Difference between revisions of "Penile cancer"
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'''Use of this site is subject to you reading and agreeing with the terms set forth in the [[HemOnc.org_-_A_Hematology_Oncology_Wiki:General_disclaimer|disclaimer]].''' | '''Use of this site is subject to you reading and agreeing with the terms set forth in the [[HemOnc.org_-_A_Hematology_Oncology_Wiki:General_disclaimer|disclaimer]].''' | ||
− | Is there a regimen missing from this list? | + | Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are [[How_to_contribute|invited to contribute to the site]]. |
{| class="wikitable" style="float:right; margin-right: 5px;" | {| class="wikitable" style="float:right; margin-right: 5px;" | ||
|- | |- | ||
− | |<div style="background-color: #66FF66; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] | + | |<div style="background-color: #66FF66; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} regimens on this page</b></font></div> |
− | <div style="background-color: #66CCFF; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] | + | <div style="background-color: #66CCFF; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} variants on this page</b></font></div> |
|} | |} | ||
{{TOC limit|limit=3}} | {{TOC limit|limit=3}} | ||
− | = | + | =Neoadjuvant chemotherapy= |
− | ==TIP {{#subobject: | + | |
+ | ==TIP {{#subobject:fe995|Regimen=1}}== | ||
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|- | |- | ||
|[[#toc|back to top]] | |[[#toc|back to top]] | ||
|} | |} | ||
− | + | TIP: '''<u>T</u>'''axol (Paclitaxel), '''<u>I</u>'''fosfamide, '''<u>P</u>'''latinol (Cisplatin) | |
− | == | + | ===Regimen {{#subobject:b81dfa|Variant=1}}=== |
− | {| | + | {| border="1" style="text-align:center;" !align="left" |
+ | |'''Study''' | ||
+ | |[[Levels_of_Evidence#Evidence|'''Evidence''']] | ||
|- | |- | ||
− | |[ | + | |[http://jco.ascopubs.org/content/28/24/3851.long Pagliaro et al. 2010] |
− | + | |<span | |
− | + | style="background:#EEEE00; | |
− | |||
− | |||
− | |||
− | |||
− | |||
− | <span | ||
− | style="background:# | ||
padding:3px 6px 3px 6px; | padding:3px 6px 3px 6px; | ||
border-color:black; | border-color:black; | ||
border-width:2px; | border-width:2px; | ||
− | border-style:solid;"> | + | border-style:solid;">Phase II</span> |
+ | |- | ||
+ | |} | ||
+ | ====Chemotherapy==== | ||
+ | *[[Paclitaxel (Taxol)]] 175 mg/m<sup>2</sup> IV over 3 hours once on day 1 | ||
+ | *[[Ifosfamide (Ifex)]] 1200 mg/m<sup>2</sup> IV over 2 hours once per day on days 1 to 3 | ||
+ | *[[Cisplatin (Platinol)]] 25 mg/m<sup>2</sup> IV over 2 hours once per day on days 1 to 3 | ||
+ | **Administered intravenously in 250 mL of normal saline containing 12.5 g of mannitol | ||
− | *[[ | + | ====Supportive medications==== |
− | *[[ | + | *[[Mesna (Mesnex)]] as follows: |
− | *[[ | + | **400 mg/m<sup>2</sup> IV once before each dose of [[Ifosfamide (Ifex)]] |
+ | **200 mg/m<sup>2</sup> IV given twice, at 4 and 8 hours after each dose of [[Ifosfamide (Ifex)]] | ||
+ | *After cisplatin, hydration with 3 liters of a solution of 5% dextrose, sodium chloride, potassium chloride, magnesium sulfate, and mannitol | ||
+ | *Either [[Dexamethasone (Decadron)]] 8 mg IV once 1 hour before [[Paclitaxel (Taxol)]], or [[Dexamethasone (Decadron)]] 20 mg PO given twice, at 12 and 6 hours before [[Paclitaxel (Taxol)]] | ||
+ | *[[Diphenhydramine (Benadryl)]] 50 mg IV once prior to [[Paclitaxel (Taxol)]] | ||
+ | *One of the following H2 blockers: | ||
+ | **[[Cimetidine (Tagamet)]] 300 mg IV once prior to [[Paclitaxel (Taxol)]] | ||
+ | **[[Ranitidine (Zantac)]] 50 mg IV once prior to [[Paclitaxel (Taxol)]] | ||
+ | **[[Famotidine (Pepcid)]] 20 mg IV once prior to [[Paclitaxel (Taxol)]] | ||
+ | *"The use of prophylactic granulocyte colony-stimulating factor was allowed but not required" | ||
− | '''21-day cycles | + | '''21 to 28-day cycle for 4 cycles; "cycle was repeated on day 22 if the patient's absolute neutrophil count was at least 1,400/µL and platelet count was at least 100,000/µL"''' |
===References=== | ===References=== | ||
− | # | + | # Pagliaro LC, Williams DL, Daliani D, Williams MB, Osai W, Kincaid M, Wen S, Thall PF, Pettaway CA. Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy for metastatic penile cancer: a phase II study. J Clin Oncol. 2010 Aug 20;28(24):3851-7. Epub 2010 Jul 12. [http://jco.ascopubs.org/content/28/24/3851.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/20625118 PubMed] |
− | = | + | ==VBM {{#subobject:fdb0db|Regimen=1}}== |
− | |||
− | |||
{| class="wikitable" style="float:right; margin-left: 5px;" | {| class="wikitable" style="float:right; margin-left: 5px;" | ||
|- | |- | ||
|[[#toc|back to top]] | |[[#toc|back to top]] | ||
|} | |} | ||
− | + | VBM: '''<u>V</u>'''incristine, '''<u>B</u>'''leomycin, '''<u>M</u>'''ethotrexate | |
− | ===Regimen | + | ===Regimen {{#subobject:a25051|Variant=1}}=== |
− | + | {| border="1" style="text-align:center;" !align="left" | |
− | <span | + | |'''Study''' |
− | style="background:# | + | |[[Levels_of_Evidence#Evidence|'''Evidence''']] |
+ | |- | ||
+ | |[http://www.tandfonline.com/doi/abs/10.3109/02841868809094366 Pizzocaro et al. 1988] | ||
+ | |<span | ||
+ | style="background:#ff0000; | ||
padding:3px 6px 3px 6px; | padding:3px 6px 3px 6px; | ||
border-color:black; | border-color:black; | ||
border-width:2px; | border-width:2px; | ||
− | border-style:solid;"> | + | border-style:solid;">Pilot, <20 pts</span> |
+ | |- | ||
+ | |} | ||
− | + | ''Note: ''The NCCN, Penile Cancer version 1.2013, says that "bleomycin-containing regimens were associated with unacceptable toxicity and are no longer recommended. Adjuvant therapy starts 2 to 4 weeks after surgery."'' | |
− | *[[ | + | ====Chemotherapy==== |
− | *[[ | + | *[[Bleomycin (Blenoxane)]] 15 mg IM twice per week, '''6 hours and 24 hours after vincristine''' |
− | + | *[[Vincristine (Oncovin)]] 1 mg IV once per week | |
− | *[[ | + | *[[Methotrexate (MTX)]] 30 mg PO once per week, '''48 hours after vincristine''' |
− | |||
− | ''' | + | '''12-week course''' |
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
===References=== | ===References=== | ||
− | # | + | # Pizzocaro G, Piva L. Adjuvant and neoadjuvant vincristine, bleomycin, and methotrexate for inguinal metastases from squamous cell carcinoma of the penis. Acta Oncol. 1988;27(6b):823-4. [http://www.tandfonline.com/doi/abs/10.3109/02841868809094366 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/2466471 PubMed] |
+ | # '''Review''': Pagliaro LC, Crook J. Multimodality therapy in penile cancer: when and which treatments? World J Urol. 2009 Apr;27(2):221-5. Epub 2008 Aug 6. [http://link.springer.com/article/10.1007%2Fs00345-008-0310-z link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18682961 PubMed] | ||
− | == | + | =Adjuvant chemotherapy= |
+ | ==TIP== | ||
{| class="wikitable" style="float:right; margin-left: 5px;" | {| class="wikitable" style="float:right; margin-left: 5px;" | ||
|- | |- | ||
|[[#toc|back to top]] | |[[#toc|back to top]] | ||
|} | |} | ||
− | + | ''Note: No primary reference available, but the NCCN, Penile Cancer version 1.2013, says that "it is reasonable to give [[#TIP|4 courses of TIP]] in the adjuvant setting if it was not given preoperatively and the pathology shows high-risk features." (see neoadjuvant chemotherapy section)'' | |
− | == | + | ==TPF (Docetaxel) {{#subobject:118691|Regimen=1}}== |
− | '' | + | {| class="wikitable" style="float:right; margin-left: 5px;" |
+ | |- | ||
+ | |[[#toc|back to top]] | ||
+ | |} | ||
+ | TPF: '''<u>T</u>'''axotere (Docetaxel), '''<u>P</u>'''latinol (Cisplatin), '''<u>F</u>'''luorouracil | ||
− | + | ===Regimen {{#subobject:a57146|Variant=1}}=== | |
− | <span | + | {| border="1" style="text-align:center;" !align="left" |
+ | |'''Study''' | ||
+ | |[[Levels_of_Evidence#Evidence|'''Evidence''']] | ||
+ | |- | ||
+ | |[http://jco.ascopubs.org/content/29/22/e650.long Necchi et al. 2011] | ||
+ | |<span | ||
style="background:#ff0000; | style="background:#ff0000; | ||
padding:3px 6px 3px 6px; | padding:3px 6px 3px 6px; | ||
border-color:black; | border-color:black; | ||
border-width:2px; | border-width:2px; | ||
− | border-style:solid;"> | + | border-style:solid;">Case report</span> |
+ | |- | ||
+ | |} | ||
+ | ====Chemotherapy==== | ||
+ | *[[Docetaxel (Taxotere)]] 75 mg/m<sup>2</sup> IV once on day 1 | ||
+ | *[[Cisplatin (Platinol)]] 75 mg/m<sup>2</sup> IV once on day 1 | ||
+ | *[[Fluorouracil (5-FU)]] 750 mg/m<sup>2</sup>/day IV continuous infusion on days 1 to 4 | ||
− | '' | + | '''21-day cycle for 3 cycles''' |
− | |||
− | |||
− | |||
− | |||
− | |||
===References=== | ===References=== | ||
− | # | + | # Necchi A, Nicolai N, Colecchia M, Catanzaro M, Torelli T, Piva L, Salvioni R. Proof of activity of anti-epidermal growth factor receptor-targeted therapy for relapsed squamous cell carcinoma of the penis. J Clin Oncol. 2011 Aug 1;29(22):e650-2. Epub 2011 May 31. [http://jco.ascopubs.org/content/29/22/e650.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21632506 PubMed] |
− | |||
=Metastatic or unresectable disease= | =Metastatic or unresectable disease= | ||
− | ==BMP | + | ==BMP; MPB {{#subobject:ab9e5f|Regimen=1}}== |
{| class="wikitable" style="float:right; margin-left: 5px;" | {| class="wikitable" style="float:right; margin-left: 5px;" | ||
|- | |- | ||
|[[#toc|back to top]] | |[[#toc|back to top]] | ||
|} | |} | ||
− | BMP: '''<u>B</u>'''leomycin, '''<u>M</u>'''ethotrexate, '''<u>P</u>'''latinol | + | BMP: '''<u>B</u>'''leomycin, '''<u>M</u>'''ethotrexate, '''<u>P</u>'''latinol (Cisplatin) |
− | <br>MPB: '''<u>M</u>'''ethotrexate, '''<u>P</u>'''latinol, '''<u>B</u>'''leomycin | + | <br>MPB: '''<u>M</u>'''ethotrexate, '''<u>P</u>'''latinol (Cisplatin), '''<u>B</u>'''leomycin |
− | + | ''Note: The NCCN, Penile Cancer version 1.2013, says that "bleomycin-containing regimens were associated with unacceptable toxicity and are no longer recommended."'' | |
− | + | ===Regimen #1 {{#subobject:8938|Variant=1}}=== | |
− | ''The NCCN, Penile Cancer version 1.2013, says that "bleomycin-containing regimens were associated with unacceptable toxicity and are no longer recommended."'' | + | {| border="1" style="text-align:center;" !align="left" |
− | + | |'''Study''' | |
− | + | |[[Levels_of_Evidence#Evidence|'''Evidence''']] | |
− | <span | + | |- |
+ | |[http://www.jurology.com/article/S0022-5347(05)68815-5/abstract Haas et al. 1999 (SWOG 8520)] | ||
+ | |<span | ||
style="background:#EEEE00; | style="background:#EEEE00; | ||
padding:3px 6px 3px 6px; | padding:3px 6px 3px 6px; | ||
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border-width:2px; | border-width:2px; | ||
border-style:solid;">Phase II</span> | border-style:solid;">Phase II</span> | ||
+ | |- | ||
+ | |} | ||
+ | |||
+ | ====Chemotherapy==== | ||
+ | *[[Bleomycin (Blenoxane)]] 10 units/m<sup>2</sup> IV bolus once per day on days 1 & 8 | ||
+ | **Chemotherapy with bleomycin was discontinued when a total cumulative dose of 200 units/m<sup>2</sup> was reached | ||
+ | *[[Methotrexate (MTX)]] 25 mg/m<sup>2</sup> IV bolus once per day on days 1 & 8 | ||
+ | *[[Cisplatin (Platinol)]] 75 mg/m<sup>2</sup> at a concentration of 1 mg/mL normal saline IV given at a rate of 1 mg/min once on day 1 | ||
− | *[[ | + | ====Supportive medications==== |
− | + | *Normal saline IV at 250 mL/hour, starting 1 hour before [[Cisplatin (Platinol)]] and continued at least 6 hours after completion of [[Cisplatin (Platinol)]] | |
− | + | *Furosemide (Lasix) 40 mg IV once prior to [[Cisplatin (Platinol)]] | |
− | |||
'''21-day cycles, given until disease progression; patients who achieved complete remission discontinued therapy after 6 cycles''' | '''21-day cycles, given until disease progression; patients who achieved complete remission discontinued therapy after 6 cycles''' | ||
− | + | ===Regimen #2 {{#subobject:99e731|Variant=1}}=== | |
− | |||
− | |||
− | |||
− | ===Regimen #2 | ||
''The NCCN, Penile Cancer version 1.2013, says that "bleomycin-containing regimens were associated with unacceptable toxicity and are no longer recommended."'' | ''The NCCN, Penile Cancer version 1.2013, says that "bleomycin-containing regimens were associated with unacceptable toxicity and are no longer recommended."'' | ||
− | + | {| border="1" style="text-align:center;" !align="left" | |
− | + | |'''Study''' | |
− | <span | + | |[[Levels_of_Evidence#Evidence|'''Evidence''']] |
+ | |- | ||
+ | |[http://www.jurology.com/article/S0022-5347%2801%2962402-9/abstract Corral et al. 1998] | ||
+ | |<span | ||
style="background:#EEEE00; | style="background:#EEEE00; | ||
padding:3px 6px 3px 6px; | padding:3px 6px 3px 6px; | ||
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border-width:2px; | border-width:2px; | ||
border-style:solid;">Phase II</span> | border-style:solid;">Phase II</span> | ||
+ | |- | ||
+ | |} | ||
+ | |||
+ | ''21 of 29 evaluable patients in Corral et al. 1998 had penile cancer. Please see the paper for additional variations in the protocol, including some patients being treated with intraarterial therapy.'' | ||
+ | ====Chemotherapy==== | ||
+ | *[[Bleomycin (Blenoxane)]] 10 mg/m<sup>2</sup> IV once per day on days 2 to 6 | ||
+ | **Note: Pagliaro et al. 2009 lists a "dosage of 50 mg/m<sup>2</sup> on days 2 to 6," which could be misinterpreted as 50 mg/m<sup>2</sup> for each dose, which is in contrast to the 50 mg/m<sup>2</sup> for each cycle that Corral et al. 1998 describes. | ||
+ | *[[Methotrexate (MTX)]] 200 mg/m<sup>2</sup> IV once per day on days 1, 15, 22 | ||
+ | *[[Cisplatin (Platinol)]] 20 mg/m<sup>2</sup> IV over 3 hours once per day on days 2 to 6 | ||
+ | **Note: Corral et al. 1998 does not specify which days cisplatin is given on. Pagliaro et al. 2009 specifies that cisplatin is given on days 2 to 6. For Corral et al. 1998, the 5 day course is inferred based on the paper saying that the total dosage--presumably per cycle--was 100 mg/m<sup>2</sup>. | ||
− | + | ====Supportive medications==== | |
− | + | *[[Folinic acid (Leucovorin)]] 25 mg PO every 6 hours x 12 doses, starting 24 hours after each dose of [[Methotrexate (MTX)]] | |
− | |||
− | *[[Folinic acid (Leucovorin)]] 25 mg PO every 6 hours x 12 doses, starting 24 hours after each dose of | ||
− | |||
'''28-day cycles''' | '''28-day cycles''' | ||
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===References=== | ===References=== | ||
# Corral DA, Sella A, Pettaway CA, Amato RJ, Jones DM, Ellerhorst J. Combination chemotherapy for metastatic or locally advanced genitourinary squamous cell carcinoma: a phase II study of methotrexate, cisplatin and bleomycin. J Urol. 1998 Nov;160(5):1770-4. [http://www.jurology.com/article/S0022-5347%2801%2962402-9/abstract link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/9783949 PubMed] | # Corral DA, Sella A, Pettaway CA, Amato RJ, Jones DM, Ellerhorst J. Combination chemotherapy for metastatic or locally advanced genitourinary squamous cell carcinoma: a phase II study of methotrexate, cisplatin and bleomycin. J Urol. 1998 Nov;160(5):1770-4. [http://www.jurology.com/article/S0022-5347%2801%2962402-9/abstract link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/9783949 PubMed] | ||
− | # Haas GP, Blumenstein BA, Gagliano RG, Russell CA, Rivkin SE, Culkin DJ, Wolf M, Crawford ED. Cisplatin, methotrexate and bleomycin for the treatment of carcinoma of the penis: a Southwest Oncology Group study. J Urol. 1999 Jun;161(6):1823-5. [http://www. | + | # Haas GP, Blumenstein BA, Gagliano RG, Russell CA, Rivkin SE, Culkin DJ, Wolf M, Crawford ED. Cisplatin, methotrexate and bleomycin for the treatment of carcinoma of the penis: a Southwest Oncology Group study. J Urol. 1999 Jun;161(6):1823-5. [http://www.jurology.com/article/S0022-5347(05)68815-5/abstract link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/10332445 PubMed] content property of [http://hemonc.org HemOnc.org] |
− | # '''Review''': Pagliaro LC, Crook J. Multimodality therapy in penile cancer: when and which treatments? World J Urol. 2009 Apr;27(2):221-5 | + | # '''Review''': Pagliaro LC, Crook J. Multimodality therapy in penile cancer: when and which treatments? World J Urol. 2009 Apr;27(2):221-5. Epub 2008 Aug 6. [http://link.springer.com/article/10.1007%2Fs00345-008-0310-z link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18682961 PubMed] |
==Cisplatin & Fluorouracil {{#subobject:f70357|Regimen=1}}== | ==Cisplatin & Fluorouracil {{#subobject:f70357|Regimen=1}}== | ||
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|[[#toc|back to top]] | |[[#toc|back to top]] | ||
|} | |} | ||
− | ===Regimen | + | ===Regimen {{#subobject:1e2b1c|Variant=1}}=== |
− | + | {| border="1" style="text-align:center;" !align="left" | |
− | <span | + | |'''Study''' |
+ | |[[Levels_of_Evidence#Evidence|'''Evidence''']] | ||
+ | |- | ||
+ | |[http://www.ncbi.nlm.nih.gov/pubmed/1538445 Shammas et al. 1992] | ||
+ | |<span | ||
style="background:#ff0000; | style="background:#ff0000; | ||
padding:3px 6px 3px 6px; | padding:3px 6px 3px 6px; | ||
border-color:black; | border-color:black; | ||
border-width:2px; | border-width:2px; | ||
− | border-style:solid;"> | + | border-style:solid;">Pilot, <20 pts</span> |
− | + | |- | |
− | *[[Cisplatin (Platinol)]] 100 mg/ | + | |} |
− | *[[Fluorouracil (5-FU)]] 1000 mg/ | + | ====Chemotherapy==== |
− | + | *[[Cisplatin (Platinol)]] 100 mg/m<sup>2</sup> IV once once on day 1 | |
− | + | *[[Fluorouracil (5-FU)]] 1000 mg/m<sup>2</sup>/day IV continuous infusion on days 1 to 5 | |
===References=== | ===References=== | ||
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|[[#toc|back to top]] | |[[#toc|back to top]] | ||
|} | |} | ||
− | ===Regimen | + | ===Regimen {{#subobject:ec3985|Variant=1}}=== |
− | + | {| border="1" style="text-align:center;" !align="left" | |
− | <span | + | |'''Study''' |
+ | |[[Levels_of_Evidence#Evidence|'''Evidence''']] | ||
+ | |- | ||
+ | |[http://annonc.oxfordjournals.org/content/19/7/1304.long Theodore et al. 2008 (EORTC 30992)] | ||
+ | |<span | ||
style="background:#EEEE00; | style="background:#EEEE00; | ||
padding:3px 6px 3px 6px; | padding:3px 6px 3px 6px; | ||
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border-width:2px; | border-width:2px; | ||
border-style:solid;">Phase II</span> | border-style:solid;">Phase II</span> | ||
+ | |- | ||
+ | |} | ||
+ | ====Chemotherapy==== | ||
+ | *[[Cisplatin (Platinol)]] 80 mg/m<sup>2</sup> IV over 1 to 3 hours once on day 1, '''given second''' | ||
+ | *[[Irinotecan (Camptosar)]] 60 mg/m<sup>2</sup> IV over 30 minutes once per day on days 1, 8, 15, '''given first''' | ||
− | + | ====Supportive medications==== | |
− | |||
− | |||
− | |||
− | |||
− | Supportive medications | ||
*Adequate hydration with cisplatin, per guidelines at each investigator's site | *Adequate hydration with cisplatin, per guidelines at each investigator's site | ||
*Antiemetic medication per routine local practice. | *Antiemetic medication per routine local practice. | ||
*"Systematic premedication with atropine as of the first cycle of treatment was at the investigator's discretion but was not recommended." | *"Systematic premedication with atropine as of the first cycle of treatment was at the investigator's discretion but was not recommended." | ||
+ | |||
+ | '''28-day cycles, with up to 4 cycles before surgery in the neoadjuvant setting for T3 or N1 to N2; up to 8 cycles for patients with T4, N3, or M+ distant metastatic disease''' | ||
===References=== | ===References=== | ||
− | # Theodore C, Skoneczna I, Bodrogi I, Leahy M, Kerst JM, Collette L, Ven K, Marréaud S, Oliver RD; EORTC Genito-Urinary Tract Cancer Group. A phase II multicentre study of irinotecan (CPT 11) in combination with cisplatin (CDDP) in | + | # Theodore C, Skoneczna I, Bodrogi I, Leahy M, Kerst JM, Collette L, Ven K, Marréaud S, Oliver RD; EORTC Genito-Urinary Tract Cancer Group. A phase II multicentre study of irinotecan (CPT 11) in combination with cisplatin (CDDP) in metastatic or locally advanced penile carcinoma (EORTC PROTOCOL 30992). Ann Oncol. 2008 Jul;19(7):1304-7. [http://annonc.oxfordjournals.org/content/19/7/1304.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18417462 PubMed] |
==Paclitaxel (Taxol) {{#subobject:3bde8f|Regimen=1}}== | ==Paclitaxel (Taxol) {{#subobject:3bde8f|Regimen=1}}== | ||
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|[[#toc|back to top]] | |[[#toc|back to top]] | ||
|} | |} | ||
− | ===Regimen | + | ===Regimen {{#subobject:2565c5|Variant=1}}=== |
− | + | {| border="1" style="text-align:center;" !align="left" | |
− | <span | + | |'''Study''' |
+ | |[[Levels_of_Evidence#Evidence|'''Evidence''']] | ||
+ | |- | ||
+ | |[http://www.sciencedirect.com/science/article/pii/S0302283811008967 Di Lorenzo et al. 2011] | ||
+ | |<span | ||
style="background:#EEEE00; | style="background:#EEEE00; | ||
padding:3px 6px 3px 6px; | padding:3px 6px 3px 6px; | ||
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border-width:2px; | border-width:2px; | ||
border-style:solid;">Phase II</span> | border-style:solid;">Phase II</span> | ||
+ | |- | ||
+ | |} | ||
+ | ====Chemotherapy==== | ||
+ | *[[Paclitaxel (Taxol)]] 175 mg/m<sup>2</sup> IV over 3 hours once on day 1 | ||
− | *[[ | + | ====Supportive medications==== |
+ | *[[Filgrastim (Neupogen)|G-CSF]] could be used in later cycles if the patient developed febrile neutropenia during treatment | ||
+ | *[[Dexamethasone (Decadron)]] 8 mg PO given three times, at 12 hours before, immediately before, and 12 hours after paclitaxel | ||
'''21-day cycles, administered until disease progression or unacceptable toxicity''' | '''21-day cycles, administered until disease progression or unacceptable toxicity''' | ||
− | |||
− | |||
− | |||
− | |||
===References=== | ===References=== | ||
− | # Di Lorenzo G, Federico P, Buonerba C, Longo N, Cartenì G, Autorino R, Perdonà S, Ferro M, Rescigno P, D'Aniello C, Matano E, Altieri V, Palmieri G, Imbimbo C, De Placido S, Mirone V. Paclitaxel in pretreated metastatic penile cancer: final | + | # Di Lorenzo G, Federico P, Buonerba C, Longo N, Cartenì G, Autorino R, Perdonà S, Ferro M, Rescigno P, D'Aniello C, Matano E, Altieri V, Palmieri G, Imbimbo C, De Placido S, Mirone V. Paclitaxel in pretreated metastatic penile cancer: final results of a phase 2 study. Eur Urol. 2011 Dec;60(6):1280-4. [http://www.sciencedirect.com/science/article/pii/S0302283811008967 link to SD article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21871710 PubMed] |
==Panitumumab (Vectibix) {{#subobject:92a67f|Regimen=1}}== | ==Panitumumab (Vectibix) {{#subobject:92a67f|Regimen=1}}== | ||
Line 250: | Line 297: | ||
|} | |} | ||
− | ===Regimen | + | ===Regimen {{#subobject:7d9cd7|Variant=1}}=== |
− | ''Necchi et al. 2011 | + | {| border="1" style="text-align:center;" !align="left" |
− | + | |'''Study''' | |
− | + | |[[Levels_of_Evidence#Evidence|'''Evidence''']] | |
− | <span | + | |- |
+ | |[http://jco.ascopubs.org/content/29/22/e650.long Necchi et al. 2011] | ||
+ | |<span | ||
style="background:#ff0000; | style="background:#ff0000; | ||
padding:3px 6px 3px 6px; | padding:3px 6px 3px 6px; | ||
Line 260: | Line 309: | ||
border-width:2px; | border-width:2px; | ||
border-style:solid;">Case report</span> | border-style:solid;">Case report</span> | ||
− | + | |- | |
+ | |} | ||
+ | ''Note: Necchi et al. 2011 is a case report referenced by the NCCN Guidelines, Penile Cancer version 1.2013.'' | ||
+ | ====Chemotherapy==== | ||
*[[Panitumumab (Vectibix)]] 6 mg/kg IV once on day 1 | *[[Panitumumab (Vectibix)]] 6 mg/kg IV once on day 1 | ||
Line 266: | Line 318: | ||
===References=== | ===References=== | ||
− | # Necchi A, Nicolai N, Colecchia M, Catanzaro M, Torelli T, Piva L, Salvioni R. Proof of activity of anti-epidermal growth factor receptor-targeted therapy for relapsed squamous cell carcinoma of the penis. J Clin Oncol. 2011 Aug 1;29(22):e650-2 | + | # Necchi A, Nicolai N, Colecchia M, Catanzaro M, Torelli T, Piva L, Salvioni R. Proof of activity of anti-epidermal growth factor receptor-targeted therapy for relapsed squamous cell carcinoma of the penis. J Clin Oncol. 2011 Aug 1;29(22):e650-2. Epub 2011 May 31. [http://jco.ascopubs.org/content/29/22/e650.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21632506 PubMed] |
==TIP {{#subobject:2169d9|Regimen=1}}== | ==TIP {{#subobject:2169d9|Regimen=1}}== | ||
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|[[#toc|back to top]] | |[[#toc|back to top]] | ||
|} | |} | ||
− | TPF: '''<u>T</u>'''axol, '''<u>P</u>'''latinol, '''<u>F</u>'''luorouracil | + | TPF: '''<u>T</u>'''axol (Paclitaxel), '''<u>P</u>'''latinol (Cisplatin), '''<u>F</u>'''luorouracil |
− | ===Regimen | + | ===Regimen {{#subobject:5f8356|Variant=1}}=== |
− | + | {| border="1" style="text-align:center;" !align="left" | |
− | <span | + | |'''Study''' |
+ | |[[Levels_of_Evidence#Evidence|'''Evidence''']] | ||
+ | |- | ||
+ | |[http://www.europeanurology.com/article/S0302-2838(08)00835-X/fulltext/taxanes-in-combination-with-cisplatin-and-fluorouracil-for-advanced-penile-cancer-preliminary-results Pizzocaro et al. 2009] | ||
+ | |<span | ||
style="background:#ff0000; | style="background:#ff0000; | ||
padding:3px 6px 3px 6px; | padding:3px 6px 3px 6px; | ||
border-color:black; | border-color:black; | ||
border-width:2px; | border-width:2px; | ||
− | border-style:solid;"> | + | border-style:solid;">Pilot, <20 pts</span> |
+ | |- | ||
+ | |} | ||
+ | ====Chemotherapy==== | ||
+ | *[[Paclitaxel (Taxol)]] 120 mg/m<sup>2</sup> in 500 mL 5% glucose solution IV once on day 1, '''given first''' | ||
+ | *[[Cisplatin (Platinol)]] 50 mg/m<sup>2</sup> IV once per day on days 1 & 2 | ||
+ | *[[Fluorouracil (5-FU)]] 1000 mg/m<sup>2</sup>/day in 2 liters half normal 2.5% glucose saline IV continuous infusion on days 2 to 5 | ||
− | * | + | ====Supportive medications==== |
− | *[[Cisplatin (Platinol)]] | + | *"Corticosteroids, antihistamines, and an H2 antagonist were administered before starting paclitaxel" |
− | * | + | *"Antiemetic drugs and glutathione were administered before [[Cisplatin (Platinol)]]" |
+ | *1 liter half normal 2.5% glucose saline with 20 mEq potassium chloride and 10 mEq magnesium sulfate (MgSO4) IV given twice, before and after [[Cisplatin (Platinol)]] | ||
'''21-day cycles'''; "two patients received more than the standard four courses" | '''21-day cycles'''; "two patients received more than the standard four courses" | ||
− | |||
− | |||
− | |||
− | |||
− | |||
===References=== | ===References=== | ||
− | # Pizzocaro G, Nicolai N, Milani A. Taxanes in combination with cisplatin and fluorouracil for advanced penile cancer: preliminary results. Eur Urol. 2009 Mar;55(3):546-51 | + | # Pizzocaro G, Nicolai N, Milani A. Taxanes in combination with cisplatin and fluorouracil for advanced penile cancer: preliminary results. Eur Urol. 2009 Mar;55(3):546-51. Epub 2008 Jul 14. [http://www.europeanurology.com/article/S0302-2838(08)00835-X/fulltext/taxanes-in-combination-with-cisplatin-and-fluorouracil-for-advanced-penile-cancer-preliminary-results link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18649992 PubMed] |
[[Category:Chemotherapy regimens]] | [[Category:Chemotherapy regimens]] | ||
[[Category:Solid oncology regimens]] | [[Category:Solid oncology regimens]] | ||
[[Category:Genitourinary (GU) oncology regimens]] | [[Category:Genitourinary (GU) oncology regimens]] |
Revision as of 16:14, 22 August 2016
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Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are invited to contribute to the site.
9 regimens on this page
10 variants on this page
|
Neoadjuvant chemotherapy
TIP
back to top |
TIP: Taxol (Paclitaxel), Ifosfamide, Platinol (Cisplatin)
Regimen
Study | Evidence |
Pagliaro et al. 2010 | Phase II |
Chemotherapy
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
- Ifosfamide (Ifex) 1200 mg/m2 IV over 2 hours once per day on days 1 to 3
- Cisplatin (Platinol) 25 mg/m2 IV over 2 hours once per day on days 1 to 3
- Administered intravenously in 250 mL of normal saline containing 12.5 g of mannitol
Supportive medications
- Mesna (Mesnex) as follows:
- 400 mg/m2 IV once before each dose of Ifosfamide (Ifex)
- 200 mg/m2 IV given twice, at 4 and 8 hours after each dose of Ifosfamide (Ifex)
- After cisplatin, hydration with 3 liters of a solution of 5% dextrose, sodium chloride, potassium chloride, magnesium sulfate, and mannitol
- Either Dexamethasone (Decadron) 8 mg IV once 1 hour before Paclitaxel (Taxol), or Dexamethasone (Decadron) 20 mg PO given twice, at 12 and 6 hours before Paclitaxel (Taxol)
- Diphenhydramine (Benadryl) 50 mg IV once prior to Paclitaxel (Taxol)
- One of the following H2 blockers:
- Cimetidine (Tagamet) 300 mg IV once prior to Paclitaxel (Taxol)
- Ranitidine (Zantac) 50 mg IV once prior to Paclitaxel (Taxol)
- Famotidine (Pepcid) 20 mg IV once prior to Paclitaxel (Taxol)
- "The use of prophylactic granulocyte colony-stimulating factor was allowed but not required"
21 to 28-day cycle for 4 cycles; "cycle was repeated on day 22 if the patient's absolute neutrophil count was at least 1,400/µL and platelet count was at least 100,000/µL"
References
- Pagliaro LC, Williams DL, Daliani D, Williams MB, Osai W, Kincaid M, Wen S, Thall PF, Pettaway CA. Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy for metastatic penile cancer: a phase II study. J Clin Oncol. 2010 Aug 20;28(24):3851-7. Epub 2010 Jul 12. link to original article contains verified protocol PubMed
VBM
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VBM: Vincristine, Bleomycin, Methotrexate
Regimen
Study | Evidence |
Pizzocaro et al. 1988 | Pilot, <20 pts |
Note: The NCCN, Penile Cancer version 1.2013, says that "bleomycin-containing regimens were associated with unacceptable toxicity and are no longer recommended. Adjuvant therapy starts 2 to 4 weeks after surgery."
Chemotherapy
- Bleomycin (Blenoxane) 15 mg IM twice per week, 6 hours and 24 hours after vincristine
- Vincristine (Oncovin) 1 mg IV once per week
- Methotrexate (MTX) 30 mg PO once per week, 48 hours after vincristine
12-week course
References
- Pizzocaro G, Piva L. Adjuvant and neoadjuvant vincristine, bleomycin, and methotrexate for inguinal metastases from squamous cell carcinoma of the penis. Acta Oncol. 1988;27(6b):823-4. link to original article contains verified protocol PubMed
- Review: Pagliaro LC, Crook J. Multimodality therapy in penile cancer: when and which treatments? World J Urol. 2009 Apr;27(2):221-5. Epub 2008 Aug 6. link to original article contains verified protocol PubMed
Adjuvant chemotherapy
TIP
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Note: No primary reference available, but the NCCN, Penile Cancer version 1.2013, says that "it is reasonable to give 4 courses of TIP in the adjuvant setting if it was not given preoperatively and the pathology shows high-risk features." (see neoadjuvant chemotherapy section)
TPF (Docetaxel)
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TPF: Taxotere (Docetaxel), Platinol (Cisplatin), Fluorouracil
Regimen
Study | Evidence |
Necchi et al. 2011 | Case report |
Chemotherapy
- Docetaxel (Taxotere) 75 mg/m2 IV once on day 1
- Cisplatin (Platinol) 75 mg/m2 IV once on day 1
- Fluorouracil (5-FU) 750 mg/m2/day IV continuous infusion on days 1 to 4
21-day cycle for 3 cycles
References
- Necchi A, Nicolai N, Colecchia M, Catanzaro M, Torelli T, Piva L, Salvioni R. Proof of activity of anti-epidermal growth factor receptor-targeted therapy for relapsed squamous cell carcinoma of the penis. J Clin Oncol. 2011 Aug 1;29(22):e650-2. Epub 2011 May 31. link to original article contains verified protocol PubMed
Metastatic or unresectable disease
BMP; MPB
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BMP: Bleomycin, Methotrexate, Platinol (Cisplatin)
MPB: Methotrexate, Platinol (Cisplatin), Bleomycin
Note: The NCCN, Penile Cancer version 1.2013, says that "bleomycin-containing regimens were associated with unacceptable toxicity and are no longer recommended."
Regimen #1
Study | Evidence |
Haas et al. 1999 (SWOG 8520) | Phase II |
Chemotherapy
- Bleomycin (Blenoxane) 10 units/m2 IV bolus once per day on days 1 & 8
- Chemotherapy with bleomycin was discontinued when a total cumulative dose of 200 units/m2 was reached
- Methotrexate (MTX) 25 mg/m2 IV bolus once per day on days 1 & 8
- Cisplatin (Platinol) 75 mg/m2 at a concentration of 1 mg/mL normal saline IV given at a rate of 1 mg/min once on day 1
Supportive medications
- Normal saline IV at 250 mL/hour, starting 1 hour before Cisplatin (Platinol) and continued at least 6 hours after completion of Cisplatin (Platinol)
- Furosemide (Lasix) 40 mg IV once prior to Cisplatin (Platinol)
21-day cycles, given until disease progression; patients who achieved complete remission discontinued therapy after 6 cycles
Regimen #2
The NCCN, Penile Cancer version 1.2013, says that "bleomycin-containing regimens were associated with unacceptable toxicity and are no longer recommended."
Study | Evidence |
Corral et al. 1998 | Phase II |
21 of 29 evaluable patients in Corral et al. 1998 had penile cancer. Please see the paper for additional variations in the protocol, including some patients being treated with intraarterial therapy.
Chemotherapy
- Bleomycin (Blenoxane) 10 mg/m2 IV once per day on days 2 to 6
- Note: Pagliaro et al. 2009 lists a "dosage of 50 mg/m2 on days 2 to 6," which could be misinterpreted as 50 mg/m2 for each dose, which is in contrast to the 50 mg/m2 for each cycle that Corral et al. 1998 describes.
- Methotrexate (MTX) 200 mg/m2 IV once per day on days 1, 15, 22
- Cisplatin (Platinol) 20 mg/m2 IV over 3 hours once per day on days 2 to 6
- Note: Corral et al. 1998 does not specify which days cisplatin is given on. Pagliaro et al. 2009 specifies that cisplatin is given on days 2 to 6. For Corral et al. 1998, the 5 day course is inferred based on the paper saying that the total dosage--presumably per cycle--was 100 mg/m2.
Supportive medications
- Folinic acid (Leucovorin) 25 mg PO every 6 hours x 12 doses, starting 24 hours after each dose of Methotrexate (MTX)
28-day cycles
References
- Corral DA, Sella A, Pettaway CA, Amato RJ, Jones DM, Ellerhorst J. Combination chemotherapy for metastatic or locally advanced genitourinary squamous cell carcinoma: a phase II study of methotrexate, cisplatin and bleomycin. J Urol. 1998 Nov;160(5):1770-4. link to original article contains verified protocol PubMed
- Haas GP, Blumenstein BA, Gagliano RG, Russell CA, Rivkin SE, Culkin DJ, Wolf M, Crawford ED. Cisplatin, methotrexate and bleomycin for the treatment of carcinoma of the penis: a Southwest Oncology Group study. J Urol. 1999 Jun;161(6):1823-5. link to original article contains verified protocol PubMed content property of HemOnc.org
- Review: Pagliaro LC, Crook J. Multimodality therapy in penile cancer: when and which treatments? World J Urol. 2009 Apr;27(2):221-5. Epub 2008 Aug 6. link to original article contains verified protocol PubMed
Cisplatin & Fluorouracil
back to top |
Regimen
Study | Evidence |
Shammas et al. 1992 | Pilot, <20 pts |
Chemotherapy
- Cisplatin (Platinol) 100 mg/m2 IV once once on day 1
- Fluorouracil (5-FU) 1000 mg/m2/day IV continuous infusion on days 1 to 5
References
- Shammas FV, Ous S, Fossa SD. Cisplatin and 5-fluorouracil in advanced cancer of the penis. J Urol. 1992 Mar;147(3):630-2. contains protocol PubMed
Cisplatin & Irinotecan
back to top |
Regimen
Study | Evidence |
Theodore et al. 2008 (EORTC 30992) | Phase II |
Chemotherapy
- Cisplatin (Platinol) 80 mg/m2 IV over 1 to 3 hours once on day 1, given second
- Irinotecan (Camptosar) 60 mg/m2 IV over 30 minutes once per day on days 1, 8, 15, given first
Supportive medications
- Adequate hydration with cisplatin, per guidelines at each investigator's site
- Antiemetic medication per routine local practice.
- "Systematic premedication with atropine as of the first cycle of treatment was at the investigator's discretion but was not recommended."
28-day cycles, with up to 4 cycles before surgery in the neoadjuvant setting for T3 or N1 to N2; up to 8 cycles for patients with T4, N3, or M+ distant metastatic disease
References
- Theodore C, Skoneczna I, Bodrogi I, Leahy M, Kerst JM, Collette L, Ven K, Marréaud S, Oliver RD; EORTC Genito-Urinary Tract Cancer Group. A phase II multicentre study of irinotecan (CPT 11) in combination with cisplatin (CDDP) in metastatic or locally advanced penile carcinoma (EORTC PROTOCOL 30992). Ann Oncol. 2008 Jul;19(7):1304-7. link to original article contains verified protocol PubMed
Paclitaxel (Taxol)
back to top |
Regimen
Study | Evidence |
Di Lorenzo et al. 2011 | Phase II |
Chemotherapy
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
Supportive medications
- G-CSF could be used in later cycles if the patient developed febrile neutropenia during treatment
- Dexamethasone (Decadron) 8 mg PO given three times, at 12 hours before, immediately before, and 12 hours after paclitaxel
21-day cycles, administered until disease progression or unacceptable toxicity
References
- Di Lorenzo G, Federico P, Buonerba C, Longo N, Cartenì G, Autorino R, Perdonà S, Ferro M, Rescigno P, D'Aniello C, Matano E, Altieri V, Palmieri G, Imbimbo C, De Placido S, Mirone V. Paclitaxel in pretreated metastatic penile cancer: final results of a phase 2 study. Eur Urol. 2011 Dec;60(6):1280-4. link to SD article contains verified protocol PubMed
Panitumumab (Vectibix)
back to top |
Regimen
Study | Evidence |
Necchi et al. 2011 | Case report |
Note: Necchi et al. 2011 is a case report referenced by the NCCN Guidelines, Penile Cancer version 1.2013.
Chemotherapy
- Panitumumab (Vectibix) 6 mg/kg IV once on day 1
14-day cycles
References
- Necchi A, Nicolai N, Colecchia M, Catanzaro M, Torelli T, Piva L, Salvioni R. Proof of activity of anti-epidermal growth factor receptor-targeted therapy for relapsed squamous cell carcinoma of the penis. J Clin Oncol. 2011 Aug 1;29(22):e650-2. Epub 2011 May 31. link to original article contains verified protocol PubMed
TIP
back to top |
No primary reference available, but the NCCN, Penile Cancer version 1.2013, says that "TIP is a reasonable first-line treatment for patients with metastatic penile cancer." (see neoadjuvant chemotherapy section)
TPF (Paclitaxel)
back to top |
TPF: Taxol (Paclitaxel), Platinol (Cisplatin), Fluorouracil
Regimen
Study | Evidence |
Pizzocaro et al. 2009 | Pilot, <20 pts |
Chemotherapy
- Paclitaxel (Taxol) 120 mg/m2 in 500 mL 5% glucose solution IV once on day 1, given first
- Cisplatin (Platinol) 50 mg/m2 IV once per day on days 1 & 2
- Fluorouracil (5-FU) 1000 mg/m2/day in 2 liters half normal 2.5% glucose saline IV continuous infusion on days 2 to 5
Supportive medications
- "Corticosteroids, antihistamines, and an H2 antagonist were administered before starting paclitaxel"
- "Antiemetic drugs and glutathione were administered before Cisplatin (Platinol)"
- 1 liter half normal 2.5% glucose saline with 20 mEq potassium chloride and 10 mEq magnesium sulfate (MgSO4) IV given twice, before and after Cisplatin (Platinol)
21-day cycles; "two patients received more than the standard four courses"
References
- Pizzocaro G, Nicolai N, Milani A. Taxanes in combination with cisplatin and fluorouracil for advanced penile cancer: preliminary results. Eur Urol. 2009 Mar;55(3):546-51. Epub 2008 Jul 14. link to original article contains verified protocol PubMed