Carcinoma of Unknown Primary

Carcinoma of Unknown Primary

Endocrine ^^C^^qSB^^H Breast Cancer Brain Cancer Cancer HjUklSw^l

Agent Dosage

EP (PE) VP-16 80-120 mg/M2 IV days 1-3 cisplatin/ Cisplatin 60-100 mg/M2 IV day 1 etoposide

(VP-16) REF: There are multiple variants of this regimen PREMEDICATIONS

1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after cisplatin

2. Dexamethasone 20 mg IV 30 minutes before cisplatin

3. Compazine 10 mg PO/IV 30 minutes before etoposide

OTHER MEDICATIONS

1. Give cisplatin delayed emesis prophylaxis Repeat every 21-28 days

Cisplatin—vigorous hydration is required; can be nephrotoxic and ototoxic; can cause peripheral neuropathy; hold or reduce for creatinine > 1.5

FAM 5-FU 600 mg/M2 IV days 1,8,29,36 fluorouracil Doxorubicin 30 mg/M2 IV days 1,29 (5-FU)/ Mitomycin C 10 mg/M2 IV day 1 doxorubicin/

mitomycin C REF: Sporn et al. Semin Oncol 1993; 20:261-267 PREMEDICATIONS

1. Kytril 1 mg PO/IV 30 minutes before and 12 hours after therapy on days 1 and 29

2. Dexamethasone 20 mg IV 30 minutes before doxorubicin

3. Compazine 10 mg PO/IV 30 minutes before 5-FU PRN

Repeat every 56 days

Mitomycin C—myelosuppression occurs late (approximately 4 weeks); limit cumulative dose to 50 mg/M2 (vascular toxicity)

Doxorubicin—monitor cumulative dose for cardiac toxicity (not to exceed 550 mg/M2); vesicant—avoid extravasation; use 50% for bilirubin 1.5-3.0 and 25% for bilirubin > 3.0

Hematologic Head and Neck Gynecologic Genitourinary Gastrointestina Malignancies Cancer Cancer Cancer Cancer

PCE Paclitaxel 200 mg/M2 IV (over 1 h) day 1 paclitaxel/ Carboplatin AUC 6 IV day 1 carboplatin/ VP-16 50 mg/ PO alter- days 1-10 etoposide 100 mg nating QOD (VP-16)

REF: Hainsworth et al. J Clin Oncol 1997; 15:2385-2393

PREMEDICATIONS

1. Dexamethasone 20 mg IV 30 minutes before paclitaxel OR

Dexamethasone 20 mg PO 6 and 12 hours prior to paclitaxel

2. Diphenhydramine 25-50 mg IV 30 minutes before paclitaxel

3. Cimetidine 300 mg IV 30 minutes before paclitaxel

4. Kytril 1 mg PO/IV 30 minutes before and 12 hours after carboplatin

OTHER MEDICATIONS

1. Dexamethasone 4 mg PO BID for 6 doses after paclitaxel (for myalgias)

2. Give cisplatin delayed emesis prophylaxis

Repeat every 21 days

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