(BQ) Part 1 book “Practical chemotherapy - A multidisciplinary guide” has contents: What''s in the monographs and how to use them, chlorambucil with or without prednisolone, gemcitabine, gemcitabine plus cisplatin, liposomal daunorubicin, liposomal doxorubicin,… and other contents.
Practical Chemotherapy A multidisciplinary guide Maxwell Summerhayes BPharm, PHD, MRPharms Scientific Advisor, Oncology Business Unit, Roche Products, Welwyn Garden City, UK and Susanna Daniels BSc(Hons), MRPharmS Lead Pharmacist, Cancer Services University College London Hospitals NHS Trust CRC Press Taylor & Francis Group Boca Raton London New York CRC Press is an imprint of the Taylor & Francis Group, an informa business Radcliffe Medical Press Ltd 18 Marcham Road Abingdon Oxon OX14 1AA United Kingdom www.radcliffe-oxford.com The Radcliffe Medical Press electronic catalogue and online ordering facility Direct sales to anywhere in the world © 2003 Maxwell Summerhayes and Susanna Daniels Reprinted 2007 All rights reserved No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the copyright owner Every effort has been made to ensure the accuracy of this text, and that the best information available has been used This does not diminish the requirement to exercise clinical judgement, and neither the publishers nor the authors can accept any responsibility for its use in practice British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN 978 85775 965 Typeset by Aarontype Limited, Easton, Bristol Printed and bound byTJI Digital, Padstow, Cornwall Contents About the authors vii List of abbreviations ix Acknowledgements xi Introduction What's in the monographs and how to use them xiii 5-Fluorouracil (5FU) continuous infusion (single-agent) 13 ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) 17 BCD (carmustine, cisplatin, dacarbazine; the 'Dartmouth' regimen) 23 BEP (3 day) and BEP (5 day) (bleomycin, etoposide, cisplatin) 27 BIP (bleomycin, ifosf amide, cisplatin) 33 BOP (bleomycin, vincristine, cisplatin) 39 CAP (cyclophosphamide, doxorubicin, cisplatin) 45 Capecitabine (single-agent) 51 CAPOMEt (cyclophosphamide, doxorubicin, prednisolone, vincristine, methotrexate, etoposide) 57 Carboplatin (single-agent) 69 CAV (cyclophosphamide, doxorubicin, vincristine) 73 Chlorambucil with or without prednisolone 77 CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) 81 Cisplatin (single-agent) 87 CMF (cyclophosphamide, methotrexate, 5-fluorouracil) 91 COP-X (cyclophosphamide, vincristine, prednisolone, liposomal daunorubicin) 97 CT (carboplatin plus paclitaxel) 103 C-VAMP (cyclophosphamide, vincristine, doxorubicin, methylprednisolone) 107 iv V CONTENTS de Gramont regimen and modified de Gramont (5-fluorouracil plus folinic acid) 113 de Gramont regimen plus irinotecan (IrdG) and modified de Gramont plus irinotecan (IrMdG) (5-fluorouracil, folinic acid, irinotecan) 119 de Gramont regimen plus oxaliplatin (OxdG) and modified de Gramont plus oxaliplatin (OxMdG) 125 DHAP (dexamethasone, cytarabine, cisplatin) 133 Docetaxel (single-agent) 139 Doxorubicin (single-agent) 143 DTIC (dacarbazine) (single-agent) 147 ECF (epirubicin, cisplatin, 5-fluorouracil) 151 EMI (IME, IMVP-16) (ifosfamide, methotrexate, etoposide) 157 Epirubicin (single-agent) 163 Etoposide (single-agent) oral 167 FAC (CAP) (5-fluorouracil, doxorubicin, cyclophosphamide) 171 PEC (5-fluorouracil, epirubicin, cyclophosphamide) 175 Fludarabine IV (single-agent) 179 Fludarabine oral (single-agent) 183 FMD (fludarabine, mitoxantrone, dexamethasone) 187 Gemcitabine (single-agent) 193 Gemcitabine plus cisplatin 197 Ifosfamide (single-agent) 203 Irinotecan (CPT-11) (single-agent) 209 Liposomal daunorubicin (single-agent) 213 Liposomal doxorubicin (pegylated) (single-agent) 217 Mayo regimen (folinic acid plus 5-fluorouracil) 225 MCF (mitomycin, cisplatin, 5-fluorouracil) 229 Melphalan (IV intermediate-dose) plus dexamethasone 235 MIC (mitomycin, ifosfamide, cisplatin) 239 MMM (mitomycin, methotrexate, mitoxantrone) 245 MOPP (chlormethine, vincristine, prednisolone, procarbazine) 249 MV (mitomycin, vinblastine) 255 MVAC (methotrexate, vinblastine, doxorubicin, cisplatin) 259 MVP (mitomycin, vinblastine, cisplatin) 265 CONTENTS V v NP (vinorelbine plus cisplatin) 269 Paclitaxel (single-agent) 275 Paclitaxel plus trastuzumab 279 PCV (procarbazine, lomustine, vincristine) 285 PE (cisplatin plus etoposide) 291 PMB (cisplatin, methotrexate, bleomycin) 295 PMitCEBO (prednisolone, mitoxantrone, cyclophosphamide, etoposide, bleomycin, vincristine) 301 R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone) 307 Rituximab (single-agent) 315 Temozolomide (single-agent) 319 Topotecan (single-agent) 323 Trastuzumab (single-agent) 327 VAD (vincristine, doxorubicin, dexamethasone) 331 Vinorelbine (single-agent) 335 VIP (etoposide, ifosfamide, cisplatin) 339 XT (capecitabine plus docetaxel) 345 Z-DEX (oral idarubicin plus dexamethasone) 353 Appendix I Dosage adjustment for cytotoxics in hepatic impairment 357 Appendix Dosage adjustment for cytotoxics in renal impairment 375 Appendix Example of a pharmacy patient record 391 Index 393 About the authors Max Summerhayes graduated in pharmacy from the London School of Pharmacy in 1981 and, after completing a pre-registration year at Guy's Hospital, returned to the School of Pharmacy to undertake research on the pharmacology of brain dopamine systems, for which he was awarded a PhD in 1985 After 18 months as a post-doctoral researcher at the Institute of Cancer Research in London, investigating the use of monoclonal antibodies as vehicles for drug delivery, he returned to work as a hospital pharmacist at Guy's Two years later he took over responsibility for the satellite oncology pharmacy unit there This was one of the first of its kind in the UK By the time of his departure in 2002 he was responsible for about 15 staff in three units In the same year, he decided on a career change and joined the oncology medical team at Roche Products Max was the founding chairman of the British Oncology Pharmacy Association and has had more than 25 peer-reviewed articles published, as well as a large number of other commissioned articles He is a clinical pharmacology examiner for the Royal College of Radiologists and serves on the editorial board of the Journal of Oncology Pharmacy Practice Susanna Daniels studied at Aston University and then completed her preregistration training at Guy's Hospital Her basic training continued at UCLH where she developed an interest in oncology After completing the rotational training, Susanna was appointed Haematology Pharmacist at the Royal London Hospital, managing the cytotoxic unit Susanna then moved to a position at St Thomas' Hospital which involved managing the busy cytotoxic unit During this time, she increased her role with the Drug and Therapeutics Committee and in training A promotion led to a new role as Clinical Governance Pharmacist for Oncology for the Trust, which involved the production of various guidelines Susanna has also gained valuable experience developing the website for the Drug Development Program at Princess Margaret Hospital in Toronto, Canada, during a one-year sabbatical In addition, she co-ordinated the pharmacy training programme during this period Susanna is now Lead Pharmacist, Cancer Services, at University College London Hospitals NHS Trust List of abbreviations AIC ALT AST AUC BBB BSA CNS CrCl dFdU DPD ECOG EDTA FBC G-CSF GFR GM-CSF GTN h INR IP IU IV kg L LFT MAO MAOI mg MUGA NCIC NICE NSCLC od PICC PO PT s SC -amino-imidazole-4-carboxamide alanine transaminase aspartate transaminase area under plasma concentration-time curve blood-brain barrier body surface area central nervous system creatinine clearance 2/-deoxy-2/,2/-difluorouridine dihydropyrimidine dehydrogenase Eastern Cooperative Oncology Group ethylene diamine tetra-acetic acid full blood count granulocyte colony-stimulating factor glomerular filtration rate granulocyte-macrophage colony-stimulating factor glyceryl trinitrate hour international normalised ratio inpatient International Unit intravenous kilogram litre liver function test monoamine oxidase monoamine oxidase inhibitor milligram minute multiple gated acquisition test of cardiac output National Cancer Institute of Canada National Institute for Clinical Excellence non-small-cell lung cancer once daily peripherally inserted central catheter by mouth prothrombin time second subcutaneous 172 V FAC NUMBER OF CYCLES Usually SIDE-EFFECTS Bone-marrow suppression, alopecia, nausea and vomiting, mucositis, cardiac arrhythmias, dilated cardiomyopathy (especially at cumulative doxorubicin doses in excess of 450mg/m ) Cyclophosphamide can cause haemorrhagic cystitis at high doses However, the doses used in FAC are not likely to cause this problem, so prophylactic mesna and hydration are not required BLOOD NADIR 10 days TTOS REQUIRED • Anti-emetics appropriate to highly emetogenic chemotherapy (see local protocol) NOTES FOR PRESCRIBERS • Patients over 60 years of age or with a history of heart disease must have an echocardiogram or MUGA scan prior to treatment to ensure that there is adequate left ventricular function • Check the LFTs If these show serious impairment, a reduction in doxorubicin and 5-FU doses may be required (see Appendix for further guidance) • Check the renal function A Cyclophosphamide dose reduction is required in patients with severe renal impairment (see Appendix for further guidance) • Check the FBC prior to giving the go-ahead for chemotherapy Seek advice if the neutrophil count is