1996;14:2353–2364.

Repeat cycle every 2 wk

Docetaxel

Docetaxel 25 mg/m2 i.v. on day 1

Lim ST. Cancer 2004;103:417–421.

Repeat cycle weekly × 8

Doxil

Liposomal doxorubicin 20 mg/m2 i.v. on day 1

Northfelt DW. J Clin Oncol 1997;15:653–659.

Repeat cycle every 3 wk

Stewart S. J Clin Oncol 1998;16:683–691.

Paclitaxel

Paclitaxel 100 mg/m2 i.v. over 3 h on day 1

Tulpule A. Cancer 2002;95:147–154.

Repeat cycle every 2 wk

Vinorelbine

Vinorelbine 30 mg/m2 i.v. on day 1

Nasti G. J Clin Oncol 2000;18:1550–1557.

Repeat cycle every 14 d

Non-Hodgkin’s lymphoma

CDE

Cyclophosphamide 187.5–200 mg/m2/d CIVI on days 1–4

Spina M. Cancer 2001;92:200–206.

Doxorubicin 12.5 mg/m2/d CIVI on days 1–4

Sparano JA. J Clin Oncol 2004;22:1491–1500.

Etoposide 60 mg/m2/d CIVI on days 1–4

Repeat cycle every 28 d

CHOP

Cyclophosphamide 750 mg/m2 i.v. on day 1

Vaccher E. Cancer 2001;91:155–163.

Doxorubicin 50 mg/m2 i.v. on day 1

Ratner L. J Clin Oncol 2001;19:2171–2178.

Vincristine 1.4 mg/m2 i.v. on day 1 (maximum dose of 2 mg)

Prednisone 100 mg p.o. daily on days 1–5

Repeat cycle every 21 d

CODOX-M/IVAC

Low-risk patients:

CODOX-M only

Wang ES. Cancer 2003;98:1196–1205.

Cyclophosphamide 800 mg/m2 i.v. on day 1

Cyclophosphamide 200 mg/m2 i.v. on days 2–5

Doxorubicin 40 mg/m2 i.v. on day 1

Vincristine 1.5 mg/m2 i.v. on days 1 and 8 (cycle 1)

Vincristine 1.5 mg/m2 i.v. on days 1, 8, and 15 (cycle 2)

Methotrexate 1200 mg/m2 i.v. over 1 h, followed by 240 mg/m2/h × 23 h with leucovorin

Cytarabine 70 mg intrathecal (IT) on days 1 and 3

Methotrexate 12 mg IT on day 15

High-risk patients:

CODOX-M (alternate with IVAC)

Cyclophosphamide 800 mg/m2 i.v. on day 1

Cyclophosphamide 200 mg/m2 i.v. on days 2–5

Doxorubicin 40 mg/m2 i.v. on day 1

Vincristine 1.5 mg/m2 i.v. on days 1 and 8 (cycle 1)

Vincristine 1.5 mg/m2 i.v. on days 1, 8, and 15 (cycle 2)

Methotrexate 1200 mg/m2 i.v. over 1 h, followed by 240 mg/m2/h × 23 h with leucovorin

Cytarabine 70 mg IT on days 1 and 3

Methotrexate 12 mg IT on day 15

IVAC (alternate with CODOX-M)

Ifosfamide 1500 mg/m2 i.v. on days 1–5 (with Mesna)

Etoposide 60 mg/m2 i.v. on days 1–5

Cytarabine 2000 mg/m2 i.v. q12h × 4 on day 1 and 2

Methotrexate 12 mg IT on day 5

Dose-adjusted EPOCH

Etoposide 50 mg/m2/d CIVI on days 1–4

Little RF. Blood 2003;101:4653–4659.

Doxorubicin 10 mg/m2/d CIVI on days 1–4

Vincristine 0.4 mg/m2/d CIVI on days 1–4

Cyclophosphamide (cycle 1)

375 mg/m2 i.v. on day 5 (CD4 + cells ≥100/mm3)

187 mg/m2 i.v. on day 5 (CD4 + cells <100 mm3)

Cyclophosphamide (subsequent cycles)

Increase by 187 mg/m2 if nadir ANC >500/μL

Decrease by 187 mg/m2 if nadir ANC <500/μL or platelets <25000/μL

Prednisone 60 mg/m2/d p.o. daily on days 1–5

Repeat cycle every 21 d

EPOCH

Etoposide 50 mg/m2/d CIVI on days 1–4

Gutierrez M. J Clin Oncol 2000;18:3633–3642.

Doxorubicin 10 mg/m2/d CIVI on days 1–4

Vincristine 0.4 mg/m2/d CIVI on days 1–4

Cyclophosphamide 750 mg/m2 i.v. on day 5

Prednisone 60 mg/m2/d p.o. daily on days 1–5

Repeat cycle every 21 d

Hyper-CVAD

Odd numbered cycles:

Cyclophosphamide 300 mg/m2 i.v. q12h × 6 starting on day 1

Cortes J. Cancer 2002;94:1492–1499.

Mesna 600 mg/m2/d CIVI daily × 3 d

Vincristine 2 mg i.v. on days 4 and 11

Doxorubicin 50 mg/m2 i.v. on day 4

Dexamethasone 40 mg i.v./p.o. on days 1–4 and 11–14

Even numbered cycles:

Methotrexate 1000 mg/m2 CIVI on day 1

Cytarabine 3000 mg/m2 i.v. q12h × 4 on days 2 and 3

Leucovorin 50 mg i.v. × 1 starting 12 h after the completion of methotrexate, followed by 15 mg i.v. q6h until methotrexate level <0.1 μM

m-BACOD

Methotrexate 200 mg/m2 i.v. on day 15

Kaplan LD. N Engl J Med 1997;336:1641–1648.

Bleomycin 4 units/m2 i.v. on day 1

Doxorubicin 25 mg/m2 i.v. on day 1

Cyclophosphamide 300 mg/m2 i.v. on day 1

Vincristine 1.4 mg/m2 i.v. on day 1

Dexamethasone 3 mg/m2 p.o. daily on days 1–5

Cytarabine 50 mg IT on days 1, 8, 15, and 22

m-CHOP

Cyclophosphamide 375 mg/m2 i.v. on day 1

Ratner L. J Clin Oncol 2001;19:2171–2178.

Doxorubicin 25 mg/m2 i.v. on day 1

Vincristine 1.4 mg/m2 i.v. (maximum dose 2 mg) on day 1

Prednisone 100 mg p.o. daily on days 1–5

Bladder

Cisplatin/docetaxel

Cisplatin 75 mg/m2 i.v. on day 1

Docetaxel 75 mg/m2 i.v. on day 1

Dimopoulos MA. Ann Oncol 1999;10:1385–1388.

Repeat cycle every 21 d

CMV

Methotrexate 30 mg/m2 i.v. on days 1 and 8

Harker WG. J Clin Oncol 1985;3:1463–1470.

Vinblastine 4 mg/m2 i.v. on days 1 and 8

Cisplatin 100 mg/m2 i.v. on day 2 (≥12 h after methotrexate and vinblastine)

Repeat cycle every 21 d

Gemcitabine/carboplatin

Gemcitabine 1000 mg/m2 i.v. on days 1 and 8

Carboplatin (AUC 4.5) i.v. on day 1

Repeat cycle every 21 d

De Santis M. J Clin Oncol 2009;27:5634–5639.

Gemcitabine/cisplatin

Gemcitabine 1000 mg/m2 i.v. on days 1, 8, and 15

Moore MJ. J Clin Oncol 1999;17:2876–2881.

Cisplatin 70 mg/m2 i.v. on day 2

Repeat cycle every 28 d

HD-MVAC

Methotrexate 30 mg/m2 i.v. on day 1

Vinblastine 3 mg/m2 i.v. on day 2

Doxorubicin 30 mg/m2 i.v. on day 2

Cisplatin 70 mg/m2 i.v. on day 2

G-CSF 240 mcg/m2/d s.c. on days 4–10

Repeat cycle every 14 d

Sternberg C. J Clin Oncol 2001;19:2638–2646.

MVAC

Methotrexate 30 mg/m2 i.v. on days 1, 15, and 22

Stemberg CN. Cancer 1989;64:2448–2458.

Vinblastine 3 mg/m2 i.v. on days 2, 15, and 22

Doxorubicin 15–30a mg/m2 i.v. on day 2

Cisplatin 70 mg/m2 i.v. on day 2

Repeat cycle every 28 d

Paclitaxel/cisplatin

Paclitaxel 135 mg/m2 i.v. on day 1

Cisplatin 70 mg/m2 i.v. on day 1

Repeat cycle every 21 d

Burch P. J Urol 2000;164:1538–1542.

Paclitaxel/cisplatin/ gemcitabine (PCG)

Paclitaxel 80 mg/m2 i.v. on days 1 and 8

Cisplatin 70 mg/m2 i.v. on days 1 and 8

Gemcitabine 1000 mg/m2 i.v. on days 1 and 8

Repeat cycle every 21 d

Bellmunt J. J Clin Oncol 2012;30:1107–1113.

Paclitaxel/carboplatin/gemcitabine

Paclitaxel 200 mg/m2 i.v. on day 1

Hussain M. J Clin Oncol 2001;19:2527–2533.

Carboplatin (AUC 5) i.v. on day 1

Gemcitabine 800 mg/m2 i.v. on days 1 and 8

Repeat cycle every 21 d

Brain

Bevacizumab

Bevacizumab 10 mg/kg i.v. on day 1

Repeat cycle every 14 d

Norden AD. Neurology 2008;70:779–787.

Bevacizumab/irinotecan

Bevacizumab 10 mg/kg i.v. on day 1

Irinotecan 125 mg/m2 i.v. on day 1 or

Irinotecan 340 mg/m2 i.v. on day 1 (patients on enzyme-inducing antiepileptic drugs)

Repeat cycle every 14 d

Taillibert S. Neurology 2009;72:1601–1606.

Carmustine/XRT

Carmustine 80 mg/m2/d i.v. on days 1–3

Green SB. Cancer Treat Rep 1983;67:121–132.

Repeat cycle every 8 wk

PCV

Lomustine 110 mg/m2 p.o. on day 1

Glass J. J Neurosurg 1992;76:741–745.

Procarbazine 60 mg/m2/d p.o. on days 8–21

Vincristine 1.4 mg/m2 i.v. (maximum dose 2 mg) on days 8 and 29

Repeat cycle every 6 wk

Temozolomide

Temozolomide 200 mg/m2/d p.o. daily × 5 d

Chinot OL. J Clin Oncol 2001;19:2449–2455.

Repeat cycle every 28 d

(first cycle, give only 150 mg/m2/d p.o. daily × 5 d; if no toxicity, then increase dose as above)

Breast

AC

Doxorubicin 60 mg/m2 i.v. on day 1

Fisher B. J Clin Oncol 1990;8:1483–1496.

Cyclophosphamide 600 mg/m2 i.v. on day 1

Fisher B. J Clin Oncol 1997;15:1858–1869.

Repeat cycle every 21 d

AC→TH

Doxorubicin 60 mg/m2 i.v. on day 1

Henderson IC. J Clin Oncol 2003;21:976–983.

Cyclophosphamide 600 mg/m2 i.v. on day 1

Romond EH. N Engl J Med 2005;353:1673–1684.

Repeat cycle every 21 d for 4 cycles

Followed by

paclitaxel 175–225 mg/m2 i.v. on day 1

Repeat cycle every 21 d for 4 cycles or

Paclitaxel 80 mg/m2 i.v. weekly for 12 wk

With trastuzumab 4 mg/kg i.v. with first dose of paclitaxel, followed by 2 mg/kg i.v. weekly

AC→ TH (dose dense)

Doxorubicin 60 mg/m2 i.v. on day 1

Cyclophosphamide 600 mg/m2 i.v. on day 1

Repeat cycle every 14 d for 4 cycles

Followed by paclitaxel 175 mg/m2 i.v. on day 1

Repeat cycle every 14 d for 4 cycles

Give with trastuzumab 4 mg/kg i.v. on day 1, followed by 2 mg/kg i.v. weekly to complete 8 wk

Followed by trastuzumab 6 mg/kg i.v. on day 1

Repeat cycle every 21 d to complete 52 wk total

Doxorubicin 60 mg/m2 i.v. on day 1

Cyclophosphamide 600 mg/m2 i.v. on day 1

Dang C. J Clin Oncol 2008;26:1216–1222.

AC→Paclitaxel (dose dense)

Citron ML. J Clin Oncol 2003;21:1431–1439.

Repeat cycle every 14 d for 4 cycles

Mamounas EP. J Clin Oncol 2005;16:3686–3696.

Followed by paclitaxel 80 mg/m2 i.v.

Sparano JA. N Engl J Med 2008;358:1663–1671.

weekly for 12 wk or paclitaxel 175 mg/m2 i.v. on day 1 every 14 d for 4 cycles

Ado-trastuzumab emtansine

Ado-trastuzumab emtansine 3.6 mg/kg i.v. on day 1

Repeat cycle every 21 d

Verma S. N Engl J Med 2012;376:1783–1791.

CAF

Cyclophosphamide 100 mg/m2 p.o. daily on days 1–14

Bull JM. Cancer 1978;41:1649–1657.

Doxorubicin 30 mg/m2 i.v. on days 1 and 8

Fluorouracil (5-FU) 500 mg/m2 i.v. on days 1 and 8

Repeat cycle every 28 d

Capecitabine

Capecitabine 1250 mg/m2 p.o. b.i.d. on days 1–14

Fumoleau P. Eur J Cancer 2004;40:536–542.

Repeat cycle every 21 d

Capecitabine/docetaxel

Capecitabine 1250 mg/m2 p.o. b.i.d. on days 1–14

Docetaxel 75 mg/m2 i.v. on day 1

Repeat cycle every 21 d

O’Shaughnessy J. J Clin Oncol 2002;20:2812–2823.

Capecitabine/paclitaxel

Capecitabine 825 mg/m2 p.o. b.i.d. on days 1–14

Blum JL. J Clin Oncol 2006;24:4384–4390.

Paclitaxel 80 mg/m2 i.v. on days 1 and 8

Repeat cycle every 21 d

Capecitabine/trastuzumab

Capecitabine 1250 mg/m2 p.o. b.i.d. on days 1–14

Trastuzumab 8 mg/kg i.v. on day 1, followed by 6 mg/kg i.v. every 21 d

Repeat cycle every 21 d

Bartsch R. J Clin Oncol 2007;25:3853–3858.

Capecitabine/vinorelbine

Capecitabine 1000 mg/m2 p.o. b.i.d. on days 1–14

Welt A. Ann Oncol 2005;16:64–69.

Vinorelbine 25 mg/m2 i.v. on days 1 and 8

Repeat cycle every 21 d

CEF

Cyclophosphamide 75 mg/m2 p.o. on days 1–14

Epirubicin 60 mg/m2 i.v. on days 1 and 8

5-FU 500 mg/m2 i.v. on days 1 and 8

Repeat cycle every 28 d

Findlay B. J Clin Oncol 1998;16:2651–2658.

CMF

Cyclophosphamide 600 mg/m2 i.v. on day 1

Weiss RB. Am J Med 1987;83:455–463.

Methotrexate 40 mg/m2 i.v. on day 1

5-FU 600 mg/m2 i.v. on day 1

Repeat cycle every 21 d

CMF

Cyclophosphamide 100 mg/m2 p.o. on days 1–14

Bonadonna G. N Engl J Med 1976;294:405–410.

Methotrexate 40 mg/m2 i.v. on days 1 and 8

5-FU 600 mg/m2 i.v. on days 1 and 8

Repeat cycle every 28 d

Docetaxel

Docetaxel 75–100 mg/m2 i.v. on day 1

Repeat cycle every 21 d

Harvey V. J Clin Oncol 2006;24:4963–4970.

Chan S. J Clin Oncol 1999;17:2341–2354.

Docetaxel/trastuzumab

Docetaxel 100 mg/m2 i.v. on day 1

Esteva FJ. J Clin Oncol 2002;20:1800–1808.

Repeat cycle every 21 d

or

Marty M. J Clin Oncol 2005;23:4265–4274.

Docetaxel 35 mg/m2 i.v. weekly

Anderson M. J Clin Oncol 2011;29:264–271.

Trastuzumab 4 mg/kg i.v. on day 1, followed by 2 mg/kg i.v. weekly or

Trastuzumab 8 mg/kg i.v. on day 1, followed by 6 mg/kg i.v. every 21 d

Eribulin

Eribulin 1.4 mg/m2 i.v. on days 1 and 8

Repeat cycle every 21 d

Cortes J. Lancet 2011;377:914–923.

Everolimus/exemestane

Everolimus 10 mg p.o. daily days 1–28

Exemestane 25 mg p.o. daily days 1–28

Repeat cycle every 28 d

Baselga J. N Engl J Med 2012;366:520–529.

FAC

5-FU 500 mg/m2 i.v. on days 1 and 8 or days 1 and 4

Smalley RV. Cancer 1977;40:625–632.

Doxorubicin 50 mg/m2 i.v. on day 1

Cyclophosphamide 500 mg/m2 i.v. on day 1

Repeat cycle every 21 d

FEC

Cyclophosphamide 75 mg/m2 p.o. daily on days 1–14

Levine MN. J Clin Oncol 1998;16:2651–2658.

Epirubicin 60 mg/m2 i.v. on days 1 and 8

Therasse P. J Clin Oncol 2003;21:843–850.

5-FU 500 mg/m2 i.v. on days 1 and 8

Repeat cycle every 28 d

FEC100 ± docetaxel

Cyclophosphamide 500 mg/m2 i.v. on day 1

French Adjuvant Study Group. J Clin Oncol 2001;19:602–611.

Epirubicin 100 mg/m2 i.v. on day 1

Roche H. J Clin Oncol 2006;24:5664–5671.

5-FU 500 mg/m2 i.v. on day 1

Repeat cycle every 21 d for 3 cycles

Followed by ±

docetaxel 100 mg/m2 i.v. on day 1

Repeat cycle every 21 d for 3 cycles

FEC ± paclitaxel

Cyclophosphamide 500 mg/m2 i.v. on day 1

Epirubicin 90 mg/m2 i.v. on day 1

5-FU 500 mg/m2 i.v. on day 1

Repeat cycle every 21 d for 4 cycles

Followed by ± paclitaxel 100 mg/m2 i.v. on day 1

Repeat cycle weekly for 8 wk

Gemcitabine 1000 mg/m2 i.v. on days 1 and 8

Martin M. J Natl Cancer Inst 2008;100:805–814.

Gemcitabine–Carboplatin

Carboplatin (AUC 2) i.v. on days 1 and 8

Repeat cycle every 21 d

Paclitaxel 175 mg/m2 i.v. on day 1

O’Shaughnessy J. N Eng J Med 2011;364:205–214.

GT

Albain KS. J Clin Oncol 2008;26:3950–3957.

Gemcitabine 1250 mg/m2 i.v. on days 1 and 8

Repeat cycle every 21 d

Ixabepilone

Ixabepilone 40 mg/m2 i.v. on day 1

Repeat cycle every 21 d

Perez EA. J Clin Oncol 2007;25:3407–3414.

Lapatinib/capecitabine

Lapatinib 1250 mg p.o. daily on days 1–21

Capecitabine 1000 mg/m2 p.o. b.i.d. on days 1–14

Repeat cycle every 21 d

Geyer CE. N Engl J Med 2006;355:2733–2743.

Lapatinib/letrozole

Lapatinib 1500 mg p.o. daily

Letrozole 2.5 mg p.o. daily

Johnston S. J Clin Oncol 2009;27:5538–5546.

Lapatinib/trastuzumab

Lapatinib 1000 mg p.o. daily

Trastuzumab 4 mg/kg i.v. on day 1, followed by 2 mg/kg i.v. weekly

Blackwell KL. J Clin Oncol 2010;28:1124–1130.

Liposomal doxorubicin

Liposomal doxorubicin 40–50 mg/m2 i.v. on day 1

Repeat cycle every 28 d

Yardley DA. Clin Breast Cancer 2009;9:247–252.

nab-Paclitaxel

nab-Paclitaxel 260 mg/m2 i.v. on day 1

O’Brien ME. Annals Oncol 2004;15:440–449.

Repeat cycle every 21 d

Gradishar W J. J Clin Oncol 2005;23:7794–7803.

nab-Paclitaxel

nab-Paclitaxel 100–150 mg/m2 i.v. on days 1, 8, and 15

Repeat cycle every 28 d

Gradishar WJ. J Clin Oncol 2009;27:3611–3619.

Paclitaxel

Paclitaxel 175 mg/m2 i.v. on day 1

Repeat cycle every 21 d

Seidman AD. J Clin Oncol 1995;13:2575–2581.

Paclitaxel/trastuzumab

Paclitaxel 175 mg/m2 i.v. on day 1

Leyland-Jones B. J Clin Oncol 2003;21:3965–3971.

Trastuzumab 4 mg/kg i.v. on day 1, followed by 2 mg/kg i.v. weekly

Slamon DJ. N Engl J Med 2001;344:783–792.

Repeat cycle every 21 d

Pertuzumab/trastuzumab

Pertuzumab 840 mg i.v. on day 1, followed by 420 mg i.v.

Trastuzumab 8 mg/kg i.v. on day 1, followed by 6 mg/kg i.v.

Baselga J. J Clin Oncol 2010;28:1138–1144.

Pertuzumab/trastuzumab/ docetaxel

Repeat cycle every 21 d

Pertuzumab 840 mg i.v. on day 1, followed by 420 mg i.v.

Trastuzumab 8 mg/kg i.v. on day 1, followed by 6 mg/kg i.v.

Docetaxel 75 mg/m2 i.v. on day 1

Baselga J. N Engl J Med 2012;366:109–119.

TCH

TPC

Repeat cycle every 21 d

Docetaxel 75 mg/m2 i.v. on day 1

Carboplatin (AUC 6) i.v. on day 1

Trastuzumab 4 mg/kg i.v. on day 1, followed by 2 mg/kg weekly

Repeat cycle every 21 d for 6 cycles

Followed by trastuzumab 6 mg/kg i.v. every 21 d to complete 1 yr

Carboplatin (AUC 6) i.v. on day 2

Slamon D. N Engl J Med 2011;365:1273–1283.

Robert N. J Clin Oncol 2006;24:2786–2792.

Paclitaxel 175 mg/m2 i.v. on day 2

Trastuzumab 4 mg/kg i.v. on day 1, followed by 2 mg/kg i.v. weekly

Repeat cycle every 21 d

Trastuzumab

Trastuzumab 8 mg/kg i.v. on day 1, followed by 6 mg/kg i.v. every 3 wk

Piccart-Gebhart MJ. N Engl J Med 2005;353:1659–1672.

Vinorelbine

Vinorelbine 25–30 mg/m2 i.v. weekly

Fumoleau P. J Clin Oncol 1993;11:1245–1252.

Zelek L. Cancer 2001;92:2267–2272.

Vinorelbine/trastuzumab

Trastuzumab 4 mg/kg i.v. on day 1, followed by 2 mg/kg i.v. weekly

Burstein HJ. J Clin Oncol 2001;19:2722–2730.

Vinorelbine 25 mg/m2 i.v. weekly

Vinorelbine/trastuzumab

Trastuzumab 8 mg/kg i.v. on day 1, followed by 6 mg/kg i.v. every 21 d

Vinorelbine 30–35 mg/m2 i.v. on days 1 and 8

Repeat every 21 d

Anderson M. J Clin Oncol 2011;29:264–271.

Cervical

Cisplatin/XRT

Cisplatin 40 mg/m2 i.v. weekly (maximum dose is 70 mg/wk)

Keys HM. N Engl J Med 1999;340:1154–1161.

Repeat weekly for a maximum of 6 doses

XRT: 1.8–2 Gy daily, 5 d per wk for a total of 45 Gy

Cisplatin/5-FU/XRT

Cisplatin 70 mg/m2 i.v. on day 1

Peters WA. J Clin Oncol 2000;18:1606–1613.

5-FU 1000 mg/m2/d CIVI on days 1–4

Repeat cycle every 21 d

XRT: 1.7 Gy/day on days 1–5 of each wk for a total of 49.3 Gy (29 fractions)

Cisplatin/5-FU/hydroxyurea/XRT

Cisplatin 50 mg/m2 i.v. on days 1 and 29 then

Rose PG. N Engl J Med 1999;340:1144–1153.

5-FU 4 gm/m2 CIVI over 96 h beginning on days 1 and 29

Rose PG. J Clin Oncol 2007;25:2804–2810.

Hydroxyurea 2 gm/m2 p.o. twice weekly 2 h before XRT at weeks 1–6

Cisplatin/vinorelbine

Cisplatin 80 mg/m2 i.v. on day 1

Pignata S. J Clin Oncol 1999;17:756–760.

Vinorelbine 25 mg/m2 i.v. on days 1 and 8

Geggia V. Oncology 2002;63:31–37.

Repeat cycle every 21 d

Cisplatin/vinorelbine

Cisplatin 50 mg/m2 i.v. on day 1

Vinorelbine 30 mg/m2 i.v. on days 1 and 8

Repeat cycle every 21 d

Monk BJ. J Clin Oncol 2009;27:4649–4655.

Carboplatin/docetaxel

Carboplatin (AUC 6) i.v. on day 1

Docetaxel 60 mg/m2 i.v. on day 1

Repeat cycle every 21 d

Nagao S. Gynecol Oncol 2005;96:805.

Gemcitabine/cisplatin

Gemcitabine 1000 mg/m2 i.v. on days 1 and 8, followed by

Monk BJ. J Clin Oncol 2009;27:4649.

cisplatin 50 mg/m2 i.v. on day 1

Repeat cycle every 21 d

Mitomycin-C/cisplatin

Mitomycin-C 6 mg/m2 i.v. on day 1, followed by

Wagenaar HC. Eur J Cancer 2001;37:1624–1628.

cisplatin 50 mg/m2 i.v. on day 1

Repeat every 28 d

Paclitaxel/carboplatin

Paclitaxel 175 mg/m2 i.v. on day 1

Moore KN. Gynecol Oncol 2007;105:299.

Carboplatin (AUC 5) i.v. on day 1

Repeat cycle every 21 d

Kitagawa R. J Clin Oncol 2012;30 (Supp15). Abstract 5006.

Paclitaxel/cisplatin

Paclitaxel 175 mg/m2 i.v. on day 1

Papadimitriou CA. J Clin Oncol 1999;17:761–766.

Cisplatin 75 mg/m2 i.v. on day 1

Repeat cycle every 21 d

Paclitaxel/cisplatin

Paclitaxel 135 mg/m2 CIVI on day 1, followed by

Moore DH. J Clin Oncol 2004;22:3113–3119.

cisplatin 50–75 mg/m2 i.v. on day 2

Rose PG. J Clin Oncol 1999;17:2676–2680.

Repeat cycle every 21 d

Topotecan/cisplatin

Topotecan 0.75 mg/m2 i.v. on days 1–3, followed by

Long HJ. J Clin Oncol 2005;23:4626–4633.

cisplatin 50 mg/m2 i.v. on day 1

Monk BJ. J Clin Oncol. 2009;27:4649.

Repeat cycle every 21 d

Colorectal

Bevacizumab

Bevacizumab 5 mg/kg i.v. every 2 wk plus

Kabbinavar FF. J Clin Oncol 2005;23:3706–3712.

5-FU–leucovorin

OR IFL

OR FOLFOX

OR FOLFIRI

Hurwitz HI. J Clin Oncol 2005;23:3502–3508.

Giantonio BJ. J Clin Oncol 2007;25:1539–1544.

Capecitabine

Capecitabine 2500 mg/m2/d (given as 1250 mg/m2 b.i.d.) p.o. for 2 wk

Hoff PM. J Clin Oncol 2001;19:2282–2292.

Repeat cycle every 3 wk

Cetuximab

Cetuximab 400 mg/m2 first infusion, then 250 mg/m2 i.v. weekly

Cunningham D. N Engl J Med 2004;351:337–345.

May be used alone or in combination with irinotecan

5-FU/leucovorin

Leucovorin 500 mg/m2 i.v.

5-FU 500 mg/m2 i.v. given 1 h into leucovorin infusion

Petrelli N. J Clin Oncol 1989;7:1419–1426.

Weekly for 6 wk, followed by 2 wk rest

5-FU/leucovorin

Leucovorin 20 mg/m2 i.v. on days 1–5

O’Connell MJ. Cancer 1989;63:1026–1030.

5-FU 425 mg/m2 i.v. after leucovorin on days 1–5

Repeat cycle at 4 wk, 8 wk, then every 5 wk thereafter

Irinotecan (every 3 wk)

Irinotecan 300–350 mg/m2 b i.v. over 90 min

Rougier P. Lancet 1998;352:1407–1412.

Repeat cycle every 3 wk

Irinotecan/5-FU/LCV (FOLFIRI)

Irinotecan 180 mg/m2 i.v. on day 1

Andre T. Eur J Cancer 1999;35:1343–1347.

Leucovorin 400 mg/m2 i.v. over 2 h before 5-FU on days 1–2

5-FU 400 mg/m2 i.v. bolus, then 1200 mg/m2/d CIVI over 46 h on days 1 and 2

Repeat cycle every 2 wk

Oxaliplatin/5-FU/LCV (FOLFOX4)

Oxaliplatin 85 mg/m2 i.v. on day 1

de Gramon A. J Clin Oncol 2000;18:2938–2947.

5-FU 400 mg/m2 i.v. bolus, followed by 600 mg/m2 CIVI for 22 h on days 1 and 2

Leucovorin 200 mg/m2 i.v. (before 5-FU) on days 1 and 2

Repeat cycle every 2 wk

Oxaliplatin/5-FU/LCV (FOLFOX6)

Oxaliplatin 100 mg/m2 i.v. on day 1

Tournigand C. J Clin Oncol 2004;22:229–237.

5-FU 400 mg/m2 i.v. bolus, followed by 2400 mg/m2 CIVI for 46 h

Leucovorin 400 mg/m2 i.v. (before 5-FU) on day 1

Panitumumab

Regorafenib

Ziv-aflibercept

Repeat cycle every 2 wk

Panitumumab 6 mg/kg i.v. every 2 wk

May be used alone or in combination with FOLFIRI

OR FOLFOX

OR irinotecan

Regorafenib 160 mg p.o. daily on days 1–21

Repeat every 28 d

Ziv-aflibercept 4 mg/kg i.v. every 2 wk plus

FOLFIRI

or irinotecan

Van Custem E. J Clin Oncol 2007;25:1658–1664.

Peeters M. J Clin Oncol 2010;28:4706–4713.

Douillard JY. J Clin Oncol 2010;28:4697–4705.

Grothey A. Lancet 2013;381:303–312.

Van Custem E. J Clin Oncol 2012;30:3499–3506.

Endometrial Cancer

AP

Doxorubicin 60 mg/m2 i.v. on day 1 (cycle 1–7 only)

Randall ME. J Clin Oncol 2006;24:36–44.

Cisplatin 50 mg/m2 i.v. on day 1 (cycle 8 only)

Repeat cycle every 21 d

AP

Doxorubicin 60 mg/m2 i.v. on day 1

Barrett RJ. Am J Clin Oncol 1993;16:494–496.

Cisplatin 60 mg/m2 i.v. on day 1

Repeat cycle every 28 d

Carboplatin/paclitaxel

Paclitaxel 175 mg/m2 i.v. on day 1, followed by

Hoskins PJ. J Clin Oncol 2001;19:4048–4053.

carboplatin (AUC 5–7) i.v. on day 1

Repeat every 28 d

Doxorubicin

Doxorubicin 60 mg/m2 i.v. on day 1

Thigpen JT. J Clin Oncol 1994;12:1408–1414.

Repeat cycle every 21 d

Paclitaxel

Paclitaxel 175–200 mg/m2 i.v. on day 1

Lincoln S. Gynecol Oncol 2003;88:277–281.

Repeat cycle every 21 d

Paclitaxel/cisplatin

Paclitaxel 175 mg/m2 i.v. on day 1, followed by

Dimopoulos MA. Gynecol Oncol 2000;78:52–57.

cisplatin 75 mg/m2 i.v. on day 1

Filgrastim 5 μg/kg/d s.c. on day 5 until ANC recovery

Repeat cycle every 21 d

TAP

Doxorubicin 45 mg/m2 i.v. on day 1, followed by

Fleming GF. J Clin Oncol 2004;22:2159–2166.

cisplatin 50 mg/m2 i.v. on day 1

Paclitaxel 160 mg/m2 i.v. on day 2

Filgrastim 5 μg/kg/d s.c. on days 3–12

Repeat cycle every 21 d

Gastric

Capecitabine + XRT

Capecitabine/cisplatin/XRT

Carboplatin/paclitaxel/XRT

DC

Capectiabine 825 mg/m2 p.o. b.i.d. days 1–5 during radiation

Capecitabine 800 mg/m2 p.o. b.i.d. days 1–5

Cisplatin 30 mg/m2 i.v. on day 1, weekly during XRT

Carboplatin (AUC 2) i.v. weekly during XRT

Paclitaxel 50 mg/m2 i.v. weekly during XRT

Docetaxel 85 mg/m2 i.v. on day 1

Lee J. J Clin Oncol 2012;30:268–273.

Lee SS. Jpn J Clin Oncol 2007;37:829–835.

Hagen PV. N Engl J Med 2012;366:2074–2084.

Roth AD. Ann Oncol 2000;11:301–306.

Cisplatin 75 mg/m2 i.v. on day 1

Repeat cycle every 21 d

DCF

Docetaxel 75 mg/m2 i.v. on day 1

Roth AD. Ann Oncol 2004;15:759–764.

Cisplatin 75 mg/m2 i.v. on day 1

Roth AD. J Clin Oncol 2007;25:3217–3223.

5-FU 300 mg/m2/d CIVI on days 1–14

Repeat cycle every 21 d

ECF

Epirubicin 50 mg/m2 i.v. on day 1

Webb A. J Clin Oncol 1997;15:261–267.

Cisplatin 60 mg/m2 i.v. on day 1

Ross P. J Clin Oncol 2002;20:1996–2004.

5-FU 200 mg/m2/day CIVI on days 1–21

Cunningham D. N Engl J Med 2006;355:11–20.

Repeat cycle every 21 d

EOF

Epirubicin 50 mg/m2 i.v. on day 1

Oxaliplatin 130 mg/m2 i.v. on day 1

5-FU 2000 mg/m2 i.v. on days 1–21

Repeat cycle every 21 d

Cunningham D. N Engl J Med 2006;355:11–20.

EOX

Epirubicin 50 mg/m2 i.v. on day 1

Sumpter K. Br J Cancer 2005;92:1976–1983.

Oxaliplatin 130 mg/m2 i.v. on day 1

Cunningham D. N Engl J Med 2006;355:11–20.

Capecitabine 625 mg/m2 p.o. b.i.d.

Repeat cycle every 21 d

FAP

5-FU 300 mg/m2 i.v. on days 1–5

Moertel CG. J Clin Oncol 1986;4:1053–1057.

Doxorubicin 40 mg/m2 i.v. on day 1

Cisplatin 60 mg/m2 i.v. on day 1

Repeat cycle every 5 wk

FLO

Oxaliplatin 85 mg/m2 i.v. on day 1

Al-Batran SE. J Clin Oncol 2004;22:658–663.

5-FU 2600 mg/m2 i.v. for 24 h on day 1

Leucovorin 500 mg/m2 i.v. (before 5-FU) on day 1

Repeat cycle every 2 wk

5-FU

5-FU 500 mg/m2 i.v. daily on days 1–5

Cullinan SA. J Clin Oncol 1994;12:412–416.

Repeat cycle every 5 wk

5-FU

5-FU 425 mg/m2 i.v. daily on days 1–5

MacDonald JS. N Engl J Med 2001;345:725–730.

Leucovorin 20 mg/m2 i.v. daily on days 1–5

Followed 28 d later with

5-FU 400 mg/m2 i.v. daily on days 1–4 and 23–25 with XRT

Leucovorin 20 mg/m2 i.v. daily on days 1–4 and 23–25 with XRT

Followed 1 mo later and repeated monthly × 2 with

5-FU 425 mg/m2 i.v. daily on days 1–5

Leucovorin 20 mg/m2 i.v. daily on days 1–5

5-FU/cisplatin

Cisplatin 80 mg/m2 i.v. on day 1

5-FU 800 mg/m2 i.v. on days 1–5

Repeat every 21 d

Kang YK. Ann Oncol 2009;20:666–673.

FOLFOX4

Oxaliplatin 85 mg/m2 i.v. on day 1

De Vita F. Br J Cancer 2005;92:1644–1649.

5-FU 400 mg/m2 i.v. bolus, followed by 600 mg/m2 CIVI for 22 h on days 1 and 2

Leucovorin 200 mg/m2 i.v. (before 5-FU) on days 1 and 2

Repeat cycle every 2 wk

FOLFOX6

Oxaliplatin 100 mg/m2 i.v. on day 1

Louvet C. J Clin Oncol 2002;20:4543–4548.

5-FU 400 mg/m2 i.v. bolus, followed by 3000 mg/m2 CIVI over 46 h on day 1

Leucovorin 400 mg/m2 i.v. (simultaneously with oxaliplatin and before 5-FU) on day 1

Repeat cycle every 2 wk

FUP

5-FU 1000 mg/m2/d CIVI on days 1–5

Vanhoefer U. J Clin Oncol 2000;18:2648–2657.

Cisplatin 100 mg/m2 i.v. on day 2

Bouche O. Ann Oncol 2005;16:1488–1497.

Repeat cycle every 4 wk

IP

Irinotecan 70 mg/m2 i.v. on days 1 and 15

Boku N. J Clin Oncol 1999;17:319–323.

Cisplatin 80 mg/m2 i.v. on day 1

Repeat cycle every 4 wk

Trastuzumab + chemotherapy

Trastuzumab 8 mg/kg i.v. on day 1 of cycle 1, followed by 6 mg/kg i.v. on day 1 beginning with cycle 2

Repeat cycle every 21 d

Bang YJ, Lancet 2010;376:687–697.

XELOX

Capecitabine 1000 mg/m2 p.o. b.i.d. on days 1–14

Park YH. Br J Cancer 2006;94:959–963.

Oxaliplatin 130 mg/m2 i.v. on day 1

XP

Repeat cycle every 21 d

Capecitabine 1000 mg/m2 p.o. b.i.d. on days 1–14

Cisplatin 80 mg/m2 i.v. on day 1

Repeat cycle every 21 d

Kang YK. Ann Oncol 2009;20:666–673.

Gestational trophoblastic disease

EMA-CO

Dactinomycin 0.5 mg/d i.v. on days 1 and 2

Newlands ES. Br J Obstet Gynecol 1986;93:63–69.

Etoposide 100 mg/m2/d i.v. on days 1 and 2

Methotrexate 100 mg/m2 i.v., followed by 200 mg/m2 CIVI over 12 h on day 1

Leucovorin 15 mg i.m./p.o. q12h for 4 doses (starting 24 h after the start of methotrexate)

Cyclophosphamide 600 mg/m2 i.v. on day 8

Vincristine 1 mg/m2 i.v. on day 8

EP/EMA

Repeat cycle every 14 d

Etoposide 100 mg/m2 i.v. on days 1 and 2

Dactinomycin 0.5 mg i.v. on days 1 and 2

Methotrexate 100 mg/m2 i.v. push, followed by 200 mg/m2 i.v. over 12 h on day 1

Leucovorin 15 mg i.m./p.o. every 12 h × 4 doses beginning 12 h after starting MTX

Cisplatin 60 mg/m2 i.v. on day 8

Etoposide 100 mg/m2 i.v. on day 8

Repeat every 14 d

Xiang Y. J Reprod Med 2004;49:443.

Methotrexate

Methotrexate 30–50 mg/m2 i.m. weekly

Homseley HD. Obstet Gynecol 1988;72:413.

Head and neck

Carboplatin/5-FU

Carboplatin 300–400 mg/m2 i.v. on day 1

Forastiere AA. J Clin Oncol 1992;10:1245–1251.

5-FU 1000 mg/m2 i.v. on day 1

Repeat cycle every 4 wk

Cetuximab

Cetuximab 400 mg/m2 i.v. over 2 h on day 1, followed by 250 mg/m2 over 1 h weekly

Bonner JA. N Engl J Med 2006;354:567–578.

Cetuximab/cisplatin

Cetuximab 400 mg/m2 i.v. over 2 h on day 1, followed by 250 mg/m2 over 1 h weekly

Burtness B. J Clin Oncol 2005;23:8646–8654.

Cisplatin 100 mg/m2 i.v. on day 1

Repeat every 28 d

CF

Cisplatin 75 mg/m2 i.v. on day 1, immediately followed by

Cooper JS. JAMA 1999;281:1623–1627.

5-FU 1000 mg/m2/d CIVI for 96 h

Repeat cycle every 21 d

CF

Cisplatin 100 mg/m2 i.v. on day 1, immediately followed by

Kish JA. Cancer 1984;53:1819–1824.

5-FU 1000 mg/m2/d CIVI for 96 h

Repeat cycle every 21 d

Cisplatin/docetaxel

Cisplatin 75 mg/m2 i.v. on day 1

Specht L. Ann Oncol 2000;11:845–849.

Docetaxel 75 mg/m2 i.v. on day 1

Gibson BS. J Clin Oncol 2002;20:1593.

Repeat cycle every 3 wk

Cisplatin/XRT

Cisplatin 100 mg/m2 i.v. on days 1, 22, and 43

Forastiere AA. N Engl J Med 2003;349:2091–2098.

Administer concurrently with XRT

Docetaxel/cisplatin/5-FU

Docetaxel 70 mg/m2 i.v. on day 1

Cisplatin 75 mg/m2 i.v. on day 1

5-FU 1000 mg/m2 CIVI on days 1–4

Repeat cycle every 21 d, then

cisplatin 100 mg/m2 i.v. on day 1

Administered concurrently with XRT

Repeat every 21 d

5-FU 500 mg/m2 i.v. daily × 5

Bae WK. Cancer Chemother Pharmacol 2010;65:589.

5-FU

Repeat cycle every 5 wk

Ezdinli EZ. Cancer 1980;46:2149–2153.

Methotrexate

Methotrexate 40 mg/m2/wk i.m.

Taylor SG. J Clin Oncol 1984;2:1006–1011.

Increase dose by 10 mg/m2 weekly as tolerated (expect tolerable dose of 60 mg/m2/wk)

Paclitaxel/carboplatin

Paclitaxel 175 mg/m2 i.v. on day 1

Fountzilas G. Semin Oncol 1997;24(Suppl 2):65–67.

Carboplatin (AUC 6) i.v. on day 1

Repeat cycle every 21 d

Paclitaxel/cisplatin

Paclitaxel 175 mg/m2 i.v. on day 1

Hitt R. Semin Oncol 1995;22(Suppl 2):50–54.

Cisplatin 75 mg/m2 i.v. on day 2

Filgrastim 5 μg/kg/d s.c. on days 4–10

Repeat cycle every 21 d

TIP

Paclitaxel 175 mg/m2 i.v. on day 1

Shin DM. J Clin Oncol 1998;16:1325–1330.

Ifosfamide 1000 mg/m2 i.v. on days 1–3

Mesna 600 mg/m2/d divided as 400 mg/m2 i.v. before ifosfamide and 200 mg/m2 i.v. 4 h after ifosfamide

Cisplatin 60 mg/m2 i.v. on day 1

Repeat cycle every 3–4 wk

TPF

Docetaxel 75 mg/m2 i.v. on day 1

Posner M. J Clin Oncol 2001;19:1096–1104.

Cisplatin 75–100 mg/m2 i.v. on day 1

5-FU 1000 mg/m2 on days 1–4

Repeat cycle every 21 d

Hepatocellular

Sorafenib

Sorafenib 400 mg p.o. b.i.d. without food

Llovet J. Lancet Oncology 2009;10:25–34.

Leukemias

Acute lymphocytic leukemia (ALL)

Clofarabine

Clofarabine 52 mg/m2 i.v. daily on days 1–5

Jeha S. J Clin Oncol 2006;24:1917–1923.

Repeat cycle every 2–6 wk

Dasatinib

(Ph+)

Dasatinib 140 mg p.o. daily

Lilly MB. Am J Hematol 2010;85:164–170.

Hyper-CVAD ± imatinib

Course I, III, V, and VII:

Cyclophosphamide 300 mg/m2 i.v. q12h × 6 doses on days 1–3

Kantarjian HM. J Clin Oncol 2000;18:547–561.

Thomas DA. Blood 2004;103:4396–4407.

Mesna 600 mg/m2/d CIVI daily on days 1–3

Vincristine 2 mg i.v. on days 4 and 11

Doxorubicin 50 mg/m2 i.v. on day 4

Dexamethasone 40 mg i.v./p.o. daily on days 1–4 and 11–14

Filgrastim 10 μg/kg/d s.c. in divided doses starting on day 5

Course II, IV, VI, and VIII:

Methotrexate 200 mg/m2 i.v. over 2 h, followed by 800 mg/m2 CIVI over 24 h on day 1 with leucovorin rescue

Cytarabine 3000 mg/m2 i.v. q12h × 4 doses on days 2 and 3

Methylprednisolone 50 mg i.v. b.i.d. on days 1–3

Filgrastim 10 μg/kg/d s.c. in divided doses starting on day 4

± Imatinib 400 mg p.o. daily on days 1–14 of all intensive chemotherapy courses

Refer to the references for IT therapy recommendations

Larson regimen

Course I (induction <60 years):

Cyclophosphamide 1200 mg/m2 i.v. on day 1

Larson RA. Blood 1995;85:2025–2037.

Daunorubicin 45 mg/m2 i.v. on days 1–3

Vincristine 2 mg i.v. on days 1, 8, 15, and 22

Prednisone 60 mg/m2/d p.o. on days 1–21

L-Asparaginase 6000 IU/m2 s.c. on days 5, 8, 11, 15, 18, and 22

Course I (induction ≥60 yr):

Cyclophosphamide 800 mg/m2 i.v. on day 1

Daunorubicin 30 mg/m2 i.v. on days 1–3

Prednisone 60 mg/m2/d p.o. on days 1–7

Course II (early intensification):

Methotrexate 15 mg IT on day 1

Cyclophosphamide 1000 mg/m2 i.v. on day 1

6-Mercaptopurine 60 mg/m2/d p.o. on days 1–14

Cytarabine 75 mg/m2/d s.c. on days 1–4 and 8–11

Vincristine 2 mg i.v. on days 15 and 22

L-Asparaginase 6000 IU/m2 s.c. on days 15, 18, 22, and 25

Course III (CNS prophylaxis and interim maintenance):

IT methotrexate 15 mg IT on days 1, 8, 15, 22, and 29

6-Mercaptopurine 60 mg/m2/d p.o. on days 1–70

Methotrexate 20 mg/m2 p.o. on days 36, 43, 50, 57, and 64

Course IV (late intensification):

Doxorubicin 30 mg/m2 i.v. on days 1, 8, and 15

Vincristine 2 mg i.v. on days 1, 8, and 15

Dexamethasone 10 mg/m2/d p.o. on days 1–14

Cyclophosphamide 1000 mg/m2 i.v. on day 29

6-Thioguanine 60 mg/m2/d p.o. on days 29–42

Cytarabine 75 mg/m2/d s.c. on days 29–32 and 36–39

Course V (maintenance):

Vincristine 2 mg i.v. on day 1

Prednisone 60 mg/m2/d p.o. on days 1–5

Methotrexate 20 mg/m2 p.o. on days 1, 8, 15, and 22

6-Mercaptopurine 60 mg/m2/d p.o. on days 1–28

Repeat maintenance every 28 d

Nelarabine

Nelarabine 1500 mg/m2 i.v. on days 1, 3, and 5

DeAngelo DJ. Blood 2007;109:5136–5142.

Ponatinib (Ph+)

Ponatinib 45 mg p.o. daily

Cortes JE. N Engl J Med 2013;369:1783–1796.

Vincristine, liposomal

Vincristine, liposomal 2.25 mg/m2 i.v. weekly on day 1

O’Brien S. J Clin Oncol 2012;31:676–683.

Acute myelogenous leukemia (AML)

7 + 3

Cytarabine 100 mg/m2/d CIVI on days 1–7

Rai KR. Blood 1981;58:1203–1212.

Daunorubicin 45 mg/m2 i.v. on days 1–3 or

Preisler H. Blood 1987;69:1441–1449.

Idarubicin 12 mg/m2 i.v. on days 1–3 or

Vogler WR. J Clin Oncol 1992;10:1103–1111.

Mitoxantrone 12 mg/m2 i.v. on days 1–3

Arlin Z. Leukemia 1990;4:177–183.

7 + 3 (dose intensification)

Cytarabine 100 mg/m2/d CIVI on days 1–7

Fernandez HF. N Eng J Med 2009;361:1249–1259.

Daunorubicin 90 mg/m2 i.v. on days 1–3

Azacitidine

Azacitidine 75 mg/m2 s.c. or i.v. on days 1–7

Fenaus P. Lancet Oncol 2009;10:223–232.

Repeat every 28 d until progression

CLAG

Cladribine 5 mg/m2 i.v. on days 1–5

Wrzesien-Kus A. Eur J Haematol 2003;71:155–162.

Cytarabine 2000 mg/m2 i.v. on days 1–5

Filgrastim 300 mcg s.c. on days 0–5

CLAG-Ida

Cladribine 5 mg/m2 i.v. on days 1–5

Martin MG. Clin Lymphoma Myeloma 2009;9:298–301.

Cytarabine 2000 mg/m2 i.v. on days 1–5

Idarubicin 10 mg/m2 i.v. on days 1–3

Filgrastim 300 mcg s.q. on days 0–5

CLAG-M

Cladribine 5 mg/m2 i.v. on days 1–5

Wierzbowska A. Eur J Haematol 2008;80:115–126.

Cytarabine 2000 mg/m2 i.v. on days 1–5

Mitoxantrone 10 mg/m2 i.v. on days 1–3

Filgrastim 300 mcg s.c.on days 0–5

Clofarabine

Clofarabine 30 mg/m2 i.v. on days 1–5 (induction)

Kantarjian H. J Clin Oncol 2010;28:549–555.

Clofarabine 20 mg/m2 i.v. on days 1–5 (consolidation)

Claxton D. Leuk Lymphoma 2012;53:435–440.

Repeat every 28 d for 5 cycles

DAC

Cytarabine 200 mg/m2/d CIVI on days 1–7

Holowiecki J. J Clin Oncol 2012;30:2441–2448.

Daunorubicin 60 mg/m2 i.v. on days 1–3

Cladribine 5 mg/m2 i.v. on days 1–5

Decitabine

Decitabine 20 mg/m2 i.v. on days 1–5

Cashen AF. J Clin Oncol 2010;28:556–561.

Repeat every 28 d

FLAG ± idarubicin

Fludarabine 30 mg/m2 i.v. daily on days 1–5

Clavio M. Haematologica 1996;81:513–520.

Cytarabine 2000 mg/m2 i.v. daily on days 1–5

Montillo M. Am J Hematol 1998;58:105–109.

Filgrastim 300 μg s.c. daily starting on day 0

Virchis A. Br J Haematol 2004;124:26–32.

± Idarubicin 8 mg/m2 i.v. daily on days 1–3

HDAC

Cytarabine 3000 mg/m2 i.v. over 3 h q12h on days 1, 3, and 5

Mayer RJ. N Engl J Med 1994;331:896–903.

MEC

Mitoxantrone 8 mg/m2 i.v. daily on days 1–5

Greenberg PL. J Clin Oncol 2004;22:1078–1086.

Etoposide 100 mg/m2 i.v. daily on days 1–5

Cytarabine 1000 mg/m2 i.v. daily on days 1–5

Mitoxantrone–etoposide

Mitoxantrone 10 mg/m2 i.v. daily on days 1–5

Ho AD. J Clin Oncol 1988;6:213–217.

Etoposide 100 mg/m2 i.v. daily on days 1–5

Acute promyelocytic leukemia (APL)

AIDA

All-trans retinoic acid (ATRA) 45 mg/m2/d p.o. in 2 divided doses

Idarubicin 12 mg/m2 i.v. daily on days 2, 4, 6, and 8

Sanz MA. Blood 2004;15:1237–1243.

Lo-Coco F. Blood 2010;116:3171–3179.

Arsenic trioxide

Arsenic trioxide 0.15 mg/kg i.v. daily for up to 60 d (induction)

Arsenic trioxide 0.15 mg/kg i.v. on days 1–5 weekly for 5 wk, followed by 2 wk off for 2 cycles (consolidation)

Soignet SL. J Clin Oncol 2001;19:3852–3860.

Powell BL. Blood 2010;116:3751–3457.

Arsenic/ATRA

All-trans retinoic acid (ATRA) 45 mg/m2/d p.o. in 2 divided doses

Arsenic 0.15 mg/kg i.v. daily

Estey E. Blood 2006;107:3469–3473.

Shen ZX. Proc Natl Acad Sci USA 2004;101:5328–5335.

ATRA/7+3

ATRA 45 mg/m2/d p.o. divided into 2 doses starting on day 1 and continuing until complete response (maximum of 90 d)

Fenaux P. Blood 1999;94:1192–1200.

Daunorubicin 60 mg/m2/d i.v. on days 3–5

Cytarabine 200 mg/m2/d CIVI on days 3–10

Chronic lymphocytic leukemia (CLL)

Alemtuzumab

Alemtuzumab 30 mg i.v. or s.c. thrice weekly

Keating MJ. Blood 2002;99:3554–3561.

Begin with an initial dose of 3 mg, and increase the dose to 10 mg and then to a final dose of 30 mg as tolerated

Lundin J. Blood 2002;100:768–773.

Bendamustine + rituximab

Rituximab 375 mg/m2 i.v. on day 1 of cycle 1

Fisher K. J Clin Oncol 2012;30:3209–3216.

Rituximab 500 mg/m2 i.v on day 1 of cycles 2–6

Fisher K. J Clin Oncol 2011;29:3559–3566.

Bendamustine 70–90 mg/m2 i.v. on days 1–2

Repeat every 28 d

CP

Variation 1:

Chlorambucil 30 mg/m2 p.o. on day 1

Prednisone 80 mg p.o. daily on days 1–5

Repeat cycle every 28d

Variation 2:

Chlorambucil 0.3 mg/kg p.o. daily on days 1–5

Prednisone 40 mg/m2 p.o. daily on days 1–5

Repeat cycle every 28 d

Raphael B. J Clin Oncol 1991;9:770–776.

Dighiero G. N Engl J Med 1992;338:1506–1514.

CVP

Cyclophosphamide 300 mg/m2 p.o. daily on days 1–5

Raphael B. J Clin Oncol 1991;9:770–776.

Vincristine 1.4 mg/m2 i.v. on day 1 (maximum dose of 2 mg)

Prednisone 100 mg/m2 p.o. daily on days 1–5

Repeat cycle every 21 d

FC

Fludarabine 30 mg/m2 i.v. daily on days 1–3

O’Brien S. J Clin Oncol 2001;19:1414–1420.

Cyclophosphamide 250–300 mg/m2 i.v. daily on days 1–3

Eichhorst BF. Blood 2006;107:885–891.

Repeat cycle every 28–42 d

FCR

See Non-Hodgkin’s lymphoma (NHL) for dosing recommendations

FR

See NHL for dosing recommendations

Ibrutinib

Ibrutinib 420 mg p.o. once daily

Byrd JC. N Engl J Med 2013;369:32–42.

Obinutuzumab

Obinutuzumab 100 mg i.v. on day 1 of cycle one, then

Obinutuzimab 900 mg i.v. on day 2 of cycle one, followed by 1000 mg i.v. on days 8 and 15, then

Obinutuzumab 1000 mg i.v. on day 1 for cycles 2–6

Repeat every 28 d

Goede V. N Engl J Med 2014;370:1101–1110.

Ofatumumab

Ofatumumab 300 mg i.v. on day 1 of week 1, then

Ofatumumab 2000 mg i.v. on day 1 of weeks 2–8, then

Ofatumumab 2000 mg i.v. on day 1 of week 12 and

Repeat every 28 d for 4 doses

Pentostatin 4 mg/m2 i.v. on day 1

Wierda WG. J Clin Oncol 2010;28:1749–1755.

PC ± rituximab

Weiss MA. J Clin Oncol 2003;21:1278–1284.

Cyclophosphamide 600 mg/m2 i.v. on day 1

Lamanna N. J Clin Oncol 2006;24:1575–1581.

± Rituximab 375 mg/m2 i.v. on day 1 (omit with cycle 1)

Repeat cycle every 21 d

Chronic myelogenous leukemia (CML)

Bosutinib

Bosutinib 500 mg p.o. daily

Cortes JE. Blood 2011;118:4567–4576.

Dasatinib

Dasatinib 70 mg p.o. b.i.d.

Hochhaus A. Blood 2005;106:41. Abstract.

Guihot F. Blood 2005;106:39. Abstract.

Talpaz M. Blood 2005;106:40. Abstract.

Imatinib

Imatinib 400 mg p.o. daily (chronic phase)

Kantarjian H. N Engl J Med 2002;346:645–652.

Imatinib 600 mg p.o. daily (accelerated phase or blast crisis)

Talpaz M. Blood 2002;99:1928–1937.

Sawyer CL. Blood 2002;99:3530–3539.

Nilotininb

Nilotinib 300 mg p.o. b.i.d. (chronic phase)

Saglio G. N Engl J Med 2010;362:2251–2259.

Nilotinib 400 mg p.o. b.i.d. (accelerated or blast phase)

Omacetaxine

Omacetaxine 1.25 mg/m2 s.c. b.i.d. on days 1–14 (induction)

Cortes J. Blood 2012;120:2573–2580.

Omacetaxine 1.25 mg/m2 s.c. b.i.d. on days 1–7 (maintenance)

Ponatinib

Ponatinib 45 mg p.o. daily

Cortes J. N Engl J Med 2013;369:1783–1796.

Hairy cell leukemia

Cladribine

Cladribine 0.1 mg/kg/d CIVI on days 1–7

Saven A. Blood 1998;92:1918–1926.

One cycle only

Chadha P. Blood 2005;106:241–246.

Cladribine

Cladribine 0.12 mg/kg i.v. daily on days 1–5

Robak T. Eur J Haematol 1999;62:49–56.

Pentostatin

Pentostatin 4 mg/m2 i.v. on day 1

Grever M. J Clin Oncol 1995;13:974–982.

Repeat cycle every 14 d

Flinn IW. Blood 2000;96:2981–2986.

Myelodysplastic syndrome

Antithymocyte Globulin/cyclosporine

Antithymocyte globulin 40 mg/kg i.v. daily × 4 d

Yazji S. Leukemia 2003;17:2101–2106.

Cyclosporine titrated to maintain level between 200 and 400 mg/dL

Methylprednisolone 1 mg/kg i.v. daily × 4 before each dose of antithymocyte globulin, followed by prednisone 60 mg p.o. daily tapered over 1 mo

Azacitidine

Azacitidine 75 mg/m2 s.c. daily × 7 d

Silverman LR. J Clin Oncol 2002;20:2429–2440.

Repeat cycle every 28 d

Decitabine

Decitabine 15 mg/m2 i.v. q8h × 3 d

Kantarjian H. Cancer 2006;106:1794–1803.

Repeat cycle every 6 wk

Revlimid

Lenalidomide 10 mg p.o. daily

List A. N Engl J Med 2005;352:549–557.

Lung cancer

Nonsmall cell

Afatinib

Afatinib 40 mg p.o. daily

Sequist LV. J Clin Oncol. 2013;31:3327.

Carboplatin/docetaxel

Docetaxel 75 mg/m2 i.v. on day 1

Fossella F. J Clin Oncol 2003;21:3016–3024.

Carboplatin (AUC 6) i.v. on day 1

Repeat cycle every 3 wk

Carboplatin/gemcitabine

Gemcitabine 1250 mg/m2 i.v. on days 1 and 8

Sederholm C. J Clin Oncol 2005;23:8380–8388.

Carboplatin (AUC 5) i.v. on day 1

Repeat cycle every 21 d

Carboplatin/paclitaxel

Paclitaxel 225 mg/m2 i.v. on day 1

Kelly K. J Clin Oncol 2001;19:3210–3218.

Carboplatin (AUC 6) i.v. on day 1

Schiller JH. N Engl J Med 2002;346:92–98.

Repeat cycle every 3 wk

Carboplatin/paclitaxel

Paclitaxel 200 mg/m2 i.v. on day 1

Greco FA. Cancer 2001;92:2142–2147.

Carboplatin (AUC 6) i.v. on day 1

Repeat cycle every 3 wk

Carboplatin/nab-paclitaxel

nab-Paclitaxel 100 mg/m2 i.v. on day 1, 8, and 15

Socinski MA. J Clin Oncol. 2012;30:2055.

Carboplatin (AUC 6) i.v. on day 1

Repeat cycle every 21 d

Carboplatin/paclitaxel/ bevacizumab

Paclitaxel 200 mg/m2 i.v.on day 1

Sandler A. N Engl J Med. 2006;355:2542.

Carboplatin (AUC 6) i.v.on day 1

Bevacizumab 15 mg/kg i.v. on day 1

Repeat cycle every 21 d

Carboplatin/pemetrexed

Pemetrexed 500 mg/m2 i.v. on day 1

Gronberg BH. J Clin Oncol. 2009;27:3217.

Carboplatin (AUC 5) i.v. on day 1

Repeat cycle every 21 d

Cisplatin/docetaxel

Docetaxel 75 mg/m2 i.v. on day 1

Schiller JH. N Engl J Med 2002;346:92–98.

Cisplatin 75 mg/m2 i.v. on day 1

Fossella F. J Clin Oncol 2003;21:3016–3024.

Repeat cycle every 3 wk

Cisplatin/etoposide

Cisplatin 60 mg/m2 i.v. on day 1

Longeval E. Cancer 1982;50:2751–2756.

Etoposide 100 mg/m2 i.v. on days 4, 6, and 8

Repeat cycle every 3–4 wk

Cisplatin/gemcitabine

Gemcitabine 1000 mg/m2 i.v. on days 1, 8, and 15

Sandler AB. J Clin Oncol 2000;18:122–130.

Cisplatin 100 mg/m2 i.v. on day 1

Schiller JH. N Engl J Med 2002;346:92–98.

Repeat cycle every 4 wk

Cisplatin/paclitaxel

Paclitaxel 175 mg/m2 i.v. on day 1

Smit EF. J Clin Oncol 2003;21:3909–3917.

Cisplatin 80 mg/m2 i.v. on day 1

Repeat cycle every 3 wk

Cisplatin/pemetrexed

Pemetrexed 500 mg/m2 i.v. on day 1

Scagliotti GV. J Clin Oncol. 2008;26:3543.

Cisplatin 75 mg/m2 i.v. on day 1

Repeat cycle every 21 d

Cisplatin/vinorelbine

Vinorelbine 25–30 mg/m2 i.v. on days 1, 8, 15, and 22

Wozniak AJ. J Clin Oncol 1998;16:2459–2465.

Cisplatin 100 mg/m2 i.v. on day 1

Arriagada R. N Engl J Med 2004;350:351–360.

Repeat cycle every 4 wk

Cisplatin/vinorelbine/cetuximab

Cisplatin 80 mg/m2 i.v. on day 1

Pirker R. Lancet. 2009;373:1525.

Vinorelbine 25–30 mg/m2 i.v. on days 1 and 8

Cetuximab 400 mg/m2 i.v. on day 1, then

Cetuximab 250 mg/m2 i.v. weekly

Repeat cycle every 21 d

Crizotinib

(ALK +)

Docetaxel

Crizotinib 250 mg p.o. every 12 h

Docetaxel 75 mg/m2 i.v. on day 1

Crino L. J Clin Oncol 2011;29(Suppl). Abstract 7514.

Shepherd FA. J Clin Oncol 2000;18:2095–2103.

Repeat cycle every 3 wk

Fossella FV. J Clin Oncol 2000;18:2354–2362.

Erlotinib

Erlotinib 150 mg p.o. daily

Shepherd FA. N Engl J Med 2005;353:123–132.

Inoue A. J Clin Oncol 2009;27:1394.

Pemetrexed

Pemetrexed 500 mg/m2 i.v. on day 1

Hanna N. J Clin Oncol 2004;22:1589–1597.

Repeat cycle every 21 d

Vinorelbine

Vinorelbine 30 mg/m2 i.v. on days 1, 8, and 15

Repeat every 21 d

Furuse K. Ann Oncol. 1996;7:815.

Small cell

CAV

Cyclophosphamide 1000 mg/m2 i.v. on day 1

von Pawel J. J Clin Oncol 1999;17:658–667.

Doxorubicin 45 mg/m2 i.v. on day 1

Vincristine 2 mg i.v. on day 1

Repeat cycle every 21 d

EC

Carboplatin (AUC 5–6) i.v. on day 1

Okomoto H. J Clin Oncol 1999;17:3540–3545.

Etoposide 100 mg/m2 i.v. on days 1–3

Skarlos DV. Ann Oncol 2001;12:1232–1238.

Repeat cycle every 21–28 d

EP

Etoposide 80 mg/m2 i.v. on days 1–3

Ihde DC. J Clin Oncol 1994;12:2022–2034.

Cisplatin 80 mg/m2 i.v. on day 1

Repeat cycle every 21 d

Irinotecan/cisplatin

Irinotecan 60 mg/m2 i.v. on days 1, 8, and 15

Noda K. N Engl J Med 2002;346:85–91.

Cisplatin 60 mg/m2 i.v. on day 1

Repeat cycle every 28 d

Topotecan

Topotecan 1.5 mg/m2 i.v. on days 1–5

von Pawel J. J Clin Oncol 1999;17:658–667.

Repeat cycle every 21 d

Lymphoma

Hodgkin’s lymphoma

ABVD

Doxorubicin 25 mg/m2 i.v. on days 1 and 15

Bonadonna G. Cancer Treat Rev 1982;9:21–35.

Bleomycin 10 mg/m2 i.v. on days 1 and 15

Vinblastine 6 mg/m2 i.v. on days 1 and 15

Dacarbazine 375 mg/m2 i.v. on days 1 and 15

Repeat cycle every 28 d

BEACOPP (increased dose)

Bleomycin 10 mg/m2 i.v. on day 8

Diehl V. N Engl J Med 2003;348:2386–2395.

Etoposide 200 mg/m2 i.v. on days 1–3

Doxorubicin 35 mg/m2 i.v. on day 1

Cyclophosphamide 1200 mg/m2 i.v. on day 1

Vincristine 1.4 mg/m2 i.v. on day 8 (maximum dose of 2 mg)

Procarbazine 100 mg/m2 p.o. on days 1–7

Prednisone 40 mg/m2 p.o. on days 1–14

Filgrastim to start on day 8

Repeat cycle every 21 d

Brentuximab vedotin

Brentuximab vedotin 1.8 mg/kg (max dose 180 mg) i.v. every 3 wk

Younes A. J Clin Oncol 2012;30:2183–2189.

Stanford V

Doxorubicin 25 mg/m2 i.v. on days 1 and 15

Bartlett NL. J Clin Oncol 1995;13:1080–1088.

Vinblastine 6 mg/m2 i.v. on days 1 and 15c

Horning SJ. J Clin Oncol 2002;20:630–637.

Mechlorethamine 6 mg/m2 i.v. on day 1

Vincristine 1.4 mg/m2 i.v. on days 8 and 22c (maximum dose of 2 mg)

Bleomycin 5 mg/m2 i.v. on days 8 and 22

Etoposide 60 mg/m2 i.v. on days 15 and 16

Prednisone 40 mg/m2 p.o. every other day

Repeat cycle every 28 d

Non-Hodgkin’s lymphoma

Bendamustine

Bendamustine 120 mg/m2 i.v. on days 1 and 2

Repeat cycle every 21 d

Kahl BS. Cancer 2010;116:106–114.

Bortezomib

Bortezomib 1.3 mg/m2 i.v. on days 1, 4, 8, and 11

Fisher RI. J Clin Oncol 2006;24:4867–4874.

Repeat cycle every 21 d

Goy A. Ann Oncol 2009;20:520–525.

Brentuximab vedotin

Brentuximab vedotin 1.8 mg/kg (max dose 180 mg) i.v. every 3 wk

Pro B. J Clin Oncol 2012;30:2190–2196.

CHOP ± rituximab

Cyclophosphamide 750 mg/m2 i.v. on day 1

McKelvey EM. Cancer 1976;38:1484–1493.

Doxorubicin 50 mg/m2 i.v. on day 1

Lenz G. J Clin Oncol 2005;23:1984–1992.

Vincristine 1.4 mg/m2 i.v. on day 1 (maximum dose of 2 mg)

Hiddemann W. Blood 2005;106:3725–3732.

Prednisone 100 mg p.o. daily on days 1–5

± Rituximab 375 mg/m2 i.v. on day 0

Repeat cycle every 21 d

CNOP

Cyclophosphamide 750 mg/m2 i.v. on day 1

Pavlovsky S. Ann Oncol 1992;3:205–209.

Mitoxantrone 10 mg/m2 i.v. on day 1

Vincristine 1.4 mg/m2 i.v. on day 1 (maximum dose of 2 mg)

Prednisone 50 mg/m2 p.o. daily on days 1–5

Repeat cycle every 21 d

CVP ± rituximab

Cyclophosphamide 750 mg/m2 i.v. on day 1

Marcus R. Blood 2005;105:1417–1423.

Vincristine 1.4 mg/m2 i.v. on day 1 (maximum dose of 2 mg)

Prednisone 40 mg/m2 p.o. daily on days 1–5

± Rituximab 375 mg/m2 i.v. on day 1

Repeat cycle every 21 d

DHAP

Cisplatin 100 mg/m2 CIVI over 24 h on day 1

Velasquez WS. Blood 1988;71:117–122.

Cytarabine 2000 mg/m2 i.v. q12h × 2 doses on day 2

Dexamethasone 40 mg p.o./i.v. daily on days 1–4

Repeat cycle every 21–28 d

EPOCH

Etoposide 50 mg/m2/d CIVI on days 1–4

Wilson WH. J Clin Oncol 1993;11:1573–1582.

Doxorubicin 10 mg/m2/d CIVI on days 1–4

Gutierrez M. J Clin Oncol 2000;18:3633–3642.

Vincristine 0.4 mg/m2/d CIVI on days 1–4 (dose not capped)

Cyclophosphamide 750 mg/m2 i.v. on day 5

Prednisone 60 mg p.o. daily on days 1–5

Filgrastim daily starting on day 6

Repeat cycle every 21 d

ESHAP

Etoposide 40 mg/m2 i.v. daily on days 1–4

Velasquez WS. J Clin Oncol 1994;12:1169–1176.

Methylprednisolone 500 mg i.v. daily on days 1–5

Cytarabine 2000 mg/m2 i.v. on day 5

Cisplatin 25 mg/m2/d CIVI on days 1–4

Repeat cycle every 21–28 d

FC

Fludarabine 20 mg/m2 i.v. on days 1–5

Flinn IW. Blood 2000;96:71–75.

Cyclophosphamide 600 mg/m2 i.v. on day 1

Filgrastim 5 μg/kg/d s.c. starting on day 8

Repeat cycle every 28 d

FCMR

Rituximab 375 mg/m2 i.v. on day 1

Forstpointner R. Blood 2004;104:3064–3071.

Fludarabine 25 mg/m2 i.v. on days 1–3

Cyclophosphamide 200 mg/m2 i.v. on days 1–3

Mitoxantrone 8 mg/m2 i.v. on day 1

Repeat cycle every 28 d

FCR

Fludarabine 25 mg/m2 i.v. on days 1–3

Keating MJ. J Clin Oncol 2005;23:4079–4088.

Cyclophosphamide 250 mg/m2 i.v. on days 1–3

Tam CS. Cancer 2006;106:2412–2420.

Rituximab 375 mg/m2 i.v. on day 1 or

Rituximab 375 mg/m2 i.v. on day 1 (cycle 1 only)

Rituximab 500 mg/m2 i.v. on day 1 (cycles 2–6)

Repeat cycle every 28 d

FND

Fludarabine 25 mg/m2 i.v. on days 1–3

McGlaughlin P. J Clin Oncol 1996;14:1262–1268.

Mitoxantrone 10 mg/m2 i.v. on day 1

Dexamethasone 20 mg i.v./p.o. daily on days 1–5

Repeat cycle every 28 d

FR

Fludarabine 25 mg/m2 i.v. daily on days 1–5

Byrd JC. Blood 2003;101:6–14.

Rituximab 50 mg/m2 i.v. on day 1 (cycle 1 only)

Rituximab 325 mg/m2 i.v. on day 3 (cycle 1 only)

Rituximab 375 mg/m2 i.v. on day 5 (cycle 1 only)

Rituximab 375 mg/m2 i.v. on day 1 (cycles 2–6)

Repeat cycle every 28 d

Hyper-CVAD

Course I, III, V, and VII:

Cyclophosphamide 300 mg/m2

Khouri IF. J Clin Oncol 1998;16:3803–3809.

i.v. q12h × 6 doses on days 1–3

Thomas DA. Blood 2004;104:1624–1630.

Mesna 600 mg/m2/d CIVI daily on days 1–3

Vincristine 2 mg i.v. on days 4 and 11

Doxorubicin 50 mg/m2 i.v. on day 4

Dexamethasone 40 mg i.v./p.o. daily on days 1–4 and 11–14

Filgrastim 5–10 μg/kg/d s.c. starting on day 5

Course II, IV, VI, and VIII:

Methotrexate 200 mg/m2 i.v. over 2 h, followed by methotrexate 800 mg/m2 CIVI over 22 h on day 1 with leucovorin rescue

Cytarabine 3000 mg/m2 i.v. q12h × 4 doses on days 2 and 3

Filgrastim 5–10 μg/kg/d s.c. starting on day 4

Refer to the references for IT therapy recommendations

Ibritumomab tiuxetan

Rituximab 250 mg/m2 i.v. on days 1 and 8

Witzig TE. J Clin Oncol 2002;20:2453–2463.

Ibritumomab tiuxetan 5 mCi i.v. on day 1 and 0.4 mCi/kg i.v. on day 8 immediately following day 8 rituximab

Witzig TE. J Clin Oncol 2002;20:3262–3269.

Ibrutinib

Ibrutinib 560 mg p.o. daily for mantle cell lymphoma

Wang ML. N Engl J Med 2013;369:507–516.

ICE ± rituximab

Ifosfamide 5000 mg/m2 CIVI over 24 h on day 2

Moskowitz CH. J Clin Oncol 1999;17:3776–3785.

Mesna 5000 mg/m2 CIVI over 24 h on day 2

Kewalramani T. Blood 2004;103:3684–3688.

Carboplatin (AUC 5) i.v. on day 2 (maximum dose of 800 mg)

Etoposide 100 mg/m2 i.v. daily on days 1–3

± Rituximab 375 mg/m2 i.v. 48 h before start of cycle 1 and on day 1 of each cycle

Repeat cycle every 14–15 d

R-EPOCH

Rituximab 375 mg/m2 i.v. on day 1

Jermann M. Ann Oncol 2004;15:511–516.

Doxorubicin 15 mg/m2 CIVI on days 2–4

Etoposide 65 mg/m2 CIVI on days 2–4

Vincristine 0.5 mg CIVI on days 2–4

Cyclophosphamide 750 mg/m2 i.v. on day 5

Prednisone 60 mg/m2 daily p.o. on days 1–14

Repeat cycle every 21 d

R–Hyper-CVAD

Course I, III, V, and VII:

Rituximab 375 mg/m2 i.v. on day 1

Romaguera JE. J Clin Oncol 2005;23:7013–7023.

Cyclophosphamide 300 mg/m2 i.v. q12h × 6 doses on days 2–4

Mesna 600 mg/m2/d CIVI daily on days 1–3

Vincristine 1.4 mg/m2 i.v. (maximum dose of 2 mg) administered 12 h after the last dose of cyclophosphamide and repeated on day 12

Doxorubicin 16.7 mg/m2/d CIVI on days 5–7

Dexamethasone 40 mg i.v./p.o. daily on days 2–5 and 12–15

Filgrastim 5 μg/kg s.c. daily starting 24–36 h after the completion of doxorubicin

Course II, IV, VI, and VIII:

Rituximab 375 mg/m2 i.v. on day 1

Methotrexate 200 mg/m2 i.v. on day 2 immediately, followed by methotrexate 800 mg/m2 CIVI over 22 h with leucovorin rescue

Cytarabine 3000 mg/m2 i.v. q12h × 4 doses on days 3 and 4

Filgrastim 5 μg/kg/d s.c. starting 24–36 h after the completion of chemotherapy

Refer to the reference for IT therapy recommendations

Rituximab

Rituximab 375 mg/m2 i.v. weekly × 4 doses

Davis TA. J Clin Oncol 1999;17:1851–1857.

Romidepsin

Romidepsin 14 mg/m2 i.v. on days 1, 8, and 15

Repeat cycle every 28 d

Coiffier B. J Clin Oncol 2012;30:631–636.

Tositumomab

Step 1:

Tositumomab 450 mg i.v., followed by tositumomab 35 mg labeled with 5mCi of iodine-131 (131I) on day 1

Kaminski MS. J Clin Oncol 2001;19:3918–3928.

Kaminski MS. N Engl J Med 2005;352:441–449.

Step 2:

Tositumomab 450 mg i.v., followed by tositumomab 35 mg labeled with an amount of 131I calculated from serial total-body γ-camera counts 7–14 d after step 1

Vorinostat

Vorinostat 400 mg p.o. daily

Duvic M. Clin Lymphoma Myeloma 2009;9:412–416.

Melanoma

Cisplatin/vinblastine/dacarbazine/interferon-α/interleukin-2

Cisplatin 20 mg/m2 i.v. daily on days 1–4

Vinblastine 1.6 mg/m2 i.v. daily on days 1–4

Legha SS. J Clin Oncol 1998;16:1752–1759.

Lewis KD. J Clin Oncol 2006;24:3157–3163.

Dacarbazine 800 mg/m2 i.v. daily on day 1

Interferon-α 9 MU/m2/d CIVI on days 1–4

Interleukin-2 5 MU/m2 s.c. daily on days 1–5

CVD

Cisplatin 20 mg/m2 i.v. daily on days 2–5

Legha SS. Cancer 1989;64:2024–2029.

Vinblastine 1.6 mg/m2 i.v. daily on days 1–5

Dacarbazine 800 mg/m2 i.v. daily on day 1

Repeat cycle every 21 d

Dabrafenib

Dabrafenib 150 mg p.o. every 12 h

Hauschild A. Lancet 2012;380:358–365.

Dacarbazine

Dacarbazine 250 mg/m2 i.v. daily on days 1–5

Middleton MR. J Clin Oncol 2000;18:156–166.

Repeat cycle every 21 d

Ipilimumab

Ipilimumab 3 mg/kg i.v. on day 1

Repeat cycle every 21 d for a maximum of 4 cycles

Hodi FS. N Engl J Med 2010;363:711–723.

Interferon-α-2B

Interferon-α-2B 20 MU/m2/d i.v. 5 d per wk for 4 wk, followed by 10 MU/m2/d s.c. 3 times a wk for 48 wk

Kirkwood JM. J Clin Oncol 1996;14:7–17.

Interleukin-2

Interleukin-2600000–720000 IU/kg i.v. every 8 h × 14 consecutive doses over 5 d and after a 6–9 d rest period, repeat an additional 14 doses over 5 d

Atkins MB. J Clin Oncol 1999;17:2105–2116.

nab-Paclitaxel/carboplatin

Paclitaxel/carboplatin

Repeat cycle every 6–12 wk

nab-Paclitaxel 100 mg/m2 i.v. on days 1, 8, and 15

Carboplatin (AUC 2) i.v. on days 1, 8, and 15

Repeat every 28 d

Paclitaxel 100 mg/m2 i.v. on days 1, 8, and 15

Carboplatin (AUC 2) i.v. on days 1, 8, and 15

Repeat every 28 d

Kottschade LA. Cancer 2011;117:1704.

Rao RD. Cancer 2006;106:375.

Temozolomide

Temozolomide 200 mg/m2 p.o. daily on days 1–5

Middleton MR. J Clin Oncol 2000;18:156–166.

Repeat cycle every 28 d

Temozolomide/interferon-α

Temozolomide 200 mg/m2 p.o. daily on days 1–5

Kaufmann R. J Clin Oncol 2005;23:9001–9007.

Interferon-α 5 MU/m2 s.c. 3 times a wk

Repeat cycle every 28 d

Trametinib

Trametinib 2 mg p.o. daily

Flaherty KT. N Engl J Med 2012;367:107–114.

Trametinib/dabrafenib

Trametinib 2 mg p.o. daily

Dabrafenib 150 mg p.o. every 12 h

Flaherty KT. N Engl J Med 2012;367:1694–1703.

Vemurafenib

(BRAF V600E +)

Vemurafenib 960 mg p.o. every 12 h

Chapman PB. N Engl J Med 2011;364:2507–2516.

Multiple myeloma

Carfilzomib

Carfilozmib 20 mg/m2/d i.v. on days 1–2, 8–9, and 16

Jagannath S. J Clin Oncol 2009. Abstract 8504.

Repeat every 28 d

Siegel DS. J Clin Oncol 2011;29 (Suppl 20). Abstract 8027.

Dexamethasone

40 mg p.o. daily on days 1–4, 9–12, and 17–20

Alexanian R. Ann Intern Med 1986;105:8–11.

Repeat cycle every 21 d

DVD

Pegylated liposomal doxorubicin 40 mg/m2 i.v. day 1

Vincristine 2 mg i.v. day 1

Dexamethasone 40 mg p.o daily for 4 d

Repeat cycle every 28 d

Hussein M. Cancer 2002;95:2160–2168.

Dimopoulos MA. Ann Oncol 2003;14:1039–1044.

MP

Melphalan 8 mg/m2 p.o. days 1–4

Oken MM. Cancer 1997;79:1561–1567.

Prednisone 60 mg/m2 p.o. days 1–4

Repeat cycle every 28 d

MPB

Melphalan 9 mg/m2 p.o. days 1–4

San Miguel JF. Blood 2011;118. Abstract 476.

Prednisone 60 mg/m2 p.o. days 1–4

Bortezomib 1.3 mg/m2 i.v. days 1, 4, 8, 11, 22, 25, 29, and 32 (cycles 1–4) and days 1, 8, 22, and 29 (cycles 5–9)

Repeat every 42 d

San Miguel J Clin Oncol 2013;31(4):448–465.

MPR

Melphalan 0.18 mg/kg/d p.o. days 1–4

Prednisone 2 mg/kg/d p.o. days 1–4

Lenalidomide 10 mg p.o. daily days 1–21

Repeat every 28 d

Palumbo A. N Engl J Med 2012;366:1759–1769.

MPT

Melphalan 0.2–0.25 mg/kg/d p.o. days 1–4 or

Melphalan 4 mg/m2/d p.o. days 1–7

Prednisone 1–2 mg/kg/d p.o. days 1–4 or

Prednisone 40 mg/m2/d p.o. days 1–7

Thalidomide 100–400 mg p.o. daily

Repeat every 28–42 d

Kapoor P. Leukemia 2011;25:686–696.

Pad

Bortezomib 1.3 mg/m2 i.v. days 1, 4, 8, and 11

Palumbo A. Ann Oncol 2008;19:1160.

Doxorubicin 9 mg/m2 i.v. days 1–4

Dexamethasone 40 mg p.o. days 1–4, 9–12, and 17–20

Repeat cycle every 28 d

Sonneveld P. J Clin Oncol 2012;30:2946.

Pomalidomide/dexamethasone

Pomalidomide 4 mg p.o. on days 1–21

Dexamethasone 40 mg p.o. on days 1, 8, 15, and 22

Repeat cycle every 28 d

Lacy MQ. J Clin Oncol 2009;27:5508–5014.

Revlimid/dexamethasone

Lenalidomide 25 mg p.o. daily × 21 d

Rajkumar SV. Blood 2005;106:4050–4053.

Dexamethasone 40 mg p.o. daily on days 1–4, 9–12, and 17–20

Repeat cycle every 28 d

Thalidomide/dexamethasone

Thalidomide initial dose to start at 100–200 mg p.o. every day at bedtime and increase as tolerated

Cavo M. Blood 2005;106:35–39.

Rajkumar SV. J Clin Oncol 2006;24:431–436.

Dexamethasone 40 mg p.o. daily on days 1–4, 9–12, and 17–20

Repeat cycle every 28 d

VAD

Vincristine 0.4 mg/d CIVI days 1–4

Barlogie B. N Engl J Med 1984;310:1353–1356.

Doxorubicin 9 mg/m2/d CIVI days 1–4

Dexamethasone 40 mg p.o. daily days 1–4, 9–12, and 17–20

Repeat cycle every 28–35 d

Velcade ± dexamethasone

Bortezomib 1.3 mg/m2 i.v. on days 1, 4, 8, and 11

Richardson PG. N Engl J Med 2003;348:2609–2617.

± Dexamethasone 20–40 mg p.o. on days 1, 2, 4, 5, 8, 9, 11, and 12

Jagannath S. Br J Haematol 2005;129:776–783.

Richardson PG. N Engl J Med

Repeat cycle every 21 d

2005;352:2487–2498.

VDC (CyBorD)

Bortezomib 1.3 mg/m2 i.v days 1, 4, 8, and 11

Dexamethasone 40 mg p.o. days 1–4, 9–12, and 17–20 or

Dexamethasone 40 mg p.o. days 1, 8, and 15 (every 21 d)

Cyclophosphamide 300 mg/m2 p.o. days 1, 8, 15, and 22 or

Cyclophosphamide 500 mg/m2 p.o. days 1, 8, and 15 (every 21 d)

Repeat every 21–28 d

Bortezomib 1.3 mg/m2 i.v. days 1, 4, 8, and 11

Reeder CB. Leukemia 2009;23:1337.

VRd

Lenalidomide 25 mg p.o. days 1–14

Kumar S. Blood 2012;119:4375.

Dexamethasone 20 mg p.o. days 1, 2, 4, 5, 8, 9, 11, and 12 or

Dexamethasone 40 mg p.o. days 1, 8, and 15

Repeat every 21 d

Bortezomib 1.3 mg/m2 i.v. days 1, 4, 8, and 11

Richardson PG. Blood 2010;116:679.

VTD

Thalidomide 50–200 mg p.o. days 1–21

Cavo M. Lancet 2010;376:2075.

Dexamethasone 40 mg p.o. days 1, 2, 4, 5, 8, 9, 11, and 12 or days 1–4 and 9–12

Repeat every 21 d

Ovarian cancer

Altretamine

Altretamine 260 mg/m2/d p.o. in 4 divided doses on days 1–14

Rustin GJ. J Clin Oncol 1997;15:172–176.

Repeat cycle every 28 d

Carboplatin/paclitaxel

Carboplatin (AUC 5–7.5) i.v. on day 1

Neijt JP. J Clin Oncol 2000;18:3084–3092.

Paclitaxel 175 mg/m2 i.v. on day 1

Ozols RF. J Clin Oncol 2003;21:3194–3200.

Repeat cycle every 21 d

ICON 4. Lancet 2003;361:2099–2106.

Cisplatin/paclitaxel

Paclitaxel 135 mg/m2 CIVI over 24 h on day 1

McGuire WP. N Engl J Med 1996;334:1–6.

Cisplatin 75 mg/m2 i.v. on day 2

Repeat cycle every 21 d

Docetaxel

Docetaxel 100 mg/m2 i.v. on day 1

Verschraegen CR. J Clin Oncol 2000;18:2733–2739.

Repeat cycle every 21 d

Docetaxel/carboplatin

Docetaxel 75 mg/m2 i.v. on day 1

Vasey P. J Natl Cancer Inst 2004;96:1682–1691.

Carboplatin (AUC 5) i.v. on day 1

Repeat cycle every 21 d

Docetaxel/cisplatin

Docetaxel 75 mg/m2 i.v. on day 1, followed by

Vasey PA. J Clin Oncol 1999;17:2069–2080.

cisplatin 75 mg/m2 i.v. on day 1

Repeat cycle every 21 d

Etoposide

Etoposide 50 mg/m2/d p.o. on days 1–21

Rose PG. J Clin Oncol 1998;16:405–410.

Repeat cycle every 28 d

Gemcitabine

Gemcitabine 800–1250 mg/m2 i.v. on days 1, 8, and 15

Von Minckwitz G. Ann Oncol 1999;10:853–855.

Repeat cycle every 28 d

Markman M. Gynecol Oncol 2003;90:593–596.

Lund B. J Natl Cancer Inst 1994;86:1530–1533.

Gemcitabine/carboplatin

Gemcitabine 1000 mg/m2 i.v. on days 1 and 8

Pfisterer J. J Clin Oncol 2006;24:4699–4707.

Carboplatin (AUC 4) on day 1

Repeat cycle every 21 d

Gemcitabine/cisplatin

Cisplatin 30 mg/m2 i.v. on days 1 and 8

Nagourney RA. Gynecol Oncol 2003;88:35–39.

Gemcitabine 600–750 mg/m2 i.v. on days 1 and 8

Repeat cycle every 21 d

Liposomal doxorubicin

Liposomal doxorubicin 40–50 mg/m2 i.v. on day 1

Muggia FM. J Clin Oncol 1997;15:987–993.

Repeat cycle every 21–28 d

Topotecan

Topotecan 1.5 mg/m2/d i.v. on days 1–5

Brookman MA. J Clin Oncol 1998;16:3345–3352.

Repeat cycle every 21 d

Topotecan weekly

Topotecan 4 mg/m2 i.v. on days 1, 8, and 15

Levy T. Gynecol Oncol 2004;95:686–690.

Repeat cycle every 28 d

Vinorelbine

Vinorelbine 30 mg/m2 i.v. on days 1 and 8

Rothenberg ML. Gynecol Oncol 2004;95:506–512.

Repeat cycle every 21 d

Pancreatic

5-FU/irinotecan/oxaliplatin (FOLFIRINOX)

5-FU 400 mg/m2 i.v. bolus, followed by 2400 mg/m2 CIVI for 46 h

Leucovorin 400 mg/m2 i.v. (before 5-FU) on day 1

Irinotecan 180 mg/m2 i.v. on day 1

Oxaliplatin 85 mg/m2 i.v. on day 1

Repeat cycle every 2 wk

Conroy T. N Engl J Med 2011;364:1817–1825.

5-FU/oxaliplatin

5-FU 2000 mg/m2 i.v. on days 1, 8, 15, and 22

Pelzer U. Eur J Cancer 2011;47:1676–1681.

Folinic acid 200 mg/m2 i.v. on days 1, 8, 15, and 22

Oxaliplatin 85 mg/m2 i.v. on days 8 and 22

Repeat cycle every 42 d

Gemcitabine

Gemcitabine 1000 mg/m2 i.v. weekly × 7, followed by 1 wk rest, then once weekly × 3 and repeat every 28 d

Burris HA. J Clin Oncol 1997;15:2403–2413.

Gemcitabine

Gemcitabine 1000 mg/m2 i.v. on days 1, 8, and 15

Neuhaus P. J Clin Oncol 2008;26:4504. Abstract.

Repeat cycle every 28 d

Gemcitabine/capecitabine

Gemcitabine 1000 mg/m2 i.v. on days 1 and 8

Hess V. J Clin Oncol 2003;21:66–68.

Capecitabine 650 mg/m2 p.o. b.i.d. on days 1–14

Stathopoulos GP. Ann Oncol 2004;15:224–229.

Repeat cycle every 21 d

Gemcitabine/cisplatin

Gemcitabine 1000 mg/m2 i.v. on days 1 and 15

Heinemann V. J Clin Oncol 2006;24:3946–3952.

Cisplatin 50 mg/m2 i.v. on days 1 and 15

Repeat cycle every 28 d

Gemcitabine/erlotinib

Gemcitabine 1000 mg/m2 i.v. weekly × 7, followed by 1 wk rest, then once weekly × 3

Moore MJ. J Clin Oncol 2007;25:1960–1966.

Erlotinib 100 mg p.o. daily

Repeat 3 wk cycle every 28 d

Gemcitabine/nab-paclitaxel

Gemcitabine 1000 mg/m2 i.v. on days 1, 8, and 15 every 4 wk or

Gemcitabine 1000 mg/m2 i.v. weekly × 7, followed by 1 wk rest, then weekly on days 1, 8, and 15 every 4 wk

nab-Paclitaxel 125 mg/m2 i.v. on days 1, 8, and 15

Repeat cycle every 4 wk

Von Hoff DD. Gastrointestinal Cancers Symposium 2013. Abstract LBA148.

Gemcitabine/oxaliplatin (GemOX)

Gemcitabine 1000 mg/m2 i.v. over 100 min on day 1

Louvet C. J Clin Oncol 2005;23:3509–3516.

Oxaliplatin 100 mg/m2 i.v. on day 2

Demols A. Br J Cancer 2006;94:481–485.

Repeat cycle every 2 wk

GTX

Capecitabine 750 mg/m2 p.o. b.i.d. × 14 d

Gemcitabine 750 mg/m2 i.v. on days 4 and 11

Fine RL. Cancer Chemother Pharmacol 2008;61:167–175.

Docetaxel 30 mg/m2 i.v. on days 4 and 11

Repeat cycle every 21 d

Prostate

Abiraterone

Cabazitaxel

Docetaxel

Abiraterone 1000 mg p.o. daily

Prednisone 5 mg p.o. b.i.d.

Repeat cycle every 28 d

Cabazitaxel 25 mg/m2 i.v. on day 1

Prednisone 10 mg p.o. daily

Repeat cycle every 21 d

Docetaxel 75 mg/m2 i.v. on day 1

Repeat cycle every 21 d

deBono JS. N Eng J Med 2011;364:1995–2005.

deBono JS. Lancet 2010;376:1147–1154.

Picus J. Semin Oncol 1999;26(5 Suppl 17):14–18.

Docetaxel/estramustine

Docetaxel 35 mg/m2 i.v. on day 2 of weeks 1 and 2

Copur MS. Semin Oncol 2001;28:16–21.

Estramustine 420 mg p.o. for the first 4 doses and 280 mg p.o. for the next 5 doses on days 1–3 of weeks 1 and 2

Dexamethasone 4 mg p.o. b.i.d. on days 1–3 of weeks 1 and 2

Repeat cycle every 21 d

Docetaxel/prednisone

Docetaxel 75 mg/m2 i.v. on day 1

Eisenberger MA. J Clin Oncol 2004;22:4. Abstract.

Prednisone 5 mg p.o. daily

Repeat cycle every 21 d for up to a total of 10 cycles

Enzalutamide

Enzalutamide 160 mg p.o. daily

Repeat cycle every 28 d

Scher HI. N Engl J Med 2012;367:1187–1197.

Estramustine/etoposide

Estramustine 15 mg/kg/d p.o. in 4 divided doses × 21 d

Clark PE. Urology 2001;57:281–285.

Etoposide 50 mg/m2/d p.o. in 2 divided doses × 21 d

Repeat cycle every 28 d

Mitoxantrone/hydrocortisone

Mitoxantrone 14 mg/m2 i.v. every 3 wk

Kantoff PW. J Clin Oncol 1999;17:2506–2513.

Hydrocortisone 30 mg every morning and 10 mg every night

Mitoxantrone/prednisone

Mitoxantrone 12 mg/m2 i.v. on day 1

Tannock IF. J Clin Oncol 1996;14:1756–1764.

Prednisone 5 mg p.o. b.i.d.

Repeat cycle every 3 wk

Paclitaxel

Paclitaxel 135–170 mg/m2 i.v. on day 1

Roth BJ. Cancer 1993;72:2457–2460.

Repeat cycle every 3 wk

PE

Paclitaxel 120 mg/m2 CIVI over 96 h

Hudes GR. J Clin Oncol 1997;15:3156–3163.

Estramustine 600 mg/m2/d p.o. in 2–3 divided doses continuously starting 24 h before first paclitaxel

Repeat paclitaxel every 21 d

TEC

Estramustine 10 mg/kg/d in divided doses 5 d per wk (start 48 h before chemotherapy)

Kelly WK. J Clin Oncol 2001;19:44–53.

Paclitaxel 60–100 mg/m2 i.v. weekly

Carboplatin (AUC 6) i.v. every 4 wk

Renal cell carcinoma

Axitinib

Axitinib 5 mg p.o. b.i.d.

Rini BI. Lancet 2011;378:1931–1939.

Everolimus

Everolimus 10 mg p.o. daily

Motzer RJ. Lancet 2008;372:449–456.

Interferon-α-2A/bevacizumab

Interferon-α-2A 9 MU s.c. thrice weekly

Bevacizumab 10 mg/kg i.v. every 2 wk

Escudier B. Lancet 2007;370:2103–2111.

Interferon-α-2A/interleukin-2

Interferon-α-2A 6 MU s.c. thrice weekly

Negrier S. N Engl J Med 1998;338:1272–1278.

Interleukin-2 18 MU/m2/d CIVI × 5 d every 3 wk for 2 induction cycles and 4 maintenance cycles

Sorafenib

Sorafenib 400 mg p.o. b.i.d.

Ratain MJ. J Clin Oncol 2006;24:2505–2512.

Sunitinib

Sunitinib 50 mg p.o. daily × 4 wk

Motzer RJ. JAMA 2006;295:2516–2524.

Pazopanib

Temsirolimus

Repeat cycle every 6 wk

Pazopanib 800 mg p.o. daily

Temsirolimus 25 mg i.v. weekly

Sternberg CN. J Clin Oncol 2010;28:1061–1068.

Hudes G. N Engl J Med 2007;22:2271–2281.

Sarcoma

Ewing’s sarcoma

CAV alternating with IE

Odd cycles:

Cyclophosphamide 1200 mg/m2 i.v. on day 1 (with Mesna)

Grier HE. N Engl J Med 2003;348:364–701.

Doxorubicin 75 mg/m2 i.v. on day 1

Vincristine 2 mg i.v. on day 1

Dactinomycin 1.25 mg/m2 i.v. on day 1 when cumulative dose of doxorubicin reaches 375 mg/m2

Even cycles:

Ifosfamide 1800 mg/m2 i.v. on days 1–5 (with Mesna)

Etoposide 100 mg/m2 i.v. on days 1–5

HDCAV/IE

Cycles 1, 2, 3, and 6: Cyclophosphamide 2100 mg/m2 i.v. on days 1 and 2 (with Mesna)

Kolb EA. J Clin Oncol 2003;21:3423–3430.

Doxorubicin 25 mg/m2/d CIVI on days 1–3

Vincristine 0.67 mg/m2/d CIVI on days 1–3 (maximum dose of 2 mg/cycle)

Cycles 4, 5, and 7:

Ifosfamide 1800 mg/m2 i.v. on days 1–5 (with Mesna)

Etoposide 100 mg/m2 i.v. on days 1–5

VACA

Vincristine 1.5 mg/m2/d i.v. on days 1 and 22 (maximum dose of 2 mg)

Burgert EO. J Clin Oncol 1990;8:1514–1524.

Doxorubicin 75 mg/m2/d i.v. on day 1

Cyclophosphamide 1400 mg/m2/d i.v. on day 22 (with Mesna)

Repeat cycle every 6 wk × 6

then

Vincristine 1.5 mg/m2/d i.v. on days 1 and 22 (maximum dose of 2 mg)

Dactinomycin 0.45 mg/m2/d i.v. on days 1–5 (maximum dose of 0.5 mg)

Cyclophosphamide 1400 mg/m2/d i.v. on day 22 (with Mesna)

Repeat cycle every 6 wk × 7

VAIA

Vincristine 1.5 mg/m2/d i.v. on days 1, 8, 15, and 22

Paulssen M. J Clin Oncol 2001;19:1818–1829.

Ifosfamide 3000 mg/m2/d i.v. on days 1, 2, 22, 23, 43, and 44 (with Mesna)

Doxorubicin 30 mg/m2/d i.v. on days 1, 2, 43, and 44

Dactinomycin 0.5 mg/m2/d i.v. on days 22–24

Gastrointestinal stromal tumor (GIST)

Imatinib

Imatinib 400 mg p.o. daily

Demetri GD. N Engl J Med 2002;347:472–480.

Sunitinib

Sunitinib 50 mg p.o. daily

Casali PG. J Clin Oncol 2006;24:9513. Abstract.

Osteosarcoma

Doxorubicin/cisplatin

Doxorubicin 25 mg/m2 i.v. on days 1–3

Bramwell VHC. J Clin Oncol 1992;10:1579–1591.

Cisplatin 100 mg/m2 i.v. on day 1

Repeat cycle every 21 d

Doxorubicin/cisplatin/high-dose methotrexate

Gemcitabine/docetaxel

Cisplatin 120 mg/m2 i.v. on day 1 of weeks 1, 6, 13, and 18

Doxorubicin 25 mg/m2/d CIVI on days 1–3 of weeks 1, 6, 13, 18, 23, and 28

Methotrexate 12 g/m2 i.v. on day 1 of weeks 4, 5, 9, 10, 16, 17, 21, 22, 26, 27, 31, and 32

Leucovorin 10 mg/m2 i.v. q 6 h after each dose of methotrexate

Gemcitabine 675 mg/m2 i.v. on days 1 and 8

Myers PA. J Clin Oncol 2005;23:2004–2011.

Leu KM. J Clin Oncol 2004;22:1706–1712.

Docetaxel 100 mg/m2 i.v. on day 8

Repeat cycle every 21 d

Methotrexate/doxorubicin/cisplatin/BCD

Methotrexate 12 gm/m2 i.v. in weeks 3, 4, 8, 9, 13, 14, 18, 19, 23, 24, 37, and 38

Goorin AM. J Clin Oncol 2003;21:1574–1580.

Leucovorin 15 mg/m2 i.v. q6h × 10 doses in weeks 3, 4, 8, 9, 13, 14, 18, 19, 23, 24, 37, and 38

Doxorubicin 37.5 mg/m2 i.v. on days 1 and 2 in weeks 5, 10, 25, and 28

Cisplatin 60 mg/m2 i.v. on days 1 and 2 in weeks 5, 10, 25, and 28

Cyclophosphamide 600 mg/m2 i.v. in days 1–3 on weeks 15, 31, 34, 39, and 42

Bleomycin 15 mg/m2 i.v. on days 1–3 in weeks 15, 31, 34, 39, and 42

Dactinomycin 0.6 mg/m2 i.v. on days 1–3 in weeks 15, 31, 34, 39, and 42

Doxorubicin 30 mg/m2 i.v. on days 1–3 in week 20

Soft tissue sarcoma

AD

Doxorubicin 15 mg/m2/d CIVI daily on days 1–4

Antman K. J Clin Oncol 1993;11:1276–1285.

Dacarbazine 250 mg/m2/d CIVI daily on days 1–4

Repeat cycle every 21 d

AIM

Doxorubicin 50 mg/m2 i.v. on day 1

Le Cesne A. J Clin Oncol 2000;18:2676–2684.

Ifosfamide 5000 mg/m2 CIVI over 24 h on day 1 immediately following doxorubicin

Mesna 600 mg/m2 i.v. before ifosfamide, followed by 2500 mg/m2 CIVI over 24 h on day 1

Mesna 1250 mg/m2 i.v. over 12 h starting at the end of the ifosfamide infusion

Repeat cycle every 21 d

Dacarbazine

Dacarbazine 250 mg/m2 i.v. on days 1–4

Repeat cycle every 21 d

Antman K. J Clin Oncol 1993;11:1276–1285.

Doxil

Doxil 50 mg/m2 i.v. on day 1

Repeat cycle every 28 d

Judson I. Eur J Cancer 2001;37:870–877.

Doxorubicin

Doxorubicin 75 mg/m2 i.v. on day 1

Santoro A. J Clin Oncol 1995;13:1537–1545.

Repeat cycle every 21 d

Gemcitabine/docetaxel

Gemcitabine 900 mg/m2 i.v. on days 1 and 8

Hensley ML. J Clin Oncol 2002;20:2824–2831.

Docetaxel 100 mg/m2 i.v. on day 8

Repeat cycle every 21 d

Gemcitabine/docetaxel

Gemcitabine 675 mg/m2 i.v. on days 1 and 8

Leu KM. J Clin Oncol 2004;22:1706–1712.

Docetaxel 100 mg/m2 i.v. on day 8

Repeat cycle every 21 d

MAID

Mesna 2500 mg/m2/d CIVI daily on days 1–4

Antman K. J Clin Oncol 1993;11:1276–1285.

Doxorubicin 15 mg/m2/d CIVI daily on days 1–4

Ifosfamide 2000 mg/m2/d CIVI daily on days 1–3

Dacarbazine 250 mg/m2/d CIVI daily on days 1–4

Pazopanib

Repeat cycle every 21 d

Pazopanib 800 mg p.o. daily

van der Graaf WTA. Lancet 2012;379:1879–1886.

Testicular cancer

BEP

Cisplatin 20 mg/m2 i.v. on days 1–5

Peckham MJ. Br J Cancer 1983;47:613–619.

Bleomycin 30 U i.v. on days 2, 9, and 16

Etoposide 100 mg/m2 i.v. on days 1–5

Repeat cycle every 3 wk

EP

Etoposide 100 mg/m2/d i.v. on days 1–5

Motzer RJ. J Clin Oncol 1995;13:2700–2704.

Cisplatin 20 mg/m2/d i.v. on days 1–5

Repeat cycle every 21 d

TIP

Paclitaxel 250 mg/m2 i.v. on day 1

Kondagunta GV. J Clin Oncol 2005;23:6549–6555.

Ifosfamide 1500 mg/m2 i.v. on days 2–5

Cisplatin 25 mg/m2 i.v. on days 2–5

Mesna 500 mg/m2 i.v. before and then 4 and 8 h after each dose of ifosfamide

Repeat cycle every 21 d

VeIP

Vinblastine 0.11 mg/kg i.v. on days 1 and 2

Miller K. J Clin Oncol 1997;15:1427–1431.

Ifosfamide 1200 mg/m2 i.v. on days 1–5

Cisplatin 20 mg/m2 i.v. on days 1–5

Mesna 400 mg/m2 i.v. before first ifosfamide dose, then 1200 mg/m2/d on CIVI days 1–5

Repeat cycle every 21 d

VIP

Etoposide 75 mg/m2/d i.v. on days 1–5

Loehrer PJ. Ann Intern Med 1988;109:540–546.

Ifosfamide 1200 mg/m2/d i.v. on days 1–5

Cisplatin 20 mg/m2/d i.v. on days 1–5

Mesna 400 mg/m2 i.v. before ifosfamide, then 1200 mg/m2/d CIVI on days 1–5

Repeat cycle every 21 d

AUC, area under the curve; CIVI, continuous intravenous infusion; ANC, absolute neutrophil count; XRT, radiation therapy.

aIf patient received pelvic irradiation in the 5 d preceding, give 15 mg/m2.

bFor patients older than 69 yr or World Health Organization (WHO) performance status (PS) 2 give 300 mg/m2 i.v.

cDuring course III for patients >50 yr, vinblastine reduced to 4 mg/m2 and vincristine reduced to 1 mg/m2.



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