Systemic Anti-Cancer Therapy Regimen Library
GYN END Advanced - leNVAtinib and pembrolizumab Q3W [flat dosing]
Treatment Overview
Continuous for 2 years (35 cycles of pembrolizumab) or until disease progression or unacceptable toxicity.
Cycle 1 (and all further cycles) - 21 days
Emetogenicity leNVAtinib: MEDIUM to HIGH—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.
Cycle details
Cycle 1 (and all further cycles) - 21 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration | 1 to 21 | |
| pembrolizumab | 200 mg flat dosing | intravenous | 1 | 30 minutes |
| cycliZINE | 50 mg Three times daily | oral administration | 1 | |
| loperamide | 2 mg | oral administration | 1 |
Emetogenicity leNVAtinib: MEDIUM to HIGH—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.
Full details
Cycle 1 (and all further cycles) - 21 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
|
| pembrolizumab | 200 mg flat dosing | intravenous | 30 minutes |
Instructions:
Administer via a sterile, non-pyrogenic, low protein binding 0.2 to 5 micron in-line or add-on filter. |
| cycliZINE | 50 mg Three times daily | oral administration |
Instructions:
When required for nausea and/or vomiting. Warning: may cause drowsiness. Consider starting dose at 25 mg and increasing as tolerated/required. 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 |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 3
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 4
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 5
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 6
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 7
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 8
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 9
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 10
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 11
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 12
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 13
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 14
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 15
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 16
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 17
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 18
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 19
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 20
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Day: 21
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| leNVAtinib | 20 mg | oral administration |
Instructions:
Swallow the capsules whole with a full glass of water. If unable to swallow capsules see NZF monograph for leNVAtinib or Lenvima® New Zealand Medsafe. |
Supportive Care Factors
| Factor | Value |
|---|---|
| Diarrhoea risk: | Anti-diarrhoeals are usually prescribed with this treatment |
| Emetogenicity: | Medium to high |
References
Merck Sharp & Dohme (New Zealand) Limited. Keytruda New Zealand Data Sheet 16 September 2021. https://www.medsafe.govt.nz/profs/Datasheet/k/Keytruda.pdf (Accessed 14 October 2021).
Eisai New Zealand Ltd. Lenvima New Zealand Data Sheet 15 December 2020. https://www.medsafe.govt.nz/profs/Datasheet/l/lenvimacap.pdf (Accessed 14 October 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.