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Systemic Anti-Cancer Therapy Regimen Library

Home > GYN OV Advanced - cARBOplatin and PACLItaxel [Q1W]

GYN OV Advanced - cARBOplatin and PACLItaxel [Q1W]

Treatment Overview

Continuous until disease progression or unacceptable toxicity; 18 cycles were administered in the clinical trial.

Cycles 1 to 3 - 7 days - cARBOplatin and PACLItaxel Q1W

Cycle length:
7

Cycle 4 - 7 days - cARBOplatin and PACLItaxel Q1W (tapering hypersensitivity pre-medications)

Cycle length:
7

PACLItaxel: Tapering schedule of pre-medications is for patients who did not experience a hypersensitivity reaction to the previous dose of weekly PACLItaxel.

Cycles 5 to 18 - 7 days - cARBOplatin and PACLItaxel Q1W (no hypersensitivity pre-medications)

Cycle length:
7

PACLItaxel: Tapering schedule of pre-medications is for patients who did not experience a hypersensitivity reaction to the previous dose of weekly PACLItaxel.

Cycle details

Cycles 1 to 3 - 7 days - cARBOplatin and PACLItaxel Q1W

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

Cycle 4 - 7 days - cARBOplatin and PACLItaxel Q1W (tapering hypersensitivity pre-medications)

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

PACLItaxel: Tapering schedule of pre-medications is for patients who did not experience a hypersensitivity reaction to the previous dose of weekly PACLItaxel.

Cycles 5 to 18 - 7 days - cARBOplatin and PACLItaxel Q1W (no hypersensitivity pre-medications)

Medication Dose Route Days Max Duration
dexamethasone * 8 mg oral administration 1, 2, 3
ondansetron 8 mg oral administration 1
PACLItaxel * 60 mg/m² intravenous 1 60 minutes
cARBOplatin * 2 AUC (area under the curve) intravenous 1 60 minutes
ondansetron 8 mg oral administration 1
domperidone 10 mg Three times daily oral administration 1

PACLItaxel: Tapering schedule of pre-medications is for patients who did not experience a hypersensitivity reaction to the previous dose of weekly PACLItaxel.

Full details

Cycles 1 to 3 - 7 days - cARBOplatin and PACLItaxel Q1W

Day: 1

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy with food.
ondansetron 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy.
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 * 60 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 * 2 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.

Day: 2

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:

ONCE daily in the morning with food.

  • This dose may be reduced or omitted 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.

  • This dose may be reduced or omitted at clinician’s discretion.

Cycle 4 - 7 days - cARBOplatin and PACLItaxel Q1W (tapering hypersensitivity pre-medications)

Day: 1

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy with food.
ondansetron 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy.
loratadine * 10 mg oral administration
Instructions:
ONE hour prior to PACLItaxel infusion.
PACLItaxel * 60 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 * 2 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.

Day: 2

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:

ONCE daily in the morning with food.

  • This dose may be reduced or omitted 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.

  • This dose may be reduced or omitted at clinician’s discretion.

Cycles 5 to 18 - 7 days - cARBOplatin and PACLItaxel Q1W (no hypersensitivity pre-medications)

Day: 1

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy with food.
ondansetron 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy.
PACLItaxel * 60 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 * 2 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.

Day: 2

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:

ONCE daily in the morning with food.

  • This dose may be reduced or omitted 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.

  • This dose may be reduced or omitted at clinician’s discretion.

Supportive Care Factors

Factor Value
Emetogenicity: Medium
Hypersensitivity / Infusion related reaction risk: High - routine premedication recommended

References

Falandry, C., F. Rousseau, M. A. Mouret-Reynier, et al. 2021. "Efficacy and Safety of First-line Single-Agent Carboplatin vs Carboplatin Plus Paclitaxel for Vulnerable Older Adult Women With Ovarian Cancer: A GINECO/GCIG Randomized Clinical Trial." JAMA Oncol 7(6):853-861., PMID: 33885718

Clamp, A. R., E. C. James, I. A. McNeish, et al. 2019. "Weekly dose-dense chemotherapy in first-line epithelial ovarian, fallopian tube, or primary peritoneal carcinoma treatment (ICON8): primary progression free survival analysis results from a GCIG phase 3 randomised controlled trial." Lancet 394(10214):2084-2095., PMID: 31791688

Blagden, S. P., A. D. Cook, C. Poole, et al. 2020. "Weekly platinum-based chemotherapy versus 3-weekly platinum-based chemotherapy for newly diagnosed ovarian cancer (ICON8): quality-of-life results of a phase 3, randomised, controlled trial." Lancet Oncol 21(7):969-977., PMID: 32615110

Pignata, S., G. Scambia, et al. 2014. "Carboplatin plus paclitaxel once a week versus every 3 weeks in patients with advanced ovarian cancer (MITO-7): a randomised, multicentre, open-label, phase 3 trial." Lancet Oncol. 15(4): 396-405., PMID: 24582486

Katsumata, N., M. Yasuda, F. Takahashi, et al. 2009. "Dose-dense paclitaxel once a week in combination with carboplatin every 3 weeks for advanced ovarian cancer: a phase 3, open-label, randomised controlled trial." Lancet 374(9698):1331-1338.Vasey, P. A., G. C. Jayson, A. Gordon, et al. 2004. "Phase III randomized trial of docetaxel-carboplatin versus paclitaxel-carboplatin as first-line chemotherapy for ovarian carcinoma." J Natl.Cancer Inst. 96(22):1682-1691. , PMID: 19767092

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

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/contents/infusion-reactions-to-systemic-chemotherapy (Accessed 26 March 2021).

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).

* 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.