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Systemic Anti-Cancer Therapy Regimen Library

CRC Metastatic - raltitrexed

Treatment Overview

Cycle 1 (and all further cycles) - 21 days

Cycle length:
21

Cycle details

Cycle 1 (and all further cycles) - 21 days

Medication Dose Route Days Max Duration
ondansetron 8 mg oral administration 1
dexamethasone * 8 mg oral administration 1, 2, 3
raltitrexed 3 mg/m² intravenous 1 15 minutes
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) - 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 chemotherapy with food.
raltitrexed 3 mg/m² intravenous 15 minutes
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.
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.

Day: 3

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

Supportive Care Factors

Factor Value
Diarrhoea risk: Anti-diarrhoeals are usually prescribed with this treatment
Emetogenicity: Medium
Hypersensitivity / Infusion related reaction risk: Low - routine premedication not recommended

References

1. Ransom, D., K. Wilson, S. Bishnoi, et al. 2012. "Results of Australasian Gastrointestinal Trials Group (AGITG) Arctic study: An international audit of raltitrexed for patients with cardiac toxicity induced by fluoropyrimidines (FP)." ASCO Meeting Abstracts 30(15_suppl):e13007.

2. NICE. 2005. "Irinotecan, oxaliplatin and raltitrexed for the treatment of advanced colorectal cancer. (National Institute for Health and Clinical Excellence guidance)."

3. Cunningham, D., J. R. Zalcberg, U. Rath, et al. 1996. "Final results of a randomised trial comparing 'Tomudex' (raltitrexed) with 5-fluorouracil plus leucovorin in advanced colorectal cancer. "Tomudex" Colorectal Cancer Study Group." Ann Oncol 7(9):961-965., PMID: 9006748

4. Maughan, T. S., R. D. James, D. J. Kerr, et al. 2002. "Comparison of survival, palliation, and quality of life with three chemotherapy regimens in metastatic colorectal cancer: a multicentre randomised trial." Lancet 359(9317):1555-1563., PMID: 12047964

5. Cocconi, G., D. Cunningham, E. Van Cutsem, et al. 1998. "Open, randomized, multicenter trial of raltitrexed versus fluorouracil plus high-dose leucovorin in patients with advanced colorectal cancer. Tomudex Colorectal Cancer Study Group." J Clin Oncol 16(9):2943-2952. , PMID: 9738562

6. Pazdur, R and M Vincent. 1997. "Raltitrexed (Tomudex) versus 5-fluorouracil and leucovorin (5-FU+ LV) in patients with advanced colorectal cancer (ACC): results of a randomized, multicenter, North American trial."

* 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.