New Zealand Formulary
Menu Close Menu

Fewer cancers.
Better survival.
Equity for all.

Systemic Anti-Cancer Therapy Regimen Library

Home > BR NON-Metastatic - cARBOplatin Q3W and PACLItaxel Q1W

[Discontinued] BR NON-Metastatic - cARBOplatin Q3W and PACLItaxel Q1W

Treatment Overview

Cycles 1 to 4 - 21 days

Cycle length:
21

If the initial infusion of PACLItaxel is well tolerated, the clinician may decide at their discretion to taper off and eventually omit dexamethasone premedication on days 8 and 15. If dexamethasone is omitted, the clinician may consider ondansetron 8 mg orally ONE hour prior to PACLItaxel infusion on days 8 and 15 for antiemetic cover.


Emetogenicity: MEDIUM day 1; LOW day 8 and 15.

Cycle details

Cycles 1 to 4 - 21 days

Medication Dose Route Days Max Duration
ondansetron 8 mg oral administration 1
dexamethasone * 8 mg oral administration 1, 2, 3,
8, 15
loratadine * 10 mg oral administration 1, 8, 15
famotidine * 20 mg oral administration 1, 8, 15
PACLItaxel * 80 mg/m² intravenous 1, 8, 15 60 minutes
cARBOplatin * 6 AUC (area under the curve) intravenous 1 60 minutes
ondansetron 8 mg oral administration 1
pegFILGRASTIM 6 mg subcutaneous injection 2
domperidone 10 mg Three times daily oral administration 1
loperamide 2 mg oral administration 1

If the initial infusion of PACLItaxel is well tolerated, the clinician may decide at their discretion to taper off and eventually omit dexamethasone premedication on days 8 and 15. If dexamethasone is omitted, the clinician may consider ondansetron 8 mg orally ONE hour prior to PACLItaxel infusion on days 8 and 15 for antiemetic cover.


Emetogenicity: MEDIUM day 1; LOW day 8 and 15.

Full details

Cycles 1 to 4 - 21 days

Day: 1

Medication Dose Route Max duration Details
ondansetron 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy.
dexamethasone * 8 mg oral administration
Instructions:
ONE hour prior to PACLItaxel infusion with food.
loratadine * 10 mg oral administration
Instructions:
ONE hour prior to PACLItaxel infusion.
famotidine * 20 mg oral administration
Instructions:
ONE hour prior to PACLItaxel infusion. Do not take indigestion remedies, iron or calcium preparations within 2 hours of taking this medicine.
PACLItaxel * 80 mg/m² intravenous 60 minutes
Instructions:
Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.22 microns or less in size. Please carry out graded challenge as per institutional policy.
cARBOplatin * 6 AUC (area under the curve) intravenous 60 minutes
Instructions:
Hypersensitivity risk increases with number of cycles of cARBOplatin.
ondansetron 8 mg oral administration
Instructions:
EIGHT hours after chemotherapy OR before bed.
domperidone 10 mg Three times daily oral administration
Instructions:
When required for nausea and/or vomiting. The choice of rescue antiemetic may be substituted to reflect institutional policy or individual patient characteristics.
loperamide 2 mg oral administration
Instructions:
Take TWO capsules (=4 mg) at onset of loose bowel motions and a further ONE capsule (=2 mg) for every loose bowel motion (maximum of EIGHT capsules in 24 hours), or use as directed by oncologist or haematologist.

Day: 2

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:
ONCE daily in the morning with food.
pegFILGRASTIM 6 mg subcutaneous injection

Day: 3

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:
ONCE daily in the morning with food.

Day: 8

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:
ONE hour prior to PACLItaxel infusion with food.
loratadine * 10 mg oral administration
Instructions:
ONE hour prior to PACLItaxel infusion.
famotidine * 20 mg oral administration
Instructions:
ONE hour prior to PACLItaxel infusion. Do not take indigestion remedies, iron or calcium preparations within 2 hours of taking this medicine.
PACLItaxel * 80 mg/m² intravenous 60 minutes
Instructions:
Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.22 microns or less in size. Please carry out graded challenge as per institutional policy.

Day: 15

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:
ONE hour prior to PACLItaxel infusion with food.
loratadine * 10 mg oral administration
Instructions:
ONE hour prior to PACLItaxel infusion.
famotidine * 20 mg oral administration
Instructions:
ONE hour prior to PACLItaxel infusion. Do not take indigestion remedies, iron or calcium preparations within 2 hours of taking this medicine.
PACLItaxel * 80 mg/m² intravenous 60 minutes
Instructions:
Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.22 microns or less in size. Please carry out graded challenge as per institutional policy.

Supportive Care Factors

Factor Value
Diarrhoea risk: Anti-diarrhoeals are usually prescribed with this treatment
Emetogenicity: Variable
Growth factor support: Recommended for primary prophylaxis
Hypersensitivity / Infusion related reaction risk: High - routine premedication recommended

References

1. Sikov, W. M., D. A. Berry, C. M. Perou, et al. 2015. "Impact of the addition of carboplatin and/or bevacizumab to neoadjuvant once-per-week paclitaxel followed by dose-dense doxorubicin and cyclophosphamide on pathologic complete response rates in stage II to III triple-negative breast cancer: CALGB 40603 (Alliance)." J Clin Oncol 33(1):13-21., PMID: 25092775

2. Senkus, E., S. Kyriakides, S. Ohno, et al. 2015. “Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.” Ann Oncol 26 Suppl 5:v8-30, PMID: 26314782

3. Sparano, J. A. 2015. "Defining a role and predicting benefit from platinum-based therapy in breast cancer: an evolving story." J Clin Oncol 33(1):1-3., PMID: 25332246

4. Novartis New Zealand Ltd. Paclitaxel Ebewe New Zealand Data Sheet 16 April 2020. https://www.medsafe.govt.nz/profs/Datasheet/p/PaclitaxelEbeweinj.pdf (Accessed 26 November 2020)

5. Boulanger J, Boursiquot JN, Cournoyer G, et al. Management of hypersensitivity to platinum- and taxane-based chemotherapy: cepo review and clinical recommendations. Curr Oncol. 2014;21(4):e630-e641., PMID: 25089112

6. Castells, M.C., Matulonis, U.A., and Horton, TM. Infusion reactions to systemic chemotherapy. Savarese DMF and Feldweg AM, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com (Accessed 26 March 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.