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Systemic Anti-Cancer Therapy Regimen Library

Home > GYN OV Recurrent - topotecan and beVACizumab Q4W

GYN OV Recurrent - topotecan and beVACizumab Q4W

Treatment Overview

This regimen contains a medicine where one or more biosimilars may exist. Any biosimilars used have been reviewed by the regulator (Medsafe) and relevant specialists were consulted nationally. Where regulators, in consultation with relevant specialists, have agreed that there are no clinically significant differences in either safety or effectiveness between a biosimilar and originator product, these drugs may be used interchangeably.

Cycles 1 to 6 - 28 days

Cycle length:
28

Cycle details

Cycles 1 to 6 - 28 days

Medication Dose Route Days Max Duration
beVACizumab 10 mg/kg intravenous 1, 15 90 minutes
ondansetron 8 mg oral administration 1, 8, 15
topotecan 4 mg/m² intravenous 1, 8, 15 30 minutes
domperidone 10 mg Three times daily oral administration 1

Full details

Cycles 1 to 6 - 28 days

Day: 1

Medication Dose Route Max duration Details
beVACizumab 10 mg/kg intravenous 90 minutes
Instructions:
Blood pressure and urinalysis should be checked before each administration. If urine dipstick protein is less than or equal to 3+, proceed with infusion. If the initial dose of beVACizumab is well tolerated, the second dose may be administered over 60 minutes, and the third and subsequent doses may be administered over 30 minutes.
ondansetron 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy. Alternative is dexamethasone 4 mg.
topotecan 4 mg/m² intravenous 30 minutes
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: 8

Medication Dose Route Max duration Details
ondansetron 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy. Alternative is dexamethasone 4 mg.
topotecan 4 mg/m² intravenous 30 minutes

Day: 15

Medication Dose Route Max duration Details
beVACizumab 10 mg/kg intravenous 90 minutes
Instructions:
Blood pressure and urinalysis should be checked before each administration. If urine dipstick protein is less than or equal to 3+, proceed with infusion. If the initial dose of beVACizumab is well tolerated, the second dose may be administered over 60 minutes, and the third and subsequent doses may be administered over 30 minutes.
ondansetron 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy. Alternative is dexamethasone 4 mg.
topotecan 4 mg/m² intravenous 30 minutes

Supportive Care Factors

Factor Value
Emetogenicity: Low

References

Pujade-Lauraine E, Hilpert F, Weber B, Reuss A, et al. Bevacizumab combined with chemotherapy for platinum-resistant recurrent ovarian cancer: The AURELIA open-label randomized phase III trial. J Clin Oncol. 2014 May 1;32(13):1302-8., PMID: 24637997

Stockler MR, Hilper F, Friedlander M, et al. Patient-reported outcome results from the open-label phase III AURELIA trial evaluating bevacizumab-containing therapy for platinum-resistant ovarian cancer. J Clin Oncol. 2014 May 1;32(13):1309-16., PMID: 24687829

Roche Products (New Zealand) Limited. Avastin New Zealand Data Sheet. 15 January 2021 https://www.medsafe.govt.nz/profs/datasheet/a/Avastininf.pdf (Accessed 14 October 2021)

Novartis Australian Product information Hycamtin 29 August 2019 https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-05311-3&d=20220426172310101 (Accessed 27 April 2022)

Tabernero J, Vyas M, Giuliani R, Arnold D, Cardoso F, Casali PG, Cervantes A, Eggermont AMM, Eniu A, Jassem J, Pentheroudakis G, Peters S, Rauh S, Zielinski CC, Stahel RA, Voest E, Douillard JY, McGregor K, Ciardiello F. Biosimilars: a position paper of the European Society for Medical Oncology, with particular reference to oncology prescribers. ESMO Open. 2017 Jan 16;1(6):e000142. doi: 10.1136/esmoopen-2016-000142., PMID: 28848668

Lyman GH, Balaban E, Diaz M, Ferris A, Tsao A, Voest E, Zon R, Francisco M, Green S, Sherwood S, Harvey RD, Schilsky RL. American Society of Clinical Oncology Statement: Biosimilars in Oncology. J Clin Oncol. 2018 Apr 20;36(12):1260-1265. doi: 10.1200/JCO.2017.77.4893. Epub 2018 Feb 14., PMID: 29443651

Regimen details sometimes vary slightly from the published literature after recommendation by expert committee consensus.

* 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.