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Upfront Therapy

COG ARST0431

IRIN-VCR

Week 1 (IRIN-VCR)

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(VCR)

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(VCR)

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(IRIN-VCR)

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(VCR)

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(VDC)

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:
- Age ≥ 3 years: 240 mg/m² 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(VCR)

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(IE)

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(VDC)

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:
- Age ≥ 3 years: 240 mg/m² 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(VCR)

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(IE)

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(VDC)

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:
- Age ≥ 3 years: 240 mg/m² 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(VCR)

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(IE)

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(IRIN-VCR)

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(VCR)

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(VCR)

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(IRIN-VCR)

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(VCR)

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(IE)

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(VDC)

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:
- Age ≥ 3 years: 240 mg/m² 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(VCR)

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(IE)

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(VDC)

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:
- Age ≥ 3 years: 240 mg/m² 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(VCR)

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(VAC)

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:
- Age ≥ 3 years: 240 mg/m² 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(VAC)

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:
- Age ≥ 3 years: 240 mg/m² 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(VAC)

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:
- Age ≥ 3 years: 240 mg/m² 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(VCR)

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(VCR)

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(VAC)

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:
- Age ≥ 3 years: 240 mg/m² 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(IRIN-VCR)

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(VCR)

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(IRIN-VCR)

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(VCR)

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

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

@@ Line 12: / Line 12: @@
 ===IRIN-VCR===
-====Week 1====
+====Week 1 (IRIN-VCR)====
 *[[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
@@ Line 19: / Line 19: @@
   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====
+====Week 2(VCR)====
 *[[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====
+====Week 3(VCR)====
 *[[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====
+====Week 4(IRIN-VCR)====
 *[[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
@@ Line 36: / Line 36: @@
   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 5====
+====Week 5(VCR)====
 *[[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
@@ Line 45: / Line 45: @@
 ===VDC/IE===
-====Week 7====
+====Week 7(VDC)====
 *[[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
@@ Line 59: / Line 59: @@
 **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====
+====Week 8(VCR)====
 *[[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====
+====Week 9(IE)====
 *[[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
@@ Line 76: / Line 76: @@
 ====Week 10====
 *Off Chemotherapy Week
-====Week 11====
+====Week 11(VDC)====
 *[[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
@@ Line 90: / 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: 8 mg/kg at hour 0, 4, and 8 from the start of each [[Cyclophosphamide (Cytoxan)]] infusion on days 1
-====Week 12====
+====Week 12(VCR)====
 *[[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====
+====Week 13(IE)====
 *[[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
@@ Line 107: / Line 107: @@
 ====Week 14====
 *Off Chemotherapy Week
-====Week 15====
+====Week 15(VDC)====
 *[[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
@@ Line 121: / Line 121: @@
 **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====
+====Week 16(VCR)====
 *[[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====
+====Week 17(IE)====
 *[[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
@@ Line 142: / Line 142: @@
 ===IRIN-VCR/IE/VDC===
-====Week 20====
+====Week 20(IRIN-VCR)====
 *[[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
@@ Line 149: / Line 149: @@
   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====
+====Week 21(VCR)====
 *[[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====
+====Week 22(VCR)====
 *[[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====
+====Week 23(IRIN-VCR)====
 *[[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
@@ Line 166: / Line 166: @@
   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====
+====Week 24(VCR)====
 *[[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
@@ Line 173: / Line 173: @@
 ====Week 25====
 *Off Chemotherapy Week
-====Week 26====
+====Week 26(IE)====
 *[[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
@@ Line 185: / Line 185: @@
 ====Week 27====
 *Off Chemotherapy Week
-====Week 28====
+====Week 28(VDC)====
 *[[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
@@ Line 199: / Line 199: @@
 **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====
+====Week 29(VCR)====
 *[[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====
+====Week 30(IE)====
 *[[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
@@ Line 216: / Line 216: @@
 ====Week 31====
 *Off Chemotherapy Week
-====Week 32====
+====Week 32(VDC)====
 *[[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
@@ Line 230: / Line 230: @@
 **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====
+====Week 33(VCR)====
 *[[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
@@ Line 240: / Line 240: @@
 ===VAC/IRIN-VCR===
-====Week 35====
+====Week 35(VAC)====
 *[[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
@@ Line 258: / Line 258: @@
 ====Week 37====
 *Off Chemotherapy Week
-====Week 38====
+====Week 38(VAC)====
 *[[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
@@ Line 276: / Line 276: @@
 ====Week 40====
 *Off Chemotherapy Week
-====Week 41====
+====Week 41(VAC)====
 *[[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
@@ Line 290: / Line 290: @@
 **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====
+====Week 42(VCR)====
 *[[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====
+====Week 43(VCR)====
 *[[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====
+====Week 44(VAC)====
 *[[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
@@ Line 318: / Line 318: @@
 ====Week 46====
 *Off Chemotherapy Week
-====Week 47====
+====Week 47(IRIN-VCR)====
 *[[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
@@ Line 325: / Line 325: @@
   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====
+====Week 48(VCR)====
 *[[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
@@ Line 332: / Line 332: @@
 ====Week 49====
 *Off Chemotherapy Week
-====Week 50====
+====Week 50(IRIN-VCR)====
 *[[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
@@ Line 339: / Line 339: @@
   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====
+====Week 51(VCR)====
 *[[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

Difference between revisions of "Rhabdomyosarcoma, pediatric"

Revision as of 22:44, 1 June 2022

Upfront Therapy

COG ARST0431

IRIN-VCR

Week 1 (IRIN-VCR)

Week 2(VCR)

Week 3(VCR)

Week 4(IRIN-VCR)

Week 5(VCR)

Week 6

VDC/IE

Week 7(VDC)

Week 8(VCR)

Week 9(IE)

Week 10

Week 11(VDC)

Week 12(VCR)

Week 13(IE)

Week 14

Week 15(VDC)

Week 16(VCR)

Week 17(IE)

Week 18

Week 19

IRIN-VCR/IE/VDC

Week 20(IRIN-VCR)

Week 21(VCR)

Week 22(VCR)

Week 23(IRIN-VCR)

Week 24(VCR)

Week 25

Week 26(IE)

Week 27

Week 28(VDC)

Week 29(VCR)

Week 30(IE)

Week 31

Week 32(VDC)

Week 33(VCR)

Week 34

VAC/IRIN-VCR

Week 35(VAC)

Week 36

Week 37

Week 38(VAC)

Week 39

Week 40

Week 41(VAC)

Week 42(VCR)

Week 43(VCR)

Week 44(VAC)

Week 45

Week 46

Week 47(IRIN-VCR)

Week 48(VCR)

Week 49

Week 50(IRIN-VCR)

Week 51(VCR)

Week 52

Week 53

Week 54

References

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