Systemic Anti-Cancer Therapy Regimen Library
CRC Metastatic - mFOLFIRI [irinotecan, foliNIc acid fluorouracil] and CETUximab [Q2W] [low dose foliNIc acid]
Treatment Overview
Cycle 1 (and all further cycles) - 14 days
Cycle details
Cycle 1 (and all further cycles) - 14 days
Medication | Dose | Route | Days | Max Duration |
---|---|---|---|---|
doxycycline * | 100 mg Once daily | oral administration | 0 | |
hydrocortisone * | 1 % Once daily | topical administration | 0 | |
cetostearyl alcohol + paraffin liquid + paraffin soft white | 50 g Once daily | topical administration | 0 | |
avobenzone + homosalate + octisalate + octocrilene + oxybenzone | 50 g | topical administration | 0 | |
ondansetron | 8 mg | oral administration | 1 | |
dexamethasone * | 8 mg | oral administration | 1, 2, 3 | |
loratadine * | 10 mg | oral administration | 1 | |
CETUximab * | 500 mg/m² | intravenous | 1 | 120 minutes |
atropine sulfate * | 600 microgram | intravenous | 1 | 2 minutes |
irinotecan | 180 mg/m² | intravenous | 1 | 90 minutes |
foliNIc acid (as calcium folinate) | 50 mg flat dosing | intravenous | 1 | 2 minutes |
fluorouracil | 400 mg/m² | intravenous | 1 | 15 minutes |
fluorouracil | 2400 mg/m² | intravenous | 1 | 46 hours Min: 46 hours |
ondansetron | 8 mg | oral administration | 1 | |
domperidone | 10 mg Three times daily | oral administration | 1 | |
loperamide | 2 mg | oral administration | 1 |
Full details
Cycle 1 (and all further cycles) - 14 days
Day: 0
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
doxycycline * | 100 mg Once daily | oral administration |
Instructions:
|
|
hydrocortisone * | 1 % Once daily | topical administration |
Instructions:
|
|
cetostearyl alcohol + paraffin liquid + paraffin soft white | 50 g Once daily | topical administration |
Instructions:
|
|
avobenzone + homosalate + octisalate + octocrilene + oxybenzone | 50 g | topical administration |
Instructions:
|
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 CETUximab with food. |
|
loratadine * | 10 mg | oral administration |
Instructions:
ONE hour prior to CETUximab. |
|
CETUximab * | 500 mg/m² | intravenous | 120 minutes |
Instructions:
|
atropine sulfate * | 600 microgram | intravenous | 2 minutes |
Instructions:
Only if required for acute diarrhoea or cholinergic symptoms.
|
irinotecan | 180 mg/m² | intravenous | 90 minutes | |
foliNIc acid (as calcium folinate) | 50 mg flat dosing | intravenous | 2 minutes | |
fluorouracil | 400 mg/m² | intravenous | 15 minutes | |
fluorouracil | 2400 mg/m² | intravenous | 46 hours Min: 46 hours |
Instructions:
Continuous infusion via pump over 46 hours. |
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. Dose and duration may be individualised at clinician’s discretion. |
Day: 3
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
dexamethasone * | 8 mg | oral administration |
Instructions:
ONCE daily in the morning with food. Dose and duration may be individualised at clinician’s discretion. |
Supportive Care Factors
Factor | Value |
---|---|
Diarrhoea risk: | Anti-diarrhoeals are usually prescribed with this treatment |
Emetogenicity: | Medium |
Hypersensitivity / Infusion related reaction risk: | High - routine premedication recommended |
References
Nott, L., M. Khattak, T. Price, et al. Cancer Council Australia Colorectal Cancer Guidelines Working Party. [Version URL: https://wiki.cancer.org.au/australiawiki/index.php?oldid=173114, cited 2018 Apr 16]. Available from https://wiki.cancer.org.au/australia/Guidelines:Colorectal_cancer/Systemic_therapy_molecular_pathology. In: Cancer Council Australia Colorectal Cancer Guidelines Working Party. Cl
Cheng, Ann-Lii, Gerardo Cornelio, Lin Shen, et al. 2013. "First-line Cetuximab with FOLFOX or FOLFIRI Every 2 Weeks In KRAS Wild-Type Metastatic Colorectal Cancer: phase II APEC Study." Annals of oncology 24 (suppl 4):iv34-iv35. Abstract No:PD-0028
Healthcare Logistics Ltd. Erbitux New Zealand Data Sheet 4 September 2018. https://www.medsafe.govt.nz/profs/Datasheet/e/Erbituxinf.pdf (Accessed 26 November 2020)
* 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.