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6 regimens on this page 10 variants on this page 0 citations on this page

4,430 regimens on HemOnc.org 6,549 variants on HemOnc.org

Carboplatin, Paclitaxel, Bevacizumab (PacCBev)

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PacCBev: Paclitaxel, Carboplatin, Bevacizumab

Carboplatin, Paclitaxel, Bevacizumab (PacCBev)

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PacCBev: Paclitaxel, Carboplatin, Bevacizumab

Endorsements

ASCO 2015 update

NCCN v.3.2016

Regimen #1

Study	Evidence	ORR	Comparator
Johnson et al. 2004	Randomized Phase II	Put overall response rate here	Carboplatin & Paclitaxel
Sandler et al. 2006 (ECOG 4599)	Phase III	Put overall response rate here	Carboplatin & Paclitaxel

• Carboplatin (Paraplatin) AUC 6 IV over 15 to 30 minutes once on day 1, given second, starting 60 minutes after the completion of paclitaxel
• Paclitaxel (Taxol) 200 mg/m2 IV over 3 hours once on day 1, given first
• Bevacizumab (Avastin) 15 mg/kg IV on day 1, given third, starting 60 minutes after the completion of carboplatin
  • Infusion time for bevacizumab per Johnson, et al. 2004 was over 90 minutes for cycle 1; if tolerated, bevacizumab was given over 30 to 60 minutes for cycles 2 and later

21-day cycle x up to 6 cycles, or until progression of disease, or unacceptable toxicity

After 6 cycles, patients in ECOG 4599 who had stable disease or response continued to bevacizumab maintenance therapy.

Regimen #2

Study	Evidence	Comparator
Patel et al. 2013 (PointBreak)	Phase III	PemCBev -> Maintenance PemBev

• Carboplatin (Paraplatin) AUC 6 IV once on day 1
• Paclitaxel (Taxol) 200 mg/m2 IV once on day 1
• Bevacizumab (Avastin) 15 mg/kg IV once on day 1

Supportive medications:

• Premedications per paclitaxel label
• Erythropoietic agents or granulocyte colony-stimulating factors allowed per ASCO & NCCN guidelines

21-day cycle x 4 cycles

Patients with complete response, partial response, or stable disease proceeded to bevacizumab maintenance therapy.

References

1. Johnson DH, Fehrenbacher L, Novotny WF, Herbst RS, Nemunaitis JJ, Jablons DM, Langer CJ, DeVore RF 3rd, Gaudreault J, Damico LA, Holmgren E, Kabbinavar F. Randomized phase II trial comparing bevacizumab plus carboplatin and paclitaxel with carboplatin and paclitaxel alone in previously untreated locally advanced or metastatic non-small-cell lung cancer. J Clin Oncol. 2004 Jun 1;22(11):2184-91. link to original article PubMed
2. Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A, Lilenbaum R, Johnson DH. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med. 2006 Dec 14;355(24):2542-50. link to original article contains verified protocol PubMed
   1. Subset analysis: Ramalingam SS, Dahlberg SE, Langer CJ, Gray R, Belani CP, Brahmer JR, Sandler AB, Schiller JH, Johnson DH; Eastern Cooperative Oncology Group. Outcomes for elderly, advanced-stage non small-cell lung cancer patients treated with bevacizumab in combination with carboplatin and paclitaxel: analysis of Eastern Cooperative Oncology Group Trial 4599. J Clin Oncol. 2008 Jan 1;26(1):60-5. link to original article contains verified protocol PubMed
3. Patel JD, Socinski MA, Garon EB, Reynolds CH, Spigel DR, Olsen MR, Hermann RC, Jotte RM, Beck T, Richards DA, Guba SC, Liu J, Frimodt-Moller B, John WJ, Obasaju CK, Pennella EJ, Bonomi P, Govindan R. PointBreak: a randomized phase III study of pemetrexed plus carboplatin and bevacizumab followed by maintenance pemetrexed and bevacizumab versus paclitaxel plus carboplatin and bevacizumab followed by maintenance bevacizumab in patients with stage IIIB or IV nonsquamous non-small-cell lung cancer. J Clin Oncol. 2013 Dec 1;31(34):4349-57. link to original article contains verified protocol PubMed

CapeOx, XELOX

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CapeOX: Capecitabine, OXaliplatin
XELOX: XELoda (Capecitabine), OXaliplatin

Regimen #1

Study	Evidence	Comparator
Schmoll et al. 2007	Phase III	5-FU & Leucovorin

Note: This is the same trial as described by Haller et al. 2011, but the schedule for Capecitabine (Xeloda) is slightly different.

• Capecitabine (Xeloda) 1000 mg/m2 PO BID, starting the evening of day 1, to continue through the morning of day 15 (28 total doses)
• Oxaliplatin (Eloxatin) 130 mg/m2 IV over 2 hours once on day 1

21-day cycles x 8 cycles

Regimen #2

Study	Evidence	Comparator
Haller et al. 2011	Phase III	5-FU & Leucovorin

Note: This is the same trial as described by Schmoll et al. 2007, but the schedule for Capecitabine (Xeloda) is slightly different.

• Capecitabine (Xeloda) 1000 mg/m2 PO BID on days 1 to 14
• Oxaliplatin (Eloxatin) 130 mg/m2 IV over 2 hours once on day 1

21-day cycles x 8 cycles

Example orders

• Example orders for CapeOx (XELOX) in colon cancer

References

1. Schmoll HJ, Cartwright T, Tabernero J, Nowacki MP, Figer A, Maroun J, Price T, Lim R, Van Cutsem E, Park YS, McKendrick J, Topham C, Soler-Gonzalez G, de Braud F, Hill M, Sirzén F, Haller DG. Phase III trial of capecitabine plus oxaliplatin as adjuvant therapy for stage III colon cancer: a planned safety analysis in 1,864 patients. J Clin Oncol. 2007 Jan 1;25(1):102-9. link to original article contains verified protocol PubMed
2. Haller DG, Tabernero J, Maroun J, de Braud F, Price T, Van Cutsem E, Hill M, Gilberg F, Rittweger K, Schmoll HJ. Capecitabine plus oxaliplatin compared with fluorouracil and folinic acid as adjuvant therapy for stage III colon cancer. J Clin Oncol. 2011 Apr 10;29(11):1465-71. Epub 2011 Mar 7. link to original article contains verified protocol PubMed