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Systemic Anti-Cancer Therapy Regimen Library

Home > CNS GLI Adjuvant - PCV [procarbazine, lomustine and vinCRISTine] [high grade]

CNS GLI Adjuvant - PCV [procarbazine, lomustine and vinCRISTine] [high grade]

Treatment Overview

Cycles 1 to 6 - 42 days

Cycle length:
42

Cycle details

Cycles 1 to 6 - 42 days

Medication Dose Route Days Max Duration
ondansetron 8 mg Twice daily oral administration 1
lomustine 110 mg/m² oral administration 1
vinCRISTine 1.4 mg/m² Cap dose per administration at: 2 mg intravenous 8, 29 10 minutes
procarbazine 60 mg/m² Once daily oral administration 8 to 21
domperidone 10 mg Three times daily oral administration 1
docusate sodium + sennoside B 2 Tablet(s) oral administration 1

Full details

Cycles 1 to 6 - 42 days

Day: 1

Medication Dose Route Max duration Details
ondansetron 8 mg Twice daily oral administration
Instructions:

ONE hour prior to chemotherapy and if required 8 to 12 hours after chemotherapy.
lomustine 110 mg/m² oral administration
Instructions:

Take each dose on an empty stomach - one hour before OR two hours after food.

Round dose to closest multiple of 10 mg or 40 mg capsules.
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.
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
vinCRISTine 1.4 mg/m² Cap dose per administration at: 2 mg intravenous 10 minutes
Instructions:
  • Diluted in a minibag.
  • FOR INTRAVENOUS USE ONLY – fatal if given by any other routes.
  • Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration.
procarbazine 60 mg/m² Once daily oral administration
Instructions:
  • Take at night with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.

Day: 9

Medication Dose Route Max duration Details
procarbazine 60 mg/m² Once daily oral administration
Instructions:
  • Take at night with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.

Day: 10

Medication Dose Route Max duration Details
procarbazine 60 mg/m² Once daily oral administration
Instructions:
  • Take at night with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.

Day: 11

Medication Dose Route Max duration Details
procarbazine 60 mg/m² Once daily oral administration
Instructions:
  • Take at night with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.

Day: 12

Medication Dose Route Max duration Details
procarbazine 60 mg/m² Once daily oral administration
Instructions:
  • Take at night with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.

Day: 13

Medication Dose Route Max duration Details
procarbazine 60 mg/m² Once daily oral administration
Instructions:
  • Take at night with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.

Day: 14

Medication Dose Route Max duration Details
procarbazine 60 mg/m² Once daily oral administration
Instructions:
  • Take at night with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.

Day: 15

Medication Dose Route Max duration Details
procarbazine 60 mg/m² Once daily oral administration
Instructions:
  • Take at night with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.

Day: 16

Medication Dose Route Max duration Details
procarbazine 60 mg/m² Once daily oral administration
Instructions:
  • Take at night with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.

Day: 17

Medication Dose Route Max duration Details
procarbazine 60 mg/m² Once daily oral administration
Instructions:
  • Take at night with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.

Day: 18

Medication Dose Route Max duration Details
procarbazine 60 mg/m² Once daily oral administration
Instructions:
  • Take at night with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.

Day: 19

Medication Dose Route Max duration Details
procarbazine 60 mg/m² Once daily oral administration
Instructions:
  • Take at night with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.

Day: 20

Medication Dose Route Max duration Details
procarbazine 60 mg/m² Once daily oral administration
Instructions:
  • Take at night with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.

Day: 21

Medication Dose Route Max duration Details
procarbazine 60 mg/m² Once daily oral administration
Instructions:
  • Take at night with food.
  • Do not drink alcohol and avoid large amounts of tyramine-rich foods (e.g. aged cheeses, cured meats, fermented foods and yeast extracts such as Marmite®) while being treated with this medicine. Talk to your doctor or pharmacist before taking medicines purchased over the counter from a pharmacy, supermarket or health food store.
  • Round dose to closest multiple of 50 mg capsules.

Day: 29

Medication Dose Route Max duration Details
vinCRISTine 1.4 mg/m² Cap dose per administration at: 2 mg intravenous 10 minutes
Instructions:
  • Diluted in a minibag.
  • FOR INTRAVENOUS USE ONLY – fatal if given by any other routes.
  • 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: Variable

Emetogenicity:

  • MEDIUM to HIGH day 1.
  • MEDIUM to HIGH 8 to 21. Routine antiemetic premedication may not be required for continuous dosing of oral anti-cancer medicines with MEDIUM to HIGH emetic risk; an individualised approach is appropriate.
  • MINIMAL day 29.

References

van den Bent, M. J., A. F. Carpentier, A. A. Brandes, et al. 2006. "Adjuvant procarbazine, lomustine, and vincristine improves progression-free survival but not overall survival in newly diagnosed anaplastic oligodendrogliomas and oligoastrocytomas: a randomized European Organisation for Research and Treatment of Cancer phase III trial." J Clin Oncol 24 (18):2715-2722., PMID: 16782911

van den Bent, M. J., A. A. Brandes, M. J. Taphoorn, et al. 2013. "Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC brain tumor group study 26951." J Clin Oncol 31(3):344-350., PMID: 23071237

Cairncross, G., B. Berkey, E. Shaw, et al. 2006. "Phase III trial of chemotherapy plus radiotherapy compared with radiotherapy alone for pure and mixed anaplastic oligodendroglioma: Intergroup Radiation Therapy Oncology Group Trial 9402." J Clin Oncol 24(18):2707-2714., PMID: 16782910

Cairncross, G., M. Wang, E. Shaw, et al. 2013. "Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402." J Clin Oncol 31(3):337-343., PMID: 23071247

Cairncross, J. G., M. Wang, R. B. Jenkins, et al. 2014. "Benefit from procarbazine, lomustine, and vincristine in oligodendroglial tumors is associated with mutation of IDH." J Clin Oncol 32(8):783-790., PMID: 24516018

van den Bent, M. J., B. Baumert, S. C. Erridge, et al. 2017. "Interim results from the CATNON trial (EORTC study 26053-22054) of treatment with concurrent and adjuvant temozolomide for 1p/19q non-co-deleted anaplastic glioma: a phase 3, randomised, open-label intergroup study." Lancet. 390 (10103): 1645-1653., PMID: 28801186

* 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.