Rhabdomyosarcoma, pediatric

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Upfront Therapy

COG ARST0431

IRIN-VCR (Weeks 1-6)

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 (Weeks 7-19)

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:

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:

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:

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 (Weeks 20-34)

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:

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:

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 (Weeks 35-54)

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:

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:

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:

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:

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

  1. 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
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