Difference between revisions of "Neuroblastoma - historical"

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=High Risk=
 
=High Risk=
−
==COG ANBL0532==
+
==COG ANBL0532 Regimen A==
−
===Consolidation,===
+
===Induction,===
−
====Chemotherapy,====
+
 
−
'''Day 0 Corresponds to PBSC Infusion'''
+
====Chemotherapy, Cycle 1 (CPM + TOPO)====
−
*[[Melphalan (Alkeran)]] by the following criteria:
+
 
−
**Patients with GFR ≥ 100 mL/min and ≤ 12 kg: 2.3 mg/kg IV over 15 to 30 minutes once daily on days -7, -6, -5
+
*[[Cyclophosphamide (Cytoxan)]] by the following weight-based criteria:
−
**Patients with GFR ≥ 100 mL/min and > 12 kg: 70 mg/m<sup>2</sup> IV over 15 to 30 minutes once daily on days -7, -6, -5
+
**≤ 12 kg: 13.3 mg/kg iV over 30 to 60 minutes once daily on days 1 through 5
−
**Patients with GFR < 100 mL/min and ≥ 60 mL/min and are > 12 kg: 60 mg/m<sup>2</sup> IV over 15 to 30 minutes once daily on days -7, -6, -5
+
**> 12 kg: 400 mg/m<sup>2</sup> IV over 30 to 60 minutes once daily on days 1 through 5
−
**Patients with GFR < 100 mL/min and ≥ 60 mL/min and are ≤ 12 kg: 2 mg/kg IV over 15 to 30 minutes once daily on days -7, -6, -5
+
 
 +
*[[Topotecan (Hycamtin)]] 1.2 mg/m<sup>2</sup> IV over 30 minutes once daily on days 1 through 5
 +
 
 +
'''21 Day Cycle'''
 +
 
 +
====Chemotherapy, Cycle 2 (CPM + TOPO)====
 +
 
 +
*[[Cyclophosphamide (Cytoxan)]] by the following weight-based criteria:
 +
**≤ 12 kg: 13.3 mg/kg iV over 30 to 60 minutes once daily on days 1 through 5
 +
**> 12 kg: 400 mg/m<sup>2</sup> IV over 30 to 60 minutes once daily on days 1 through 5
 +
 
 +
*[[Topotecan (Hycamtin)]] 1.2 mg/m<sup>2</sup> IV over 30 minutes once daily on days 1 through 5
 +
 
 +
'''21 Day Cycle'''
 +
 
 +
====Supportive Therapy, Cycle 2====
 +
 
 +
*[[Filgrastim (Neupogen)]] 5 μg/kg SubQ or IV once daily on Day 6 beginning 24 hours after completion of chemotherapy and continuing until ANC > 1000/μL
 +
 
 +
*[[Filgrastim (Neupogen)]] 10 μg/kg SubQ or IV once daily beginning once ANC > 1000/μL and continuing until PBSC harvest is complete
 +
 
 +
*PBSC harvest on day 14
 +
 
 +
'''21 Day Cycle'''
 +
 
 +
====Chemotherapy, Cycle 3 (CDDP + ETOP)====
 +
 
 +
*[[Cisplatin (Platinol)]] by the following weight-based criteria:
 +
**≤ 12 kg: 1.66 mg/kg IV over 1 hour once daily on days 1 through 4
 +
**> 12 kg: 50 mg/m<sup>2</sup> IV over 1 hour once daily on days 1 through 4
 +
 
 +
*[[Etoposide (Vepesid)]] by the following weight-based criteria:
 +
**≤ 12 kg: 6.67 mg/kg IV over 1 hour once daily on days 1 through 3
 +
**> 12 kg: 200 mg/m<sup>2</sup> IV over 1 hour once daily on days 1 through 3
 +
 
 +
====Chemotherapy, Cycle 4 (CPM + DOXO + VCR)====
 +
*[[Cyclophosphamide (Cytoxan)]] by the following weight-based criteria:
 +
**≤ 12 kg: 70 mg/kg iV over 6 hours once daily on days 1 through 2
 +
**> 12 kg: 2100 mg/m<sup>2</sup> IV over 6 hours once daily on days 1 through 2
 +
 
 +
*[[Vincristine (Oncovin)]] by the following criteria:
 +
**< 12 months: 0.017 mg/kg (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before [[Doxorubicin (Adriamycin)]]  on days 1 through 3
 +
**≥ 12 months and > 12 kg: 0.097 mg/m<sup>2</sup> or 0.022 mg/kg (choose lower dose) (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before [[Doxorubicin (Adriamycin)]] on days 1 through 3
 +
**≥ 12 months and ≤ 12 kg: 0.022 mg/kg (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before [[Doxorubicin (Adriamycin)]] on days 1 through 3
 +
 
 +
*[[Doxorubicin (Adriamycin)]] by the following weight-based criteria:
 +
**≤ 12 kg: 0.83 mg/kg iV over 24 hours once daily on days 1 through 3
 +
**> 12 kg: 25 mg/m<sup>2</sup> IV over 24 hours once daily on days 1 through 3
 +
 
 +
'''21 Day Cycle'''
 +
 
 +
====Supportive Therapy, Cycle 4 (CPM + DOXO + VCR)====
 +
 
 +
*[[Mesna (Mesnex)]] by the following weight-based criteria:
 +
**≤ 12 kg: 14 mg/kg IV over 15 minutes immediately prior to each [[Cyclophosphamide (Cytoxan)]] dose and again at 4 and 8 hours after  each[[Cyclophosphamide (Cytoxan)]] infusion
 +
**> 12 kg: 420 mg/m<sup>2</sup> IV over 15 minutes immediately prior to each [[Cyclophosphamide (Cytoxan)]] dose and again at 4 and 8 hours after  each[[Cyclophosphamide (Cytoxan)]] infusion
 +
 
 +
'''21 Day Cycle'''
 +
 
 +
====Chemotherapy, Cycle 5 (CDDP + ETOP)====
 +
 
 +
*[[Cisplatin (Platinol)]] by the following weight-based criteria:
 +
**≤ 12 kg: 1.66 mg/kg IV over 1 hour once daily on days 1 through 4
 +
**> 12 kg: 50 mg/m<sup>2</sup> IV over 1 hour once daily on days 1 through 4
 +
 
 +
*[[Etoposide (Vepesid)]] by the following weight-based criteria:
 +
**≤ 12 kg: 6.67 mg/kg IV over 1 hour once daily on days 1 through 3
 +
**> 12 kg: 200 mg/m<sup>2</sup> IV over 1 hour once daily on days 1 through 3
 +
 
 +
'''21 Day Cycle'''
 +
 
 +
====Chemotherapy, Cycle 6 (CPM + DOXO + VCR)====
 +
 
 +
*[[Cyclophosphamide (Cytoxan)]] by the following weight-based criteria:
 +
**≤ 12 kg: 70 mg/kg iV over 6 hours once daily on days 1 through 2
 +
**> 12 kg: 2100 mg/m<sup>2</sup> IV over 6 hours once daily on days 1 through 2
 +
 
 +
*[[Vincristine (Oncovin)]] by the following criteria:
 +
**< 12 months: 0.017 mg/kg (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before [[Doxorubicin (Adriamycin)]]  on days 1 through 3
 +
**≥ 12 months and > 12 kg: 0.097 mg/m<sup>2</sup> or 0.022 mg/kg (choose lower dose) (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before [[Doxorubicin (Adriamycin)]] on days 1 through 3
 +
**≥ 12 months and ≤ 12 kg: 0.022 mg/kg (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before [[Doxorubicin (Adriamycin)]] on days 1 through 3
 +
 
 +
*[[Doxorubicin (Adriamycin)]] by the following weight-based criteria:
 +
**≤ 12 kg: 0.83 mg/kg iV over 24 hours once daily on days 1 through 3
 +
**> 12 kg: 25 mg/m<sup>2</sup> IV over 24 hours once daily on days 1 through 3
 +
 
 +
'''21 Day Cycle'''
  
−
*[[Etoposide (Vepesid)]] by the following criteria:
+
====Supportive Therapy, Cycle 6 (CPM + DOXO + VCR)====
−
**Patients with GFR ≥ 100 mL/min and ≤ 12 kg: 11.3 mg/kg IV over 24 hours once daily on days -7, -6, -5, -4
 
−
**Patients with GFR ≥ 100 mL/min and > 12 kg: 338 mg/m<sup>2</sup> IV over 24 hours once daily on days -7, -6, -5, -4
 
−
**Patients with GFR < 100 mL/min and ≥ 60 mL/min and are > 12 kg: 200 mg/m<sup>2</sup> IV over 24 hours once daily on days -7, -6, -5, -4
 
−
**Patients with GFR < 100 mL/min and ≥ 60 mL/min and are ≤ 12 kg: 6.7 mg/kg IV over 24 hours once daily on days -7, -6, -5, -4
 
  
−
*[[Carboplatin (Paraplatin)]] by the following criteria:
+
*[[Mesna (Mesnex)]] by the following weight-based criteria:
−
**Patients with GFR ≥ 100 mL/min and ≤ 12 kg: 14.2 mg/kg IV over 24 hours once daily on days -7, -6, -5, -4
+
**≤ 12 kg: 14 mg/kg IV over 15 minutes immediately prior to each [[Cyclophosphamide (Cytoxan)]] dose and again at 4 and 8 hours after  each[[Cyclophosphamide (Cytoxan)]] infusion
−
**Patients with GFR ≥ 100 mL/min and > 12 kg: 425 mg/m<sup>2</sup> IV over 24 hours once daily on days -7, -6, -5, -4
+
**> 12 kg: 420 mg/m<sup>2</sup> IV over 15 minutes immediately prior to each [[Cyclophosphamide (Cytoxan)]] dose and again at 4 and 8 hours after  each[[Cyclophosphamide (Cytoxan)]] infusion
−
**Patients with GFR < 100 mL/min and ≥ 60 mL/min and are > 12 kg: AUC = 4.1 (Calvert Formula) (Max Daily Dose = 300 mg/m<sup>2</sup>) IV over 24 hours once daily on days -7, -6, -5, -4
 
−
**Patients with GFR < 100 mL/min and ≥ 60 mL/min and are ≤ 12 kg: AUC = 4.1 (Calvert Formula) (Max Daily Dose of 10 mg/kg) IV over 24 hours once daily on days -7, -6, -5, -4
 
  
−
'''36 Day Cycle'''
+
'''21 Day Cycle'''
  
−
====Supportive Therapy,====
+
===Maintenance, 6 Cycles===
 +
====Chemotherapy,====
 +
*[[Isotretinoin (Accutane)]] by the following weight-based criteria:
 +
**≤ 12 kg: 5.33 mg/kg (Round dose to nearest 10 mg) PO twice daily on days 1 through 14
 +
**> 12 kg: 160 mg/m<sup>2</sup> (Round dose to nearest 10 mg) PO twice daily on days 1 through 14
  
−
*[[Filgrastim (Neupogen)]] 5 μg/kg SubQ or IV once daily on day 0 and continuing until ANC > 2000 μL for 3 consecutive days
+
'''28 Day Cycle'''
  
−
'''36 Day Cycle'''
+
===References===
 +
#'''COG ANBL0532:'''Seif AE, Naranjo A, Baker DL, Bunin NJ, Kletzel M, Kretschmar CS, Maris JM, McGrady PW, von Allmen D, Cohn SL, London WB, Park JR, Diller LR, Grupp SA. A pilot study of tandem high-dose chemotherapy with stem cell rescue as consolidation for high-risk neuroblastoma: Children's Oncology Group study ANBL00P1. Bone Marrow Transplant. 2013 Jul;48(7):947-52. [https://doi.org/10.1038/bmt.2012.276 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3638062/pdf/nihms426908.pdf link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/23334272/ PubMed]

Revision as of 21:05, 14 November 2022

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Section editor transclusions

The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. Is there a regimen missing from this list? See the main neuroblastoma page for current regimens.

2 regimens on this page
2 variants on this page


High Risk

COG ANBL0532 Regimen A

Induction,

Chemotherapy, Cycle 1 (CPM + TOPO)

  • Cyclophosphamide (Cytoxan) by the following weight-based criteria:
    • ≤ 12 kg: 13.3 mg/kg iV over 30 to 60 minutes once daily on days 1 through 5
    • > 12 kg: 400 mg/m2 IV over 30 to 60 minutes once daily on days 1 through 5

21 Day Cycle

Chemotherapy, Cycle 2 (CPM + TOPO)

  • Cyclophosphamide (Cytoxan) by the following weight-based criteria:
    • ≤ 12 kg: 13.3 mg/kg iV over 30 to 60 minutes once daily on days 1 through 5
    • > 12 kg: 400 mg/m2 IV over 30 to 60 minutes once daily on days 1 through 5

21 Day Cycle

Supportive Therapy, Cycle 2

  • Filgrastim (Neupogen) 5 μg/kg SubQ or IV once daily on Day 6 beginning 24 hours after completion of chemotherapy and continuing until ANC > 1000/μL
  • Filgrastim (Neupogen) 10 μg/kg SubQ or IV once daily beginning once ANC > 1000/μL and continuing until PBSC harvest is complete
  • PBSC harvest on day 14

21 Day Cycle

Chemotherapy, Cycle 3 (CDDP + ETOP)

  • Cisplatin (Platinol) by the following weight-based criteria:
    • ≤ 12 kg: 1.66 mg/kg IV over 1 hour once daily on days 1 through 4
    • > 12 kg: 50 mg/m2 IV over 1 hour once daily on days 1 through 4
  • Etoposide (Vepesid) by the following weight-based criteria:
    • ≤ 12 kg: 6.67 mg/kg IV over 1 hour once daily on days 1 through 3
    • > 12 kg: 200 mg/m2 IV over 1 hour once daily on days 1 through 3

Chemotherapy, Cycle 4 (CPM + DOXO + VCR)

  • Cyclophosphamide (Cytoxan) by the following weight-based criteria:
    • ≤ 12 kg: 70 mg/kg iV over 6 hours once daily on days 1 through 2
    • > 12 kg: 2100 mg/m2 IV over 6 hours once daily on days 1 through 2
  • Vincristine (Oncovin) by the following criteria:
    • < 12 months: 0.017 mg/kg (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before Doxorubicin (Adriamycin) on days 1 through 3
    • ≥ 12 months and > 12 kg: 0.097 mg/m2 or 0.022 mg/kg (choose lower dose) (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before Doxorubicin (Adriamycin) on days 1 through 3
    • ≥ 12 months and ≤ 12 kg: 0.022 mg/kg (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before Doxorubicin (Adriamycin) on days 1 through 3
  • Doxorubicin (Adriamycin) by the following weight-based criteria:
    • ≤ 12 kg: 0.83 mg/kg iV over 24 hours once daily on days 1 through 3
    • > 12 kg: 25 mg/m2 IV over 24 hours once daily on days 1 through 3

21 Day Cycle

Supportive Therapy, Cycle 4 (CPM + DOXO + VCR)

21 Day Cycle

Chemotherapy, Cycle 5 (CDDP + ETOP)

  • Cisplatin (Platinol) by the following weight-based criteria:
    • ≤ 12 kg: 1.66 mg/kg IV over 1 hour once daily on days 1 through 4
    • > 12 kg: 50 mg/m2 IV over 1 hour once daily on days 1 through 4
  • Etoposide (Vepesid) by the following weight-based criteria:
    • ≤ 12 kg: 6.67 mg/kg IV over 1 hour once daily on days 1 through 3
    • > 12 kg: 200 mg/m2 IV over 1 hour once daily on days 1 through 3

21 Day Cycle

Chemotherapy, Cycle 6 (CPM + DOXO + VCR)

  • Cyclophosphamide (Cytoxan) by the following weight-based criteria:
    • ≤ 12 kg: 70 mg/kg iV over 6 hours once daily on days 1 through 2
    • > 12 kg: 2100 mg/m2 IV over 6 hours once daily on days 1 through 2
  • Vincristine (Oncovin) by the following criteria:
    • < 12 months: 0.017 mg/kg (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before Doxorubicin (Adriamycin) on days 1 through 3
    • ≥ 12 months and > 12 kg: 0.097 mg/m2 or 0.022 mg/kg (choose lower dose) (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before Doxorubicin (Adriamycin) on days 1 through 3
    • ≥ 12 months and ≤ 12 kg: 0.022 mg/kg (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before Doxorubicin (Adriamycin) on days 1 through 3
  • Doxorubicin (Adriamycin) by the following weight-based criteria:
    • ≤ 12 kg: 0.83 mg/kg iV over 24 hours once daily on days 1 through 3
    • > 12 kg: 25 mg/m2 IV over 24 hours once daily on days 1 through 3

21 Day Cycle

Supportive Therapy, Cycle 6 (CPM + DOXO + VCR)

21 Day Cycle

Maintenance, 6 Cycles

Chemotherapy,

  • Isotretinoin (Accutane) by the following weight-based criteria:
    • ≤ 12 kg: 5.33 mg/kg (Round dose to nearest 10 mg) PO twice daily on days 1 through 14
    • > 12 kg: 160 mg/m2 (Round dose to nearest 10 mg) PO twice daily on days 1 through 14

28 Day Cycle

References

  1. COG ANBL0532:Seif AE, Naranjo A, Baker DL, Bunin NJ, Kletzel M, Kretschmar CS, Maris JM, McGrady PW, von Allmen D, Cohn SL, London WB, Park JR, Diller LR, Grupp SA. A pilot study of tandem high-dose chemotherapy with stem cell rescue as consolidation for high-risk neuroblastoma: Children's Oncology Group study ANBL00P1. Bone Marrow Transplant. 2013 Jul;48(7):947-52. link to original article link to PMC article PubMed
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