Example orders for Cabazitaxel (Jevtana) in prostate cancer

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Remember that example order sets that may contain additional information about supportive medications, suggestions for monitoring, hydration, and pre-treatment screening information for chemotherapy regimens are purely anecdotal, provided only as examples of what some other providers may be using, and are typically not based on references in the primary literature.

Cabazitaxel (Jevtana)

Published regimens and references can be found on the prostate cancer page.

Example order set #1

• Cabazitaxel (Jevtana) 25 mg/m² IV over 60 minutes once on day 1; use non-DEHP (paclitaxel) tubing
• Optional: Prednisone (Sterapred) 10 mg PO once per day on days 1 to 21

21-day cycles

Supportive medications

• Dexamethasone (Decadron) 12 mg PO once 30 minutes prior to chemotherapy
• Diphenhydramine (Benadryl) 25 to 50 mg IV once 30 minutes prior to chemotherapy
• Ondansetron (Zofran) 8 mg PO once 30 minutes prior to chemotherapy
• If ondansetron not used: Prochlorperazine (Compazine) 10 mg PO/IV once 30 to 60 minutes prior to chemotherapy
• Famotidine (Pepcid) 20 mg IV over 15 minutes once 30 minutes prior to chemotherapy
• Pegfilgrastim (Neulasta) 6 mg SC once on day 2, 24 hours after completion of chemotherapy

Hydration:

• Normal saline IV continuous infusion at 5 mL/H
• Normal saline 25 to 50 mL IV prn flush before and after chemotherapy

Monitoring/precautions:

• Notify physician if ANC <1500, AST/ALT ≥1.5 times upper limit of normal
• Exercise caution with/avoid use of Cyp3A inducers such as phenytoin and rifampin
• Exercise caution with/avoid use for patients with hepatic insufficiency

Nursing:

• Patients without central lines: insert peripheral IV before therapy. Flush peripheral IV with 10 mL 0.9% normal saline after each day's dose of chemotherapy. Remove peripheral IV when therapy is complete.
• Patients with central lines: access the central venous access device before therapy. Flush central line according to institutional guidelines after each day's dose of chemotherapy. Deaccess device when therapy is complete.

Example order set #2

• Cabazitaxel (Jevtana) 25 mg/m² IV over 60 minutes once on day 1; use non-DEHP (paclitaxel) tubing

21-day cycles

Supportive medications

• Dexamethasone (Decadron) 12 mg IV once 30 minutes prior to chemotherapy
• Prochlorperazine (Compazine) 10 mg PO/IV once 30 to 60 minutes prior to chemotherapy
• Diphenhydramine (Benadryl) 25 to 50 mg IV once 30 minutes prior to chemotherapy
• Famotidine (Pepcid) 20 mg IV over 15 minutes once 30 minutes prior to chemotherapy
• Due to refractory nausea/vomiting, the following were also used:
  • Ondansetron (Zofran) 8 mg IV once 30 minutes prior to chemotherapy
  • Fosaprepitant (Emend) 150 mg IV once 30 minutes prior to chemotherapy, admix with dexamethasone and ondansetron

Nursing:

• Patients without central lines: insert peripheral IV before therapy. Flush peripheral IV with 10 mL 0.9% normal saline after each day's dose of chemotherapy. Remove peripheral IV when therapy is complete.
• Patients with central lines: access the central venous access device before therapy. Flush central line according to institutional guidelines after each day's dose of chemotherapy. Deaccess device when therapy is complete.