Difference between revisions of "Rhabdomyosarcoma, pediatric"

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=Upfront Therapy=
 
=Upfront Therapy=
 +
 
==COG ARST0431==
 
==COG ARST0431==
  
−
 
+
===IRIN-VCR===
−
===Vincristine and Irinotecan===
+
====Week 1====
−
Weeks 1, 4, 20, 23, 47, & 50
+
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
Administer [[Vincristine (Oncovin)]] before [[Irinotecan (Camptosar)]]
 +
*[[Irinotecan (Camptosar)]] 50 mg/m<sup>2</sup> (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5
 +
====Week 2====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
====Week 3====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
====Week 4====
 
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
Line 19: Line 36:
 
  Administer [[Vincristine (Oncovin)]] before [[Irinotecan (Camptosar)]]
 
  Administer [[Vincristine (Oncovin)]] before [[Irinotecan (Camptosar)]]
 
*[[Irinotecan (Camptosar)]] 50 mg/m<sup>2</sup> (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5
 
*[[Irinotecan (Camptosar)]] 50 mg/m<sup>2</sup> (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5
 +
====Week 5====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
====Week 6====
 +
*Evaluation Week
  
−
===Vincristine Monotherapy===
+
===VDC/IE===
−
Weeks 2, 3, 5, 8, 12, 16, 21, 22, 24, 29, 33, 42, 43, 48, & 50
+
====Week 7====
 
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
−
===Off Chemotherapy Weeks===
+
*[[Doxorubicin (Adriamycin)]] by the following age-based criteria:
−
Weeks 6, 10, 14, 18, 19, 25, 27, 31, 34, 36, 37, 39, 40, 45, 46, 49, 52, 53, & 54
+
**Age ≥ 1 year: 37.5 mg/m<sup>2</sup> (Total dose per week of 75 mg/m<sup>2</sup>) IV over 24 hours once per day on days 1 through 2
−
===Vincristine, Doxorubicin, and Cyclophosphamide===
+
**Age < 1 year: 18.75 mg/m<sup>2</sup> IV over 24 hours once per day on days 1 through 2
−
Weeks 7, 11, 15, 28, & 32
+
*[[Cyclophosphamide (Cytoxan)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1200 mg/m<sup>2</sup> IV over 1 hour once per day on day 1
 +
**Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
 +
*[[Mesna (Mesnex)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 240 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
**Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
====Week 8====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
====Week 9====
 +
*[[Ifosfamide (Ifex)]] by the following age-based criteria:
 +
**Age ≥ 1 year: 1800 mg/m<sup>2</sup> IV over 1 hour once per day on days 1 through 5
 +
**Age < 1 year: 900 mg/m<sup>2</sup> IV over 1 hour once per day on days 1 through 5
 +
*[[Mesna (Mesnex)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 360 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Ifosfamide (Ifex)]] infusion on days 1 through 5
 +
**Age < 3 years: 180 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Ifosfamide (Ifex)]] infusion on days 1 through 5
 +
*[[Etoposide (Vepesid)]] by the following age-based criteria:
 +
**Age ≥ 1 year: 100 mg/m<sup>2</sup> IV over 30 to 60 minutes once per day on days 1 through 5
 +
**Age < 1 year: 50 mg/m<sup>2</sup> IV over 30 to 60 minutes once per day on days 1 through 5
 +
====Week 10====
 +
*Off Chemotherapy Week
 +
====Week 11====
 
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
Line 43: Line 90:
 
**Age ≥ 3 years: 240 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 
**Age ≥ 3 years: 240 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 
**Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 
**Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
====Week 12====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
====Week 13====
 +
*[[Ifosfamide (Ifex)]] by the following age-based criteria:
 +
**Age ≥ 1 year: 1800 mg/m<sup>2</sup> IV over 1 hour once per day on days 1 through 5
 +
**Age < 1 year: 900 mg/m<sup>2</sup> IV over 1 hour once per day on days 1 through 5
 +
*[[Mesna (Mesnex)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 360 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Ifosfamide (Ifex)]] infusion on days 1 through 5
 +
**Age < 3 years: 180 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Ifosfamide (Ifex)]] infusion on days 1 through 5
 +
*[[Etoposide (Vepesid)]] by the following age-based criteria:
 +
**Age ≥ 1 year: 100 mg/m<sup>2</sup> IV over 30 to 60 minutes once per day on days 1 through 5
 +
**Age < 1 year: 50 mg/m<sup>2</sup> IV over 30 to 60 minutes once per day on days 1 through 5
 +
====Week 14====
 +
*Off Chemotherapy Week
 +
====Week 15====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
*[[Doxorubicin (Adriamycin)]] by the following age-based criteria:
 +
**Age ≥ 1 year: 37.5 mg/m<sup>2</sup> (Total dose per week of 75 mg/m<sup>2</sup>) IV over 24 hours once per day on days 1 through 2
 +
**Age < 1 year: 18.75 mg/m<sup>2</sup> IV over 24 hours once per day on days 1 through 2
 +
*[[Cyclophosphamide (Cytoxan)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1200 mg/m<sup>2</sup> IV over 1 hour once per day on day 1
 +
**Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
 +
*[[Mesna (Mesnex)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 240 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
**Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
====Week 16====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
====Week 17====
 +
*[[Ifosfamide (Ifex)]] by the following age-based criteria:
 +
**Age ≥ 1 year: 1800 mg/m<sup>2</sup> IV over 1 hour once per day on days 1 through 5
 +
**Age < 1 year: 900 mg/m<sup>2</sup> IV over 1 hour once per day on days 1 through 5
 +
*[[Mesna (Mesnex)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 360 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Ifosfamide (Ifex)]] infusion on days 1 through 5
 +
**Age < 3 years: 180 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Ifosfamide (Ifex)]] infusion on days 1 through 5
 +
*[[Etoposide (Vepesid)]] by the following age-based criteria:
 +
**Age ≥ 1 year: 100 mg/m<sup>2</sup> IV over 30 to 60 minutes once per day on days 1 through 5
 +
**Age < 1 year: 50 mg/m<sup>2</sup> IV over 30 to 60 minutes once per day on days 1 through 5
 +
====Week 18====
 +
*Off Chemotherapy Week
 +
====Week 19====
 +
*Evaluation Week
  
−
 
+
===IRIN-VCR/IE/VDC===
−
===Ifosfamide and Etoposide===
+
====Week 20====
−
Weeks 9, 13, 17, 26, & 30
+
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
Administer [[Vincristine (Oncovin)]] before [[Irinotecan (Camptosar)]]
 +
*[[Irinotecan (Camptosar)]] 50 mg/m<sup>2</sup> (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5
 +
====Week 21====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
====Week 22====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
====Week 23====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
Administer [[Vincristine (Oncovin)]] before [[Irinotecan (Camptosar)]]
 +
*[[Irinotecan (Camptosar)]] 50 mg/m<sup>2</sup> (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5
 +
====Week 24====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
====Week 25====
 +
*Off Chemotherapy Week
 +
====Week 26====
 +
*[[Ifosfamide (Ifex)]] by the following age-based criteria:
 +
**Age ≥ 1 year: 1800 mg/m<sup>2</sup> IV over 1 hour once per day on days 1 through 5
 +
**Age < 1 year: 900 mg/m<sup>2</sup> IV over 1 hour once per day on days 1 through 5
 +
*[[Mesna (Mesnex)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 360 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Ifosfamide (Ifex)]] infusion on days 1 through 5
 +
**Age < 3 years: 180 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Ifosfamide (Ifex)]] infusion on days 1 through 5
 +
*[[Etoposide (Vepesid)]] by the following age-based criteria:
 +
**Age ≥ 1 year: 100 mg/m<sup>2</sup> IV over 30 to 60 minutes once per day on days 1 through 5
 +
**Age < 1 year: 50 mg/m<sup>2</sup> IV over 30 to 60 minutes once per day on days 1 through 5
 +
====Week 27====
 +
*Off Chemotherapy Week
 +
====Week 28====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
*[[Doxorubicin (Adriamycin)]] by the following age-based criteria:
 +
**Age ≥ 1 year: 37.5 mg/m<sup>2</sup> (Total dose per week of 75 mg/m<sup>2</sup>) IV over 24 hours once per day on days 1 through 2
 +
**Age < 1 year: 18.75 mg/m<sup>2</sup> IV over 24 hours once per day on days 1 through 2
 +
*[[Cyclophosphamide (Cytoxan)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1200 mg/m<sup>2</sup> IV over 1 hour once per day on day 1
 +
**Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
 +
*[[Mesna (Mesnex)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 240 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
**Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
====Week 29====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
====Week 30====
 
*[[Ifosfamide (Ifex)]] by the following age-based criteria:
 
*[[Ifosfamide (Ifex)]] by the following age-based criteria:
 
**Age ≥ 1 year: 1800 mg/m<sup>2</sup> IV over 1 hour once per day on days 1 through 5
 
**Age ≥ 1 year: 1800 mg/m<sup>2</sup> IV over 1 hour once per day on days 1 through 5
Line 56: Line 214:
 
**Age ≥ 1 year: 100 mg/m<sup>2</sup> IV over 30 to 60 minutes once per day on days 1 through 5
 
**Age ≥ 1 year: 100 mg/m<sup>2</sup> IV over 30 to 60 minutes once per day on days 1 through 5
 
**Age < 1 year: 50 mg/m<sup>2</sup> IV over 30 to 60 minutes once per day on days 1 through 5
 
**Age < 1 year: 50 mg/m<sup>2</sup> IV over 30 to 60 minutes once per day on days 1 through 5
 +
====Week 31====
 +
*Off Chemotherapy Week
 +
====Week 32====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
*[[Doxorubicin (Adriamycin)]] by the following age-based criteria:
 +
**Age ≥ 1 year: 37.5 mg/m<sup>2</sup> (Total dose per week of 75 mg/m<sup>2</sup>) IV over 24 hours once per day on days 1 through 2
 +
**Age < 1 year: 18.75 mg/m<sup>2</sup> IV over 24 hours once per day on days 1 through 2
 +
*[[Cyclophosphamide (Cytoxan)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1200 mg/m<sup>2</sup> IV over 1 hour once per day on day 1
 +
**Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
 +
*[[Mesna (Mesnex)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 240 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
**Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
====Week 33====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
====Week 34====
 +
*Evaluation Week
  
−
===Vincristine, Dactinomycin, and Cyclophosphamide===
+
 
−
Weeks 35, 38, 41, & 44
+
===VAC/IRIN-VCR===
 +
====Week 35====
 
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
Line 72: Line 254:
 
**Age ≥ 3 years: 240 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 
**Age ≥ 3 years: 240 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 
**Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 
**Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
====Week 36====
 +
*Off Chemotherapy Week
 +
====Week 37====
 +
*Off Chemotherapy Week
 +
====Week 38====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
*[[Dactinomycin (Cosmegen)]] by the following age-based criteria:
 +
**Age ≥ 1 year: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
 +
**Age < 1 year: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
 +
*[[Cyclophosphamide (Cytoxan)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1200 mg/m<sup>2</sup> IV over 1 hour once per day on day 1
 +
**Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
 +
*[[Mesna (Mesnex)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 240 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
**Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
====Week 39====
 +
*Off Chemotherapy Week
 +
====Week 40====
 +
*Off Chemotherapy Week
 +
====Week 41====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
*[[Dactinomycin (Cosmegen)]] by the following age-based criteria:
 +
**Age ≥ 1 year: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
 +
**Age < 1 year: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
 +
*[[Cyclophosphamide (Cytoxan)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1200 mg/m<sup>2</sup> IV over 1 hour once per day on day 1
 +
**Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
 +
*[[Mesna (Mesnex)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 240 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
**Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
====Week 42====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
====Week 43====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
====Week 44====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
*[[Dactinomycin (Cosmegen)]] by the following age-based criteria:
 +
**Age ≥ 1 year: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
 +
**Age < 1 year: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
 +
*[[Cyclophosphamide (Cytoxan)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1200 mg/m<sup>2</sup> IV over 1 hour once per day on day 1
 +
**Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
 +
*[[Mesna (Mesnex)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 240 mg/m<sup>2</sup> at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
**Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
 +
====Week 45====
 +
*Off Chemotherapy Week
 +
====Week 46====
 +
*Off Chemotherapy Week
 +
====Week 47====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
Administer [[Vincristine (Oncovin)]] before [[Irinotecan (Camptosar)]]
 +
*[[Irinotecan (Camptosar)]] 50 mg/m<sup>2</sup> (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5
 +
====Week 48====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
====Week 49====
 +
*Off Chemotherapy Week
 +
====Week 50====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
Administer [[Vincristine (Oncovin)]] before [[Irinotecan (Camptosar)]]
 +
*[[Irinotecan (Camptosar)]] 50 mg/m<sup>2</sup> (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5
 +
====Week 51====
 +
*[[Vincristine (Oncovin)]] by the following age-based criteria:
 +
**Age ≥ 3 years: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
 +
**Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
 +
====Week 52====
 +
*Off Chemotherapy Week
 +
====Week 53====
 +
*Off Chemotherapy Week
 +
====Week 54====
 +
*Evaluation Week
 +
  
 
====References====
 
====References====

Revision as of 22:39, 1 June 2022

Section editor transclusions

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Upfront Therapy

COG ARST0431

IRIN-VCR

Week 1

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Administer Vincristine (Oncovin) before Irinotecan (Camptosar)
  • Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5

Week 2

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1

Week 3

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1

Week 4

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Administer Vincristine (Oncovin) before Irinotecan (Camptosar)
  • Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5

Week 5

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1

Week 6

  • Evaluation Week

VDC/IE

Week 7

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
  • Doxorubicin (Adriamycin) by the following age-based criteria:
    • Age ≥ 1 year: 37.5 mg/m2 (Total dose per week of 75 mg/m2) IV over 24 hours once per day on days 1 through 2
    • Age < 1 year: 18.75 mg/m2 IV over 24 hours once per day on days 1 through 2
  • Cyclophosphamide (Cytoxan) by the following age-based criteria:
    • Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
    • Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
  • Mesna (Mesnex) by the following age-based criteria:

Week 8

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1

Week 9

  • Ifosfamide (Ifex) by the following age-based criteria:
    • Age ≥ 1 year: 1800 mg/m2 IV over 1 hour once per day on days 1 through 5
    • Age < 1 year: 900 mg/m2 IV over 1 hour once per day on days 1 through 5
  • Mesna (Mesnex) by the following age-based criteria:
    • Age ≥ 3 years: 360 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
    • Age < 3 years: 180 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
  • Etoposide (Vepesid) by the following age-based criteria:
    • Age ≥ 1 year: 100 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5
    • Age < 1 year: 50 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5

Week 10

  • Off Chemotherapy Week

Week 11

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
  • Doxorubicin (Adriamycin) by the following age-based criteria:
    • Age ≥ 1 year: 37.5 mg/m2 (Total dose per week of 75 mg/m2) IV over 24 hours once per day on days 1 through 2
    • Age < 1 year: 18.75 mg/m2 IV over 24 hours once per day on days 1 through 2
  • Cyclophosphamide (Cytoxan) by the following age-based criteria:
    • Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
    • Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
  • Mesna (Mesnex) by the following age-based criteria:

Week 12

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1

Week 13

  • Ifosfamide (Ifex) by the following age-based criteria:
    • Age ≥ 1 year: 1800 mg/m2 IV over 1 hour once per day on days 1 through 5
    • Age < 1 year: 900 mg/m2 IV over 1 hour once per day on days 1 through 5
  • Mesna (Mesnex) by the following age-based criteria:
    • Age ≥ 3 years: 360 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
    • Age < 3 years: 180 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
  • Etoposide (Vepesid) by the following age-based criteria:
    • Age ≥ 1 year: 100 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5
    • Age < 1 year: 50 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5

Week 14

  • Off Chemotherapy Week

Week 15

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
  • Doxorubicin (Adriamycin) by the following age-based criteria:
    • Age ≥ 1 year: 37.5 mg/m2 (Total dose per week of 75 mg/m2) IV over 24 hours once per day on days 1 through 2
    • Age < 1 year: 18.75 mg/m2 IV over 24 hours once per day on days 1 through 2
  • Cyclophosphamide (Cytoxan) by the following age-based criteria:
    • Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
    • Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
  • Mesna (Mesnex) by the following age-based criteria:

Week 16

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1

Week 17

  • Ifosfamide (Ifex) by the following age-based criteria:
    • Age ≥ 1 year: 1800 mg/m2 IV over 1 hour once per day on days 1 through 5
    • Age < 1 year: 900 mg/m2 IV over 1 hour once per day on days 1 through 5
  • Mesna (Mesnex) by the following age-based criteria:
    • Age ≥ 3 years: 360 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
    • Age < 3 years: 180 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
  • Etoposide (Vepesid) by the following age-based criteria:
    • Age ≥ 1 year: 100 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5
    • Age < 1 year: 50 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5

Week 18

  • Off Chemotherapy Week

Week 19

  • Evaluation Week

IRIN-VCR/IE/VDC

Week 20

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Administer Vincristine (Oncovin) before Irinotecan (Camptosar)
  • Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5

Week 21

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1

Week 22

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1

Week 23

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Administer Vincristine (Oncovin) before Irinotecan (Camptosar)
  • Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5

Week 24

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1

Week 25

  • Off Chemotherapy Week

Week 26

  • Ifosfamide (Ifex) by the following age-based criteria:
    • Age ≥ 1 year: 1800 mg/m2 IV over 1 hour once per day on days 1 through 5
    • Age < 1 year: 900 mg/m2 IV over 1 hour once per day on days 1 through 5
  • Mesna (Mesnex) by the following age-based criteria:
    • Age ≥ 3 years: 360 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
    • Age < 3 years: 180 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
  • Etoposide (Vepesid) by the following age-based criteria:
    • Age ≥ 1 year: 100 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5
    • Age < 1 year: 50 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5

Week 27

  • Off Chemotherapy Week

Week 28

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
  • Doxorubicin (Adriamycin) by the following age-based criteria:
    • Age ≥ 1 year: 37.5 mg/m2 (Total dose per week of 75 mg/m2) IV over 24 hours once per day on days 1 through 2
    • Age < 1 year: 18.75 mg/m2 IV over 24 hours once per day on days 1 through 2
  • Cyclophosphamide (Cytoxan) by the following age-based criteria:
    • Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
    • Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
  • Mesna (Mesnex) by the following age-based criteria:

Week 29

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1

Week 30

  • Ifosfamide (Ifex) by the following age-based criteria:
    • Age ≥ 1 year: 1800 mg/m2 IV over 1 hour once per day on days 1 through 5
    • Age < 1 year: 900 mg/m2 IV over 1 hour once per day on days 1 through 5
  • Mesna (Mesnex) by the following age-based criteria:
    • Age ≥ 3 years: 360 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
    • Age < 3 years: 180 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
  • Etoposide (Vepesid) by the following age-based criteria:
    • Age ≥ 1 year: 100 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5
    • Age < 1 year: 50 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5

Week 31

  • Off Chemotherapy Week

Week 32

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
  • Doxorubicin (Adriamycin) by the following age-based criteria:
    • Age ≥ 1 year: 37.5 mg/m2 (Total dose per week of 75 mg/m2) IV over 24 hours once per day on days 1 through 2
    • Age < 1 year: 18.75 mg/m2 IV over 24 hours once per day on days 1 through 2
  • Cyclophosphamide (Cytoxan) by the following age-based criteria:
    • Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
    • Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
  • Mesna (Mesnex) by the following age-based criteria:

Week 33

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1

Week 34

  • Evaluation Week


VAC/IRIN-VCR

Week 35

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
  • Dactinomycin (Cosmegen) by the following age-based criteria:
    • Age ≥ 1 year: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
    • Age < 1 year: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
  • Cyclophosphamide (Cytoxan) by the following age-based criteria:
    • Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
    • Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
  • Mesna (Mesnex) by the following age-based criteria:

Week 36

  • Off Chemotherapy Week

Week 37

  • Off Chemotherapy Week

Week 38

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
  • Dactinomycin (Cosmegen) by the following age-based criteria:
    • Age ≥ 1 year: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
    • Age < 1 year: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
  • Cyclophosphamide (Cytoxan) by the following age-based criteria:
    • Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
    • Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
  • Mesna (Mesnex) by the following age-based criteria:

Week 39

  • Off Chemotherapy Week

Week 40

  • Off Chemotherapy Week

Week 41

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
  • Dactinomycin (Cosmegen) by the following age-based criteria:
    • Age ≥ 1 year: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
    • Age < 1 year: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
  • Cyclophosphamide (Cytoxan) by the following age-based criteria:
    • Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
    • Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
  • Mesna (Mesnex) by the following age-based criteria:

Week 42

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1

Week 43

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1

Week 44

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
  • Dactinomycin (Cosmegen) by the following age-based criteria:
    • Age ≥ 1 year: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
    • Age < 1 year: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
  • Cyclophosphamide (Cytoxan) by the following age-based criteria:
    • Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
    • Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
  • Mesna (Mesnex) by the following age-based criteria:

Week 45

  • Off Chemotherapy Week

Week 46

  • Off Chemotherapy Week

Week 47

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Administer Vincristine (Oncovin) before Irinotecan (Camptosar)
  • Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5

Week 48

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1

Week 49

  • Off Chemotherapy Week

Week 50

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Administer Vincristine (Oncovin) before Irinotecan (Camptosar)
  • Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5

Week 51

  • Vincristine (Oncovin) by the following age-based criteria:
    • Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
    • Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1

Week 52

  • Off Chemotherapy Week

Week 53

  • Off Chemotherapy Week

Week 54

  • Evaluation Week


References

  1. COG ARST0431: Weigel BJ, Lyden E, Anderson JR, Meyer WH, Parham DM, Rodeberg DA, Michalski JM, Hawkins DS, Arndt CAS. Intensive Multiagent Therapy, Including Dose-Compressed Cycles of Ifosfamide/Etoposide and Vincristine/Doxorubicin/Cyclophosphamide, Irinotecan, and Radiation, in Patients with High-Risk Rhabdomyosarcoma: A Report from the Children's Oncology Group. Journal of Clinical Oncology. 2016 Oct;34(2):117-122. link to original article link to PMC article PubMed NCT00354744
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