Compression stockings and sleeves

Carboplatin & Paclitaxel (CP)

CP: Carboplatin & Paclitaxel

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Forde et al. 2022 (CheckMate 816)	2017-2019	Phase 3 (C)	1a. CP & Nivolumab 1b. CVb & Nivolumab 1c. DC & Nivolumab	Inferior EFS

Note: there were additional comparator options depending on histology; see the respective histology-specific pages for more details. This study was conducted in the United States. The reason for the study was that an unanswered question at the time was whether adding an immune checkpoint inhibitor would improve outcomes.

Biomarker eligibility criteria

• CheckMate 816: No sensitizing EGFR or ALK mutations

Chemotherapy

• Carboplatin (Paraplatin) AUC 5 or 6 IV once on day 1
• Paclitaxel (Taxol) 175 or 200 mg/m² IV once on day 1

21-day cycle for 3 cycles

Subsequent treatment

• Complete resection

References

1. CheckMate 816: Forde PM, Spicer J, Lu S, Provencio M, Mitsudomi T, Awad MM, Felip E, Broderick SR, Brahmer JR, Swanson SJ, Kerr K, Wang C, Ciuleanu TE, Saylors GB, Tanaka F, Ito H, Chen KN, Liberman M, Vokes EE, Taube JM, Dorange C, Cai J, Fiore J, Jarkowski A, Balli D, Sausen M, Pandya D, Calvet CY, Girard N; CheckMate 816 Investigators. Neoadjuvant Nivolumab plus Chemotherapy in Resectable Lung Cancer. N Engl J Med. 2022 May 26;386(21):1973-1985. Epub 2022 Apr 11. link to original article contains dosing details in manuscript PubMed NCT02998528

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Indications for Gradient of Counterpressure

Gradient I (8-12 mm Hg)

• Heaviness and fatigue in legs

Gradient II (15-20 mm Hg)

• Tired, aching legs
• Minor ankle, leg, and foot swelling
• Minor varicose veins

Gradient III (20-30 mm Hg)

• Prophylaxis and treatment of mild vascular insufficiencies
• Mild varicosities without significant edema

Gradient IV (30-40 mm Hg)

• Varicose veins
• Chronic venous insufficiency
• Peripheral edema
• Prophylaxis post surgical stripping
• Post-phlebitis syndrome
• Pregnancy-related varices
• Prophylaxis and treatment of edema and phlebitis due to post-fracture conditions and injury
• Postural hypotension
• Stasis dermatitis due to chronic venous insufficiency (CVI)
• Venous stasis ulcers
• Post-cast removal
• Post-ligation or stripping
• Inguinal lymphadenectomy
• Muscular inactivity
• Cellulitis

Gradient V (40-50 mm Hg)

• Severe, marked degrees of Gradient IV conditions
• Reversible lymphedema
• Complications of chronic venous insufficiency such as:
  • Marked dependent edema
  • Venous ulcers
  • Severe chronic venous insufficiency
• Post-phlebitis syndrome

Gradient VI (50-60 mm Hg)

• Severe marked degrees of Gradient V conditions
• Severe post-thrombotic cases
• Irreversible lymphedema

Compression therapy support styles

• Knee length
• Thigh length
• Waist height—either 1 or 2-leg
• Maternity
• Lymphedema arm sleeve
• Lymphedema gauntlet (glove without fingers)
• Lymphedema glove

Contraindications to compression therapy

• Cutaneous infections
• Hypodermitis in the acute phase
• Wet dermatoses
• Massive edema from congestive heart failure
• Severe arterial insufficiency