Rhabdomyosarcoma, pediatric
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Upfront Therapy
COG ARST0431
IRIN-VCR
Week 1 (IRIN-VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Administer Vincristine (Oncovin) before Irinotecan (Camptosar)
- Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5
Week 2 (VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Week 3 (VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Week 4 (IRIN-VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Administer Vincristine (Oncovin) before Irinotecan (Camptosar)
- Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5
Week 5 (VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Week 6
- Evaluation Week
VDC/IE
Week 7 (VDC)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
- Doxorubicin (Adriamycin) by the following age-based criteria:
- Age ≥ 1 year: 37.5 mg/m2 (Total dose per week of 75 mg/m2) IV over 24 hours once per day on days 1 through 2
- Age < 1 year: 18.75 mg/m2 IV over 24 hours once per day on days 1 through 2
- Cyclophosphamide (Cytoxan) by the following age-based criteria:
- Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
- Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
- Mesna (Mesnex) by the following age-based criteria:
- Age ≥ 3 years: 240 mg/m2 at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
- Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
Week 8 (VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Week 9 (IE)
- Ifosfamide (Ifex) by the following age-based criteria:
- Age ≥ 1 year: 1800 mg/m2 IV over 1 hour once per day on days 1 through 5
- Age < 1 year: 900 mg/m2 IV over 1 hour once per day on days 1 through 5
- Mesna (Mesnex) by the following age-based criteria:
- Age ≥ 3 years: 360 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
- Age < 3 years: 180 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
- Etoposide (Vepesid) by the following age-based criteria:
- Age ≥ 1 year: 100 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5
- Age < 1 year: 50 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5
Week 10
- Off Chemotherapy Week
Week 11 (VDC)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
- Doxorubicin (Adriamycin) by the following age-based criteria:
- Age ≥ 1 year: 37.5 mg/m2 (Total dose per week of 75 mg/m2) IV over 24 hours once per day on days 1 through 2
- Age < 1 year: 18.75 mg/m2 IV over 24 hours once per day on days 1 through 2
- Cyclophosphamide (Cytoxan) by the following age-based criteria:
- Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
- Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
- Mesna (Mesnex) by the following age-based criteria:
- Age ≥ 3 years: 240 mg/m2 at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
- Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
Week 12 (VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Week 13 (IE)
- Ifosfamide (Ifex) by the following age-based criteria:
- Age ≥ 1 year: 1800 mg/m2 IV over 1 hour once per day on days 1 through 5
- Age < 1 year: 900 mg/m2 IV over 1 hour once per day on days 1 through 5
- Mesna (Mesnex) by the following age-based criteria:
- Age ≥ 3 years: 360 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
- Age < 3 years: 180 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
- Etoposide (Vepesid) by the following age-based criteria:
- Age ≥ 1 year: 100 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5
- Age < 1 year: 50 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5
Week 14
- Off Chemotherapy Week
Week 15 (VDC)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
- Doxorubicin (Adriamycin) by the following age-based criteria:
- Age ≥ 1 year: 37.5 mg/m2 (Total dose per week of 75 mg/m2) IV over 24 hours once per day on days 1 through 2
- Age < 1 year: 18.75 mg/m2 IV over 24 hours once per day on days 1 through 2
- Cyclophosphamide (Cytoxan) by the following age-based criteria:
- Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
- Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
- Mesna (Mesnex) by the following age-based criteria:
- Age ≥ 3 years: 240 mg/m2 at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
- Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
Week 16 (VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Week 17 (IE)
- Ifosfamide (Ifex) by the following age-based criteria:
- Age ≥ 1 year: 1800 mg/m2 IV over 1 hour once per day on days 1 through 5
- Age < 1 year: 900 mg/m2 IV over 1 hour once per day on days 1 through 5
- Mesna (Mesnex) by the following age-based criteria:
- Age ≥ 3 years: 360 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
- Age < 3 years: 180 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
- Etoposide (Vepesid) by the following age-based criteria:
- Age ≥ 1 year: 100 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5
- Age < 1 year: 50 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5
Week 18
- Off Chemotherapy Week
Week 19
- Evaluation Week
IRIN-VCR/IE/VDC
Week 20 (IRIN-VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Administer Vincristine (Oncovin) before Irinotecan (Camptosar)
- Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5
Week 21 (VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Week 22 (VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Week 23 (IRIN-VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Administer Vincristine (Oncovin) before Irinotecan (Camptosar)
- Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5
Week 24 (VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Week 25
- Off Chemotherapy Week
Week 26 (IE)
- Ifosfamide (Ifex) by the following age-based criteria:
- Age ≥ 1 year: 1800 mg/m2 IV over 1 hour once per day on days 1 through 5
- Age < 1 year: 900 mg/m2 IV over 1 hour once per day on days 1 through 5
- Mesna (Mesnex) by the following age-based criteria:
- Age ≥ 3 years: 360 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
- Age < 3 years: 180 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
- Etoposide (Vepesid) by the following age-based criteria:
- Age ≥ 1 year: 100 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5
- Age < 1 year: 50 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5
Week 27
- Off Chemotherapy Week
Week 28 (VDC)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
- Doxorubicin (Adriamycin) by the following age-based criteria:
- Age ≥ 1 year: 37.5 mg/m2 (Total dose per week of 75 mg/m2) IV over 24 hours once per day on days 1 through 2
- Age < 1 year: 18.75 mg/m2 IV over 24 hours once per day on days 1 through 2
- Cyclophosphamide (Cytoxan) by the following age-based criteria:
- Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
- Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
- Mesna (Mesnex) by the following age-based criteria:
- Age ≥ 3 years: 240 mg/m2 at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
- Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
Week 29 (VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Week 30 (IE)
- Ifosfamide (Ifex) by the following age-based criteria:
- Age ≥ 1 year: 1800 mg/m2 IV over 1 hour once per day on days 1 through 5
- Age < 1 year: 900 mg/m2 IV over 1 hour once per day on days 1 through 5
- Mesna (Mesnex) by the following age-based criteria:
- Age ≥ 3 years: 360 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
- Age < 3 years: 180 mg/m2 at hour 0, 4, and 8 from the start of each Ifosfamide (Ifex) infusion on days 1 through 5
- Etoposide (Vepesid) by the following age-based criteria:
- Age ≥ 1 year: 100 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5
- Age < 1 year: 50 mg/m2 IV over 30 to 60 minutes once per day on days 1 through 5
Week 31
- Off Chemotherapy Week
Week 32 (VDC)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
- Doxorubicin (Adriamycin) by the following age-based criteria:
- Age ≥ 1 year: 37.5 mg/m2 (Total dose per week of 75 mg/m2) IV over 24 hours once per day on days 1 through 2
- Age < 1 year: 18.75 mg/m2 IV over 24 hours once per day on days 1 through 2
- Cyclophosphamide (Cytoxan) by the following age-based criteria:
- Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
- Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
- Mesna (Mesnex) by the following age-based criteria:
- Age ≥ 3 years: 240 mg/m2 at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
- Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
Week 33 (VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Week 34
- Evaluation Week
VAC/IRIN-VCR
Week 35 (VAC)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
- Dactinomycin (Cosmegen) by the following age-based criteria:
- Age ≥ 1 year: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
- Age < 1 year: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
- Cyclophosphamide (Cytoxan) by the following age-based criteria:
- Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
- Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
- Mesna (Mesnex) by the following age-based criteria:
- Age ≥ 3 years: 240 mg/m2 at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
- Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
Week 36
- Off Chemotherapy Week
Week 37
- Off Chemotherapy Week
Week 38 (VAC)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
- Dactinomycin (Cosmegen) by the following age-based criteria:
- Age ≥ 1 year: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
- Age < 1 year: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
- Cyclophosphamide (Cytoxan) by the following age-based criteria:
- Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
- Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
- Mesna (Mesnex) by the following age-based criteria:
- Age ≥ 3 years: 240 mg/m2 at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
- Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
Week 39
- Off Chemotherapy Week
Week 40
- Off Chemotherapy Week
Week 41 (VAC)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
- Dactinomycin (Cosmegen) by the following age-based criteria:
- Age ≥ 1 year: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
- Age < 1 year: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
- Cyclophosphamide (Cytoxan) by the following age-based criteria:
- Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
- Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
- Mesna (Mesnex) by the following age-based criteria:
- Age ≥ 3 years: 240 mg/m2 at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
- Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
Week 42 (VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Week 43 (VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Week 44 (VAC)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
- Dactinomycin (Cosmegen) by the following age-based criteria:
- Age ≥ 1 year: 0.045 mg/kg (maximum dose of 2.5 mg) IV push over 1 to 5 minutes once per day on day 1
- Age < 1 year: 0.025 mg/kg IV over 1 to 5 minutes once per day on day 1
- Cyclophosphamide (Cytoxan) by the following age-based criteria:
- Age ≥ 3 years: 1200 mg/m2 IV over 1 hour once per day on day 1
- Age < 3 years: 40mg/kg IV over 1 hour once per day on day 1
- Mesna (Mesnex) by the following age-based criteria:
- Age ≥ 3 years: 240 mg/m2 at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
- Age < 3 years: 8 mg/kg at hour 0, 4, and 8 from the start of each Cyclophosphamide (Cytoxan) infusion on days 1
Week 45
- Off Chemotherapy Week
Week 46
- Off Chemotherapy Week
Week 47 (IRIN-VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Administer Vincristine (Oncovin) before Irinotecan (Camptosar)
- Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5
Week 48 (VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Week 49
- Off Chemotherapy Week
Week 50 (IRIN-VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Administer Vincristine (Oncovin) before Irinotecan (Camptosar)
- Irinotecan (Camptosar) 50 mg/m2 (maximum dose of 100 mg/day) IV over 60 minutes once per day on days 1 through 5
Week 51 (VCR)
- Vincristine (Oncovin) by the following age-based criteria:
- Age ≥ 3 years: 1.5 mg/m2 (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age ≥ 1 year to < 3 years: 0.05 mg/kg (maximum dose of 2 mg) IV push over 1 minute once on day 1
- Age < 1 year: 0.025 mg/kg IV push over 1 minute once on day 1
Week 52
- Off Chemotherapy Week
Week 53
- Off Chemotherapy Week
Week 54
- Evaluation Week
References
- COG ARST0431: Weigel BJ, Lyden E, Anderson JR, Meyer WH, Parham DM, Rodeberg DA, Michalski JM, Hawkins DS, Arndt CAS. Intensive Multiagent Therapy, Including Dose-Compressed Cycles of Ifosfamide/Etoposide and Vincristine/Doxorubicin/Cyclophosphamide, Irinotecan, and Radiation, in Patients with High-Risk Rhabdomyosarcoma: A Report from the Children's Oncology Group. Journal of Clinical Oncology. 2016 Oct;34(2):117-122. link to original article link to PMC article PubMed NCT00354744