Systemic Anti-Cancer Therapy Regimen Library
BR Metastatic - trastuzumab Q3W and vinORELBine [IV]
Treatment Overview
This regimen contains a biological anti-cancer medicine where one or more biosimilars may exist. These have been reviewed by the regulator (Medsafe) and by haematologists and/or oncologists nationally. Where haematologists and/or oncologists have agreed that there are no clinically significant differences in either safety or effectiveness between a biosimilar and originator product, these drugs may be used interchangeably. If a prescriber thinks there is a difference, then a specific brand will be named when prescribing.
Cycle 1 - 21 days - Loading Dose
Cycle 2 (and all further cycles) - 21 days - Maintenance Dose
If the initial loading dose of trastuzumab is well tolerated, subsequent doses may be administered over 30 minutes.
Cycle details
Cycle 1 - 21 days - Loading Dose
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| trastuzumab | 8 mg/kg | intravenous | 1 | 90 minutes |
| vinORELBine | 30 mg/m² | intravenous | 1, 8 | 10 minutes |
| docusate sodium + sennoside B | 2 Tablet(s) | oral administration | 1 |
Cycle 2 (and all further cycles) - 21 days - Maintenance Dose
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| trastuzumab | 6 mg/kg | intravenous | 1 | 90 minutes |
| vinORELBine | 30 mg/m² | intravenous | 1, 8 | 10 minutes |
| docusate sodium + sennoside B | 2 Tablet(s) | oral administration | 1 |
If the initial loading dose of trastuzumab is well tolerated, subsequent doses may be administered over 30 minutes.
Full details
Cycle 1 - 21 days - Loading Dose
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| trastuzumab | 8 mg/kg | intravenous | 90 minutes | |
| vinORELBine | 30 mg/m² | intravenous | 10 minutes |
Instructions:
Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration. |
| docusate sodium + sennoside B | 2 Tablet(s) | oral administration |
Instructions:
At night when required for constipation. Each tablet contains docusate sodium 50 mg + sennoside B 8 mg. |
Day: 8
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| vinORELBine | 30 mg/m² | intravenous | 10 minutes |
Instructions:
Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration. |
Cycle 2 (and all further cycles) - 21 days - Maintenance Dose
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| trastuzumab | 6 mg/kg | intravenous | 90 minutes |
Instructions:
If the initial loading dose of trastuzumab is well tolerated, subsequent doses may be administered over 30 minutes. |
| vinORELBine | 30 mg/m² | intravenous | 10 minutes |
Instructions:
Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration. |
| docusate sodium + sennoside B | 2 Tablet(s) | oral administration |
Instructions:
At night when required for constipation. Each tablet contains docusate sodium 50 mg + sennoside B 8 mg. |
Day: 8
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| vinORELBine | 30 mg/m² | intravenous | 10 minutes |
Instructions:
Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration. |
Supportive Care Factors
| Factor | Value |
|---|---|
| Constipation risk: | laxatives are usually prescribed |
| Emetogenicity: | Minimal |
References
3. Roche Products (New Zealand) Limited. Herceptin (trastuzumab) New Zealand Data Sheet. https://www.medsafe.govt.nz/profs/Datasheet/h/Herceptininf.pdf (Accessed 16 February 2021)
* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.
s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.