Example orders for Cabazitaxel (Jevtana) in prostate cancer
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
References
- 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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Remember that example order sets that may contain additional information about supportive medications, suggestions for monitoring, hydration, and pre-treatment screening information for chemotherapy regimens are purely anecdotal, provided only as examples of what some other providers may be using, and are typically not based on references in the primary literature.
Cabazitaxel (Jevtana)
Published regimens and references can be found on the prostate cancer page.
Example order set #1
- Cabazitaxel (Jevtana) 25 mg/m2 IV over 60 minutes once on day 1; use non-DEHP (paclitaxel) tubing
- Optional: Prednisone (Sterapred) 10 mg PO once per day on days 1 to 21
21-day cycles
Supportive medications
- Dexamethasone (Decadron) 12 mg PO once 30 minutes prior to chemotherapy
- Diphenhydramine (Benadryl) 25 to 50 mg IV once 30 minutes prior to chemotherapy
- Ondansetron (Zofran) 8 mg PO once 30 minutes prior to chemotherapy
- If ondansetron not used: Prochlorperazine (Compazine) 10 mg PO/IV once 30 to 60 minutes prior to chemotherapy
- Famotidine (Pepcid) 20 mg IV over 15 minutes once 30 minutes prior to chemotherapy
- Pegfilgrastim (Neulasta) 6 mg SC once on day 2, 24 hours after completion of chemotherapy
Hydration:
- Normal saline IV continuous infusion at 5 mL/H
- Normal saline 25 to 50 mL IV prn flush before and after chemotherapy
Monitoring/precautions:
- Notify physician if ANC <1500, AST/ALT ≥1.5 times upper limit of normal
- Exercise caution with/avoid use of Cyp3A inducers such as phenytoin and rifampin
- Exercise caution with/avoid use for patients with hepatic insufficiency
Nursing:
- Patients without central lines: insert peripheral IV before therapy. Flush peripheral IV with 10 mL 0.9% normal saline after each day's dose of chemotherapy. Remove peripheral IV when therapy is complete.
- Patients with central lines: access the central venous access device before therapy. Flush central line according to institutional guidelines after each day's dose of chemotherapy. Deaccess device when therapy is complete.
Example order set #2
- Cabazitaxel (Jevtana) 25 mg/m2 IV over 60 minutes once on day 1; use non-DEHP (paclitaxel) tubing
21-day cycles
Supportive medications
- Dexamethasone (Decadron) 12 mg IV once 30 minutes prior to chemotherapy
- Prochlorperazine (Compazine) 10 mg PO/IV once 30 to 60 minutes prior to chemotherapy
- Diphenhydramine (Benadryl) 25 to 50 mg IV once 30 minutes prior to chemotherapy
- Famotidine (Pepcid) 20 mg IV over 15 minutes once 30 minutes prior to chemotherapy
- Due to refractory nausea/vomiting, the following were also used:
- Ondansetron (Zofran) 8 mg IV once 30 minutes prior to chemotherapy
- Fosaprepitant (Emend) 150 mg IV once 30 minutes prior to chemotherapy, admix with dexamethasone and ondansetron
Nursing:
- Patients without central lines: insert peripheral IV before therapy. Flush peripheral IV with 10 mL 0.9% normal saline after each day's dose of chemotherapy. Remove peripheral IV when therapy is complete.
- Patients with central lines: access the central venous access device before therapy. Flush central line according to institutional guidelines after each day's dose of chemotherapy. Deaccess device when therapy is complete.