Difference between revisions of "Neuroblastoma - historical"
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** > 12 kg and GFR ≥ 100 mL/min: 425 mg/m<sup>2</sup> IV over 24 hours once daily on days -7, -6, -5, -4 | ** > 12 kg and GFR ≥ 100 mL/min: 425 mg/m<sup>2</sup> IV over 24 hours once daily on days -7, -6, -5, -4 | ||
** ≤ 12 kg and GFR between 100 mL/min and 60 mL/min: 4.1 AUC using Calvert Formula (Max Dose = 300 mg/m<sup>2</sup>) IV over 24 hours once daily on days -7, -6, -5, -4 | ** ≤ 12 kg and GFR between 100 mL/min and 60 mL/min: 4.1 AUC using Calvert Formula (Max Dose = 300 mg/m<sup>2</sup>) IV over 24 hours once daily on days -7, -6, -5, -4 | ||
− | ** > 12 kg and GFR between 100 mL/min and 60 mL/min: 4.1 AUC using Calvert Formula | + | ** > 12 kg and GFR between 100 mL/min and 60 mL/min: Use the lowest of either 4.1 AUC using Calvert Formula or 10 mg/kg IV over 24 hours once daily on days -7, -6, -5, -4 |
*PBSC on day 0 | *PBSC on day 0 |
Revision as of 16:54, 27 November 2022
The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. Is there a regimen missing from this list? See the main neuroblastoma page for current regimens.
2 regimens on this page
2 variants on this page
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High Risk
COG ANBL0532 Regimen A
Induction,
Chemotherapy, Cycle 1 (CPM + TOPO)
- Cyclophosphamide (Cytoxan) by the following weight-based criteria:
- ≤ 12 kg: 13.3 mg/kg iV over 30 to 60 minutes once daily on days 1 through 5
- > 12 kg: 400 mg/m2 IV over 30 to 60 minutes once daily on days 1 through 5
- Topotecan (Hycamtin) 1.2 mg/m2 IV over 30 minutes once daily on days 1 through 5
21 Day Cycle
Chemotherapy, Cycle 2 (CPM + TOPO)
- Cyclophosphamide (Cytoxan) by the following weight-based criteria:
- ≤ 12 kg: 13.3 mg/kg iV over 30 to 60 minutes once daily on days 1 through 5
- > 12 kg: 400 mg/m2 IV over 30 to 60 minutes once daily on days 1 through 5
- Topotecan (Hycamtin) 1.2 mg/m2 IV over 30 minutes once daily on days 1 through 5
21 Day Cycle
Supportive Therapy, Cycle 2
- Filgrastim (Neupogen) 5 μg/kg SubQ or IV once daily on Day 6 beginning 24 hours after completion of chemotherapy and continuing until ANC > 1000/μL
- Filgrastim (Neupogen) 10 μg/kg SubQ or IV once daily beginning once ANC > 1000/μL and continuing until PBSC harvest is complete
- PBSC harvest on day 14
21 Day Cycle
Chemotherapy, Cycle 3 (CDDP + ETOP)
- Cisplatin (Platinol) by the following weight-based criteria:
- ≤ 12 kg: 1.66 mg/kg IV over 1 hour once daily on days 1 through 4
- > 12 kg: 50 mg/m2 IV over 1 hour once daily on days 1 through 4
- Etoposide (Vepesid) by the following weight-based criteria:
- ≤ 12 kg: 6.67 mg/kg IV over 1 hour once daily on days 1 through 3
- > 12 kg: 200 mg/m2 IV over 1 hour once daily on days 1 through 3
Chemotherapy, Cycle 4 (CPM + DOXO + VCR)
- Cyclophosphamide (Cytoxan) by the following weight-based criteria:
- ≤ 12 kg: 70 mg/kg iV over 6 hours once daily on days 1 through 2
- > 12 kg: 2100 mg/m2 IV over 6 hours once daily on days 1 through 2
- Vincristine (Oncovin) by the following criteria:
- < 12 months: 0.017 mg/kg (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before Doxorubicin (Adriamycin) on days 1 through 3
- ≥ 12 months and > 12 kg: 0.097 mg/m2 or 0.022 mg/kg (choose lower dose) (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before Doxorubicin (Adriamycin) on days 1 through 3
- ≥ 12 months and ≤ 12 kg: 0.022 mg/kg (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before Doxorubicin (Adriamycin) on days 1 through 3
- Doxorubicin (Adriamycin) by the following weight-based criteria:
- ≤ 12 kg: 0.83 mg/kg iV over 24 hours once daily on days 1 through 3
- > 12 kg: 25 mg/m2 IV over 24 hours once daily on days 1 through 3
21 Day Cycle
Supportive Therapy, Cycle 4 (CPM + DOXO + VCR)
- Mesna (Mesnex) by the following weight-based criteria:
- ≤ 12 kg: 14 mg/kg IV over 15 minutes immediately prior to each Cyclophosphamide (Cytoxan) dose and again at 4 and 8 hours after eachCyclophosphamide (Cytoxan) infusion
- > 12 kg: 420 mg/m2 IV over 15 minutes immediately prior to each Cyclophosphamide (Cytoxan) dose and again at 4 and 8 hours after eachCyclophosphamide (Cytoxan) infusion
21 Day Cycle
Chemotherapy, Cycle 5 (CDDP + ETOP)
- Cisplatin (Platinol) by the following weight-based criteria:
- ≤ 12 kg: 1.66 mg/kg IV over 1 hour once daily on days 1 through 4
- > 12 kg: 50 mg/m2 IV over 1 hour once daily on days 1 through 4
- Etoposide (Vepesid) by the following weight-based criteria:
- ≤ 12 kg: 6.67 mg/kg IV over 1 hour once daily on days 1 through 3
- > 12 kg: 200 mg/m2 IV over 1 hour once daily on days 1 through 3
21 Day Cycle
Chemotherapy, Cycle 6 (CPM + DOXO + VCR)
- Cyclophosphamide (Cytoxan) by the following weight-based criteria:
- ≤ 12 kg: 70 mg/kg iV over 6 hours once daily on days 1 through 2
- > 12 kg: 2100 mg/m2 IV over 6 hours once daily on days 1 through 2
- Vincristine (Oncovin) by the following criteria:
- < 12 months: 0.017 mg/kg (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before Doxorubicin (Adriamycin) on days 1 through 3
- ≥ 12 months and > 12 kg: 0.097 mg/m2 or 0.022 mg/kg (choose lower dose) (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before Doxorubicin (Adriamycin) on days 1 through 3
- ≥ 12 months and ≤ 12 kg: 0.022 mg/kg (Max Dose of 2 mg in 72 hours) IV over 1 minute or infusion (per institutional policy) once daily before Doxorubicin (Adriamycin) on days 1 through 3
- Doxorubicin (Adriamycin) by the following weight-based criteria:
- ≤ 12 kg: 0.83 mg/kg iV over 24 hours once daily on days 1 through 3
- > 12 kg: 25 mg/m2 IV over 24 hours once daily on days 1 through 3
21 Day Cycle
Supportive Therapy, Cycle 6 (CPM + DOXO + VCR)
- Mesna (Mesnex) by the following weight-based criteria:
- ≤ 12 kg: 14 mg/kg IV over 15 minutes immediately prior to each Cyclophosphamide (Cytoxan) dose and again at 4 and 8 hours after eachCyclophosphamide (Cytoxan) infusion
- > 12 kg: 420 mg/m2 IV over 15 minutes immediately prior to each Cyclophosphamide (Cytoxan) dose and again at 4 and 8 hours after eachCyclophosphamide (Cytoxan) infusion
21 Day Cycle
Consolidation,
Chemotherapy, High Dose with PBSC Support
- Melphalan (Alkeran) by the following criteria:
- ≤ 12 kg and GFR ≥ 100 mL/min: 2.3 mg/kg IV over 15 to 30 minutes once daily on days -7, -6, -5
- > 12 kg and GFR ≥ 100 mL/min: 70 mg/m2 IV over 15 to 30 minutes once daily on days -7, -6, -5
- ≤ 12 kg and GFR between 100 mL/min and 60 mL/min: 2 mg/kg IV over 15 to 30 minutes once daily on days -7, -6, -5
- > 12 kg and GFR between 100 mL/min and 60 mL/min: 60 mg/m2 IV over 15 to 30 minutes once daily on days -7, -6, -5
- Etoposide (Vepesid) by the following criteria:
- ≤ 12 kg and GFR ≥ 100 mL/min: 11.3 mg/kg IV over 24 hours once daily on days -7, -6, -5, -4
- > 12 kg and GFR ≥ 100 mL/min: 338 mg/m2 IV over 24 hours once daily on days -7, -6, -5, -4
- ≤ 12 kg and GFR between 100 mL/min and 60 mL/min: 6.7 mg/kg IV over 24 hours once daily on days -7, -6, -5, -4
- > 12 kg and GFR between 100 mL/min and 60 mL/min: 200 mg/m2 IV over 24 hours once daily on days -7, -6, -5, -4
- Carboplatin (Paraplatin) by the following criteria:
- ≤ 12 kg and GFR ≥ 100 mL/min: 14.2 mg/kg IV over 24 hours once daily on days -7, -6, -5, -4
- > 12 kg and GFR ≥ 100 mL/min: 425 mg/m2 IV over 24 hours once daily on days -7, -6, -5, -4
- ≤ 12 kg and GFR between 100 mL/min and 60 mL/min: 4.1 AUC using Calvert Formula (Max Dose = 300 mg/m2) IV over 24 hours once daily on days -7, -6, -5, -4
- > 12 kg and GFR between 100 mL/min and 60 mL/min: Use the lowest of either 4.1 AUC using Calvert Formula or 10 mg/kg IV over 24 hours once daily on days -7, -6, -5, -4
- PBSC on day 0
36 Day Cycle
Supportive therapy,
- Filgrastim (Neupogen) 5 μg/kg SubQ or IV once daily starting on day 0 and continuing until post-nadir ANC > 2000/μL for 3 consecutive days
36 Day Cycle
Maintenance, 6 Cycles
Chemotherapy,
- Isotretinoin (Accutane) by the following weight-based criteria:
- ≤ 12 kg: 5.33 mg/kg (Round dose to nearest 10 mg) PO twice daily on days 1 through 14
- > 12 kg: 160 mg/m2 (Round dose to nearest 10 mg) PO twice daily on days 1 through 14
28 Day Cycle
References
- COG ANBL0532:Seif AE, Naranjo A, Baker DL, Bunin NJ, Kletzel M, Kretschmar CS, Maris JM, McGrady PW, von Allmen D, Cohn SL, London WB, Park JR, Diller LR, Grupp SA. A pilot study of tandem high-dose chemotherapy with stem cell rescue as consolidation for high-risk neuroblastoma: Children's Oncology Group study ANBL00P1. Bone Marrow Transplant. 2013 Jul;48(7):947-52. link to original article link to PMC article PubMed