Difference between revisions of "Ewing sarcoma, pediatric"
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===Regimen A Induction=== | ===Regimen A Induction=== | ||
*Regimen A is a standard regimen consisting of 14 day cycles | *Regimen A is a standard regimen consisting of 14 day cycles | ||
− | ==== | + | ====Chemotherapy, VDC portion==== |
− | *[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup>/dose IV push once on day 1 of weeks 1, 2, 5, 6, 9 & 10 (maximum dose of 2 mg) | + | *[[Vincristine (Oncovin)]] as follows: |
− | **For children < 10 kg or < 1 year, the dose is 0.05 mg/kg/dose | + | **Cycles 1, 3, 5: 1.5 mg/m<sup>2</sup>/dose IV push once on day 1 of weeks 1, 2, 5, 6, 9 & 10 (maximum dose of 2 mg) |
− | *[[Doxorubicin (Adriamycin)]] 37.5 mg/m<sup>2</sup>/dose IV push/infusion over 1-15 minutes on days 1 and 2 of weeks 1, 5 and 9. | + | ***For children < 10 kg or < 1 year, the dose is 0.05 mg/kg/dose |
− | **For children < 10 kg or < 1 year, the dose is 1.25 mg/kg/dose | + | *[[Doxorubicin (Adriamycin)]] as follows: |
− | **Administer at a concentration not to exceed 2 mg/mL. [[Doxorubicin (Adriamycin)]] should be administered through the tubing of rapidly infusing solution of D5W or 0.9% NaCl, and it should not be infused into a large vein | + | **Cycles 1, 3, 5: 37.5 mg/m<sup>2</sup>/dose IV push/infusion over 1-15 minutes on days 1 and 2 of weeks 1, 5 and 9. |
− | *[[Cyclophosphamide (Cytoxan)]] 1200 mg/m<sup>2</sup>/dose IV over 30 to60 minutes on day 1 of weeks 1, 5 and 9 | + | ***For children < 10 kg or < 1 year, the dose is 1.25 mg/kg/dose |
− | **For children < 10 kg or < 1 year, the dose is 40 mg/kg/dose | + | ***Administer at a concentration not to exceed 2 mg/mL. [[Doxorubicin (Adriamycin)]] should be administered through the tubing of rapidly infusing solution of D5W or 0.9% NaCl, and it should not be infused into a large vein |
− | **May be administered as undiluted drug (20 mg/mL, reconstitute with 0.9% NaCl to avoid hypotonic solution) or further diluted | + | *[[Cyclophosphamide (Cytoxan)]] as follows: |
− | *[[Mesna (Mesnex)]] 720 mg/m<sup>2</sup>/day by IV infusion or IV/PO with [[Cyclophosphamide (Cytoxan)]] on day 1 of weeks 1, 5 and 9 | + | **Cycles 1, 3, 5: 1200 mg/m<sup>2</sup>/dose IV over 30 to60 minutes on day 1 of weeks 1, 5 and 9 |
− | **For children < 10 kg or < 1 year, the dose is 24 mg/kg/dose | + | ***For children < 10 kg or < 1 year, the dose is 40 mg/kg/dose |
− | + | ***May be administered as undiluted drug (20 mg/mL, reconstitute with 0.9% NaCl to avoid hypotonic solution) or further diluted | |
− | ==== | + | ====Supportive medications, VDC portion==== |
− | *[[Ifosfamide (Ifex)]] | + | *[[Mesna (Mesnex)]] as follows: |
− | **For children < 10 kg or < 1 year, the dose is 60 mg/kg/dose | + | **Cycles 1, 3, 5: 720 mg/m<sup>2</sup>/day by IV infusion or IV/PO with [[Cyclophosphamide (Cytoxan)]] on day 1 of weeks 1, 5 and 9 |
− | **Achieve urine specific gravity ≤ 1.010 prior to start of [[Ifosfamide (Ifex)]]. | + | ***For children < 10 kg or < 1 year, the dose is 24 mg/kg/dose |
− | *[[ | + | |
− | **For children < 10 kg or < 1 year, the dose is | + | ====Chemotherapy, IE portion==== |
− | *[[ | + | *[[Ifosfamide (Ifex)]] as follows: |
− | **For children < 10 kg or < 1 year, the dose is | + | **Cycles 2, 4, 6: 1800 mg/m<sup>2</sup>/dose IV infusion over 1 hour on days 1, 2, 3, 4, and 5 of Weeks 3, 7 and 11 |
− | '''14 day cycle''' | + | ***For children < 10 kg or < 1 year, the dose is 60 mg/kg/dose |
+ | ***Achieve urine specific gravity ≤ 1.010 prior to start of [[Ifosfamide (Ifex)]]. | ||
+ | *[[Etoposide (Vepesid)]] as follows: | ||
+ | **Cycles 2, 4, 6: 100 mg/m<sup>2</sup>/dose IV infusion over 1 to 2 hours once on days 1, 2, 3, 4, and 5 of weeks 3, 7 and 11 | ||
+ | ***For children < 10 kg or < 1 year, the dose is 3.3 mg/kg/dose | ||
+ | ====Supportive medications, IE portion==== | ||
+ | *[[Mesna (Mesnex)]] as follows: | ||
+ | **Cycles 2, 4, 6: 1080 mg/m<sup>2</sup>/day by IV infusion or IV/PO with ifosfamide on days 1, 2, 3, 4, and 5 of Weeks 3, 7 and 11 | ||
+ | ***For children < 10 kg or < 1 year, the dose is 36 mg/kg/dose | ||
+ | '''14-day cycle for 6 cycles''' | ||
===Regimen A Consolidation=== | ===Regimen A Consolidation=== | ||
===Regimen B Induction=== | ===Regimen B Induction=== |
Revision as of 17:13, 9 September 2022
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Upfront Therapy
COG AEWS1031
Regimen A Induction
- Regimen A is a standard regimen consisting of 14 day cycles
Chemotherapy, VDC portion
- Vincristine (Oncovin) as follows:
- Cycles 1, 3, 5: 1.5 mg/m2/dose IV push once on day 1 of weeks 1, 2, 5, 6, 9 & 10 (maximum dose of 2 mg)
- For children < 10 kg or < 1 year, the dose is 0.05 mg/kg/dose
- Cycles 1, 3, 5: 1.5 mg/m2/dose IV push once on day 1 of weeks 1, 2, 5, 6, 9 & 10 (maximum dose of 2 mg)
- Doxorubicin (Adriamycin) as follows:
- Cycles 1, 3, 5: 37.5 mg/m2/dose IV push/infusion over 1-15 minutes on days 1 and 2 of weeks 1, 5 and 9.
- For children < 10 kg or < 1 year, the dose is 1.25 mg/kg/dose
- Administer at a concentration not to exceed 2 mg/mL. Doxorubicin (Adriamycin) should be administered through the tubing of rapidly infusing solution of D5W or 0.9% NaCl, and it should not be infused into a large vein
- Cycles 1, 3, 5: 37.5 mg/m2/dose IV push/infusion over 1-15 minutes on days 1 and 2 of weeks 1, 5 and 9.
- Cyclophosphamide (Cytoxan) as follows:
- Cycles 1, 3, 5: 1200 mg/m2/dose IV over 30 to60 minutes on day 1 of weeks 1, 5 and 9
- For children < 10 kg or < 1 year, the dose is 40 mg/kg/dose
- May be administered as undiluted drug (20 mg/mL, reconstitute with 0.9% NaCl to avoid hypotonic solution) or further diluted
- Cycles 1, 3, 5: 1200 mg/m2/dose IV over 30 to60 minutes on day 1 of weeks 1, 5 and 9
Supportive medications, VDC portion
- Mesna (Mesnex) as follows:
- Cycles 1, 3, 5: 720 mg/m2/day by IV infusion or IV/PO with Cyclophosphamide (Cytoxan) on day 1 of weeks 1, 5 and 9
- For children < 10 kg or < 1 year, the dose is 24 mg/kg/dose
- Cycles 1, 3, 5: 720 mg/m2/day by IV infusion or IV/PO with Cyclophosphamide (Cytoxan) on day 1 of weeks 1, 5 and 9
Chemotherapy, IE portion
- Ifosfamide (Ifex) as follows:
- Cycles 2, 4, 6: 1800 mg/m2/dose IV infusion over 1 hour on days 1, 2, 3, 4, and 5 of Weeks 3, 7 and 11
- For children < 10 kg or < 1 year, the dose is 60 mg/kg/dose
- Achieve urine specific gravity ≤ 1.010 prior to start of Ifosfamide (Ifex).
- Cycles 2, 4, 6: 1800 mg/m2/dose IV infusion over 1 hour on days 1, 2, 3, 4, and 5 of Weeks 3, 7 and 11
- Etoposide (Vepesid) as follows:
- Cycles 2, 4, 6: 100 mg/m2/dose IV infusion over 1 to 2 hours once on days 1, 2, 3, 4, and 5 of weeks 3, 7 and 11
- For children < 10 kg or < 1 year, the dose is 3.3 mg/kg/dose
- Cycles 2, 4, 6: 100 mg/m2/dose IV infusion over 1 to 2 hours once on days 1, 2, 3, 4, and 5 of weeks 3, 7 and 11
Supportive medications, IE portion
- Mesna (Mesnex) as follows:
- Cycles 2, 4, 6: 1080 mg/m2/day by IV infusion or IV/PO with ifosfamide on days 1, 2, 3, 4, and 5 of Weeks 3, 7 and 11
- For children < 10 kg or < 1 year, the dose is 36 mg/kg/dose
- Cycles 2, 4, 6: 1080 mg/m2/day by IV infusion or IV/PO with ifosfamide on days 1, 2, 3, 4, and 5 of Weeks 3, 7 and 11
14-day cycle for 6 cycles