Ebook Practical chemotherapy - A multidisciplinary guide: Part 2

(BQ) Part 2 book “Practical chemotherapy - A multidisciplinary guide” has contents: Fludarabine oral, gemcitabine, liposomal daunorubicin, liposomal doxorubicin, mayo regimen, rituximab, prednisolone, mitoxantrone, cyclophosphamide, etoposide, bleomycin, vincristine,… and other contents.

FMD (fludarabme, mitoxantroiie* dexamethasoite}, also known as FND (fiudarabine, Novantrcme®, dexamethasone) and FMP (fludarabine, mitoxaittroite, prednisolone) USUAL INDICATION Relapsed low-grade lymphoma DOSES FMD Fludarabine 25 mg/m2 IV* on days 1-3 Mitoxantrone 10 mg/m2 IV on day I Dexamethasone 20 mg (total dose) IV or by mouth on days 1-5 FMP Fludarabine 25 mg/m2 IV* on days 1—3 Mitoxantrone 10 mg/m2 IV on day Prednisolone' 40mg (total dose) by mouth on days 1—5 ADMINISTRATION Fludarabine is administered by IV bolus or short IV infusion, and mitoxantrone is administered as a slow IV bolus into a free-running saline infusion The order of administration of IV drugs is not critical Dexamethasone (FMD) is administered as a slow IV bolus (over a period of 4-5 - rapid administration leads to histamine release, which causes perineal discomfort) or by mouth (oral administration should be used if possible), and prednisolone (FMP) is administered by mouth Mitoxantrone can cause tissue necrosis following extravasation, and should be administered with appropriate precautions to prevent this from occurring If there is any possibility that extravasation has occurred, contact a senior member of the medical team immediately and follow local procedures for dealing with extravasation incidents * Published studies were conducted before fludarabine tablets became available However, it is reasonable to suppose that oral fludarabine at a dose of 40 mg/m /day could be substituted for IV fludarabine on days 1-3 Oral fludarabine at this dose has been shown to be equivalent to IV fludarabine 25 mg/m2 in other situations (see chapter on fludarabine monotherapy) t Published studies have used IV prednisone This is not available in the UK Oral prednisolone is often used as a substitute without any requirement for dose adjustment 188 V FMD ANTI-EMETICS Low emetogenic potential (see local policy) Note that the steroids included in the regimen will have a substantial anti-emetic effect, so no additional steroids should be prescribed CYCLE LENGTH 28 days NUMBER OF CYCLES Usually SIDE-EFFECTS Bone-marrow suppression, alopecia (relatively low risk of major hair loss), nausea and vomiting, mucositis, neurotoxicity (weakness, agitation, confusion, visual disturbances and peripheral neuropathy; these neurotoxic effects are rare at the recommended doses of fludarabine) Cardiotoxicity has been reported after mitoxantrone administration, but it is less common than with anthracyclines It seems to be more likely at cumulative doses in excess of 160mg/m2, or 100mg/m2 after previous anthracycline therapy The high-dose steroids that are used in these regimens can cause a variety of side-effects, including euphoria/depression, epigastric discomfort, glucose intolerance, insomnia and psychosis BLOOD NADIR 10-15 days (not well defined - mitoxantrone produces an earlier nadir than fludarabine, resulting in a window of several days where the nadir might occur) TTOS REQUIRED • Anti-emetics appropriate to chemotherapy with low emetogenic potential (see local protocol) • Unless it is contraindicated (e.g in sulphonamide-allergic patients), co-trimoxazole (e.g 960 mg three times a week) (2 tablets three times a week) should be prescribed as Pneumocystis carinii pneumonia (PCP) prophylaxis during and for 6-12 months after treatment This is because of the profound reduction in lymphocyte numbers that is caused by fludarabine However, it should be remembered that a significant number of patients are allergic to sulphonamides, so all patients should be asked about this before prescribing FMD V 189 Ensure that sufficient dexamethasone (FMD) or prednisolone (FMP) tablets are prescribed to finish the cycle of treatment Allopurinol (300 mg by mouth once a day; reduced in cases of renal impairment) to prevent tumour lysis syndrome should be prescribed while the patient has bulky disease Consideration should be given to prescribing a gastroprotective agent (e.g ranitidine 150mg by mouth twice a day) for the duration of steroid treatment, in order to prevent gastritis NOTES TO PRESCRIBERS • Check the FBC prior to giving the go-ahead for chemotherapy Seek advice if the neutrophil count is i CD -2^ LD |-s « tn C * S 1= ^J B en 03 sS r^ E c I U LO s£ i y o en u r J^ \ 'u c _g •*- £ "^ £ CD c 384 T APPENDIX CYTOTOXICS IN RENAL IMPAIRMENT %o -ÊS Đ K ^ C ^ JZ g "g g -S | o £ 13 c Cu LO O O3 CJ ^ "0 ^ '£ 0 V-M ^ P-i r-i ^ 'G K" Q -4-» QJ fi ^^ "^NI P C £^ C 'Ji TO J-l o g, s a o ^ en QJ C "*"* O "TT ^ V-1 Vj_< ^ J2 flj ^ "^ CL) -*-* en X gtn -^ ^ -g ^_o h—( -4-» _Q CLi >-i CL> ^ ^ > ^ ^ ^ * QJc '"I rt^ Ê ôj^ ^r "-H a- -£7 O i— T35 ••—Ci ^3 ,£ •C T^ ^ ^3 C Qj >> H o -fa d> QJ -2 -g S^ J ^ TO CL) X3 -^ C """ '"^ C T3 Q 1? ^ -*- '§ ^ i! jju-fi § S,-S^ c w '0 ^ QJ -g "3 en )= ucu -r-c1 -gy _Q_ ^g TO > fe , g en c &-•€ -8 a C 0) J^ r- -4-» SPC - oxaliplatin has not been i severe renal impairment (-( O en X £ jjj Ix IS o SPC - no information available Wyeth - dose reductions appear patients with reduced renal fund limiting side-effect is myelosupp monitored Mitoxantrone does n by haemodialysis, and dose adju such patients z S c c X _o Extensive metabolism in the liver Excretion is predominantly via the bile and faeces Around 5-10% of the dose is excreted in the urine APPENDIX CYTOTOXICS IN RENAL IMPAIRMENT V 385 U G ^ ^ *-" ^"i ^ £ ^tn -C P £ en K V *[L Q t>* IT) (U n oo C r£ O O O ^H QJ P^H boO §o TO C E i c S on CD ,-C nfo 386 T APPENDIX CYTOTOXICS IN RENAL IMPAIRMENT - • g S -S ^ 15 e JB gH i - 5^ DH ts with impaired CrCl response without un ed with mg/m2 (50% f CrCl is ^ QJ -o ^ ^yjJ-g < ex fe H a^ QJ s bo H X o -a '§ o "3 oN QJ H — no information th - no information Only traces of unchange thiotepa and triethylene phosphoramide are excreted in the urine, together with a large proportion of metabolite f x >- to m LD LO V ^ O LO rq x ^ - °^ ^^^8-§ 1*1-^5; E o g o „ ^ sT-Sss^s-? Đ S S "O _gs in c^ "flS - no data on use in patients with ysis of population pharmacokinetic na temozolomide clearance was in< renal function It is unlikely that d ired in patients with severe renal c ing-Plough - no further informatio Temozolomide is rapidly absorbed Half-life is c 1.8 h The major route of elimination is renal Around 5-10% is excreted unchanged, and the remainder is eliminated as metabolites - see recommendations iZeneca — as SPC en -3 uc ^gS S0 03 O XI 03 ° >s g T3 ^ en i i T3 2^ QJ JH w C c g ^ c S S QJ J^-TD a n 6C o 03C3 'cp^'— d •£i , u? _; ^s mi -.j-f CL» o i- ^^ ^t; sgD&-£tl'f "o 'S £ *-" c o5 -•-» g -Q -£ bx >,£ wJJ ^o X! ^ "n ^ B ^ r- O> Ui ( 22 P{ 'Tu vU O " J i VJ 5/5 >-H r\ J £ a£ M- ^ s >,s T^ en ^ S r- T3 ^o-S ^ S ^ y^ ^ pc x >^ 388 T APPENDIX CYTOTOXICS IN RENAL IMPAIRMENT cs *Đ s Si g g o & (^ S •S ts o Jp -%S *^^^ flJ% -yu ^ en ^ W ^0 C ~fe T3 o3 £ 03 a Ê Đ S OT S tl S -2 -2-3^ c.5^^3 r^ =; S ^ S ^ j i S ^ ô ô-Ê ^-^c ^-Ê _ s^ Lf ^2 H Sk E SP > C en 03 Vinblastine is extensively metabolised, primarily in the liver to desacetylvinblastine, which is more active than the parent compound The drug is excreted slowly in the urine and also in the faeces via the bile »-^ »-c> js "S a ^ en O 0) c H Treosulfan is a pro-drug of a bifunctional alkylating agent It has high and relatively constant bioavailability The mean urinary excretion of the parent compound is c 15% over 24 h JSP-I s ^ Q Pharmacokinetics en •fH TJ *"" ^ en £3 O en Z c >> OS en en *"H "Đ 13 *-< CD C? Ê en ^ O H3 en CD °8 Z c >> V-i «tf 2P " APPENDIX CYTOTOXICS IN RENAL IMPAIRMENT T 389 ^ 1-3 en o \/ """ n en en X QJ -£j en *'""' _ v U S ^ r>x *~*^ 03 £* A\ CD CD H / " *-« S S « g S -c £H -M ^ £ ^ ~03 ^ g >-< CD C "^ "^ S 1C en ^C ^ bp ^ "2 C x-^ CD | g _2 s J3 S ! J2 S a j> "g :s & ^3 x ^ ^ 'en CD K5" "CD >^ o J £> J3 CD rs) ^ -^ Ti i-H 0^ I^^S ^8^^ S v: £ J: ^^ ^"^ S ^ Ig ^ ^^0 o — *§ -^^o ^ ^ U f p o ^ ^ § s^^^^^S c os ^ ^ ^ S ^ S ^ r , ^ C D ^ 0s -S! ,£i O ON bO*7S C ^ ^ ^ ^ Đ ^ & tJ C ^ C S ^ v ^ e n %^H h ^ nU V ^l^a"||°l| i^tllslp ^ ( D O ^ ^ ^ O ^ C F ^^S^H^c^ •?i ±i -*-> -C f— i CD SPC - no information Lilly — no dose reduction CD Metabolised by cytochrome P450 (in the CYP 3A subfamily) Elimination is primarily biliary (13% is excreted in the urine within 24 h) S SPC — no information Lilly — no dose reduction S _i—> Metabolised by cytochrome P450 (in the CYP A subfamily) Elimination is primarily biliary (10% is excreted in the urine within 24 h) patient Record Name: Sheet Hospital number: Trial? Date of birth: Date Consultant: Of Yes/No Trial ID: Diagnosis: Treatment started on: Regimen: Approval gained for expensive Height Weight drug USe (sign and date): BSA Date REFERRAL FORM D (Tick) Course Antiemetics Pharmacist dinkal check Date Course Antiemetics Pharmacist clinical check Index 5-fluorouracil (5-FU) CMF 91-5 continuous infusion, single-agent 13—16 de Gramont regimen 113—17 de Gramont regimen plus irinotecan (IrdG) 119—24 de Gramont regimen plus oxaliplatin (OxdG) 125—31 dosage adjustment, hepatic impairment 363 dosage adjustment, renal impairment 381 ECF 151-6 FAC 171-3 FEC 175-8 MCF 229-34 Mayo regimen 225-7 abbreviations ix—x ABVD (doxorubicin [Adriamycin], bleomycin, vinblastine, dacarbazine) 17—21 administration, guide to 3—4 Adriamycin see doxorubicin amsacrine dosage adjustment, hepatic impairment 358 dosage adjustment, renal impairment 376 anti-emetics, guide to Ara-C see cytarabine B-cell chronic lymphocytic leukaemia fludarabine IV (single-agent) 179-81 fludarabine oral (single-agent) 183-5 BCD (carmustine [BCNU], cisplatin, dacarbazine) 23-6 BEP (bleomycin, etoposide, cisplatin) 27—31 BIP (bleomycin, ifosfamide, cisplatin) 33—7 bladder cancer gemcitabine plus cisplatin 197—202 MVAC 259-64 bleomycin ABVD 17-21 BEP 27-31 BIP 33-7 BOP 39-43 dosage adjustment, hepatic impairment 358 dosage adjustment, renal impairment 376 PMB 295-300 PMitCEBO 301-6 blood counts, guide to 5—6, 7—8, blood nadir, guide to BOP (bleomycin, vincristine [Oncovin®], cisplatin) 39-43 VIP 39-43 brain tumourslymphoma, PCV 285—90 breast cancer capecitabine (single-agent) 51—5 CMF 91-5 docetaxel (Taxotere®) (single-agent) 139—42 doxorubicin (single-agent) 143—5 ECF 151-6 epirubicin (single-agent) 163—5 FAC 171-3 FEC 175-8 MCF 229-34 MMM 245-8 MV 255-7 paclitaxel (Taxol®) plus trastuzumab (Herceptin®) 279-84 paclitaxel (Taxol®) (single-agent) 275-8 trastuzumab (single-agent) 327—30 vinorelbine (single-agent) 335—7 XT 345-52 busulphan dosage adjustment, hepatic impairment 358 dosage adjustment, renal impairment 376 C-VAMP (cyclophosphamide, vincristine, doxorubicin [Adriamycin], methylprednisolone) 107-12 Caelyx® 217-23 CAP see FAC calcium folinate see folinic acid calcium leucovorin see folinic acid CAP (cyclophosphamide, doxorubicin [Adriamycin], cisplatin) 45-9 capecitabine dosage adjustment, hepatic impairment 358 dosage adjustment, renal impairment 377 XT 345-52 capecitabine (single-agent) 51-5 CAPOMEt (cyclophosphamide, doxorubicin [Adriamycin], prednisolone, vincristine [Oncovin®], methotrexate, etoposide) 57-67 carboplatin CT 103-6 dosage adjustment, hepatic impairment 359 dosage adjustment, renal impairment 377 carboplatin (single-agent) 69-71 carmustine [BCNU] BCD 23-6 dosage adjustment, hepatic impairment 359 dosage adjustment, renal impairment 377 394 INDEX CAV (cyclophosphamide, doxorubicin [Adriamycin], vincristine) 73—6 CCNU®, PCV 285-90 cervical cancer 33—7 PMB 295-300 chlorambucil 77-9 dosage adjustment, hepatic impairment 359 dosage adjustment, renal impairment 377 with prednisolone 77-9 chlormethine, MOPP 249-54 chlorpheniramine 221 paclitaxel (Taxol®) (single-agent) 275-8 rituximab (single-agent) 315—18 cholangiocarcinoma, 5-fluorouracil (5-FU) 13—16 CHOP (cyclophosphamide, doxorubicin [hydroxydaunorubicin], vincristine [Oncovin ], prednisolone) 81-5 chronic lymphocytic leukaemia chlorambucil 77-9 prednisolone 77—9 ciprofloxacin 210 cisplatin BCD 23-6 BEP 27-31 BIP 33-7 BOP 39-43 CAP 45-9 DHAP 133-7 dosage adjustment, hepatic impairment 359 dosage adjustment, renal impairment 378 ECF 151-6 gemcitabine plus cisplatin 197—202 MCF 229-34 MIC 239-44 MVAC 259-64 MVP 265-8 NP 269-73 PE 291-4 PMB 295-300 VIP 339-44 cisplatin (single-agent) 87-9 cited references, guide to 10-11 cladribine dosage adjustment, hepatic impairment 360 dosage adjustment, renal impairment 378 CMF (cyclophosphamide, methotrexate, 5-fluorouracil) 91-5 Cockcroft-Gault equation ABVD 19 BCD 24-5 colorectal cancer 5-fluorouracil (5-FU) 13-16 capecitabine (single-agent) 51—5 de Gramont regimen 113—17 de Gramont regimen plus irinotecan (IrdG) 119—24 de Gramont regimen plus oxaliplatin (OxdG) 125—31 irinotecan (CPT-11) (single-agent) 209-12 Mayo regimen 225-7 COP-X (cyclophosphamide, vincristine [Oncovin®], prednisolone, liposomal daunorubicin [DaunoXome®]) 97-102 corticosteroids 221 CT (carboplatin, paclitaxel [Taxol®]) 103-6 cycle length, guide to 4—5 cyclophosphamide C-VAMP 107-12 CAP 45-9 CAPOMEt 57-67 CAV 73-6 CHOP 81-5 CMF 91-5 COP-X 97-102 dosage adjustment, hepatic impairment 360 dosage adjustment, renal impairment 378 FAC 171-3 FEC 175-8 PMitCEBO 301-6 R-CHOP 307-13 cytarabine DHAP 133-7 dosage adjustment, hepatic impairment 360 dosage adjustment, renal impairment 378—9 cy to sine arabinoside see cytarabine cytotoxics dosage adjustment, hepatic impairment 357-73 dacarbazine ABVD 17-21 BCD 23-6 dosage adjustment, hepatic impairment 361 dosage adjustment, renal impairment 379 dacarbazine (DTIC) (single-agent) 147-9 dactinomycin dosage adjustment, hepatic impairment 361 dosage adjustment, renal impairment 379 'Dartmouth' regimen (BCD) 23-6 daunorubicin dosage adjustment, hepatic impairment 361 dosage adjustment, renal impairment 379—80 daunorubicin, liposomal see liposomal daunorubicin (DaunoXome®) DaunoXome see liposomal daunorubicin (DaunoXome ) de Gramont regimen (5-fluorouracil plus folinic acid, 5-FU/FA, 5-FU/LV) 113-17 de Gramont regimen plus irinotecan (IrdG) 119-24 de Gramont regimen plus oxaliplatin (OxdG) 125-31 dexamethasone DHAP 133-7 FMD 187-92 melphalan 235—8 paclitaxel (Taxol®) (single-agent) 275-8 VAD 331-4 XT 345-52 Z-DEX 353-6 DHAP (dexamethasone, cytarabine, cisplatin) 133—7 INDEX V 395 docetaxel dosage adjustment, hepatic impairment 362 dosage adjustment, renal impairment 380 XT 345-52 docetaxel (Taxotere®) (single-agent) 139-42 dosage adjustment, cytotoxics, hepatic impairment 357-73 doses, guide to 2—3 Doxil® 217-23 doxorubicin ABVD 17-21 C-VAMP 107-12 CAP 45-9 CAPOMEt 57-67 CAV 73-6 CHOP 81-5 dosage adjustment, hepatic impairment 362 dosage adjustment, renal impairment 380 FAC 171-3 MVAC 259-64 R-CHOP 307-13 VAD 331-4 doxorubicin (single-agent) 143—5 liposomal doxorubicin (pegylated) (Caelyx ; Doxil®) (single-agent) 217-23 DTIC (dacarbazine) (single-agent) 147-9 ECF (epirubicin, cisplatin, 5-fluorouracil) 151—6 see also FEC EFC see FEC EMI (IME, IMVP-16) (ifosfamide, methotrexate, etoposide) 157-62 epirubicin dosage adjustment, hepatic impairment 362 dosage adjustment, renal impairment 380 ECF 151-6 FEC 175-8 epirubicin (single-agent) 163—5 etoposide BEP 27-31 CAPOMEt 57-67 dosage adjustment, hepatic impairment 363 dosage adjustment, renal impairment 381 EMI 157-62 PE 291-4 PMitCEBO 301-6 VIP 339-44 etoposide (single-agent) oral 167—70 extravasation, guide to 8—9 FAC (CAF) (5-fluorouracil, doxorubicin [Adriamycin], cyclophosphamide) 171-3 FEC (5-fluorouracil, epirubicin, cyclophosphamide) 175—8 fludarabine dosage adjustment, hepatic impairment 363 dosage adjustment, renal impairment 381 FMD 187-92 FMP 187-92 fludarabine IV (single-agent) 179-81 fludarabine oral (single-agent) 183—5 fluorouracil see 5-fluorouracil (5-FU) FMD (fludarabine, mitoxantrone, dexamethasone) 187-92 FMP (fludarabine, mitoxantrone, prednisolone) 187—92 FND (fludarabine, Novantrone®, dexamethasone) 187-92 folinate see folinic acid folinic acid de Gramont regimen 113-17 de Gramont regimen plus irinotecan (IrdG) 119—24 de Gramont regimen plus oxaliplatin (OxdG) 125—31 EMI 157-62 Mayo regimen 225—7 PMB 295-300 follicular lymphoma, relapsed, rituximab (single-agent) 315-18 gastric cancer ECF 151-6 MCF 229-34 gemcitabine dosage adjustment, hepatic impairment 364 dosage adjustment, renal impairment 381 gemcitabine plus cisplatin 197—202 gemcitabine (single-agent) 193—6 germ-cell tumours BEP 27-31 BOP 39-43 VIP 339-44 glioma, temozolomide (single-agent) 319—22 haematopoietic growth factors, guide to hair loss, guide to 7, hepatic impairment, cytotoxics dosage adjustment 357-73 Herceptin®, paclitaxel (Taxol ) plus trastuzumab (Herceptin®) 279-84 high-grade lymphoma, relapsed, EMI 157—62 high-grade non-Hodgkin's lymphoma CAPOMEt 57-67 CHOP 81-5 COP-X 97-102 PMitCEBO 301-6 R-CHOP 307-13 Hodgkin's disease ABVD 17-21 MOPP 249-54 hydrocortisone 221 hydroxyurea dosage adjustment, hepatic impairment 364 dosage adjustment, renal impairment 382 idarubicin dosage adjustment, hepatic impairment 364 dosage adjustment, renal impairment 382 Z-DEX 353-6 396 T INDEX ifosfamide BIP 33-7 dosage adjustment, hepatic impairment 365 dosage adjustment, renal impairment 382 EMI 157-62 MIC 239-44 VIP 339-44 ifosfamide (single-agent) 203—7 IME see EMI (IME, IMVP-16) (ifosfamide, methotrexate, etoposide) IMVP-16 see EMI (IME, IMVP-16) (ifosfamide, methotrexate, etoposide) irinotecan de Gramont regimen plus irinotecan (IrdG) 119-24 dosage adjustment, hepatic impairment 365 dosage adjustment, renal impairment 382 irinotecan (CPT-11) (single-agent) 209-12 Kaposi's sarcoma liposomal daunorubicin (DaunoXome ) (single-agent) 213-15 liposomal doxorubicin (pegylated) (Caelyx®; Doxil®) (single-agent) 217-23 leucovorin (LV) see folinic acid leukaemia, chronic lymphocytic chlorambucil 77—9 fludarabine IV (single-agent) 179-81 fludarabine oral (single-agent) 183—5 prednisolone 77—9 liaison, guide to liposomal daunorubicin (DaunoXome ) COP-X 97-102 dosage adjustment, hepatic impairment 365 dosage adjustment, renal impairment 383 liposomal daunorubicin (DaunoXome ) (single-agent) 213-15 liposomal doxorubicin dosage adjustment, hepatic impairment 366 dosage adjustment, renal impairment 383 liposomal doxorubicin (pegylated) (Caelyx®; Doxil®) (single-agent) 217-23 liver function, guide to 6—7, 9—10 lomustine dosage adjustment, hepatic impairment 366 dosage adjustment, renal impairment 383 PCV 285-90 low-grade lymphoma chlorambucil 77—9 fludarabine IV (single-agent) 179-81 fludarabine oral (single-agent) 183—5 FMD 187-92 prednisolone 77—9 lung cancer, non-small-cell cisplatin (single-agent) 87—9 CT 103-6 docetaxel (Taxotere®) (single-agent) 139-42 gemcitabine plus cisplatin 197—202 gemcitabine (single-agent) 193—6 MIC 239-44 MVP 265-8 NP 269-73 PE 291-4 vinorelbine (single-agent) 335-7 lung cancer, small-cell, CAV 73-6 LV (leucovorin) see folinic acid lymphoma, low-grade chlorambucil 77-9 fludarabine IV (single-agent) 179-81 fludarabine oral (single-agent) 183-5 FMD 187-92 prednisolone 77—9 lymphoma, non-Hodgkin's see non-Hodgkin's lymphoma lymphoma, relapsed DHAP 133-7 EMI 157-62 fludarabine IV (single-agent) 179-81 fludarabine oral (single-agent) 183—5 FMD 187-92 lymphoma, relapsed follicular, rituximab (single-agent) 315-18 MCF (mitomycin, cisplatin, 5-fluorouracil) 229—34 malignant melanoma BCD 23-6 DTIC (dacarbazine) (single-agent) 147-9 malignant thymoma, ifosfamide (single-agent) 203—7 mannitol, CAP 46 Mayo regimen (folinic acid plus 5-fluorouracil, 5FU/FA, 5-FU/LV) 225-7 melanoma, malignant, DTIC (dacarbazine) (single-agent) 147-9 melanoma, malignant metastatic, BCD 23—6 melphalan dosage adjustment, hepatic impairment 366 dosage adjustment, renal impairment 384 melphalan (IV intermediate-dose) plus dexamethasone 235-8 mercaptopurine dosage adjustment, hepatic impairment 366—7 dosage adjustment, renal impairment 384 mesna BIP 33-7 EMI 157-62 ifosfamide (single-agent) 203-7 MIC 239-44 VIP 339-44 metastatic malignant melanoma, BCD 23—6 methotrexate CAPOMEt 57-67 CMF 91-5 dosage adjustment, hepatic impairment 367 dosage adjustment, renal impairment 384—5 EMI 157-62 MMM 245-8 MVAC 259-64 PMB 295-300 INDEX T 397 methylene blue, ifosfamide encephalopathy 205, 207, 241-2, 244, 339-44 methylprednisolone, C-VAMP 107-12 MIC (mitomycin, ifosfamide, cisplatin) 239—44 mitomycin dosage adjustment, hepatic impairment 367 dosage adjustment, renal impairment 385 MCF 229-34 MIC 239-44 MMM 245-8 MV 255-7 MVP 265-8 mitoxantrone dosage adjustment, hepatic impairment 368 dosage adjustment, renal impairment 385 FMD 187-92 FMP 187-92 MMM 245-8 PMitCEBO 301-6 MMM (mitomycin, methotrexate, mitoxantrone) 245-8 MOPP (chlormethine [mustine], vincristine [Oncovin ], prednisolone, procarbazine) 249—54 multiple myeloma C-VAMP 107-12 melphalan 235—8 VAD 331-4 Z-DEX 353-6 mustine, MOPP 249-54 MV (mitomycin, vinblastine) 255—7 MVAC (methotrexate, vinblastine, doxorubicin [Adriamycin], cisplatin) 259—64 MVP (mitomycin, vinblastine, cisplatin) 265—8 myeloma, multiple C-VAMP 107-12 melphalan 235—8 VAD 331-4 Z-DEX 353-6 myeloma, relapsed, DHAP 133-7 Navelbine®, NP 269-73 non-Hodgkin's lymphoma CAPOMEt 57-67 CHOP 81-5 COP-X 97-102 PMitCEBO 301-6 notes for nurses, guide to 7—9 notes for pharmacists, guide to 9—10 notes for prescribers, guide to 5—7 NP (vinorelbine [Navelbine®] plus cisplatin) 269-73 NSCLC see lung cancer, non-small-cell number of cycles, guide to oesophageal cancer ECF 151-6 MCF 229-34 Oncovin® see vincristine oral treatments, guide to 7, 8, 10 ovarian cancer CAP 45-9 carboplatin (single-agent) 69—71 cisplatin (single-agent) 87—9 CT 103-6 ECF 151-6 etoposide (single-agent) oral 167—70 liposomal doxorubicin (pegylated) (Caelyx®; Doxil ) (single-agent) 217-23 MCF 229-34 paclitaxel (Taxol®) (single-agent) 275-8 topotecan (Hycamtin®) (single-agent) 323—5 oxaliplatin de Gramont regimen plus oxaliplatin (OxdG) 125-31 dosage adjustment, hepatic impairment 368 dosage adjustment, renal impairment 385—6 paclitaxel CT 103-6 dosage adjustment, hepatic impairment 368—9 dosage adjustment, renal impairment 386 paclitaxel (Taxol®) plus trastuzumab (Herceptin®) 279-84 paclitaxel (Taxol®) (single-agent) 275-8 pancreatic cancer, gemcitabine (single-agent) 193—6 paracetamol, rituximab (single-agent) 315—18 patient record, example 391 PCV (procarbazine, lomustine [CCNU®], vincristine) 285-90 PE (cisplatin plus etoposide) 291-4 pentostatin dosage adjustment, hepatic impairment 369 dosage adjustment, renal impairment 386 pharmacy patient record, example 391 PMB (cisplatin, methotrexate, bleomycin) 295-300 PMitCEBO (prednisolone, mitoxantrone, cyclophosphamide, etoposide, bleomycin, vincristine [Oncovin]) 301-6 prednisolone CAPOMEt 57-67 chlorambucil 77-9 CHOP 81-5 COP-X 97-102 FMP 187-92 MOPP 249-54 PMitCEBO 301-6 R-CHOP 307-13 Predsol® 135 procarbazine dosage adjustment, hepatic impairment 369 dosage adjustment, renal impairment 386 MOPP 249-54 PCV 285-90 pyridoxine 15, 129, 221 R-CHOP (rituximab, cyclophosphamide, doxorubicin [hydroxydaunorubicin], vincristine [Oncovin], prednisolone) 307-13 398 T INDEX raltitrexed dosage adjustment, hepatic impairment 369 dosage adjustment, renal impairment 387 ranitidine, paclitaxel (Taxol®) (single-agent) 275—8 record keeping guide to 10 pharmacy patient record, example 391 regimen, guide to renal function, guide to 6—7, 9—10 renal impairment, cytotoxics dosage adjustment 375-89 rituximab, R-CHOP 307-13 rituximab (single-agent) 315—18 sarcoma ifosfamide (single-agent) 203—7 liposomal daunorubicin (DaunoXome ) (single-agent) 213-15 liposomal doxorubicin (pegylated) (Caelyx®; Doxil®) (single-agent) 217-23 side-effects, guide to small-cell lung cancer, CAV 73—6 sodium bicarbonate, PMB 295-300 source material, guide to 10—11 steroid eyedrops 135 tamoxifen, BCD 23-6 Taxol®, paclitaxel (Taxol®) (single-agent) 275-8 Taxotere®, XT 345-52 temozolomide dosage adjustment, hepatic impairment 370 dosage adjustment, renal impairment 387 temozolomide (single-agent) 319—22 thioguanine dosage adjustment, hepatic impairment 370 dosage adjustment, renal impairment 387 thiotepa dosage adjustment, hepatic impairment 370 dosage adjustment, renal impairment 387 thymoma, if osf amide (single-agent) 203—7 topotecan dosage adjustment, hepatic impairment 370 dosage adjustment, renal impairment 387—8 topotecan (Hycamtin ) (single-agent) 323—5 trastuzumab, paclitaxel (Taxol ) plus trastuzumab (Herceptin®) 279-84 trastuzumab (single-agent) 327—30 treosulphan dosage adjustment, hepatic impairment 371 dosage adjustment, renal impairment 388 TTOs (To take out' medications), guide to UFT (tegafur-uracil) dosage adjustment, hepatic impairment 371 dosage adjustment, renal impairment 388 usual indication, guide to VAD (vincristine, doxorubicin [Adriamycin], dexamethasone) 331—4 vinblastine ABVD 17-21 dosage adjustment, hepatic impairment 371 dosage adjustment, renal impairment 388 MV 255-7 MVAC 259-64 MVP 265-8 vincristine BOP 39-43 C-VAMP 107-12 CAPOMEt 57-67 CAV 73-6 CHOP 81-5 COP-X 97-102 dosage adjustment, hepatic impairment 372 dosage adjustment, renal impairment 389 MOPP 249-54 PCV 285-90 PMitCEBO 301-6 R-CHOP 307-13 VAD 331-4 vindesine dosage adjustment, hepatic impairment 372 dosage adjustment, renal impairment 389 vinorelbine dosage adjustment, hepatic impairment 372 dosage adjustment, renal impairment 389 NP 269-73 vinorelbine (single-agent) 335—7 VIP (etoposide [VP-16], ifosfamide, cisplatin) 339-44 BOP 39-43 XT (capecitabine [Xeloda®] plus docetaxel [Taxotere®]) 345-52 Z-DEX (oral idarubicin [Zavedos 353-6 ] plus dexamethasone) ... gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial / Clin Oncol 15 :24 0 3-1 3 Manegold C, Bergman B, Chemaissani A et al (1997) Single-agent gemcitabine... locally advanced or metastatic non-small-cell lung cancer Ann Oncol 8: 52 5-9 plus cisplatin USUAL INDICATION First-line treatment of non-small-cell lung cancer (NSCLC) and bladder cancer DOSES Non-small-cell... fluorouracil failure for patients with metastatic colorectal cancer Lancet 3 52: 1413—18 Liposomal daunorubicin (single-agent) USUAL INDICATION Advanced HIV-related Kaposi's sarcoma DOSES Liposomal daunorubicin