Difference between revisions of "Endometrial cancer"
Jump to navigation
Jump to search
m (Text replace - "content property of HemOnc.org" to "content property of [http://hemonc.org HemOnc.org]") |
(added regimens) |
||
| Line 7: | Line 7: | ||
=Hormone therapy for endometrioid histologies= | =Hormone therapy for endometrioid histologies= | ||
==Anastrozole (Arimidex)== | ==Anastrozole (Arimidex)== | ||
| − | *[[Anastrozole (Arimidex)]] 1 mg PO daily | + | *[[Anastrozole (Arimidex)]] 1 mg PO once daily |
'''given until progression of disease or unacceptable toxicity''' | '''given until progression of disease or unacceptable toxicity''' | ||
| Line 16: | Line 16: | ||
==Medroxyprogesterone acetate (MPA)== | ==Medroxyprogesterone acetate (MPA)== | ||
===Regimen=== | ===Regimen=== | ||
| − | *Medroxyprogesterone acetate (MPA) 200 mg PO daily | + | *Medroxyprogesterone acetate (MPA) 200 mg PO once daily |
'''given until progression of disease or unacceptable toxicity''' | '''given until progression of disease or unacceptable toxicity''' | ||
| Line 65: | Line 65: | ||
==Cisplatin (Platinol), Doxorubicin (Adriamycin), RT== | ==Cisplatin (Platinol), Doxorubicin (Adriamycin), RT== | ||
===Regimen=== | ===Regimen=== | ||
| − | Adjuvant radiation | + | ====Adjuvant radiation==== |
| − | *Radiation therapy to the pelvis, 1.8 Gy x 28 fractions | + | *Radiation therapy to the pelvis, 1.8 Gy x 28 fractions (total dose: 50.4 Gy) |
| − | **Patients with positive para-aortic lymph nodes received 1.5-1.8 Gy x 24-29 fractions | + | **Patients with positive para-aortic lymph nodes received 1.5-1.8 Gy x 24-29 fractions (total dose: 43.5 Gy) |
'''6-week course, begins within 8 weeks after surgery''' | '''6-week course, begins within 8 weeks after surgery''' | ||
| − | Chemotherapy | + | ====Chemotherapy==== |
| − | *[[Cisplatin (Platinol)]] 50 mg/m2 IV on day 1, given second | + | *[[Cisplatin (Platinol)]] 50 mg/m2 IV once on day 1, given second |
| − | *[[Doxorubicin (Adriamycin)]] 45 mg/m2 IV on day 1, given first | + | *[[Doxorubicin (Adriamycin)]] 45 mg/m2 IV once on day 1, given first |
*Body surface area capped at 2.0 m2 | *Body surface area capped at 2.0 m2 | ||
| Line 79: | Line 79: | ||
Supportive medications: | Supportive medications: | ||
| − | *[[Filgrastim (Neupogen)]] 5 mcg/kg SC on days 2-11, or until ANC increases to 10,000; or [[Pegfilgrastim (Neulasta)]] | + | *[[Filgrastim (Neupogen)]] 5 mcg/kg SC once daily on days 2-11, or until ANC increases to 10,000; or [[Pegfilgrastim (Neulasta)]] |
| − | *[[Dexamethasone (Decadron)]] 10 mg IV prior to chemotherapy | + | *[[Dexamethasone (Decadron)]] 10 mg IV once prior to chemotherapy |
| − | * | + | *[[antiemesis|5-HT3 antagonist]] |
===References=== | ===References=== | ||
| Line 88: | Line 88: | ||
==Cisplatin (Platinol), Doxorubicin (Adriamycin), Paclitaxel (Taxol), RT== | ==Cisplatin (Platinol), Doxorubicin (Adriamycin), Paclitaxel (Taxol), RT== | ||
===Regimen=== | ===Regimen=== | ||
| − | Adjuvant radiation | + | ====Adjuvant radiation==== |
| − | *Radiation therapy to the pelvis, 1.8 Gy x 28 fractions | + | *Radiation therapy to the pelvis, 1.8 Gy x 28 fractions (total dose: 50.4 Gy) |
| − | **Patients with positive para-aortic lymph nodes received 1.5-1.8 Gy x 24-29 fractions | + | **Patients with positive para-aortic lymph nodes received 1.5-1.8 Gy x 24-29 fractions (total dose: 43.5 Gy) |
'''6-week course, begins within 8 weeks after surgery''' | '''6-week course, begins within 8 weeks after surgery''' | ||
| − | Chemotherapy | + | ====Chemotherapy==== |
| − | *[[Cisplatin (Platinol)]] 50 mg/m2 IV on day 1, given second | + | *[[Cisplatin (Platinol)]] 50 mg/m2 IV once on day 1, given second |
| − | *[[Doxorubicin (Adriamycin)]] 45 mg/m2 IV on day 1, given first | + | *[[Doxorubicin (Adriamycin)]] 45 mg/m2 IV once on day 1, given first |
| − | *[[Paclitaxel (Taxol)]] 160 mg/m2 IV over 3 hours on day 2 | + | *[[Paclitaxel (Taxol)]] 160 mg/m2 IV over 3 hours once on day 2 |
*Body surface area capped at 2.0 m2 | *Body surface area capped at 2.0 m2 | ||
| Line 103: | Line 103: | ||
Supportive medications: | Supportive medications: | ||
| − | *[[Filgrastim (Neupogen)]] 5 mcg/kg SC on days 3-12, or until ANC increases to 10,000 | + | *[[Filgrastim (Neupogen)]] 5 mcg/kg SC once daily on days 3-12, or until ANC increases to 10,000 |
| − | *[[Dexamethasone (Decadron)]] 10 mg IV prior to day 1 chemotherapy; 20 mg 5 | + | *[[Dexamethasone (Decadron)]] 10 mg IV once prior to day 1 chemotherapy; [[Dexamethasone (Decadron)]] 20 mg once 5 to 12 hours prior to paclitaxel on day 2 |
| − | * | + | *[[antiemesis|5-HT3 antagonist]] |
===References=== | ===References=== | ||
# Homesley HD, Filiaci V, Gibbons SK, Long HJ, Cella D, Spirtos NM, Morris RT, DeGeest K, Lee R, Montag A. A randomized phase III trial in advanced endometrial carcinoma of surgery and volume directed radiation followed by cisplatin and doxorubicin with or without paclitaxel: A Gynecologic Oncology Group study. Gynecol Oncol. 2009 Mar;112(3):543-52. Epub 2008 Dec 23. [http://www.sciencedirect.com/science/article/pii/S0090825808009384 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/19108877 PubMed] | # Homesley HD, Filiaci V, Gibbons SK, Long HJ, Cella D, Spirtos NM, Morris RT, DeGeest K, Lee R, Montag A. A randomized phase III trial in advanced endometrial carcinoma of surgery and volume directed radiation followed by cisplatin and doxorubicin with or without paclitaxel: A Gynecologic Oncology Group study. Gynecol Oncol. 2009 Mar;112(3):543-52. Epub 2008 Dec 23. [http://www.sciencedirect.com/science/article/pii/S0090825808009384 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/19108877 PubMed] | ||
| − | =Advanced or metastatic disease= | + | =Advanced, recurrent, or metastatic disease= |
| + | ==Bevacizumab (Avastin)== | ||
| + | ===Regimen, Aghajanian, et al. 2011=== | ||
| + | *[[Bevacizumab (Avastin)]] 15 mg/kg IV once on day 1 | ||
| + | |||
| + | '''21-day cycles, given until progression of disease or unacceptable toxicity''' | ||
| + | |||
| + | ===References=== | ||
| + | # Aghajanian C, Sill MW, Darcy KM, Greer B, McMeekin DS, Rose PG, Rotmensch J, Barnes MN, Hanjani P, Leslie KK. Phase II trial of bevacizumab in recurrent or persistent endometrial cancer: a Gynecologic Oncology Group study. J Clin Oncol. 2011 Jun 1;29(16):2259-65. doi: 10.1200/JCO.2010.32.6397. Epub 2011 May 2. [http://jco.ascopubs.org/content/29/16/2259.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21537039 PubMed] | ||
| + | |||
==Carboplatin (Paraplatin)== | ==Carboplatin (Paraplatin)== | ||
===Regimen=== | ===Regimen=== | ||
| − | *[[Carboplatin (Paraplatin)]] 400 mg/m2 IV over 30 minutes on day 1 | + | *[[Carboplatin (Paraplatin)]] 400 mg/m2 IV over 30 minutes once on day 1 |
| − | **Dosage for patients with previously treated with chemotherapy is [[Carboplatin (Paraplatin)]] 300 mg/m2 | + | **Dosage for patients with previously treated with chemotherapy is [[Carboplatin (Paraplatin)]] 300 mg/m2 IV over 30 minutes once on day 1 |
'''28-day cycles''' | '''28-day cycles''' | ||
| Line 123: | Line 132: | ||
==Carboplatin (Paraplatin) & Paclitaxel (Taxol)== | ==Carboplatin (Paraplatin) & Paclitaxel (Taxol)== | ||
===Regimen #1, Pectasides, et al. 2008=== | ===Regimen #1, Pectasides, et al. 2008=== | ||
| − | *[[Carboplatin (Paraplatin)]] AUC 5 IV over 1 hour on day 1, given second | + | *[[Carboplatin (Paraplatin)]] AUC 5 IV over 1 hour once on day 1, given second |
| − | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours on day 1, given first | + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1, given first |
| − | '''21-day cycles x 6 | + | '''21-day cycles x 6 to 9 cycles''' |
===Regimen #2, Hoskins, et al. 2001 & Shechter-Maor, et al. 2008=== | ===Regimen #2, Hoskins, et al. 2001 & Shechter-Maor, et al. 2008=== | ||
| − | *[[Carboplatin (Paraplatin)]] AUC 5 | + | *[[Carboplatin (Paraplatin)]] AUC 5 to 7 IV once on day 1, given second |
| − | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours on day 1, given first | + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1, given first |
'''21-day cycles''' | '''21-day cycles''' | ||
===Regimen #3, Sorbe, et al. 2008=== | ===Regimen #3, Sorbe, et al. 2008=== | ||
| − | *[[Carboplatin (Paraplatin)]] AUC 5 IV on day 1 | + | *[[Carboplatin (Paraplatin)]] AUC 5 IV once on day 1 |
| − | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV on day 1 | + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV once on day 1 |
'''21-day cycles''' | '''21-day cycles''' | ||
| Line 148: | Line 157: | ||
==Cisplatin (Platinol) & Doxorubicin (Adriamycin)== | ==Cisplatin (Platinol) & Doxorubicin (Adriamycin)== | ||
===Regimen #1, Fleming et al. 2004=== | ===Regimen #1, Fleming et al. 2004=== | ||
| − | *[[Cisplatin (Platinol)]] 50 mg/m2 IV over 1 hour on day 1, given second | + | *[[Cisplatin (Platinol)]] 50 mg/m2 IV over 1 hour once on day 1, given second |
| − | *[[Doxorubicin (Adriamycin)]] 60 mg/m2 IV on day 1, given first | + | *[[Doxorubicin (Adriamycin)]] 60 mg/m2 IV once on day 1, given first |
| − | **Dosage for patients with previous pelvic radiation or who were >65 years old is [[Doxorubicin (Adriamycin)]] 45 mg/m2 | + | **Dosage for patients with previous pelvic radiation or who were >65 years old is [[Doxorubicin (Adriamycin)]] 45 mg/m2 IV once on day 1 |
*Body surface area capped at 2.0 m2 | *Body surface area capped at 2.0 m2 | ||
| Line 156: | Line 165: | ||
===Regimen #2, Randall et al. 2006=== | ===Regimen #2, Randall et al. 2006=== | ||
| − | *[[Cisplatin (Platinol)]] 50 mg/m2 IV on day 1 of cycles 1 | + | *[[Cisplatin (Platinol)]] 50 mg/m2 IV once on day 1 of cycles 1 to 8 |
| − | *[[Doxorubicin (Adriamycin)]] 60 mg/m2 IV on day 1 of cycles 1 | + | *[[Doxorubicin (Adriamycin)]] 60 mg/m2 IV once on day 1 of cycles 1 to 7 |
'''21-day cycles x 8 cycles''' | '''21-day cycles x 8 cycles''' | ||
| Line 170: | Line 179: | ||
==Cisplatin (Platinol), Doxorubicin (Adriamycin), Paclitaxel (Taxol)== | ==Cisplatin (Platinol), Doxorubicin (Adriamycin), Paclitaxel (Taxol)== | ||
===Regimen=== | ===Regimen=== | ||
| − | *[[Cisplatin (Platinol)]] 50 mg/m2 IV over 1 hour on day 1, given second | + | *[[Cisplatin (Platinol)]] 50 mg/m2 IV over 1 hour once on day 1, given second |
| − | *[[Doxorubicin (Adriamycin)]] 45 mg/m2 IV on day 1, given first | + | *[[Doxorubicin (Adriamycin)]] 45 mg/m2 IV once on day 1, given first |
| − | *[[Paclitaxel (Taxol)]] 160 mg/m2 IV over 3 hours on day 2 | + | *[[Paclitaxel (Taxol)]] 160 mg/m2 IV over 3 hours once on day 2 |
*Body surface area capped at 2.0 m2 | *Body surface area capped at 2.0 m2 | ||
| Line 178: | Line 187: | ||
Supportive medications: | Supportive medications: | ||
| − | *[[Filgrastim (Neupogen)]] 5 mcg/kg SC on days 3 | + | *[[Filgrastim (Neupogen)]] 5 mcg/kg SC once daily on days 3 to 12 |
===References=== | ===References=== | ||
# Fleming GF, Brunetto VL, Cella D, Look KY, Reid GC, Munkarah AR, Kline R, Burger RA, Goodman A, Burks RT. Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2004 Jun 1;22(11):2159-66. [http://jco.ascopubs.org/content/22/11/2159.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/15169803 PubMed] | # Fleming GF, Brunetto VL, Cella D, Look KY, Reid GC, Munkarah AR, Kline R, Burger RA, Goodman A, Burks RT. Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2004 Jun 1;22(11):2159-66. [http://jco.ascopubs.org/content/22/11/2159.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/15169803 PubMed] | ||
| − | ==Cisplatin (Platinol), Ifosfamide (Ifex), Mesna (Mesnex) (CIM) | + | ==Cisplatin (Platinol), Ifosfamide (Ifex), Mesna (Mesnex) (CIM)== |
| − | ===Regimen=== | + | ===Regimen, Wolfson, et al. 2007 - GOG 150=== |
| − | *[[Cisplatin (Platinol)]] 20 mg/m2 IV at an infusion rate of approximately 1 mg/min on days 1 | + | *[[Cisplatin (Platinol)]] 20 mg/m2 IV at an infusion rate of approximately 1 mg/min once daily on days 1 to 4, given first |
| − | *[[Ifosfamide (Ifex)]] 1500 mg/m2 IV over 1 hour on days 1 | + | *[[Ifosfamide (Ifex)]] 1500 mg/m2 IV over 1 hour once daily on days 1 to 4, given second together with mesna |
| − | *[[Mesna (Mesnex)]] 120 mg/m2 IV bolus over 15 minutes, then 1500 mg/m2/day IV continuous infusion over 96 hours on days 1 | + | *[[Mesna (Mesnex)]] 120 mg/m2 IV bolus over 15 minutes once on day ;, then [[Mesna (Mesnex)]] 1500 mg/m2/day IV continuous infusion over 96 hours on days 1 to 4, given second together with ifosfamide |
'''21-day cycles x 3 cycles''' | '''21-day cycles x 3 cycles''' | ||
| Line 199: | Line 208: | ||
==Cisplatin (Platinol) & Paclitaxel (Taxol)== | ==Cisplatin (Platinol) & Paclitaxel (Taxol)== | ||
===Regimen=== | ===Regimen=== | ||
| − | *[[Cisplatin (Platinol)]] 75 mg/m2 IV over 2 hours on day 1, given second | + | *[[Cisplatin (Platinol)]] 75 mg/m2 IV over 2 hours once on day 1, given second |
| − | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours on day 1, given first | + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1, given first |
'''21-day cycles x up to 6 cycles''' | '''21-day cycles x up to 6 cycles''' | ||
Supportive medications: | Supportive medications: | ||
| − | *[[Dexamethasone (Decadron)]] 20 mg PO/IV 12 and 6 hours prior to paclitaxel | + | *[[Dexamethasone (Decadron)]] 20 mg PO/IV given twice, 12 and 6 hours prior to paclitaxel |
| − | *Diphenhydramine (Benadryl) 25 mg IV 30 minutes prior to paclitaxel | + | *Diphenhydramine (Benadryl) 25 mg IV once 30 minutes prior to paclitaxel |
| − | *Ranitidine (Zantac) 50 mg IV 30 minutes prior to paclitaxel | + | *Ranitidine (Zantac) 50 mg IV once 30 minutes prior to paclitaxel |
*900 mL normal saline mixed with 100 mL mannitol given over 1 hour prior to cisplatin | *900 mL normal saline mixed with 100 mL mannitol given over 1 hour prior to cisplatin | ||
*2 liters NS with potassium & magnesium after cisplatin | *2 liters NS with potassium & magnesium after cisplatin | ||
*"Appropriate [[antiemesis|antiemetics]]" | *"Appropriate [[antiemesis|antiemetics]]" | ||
| − | *[[Filgrastim (Neupogen)]] 5 mcg/kg SC daily, starting on day 5 and continuing until WBC >10,000 | + | *[[Filgrastim (Neupogen)]] 5 mcg/kg SC once daily, starting on day 5 and continuing until WBC >10,000 |
===References=== | ===References=== | ||
| Line 218: | Line 227: | ||
==Dactinomycin (Cosmegen)== | ==Dactinomycin (Cosmegen)== | ||
===Regimen=== | ===Regimen=== | ||
| − | *[[Dactinomycin (Cosmegen)]] 2 mg/m2 IV over 15 minutes on day 1 | + | *[[Dactinomycin (Cosmegen)]] 2 mg/m2 IV over 15 minutes once on day 1 |
'''28-day cycles''' | '''28-day cycles''' | ||
| Line 228: | Line 237: | ||
===Regimen=== | ===Regimen=== | ||
''Note: Homesley, et al. 2007 specifies that PO [[Mesna (Mesnex)]] is to be taken in 3 divided doses, but only lists 2 time points for its use. The timing of the middle dose is estimated based on other references.'' | ''Note: Homesley, et al. 2007 specifies that PO [[Mesna (Mesnex)]] is to be taken in 3 divided doses, but only lists 2 time points for its use. The timing of the middle dose is estimated based on other references.'' | ||
| − | *[[Ifosfamide (Ifex)]] 1600 mg/m2 IV on days 1 | + | *[[Ifosfamide (Ifex)]] 1600 mg/m2 IV once daily on days 1 to 3 |
| − | **Dosage for patients with previous radiation is [[Ifosfamide (Ifex)]] 1200 mg/m2 | + | **Dosage for patients with previous radiation is [[Ifosfamide (Ifex)]] 1200 mg/m2 IV once daily on days 1 to 3 |
| − | *[[Mesna (Mesnex)]] 2000 mg IV over 12 hours on days 1 | + | *[[Mesna (Mesnex)]] 2000 mg IV over 12 hours once daily on days 1 to 3, starting 15 minutes before ifosfamide |
| − | **Alternate PO dosing: [[Mesna (Mesnex)]] 1330 mg PO taken 1 hour before, 4 hours after, and 8 hours after ifosfamide (4000 mg total dose per day), on days 1 | + | **Alternate PO dosing: [[Mesna (Mesnex)]] 1330 mg PO taken three times per day, 1 hour before, 4 hours after, and 8 hours after ifosfamide (4000 mg total dose per day), on days 1 to 3 |
| − | *[[Paclitaxel (Taxol)]] 135 mg/m2 IV over 3 hours on day 1 | + | *[[Paclitaxel (Taxol)]] 135 mg/m2 IV over 3 hours once on day 1 |
'''21-day cycles x 8 cycles''' | '''21-day cycles x 8 cycles''' | ||
Supportive medications: | Supportive medications: | ||
| − | *[[Filgrastim (Neupogen)]] 5 mcg/kg SC daily starting on day 4, to continue until ANC is greater than or equal to 2000 | + | *[[Filgrastim (Neupogen)]] 5 mcg/kg SC once daily starting on day 4, to continue until ANC is greater than or equal to 2000 |
| − | *[[Dexamethasone (Decadron)]] 20 mg PO/IV 12 and 6 hours prior to paclitaxel | + | *[[Dexamethasone (Decadron)]] 20 mg PO/IV given twice, 12 and 6 hours prior to paclitaxel |
| − | *Diphenhydramine (Benadryl) 50 mg IV 30 minutes prior to paclitaxel | + | *Diphenhydramine (Benadryl) 50 mg IV lonce 30 minutes prior to paclitaxel |
| − | *Cimetidine (Tagamet) 300 mg IV or Ranitidine (Zantac) 50 mg IV 30 minutes prior to paclitaxel | + | *Cimetidine (Tagamet) 300 mg IV or Ranitidine (Zantac) 50 mg IV once 30 minutes prior to paclitaxel |
===References=== | ===References=== | ||
| Line 247: | Line 256: | ||
==Paclitaxel (Taxol)== | ==Paclitaxel (Taxol)== | ||
===Regimen #1, Lincoln, et al. 2003=== | ===Regimen #1, Lincoln, et al. 2003=== | ||
| − | *[[Paclitaxel (Taxol)]] 200 mg/m2 IV over 3 hours on day 1 | + | *[[Paclitaxel (Taxol)]] 200 mg/m2 IV over 3 hours once on day 1 |
| − | **Dosage for patients with previous pelvic radiation is [[Paclitaxel (Taxol)]] 175 mg/m2 | + | **Dosage for patients with previous pelvic radiation is [[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1 |
| − | **Dose of [[Paclitaxel (Taxol)]] can be changed to 135 or | + | **Dose of [[Paclitaxel (Taxol)]] can be changed to 135 or 110 mg/m2 depending on toxicity |
'''21-day cycles''' | '''21-day cycles''' | ||
Supportive medications: | Supportive medications: | ||
| − | *[[Dexamethasone (Decadron)]] 20 mg PO/IV 12 and 6 hours prior to paclitaxel | + | *[[Dexamethasone (Decadron)]] 20 mg PO/IV given twice, 12 and 6 hours prior to paclitaxel |
| − | *Diphenhydramine (Benadryl) 50 mg PO/IV 30 minutes prior to paclitaxel | + | *Diphenhydramine (Benadryl) 50 mg PO/IV once 30 minutes prior to paclitaxel |
| − | *Cimetidine (Tagamet) 300 mg IV 30 minutes prior to paclitaxel | + | *Cimetidine (Tagamet) 300 mg IV once 30 minutes prior to paclitaxel |
===Regimen #2, Lissoni, et al. 1996=== | ===Regimen #2, Lissoni, et al. 1996=== | ||
| − | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours on day 1 | + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1 |
'''21-day cycles''' | '''21-day cycles''' | ||
Supportive medications: | Supportive medications: | ||
| − | *Hydrocortisone 250 mg IV 1 hour prior to paclitaxel | + | *Hydrocortisone (Cortef) 250 mg IV once 1 hour prior to paclitaxel |
| − | *Chlorphenamine/chlorpheniramine (H1 blocker) 10 mg IM 1 hour prior to paclitaxel | + | *Chlorphenamine/chlorpheniramine (H1 blocker) 10 mg IM once 1 hour prior to paclitaxel |
| − | *Cimetidine (Tagamet) 300 mg IV 1 hour prior to paclitaxel | + | *Cimetidine (Tagamet) 300 mg IV once 1 hour prior to paclitaxel |
===Regimen #3, Ball, et al. 1996=== | ===Regimen #3, Ball, et al. 1996=== | ||
| − | *[[Paclitaxel (Taxol)]] 250 mg/m2 IV continuous infusion over 24 hours on day 1 | + | *[[Paclitaxel (Taxol)]] 250 mg/m2 IV continuous infusion over 24 hours once on day 1 |
| − | **Dosage for patients with previous pelvic radiation is [[Paclitaxel (Taxol)]] 200 mg/m2 | + | **Dosage for patients with previous pelvic radiation is [[Paclitaxel (Taxol)]] 200 mg/m2 IV continuous infusion over 24 hours once on day 1 |
| − | **Dose of [[Paclitaxel (Taxol)]] can be changed to 200, 170, 135, | + | **Dose of [[Paclitaxel (Taxol)]] can be changed to 200, 170, 135, 110 mg/m2 depending on toxicity |
'''21-day cycles''' | '''21-day cycles''' | ||
Supportive medications: | Supportive medications: | ||
| − | *[[Dexamethasone (Decadron)]] 20 mg PO/IV 12 and 6 hours prior to paclitaxel | + | *[[Dexamethasone (Decadron)]] 20 mg PO/IV given twice, 12 and 6 hours prior to paclitaxel |
| − | *Diphenhydramine (Benadryl) 50 mg PO/IV 30 minutes prior to paclitaxel | + | *Diphenhydramine (Benadryl) 50 mg PO/IV once 30 minutes prior to paclitaxel |
| − | *Cimetidine (Tagamet) 300 mg IV 30 minutes prior to paclitaxel | + | *Cimetidine (Tagamet) 300 mg IV once 30 minutes prior to paclitaxel |
| − | *[[Filgrastim (Neupogen)]] 5 mcg/kg SC daily starting on day 3, 24 hours after chemotherapy, continued for at least 12 days or until two successive total leukocyte counts are 10,000 or greater, whichever comes last | + | *[[Filgrastim (Neupogen)]] 5 mcg/kg SC once daily starting on day 3, 24 hours after chemotherapy, continued for at least 12 days or until two successive total leukocyte counts are 10,000 or greater, whichever comes last |
===References=== | ===References=== | ||
| Line 285: | Line 294: | ||
# Lissoni A, Zanetta G, Losa G, Gabriele A, Parma G, Mangioni C. Phase II study of paclitaxel as salvage treatment in advanced endometrial cancer. Ann Oncol. 1996 Oct;7(8):861-3. [http://annonc.oxfordjournals.org/content/7/8/861.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/8922203 PubMed] | # Lissoni A, Zanetta G, Losa G, Gabriele A, Parma G, Mangioni C. Phase II study of paclitaxel as salvage treatment in advanced endometrial cancer. Ann Oncol. 1996 Oct;7(8):861-3. [http://annonc.oxfordjournals.org/content/7/8/861.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/8922203 PubMed] | ||
# Lincoln S, Blessing JA, Lee RB, Rocereto TF. Activity of paclitaxel as second-line chemotherapy in endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2003 Mar;88(3):277-81. [http://www.sciencedirect.com/science/article/pii/S0090825802000689 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/12648575 PubMed] | # Lincoln S, Blessing JA, Lee RB, Rocereto TF. Activity of paclitaxel as second-line chemotherapy in endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2003 Mar;88(3):277-81. [http://www.sciencedirect.com/science/article/pii/S0090825802000689 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/12648575 PubMed] | ||
| + | |||
| + | ==Temsirolimus (Torisel)== | ||
| + | ===Regimen, Oza, et al. 2011=== | ||
| + | *[[Temsirolimus (Torisel)]] 25 mg IV over 30 minutes once daily on days 1, 8, 15, 22 | ||
| + | |||
| + | '''28-day cycles, given until progression of disease, unacceptable toxicity, or patient decision''' | ||
| + | |||
| + | ===References=== | ||
| + | # Oza AM, Elit L, Tsao MS, Kamel-Reid S, Biagi J, Provencher DM, Gotlieb WH, Hoskins PJ, Ghatage P, Tonkin KS, Mackay HJ, Mazurka J, Sederias J, Ivy P, Dancey JE, Eisenhauer EA. Phase II study of temsirolimus in women with recurrent or metastatic endometrial cancer: a trial of the NCIC Clinical Trials Group. J Clin Oncol. 2011 Aug 20;29(24):3278-85. doi: 10.1200/JCO.2010.34.1578. Epub 2011 Jul 25. [http://jco.ascopubs.org/content/29/24/3278.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21788564 PubMed] | ||
==Topotecan (Hycamtin)== | ==Topotecan (Hycamtin)== | ||
===Regimen=== | ===Regimen=== | ||
| − | *[[Topotecan (Hycamtin)]] 1.5 mg/m2 IV on days 1 | + | *[[Topotecan (Hycamtin)]] 1.5 mg/m2 IV once daily on days 1 to 5 |
**Dosage for patients with previous pelvic radiation is [[Topotecan (Hycamtin)]] 1.2 mg/m2, which can be increase to the 1.5 mg/m2 dose in later cycles if there are no toxicities higher than grade 1 | **Dosage for patients with previous pelvic radiation is [[Topotecan (Hycamtin)]] 1.2 mg/m2, which can be increase to the 1.5 mg/m2 dose in later cycles if there are no toxicities higher than grade 1 | ||
Revision as of 19:56, 14 May 2013
Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer.
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.
Hormone therapy for endometrioid histologies
Anastrozole (Arimidex)
- Anastrozole (Arimidex) 1 mg PO once daily
given until progression of disease or unacceptable toxicity
References
- Rose PG, Brunetto VL, VanLe L, Bell J, Walker JL, Lee RB. A phase II trial of anastrozole in advanced recurrent or persistent endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2000 Aug;78(2):212-6. link to original article contains verified protocol PubMed
Medroxyprogesterone acetate (MPA)
Regimen
- Medroxyprogesterone acetate (MPA) 200 mg PO once daily
given until progression of disease or unacceptable toxicity
References
- Thigpen JT, Brady MF, Alvarez RD, Adelson MD, Homesley HD, Manetta A, Soper JT, Given FT. Oral medroxyprogesterone acetate in the treatment of advanced or recurrent endometrial carcinoma: a dose-response study by the Gynecologic Oncology Group. J Clin Oncol. 1999 Jun;17(6):1736-44. link to original article contains verified protocol PubMed
Medroxyprogesterone acetate (MPA) & Tamoxifen (Nolvadex)
Regimen
- Medroxyprogesterone acetate (MPA) 100 mg PO BID on even-numbered weeks (for example, week 2, 4, 6, etc.)
- Tamoxifen (Nolvadex) 20 mg PO BID
given until progression of disease or unacceptable toxicity
References
- Whitney CW, Brunetto VL, Zaino RJ, Lentz SS, Sorosky J, Armstrong DK, Lee RB; Gynecologic Oncology Group study. Phase II study of medroxyprogesterone acetate plus tamoxifen in advanced endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2004 Jan;92(1):4-9. link to original article contains verified protocol PubMed
Megestrol acetate (Megace)
Regimen
- Megestrol acetate (Megace) 80 mg PO BID
given until progression of disease or unacceptable toxicity
References
- Pandya KJ, Yeap BY, Weiner LM, Krook JE, Erban JK, Schinella RA, Davis TE. Megestrol and tamoxifen in patients with advanced endometrial cancer: an Eastern Cooperative Oncology Group Study (E4882). Am J Clin Oncol. 2001 Feb;24(1):43-6. link to original article contains verified protocol PubMed
Megestrol acetate (Megace) & Tamoxifen (Nolvadex)
Regimen
- Megestrol acetate (Megace) 80 mg PO BID x 3 weeks, alternating with tamoxifen
- Tamoxifen (Nolvadex) 20 mg PO BID x 3 weeks, alternating with megestrol
3-week courses of Megestrol acetate (Megace), alternating back and forth with 3-week courses of Tamoxifen (Nolvadex); given until progression of disease or unacceptable toxicity
References
- Fiorica JV, Brunetto VL, Hanjani P, Lentz SS, Mannel R, Andersen W; Gynecologic Oncology Group study. Phase II trial of alternating courses of megestrol acetate and tamoxifen in advanced endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2004 Jan;92(1):10-4. link to original article contains verified protocol PubMed
Tamoxifen (Nolvadex)
Regimen
- Tamoxifen (Nolvadex) 20 mg PO BID
given until progression of disease or unacceptable toxicity
References
- Quinn MA, Campbell JJ. Tamoxifen therapy in advanced/recurrent endometrial carcinoma. Gynecol Oncol. 1989 Jan;32(1):1-3. PubMed
- Thigpen T, Brady MF, Homesley HD, Soper JT, Bell J. Tamoxifen in the treatment of advanced or recurrent endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol. 2001 Jan 15;19(2):364-7. link to original article contains verified protocol PubMed
Adjuvant radiation & chemotherapy
Cisplatin (Platinol), Doxorubicin (Adriamycin), RT
Regimen
Adjuvant radiation
- Radiation therapy to the pelvis, 1.8 Gy x 28 fractions (total dose: 50.4 Gy)
- Patients with positive para-aortic lymph nodes received 1.5-1.8 Gy x 24-29 fractions (total dose: 43.5 Gy)
6-week course, begins within 8 weeks after surgery
Chemotherapy
- Cisplatin (Platinol) 50 mg/m2 IV once on day 1, given second
- Doxorubicin (Adriamycin) 45 mg/m2 IV once on day 1, given first
- Body surface area capped at 2.0 m2
21-day cycles x 6 cycles, to start within 8 weeks after adjuvant radiation is complete
Supportive medications:
- Filgrastim (Neupogen) 5 mcg/kg SC once daily on days 2-11, or until ANC increases to 10,000; or Pegfilgrastim (Neulasta)
- Dexamethasone (Decadron) 10 mg IV once prior to chemotherapy
- 5-HT3 antagonist
References
- Homesley HD, Filiaci V, Gibbons SK, Long HJ, Cella D, Spirtos NM, Morris RT, DeGeest K, Lee R, Montag A. A randomized phase III trial in advanced endometrial carcinoma of surgery and volume directed radiation followed by cisplatin and doxorubicin with or without paclitaxel: A Gynecologic Oncology Group study. Gynecol Oncol. 2009 Mar;112(3):543-52. Epub 2008 Dec 23. link to original article contains verified protocol PubMed
Cisplatin (Platinol), Doxorubicin (Adriamycin), Paclitaxel (Taxol), RT
Regimen
Adjuvant radiation
- Radiation therapy to the pelvis, 1.8 Gy x 28 fractions (total dose: 50.4 Gy)
- Patients with positive para-aortic lymph nodes received 1.5-1.8 Gy x 24-29 fractions (total dose: 43.5 Gy)
6-week course, begins within 8 weeks after surgery
Chemotherapy
- Cisplatin (Platinol) 50 mg/m2 IV once on day 1, given second
- Doxorubicin (Adriamycin) 45 mg/m2 IV once on day 1, given first
- Paclitaxel (Taxol) 160 mg/m2 IV over 3 hours once on day 2
- Body surface area capped at 2.0 m2
21-day cycles x 6 cycles, to start within 8 weeks after adjuvant radiation is complete
Supportive medications:
- Filgrastim (Neupogen) 5 mcg/kg SC once daily on days 3-12, or until ANC increases to 10,000
- Dexamethasone (Decadron) 10 mg IV once prior to day 1 chemotherapy; Dexamethasone (Decadron) 20 mg once 5 to 12 hours prior to paclitaxel on day 2
- 5-HT3 antagonist
References
- Homesley HD, Filiaci V, Gibbons SK, Long HJ, Cella D, Spirtos NM, Morris RT, DeGeest K, Lee R, Montag A. A randomized phase III trial in advanced endometrial carcinoma of surgery and volume directed radiation followed by cisplatin and doxorubicin with or without paclitaxel: A Gynecologic Oncology Group study. Gynecol Oncol. 2009 Mar;112(3):543-52. Epub 2008 Dec 23. link to original article contains verified protocol PubMed
Advanced, recurrent, or metastatic disease
Bevacizumab (Avastin)
Regimen, Aghajanian, et al. 2011
- Bevacizumab (Avastin) 15 mg/kg IV once on day 1
21-day cycles, given until progression of disease or unacceptable toxicity
References
- Aghajanian C, Sill MW, Darcy KM, Greer B, McMeekin DS, Rose PG, Rotmensch J, Barnes MN, Hanjani P, Leslie KK. Phase II trial of bevacizumab in recurrent or persistent endometrial cancer: a Gynecologic Oncology Group study. J Clin Oncol. 2011 Jun 1;29(16):2259-65. doi: 10.1200/JCO.2010.32.6397. Epub 2011 May 2. link to original article contains verified protocol PubMed
Carboplatin (Paraplatin)
Regimen
- Carboplatin (Paraplatin) 400 mg/m2 IV over 30 minutes once on day 1
- Dosage for patients with previously treated with chemotherapy is Carboplatin (Paraplatin) 300 mg/m2 IV over 30 minutes once on day 1
28-day cycles
References
- van Wijk FH, Lhommé C, Bolis G, Scotto di Palumbo V, Tumolo S, Nooij M, de Oliveira CF, Vermorken JB; European Organization for Research and Treatment of Cancer. Gynaecological Cancer Group. Phase II study of carboplatin in patients with advanced or recurrent endometrial carcinoma. A trial of the EORTC Gynaecological Cancer Group. Eur J Cancer. 2003 Jan;39(1):78-85. link to original article contains verified protocol PubMed
Carboplatin (Paraplatin) & Paclitaxel (Taxol)
Regimen #1, Pectasides, et al. 2008
- Carboplatin (Paraplatin) AUC 5 IV over 1 hour once on day 1, given second
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1, given first
21-day cycles x 6 to 9 cycles
Regimen #2, Hoskins, et al. 2001 & Shechter-Maor, et al. 2008
- Carboplatin (Paraplatin) AUC 5 to 7 IV once on day 1, given second
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1, given first
21-day cycles
Regimen #3, Sorbe, et al. 2008
- Carboplatin (Paraplatin) AUC 5 IV once on day 1
- Paclitaxel (Taxol) 175 mg/m2 IV once on day 1
21-day cycles
References
- Hoskins PJ, Swenerton KD, Pike JA, Wong F, Lim P, Acquino-Parsons C, Lee N. Paclitaxel and carboplatin, alone or with irradiation, in advanced or recurrent endometrial cancer: a phase II study. J Clin Oncol. 2001 Oct 15;19(20):4048-53. link to original article contains verified protocol PubMed
- Pectasides D, Xiros N, Papaxoinis G, Pectasides E, Sykiotis C, Koumarianou A, Psyrri A, Gaglia A, Kassanos D, Gouveris P, Panayiotidis J, Fountzilas G, Economopoulos T. Carboplatin and paclitaxel in advanced or metastatic endometrial cancer. Gynecol Oncol. 2008 May;109(2):250-4. Epub 2008 Mar 4. link to original article contains verified protocol PubMed content property of HemOnc.org
- Sorbe B, Andersson H, Boman K, Rosenberg P, Kalling M. Treatment of primary advanced and recurrent endometrial carcinoma with a combination of carboplatin and paclitaxel-long-term follow-up. Int J Gynecol Cancer. 2008 Jul-Aug;18(4):803-8. Epub 2007 Oct 18. PubMed
- Shechter-Maor G, Bruchim I, Ben-Harim Z, Altaras M, Fishman A. Combined chemotherapy regimen of carboplatin and paclitaxel as adjuvant treatment for papillary serous and clear cell endometrial cancer. Int J Gynecol Cancer. 2009 May;19(4):662-4. link to original article PubMed
Cisplatin (Platinol) & Doxorubicin (Adriamycin)
Regimen #1, Fleming et al. 2004
- Cisplatin (Platinol) 50 mg/m2 IV over 1 hour once on day 1, given second
- Doxorubicin (Adriamycin) 60 mg/m2 IV once on day 1, given first
- Dosage for patients with previous pelvic radiation or who were >65 years old is Doxorubicin (Adriamycin) 45 mg/m2 IV once on day 1
- Body surface area capped at 2.0 m2
21-day cycles x 7 cycles
Regimen #2, Randall et al. 2006
- Cisplatin (Platinol) 50 mg/m2 IV once on day 1 of cycles 1 to 8
- Doxorubicin (Adriamycin) 60 mg/m2 IV once on day 1 of cycles 1 to 7
21-day cycles x 8 cycles
Supportive hydration:
- Normal saline at 500 mL/H for 2 hours prior to and after cisplatin
References
- Fleming GF, Brunetto VL, Cella D, Look KY, Reid GC, Munkarah AR, Kline R, Burger RA, Goodman A, Burks RT. Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2004 Jun 1;22(11):2159-66. link to original article contains verified protocol PubMed
- Randall ME, Filiaci VL, Muss H, Spirtos NM, Mannel RS, Fowler J, Thigpen JT, Benda JA; Gynecologic Oncology Group Study. Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2006 Jan 1;24(1):36-44. Epub 2005 Dec 5. link to original article contains verified protocol PubMed
Cisplatin (Platinol), Doxorubicin (Adriamycin), Paclitaxel (Taxol)
Regimen
- Cisplatin (Platinol) 50 mg/m2 IV over 1 hour once on day 1, given second
- Doxorubicin (Adriamycin) 45 mg/m2 IV once on day 1, given first
- Paclitaxel (Taxol) 160 mg/m2 IV over 3 hours once on day 2
- Body surface area capped at 2.0 m2
21-day cycles x 7 cycles
Supportive medications:
- Filgrastim (Neupogen) 5 mcg/kg SC once daily on days 3 to 12
References
- Fleming GF, Brunetto VL, Cella D, Look KY, Reid GC, Munkarah AR, Kline R, Burger RA, Goodman A, Burks RT. Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2004 Jun 1;22(11):2159-66. link to original article contains verified protocol PubMed
Cisplatin (Platinol), Ifosfamide (Ifex), Mesna (Mesnex) (CIM)
Regimen, Wolfson, et al. 2007 - GOG 150
- Cisplatin (Platinol) 20 mg/m2 IV at an infusion rate of approximately 1 mg/min once daily on days 1 to 4, given first
- Ifosfamide (Ifex) 1500 mg/m2 IV over 1 hour once daily on days 1 to 4, given second together with mesna
- Mesna (Mesnex) 120 mg/m2 IV bolus over 15 minutes once on day ;, then Mesna (Mesnex) 1500 mg/m2/day IV continuous infusion over 96 hours on days 1 to 4, given second together with ifosfamide
21-day cycles x 3 cycles
Supportive medications:
- Suggested hydration: 1 liter of NS or 1/2 NS given over several hours prior to chemotherapy
References
- Wolfson AH, Brady MF, Rocereto T, Mannel RS, Lee YC, Futoran RJ, Cohn DE, Ioffe OB. A gynecologic oncology group randomized phase III trial of whole abdominal irradiation (WAI) vs. cisplatin-ifosfamide and mesna (CIM) as post-surgical therapy in stage I-IV carcinosarcoma (CS) of the uterus. Gynecol Oncol. 2007 Nov;107(2):177-85. Epub 2007 Sep 5. link to original article contains verified protocol PubMed
Cisplatin (Platinol) & Paclitaxel (Taxol)
Regimen
- Cisplatin (Platinol) 75 mg/m2 IV over 2 hours once on day 1, given second
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1, given first
21-day cycles x up to 6 cycles
Supportive medications:
- Dexamethasone (Decadron) 20 mg PO/IV given twice, 12 and 6 hours prior to paclitaxel
- Diphenhydramine (Benadryl) 25 mg IV once 30 minutes prior to paclitaxel
- Ranitidine (Zantac) 50 mg IV once 30 minutes prior to paclitaxel
- 900 mL normal saline mixed with 100 mL mannitol given over 1 hour prior to cisplatin
- 2 liters NS with potassium & magnesium after cisplatin
- "Appropriate antiemetics"
- Filgrastim (Neupogen) 5 mcg/kg SC once daily, starting on day 5 and continuing until WBC >10,000
References
- Dimopoulos MA, Papadimitriou CA, Georgoulias V, Moulopoulos LA, Aravantinos G, Gika D, Karpathios S, Stamatelopoulos S. Paclitaxel and cisplatin in advanced or recurrent carcinoma of the endometrium: long-term results of a phase II multicenter study. Gynecol Oncol. 2000 Jul;78(1):52-7. link to original article contains verified protocol PubMed
Dactinomycin (Cosmegen)
Regimen
- Dactinomycin (Cosmegen) 2 mg/m2 IV over 15 minutes once on day 1
28-day cycles
References
- Moore DH, Blessing JA, Dunton C, Buller RE, Reid GC. Dactinomycin in the treatment of recurrent or persistent endometrial carcinoma: A Phase II study of the Gynecologic Oncology Group. Gynecol Oncol. 1999 Dec;75(3):473-5. link to original article contains verified protocol PubMed
Ifosfamide (Ifex) & Paclitaxel (Taxol)
Regimen
Note: Homesley, et al. 2007 specifies that PO Mesna (Mesnex) is to be taken in 3 divided doses, but only lists 2 time points for its use. The timing of the middle dose is estimated based on other references.
- Ifosfamide (Ifex) 1600 mg/m2 IV once daily on days 1 to 3
- Dosage for patients with previous radiation is Ifosfamide (Ifex) 1200 mg/m2 IV once daily on days 1 to 3
- Mesna (Mesnex) 2000 mg IV over 12 hours once daily on days 1 to 3, starting 15 minutes before ifosfamide
- Alternate PO dosing: Mesna (Mesnex) 1330 mg PO taken three times per day, 1 hour before, 4 hours after, and 8 hours after ifosfamide (4000 mg total dose per day), on days 1 to 3
- Paclitaxel (Taxol) 135 mg/m2 IV over 3 hours once on day 1
21-day cycles x 8 cycles
Supportive medications:
- Filgrastim (Neupogen) 5 mcg/kg SC once daily starting on day 4, to continue until ANC is greater than or equal to 2000
- Dexamethasone (Decadron) 20 mg PO/IV given twice, 12 and 6 hours prior to paclitaxel
- Diphenhydramine (Benadryl) 50 mg IV lonce 30 minutes prior to paclitaxel
- Cimetidine (Tagamet) 300 mg IV or Ranitidine (Zantac) 50 mg IV once 30 minutes prior to paclitaxel
References
- Homesley HD, Filiaci V, Markman M, Bitterman P, Eaton L, Kilgore LC, Monk BJ, Ueland FR; Gynecologic Oncology Group. Phase III trial of ifosfamide with or without paclitaxel in advanced uterine carcinosarcoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2007 Feb 10;25(5):526-31. link to original article contains verified protocol PubMed
Paclitaxel (Taxol)
Regimen #1, Lincoln, et al. 2003
- Paclitaxel (Taxol) 200 mg/m2 IV over 3 hours once on day 1
- Dosage for patients with previous pelvic radiation is Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
- Dose of Paclitaxel (Taxol) can be changed to 135 or 110 mg/m2 depending on toxicity
21-day cycles
Supportive medications:
- Dexamethasone (Decadron) 20 mg PO/IV given twice, 12 and 6 hours prior to paclitaxel
- Diphenhydramine (Benadryl) 50 mg PO/IV once 30 minutes prior to paclitaxel
- Cimetidine (Tagamet) 300 mg IV once 30 minutes prior to paclitaxel
Regimen #2, Lissoni, et al. 1996
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
21-day cycles
Supportive medications:
- Hydrocortisone (Cortef) 250 mg IV once 1 hour prior to paclitaxel
- Chlorphenamine/chlorpheniramine (H1 blocker) 10 mg IM once 1 hour prior to paclitaxel
- Cimetidine (Tagamet) 300 mg IV once 1 hour prior to paclitaxel
Regimen #3, Ball, et al. 1996
- Paclitaxel (Taxol) 250 mg/m2 IV continuous infusion over 24 hours once on day 1
- Dosage for patients with previous pelvic radiation is Paclitaxel (Taxol) 200 mg/m2 IV continuous infusion over 24 hours once on day 1
- Dose of Paclitaxel (Taxol) can be changed to 200, 170, 135, 110 mg/m2 depending on toxicity
21-day cycles
Supportive medications:
- Dexamethasone (Decadron) 20 mg PO/IV given twice, 12 and 6 hours prior to paclitaxel
- Diphenhydramine (Benadryl) 50 mg PO/IV once 30 minutes prior to paclitaxel
- Cimetidine (Tagamet) 300 mg IV once 30 minutes prior to paclitaxel
- Filgrastim (Neupogen) 5 mcg/kg SC once daily starting on day 3, 24 hours after chemotherapy, continued for at least 12 days or until two successive total leukocyte counts are 10,000 or greater, whichever comes last
References
- Ball HG, Blessing JA, Lentz SS, Mutch DG. A phase II trial of paclitaxel in patients with advanced or recurrent adenocarcinoma of the endometrium: a Gynecologic Oncology Group study. Gynecol Oncol. 1996 Aug;62(2):278-81. link to original article contains verified protocol PubMed
- Lissoni A, Zanetta G, Losa G, Gabriele A, Parma G, Mangioni C. Phase II study of paclitaxel as salvage treatment in advanced endometrial cancer. Ann Oncol. 1996 Oct;7(8):861-3. link to original article contains verified protocol PubMed
- Lincoln S, Blessing JA, Lee RB, Rocereto TF. Activity of paclitaxel as second-line chemotherapy in endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2003 Mar;88(3):277-81. link to original article contains verified protocol PubMed
Temsirolimus (Torisel)
Regimen, Oza, et al. 2011
- Temsirolimus (Torisel) 25 mg IV over 30 minutes once daily on days 1, 8, 15, 22
28-day cycles, given until progression of disease, unacceptable toxicity, or patient decision
References
- Oza AM, Elit L, Tsao MS, Kamel-Reid S, Biagi J, Provencher DM, Gotlieb WH, Hoskins PJ, Ghatage P, Tonkin KS, Mackay HJ, Mazurka J, Sederias J, Ivy P, Dancey JE, Eisenhauer EA. Phase II study of temsirolimus in women with recurrent or metastatic endometrial cancer: a trial of the NCIC Clinical Trials Group. J Clin Oncol. 2011 Aug 20;29(24):3278-85. doi: 10.1200/JCO.2010.34.1578. Epub 2011 Jul 25. link to original article contains verified protocol PubMed
Topotecan (Hycamtin)
Regimen
- Topotecan (Hycamtin) 1.5 mg/m2 IV once daily on days 1 to 5
- Dosage for patients with previous pelvic radiation is Topotecan (Hycamtin) 1.2 mg/m2, which can be increase to the 1.5 mg/m2 dose in later cycles if there are no toxicities higher than grade 1
21-day cycles
References
- Wadler S, Levy DE, Lincoln ST, Soori GS, Schink JC, Goldberg G. Topotecan is an active agent in the first-line treatment of metastatic or recurrent endometrial carcinoma: Eastern Cooperative Oncology Group Study E3E93. J Clin Oncol. 2003 Jun 1;21(11):2110-4. link to original article contains verified protocol PubMed