The purpose of this page is to document a "manual of style" that should be used for all entries on HemOnc.org. If you're looking for more general information on how to make edits in Mediawiki, visit this page. If you're looking for a general overview of the site, visit this page. As outlined in the HemOnc.org philosophy, it is important for the overall user experience to adhere to a consistent format for pages and entries because it makes it easier for people to find information. It also contributes to safety by communicating information about treatment regimens in a standard and unambiguous way. It's understood that, due to the ever-evolving nature of this website, some pages will have older formatting, but it is expected that existing pages will gradually be transitioned to the standard format, and all pages moving forward will be created following these guidelines.

HemOnc.org is collaborative, and suggestions for revisions to the style guide are welcome. The style guide will always be a work in progress.

Introduction

If you've found this page, chances are you're considering making edits to HemOnc.org. Thank you in advance! The goal of this page is to provide guidance on a uniform style across the site. As with many knowledge base endeavors, HemOnc.org has grown organically and the style has evolved over time. In fact, parts of this style guide are/will be outdated, although we do our best to keep the recommendations here concordant with our current best practice. Future work will include adding more templates here, to make it easier to create your own content on the site.

If you're looking for templates for treatment regimens, click this link.

General conventions

The formatting guidance in this section applies to all pages on HemOnc.org. The information below is pertinent to specific types of pages.

Dates

All dates on HemOnc.org should be expressed in ISO 8601 format, as follows:

Year only: YYYY (example: 2023)
Year and month: YYYY-MM (example: 2023-01)
Year, month, and day: YYYY-MM-DD (example: 2023-01-01)

Drug index

Alphabetical list of medications

The primary organization of this page is alphabetical, by (preferred) generic name. There is a separate heading for each letter A-Z for which there is at least one medication.

Examples

Acyclovir (Zovirax)
Afatinib (BIBW 2992) in clinical trials

Standard format for this page is as follows:

*[[Generic name (Brand name)]] '''FDA approved YYYY-MM-DD''' or '''in clinical trials''' (see notes)

Medications are listed alphabetically in the drug index by their generic name, with--preferentially--the most common brand name in parentheses, which is usually the predominant United States brand name. Medications which are not yet FDA approved should have a bold in clinical trials after it. Medications which do not yet have generic or brand names can have placeholder entries based on their pharmaceutical company code name, with updates based on generic names and brand names when they become available. So, for example, a preliminary entry may be:

*[[MDV3100]] '''in clinical trials'''

When a generic name is available, the entry on the drug index and the medication's information page--if it exists--will be updated:

*[[Enzalutamide (MDV3100)]] '''in clinical trials'''

The older "MDV3100" page should be redirected to "Enzalutamide (MDV3100)" via the Move function, which is in the downward pointing triangle menu to the right of "view history" at the top of the page. When the medication gets approved by the FDA, its drug index entry and name of the medication page should again be updated:

*[[Enzalutamide (Xtandi)]] '''FDA approved 2012-08-31'''

The FDA approved label remains in place for medications that have been FDA approved since the beginning of the prior year. Specifically, if the current year was 2018, all medications that have been FDA approved since 2017-01-01 will be labeled with the approval date. This choice was made rather than, say, within the last year, to facilitate these updates being made in batches rather than continuously year-round. The labels are also removed so as not to clutter up the page too much. For example, imatinib, which was FDA approved in 2001, simply appears as:

*[[Imatinib (Gleevec)]]

Drugs in preclinical or early phase clinical trials

Given that most early phase drugs will not ultimately be approved, one should exercise caution before adding these drugs to the drug index. The only drugs which are in development that should be added are the ones with promising clinical data already presented; for example, drugs featured in plenary sessions at ASCO or ASH and described in phase I or II trials published in high impact journals.

It is also difficult to tell if a drug has officially been dropped from further development, so updating drugs in clinical trials is difficult. If you are certain that a drug has been discontinued from development, you can remove it from the medication list and make a note on the medication page.

Drugs that have lost FDA approval

A prime example was Gemtuzumab ozogamicin (Mylotarg), which was withdrawn from the US market for approximately 7 years. These withdrawn drugs may remain on the drug index because the information could still be useful to someone looking at older literature and because they may still be investigated in other studies to evaluate them for new indications, leading to re-listing as was the case with gemtuzumab ozogamicin. These should be denoted:

*[[Lepirudin (Refludan)]] '''discontinued'''

List of medications by category

This section of the [drug index] page was created prior to the extensive use of Mediawiki semantic tags, and will eventually be removed. The same information can be found by starting at the top of the drugs category page.

Interesting and helpful links

This list is currently unordered and could use some refinement.

Medication pages

General information

This section should contain a brief description of the class/mechanism of the drug, either in your own words or borrowed (with attribution) from a public site such as Wikipedia or the NCI Drug Dictionary.

==General information==

Class/mechanism: Short description about the medication's class and mechanism of action, written in your own words. Try to use information contained within the package insert--if available--for this information.<ref name=insert>[http://www.manufacturer.com/link_to_package_insert.pdf Generic_name (Brand_name) package insert]</ref><ref>[[:File:Generic_name.pdf | Generic_name (Brand_name) package insert (locally hosted backup)]]</ref><ref>[http://www.brand_name.com/ Brand_name manufacturer's website]</ref>
<br>Route: IV, PO, SC, IM, IT, nasal, NG, GT, topical, transdermal, sublingual, intraocular, rectal, intravesicular, intralesional
<br>Extravasation: no information, none, n/a (e.g. for oral medications), [[vesicant]], and/or [[irritant]]

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the prescribing information.<ref name="insert"></ref>

Diseases for which it is used

This section should contain a list of all the diseases for which there is some demonstrated degree of efficacy for the particular medication, as monotherapy or in a regimen. This is 'not the same as FDA approved indications, which are only a minority of potential indications (see below).

==Diseases for which it is used==
*[[Bladder cancer]]
*[[Breast cancer]]
*[[Cervical cancer]]
*[[Esophageal cancer]]
*[[Gastric cancer]]
*[[Classical Hodgkin lymphoma]]
*[[Melanoma]]

Patient drug information

This section should contain links of direct relevance to patients, including package inserts and patient-specific drug information.

==Patient drug information==
*[http://www.manufacturer.com/link_to_package_insert.pdf#page=10 Generic_name (Brand_name) package insert PDF pages 10-12]<ref name="insert"></ref>
*Patient counseling information can be found on [http://www.manufacturer.com/link_to_package_insert.pdf#page=8 page 8 of the Generic_name (Brand_name) package insert]<ref name="insert"></ref>
*[https://chemocare.com/druginfo/generic_name.aspx Generic_name (Brand_name) patient drug information (Chemocare)]<ref>[https://chemocare.com/druginfo/generic_name.aspx Generic_name (Brand_name) patient drug information (Chemocare)]</ref>
*[http://www.uptodate.com/contents/generic_name-patient-drug-information Generic_name (Brand_name) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/generic_name-patient-drug-information Generic_name (Brand_name) patient drug information (UpToDate)]</ref>

History of changes in FDA indication

This section should quote FDA approvals verbatim, along with the date that they were issued. A link to the press announcement is optional, mostly because the FDA archives these links after several years so that they are no longer active. Optional but highly desired are page tags within the approval statement itself, as shown in the below example from the Trastuzumab (Herceptin) page. A useful site to get information about FDA approval histories is here.

==History of changes in FDA indication==
*1998-09-25: Initial FDA approval as a single agent for treatment of patients with metastatic [[Breast_cancer,_HER2-positive|breast cancer whose tumors overexpress the HER2 protein]] and who have received one or more chemotherapy regimens for their metastatic disease.
*2002-08-28: Label revised: trastuzumab in combination with [[Paclitaxel (Taxol) | paclitaxel]] is indicated for treatment of patients with metastatic [[Breast_cancer,_HER2-positive| breast cancer whose tumors overexpress the HER2 protein]] and who have not received chemotherapy for their metastatic disease.
*2006-11-16: Label revised: trastuzumab as part of a treatment regimen containing [[Doxorubicin (Adriamycin) | doxorubicin]], [[Cyclophosphamide (Cytoxan) | cyclophosphamide]], and [[Paclitaxel (Taxol) | paclitaxel]] is indicated for the adjuvant treatment of patients with [[Breast_cancer,_HER2-positive|HER2-overexpressing, node-positive breast cancer]].
*2008-01-18: Labeling simplified: indicated for the treatment of [[Breast_cancer,_HER2-positive|HER2 overexpressing breast cancer]].
*2010-10-20: Label expanded to include the treatment of HER2-overexpressing metastatic [[Gastric cancer | gastric]] or [[Esophageal cancer | gastroesophageal junction]] adenocarcinoma.

Synonyms

This section should be structured so that entries are under one of the following categories: code name(s); generic name(s); brand name(s). One source that can be used for this information is: https://www.mediguard.org/medication/facts-figures; sort and reformat the lists by copy and pasting the list to: http://sortmylist.com/

Example from the Pembrolizumab (Keytruda) page:

==Also known as==
*'''Code names:''' MK-3475, SCH 900475
*'''Generic names:''' lambrolizumab
*'''Brand name:''' Keytruda

References

This section header should live at the bottom of the page so that any references (e.g., package insert) can be found here.

==References==
<references/>

Treatment regimen pages

The general format of each treatment regimen page is as follows. See the treatment regimen formatting section for specific information about how to describe treatment regimens in a standard way.

Header

This section at the top of every page is fairly standardized and should not be altered; the following is an example from the NSCLC page:

<span id="BackToTop"></span>
<div class="noprint" style="background-color:LightGray; position:fixed; bottom:2%; right:0.25%; padding-left:5px; padding-right:5px; margin: 15px; opacity:0.8; border-style: solid; border-color:DarkGray; border-width: 1px">
[[#top|Back to Top]]
</div>
{{#lst:Editorial board transclusions|nsclc}}
''Are you looking for a regimen but can't find it here? It is possible that we've moved it to the [[Non-small cell lung cancer_-_historical|historical regimens page]] or to one of the histology-specific, biomarker-specific, or site-specific pages that are linked below. For placebo or observational studies in this condition, please visit [[Non-small cell lung cancer - null regimens|this page]]. If you still can't find it, please let us know so we can add it!''.
{| class="wikitable" style="float:right; margin-right: 5px;"
|-
|<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} [[Tutorial#Regimens|regimens]] on this page</b></font></div>
<div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div>
|}
{{TOC limit|limit=3}}

Guidelines

Most disease-specific pages now have guidelines, organized by the issuing professional society (or societies). With the exception of NCCN, which are presumed current as the link goes directly to the NCCN webpage, the year that the guideline was issued should be prominent (bolded). The year should be followed by the first author's last name, if one author. If there are two authors, each last name should be listed, separated by "&". If three or more authors, the first author's last name followed by et al. should be used. The title of the guideline should be in sentence case, and a link to the original article in the DOI format should be used, unless a PubMed Central version is available, in which case that is preferred. PubMed links should be provided whenever they are available. Try to avoid linking to guidelines directly on a society page, as these are subject to change and/or deletion with little notice.

Each guideline should be entered in a new line, with a single asterisk for the newest version of the guideline. If there are older versions of the guideline, these should be nested under the newest guideline in reverse chronological order, using double asterisks.

=Guidelines=
'''Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.'''
==[https://www.asco.org/ ASCO]==
*'''2022:''' Singh et al. [https://doi.org/10.1200/jco.22.00825 Therapy for Stage IV Non-Small-Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline]
**'''2017:''' Hanna et al. [https://doi.org/10.1200/JCO.2017.74.6065 Systemic therapy for stage IV non–small-cell lung cancer: American Society of Clinical Oncology clinical practice guideline update] [https://pubmed.ncbi.nlm.nih.gov/28806116/ PubMed]
*'''2022:''' Daly et al. [https://doi.org/10.1200/jco.21.02528 Management of Stage III Non-Small-Cell Lung Cancer: ASCO Guideline]
*'''2020:''' Schneider et al. [https://doi.org/10.1200/jco.19.02748 Lung Cancer Surveillance After Definitive Curative-Intent Therapy: ASCO Guideline]
==[https://www.nccn.org/ NCCN]==
*[https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf NCCN Guidelines - Non-Small Cell Lung Cancer]

Treatment context

Level 1 headings that contain treatment regimens should be delineated by treatment context, using the following conventions:

Neoadjuvant: treatment given before a definitive surgical procedure
Adjuvant: treatment given after a definitive surgical procedure
Induction: treatment given as part of a course with primary curative intent, whether or not subsequent treatment is surgical (e.g., induction chemotherapy prior to consolidation in AML; induction chemoradiotherapy prior to surgery or consolidation in bladder cancer)
Definitive: the primary treatment for curative intent; usually surgery but can also include definitive chemoradiotherapy as in for some stage III NSCLC
Consolidation: treatment given as part of a course for primary curative intent, usually after induction or definitive therapy.
Upfront: initial treatment given with curative intent (e.g., upfront induction, upfront consolidation, etc.)
Salvage: subsequent treatment given with curative intent (e.g., salvage induction)
First-line: initial treatment given with non-curative intent
Second-line: the next treatment given with non-curative intent after first-line treatment fails
Third-line: the next treatment given with non-curative intent after second-line treatment fails
Subsequent line: any line of treatment given with non-curative intent after first-line treatment fails
All lines: any line of treatment; more granular descriptions are preferred most of the time

Headings

If you have any questions about the difference between a level 1, level 2, etc. heading, please go back to the general editing tutorial. On treatment pages, headings have very specific meanings, primarily so that we can successfully parse the content into the HemOnc ontology. Here is a general schema of a treatment page:

=Treatment context #1=
==Regimen #1==
		===Variant and/or protocol indicator===
			====Treatment details organized by modality====
		===References===
==Regimen #2==
		===Variant and/or protocol indicator===
			====Treatment details organized by modality====
		===References===
	==Regimen…==
=Treatment context #2=
	==Regimen…==
=Treatment context…=

Level 1 headings

On disease pages, level 1 headings that include treatments should be used to describe a context of therapy. There can be some variability here, which gets normalized by the parser (e.g., adjuvant chemotherapy and adjuvant endocrine therapy will both get normalized to adjuvant therapy). Other level 1 headings are allowed but they need to contain at least one forbidden word so that the parser will ignore them:

measuring, quality, links, tests, guidelines, response, statistics, prognosis, investigational, resources, information, references

Level 2 headings

If these are nested under a level 1 treatment heading, they should only be used for the regimen or protocol name, following the regimen naming conventions as much as possible. See the section below for more details on regimen names. Optionally, any additional description can be added within [brackets] at the end of the regimen name; this description will be ignored by the parser.

Level 3 headings

These are used to convey a specific instruction to the parser – whether the regimen to be extracted is stand-alone, whether it represents a variant, and/or whether it is a part of a multi-part protocol. Stand-alone regimens typically only have one “cycle SIG”. These can have distinct sections, such as sequenced adjuvant chemotherapy for breast cancer. Conversely, protocols usually have multiple “cycle SIGs” and can either be entirely contained within one level 2 heading/context, or spread across multiple level 2 headings/contexts and linked together using the “preceding treatment” and “subsequent treatment” level 4 section headers. Variants are considered to be of the same parent regimen and are numbered sequentially, ideally with a descriptor that is separated using a comma:

===Regimen variant #1, <optional descriptor>===

For protocols that are split across multiple treatment contexts defined by the containing level 1 heading, the following syntax should be used:

===Protocol===
===Protocol variant #1, <optional descriptor>===

For protocols with more than one phase within a contextual level 1 heading (e.g., induction/consolidation/maintenance contained within an upfront therapy level 1 heading) the following case-sensitive reserved words may be used in lieu of the word “Protocol”:

Adjuvant
Consolidation
Continuation
Definitive
Delayed Intensification
Induction
Intensification
Interim Maintenance
Maintenance
Neoadjuvant
Pre-phase

As above, any additional descriptors must be comma separated.

Level 3 is also used to contain references, and the reference section should always be last, after all the treatment details, as shown in the diagram above.

Level 4 headings

These are used to indicate the modality of the components of a regimen or protocol, along with several other special categories.

Allowed names for level 4 headings

The following are the allowed names for the level 4 headings (as of October 2022):

“Clean” systemic anticancer modalities

Chemotherapy
Endocrine therapy
Glucocorticoid therapy
Immunotherapy
Targeted therapy
Tumor treating fields

“Messy” systemic anticancer modalities

Antibody-drug conjugate therapy
Immunotoxin therapy
Peptide-drug conjugate therapy
Radioconjugate therapy

Localized anticancer modalities

CNS prophylaxis/therapy/treatment
Intrathecal therapy (prefer to use CNS therapy, instead)
Local therapy
Radiotherapy
Surgery
Topical therapy

Other modalities

Antibiotic therapy
Anticoagulation
GVHD prophylaxis
Hemostasis therapy
Hormone replacement therapy
Immunosuppressive therapy
Supportive therapy

Eligibility criteria

Biomarker eligibility criteria
Eligibility criteria
Prior treatment criteria

Temporal linkers

Preceding treatment
Subsequent treatment

Other

Dose modifications
Stem cell collection

Level 4 heading modifiers

An optional comma-separated descriptor can be added to help a human reader and to guide the parser when building structured representations. If the descriptor is being used to break a regimen into portions, the word "portion" should be used, and the cycles for that portion can be placed within parentheses thereafter.

For example, the ddAC-T regimen:

====Chemotherapy, ddAC portion (cycles 1 to 4)====
====Supportive therapy, ddAC portion (cycles 1 to 4)====
====Chemotherapy, T portion (cycles 5 to 8)====

Sometimes, a complex regimen uses the word "part" to convey the same meaning that we intend with the word "portion"; because part is also used in other ways in the HemOnc temporal model, the preferred syntax should be still to use portion and to report the common name within quotations, for example Hyper-CVAD/MA:

====Chemotherapy, Hyper-CVAD portion (cycles 1, 3, 5, 7; "Part A")====
====Chemotherapy, MA portion (cycles 2, 4, 6, 8; "Part B")====

Regimen name and acronyms

We have developed guidelines for regimen naming conventions which can be accessed here. For acronyms, the expansion should be provided below the main header, as shown below. If an acronym has a brand name (e.g., O is commonly used for Oncovin) that brand name should be expanded and the common generic name should be provided in parentheses, for example: Oncovin (Vincristine). Other common variants of the acronyms can also be provided here, as shown below.

Regimens should be listed in alphabetical order within a disease context. Note that every regimen on a given page needs to have a different subobject number in order to be added up properly. Best practice is to use a randomly generated number for this subobject, although other logical schemas can also be used. Make sure to also include the "back to top" table so that users can easily navigate the page.

==R-ICE {{#subobject:123456 |Regimen=1}}==

R-ICE: '''<u>R</u>'''ituximab, '''<u>I</u>'''fosfamide, '''<u>C</u>'''arboplatin, '''<u>E</u>'''toposide
<br>ICE-R: '''<u>I</u>'''fosfamide, '''<u>C</u>'''arboplatin, '''<u>E</u>'''toposide, '''<u>R</u>'''ituximab

Example orders

If your regimen has example orders (or you would like to create them), the next item within the regimen should be a link to the example orders page:

===Example orders===
*[[Example orders for Regimen_name in Disease_type]]

Regimen variants

A variant is a regimen that is substantively similar to another regimen with minor differences e.g. in dosages, routes, or frequencies of administration. For example, we would consider R-CHOP that uses prednisone and R-CHOP that uses prednisolone as variants, not separate regimens. Conversely, R-CVP is considered a completely different regimen than R-CHOP, due to omission of one of the main chemotherapeutics (doxorubicin). There is no absolute rule for what order different variants of a regimen should be listed in within a regimen. One may choose to put the most commonly used version of the regimen at the top, order in reverse chronology, order by increasing dose(s), or just add new ones as successive regimen numbers in the sequence. Similar to what is used for regimens above, every variant of a regimen needs to have a different subobject number in order to be added up properly. These have to be distinct; i.e., if you use "1" for variant 1 of regimen A and of regimen B, it will only be counted one time on that page. Ideally, besides numbering the variants, also provide a very succinct description about what makes this variant different than the others under the same regimen heading.

===Regimen variant #1, 28-day cycles {{#subobject:1 |Variant=1}}===
[Insert manuscript and efficacy table here]
''Comment about variant, if needed.''
====Chemotherapy====
*[[Generic name (Brand name)]] 10 mg PO once per day on days 1 to 21

'''28-day cycles'''

===Regimen variant #2, 21-day cycles {{#subobject:2 |Variant=1}}===
[Insert manuscript and efficacy table here]
''Comment about variant, if needed.''
====Chemotherapy====
*[[Generic name (Brand name)]] 10 mg IV over 60 minutes once on day 1

'''21-day cycles'''

Treatment regimen formatting

Instructions

The following sections get into the nitty-gritty of regimen formatting. If you would like, you can skip straight to the examples.

Treatment (SIG) formatting

The standard format for describing a treatment prescription is:

*[[Generic name (Brand name)]] (dose) (units) (route[s]) (time of infusion) (frequency and/or number of times given) (schedule) (order of administration) (special comments)
**Special instructions, such when patients over a certain age receive a reduced dose, or for other needed comments about the use of this specific medication in this regimen.

If there are clear instructions for different doses/routes/schedules based on time units other than a day (typically these are expressed by cycles or sometimes weeks) use this standard format:

*[[Generic name (Brand name)]] as follows:
**Time interval/cycle A: (dose) (units) (special comments) (route[s]) (time of infusion) (frequency and/or number of times given) (schedule) (order of administration) (special comments)
**Time interval/cycle B: (dose) (units) (special comments) (route[s]) (time of infusion) (frequency and/or number of times given) (schedule) (order of administration) (special comments)

If there are clear instructions for different doses/routes/schedules for a single drug on the same day use this standard format:

*[[Generic name (Brand name)]] by the following split schedule:
**Dose instruction 1: (dose) (units) (special comments) (route[s]) (time of infusion) (frequency and/or number of times given) (schedule) (order of administration) (special comments)
**Dose instruction 2: (dose) (units) (special comments) (route[s]) (time of infusion) (frequency and/or number of times given) (schedule) (order of administration) (special comments)

If there are clear instructions for different doses/routes/schedules based on some criteria other than time (e.g., age, response, creatine clearance, etc.), use this standard format:

*[[Generic name (Brand name)]] by the following (age/laboratory/study/etc-specific) criteria:
**Criterion A: (dose) (units) (special comments) (route[s]) (time of infusion) (frequency and/or number of times given) (schedule) (order of administration) (special comments)
**Criterion B: (dose) (units) (special comments) (route[s]) (time of infusion) (frequency and/or number of times given) (schedule) (order of administration) (special comments)

Drug name

Best practice is to make sure that this links to an existing HemOnc.org page, in which case it will appear blue in the default MediaWiki view. If the linked page does not exit, it will appear red.

Dose

Don't use commas for any value less than 10,000.
If the dose is a fraction of an integer, list up to two digits beyond the decimal point; otherwise do not use a decimal point (e.g., "100" not "100.0")
If the dose in a manuscript is expressed in grams, convert to milligrams (e.g., "2000" not "2")
If the dose is given as a range, separate the bounds with the word "to" (e.g., "500 to 600")

Units

Avoid confusing abbreviations (e.g., IU should be spelled out as "international units")
For micrograms, use the abbreviation "mcg"
For BSA-based dosing, use the superscript i.e.,
```
mg/m<sup>2</sup>
```
For AUC-based dosing, make clear which formula is used

Route

Use the following standard abbreviations:
- Intramuscular: IM
- Intravenous: IV
- Oral: PO
- Subcutaneous: SC
If the regimen provides more than one route as an option, do not use a "/" to separate the routes (e.g., do not use "PO/IV"). Instead, use the word "or" to separate the alphabetically-ordered routes (e.g., IV or PO)

Time of infusion

For infusions of up to 1.5 hours in length, convert the time into minutes (e.g., "over 90 minutes")
For infusions of 2 hours or longer, use hours (e.g., "over 4 hours")
For infusions with a range, use the format A to B (e.g., "over 5 to 10 minutes"; "over 60 minutes to 3 hours")

Continuous infusions

For continuous infusions, use the words "continuous infusion" not the abbreviation CI
For continuous infusions of exactly 24 hours or a unit of time that is not a multiple of days (e.g., 46 hours), report the dosage directly, e.g., 2400 mg/m²
For continuous infusions that are multiples of days (e.g., 96 hours), report the dosage per day, e.g., 1000 mg/m²/day
For continuous infusions other than those exactly 24 hours long, specify the total dose per cycle at the end of the line, in parentheses e.g., "(total dose per cycle: 200 mg/m²)"
For continuous infusions that are reasonably anticipated to cross a midnight (i.e., most of them), use the format "YY dose mg/m²/day, started on day XX", instead of the format "YY dose mg/m²/day on day XX"

Frequency and/or number of times given

If the drug is only given once, use the word "once"
If the drug is given on more than one day of a cycle but only once on any given day, use the phrase "once per day"
If the drug is given more than once per day, try to avoid abbreviations as they may not translate to other languages correctly. Some acceptable frequencies to use are:
- twice per day (not BID)
- three times per day (not TID)
- four times per day (not QID)
- every 3 hours, every 4 hours, etc. (not q3h, q4h, etc.)
Do not use abbreviations or numbers which are on the Joint Commission (TJC), previously known as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)'s "Do not use" list: U, u (unit); IU (international units); Q.D., QD, q.d., qd (daily); Q.O.D., QOD, q.o.d., qod (every other day); MS, MSO4, MgSO4 (morphine sulfate or magnesium sulfate); trailing zeroes (X.0 mg); or omitted leading zeroes (.X mg). Also, based on suggestions in Making Health Care Safer II, please do not use any abbreviations involving frequencies during a week--e.g. use "3 times a week" instead of TIW--and do not use cc as an abbreviation for mL.

Schedule

If the drug is only given once per cycle, use the phrase "on day X"
If the drug is given twice per cycle on two distinct days, use the phrase "on days X & Y"
If the drug is given more than twice per cycle on more than two distinct days, report the days as follows:
- Contiguous days: "on days X to Y" (e.g., "on days 1 to 4")
  - Do not use a dash to separate days (e.g., do not use "on days 1-4") as this can be confused for intermittent administration
- Discontinuous days: "on days X, Y, Z" (e.g., "on days 1, 8, 15")
- Mix of contiguous and discontinuous days: "on days A to B, X to Y" (e.g., "on days 1 to 4, 9 to 12, 15, 16")
If the drug is continuously given throughout the cycle, either specify the days (e.g., "once per day on days 1 to 28") or it can be left implied by leaving out the days ("once per day")
For a drug with an predefined event-driven endpoint, make this clear in the prose (e.g., "starting on day 6 and continuing until ANC greater than 5000/μL past nadir")

Order of administration

This is not often reported in manuscripts but is considered very important, when it is mentioned.

Denote a sequence instruction using bold (e.g., given first)
For regimens with two or more drugs, use given first, given second, given third, and so forth. Do not use given last as this does not allow for automated calculation of final ordering if there are more than two drugs.
If there is a specified time separation, mention in both sequences (e.g., given first; 30 minutes prior to drug Y and given second, 30 minutes after drug X)

Special comments

There are two places where special comments can go inline with the prescription: after units or at the end of the line.

After units, add information about capped dose, if applicable (e.g., "1.4 mg/m² (maximum dose of 2 mg)")
In order to further reduce ambiguity, when thought to be beneficial, contributors may optionally add the total number of doses at the end of the instruction, e.g.:
- once on day 1 (1 dose per cycle)
- once per day on days 1 to 3 (3 doses per cycle)
- once per day on days 1 & 8 (2 doses per cycle)
- once per day on days 1, 8, 15 (3 doses per cycle)
- twice per day on days 1 to 14 (28 doses per cycle)

Branching instructions

A non-trivial number of regimens have complex timing instructions for one or more components, or certain criteria that specify alternate dosing instructions. We refer to these generically as branches and the following section includes guidance on how to format branching instructions in a standardized way.

Time-based branching

This is the most common branch type and comes in two main flavors: 1) one component of a multi-component regimen is given for a limited period of time, whereas the other components might be given for a longer period or indefinitely; 2) a component has a different SIG for different cycles in the regimen; e.g., many multiple myeloma regimens reduce the corticosteroid intensity after a certain number of cycles have been given. Time-based branching is denoted with the special phrase "as follows:". If a time-based branch instruction is not present, it is assumed that the component is given in the same manner for each cycle of treatment. Here is example markup for each of these two most common types:

====Chemotherapy====
*[[Carboplatin (Paraplatin)]] as follows:
**Cycles 1 to 4: AUC 6 IV once on day 1
*[[Paclitaxel, nanoparticle albumin-bound (Abraxane)]] as follows:
**Cycles 1 to 4: 100 mg/m<sup>2</sup> IV once per day on days 1, 8, 15
====Immunotherapy====
*[[Durvalumab (Imfinzi)]] 1500 mg IV over 60 minutes once on day 1
'''21-day cycle for 4 cycles, then 28-day cycles'''

*[[Dexamethasone (Decadron)]] as follows:
**Cycles 1 to 13: 20 mg (route not specified) once per day on days 1 to 4, 8 to 11
**Cycles 14 to 39: 20 mg (route not specified) once per day on days 1, 8, 15, 22

Age-based branching

This is also a fairly common type of branching logic seen in regimens. With few exceptions, age-based branches are specified as one-sided bounds or two-sided intervals. In both cases the bounds may be "exclusive" (i.e., mathematically expressed by the greater than or less than operators) or "inclusive" (i.e., mathematically expressed by the greater than or equal or less than or equal operators). Age-based branches should be preceded by the following standard phrase: "by the following age-based criteria:". Age itself should be expressed in the format "(days/weeks/months/years) old". Formatting should be as follows:

Type	Format	Example
Exclusive upper bound	Younger than X (days/weeks/months/years) old:	Younger than 60 years old:
Exclusive lower bound	Older than X (days/weeks/months/years) old:	Older than 60 years old:
Inclusive upper bound	X (days/weeks/months/years) old or younger:	60 years old or younger:
Inclusive lower bound	X (days/weeks/months/years) old or older:	60 years old or older:
Inclusive interval	X to Y (days/weeks/months/years)¹ old:	50 to 60 years old: 1 to 1.99^a years old:
Intervals where the upper bound is exclusive	X up to Y (days/weeks/months/years)¹ old:	12 up to 18 months old:

¹If the original reference uses different units of measure for the lower and upper bounds of the interval, convert these such that they are in the same unit of measure, to reduce confusion.
^aIn the pediatric literature, it is not uncommon to encounter intervals with fractional upper bounds such as this one. This can create confusion since the fractions will sometimes introduce gaps (e.g., a child aged 1 year 363 days is 1.994 years old). For now we will faithfully adhere to the reported intervals but may attempt to standardize these further in the future.

Other nominal branching

Besides age, there are several other types of branching instructions that are based on numeric quantities. The same general rules for bounds and intervals as described above apply. However, for these branches, we use a more generic language of "more" and "less" rather than the younger/older used in age. Currently (as of September 2023), the nominal branch types encountered across HemOnc.org are:

BMI-based
BSA-based (these should be standardized to m²)
Laboratory-based
Renal function-based
Weight-based (these should be standardized to kg)

Formatting should be as follows, using weight-based examples:

Type	Format	Example
Exclusive upper bound	Less than X (units of measure):	Less than 12 kg:
Exclusive lower bound	More than X (units of measure):	More than 12 kg:
Inclusive upper bound	X (units of measure) or less:	12 kg or less:
Inclusive lower bound	X (units of measure) or more:	12 kg or more:
Inclusive interval	X to Y (units of measure):	6 to 12 kg:
Intervals where the upper bound is exclusive	X up to Y (units of measure):	6 up to 12 kg:

Complex branching

Some branches have compound criteria, such as both age-based and weight-based criteria. If these criteria can be named, they should be listed in alphabetic order (e.g., "by the following age- and weight-based criteria:", not "by the following weight- and age-based criteria:"). If they are too complex to enumerate, then the branching statement should say "by the following complex criteria:".

In the branching instructions themselves, complex criteria are usually expressed using logical statements of the AND, OR, and NOT types. When recording these instructions, please capitalize the logical separators, as this immensely aids the parsing process that takes place to transform HemOnc.org into the HemOnc knowledge base.

Order of medications within a regimen

List medications within the regimen in the same order as they are found in the title of the regimen. So, for example, if the regimen is an acronym, the medications should be listed in the same order as they are used in the acronym - even if this does not correspond to the order of administration. All regimens have a required antineoplastic section, and can have several optional sections. The antineoplastic section should have a heading which describes the general class to which the regimen belongs (e.g., chemotherapy, immunotherapy, chemoradiotherapy).

Optional: preceding and subsequent treatments

See below for a discussion of this.

Optional: supportive medications

Only list what is specifically described by the cited paper(s). Details about hydration also can go in this section. Both prn and "as needed for" may be used to describe medications taken on an as needed basis. It is encouraged to also list whether the paper specifically mentioned agents which were not used, such as:
- No routine antibiotic or antiviral prophylaxis was given
- Growth factor support was NOT allowed
If the reference gives more than one choice from a category, use the following syntax:

*ONE of the following xyz medications:
**[[Option 1]]
**[[Option 2]]

If the reference only refers to categories of medications, such as "5-HT3 antagonists," that is all that can be written; we cannot say, for example, Ondansetron (Zofran). Instead, provide a link to the relevant category, using this format (make note of the colon before and after the "Category":

*[[:Category:5-HT3 antagonists|5-HT3 antagonists]]

If there is more than one antineoplastic drug, and a supportive medication is clearly intended for use in context of one of those drugs, explicitly link the two together using the generic drug name. Example:

====Supportive therapy====
*[[Acetaminophen (Tylenol)]] 650 mg PO once as premedication for rituximab

If a supportive medication is admixed with an antineoplastic, denote this with the generic drug name. Example:

====Supportive therapy====
*[[Mesna (Mesnex)]] 5000 mg/m<sup>2</sup> IV continuous infusion over 24 hours on day 4, mixed together with ifosfamide

If more than one manuscript describes a regimen, but one of them describes the supportive medications more completely, make note of this. Example:

====Supportive therapy====
*(as described by Kewalramani et al. 2004):

Optional: CNS therapy

If described, the drug(s) used for CNS prophylaxis and/or treatment should be under a separate heading.

Duration of cycle

This line should come after the required antineoplastic drug(s) and the optional supportive and/or CNS drugs, and should always be bolded.
For cycles lasting 6 weeks or less, report the numeric duration in days, with a dash between the number and "day" (e.g., 21-day cycle; 42-day cycle).
- Exception: for cycles that are specified as monthly, use 1-month cycle since months have different numbers of days.
For cycles lasting more than 6 weeks, report the numeric duration in weeks (e.g., 12-week cycle)
- Exception: the primary reference specifies the cycle in days which are not easily transformed to weeks, e.g., 90-day cycles or 3-month cycles
- If the total duration of a regimen is very long, as with some maintenance regimens, give the actual number of cycles as well as the total duration in parentheses: 14-day cycle for 26 cycles (1 year) and 21-day cycle for 35 cycles (2 years)
If a range is given for the cycle length in the reference, use this format: 14- to 21-day cycles
When the total number of cycles is singular, use "for X cycles", e.g., 14-day cycle for 4 cycles
When the total number of cycles has an upper bound, use "for up to X cycles", e.g., 28-day cycle for up to 4 cycles
When the total number of cycles has a lower bound, use "X or more cycles", e.g., 28-day cycle for 4 or more cycles
When the total number of cycles is a range, use "for X to Y cycles", e.g., 21-day cycle for 6 to 8 cycles
When there is additional information regarding the total number of cycles, use "(see note)" and explain in prose just below the reference table for the regimen or variant.
For regimens with no definite stopping point, report merely the cycle length, e.g., 28-day cycles. This is generally understood to be equivalent to "28-day cycles until progression, unacceptable side effects, or patient preference to discontinue."
Although there are various terms used to describe a cycle of treatment (e.g. round is often used in the literature) we encourage the consistent use of the word cycle for regimens with two or more planned repetitions
If there is only one course of treatment, as in a course of chemoradiotherapy or of induction, use the word course

Linking parts of protocols

Often, a protocol will be divided into parts, each of which could be considered an independent regimen, e.g., upfront treatment followed by consolidation followed by maintenance. Or, some regimens are response-adopted, e.g., R-MegaCHOP with intensification treatment based on early FDG-PET in patients with high-risk diffuse large B-cell lymphoma. In these cases, even if a regimen is detailed in a single reference, we encourage breaking the regimen up across the appropriate contexts. Links should not be left implicit but rather should be detailed as follows:

Preceding treatments

If anything comes before the regimen (optional or required), the following format should be used:

Only one preceding treatment option

====Preceding treatment====
* [[Regimen A]]

More than one preceding treatment option, as part of a single non-randomized protocol

====Preceding treatment====
* [[Regimen A]] or [[Regimen B]] or [[Regimen C]]

More than one preceding treatment option, as part of a single randomized protocol

====Preceding treatment====
* [[Regimen A]] versus [[Regimen B]] versus [[Regimen C]]

More than one preceding treatment option, from more than one protocol

====Preceding treatment====
* Protocol 1 & Protocol 2: [[Regimen A]]
* Protocol 3: [[Regimen B]]
* Protocol 4: [[Regimen A]] versus [[Regimen B]]
* Protocol 5: [[Regimen A]] or [[Regimen B]]

Subsequent treatments

As opposed to preceding treatments, subsequent treatments are often conditional, i.e., they require the patient meeting some predefined parameters, such as achieving a certain level of response to the treatment regimen. When these conditional statements are complex, they should be written in narrative style with lengthy explanation as needed. When they are relatively simple (e.g., AC, then T in adjuvant breast cancer), then the links can be in a structured style analogous to the preceding treatment examples above, using "subsequent" in place of preceding.

Templates

These templates are meant to be "plug and play" for the tables that are displayed under a regimen - copy them into a page, fill out the blanks, and you should have a new regimen table ready to go.

Non-randomized trials without efficacy

Note: the trial type is defaulted to "Phase 2".

{| class="wikitable" style="width: 40%; text-align:center;" 
!style="width: 25%"|Study
!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
|-
|[https://www.nameofjournal.org/xxx yyyy et al. 20zz]
|style="background-color:#91cf61"|Phase 2
|-
|}

What it looks like:

Study	Evidence
yyyy et al. 20zz	Phase 2

Non-randomized trials with efficacy

Note: the trial type is defaulted to "Phase 2".

{| class="wikitable" style="width: 60%; text-align:center;" 
!style="width: 33%"|Study
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
|-
|[https://www.nameofjournal.org/xxx yyyy et al. 20zz]
|style="background-color:#91cf61"|Phase 2
|
|-
|}

What it looks like:

Study	Evidence	Efficacy
yyyy et al. 20zz	Phase 2

Randomized trials without toxicity

Note: the trial type is defaulted to "Phase 3" and the comparative efficacy is defaulted to "seems not superior".

{| class="wikitable sortable" style="width: 100%; text-align:center;" 
!style="width: 25%"|Study
!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
!style="width: 25%"|Comparator
!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
|-
|[https://www.nameofjournal.org/xxx yyyy et al. 20zz]
|style="background-color:#1a9851"|Phase 3
|[[#other_regimen|Display name of other regimen]]
|style="background-color:#ffffbf"|Seems not superior
|-
|}

What it looks like:

Study	Evidence	Comparator	Comparative Efficacy
yyyy et al. 20zz	Phase 3	Display name of other regimen	Seems not superior

Randomized trials with toxicity

Note: the trial type is defaulted to "Phase 3" and the comparative efficacy and toxicity are defaulted to "seems not superior".

{| class="wikitable sortable" style="width: 100%; text-align:center;" 
!style="width: 20%"|Study
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
!style="width: 20%"|Comparator
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
!style="width: 20%"|[[Levels_of_Evidence#Toxicity|Comparative Toxicity]]
|-
|[https://www.nameofjournal.org/xxx yyyy et al. 20zz]
|style="background-color:#1a9851"|Phase 3
|[[#other_regimen|Display name of other regimen]]
|style="background-color:#ffffbf"|Seems not superior
|style="background-color:#ffffbf"|Seems not superior
|-
|}

What it looks like:

Study	Evidence	Comparator	Comparative Efficacy	Comparative Toxicity
yyyy et al. 20zz	Phase 3	Display name of other regimen	Seems not superior	Seems not superior

Regimen examples

For simplicity, the references are omitted from these examples. Wiki markup is shown followed by what the rendered wiki markup should look like; note that the rendered version is not quite the same as the markup, as headings have been replaced with bolded lines so as not to create havoc on the table of contents above.

Regimen example #1, single drug

Cladribine monotherapy in mantle cell lymphoma

==Cladribine monotherapy {{#subobject:f729d6|Regimen=1}}==
<div class="toccolours" style="background-color:#eeeeee">
===Regimen {{#subobject:986eae|Variant=1}}===
{| class="wikitable sortable" style="width: 60%; text-align:center;" 
!style="width: 33%"|Study
!style="width: 33%"|Dates of enrollment
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
|-
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3465670/ Inwards et al. 2008 (NCCTG 95-80-53)]
|2003-2005
|style="background-color:#91cf61"|Phase 2
|-
|}
<div class="toccolours" style="background-color:#b3e2cd">
====Chemotherapy====
*[[Cladribine (Leustatin)]] 5 mg/m<sup>2</sup> IV over 2 hours once per day on days 1 to 5 
'''28-day cycle for up to 6 cycles'''
</div></div>
===References===

Rendered version:
Cladribine monotherapy

Regimen

Study	Dates of enrollment	Evidence
Inwards et al. 2008 (NCCTG 95-80-53)	2003-2005	Phase 2

Chemotherapy

Cladribine (Leustatin) 5 mg/m² IV over 2 hours once per day on days 1 to 5

28-day cycle for up to 6 cycles

References

Regimen example #2, single drug with many references

Lenalidomide monotherapy in mantle cell lymphoma

==Lenalidomide monotherapy {{#subobject:b5de78|Regimen=1}}==


===Regimen {{#subobject:2d2b4a|Variant=1}}===
{| class="wikitable sortable" style="width: 100%; text-align:center;" 
!style="width: 25%"|Study
!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
!style="width: 25%"|Comparator
!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
|-
|[https://doi.org/10.1111/j.1365-2141.2009.07626.x Habermann et al. 2009]
|style="background-color:#ffffbe"|Phase 2, fewer than 20 pts in subgroup
|style="background-color:#d3d3d3"|
|style="background-color:#d3d3d3"|
|-
|[http://annonc.oxfordjournals.org/content/22/7/1622.long Witzig et al. 2011 (NHL-003)]
|style="background-color:#91cf61"|Phase 2
|style="background-color:#d3d3d3"|
|style="background-color:#d3d3d3"|
|-
|[https://doi.org/10.1111/bjh.12008 Eve et al. 2012]
|style="background-color:#91cf61"|Phase 2
|style="background-color:#d3d3d3"|
|style="background-color:#d3d3d3"|
|-
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4879693/ Goy et al. 2013 (MCL-001, EMERGE)]
|style="background-color:#91cf61"|Phase 2
|style="background-color:#d3d3d3"|
|style="background-color:#d3d3d3"|
|-
|[https://doi.org/10.1016/S1470-2045(15)00559-8 Trněný et al. 2016 (MCL-002, SPRINT)]
|style="background-color:#1a9851"|Randomized Phase 2
|Investigator's choice
|style="background-color:#1a9850"|Superior PFS
|-
|}

''Participants in '''EMERGE''' "were required to have had prior treatment with rituximab, cyclophosphamide and anthracycline (or mitoxantrone), and to have relapsed or progressed (less than 12 months) after or were refractory to bortezomib." Investigator's choice in the '''SPRINT''' trial was restricted to single-agent therapy with cytarabine, rituximab, gemcitabine, fludarabine, or chlorambucil.''
====Chemotherapy====
*[[Lenalidomide (Revlimid)]] 25 mg PO once per day on days 1 to 21

'''28-day cycles'''

''Patients in Eve et al. 2012 proceeded to receive [[#Lenalidomide_monotherapy_2|lenalidomide]] maintenance after 6 cycles.''

===References===

Rendered version:

Regimen example #3, two drugs with sequencing

Carboplatin & Gemcitabine for ovarian cancer

==Carboplatin & Gemcitabine (GCb) {{#subobject:65ad86|Regimen=1}}==

===Regimen {{#subobject:dd8477|Variant=1}}===
{| class="wikitable sortable" style="width: 100%; text-align:center;" 
!style="width: 25%"|Study
!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
!style="width: 25%"|Comparator
!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
|-
|[https://doi.org/10.1016/j.ygyno.2011.08.018 Gordon et al. 2011]
|style="background-color:#1a9851"|Phase 3
|[[Ovarian_cancer#Carboplatin_.26_Paclitaxel_.28CP.29|Carboplatin & Paclitaxel]]
|style="background-color:#ffffbf"|Seems not superior
|-
|}
====Chemotherapy====
*[[Carboplatin (Paraplatin)]] AUC 5 IV over 30 minutes once on day 1, '''given second'''
*[[Gemcitabine (Gemzar)]] 1000 mg/m<sup>2</sup> IV over 30 minutes once per day on days 1 & 8, '''given first'''

'''21-day cycle for up to 6 cycles'''

''Patients with complete response could optionally proceed to receive [[Ovarian_cancer#Paclitaxel_monotherapy|paclitaxel]] consolidation.''

===References===

Rendered version:

Regimen example #4, supportive medications with optionality and explicit linking

Carboplatin & Docetaxel for ovarian cancer

==Carboplatin & Docetaxel {{#subobject:1113e0|Regimen=1}}==

===Regimen {{#subobject:e5c1b0|Variant=1}}===
{| class="wikitable sortable" style="width: 100%; text-align:center;" 
!style="width: 25%"|Study
!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
!style="width: 25%"|Comparator
!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
|-
|[http://jnci.oxfordjournals.org/content/96/22/1682.long Vasey et al. 2004]
|style="background-color:#1a9851"|Phase 3
|[[Ovarian_cancer#Carboplatin_.26_Paclitaxel_.28CP.29|Carboplatin & Paclitaxel]]
|style="background-color:#ffffbf"|Seems not superior
|-
|}
====Chemotherapy====
*[[Carboplatin (Paraplatin)]] AUC 5 IV over 60 minutes once on day 1, '''given second'''
*[[Docetaxel (Taxotere)]] 75 mg/m<sup>2</sup> IV over 60 minutes once on day 1, '''given first'''

====Supportive therapy====
*[[Dexamethasone (Decadron)]] 8 mg PO twice per day the day before, the day of, and day after docetaxel
*ONE of the following 5-HT3 antagonists:
**[[Ondansetron (Zofran)]] 8 mg
**[[Granisetron]] 3 mg

'''21-day cycle for 6 cycles'''

===References===

Rendered version:

Regimen example #5, preceding and subsequent regimens

Adjuvant AC in breast cancer (variant 2)
Note: in this particular regimen, the preceding "regimen" is surgery and is not further specified. The subsequent regimens are all for HER2-positive breast cancer and are as such on a separate page from this regimen (AC), which is generically for any type of breast cancer. Note also that there is a mix of randomization ("versus") and non-randomized choices ("or") in the subsequent treatment options.

===Regimen variant #2, with range {{#subobject:67eda7|Variant=1}}===
{| class="wikitable" style="width: 40%; text-align:center;" 
!style="width: 25%"|Study
!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
|-
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5538020/ von Minckwitz et al. 2017 (APHINITY)]
|style="background-color:#91cf61"|Non-randomized part of RCT
|-
|}
''Patients in '''APHINITY''' had HER2-positive breast cancer. Note that ranges for AC are given in the protocol, replicated here.''
====Preceding treatment====
*[[Surgery]]
====Chemotherapy====
*[[Doxorubicin (Adriamycin)]] 60 mg/m<sup>2</sup> IV once on day 1 
*[[Cyclophosphamide (Cytoxan)]] 500 to 600 mg/m<sup>2</sup> IV once on day 1

'''21-day cycle for 4 cycles'''
====Subsequent treatment====
*[[Breast_cancer,_HER2-positive#Paclitaxel_.26_Trastuzumab_.28TH.29_2|TH (Paclitaxel)]] versus [[Breast_cancer,_HER2-positive#THP_.28Paclitaxel.29_2|THP (Paclitaxel)]] or [[Breast_cancer,_HER2-positive#Docetaxel_.26_Trastuzumab_.28TH.29_2|TH (Docetaxel)]] versus [[Breast_cancer,_HER2-positive#THP_.28Docetaxel.29_2|THP (Docetaxel)]]

Rendered version:

References

For each regimen, references should be listed in chronologic order, with the oldest references at the top, and the newest references at the bottom. References have a standard format, as explained below, following this example:

#'''CHAARTED:''' Sweeney CJ, Chen YH, Carducci M, Liu G, Jarrard DF, Eisenberger M, Wong YN, Hahn N, Kohli M, Cooney MM, Dreicer R, Vogelzang NJ, Picus J, Shevrin D, Hussain M, Garcia JA, DiPaola RS. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer. N Engl J Med. 2015 Aug 20;373(8):737-46. Epub 2015 Aug 5. [https://doi.org/10.1056/NEJMoa1503747 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4562797/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/26244877/ PubMed] [https://clinicaltrials.gov/study/NCT00309985 NCT00309985]
##'''Update:''' Kyriakopoulos CE, Chen YH, Carducci MA, Liu G, Jarrard DF, Hahn NM, Shevrin DH, Dreicer R, Hussain M, Eisenberger M, Kohli M, Plimack ER, Vogelzang NJ, Picus J, Cooney MM, Garcia JA, DiPaola RS, Sweeney CJ. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer: long-term survival analysis of the randomized phase III E3805 CHAARTED trial. J Clin Oncol. 2018 Apr 10;36(11):1080-1087. Epub 2018 Jan 31. [https://doi.org/10.1200/JCO.2017.75.3657 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5891129/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/29384722/ PubMed]

Primary references

Numbering

Each primary reference should start with a "#" sign in Wiki markup, which will automatically convert to the appropriate number.

Header

In order to increase the findability of references, we generally try to tag them with the bolded study name, CHAARTED in the example. We use special labels for several article types:

Retrospective: self-explanatory
Review: self-explanatory
Abstract: these are references that are only available in the gray literature, e.g., conference abstracts.

Author list

This should be the full author list (no et al.) in the format Last Name First Initial (Middle Initial). This is the format that PubMed provides when using the "Cite" button.

Study group

If provided in PubMed, the study group should be listed after the authors, separated by a semicolon.

Article title

This is easiest copied directly from PubMed. If time allows, we try to use sentence case. Some journals capitalize every word in the title, and this has to be undone manually.

Journal title

Use the standard abbreviations provided by PubMed.

Publication date and pages

Use the format directly from PubMed, including the Epub date if it is provided. The main publication and Epub date are often separated by a doi:xyz in the PubMed citation; this portion should be removed as it is visually distracting.

Link to original article

This should be the DOI: link as provided on PubMed. To get the link, right click (PC) or CTRL+click (Mac) on the hyperlink just to the right of the PMID:, below the author list. Choose "Copy Link" and then paste the link into the reference. The reason to use the DOI: link is that journals often change publishers and do not always leave behind redirects. This is a work in progress for HemOnc.org - as you'll see in the example above, the NEJM article has a direct link to the NEJM website, whereas the JCO article uses the DOI link. For abstracts, links often break from year-to-year as the conference websites refresh/update - something to be aware of but there is no easy fix.

Link to PMC article

If the manuscript has been deposited in PubMed Central, please add the PMC link, so that users from around the world can access otherwise paywalled content. This should be done even if the PMC link is still under embargo.

Link to PubMed

Nearly every reference on HemOnc.org should have an entry in PubMed. Provide the link here.

Clinical trial ID

If there is a clinical trial ID, such as the NCT number assigned by ClinialTrials.gov, add as plain text (no link necessary) at the end of the reference. Most trials started after 2010 should have a clinical trial ID, although sometimes it is not easy to find in the reference.

Updates and sub-group analyses

When an interim or final update is published, we try to include these references, nested under the original publication. Depending on the trial, there can be zero, one, or many updates.

Numbering

In order to make these nested, they need to start with a double "##" sign in Wiki markup, which will automatically convert to the appropriate number.

Header

We also nest several other categories under the original reference:

Update: this is the default header for any interim or final update
Subgroup analysis: a pre-planned or post-hoc analysis of defined subgroups of the original study population
HRQoL analysis: a pre-planned or post-hoc analysis of health-related quality of life outcomes

Remainder of citation

The remainder of an update follows the format of the primary analysis, except that the clinical trial ID should not be appended to the end again.

Review status

If a reference says contains dosing details in manuscript, that means the original paper has been reviewed by the submitter, with the details of the regimen confirmed with the primary literature. If the reference says contains dosing details in abstract, the reference contains details about the regimen in the abstract, but the full manuscript was not personally reviewed by the submitter. Note that dosing details in abstracts are not as extensive, and it is not infrequent that there are direct conflicts between details in the abstract and the manuscript; we favor details in the manuscript in these cases if the matter cannot be directly resolved with the authors. Exception: numerous regimens on HemOnc.org were manually verified prior to the adoption of the contains dosing details in manuscript tag and instead only currently say contains dosing details in abstract. Those regimens will be changed over time to contains dosing details in manuscript as the content is re-reviewed during an update of each page's regimens.

Sometimes dosing information is only available from the original protocol, which is often included as supplemental material to a publication. In this case, the reference will say contains dosing details in supplement".

For example, if a submitter is able to see which dosages are described in the abstract, but the submitter lacks a subscription to access the complete paper, the reference would be labelled as contains dosing details in abstract. A review article which discusses the regimen would not contain one of these labels unless it specifically describes the fine details of the regimen. Review articles are generally discouraged unless they add significant further information to the primary references for treatment regimens. Meta-analyses and comparative effectiveness research articles could be added.

===References===
# Authors of reference 1. Title of reference 1. Journal, volume, page of reference 1. [http://journal.com/link_to_article.html link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/10000000/ PubMed]
## '''Update:''' Authors of update 1. Title of update 1. Journal, volume, page of update 1. [http://journal.com/link_to_article.html link to original article] [https://pubmed.ncbi.nlm.nih.gov/10000000/ PubMed]
# Authors of reference 2. Title of reference 2. Journal, volume, page of reference 2. [http://journal.com/link_to_article.html link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/10000000/ PubMed]
# Authors of reference 3. Title of reference 3. Journal, volume, page of reference 3. [http://journal.com/link_to_article.html link to original article] '''does not contain dosing details''' [https://pubmed.ncbi.nlm.nih.gov/10000000/ PubMed]

Units of measurement

We are currently trying to unify our units of measurement, to be concordant with SI units (unless otherwise noted below, e.g., hemoglobin). Further details about conversions between conventional and SI units, here.

Measure	Example(s)	Do not use	Wiki code
Separators for large numbers	1000	1,000
	10,000	10000
	10,000,000
BSA-based dosing	mg/m²	mg/m2	`mg/m<sup>2</sup>`
Micrograms	mcg	μg
Ranges: don't use dashes as these can be confused for hyphens	1 to 2	1-2
Bounds: don't use symbols as these can be confused and don't render in all browsers	greater than X more than X measurement specific (e.g., older than X)	>
	greater than or equal to X at least X X or more no less than X	≥
	less than X measurement specific (e.g., younger than X)	<
	less than or equal to X at most X not exceeding X up to and including X X or less no more than X	≤
Platelet count	25 x 10⁹/L		`25 x 10<sup>9</sup>/L`
Hemoglobin (Hb)	12 g/dL
Absolute neutrophil count (ANC)	500/μL	500/mcl
White blood cell (WBC) count	3.5 x 10⁹/L	3500 x 10⁶	`3.5 x 10<sup>9</sup>/L`
Creatinine	0.8 mg/dL
Creatinine clearance (CrCl)	90 mL/min/1.73m²		`90 mL/min/1.73m<sup>2</sup>`
Bilirubin	1.4 mg/dL
Methotrexate level	100 nmol/L

Style guide

Introduction

General conventions

Dates

Drug index

Alphabetical list of medications

Examples

Drugs in preclinical or early phase clinical trials

Drugs that have lost FDA approval

List of medications by category

Interesting and helpful links

Medication pages

General information

Diseases for which it is used

Patient drug information

History of changes in FDA indication

Synonyms

References

Categories

Treatment regimen pages

Header

Guidelines

Treatment context

Headings

Level 1 headings

Level 2 headings

Level 3 headings

Level 4 headings

Allowed names for level 4 headings

“Clean” systemic anticancer modalities

“Messy” systemic anticancer modalities

Localized anticancer modalities

Other modalities

Eligibility criteria

Temporal linkers

Other

Level 4 heading modifiers

Regimen name and acronyms

Example orders

Regimen variants

Treatment regimen formatting

Instructions

Treatment (SIG) formatting

Drug name

Dose

Units

Route

Time of infusion

Continuous infusions

Frequency and/or number of times given

Schedule

Order of administration

Special comments

Branching instructions

Time-based branching

Age-based branching

Other nominal branching

Complex branching

Order of medications within a regimen

Optional: preceding and subsequent treatments

Optional: supportive medications

Optional: CNS therapy

Duration of cycle

Linking parts of protocols

Preceding treatments

Subsequent treatments

Templates

Non-randomized trials without efficacy

Non-randomized trials with efficacy

Randomized trials without toxicity

Randomized trials with toxicity

Regimen examples

Regimen example #1, single drug

Regimen example #2, single drug with many references

Regimen example #3, two drugs with sequencing

Regimen example #4, supportive medications with optionality and explicit linking

Regimen example #5, preceding and subsequent regimens

References

Primary references

Numbering